bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward Computational Simulations of Behavior During Automated Driving Takeovers: A Review of the Empirical and Modeling Literatures
Authors: McDonald Anthony D. , Alambeigi Hananeh , Engström Johan , Markkula Gustav , Vogelpohl Tobias , Dunne Jarrett , Yuma Norbert
Published: March 2019

Objective:

This article provides a review of empirical studies of automated vehicle takeovers and driver modeling to identify influential factors and their impacts on takeover performance and suggest driver models that can capture them.

Background:

Significant safety issues remain in automated-to-manual transitions of vehicle control. Developing models and computer simulations of automated vehicle control transitions may help designers mitigate these issues, but only if accurate models are used. Selecting accurate models requires estimating the impact of factors that influence takeovers.

Method:

Articles describing automated vehicle takeovers or driver modeling research were identified through a systematic approach. Inclusion criteria were used to identify relevant studies and models of braking, steering, and the complete takeover process for further review.

Results:

The reviewed studies on automated vehicle takeovers identified several factors that significantly influence takeover time and post-takeover control. Drivers were found to respond similarly between manual emergencies and automated takeovers, albeit with a delay. The findings suggest that existing braking and steering models for manual driving may be applicable to modeling automated vehicle takeovers.

Conclusion:

Time budget, repeated exposure to takeovers, silent failures, and handheld secondary tasks significantly influence takeover time. These factors in addition to takeover request modality, driving environment, non-handheld secondary tasks, level of automation, trust, fatigue, and alcohol significantly impact post-takeover control. Models that capture these effects through evidence accumulation were identified as promising directions for future work.

Application:

Stakeholders interested in driver behavior during automated vehicle takeovers may use this article to identify starting points for their work.
Using project-based learning to teach electromagnetic and wave concepts
Authors: Cutri Rodrigo , Roberto Marim Luiz , Roberto Cardoso José
Published: March 2019

For the past three years, the project-based learning (PBL) approach was used to teach electromagnetics and wave concepts in an engineering course, by the implementation of three main projects: 2014—electromagnetic crane, 2015—wind generator, and 2016—free video competition. This paper analyzes the impact on students’ learning and motivation during last three years. Design characteristics, positive and negative aspects, and recommendations are also discussed.
Gang Influence: Mediating the Gang–Delinquency Relationship With Proactive Criminal Thinking
Authors: Walters Glenn D.
Published: March 2019

Controlling for basic demographic variables, parental knowledge, prosocial peer associations, and precursor measures of each outcome, the current study sought to compare two putative intervening mechanisms for the gang affiliation–participant delinquency relationship: a social learning mechanism (proactive criminal thinking) and a self-control mechanism (reactive criminal thinking). The two mechanisms were explored in 3,136 (1,519 male, 1,612 female) early adolescents (mean age = 12.14 years) from the Gang Resistance Education and Training (G.R.E.A.T.) study. A three-wave path analysis of Waves 1 to 3 of the G.R.E.A.T. study revealed a significant social learning pathway (gang affiliation → proactive criminal thinking → delinquency) and a nonsignificant self-control pathway (gang affiliation → reactive criminal thinking → delinquency). These findings were then replicated using data from Waves 4 to 6. From these results, it is concluded that gang affiliation may increase future delinquency by providing youth with increased opportunities to learn proactive criminal thinking.
“We Look (and Feel) Better Through System-Justifying Lenses”: System-Justifying Beliefs Attenuate the Well-Being Gap Between the Advantaged and Disadvantaged by Reducing Perceptions of Discrimination
Authors: Bahamondes Joaquín , Sibley Chris G. , Osborne Danny
Published: March 2019

Low-status groups report lower levels of well-being than do high-status groups. Although system justification theory posits that the endorsement of system-justifying beliefs should decrease this well-being gap, the underlying mechanisms responsible for this hypothesized palliative effect have evaded empirical scrutiny. We address this oversight by arguing that system-justifying beliefs confer palliative benefits upon low-status groups by decreasing perceptions of group-based discrimination. Using nationally representative data from New Zealand ( N = 12,959), we demonstrate that ethnic minorities (Study 1a) and women (Study 1b) generally report lower levels of well-being than do New Zealand Europeans and men, respectively. Nevertheless, as hypothesized, these differences were mitigated by the endorsement of ethnic- and gender-specific system justification, respectively. Mediated moderation analyses further revealed that part of the palliative effects of system justification occurred via reductions in perceived group-based discrimination. The implications of these findings for intergroup relations are discussed.
Received Respect and Constructive Voice: The Roles of Proactive Motivation and Perspective Taking
Authors: Ng Thomas W. H. , Hsu Dennis Y. , Parker Sharon K.
Published: March 2019

This study advances voice research by offering a social-relational view of the drivers of voice, a theoretical approach to voice that is seldom considered within the current paradigm largely focused on personality traits, job conditions, and organizational characteristics. One overlooked yet important social-relational antecedent of voice is received respect. Our core premise is that when employees believe they are respected by coworkers, they experience psychological changes to their control beliefs (representing “can-do” proactive motivation) and positive mood (representing “energized-to” proactive motivation), which then motivate voice. We further consider another social-relational variable—perspective taking—as a predictor of received respect and therefore as an indirect predictor of voice. Through a multimethod, multisample research program comprising four studies (two experiments involving more than 400 subjects in total, a sample involving more than 700 matched employee-coworker and subordinate-supervisor dyads, and a 9-week within-person field investigation of more than 400 university alumni), we provide evidence to support the proposed model. That is, received respect was associated with employees’ voice through control beliefs and positive mood, and perspective taking was a prominent predictor of received respect.
The Complex Sources of Immigration Control
Authors: Vigneswaran Darshan
Published: March 2019

All governments enforce immigration laws, but we have a limited understanding of the factors that determine how much they do so. Immigration policymakers can empower or compel officials and non-state actors to enforce immigration laws. This study suggests that non-immigration policymakers may play an equally important role — albeit in complex ways. Policies designed to control human mobility in other ways (transportation, crime control, segregation, etc.) can determine the amount of resources a given country devotes to immigration enforcement and the effectiveness of enforcement efforts. When officials ban old — or invent new — forms of movement control, they can determine how much resources are available to enforce immigration laws, whether these resources are used for immigration enforcement, and how effective they are. The study demonstrates this potential power of non-immigration policy through an in-depth analysis of South Africa’s unexpected capacity to control migration. South Africa is one of the world’s most prolific deporters of foreign nationals but not a very strong state. The study shows how decisions to ban segregation and invent new policing methods impacted the South African state’s capacity to deport foreign nationals. Using these findings, the article calls for more detailed research into the complex relationships between immigration enforcement and other movement control policies and for greater attention to heretofore neglected cases in the developing world.
Relationship dynamics and divorcing mothers’ adjustment: Moderating role of marital violence, negative life events, and social support
Authors: Hardesty Jennifer L. , Ogolsky Brian G. , Raffaelli Marcela , Whittaker Angela
Published: March 2019

Longitudinal associations between postseparation relationship stressors (coparenting conflict and harassment) and health outcomes (depressive, posttraumatic stress disorder [PTSD], and physical health symptoms) as moderated by contextual factors (i.e., marital intimate partner violence [IPV], negative life events, and social support) were examined in a sample of divorcing mothers. Respondents were 135 mothers recruited within 4 months of a divorce filing who participated in five interviews at 3-month intervals over a 1-year period. Multilevel modeling procedures used to account for the repeated assessments over time revealed direct associations between postseparation stressors and health outcomes differing based on IPV and negative life events. For example, coparenting conflict after separation was associated with higher levels of depressive, PTSD, and physical health symptoms among mothers who experienced no violence, whereas the opposite pattern was observed among mothers whose marriages were characterized by coercive controlling violence. Negative life events magnified that negative impact of coparenting conflict on mental and physical health. Contrary to expectation, social support did not diminish the negative health effects of postseparation stressors. Findings support the value of examining how distinct postseparation factors are associated with divorcing mothers’ health within the broader context against which the divorce process plays out.
Group identity, empathy and shared suffering: Understanding the ‘community’ impacts of anti-LGBT and Islamophobic hate crimes
Authors: Walters Mark A , Paterson Jenny L , McDonnell Liz , Brown Rupert
Published: March 2019

This article examines the indirect impacts of hate crimes on lesbian, gay, bisexual and transgender and Muslim communities in the United Kingdom. Based on 34 qualitative interviews, we explore both the perceived meaning of ‘community’ in the context of targeted victimization and the emotional and behavioural effects that anti-lesbian, gay, bisexual and transgender and Islamophobic hate crimes have on other members of the victim’s group. Building on previous quantitative data undertaken as part of a larger programme of research, this study helps to explain how and why hate crimes have significant indirect consequences on two distinct but commonly targeted communities. The focus on lesbian, gay, bisexual and transgender and Muslim communities allowed us to draw out similarities and commonalities across different groups, further enhancing the understanding of the impacts of hate crime. In particular, the article highlights how for many lesbian, gay, bisexual and transgender and Muslim people feelings of anger and anxiety about hate crimes were linked to enhanced levels of empathy towards those that they share a group identity with. These empathic bonds often gave rise to a sense of ‘shared suffering’, with participants frequently feeling connected to group members worldwide through their common experiences of hate and prejudice. Although group identity was important to many participants’ sense of belonging to lesbian, gay, bisexual and transgender or Muslim communities, it was clear that the most profound impacts of hate crime were experienced when incidents occurred within someone’s local area. This highlighted the importance of location as a key variable in understanding both the meaning of ‘community’ and the indirect impacts of hate crime.
A Probabilistic Model to Support Radiologists’ Classification Decisions in Mammography Practice
Authors: Zeng Jiaming , Gimenez Francisco , Burnside Elizabeth S. , Rubin Daniel L. , Shachter Ross
Published: March 2019

We developed a probabilistic model to support the classification decisions made by radiologists in mammography practice. Using the feature observations and Breast Imaging Reporting and Data System (BI-RADS) classifications from radiologists examining diagnostic and screening mammograms, we modeled their decisions to understand their judgments. Our model could help improve the decisions made by radiologists using their own feature observations and classifications while maintaining their observed sensitivities. Based on 112,433 mammographic cases from 36,111 patients and 13 radiologists at 2 separate institutions with a 1.1% prevalence of malignancy, we trained a probabilistic Bayesian network (BN) to estimate the malignancy probabilities of lesions. For each radiologist, we learned an observed probabilistic threshold within the model. We compared the sensitivity and specificity of each radiologist against the BN model using either their observed threshold or the standard 2% threshold recommended by BI-RADS. We found significant variability among the radiologists’ observed thresholds. By applying the observed thresholds, the BN model showed a 0.01% (1 case) increase in false negatives and a 28.9% (3612 cases) reduction in false positives. When using the standard 2% BI-RADS-recommended threshold, there was a 26.7% (47 cases) increase in false negatives and a 47.3% (5911 cases) reduction in false positives. Our results show that we can significantly reduce screening mammography false positives with a minimal increase in false negatives. We find that learning radiologists’ observed thresholds provides valuable information regarding the conservativeness of clinical practice and allows us to quantify the variability in sensitivity across and within institutions. Our model could provide support to radiologists to improve their performance and consistency within mammography practice.
From features to fingerprints: A general diagnostic framework for anthropogenic geomorphology
Authors: Tarolli Paolo , Cao Wenfang , Sofia Giulia , Evans Damian , Ellis Erle C
Published: March 2019

Human societies have been reshaping the geomorphology of landscapes for thousands of years, producing anthropogenic geomorphic features ranging from earthworks and reservoirs to settlements, roads, canals, ditches and plough furrows that have distinct characteristics compared with landforms produced by natural processes. Physical geographers have long recognized the widespread importance of these features in altering landforms and geomorphic processes, including hydrologic flows and stores, to processes of soil erosion and deposition. In many of the same landscapes, archaeologists have also utilized anthropogenic geomorphic features to detect and analyse human societal activities, including symbolic formations, agricultural systems, settlement patterns and trade networks. This paper provides a general framework aimed at integrating geophysical and archaeological approaches to observing, identifying and interpreting the full range of anthropogenic geomorphic features based on their structure and functioning, both individually and as components of landscape-scale management strategies by different societies, or “sociocultural fingerprints”. We then couple this framework with new algorithms developed to detect anthropogenic geomorphic features using precisely detailed three-dimensional reconstructions of landscape surface structure derived from LiDAR and computer vision photogrammetry. Human societies are now transforming the geomorphology of landscapes at increasing rates and scales across the globe. To understand the causes and consequences of these transformations and contribute to building sustainable futures, the science of physical geography must advance towards empirical and theoretical frameworks that integrate the natural and sociocultural forces that are now the main shapers of Earth’s surface processes.
Application of fuzzy inference system for analysis of oil field data to optimize combustion engine maintenance
Authors: Vališ David , Žák Libor , Vintr Zdenek
Published: March 2019

The condition of a technical system has been subject to intense scrutiny in recent years. Monitoring the technical condition of a system may be performed by applying different approaches. The main intention of the monitoring is to get the information about the instant system condition, and to estimate and predict reliability measures. In the article, the authors suggest possible ways to process diagnostic measures which have the potential to determine the system condition and to predict its future development. The diagnostic measures are in this case indirect and they are introduced in the form of oil data. The diagnostic data are obtained from the tribodiagnostic system which is composed of kinematic pairs and oil. The analysed oil samples come from the combustion engine of a heavy ground vehicle. The authors focus on the output values in the form of wear particles, iron and lead, and additive particles. The concentration of these particles in the oil is influenced by operating time and calendar time. However, the particles include inherent and natural levels of uncertainty and fuzziness. Therefore, the authors apply and present the models imitating the development of the particles which are based on a fuzzy inference system. Highly valuable and extensive data set records enabled the authors to perform two-dimensional data modelling based both on operation time and calendar time. The obtained results enable us to predict the remaining useful life of the system. Moreover, the results could also be beneficial when modifying hard time scheduled preventive maintenance intervals (e.g. when to change the oil). The major contribution of this paper is the fact that all analysed diagnostic data are not artificial but real; moreover, they were collected for more than 10 years and therefore contain hundreds of records.
Encountering the stranger: Hannah Arendt and the shortcomings of empathy as a moral compass
Authors: Matthiesen Noomi , Klitmøller Jacob
Published: March 2019

It is a notion often taken for granted in contemporary Western everyday life that there is an intimate connection between empathy and moral action. Yet, in recent years, this connection has come under scrutiny. In this article, we first ask the question, “What is empathy?” A brief survey of the psychological and philosophical approaches to the notion of empathy shows that it remains a highly contested concept. The field has a propensity to discuss empathy within the frame of sameness. We instead argue that, in order to grasp empathy, it is necessary to foreground otherness. Drawing on Hannah Arendt, we further argue that, when encountering the stranger, moral action requires both visiting the other—as distinct from empathic knowledge—and thinking in order to judge what is right. Ultimately, moral dilemmas are solved, not by having or demanding empathy, but by addressing the issues at hand in joint action.
An obstacle problem for Koiter’s shells
Authors: Ciarlet Philippe G , Piersanti Paolo
Published: March 2019

In this paper, we define, a priori, a natural two-dimensional Koiter’s model of a ‘general’ linearly elastic shell subject to a confinement condition. As expected, this model takes the form of variational inequalities posed over a non-empty closed convex subset of the function space used for the ‘unconstrained’ Koiter’s model. We then perform a rigorous asymptotic analysis as the thickness of the shell, considered a ‘small’ parameter, approaches zero, when the shell belongs to one of the three main classes of linearly elastic shells, namely elliptic membrane shells, generalized membrane shells and flexural shells. To illustrate the soundness of this model, we consider elliptic membrane shells to fix ideas. We then show that, in this case, the ‘limit’ model obtained in this fashion coincides with the two-dimensional ‘limit’ model obtained by means of another rigorous asymptotic analysis, but this time with the three-dimensional model of a ‘general’ linearly elastic shell subject to a confinement condition as a point of departure. In this fashion, our proposed Koiter’s model of a linearly elastic shell subject to a confinement condition is fully justified in this case, even though it is not itself a ‘limit’ model.
Book review: Justin Yifu Lin and Celestin Monga. 2017: Beating the Odds: Jump-Starting Developing Countries
Authors: Chuku Chuku
Published: March 2019

Justin Yifu Lin and Celestin Monga. 2017: Beating the Odds: Jump-Starting Developing Countries. New Jersey and Oxfordshire: Princeton University Press. viii + 384 pp. $35 (Hardcover). ISBN 978-0-691-17605-5
Sustainable resilience? Disaster recovery and the marginalization of sociocultural needs and concerns
Authors: Sou Gemma
Published: March 2019

Resilience has become the dominant and normative ideology of sustainability more generally, and disaster recovery more specifically. Most studies focus on how to achieve resilient recovery. This is premised on an assumption that resilience meets the needs and concerns of disaster-affected populations and is thereby sustainable. However, this article critically explores to what extent the recovery needs and concerns of disaster-affected households fit neatly within resilience vernacular and analytical frameworks. The research shows that resilience is informed by a reductive understanding of human needs as many socio-cultural needs of disaster-affected people are marginalized from resilience-based recovery. The article suggests that if disaster recovery is to be a normative and sustainable agenda, then resilience alone may be insufficient, and that needs and concerns that do not directly adapt to, reduce or avoid the impacts of hazards, ought to be prioritized in recovery programmes. The article explores these issues by investigating self-build housing processes in a post-disaster setting in Cochabamba city in Bolivia.
A Case Study of Two Successful Social Marketing Interventions to Promote 1% Low-Fat Milk Consumption
Authors: John Robert , Finnell Karla Jaye , Scott-Kaliki Meredith S. , DeBerry Stephanie M.
Published: March 2019

This article presents a case study of two effective interventions promoting 1% low-fat milk consumption. Developed after extensive formative research and use of the 4Ps marketing mix, the first intervention in 2012, 1% Low-Fat Milk Has Perks!, was a multilevel intervention implemented in the Oklahoma City media market (OKCMM), which covers most of the western portion of the state of Oklahoma. The program evaluation was based on a quasi-experimental comparison-group design that compared milk sales in the OKCMM with the Tulsa media market (TMM) supplemented by a pre- and post-intervention telephone survey of Supplemental Nutrition Assistance Program recipients. The program evaluation revealed that 1% milk sales significantly increased 15% from before to after the intervention ended in the OKCMM compared to a smaller increase in the TMM. In 2014, the second intervention, Choose 1% Milk: A Healthy Family Choice, was implemented statewide using three experimental conditions. The intervention resulted in a 42.9% statewide increase in 1% milk sales from before to after the intervention ended. In this article, we describe the use of the marketing mix in the planning, implementation, and summative evaluation of both interventions, including strategic decisions that provide insight into efforts to influence behavior at the population level.
Ulnar Wrist Deviation in Children With Obstetric Brachial Plexus Palsy: A Descriptive Study of Clinical and Radiological Findings of Impaired Ulnar Growth and Associated Incongruence of the Distal Radioulnar Joint
Authors: Bahm Jörg , Bouslama Sarra , Hagert Elisabet M. , Andersson Jonny K.
Published: March 2019

Backround: Some children with obstetric brachial plexus palsy (OBPP) present later on with an ulnarly deviated wrist. The aim of this study was to present a retrospective analysis of a subgroup of OBPP children with ulnarly deviated wrists and to describe their morphologic wrist deformity in terms of clinical and radiological appearance. Methods: We present a retrospective analysis of the records of 27 children with an ulnarly deviated wrist as a consequence of OBPP. Radiographs of the affected wrist were performed when the ulnar deformity became clinically manifest and merited investigation, at a mean age of 15 (range: 6.5-27) years. Available clinical and radiological data were analyzed and categorized. Results: The ulnar-deviated position was associated with impaired active and passive pronosupination in all patients. Fifteen fixed supination deformities and 3 anterior radial head dislocations were noted clinically. Plain radiographs were completed in 24 patients and could be analyzed in 18, showing variations in ulnar variance (7 neutral, 7 ulna minus, and 4 ulna plus) along with 6 subluxations of the distal radioulnar joint (DRUJ). Of the patients treated surgically (n = 7), only the 2 patients treated with wrist fusion had an actual improvement in ulnar wrist deformity. Conclusion: Radiologically visible ulnar head hypoplasia, overgrowth of the distal ulna, or a shortened ulnar diaphysis and an incongruent DRUJ were present in all examined OBPP patients with a clinically evident ulnarly deviated wrists. The radiological findings highlight the morphologic adaptation behind this clinical condition and could allow further investigation into suitable treatment strategies.
Transplantation of a three-lobed donor left lung: A case report
Authors: Jacob Samuel , Makey Ian A , El-Sayed Ahmed Magdy M , Mallea Jorge M , Erasmus David B , Belli Erol V
Published: March 2019

A true left middle lobe (lingular lobe) is very rare, but accessory fissures can be unexpectedly found at transplant. Pre-transplant knowledge of accessory lobes and accessory fissures aids in preparation, transplantation, postoperative assessment, and long-term care planning; however, fissures and accessory lobes can be overlooked by radiologists during routine evaluation of images. Here, we describe the first left lung with three anatomical lobes that was successfully transplanted into a 63-year-old patient with idiopathic pulmonary fibrosis. This anatomical variation did not change our surgical plan or technique, but surgeons should be aware of this possibility, especially when planning postoperative care.
Subclavian vein thrombosis and fatal pulmonary embolism after proximal humerus fracture surgery
Authors: Li Yonggang , Wang Zhiyong , Sang Xiguang
Published: March 2019

Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. Although deep vein thrombosis in the upper extremity is less common than lower extremity, it has been associated with similar adverse consequences. We have had experienced with one case of subclavian vein thrombosis and fatal pulmonary embolism after proximal humeral fracture surgery. The purpose of our report is to raise awareness to orthopedic surgeons that pulmonary embolism can occur with proximal humeral fracture surgery and patients with high risk factors should be considered for anticoagulation therapy.
Overdiagnosis of pulmonary embolism: definition, causes and implications
Authors: Dobler Claudia C.
Published: March 2019

Overuse of computed tomography pulmonary angiography to diagnose pulmonary embolism in people who have only a low pre-test probability of pulmonary embolism has received significant attention in the past. The issue of overdiagnosis of pulmonary embolism, a potential consequence of overtesting, has been less explored. The term “overdiagnosis”, used in a narrow sense, describes a correct (true positive) diagnosis in a person but without any associated harm. The aim of this review is to summarise literature on the topic of overdiagnosis of pulmonary embolism and translate this epidemiological concept into the clinical practice of respiratory professionals. The review concludes that the location of pulmonary embolism at a subsegmental level, rather than whether a diagnosis was made incidentally or following an investigation for suspected pulmonary embolism, is the best predictor for situations in which anticoagulation may not be necessary. In the absence of strong evidence of the optimal management of subsegmental pulmonary embolism, treatment decisions should be made case by case, taking into account the patient's situation and preference.

Key points

Since the introduction of computed tomography pulmonary angiography in 1998, there has been a steep increase in the diagnosis of pulmonary embolism (PE).

An increased incidence of PE diagnoses, but an almost stable mortality from PE in the population, together with a decreased case fatality, point towards overdiagnosis (in the absence of more effective treatment).

Whether PE is diagnosed as an incidental finding or following an investigation for suspected PE does not appear to influence the need for anticoagulation therapy.

An isolated subsegmental PE may not require anticoagulation therapy, and treatment decisions should be made case by case, taking into account the patient's situation and preference.

A suggested definition of overdiagnosis of PE: a diagnosis of PE that, if left untreated, would not lead to more harm than if it were treated with anticoagulation therapy, independent of symptoms.

Educational aims

To understand the term “overdiagnosis” based on its narrow definition and be able to apply it to PE.

To outline the diagnostic approach to PE.

To summarise what is known about the treatment of incidentally detected PE.

To summarise what is known about the treatment of subsegmental PE.

To understand in which situations anticoagulation therapy for PE may not be beneficial.
A pilot study of safety of sulfamethoxazole, trimethoprim and guaifenesin in pediatric and adult patients with acute bronchitis
Authors: Falcon Mayer , Iberico Carlos , Guerra Frances , Reyes Isabel , Felix Efraín , Flores Mónica , de los Ríos Jorge , Diaz Maria E. , Casas Alberto , Sanchez-Gambetta Sergio , Carrasco Roberto
Published: March 2019

Objective

This exploratory study assessed the safety of the combination of sulfamethoxazole, trimethoprim and guaifenesin (STG) in adult and pediatric patients with acute bronchitis according to local labelling in Peru.

Results

We enrolled 51 pediatric and 52 adult participants diagnosed with acute bronchitis and indication of STG. The mean ages were 7.6 years (SD ± 3.2 years) and 42.8 years (SD ± 16.1) and the proportion of female patients were 51% and 65%, respectively. The duration of treatment in pediatric patients was < 5 days in 2% of patients, 5 days in 13.7%, 6–7 days, in 82.4% and > 7 days in 2% while in adults patients it was < 5 days in 17%, 5 days in 69.2%; 6–7 days in 28.8% of patients. Adverse events (AEs) were registered in 9.6% and 19.2% of pediatric and adult patients, respectively. These AEs had definite relation of causality with the study drugs in 2 adults (20% of AEs) and possible causality with the study drugs in 4 pediatric (80% of AEs) and 2 adult cases (20% of AEs). Our results provide valuable data to develop trials of pharmacovigilance where different statistical parameters should be considered to calculate an adequate sample size in studies evaluating STG in pediatric or adult patients.

Trial registration NCT02879981 and NCT02902640
RETRACTED ARTICLE: Acute and sub-acute (30-day) toxicity studies of Aegialitis rotundifolia Roxb., leaves extract in Wistar rats: safety assessment of a rare mangrove traditionally utilized as pain antidote
Authors: Ghosh Debjit , Mondal Sumanta , Ramakrishna K.
Published: March 2019

Background

Aegialitis rotundifolia Roxb., (Plumbaginaceae) is a small mangrove tree or shrub traditionally used by the local healers of mangroves for curing pain and inflammation. However, there are no scientific reports of its toxicological properties which would guarantee the safety of its folkloric usage as a potent pain reliever. Therefore, the present study deals in acute and sub-acute (30-day) toxicity studies of Aegialitis rotundifolia ethanolic leaves extract (ARELE) on male and female Wistar rats administered through oral gavage.

Methods

Acute toxicity study was conducted at a single oral dose of 1000, 1500, and 2000 mg/kg, body weight (b.wt.) for 14 days with a special emphasis on the first four hours after drug administration to find out any mortality and morbidity. In sub-acute toxicity, the extract at the doses of 125, 250 and 500 mg/kg, b.wt., was administered orally for 30 days. Important parameters such as general behaviour, body and organ weight, urinalysis, haematological and biochemical profile, organ macroscopy and microscopy were conducted. Organ sample of liver, kidney, pancreas, heart, lungs, and stomach were taken from both male and female rats, whereas the sample of testis and ovary was taken from male and female rats respectively for organ necropsy and histopathological studies. Neurobehavioral toxicity was conducted by performing a functional observational battery (FOB) and locomotor activity on the initial and final week of the 30-day study period.

Results

No mortality or any major signs of morbidity was recorded for acute toxicity except for the limit dose (2000 mg/kg, b.wt.) which produced a slight short-term sedative effect. In sub-acute toxicity, no major alteration was observed in the evaluated parameters. However, few minor changes were recorded for high dose (500 mg/kg, b.wt.) group.

Conclusion

The results of the present study showed that oral administration of Aegialitis rotundifolia ethanolic leaves extract did not produce any severe toxic effects in both acute and sub-acute studies in Wistar rats. Therefore, usage of an appropriate amount of Aegialitis rotundifolia leaves extract preferably at low doses for its traditional use should be considered safe.
FAIL Is Not a Four-Letter Word: A Theoretical Framework for Exploring Undergraduate Students’ Approaches to Academic Challenge and Responses to Failure in STEM Learning Environments
Authors: Henry Meredith A. , Shorter Shayla , Charkoudian Louise , Heemstra Jennifer M. , Corwin Lisa A.
Published: March 2019

Navigating scientific challenges, persevering through difficulties, and coping with failure are considered hallmarks of a successful scientist. However, relatively few studies investigate how undergraduate science, technology, engineering, and mathematics (STEM) students develop these skills and dispositions or how instructors can facilitate this development in undergraduate STEM learning contexts. This is a critical gap, because the unique cultures and practices found in STEM classrooms are likely to influence how students approach challenges and deal with failures, both during their STEM education and in the years that follow. To guide research aimed at understanding how STEM students develop a challenge-engaging disposition and the ability to adaptively cope with failure, we generate a model representing hypotheses of how students might approach challenges and respond to failures in undergraduate STEM learning contexts. We draw from theory and studies investigating mindset, goal orientations, attributions, fear of failure, and coping to inform our model. We offer this model as a tool for the community to test, revise, elaborate, or refute. Finally, we urge researchers and educators to consider the development, implementation, and rigorous testing of interventions aimed at helping students develop a persevering and challenge-engaging disposition within STEM contexts.
Computer-Based and Bench-Based Undergraduate Research Experiences Produce Similar Attitudinal Outcomes
Authors: Kirkpatrick Catherine , Schuchardt Anita , Baltz Daniel , Cotner Sehoya
Published: March 2019

Course-based undergraduate research experiences (CUREs) have the potential to improve undergraduate biology education by involving large numbers of students in research. CUREs can take a variety of forms with different affordances and constraints, complicating the evaluation of design features that might contribute to successful outcomes. In this study, we compared students’ responses to three different research experiences offered within the same course. One of the research experiences involved purely computational work, whereas the other two offerings were bench-based research experiences. We found that students who participated in computer-based research reported at least as much interest in their research projects, a higher sense of achievement, and a higher level of satisfaction with the course compared with students who did bench-based research projects. In open-ended comments, similar proportions of students in each research area expressed some sense of project ownership as contributing positively to their course experiences. Their comments also supported the finding that experiencing a sense of achievement was a predictor of course satisfaction. We conclude that both computer-based and bench-based CUREs can have positive impacts on students’ attitudes. Development of more computer-based CUREs might allow larger numbers of students to benefit from participating in a research experience.
Chromogranin A regulates neuroblastoma proliferation and phenotype
Authors: Zhang Dongyun , Babayan Lilit , Ho Hillary , Heaney Anthony P.
Published: March 2019

Neuroblastoma is a commonly encountered solid tumor in early childhood with high neuroplasticity, and differentiation therapy is hypothesized to lead to tumor mass shrinkage and/or symptom relief. CgA is a tissue specific protein restricted to the diffuse neuroendocrine system, and widely expressed in neuroblastomas. Using knockdown and knockout approaches to deplete CgA levels, we demonstrated that CgA loss inhibits SH-SY5Y cell proliferation and leads to a morphological shift with increased expression of Schwann and extracellular matrix specific molecules, and suppression of chromaffin features. We further confirmed the effects of CgA in a series of neuroblastoma cells with [BE(2)-M17 and IMR-32] and without (SK-N-SH) N-Myc amplification. We demonstrated that CgA depletion reduced IGF-II and IGFBP-2 expression, increased IGFBP-3 levels, and suppresses IGF downstream signaling as evidenced by reduced AKT/ERK pathway activation. This was further supported by an increased anti-proliferative effect of the ERK inhibitor in the CgA depleted cells. In an in vivo xenograft neuroblastoma model, CgA knockdown led to increased S-phenotypic marker expression at both protein and mRNA levels. Together these results suggest that CgA maintains IGF secretion and intracellular signaling to regulate proliferation and differentiation in neuroblastomas.
(T) infective larvae of Anisakis simplex (Nematoda) accumulate trehalose and glycogen in response to starvation and temperature stress
Authors: Łopieńska-Biernat Elżbieta , Stryiński Robert , Dmitryjuk Małgorzata , Wasilewska Barbara
Published: March 2019

Anisakis simplex L3 larvae infect fish and other seafood species such as squids or octopuses; therefore, humans consuming raw or undercooked fish may become accidental hosts for this parasite. These larvae are induced to enter hypometabolism by cold temperature. It is assumed that sugars (in particular trehalose and glycogen) are instrumental for survival under environmental stress conditions. To elucidate the mechanisms of environmental stress response in A. simplex, we observed the effects of starvation and temperature on trehalose and glycogen content, the activity of enzymes metabolizing those sugars, and the relative expression of genes of trehalose and glycogen metabolic pathways. The L3 of A. simplex synthesize trehalose both in low (0°C) and high temperatures (45°C). The highest content of glycogen was observed at 45°C at 36 h of incubation. On the second day of incubation, tissue content of trehalose depended on the activity of the enzymes: TPS was more active at 45°C, and TPP was more active at 0°C. The changes of TPP activity were consistent with the transcript level changes of the TPP gene, and the trehalose level, while glycogen synthesis correlates with the expression of glycogen synthase gene at 45°C; this suggests that the synthesis of trehalose is more essential. These results show that trehalose plays a key role in providing energy during the thermotolerance and starvation processes through the molecular and biochemical regulation of trehalose and glycogen metabolism.
Determinants of knowledge, attitude and practice in patients with both type 2 diabetes and chronic kidney disease in Fiji
Authors: Zibran Mohammed Alvis , Mohammadnezhad Masoud
Published: March 2019

Background:In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018.

Methods:A cross-sectional study was conducted at Sigatoka Sub-divisional Hospital (SSH) in Fiji in July-August, 2018 using a self-structured questionnaire to test KAP of 225 patients. The inclusion criteria were confirmed T2DM patients (Fijian citizens) with CKD, aged 30 years or above and attending Special Out-Patient's Department (SOPD) at SSH. Independent t-test and ANOVA was used to test differences between demographic variable and practice score while non-parametric tests were used for knowledge and attitude. Spearman correlation and multiple linear regressions were also done. All the tests were set at 5% level of significance.

Results:The mean KAP level was high: knowledge, 23.3 (SD±3.25); attitude, 23.1 (SD±2.73) and practice, 7.1 (SD±2.04). A high level of knowledge was seen in those with university-level education (p<0.001), unemployed (p=0.05) and high average monthly income (p=0.03). Those aged 61-70 years had a 0.53-point lower attitude score (p=0.05) than other age categories, while those >70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Fijians of Indian descent (FID) had lower attitude (p=0.002) and higher practice (p=0.001) scores.

Conclusion:Patients with both T2DM and CKD at SSH have high levels of KAP. Those with higher levels of education, the unemployed and those with high monthly income had higher knowledge, FID had low attitude but high practice scores, and the higher age category had lower attitude scores. The study identified high-risk groups for low KAP, which can become the focus of future public health intervention.
National Survey of Hospitalists' Experiences with Incidental Pulmonary Nodules
Authors: Umscheid Craig A , Wilen Jonathan , Garin Matthew , Goldstein Jenna D , Cook Tessa S , Liu Yulun , Chen Yong , Myers Jennifer S
Published: March 2019

Incidental pulmonary nodules (IPNs) are common and often require follow‐up. The Fleischner Society guidelines were created to support IPN management. We developed a 14‐item survey to examine hospitalists' exposure to and management of IPNs. The survey targeted attendees of the 2016 Society of Hospital Medicine (SHM) annual conference. We recruited 174 attendees. In total, 82% were identified as hospitalist physicians and 7% as advanced practice providers; 63% practiced for >5 years and 62% supervised trainees. All reported seeing ≥1 IPN case in the past six months, with 39% seeing three to five cases and 39% seeing six or more cases. Notwithstanding, 42% were unfamiliar with the Fleischner Society guidelines. When determining the IPN follow‐up, 83% used radiology report recommendations, 64% consulted national or international guidelines, and 34% contacted radiologists; 34% agreed that determining the follow‐up was challenging; only 15% reported availability of automated tracking systems. In conclusion, despite frequent IPN exposure, hospitalists are frequently unaware of the Fleischner Society guidelines and rely on radiologists' recommendations.
Increasing Mobility via In‐hospital Ambulation Protocol Delivered by Mobility Technicians: A Pilot Randomized Controlled Trial
Authors: Hamilton Aaron C , Lee Natalie , Stilphen Mary , Hu Bo , Schramm Sarah , Frost Frederick , Fox Jacqueline , Rothberg Michael B
Published: March 2019

BACKGROUND

Ambulating medical inpatients may improve outcomes, but this practice is often overlooked by nurses who have competing clinical duties.

OBJECTIVE

This study aimed to assess the feasibility and effectiveness of dedicated mobility technician‐assisted ambulation in older inpatients.

DESIGN

This study was a single‐blind randomized controlled trial.

SETTING

Patients aged ≥60 years and admitted as medical inpatients to a tertiary care center were recruited.

INTERVENTION

Patients were randomized into two groups to participate in the ambulation protocol administered by a dedicated mobility technician. Usual care patients were not seen by the mobility technician but were not otherwise restricted in their opportunity to ambulate.

MEASUREMENTS

Primary outcomes were length of stay and discharge disposition. Secondary outcomes included change in mobility measured by six‐clicks score, daily steps measured by Fitbit, and 30‐day readmission.

RESULTS

Control (n = 52) and intervention (n = 50) groups were not significantly different at baseline. Of patients randomized to the intervention group, 74% participated at least once. Although the intervention did not affect the primary outcomes, the intervention group took nearly 50% more steps than the control group (P = .04). In the per protocol analysis, the six‐clicks score significantly increased (P = .04). Patients achieving ≥400 steps were more likely to go home (71% vs 46%, P = .01).

CONCLUSIONS

Attempted ambulation three times daily overseen by a dedicated mobility technician was feasible and increased the number of steps taken. A threshold of 400 steps was predictive of home discharge. Further studies are needed to establish the appropriate step goal and the effect of assisted ambulation on hospital outcomes.
Examining the Utility of 30‐day Readmission Rates and Hospital Profiling in the Veterans Health Administration
Authors: Wray Charlie M , Vali Marzieh , Walter Louise C , Lopez Lenny , Austin Peter C , Byers Amy , Keyhani Salomeh
Published: March 2019

BACKGROUND

The Veterans Health Administration (VA) reports hospital‐specific 30‐day risk‐standardized readmission rates (RSRRs) using CMS‐derived models.

OBJECTIVE

The aim of this study was to examine and describe the interfacility variability of 30‐day RSRRs for acute myocardial infarction (AMI), heart failure (HF), and pneumonia as a means to assess its utility for VA quality improvement and hospital comparison.

RESEARCH DESIGN

A retrospective analysis of VA and Medicare claims data using one‐year (2012) and three‐year (2010‐2012) data given their use for quality improvement or for hospital comparison, respectively.

SUBJECTS

This study included 3,571 patients hospitalized for AMI at 56 hospitals, 10,609 patients hospitalized for HF at 102 hospitals, and 10,191 patients hospitalized for pneumonia at 106 hospitals.

MEASURES

Hospital‐specific 30‐day RSRRs for AMI, HF, and pneumonia hospitalizations were calculated using hierarchical generalized linear models.

RESULTS

Of 164 qualifying VA hospitals, 56 (34%), 102 (62%), and 106 (64%) qualified for analysis based on CMS criteria for AMI, HF, and pneumonia cohorts, respectively. Using 2012 data, we found that two hospitals (2%) had CHF RSRRs worse than the national average (+95% CI), whereas no hospital demonstrated worse‐than‐average risk‐stratified readmission Rate (RSRR; +95% CI) for AMI or pneumonia. After increasing the number of facility admissions by combining three years of data, we found that four (range: 3.5%‐5.3%) hospitals had RSRRs worse than the national average (+95% CI) for all three conditions.

CONCLUSIONS

The Centers for Medicare and Medicaid Services‐derived 30‐day readmission measure may not be a useful measure to distinguish VA interfacility performance or drive quality improvement given the low facility‐level volume of such readmissions.