bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the Schoolwide Expectations Survey for Specific Settings to Build Expectation Matrices
Authors: Lane Kathleen Lynne , Oakes Wendy Peia , Royer David J. , Cantwell Emily D. , Menzies Holly Mariah , Jenkins Abbie B. , Hicks Tyler
Published: January 2019

Schoolwide expectations are a critical component of tiered systems of support, particularly when established with input from faculty and staff and then taught to all students. The expectation matrices depicting these expectations for all key settings serve as important instructional tools when teaching schoolwide expectations. In this study, we examined psychometric properties of the Schoolwide Expectations Survey for Specific Settings (SESSS)—a measure designed to assist school teams in K-12 settings constructing schoolwide expectations for seven school settings with input from all faculty and staff—with results indicating strong internal consistency of items. These settings are classrooms, hallways, cafeterias, playgrounds, restrooms, buses, and arrival/dismissal. In addition, we examined the degree to which adults in elementary, middle, and high school converged and diverged in their expectations for each setting. Using mixed-effects modeling for nested data, we found some expectations varied among school levels in some noninstructional settings. We conclude with limitations and future directions.
Le spectacle de la douleur dans l’expérience : une étude dans les stades de rugby
Authors: Dubreuil Clément , Dion Delphine
Published: January 2019

Résumé

Cette recherche s’attache à comprendre comment le spectacle de la douleur contribue à l’expérience des spectateurs. Reposant sur une approche abductive et une collecte de données mixte et longitudinale de trois ans dans les stades, ce travail identifie quatre fonctions du spectacle de la douleur, en détaille les modalités et la progressivité. Cette recherche sur les matchs de rugby contribue à la littérature sur l’expérience et sur la douleur. Premièrement, elle approfondit la compréhension de l’ambivalence des expériences. Elle montre que les dimensions négatives de l’expérience sont valorisées par un système moral et normatif. Deuxièmement, cette recherche contribue à approfondir les connaissances sur l’attrait de la douleur, en montrant son association à un contenu symbolique. Troisièmement, elle introduit le concept de domestication de la violence face à la douleur. Le spectacle de rugby s’inscrit dans une dialectique nature / culture, avec d’un côté une violence pseudo-primitive et de l’autre une sophistication de codes et de règles. Des recommandations managériales et des perspectives de recherche sont également présentées.
Early diagnosis of cerebral thrombosis by EGFP–EGF1 protein conjugated ferroferric oxide magnetic nanoparticles
Authors: Hu Yu , Li Ziying , Shi Wei , Yin Yanxue , Mei Heng , Wang Huafang , Guo Tao , Deng Jun , Yan Han , Lu Xuan
Published: January 2019

Cerebral thrombosis disease is a worldwide problem, with high rates of morbidity, disability, and mortality. Magnetic resonance imaging diffusion-weighted imaging was used as an important early diagnostic method for cerebral thrombotic diseases; however, its diagnosis time is 2 h after onset. In this study, we designed EGFP–EGF1–NP–Fe3O4 for earlier diagnosis of cerebral thrombosis by taking advantage of EGFP–EGF1 fusion protein, in which EGF1 can bind with tissue factor and enhanced green fluorescent protein has previously been widely used as a fluorescent protein marker. EGFP–EGF1–NP–Fe3O4 or NP–Fe3O4 reaches the highest concentration in the infarction areas in 1 h. To evaluate the targeting ability of EGFP–EGF1–NP–Fe3O4, a fluorochrome dye, Dir, was loaded into the nanoparticle. As shown by the in vivo organ multispectral fluorescence imaging, Dir-loaded EGFP–EGF1–NP–Fe3O4 exhibited higher fluorescence than those of model rats treated with Dir-loaded NP–Fe3O4. Coronal frozen sections and transmission electron microscope further showed that EGFP–EGF1–NP–Fe3O4 was mainly accumulated in the tissue factor exposure region of brain. The data indicated that the EGFP–EGF1–NP–Fe3O4 targeted cerebral thrombosis and might be applied in the early diagnosis of intracranial thrombosis.
A mesh objective continuum damage model for quasi-brittle crack modelling and finite element implementation
Authors: Li Xiaole , Gao Weicheng , Liu Wei
Published: January 2019

In the framework of continuum damage mechanics, a computational model for quasi-brittle crack modelling is proposed. The proposed model has significant mesh-objectivity and accuracy advantages over existing methods for modeling quasi-brittle crack. These stem from the combination of the local crack tracking algorithm, the new calculation of crack bandwidth and the non-local treatment regarding strain field. Resorting to the implementation of local crack tracking algorithm, it is desirable that the spurious dependence of conventional continuum damage mechanics-based model on mesh bias can be effectively addressed. The new estimation of the real-time crack bandwidth can be not only depending on the element size and pattern, but also on the physical crack path within each consolidate cracked element. Thus, the energy dissipation during crack propagation can be characterized in a more accurate, physically based manner. The non-local averaging regarding the strain field in the course of failure evolution is carried out within an elliptical domain, the configuration of which is related to finite element and crack trajectory obtained by the local crack track algorithm. With this combined technique, it is expected that a more accurate crack evolution course can be achieved numerically, which allows engineers to adopt relatively coarse unstructured discretizations without sacrificing solution accuracy. By numerical examples, the proposed model, empowered by the combined techniques, demonstrates significant improvements in the prediction of crack propagating of quasi-brittle materials. This model may provide engineers a more reliable tool in practical application of computational material failure.
Severe left atrial enlargement due to carfilzomib use in multiple myeloma
Authors: Dasanu Constantin A , Plaxe Steven C , Popescu Iliana M , Gupta Varun , Sontz Eric , Codreanu Ion
Published: January 2019

Several cardiovascular effects have been attributed to carfilzomib in the recent literature. These side effects must be recognized promptly by treating physicians and pharmacists. Special attention is required in patients with pre-existing cardiac conditions, liver function abnormalities and/or advanced age. This is the first report of a severe left atrial enlargement due to carfilzomib use in the setting of multiple myeloma. This condition improved dramatically seven months after cessation of carfilzomib. The authors discuss further various cardiac and vascular abnormalities linked with carfilzomib in the medical literature. Prompt withdrawal of this agent is essential in these cases as it may prevent dismal outcomes.
Prevalence of High-Intensity Drinking from Adolescence through Young Adulthood: National Data from 2016-2017
Authors: Patrick Megan E , Terry-McElrath Yvonne M
Published: January 2019

High-intensity drinking (HID; ie, having 10+ drinks in a row) is a recognized public health concern due to the individual and public risks (eg, alcohol-related injuries, alcohol poisoning, memory loss, sexual risk) associated with consumption of a large quantity of alcohol over a relatively short time period. Using nationally representative samples of US 8th, 10th, and 12th grade students, and follow-up of subsamples of 12th graders, we present overall and sex-specific prevalence estimates of past 2-week HID from 29 966 individuals at the modal ages of 14 to 30 in 2016-2017. Similar data for the more commonly studied measure of binge drinking (having 5+ drinks in a row) is provided for comparison. HID prevalence ranged from 1% to 11.5% and was significantly higher for males than females at all ages other than modal age 14 (8th grade). Binge drinking prevalence ranged from 3.5% to 32.5%; males reported a higher prevalence than females at approximately half of the ages examined. Peak binge drinking and HID age for males was earlier (modal age 21/22) than that for females (modal age 21-24 for binge drinking and 25/26 for HID). The observed rapid increase in HID from adolescence through the early to mid-20s highlights the importance of prevention and intervention efforts targeted to these ages.
Women’s and men’s role in culture of honor endorsement within families
Authors: Lopez-Zafra Esther , Rodríguez-Espartal Noelia , Ramos-Alvarez Manuel Miguel
Published: January 2019

In this article, we analyze the patterns of culture of honor within Spanish families. Each member of 271 Spanish four-member families (parents and two children each, total N = 1084) completed a questionnaire containing scales for the culture of honor and for sociodemographic variables (gender, order born and age). The results show that intra-family similarities emerge. However, path analyses show that the gender and birth order of the child are relevant in predicting this similarity. In particular, the first-born child converges with their mother to a higher extent than the father regardless of their gender. However, for the second-born child both parents instill their ideas about culture of honor in a gender congruent way (father–boy and mother–girl). Furthermore, there are higher similarities within younger families, indicating a stronger influence from parents to children. Results are discussed in view of social role and gender social learning theories.
Syntactic awareness skills in English among children who speak Slavic or Chinese languages as a first language and English as a second language
Authors: Lipka Orly
Published: January 2019

Aims and objectives/purpose/research questions:

The purpose of this study was to examine syntactic awareness skills in English, among two groups of children: native Chinese speakers and native Slavic (L1) speakers. Both groups were second language English (L2) speakers. Their syntactic awareness skills were compared to a matched sample of L1 English speakers.

Design/methodology/approach:

Eighty-six third grade students participated in the study, matched between language groups on the basis of age and gender, as well as academic achievements and word reading levels.

Data and analysis:

L1 English and L1 Slavic groups performed significantly better on the syntactic awareness task than did the L1 Chinese group. A close examination of specific syntactic constructions revealed that the L1 Chinese group did not perform as well as the other groups on past tense constructions, which do not exist in Chinese but do exist in Slavic languages. However, there were no between-group differences on superlative and comparative constructions, which exist in all three languages.

Findings/conclusions:

The results contribute to our knowledge about cross-linguistic influences between English, Slavic, and Chinese, showing that L1 Slavic facilitates the learnability of L2 English, while L1 Chinese impedes the learnability of L2 English.

Originality:

The originality of the study lies in the comparison of children from three different L1 groups, matched with respect to reading level. The examination of languages that are typologically different in their syntax is unique.

Significance/implications:

The results highlight the importance of taking the specific language backgrounds of L2 learners into consideration.

Limitations:

The current study did not include an assessment of L1 language proficiency among participants.
Bilateral scapholunate widening may have a nontraumatic aetiology and progress to carpal instability and osteoarthritis with advancing age
Authors: Hollevoet Nadine
Published: January 2019

It was hypothesized that bilateral widening of the scapholunate gap is relatively common in the absence of trauma and that it progresses to radiological carpal instability and scapholunate advanced collapse. Electronic files of 1000 patients with bilateral X-rays were studied in retrospect. Wide scapholunate gaps were bilaterally present in 67 and unilaterally in 51 patients. Scapholunate advanced collapse was observed in 26 patients; in nine it was in both wrists. A trauma was recorded in less than half of the patients with a bilateral wide scapholunate gap. Patients with bilateral wide gaps were younger if signs of carpal instability or osteoarthritis were absent. Bilateral scapholunate widening may not be caused by an acute trauma, but may lead to carpal instability and degenerative changes with advancing age.
Quantifying outcomes for leech therapy in digit revascularization and replantation
Authors: Lee Z-Hye , Cohen Joshua M. , Daar David , Anzai Lavinia , Hacquebord Jacques , Thanik Vishal
Published: January 2019

We retrospectively reviewed 201 digit replantations or revascularizations that were performed between August 2007 and June 2015. Leeching therapy was used in 48 digits and was more commonly required in replanted digits. In revascularized digits, leeching was used significantly more frequently in avulsion injuries and injuries associated with fractures. Digits that were leeched for more than 4.5 days had significantly higher rates of survival of digits after replantation or revascularization. Leeching was associated with higher incidence of transfusion, higher mean number of transfusions, and longer length of stay. We conclude from this study that leeching is used more frequently after digital replantation than revascularizaion, and in revascularized digits, leeching is used more often in avulsion injury and in patients with fractures. In patients requiring leeching therapy, leaching for more than 4.5 days leads to higher rate of digital survival.

Level of evidence: IV
Identifying Factors That Contribute to Adolescent Bony Stress Injury in Secondary School Athletes: A Comparative Analysis With a Healthy Athletic Control Group
Authors: Nussbaum Eric D. , Bjornaraa Jaynie , Gatt Charles J.
Published: January 2019

Background:

Bony stress injuries (BSIs) are common among adolescents involved in high school sports. A better understanding of factors that contribute to adolescent BSI is needed to target preventative measures.

Hypothesis:

Individuals who suffer a BSI will demonstrate significant differences in training methods, sleep, diet, and history of injury compared with a healthy, noninjured control group.

Study Design:

Descriptive epidemiologic study.

Methods:

Data from the National High School Stress Fracture Registry (NHSSFR), an internet-based adolescent BSI survey, were used to identify variables reported with adolescent (13-18 years of age) BSI. These findings were compared with a survey of 100 (50 males, 50 females) healthy athletic controls to identify significant differences between healthy adolescents and those with BSI.

Results:

A total of 346 stress fractures were reported in 314 (206 females, 108 males) athletes within the NHSSFR. Comparison with healthy control participants demonstrated multiple significant findings. In particular, body mass index was significantly lower for patients with BSI injury compared with controls ( P < 0.001). Patients slept significantly less than the control group (7.2 vs 7.95 hours; F = 34.41; P < 0.001). Females also slept significantly less hours than males (7.2 vs 7.63 hours; F = 11.02; P < 0.001). Fifty-eight percent of those who reported a BSI did not engage in any weight training. Those with a BSI had significantly higher average stress ratings than control participants (1.67 vs 1.42; P < 0.001), and females also rated their stress levels significantly higher than males (1.8 vs 1.38; P < 0.001). A significant difference between patients with any BSI and control participants existed for history of “shin splints” (Pearson χ2 = 28.31; P < 0.001), and females also expressed having shin pain lasting for longer than 4 weeks (Pearson χ2 = 8.12; P < 0.001) and more often (Pearson χ2 = 5.84; P = 0.02) than males. There was also a significant difference between patients with BSI and control subjects regarding dairy intake (2.25 vs 2.69; F = 6.43; P = 0.01).

Conclusion:

Findings revealed significant differences between those who reported a BSI relative to healthy athletic adolescents. These differences included body mass index, prior history of shin splints, involvement in weight training, amount of sleep, daily stress, and dairy intake. Preventive measures should be developed to address these areas to reduce the incidence of BSIs in the adolescent population.
Extensive unroofing of myocardial bridge: A case report and literature review
Authors: Mok Salvior , Majdalany David , Pettersson Gosta B
Published: January 2019

Background:

Myocardial bridge is defined as a segment of a coronary artery that takes an intramyocardial course. The presence of myocardial bridge has been observed in as many as 40%–80% of cases on autopsy, angiographically from 0.5% to 16.0%, and often asymptomatic. However, it has been associated with angina, coronary spasm, myocardial infarction, arrhythmias, syncope, sudden cardiac arrest, and death. Conflicting opinions exist on the timing of surgical intervention for myocardial bridge.

Methods:

We present an unusual case of a young female, with prior aortic surgery, who had refractory chest pain despite optimal medical therapy. Stress testing revealed anterior ischemia. Cardiac catherization showed myocardial bridge of the left anterior descending artery with significant compromise of blood flow (fractional flow reserve = 0.75 with adenosine). We proceeded with surgery. Intraoperatively, we found an unusually long (10-cm) intramyocardial segment of the left anterior descending artery which was managed by surgically unroofing. Our patient felt better post procedure. Repeat cardiac catheterization showed no further narrowing of the left anterior descending artery with a fractional flow reserve of 0.87 in its distal segment.

Results/discussion:

Myocardial bridge is present mostly in female patients (74.5%), with median age at 56.2 years and mostly involving the left anterior descending artery (77.2%). The average length of myocardial bridge is 21.85 ± 16.10 mm (range: 5–70 mm). Our case is unique as the involved myocardial bridge was 10 cm in length, the longest ever reported. Multiple imaging modality revealed significant coronary insufficiency, with a subsequent clinical and angiographic improvement upon unroofing of the culprit coronary vessel.

Conclusion:

Management decision on myocardial bridge remains controversial. This is a case of the longest symptomatic myocardial bridge, with a subsequent improvement post unroofing.
Left ventricular pseudoaneurysm following atrioventricular groove rupture after mitral valve replacement
Authors: Antonic Miha , Djordjevic Anze , Mohorko Tamara , Petrovic Rene , Lipovec Robert , Juric Peter
Published: January 2019

Left ventricular pseudoaneurysm is a partial cardiac rupture, contained by the surrounding pericardium that maintains communication with the left ventricular lumen. Whereas most cases of left ventricular pseudoaneurysms are related to myocardial infarction (loss of myocardial integrity), only a handful are associated with valve surgery. We present a female patient, who was admitted for elective mitral valve replacement. After the implantation of the mechanical valve, we encountered a rupture of the atrioventricular groove. After 3 months, a left ventricular pseudoaneurysm was found and the patient was reoperated. The valve was explanted and the inspection of the annulus and previously implanted pericardial patch revealed a loosened stitch on the inferior (ventricular) side. The defect was reinforced with additional stitches and the valve was reimplanted. In conclusion, we report an unusual case with two serious complications after mitral valve replacement – atrioventricular groove rupture and left ventricular pseudoaneurysm.
Combined excision and ablation of ampullary tumors with biliary or pancreatic intraductal extension is effective even in malignant neoplasms
Authors: Pérez-Cuadrado-Robles Enrique , Piessevaux Hubert , Moreels Tom G , Yeung Ralph , Aouattah Tarik , Komuta Mina , Dano Hélène , Jouret-Mourin Anne , Deprez Pierre H
Published: January 2019

Background

The feasibility and outcome of endoscopic resection in ampullary tumors with intraductal growth remains unclear.

Objective

To assess the safety, feasibility and outcomes of these patients treated by thermal ablation.

Methods

Retrospective observational study. All consecutive patients who underwent an endoscopic snare papillectomy with a 6‐month minimum follow‐up were included. Ablation was performed with cystotomes and soft/forced coagulation. Successful endoscopic treatment was defined as no adenomatous residual tissue or recurrence observed at follow‐up.

Results

Of 86 patients presenting with an ampullary tumor, 73 (58 ± 14 years old, 49% men, 34% familial adenomatous polyposis) (median tumor size: 20 mm, range: 8–80) were included. En bloc and curative resection rates were achieved in 46.6% and 83.6%, respectively.

Intraductal ingrowth was seen in 18 (24.7%) patients and histologically confirmed in 12 (16.4%). Intraductal ablation achieved a 100% success rate, with a 20‐month median follow‐up. Most of these patients had malignant forms (n = 8, 66.7%), with a higher adenocarcinoma rate (33.3% versus 3.3%, p = 0.001) compared to extraductal tumors.

Overall, there was a 20.5% complication rate with no significant differences between both groups (p = 0.676).

Conclusions

Intraductal ablation achieves a high therapeutic success rate in ampullary tumors with ≤20 mm ductal extension, even in malignant forms or biliary and pancreatic involvement. The technique is feasible, cheap and safe and may avoid major surgery.
Appropriateness of pancreatic resection in high‐risk individuals for familial pancreatic ductal adenocarcinoma: a patient‐level meta‐analysis and proposition of the Beaujon score
Authors: de Mestier Louis , Muller Marie , Cros Jérôme , Vullierme Marie-Pierre , Vernerey Dewi , Maire Frédérique , Dokmak Safi , Rebours Vinciane , Sauvanet Alain , Lévy Philippe , Hammel Pascal
Published: January 2019

Background

About 5% of pancreatic ductal adenocarcinomas are inherited due to a deleterious germline mutation detected in 20% or fewer families. Pancreatic screening in high‐risk individuals is proposed to allow early surgical treatment of (pre)malignant lesions. The outcomes of pancreatic surgery in high‐risk individuals have never been correctly explored.

Objectives

To evaluate surgical appropriateness and search for associated factors in high‐risk individuals.

Methods

A patient‐level meta‐analysis was performed including studies published since 1999. Individual classification distinguished the highest risk imaging abnormality into low‐risk or high‐risk abnormality, and the highest pathological degree of malignancy of lesions into no/low malignant potential or potentially/frankly malignant. Surgical appropriateness was considered when potentially/frankly malignant lesions were resected.

Results

Thirteen out of 24 studies were selected, which reported 90 high‐risk individuals operated on. Low‐risk/high‐risk abnormalities were preoperatively detected in 46.7%/53.3% of operated high‐risk individuals, respectively. Surgical appropriateness was consistent in 38 (42.2%) high‐risk individuals, including 20 pancreatic ductal adenocarcinomas (22.2%). Identification of high‐risk abnormalities was strongly associated with surgical appropriateness at multivariate analysis (P = 0.001). We proposed a score and nomogram predictive of surgical appropriateness, including high‐risk abnormalities, age and existence of deleterious germline mutation.

Conclusion

Overall, 42.2% of high‐risk individuals underwent appropriate surgery. The proposed score might help selecting the best candidates among high‐risk individuals for pancreatic resection.
Executive turnovers in sub-Saharan Africa
Authors: Damore David F , Kuenzi Michelle
Published: January 2019

We use competing risks duration analysis to examine the role of ethnicity and governance institutions in executive turnovers of power in 47 sub-Saharan African countries between 1960 and 2008. Using measures that capture the politically important aspects of countries’ ethnic divisions, we find that as compared to countries characterized by one, and only one, potential majority ethnic grouping, leaders’ tenures are shorter in countries with a majority ethnic group that comprises a majority subgroup and that these leaders are at risk of losing power through both coups and elections. In contrast, leaders of countries with no ethnic majority group are better positioned to stave off coups, perhaps by undercutting rivals’ efforts to coordinate among different ethnic groups. Our results, however, suggest that the effectiveness of this strategy wanes over time. Although the results also suggest that the type of regime matters, they do not indicate a monotonic relationship between democracy and elections and authoritarianism and coups.
Severe Restrictive Lung Disease in One of the Oldest Documented Males With Coffin-Lowry Syndrome
Authors: Venter Frederick , Evans Andrew , Fontes Claudia , Stewart Carol
Published: January 2019

Coffin-Lowry syndrome is expressed as different phenotypes in males and females. In males, it is characterized by facial abnormalities, marked developmental disability, and skeletal changes. Approximately 80% of cases are associated with kyphoscoliosis, which can be quite severe, as seen in our patient, causing paraplegia and restrictive lung disease. In this article, we present the third oldest documented male case of Coffin-Lowry syndrome with severe kyphoscoliosis, paraplegia, and restrictive lung disease.
Rethinking high reliability in healthcare: The role of error management theory towards advancing high reliability organizing
Authors: Guttman Oren , Keebler Joseph R , Lazzara Elizabeth H , Daniel William , Reed Gary
Published: January 2019

US Healthcare, despite its exceptional technology and innovative treatments, is still unsafe and unreliable. It is estimated that medical errors account for an estimated 254,000 inpatient deaths a year and hold the distinction as the third leading cause of death in the US. Despite an aggressive national campaign set by organizations like the National Academy of Medicine, the Institute for Healthcare Improvement, the National Patient Safety Foundation, and the National Quality Forum, efforts to improve the quality and safety of US Healthcare have been unsuccessful, or at best, unsustainable at eliminating preventable patient harm. Historically, US Healthcare has turned to commercial aviation, nuclear energy, oil and gas, and other high reliability industries for lessons on how to avoid harm. In this paper, we join two pre-existing conceptual models: high reliability organizing and error management theory to propose a strategy for embedding and sustaining a preoccupation with failure and commitment to resilience within healthcare to advance a practical and disciplined focus to advance organizational high reliability.
‘You feel like you haven’t got any control’: A qualitative study of side effects from medicines
Authors: O’Donovan Bernadine , Rodgers Ruth M , Cox Anthony R , Krska Janet
Published: January 2019

Objectives

An aging UK population and multi-morbidity means patients are receiving an increasing number of medicines. This can lead to greater risk of unintended side effects. The aim of this study was to increase understanding of how people identify and manage side effects from their medicines.

Design

A qualitative interview study with patients who had experienced side effects, recruited from community pharmacies.

Methods

This study examined patients’ experiences of side effects and the impact of these effects on their daily life. Fifteen participants were interviewed – 10 females and 5 males, with ages that ranged between 25 and 80 years, using different types and numbers of medicines.

Results

Thematic analysis revealed six themes: side effect experience, identification, adherence, information use, coping and body awareness. Participants described a wide range of physical and psychological symptoms which had both explicit and implicit impact on their lives. A system of identification based on constructed cognitive processes was common across participants. A variety of strategies were used by participants to cope with their side effects which included information seeking, social support seeking and non-adherent behaviours.

Conclusions

Psychological factors, such as medication beliefs, symptom interpretation and body awareness, contribute to cognitive and behavioural processes used to identify and manage side effects. These processes can have significant impacts on an individual’s decisions about adherence.
The HLA-B −21 dimorphism impacts on NK cell education and clinical outcome of immunotherapy in acute myeloid leukemia
Authors: Hallner Alexander , Bernson Elin , Hussein Brwa Ali , Ewald Sander Frida , Brune Mats , Aurelius Johan , Martner Anna , Hellstrand Kristoffer , Thorén Fredrik B.
Published: January 2019

Natural killer (NK) cell function is regulated by inhibitory receptors, such as the family of killer immunoglobulin-like receptors (KIRs) and the NKG2A/CD94 heterodimer. These receptors recognize cognate HLA class I molecules on potential target cells, and recent studies imply that an HLA-B dimorphism at position −21 in the gene segment encoding the leader peptide dictates whether NK cell regulation primarily relies on the KIRs or the NKG2A/CD94 receptor. The impact of this HLA-B dimorphism on NK cell–mediated destruction of leukemic cells or on the course of leukemia is largely unknown. In a first part of this study, we compared functions of NK cells in subjects carrying HLA-B −21M or 21T using interleukin-2 (IL-2)–activated NK cells and leukemic cells from patients with acute myeloid leukemia (AML). Subjects carrying HLA-B −21M harbored better-educated NKG2A+ NK cells and displayed superior capacity to degranulate lytic granules against KIR ligand-matched primary leukemic blasts. Second, we aimed to define the potential impact of HLA-B −21 variation on the course of AML in a phase 4 trial in which patients received IL-2–based immunotherapy. In keeping with the hypothesis that 21M may be associated with improved NK cell functionality, we observed superior leukemia-free survival and overall survival in −21M patients than in −21T patients during IL-2–based immunotherapy. We propose that genetic variation at HLA-B −21 may determine the antileukemic efficacy of activated NK cells and the clinical benefit of NK cell–activating immunotherapy.
Correction to: Age at immigration matters for labor market integration—the Swedish example
Authors: Gustafsson Bjorn Anders , Mac Innes Hanna , Österberg Torun
Published: January 2019

Following publication of the original article (Gustafsson et al., 2017), the authors reported a list of errors.
A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer
Authors: Rolland Viannique , Meyer François , Guitton Matthieu J. , Bussières Richard , Philippon Daniel , Bairati Isabelle , Leclerc Mathieu , Côté Mathieu
Published: January 2019

Background

Cisplatin-induced hearing loss is frequent and severe. Antioxidants such as sodium thiosulfate (STS) can neutralize the effects of cisplatin. The objective of the trial was to test the efficacy of trans-tympanic injections of a STS gel to prevent cisplatin-induced ototoxicity.

Methods

Eligible participants were newly diagnosed patients with stage III or IV squamous cell carcinoma of the mouth, oropharynx, hypopharynx, or larynx and scheduled to be treated by concurrent chemoradiation (CCR). Patients with asymmetric hearing were not eligible. The planed treatment included cisplatin 100 mg/m2 at days 1, 22 and 43. A baseline pre-treatment complete audiometric evaluation (pure tone at frequencies ranging from 0.5 to 14 kHz, bone conduction at 0.5–4 kHz and DPOAEs) was performed. Adverse effects were noted according to CTCAE. On the day before the beginning of CCR, eligible and consenting patients were randomized to receive a trans-tympanic injection of the gel either in the left ear or in the right ear. A final post-treatment complete audiometric evaluation was scheduled to be performed 1 month after the end of CCR by audiologists kept blind to the ear assignment. For the main outcome, the permanent threshold shift (PTS) in decibel (dB) was calculated as the difference between the final and baseline measures at all pure tone frequencies at 0.5–14 kHz for each patient and for each ear. The main outcome was assessed blindly in a mixed linear model with the PTS as the dependent variable and intervention, frequency, their interaction and radiation dose to the cochlea as independent variables.

Results

Between January 2015 and April 2016, 13 patients were randomized. The trial was stopped in June 2016 for poor accrual. The average loss of hearing over all frequencies was 1.3 dB less for treated ears compared to control ears. Although not statistically ( p = 0.61) nor clinically significant, the difference was in favor of the treated ears for all frequencies between 3 and 10 kHz.

Conclusions

Our trial suggests that STS deposited on the round window was safe for the middle and inner ears. More work is needed to improve the efficacy of trans-tympanic injections of cisplatin antidotes.

Trial registration

ClinicalTrials.gov, NTC02281006 , Registered 3 November 2014.
Innovation in Education Research: Creation of an Education Research Core
Authors: Schwengel Deborah A. , Toy Serkan
Published: January 2019

Within academic medical centers, there is increasing interest among physicians to pursue education as a promotion pathway. Many medical schools and universities offer professional development opportunities for these individuals such as workshops and certificate and advanced degree programs. However, there exists a need for a more personalized support for clinician-educators to be successful in educational scholarship in the health care setting. In 2017, a departmental level educational research community was established within Anesthesiology and Critical Care Medicine at Johns Hopkins University to support faculty, staff, and trainees in creating, completing, and publishing educational scholarship. The research infrastructure includes administrative and institutional review board submission assistance, internal grant support, database management, statistical analysis, and consultation with professional educators. Also, integral to the education core is monthly education lab meetings that allow an opportunity for education researchers to present work in progress, conceive new projects, discuss relevant literature, and cultivate and sustain a community of educational scholars.

This innovation in education demonstrates feasibility at a departmental level to successfully support educational research. We have initiated education meetings with a cohort of core education faculty who are interested in an educational promotion track. We present several metrics that can be used to evaluate the effectiveness of the programs similar to this innovation.
The Effects of Postoperative Residual Neuromuscular Blockade on Hospital Costs and Intensive Care Unit Admission: A Population-Based Cohort Study
Authors: Grabitz Stephanie D. , Rajaratnam Nishan , Chhagani Khushi , Thevathasan Tharusan , Teja Bijan J. , Deng Hao , Eikermann Matthias , Kelly Barry J.
Published: January 2019

BACKGROUND:

Postoperative residual neuromuscular blockade continues to be a frequent occurrence with a reported incidence rate of up to 64%. However, the effect of postoperative residual neuromuscular blockade on health care utilization remains unclear. We conducted a retrospective cohort study to investigate the effects of postoperative residual neuromuscular blockade on hospital costs (primary outcome), intensive care unit admission rate, and hospital length of stay (secondary outcomes).

METHODS:

We performed a prespecified secondary analysis of data obtained in 2233 adult patients undergoing surgery under general anesthesia. Postoperative residual neuromuscular blockade was defined as a train-of-four ratio <0.9 in the postanesthesia care unit (PACU). Our confounder model adjusted for a variety of patient, surgical, and anesthesia-related factors. We fitted truncated negative binomial regression models for hospital cost and hospital length of stay analyses and a logistic regression model for our intensive care unit admission analysis.

RESULTS:

Overall, 457 (20.5%) patients in our cohort had residual neuromuscular blockade on admission to the PACU. Postoperative residual neuromuscular blockade was not independently associated with increased hospital costs (adjusted incidence rate ratio, 1.04, CI, 0.98–1.11; P = .22). There were significantly higher odds of intensive care unit admission in those with postoperative residual neuromuscular blockade compared to those without (adjusted odds ratio, 3.03, CI, 1.33–6.87; P < .01). Further, we found a trend toward increased hospital length of stay in patients with postoperative residual neuromuscular blockade (adjusted incidence rate ratio, 1.09; P = .06). Sensitivity analysis using the same model in the day of surgery admissions and ambulatory surgery confirmed our findings.

CONCLUSIONS:

Postoperative residual neuromuscular blockade at PACU admission was not significantly associated with increased hospital costs, but was associated with higher rates of intensive care unit admission. These findings support the view that clinicians should continue to work to reduce the rate of postoperative residual neuromuscular blockade.
Analisis Prediksi Kebangkrutan dan Rasio Keuangan Bank Umum Syariah dengan Metode Altman Z-Score pada Tahun 2011-2015
Authors: Muharrami Rais Sani , Sinta Sinta
Published: January 2019

The purpose of this research is to perform a comparative analysis of bankruptcy prediction and financial ratio related to Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa. This research applied Altman model on Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa to explain its bankruptcy prediction., while Mann Withney test is used to show a comparative analysis on its financial ratio related to bankruptcy.  Data was use in this research is time series data, the data from 2011 up to 2015. The data is obtained from publication in Otoritas Jasa Keuangan (OJK) and publication in each bank’s website. The sampling techniques using purposive sampling methods. This research can be concluding that there is no difference between Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa on Bankruptcy prediction with Altman model. In financial ratios related to bankrupty exposure such as liquidity, Profitability, and Productivity has not significant difference to. While insolvency ratio at Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa foundto have differences. For bankruptcy prediction at Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa is found not difference. So, we can conclude that the difference in bankruptcy perdiction on Bank Umum Syariah Devisa and Bank Umum Syariah non Devisa caused by the absence of dirrerences in the financial ratios with regard to bankruptcy unless insolvency.
Instrumentos para a eficácia das políticas públicas energéticas: Brasil e União Européia
Authors: Bianchi Patricia Nunes Lima
Published: January 2019

O presente estudo teve como objetivo a análise de alguns instrumentos que contribuem para a eficácia das políticas públicas energéticas no Brasil e na União Européia. Objetivou-se verificar até que ponto os sistemas democráticos europeu e brasileiro apresentam avanços ou retrocessos, na execução de uma governança ambiental que realmente incorpore em seus processos critérios e elementos de sustentabilidade. Esse tema levou a importantes reflexões sobre sistemas democráticos e suas intersecções e incompatibilidades com os atuais modelos de governança, representando um avanço na investigação de algumas causas da ineficácia de políticas públicas no âmbito energético. Concluiu-se que, para que as normas adquiram real eficácia no âmbito da implementação de tais políticas, é necessário que elas encontrem condições sociais para o seu enforcement. Nesses termos, tanto a responsabilização, quanto à participação popular, poderão servir de veículo para a construção de uma nova realidade. E essa construção deverá afetar positivamente questões ligadas à eficácia das normas destinadas a estabelecer um desenvolvimento econômico que respeite algumas condições ambientais, o que, por sua vez, garantiria certa qualidade na vida às pessoas, entre outros benefícios coletivos, característicos de sociedades mais avançadas. Neste artigo, utilizou-se como metodologia um estudo descritivo analítico, mediante análise bibliográfica, documental e legislativa.
A CIÊNCIA ABERTA E OS DIREITOS DE PROPRIEDADE INTELECTUAL: UM OLHAR A PARTIR DA ECONOMIA CRIATIVA E DA CIÊNCIA DO COMMONS
Authors: Oliveira Adriana Carla Silva de , Guimarães Patrícia Borba Vilar , Koshiyama Débora Costa Araújo Di Giacomo
Published: January 2019

O estudo é resultante de uma tese de doutoramento que versa pela Ciência Aberta e pelos Direitos de Propriedade Intelectual na contemporaneidade. Os Direitos de Propriedade Intelectual vigentes no paradigma proprietário econômico são refletidos para a ambiência da ciência aberta. O estudo é inovador e objetiva refletir os direitos de propriedade intelectual à luz da Economia Criativa e da Ciência do Commons. Os dados de pesquisa oriundos da pesquisa aberta são compreendidos como bens intelectuais comuns. Teoricamente, o estudo está substanciado pelas seis dimensões (epistemológica, teórica, técnica, morfológica, política e ética) do estudo de Bufrem. É predominantemente qualitativa e adotou a multidisciplinaridade para as conexões temáticas que substanciam o estudo. Por fim, observa-se que a ciência aberta é um potencial inovador das práticas científicas modernas. Os dados de pesquisa oriundos da investigação científica são bens intelectuais comuns e, portanto, são de acesso aberto, público e gratuito. Direcionam assim, os direitos de propriedade intelectual para novas formas de recompensa autoral, por meio da atribuição e citação. Conclui-se que há uma necessidade de promoção da ciência aberta, na perspectiva de superar a proprietização dos bens intelectuais, baseada no modelo econômico tradicional vigente, para um ambiente aberto, colaborativo e compartilhado à luz do paradigma do Commons.
Focando as lentes: Criminologia Cultural e a Imagem
Authors: Hayward Keith J.
Published: January 2019

O presente estudo busca analisar o crescente papel/uso da imagem em relação às condições contemporâneas da sociedade na modernidade tardia e, particularmente, as representações visuais (significados) extraídas da imagem do crime e do controle social enquanto produtos culturais carregados de sentido, de interpretações, de tensões, etc., o poder dessas imagens e desses múltiplos visuais (estilos), de que forma podemos focalizar as lentes (imagens) da transgressão e das agências de controle, e as maneiras pelas quais essas lentes são manipuladas pelos meios de comunicação, a fim de gerarem uma cultura estilizada e espetacularizada em torno dessas questões. Para a concreção dessa intenção de pesquisa, a Criminologia Cultural procura compreender, tanto metodológica quanto teoricamente, o impacto simbólico e cultural dessas condições da sociedade moderna frente às instituições de controle, e ao próprio significado circular dos termos crime e controle social, no sentido de desafiar a Criminologia, fazendo girar o seu caleidoscópio para além das análises econômicas e sociais da Criminologia ortodoxa, para focalizar ou melhor identificar o lado impreciso da imagem do crime e do controle social vistas em cada aspecto de nossa existência, e projetadas por uma cultura de estilo, que festeja e promove o seu lado sedutor. Palavras-chave: Imagem; Crime e Controle social; Criminologia Cultural; Representações visuais.
Política social e famílias: a difícil arte da superação da autoimagem familiar | Social policy and families: the difficult art of overcoming family self-image
Authors: Santos Rosemeire Dos
Published: January 2019

O artigo ora apresentando se propõe a refletir sobre a categoria família diante das transformações societárias, perspectivando salientar a necessidade de superação da autoimagem da família a partir da experiência vivida de um modelo unívoco familiar. Consequentemente, indica ao leitor, principalmente os trabalhadores sociais que cotidianamente atendem e intervêm na vida das famílias brasileiras, a necessidade de compreensão das mais diversas possibilidades dos modos de viver em família na sociedade contemporânea, a partir de estudiosos da categoria família. Tal discussão se faz necessária, principalmente, pelo direcionamento das políticas sociais de proteção social que, desde os anos de 1980, vem chamando às famílias a responsabilidades e funções de proteção social que historicamente estão além do grupo familiar. A construção e a reflexão teórica desse artigo partem do processo da pesquisa bibliográfica da tese que se debruçou sobre família e proteção social.Palavras-Chave: famílias; proteção social; política social. Abstract – The present article proposes to reflect on the family category in face of societal transformations, with a view to emphasizing the need to overcome the family’s self-image arising from the experience of a univocal family model. Consequently, it indicates the need to understand the most diverse ways of living in family in contemporary society, as pointed by scholars of the family category, mainly to social workers that attend and intervene daily in the life of Brazilian families. This discussion is necessary, mainly for the direction of social policies of social protection that, since the years of 1980, have been transfering to families the responsibilities and functions of social protection which historically are beyond the scope of the family group. This article’s construction and theoretical reflection starts from the process of bibliographical research for a doctoral thesis that focused on family and social protection.Keywords: families; social protection; social policy.