bluuebunny/crossref_metadata_2025 huggingface dataset:
Assistive Technology for Students With Disabilities: An Updated Snapshot
Authors: Bouck Emily C. , Long Holly
Published: March 2020

Assistive technology can benefit students with disabilities in terms of independence and performance. Yet more research is needed regarding usage of assistive technology. Using the National Longitudinal Transition Study 2012 database, the authors explored reported use regarding assistive technology by secondary students with disabilities. Overall, the authors found low rates of assistive technology reported use among students with disabilities aggregated, although there were large ranges across disability categories (e.g., 14.5%–74.0% for use of assistive technology). Disability category had a statistically significant relationship with reported assistive technology use for secondary students.
(Re)Playing Shakespeare through modern dance: Youri Vámos’s Romeo and Juliet
Authors: Mantellato Mattia
Published: March 2020

This article discusses Youri Vámos’s 1997 modern-dance adaptation of William Shakespeare’s Romeo and Juliet. It examines the shift from Renaissance Verona to the 20th century; his choreographic architecture within physical and spatial ‘partitions’; and his contemporary-dance vocabulary, which fuses classical technique with modern gestures and movements. The lovers are interpreted by the youngest, least experienced dancers in the ensemble, while the dramatisation shifts between irony and tragedy, following a succession of intersemiotic translations of the text and stylistic reworkings. The article concludes with a study of the lovers’ pas de deux, comparing their first encounter and the ballet’s tragic conclusion.
Vitamin C and inflammatory cytokine levels in elective total knee arthroplasty
Authors: Shah Shalin , Brown Christopher , Owen John , Fisher Bernard , Natarajan Ramesh , Kates Stephen
Published: March 2020

Background:

Vitamin C levels are decreased in arthritis patients and reduced levels following surgery may impair adequate healing.

Aim:

This study measured changes in vitamin C and inflammatory markers in patients undergoing total knee arthroplasty (TKA).

Methods:

Venous blood samples were collected from 10 patients during the preoperative to postoperative period. Vitamin C, interleukin-1 β, interleukin-6 (IL-6), and C-reactive protein (CRP) levels were measured using various assays.

Results:

No significant changes in vitamin C levels were measured. However, all participants had suboptimal preoperative vitamin C levels and 90% had suboptimal levels postoperatively. IL-6 and CRP levels significantly increased during the immediate postoerative period.

Conclusion:

There was a rise in inflammation following TKA while vitamin C levels did not significantly change during this short study period. Of note, every patient had suboptimal vitamin C levels prior to surgery and 90% continued with suboptimal levels two days postoperatively.
Agribiopolitics: The health of plants and humans in the age of monocrops
Authors: Hetherington Kregg
Published: March 2020

The well-known story of biopolitics tells us that as Europe urbanized, security was increasingly linked to human well-being. What the story tends to leave out is the way that biopolitics also depended on the expansion of monocrop agriculture: the thriving of human populations was enabled by the thriving of non-human food crops, especially grains. As a result, new human diseases were also shadowed by new plant diseases, and a whole other, parallel governmental apparatus built to manage the crop health in rural Europe. During the great postwar development initiative known as the Green Revolution, plant health techniques would be expanded to the Global South in a massive realignment of biopolitical relations. Though the core tradition of biopolitical thought rarely made it explicit, biopolitics was always, in other words, agribiopolitics, a political technique that made certain populations of humans thrive alongside companion crops. Using Paraguay as a site of genealogical engagement, this paper explores agribiopolitical relations through three phases of the Green Revolution, culminating in the current age of monocrops.
A Foolish Proposal? Vulnerability as an Alternative Attempt to Contribute to Decolonisation and Reconciliation in Post-Colonial South Africa
Authors: Grohmann Marcus
Published: March 2020

Reconciliation in South Africa is often taken to mean the creation of culturally diverse communities. In reality, though, the multicultural often turns out to be multiracial only with People of Colour being included in White-dominated spaces. Likewise, socio-economic transformation means raising people’s chances to attain a living standard more equal to that of the bulk of the White population. In both cases, the strong position of White people in sociocultural and socio-economic terms remains largely untouched. Hence the calls for decolonisation which seem to render the reconciliation discourse dispensable. Vulnerability by White South Africans is proposed as an alternative response to ongoing inequalities which – it is suggested – could contribute to both decolonisation and reconciliation on an interpersonal level. Likely objections to such a proposal are considered before making a case for vulnerability as an appropriate Christian way of living, particularly in the context of former settler colonialism.
A narrative review of antithrombin use during veno-venous extracorporeal membrane oxygenation in adults: rationale, current use, effects on anticoagulation, and outcomes
Authors: Piacente Claudia , Martucci Gennaro , Miceli Vitale , Pavone Gaetano , Papeo Anna , Occhipinti Giovanna , Panarello Giovanna , Lorusso Roberto , Tanaka Kenichi , Arcadipane Antonio
Published: March 2020

Background:

During extracorporeal membrane oxygenation, the large contact surface between the blood and the extracorporeal circuit causes a continuous activation of coagulation and inflammation. Unfractionated heparin, a glycosaminoglycan that must bind to antithrombin as a cofactor, is currently the standard anticoagulant adopted during extracorporeal membrane oxygenation. Antithrombin, beyond being a potent natural anticoagulant, acts in the cross-talk between coagulation and inflammatory system through anticoagulation and coagulation-independent effects.

Objectives:

In this review, we describe, in the adult setting of veno-venous extracorporeal membrane oxygenation, the pathophysiological rationale for antithrombin use, the current practice of administration, and the effects of antithrombin on anticoagulation, bleeding, and outcomes.

Data sources:

Studies on adults (18 years or older) on veno-venous extracorporeal membrane oxygenation published from 1995 to 2018 in order to evaluate the use of antithrombin.

Results:

In adults on veno-venous extracorporeal membrane oxygenation, antithrombin supplementation has a highly pathophysiological rationale since coagulation factor consumption, systemic inflammatory response syndrome, and endothelial activation are triggered by extracorporeal membrane oxygenation. Eleven articles are focused on the topic but among the authors there is no consensus on the threshold for supplementation (ranging from 70% to 80%) as well as on the dose (rarely standardized) and time of administration (bolus vs continuous infusion). Consistently, antithrombin is considered able to achieve better anticoagulation targets in or not in the presence of heparin resistance. The impact of antithrombin administration on bleeding still shows contrasting results.

Conclusion:

Antithrombin use in veno-venous extracorporeal membrane oxygenation should be investigated on the threshold for supplementation, dose, and time of administration.
Outcomes of Effective Integration of Clinical Risk Management Into Health Care From Nurses’ Viewpoints: A Qualitative Study
Authors: Farokhzadian Jamileh , Sabzi Amirreza , Nayeri Nahid Dehghan
Published: March 2020

The aim of this study was to explore nurses’ experiences and viewpoints about the outcomes of effective integration of clinical risk management (CRM) into health care. This qualitative study was conducted using purposive sampling and semistructured interviews with 19 nurses from three hospitals affiliated with a large medical university. Data were analyzed by the conventional qualitative content analysis method proposed by Lundman and Graneheim. Data analysis reflected the following concepts: improving the quality of services and promoting health, preserving and protecting patient safety, increasing satisfaction, improving staff morale, and improving organizational awareness and vigilance. According to the results, CRM with its positive outcomes can help the development of a patient-oriented culture. The results can be a starting point for further quantitative and qualitative research to explore other strategies, potentials, and capacities of quality improvement activities such as CRM in other contexts and cultures.
Acute cholecystitis: predictive clinico-radiological assessment for conversion of laparoscopic cholecystectomy
Authors: Jang Young Rock , Ahn Su Joa , Choi Seung Joon , Lee Ki Hyun , Park Yeon Ho , Kim Keon Kuk , Kim Hyung-Sik
Published: March 2020

Background

Previous studies evaluating predictive factors for the conversion from laparoscopic to open cholecystectomy have reported conflicting conclusions.

Purpose

To create a risk assessment model to predict the conversion from laparoscopic to open cholecystectomy in patients with acute calculous cholecystitis.

Material and Methods

A retrospective review of patients with acute calculous cholecystitis with available preoperative contrast-enhanced computed tomography (CT) findings who underwent laparoscopic cholecystectomy was performed. Forty-four parameters—including demographics, clinical history, laboratory data, and CT findings—were analyzed.

Results

Among the included 581 patients, conversion occurred in 113 (19%) cases. Multivariate analysis identified obesity (odd ratio [OR] 2.58, P = 0.04), history of abdominal surgery (OR 1.78, P = 0.03), and prolonged prothrombin time (OR 1.98, P = 0.03) as predictors of conversion. In preoperative CT findings, the absence of gallbladder wall enhancement (OR 3.15, P = 0.03), presence of a gallstone in the gallbladder infundibulum (OR 2.11, P = 0.04), and inflammation of the hepatic pedicle (OR 1.71, P = 0.04) were associated with conversion. Inter-observer agreement for CT study interpretation was very good (range 0.81–1.00). A model was created to calculate the risk for conversion, with an area under the receiver operating characteristic curve of 0.87. The risk for conversion, estimated based on the number of factors identified, was in the range of 5.3% (with one factor) to 86.4% (with six factors).

Conclusion

Obesity, history of abdominal surgery, prolonged prothrombin time, absence of gallbladder wall enhancement, presence of a gallstone in the gallbladder infundibulum, and inflammation of the hepatic pedicle are associated with conversion of laparoscopic to open cholecystectomy.
Myocardial damage associated with elective percutaneous coronary intervention in Chinese patients: a retrospective study
Authors: Sun Shengjia , Ou Yang , Shi Haiming , Luo Jianfeng , Luo Xinping , Shen Yunzhi , Chen Yufei , Liu Xiaojin , Zhu Zhidong , Shen Wei
Published: March 2020

Objective

To determine the prevalence of percutaneous coronary intervention (PCI) related myocardial damage (injury or myocardial infarction), investigate several cardiac biomarkers, explore possible risk factors and assess survival in patients undergoing elective PCI.

Methods

Patients >18 years of age who had undergone an elective PCI at Huashan hospital in Shanghai, China from October 2016 to June 2017 and had baseline and post-PCI results available for four cardiac biomarkers (cTnT, CK-MB mass, hs-CRP and NT-ProBNP) were eligible. Patients were separated into two groups according to whether or not they had PCI related myocardial damage.

Results

Of the 143 patients who were eligible for the study, 75 (52%) were classified as ‘controls,’ and 68 (48%) had PCI related myocardial damage. Of the 68 patients, 64 (45%) had PCI related myocardial injury and 4 (3%) had PCI related myocardial infarction. Elderly Chinese patients, with high systolic blood pressure on admission and who required multiple coronary segments for PCI had a high risk of myocardial damage. Relative cTnT or relative CK-MB mass may be useful cardiac biomarkers for monitoring PCI related myocardial damage, especially at 24h post-PCI. There was no significant difference in survival rates between controls and those with myocardial complications.

Conclusions

PCI related myocardial damage is common but appears to have no impact on prognosis. Senior age, high systolic blood pressure and multiple coronary segments for PCI are risk factors.
Comparative analysis of electrocardiographic imaging and ECG in predicting the origin of outflow tract ventricular arrhythmias
Authors: Zhou Xinbin , Fang Lin , Wang Zhijun , Liu Huafeng , Mao Wei
Published: March 2020

Objectives

The aim of this study was to investigate the accuracy of electrocardiographic imaging (ECGI) in localizing the origin of outflow tract ventricular arrhythmias (OTVAs) and compare its performance with that of seven published 12-lead electrocardiography (ECG) algorithms.

Methods

Patients with OTVAs who were undergoing catheter ablation were prospectively investigated. The OVTA origins were localized using both ECGI and seven 12-lead ECG algorithms, with the successful ablation site set as the gold standard. The performance of the ECGI and 12-lead ECG algorithms were compared.

Results

Twenty-seven patients were enrolled into the study. The ECGI system correctly identified the chamber of OTVA origin in 27/27 (100%) patients and the sublocalization within the right ventricular outflow tract (RVOT) in 21/22 (95.5%) patients. However, the ECG algorithms correctly diagnosed the chamber and sublocalization in only 21/27 (77.8%) patients and 13/22 (59.1%) patients, respectively, which was significantly lower compared with the ECGI system.

Conclusions

Non-invasive ECGI can accurately predict the origin of OTVAs in a manner that is superior to that of conventional 12-lead ECGs in differentiating the RVOT from the left ventricular outflow tract (LVOT) and septum from free wall in the RVOT. This provides a useful tool to guide catheter ablation. This trial has been registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1900025527).
Whole clinical process in a patient with portal hypertensive biliopathy: a case report
Authors: Ma Yimin , Cai Rencheng , Zhuang Duanming , Tang Yuehua , Cao Youhong , Wang Xiaoping , Qiao Zhenguo
Published: March 2020

Portal hypertensive biliopathy is characterized by abnormalities in the biliary tract secondary to portal hypertension, especially extrahepatic portal vein obstruction. Most patients are asymptomatic; only about 20% have clinical symptoms. We herein report a case of portal hypertensive biliopathy caused by cavernous transformation of the portal vein with the development of recurrent cholangitis with common bile duct stones and stricture. This patient underwent endoscopic retrograde cholangiopancreatography, a surgical operation, and a transvenous intrahepatic portosystemic shunt procedure during the whole clinical process. Finally, we found the recurrent plastic stent insertion at endoscopic retrograde cholangiopancreatography was the best option for him at present. In addition, we also discussed the diagnosis and management of this disease.
Preparing for uncertainty during public health emergencies: What Canadian health leaders can do now to optimize future emergency response
Authors: Tam Theresa W. S.
Published: March 2020

It is clear that the risk for epidemics with high health and socio-economic impacts remains but there will be many unknowns at the start of future responses to these events. This article highlights principles and practices to assist health leaders in preparing for uncertainty, including integrating scalability to ensure response activities can be more easily adapted to suit evolving needs; assessing risk and capabilities to inform planning for appropriate response measures; and considering overall flexibility and adaptability of plans, systems, and resources. Ultimately, being prepared for “Disease X” is about applying the approaches that we have learned from previous events, using evidence-based practices to develop and strengthen foundational capacities, so that we are able to respond to the unanticipated in proportionate and appropriate ways.
Intimate Partner Violence Among Persons With Mental Health-Related Disabilities in Canada
Authors: Brownridge Douglas A. , Taillieu Tamara , Urquia Marcelo L. , Lysova Alexandra , Chan Ko Ling , Kelly Christine , Santos Susy
Published: March 2020

This study examined the elevated risk of intimate partner violence (IPV) among persons with mental health-related disabilities (MH-RD) and the extent to which known risk factors accounted for this phenomenon. Data were drawn from a nationally representative sample of 33,127 Canadians collected in 2014 as part of Statistics Canada’s General Social Survey. Results showed that respondents with MH-RD had more than three-fold increased odds of both overall and severe IPV victimization. Although females were more likely to possess a MH-RD, males and females with MH-RD reported similarly elevated odds of IPV victimization. Risk factors that contributed to a significant reduction in elevated odds of IPV for respondents with MH-RD were child maltreatment (CM), respondents’ nonprescription drug abuse, and perpetrators’ jealous, monitoring, and socially isolating behaviors. The inability to test additional risk factors and bidirectionality in the relationship between MH-RD and IPV may have contributed to the failure to fully account for these respondents’ elevated odds of IPV. Future research is needed to understand the complex mechanisms contributing to the elevated risk of IPV and enhance prevention and intervention strategies for this underresearched and underserved vulnerable population.
Relationships Among Childhood Maltreatment, Limbic System Dysfunction, and Eating Disorders in College Women
Authors: Mercurio Andrea E. , Hong Fang , Amir Carolyn , Tarullo Amanda R. , Samkavitz Anna , Ashy Majed , Malley-Morrison Kathleen
Published: March 2020

The mechanisms linking childhood maltreatment and eating pathology are not fully understood. We examined the mediating role of limbic system dysfunction in the relationships between three forms of childhood maltreatment (parental psychological maltreatment, parental physical maltreatment, and parental emotional neglect) and eating disorder symptoms. A convenience sample of college women ( N = 246, M age = 19.62, SD = 2.41) completed measures of maltreatment (Parent-Child Conflict Tactics Scales and the Parental Bonding Instrument), limbic system dysfunction (Limbic System Questionnaire), and eating pathology (Eating Disorder Examination Questionnaire). We hypothesized that there would be an indirect effect of each type of childhood maltreatment on eating disorder symptoms via limbic system irritability. Results generally supported the hypotheses. Examination of the individual paths that defined the indirect effect indicated that higher reported childhood maltreatment was associated with greater limbic irritability symptoms, and higher limbic irritability symptomatology was related to higher total eating disorder scores. There were no significant direct effects for any of the proposed models. Findings are in line with research supporting the role of limbic system dysfunction as a possible pathway in the maltreatment-eating disorder link. Given that limbic system dysfunction may underlie behavioral symptoms of eating disorders, efforts targeting limbic system dysfunction associated with child maltreatment might best be undertaken at an early developmental stage, although interventions for college women struggling with eating disorders are also crucial.
Managerialism – A Social Order on the Rise
Authors: Shatil Sharron
Published: March 2020

This paper investigates the deeper ideological aspects of managerialism, or managerial social dominance in recent decades. While two academic discourses of managerialism can be identified, and management takeover of all major social organisations is receiving considerable academic attention, managerial dominance is yet to be explicitly discussed. In the hope of contributing towards this goal, this paper focuses on the managerialist picture of the subject, which – based on post-Althusserian ideology theory – lies at the heart of its ideological structures. I call this picture the ‘ultra-individual’, based mainly on the three factors of improvability, employability and satisfaction. The ultra-individual is a perfectly adaptable team player, who in return gains the right to satisfaction in all social dealings. Managerial social dominance is thereby cast as a superior model of social justice and individual empowerment leading to everyone’s satisfaction and self-fulfilment, over against the conflict ridden liberal models of capitalism.
The logic of regulatory venue shopping: A firm’s perspective
Authors: Coen David , Guidi Mattia , Yordanova Nikoleta , Héritier Adrienne
Published: March 2020

Drawing on an original and unique survey data set of 243 medium- and big-sized firms operating in five sectors (energy, telecommunications, railways, airlines and postal services) and across 29 European countries, we analyse what incentivizes firms to interact with and influence multiple regulators. In so doing, we map the regulatory opportunity structure and scrutinize firms’ venue shopping logics. The study shows that firms can clearly identify where the locus of political and regulatory competence lies and that they concentrate their activities at this level. In particular, the data show that the national level is still the most important target level for regulatory representation. Regulatory venue shopping, the study illustrates, occurs when issues are highly salient, highly technical and when high stakes are involved. Notably, we show that firms tend to address more regulators in sectors characterized by higher international competitiveness to mitigate uncertainty when operating in multiple markets and facing rivalry from international competitors.
Combined scalar tracking, computational fluid dynamics, and multi-objective genetic algorithm method to accelerate optimization of film cooling systems
Authors: Ornano Francesco , Povey Thomas
Published: March 2020

This paper presents a method to significantly accelerate optimization of film cooling systems. The method combines high-fidelity computational fluid dynamics with scalar tracking implemented, a proxy model (linear superposition model) initialized with the computational fluid dynamics solution, and a multi-objective evolutionary algorithm approach. The proposed method is structured as follows: the computational fluid dynamics solution is used to predict the (generally complex) flow domain for the film cooling system; the scalar tracking method identifies the contributions of individual holes to an overall cooling effectiveness distribution by associating a unique passive scalar variable to the flow associated with each hole, and solving an additional advection–diffusion (scalar transport) equation; the proxy model is a (generally linear) superposition model implemented – for example – in Matlab, which inherits the scalar values from the computational fluid dynamics solution, and allows extrapolation of solutions to new design points as part of an optimization process; the optimization process is handled with a multi-objective evolutionary algorithm approach which iterates the proxy model to optimize for a defined objective function. The process works with inner and outer convergence loops. The inner convergence loop is the multi-objective evolutionary algorithm interfacing with the proxy model, which achieves convergence against a design target. At the end of each inner loop cycle, a high-fidelity computational fluid dynamics simulation is run, and this is used to recalibrate the proxy model. Convergence for a given objective function is typically achieved with six outer-loop iterations (high-fidelity computational fluid dynamics runs) and 10,000 inner-loop iterations per outer-loop iteration. The significant advantage of the proposed method is that for certain optimization problems, the computational cost can be reduced by several orders of magnitude, replacing thousands of high-fidelity computational fluid dynamics runs with approximately six computational fluid dynamics runs. The process is demonstrated by applying the optimization method to the film cooling of a flat plate. In our example we have an objective function which maximizes the component life (related to the difference from an arbitrary target temperature distribution) and minimizes the mixing loss introduced by the films. The flow environment was moderately compressible. The optimization converged after six computational fluid dynamics runs. A 30% reduction in mixing loss, a 11% increase in component life, and a 30% reduction in cooling mass flow rate were achieved. The advantages and limitations of the proposed method are also discussed in detail.
Dry needling for scar treatment
Authors: Rozenfeld Evgeni , Sapoznikov Sebakhutu Eleanora , Krieger Yuval , Kalichman Leonid
Published: March 2020

Objective:

To review current scientific knowledge as to the efficacy of dry needling of scars on pain and other related symptoms and explore the possible physiological mechanisms of action.

Methods:

A narrative review of scientific literature published in English.

Results:

Two randomized controlled trials found that dry needling of scars (using the classic “surrounding the dragon” technique in one study and intradermal needling in a second study) was more effective than sham or control interventions with respect to scar appearance and pain. Two case reports have suggested that scar needling generates a rapid decrease in pain and improvement of mobility in scarred tissues. Another two case reports have reported positive effects of scar needling on the wound healing process. These findings are supported by an animal study examining the effect of needling on the wound healing process and the physiological mechanisms of action underlying the technique.

Conclusion:

There is preliminary evidence that the “surrounding the dragon” needling technique is a beneficial treatment for patients suffering from scar pain and other scar-related symptoms and can facilitate wound healing and make this process less painful. Further high-quality studies should be conducted to verify/quantify the efficacy of this method, to better understand the underlying mechanisms of action underlying the effects of scar needling and to establish an effective intervention protocol.
A nurses’ ethical commitment to people with intellectual and developmental disabilities
Authors: Fisher Kathleen , Robichaux Catherine , Sauerland Jeanie , Stokes Felicia
Published: March 2020

Aim: This article explores the issues of knowledge deficits of healthcare professionals in meeting the needs of people with IDD throughout the life span, and to identify factors that contribute to these deficits.

Although statistics vary due to census results and the presence of a “hidden population,” approximately 1%–3% of the global population identify as living with an intellectual or developmental disability. People with intellectual or developmental disability experience health inequities and confront multiple barriers in society, often related to the stigma of intellectual or developmental disability. Disparities in care and service are attributed to a lack of knowledge and understanding among healthcare providers about people with intellectual or developmental disability, despite their increased risk for chronic health problems. The near absence of educational programs in nursing both nationally and internationally contributes to this significant knowledge deficit. In addition, ethical considerations between paternalistic beneficence and idealized autonomy have resulted in a lack of clear direction in working with a population that is often ignored or exploited. Nurses who view people with intellectual or developmental disability as vulnerable without assessing or acknowledging their capabilities may err toward paternalism in an effort to “first do no harm.” Likewise, nurses who fail to recognize the challenges and limitations faced by people with intellectual or developmental disability may not provide sufficient protections for a vulnerable person. People with intellectual or developmental disability are not binary, but rather complex individuals with a myriad of presentations. This article seeks to encourage a well-informed model of nursing care. Through an ethical lens, this article explores the nurse’s ethical commitments in cases of victimization, access to care, decision making, and the provision of optimal end-of-life care for people with intellectual or developmental disability.
Book review: Anne de Bruin and Simon Teasdale (Eds.), A Research Agenda for Social Entrepreneurship
Authors: Chand Vijaya Sherry
Published: March 2020

Anne de Bruin and Simon Teasdale (Eds.), A Research Agenda for Social Entrepreneurship, Cheltenham: Edward Elgar Publishing, 2019, 183 pp.
Gender Differences in Millennial Consumers of Latin America Associated with Conspicuous Consumption of New Luxury Goods
Authors: Verdugo Gustavo Barrera , Ponce Héctor R.
Published: March 2020

Conspicuous consumption has been studied in the millennial generation in the United States and Asia; in Latin America, however, it has scarcely been analysed. The purpose of this study is to examine whether conspicuous motivations in millennial consumers are more prominent in men than in women associated with the consumption of new luxury goods in Latin America. A survey was developed to measure conspicuous motivation, more specifically, bandwagon and snob effects. It was responded by 712 university students located in five different cities in Chile. The findings of the study showed that the bandwagon and snob motivations were higher in men than in women. Men also showed a greater tendency than women to purchase and use new luxury products in social contexts. These results suggest that managers could adjust their marketing strategies to better target millennial consumers of new luxury products.
Cultural logics and modes of consumption: Unraveling the multiplicity of symbolic distinctions among concert audiences
Authors: Willekens Mart , Daenekindt Stijn
Published: March 2020

In this study, we examined how audiences for different types of concerts structure their musical preferences according to specific cultural logics and how this relates to the motives for going to the concert. We used large-scale audience data collected at 73 concerts in Belgium ( n = 1594). Using Correlational Class Analysis, we inductively uncovered four different cultural logics: omnivore vs. disinterested; highbrow vs. lowbrow; acoustic vs. electric; and anything but/with distortion. Accordingly, besides the well-documented oppositions between highbrow and lowbrow, and between omnivorousness and univorousness, we found two other cultural logics among concert audiences. In subsequent analyses, we related these cultural logics to concert genre (e.g., classical and electronic) and mode of consuming concerts (e.g., music-centered and entertainment-centered). We demonstrate that mode of consumption is associated with both concert genre and the cultural logic to which one adheres.
Functionally Significant Coumarin-Related Variant Alleles and Time to Therapeutic Range in Chilean Cardiovascular Patients
Authors: Rojo Mario , Roco Angela Margarita , Suarez Marcelo , Lavanderos Maria Alejandra , Verón Gabriel , Bertoglia Maria Paz , Arredondo Annabella , Nieto Elena , Rubilar Juan Carlos , Tamayo Francisca , Cruz Daniela , Muñoz Jessica , Bravo Gabriela , Salas Patricio , Mejías Fanny , Véliz Paulo , Godoy Gerald , Varela Nelson Miguel , Llull G. , Quiñones Luis Abel
Published: March 2020

Despite the development of new oral agents over the last decade, vitamin K antagonists (VKAs) remain the most widely used anticoagulants for treating and preventing thromboembolism worldwide. In Chile, the Ministry of Health indicates that acenocoumarol should be used in preference to any other coumarin. Complications of inappropriate dosing are among the most frequently reported adverse events associated with this medication. It is well known that polymorphisms in pharmacokinetic and pharmacodynamic proteins related to coumarins (especially warfarin) influence response to these drugs. This work analyzed the impact of CYP2C19*2 ( rs4244285), CYP1A2*1F ( rs762551), GGCx ( rs11676382), CYP2C9*2 ( rs1799853), CYP2C9*3 ( rs1057910), CYP4F2 ( rs2108622), VKORC1 ( rs9923231), VKORC1 ( rs7294), CYP3A4*1B ( rs2740574), and ABCB1 ( rs1045642) polymorphisms on time to therapeutic range for oral anticoagulants in 304 Chilean patients. CYP2C9*3 polymorphisms were associated with time to therapeutic range for acenocoumarol in Chilean patients, and the CYP4F2 TT genotype, MDR1 A allele, CYP1A2 A allele, and CYP3A4T allele are promising variants that merit further analysis. The presence of polymorphisms explained only 4.1% of time to therapeutic range for acenocoumarol in a multivariate linear model. These results improve our understanding of the basis of ethnic variations in drug metabolism and response to oral anticoagulant therapy. We hope that these findings will contribute to developing an algorithm for VKA dose adjustment in the Chilean population in the near future, decreasing the frequency of stroke, systemic embolism, and bleeding-related adverse events.
Directing “The Performance of Possibilities” Within Whiteness: Casting, Staging, and Interaction in Postperformance Discussions
Authors: Syler Claire
Published: March 2020

Postperformance discussions are common, talk-driven events that follow cultural affairs (i.e., lectures, film screenings, theater) and often feature expert panelists in conversation with everyday spectators. This article examines the postperformance discussions held after The Every 28 Hours Plays, a critical performance project focused on anti-Black racism and police brutality, at the predominantly White University of Missouri. Applying discourse analysis to transcripts of the postproduction dialogues, I show how Whiteness challenged some White spectators’ understanding of the pedagogically oriented performance and, as such, I examine how critical performance pedagogues can grapple with the White racial frame of spectatorship to navigate and, potentially, resist it. One way to navigate Whiteness during postperformance discussions is to approach the discussions as performance, using directorial practices like casting, staging, and structured interaction to focus the dialogue on a production’s critical themes.
Evaluation of different cleaning methods for feline inhalation chambers after bacterial contamination
Authors: Klenk Friederike K , DeSimoi Vanessa , Wolf Georg , Schulz Bianka S
Published: March 2020

Objectives

Inhalation chambers are commonly used for the delivery of aerosol drugs to cats with respiratory disease. The aim of the study was to identify successful cleaning methods for inhalation devices after standardised bacterial contamination.

Methods

Spacer devices of two different manufacturers were used: RC Chamber (Cegla Medizintechnik) and Aerokat (Trudell Medical International). The bacterial contamination was performed using Pseudomonas aeruginosa. Previously marked areas of the chamber were contaminated with 50 μl of bacterial solution, containing between 2.2 ×105 and 2.1 ×108 colony-forming units/ml each. After cleaning the devices as recommended by each manufacturer (RC Chamber: special microwave cleaning bag [n = 5] or boiling water with liquid dish detergent for 15 mins [n = 5]; Aerokat: rinsing in a solution of lukewarm water and liquid dish detergent for 15 mins), chambers were air-dried for 24 h and samples for bacterial culture were taken from three defined areas. Sample material was applied on Müller–Hinton agar plates and subsequently incubated for 24 h at 37°C.

Results

Bacterial contamination was not detected in any of the examined inhalation devices using the recommended cleaning methods.

Conclusions and relevance

If inhalation chambers are cleaned following the manufacturers’ recommendations, successful bacterial decontamination can be expected.
Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma
Authors: Tekeli Oya , Köse Helin Ceren
Published: March 2020

Purpose:

The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma.

Methods:

Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C).

Results:

Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20–91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12–16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05).

Conclusion:

Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.
Reliability of cutaneous landmarks for the catheter length assessment during peripherally inserted central catheter insertion: A retrospective observational study
Authors: Elli Stefano , Bellani Giacomo , Cannizzo Luigi , Giannini Luciano , De Felippis Christian , Vimercati Simona , Madotto Fabiana , Lucchini Alberto
Published: March 2020

Introduction:

Peripherally inserted central catheters are very common devices for short, medium and long-term therapies. Their performance is strictly dependent on the correct tip location, at the junction between the upper caval vein and the right atrium. It is very important to obtain an estimated measure of the catheter, in order to reach the cavo-atrial junction and optimize the catheter length. Estimated measures are often obtained using cutaneous landmarks.

Objective:

Evaluate the reliability of cutaneous landmark-based length estimation during catheter insertion. Identify any patient’s related factors that may affect cutaneous landmarks reliability.

Methods:

We used two distinct techniques and collected data about cutaneous landmark-based length estimation, electrocardiographic guided intravascular length, age, weight and height. We studied the reliability of possible correcting factors, balancing the error average by regression models, and we found and tested two different models of prediction.

Results:

A total number of 519 patients were studied. The average bias, between the two studied length assessment by cutaneous landmarks and electrocardiographic guided catheter length, were 3.77 ± 2.44 cm and 3.28 ± 2.57 cm, respectively. The analysed prediction models (deviance explained 43.5%, Akaike information criterion = 1313.67% and 43.4%, Akaike information criterion = 1313.92), fitted on the validation set, showed a root mean square error of 3.07 and 3.06.

Conclusion:

Landmark-based length estimation for preventive catheter length assessment seems to be unreliable, when associated with post-procedural tip location. They are useful for distal trimming catheters to optimize the ‘out of skin’ portion when associated with electrocardiographic tip location. Models identified for balancing bias are probably not useful.
Acute anosmia in neuromyelitis optica spectrum disorder
Authors: Marshall Joseph , Kleerekooper Iris , Davagnanam Indran , Trip S Anand
Published: March 2020

The cardinal features of neuromyelitis optica spectrum disorder (NMOSD) are optic neuritis, longitudinal extensive transverse myelitis and area postrema syndrome. Olfactory dysfunction is not listed as a feature in the NMOSD diagnostic criteria. Here, we present an aquaporin-4 antibody positive patient who, in addition to classical features of NMOSD, developed acute anosmia with magnetic resonance imaging (MRI) evidence of olfactory bulb abnormalities. While the association of anosmia and NMOSD has been rarely noted previously, to our knowledge, no prior cases have found this to be one of the presenting features of a relapse nor have they identified acute radiological correlates.
Does national policy in England help deliver better and more consistent care for those at the end of life?
Authors: Barker Rhiannon , Wilson Patricia , Butler Claire
Published: March 2020

Objectives

To explore the extent to which national policy in end of life care in England influences and guides local practice, to ensure that care for patients over the age 75 years is of a consistently good quality.

Method

This paper reports on phase one of a larger study and focuses its discussion on the high-level (macro) determinants emerging from the analysis. Fifteen in-depth interviews were conducted with professionals involved in the development of English policy in end of life care.

Results

Factors influencing the quality of end of life care were stratified into three system levels: meso, macro and micro. English national policy was reported to be an important macro-level determinant of effective outcomes, and examples were provided to demonstrate how policy was influencing practice. Yet, the complexity of the area and the range of interacting contributory factors mean the value of policy alone is hard to assess. At the macro-level, concern was voiced around: whether policy was effective in tackling rising inequity; lack of mandatory leverage to exert change relating to end of life outcomes; the impact of ongoing infrastructural change on statutory services; workforce pressures; over-reliance on acute services and continued abdication of responsibility for end of life care to medical professionals supported by the continued dominance of the medical model of care.

Conclusions

The links between the existence of policy at the macro-level of the system and the effective enactment of good practice remain unclear, although strategies are suggested to help achieve greater national consistency in end of life care outcomes. Policymakers must pay attention to the following: controlling the rise in localism and its contribution to regional inequalities; the impact of continuous infrastructural change together with increasing workforce pressures; encouraging broader professional and public responsibility for recognition and care of those at the end of life.
Comparison of video and in-hospital consultations during early in-home care for premature infants and their families: A randomised trial
Authors: Hägi-Pedersen Mai-Britt , Dessau Ram B , Norlyk Annelise , Stanchev Hristo , Kronborg Hanne
Published: March 2020

Introduction

Early in-home care is increasingly being used in Scandinavian countries for clinically stable premature infants. Due to challenges with travel and hospital resources, alternative ways to support parents during early in-home care are being considered. The aim of this study was to test whether the proportion of mothers exclusively breastfeeding, parental confidence and mother–infant interaction increased after early in-home care with premature infants, and to compare the outcomes of in-home care involving the use of video communication and a mobile application with those of in-home care involving in-hospital consultations.

Methods

This study was conducted in four neonatal wards offering premature infant in-home care in Denmark. Premature infants were randomised using 1:1 block randomisation. During early in-home care, families had planned consultations two to three times a week, during which they received support from nurses: the intervention group had video consultations, while the control group had in-hospital consultations.

Results

The proportion of exclusively breastfeeding mothers at discharge was 66.7% in the intervention group vs 66% in the control group and decreased to 49.4% vs 55%, respectively, 1 month after discharge. No significant improvements were found in the intervention group compared with the control group. In the intervention group, some video consultations were changed to telephone consultations due to problems with the video function, or to in-hospital consultations due to infants’ requirement for medical services. No significant differences in secondary outcomes were observed.

Discussion

The study showed similar breastfeeding proportions at discharge. No unfavourable effects of video consultation compared with in-hospital consultation were found, indicating that video consultation could be a viable option and an important supplement during early in-home care.

Trial registration

ClinicalTrials.gov ID: NCT02581800.
Characterization of dayshift tele-ICU pharmacist activities
Authors: Griffiths Carrie L , Kosmisky Desiree E , Everhart Sonia S
Published: March 2020

Background

Critical care services have expanded over the last decade to include tele-ICU. In 2015, Atrium Health’s pharmacy services began covering tele-ICU patients from 3–11 PM. In 2017, dayshift tele-ICU pharmacy services were added on Monday, Wednesday and Friday from 8 AM to 12 PM. Cutting-edge technology and software integration allow alerts to be generated in areas of abnormal glucose, electrolyte and lactate levels. This analysis was conducted to describe the interventions recommended during dayshift hours.

Methods

Data collected from 1 August 2017 to 30 June 2018, the first 11 months of dayshift pharmacist coverage, include number of charts reviewed per shift, interventions and specific types logged, if the intervention was tied to an alert and if it was accepted or rejected. Interventions can originate from alerts or from proactive assessment by the pharmacist. Descriptive statistics were reported.

Results

On average, 41 charts were reviewed per shift. Over an 11-month period, 1024 interventions were made for 634 patient chart reviews. Some 89% of all interventions were accepted or accepted with modifications. Of the total interventions, 37 (3.6%) were adverse drug events avoided and 658 (64.4%) were interventions unrelated to alert data. Medication management accounted for 44.3% of all interventions.

Discussion

Proactive assessment rather than alert review resulted in the majority of interventions, demonstrating that reviewing every ICU patient is vital for improving patient care. Determining optimal avenues for intervention delivery and integration with the bedside multidisciplinary teams remains one of the biggest challenges. Dayshift innovations included weekly virtual rounds and providing drug information for the bedside teams.