bluuebunny/crossref_metadata_2025 huggingface dataset:
Physicochemical characterization and release properties of oral drug delivery: A pH-sensitive nanocomposite based on sodium alginate–pectin–tannic acid–silver
Authors: Agili Fatimah A , Aly Sahera FM
Published: December 2019

A pH-sensitive nanocomposite formed from sodium alginate (SA)/pectin (Pec)/tannic acid (TA)–silver (Ag) was developed using microwave irradiation and it was applied as a carrier for propranolol drug. TA acts as a cross-linker and a reducing agent for Ag ions. Physicochemical characteristics of the fabricated system using Fourier transform infrared spectroscopy, X-ray diffraction, field-emission scanning electron microscope, high-resolution transmission electron microscope, dynamic light scattering instrument, and energy dispersive X-ray analysis. The swelling percent and the drug release were observed to be pH-sensitive. The occurrence of Ag nanoparticles in the network enhances the drug release that is 96% at pH 7.4 within 420 min. The drug release data were adjusted into different kinetic models involved zero order, first order, Higuchi, and Ritger–Peppas models. The release mechanism is a non-Fickian character where it controls by diffusion and relaxation of polymer chains. It can be concluded that SA/Pec/TA-Ag nanocomposite is a candidate for the oral drug carrier specific for the intestinal system and has ability against the gastric fluid.
Which families move out from metropolitan areas? Counterurban migration and professions in Sweden
Authors: Sandow Erika , Lundholm Emma
Published: December 2019

This paper seeks to contribute to the ongoing revitalisation of the counterurbanisation research within population geography by nuancing counterurban migration beyond the rural–urban dichotomy, including all moves downwards in the urban hierarchy. The focus is to explore counterurban migration patterns among families with children leaving Swedish metropolitan areas, and whether some groups of skilled professions are more likely to make a counterurban move than others. Using register data on all families moving out from metropolitan areas in Sweden during the period 2003–2013, we found a small but steady outflow of families, mainly to medium-sized or small towns. The highly educated are overrepresented among these families, thus providing potential for an inflow of competence to the receiving areas. Contrary to expected, the assumed flexibility in time and space among knowledge sector professionals does not seem to enable them more than others to pursue counterurban moves. Instead, public sector professionals characterise families making a counterurban move to all destination regions, while men with a profession within arts and crafts to a higher extent move with their family to more rural areas.
Scaffolding Feedback Between Cowriters With Different Levels of English-Language Proficiency
Authors: Poznahovska Feuer Maria
Published: December 2019

When students cowrite with others who have different levels of proficiency with the English language, they can experience unproductive conflict related to feedback avoidance. The author interviewed 20 professionals with experience cowriting across such different English proficiencies and found three strategies that can facilitate feedback and collaboration: calibrate genre and reader expectations, establish protocols for reviewing texts, and frame feedback as a learning opportunity. She suggests that these strategies can be a step toward helping students mitigate their anxieties about feedback and feel more empowered to engage with linguistically diverse peers.
Principal Component Analysis on Recurrent Venous Thromboembolism
Authors: Martins Tiago D. , Annichino-Bizzacchi Joyce M. , Romano Anna V. C. , Filho Rubens Maciel
Published: December 2019

The rates of recurrent venous thromboembolism (RVTE) vary widely, and its causes still need to be elucidated. Statistical multivariate methods can be used to determine disease predictors and improve current methods for risk calculation. The objective of this study was to apply principal component analysis to a set of data containing clinical records of patients with previous venous thromboembolism and extract the main factors that predict recurrent thrombosis. Records of 39 factors including blood and lipid parameters, hereditary thrombophilia, antiphospholipid syndrome, clinical data regarding previous thrombosis and treatment, and Doppler ultrasound results were collected from 235 patients. The results showed that 13 principal components were associated with RVTE and that 18 of 39 factors are the important for the analysis. These factors include red blood cell, white blood cell, hematocrit, red cell distribution width, glucose, lipids, natural anticoagulant, creatinine, age, as well as first deep vein thrombosis data (distal/proximal, d-dimer, and time of anticoagulation). The results demonstrated that simple clinical parameters easy to be collected can be used to predict rates of recurrence and to develop new clinical decision support systems to predict the rates of RVTE.
Exploring the Spirit in U.S. Audiences: The Role of the Virtue of Transcendence in Inspiring Media Consumption
Authors: Janicke-Bowles Sophie H. , Raney Arthur A. , Oliver Mary Beth , Dale Katherine R. , Jones Robert P. , Cox Daniel
Published: December 2019

Little is yet known about audiences who routinely seek out media content that is inspirational in nature. The current study expands the research on inspirational media by utilizing a nationally representative sample of U.S. audiences ( n = 2,016) to explore relationships between inspiring media exposure, trait transcendence, and self-transcendent emotions. Results show that media content is a reliable source for everyday self-transcendent emotional experiences in U.S. audiences. These experiences are most frequently encountered by persons with high levels of trait spirituality and gratitude. The profile of U.S. audiences that seek out inspiring media is discussed.
Men’s perception of post-marriage body image: Pakistan milieu
Authors: Zubair Subaita , Ali Urwah
Published: December 2019

The present psychological anthropological study tends to explore the perception of single men and their understanding of cultural role regarding post-marriage body between both genders. A qualitative methodology of in-depth interviews and one focus group discussion were employed. The sample included late adolescents (aged 18–24) and early adults (24–34) from Islamabad and Rawalpindi (Pakistan). Purposive sampling was applied and thematic analysis was used as a qualitative paradigm. The number of respondents comprised of 17 males of which each 7 were gym-goers. Results highlighted that Pakistani culture has its biased and paradoxical ways when it comes to expectations genders face with regard to body after marriage. Overall, males have an upper hand when it comes to body image both pre and post marriage. With the female body, men associate modesty and role of spouse and with their own body its supremacy. Expectations are not much held for men with regard to body image, but if they are looking after their body, it is all out of their own will, needs, reason and to some extent on spouse demand.
‘Sociologists Shouldn’t Have to Study Statistics’: Epistemology and Anxiety of Statistics in Sociology Students
Authors: Ralston Kevin
Published: December 2019

Worry about learning maths and statistics has been widely researched internationally but very little of this work has focussed on sociology. It is well documented that sociology students can be reluctant to engage with statistical methods. This article provides an exploration of the relationship between anxiety of statistics and its antecedents in sociology students. The analyses presented are based upon data collected from over 30 universities in the UK and is the most comprehensive sample of its type. The primary aim of this article is to analyse whether the perceived epistemological legitimacy of statistics, among sociology students, is associated with reported statistics anxiety. The results show that epistemological legitimacy is highly associated with reported statistics anxiety. Confidence in maths is also strongly associated with statistics anxiety. The implications of acknowledging these and other pedagogical issues in teaching quantitative research methods are complex and layered. Measures capturing whether students accept the epistemological legitimacy of statistical methods should be routinely incorporated in research examining statistics anxiety.
Qualitative data analysis software as a tool for teaching analytic practice: Towards a theoretical framework for integrating QDAS into methods pedagogy
Authors: Schmieder Christian
Published: December 2019

Methods educators who include qualitative data analysis software (QDAS) in their teaching see the software as an opportunity to bring authentic experiences of analytic practice into classrooms. However, we currently lack a shared language for outlining and understanding what this analytic practice could or should entail. By expanding Silver and Woolf’s 5-Level QDAS® pedagogy, I introduce a theoretical framework of analytic practice with QDAS designed for methods educators to reflect on their curricula, and for academic leaders and administrators to reflect on their institutions’ overall educational ecologies regarding qualitative methods. Further, I illustrate how barriers to integrating QDAS reflect broader issues in qualitative methods education, specifically regarding analysis training and apprenticeship. Given these barriers, I suggest that discussions of the positive or negative impacts of QDAS should focus less on the users and the software itself, and instead more on the way we teach, or fail to teach the practice of qualitative analysis.
Combined but not single treatment with ethinylestradiol/levonorgestrel and spironolactone reduces plasminogen activator inhibitor-1 in insulin-resistant ovariectomised rats
Authors: Aremu Adeyanju Oluwaseun , Lilian Dibia Chinaza , Olufemi Soladoye Ayodele , Aderemi Olatunji Lawrence
Published: December 2019

Objective:

Increased circulating level of plasminogen activator inhibitor-1 (PAI-1) is associated with menopausal oestrogen deficiency. We therefore hypothesised that the combined oral contraceptive (COC) with spironolactone (SPL) improves insulin resistance (IR) in ovariectomised (OVX) rats by reducing circulating PAI-1.

Methods:

Twelve-week-old female Wistar rats were divided into sham-operated (SHM), OVX, OVX+SPL (0.25 mg/kg), COC (1.0 µg ethinylestradiol and 5.0 µg levonorgestrel) and OVX+COC+SPL rats treated with COC and SPL daily for eight weeks. IR was assessed by homeostatic model assessment of IR (HOMA-IR).

Results:

Data showed that OVX rats had a higher HOMA-IR value that is associated with increased visceral adiposity, triglycerides (TG), total cholesterol/high-density lipoprotein cholesterol (HDL-C), TG/HDL-C, plasma insulin, GSK-3, corticosterone and decreased 17β-oestradiol. However, these effects were attenuated in OVX+COC, OVX+SPL and OVX+COC+SPL rats compared to OVX rats. OVX rats had lower PAI-1 than SHM rats, whereas the beneficial effect on IR and other parameters by COC or SPL was accompanied with increased PAI-1. Improvement of IR and other parameters with combined COC and SPL in OVX rats was accompanied with reduced PAI-1.

Conclusion:

Taken together, COC or SPL improves IR independent of PAI-1, whereas a combination of COC and SPL in OVX rats ameliorates IR in a PAI-1-dependent manner.
No Further Action: Contextualising Social Care Decisions for Children Victimised in Extra-Familial Settings
Authors: Lloyd Jenny , Firmin Carlene
Published: December 2019

England’s child protection system is intended to safeguard young people at risk of significant harm – physical, sexual, emotional abuse and neglect. When young people are physically assaulted, stabbed or groomed into drugs trafficking they experience significant harm. To this extent they are entitled to support from statutory child protection services. Using findings from one component of a mixed method multi-site study, data from referrals and assessments into children’s social care is examined to identify the extent to which the right support and protection is realised. Such analysis indicates that despite being at risk of significant harm, young people abused in community or peer, rather than familial, settings will most likely receive a ‘no further action’ decision from social workers following referrals for support. This article suggests that to a certain extent no further action decisions are aligned to the legal and cultural parameters of social work and child protection practice, thus raising questions about the sufficiency of such for safeguarding young people abused in extra-familial settings.
The use of the Box–Behnken experimental design to model tensile strength of spunlaced fabrics and evaluating fabrics behaviour in acidic condition
Authors: Maduna Lebo , Patnaik Asis , Nayak Rajkishore
Published: December 2019

Determining the tensile strength of nonwoven fabrics is one of the important factors considered for operational performance of the fabrics, especially for fabrics that are exposed to acidic condition. Polyacrylonitrile (PAN), polyphenylene sulfide (PPS) and polyimide (PI) fibres are used to produce fabrics that can withstand harsh chemical condition and still possess the required tensile strength; however, over a period of time the tensile strength gradually decreases. The Box–Behnken design method results showed that it can model and describe the effects of process parameters on the tensile strength of spunlaced fabrics in both cross direction and machine direction. The contour plots’ results indicate that varying the fibres polyacrylonitrile (−1), polyphenylene sulfide (0) and polyphenylene sulphide/polyimide (1) from −1 to 1 increases the fabric tensile strength in both machine direction and cross direction. For water jet pressure 60 bar (−1), 80 bar (0) and 100 bar (1), increasing the pressure from −1 to 1 increases the fabric tensile strength in cross direction but in the machine direction the fabric strength decreases. Increasing the fabric area weight of 440 g/m2 (−1), 500 g/m2 (0) and 560 g/m2 (1) from −1 to 1 decreases the tensile strength. Exposing fabrics to sulphuric acid (H2SO4) decreases the fabric tensile strength in both machine direction and cross direction due to the degradation of the fibres and the loss decreases gradually with the duration of exposure. For PAN fabrics, the tensile strength decreases by 21% and that of PPS and PPS/PI fabrics decrease by 10% and 6%, respectively.
Influence and evaluation of array-nozzle geometry on near- field electrospinning direct writing
Authors: Zhang Jiarong , Wang Han , Wang Zhifeng , Yao Honghui , Xu Guojie , Yan Shengyong , Zeng Jun , Zhu Xiangyou , Deng Jiannan , Zhuo Shaomu , Zeng Jinghua
Published: December 2019

Near-field electrospinning direct writing of array-nozzle is an efficient method for preparing large-area aligned fibers. However, electric field between the array-nozzle interferes with the stability and uniformity of near-field electrospinning, and little research has been done in this field. To clarify the electric field interference generated by array-nozzle, the experimental results compared with the simulation are discussed. In this work, electric field interference between the five-nozzle linear arrangement near-field electrospinning process was demonstrated by the initial ejection behavior, the electric field distribution of near-field electrospinning environment and the deposition spacing of fibers. In addition, we developed a simple and flexible method serving as a quantitative evaluation index for evaluating the degree of electric field interference. Then, the mapping effects of electric field interference of nozzle structure on the surface morphology and uniformity of aligned fibers were studied, including the number of nozzle, nozzle spacing and nozzle length with linear and toothed arrangement. According to the result of experiment and characterization, suitable arrayed nozzle parameters for stably direct-write aligned array pattern with near-field electrospinning were available, whose geometric parameters are linear two-nozzle with a nozzle spacing of 2 mm and a nozzle length of 6.35 mm. Finally, on the basis of our previous research, a microfluidic channel was successfully prepared on polydimethylsiloxane by two-nozzle cooperation, which verified the rationality of the geometry.
The importance of being European: Airbus and West German industrial policy from the 1960s to the 1980s
Authors: Ahrens Ralf
Published: December 2019

Focusing on the time span from the 1960s to the late 1980s, that is, on the period during which Airbus established itself as a serious competitor on the world market, this article analyses the German aircraft industry’s interests, its representation within the transnational Airbus project, and the relevance of what might be called ‘Europeanness’. Occasionally also touching upon the situation in its partner countries, the central question is whether the respective political strategies of collaboration in the German aircraft industry were motivated by self-serving national interests or broader European ones. The article is divided into three sections. It begins by scrutinizing the motivations of German politics in the establishment and promotion of the Airbus project. Second, it deals with the representation of national interests in the allocation of production shares and the organization of cooperation, and, finally, with the European aspects of the massive subsidization of national manufacturers. It comes to the conclusion that the German case in particular illustrates that European collaboration in the aircraft sector was appreciated as an instrument to facilitate the survival of national industries pursuing their own business interests. The establishment of Airbus was supported as a European project to ensure the survival of the German aircraft industry and sometimes even as an instrument of business concentration. Nevertheless, notions about European integration or Franco-German friendship certainly increased the willingness to spend a lot of money on the Airbus project as the flagship of entanglement and interconnectedness in a ‘future industry’.
Intersection signal timing optimization considering the travel safety of the elderly
Authors: Ma Changxi , Liu Pengfei
Published: December 2019

With the rapid growth of the elderly population in China, the proportion of middle-aged and elderly pedestrians crossing streets at signalized intersections has been increasing gradually, mandating the consideration of the crossing characteristics and travel safety of the elderly in signal matching. This article proposes a new signal control parameter optimization method for intersections based on an improved genetic algorithm. According to the crossing characteristics and travel safety of the elderly, the average vehicle delay is used as the control objective, and the green signal ratio and cycle time are used as control variables. The improved genetic algorithm with an improved fitness calibration method and an adaptive cross-mutation function is used to solve the signal control model. Based on the optimization analysis of traffic signal control parameters at a traffic intersection, the study shows that the improved signal control method can effectively reduce the average vehicle delay compared to the Webster algorithm and the traditional genetic algorithm.
Sufferings in silence: Violence against female workers in the ready-made garment industry in Bangladesh: A qualitative exploration
Authors: Akhter Sadika , Rutherford Shannon , Chu Cordia
Published: December 2019

Introduction:

Despite the improved safety of the ready-made garment industry in Bangladesh since 2013, other workplace health and safety issues in the ready-made garment industry continue, especially violence towards female workers. This article examines this violence as well as the social norms and attitudes of key stakeholders underpinning it.

Methods:

Data were collected in four ready-made garment factories in Bangladesh through in-depth interviews, focus group discussions with female workers and key-informant interviews with different stakeholders, along with factory observations.

Results:

Findings were analysed thematically. Female workers described personal experience of violence in the workplace: physical and verbal abuse, constant pressure, other personal restrictions and withholding of pay. They did not make complaints for fear of losing their jobs. Supervisors characterized the women as ‘disobedient,’ ‘uncooperative’ and ‘unwilling’ to work and viewed their behaviour as acceptable. Other stakeholders ignored these problems.

Conclusion:

Finally, this study suggests how the findings encourage action to prevent violence in the workplace in order to address the emerging occupational health problems in Bangladesh.
Impact of an automatic hospital probiotic protocol on Clostridioides (Clostridium) difficile infection (CDI) rates and CDI antibiotic usage in a community hospital setting
Authors: Slain Douglas , Georgulis Amy , Dermitt Ron , Morris Laura , Colodny Stephen M
Published: December 2019

The aim of the present study was to see how widespread preventative use of the probiotic Saccharomyces boulardii via automatic protocol in hospitalised patients receiving antibacterials affected rates of hospital-associated Clostridioides ( Clostridium) difficile infection (HA-CDI). Rates of HA-CDI appeared to be similar between the pre-protocol and protocol periods. Use of CDI treatment antibiotics (oral metronidazole and oral vancomycin) was also similar. Laboratory-confirmed isolation of S. boulardii from sterile body sites was identified in five patients during the protocol versus only one case in the pre-protocol years.
Resisting Restless Protestant Religious Consumers in the Korean Burnout Society: Examining Korean Protestantism’s Rising Interest in Apophatic and Desert Spirituality
Authors: Cho Euiwan
Published: December 2019

Why have Korean Protestants been enthusiastic for Henri Nouwen, Thomas Merton, and Orthodox books in recent years? This article proposes that apophatic spirituality and desert asceticism, influential in both Catholic and Eastern Orthodox traditions, can help assuage the thirst of Korean Protestants exhausted by the excesses of positivity and the exploitation of self. I focus on the insatiable consuming passions of Korean Protestant religious consumerism as symptoms of the burnout society. I then explore the major contribution of apophatic spirituality and desert asceticism, which have much to teach contemporary Korean Protestantism.
Locating and Preserving the Sphenopalatine Ganglion in Endoscopic Endonasal Pterygopalatine Fossa Surgery: An Anatomical Study
Authors: Spielman Daniel B. , Kim Matthew , Overdevest Jonathan , Gudis David A.
Published: December 2019

Background

The pterygopalatine fossa (PPF) contains numerous important neurovascular structures; notably, the sphenopalatine ganglion (SPG), the maxillary branch of the trigeminal nerve (V2), and the internal maxillary artery. With the advent of extended endoscopic endonasal surgery, the surgical anatomy of the PPF warrants increased investigation. Intraoperative dissection and preservation of the SPG is essential to prevent postoperative xeropthalmia and facial hypoesthesia.

Objective

This study aims to (1) describe a novel dissection technique for identifying the SPG and (2) define the SPG location relative to the sphenopalatine foramen (SPF), which is a consistently identifiable landmark.

Methods

Eight cadaveric PPFs were dissected in step-wise fashion. An endoscopic medial maxillectomy was performed, the SPF was identified, and the posterior maxillary wall was resected. The maxillary branch of the trigeminal nerve (V2) was identified anterolaterally in its infraorbital canal and traced medially to identify the pterygopalatine nerve to the SPG. The lateral distance and superior/inferior distance from the SPG to the fixed SPF was measured.

Results

The surgical technique described allowed for reliable identification of the SPG. The SPG was located on average 4.5 ± 1.1 mm lateral and 1 ± 1.4 mm inferior to the SPF.

Conclusion

Identification and preservation of the SPG is necessary to prevent complications in endoscopic endonasal PPF surgery. The SPG can be reliably located near the SPF by following the pterygopalatine nerve branch of V2.
Monetised childhoods: Money and consumption among young weavers in Addis Ababa, Ethiopia
Authors: Taye Fasil Nigussie , Huijsmans Roy
Published: December 2019

In this article, we bring to the foreground an understudied dimension of working children’s lives in the Global South: their access to money and the consumption this facilitates. Drawing on life history interviews, we show that among the Gamo weavers of Ethiopia, the modern phenomenon of a monetised childhood is at least six decades old and an element of the informal apprenticeships through which Gamo children learn to weave. Qualitative research with young weavers shows that both girls and boys become involved in weaving. Yet the amount of senbeta misa money they receive differs substantially, fuelling distinctly different consumption practices and reinforcing broader gender relations. Zooming in on boys’ monetised leisure activities, we furthermore argue that through consumption belonging to age-based, ethnic peer groups is realised. Moreover, while the monetisation of leisure is shaped by globalisation and market forces, we show that boys and young men themselves also actively contribute to the monetisation of their leisure activities and thereby transform the nature of play.
Pulmonary vasodilation in acute pulmonary embolism – a systematic review
Authors: Lyhne Mads Dam , Kline Jeffrey Allen , Nielsen‐Kudsk Jens Erik , Andersen Asger
Published: December 2019

Acute pulmonary embolism is the third most common cause of cardiovascular death. Pulmonary embolism increases right ventricular afterload, which causes right ventricular failure, circulatory collapse and death. Most treatments focus on removal of the mechanical obstruction caused by the embolism, but pulmonary vasoconstriction is a significant contributor to the increased right ventricular afterload and is often left untreated. Pulmonary thromboembolism causes mechanical obstruction of the pulmonary vasculature coupled with a complex interaction between humoral factors from the activated platelets, endothelial effects, reflexes and hypoxia to cause pulmonary vasoconstriction that worsens right ventricular afterload. Vasoconstrictors include serotonin, thromboxane, prostaglandins and endothelins, counterbalanced by vasodilators such as nitric oxide and prostacyclins. Exogenous administration of pulmonary vasodilators in acute pulmonary embolism seems attractive but all come with a risk of systemic vasodilation or worsening of pulmonary ventilation‐perfusion mismatch. In animal models of acute pulmonary embolism, modulators of the nitric oxide‐cyclic guanosine monophosphate‐protein kinase G pathway, endothelin pathway and prostaglandin pathway have been investigated. But only a small number of clinical case reports and prospective clinical trials exist. The aim of this review is to give an overview of the causes of pulmonary embolism‐induced pulmonary vasoconstriction and of experimental and human investigations of pulmonary vasodilation in acute pulmonary embolism.
First steps towards combining faecal immunochemical testing with the gut microbiome in colorectal cancer screening
Authors: Grobbee Esmée J , Lam Suk Yee , Fuhler Gwenny M , Blakaj Blerdi , Konstantinov Sergey R , Bruno Marco J , Peppelenbosch Maikel P , Kuipers Ernst J , Spaander Manon CW
Published: December 2019

Objectives

Many countries use faecal immunochemical testing (FIT) to screen for colorectal cancer. There is increasing evidence that faecal microbiota play a crucial role in colorectal cancer carcinogenesis. We assessed the possibility of measuring faecal microbial features in FIT as potential future biomarkers in colorectal cancer screening.

Methods

Bacterial stability over time and the possibility of bacterial contamination were evaluated using quantitative polymerase chain reaction analysis. Positive FIT samples (n  = 200) of an average‐risk screening cohort were subsequently analysed for universal 16S, and bacteria. Escherichia coli (E. coli), Fusobacterium nucleatum (F. nucleatum), Bacteroidetes and Faecalibacterium prausnitzii (F. prausnitzii) by qPCR. The results were compared with colonoscopy findings.

Results

Faecal microbiota in FIT were stably measured up to six days for E. coli (p  = 0.53), F. nucleatum (p  = 0.30), Bacteroidetes (p = 0.05) and F. prausnitzii (p  = 0.62). Overall presence of bacterial contamination in FIT controls was low. Total bacterial load (i.e. 16S) was significantly higher in patients with colorectal cancer and high‐grade dysplasia (p  = 0.006). For the individual bacteria tested, no association was found with colonic lesions.

Conclusions

These results show that the faecal microbial content can be measured in FIT samples and remains stable for six days. Total bacterial load was higher in colorectal cancer and high‐grade dysplasia. These results pave the way for further research to determine the potential role of microbiota assessment in FIT screening.
Myanmar’s military and the garrison state: State-military relations in Myanmar and their influence in the [re]production of violence against minorities
Authors: Biswas Niloy Ranjan
Published: December 2019

The article examines the relationship between the state and military in Myanmar to understand the country’s policies regarding persecution of religious and ethnic minorities in the context of the Rohingya population of Arakan. The article applies the idea of the garrison state, a concept originally developed by Harold J Lasswell. It applies a process-tracing approach to understand the relations between the state and military of Myanmar, by examining primary documents and secondary literature on the subject. The article argues that Myanmar is a state which is compulsively concerned about perceived threats to its sovereignty. This real or imagined anxiety translates into cultural, social and economic attributes, and its policies to [re]produce violence against the Rohingya minorities of Arakan. These features endorse the idea that militarism is habitually developed by a garrison state, such as Myanmar, which is reflected in the policies of citizenship and the construction of minorities. Therefore, violence becomes a continuous tool that is applied by the state, particularly against the peripheral minorities and other marginalised groups.
Imaging of penetrating thoracic trauma in a large Nordic trauma center
Authors: Nummela Mari T , Thorisdottir Sigurveig , Oladottir Gudrun L , Koskinen Seppo K
Published: December 2019

Background

Penetrating trauma is rarely encountered in Nordic trauma centers, yet the incidence is increasing. Typical imaging findings in penetrating trauma should thus be familiar to all radiologists.

Purpose

To evaluate incidence and imaging findings of penetrating chest trauma, gunshot wound (GSW) and stab wound (SW) injury spectrum, imaging protocols, and outcome in a large trauma center.

Material and Methods

Trauma registry data from 2013–2016 was retrieved, and imaging accessed through hospital PACS. Retrieved variables included age, gender, injury severity scores, mechanism of injury, time to CT, and 30-day mortality. Depth of thoracic, pulmonary, abdominal and skeletal injury, active bleeding, and use of chest tubes were evaluated.

Results

Of 636 patients with penetrating injuries, 443 (69.7%) underwent imaging. Of these, 161 (36.3%) had penetrating thoracic injuries. Of 161 patients with penetrating chest trauma in imaging, 151 (93.8%) were men (mean age = 34.9 years) and 10 (6.2%) were women (mean age = 40.7 years). The majority of patients had SWs (138 SW vs. 15 GSW). Patients with GSWs were more severely injured (mean ISS 17.00 vs. 8.84 [ P=0.0014] and ISS≥16 in 53.3% vs. 16.7%) than SW patients. In CT, intrathoracic injuries were found in 49.4% (77/156) and active bleeding in 26.3% (41/156). Emergency surgery was performed in 6.2% (10/161) with postoperative CT imaging. Thirty-day mortality rate was 1.2% (2/161).

Conclusion

Penetrating thoracic trauma often violates intrathoracic structures and nearby compartments. Arterial phase whole-body CT is recommended as multiple injuries and active bleeding are common. CT after emergency surgery is warranted, especially to assess injuries outside the surgical field.
Factors Associated With Disability Self-Disclosure to Their Professors Among College Students With Disabilities
Authors: Mamboleo George , Dong Shengli , Fais Connor
Published: December 2019

This study examined factors associated with disability disclosure to professors among students with disabilities ( n = 289) who either registered or did not register with disability support services (DSS) in postsecondary education from six public colleges and universities located in a Mid-Atlantic U.S. state. Past experience in requesting accommodations and perceptions of faculty’s willingness to provide accommodations were correlated with willingness to disclose disability. Multiple regression results revealed that gender, grade level, and past experience in requesting accommodations predicted students’ willingness to disclose their disabilities. Implications for counselors and transition educators working with students with disabilities are discussed, along with recommendations for future research.
Epidemiology, Injury Patterns, and Treatment of Meniscal Tears in Pediatric Patients: A 16-Year Experience of a Single Center
Authors: Jackson Taylor , Fabricant Peter D. , Beck Nicholas , Storey Eileen , Patel Neeraj M. , Ganley Theodore J.
Published: December 2019

Background:

Meniscal injuries in children continue to increase, which may be attributable to increasing levels of athletic participation and may be associated with additional injuries or need for additional surgeries.

Purpose:

To better understand the patterns of pediatric meniscal injuries by analyzing tear location, morphologic features, and associated injury patterns over a 16-year period.

Study Design:

Case series; Level of evidence, 4.

Methods:

Pediatric patients were identified and were included in the study if age at the time of initial surgery for meniscal tear was between 5 and 14 years for female patients and 5 and 16 years for male patients. Patients were observed until age 18, and any subsequent surgeries were noted. Demographic factors, tear type and location, associated injuries, and treatment type were analyzed.

Results:

Mean patient age at surgery was 13.3 years, and 37% of patients were female. A total of 1040 arthroscopic meniscal surgeries in 880 pediatric patients were evaluated. There were 160 reoperations in 138 patients, representing a reoperation rate of 15%. These included 98 reoperations on the ipsilateral knee in 88 patients and 62 operations for injuries to the contralateral knee in 50 patients; 53% of surgeries were meniscal repair, as opposed to partial meniscectomy, and the most common technique was an all-inside repair (91%). Significant differences were identified between male and female patients. Male patients were more likely to have lateral meniscus (74% vs 65%), posterior horn (71% vs 60%), peripheral (45% vs 30%), and vertical tears (31% vs 21%); concomitant ACL injury (50% vs 40%); and an associated osteochondritis dissecans lesion (7% vs 4%). Female patients were more likely to have medial meniscus (24% vs 17%), anterior horn (25% vs 15%), and degenerative tears (34% vs 26%); discoid meniscus (33% vs 24%); and isolated meniscal tears (47% vs 33%).

Conclusion:

This evaluation of a large series of patients has helped characterize injury patterns associated with pediatric meniscal surgeries. Most meniscal tears were repaired (53%) and were associated with additional injuries (62%), especially anterior cruciate ligament injuries (48%). More than 25% of patients had a discoid meniscus. Injury patterns differed significantly between male and female patients.
DACA and the Supreme Court: How We Got to This Point, a Statistical Profile of Who Is Affected, and What the Future May Hold for DACA Beneficiaries
Authors: Alulema Daniela
Published: December 2019

Executive Summary

In June 2012, the Obama administration announced the establishment of the Deferred Action for Childhood Arrivals (DACA) program, which sought to provide work authorization and a temporary reprieve from deportation to eligible undocumented young immigrants who had arrived in the United States as minors. Hundreds of thousands of youth applied for the program, which required providing extensive evidence of identity, age, residence, education, and good moral character. The program allowed its recipients to pursue higher education, to access more and better job opportunities, and to deepen their social ties in the United States. This article provides a statistical portrait of DACA recipients based on administrative data from US Citizenship and Immigration Services (USCIS) and estimates drawn from the 2017 American Community Survey (ACS) Census data. It finds the following: As of September 30, 2019, there were 652,880 active DACA recipients. Sixty-six percent of recipients are between the ages of 21 and 30. The top five countries of birth for DACA recipients are Mexico (80 percent), El Salvador (4 percent), Guatemala (3 percent), Honduras (2 percent), and Peru (1 percent). DACA recipients reside in all 50 states and Washington, DC, and in US territories including Puerto Rico, Guam, and the Virgin Islands. The top five states with the highest number of DACA recipients are California (29 percent), Texas (17 percent), Illinois (5 percent), New York (4 percent), and Florida (4 percent). Eighty-one percent of DACA recipients has lived in the United States for more than 15 years. Six percent is married to US citizens, 4 percent to lawful permanent residents (LPRs), and 13 percent to undocumented immigrants. Among US-born children younger than 18 years, 346,455 have at least one DACA parent. Fifty-five percent of DACA recipients graduated from high school, 36 percent has some college education, and 7 percent a bachelor’s degree or higher. Ninety-five percent is employed. The Trump administration rescinded the DACA program in September 2017, leaving recipients and their families in a legal limbo. Federal litigation led to a nationwide preliminary injunction and DACA’s partial reinstatement for existing recipients. At this writing, the case is before the US Supreme Court, which will determine the program’s fate. Beyond its statistical portrait, the article provides testimonies from DACA recipients who recount how the program improved their lives and their concerns over its possible termination. It also provides recommendations for Congress, local and state governments, and immigration advocates. In particular, it recommends passage of legislation that would create a path to citizenship for DACA recipients and programs and policies to support and empower young immigrants.
“At 80 I Know Myself”: Embodied Learning and Older Adults’ Experiences of Polypharmacy and Perceptions of Deprescribing
Authors: Ross Alison , Gillett James
Published: December 2019

In response to the risks of polypharmacy for older adults, there are increasing calls for the development and implementation of deprescribing programs. This article examines the forms of expertise that inform older adults’ decisions about how to use medications given concerns over polypharmacy and a clinical focus on deprescribing. In-depth interviews with older adults found that diverse knowledge sources underpin decisions regarding polypharmacy and deprescribing. Findings indicate that this knowledge is formed through a lifetime of embodied learning—the production of relevant knowledge through lived experiences of the body. By way of this embodied learning, older adults possess individualized knowledge bases that inform health and health care decisions, especially regarding the use of medications. If deprescribing programs are to be embedded into standard preventive medical care of older adults, then it is valuable for health care providers to be aware of and take seriously the contribution of embodied knowledge.
Simple Test, Complex System: Multifaceted Views of Newborn Screening Science, Technology, and Policy
Authors: Chan Kee , Petros Michael
Published: December 2019

Newborn screening (NBS) is a public health service provided for all babies born in the United States and in most countries of the developed world. A series of tests are applied to the blood taken from newborn babies to detect genetic and metabolic disorders that can be treated if identified early. With early treatment and therapy, the affected babies can usually live a normal, healthy life. Timing for sampling, testing, and reporting is vital for NBS to function as an effective system. In order to be an effective system, the evolution of science, technology, and policy gradually had to come into a synchronous partnership, where the discovery of new genetic disorders led to timely development of technology for screening, which is supported by policy and implemented into practice. The timely “dance” of these partnerships in an era of personalized health and medicine forms the integrated approach supporting NBS. This review will include a brief history of scientific development, policymaking, and the economic consideration in the expansion of the NBS.
Gastrointestinal involvement in systemic sclerosis: Effects on morbidity and mortality and new therapeutic approaches
Authors: Hoffmann-Vold Anna-Maria , Volkmann Elizabeth R.
Published: December 2019

The majority of research studies in systemic sclerosis focus largely on addressing skin and cardiopulmonary manifestations. Fewer studies assess the pathogenesis and treatment of gastrointestinal tract involvement in systemic sclerosis, despite the fact that the majority of patients with systemic sclerosis have gastrointestinal manifestations and these manifestations are a leading cause of death in systemic sclerosis. The present review provides a comprehensive update on morbidity and mortality outcomes related to gastrointestinal involvement in systemic sclerosis. This review also describes conventional and emerging approaches to managing gastrointestinal symptoms in systemic sclerosis. Recent developments in systemic sclerosis–gastrointestinal research efforts have revealed promising treatment targets, including specific auto-antibodies and microbiota alterations. This review will conclude with an overview of future research directions that may improve our understanding of systemic sclerosis–gastrointestinal involvement and ultimately help to alleviate suffering from this devastating dimension of systemic sclerosis.
Systematic Review of Stress Radiographic Modalities Stability Assessment in Supination External Rotation Ankle Fractures
Authors: Yousaf Sohail , Saleh Alan , Ahluwalia Aashish , Haleem Shahnawaz , Hayat Zara , Ramesh Palanisamy
Published: December 2019

Background:

Isolated distal fibular fractures resulting from supination external rotation (SER) injuries without evidence of obvious talar shift on standard radiographs present a diagnostic dilemma for clinicians. The status of the deep deltoid ligament, the main stabilizer of the ankle joint, is assessed by an increase in medial clear space (MCS) on radiographs. Therefore, these injuries can be either stable or unstable. In recent years, considerable clinical and research efforts have been made to determine ankle stability following SER fracture. The purpose of this systematic review was to evaluate and compare the role of different stress radiograph modalities in assessing stability of the ankle with SER fractures with no obvious talar subluxation on standard radiographs.

Methods:

The electronic databases MEDLINE, EMBASE, Ovid, Cochrane Central, CINAHL, and Google Scholar were searched from January 2000 to January 2018 to identify literature relating to radiologic assessment of stability of SER ankle fractures.

Results:

Our literature search revealed 10 peer-reviewed articles that fulfilled inclusion criteria. This yielded a total of 698 patients. The systematic review found 3 broad categories of radiographic investigations in the assessment of ankle joint stability: external rotation (ER) stress radiographs, gravity stress views (GSV), and weightbearing (WB) radiographs. Proponents of WB radiographs have demonstrated how axial load can normalize ankle joint alignment in cases of proven instability. There was a consistently high grade of evidence for using a medial clear space (MCS) value of more than 4 to 5 mm to indicate an unstable ankle following SER fracture.

Conclusion:

In conclusion, the results of this systematic review support an MCS value of less than 4 to 5 mm as a good indicator of stability, regardless of choice of stress imaging modality. These patients can be allowed early weightbearing with expected good functional outcomes. Recent published literature favors WB stress radiographs as a reliable and safe technique for assessing stability in SER ankle fractures. However, it should be kept in mind that this is based on studies with relatively low grades of evidence.

Level of Evidence:

Level II, systematic review of variable quality studies.
Normative data for multiple breath washout outcomes in school-aged Caucasian children
Authors: Anagnostopoulou Pinelopi , Latzin Philipp , Jensen Renee , Stahl Mirjam , Harper Alana , Yammine Sophie , Usemann Jakob , Foong Rachel E. , Spycher Ben , Hall Graham L. , Singer Florian , Stanojevic Sanja , Mall Marcus A. , Ratjen Felix , Ramsey Kathryn A.
Published: December 2019

Background

The multiple breath nitrogen washout (N2MBW) technique is increasingly used to assess the degree of ventilation inhomogeneity in school-aged children with lung disease. However, reference values for healthy children are currently not available. The aim of this study was to generate reference values for N2MBW outcomes in a cohort of healthy Caucasian school-aged children.

Methods

N2MBW data from healthy Caucasian school-age children between 6 and 18 years old were collected from four experienced centres. Measurements were performed using an ultrasonic flowmeter (Exhalyzer D, Eco Medics AG, Duernten, Switzerland) and were analysed with commercial software (Spiroware version 3.2.1, Eco Medics AG). Normative values and upper limits of normal (ULN) were generated for lung clearance index (LCI) at 2.5% (LCI2.5%) and at 5% (LCI5%) of the initial nitrogen concentration and for moment ratios (M1/M0and M2/M0). A prediction equation was generated for functional residual capacity (FRC).

Results

Analysis used 485 trials from 180 healthy Caucasian children aged from 6 to 18 years old. While LCI increased with age, this increase was negligible (0.04 units·year–1for LCI2.5%) and therefore fixed ULN were defined for this age group. These limits were 7.91 for LCI2.5%, 5.73 for LCI5%, 1.75 for M1/M0and 6.15 for M2/M0, respectively. Height and weight were found to be independent predictors of FRC.

Conclusion

We report reference values for N2MBW outcomes measured on a commercially available ultrasonic flowmeter device (Exhalyzer D, Eco Medics AG) in healthy school-aged children to allow accurate interpretation of ventilation distribution outcomes and FRC in children with lung disease.