bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mobility Norms in Free Trade Agreements
Authors: Jurje Flavia , Lavenex Sandra 
Published: June 2018

Abstract
Notwithstanding their traditional attachment to sovereignty, Southeast and East Asian countries have embraced a dynamic agenda of labour mobility liberalisation through trade agreements. This article assesses the free movement agenda within ASEAN from a multi-level perspective, comparing it to ASEAN countries’ corresponding commitments within the World Trade Organisation’s General Agreement on Trade in Services and Free Trade Agreements (FTAs) concluded as a group or individually with non-ASEAN countries. Contrary to other trade aspects it turns out that intra-regional commitments within ASEAN do not significantly exceed multilateral ones, and score below the level of liberalisation achieved in ASEAN+ and bilateral FTAs. This article interprets this discrepancy as a consequence of strong economic and labour market differences among ASEAN members as well as the lower sensitivity of allegedly technocratic FTAs for considerations of national sovereignty. The article concludes with the limits of this trade policy approach for migration governance and migrants’ rights.
Challenging State Sovereignty in the Age of Migration
Authors: Piper Nicola , Rother Stefan , Rüland Jürgen 
Published: June 2018

Abstract
This two-part Special Issue has examined the migration–sovereignty nexus in the context of intra-regional migration in Asia, with specific focus on Southeast Asia (‘Special Issue’). The sub-region represents the perfect laboratory for teasing out the complexities involved in (actual and rhetorical) attempts made by states to control and regulate migration in what has become a space characterised by increasing diversity of (collective and individual) actors operating at various levels. The diversity, complexity and breadth of migratory movements discussed in this Special Issue thus constitute one of the policy fields where the sovereignty norm clashes with the need to manage interdependence. The seven empirical studies in this Special Issue have examined current political, economic, social and legal dimensions of migration in Southeast Asia from an interdisciplinary perspective, linking the discussion of the migration–sovereignty nexus to ‘regional migration regimes’, ‘the transnational–national intersection’ and ‘grass-roots responses’. The common message that emerges from the papers in this issue—that state sovereignty in the area of migration is being challenged from multiple levels—leads us to argue for a future research agenda which would align the study of sovereignty more closely with governance studies as well as studies on norm diffusion. Such an agenda would contribute new insights into emerging forms of sovereignty beyond the confines of the state.
Pursuing Transformation: Healing, Deliverance, and Discourses of Development among Catholics in Uganda
Authors: Fitchett Climenhaga Alison 
Published: June 2018

AbstractThis article considers how Catholics in Uganda engage with and respond to charismatic healing ministries, arguing that controversies over faith healing and deliverance ministries afford a privileged glimpse into how different actors understand how the church is called to effect specific forms of transformation in individuals and the societies they inhabit. Approaches to healing are multiple and contested, with local Catholics disagreeing about which methods of dealing with affliction are acceptable. While some understand biomedical treatment and healing prayer as competing alternatives – interpreting healing prayer as a threat to development initiatives and mature Christian discipleship – others understand them as complementary avenues of addressing affliction. Close analysis of how rural Catholics approach healing highlights the diversity of practice within the Catholic tradition, and the potential for different approaches to religious transformation to cause friction within parish communities.
The Imamate in Early Ismaili Doctrine
Authors: Madelung Wilferd 
Published: June 2018

AbstractThis paper analyses the theorisation of the Imamate in Ismaili thought before and during the Fatimid period, drawing on Ismaili and Druze sources. It outlines early Ismaili interpretations of the doctrine of historical cycles of seven imams and the culmination of these cycles in the Mahdi/Qāʾim, and it traces the evolution of this doctrine under the Fatimids as well as among the eastern Ismailis, with attention to issues such as the genealogies of the first Fatimids, adherence to the law, and the role of the Mahdi or Qāʾim.
Clinical Predictors of Pediatric Obstructive Sleep Apnea Syndrome
Authors: Lai Chi-Chih , Lin Pei-Wen , Lin Hsin-Ching , Friedman Michael , Chang Hsueh-Wen , Salapatas Anna M. , Lin Meng-Chih , Wang Pa-Chun 
Published: June 2018

Objective: To develop an adequate model using reliable clinical and physical factors to predict pediatric obstructive sleep apnea/hypopnea syndrome (OSAS). Methods: Complete anthropometric measurements including BMI z score, tonsil size grading, and updated Friedman tongue position (uFTP) were evaluated. Subjective assessments of clinical symptoms/signs, including snoring visual analog scale (VAS), nasal obstruction, and mouth breathing, were recorded. Results: Eighty-eight children (57 boys and 31 girls, mean age = 9.0 years) were confirmed to have OSAS by comprehensive polysomnography (PSG). When the aforementioned variables were analyzed individually, the results indicated that snoring VAS, nasal obstruction, mouth breathing, and BMI z score were reliable predictors of apnea/hypopnea index (AHI/h) values (correlation coefficient r = 0.386, P < .001; r = 0.416, P < .001; r = 0.255, P = .02; and r = 0.243, P = .02, respectively). When all significant factors were included in the stepwise multiple linear regression analysis, the final predictive model is: Pediatric AHI = 0.108 + 0.103 snoring VAS + 0.894 nasal obstruction + 0.207 BMI z score ( F = 4.06, P = .01). Conclusion: The proposed noninvasive, simple, inexpensive, and easy to perform screening tool could be used to predict pediatric OSAS. An abnormal calculated AHI may prompt clinical physicians to conduct further PSG diagnostics and treatment.
Using Clinical Indicators to Reduce Perianesthesia Recovery Time Following Outpatient Tonsillectomy
Authors: Zalzal Habib G. , Makary Chadi A. , Evans Raquel , Giardina Stacy , Underwood Tracy , Rowlands Aletha , Ramadan Hassan H. 
Published: June 2018

Objective: To determine whether we could reduce the time that patients undergoing tonsillectomy are observed postoperatively without decreasing the quality of care, which would eliminate the unnecessary use of resources to monitor those patients. Study Design: Prospective cohort. Methods: Patients undergoing tonsillectomy were recruited for the study prior to their operation. Each patient was then monitored in perianesthesia recovery until clinical indicators for discharge readiness were met (baseline respiratory function, afebrile, ambulation per age, adequate consciousness, absence of nausea/vomiting, adequate pain control, no active bleeding, fluid toleration). Patients were then contacted by phone approximately 24 to 72 hours after discharge to determine if they experienced any postoperative complications. Data analyzed included general demographics and surgical case information such as surgical duration, medications, and timeframes during recovery. Results: Data from 93 patients (age range, 3-34 years) were analyzed. Clinical indicators were met in a mean time of 253.36 (SD ± 79.0) minutes, an average of 93.2 (SD ± 63.4) minutes sooner than average total post-anesthesia recovery time (346.63 minutes). Eight patients experienced minor complications overall (3 in perianesthesia recovery, 5 at home). Conclusion: This study demonstrates that using clinical indicators as discharge criteria is both safe and efficient, with a low rate of postoperative complications.
Priorities in the Neurotology Fellowship Match: A Survey Study of Program Directors and Fellows
Authors: Judge Paul D. , Alvi Sameer A. , Tawfik Kareem O. 
Published: June 2018

Objectives: To ascertain motivations and priorities for neurotology fellowship applicants and program directors during the match process. Methods: Anonymous online survey distributed to 20 fellowship program directors and 40 current and incoming neurotology fellows. A 5-point Likert scale was used to assess the priorities of fellowship applicants and program directors in the match process. Results: Twenty-four of 40 (60%) current or incoming fellows and 14 of 20 (65%) program directors responded to the survey. Fellows rated surgical exposure and volume as their highest priorities. In addition to neurotology case load, fellows highly valued exposure to otologic surgery. Salary, call, and work/life balance were among the lowest rated factors among fellows. Program directors attached the highest priority to the applicant interview performance, followed by strength of letters of recommendation and quality of prior research. Ethnicity, sex, and likelihood of an applicant ranking a program highly were the lowest rated factors among program directors. Conclusion: Among neurotology fellows, operative case load and breadth of surgical exposure are highly valued components of accredited fellowship training. Among neurotology fellowship program directors, candidates’ performance during the fellowship interview appears to be highly valued, more so than the strength of applicants’ letters of recommendation or prior research credentials.
Therapeutic Effects of the Addition of Platelet-Rich Plasma to Bioimplants and Early Rehabilitation Exercise on Articular Cartilage Repair
Authors: Chang Nai-Jen , Erdenekhuyag Yanjmaa , Chou Pei-Hsi , Chu Chih-Jou , Lin Chih-Chan , Shie Ming-You 
Published: June 2018

Background: Treating articular cartilage lesions is clinically challenging. However, whether the addition of autologous platelet-rich plasma (PRP) to bioimplants along with early rehabilitation exercise provides therapeutic effects and regenerates the osteochondral defect remains uninvestigated. Hypothesis: The addition of PRP to a polylactic-co-glycolic acid (PLGA) scaffold along with continuous passive motion (CPM) in osteochondral defects may offer beneficial in situ microenvironment changes to facilitate hyaline cartilage and subchondral bone tissue repair. Study Design: Controlled laboratory study. Methods: In 26 rabbits, 52 critical osteochondral defects were created in bilateral femoral trochlear grooves. The rabbits were allocated to 1 of the following 3 groups: PRP gel (PG group), PRP + PLGA scaffold (PP group), and PRP + PLGA scaffold + CPM (PPC group). At 4 and 12 weeks after surgery, the specimens were assessed by a macroscopic examination, a histological evaluation with immunohistochemical staining, and micro–computed tomography. Results: The PPC group exhibited the most favorable therapeutic outcomes in terms of hyaline cartilage regeneration. At week 4, the PPC group exhibited significantly higher levels of glycosaminoglycan (GAG) and collagen (COL) II and modest increases in COL I, matrix metalloproteinase–3 (MMP-3), and inflammatory cells with tumor necrosis factor–alpha (TNF-α) and interleukin-6 (IL-6). At week 12, the PPC group had significantly higher tissue repair scores, corresponding to a sound articular cartilage surface and chondrocyte and collagen arrangement. This group demonstrated restored hyaline cartilage and mineralized bone volume per tissue volume, which had an integrating structure in the repair site. However, the PG and PP groups exhibited mainly fibrous tissue and fibrocartilage, corresponding to higher expressions of COL I, TNF-α, IL-6, and MMP-3. Conclusion: PRP with a PLGA graft along with early CPM exercise is promising for the repair of osteochondral defects in rabbit knee joints. Clinical Relevance: This study demonstrates the efficacy of a triad therapy involving the addition of PRP to bioimplants along with early CPM intervention for hyaline cartilage and subchondral regeneration. However, PRP alone (with or without PLGA implants) is limited to osteochondral defect repair without significant regeneration.
Does Introducing Public Funding for Allied Health Psychotherapy Lead to Reductions in Private Insurance Claims? Lessons for Canada from the Australian Experience
Authors: Diminic Sandra , Bartram Mary 
Published: June 2018

Objective: Provincial and territorial governments are considering how best to improve access to psychotherapy from the current patchwork of programmes. To achieve the best value for money, new funding needs to reach a wider population rather than simply replacing services funded through insurance benefits. We considered lessons for Canada from the relative uptake of private insurance and public funding for allied health psychotherapy in Australia. Method: We analysed published administrative claims data from 2003–2004 to 2014–2015 on Australian privately insured psychologist services, publicly insured psychotherapy under the ‘Better Access’ initiative, and public grant funding for psychotherapy through the ‘Access to Allied Psychological Services’ programme. Utilisation was compared to the prevalence of mental disorders and treatment rates in the 2007 National Survey of Mental Health and Wellbeing. Results: The introduction of public funding for psychotherapy led to a 52.1% reduction in private insurance claims. Costs per session were more than double under private insurance and likely contributed to individuals with private coverage choosing to instead access public programmes. However, despite substantial community unmet need, we estimate just 0.4% of the population made private insurance claims in the 2006–2007 period. By contrast, from its introduction, growth in the utilisation of Better Access quickly dwarfed other programmes and led to significantly increased community access to treatment. Conclusions: Although insurance in Canada is sponsored by employers, psychology claims also appear surprisingly low, and unmet need similarly high. Careful consideration will be needed in designing publicly funded psychotherapy programmes to prepare for the high demand while minimizing reductions in private insurance claims.
Intimate Partner Violence and Breastfeeding Outcomes in a Sample of Low-Income Women
Authors: Miller-Graff Laura E. , Ahmed Azza H. , Paulson Julia L. 
Published: June 2018

Background: Intimate partner violence has been related to breastfeeding difficulties. Few studies, however, have also accounted for other biopsychosocial risk factors associated with women’s breastfeeding. Research aim: This study aimed to examine how prenatal intimate partner violence affects women’s breastfeeding initiation, early cessation, and exclusivity at 6 weeks postpartum, controlling for perinatal health problems, prenatal depression, childhood adverse experiences, and prenatal breastfeeding education. Methods: A longitudinal, prospective one-group study was conducted. Data were collected via interview and survey from a sample of low-income pregnant women ( N = 101) during pregnancy and at 6 weeks postpartum. The Pregnancy Risk Assessment Monitoring System was used to assess breastfeeding behaviors, prenatal breastfeeding education, and perinatal health problems. Intimate partner violence was assessed using the Conflict Tactics Scales–Revised; adverse childhood experiences and depression were assessed using the Adverse Childhood Experiences and Center for Epidemiologic Studies Depression Scale, respectively. Results: Women’s breastfeeding initiation was predicted by prenatal breastfeeding education (adjusted odds ratio [ OR] = 3.21, p < .05). Early breastfeeding cessation was predicted by prenatal exposure to intimate partner violence (adjusted OR = 0.22, p < .05), preterm labor (adjusted OR = 0.33, p < .05), and prenatal breastfeeding education (adjusted OR = 1.80, p < .05). Conclusion: These findings highlight the importance of addressing biopsychosocial risk factors, particularly adversity and perinatal health, in efforts to promote women’s breastfeeding success. Future research should evaluate mechanisms that may explain the link between intimate partner violence and breastfeeding cessation.
Is lung ultrasonography a useful method to diagnose children with community-acquired pneumonia in emergency settings?
Authors: Çağlar Aykut , Ulusoy Emel , Er Anıl , Akgül Fatma , Çitlenbik Hale , Yılmaz Durgül , Duman Murat 
Published: June 2018

Background: Lung ultrasonography is a new method for diagnosing community-acquired pneumonia. Lung ultrasonography has some advantages over chest X-ray, such as lack of ionizing radiation risk, bedside performance, and cost-effectiveness. Objectives: In this study, we aimed to determine the feasibility of lung ultrasonography in emergency settings in children with community-acquired pneumonia. Methods: The study included patients younger than 18 years of age with suspicion of community-acquired pneumonia. On the first evaluation, patients with positive clinical and/or chest X-ray findings were defined to have community-acquired pneumonia, and this was accepted as the gold standard. The chest X-rays were evaluated by the chief of the pediatric emergency department, who was blinded to the patients and the lung ultrasonography results. Lung ultrasonography was performed by another pediatric emergency physician who was also blinded to the chest X-ray results and clinical findings such as fever, respiratory distress, rales, and wheezing. Results: Of the 91 patients enrolled, 71 (78.0%) were diagnosed with community-acquired pneumonia based on clinical and chest X-ray findings. The median (interquartile range) duration of the lung ultrasonography procedure was 4.0 (3.5–6.0) min. Shred sign, air bronchogram, and hepatization were significantly more frequent in the patients with community-acquired pneumonia ( p < 0.01, p < 0.01, and p = 0.01, respectively). Sensitivity and specificity of lung ultrasonography were 78.5% (67.1–87.4) and 95.2% (76.1–99.8), respectively. Conclusion: Lung ultrasonography is a useful diagnostic method for children with suspicion of community-acquired pneumonia.
A short report on the acquisition of point-of-care ultrasound skills and knowledge by the ambulance personnel in Hong Kong
Authors: Hon Suet , Fan Min , Leung Ling-Pong , Mok Ka-Leung , Kwok Kin-Man 
Published: June 2018

Background: Point-of-care ultrasound plays an important role in patient management in the prehospital setting. Prehospital ultrasound training for the paramedics has been developed in the West for many years. However, the present training curriculum for the local ambulance personnel does not include point-of-care ultrasound. This study is the first of its kind in Hong Kong on the feasibility of teaching ambulance personnel how to perform focused assessment with sonography in trauma by a 1-day course. Objective: It aimed to assess whether the ultrasound-naïve ambulance personnel could acquire the skills and knowledge of point-of-care ultrasound following a tailor-made training programme. Methods: This was a prospective observational study. The training programme was a 1-day course consisted of didactic lectures and hands-on practice. Each participant was assessed by a written test and a skills test. Descriptive statistics were used to describe the ambulance personnel and their results of the written and skills test. Significance testing was by Mann–Whitney U test and Spearman correlation test where appropriate. Results: Seventeen members of Ambulance Service Institute (Hong Kong Branch) participated in the programme. All of them currently are the ambulance personnel and they joined the programme via the captioned institute. Enrollment was voluntary. The median score in the written test was 20 out of 25. The median time to complete the four views of the focused assessment with sonography in trauma scan was 3.4 min. There was no significant relationship between test performance and educational background and work experience of the ambulance personnel. Conclusion: Training the local ambulance personnel point-of-care ultrasound is feasible. Their acquisition of skills and knowledge of point-of-care ultrasound after a 1-day course was satisfactory.
Examining Interventions Designed to Support Shared Decision Making and Subsequent Patient Outcomes in Palliative Care: A Systematic Review of the Literature
Authors: Baik Dawon , Cho Hwayoung , Masterson Creber Ruth M. 
Published: June 2018

Background: Shared decision making (SDM) is a key attribute of patient-centered care, which empowers palliative care patients to be able to make optimal medical decisions about end-of-life treatments based on their own values and preferences. Aim: The aim of this systematic literature review is to detail and compare interventions supporting SDM over the last 10 years (January 2008 to December 2017) and to analyze patient/caregiver outcomes at the end of life. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, CINAHL, Embase, and Cochrane Library were searched with key search terms: SDM, decision aid, decision support, palliative care, and hospice care. The Mixed Methods Appraisal Tool was used to assess the quality of the included studies. Results: The initial search yielded 2705 articles, and 12 studies were included in the final review. The quality of the studies was modest and technology-enabled delivery modes (e.g., video, DVD, web-based tool) were most commonly used. Patient/caregiver knowledge of end-of-life care was the most common primary outcome across studies. The strength of the association between the SDM interventions and patient/caregiver outcomes varied. Conclusion: The findings from the studies that examined the effects of the SDM intervention on patient outcomes were inconsistent, highlighting the need for further SDM intervention studies among diverse patient populations using consistent measures. Given the availability of health technologies, future studies should focus on developing individual-tailored, technology-enabled interventions to support patient-centered medical decision making.
Retina-specific loss of Ikbkap/Elp1 causes mitochondrial dysfunction that leads to selective retinal ganglion cell degeneration in a mouse model of familial dysautonomia
Authors: Ueki Yumi , Shchepetkina Veronika , Lefcort Frances 
Published: June 2018

ABSTRACT
Familial dysautonomia (FD) is an autosomal recessive disorder marked by developmental and progressive neuropathies. It is caused by an intronic point-mutation in the IKBKAP/ELP1 gene, which encodes the inhibitor of κB kinase complex-associated protein (IKAP, also called ELP1), a component of the elongator complex. Owing to variation in tissue-specific splicing, the mutation primarily affects the nervous system. One of the most debilitating hallmarks of FD that affects patients' quality of life is progressive blindness. To determine the pathophysiological mechanisms that are triggered by the absence of IKAP in the retina, we generated retina-specific Ikbkap conditional knockout (CKO) mice using Pax6-Cre, which abolished Ikbkap expression in all cell types of the retina. Although sensory and autonomic neuropathies in FD are known to be developmental in origin, the loss of IKAP in the retina did not affect its development, demonstrating that IKAP is not required for retinal development. The loss of IKAP caused progressive degeneration of retinal ganglion cells (RGCs) by 1 month of age. Mitochondrial membrane integrity was breached in RGCs, and later in other retinal neurons. In Ikbkap CKO retinas, mitochondria were depolarized, and complex I function and ATP were significantly reduced. Although mitochondrial impairment was detected in all Ikbkap-deficient retinal neurons, RGCs were the only cell type to degenerate; the survival of other retinal neurons was unaffected. This retina-specific FD model is a useful in vivo model for testing potential therapeutics for mitigating blindness in FD. Moreover, our data indicate that RGCs and mitochondria are promising targets.