bluuebunny/crossref_metadata_2025 huggingface dataset:
Trauma as counter-revolutionary colonisation: Narratives from (post)revolutionary Egypt
Authors: Matthies-Boon Vivienne , Head Naomi
Published: December 2017

We argue that multiple levels of trauma were present in Egypt before, during and after the 2011 revolution. Individual, social and political trauma constitute a triangle of traumatisation which was strategically employed by the Egyptian counter-revolutionary forces – primarily the army and the leadership of the Muslim Brotherhood – to maintain their political and economic power over and above the social, economic and political interests of others. Through the destruction of physical bodies, the fragmentation and polarisation of social relations and the violent closure of the newly emerged political public sphere, these actors actively repressed the potential for creative and revolutionary transformation. To better understand this multi-layered notion of trauma, we turn to Habermas’ ‘colonisation of the lifeworld’ thesis which offers a critical lens through which to examine the wider political and economic structures and context in which trauma occurred as well as its effects on the personal, social and political realms. In doing so, we develop a novel conception of trauma that acknowledges individual, social and political dimensions. We apply this conceptual framing to empirical narratives of trauma in Egypt’s pre- and post-revolutionary phases, thus both developing a non-Western application of Habermas’ framework and revealing ethnographic accounts of the revolution by activists in Cairo.
Response of a swirl flame to inertial waves
Authors: Albayrak Alp , Bezgin Deniz A , Polifke Wolfgang
Published: December 2017

Acoustic waves passing through a swirler generate inertial waves in rotating flow. In the present study, the response of a premixed flame to an inertial wave is scrutinized, with emphasis on the fundamental fluid-dynamic and flame-kinematic interaction mechanism. The analysis relies on linearized reactive flow equations, with a two-part solution strategy implemented in a finite element framework: Firstly, the steady state, low-Mach number, Navier–Stokes equations with Arrhenius type one-step reaction mechanism are solved by Newton’s method. The flame impulse response is then computed by transient solution of the analytically linearized reactive flow equations in the time domain, with mean flow quantities provided by the steady-state solution. The corresponding flame transfer function is retrieved by fitting a finite impulse response model. This approach is validated against experiments for a perfectly premixed, lean, methane-air Bunsen flame, and then applied to a laminar swirling flame. This academic case serves to investigate in a generic manner the impact of an inertial wave on the flame response. The structure of the inertial wave is characterized by modal decomposition. It is shown that axial and radial velocity fluctuations related to the eigenmodes of the inertial wave dominate the flame front modulations. The dispersive nature of the eigenmodes plays an important role in the flame response.
Should preoperative showering or cleansing with chlorhexidine gluconate (CHG) be part of the surgical care bundle to prevent surgical site infection?
Authors: Edmiston Charles E , Leaper David
Published: December 2017

Showering preoperatively with chlorhexidine gluconate is an issue that continues to promote debate; however, many studies demonstrate evidence of surgical site infection risk reduction. Methodological issues have been present in many of the studies used to compile guidelines and there has been a lack of standardisation of processes for application of the active agents in papers pre-2009. This review and commentary paper highlights the potential for enhancing compliance with this low-risk and low-cost intervention and provides some guidance for enhancing implementation of preoperative showering with both chlorhexidine in solution and impregnated wipes.
Implementing the Aseptic Non Touch Technique (ANTT®) clinical practice framework for aseptic technique: a pragmatic evaluation using a mixed methods approach in two London hospitals
Authors: Clare Simon , Rowley Stephen
Published: December 2017

Background:

Aseptic technique is an important infection prevention competency for protecting patients from healthcare-associated infection (HAI). Healthcare providers using the Aseptic Non Touch Technique (ANTT®) aseptic technique have demonstrated reduced variability and improved compliance with aseptic technique.

Objectives:

The primary aim of this study is to determine whether standardizing aseptic technique for invasive IV procedures, using the ANTT® - Clinical Practice Framework (CPF), increases staff compliance with the infection prevention actions designed to achieve a safe and effective aseptic technique, and whether this is sustainable over time.

Methods:

A pragmatic evaluation using a mixed-methods approach consisting of an observational audit of practice, a self-report survey and structured interviews with key stakeholders. Compliance with aseptic technique before and after the implementation of ANTT® was measured by observation of 49 registered healthcare professionals.

Results:

Mean compliance with competencies was 94%; each component of practice was improved over baseline: hand hygiene = 63% ( P ≤ 0.001); glove use = 14% ( P ≤ 0.037); Key-Part protection = 54% ( P ≤ 0.001); a non-touch technique = 45% ( P ≤ 0.001); Key-Part cleaning = 82% ( P ≤ 0.001); and aseptic field management = 80% ( P ≤ 0.001).

Conclusions:

Results show implementation of ANTT® improved compliance with the prerequisite steps for safe and effective aseptic technique as defined by the ANTT®-CPF. Improvements in compliance were sustained over four years.
Outbreak column 21: Tuberculosis (TB): Still a nosocomial threat
Authors: Curran Evonne T
Published: December 2017

This outbreak column explores the epidemiology and infection prevention guidance on tuberculosis (TB) in the UK. The column finds that, at present, national guidance leaves UK hospitals ill-prepared to prevent nosocomial TB transmission. Reasons for this conclusion are as follows: (1) while TB is predominantly a disease that affects people with ‘social ills’, it has the potential to infect anyone who is sufficiently exposed; (2) nosocomial transmission is documented throughout history; (3) future nosocomial exposures may involve less treatable disease; and (4) current UK guidance is insufficient to prevent nosocomial transmission and is less than that advocated by the World Health Organization and the Centers for Disease Control and Prevention.
Outbreak Column 22: How to manage an outbreak
Authors: Curran Evonne T
Published: December 2017

This outbreak column uses the Health Protection Scotland (HPS) Outbreak Process and Algorithm to examine and reflect on a published outbreak report. The report involved an extensively drug-resistant Acinetobacter baumannii in an oncology unit. High-reliability theory is then used to reflect on how the outbreak was managed and consider how best to improve local outbreak prevention, preparedness, detection and management. The conclusion of this exercise is that if the possibility of an era of untreatable infections caused by antibiotic-resistant organisms is to be significantly postponed, Infection Prevention and Control Teams must improve their ability to get others to prevent cross-transmission in the absence of recognised risks.
Post-exposure prophylaxis following occupational exposure to HIV and hepatitis B: an analysis of a 12-year record in a Nigerian tertiary hospital
Authors: Abubakar Salisu , Iliyasu Garba , Dayyab Farouq Muhammad , Inuwa Salisu , Tudun Wada Rabiu Alhassan , Sadiq Nasiru Magaji , Gadanya Muktar Ahmed , Sheshe Abdulrahman Abba , Mijinyawa Mohammad Sani , Habib Abdulrazaq Garba
Published: December 2017

Background:

Healthcare workers (HCWs) have an increased risk of occupational exposure to blood-borne pathogens.

Aims/objectives:

We aim to examine the utilisation and outcome of post-exposure prophylaxis (PEP) for both HIV and hepatitis B (HBV) among HCWs.

Methods:

This was a retrospective study conducted in a tertiary hospital in North-Western Nigeria. We reviewed data on HIV or HBV PEP given to HCWs between 2004 and 2016.

Results:

A total of 115 HCWs presented for PEP during the study period. Intern doctors were the most exposed group (40/115; 34.8%). There were 86/115 (74.8%) needle stick exposures. While 53/115 (46.1%) of the sources of exposure were HIV-positive, 9/115(7.83%) were HBV-positive. Zidovudine-based regimen (40/70) was the most commonly prescribed. No seroconversion occurred among those that completed PEP treatment and follow-up.

Discussion:

No seroconversion occurred among those that received either or both HIV and HBV PEP and completed PEP treatment.
Personalization of regorafenib treatment in metastatic gastrointestinal stromal tumours in real-life clinical practice
Authors: Nannini Margherita , Nigro Maria Concetta , Vincenzi Bruno , Fumagalli Elena , Grignani Giovanni , D’Ambrosio Lorenzo , Badalamenti Giuseppe , Incorvaia Lorena , Bracci Raffaella , Gasperoni Silvia , Saponara Maristella , Gatto Lidia , Indio Valentina , Astolfi Annalisa , Di Scioscio Valerio , Casali Paolo G. , Tonini Giuseppe , Aglietta Massimo , Russo Antonio , Biasco Guido , Pantaleo Maria A.
Published: December 2017

Background:

Regorafenib (REG) has now been approved as the standard third-line therapy in metastatic gastrointestinal stromal tumour (GIST) patients at the recommended dose and schedule of 160 mg once daily for the first 3 weeks of each 4-week cycle. However, it has a relevant toxicity profile that mainly occurs within the first cycles of therapy, and dose and schedule adjustments are often required to reduce the frequency or severity of adverse events and to avoid early treatment discontinuation. To date, large amounts of data on the use of REG in metastatic GIST patients in daily clinical practice are not available, and we lack information about how this treatment personalization really affects the quality of life (QoL) of patients. The aim of the present retrospective study is to build a comprehensive picture of all alternative REG strategies adopted in daily clinical practice for use in metastatic GIST patients.

Methods:

Metastatic GIST patients treated with dose adjustment or alternative schedules of REG at seven reference Italian centres were retrospectively included.

Results:

For a total of 62 metastatic GIST patients, we confirmed that REG treatment adjustment is common in clinical practice and that it is very heterogeneous, with approximately 20 different strategies being adopted. Independent of which strategy is chosen, treatment personalization has led to a clinical benefit defined as complete or partial resolution of side effects in almost all patients, affecting the duration of REG treatment.

Conclusions:

The personalization of REG, even if it is heterogeneous, seems to be crucial to maximize the overall treatment duration.
Fabrication of nanofiber mats with microstructure gradient by cone electrospinning
Authors: Zhou Yingge , Tan George Z
Published: December 2017

As a versatile nanofiber manufacturing technique, electrospinning has been widely used for tissue engineering scaffold fabrication. However, it remains challenging to create scaffolds with anisotropic microstructure close to native tissues. This article presented a novel electrospinning configuration to generate fibrous mat with microstructure gradient. A series of proof-of-concept tests were performed to investigate the effects of process parameters on the gradient of nanofiber morphology and mat attributes. The technique developed in this study showed great potentials as a fabrication platform for heterogenous nanofiber products.
Influence of stroke and bleeding risk on prescribing of oral anticoagulants in older inpatients; has the availability of direct oral anticoagulants changed prescribing?
Authors: Farinola Nicholas , Caughey Gillian E. , Bell J. Simon , Johns Sally , Hauta-aho Milka , Shakib Sepehr
Published: December 2017

Background

Little is known about changes in prescribing practices in Australia since the introduction of the direct oral anticoagulants (DOACs). Our objective was to examine if the availability of DOACs has coincided with a change in prescribing of oral anticoagulants in older hospital inpatients with regard to risk factors for stroke and bleeding.

Methods

A prospective observational study was conducted between October 2012 and August 2015 of inpatients aged over 60 years initiated on an oral anticoagulant in a large metropolitan, tertiary referral, public teaching hospital in Australia. Treatment groups were patients who commenced an oral anticoagulant prior to inclusion of DOACs on the formulary and those who commenced after the introduction of DOACs. Subgroup analyses were conducted in patients with atrial fibrillation (AF). Differences in clinical characteristics and risk for stroke and bleeding were calculated using the CHADS2 and HAS-BLED scores, respectively, were examined.

Results

A total of 289 patients were included. Inpatients prescribed an oral anticoagulant after the introduction of DOACs were significantly older, a greater proportion were female and more likely to have had a prior stroke. This was associated with a statistically higher CHADS2 score in the post-DOAC group. Similar findings were observed when limiting the sample to patients with AF. Patients with AF who were at greatest likelihood of having a bleeding event were less likely to be treated with a DOAC.

Conclusion

Since the introduction of the DOACs, patients who may have previously received no therapy or suboptimal treatment were now more likely to be receiving anticoagulation, suggesting an appropriate change in prescribing practice.
Polypills for the secondary prevention of cardiovascular disease: effective in improving adherence but are they safe?
Authors: Selak Vanessa , Webster Ruth
Published: December 2017

International guidelines recommend blood pressure-lowering therapy, statins and aspirin for people who have had a cardiovascular event but use of these medications is low, particularly for lower income countries. Clinical trials have demonstrated that combining these medications into a single pill or capsule (a ‘polypill’) improves adherence, systolic blood pressure and low density lipoprotein cholesterol compared with usual care in secondary prevention. Uptake of polypill-based care has been underwhelming, possibly due to safety concerns. Overall, results from the clinical trials of polypill use among people who have had a cardiovascular event show no immediate safety concerns. Increased use and adherence to medications will always be associated with side effects however use within a combination medication has not been shown to be any less safe than individual component medications. Research investigating the relative consequences of nonadherence to a polypill compared with individual components would be useful.
Ready or not, here they come! Care as a material and organizational practice in ECEC for children under two
Authors: Aslanian Teresa K
Published: December 2017

Caring relationships between children and educators in early childhood education and care centers become in an array of entanglements with spaces, materials, and the organization of time. An exclusively dyadic understanding of care is insufficient in the material, institutional, pedagogic, and professional environment of early childhood education and care. This article reports on an ethnographic study of material and organizational professional care practices in a high-functioning full-day early childhood education and care center for children less than 3 years in Norway. Drawing on Tronto and Fisher’s feminist care ethics and a posthuman perspective, the study’s aim was to gain knowledge about how early childhood educators perform care as a professional practice beyond the dyad. The article explores care through the lens of a disruption in daily activities, when the laying down of new flooring in the center produced changes in the otherwise highly functioning caring environment. Changes in the availability of materials and the organization of space and time are analyzed using Malabou’s concept of plasticity. The effects of the agentic force of material changes on the caring practices of the center, despite the already strong and established dyadic relationships between the children and educators, are discussed.
Injured lung endothelium: mechanisms of self‐repair and agonist‐assisted recovery (2017 Grover Conference Series)
Authors: Birukov Konstantin G. , Karki Pratap
Published: December 2017

The lung endothelium is vulnerable to both exogenous and endogenous insults, so a properly coordinated efficient repair system is essential for the timely recovery of the lung after injury. The agents that cause endothelial injury and dysfunction fall into a broad range from mechanical forces such as pathological cyclic stretch and shear stress to bacterial pathogens and their virulent components, vasoactive agonists including thrombin and histamine, metabolic causes including high glucose and oxidized low‐density lipoprotein (OxLDL), circulating microparticles, and inflammatory cytokines. The repair mechanisms employed by endothelial cells (EC) can be broadly categorized into three groups: (1) intrinsic mechanism of recovery regulated by the cross‐talk between small GTPases as exemplified by Rap1‐mediated EC barrier recovery from Rho‐mediated thrombin‐induced EC hyperpermeability; (2) agonist‐assisted recovery facilitated by the activation of Rac and Rap1 with subsequent inhibition of Rho signaling as observed with many barrier protective agonists including oxidized phospholipids, sphingosine 1‐phosphate, prostacyclins, and hepatocyte growth factor; and (3) self‐recovery of EC by the secretion of growth factors and other pro‐survival bioactive compounds including anti‐inflammatory molecules such as lipoxins during the resolution of inflammation. In this review, we will discuss the molecular and cellular mechanisms of pulmonary endothelium repair that is critical for the recovery from various forms of lung injuries.
Understanding and treating solid tumor–related disseminated intravascular coagulation in the “era” of targeted cancer therapies
Authors: Vitale Felice Vito , Longo-Sorbello Giuseppe SA , Rotondo Stefano , Ferrau Francesco
Published: December 2017

A systemic activation of blood coagulation is usually present in many clinical conditions including the infectious or inflammatory ones and malignant disease as well. Depending upon circumstances, patients suffering from acute decompensated disseminated intravascular coagulation may be managed by a medical oncologist and either an internist or a physician working in an emergency and/or intensive care unit. In some cases, for example, the indolent ones, the activation of coagulation might not be easily detected by routine laboratory tests and not lead to clinical manifestations. Such a chronically activated intravascular coagulation can progress toward an overt decompensated disseminated intravascular coagulation. Traditional therapy of decompensated disseminated intravascular coagulation is based on reversing the underlying triggering disease and providing patients with adequate supportive treatment. The dilemma for the oncologist is whether or not the trigger cause can be treated and amended with a specific antineoplastic treatment, without worsening the consumption of platelets and the risk of bleeding. In light of the availability of new targeted therapies, the main criteria that should drive the strategy against solid cancer–related disseminated intravascular coagulation will be discussed.
The Anthropocene and the production and reproduction of capital
Authors: Soriano Carles
Published: December 2017

Regardless of the final fitting of the Anthropocene in the Geologic Time Scale, conceptualizing the Anthropocene as a human-induced ecological crisis of planetary scale linked to the capitalist mode of production allows addressing the research on the deep roots of such crisis into the fundamentals of this production mode. In this regard, a Marxian dialectical approach is pertinent to face some of the major challenges launched by the Anthropocene narrative. In particular, understanding capital as the automatic fetish that commands social production and reproduction in modern society allows not falling into mystified techno-scientific solutions for the crisis. Capital as the automatic fetish that mediates in the universal metabolism between humans and nature yields an alienated form of social metabolism that is at the base of the metabolic rift inherent to the production and reproduction of capital and that is enhanced by the tendency of the rate of profit to fall.
The Opioid Abuse Risk Screener predicts aberrant same-day urine drug tests and 1-year controlled substance database checks: A brief report
Authors: Averill Lynnette A , Averill Christopher L , Staley Lyndsay A , Ozawa-Kirk JL , Kauwe John SK , Henrie-Barrus Patricia
Published: December 2017

The Opioid Abuse Risk Screener was developed to support well-informed decision-making in opioid analgesic prescribing by extending the breadth of psychiatric risk factors evaluated relative to other non–clinician-administered measures. We examined the preliminary predictive validity of the Opioid Abuse Risk Screener relative to the widely used Screener and Opioid Assessment for Patients with Pain–Revised in predicting aberrant urine drug tests and controlled substance database checks. The Opioid Abuse Risk Screener is significantly different from the Screener and Opioid Assessment for Patients with Pain–Revised in predicting aberrant same-day urine drug tests ( Z = 2.912, p = 0.0036) and controlled substance database checks within 1 year of assessment ( Z = 3.731, p = 0.0002). Promising preliminary analyses using machine learning methods are also discussed.
Relationship between advertising and consumption in China: Exploring the roles of economic development and mass media
Authors: Chan-Olmsted Sylvia M. , Su Linsen
Published: December 2017

The article investigates the dynamic interaction between national advertising spending and consumption in China from 1979 to 2014, including the media production in this process. The results show that the household consumption, economic openness, and economic freedom all positively predict advertising spending. As a peculiar combination of market economy and party-state controlled political system, there exists an asymmetry in the role of the government in terms of media advertising versus media product supply, and newspaper versus television. The ad-consumption elasticity is larger after 1992 than that before 1992, and newspaper ad is more sensitive to economic changes than TV advertising. The imbalance between media dual markets suggests there exists a semi-market in media industrialization in China. Media contents in China serve as both propaganda tool and advertising vehicle, and content production investment is mainly compensated by advertising.
‘Jumping the first hurdle’: Framing action research questions using the Ice Cream Cone Model
Authors: Brownhill Simon , Ungarova Talash , Bipazhanova Aiman
Published: December 2017

The importance of good research questions is well recognised in the research community. The difficulty lies in actually formulating these research questions, an issue which both beginning and established researchers have expressed concerns about. This article reports on an innovative framing device which was developed for international trainers and teachers to help them ‘jump the first hurdle’ and write a ‘good’ research question to specifically drive a cycle of action research. Through a staged exploration of the thoughts and perceptions of Kazakhstani trainers who used the Ice Cream Cone Model, findings highlight strong support for the use of the framing device and the ‘logical steps’ it provides for producing small-scale action-based research questions. The value of this framing device for teacher researchers and those involved in supporting teachers to carry out action research will be considered following an exploration of model-generated research questions.
Documenting the invisible – on the ‘how’ of process research: (Re)considering method from process philosophy
Authors: Pallesen Eva
Published: December 2017

Currently, there is a growing field in organization studies, reflecting a stream in social science more broadly, which seeks to encompass a process philosophical view of the world as multiple and in constant becoming. However, this raises new questions and challenges to the field of methodology: If movement and process are the basic forms of the universe, then the vagueness and multiplicity that come with the flux of the world are not to be ruled out by rigorous research designs; rather, relating to vagueness and multiplicity may be the very precondition of approaching the studied phenomena. For some scholars, this has been an occasion for deeming the discipline of methodology ‘dead’ or ‘emptied’. In contrast to such claims, this article argues that the scholar doing empirical research from approaches drawing on process philosophy to no less extent than other scholars must deal with problems of methodological character. However, he or she may need a renewed understanding of traditional methodological categories such as documentation, validity and variation. Rather than cancelling such concepts, this article experimentally reconsiders them in a process view, using a piece of observational material to think from. The article suggests that process philosophy may open up a methodological thinking that has room for a more connotative, playful way of relating to research material – which does not demand from a method to overcome the gap between what is there and what is captured but makes use of this gap as a space of invitation and play. Rather than adhering to the promise of ruling out vagueness and filling out a gap, the article, therefore, in itself aims at being such an invitation for a connotative, playful methodology.
The Analect and the Arthaśāstrsa: Kongzi of Zhou China and Kauṭilya of Maurya India Compared
Authors: Sil Narasingha P.
Published: December 2017

Kongzi/Kongfuzi or Confucius of “China” and Cānakya/Viṣṇugupta or Kauṭilya of “India” were statesmen as well as teachers, though never professional classroom instructors. They both dedicated themselves to advising royalty and the ruling class in the art of administration as well as in the secrets of success and survival in a world that was at once uncharitable and unprincipled. Nevertheless, both base their counsels on morality—Kongzi on ren [benevolence] and de [virtue] and Kauṭilya on dharma [duty] and daṇḍa [law]. Both seek to enhance the quality of human life in terms of material and moral riches, their only distinction being the Chinese Master’s teachings are primarily philosophical thus bearing the stamp of universality, whereas the Indian ācārya’s [preceptor’s] insights pertain to the interests of his particular state.
An Experimental Examination of Framing Effects on Consumer Response to Cause Marketing Campaigns
Authors: Sunitha T.R.  , Edward Manoj
Published: December 2017

Consumer decision-making is contextual and is heavily influenced by what is considered to be personally relevant. Cause marketing creates a context for social activism by inducing prosocial behaviour in consumers; however, not all consumers find every social issue relevant to their interests, values and goals. Marketers use messaging strategies to convey the importance of a social issue and make it seem relevant enough to motivate consumers to behave in a desirable way. This research examines the effects of message framing in cause marketing campaigns by identifying the role that positive and negative framing play in influencing consumer response based on the degree of relevance they have towards the cause. An experiment using fictitious brands in a cause marketing campaign revealed that framing and relevance have an impact on consumer response to such campaigns, in that negatively farmed messages served as an effective cue to influence attitude and participation intention. Consumers who found the issue to be highly personally relevant had more favourable attitudes and participation intentions than those for whom the cause was not personally relevant. An Interaction of message framing and cause relevance revealed that negative framing impacted the participation intentions of consumers who find a social issue to be of less relevance, while for those who believed the social issue to be of high relevance, message framing did not influence behavioural intentions.
Sagittal Plane Hip, Knee, and Ankle Biomechanics and the Risk of Anterior Cruciate Ligament Injury: A Prospective Study
Authors: Leppänen Mari , Pasanen Kati , Krosshaug Tron , Kannus Pekka , Vasankari Tommi , Kujala Urho M. , Bahr Roald , Perttunen Jarmo , Parkkari Jari
Published: December 2017

Background:

Stiff landings with less knee flexion and high vertical ground-reaction forces have been shown to be associated with an increased risk of anterior cruciate ligament (ACL) injury. The literature on the association between other sagittal plane measures and the risk of ACL injuries with a prospective study design is lacking.

Purpose:

To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injury in young female team-sport athletes.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 171 female basketball and floorball athletes (age range, 12-21 years) participated in a vertical drop jump test using 3-dimensional motion analysis. All new ACL injuries, as well as match and training exposure data, were recorded for 1 to 3 years. Biomechanical variables, including hip and ankle flexion at initial contact (IC), hip and ankle ranges of motion (ROMs), and peak external knee and hip flexion moments, were selected for analysis. Cox regression models were used to calculate hazard ratios (HRs) with 95% CIs. The combined sensitivity and specificity of significant test variables were assessed using a receiver operating characteristic (ROC) curve analysis.

Results:

A total of 15 noncontact ACL injuries were recorded during follow-up (0.2 injuries/1000 player-hours). Of the variables investigated, landing with less hip flexion ROM (HR for each 10° increase in hip ROM, 0.61 [95% CI, 0.38-0.99]; P < .05) and a greater knee flexion moment (HR for each 10-N·m increase in knee moment, 1.21 [95% CI, 1.04-1.40]; P = .01) was significantly associated with an increased risk of ACL injury. Hip flexion at IC, ankle flexion at IC, ankle flexion ROM, and peak external hip flexion moment were not significantly associated with the risk of ACL injury. ROC curve analysis for significant variables showed an area under the curve of 0.6, indicating a poor combined sensitivity and specificity of the test.

Conclusion:

Landing with less hip flexion ROM and a greater peak external knee flexion moment was associated with an increased risk of ACL injury in young female team-sport players. Studies with larger populations are needed to confirm these findings and to determine the role of ankle flexion ROM as a risk factor for ACL injury. Increasing knee and hip flexion ROMs to produce soft landings might reduce knee loading and risk of ACL injury in young female athletes.
“Now I Don’t Have to Guess”: Using Pamphlets to Encourage Residents and Families/Friends to Engage in Advance Care Planning in Long-Term Care
Authors: Sussman Tamara , Kaasalainen Sharon , Bui Matthew , Akhtar-Danesh Noori , Mintzberg Susan , Strachan Patricia
Published: December 2017

Objective: This article explores whether access to illness trajectory pamphlets for five conditions with high prevalence in long-term care (LTC) can encourage residents and families/friends to openly engage in advance care planning (ACP) discussions with one another and with health providers. Method: In all, 57 residents and families/friends in LTC completed surveys and 56 participated in seven focus groups that explored whether the pamphlets supported ACP engagement. Results: Survey results suggested that access to pamphlets encouraged residents and families/friends to reflect on future care (48/57, 84%), clarified what questions to ask (40/57, 70%), and increased comfort in talking about end of life (EOL) care (36/57, 63%). Discussions between relatives and friends/families (32/57, 56%) or with health providers (21/57, 37%) were less common. Focus group deliberations illuminated that while reading illness-specific information was validating, a tendency to protect one another from an emotional topic, prevented residents and families/friends from conversing with one another about EOL issues. Discussion: Having access to pamphlets with information about EOL care provides important and welcome opportunities for reflection for both residents in LTC and their families/friends. Moving residents and families/friends from reflecting on issues to discussing them together could require staff support through planned care conferences or staff initiated conversations at the bedside.
Sex Differences Shape Brain Development and Function, in Health and Disease: Policy Implications
Authors: Bilbo Staci D.
Published: December 2017

Sex differences profoundly impact health and disease. Despite this, the inclusion of females in clinical and fundamental research lags far behind advances in other aspects of medicine, especially in the brain sciences. Regardless of whether neuroscientists are intrinsically interested in sex differences per se, observing a sex disparity in the incidence or presentation of a given neurological disorder provides a significant clue into the neurobiology of that disorder. Autism spectrum disorder (ASD) is one of the most sex-biased disorders, with a 4:1 male-to-female ratio, an important aspect of its etiology and biology that has largely been ignored in the preclinical literature. This article briefly overviews what is known about the sexual differentiation of the developing healthy brain, with a focus on the preclinical literature. This places observed sex differences in neurological disorders such as ASD into the context of known sex differences in neurobiology—along with insight from known sex-specific mechanisms in other systems that impact the brain (e.g., immune system, microbiome). Finally, the article provides recommendations for progress forward.
Impaired praxis in gesture imitation by deaf children with autism spectrum disorder
Authors: Shield Aaron , Knapke Krista , Henry Morgan , Srinivasan Sudha , Bhat Anjana
Published: December 2017

Background and aims

Praxis, the ability to plan and execute a series of gestures or motor sequences, is impaired in individuals with autism spectrum disorder. In this paper, we present the first study of praxis during a gesture imitation task in a unique population of children with autism spectrum disorder: deaf children who have been exposed to American Sign Language from birth by their Deaf parents. Lifelong exposure to sign language in deaf individuals entails practice with gesture imitation. We ask if deaf, signing children with autism spectrum disorder present with praxis impairments similar to those reported in the literature for hearing children with autism spectrum disorder not exposed to sign.

Methods

Thirty deaf children of Deaf parents (16 typically developing and 14 with autism spectrum disorder), matched for chronological and mental age, were tested on a simple gesture imitation task. Children were asked to imitate 24 gestures performed by an adult model on a laptop computer that varied along dimensions of movement type (16 trials) and palm orientation direction (eight trials). Data were coded for nine praxis parameters (five formation parameters and four manner parameters) and three timing measures.

Results

Results showed that the deaf children with autism spectrum disorder produced more errors than the typically developing deaf children on six of the nine praxis dimensions (hand orientation, final orientation, modulation, directness, pace, and overflow) and were more impaired on manner parameters than formation parameters, suggesting underlying deficits in motor control/coordination leading to dyspraxia. Praxis scores were strongly related to severity of autism spectrum disorder symptoms and receptive sign language scores.

Conclusions

We thus find evidence that praxis is impaired in deaf, signing children with autism spectrum disorder, despite lifelong exposure to a gestural language and extensive practice with gesture imitation.

Implications

Our findings suggest that interventions targeted toward enhancing praxis and coordination of finger and hand movements could help facilitate language development in children with autism spectrum disorder.
Tyrosine phosphorylation and proteolytic cleavage of Notch are required for non-canonical Notch/Abl signaling in Drosophila axon guidance
Authors: Kannan Ramakrishnan , Cox Eric , Wang Lei , Kuzina Irina , Gu Qun , Giniger Edward
Published: December 2017

Notch signaling is required for the development and physiology of nearly every tissue in metazoans. Much of Notch signaling is mediated by transcriptional regulation of downstream target genes, but Notch controls axon patterning in Drosophila by local modulation of Abl tyrosine kinase signaling, via direct interactions with the Abl co-factors Disabled and Trio. Here, we show that Notch-Abl axonal signaling requires both of the proteolytic cleavage events that initiate canonical Notch signaling. We further show that some Notch protein is tyrosine phosphorylated in Drosophila, that this form of the protein is selectively associated with Disabled and Trio, and that relevant tyrosines are essential for Notch-dependent axon patterning but not for canonical Notch-dependent regulation of cell fate. Based on these data, we propose a model for the molecular mechanism by which Notch controls Abl signaling in Drosophila axons.
Two distinct mechanisms silence chinmo in Drosophila neuroblasts and neuroepithelial cells to limit their self-renewal
Authors: Dillard Caroline , Narbonne-Reveau Karine , Foppolo Sophie , Lanet Elodie , Maurange Cédric
Published: December 2017

Whether common principles regulate the self-renewing potential of neural stem cells (NSCs) throughout the developing central nervous system is still unclear. In the Drosophila ventral nerve cord and central brain, asymmetrically dividing NSCs, called neuroblasts (NBs), progress through a series of sequentially expressed transcription factors that limits self-renewal by silencing a genetic module involving the transcription factor Chinmo. Here, we find that Chinmo also promotes neuroepithelium growth in the optic lobe during early larval stages by boosting symmetric self-renewing divisions while preventing differentiation. Neuroepithelium differentiation in late larvae requires the transcriptional silencing of chinmo by ecdysone, the main steroid hormone, therefore allowing coordination of neural stem cell self-renewal with organismal growth. In contrast, chinmo silencing in NBs is post-transcriptional and does not require ecdysone. Thus, during Drosophila development, humoral cues or tissue-intrinsic temporal specification programs respectively limit self-renewal in different types of neural progenitors through the transcriptional and post-transcriptional regulation of the same transcription factor.
Suppressor of cytokine signaling 2 (Socs2) deletion protects bone health of mice with DSS-induced inflammatory bowel disease
Authors: Dobie Ross , MacRae Vicky E. , Pass Chloe , Milne Elspeth M. , Ahmed S. Faisal , Farquharson Colin
Published: December 2017

Individuals with inflammatory bowel disease (IBD) often present with poor bone health. The development of targeted therapies for this bone loss requires a fuller understanding of the underlying cellular mechanisms. Although bone loss in IBD is multifactorial, the altered sensitivity and secretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in IBD is understood to be a critical contributing mechanism. The expression of suppressor of cytokine signaling 2 (SOCS2), a well-established negative regulator of GH signaling, is stimulated by proinflammatory cytokines. Therefore, it is likely that SOCS2 expression represents a critical mediator through which proinflammatory cytokines inhibit GH/IGF-1 signaling and decrease bone quality in IBD. Using the dextran sodium sulfate (DSS) model of colitis, we reveal that endogenously elevated GH function in the Socs2−/− mouse protects the skeleton from osteopenia. Micro-computed tomography assessment of DSS-treated wild-type (WT) mice revealed a worsened trabecular architecture compared to control mice. Specifically, DSS-treated WT mice had significantly decreased bone volume, trabecular thickness and trabecular number, and a resulting increase in trabecular separation. In comparison, the trabecular bone of Socs2-deficient mice was partially protected from the adverse effects of DSS. The reduction in a number of parameters, including bone volume, was less, and no changes were observed in trabecular thickness or separation. This protected phenotype was unlikely to be a consequence of improved mucosal health in the DSS-treated Socs2−/− mice but rather a result of unregulated GH signaling directly on bone. These studies indicate that the absence of SOCS2 is protective against bone loss typical of IBD. This study also provides an improved understanding of the relative effects of GH/IGF-1 signaling on bone health in experimental colitis, information that is essential before these drugs are explored as bone protective agents in children and adults with IBD.
Emotion recognition and theory of mind in chronic
schizophrenia: association with negative symptoms
Authors: Andrzejewska Marta , Wójciak Paweł , Domowicz Klaudia , Rybakowski Janusz
Published: December 2017

Aim of the study

Assessing a relationship between the negative symptoms and deficits in emotion recognition and theory of mind (ToM) as well as social functioning, in chronic schizophrenia patients.

Subject or material and methods

Twenty patients with schizophrenia (10 male, 10 female), aged 36+11 years, with mean duration of the illness of 13+9 years, were studied during improvement period, stabilized on medications for at least 3 months. For the assessment of symptoms, the Positive and Negative Symptoms Scale (PANSS) and the Brief Negative Symptoms Scale (BNSS) were used. Emotion recognition was measured by the Facial Emotion Identification Test (FEIT) and ToM - by the Reading Mind in the Eyes (R-MET) test. Patients' social functioning was evaluated by the Personal and Social Performance Scale (PSP).

Results

Significant correlations were obtained between the negative symptoms of PANSS and BNSS, and the results of FEIT and R-MET. Association between BNSS and FEIT was observed for anhedonia, distress, asociality, avolition, blunted affect, alogia, and with R-MET, for distress, emotional blunting and alogia. Both PANSS and BNSS negative symptoms significantly correlated with the results of PSP.

Discussion

The results correspond to those of recent studies showing a priority of negative over positive symptoms in determining deficits in social cognition and functioning in chronic schizophrenia.

Conclusions

All domains of negative symptoms assessed by the BNSS correlated with deficits in emotion recognition and of social functioning and some domains correlated with the measure of the ToM.
Treating the unexpected: the opiate overdose patient
Authors: Willis Sam
Published: December 2017

Ambulance practitioners are regularly faced with those who present with a form of drug overdose. The subject of substance misuse can be controversial, delicate and are not always straightforward to manage. Not only can substance misuse be a sensitive topic to approach, but patients can be adept at hiding the signs and symptoms from friends, family and ambulance practitioners (Caroline 2008). In addition, it may be difficult to establish what exactly has been taken, when, and how much. Gaining consent to treat the patient can also be fraught with difficulties. This reflective account uses a case from practice which highlights several of the difficulties that ambulance practitioners face when dealing with this type of patient.
The changing Australian healthcare landscape: implications for paramedics
Authors: Williams Brett , Onsman Andrys , Brown Ted
Published: December 2017

This article argues that the Australian paramedic sector has reached a critical point in its development as a recognized profession. It identifies and describes a number of the most influential factors that are currently driving change throughout the Australian health care system and that can be demonstrated to have significant impact upon the emergency health care sector. In order to remain and grow as an autonomous and respected part of being part of contemporary service delivery, and consequently becoming recognized as a profession, a number of key questions demand answers: does the sector have the capacity to help with burgeoning health care workforce shortages or offer alternatives in service delivery? If it does, does the role equate to some form of extended practitioner or shared care roles such as physician assistant or paramedic practitioner? Either way, it appears reasonable that the role, responsibilities and function of a paramedic both in urban and rural locales in the near future will undergo some form of change: the question is whether any such change will be professionally developmental or detrimental? While this article focuses on the issues in Australia, many of these issues are also faced by the paramedic profession and health care sector in the UK. Therefore, it should provide the JPP readership with useful material in their ongoing development of alternative service delivery models and quest to improve workforce productivity.
December roundup of the EMS blogging world
Authors: Glencorse Mark
Published: December 2017

It is that time of year again, and while many of our potential patients are enjoying the festive season (sometimes to excess), the ambulance services struggle to cope with the normal –winter pressures— that we see each and every year. So with that in mind, lets give you some reading for those long, lonely periods of standby.
Prehospital use of intra-muscular adrenaline in severe allergic reactions
Authors: Godfrey Claire , Orrill Richard
Published: December 2017

Prehospital use of intra-muscular adrenaline in severe allergic reactions

Does e-learning make a difference?