bluuebunny/crossref_metadata_2025 huggingface dataset:
Everyday Place Making Through Social Capital Among Street Vendors at Manek Chowk, Gujarat, India
Authors: P. Neethi , Kamath Anant , Paul Anjali M.
Published: February 2019

This is a novel interpretation of the dynamics of the historic market of Manek Chowk in Ahmedabad in Gujarat, India. Applying elements of spatial ethnographic methodology, we capture the processes, routines, and unique features of operation among the myriad actors operating here, and the frictionless multiple transformation of this traditional market within the course of a full day. These findings are viewed through the critical geography concept of place making, which is realized to be supported by the economic sociology concept of social capital. In this process of offering a fresh understanding, we examine the meanings that people here have attached to this locale, given their operation here for several decades and across generations. We realize that this traditional market with its characteristic dynamism is not just a commercial space but an entity intertwined with physical elements, activities, relationships, and constructed meanings. Hence, we offer a fresh interpretation of the character and vibrancy of Manek Chowk by understanding its continuing life and sustenance as a social capital–bolstered place-making process.
Vernacular Participatory Designs: The Do-It-Yourself (DIY) Housing Scene in South Korea
Authors: Yun Jieheerah
Published: February 2019

This article analyzes cases of do-it-yourself (DIY) homes in South Korea in terms of the role of architects in today’s information society. Some South Koreans have started to seek residential options that reflect their personal tastes and particularized lifestyles. With the development of digital technologies and widening access to computer programming tools, technology-savvy South Koreans have started to design and construct their own homes. This article explores the emerging DIY housing movement to see whether its participatory nature enhances individual agency and how the movement may influence the professional field of architecture. Contrary to the commonly held notion, this article concludes that the role of architects is unlikely to diminish in the context of a rising number of DIY homes. Although the possibility of neoliberal co-optation exists, the rise of DIY homes presents an opportunity for architects to play an enhanced role in promoting community empowerment.
Flipped learning, pedagogy and digital technology: Establishing consistent practice to optimise lesson time
Authors: Sargent Julia , Casey Ashley
Published: February 2019

Flipped learning (FL) is a pedagogical approach that has scarcely been examined in physical education (PE). As a result, we have little information regarding what PE teachers think of the approach, how they apply it, or what perceived value it has for their teaching. This research explores the reasons which two UK-based PE teachers gave for why and how they used FL to complement their use of digital technology (DigiTech). Their experiences and views are explored through a case study/appreciative inquiry approach. Data were generated from: (a) interviews with the teachers; (b) lesson observations and field notes and (c) document analysis, all of which were analysed using grounded theory. The findings showed that each teacher used FL and DigiTech in nuanced ways to support their teaching. Despite personal differences, FL was established by both teachers as a consistent routine of practice to support the use of DigiTech. The teachers’ rationales for using FL hinged on their belief that: (a) it optimised the lesson time in which students could be physically active and (b) it supported their examination PE students. Overall, the results indicated that, when used in conjunction with DigiTech, FL has the potential to pedagogically support teachers’ teaching of PE. This is particularly pertinent given the limited time allocated in the curriculum to PE (some of which is inevitably lost in the changing rooms) and the perceived need for students to be physically active in lessons.
Testing mechanisms in large-N realistic evaluations
Authors: Ravn Rasmus
Published: February 2019

The concept of generative mechanisms is central to the realistic evaluation approach. They are seen as the drivers of change. Qualitative evidence is especially well suited to unearthing how mechanisms work. However, when evaluating a large-N programme, a realist evaluation might benefit from quantitative tests of the mechanisms hypothesized in the programme theory. Despite this, quantitative tests of mechanisms are rarely applied in realistic evaluation. The purpose of this article is therefore to illustrate how widely used quantitative social science methods can be utilized to test mechanisms in realistic evaluation when evaluating large-N programmes. The proposed methods focus on intra-programme comparison based on the strength of a quantitatively measured mechanism. The article illustrates how simple statistical methods in the form of descriptive statistics and logistic regression can be used to test the influence of mechanisms in generating outcomes.
The empowered patient on a historical-rhetorical model: 19th-century patent-medicine ads and the 21st-century health subject
Authors: Segal Judy Z
Published: February 2019

The contemporary health subject, often described as a new, empowered patient, is not simply a character in a story of progress toward knowledge and power, away from credulity and passivity. Before the 20th century, and the assertion of a medical system that became frankly paternalistic, laypeople adjudicated on many matters of illness and its treatments. That is, 18th- and 19th-century health subjects were empowered too, and studying them, especially as consumers of health products, helps us develop a more nuanced account of our current medico-commercial selves. Comparing historical advertisements for “patent medicines” and contemporary direct-to-consumer ads for prescription pharmaceuticals, this essay contributes to such an account. It identifies strategies that drug marketers have deployed over centuries to persuade consumers to buy their products, and it tracks a rhetoric of interpellation in advertisements that not only address but also constitute health subjects. The goal of the analysis is to increase alertness to our own susceptibilities to pharmaceutical ads and adjacent rhetorics of health and illness.
Creating ‘automatic subjects’: Corporate wellness and self-tracking
Authors: Till Christopher
Published: February 2019

The use of self-tracking devices has increased dramatically in recent years with enthusiasm from the public as well as public health officers, healthcare providers and workplaces seeking to instigate behaviour change in populations. Analysis of the ontological principles informing the design and implementation of the Apple Watch and corporate wellness programmes using self-tracking technologies shows that their primary focus is on the capture and control of attention rather than material health outcomes. Health, wellness and happiness have been conflated with productivity, which is now deemed to be dependent on the harnessing of libidinal as well as physical energy. In this context, self-tracking technologies and related corporate wellness interventions have been informed by ‘emotional design’, neuroscientific and behavioural principles which target the ‘pre subjective’ consciousness of individuals through manipulating their habits and neurological functioning. This article draws on the work of Bernard Stiegler to suggest framing self-tracking as ‘industrial temporal objects’, which capture and ‘short circuit’ attention. It is proposed that a central aim is to ‘accumulate the consciousnesses’ of subjects consistent with the methods of a contemporary ‘attention economy’. This new logic of accumulation informs the behaviour change strategies of designers of self-tracking devices, and corporate wellness initiatives, taking the form of ‘psychotechnologies’ which attempt to reconstruct active subjects as automatic and reactive ‘nodes’ as part of managed networks.
Analysis of the rotor dynamics characteristics of multi-degree-of-freedom permanent magnet synchronous motor
Authors: Li Zheng , Chen Qiushuo , Yue Feihong , Wang Qunjing
Published: February 2019

The spherical shell rotor is contained in the multi-degree-of-freedom permanent magnet synchronous motor. When the rated speed of motor is close to the critical speed, the motor will generate multiple resonances, which will affect the normal operation of the motor. The motor rotor must pass through the first-order critical speed and work at the safety range between 1-order and 2-order critical speed. According to the dynamic characteristics of rotor system, a mathematical model of rotor under free state is established, and the result between finite element and analytical methods is comparison. The influence of rotor gyroscope effect on critical speed is analyzed, and the finite element analysis of whether the rigidity of rotor material affects the critical speed is also carried out. The relationship between bending modal and deformation displacement is tested under different rigidity conditions and the stator deformation caused by rotor rotation is analyzed when the stator is filled with different liquids. The relationship between the rotational speed and the amplitude of the spherical rotor is verified by experiments, and the corresponding rules are summarized. The results of the simulation and analysis are referenced by the optimal design of motor.
China’s social credit systems and public opinion: Explaining high levels of approval
Authors: Kostka Genia
Published: February 2019

A variety of commercial and local government social credit systems (SCSs) are now being implemented in China in order to steer the behavior of Chinese individuals, businesses, social organizations, and government agencies. Previous research finds that these SCSs are employed by the Chinese state as “surveillance infrastructure” and for social management. This article focuses on a different angle: the public’s opinion of SCSs. Based on a cross-regional survey, the study finds a surprisingly high degree of approval of SCSs across respondent groups. Interestingly, more socially advantaged citizens (wealthier, better-educated, and urban residents) show the strongest approval of SCSs, along with older people. While one might expect such knowledgeable citizens to be most concerned about the privacy implications of SCS, they instead appear to embrace SCSs because they interpret it through frames of benefit-generation and promoting honest dealings in society and the economy instead of privacy-violation.
The aging physician: A practical approach to protect our patients
Authors: Fortunato John T , Menkes Daniel Londyn
Published: February 2019

As the median age of practicing physicians increases, ethical dilemmas due to age-related cognitive decline among clinicians will become ever more pressing. Compelling data show that despite acknowledgement of their duty to protect the public, physicians often fail to report themselves, their colleagues, or their physician-patients when cognitive decline appears to impact medical practice adversely. As such, efforts to educate physicians about ethical obligations and various tactful methodologies to report themselves or others seem ineffective. Illustrated by a case report of age-related cognitive decline in a practicing physician, practical recommendations are made both to develop and validate cognitive screening in middle-aged physicians, presumably before the onset of age-related cognitive decline.
Combination of Astragali Polysaccharide and Curcumin Improves the Morphological Structure of Tumor Vessels and Induces Tumor Vascular Normalization to Inhibit the Growth of Hepatocellular Carcinoma
Authors: Tang Decai , Zhang Shuo , Shi Xiaoxia , Wu Jiafei , Yin Gang , Tan Xiying , Liu Fuyan , Wu Xingdong , Du Xiangyu
Published: February 2019

Normalizing the disordered tumor vasculature, rather than blocking it, is a novel method for anticancer therapy. Astragali polysaccharide (APS) and curcumin were reported to be active against carcinomas. However, the effect and mechanism of the combination of APS and curcumin on vascular normalization in hepatocellular carcinoma (HCC) was not clear. In the present study, effects of combined APS and curcumin on tumor vascular normalization were evaluated in HepG2 tumor-bearing mice. Photoacoustic tomography (PAT) was performed to observe the morphological structure of tumor vessels in vivo. The microstructure of the tumor vessels was also analyzed through scanning electron microscopy. Additionally, the expression of CD31 and NG2 was analyzed by immunohistochemical staining. Tumor vessels of HepG2 tumor-bearing mice treated with the combination were sparse with uniform growth, morphology rules, and complete vascular walls, which had fewer branches and sprouts. ECs of tumor vessels were arranged regularly and were tightly connected, tending toward normalization. The expression of CD31 was reduced while NG2 was increased significantly by the combination of APS and curcumin. The results indicated that APS and curcumin in combination showed a better effect on inhibiting tumor growth in an orthotopic nude-mouse model of HCC. More important, the combination induced normalization of tumor vascular better than APS or curcumin administration alone, improving the morphological structure of tumor vessels and promoting maturation of tumor vessels. The results of the present study provided a reasonable possibility for combination therapy of APS and curcumin in the treatment of HCC via tumor vascular normalization.
A mole rat’s gut microbiota suggests selective influence of diet on microbial niche space and evolution
Authors: Ren Linda , Holzknecht Robert A , Holzknecht Zoie E , Kotzé Sanet H , Bowles Dawn E , Lin Shu S , McKenney Erin A , Parker William
Published: February 2019

The coevolution of mammals with their gut microbiota is heavily influenced by diet. Here we investigate the evolution of the gut microbiota in an African mole rat, which has a highly fibrous diet that includes underground storage organs of plants. For this purpose, microbial DNA was isolated from the digesta of a Cape dune mole rat gut, and 23 of 62 partial length 16S rRNA sequences were chosen for full length sequence determination. In addition, V4 regions of 16S rRNA were sequenced using Illumina technology. These sequences were then compared to previously identified sequences in the NCBI and Greengenes databases. Treponeme-related sequences within the mole rat showed evidence of a substantial adaptive radiation, with considerable diversity found within the mole rat (81% minimum sequence identity) as well as substantial divergence (87.3% average sequence identity to nearest neighbor) from previously identified organisms. It also appears likely that Desulfovibrio and several other bacterial clades, but not Clostridia-related organisms, have undergone substantial evolutionary changes during the evolution of mole rats and their ancestors. These findings support the intuitive view that some enteric bacteria can be described as “housekeeping,” with a niche defined by the host gut largely independent of diet. This diet-independent niche space and the microbes occupying it appear to be stable despite substantial alteration of diet-dependent niches and adaptive radiation of microbes occupying those niches.

Impact statement

The composition of the microbiota is of critical importance for health and disease, and is receiving increased scientific and medical scrutiny. Of particular interest is the role of changing diets as a function of agriculture and, perhaps to an even greater extent, modern food processing. To probe the connection between diet and the gut’s microbial community, the microbiota from a mole rat, a rodent with a relatively unusual diet, was analyzed in detail, and the microbes found were compared with previously identified organisms. The results show evidence of an adaptive radiation of some microbial clades, but relative stability in others. This suggests that the microbiota, like the genome, carries with it housekeeping components as well as other components which can evolve rapidly when the environment changes. This study provides a very broad view of the niche space in the gut and how factors such as diet might influence that niche space.
A Matter of Genes: The Hurdles of Gene Therapy for Epilepsy
Authors: Ingusci Selene , Cattaneo Stefano , Verlengia Gianluca , Zucchini Silvia , Simonato Michele
Published: February 2019

Gene therapy has recently advanced to the level of standard of care for several diseases. However, its application to neurological disorders is still in the experimental phase. In this review, we discuss recent advancements in the field that provide optimism on the possibility to have first-in-human studies for gene therapy of some forms of epilepsy in the not so distant future.
The Ontology of Gameplay: Toward a New Theory
Authors: Juel Larsen Lasse , Kampmann Walther Bo
Published: February 2019

The goal of the article is to present a new theory of the concept of gameplay, a term everybody uses without ample definitions and with little consistency. The aim is to provide an understanding of gameplay outlining the inherent complexities and convoluted layers of play and game which exist in the playing of a game. The theory is inspired by phenomenology and Martin Heidegger’s concept of Dasein. We do not intent to resolve the paradox that games are both objects and activities. Instead, we offer an analytical and methodological guide to the ontology of gameplay resting on an oscillating relationship between a double-layered structure of “here” and “there” in playing and gaming.
A dynamic estimation method for aircraft emergency evacuation based on cellular automata
Authors: Zhang Yugang , Yang Zhaohui , Sun Zhongchao
Published: February 2019

To reduce the time of aircraft passenger evacuation in an unplanned emergency and improve passenger safety, this article proposed a dynamic estimation method of an aircraft emergency evacuation process; optimal performance statistics can be estimated eﬃciently. Then, the emergency guiding model is established based on the cellular automata theory. In this model, multiple factors are considered, such as seat pitch, exit width, and occupant behavior. A total of six categories (target exit choice, movement direction selection, movement speed calculation, behavior representation, crew operation, and exit modeling) and 24 evacuation regulations are included. Two kinds of civil aircraft with 90 seats and 149 seats were tested individually using the proposed model and a traditional model. The total evacuation time can be reduced by more than 5%, and optimal performance statistics can be reduced by more than 30%. The results indicate that with this model, more lives can be saved in the case of an emergency.
The effect of positive parenting program on mental health in mothers of children with intellectual disability
Authors: Ashori Mohammad , Norouzi Ghasem , Jalil-Abkenar Seyyedeh Somayyeh
Published: February 2019

The aim of this research was to examine the effectiveness of positive parenting program (Triple-P) on the mental health of mothers of children with intellectual disability (ID). This study was a quasi-experimental research with pretest, posttest design, and a control group. Thirty-six mothers of students with ID participated in this study and were divided into two groups (intervention group and control group). Each group consisted of 18 participants. The intervention group received a parent training program during 12 sessions, each session lasting for 80 min, while the control group did not receive any special training. Multivariate analysis of covariance test was applied to analyze the obtained data using SPSS software. The results of this study indicated that Triple-P had significant effect on the somatic symptoms, anxiety, depression, social dysfunction, and mental health of mothers of children with ID. As a result, this research emphasized that parenting skills training will improve the mental health of mothers of children with ID, and therefore, planning for Triple-P training is of particular importance.
Valence, arousal, and dominance ratings for facial stimuli
Authors: Sutton Tina M , Herbert Andrew M , Clark Dailyn Q
Published: February 2019

A total of 1,363 images from seven sets of facial stimuli were normed using the self-assessment manikin procedure. Each participant provided valence, arousal, and dominance ratings for 120-130 faces displaying various emotional expressions (e.g., happiness, sadness). The current work provides a large database of normed ratings for facial stimuli that complements the existing International Affective Picture System and the Affective Norms for English Words that were developed to provide a normative set of emotional ratings for photographs and words, respectively. This new database will increase experimental control in studies examining the perception, processing, and identification of emotional faces.
The effect of cerebellar transcranial direct current stimulation to improve standing balance performance early post-stroke, study protocol of a randomized controlled trial
Authors: Zandvliet Sarah B , Meskers Carel GM , Nijland Rinske HM , Daffertshofer Andreas , Kwakkel Gert , van Wegen Erwin EH
Published: February 2019

Rationale

Restoration of adequate standing balance after stroke is of major importance for functional recovery. POstural feedback ThErapy combined with Non-invasive TranscranIAL direct current stimulation (tDCS) in patients with stroke (POTENTIAL) aims to establish if cerebellar tDCS has added value in improving standing balance performance early post-stroke.

Methods

Forty-six patients with a first-ever ischemic stroke will be enrolled in this double-blind controlled trial within five weeks post-stroke. All patients will receive 15 sessions of virtual reality-based postural feedback training (VR-PFT) in addition to usual care. VR-PFT will be given five days per week for 1 h, starting within five weeks post-stroke. During VR-PFT, 23 patients will receive 25 min of cerebellar anodal tDCS (cb_tDCS), and 23 patients will receive sham stimulation.

Study outcome

Clinical, posturographic, and neurophysiological measurements will be performed at baseline, directly post-intervention, two weeks post-intervention and at 15 weeks post-stroke. The primary outcome measure will be the Berg Balance Scale (BBS) for which a clinical meaningful difference of six points needs to be established between the intervention and control group at 15 weeks post-stroke.

Discussion

POTENTIAL will be the first proof-of-concept randomized controlled trial to assess the effects of VR-PFT combined with cerebellar tDCS in terms of standing balance performance in patients early post-stroke. Due to the combined clinical, posturographical and neurophysiological measurements, this trial may give more insights in underlying post-stroke recovery processes and whether these can be influenced by tDCS.
Cost-utility analysis of mechanical thrombectomy between 6 and 24 hours in acute ischemic stroke
Authors: Pizzo Elena , Dumba Maureen , Lobotesis Kyriakos
Published: February 2019

Background

Recently, two randomized controlled trials demonstrated the benefit of mechanical thrombectomy performed between 6 and 24 h in acute ischemic stroke. The current economic evidence is supporting the intervention only within 6 h, but extended thrombectomy treatment times may result in better long-term outcomes for a larger cohort of patients.

Aims

We compared the cost-utility of mechanical thrombectomy in addition to medical treatment versus medical treatment alone performed beyond 6 h from stroke onset in the UK National Health Service (NHS).

Methods

A cost-utility analysis of mechanical thrombectomy compared to medical treatment was performed using a Markov model that estimates expected costs and quality-adjusted life years (QALYs) over a 20-year time horizon. We present the results of three models using the data from the DEFUSE 3 and DAWN trials and evidence from published sources.

Results

Over a 20-year period, the incremental cost per QALY of mechanical thrombectomy was $1564 (£1219) when performed after 12 h from onset, $5253 (£4096) after 16 h and $3712 (£2894) after 24 h. The probabilistic sensitivity analysis demonstrated that thrombectomy had a 99.9% probability of being cost-effective at the minimum willingness to pay for a QALY commonly used in the UK.

Conclusions

The results of this study demonstrate that performing mechanical thrombectomy up to 24 h from acute ischemic stroke symptom onset is still cost-effective, suggesting that this intervention should be implemented by the NHS on the basis of improvement in quality of life as well as economic grounds.
Cerebral microbleeds: Beyond the macroscope
Authors: Pétrault Maud , Casolla Barbara , Ouk Thavarak , Cordonnier Charlotte , Bérézowski Vincent
Published: February 2019

While being increasingly recognized in clinical routine, brain microbleeds remain a puzzling finding for physicians. These small dot-like lesions are thought to be old perivascular collections of hemosiderin deposits. They can be found in different neurological settings such as cerebrovascular or neurodegenerative diseases. While their microscopic size would suggest considering these lesions as anecdotal, they are now regarded as biomarkers of severity of an underlying cerebrovascular disease. Their natural history and the interactions with surrounding brain cells remain unknown. However, their presence may impact therapeutic decisions. Deciphering the biological mechanisms leading to, or following microbleeds would enable us to address a key question: do microbleeds arise and impact the surrounding parenchyma like a miniature version of intracerebral hemorrhages or do they represent a different kind of injury? We hereby discuss, based on both clinical and experimental literature, the gap between the definition of microbleeds coming from neuroimaging and the pathophysiological hypotheses raised from histopathological and experimental data. Our analysis supports the need for a convergent effort from clinicians and basic scientists to go beyond the current “macro” view and disclose the cellular and molecular insights of these cerebral hemorrhagic microlesions.
The Democratic People’s Republic of Korea, Procedural Rhetoric and the Military-Entertainment Complex: Two Case Studies from the War on Terror
Authors: Spokes Matthew
Published: February 2019

This article explores how the Democratic People’s Republic of North Korea is represented in video games developed and played during the height of the War on Terror. Drawing on Šisler’s article, ‘Digital Arabs: Representation in video games’ (2008) and Robinson’s articles ‘Videogames, persuasion and the War on Terror: Escaping or embedding the military-entertainment complex? (2012) and ‘Have you won the war on terror? Military videogames and the state of American exceptionalism’ (2015), this article explores two case studies Tom Clancy’s Splinter Cell: Chaos Theory (2005) and Tom Clancy’s Ghost Recon 2 (2004) using Bogost’s (2008, 2010) concept of ‘procedural rhetoric’ to unpack and detail the visual signifiers and gameplay mechanics of these titles in comparison with other work on games set in ‘Axis of Evil’ countries. The article concludes by situating the games within the military-entertainment complex more broadly (here focusing on film), arguing that North Korea is ultimately framed paradoxically in video games, a country that is viewed on the one hand as a threat to world peace and on the other as an absurdist dictatorship.
Interventions for Postsecondary Success for Low-Income and High-Potential Students: A Systematic Review
Authors: Renbarger Rachel , Long Kody
Published: February 2019

Research indicates that high-potential students from low-income backgrounds have decreased educational attainment and success in college compared with their higher income peers. The purpose of this review is to synthesize the interventions that support postsecondary success for this group. Using a systematic review protocol, we identified five categories of support for these students: a summer intervention, advanced coursework, financial aid, college information, and a program that provides year-round supports. Findings suggest these programs differentially help certain groups, but can provide support in accessing college, persisting and attaining degrees, and helping with noncognitive supports such as peer support.
Impact of Human Factors Testing on Medical Device Design: Validation of an Automated CGM Sensor Applicator
Authors: North Robert , Pospisil Christine , Clukey Ryan J. , Parkin Christopher G.
Published: February 2019

Improving user engagement with continuous glucose monitoring (CGM) is considered a major requirement for achieving optimal treatment efficacy. Human factors testing is needed to ensure that CGM product designs and requisite training simplify the user experience and enhance usability and patient safety. Dexcom, Inc, recently introduced a novel, “one-button” automatic sensor applicator (ASA) for use with the Dexcom G6 (rtCGM) system. The device was developed utilizing all phases of the human factors testing process. We recruited eight certified diabetes educators from independent health care institutions to conduct a comparative ease-of-use analysis to confirm the usability of the ASA. Participants judged the instructions and device to be easier to use than the previous sensor applicator.
Spontaneous cholecystopleural fistula leading to biliothorax and sepsis in a cat
Authors: VanDeventer Gretchen M , Cuq Benoît Y
Published: February 2019

Case summary

A 13-year-old spayed female domestic shorthair cat presented with pleural effusion and suspected triaditis. Intake vitals and leukocytosis were consistent with a diagnosis of systemic inflammatory response syndrome. Biochemical analysis confirmed a pleural fluid-to-serum bile ratio consistent with a diagnosis of biliothorax. Abdominal ultrasound failed to identify a definitive gall bladder but noted a hypoechoic tubular structure ventral to the liver and contacting the diaphragm. Thoracic ultrasound identified a hyperechoic structure contacting the diaphragm at the same location. Thoracoabdominal CT scan identified a fluid-dense tubular structure extending from ventral to the liver, through a diaphragmatic defect and directly communicating with the pleural space, suspected to be an abnormal gall bladder. The cat was humanely euthanized, and post-mortem analysis confirmed a cholecystopleural fistula arising from the gall bladder with multifocal abscesses, mixed inflammatory hepatic infiltrates and small-cell gastrointestinal lymphoma. Culture of the abscess isolated Parabacteroides merdae, meeting the reported feline criteria for sepsis.

Relevance and novel information

To our knowledge, spontaneous cholecystopleural fistula formation leading to biliothorax and sepsis has not been previously reported in the cat. This case highlights a novel sequela of gall bladder disease in this species, and biliothorax should be a differential diagnosis for pleural effusion in cats with evidence of cholecystitis or triaditis.
Effect of Noise Reduction Gain Errors on Simulated Cochlear Implant Speech Intelligibility
Authors: Kressner Abigail A. , May Tobias , Dau Torsten
Published: February 2019

It has been suggested that the most important factor for obtaining high speech intelligibility in noise with cochlear implant (CI) recipients is to preserve the low-frequency amplitude modulations of speech across time and frequency by, for example, minimizing the amount of noise in the gaps between speech segments. In contrast, it has also been argued that the transient parts of the speech signal, such as speech onsets, provide the most important information for speech intelligibility. The present study investigated the relative impact of these two factors on the potential benefit of noise reduction for CI recipients by systematically introducing noise estimation errors within speech segments, speech gaps, and the transitions between them. The introduction of these noise estimation errors directly induces errors in the noise reduction gains within each of these regions. Speech intelligibility in both stationary and modulated noise was then measured using a CI simulation tested on normal-hearing listeners. The results suggest that minimizing noise in the speech gaps can improve intelligibility, at least in modulated noise. However, significantly larger improvements were obtained when both the noise in the gaps was minimized and the speech transients were preserved. These results imply that the ability to identify the boundaries between speech segments and speech gaps may be one of the most important factors for a noise reduction algorithm because knowing the boundaries makes it possible to minimize the noise in the gaps as well as enhance the low-frequency amplitude modulations of the speech.
Health-Related Quality of Life and Self-Care Management Among People With Diabetic Foot Ulcers in Northern Thailand
Authors: Khunkaew Saneh , Fernandez Ritin , Sim Jenny
Published: February 2019

Diabetic foot ulcers (DFUs) are a common complication of diabetes that impacts on the health-related quality of life (HRQOL). Foot care is an important factor in the self-care management of patients with DFUs. The objective of this study was to investigate the HRQOL and foot care management of people with DFUs. A cross-sectional study involving 41 people with DFUs was conducted at a large tertiary hospital in Northern Thailand. The Diabetic Foot Ulcer Scale-Short Form and the VA-Diabetes Foot Care Survey were used to assess the HRQOL and foot care management among people with DFUs. The majority of the participants were female ( n = 24, 58.5%), and the mean age was 62.13 years. The scores for HRQOL in the six domains were as follows: leisure (66.95 ± 28.03), physical health (68.93 ± 28.51), dependence or daily life (80.08 ± 25.23), negative emotions (71.23 ± 29.48), worried about ulcers (62.20 ± 31.97), and bothered by ulcer care (69.36 ± 25.20). High scores indicate a high (good) HRQOL. Less than a third of the participants reported that they had received education about foot care management. Almost all participants reported that they washed their feet daily; however, a large proportion did not test the water temperature or use lubricants on their feet. Most of the participants did not have a mirror for checking under their feet (48.8%), and there was a lack of knowledge about how to use a mirror for foot inspections (51.2%). This study provides guidance for clinicians on the content and delivery of diabetes education programs for people with diabetes (and DFUs) in Northern Thailand. The findings provide guidance on existing knowledge and the need for programs to address barriers to foot self-care management both in terms of skills and attitudes.
A Cross-Sectional Study of Perceived Stress, Mindfulness, Emotional Self-Regulation, and Self-Care Habits in Registered Nurses at a Tertiary Care Medical Center
Authors: Vivian Elaina , Oduor Hellen , Arceneaux Sharina R. , Flores Jasmine A. , Vo Allison , Madson Madden Barbara
Published: February 2019

Introduction

Workplace stress and burnout may influence nurses’ physical and emotional well-being, which can impact the quality of care patients receive and their overall satisfaction with their hospitalization.

Objectives

The objectives of the study were to evaluate whether there are significant statistical relationships between nurses’ perceived stress, frequency of stressors, mindfulness, emotional self-regulation, self-care habits, and patient satisfaction scores.

Methods

The study took place over the course of 4 weeks. In this study, 340 nurse participants were surveyed using cross-sectional voluntary sampling design. The survey included previously developed and validated instruments. SAS v. 9.4 was used for statistical analysis.

Results

Significant differences were noted in average patient satisfaction scores by perceived stress; major nursing units in the Death and Dying, Conflict with Physicians, Lack of Support, and Work Load subscales of the Nursing Stress Scale; and major nursing units and dispositional mindfulness.

Conclusions

Hospital administrators can use this information in their organizations and set priorities and tailor mindfulness-based stress-reduction interventions for nursing professionals.
Evaluating and characterizing urban vibrancy using spatial big data: Shanghai as a case study
Authors: Huang Bo , Zhou Yulun , Li Zhigang , Song Yimeng , Cai Jixuan , Tu Wei
Published: February 2019

Although people may recognize urban vibrancy when they see or sense it, developing direct and comprehensive measures of urban vibrancy remains a challenge. In the context of intense global competition, there is an increased realization that urban vibrancy is vital to the social and economic sustainability of cities. Such vibrancy may be significantly shaped by the urban built environment, yet we know little about the close connections between vibrancy and urban built environments. Empowered by newly available sources of spatial big data, which provide enormous amounts of information on both human dynamics and the built environment, this paper proposes a framework for evaluating and characterizing urban vibrancy. Thus far, vibrancy measures have mostly used single-source data that hardly reflect the multifaceted manifestations of urban vibrancy. Therefore, we propose a more comprehensive measure of urban vibrancy, extracted as the common latent factor from multiple surface attributes. Using the proposed framework, we evaluated and mapped the spatial dynamics of vibrancy in Shanghai, a typical large city in post-reform China, and investigated the associations between vibrancy and various urban built environment indicators. The evidence shows that the horizontal built-up density, rather than vertical height, is the leading generator of vibrancy in Shanghai, followed by the density and mixture of urban functions, accessibility, and walkability. In this vein, we contribute to current debates and future planning practices regarding vibrant spaces in large cities. This proposed evaluation framework, equipped with spatial big data, can benefit future urban studies.
The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis
Authors: Matthews Barry G. , Hurn Sheree E. , Harding Michael P. , Henry Rachel A. , Ware Robert S.
Published: February 2019

Background

Morton's neuroma (MN) is a compressive neuropathy of the common plantar digital nerve. It is a common compressive neuropathy often causing significant pain which limits footwear choices and weight bearing activities. This paper aims to review non‐surgical interventions for MN, to evaluate the evidence base for the clinical management of MN.

Methods

Electronic biomedical databases (CINAHL, EMBASE, MEDLINE and Cochrane) were searched to January 2018 for studies evaluating the effectiveness of non‐surgical interventions for Morton's neuroma. Outcome measures of interest were treatment success rate (SR) (binary) and pain as measured using 100‐point visual analogue scale (VAS) (continuous). Studies with and without control groups were included and were evaluated for methodological quality using the Downs and Black Quality Index. Results from randomised controlled trials (RCT) were compared between‐groups, and case series were compared pre‐ versus post‐treatment. Effect estimates are presented as odds ratios (OR) for binary data or mean differences (MD) for continuous data. Random effects models were used to pool effect estimates across studies where similar treatments were used. Heterogeneity was assessed using the I2 statistic.

Results

A total of 25 studies met the inclusion criteria, seven RCTs and 18 pre/post case series. Eight different interventions were identified, with corticosteroid or sclerosing injections being the most often reported (seven studies each). Results from a meta‐analysis of two RCTs found corticosteroid injection decreased pain more than control on VAS (WMD: ‐5.3, 95%CI: ‐7.5 to − 3.2). Other RCTs reported efficacy of: manipulation/mobilisation versus control (MD: ‐15.3, 95%CI: ‐29.6 to − 1.0); extracorporeal shockwave therapy versus control (MD: ‐5.9, 95%CI: ‐21.9 to 10.1). Treatment success was assessed for extracorporeal shockwave therapy versus control (OR: 0.3, 95%CI: 0.0 to 7.1); and corticosteroid injection vs footwear/padding (OR: 6.0, 95%CI: 1.9 to 19.2). Sclerosing and Botox injections, radiofrequency ablation and cryoneurolysis have been investigated by case series studies, however these were of limited methodological quality.

Conclusions

Corticosteroid injections and manipulation/mobilisation are the two interventions with the strongest evidence for pain reduction, however high‐quality evidence for a gold standard intervention was not found. Although the evidence base is expanding, further high quality RCTs are needed.
Scale effects of velocity dispersion and attenuation (Q−1) in layered viscoelastic medium
Authors: Das Vishal , Mukerji Tapan , Mavko Gary
Published: February 2019

We have used numerical modeling of normal incidence P-waves in periodic and nonperiodic viscoelastic layered media to help improve understanding of the scale effects of heterogeneity on velocity dispersion and attenuation. The improved understanding of these effects facilitates better interpretation and integration of data acquired at different scales, such as seismic data, well-log data, and laboratory measurements. We developed a direct method for estimating velocity and attenuation for viscoelastic media, the viscoelastic Kennett-Frazer (vKF) method, which is an invariant imbedding (reflectivity) method that uses reflection and transmission transfer functions. The vKF method is used to estimate rigorous dispersion and attenuation curves for periodic and nonperiodic cases. The results from our studies validate and quantify the intuitive qualitative understanding that dispersion and attenuation for a layered viscoelastic medium depend on the ratio of wavelength of the waves ([Formula: see text]) and the spatial period of the medium ([Formula: see text]), similar to the elastic case. We also decoupled the total effective attenuation obtained from the viscoelastic case into scattering attenuation that can be modeled from the elastic case and the intrinsic effective attenuation that is present in addition to the scattering attenuation in the viscoelastic case. The calculated intrinsic effective attenuation curves matched the theoretical values at the ray theory and effective medium theory limits. We derived analytical expressions for the long-wavelength limit of velocity and attenuation in a viscoelastic medium. Our expressions can be used directly for the upscaling of well logs to seismic scale considering viscoelastic effects. The expressions indicate the coupling between effective velocity and effective intrinsic attenuation in the long-wavelength limit. Finally, we use the derived expressions to determine the difference between elastic versus viscoelastic upscaling and to highlight the impact on traveltime and amplitude by properly considering viscoelastic information, especially for quantitative seismic interpretation workflows.
The CORE service improvement programme for mental health crisis resolution teams: results from a cluster-randomised trial
Authors: Lloyd-Evans Brynmor , Osborn David , Marston Louise , Lamb Danielle , Ambler Gareth , Hunter Rachael , Mason Oliver , Sullivan Sarah , Henderson Claire , Onyett Steve , Johnston Elaine , Morant Nicola , Nolan Fiona , Kelly Kathleen , Christoforou Marina , Fullarton Kate , Forsyth Rebecca , Davidson Mike , Piotrowski Jonathan , Mundy Edward , Bond Gary , Johnson Sonia
Published: February 2019

Background

Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care.

Aims

To evaluate a 1-year programme to improve CRTs’ model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research programme, trial registration number: ISRCTN47185233).

Method

Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated.

Results

All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI −1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes.

Conclusions

The CRT service improvement programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.
Acute Lymphoblastic Leukemia in the Older Adult
Authors: Aldoss Ibrahim , Forman Stephen J. , Pullarkat Vinod
Published: February 2019

Acute lymphoblastic leukemia (ALL) in older adults presents a real challenge as a result of adverse disease biology and comorbidities that preclude delivering curative regimens. Conventional chemotherapy approaches have generally yielded unsatisfactory results in older patients with ALL as a result of excessive induction mortality, chemotherapy resistance of the leukemia, and the need to omit or dose reduce key drugs during the course of therapy because of adverse effects. Philadelphia chromosome–positive ALL represents about a quarter of newly diagnosed older adults, and the striking single-agent activity and excellent safety profile of tyrosine kinase inhibitors has allowed incorporation of these agents into therapy, significantly improving the outcome of older adults with Philadelphia chromosome–positive ALL. Allogeneic hematopoietic cell transplantation using reduced-intensity conditioning is a potentially curative approach in the older adult with ALL, and ironically, it may be better tolerated than intensive combination chemotherapy in a subset of older patients with ALL. Immunotherapies such as chimeric antigen receptor–modified T-cells, the bispecific T-cell–engaging antibody targeting CD19 (blinatumomab), and the antibody-drug conjugate targeting CD22 (inotuzumab) have shown safety and exceptional activity even in advanced ALL, and the efficacy of these agents has been observed irrespective of patient age. Several promising studies tailored specifically toward older adults with ALL are ongoing, with the majority of them incorporating novel immunotherapies, targeted therapies, or third-generation tyrosine kinase inhibitors into the front-line treatment regimen.