bluuebunny/crossref_metadata_2025 huggingface dataset:
Outpatient Procedural Sedation of Patients With Autism Spectrum Disorders for Magnetic Resonance Imaging of the Brain Using Propofol
Authors: Kamat Pradip P. , Karaga Marie K. , Wisniewski Benjamin L. , McCracken Courtney E. , Simon Harold K. , Sidhu Reet , Grunwell Jocelyn R.
Published: February 2018

Objective:

To quantify the number of personnel, time to induce and complete sedation using propofol for outpatient magnetic resonance imaging (MRI) of the brain, and the frequency of serious adverse events (SAEs) in children with autism spectrum disorder (ASD) compared with children without ASD.

Results:

Baseline characteristics were the same between both groups. Overall sedation success was 99%. Although most children were sedated with ≤3 providers, 10% with ASD needed ≥4 providers (P = .005). The duration of sedation was less for the ASD group compared with the non-ASD group (49 minutes vs 56 minutes, P = .005). There was no difference in SAE frequency between groups (ASD 14% vs non-ASD 16%, P = .57).

Conclusion:

Children with ASD can be sedated for brain MRI using propofol with no increased frequency of SAEs compared with children without ASD. Sedation teams should anticipate that 10% of children with ASD may need additional personnel before propofol induction.
Bleeding Risks in Patients on Percutaneous Ventricular Assist Devices Receiving Two Different Dextrose Concentrations of Heparinized Purge Solution: A Case Series
Authors: Dietrich Jenna N. , Kazmi Hasan
Published: February 2018

Background:

The Impella manufacturer has changed its recommendation for the diluent of the heparinized purge solution from 20% dextrose (D20) to 5% dextrose (D5). This reduced viscosity may result in increased purge solution infusion rates and unfractionated heparin (UFH) exposure. Increased UFH exposure could potentially cause increased bleeding events and may necessitate reduction in UFH concentration in the purge solution. Our objective was to evaluate anticoagulation for patients on Impella pumps receiving heparinized purge solution with D20 or D5 diluents.

Methods:

This retrospective cohort analysis evaluated patients requiring Impella support outside of the cardiac catheterization lab. The primary outcome evaluated the number of patients with at least one supratherapeutic activated partial thromboplastin time (aPTT) while receiving heparinized purge solution alone without systemic UFH. Secondary outcomes included heparin concentration changes made to the purge solution, bleeding, and thrombotic events.

Results:

Twelve patients received Impella support for an average of 37 hours (range, 10.8-89.6). Four patients received D20 and 8 patients received D5 purge solution. Five patients had at least one supratherapeutic aPTT while receiving heparinized purge solution alone without additional systemic UFH. All 5 patients were in the D5 group. Of these 5 patients, 3 required purge heparin concentration decreases and 3 had bleeding events. No patients had pump thrombosis.

Conclusion:

D5 purge solution with heparin 50 units/mL may increase the risk of supratherapeutic aPTTs, leading to increased bleeding. Decreasing heparin to 25 units/mL as a standard in purge solution may decrease these risks; however, protection against thrombosis remains unknown.
Associations Between Functional Biological Age and Cognition Among Older Adults in Rural Bangladesh: Comparisons With Chronological Age
Authors: Sternäng Ola , Palmer Katie , Kabir Zarina N. , Hasan Mohammed I. , Wahlin Åke
Published: February 2018

Objectives: We constructed a functional biological age (fBioAge) indicator by using four functional variables: grip strength, forced expiratory lung volume, visual acuity, and hearing. Our aim was to compare how chronological age (ChronAge) and fBioAge are related to cognitive abilities in older adults. Method: We used data from the Poverty and Health in Aging project, Bangladesh. Participants ( N = 400) were 60+ years of age and diagnosed as nondemented. Examined cognitive abilities were four episodic memory measures (including recall and recognition), two verbal fluency indicators, two semantic knowledge, and two processing speed tasks. Results: fBioAge accounted for cognitive variance beyond that explained by ChronAge also after controlling for medical diagnoses and blood markers. Discussion: Compared with ChronAge, fBioAge was a stronger predictor of cognition during a broad part of the old adult span. fBioAge seems, in that respect, to have the potential to become a useful age indicator in future aging studies.
Error analysis and compensation for dual-axis inertial navigation system with horizontal rotation modulation
Authors: Zhang H , Wang L , Song TX , Li K
Published: February 2018

Rotational inertial navigation system can significantly improve the navigation accuracy by rotating the inertial measurement unit about gimbals periodically. The precise calibration for installation errors and scale factor errors in rotational inertial navigation system can contribute to better navigation performance further. Especially in application requiring excellent azimuth precision, the horizontal rotation modulation will be badly required to modulate the vertical sensors’ errors as periodic variation, which can make inhibiting effect on the navigation errors. However, it also enlarges the impact of specific errors, which contains gyro’s scale factor error and the installation errors of inertial components. To meet the requirement of navigation precision, this paper has made error analysis and established mathematical model for a proposed horizontal rotation modulation in dual-axis rotational inertial navigation system. The crucial error parameters can be calibrated based on the measurements of attitude and velocity output without additional equipment. The results of experiment performed in an actual system demonstrate that navigation accuracy has been improved significantly, fully illustrating the significance and necessity of the calibration for specific errors in the horizontal rotation modulation.
Multidisciplinary design optimization of sandwich-structured radomes
Authors: Deng Jian , Zhou Guangming , Qiao Yu
Published: February 2018

A multidisciplinary design optimization framework is proposed for sandwich-structured radomes. Radomes ensure the functional operation of antenna systems in adverse environment catering for aerodynamic stresses and payload requirements. The existence of radomes can partially degrade the electromagnetic performance of antenna systems. The electromagnetic performance and mechanical responses are taken into account simultaneously in the optimization design. This is more time-saving and economical compared to the traditional separate considerations on these two aspects. Coupled with multi-island genetic algorithm, transmission coefficient and boresight error are identified as the objectives. Lateral deformation, material failure, and structural stability are included in mechanical analysis. Three-dimensional ray-tracing technique and physical optics based aperture integration method are employed to address interactions between the antenna and radome. Tsai–Wu and maximum stress criteria are used to predict material failure. Structural stability is analyzed using the linear perturbation of stiffness matrices. The applicability of the electromagnetic model is validated using examples of a hemispheric air and single-layered radome. A numerical experiment is conducted to investigate the utility and feasibility of the multidisciplinary design optimization model. Results show that the optimal section profile brings about considerable improvement in transmission coefficient and boresight error. Mechanical constrains are reasonably subjected to the preset limits. Hence, the proposed multidisciplinary design optimization model is an effective and feasible alternative in the environment of radome design.
Variable height modification of TA worm drive
Authors: Huai Chongfei , Zhao Yaping
Published: February 2018

The related research shows that a constant contact line, which is negative for the normal operation of the worm gearing, exists on the middle of the unmodified and the constant height modified TA worm wheel surface. To overcome this drawback, a variable height modification method is proposed for the TA worm drive. In line with this modification method, the height modification parameter is variable during the whole processing cycle. Accordingly, the obtained gearing can be named as the variable height modified TA worm drive. The mathematical model for the meshing analysis of this novel worm drive is established according to its generation mechanism and the mesh theory of gearing. The reason why the variable height modification can remove the constant contact line on the worm gear tooth surface is analyzed in detail. In addition, the classification criterion of the transmission type is also derived. The computing methods of the key points on the contact zone boundary and the instantaneous meshing line are elaborated. On the basis of the above theoretical analysis, the meshing characteristics of this novel worm gearing are well investigated. The results manifest that the above theoretical analysis is valid, and the obtained gearing has favorable meshing properties. Furthermore, it is pointed out that the linear variable height modification with larger quantity can be recommended as the ideal strategy in practice.
A new road tracking method based on heading direction detection
Authors: Guo Xiaoxin , Li Qun , Sun Chao
Published: February 2018

Current research on road tracking is mostly based on the visual perception of road boundaries. In this paper, we propose a novel and general road tracker based on optical flow computation, which can be applied to most of road environments including the case of a lack of lane markings or road boundaries. When the heading direction of the vehicle and the road direction are identical, the focus of expansion (FOE) coincides with the road vanishing point (RVP). This is an important foundation for the subsequent heading direction departure decision. By comparing the relative positions of the estimated FOE and RVP, we can learn the traveling state of the vehicle. The experimental results show that the proposed tracker is a simple and efficient road tracking method.
Adapting and pilot testing the Healthy Love HIV and sexually transmitted infection prevention intervention with African, Caribbean and Black women in community-based settings in Toronto, Canada
Authors: Logie Carmen H , Okumu Moses , Ryan Shannon , Yehdego Dahlak M , Lee-Foon Nakia
Published: February 2018

We adapted the Healthy Love Workshop (HLW), an HIV prevention workshop for African American women in the United States, for African, Caribbean and Black (ACB) women in Toronto, Canada. We conducted a pilot study with ACB women ( n = 80) in ten community-based settings with pre-test (T1), post-test (T2) and three-month follow-up (T3) surveys. Mixed-effect regression results indicated significant increases in condom use self-efficacy and sexually transmitted infection (STI) knowledge scores from T1 to T3. Qualitative feedback revealed increased STI knowledge, confidence using condoms and suggestions for future HLWs. Findings highlight the promise of the adapted HLW for HIV/STI prevention with ACB women in Canada.
Is Source Information Automatically Available in Working Memory?
Authors: Chen Hui , Carlson Richard A. , Wyble Brad
Published: February 2018

We often remember information without its source (e.g., word or picture format). This phenomenon has been studied extensively in long-term memory but rarely in the context of short-term working memory (WM), which leaves open the question of whether source amnesia can result from a lack of memory encoding rather than forgetting. This study provided a series of striking and novel demonstrations showing participants’ inability to report the source of a color representation immediately after that color was used in a task and stored in memory. These counterintuitive findings occurred when participants repeatedly judged the congruency between two color representations from one single object (i.e., color and identity of a color word) or two distinct objects (i.e., color of a square and identity of a color word) and then were unexpectedly asked to report the source of one color representation. These discoveries suggest that source information is often not stored in WM.
An East–West comparison of healthcare evaluations in Europe: Do institutions matter?
Authors: Popic Tamara , Schneider Simone M.
Published: February 2018

Differences in welfare attitudes of Eastern and Western Europeans have often been explained in terms of legacies of communism. In this article, we explore evaluations of healthcare systems across European countries and argue that East–West differences in these evaluations are explained by differences in the current institutional design of healthcare systems in the two regions. The empirical analysis is based on the fourth round of the European Social Survey, applying multilevel and multilevel mediation analysis. Our results support the institutional explanation. Regional differences in healthcare evaluations are explained by institutional characteristics of the healthcare system, that is, lower financial resources, higher out-of-pocket payments, and lower supply of primary healthcare services in Eastern compared to Western European countries. We conclude that specific aspects of the current institutional design of healthcare systems are crucial for understanding East–West differences in healthcare evaluations and encourage research to further explore the relevance of institutions for differences in welfare state attitudes across socio-political contexts.
Paraquat-induced inflammatory response of microglia through HSP60/TLR4 signaling
Authors: Sun Y , Zheng J , Xu Y , Zhang X
Published: February 2018

Previous studies showed that paraquat (PQ) caused the apoptosis of dopaminergic neurons by inducing the generation of oxygen radical. The purpose of this study is to explore PQ-induced microglial inflammatory response and its underlying molecular mechanisms. The murine microglia BV2 cell line was used. After stimulation with PQ and lipopolysaccharides (positive control), the concentrations of tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), and interleukin 6 (IL-6) in the culture supernatant and mRNA expression of TNF-α and IL-1β were determined by ELISA and quantitative real-time Polymerase Chain Reaction (PCR), respectively. The protein expression of heat shock protein 60 (HSP60) and toll-like receptor 4 (TLR4), along with the mRNA expression of transcription factors of nuclear factor κB-p65 (NF-κB-p65) and activated protein 1 (AP1, c-fos, and c-jun dimer) were evaluated with western blot and quantitative real-time PCR, respectively. The results showed that PQ activated microglia, which was characterized by increasing the generation and upregulated mRNA expression of pro-inflammatory cytokines, TNF-α, IL-1β, and IL-6. In addition, PQ significantly enhanced the expressions of HSP60 and TLR4 proteins in BV2 cells, as well as NF-κB-p65, c-fos, and c-jun mRNA. These findings suggest that PQ can activate microglia and enhance the expression and secretion of pro-inflammatory cytokines in a HSP60/TLR4 signaling, leading to the inflammatory response.
Protective effect of an L-type calcium channel blocker, amlodipine, on paracetamol-induced hepatotoxicity in rats
Authors: Kaya H , Polat B , Albayrak A , Mercantepe T , Buyuk B
Published: February 2018

Paracetamol (P), one of the most popular and commonly used analgesic and antipyretic agents, causes hepatotoxicity in overdoses. Amlodipine (AML), an L-type calcium channel blocker, has been shown to have anti-inflammatory activity by reversing the effect of calcium in the inflammation pathogenesis. In this study, the hepatoprotective activity of AML on P-induced hepatotoxicity was evaluated. Thirty male albino Wistar rats were divided into five groups: (1) control, (2) 2 g/kg of P, (3) 2 g/kg of P + 5 mg/kg of AML, (4) 2 g/kg of P + 10 mg/kg of AML, and (5) 10 mg/kg of AML. Some liver enzymes, oxidative parameters, cytokine mRNA expressions, histopathology, and immunohistochemical studies were performed in liver and blood samples. The serum levels of alanine aminotransferase and aspartate aminotransferase and the mRNA expression of tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta in the liver tissues were significantly increased in the group treated with P. The superoxide dismutase and glutathione parameters decreased and malondialdehyde levels increased in the livers of the rats treated with P. All these parameters were increased with both doses of the AML similar to the control group. A histopathological examination of the liver showed that AML administration ameliorated the P-induced inflammatory liver damage. In immunohistochemical staining, the expression of TNF-α in the cytoplasm of the hepatocytes was increased in the P group but not in other treatment groups when compared to the control. In conclusion, AML treatment showed significant protective effects against P-induced hepatotoxicity by increasing the activity of antioxidants and reducing inflammatory cytokines.
Founder as Steward or Agent? A Study of Founder Ownership and Firm Value
Authors: Dawson Alexandra , Paeglis Imants , Basu Nilanjan
Published: February 2018

This study addresses the relationship between founder ownership and firm value in young and entrepreneurial businesses. We argue that a stewardship effect prevails when founders have low or high levels of ownership while an agency effect prevails at intermediate levels. Using a dataset of 1,269 firms with 11,645 firm-year observations, we find support for our hypothesis that there is a convex relationship between founder ownership and firm value. The agency effect at intermediate founder ownership is consistent with evidence indicating that these firms display lower leverage, greater unrelated diversification, and higher disproportionate board representation.
Social Impact Measurement: Current Approaches and Future Directions for Social Entrepreneurship Research
Authors: Rawhouser Hans , Cummings Michael , Newbert Scott L.
Published: February 2018

Despite the importance of social impact to social entrepreneurship research, standards for measuring an organization’s social impact are underdeveloped on both theoretical and empirical grounds. We identify a sample of 71 relevant papers from leading (FT50) business journals that examine, conceptually or empirically, the measurement of social impact. We first describe the breadth of definitions, data sources, and operationalizations of social impact. Based on this analysis, we generate a typology of four approaches to conceptualizing social impact, which we use to organize insights and recommendations regarding improved measurement of the social impact of entrepreneurial ventures.
Don’t Pitch Like a Girl!: How Gender Stereotypes Influence Investor Decisions
Authors: Balachandra Lakshmi , Briggs Tony , Eddleston Kim , Brush Candida
Published: February 2018

We consider the role that gender-stereotyped behaviors play in investors’ evaluations of men- and women-owned ventures. Contrary to research suggesting that investors exhibit bias against women, we find that being a woman entrepreneur does not diminish interest by investors. Rather, our findings reveal that investors are biased against the display of feminine-stereotyped behaviors by entrepreneurs, men and women alike. Our study finds that investor decisions are driven in part by observations of gender-stereotyped behaviors and the implicit associations with the entrepreneur’s business competency, rather than the entrepreneur’s sex.
Who Goes Freelance? The Determinants of Self-Employment for Artists
Authors: Woronkowicz Joanna , Noonan Douglas S.
Published: February 2018

This study examines the self-employment behavior of artists. Using data from the Current Population Survey between 2003 and 2015, we estimate a series of logit models to predict transitions from paid employment to self-employment in the arts. The results show that artists disproportionately freelance and frequently switch in and out of self-employment compared to all other professional workers. We also find that artists exhibit unique entrepreneurial profiles, particularly in terms of their demographic and employment characteristics. In particular, artist workers are considerably more likely to attain self-employment status when living in a city with a high saturation of artist occupations.
The Role of Governmental Venture Capital in the Venture Capital Ecosystem: An Organizational Ecology Perspective
Authors: Bertoni Fabio , Colombo Massimo G. , Quas Anita
Published: February 2018

We use the theory of organizational ecology to study how governmental venture capital (GVC) affects the investment behavior of private venture capital (PVC). Because of its objectives and dominant competencies, GVC is a unique organizational species that occupies a different niche than PVC. GVC is conceived to establish mutualistic relations with PVC. Accordingly, the greater the presence of GVC in a venture capital (VC) ecosystem, the more PVC investors should be attracted toward GVC’s niche. We consider several relevant niche dimensions at the company (age and size), industry (biotechnology), and regional (competitiveness) levels. Our analysis of 1,239 PVC investments in Europe confirms most of our predictions.
Relocation to Get Venture Capital: A Resource Dependence Perspective
Authors: De Prijcker Sofie , Manigart Sophie , Collewaert Veroniek , Vanacker Tom
Published: February 2018

Using a resource dependence perspective, we theorize and show that non-venture-capital-backed ventures founded in U.S. states with a lower availability of venture capital (VC) are more likely to relocate to California (CA) or Massachusetts (MA)—the two VC-richest states—compared to ventures founded in states with a greater availability of VC. Moreover, controlling for self-selection, ventures that relocate to CA or MA subsequently have a greater probability of attracting initial VC compared to ventures that stay in their home state. We discuss the implications for theory, future research, and practice.
Beyond the Firm: Business Families as Entrepreneurs
Authors: Le Breton-Miller Isabelle , Miller Danny
Published: February 2018

Business families, we argue, will be core drivers of economic growth over the next decades, particularly in developing markets. We discuss the resources that provide them with advantages in multibusiness and multimarket entrepreneurial initiatives, the family-based challenges and opportunities that drive or pull them toward such initiatives, the environments in which significant business families thrive, and the resulting socioeconomic consequences.
Opening the Black Box of Effectuation Processes: Characteristics and Dominant Types
Authors: Jiang Yi , Rüling Charles-Clemens
Published: February 2018

In this paper, we open the black box of effectuation as a process by identifying effectuation process characteristics and patterns and thereby unveiling the heterogeneity of effectuation processes. Based on a multiple case research approach, sequential qualitative analysis is used to contrast similarities and differences in effectuation processes among six high-technology ventures. By theorizing the relationship between effectuation principles and process characteristics, we increase the conceptual clarity of effectuation theory and provide insights into how effectuation may be operationalized for scholars in future research.
Analysis of delamination of unimorph cantilever piezoelectric energy harvesters
Authors: Zeng Shan , Zhang Chunwei , Wang Kaifa , Wang Baolin , Sun Li
Published: February 2018

Unimorph piezoelectric energy harvesters are typically a unimorph cantilever beam located on a vibrating host structure. Delamination is one of the major failure modes of such unimorph cantilevers and therefore is studied in this article. The delaminated cantilever unimorph is modeled with one through-width crack using four Euler beams connected at delamination edges. The governing equations, the corresponding boundary conditions, and the kinematic continuity conditions are derived based on the Hamiltonian principle. The solutions of the voltage and power output for the present model are derived. The influence of the position and the length of the delamination, frequency of input base excitation, and load resistance on the voltage and power output are discussed in detail. The results show that delamination in the unimorph of the energy harvester will impressively decrease the voltage and power outputs. Influences of the delamination located at the free end of the cantilever are more obvious. For a given active length of the delaminated cantilever energy harvester, it is useful to increase the overall length of the cantilever to obtain a higher voltage and power outputs.
Instructional Strategies for the Inclusive Music Classroom
Authors: Darrow Alice-Ann , Adamek Mary
Published: February 2018

While inclusive education is an admirable ideal, it is often difficult to implement. Successful educators have found that employing certain instructional strategies can help meet the needs of students with varying abilities. Inclusive teaching strategies refer to any number of teaching approaches that address the needs of students with a variety of backgrounds, learning styles, and abilities. This article cites various strategies found to be effective in the inclusive classroom. These strategies contribute to the overall learning environment.
Free Staff Notation Options
Authors: Dunbar Laura
Published: February 2018

As technological access continues to expand, teachers are expected to use the technology available to enhance learning in all classrooms. This article discusses three technological options for staff notation that are free, easy to use, and produce a quality end product.
“It Was Not Me That Was Sick, It Was the Building”: Rhetorical Identity Management Strategies in the Context of Observed or Suspected Indoor Air Problems in Workplaces
Authors: Finell Eerika , Seppälä Tuija , Suoninen Eero
Published: February 2018

Suffering from a contested illness poses a serious threat to one’s identity. We analyzed the rhetorical identity management strategies respondents used when depicting their health problems and lives in the context of observed or suspected indoor air (IA) problems in the workplace. The data consisted of essays collected by the Finnish Literature Society. We used discourse-oriented methods to interpret a variety of language uses in the construction of identity strategies. Six strategies were identified: respondents described themselves as normal and good citizens with strong characters, and as IA sufferers who received acknowledge from others, offered positive meanings to their in-group, and demanded recognition. These identity strategies located on two continua: (a) individual- and collective-level strategies and (b) dissolved and emphasized (sub)category boundaries. The practical conclusion is that professionals should be aware of these complex coping strategies when aiming to interact effectively with people suffering from contested illnesses.
The Secret Drama at the Patient’s Bedside—Refusal of Treatment Because of the Practitioner’s Ethnic Identity: The Medical Staff ’s Point of View
Authors: Popper-Giveon Ariela , Keshet Yael
Published: February 2018

Patients’ refusal of treatment based on the practitioner’s ethnic identity reveals a clash of values: neutrality in medicine versus patient-centered care. Taking the Israeli–Palestinian conflict into account, this article aims at examining Israeli health care professionals’ points of view concerning patients’ refusal of treatment because of a practitioner’s ethnic identity. Fifty in-depth interviews were conducted with 10 managers and 40 health care professionals, Jewish and Arab, employed at 11 public hospitals. Most refusal incidents recorded are unidirectional: Jewish patients refusing to be treated by Arab practitioners. Refusals are usually directed toward nurses and junior medical staff members, especially if recognizable as religious Muslims. Refusals are often initiated by the patients’ relatives and occur more frequently during periods of escalation in the conflict. The structural competency approach can be applied to increase awareness of the role of social determinants in shaping patients’ ethnic-based treatment refusals and to improve the handling of such incidents.
Comparison of the Nephrotoxicity of Vancomycin in Combination With Cefepime, Meropenem, or Piperacillin/Tazobactam: A Prospective, Multicenter Study
Authors: Mullins Brandon P. , Kramer C. Joseph , Bartel Billie J. , Catlin Jennifer S. , Gilder Richard E.
Published: February 2018

Background: Patients often receive broad-spectrum antibiotics for nosocomial infections commonly with activity against Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Previous retrospective and/or single-center studies have suggested that the combination of vancomycin and piperacillin/tazobactam might be associated with an increased risk of acute kidney injury. Objectives: To compare the incidence of nephrotoxicity in patients receiving intravenous vancomycin in combination with cefepime, meropenem, or piperacillin/tazobactam. Methods: This was a prospective, multicenter observational study of patients receiving vancomycin in combination with piperacillin/tazobactam versus cefepime or meropenem. Adult patients 18 years of age or older who were hospitalized and received 72 or more hours of intravenous vancomycin and 72 hours or more of cefepime, meropenem, or piperacillin/tazobactam were eligible. Patient and medication characteristics were examined for the 242 patients included. Results: The incidence of acute kidney injury for patients treated with vancomycin and piperacillin/tazobactam was significantly higher than for those treated with vancomycin and cefepime or meropenem, 29.8% versus 8.8%, respectively, P < 0.001. Binary logistic regression demonstrated that patients receiving vancomycin and piperacillin/tazobactam were 6.7 times more likely to develop acute kidney injury compared with the other cohort. Conclusions: The combination of vancomycin with piperacillin/tazobactam significantly increases the risk of acute kidney injury compared with other broad-spectrum antibiotic combinations. Clinicians should be vigilant when employing this regimen.
Dolutegravir Dual Therapy as Maintenance Treatment in HIV-Infected Patients: A Review
Authors: Boswell Rosaleen , Foisy Michelle M. , Hughes Christine A.
Published: February 2018

Objective: To review available evidence for dolutegravir-based dual therapy as maintenance treatment in HIV-1 infected patients. Data Sources: A literature search was conducted using PubMed, MEDLINE, and Google Scholar to the end of January 2018. Conference abstracts and article bibliographies were also reviewed. Study Selection and Data Extraction: All English-language, randomized, and observational studies were included. Data Synthesis: In all, 12 studies were identified: 10 were observational, and 2 were randomized trials. Rilpivirine or lamivudine were the most common second agent used in combination with dolutegravir. Virological suppression seen in observational studies appear promising; however, the most compelling evidence to date is the 48-week results from 2 large open-label randomized trials (SWORD 1 and 2). These studies found that dual therapy with rilpivirine and dolutegravir was noninferior to 3- or 4-drug combination antiretroviral therapy (cART). The long-term efficacy, safety, and tolerability of dual therapy, as compared with usual cART, are less clear and require further data. Conclusions: Regimen switching in virally suppressed HIV-1–infected patients may be considered to reduce pill burden or dosing frequency, decrease short- or long-term toxicity, prevent or manage drug-drug interactions, and/or decrease cost. Based on available evidence, a switch to dual therapy with dolutegravir and rilpivirine appears viable for virologically suppressed patients without prior resistance mutations to these agents. Randomized studies of other dual-therapy regimens that include dolutegravir and longer-term follow-up as well as cost-effectiveness analyses are needed to provide confirmation that this strategy offers advantages to traditional cART regimens.
Pyridoxine Add-On Treatment for the Control of Behavioral Adverse Effects Induced by Levetiracetam in Children: A Case-Control Prospective Study
Authors: Marino Silvia , Vitaliti Giovanna , Marino Simona Domenica , Pavone Piero , Provvidenti Simona , Romano Catia , Falsaperla Raffaele
Published: February 2018

Background: Few studies on adult and pediatric patients have shown pyridoxine efficacy as additional therapy for those receiving levetiracetam (LEV) to prevent and mitigate behavioral adverse effects (BAEs). Objective: The aim of our study was to analyze the safety and efficacy of pyridoxine supplementation in the prevention of LEV adverse effects, including suicidal ideation. Methods: This randomized, case-control trial included patients receiving LEV as monotherapy treatment. Patients were subdivided into 2 groups, according to whether they were treated with LEV only (group 1) or LEV with supplemental pyridoxine (group 2). Results: In both cohorts, the most frequent BAEs were irritability/aggression followed by depression and confusion. Those patients (92%) who initiated pyridoxine after 1 month of LEV treatment did not need to change or suspend LEV ( P < 0.001), and BAE improved after 9.06 ± 3.05 days of pyridoxine supplementation. None of the patients complained of symptoms of pyridoxine toxicity, and no new adverse effects of LEV off-label were reported. Conclusions: In our study, we found pyridoxine to be safe and effective in controlling LEV-induced BAEs in children.
Reviewing for Beyond Behavior: An Editor’s Guide for Submitting a Comprehensive and Meaningful Review
Authors: Mooney Paul , Ryan Joseph B.
Published: February 2018

Reviewing manuscripts is an integral part of the publication process. Unfortunately, few scholars receive training in this skill. This article provides an overview of what it takes to conduct a quality review of a manuscript submission for a practitioner journal. The editors describe the manuscript types published by Beyond Behavior and a four-step approach for conducting a quality review that is informed by a review of literature and the editors’ professional experience.
Thrombin Generation Biomarkers Decline With Parenteral Anticoagulation—An Overlooked Means of Anticoagulation Monitoring?
Authors: McFarland Craig P. , Lind Stuart E.
Published: February 2018

Anticoagulation therapy is administered to patients to prevent or stop thrombin generation in vivo. Although plasma tests of in vivo thrombin generation have been available for more than 2 decades, they are not routinely used in clinical trials or practice to monitor anticoagulation therapy. We observed a fall in one such marker, the D-dimer antigen, in patients receiving anticoagulation therapy. We therefore conducted a systematic review of the medical literature to document the change in serum biomarkers of thrombin generation following the initiation of anticoagulation therapy. Using a defined search strategy, we screened PubMed and Embase citations and identified full-length articles published in English. Eighteen articles containing serial changes in 1 of 3 markers of thrombin generation (D-dimer antigen, thrombin–antithrombin complexes, and prothrombin fragment 1+2 antigen levels) in the 14 days following the initiation of anticoagulation were identified. Even though the assays used varied considerably, each of the 3 markers of thrombin generation declined in the initial period of anticoagulation therapy, with changes evident as early as 1 day after beginning therapy. These observations provide a rationale for further exploration of these markers as measures of the adequacy of anticoagulation using classic as well as novel anticoagulants. Particular patient groups that would benefit from additional means of monitoring anticoagulation therapy are discussed.
An Evaluation of Hemostatic Abnormalities in Patients With Hemophilia According to the Activated Partial Thromboplastin Time Waveform
Authors: Katayama Haruna , Matsumoto Takeshi , Wada Hideo , Fujimoto Naoki , Toyoda Junki , Abe Yasunori , Ohishi Kohshi , Yamashita Yoshiki , Ikejiri Makoto , Habe Koji , Katayama Naoyuki
Published: February 2018

The usefulness of the waveform of activated partial thromboplastin time (APTT) in various diseases has been evaluated in recent years. The APTT waveform was examined in patients with hemophilia and patients positive for lupus anticoagulant (LA). The correlation with the FVIII activity was highest for the height of acceleration peak. The peak time of acceleration, velocity, and ½ fibrin formation, and the width of acceleration and velocity were significantly long and the height of acceleration was significantly low in patients with hemophilia. The height of velocity was significantly low in patients with hemophilia with inhibitor. There were no significant differences in the APTT waveform between patients with hemophilia and patients with LA, but the peak of acceleration and ½ fibrin formation were significantly longer and the height of acceleration and velocity were significantly lower in patients with hemophilia with inhibitor than in the patients with LA. Wave changes in the APTT were observed in all 22 patients positive for LA, while a biphasic waveform was observed in patients with hemophilia with FVIII activity <10.0%. The APTT waveform is useful for the analysis of hemostatic abnormalities in patients with hemophilia.
Methylenetetrahydrofolate Reductase Gene Polymorphism (C677T) as a Risk Factor for Arterial Thrombosis in Georgian Patients
Authors: Garakanidze Sopio , Costa Elísio , Bronze-Rocha Elsa , Santos-Silva Alice , Nikolaishvili Giorgi , Nakashidze Irina , Kakauridze Nona , Glonti Salome , Khukhunaishvili Rusudan , Koridze Marina , Ahmad Sarfraz
Published: February 2018

Methylenetetrahydrofolate reductase ( MTHFR) gene polymorphism (C677T)] is a well-recognized genetic risk factor for venous thrombosis; however, its association with arterial thrombosis is still under debate. Herein, we evaluated the prevalence of MTHFR C677T polymorphism in Georgian patients in comparison with healthy individuals and its association with arterial thrombosis. We enrolled 214 participants: 101 with arterial thrombosis (71.3% males; mean age: 66.3 ± 12.1 years) and 113 controls (67.3% males; mean age: 56.6 ± 11.3 years). Genomic DNA was extracted from dry blood spot on Whatman filter paper. Polymerase chain reaction was performed to determine MTHFR C677T polymorphism. Frequency of C677T allele polymorphism in controls was 21.2%, which corresponded to heterozygous and homozygous stage frequencies of 35.4% and 3.5%, respectively. In patient group, an allelic frequency of 33.2% was found, which corresponded to the presence of 48.5% of heterozygous and 8.9% of homozygous individuals. Comparing the frequency of mutated alleles between the 2 groups, a significantly high frequency of mutated alleles was found in patient group ( P < .05). In conclusion, high frequency of MTHFR C677T polymorphism found in arterial thrombosis patient group suggests that this polymorphism might increase the risk of arterial thrombosis in Georgian patients.
County Government Fleet Acquisition Practices: Service Demand or Budget Limitations
Authors: Modlin Steve
Published: February 2018

Service provision through automobile use prompts the need for periodic replacement. Questions arise concerning service need versus popular trends. Any change has some type of cost impact and budget implications. The finance officer is charged with finding the balance between need and affordability. Very limited information exists concerning budget actor influence on fleet acquisition. This study examines fleet acquisition practices of professionally administered county governments. Findings indicate that the sheriff and departments can acquire specific makes and models, but only in conjunction with finance officer need assessment and the presence of appropriate facilities and financing mechanisms.
Comparative Effectiveness and Harms of Intraoperative Transesophageal Echocardiography in Noncardiac Surgery: A Systematic Review
Authors: Fayad Ashraf , Shillcutt Sasha , Meineri Massimiliano , Ruddy Terrence D. , Ansari Mohammed Toseef
Published: February 2018

Intraoperative use of transesophageal echocardiography (TEE) has become commonplace in high-risk noncardiac surgeries but the balance of benefits and harms remains unclear. This systematic review investigated the comparative effectiveness and harms of intraoperative TEE in noncardiac surgery. We searched Ovid MEDLINE, PubMed, EMBASE, and the Cochrane Library from 1946 to March 2017. Two reviewers independently screened the literature for eligibility. Studies were assessed for the risk of selection bias, confounding, measurement bias, and reporting bias. Three comparative and 13 noncomparative studies were included. Intraoperative TEE was employed in a total of 1912 of 3837 patients. Studies had important design limitations. Data were not amenable to quantitative synthesis due to clinical and methodological diversity. Reported incidence of TEE complications ranged from 0% to 1.7% in patients undergoing various procedures (5 studies, 540 patients). No serious adverse events were observed for mixed surgeries (2 studies, 197 patients). Changes in surgical or medical management attributable to the use of TEE were noted in 17% to 81% of patients (7 studies, 558 patients). The only randomized trial of intraoperative TEE was grossly underpowered to detect meaningful differences in 30-day postoperative outcomes. There is lack of high-quality evidence of effectiveness and harms of intraoperative TEE in the management of non-cardiac surgeries. Evidence, however, indicates timely evaluation of cardiac function and structure, and hemodynamics. Future studies should be comparative evaluating confounder-adjusted impact on both intraoperative and 30-day postoperative clinical outcomes.
A Place for Immigrants in the Ghetto: The Rise and Fall of the NaunynRitze Youth Centre
Authors: Güney Serhat , Kabaş Bülent , Çömlekçi Fatih
Published: February 2018

In this work, we attempt to examine the role of strategies like arts sponsorship and culturalism in the solution of immigrant youth issues around a specific immigrant place. This is a case study that focuses on the NaunynRitze Youth Centre in Berlin-Kreuzberg, which was presented as a successful example by policy makers and the public in the 1990s when the footsteps of the crisis of multiculturalism had begun to be heard in Germany. Our research shows that the social engineering strategies shaped around a multikulti production base are not permanent or sustainable as long as these institutions are also given the responsibility of eliminating the cycle of crime and violence in addition to promote individual artistic development and subcultural entities. As long as political figures and the public opinion continue to generally see the immigrant youth as a danger to the secure and untarnished development of society, it does not appear possible for the multiculturalism and the immigrant youth work system to develop.
Is franchising an additional financing source for franchisors? A Blinder–Oaxaca decomposition analysis
Authors: Park Kwangmin , Jang SooCheong (Shawn)
Published: February 2018

Numerous studies have used agency theory (Jensen and Meckling, 1976) and capital scarcity theory (Oxenfeldt and Kelly, 1969) to explain franchising motivations. Although both theories may in part account for why firms choose to franchise, past studies have not seriously considered the potential relationship between franchising and capital structures. Using Blinder–Oaxaca decomposition analysis, this study examined the impact of franchising on short- and long-term debt leverage. The final sample included 191 restaurant firms from 1980 to 2015. Sixty-five firms were non-franchise firms, while 126 firms engaged in the franchising business. The results of the Blinder–Oaxaca decomposition analysis showed that franchising has a significant effect on decreasing long-term debts and confirmed that franchising plays an important role as an additional source of long-term capital. Consequently, the capital scarcity theory is supported as one aspect of long-term debt leverage. However, franchise restaurant firms have larger short-term debt than non-franchise firms, although it is merely marginally significant. This contradicts capital scarcity theory but is in accordance with some past studies (e.g. Norton, 1988; 1995). This implies that franchisors constantly need short-term capital to support franchisees.
Double-tube concrete columns with a high-strength internal steel tube: Concept and behaviour under axial compression
Authors: Teng Jin-Guang , Wang Zihao , Yu Tao , Zhao Yang , Li Li-Juan
Published: February 2018

This article presents a new form of fibre-reinforced polymer-concrete-steel hybrid columns and demonstrates some of its expected advantages using results from an experimental study. These columns consist of a concrete-filled fibre-reinforced polymer tube that is internally reinforced with a high-strength steel tube and are referred to as hybrid double-tube concrete columns. The three components in hybrid double-tube concrete columns (i.e. the external fibre-reinforced polymer tube, the concrete infill and the internal high-strength steel tube) are combined in an optimal manner to deliver excellent short- and long-term performance. The experimental study included axial compression tests on eight hybrid double-tube concrete columns with a glass fibre–reinforced polymer external tube covering different glass fibre–reinforced polymer tube thicknesses and diameters as well as different high-strength steel tube diameters. The experimental results show that in hybrid double-tube concrete columns, the concrete is well confined by both the fibre-reinforced polymer tube and the high-strength steel tube, and the buckling of the high-strength steel tube is suppressed so that its high material strength can be effectively utilized, leading to excellent column performance. Due to the high yield stress of high-strength steel, the hoop stress developed to confine the core concrete is much higher than can be derived from a normal-strength steel tube, giving the use of high-strength steel in double-tube concrete columns an additional advantage.
Three-dimensional numerical and linearly distributed multi-parameter fitted analytical modeling of hybrid beam–column with partially welded flush end-plate connection
Authors: Omer Joma HM , Kueh Ahmad BH , Shek Poi-Ngian
Published: February 2018

The flexural behavior of partially welded flush end-plate connections incorporating built-up hybrid beams and columns is analytically and numerically investigated. An experimentally obeying three-dimensional finite element model is first constructed. To circumvent the laborious effort of three-dimensional simulation and experimental work, a new experimentally and numerically complying equation approach is introduced for the construction of a continuous moment–rotation ( M–θ) description. For the proposed equation, two essential terms are required: the rotational stiffness, Sj,ini, obtained by employing the component method and the maximum moment, Mmax, produced using the proposed linearly distributed multi-parameter fitting technique. To demonstrate the applicability of the proposed equation, a variation in the geometric configuration of connections within the practical range is considered. Excellent agreement is noted when comparing all M–θ relationships produced by the proposed equation to those by the finite element method and experiments. In addition, the stress distribution and main deformation modes are numerically obtained, where the ranking of stress criticality is offered for all structural parts. The depth, width, flange, and web thicknesses, as well as the yield stress of the beam, have a major influence on Mmax, as predicted by the proposed equation. Also, bolts have been identified as the most critically stressed component.