bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical nurses’ knowledge and practices about informed consent
Authors: Akyüz Elif , Bulut Hülya , Karadağ Mevlüde
Published: December 2018

Background:

Informed consent involves patients being informed, in detail, of information relating to diagnosis, treatment, care and prognosis that relates to him or her. It also involves the patient explicitly demonstrating an understanding of the information and a decision to accept or decline the intervention. Nurses in particular experience problems regarding informed consent.

Research question and design:

This descriptive study was designed to determine nurse knowledge and practices regarding their roles and responsibilities for informed consent in Turkey. The research was performed using 92 nurses who work at the surgical clinics. Data collection form was prepared by the researchers with assistance from the literature, and the data were evaluated by the SPSS 12.0 data analysis program.

Ethical consideration:

This study was approved by the Medicine and Health Sciences Research and Ethics Committee of the university. Written consent was received from the nurses.

Findings:

Among the nurses who participated in this study, 39.1% indicated that they were responsible for obtaining informed consent. It was also found that 90.2% of the nurses informed patients before providing nursing interventions and 32.6% of the nurses obtained consent from patients, and 90.0% of the nurses who indicated that they obtain patient consent only obtain verbal consent. Among all of the nurses, 21.7% agreed that informed consent needs to be obtained in order to protect the medical staff legally.

Discussion:

It is argued that a lack of official procedures at hospitals regarding informed consent and insufficient information being provided to healthcare providers has caused problems regarding informed consent.

Conclusion:

The nurses in this study lacked information regarding their role in obtaining informed consent from patients and they often performed incomplete and/or incorrect practices within the framework of their required role. It is believed that an increased level of education along with the creation of official policies and procedures would contribute towards solving these problems.
Reversal of End Diastolic Flow in Anterior Cerebral Artery in Late-Onset Neonatal Sepsis
Authors: Singh Yengkhom Rameshwor , Suryawanshi Pradeep
Published: December 2018

Hemodynamics in neonatal sepsis is complex and poorly understood. Circulatory abnormalities are variable from vasodilatation with increased systemic blood flow to vasoconstriction with decreased blood flow, volume depletion or myocardial depression. Cerebral hemodynamics changes in neonatal sepsis. Most studies on cerebral hemodynamics in neonatal sepsis till now have been conducted on early-onset neonatal sepsis, and most of them have shown increased cerebral blood flow with a decreased resistive index (RI) in sepsis. Only a few studies have documented decreased cerebral flow in neonatal sepsis. Here we report a case of late-onset neonatal sepsis with the reversal of end diastolic flow, leading to increased RI associated with the death of the infant.
Twenty-Five Percent Dextrose and EBM in Pain Relief During Heel Lance in Late Preterm Babies Using the PIPP Score: A Randomized Controlled Trial
Authors: Rawal Sandeep , Ghai Anirudh , Jindal Tarsem
Published: December 2018

Objective: To compare the analgesic effect of 25% dextrose and expressed breast milk (EBM) in pain relief during heel lance in late preterm babies using the premature infant pain profile (PIPP) score.

Study Design: Prospective, double blind, randomized controlled trial.

Setting: The neonatal intensive care unit of Jaipur Golden Hospital, Rohini, Delhi.

Participants: One-hundred eleven late preterm babies who required heel lancing for glycemic control and who were on oral feeds and were hemodynamically stable.

Methodology: The babies were randomized into 2 intervention groups (25% dextrose and EBM) and control group (sterile water). The test solution of 2mL was given to baby 2 minutes before heel lancing. The facial response to pain (brow bulge, eye squeeze, and nasolabial furrow) was analyzed from the video. Maximum heart rate (HR) and minimum blood oxygen saturation (SpO2) were also recorded at 30 seconds, 1 minute, 1.5 minutes, and 2.5 minutes after heel lancing by another camera.

Outcome Variable: PIPP score, HR, SpO2 at 30 seconds, 1 minute, 1.5 minutes, and 2.5 minutes after heel lancing.

Results: A total of 63 babies were considered for final analysis with 21 each in the 25% dextrose, EBM, and sterile water groups. The mean PIPP score in the 25% dextrose, EBM, and control groups at 30 seconds were 4.52, 6.86, and 10.14, respectively ( P < .001). At 1 minute, the PIPP scores were 3.24, 5.14, and 8.24, respectively, for the 25% dextrose, EBM, and control groups ( P < .001). Twenty-five percent dextrose gave better pain relief than EBM. Mean difference between the PIPP score in the 25% dextrose and EBM groups was –2.34 and –1.9 at 30 seconds and 1 minute, respectively, after the painful procedure ( P = .001). Babies in intervention groups had less increase in HR and less decrease in SpO2.

Conclusions: Twenty-five percent dextrose and EBM significantly reduced procedural pain in neonates, though pain relief was better in the 25% dextrose group as compared to the EBM group.
Acute Kidney Injury in Perinatal Asphyxia: Comparison Between Term and Preterm Neonates
Authors: Malhotra Preeti , Syal Simran Kaur , Singh Ankush , Thapar Karuna
Published: December 2018

Objective: To investigate asphyxiated neonates for acute kidney injury, compare the occurrence between preterms and terms and to correlate the severity and type of renal injury with the degree of asphyxia and hypoxic ischemic encephalopathy (HIE) grading.

Materials and Methods: Renal functions were assessed using urine output and biochemical parameters such as blood urea, serum creatinine, serum sodium, potassium, and calcium. These were evaluated on alternate days till day 7 or recovery or death.

Results: Total 108 asphyxiated neonates were enrolled: 63 term and 45 preterm. A total of 28 (25.9%) developed acute kidney injury: 9 (32.1%) had oliguric acute renal injury and the rest 19 (67.8%) had nonoliguric acute renal injury. A total of 77.7% neonates had a prerenal cause and the other 22.2% had an intrinsic cause for the kidney injury. Levels of blood urea and serum creatinine were maximally elevated on day 5 of life. Biochemical derangements correlated well with the Apgar score at birth and severity of HIE. No statistically significant difference was observed in the incidence of renal injury between preterm and term asphyxiated neonates.

Conclusion: Perinatal asphyxia is an important cause of renal injury in neonates. A majority of neonates had nonoliguric and pre renal type of acute kidney injury. The more severe the degree of asphyxia, the more prone they were to develop renal complications.
Gastrointestinal Mucormycosis Mimicking as Necrotizing Enterocolitis: Case Series of 5 Neonates
Authors: Athwani Vivek Kumar , Sharma Pardeep Kumar , Mahal Tania , Kaur Bhupinder
Published: December 2018

Background: Gastrointestinal mucormycosis (GIM) is a rare potentially lethal fungal infection in neonates associated with rapid progression and high mortality.

Case Characteristics: We herein report 2 preterm and 3 term cases of GIM; all term neonates had perinatal asphyxia. All cases were preoperatively diagnosed as necrotizing enterocolitis (NEC).

Observation: All cases underwent laparotomy, and the diagnosis of GIM was made on postoperative histopathological examination.

Results: Asphyxia might be an important risk factor for mucormycosis in term neonates, and to improve outcome, a high index of suspicion of GIM should be kept in cases of NEC in neonates, especially in term neonates.
Value Added Tax and Informality: Determinants of Registration of Enterprises under State VAT in India
Authors: Mukherjee Sacchidananda , Rao R. Kavita
Published: December 2018

Unincorporated enterprises often bypass formal regulations in general and taxation in particular. Bringing unincorporated enterprises under the taxation system is a challenge often faced by tax administrators, and it is in this regard that the present study explores the factors which influence the decision of unincorporated enterprises to register with the state value added tax (VAT)/sales tax authority across states in India. This analysis is limited to the decision regarding registration. It is not necessary that enterprises that are registered pay taxes and/or file returns—however, the process of registration does provide some information to the tax department for follow ups. The study throws up some interesting results for policymakers and tax administrators.

JEL Classification: H25, H32, H26, L53
The Professional Learning of Teacher Educators Leading International Professional Experience
Authors: Williams Judy
Published: December 2018

In this article, the professional learning of teacher educators leading international professional experience (IPE) is examined. There is a growing body of research on the learning of pre-service teachers who undertake a period of professional experience in international contexts, but much less is known about the experiences of the academics who lead these programs. This knowledge is important because the success of such programs for pre-service teachers depends largely on the quality of the planning, preparation, and leadership of these as educational experiences. Based on data collected in semistructured interviews with 10 teacher educators who have led IPE to a variety of global locations, this article outlines the professional learning gained from leading a group of pre-service teachers on 3-week IPEs. Findings include the importance of building professional relationships with others involved in the IPE, including the pre-service teachers, school staff, and communities, and the impact of the experience on the development of teacher educator identities and practice.
Using a Flexible Diary Method Rigorously and Sensitively With Family Carers
Authors: Herron Rachel , Dansereau Lisette , Wrathall Meghan , Funk Laura , Spencer Dale
Published: December 2018

Health and social science researchers are increasingly interested in the range of new possibilities and benefits associated with diary methods, particularly using digital devices. In this article, we explore how a flexible diary method, which enables participants to choose the device (i.e., paper notebook, tablet, or computer) and medium (i.e., text, photographs, sketches) through which they narrate their experiences, can be used to promote sensitive and rigorous research engagement with family carers to people with dementia. We used a diary interview method with 10 carers over the course of 6 weeks to explore how they experience and interpret the changing behaviors of their cognitively impaired kin. We reflect on how the quality of diary data can be enhanced alongside the ethical dimensions of research with carer populations, through different forms of diary keeping, regular interaction with participants, reflexive practice, and follow-up interviews.
Omadacycline: A New Tetracycline Antibiotic
Authors: Dougherty John A. , Sucher Allana J. , Chahine Elias B. , Shihadeh Katherine C.
Published: December 2018

Objective: To review the chemistry, pharmacology, microbiology, pharmacokinetics, pharmacodynamics, clinical efficacy, tolerability, dosage, and administration of omadacycline, a new tetracycline antibiotic. Data Sources: A literature search through PubMed, Google Scholar, and clinicaltrials.gov was conducted (2008 to October 2018) using the search terms omadacycline and PTK-0796. Abstracts presented at recent conferences, prescribing information and information from the FDA and the manufacturer’s website were reviewed. Study Selection and Data Extraction: Preclinical data and published phase 1, 2, and 3 studies were evaluated. Data Synthesis: Omadacycline displays in vitro activity against a wide range of bacteria. Clinical trials have shown that omadacycline is noninferior to linezolid for the treatment of acute bacterial skin and skin structure infections (ABSSSI) and noninferior to moxifloxacin for the treatment of community-acquired bacterial pneumonia (CABP). A loading dose of 200 mg intravenously (IV) once or 100 mg IV twice or 450 mg orally for two days is recommended followed by a maintenance dose of 100 mg IV or 300 mg orally once daily. No dosage adjustment is needed in patients with renal or hepatic impairment. Omadacycline is well tolerated, with nausea being a common adverse effect, but is associated with food and drug interactions. Relevance to Patient Care and Clinical Practice: Omadacycline is active against staphylococci, including methicillin-resistant strains, and streptococci, including tetracycline-resistant strains, as well as atypical bacteria. Omadacycline provides clinicians with an additional parenteral and oral option for the treatment of adults with ABSSSI and CABP. Conclusion: Omadacycline is an alternative treatment option for ABSSSI and CABP.
Collagenous Spherulosis in Well-Differentiated Papillary Mesothelioma in a Female With Multilocular Peritoneal Inclusion Cysts
Authors: AbdullGaffar Badr , Raman Lakshmiah G.
Published: December 2018

Multilocular peritoneal inclusion cysts are mesothelial tumor-like lesions with or without small foci of florid papillary mesothelial hyperplasia that might simulate serous epithelial papillary lesions or well-differentiated papillary mesothelioma (WDPM) of the peritoneum. The papillary cores in papillary mesothelial hyperplasia and in WDPM display a variety of different histomorphologic features. To our knowledge, collagenous spherulosis in WDPM was not previously described or illustrated in the literature. Collagen spherules have been described in several miscellaneous benign and malignant lesions of the breast, prostate, salivary gland, and cutaneous adnexal tumors. They sometimes impose a diagnostically challenging cribriform growth pattern. We report a case of a young adult woman who presented with a large painful palpable multicystic mass in the right iliac fossa and pelvis. Histologically, it showed features of multilocular peritoneal inclusion cysts with an incidental finding of a small nodule demonstrating morphologic and immunohistochemical features of WDPM. The papillary cores revealed uniform homogenous eosinophilic round collagenous spheres with a cribriform pattern. The unusual finding of collagen spherules may expand the morphologic spectrum of mesothelial papillary lesions, the differential diagnosis of female pelvic peritoneal and omental epithelial and nonepithelial lesions and might cause some diagnostic confusion on small specimens. It may also shed some light on the pathophysiology and role of mesothelial and submesothelial stromal cells in the variable morphologic patterns of the stroma of papillary cores in different mesothelial lesions.
Cystic Anastomosing Hemangioma of the Ovary: A Case Report With Immunohistochemical and Ultrastructural Analysis
Authors: Gunduz Mehmet , Hurdogan Ozge , Onder Semen , Yavuz Ekrem
Published: December 2018

In this article, we present a case of anastomosing hemangioma that shows cystic change. The tumor was a unilocular cystic lesion consisting of 2 distinct layers. The inner layer was composed of a proliferation of capillary-sized blood vessels resembling red pulp of the spleen. The outer layer was composed of stromal cells that resembled Leydig or steroid cell tumor of the ovary. An immunohistochemical examination confirmed endothelial and stromal characteristics of the layers, respectively. An ultrastructural analysis revealed absence of Reinke crystalloids in the stromal cells. We conclude that anastomosing hemangioma may rarely arise from the ovary as a cystic tumor and may be accompanied with luteinization of stromal cells.
Differential Response and Children Re-Reported to Child Protective Services: County Data From the National Child Abuse and Neglect Data System (NCANDS)
Authors: Fluke John D. , Harlaar Nicole , Brown Brett , Heisler Kurt , Merkel-Holguin Lisa , Darnell Adam
Published: December 2018

Child protection systems that implement differential response (DR) systems screen to route referrals to an investigation response (IR) or alternative response (AR). AR responses emphasize family engagement, assessment of family needs, and service linkage. Usually, AR state-level policy does not require child welfare staff to make a maltreatment determination. Jurisdictions implement DR systems differently, leading to variations in the proportion of AR cases, risk levels of cases served, and the ways families access and use services. County data from the National Child Abuse and Neglect Data System were analyzed for six states from 2004 to 2013 that implemented DR. Variation in county-level AR rates were associated with county-level re-report rates using regression models with risk adjustments for socioeconomic and other county characteristics. Counties had 3% fewer re-reports overall for each percentage increase in AR use; higher levels of AR use are related to lower levels of re-reporting. When county AR and IR cases were analyzed separately, increasing rates of AR were associated with lower re-report rates for IR cases, but higher re-report rates for AR cases. Findings for the AR and IR subgroup must be interpreted with caution as a number of technical factors may be driving these results.
Predictors for Receiving Medication and/or Psychotherapy in Children Newly Diagnosed With ADHD: A Longitudinal Population-Based Cohort Study
Authors: Scholle Oliver , Fegert Jörg M. , Kollhorst Bianca , Öztürk Eyyub E. , Riedel Oliver , Kölch Michael
Published: December 2018

Objective: The aim of this study is to identify characteristics predicting the use of medication and/or psychotherapy after a first ADHD diagnosis. Method: This cohort study was based on German claims data including 12,250 treatment-naïve children aged 5 to 12 years with an incident ADHD diagnosis in 2010. Logistic regression models were used to estimate associations between children’s characteristics at first diagnosis and the chosen treatment within the following 5 years. Results: Medication use was associated with male sex, an ADHD diagnosis “with hyperactivity,” comorbid depression, and comorbid developmental and conduct disorders. Male sex and comorbid neurotic and somatoform, conduct, and emotional disorders were associated with psychotherapy only. Receiving both treatments—instead of medication only—was associated with comorbid depression, neurotic and somatoform, conduct, and emotional disorders. Conclusion: In case of equal access to both treatment options, patients, for example, with externalizing symptoms were more prone to receive medication and/or psychotherapy than the average child diagnosed with ADHD.
The Implications of Cannabis Policy Changes in Washington on Adolescent Perception of Risk, Norms, Attitudes, and Substance Use
Authors: Blevins Claire E , Marsh Eliza , Banes Kelsey E , Stephens Robert S , Walker Denise D , Roffman Roger A
Published: December 2018

There is increasing interest in the effect of legalization (particularly recreational legalization) of cannabis on prevalence of use and related problems. However, there is no consensus about the impact of policy change on cannabis use, particularly among adolescents. Legalization may increase adolescent use through mediating factors such as perceived risk and normative beliefs regarding the use of cannabis. Washington State enacted Initiative 502 on December 2012, which legalized and taxed recreational cannabis for adults aged ⩾21 years. This paper used data from a randomized, controlled intervention trial for cannabis-using adolescents that was recruiting participants in Seattle before and after the policy change to evaluate the following goals: assess differences in substance use, problems, and symptomatology pre- and post-policy change; evaluate several proposed risk factors that may be associated with such differences; and describe participants’ understanding of the law and how this understanding may relate to rates of use. Analyses revealed no significant differences pre- to post-policy in rate of substance use. However, there were significant post-policy increases in problems and use disorder symptoms. Despite these differences, there were no significant increases in norms, attitudes, or perceptions of risk. Participants were able to answer most questions regarding policy changes correctly, indicating a good understanding of the policy. Results provided no evidence that policy change influenced heavy-using adolescents’ rates of use nor the proposed risk factors associated with problematic use patterns.
Numerical modeling and analysis of the noncontacting impulse gas face seals
Authors: Blasiak Slawomir
Published: December 2018

Noncontacting mechanical seals with various kinds of face surface modifications have established their position in the sealing technique. Over the last few years, a lot of works dedicated to the impact of various surface modifications on the dynamics of working rings have been created. This paper presents model studies regarding relatively unknown noncontacting impulse gas face seals. Here, a mathematical model of impulse gas face seals is developed including the nonlinear Reynolds equation and stator dynamics equations, which were solved simultaneously using numerical methods. An original computer software written in C + + language was developed. A number of numerical tests were conducted and the phenomena occurring in the radial gap during seal operation were analyzed. Final conclusions were drawn and several features were indicated characterizing impulse face seals. It should be emphasized that numerical research on this type of seals has not been published yet. The literature usually presents simplified models for the noncompressible medium, which can be solved with the use of analytical methods.
Impairments in resource allocation and executive control in children with ADHD
Authors: Dörrenbächer Sandra , Kray Jutta
Published: December 2018

Children diagnosed with attention-deficit hyperactivity disorder (ADHD) show pronounced alterations in cognitive tasks, such as a highly variable mode of responding. There is an ongoing debate about the key driving mechanisms of such alterations (e.g. specific inhibition or working memory (WM) impairments or general impairments in the allocation of energetic resources). The aim of this study was to disentangle such process-specific versus general limitations in cognitive and energetic mechanisms in children with ADHD compared to typically developed (TD) children based on the performance in a task-switching paradigm. This paradigm allows for both a common measurement and a later segregation of different executive sub-processes. Task-switching performance, including performance variability, of 26 children diagnosed with combined-type ADHD (8–13 years) was compared against the performance of 26 age-matched/IQ-matched TD children. Results revealed that compared to TD children, ADHD-diagnosed children showed alterations in performance variability during task switching, both in general (indicating disturbances in resource allocation) and conditionally on WM demands (indicating a specific WM deficit). Hence, our study provides diagnostically relevant new insights into performance impairments in children with ADHD compared to TD children. Importantly, it seems mandatory to include information on performance variability when trying to phenotype alterations in cognitive performance in ADHD.
Early emergence of discrepancy in adaptive behavior and cognitive skills in toddlers with autism spectrum disorder
Authors: Bradshaw Jessica , Gillespie Scott , Klaiman Cheryl , Klin Ami , Saulnier Celine
Published: December 2018

Individuals with autism spectrum disorder and average IQ exhibit a widening discrepancy between lagging adaptive skills relative to their cognitive potential, but it is unknown when this discrepancy emerges in development. To address this important question, we measured adaptive and cognitive skills longitudinally, from 12–36 months, in 96 low-risk typically developing infants and 69 high-risk siblings of children with autism spectrum disorder who at 36 months were diagnosed with autism spectrum disorder ( N = 21), the broader autism phenotype ( N = 19), or showed no concerns (unaffected; N = 29). Results indicate that both cognitive and adaptive communication skills remained stable over time for all four groups, but toddlers with autism spectrum disorder and the broader autism phenotype failed to keep pace with unaffected and typically developing toddlers with regard to adaptive socialization skills and, to a lesser extent, daily living skills. The odds of having a discrepant developmental profile, with average cognitive skills and below average adaptive skills, was significantly greater for socialization and daily living skills in toddlers with autism spectrum disorder or the broader autism phenotype and increased over time from 12 to 36 months. The discrepancy between adaptive skills and cognition emerges early and widens over time for infants with autism spectrum disorder symptomology, supporting early assessment and intervention of adaptive socialization and daily living skills.
The day after: Protecting the human rights affected by environmental challenges after the EU accession to the European Convention on Human Rights
Authors: Antonopoulos Irene
Published: December 2018

This article explores whether a potential accession of the European Union to the European Convention on Human Rights, offers a more effective method of protection for ‘environmental human rights’: those rights whose enjoyment is allegedly affected by environmental challenges. The European Court of Human Rights has decided on claims of alleged violations of human rights by both environmental degradation and the enforcement of environmental protection policies implementing EU environmental law. On the other hand, the capacity of the Court of Justice of the European Union to decide on human rights issues has been repeatedly challenged, while the inability of the Court to protect procedural (environmental) rights when it came to NGOs, allows for challenging the capacity of the Court of Justice of the European Union to protect substantive (environmental) rights as well. Will an accession mean that applicants will be able to bring claims for alleged violations, caused by the enforcement of EU generated environmental protection policies, against the EU Institutions rather than the enforcing State? This article follows the relevant developments towards the accession, and consequently seeks to determine how the day after the accession will look for the protection of human rights affected by environmental challenges.
Ivory trade: Policy and law change
Authors: Lowther Jason
Published: December 2018

Against a backdrop of consistent NGO pressure, countered by an unrelenting and increasingly transnational organised crime-framed poaching effort, the Secretary of State for the Environment Food and Rural Affairs moved to enact legislation which will significantly curtail what remains of the market for ivory products in the UK. The Ivory Bill, at the time of writing going through its parliamentary stages, will sidestep the majority of the current exemptions, premised on the antiquity of a worked item, to the usual prohibition on the trade of raw or worked ivory which owes its existence to the Convention on the International Trade in Endangered Species of Wild Fauna and Flora 1973 (CITES) and the Treaty’s domestic implementing measures. The accelerated illegal killing of charismatic species such as elephants has prompted legal responses at international and local levels in both range and destination-market states. Laws targeting both the supply and demand sides of the trade have been undermined by the trade in antique ivory: a shadow, parallel market of imitation antiques has existed for some time to launder poached ivory through the exemptions to the CITES system. This short article will introduce the mechanics of the Ivory Bill, set in the context of the drivers which have prompted it, and will evaluate its potential contribution to curtailing this destructive trade.
Intervention analysis for low-count time series with applications in public health
Authors: Moriña David , Leyva-Moral Juan M , Feijoo-Cid Maria
Published: December 2018

It is common in many fields to be interested in the evaluation of the impact of an intervention over a particular phenomenon. In the context of classical time series analysis, a possible choice might be intervention analysis, but there is no analogous methodology developed for low-count time series. In this article, we propose a modified INAR model that allows us to quantify the effect of an intervention, and is also capable of taking into account possible trends or seasonal behaviour. Several examples of application in different real and simulated contexts will also be discussed.
Cognitive and Emotional Engagement for Students with Severe Intellectual Disability Defined by the Scholars with Expertise in the Field
Authors: Hollingshead Aleksandra , Williamson Pamela , Carnahan Christina
Published: December 2018

Although a great deal has been written about the complexities of engagement in learning, this is less true for students with severe intellectual disability. The concept of engagement of these students remains strictly behavioral. Engagement as a complex construct, consisting of behavioral, cognitive, and emotional components, must be addressed as conversations continue to grow around instructional practices for these learners. The current study employed phenomenological analysis to examine the perceptions of 23 scholars with expertise in the field of severe disability related to cognitive and emotional components of engagement. The findings demonstrate that the essence of cognitive engagement involves academic responding, meaningful instruction, and learning outcomes, while the essence of emotional engagement consists of both the factors influencing emotional engagement and the variety of means with which to express it. Across both topics, the challenges with defining and measuring engagement remain.
Effect of occupation-based interventions in patients with haematopoietic malignancies undergoing chemotherapy: A pilot randomised controlled trial
Authors: Sagari Akira , Ikio Yuta , Imamura Nobuko , Deguchi Kayoko , Sakai Toko , Tabira Takayuki , Higashi Toshio
Published: December 2018

Background/objective

Chemotherapy for cancer negatively affects activities of daily living and quality of life. This study aimed to validate and compare the efficacy of two different interventions in patients with haematopoietic malignancies undergoing chemotherapy: (1) occupation-based interventions, designed using the Aid for Decision-making in Occupation Choice (ADOC) (an iPAD application) and (2) impairment-based interventions. ADOC helps promote decision-making during activities and participation in occupation-based goal setting. The impairment-based intervention group served as the comparison group and underwent impairment-based interventions focusing on dysfunction.

Methods

In this single-blinded pilot randomised controlled trial, 19 participants received an occupation-based intervention (n = 9) or an impairment-based intervention (n = 10). The treatment period comprised two sessions. Recruitment, compliance and outcome completion rates were calculated for the study. Effect sizes were examined for outcomes regarding physical performance, instrumental activities of daily living and quality of life as evaluated by a blinded assessor.

Results

In this study, 24.8% (28/113) of the eligible patients with haematopoietic malignancies were enrolled, and 67.9% (19/28) of these were retained up to the post-assessment stage. Recruitment (25%) and compliance (68%) rates were satisfactory. The Functional Assessment of Cancer Therapy-General emotional well-being and total scores were significantly higher for the occupation-based intervention group than for the impairment-based intervention group (both p < 0.05; d = 0.54, d = 0.51, respectively). Other outcomes showed no significant differences.

Conclusion

Occupation-based interventions designed using the ADOC application were useful for patients with haematopoietic malignancies.
Nanoindentation response of monocrystalline copper under various tensile pre-deformations via molecular dynamic simulations
Authors: Li Lijia , Sun Xingdong , Guo Yue , Zhao Dan , Du Xiancheng , Zhao Hongwei , Ma Zhichao
Published: December 2018

The mechanical properties of a material can be positively or negatively affected by its applied or residual stress. In this article, a series of molecular dynamic simulations were adopted to investigate the nanoindentation response of monocrystalline copper under tensile pre-deformation. Nanoindentation simulation under stress-free condition was compared with those under pre-tension strain values of 1.2%, 2.4% and 3.6%. Load–displacement curves with hardness value and recovery rates of total work for nanoindentation based on various tensile pre-deformations were obtained and discussed. It indicated that tensile pre-deformations resulted in a higher potential energy in substrate and a lower external energy will be introduced to realize the same elastic or plastic deformation during indentation. Moreover, the evolution of interior defects during indentation was also observed and analysed. The results showed that tensile pre-strain can influence dislocation nucleation behaviour of material during indentation. This article proposed a special molecular dynamic simulation method to characterize the mechanical properties of the material under tensile pre-deformations via nanoindentation, which gives an effective approach to characterize residual stresses in micro- and nanoscale and will have promising application in mechanical characterization of Microelectro Mechanical Systems devices and structures. Further analysis based on experiments will be done in our further research work.
Car-following method based on inverse reinforcement learning for autonomous vehicle decision-making
Authors: Gao Hongbo , Shi Guanya , Xie Guotao , Cheng Bo
Published: December 2018

There are still some problems need to be solved though there are a lot of achievements in the fields of automatic driving. One of those problems is the difficulty of designing a car-following decision-making system for complex traffic conditions. In recent years, reinforcement learning shows the potential in solving sequential decision optimization problems. In this article, we establish the reward function R of each driver data based on the inverse reinforcement learning algorithm, and r visualization is carried out, and then driving characteristics and following strategies are analyzed. At last, we show the efficiency of the proposed method by simulation in a highway environment.
Active control of hydropneumatic suspension parameters of wheel loaders based on road condition identification
Authors: Wang Shuai , Lu Zhen , Liu Xinhui , Cao Yue , Li Xuefei
Published: December 2018

Wheel loader is off-road vehicle and works on uneven terrain, unexpected banks or steep slopes. In order to improve the ride and stability of the vehicle, this study mainly focuses on how to adjust the parameters of hydropneumatic suspension through the identification of road conditions. Firstly, the multibody model of a wheel loader with hydropneumatic suspension is developed by RecurDyn in a co-simulation with MATLAB/Simulink. Secondly, a method of road level recognition based on learning vector quantization neural network is proposed to accurately identify the level of roads on which the wheel loader travels. Then, the hydropneumatic suspension parameters are optimized by using the particle swarm algorithm. A fuzzy controller is established based on the optimized parameters of the hydropneumatic suspension to realize the active adjustment of the suspension parameters under different road levels and driving speeds. Finally, a virtual prototyping model is used to analyse the influence of the active adjustment of suspension parameters on the vertical vibration under different driving conditions. Results show that the fuzzy controller can reasonably adjust the parameters of hydropneumatic suspension according to the identified road condition and effectively reduce the vertical vibration of the wheel loader.
Defining a relationship between transitional justice and jus post bellum: A call and an opportunity for post-conflict justice
Authors: Fisher Kirsten J
Published: December 2018

While there is an acknowledged overlap of transitional justice and jus post bellum, there has been no real attention to delineating a clear relationship between the two or addressing the significant differences regarding aims, scope and audience. These differences must be acknowledged and a clear relationship between the two fields needs to be demarcated for both intellectual clarity and practical reasons. It seems right to question not only where these fields of inquiry fall in relation to each other but how the two can co-exist and inform each other in a meaningful way that works to the benefit of victims of conflict and mass atrocity. Done correctly, this overlap can be ushered into a coherent research agenda where the two perspectives can be brought together in a careful and concise manner. This article aims to start to address this gap.
Moral Dichotomization at the Heart of Prejudice: The Role of Moral Foundations and Intolerance of Ambiguity in Generalized Prejudice
Authors: Forsberg Erik , Nilsson Artur , Jørgensen Øyvind
Published: December 2018

This study confronted the classical idea that generalized prejudice is rooted in a cognitive tendency to sort reality into rigid and simple categories with the more recent idea that prejudice is shaped by moral intuitions. In a diverse Swedish sample ( N = 430), moral absolutism was more strongly associated with generalized prejudice against derogated and dissident (but not dangerous) groups than were other aspects of intolerance of ambiguity. But there was little direct association between any aspect of intolerance of ambiguity and generalized prejudice once indirect relations through binding moral intuitions (which elevated prejudice) and individualizing moral intuitions (which decreased prejudice) had been taken into account. These findings suggest that intolerance of ambiguity is associated with generalized prejudice mainly insofar as it leads to a distinctly moral dichotomization of persons into categories such as insiders and outsiders, law-abiding citizens and deviants, and the righteous and the impure.
Unpacking social-ecological transformations: Conceptual, ethical and methodological insights
Authors: Shah Sameer H , Rodina Lucy , Burt Jenn M , Gregr Edward J , Chapman Mollie , Williams Steve , Wilson Nicole J , McDowell Graham
Published: December 2018

Social-ecological systems contribute to environmental change and, in turn, face its corresponding shocks and disturbances. As scholarship on resilience and social-ecological transformations grows, researchers from various disciplines continue to debate how major transitions and environmental change can be anticipated, studied or guided towards just and ethical outcomes. To this end, we apply an interdisciplinary perspective to describing key aspects of social-ecological transformations scholarship around three pressing questions: (1) What features or criteria distinguish transformations from other forms of change?; (2) What are the political, ethical, and normative concerns associated with transformations?; and (3) How can we better track, measure, and evaluate such transformations? Our insights, which emerged from a workshop with early-career interdisciplinary scholars, highlight questions of justice, equity and ethics in transformations research, and suggest that more precise indicators of change, a more explicit understanding of system boundaries, and a dual focus on process and outcomes will help advance our understanding of the social-ecological implications of transformations. We hope that articulating these challenges and recommendations in an interdisciplinary framing will help further the conversation on these critical topics and provide an accessible perspective of key considerations for multidisciplinary scholarship on social-ecological transformations.
A compromised paraventricular nucleus within a dysfunctional hypothalamus: A novel neuroinflammatory paradigm for ME/CFS
Authors: Mackay Angus , Tate Warren P
Published: December 2018

A neuroinflammatory paradigm is presented to help explain the pathophysiology of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The hypothalamic paraventricular nucleus (PVN) is responsible for absorbing and processing multiple, incoming and convergent ‘stress’ signals, and if this cluster of neurons were affected (by neuroinflammation), the ongoing hypersensitivity of ME/CFS patients to a wide range of ‘stressors’ could be explained. Neuroinflammation that was chronic and fluctuating, as ‘inflammatory-marker’ studies support, could reflect a dynamic change in the hypothalamic PVN’s threshold for managing incoming ‘stress’ signals. This may not only be a mechanism underpinning the characteristic feature of ME/CFS, post-exertional malaise, and its associated debilitating relapses, but could also be responsible for mediating the long-term perpetuation of the disease. Triggers (sustained physiological ‘stressors’) of ME/CFS, such as a particular viral infection, toxin exposure, or a traumatic event, could also target the hypothalamic PVN, a potentially vulnerable site in the brains of ME/CFS susceptible people, and disruption of its complex neural circuitry could account for the onset of ME/CFS. In common with the different ‘endogenous factors’ identified in the early ‘neuroinflammatory’ stages of the ‘neurodegenerative’ diseases, an as yet, unidentified factor within the brains and central nervous system (CNS) of ME/CFS patients might induce both an initial and then sustained ‘neuroinflammatory’ response by its ‘innate immune system’. Positron emission tomography/magnetic resonance imaging has reinforced evidence of glial cell activation centred on the brain’s limbic system of ME/CFS patients. Neuroinflammation causing dysfunction of the limbic system and its hypothalamus together with a consequently disrupted autonomic nervous system could account for the diverse range of symptoms in ME/CFS relating, in particular to fatigue, mood, cognitive function, sleep, thermostatic control, gastrointestinal disturbance, and hypotension.
Invertebrate models of behavioural plasticity and human disease
Authors: Holden-Dye Lindy , Walker Robert J.
Published: December 2018

The fundamental processes of neural communication have been largely conserved through evolution. Throughout the last century, researchers have taken advantage of this, and the experimental tractability of invertebrate animals, to advance understanding of the nervous system that translates to mammalian brain. This started with the inspired analysis of the ionic basis of neuronal excitability and neurotransmission using squid during the 1940s and 1950s and has progressed to detailed insight into the molecular architecture of the synapse facilitated by the genetic tractability of the nematode Caenorhabditis elegans and the fruit fly Drosophila melanogaster. Throughout this time, invertebrate preparations have provided a means to link neural mechanisms to behavioural plasticity and thus key insight into fundamental aspects of control systems, learning, and memory. This article captures key highlights that exemplify the historical and continuing invertebrate contribution to neuroscience.
Diagnostic Accuracy of Virtual Touch Quantification and Virtual Touch Imaging Quantification Sonoelastography Techniques in Pediatric Undescended Testes Patients
Authors: Özkan Mehmet Burak , Bilgic Meltem , Bicakci Unal , Germiyanoglu Cankon
Published: December 2018

The purpose of this study was to determine the usefulness of virtual touch quantification (VTQ) and virtual touch imaging quantification (VTIQ) techniques for assessing undescended testes stiffness, by age and location. One testicle from each of 84 participants (31 of whom were healthy volunteers) was assessed by the point shear-wave elastography (p-SWE) method, using both VTQ and VTIQ techniques. The patients were grouped by location of assessment (intra-abdominal, inguinal, and scrotal) and age (group 1, healthy patients; group 2, patients age one and younger; and group 3, patients older than age one). Although the VTQ and VTIQ methods for group 2 showed similar results in the Bland-Altman plot, for group 3, the VTIQ method was more effective than the VTQ method. The use of p-SWE with VTIQ may be an appropriate technique for determining the tissue stiffness of testes located in the inguinal canal and for patients over one year of age.
Ibrutinib for the treatment of Bing-Neel syndrome: a multicenter study
Authors: Castillo Jorge J. , Itchaki Gilad , Paludo Jonas , Varettoni Marzia , Buske Christian , Eyre Toby A. , Chavez Julio C. , Shain Kenneth H. , Issa Samar , Palomba M. Lia , Pasvolsky Oren , Simpson David , Talaulikar Dipti , Tam Constantine S. , Tedeschi Alessandra , Ansell Stephen M. , Nayak Lakshmi , Treon Steven P.
Published: December 2018

The treatment of patients with Bing-Neel syndrome (BNS) is not standardized. We included patients with Waldenström macroglobulinemia (WM) and a radiologic and/or cytologic diagnosis of BNS treated with ibrutinib monotherapy. Response assessment was based on criteria for BNS from the 8th International Workshop for WM. Survival from BNS diagnosis (BNS survival), survival from ibrutinib initiation to last follow-up or death (ibrutinib survival), and time from ibrutinib initiation to ibrutinib discontinuation for toxicity, progression, or death (event-free survival [EFS]) were estimated. Twenty-eight patients were included in our study. The median age at BNS diagnosis was 65 years. Ibrutinib was the first line of treatment for BNS in 39% of patients. Ibrutinib was administered orally at a dose of 560 and 420 mg once daily in 46% and 54% of patients, respectively; symptomatic and radiologic improvements were seen in 85% and 60% of patients within 3 months of therapy. At best response, 85% of patients had improvement or resolution of BNS symptoms, 83% had improvement or resolution of radiologic abnormalities, and 47% had cleared the disease in the cerebrospinal fluid. The 2-year EFS rate with ibrutinib was 80% (95% confidence interval [CI], 58%-91%), the 2-year ibrutinib survival rate was 81% (95% CI, 49%-94%), and the 5-year BNS survival rate was 86% (95% CI, 63%-95%). Ibrutinib therapy is effective in patients with BNS and should be considered as a treatment option in these patients.