bluuebunny/crossref_metadata_2025 huggingface dataset:
Resolving Lingering Problems or Continued Support for Pseudoscience? The ICER Value Assessment Update
Authors: Langley Paul C.
Published: January 2018

The Institute for Clinical and Economic Review (ICER) released its updated value assessment framework in mid-2017. This included refinements to its conceptual structure and modifications to methods of collecting and assessing evidence. Consequent to this release, a number of authors have commented on the updated value framework, addressing the question of whether the latest framework represents a major revision or merely attempts to resolve lingering problems. The purpose of this commentary is twofold: (i) to revisit what are considered to be fundamental flaws in the ICER value assessment framework and (ii) to question whether or not post-release critiques of the value framework address the fundamental weaknesses in the ICER approach: the absence of credible, evaluable and replicable claims for the benefits and harms of a therapy intervention. The commentary argues that while ICER sees the purpose of its value assessment framework as forming ‘the backbone of rigorous, transparent evidence reports’ in placing ‘scientific methods of evidence analysis at the heart of a clearer and more transparent process’ it falls far short of these ideals. Rather, in attempting to replicate in the US health care environment the evaluation framework mandated by the National Institute for Health and Care Excellence (NICE) in the UK, the ICER falls into the trap of generating value claims for product impact that fail to meet the standards of normal science.

 

Type: Commentary
Using Debates to Mimic Clinical Discussion in Experiential Education
Authors: Nisly Sarah A. , Kingdon Lisa K. , Janzen Kristin M. , Dy-Boarman Eliza A.
Published: January 2018

Critical thinking and application of knowledge to an ambiguous patient care scenario are often difficult skills to cultivate in learners. Use of traditional teaching techniques (e.g. topic discussions and journal clubs) helps to develop these competencies within learners. However, alternative teaching strategies may help develop critical thinking and direct application. Debates have been used in healthcare education for decades with positive results. This paper provides supporting evidence for use of debates in pharmacy education and is designed to serve as a general guide for preceptors interested in implementing debates into the experiential setting. Specifically, the objectives are to: 1) highlight the pedagogical outcomes as reported in the literature, 2) offer practical considerations to implement debates as a teaching tool in experiential education, and 3) encourage future research and scholarship in this area.

 

Type: Idea Paper
Untangling Partnership and Domination Morality
Authors: Loye David
Published: January 2018

Riane Eisler’s (1987) cultural transformation theory is an effective framework for understanding many of the constructs that shape society. This article uses Eisler’s theory to explain the formation of morality and the construction of conscience. It contrasts partnership morality and domination morality, and describes the factors that shape our tendency to embrace one or the other. The article helps us understand that we have a choice, and invites us to choose partnership morality.
Making the Choice Clear: Partnership and Domination Examples from Nursing Practice
Authors: Potter Teddie M , Koehn Katheren
Published: January 2018

Health care is in desperate need of transformation, which will require careful scrutiny of the current culture. Riane Eisler’s Cultural Transformation Theory (1987, 2007) and particularly its application in partnership-based health care (Eisler & Potter, 2014), offers nurses and other health care providers a framework to clarify choices regarding their organization’s culture. In this article, nursing leaders offer examples of common domination and partnership behaviors at play in health care today. The intent is to provide a clear choice and increase awareness of the stakes of failing to move towards partnership.
Creativity, Society, and Gender: Contextualizing and Redefining Creativity
Authors: Eisler Riane , Donnelly Gabrielle , Montuori Alfonso
Published: January 2018

Creativity is currently being redefined in more inclusive and accurate ways. This article examines old and new ways of viewing creativity, focusing especially on how creativity has been considered a male preserve and the need for a more inclusive definition that includes areas such as “everyday creativity.” It places definitions of creativity in their social and historical context, showing how a society’s orientation to a partnership model or a dominator model affects what and who is considered creative. It proposes an un-gendered definition of creativity; highlights the need for this broader definition to meet the enormous contemporary challenges we face; and distinguishes between innovativeness and creativity.
Seven Lessons in Partnership: How a Hospital and a Happiness Organization Teamed to Decrease Practitioner Burnout, Increase Practitioner Well-Being and Improve Patient Satisfaction
Authors: O'Brien Nancy , Saggau Linda
Published: January 2018

Nancy O’Brien and Linda Saggau, co-founders of Experience Happiness, LLC., and co-developers of The Happiness Practice™ (THP), share key discoveries derived from the partnership between Hennepin County Medical Center (HCMC) and Experience Happiness (EH) which focused on using THP as an intervention to increase Emergency Department and Urgent Care practitioner well-being and happiness in order to reduce the signs and symptoms of burnout and improve patient experience and satisfaction. This article includes a case study demonstrating the efficacy of the 6-month THP intervention, as well as an overview of THP and seven valuable partnership lessons to encourage and guide successful partnerships in healthcare and other systems.
Media Review: Nurses as Leaders in Healthcare Design: A Resource for Nurses and Interprofessional Partners
Authors: Ziel Susan E
Published: January 2018

Susan Ziel reviews Nurses as Leaders in Healthcare Design: A Resource for Nurses and Interprofessional Partners, by Jaynelle F. Stichler & Kathy Okland.
Media Review: Non-Obvious: How to Think Different, Curate Ideas and Predict the Future
Authors: Ziel Susan E
Published: January 2018

Susan Ziel reviews Non-Obvious: How to Think Different, Curate Ideas and Predict the Future, by Rohit Bhargava.
Core Support for the New Economy
Authors: Goodwin Neva
Published: January 2018

This paper proposes an income guarantee called Core Support (CS), defined as compensation for household activities such as childcare, food preparation, care of elderly or ill persons in the home, and maintenance of the home and of household vehicles and appliances. The immediate goals of the proposal are to highlight, through compensation, the reality that the productive activities carried on in households are of essential importance for the whole economy and society, and to enable the people who carry out these essential activities to do so without having to short-change the care work because of the need to earn money through the market. The CS concept builds on literature on Basic Income Guarantees (BIG) and on feminist economics, which tends to be skeptical of BIG proposals. By addressing intra-household allocations, CS shows how a basic income system can promote a more caring democracy and a more partnership-oriented socioeconomic system that rewards the essential work of care. Appendix A surveys seven ways by which such a program could be financed.
The Path Forward
Authors: Sund Sharon
Published: January 2018

Abstract

We in America all care about our democracy and want the best possible outcome for our nation. But how do we get there? What is your role and mine? Can we really make a difference? The American political system is facilitating the election of candidates whom citizens feel do not represent them. My personal experience living in Germany as the country was rebuilding after World War II, then living in Mississippi during school desegregation, and later in corporate America, and finally as a candidate for the U.S. Congress, showed me that good people can wait too long to act. This article is written to save people from regretting that they didn’t do something when they had a chance. I show ways to advance ideals to help create a world we are happy to leave to the next generation. This article will empower readers to take action.
Case Study: "Care" as a Political Winner
Authors: Quinlan Meredith Loomis
Published: January 2018

Through face-to-face conversations and open-ended questions designed to elicit stories and deeper interactions, the Michigan People’s Campaign (MPC) may have altered voting patterns more effectively than using traditional electoral engagement strategies. During the 2016 election, by campaigning on issues of family care, MPC helped elect a progressive state house candidate in a Downriver Detroit district that Republican presidential candidate Donald Trump carried by over 6,000 votes.
One World, One Standard for Burn Care: Nursing's Role in Global Health
Authors: Ramstad Sheryl A , Potter Teddie M
Published: January 2018

In 1978, a landmark United Nations conference in Alma-Ata declared the goal of health for all by the year 2000 (WHO, 1978). Yet, today significant disparities exist between the health care afforded individuals in resource-limited countries and those in the industrialized world. Nursing, as a global profession, can become a powerful force for change so that better health is universally achieved.

Problem/Background: This project started with a partnership between a burn center in the United States and a pediatric burn center (Burn Center) in Peru, a country in which it is estimated that 15,000 children endure burn injuries each year (Huby-Vidaurre, 2016). Most are under the age of five, and suffer scald burns from pots with hot liquids left to cool on the floors of their homes. Pressure garment therapy (PGT) is a major treatment to reduce scarring for pediatric burn survivors in the United States since the early 1970s, but is unavailable in Peru.

Strategy: The Doctor of Nursing Practice project leader worked with the Burn Center team to develop a plan to use PGT as an intervention to address disfiguring scarring among pediatric burn survivors, utilizing the twinning approach.

Methods: This quality improvement project involved interdisciplinary collaboration and international partnerships between resource-rich and resource-challenged nations. Obtaining supplies needed to promote PGT in Peru required cultivating relationships with many people in the United States, including translators and interpreters to assist in overcoming language barriers among the participants, manufacturers and distributors of pressure garments to donate fabrics, and people regularly traveling to Peru who transported the donated PGT materials. It also involved working closely with the Burn Center team on developing a culture conducive to conforming to an international standard of practice.

Results: Resources were successfully leveraged to build a sustainable PGT program for all pediatric burn survivors in Peru.

Conclusion: Forging partnerships between the U.S. and Peru utilizing the twinning approach led to implementation of PGT, allowing for a best practice standard of care in the treatment of pediatric burns.
Cover Art: Two Ships
Authors: Monroe Amy
Published: January 2018

Artist's Statement for the cover art of IJPS volume 4, issue 2: Two Ships, 2017. Watercolor and chalk on paper.
Building a Leadership Culture for Environmental Health in a Nurse-Led Clinic
Authors: Demorest Shanda L , Potter Teddie M , Anderson Jane , Funk Kylee , Napral Michelle , Wagner Austin
Published: January 2018

Climate change is the biggest global health threat of the 21st century (Costello et al., 2009). Temperature shifts caused by greenhouse gases have negative health impacts such as worsening of chronic diseases and increases in vector-borne diseases (American Public Health Association, 2016), which nurses are ethically responsible to address (American Nurses Association, 2015). At an interdisciplinary nurse-led clinic, staff were not prepared to assist patients in building resiliency related to the health impacts of climate change or to implement environmental sustainability in their workplace. Based on principles of partnership-based healthcare (Eisler & Potter, 2014), this project included Climate Conversations - sharing stories, values, and knowledge about climate change – (Minnesota Interfaith Power & Light, 2010) and evidence-based transformational leadership. The Nurses’ Environmental Awareness Tool (Schenk et al., 2015) was used to survey staff before and after they participated in behavioral interventions to incorporate environmental sustainability at their workplace. Compared to baseline, staffs’ knowledge of environmental sustainability increased significantly (pp
Once Upon a Toxic Sanctuary: Partnering to Restore and Reclaim a Dakota Sacred Site
Authors: Gould Roxanne , Rock James
Published: January 2018

In this article, we examine the role of partnerships as they relate to the destruction and reconstruction of Wakaŋ Tipi and Indian Mounds Park as a Dakota sacred feminine, origin, birth site through a theoretical lens of critical Indigenous pedagogy of place (Trinidad, 2016) and partnership studies (Eisler, 2005). We discuss the deep historical, social, psychological, and cultural relationship the Dakota have to this sacred site and the challenge of partnering with non-Dakota entities to restore Wakaŋ Tipi/Indian Mounds Park from a toxic waste dump to a spiritual sanctuary.
Partnership Education in the Forest
Authors: Bruce Heidi G
Published: January 2018

Heidi Bruce is a founding board member of the Orcas Island Forest School, an outdoor early childhood education program located on Orcas Island, Washington State. In this article, she describes the interconnectedness of nature-based education and Partnership education, as outlined in Riane Eisler‘s book, Tomorrow’s Children: A Blueprint for Partnership Education in the 21st Century (2000). She also shares her experience in advocating for the first legislation in the country that creates a pilot program for licensing nature-based early childhood education programs.
The 2016 National Matriculation and General Certificate of Secondary Education English Test: a Challenge to the Goal of Foreign Languages Education in Vietnamese Schools
Authors: Van Hoang Van
Published: January 2018

Every year in Vietnam there are nearly a million Vietnamese 12 graders taking as compulsory the national general certificate of secondary education English testto be eligible to receive  general certificate of secondary school education. Since 2015, the English test has been used for students to achieve two goals: (1) to receive general certificate of secondary school education and (2) to gain entrance to Vietnamese universities and colleges. The test is referred to as “the national matriculation and general certificate of secondary education English test”. It has a clear format, clearly specified contents, a clear and detailed scoring scheme, and is made public in the Vietnamese mass media. However, looked at from both theoretical and practical levels, there are still problems with the test that need to be examined and discussed. This is the purpose of this paper. As a way of start, the paper will provide a description of the test. Then, it will examine some of its key qualities, and present its washback and impact on the Vietnamese general school foreign language education. In the conclusion, after summarizing the strengths and weaknesses of the test, the paper will conclude that due to its weaknesses in both content and format,and its long-term negative washback, the 2016 national matriculation and general certificate of secondary education English test presents a big challenge to the communication goal of the Vietnamese general foreign language education. The paper recommends that for the quality of foreign language teaching and learning in Vietnamese schools to be improved andfor the foreign language education in Vietnamese schools to meet the requirements of globalization in Vietnam, a radical renovation in both test format and test administration should be exercised.
Anatomical features of three perennial swampy plants of Poaceae, grown on the water stream banks in Nile Delta, Egypt
Authors: Abd El-Gawad Ahmed M. , El-Amier Yasser A
Published: January 2018

The anatomical structure of plants is largely varied according to genetics as well as the environmental conditions. The present study aims to describe the anatomical features of three species of family Poaceae growing naturally in canal bank habitat namely: Arundo donax, Pennisetum setaceum and Saccharum spontaneum. These plants are referred as medicinal, grazing or fiber producing plants. Samples were obtained from the canal banks in Nile delta of Egypt. The samples were fixed in formalin-aceto-alcohol and cross sections were prepared, examined using full automatic Olympus microscope and photographed at different power. In the present study, regarding leaves, the general appearance of the leaves sections showed either flat or V-shaped blade. The leaf blades of the three plants show a typical monocot organization. The mesophyll cells showed no distinct differentiation into palisade or spongy tissue. In P. setaceum and S. spontaneum, the leaves have distinct bulliform cells which enable the leaf to fold or roll. The vascular bundles of leaves are collateral, closed, numerous and diffuse in distribution. The vascular bundles are larger in size and surrounded by a sheath of fibers. However, the cross-section of the stem is more or less circular. Ground tissue is parenchymatous and not differentiated into cortex and pith in P. setaceum and S. spontaneum, while A. donax has large hollow pith. The bundles are collateral and are usually surrounded by a sclerenchymatous sheath.
POR UMA TANATOLOGIA RELIGIOSA A PARTIR DAS MÚLTIPLAS PERSPECTIVAS DA MORTE E DO MORRER
Authors: Henriques Ana Candida Vieira , Gnerre Maria Lúcia Abaurre
Published: January 2018

Este artigo tem o propósito de destacar as particularidades de três termos usualmente empregados para designar respectivamente, o morrer, a morte e o fim. A tanatologia, a escatologia e a teleologia aristotélica, chamada cósmica, são campos de estudo diferenciados, onde a morte ou o fim, enquanto propósito, é o centro de todas as especulações. Devemos lembrar que neste contexto, quando nos referirmos à morte, estaremos limitando-a apenas ao universo fenomênico religioso, visto sua grande amplitude no universo dos fenômenos. Desta forma, a partir dos esclarecimentos sobre a tanatologia, achamos pertinente e oportuno neste estudo, a introdução de um novo termo que criamos com o intuito de abarcar e expressar todos os aspectos espirituais, religiosos e transcendentais que repousam no processo de morte, a Tanatologia Religiosa. Com base em nosso objetivo central, o percurso metodológico adotado será a análise explicativa, pois que apenas temos o intuíto de esclarecer tais campos de estudo quanto aos seus fundamentos, objetivos e abrangência. Palavras-chave: Morte; Morrer; Tanatologia; Escatologia; Teleologia
ŚRADDHĀ: A FÉ COMO O ÍMPETO A MOVER O PROCESSO RELIGIOSO DENTRO DO HINDUÍSMO DEVOCIONAL
Authors: Valera Lúcio , Lara Marco Antonio
Published: January 2018

O presente trabalho vem problematizar o conceito de śraddhā, entendido como a fé dentro do Vaiṣṇavismo Gauḍīya de Caitanya Mahāprabhu (1486-1534), baseado em textos como a Bhagavad-gītā e o Bhāgavata Purāṇa, os quais servem de norte para toda Filosofia e Teologia nos Vedas dessa tradição de devoção monoteísta (bhakti), uma das mais proeminentes vertentes religiosas do hinduísmo. Será a fé um recurso desenvolvido por ignorantes em sua infância racional, ou seria um elemento universal sob certa perspectiva comum a todos? Tal elemento, por distinguir e caracterizar a existência entre teístas e ateístas seria concedido a uns e negado para outros de acordo com os caprichos de Deus? Analisaremos o desenvolvimento sistemático e gradual de śraddhā a prema (amor puro) como demonstrado em textos como o Bhāgavata Purāṇa e o Bhakti-rasāmṛta-sindhu de Śrīla Rūpa Gosvāmī com as considerações finais ao problema aberto sendo verificadas no Caitanya-caritāmṛta e por Viśvanātha Cakravartī Ṭhākura de como a divindade se mantém imparcial mas essa segue a vontade de seu devoto.
RELIGIÃO E RESISTÊNCIAS: OS AFRO-BRASILEIROS E A PERSEGUIÇÃO
Authors: Campos Zuleica Dantas Pereira
Published: January 2018

Nos últimos trinta anos, o movimento político - que valoriza a negritude e seus símbolos culturais - tomou força desenvolvendo diversas formas de intervenção e de atuação junto ao espaço público. Entre esses marcadores de singularidades, as religiões afro-brasileiras desempenham um papel importante. No entanto, apesar de a relação entre religiões afro-brasileiras e identidade negra não ser necessariamente obrigatória, essa vinculação vem sendo utilizada pelo Estado através das políticas de promoção da igualdade racial, favorecendo a inserção dessas religiões na cena pública. No entanto, também sabemos que as práticas das religiões afro-brasileiras são historicamente alvo de perseguições. Adeptos das religiões afro-brasileiras têm denunciado sistematicamente ao Ministério Público as violações de seus direitos, exigindo o cumprimento da Constituição Brasileira no que diz respeito à liberdade de crença e credo. Nesse sentido, pretendemos discutir, no âmbito do mercado de consumo da fé, como os devotos afro-brasileiros agem no enfrentamento aos ataques sistemáticos de neopentecostais que agenciam seus discursos e práticas de controle e discriminação. No combate em busca de conquistas de mais consumidores/fiéis, essas religiões lançam uma gama variada de estratégias, desde ocupação dos meios de comunicação de massa, do proselitismo ambulante até a demonização, apedrejamento, destruição de territórios religiosos e outras formas de violência e negação da diversidade religiosa. Por esse caminho, acreditamos poder ampliar a compreensão da forma de atuação política desses segmentos da sociedade, sobretudo a maneira como podemos garantir o direito e o respeito à existência da diferença, da pluralidade, das alteridades.
Geodésicas Poster Nahuatl Hñähñu
Authors: Almazán Vega Gabriel , Ramos Iván Lina
Published: January 2018

La matemática es una parte fundamental en la formación académica. Para significarla y potenciarla en México debe dialogar con su diversidad cultural. Gracias a ello tanto el mundo académico como las culturas originarias se ven reconocidas y enriquecidas. Esta es una primera intervención de algunos miembros del sector académico-mestizo en espera de respuestas (reacciones, intervenciones, ...) de las voces de los más cercanos que nosotros a las culturas originarias convocadas. Tiene como objetivo específico crear un Manual Constructivo de Domos Geodésicos trilingüe: español, hñähñu y náhuatl.
Alimentos funcionales: Impacto en la salud
Authors: Avila de la Cruz Fabiola Maricela , Gómez Aldapa Carlos Alberto , Castro Rosas Javier , Rangel Vargas Esmeralda
Published: January 2018

En este documento se revisan las aplicaciones de compuestos fenólicos y polifenólicos presentes en las plantas, que forman parte de la dieta humana y se consideran de interés debido a sus propiedades antioxidantes y beneficios a la salud. Estos compuestos se estructuran a partir de un complejo fenólico simple, formando polímeros complejos de alto peso molecular. El consumo de compuestos fenólicos presentes en los alimentos puede reducir riesgos en la salud, debido a su actividad antioxidante, así mismo, los antioxidantes controlan la rancidez, retardan la formación de productos por oxidación, manteniendo la nutrición, calidad y prolongando la vida útil de los alimentos. Esta contribución resume el efecto en la salud de los compuestos fenólicos y polifenólicos, así como su metabolismo, degradación y toxicología. Además, se presentan algunas fuentes de antioxidantes fenólicos.
Desarrollo y Evaluación de un Potenciostato Electrónico Digital de Bajo Costo para la Cuantificación de Sustancias Químicas Mediante Biosensores Amperométricos
Authors: González-Vidal José Luis , Galán-Vidal Carlos Andrés , Morales-Jiménez Francisco , García-Dávila Miguel , Reyes-Ángeles Mayra
Published: January 2018

En este trabajo se describe el diseño, desarrollo y evaluación de un potenciostato de bajo costo para la cuantificación de sustancias química mediante biosensores amperométricos. El instrumento hace uso de amplificadores operacionales (opamps) y, una etapa de conversión analógica-digital con un display digital para determinar la corriente de oxidación de ferrocianuro de potasio. El equipo desarrollado fue evaluado con un electrodo de carbón vítreo y electrodos serigráficos de carbono en buffer de fosfatos 0.1 M en NaCl 0.1 M pH = 7.0. Los resultados de las mediciones del potenciostato son equivalentes a los obtenidos mediante un instrumento comercial y en ambos casos se ubican en el rango de los nanoamperes, destacando así su alta sensibilidad.
Las tecnologías de bajo impacto como alternativa para aprovechar el agua de lluvia en viviendas unifamiliares
Authors: Lizárraga-Mendiola Liliana , Bigurra-Alzati Carlos Alfredo , Lagarda-García Francisco Omar , Montiel-Palma Silvia , González-Sandoval María Del Refugio
Published: January 2018

En este trabajo se analizaron las posibilidades de implementar tecnologías de bajo impacto (cosecha de agua de lluvia en azoteas y pavimento permeable) en viviendas de tipo unifamiliar. Se cuantificaron los volúmenes de agua de lluvia cosechables y se di señó una mezcla de pavimento permeable para determinar sus propiedades mecánicas (resistencia a la compresión) e hidráulicas (permeabilidad). Se observó que es posible cosechar volúmenes suficientes de agua en azoteas de viviendas unifamiliares con superficies de 100 m2 que satisfagan al menos el 25% del volumen necesario para fines no potables. Además, es posible facilitar la infiltración de escorrentía superficial a través de pavimentos permeables destinados a estacionamientos, cocheras y andadores. Este tipo de tecnologías podrían auto-construirse por usuarios y propietarios.
Study Regarding the Participation of Romanian Track and Field Athletes in the Last Three Olympic Games
Authors: Ababei Cătălina
Published: January 2018

Romania's ranking on decreasingly lower places in the hierarchy of the countries participating in the last three Olympic Games (OG) raises a lot of questions in regards to the way in which the athletes, the coaches, the sports clubs, the federations, the Ministry of Youth and Sports (MYS), the Romanian Olympic and Sports Committee (ROSC) look at the Romanian team's training and participation in this important competition. When talking only about the last three editions of OG, when Romania ranked 17th in 2008 (Beijing), 27th in 2012 (London), and 47th at the last edition, in Rio de Janeiro, one can sound the alarm for all the institutions involved. This research started from the following hypothesis: a careful analysis of the Romanian athletes' participation in the last three Olympic Games could suggest new strategies for their training.
Sociality and Good-Faith Economy in Daniel Defoe’s Robinson Crusoe
Authors: Yu Daniel
Published: January 2018

Robinson Crusoe (1719) by Daniel Defoe was long hailed as the founding myth of “Economic Man,” with critics until the mid-twentieth century tending to portray the shipwrecked narrator as the exemplar of utilitarian individualism. The novel’s reception among economists from David Ricardo to Karl Marx was largely determined by Jean-Jacques Rousseau’s revisionary reading, which excluded large parts of the narrative from consideration. In revisiting the parts that Rousseau thought extraneous, this essay finds that the character of Crusoe is an eminently social being who relies on the charity of several generous benefactors. Their relationships are notably amicable, constituted by mutual trust and goodwill. As an intimate society, they share gifts and ex change favours without apparent regard for profit-making. In representing them selves as generous friends, they belie the economic realities that support their accumulation of wealth. The Crusoe that emerges from an examination of his symbolic activity is one whose practices of gift-giving are governed less by reason or notions of utility than by powerful symbols and the relations that inhere in them.
“He bears no rival near the throne”: Male Narcissism and Early Feminism in the Works of Charlotte Dacre
Authors: Airey Jennifer L.
Published: January 2018

For many critics, Charlotte Dacre is an essentially conservative author, whose female villains ventriloquize and thereby discredit early feminist thought. This essay disputes such readings by exploring her under-acknowledged criticisms of patriarchy. Dacre’s male characters are self-important narcissists, who disdain female education for the agency it gives women. If a woman is well-educated, she is less likely to submit, less likely to serve as an extension of her husband’s will alone. Patriarchy also encourages women to turn on one another, Dacre argues; her female villains uniformly value advancement among men over sisterhood, and they willingly destroy other women to attain their own ends. Dacre thus takes a pessimistic approach to women’s options at the beginning of the nineteenth century. Her female characters do not enjoy happy endings, regardless of marital status, level of education, or morality, because patriarchal systems are designed to crush women no matter how they behave. Far from mocking early feminism, then, Dacre criticizes it for being insufficiently radical in addressing problems with male behaviour.
Rauheitsanforderungen für die mobile Härteprüfung metallischer Werkstoffe
Authors: Schnapp Jürgen Dieter , Herold Volker , Reuschel Janine
Published: January 2018

Kurzfassung

Der Einfluss der Oberflächenrauheit und die Anzahl der Messungen auf die Zuverlässigkeit und Streuung der Ergebnisse der mobilen Härteprüfung metallischer Werkstoffe wird kritisch untersucht. Dafür werden die häufigsten mobilen Härteprüfverfahren, UCI, Leeb und TIV an vier gängigen Stahlwerkstoffen mit abgestuften Rauheitswerten eingesetzt. Da die meisten Verfahren „blind“, d. h. ohne optische Kontrolle der Eindrücke arbeiten, ist die Zuverlässigkeit der Ergebnisse hier nur über die Streuung der Einzelmessungen kontrollierbar. Es wird gezeigt, dass die Rauheitsanforderungen gültiger Normen und Richtlinien oft unterschritten werden können. Dagegen sollte zur Sicherstellung einer hohen Messgenauigkeit, insbesondere bei großen Rauheiten, die Anzahl der Messungen jedoch erhöht werden.
Corrosion fatigue assessment of extruded magnesium alloys AZ31 and ME20
Authors: Klein Martin , Wittke Philipp , Hoppe Roland , Letzig Dietmar , Walther Frank
Published: January 2018

The corrosion fatigue behavior of extruded magnesium alloys AZ31 and ME20 was characterized by means of load increase tests in 5 wt.-% NaCl solution. The results were correlated with the respective corrosion behaviors investigated in immersion tests and by means of microstructural investigations after precorrosion. ME20 exhibited a superior corrosion resistance compared to AZ31, probably as a result of an enhanced passivation tendency due to grain refinement because of the presence of rare earth alloying elements. Accordingly, no differences in the cyclic deformation behaviors of ME20 in air and 5 wt.-% NaCl solution were observed in the load increase tests, while AZ31 exhibited a reduction of the estimated fatigue strengths as well as signs of embrittlement due to the mechanical-medial load.
Gaussian filtering algorithm describing the topography of temper rolled strip and related edge effect
Authors: Xia Chunyu , Li Hongbo , Zhang Jie , Zhang Xin , Jia Shenghui
Published: January 2018

The surface topography of temper rolled strip consists of a range of spatial wavelengths with approximate normal distribution in height. Gaussian filtering methods can be applied in measuring and characterizing the topography of temper rolled strip. In this study, three Gaussian filtering algorithms, namely convolution algorithm, fast Fourier transform algorithm and fast recursive algorithm, are compared, in order to find out the most suitable one for the topography of temper rolled strip. A similar profile extension method based on the distribution of the topography of strip is proposed to eliminate the edge effect. The results show that the convolution algorithm is obviously beneficial for the computational efficiency. It is also found that the similar profile extension method can effectively eliminate the edge effect and improve the reliability of edge data. The Gaussian convolution algorithm, combined with the similar profile extension method, is able to effectively assess the surface topography of temper rolled strip.
Impression creep behavior of magnesium alloy ZK60
Authors: Liao Huimin , Zeng Ming , Chen Hong
Published: January 2018

Creep behavior of the ZK60 magnesium alloy was investigated using impression creep technique. The tests were carried out under constant punching stress at high temperatures (175, 200 and 225 °C) under low stresses (25, 50, 75 and 100 MPa) and at low temperatures (100, 125 and 150 °C) under high stresses (100, 125, 150 and 175 MPa). The creep mechanism of the extruded ZK60 magnesium alloy is grain boundary sliding by dislocation climbing obtained at low temperature and high pressure. At high temperature and under low pressure, the creep mechanism of the extruded ZK60 magnesium alloy is grain boundary diffusion by grain boundary sliding. The initial microstructure of the extruded ZK60 magnesium alloy was composed of mainly Mg phase and a little MgZn phase. Under the conditions of low temperature and high pressure, MgZn2 phase precipitated during creep deformation. Under the conditions of high temperature and low pressure, MgZn2 phase and a small amount of Zr-Zn phase precipitated during creep deformation. The creep resistance of magnesium alloy ZK60 under the conditions of low temperature and high pressure is better than under the conditions of high temperature and low pressure.
Low heat input welding of nickel superalloy GTD-111 with Inconel 625 filler metal
Authors: Athiroj Athittaya , Wangyao Panyawat , Hartung Fritz , Lothongkum Gobboon
Published: January 2018

GTD-111 precipitation-strengthened nickel-based superalloy is widely used in blades of gas turbine engines which operate at high temperature and in a hot localized corrosion atmosphere. After long-term exposure to high temperature, γ' precipitate is known to exhibit catastrophic changes in size and distribution which cause deterioration of its properties and failure of the component. In this study, a damaged blade removed froma land-based gas turbine generator was subjected to nonpre-heat-treated GTAW and laser welding repair with various welding powers in the range of 135 to 295 J × mm−1, followed by post-weld heat treatment (PWHT) at 1473 K for 7200 s and strain aging at 1118 K for 86 400 s. Results show no significant relationship between welding powers, size and area fraction of the γ' precipitate in the fcc γ matrix in both GTAW and laser-welded specimens. The final γ' precipitate size and distribution depend mainly on PWHT parameters as γ' precipitates in all GTAW and laser welded specimens showed similar size and area fraction independently of the heat input from welding. Unmixed zones are observed in all laser welding specimens which may cause preferential weld corrosion during service. Microcrack occurrence due to welding and PWHT processes is also discussed.
Prospective, randomized multicenter study of cervical arthroplasty versus anterior cervical discectomy and fusion: 5-year results with a metal-on-metal artificial disc
Authors: Coric Domagoj , Guyer Richard D. , Nunley Pierce D. , Musante David , Carmody Cameron , Gordon Charles , Lauryssen Carl , Boltes Margaret O. , Ohnmeiss Donna D.
Published: January 2018

OBJECTIVE

Seven cervical total disc replacement (TDR) devices have received FDA approval since 2006. These devices represent a heterogeneous assortment of implants made from various biomaterials with different biomechanical properties. The majority of these devices are composed of metallic endplates with a polymer core. In this prospective, randomized multicenter study, the authors evaluate the safety and efficacy of a metal-on-metal (MoM) TDR (Kineflex|C) versus anterior cervical discectomy and fusion (ACDF) in the treatment of single-level spondylosis with radiculopathy through a long-term (5-year) follow-up.

METHODS

An FDA-regulated investigational device exemption (IDE) pivotal trial was conducted at 21 centers across the United States. Standard validated outcome measures including the Neck Disability Index (NDI) and visual analog scale (VAS) for assessing pain were used. Patients were randomized to undergo TDR using the Kineflex|C cervical artificial disc or anterior cervical fusion using structural allograft and an anterior plate. Patients were evaluated preoperatively and at 6 weeks and 3, 6, 12, 24, 36, 48, and 60 months after surgery. Serum ion analysis was performed on a subset of patients randomized to receive the MoM TDR.

RESULTS

A total of 269 patients were enrolled and randomly assigned to undergo either TDR (136 patients) or ACDF (133 patients). There were no significant differences between the TDR and ACDF groups in terms of operative time, blood loss, or length of hospital stay. In both groups, the mean NDI scores improved significantly by 6 weeks after surgery and remained significantly improved throughout the 60-month follow-up (both p < 0.01). Similarly, VAS pain scores improved significantly by 6 weeks and remained significantly improved through the 60-month follow-up (both p < 0.01). There were no significant changes in outcomes between the 24- and 60-month follow-ups in either group. Range of motion in the TDR group decreased at 3 months but was significantly greater than the preoperative mean value at the 12- and 24-month follow-ups and remained significantly improved through the 60-month period. There were no significant differences between the 2 groups in terms of reoperation/revision surgery or device-/surgery-related adverse events. The serum ion analysis revealed cobalt and chromium levels significantly lower than the levels that merit monitoring.

CONCLUSIONS

Cervical TDR with an MoM device is safe and efficacious at the 5-year follow-up. These results from a prospective randomized study support that Kineflex|C TDR as a viable alternative to ACDF in appropriately selected patients with cervical radiculopathy.

Clinical trial registration no.: NCT00374413 (clinicaltrials.gov)
The relationship between repeat resection and overall survival in patients with glioblastoma: a time-dependent analysis
Authors: Goldman Debra A. , Hovinga Koos , Reiner Anne S. , Esquenazi Yoshua , Tabar Viviane , Panageas Katherine S.
Published: January 2018

OBJECTIVE

Previous studies assessed the relationship between repeat resection and overall survival (OS) in patients with glioblastoma, but ignoring the timing of repeat resection may have led to biased conclusions. Statistical methods that take time into account are well established and applied consistently in other medical fields. The goal of this study was to illustrate the change in the effect of repeat resection on OS in patients with glioblastoma once timing of resection is incorporated.

METHODS

The authors conducted a retrospective study of patients initially diagnosed with glioblastoma between January 2005 and December 2014 who were treated at Memorial Sloan Kettering Cancer Center. Patients underwent at least 1 craniotomy with both pre- and postoperative MRI data available. The effect of repeat resection on OS was assessed with time-dependent extended Cox regression controlling for extent of resection, initial Karnofsky Performance Scale score, sex, age, multifocal status, eloquent status, and postoperative treatment.

RESULTS

Eighty-nine (55%) of 163 patients underwent repeat resection with a median time between resections of 7.7 months (range 0.5–50.8 months). Median OS was 18.8 months (95% confidence interval [CI] 16.3–20.5 months) from initial resection. When timing of repeat resection was ignored, repeat resection was associated with a lower risk of death (hazard ratio [HR] 0.62, 95% CI 0.43–0.90, p = 0.01); however, when timing was taken into account, repeat resection was associated with a higher risk of death (HR 2.19, 95% CI 1.47–3.28, p < 0.001).

CONCLUSIONS

In this study, accounting for timing of repeat resection reversed its protective effect on OS, suggesting repeat resection may not benefit OS in all patients. These findings establish a foundation for future work by accounting for timing of repeat resection using time-dependent methods in the evaluation of repeat resection on OS. Additional recommendations include improved data capture that includes mutational data, development of algorithms for determining eligibility for repeat resection, more rigorous statistical analyses, and the assessment of additional benefits of repeat resection, such as reduction of symptom burden and enhanced quality of life.
Analysis of clinical factors and PDGFR-β in predicting prognosis of patients with clival chordoma
Authors: Zhai Yixuan , Bai Jiwei , Wang Shuai , Gao Hua , Li Mingxuan , Li Chuzhong , Gui Songbai , Zhang Yazhuo
Published: January 2018

OBJECTIVE

In this study, the authors’ aim was to research clinical features and prognostic factors in patients harboring clival chordomas and explore the relationship between platelet-derived growth factor receptor-β (PDGFR-β) expression and tumor invasion and prognosis of clival chordoma.

METHODS

A total of 242 patients were retrospectively analyzed. Clinical information, including extent of resection, Al-Mefty classification, postoperative complications, and postoperative radiotherapy, was reviewed. Kaplan-Meier analysis was used to estimate survival time. Immunohistochemical analysis, quantitative reverse transcription polymerase chain reaction, and Western blotting were used to measure the expression level of proteins or mRNA. Transwell assaying was performed to measure the invasive ability of the tumor cells.

RESULTS

According to the Al-Mefty classification, there were 37, 112, and 93 type I, II, and III tumors, respectively. Gross-total resection (GTR) was achieved in 86 cases (35.5%), subtotal resection (STR) in 63 cases (26.0%), and partial resection (PR) in 93 cases (38.4%). The 5-year progression-free survival (PFS) and overall survival (OS) rates in the GTR group were significantly higher than those in the non–total resection (NTR; i.e., STR and PR) group (p < 0.001). The 5-year PFS and OS rates for patients with type I tumors were significantly higher than those for patients harboring types II and III tumors (p < 0.001). In the NTR group, the median PFS and OS of patients with lower PDGFR-β expression were significantly longer than those of patients with higher PDGFR-β expression. Reduction of PDGFR-β suppressed the invasion ability of cells in vitro. In addition, reduction of PDGFR-β can obviously downregulate the expression levels of mammalian target of rapamycin (mTOR) or phospho-mTOR.

CONCLUSIONS

Extent of resection, Al-Mefty classification, primary tumor, postoperative radiotherapy, and PDGFR-β expression level are valuable prognostic factors in patients with clival chordomas. PDGFR-β could regulate invasion through the mTOR pathway in clival chordoma cells.
Comparison of percutaneous endoscopic transforaminal discectomy, microendoscopic discectomy, and microdiscectomy for symptomatic lumbar disc herniation: minimum 2-year follow-up results
Authors: Liu Xinyu , Yuan Suomao , Tian Yonghao , Wang Lianlei , Gong Liangtai , Zheng Yanping , Li Jianmin
Published: January 2018

OBJECTIVE

This study aimed to evaluate the clinical outcomes of percutaneous endoscopic transforaminal discectomy (PETD), microendoscopic discectomy (MED), and microdiscectomy (MD) for treatment of symptomatic lumbar disc herniation (LDH).

METHODS

One hundred ninety-two patients with symptomatic LDH at L3–4 and L4–5 were included in this study. The mean (± SD) age of patients was 34.2 ± 2.6 years (range 18–62 years). The patients were divided into groups as follows: group A was treated with PETD and included 60 patients (31 men and 29 women) with a mean age of 36.2 years; group B was treated with MED and included 63 patients (32 men and 31 women) with a mean age of 33.1 years; and group C was treated with MD and included 69 patients (36 men and 33 women) with a mean age of 34.0 years. The Japanese Orthopaedic Association (JOA) scale for low-back pain (LBP), Oswestry Disability Index (ODI), creatine phosphokinase activity 3 days after surgery, and visual analog scale (VAS) scores for LBP and leg pain were used for evaluation of clinical results.

RESULTS

There were no significant differences in mean preoperative JOA score, ODI score, and VAS scores for LBP and leg pain among groups A, B, and C. Incision length, duration of the operation, blood loss, creatine phosphokinase, length of hospital stay, and postoperative incision pain according to the VAS were best in the PETD group (p < 0.05). The number of seconds of intraoperative fluoroscopy was highest in the PETD group (p < 0.05), whereas there was no difference between the MED and MD groups. Three cases from the MED group and 2 cases from the MD group had an intraoperative durotomy. No CSF leakage was observed after surgery. One case from the MED group and 3 cases from the MD group had incision infections. There were no neurological deficits related to the surgeries in any of the groups. Fifty-five (91.6%), 59 (93.7%), and 62 patients (89.9%) had at least 2 years of follow-up in groups A, B, and C, respectively. At the last follow-up, JOA scores, VAS scores of LBP and leg pain, and ODI scores were significantly better than preoperative correlates in all groups. There were no differences among the 3 groups in JOA scores, JOA recovery rate, ODI scores, and VAS scores for leg pain. The VAS score for LBP was best in the PETD group (p < 0.05). No lumbar instability was observed in any group. Three cases (5.5%) in the PETD group had recurrent LDH, and 2 recurrent cases (3.4%) were confirmed in the MED group.

CONCLUSIONS

PETD, MED, and MD were all reliable techniques for the treatment of symptomatic LDH. With a restricted indication, PETD can result in rapid recovery and better clinical results after at least 2 years of follow-up.
Delayed neurological deterioration following atlantoaxial facet joint distraction and fixation in a patient with Chiari malformation type I
Authors: Inoue Tatsushi , Hattori Natsuki , Ganaha Tsukasa , Kumai Tadashi , Tateyama Shinichiro , Hirose Yuichi
Published: January 2018

Chiari malformation type I (CM-I) is typically treated with foramen magnum decompression. However, a recent study proposed a new technique for patients with CM-I, wherein only short atlantoaxial joint fusion and distraction is applied. Posterior fusion with or without atlantoaxial distraction is a potential option for patients with CM-I associated with basilar invagination or complex anomalous bony craniovertebral junction pathology, since this procedure allows clinicians to avoid using the technically demanding transoral approach in which some or all of the odontoid tip is invisible. Distraction of the atlantoaxial joint reduces ventral cervicomedullary compression, leading to neurological improvement. Here, the authors report the case of a 50-year-old woman with CM-I plus basilar invagination whose condition immediately improved but then gradually deteriorated following atlantoaxial joint distraction and fusion. Therefore, the authors performed endonasal/transoral odontoidectomy, which resulted in prolonged neurological recovery. Short atlantoaxial fusion with distraction is a smart and ideal surgical planning concept that can result in significant neurological improvement. However, this case suggests that anterior odontoidectomy is still an essential element of the intervention strategy for patients with CM-I with complex craniovertebral junction pathology.