bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal Trends in Traumatic Digit Amputations: Experience of a Level І and a Level ІІ Hospital in a Northeastern State
Authors: Harris Andrew P. , Goodman Avi D. , Kuczmarski Alexander S. , Gil Joseph A. , Katarincic Julia A.
Published: May 2019

Background: Traumatic digit amputations are common hand injuries in the United States. The primary aim of our study was to describe the relationship between season and mechanisms of amputation. Methods: The Emergency Department and Orthopaedic Surgery Billing Department databases of our level І institution in the Northeast were reviewed to identify patients with a traumatic digit amputation between January 2010 and December 2015. Inclusion criteria were defined as any patient presenting with a partial or complete amputation through Verdan zone I or II. All patient information was entered into a secure database, including date of injury, demographic information, digits amputated, mechanism of injury (crush, laceration, avulsion, bite, blast, saw, snow blower, or lawn mower), and Verdan zones of amputation. In addition to descriptive statistics, Fisher exact and χ2 tests were used to compare the incidence of these traumatic digit amputation mechanisms between seasons. Results: For this 6-year period, an average of 24 patients presented each season for treatment of a traumatic digit amputation. Of all seasons, spring had the highest proportion of lawn mower amputations (62.5%; P < .0001), summer had the highest proportion of blast amputations (75.0%; P = .011), and winter had the highest proportion of snow blower amputations (90.9%; P < .0001). All other traumatic digit amputation mechanisms had no significant seasonal variation in incidence ( P > .30). Conclusions: Given that certain traumatic digit amputation mechanisms occur predictably during certain seasons, seasonal public education has the potential to prevent these debilitating injuries.
Iatrogenic Radial Artery Injuries: Variable Injury Patterns, Treatment Times, and Outcomes
Authors: Kim Doris , Arbra Chase A. , Simon Ivey J. , Burchett Philip , Gonzalez Gilberto , Herrera Fernando A.
Published: May 2019

Background: The radial artery is commonly accessed for arterial blood sampling, invasive blood pressure monitoring, and vascular access for cardiac catheterization. Iatrogenic radial artery injury is a rare complication with potentially devastating outcomes. The purpose of our study was to identify the timing of these injuries and define a treatment algorithm. Methods: A retrospective chart review of all patients with iatrogenic radial artery injuries were identified between the years 2008 and 2018. Patient demographics, mechanism of injury, interventions, and outcomes were recorded. Results: A total of 18 patients were identified with iatrogenic radial artery injury over a 10-year period. Fifty percent of these resulted from arterial line cannulation, and 50% occurred after transradial cardiac catheterization. Thirty-three percent resulted in radial artery pseudoaneurysm (RAP), and 66% had acute radial artery thrombosis (RAT). Eleven of the 18 patients underwent operative intervention. Of the 12 patients with RAT, 4 were treated with systemic anticoagulation for 3 months. All patients with RAP who were surgically treated had resolution of symptoms on follow-up evaluation. Of the patients with RAT, 2 had persistent sensorimotor deficits after treatment, and 1 patient had multiple necrotic fingers requiring amputation. Conclusion: Radial artery injuries are an uncommon but potentially devastating complication of common invasive procedures resulting in thrombosis, pseudoaneurysm, or overt hand ischemia. The treatment options vary depending on presenting symptoms.
The Effect of Image-Guided Corticosteroid Injections on Thumb Carpometacarpal Arthritis
Authors: Gershkovich Grigory E. , Boyadjian Haroutioun , Conti Mica Megan
Published: May 2019

Background: Arthritis involving the thumb carpometacarpal (CMC) joint is common in the adult population. Initial treatment includes corticosteroid injections. Injections can be performed with image guidance to assist with placement; however, the clinical benefits are unclear. Methods: This retrospective study used Truven Health Marketscan Research Databases to identify patients from 2003 to 2014 with common International Classification of Diseases, Ninth Revision (ICD-9) codes for osteoarthritis of the CMC joint, Common Procedural Terminology (CPT) codes for image and non-image-guided injections, and codes for surgical interventions. Length of time from injection until subsequent injection(s) and/or surgery was extrapolated for identified patients. Analysis of variance and binomial logistic regression were used to compare continuous variables and calculate odds ratios, respectively. Results: We identified 62 333 patients (68% women, 32% men), average age 59.7, with common ICD-9 diagnostic codes for CMC arthritis with respective injection CPT codes. The average number of days between the first and second injection for patients treated with non-guided injection was 237.3 versus 266.7 for image-guided injections. Of the 62333 patients, 8107 went on to operative treatment. Among operative patients, the average number of days to surgery following non-guided injection was 317.7 versus 333.7 days in the image-guided group. The average cost of performing non-image-guided injections was $203 less than using ultrasound. Conclusions: Image-guided thumb CMC injections do not result in significant increases in time between injections and do not lead to a meaningful delay to surgery. Future research needs to clarify the value of image-guided CMC injections in an increasingly economically conscientious health care environment.
Global liberal education: Theorizing emergence and variability
Authors: Boyle Mary-Ellen
Published: May 2019

Liberal education as a form of higher education is increasing globally even as it struggles for support and legitimacy in the USA. Its emergence and spread are only partially attributable to the growth in the tertiary sector worldwide: although the sharpest spike has been in Asia, new programs have opened in Western Europe, Russia and the Middle East. Why now? Why in a particular locale? What forms do these programs take, and why? This article uses concepts from organizational theory to argue that such programs are decoupled from economic ‘needs’, challenging the predominant explanations for the global growth. Complexity theories explain the uneven expansion and variability in approach, and offer insights for replication and/or critique. This theoretical analysis allows insight into the interplay and explanatory power of isomorphism and complexity, and suggests that studies of convergence should assess not only the form, but also the processes and substance of educational innovations.
Recruiting foreign language teachers: An international comparison of career choice influences
Authors: Kissau Scott , Davin Kristin , Wang Chuang , Haudeck Helga , Rodgers Marion , Du Lixia
Published: May 2019

In response to the critical shortage of foreign language teachers internationally, school districts around the world are employing a variety of recruitment strategies, including conducting international searches. While these strategies may help to fill foreign language teacher vacancies, they lack a strong research base, as little is known about what motivates someone to pursue a career as a foreign language teacher, and how these motivational influences vary across nations. To address this void in the research, and to guide and inform recruitment initiatives, the researchers used a mixed methodology to investigate and compare the motivational influences and perceptions that drew pre-service foreign language teachers in the United States, Germany, and China to the profession. The findings contribute to an emerging consensus with respect to motivational influences for all teachers, while also pointing out unique motivational draws associated with foreign language teaching. School administrators, teacher recruiters, and foreign language stakeholders should consider these motivational influences when determining where to focus their recruitment effort, time, and funds.
Prevention of recurrent urinary tract infections: bridging the gap between clinical practice and guidelines in Latin America
Authors: Ortega Martell José Antonio , Naber Kurt G. , Milhem Haddad Jorge , Tirán Saucedo José , Domínguez Burgos Jesús Alfonso
Published: May 2019

The branches of the immune system work in concert to defend against pathogens and prevent tissue damage due to excessive inflammation. Uropathogens in general, and uropathogenic Escherichia coli (UPEC) in particular, have evolved a diverse range of virulence mechanisms to avoid detection and destruction by the mucosal immune system of the urinary tract. Research towards a vaccine active against UPEC continues but has yet to be successful. Orally administered immunomodulatory bacterial lysates both stimulate and modulate the immune response in the urinary tract via the integrated mucosal immune system. The 2018 European Association of Urology (EAU) guidelines on treating acute uncomplicated cystitis recommend aiming for rapid resolution of symptoms, reduction of morbidity, and prophylaxis against reinfection. Recommended short-term antibiotic therapy has the advantage of good compliance, low cost, few adverse events, and low impact on bacterial flora. Antibiotic treatment of asymptomatic bacteriuria is only indicated during pregnancy and before invasive interventions. For recurrent infection, prophylaxis using behavioral modification and counseling should be employed first, then nonantibiotic prophylaxis, and, finally, low-dose continuous or postcoital antibiotic prophylaxis. The 2018 EAU guidelines give a strong recommendation for the oral bacterial lysate immunomodulator OM-89. All other nonantibiotic prophylactic strategies require more data, except for topical estrogen for postmenopausal women. For last-resort antibiotic prophylaxis, nitrofurantoin or fosfomycin trometamol are recommended. Guidelines for Latin America are currently being drafted, taking into account the unique ethnicity, availability of medicines, prevalence of antibiotic resistance, and healthcare practices found throughout the region.
An introduction to the epidemiology and burden of urinary tract infections
Authors: Medina Martha , Castillo-Pino Edgardo
Published: May 2019

Urinary tract infections (UTIs) are the most common outpatient infections, with a lifetime incidence of 50−60% in adult women. This is a narrative review aimed at acting as an introduction to the epidemiology and burden of UTIs. This review is based on relevant literature according to the experience and expertise of the authors. The prevalence of UTI increases with age, and in women aged over 65 is approximately double the rate seen in the female population overall. Etiology in this age group varies by health status with factors such as catheterization affecting the likelihood of infection and the pathogens most likely to be responsible. In younger women, increased sexual activity is a major risk factor for UTIs and recurrence within 6 months is common. In the female population overall, more serious infections such as pyelonephritis are less frequent but are associated with a significant burden of care due to the risk of hospitalization. Healthcare-associated UTIs (HAUTIs) are the most common form of healthcare-acquired infection. Large global surveys indicate that the nature of pathogens varies between the community and hospital setting. In addition, the pathogens responsible for HAUTIs vary according to region making adequate local data key to infection control. UTIs create a significant societal and personal burden, with a substantial number of medical visits in the United States every year being related to UTIs. European data indicate that recurrent infections are related to increased absenteeism and physician visits. In addition, quality of life measures are significantly impacted in women suffering from recurrent UTIs. Data suggest that nonantimicrobial prophylactic strategies offer an opportunity to reduce both the rate of UTIs and the personal burden experience by patients.
Numerical study of blast performance of concrete filled double-steel-plate composite walls
Authors: Zheng Zejun , Yu Jun , Wei Fangfang , Wu Jun
Published: May 2019

Currently, terrorism attack is one of the main concerns in public safety, although the probability of such attack is fairly low. From the perspective of multi-hazard mitigation, it is expected that the structural members that are used to resist earthquakes or winds in buildings should also reduce the vulnerability to blast. Concrete filled double-steel-plate composite walls are one of the novel structural members which are used as shear walls, in which concrete is filled between two steel plates and connected to them through shear studs. In this article, finite-element-based analyses were carried out to investigate the dynamic behaviour of concrete filled double-steel-plate composite walls subjected to blast loading. A three-dimensional numerical model was developed and validated based on previously published experimental results. Then, the numerical models were employed to investigate the effects of axial compression ratio, concrete strength, wall thickness and shear connector spacing on the blast performance of concrete filled double-steel-plate composite walls under different blast intensities. The results show that axial compression has both positive and negative effects on the blast performance of concrete filled double-steel-plate composite walls. The positive effect prevails due to increased effective flexural stiffness when plastic deformation under zero axial compression and the same blast load is marginal, whereas the negative effect is more dominant due to P-delta effect when evident plastic deformation occurs under zero axial compression and the same blast load.
A dermatomyositis/lichen planus overlap syndrome presenting with erythroderma: A case report
Authors: Ali Asma Amir , Basharat Pari , Lovegrove Fiona
Published: May 2019

This case report describes a novel presentation of a lichen planus and dermatomyositis overlap syndrome. The patient presented with pruritic and painful violaceous erythroderma with biopsy reports suggestive of both lichen planus and dermatomyositis. The patient failed first-line treatment with prednisone and hydroxychloroquine and eventually required treatment with methotrexate and intravenous immunoglobulin to achieve control of her disease. Overlap syndromes have been described between lichen planus and lupus erythematosus; however, to date, little has been described about a dermatomyositis/lichen planus overlap.
Onychomadesis following hand, foot, and mouth disease in a pregnant woman: A case report
Authors: Deeb Maya , Beach Renée A , Kim Susie
Published: May 2019

Hand, foot, and mouth disease is an enteroviral infection characterized by vesicles on the hands, feet, and oral mucosa. Given its rising incidence among adults, it is important to recognize its variable presentations and sequelae. These include onychomadesis, a complication of hand, foot, and mouth disease that is well described in children, with limited reports in adults. We present the unique case of a pregnant woman who developed onychomadesis following hand, foot, and mouth disease, with no adverse pregnancy outcomes. This case illustrates that (1) onychomadesis can occur in pregnant women with hand, foot, and mouth disease; (2) onychomadesis is typically a benign change that can occur following hand, foot, and mouth disease; and (3) onychomadesis is not necessarily associated with more severe disease or adverse pregnancy outcomes.
Ustekinumab for the treatment of recalcitrant pyoderma gangrenosum: A case report
Authors: Vallerand Isabelle A , Hardin Jori
Published: May 2019

Pyoderma gangrenosum is an ulcerating disease associated with a high degree of morbidity and mortality. Currently, little is known about the pathophysiology of pyoderma gangrenosum, though it has been linked to increased levels of inflammatory cytokines including interleukin-23. As pyoderma gangrenosum is a rare disease, evidence for pyoderma gangrenosum treatment is dependent on reporting of cases with successful therapies. Here, we describe a case of pyoderma gangrenosum developing on the lateral leg of a medically complex 47-year-old male already on chronic immunosuppressive therapy, who achieved successful wound healing with the use of ustekinumab, a monoclonal antibody targeting inhibition of interleukin-12 and interleukin-23. This case lends further evidence for the role of interleukin-23 in the pathogenesis of recalcitrant pyoderma gangrenosum and also suggests that healthcare providers may consider a trial of ustekinumab in pyoderma gangrenosum that has failed previous topical treatments or systemic immunosuppression.
Silver-coated textiles in hidradenitis suppurativa: A case report
Authors: Morand Meggie , Hatami Afshin
Published: May 2019

Hidradenitis suppurativa is a chronic and debilitating skin disease of apocrine gland–bearing areas. The mainstay of treatment usually includes topical and systemic antibiotics. These agents can be used as monotherapy or combination therapy. The therapeutic role of functional textiles with antimicrobial activity has been recently emerging in the treatment of other skin diseases such as atopic dermatitis and epidermolysis bullosa. The pathologic processes involved in the development of atopic dermatitis and hidradenitis suppurativa are still incompletely understood, but these two diseases share some similarities including bacterial proliferation and chronic inflammation. We report the case of a 14-year-old boy with hidradenitis suppurativa that has been successfully treated with silver-coated textiles. To the best of our knowledge, this article is the first to report the benefits of silver-coated textiles in the treatment of hidradenitis suppurativa.
Intranodal capillary-cavernous hemangioma: Report of a very rare case
Authors: Tessieras Jérôme , Chenaye Jinane , Senechaud Christophe , Banz Yara
Published: May 2019

Mixed type capillary-cavernous hemangioma is a rare vascular anomaly, with an intranodal localization being extremely rare. Its finding is often accidental but may be clinically symptomatic. The diagnosis relies on histopathology, showing a proliferation of capillaries and cavernous vessels filled with erythrocytes and lined by endothelial cells. Magnetic resonance imaging with enhanced and T2 STIR sequences is the most efficient imaging for diagnosing this type of hemangioma. Rarely, malignancy or another vascular lesion can be evoked as a differential diagnosis of mixed hemangioma. Treatment in this localization is often surgical, even if other possibilities exist for other areas. In this article, we describe a very rare case of intranodal capillary-cavernous hemangioma.
The stigma of a criminal record in the labour market in Spain: An experimental study
Authors: Rovira Marti
Published: May 2019

The aim of this research is to determine whether the stigma of a criminal record should be considered in understanding the precarious conditions of individuals with convictions in the Spanish labour market. Previous studies have been unable to separate this effect from other explanations such as low levels of education or the breakdown of networks resulting from the conviction. Following Pager (2007), this study adopts the experimental methodology of the audit tests, in which matched fictitious curricula vitae, differing only in the mention of a conviction, are sent to real job offers, to verify whether there is a difference in the number of responses to each CV. The results show that skilled former offenders are discriminated in the Spanish labour market as a result of the stigma of a criminal record.
Validity and Reliability of the Exercise Vital Sign Questionnaire in an Ethnically Diverse Group: A Pilot Study
Authors: Quiles Norberto N. , McCullough Aston K. , Piao Lin
Published: May 2019

The purpose of this study was to determine the validity and reliability of the Exercise Vital Sign (EVS) questionnaire in an ethnically diverse sample. Participants (N = 39) were asked to wear an accelerometer at the hip for at least 7 days and to complete the EVS at the beginning (T1) and end (T2) of the wear period. The EVS questionnaire validity was determined against accelerometry, and bias was calculated as the mean difference between measures. The sensitivity and specificity of the EVS questionnaire were also evaluated. The reliability of the questionnaire was calculated using intraclass correlation coefficient (ICC) between EVS responses at T1 and T2. The mean difference in EVS- and accelerometer-determined time in MVPA was 24 min/wk. The reliability for the questionnaire was excellent (ICC = 0.98). The EVS specificity and sensitivity at T2 were 56% and 78%, respectively. The EVS questionnaire may be an acceptable measure of weekly MVPA time compared to accelerometry in an ethnically diverse sample; however, further research is needed to confirm these findings.
The Safety Profile of Intentional or Iatrogenic Sacrifice of the Artery of Adamkiewciz and Its Vicinity’s Spinal Segmental Arteries: A Systematic Review
Authors: Tan Terence , Rutges Joost , Marion Travis , Fisher Charles , Tee Jin
Published: May 2019

Study Design:

Systematic review.

Objectives:

There is paucity of consensus on whether (1) the artery of Adamkiewicz (AoA) and (2) the number of contiguous segmental spinal arteries (SSAs) that can be safely ligated without causing spinal cord ischemia. The objective of this review is to determine the risk of motor neurological deficits from iatrogenic sacrifice of the (1) AoA and (2) its vicinity’s SSAs.

Methods:

Systematic review of the spine and vascular surgery was carried out in accordance to PRISMA guidelines. Outcomes in terms of risk of postoperative motor neurological deficit with occlusion of the AoA, bilateral contiguous SSAs, or unilateral contiguous SSAs were analyzed.

Results:

Ten articles, all retrospective case series, were included. Three studies (total N = 50) demonstrated a postoperative neurological deficit risk of 4.0% when the AoA is occluded. When 1 to 6 pairs of SSAs (without knowledge of AoA location) were ligated, the postoperative neurological deficit risk was 0.6%, as compared with 5.4% when more than 6 bilateral pairs of SSAs were ligated (relative risk [RR] = 0.105, 95% CI 0.013-0.841, P = .0337). For unilateral ligation of SSAs of two to nine levels, the risk of postoperative neurological deficit does not exceed 1.3%.

Conclusion:

The current best evidence indicates that (1) occlusion of the AoA and (2) occlusion of up to 6 pairs of SSAs is associated with a low risk of postoperative neurological deficit. This limited number of low quality studies restrict the ability to draw definitive conclusions. Ligation of AoA and SSAs should only be undertaken when absolutely required to mitigate the small but devastating risk of paralysis.
Xanthogranulomatous Pyelonephritis: Synchronous Upper and Lower Gastrointestinal Bleed
Authors: Mirza Muhammad Usman , Van Taunay John , Waleed Muhammad , Vangimalla Shiva Shankar , Hegde Sharana , Moustafa Muhamad Alhaj
Published: May 2019

Xanthogranulomatous pyelonephritis (XGP) is a rare chronic granulomatous destructive process of the renal parenchyma. It is caused by a chronic inflammatory process due to recurrent urinary tract infections and/or obstructing renal calculi. Rarely, it presents with advanced complications including abscesses and fistula formations. In this article, we report a unique presentation of XGP with simultaneous upper and lower gastrointestinal bleeding in the setting of XGP with reno-gastric and reno-colic fistulas.
Erosive Vulvovaginitis Associated With Borrelia burgdorferi Infection
Authors: Fesler Melissa C. , Middelveen Marianne J. , Burke Jennie M. , Stricker Raphael B.
Published: May 2019

We describe a case of acute erosive vulvovaginitis accompanying Borrelia burgdorferi infection. The patient is a 57-year-old woman previously diagnosed with Lyme disease who presented with a painful erosive genital lesion. At the time of the outbreak, she was being treated with oral antibiotics, and she tested serologically positive for B burgdorferi and serologically negative for syphilis. Histological examination of biopsy tissue from the lesion was not characteristic of dermatopathological patterns typical of erosive vulvar conditions. Dieterle-stained biopsy sections revealed visible spirochetes throughout the stratum spinosum and stratum basale, and anti– B burgdorferi immunostaining was positive. Motile spirochetes were observed by darkfield microscopy and cultured in Barbour-Stoner-Kelly–complete medium inoculated with skin scrapings from the lesion. Cultured spirochetes were identified genetically as B burgdorferi sensu stricto by polymerase chain reaction, while polymerase chain reaction amplification of treponemal gene targets was negative. The condition resolved after treatment with additional systemic antibiotic therapy and topical antibiotics. In cases of genital ulceration that have no identifiable etiology, the possibility of B burgdorferi spirochetal infection should be considered.
Wealth Distribution and Social Mobility in the US: A Quantitative Approach
Authors: Benhabib Jess , Bisin Alberto , Luo Mi
Published: May 2019

We quantitatively identify the factors that drive wealth dynamics in the United States and are consistent with its skewed cross-sectional distribution and with social mobility. We concentrate on three critical factors: (i) skewed earnings, (ii) differential saving rates across wealth levels, and (iii) stochastic idiosyncratic returns to wealth. All of these are fundamental for matching both distribution and mobility. The stochastic process for returns which best fits the cross-sectional distribution of wealth and social mobility in the United States shares several statistical properties with those of the returns to wealth uncovered by Fagereng et al. (2017) from tax records in Norway. (JEL D31, E13, E21, E25)
What Drives Differences in Management Practices?
Authors: Bloom Nicholas , Brynjolfsson Erik , Foster Lucia , Jarmin Ron , Patnaik Megha , Saporta-Eksten Itay , Van Reenen John
Published: May 2019

Partnering with the US Census Bureau, we implement a new survey of “structured” management practices in two waves of 35,000 manufacturing plants in 2010 and 2015. We find an enormous dispersion of management practices across plants, with 40 percent of this variation across plants within the same firm. Management practices account for more than 20 percent of the variation in productivity, a similar, or greater, percentage as that accounted for by R&D, ICT, or human capital. We find evidence of two key drivers to improve management. The business environment, as measured by right-to-work laws, boosts incentive management practices. Learning spillovers, as measured by the arrival of large “Million Dollar Plants” in the county, increases the management scores of incumbents. (JEL D22, D24, L25, L60, M11, M50)
Monetary Policy and Rational Asset Price Bubbles: Comment
Authors: Miao Jianjun , Shen Zhouxiang , Wang Pengfei
Published: May 2019

We revisit Galí’s (2014 ) analysis by extending his model to incorporate persistent bubble shocks. We find that, under adaptive learning, a stable bubbly steady state and the associated sunspot solutions under optimal monetary policy are not E-stable. When deriving the unique forward-looking minimum stable variable (MSV ) solution around an unstable bubbly steady state, we obtain results that are consistent with the conventional views: leaning against the wind policy reduces bubble volatility and is optimal. Such a steady state and the associated MSV solution are E-stable. (JEL E13, E32, E44, E52, G12)
Strain wave elastography in response assessment to neo-adjuvant chemotherapy in patients with locally advanced breast cancer
Authors: Katyan Amit , Mittal Mahesh Kumar , Mani Chinta , Mandal Ashish Kumar
Published: May 2019

Objective:

The study was conducted to study the role of strain wave elastography in evaluating the response to neo-adjuvant chemotherapy (NACT) in patients with locally advanced breast cancer (LABC).

Methods:

In this Institutional review board approved study, 86 patients of LABC were investigated with strain wave elastography. Females receiving NACT had the affected breast scanned by strain wave elastography before each cycle of chemotherapy and immediately before surgery by two independent observers. Changes in elastographic parameters (size ratio, strain ratio) were documented and then compared to clinical and pathologic tumor response as evaluated after mastectomy.

Results:

Elastographic strain ratio parameters demonstrated high sensitivity and moderate specificity for determining response even after the first cycle of neo-adjuvant chemotherapy [97.7% sensitivity (Sn), 68.7% specificity (Sp)]. Elastographic size ratio parameters showed moderate sensitivity and specificity for response detection after second and third cycle of neo-adjuvant chemotherapy (Sn, Sp: after second cycle of NACT Sn 83.3% Sp 80%; after third cycle of NACT Sn 77.8% Sp 100%).

Conclusion:

Strain ratio is the earliest predictor of treatment response in patients of LABC. Serial imaging with elastography has the potential to predict treatment response early during the course of NACT, which may prove vital in management of patients with breast cancer.

Advances in knowledge:

Strain wave elastography is a powerful tool to predict chemoresponse early during the course of management, thereby providing an optimal window to change treatment protocols.
“Walt antes do Mickey”: um estudo observacional das características empreendedoras de Walt Disney
Authors: Vasconcelos Douglas Albuquerque , Machado Diego De Queiroz , Moreira Márcia Zabdiele , Guimarães Daniel Barboza , Silva Luís Matheus Tavares
Published: May 2019

Este trabalho tem como objetivo geral analisar as características empreendedoras de Walt Disney presentes no filme “Walt Antes do Mickey” e como objetivos específicos, Busca-se apresentar os principais modelos de empreendedores na literatura; identificar, na narrativa, elementos dos modelos de empreendedores da literatura abordada e traçar um perfil das características empreendedoras em Walt Disney. A metodologia alicerça-se na análise do filme “Walt Antes do Mickey”, abordando qualitativamente e com coleta de dados através de observação fílmica respaldada pelo estudo observacional indireto e não participante, com o intuito de realizar um paralelo entre o filme e as características do empreendedor situadas no referencial teórico.  A pesquisa possui, como resultados, a identificação de características em Walt Disney, como disposição a correr riscos e compromisso, que são apontadas como essenciais ao sucesso empreendedor. Conclui-se, através do filme, a existência de várias características atreladas ao perfil do empreendedor em Walt Disney.
Geração Z: relações de uma geração hipertecnológica e o mundo do trabalho
Authors: Bezerra Mariana Maia , Lima Eduardo Carneiro , Brito Francisco Wilker Carneiro , Santos Ana Cristina Batista dos
Published: May 2019

Esta pesquisa tem como objetivo compreender as características da geração Z e suas percepções sobre trabalho em face do contexto hipertecnológico. Entrevistas semiestruturadas foram realizadas com quatro sujeitos, utilizando a técnica da análise temática de conteúdo para categorização das falas. Como resultados, foram identificados aspectos relacionados a características e a projeções de trabalho; percepções sobre tecnologia e seu uso no trabalho; além de confirmar alguns dos aspectos abordados pela literatura. A virtualidade na relação de formação causa um autodidatismo, refletindo na emergência de um novo trabalhador que, diferentemente do que aponta a literatura, não confia em realizar múltiplas atividades ao mesmo tempo, e que difere das demais gerações. Além disso, percebem-se novas dimensões às noções de tempo e espaço, permeadas pela hipertecnologia. Conclui-se com a defesa da recolocação da convivência multigeracional como caminho para lidar com as novas demandas do trabalho em contexto hipertecnológico com significações múltiplas para as gerações.
Diálogos consistentes em tempos líquidos
Authors: Luna Sóstenes
Published: May 2019

Este ensaio pretende apresentar um texto provocativo e, ao mesmo tempo, ensejar uma reflexão comportamental sobre a situação hodierna dos relacionamentos humanos na gestão empresarial, tendo como fulcro, a espiritualidade cristã e o respeito à dignidade da pessoa humana, nas relações interpessoais, dentro do ambiente de trabalho. Tomamos como referência e fundamentação teórica, a citação bíblica do Evangelho de João capítulo 4 e versículos de 1 a 29. Ali, são abordadas as realidades da cultura líquida e os influxos dessa realidade, na problemática do ser humano como ente de relações. Ajudou-nos a aprofundar o tema o contributo teórico de Bauman (2009) e Ravasi (2014) dentro do paradigma do pensamento líquido e da hermenêutica teológica da fonte bíblica Joanina.  O aludido trabalho apresenta de forma humilde e despretensiosa o diálogo de Jesus de Nazaré e uma mulher estrangeira à margem de um poço, onde se desvela o método mais humano de dialogar, acolher e corrigir de um líder amoroso, que vai além da realidade líquida oferecendo um sólido projeto vida interior, para aquela mulher e para a pessoa humana, que se compromete com o bem de seu empreendimento e daqueles que colaboram consigo, em um projeto administrativo e existencial bem sucedido.
Hidrovias do Brasil: um estudo de inteligência de marketing
Authors: Toledo Luciano Augusto , Leon Felix Hugo Aguero Diaz
Published: May 2019

O presente trabalho se apresenta sob a modalidade de pesquisa exploratória qualitativa. Como método, foi utilizado o estudo de caso. O fenômeno estudado é a atividade de inteligência de marketing sob a perspectiva da empresa HBSA. Como resultado de estudo, verificou-se que as atividades de inteligência de marketing ocorrem, informalmente, nas diversas unidades de negócios. Observou-se que uma série de ações relativas a estudos de cenários e oportunidades de mercado é realizada na empresa, configurando a presença de atividades de inteligência de marketing, as quais auxiliam a estruturação de decisões de mercado.
As competências docentes na perspectiva da Geração Y: uma investigação entre estudantes do bacharelado em Administração
Authors: Deus Valenna Cássia de , Mattos Carlos André Corrêa de , Fernandes José Augusto Lacerda
Published: May 2019

O objetivo da pesquisa foi analisar as competências docentes na perspectiva dos estudantes do bacharelado em administração da Geração Y e, com isso, identificar as características dos bons professores. A pesquisa classificada como exploratória e descritiva, foi feita na cidade de Belém-Pa, Brasil, sob forma de levantamento, e contou com 210 entrevistados em amostra não probabilística por acessibilidade. O instrumento de pesquisa foi o questionário, desenvolvido por Nogueira, Casa Nova e Carvalho (2012), e os dados foram tratados com estatística descritiva e multivariada. Os resultados da análise fatorial revelaram quatro fatores que explicaram 67,12% da variância e foram denominados como competência interpessoal, profissional, de técnicas de ensino e tecnológica. A análise de clusters formou cinco agrupamentos diferenciados principalmente pela competência profissional. A conclusão do estudo mostra elevada expectativa dos estudantes e necessidade de múltiplas competências para que os docentes sejam considerados bons professores.
Placement Strategy for Intercommunicating Tasks of an Elastic Request in Fog-Cloud Environment
Authors: Sridharan R. , Domnic S.
Published: May 2019

Cloud computing hosts large number of modern day applications using the virtualization concept. However, end-to-end network latencies are detrimental to the performance of IoT (Internet of Things) applications like video surveillance and health monitoring. Although edge/fog computing alleviates the latency concerns to some extent, it is still not suitable for applications having intercommunicating tasks. Further, these applications can be elastic in nature and demand more tasks during their life-time. To address this gap, in this paper a network aware co-allocation strategy for the tasks of an individual applications is proposed. After modelling the problem using bin packing approach with additional constraints, the authors propose a novel heuristic IcAPER,(Inter-communication Aware Placement for Elastic Requests) algorithm. The proposed algorithm uses the network neighborhood machine for placement, once current resource is fully utilized by the application. Using CloudsimPlus simulator the performance IcAPER algorithm is compared with First Come First Serve (FCFS), Random and First Fit Decreasing (FFD) algorithms for the parameters (a) resource utilization (b) resource fragmentation and (c) Number of requests having intercommunicating tasks placed on to same PM. Extensive simulation results shows IcAPER maps 34% more tasks on to the same PM and also increase the resource utilization by 13% while decreasing the resource fragmentation by 37.8% when compared to other algorithms in our consideration.
Trust Factor Based Key Distribution Protocol in Hybrid Cloud Environment
Authors: Velliangiri S. , Rajagopal R. , Karthikeyan P.
Published: May 2019

In the Hybrid cloud deployment model, security is essential to restrict access while using resources such as virtual machine, platform, and application. Many protocols were developed to provide security via the cryptography technique, but these protocols rarely considered the trust factor which is an essential factor for cloud security. The existing Elliptic Curve Cryptography and Diffie Hellman key distribution mechanism failed to stress the trust factor, and further, they have provided not only higher complexity but also lower security and reliability. The proposed method comprised two stages: first stage, Group Creation using the trust factor and develop key distribution security protocol. It performs the communication process among the virtual machine communication nodes. Creating several groups based on the cluster and trust factors methods. The second stage, the ECC (Elliptic Curve Cryptography) based distribution security protocol is developed. The proposed Trust Factor Based Key Distribution Protocol reduced error rate, improve the key computation time and maximize resource utilization.
Data Placement in Era of Cloud Computing: a Survey, Taxonomy and Open Research Issues
Authors: Kaur Avinash , Gupta Pooja , Singh Manpreet , Nayyar Anand
Published: May 2019

In cloud computing, data placement is a critical operation performed as part of workflow management and aims to find the best physical machine to place the data. It has direct impact on performance, cost and execution time of workflows. Number of data placement algorithms is designed in cloud computing environment that aimed to improve various factors affecting the workflows and their execution including the movement of data among data centers. This paper provides a complete survey and analyses of existing data placement schemes proposed in literature for cloud computing. Further, it classifies data placement schemes based on their assess capabilities and objectives. Further objectives and properties of data placement schemes are compared. Finally future research directions are provided with concluding remarks.
Dynamic Task Scheduling using Balanced VM Allocation Policy for Fog Computing Platforms
Authors: Singh Simar Preet , Nayyar Anand , Kaur Harpreet , Singla Ashu
Published: May 2019

The fog computing models are getting popular as the demand and capacity of data processing is rising for the various applications every year. The fog computing models incorporate the various task scheduling algorithms for the resource selection among the given list of virtual machines (VMs). The task scheduling models are designed around the various task metrics, which include the task length (time), energy, processing cost etc. for the various purposes. The cost oriented scheduling models are primarily built for the customer's perspectives, and saves them a handful amount of money by efficiently assigning the resources for the tasks. In this paper, we have worked upon the multiple task scheduling models based upon the Local Regression (LR), Inter Quartile Range (IQR), Local Regression Robust (LRR), Non-Power Aware (NPA), Median Absolute Deviation (MAD), Dynamic Voltage and Frequency Scheduling (DVFS) and The Static Threshold (THR) methods using the ifogsim simulation designed with the 50 nodes and 50 virtual machines, i.e. 1 virtual machine per node. All of the models have been implemented using the standard input simulation parameters for the purpose of performance assessment in the various domains, specifically in the time domain and effective consumption of energy. The results obtained from the experiments have shown the overall time of 86,400 seconds during the simulation, where the DVFS has been recorded with the 52.98 kWh consumption of energy, which shows the efficient processing in comparison to the 150.68 kWh of energy consumption in the NPA model. Also, there are no SLA violations recorded during both of the simulation, because no VM migration model has been utilized among both of the implemented models, which clearly shows that the VM migrations are the major cause of SLA violation cases. The LRR (2520 VMs) has been observed as best contender on the basis of mean of number of VM migrations in comparison with LR (2555 VMs), THR (4769 VMs), MAD (5138 VMs) and IQR (5352 VMs).
Gulf Coast Port Selection Using Multiple-Objective Decision Analysis
Authors: De Icaza Rivelino R. , Parnell Gregory S. , Pohl Edward A.
Published: May 2019

In today’s competitive global markets, ports play a vital role in global supply chain operations. A port selection model was developed to demonstrate the potential to aid shipping line companies with decisions to select the best ports in the U.S. Gulf Coast. Because port selection is complex, is dynamic, and includes multiple objectives, a multiple-objective decision analysis quantified the value of the various ports using industry data and an industry expert’s knowledge. In addition, a corresponding cost model was developed using available cost data for each port. Monte Carlo simulation analyzed the uncertainties in the value and cost models. For the demonstration model scenario assumptions, the results show that the Houston port would be the best alternative for shipping lines in the Gulf Coast. The value model also identified opportunities for improvement for each port compared with the best West Coast port. The demonstration models show that port data exist to support the development of a multiple-objective decision analysis model and a cost model that can provide useful insights to port selection decision makers. Furthermore, these models can be easily tailored to support port selection in other regions by tailoring the objectives and measures to the decision-maker objectives.
Data-Driven Patient Scheduling in Emergency Departments: A Hybrid Robust-Stochastic Approach
Authors: He Shuangchi , Sim Melvyn , Zhang Meilin
Published: May 2019

Emergency care necessitates adequate and timely treatment, which has unfortunately been compromised by crowding in many emergency departments (EDs). To address this issue, we study patient scheduling in EDs so that mandatory targets imposed on each patient’s door-to-provider time and length of stay can be collectively met with the largest probability. Exploiting patient flow data from the ED, we propose a hybrid robust-stochastic approach to formulating the patient scheduling problem, which allows for practical features, such as a time-varying patient arrival process, general consultation time distributions, and multiple heterogeneous physicians. In contrast to the conventional formulation of maximizing the joint probability of target attainment, which is computationally excruciating, the hybrid approach provides a computationally amiable formulation that yields satisfactory solutions to the patient scheduling problem. This formulation enables us to develop a dynamic scheduling algorithm for making recommendations about the next patient to be seen by each available physician. In numerical experiments, the proposed hybrid approach outperforms both the sample average approximation method and an asymptotically optimal scheduling policy.

This paper was accepted by Yinyu Ye, optimization.
Dynamic Mechanism Design with Budget-Constrained Buyers Under Limited Commitment
Authors: Balseiro Santiago R. , Besbes Omar , Weintraub Gabriel Y.
Published: May 2019

We study the dynamic mechanism design problem of a seller who repeatedly auctions independent items over a discrete time horizon to buyers who face a cumulative budget constraint. A driving motivation behind our model is the emergence of real-time bidding markets for online display advertising in which such budgets are prevalent. We assume the seller has a strong form of limited commitment: she commits to the rules of the current auction but cannot commit to those of future auctions. We show that the celebrated Myersonian approach that leverages the envelope theorem fails in this setting, and therefore, characterizing the dynamic optimal mechanism seems intractable. Despite these challenges, we derive and characterize a near-optimal dynamic mechanism. To do so, we show that the Myersonian approach is recovered in a corresponding fluid continuous time model in which the time interval between consecutive items becomes negligible. Then we leverage this approach to characterize the optimal dynamic direct-revelation mechanism, highlighting novel incentives at play in settings with buyers’ budget constraints and seller’s limited commitment. We show through a combination of theoretical and numerical results that the optimal mechanism arising from the fluid continuous time model approximately satisfies incentive compatibility for the buyers and is approximately sequentially rational for the seller in the original discrete time model.

Supplemental material is available at https://doi.org/10.1287/opre.2018.1830 .
What's in a kiss?
Authors: Craig Chezelle
Published: May 2019

After Chezelle Craig lost her newborn son, Tay, to late-diagnosed neonatal herpes, she established ‘What's in a Kiss?’ to address the lack of awareness about this dangerous condition
Anencephaly
Authors: Winter George F
Published: May 2019

The trauma of a diagnosis of a life-limiting condition is compounded by the difficulty of making ethical and legal decisions about a baby's future. George Winter examines the case of anencephaly
Chiropractic care of the pregnant woman and neonate
Authors: Curnow Erin , Geraghty Sadie
Published: May 2019

The history and values of the chiropractic profession are part of the complementary and alternate medicine model. Chiropractic care in pregnancy is used for relief of back pain, turning breech presenting fetuses, and treatment of colic, breastfeeding and constipation issues in the neonate.
Diet and physical activity in pregnancy: a study exploring women's beliefs and behaviours
Authors: Chana Rebecca , Haith-Cooper Melanie
Published: May 2019

Background

Being obese or gaining excessive weight during pregnancy can increase health risks for mother and baby. Adopting a healthy diet and increasing physical activity reduces these risks and has long-term health benefits for women. Despite this, women do not always maintain a healthy lifestyle during pregnancy.

Aim

To explore the factors that encouraged and prevented a diverse group of women to maintain a healthy lifestyle during pregnancy.

Methods

A total of 12 women participated in semi-structured qualitative interviews, underpinned by the theory of planned behaviour. Interviews were audio recorded, transcribed verbatim then subject to deductive thematic analysis.

Findings

Four themes emerged: women's knowledge of a healthy lifestyle, sociocultural influences, physical health and health professional support. These influenced women's intentions and actual behaviours during pregnancy.

Conclusions

Enhanced health professional advice may motivate women to adopt a healthy lifestyle during pregnancy. This could be through new means such as health technology.