bluuebunny/crossref_metadata_2025 huggingface dataset:
Offering an app to book cervical screening appointments: A service evaluation
Authors: Ryan Mairead , Marlow Laura , Forster Alice , Ruwende Josephine , Waller Jo
Published: September 2019

Objective

To assess the feasibility of offering women who are overdue for cervical screening the use of a smartphone app to book their appointment.

Methods

Women who were at least six months overdue for cervical screening in three general practice surgeries in a deprived East London borough were identified from practice records. Staff sent batches of text messages informing women that they were overdue for screening, and inviting them to download an app to book their appointment.

Results

Across the three practices, 2632 eligible women were identified. Valid mobile phone numbers were available for 1465 women. One woman had opted out of receiving text messages, so messages were sent to 1464 women. Of these, 158 (11%) booked a screening appointment within five months. The majority of these women booked without using the app (72%; 113/158); just over a quarter booked via the app (28%; 45/158).

Conclusions

Just over 10% of cervical screening non-attenders booked an appointment in response to a text message with a link to a downloadable app; however, only one in four of these women booked using the app. This suggests that the text message reminder was likely to have been the key ‘active ingredient’ for most women, rather than the app itself. Future research could explore the optimal message for a text reminder in this context and evaluate the inclusion of a link to existing online booking systems.
The formation and use of a profit reserve at the end of the fourteenth century
Authors: Kuter Mikhail , Sangster Alan , Gurskaya Marina
Published: September 2019

This article analyses the earliest known use of reserve accounting in the late fourteenth century. It reveals the dual purpose of this reserve, the entries made, including those made when the reserve was utilized and when the remainder was written-back to be distributed to the owners in the following accounting period. The research method is archival, using logical–analytical modelling of a merchant’s accounting records from 1392 to 1400. It finds that a reserve was initially an estimate of costs that had been incurred the amount of which was unclear, and that it was then extended to act as a suspense account to balance the ledger when errors in the double entries could not be identified. In doing so, this study also reveals changes made in how the entries were made to the reserve as bookkeepers sought more efficient ways to make them.
Exploring Conflicts Between Work and Care: Vulnerable Populations and Paid Family Leave
Authors: Gates Alice B. , Pacheco Dorian , Mejía Anaceli , Varquez Caitlin , Martínez Emma , Dillard Danielle
Published: September 2019

This exploratory study aims to increase understanding of conflict related to integrating work and care among racial and ethnic minority and economically disadvantaged populations. Employing community-based research methods, we conducted qualitative interviews with women about their caregiving needs following the birth of a child. Interviewees struggled to balance their families’ need for care with income and other basic needs, and they reported experiencing physical, emotional, and financial strain. The process of negotiating leave created additional stress for workers and families. Our analysis suggests that the conflict between work and care is associated with increased social risk and vulnerability for members of already vulnerable and marginalized groups. Drawing on these insights, specific implications for paid family leave policy are discussed.
Training Second-Year MSW Students to Improve Cultural and Linguistic Competence
Authors: Neely-Barnes Susan L. , Kirk Brittany G. , Elswick Susan Elizabeth , Taylor Laura C. , Delavega Elena , Pettet Fawn Lindsey , Landry Maggie
Published: September 2019

Purpose:

Cultural competency is a critical construct in social work education. This study investigated whether a grant-funded training program completed in tandem with second-year field placement and second-year Master of Social Work (MSW) curriculum could improve the cultural competence of MSW students.

Method:

Ninety-nine trainees completed the program over the 3-year grant period funded by the Health Resources and Services Administration. Cultural and linguistic competence was measured at the beginning and end of the training program for each cohort using a preexperimental design.

Results:

Findings suggest that MSW students saw improvement in their communication, values, and attitudes with respect to cultural and linguistic competence. Trainees did not report improvement on the Physical Environment subscale portion of the measure.

Discussion:

Results suggest that training can improve knowledge, values, and skills on cultural and linguistic competence. However, trainees may not have adequate authority to make an impact on the environment of their field placements.
Breast Cancer Screening Program in Lithuania: Interval Cancers and Program Sensitivity After 7 Years of Mammography Screening
Authors: Steponaviciene Laura , Vincerzevskiene Ieva , Briediene Ruta , Urbonas Vincas , Vanseviciute-Petkeviciene Rasa , Smailyte Giedre
Published: September 2019

Objective:

Analysis of interval cancers is critical in determining the sensitivity of screening and represents an objective measure of the quality of mammography screening program (MSP).

Methods:

Period analyzed: from 2006 to 2012. The rate of screen-detected, interval cancers and program sensitivity were measured. A comparison of screen-detected and interval cancers was performed.

Results:

During the period of the study, 429 473 women were screened and 1297 were found to have cancer. The overall screen-detected cancer rate was 30.2 per 10 000 women screened. Four hundred thirty-one case of interval cancers have occurred during the period of the study. The interval cancer ratio (ICR) was 0.25. Overall sensitivity of MSP amounted to 75.1%. Slightly lower sensitivity was found among the youngest age-group, especially for those with lobular cancers. Interval cancers were bigger in size, more often with metastases in lymph nodes, than screen-detected cancers, but these differences were not statistically significant.

Conclusions:

Overall program sensitivity in Lithuania is about 75%, ICR is 0.25, and these parameters are comparable to other European countries.
The Experience of Consensus: Video as an Effective Medium to Communicate Scientific Agreement on Climate Change
Authors: Goldberg Matthew H. , van der Linden Sander , Ballew Matthew T. , Rosenthal Seth A. , Gustafson Abel , Leiserowitz Anthony
Published: September 2019

Research on the gateway belief model indicates that communicating the scientific consensus on global warming acts as a “gateway” to other beliefs and support for action. We test whether a video conveying the scientific consensus on global warming is more effective than a text transcript with the same information. Results show that the video was significantly more effective than the transcript in increasing people’s perception of scientific agreement. Structural equation models indicate indirect increases in the beliefs that global warming is happening and is human-caused, and in worry about global warming, which in turn predict increased global warming issue priority.
The Effects of Performance Audits on School District Financial Behavior
Authors: Thompson Paul N. , St. John Mark
Published: September 2019

Performance audits are a form of weak financial oversight intended to curb inefficient spending and help alleviate financial problems. This study examines the effect of these performance audits on school district finances in Ohio, where performance audits are used on their own and within the context of the state’s fiscal stress labeling system—a strong financial oversight system. Using a difference-in-differences analysis, we find school districts do reduce expenditures as a result of these performance audits. These changes in financial behavior are found even for performance audits in nonfiscal stress districts, suggesting that weak oversight programs may be an effective means toward changing fiscal behavior. Despite the financial changes in nonfiscal stress districts that receive audits, there appears to be little impact on school district proficiency rates. These results suggest that audits may provide a useful mechanism for changing financial behavior of school districts without much associated efficiency losses.
Pattern electroretinogram changes in patients with primary open-angle glaucoma in correlation with visual field and optical coherence tomography changes
Authors: Elgohary Asmaa M , Elbedewy Hazem A , Saad Hisham A , Eid Tarek M
Published: September 2019

Purpose:

To study the pattern electroretinogram changes in primary open-angle glaucoma patients in correlation with visual field changes and optical coherence tomography measurements of retinal nerve fiber layer thickness in the peripapillary region in an attempt to evaluate the clinical value of pattern electroretinogram as an objective test of functional deficit in glaucoma.

Patients and Methods:

The study included 81 eyes of 81 participants: 50 primary open-angle glaucoma patients, 16 primary open-angle glaucoma suspects, and 15 controls. All subjects underwent visual field testing using 24-2 Humphrey standard automated perimetry, peripapillary retinal nerve fiber layer average thickness using the 3.4-mm circular scan of the Heidelberg OCT spectralis and pattern electroretinogram using CSO RetiMax device in accordance with the International Society for Clinical Electrophysiology of Vision guidelines.

Results:

We had three main groups: normal, glaucoma suspect, and primary open-angle glaucoma patients, and the last group included three subgroups: mild, moderate, and severe. There was significant difference in the visual field mean deviation, peripapillary retinal nerve fiber layer average thickness, and most pattern electroretinogram measured parameters between the three main groups and in between primary open-angle glaucoma subgroups. There was significant positive correlation between visual field mean deviation and the peripapillary retinal nerve fiber layer average thickness, P50 amplitude, and P50–N95 amplitude (p < 0.001, p = 0.018, and p < 0.001, respectively). Significant negative correlation was also found between peripapillary retinal nerve fiber layer average thickness and N95 amplitude (p < 0.001). Significant positive correlation was found between retinal nerve fiber layer average thickness and P50–N95 amplitude (p = 0.001). Significant negative correlation was found between peripapillary retinal nerve fiber layer average thickness and N95 amplitude (p = 0.001) and significant positive correlation of retinal nerve fiber layer average thickness with P50–N95 amplitude (p = 0.017) in primary open-angle glaucoma patients.

Conclusion:

Peripapillary retinal nerve fiber layer average thickness shows significant negative correlation with pattern electroretinogram N95 amplitude and a significant positive correlation with P50–N95 amplitude. In combination with optical coherence tomography, pattern electroretinogram can be used to objectively assess functional loss in glaucoma.
PCOS and Hyperprolactinemia: what do we know in 2019?
Authors: Delcour Clémence , Robin Geoffroy , Young Jacques , Dewailly Didier
Published: September 2019

Polycystic ovary syndrome (PCOS) and hyperprolactinemia (HPRL) are the two most common etiologies of anovulation in women.

Since the 1950s, some authors think that there is a pathophysiological link between PCOS and HPRL. Since then, many authors have speculated about the link between these two endocrine entities, but no hypothesis proposed so far could ever be confirmed. Furthermore, PCOS and HPRL are frequent endocrine diseases and a fortuitous association cannot be excluded.

The evolution of knowledge about PCOS and HPRL shows that studies conducted before the 2000s are obsolete given current knowledge. Indeed, most of the studies were conducted before consensual diagnosis criteria of PCOS and included small numbers of patients. In addition, the investigation of HPRL in these studies relied on obsolete methods and did not look for the presence of macroprolactinemia. It is therefore possible that HPRL that has been attributed to PCOS corresponded in fact to macroprolactinemia or to pituitary microadenomas of small sizes that could not be detected with the imaging methods of the time.

Recent studies that have conducted a rigorous etiological investigation show that HPRL found in PCOS correspond either to non-permanent increase of prolactin levels, to macroprolactinemia or to other etiologies. None of this recent study found HPRL related to PCOS in these patients.

Thus, the link between PCOS and HPRL seems to be more of a myth than a well-established medical reality and we believe that the discovery of an HPRL in a PCOS patient needs a standard etiological investigation of HPRL.
Impact of hot molding temperature and duration on braking behavior of friction material
Authors: Hentati Nesrine , Kchaou Mohamed , Cristol Anne-Lise , Elleuch Riadh , Desplanques Yannick
Published: September 2019

The manufacturing process of brake materials used for braking applications consists of a succession of steps among which the hot molding has a major impact on properties and performance of materials. In this paper, impact of hot molding temperature and duration on mechanical and thermal properties of friction materials developed with simplified formulation was investigated. Two different hot molding conditions were studied: condition 1 (low temperature associated to long duration) and condition 2 (high temperature associated to short duration). Braking behavior, thermo-mechanical phenomena and wear and friction mechanisms were also investigated. Results indicated that hot molding conditions did not significantly affect mechanical properties and tribological behavior, but they had impact on thermal properties (material molded according to condition 1, material A presented a higher thermal conductivity) and on wear mechanisms involved in the contact. In addition, results revealed that the studied hot molding conditions impacted thermal localization recorded during braking that was denser for the disc rubbed against material B (material molded according to condition 2).
A review on dynamic substructuring methods for model updating and damage detection of large-scale structures
Authors: Weng Shun , Zhu Hongping , Xia Yong , Li Jiajing , Tian Wei
Published: September 2019

Substructuring methods possess many merits in model updating and damage identification of large-scale structures. With substructuring methods, a global structure is divided into a number of independent substructures. Only the substructures are repeatedly analyzed and the re-analysis of the global structure is thereby avoided. This article reviews widely used dynamic substructuring methods for model updating and damage identification of large-scale structures. These methods can be categorized into forward and inverse substructuring approaches. The former is a conventional process that assembles the vibration properties of each substructure to obtain the vibration properties of the global structure. The latter, on the contrary, disassembles the vibration properties of the global structure into those of the substructures. In each category, both frequency and time domain methods have been developed and will be reviewed.
Active multimode vibration control of a smart structure using macro fiber composite actuators based on ANFIS
Authors: Chu Wen-Lin , Lin Chih-Jer , Li Ming-Jia
Published: September 2019

In this study, vibration control was achieved using macro fiber composite actuators initiated by feedback from polyvinylidene difluoride (PVDF) membrane sensors. First, the structure mode was found using the finite element method after which simulation of the effect of piezoelectric actuators on the structure as well as a feasibility investigation was carried out. The ANSYS Workbench was used for parametric design and to determine the best position for the actuators. Structure vibration in different modes was measured using PVDF membrane sensors for feedback control and to investigate the vibration reduction effect achieved with three individual controllers. The pros and cons of active vibration reduction control were also examined in several different modes. The experimental results obtained with several types of vibration reduction control were compared: Type-1 fuzzy control, Type-1 adaptive fuzzy control, and the vibration reduction effect of an adaptive neuro-fuzzy inference system. The results showed that the adaptive neuro-fuzzy inference system controller was the best choice under the experimental conditions used in this study.
Getting more out of interviews. Understanding interviewees’ accounts in relation to their frames of orientation
Authors: Philipps Axel , Mrowczynski Rafael
Published: September 2019

This paper contributes to an ongoing debate about the validity of interview data and the ways in which they are interpreted in the ‘interview society’. We understand the need for an extensive reliance on interviews and, at the same time, recognise the serious limitations that exist regarding access to the interviewee’s worldview, their motivations and orientations. A crucial problem in this regard and the main concern of our paper is how to interpret subjective accounts, such as arguments or everyday theories, interviewees hold about themselves. While ethnomethodologists suggest that the complete authorship for meaning depends on the interview setting, we argue that the interviewee’s practices of generating interview content are quite stable across various sequences that allows for a reconstruction of their agency dispositions based on interview transcripts. Taking Mannheim’s and Bourdieu’s idea of a formative or generative principle as a point of departure, we introduce the most recent variant of the documentary method of interpretation (DMI) that aims at the reconstruction of this principle’s manifestation (as an individual’s frame of orientation) and helps us then to understand everyday theories, subjective explanations and justifications presented by interviewees.
Same-Day ICU Discharge in Selected Patients With Severe Submassive Pulmonary Embolism Treated With Catheter-Directed Thrombolysis
Authors: Das Gupta Jaideep , Marek John , Rana Muhammad Ali , Guliani Sundeep
Published: September 2019

A retrospective review from July 2016 to April 2018 was performed of 23 patients with submassive pulmonary embolism (PE) who received catheter-directed thrombolysis (CDT). Five (22%) of the 23 patients were discharged the same day from the intensive care unit (ICU) following thrombolysis completion. Their presentation, hospital courses, complications, and follow-up are reviewed. All 5 patients were diagnosed using chest computed tomography (CT) demonstrating a clot in the pulmonary vasculature and right ventricle dysfunction based on abnormal right ventricle to left ventricle (RV/LV) ratio. Patients with severe right heart dysfunction (RV/LV ratio ≥1.4) were protocolized to receive CDT via EkoSonic catheters (EKOS Corporation). Postoperatively, patients were admitted to the ICU with continuous alteplase at 1 mg/h. Echocardiography was then performed after 24 hours of therapy to assess right ventricle function and removal of EkoSonic catheters. Patients with reversal of right heart dysfunction and symptomatic improvement received bedside removal of catheters. The mean patient age was 50.6 years and body mass index was 33.6. Mean RV/LV ratio on admission via CT imaging was 1.56, with a mean troponin of 0.44. Interval mean RV/LV ratio on echocardiography after thrombolysis therapy was 0.91. There was a 0% incidence of periprocedural complications. One (20%) patient out of 5 had an emergency department visit 10 days postdischarge for acute shortness of breath, with workup revealing no evidence of recurrent PE. No patient required hospital readmission within 30 days. At the 6-week follow-up, all patients had continued normal right ventricular function noted on echocardiography. This case series demonstrates that for a select population of patients with severe submassive PE, the use of CDT and echocardiography monitoring can facilitate same-day discharge from the ICU.
Complete Revascularization of Acute Limb Ischemia With Distal Pedal Access
Authors: Cho Sungsin , Lee Seung Hwan , Joh Jin Hyun
Published: September 2019

Acute limb ischemia (ALI) is an abrupt decrease of blood flow to a limb, resulting in a potential threat to that body part. In ALI, which is commonly caused by embolism or traumatic occlusion, symptoms appear quickly due to a lack of collateral blood flow and extension of the thrombus to arterial outflow. In cases with ALI presentation, urgent evaluation and management are necessary. Here, we report 3 cases with ALI due to thromboembolism. Conventional open thromboembolectomy was performed with a femoral artery cutdown and antegrade passage of the embolectomy catheter. Further, distal access was created in the dorsalis pedis artery and/or posterior tibial artery at the ankle level. After the retrograde passage of the guidewire and antegrade insertion of the embolectomy catheter, the embolus was completely removed.
Hybrid Coronary Artery Revascularization: A Review and Current Evidence
Authors: Kiaii Bob , Teefy Patrick
Published: September 2019

Objective

The role of hybrid coronary revascularization (HCR), which utilizes the combination of minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery and percutaneous coronary intervention (PCI) of non-left anterior descending vessels to treat multivessel coronary artery disease, is expanding. We set out to provide a review of this technology.

Methods

We conducted a retrospective analysis of all minimally invasive hybrid operations performed at our institution from September 2004 to December 2018. An effective analysis comparing patients undergoing HCR vs off-pump or on-pump surgical coronary artery revascularization was undertaken using an adjusted analysis with inverse-probability weighting based on the propensity score. Outcomes that were assessed include death, myocardial infarction, stroke, atrial fibrillation, renal failure, requirement of blood transfusion, conversion to open procedure (in the hybrid group), length of stay in intensive care unit, and total length of stay in hospital. Intention-to-treat analysis was performed. An up-to-date literature review of HCR complements this study.

Results

Since 2004 a total of 191 consecutive patients (61.4±11.1 years; 142 males and 49 females) underwent HCR (robotic-assisted coronary artery bypass graft of the left internal thoracic artery to the left anterior descending coronary artery (LAD) and PCI of a non-LAD vessel) in a single- or double-stage fashion. Successful HCR occurred in 183 of the 191 patients (8 patients required intraoperative conversion to conventional coronary bypass). From our comparative analysis and literature review we found no significant difference between HCR and coronary artery bypass grafting groups with respect to in-hospital and 1-year follow-up.

Conclusions

Current evidences suggest that HCR is a feasible, safe, and effective coronary artery revascularization strategy in selected patients with multivessel coronary artery disease.
Associations Between Dietary Patterns and Sleep-Related Impairment in a Cohort of Community Physicians: A Cross-sectional Study
Authors: Makowski Maryam S. , Shanafelt Tait D. , Hausel Andrea , Bohman Bryan D. , Roberts Rachel , Trockel Mickey T.
Published: September 2019

There is increasing evidence that diet can mitigate fatigue. The objective of this study was to assess the associations between dietary habits and sleep-related impairment (SRI) in a cohort of community physicians. In this cross-sectional study, we analyzed data from 245 physicians who had completed a wellness survey in March 2016 (98% response rate). Three dietary patterns were derived using principal component analysis: plant based, high protein, and high saturated fat and sugar. In the adjusted analysis, every SD increase in the plant-based dietary pattern score was associated with a 0.71-point decrease ( β = −0.72; SE = 0.32; P = .027; 95% CI = −1.35 to −0.08) in the SRI score, and every SD increase in the high saturated fat and sugar dietary pattern score was associated with a 0.77-point increase ( β = 0.77; SE = 0.32; P = .015; 95% CI = 0.15 to 1.39) in the SRI score. There were no associations between high protein diets and SRI scores. Physicians adhering to diets that are high in plant-based foods and low in saturated fat and added sugars had less SRI. Physicians currently face significant barriers to maintaining a healthy diet. This study highlights the potential role of workplace nutrition on SRI and work performance of physicians.
Development of a high-performance tactile feedback display for three-dimensional shape rendering
Authors: Zhang Zhen , Lu Xin , Hagihara Yoshihiro , Yimit Adiljan
Published: September 2019

This article presents a virtual tactile display using a shape-displaying method with flexible tendon-driven transmission to enhance performance. Sixteen tactors move perpendicularly in a 4 × 4 module to render the local shape of the virtual object to the skin of the user’s fingertip. We detail the display structure design and the transmission system, and we combine the compact design of the drive unit and tactor module with a flexible tendon-driven transmission to address the ergonomic constraints on previous devices and make them more suitable for tactile feedback. In this work, we integrate the display with leap motion controller and a ray detection rendering method to generate tactile feedback. To evaluate the performance, we perform a virtual touch experiment that assesses how much the display can render the surface of three-dimensional objects to aid the participant to match the tactile sensation with visual stimuli in the virtual scene. Results show that the display improves the user experience and has good feasibility and effectiveness. In addition, the portable structure allows the user’s hand to move more freely without redundant restrictions, and the larger tactor amplitude provides more shape patterns than previous models.
New media, old paradigms: News representations of technology in adolescent sexual assault
Authors: Gjika Anna
Published: September 2019

This study examines news coverage of the Steubenville, Audrie Pott and Daisy Coleman cases, three highly publicized instances of sexual assault featuring teens and the use of digital media to capture and distribute the incidents. Thematic analysis of 146 articles on the assaults was conducted to identify mainstream media portrayals of emerging technologies in relation to each sex crime, and the problem of sexual assault and rape culture, more broadly. Prevailing news themes in the reporting include technology as a model witness, evidence-gatherer and mobilizer, and threat. The focus on technology in these stories, I argue, detracts from considerations of the underlying sexual violence and its causes, and contributes to the media reframing the incidents as cautionary tales about youth and social media. My analysis also suggests the discourses about digital media in the coverage reinforce existing deterministic understandings of new media platforms, and reproduce risk and responsibilization narratives pertaining to youth, sexuality and technology.
The Misperception of Racial Economic Inequality
Authors: Kraus Michael W. , Onyeador Ivuoma N. , Daumeyer Natalie M. , Rucker Julian M. , Richeson Jennifer A.
Published: September 2019

Racial economic inequality is a foundational feature of the United States, yet many Americans appear oblivious to it. In the present work we consider the psychology underlying this collective willful ignorance. Drawing on prior research and new evidence from a nationally representative sample of adults ( N = 1,008), we offer compelling evidence that Americans vastly underestimate racial economic inequality, especially the racial wealth gap. In particular, respondents thought that the Black–White wealth gap was smaller, by around 40 percentage points in 1963 and around 80 percentage points in 2016, than its actual size. We then consider the motivational, cognitive, and structural factors that are likely to contribute to these misperceptions and suggest directions for future research to test these ideas. Importantly, we highlight the implications of our collective ignorance of racial economic inequality and the challenge of creating greater accuracy in perceptions of these racial economic disparities, as well as outline the steps policymakers might take to create messages on this topic that effectively promote equity-enhancing policies. We close with an appeal to psychological science to at least consider, if not center, the racial patterning of these profound economic gaps.
The redundancy effect is related to a lack of conditioned inhibition: Evidence from a task in which excitation and inhibition are symmetrical
Authors: Zaksaite Tara , Jones Peter M
Published: September 2019

Rescorla and Wagner’s model of learning describes excitation and inhibition as symmetrical opposites. However, tasks used in human causal learning experiments, such as the allergist task, generally involve learning about cues leading to the presence or absence of the outcome, which may not reflect this assumption. This is important when considering learning effects which provide a challenge to this model, such as the redundancy effect. The redundancy effect describes higher causal ratings for the blocked cue X than for the uncorrelated cue Y in the design A+/AX+/BY+/CY–, the opposite pattern to that predicted by the Rescorla–Wagner model, which predicts higher associative strength for Y than for X. Crucially, this prediction depends on cue C gaining some inhibitory associative strength. In this article, we used a task in which cues could have independent inhibitory effects on the outcome, to investigate whether a lack of inhibition was related to the redundancy effect. In Experiment 1, inhibition for C was not detected in the allergist task, supporting this possibility. Three further experiments using the alternative task showed that a lack of inhibition was related to the redundancy effect: the redundancy effect was smaller when C was rated as inhibitory. Individual variation in the strength of inhibition for C also determined the size of the redundancy effect. Given that weak inhibition was detected in the alternative scenario but not in the allergist task, we recommend carefully choosing the type of task used to investigate associative learning phenomena, as it may influence results.
Multi-level community interventions for primary stroke prevention: A conceptual approach by the World Stroke Organization
Authors: Brainin Michael , Feigin Valery , Bath Philip M , Collantes Epifania , Martins Sheila , Pandian Jeyaraj , Sacco Ralph , Teuschl Yvonne
Published: September 2019

The increasing burden of stroke and dementia emphasizes the need for new, well-tolerated and cost-effective primary prevention strategies that can reduce the risks of stroke and dementia worldwide, and specifically in low- and middle-income countries (LMICs).

 This paper outlines conceptual frameworks of three primary stroke prevention strategies: (a) the “polypill” strategy; (b) a “population-wide” strategy; and (c) a “motivational population-wide” strategy.

 (a) A polypill containing generic low-dose ingredients of blood pressure and lipid-lowering medications (e.g. candesartan 16 mg, amlodipine 2.5 mg, and rosuvastatin 10 mg) seems a safe and cost-effective approach for primary prevention of stroke and dementia.

 (b) A population-wide strategy reducing cardiovascular risk factors in the whole population, regardless of the level of risk is the most effective primary prevention strategy. A motivational population-wide strategy for the modification of health behaviors (e.g. smoking, diet, physical activity) should be based on the principles of cognitive behavioral therapy. Mobile technologies, such as smartphones, offer an ideal interface for behavioral interventions (e.g. Stroke Riskometer app) even in LMICs.

 (c) Community health workers can improve the maintenance of lifestyle changes as well as the adherence to medication, especially in resource poor areas. An adequate training of community health workers is a key point.

Conclusion

An effective primary stroke prevention strategy on a global scale should integrate pharmacological (polypill) and lifestyle modifications (motivational population-wide strategy) interventions. Side effects of such an integrative approach are expected to be minimal and the benefits among individuals at low-to-moderate risk of stroke could be significant. In the future, pragmatic field trials will provide more evidence.
Adverse effects of pre-existing cerebral small vessel disease on cognitive improvement after carotid endarterectomy
Authors: Yoshida Jun , Yamashita Fumio , Sasaki Makoto , Yoshioka Kunihiro , Fujiwara Shunrou , Kobayashi Masakazu , Yoshida Kenji , Kubo Yoshitaka , Ogasawara Kuniaki
Published: September 2019

Background

Although patients with improved cognition after carotid endarterectomy usually exhibit postoperative restoration of cerebral blood flow, less than half of patients with such cerebral blood flow change have postoperatively improved cognition. Cerebral small vessel disease on magnetic resonance imaging is associated with irreversible cognitive impairment.

Aims

The purpose of the present prospective study was to determine whether pre-existing cerebral small vessel disease affects cognitive improvement after carotid endarterectomy.

Methods

Brain MR imaging was performed preoperatively, and the number or grade of each cerebral small vessel disease was determined in 80 patients undergoing carotid endarterectomy for ipsilateral internal carotid artery stenosis (≥70%). The volume of white matter hyperintensities relative to the intracranial volume was also calculated. Brain perfusion single-photon emission computed tomography and neuropsychological testing were performed preoperatively and two months postoperatively. Based on these data, a postoperative increase in cerebral blood flow and postoperative improved cognition, respectively, were determined.

Results

Logistic regression analysis using the sequential backward elimination approach revealed that a postoperative increase in cerebral blood flow (95% confidence interval [CI], 10.74–3730.00; P = 0.0004) and the relative volume of white matter hyperintensities (95% CI, 0.01–0.63; P = 0.0314) were significantly associated with postoperative improved cognition. Although eight of nine patients with postoperative improved cognition exhibited both a relative volume of white matter hyperintensities <0.65% and a postoperative increase in cerebral blood flow, none of patients with a relative volume of white matter hyperintensities ≥0.65% had postoperative improved cognition regardless of any postoperative change in cerebral blood flow.

Conclusion

Pre-existing cerebral white matter hyperintensities on magnetic resonance imaging adversely affect cognitive improvement after carotid endarterectomy.
Estimation of baseball bat trajectory during a practice swing using a Kalman filter for velocity compensation
Authors: Shibata Shohei , Hirose Kiyoshi , Naruo Takeshi , Shimizu Yuichi
Published: September 2019

This study aimed to (a) develop an algorithm that could estimate a baseball bat trajectory from the beginning of the swing to the follow-through phase during a practice swing without a ball and (b) evaluate the accuracy of the proposed method using a three-dimensional motion capture system. The sensor fusion using the adaptive Kalman filter for compensating velocity decreased the error of acceleration integration during the follow-through phase. Further, the three-dimensional bat trajectory in a global coordinate was estimated by combining the sensor fusion and compensation by motion characteristics. The three-dimensional bat trajectory from the swing beginning to the follow-through phase estimated by the proposed method was compared with the three-dimensional bat trajectory obtained by the three-dimensional motion capture system. The proposed method achieved a root mean square of the error of 7.72 km/h for velocity, which was less than the root mean square of the error (8.91 km/h) obtained by simple time integration of forward direction. These results indicate that the error by acceleration integration during the follow-through phase is compensated. The proposed method is, thus, deemed effective and can be used to evaluate baseball swing, including the follow-through phase, with high accuracy.
Characteristics and survival of older patients with metastatic pancreatic cancer: a retrospective analysis of the AC Camargo Cancer Center experience
Authors: Costa Josenon Gomes , de Jesus Victor Hugo Fonseca , Camandaroba Marcos Pedro Guedes , Dettino Aldo Lourenço Abbade
Published: September 2019

Background:

Advanced age is the most important risk factor for pancreatic cancer and about half of patients are diagnosed with metastatic disease. In the first-line setting, multidrug chemotherapy regimens were shown to be more effective than gemcitabine alone. However, the older population was under-represented in randomized clinical trials. We aimed to describe the clinical profile of older patients with metastatic pancreatic cancer and their survival outcomes.

Materials and methods:

This was a retrospective, unicentric study that included patients diagnosed with metastatic pancreatic cancer (non-neuroendocrine), aged 65 years and over.

Results:

The study population comprised 196 patients. The median age was 73 years; 67% of these patients presented Eastern Cooperative Oncology Group performance status (ECOG) ⩽ 1 and the median Charlson Comorbidity score was 10. Chemotherapy was given to 89% of the patients. The most frequently used chemotherapy regimens were gemcitabine (44%), 5-fluorouracil and oxaliplatin [FOLFOX; 26%], and 5-fluorouracil, oxaliplatin and irinotecan (FOLFIRINOX; 20%). Patients treated with FOLFIRINOX were younger and they presented better performance status. After a median follow up of 19.8 months, the median overall survival (OS) was of 7.2 months and the median time to first-line-treatment failure was 4.6 months. Among patients treated with chemotherapy, the median OS was highest for those treated with FOLFIRINOX (13.8 months), as compared with FOLFOX (7.0 months) or gemcitabine (6.7 months); p = 0.004. Nonetheless, treatment with FOLFIRINOX was associated with increased risk of severe toxicity ( p = 0.008).

Conclusion:

Older patients with metastatic pancreatic cancer benefit from palliative chemotherapy, and FOLFIRINOX is a therapeutic option in rigorously selected older patients.
The necessity to develop a national classification system for Iranian traditional medicine
Authors: Safdari Reza , Rezaeizadeh Hossein , Arji Goli , Abbassian Alireza , Mokhtaran Mehrshad , Dehghan Reza , Shekalyou Sara
Published: September 2019

Background:

Classification of disease and interventions in traditional medicine (TM) is necessary for standardised coding of information. Currently, in Iran, there is no standard electronic classification system for disease and interventions in TM.

Objective:

The current study aimed to develop a national framework for the classification of disease and intervention in Persian medicine based on expert opinion.

Method:

A descriptive cross-sectional study was carried out in 2018. The existing systems for the classification of disease and interventions in TM were reviewed in detail, and some of the structural and content characteristics were extracted for the development of the classification of Iranian traditional medicine. Based on these features, a self-administered questionnaire was developed. Study participants (25) were experts in the field of Persian medicine and health information management in Tehran medical universities.

Results:

Main axes for the classification of disease and interventions were determined. The most important applications of the classification system were related to clinical coding, policymaking, reporting of mortality and morbidity data, cost analysis and determining the quality indicators. Half of the participants (50%) stated that the classification system should be designed by maintaining the main axis of the World Health Organization classification system and changing the subgroups if necessary. A computer-assisted coding system for TM was proposed for the current study.

Conclusion:

Development of this classification system will provide nationally comparable data that can be widely used by governments, national organisations and academic researchers.
The “Readiness” of Timor-Leste: Narratives about the Admission Procedure to ASEAN
Authors: Seixas Paulo Castro , Mendes Nuno Canas , Lobner Nadine
Published: September 2019

This article is based on an empirical research with an inductive approach about the admission of Timor-Leste (TL) to Association of Southeast Asian Nations (ASEAN). We examined a corpus of international newspapers ( n = 48) which forms a debate over this case on the Internet. The articles are reproduced in English and are currently the most representative form of debating the membership delay which takes place since 2011. Throughout the observation of our gathered data, we discovered one main narrative that is reproduced by several authors: The Readiness of TL to join the Southeast Asian grouping. Hence, built through three rationalities (preparedness, ambivalence, and conflict), the Narrative of Readiness reveals a common sense among the agents. Built on two constructs, scattered agents and International Online Media, we propose an eventual International Imagined Community in the making. This article raises the possibility that TL plays a test role in the identity of ASEAN, even though the delay of the TL admission to ASEAN still raises further questions.
Ravulizumab: a novel C5 inhibitor for the treatment of paroxysmal nocturnal hemoglobinuria
Authors: Stern Robert M. , Connell Nathan T.
Published: September 2019

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare stem cell disorder characterized by hemolytic anemia, bone marrow failure, and thrombosis. Until recently, the complement inhibitor, eculizumab, was the only United States Food and Drug Administration (US FDA)-approved therapy for the treatment of PNH. Although effective, eculizumab requires a frequent dosing schedule that can be burdensome for some patients and increases the risk of breakthrough intravascular hemolysis. Ravulizumab, an eculizumab-like monoclonal antibody engineered to have a longer half-life, is intended to provide the same benefits as eculizumab but with a more convenient and effective dosing schedule. In two recently published phase III non-inferiority trials, ravulizumab was found to be non-inferior to eculizumab both in efficacy and safety for the treatment of patients with PNH. Based on these results, ravulizumab was approved by the US FDA on 21 December 2018 and is currently under regulatory review in both the European Union and Japan.
Building team effectiveness through adaptation: Team knowledge and implicit and explicit coordination
Authors: Rico Ramón , Gibson Cristina B. , Sánchez-Manzanares Miriam , Clark Mark A.
Published: September 2019

We develop a theory of team adaptation that centers on team knowledge structures and coordination processes. Specifically, we explain that when a team’s task changes, there may be a disruption in the extent to which their team mental model (TMM) fits the current situation. Whether this is the case is likely to depend on team compositional factors, emergent states, and structural characteristics of the team. When there is a lack of correspondence between the TMM and the situation, this then requires a shift in the extent to which the team uses implicit or explicit coordination processes. We also explain that the team performance phase matters, such that during action phases, a prevalence of implicit coordination relative to explicit coordination results in greater effectiveness; during a transition phase, the opposite is likely. In this way, we address central questions in the field: what types of task changes require team adaptive response, what happens during the adaptation process, and how this influences team effectiveness over time.
Case Studies in Instructional Design Education: Students’ Communication Preferences During Online Discussions
Authors: Trespalacios Jesús , Uribe-Flórez Lida J.
Published: September 2019

The analysis of case studies is an important constructivist instructional strategy that shows potential for engaging students in asynchronous online discussions. However, little is known about the use of audio-based discussions to promote this type of analysis. Twenty-nine students from two sections enrolled in an online instructional design course participated in the study. Students from both sections had the opportunity to experience different learning activities including online case-based discussion forums using text-based (Moodle) and audio-based (VoiceThread) formats. Data from a course evaluation survey were collected and analyzed based on the diffusion of innovation theory. Results revealed that students considered the case-based discussion as the most relevant learning activity. Additionally, students preferred the text-based format over the audio-based for the discussion of case studies. Reasons for their preferences and implications for research and practice are discussed.
Looking back and going forward: The concept of the public in public relations theory
Authors: Pieczka Magda
Published: September 2019

This article examines the development of the public as a foundational concept in public relations theory. It provides an overview of the way in which public relations has understood the term as referring to two distinct phenomena of a public and the public. The article approaches public relations theory as unfolding of a narrative identity of public relations. The discussion subsequently reaches to the work of Michael Warner and Judith Butler to consider the limitations and implications of the situational theory of publics and the deliberativist approach to the public derived from the work of John Dewey and Jürgen Habermas. In its final sections, the article redefines the public as a family of three distinct, but at times, overlapping terms: an audience as a public of shared spaces, a self-organized public of shared attention, and the public as a political and social imaginary. This article argues for the need to adopt the performative approach to the public in order to tackle some of the biases in public relations theory. It also suggest the PESO model of communication a useful starting point to create a more complex understanding of the formation of the public (in all three senses) in relation to processes of co-creation and circulation of a wide range of texts.