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Study Objective: The purpose of this study was to evaluate the utility of routine anti‐Xa peak monitoring for trauma patients initiated on weight‐based enoxaparin for venous thromboembolism (VTE) prophylaxis and identify patient populations where monitoring is necessary. Design: Retrospective study. Setting: Augusta University (AU) Medical Center in Augusta, Georgia, a level 1 trauma center. Patients: Adult patients admitted to the trauma surgery service requiring chemical VTE prophylaxis. Intervention: At least three consecutive doses of enoxaparin 0.5 mg/kg subcutaneously every 12 hour for VTE prophylaxis prior to an anti‐Xa peak as the initial chemical VTE prophylaxis strategy. Measurements: The primary end point was the percentage of patients who achieved goal anti‐Xa peak of 0.2–0.6 unit/ml. The incidence of newly diagnosed VTE and clinically significant bleeding were assessed as secondary end points. Main Results: From January 1, 2018, through February 28, 2019, 300 patients met inclusion criteria. Anti‐Xa peaks were within goal in 91% of all patients, 7.7% were below goal, and 1.3% were above goal. For patients who did not meet the goal, dose adjustments were made in 70.4% of patients. New levels were obtained in 73.7% of those patients, and all repeat levels was within goal. Clinically significant bleeding occurred in 5.3% of patients. Newly diagnosed VTE occurred in 1.7% of patients. Conclusions: The use of initial weight‐based enoxaparin dosing in trauma patients routinely achieved the prespecified target anti‐Xa goal. In conclusion, anti‐Xa levels are not necessary for routine monitoring of weight‐based enoxaparin for VTE prophylaxis in trauma patients. Incidence of clinically significant bleeding and newly diagnosed VTE were similar to previous studies. [ABSTRACT FROM AUTHOR]

Dissent is conceptualized as a largely able‐minded political expression. Ashley Taylor argues in this essay that educational philosophers, therefore, lack an understanding of dissent that can capture the politically relevant expressions of students labeled with significant disabilities. While traditional frameworks of dissent may capture many of the ways disabled activists and their nondisabled allies have challenged oppressive social structures, these models nevertheless rely on a conceptualization of dissent that fails to make sense of the political agency of people understood as having significant intellectual disabilities. Taylor reframes the embodied and localized refusals and transgressions of labeled students as forms of politically relevant dissent, drawing on her own observational data from the classroom as well as the ethnographic work of researchers in the field of disability studies in education. By developing a richer and experientially‐based understanding of dissent, Taylor offers an alternative conceptual orientation toward dissent that has normative implications for theorists and practitioners alike. [ABSTRACT FROM AUTHOR]

Evidence suggests that lipopolysaccharide (LPS) absorbed from the large intestine may contribute to the inflammatory response to high starch feeding in dairy cows. This work evaluated the impact of buffers or alkalinizing agents with expected large intestinal activity on faecal indicators of intestinal fermentation and LPS. Ten late‐lactation cows were used in a replicated 5 × 5 Latin square design with 7‐day periods. Cows were fed a diet containing 265 g/kg dry matter of starch and were abomasally infused with 1 g/kg body weight cornstarch daily. Treatments were control (CON), ration supplementation with 200 g/day sodium bicarbonate (FSB), 200 g/day calcium carbonate (FCC) or 125 g/day calcium carbonate plus 75 g/day of magnesium oxide (FCCM), or abomasal infusion of a lipid encapsulate providing 200 g/day sodium bicarbonate (ISB). The FCC, FCCM and ISB treatments were hypothesized to have large intestinal buffering effects, and FSB was included as a secondary control. Milk, feed, rumen and faecal samples were collected on day 7 of each period. Treatment did not affect intake, milk yield or milk composition. There were no effects of treatment on ruminal measures except that ISB tended to reduce and the post‐ruminal treatments as a whole (FCC, FCCM and ISB) reduced rumen butyrate compared with CON. Faecal pH was greater for FCCM compared with all other treatments. Total faecal VFA tended to increase with FCC and FCCM compared with CON and was increased by the post‐ruminal treatments as a whole compared with CON. Treatment did not affect faecal dry matter, lactate or LPS or apparent total tract nutrient digestibility. Although some treatments altered fermentation as evidenced by the change in faecal VFA, this was not accompanied by a decrease in faecal LPS. The strategies employed in this study had limited effects on large intestinal fermentation. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacists are widely recognized members of the critical care health care team. However, unlike other health care professions, critical care pharmacists do not have standardized pharmacist to patient ratios that establish maximal cost‐efficiency while maintaining optimal patient safety. Though many prior recommendations claim a ratio of 1:15 for safe pharmacy practice, recommendations have ranged as low as 1:8 to as high as 1:30. Objectives: To determine critical care pharmacists' perceptions of pharmacist to patient ratios within the intensive care unit (ICU) and qualitatively and quantitatively describe critical care pharmacist work environments. Methods: A cross‐sectional survey of pharmacists was conducted to identify current pharmacist to patient ratios and identify pharmacist perceptions of the safety of these ratios. Responses were presented using descriptive statistics. Multiple linear regression was conducted to determine factors associated with perceptions of workload and patient safety. Results: The response rate was 11% (n = 185). The majority of respondents reported participating in activities beyond patient care. The majority of pharmacists cared for more than 15 patients daily (n = 155, 84%), and 16% took care of 15 or fewer patients. About 30% of pharmacists did not feel the pharmacist to patient ratio optimized patient safety, and over half reported perceptions overwork. A majority of participants (n = 130, 76%) expressed a need for additional critical care pharmacists at their institutions. Higher pharmacist to patient ratios were associated with increased perception of unsafe patient care −.343 (−.507 to −.180, P <.001). Conclusions: Heterogeneity exists among critical care pharmacy activities that may influence pharmacists' perceptions of workload and patient safety. Critical care pharmacists report that their institutions should have more critical care pharmacists. Pharmacists' perceptions of workload vary based on differences in their activities outside of patient care. [ABSTRACT FROM AUTHOR]

Disability studies in education scholars have discussed the need to engage students, and certainly preservice teachers, in critical discussion of disability as a concept. To better understand what such critical discussion entails, Ashley Taylor examines the pedagogical implications of promoting an understanding of disability as a shared experience of being human. In particular, Taylor is concerned with how the appeal to a shared experience of disability (which she calls 'the shared reality view') might contribute to or impede students' development of critical attitudes toward ableist social and educational practices. She describes two chief limitations of the shared reality view and argues that these complicate efforts to teach about disability in ways that avoid reinforcing students' existing beliefs. Taylor concludes by offering a pedagogical framework that retains valuable aspects of the shared reality view while avoiding its limitations. [ABSTRACT FROM AUTHOR]

Background: Current limitations of platelet shelf life to 5 days have led to an increasingly greater demand for hemostatic agents with greater longevity. The objective of this study was to evaluate the function of a lyophilized platelet-derived hemostatic product (thrombosome [TS]) as a potential alternative to fresh platelets.Methods: Platelets were collected from whole blood from healthy donors. TSs were reconstituted with water and added to various configurations of reassembled whole blood (platelets, plasma, and RBCs); measures included rotational thromboelastometry (ROTEM), optical aggregometry, mitochondrial function, calibrated automated thrombogram, collagen adhesion under flow (shear flow assay), and flow cytometry.Results: In ROTEM, no differences were observed between maximum clot formation values for contact pathway activation thromboelastometry tests with TSs or platelet samples. Significantly decreased aggregation was observed in the TSs versus platelets (p < 0.001 for all agonists). Flow cytometry measures demonstrated significant decreases in glycoprotein Ib expression and increases in phosphatidylserine expression in the TS group (p < 0.01). The calibrated automated thrombogram assay was suggestive (lag time and peak thrombin) that the TSs might have some thrombogenic properties. Measurements of mitochondrial function revealed that TSs had no functional mitochondria.Conclusion: In this study, TSs were shown to have nonfunctional mitochondria. ROTEM measures revealed that the TSs had no impact on clot strength. Likewise, compared to platelets, the TSs displayed minimal aggregation, had significantly more phosphatidylserine (measure of activation status), but had the ability to adhere to a collagen surface under flow conditions and contribute to clot formation and induced greater thrombin generation. [ABSTRACT FROM AUTHOR]

Background: Mixed methods research designs in engineering education often frame the "mixed" aspect of the design from the perspective of data collection. However, intentional mixing throughout the research design—particularly during data analysis—may enable richer meta‐inferences about a phenomenon. Purpose: This paper provides examples of strategies for mixing during data analysis in mixed methods program evaluation in engineering education. Although the context is program evaluation, the procedures are applicable in engineering education research more broadly. Scope/Method: This review presents examples of mixed methods analysis strategies in the context of a data set with qualitative and quantitative data from a global engineering program at a large Mid‐Atlantic university. The structure of the examples presents mixed research questions, pragmatic purposes for such studies, and examples of different mixing strategies for the analysis stage. The mixing strategies highlighted include extreme case sampling, converting, creating a blended variable, blending variables and themes across strands, and cross‐case comparison. Conclusions: This review of mixed methods in program evaluation prompted a reflection of processes in the design of studies, how the designs are described beyond the usual taxonomies in the mixed methods literature, and implications for the greater community of engineering education researchers. Five mixed methods designs were formulated around the mixing strategies. [ABSTRACT FROM AUTHOR]

Gender-based harassment not only includes harassment of women, but also encompasses other forms of harassment based on gender identification and hegemonic enforcement of heteronormative expectations. For Howlett, harassment policies are not only insufficient as a means to address harassment, but they are also dangerously individualistic; indeed, policies are part of the problem, not the solution. While Greenhalgh-Spencer, Harless, and Greteman all examine gendered harassment within schools and classrooms, and look to these sites to promote remedies, they diverge in the types of discursive, structural, and dialogic interventions they advocate as productive responses to gendered harassment. The issue of racialized and gendered harassment is especially complex because of the different vulnerabilities that women and trans people of color have in terms of experiencing harassment and securing remedies to harassment, whether in the form of legal or social support. [Extracted from the article]

Background: Dried plasmas can overcome logistical barriers that prevent fresh frozen plasma (FFP) usage in acute resuscitation, but processing of these products can detrimentally alter the composition. Spray-dried plasma (SpDP) from single units is deficient in high-molecular-weight multimers of von Willebrand factor (vWF), a critical facilitator of platelet adhesion and thrombus formation. We hypothesized that converting high-molecular-weight multimers to smaller-molecular-weight multimers would retain vWF's capacity to mediate platelet adhesion.Study Design and Methods: SpDP obtained from untreated FFP was reconstituted with glycine-hydrochloric acid (HCl) and glycine (20 mM:50 mM) or pretreated with glycine-HCl (20 mM) or glycine-glycine-HCl (20 mM:50 mM) and reconstituted with water. In vitro hemostatic potential of SpDPs versus FFP or FFP spiked with 70 mM of glycine was evaluated, leading to a more detailed in vitro study of glycine-HCl-glycine (20 mM:50 mM) pretreated SpDP. Plasmas were combined with RBCs and platelets to observe global coagulation response.Results: While vWF-ristocetin cofactor activity is significantly decreased (-41.13%; p < .0001) in SpDP, a model of vWF-mediated platelet adhesion to collagen under flow showed enhanced function (+13%; p < .01). Fewer microparticles, particularly of platelet origin, were observed in SpDP versus FFP (p < .0001). Small but significant differences in thromboelastography results were observed, although SpDP and FFP were within normal ranges.Conclusion: Comparable coagulability was observed in FFP and SpDP. The apparent paradox between vWF-ristocetin cofactor assay and vWF-mediated platelet adhesion may be explained by the increase in smaller multimers of vWF in SpDP, producing different outcomes in these assays. [ABSTRACT FROM AUTHOR]

The article explains the comparison of obligation and motivation in showing solidarity through its two types expressional solidarity and robust solidarity. Topics cited include known applications of the word "solidarity" are linked to unity, charity and sympathy for opposition against an out-group, robust solidarity applies important conditions like joint interest, disposition to empathy and mutual trust and expressional solidarity applies to unidirectional robust solidarity conditions.

The current study examined the accuracy of the multiple-stimulus without replacement (MSWO) preference assessment for identifying preferred common classroom activities as reinforcers with children with behavioral disorders. The accuracy of predictions from the MSWO regarding high, medium, and low stimulus preference was tested by providing contingent access to activities for completing math problems within an independent seatwork format. Overall, there was an interaction effect between preference ranking (high, medium, or low) and number of problems completed. The results confirm and extend previous findings regarding the accuracy of predictions with the MSWO. The findings also reveal, however, some individual differences that may account for instances in which student behavior did not conform to predictions of stimulus preference assessments. [ABSTRACT FROM AUTHOR]

This paper examines whether recent international policy initiatives to facilitate financial rescues in emerging market countries have influenced debtors' incentives to access official sector resources. The paper highlights a country's systemic importance as a key characteristic that drives access to official sector finance. It estimates the effect of these financial rescue initiatives on IMF programme participation using a pooled probit model. The safety net permitting exceptional access is shown to have a greater marginal impact on official sector resource usage, the more systemically important the debtor country. The results can be interpreted as offering some support for the presence of debtor-country moral hazard. [ABSTRACT FROM AUTHOR]

Gene editing is a relatively new plant‐breeding tool that, unlike earlier methods such as genetic modification, is more precise in targeting its manipulations to site‐specific locations within the genome. This precision with gene editing offers considerable research and development cost economies and a higher probability of success, particularly for the initial discovery phase of research and development. This study quantifies the advantages of gene editing versus genetic modification by examining the minimum required planted area for a proposed trait where a typical crop technology company can expect to break even on its research and development investment using a real option valuation model. A novel feature of the model is the combination of a decision tree with a binomial lattice for project valuation with an embedded abandonment real option. A primary numerical result from the model was the observation that gene editing required a much smaller potential market area (96% smaller) to break even on the financial investment when compared to genetic modification for the same trait value per acre. This result held across a wide range of potential trait values. Sensitivity analysis on the results indicated that the much higher probability of success for gene editing in the discovery phase of research and development was the primary driver of the difference in break‐even acreage. [ABSTRACT FROM AUTHOR]

In 2016, United Nations Secretary General Ban Ki Moon responded to the unfolding refugee crisis[1] by declaring it "is not a crisis of numbers, it is a crisis of solidarity." While refugees at least share a defined legal status, and may share some of the same experiences, refugees and asylum seekers have diverse cultural, religious, and political affinities; there is no reason to assume homogeneity within refugee populations (Sigona 2014).[5] Yet the idea of "solidarity I with refugees i ", taken as a single entity, is a popular trope among those campaigning for better conditions for refugees, and/or for states to accept more refugees. Refugees' Stories There are several domains within which refugees' stories are publicly told,[17] either by refugees themselves or mediators of one kind or another: in asylum hearings, in the media, academic discourse and NGO reports, and in the arts, for example, in plays, novels, and so on. This returns us to a point raised in the previous section: If solidarity with refugees engenders concerns not only for the well-being of refugees who may come to receiving states, but also for the kind of political community that one inhabits, and, as part of that, its general welcoming-ness toward refugees, then it matters very much how citizens proclaiming solidarity construct their identities, the identities of refugees, and the relation between their identities as putative solidary partner and the neediness of others. [Extracted from the article]

This essay explores various philosophical approaches to cognitive disability within feminist philosophy. In doing so, it addresses three broad questions: What positive contributions can feminist philosophy make to the philosophy of cognitive disability? How have feminist philosophers critiqued the presence and absence of cognitive disability in philosophy? And what challenges does cognitive disability pose to feminist philosophy itself? The essay begins with definitions and models of disability and then turns to feminist work on cognitive disability in moral and political philosophy, bioethics, and epistemology. It concludes with some methodological considerations. [ABSTRACT FROM AUTHOR]

The current study findings refute the recent claim that marginality theory lacks construct validity. Cultural marginalization is significantly related to depressive symptoms in Korean American, Chinese American, and Japanese American parents and adolescents living in the United States. Correlational analyses indicate that adolescents' depressive symptoms are significantly related to Asian and Asian American marginality scores, whereas mothers' and fathers' depressive symptoms are significantly related to their levels of Anglo and Asian American marginality. In a structural equation model, adolescents' Asian American marginalization and fathers' Anglo marginalization are significantly related to adolescents' depressive symptoms. It appears that marginality is a significant factor in the depressive symptoms of mothers, fathers, and adolescents. Furthermore, marginality scores of fathers and adolescents are both significant factors in adolescents' depressive symptoms.© 2006 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

An author and title index for the Volume 23, Number 4 (2015) issue of "The Journal of Poltical Philosophy" is presented.