bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparing Teachers With Sociocultural Knowledge in Literacy: A Literature Review
Authors: Wetzel Melissa Mosley , Vlach Saba Khan , Svrcek Natalie Sue , Steinitz Erica , Omogun Lakeya , Salmerón Cori , Batista-Morales Nathaly , Taylor Laura A. , Villarreal Doris
Published: March 2019

Although the call for teachers to address the demographic imperative has existed for decades, recently, there has been an uptake of frameworks of multicultural education, culturally responsive pedagogies, critical literacy, and others into literacy teacher preparation. In this study, we examine connections that pre-service teachers make as a result of experiences focused on sociocultural knowledge and literacy and barriers they face in building these connections. Areas of connection include examining one’s past; recognizing students’ lives and resources in literacy teaching; considering race, racism, and students’ racial identity; drawing on multilingualism as a strength of students for literacy learning; and engaging actively and inquiring into literacy.
Constructs of Teaching Writing in Research About Literacy Teacher Education
Authors: Bomer Randy , Land Charlotte L. , Rubin Jessica Cira , Van Dike Laura M.
Published: March 2019

This review of empirical research focused on the preparation of writing teachers synthesizes findings from 82 articles published between 2000 and early 2018. The new understandings generated through this analysis are presented in two sections. First, we provide an overview of how the studies we reviewed draw from and circulate dominant discourses of writing, leading to a call for more transparency and clarity on the part of scholars who study writing and writing pedagogy. Then, we explore experiences in literacy teacher education that may shift the writing identities, beliefs, or teaching practices of prospective writing teachers. We position these shifts as being potentially disruptive to the often uninterrupted circulation of powerful discourses in important and generative ways, since the teaching of writing in the 21st century must break from inherited traditions to best prepare writers to use their voices actively and confidently in the world.
The Risk of Making False Confessions: The Role of Developmental Disorders, Conduct Disorder, Psychiatric Symptoms, and Compliance
Authors: Gudjonsson Gisli Hannes , Gonzalez Rafael A. , Young Susan
Published: March 2019

Objective: To investigate salient predictors of self-reported false confessions. The conditions included mild intellectual disability (ID), autism spectrum disorder (ASD), ADHD, conduct disorder (CD), psychiatric symptoms, and compliance. Method: The sample consisted of 386 male Scottish prisoners, who completed a diagnostic ADHD interview, psychometric tests, and a questionnaire about false confessions they had given to police over their lifetime. Results: There was a high rate of reported false confessions (33.4%); the reason for the majority (62.2%) being to “cover up for somebody else.” CD, ADHD, psychological distress and psychiatric symptoms, and compliance were all significant predictors of false confession. When examining the influence of underlying domains of ADHD, it was found that hyperactivity/impulsivity drove the association with false confession after adjusting for coexisting CD. Conclusion: CD and ADHD were the two most powerful predictors of false confessions, with CD mediating some of the effects of ADHD.
Two-dimensional and contrast-enhanced ultrasound of intestinal ischaemia in cats: four cases
Authors: Linta Nikolina , Baron Toaldo Marco , Del Magno Sara , Pey Pascaline , Quinci Manuela , Diana Alessia
Published: March 2019

Objectives

The aim of this study was to describe the results of two-dimensional (2D) and contrast-enhancement ultrasound (CEUS) in four cats with intestinal ischaemia.

Methods

Data were collected from hospital records of all cats that had intestinal ischaemia between January 2012 and August 2018. The inclusion criteria were complete abdominal ultrasound examination, colour flow Doppler and CEUS of lesions, confirmation of intestinal ischaemia detected by visual assessment of avascular intestinal segment at surgery, and/or necropsy and histopathology. All images and video clips were reviewed by the same experienced operator.

Results

Four cats with different intestinal ischaemic lesions were included in the study: duodenal perforating ulcer, jejunal necrotising enteritis, necrosis secondary to jejunojejunal intussusception and iatrogenic damage of jejunal arteries. On the 2D ultrasound, all intestinal lesions were characterised by non-specific findings: focal hypoechoic wall thickening with loss of normal layering associated with hyperechoic mesentery surrounding the intestinal tract. CEUS showed a reduced or absent enhancement of the intestinal lesions in comparison to the surrounding perfused wall.

Conclusions and relevance

Intestinal ischaemia is a potentially fatal disorder. Grey-scale, colour and power Doppler ultrasonography are not sensitive for evaluating this condition. Our preliminary findings illustrate the usefulness of CEUS for the detection of intestinal wall impaired perfusion in cats.
Familial confounding on the ability to read minds: A co-twin control study
Authors: Isaksson Johan , Taylor Mark J , Lundin Karl , Neufeld Janina , Bölte Sven
Published: March 2019

Alterations in social cognition are hypothesized to underlie social communication challenges in autism spectrum disorder. However, the etiologic underpinnings driving this association, as well as the impact of other psychiatric conditions on the association, remain unclear. Using a co-twin control design, we examined n = 308 twins (mean age = 16.63; 46% females) with autism spectrum disorder, attention-deficit/hyperactivity disorder, affective disorders, or typical development using the Reading the Mind in the Eyes Test to operationalize social cognition ability. Clinical diagnosis of autism spectrum disorder, as well as the extent of quantitative autistic traits, as measured by parental reports using the Social Responsiveness Scale-2, predicted fewer expected responses on the Reading the Mind in the Eyes Test across the pairs. The association remained when adjusting for other diagnoses and IQ. In addition, male sex, lower age, and lower IQ predicted poorer performance on the Reading the Mind in the Eyes Test. The associations between autism and social cognition ability were lost within pairs in both the full sample and the monozygotic subsample. We conclude that the association between autism and social cognition across the sample highlights the importance of social cognition alterations in autism spectrum disorder when compared with other conditions. The attenuation of the association in the within-pair models indicate familial confounding, such as genes and shared environment, influencing both autism and social cognition.
Burnout in social workers and socio-demographic factors
Authors: Gómez-García Rogelio , Alonso-Sangregorio Margarita , Llamazares-Sánchez María L.
Published: March 2019

The objectives of this study were to estimate the prevalence of burnout syndrome in a sample of Spanish social workers and analyse the influence of a series of socio-demographic variables that may potentially be related to the appearance and development of one of the three dimensions of burnout. A total of 947 Spanish social workers participated in the study.

Findings

33.2% and 22.1 of Spanish social workers experienced high levels of emotional exhaustion and depersonalisation, and 54.2% experienced low personal accomplishment at work. The hierarchical regression analysis showed that having been on sick leave in the preceding year was the most important predictor of emotional exhaustion. Moreover, full-time employment status was the most robust predictor of depersonalisation, and professional activity in specialised social services was the main predictor of personal accomplishment. The low percentages of total variance explained imply that although certain socio-demographic characteristics are significant predictors, their effects are very small.

Applications

Public and private organisations devoted to social services should be aware of the need to prevent this type of psychosocial risk to which social workers are exposed every day. This would help improve the health and quality of their lives as well as reduce the high costs which frequent worker turnover and sick leave entail, and would also enhance the effectiveness of the services provided.
Genetic knockdown of brain-derived neurotrophic factor in the nervous system attenuates angiotensin II-induced hypertension in mice
Authors: Zhang Zhongming , Zhang Yijing , Wang Yan , Ding Shengchen , Wang Chenhui , Gao Li , Johnson Alan , Xue Baojian
Published: March 2019

Introduction:

Brain-derived neurotropic factor (BDNF) is expressed throughout the central nervous system and peripheral organs involved in the regulation of blood pressure, but the systemic effects of BDNF in the control of blood pressure are not well elucidated.

Materials and methods:

We utilized loxP flanked BDNF male mice to cross with nestin-Cre female mice to generate nerve system BDNF knockdown mice, nestin-BDNF (+/–), or injected Cre adenovirus into the subfornical organ to create subfornical organ BDNF knockdown mice. Histochemistry was used to verify injection location. Radiotelemetry was employed to determine baseline blood pressure and pressor response to angiotensin II (1000 ng/kg/min). Real-time polymerase chain reaction was used to measure the expression of renin–angiotensin system components in the laminal terminalis and peripheral organs.

Results:

Nestin-BDNF (+/–) mice had lower renin–angiotensin system expression in the laminal terminalis and peripheral organs including the gonadal fat pad, and a lower basal blood pressure. They exhibited an attenuated hypertensive response and a weak or similar modification of renin–angiotensin system component expression to angiotensin II infusion. Subfornical organ BDNF knockdown was sufficient for the attenuation of angiotensin II-induced hypertension.

Conclusion:

Central BDNF, especially subfornical organ BDNF is involved in the maintenance of basal blood pressure and in augmentation of hypertensive response to angiotensin II through systemic regulation of the expression of renin–angiotensin system molecules.
Quality of Life, Functioning, and Coping in HCV Patients Continuing Versus Ceasing Alcohol Use
Authors: Sims Omar T. , Oh Hyejung , Pollio David E. , Hong Barry A. , Pollio E. Whitney , North Carol S.
Published: March 2019

The purpose of this study was to compare quality of life, functioning, and coping among hepatitis C virus (HCV) patients who continued versus ceased alcohol use in the past year. HCV patients ( n = 291) were recruited from three liver and infectious disease clinics. Student’s t test was used to compare HCV patients who were former and active users of alcohol. The majority of HCV patients were male, African American, and without a high school degree. Compared to former users of alcohol, active users of alcohol self-reported lower ratings on home life, personal leisure, and overall quality of life. In the area of functioning, active users of alcohol self-reported lower ratings on home life, close relationships, sex life, and overall functioning. The two groups did not differ on coping. Most HCV clinicians advise HCV patients to avoid alcohol completely because of its adverse biological effects on the liver. Despite this important advice by their HCV clinicians, most HCV patients continue to use alcohol. HCV clinicians can additionally consider advising these patients that continued alcohol use is associated with lower quality of life and functioning as further evidence to convince these patients to avoid alcohol or to participate in alcohol cessation treatment.
Fabrication of fibrous microfiltration membrane by pore filling of nanofibers into poly(ethylene terephthalate) nonwoven scaffold
Authors: Xu Xianlin , Zhang Gaokao , Wang Shubo , Lv Shengnan , Zhuang Xupin
Published: March 2019

A nanofibrous microfiltration membrane with high flux, low pressure drop, and high retention capacity was fabricated by pore filling of copolyetherester nanofibers (low-melting-point polyester; melting point of 110℃) into a poly(ethylene terephthalate) nonwoven scaffold. Short low-melting-point polyester nanofibers were anchored on the surface of the poly(ethylene terephthalate) fibers by heat treatment to form a crosslinked nanostructured mesh with very high porosity and high specific surface area. The pore size and distribution of the membranes can be adjusted by varying the loading amount of nanofibers. The resulting membrane not only possessed good interception ability for 5, 3, and 1.3 µm polystyrene microspheres but also exhibited desirable water permeability. In the circulating filtration test, with the accumulation of membrane fouling in the filtration, the membrane was also effective in retaining particulate matter while improving the antipollution ability. These properties are desirable for the effective removal of pollutants on the membrane and restoration of the membrane flux.
Dependability of Direct Behavior Rating Single- and Multi-Item Scales Across Raters and Occasions in Two School Subjects
Authors: Casale Gino , Volpe Robert J. , Briesch Amy M. , Hennemann Thomas , Grosche Michael
Published: March 2019

Direct Behavior Rating (DBR) has been proposed as a promising approach to assess student behavioral progress in classroom settings. The current study examines raters and occasions as well as their interactions as sources of error in the use of DBR–Multi-Item Scales (DBR-MIS) and DBR–Single-Item Scales (DBR-SIS) for academically engaged (AE) and disruptive behavior (DB). Furthermore, the stability of scores across two school subjects (i.e., German language, mathematics) was examined. A total of 20 students and two teachers in an inclusive elementary school classroom participated in the study. Generalizability study results suggest that little variance in DBR scores was attributable to the facets of raters or occasions, but the interactions between persons with raters and occasions accounted for a large portion of variance. Variance attributable to these interactions was slightly higher for DBR-MIS than for DBR-SIS ratings. Decision studies revealed that dependable measurements of AE could be achieved within 1.5 weeks of daily ratings for absolute decision-making. Findings regarding DB were mixed. Differences across both school subjects were found indicating that DBR ratings that are obtained in one academic setting may not necessarily be exchangeable with ratings obtained in another. Overall, the results demonstrate the utility of DBR for behavioral progress-monitoring purposes.
I’d Like to Have All the Characteristics of a Hero: A Case Study of Strength-Centered Therapy
Authors: Li P. F. Jonah , Wong Y. Joel , Cawthra Julia N.
Published: March 2019

Strength-centered therapy (ST) is a therapeutic model based on character strengths in positive psychology and social constructionist perspectives on psychotherapy. Although there is no documented empirical research on ST, research evidence indicates that interventions that identify and cultivate character strengths have consistently yielded positive outcomes in well-being. Some specific techniques adopted in ST have shown effectiveness in improving psychological outcomes. The present case study adds research evidence to the potential effectiveness of ST. This case study provides an analysis of ST with a 20-year-old White female client. The focus of this case study is to illustrate how ST techniques work with a real client. A total of 12 therapy sessions and pre- and post-therapy interviews and assessments with the client were recorded and transcribed for data analysis. The research team analyzed the data qualitatively, illustrated several ST therapeutic strategies, and explored the client’s experience of therapy in four phases of ST. Implications for practice and research are discussed.
Acceptance and Commitment Therapy for the Treatment of Chronic Pain and Coexisting Depression: A Single-Case Study
Authors: Knowlton Charlie N. , Kryvanos Alena , Poole Megan , Christopher Michael , Lafavor Theresa
Published: March 2019

Pain resulting from chronic medical conditions (CMCs) can create debilitating effects globally across domains of functioning in the lives of those it impacts. There currently remain no treatment options to eliminate associated pain entirely, leaving care efforts often to manage the disabling effects and consequential depression. Acceptance and commitment therapy (ACT) has recently been introduced as an alternative treatment approach, emphasizing the commitment to engage in actions that contribute to a fulfilling life even in the face of disability through the fostering of psychological flexibility. For patients who do not respond to traditional psychological approaches, ACT may offer a sensible substitute. This single-case study delineates ACT for chronic pain and comorbid depression using standardized and patient-centered outcome measures across areas of general symptom functioning, therapeutic processes, and flexibility surrounding pain associated with CMCs. Clinical significance and reliable change were calculated using the reliable change index, in conjunction with patient-reported behavioral engagement and subjective assessment. Results indicate significant improvement across areas of depression, psychological flexibility, and flexibility in relating to pain endured from CMCs. The patient reported perceived improvement in quality of life and no longer viewed herself as a “professional patient.” This case study illustrates the potential of shifting from restraining and extinguishing symptoms to fostering a stance of willingness to reengage in a valued life while continuing to live with CMCs.
The Contribution of Ethics Review to Protection of Human Participants: Comment on “Measuring the Quality and Performance of Institutional Review Boards”
Authors: Grady Christine
Published: March 2019

Measuring the quality and performance of IRBs requires clarity about what IRBs are supposed to do. Although many agree that IRBs are supposed to protect the rights and welfare of human subjects, exactly how review by an IRB contributes to protection is not always clear. Originally, ethics review was instituted as a way to check the interests, possible conflicts, and enthusiasm of investigators whose relationship to participants is different from physicians’ relationship to patients. IRB performance might include evaluating how well IRBs do this.
Congenital Thumb-Index Web Space Deficiency
Authors: Wu Tiffany , Walchak Adam , Rayan Ghazi M.
Published: March 2019

Background: There are several congenital hand differences that cause thumb-index (TI) web space deficiency. There is a knowledge gap in the literature about the hand differences that are associated with TI web space deficiency. We aimed to identify these congenital differences and the various specific reconstructive surgical procedures that are used for these conditions. Methods: We conducted a retrospective chart review of children treated operatively over a period of 30 years for congenital TI web space deficiency by the senior author (G.M.R.). We gathered data on demographics and associated congenital hand differences and compiled a list of all surgical procedures performed for the web space and the ipsilateral upper extremity. Results: We included 71 patients (77 hands) with 12 congenital hand differences (62 developmental and 9 spastic). The total number of upper extremity operations, (ie), anesthetics performed for these patients was 186, averaging 2.6 settings and 7.5 procedures for each patient. Cutaneous reconstructive procedures included first dorsal metacarpal artery pedicle flaps (49 patients), 4-flap Z-plasties (15), and transposition flaps (13). In addition, 16 different thumb reconstructive procedures were necessary. Ten patients required revision of their TI web space procedures for recurrence. Conclusions: The prevalence of TI web space deficiency is underappreciated. These patients often have multiple musculoskeletal anomalies of the hand and upper extremity that should be ruled out and require surgical treatment to optimize hand function. Consideration should be given to performing more than one procedure in one setting when possible.
Perception of Body Weight Status Is Associated With the Health and Food Intake Behaviors of Adolescents in the United States
Authors: Mbogori Teresia , Arthur Tya M.
Published: March 2019

The purpose of this study was to determine the associations among body weight status perception, health status, diet quality, and consumption of fruits and vegetables within the adolescent population in the United States. A cross-sectional study was conducted with 1737 adolescents (12-17 years) participating in the Family Life, Activity, Sun, Health, and Eating study, an internet-based survey study sponsored by the National Cancer Institute. Adolescents reported their perception of their weight status, diet quality, health status, and the frequency with which they consumed common fruits and vegetables in a week. Results showed that 62% of the adolescents reported perceiving their weight as “just right,” and 10.9%, 22.4%, and 4.7% perceived their weight to be “underweight,” “a little overweight,” and “very overweight,” respectively. Those who perceived their weight status as “just right” also reported their health to be “very good” or “excellent” and that their diet was good. Similarly, adolescents who perceived their weight to be just right consumed significantly more fruits and vegetables than those who perceived their weight as “underweight” or “overweight.” Results of this study have important implications for future research on weight and health status, diet quality, and healthy eating behaviors among adolescents.
Research on the pressurization performance of an impeller in a multi-phase pump under different working conditions
Authors: Shi Guangtai , Wang Zhiwen , Wang Zhengwei , Li Zhenggui , Liu Xiaobing
Published: March 2019

In order to improve the working performance of the impeller in a multi-phase pump under different working conditions and expand the range of the high-efficiency areas of the multi-phase pump, each section of the impeller was divided into an inlet section, middle section and outlet section. The pressurization performance of different areas within the impeller was obtained by numerical calculation under different flow rates and different gas volume fractions, respectively. The results show that the pressurization performance of the different areas within the impeller can be predicted well. In the first half of the impeller, when the blades were closer to the rim, the pressurization performance was stronger, and in the second half of the impeller, when the blades were closer to the hub, the pressurization performance was stronger. With an increase in the flow rate, from the inlet section to the outlet section, the pressurization performance of each stage of the impeller gradually decreased, and the strongest pressurization performance area was always in the inlet section with no obvious movement. With the increase in the gas volume fractions, the pressurization value of each stage of the impeller dropped faster, except for the outlet section. When there was an increase in the flow rate or the gas volume fraction, the inlet section was influenced the most and the outlet section was influenced the least. The research results provide an important theoretical basis for further optimization of the impeller design for a multi-phase pump.
Minimally actuated hyper-redundant robots: Motion planning methods based on fractals and self-organizing systems
Authors: Mann Moshe P , Damti Lior , Zarrouk David
Published: March 2019

This article presents a motion planning method for a novel hyper-redundant robot with minimal actuation based on the principles of fractals and self-organizing systems. The robot consists of multiple links connected by passive joints and a movable actuator. The actuator travels over the links to a given joint and adjusts the relative angle between the two adjacent links allowing the robot to undergo the same wide range of motions of hyper-redundant robot but with only one actuator. A suitable objective of the motion planner is to minimize the number of actuator traversals, which translates into minimizing the number of bends in the c-space trajectory. To this end, we propose a novel method for motion planning using fractals and self-organizing systems. A self-similar pattern for the path is implemented to map a path from start to finish. Each iteration of path segments is of smaller dimension than the previous one and is appended to it, just as in classical fractals. This process continues until a feasible trajectory is calculated. Self-organizing systems are then applied to this trajectory post-processing to optimize it by eliminating bends in the path. Examples of the robot maneuvering around obstacles and through confined spaces are shown to demonstrate the efficacy of the motion planner.
Molecular studies of meningococcal and pneumococcal meningitis patients in Ethiopia
Authors: Mihret Wude , Sletbakk Brusletto Berit , Øvstebø Reidun , Siebke Troseid Anne-Marie , Norheim Gunnstein , Merid Yared , Kassu Afework , Abebe Workeabeba , Ayele Samuel , Silamsaw Asres Mezgebu , Yamuah Lawrence , Aseffa Abraham , Petros Beyene , Caugant Dominique A. , Brandtzaeg Petter
Published: March 2019

Neisseria meningitidis infections in sub-Saharan Africa usually present with distinct symptoms of meningitis but very rarely as fulminant septicemia when reaching hospitals. In Europe, development of persistent meningococcal shock and multiple organ failure occurs in up to 30% of patients and is associated with a bacterial load of >106/ml plasma or serum. We have prospectively studied 27 Ethiopian patients with meningococcal infection as diagnosed and quantified with real-time PCR in the cerebrospinal fluid (CSF) and serum. All presented with symptoms of meningitis and none with fulminant septicemia. The median N. meningitidis copy number (NmDNA) in serum was < 3.5 × 103/ml, never exceeded 1.8 × 105/ml, and was always 10–1000 times higher in CSF than in serum. The levels of LPS in CSF as determined by the limulus amebocyte lysate assay were positively correlated to NmDNA copy number ( r = 0.45, P = 0.030), levels of IL-1 receptor antagonist, ( r = 0.46, P = 0.017), and matrix metallopeptidase-9 (MMP-9; r = 0.009). We also compared the inflammatory profiles of 19 mediators in CSF of the 26 meningococcal patients (2 died and 2 had immediate severe sequelae) with 16 patients with Streptococcus pneumoniae meningitis (3 died and 3 with immediate severe sequelae). Of 19 inflammatory mediators tested, 9 were significantly higher in patients with pneumococcal meningitis and possibly linked to worse outcome.
Chronic urticaria in childhood
Authors: Lee Rachel , Michaelis Louise J , Mahadevan Janaki
Published: March 2019

Chronic urticaria (CU) is characterised by recurrence of hives or angioedema almost daily for at least 6 weeks. It is benign, but can be intractable, and hence, frustrating for patients and physicians alike. Diagnosis is clinical and based primarily on an allergy-focused history and physical examination. Routine referral for allergy testing is not always required. The goal of treatment is symptomatic relief with non-sedating antihistamines. Targeted screening for nutritional deficiency is of proven benefit. Triggers of CU in childhood are varied and different from CU in adults. This article aims to update GPs on CU in children, focusing on management in primary care, guidance on specialist referral and details of the subsequent targeted diagnostic pathway with non-invasive testing undertaken by paediatricians.
Sepsis: The evolution in definition, pathophysiology, and management
Authors: Gyawali Bishal , Ramakrishna Karan , Dhamoon Amit S
Published: March 2019

There has been a significant evolution in the definition and management of sepsis over the last three decades. This is driven in part due to the advances made in our understanding of its pathophysiology. There is evidence to show that the manifestations of sepsis can no longer be attributed only to the infectious agent and the immune response it engenders, but also to significant alterations in coagulation, immunosuppression, and organ dysfunction. A revolutionary change in the way we manage sepsis has been the adoption of early goal-directed therapy. This involves the early identification of at-risk patients and prompt treatment with antibiotics, hemodynamic optimization, and appropriate supportive care. This has contributed significantly to the overall improved outcomes with sepsis. Investigation into clinically relevant biomarkers of sepsis are ongoing and have yet to yield effective results. Scoring systems such as the sequential organ failure assessment and Acute Physiology and Chronic Health Evaluation help risk-stratify patients with sepsis. Advances in precision medicine techniques and the development of targeted therapy directed at limiting the excesses of the inflammatory and coagulatory cascades offer potentially viable avenues for future research. This review summarizes the progress made in the diagnosis and management of sepsis over the past two decades and examines promising avenues for future research.
Metastatic carcinoma of unknown primary with complete metabolic response following sorafenib-based chemotherapy
Authors: Usón Junior Pedro Luiz Serrano , Wagner Jairo , Corpa Marcus Vinicius de Nigro , Coelho Iracema Moraes , Nagourney Robert A , Yamaguchi Nise Hitomi
Published: March 2019

Background:

The treatment of carcinoma of unknown primary based on histopathology and immunohistochemistry is generally chemotherapy. The use of molecular markers, genetic profiling platforms, and personalized medicine is under active investigation.

Case Report:

We report the case of a 56-year-old patient who presented to medical attention with palpable axillary adenopathy. Biopsy confirmed poorly differentiated adenocarcinoma. Formal staging revealed extensive metastatic disease to bone and liver. Initial chemotherapy proved ineffective. We describe the diagnostic evaluation, treatment, and achievement of durable remission using a novel sorafenib-based drug combination that was chosen through the application of a functional analytic laboratory platform.

Conclusion:

The clinical management of patients with carcinoma of unknown primary continues to present a considerable challenge for practicing oncologists. Laboratory platforms capable of examining cellular response to injury, growth factor withdrawal, and cytotoxic insult at the level of cellular function may provide insights for drug selection in this patient population.
Guillain–Barré syndrome with unilateral peripheral facial and bulbar palsy in a child: A case report
Authors: Sharma Kamal , Tengsupakul Supatida , Sanchez Omar , Phaltas Rozaleen , Maertens Paul
Published: March 2019

Guillain–Barré syndrome is characterized by progressive motor weakness, sensory changes, dysautonomia, and areflexia. Cranial nerve palsies are frequent in Guillain–Barré syndrome. Among cranial nerve palsies in Guillain–Barré syndrome, facial nerve palsy is the most common affecting around half of the cases. Facial palsy in Guillain–Barré syndrome is usually bilateral. We describe a pediatric Guillain–Barré syndrome variant presenting with unilateral peripheral facial palsy and dysphagia. A 5-year-old boy had progressive lower extremity weakness and pain 3 days prior to onset of unilateral peripheral facial palsy. On presentation, diagnosis of Guillain–Barré syndrome was supported by areflexia and albuminocytologic dissociation. His condition deteriorated with a decline in his respiratory effort and inability to handle secretions. He was given non-invasive ventilation to prevent worsening of his acute respiratory failure. Brain and spine magnetic resonance imaging scans showed enhancement of the left bulbar nerve complex and anterior and posterior cervical nerve roots with gadolinium. Treatment with intravenous immunoglobulin led to an uneventful clinical course with partial recovery within 2 weeks. In summary, Guillain–Barré syndrome should be considered as a possible cause of unilateral peripheral facial palsy. Guillain–Barré syndrome patients with facial nerve and bulbar palsy require close monitoring as they are at risk of developing acute respiratory failure. Early intervention with intravenous immunoglobulin may benefit these patients. Magnetic resonance imaging findings may lend support to early intervention.
Fractographic analysis of lithium silicate crown failures during sintering
Authors: Lohbauer Ulrich , Wendler Michael , Rapp Doreen , Belli Renan
Published: March 2019

The two-step production process of glass-ceramic dental restorations involves a computer-aided design/computer-aided machining step followed by a crystallization firing for the final material properties to be achieved. Certain firing parameters are believed to trigger spontaneous fracture of crowns during the cooling process. In this study, cooling fractures have been reproducibly observed and investigated using fractography combined with material (glass transition temperature) and process (cooling rate) characterization. Stress distribution was visualized using birefringence measurements. Fractographic observations revealed fracture starting at the intaglio side of the crowns specifically at contact points with the support firing pins. Further analysis showed that a fast cooling rate was applied during the glass transition region. Thermal stresses were concentrated around the firing pin supports and released the fracture. To prevent such fractures, a slow cooling protocol below the glass transition temperature is our recommendation to dental technicians. Furthermore, the use of planar firing pad or paste supports is advised over the use of point contact supports.
Health-Predictive Social-Environmental Stressors and Social Buffers Are Place Based: A Multilevel Example From San Bernardino Communities
Authors: Arthur Kristen N. , Knutsen Synnøve F. , Spencer-Hwang Rhonda , Shavlik David , Montgomery Susanne
Published: March 2019

Significant evidence demonstrates the powerful effects social determinants have on health-related perceptions, behaviors, and health outcomes. However, these factors are often studied out of context, despite the acknowledgement that social determinants of health are place based. This research aimed to demonstrate that health-related perceptions are dependent on where one lives. Via a community-based participatory study, participants were randomly selected from 3 residential regions varying distances from a freight railyard (nearest n = 300, middle n = 338, farthest n = 327), all mostly low-income, predominately Latino areas. Interview-administered surveys with adults were collected by bilingual trained community members (87% response) in English/Spanish. Adjusted-logistic regression models assessed residential region as a predictor of stressors (perceptions of community safety, community noise disturbance, health care access, food insecurity) and buffers (3 neighborhood cohesion variables), after adjusting for household income, race/ethnicity, gender, and age. Each region experienced a unique amalgam of stressors and buffers. In general, the region closest to the railyard experienced more stressors (odds ratio [OR] = 1.58; 95% CI 1.12-2.20) and less buffers (OR = 0.69; 95% CI 0.49-0.96) than the region furthest from the railyard. More than half of participants in each region reported 2 or more stressors and 2 or more buffers. In this seemingly homogenous study population, place remained important in spite of traditionally used socioeconomic factors, such as household income and race/ethnicity. Social determinants of health should be studied with regard to their environmental context, which will require interdisciplinary collaboration to improve multilevel research methods. Including the study of social buffers will also promote sustainable, positive change to reduce health disparities.
From Bright Bodies to iChoose: Using a CBPR Approach to Develop Childhood Obesity Intervention Materials for Rural Virginia
Authors: Brito Fabiana A. , Zoellner Jamie M. , Hill Jennie , You Wen , Alexander Ramine , Hou Xiaolu , Estabrooks Paul A.
Published: March 2019

This community-based participatory research (CBPR) project used a collaborative process to develop a culturally relevant workbook for parents of overweight children. We followed a mixed methods iterative process to assess clear communication using a CBPR approach. Materials were evaluated using readability tests, the Clear Communication Index (CCI), and the Suitability Assessment of Materials (SAM). In addition, we used surveys and focus groups to investigate parents’ perceptions and gather feedback from delivery staff using the workbook. While workbook materials maintained adequate grade reading levels, our iterative process and the use of CCI and SAM led to significant improvements in (a) clearly communicating the objectives of the program, (b) being culturally relevant, and (c) reaching a high satisfaction among users. These findings suggest that evaluative measures for written materials should move beyond readability and need to account for level of clarity and cultural appropriateness of messages. Furthermore, we found that that an iterative process to intervention’s material development using clear communication strategies while involving community members, parents, and research partners can lead to workbook materials that are culturally relevant to the target audience, and better communicate program objectives. Finally, this is a potentially generalizable process for improving clear communication of written health information materials.
Recent Preoperative Lumbar Epidural Steroid Injection Is an Independent Risk Factor for Incidental Durotomy During Lumbar Discectomy
Authors: Labaran Lawal A. , Puvanesarajah Varun , Rao Sandesh S. , Chen Dennis , Shen Francis H. , Jain Amit , Hassanzadeh Hamid
Published: March 2019

Study Design:

Retrospective review.

Objective:

To investigate the association between lumbar epidural steroid injection (LESI) and incidental durotomy (ID) in patients with a diagnosis of disc herniation undergoing a primary discectomy.

Methods:

A Medicare patient database was queried for patients between the ages of 65 and 85 years who underwent a primary lumbar discectomy for a diagnosis of lumbar disc herniation or degeneration from 2008 to 2014. Our main cohort of 64 849 patients was then divided into 2 groups: patients who experienced a dural tear (N = 2369) and our matched (age, gender, and history of diabetes) control cohort of patients who did not (N = 62 480). All patients who had a history of LESI were further identified and stratified into 4 subgroups by duration between LESI and discectomy (<3 months, 3-6 months, 6 months to 1 year, and overall), and a comparison of the relative incidence of ID was made among these subgroups. A multivariate logistic regression analysis was employed to determine the relationship between LESI and ID.

Results:

Overall incidence of ID was 3.7%. There was a significant difference in incidence of LESI (27.1% vs 35.0%, P < .001) between our control and ID groups. An adjusted odds ratio (OR) showed that prior LESI within 3 to 6 months (OR 1.47, 95% CI 1.20-1.81, P < .001) and within less than 3 months (OR 1.46, 95% CI 1.24-1.72, P < .001) of surgery were significantly associated with ID.

Conclusion:

LESI increases the risk of ID in patients who undergo a subsequent lumbar discectomy within 6 months of injection.
Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies
Authors: Yammine Kaissar , Assi Chahine
Published: March 2019

Purpose:

Ankle Charcot neuroarthropathy presents a great challenge for treatment. While conservative treatments yield poor results, arthrodesis is considered the treatment of choice for unstable Charcot ankles. There are two methods used for ankle fusion: retrograde intramedullary nail (IMN) and external fixator (EF). Literature reports inconclusive results on which method is better for arthrodesis.

Methods:

The aim of this meta-analysis is to look for significant difference between the two techniques in terms of fusion rate and complications. Four comparative studies including 117 patients (117 interventions) were located and analyzed.

Results:

IMN was found to yield double fusion rate than EF ( p = 0.2) with 5 weeks less time to heal ( p = 0.4). While no significance was noted for revision surgery and amputation rates, EF yielded higher rates of hardware infection ( p = 0.01) and wound infection ( p = 0.01). The IMN method seems to offer quicker and better fusion rate when compared to EF with significantly lower postoperative infection rates.

Conclusion:

In the clinical context of high-risk patients such as the diabetic population, IMN technique could be a better option in the case of ulcer-free ankles/feet or in the presence of medial/lateral ulcers. In case of presence of plantar ulcers, EF might be a better choice to avoid the plantar approach for nail insertion. Future research with bigger sample sized and randomized studies are warranted for validation.
Posterior tibial slope modification in osteoarthritis knees with different ACL conditions: Cadaveric study of fixed-bearing UKA
Authors: Adulkasem Nath , Rojanasthien Sattaya , Siripocaratana Nattapol , Limmahakhun Sakkadech
Published: March 2019

Unicompartmental knee arthroplasty (UKA) in anterior cruciate ligament deficiency (ACLD) has been debated for decades after the development of highly cross-linked polyethylene. This study aims to evaluate the effect of posterior tibial slope on restoring adequate knee stability and flexion after UKA in patients with ACLD. A total of 15 fresh cadaveric knees were divided into three groups: intact ACL, partial ACLD, and complete ACLD. Fixed-bearing UKAs including 3-D-printed tibial inserts with the slopes ranging from 3° to 12° were performed using computer-assisted navigation. Blinded evaluation of knee motion and anterior knee translation with knees flexed 20° and 90° was conducted using KT-arthrometry and stress radiography. A 1° slope increase translated the knees anteriorly by 0.85 mm and 0.76 mm in 20° and 90° of knee flexion for a complete ACLD ( R = 0.7 and 0.8, respectively, p < 0.001) compared to 0.5–0.6 mm for the normal and partial ACLD groups, respectively. Setting a slope of 5–8° of UKA for an intact ACL maintained both the stability and the motion of native knees. No significant changes of knee translation and flexion ability were observed after leveling the slopes at 5–7° and 5–6° for partial and complete ACLD, respectively ( p > 0.05 for all comparisons). In conclusion, UKA in complete ACLD knees is challenging since 1° of slope change nearly doubles the degree of knee translation compared to ACL-intact knees. The optimum posterior tibial slopes for fixed-bearing UKA patients with partial and complete ACLD are 5–7° and 5–6°, respectively.
Traumatized index finger pollicization for thumb reconstruction—A case report
Authors: Yi’an Lu , Haijun Xiao , Feng Xue
Published: March 2019

When the index finger is injured or severed with a traumatic thumb amputation, transfer of the injured index finger can restore the function of the thumb. The purpose of this study was to evaluate the result of the transfer of an injured index finger for the traumatic loss of the thumb. A patient had a traumatic amputation at the first metacarpal level with the bone defect of the second metacarpal and proximal part of index finger. She was treated with a pedicled transfer of the injured index finger to the ipsilateral thumb. Postoperative evaluations included thumb range of motion, opposition and pinch function, grasp and pinch strength, sensation, and a patient-rated appearance of the thumb and hand. In result, the blood supply of the transferred traumatic index fingers was normal, and the transferred index fingers survived without complications. The range of motion of the first metacarpophalangeal joint and interphalangeal joint was almost the same as that of a normal thumb. The opposition and pinch function of the thumb was also normal. The patient is able to complete activities of daily living with the new thumb. Nevertheless, the sensation has not yet been completely restored. In conclusion, it is feasible to treat traumatic thumb amputation with the transfer of injured index finger.
Torture and Desecration in the American South, an Exclamation Point on White Supremacy, 1877–1950
Authors: Beck E. M. , Tolnay Stewart E.
Published: March 2019

Prior research has revealed a great deal about the frequency of southern lynchings and how and why they varied in intensity across space and over time. In this study, we consider two characteristics of lynching incidents about which there has been much speculation, but little actual evidence: (1) whether the victim was tortured before death and (2) whether the victim’s corpse was desecrated. We use data on 3,767 completed lynchings in 11 southern states between 1877 and 1950 to describe the frequency with which antemortem torture and postmortem desecration occurred and to determine what factors were most important in shaping the likelihood of both. We conclude that 7.7 percent of victims were physically tortured prior to death and that 8.2 percent had their bodies desecrated. Both torture and desecration were more likely to occur after 1910 and when lynchings were carried out by larger mobs. Victims accused of gender-related crimes were more likely than others to be tortured or desecrated.
Religion and Politics in the East African Revival
Authors: Bruner Jason
Published: March 2019

This article briefly describes what was at stake for European missionaries, British colonial officials, and African converts in maintaining a distinction between religion and politics with respect to the East African Revival in Uganda. Focusing upon the years 1935–70, it problematizes clear distinctions between religion and politics by using Derek Peterson’s work on the revival as an expression of dissenting politics. The article argues that “religion” and “politics” were both emic categories with contextualized referents, as well as analytic categories with comparative implications.
And God Said, “Let There Be Ritual. . . .”
Authors: Watkins Nathan
Published: March 2019

All human cultures are inclined toward ritualization. This article argues that Genesis 1–3 reveals God as the first cause of that inclination, establishing ritual behavior as a path for humans to safely and productively navigate the darkness and chaos of their fallen time and space. Missiologically, this implies that pre-Christian ritual should not be viewed as a danger to the contextualization process but valued as a window of insight into how that particular people group has been “groping their way toward God,” and as an apparatus designed to help them “reach out and find him” (Acts 17:26–27).
Inspiring Others with a Vision, Mission, and Values
Authors: Cueva Samuel
Published: March 2019

In this article I explain the meaning and the importance of a vision, as well as how mission and values help to achieve a vision. Knowing the vision, mission, and values for our lives helps us understand what we must achieve in life. I therefore propose that discovering and strengthening the purpose of our Christian life should include an understanding that working with others involves a dimensional mission theology of reciprocal collaboration. If we want to leave a spiritual inheritance, we need to inspire others. Sharing with clarity one’s vision, mission, and values is significant within God’s kingdom mission.