Search

PurposeThe purpose of this study is to conduct a systematic review of the literature addressing international aid to education, primarily focusing on China's aid principles and its practice of scholarship programs and short-term training held in higher education institutions (HEIs).Design/methodology/approachUsing the systematic review approach, the authors identified 25 English-language articles in the academic databases. The review is driven by the analytical lenses of (a) the policy formulation and implementation of China's educational aid across macro-, meso- and micro-levels and (b) theories and methodologies that are commonly adopted in the existing studies.FindingsThe review identified three themes: (a) China's aid discourse in the international aid landscape, (b) critical reflections on educational aid program management and (c) international students' study experiences and perceptions of China. The authors also outline prevalent theories and methodological approaches used in the existing literature.Research limitations/implicationsThis literature review provides a review of research on China's international aid to education in the past 20 years, as a frequently cited example of emerging donors that have taken alternative aid approaches, thus bringing about a broader and nuanced perspective of aid to education. It also generates implications for researchers who are interested in studying education and development in the global context.Originality/valueThis study provides is first systematic literature review of studies on international aid to education provided by emerging donors, taking China as an example, to summarize its aid principles and aid practice in China's HEIs.

To assess the efficacy, effect of radiotherapy, and complications of direct visual internal urethrotomy (DVIU) and intralesional mitomycin C (MMC) for recurrent bladder neck contracture/vesicourethral anastomotic stenosis (BNC/VUAS).Patients who underwent DVIU with intralesional MMC for recurrent BNC/VUAS between 2007 and 2019 at 2 institutions were included. Cold knife incisions were performed in a reproducible fashion followed by injection of 0.3-0.4 mg/mL MMC at each incision site. Those with evidence of complete urethral obliteration, stenosis of the entire posterior urethra, or3 months follow-up were excluded. Success was defined as the ability to pass a 17-French cystoscope postoperatively without the need for catheterization or additional procedures.Eighty-six patients were analyzed over a median follow-up of 21.1 months. Around 91% had at least 1 prior DVIU, 56% had at least 1 prior dilation, and 44% presented with an indwelling catheter or performed intermittent catheterization. Success was achieved in 65% after 1 procedure, an additional 18% after 2 procedures, and another 7% after 3 or more procedures (90% overall success rate). Nonradiated patients showed a higher overall success rate compared to radiated patients (94% vs 76%, P = 0.04). Of the 9 cystoscopic failures, 5 were asymptomatic and pursued observation. Only 2 (5%) patients with a history of catheterization required this postoperatively. Two patients underwent subsequent urinary diversion surgery. No long-term complications were seen.DVIU with low-dose MMC remains a safe and effective BNC/VUAS treatment. A patent bladder neck was achieved in90% of nonradiated patients and75% of radiated patients.

This article presents the results of a descriptive case study of the Union School of the Chilean nongovernmental organization (NGO) Alejandro Lipschutz Institute of Science (ICAL-Spanish acronym). The study contributes to the field of adult education by providing a contemporary example of what Gramscian pedagogy can look like. Theoretically, this case contributes Latin American social movement-based analysis of neoliberalism, and its impact on the nature of work for working-class people. The study presents an example of educational praxis; the dialectical relationship between theory and educational practice that emerges from ICAL’s efforts to advance the Chilean union movement’s struggle to challenge neoliberalism through educational and leadership development work.

This article is an effort to build on academic theories of race and antiracist education. Using a Gramscian theoretical framework that emphasizes perspectives from organic intellectuals, this article puts the academic literature on race and adult education in conversation with the theory generated on race from select U.S. working-class organic intellectuals and scholar activists. The principal argument of the article, drawn from the dialectical and materialist work of select organic intellectuals and scholar activists, is that race seen as a social construct captures the subjective aspect of race but does not capture the internal relationship of the subjective aspect with the objective aspect of race. All social constructs must be seen objectively and subjectively to consider the prospects for change and antiracist adult education in specific historical and geographical contexts.

Objective To assess the outcomes and safety of conservative management of lichen sclerosus urethral stricture disease (LS-USD). Methods This multi-institutional study included patients with LS-USD managed with endoscopic procedures or clean intermittent catheterization (CIC) regimens between 2005 and 2019. Those with an obliterative stricture, a history of prior urethral reconstruction, or Results 112 men were analyzed with a median follow-up of 30.0 months (IQR 12.0-55.5). Median age was 52.5 years (IQR 42.6-61.0) and median body mass index was 34.5 kg/m2 (IQR 29.9-40.7). Median stricture length was 12.0 cm (IQR 2.8-20.0). 89% of patients underwent urethral balloon dilation, with a median of 2 (IQR 1-3) per patient. CIC was performed in 46% of patients, with 31% of this subgroup using intraurethral steroids. 84% of patients avoided invasive surgery or permanent indwelling catheterization, with an improvement in urethral stricture patient-reported outcome measure scores (P = .0013). Those who failed were more likely to have a history of UTI (P = .04), urosepsis (P = .03), AUR (P Conclusions Over medium-term follow-up, most patients with LS-USD were safely managed with conservative techniques. Caution is warranted in those who develop UTIs, urosepsis, and AUR and the potential long-term consequences of repetitive conservative interventions must be considered.

Introduction and Objectives: The goal of this study is to evaluate the outcomes in a cohort of patients who underwent minimally invasive percutaneous nephrolithotomy (MIP) at a single institution f...

The concept of reflection is central to theories of experiential learning common in the field of adult education. In this article, we expand upon the work of Michelson on the dualistic split between experience and knowing inherent in the field’s most common conceptualizations of reflection. We develop alternative approaches to reflection drawing from feminist standpoint theory and theories of embodied knowing. We identify and discuss how each alternative approach points to different positioning of the concept of reflection in experiential learning. We highlight how the alternative positioning of reflection in experiential learning relates to adult education practice through narrative building and the recognition of prior learning. We also identify what we believe are implications of our reconceptualization of reflection for theories of adult learning.

Outpatient percutaneous nephrolithotomy (PCNL) has been described for highly selected patients. We sought to assess the safety and feasibility of outpatient PCNL in a tertiary referral stone center without strict patient selection criteria.We reviewed all PCNLs performed at our institution from September 2015 to October 2016. Of the 97 eligible cases, 60 patients underwent planned outpatient PCNL. Primary outcome was complication rate, and secondary outcome determined predictor variables of inpatient admission.Thirty-seven inpatient and 60 planned outpatient (one bilateral) PCNLs were performed with 65% and 44% American Society of Anesthesiologists (ASA) score ≥3, respectively. The 30-day overall complication rate for the inpatient and planned outpatient groups was 27% and 20%, respectively (p = 0.43) [70% and 92% Clavien grades I-II]. Emergency department presentation within 30 days was 19% and 18% (p = 0.94), and unplanned hospital readmission rate was 3% and 10% (p = 0.05). The 37 inpatient PCNL patients had larger total stone burden than outpatient cases (40.7 vs 25.8 mm, p = 0.0014); more often required two or more punctures into the kidney during the procedure (73% vs 45%, p = 0.025); and more often had supracostal access (20% vs 7%, p = 0.05). For the outpatient PCNL cohort, 72% patients were discharged same day, 28% were observed overnight for refractory symptoms or social reasons. Outpatient cohort radiographic stone-free rate by CT (no stones) was 67%.Outpatient PCNL has been safely and effectively performed within our institution in moderate-sized stones almost regardless of comorbidity status. We suggest that this approach is a potential algorithmic change in centers with sufficient case volume.

Background:Although seronegative RA patients often present with substantial disease burden [1], patients are underrepresented in research cohorts or clinical trials. Consequently, less knowledge about this subgroup has been accumulated.Objectives:To describe outcome of seronegative vs. seropositive RA patients treated with sarilumab in regular care in Germany.Methods:The prospective, observational, 24-month single-arm PROSARA study (SARILL08661) is currently running in Germany at 96 sites, aiming to enroll up to 750 RA patients treated with sarilumab. RA patients are prospectively selected at physician’s discretion according to label, and medical history is documented before treatment. This interim analysis included patients with data available up to 24 months. Here we focus on sustained treatment response after 6 and 12 months, respectively. Patients were stratified according to serostatus (RF- AND ACPA- as seronegative or RF+ AND/OR ACPA+ as seropositive). All analyses are descriptive only.Results:To date 473 patients were included in the study, of which 22.2% (n=105) were seronegative and 59.0% (n=279) were seropositive (Table 1). For 89 patients (18.8%) serostatus was not specified.Table 1.Baseline data regarding patient characteristics, prior treatment and disease activityseronegativeseropositivepatients [n] (%)105(22.2)279(59.0)patient characteristicsSex female [n] (%)81(77.1)207(74.2)Age mean [years] (SD)56.6(12.5)59.6(10.9)BMI mean (SD) [kg/m2]29.2(6.7)28(6.0)Smoking history current/former [%]22.1/11.525.5/20.4Time since diagnosis of RA mean [years] (SD)7.9(7.6)11.5(9.9)prior RA treatmentcsDMARD [n] (%)102(97.1)273(97.8)bDMARD (TNFi) [n] (%)54(51.4)167(59.9)bDMARD (non-TNFi) [n] (%)32(30.5)83(29.7)tsDMARD (JAKi) [n] (%)25(23.8)57(20.4)disease activityCRP [mg/l] (SD)12.9(30.9)14.2(31.0)ESR [mm/h] (SD)23.7(20.5)25.3(22.4)SJC mean (SD)5.3(5.5)4.6(4.8)TJC mean (SD)10.2(8.2)7.2(6.6)HAQ-DI mean (SD)1.4(0.7)1.2(0.7)DAS28-ESR mean (SD)5.0(1.5)4.6(1.5)CDAI mean (SD)27.7(14.7)23.0(12.9)Fatigue [VAS] (SD)64.0(25.5)51.1(28.1)The mean time since diagnosis of RA was shorter in seronegative than in seropositive patients (7.9±7.6 years vs. 11.5±9.9 years) (Table 1).At baseline, CDAI score was 27.7±14.7 (n=104) and 23.0±12.9 (n=272) in seronegative and seropositive patients, respectively. After 12 months of sarilumab treatment, CDAI improved to 15.6±12.3 (n=38) and 9.1±8.7 (n=101) in seronegative and seropositive, respectively, for patients with post-baseline data available. At that time, remission/low disease activity according to CDAI was reached by 5.3% (n=2/38) / 39.5% (n=15/38) of seronegative patients, respectively and by 26.7% (n=27/101) / 68.3% (n=69/101) of seropositive patients, respectively (Fig. 1A, B).Figure 1.CDAI (A, B) and HAQ-DI (C) outcomes in seronegative and seropositive patientsPhysical function, assessed by HAQ-DI, was slightly more impaired in seronegative patients (1.4±0.7) than in seropositive patients (1.2±0.7) at baseline. HAQ-DI improved over 12 months to 0.9±0.7 in seropositive patients (n=90) but showed no change in seronegative patients (1.4±0.7; n=37) (Fig. 1C).Safety was consistent with the anticipated profile of IL-6-R-inhibition and no new safety signals occurred. Adverse events and serious adverse events were described in 61.7% and 12.8% of seronegative patients, respectively and in 55.2% and 13.7% of seropositive patients, respectively.Conclusion:Sarilumab treatment ameliorated CDAI in both seronegative (ΔCDAI -17.0±16.5) and seropositive (ΔCDAI -15.4±14.3) patients to the same extent over the course of 12 months, with a higher remission rate in seropositive patients. Functional capacity improved meaningfully in the seropositive cohort but had no significant impact in seronegative patients. The safety profile was consistent with data reported from controlled clinical trials.References:[1]Choi S-T et al. (2018) PLoS ONE 13(4): e0195550.Acknowledgements:We thank Cornelia Kühne (Haldensleben) for substantial contribution to patient recruitment in PROSARA.Disclosure of Interests:Harald Burkhardt Speakers bureau: Sanofi, Pfizer, Roche, Abb- vie, Boehringer Ingelheim, UCB, Eli Lilly, Chugai, Bristol Myer Scribb, Janssen, and Novartis, Consultant of: Sanofi, Pfizer, Roche, Abbvie, Boehringer Ingelheim, UCB, Eli Lilly, Chugai, Bristol Myer Scripps, Janssen, and Novartis, Grant/research support from: Pfizer, Roche, Abbvie, Hans-Peter Tony Consultant of: AbbVie, Astra-Zeneca, BMS, Chugai, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi, Peer-Malte Aries Speakers bureau: Abbvie, Biogen, Berlin Chemie, Celgene, GSK, Hexal, Mylan, Novartis, Pfizer, UCB, Consultant of: Abbvie, Celgene, Hexal, Janssen, Medac, Novartis, Pfizer, Sanofi, UCB, Silke Zinke: None declared, Klaus Krueger Speakers bureau: Sanofi, Jonas Ahlers Employee of: Sanofi, Rolf Hecker Employee of: Sanofi, Inka Albrecht Employee of: Sanofi, Stefanie Kalus Consultant of: Sanofi, Oliver Bley Employee of: Sanofi, Patrizia Sternad: None declared, Ann-Dörthe Holst: None declared, Niklas Thomas Baerlecken: None declared, Thilo Klopsch: None declared, Martin Welcker Speakers bureau: Abbvie, Aescu, Amgen, Biogen, Berlin Chemie, Celgene, GSK, Hexal, Mylan, Novartis, Pfizer, UCB, Consultant of: Abbvie, Actelion, Aescu, Amgen, Cel- gene, Hexal, Janssen, Medac, Novartis, Pfizer, Sanofi, UCB, Grant/research support from: Abbvie, Novartis, UCB, Hexal, BMS, Lilly, Roche, Celgene, Sanofi, Eugen Feist Speakers bureau: Novartis, Roche, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Sanofi, Consultant of: Novartis, Roche, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Sanofi

Purpose of review To provide the reader an understanding of the importance and limitations of prostate cancer (PCa) screening, the heritable component of PCa and the role that germline genetic markers can play in risk-adapted screening and treatment. Recent findings Despite strong science supporting the association of germline genetic change with PCa risk and outcome, there has been a reluctance to pursue practical application of these technologies. Recent findings suggest that actionable information may now be garnered from this form of testing, which can help men at risk for and with PCa. Summary This is an exciting time whereby germline genetic markers can help overcome some of the shortcomings of current PCa screening and treatment paradigms. Understanding their benefit and limitations while keeping the patient's best interest in mind will be the key for the responsible application of these exciting technologies.

Background:Blockade of IL-6 signaling by sarilumab has been demonstrated to be an effective treatment approach for rheumatoid arthritis. Due to strict inclusion and exclusion criteria, randomized controlled trials may not represent the heterogeneous RA patient population encountered in regular care.Objectives:The current study investigated the safety and effectiveness of sarilumab in the treatment of RA in regular care in Germany.Methods:The prospective, observational, single-arm 24-months PROSARA study (SARILL08661) is currently running in Germany at 79 sites, aiming to include up to 750 RA patients treated with sarilumab. RA patients are selected at physician discretion and treated according to the label. Study objectives include the documentation of safety and various effectiveness outcomes. This interim analysis included patients with data available up to 12 weeks. All analyses are descriptive only.Results:To date 348 patients were included in the study; of which 265 patients had post-baseline data. The mean age of the patients analyzed was 58.6 years (24-83); 76.3% are female. The mean disease duration was 10.3 years; comorbidities were present in 80.7% of patients. At baseline, 32.5% were biologic naïve. Most common pretreatment with b/ts DMARDs included TNF-inhibitors (TNFi, 56.2%), non-TNFi biologics (29.1%) or JAK-inhibitors (JAKi, 17.4%). At baseline, 49% received sarilumab as monotherapy and 29% in combination with conventional DMARDs (not specified for 22%). After 12 weeks of treatment with sarilumab, the mean DAS28-ESR decreased from 5.0±1.46 to 3.0±1.44 and CDAI from 26.7±13.79 to 13.6±11.4, respectively. DAS28-ESR remission/ low disease activity was achieved in 42.8% [n=77/180 patients with valid data on this parameter]/ 59.4% [n=107/180] of patients; 13.6% [n=28/206] and 49% [n=101/206] of patients reached CDAI remission and low disease activity. Boolean remission was observed in 9.5% [n=19/201] of patients at week 12. HAQ-DI improved from 1.3 at baseline to 1.1 at week 12 (n=195). The mean CDAI improvement was similar for autoantibody-positive (RF and/or ACPA; CDAI -12.5 at week 12) compared to -negative patients (CDAI -15.4 at week 12). Patients switching from JAKi to sarilumab (n=32), were more severely affected, had longer disease duration and received more prior treatments than patients switched from another compound. Of note, similar efficacy was observed among patients that switched from JAKi to sarilumab vs patients switched from other DMARDs; disease activity outcome measures including DAS28, CDAI, TJC, SJC and global assessments improved consistently (Figure 1).Safety was consistent with the anticipated profile of IL-6-R-inhibition and no new safety signals occurred. Adverse events and serious adverse events were described in 33.9% and 6.3% of patients, respectively.Conclusion:Sarilumab administered in regular care demonstrated rapid and clinically meaningful improvement in a general RA patient population including patients switching from JAKi. The safety profile was consistent with data reported from controlled clinical trials.Disclosure of Interests:Eugen Feist Consultant of: Novartis, Roche, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Sanofi, Speakers bureau: Novartis, Roche, Sobi, Lilly, Pfizer, Abbvie, BMS, MSD, Sanofi, Peer-Malte Aries Consultant of: Sanofi, Speakers bureau: Sanofi, Silke Zinke: None declared, Harald Burkhardt Grant/research support from: Pfizer, Roche, Abbvie, Consultant of: Sanofi, Pfizer, Roche, Abbvie, Boehringer Ingelheim, UCB, Eli Lilly, Chugai, Bristol Myer Scripps, Janssen, and Novartis, Speakers bureau: Sanofi, Pfizer, Roche, Abbvie, Boehringer Ingelheim, UCB, Eli Lilly, Chugai, Bristol Myer Scripps, Janssen, and Novartis, Inka Albrecht Employee of: Sanofi, Oliver Bley Employee of: Sanofi, Michael Obermeier: None declared, Patrizia Sternad: None declared, Martin Welcker Grant/research support from: Abbvie, Novartis, UCB, Hexal, BMS, Lilly, Roche, Celgene, Sanofi, Consultant of: Abbvie, Actelion, Aescu, Amgen, Celgene, Hexal, Janssen, Medac, Novartis, Pfizer, Sanofi, UCB, Speakers bureau: Abbvie, Aescu, Amgen, Biogen, Berlin Chemie, Celgene, GSK, Hexal, Mylan, Novartis, Pfizer, UCB, Cornelia Kühne Grant/research support from: Novartis, Amgen, Roche/Chugai, Pfizer, Celgene, AbbVie, Sanofi, Ann-Dörthe Holst: None declared, Niklas Thomas Baerlecken: None declared, Hans-Peter Tony Consultant of: AbbVie, Astra-Zeneca, BMS, Chugai, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Sanofi

Wind turbine industry has a special need for accurate post stall airfoil data. While literature often covers incidence ranges [−10 deg, +25 deg], smaller machines experience a range of up to 90 deg for horizontal axis and up to 360 deg for vertical axis wind turbines (VAWTs). The post stall data of airfoils is crucial to improve the prediction of the start-up behavior as well as the performance at low tip speed ratios. The present paper analyzes and discusses the performance of the symmetrical NACA 0021 airfoil at three Reynolds numbers (Re = 100 k, 140 k, and 180 k) through 180 deg incidence. The typical problem of blockage within a wind tunnel was avoided using an open test section. The experiments were conducted in terms of surface pressure distribution over the airfoil for a tripped and a baseline configuration. The pressure was used to gain lift, pressure drag, moment data. Further investigations with positive and negative pitching revealed a second hysteresis loop in the deep post stall region resulting in a difference of 0.2 in moment coefficient and 0.5 in lift.

Background Certolizumab pegol (CZP)-treated patients (pts) with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA, including ankylosing spondylitis [AS] and non-radiographic [nr-]axSpA), and psoriatic arthritis (PsA) may be recommended the patient-coaching program, coach@home (c@h) in Germany to manage their disease. Eight coaching calls are offered over one year, scheduled around ‘critical’ milestones along the therapeutic journey. These calls are made by professionally-trained nurses, who offer support and information about both the disease and its treatment with CZP. Objectives The purpose of this observational analysis was to assess the baseline characteristics of pts subscribed to c@h, and the level of pt satisfaction with the program. Methods c@h was launched in , June 2014 and is available to pts who are prescribed CZP according to the local product label. Pts must be CZP-naive when subscribed to the program, and pt consent is required prior to subscription by the treating physician. There are no additional criteria for enrolment, although the program must be recommended to the pt by the treating physician. Pt satisfaction was measured either at the end of the program or at discontinuation using the net promoter score (NPS), which has previously been used for this purpose. 1 The NPS is derived by asking pts to state how likely it is that they would recommend c@h to others (on a 0–10 scale). Rankings of 9–10 are considered ‘promoters’, 7–8 ‘passives’, and 0–6 ‘detractors’. Subtracting the percentage of detractors from that of promoters yields the NPS (figure 1). Results A cumulative total of 655 pts had been registered to the program as of 5 . Oct 2017 Of the total number of reported indications (n=683; multiple indications per pt possible), 55.9% were RA, 16.5% AS, 7.6% nr-axSpA, and 19.9% PsA. The mean age at baseline was 55 (RA), 54 (AS), 53 (nr-axSpA), and 52 (PsA), and the proportion of female pts was 80%, 58%, 65%, and 69%, respectively. Prior biologic DMARD exposure was 32.8%. The most common topics discussed on phone calls were therapy compliance (in 1339 calls), CZP maintenance dose (in 1333 calls) and syringe disposal (in 870 calls). The average length per call was 15.9 min at the end of Week 0 (total: 28 calls), and 14.0 min at the end of Week 52 (total: 1796 calls). A cumulative total of 272 pts had either completed the 1 year coaching period (n=70) or discontinued (n=202) by 28 , Sep 2017 of whom 106 rated the program. Of these, 87.5% gave promoter scores, 10.4% passive, and 3.8% detractor, yielding an NPS of 83.7 (figure 1). The program was still ongoing at the time of this data cut. Patients were asked to rate the coach@home program on a scale of 0–10, where 0=“I would certainly not recommend this program” and 10=“I would most probably recommend this program”. Scores of 9–10 were considered ‘promoters’, 7–8 ‘passives’ and 0–6 ‘detractors’. Percentages shown are out of the total number of responders by the end of September 2017 (n=106). NPS: Net Promoter Score. Conclusions The c@h program offers guidance and support to pts treated with CZP in Germany. Feedback from pts who were willing to provide a rating indicates a high level of satisfaction with the program. Reference [1] Hamilton DF. Bone Joint J 2014;96-B(5):622–8. Acknowledgements The c@h program is performed by Healthcare@home Deutschland GmbH, funded by UCB Pharma, led by Elke Zeise and managed by Karen Thiel and Manh Dan Nguyen. We thank the patients and their caregivers in addition to the investigators and their teams who contributed to this program. Editorial services were provided by Costello Medical. Disclosure of Interest N. Bohme: None declared, A.-D. Holst Grant/research support from: AbbVie, BMS, Chugai, Pfizer, Paid instructor for: BMS, Lilly, UCB Pharma, F. Dybowski: None declared, C. Volberg: None declared, H.-G. Pott Paid instructor for: Hexal, Lilly, Novartis, MSD, Speakers bureau: AbbVie, Biogen, Chugai, Roche, Pfizer, Celgene, UCB Pharma, Medac, U. Lendl Employee of: UCB Pharma

Holst traces the changing nature of social justice-oriented adult education from the days of radical adult education to contemporary social movement learning. The chapter relates the changing descriptors of lifelong education and learning for social change to the changes in social movements themselves and the broader socio-political economic contexts in which they take place. The chapter argues that the concepts of new social movements and old social movements do not capture the nature of growing contemporary social movements among dispossessed sectors of society. Today, educators must have a clear understanding of the nature of polarization caused by neoliberal globalization in order to confront the challenges and understand the revolutionary potential for social movement learning in the new emerging movements.

Objective To compare two different management approaches in prenatally diagnosed twin reversed arterial perfusion (TRAP) sequence. Methods Retrospective analysis of all cases with TRAP sequence diagnosed in one center over a period of 10 years. Prior to 2010, all cases were managed expectantly until 19 weeks’ gestation; thereafter, patients could choose either radiofrequency ablation (RFA) or expectant management (Group A). From 2010 onward all patients were offered interstitial laser at the time of diagnosis (12 weeks at the earliest) or expectant management (Group B). Results Forty cases were included in the study. In Group A, 23 cases were diagnosed at a mean gestational age of 19.9 ± 6.3 weeks. Sixteen patients were managed expectantly (13 survivors, 81%), while six underwent RFA at the time of diagnosis and one later in pregnancy (six survivors, 86%). In Group B, 17 cases were diagnosed at a mean gestational age of 16.4 ± 4.7 weeks. Six patients chose expectant management (five survivors, 83%) and 11 had interstitial laser therapy at the time of diagnosis (eight survivors, 73%). The loss rate of the pump twin was not significantly different between Group A and Group B (three of 23 vs four of 17; P = 0.3). In Group B the rates of preterm premature rupture of membranes (PPROM) and delivery < 34 weeks were significantly lower, and gestational age at birth as well as birth weight were significantly higher than in Group A. Conclusion Despite the limitations resulting from its retrospective design, our study on management of TRAP sequence adds some evidence in favor of prophylactic intervention by intrafetal laser from 12 weeks onward. Copyright  2013 ISUOG. Published by John Wiley & Sons Ltd.

In this chapter, based on a philological investigation of Gramsci’s pre-prison and prison writings in the context of his political practice, we make four major arguments. First, we argue that the major leitmotif of Gramsci’s writings and political practice was the struggle to achieve the political independence of the working class. The idea and goal of working-class political independence share much in common with basic principles held by many educators and particularly educators explicitly oriented toward social justice. Second, we demonstrate how the leitmotif of working-class political independence provides for a revolutionary understanding of the interrelatedness of Gramsci’s major concepts such as intellectuals, the state and civil society, hegemony, and war of position, as well as his insistence on and continuous work in revolutionary political parties. Third, we assert that the leitmotif of working-class political independence demonstrates the centrality of revolutionary pedagogy at the heart of Gramsci’s political practice. The centrality of pedagogy in Gramsci’s leitmotif is captured by his concept of catharsis. Fourth, based on the assessment that precarity or dispossession is actually the historic development of an objectively revolutionary class, we propose that Gramsci’s revolutionary pedagogical practice is increasingly relevant for development of the subjective conditions for revolutionary practice by the growing masses of dispossessed.

This chapter contextualises the contributions to this volume in an interpretive framework based in the Italian and English language scholarship on Gramsci and education. This framework is of particular importance for English language readers who may not be familiar with the extended and extensive literature on Gramsci and education in the Italian scholarship. The chapter traces the development of Gramsci’s ideas about the nexus between pedagogy and politics from the years of L’Ordine Nuovo to the more mature formulation of the Prison Notebooks and assesses them in the light of some key voices in the historiography. The broader aim of this chapter is to expand the discussion of Gramsci and education to include formal, nonformal and informal forms and contexts of education.

This chapter compares Antonio Gramsci and Luis Emilio Recabarren as educators of their respective working classes, with the understanding that they viewed the education of the working class for power as the means to achieve a socialist society. The chapter examines their views on the pedagogical roles of the working-class organizations in the self-education of workers towards their role in bringing about and leading a new society. The purpose of this study is not to show mutual influence but, rather, to highlight the outstanding similarities in Gramsci’s and Recabarren’s views during the period covered. The chapter draws on Recabarren’s original writings that appeared in the Chilean working-class press between 1903 and 1924 and Gramsci’s pre-prison writings, from 1914 to 1926.

Small horizontal axis wind turbines (sHAWTs) are mostly designed by smaller companies with no or just small possibilities of aerodynamic testing and hence, airfoil selection is often based on published performance data and minimal or no experimental testing from the blade designer’s side. This paper focuses on the aerodynamic consequences resulting from an unqualified airfoil selection and accumulating surface soiling. The high performance low Reynolds profile FX 63-137 is compared to an Eppler-338 wing section as well as to a high performance utility scale wind turbine airfoil, AH 93-W-174 -1ex. We extensively investigated these three different airfoils within the low Reynolds regime between 50,000 and 200,000. This regime is especially important for the starting behavior of a wind turbine, i.e. a quick speed up, and is crucial for small wind turbines because they have more frequent start/stop events. A Reynolds number of 200 k is additionally the operational regime of some sHAWT under the 5–10 kW level. The present study discusses not only the low Reynolds performance of the smooth profiles but investigates the influence of surface soiling. This ranges from 2D disturbances, such as a 0.2mm thin tripwire or several zigzag tapes, up to the simulation of massive sand build up by covering the entire leading edge region with a 40 grit sand paper. The experiments reveal that even small surface soiling has an impact and massive roughness leads in some cases to the loss of 50% in lift coefficient. The experimental data is used to simulate a sHAWT in different stages of debris. While the peak power was reduced by two thirds compared to the clean configuration the annual energy production has halved under certain conditions.

Neuronal cholinergic transmission is a prerequisite for proper CNS function. Consequently, disturbance of this system is associated with a number of pathophysiological conditions such as Parkinson's disease, Alzheimer's disease, schizophrenia and ADHD. Consequently, drug discovery efforts have spurred considerable research endeavours into identifying specific compounds for this system. Nicotinic acetylcholine receptors (nAChR) are ligand gated ion channels involved in cholinergic transmission. nAChRs are homo- or heteromeric pentamers with α4β2 receptors being the most abundant heteromer. The stoichiometry of α4β2 receptors can be either (α4)(3)(β2)(2) or (α4)(2)(β2)(3) representing channels with low (LS) or high (HS) sensitivity, respectively, to endogenous ligands. In the present study we applied the partial nAChR α4β2 LS and HS agonist NS3956 and the LS selective positive allosteric modulator NS9283 to investigate the role of α4β2 in Parkinson and pain models. In 6-OHDA lesioned rats, NS3956 increased rotational behaviour when rats were co-treated with nomifensine. This effect was absent in the presence of mecamylamine. In contrast, co-treatment with NS3956 and NS9283 reduced rotational behaviour in the animals. In a rat formalin pain model NS3956 induced an analgesic response that was strongly potentiated by NS9283. Finally in vitro experiments were applied to determine dopamine release from striatal minces. NS3956 induced a concentration dependent release while NS9283 was unable to potentiate agonist induced release. Together these results emphasize involvement of α4β2 nAChR in rotational and analgesic responses and confirm striatal α4β2 receptors to be of the HS form.

This article has three primary goals centring on a re-examination of the research frameworks we use for understanding the politics of social movements. First, I detail the ideological and methodological deficiencies of the old social movement/new social movement framework. Second, I highlight the positive contributions of research that favoured or in some way promoted one side in the debate over old and new social movements. Third, I elaborate what I consider to be the major challenges which new forms of social movement organising pose for adult education research interested in advancing social justice.

The article identifies dispositions from a thematic investigation of the pedagogical practice of Ernesto Che Guevara and various social movements in the United States. The article outlines and places these dispositions within the context of debates over social justice and dispositions for education program accreditation in the United States that often directly impact adult education graduate programs. These dispositions are then demonstrated in historical and contemporary adult education practice. The article argues that these dispositions have increasing relevance given the growing polarization of wealth and poverty and environmental destruction facing humanity.

This article reviews contemporary definitions of training in adult education literature with a focus on the narrowing of what is generally considered and not considered to be training today. The article then provides a number of historical and contemporary examples of training within the radical tradition. It argues that in the radical tradition, training is not conceived so narrowly and the terms training and education are at times used interchangeably to refer to a democratic and participatory form of education. The article concludes with a thematic summary of training conceptualized within the radical adult education tradition.

This article identifies and describes the major principles and themes that emerge from an analysis of the revolutionary pedagogical practice and ideas of Ernesto Che Guevara. The principles and themes outlined in this article are based on a thematic investigation of the approximately 2000 pages of Guevara’s writings, speeches and interviews available in numerous English‐translation compilations and full‐length books. The analysis also draws on what are considered to be some of the most important biographies and secondary sources on the educational and political thought and practice of Guevara in English and Spanish. The article is organised thematically and in each section that outlines a major theme or principle of Guevara’s pedagogy, examples are provided from Guevara’s practice that help illustrate the theme or principle. Reverences are made throughout the text to other revolutionary pedagogues and movements that share specific commonalities with Guevara’s pedagogy.

While most of Gramsci's party work is well known to education scholars of Gramsci, and the educational aspects of his writings have been repeatedly analyzed, what remains a constant in education‐based Gramsci studies is the nearly universal minimization of this work for what it was, namely party work. For Gramsci, it would have been unthinkable to consider this work outside the framework of a revolutionary party. Yet, for contemporary educational scholars it seems unthinkable to consider Gramsci's work within the framework of a revolutionary party. The goals of this article are to outline Gramsci's interrelated conceptualization of the roles of the revolutionary party; the nature of education within and by the revolutionary party; and the aims of party education. For considerations of space, I limit this analysis to Gramsci's pre‐prison praxis, the period of his active militancy in the PSI and the PCI. I conclude the article with what I consider to be lessons with continued relevance from Gramsci's praxis...

The results of stereo Particle-Image-Velocimetry measurements are presented in this paper to gain further insight into the wake of a finite width Gurney flap. It is attached to an FX 63-137 airfoil which is known for a very good performance at low Reynolds numbers and is therefore used for small wind turbines and is most appropriate for tests in the low speed wind tunnel presented in this study. The Gurney flaps are a promising concept for load control on wind turbines but can have adverse side effects, e.g. shedding of additional vortices. The investigation focuses on frequencies and velocity distributions in the wake as well as on the structure of the induced tip vortices. Phase averaged velocity fields are derived of a Proper-Orthogonal-Decomposition based on the stereo PIV measurements. Additional hot-wire measurements were conducted to analyze the fluctuations downstream of the finite width Gurney flaps. Experiments indicate a general tip vortex structure that is independent from flap length but altered by the periodic shedding downstream of the flap. The influence of Gurney flaps on a small wind turbine is investigated by simulating a small 40 kW turbine in Q-Blade. They can serve as power control without the need of an active pitch system and the starting performance is additionally improved. The application of Gurney flaps imply tonal frequencies in the wake of the blade. Simulation results are used to estimate the resulting frequencies. However, the solution of Gurney flaps is a good candidate for large scale wind turbine implementation as well. A FAST simulation of the NREL 5MW turbine is used to generate realistic time series of the lift. The estimations of control capabilities predict a reduction in the standard deviation of the lift of up to 65%. Therefore finite width Gurney flaps are promising to extend the lifetime of future wind turbines.

In this article, John Holst presents findings of his historical research on Paulo Freire's educational work in Chile from 1964 to 1969. Freire's Education as the Practice of Freedom, which was written in 1965 from notes he brought from Brazil, was informed by a liberal developmentalist outlook. In contrast, his Pedagogy of the Oppressed, written toward the end of his stay in Chile from 1967 to 1968, was influenced by Marxist humanist ideology. Considering this relatively rapid change in Freire's educational philosophy, Holst explores the manner in which Freire's time and work in Chile affected his ideological evolution. Holst contributes to Freirean studies by demonstrating that Freire's work in the Chilean political context proved to be decisive in his ideological and pedagogical growth. Freire's ideological evolution inspired his writing of Pedagogy of the Oppressed, widely considered one of the most important books on education in the twentieth century. Ultimately, Holst argues that Freire's pedagogy, like all pedagogy, can only be understood fully when seen within the specific sociopolitical and economic contexts within which it developed. Pedagogies are collective in nature, and Freire's, as he himself recognized, was no exception.

Objectives The aim of the present study was to describe the inter-individual variation in the plaque formation rate of 38 young adults. Methods The plaque formation rate was estimated by employing a quantitative plaque percent index (P% index). A substantial inter-individual variation in the plaque formation rate was observed. The possible contributions of stimulated salivary flow rate, buffer capacity, diet and smoking to the variation in plaque formation were estimated by regression analysis. Results The control variables explained only 2.5% of the variance in the plaque formation rate. Neither associations nor the total model were significant. The present method of measuring plaque presented as a simple and time-effective procedure. Conclusions It is suggested that the observed variation in the plague formation rate between the young individuals can be regarded as a biological function which is possibly an inherent individual characteristic. Studies with larger sample sizes are required to confirm the findings of the present study.

This article is a response to the debate opened by Marcia Moraes's interview with Peter McLaren, which was published in the April 2003 issue of JTE . As such, this article expands on the need for transformative educators to use Marxist political economy to analyze the role of education and schooling in capitalist societies. Specifically, the article provides an introduction to Marx's analysis of value production, argues that transformative educators need to take seriously the educational work of revolutionary organizations, and presents the analysis of value production of one such organization.

The Russian communists are a first-class ruling elite. As all those who have dealt with him have attested, Lenin has revealed himself as the greatest statesman of contemporary Europe. He is a man who radiates prestige, a man who can enflame and discipline whole populaces; a man whose vast brain can dominate all those social energies, throughout the world, which can be turned to the benefit of the revolution; a man who can check and even checkmate, the most wily and refined statesman of the bourgeois political routine. (Antonio Gramsci 1994 [1919]: 92) One of the most striking characteristics of Leninism is its formidable coherence and consistency. Leninism is a unified system of thought and practical action, in which everything hangs together and everything confirms everything else, from the general conception of the world right down to the most minute problems of organization. The fundamental nucleus of Leninism, where practical action is concerned, is the dictatorship of the proletariat and all the tact...

The dominant modes of program planning in the field of adult education are drawn from three intellectual traditions: humanistic psychology, progressivism, and behaviorism. This chapter proposes a model of program planning drawn from a different intellectual framework, the tradition of European critical social theory. Articulated by the Frankfurt School of Social Theory, a critical perspective emphasizes the role of adult education programming in fostering social movements for democratic social change. The chapter specifies the organizing principles and specific goals of a critical theory approach to program development and poses a number of questions that can be asked to determine the success of such an initiative.

The neural cell adhesion molecule (N-CAM) mediates cell–cell interactions and is expressed in characteristic spatiotemporal patterns during development. In previous studies of factors that control N-CAM gene expression, we identified a binding site for the paired domain of Pax proteins (designated PBS) in the mouse N-CAM promoter. In this study, we demonstrate that a transcription factor known to be important for development of the central nervous system, Pax-6, binds to the N-CAM PBS and show that the PBS can influence N-CAM expression in vivo . Pax-6, produced in COS-1 cells, bound to the PBS through two half-sites, PBS-1 and PBS-2; mutations in both of these sites completely disrupted binding. Moreover, nuclear extracts from embryonic day (E) 11.5 mouse embryos bound to the PBS, and this binding was inhibited by antibodies to Pax-6. To determine the role of the PBS in vivo , we generated transgenic mice with N-CAM promoter/ lacZ gene constructs containing either a wild-type or a mutated PBS. Mutations in PBS-1 and PBS-2 decreased the extent of β-galactosidase expression in the mantle layer of the spinal cord limiting it to ventral regions at E11.5. At E14.5, these mutations eliminated most of the expression that was seen in the wild-type spinal cord. Taken together with our previous observations that the PBS binds multiple Pax proteins, the data indicate that such binding contributes to the regulation of N-CAM gene expression during neural development.