bluuebunny/crossref_metadata_2025 huggingface dataset:
Dysregulated apoptosis of the venous wall in chronic venous disease and portal hypertension
Authors: Kun Li , Ying Li , Lei Wang , Jianhua Zhao , Yongbo Xu , Tao Wang , Jinyuan Tang , Haibo Chu
Published: October 2015

Introduction

The etiology of varicose veins remains elusive. We hypothesized that abnormal cell cycle events in the vein wall may contribute to changes in the structural integrity, thus predisposing to the development of varicosities. The present study was designed to determine whether or not the same molecular apoptotic pathway exists between great saphenous and splenic veins.

Methods

Thirty-six samples of diseased splenic veins and varicose great saphenous veins were collected. Twenty-five samples of control splenic and great saphenous veins were also collected. The apoptotic cell proteins expression was immunohistochemically stained with antibodies (anti-Bax and anti-Bcl-xl). Apoptosis was evaluated by the terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL) assay and immunofluorescence staining. The morphology of apoptotic cells was observed with an electron microscope.

Results

The apoptotic ratio in walls (intima and media) of diseased splenic vein and varicose great saphenous vein groups were significantly lower than the corresponding regions in the splenic vein and great saphenous vein groups ( p < 0.01), respectively. A significant difference was not noted in the ratio change of apoptotic cells between the diseased splenic vein and varicose great saphenous vein groups ( p > 0.05). The high positive expression of Bcl-xl proteins was detected in the diseased splenic vein and varicose great saphenous vein groups, respectively. While the high positive expression of Bax proteins was also observed in the splenic vein and great saphenous vein groups, respectively. Electron microscopic observations confirmed that endothelial and smooth muscle cells in diseased splenic vein, varicose great saphenous vein, splenic vein, and great saphenous vein walls exhibited apoptotic morphologic features, such as fuzzy mitochondrial cristae, medullary changes, and margination of the nuclear chromatin.

Conclusions

Our results showed the same dysregulation of apoptosis via the intrinsic pathway in diseased splenic veins and varicose great saphenous veins. This observational study suggests that apoptotic down-regulation in the veins wall is a cause of diseased splenic veins and varicose great saphenous veins, but does not exclude the possibility that other mechanisms are involved.
Examining the Distinctiveness and the Socio-Emotional Correlates of Anxious-Withdrawal and Unsociability During Early Adolescence in Finland
Authors: Ojanen Tiina , Findley-Van Nostrand Danielle , Bowker Julie C. , Markovic Andrea
Published: October 2015

This study examined the distinctiveness of and the correlates associated with anxious-withdrawal and unsociability during early adolescence in Finland ( N = 384; 12-14 years; 53% girls). As expected, confirmatory factor analyses revealed that anxious-withdrawal and unsociability were distinct and moderately positively correlated constructs. Only anxious-withdrawal was found to be related uniquely and positively to fearful temperament, anxious attachment, low self-esteem, and peer victimization. In addition, anxious-withdrawal was found to be more strongly related to negative affect than unsociability, but adolescents reported higher levels of unsociability than anxious-withdrawal. Theoretical and practical implications for the study of social withdrawal during adolescence are discussed.
Online self-calibration for robotic systems
Authors: Maye Jérôme , Sommer Hannes , Agamennoni Gabriel , Siegwart Roland , Furgale Paul
Published: October 2015

We present a generic algorithm for self-calibration of robotic systems that utilizes two key innovations. First, it uses an information-theoretic measure to automatically identify and store novel measurement sequences. This keeps the computation tractable by discarding redundant information and allows the system to build a sparse but complete calibration dataset from data collected at different times. Second, as the full observability of the calibration parameters may not be guaranteed for an arbitrary measurement sequence, the algorithm detects and locks unobservable directions in parameter space using a combination of rank-revealing QR and singular value decompositions of the Fisher information matrix. The result is an algorithm that listens to an incoming sensor stream, builds a minimal set of data for estimating the calibration parameters, and updates parameters as they become observable, leaving the others locked at their initial guess. We validate our approach through an extensive set of simulated and real-world experiments.
Stability and quantization-error analysis of haptic rendering of virtual stiffness and damping
Authors: Colonnese Nick , Okamura Allison
Published: October 2015

The stable, quantization-error noise-free, rendering of high-stiffness dynamics can be challenging using impedance-type haptic displays. In this paper we examine a canonical, one degree of freedom, haptic display rendering a virtual spring and damper, including the effects of the device and human dynamics, sampling, position quantization, time delay, and the low-pass filter operating on the device velocity estimate. We construct various stability and quantization-error regions as a function of the system parameters and show the necessary trade-offs that occur between them. Although we apply the quantization-error analysis to virtual spring and damper rendering, it applies to a general virtual environment. We present sufficiency for quantization-error passivity, necessity for no malicious-touch limit cycles, and necessity for no uncoupled-touch limit cycles. Using these results, aided by the presented supplementary code, we find control parameters to render the largest, renderable, virtual stiffness for a given haptic display. The analytical results are experimentally verified using a Phantom Premium 1.5 haptic device.
Starch-grafted-polypropylene/kenaf fibres composites. Part 2: thermal stability and dynamic-mechanical response
Authors: Hamma A , Kaci M , Mohd Ishak ZA , Ceccato R , Pegoretti A
Published: October 2015

Kenaf fibres of different aspect ratios (L/D = 30 and 160) were melt compounded in an internal mixer with two types of starch-grafted-polypropylene matrices (G906PF and G906PJ) at various loadings, i.e. 10, 20 and 30 wt%. The compound was then compression-moulded into plaques of 1-mm thickness. Thermal, rheological and dynamic mechanical properties of the composite samples were investigated by several techniques involving differential scanning calorimetry, thermogravimetric analysis, melt flow index, Vicat softening point and dynamic mechanical thermal analysis. The results indicated that both thermal and mechanical properties of the composites were remarkably improved by kenaf fibres. Loss modulus and loss factor showed a shift of peak transitions to higher temperatures. Finally, the properties of the investigated composite materials were not affected by the fibre aspect ratio.
Quantifying food waste in Hawaii’s food supply chain
Authors: Loke Matthew K , Leung PingSun
Published: October 2015

Food waste highlights a considerable loss of resources invested in the food supply chain. While it receives a lot of attention in the global context, the assessment of food waste is deficient at the sub-national level, owing primarily to an absence of quality data. This article serves to explore that gap and aims to quantify the edible weight, economic value, and calorie equivalent of food waste in Hawaii. The estimates are based on available food supply data for Hawaii and the US Department of Agriculture’s (USDA’s) loss-adjusted food availability data for defined food groups at three stages of the food supply chain. At its highest aggregated level, we estimate Hawaii’s food waste generation at 237,122 t or 26% of available food supply in 2010. This is equivalent to food waste of 161.5 kg per person, per annum. Additionally, this food waste is valued at US$1.025 billion annually or the equivalent of 502.6 billion calories. It is further evident that the occurrence of food waste by all three measures is highest at the consumer stage, followed by the distribution and retail stage, and is lowest at the post-harvest and packing stage. The findings suggest that any meaningful intervention to reduce food waste in Hawaii should target the consumer, and distribution and retail stages of the food supply chain. Interventions at the consumer stage should focus on the two protein groups, as well as fresh fruits and fresh vegetables.
Thermal protective performance evaluation of fire proof garment eliminating air gaps effect based on computational fluid dynamics simulation
Authors: Wang Zhaoli , Li Jun , Tian Miao
Published: October 2015

To evaluate thermal protective performance of fire proof garment under flash fire exposures, it is important to discuss garment heat transfer characteristics eliminating the effect of air gaps between garment and body. In this study, a test of flame manikin clothed with close-fitting garment was designed. And a three-dimensional transient heat transfer computational fluid dynamics simulation of the test was achieved to gain the garment surface temperature. By means of three-dimensional body scanner, Geomagic and Gambit software, we developed a method of three-dimensional geometrical modeling of the full-scale close-fitting clothed manikin. The accuracy of the computational fluid dynamics simulation was validated by actual experiments. It was found that the average incident heat flux to the exterior of the Nomex® IIIA garment is not 84 kW/m2, the value measured in nude manikin tests, but the value is 11% lower than it. This will help to set more accurate boundary conditions on garment surface in further simulations.
Having Trouble Typing? What on Earth Is Chronotype?
Authors: Roenneberg Till
Published: October 2015

In this commentary (which is by no means a review of chronotyping), I try to clarify the distinction between 2 different ways of assessing chronotype by questionnaires. The morningness/eveningness questionnaire (MEQ) determines daily preferences producing a score, and the Munich ChronoType Questionnaire aims to determine phase of entrainment producing a time. An understanding of the MEQ requires knowledge of its history. Although both have their respective validity, they mean very different things and should be used appropriately in studies with different aims and questions. Although they show correlations in population comparisons, they should not be amalgamated when reviewing the literature.
Acute Liver Failure
Authors: Punzalan Carmi S. , Barry Curtis T.
Published: October 2015

Acute liver failure is life threatening liver injury with coagulopathy and hepatic encephalopathy within 26 weeks and generally, in the absence of preexisting liver disease. Fulminant liver failure occurs when hepatic encephalopathy occurs within 8 weeks of jaundice. The majority of patients with ALF are women with the median age of 38 years. In the United States, drug induced liver injury including acetaminophen causes the majority of ALF cases. The etiology of ALF should be determined, if possible, because many causes have a specific treatment. The mainstay for ALF is supportive care and liver transplantation, if necessary. There are multiple prognostic criteria available. Prognosis can be poor and patients should be referred to a liver transplantation center as soon as possible.
Pacifier Use and Exclusive Breastfeeding in Brazil
Authors: Buccini Gabriela dos Santos , Pérez-Escamilla Rafael , Venancio Sonia Isoyama
Published: October 2015

Background:

Exclusive breastfeeding (EBF) rates for infants younger than 6 months have increased in Brazil, although at the current pace of improvement it would take 6 years to reach an EBF rate of 50%. Thus, it is important to identify relevant modifiable key risk factors for the premature interruption of EBF.

Objective:

This study aimed to find out if pacifier use is an independent risk factor for the interruption of EBF among Brazilian infants.

Methods:

We conducted secondary cross-sectional data analyses of 2 waves of infant feeding surveys conducted in 1999 and in 2008 in the Brazilian state capitals and Federal District (N = 42 395 children < 6 months). Multivariate logistic regression was used to test the association between pacifier use and the risk of interruption of EBF in a pooled sample and within each survey wave, adjusting for socioeconomic, demographic, and biomedical confounders.

Results:

In the pooled sample, a third of the infants were exclusively breastfed (32.7%) and almost 50% had used a pacifier. Whereas EBF prevalence among infants increased from 25.1% in 1999 to 40.3% in 2008, pacifier use prevalence decreased from 58.5% to 41.6% in the same time period. Pacifier use was strongly associated with the risk of interruption of EBF in 1999 (adjusted odds ratio [AOR] = 2.65; 95% confidence interval [CI], 2.38-2.94), in 2008 (AOR = 3.18; 95% CI, 2.81-3.60), and in the pooled sample (AOR = 2.77; 95% CI, 2.63-2.91) after adjusting for key confounders.

Conclusion:

Pacifier use was the strongest risk factor for EBF interruption. Effective strategies to reduce pacifier use among infants younger than 6 months may further improve EBF rates in Brazil.
Breastfeeding Knowledge and Attitudes of Nevada Health Care Professionals Remain Virtually Unchanged over 10 Years
Authors: Sigman-Grant Madeleine , Kim Yaebin
Published: October 2015

Background:

It is prudent that health care professionals remain cognizant of breastfeeding-related issues to support nursing mothers. In 1995, Freed and colleagues noted deficits in breastfeeding knowledge among family medicine, pediatric, and obstetrics/gynecology residents and practitioners. Others reported similar findings despite calls to action and reports of successful breastfeeding interventions.

Objective:

This retrospective study compared baseline breastfeeding knowledge and attitude scores from Nevada health care professionals from 2004 through 2013.

Methods:

In-training and practicing professionals (pediatric/family practice/obstetric residents and attending physicians; hospital nursing staff; nursing and medical students) attended a 90-minute workshop at their sites. Following each session, attendees voluntarily completed a survey consisting of 2 knowledge and 2 attitudinal questions, using the post:pre-evaluation method, which diminishes overinflation of pretest scores as respondents can more accurately reflect their baseline levels. A Kruskal-Wallis test evaluated differences in baseline knowledge and attitude scores among 3 professional groups and for physicians over the 10-year period using Bonferroni post-hoc analyses.

Results:

A total of 889 professionals participated, with only physicians represented yearly. Except for knowledge of milk production, physician median baseline scores did not differ significantly over time. Overall, hospital nurses had significantly higher median baseline knowledge scores about initiation and frequent feeding than physicians and students. Nurses also had higher median attitude scores (likelihood of and confidence in talking with parents about breastfeeding) than physicians who had higher scores than students.

Conclusion:

Despite growing societal enthusiasm and support, the baseline knowledge of and attitudes toward breastfeeding showed minimal change over 10 years.
In-flight performance analysis of a non-cooperative radar-based sense and avoid system
Authors: Fasano Giancarmine , Accardo Domenico , Moccia Antonio , Luongo Salvatore , Di Vito Vittorio
Published: October 2015

This paper discusses the outcome of flight experiments relevant to non-cooperative sense and avoid that were carried out in the framework of a collaboration between the Italian Aerospace Research Center and the University of Naples “Federico II”. Within the project, aimed at full autonomy for medium/large Unmanned Aircraft Systems, an integrated radar/electro-optical system configuration was adopted, and real-time data fusion/automatic decision-making algorithms were developed to estimate intruders’ motion, and generate and follow proper escape trajectories. All the systems were designed to guarantee collision avoidance without any dependence on the command and control link. The hardware/software sense and avoid system was installed onboard an optionally piloted flying laboratory of Very Light Aircraft category, and a single intruder aircraft of the same class was considered for avoidance experiments. In particular, the paper focuses on the results from radar-based autonomous avoidance flight tests. Performance is analyzed in terms of situational awareness before and during the maneuver, and effectiveness in performing safe avoidance maneuvers while generating smooth commands and minimizing the deviation from nominal trajectory. Statistics relevant to several encounters show that in spite of a small number of valid sensor measurements, the tracking algorithm is able to keep a satisfying level of situational awareness, thus enabling safe avoidance. However, the limits deriving from coarse radar accuracy, low scan rate, and interaction between mechanical scanning and aircraft flight dynamics are also pointed out. While these limits did not impact avoidance safety in the considered tests due to the favorable operating environment in terms of time to collision, radar detection range, and ownship maneuverability, they confirm the need of improved sensing concepts in more challenging avoidance scenarios, such as adoption of radar/electro-optical data fusion and electronic scanning technologies.
Fast and highly efficient pseudo-likelihood methodology for large and complex ordinal data
Authors: Ivanova Anna , Molenberghs Geert , Verbeke Geert
Published: October 2015

In longitudinal studies, continuous, binary, categorical, and survival outcomes are often jointly collected, possibly with some observations missing. However, when it comes to modeling responses, the ordinal ones have received less attention in the literature. In a longitudinal or hierarchical context, the univariate proportional odds mixed model (POMM) can be regarded as an instance of the generalized linear mixed model (GLMM). When the response of the joint multivariate model encompass ordinal responses, the complexity further increases. An additional problem of model fitting is the size of the collected data. Pseudo-likelihood based methods for pairwise fitting, for partitioned samples and, as introduced in this paper, pairwise fitting within partitioned samples allow joint modeling of even larger numbers of responses. We show that that pseudo-likelihood methodology allows for highly efficient and fast inferences in high-dimensional large datasets.
The gap between formalised children’s rights and children’s real lives in sport
Authors: Eliasson Inger
Published: October 2015

The purpose of this paper is to use the theoretical standpoint of sociology of childhood to enhance understanding about how children’s rights, as outlined by the United Nations Convention on the Rights of the Child, are experienced by child athletes and adult coaches in the context of sport clubs in Sweden. Data were gathered through semi-structured interviews with children and coaches in floorball and equestrian sports during the years 2011 and 2012. The results showed that neither child athletes nor adult coaches were aware that the United Nations Convention on the Rights of the Child has been incorporated into Swedish sport policy; they also lack knowledge of the convention’s content. After interviews about selected rights were conducted, it was evident that children and adults both considered the themes of those rights to be of utmost importance. However, they did not find the convention meaningful as a policy document, and no systematic, deliberate or preventive work with regard to the rights of the child was experienced in the sport clubs. This paper discusses some challenges in the children’s sport context, including children’s rights, the social ordering of children and adults and the goal of making children’s sport a safe activity for children.
Are dictators loss averse?
Authors: Halvorsen Trond U
Published: October 2015

This paper investigates whether individuals are loss averse with respect to their status quo wealth level in sharing situations. In a real-effort dictator game, dictators are asked to share their earnings either before or after earning them. The instructions also variably emphasize the amount that the dictator will give or receive at the end of the experiment. This study finds that whether the money is already earned or not has no statistically significant effects on the average sharing behavior, regardless of which instructions are used. The results indicate that dictator game participants are not loss averse with respect to their status quo wealth level.
Recruiting and Retaining Chinese Elders in a Longitudinal Study
Authors: Li Wen-Wen , Tsoh Janice Y.
Published: October 2015

Purpose: This article describes strategies for recruiting and retaining Chinese elders in a longitudinal research study related to hypertension management. Design: Chinese participants were recruited for a pilot, longitudinal intervention study. The information presented represents observations on both the recruitment process and participant retention. Results: Recruiting via convenience sampling, offering frequent incentives, and having culturally competent research staff were important in this study with Chinese elders as participants. Among the various approaches used, the highest recruitment rate (50% [11/22]) was obtained from personal referrals with a retention rate of 91% (20/22) over a 6-month intervention period. Conclusion/Practice Implication: Personal referral is the best approach for recruiting Chinese elders in the study. In addition, frequent incentives and reminder calls are helpful in retaining participants.
Rape Myth Consistency and Gender Differences in Perceiving Rape Victims
Authors: Hockett Jericho M. , Smith Sara J. , Klausing Cathleen D. , Saucier Donald A.
Published: October 2015

An overview discusses feminist analyses of oppression, attitudes toward rape victims, and previously studied predictors of individuals’ attitudes toward rape victims. To better understand such attitudes, this meta-analysis examines the moderating influences of various rape victim, perpetrator, and crime characteristics’ rape myth consistency on gender differences in individuals’ perceptions of rape victims (i.e., victim responsibility and blame attributions and rape minimizing attitudes). Consistent with feminist theoretical predictions, results indicated that, overall, men perceived rape victims more negatively than women did. However, this sex difference was moderated by the rape myth consistency within the rape vignettes. Implications for research are discussed.
Postsecondary Expectations of High-School Students With Autism Spectrum Disorders
Authors: Anderson Kristy A. , McDonald T. A. , Edsall Deirdre , Smith Leann E. , Taylor Julie Lounds
Published: October 2015

This study examined the perceptions of adulthood among 31 high-school students with autism spectrum disorder (ASD). We had two research aims: (a) to report students’ postsecondary expectations in terms of school, work, friendships, and living arrangement and (b) to describe how our sample defined adulthood. To better compare our sample’s criteria of adulthood with the criteria traditionally endorsed in secondary schools, we used a directed content analysis approach. Data were derived from a semi-structured interview that questioned students about friendships, activities, and the transition to adulthood. The majority of students expected to attain traditional markers of adulthood after high school. For some the pathways to achieving these outcomes were narrowly defined and perceived as a linear process. Independence, maturity, and personal responsibility were the most highly endorsed characteristics of adulthood, followed by chronological age and traditional markers. Implications for transition planning and adult services are discussed.
Rethinking Lactation Space
Authors: Porter Jennifer , Oliver Robert
Published: October 2015

The 2001 dedication of the Lactation Support Program at Virginia Tech launched an initiative meant to support the needs of breastfeeding employees and the progressive image of the university as a family-friendly institution. While the program created clean, comfortable, private spaces to express breastmilk, the institutionalization of lactation spaces in university construction policy was not accompanied by a planned education piece and consequently an opportunity to have a broader conversation about gender equity was lost. The absence of an ongoing conversation about the meaning and purpose of this important spatial allotment meant that the “production of space” was limited to the creation of a physical space, and failed to consider how powerful these lactation rooms could be in representing not just the material needs of some working mothers but also in facilitating a dialogue about what it means to be a worker and a mother.
Prediction of fatigue life of rubber mounts using stress-based damage indexes
Authors: Shangguan Wen-Bin , Zheng Guo-feng , Liu Tai-Kai , Duan Xiao-Cheng , Rakheja Subhash
Published: October 2015

Prediction of fatigue lives of a rubber mount necessitate formulation of models for estimating fatigue life of the rubber materials used in the mount. Moreover, the prediction accuracy of the model is strongly dependent upon the choice of damage index that are based on different strain, energy or stress measures in the vicinity of critical locations of the rubber mount. In this study, relative performance of models employing different damage indices are evaluated for prediction of fatigue lives of rubber material and a drive-train rubber mount. A combined stress and an effective stress function are proposed as a damage index for predicting fatigue lives of rubber materials and the mounts. Different damage indices, identified from the finite element models of the rubber dumbbell cylindrical specimen are applied for formulations of fatigue life prediction models. The model parameters are identified from the measured data acquired for the rubber dumbbell cylindrical specimen under 31 different uniaxial displacement loads, using least squared error minimization technique. The identified models employing different damage indices are subsequently applied for predicting fatigue lives of rubber mounts under different magnitudes of loads applied along two different directions. The correlations of the predicted lives of the rubber mount from the models employing different damage indices with measured fatigue life data were subsequently investigated for the rubber mount subject to different load conditions. It is shown that the models identified for the rubber material could be effectively used for predicting fatigue lives of the mounts, which are made of same material. The fatigue lives predicted by the models considering either effective stress or combined stress as the damage index correlated with the measured data within a factor of two for the two, suggesting that stress-based damage indices could yield more accurate predictions of fatigue lives of typical mounts.
Feminism's there: On post-ness and nostalgia
Authors: Eichhorn Kate
Published: October 2015

Over the past decade, feminists born during and after the rise of women's liberation have become increasingly preoccupied with the movement's past – its documents and artefacts. This is evident in publications such as Elizabeth Freeman's Time Binds and Victoria Hesford's Feeling Women's Liberation, as well as artistic interventions by artists such as Sharon Hayes and Allyson Mitchell. In different ways, these theorists' and artists' projects each enact a longing for and reassessment of 1970s feminisms. At the same time, a younger generation of feminists comprising women born since 1980 has begun to look back to 1990s feminism as a site of longing and an object of critique. While both generations continue to distance themselves and their projects from nostalgia, this article suggests that rather than reject nostalgia entirely, these projects in fact bring feminist nostalgia into relief, pointing to both its dangers and possibilities.
Experiencing flow, enjoyment and risk in skydiving and climbing
Authors: Hardie-Bick James , Bonner Penny
Published: October 2015

This article brings together findings from two separate ethnographic studies that explore the motivations, behaviours and experiences of those who voluntarily engage in high-risk activities. Focusing on Csikszentmihalyi’s phenomenology of enjoyment, and taking a particular interest in the psychological and experiential aspects of action, the accounts of skydivers and climbers are presented and discussed in relation to each of the components Csikszentmihalyi has identified as necessary for providing a deep sense of enjoyment. The aim of the article is to show how the concept of flow provides a useful framework for understanding the attractions of engaging in high-risk pursuits that are often overlooked. This contributes to an understanding of particular rural settings, specifically mountains and flying sites, as a backdrop for meaningful action.
An Urban Carnival on the City Walls: The Visual Representation of Financial Power in European Street Art
Authors: Baldini Andrea
Published: October 2015

By discussing a selection of socially engaged street artworks from the Frankfurt-based project ‘Under Art Construction’, this essay sheds light on street art’s possibilities as a form of resistance against the power of globalizing finance. The author argues that through the use of carnivalesque strategies of irony and appropriation, street art can challenge the pretense of rationality of recent policies of austerity in the eurozone. Such a challenge exposes the contingency of spending cut programs. He finally suggests that, in debunking the myth of economic rationality, street art can change people’s experience of finance, while opening up a space for imagining alternative economic scenarios.
Cuts to Support
Authors: Kent Charlotte Lucy
Published: October 2015

Lucio Fontana’s tagli (or cuts) challenge traditional notions of painting; likewise Tate Modern’s Bigger Picture caption project alters how museum text ‘speaks’ to spectators. Colin Blakemore’s alternative caption on Fontana’s piece provides an opportunity to witness how cuts can transform a discourse by opening up new possibilities.
Eliciting User Decision Requirements for Designing Computerized Diagnostic Support for Family Physicians
Authors: Porat Talya , Kostopoulou Olga , Woolley Amanda , Delaney Brendan C.
Published: October 2015

Despite its 40-year history, computerized diagnostic support is not used in routine clinical practice. As part of a European project to develop computerized diagnostic support for family physicians, we identified user decision requirements and made design recommendations. To this end, we employed multiple data types and sources. All data were elicited from U.K. family physicians and pertained to consultations with patients, either real or simulated. To elicit user requirements, we conducted in situ observations and interviews with eight physicians and performed a hierarchical task analysis of the diagnostic task. We also analyzed 34 think-aloud transcripts of 17 family physicians diagnosing detailed patient scenarios on a computer and 24 interview transcripts of 18 family physicians describing past cases of intuitive diagnoses from their experience. All transcripts were coded using the situation assessment record (SAR) method. We report our methods and results using the decision-centered design framework. Studies employing multiple human factors techniques and data types in order to elicit user requirements are rare. Our approach enabled us to propose interface design recommendations that go beyond existing “differential diagnosis generators,” with the aim to improve physicians’ performance and acceptance of the resulting tool.
Punishment, protection, and precaution: ‘Project X’ riots and the attitudes towards risk and responsibility in late-modern society
Authors: Peeters Rik
Published: October 2015

In the aftermath of severe and unprecedented riots in a small Dutch town, local inhabitants express a broad and contradictory set of interpretations of what had happened and opinions on who should be held responsible. In order to understand this variety, we reinterpret Ewald’s theory on the transformations in the modern attitude towards risk and responsibility. Instead of distinct historical phases, the three attitudes identified by Ewald are simultaneously at play: punishment of delinquents, protection of victims, and precaution by the authorities. Only by taking all attitudes into account can we explain the variety of interpretations and the following, often contradictory, political responses. My findings also suggest that these three attitudes can be used as a model to make sense of contemporary security policies, which simultaneously emphasise punishment, protection, and precaution.
Presentation and management of acute hypertriglyceridemic pancreatitis in pregnancy: A case report
Authors: Lim Rachel , Rodger Sheila J , Hawkins T Lee-Ann
Published: October 2015

Pancreatitis related to hypertriglyceridemia can occasionally occur during pregnancy, particularly if there are underlying genetic abnormalities in lipid metabolism. We report the case of a 27-year-old female with hypertriglyceridemic pancreatitis in pregnancy that was treated initially with lipid lowering medications, followed by plasma exchange for persistently elevated triglyceride levels. Despite multiple interventions, she developed recurrent pancreatitis and simultaneously had a preterm birth. In this case report, we highlight the various therapies and the use of plasmapharesis in secondary prevention of hypertriglyceridemic pancreatitis in pregnancy.
A comparison between plasmapheresis and intravenous immunoglobulin in children with Guillain–Barré syndrome in Upper Egypt
Authors: Saad Khaled , Mohamad Ismail L. , Abd El-Hamed Mohamed A. , Tawfeek Mostafa S K , Ahmed Ahmed E. , Abdel Baseer Khaled A. , El-Shemy Ahmed S. , El-Houfey Amira A. , Tamer Diaa M.
Published: October 2015

Objective:

The aim of our study is to assess the clinico-electrophysiological proﬁle of children with Guillain–Barré syndrome (GBS) in Upper Egypt and to compare the efficacy of plasmapheresis versus other treatment modalities.

Patients and methods:

This was a retrospective study of children from January 2010 to October 2014 diagnosed as GBS. It included 62 cases.

Results:

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was the most prevalent type of GBS in our locality. As regards the treatment, 32 cases received plasmapheresis while 30 patients received intravenous immunoglobulin. We found a significant decrease in the duration of hospitalization and a significant increase in the number of children with complete recovery in cases treated with plasmapheresis.

Conclusion:

GBS is not uncommon in children of Upper Egypt, with AIDP the most prevalent type. Plasmapheresis is the best treatment modalities for GBS as it reduces the duration of hospital stay and hastens the recovery of those children.
Dislocated Posterior Tibial Tendon Treated With Plate Buttress Fixation in a Collegiate Gymnast
Authors: Mullens Jess , Whiteside William , Nilssen Erik , Kennedy Chad
Published: October 2015

Dislocation of the posterior tibial tendon (PTT) is a rare pathological process that occurs most often as a result of acute trauma. The injury involves forced dorsiflexion and eversion of the foot against a contracted posterior tibialis. Diagnosis of the injury is often difficult secondary to the rarity of the injury and its similarity with other benign injuries of the medial ankle. Routine diagnostic imaging often does not reveal the injury, and advanced imaging with magnetic resonance imaging or ultrasound to confirm the diagnosis is often required. The injury can be a result of an abnormal retromalleolar groove or a tear of the flexor retinaculum. Because nonoperative treatment frequently results in poor outcomes with continuing pain and progressive flat foot, operative treatment with repair of the flexor retinaculum with correction of the retromalleolar groove is the most described intervention. We report an acute case of PTT dislocation in a collegiate gymnast during competition and offer our technique for surgical correction in the setting of a partially torn, attenuated flexor retinaculum with plate buttressing of the PTT into its native uncorrected groove.

Levels of Evidence: Therapeutic, Level IV: Case study
Organizational Support for Employee Engagement in Technology-Enhanced Learning
Authors: Naujokaitiene Justina , Tereseviciene Margarita , Zydziunaite Vilma
Published: October 2015

When trying to integrate technology-enhanced learning (TEL) into employees’ competence development, it is necessary for an organization to have an appropriate support system. The research aim was to identify the form of organizational support that is most relevant for employee engagement in TEL. Findings of a questionnaire survey showed that employees become involved in TEL if organizations support their learning. The policy of the organization and its infrastructure-based support are also important for employees while engaging in TEL. Manager and colleague support is slightly more related to engagement in TEL than is infrastructural and institutional policy support. Benefits of organizational support for both employees and employers are mutual. Employees benefit by receiving higher salaries, better working conditions, satisfaction of attention given by managers, and the feeling that their work is meaningful and contributes to the organization’s operations, whereas the organization benefits as its employees are more committed to the organization, and work harder and more effectively. Findings extend the understanding about the relationship of organizational support and its different elements with employees’ engagement in TEL. However, there are aspects that are not covered in this research, and further research should be considered. It might be useful to carry out research in different kinds of organizations, especially in those where the use of technological tools is low. According to scientific literature analysis, not only internal support, but also external support, such as family, influences employees’ willingness to engage into TEL, should be studied.
Guillain Barré Syndrome in a Child With X-Linked Adrenoleukodystrophy
Authors: Jacob Ron , Mandel Hanna , Shehadeh Naim
Published: October 2015

X-Linked adrenoleukodystrophy is the most common peroxisomal disorder with different phenotypes among patients carrying the same ABCD1 mutation. There were previously reported associations of X-linked adrenoleukodystrophy with autoimmune disorders. The authors describe Guillain Barré syndrome in a child with X-linked adrenoleukodystrophy. The available evidence does not permit conclusion concerning etiological linkage between the 2 diseases, but it warrants further study.
Clinical impact of molecular features in diffuse large B-cell lymphoma and follicular lymphoma
Authors: Pon Julia R. , Marra Marco A.
Published: October 2015

Our understanding of the pathogenesis and heterogeneity of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) has been dramatically enhanced by recent attempts to profile molecular features of these lymphomas. In this article, we discuss ways in which testing for molecular features may impact DLBCL and FL management if clinical trials are designed to incorporate such tests. Specifically, we discuss how distinguishing lymphomas on the basis of cell-of-origin subtypes or the presence of other molecular features is prognostically and therapeutically significant. Conversely, we discuss how the molecular similarities of DLBCL and FL have provided insight into the potential of both DLBCL and FL cases to respond to agents targeting alterations they have in common. Through these examples, we demonstrate how the translation of our understanding of cancer biology into improvements in patient outcomes depends on analyzing the molecular correlates of treatment outcomes in clinical trials and in routinely treated patients.
Non-contiguous finished genome sequence and description of Clostridium
ihumii sp. nov.
Authors: Merhej Vicky , Pfleiderer Anne , Ramasamy Dhamodharan , Lagier Jean-Christophe , Michelle Caroline , Raoult Didier , Fournier Pierre-Edouard
Published: October 2015

Clostridium ihumii strain AP5T sp. nov. is a new species within the genus Clostridium. This strain, whose genome is described here, was isolated from the stool sample of a 21-year-old French Caucasian female with anorexia nervosa. C. ihumii is a Gram-positive, anaerobic bacillus. Here we describe the features of this organism, together with the complete genome sequence and annotation. The 4,433,668 bp long genome contains 4,076 protein-coding and 85 RNA genes, including 9 rRNA genes.
Reevaluating Reports of Defensive Medicine
Authors: Baicker Katherine , Wright Bill J. , Olson Nicole A.
Published: October 2015

There is ongoing policy debate about the potential for malpractice liability reform to reduce the use of defensive medicine and slow the growth of health care spending. The effectiveness of such policy levers hinges on the degree to which physicians respond to liability pressures by prescribing medically unnecessary care. Many estimates of this relationship are based on physician reports. We present new survey evidence on physician assessment of their own use of medically unnecessary care in response to medical liability and other pressures, including a randomized evaluation of the sensitivity of those responses to survey framing. We find that while use of such care is potentially quite prevalent, responses vary substantially based on survey framing, with the way the question is phrased driving differences in responses that are often as great as those driven by physician specialty or whether the physician has personally been named in a lawsuit. These results suggest that self-reported use of medically unnecessary care ought to be used with caution in the formulation of malpractice liability system reform.
Covered California: The Impact of Provider and Health Plan Market Power on Premiums
Authors: Scheffler Richard M. , Kessell Eric , Brandt Margareta
Published: October 2015

We explain the establishment of Covered California, California's health insurance marketplace. The marketplace uses an active purchaser model, which means that Covered California can selectively contract with some health plans and exclude others. During the 2014 open-enrollment period, it enrolled 1.3 million people, who are covered by eleven health plans. We describe the market shares of health plans in California and in each of the nineteen rating regions. We examine the empirical relationship between measures of provider market concentration — spanning health plans, hospitals, and medical groups — and rating region premiums. To do this, we analyze premiums for silver and bronze plans for specific age groups. We find both medical group concentration and hospital concentration to be positively associated with premiums, while health plan concentration is not statistically significant. We simulate the impact of reducing hospital concentration to levels that would exist in moderately competitive markets. This produces a predicted overall premium reduction of more than 2 percent. However, in three of the nineteen rating regions, the predicted premium reduction was more than 10 percent. These results suggest the importance of provider market concentration on premiums.
Consistency of constructions for cell division processes
Authors: Nagel Werner , Biehler Eike
Published: October 2015

For a class of cell division processes in the Euclidean space ℝd, spatial consistency is investigated. This addresses the problem whether the distribution of the generated structures, restricted to a bounded set V, depends on the choice of a larger region W ⊃ V where the construction of the cell division process is performed. This can also be understood as the problem of boundary effects in the cell division procedure. It is known that the STIT tessellations are spatially consistent. In the present paper it is shown that, within a reasonable wide class of cell division processes, the STIT tessellations are the only ones that are consistent.
On the asymptotic optimality of greedy index heuristics for multi-action restless bandits
Authors: Hodge D. J. , Glazebrook K. D.
Published: October 2015

The class of restless bandits as proposed by Whittle (1988) have long been known to be intractable. This paper presents an optimality result which extends that of Weber and Weiss (1990) for restless bandits to a more general setting in which individual bandits have multiple levels of activation but are subject to an overall resource constraint. The contribution is motivated by the recent works of Glazebrooket al.(2011a), (2011b) who discussed the performance of index heuristics for resource allocation in such systems. Hitherto, index heuristics have been shown, under a condition offull indexability,to be optimal for a natural Lagrangian relaxation of such problems in which a resource is purchased rather than constrained. We find that under key assumptions about the nature of solutions to a deterministic differential equation that the index heuristics above are asymptotically optimal in a sense described by Whittle. We then demonstrate that these assumptions always hold for three-state bandits.
On the total length of external branches for beta-coalescents
Authors: Dhersin Jean-Stéphane , Yuan Linglong
Published: October 2015

In this paper we consider the beta(2 − α, α)-coalescents with 1 < α < 2 and study the moments of external branches, in particular, the total external branch lengthof an initial sample ofnindividuals. For this class of coalescents, it has been proved thatnα-1T(n)→DT, whereT(n)is the length of an external branch chosen at random andTis a known nonnegative random variable. For beta(2 − α, α)-coalescents with 1 < α < 2, we obtain limn→+∞n3α-5𝔼(Lext(n)−n2-α𝔼T)2= ((α − 1)Γ(α + 1))2Γ(4 − α) / ((3 − α)Γ(4 − 2α)).
Perfect sampling for infinite server and loss systems
Authors: Blanchet Jose , Dong Jing
Published: October 2015

We present the first class of perfect sampling (also known as exact simulation) algorithms for the steady-state distribution of non-Markovian loss systems. We use a variation of dominated coupling from the past. We first simulate a stationary infinite server system backwards in time and analyze the running time in heavy traffic. In particular, we are able to simulate stationary renewal marked point processes in unbounded regions. We then use the infinite server system as an upper bound process to simulate the loss system. The running time analysis of our perfect sampling algorithm for loss systems is performed in the quality-driven (QD) and the quality-and-efficiency-driven regimes. In both cases, we show that our algorithm achieves subexponential complexity as both the number of servers and the arrival rate increase. Moreover, in the QD regime, our algorithm achieves a nearly optimal rate of complexity.