bluuebunny/crossref_metadata_2025 huggingface dataset:
Being a Coptic Man: Masculinity, Class, and Social Change among Egyptian Copts
Authors: Kartveit Bard Helge
Published: October 2018

Inspired by Marcia Inhorn’s work on Arab masculinities, this article looks at changes in masculine ideals and practices among Egyptian middle-class Copts. Based on fieldwork among Copts in the city of Alexandria, Egypt, this article argues that young Coptic men embrace ideals of manhood that highlights conjugal connectivity and involved fatherhood at the expense of other social commitments; that in doing so, they define themselves in opposition to Muslim men of lower socioeconomic status, widely construed as their “masculine others”; and finally that these men ascribe to forms of masculinity that do not seem to reinforce patriarchal power relations, nor lend themselves to hierarchical placement in relation to otherwise dominant forms of masculinity within a predominantly Muslim society. As such, they constitute forms of masculinity that are parallel, but not subordinate to a “hegemonic masculinity,” challenging some of the central premises on which the concept of hegemonic masculinity is commonly based. The case of middle-class Coptic men point to the concept of “emergent masculinities” as a promising starting point for analyzing masculinity in diverse Arab societies.
Co-occurrence of acute ophthalmoplegia (without ataxia) and idiopathic intracranial hypertension
Authors: Yeak Justin , Zahari Mimiwati , Singh Sujaya , Mohamad Nor Fadhilah
Published: October 2018

Background:

Acute ophthalmoparesis without ataxia was designated as ‘atypical Miller Fisher syndrome’ as it presents with progressive, relatively symmetrical ophthalmoplegia, but without ataxia nor limb weakness, in the presence of anti-GQ1b antibody. Idiopathic intracranial hypertension is characterized by signs of raised intracranial pressure occurring in the absence of cerebral pathology, with normal composition of cerebrospinal fluid and a raised opening pressure of more than 20 cmH2O during lumbar puncture. We aim to report a rare case of acute ophthalmoplegia with co-occurrence of raised intracranial pressure.

Case Description:

A 28-year-old gentleman with body mass index of 34.3 was referred to us for management of double vision of 2 weeks duration. His symptom started after a brief episode of upper respiratory tract infection. His best corrected visual acuity was 6/6 OU. He had bilateral sixth nerve palsy worse on the left eye and bilateral hypometric saccade. His deep tendon reflexes were found to be hyporeflexic in all four limbs. No sensory or motor power deficit was detected, and his gait was normal. Plantar reflexes were downwards bilaterally and cerebellar examination was normal. Both optic discs developed hyperaemia and swelling. Magnetic resonance imaging of brain was normal and lumbar puncture revealed an opening pressure of 50 cmH2O. Anti-GQ1b IgG and anti-GT1a IgG antibody were tested positive.

Conclusion:

Acute ophthalmoparesis without ataxia can present with co-occurrence of raised intracranial pressure. It is important to have a full fundoscopic assessment to look for papilloedema in patients presenting with Miller Fisher syndrome or acute ophthalmoparesis without ataxia.
Monte Carlo Simulations Demonstrate Algorithmic Interventions Over Time Reduce Hospitalisation in Patients With Schizophrenia and Bipolar Disorder
Authors: Knight Alissa , Jarrad Geoff A , Schrader Geoff D , Strobel Jorg , Horton Dennis , Bidargaddi Niranjan
Published: October 2018

Non-adherence with pharmacologic treatment is associated with increased rates of relapse and rehospitalisation among patients with schizophrenia and bipolar disorder. To improve treatment response, remission, and recovery, research efforts are still needed to elucidate how to effectively map patient’s response to medication treatment including both therapeutic and adverse effects, compliance, and satisfaction in the prodromal phase of illness (ie, the time period in between direct clinical consultation and relapse). The Actionable Intime Insights (AI2) application draws information from Australian Medicare administrative claims records in real time when compliance with treatment does not meet best practice guidelines for managing chronic severe mental illness. Subsequently, the AI2 application alerts clinicians and patients when patients do not adhere to guidelines for treatment. The aim of this study was to evaluate the impact of the AI2 application on the risk of hospitalisation among simulated patients with schizophrenia and bipolar disorder. Monte Carlo simulation methodology was used to estimate the impact of the AI2 intervention on the probability of hospitalisation over a 2-year period. Results indicated that when the AI2 algorithmic intervention had an efficacy level of (>0.6), over 80% of actioned alerts were contributing to reduced hospitalisation risk among the simulated patients. Such findings indicate the potential utility of the AI2 application should replication studies validate its methodologic and ecological rigour in real-world settings.
Use of traditional and alternative healers by psychiatric patients: A descriptive study in urban South Africa
Authors: Zingela Zukiswa , van Wyk Stephan , Pietersen Jacques
Published: October 2018

This study investigates the pattern of use of traditional and alternative healers among psychiatric patients in Nelson Mandela Metropole. An interview schedule was applied to 254 subjects at six sites, enquiring about consultations with traditional and alternative healers in the past year. Multivariate analysis was performed to determine predictors of consultation. Overall, 78 (31%) of respondents had consulted a healer in the past year. The ethnic distribution was: 156 (61%) Black, 53 (21%) Coloured (Mixed Race), 42 (17%) White and three (1%) Indian. The male to female ratio was 119 (46.85%):135 (53.14%). The healers gave no advice about psychiatric medication to 48 (61.5%) of consulters, 23 (29.5%) were told to continue their medication, four (5.1%) told to stop, and one (1.3%) told to stop and restart later. In multivariate models, predictors of consultation were being Black and of lower education. Although 45 (58%) of the consulters indicated that medical treatment was more helpful than the healer’s, 45 (58%) intended to consult again. Overall, 22% of consulters reported abuse by the healer.
Dynamic behavior of a polyurethane foam solidified ballasted track in a heavy haul railway tunnel
Authors: Cai Xiaopei , Zhong Yanglong , Hao Xiaocheng , Zhang Yanrong , Cui Rixin
Published: October 2018

Dynamic behavior of a new type of track using the polyurethane foam solidified ballast in heavy haul railway tunnels is comprehensively investigated in this study. First, a dynamic model of the vehicle–track–tunnel interaction system was developed based on the multi-body system dynamics theory and finite element method. Then, the dynamic effects of the polyurethane foam solidified ballast track on the train and the surrounding infrastructures were calculated and compared to those of the traditional ballasted track. Moreover, the effects of the elastic modulus and the solidified area size of polyurethane foam solidified ballast on the dynamic behavior were analyzed. Results show that, compared to the traditional ballast bed, polyurethane foam solidified ballast decreases the track stiffness and the vibration acceleration of the tunnel, while does not affect the vehicle safety (derailment coefficient and the rate of wheel load reduction). A larger elastic modulus of polyurethane foam solidified ballast has little effects on the wheel–rail interaction and the vibration acceleration of the tunnel, while a smaller modulus results in amplification of the displacements of rails and sleepers. Considering the vehicle–track interaction and tunnel vibration, the optimal elastic modulus of polyurethane foam solidified ballast is suggested to be 60–80 MPa. In addition, smaller solidified area of polyurethane foam solidified ballast presents lower effects on the vibration reduction and rate of wheel load reduction, while larger area leads to a higher derailment coefficient and cost. Therefore, an optimal solidified area size of polyurethane foam solidified ballast with the top width of 0.85 m is recommended.
What about ethics? Developing qualitative research in confinement settings
Authors: Gomes Sílvia , Duarte Vera
Published: October 2018

The main purpose of this article is to discuss some ethical-methodological issues associated with scientific research in confinement settings, particularly those that result from the relationship with the confined individual in the framework of qualitative research. Basing the reflection on empirical research developed by both authors in Portuguese confinement settings – prisons and youth educational centres – we examine the significant challenges and dilemmas this type of research entails, exploring the interface between procedural ethics and ethics in practice at three points in the analytical process: before, during and after data collection. This article illustrates the interplay between formal and informal procedures, and between the initial distancing and strangeness when making contact with confinement settings and their social actors and the institutional and relational dynamics that become ingrained in our everyday practice. Our goal is to give visibility to these institutional and relational dynamics and to reflect on the challenges experienced by those who enter confinement settings to do research, in an effort to make the research process more transparent and at the same time more reflexive. We end our reflection advocating more ethically committed and critical scientific research.
An Automated Preprocessing Method for Diffuse Optical Tomography to Improve Breast Cancer Diagnosis
Authors: Althobaiti Murad , Vavadi Hamed , Zhu Quing
Published: October 2018

The ultrasound-guided diffuse optical tomography is a noninvasive imaging technique for breast cancer diagnosis and treatment monitoring. The technique uses a handheld probe capable of providing measurements of multiple wavelengths in a few seconds. These measurements are used to estimate optical absorptions of lesions and calculate the total hemoglobin concentration. Any measurement errors caused by low signal to noise ratio data and/or movements during data acquisition would reduce the accuracy of reconstructed total hemoglobin concentration. In this article, we introduce an automated preprocessing method that combines data collected from multiple sets of lesion measurements of 4 optical wavelengths to detect and correct outliers in the perturbation. Two new measures of correlation between each pair of wavelength measurements and a wavelength consistency index of all reconstructed absorption maps are introduced. For phantom and patients’ data without evidence of measurement errors, the correlation coefficient between each pair of wavelength measurements was above 0.6. However, for patients with measurement errors, the correlation coefficient was much lower. After applying the correction method to 18 patients’ data with measurement errors, the correlation has improved and the wavelength consistency index is in the same range as the cases without wavelength-dependent measurement errors. The results show an improvement in classification of malignant and benign lesions.
Effect of Exercise on Behavioral Symptoms and Pain in Patients With Dementia Living in Nursing Homes
Authors: Maltais Mathieu , Rolland Yves , Vellas Bruno , Haÿ Paul-Emile , Armaingaud Didier , Cestac Philippe , Rouch Laure , Cesari Matteo , de Souto Barreto Philipe
Published: October 2018

Objectives:

Examine the effects of a 6-month exercise intervention on neuropsychiatric symptoms, pain, and medication consumption in older people with dementia (PWD) living in nursing homes (NH).

Methods:

Ninety-one older PWD living in NH performed a 6-month structured exercise intervention (n = 44) or a social activity intervention (n = 47). Neuropsychiatric symptoms were measured by the neuropsychiatric inventory (NPI), pain was assessed using the Algoplus scale, and dementia-related drug prescriptions were obtained for all participants.

Results:

Between-group analysis found a nonsignificant difference that could be of clinical relevance: a 4-point difference in the NPI and 1.3-point difference in the reduction of the number of medications favoring exercisers. No significant differences were found for pain, and a trend was found for an increase in medication consumption in the social group.

Conclusion:

Exercise effects did not differ from social intervention effects on neuropsychiatric symptoms, pain, and medication consumption in older PWD living in NH.
Complete Technical Scheme for Automatic Biological Dose Estimation Platform
Authors: Dai Hong , Feng Junchao , Bian Huahui , Chen Weibo , Wang Youyou , Liu Yulong , Hu Wentao
Published: October 2018

To establish a complete technical solution for the automatic radiation biological dose estimation platform for biological dose estimation and classification of the wounded in large-scale radiation accidents, the “dose–effect curve by dicentric chromosome (DIC) automatic analysis” was established and its accuracy was verified. The effects of analyzed cell number and the special treatment of the culture on dose estimation by DIC automatic analysis were studied. Besides, sample processing capabilities of the special equipments were tested. The fitted “dose–effect curve by DIC automatic analysis” was presented as follows: Y = (0.01806 ± 0.00032) D2 + (0.01279 ± 0.00084) D + (0.0004891 ± 0.0001358) ( R2 = 0.961). Three-gradient scanning method, culture refrigeration method, and interprofessional collaboration under extreme conditions were proposed to improve the detection speed, prolong the sample processing time window, and reduce the equipment investment. In addition, the optimized device allocation ratio for the automatic biological dose estimation laboratory was proposed to eliminate the efficiency bottleneck. The complete set of technical solutions for the high-throughput automatic biological dose estimation laboratory proposed in this study can meet the requirements of early classification and rapid biological dose assessment of the wounded during the large-scale nuclear radiation events, and it is worthy of further promotion.
Netnographic Slog
Authors: Wallace Ruth , Costello Leesa , Devine Amanda
Published: October 2018

Active, participatory netnography, in contrast to passive netnography, is essential if researchers are to gain rich rewards from the rigorous collection of qualitative data. However, researchers should be aware of the ‘netnographic slog’; “the blood, sweat and tears” associated with eliciting quality data and encouraging active participation in online communities.

This article examines the – Supporting Nutrition for Australian Childcare (SNAC) – online community of practice, established to support healthy eating practices in early childhood education and care settings. To ensure research rigour, Kozinets’ netnographic steps were employed. Garnering member participation in this online community was a slog; most community content was contributed by few members, although accessed by many. The success (and failure) of the creative elicitation strategies implemented by the researchers to promote participation are discussed, and examples provided that could be used by other netnographers in online communities. A key consideration, however, appears to be the waning success of web-based discussion boards as an effective platform. Future netnographers should carefully consider the effort required to attract new community members and encourage participation. While SNAC is a unique resource, presenting an ideal platform to launch further initiatives, other more effective social media platforms that can support healthy eating in this key setting should be considered. If participatory netnography is to be successful, budding netnographers must be prepared to invest the blood, sweat and tears required to nurture emerging communities of practice.
Using synthetic basis feature descriptor for motion estimation
Authors: Zhang Dong , Desai Alok , Lee Dah-Jye
Published: October 2018

Development of advanced driver assistance systems has become an important focus for automotive industry in recent years. Within this field, many computer vision–related functions require motion estimation. This article discusses the implementation of a newly developed SYnthetic BAsis (SYBA) feature descriptor for matching feature points to generate a sparse motion field for analysis. Two motion estimation examples using this sparse motion field are presented. One uses motion classification for monitoring vehicle motion to detect abrupt movement and to provide a rough estimate of the depth of the scene in front of the vehicle. The other one detects moving objects for vehicle surrounding monitoring to detect vehicles with movements that could potentially cause collisions. This algorithm detects vehicles that are speeding up from behind, slowing down in the front, changing lane, or passing. Four videos are used to evaluate these algorithms. Experimental results verify SYnthetic BAsis’ performance and the feasibility of using the resulting sparse motion field in embedded vision sensors for motion-based driver assistance systems.
Design and implementation of a multi-degrees-of-freedom cable-driven parallel robot with gripper
Authors: Lin Jonqlan , Wu Chi Ying , Chang Julian
Published: October 2018

Cable-driven parallel robots comprise driven actuators that allow controlled cables to act in parallel on an end-effector. Such a robotic system has a potentially large reachable workspace, large load capacity, high payload-to-weight ratio, high reconfigurability, and low inertia, relative to rigid link serial and parallel robots. In this work, a multi-degrees-of-freedom cable-suspended robot that can carry out pick-and-place tasks in large workspaces with heavy loads is designed. The proposed cable-driven parallel robot is composed of a rigid frame and an end-effector that is suspended from eight cables—four upper cables and four lower cables. The lengths of the cables are computed from the given positions of the suspended end-effector using a kinematic model. However, most multi-cable-driven robots suffer from interference among the cables, requiring a complex control methodology to find a target goal. Owing to this issue with cable-driven parallel robots, the whole control structure decomposes positioning control missions and allocates them into upper level and lower level. The upper level control is responsible for tracking the suspended end-effector to the target region. The lower level control makes fine positional modifications. Experimental results reveal that the hybrid control mode notably improves positioning performance. The wide variety of issues that are considered in this work apply to aerostats, towing cranes, locomotion interfaces, and large-scale manufacturing that require cable-driven parallel robots.
Paracatadioptric camera calibration based on properties of polar line of infinity point with respect to circle and line
Authors: Li Yuanzhen , Zhao Yue
Published: October 2018

Two linear calibration methods based on space-line projection properties for a paracatadioptric camera are presented. Considering the central catadioptric system, a straight line is projected into a circle on the viewing spherical surface for the first projection. The tangent lines in a group at antipode point pairs with respect to the circle are parallel, with the infinity point being the intersection point; therefore, the infinity line can be obtained from two groups of antipode point pairs. Further, the direction of the polar line of an infinity point with respect to the circle is orthogonal to the direction of its infinity point. Hence, on the imaging plane, images of the circular points or orthogonal vanishing points are used to determine the intrinsic parameters. On the basis of the properties of the antipodal point pairs and a least-squares fitting, a corresponding optimization algorithm for line image fitting is proposed. Experimental results demonstrate the robustness of the two calibration methods, that is, for images of the circular points and orthogonal vanishing points.
On operation termination for degrading systems with two types of failures
Authors: Finkelstein Maxim , Levitin Gregory , Stepanov Oleg A
Published: October 2018

When a failure occurring during a system operation can result in considerable penalties, it can be more cost-effective to terminate the operation at some time avoiding the risk of future failures. This strategy can be relevant for aging systems, for example, when the system failure rate is increasing. The paper analyzes three strategies of termination for systems with major and minor failures. A major failure automatically terminates the operation, whereas the minor failures are minimally repaired. We show that the age-based strategy outperforms the one with termination after the mth minimal repair. The combined strategy when the termination is performed at time t or upon the mth minimal repair, whichever comes first, is also considered. The emphasis for the latter setting is on the practically relevant case when the number of possible minimal repairs is limited. Numerical examples illustrating the findings are presented.
Food and Drug Administration guidances on biosimilars: an update for the gastroenterologist
Authors: Epstein Michael
Published: October 2018

The management of inflammatory bowel disease (IBD), a significant cause of morbidity in the United States (US), has been revolutionized over the last two decades by the introduction of biologic therapies. These include antitumor necrosis factor α (TNF-α) agents. Since 2016, five biosimilar TNF-α inhibitors have been approved by the US Food and Drug Administration (FDA) for use in the treatment of IBD. The FDA has published a series of guidance documents related to the evaluation, licensing, and approval of biosimilars. The aim of this review is to provide an overview of these FDA guidances and the issues associated with biosimilars in the US.
One-Stage Metatarsal Interposition Lengthening With an Autologous Fibula Graft for Treatment of Brachymetatarsia
Authors: Waizy Hazibullah , Polzer Hans , Schikora Nils , Forth Andreas , Becker Felix , Stukenborg-Colsman Chrisitina , Yao Daiwei
Published: October 2018

Objective: Brachymetatarsia is defined as the pathological shortening of a metatarsal bone, which can cause cosmetic problems and pain in the forefoot. The main surgical treatment options are: extension osteotomy, interposition of a bone graft, and callus distraction. Usually, a bone graft from the iliac crest is used for the interposition osteotomy. The operative technique of graft extraction from the fibula has not been described in the literature yet. Methods: Eight feet with brachymetatarsia in 5 patients were evaluated retrospectively. The minimum follow-up period was 2 years. Via a dorsal V/Y skin incision, a central osteotomy on the metatarsal bone was done. A graft was obtained from the anterior fibula. The graft was inserted and fixed by a locking plate. Additional soft tissue procedures were done. Results: We had bony consolidation in all cases. The mean extension was 9.01 mm (5.49 to 12.54 mm). This corresponded to a mean 20.3% extension of the entire metatarsal. High patient satisfaction as well as high satisfaction regarding the cosmetic results were achieved. There were no postoperative complications. The range of motion of the metatarsal-phalangeal joint IV was 20% less preoperative in terms of plantar flexion. Standing up on tiptoes was possible in all patients postoperatively. One patient reported mild symptoms after sports activities. Conclusions: Because of its anatomy the graft adapts to the metatarsal IV bone. As our study showed, harvesting from the distal fibula causes no functional restriction. In terms of wound and bone healing as well as pain symptoms, this method should be considered as an alternative to the standard iliac graft.
Characterization of the structure, cells, and cellular mechanobiological response of human plantar fascia
Authors: Zhang Jianying , Nie Daibang , Rocha Jorge L , Hogan MaCalus V , Wang James H-C
Published: October 2018

In this study, we report that human plantar fascia consists of two distinct tissues with differential structural properties. These tissues also contain stem/progenitor cells with differential biological properties. The mechanobiological responses of these two plantar fascia stem cells also differ in terms of expression of collagen I and IV, non-ligament-related genes, and proinflammatory genes. The production of inflammatory agents (prostaglandin E2, interleukin-6) and matrix degradative enzymes (matrix metalloproteinase-1, matrix metalloproteinase-2) are also different between the two types of plantar fascia stem cells. Based on the findings from this study, we suggest that plantar fasciitis results from the aberrant mechanobiological responses of the stem cells from plantar fascia sheath and core tissues. Our findings may also be used to devise tissue engineering approaches to treat plantar fascia injury effectively.
Spokesperson is a four-letter word: Public relations and power in Occupy New York
Authors: Reyes Camille
Published: October 2018

Adding to the growing literature considering public relations practitioners as activists, this qualitative, interpretative research article explores the controversial idea of acting as spokesperson for a so-called leaderless social movement, Occupy Wall Street (OWS). Through interviews with members of the erstwhile OWS Press Relations Working Group in New York, this article explores their negotiated dual roles as both activists and practitioners. Using critical cultural theory with its emphasis on power, context, and history, the group’s media relations tactics are discussed with an emphasis on the role of spokesperson, revealing contested meanings about public relations work. The framework of the circuit of culture explains the constraints experienced by many of these activist practitioners as they navigated ideals of their movement that were often in conflict with their public relations practices. The study finds uneasy relationships with power in relation to internal and external communication. Specifically, the group disrupts the false binaries of managerial and critical cultural approaches to public relations, as well as agency and oppression through contextual power. Their work brokers a paradox – speaking to change the status quo through a media system arguably captured by the status quo, while using a tactic that was seen as equally problematic.
Folk theorizing the quality and credibility of health apps
Authors: Kanthawala Shaheen , Joo Eunsin , Kononova Anastasia , Peng Wei , Cotten Shelia
Published: October 2018

Increase in availability and accessibility of health apps raises important questions regarding strategies smartphone owners use to determine what health apps to download. As mobile health apps aim at helping users manage their healthy lifestyles and health conditions, it is important for researchers, developers, and educators to know how individuals find and assess the quality and credibility of these apps, and what guides their decisions to download and use them.

We conducted semistructured interviews using the think-aloud technique with 19 community members in a U.S. Midwestern city and analyzed the data using open coding thematic analysis to determine how smartphone users assess health apps before downloading them. We find users determined app credibility through quick, but holistic cues based on the app’s features, and “borrowed” credibility decisions from friends or other health app users. App quality was often equated to personal preferences, that is, how the app met those preferences. Additional cues (cost, app size, order in App Store) led to download decisions but had nothing to do with quality or credibility. We categorized the findings as folk theories regarding quality and credibility of health apps and discuss them using information dual-processing models and media and technology literacy.
Photodistributed sarcoidosis: a case report and approach to management
Authors: Olteanu Cristina , Worley Brandon , Teo Iris , Macdonald Jillian
Published: October 2018

Sarcoidosis is an idiopathic disease, characterized by non-caseating granulomas in multiple organs/tissues. Cutaneous involvement occurs in approximately one-quarter of patients with a wide variety of presenting morphologies. This case report describes a case of photodistributed sarcoidosis, a rare cutaneous variant, with systemic involvement. A 42-year-old man presented with a history of a pruritic, rash with photoexacerbated annular plaques along with arthralgias and bone pain. Compared to previous reports of photodistributed sarcoidosis, our case presented with annular plaques rather than papules, and there was no prior exposure to ionizing radiation. He was treated successfully with prednisone and hydroxychloroquine. It is important to include sarcoidosis in the differential of photodistributed dermatoses.
Mentoring for urologists
Authors: Terry Tim , Redfern Nancy , French Gordon
Published: October 2018

Trainee and established urologists are familiar with ‘generic mentoring’ as a potpourri of helping aids that include supervision, coaching, buddying, career advice, counselling and patronage to enable mentees to develop professionally. However, most are unfamiliar with ‘developmental mentoring’ as a highly specific learnt technique through which mentors help mentees, by interactive dialogue, to choose their own agendas and arrive at their own solutions to career/professional/personal opportunities or difficulties as distinct from the paternalistic mentor approach typified by the downward flow of information generated by ‘generic mentoring’. This paper is a systematic review of developmental mentoring as pertains to urologists in the UK, and reports outcomes of 1-hour taster sessions between Egan-trained mentors and urologists offered at British Association of Urological Surgeons (BAUS) annual general meetings since 2013. Both the General Medical Council and the Royal College of Surgeons of England imply that ‘mentoring’ is mandatory for both trainees and trained urologists, but fail to clarify what they mean by a ‘mentor’, which potentially creates a void in providing ‘developmental mentoring’ since the later requires specific training and is costly to provide. Currently, most ‘developmental mentoring’ is performed by trained staff in Local Education and Training Boards or National Health Service Trusts. BAUS has an opportunity to offer ‘developmental mentoring’ through a portal on its website to manage opportunities and difficulties experienced by its members.

Level of evidence: This paper is a systematic review as pertains to the place of mentoring in current urological practice. By its nature, it has reviewed previous narrative reviews and its highest level of evidence is a contemporary paper from 2016, which was a comparative cross-sectional study; other case series were reviewed. Overall, this amounts to level 4 with a recommendation of C as per the Oxford Centre for Evidence-based Medicine Levels of Evidence.
“We Will Either Find a Way, or Make One”: How Iranian Green Movement Online Activists Perceive and Respond to Repression
Authors: Honari Ali
Published: October 2018

While studies on the effect of repression of online activism mainly focus on the capabilities of states in surveillances and filtering on the web, this article focuses on individuals’ responses to repression. Using data gathered by in-depth interviews of online activists of the Iranian Green Movement—the pro-democracy movement which emerged after the disputed 2009 elections—this article attempts to shed light on online activism under repression. The article focuses on two questions: How do activists perceive repression? How do they respond to repression? The research distinguishes three dimensions of perceived repression which interactively influence activists’ choices in their response to repression: the importance of the repression, the external assessment of this repression, and the internal assessment. Regarding the response to repression, five distinct strategies are identified (1) de-identification, (2) network reformation, (3) circumvention, (4) self-censoring, and (5) being inconspicuously active. The study has a number of important theoretical and empirical implications for future studies on repression and online activism under authoritarian contexts.
Self-Reported Hearing Loss and Pure Tone Audiometry for Screening in Primary Health Care Clinics
Authors: Louw Christine , Swanepoel De Wet , Eikelboom Robert H
Published: October 2018

Objective: To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. Design: Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss. Results: Four hundred and thirty-six participants (40.2%) self-reported a hearing loss with no significant association with gender or race. One hundred and thirty-six participant (12.5%) self-reported hearing loss and failed audiometry screening (35 dB HL at 1, 2, and 4 kHz). Combining self-report with a second stage audiometry screening revealed a high test accuracy (81.0%) for hearing loss, being most accurate (86.1%) to identify high-frequency hearing loss. Conclusion: While self-report of hearing loss is an easy and time-efficient screening method to use at primary health care clinics, its accuracy may be limited when used in isolation and it may not be sufficiently sensitive to detect hearing loss. Combining a simple audiometry screening as a second-stage screen can significantly improve overall performance and efficiency of the screening protocol.
The Effect of Serious Offending on Health: A Marginal Structural Model
Authors: Baćak Valerio , Karim Mohammad Ehsanul
Published: October 2018

In this study, we contribute to the emerging scholarship at the intersection of crime and health by estimating the effect of serious offending on offenders’ health. By building on sociological stress research, we identify and adjust for the key life course processes that may intervene on the pathway from offending to health using a rich set of measures available in the panel data from the National Longitudinal Study of Adolescent to Adult Health. Because offending and health share many causes and consequences, a critical challenge is accounting for confounding and mediation that unfold over time. We adjust for these time-varying processes by estimating repeated measures marginal structural models with inverse probability of treatment weights. The results show that offending over the life course is adversely linked to health but not uniformly across race and gender.
Process Trumps Protocol: What I Liked About Hofmann and Hayes
Authors: Hollon Steven D.
Published: October 2018

Hofmann and Hayes (this issue, p. 37) argue for a move away from a reliance on a medical illness model in which rigid therapy protocols are targeted at presumed disease entities in favor of a more process-based approach that targets core mediators and moderators based on testable theories. I could not agree more. I find their arguments persuasive and their implications exciting.
The Rapidly Assessed Predictor of Intraoperative Damage (RAPID) Score: An In-Clinic Predictive Model for High-Grade Acetabular Chondrolabral Disruption
Authors: Hevesi Mario , Hartigan David E. , Wu Isabella T. , Wyles Cody C. , Desai Vishal S. , van Wijnen Andre J. , Saris Daniel B.F. , Levy Bruce A. , Krych Aaron J.
Published: October 2018

Background:

The preoperative assessment of cartilage lesions is critical to surgical planning and decision making. The accurate radiographic determination of acetabular cartilage damage has remained elusive for modern imaging modalities, including magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA). While risk factors have been individually described, no multivariable system exists for predicting high-grade cartilage damage.

Purpose:

To determine the preoperative predictors of grade 3 to 4 acetabular labrum articular disruption (ALAD) lesions.

Study Design:

Case-control study; Level of evidence, 3. Cohort study (diagnosis); Level of evidence, 1.

Methods:

Retrievable radiographs were reviewed from primary hip arthroscopic procedures performed at 2 high-volume institutions between December 2007 and April 2017. The predictive value of demographic and radiographic factors for the intraoperative documentation of ALAD grade 3 to 4 damage was analyzed and entered into a multivariable model, and a statistically guided scoring system for the damage risk was created using the Akaike information criterion. The scoring system was then prospectively validated on 167 patients who underwent primary hip arthroscopy between April 2017 and February 2018.

Results:

A total of 652 primary hip arthroscopic procedures in 614 patients (390 female, 224 male; mean age, 33.2 ± 12.5 years; mean body mass index, 26.9 ± 5.5 kg/m2) from 2007 to 2017 were analyzed. Male sex (odds ratio [OR], 3.11; P < .01), age ≥35 years (OR, 1.96; P < .01), cam morphology (alpha angle >55°) (OR, 2.96; P < .01), and Tönnis grade 1 to 2 (grade 1: OR, 4.14; P < .01, and grade 2: OR, 9.29; P < .01) were univariate risk factors for intraoperatively documented high-grade damage. A multivariable scoring system, the Rapidly Assessed Predictor of Intraoperative Damage (RAPID) score (0-5 points), was generated based on sex, Tönnis grade, and cam morphology. Patients with increasing RAPID scores had an increasing risk of damage, with a 10.5% risk for those with 0 points and an 88.0% risk for those with 5 points ( P < .01). The area under the curve was 0.75 for the study group and 0.76 for the validation group ( P = .94).

Conclusion:

While preoperative MRI has diagnostic value for hip arthroscopic surgery, the RAPID score provides added benefit as a readily employable, in-clinic system for predicting high-grade cartilage damage. The discriminatory value of the RAPID score compares favorably with previous MRI and MRA studies. This information will help the clinician and patient plan for high-grade damage and identify potential targets for cartilage treatment.
Development of Self-Directedness and Cooperativeness in Relation to Post-Traumatic Stress Disorder Symptom Trajectories After Military Deployment
Authors: Reijnen Alieke , Geuze Elbert , Gorter Rosalie , Vermetten Eric
Published: October 2018

Background

Personality traits, such as the character traits self-directedness and cooperativeness, might play a role in the risk of developing post-traumatic stress disorder (PTSD) after deployment to a combat zone. However, it is unclear whether these traits are preexisting risk factors or if event-related changes might also be associated with PTSD symptoms over time. Therefore, the current aim was to assess if military deployment is associated with changes in cooperativeness and self-directedness and to study how these traits are related to PTSD symptom trajectories.

Methods

In a large cohort of military personnel (N = 1007), measurements were performed before, at one and six months, and two and five years after deployment to Afghanistan. Linear mixed-effect models were used to assess the individual change in the traits over time and to study the relation with potential predictors.

Results

Cooperativeness was found to remain stable, whereas self-directedness was found to slightly decrease over time. This decrease was related to the development of PTSD symptoms over time. Furthermore, lower levels of self-directedness were associated with the symptomatic trajectories of PTSD symptoms. Lower levels of cooperativeness were only associated with the recovered PTSD trajectory.

Conclusions

So, not only do the findings confirm that lower levels of these character traits are associated with the development of PTSD symptoms, it was also shown that there are differences in the relation between these traits and the course of PTSD symptoms. Studying methods to promote the levels of these character traits might help to improve the resiliency of military personnel.
Successful hematopoietic stem cell mobilization and apheresis collection using plerixafor alone in sickle cell patients
Authors: Esrick Erica B. , Manis John P. , Daley Heather , Baricordi Cristina , Trébéden-Negre Hélène , Pierciey Francis J. , Armant Myriam , Nikiforow Sarah , Heeney Matthew M. , London Wendy B. , Biasco Luca , Asmal Mohammed , Williams David A. , Biffi Alessandra
Published: October 2018

Novel therapies for sickle cell disease (SCD) based on genetically engineered autologous hematopoietic stem and progenitor cells (HSPCs) are critically dependent on a safe and effective strategy for cell procurement. We sought to assess the safety and efficacy of plerixafor when used in transfused patients with SCD for HSC mobilization. Six adult patients with SCD were recruited to receive a single dose of plerixafor, tested at lower than standard (180 µg/kg) and standard (240 µg/kg) doses, followed by CD34+ cell monitoring in peripheral blood and apheresis collection. The procedures were safe and well-tolerated. Mobilization was successful, with higher peripheral CD34+ cell counts in the standard vs the low-dose group. Among our 6 donors, we improved apheresis cell collection results by using a deep collection interface and starting apheresis within 4 hours after plerixafor administration. In the subjects who received a single standard dose of plerixafor and followed the optimized collection protocol, yields of up to 24.5 × 106 CD34+ cells/kg were achieved. Interestingly, the collected CD34+ cells were enriched in immunophenotypically defined long-term HSCs and early progenitors. Thus, we demonstrate that plerixafor can be employed safely in patients with SCD to obtain sufficient HSCs for potential use in gene therapy.
Cardiovascular disease and COPD: dangerous liaisons?
Authors: Rabe Klaus F. , Hurst John R. , Suissa Samy
Published: October 2018

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently occur together and their coexistence is associated with worse outcomes than either condition alone. Pathophysiological links between COPD and CVD include lung hyperinflation, systemic inflammation and COPD exacerbations. COPD treatments may produce beneficial cardiovascular (CV) effects, such as long-acting bronchodilators, which are associated with improvements in arterial stiffness, pulmonary vasoconstriction, and cardiac function. However, data are limited regarding whether these translate into benefits in CV outcomes. Some studies have suggested that treatment with long-acting β2-agonists and long-acting muscarinic antagonists leads to an increase in the risk of CV events, particularly at treatment initiation, although the safety profile of these agents with prolonged use appears reassuring. Some CV medications may have a beneficial impact on COPD outcomes, but there have been concerns about β-blocker use leading to bronchospasm in COPD, which may result in patients not receiving guideline-recommended treatment. However, there are few data suggesting harm with these agents and patients should not be denied β-blockers if required. Clearer recommendations are necessary regarding the identification and management of comorbid CVD in patients with COPD in order to facilitate early intervention and appropriate treatment.
Combination systemic therapies with immune checkpoint inhibitors in pancreatic cancer: overcoming resistance to single‐agent checkpoint blockade
Authors: Gong Jun , Hendifar Andrew , Tuli Richard , Chuang Jeremy , Cho May , Chung Vincent , Li Daneng , Salgia Ravi
Published: October 2018

Immune checkpoint inhibitors have demonstrated broad single‐agent antitumor activity and a favorable safety profile that render them attractive agents to combine with other systemic anticancer therapies. Pancreatic cancer has been fairly resistant to monotherapy blockade of programmed cell death protein 1 receptor, programmed death ligand 1, and cytotoxic T‐lymphocyte associated protein 4. However, there is a growing body of preclinical evidence to support the rational combination of checkpoint inhibitors and various systemic therapies in pancreatic cancer. Furthermore, early clinical evidence has begun to support the feasibility and efficacy of checkpoint inhibitor‐based combination therapy in advanced pancreatic cancer. Despite accumulating preclinical and clinical data, there remains several questions as to the optimal dosing and timing of administration of respective agents, toxicity of combination strategies, and mechanisms by which immune resistance to single‐agent checkpoint blockade are overcome. Further development of biomarkers is also important in the advancement of combination systemic therapies incorporating checkpoint blockade in pancreatic cancer. Results from an impressive number of ongoing prospective clinical trials are eagerly anticipated and will seek to validate the viability of combination immuno‐oncology strategies in pancreatic cancer.
X-ray computed tomography (XCT) and chemical analysis (EDX and XRF) used in conjunction for cultural conservation: the case of the earliest scientifically described dinosaur Megalosaurus bucklandii
Authors: Wilson P. F. , Smith M. P. , Hay J. , Warnett J. M. , Attridge A. , Williams M. A.
Published: October 2018

This paper demonstrates the combined use of X-ray computed tomography (XCT), energy dispersive X-ray spectroscopy (EDX) and X-ray fluorescence (XRF) to evaluate the conservational history of the dentary (lower jaw) of Megalosaurus bucklandii Mantell, 1827, the first scientifically described dinosaur. Previous analysis using XCT revealed that the specimen had undergone at least two phases of repair using two different kinds of plaster, although their composition remained undetermined. Additional chemical analysis using EDX and XRF has allowed the determination of the composition of these unidentified plasters, revealing that they are of similar composition, composed dominantly of ‘plaster of Paris’ mixed with quartz sand and calcite, potentially from the matrix material of the Stonesfield Slate, with the trace presence of chlorine. One of the plasters unusually contains the pigment minium (naturally occurring lead tetroxide; Pb2
2+Pb4+O4) whilst the other seems to have an additional coating of barium hydroxide (Ba(OH)2), indicating that these likely represent two separate stages of repair. The potential of this combined approach for evaluating problematic museum objects for conservation is further discussed as is its usage in cultural heritage today.