bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between the use of gay mobile phone applications and HIV infection among men who have sex with men in Ningbo, China: a cross-sectional study
Authors: Hong Hang , Xu Jie , McGoogan Jennifer , Dong Hongjun , Xu Guozhang , Wu Zunyou
Published: November 2017

In recent years, there has been a significant increase in the use of gay mobile phone applications (gay apps) and HIV prevalence among men who have sex with men (MSM) in China. The aim of this study was to investigate whether there was a relationship between the use of gay apps and HIV infection and provide a targeted intervention to MSM. A cross-sectional study was conducted. Chinese MSM who were over 18 years old and had self-reported homosexual intercourse in the past six months were interviewed in 2016. Proportions were used for categorical variables and determinants of HIV infection were assessed using univariate and multivariate regression. Of the 403 participants, nearly 66.0% reported having used gay apps to seek sexual partners in the past six months. A higher proportion of the gay app users were younger than 19 years old, single, had high school education, were earning less than 115 GBP income per month, and identified themselves as homosexual. Compared to app non-users, a greater proportion of app users reported a higher frequency of male–male sexual contact (≥1 time/week: 57.5% versus 39.4%, p < 0.01), multiple male sex partners (34.2% versus 11.7%, p < 0.001), and unprotected sex with men (51.5% versus 36.5%, p < 0.01) in the past six months. The prevalence of HIV among app users was 7.9%. HIV infection was significantly associated with being an app user (adjusted odds ratio = 5.2, 95% CI = 1.1–24.3). It is suggested that the use of gay apps, especially Blued, is popular among Chinese MSM and is associated with high-risk sexual behaviors and HIV infection. Therefore, there is an urgent need to promote HIV testing and HIV prevention through gay apps to decrease the risk of HIV infection among Chinese MSM.
Can Science Explain the Human Mind? Intuitive Judgments About the Limits of Science
Authors: Gottlieb Sara , Lombrozo Tania
Published: November 2017

Can science explain romantic love, morality, and religious belief? We documented intuitive beliefs about the limits of science in explaining the human mind. We considered both epistemic evaluations (concerning whether science could possibly fully explain a given psychological phenomenon) and nonepistemic judgments (concerning whether scientific explanations for a given phenomenon would generate discomfort), and we identified factors that characterize phenomena judged to fall beyond the scope of science. Across six studies, we found that participants were more likely to judge scientific explanations for psychological phenomena to be impossible and uncomfortable when, among other factors, they support first-person, introspective access (e.g., feeling empathetic as opposed to reaching for objects), contribute to making humans exceptional (e.g., appreciating music as opposed to forgetfulness), and involve conscious will (e.g., acting immorally as opposed to having headaches). These judgments about the scope of science have implications for science education, policy, and the public reception of psychological science.
Reward Adaptation and the Mechanisms of Learning: Contrast Changes Reward Value in Rats and Drives Learning
Authors: Dwyer Dominic Michael , Figueroa Jaime , Gasalla Patricia , López Matías
Published: November 2017

Formal theories of learning suggest that associations between events are determined by the internal representations of those events. Thus, learning should depend on perceived reward value—even when perceptions differ from objective values. We examined this prediction in flavor-preference learning in rats. In two experiments, simultaneous contrast either increased perceived reward value, which was paired with a distinctive flavor cue (the positive conditioned stimulus, CS+), or decreased the perceived value of the same reward, which was then paired with a second flavor (the negative conditioned stimulus, CS–). Even though the CS+ and CS– were paired with the same objective reward, there was a preference for the CS+ in subsequent tests. Moreover, the size of contrast-produced changes in reward value during training predicted the preference for the CS+ at test. This contrast-produced learning effect illustrates the mechanisms by which associations, which normally track veridical relationships between events in the world, are formed.
Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment
Authors: Dillon Ellis , Chuang Judith , Gupta Atul , Tapper Sharon , Lai Steve , Yu Peter , Ritchie Christine , Tai-Seale Ming
Published: November 2017

Context:

Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic.

Objectives:

In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice.

Methods:

Structured interviews were conducted with 13 providers with high and low rates of ACP documentation in primary care, oncology, pulmonology, and cardiology departments. The EHR problem list data on Advance Health Care Directives (AHCDs) and Physician Orders for Life-Sustaining Treatment (POLST) were used to calculate ACP documentation rates.

Results:

Examining seriously ill patients ≥65 years with no preexisting ACP documentation seen by providers during 2013 to 2014, 88.6% (AHCD) and 91.1% (POLST) of 79 specialists had zero ACP documentations. Of 358 PCPs, 29.1% (AHCD) and 62.3% (POLST) had zero ACP documentations. Interviewed PCPs often believed ACP documentation was beneficial and accessible, while specialists more often did not. Specialists expressed more confusion about documenting ACP, whereas PCPs reported standard clinic workflows. Problems with interoperability between outpatient and inpatient EHR systems and lack of consensus about who should document ACP were sources of variations in practices.

Conclusion:

Results suggest that providers desire standardized workflows for ACP discussion and documentation. New Medicare reimbursement for ACP and an increasing number of quality metrics for ACP are incentives for health-care systems to address barriers to ACP documentation.
Expressions of Gratitude, Wishes, and Spending Preferences Among Chinese Children and Adolescents
Authors: Liang Yue , Kiang Lisa
Published: November 2017

The present study investigated age-related differences in gratitude expression and spending preferences, as well as their relations with wishes among 520 7- to 14-year-old Chinese children and adolescents. Results suggested that older Chinese children were more likely than younger ones to express connective gratitude and that the probability of expressing verbal and concrete gratitude remained stable across ages. In addition, older children tended to spend less money on buying things for others as compared with younger children. Regarding the relations between wish types and gratitude and spending preferences, we found that children who wished for social well-being were more likely to express connective gratitude, and to spend a larger amount of money on charity. In addition, children who had hedonistic wishes were more likely to express concrete gratitude. Findings of the present study contribute to the theoretical understanding of gratitude development among Chinese children and adolescents.
Comparing Public Quality Ratings for Accredited and Nonaccredited Home Health Agencies
Authors: Williams Scott C. , Morton David J. , Yendro Susan , Baker David W.
Published: November 2017

This was a descriptive study comparing 1,582 accredited and 10,008 nonaccredited home health agencies over a 3-year period using the Centers for Medicare and Medicaid Services Home Health Compare data set. Metrics included the star rating and 22 quality measures. A longitudinal model was used to determine differences between accredited and nonaccredited organizations on the quality measures. Categorical differences in star ratings and risk-adjusted outcome categories were analyzed using a chi-square test. Accredited agencies had statistically higher star ratings than nonaccredited organizations (3.4 vs. 3.2, p < .001), and they were more likely to be categorized 4, 4.5, and 5 star organizations ( p < .001). Absolute differences between accredited and nonaccredited agencies on the OASIS quality measures were generally small but consistently favored accredited facilities over all 3 years studied ( p < .05).
Psychometric Properties of the Persian Version of the Weiss Functional Impairment Rating Scale–Self-Report Form in Iranian Adolescents
Authors: Hadianfard Habib , Kiani Behnaz , Weiss Margaret D.
Published: November 2017

Objective: The Weiss Functional Impairment Rating Scale–Self-Report Form (WFIRS-S) was developed as a measure of functional impairment in adolescents and adults with ADHD. This study reports the psychometric properties of the Persian version of the WFIRS-S in a sample of normal Iranian adolescents. Method: Internal consistency and factor structure of the WFIRS-S were tested on a sample of 386 students (Grades 7-12). The test-retest reliability and the convergent validity of the WFIRS-S were evaluated by using two different subsamples including 50 and 100 students, respectively. Results: The Cronbach’s alpha values were between .72 and .94 for the WFIRS-S subdomains and total scale. The test-retest reliability was .80 for the total scale. The WFIRS-S subdomains had moderate to high significant correlations with the Pediatric Quality of Life total scale. Conclusion: The Persian version of the WFIRS-S has acceptable psychometric properties and could be used as a functional impairment assessment for adolescents.
The Use of Ion Chromatography for the Determination of Clean-In-Place-200 (CIP-200) Detergent Traces
Authors: Resto Wilfredo , Roque Joan , Rey Rosamil , Colón Héctor , Zayas Josέ
Published: November 2017

Anion chromatography with conductivity detection was chosen as the analytical technique for the development of a cleaning validation method for clean-in-place (CIP) detergents. The method was developed and validated for the determination of traces of the detergent CIP-200. It was shown to be linear with a squared correlation coefficient (r2) of 0.9999 and the accuracy experiments presented average recoveries of 88.2% (area response factor) from stainless steel surfaces. The repeatability was found to be 1.6% and an intermediate precision of 1.9% across the range. The method was also shown to be sensitive with an average Detection Limit (DL) of 0.23 ppm and a Quantitation Limit (QL) of 0.70 ppm based on the amount of phosphate in the detergent sample. The phosphate signal was well resolved from typical ions encountered in water samples or any other interference presented from swabs and surfaces. The method was applied to cleaning validation samples and proved to be suitable for rapid and reliable quality control.
Breakthrough Pain: Focus on Fentanyl Buccal Tablet
Authors: Lecybyl Remigiusz , Hanna Magdi
Published: November 2017

Breakthrough pain (BTP) management is an unmet clinical need. BTP is poorly diagnosed, rarely evaluated and inadequately treated. BTP is transitory exacerbation of pain experienced by the patient who has relatively stable and adequately controlled baseline pain. BTP is reported to be common in adults and children with cancer as well as in non-cancer diseases associated with acute/chronic pain. Successful management of breakthrough pain depends on adequate assessment, appropriate treatment (cause of pain and symptomatic) and adequate reassessment. Ideal medication for BTP should be characterized with good efficacy and minimal side effects. Pharmacodynamic profile should mimic dynamics of BTP. Strong, short acting analgesics (e.g. opioids) administrated by route which allow quick action had potential to fulfil criteria for ideal ‘rescue’ medication for BTP. Fentanyl Buccal tablets (FBT; Fentora®, Frazer, PA, Cephalon Inc.) is novel delivery system for fentanyl citrate. FBT utilize OraVescent (r) technology to improve bioavability and speed of transmucosal delivery. Alternate routes of administration could further improve efficacy of BTP management. Intranasal and intrapulmonary routes are under exploration. Recently introduced new delivery systems for opioids medication do represent an improvements in BTP management, however BTP is still a major challenge to pain and palliative physicians.
Fospropofol Disodium for Procedural Sedation: Emerging Evidence of its Value?
Authors: Mueller Scott W. , Moore Gina D. , MacLaren Robert
Published: November 2017

Background

Fospropofol is a phosphate-ester water soluble prodrug of propofol approved in the United States for the short-term sedation of adults undergoing diagnostic or therapeutic procedures with monitored anesthesia care. Fospropofol may be advantageous for procedural sedation because it is not a lipid formulation, it lacks pain on injection, it possesses a different pharmacokinetic profile due to in vivo conversion of fospropofol to propofol, and it offers rapid recovery from sedation.

Objective

To review published pharmacokinetic data, clinical trials, and the safety profile of fospropofol and provide comment on its use for sedation.

Clinical trials

Fospropofol has been studied for sedation in colonoscopy and bronchoscopy with fentanyl for analgesia. Results indicate that a 6.5 mg/kg bolus dose with repeated doses of 25% of the original bolus dose up to every 4 minutes produces an effective and safe level of sedation. Fospropofol comparisons to midazolam were not assessed. Patient satisfaction is high for those treated with the recommended dosage regimen. Most commonly reported adverse effects included pruritus and paresthesia. Sedation related side effects such as hypoxia and apnea were rarely reported and generally mild in scope.

Conclusion

Fospropofol represents an alternative sedative agent to midazolam and propofol for short-term sedation. However, the efficacy and safety of fospropofol compared to midazolam or propofol has not been assessed, therefore use will be based on practitioner preference. Restrictive package labelling requiring MAC poses medico-legal and cost-benefit issues thereby not conferring a benefit over propofol which caries similar labelling. Additional studies designed to compare fospropofol to propofol and/or midazolam for procedural sedation are needed.
Never social and entrepreneurial enough? Exploring the identity work of social entrepreneurs from a psychoanalytic perspective
Authors: Driver Michaela
Published: November 2017

Building on an analysis of interviews with 61 social entrepreneurs, the study offers a more fine-grained exploration of the identity work of social entrepreneurs from a psychoanalytic, particularly Lacanian, perspective. Specifically, it suggests that what defines social entrepreneurial identity work is the blurring of beatific and horrific aspects of fantasies and a desire for struggle and lack. This in turn creates an emancipatory space in which discursive movement enables alternative forms of market enjoyment and ethical agency. The latter unsettles macro-discourses of capitalism by demanding and amplifying their lack. The study contributes new avenues for exploring Lacanian concepts such as the traversal of fantasy as a product of discursive movement particularly relevant for transformative readings of identity narratives.
Pricing Beach Congestion
Authors: López-del-Pino Francisco , Grisolía José M.
Published: November 2017

There is a growing need for instruments to control and reduce the impacts of the increasing number of tourists visiting protected natural areas. Among these economic instruments, the use of access fees can have positive effects on enhancing environmental sustainability by reducing the number of visitors. Access fees are also a source of financing the management costs of a protected area. Among the negative impacts of tourism, users of beaches perceive congestion as a factor in reducing the final value of the touristic experience. This article analyses the perception of locals of an access fee to enter the small Canary island of Lobos, a protected natural area with high quality beaches, whose quietness is endangered by an increasing number of visitors, clearly exceeding the current carrying capacity. We approached the problem using different tools: firstly, we looked at visitors’ opinions on the website TripAdvisor to identify whether congestion is perceived as a problem; secondly, we carried out an opinion survey using Likert-type scale questions to capture opinions about crowding and pricing; and finally, we used a discrete choice experiment to estimate the willingness to pay (WTP) for accessing the island and reducing congestion. The results reveal a high degree of perception of congestion and the potential of an entrance fee as an effective tool in reducing that congestion and thus generating resources to cover the maintenance costs of the protected area.
Correlates of adaptive behavior profiles in a large cohort of children with autism: The autism speaks Autism Treatment Network registry data
Authors: Pathak Manina , Bennett Amanda , Shui Amy M
Published: November 2017

Children with autism spectrum disorder have deficits in adaptive functioning. This study examines the adaptive behavior, its association with cognitive ability, gender, age, and symptom severity in children with autism spectrum disorder. Using data from Autism Treatment Network registry, the adaptive behavior profiles were examined in 2538 school-aged children (between 5 and 17 years, mean: 8.8 years, standard deviation: 3.0) who had an overall intelligence quotient and Vineland Adaptive Behavior Scale scores available. The children were grouped according to their intelligence quotient (low intelligence quotient < 70; borderline intelligence quotient = 70–85; average intelligence quotient > 85), age (5–10 and 11–17 years), and gender for the analyses. Significantly lower Vineland Adaptive Behavior Scale scores were found in borderline and average intelligence quotient groups when compared to mean intelligence quotient, while an opposite pattern was seen in the low intelligence quotient group, with better adaptive behavior scores than mean intelligence quotient. Vineland Adaptive Behavior Scale standard scores were positively correlated with intelligence quotient and poorly associated with autism spectrum disorder severity. Younger children had significantly higher Vineland Adaptive Behavior Scale scores. Adjusted comparisons by gender were not significant. Adaptive behavior profiles in the intelligence quotient categories are discussed. This study confirms a positive relationship between adaptive behavior and intellectual function in autism and indicates that children with higher intelligence quotient and older age are specifically impaired, with lower adaptive behavior, highlighting the need for assessment and targeted intervention in these groups. Future directions for research are discussed.
Transnational student associations in the European multi-level governance of higher education policies
Authors: Klemenčič Manja , Galán Palomares Fernando Miguel
Published: November 2017

The article seeks to advance understanding of the involvement of transnational student associations in European governance of higher education policies within the European Union (EU) and the European Higher Education Area (EHEA). Specifically, the article explores the mechanisms for interest intermediation that exist for transnational student associations in both policy arenas. Three transnational student associations stand out in terms of their involvement: European Students’ Union (ESU), Erasmus Student Network (ESN) and European Students’ Forum (AEGEE). The findings point to two distinct models of student interest intermediation in European policy-making. Within the EU, the European Commission interacts with all three transnational student associations; however, ESU and ESN participate in more expert and working groups. The roles afforded to each association in relation to the European Commission are demarcated and functionally differentiated. Within EHEA, in neo-corporatist fashion, ESU, as a representative platform of national student unions, holds representational monopoly. In the EHEA and the EU, the involvement of transnational student associations in policy-making can be attributed to the evolving nature of transnational governance regimes in which participation of transnational student associations not only brings expertise to but also aids the legitimacy of the policy processes and outcomes.
Understanding the motivation and transformation of White culturally responsive professors
Authors: Jenkins China , Alfred Mary
Published: November 2017

The purpose of this study was to examine the motivation for White professors in higher education to become culturally inclusive in their teaching practices and the transformational experiences that created this motivation and shaped their development. The findings revealed personal convictions that centred on moral obligations towards teaching was the primary motivation for the participants, that culturally responsive teaching requires complex consideration in its implementation, and there are a variety of challenges that impact culturally responsive professors. Above all, the participants believed in the moral rightness of their work and felt obligated to teach in a culturally responsive manner.
Child Sexual Abuse: Toward a Conceptual Model and Definition
Authors: Mathews Ben , Collin-Vézina Delphine
Published: November 2017

The problem of defining “child sexual abuse” (CSA), and the need to define this concept, has been recognized by major policy bodies and leading researchers since the 1970s. Recent demands for a more theoretically robust, explicit definition of CSA show this challenge remains urgent. In this article, we identify problems caused by variance in definitions of CSA for five domains: research and knowledge formation, legal frameworks and principles, prevention efforts, policy responses, and the establishment of social norms. We review and analyze definitions used in leading international epidemiological studies, national and international policy documents, social science literature, and legal systems in the United States, Canada, and Australia to demonstrate the continuing use of different concepts of CSA and identify key areas of conceptual disagreement. Informed by our literature review, we use a methodology of conceptual analysis to develop a conceptual model of CSA. The purpose of this model is to propose a more robust, theoretically sound concept of CSA, which clarifies its defining characteristics and distinguishes it from other concepts. Finally, we provide operational examples of the conceptual model to indicate how it would translate to a classificatory framework of typologies of acts and experiences. A sound conceptual model and classificatory system offers the prospect of more appropriate and effective methods of research, response, regulation, and prevention. While total consensus is unattainable, this analysis may assist in developing understanding and advancing more coherent approaches to the conceptual foundation of CSA and its operationalization.
In silico modeling to optimize interpretation of liver safety biomarkers in clinical trials
Authors: Church Rachel J , Watkins Paul B
Published: November 2017

Current strategies to delineate the risk of serious drug-induced liver injury associated with drugs rely on assessment of serum biomarkers that have been utilized for many decades. In particular, serum alanine aminotransferase and total bilirubin levels are typically used to assess hepatic integrity and function, respectively. Parallel measurement of these biomarkers is utilized to identify patients with drug-induced hepatocellular jaundice (“Hy’s Law” cases) which carries at least a 10% risk of death or liver transplant. However, current guidelines regarding use of these biomarkers in clinical trials can put study subjects at risk for life-threatening drug-induced liver injury, or result in over estimation of risk that may halt development of safe drugs. In addition, pharmaceutical companies are increasingly being required to conduct large and expensive clinical trials to “defend” the safety of their new drug when results from smaller trials are inconclusive. Innovative approaches and some novel biomarkers are now being employed to maximize the value of traditional biochemical tests. DILIsym®, a product of the DILIsim Initiative, utilizes serial serum alanine aminotransferase values, along with serum biomarkers of apoptosis vs necrosis, to estimate percent hepatocyte loss and total bilirubin elevations resulting from loss of global liver function. The results from analyses conducted with DILIsym have been reported to the FDA to support the safety of entolimod and cimaglermin alfa after elevations in serum alanine aminotransferase and/or bilirubin halted clinical development. DILIsym can also be utilized to determine whether rises in serum conjugated and unconjugated bilirubin are consistent with mechanisms unrelated to toxicity ( i.e. inhibition of bilirubin transport or metabolism). In silico modeling of traditional and novel drug-induced liver injury biomarker data obtained in clinical trials may be the most efficient and accurate way to define the liver safety profile of new drug candidates.

Impact statement

Blood tests used in clinical trials to detect and monitor drug-induced liver injury (DILI) have not changed in half a century. These tests have several shortcomings: their use has not completely prevented clinical trial participants from risk of life-threatening DILI, they can give false positive results that halt the development of safe drug candidates, and they can create liver safety “concerns” that require large additional clinical trials to accurately define DILI risk. This review highlights the use of in silico modeling to improve interpretation of the blood tests currently available to detect DILI risk in new drug candidates. This approach is increasingly being applied in clinical trials to more precisely assess the degree of hepatocellular injury and its functional impact. This new approach holds the promise of more accurately defining DILI risk in smaller clinical trials.
Radiochemistry and Preclinical PET Imaging of 68Ga-Desferrioxamine Radiotracers Targeting Prostate-Specific Membrane Antigen
Authors: Gourni Eleni , Del Pozzo Luigi , Bartholomä Mark , Kiefer Yvonne , T. Meyer Philipp , Maecke Helmut R. , Holland Jason P.
Published: November 2017

Radiotracers incorporating the urea-based Glu-NH-C(O)-NH-Lys group have gained prominence due to their role in targeting prostate-specific membrane antigen (PSMA)—a clinical biomarker of prostate cancer. Here, the synthesis, radiolabeling, and in vitro and in vivo characterization of two 68Ga-radiolabeled Glu-NH-C(O)-NH-Lys radiotracers conjugated to the desferrioxamine B (DFO) chelate were evaluated. Two linker groups based on amide bond and thiourea coupling chemistries were employed to develop 68Ga-DFO-Nsucc-PSMA (68Ga-4) and 68Ga-DFO- pNCS-Bn-PSMA (68Ga-7), respectively. Radiosynthesis proceeded quantitatively at room temperature with high radiochemical yields, chemical/radiochemical purities, and specific activities. Pharmacokinetic profiles of 68Ga-4 and 68Ga-7 were assessed using positron-emission tomography (PET) in mice bearing subcutaneous LNCaP tumors. Data were compared to the current clinical benchmark radiotracer 68Ga-HBED-CC-PSMA (68Ga-1) (HBED = N,N′-Bis(2-hydroxy-5-(ethylene-beta-carboxy)benzyl)ethylenediamine N,N′-diacetic acid). Results indicated that the target binding affinity, protein association, blood pool and background organ clearance properties, and uptake in PSMA-positive lesions are strongly dependent on the nature of the chelate, the linker, and the spacer groups. Protein dissociation constants ( Kd values) were found to be predictive of pharmacokinetics in vivo. Compared to 68Ga-1, 68Ga-4 and 68Ga-7 resulted in decreased tumor uptake but enhanced blood pool clearance and reduced residence time in the kidney. The study highlights the importance of maximizing protein binding affinity during radiotracer optimization.
The Influence of Carbon Dioxide Pneumoperitoneum on Systemic Inflammatory Response Syndrome and Bacterial Translocation in Patients With Bacterial Peritonitis Caused by Acute Appendicitis
Authors: Peng Huaidu , Zhang Junshuo , Cai Chudong , Fang Xi , Wu Junwei
Published: November 2017

Objective. To explore the influence of carbon dioxide pneumoperitoneum (CDP) on system inflammatory response syndrome (SIRS) and bacterial translocation (BT) in patients with bacterial peritonitis (BP) caused by acute appendicitis (AA). Methods. Eighty-six consecutive subjects were randomly divided into the laparoscopy and laparotomy groups (n = 44 and n = 42, respectively). The levels of white blood cells (WBC), C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and interleukin 6 (IL-6) of the 2 groups were tested preoperatively and at days 1, 2, and 4 after surgery. Blood and secretion culture was performed to verify whether septicemia or incision infection occurred, respectively. And the abdominal ultrasound or computed tomography scanning was used to diagnose peritoneal abscess for the suspected patients. The essential risk factors related to the aggravation of SIRS were analyzed through analysis of variance and binary logistic regression. Results. The postoperative blood levels of WBC, CRP, TNF-α, and IL-6 on day 4 in the laparoscopy group were significantly lower than those in the control group (all Ps < .05). The differences in incidence rates of septicemia and peritoneal abscess between the CDP and control groups were not statistically significant ( P > .05). Nevertheless, the incision infection rate in the laparoscopy group was apparently lower than that in the control group (4.55% vs 19.04%, P = .047). Analysis of variance and binary logistic regression showed that the non-pneumoperitoneum, pathological type of appendicitis, and multidrug resistant infections were the 3 major risk factors for SIRS (the P values were .001, .019, and .012, respectively). Conclusion. It was found that CDP is safe for BP and could be a potential protective factor to mitigate BP effectively, indicating that the performance of laparoscopy operation under CDP is feasible to control SIRS; at the same time, CDP would not raise the incidence rate of BT.
Perspectives on Automotive Automation and Autonomy
Authors: Lee John D.
Published: November 2017

As automation becomes more capable, the need to craft designs compatible with people becomes more important. This is particularly true with increasingly autonomous vehicles, which have begun to change what it means to drive. Kaber (2018) argues that the levels-of-automation framework provides a useful perspective to guide design, but he acknowledges that others, such as Dekker and Woods (2002), have argued otherwise. The levels-of-automation perspective addresses an essential issue of “who does what,” and the Dekker-Woods perspective addresses an equally important issue of how to coordinate automation and people: “how to work together.” Kaber argues for greater precision in describing human behavior as it relates to automation, but this commentary argues for greater precision in describing automation as it relates to people. This paper describes a perspective that received little attention in Kaber’s review: automation elements as part of a network, addressing the issue of “what’s connected.” Applying this perspective to the challenge of increasingly autonomous vehicles shows that considering several perspectives may be more effective than fine-tuning the single perspective of “who does what.”
The Impact of isolation on new principals’ persistence: Evidence from a southern US state
Authors: Bauer Scott C , Silver Lori , Schwartzer Jessica
Published: November 2017

Isolation has affected the quality of the work experience for employees in education for decades. This study explores the role that isolation plays in impacting the quality of the work experience among new principals. Building on recent studies, the analysis tests whether isolation serves as a mediator in the relationship between factors that are known to affect the work experience of principals (social support; role ambiguity, role overload; administrative experience; and participation in a structured coaching relationship), as independent variables, and persistence of new principals. We find some support for this mediating effect, and support for the role of isolation as a predictor of persistence.
Relationship between demographic variables and collegiate athletes’ perceptions of social support from head coaches
Authors: Newman Nathan D , Weiss Windee M
Published: November 2017

Previous research has demonstrated the importance of social support during the rehabilitation of an injury. In particular, athletes view coaches as a primary source of social support. However, coaches have been an inconsistent or insufficient source of social support. Certain demographic variables may be related to differences in perceived social support from coaches. The purpose of this study was to describe injured collegiate athletes’ perceptions of social support and explore whether differences in perceived social support from coaches existed due to contextual or situational factors. A survey on perceived social support from coaches was completed by athletes ( n = 246) at five NCAA institutions. Results support previous findings that injured athletes perceive coaches as sources of moderate to high amounts of social support. Additionally, significant differences emerged in perceived social support based on the level of competition and type of sport. These results reaffirm the role head coaches play in the rehabilitation of injured athletes. Understanding variables that influence how an athlete perceives social support from a coach could improve rehabilitation outcomes.
The relationship of race discipline with overall performance in sprint and standard distance triathlon age-group world championships
Authors: Horne Mark J
Published: November 2017

The study analysed data of 25 - to 29-year-old athletes from the 2015 International Triathlon Union Age-group World Championship. Four separate draft-illegal races were analysed (male standard, male sprint, female standard and female sprint). The correlation of individual race disciplines with overall finish time, and the variance accounted for by each discipline was considered. Running had the strongest relationship with finishing time in standard racing. Cycling had the strongest relationship in sprint racing. There were no gender differences in correlations or in the greatest predictors of performance. It was concluded that the importance of running in predicting triathlon performance seen in previous research on standard distance racing is not due to the legality of drafting in the cycle discipline.
Sleep at the helm: A case study of how a head coach sleeps compared to his team
Authors: Lastella M , Roach GD , Halson SL , Gore CJ , Garvican-Lewis LA , Sargent C
Published: November 2017

In recent years, research examining the sleep of elite athletes has increased. This is predominantly due to the importance sleep has on an athlete’s psychological and physiological well-being. Despite the growing importance of sleep in athletes, the amount and quality of sleep coaches obtain has been neglected. The aim of this study was to examine the sleep of a head coach and compare it to his team. The sleep of 16 members of the Australian U/20 men’s football team (age 18.8 ± 0.9 years) and the head coach (age 55 years) was monitored using wrist activity monitors and self-report sleep diaries. Sleep was examined for 15 nights in preparation for the 2011 U/20 FIFA World Cup. The head coach went to bed earlier (23:30 h ± 65 min vs. 23:36 h ± 30 min), spent less time in bed (8.4 ± 1.3 h vs. 8.6 ± 1.0 h), obtained less sleep per night (6.4 ± 1.5 h vs. 6.6 ± 0.8 h), and woke up earlier (07:54 h ± 46 min vs. 08:12 h ± 52 min) than his team. In general, the head coach obtained less sleep than his team and slept considerably poorer the night before important games. Future investigations need to examine the extent to which sleep impairs psychological state, decision-making and overall coaching performance.
Athlete and coach agreement: Identifying successful performance
Authors: Millar Sarah-Kate , Oldham Anthony RH , Renshaw Ian , Hopkins Will G
Published: November 2017

Traditional coaching views the coach as an informed resource and the athlete as a reflection of expert knowledge. Recent approaches have criticised a strictly coach driven model of expertise, and in doing so have acknowledged the unique and developing knowledge of athletes, which emerges from extended practice. The growth of the athlete’s contribution in the coach–athlete dyad invites interesting questions about the usefulness of athlete knowledge and the changing role of the coach. Athlete–coach agreement was assessed via a triangulation of quantitative boat speed data from a single sculler and matched to phases of successful rowing that rowers and coaches both agreed on. Coach and rower were able to identify when the boat was travelling its fastest or slowest. However, when the performance was marginally faster or slower, they disagreed, and generally the rowers were more accurate about the performance than their coach. Implications for contemporary coaching practices are considered.
The learning pathways of Brazilian surf coach developers
Authors: Brasil Vinicius Z , Ramos Valmor , Milistetd Michel , Culver Diane M , do Nascimento Juarez V
Published: November 2017

The purpose of this study was to explore the learning pathways of five Brazilian surf coach developers, in order to understand how they became coach developers. A case study was conducted with five surf coach developers working in the sport participation context, and linked to a legally organized Brazilian surf federation. Three main research topics guided the semi-structured interviews: participants’ experiences as a surfer, as a surf coach, and as a coach developer. Data were analyzed using thematic analysis to explore the participants’ perceptions of the experiences around becoming a surf coach developer. The study revealed a pattern of formative experiences for the participants, across their lives and careers. Their experiences as a surfer and as a surf coach, as well as their exposure to the surfing environment and their contact with significant others, influenced in their engagement in surfing and in the surf coach context; leading them eventually to the desire to share knowledge with others. Becoming a surf coach developer in this study corresponded to a mutual socialization process across a lifetime. This process was marked by situated socio-cultural aspects of different life phases, strongly influenced by the social relations established in immediate contexts (family) and with other specific groups (surfers, coaches, and developers).
Technology-embedded health education on nutrition for middle-aged and older adults living in the community
Authors: Chiu Ching-Ju , Kuo Su-E , Lin Dai-Chan
Published: November 2017

Mobile technology provides young adults important support for self-directed learning, but whether there is related support for older adults is not clear. This study aims to determine whether 1) nutrition education combined with mobile technology-supported teaching improves knowledge of and self-efficacy for a healthy diet; 2) if adults who reported reviewing the electronic course material or searching health information online, showed significantly greater progress in knowledge of and self-efficacy for a healthy diet than did those who did not adopt the electronic support. A total of 35 middle-aged and older adults were recruited from the community. Enrollees who were unable to read, who participated in the course fewer than five times, who did not take the post-test, or who did not return complete questionnaires at the pre-test were excluded. Overall, 21 participants were finally analyzed, and 14 participated in the qualitative investigation. The study interventions included three traditional nutrition lectures and three touch-screen tablet computer lessons to access the Internet and nutrition applications. Structured and semi-structured questionnaires were used to collect both quantitative and qualitative data and record participants’ Internet use conditions at home. Participants’ nutrition knowledge significantly improved (meanpost-pre = 1.19, p = 0.001) and their self-efficacy about a healthy diet showed marginal improvement (meanpost-pre = 0.22, p = 0.07). Nutrition knowledge was positively correlated with their intensity of surfing the Internet ( r = 0.46, p < 0.05), or reviewing the electronic course material ( r = 0.48, p < 0.05) but not correlated with reviewing paper course material ( r = 0.19, p = 0.09). Qualitative results showed that participants reported feeling freshness, joyfulness, and great achievement because of the combined course material. Technology-supported learning combined with traditional health education might provide great opportunities for positive behavioral change, even in older adults without any previous Internet experience.
Role of therapeutic plasma exchange in the treatment of severe hypertriglyceridemia: an experience
Authors: Wassay Shaikh Ahmed Muntajib , Dar Farhan Javed , Saleh Asem K. , Mansoor Ibrahim
Published: November 2017

Hypertriglyceridemia of obesity, the metabolic syndrome, and type II diabetes mellitus are highly prevalent in Saudi Arabia. Severe hypertriglyceridemia is a rare but well known cause of acute pancreatitis. In treatment pancreatic rest, lifestyle changes, and lipid-lowering medications are essential, but the response is slow. Recently the role of therapeutic plasma exchange (TPE) has been stressed for fast and effective management in addition to insulin and heparin infusion. TPE for hypertriglyceridemic pancreatitis resulted in drastic improvements in clinical and laboratory findings and patient outcomes as suggested in our cases. However, this procedure is limited due to its high cost and availability only in specialized hospitals.
First‐in‐child use of the oral soluble guanylate cyclase stimulator riociguat in pulmonary arterial hypertension
Authors: Spreemann Till , Bertram Harald , Happel Christoph M. , Kozlik‐Feldmann Rainer , Hansmann Georg
Published: November 2017

Riociguat has been approved for use in adults with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension. No clinical data on its therapeutic use in children with PAH are currently available. We report the case of a now four‐year‐old boy who initially presented at the age of 10 months with suprasystemic pulmonary hypertension (PH) and right ventricular (RV) failure, vomiting, peripheral cyanosis, and failure to thrive. Cardiac catheterization revealed severe PAH. At radiologic suspicion of interstitial lung disease, repeated CT scan and an open lung biopsy were performed but could not clarify the entity of PAH. Given the demonstrated vasoreactivity, the boy was started on the calcium channel blocker amlodipine, in combination with the endothelin‐1 receptor antagonist bosentan. Two years later, based on persistently systemic PAH with lost vasoreactivity, PAH therapy was changed to bosentan and phosphodiesterase‐5 inhibitor sildenafil. No significant improvement on the aforementioned therapy was seen, so that the patient was referred to our institution. Invasive hemodynamic evaluation showed suprasystemic PAH and marked acute vasoreactivity (PAP 127/103/83 mmHg, PVRi 23.48 WU·m2 and PVR/SVR ratio 1.59 at baseline vs. PVRi 5.89 WU·m2 and PVR/SVR ratio 0.93 under O2/NO). Subsequently, we switched the patient from sildenafil to riociguat. After six months on bosentan/riociguat, the patient showed a marked decrease in PVR/SVR and transpulmonary pressure gradients, in RV hypertrophy, PA acceleration time, and left ventricular‐eccentricity index. Clinically, the patient improved in pediatric functional class from 2/3 to 1. In conclusion, off‐label use of oral riociguat may be considered in selected children with severe PAH.
Endothelial stem and progenitor cells (stem cells): (2017 Grover Conference Series)
Authors: Yoder Mervin C.
Published: November 2017

The capacity of existing blood vessels to give rise to new blood vessels via endothelial cell sprouting is called angiogenesis and is a well‐studied biologic process. In contrast, little is known about the mechanisms for endothelial cell replacement or regeneration within established blood vessels. Since clear definitions exist for identifying cells with stem and progenitor cell properties in many tissues and organs of the body, several groups have begun to accumulate evidence that endothelial stem and progenitor cells exist within the endothelial intima of existing blood vessels. This paper will review stem and progenitor cell definitions and highlight several recent papers purporting to have identified resident vascular endothelial stem and progenitor cells.
Listening to and letting pain speak: poetic reflections
Authors: Hovey Richard B , Khayat Valerie Curro , Feig Eugene
Published: November 2017

The humanities invite opportunities for people to describe through their metaphors, symbols and language a means in which to interpret their pain and reinterpret their new lived experiences. The patient and family all live with pain and can only use their pain narratives of that experience to confront or even to begin to understand the quantifiable discipline of medicine. The patient and family narratives act to retain meaning within a lived pained experience. These narratives add meaning to the person as a stay against only having a clinical–pathological understanding of what is happening to our body and as a person. We need to understand the pathology pain while also being mindful of suffering. In this article, the theoretical and scientific approach to pain research and clinical practice intersects with the philosophical, ontological and reflective lived experience of the person living with pain. Through unique pain narratives, poetry and stories as a means of offering empathy and understanding as healing, the humanities in medicine bring into meaning another kind of therapy equal to the evidence-based medicine clinicians and researchers use to seek a cure. In this way, the medical humanities are addressing the person’s healing through the reduction of suffering and isolation by letting pain speak while others can focus in on their medical knowledge/practice and research while ‘finding’ a cure. Listening to pain opens-up to the possibility that much can be learned through multiple expressions of the pain narrative. This article provides an invitation to learn how we might articulate and listen to pain carefully and differently.