bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Soul and the Cyberpunk Future: St Macrina, St Gregory of Nyssa and Contemporary Mind/Body Dualism
Authors: Dewhurst E. Brown
Published: July 2019

In On the Soul and the Resurrection, St Macrina and St Gregory of Nyssa consider what the soul is, and its relationship to our body and identity. Gregory notes the way that our bodies are always changing, and asks which is most truly our ‘real’ body if we are always in a state of growth, decay and transience? What physical body will be with us at the resurrection? If our body is as important to our identity as our soul, then who am I when my body changes? Macrina answers that our identity is bodily, but that the sufferings and passages of time that alter our bodies mean that we are an imperfect version of ourselves in this life. The person that we will be at the resurrection will be free from the influence of evil and the ravages of impermanence. Modern-day science fiction wrestles with Gregory’s problem—where is my identity located? If my body is altered beyond recognition, or my mind transferred to a new body, am I still me? These cyberpunk and transhumanist worries call to mind the ancient topic of mind/body dualism, and Macrina and Gregory have some surprisingly relevant insights to offer to our contemporary technological dilemmas.
Modeling and characterization of the shape memory alloy–based morphing wing behavior using proposed rate-dependent Prandtl-Ishlinskii models
Authors: Shakiba Saeid , Yousefi-Koma Aghil , Jokar Mehdi , Zakerzadeh Mohammad Reza , Basaeri Hamid
Published: July 2019

Unique features of shape memory alloys make them a proper actuation choice in various control systems. However, their nonlinear hysteresis behavior negatively affects wide utilization of such materials in structure actuation. In this study, the frequency effect on the hysteresis behavior of a shape memory alloy–actuated structure is experimentally investigated, and also two proposed versions of rate-dependent Prandtl-Ishlinskii (modified rate-dependent Prandtl-Ishlinskii and revised modified rate-dependent Prandtl-Ishlinskii) are presented, which are capable of characterizing this phenomenon. Experimental results show that increasing excitation frequency leads to bigger hysteresis loops. It is also proven that rate-dependency cannot be predicted by generalized Prandtl-Ishlinskii model. In addition, a comparison between the dead zone function-based rate-dependent Prandtl-Ishlinskii model as an only benchmark model and the proposed models have been done that proves the proposed models’ superiority. In addition, genetic algorithm is exploited to identify unknown parameters of all models. Trained models performance is also experimentally evaluated at different input frequencies. Comparison between simulation and experimental results indicates that the proposed models can reliably predict saturated, asymmetric, rate-dependent hysteresis behavior, and minor loops in shape memory alloy–embedded actuators.
The social configuration of labour market divides: An analysis of Germany, Belgium and Italy
Authors: Doerflinger Nadja , Pulignano Valeria , Lukac Martin
Published: July 2019

We analyse insecurity-based dividing lines and their social configurations in the German, Belgian and Italian labour markets in 2015, using latent class analysis applied to EU Labour Force Survey data. In contrast to the dual vision of ‘insider-outsider’ approaches, our findings illustrate the existence of five distinctive labour market groups or segments across countries with similar social configurations. We explain this through the social embeddedness of national regulatory systems which generate different degrees of inclusiveness for different groups of workers. This adds to ongoing debates on connecting micro- and macro-levels of analysis, as labour market segmentation as a macro-phenomenon is studied based on its micro-foundations (terms and conditions of employment relationships). We use the interlinkages between national regulatory systems and social categories to explain the findings.
Complement alternative pathway activation associated with pulmonary hypertension in lupus nephritis patients
Authors: Li Q , Li H , Shi J , He B , Yu F
Published: July 2019

Pulmonary hypertension occurs in systemic lupus erythematosus (SLE) for several reasons, such as vasculopathy. Previous studies have indicated that the excessive activation of the complement alternative pathway might be involved in the pathogenesis of lupus nephritis, especially in the absence of factor H or its functional impairment. However, the clinical and pathological significance of the alternative complement activation in lupus nephritis patients with pulmonary hypertension remains elusive. The data on patients with pulmonary hypertension and non-pulmonary hypertension lupus nephritis were retrospectively analyzed in our centre. Major plasma levels of complement components were evaluated. The depositions of Bb, C3d and C5b-9 in the lung specimens of pulmonary hypertension combined with SLE patients were detected by immunofluorescence staining. Among 352 lupus nephritis cases, 24 were diagnosed with pulmonary hypertension and 328 with non-pulmonary hypertension. Higher levels of Bb and lower levels of factor H were detected in the pulmonary hypertension group in comparison with the negative group ( P = 0.049, P = 0.024, respectively). Pulmonary hypertension was a risk factor for renal outcome as deduced by the log-rank and Cox test for survival analysis. C3d, C5b-9 and Bb were found to be positive in lung specimens of lupus nephritis patients with pulmonary hypertension. We concluded that activation of the complement alternative pathway may be involved in the pathogenesis of pulmonary hypertension in lupus nephritis.
Making the law work for women: Standard-setting through a new Gender Legislative Index
Authors: Vijeyarasa Ramona
Published: July 2019

This article is premised on the fact that every area of law needs a gender perspective. It discusses the prospects for a Gender Legislative Index, a tool to enable us to evaluate and score legislation, by placing laws on a scale from gender-regressive to gender-responsive, when set against global benchmarks from international law – primarily CEDAW. In doing so, this article defines and defends the need for gender-responsive legislation, showing how a common set of standards for global good practice can be developed and the shortcomings, but also advantages, of an online tool to benchmark, score and rank laws.
Simondon and enaction: the articulation of life, subjectivity, and technics
Authors: Dereclenne Emilien
Published: July 2019

Clear similarities may be found between enaction and Simondon’s philosophy of individuation. In this article, and in the wake of recent research in the field of enaction, I argue that Simondon’s work is relevant to our understanding of the articulation between life, subjectivity, and technics. In line with John Stewart, I define enaction as the dynamic relation whereby living organisms and their environment co-emerge, a process in which technics is revealed as “anthropologically constitutive.” I show that this process is truly enlightened by Simondon’s theory of imagination and invention.
Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency
Authors: Coughlin Ryan F. , Peaper David , Rothenberg Craig , Golden Marjorie , Landry Marie-Louise , Cotton Jeffrey , Parwani Vivek , Shapiro Marc , Ulrich Andrew , Venkatesh Arjun K.
Published: July 2019

The authors evaluated the effectiveness of an electronic health record (EHR)-based reflex urine culture testing algorithm on urine test utilization and diagnostic yield in the emergency department (ED). The study implemented a reflex urine culture order with EHR decision support. The primary outcome was the number of urine culture orders per 100 ED visits. The secondary outcome was the diagnostic yield of urine cultures. After the intervention, the mean number of urine cultures ordered was 5.95 fewer per 100 ED visits (9.3 vs 15.2), and there was a decrease in normal, or negative, cultures by 2.42 per 100 ED visits. There also was a statistically significant decrease in urine culture utilization and an increase in the positive proportion of cultures. Simple EHR clinical decision-support tools along with reflex urine culture testing can significantly reduce the number of urine cultures performed while improving diagnostic yield in the ED.
A Longitudinal Ambulatory Quality Improvement Curriculum That Aligns Resident Education With Patient Outcomes: A 3-Year Experience
Authors: Parekh Natasha , Lebduska Elena , Hoffman Erika , Kohli Amar , Demoise David , Jeong Kwonho , Rothenberger Scott , Fischer Gary S. , Spagnoletti Carla , Hariharan Jaishree
Published: July 2019

Quality improvement (QI) plays a vital role in practice management, patient care, and reimbursement. The authors implemented a 3-year longitudinal curriculum that combined QI didactics, intervention development, and implementation at university-based, community-based, and Veterans Administration–based practices. Highlights included Plan-Do-Study-Act cycle format, team-based collaboration to brainstorm interventions, interdisciplinary QI council to select and plan interventions, system-wide intervention implementation across entire clinic populations with outcome monitoring, and intervention modifications based on challenges. A pre–post survey assessed residents’ confidence in QI skills and interdisciplinary team participation, while quarterly quality data assessed patient outcomes. All 150 internal medicine residents participated. Confidence in QI and interdisciplinary team participation improved significantly ( P < .001). Patient outcomes improved for 6 of 9 targeted projects and were sustained at 1 year. This curriculum is a systems-based innovation designed to improve patient care and encourage interdisciplinary teamwork and can be adopted by residencies seeking to improve engagement in QI.
Learning Health Systems and the Revised Common Rule
Authors: Rolnick Joshua A.
Published: July 2019

Quality improvement (QI) is an important function of learning health systems, and public policy should promote QI activities. Use of systematic methodologies in QI has prompted substantial confusion regarding when QI is human subjects research under the Common Rule, and this confusion persists with the revised Rule. Difficulty distinguishing research from QI imposes costs on the quality improvement process. I offer guidance to IRBs to mitigate these costs and suggest a new regulatory exclusion for minimal risk quality improvement activities.
Vexed Again: Social Scientists and the Revision of the Common Rule, 2011-2018
Authors: Schrag Zachary M.
Published: July 2019

In revising the Federal Policy for the Protection of Human Subjects (Common Rule) between 2009 and 2018, regulators devoted the vast bulk of their attention to debates over biomedical research. They lacked both expertise in and concern about the social sciences and humanities, yet they imposed their will on experts in those fields. The revision process was secretive, spasmodic, and unrepresentative, especially compared to rulemaking in Canada, where social scientists participate in the process, and revisions take place every few years. The result was a final rule that offers some wins for social science and the humanities, but that fails to solve the problems identified by Ezekiel Emanuel and in the 2011 advance notice of proposed rulemaking.
The Role of Advocacy in Public Health Law
Authors: Berman Micah L. , Tobin-Tyler Elizabeth , Parmet Wendy E.
Published: July 2019

This article discusses how advocacy can be taught to both law and public health students, as well as the role that public health law faculty can play in advocating for public health. Despite the central role that advocacy plans in translating public health research into law, policy advocacy skills are rarely explicitly taught in either law schools or schools of public health, leaving those engaged in public health practice unclear about whether and how to advocate for effective policies. The article explains how courses in public health law and health justice provide ideal opportunities to teach advocacy skills, and it discusses the work of the George Consortium, which seeks to engage public health law faculty in advocacy efforts.
Public Health Law and Policy Implications: Justice Kavanaugh
Authors: Hodge James G. , Parmet Wendy E. , Benjamin Georges , Somers Sarah , Gulinson Chelsea
Published: July 2019

Following the confirmation of U.S. Supreme Court Justice Brett Kavanaugh in one of the most sensational jurisprudence events of the modern era, we examine potential repercussions across multiple themes in public health, law, and policy stemming from his ideology and the confirmation process.
Healthy People: The Role of Law and Policy in the Nation's Public Health Agenda
Authors: McGowan Angela K. , Kramer K.T. , Teitelbaum Joel B.
Published: July 2019

Each decade since 1979, the Healthy People initiative establishes the national prevention agenda and provides the foundation for disease prevention and health promotion policies and programs. Law and policy have been included in Healthy People objectives from the start, but not integrated into the overall initiative as well as possible to potentially leverage change to meet Healthy People targets and goals. This article provides background on the Healthy People initiative and its use among various stakeholder groups, describes the work of a project aiming to better integrate law and policy into this initiative, and discusses the development of Healthy People 2030 — the next iteration of health goals for the nation. Lessons from the preliminary stages of developing Healthy People by the HHS Secretary's Advisory Committee (Committee) on National Health Promotion and Disease Prevention Objectives for 2030 and a Federal Interagency Workgroup will be included. Efforts by the Committee focused on the role of law and policy as determinants of health and valuable resources around health equity are also shared. Finally, the article discusses ways that law and policy can potentially be tools to help meet Healthy People targets and to attain national health goals.
Increasing Price and Reducing Access to Tobacco in New York City
Authors: Schroth Kevin R.J.
Published: July 2019

This paper describes novel tobacco control laws passed in New York City in 2017. These laws are designed to improve the city's strategy of using price to decrease tobacco consumption, and over time, change the city's landscape by making tobacco less accessible.
Reversal of Factor Xa Inhibitors by Andexanet Alfa May Increase Thrombogenesis Compared to Pretreatment Values
Authors: Siddiqui Fakiha , Tafur Alfonso , Ramacciotti Lorenzo Storino , Jeske Walter , Hoppensteadt Debra , Ramacciotti Eduardo , Iqbal Omer , Fareed Jawed
Published: July 2019

Recombinant coagulation factor Xa (FXa), inactivated Zh-zo, also known as andexanet alfa (AA), is a modified version of human FXa that has been developed to neutralize FXa inhibitors. We studied the reversal effect of AA for these inhibitors in various anticoagulant and thrombin generation (TG) assays. Individual aliquots of normal human plasma containing 1 µg/mL of apixaban, betrixaban, edoxaban, and rivaroxaban, were supplemented with saline or AA at a concentration of 100 µg/mL. Clotting profiles include prothrombinase-induced clotting time, activated partial thromboplastin time, and prothrombin time. Factor Xa activity was measured using an amidolytic method. Thrombin generation was measured using a calibrated automated thrombogram. Differential neutralization of all 4 anticoagulants was noted in the activated clotting time and other clotting tests. The FXa activity reversal profile varied with an observed decrease in apixaban (22%), betrixaban (56%), edoxaban (28%), and rivaroxaban (49%). Andexanet alfa also led to an increased TG in comparison to saline. The peak thrombin was higher (40%), area under the curve (AUC) increased (15%), whereas the lag time (LT) decreased (17%). Andexanet alfa added at 100 µg/mL to various FXa supplemented systems resulted in reversal of the inhibitory effects, restoring the TG profile; AUC, LT, and peak thrombin levels were comparable to those of unsupplemented samples. Andexanet alfa is capable of reversing anti-Xa activity of different oral FXa inhibitors but overshoots thrombogenesis in both the saline and FXa inhibitor supplemented systems. The degree of neutralization of Xa inhibitor is specific to each agent.
Outcomes of conversion THA after failed porous tantalum implant for osteonecrosis of the femoral head: a comparative matched study
Authors: Ma Jinhui , Wang Bailiang , Yue Debo , Sun Wei , Wang Weiguo , Li Zirong
Published: July 2019

Background:

As a joint-preserving surgery, porous tantalum implantation (PTI) provides an additional treatment option for osteonecrosis of the femoral head (ONFH). However, conversion to a total hip arthroplasty (THA) after failed PTI is considered a challenging procedure. The purpose of this study was to compare the clinical and radiologic outcomes and complications of THA after failed PTI with those of primary THA without any previous surgery for ONFH.

Methods:

This retrospective study included 32 patients undergoing THA after failed PTI and 25 age, sex, and body mass index matched patients who underwent primary THA without any previous surgery for ONFH between December 2009 and March 2014. All patients were followed for at least 36 months. The postoperative clinical and radiological evaluations were based on Harris Hip Score (HHS) and plain radiographs. The independent sample test and the chi-square test were used for the statistical analysis.

Results:

The HHS in the PTI group was similar to that in the primary group at the latest follow-up ( p = 0.274), but longer operation time and greater intraoperative blood loss were observed in the PTI group ( p < 0.001, respectively). No significant differences in radiological parameters and postoperative complications were found between the 2 groups ( p > 0.05).

Conclusions:

THA after PTI showed similar clinical and radiological outcomes to primary THA except for longer operation time and greater intraoperative blood loss.
Experiential avoidance, committed action and quality of life: Differences between college students with and without chronic illness
Authors: Coutinho Mariana , Trindade Inês A , Ferreira Cláudia
Published: July 2019

This study aimed to explore, through structural equation modelling, experiential avoidance and committed action’s effects on the association between anxiety and psychological quality of life and whether this relationship presents significant differences across a sample of 115 college students with chronic illness and a sample of 232 students without illness. Students with chronic illness presented higher levels of anxiety and experiential avoidance and lower levels of quality of life. The association between anxiety and psychological quality of life was partially explained by experiential avoidance and committed action. This path model was shown to be invariant between the two groups of students.
Displacement monitoring method based on laser projection to eliminate the effect of rotation angle
Authors: Liu Peng , Liu Chengcheng , Zhang Lixiao , Zhao Xuefeng
Published: July 2019

Currently, laser technology has become increasingly mature. Semiconductor lasers have the characteristics of small size, long indication distance, long life, and low cost. Therefore, many studies regard them as the launching devices of monitoring system and fix them at the monitoring points of structures to reflect the displacements of the monitoring points through the spots produced by them. However, this method also exhibits a drawback, that is, this method can only be applied to the case where only displacement is generated at the monitoring point and no rotation angle is generated. If the rotation occurs at the monitoring point, the spot displacement is caused by the coupling effect of the displacement and rotation angle at the monitoring point, which will affect the monitoring results significantly. In this article, a method is proposed to decouple the effect of the displacement and angle and eliminate the influence of the angle sufficiently, by projecting the laser spots onto two screens. This method can significantly improve the application scope of the monitoring system and provide the possibility for its application in practical engineering.
Socio-economic disparity in risk of undergoing emergency laparotomy and postoperative mortality
Authors: Møller Sanne Pagh , Jeppesen Maja Mønster , Gögenur Ismail , Thygesen Lau Caspar
Published: July 2019

Aims: Socio-economic disparities in health and access to care are well documented, but socio-economic disparities in surgical care and outcomes have received less attention. The aim of the study was to determine if there are socio-economic disparities in the risk of undergoing emergency laparotomy and postoperative mortality in a universal health-care system with free and equal access to care. Methods: This was a nationwide case-control study including patients undergoing non-malignant emergency laparotomy involving resection, ostomy or open drainage between 2003 and 2014 and population references matched 1:1 on age and sex. Socio-economic disparities in one-year postoperative mortality were explored through a cohort study including all patients. Exposure measures were register-based household disposable income, educational level and employment status. Analyses were adjusted by age, sex, country of origin, marital status and co-morbidity. Results: A total of 11,962 cases and 11,962 population references were included. The highest odds ratios (OR) for undergoing surgery were found among those with the lowest income (OR=1.51; 95% confidence interval (CI) 1.39–1.63), those with elementary school education (OR=1.33; 95% CI 1.22–1.46) and those on early-retirement pension (OR=3.49; 95% CI 3.07–3.98). One-year postoperative mortality was highest among those with lowest income (hazard ratio (HR)=1.51; 95% CI 1.35–1.69), those with elementary school education (HR=1.39; 95% CI 1.22–1.59) and those on early-retirement pension (HR=2.12; 95% CI 1.73–2.61). Conclusions: Socio-economic disparities in health exist in relation to non-malignant emergency laparotomies and still exist after adjustment for confounders, including co-morbidity, indicating that mechanisms other than differences in disease burden are involved. There is a substantial need for exploration of mechanisms and preventive measures.
How do institutional constraints affect judicial decision-making? The European Court of Justice’s French language mandate
Authors: Cheruvu Sivaram
Published: July 2019

Under what conditions do the institutional features of courts affect the efficiency of judicial decision-making? Examining the Court of Justice of the European Union’s mandate that all judgments be written in French, I argue that francophone judges—i.e. judges from France, French-speaking Belgium, and Luxembourg—write judgments more efficiently than their non-francophone counterparts. Leveraging the institutional feature of the judge-rapporteur and using matching methods, I show that comparable cases with a francophone judge-rapporteur are a month shorter on average than cases with a non-francophone judge-rapporteur. This estimate is robust to scaling the judgments by their word counts. Although I provide evidence francophones write judgments with lower lexical diversity on average than non-francophones, existing empirical measures are limited in examining differences in judgment quality. These findings have implications for the efficient processing of cases at the Court of Justice and the potential consequences of adopting a lingua franca in the European Union.
The experiences of German social workers working with refugees
Authors: Hagues Rachel J , Cecil David , Stoltzfus Ken
Published: July 2019

This study examines the experiences of German social workers who provided services to refugees during the refugee crisis of 2014–2016. Interviews were conducted in 2016 in two regions of Germany, Berlin/Brandenburg ( n = 18) and Würzburg (Bavaria; n = 16). Researchers used a semi-structured interview guide complemented by a five-item Likert-type instrument. Questions explored Social Service Provider’s Background and Training, Refugees’ Needs, Role of Faith in Coping, and Recommendations for Universities and Churches and measure Effectiveness of Services, Adequacy of Resources, Benefits to Refugees, and Extent of Work-Related Stress.

Findings

A thematic analysis indicates social workers feel Germany has effectively responded to paramount refugee needs. Social workers emphasize the importance of learning to see people “eye-to-eye,” cultivating empathy, cross-cultural competence, overcoming personal biases, and self-reflection.

Applications

Findings suggest social workers who practice with refugees should devote attention to the development of personal attributes to facilitate effective service delivery (e.g. learning to respond empathetically, practicing self-reflection, and treating refugees as equals) and refining practical skills (e.g. study of refugee and immigration law nationally and internationally and development of cross-cultural knowledge and understanding). Suggestions include learning a greeting in another language or understanding gender roles in different cultures. The usefulness of cultural immersion gained by spending time abroad was highlighted; such experiences allow one to cultivate the ability to be open-minded, encourage the development of a capacity to empathize with members of under-represented groups, and prevent the tendency of seeing refugees or migrants as “the Other” ( Said, 1978 ).
Lessons learned from applying Sandelowski and Barroso’s approach for synthesising qualitative research
Authors: Herber Oliver Rudolf , Barroso Julie
Published: July 2019

Despite the proliferation of differing methods for synthesising qualitative research, Sandelowski and Barroso’s approach stands out because it is a stimulus to thinking and creativity. Yet, when applying the approach within our qualitative meta-summary and meta-synthesis project, we encountered some methodological challenges. Key aspects of the approach are outlined and juxtaposed with how we handled them in practical terms thereby entering into a methodological discussion based on the existing international research synthesis literature. For example, we encountered challenges pertaining to the researchers’ underlying epistemological assumptions, the composition of the research team, the construction of a feasible research question, the application of critical appraisal tools and the determination of an appropriate cut-off point for effect sizes to create a more parsimonious theory. From that reflective process, we draw out lessons learned for each aspect to provide neophyte researchers with valuable information that can increase the validity of future meta-syntheses projects.
Simplified model for unsteady air cavities under ship hulls
Authors: Matveev Konstantin I
Published: July 2019

The drag reduction technique involving air cavities under ship hulls is a promising energy-saving technology. Understanding the air cavity dynamics in unsteady conditions and developing methods for the air cavity system optimization are critically important for practical implementation of this technology. In this study, a potential-flow theory is applied for modeling the air cavities under solid walls in water flow with fluctuating pressure. The present modeling approach incorporates detachment of macroscopic air pockets from the cavity tail. For specific configurations considered in this article, it is found that a change of the rate of air supply into the cavity can partly mitigate degradation of the overall power savings by the air cavity system in unsteady conditions.
Scripting the mechanics of the benchmark manipulation corporate scandals: The ‘guardian’ paradox
Authors: Jordanoska Aleksandra , Lord Nicholas
Published: July 2019

This article implements a crime script analysis to understand the procedural dynamics of corporate benchmark-rigging in the financial services industry. In 2012 several global banks were implicated in the manipulation of various trading benchmarks, portraying the industry as affected by serious, pervasive and ‘organized’ corporate crimes. Yet their dynamics have been relatively little studied by criminologists. To address this gap, we analyse official enforcement documentation, supplemented with data from interviews with key informants in the UK financial markets. We analyse the range of interactions between the relevant actors, their actions and the resources essential to the manipulations, and deconstruct the benchmark manipulations into four scenes (calculated positioning and identification of co-collaborators; recruitment; (ephemeral) manipulation; recompense and solicitation). The analysis reveals that regulatory and organizational systems play a paradoxical role of both ‘capable guardians’ and ‘facilitators of misconduct’; this has implications for criminological theory.
Socrates’ defensible devices in Plato’s Meno
Authors: Marshall Mason
Published: July 2019

Despite how revered Socrates is among many educators nowadays, he can seem in the end to be a poor model for them, particularly because of how often he refutes his interlocutors and poses leading questions. As critics have noted, refuting people can turn them away from inquiry instead of drawing them in, and being too directive with them can squelch independent thought. I contend, though, that Socrates’ practices are more defensible than they often look: although there are risks in refuting people and posing leading questions, Socrates has sensible ways of minimizing the risks, ways that are feasible even for teachers nowadays, and there are times when the risks are worth taking. I illustrate my point by discussing Plato’s Meno.
Presidents and Cabinets: Coordinating Executive Leadership in Premier-Presidential Regimes
Authors: Raunio Tapio , Sedelius Thomas
Published: July 2019

A key factor of semi-presidential regimes is power-sharing mechanisms between president and government. Influenced by Shugart and Carey’s seminal work on premier-presidential regimes, this article addresses intra-executive dynamics in light of recent scholarship on the risks and consequences associated with conflict and cooperation between the president and the cabinet. Through an in-depth comparison of three premier-presidential systems with broadly similar constitutional designs, Finland, Lithuania and Romania, it forces us to reconsider how coordination mechanisms and political context shape presidential influence. Absent of a working constitutional division of labour and established modes of intra-executive coordination, presidents are more likely to use alternative channels of influence – such as the strategy of ‘going public’ or direct contacts with political parties, the legislature or civil society stakeholders – and to intervene in questions falling under the competence of the government. Lack of institutionalized coordination also benefits the presidents as they hold the initiative regarding cooperation between the two executives.
Is the Glasses-Free 3-Dimensional Display System More Effective for Complex Video-Assisted Thoracic Surgery? A Self-Controlled Study Ex Vivo
Authors: Liu Jun , Li Jingpei , Liang Hengrui , Cui Fei , Wang Wei , Huang Jun , Peng Guilin , Huang Weizhe , Wang Yidong , He Kaiming , Pan Qi , He Jianxing
Published: July 2019

Objective. Considering the demerits of a high-definition 2-dimensional (HD-2D) system, with its lack of stereopsis, and a conventional 3-dimensional (C-3D) system, which results in a dimmed image, we have recently developed a glasses-free 3-dimensional (GF-3D) display system for reconstruction surgeries such as video-assisted thoracic surgery (VATS) for tracheal reconstruction. Methods. Thoracic surgeons were invited to complete thoracoscopic continuous suture of a transected porcine trachea using the HD-2D, C-3D, and GF-3D systems on separate mornings in randomized order. The duration, numbers of stitches, and distance between every 2 stitches were recorded for every procedure. The surgeons’ spontaneous eye blink rate was recorded for 5 minutes before the procedure and the last 5 minutes of the procedure. Results. Fifteen volunteers successfully completed the tracheal reconstruction procedures in this study. Both C-3D (0.403 ± 0.064 stitch/min, P < .001) and GF-3D (0.427 ± 0.079 stitch/min, P < .001) showed significant advantages in speed compared with HD-2D (0.289 ± 0.065 stitch/min). Both C-3D (2.536 ± 2.223 mm, P < .001) and GF-3D (2.603 ± 2.159 mm, P < .001) showed significant advantages in accuracy compared with HD-2D (3.473 ± 3.403 mm). Both HD-2D (1.240 ± 0.642, P < .001) and GF-3D (1.307 ± 0.894, P < .001) showed significant advantages in eye fatigue compared with C-3D (3.333 ± 1.44). Conclusions. All 3 available display systems are efficient for complex VATS. With the help of stereopsis, surgeons can achieve faster operation using C-3D and GF-3D systems in a thoracoscopic simulated setting. GF-3D may be a more effective display system for VATS reconstruction in terms of speed, accuracy, and eye fatigue during operations.
Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study
Authors: Lucchina Stefano , Fusetti Cesare , Guidi Marco
Published: July 2019

Background:The measurement of cross-sectional area (CSA) is a diagnostic tool to detect entrapments syndrome. The aim of this study was to compare the clinical outcome in elbows undergoing endoscopic and “in situ” open cubital tunnel release for cubital tunnel syndrome (CuTS) using ultrasound-related changes in the largest CSA of the ulnar nerve. The purpose is to determine the association between clinical outcome and CSA. Methods: From May 2011 to April 2016, 60 patients with CuTS were prospectively followed and not randomly divided in two groups: 30 patients undergoing an endoscopic release (ER) and 30 patients with “in situ” open neurolysis (OR). A sonographic examination was performed by the senior authors at baseline and 3, 6, and 12 months after surgical decompression. Results: CSA values were statistically significantly lower in the ER. Hand grip strength difference with Jamar test was not statistically significant a 12 months (39 kg vs 27 kg). Static-2 point discrimination test difference was only statistically significant lower in the endoscopic group at 3, 6 and 12 months but not clinically relevant (5 mm vs 6 mm). The American Shoulder and Elbow Surgeons—Elbow questionnaire (ASES-e) function score, ASES-e Pain score, and ASES-e Satisfaction score were not statistically significant different between the two groups at 3, 6, and 12 months post operatively. Conclusions: The study confirms that in spite of lower values of CSA in the ER, there is not a statistically significant difference between the two techniques in terms of subjective outcomes. Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve.

Type of study/LOE: Prognostic Level III
Rehabilitation with a stabilizing exercise program in triangular fibrocartilage complex lesions with distal radioulnar joint instability: A pilot intervention study
Authors: Bonhof-Jansen EDJ , Kroon GJ , Brink SM , van Uchelen JH
Published: July 2019

Introduction

It is unclear whether rehabilitation with the use of an exercise program can be an alternative to surgery in distal radioulnar joint instability resulting from injuries of the triangular fibrocartilage complex. The purpose of this study was to gain insights into the feasibility and effects in reducing pain and functional limitations by using distal radioulnar stability training.

Methods

A prospective pilot cohort intervention study was used including patients with a triangular fibrocartilage complex Palmer 1B lesion and distal radioulnar joint instability. The primary objective was the reduction of pain and functional limitations as measured by the Patient-Rated Wrist-Hand Evaluation. Secondary objectives were to assess number of surgical interventions, treatment sessions, and patient satisfaction.

Results

Twenty-one patients (mean age: 33.2 years) were included with a median time of symptom onset of eight months (IQR: 5–24). The distal radioulnar stability training program showed a clinically relevant positive change in the Patient-Rated Wrist-Hand Evaluation total and subscale scores when compared to the baseline assessment. Six patients opted for surgical intervention at six months follow-up, and two patients were considering surgery at the long-term follow-up.

Conclusion

Rehabilitation with stabilizing exercises in patients with distal radioulnar joint instability caused by triangular fibrocartilage complex 1B lesions provides pain relief and increases function. Findings should be validated by further controlled prospective studies.
Halloysite nanotubes as a nature’s boon for biomedical applications
Authors: Satish Swathi , Tharmavaram Maithri , Rawtani Deepak
Published: July 2019

The arena of biomedical science has long been in quest of innovative mediums for diagnostic and therapeutic applications. The latest being the use of nanomaterials for such applications, thereby giving rise to the branch of nanomedicine. Halloysite nanotubes (HNTs) are naturally occurring tubular clay nanomaterials, made of aluminosilicate kaolin sheets rolled several times. The aluminol and siloxane groups on the surface of HNT facilitate the formation of hydrogen bonding with the biomaterials onto its surface. These properties render HNT pivotal in diverse range of applications, such as in environmental sciences, waste-water treatment, dye removal, nanoelectronics and fabrication of nanocomposites, catalytic studies, as glass coatings or anticorrosive coatings, in cosmetics, as flame retardants, stimuli response, and forensic sciences. The specific properties of HNT also lead to numerous applications in biomedicine and nanomedicine, namely drug delivery, gene delivery, tissue engineering, cancer and stem cells isolation, and bioimaging. In this review, recent developments in the use of HNT for various nanomedicinal applications have been discussed.
RAPID-CPU: a prospective study on implementation of the ESC 0/1-hour algorithm and safety of discharge after rule-out of myocardial infarction
Authors: Stoyanov Kiril M , Hund Hauke , Biener Moritz , Gandowitz Jochen , Riedle Christoph , Löhr Julia , Mueller-Hennessen Matthias , Vafaie Mehrshad , Katus Hugo A , Giannitsis Evangelos
Published: July 2019

Background:

Although the value of fast diagnostic protocols in suspected acute coronary syndrome has been validated, there is insufficient real world evidence including patients with lower pre-test probability, atypical symptoms and confounding comorbidities. The feasibility, efficacy and safety of European Society of Cardiology (ESC) 0/1 and 0/3-hour algorithms using high-sensitivity troponin T were evaluated in a consecutive cohort with suspected acute coronary syndrome.

Methods:

During 12 months, 2525 eligible patients were enrolled. In a pre-implementation period of 6 months, the prevalence of protocols, disposition, lengths of emergency department stay and treatments were registered. Implementation of the 0/1-hour protocol was monitored for another 6 months. Primary endpoints comprised the change of diagnostic protocols and 30-day mortality after direct discharge from the emergency department.

Results:

Use of the ESC 0/1-hour algorithm increased by 270% at the cost of the standard 0/3-hour protocol. After rule-out (1588 patients), 1309 patients (76.1%) were discharged directly from the emergency department, with an all-cause mortality of 0.08% at 30 days (one death due to lung cancer). Median lengths of stay were 2.9 (1.9–3.8) and 3.2 (2.7–4.4) hours using a single high-sensitivity troponin T below the limit of detection (5 ng/L) at presentation and the ESC 0/1-hour algorithm, respectively, as compared to 5.3 (4.7–6.5) hours using the ESC 0/3-hour rule-out protocol ( P<0.001). Discharge rates increased from 53.9% to 62.8% ( P<0.001), without excessive use of diagnostic resources within 30 days.

Conclusion:

Implementation of the ESC 0/1-hour algorithm is feasible and safe, is associated with shorter emergency department stay than the ESC 0/3-hour protocol, and an increase in discharge rates.

Trial registration:

ClinicalTrials.gov , Unique identifier: NCT03111862.
Effects of GIT-27NO, a NO-donating compound, on hepatic ischemia/reperfusion injury
Authors: Mangano Katia , Lanteri Raffaele , Basile Maria Sofia , Bellavia Noemi , Latino Rosalia , Messina Domenico , Fagone Paolo , Colletti Giuseppe , Nania Riccardo , Caltabiano Rosario , Di Marco Roberto , Di Cataldo Antonio
Published: July 2019

Hepatic ischemia/reperfusion injury (IRI) is a clinical condition that may lead to cellular injury and organ dysfunction that can be observed in different conditions, such as trauma, shock, liver resection, and transplantation. Moderate levels of nitric oxide (NO) produced by the endothelial isoform of the NO synthase protect against liver IRI. GIT-27NO is a NO-derivative of the toll-like receptor 4 antagonist VGX-1027 that has been shown to possess both antineoplastic and immunomodulatory properties in vitro and in vivo. In this study, we have investigated the effects of this compound in vitro, in a model of oxidative stress induced in HepG2 cells by hydrogen peroxide (H2O2), and in vivo, in a rat model of IRI of the liver. GIT-27NO significantly counteracted the toxic effects induced by the H2O2 on the HepG2 cells and in vivo, GIT-27NO reduced the transaminase levels and the histological liver injury by reducing necrotic areas with preservation of viable tissue. These effects were almost similar to that of the positive control drug dimethyl fumarate. These data suggest that the beneficial effect of GIT-27NO in the hepatic IRI can be secondary to anti-oxidative effects and hepatocyte necrosis reduction probably mediated by NO release.
Awareness as Determinant of Choice of Law Librarianship as a Career Among Law Students in South-West Nigeria
Authors: Onoyeyan Glory O. , Unegbu Vincent
Published: July 2019

Several career paths are open to law graduates. Many of them pursue careers in other fields without giving a thought to law librarianship. The fact that majority of law students do not consider law librarianship as a career option is undesirable for the future of law librarianship. The future of law librarianship profession may depend on awareness. The study therefore examined the influence of awareness on the career choice of law librarianship among law students in South-West, Nigeria. The study employed the survey research design. The population for the study was 2,945 undergraduate law students in the in the 12 purposively selected universities that run the approved undergraduate law program up to 500 level in South-West, Nigeria. Krejcie and Morgan’s formula was used to select the sample size of 597. The instrument for data collection was a validated questionnaire. Cronbach’s alpha coefficients for the constructs ranged from .80 to .89. The return rate was 94%. Data were analyzed using descriptive and inferential statistics. The result showed that awareness of law librarianship significantly influenced law students’ choice of law librarianship as a career. The study also revealed that law students were slightly aware of law librarianship as a choice of career. Results indicated that the inclination to pursue a career in law librarianship was based on altruistic consideration.
Patterns and prognosis of commotio retinae in orbital wall fractures
Authors: Blegen Halward M.J. , Santamaria Joseph A. , Mehta Aditya , Reed Donovan S. , Drayna Paul M. , Davies Brett
Published: July 2019

Purpose:

Orbital wall fractures are a significant cause of ocular injury in trauma and are associated with posterior segment pathology. This study aims to characterize patterns and prognosis of commotio retinae following orbital wall fracture.

Methods:

This study is a retrospective analysis of 294 orbital wall fractures diagnosed by computed tomography imaging from August 2015 to October 2016 at a Level 1 trauma center. Dilated funduscopic exams were assessed for acute posterior segment pathology, focusing specifically on commotio retinae ( N = 38). These were compared with patients with no traumatic retinal findings ( N = 253) to indicate statistically significant differences in the mechanism of injury, fracture pattern, subjective symptoms, radiologic and exam findings, and acute interventions.

Results:

Commotio was most commonly associated with assault (60.5%, p = 0.004) in a younger patient population, whereas normal retinal exams were more likely after falls from standing (24.1%, p = 0.022). Half of all commotio was found inferiorly and most commonly occurred in medial or inferior wall fracture. Patients with commotio were more likely to have motility deficits (29.7%, p = 0.049) with clinical evidence of entrapment (13.2%, p < 0.001), requiring acute operative repair (15.8%, p = 0.005). Inferior wall fracture was associated with 19.4% surgical intervention in commotio as compared with those with normal funduscopic exams (6.1%, p = 0.012). All patients with follow-up had resolution of commotio and best-corrected visual acuity of 20/25 or better.

Conclusion:

Retinal pathology is not infrequent in orbital wall fractures. Inferior wall fracture was associated with 19.4% surgical intervention in commotio as compared to those with normal funduscopic exams (6.1%, p = 0.012). A high index of suspicion and thorough investigation is warranted in evaluating these patients.
Resolvin D4 attenuates the severity of pathological thrombosis in mice
Authors: Cherpokova Deya , Jouvene Charlotte C. , Libreros Stephania , DeRoo Elise P. , Chu Long , de la Rosa Xavier , Norris Paul C. , Wagner Denisa D. , Serhan Charles N.
Published: July 2019

The authors discovered the important role that lipid mediators (resolvin D4 in this study) play in both formation and resolution of clots in deep vein thrombosis.
The splicing factor Sf3b1 regulates erythroid maturation and proliferation via TGFβ signaling in zebrafish
Authors: De La Garza Adriana , Cameron Rosannah C. , Gupta Varun , Fraint Ellen , Nik Sara , Bowman Teresa V.
Published: July 2019

The spliceosomal component Splicing Factor 3B, subunit 1 (SF3B1) is one of the most prevalently mutated factors in the bone marrow failure disorder myelodysplastic syndrome. There is a strong clinical correlation between SF3B1 mutations and erythroid defects, such as refractory anemia with ringed sideroblasts, but the role of SF3B1 in normal erythroid development is largely unknown. Loss-of-function zebrafish mutants for sf3b1 develop a macrocytic anemia. Here, we explore the underlying mechanism for anemia associated with sf3b1 deficiency in vivo. We found that sf3b1 mutant erythroid progenitors display a G0/G1 cell-cycle arrest with mutant erythrocytes showing signs of immaturity. RNA-sequencing analysis of sf3b1 mutant erythroid progenitors revealed normal expression of red blood cell regulators such as gata1, globin genes, and heme biosynthetic factors, but upregulation of genes in the transforming growth factor β (TGFβ) pathway. As TGFβ signaling is a known inducer of quiescence, the data suggest that activation of the pathway could trigger sf3b1 deficiency–induced anemia via cell-cycle arrest. Indeed, we found that inhibition of TGFβ signaling released the G0/G1 block in erythroid progenitors. Surprisingly, removal of this checkpoint enhanced rather than suppressed the anemia, indicating that the TGFβ-mediated cell-cycle arrest is protective for sf3b1-mutant erythrocytes. Together, these data suggest that macrocytic anemia arising from Sf3b1 deficiency is likely due to pleiotropic and distinct effects on cell-cycle progression and maturation.