bluuebunny/crossref_metadata_2025 huggingface dataset:
Baclofen systemic toxicity: Experimental histopathological and biochemical study
Authors: Issa SY , Hafez EM , El-Banna AS , Abdel Rahman SM , AlMazroua MK , El-Hamd MA
Published: June 2017

Objective:

The present study was designed to highlight the toxic impact of baclofen on both biochemical and histopathological aspects in rats’ liver, gastric, lung, kidney, and brain tissues.

Methods:

The study was performed on 30 healthy adult male albino rats divided into four groups with 5 rats in each control group, and 10 rats in either experimental groups (two experimental and two control groups). Five rats (negative control) were kept in a quite non-stressful environment, provided with food ad libitum and free access to water. Normal saline (1 ml) was given orally as placebo in the positive control group ( n = 5). Experimental group III, baclofen acute toxicity group (10 rats): Each animal received a single dose of lethal dose (LD50) of baclofen orally by gavage. It equals 145 mg/kg body weight. The rats were observed for acute toxicity manifestations as well as for LD50 deaths. Group IV, (baclofen-dependent group, 10 rats): Each animal received baclofen (1/10th LD50) in gradually increasing doses for 1 month.

Results:

The levels of blood urea nitrogen, creatinine kinase, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, cardiac troponin I, and prothrombin time in both baclofen-treated groups showed significant elevation when compared to controls. There were brain, lung, gastric, hepatic, and renal histopathological changes in baclofen-treated rats whose severity varied between the two experimental groups.

Conclusion and recommendation:

Baclofen toxicity is an under diagnosed emergency. Physicians should consider baclofen toxicity in users having hepatorenal dysfunction, presenting with altered mental status, bradycardia, and hypotension.
Acrylamide-derived cytotoxic, anti-proliferative, and apoptotic effects on A549 cells
Authors: Kacar S , Vejselova D , Kutlu HM , Sahinturk V
Published: June 2017

Background:

Acrylamide is a very common compound even reaching up to our daily foods. It has been studied in a wealth of cell lines on which it proved to have various toxic effects. Among these cell lines, human lung adenocarcinoma cell line (A549) is one of that on which acrylamide’s toxicity has not been studied well yet.

Aim:

We intended to determine the half maximal inhibitory concentration (IC50) dose of acrylamide and to investigate its cytotoxic, anti-proliferative and apoptotic effects on A549 cells.

Methods:

We determined the IC50 dose by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Then, the mode of cell death was evaluated by flow cytometry using Annexin-V fluorescein isothiocyanate (FITC)/propidium iodide (PI) staining. Next, we performed transmission electron microscopy (TEM) and confocal microscopy analyses for morphological alterations and apoptotic indices.

Results:

According to the MTT assay results, A549 cell viability decreases proportionally with increasing acrylamide concentrations and IC50 for A549 was 4.6 mM for 24 h. Annexin-V FITC/PI assay results indicated that acrylamide induces apoptosis in 64% of the A549 cells. TEM and confocal microscopy analyses showed nuclear condensations, fragmentations, cytoskeleton laceration, and membrane blebbing, which are morphological characteristics of apoptosis.

Conclusion:

Our research suggests that acrylamide causes cytotoxic, anti-proliferative, and apoptotic effects on A549 cells at 4.6 mM IC50 dose in 24 h.
Police responses to family violence: Recasting a duty of care
Authors: Vallins Nina
Published: June 2017

This article explores the issue of police liability in negligence for failing to protect victims of crime. UK courts have held that police, in the course of investigation or suppression of a crime, do not have a duty of care to individuals. The law in Australia, however, is unsettled. The author discusses cases where police have failed to protect victims of family violence and finds that public policy reasons for granting police immunity from suit are unsatisfactory and unjust.
UN decision on Marlon Noble case: Imprisonment of an Aboriginal man with intellectual disability found unfit to stand trial in Western Australia
Authors: McGaughey Fiona , Tulich Tamara , Blagg Harry
Published: June 2017

On 23 September 2016, the United Nations (UN) Committee on the Rights of Persons with Disabilities found that the Australian government had breached its obligations under the UN Convention on the Rights of Persons with Disabilities. The case against Australia was brought by Marlon Noble, an Aboriginal man with an intellectual disability who was charged with sexual assault but found unfit to stand trial under the Mentally Impaired Defendants Act 1996 (WA). He was imprisoned indefinitely in 2001 and has been held in civil detention in the community since 2012. This article analyses the current policy and legislative context in Western Australia on this issue and reflects on Australia’s previous responses to individual human rights complaints to UN Committees.
Tortured genius: The legality of injurious performance art
Authors: Bennett Theodore
Published: June 2017

In the 20th century, a distinct subset of performance art emerged in which the artist is deliberately physically injured as part of their performance. While such performances are now a settled type of artistic expression their legal status is unclear. This article examines the legality of such performances under the Australian criminal law. Focusing on common law principles, it compares injurious performance art to the legally recognised category of ‘dangerous exhibitions’ and ultimately argues that such performances will only be lawful if it can be clearly demonstrated that they have public utility.
Shutting-up or speaking-up: Navigating the invisible line between voice and silence in workplace bullying
Authors: Easteal Patricia , Ballard Allison J
Published: June 2017

In this article, we identify and discuss individual and organisational factors which contribute to bully victims’ or targets’ decisions about whether or not to voice complaints about workplace bullying in Australian workplaces. This article examines the costs of voice and silence in workplace bullying matters for both targets and organisations. ‘Voice’ is understood as existing on a continuum, which ranges from informally voicing concerns about bullying behaviour to making a formal complaint or report within the workplace or to an external agency. The ‘silence’ of workplace bullying is also considered to exist on a continuum and may include things such as not raising the bully issue at all, exiting the workplace rather than addressing the issue, and ‘being silenced’ by external influences after having made a complaint. We suggest some organisational changes to facilitate the reporting and better handling of bullying complaints.
Advancing the Field of Synthesis Scholarship: A Response to Nicky Britten and Colleagues
Authors: Thorne Sally
Published: June 2017

Continuing the dialogue and debate on the relevance and value of qualitative metasynthesis research for the health fields, Thorne comments on some of the ideas raised by Britten and colleagues in response to her January 2017 Qualitative Health Research editorial on Metasynthetic Madness. Here she extends the debate on the terminology with which we refer to this kind of scholarly work and the kinds of research synthesis that hold potential for adding value to existing knowledge about matters of health and illness. In the spirit of engaging an ongoing critical conversation, she proposes that the kinds of metasynthesis products that get published ought to be those capable of demonstrating actual relevance. She reminds us that the procedural steps that have come to be associated with metasynthesis in many of the recently published reports are merely the stage-setting one does in order to prepare the way for the actual intellectual work of synthesis. By whatever name it is known, if qualitative synthesis is to make a meaningful scholarly contribution in the health domain, Thorne argues that it must demonstrate the kind of thoughtfully critical and interpretive intellectual engagement that takes our understanding of phenomena significantly beyond what we could have known on the basis of an ordinary kind of literature review, offering us an original form of insight that would not have been otherwise accessible.
“I Have Strong Hopes for the Future”: Time Orientations and Resilience Among Canadian Indigenous Youth
Authors: Hatala Andrew R. , Pearl Tamara , Bird-Naytowhow Kelley , Judge Andrew , Sjoblom Erynne , Liebenberg Linda
Published: June 2017

In this article, we demonstrate how concepts of time and the future inform processes of resilience among Indigenous adolescents within an urban Canadian context. This study employed a modified grounded theory methodology by conducting 38 qualitative interviews with 28 Indigenous youth (ages 15–25) over the course of 1 year. The analysis revealed complex processes of and navigations between moments of distress and strategies for resilience. The distressing contexts in which Indigenous youth often find themselves can impact the development of their concepts of time and limit their abilities to conceptualize a future. A future time orientation (FTO) emerged as central to processes of resilience and was supported by (a) nurturing a sense of belonging, (b) developing self-mastery, and (c) fostering cultural continuity.
School Counselors’ Perceptions of Family Systems Perspectives
Authors: Martin Dottie M.
Published: June 2017

School counselors traditionally have been trained in individual models and often lack the training in a family systems perspective that is necessary to provide a comprehensive school counseling program. One project 10 years ago empirically studied school counselors’™ perceptions of the importance of utilizing a family systems perspective when working with children and families. The present study updated this information, and determined how prepared and competent they felt, and how frequently they use a family systems perspective. A total of 657 school counselors completed 56 online questions about a family systems approach, including its importance, their preparedness, rating of their own competency, frequency of use, how they learned about family systems, and barriers might prevent use. Less than half (39%) reported taking a course in family systems, but more than half (87%) said that such a course should be required. They used family systems daily or at least several times per week. Overall, the more methods they used to learn about family systems, the more important they rated it, the more prepared and competent they rated themselves, and the more frequently they used this approach. Many (79%) responded to the open-ended question about barriers and often mentioned barriers such as lack of training (23%), lack of parental involvement (18%), and time (18%). In both quantitative and qualitative data, most school counselors recognized the importance of requiring a family systems course in their training curriculum. Lack of this kind of course may be leaving counselors unprepared to respond to student needs.
Child Maltreatment Trauma, Posttraumatic Stress Disorder, and Cortisol Levels in Women: A Literature Review
Authors: Li Yang , Seng Julia S.
Published: June 2017

BACKGROUND:Studies of the relationship between cortisol and posttraumatic stress disorder (PTSD) have had inconsistent results. Gender, trauma type, and age at trauma exposure may explain the inconsistencies. OBJECTIVE: The objective of the review was to examine cortisol levels in relation to PTSD in women with a history of child maltreatment trauma. DESIGN: A review of literature found 13 articles eligible for inclusion. RESULTS: Despite limiting focus to the relatively homogeneous population, the patterns of associations between PTSD and cortisol levels were still inconsistent. CONCLUSIONS: The reasons for the inconsistencies likely include highly varied methods across studies, small convenience samples, and unmeasured neuroendocrine hormones that may be stronger predictors of PTSD. The review does not point to a clear bio-behavioral target for psychiatric nursing intervention. It is important to continue to address the developmental and clinical stress response aspects of child maltreatment trauma–related PTSD without assuming that these stress responses are hypothalamic-pituitary-adrenal–axis driven.
The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia
Authors: Rayan Ahmad , Obiedate Khaldoon
Published: June 2017

BACKGROUND:Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. AIMS: The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. METHOD: In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. RESULTS: Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. CONCLUSIONS: Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.
Review of Use of Standardized Patients in Psychiatric Nursing Education
Authors: Goodman Janice H. , Winter Shira G.
Published: June 2017

BACKGROUND: Simulations using standardized patients (SPs) are increasingly used to teach and assess competencies in psychiatric/mental health (PMH) nursing education. To advance the field, it is important to identify current knowledge, practice, and evidence. OBJECTIVE: To determine the current knowledge, evidence, and practice of using SPs in PMH nursing education by conducting an integrative review of the empirical research on the use of SPs in PMH nursing education, and by providing a supplementary descriptive review of non-research articles on PMH simulations using SPs. DESIGN: A comprehensive search using electronic databases was conducted to identify both research and simulation description papers meeting inclusion criteria. The research literature was reviewed using an integrative review approach and a simple descriptive review of the non-research simulation literature was also conducted. RESULTS: Six research studies and 18 simulation description articles were included in the review. Although there are several PMH SP simulation descriptions in the literature, and anecdotal indications that they are a valuable educational tool, there is insufficient research evidence regarding their effectiveness as a method in psychiatric nursing education due to few published studies and methodological limitations of existing studies. CONCLUSIONS: Well-designed research studies are needed to develop an evidence base for this promising and increasingly employed teaching method.
The Importance of Having a Balanced Rating Index for Ranking Academic Journals
Authors: Okumus Fevzi , Zhao Xinyuan Roy , Van Niekerk Mathilda , Law Rob
Published: June 2017

Publishing in high-ranking journals is one of the many critical dimensions by which academic performances of scholars in higher education are measured. Researchers have proposed various approaches in ranking academic journals, although they are inconsistent because of their reliance on either subjective or objective indicators. However, both of these approaches have various advantages and disadvantages and integrating these approaches to completely demonstrate journal performance on various dimensions are still lacking. This study reviews previous journal ranking approaches and proposes a balanced-rating index in ranking hospitality and tourism journals. This proposed approach integrates both subjective and objective indicators into five dimensions (article influence, journal reputation, publisher reputation, efficiency and effectiveness, and readership) with 39 indicators in relation to the corresponding data collection method needed. The balanced-rating index is a new approach in ranking hospitality and tourism journals. The study also presents several critical implications for future research and practices to consider.
Effect of a high phosphorus diet on indicators of renal health in cats
Authors: Dobenecker Britta , Webel Anna , Reese Sven , Kienzle Ellen
Published: June 2017

Objectives

High phosphorus intake may further impair renal health in cats with chronic kidney disease (CKD). The hypothesis that a high phosphorus (HP) diet might be nephrotoxic for healthy animals was tested in cats, a species with a high incidence of naturally occurring CKD.

Methods

Thirteen healthy adult cats were fed a phosphorus excess diet (about five times maintenance requirements), and this HP group was compared with cats on a balanced control diet (CON). The trial lasted for 29 days (10 days of faeces and urine collection). Endogenous creatinine clearance was determined towards the end of the trial. Fresh urine was tested for glucose and proteins.

Results

Glucosuria and microalbuminuria were observed exclusively in the HP group in 9/13 cats. Creatinine clearance was significantly decreased after feeding HP. In the HP group phosphorus was highly available (apparent digestibility around 60%). Renal phosphorus excretion was significantly increased in the HP group (115 mg/kg body weight/d vs 16 mg/kg body weight/d in the CON group).

Conclusions and relevance

The intake of a diet with an excessive content of highly available phosphorus may have adverse effects on parameters of kidney function in healthy cats.
Comparison of carbohydrate content between grain-containing and grain-free dry cat diets and between reported and calculated carbohydrate values
Authors: Prantil Lori R , Heinze Cailin R , Freeman Lisa M
Published: June 2017

Objectives

The aim of this study was to compare the carbohydrate content of grain-containing and grain-free dry cat diets and compare major protein and carbohydrate sources of these diets.

Methods

This was a cross-sectional study of 77 randomly selected dry cat diets (42 grain-containing, 35 grain-free). Reported carbohydrate values were compared between grain-containing and grain-free cat diets. A subset of 25% of diets from each category (grain-containing and grain-free) was analyzed and nitrogen-free extract was calculated as an estimate of carbohydrate content. These calculated values were compared with reported values from the manufacturer. Animal- and plant-sourced ingredients were also compared between grain-containing and grain-free diets.

Results

Mean reported carbohydrate content of the grain-free diets (n = 35) was lower than the grain-containing diets (n = 41; 64 ± 16 vs 86 ± 22 g/1000 kcal; P <0.001). Reported carbohydrate values were higher than analyzed nitrogen-free extract (n = 20; 79 ± 30 vs 73 ± 27 g/1000 kcal; P = 0.024). Poultry ( P = 0.009) and soy (P = 0.007) were less common in grain-free diets than in diets containing grain. The alternative carbohydrate sources of chickpeas, lentils, peas, potato, sweet potato and cassava/tapioca were more common ( P <0.05) in grain-free diets than in diets containing grain.

Conclusions and relevance

This sample of grain-free diets had lower mean reported carbohydrate content than grain-containing diets, but there was considerable overlap between groups and individual diets’ carbohydrate/nitrogen-free extract content varied widely.
In vivo evidence of oxidative stress in brains of patients with progressive multiple sclerosis
Authors: Choi In-Young , Lee Phil , Adany Peter , Hughes Abbey J , Belliston Scott , Denney Douglas R , Lynch Sharon G
Published: June 2017

Background:

The oxidative stress hypothesis links neurodegeneration in the later, progressive stages of multiple sclerosis (MS) to the loss of a major brain antioxidant, glutathione (GSH).

Objective:

We measured GSH concentrations among major MS subtypes and examined the relationships with other indices of disease status including physical disability and magnetic resonance imaging (MRI) measures.

Methods:

GSH mapping was performed on the fronto-parietal region of patients with relapsing-remitting multiple sclerosis (RRMS, n = 21), primary progressive multiple sclerosis (PPMS, n = 20), secondary progressive multiple sclerosis (SPMS, n = 20), and controls ( n = 28) using GSH chemical shift imaging. Between-group comparisons were performed on all variables (GSH, T2-lesion, atrophy, Expanded Disability Status Scale (EDSS)).

Results:

Patients with MS had substantially lower GSH concentrations than controls, and GSH was lower in progressive MS (PPMS and SPMS) compared with RRMS. GSH concentrations were not significantly different between PPMS and SPMS, or between RRMS and controls. Brain atrophy was significant in both RRMS and progressive MS compared with controls.

Conclusion:

Markedly lower GSH in progressive MS than RRMS indicates more prominent involvement of oxidative stress in the progressive stage of MS than the inflammatory stage. The association between GSH and brain atrophy suggests the important role of oxidative stress contributing to neurodegeneration in progressive MS, as suggested in other neurodegenerative diseases.
Introduction: Anthropology’s Queer Sensibilities
Authors: Boyce Paul , Engebretsen Elisabeth L , Posocco Silvia
Published: June 2017

This special issue addresses vital epistemological, methodological, ethical and political issues at the intersections of queer theory and anthropology as they speak to the study of sexual and gender diversity in the contemporary world. The special issue centres on explorations of anthropology’s queer sensibilities, that is, experimental thinking in ethnographically informed investigations of gender and sexual difference, and related connections, disjunctures and tensions in their situated and abstract dimensions. The articles consider the possibilities and challenges of anthropology’s queer sensibilities that anthropologize queer theory whilst queering anthropology in ethnographically informed analyses. Contributors focus on anthropologizing queer theory in research on same-sex desire in Congo; LGBT migrant and asylum experience in the UK and France; same-sex intimacies within opposite gender oriented sexualities in Kenya and Ghana; secret and ambiguous intimacies and sensibilities beyond an identifiable ‘queer subject’ of rights and recognition in India; migrant imaginings of home in Indonesian lesbian relationships in Hong Kong; and cross-generational perspectives on ‘coming out’ in Taiwan, and their implications for theories of kinship and relatedness. An extensive interview with Esther Newton, the prominent figure in gay and lesbian and queer anthropology concludes the collection.
Intervention study on school meal habits in Norwegian 10–12-year-old children
Authors: Illøkken Kristine E. , Bere Elling , Øverby Nina C. , Høiland Renate , Petersson Kirsten O. , Vik Frøydis N.
Published: June 2017

Aim: The aim of this study was to investigate whether a free school meal every day was associated with children’s intake of healthy food during school. Methods: A non-randomized study design with an intervention and a control group was used to measure change in children’s meal habits at lunchtime. In total, 164 children participated; 55 in the intervention group and 109 in the control group. Children in the intervention group were served a free, healthy school meal every school day. Participating children completed a questionnaire at baseline and at 6 months’ follow up. Possible associations were evaluated with a healthy food score, which was calculated based on a food frequency questionnaire on lunch habits at school. Chi-square and Independent Samples t-test were used to analyse the data. Results: At baseline, there was no significant difference in the healthy food score between the intervention and the control group ( p = 0.08). Children in the intervention group increased their healthy food score significantly compared with children in the control group after 6 months ( p ⩽ 0.01). Change in the healthy food score was mainly due to an increase in the intake of fruit ( p ⩽ 0.01), vegetables ( p ⩽ 0.01) and fish spread ( p = 0.02); all in favour of the intervention group. Conclusions: A serving of a free school meal every day for 6 months increased children’s intake of healthy food at lunchtime compared with the control group. Further studies are needed to establish possible long-term effects.
Do parents of adolescents request the same universal parental support as parents of younger children? A random sample of Swedish parents
Authors: Thorslund Karin , Johansson Hanse Jan , Axberg Ulf
Published: June 2017

Universal parental support intended to enhance parents’ capacity for parenting is an important aspect of public health strategies. However, support has mostly been aimed at parents, especially mothers, of younger children. There is a gap in the research concerning parents of adolescents and fathers’ interest in parenting support. Aim: To investigate and compare the interest in parenting support of parents of adolescents and younger children, potential differences between mothers and fathers, and their knowledge of what is being offered to them already, and to explore their requirements for future universal parental support. Methods: Telephone interviews were conducted with a random sample of 1336 parents. Quantitative methods were used to analyze differences between groups and qualitative methods were used to analyze open-ended questions in regard to parents’ requirements for future universal parental support. Results: About 82% of the parents of adolescents interviewed think that offering universal parental support is most important during child’s adolescence. There is a substantial interest, particularly among mothers, in most forms of support. Despite their interest, parents have limited awareness of the support available. Only 7% knew about the local municipality website, although 70% reported a possible interest in such a website. Similarly, 3% knew that a parent phone line was available to them, while 59% reported a possible interest. Conclusions: It poses a challenge but is nevertheless important for municipalities to develop support targeted at parents of adolescents which is tailored to their needs, and to reach out with information.
Book review: Islam, S. and Hossain, I. 2016: Social Justice in the Globalisation of Production: Labor, Gender, and the Environment Nexus
Authors: Hansda Regina
Published: June 2017

Islam, S. and Hossain, I. 2016: Social Justice in the Globalisation of Production: Labor, Gender, and the Environment Nexus. London: Palgrave Macmillan, International Political Economy Series. Xvi + 206 pp. $109.00 (hardcover). ISBN: 978-1-137-43400-5.
Theatrical dialogue in teaching the classics
Authors: Darmon Isabelle , Frade Carlos
Published: June 2017

This article addresses some fundamental affinities between theatre and teaching and is based on emerging work in a long-term experiment which we began in the conference ‘Weber/Simmel Antagonisms: Staged Dialogues’, held at the University of Edinburgh on December 2015. Aimed at exploring the possibilities of the theatrical and dialogical forms for teaching the classics of social and cultural theory, it is a risky experiment whose initial results are presented in this special issue. In order to introduce the dialogues and situate them in the context of the broader project, the article does three things: first, it expounds the process of subjectivation at work in both theatre and teaching and explores some of the modalities of the subjective shift sought for in the public and students. Second, it explains the specificity of this experiment by contrasting it with other uses of theatrical dialogue in teaching. Finally, before briefly introducing each of the dialogues, the article clarifies the fundamental difference between the dialogical form and debate, as radically separating them is at the heart of any experiment in subjectivation, away from the stirring of opinions.
Weber and Simmel talk about picture-frames
Authors: Parker John , Stanworth Hilary
Published: June 2017

The dialogue imagines that in early July 1914 Weber seeks guidance from Simmel about how to approach the visual arts when pursuing his ambition to produce a sociology of all the arts. During the previous decade, Weber became enthusiastic about medieval, renaissance and modern painting. We assume he has read Simmel’s The Picture Frame as well as two pieces about Rembrandt, later elaborated to become the third chapter of Simmel’s Rembrandt. Weber questions Simmel’s ideas about the autonomy of works of art and encourages Simmel to re-state them in the light of the relational implications of his ideas about form. They discuss how one might explain the origins of the use of picture-frames, how they work as form for content and their possibly positive implications for interaction under modern, metropolitan conditions of life.
Contemporary Approaches to Mixed Methods–Grounded Theory Research: A Field-Based Analysis
Authors: Guetterman Timothy C. , Babchuk Wayne A. , Howell Smith Michelle C. , Stevens Jared
Published: June 2017

Key scholars have lauded benefits of integrating mixed methods and grounded theory—or mixed methods–grounded theory (MM-GT)—yet there have been few attempts to ascertain in what ways researchers use MM-GT. Our aim was to systematically, but not exhaustively, examine applications of MM-GT and offer procedural guidelines. We identified 61 empirical MM-GT articles and developed a codebook for analysis. MM-GT was widely used across disciplines. Most published MM-GT provided little methodological detail regarding grounded theory, mixed methods, and their integration; theoretical development was noticeably absent; and the majority followed a convergent mixed methods design. This inquiry contributes to emerging discussions regarding the ways in which MM-GT can or should be used to more fully realize the potential of this approach.
Developing a perspective on schools as complex, evolving, loosely linking systems
Authors: Hawkins Melissa , James Chris
Published: June 2017

The rationale for this article is to give complexity the central place it warrants in school leadership, management and organisational practice and research. We analyse the relevant literature, particularly that relating to complex human systems and their loose coupling nature. The analysis reveals the dimensions of complex human systems and consequences that emanate from those dimensions, which include system evolution. We use the dimensions, together with notions of interactional capability, opportunities for interaction, the legitimacy of interactions and the extent to which the institutional primary task conditions interactions, to create an organisational/institutional perspective on schools as complex, evolving, loosely linking systems (CELLS). Five main systems of a school as a whole-school system are identified: the teaching staff system; the ancillary staff system; the student system; the parent system; and significant other systems in the wider system. In the article, we illustrate the nature of the teaching staff system from a CELLS perspective. We discuss issues arising from our analyses: interaction, influence and leadership; ontological issues; the nature of ‘the school’; the significance of the parent system; the special nature of interactions between the members of the teaching staff system and the student system; and institutional performance.
Rationale and design of combination of an immune modulator Fingolimod with Alteplase bridging with Mechanical Thrombectomy in Acute Ischemic Stroke (FAMTAIS) trial
Authors: Zhang Sheng , Zhou Ying , Zhang Ruiting , Zhang Meixia , Campbell Bruce , Lin Longting , Shi Fu-Dong , Lou Min
Published: June 2017

Rationale

In acute ischemic stroke patients with large vessel occlusion, although reperfusion within 6 h after stroke onset using combined intravenous alteplase and mechanical thrombectomy (bridging therapy) can improve functional outcome, still approximately 50% patients suffer disability which may result from reperfusion injury. Proof-of-concept clinical trials have indicated that the sphingosine-1-phosphate receptor modulator fingolimod may be efficacious in attenuating brain inflammation and improving clinical outcomes in acute ischemic stroke patients as a single therapy beyond 4.5 h of disease onset, or in combination with alteplase within 4.5 h of disease onset.

Aim

To assess whether the treatment of fingolimod combined with bridging therapy in large vessel occlusion acute ischemic stroke patients is effective and safe.

Design and sample size estimates

Fingolimod with Alteplase bridging with Mechanical Thrombectomy in Acute Ischemic Stroke (FAMTAIS) study is a randomized, open-label, multiple central trial. This study includes 98 patients with anterior circulation large vessel occlusion acute ischemic stroke who are eligible for bridging therapy, providing 80% power to reject the null hypothesis that, combined with fingolimod, the bridging therapy has an at least 15% higher penumbra tissue salvage index than receiving bridging therapy alone.

Study outcomes

The primary outcome is the penumbra tissue salvage index. Key secondary outcomes focus on: infarct growth and extent of clinical improvement from day 1 to day 7, frequency of parenchymal hemorrhage at day 1.

Discussion

If the hypothesis of FAMTAIS is confirmed, combination of fingolimod with bridging therapy is effective in attenuating reperfusion injury in patients with large vessel occlusion treated with 6 h of stroke onset.
Diffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with Trevo (DAWN) trial methods
Authors: Jovin Tudor G , Saver Jeffrey L , Ribo Marc , Pereira Vitor , Furlan Anthony , Bonafe Alain , Baxter Blaise , Gupta Rishi , Lopes Demetrius , Jansen Olav , Smith Wade , Gress Daryl , Hetts Steven , Lewis Roger J , Shields Ryan , Berry Scott M , Graves Todd L , Malisch Tim , Rai Ansaar , Sheth Kevin N , Liebeskind David S , Nogueira Raul G
Published: June 2017

Rationale

Efficacy of mechanical thrombectomy for acute stroke due to large vessel occlusion initiated beyond 6 h of time last seen well has not been demonstrated in randomized trials.

Aim

To establish whether subjects considered to have substantial areas of salvageable brain based on age-adjusted clinical core mismatch who can undergo endovascular treatment within 6–24 h from time last seen well (TLSW) have better outcomes at three months compared to subjects treated with standard medical therapy alone. Age-adjusted clinical core mismatch is defined by age (≤80 or >80 years), baseline National Institutes of Health Stroke Scale (NIHSS) (10–20 or ≥21), and core size (0–20 cm3 in subjects older than 80 and, in subjects younger than 80, 0–30 cm3 with NIHSS 10–20 and 31–50 cm3 with NIHSS ≥21).

Design

Prospective, randomized, multicenter, Bayesian adaptive-enrichment, open label trial with blinded endpoint assessment. For the purpose of enrolment, ischemic core size will be evaluated by CT perfusion or magnetic resonance imaging-diffusion-weighted imaging measured by automated software (RAPID).

Procedures

Subjects with acute ischemic stroke due to computed tomography angiography- or magnetic resonance angiogram-proven arterial occlusion of the intracranial internal carotid and/or proximal middle cerebral artery (M1) with age-adjusted clinical core mismatch in whom treatment can be initiated between 6 and 24 h from TSLW are randomized in a 1:1 ratio to receive mechanical embolectomy with the Trevo device or medical management alone. Sequential interim analyses allowing adaptation of enrolment criteria or stopping new enrolment for futility or predicted success will occur in every 50 randomized patients starting at 150 to a maximum of 500 patients.

Study outcomes

The primary endpoint is the modified Rankin Scale score at 90 days. The primary safety outcome is stroke-related mortality at 90 days.

Analysis

The primary endpoint, expressed as a utility-weighted modified Rankin Scale score is analyzed using a Bayesian posterior probability with adjustment for ischemic core size. For regulatory reasons, a nested co-primary endpoint analysis was added consisting of the proportion of subjects with modified Rankin Scale 0–2 between the active and control groups also analyzed using a Bayesian model.
Reduced-order methodology for prediction of loads generated by a flexible flapping wing
Authors: Tran Jason , Gao Haotian , Sirohi Jayant , Wei Mingjun
Published: June 2017

This paper describes a methodology to predict the loads generated by a flexible flapping wing. The three-dimensional, whole field wing deformation was first measured using a non-contact optical technique. The measured deformation and motion were then input to a reduced-order model of the flapping wing to calculate the loads generated. Experiments were performed on a thin rectangular plate of 100 mm wing length flapping in air at a frequency of 15 Hz and stroke amplitude of 40°. The wing deformation as well as wing root loads were measured and showed good agreement with previously published data. A direct numerical simulation of the Navier–Stokes equation with exactly the same configuration, but at lower Reynolds number, provided full-field dataset for the development of data-driven reduced-order models. A modified proper orthogonal decomposition-Galerkin method, which includes extra terms to represent moving boundaries, was applied for reduced-order model development. It was found that the reduced-order model with only eight proper orthogonal decomposition modes was sufficient to show good correlation of loads with direct numerical simulations and experimentally measured trends.
Clinical Impact of Blood Glucose Monitoring Accuracy: An In-Silico Study
Authors: Campos-Náñez Enrique , Fortwaengler Kurt , Breton Marc D.
Published: June 2017

Background:

Patients with diabetes rely on blood glucose (BG) monitoring devices to manage their condition. As some self-monitoring devices are becoming more and more accurate, it becomes critical to understand the relationship between system accuracy and clinical outcomes, and the potential benefits of analytical accuracy.

Methods:

We conducted a 30-day in-silico study in type 1 diabetes mellitus (T1DM) patients using continuous subcutaneous insulin infusion (CSII) therapy and a variety of BG meters, using the FDA-approved University of Virginia (UVA)/Padova Type 1 Simulator. We used simulated meter models derived from the published characteristics of 43 commercial meters. By controlling random events in each parallel run, we isolated the differences in clinical performance that are directly associated with the meter characteristics.

Results:

A meter’s systematic bias has a significant and inverse effect on HbA1c ( P < .01), while also affecting the number of severe hypoglycemia events. On the other hand, error, defined as the fraction of measurements beyond 5% of the true value, is a predictor of severe hypoglycemia events ( P < .01), but in the absence of bias has a nonsignificant effect on average glycemia (HbA1c). Both bias and error have significant effects on total daily insulin (TDI) and the number of necessary glucose measurements per day ( P < .01). Furthermore, these relationships can be accurately modeled using linear regression on meter bias and error.

Conclusions:

Two components of meter accuracy, bias and error, clearly affect clinical outcomes. While error has little effect on HbA1c, it tends to increase episodes of severe hypoglycemia. Meter bias has significant effects on all considered metrics: a positive systemic bias will reduce HbA1c, but increase the number of severe hypoglycemia attacks, TDI use, and number of fingersticks per day.
Left main coronary artery compression by a dilated main pulmonary artery and left coronary sinus of Valsalva aneurysm in a patient with heritable pulmonary arterial hypertension and FLNA mutation
Authors: Hirashiki Akihiro , Adachi Shiro , Nakano Yoshihisa , Kamimura Yoshihiro , Ogo Takeshi , Nakanishi Norifumi , Morisaki Takayuki , Morisaki Hiroko , Shimizu Atsuya , Toba Kenji , Murohara Toyoaki , Kondo Takahisa
Published: June 2017

Left main coronary artery (LMCA) disease due to external compression by a dilated main pulmonary artery (MPA) is an uncommon clinical entity. Here, we describe a 52‐year‐old woman with pulmonary arterial hypertension (PAH) and anteroseptal old myocardial infarction (OMI). The cause of the OMI was external compression of the LMCA by the dilated MPA and aneurysm of the left coronary sinus of Valsalva. The patient’s sister (aged 56 years) had also been diagnosed with PAH and both women had a novel heterozygous splicing mutation, IVS2‐2A > G (c.374‐2A > G in NM_001456), in the filamin A (FLNA) gene. To our knowledge, this is the first report of HPAH which is likely to be due to FLNA mutation and compression of the LMCA between a dilated MPA and aneurysm of the left coronary sinus of Valsalva.
The negative predictive value of a negative repeat urinalysis in patients presenting with haematuria: A review of 1138 patients
Authors: Starmer Benjamin Zak , Singh Amal , Bromage Stephen
Published: June 2017

Objective:

Haematuria may be transient for a number of benign conditions, particularly a urinary-tract infection (UTI). We set out to determine if a negative repeat urinalysis at the time of urological assessment for patients with haematuria could predict negative investigations and whether investigations could be tailored by this test.

Methods:

This was a retrospective analysis of records for all patients attending a haematuria clinic between 16 September 2013 and 12 September 2014. This included patients with visible and non-visible (microscopic) haematuria.

Results:

There were 1138 patients, 599 with visible haematuria (VH) and 460 with non-visible haematuria (NVH). Seventy-two patients were excluded. A total of 546 patients had a positive repeat urinalysis for blood; 438 patients had a negative repeat urinalysis when tested at the haematuria clinic, 298/599 for VH and 140/460 NVH. For those who had negative repeat urinalysis, urothelial cancer was found in 15/298 VH and 1/140 NVH. The one patient with negative repeat urinalysis and NVH was found to have a grade 2 (high grade) bladder tumour. The negative predictive value for a negative repeat urinalysis in transient haematuria was 0.95 for VH and 0.99 for NVH. Twenty-nine patients with VH and repeat negative urinalysis on assessment had a positive urine culture suggesting a UTI as a cause. None of these patients was found to have urothelial cancer ( p = 0.0413).

Conclusion:

Patients who experience transient VH and subsequent repeat negative urinalysis in the absence of infection have a 5% chance of urothelial cancer and should still be investigated. For those with transient NVH, the probability of finding a urothelial cancer is <1%, although we did find a high-grade bladder tumour in this group. If patients have a positive urine culture and a negative repeat urinalysis following treatment, they could be spared haematuria investigations.
Affordable stroke therapy in high-, low- and middle-income countries: From Theradrive to Rehab CARES, a compact robot gym
Authors: Johnson Michelle Jillian , Rai Roshan , Barathi Sarath , Mendonca Rochelle , Bustamante-Valles Karla
Published: June 2017

Affordable technology-assisted stroke rehabilitation approaches can improve access to rehabilitation for low-resource environments characterized by the limited availability of rehabilitation experts and poor rehabilitation infrastructure. This paper describes the evolution of an approach to the implementation of affordable, technology-assisted stroke rehabilitation which relies on low-cost mechatronic/robot devices integrated with off-the-shelf or custom games. Important lessons learned from the evolution and use of Theradrive in the USA and in Mexico are briefly described. We present how a stronger and more compact version of the Theradrive is leveraged in the development of a new low-cost, all-in-one robot gym with four exercise stations for upper and lower limb therapy called Rehab Community-based Affordable Robot Exercise System (Rehab C.A.R.E.S). Three of the exercise stations are designed to accommodate versions of the 1 DOF haptic Theradrive with different custom handles or off-the-shelf commercial motion machine. The fourth station leverages a unique configuration of Wii-boards. Overall, results from testing versions of Theradrive in USA and Mexico in a robot gym suggest that the resulting presentation of the Rehab C.A.R.E.S robot gym can be deployed as an affordable computer/robot-assisted solution for stroke rehabilitation in developed and developing countries.
The development and testing of a modified natural rubber CR solid ankle–cushion heel prosthetic foot for developing countries
Authors: Sasaki Kazuhiko , Pinitlertsakun Jutamat , Rattanakoch Jutima , Sukthomya Sasithon , Guerra Gary , Latt Tuntun , De Silva Nirosha , Kanagarandnam Bamini , Suntharalingam Sharmila
Published: June 2017

Background

Durable and locally fabricated prosthetic feet are important for developing countries. Modifications to the current CR solid ankle–cushion heel prosthetic foot could enhance current foot characteristics and reduce costs. The goal of this project was to modify the keel and rubber outer foot shell to enhance features and reduce costs of the current CR solid ankle–cushion heel offering.

Methods

The prosthetic foot was designed, fabricated and then tested mechanically for strain and displacement in a cyclic testing machine according to a component of the ISO-10328 testing protocol. Dynamic cyclic testing of both forefoot and heel portions of the foot was conducted.

Findings

Dynamic mechanical cyclic testing of the forefoot and heel at 1.28 kN for two million cycles at a rate of 1 Hz was successfully achieved. The final cost of producing the foot was roughly $16 USD. Limitations include the inability to perform the full battery of ISO-10328 foot testing, UV testing and a limitation to laboratory testing. Clinical studies examining practical application of the modified foot should be conducted.