bluuebunny/crossref_metadata_2025 huggingface dataset:
Conceptual design study of a geared turbofan and an open rotor aero engine with intercooled recuperated core
Authors: Salpingidou C , Misirlis D , Vlahostergios Z , Flouros M , Donus F , Yakinthos K
Published: April 2018

The development of more efficient aero engines is becoming a matter of great importance due to the need for pollutant emissions reduction (e.g. CO2, NOx). Toward this direction, two of the most promising aero engine architectures that have been proposed are the ultrahigh by-pass geared turbofan and the open rotor configurations, both of which are targeting the low thrust-specific fuel consumption and reduced NOx production. In the current study, investigations are performed in order to determine the improvements in thrust-specific fuel consumption for these configurations. More specifically, on the basic geared turbofan and open rotor configurations an intercooler and a recuperator are implemented between the compressors and the exhaust nozzle, respectively. The intercooler is installed in order to reduce the high pressure compressor work demand, while the recuperator is used in order to preheat the compressor discharge air by exploiting the otherwise wasted increased enthalpy content of the exhaust hot gas. The recuperator consists of elliptically profiled tubes and its design is based on the innovative tubular heat exchanger core arrangement that has been invented and developed by MTU Aero engines AG. The intercooled recuperative geared turbofan is evaluated against a nonintercooled recuperative geared turbofan, while the intercooled recuperative open rotor is evaluated against a nonintercooled recuperative open rotor. The results showed that the implementation of intercoolers and recuperators can further improve specific fuel consumption and can also lead to NOx emission reduction.
Seeing information: Visual methods as entry points to information practices
Authors: Hicks Alison , Lloyd Annemaree
Published: April 2018

Recognising the importance of exploring multimodal experiences of information, this paper provides a detailed examination of the scope of visual research methods within information practices research. More specifically, the paper will use the examples from one completed study (Lloyd and Wilkinson, 2017) and one ongoing study (Hicks, in progress) to discuss and provide a detailed examination of the use, affordances and limitations of two research methods that centre upon participant-created photographs: photo-elicitation and photovoice. Demonstrating that the use of photographs helps to evoke and communicate complex meaning as well as to mediate between linguistic, temporal and spatial constraints, this study highlights the continuing need to develop research methods that privilege participants’ understandings and perspectives.
Textbook descriptions of people with psychosis – some ethical aspects
Authors: Fredwall Terje Emil , Larsen Inger Beate
Published: April 2018

Background:

Textbooks are central for the education of professionals in the health field and a resource for practitioners already in the field.

Objectives:

This article focuses on how 12 textbooks in psychiatric nursing and psychiatry, published in Norway between 1877 and 2012, describe and present people with psychosis.

Research design:

We used qualitative content analysis.

Ethical considerations:

The topic is published textbooks, made available to be read by students, teachers and professionals, and no ethical approval was required.

Findings:

The analysis shows that all 12 textbooks describe and present people who are considered as psychotic from a ‘perspective from above’. In this perspective, the readers are learning about psychosis in the professional’s language and from the author’s viewpoint. Most often the textbooks communicate a universal image of people with psychosis, a description that fits with the diagnostic criteria. The analysis also shows that two textbooks in psychiatric nursing combined this perspective with a ‘perspective from within’. Here, the readers are learning about psychosis from the patients’ own viewpoint. The authors communicate a personal, psychotic universe that differs from various people, even if they have the same diagnosis, and the descriptions are focusing on the patient as a whole person.

Discussion and conclusion:

Drawing partly on Rita Charon’s writings about narrative knowledge in the health field, and partly on insights from Martha Nussbaum and her concept of narrative imagination, we argue that mental health professionals need to learn about, understand and fathom what patients go through by reading, listening to and acknowledging the patients’ own stories and experiences. Cultivating the capacity for empathy and compassion are at the very heart of moral performance in the mental health field. A valuable moral resource in that regard is leading textbooks and how they describe and present people with severe mental illness.
Test of Five-factor Asset Pricing Model in India
Authors: Balakrishnan A. , Maiti Moinak , Panda Pradiptarathi
Published: April 2018

In this article, we examine whether stock returns are related with important firm characteristics and fundamentals such as size, value, profitability and investment. We also evaluate whether the existing asset pricing models of Fama–French three-factor (FFTF) model and Fama–French five-factor model can capture the average returns on portfolios constructed based on the above characteristics and fundamentals. We find from the results that average return pattern clearly shows that Indian stock market is strongly influenced by the factors mentioned above. Asset pricing results also shed light that FFTF model clings on to its efficiency at capturing the average returns on portfolios, while Fama–French five-factor model does a plausible job.
Old Market Square as a Container of Diasporic Meaning in Chinese Kuala Lumpur
Authors: Peng Ng Foong , Ng Ian A. S.
Published: April 2018

Urban growth in the twentieth century engulfed many cultural enclaves and led to threatened histories, communities and cultural practices of places. One such spatial context within the urban space of cities is the diasporic space of the Chinese, often named Chinatown. Petaling Street has been commonly perceived as the microcosm of the Chinese diaspora in Kuala Lumpur with Yap Ah Loy the figure who catalyzed its urban growth that resulted in the fabrication of a sense of belonging and a sense of home for the Chinese diaspora. This paper argues that while discourses on the Chinese diaspora have been centred on the street as a diasporic space it is Market Square (Medan Pasar), the foci of Chinese diasporic development during the historical period of Yap Ah Loy, that offers a more critical perspective. It first examines how the Chinese diaspora constructed the street and the square in Old Kuala Lumpur, and looks at the question, ‘In what sense do they still own them?’ By focusing the discourse on the context of the square in more detail, through historical narrative and spatial analysis, it then highlights the fact that the discourse extends beyond the street. It contends that urban patterns such as the square act as a critical text for unfolding the varying issues of diasporic space within enclaves that are not only contested but record the erosion of culture.
Gendered Migrations and Literary Narratives: Writing Communities in South Asian Diaspora
Authors: Suman
Published: April 2018

Migrations are gendered journeys. During contemporary times when migrations happen due to personal reasons like pursuit of better job opportunities, the spouses, mostly women, face several challenges in finding jobs and sustaining a career. Many of these qualified women often turn to alternate means of finding identity and fulfilment. Writing is one activity that provides them with this sense of purpose and achievement. The personal act of writing a literary text becomes as much a social activity when few of them form writing communities. This socio-literary study begins with an analysis of the social and material conditions that foster gendered migrations, and goes on to analyse writing as an alternate career, the role these gendered writing communities play in the process of writing, publishing and marketing as well as the choice of certain topics, like romance, thus functioning as mini-publishing houses. Through detailed interviews of five women writers of South Asian origin, this paper posits that these popular narratives, the products of these writing communities, are very temporal in nature and a product of interesting intersections between migrations as a condition and the gendered communities.
Book review: Marie J. Ainslie and Joan B. Y. Lim (Eds.). 2015. Korean Wave in Southeast Asia: Consumption and Cultural Production.
Authors: Fatema-Tuj-Juhra
Published: April 2018

Marie J. Ainslie and Joan B. Y. Lim (Eds.). 2015. Korean Wave in South-east Asia: Consumption and Cultural Production. Petaling Jaya, Malaysia: Strategic Information and Research Development Centre. ISBN:978-9670630472.
Evaluating practice strategies, behavior and learning progress in elite performers: An exploratory study
Authors: Mornell Adina , Osborne Margaret S. , McPherson Gary E.
Published: April 2018

Typical musicians devote most of their time to blocks of physical practice and mistake-avoidance, as opposed to mental preparation, desirable difficulties, and strategies that strengthen self-efficacy and autonomy. For this reason, teachers try to steer students away from mindless drill and towards self-regulated learning strategies. Yet, both the scientific and pedagogical literature lack guidelines for developing musicians that are supported by empirical research. This exploratory study with 14 musicians was designed to capture what they planned to practice, as well as what they actually did in the practice room, in order to assess the level of repetition and innovation intended and carried out. A questionnaire captured the musician’s self-reported intentions (cognitions), behavior, and emotions during practice. The questionnaire accompanied a self-recorded video of a practice session of the participant’s choice. Evaluation of the questionnaire and videos provided evidence that participant’s own ratings of the effectiveness of their practice supported their belief in the importance of repetition. The evaluation scores of these students’ practice sessions by two independent raters, in contrast, indicated that varied strategies were more beneficial with regard to individual progress than habitual repetition.
A History of EI/ECSE in the United States: A Personal Perspective
Authors: Bricker Diane , Xie Huichao , Bohjanen Sharon
Published: April 2018

This article offers a view of the evolution of Early Intervention/Early Childhood Special Education (EI/ECSE) in the United States. This view of the field’s growth and change over time reflects the personal memories, experiences, and perspectives of Diane Bricker, who reviews the evolutionary changes in EI/ECSE based on her experiences with a range of theorists, scientists, and clinicians who affected the EI/ECSE profession both directly and indirectly. The challenge of succinctly summarizing the history of EI/ECSE required Bricker to make many difficult choices and prohibited recognizing many important contributors and events over the years. The following narrative of her presentation provides a powerful backdrop for the future of the field.
A Culture of Hostility and Crime Motivated by Bias: A Cross-National Multilevel Analysis of Structural Influences
Authors: Piatkowska Sylwia J. , Hövermann Andreas
Published: April 2018

This study examines the impact of macrolevel indicators of social environment on officially recorded crime motivated by racial bias and xenophobia across 44 regions in 7 European nations between 2002 and 2011. In doing so, we estimate multilevel Poisson regression growth models where time is nested within subnational units, which avoids direct comparison of biased crime across different nations. We test the utility of various theoretical frameworks that have proven to be of relevance in explaining crime motivated by bias. The results reveal that the role of a hostile social climate is of particular interest, as xenophobic and racially motivated crimes are higher in regions with higher levels of anti-immigrant sentiment and higher levels of ethnic discrimination, in line with the “Doing Difference” approach developed by Perry. Consistent with the Power-Differential Hypothesis and Group Contact Theory, xenophobic and racially motivated crime rates are negatively associated with the percentage of the foreign-born population. Finally, the results reveal that xenophobic and racially motivated crime rates are higher in regions with lower levels of social integration, which is congruent with social disorganization theory. We conclude with a discussion of the effects of social climate on crime motivated by bias.
Program Evaluation in Doctoral-Level Counselor Education Preparation
Authors: Sink Christopher A. , Lemich Gregory
Published: April 2018

Within the context of intentional collaboration between doctoral-level program evaluation and counselor educators, this article addresses the need for advanced training in program evaluation for preservice doctoral-level counselor education (CE) students. To determine the current level of evaluation training provided to doctoral students attending a nationally accredited CE program, 81 institutions and their program websites and accompanying materials were analyzed. Approximately 25% of these graduate programs appeared to provide a modest level of training. Over 50% of these units did not fully identify what program evaluation preparation was required or offered to students. Recommendations to enhance the program evaluation component of counselor educator training are offered. To assist program evaluation and counselor educators to restructure training, an instructional planning and implementation tool (Program Evaluation Competency Matrix) is provided.
Systemic Monotherapy Treatments for Generalized Pustular Psoriasis: A Systematic Review
Authors: Zhou Linghong Linda , Georgakopoulos Jorge R. , Ighani Arvin , Yeung Jensen
Published: April 2018

Generalized pustular psoriasis (GPP) is a rare but serious and difficult to treat cutaneous disease, with high morbidity and mortality rates. Despite the numerous treatment regimens available, the overall quality of evidence-based research is limited with a lack of an algorithmic approach available. In this review, we aim to evaluate the current level of evidence regarding the efficacy and safety/tolerability of systemic monotherapies available in the treatment of GPP. A comprehensive MEDLINE, EMBASE, and PubMed search of clinical studies examining systemic monotherapy treatment options for GPP was conducted. In total, 31 studies met eligibility criteria. Described treatment modalities included retinoids, cyclosporine, biologics, and dapsone. Despite the lack of high-quality evidence or a well-accepted treatment algorithm for GPP, systemic retinoids, cyclosporine, biologics, and dapsone are all possible first-line agents, with retinoids being one of the best-supported treatment options and biologics as an emerging therapeutic field with great potential requiring additional data. However, the final choice of treatment should be considered within the unique context of each patient.
Bright young women, sick of swimmin’, ready to … consume? The construction of postfeminist femininity in Disney’s The Little Mermaid
Authors: Frasl Beatrice
Published: April 2018

This study assesses how Disney’s The Little Mermaid can be read as a ‘postfeminist text’. It uses Gill’s concept of ‘postfeminist sensibility’ and McRobbie’s understanding of postfeminism as a ‘double entanglement’ of feminist and antifeminist discourses in analysing the text. Furthermore it aims at contributing to the understanding of postfeminism as a pop cultural discursive mode by focusing on the ways heteronormativity structures and presupposes it. In this sense, this reading of The Little Mermaid can be understood as a case study on the heteronormativity of postfeminist discourses and representations.
How conservation matters: Ethnographic explorations of historic building renovation
Authors: Yarrow Thomas
Published: April 2018

This article focuses on ideas of historic conservation, examining the multiple ways in which these are made to matter through practices of renovation. Bypassing normatively inflected literatures on heritage, the author adopts a more ‘agnostic’ ethnographic approach, highlighting how conservation involves an imperative of continuity that is elaborated in a multiplicity of ways by conservation and construction professionals, and inhabitants of old buildings. This focus brings to light a series of dynamics that have received limited attention, demonstrating how conservation is practically substantiated in a range of ways including materially, bodily, emotionally, ethically and conceptually.
Following Policy: A Network Ethnography of the UK Character Education Policy Community
Authors: Allen Kim , Bull Anna
Published: April 2018

Over the past 15 years, there has been a growing interest and investment in ‘character’ education across the UK political landscape. Alongside the activities of central government, character education has been promoted by a range of non-government actors in the UK and beyond, including philanthropic foundations, think tanks, education entrepreneurs, and academics. It is the presence of these actors and their relationship to, and influence on, UK government policy that we examine in this article. Investigating character education from a perspective of policy formation and influence, we trace the key policy actors who have contributed to the adoption of character education in the UK, and their international connections, identifying the resources, activities and relationships through which they have achieved policy influence. A central and original contribution of this article is in identifying the financial and ideological influence of US Christian neoconservative philanthropic foundation the John Templeton Foundation on social science research and policy in the UK. Our analysis identifies academics in the UK and US who, through considerable John Templeton Foundation funding, have provided an evidence base that authorises character education as a policy solution. We also locate ‘policy entrepreneurs’ as key nodal actors, whose social capital and elite membership helps to lubricate network relations and facilitate policy influence. Finally, we consider the motivations and vested interests of policy actors, including the John Templeton Foundation’s particular model of philanthropy, and conclude that the character education agenda is underpinned by a set of ideas that promote a free-market, individualistic and socially conservative worldview.
The Return of Character: Parallels Between Late-Victorian and Twenty-First Century Discourses
Authors: Taylor Nick
Published: April 2018

There has been an increasingly common trend in the UK to identify character skills and traits as the basis for various individual successes and achievements. In education policy and employment services, character has been linked to the making of successful, morally aware, employable and socially mobile citizens. This article explores the late-19th-century use of character discourses, focusing on the economist Alfred Marshall. During this period character was associated with future-oriented subjects – those displaying provident and thrifty habits and dispositions – and held particular class, race, and gender prejudices. The article draws parallels between this late-Victorian approach to character and the ‘return’ of character in 21st-century education and welfare-to-work policy, in particular, where cultivating character is linked to improving employability and social mobility. We can make productive comparisons between character’s Victorian legacy and its re-emergence more recently amid increasingly moralised discourses around poverty, inequality, and unemployment. In doing so, we might better understand the historical antecedents to stigmatising character discourses today, insofar as they leave the burden of responsibility for particular social outcomes in life and the labour market with individuals and their ability to cultivate their own human capital.
Service delivery innovation for hospital emergency management using rich organizational modelling
Authors: Dhakal Yogit , Bhuiyan Moshiur , Prasad PWC , Krishna Aneesh
Published: April 2018

The purpose of this article is to identify and assess service delivery issues within a hospital emergency department and propose an improved model to address them. Possible solutions and options to these issues are explored to determine the one that best fits the context. In this article, we have analysed the emergency department’s organizational models through i* strategic dependency and rational modelling technique before proposing updated models that could potentially drive business process efficiencies. The results produced by the models, framework and improved patient journey in the emergency department were evaluated against the statistical data revealed from a reputed government organization related to health, to ensure that the key elements of the issues such as wait time, stay time/throughput, workload and human resource are resolved. The result of the evaluation was taken as a basis to determine the success of the project. Based on these results, the article recommends implementing the concept on actual scenario, where a positive result is achievable.
Adding a temporal dimension to the analysis of argumentative discourse: Justified reframing as a means of turning a single-issue discussion into a complex argumentative discussion
Authors: Greco Sara , Schär Rebecca , Pollaroli Chiara , Mercuri Chiara
Published: April 2018

This article seeks to extend existing models of argumentation by considering an important dimension of real-life argumentative discourse: how complex argumentative discussions evolve over time. We define a complex argumentative discussion as a multi-issue discussion, in which the different issues are interrelated in the form of a hierarchy. We claim that justified reframing might be used to transform a single-issue argumentative discussion into a complex argumentative discussion. To illustrate this, we examine the Facebook discourse of the Rhodes Must Fall movement in South Africa. We analyse how reframing is justified by means of arguments, allowing the protagonists to claim as legitimate their reframing of a single issue into a complex argumentative discussion. Our findings complement existing sociological research on social movements by highlighting how their goals are achieved by means of argumentative discourse.
Sustained Effectiveness of Cilostazol After Endovascular Treatment of Femoropopliteal Lesions: Midterm Follow-up From the Sufficient Treatment of Peripheral Intervention by Cilostazol (STOP-IC) Study
Authors: Soga Yoshimitsu , Hamasaki Toshimitsu , Edahiro Ryuya , Iida Osamu , Inoue Naoto , Suzuki Kenji , Yokoi Yoshiaki , Kawasaki Daizo , Zen Kan , Urasawa Kazushi , Aodo Kenji
Published: April 2018

Purpose: To investigate the midterm safety and effectiveness of cilostazol treatment in claudicant patients undergoing endovascular therapy. Methods: The Sufficient Treatment of Peripheral Intervention by Cilostazol (STOP-IC) study ( ClinicalTrials.gov identifier NCT00912756; University Hospital Medical Information Network identifier UMIN000002091) enrolled 200 patients (mean age 73 years; 131 men) treated for femoropopliteal disease from March 2009 to April 2011 at 13 cardiovascular centers in Japan. The participants were randomized 1:1 to receive oral aspirin with or without cilostazol. Of the 100 patients assigned to the 2 treatment groups, 7 patients in the cilostazol group and 2 patients in the no-cilostazol group were withdrawn from the study without undergoing endovascular treatment, leaving 93 patients in the cilostazol group and 98 patients in the no-cilostazol group for follow-up analysis. The primary outcome measure was primary patency; secondary outcome measures were freedom from clinically-driven target lesion revascularization (CD-TLR) and overall survival. Outcomes were analyzed on an intention-to-treat basis using the Kaplan-Meier method; estimates were compared with the log-rank test. Results: The median follow-up was 38.1 months (interquartile range 25.1, 47.7). Among the 93 subjects in the cilostazol group, 7 died and 26 withdrew from administration 1 year after the endovascular procedure. Discontinuation of cilostazol was not a significant factor for restenosis. Primary patency was significantly higher in the cilostazol group than in the no-cilostazol group (69% vs 54%, p=0.026) at 3 years. The cilostazol group also had better 3-year freedom from CD-TLR (78% vs 63%, p=0.014), although overall survival estimates did not differ significantly (p=0.95). Conclusion: These results suggest that the safety and effectiveness of cilostazol treatment were sustained in patients with femoropopliteal disease undergoing endovascular treatment.
Electroencephalography Findings in Crohn’s Disease
Authors: Kelleci Ulker Anadol , Calhan Turan , Sahin Abdurrahman , Aydin-Ozemir Zeynep , Kahraman Resul , Ozdil Kamil , Sokmen Haci Mehmet , Yalcin Ayse Destina
Published: April 2018

Objectives. Crohn’s Disease (CD) is a chronic systemic inflammatory disease associated with various extraintestinal manifestations, including seizure as a neurological finding. In this study, the prevalence of seizure and electroencephalographic abnormalities in patients with CD was investigated. Materials and Methods. This study involved 41 patients with CD (female/male: 25/16) and 39 subjects in the control group (female/male: 25/14). Patients in the CD group were diagnosed and monitored according to the European Crohn’s and Colitis Organization diagnostic criteria. The control group was composed of healthy subjects with similar age and sex as the CD group. Seizures were classified according to the criteria of the International League Against Epilepsy. Electroencephalography (EEG) was performed for all patients with CD and for healthy subjects. Seizure prevalence and EEG findings were also compared. Results. One patient in the CD group had history of seizures. EEG abnormality was significantly higher in the CD group (16/41, 39%) ( P = .001). The most common EEG abnormality was intermittent generalized slow wave abnormality in theta frequency. Discussion. Our study indicated that CD was associated with EEG abnormalities rather than seizure. The results also indicated that EEG was a potential indicator for detecting subclinical neurological abnormalities in CD.
Interviewing Elites
Authors: Liu Xu
Published: April 2018

This article explores issues that arise when a relatively inexperienced researcher interviews people who have an elite position or status. These issues include making preparation, gaining access, establishing trust, and facing interpersonal challenges during interviews. Additionally, there remains the need as with any qualitative research of ensuring authenticity and reliability of the views being expressed and recorded. This article is based upon extensive experience of interviewing senior managers operating within private higher education institutions in China. The article makes a contribution to research which rest upon gaining access to and identifying the views of elites who exercise authority and power within institutions.
High expression of Aurora-B is correlated with poor prognosis and drug resistance in non-small cell lung cancer
Authors: Yu JingJing , Zhou Jing , Xu Fei , Bai Wei , Zhang Wei
Published: April 2018

Objective:

Aurora kinase B (Aurora-B) is a crucial regulator of accurate mitosis. Abnormal Aurora-B expression is associated with aneuploidy and has been implicated in the pathogenesis and drug resistance in a variety of human cancers. However, little evidence is available regarding the role of Aurora-B in regulating drug response in non-small cell lung cancer (NSCLC), which is the most common type of lung cancer, and is characterized with poor prognosis and high mortality.

Method:

In the current study, we investigated the association of Aurora-B with the prognosis of NSCLC patients, and we also used the latest CRISPR/Cas9 system to explore the regulatory role of Aurora-B in NSCLC cells developing resistance to cisplatin (CDDP) and paclitaxel.

Results:

We found that Aurora-B was correlated with significantly reduced overall survival and disease-free survival in NSCLC patients. Aurora-B overexpression was also observed in NSCLC cells developing impaired response to both CDDP and paclitaxel. Moreover, we found, for the first time, that Aurora-B may impair NSCLC drug response by disturbing cell proliferation and inhibiting p53-related DNA damage response and apoptotic pathway, while the knockout of Aurora-B resensitized NSCLC cells to chemo drugs by ensuring correct chromosome segregation and restoring p53 expression.

Conclusions:

Our results demonstrated the association of Aurora-B with chemoresistance in NSCLC, which may finally contribute to the poor prognosis of NSCLC patients. We also suggested Aurora-B as a promising therapeutic target in NSCLC treatment.
Development of a self-balancing robot with a control moment gyroscope
Authors: Park Ji-Hyun , Cho Baek-Kyu
Published: April 2018

This study introduces a two-wheeled self-balancing mobile robot based on a control moment gyroscope module. Two-wheeled mobile robots are able to achieve better mobility and rotation in small spaces and to move faster than legged robots such as humanoid type robots. For this reason, the two-wheeled mobile robot is generally used as a mobile robot platform. However, to maintain its balance, the two-wheeled robot needs to use movements of its two wheels. When an unexpected disturbance affects the robot, the robot maintains its balance with movements of the wheels and tilting of the body. If the disturbance exceeds the response capability of the robot, the robot will lose its stability. At the same time, the safety of the robot may be put at risk by movements to maintain balance. To address these issues, a robot was designed with a control moment gyroscope module to improve balance while minimizing movement. When a disturbance is applied to the robot, the disturbance is estimated by a disturbance observer and the control moment gyroscope controller compensates the disturbance. Using the control moment gyroscope module, the robot can maintain balance with just small movements of its wheels. Improved performance and stability were verified with experiments and simulations.
Mobile methods: Explorations, innovations, and reflections
Authors: Boase Jeffrey , Humphreys Lee
Published: April 2018

In this introduction, we define mobile methods as the means by which mobile communication technology is used to study the social world. We identify and describe three themes of mobile methods. First, they are field-based research, which enables the researcher to go into the world of their participants, enhancing ecological validity. Second, mobile methods engage in controlled complexity regarding the data they collect. Often complex and very large datasets are created through mobile methods and researchers must thoughtfully decide how best to analyze such data. Third, these methods raise important ethical considerations. Researchers employing mobile methods may collect a variety of personal or sensitive information and must be vigilant regarding informed consent and data management procedures. Lastly, we summarize the seven articles in this Special Issue.
Human papillomavirus type 16 (HPV16) DNA copy number in oral rinse samples from oral cavity cancer patients
Authors: Shigeishi Hideo , Yokoyama Sho , Ohta Kouji , Takechi Masaaki , Sugiyama Masaru
Published: April 2018

Objectives:

The objective of this study is to examine the human papillomavirus type 16 (HPV16) DNA copy number in the oral cavity of cancer patients using oral rinse samples.

Methods:

We analyzed the HPV16 DNA copy number of oral rinse samples in 13 primary oral cavity cancer patients (mean age 67.8 years, range 48–84 years) who visited the Department of Oral and Maxillofacial Reconstructive Surgery of Hiroshima University Hospital (Hiroshima, Japan). The 13 oral cavity cancers included 6 carcinomas in situ and 7 squamous cell carcinomas. Real-time PCR analysis was performed to examine the number of HPV16 E6 viral copies in oral rinse samples. Additionally, the HPV16 integration status was investigated using the real-time PCR findings for HPV16 E2 genes in HPV16 E6-positive oral rinse samples.

Results:

HPV16 E6 copy numbers above the detection limit in a standard curve for HPV16 E6 DNA were assessed as HPV16 positive in oral rinse samples from 6 of 13 patients. The average number of HPV16 E6 viral copies was 1.71 ± 1.72 per cell (range, 0.39–4.96 copies/cell) in six oral rinse samples. The HPV16 E2 viral load was detected in four of the six HPV16-positive oral rinse samples. Two of the six HPV16-positive oral rinse samples showed HPV16 E2 copy numbers below the detection limit, indicating the full integration of HPV16 DNA.

Conclusions:

The number of patients in this study was small; therefore, further investigation using a larger number of participants is required to clarify the level of HPV16 viral copy number in the oral cavity of cancer patients.
Recruiting and retaining service agencies and public health providers in longitudinal studies: Implications for community-engaged implementation research
Authors: Pinto Rogério M , Witte Susan S , Wall Melanie M , Filippone Prema L
Published: April 2018

This article addresses a lack of attention in the implementation science literature regarding how to overcome recruitment and retention challenges in longitudinal studies involving large samples of service agencies and health service providers (“providers”). Herein, we provide a case-illustration of procedures that improved recruitment and retention in a longitudinal, mixed-method study—Project Interprofessional Collaboration Implementation—funded by the US National Institute of Mental Health. Project Interprofessional Collaboration Implementation included counselors, program workers, educators, and supervisors. We present a research-engagement model to overcome barriers that included developing a low-burden study, social gatherings to engage stakeholders, protocols to recruit agencies and providers, comprehensive record-keeping, research procedures as incentives to participation, a plan to retain hard-to-reach participants, and strategies for modifying incentives over time. Using our model, we retained 36 agencies over the life of the project. Between baseline (N = 379) and 12-month follow-up (N = 285), we retained 75% of the sample and between the 12- (N = 285) and 24-month follow-ups (N = 256), we retained 90%. For qualitative interviews (between baseline and 12-month follow-up and between 12- and 24-month follow-ups), we retained 100% of the sample (N = 20). We provide a summary of frequency of contacts required to initiate data collection and time required for data collection. The model responded to environmental changes in policy and priorities that would not have been achievable without the expertise of community partners. To recruit and retain large samples longitudinally, researchers must strategically engage community partners. The strategies imbedded in our model can be performed with moderate levels of effort and human resources. Creating opportunities for research partners to participate in all phases of the research cycle is recommended, which can help build research capacity for future research.
Empathy in Internal Medicine Residents at Community-based Hospitals: A Cross-sectional Study
Authors: Foreback Jami , Kusz Halina , Lepisto Brenda Lovegrove , Pawlaczyk Barbara
Published: April 2018

Introduction:

Many research reports revealed declining empathy in medical schools that continues in postgraduate years of training.

Objective:

The aim of this study is to examine the self-reported empathy levels of internal medicine (IM) residents in 3 community-based teaching hospitals.

Methods:

The Jefferson Scale of Physician Empathy, Health Professionals version, is an online, self-administered, questionnaire that was offered to 129 current and incoming residents at 1 osteopathic and 2 allopathic, IM training programs in Flint, Michigan.

Results:

Forty-five residents responded (35% response rate). Our residents’ cumulative mean empathy score was 112.5 with a SD of 12.72, which is comparable with the cumulative empathy scores for IM residents at university hospitals. There was an increase in empathy score from the beginning level of training, postgraduate year 0 (PGY0), to the PGY1 level, and a noticeable, although statistically non-significant, decrease in empathy score for both PGY2 and PGY3 residents. The graduating residents’ scores were higher compared with incoming residents.

Conclusions:

The cumulative mean empathy score in community-based IM residents showed an increase in the beginning of residents’ training and decrease in empathy score by the end of training. There were significant differences in empathy scores by level of training at individual hospitals. This might be related to different targeted curricula.
Incidence and determinants of cerebrovascular events in outpatients with stable coronary artery disease
Authors: Cordonnier Charlotte , Lemesle Gilles , Casolla Barbara , Bic Matthieu , Caparros François , Lamblin Nicolas , Bauters Christophe
Published: April 2018

Introduction

There are limited data on cerebrovascular events in patients with stable coronary artery disease. To study the risk of cerebrovascular event, the relative proportion of ischaemic stroke and intracranial haemorrhage, and their prognostic factors in stable coronary artery disease are investigated.

Patients and methods

The CORONOR registry prospectively recruited, between February 2010 and April 2011, 4184 unselected stable coronary artery disease outpatients. All events occurring during a five-year follow-up were adjudicated.

Results

Ninety-six patients had an ischaemic stroke and 34 had an intracranial haemorrhage, reaching a cumulative incidence after five years of 3.2 (2.7–3.8)%. During the same period, 677 deaths and 170 myocardial infarctions (ST-elevation MI, n = 55; non-ST-elevation MI, n = 115) occurred. In elderly individuals, the number of cerebrovascular events was higher than that of myocardial infarctions and largely exceeded that of ST-elevation myocardial infarctions. Predictors of ischaemic stroke were: previous history of stroke (subhazard ratio (SHR)=3.16(1.95–5.14)), absence of statin therapy at inclusion (SHR = 2.45(1.47–4.10), increasing age (SHR = 1.45(1.16–1.82) per 10-year increase) and diabetes mellitus (SHR = 1.65(1.10–2.49)). Predictors of intracranial haemorrhage were: combination of vitamin K antagonists with an antiplatelet agent at inclusion (SHR = 5.41(2.49–11.75), single antiplatelet therapy as reference), and increasing age (SHR = 1.47(1.12–1.93) per 10-year increase).

Discussion

In stable coronary artery disease patients, the brain deserves attention. In patients at high risk of ischaemic stroke, secondary prevention could be intensified. Our results raise awareness of the hazard of the association of antiplatelet drugs with oral anticoagulants in stable coronary artery disease patients.

Conclusion

While improving the prevention of future vaso-occlusive events should be our ultimate goal in coronary artery disease patients, the net clinical benefit of our treatments should carefully be studied.
Initiating and Monitoring Patients on Biologic Therapy for Psoriasis beyond the FDA: Our more Cautious Approach
Authors: Routhouska Shannon B. , Korman Neil J.
Published: April 2018

Biologics are offering new hope for patients with moderate to severe chronic plaque psoriasis and psoriatic arthritis, and every day more dermatologists are prescribing these medications for their patients. Prior to prescribing a biologic it is important to conduct the proper screening to determine if your patient is an appropriate candidate. While patients are being treated with biologics they need to be monitored carefully to maximize the benefit of the agent and minimize harmful side effects. Apart from the recommendations and requirements of the U.S. Food and Drug Administration (FDA), there are as yet no consensus statements or guidelines addressing the appropriate approach to initiating and monitoring patients being treated with biologics. In this article we will discuss our own approach to initiating and monitoring that we believe is appropriate for patients being treated with biologics. Our recommendations, which in many ways go beyond the recommendations and requirements of the FDA, should not be interpreted as the standard of care.
Psoriasis and Co-Morbidities: Approach to Treatment with Biologics
Authors: Robinson Maria R. , Korman Neil J.
Published: April 2018

Biologics have emerged as an exciting new therapy for the treatment of psoriasis and psoriatic arthritis. Currently, four biologics are approved by the U.S. Food and Drug Administration (FDA) for the treatment of moderate to severe psoriasis, including alefacept (Amevive), efalizumab (Raptiva), etanercept (Enbrel) and infliximab (Remicade). A fifth, adalimumab (Humira), is being studied in late-stage clinical trials. The use of biologics in patients with psoriasis and concurrent co-morbidities has not been extensively studied. Because several of the biologics have been used for many years to treat other immune-mediated diseases such as rheumatoid arthritis and Crohn's disease, more data exist on their use in these patients with co-morbidities. Here, we review the literature and offer our opinions on the appropriate use of alefacept, efalizumab, etanercept, infliximab and adalimumab in patients with psoriasis and specific co-morbidities, including multiple sclerosis, tuberculosis, heart failure, cancer, hepatitis C, HIV and renal failure.
Methotrexate for Psoriatic Arthritis
Authors: Lutt Joseph R. , Deodhar Atul A.
Published: April 2018

Methotrexate, a folic acid antagonist, is one of the most commonly prescribed systemic therapies for the treatment of moderate to severe psoriasis as well as psoriatic arthritis, despite a lack of well-designed, double-blind, placebo-controlled studies supporting its efficacy. Methotrexate's anti-inflammatory action is related to an increase in extra-cellular adenosine, which suppresses neutrophil and monocyte actions. Myelosuppression, hepatotoxicity and interstitial pneumonitis are three most worrisome complications of methotrexate therapy. Accepted monitoring of methotrexate therapy includes complete blood count and liver function tests every four to eight weeks. Although dermatologists and rheumatologists often co-manage these patients, monitoring the potential hepatotoxicity of methotrexate differs in these two specialties. An American dermatology consensus conference recommends liver biopsy for certain high-risk groups and after reaching a cumulative dose of 1–1.5 grams. Rheumatologists, because of an assumption of a similar low rate of hepatotoxicity they experience with rheumatoid arthritis, rarely order liver biopsies.
A Randomized, Double-Blind Clinical Trial of a Probiotic Nutritional Intervention in the Treatment of Mild to Moderate Non-Scalp Psoriasis
Authors: Kaur Mandeep , Conde Jennifer , Willard Joy D. , Taylor Sarah , Camacho Fabian , Fleischer Alan B. , Feldman Steven R.
Published: April 2018

Background

The cellular immune system plays an important role in the pathogenesis of psoriasis. The digestive system (by virtue of the profile, number and species of bacteria present at any given time and nutritional factors) can influence the status of the immune system. Bacterial pathogens influence specific cytokine activity due to the activity of superantigens. Modulation of bacterial gut flora offers a potential target for psoriasis treatment.

Methods

Forty-two subjects with mild to moderate plaque-type psoriasis were enrolled in a 12-week, randomized, placebo-controlled trial of a lactobacillus nutritional supplement. The supplement or placebo was taken orally once daily for eight weeks. The primary outcome of this study was the change from baseline to week 12 (or end of treatment) in the composite score of the signs of psoriasis (erythema, scaling, plaque thickness) for target lesions. Other outcomes included Investigator's and Subject's Global Assessment of Response and change in pruritus score.

Results

Data were evaluable for 40 subjects (18 on the nutritional supplement and 22 on placebo). No significant improvement was found with the lactobacillus nutritional supplement compared to placebo-treated patients.

Conclusion

Patients commonly seek out alternative treatments for psoriasis. Nutritional supplementation is an intriguing way to manage the disease, offering the potential for a very safe treatment, however we found little to no benefit for lactobacillus nutritional supplement in this group of subjects with mild to moderate psoriasis.
Practical Management and Monitoring of Psoriasis Patients on Biologic Therapy: A Survey of Opinion Leaders and Practitioners
Authors: Halverstam Caroline P.
Published: April 2018

Objective

To provide practical guidance to dermatologists on how to monitor psoriasis patients on biologic therapies.

Design

Survey of health care providers on monitoring and vaccination practices in patients on biologic therapies.

Participants

21 present and former members of the Medical Board of the National Psoriasis Foundation.

Results

The survey revealed a wide variety of practices, but some general trends emerged. Most of the experts who were surveyed checked screening hematology with all of the drugs and continued to check it every two to six months. CD4+ counts were only checked with alefacept and were generally taken at screening and at least every two weeks. Serum chemistry and liver function monitoring were usually checked at screening and then every two to six months, especially in patients on infliximab. Most of the practitioners surveyed did not check for antinuclear antibodies (ANA) at screening. However, approximately one-third did screen for ANA in patients on tumor necrosis factor (TNF)-blocking agents; only a few continued to check it every three to six months. Tuberculosis screening was generally done for patients on all of the biologic therapies, but was almost universally done in patients treated with TNF-blocking drugs. Yearly tuberculin skin testing was continued by approximately two-thirds of the practitioners. Approximately half of respondents gave influenza vaccines to patients on biologic therapy.

Conclusions

Currently there are no guidelines for the monitoring of patients on biologic therapy and there is a lack of consistency among practitioners. However, medical literature provides a great deal of information on which to base monitoring practices. Monitoring and vaccination practices should vary from patient to patient depending on many factors, so these findings should not be viewed as guidelines.