bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Language Determine Our World’s Borders? The Deaf Beyond the Pale
Authors: Szpilman Magdalena 
Published: December 2019

Does Language Determine Our World’s Borders? The Deaf Beyond the PaleThe limits of our language are the limits of our worldLudwig Wittgenstein“If not in words, how did she organize her thoughts?,” asks contemporary American writer André Aciman thinking of his deaf mother. In other words, how did she organize her world – one could ask, since even if not consciously, it is often assumed that “the limits of our language are the limits of our world.” Taking Ludwig Wittgenstein’s well-known dictum as a starting point, I would like to present an interdisciplinary approach to the subject, set on the border of comparative literature, linguistics, and medicine. In my paper, using the works of Plato (Cratylus), Denis Diderot (Paradox of Acting), Étienne Bonnot de Condillac (Philosophical Writings of Etienne Bonnot Abbé de Condillac), Oliver Sacks (Seeing Voices: A Journey into the World of the Deaf), and others, I focus on how people perceive the borders (limits) of our world through the prism of language. Is language just a prosthesis, a grafted limb one can live without? Do hands speak more intimately than words? Or maybe deafness is more of a disability than blindness? Is hearing essential for creating memory, allowing comparison, judgment and association of ideas? From a medical point of view, it is impossible to develop speech without hearing. So how does not hearing and therefore not speaking limit our world? Does it at all? Czy język określa granice naszego świata? Głusi poza nawiasemGranice naszego języka są granicami naszego świata.(Ludwig Wittgenstein)Jeśli nie w słowach, jak organizowała swoje myśli? – pyta współczesny amerykański pisarz André Acimana w eseju o swoje głuchej matce. Innymi słowy, można zapytać - jak organizowała swój świat - bo nawet nieświadomie wierzymy, że: granice naszego języka są granicami naszego świata. Biorąc za punkt wyjścia słynne powiedzenie Ludwiga Wittgensteina oraz wykorzystując dzieła Platona (Kratylos), Denisa Diderota (Paradoks o aktorze), Étienne’a Bonnota de Condillaca (Traktat o wrażeniach zmysłowych), Olivera Sacksa (Zobaczyć głos) i innych, analizuję postrzeganie granic świata przez pryzmat języka, w ujęciu interdyscyplinarnym, z pogranicza literatury porównawczej, językoznawstwa i medycyny. Czy język to tylko proteza, bez której można żyć? Czy ręce mówią dokładniej niż słowa? A może bycie głuchym to niepełnosprawność znacznie bardziej ograniczająca niż bycie niewidomym? Czy słyszenie jest naprawdę ważne, ponieważ odgrywa kluczową rolę w tworzeniu pamięci, umożliwiając porównywanie, ocenianie i tworzenie skojarzeń? Słyszenie, z medycznego punktu widzenia, jest niezbędne do wykształcenia mowy. Jak zatem niesłyszenie, a zatem niemówienie ogranicza nasz świat? Czy ogranicza?
Monte Carlo–Based Quantification of Uncertainties in Determining Ocean Remote Sensing Reflectance from Underwater Fixed-Depth Radiometry Measurements
Authors: Białek Agnieszka , Vellucci Vincenzo , Gentil Bernard , Antoine David , Gorroño Javier , Fox Nigel , Underwood Craig 
Published: December 2019

AbstractA new framework that enables evaluation of the in situ ocean color radiometry measurement uncertainty is presented. The study was conducted on the multispectral data from a permanent mooring deployed in clear open ocean water. The uncertainty is evaluated for each component of the measurement equation and data processing step that leads to deriving the remote sensing reflectance. The Monte Carlo method was selected to handle the data complexity such as correlation and nonlinearity in an efficient manner. The results are presented for a prescreened dataset that is suitable for system vicarious calibration applications. The framework provides uncertainty value per measurement taking into consideration environmental conditions present during acquisition. A summary value is calculated from the statistics of the individual uncertainties per each spectral channel. This summary value is below 4% (k = 1) for the blue and green spectral range. For the red spectral channels, the summary uncertainty value increases to approximately 5%. The presented method helps to understand the significance of various uncertainty components and to provide a way of identifying major contributors. This can be used for efficient system performance improvement in the future.
Neighborhood- and Object-Based Probabilistic Verification of the OU MAP Ensemble Forecasts during 2017 and 2018 Hazardous Weather Testbeds
Authors: Johnson Aaron , Wang Xuguang , Wang Yongming , Reinhart Anthony , Clark Adam J. , Jirak Israel L. 
Published: December 2019

Abstract
An object-based probabilistic (OBPROB) forecasting framework is developed and applied, together with a more traditional neighborhood-based framework, to convection-permitting ensemble forecasts produced by the University of Oklahoma (OU) Multiscale data Assimilation and Predictability (MAP) laboratory during the 2017 and 2018 NOAA Hazardous Weather Testbed Spring Forecasting Experiments. Case studies from 2017 are used for parameter tuning and demonstration of methodology, while the 2018 ensemble forecasts are systematically verified. The 2017 case study demonstrates that the OBPROB forecast product can provide a unique tool to operational forecasters that includes convective-scale details such as storm mode and morphology, which are typically lost in neighborhood-based methods, while also providing quantitative ensemble probabilistic guidance about those details in a more easily interpretable format than the more commonly used paintball plots. The case study also demonstrates that objective verification metrics reveal different relative performance of the ensemble at different forecast lead times depending on the verification framework (i.e., object versus neighborhood) because of the different features emphasized by object- and neighborhood-based evaluations. Both frameworks are then used for a systematic evaluation of 26 forecasts from the spring of 2018. The OBPROB forecast verification as configured in this study shows less sensitivity to forecast lead time than the neighborhood forecasts. Both frameworks indicate a need for probabilistic calibration to improve ensemble reliability. However, lower ensemble discrimination for OBPROB than the neighborhood-based forecasts is also noted.
Pediatric Drug Induced Sleep Endoscopy: A Simple Sedation Recipe
Authors: Adler Adam C. , Musso Mary F. , Mehta Deepak K. , Chandrakantan Arvind 
Published: December 2019

Objective: To describe a minimalist approach to sedating children for DISE procedures. Methods: We searched existing literature and derived and tested our algorithm on patients using evidence-based studies. Results: We were able to successfully sedate, without airway intervention, 15 highly complex children with a variety of comorbidities for DISE procedures. Conclusion: We describe a minimalistic sedation approach for DISE procedures in highly complex children. Further studies are required to compare this regimen to natural sleep states.
An eHealth Program for Parents of Adolescents With T1DM Improves Parenting Stress: A Randomized Control Trial
Authors: Whittemore Robin , Coleman Julia , Delvy Roberta , Zincavage Rebekah , Ambrosoli James A. , Shi Ling , Kato Bernet , Marceau Lisa 
Published: December 2019

Purpose The purpose of this study was to evaluate the short-term effects of the Type 1 Teamwork program for parents of adolescents with type 1 diabetes mellitus (T1DM) on the primary outcome of psychosocial stress. Methods The study was a randomized wait-list control trial evaluating an eHealth program to reduce parenting stress around T1DM management during adolescence through interactive sessions on the safe transfer of responsibility, positive communication, and stress management. The primary outcome was psychosocial stress (parenting stress specific to child illness and general stress). Secondary outcomes included depressive and anxiety symptoms, parent support for adolescent autonomy, family conflict, and adolescent metabolic control (A1C). Data were collected at baseline, 3 months, and 6 months online. Mixed-model analyses were conducted, using intent-to-treat procedures. Results Parents (n = 162) had a mean age of 45.6 (±5.3) years, were 98% female, 91% white, 91% married/partnered, 51% of high income, and geographically dispersed around the United States. Parents reported that adolescents had a mean A1C of 7.9% (±1.2%) and T1DM duration of 5.08 (±3.62) years. At 6 months, parents in the Type 1 Teamwork group demonstrated less parenting stress compared with the control group. There were no differences between groups on general stress or secondary outcomes. Attrition at 6 months was 32% in the treatment group and 11% in the control group. Conclusions An eHealth program for parents of adolescents with T1DM improves parenting stress in a sample of parents from across the United States.
The TRIPS Agreement and the Pharmaceutical Industry in India
Authors: Kamiike Atsuko 
Published: December 2019

The World Trade Organization’s (WTO’s) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) calls for the harmonization of intellectual property rights (IPRs) regulations across all WTO member countries. The TRIPS Agreement requires all WTO member countries to adopt and enforce minimum standards of intellectual property. It was assumed that the introduction of pharmaceutical product patents would hamper the Indian pharmaceutical industry’s growth. Contrary to expectations, however, the Indian pharmaceutical industry has been growing in the post-TRIPS period. The TRIPS Agreement changed the research and development (R&D) orientation of Indian pharmaceutical companies, which have increased their R&D investments. Since the TRIPS Agreement was signed, the pharmaceutical global value chain (GVC) has been re-structured and has now expanded to emerging countries like India. Indian pharmaceutical firms have thus been participating in the pharmaceutical GVC in the post-TRIPS period. This participation is conducive to technological upgrading and technology transfers. While operating in the GVC, Indian pharmaceutical firms are upgrading by adopting state-of-the-art technologies. This study explores how the TRIPS Agreement is influencing the Indian pharmaceutical industry and discusses the industry’s growth factors in the post-TRIPS period within the GVC framework. JEL: L21, L24, L26, L65
Effects of insoles adapted in flip-flop sandals in people with plantar fasciopathy: a randomized, double-blind clinical, controlled study
Authors: Costa Ana Rafaella Araújo , de Almeida Silva Hugo Jário , Mendes André Augusto Martines Teixeira , Scattone Silva Rodrigo , de Almeida Lins Caio Alano , de Souza Marcelo Cardoso 
Published: December 2019

Objective: To evaluate the effects of insoles adapted into flip-flop sandals on pain and function in individuals with plantar fasciopathy (PF). Design: Randomized, double-blind controlled study. Setting: Physiotherapy clinic of the Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil. Subjects: Sixty-six patients of both genders with PF were randomized into two groups: sandal insole group (SI; n = 34), which received a pair of custom flip-flop sandals with insoles covered with smooth synthetic leather; and plain sandal group (PS; n = 32), which received an identical pair of flip-flop sandals, but without the insoles. Interventions: Patients were instructed to wear the flip-flops for 12 weeks for at least 4 hours/day. Main measures: Pain (visual analogue scale—VAS) in the morning and at the end of the day were considered primary outcomes. Function (Foot Function Index—FFI and Foot and Ankle Ability Measure—FAAM) and functional capacity (6-minute walk test—6MWT) were considered secondary outcomes. The outcomes were evaluated at baseline and immediately after the intervention by a blind assessor. Results: Between-group differences were observed in terms of morning pain (mean difference (MD) = –1.82 cm; 95% confidence interval (CI) = –3.3 to −0.3; P = 0.016) and function (MD = –0.10; 95% CI = –0.19 to −0.01; P = 0.023) after the interventions with the SI group showing superior improvements in comparison to the PS group. Conclusion: The use of insoles adapted in flip-flop sandals for 12 weeks was effective at improving pain and function in individuals with PF. Level of evidence: 1b.
Development of an energy management education program (“the PEP program”) for adults with end-stage renal disease
Authors: Farragher Janine F , Jassal Sarbjit V , McEwen Sara , Polatajko Helene J 
Published: December 2019

Introduction Fatigue is a highly common symptom of end-stage renal disease, interferes with occupational engagement, and is a top research priority of patients. The objective of this project was to develop an energy management education program that would meet the needs of people with end-stage renal disease and to conduct a preliminary evaluation of the acceptability and usability of the program. Methods We used the World Health Organization’s health education planning framework to guide the intervention development process. We systematically assessed the needs of people with end-stage renal disease related to energy management education, and transformed them into program objectives. Based on these findings, we designed a program that would (a) improve occupational engagement in people with end-stage renal disease; (b) be feasible; and (c) build on existing energy management education and health education literature. Finally, we conducted qualitative interviews about the program with four key informants and conducted usability testing with five target end-users. Findings: The Personal Energy Planning program combines an established problem-solving approach with three brief web modules on energy management. Preliminary testing suggested the program was acceptable to stakeholders and was usable by the target population. Conclusions Future research should explore the effects of the program on fatigue and occupational engagement in people with end-stage renal disease.
Comprehensive Migraine Initiative in the Pediatric Emergency Department Improves Treatment Outcomes
Authors: Skora Clare E. , Worden Lila T. , Oakley Chris B. 
Published: December 2019

Objective: To compare pediatric migraine treatment efficacy in the emergency department before and after the implementation of a comprehensive migraine initiative, consisting of a standardized treatment protocol, provider educational series and standardized physician documentation template. Background: Pediatric migraine is common, accounting for 1% of pediatric emergency department visits. Yet there is large variability in treatment practices, with few studies looking into measures of both clinical effectiveness and timeliness of treatment following implementation of standardized protocols. Methods: A single-center retrospective chart review of pediatric patients presenting to the emergency department with migraine before and after implementation of an institutional headache initiative designed to more effectively and efficiently deliver care to pediatric migraine patients. Results: The study yielded 110 patients each in the intervention and preintervention groups. There were no significant differences in patient characteristics with respect to age, gender, or initial pain score. Compared with the preintervention group, the intervention group demonstrated a significant reduction in headache pain score prior to discharge (decrease of 5.9 vs 4.8 in preintervention group, P value .006) with a greater percentage of patients achieving ≥50% reduction in pain (82% vs 67% in preintervention group, P value .039). Additionally, we found a significantly decreased time to treatment in the intervention group compared with the preintervention group (1.8 vs 2.1 hours, P value .046). Conclusion: Through the use of a standardized treatment protocol, improved provider education, and ease of documentation, this comprehensive migraine initiative improved efficacy and efficiency of migraine treatment in the pediatric emergency department.
Eliminating the Surprise Question Leaves Home Care Providers With Few Options for Identifying Mortality Risk
Authors: Sullivan Suzanne S. , Casucci Sabrina , Li Chin-Shang 
Published: December 2019

Background: Precision health initiatives for end-of-life planning require robust methods for identifying patient risk for decline and mortality. The Outcome and Assessment Information Set (OASIS) surprise question (SQ; M1034 Overall Status) is the primary tool for evaluating risks in homebound older adults. However, the OASIS-D, Released in 2019, eliminates this question. This study examines the prognostic ability of 12- and 24-month mortality risk reflected in the OASIS-SQ and develops an alternative approach for classifying mortality risk to support decision-making in the absence of the OASIS-SQ. Design: Retrospective secondary data analysis. Setting/Participants: A nationally representative sample of 69 097 OASIS-C assessments (2012) linked to the Master Beneficiary Summary file (2012 and 2013). Measurements: Survival analysis, k-means clustering, and Cohen κ coefficient with Z test. Results: The OASIS-SQ predicts mortality (35% at 12 and 45% at 24 months; P < .001). Cluster analysis identified 2 risk groups: OASIS activity of daily living “ADL total scores” >15 = (lower risk) and ≤15 = (higher risk) for 24-month mortality. Model agreement is weak for both cluster 1 and cluster 2, the OASIS-SQ κ = 0.20, 95% confidence interval (CI) = .19 to .21, and “alive/not alive” κ = .17, 95% CI = .16 to .18. Conclusion: The OASIS-SQ and “ADL total score” are almost equally likely to predict 24-month mortality; therefore, it was reasonable to use the “ADL total score” as a substitute for the OASIS-SQ. Removal of the OASIS-SQ leaves home care providers with few clear options for risk screening resulting in missed opportunities to refer to palliative or hospice services.
Clinical outcomes of 28 cats 12–24 months after urethrostomy
Authors: Sousa-Filho Reginaldo P , Nunes-Pinheiro Diana CS , Sampaio Keytyanne O , da Silva Ellen CB , Cavalcanti Grazielle ASA , Mori da Cunha Marina Gabriela MC 
Published: December 2019

Objectives The aim of this study was to evaluate and compare the long-term clinical outcomes and quality of life of cats having undergone perineal urethrostomy (PU) or prepubic urethrostomy (PPU). Methods This clinical study followed 28 cats (PU, n = 22; PPU, n = 6) that underwent a urethrostomy, with a minimum of 1 year postoperative follow-up. Medical records, pet owner surveys and urologic laboratory tests were used for assessment. Urologic laboratory tests included serum symmetric dimethylarginine (SDMA), serum creatinine, urinalysis, urine specific gravity (USG), urine protein:creatinine (UPC) ratio and urine culture. Results The main indications for urethrostomy were multiple catheterizations and PU stricture. The overall complication rates of PU and PPU were 31.8% and 83.3%, respectively. Recurrent urinary tract infection (UTI) and urine scald dermatitis were less frequent in PU than in PPU cats (UTI 22.7% vs 66.6%; dermatitis 4.5% vs 83.3%). Bacteriuria was present in 77.2% and 100% of PU and PPU cats, respectively. Owner satisfaction rates were excellent in 81.8% of PU and 33.3% of PPU cases. Conclusions and relevance A proportion of cats that underwent urethrostomy showed bacteriuria, recurrent UTIs and increased levels of SDMA. PPU is important as a salvage procedure; however, it should be limited to cases in which standard techniques for PU cannot be performed, owing to the potential for recurrent complications and lower owner satisfaction.
Assessment of Shave Removal Without Further Excision in the Treatment of Spitz Nevi: A Retrospective Study of 58 Cases
Authors: Nawrocki Shiri , Mikhail Nagy , Ghotb Sara , Maghari Amin 
Published: December 2019

Background Spitz nevi (or tumors) are noncancerous growths that are found particularly in the pediatric population. Their histologic features overlap with melanoma, but they have a favorable prognosis, even when showing atypical features. Objectives The aim of this research is to examine whether Spitz nevi can be sufficiently removed by adequate shave excisions without a subsequent excision. Methods Melan-A stained shave removal specimens (SRS) were obtained for 58 consecutively diagnosed Spitz nevi, along with slides of their postshave excision specimens. The SRS were reviewed for negative (clear) margins, defined as no neoplastic melanocytes detected within <0.2 mm of the deep and lateral margins of the specimen. Postshave excision specimens were reviewed for residual or recurrent lesions. Results The 15 shave excision specimens with negative margins had no corresponding residual lesions on postshave specimens. There were no recurrences in any of the cases in an average of 17 months of follow-up. Conclusions Observation may be a logical approach for the management of Spitz nevi when shave removal achieves clear margins and the lesion lacks atypical features.
Determining when a hospital admission of an older person can be avoided in a subacute setting: a systematic review and concept analysis
Authors: Huntley Alyson L , Davies Ben , Jones Nigel , Rooney James , Goyder Peter , Purdy Sarah , Baxter Helen 
Published: December 2019

Objective To conduct a systematic review of the evidence for when a hospital admission for an older person can be avoided in subacute settings. We examined the definition of admission avoidance and the evidence for the factors that are required to avoid admission to hospital in this setting. Methods Using defined PICOD criteria, we conducted searches in three databases (Medline, Embase and Cinahl) from January 2006 to February 2018. References were screened by title and abstract followed by full paper screening by two reviewers. Additional studies were searched from the grey literature, experts in the field and forward and backward referencing. Data were narratively described, and concept analysis was used to investigate the definition of admission avoidance. Results A total of 17 studies were considered eligible for review; eight provided a definition of admission avoidance and 10 described admission avoidance criteria. We identified three factors which play a key role in admission avoidance in the subacute setting: (1) ambulatory care sensitive conditions and common medical scenarios for the older person, which included respiratory infections or pneumonia, urinary tract infections and catheter care, dehydration and associated symptoms, falls and behavioural management, and managing ongoing chronic conditions; (2) criteria/tools, referring to interventions that have used clinical expertise in conjunction with a range of general and geriatric triage tools; in condition-specific interventions, the decision whether to admit or not was based on level of risk determined by defined clinical tools; and (3) personnel and resources, referring to the need for experts to make the initial decision to avoid an admission. Supervision by nurses or physicians was still needed at subacute level, requiring resources such as short-stay beds, intravenous antibiotic treatment or fluids for rehydration and rapid access to laboratory tests. Conclusion The review identified a set of criteria for ambulatory care sensitive conditions and common medical scenarios for the older person that can be treated in the subacute setting with appropriate tools and resources. This information can help commissioners and care providers to take on these important elements and deliver them in a locally designed way.