bluuebunny/crossref_metadata_2025 huggingface dataset:
Almost-certain malignant hyperthermia during cardiopulmonary bypass: a case report and literature review
Authors: Zhang Yan , Zhou Ronghua
Published: March 2019

Malignant hyperthermia is a well-known but potentially lethal disorder which is triggered by volatile anesthetics and depolarizing muscle relaxants. Early diagnosis and treatment could save lives. However, during cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of malignant hyperthermia extremely difficult than other surgeries. We report a case of almost-certain malignant hyperthermia, according to the clinical grading scale, in a patient undergoing on-pump coronary artery bypass grafting surgery. The patient underwent difficult weaning from cardiopulmonary bypass until intra-aortic balloon pump and temporary cardiac pacemaker had been implanted. Although dantrolene and corresponding treatments were administered recently, the patient died 12 days after surgery because of acute kidney failure and cardiac arrest. Therefore, it is important for us to previously recognize some specific signs of malignant hyperthermia during cardiopulmonary bypass to avoid severe outcomes.
A 3D quantitative imaging biomarker in pre-treatment MRI predicts overall survival after stereotactic radiation therapy of patients with a singular brain metastasis
Authors: Della Seta Marta , Collettini Federico , Chapiro Julius , Angelidis Alexander , Engeling Fidelis , Hamm Bernd , Kaul David
Published: March 2019

Background

Brain metastases (BM) are the most frequent intracranial malignant tumor. Various prognostic factors facilitate the prediction of survival; however, few have become tools for clinical use.

Purpose

To investigate the role of three-dimensional (3D) quantitative tissue enhancement in pre-treatment cranial magnetic resonance imaging (MRI) as a radiomic biomarker for survival (OS) in patients with singular BM treated with stereotactic radiation therapy (SRT).

Material and Methods

In this retrospective study, 48 patients (27 non-small cell lung cancer and 21 melanoma) with singular BM treated with SRT, were analyzed. Contrast-enhanced MRI scans of the neurocranium were used for quantitative image analyses. Segmentation-based 3D quantification was performed to measure the enhancing tumor volume. A cut-off value of 68.61% of enhancing volume was used to stratify the cohort into two groups (≤68.61% and > 68.61%). Univariable and multivariable cox regressions were used to analyze the prognostic factors of OS and intracranial progression-free survival (iPFS).

Results

The level of enhancing tumor volume achieved statistical significance in univariable and multivariable analysis for OS (univariable: P = 0.005, hazard ratio [HR] = 0.375, 95% confidence interval [CI] = 0.168–0.744; multivariable: P = 0.006, HR = 0.376, 95% CI = 0.186–0.757). Patients with high-level enhancement (>68.61% enhancing lesion volume) survived significantly longer (4.9 vs. 10.2 months) and showed significantly longer iPFS rates (univariable: P < 0.001, HR = 0.046, 95% CI = 0.009–0.245).

Conclusions

Patients with lesions that show a higher percentage of enhancement in pre-treatment MRI demonstrated improved iPFS and OS compared to those with mainly hypo-enhancing lesions. Lesion enhancement may be a radiomic marker, useful in prognostic indices for survival prediction, in patients with singular BM.
Astragaloside IV promotes the eNOS/NO/cGMP pathway and improves left ventricular diastolic function in rats with metabolic syndrome
Authors: Lin Xin , Wang Qiongying , Sun Shougang , Xu Guangli , Wu Qiang , Qi Miaomiao , Bai Feng , Yu Jing
Published: March 2019

Objectives

This study aimed to explore the effects of astragaloside IV on metabolic syndrome induced by a high-fructose/high-fat diet in rats.

Methods

Rats were randomized into four groups: normal control, metabolic syndrome, metabolic syndrome + intraperitoneal astragaloside 0.5 mg/kg/day, and metabolic syndrome + intraperitoneal astragaloside 2.0 mg/kg/day (n=30 per group) for 14 continuous days. Left ventricular functions were evaluated by hemodynamic and echocardiographic parameters.

Results

Metabolic syndrome rats had a thicker interventricular septum and left ventricular posterior wall, accompanied by a higher E/A wave ratio, reduced E′ wave, increased A′ wave, decreased E′/A′ wave ratio, and higher E/E′ wave ratio. Astragaloside decreased insulin and triglyceride levels and improved diastolic dysfunction with no effects on systolic function. A high-fructose/high-fat diet also increased oxidative stress and decreased the myocardial endothelial nitric oxide synthase (NOS) dimer ratio, thus impairing nitric oxide (NO) production and reducing cyclic guanosine monophosphate (cGMP) production. Astragaloside increased NO and cGMP production in the myocardium and improved diastolic function.

Conclusions

Astragaloside alleviated oxidative stress and restored NO signaling, thus improving myocardial left ventricular diastolic dysfunction in rats with metabolic syndrome. The underlying mechanisms could be associated with alleviation of oxidative stress and activation of the endothelial NOS/NO/cGMP pathway.
Application of the hole-drilling method for the evaluation of residual stresses near rounded ends
Authors: Alegre Jesus Manuel , Díaz Andrés , Cuesta Isidoro Ivan , Manso Juan Manuel
Published: March 2019

The experimental measurement of residual stresses by the hole-drilling method is a versatile technique due to its great simplicity. The technique consists of drilling on a material surface and measuring the relieved deformation on the surface by means of strain gauge rosettes. The most widespread method to obtain residual stresses from relieved deformation is the integral method and is found in the ASTM E837-13a standard. The procedure is standardised for very specific conditions, which are based on the application of the technique on a large flat-plate. To apply this technique to situations outside the standard scope, it is necessary to perform studies that validate its applicability. One of these situations is to evaluate the stresses introduced in hot- or cold-rolled profiles, where the residual stresses are concentrated on the rounded corners generated by rolling operations. In this study, a numerical simulation by finite elements has been carried out to obtain the relieved deformations for the case of drilling near rounded ends. The results show that the hole-drilling technique is applicable for the case of rounded ends; however, there is a significant deviation from the flat-plate condition which can be minimised by considering new matrices for the specific rounding radius and thickness of the analysed workpiece.
A Note on Pricing With Market Power: Third-Degree Price Discrimination With Quality-Differentiated Demand
Authors: Adams Charles F.
Published: March 2019

The article points up limitations in the standard undergraduate treatment of third-degree price discrimination by monopolists. While such treatments allude to qualitative distinctions between higher and lower priced alternatives, failure to capture those distinctions in underlying cost and demand structures results in only partial and possibly misleading conclusions about the nature and consequences of such discrimination. Deriving quality-differentiated linear demand and cost structures from the constructs underlying undergraduate microeconomics, the article compares the standard analysis of price discrimination with one that explicitly accounts for quality choices and monopoly power in manipulating those choices. The analysis illustrates the potential for substantially greater monopoly profits and greater efficiency losses by forcing some groups of consumers into suboptimal quality choices once quality variations are explicitly accounted for.

JEL Classifications: A1, A22, D11, D21, D42
Power changes, alliance credibility, and extended deterrence
Authors: Johnson Jesse C , Joiner Stephen
Published: March 2019

A primary motivation for forming military alliances is to deter adversaries. However, some alliances are more effective at deterrence than others. Deterrence theory suggests that an alliance may fail to deter if the commitment is not considered credible by adversaries. Building on alliance reliability research, we contend that alliances whose members have experienced significant changes in power since formation are vulnerable to violation. Moreover, we argue that these changes are observable to adversaries, making them more likely to target the alliance. We test this argument using a sample of countries with membership in defensive alliances between 1816 and 2000. Our results indicate that states whose allies have experienced significant changes in power are more likely to be the target of militarized disputes than states whose allies have not experienced significant changes in power. These findings connect alliance reliability research to deterrence theory, illustrating the need to take into account changes over time in understanding the deterrence potential of military alliances. Our findings also suggest that future research should take these processes into account in studying dispute escalation and intra-alliance relations.
An experimental study on surface roughness and frictional property of ultrasonic-vibration-assisted milled surface
Authors: Verma Girish C , Pandey Pulak M , Dixit Uday S
Published: March 2019

Ultrasonic-vibration-assisted milling is a variant of conventional milling process. In this study, experimental investigations were carried out to evaluate the effect of process parameters on the average surface roughness of machined surface (of Al6063 alloy). The results were evaluated to understand the effect of process parameters and are explained using the physics of the process. The effect of ultrasonic amplitude on frictional and wettability property of machined bottom surface was also evaluated. With the increase in power of ultrasonic vibration, the surface roughness increased; however, the friction of lubricated machined surface decreased while sliding on a mild steel surface. With the increase in ultrasonic power, the wettability of the surface increased resulting in a better lubrication and consequent reduction of friction.
Characteristics of train passages over slab tracks from measurements and different track–soil models: Damage detection and ground vibration reduction
Authors: Auersch L
Published: March 2019

The characteristics of train passages over intact or damaged slab tracks on different soils have been calculated by the finite-element boundary-element method or the wavenumber-domain method. The influence of track and soil parameters on the distribution of track displacements and soil forces has been analysed. The measured and calculated displacement time histories of train passages could be used to identify track damages such as loose sleepers or a loose track plate. The time histories and spectra of soil forces can explain the measured ground vibration reduction in the slab tracks. The calculated displacement and force distributions of slab tracks on continuous soils do not fulfil the Winkler hypothesis, and Winkler models should not be used for track analysis.
Prediction of thigh-calf contact parameters from anthropometric regression
Authors: Kingston David C , Acker Stacey M
Published: March 2019

High knee flexion postures are common in industry and cultural practices, but the mechanical effect of intersegmental force, particularly thigh-calf contact force, on knee joint compressive force is poorly understood. Although some studies have measured thigh-calf contact parameters occurring in a number of high flexion postures, joint contact modeling would benefit from efforts to predict thigh-calf contact force for use in computational models. Therefore, this study assessed the strength of correlations and linear multiple regression models on the following five high flexion thigh-calf contact parameters in a young, healthy population: the onset angle of thigh-calf contact, maximum flexion angle, total thigh-calf contact force, center of force, and contact area at maximum flexion. Regressions used anthropometric values (and in some cases, maximum flexion angle). Overall, maximum flexion angle and center of force location had the most significant correlates and strong linear fits with regressive models. Thigh-calf contact onset, total force magnitude, and contact area had only moderate to weak relationships. An exploratory attempt at regression using grouped movements into gross patterns (e.g. two types of squatting were grouped into a general squatting category) using maximum flexion angle and center of force location as dependent variables resulted in similar model fitting. These findings suggest that a causal relationship between select anthropometrics and lower limb range of motion may exist, but further exploration is necessary to determine clinically reliable predictive models.
Study on acoustic source characteristics of gas pipeline leakage
Authors: Baokun Han , Xiyang Liu , Bing Liu , Huaiqian Bao , Xiangguang Jiang
Published: March 2019

The characteristics of acoustic source of gas pipeline leakage determine the accuracy and adaptability of leak detection for gas pipelines based on acoustic method. In order to explore the characteristics of leakage acoustic source of gas pipeline, a physical model of gas pipeline leakage was developed. Initially, generation mechanism of acoustic source of gas pipeline leakage is studied in order to identify the basic principle of leak detection of gas pipeline based on acoustic method. After that, the simulation model is developed according to the basic principle of aeroacoustics, the flow field, and sound source characteristics of the gas pipeline leakage. Then, the experimental platform for the study on acoustic source characteristics of gas pipeline leakage is set up using the basic principle of the leak detection based on acoustic method and simulation results. The characteristics of acoustic source of leakage are obtained through experiments. Finally, the simulation and experimental results of acoustic source of leakage under different operating conditions are compared, and the accuracy of the simulation results is verified, which provides a theoretical basis for the engineering application of leak detection for gas pipeline based on acoustic method. The results show that the acoustic source of gas pipeline leakage is mainly quadrupole source and the leakage acoustic energy is mainly in the range of less than 100 Hz. The mean value of sound pressure level is increased with the pressure in pipeline and the size of leak aperture.
Measurability, systematic error, and the replication crisis: A reply to Michell (2019) and Krantz and Wallsten (2019)
Authors: Trendler Günter
Published: March 2019

Although Krantz and Wallsten (2019) claim that interval and ratio scales abound in psychology, they miss the opportunity to deliver specific evidence for their existence. Michell (2019), on the other hand, misconstrues my objection against the practical usefulness of conjoint measurement (Trendler, 2019). Furthermore, he underestimates the critical role humans play as measurement instruments—that is, as detectors of magnitudes of psychological attributes as derived quantities—and he also misunderstands the meaning of the Millean Quantity Objection. Finally, in answer to Krantz and Wallsten, I specify my position with regard to the connection between scientific stagnation, measurability, and reproducibility.
The meaning and origin of the activity concept in Soviet psychology—with primary focus on A. N. Leontiev’s approach
Authors: Chaiklin Seth
Published: March 2019

The concept of activity in Soviet psychology reflects a fundamental ontological assumption about the dynamic internal relation between person and world, arising from a person’s intentional actions, which draws on historically developed traditions of action. The article gives a deeper understanding of the activity concept by examining the historical process by which the concept was formed, providing a compact conceptual overview of the concept, formulated as a series of assumptions and implications. A conceptual dialectic is offered to explain the historical development of the concept, along with a chronological overview. This analysis shows that the concept of activity emerged collectively among Soviet researchers, and cannot be located as the discovery or introduction by a single person (such as A. N. Leontiev, who is often associated with the concept). It is suggested that a practice concept should be introduced to distinguish historical traditions of action from psychological activity.
De-othering “schizophrenia”
Authors: Kamens Sarah
Published: March 2019

Do psychiatry and clinical psychology have an “other”? This article critically addresses the clinical-scientific fascination with diagnostic challenges and other psychiatric mysteries, focusing on the example of “schizophrenia,” often seen as the most severe and enigmatic of all mental disorders. Over a century of clinical and scientific discourse on schizophrenia has painted a portrait of something indecipherable at the very foundation of psychiatric inquiry. Despite entrenched beliefs, mounting evidence from both qualitative-phenomenological and quantitative research suggests that the experience of psychosis can be meaningfully understood. Further, there is a wealth of data indicating that persons with lived experience of psychosis can lead self-actualized lives, and new studies have revealed that psychotic experiences are common in non-clinical populations. Yet traditional views of psychosis persist in the face of this mounting evidence. I suggest that the key to de-othering schizophrenia may lie in an emerging body of research on “social defeat,” marginalization, and alienation. More specifically, the experiences and behaviors commonly designated as psychosis arise in social and interpersonal contexts that are distinctly alienating, including the psychiatric encounter. It follows that schizophrenia may not be the elusive empirical object of debates about unintelligibility or “ununderstandability,” but rather a social configuration that is manifest within the deadlock of this debate itself.
Effect of the chain length on near-infrared spectra of 1-alcohols from methanol to 1-decanol
Authors: Czarnecki Mirosław Antoni , Kwaśniewicz Michał
Published: March 2019

This work shows the effect of the chain length on near-infrared spectra of 1-alcohols and is based on a recent paper by Kwaśniewicz and Czarnecki ( Appl Spectrosc 2018, 72: 288). Near-infrared spectra of 1-alcohols from methanol to 1-decanol in the pure liquid phase were recorded from 5200 to 9000 cm−1. The similarities and differences between the spectra were analyzed by the classical and chemometric methods (principal component analysis). The obtained results reveal that the near-infrared spectra of methanol, ethanol, and 1-propanol are appreciably different from the spectra of higher 1-alcohols. As shown, the degree of self-association of 1-alcohols decreases with the increase in the chain length.
Response-adaptive treatment allocation for clinical studies with ordinal responses
Authors: Lu Tong-Yu , Chung Ka Pui , Poon Wai-Yin , Cheung Siu Hung
Published: March 2019

Ordinal responses are common in clinical studies. Although the proportional odds model is a popular option for analyzing ordered-categorical data, it cannot control the type I error rate when the proportional odds assumption fails to hold. The latent Weibull model was recently shown to be a superior candidate for modeling ordinal data, with remarkably better performance than the latent normal model when the data are highly skewed. In clinical trials with ordinal responses, a balanced design is common, with equal sample allocation for each treatment. However, a more ethical approach is to adopt a response-adaptive allocation scheme in which more patients receive the better treatment. In this paper, we propose the use of the doubly adaptive biased coin design to generate treatment allocations that benefit the trial participants. The proposed treatment allocation scheme not only allows more patients to receive the better treatment, it also maintains compatible test power for the comparison of treatment efficiencies. A clinical example is used to illustrate the proposed procedure.
Hot topics in science communication: Aggressive language decreases trustworthiness and credibility in scientific debates
Authors: König Lars , Jucks Regina
Published: March 2019

Current scientific debates, such as on climate change, often involve emotional, hostile, and aggressive rhetorical styles. Those who read or listen to these kinds of scientific arguments have to decide whom they can trust and which information is credible. This study investigates how the language style (neutral vs aggressive) and the professional affiliation (scientist vs lobbyist) of a person arguing in a scientific debate influence his trustworthiness and the credibility of his information. In a 2 X 2 between-subject online experiment, participants watched a scientific debate. The results show that if the person was introduced as a lobbyist, he was perceived as less trustworthy. However, the person’s professional affiliation did not affect the credibility of his information. If the person used an aggressive language style, he was perceived as less trustworthy. Furthermore, his information was perceived as less credible, and participants had the impression that they learned less from the scientific debate.
A Review of Healthcare Service Quality Dimensions and their Measurement
Authors: Upadhyai Raghav , Jain Arvind Kumar , Roy Hiranmoy , Pant Vimal
Published: March 2019

Service quality has been a matter of concern for public and private healthcare institutions across the world. Increased focus on patient-centered care led to several researches in exploring what determines service quality and how can it be measured. The objective of this paper is to explore and summarize the available pool of published knowledge as to understand what comprises healthcare service quality, the underlying dimensions of healthcare service quality, and how it is measured. Literature review, covering significant researches in the field of healthcare service quality, service quality dimensions and its measurement was conducted on EBSCO and Google Scholar databases. Findings were presented in the form of medical and non-medical aspects of healthcare service quality. It can be concluded dimensionality in the healthcare service quality is context specific and patients weigh them differently. Perceptions only measures dominate healthcare quality evaluation over gap score based models. Further, healthcare service quality construct and its measurement has been primarily done from the patient’s perspective, however, the provider’s perspective of the healthcare service quality has not been taken into consideration.
The Impact of Business Cycle on Banks’ Capital Buffer, Risk and Efficiency: A Dynamic GMM Approach from a Developing Economy
Authors: Moudud-Ul-Huq Syed
Published: March 2019

This article applies the generalized method of moments (GMM) to examine the relationship between capital buffer, risk and efficiency adjustments over the macroeconomic cycles. Using a panel dataset of 32 Bangladeshi commercial banks over the period from 2000 to 2014, we find an inverse relationship between the business cycle and capital buffers, while a positive relationship between the business cycle and bank risk. These findings support the implementation of countercyclical capital buffers in Basel III Accord to ensure bank safety during economic downturns. We also observe that the bank efficiency positively responds to macroeconomic fluctuations. While examining the impact of capital buffers on bank behaviour, we find that low buffer banks raise the level of capital buffers and improve the efficiency over time. In contrast, high buffer banks incline to raise investment in risky projects by deterioration of capital ratios during economic upturns. In this case, high buffer banks in developing countries should take risk and efficiency issues into great consideration and force low capitalized banks to follow the Basel III guidelines more stringently to adjust capital buffers, risk and efficiency with macroeconomic bounce. Also, developing countries, regulatory bodies are adopting and implementing Basel guidelines slowly, and thus it has volunteer impact on the buffer, risk and efficiency adjustments. So the regulatory bodies should be adapted the global financial changes that will be enhanced country’s financial market.
Icepac Limited: Strategic Growth Choices for an SME in the Frozen Food Industry
Authors: Arifeen Shehla R.
Published: March 2019

In 2012, Mr Mansoor Arifeen, CEO of Icepac Ltd/Kold Karrier (Pvt.) Ltd, was considering growth options for his small businesses. Icepac Ltd was the first company to provide branded, value-added frozen vegetables and meat products within Pakistan, and from Pakistan to the export market. He had managed to survive in the challenging frozen food industry by diversifying into logistics (Kold Karrier [Pvt.] Ltd) and warehousing (Icepac Ltd). Over the years, Icepac Ltd/Kold Karrier had grown from microbusinesses in 1988–1990 to small and medium enterprises. The majority ownership still rested with Mr Arifeen for both the businesses. He faced two options for growth. Option one was an investment in warehousing and logistics. Option two was to focus on frozen food business, investing heavily in developing the Icepac brand. Option two could be limited to the local market or expanded to the export market. Each of these decisions had its own pros and cons. However, it was a complex decision for him as he had always been emotionally invested in the frozen food business, as frozen vegetables had been the raison d’être for his entrepreneurial venture.
An efficient resource prediction–based scheduling technique for scientific applications in cloud environment
Authors: Kaur Gurleen , Bala Anju
Published: March 2019

Cloud computing makes scientists to run complex scientific applications. The research community is able to access on-demand compute resources within a short span of time instead of experiencing peak demand bottlenecks. As the demand for cloud resources is dynamic and volatile in nature, this in turn affects the availability of resources during scheduling. In order to allocate sufficient resources for scientific applications with different execution requirements, it is necessary to predict the appropriate set of resources. To attain this objective, a resource prediction–based scheduling technique has been introduced which automates the resource allocation for scientific application in virtualized cloud environment. First, the proposed prediction model is trained on the dataset generated by concurrently deploying tasks of a scientific application on cloud. Then, the resources are scheduled based on the output of proposed prediction technique. The main objective of resource prediction–based scheduling technique is to efficiently handle the resources for virtual machines in order to reduce the execution time, error rate, and improve the accuracy.
Contra Rambo’s “Theology of Remaining”: A Chalcedonian and Pastoral Conception of Trauma
Authors: Tietje Adam
Published: March 2019

Trauma and moral injury are horrific psychological wounds of war. In this article, Tietje argues they are also overwhelming soul wounds of war. Following Deborah Hunsinger’s use of Barth’s Chalcedonian pattern, Tietje argues for a conceptual distinction between the language worlds of psychology and theology and argues for understanding moral injury and trauma as conceptually distinct soul wounds (as well as psychological injuries). Along the way, Tietje offers a thick account of Barth’s Chalcedonian pattern. He then uses the pattern to critically engage with Shelly Rambo’s Holy Saturday “theology of remaining” (a promising partner in the task of theologizing trauma). Finally, Tietje applies the Chalcedonian pattern to moral injury and trauma in order to carve out a space for understanding them as conceptually distinct soul wounds.
Satisfaction in Consensual Nonmonogamy
Authors: Garner Curtis , Person Melanie , Goddard Chelsi , Patridge Adrienne , Bixby Tara
Published: March 2019

Inaccurate stigmas and stereotypes may prevent individuals involved in consensual nonmonogamous (CNM) relationships from getting the counseling they seek when facing relational issues. Misperceptions regarding the satisfaction level of individuals in CNM relationships may perpetuate stereotypes and complicate therapeutic care. The current research attempted to determine the satisfaction levels of those involved in CNM relationships using the Relationship Assessment Scale (RAS) and the Relational Assessment Questionnaire. Results of N = 150 find a mean of 4.12 (0.76) on the RAS for the CNM group indicating no difference in satisfaction between the CNM sample and individuals identifying as monogamous. This research offers important considerations for counselors in reviewing biases and judgments they may hold in working with this population and contributes to the dearth of literature on CNM populations.
Addressing Single Parents’ Needs in Professional Counseling: A Qualitative Examination of Single Parenthood
Authors: Whisenhunt Julia L. , Chang Catherine Y. , Parrish Mark S. , Carter Juliana R.
Published: March 2019

Single parenthood is on the rise, but little research addresses the implications for professional counselors who work with single-parent clients. The present study sought to examine single parenthood from the parental perspective and, from that analysis, draw relevant counseling implications. Using qualitative content analysis, the researchers surveyed single parents about their experience of single parenthood, including role expectations, challenges and benefits, and what they believe counselors should know.
Derivation and Validation of Age- and Body Mass Index-Adjusted Weight-Based Unfractionated Heparin Dosing
Authors: Schurr James W. , Muske Anne-Marie , Stevens Craig A. , Culbreth Sarah E. , Sylvester Katelyn W. , Connors Jean M.
Published: March 2019

Unfractionated heparin dosing is unpredictable and subject to numerous pharmacokinetic changes including distribution and metabolic changes associated with obesity and age. Weight-based dosing is commonly used to better predict the dose for a patient when targeting a therapeutic range. A dosing equation that adjusts weight-based doses for age and body mass index may improve therapeutic dose prediction. We conducted a 2-phase observational study with a derivation and validation period to develop an equation to adjust weight-based unfractionated heparin for age and body mass index to target a therapeutic activated partial thromboplastin time of 60 to 80 seconds. The first phase retrospectively identified patients who acheived therapeutic anticoagulation and utilized linear regression to determine a predictive equation for weight-based dosing that adjusts for age and body mass index. The second phase prospectively identified patients in an observational manner and compared the dose of unfractionated heparin on which they became therapeutic against both the weight-based dose and the predicted dose adjusted for age and body mass index. The correlation between predictive age and body mass index adjusted dose and actual therapeutic dose was 0.703 compared to the correlation between the empiric weight-based dose and actual therapeutic dose which was 0.532 ( P = .05). Age and body mass index adjusted weight-based dosing significantly improved therapeutic dose prediction for unfractionated heparin. Further study in a prospective, randomized trial is warranted for validation of this approach in a real world setting.
Newsgames for the Greater Good: The Effects of Graphic Realism and Geographic Proximity on Knowledge Acquisition and Willingness to Help
Authors: Lin Jih-Hsuan Tammy , Wu Dai-Yun
Published: March 2019

This study examined the effects of graphic realism and geographic proximity in newsgames. In a 2 (realism: high vs. low) × 2 (proximity: high vs. low) experiment, 161 participants played a modded newsgame. Suspense fully mediated the interaction effects of realism and proximity on willingness to help (the intention of newsgame forwarding and the amount donated). Realism indirectly affected newsgame forwarding through appreciation and led to negative emotion and higher arousal. Realism and proximity did not affect players’ knowledge gained from game play, enjoyment, or subsequent reading of related news. Players underwent both hedonic and eudaimonic appraisals through the newsgames.
Lessons for Leaders on the Preparation of Literacy Educators
Authors: Bomer Randy , Maloch Beth
Published: March 2019

In this commentary, drawing from reviews of research on literacy teacher preparation, the authors discuss points of leverage in preparation of literacy educators for deans and associate deans. Categories that leaders might attend to include: mediated field experiences, faculty development, and external reputation.
Bilateral decompression retinopathy after deep sclerectomy with mitomycin C in a child with tubulointerstitial nephritis and uveitis syndrome
Authors: Muñoz-Negrete Francisco J , Díez-Álvarez Laura , Garcia Carlota Fuente , Rebolleda Gema
Published: March 2019

Introduction:

To report the first case of bilateral ocular decompression retinopathy after uneventful non-perforating deep sclerectomy with mitomycin C in a child with tubulointerstitial nephritis and uveitis syndrome.

Case description:

An 8-year-old girl affected by tubulointerstitial nephritis and uveitis syndrome developed ocular hypertension (45 mmHg in the right eye and 42 mmHg in the left eye) associated with recurrent episodes of uveitis and chronic use of steroids despite maximum hypotensive medical treatment. Bilateral non-perforating deep sclerectomy with mitomycin C (0.2 mg/mL, 1 min) was performed under general anesthesia without complications. The first postoperative day, the visual acuity was reduced to 0.6 in the right eye and 0.05 in the left eye and the intraocular pressure was 3 mmHg in both eyes. Fundoscopy revealed bilateral optic nerve swelling and diffuse retinal hemorrhages, some of them with scattered-white centers. About 2 months after surgery, the visual acuity was normal and the fundus examination showed complete resolution.

Conclusion:

The ocular decompression retinopathy is an uncommon complication after non-perforating deep sclerectomy. This is the first case of bilateral ocular decompression retinopathy reported after non-perforating deep sclerectomy in a child with ocular hypertension secondary to recurrent uveitis and chronic use of steroids associated with tubulointerstitial nephritis and uveitis syndrome.
Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome
Authors: Santamaría Álvarez Juan Francisco , Serret Camps Anna , Aguayo Alvarez Javier , García García Olga
Published: March 2019

Purpose:

To report a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome and the changes seen in the optical coherence tomography angiography before and after treatment with eculizumab.

Case description:

A 22-year-old man with an unremarkable medical history presented with acute, bilateral blurred vision and headache of 1-week duration. Best corrected visual acuity of 20/50 and 20/40, respectively, in the patient’s right eye and left eye. Funduscopy revealed multiple cotton-wool spots associated with intrarretinal fluid. Swept source optical coherence tomography revealed multifocal retinal detachments with increased choroidal thickness. Optical coherence tomography angiography showed areas of ischemia in both capillary plexus. Due to concurrent symptoms and laboratory analysis, he was diagnosed with atypical hemolytic uremic syndrome and secondary Purtscher-like retinopathy; therefore, treatment with eculizumab was initiated. After 2 months revascularization of the previous ischemic areas was seen in the optical coherence tomography angiography that were correlated with best corrected visual acuity improvement.

Conclusion:

Our findings suggest that evaluation of the macular capillary plexus revascularization by optical coherence tomography angiography during the disease could help to predict an improvement of best corrected visual acuity in these patients and the measurement of choroidal thickness could give us information about the resolution of the pathologic process.
The Voice-Related Quality Of Life: A Study on the Reliability and Validity of the Tamil Version
Authors: Rangarajan Akshaya , Selvaraj Jasmine Lydia , Santhanam Divya Perumal
Published: March 2019

Objective:

Voice serves as an identity and is one of the primary requisites of an individual, especially for singers who are extensive professional voice users with greater vulnerability to voice disorders. The aim of this study is to translate and validate the Tamil version of Voice-Related Quality of Life (T-VRQOL), a self-rating questionnaire that estimates the influence of voice disorders on quality of life. The study also intends to compare the T-VRQOL scores in singers (with and without voice complaint) and non-singers, and to correlate T-VRQOL and the Tamil Singing Voice Handicap Index-10 (TSVHI-10).

Method:

In this cross-sectional study, 120 native Tamil speakers (40 classically trained Carnatic singers without voice complaints, 40 Carnatic singers with voice complaints and 40 normal non-singers) in the age range of 20 to 50 years, filled in the T-VRQOL and the TSVHI-10 rating scales, along with a demographic questionnaire.

Results:

Reliability of T-VRQOL was established with Cronbach α coefficient (r = 0.9, P < .001) and good test-retest reliability (r = 0.98). The validity of T-VRQOL was confirmed by examining convergent and discriminant validity. T-VRQOL also demonstrated a good correlation with the TSVHI-10 (r = 0.838, P < .001). On comparing the T-VRQOL scores across the groups, singers (13.88 and 24.3) obtained higher values than the non-singers (11.63). Among the singers, those with voice complaints (24.3) scored higher than those without voice complaints (13.88) in the T-VRQOL.

Conclusions:

The Tamil version of Voice-Related Quality of Life (VRQOL) questionnaire correlates well with TSVHI-10. It proves to be an effective clinical tool in effectively evaluating the VRQOL among the Tamil-speaking population.
Predictive value of conventional MRI parameters in first spinal attacks of neuromyelitis optica spectrum disorder
Authors: Bonnan Mickael , Debeugny Stéphane , Mejdoubi Mehdi , Cabre Philippe
Published: March 2019

Background:

While spinal cord (SC) attacks of neuromyelitis optica spectrum disorder (NMOSD) are often devastating, signs predictive of their poor clinical outcome have been elusive until now, except for the delay in initiating plasma exchange (PE).

Objective:

We studied the correlation between conventional non-standardized magnetic resonance imaging (MRI) parameters, PE treatment, and clinical data obtained at nadir and recovery.

Methods:

Retrospective study of first SC attacks of NMOSD.

Results:

Sixty-nine Afro-Caribbean NMOSD patients were included (aquaporin-4 (AQP4) antibodies positive in 65%). Median nadir and residual expanded disability status score (EDSS) were, respectively, 7.5 and 4.0. In bivariate analysis, all conventional MRI parameters were correlated with nadir and residual EDSS. In multivariate analysis, nadir EDSS correlated with lesion length ( p = 0.022) and edema ( p = 0.019), whereas residual EDSS correlated with T1w (T1-weighted) hypointense signal ( p = 0.003). Gadolinium enhancement was not associated with outcome.

Conclusion:

A specific pattern of lesions in conventional MRI data is differentially associated with nadir and residual EDSS. Lesions associated with poor prognosis should prompt highly efficient treatment.
Healthcare practitioner behaviours that influence unsafe use of hospital information systems
Authors: Salahuddin Lizawati , Ismail Zuraini , Hashim Ummi Rabaah , Ismail Nor Haslinda , Raja Ikram Raja Rina , Abdul Rahim Fiza , Hassan Noor Hafizah
Published: March 2019

This study aims to investigate healthcare practitioner behaviour in adopting Health Information Systems which could affect patients’ safety and quality of health. A qualitative study was conducted based on a semi-structured interview protocol on 31 medical doctors in three Malaysian government hospitals implementing the Total Hospital Information Systems. The period of study was between March and May 2015. A thematic qualitative analysis was performed on the resultant data to categorize them into relevant themes. Four themes emerged as healthcare practitioners’ behaviours that influence the unsafe use of Hospital Information Systems. The themes include (1) carelessness, (2) workarounds, (3) noncompliance to procedure, and (4) copy and paste habit. By addressing these behaviours, the hospital management could further improve patient safety and the quality of patient care.
Automated classification of primary care patient safety incident report content and severity using supervised machine learning (ML) approaches
Authors: Evans Huw Prosser , Anastasiou Athanasios , Edwards Adrian , Hibbert Peter , Makeham Meredith , Luz Saturnino , Sheikh Aziz , Donaldson Liam , Carson-Stevens Andrew
Published: March 2019

Learning from patient safety incident reports is a vital part of improving healthcare. However, the volume of reports and their largely free-text nature poses a major analytic challenge. The objective of this study was to test the capability of autonomous classifying of free text within patient safety incident reports to determine incident type and the severity of harm outcome. Primary care patient safety incident reports (n=31333) previously expert-categorised by clinicians (training data) were processed using J48, SVM and Naïve Bayes.

The SVM classifier was the highest scoring classifier for incident type (AUROC, 0.891) and severity of harm (AUROC, 0.708). Incident reports containing deaths were most easily classified, correctly identifying 72.82% of reports. In conclusion, supervised ML can be used to classify patient safety incident report categories. The severity classifier, whilst not accurate enough to replace manual processing, could provide a valuable screening tool for this critical aspect of patient safety.
Working out availability, unavailability and awayness in social face-to-face encounters: The case of dementia
Authors: Gitte Rasmussen , Elisabeth Dalby Kristiansen , Elisabeth Muth Andersen
Published: March 2019

This article presents a study of how co-present individuals work out the nature of embodied engagement and disengagement displays by individuals with dementia in a Danish public care facility. Research has found that moderate to severe dementia may result, for example, in a lack of social engagement, apathy and problems in maintaining conversations. Research has, however, also found that co-present individuals indicate their right to unavailability for social interaction. This is accomplished through details of embodied and multimodal conduct such as gaze behavior, which includes practices of glancing and gazing at co-present individuals or practices of gazing into space. These practices may coincide with indications of ‘lack of social engagement’ and ‘apathy’. This study falls within the framework of ethnomethodology (EM) and employs multimodal conversation analytic (CA) methods to show how co-present individuals monitor residents’ displays of engagement and disengagement, primarily gaze behavior and how they respond to them. The study is based on 20 hours of video-recordings.
Parents’ and children’s perceptions of child maltreatment
Authors: Lev-Wiesel Rachel , Massrawa Nadia , Binson Bussakorn
Published: March 2019

Child maltreatment is under-reported despite its high prevalence. It ranges from one-third to one-half lifetime exposure to violence. This points out to the issue of laypersons’ perceptions of what is child maltreatment and at what severity should it be reported. The current study sought to examine children and youth versus parents’ perceptions of child maltreatment. Following ethical approval, 259 children and youth between the ages 9 and 14 and 229 parents were administered anonymous questionnaire that included demographics and The Perception of Child Maltreatment Severity Scale. Statistically significant differences between children and youth, and adults in perception of child maltreatment in general were observed.

Findings

Results indicated that the groups differ in the severity attributed to emotional abuse and sexual abuse. In addition, unlike parents, children and youth perceived exposure of embarrassing photos via Internet and silent treatment by peers to be severe whereas parents perceived sexual molestation to be most severe behavior.

Applications

The study findings were discussed in light of the cultural gap between children and parents. Practically, the gap between parents’ and children’s perceptions of child maltreatment indicates the need for parents and professionals to look beyond their own perceptions and be alert to experiences of victimization a young person may have. This might assist professionals in developing an intervention program to increase children’s awareness of violent behaviors and decrease the gap between generations in terms of the perceptions gap.
Building an authentic cultural curriculum through tertiary cultural dance
Authors: Stevens Kym , Pedro Rachel A , Hanrahan Stephanie J
Published: March 2019

This study identified a range of pedagogies developed to promote global citizenship within a university Latin American dance unit. It implemented changes to teaching and learning approaches in the unit using the Biological Sciences Curriculum Study (BSCS) 5E Instructional Model, supporting learning that privileges transcultural connections to Latin America. The action research used a range of dance teaching pedagogies that were adapted, and evaluated, using the Structure of Observed Learning Outcomes (SOLO)Taxonomy, to support a culturally enriched student learning experience. The findings challenge traditional dance teaching pedagogies through meaningful engagements with the local Latin American dance community and a range of student and teacher reflective approaches.
An experimental study on the coupling between adjacent Hartmann whistles
Authors: Lowe Todd , Silas Kevin , Boggs George , Ng Wing
Published: March 2019

An experimental study has been conducted to examine interactions between two Hartmann whistles placed in close proximity. Microphone measurements of acoustic emission from the whistles, in addition to high-speed flow field visualizations, were used to assess the physical mechanisms present. A strong coupling mode has been identified that results in frequency locking between the resonators. Observed for only one set of parameters in the experimental matrix, the frequency-locked coupling requires sufficient spacing between the nozzle exit and resonator cup of each whistle to establish the acoustic-driven feedback loop. The visualization results show this coupling to arise due to acoustic excitation from the adjacent resonator, inducing hydrodynamic perturbations that grow sufficiently to alter the flow field around the perturbed resonator. The study indicates that coupling dynamics can play a primary role in dual-whistle resonance and frequency output.
Black Debt, White Debt
Authors: Seamster Louise
Published: March 2019

Racial discrimination shapes who feels debt as a crushing burden and who experiences debt as an opportunity. U.S. financial products and rules, and the ways they’re implemented, amplify this inequality along racial lines.
Gender Convergence Over “Cheap Sex”
Authors: Bridges Tristan , Philbin Jesse M.
Published: March 2019

Tristan Bridges and Jesse M. Philbin on the behavioral patterns that betray cheap sex.