bluuebunny/crossref_metadata_2025 huggingface dataset:
Facial Changes in Adult Uremic Patients on Chronic Dialysis: Possible Role of Hyperparathyroidism
Authors: Ferrario V.F. , Sforza C. , Dellavia C. , Galassi A. , Rey L. Rocca , Chiarelli G. , Cozzolino M. , Gallieni M. , Brancaccio D.
Published: January 2018

Background

Uremic patients on regular dialytic treatment (RDT) are often affected by a complex metabolic syndrome leading to osteodystrophy. Bone changes are primarily due to high bone turn over, often combined with a mineralization defect leading to increased bone fractures and bone deformities. Although rarely considered, the craniofacial skeleton represents one of the peculiar targets of this complex metabolic disease whose more dramatic pattern is a form of leontiasis ossea. This complication, although described, has never been evaluated in depth nor quantitatively assessed. In order to assess facial deformities in uremic conditions and to understand the possible relation with hyperparathyroidism, we undertook a quantitative evaluation of soft facial structures in a cohort of uremic patients undergoing RDT.

Methods

The three-dimensional coordinates of 50 soft-tissue facial landmarks were obtained by an electromagnetic digitizer in 10 male and 10 female patients with chronic renal insufficiency aged 53–81 years, and in 34 healthy individuals of the same age, ethnicity and sex. Uremic patients were enrolled according to hyperparathyroid status (PTH < 300 pg/mL and PTH > 500 pg/mL). From the landmarks, facial distances, angles and volumes were calculated according to a geometrical face model.

Results

Overall, the uremic patients had significantly larger facial volumes than the reference subjects. The effect was particularly evident in the facial middle third (maxilla), leading to an inversion of the mandibular-maxillary ratio. Facial dimensions were increased in all three spatial directions: width (skull base, mandible, nose), length (nose, mandible), and depth (mid face, mandible). The larger maxilla was accompanied by a tendency to more prominent lips (reduced interlabial angle). Some of the facial modifications (nose, lips, mandible) were significantly related to the clinical characteristics of the patients (age, duration of renal insufficiency and PTH levels).

Conclusions

This report, the first in the literature, shows that facial structures of uremic patients are enlarged in comparison with matched normal subjects and that increased bone turnover could be responsible – at least in part – for facial bone changes.
PPS-PEG Surface Coating to Reduce Thrombogenicity of Small Diameter ePTFE Vascular Grafts
Authors: Karrer L. , Duwe J. , Zisch A.H. , Khabiri E. , Cikirikcioglu M. , Napoli A. , Goessl A. , Schaffner T. , Hess O.M. , Carrel T. , Kalangos A. , Hubbell J.A. , Walpoth B.H.
Published: January 2018

Aims

Patency failure of small vascular synthetic grafts is still a major problem for coronary and peripheral revascularization. Thus, three new surface coatings of small synthetic grafts were tested in an acute pig model to evaluate their thrombogenicity (extracorporeal arterio-venous shunt) and in a chronic rat model to evaluate the tissue reaction they induced (subcutaneous implantation).

Methods

In five domestic pigs (25–30 kg) an extracorporeal femoro-femoral arterio-venous shunt model was used. The study protocol included first a non-heparinized perfusion sequence followed by graft perfusion after 10,000 UI iv heparin. Grafts were perfused for 3 and 9 minutes. The following coatings were tested on ePTFE grafts: poly-propylene sulphide (PPS) – poly-ethylene glycol (PEG) (wet and dry applications) as well as carbon. Two sets of control were used, one dry and one wet (vehicle only). After perfusion grafts were examined by scanning electron microscopy for semiquantitative assessment (score 0–3) of cellular and microthrombi deposition. To assess tissue compatibility, pieces of each material were implanted subcutaneously in 16 Wistar rats. At 2, 4, 8, 12 weeks four animals each were sacrificed for semi-quantitative (score 0–3) histologic evaluation of tissue reaction.

Results

In the pig model, cellular deposition and microthrombi formation increased over time. In non-heparinized animals, the coatings did not improve the surface characteristics, since they did not prevent microthrombi formation and cellular deposition. In heparinized animals, thrombogenicity was lowest in coated grafts, especially in PPS–PEG dry (P&0.05), and highest in controls. Cell deposition was lowest in PPS–PEG dry, but this difference was not statistically significant vs. controls. In the rat model, no significant differences of the tissue reaction could be shown between materials.

Conclusion

While all coatings failed to add any benefit for lowering tissue reaction, surface coating with PPS–PEG (dry application) reduced thrombogenicity significantly (in heparinized animals) and thus appears to be promising for improving graft patency of small synthetic vascular prostheses.
Implant Infection and Infection Resistant Materials: A Mini Review
Authors: Arciola C.R. , Alvi F.I. , An Y.H. , Campoccia D. , Montanaro L.
Published: January 2018

Implant infection is an aggressive, often irreducible post-surgical infection. It remains the primary cause of implant failure. Bacterial contamination during surgery and subsequent adhesion onto biomaterial surface of opportunistic microorganisms, such as staphylococcal species, exopolysaccharidic slimes or specific adhesins, initiates the implant infection.

Pathogenesis of periprosthestic infection is the focus of studies aimed at developing infection resistant materials.
Vaccines and Immunotherapy for Staphylococcal Infections
Authors: Patti J.M.
Published: January 2018

Nosocomial or hospital-acquired infections are associated with prolonged hospitalizations and increased healthcare costs. Infections associated with surgical implants are becoming more difficult and more costly to manage, as they require repeated surgical procedures and a longer period of time to treat patients. Continued advances in the use of medical devices, an increase in the number of immunocompromised patients, and a steady rise in the prevalence of antibiotic-resistant organisms has renewed interest in the development of novel therapies that can be used to prevent and treat nosocomial infections. This review provides an overview of bacterial adhesins and focuses on novel immunological therapies developed to treat staphylococcal infections.
The Impact of Various Cycling Regimens on Phosphorus Removal in Chronic Peritoneal Dialysis Patients
Authors: Juergensen P. , Eras J. , Mcclure B. , Kliger A.S. , Finkelstein F.O.
Published: January 2018

Background

The National Kidney Foundation Dialysis Outcome Quality Initiative clinical practice guidelines have suggested that serum phosphate levels be maintained at ≤ 5.5 mg/dL in patients maintained on dialysis. Over 45% of anuric patients maintained on CAPD have serum phosphate levels > 5.5 mg/dL. The present study was designed to address the question whether phosphate removal could be enhanced by increasing the dialysate volume during cycler peritoneal dialysis therapy.

Methods

Medically stable patients maintained on chronic peritoneal dialysis therapy, who were high or high-average transporters and had serum phosphate levels ≥ 5.5 mg/dL, were invited to participate in the study. The protocol involved measuring phosphate and creatinine clearances at weekly intervals on three different cycler prescriptions consisting of 7 and 12 full cycles or 24 cycles with 50% tidal PD (TPD) over 9 hours. Ten patients agreed to participate. Those patients (n=7) with a BMI > 22 had 2 liter (L) fill volumes and 14 L of total dialysate (7 cycles of 2 L) or 24 L total dialysate (12 cycles of 2 L or 50% TPD with 24 cycles). The patients (n=3) with a BMI & 20 had 1.2 L fill volumes and 8.4 L total dialysate (7 cycles) or 14.4 L total dialysate (12 cycles of 1.2 L or 50% TPD with 24 cycles).

Results

The mean age (± SD) of the study patients was 50.8 (± 9.3) years. There were 6 females, 6 Caucasians and 4 African-Americans. The mean weight of the patients was 71.5 (± 24.2) kg and mean height 1.65 (+ 7.6) meters. The mean BMI was 18.3 (± 1.27) in the < 20 BMI group and 30.3 (± 6.6) in the > 22 BMI group. The mean phosphate clearance (L/night/1.73m2) increased from 3.96 (± 1.16) with 7 cycles to 4.71 (+ 1.81) with 12 cycles and 4.51 (± 1.61) with 50% TPD. Creatinine clearance (L/night/1.73m2) was 4.74 (± 1.74) with 7 cycles, 6.06 (± 2.04) with 12 cycles and 5.61 (± 2.01) with TPD.

Conclusion

The present study indicates that there is a significant, 19% (P & 0.005) rise in phosphate clearance by increasing dialysate volume 71% from 7 cycles to 14 cycles compared to a 27% increase in creatinine clearance. With tidal PD, phosphate clearance increased by 12% (p=NS) and creatinine clearance increased 18 % (p, 0.02). This increase in phosphate clearance translates into & 50 mg net phosphate removal in 9 hours, assuming a serum phosphate of 6 mg/%. Thus, increasing dialysis cycles and volume results in only a minimal increase in net phosphate removal.
Rescue and Salvage Procedures for Mechanical and Infectious Complications of Peritoneal Dialysis
Authors: Crabtree J.H.
Published: January 2018

Mechanical and infectious complications are the two most common reasons for removal of peritoneal dialysis catheters and permanent transfer of patients to in-center hemodialysis. Early and appropriate intervention can save many catheters, often without interrupting peritoneal dialysis. If peritoneal dialysis must be interrupted, other strategies may be employed to minimize the time on temporary hemodialysis and preserve peritoneal dialysis as renal replacement therapy. Procedures for managing dialysate leaks, abdominal wall hernias, infusion pain, and catheter flow dysfunction are described. Salvage techniques for catheter-related infections and peritonitis are presented. Clinical conditions are discussed where urgent removal of the dialysis catheter is indicated to protect the future integrity of the peritoneal membrane.
Imaging Work-Up for Peritoneal Access Care and Peritoneal Dialysis Complications
Authors: Scanziani R. , Pozzi M. , Pisano L. , Barbone G. Santagostino , Dozio B. , Rovere G. , Gabella P. , Magrì F.
Published: January 2018

Peritoneal dialysis (PD) represents a treatment opportunity for patients with end-stage renal failure, but it has particular complications that sometimes force cessation of this procedure (1–9). These complications are due to the presence of the peritoneal catheter and of dialysis solution within the peritoneal cavity. Infections are the most common complications of PD, followed by mechanical complications.

Diagnostic imaging of the complications of PD is important because such an evaluation can aid in the diagnosis and in the decision making process about the treatment. In this review we present the main radiologic investigations employed: plain radiograph, US, peritoneography, computed tomography peritoneography, magnetic resonance peritoneography, peritoneal scintigraphy.

To diagnose catheter-related problems plain radiograph, ultrasonography and peritoneography can be useful. US is useful in diagnosing and following-up exit-site and tunnel infections. Peritoneography and C T-peritoneography, alone or in combination, can be recommended as gold standard investigation to assess mechanical peritoneal dialysis complications, such as catheter malfunction, leaks, hernias and sclerosing peritonitis. Newer methods, such as MR peritoneography or scintigraphy could be useful in selected patients, on center-based experience. An appropriate use of radiology may significantly improve technique survival, morbidity and mortality of patients treated with PD.
Molecular Adsorbent Recirculating System (MARS) Application in Liver Failure: Clinical and Hemodepurative Results in 22 Patients
Authors: Stefoni S. , Colì L. , Bolondi L. , Donati G. , Ruggeri G. , Feliciangeli G. , Piscaglia F. , Silvagni E. , Sirri M. , Donati G. , Baraldi O. , Soverini M.L. , Cianciolo G. , Boni P. , Patrono D. , Ramazzotti E. , Motta R. , Roda A. , Simoni P. , Magliulo M. , Borgnino L.C. , Ricci D. , Mezzopane D. , Cappuccilli M.L.
Published: January 2018

Purpose

Acute liver failure (ALF) and acute on chronic liver failure (ACLF) still show a poor prognosis. MARS was used in 22 patients with ALF or ACLF to prolong patient survival for liver function recovery or as a bridge to transplantation.

Design

Evaluation of depurative efficiency, biocompatibility, hemodynamics, encephalopathy (HE) and clinical outcome.

Procedures

During 71 five-hour sessions we evaluated (0′, 60′, 120′, 180′, 240′, 300′): bilirubin, ammonia, cholic acid (CCA), chenodeoxycholic acid (CCDCA), leukocytes, platelets, hemoglobin and mean arterial pressure (MAP). Serum creatinine, electrolytes, cardiac output, cardiac index (bioimpedence) and HE (West Haven Criteria score) were evaluated at 0' and 300′. Statistical methods and outcome measures: Student's t-test for pre- vs. end-session values was used. For bilirubin and ammonia the correlation test was made between pre- and end-session values and between pre-session values and removal rates (RRS).

Main Findings

Survival was 90.9% at 7 days, 40.9% at 30 days. Pre- vs. end-session: bilirubin from 37.2±12.5 mg/dL to 24.9±8.9 mg/dL (p<0.01), ammonia from 88.0±60.4 μmol/L to 43.6±32.9 μmol/L (p<0.01), CCA from 42.8±21.0 μmol/L 18.2±9.8 μmol/L (p<0.01), CCDCA from 26.3±6.3 μmol/L to 15.7±7.6 μmol/L (p<0.01). The correlation test between pre-session values of bilirubin and ammonia vs. RRS was respectively 0.32 (p=0.01) and 0.30 (p=0.04). Leukocytes, platelets and hemoglobin remained stable. MAP increased from 82.0±12.0 mmHg to 87.0±13.0 mmHg (p<0.05), West Haven Criteria score decreased from 2.7±0.7 to 0.7±0.7 (p<0.001).

Conclusion

MARS treatment led in all patients to an improvement of clinical, hemodynamic and neurological conditions, with significant reduction in the hepatic toxins blood level. Treatment biocompatibility and tolerance were satisfactory
Observation and Quantification of Cavitation on a Mechanical Heart Valve with an Electro-Hydraulic Total Artificial Heart
Authors: Lee H. , Taenaka Y.
Published: January 2018

In previous studies, we investigated the cavitation phenomenon in a mechanical heart valve using an electro-hydraulic total artificial heart. With this system, a 50% glycerin solution kept at 37°C was used as the working fluid. We reported that most of the cavitation bubbles were observed near the valve stop and were caused by the squeeze flow. However, in these studies, the effect of the partial pressure of CO2 on the mechanical heart valve cavitation was neglected. In this study, in order to investigate the effect of the partial pressure of CO2 on mechanical heart valve cavitation using an electro-hydraulic total artificial heart, we controlled the partial pressure of the CO2 in vitro. A 25-mm Medtronic Hall valve was installed in the mitral position of an electro-hydraulic total artificial heart. In order to quantify the mechanical heart valve cavitation, we used a high-speed camera. Even though cavitation intensity slightly increased with increases in the PCO2 at heart rates of 60, 70 and 100 bpm, throughout the experiment, there was no significant difference between the PCO2 and cavitation intensity.
Model Based Study on Monitoring Ketone Bodies to Improve Safety in Intensive Insulin Therapy
Authors: Fabietti P.G. , Canonico V. , Orsini Federici M. , Sarti E. , Massi Benedetti M.
Published: January 2018

Aim

The present study explores new signals (capillary 3βhydroxybutyrate - 3 βOHB) for improving the safety of a closed loop insulin infusion system (external wearable artificial pancreas).

Methods

Data collected during a clinical trial on diabetic subjects including a period of insulin deprivation were interpreted through mathematical models to simulate the effect of monitoring ketone bodies (capillary 3βOHB, KB) compared to blood glucose in subjects on Continuous Subcutaneous Insulin Infusion (CSII) treatment.

Results

The estimation of model coefficients satisfactorily fits experimental data. The evaluation of dynamic changes of capillary 3βOHB levels showed a more rapid response than blood glucose.

Conclusions

The effect of the combination of monitoring of glucose and ketone bodies can consistently improve the safety and efficacy of the use of a closed loop system for glycemic control in dangerous situations like ketoacidosis. If a subcutaneous glucose-ketone bodies sensor were to become available in the near future it would be a key component of an external artificial pancreas.
The Influence of Surface Bioactivated Modification on Titanium Percutaneous Implants Anchored in Bone
Authors: Wu Y. , Yang B.C. , Deng C.L. , Tan Y.F. , Zhang X.D.
Published: January 2018

In order to achieve biological sealing and resist mechanical damage of load-bearing percutaneous devices, Ti with excellent mechanical properties was anodic-oxidized to be endowed with bioactivity, with plasma-sprayed hydroxyapatite coated Ti as control. Similar to previous works, hydroxyapatite coating could bond tightly with living tissues, resulting in implant stability for whole implantation periods. Meanwhile, when anodic-oxidized bioactivated Ti was implanted percutaneously in vivo, it could induce a layer of calcium phosphate at the interface of tissues/implant. This layer of Ca-P not only induced the fibrous tissue or collagen ingrowth in its structure, but also improved the osteointegration between the bone and the implant. There was no significant biological response difference for the anodic-oxidized Ti and HA coated Ti at different implantation period with histological statistical analysis (p>0.05). Accordingly, suitable bioactivated modified surface of Ti by anodic-oxidized method could not only obtain the same results as the HA coating, but also might avoid some drawbacks of plasma-sprayed HA coatings to achieve biological sealing for a long period in vivo.
Uremic Pruritus
Authors: Kosmadakis G.C. , Zerefos N.
Published: January 2018

Renal itch is a localized or generalized itch, affecting patients with chronic renal failure, where there is no primary skin disease and no systemic or psychological dysfunction that might cause pruritus. Uremic pruritus (UP) is an unpleasant sensation, rarely appearing in earlier stages of chronic kidney disease. Renal transplantation is the definite solution for that problem. The prevalence of UP has been reduced during the last years, possibly, due to a more efficient dialysis, with more biocompatible filters.

During the last decades a big number of substances were considered to be etiologic factors of UP, and an even bigger number of therapeutic substances appeared with promising potentials and conflicting results in the course of their use. The main reason for this disorientation is the lack of sound evidence on the pathogenetic mechanisms that may potentiate UP.

‘Inflammatory’ and ‘opioid’ hypothesis are the best studied and the reduction of UP is a fact. Nevertheless the mechanisms of the pathogenesis of UP are still under investigation and a long way has to be done in order to achieve more definite results.
Influence of Different Growth Factors on Chondrogenic Differentiation of Adipose-Derived Stem Cells in Polyurethane-Fibrin Composites
Authors: Froelich Katrin , Setiawan Lydia E. , Technau Antje , Ramos Tirado Mario , Hackenberg Stephan , Hagen Rudolf , Staudenmaier Rainer , Kleinsasser Norbert H.
Published: January 2018

Introduction

Chondrogenic differentiation of adipose-derived stem cells (ASCs) has proven to be feasible. To compensate for laryngeal palsy or cartilage defects after surgery or trauma using tissue engineering, a formable and stable scaffold material is mandatory.

Methods

ASCs were seeded in fibrin-polyurethane scaffolds and cultured in chondrogenic differentiation medium adding the growth factors TGF-□1, TGF-□3, and BMP-2 for up to 35 days.

Results

Histological examination showed acid glycosaminoglycans in the extracellular matrix in all groups. Immunofluorescence presented positive staining for collagen II, aggrecan, and SOX-9 in the TGF-□1–, TGF-□3–, and BMP-2-group. With Real-time PCR analyses, chondrogenic differentiation became apparent by the expression of the specific genes COL2A1 (collagen II), AGC 1 (aggrecan), and SOX-9, whereas collagen II expression was low in all groups compared to bone marrow-derived stem cells (BMSC) due to reduced chondrogenic ability.

Conclusions

These findings demonstrate the general ability of ASCs to differentiate into matrix-producing chondrocytes in fibrin-polyurethane scaffolds. However, further experiments are necessary to enhance this chondrogenic potential of ASCs seeded in fibrin-polyurethane scaffolds in order to produce a suitable regeneration method for treating cartilage defects or an implantable medialization material for vocal cord palsy.
Pretreatment of ferulic acid attenuates inflammation and oxidative stress in a rat model of lipopolysaccharide-induced acute respiratory distress syndrome
Authors: Zhang Sheng , Wang Pengyu , Zhao Pengxin , Wang Dong , Zhang Yanwei , Wang Junhui , Chen Lixia , Guo Wenping , Gao Hui , Jiao Yalou
Published: January 2018

Acute respiratory distress syndrome (ARDS) is a fatal clinical condition that can be caused by pulmonary and non-pulmonary diseases. Oxidative stress and inflammation play key roles in the development of ARDS. In this study, we investigated whether ferulic acid (FA), an anti-oxidant, was beneficial for prophylaxis of ARDS. We established an ARDS rat model using lipopolysaccharide (LPS) administration. Lung injury was assessed by lung wet/dry ratio and broncho-alveolar lavage fluid (BALF) analysis. Hematoxylin and eosin staining was performed to evaluate the histological changes of the lungs. Enzyme-linked immunosorbent assay (ELISA) and immunoblotting were performed to detect proteins in BALF and lung tissue, respectively. Pulmonary function was determined by testing the oxygen level in BALF. FA pretreatment significantly alleviated LPS-induced pulmonary histological changes. FA reversed LPS-induced changes of lung wet/dry ratio, total protein in BALF, P(A-a)O2, and PaO2/FiO2. In addition, LPS dramatically up-regulated the secretion of interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, and IL-10 in BALF ( P < 0.01). However, pretreatment of FA significantly improved LPS-induced inflammation. We found that FA indeed reduced oxidative stress in the lungs by testing malondialdehyde level, myeloperoxidase level, and total anti-oxidant capacity. We also proved that FA inactivated multiple mitogen-activated protein kinase signaling pathways in the lungs. In conclusion, FA alleviated LPS-induced ARDS through its anti-inflammatory and anti-oxidant activities.
An Intervention to Improve Physical Function and Caregiver Perceptions in Family Caregivers of Persons With Heart Failure
Authors: Gary Rebecca , Dunbar Sandra B. , Higgins Melinda , Butts Brittany , Corwin Elizabeth , Hepburn Kenneth , Butler Javed , Miller Andrew H.
Published: January 2018

Objective: This randomized controlled trial was conducted to determine whether a 12-week home-based aerobic and resistance exercise program would improve physical function and caregiving perceptions among family caregivers (FCGs) of persons with heart failure. Method: Overall, 127 FCGs were randomized to one of three groups: usual care attention control (UCAC), psychoeducation only (PE), and psychoeducation plus exercise (PE + EX). Physical function measures (6-min walk test, handgrip, and upper and lower strength) and caregiving perceptions (Bakas Caregiving Outcomes Scale) were obtained at baseline and at 6 months. Results: FCGs in the PE + EX showed significant improvement in 6-min walk distance ( p = .012), handgrip, and lower extremity strength compared with the PE and UCAC groups. The combined group had the greatest improvement in caregiver perceptions ( p < .001). Conclusion: FCGs in the PE + EX group improved the most in physical function and caregiver perception outcomes. Directions for future research are provided.
Computational Thinking Equity in Elementary Classrooms: What Third-Grade Students Know and Can Do
Authors: Tran Yune
Published: January 2018

The Computer Science Teachers Association has asserted that computational thinking equips students with essential critical thinking which allows them to conceptualize, analyze, and solve more complex problems. These skills are applicable to all content area as students learn to use strategies, ideas, and technological practices more effectively as digital natives. This research examined over 200 elementary students’ pre- and posttest changes in computational thinking from a 10-week coding program using adapted lessons from code.org’s Blockly programming language and CSUnplugged that were delivered as part of the regular school day. Participants benefited from early access to computer science (CS) lessons with increases in computational thinking and applying coding concepts to the real world. Interviews from participants included examples of CS connections to everyday life and interdisciplinary studies at school. Thus, the study highlights the importance of leveraging CS access in diverse elementary classrooms to promote young students’ computational thinking; motivation in CS topics; and the learning of essential soft-skills such as collaboration, persistence, abstraction, and creativity to succeed in today’s digital world.
Predicting Secondary School Students' Performance Utilizing a Semi-supervised Learning Approach
Authors: Livieris Ioannis E. , Drakopoulou Konstantina , Tampakas Vassilis T. , Mikropoulos Tassos A. , Pintelas Panagiotis
Published: January 2018

Educational data mining constitutes a recent research field which gained popularity over the last decade because of its ability to monitor students' academic performance and predict future progression. Numerous machine learning techniques and especially supervised learning algorithms have been applied to develop accurate models to predict student's characteristics which induce their behavior and performance. In this work, we examine and evaluate the effectiveness of two wrapper methods for semisupervised learning algorithms for predicting the students' performance in the final examinations. Our preliminary numerical experiments indicate that the advantage of semisupervised methods is that the classification accuracy can be significantly improved by utilizing a few labeled and many unlabeled data for developing reliable prediction models.
Who Gets “Housing First”? Determining Eligibility in an Era of Housing First Homelessness
Authors: Osborne Melissa
Published: January 2018

Drawing on two years of ethnographic fieldwork at a Midwest nonprofit organization, this project considers how a “housing first” approach to homelessness operates in practice. I show how formal implementation of diagnostic tools and prioritized categories reinforces normative beliefs about gender and vulnerability, which shape providers’ understandings about what people have legitimate claims to social support—or who, in other words, are the “truly vulnerable” homeless. I demonstrate that this convergence of organizational mandates and cultural expectations produces a mutually reinforcing process that guides and constrains case management. Through this, three housing eligibility trajectories arise: accessible, guided, and blocked pathways. Although this system benefits many individuals, it produces barriers to support for those deemed ineligible, leaving many in an indefinite state of services limbo. In effect, this system has produced a climate where merely being homeless is no longer enough to be considered sufficiently vulnerable for receiving housing.
Researching reciprocal leadership
Authors: Poultney Val , Fordham Jon
Published: January 2018

This article looks at the potential of using an online self-completing inventory that measures leadership consciousness awareness. The Consciousness Quotient inventory (CQ-i) has been developed to encourage leaders to be more conscious of their ability to be accountable and responsible for their leadership practice. The CQ-i as a method for researching leadership is piloted here between a university academic and a primary headteacher in the context of a school–university partnership. Pilot outcomes reveal that the inventory can be used as an evaluation of partnership work and ways of thinking about leadership on two levels: the personal and the partnership. The method is somewhat limited by a lack of distinctive criteria for personal domain statements and the absence of an overall profile outcome for the CQ score. Its strength lies in the way the outcomes of the inventory can be used as a starting point for personal reflection on leadership and as a vehicle for discussing a range of different ways of leadership working within different settings, such as school and university contexts.
Segmentation of tongue shapes during vowel production in magnetic resonance images based on statistical modelling
Authors: Delmoral Jessica C , Rua Ventura Sandra M , Tavares João Manuel RS
Published: January 2018

Quantification of the anatomic and functional aspects of the tongue is pertinent to analyse the mechanisms involved in speech production. Speech requires dynamic and complex articulation of the vocal tract organs, and the tongue is one of the main articulators during speech production. Magnetic resonance imaging has been widely used in speech-related studies. Moreover, the segmentation of such images of speech organs is required to extract reliable statistical data. However, standard solutions to analyse a large set of articulatory images have not yet been established. Therefore, this article presents an approach to segment the tongue in two-dimensional magnetic resonance images and statistically model the segmented tongue shapes. The proposed approach assesses the articulator morphology based on an active shape model, which captures the shape variability of the tongue during speech production. To validate this new approach, a dataset of mid-sagittal magnetic resonance images acquired from four subjects was used, and key aspects of the shape of the tongue during the vocal production of relevant European Portuguese vowels were evaluated.
A comparative analysis of internal bone remodelling concepts in a novel implant for direct skeletal attachment of limb prosthesis evaluation: A finite element analysis
Authors: Prochor Piotr , Sajewicz Eugeniusz
Published: January 2018

Nowadays, numerous internal bone remodelling concepts are under development, in order to estimate long-term functionality of implants by evaluating the intensity of stress-shielding effect. This effect is also analysed for the implants for direct skeletal attachment, considered as a better exoprosthesis fixation method than prosthetic sockets. Most of bone remodelling approaches are based on basic concepts, differing with certain assumptions, which may affect the accuracy of the results. This article compares commonly used internal bone remodelling concepts and evaluates the functionality of the proposed Limb Prosthesis Osseointegrated Fixation System for direct skeletal attachment of limb prosthesis in comparison with two currently available implants: the Intraosseous Transcutaneous Amputation Prosthesis and the Osseointegrated Prostheses for the Rehabilitation of Amputees. Three concepts were chosen: without and with lazy zone and with the use of quadratic formula which considers bone overloading. Therefore, three finite element models were created with identical femur implanted with each of analysed implants. The implants were loaded with loads that refer to two stages of gait cycle (heel strike and toe-off). The analysed concepts have given similar results, allowing to assume that each of them can be successfully used to estimate internal bone remodelling around analysed implants for direct skeletal attachment of limb prosthesis. The results also present higher functionality of the proposed implant for direct skeletal attachment of limb prosthesis due to a significant reduction in stress-shielding in the analysed areas around implant in comparison with the Intraosseous Transcutaneous Amputation Prosthesis and the Osseointegrated Prostheses for the Rehabilitation of Amputees. It suggests that the proposed design is a better alternative to the currently used solutions.
HIV and renal disease: a contemporary review
Authors: Gameiro Joana , Jorge Sofia , Lopes José A
Published: January 2018

The presence of human immunodeficiency virus (HIV)-related kidney disease is an important cause of mortality and morbidity. HIV infection induces renal injury by direct cytotoxicity or immune complex-mediated glomerulonephritis in patients with genetic susceptibility factors. In the last decades, with the development and diffusion of combination antiretroviral therapy, which has prolonged patient survival, there has been a shift in the spectrum of renal diseases in HIV-infected patients, with the decrease of glomerular diseases and increase in the role of nephrotoxicity and co-morbidities. This review provides a contemporary and critical review on the main renal syndromes occurring in HIV-infected patients.
A comparison of HIV-risk behaviors between young black cisgender men who have sex with men and young black transgender women who have sex with men
Authors: Crosby Richard A , Salazar Laura F , Hill Brandon , Mena Leandro
Published: January 2018

This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P < .001) and pharyngeal gonorrhea ( P = .04) occurred among YBTWSM; however, both associations were moderated and only significant for HIV-uninfected volunteers. YBTWSM had more oral sex partners and more frequent engagement in oral sex. The number of new sex partners for anal receptive sex was greater in YBTWSM. YBTWSM were more likely to exchange sex for money/drugs ( P < .001), have sex with men recently in prison ( P < .001), who were “anonymous” ( P = .004), or who were “one night stands” ( P < .001). YBTWSM were more likely to depend on sex partners for money food, etc. ( P < .001), to miss meals due to lack of money ( P = .01), and to report having ever being incarcerated ( P = .009). Compared to cisgender YBMSM, YBTWSM experience multiple risk factors relative to the acquisition/transmission of STIs and HIV.
Pathways Into Literacy: The Role of Early Oral Language Abilities and Family Risk for Dyslexia
Authors: van Viersen Sietske , de Bree Elise H. , Zee Marjolein , Maassen Ben , van der Leij Aryan , de Jong Peter F.
Published: January 2018

The present study investigated the role of early oral language and family risk for dyslexia in the two developmental pathways toward reading comprehension, through word reading and through oral language abilities. The sample contained 237 children (164 at family risk for dyslexia) from the Dutch Dyslexia Program. Longitudinal data were obtained on seven occasions when children were between 4 and 12 years old. The relationship between early oral language ability and reading comprehension at the age of 12 years was mediated by preliteracy skills and word-decoding ability for the first pathway and by later language abilities for the second pathway. Family risk influenced literacy development through its subsequent relations with preliteracy skills, word decoding, and reading comprehension. Although performance on language measures was often lower for the family-risk group than for the no-family-risk group, family risk did not have a specific relation with either early or later oral language abilities.
Digital video recorder dodgers – Sport-viewing habits in the face of changing media reality
Authors: Tamir Ilan
Published: January 2018

In an era in which viewers can record television content to be watched at any time of convenience using a variety of broadcast media, delayed viewing has emerged as a self-evident and natural option for many content-consumers. An interesting exception to this trend, however, is sport – football, in particular – which supporters insist on watching exclusively in real-time. The present study has sought to understand the obsessive dedication of sports fans with watching sport content only in real-time. This peculiar insistence results in the viewer giving up some rather useful technological amenities. Through in-depth interviews conducted with 34 soccer fans, this study aimed to explore the apparent and adamant fan refusal to "delay gratification" – that is, only watching broadcast sport content in real-time. The interview analysis offers some salient explanations for the phenomenon. For example, football fans self-identify as members of a community in a quasi-religious sense, deeply committed to rules and ceremonies to be ritualistically performed at appropriate and specific times. Indeed, to exceed these rules is to violate the norms of the community. Many fans also believe they can somehow influence the match and its outcome by their viewing presence, and must, therefore, be in front of the screen in real-time. In fact, the bond between fan and team is analogous to a relationship characterized by deep and intimate emotions. This bond can be stretched by any fan who is absent from the real-time screen-viewing experience of the sporting event, engendering feelings of treachery and betrayal of the fan-team love relationship. The dynamics of this relationship have social, media, and economic implications, as well.
Reading Modi’s Visit to Israel
Authors: Kumaraswamy P.R.
Published: January 2018

Prime Minister Narendra Modi’s Israel visit had demystified the bilateral relations and brought them out of the tradition military-security paradigm and shifted the focus to non-political and developmental issues. His economic centric approach would be a major step towards the ‘normalization’ of Israel in India’s engagements with the wider Middle East. As it seeks closer ties with Iran and Saudi Arabia—the two rival and antagonistic powers in the Gulf region—India is also seeking closer ties with Israel.  While much of the attention has been on the de-hyphenation of Israel and Palestine, the de-politicisation of the bilateral relations would be major outcome of Prime Minister Modi’s visit to Israel.
Monitoring: The slow cousin of evaluation, or an equal partner?
Authors: De Boer Marc
Published: January 2018

Evaluators often regard monitoring as playing a secondary and relatively simple role compared to evaluation proper. This paper argues that this view underestimates the potential of monitoring information in enhancing the value of evaluative work, in particular to increase the ‘half-life’ of evaluation findings. Moreover, it suggests the possibility of a more dynamic interchange between monitoring and evaluation. Specifically, monitoring complements the fragmented and ad-hoc nature of evaluation work, so that the process of monitoring presents an opportunity to develop a framework within which individual evaluations can exist. Drawing on program logic and CMO theory, the key to this interchange is to build of systematic body of knowledge and theory that drives, and is in turn informed by, evaluation and monitoring. The work within the Department of Work and Income New Zealand provides an example of an attempt at implementing such a framework.
Evaluating government - sponsored science and technology projects in China
Authors: Bao Yukun , Zhang Jinlong , Li Xinnan
Published: January 2018

The Chinese Government has invested increasingly in science and technology (S&T) since the early 1980s. Evaluation of these activities began in the 1990s, especially at the national level. This paper introduces the process by which government-sponsored S&T programs are evaluated, investigates specific issues encountered during the process of evaluation, and recommends guidelines for future improvement of S&T evaluation practice.
What did it all mean?
Authors: Elvins Richard , Kalucy Libby , Lake Robert , Barber Elizabeth , Wehipeihana Nan , Goff Susan
Published: January 2018

The final conference plenary was designed as a review session to focus on what had been learnt at the conference. Chaired by conference discussant Patricia Rogers, a panel drawn from six AES regions contributed their impressions of the conference and what they saw as the key issues over the three days. This panel session was followed by Patricia's closing address, which appears on pages 30-34.
An adapted version of a community of practice approach to evaluation owned by indigenous stakeholders
Authors: McIntyre Janet
Published: January 2018

Values are at the heart of the definition of well-being and are at the heart of all evaluation initiatives. Unless the initial definitions of evaluation are owned by the stakeholders’ groups (age, gender, ethnicity, culture, language etc.) and shared to develop a co-created sense of citizenship rights and responsibilities (McIntyre 2000; Romm 2001), then the process of evaluation may be compromised. This paper discusses work in progress where the author acts as a facilitator of indigenous facilitators who are in the process of developing an integrated model for governance that is defined and owned by an indigenous public housing association.
Insider knowledge and outsider objectivity – the benefits and risks of combined evaluator roles in a study of health care reform
Authors: Hurley Catherine , Van Eyk Helen , Baum Fran
Published: January 2018

This paper describes the experiences of the authors in conducting a three year evaluation of health system reform processes in the southern region of Adelaide and explores how the evaluation team utilised ‘insider’ and ‘outsider’ roles to establish and maintain trust and cooperation with stakeholders and informants in a turbulent policy environment. It uses the results of focus groups and interviews to analyse how the team was able to encourage the sharing of sensitive information and to examine the roles, responsibilities and risks to evaluators in carrying out a controversial evaluation. The importance and some means of finding a balance between insider knowledge and outsider objectivity in evaluation are discussed.
Vice President'S Message
Authors: Cummings Rick
Published: January 2018

In a variation from past practice, this issue of the Journal contains a message from the Vice President rather than the President of the AES. This is due to the President, Penny Hawkins, being overseas while this issue was being produced.
A conceptual framework for making evaluation support meaningful, useful and valuable
Authors: Coryn Chris LS
Published: January 2018

How does support differ from reporting and dissemination? How, and to what extent do existing evaluation theories attend to support? How, and for what purposes should support be provided? Does support infer that evaluators have ethical, moral, professional, contractual or other obligations to provide support? Is support an evaluation service, or should it be considered an evaluator competency or skill? Or, as with the traditional research paradigm, should evaluators merely let their reports speak for them? While the Key Evaluation Checklist (KEC) and other evaluation theories and approaches have provided a conceptual basis for evaluation support, further clarification is necessary in order to make support an integral part of evaluation practice. The evaluation support construct as posited here necessitates means that are direct and indirect, technical and general, and includes alternative scenarios for the purposes of advocating for, assisting and helping evaluands, clients, stakeholders, and audiences and users of evaluation.
Economic evaluation of R&D investment in natural resource management
Authors: Chudleigh Peter , Simpson Sarah , Schofield Nick
Published: January 2018

An approach is presented for evaluating in economic terms the investment made by a publicly funded natural resource management research and development (R&D) funding organisation (Land & Water Australia) over its 16-year life. The approach combines qualitative methods to describe research investments and their outputs, outcomes and benefits with conventional cost-benefit analyses that produce measures of the worth of the investment. While the major driver of such an approach is the need for accountability to the Australian Government, co-funders and the public, a number of other objectives are being met also. Benefits to the organisation are accruing, including a better understanding of the factors that contribute to a successful investment and how to communicate the benefits of research to stakeholders.

One of the important strengths of the process is the consistency of application of a standardised approach to cost-benefit analyses and the transparency of the analyses that have now addressed 28 separate case studies. The approach is flexible, is conducive to updating information over time, and recognises many of the difficulties involved in applying investment analysis to R&D investment. The development of the process has adopted a continuous improvement philosophy.
Youth participation in evaluation
Authors: Leger Pam St , Bell Catherine
Published: January 2018

This study reports on the evaluation of two Australian educational initiatives that involved a high degree of youth participation in the evaluation process. Both evaluations involved capturing youth perspectives through photographic portfolios as one of the data collection methods, in order to portray young people's understandings of the relationship between leadership and the potential to create change in their communities.

The article describes two initiatives: r.u.MAD?, a youth philanthropic program, and the Glenormiston Leadership Pilot Program for Year 9 students, and provides a brief overview of the evaluation findings in relation to each initiative.

The main findings of the r.u.MAD? evaluation were that students and their teachers believed that the r.u.MAD framework had enabled them to make significant differences in their school environments or local communities and that links with local communities were strengthened. Students also reported that their experiences in r.u.MAD? projects had given them increased organisational and leadership skills.

The main findings of the evaluation of the Glenormiston Leadership Pilot Program were that the rural setting and proximity to the sea provided a rich site for leadership program for Year 9 students, particularly those who had grown up in Melbourne. The evaluation also found that the program model was effective in terms of developing skills in leadership and independent learning.

The article also explores some of the issues and challenges that surround youth participation in the evaluation of educational programs that have a strong leadership and empowerment focus. In addition, some comments are made about the use of photographs as an evaluation strategy.