bluuebunny/crossref_metadata_2025 huggingface dataset:
As mulheres no esporte brasileiro: entre os campos de enfrentamento e a jornada heroica
Authors: Rubio Katia , Veloso Rafael Campos
Published: September 2019

A história das mulheres no esporte aponta para um protagonismo secundarizado em virtude do projeto político de um esporte dominado pelos homens. Narrar os feitos das mulheres no campo esportivo permite a visibilidade de uma jornada subdivulgada. Analisar a trajetória vivida por atletas permite compreender o protagonismo como um ato político, presente na dimensão social, definida ao se caracterizar como algo novo, que inaugura outro tempo. A entrada das mulheres no esporte, assim como em outras esferas da sociedade, é um ato transgressor, que emerge das sutilezas das relações humanas.
Leitura crítica de um manifesto feminista populista
Authors: Martínez Teresa Orozco , Galindo Martha Zapata
Published: September 2019

No presente artigo, propomos uma leitura crítica do Feminismo para os 99% - um manifesto que, retomando o slogan do movimento Occupy, faz um chamado para construir uma aliança global entre os diversos feminismos das greves de 8 de março e das marchas contra Trump nos Estados Unidos. Interessa-nos discutir os caminhos que as autoras desse texto, Cinzia Arruzza, Tithi Bhattacharya e Nancy Fraser, propõem para criar um bloco hegemônico que possa enfrentar e transformar as políticas do capitalismo neoliberal. Ao mesmo tempo, queremos chamar atenção sobre os riscos implicados numa proposta política que articula um feminismo populista operando com antagonismos abstratos que reproduzem esquecimentos históricos e hierarquias epistêmicas entre o norte e o sul global e polarizam com os feminismos atuais.
Multigene phylogenetic characterisation of Colletotrichum artocarpicola sp. nov. from Artocarpus heterophyllus in northern Thailand

Authors: BHUNJUN CHITRABHANU S. , JAYAWARDENA RUVISHIKA S. , WEI DE-PING , HUANRALUEK NARUEMON , ABEYWICKRAMA PRANAMI D. , JEEWON RAJESH , MONKAI JUTAMART , HYDE KEVIN
Published: September 2019

A new species, Colletotrichum artocarpicola, on Artocarpus heterophyllus from Chiang Rai, Thailand, is introduced using both morphological and molecular approaches. Combined phylogenetic analysis of ITS, GAPDH, CHS-1, ACT and TUB2 sequence data demonstrate that Colletotrichum artocarpicola is a distinct species within the gloeosporioides species complex. The new species is illustrated and compared with related taxa, and evidence of its pathogenicity is provided.
Strong Dependence of Wintertime Arctic Moisture and Cloud Distributions on Atmospheric Large-Scale Circulation
Authors: Nygård Tiina , Graversen Rune G. , Uotila Petteri , Naakka Tuomas , Vihma Timo
Published: September 2019

This study gives a comprehensive picture of how atmospheric large-scale circulation is related to moisture transport and to distributions of moisture, clouds, and surface downward longwave radiation in the Arctic in winter. Anomaly distributions of the abovementioned variables are compared in 30 characteristic wintertime atmospheric circulation regimes, which are allocated from 15 years (2003–17) of mean sea level pressure data of ERA-Interim reanalysis applying the self-organizing map method. The characteristic circulation regimes are further related to known climate indices—the North Atlantic Oscillation (NAO), the Arctic Oscillation (AO), and Greenland blocking index—as well as to a frequent high pressure pattern across the Arctic Ocean from Siberia to North America, herein called the Arctic bridge. Effects of large-scale circulation on moisture, cloud, and longwave radiation are to a large extent occurring through the impact of horizontal moisture transport. Evaporation is typically not efficient enough to shape those distributions, and much of the moisture evaporated in the Arctic is transported southward. The positive phase of the NAO and AO increases moisture and clouds in northern Europe and the eastern North Atlantic Ocean, and a strong Greenland blocking typically increases those in the southwest of Greenland. When the Arctic bridge is lacking, the amount of moisture, clouds, and downward longwave radiation is anomalously high near the North Pole. Our results reveal a strong dependence of moisture, clouds, and longwave radiation on atmospheric pressure fields, which also appears to be important from a climate change perspective.
Embracing Solutions-Driven Innovation to Address Institutional Voids: The Case of Uber and the Middle of the Pyramid
Authors: Barbour Olivia , Luiz John
Published: September 2019

This article explores solutions-driven innovation within an emerging market context, specifically in Africa, and how it can be utilized as a strategy by multinational enterprises to address institutional voids in these markets. Through a qualitative case study of Uber and their expansion into Africa, it demonstrates how solutions-driven innovation can create markets and mitigate distance and institutional voids in emerging market contexts. Uber created markets in Africa by developing a solution to consumers’ unmet needs. Such solutions-driven innovation can create opportunities not only at the bottom but also in the middle of the economic pyramid. But to be successful in African markets requires being mindful of how institutional voids necessitate innovative solutions and potentially different value propositions.
Bernard the Preacher: In Search of Intimacy
Authors: McGuire Brian Patrick
Published: September 2019

Bernard of Clairvaux showed an ability to speak directly and intimately to his monks. The article uses some of his sermons to show this practice as an indication of his inner life.
Energy absorption capacity of composite thin-wall circular tubes under axial crushing with different trigger initiations
Authors: Chambe JE , Bouvet C , Dorival O , Ferrero JF
Published: September 2019

The purpose of this study is to evaluate and compare the ability of various composite structures to dissipate the energy generated during a crash. To this end, circular composite tubes were tested in compression in order to identify their behavior and determine their absorbing capabilities using the specific energy absorption (energy absorbed per unit weight). Several composite tubular structures with different materials and architectures were tested, including hybrid composition of carbon–aramid and hybrid configuration of 0/90 UD with woven or braided fabric. Several inventive and experimental trigger systems have been tested to try and enhance the absorption capabilities of the tested structures. Specific energy absorption values up to 140 kJ.kg−1 were obtained, achieving better than most instances from the literature, reaching around 80 kJ.kg−1. Specimens with 0°-oriented fibers coincidental with the direction of compression reached the highest specific energy absorption values while those with no fiber oriented in this direction performed poorly. Moreover, it has consequently been established that in quasi-static loading, a unidirectional laminate oriented at 0° and stabilized by woven plies strongly meets the expectations in terms of energy dissipation. Incidentally, an inner constrained containment is more effective in most cases, reducing the initial peak load without drastically reducing the specific energy absorption value.
Convivial encounters: Conditions for the urban social inclusion of people with intellectual and psychiatric disabilities
Authors: Bredewold Femmianne , Haarsma Alke , Tonkens Evelien , Jager Marja
Published: September 2019

Recent work has pointed to the importance for their social inclusion of convivial encounters between people with and without disabilities, but little is known about the spatial and social conditions of the places that encourage these encounters. This paper is concerned with public places that are conducive for convivial encounters between people with and without disabilities. Drawing on extensive participative observations of four community projects and 78 interviews with people visiting or working at these projects we investigated which elements in these places encourage ‘strangers’ to move from merely co-presence to conviviality. Three conditions seem to be conducive, namely: (1) a shared purpose, (2) built-in boundaries, (3) freedom to (dis)engage. These conditions were beneficial for convivial encounters, but do not lead to friendship or long-term support. People engage in such contact because they can be sure that these contacts do not raise expectations of long-term support or friendship.
Next-Generation Sequencing in the Diagnosis of Rare Pediatric Sinonasal Tumors
Authors: Ahmed Atif A. , Vundamati Divya , Farooqi Midhat , Repnikova Elena , Zinkus Timothy , Hetherington Maxine , Paulson Lorien
Published: September 2019

The diagnosis of desmoid fibromatosis or other spindle cell tumors in the sinonasal region is very rare in children and needs to be thoroughly confirmed with immunohistochemical and/or molecular tests. We report 2 patients with such rare tumors and describe the use of next-generation sequencing in their evaluation. A 3-year-old female had a 4.4-cm midline nasal cavity mass involving the bony septum and extending into the base of the skull bilaterally. The moderate cellular fibroblastic proliferation revealed areas of thick keloid-like collagen bands and other areas with myxoid edematous stroma. Deep targeted sequencing identified a novel G34V mutation in the CTNNB1 gene consistent with desmoid fibromatosis. An 11-month-old male infant presented with a right nasal mass that extended through the cribriform plate into the anterior cranial fossa and involved the right ethmoid sinus and adjacent right orbit. Histology revealed an infiltrative atypical fibrous proliferation with focal calcifications that was negative for CTNNB1 and GNAS mutations. A novel RET E511K variant was identified in the tumor and later was also found in the germline and hence rendered of unknown significance. Both cases highlight the utility of next-generation sequencing in the evaluation of pediatric sinonasal spindle cell tumors that may have overlapping pathologic features. Reporting of rare or novel variants in tumor-only sequencing should be cautiously evaluated in children and pairing with germline sequencing may be needed to avoid the pitfall of assigning uncommon variants.
Are Vitamin D Levels Associated With Risk of Deep Neck Infection?
Authors: Gozeler Mustafa Sıtkı , Sakat Muhammed Sedat , Kilic Korhan , Sahin Abdulkadir , Tatar Arzu , Aktan Bülent , Kızıltınç Ahmet
Published: September 2019

Deep neck infection (DNI) refers to infections in spaces created by superficial and deep cervical fascia around the muscles and organs in the neck. Vitamin D is highly important for an effective immune system. Vitamin D receptors (VDR) have been identified in immune system cells, and particularly in T and B lymphocytes, macrophages, and dendritic cells. Vitamin D deficiency is thought to result in impaired immune response, decreased leukocyte chemotaxis, and an increased disposition to infection. The purpose of this study was to investigate whether vitamin D deficiency is an underlying occult factor in the development of DNI. Sixty-five patients aged 6 to 90, diagnosed with DNI, and 70 healthy age- and sex-compatible cases were included in the study. Serum levels of calcium, phosphorus, parathyroid hormone, and 25-hydroxy vitamin D (25(OH)D) were determined in each case. 25-hydroxy vitamin D levels above 20 ng/mL were regarded as normal, 12 to 20 ng/mL as insufficient, 5 to 12 ng/mL as deficient, and less than 5 ng/mL as severely deficient. Mean serum 25(OH)D levels were 10.4 (6.2) ng/mL in the patient group and 15.5 (6.4) ng/mL in the control group ( P < .01). This difference was statistically significant ( P < .01). Vitamin D was within normal limits in 9.2% (n = 6) of cases in the study group, insufficient in 29.2% (n = 19), deficient in 35.3% (n = 23), and severely deficient in 26.2% (n = 17). The equivalent values in the control group were 21.4% (n = 15), 48.5% (n = 34), 30% (n = 21), and 0% (n = 0). Serum 25(OH)D levels were significantly lower in patients with DNI compared to the healthy cases; 25(OH)D levels may be a factor in the development of DNI.
Sedentary behavior time as a predictor of hemoglobin A1c among adults, 40 to 59 years of age, living in the United States: National Health and Nutrition Examination Survey 2003 to 2004 and 2013 to 2014
Authors: Nicolo Michele L , Shewokis Patricia A , Boullata Joseph , Sukumar Deeptha , Smith Sinclair , Compher Charlene , Volpe Stella L
Published: September 2019

Background:

Sedentary behavior activities have been associated with an increased risk of type 2 diabetes. Aim: Our aim was to determine whether sedentary behavior time (SBT) is predictive of hemoglobin A1c (HbA1c) ≥ 6.5% (48 mmol/mol).

Methods:

We used cross-sectional data, adults 40 to 59 years of age, from the National Health and Nutrition Examination Survey (NHANES) for 2003 to 2004 and 2013 to 2014. Responses to questions on the Physical Activity Questionnaire regarding time watching television/videos, and time spent sitting in front of a computer per day were compiled into tertiles. Binary logistic regression analysis was used to determine whether SBT was a predictor of a HbA1c ≥ 6.5% adjusting for age, sex, race and ethnicity, and body mass index.

Results:

In a univariate model, adults reporting ≥ 8 hours of SBT in NHANES 2003–2004 had 2.02 increased odds of a HbA1c ≥ 6.5% (OR = 2.02, 95% CI: 1.31, 3.13, p < 0.0001) compared to adults reporting ≤ 3 hours. After adjusting the regression model for age, sex, race and ethnicity, and body mass index, adults reporting ≥ 8 hours of SBT in NHANES 2003 to 2004 had 1.72 increased odds of HbA1c ≥ 6.5% (OR = 2.02, 95% CI: 1.10, 2.68, p < 0.0001) compared to adults reporting ≤ 3 hours of SBT. Reported SBT was not a predictor of HbA1c ≥ 6.5% for NHANES 2013 to 2014.

Conclusion:

Reported SBT was a predictor of HbA1c ≥ 6.5% among adults, 40 to 59 years of age, in NHANES 2003 to 2004, but was not a predictor in 2013 to 2014.
Internal context, language acquisition and multilingualism
Authors: Sharwood Smith Michael
Published: September 2019

Research on multilingualism and the acquisition of language(s) faces numerous challenges given its inherently interdisciplinary character. This discussion will focus on the notion of internal context, a concept that forcefully demonstrates the need for integrating linguistically-oriented research with cognitive research in general. Investigating the internal context of language processing centres on the ‘interpreted’ world inside individual minds together with all the cognitive mechanisms that shape it. It will be argued that explanations are required that must go well beyond accounts of the linguistic properties of individuals’ grammatical abilities and that, for this purpose, theoretical broad-based frameworks are needed that can act as ‘base camps’ facilitating explorations that venture beyond purely local domains and allowing findings from different research areas to be integrated within a shared perspective of how the mind works.
Pseudo-monoclonal gammopathy due to autoimmune disease: a case report
Authors: Liu Hui , Wang Guojin , Song Jia , Guan Jing , Shao Zonghong , Fu Rong
Published: September 2019

Hyperglobulinemia is a common manifestation of plasma cell disease, and it is sometimes caused by autoimmune diseases (AIDs). We report an uncommon presentation of hyperglobulinemia, with a high amount of plasma cells in bone marrow, pancytopenia, hematemesis, and splenomegaly in an 18-year-old woman. Some examinations were performed to determine the diagnosis, including serum protein electrophoresis, immunofixation electrophoresis, the free light chain assay, abdominal enhanced computed tomography (CT) and CT venography, and positron-emission tomography-CT. The patient was finally diagnosed with AID. Considerable improvement in her symptoms was observed after immunosuppressive therapy. Findings in this case highlight that not only differentiation of hyperglobulinemia caused by monoclonal or polyclonal immunoglobulin, but also AIDs, need to be considered to exclude non-Hodgkin’s lymphoma and plasma cell disease.
Investigation of tensile strength and dimensional variation of T700 carbon fibres using an improved experimental setup
Authors: Islam Faisal , Joannès Sébastien , Bucknell Steve , Leray Yann , Bunsell Anthony , Laiarinandrasana Lucien
Published: September 2019

Knowledge of fibre strength is crucial for understanding the failure behaviour of fibre-reinforced composite materials and structures. Measuring the properties of technical fibres has been known to be very challenging, and the different challenges associated with single fibre characterisation are illustrated in this article. An improved and automated experimental methodology for tensile testing of single fibres is described. This process has been used to generate fibre strength data for T700 carbon fibres at three different gauge lengths of 4, 20 and 30 mm. The variability in strength and modulus of short fibres was found to be much larger than that of longer fibres. Statistical analysis of this large data set has also highlighted the limitations of the standard Weibull distribution for representing fibre strength behaviour. The need for a better statistical representation of the fibre strength data in order to provide a more accurate description of the fibre strength behaviour has been emphasized.
Types and Timing of Scaffolding to Promote Meaningful Peer Interaction and Increase Learning Performance in Computer-Supported Collaborative Learning Environments
Authors: Shin Yoonhee , Kim Dongsik , Song Donggil
Published: September 2019

This study was designed to examine the effects of negotiation scaffolding for solving complex problems, focusing on peer interaction and learning performance in a computer-supported collaborative learning environment. For this research, 38 undergraduate students performed complex tasks using a collaborative discussion tool that implemented scaffolding strategies including the fading of meaning-negotiation scaffolding (MS) and the provision of position-negotiation scaffolding (PS). The participants were assigned to one of the following conditions: (a) MS is not faded and PS is not provided (Group N), (b) MS is faded and PS is not provided (Group F), (c) MS is not faded and PS is provided (Group P), and (d) MS is faded and PS is provided (Group FP). All groups worked in pairs to complete a comprehension task and a lesson-planning task. The results revealed that Group FP outperformed the others, showing the highest learning performance and a significant increase in meaningful peer interactions, such as divergent and reflective types of discussion.
A Single Institution’s Experience of Primary Headache in Children With Celiac Disease
Authors: Hom Grant L. , Hom Brian L. , Kaplan Barbara , Rothner A. David
Published: September 2019

Background:

Few studies exist examining the frequency of primary headache in children with celiac disease and the impact of a gluten-free diet on primary headache symptomology. This study explores characteristics and frequency of headaches in children with celiac disease and response to gluten-free diet at a single institution.

Methods:

Medical records were reviewed for children with celiac disease confirmed by the presence of elevated tissue transglutaminase IgA levels and histologic changes consistent with the diagnosis of celiac disease on small bowel biopsy. Eligible participants were contacted via letter for participation in a phone survey regarding headaches. Phone interviews were conducted 2 weeks after notification and lasted approximately 10 minutes. Headaches were classified according to ICHD-3 criteria.

Results:

247 eligible patients or their families were contacted. A total of 132 (53.44%) agreed to participate. One participant was excluded due to insufficient information provided. Overall, 51 of 131 participants had recurrent headache defined as at least 1 episode per month (39%, 95% confidence interval [CI]: 31%-47%) and 33 had migraine with or without aura (25%, 95% CI: 18%-33%). Twenty-eight had frequent tension-type headache (22%, 95% CI: 15%-29%). Thirty-two participants noted headaches before a confirmed diagnosis of celiac disease. Twenty-two of 32 participants (68.75%) noticed decreased headache frequency or intensity, or both, after starting the gluten-free diet.

Conclusion:

This study suggests that at least one-third of children and adolescents with celiac disease have recurrent headaches at the time of diagnosis. A gluten-free diet led to improved headache symptomology in a significant number of these patients.
Effect of bentonite clay and polypropylene matrix on the properties of silk and glass fiber-reinforced hybrid composites
Authors: Mazumder Md RH , Numera F , Al-Asif A , Hasan M
Published: September 2019

Present research investigates the effect of bentonite clay and polypropylene (PP) matrix on the properties of silk and glass fiber hybrid composites. Three types of composite were prepared with 10 wt% silk and fiber at 1:1 ratio using hot press machine. In two composites commercial and recycled PP were used as matrix, while in third composite bentonite clay was added to silk and glass-reinforced commercial PP. Mechanical (tensile, flexural, impact, and hardness) tests, water absorption test, and thermogravimetric analysis were subsequently conducted. Tensile strength, flexural modulus, and hardness decreased, whereas Young’s modulus, impact strength, water absorption, and thermal stability increased with the addition of bentonite clay. On the other hand, change of matrix from commercial PP to recycled PP increased Young’s modulus, flexural strength, impact strength, and thermal stability and decreased tensile strength, flexural modulus, and hardness.
A Pilot Study Embedding Clinical Pharmacists Within an Interprofessional Nephrology Clinic for the Initiation and Monitoring of Empagliflozin in Diabetic Kidney Disease
Authors: Triantafylidis Laura K. , Hawley Chelsea E. , Fagbote Christopher , Li Jiahua , Genovese Nicole , Paik Julie M.
Published: September 2019

Background:

The American Diabetes Association (ADA) recommends sodium-glucose cotransporter-2 (SGLT2) inhibitors as the second medication to be started, after metformin, for patients with chronic kidney disease (CKD). Sodium-glucose cotransporter-2 inhibitors may cause volume, blood pressure, and electrolyte disturbances; consequently, frequent monitoring and adjustments to other diabetes, blood pressure, and/or diuretic medications may be necessary.

Objective:

To evaluate the safety and efficacy of an interprofessional clinic model partnering nephrologists and pharmacists for the initiation and monitoring of SGLT2 inhibitors.

Methods:

A clinical pharmacist was embedded within the nephrology clinic to provide patient education, telephone follow-up, and to work collaboratively with the nephrologists. Diabetes, hypertension, and diuretic regimens were adjusted as needed after empagliflozin initiation. Diabetes regimens were adjusted to adhere to the 2019 ADA guidelines that promote agents with CKD and atherosclerotic cardiovascular disease benefit.

Results:

Fourteen patients were initiated on empagliflozin during the study period. Urine albumin-to-creatinine ratio (UACR) improved (mean % change −12% ± 61%); the mean percentage change was greater in patients with a higher baseline UACR. The mean change in hemoglobin A1c was 0.3% ± 0.6%. Common adverse reactions were observed and improved over time; no serious adverse drug reactions occurred. Finally, empagliflozin initiation necessitated adjustments to diabetes, hypertension, and diuretic regimens in almost all patients (n = 13, 93%).

Conclusion:

The implementation of an innovative, interprofessional care model within a nephrology clinic for the initiation and monitoring of empagliflozin in patients with DKD demonstrated clinical benefit with minimal safety concerns.
DSRIP’s innovation and collaboration in population health management: A cross-sectional segmented time series model
Authors: Shenoy Amrita Gopinath
Published: September 2019

Texas Medicaid Section 1115 waiver approved Delivery System Reform Incentive Payment (DSRIP) program has four categories, namely infrastructure development, program innovation and redesign, reporting of quality improvement outcomes, and population health improvement. A metric of the fourth category, preventable hospitalization rate, was analyzed for a set of eight diagnostic conditions to assess the impact of DSRIP on participating- and non-participating hospitals over two time periods, pre-DSRIP and post-DSRIP, with the help of a cross-sectional segmented time series regression model. Texas Healthcare Information Collection database was leveraged to obtain preventable hospitalization rate data. The dependent variables were preventable hospitalization rates of eight program-specified conditions and the independent variables were time, intervention, and post-implementation intervention. The overall combined preventable hospitalization rate for DSRIP hospitals was observed to decrease by 25.73%, whereas the overall combined preventable hospitalization rate for non-DSRIP hospitals was observed to increase by 37.57%. DSRIP hospitals had invested in coordinating healthcare projects and were subsequently reimbursed by the state for healthcare improvements. The implementation of DSRIP may have had the capacity to decrease preventable hospitalization rates in regions wherein its adoption may have improved the health of the population.
Investigation of strengthening effect on the machining rigidity in longitudinal torsional ultrasonic milling of thin-plate structures
Authors: Wu Chenjun , Chen Shijin , Cheng Kai , Xiao Caiwei
Published: September 2019

Weak-stiffness structures are difficult to be machined because of their low stiffness, large deformation and poor stability through conventional machining. Ultrasonic-assisted machining has the superiority of reducing cutting force and increasing stiffness, which can result in better cutting performance particularly in machining weak-stiffness structures. In this article, the stiffness-strengthening effect of longitudinal torsional ultrasonic milling of thin-plate structures is thoroughly investigated by theoretical analysis and experimental trials. The strengthening coefficient of equivalent stiffness is obtained by analyzing the forced vibrations of the thin-plate structure under conventional milling and ultrasonic milling loading, respectively. The ultrasonic vibration period and the actual cutting time in one ultrasonic vibration period are proved to be the factors responsible for the stiffness-strengthening effect in ultrasonic cutting. When compared with conventional milling, longitudinal torsional ultrasonic milling trials show that the equivalent stiffness of the machining system can be increased by 1.92 times, despite the rigidity strengthening coefficient decreases with the increasing spindle speed.
Successful nonsurgical treatment of penile Buschke–Löwenstein tumor with 12 weeks of 5% imiquimod alone
Authors: Sonthalia Sidharth , Gandhi Vijay , Agrawal Mahima , Sharma Poonam
Published: September 2019

Anogenital warts, also known as condylomata acuminata caused by human papillomavirus constitute the most common sexually transmitted infection. Rarely, the disease may evolve into a huge cauliflower-like growth called giant condyloma acuminatum or Buschke–Löwenstein tumor (BLT). In contrast with normal anogenital warts, BLT displays local invasion, lack of spontaneous resolution, posttreatment recurrence, and potential for malignant transformation. Although radical excision with split-thickness skin grafting is considered its first-line treatment, it is not always feasible. While many other treatments have shown variable success and recurrence rates, topical imiquimod 5%, a popular evidence-based therapy for warts has also been reported as an efficacious treatment for BLT. We present a case of penile BLT where the patient refused surgery but recovered completely with no recurrence at five years following 16 weeks’ therapy with topical 5% imiquimod. Excepting a single reported case, this might be another case where BLT resolved with imiquimod as a standalone therapy. We also present a succinct review of past cases of BLT treated with imiquimod.
How Does Infrastructure Investment Affect Macroeconomic Performance? Evidence from Portugal
Authors: Pereira Alfredo Marvão , Pereira Rui Manuel
Published: September 2019

We use the industry-specific effects of 12 different types of infrastructure investment in Portugal to highlight the mechanisms through which such investments affect economic activity. Our main findings are as follows: first, demand-side effects are over 60 per cent of total effects for airport investments, ports, refineries and water, and over 45 per cent for national roads, municipal roads, telecommunications, health and education. Second, site-location effects are also very significant, in particular for national roads, highways and railroads, with 30, 35 and 64 per cent of the total effects, respectively. Site-location effects are negative for water and electricity, and statistically insignificant for municipal roads, airports and refineries, and marginally positive for ports, that is, all these are cases in which we would expect adverse or small location effects. Third, the macroeconomic effects are driven primarily by the effects of these investments on non-traded goods and service industries. The functional channel relating to internationally traded goods is much less significant while the functional effect affecting non-traded industries is much more relevant as it accounts for more than 30 per cent of the effects in the cases of municipal roads, airports and refineries, and in excess of 20 per cent for highways, railroads, telecommunications, health and education. Naturally, these results cannot be automatically generalised, as the nature of the effects of infrastructure investments crucially depends on the level of development of the country in question, on the maturity of its existent infrastructure systems, and on the rigour of all decisions pertaining to infrastructure investment. Nevertheless, they establish that, as infrastructure investments are concerned, the dominance of virtuous supply-side effects is not a foregone conclusion and, conversely, the relevance of Keynesian effects cannot be dismissed.

JEL Classification: C32, E22, H54, L90, L98, O52
Therapeutic Window of Clopidogrel and Ticagrelor in Patients With Critical Limb-Threatening Ischemia
Authors: Dhillon Ashwat S. , Caro Jorge , Tun Han , Armstrong David G. , Rowe Vincent , Shavelle David M. , Clavijo Leonardo C.
Published: September 2019

Background:

Critical limb-threatening ischemia (CLTI) is associated with an increased risk of major adverse limb events and mortality. High on-treatment platelet reactivity (HPR) is associated with an increased risk of ischemic events, while low on-treatment platelet reactivity (LPR) is associated with an increased risk of bleeding. This study investigates the frequency with which patients with CLTI on clopidogrel or ticagrelor achieve a “therapeutic window” (TW) of platelet inhibition.

Methods:

Data from the “Switch To Ticagrelor in Critical Limb Ischemia Anti-Platelet Study” were assessed retrospectively to determine the incidence of TW of on-treatment platelet reactivity in 50 consecutive patients with CLTI (mean age: 65.2 ± 10.5 years, 54% male). The data included 4 measurements of patients’ platelet reactivity using the VerifyNow P2Y12 Assay: baseline and steady state platelet reactivity on clopidogrel 75 mg daily and on ticagrelor 90 mg twice daily.

Results:

At baseline, 46% of patients on clopidogrel were within TW of on-treatment platelet reactivity compared to 10% of patients on ticagrelor ( P < .0001). At steady state, 42% of patients on clopidogrel were within the TW compared to 10% of patients on ticagrelor ( P < .0001). Patients on ticagrelor exhibited higher rates of LPR compared to those on clopidogrel at baseline as well as at steady state (baseline 88% vs 18%, steady state 88% vs 28%; P < .0001).

Conclusion:

Although ticagrelor has been proposed as an alternative for patients with HPR on clopidogrel, the current study observes an excess of platelet inhibition with ticagrelor in most patients with CLTI at a dose of 90 mg twice daily.
Rolling element bearing diagnosis using spectral kurtosis based on optimized impulse response wavelet
Authors: Rohani Bastami Abbas , Bashari Amir
Published: September 2019

Envelope analysis is widely used in fault diagnosis of rolling element bearings (REBs). In envelope analysis, it is necessary to select a frequency band which is related to the resonance of the bearing. Spectral kurtosis (SK) is known as a powerful method to find the resonance band in vibration of a defective REB. SK, calculated by short time Fourier transform, suffers from its dependency on the window length. In this article, a special wavelet transform is used to obtain a SK diagram. It is shown that choice of mother wavelet function has great influence on the resulting SK diagram. The proposed wavelet is based on the impulse response of a damped single degree of freedom system. An optimization algorithm is used to optimize the SK diagram for fault detection. The method is tested for both simulated and experimental vibration data.
Clinical impact of the etoposide injection shortage
Authors: Li Hualy , Cimino Sarah K
Published: September 2019

Purpose

Drug shortages have become a constant challenge in patient care over the past two decades. In 2018, there was a shortage of etoposide injection in the United States. The purpose of this study was to analyze the impact of the etoposide injection shortage.

Methods

This single-center, retrospective chart review included patients prescribed an etoposide-containing chemotherapy regimen between January 2018 and August 2018. The primary objective was to determine the percentage of patients who required a change in treatment due to the etoposide injection drug shortage. For the secondary objectives, the following was compared between patients who received etoposide injection versus alternative etoposide formulations (etopophos injection or oral etoposide): adverse events, medication errors, treatment delays, disease progression, and drug costs.

Results

Twenty-two patients were included in this study. Overall, seven (32%) patients required a change in treatment due to the etoposide injection shortage. Of the seven patients, six required the use of an alternative etoposide formulation and one patient had etoposide omitted in at least one treatment cycle. There were no significant differences in adverse events, medication errors, treatment delays, or disease progression when comparing patients who received etoposide injection versus alternative etoposide formulations. The average drug cost per cycle was significantly higher in the patients who required a change in treatment.

Conclusions

To our knowledge, this is the first study to characterize the clinical impact of the etoposide injection shortage. Results from this study highlight the direct impact that drug shortages have on patient care.
Catheter-related right atrial thrombosis
Authors: Tran Minh-Ha , Wilcox Tanya , Tran Phu N
Published: September 2019

Introduction:

Catheter-related right atrial thrombosis is an under-recognized complication of central venous catheter placement. We performed a retrospective review, characterizing clinical aspects of catheter-related right atrial thrombosis (CRAT).

Methods:

To identify cases, a literature search was conducted in PubMed and additional items selected by review of related items and bibliography review. Key clinical data were extracted and analyzed both in total and as stratified by hemodialysis versus non-hemodialysis groups.

Results:

A total of 68 catheter-related right atrial thrombosis events were reported in 63 patients (five recurrences, of which 4 involved catheter left in place following primary treatment). Median (interquartile range) time to CRAT diagnosis was longer among hemodialysis patients – 12 (4.0–24.0) weeks compared to 5.5 (1.8–16.1) weeks among non-hemodialysis patients. The most common presentations were asymptomatic in 16/68 (23.5%), fever/sepsis in 21/68 (30.9%), pulmonary embolism in 11/68 (16.2%), catheter dysfunction in 8/68 (11.8%), dyspnea in 8/68 (11.8%), and new murmur or valvular dysfunction in 8/68 (11.8%) patients. Primary treatment selection was anticoagulation in 33/68 (48.5%), surgical thrombectomy in 17/68 (25.0%), thrombolysis in 12/68 (17.6%), or no active therapy in 6/68 (8.8%) patients. Primary treatment failure for anticoagulation and thrombolysis was 27.3% and 33.3%, respectively. The most common rescue therapy was surgical thrombectomy, ultimately resulting in an overall rate of 26/62 (41.9%). Overall, per-patient mortality was 13/63 (20.6%). Intracardiac tip position – 27/34 (79.4%) – overshadowed thrombophilia – 16/63 (25.4%) – as a risk factor for CRAT.

Conclusion:

Catheter-related right atrial thrombosis is an underdiagnosed complication of central venous catheter placement. For the hemodialysis population, a fistula-first approach is advocated. While many instances were asymptomatic, the development of unexplained fever, dyspnea, catheter dysfunction, or new murmur should trigger a search for this complication.
Unschooling and the Self: A dialogical analysis of unschooling blogs in Australia and New Zealand
Authors: O’Hare Adele , Coyne Joe
Published: September 2019

Unschooling is a form of home education in which free play, trust and autonomy are highly valued. Unschooling is also a countercultural movement that began in the United States in the 1970s. Applying dialogical theories about the development and exchange of ideas through dialogue, unschooling can be seen as an internally persuasive, centrifugal discourse that resists an authoritative, centripetal discourse that assumes children’s education happens at school. The researchers conducted a dialogical analysis of 19 unschooling blog posts that contained autodialogue among multiple voices within the Self, including I-as-unschooler, I-as-mother, I-as-countercultural, I-as-learner, and I-as-thought-leader. These I-positions interacted with inner-Others, such as public figures in the unschooling movement, other bloggers, children, mainstream adults, and the school system. There were clear tensions as the bloggers engaged in imagined dialogue with their critics. As an exploratory, qualitative study on an under-researched phenomenon, the study opens up questions for further research, including how values, beliefs, and identities play out in unschooling families in practice, and contributes unique insights into the ways unschooling bloggers dialogically author their social identities.
Rendering assemblage dialectical
Authors: Campbell Stephen
Published: September 2019

Within anthropology, assemblage theory has achieved broad disciplinary traction, yet the theory’s philosophical premises are rarely explored. This article therefore revisits the Deleuzian notion of difference that underpins assemblage theory as a step towards rendering the theory more consonant with a relational anthropology. In place of Gilles Deleuze and Félix Guattari’s conception of discrete elements related only externally to each other within an assemblage, I propose a dialectical conception, whereby assemblage is taken to be a heterogeneous ensemble whose constituent elements also relate to each other internally. To arrive at this understanding, I examine the dialectical logic of Theodore Adorno. I then consider the implications of a dialectical notion of assemblage for recent work on the anthropology of capitalism.
Plant-Based Diets and Hypertension
Authors: Joshi Shivam , Ettinger Leigh , Liebman Scott E.
Published: September 2019

Hypertension is a global epidemic and a risk factor for many adverse outcomes, including cardiovascular disease, kidney disease, and death. Lifestyle plays a significant role in the development and maintenance of hypertension, and guidelines from several organizations recommend lifestyle modifications as first-line intervention for hypertensive patients. Data supporting the use of plant-based diets in the treatment of hypertension goes back almost a century. More recently, clinical trial data, including randomized controlled trials, have established plant-based diets as an effective lifestyle intervention for high blood pressure (BP). Plant-based diets differ from the standard American diet in a myriad of ways, with some substances being present in either substantially higher or lower amounts. Although the precise mechanism of a plant-based diet’s beneficial effects on BP is unknown, many of these differences may be responsible. Attributes of a plant-based diet that may lower BP include a lower energy content leading to weight loss, a lower sodium content, an increased potassium content, reduced oxidative stress, higher bioavailability of the vasodilator nitric oxide, and beneficial effects on the microbiome. The evidenced-based benefits of plant-based diets in treating hypertension should lead providers to advocate for this dietary pattern for their patients.
Visual working memory load does not affect the overall stimulus processing time in visual search
Authors: Xin Keyun , Li Zhi
Published: September 2019

The dual-task paradigm is widely used in studying the interaction between visual search and working memory. A number of studies showed that holding items in working memory delays the overall response time (RT) in visual search, but it does not affect the efficiency of search (i.e., the slope of the RT × set size function). Why the memory load merely affects the overall RT? Some researchers proposed that this load-effect on overall RT may be caused by factors that only affect response selection processes, while others argued that it may reflect the effect of visual working memory load on visual search. This study investigated the two competing hypotheses by measuring the threshold stimulus exposure duration (TSED) for successfully fulfilling a search task. Experiment 1 replicated the large overall RT difference with the RT method but only found a small though reliable overall TSED difference with the TSED method. Experiment 2, with better controls, found no TSED difference by manipulating the visual working memory load. Experiment 3 showed that the TSED is not influenced by processes in the response selection stage. The present findings suggest that the overall stimulus processing time in visual search is not affected by visual working memory load and that the effect of memory load on overall RT is largely due to factors affecting response selection alone.
In Scrooge’s boots: Lessons learned on disinformation from the 2019 European elections
Authors: Syrovátka Jonáš
Published: September 2019

There has been much heated discussion on the possible influence of disinformation campaigns on the 2019 European elections—including those campaigns launched by outside actors (namely the Russian Federation). This is not surprising considering previous election experiences not only in Western states, but globally. As far as we know, the 2019 European elections were fortunately not targeted by a large and coordinated disinformation campaign. Given the significant attention paid to the 2019 European elections by the public, researchers and policymakers, they present an interesting case study that might help us to learn not only how to tackle the issue of disinformation, but also how to understand and analyse it in the future.
A survey on driving behavior analysis in usage based insurance using big data
Authors: Arumugam Subramanian , Bhargavi R.
Published: September 2019

The emergence and growth of connected technologies and the adaptation of big data are changing the face of all industries. In the insurance industry, Usage-Based Insurance (UBI) is the most popular use case of big data adaptation. Initially UBI is started as a simple unitary Pay-As-You-Drive (PAYD) model in which the classification of good and bad drivers is an unresolved task. PAYD is progressed towards Pay-How-You-Drive (PHYD) model in which the premium is charged for the personal auto insurance depending on the post-trip analysis. Providing proactive alerts to guide the driver during the trip is the drawback of the PHYD model. PHYD model is further progressed towards Manage-How-You-Drive (MHYD) model in which the proactive engagement in the form of alerts is provided to the drivers while they drive. The evolution of PAYD, PHYD and MHYD models serve as the building blocks of UBI and facilitates the insurance industry to bridge the gap between insurer and the customer with the introduction of MHYD model. Increasing number of insurers are starting to launch PHYD or MHYD models all over the world and widespread customer adaptation is seen to improve the driver safety by monitoring the driving behavior. Consequently, the data flow between an insurer and their customers is increasing exponentially, which makes the need for big data adaptation, a foundational brick in the technology landscape of insurers. The focus of this paper is to perform a detailed survey about the categories of MHYD. The survey results in the need to address the aggressive driving behavior and road rage incidents of the drivers during short-term and long-term driving. The exhaustive survey is also used to propose a solution that finds the risk posed by aggressive driving and road rage incidents by considering the behavioral and emotional factors of a driver. The outcome of this research would help the insurance industries to assess the driving risk more accurately and to propose a solution to calculate the personalized premium based on the driving behavior with most importance towards prevention of risk.
Adequacy of Preoperative Resuscitation in Laparoscopic Pyloromyotomy and Anesthetic Emergence
Authors: Gilbertson Laura E. , Fiedorek Christopher S. , Fiedorek Michael C. , Lam Humphrey , Austin Thomas M.
Published: September 2019

BACKGROUND:

Pyloromyotomy is one of the most common surgical procedures performed on otherwise healthy infants. Pyloric stenosis results in a hypochloremic, hypokalemic metabolic alkalosis that is considered a medical emergency. This alkalotic state is believed to be associated with an increased incidence of apneic episodes. Because apnea tends to occur during anesthetic emergence, we sought to examine the association between the preoperative serum bicarbonate level and anesthetic emergence time after laparoscopic pyloromyotomy.

METHODS:

Data were collected from patients who underwent laparoscopic pyloromyotomies from April 2014 to October 2018. To estimate the correlation between preoperative bicarbonate level and emergence time while accounting for the positive skew of emergence time and potential confounding variables, a weighted quantile mixed regression was used. Due to a nonlinear association with emergence time, preoperative serum bicarbonate was split into 2 continuous intervals (<24 and ≥24 mEq/L) and the slope versus outcome was fit for each interval.

RESULTS:

A total of 529 patients who underwent laparoscopic pyloromyotomy were analyzed in this study. After controlling for confounders, the preoperative serum bicarbonate interval of ≥24 mEq/L was linearly associated with median emergence time (median increase of 0.81 minutes per 1 mEq/L increase of bicarbonate; 95% confidence interval [CI], 0.42–1.20; P < .001). Only 3 patients (0.6%) had apneic episodes after pyloromyotomy despite all having preoperative serum bicarbonate levels <29 mEq/L.

CONCLUSIONS:

Preoperative serum bicarbonate was positively associated with median anesthetic emergence time in a linear manner for values ≥24 mEq/L, although this correlation may not appear to be clinically substantial per 1 mEq/L unit. However, when preoperative serum bicarbonate levels were dichotomized at a commonly used presurgical threshold, the difference in median emergence time between ≥30 and <30 mEq/L was an estimated 5.4 minutes (95% CI, 3.1–7.8 minutes; P < .001).