bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a case management programme for women seeking later second-trimester abortion: the case of the Massachusetts Access Program
Authors: Ho Stephanie , Janiak Elizabeth
Published: July 2018

Objective

The Massachusetts Access Program is a statewide, centralised referral and case management program created to address barriers to later second-trimester abortions. This study outlines the scope of, describes provider experiences with, and evaluates provider acceptability of the Program.

Study design

We invited physicians, nurses and staff working in hospitals within the later abortion provider referral network to participate in a mixed-methods study that included a web-based quantitative survey and/or a semi-structured qualitative interview. We used descriptive statistics to analyse survey data and inductive coding methods to analyse interview data.

Results

From 2007–2012, 15–28% of abortions performed in Massachusetts at 19 weeks or greater gestational age annually were scheduled through the Access Program. We received 16 completed surveys and conducted seven interviews with providers who routinely receive referrals for later abortions through the Program. Providers overall reported positive experiences with the Program and found it highly acceptable. They described that the transportation, accommodation and financial assistance enabled patients access to care. The specialised and updated knowledge of the Access Coordinator in regards to abortion care also allowed her to act as a resource for providers.

Conclusions

The Access Program, through its referral and case management network, was a valuable resource both to patients seeking later second-trimester abortions and providers involved in abortion care. It acts as one example of an effective, highly acceptable and potentially replicable intervention to reduce barriers to obtaining later second-trimester abortions.
Intravenous cefazolin plus oral probenecid versus oral cephalexin for the treatment of skin and soft tissue infections: a double-blind, non-inferiority, randomised controlled trial
Authors: Dalen Dawn , Fry Amy , Campbell Samuel G , Eppler Jeffrey , Zed Peter J
Published: July 2018

Objective

The purpose of our study was to determine if cephalexin 500 mg orally four times daily was non-inferior to cefazolin 2 g intravenously daily plus probenecid 1 g orally daily in the management of patients with uncomplicated mild–moderate skin and soft tissue infection (SSTI) presenting to the ED.

Methods

This was a prospective, multicentre, double dummy-blind, randomised controlled non-inferiority trial conducted at two tertiary care teaching hospitals in Canada. Patients were enrolled if they presented to the ED with an uncomplicated SSTI, and randomly assigned in a 1:1 fashion to oral cephalexin or intravenous cefazolin plus oral probenecid for up to 7 days. The primary outcome was failure of therapy at 72 hours. Clinical cure at 7 days, intravenous to oral medication transition admission to hospital and adverse events were also evaluated.

Results

206 patients were randomised with 104 patients in the cephalexin group and 102 in the cefazolin and probenecid group. The proportion of patients failing therapy at 72 hours was similar between the treatment groups (4.2% and 6.1%, risk difference 1.9%, 95% CI −3.7% to 7.6%). Clinical cure at 7 days was not significantly different (100% and 97.7%, risk difference −2.3%, 95% CI −6.7% to 0.8%).

Conclusion

Cephalexin at appropriate doses appears to be a safe and effective alternative to outpatient parenteral cefazolin in the treatment of uncomplicated mild–moderate SSTIs who present to the ED.

Trial registration number

NCT01029782; Results.
Three-tiered score for Ki-67 and p16ink4aimproves accuracy and reproducibility of grading CIN lesions
Authors: van Zummeren Marjolein , Leeman Annemiek , Kremer Wieke W , Bleeker Maaike C G , Jenkins David , van de Sandt Miekel , Heideman Daniëlle A M , Steenbergen Renske , Snijders Peter J F , Quint Wim G V , Berkhof Johannes , Meijer Chris J L M
Published: July 2018

Aims

To investigate the accuracy and reproducibility of a scoring system for cervical intraepithelial neoplasia (CIN1–3) based on immunohistochemical (IHC) biomarkers Ki-67 and p16ink4a.

Methods

115 cervical tissue specimens were reviewed by three expert gynaecopathologists and graded according to three strategies: (1) CIN grade based on H&E staining only; (2) immunoscore based on the cumulative score of Ki-67 and p16ink4aonly (0–6); and (3) CIN grade based on H&E supported by non-objectified IHC 2 weeks after scoring 1 and 2. The majority consensus diagnosis of the CIN grade based on H&E supported by IHC was used as theReference Standard. The proportion of test positives (accuracy) and the absolute agreements across pathologists (reproducibility) of the three grading strategies within eachReference Standardcategory were calculated.

Results

We found that immunoscoring with positivity definition 6 yielded the highest proportion of test positives forReference Standard CIN3(95.5%), in combination with the lowest proportion of test positives in samples withCIN1(1.8%). The proportion of test positives forCIN3was significantly lower for sole H&E staining (81.8%) or combined H&E and IHC grading (84.8%) with positivity definition ≥CIN3. Immunoscore 6 also yielded high absolute agreements forCIN3andCIN1, but the absolute agreement was low forCIN2.

Conclusions

The higher accuracy and reproducibility of the immunoscore opens the possibility of a more standardised and reproducible definition of CIN grade than conventional pathology practice, allowing a more accurate comparison of CIN-based management strategies and evaluation of new biomarkers to improve the understanding of progression of precancer from human papillomavirus infection to cancer.
Military assistance to the civil authority: medical liaison with the Manchester clinicians after the Arena bombing
Authors: Bowley Douglas M , Davis N , Ballard M , Orr L , Eddleston J
Published: July 2018

UK Defence Medical Services’ personnel have experienced an intense exposure to patients injured during war over the last decade and a half. As some bitter lessons of war surgery were relearned and innovative practices introduced, outcomes for patients impr oved consistently as experience accumulated. The repository of many of the enduring lessons learnt at the Role 4 echelon of care remain at the Queen Elizabeth Hospital Birmingham (QEHB), with the National Health Service and Defence Medical Services personnel who treated the returning casualties. On 22 May 2017, a terrorist detonated an improvised explosive device at the Manchester Arena, killing 22 and wounding 159 people. In the aftermath of the event, QEHB was requested to provide support to the Manchester clinicians and teleconferencing and then two clinical visits were arranged. This short report describes the nature of the visits, outlines the principles of Military Aid to the Civil Authority and looks to the future role of the Defence Medical Services in planning and response to UK terrorism events.
Sophistry in American medicine? Platonic reflections on expertise, influence and the public’s health in the democratic context
Authors: Goldstein Evan V
Published: July 2018

Without question, the American medical craft—the physicians, clinicians and healthcare organisations that comprise the American healthcare sector—provides immense value to patients and contributes expertise on matters relevant to the public’s health. However, several conspicuous realities about healthcare in America should give the reader pause. Most problematic are the comparative measures of access to care, quality of care, life expectancy, racial health disparity and cost, all of which demonstrate how many Americans experience relatively lower value public health than other Western liberal democratic states. Since the early 1900s, American medical craft behaviour contributed to suboptimal social investment in public health, successfully influencing greater medical investment and higher healthcare expenditure relative to social welfare investments. Today, American policymakers seek the ‘holy grail’, a mythical panacea that purports to restrict spending and improve care quality and value, leading the USA to chase ‘technocratic solutions to political problems’. This paper explores the claim that the USA is hampered by suboptimal public health decision making. Public health decision making has been historically impacted by the overextended reach of medical craft expertise—technê in Platonic terms of art—as permitted by the American democratic political system. American policymakers must not forget that the debate over technê, epistêmê, sophistry and who should have authority in public affairs is not new. Rather, it is an ancient debate, and now as then, the ancient arguments remain relevant in a democratic context. For particularly helpful insight, one ought to look no further than the lessons of Plato’s dialogues. Platonic lessons on expertise and decision making can enlighten our understanding of modern public health decision making, specifically regarding the appropriation, allocation and distribution of health-related resources in the state.
Endotracheal tube obstruction with a blood clot following aspiration of rumen contents in a reindeer
Authors: Lehnus Kristina
Published: July 2018

An apparently otherwise healthy female reindeer was anaesthetised for open reduction and fixation of a hip luxation. The animal developed ruminal bloat which was treated with passage of an orogastric tube that was left indwelling during the procedure. A fluid inspiratory noise was audible two hours after decompression, and clear fluid was suctioned from the airway. It showed no other signs of regurgitation and aspiration of rumen contents intraoperatively, and did not develop obvious respiratory compromise while mechanically ventilated. In recovery, the deer became apnoeic and cyanotic and died suddenly within minutes of being positioned in the recovery box. Just before dying, it coughed a large blood clot out of the endotracheal tube (ETT) . Additional clots were found partially obstructing the ETT lumen once extubated postmortem. Evidence of aspiration was detected at postmortem examination, which also identified pulmonary haemorrhage.
Metabolic phenotype is not associated with vulnerability to angling in bluegill sunfish (Lepomismacrochirus)
Authors: Louison Michael J. , Stein J.A. , Suski C.D.
Published: July 2018

Prior work has described a link between an individual’s metabolic rate and a willingness to take risks. One context in which high metabolic rates and risk-prone behaviors may prove to be maladaptive is in fish that strike fishing lures only to be captured by anglers. It has been shown that metabolic phenotype may be altered by angling; however, little work has assessed metabolic rate in fish and its relationship to angling vulnerability in a realistic angling trial. To address this, we subjected a set of bluegill sunfish (Lepomis macrochirus Rafinesque, 1819) to a series of angling sessions. Following this, a subset of 23 fish that had been captured at least once and 25 fish that had not been captured were assessed for metabolic phenotype (standard and maximum metabolic rates, postexercise oxygen consumption, and recovery time) via intermittent flow respirometry. Contrary to predictions, captured and uncaptured fish did not differ in any measurement of metabolic rate. These results suggest that metabolic phenotype is not a determinant of angling vulnerability within the studied context. It is possible, therefore, that previously described alterations in metabolic phenotype owing to angling pressure may be context-specific and may not apply to all species and angling contexts.
Nonrational symplectic toric cuts
Authors: Battaglia Fiammetta , Prato Elisa
Published: July 2018

In this paper, we extend cutting and blowing up to the nonrational symplectic toric setting. This entails the possibility of cutting and blowing up for symplectic toric manifolds and orbifolds in nonrational directions.
Schramm–Loewner evolution with Lie superalgebra symmetry
Authors: Koshida Shinji
Published: July 2018

We propose a generalization of Schramm–Loewner evolution (SLE) that has internal degrees of freedom described by an affine Lie superalgebra. We give a general formulation of SLE corresponding to representation theory of an affine Lie superalgebra whose underlying finite-dimensional Lie superalgebra is basic classical type, and write down stochastic differential equations on internal degrees of freedom in case that the corresponding affine Lie superalgebra is [Formula: see text]. We also demonstrate computation of local martingales associated with the solution from a representation of [Formula: see text].
Collaboration optimization model of dynamic traffic control and guidance based on Internet of Vehicles
Authors: Sun Zhi-Yuan , Li Yue , Qu Wen-Cong , Chen Yan-Yan
Published: July 2018

In order to improve the comprehensive effect of Urban Traffic Control System (UTCS) and Urban Traffic Flow Guidance System (UTFGS), this paper puts forward a collaboration optimization model of dynamic traffic control and guidance based on Internet of Vehicles (IOV). With consideration of dynamic constraints of UTCS and UTFGS, UTCS is taken as the fast variable, and UTFGS is taken as the slow variable in the collaboration optimization modeling. The conception of Variable Cycle Management (VCM) is presented to solve the mathematical modeling problem under the background of the two variables. A unified framework for VCM is proposed based on IOV. The delay and travel time are calculated based on lane-group-based cell transmission model (LGCTM). The collaboration optimization problem is abstracted into a tri-level programming model. The upper level model is a cycle length optimization model based on multi-objective programming. The middle level model is a dynamic signal control decision model based on fairness analysis. The lower level model is a user equilibrium model based on average travel time. A Heuristic Iterative Optimization Algorithm (HIOA) is set up to solve the tri-level programming model. The upper level model is solved by Non-dominated Sorting Genetic Algorithm II (NSGA II), the middle level model and the lower level model are solved by Method of Successive Averages (MSA). A case study shows the efficiency and applicability of the proposed model and algorithm.
Design of a Quad-Band Monopole Antenna with Independent Frequency Control
Authors: Ren Wang , Wang Peng-Hong
Published: July 2018

A coplanar waveguide (CPW)-fed I-shaped monopole antenna with independent frequency control characteristic is presented for simultaneously satisfying the global positioning system (GPS), wireless local area network (WLAN), and worldwide interoperability for microwave access (WiMAX) applications. It is printed on an FR4 substrate with a single-layered metallic structure and the overall dimensions are [Formula: see text][Formula: see text]mm3. The proposed antenna consists of an I-shaped monopole, a pair of split-ring resonators (SRRs), and a coplanar ground plane. The unique advantage of this study is that the four frequency bands are generated individually by different radiating elements. That is, each of them can be controlled independently with little interference from others, which brings added convenience to the antenna design, optimization and debugging processes. Simulated and measured results both demonstrate that it can cover the 1.575[Formula: see text]GHz GPS (1.57–1.59[Formula: see text]GHz); 2.4/5.2/5.8[Formula: see text]GHz WLAN (2.4–2.485, 5.15–5.35 and 5.725–5.825[Formula: see text]GHz) and 3.5/5.5[Formula: see text]GHz WiMAX (3.40–3.60 and 5.25–5.85[Formula: see text]GHz) applications with satisfactory radiation patterns and acceptable gains.
Electropolymerization of poly-5,10,15,20-tetrakis(p-aminophenyl)porphyrin in different deposition modes and solvents
Authors: Tesakova Mariya V. , Koifman Oskar I. , Parfenyuk Vladimir I.
Published: July 2018

The influence of solvent, supporting electrolyte and electrolysis modes on poly-5,10,15,20-tetrakis([Formula: see text]-aminophenyl)porphyrin film growth were studied by the quartz crystal microbalance method. Electropolymerization was carried out in potentiostatic and potentiodynamic modes from dichloromethane and ethanol solutions. Tetrabutylammonium perchlorate (TBAP) and tetrabutylammonium hexafluorophosphate (TBAHFP) were used as supporting electrolytes. Surface micrographs of films electrodeposited over a different number of cycles of potential variation were obtained. The specific surface area, the pore size, and the thickness of the obtained polyporphyrin films were determined. The number of electrons participating in 5,10,15,20-tetrakis([Formula: see text]-aminophenyl)porphyrin electropolymerization was determined by the quartz crystal microbalance method. Based on the electronic absorption spectroscopy results, it was established that porphyrin macroheterocycles were preserved in an oxidized state in polyporphyrin.
Caesarean Section Rates and Activity-Based Funding in Northern Norway: A Model-Based Study Using the World Health Organization’s Recommendation
Authors: Norum Jan , Svee Tove Elisabeth
Published: July 2018

Objective. Caesarean section (CS) rates vary significantly worldwide. The World Health Organization (WHO) has recommended a maximum CS rate of 15%. Norwegian hospitals are paid per CS (activity-based funding), employing the diagnosis-related group (DRG) system. We aimed to document how financial incentives can be affected by reduced CS rates, according to the WHO’s recommendation. Methods. We employed a model-based analysis and included the 2016 data from the Norwegian Patient Registry (NPR) and the Medical Birth Registry of Norway (MBRN). The vaginal birth rate and CS rates of each hospital trust in Northern Norway were analyzed. Results. There were 4,860 deliveries and a 17.5% CS rate (range 13.9–20.3%). The total funding of the deliveries was €16,351,335 (CS: €6,389,323; vaginal births: €9,962,012). The CS rate varied significantly and was lower in the southern region (P<0.002). Consequently, the introduction of a cutoff at a 15% CS rate would gain the two southern hospital trusts by a budget increase of 0.2%. The two northern ones would experience 6.4% less resources. A total of €644,655 could be allocated to further quality and safety initiatives in obstetrics. Conclusion. The economic consequences of the model-based financial incentive were low, but probably sufficient to get the necessary attention and influence on the CS rate. Recommendations. A financial incentive for the reduction of CS rates should be tested as a supplement to other instruments.
Biological Impact of Exposure to Extremely Fine-Grained Volcanic Ash
Authors: Aguilera Cristina , Viteri Marco , Seqqat Rachid , Ayala Navarrette Ligia , Toulkeridis Theofilos , Ruano Ana , Torres Arias Marbel
Published: July 2018

At the northwestern edge of South America is located Ecuador. This place is a classical example of an active continental margin with widespread active volcanism. Detailed studies about the impact of volcanic ash on human health are still lacking. Therefore, the disease of exposed populations is unknown. The objective of the present investigation was to assess the biological impact of Pichincha volcanic ash on cell culture and inflammation in murine lung tissues that will contribute to the understanding of the hazards. In this study, thein vivophase was performed in mice C57BL/6 exposed to several doses of volcanic ash (0.5, 1, and 3.75 mg/100 g mouse body weight). The body weight and survival were controlled during seven days of treatment. The expression of inflammation markers NRLP 3, caspase-1, pro-IL-1, IL-1β, IL-6, IL-8, and h-HPRT was analyzed. Thein vitrophase was performed in lung cancer cells A549, peritoneal macrophages, and McCoy cells exposing them to different concentrations of volcanic ash (80, 320, and 1280 μg/cm3) to determine the cytotoxicity and the production of reactive oxygen species. The ash initiated activation of the inflammasome complex NRLP 3 and the initiation of a proinflammatory activity in the murine lung tissue depending on the concentration of this agent. The viability of A549 and McCoy cell decreased with the length of exposure and increased with the concentration of volcanic ash. The activity in superoxide dismutase decreased by about 60%, leading to the formation of reactive oxygen species. These results associated with compounds contained in Pichincha volcanic ash are considered hazardous elements which induce inflammation leading to activate inflammasome NRLP, releasing reactive oxygen species, and producing changes in cell morphology and density, all of which are expression of cytotoxicity.
Age-Related Cutoffs of Plasma Aldosterone/Renin Concentration for Primary Aldosteronism Screening
Authors: Ma Linqiang , Song Ying , Mei Mei , He Wenwen , Hu Jinbo , Cheng Qingfeng , Tang Ziwei , Luo Ting , Wang Yue , Zhen Qianna , Wang Zhihong , Qing Hua , He Yihong , Li Qifu , Yang Shumin ,   the Chongqing Primary Aldosteronism Study (CONPASS) Group
Published: July 2018

Aim. This retrospective study is aimed at investigating whether aldosterone-renin ratio (ARR) cutoffs calculated by the plasma aldosterone concentration (PAC)/plasma renin concentration (PRC) should be set differently in patients of different ages. Methods. 521 hypertensive patients were screened for primary aldosteronism (PA) by the PAC/PRC. 174 patients diagnosed with PA and 311 patients with essential hypertension (EH) were included in the final analysis. Subjects were subdivided into four age groups: <40, 40–49, 50–59, and ≥60 years old. Results. The accuracy of the ARR varied greatly among the different age groups. An ARR of 3.7 (ng/dl)/(μIU/ml) had a sensitivity of 100% and a specificity of 80% in patients ≥ 60 years old. With this cutoff, the sensitivities in patients < 40, 40–49, and 50–59 years old were 74%, 82%, and 87%, respectively, and the specificities were 94%, 95%, and 94%, respectively. To achieve a sensitivity higher than 90%, the ARR cutoff needed to be lowered to 2.0 (ng/dl)/(μIU/ml) for patients 40–49 and 50–59 years old, resulting in sensitivities of 90% and 95%, respectively, and specificities of 80% and 84%, respectively. To achieve a sensitivity higher than 90%, the ARR cutoff needed to be lowered to 1.0 (ng/dl)/(μIU/ml) for patients < 40 years old, resulting in a sensitivity of 90% and a specificity of 82%. Conclusions. An ARR of 3.7 (ng/dl)/(μIU/ml) is optimal for patients ≥ 60 years; for patients 40–59 years, the optimal ARR cutoff is 2.0; for those younger than 40 years, an ARR of 1.0 may be more reasonable.
Reduction of Offensive Odor from Natural Rubber Using Zinc‐Modified Bentonite
Authors: Pajarito Bryan B. , Castañeda Kayla C. , Jeresano Sofia Denise M. , Repoquit Dominique Ann N.
Published: July 2018

Natural bentonite was modified with zinc ions and was used as a filler to reduce the offensive odor from raw natural rubber (NR). Characterization of filler shows the limited exchange of inherent calcium ions and the preferred adsorption of zinc ions on the surface of natural bentonite during modification. The modification process was also accompanied by bassanite formation due to sulfate ions brought by the zinc salt. Zinc‐modified bentonite demonstrates an antimicrobial effect against microorganisms that are known to degrade or produce offensive odor from raw NR. Due to its antimicrobial and adsorption properties, zinc‐modified bentonite significantly reduces the offensive odor from raw NR at loadings of 2.5–7.5 phr as shown by the olfactometry test. In terms of vulcanization characteristics, the loading of zinc‐modified bentonite at 7.5 phr caused a slight decrease in elastic torque and increase in scorch and curing times of NR. The hardness and tensile properties of vulcanized NR are maintained after compounding with zinc‐modified bentonite at 7.5 phr.
Regression Discontinuity Designs Using Covariates
Authors: Calonico Sebastian , Cattaneo Matias D. , Farrell Max H. , Titiunik Rocío
Published: July 2018

We study regression discontinuity designs when covariates are included in the estimation. We examine local polynomial estimators that include discrete or continuous covariates in an additive separable way, but without imposing any parametric restrictions on the underlying population regression functions. We recommend a covariate-adjustment approach that retains consistency under intuitive conditions and characterize the potential for estimation and inference improvements. We also present new covariate-adjusted mean-squared error expansions and robust bias-corrected inference procedures, with heteroskedasticity-consistent and cluster-robust standard errors. We provide an empirical illustration and an extensive simulation study. All methods are implemented in R and Stata software packages.
Digital Inequality Across Major Life Realms
Authors: Robinson Laura , Chen Wenhong , Schulz Jeremy , Khilnani Aneka
Published: July 2018

This issue of the American Behavioral Scientist probes digital inequality as both an endogenous and exogenous factor shaping key life realms and social processes. These include aging and the life course, family and parenting, students and education, prisoner rehabilitation, and social class. The relationships between digital inequality and these life realms are explored in different institutional and national contexts. By drawing connections between digital inequality and these distinct—yet interconnected—life realms, this issue marks a new frontier in the study of digital inequality.
Extracorporeal membrane oxygenation in acute massive pulmonary embolism: a case series and review of the literature
Authors: Al-Bawardy Rasha , Rosenfield Kenneth , Borges Jorge , Young Michael N. , Albaghdadi Mazen , Rosovsky Rachel , Kabrhel Christopher
Published: July 2018

Background:

Extracorporeal membrane oxygenation (ECMO) has been used to stabilize patients with massive pulmonary embolism though few reports describe this approach. We describe the presentation, management and outcomes of patients who received ECMO for massive pulmonary embolism (PE) in our pulmonary embolism response team (PERT) registry.

Methods:

We enrolled a consecutive cohort of patients with confirmed PE for whom PERT was activated and selected patients treated with ECMO. We prospectively captured clinical, therapeutic and outcome data at the time of PERT activation and during the follow-up period for up to 365 days.

Results:

Thirteen patients who had PERT activation with confirmed PE diagnosis have undergone ECMO since the initiation of our PERT program in 2012. The mean age was 49 ± 19 years. Six (46%) patients were female. All the patients had cardiac arrest, either as an initial presentation or in-hospital cardiac arrest after presentation. All the patients exhibited right ventricular (RV) dilation on echocardiogram with RV hypokinesis. Eight (62%) patients received systemic thrombolysis with intravenous tissue plasminogen activator (tPA) and three (23%) patients underwent catheter-directed thrombolysis therapy using the EKOS system (EKOS Corporation, Bothell, WA, USA). Four (31%) patients underwent surgical embolectomy. Mean ECMO duration was 5.5 days, ranging from 2-18 days. Thirty-day mortality was 31% and one-year mortality was 54%.

Conclusions:

Patients with massive pulmonary embolism who suffer a cardiac arrest have high morbidity and mortality. ECMO can be used in conjunction with systemic thrombolysis, catheter-directed therapy or as a bridge to surgical embolectomy.
The Relative Importance of Parental Configuration for Latinx Students’ Educational Attainment
Authors: Battle Juan , Browne Anthony P.
Published: July 2018

Although many studies have examined the importance of parental configuration for Latinx students’ educational attainment, few have considered the longitudinal impact of one versus two-parent households on Latinx children’s educational attainment. This article employs intersectionality as a theoretical framework and utilizes a nationally representative sample from the National Center for Education Statistics’ (NCES) Education Longitudinal Study to investigate the importance of parental configuration on educational attainment. Findings show that (1) parental configuration had no impact; (2) though analyses were conducted separately for males and females, no major gender differences were found; and (3) for the final/full models, public schools mattered for female students, while parental social capital and socioeconomic status mattered for both female and male students.
Short Acculturation Scale for Hispanics (SASH-Y and SASH) Reliability and Validity in Low-Income, Mexican-Heritage Youth and Parents
Authors: Guntzviller Lisa M. , Wang Ningxin
Published: July 2018

The Short Acculturation Scale for Hispanics (SASH) is a popular acculturation measure. Although SASH has been validated, conflicting information has been published about the youth version (SASH-Y). We examined the psychometric properties (i.e., validity and reliability) of SASH-Y in low-income, Mexican-heritage youth (aged 8-18; n = 100) and SASH with their parents ( n = 100; total N = 200). Confirmatory factor analyses comparing the three published structural variations of the SASH-Y revealed the three-factor structure originally proposed for SASH-Y fit the data best, and the frequently used unidimensional structure did not fit. The adult SASH fit parent data well. For researchers interested in comparing parent and child scores (e.g., acculturation gap research), we examined the 10 identical parent and child items for invariance. Invariance was established for parent and child data with the traditional SASH structure. However, internal consistency was inadequate for the child data regardless of variable structure. Implications are discussed.
Numerical study of the effects of cartridge shape on the reverse pulsed flow cleaning of pleated cartridge filters
Authors: Chen Shaowen , Gong Yun
Published: July 2018

Patchy cleaning is one of the principal factors resulting in the reduction of the efficiency and quality of reverse pulse-jet cleaning as well as the service lifetime of filtration units. To resolve the above issues, a new pleated cartridge shape was introduced in this study to improve the cleaning efficiency and quality of pleated filter cartridges. To calculate the transient flow and pressure fields for a simple filtration system with one filter cartridge in the reverse pulse-jet cleaning process, an unsteady computational fluid dynamics model was developed via the commercial computational fluid dynamics software of ANSYS CFX. The transient static pressure fields for filter cartridges under four different pleated cartridge shapes were studied. The conventional cylindrical cartridge was selected as the base-model of filter cartridge and contrasted with other three cartridge shapes. It was found that the convergent–divergent cartridge was able to effectively improve the cleaning performance without the increase of tank pressure. Different pleated cartridge shapes are expected to be able to redistribute the pressure drop across the porous media along the filter height and to improve the flow behavior after pulsing gas releasing from the nozzle. For convergent–divergent cartridge shape, the peak pressure on the inner surface of porous media has an obvious increase and the peak pressure arriving time is earlier than other cases. It shows that the reverse flow has much more competence to remove the dust powder or cake from the porous media. At the same time, the area-averaged pressure drop at the bottom section of the filter has an increase of 50% under the cartridge with a convergent–divergent shape compared to that with a cylindrical shape. It is considered to enhance the cleaning mechanical stress at the bottom section of the filter cartridge. The better cleaning performance was observed in the medium, with 150% increase compared to that with a cylindrical shape. Furthermore, the cleaning performance gets improved because the value enhances on the top section. The redistribution of pressure drop observed is mainly because the special geometric construction of pleated cartridges compresses the flow on the medium and produce higher pressure drop there. Further studies indicate that the improved cleaning performance was observable under the consideration of the tank pressure reduction and variation of media permeability during each cleaning phase, and the change of pleated cartridge shapes can also improve the cleaning performance when combined with other improvement methods.
Not Just Funny After All: Sarcasm as a Catalyst for Public Engagement With Climate Change
Authors: Anderson Ashley A. , Becker Amy B.
Published: July 2018

Sarcastic content is prevalent in online social media, although little research has explored its effects. In this study, we examine how exposure to one-sided versus two-sided sarcastic perspectives on climate change shapes beliefs about climate change. We find that exposure to one-sided messages that use irony to deride those who believe that climate change is a hoax (presented in The Onion) raises belief certainty in and perceived risk of climate change for those who do not already believe climate change is an important issue ( N = 141). The two-sided message (presented by The Weather Channel) does not show any effects.
Zoledronic acid-induced orbital inflammation in a patient with multiple myeloma
Authors: Tan Marisela , Kalin-Hajdu Evan , Narayan Rupa , Wong Sandy W , Martin Thomas G
Published: July 2018

Multiple myeloma is a cancer of malignant plasma cells which stimulates osteoclasts and is associated with increased bone turnover and osteolysis. Bisphosphonates including zolendronic acid are used to prevent skeletal complications in patients with multiple myeloma. Orbital inflammation is a rare but serious complication following use of bisphosphonates. The diagnosis is made by excluding other possible causes in patients with myeloma and rapid initiation of therapy is required. Corticosteroids are the mainstay of therapy but the ideal treatment course has not been delineated. This report describes a case of this rare complication and provides a review of the literature.
Tribological behavior of BK7 optical glass at elevated temperatures
Authors: Mosaddegh Peiman , Akbarzadeh Saleh , Zareei Mostafa , Reiszadeh Hassan
Published: July 2018

Aspherical lenses are produced using glass molding technology in a temperature close to its glass transition temperature. Friction and wear between the moving mold surface and the heated glass is one of the important aspects of the optical lenses production. This paper presents an experimental study on the tribological behavior of BK7 optical glass at elevated temperatures using pin-on-disk test rig. Thirty experiments have been conducted to study the effect of operating temperature, applied load, and sliding speed on the friction coefficient and wear rate of BK7 optical glass disks in contact with alumina pin. Also, the relation between the generated entropy and the weight loss under different operating conditions has been studied. The experimental results show that with increasing the temperature up to the glass transition temperature, the wear volume and friction coefficient increase. Further increase in the temperature results in a decrease in the wear volume and friction coefficient. Increasing the applied load results in an increase in the wear rate. An investigation on the correlation of wear rate and the dissipated power shows a linear relation between these two parameters.
IAPT under the microscope
Authors: Marks David F
Published: July 2018

England’s flagship ‘Improving Access to Psychological Therapies’ (IAPT) service has cost around £1 billion yet Scott’s (2018a) study suggests that only 9.2% of IAPT patients recover. This leaves an enormous gap of 40.8% between the observed recovery rate and IAPT’s claimed recovery rate of 50.0%. The spotlight is on patients with ‘medically unexplained symptoms’ (MUS) and ‘long-term conditions’ (LTCs) such as ‘diabetes, COPD and ME/CFS, yet there is no way of knowing whether IAPT is capable of yielding the promised rewards or English patients are being sold an expensive pup. An urgent independent expert review of IAPT recovery rates is necessary to answer this question.
Transculturalized Diversity and Inclusion Model: A New Framework for Disabilities
Authors: Thoms Charlotte L. V. , Burton Sharon L.
Published: July 2018

The Problem

After 30+ years of debating the best model for disability, there is a need for a new framework. As the medical model of disability seeks a cure and the social model points to the environment, neither model is without its flaws. Human resource development (HRD) professionals and practitioners are in a position to craft a model that reflects the experiences of people with disabilities. This new model will strengthen HRD’s importance in the field and its impact on other disciplines.

The Solution

This article offers consideration to be given for a new model for disability that addresses the complexities of cultural boundaries, gives value to the experiences of people with disabilities, and changes language in how disabilities are described. Using the results of the literature review, a path to the Transculturalized Diversity and Inclusion Model lays the groundwork for further research. This article accesses the perceptions of people with disabilities regarding both models, incorporates the strategies used by HRD scholars and researchers for improving value in a growing population of disabled people, and synthesizes a platform for future discussion and development of the Transculturalized Diversity and Inclusion Model.

The Stakeholders

HRD practitioners, especially those serving populations with disabilities, will benefit greatly from a new model and perspective provided by the Transculturalized Diversity and Inclusion Model. HRD scholars likewise will be provided with a new framework for conducting research on people with disabilities in the workplace.
Influenza Vaccine Intention After a Medically Attended Acute Respiratory Infection
Authors: Nowalk Mary Patricia , Balasubramani G. K. , Zimmerman Richard K. , Bear Todd M. , Sax Theresa , Eng Heather , Susick Michael , Ford Samantha E.
Published: July 2018

Background. Little is known about vaccine intention behavior among patients recovering from a medically attended acute respiratory infection. Methods. Adults ≥ 18 years old with an acute respiratory infection in the 2014-2015, 2015-2016, and 2016-2017 influenza seasons were tested for influenza and completed surveys. Across seasons, unvaccinated participants were grouped into those who intended to receive the influenza vaccine in the following season (vaccine intention) and those who did not (no vaccine intention). In 2016-2017, participants were asked the reasons for their vaccination behavior. Results. Of the 837 unvaccinated participants, 308 (37%) intended to be vaccinated the next season. The groups did not differ in demographic or overall health factors. In logistic regression, non-Whites, those reporting wheezing or nasal congestion, and those receiving an antiviral prescription were more likely to be in the vaccine intention group. That group was significantly more likely to cite perceived behavioral control reasons for not being vaccinated (forgot), while the no vaccine intention group was significantly ( p < .001) more likely to report knowledge/attitudinal reasons (side effects). Conclusion. Because influenza vaccine is given annually, adults must make a conscious decision to receive the vaccine each year. Understanding the factors related to vaccination behavior and intent can help shape interventions to improve influenza vaccination rates. A medical visit at the time of an acute respiratory illness, especially one in which the provider suspects influenza, as evidenced by an antiviral prescription, is an ideal opportunity to recommend influenza vaccine in the next season, to prevent a similar experience.
Intradermal Acupuncture Along with Analgesics for Pain Control in Advanced Cancer Cases: A Pilot, Randomized, Patient-Assessor-Blinded, Controlled Trial
Authors: Kim Kyungsuk , Lee Sanghun
Published: July 2018

Purpose: Ninety percent of patients with advanced cancer have moderate to severe pain, and up to 70% of patients with cancer pain do not receive adequate pain relief. This randomized controlled clinical trial was designed to determine the feasibility and evaluate the effects and safety of intradermal acupuncture (IA) in patients who were being administered analgesics for cancer pain. Methods: Advanced cancer patients experiencing pain were randomly assigned to IA or sham IA treatment for 3 weeks (15 patients for each group), wherein the CV12, bilateral ST25, LI4, LR3, PC06, and Ashi points were selected and stimulated. Follow-up evaluations were conducted 3 weeks after the end of treatments. The grade and dosage of analgesics for cancer pain, pain intensity, quality of life, and safety were assessed. Results: Twenty-seven patients (90%) completed 6-week trial, and no serious adverse events were associated with either IA or sham IA procedures except the transient side effect such as fatigue. Nine patients in the IA group (64.3%) and 5 in the sham IA group (38.5%) responded to the 3-week intervention. These patients were mostly in the nonopioid and the weak opioid levels of the World Health Organization analgesic ladder. Self-reported pain declined by −1.54 ± 1.45 and −1.15 ± 1.57 in the IA and sham IA groups, respectively, with improved quality of life reported. Conclusions: IA treatment appears feasible and safe for advanced cancer patients. It might reduce analgesic usage in the early World Health Organization analgesic ladder stage cancer patient, though it could not show significant outcome differences due to design limitation of sham IA.
Return to work recommendations after carpal tunnel release: a survey of UK hand surgeons and hand therapists
Authors: Newington Lisa , Francis Kristin , Ntani Georgia , Warwick David , Adams Jo , Walker-Bone Karen
Published: July 2018

There is a limited evidence base from which to derive recommendations for safe and effective return to different types of occupation after carpal tunnel release surgery. The current practice of members of the British Society for Surgery of the Hand and the British Association of Hand Therapists was investigated with a questionnaire. In total, 173 surgeons and 137 therapists responded from an estimated sample of 1959. Median recommended return-to-work times were 7 days for desk-based duties, 15 days for repetitive light manual duties and 30 days for heavy manual duties. However, the responses were wide-ranging: 0–30 days for desk-based; 1–56 days for repetitive light manual; and 1–90 days for heavy manual. Variation in the recommended timescales for return to work and other functional activities after carpal tunnel release suggests that patients are receiving different and possibly even conflicting advice.

Level of evidence: V
What do hospitalists experience as barriers and helpful factors for having ACP conversations? A systematic qualitative evidence synthesis
Authors: Vanderhaeghen Birgit , Van Beek Karen , De Pril Mieke , Bossuyt Inge , Menten Johan , Rober Peter
Published: July 2018

Background:

Hospitalists seem to struggle with advance care planning implementation. One strategy to help them is to understand which barriers and helpful factors they may encounter.

Aims:

This review aims to give an overview on what hospitalists experience as barriers and helpful factors for having advance care planning conversations.

Method:

A systematic synthesis of the qualitative literature was conducted.

Data sources:

A bibliographic search of English peer-reviewed publications in PubMed, Embase, CINAHL, Central, PsycINFO, and Web of Science was undertaken.

Results:

Hospitalists report lacking communication skills which lead to difficulties with exploring values and wishes of patients, dealing with emotions of patients and families and approaching the conversation about letting a patient die. Other barriers are related to different interpretations of the concept advance care planning, cultural factors, like being lost in translation, and medicolegal factors, like fearing prosecution. Furthermore, hospitalists report that decision-making is often based on irrational convictions, and it is highly personal. Physician and patient characteristics, like moral convictions, experience, and personality play a role in the decision-making process. Hospitalists report that experience and learning from more experienced colleagues is helpful. Furthermore, efficient multidisciplinary co-operation is helping.

Conclusion:

This systematic review shows that barriers are often related to communication issues and the convictions of the involved hospitalist. However, they seem to be preventable by creating a culture where experienced professionals can be consulted, where convictions can be questioned, and where co-operation within and between organizations is encouraged. This knowledge can serve as a basis for implementation.
Future-Labs in the Classroom: The Experience of -skopìa
Authors: Emanuelli Chiara , Scolozzi Rocco , Brunori Francesco , Poli Roberto
Published: July 2018

During the past three years, -skopìa[EDUCATION], the educational branch of the recently established start-up of the University of Trento, -skopìa, has conducted an extensive series of future laboratories in the classroom, working in particular with students aged twelve years old (second year of “medie inferiori”) and fifteen years old (second year of “medie superiori”). Future labs follow an explicit protocol (initial and final tests, three major steps, respectively, focused on the past, the future and the present). Teachers wanting to conduct a lab in their classroom must attend a preliminary training course. Furthermore, all the labs are monitored by -skopìa.
Leveraging JAK-STAT regulation in myelofibrosis to improve outcomes with allogeneic hematopoietic stem-cell transplant
Authors: Byrne Michael , Savani Bipin , Savona Michael R.
Published: July 2018

Primary myelofibrosis (PMF) is a disease characterized by bone marrow fibrosis, extramedullary hematopoiesis, risk of transformation to acute myeloid leukemia, and a substantial symptom burden with diminished quality of life. Allogeneic hematopoietic cell transplantation (HCT) is the only curative option; however, disease relapse and graft versus host disease (GVHD) are significant barriers to long-term survival. The discovery of the JAK2 V617F mutation, and subsequent development of JAK inhibitors, resulted in improved survival and significant improvements in spleen volumes and symptom scores. Though the effect of JAK inhibition on transplant outcome is poorly understood, using JAK inhibition to achieve maximal response prior to HCT is standard practice at major centers. After allogeneic HCT, a significant proportion of patients with steroid-refractory GVHD have clinical responses to JAK inhibition. Targeting this pathway is a key component in the management of patients with PMF before and after allogeneic HCT.