bluuebunny/crossref_metadata_2025 huggingface dataset:
Flood Frequency Analysis at Ungauged Sites Based on Regionally Estimated Streamflows
Authors: Requena Ana I. , Ouarda Taha B. M. J. , Chebana Fateh
Published: July 2017

Estimation of flood events at ungauged sites is often performed through regional flood frequency analysis (RFFA). RFFA uses the available information at gauged sites to estimate the desired design events at the ungauged site. These regional methods are based on a prior aggregation of the hydrological information at the gauged sites, which implies loss of information. In the present study, a different approach or path for conducting RFFA is presented. First, the daily streamflow series at the ungauged site is regionally estimated from daily information at the gauged sites through a regional flow duration curve approach. Then, a local flood frequency analysis is performed on the extracted maximum peak flow series. The proposed approach, referred to as regional streamflow-based frequency analysis (RSBFA), is applied to a case study in the province of Quebec, Canada. Results indicate that the performance of the RSBFA approach is comparable to traditional methods. However, the proposed method has the advantages of being simple, flexible, and of providing the whole daily streamflow series at the ungauged site, which allows the direct estimation of a large number of other flow characteristics, such as low-flow features. The RSBFA approach also avoids performing a complete at-site flood frequency analysis at each gauged site. The fact that all the regional information is included in the regionally estimated daily streamflow series implies a number of benefits: annual or seasonal, absolute or specific, stationary or nonstationary, and univariate or multivariate flood quantiles corresponding to any return period may then be obtained through the estimated series without reconducting a regional analysis.
Association between Hypertension and Epistaxis: Systematic Review and Meta‐analysis
Authors: Min Hyun Jin , Kang Hyun , Choi Geun Joo , Kim Kyung Soo
Published: July 2017

Objective

Whether there is an association or a cause‐and‐effect relationship between epistaxis and hypertension is a subject of longstanding controversy. The objective of this systematic review and meta‐analysis was to determine the association between epistaxis and hypertension and to verify whether hypertension is an independent risk factor of epistaxis.

Data Sources

A comprehensive search was performed using the MEDLINE, EMBASE, and Cochrane Library databases.

Review Methods

The review was performed according to the Meta‐analysis of Observational Studies in Epidemiology guidelines and reported using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis guidelines.

Results

We screened 2768 unique studies and selected 10 for this meta‐analysis. Overall, the risk of epistaxis was significantly increased for patients with hypertension (odds ratio, 1.532 [95% confidence interval (CI), 1.181‐1.986]; number needed to treat, 14.9 [95% CI, 12.3‐19.0]). Results of the Q test and I2 statistics suggested considerable heterogeneity ( = 0.038, I2 = 49.3%). The sensitivity analysis was performed by excluding 1 study at a time, and it revealed no change in statistical significance.

Conclusion

Although this meta‐analysis had some limitations, our study demonstrated that hypertension was significantly associated with the risk of epistaxis. However, since this association does not support a causal relationship between hypertension and epistaxis, further clinical trials with large patient populations will be required to determine the impact of hypertension on epistaxis.
Pericytes secrete pro-regenerative molecules in response to platelet-derived growth factor-BB
Authors: Gaceb Abderahim , Özen Ilknur , Padel Thomas , Barbariga Marco , Paul Gesine
Published: July 2017

Brain pericytes not only maintain the anatomical, biochemical and immune blood–brain barrier, but display features of mesenchymal stem cells (MSCs) in vitro. MSCs have pro-regenerative properties attributed to their secretome. However, whether also brain pericytes possess such pro-regenerative capacities is largely unknown. Here we characterize the secretome and microvesicle (MV) release of human brain pericytes mediated by platelet-derived growth factor-BB (PDGF-BB)/PDGF receptor beta (PDGFRβ) signalling. Upon PDGF-BB, pericytes release not only a plethora of growth factors and a panel of cytokines, but also MVs containing BDNF, FGFb, βNGF, VEGF and PLGF, a response that is specific for PDGFRβ signalling and activation of the ERK 1/2 pathway. In contrast, lipopolysaccharide (LPS), an activator of the innate immune system, stimulates the secretion of much higher amounts of mainly inflammatory cytokines and activates the NFκB pathway. Pericytes change their morphology and undergo opposite changes in surface marker expression, respectively. Our findings provide evidence that the secretome of human brain pericytes varies greatly depending on the exogenous stimulus. The differential secretory functions of pericytes may play an important role in either regulating neuroinflammation or contributing to neurorestoration and identify a possible new target cell for neuroregeneration.
Toward wearable supernumerary robotic fingers to compensate missing grasping abilities in hemiparetic upper limb
Authors: Hussain Irfan , Spagnoletti Giovanni , Salvietti Gionata , Prattichizzo Domenico
Published: July 2017

This paper presents the design, analysis, fabrication, experimental characterization, and evaluation of two prototypes of robotic extra fingers that can be used as grasp compensatory devices for a hemiparetic upper limb. The devices are the results of experimental sessions with chronic stroke patients and consultations with clinical experts. Both devices share a common principle of work, which consists in opposing the device to the paretic hand or wrist so to restrain the motion of an object. They can be used by chronic stroke patients to compensate for grasping in several activities of daily living (ADLs) with a particular focus on bimanual tasks. The robotic extra fingers are designed to be extremely portable and wearable. They can be wrapped as bracelets when not being used, to further reduce the encumbrance. Both devices are intrinsically compliant and driven by a single actuator through a tendon system. The motion of the robotic devices can be controlled using an electromyography-based interface embedded in a cap. The interface allows the user to control the device motion by contracting the frontalis muscle. The performance characteristics of the devices have been measured experimentally and the shape adaptability has been confirmed by grasping various objects with different shapes. We tested the devices through qualitative experiments based on ADLs involving five chronic stroke patients. The prototypes successfully enabled the patients to complete various bimanual tasks. Results show that the proposed robotic devices improve the autonomy of patients in ADLs and allow them to complete tasks that were previously impossible to perform.
Self-assembly of hydroxyapatite with polyelectrolyte as a green flame retardant for poly(vinyl alcohol)
Authors: Chen Junmin , Jiang Shu-Dong , Huang Zheng-Qi , Tang Gang , Hu Yuan
Published: July 2017

Here, we present a multifunctional bio-based polyelectrolyte multilayer-coated hydroxyapatite (HAP@CS@LSF) as a green flame retardant through layer-by-layer inspired assembly using hydroxyapatite, chitosan, and lignosulfonate. The electrostatic interactions deposited the chitosan/lignosulfonate coating on the surface of hydroxyapatite. Subsequently, this multifunctional flame retardant was used to enhance thermal properties, flame retardancy, and mechanical properties of poly(vinyl alcohol). The addition of HAP@CS@LSF to poly(vinyl alcohol) thermally stabilized the poly(vinyl alcohol) composites and resulted in a higher char yield. Furthermore, hydroxyapatite played a critical role and generated synergies with chitosan and lignosulfonate to improve fire safety of poly(vinyl alcohol). Meanwhile, the poly(vinyl alcohol) composites exhibited superior enhancements in tensile strength than that of pure poly(vinyl alcohol).
Service-Providing Nonprofits Working in Coalition to Advocate for Policy Change
Authors: Chin John J.
Published: July 2017

Nonprofit organizations that primarily provide social or health services can play an important role in policy advocacy, as indicated by recent research. Less is known about how and why they participate in policy advocacy, and concerns remain that their advocacy is overly self-interested. This case study of an urban immigrant health policy advocacy coalition made up primarily of service-providing nonprofits in New York City suggests that (a) service-providing nonprofits’ insights as daily case-level advocates for their clients generate unique contributions to policy change agendas, particularly at the policy implementation level rather than at the legislative level; (b) these organizations do not necessarily see a conflict between their organizational survival imperatives and social change objectives, nor between case-level and higher level advocacy; and (c) a coalition structure, leadership by an experienced advocacy organization, and dedicated foundation funding can elevate case advocacy concerns into a higher level and more sustained advocacy agenda.
Assessing the value and impact of demand side response using whole-system approach
Authors: Pudjianto Danny , Strbac Goran
Published: July 2017

This paper describes the whole-system based model called Whole-electricity System Investment Model to quantify the benefits of demand flexibility. Whole-electricity System Investment Model is a holistic and comprehensive electricity system analysis model, which simultaneously optimises the long-term investment decisions against real-time operation decisions taking into account the flexibility provided by demand. The optimisation considers the impact of demand side response across all power subsystems, i.e. generation, transmission and distribution systems, in a coordinated fashion. This allows the model to capture the potential conflicts and synergies between different applications of demand side response in supporting particularly intermittency management at the national level, improving capacity margin, and minimising the cost of electrification. The impact and value of demand side response driven by whole-system approach are compared against the impact and value of distribution system operator or transmission system operator centric (silo approaches) demand side response applications and the importance of control coordination between distribution system operator and transmission system operator for optimal demand side response is discussed and highlighted.
Lipid emulsion alleviates the vasodilation and mean blood pressure decrease induced by a toxic dose of verapamil in isolated rat aortae and an in vivo rat model
Authors: Ok S-H , Shin I-W , Lee SH , Park J , Woo MS , Hong J-M , Kim J , Sohn J-T
Published: July 2017

This study aimed to examine the effects of lipid emulsion on the vasodilation and cardiovascular depression induced by toxic doses of calcium channel blockers. The effects of lipid emulsion on the vasodilation induced by bepridil, verapamil, nifedipine, and diltiazem were investigated in isolated endothelium-denuded rat aortae. The effect of lipid emulsion on the comparable hemodynamic depression induced by the continuous infusion of a toxic dose of either verapamil or diltiazem was examined in an in vivo rat model. The results showed the following decreasing order for the magnitude of lipid emulsion-mediated inhibition of vasodilation: bepridil, verapamil, nifedipine, and diltiazem. Lipid emulsion (0.5–2%) reversed the vasodilation induced by a toxic dose of verapamil, whereas only a higher concentration (2%) reversed the vasodilation induced by a toxic dose of diltiazem. Pretreatment with lipid emulsion alleviated the systolic and mean blood pressure decreases induced by a toxic dose of verapamil, whereas it had no effect on the decrease induced by diltiazem. Taken together, these results suggest that lipid emulsion alleviates the severe vasodilation and systolic blood pressure decrease induced by a toxic dose of verapamil, and this alleviation appears to be associated with the relatively high lipid solubility of verapamil.
Vibration analysis of a uniform pre-twisted rotating Euler–Bernoulli beam using the modified Adomian decomposition method
Authors: Adair Desmond , Jaeger Martin
Published: July 2017

The governing equations for a pre-twisted rotating cantilever beam are derived and used for free vibration analysis of a pre-twisted rotating beam whose flexural displacements are coupled in two planes. First differential equations of motion of a rotating twisted beam, including terms due to centrifugal stiffening, are derived for an Euler–Bernoulli beam undergoing free natural vibrations. The general solutions of these equations are obtained on applying the Adomian modified decomposition method (AMDM). The AMDM allows the governing differential equations to become recursive algebraic equations and the boundary conditions to become simple algebraic frequency equations suitable for symbolic computation. With additional simple mathematical operations on the model, the natural frequencies and corresponding closed-form series solution of the mode shape can be obtained simultaneously. Two main advantages of the application of the AMDM are, for the cases considered here, its fast convergence rate to the solution with the high degree of accuracy. As the AMDM technique is systematic, it is found straight-forward to modify boundary conditions from one case to the next. Comparison of results with published data showed the present calculations to be in reasonable agreement.
The Urban Exploration Imaginary: Mediatization, Commodification, and Affect
Authors: Klausen Maja
Published: July 2017

Using George E. Marcus’ concept of the “activist imaginary” this article focuses on the imaginary of urban exploration (UE), an alternative form of organized action. The UE imaginary is investigated through visual material, produced and shared on social media by the Copenhagen-based UE duo CphCph. Grasping UE as an assemblage, the article suggests that the imaginary undergoes a dual process of mediatization and commodification. Through a discourse analytical and aesthetic-affective approach, it is argued that CphCph strategically uses the visually mediated explorer body as an effective tool on social media to both commodify the imaginary and create “spreadability” as well as to channel followers’ engagement in urban space. In keeping with Roopali Mukherjee and Sarah Banet-Weiser’s approach to contemporary, neoliberal modes of resistance the UE imaginary is understood both as a commodity produced by entrepreneurial explorers and as an imagined geography sparking participation and enabling practices of urban citizenship.
Furanchos and adegas: exploring symmetry through wine cultures in Galicia and Alentejo
Authors: Alonso González Pablo , Parga-Dans Eva
Published: July 2017

This textual and visual piece exceeds the traditional paper form to explore popular winemaking and drinking cultures in Galicia and Alentejo. It does not illustrate our fieldwork, but evocates alternative geographies of production and consumption that coexist with the standard commercial and legal wine market. In our quotidian learning by doing and living, we understand symmetrically the cultures we are part of, and by extension our practice of cultural geography. Through a combination of documentary and ethnographic approaches, we reveal geographies of practice that enact diverse forms of being together at the verge of disappearance. Symmetry eventually emerged, but only as the practice of research, not as a discursive rhetoric nor as an alternative form of representation.
Hospitable universities and integration of refugees: First responses from Austria and Poland
Authors: Kontowski Daniel , Leitsberger Madelaine
Published: July 2017

European universities responded in different ways to the ‘refugee crisis’ of 2015. Some subscribed to the agenda of higher education (HE) as a universal human right, while others stressed different long-term benefits of offering access to it. Yet, the unprecedented sense of moral urgency that guided immediate declarations of support and subsequent actions has largely remained unaddressed. With the crisis becoming a new reality for many countries, HE has a role to play in the social inclusion of refugees, even in countries that were not attractive destinations for refugees in the past.

In this article, we provide an overview of the reasons why HE institutions supported refugees, and present the results of an empirical study of Poland and Austria during the 2015–2016 academic year. We then evaluate those first responses utilizing parts of Ager and Strang’s framework of integration, and discuss issues of institutional readiness, capabilities and the public role of HE stemming from this comparison.

Our findings suggest that reasons such as acknowledgement of basic rights, or utilizing social capital are insufficient to explain and understand strong integrative support measures. We propose that refugee support by HE institutions is both better understood and promoted through the language of hospitality.
Tiny RNAs and their voyage via extracellular vesicles: Secretion of bacterial small RNA and eukaryotic microRNA
Authors: Choi Ji-Woong , Um Jee-Hyun , Cho Jin-Hyun , Lee Heon-Jin
Published: July 2017

MicroRNAs are small non-coding RNAs that bind to the 3′-untranslated region of target mRNAs and have transcriptional or translational inhibitory function in eukaryotes. Before microRNAs were widely known, bacterial non-coding small RNAs around 50–200 nt in length were discovered whose mechanism of action resembled that of microRNAs. Recently, RNAs that are of similar size to or smaller than microRNAs have been discovered in bacteria and indeed, this class of small RNAs have been found throughout all domains of life. Moreover, recent findings suggest that these tiny RNAs can be released via extracellular vesicles (such as exosomes in eukaryotes and outer membrane vesicles in bacteria), which in turn heralds a new field of research, interkingdom communication. This review discusses two similar classes of small RNAs in evolutionarily distinct eukaryotes and bacteria. In addition to their biogenesis and regulation, we discuss small RNA vehicles and their secretion.

Impact statement

The possible endogenous functions of small RNAs such as regulatory small RNAs in bacteria and microRNAs in eukaryotes have been extensively studied since they were first discovered. However, their powerful functions should not be seen as limited to their cells of origin. Recently, several papers have demonstrated that small RNAs function as signaling molecules between cells. This is possible because small RNAs can be shuttled around after being incorporated into environmentally protective extracellular vesicles. It is now clearly plausible that secreted small RNAs can regulate other types of cells through biofluids. Given their “common molecule” status, the role of small RNAs in mediating bacteria-human crosstalk is an emerging and competitive area of genetic research. This review provides insight into the function of small RNAs in intercellular and even interkingdom communication.
Causation in Mixed Methods Research: The Meeting of Philosophy, Science, and Practice
Authors: Johnson R. Burke , Russo Federica , Schoonenboom Judith
Published: July 2017

This article provides a systematic and pluralistic theory of causation that fits the kind of reasoning commonly found in mixed methods research. It encompasses a variety of causal concepts, notions, approaches, and methods. Each instantiation of the theory is like a mosaic, where the image appears when the tiles are appropriately displayed. This means that researchers should carefully construct a causal mosaic for each research study, articulating what is causally relevant given their particular research questions, purposes, contexts, methods, methodologies, paradigms, and resources. Our theory includes 11 propositions that can guide researchers addressing causation.
Autonomous exploration of mobile robots through deep neural networks
Authors: Tai Lei , Li Shaohua , Liu Ming
Published: July 2017

The exploration problem of mobile robots aims to allow mobile robots to explore an unknown environment. We describe an indoor exploration algorithm for mobile robots using a hierarchical structure that fuses several convolutional neural network layers with decision-making process. The whole system is trained end to end by taking only visual information (RGB-D information) as input and generates a sequence of main moving direction as output so that the robot achieves autonomous exploration ability. The robot is a TurtleBot with a Kinect mounted on it. The model is trained and tested in a real world environment. And the training data set is provided for download. The outputs of the test data are compared with the human decision. We use Gaussian process latent variable model to visualize the feature map of last convolutional layer, which proves the effectiveness of this deep convolution neural network mode. We also present a novel and lightweight deep-learning library libcnn especially for deep-learning processing of robotics tasks.
Topical moringin cream relieves neuropathic pain by suppression of inflammatory pathway and voltage-gated ion channels in murine model of multiple sclerosis
Authors: Giacoppo Sabrina , Iori Renato , Bramanti Placido , Mazzon Emanuela
Published: July 2017

Background

Neuropathic pain represents the major public health burden with a strong impact on quality life in multiple sclerosis patients. Although some advances have been obtained in the last years, the conventional therapies remain poorly effective. Thus, the discovery of innovative approaches to improve the outcomes for multiple sclerosis patients is a goal of primary importance. With this aim, we investigated the efficacy of the 4-(α−L-rhamnopyranosyloxy)benzyl isothiocyanate (moringin), purified from Moringa oleifera seeds and ready-to-use as topical treatment in experimental autoimmune encephalomyelitis, murine model of multiple sclerosis. Female C57BL/6 mice immunized with myelin oligodendrocyte glycoprotein (MOG35–55) were topically treated with 2% moringin cream twice daily from the onset of the symptoms until the sacrifice occurred about 21 days after experimental autoimmune encephalomyelitis induction.

Results

Our observations showed the efficacy of 2% moringin cream treatment in reducing clinical and histological disease score, as well as in alleviating neuropathic pain with consequent recovering of the hind limbs and response to mechanical stimuli. In particular, Western blot analysis and immunohistochemical evaluations revealed that 2% moringin cream was able to counteract the inflammatory cascade by reducing the production of pro-inflammatory cytokines (interleukin-17 and interferon-γ) and in parallel by increasing the expression of anti-inflammatory cytokine (interleukin-10). Interestingly, 2% moringin cream treatment was found to modulate the expression of voltage-gated ion channels (results focused on P2X7, Nav 1.7, Nav 1.8 KV4.2, and α2δ-1) as well as metabotropic glutamate receptors (mGluR5 and xCT) involved in neuropathic pain initiation and maintenance.

Conclusions

Finally, our evidences suggest 2% moringin cream as a new pharmacological trend in the management of multiple sclerosis-induced neuropathic pain.
The place of eluxadoline in the management of irritable bowel syndrome with diarrhea
Authors: Levio Sherry , Cash Brooks D.
Published: July 2017

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal pain associated with defecation with altered stool frequency or stool form. The global prevalence of IBS ranges from 10% to 15% and total healthcare cost attributable to IBS is significant. Among individuals with IBS, the condition has dramatic effects on health-related quality of life, work and school productivity, and activities of daily living. It may be diagnosed with confidence, based on symptom-based diagnostic criteria, exclusion of alarm features and directed diagnostic testing. Management of IBS typically begins with dietary and lifestyle modifications, progressing to over-the-counter therapies, and then to prescription medications, both approved and nonapproved for IBS. This narrative summarizes the efficacy and safety of three US Food and Drug Administration (FDA)-approved prescription therapies for IBS with diarrhea (IBS-D), with a focus on the most recently marketed agent, eluxadoline, and its role in the treatment IBS-D.
Laypersons’ Beliefs and Intuitions About Free Will and Determinism
Authors: Feldman Gilad , Chandrashekar Subramanya Prasad
Published: July 2017

We linked between the social psychology and experimental philosophy paradigms for the study of folk intuitions and beliefs regarding the concept of free will to answer three questions: (1) What intuitions do people have about free will and determinism? (2) Do free will beliefs predict differences in free will and determinism intuitions? and (3) Is there more to free will and determinism than experiencing certainty or uncertainty about the nature of the universe? Overall, laypersons viewed the universe as allowing for human indeterminism, and they did so with certainty. Examining intuitions of prosociality, future orientation, learning, meaningfulness, human uniqueness, and well-being, ratings were highest in the indeterministic universe condition and lowest in the deterministic universe condition, both significantly different from the uncertain universe condition. Participants’ free will beliefs had only weak impact on realism, happiness, and learning intuitions but did not reverse the general intuition favoring indeterminism and showed no impact on other intuitions.
A Description of Advanced Chronic Kidney Disease Patients in a Major Urban Center Receiving Conservative Care
Authors: Kamar Fareed B. , Tam-Tham Helen , Thomas Chandra
Published: July 2017

Background:

Conservative/palliative (nondialysis) management is an option for some individuals for treatment of stage 5 chronic kidney disease (CKD). Little is known about these individuals treated with conservative care in the Canadian setting.

Objective:

To describe the characteristics of patients treated with conservative care for category G5 non-dialysis CKD in a Canadian context.

Design:

Retrospective chart review.

Setting:

Urban nephrology center.

Patients:

Patients with G5 non-dialysis CKD (estimated glomerular filtration rate <15 mL/min/1.73 m2).

Measurements:

Baseline patient demographic and clinical characteristics of conservative care follow-up, advanced care planning, and death.

Methods:

We undertook a descriptive analysis of individuals enrolled in a conservative care program between January 1, 2009, and June 30, 2015.

Results:

One hundred fifty-four patients were enrolled in the conservative care program. The mean age and standard deviation was 81.4 ± 9.0 years. The mean modified Charlson Comorbidity Index score was 3.4 ± 2.8. The median duration of conservative care participation was 11.5 months (interquartile range: 4-25). Six (3.9%) patients changed their modality to dialysis. One hundred three (66.9%) patients died during the study period. Within the deceased cohort, most (88.2%) patients completed at least some advanced care planning before death, and most (81.7%) of them died at their preferred place. Twenty-seven (26.7%) individuals died in hospital.

Limitations:

Single-center study with biases inherent to a retrospective study. Generalizability to non-Canadian settings may be limited.

Conclusions:

We found that individuals who chose conservative care were very old and did not have high levels of comorbidity. Few individuals who chose conservative care changed modality and accepted dialysis. The proportions of engagement in advanced care planning and of death in place of choice were high in this population. Death in hospital was uncommon in this population.
Breast cancer detected as an incidental finding on 99mTc-MIBI scintigraphy
Authors: Homma Toshihiro , Manabe Osamu , Ichinokawa Kazuomi , Yamashita Hiroko , Oyama-Manabe Noriko , Kato Fumi , Hirata Kenji , Kroenke Markus , Tamaki Nagara
Published: July 2017

We report a case of breast cancer detected as an incidental finding on 99mTc-MIBI scintigraphy. 99mTc-MIBI scintigraphy is usually used to evaluate cardiac perfusion or to detect ectopic parathyroid adenomas; however, it is also known to sensitively detect breast cancer. Accordingly, a few reports have described the incidental detection of breast cancer by 99mTc-MIBI scintigraphy performed to detect parathyroid adenoma. Our present case underscores the importance of attending to any incidental findings when searching for parathyroid adenomas using 99mTc-MIBI scintigraphy.
Hepatocellular carcinoma with disseminated skeletal muscle metastasis
Authors: Rahim Ezamin Abdul , Noh Mohamad SF , Ngah Nur A , Suraini Mohamad S , Yusof Mubarak M
Published: July 2017

Hepatocellular carcinoma (HCC) is the commonest primary tumor of the liver and carries a poor prognosis when diagnosed late or left untreated. Treatment relies heavily on the stage of the tumor when diagnosed. Extrahepatic metastasis is known to occur; these are mainly reported via autopsy studies or isolated case reports. Knowledge of extrahepatic metastasis is crucial in order to avoid unnecessary surgery. We report a rare case of a patient at our center, diagnosed to have HCC, who underwent treatment successfully, only to come back with extrahepatic metastasis to the skeletal muscles.
The Influence of Medical Insurance on Patient Access to Orthopaedic Surgery Sports Medicine Appointments Under the Affordable Care Act
Authors: Wiznia Daniel H. , Nwachuku Emmanuel , Roth Alexander , Kim Chang-Yeon , Save Ameya , Anandasivam Nidharshan S. , Medvecky Michael , Pelker Richard
Published: July 2017

Background:

The goal of the Patient Protection and Affordable Care Act (PPACA) was to expand patient access to health care. Since the rollout of the PPACA, Medicaid patients have demonstrated difficulty obtaining appointments in some specialty care settings.

Purpose:

To assess the effect of insurance type (Medicaid and private) on patient access to orthopaedic surgery sports medicine specialists for a semiurgent evaluation of a likely operative bucket-handle meniscus tear. The study was designed to determine whether disparities in access exist since the PPACA rollout.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

The design was to call 180 orthopaedic surgery sports medicine specialists in 6 representative states (California, Ohio, New York, Florida, Texas, and North Carolina) between June 2015 and December 2015. An appointment was requested for the caller’s fictitious 25-year-old-brother who had suffered a bucket-handle meniscus tear. Each office was called twice to assess the ease of obtaining an appointment: once for patients with Medicaid and once for patients with private insurance. For each call, data pertaining to whether an appointment was given, wait times, and barriers to receiving an appointment were recorded.

Results:

A total of 177 surgeons were called within the study period. Overall, 27.1% of offices scheduled an appointment for a patient with Medicaid, compared with 91.2% ( P < .0001) for a patient with private insurance. Medicaid patients were significantly more likely to be denied an appointment due to lack of referral compared with private patients (40.2% vs 3.7%, P < .0001), and Medicaid patients were more likely to experience longer wait times for an appointment (15 vs 12 days, P < .029). No significant differences were found in patients’ access to orthopaedic surgery sports medicine specialists between Medicaid-expanded and -nonexpanded states. Medicaid reimbursement for knee arthroscopy with meniscus repair was not significantly correlated with appointment success rate or patient waiting periods.

Conclusion:

Despite the passage of the PPACA, patients with Medicaid have reduced access to care. In addition, patients with Medicaid confront more barriers to receiving appointments than patients with private insurance and wait longer for an appointment.
Morphine Versus Methadone Treatment for Neonatal Withdrawal and Impact on Early Infant Development
Authors: Burke Sharon , Beckwith Anna Malia
Published: July 2017

Objective. Compare developmental outcomes in infants treated with morphine versus methadone. Method. Retrospective chart review of newborns identified through use of ICD-9 code for neonatal abstinence syndrome (NAS). Thirty-six infants were evaluated—17 treated with methadone and 19 treated with morphine. Assessment was completed following treatment using the Bayley Scales of Infant and Toddler Development–Third Edition (Bayley-III). Scores in Cognitive, Language, and Motor domains were compared. Results. Comparison of scores between morphine- and methadone-treated groups revealed differences in mean Cognitive Composite (91.3 vs 83.0; P = .03410) and mean Total Motor Composite Scores (96.3 vs 89.6; P = .0149). Conclusion. Newborns with NAS treated with morphine had significantly higher scores in Cognitive and Gross Motor domains compared to infants treated with methadone. Development screening should be pursued to determine if this difference persists throughout early childhood. Results may influence accepted treatment protocols for NAS.
Systems and precision medicine approaches to diabetes heterogeneity: a Big Data perspective
Authors: Capobianco Enrico
Published: July 2017

Big Data, and in particular Electronic Health Records, provide the medical community with a great opportunity to analyze multiple pathological conditions at an unprecedented depth for many complex diseases, including diabetes. How can we infer on diabetes from large heterogeneous datasets? A possible solution is provided by invoking next‐generation computational methods and data analytics tools within systems medicine approaches. By deciphering the multi‐faceted complexity of biological systems, the potential of emerging diagnostic tools and therapeutic functions can be ultimately revealed. In diabetes, a multidimensional approach to data analysis is needed to better understand the disease conditions, trajectories and the associated comorbidities. Elucidation of multidimensionality comes from the analysis of factors such as disease phenotypes, marker types, and biological motifs while seeking to make use of multiple levels of information including genetics, omics, clinical data, and environmental and lifestyle factors. Examining the synergy between multiple dimensions represents a challenge. In such regard, the role of Big Data fuels the rise of Precision Medicine by allowing an increasing number of descriptions to be captured from individuals. Thus, data curations and analyses should be designed to deliver highly accurate predicted risk profiles and treatment recommendations. It is important to establish linkages between systems and precision medicine in order to translate their principles into clinical practice. Equivalently, to realize their full potential, the involved multiple dimensions must be able to process information ensuring inter‐exchange, reducing ambiguities and redundancies, and ultimately improving health care solutions by introducing clinical decision support systems focused on reclassified phenotypes (or digital biomarkers) and community‐driven patient stratifications.
The Man Who Refused to Smile: Henning Mankell's Wallander Series and Postmodern Cynicism
Authors: Gregorek Jean
Published: July 2017

Henning Mankell describes his goal in the best-selling Wallander novels as an examination of the social antagonisms in his native Sweden, particularly with regard to race and immigration, within the commercial genre of the police procedural. This essay complicates Mankell's claims, which have been widely accepted by critics. Rather, the author situates Mankell's Wallander series in the literary tradition named by Ernest Mandel as the “disintegrative” thriller, which Mandel sees emerging in response to late capitalism's restructuring of electoral politics and in the context of Sweden's recent neoliberal turn. Social and political conditions in Sweden are ripe for the production of the cultural affect Peter Sloterdijk diagnoses as “cynical reason” or “modern cynicism” in his influential work, Critique of Cynical Reason. For Sloterdijk, the conflicted postmodern cynic affirms the post-Enlightenment project of ideological critique, the unmasking of concealed truth, although he has lost faith in the efficacy of this project. Sloterdijk's account provides a fascinating analogue to European detective figures noted for their “authenticity” or “realism,” and the Wallander series presents a provocative fable of disillusionment: a melancholic antihero defending the embattled welfare state, while uncovering the corruption of that same state, who gradually descends into the highly symbolic oblivion of Alzheimer's disease. This analysis of the Wallander character as postmodern cynic explores the ironies of a detective who no longer retains firm convictions of the likelihood of justice or the integrity of the individual mind. Ideally, this consideration of Mankell's best-selling series helps to explain its enormous appeal—how it speaks to its multiple audiences—and what constitutes realism in crime fiction today.
Microfinance Lit: Jhumpa Lahiri's “Sexy,” the Grameen Bank, and Kiva
Authors: Sinykin Dan
Published: July 2017

This essay develops a poetics of microfinance through an attempt to account for Jhumpa Lahiri's strange mention of the Grameen Bank in the short story “Sexy” from her collection Interpreter of Maladies. It shows how Lahiri's allusion links the intimacy of simulated global space to a central development in contemporary transnational economics. Exploring the discourses promulgated by the Grameen Bank and Kiva, a successful nonprofit microcredit organization based out of San Francisco, the essay reveals what makes microfinance seductive as a form of aid. The poetics of microfinance offers subjects a model through which they can link interpersonal intimacy to global financial projects. Lahiri's story features a scale model of the globe in a building called the Mapparium. The Mapparium is a simulacrum that produces the illusion of global intimacy, which emerges from the frisson of feeling both central and close to everywhere, a sense of nearness across distance. This essay argues that microfinance institutions such as Kiva use the poetics of microfinance to bridge bodily affect with abstract finance, thereby profiting from the further immiseration of the world's poor.
ΟΙ ΜΑΘΗΜΑΤΙΚΕΣ ΓΝΩΣΕΙΣ ΤΩΝ ΜΑΘΗΤΩΝ ΤΗΣ ΣΤ΄ ΔΗΜΟΤΙΚΟΥ ΤΟ 1998 ΚΑΙ ΤΟ 2015
Authors: ΚΛΙΑΠΗΣ ΠΕΤΡΟΣ , ΚΑΣΣΩΤΗ ΟΛΓΑ
Published: July 2017

Συγκριτικές μελέτες χρησιμοποιούνται ευρέως σε πολλά πεδία της επιστημονικής έρευνας. Ως μεθοδολογία έρευνας, η σύγκριση παίζει ένα σημαντικό ρόλο σε πολλούς διαφορετικούς κλάδους των κοινωνικών επιστημών. Στην παρούσα έρευνα εξετάζονται οι Μαθηματικές γνώσεις 292 μαθητών Στ΄ Δημοτικού από την περιοχή της Θεσσαλονίκης με τις ίδιες γραπτές δοκιμασίες που εξετάστηκαν οι μαθητές οι οποίοι συμμετείχαν το σχολικό έτος 1998-1999 στην «Έρευνα για εναλλακτικές διδακτικές προσεγγίσεις». Συγκρίνονται τα αποτελέσματα των δύο ερευνών και επιχειρείται μια πρώτη ερμηνεία για τις διαφορές στις επιδόσεις των μαθητών και το βαθμό που οι διάφοροι παράγοντες που εμπλέκονται στη μαθηματική εκπαίδευση επηρεάζουν τις επιδόσεις αυτές.
Κοινωνική Οικονομία και Κοινωνική Πολιτική: Ο Προσδιορισμός της Σχέσης, τα Διλήμματα στις Εφαρμογές
Authors: Ζάννης Παναγιώτης
Published: July 2017

Η Κοινωνική Οικονομία αποτελεί πλέον έναν από τους κύριους πυλώνες στην Κοινωνική Πολιτική. Ωστόσο, υφίσταται έντονος προβληματισμός, τόσο σε θεωρητικό επίπεδο όσο και στις πρακτικές, για τη φύση της σχέσης και το ρόλο της στο πλαίσιο του σχεδιασμού πολιτικών. Στο άρθρο αναλύονται ορισμένες κύριες πτυχές αυτών των ζητημάτων που συνδέονται με τις πλουραλιστικές κατευθύνσεις και τις σύγχρονες τάσεις ιδιωτικοποίησης και εμπορευματοποίησης στο πεδίο της Κοινωνικής Πολιτικής. Ιδιαίτερη έμφαση δίδεται στο πεδίο της κοινωνικής προστασίας και στην απασχόληση, με παράδειγμα το νομικό πλαίσιο για τη λειτουργία των Κοινωνικών Συνεταιριστικών Επιχειρήσεων στην Ελλάδα. Το κύριο συμπέρασμα που τεκμηριώνεται είναι ότι η Κοινωνική Οικονομία αποτελεί ένα εξαιρετικά ετερογενές πεδίο, όπου οι ολιστικές λογικές είναι αδόκιμες, και ο κεντρικός σχεδιασμός οφείλει να διακρίνει τις διαφορετικές οργανώσεις και πρακτικές που τη συνιστούν.
Η Φτώχεια στο Δήμο Αθηναίων: Στατιστικοί Δείκτες και Ποιοτική Ανάλυση
Authors: Πετράκη Μαρία , Υφαντόπουλος Γιάννης
Published: July 2017

Το άρθρο αυτό εξετάζει τους κοινωνικούς και οικονομικούς παράγοντες που επηρεάζουν τον κίνδυνο φτώχειας στο Δήμο Αθηναίων. Χρησιμοποιούνται στοιχεία από δειγματοληπτική έρευνα που διενεργήθηκε το β΄ εξάμηνο του 2012 σε τυχαίο δείγμα 800 νοικοκυριών.Τα ερευνητικά ερωτήματα είναι τα εξής: Ποιά είναι η έκταση και το βάθος της φτώχειας στο Δήμο Αθηναίων; Ποιές είναι οι ομάδες υψηλού κινδύνου; Ποιοί είναι αυτοί που πλήττονται περισσότερο από την κρίση; Υπάρχουν διαφορές στη φτώχεια μεταξύ Συνόλου Ελλάδος και Δήμου Αθηναίων; Η ανάλυση των στοιχείων βασίζεται σε απλές  και σύνθετες κατανομές καθώς και σε σχετικούς ποσοτικούς δείκτες  και ποιοτικές αναλύσεις. Ιδιαίτερα, αναδεικνύεται ότι ο κίνδυνος φτώχειας στην Αθήνα κυμαίνεται σε υψηλά επίπεδα, τα οποία όμως είναι χαμηλότερα από ότι ισχύει για το σύνολο της χώρας (έτος 2013: 23,1%).Καθώς οι κοινωνικές δαπάνες περιορίζονται λόγω της κρίσης, διαπιστώνεται ότι οι στοχευμένες πολιτικές σε τοπικό επίπεδο είναι απαραίτητες για την ανακούφιση των ομάδων κάτω από το όριο φτώχειας και όσων πλήττονται από την οικονομική ύφεση.
Quality of Life in the third age: a descriptive analysis
Authors: Symeonaki Maria
Published: July 2017

Η παρατηρούμενη αύξηση του προσδόκιμου ορίου της ζωής στην Ευρώπη έχει πολύ λογικά οδηγήσει στην ολοένα αυξανόμενη μελέτη της μέτρησης της ποιότητας της ζωής στην τρίτη ηλικία, που εστιάζει κυρίως στην εύρεση εκείνων των προσδιοριστικών παραγόντων που μπορούν να εγκαθιδρύσουν και να εξασφαλίσουν ένα υψηλό επίπεδο ποιότητας ζωής. Η παρούσα εργασία μελετά την ποιότητα της ζωής με δεδομένα που προέρχονται από το πέμπτο κύμα της έρευνας SHARE και τα πρότυπα που ενδέχεται να δημιουργούνται με βάση κάποιους κοινωνικο- δημογραφικούς παράγοντες.
The relationship between altmetric score with received citations in Iranian pediatrics articles
Authors: Nemati-Anaraki Leila , Aghajani Koupaei Hamed , Alibeyk Mohammadreza
Published: July 2017

Background: Today, in addition to citations and with the expansion of social media, the use of altmetrics has gained attention as a tool necessary for evaluating the effects of scientific publications. The present study intended to monitor Iranian pediatrics articles, as one of the leading areas of scientific publications in Iran, between the years 2010-2016 using altmetrics and citation-metrics, and then evaluate the relationship between the altmetric score and number of received citations.

Methods: This is a practical study of the analytical descriptive type and the research methodology is scientometrics. This research included 1332 research articles, review articles and conference articles in the field of pediatrics from Iran during 2010-2016, published in the Web of Science. Authors, year, journal and social media was determined in these articles. Data analysis was carried out using SPSS21 software and descriptive and inferential statistics (Kolmogorov-Smirnov test and Spearman correlation).

Results: A total of 1138 articles have citations and 256 articles had altmetric activity. The results indicate a significant correlation among the articles’ altmetric scores and number of received citations. Among the data sources of altmetric score, mentions of articles in Mendeley, Twitter, and Facebook had the highest ranking. The number of times an article was read in Mendeley had a significant correlation with the number of citations.

Conclusions: It seems that altmetrics better represent the impact of newer articles, while older articles had received more citations. In addition, a high number of reads in Mendeley correlates with received citations. However, Mendeley reads do not involve altmetric score calculation algorithms, and this should be implemented in the future.
In vitro regulation of reactive oxygen species formation in red blood cells of homozygous sickle cell patients using Vitamin C
Authors: Egini Ogechukwu , Guillaume Edouard , Adeyemo Titilope , Nwanyanwu Chiemeziem , Shweta Fnu , Jaffe Eric
Published: July 2017

Background: Sickle cell patients produce more reactive oxygen species (ROS) than healthy individuals, leading to increased cell membrane damage. Theoretically, reducing ROS formation would preserve red cell membranes of sickle cell patients. Vitamin C is a powerful anti-oxidant capable of inhibiting ROS formation in a variety of situations, by functioning as an electron donor to reduce molecular oxygen. This study aimed to determine whether Vitamin C reduced ROS formation in sickle red cells.

Methods:27 homozygous (HbSS) patients were recruited from the outpatient clinics of Lagos University Teaching Hospital, Nigeria, and annex at the Sickle Cell Foundation, Lagos, Nigeria. Demographic information and EDTA patient blood samples were collected. The test group were red cells preincubated in 80uM and 100uM Vitamin C concentrations before stressing with tertbutylhydroperoxide. These were compared to stressed matched controls preincubated in phosphate buffered saline. Cell staining was done with CellRox Orange followed by flow cytometry to quantify ROS.

Results: ROS count for Vitamin C pre-treated red cells was significantly lower than matched controls (p<0.001). Average ROS count for 80uM test samples was 27.5/ul (95% CI, 17.5 to 72.5) and for 100uM 3.9/ul (95% CI, 1.9 to 5.9). Male gender was significantly associated with elevated baseline ROS count (p=0.03).

Conclusion:Vitamin C reduced ROS formation in HbSS cells. Future studies should focus on a role for Vitamin C as a safe, cheap addition to maintenance therapy of sickle cell patients.
An Overview of School Dropout in Central America: Unresolved Issues and New Challenges for Education Progress
Authors: Adelman Melissa A. , Szekely Miguel
Published: July 2017

School dropout is a growing concern in Central America, and in Latin America as a whole, because of its consequences for economic productivity, the inclusiveness of growth, social cohesion, and increasing youth risks. This paper utilizes more than two decades of household survey data to construct a systematic overview of school dropout at the primary and secondary levels in Central America, focusing on recent trends in dropout patterns and their underlying causes. Within each country, poverty, rurality, and indigenous group membership are the strongest correlates of dropout, reflecting several underlying factors that affect the marginal benefits and costs of staying in school.  Global and regional evidence increasingly points to common policy priorities for reducing dropout across Central America, including addressing remaining gaps in access at the pre-primary and secondary levels, improving the quality of education at all levels, and strengthening the coverage, targeting, and coherence of existing programs aimed at improving education outcomes.  However, additional rigorous evaluations, including cost data, are needed to identify the most effective specific approaches in each country.  JEL Classification: I2, I24, I25, I26, I28, O15