bluuebunny/crossref_metadata_2025 huggingface dataset:
Following Young Children’s Health and Functioning in Everyday Life Through Their Cancer Trajectory
Authors: Darcy Laura , Björk Maria , Knutsson Susanne , Granlund Mats , Enskär Karin
Published: December 2015

Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children’s health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children’s trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.
The Liminal and the Parallax
Authors: MacArtney John I. , Broom Alex , Kirby Emma , Good Phillip , Wootton Julia
Published: December 2015

Transitions to palliative care can involve a shift in philosophy from life-prolonging to life-enhancing care. People living with a life-limiting illness will often receive palliative care through specialist outpatient clinics, while also being cared for by another medical specialty. Experiences of this point of care have been described as being liminal in character, that is, somewhere between living and dying. Drawing on experiences of illness and care taken from semistructured interviews with 30 palliative care outpatients in Australia, we found that this phase was frequently understood as concurrently living and dying. We suggest that this is a “parallax experience” involving narratives of a coherent linear self that is able to understand both realities, in a way that acknowledges the benefits of being multiple. These findings have significant implications for the ways in which palliative care is understood and how the self and subjectivity might be conceptualized at the end of life.
Parent and Friend Social Support and Adolescent Hope
Authors: Mahon Noreen E. , Yarcheski Adela
Published: December 2015

The purpose of this study was to conduct two meta-analyses. The first examined social support from parents in relation to adolescent hope, and the second examined social support from friends in relation to adolescent hope. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the literature reviewed, nine published studies or doctoral dissertations completed between 1990 and 2014 met the inclusion criteria. Using meta-analytic techniques and the mean weighted r statistic, the results indicated that social support from friends had a stronger mean effect size (ES = .31) than social support from parents (ES = .21); there was a statistically significant difference between the two ESs. Two of the four moderators for the parent social support–adolescent hope relationship were statistically significant. They were quality score and health status. Implications for school nurses and nurses in all settings are addressed, and conclusions are drawn based on the findings.
Cardiac Rehabilitation Enrollment and the Impact of Systematic Nursing Interventions for Postmyocardial Infarction and Stent Patients
Authors: Grossman Joan A. Cebrick
Published: December 2015

A randomized experimental design was used to determine the most effective intervention for enhancing cardiac rehabilitation (CR) enrollment for postmyocardial infarction and stent patients. The 104 subjects (70 males and 34 females; 23-87 years old) were patients with a discharge diagnosis of a myocardial infarction followed by a percutaneous coronary intervention, which included a percutaneous transluminal coronary angioplasty and the placement of one or more coronary stents. Regardless of the intervention, patients who received face-to-face nursing interventions were more likely to enroll in CR than were patients who had indirect interventions, χ2(3) = 32.84, p < .001. Patients who experienced an entrance interview were most likely to enroll, χ2(1) = 86.80, p < .001. Direct logistic regression determined that the full model was statistically significant for all predictors, χ2(5), 105.56, p < .001, with the strongest predictor, the entrance interview, having an odds ratio of 1.73.
Antecedents of Career Adaptability in Strategic Career Management
Authors: Chong SinHui , Leong Frederick T. L.
Published: December 2015

Career adaptability is an important characteristic that helps individuals deal effectively with career uncertainty and ambiguous job roles in current times. Based on the career construction theory, we hypothesize that conscientiousness, cognitive flexibility, and environmental exploration are positively related to career adaptability, and career adaptability is in turn positively related to strategic career management. We collected data from 307 undergraduates with work experience to test our hypothesized model. The results generally supported our hypotheses. Our research sheds light on how conscientiousness, cognitive flexibility, and environmental exploration are related to strategic career management indirectly through career adaptability. Our findings offer practical advice for vocational scholars and career counselors on how career adaptability may be developed.
An integrated multivariate empirical mode decomposition method towards modal identification of structures
Authors: Sadhu Ayan
Published: December 2015

In this paper, a hybrid empirical mode decomposition (EMD) method is proposed to undertake ambient modal identification of civil structures. Unlike univariate EMD that uses single channel measurement independently, multivariate EMD (MEMD) is employed to estimate the joint information of multichannel vibration measurements of structural systems. The mode mixing in the resulting modal responses from MEMD is then circumvented using ensemble EMD (EEMD). The proposed hybrid MEMD method is validated using a suite of numerical models and experimental studies including the presence of low energy modes, closely-spaced frequencies, measurement noise and reduced sensor densities. The results show the improved performance of the proposed method over the traditional EMD method and reveal the potential of MEMD as a possible candidate for the ambient modal identification method.
Thermodynamic formulations of continuum growth of solid bodies
Authors: Ganghoffer Jean-François , Rahouadj Rachid
Published: December 2015

The thermodynamics of open systems exchanging mass, heat, energy, and entropy with their environment is examined as a convenient unifying framework to describe the evolution of growing solid bodies in the context of volumetric growth. Following the theory of non-equilibrium thermodynamics (NET) introduced by De Donder and followers from the Brussels School of Thermodynamics, the formulation of the NET of irreversible processes for multicomponent solid bodies is shortly reviewed. In the second part, extending the framework of NET to open thermodynamic systems, the balance laws for continuum solid bodies undergoing growth phenomena incorporating mass sources and mass fluxes are expressed, leading to a formulation of the second principle highlighting the duality between irreversible fluxes and conjugated driving forces. A connection between NET and the open system thermodynamic formulation for growing continuum solid bodies is obtained by interpreting the balance laws with source terms as contributions from an external reservoir of nutrients.
Enrollment of Veterans Into a Heart Failure Home Telehealth Program
Authors: Brainerd Laurie , Hawkins Shelley Y.
Published: December 2015

Heart failure (HF) affects 5.7 million Americans and is the most common reason for 30-day readmissions. While evidence supports incorporating home telehealth (HT) programs within health care organizations to support HF patient care, it is essential to carefully map HT into existing care pathways to promote successful outcomes. The purpose of this evidence-based project was to increase enrollment in an existing Veteran’s Administration HT HF program through a strategically designed HT program plan. The outcomes included a 300% enrollment and no project participant readmissions during the 9-month project. Given the competency development in strategic and program planning, advanced practice registered nurses are ideally suited to provide the leadership in designing, implementing, and evaluating HT programs.
Critical Multimodal Literacy
Authors: Ajayi Lasisi
Published: December 2015

This research investigates how three female Nigerian high school students were taught to deploy critical multimodal literacy to interrogate texts and reconstruct unequal social structures. A class of ninth-grade students in an all-women school was given instruction through the analysis of how multiple modes were used to represent meanings in textbooks. Data were collected from multiple sources, including students’ interviews, observations, classroom videos, social media posts, and artifacts of students’ literacies to analyze how they reflect on and critique their personal experiences in Nigeria within and through the English curriculum. The findings suggest that the teacher and students co-constructed possibilities for the learners to critique the social production of gender and resist structural practices that diminish their voices and their literacy learning. The findings indicate a need for English teachers in Nigeria to enact critical multimodal literacy pedagogy which relates instruction to female students’ interests to promote agency and change.
Arguing From Experience
Authors: Ghiso María Paula
Published: December 2015

As new standards require that teachers and schools move to incorporate argument writing beginning in the earliest grades, young children’s interactions with opportunities to formulate claims require further investigation. This article, part of a yearlong ethnographic study of a first-grade class, examines young children’s practices of argument writing during a 6-week unit that invited them to take a stance on issues in their lives they considered unfair. I utilize feminist epistemologies to understand the ways children drew on their embodied knowledge to make normative claims about the world and investigate social justice concerns. Analysis focuses on the teacher’s and students’ characterizations of writing arguments and the discursive negotiation of what writing comes to mean for differently situated participants, including areas of contestation. This study illuminates the interrelationship between specific features of argument, the premises of the genre, and children’s lived experiences, and proposes a continuum of argumentation. In contrast to the dominant rationalities codified in writing standards and curricular mandates, findings suggest that young children engaged with composing arguments in ways that displayed an alternative rationality derived from their social locations. Through sponsorship from their teacher, the children came to see their personal experiences as central to the arguments they were constructing, and their role as writers as moving beyond disinterested discernment of contrasting perspectives to seeing themselves as invested in the issues under study. Implications for research and practice in early childhood literacy are discussed.
A Comprehensive Toxicological Safety Assessment of an Extract of Olea Europaea L. Leaves (Bonolive™)
Authors: Clewell Amy E. , Béres Erzsébet , Vértesi Adél , Glávits Róbert , Hirka Gábor , Endres John R. , Murbach Timothy S. , Szakonyiné Ilona Pasics
Published: December 2015

A battery of toxicological studies was conducted to investigate the genotoxicity and repeated-dose oral toxicity of Bonolive™, a proprietary water-soluble extract of the leaves of the olive tree ( Olea europaea L.), in accordance with internationally accepted protocols. There was no evidence of mutagenicity in a bacterial reverse mutation test and in an vitro mammalian chromosomal aberration test nor was any genotoxic activity observed in an in vivo mouse micronucleus test at concentrations up to the limit dose of 2000 mg/kg bw/d. Bonolive™ did not cause mortality or toxic effects in Crl:(WI)BR Wistar rats in a 90-day repeated-dose oral toxicity study at doses of 360, 600, and 1000 mg/kg bw/d. The no observed adverse effect level in the 90-day study was 1000 mg/kg bw/d for both male and female rats, the highest dose tested.
Evaluation of environment and a feline facial pheromone analogue on physiologic and behavioral measures in cats
Authors: Conti Laura MC , Champion Tatiana , Guberman Úrsula C , Mathias Carlos HT , Fernandes Stéfano L , Silva Elisângela GM , Lázaro Monique A , Lopes Aline DCG , Fortunato Viviane R
Published: December 2015

Objectives

This study assessed behavioral and physiologic stress parameters in cats placed in two environments: home and the veterinary hospital. With a widely used scale, several parameters were assessed, including respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), vagosympathetic responses using calculated intervals (heart rate variability [HRV]10, HRV20 and vasovagal tonus index [VVTI]) and ‘stress attitude’, such as struggling, vocalization and agitation during handling. In addition, we evaluated whether a feline facial pheromone analogue (FFPA) had an effect on any of these measures in either environment.

Methods

Using a placebo and a pheromone substance, we evaluated 30 adult and healthy cats at home and in veterinary hospitals. Statistical analyses were performed using the Shapiro–Wilk, Kruskal–Wallis, and Dunn or ANOVA and Tukey tests, as well as Spearman’s correlation ( P <0.05).

Results

We found that exposure to FFPA did not reduce the effects of stress. Some parameters presented differences with regard to environment: the RR was 45 and 70 breaths/min and stress attitude score was 1.3 and 0.0 for cats evaluated at home and at the hospital, respectively. The HR and two vagosympathetic responses were also different between the two environments, with a HR of 160 and 187 beats/min, HRV10 of 14.24 and 14.00, and HRV20 of 14.89 and 14.65 in cats at home and the hospital, respectively. There was no variation in SBP and VVTI parameters between the environments.

Conclusions and relevance

Exposure to FFPA does not reduce the physiologic and behavioral changes measured in this study. Furthermore, environmental change, physical restraint and manipulation during the physical examination alter RR, HR, HRV and behavior but not SBP and VVTI. This study is relevant because physiologic and behavioral stress can affect the quality and interpretation of physical examination results. This study presents detailed data that show the effects of environment and manipulation on such parameters. Furthermore, this study shows a lack of effect of FFPA on any of these parameters.
Development and psychometric evaluation of a psychosocial quality-of-life questionnaire for individuals with autism and related developmental disorders
Authors: Markowitz Leslie A , Reyes Charina , Embacher Rebecca A , Speer Leslie L , Roizen Nancy , Frazier Thomas W
Published: December 2015

This study investigated the psychometric properties of the Child and Family Quality of Life scale, a measure of psychosocial quality of life in those with autism and related developmental disorders. Parents of 212 children suspected of autism spectrum disorder completed the Child and Family Quality of Life prior to a diagnostic evaluation. Results indicated that the Child and Family Quality of Life measured six unique quality-of-life constructs (child, family/caregiver, financial, external support, partner relationship, and coping), had good reliability across score ranges and exhibited expected patterns of convergent validity. Caregivers of autism spectrum disorder–affected children reported reduced family quality of life prior to the time of diagnosis relative to caregivers of children with other developmental disabilities. The Child and Family Quality of Life is a brief, reliable measure for assessing psychosocial quality of life in families affected by developmental disability. This study is the first to demonstrate impairments in family quality of life early in the developmental course of autism spectrum disorder, prior to formal diagnosis. In addition to traditional child-focused intervention strategies, families with autism spectrum disorder–affected children require early, broad intervention strategies that positively impact the whole family.
Lighting performance of urban vernacular architecture in the East-Mediterranean area: Field study and simulation analysis
Authors: Michael A. , Heracleous C. , Thravalou S. , Philokyprou M.
Published: December 2015

This study aims to investigate the natural lighting performance in indoor and semi-open spaces of urban vernacular architecture in the Mediterranean region. In vernacular architecture, natural lighting was the main source of light available and was largely achieved through the central courtyard. In this framework, an in-depth lighting performance analysis was carried out in a typical and representative traditional urban complex in the walled city of Nicosia, Cyprus. In-situ lighting measurements, as well as software simulations, were employed in order to assess the lighting performance of the building complex. The study has shown that lighting levels of semi-open and indoor spaces on the first floor are sufficient; whereas, the dense urban fabric, and the introverted character of vernacular architecture, create certain limitations to the lighting levels in indoor spaces of the ground floor. On the other hand, the positive impact of the inner courtyard to the lighting levels of semi-open and indoor spaces has been verified.
Examining Sri Lankan professional women’s perceptions of their opportunities to undertake international careers
Authors: Hutchings Kate , Samaratunge Ramanie , Lu Ying , Gamage Aruna Shantha
Published: December 2015

Extant research has examined women’s under-representation (relative to men) in international careers in respect to prejudice towards women in host countries, organizational resistance to selecting women, women’s own disinterest in taking international work and host country societal expectations of women. Although research has suggested the benefits for global organizations of having management diversity, the literature has given limited consideration to barriers and opportunities for international careers for women from developing countries. This study addresses this gap in examining the perceptions of 243 professional women in Sri Lanka about factors they perceive affect opportunities for international careers. The findings suggest the women perceive that positive female role models and family/husband support may facilitate opportunities, whereas prejudice in host countries, organizational gender discrimination and home country societal values emphasizing a primary responsibility of women as wives, mothers and daughters may hinder opportunities. The research has business implications in that, given a global ageing population and increasing numbers of nontraditional families, organizations seeking to achieve gender and ethnic diversity among their international cross-cultural managers need to be cognizant of supporting employees with extended family responsibilities.
Policy, Practice and Perceptions: Exploring the Criminalisation of Children’s Home Residents in England
Authors: Shaw Julie
Published: December 2015

The criminalisation of young people in response to children’s residential, home-based challenging behaviour remains a persistent problem in the United Kingdom. This article presents research which, through a series of semi-structured interviews and a focus group with professionals from the care and youth justice systems, sought to gain insights into why this might be the case. It was concluded that there is a need to empower residential staff; bring greater objectivity into decision-making processes and raise awareness of how system contact can impact children’s self-perception, and future prospects.
A dual instructional model for computer-assisted qualitative data analysis software integrating faculty member and specialized instructor: Implementation, reflections, and recommendations
Authors: Leitch Judith , Oktay Julianne , Meehan Ben
Published: December 2015

Teaching qualitative methods to students has become more frequent in social work programs. The use of computer-assisted qualitative data analysis software has also increased. Improper use of these software programs, however, can lead to misinterpretation of qualitative data. Computer-assisted qualitative data analysis software instruction has evolved in an ad hoc manner in spite of the importance of correct use of this software. This results in a lack of thorough knowledge of computer-assisted qualitative data analysis software or knowledge of the software that poorly incorporates qualitative methodology. We propose a new model that addresses these barriers by incorporating computer-assisted qualitative data analysis software instruction with qualitative inquiry via a dual instruction method. This model centers on the collaboration between the qualitative faculty instructor and a specialized computer-assisted qualitative data analysis software trainer. The result of this is integration of qualitative research knowledge with computer-assisted qualitative data analysis software skills. Both the faculty member and specialized computer-assisted qualitative data analysis software trainer have the opportunity to work with the students and collaborate with one another. This paper describes the new model, including its conception and requirements for its implementation. We discuss our own experiences implementing the model and offer individual reflections of the faculty member, the trainer, and a student from the pilot program. The results appear to be more effective and appropriate use of this software.
Critically Encountering Exer-games and Young Femininity
Authors: Francombe-Webb Jessica
Published: December 2015

This article builds upon previous research into the Nintendo Wii game “We Cheer” through qualitative analysis of the lived experiences of young girls and their playing experiences. I argue here that this multi-layered approach is important as it allows for exploration of the nuances between representation and everyday lives, specifically when analyzing the complexity and contradictions related to the girls’ hetero-sexy embodiment and the process of becoming female in a (digital) culture still largely dominated by the sociocultural constitution of slenderness. Throughout the analysis, I aim to demonstrate the way in which the girls’ engagement with “We Cheer” was mediated by their own embodied sensemaking and work on the self. As such, I focus on the partial stories that the girls tell about their own embodied femininities to advance studies of media reception in ways that are arguably unique to interactive exer-games such as “We Cheer.”
Low-velocity impact failure mechanism analysis of 3-D braided composites with Hilbert–Huang transform
Authors: Zhang Yan , Wang Ping , Guo Chongbin
Published: December 2015

This paper aimed to reveal the low-velocity impact responses characteristics and failure mechanism of 3-D braided composites with experimental and frequency domain analysis method, respectively. The low-velocity impact tests were carried out by Instron® 9250 drop-weight instrument with five different impact velocities from 1 m/s to 6 m/s. The results showed that the peak load and absorbed energy increased with the increase of impact velocity. The load–time curves which were in time domain were transformed into frequency domain with Hilbert–Huang Transform (HHT) method. Combined the failure morphologies of 3-D braided composites with frequency domain analysis results, it could be precisely found out the failure mechanism of 3-D braided composites. At the impact velocity of 1 m/s, the 3-D braided composites only had elastic deformations. With the increase of impact velocity, resin crack was the main failure mode of 3-D braided composites. The frequency of impact stress waves which caused the elastic deformation and resin crack mainly located at 0–10 kHz and 60 kHz. When the impact velocity increased to 6 m/s, fiber tows breakage was the main failure mode, and the frequency of impact stress wave located at 15–20 kHz.
Time-Resolved Versus Integrated Transit Planar Dosimetry for Volumetric Modulated Arc Therapy
Authors: Persoon L.C.G.G. , Podesta M. , Nijsten S.M.J.J.G. , Troost E.G.C. , Verhaegen F.
Published: December 2015

Purpose:

It is desirable that dosimetric deviations during radiation treatments are detected. Integrated transit planar dosimetry is commonly used to evaluate external beam treatments such as volumetric-modulated arc therapy. This work focuses on patient geometry changes which result in differences between the planned and the delivered radiation dose. Integrated transit planar dosimetry will average out some deviations. Novel time-resolved transit planar dosimetry compares the delivered dose of volumetric-modulated arc therapy to the planned dose at various time points. Four patient cases are shown where time-resolved transit planar dosimetry detects patient geometry changes during treatment.

Methods:

A control point to control point comparison between the planned dose and the treatment dose of volumetric-modulated arc therapy beams is calculated using the planning computed tomography and the kV cone-beam computed tomography of the day and evaluated with a time-resolved γ function. Results were computed for 4 patients treated with volumetric-modulated arc therapy, each showing an anatomical change: pleural effusion, rectal gas pockets, and tumor regression.

Results:

In all cases, the geometrical change was detected by time-resolved transit planar dosimetry, whereas integrated transit planar dosimetry showed minor or no indication of the dose discrepancy. Both tumor regression cases were detected earlier in the treatment with time-resolved planar dosimetry in comparison to integrated transit planar dosimetry. The pleural effusion and the gas pocket were detected exclusively with time-resolved transit planar dosimetry.

Conclusions:

Clinical cases were presented in this proof-of-principle study in which integrated transit planar dosimetry did not detect dosimetrically relevant deviations to the same extent time-resolved transit planar dosimetry was able to. Time-resolved transit planar dosimetry also provides results that can be presented as a function of arc delivery angle allowing easier interpretation compared to integrated transit planar dosimetry.
Utilizing and Adapting the Delphi Method for Use in Qualitative Research
Authors: Brady Shane R.
Published: December 2015

The Delphi method is a pragmatic research method created in the 1950s by researchers at the RAND Corporation for use in policy making, organizational decision making, and to inform direct practices. While the Delphi method has been regularly utilized in mixed methods studies, far fewer studies have been completed using the Delphi method for qualitative research. Despite the utility of the Delphi method in social science research, little guidance is provided for using the Delphi in the context of theory building, in primarily qualitative studies, and in the context of community-engaged research (CER). This article will emphasize new and modest innovations in the Delphi method for improving the overall rigor of the method in theory building and CER.
Writing through the labyrinth: Using l’ecriture feminine in leadership studies
Authors: Lipton Briony
Published: December 2015

Metaphors enable us to understand organisations in distinctive ways and explain the paucity of women in leadership positions, and yet, when gender discrimination is addressed via metaphor, women’s responses, resistance and agency are rarely included in such analyses. In this article, I employ a narrative writing practice inspired by the work of Hélène Cixous as a way of exploring how we might research and write differently in leadership studies. Cixous invites women to reclaim their sexuality and subjectivity through a feminine mode of women’s writing and what she defines as l'ecriture feminine can be interpreted as a liberating bodily practice that aims to release women’s repressed creative agency and transform phallogocentric structures. Using the Greek mythology of the Minotaur and the Labyrinth, this article weaves together these seemingly disparate concepts of myth, metaphor and feminist writing practices with leadership discourse to explore the ways in which academic women experience the university organisation as a labyrinth, how they navigate pathways to promotion and practice leadership. This creative analytic operates as a metanarrative that offers new ways of researching and writing leadership studies from the body, and reveals how myths continue to influence present experiences and structures in unexpected ways.
Chinese media in Brussels and EU–China relations
Authors: Men Jing
Published: December 2015

This article examines news reports and analysis on major European affairs by Chinese correspondents based in Brussels. Along with the rapid development of EU–China relations and the need for China to strengthen international communication, more Chinese media groups send their journalists to Brussels. The article studies the three mostly covered issues by Chinese media: the European debt crisis, the Juncker Plan and the refugee crisis. By analyzing the Chinese angle on these issues, the article revisits EU–China relations and points out the major strength in their economic relationship and differences in their political understanding.
The quest for balanced reporting on China in the EU media: Forces and influences
Authors: Fingleton William
Published: December 2015

Local media in any country that is the target of soft power actions is usually the most influential force in shaping public opinion and perceptions of the other country, its culture and its people. Therefore countries should pay particular attention to foreign journalists working within their borders. This study begins by looking at the Chinese point of view and then examines some of the forces and influences at work behind the scenes that affect the coverage of China in European media, such as conditions for EU journalists working in China, lack of transparency and access to information, pressures from the audience, editors and owners at home, as well as the diverging views on the role of journalists in Europe and China. Finally, it presents some insights on how what appears to be a deteriorating relationship can be improved for the benefit of all concerned.
Measuring the cardiac output in acute emergency admissions: use of the non-invasive ultrasonic cardiac output monitor (USCOM) with determination of the learning curve and inter-rater reliability
Authors: Hodgson Luke E , Venn Richard , Forni Lui G , Samuels Theophilus L , Wakeling Howard G
Published: December 2015

Traditionally, assessment of the cardiac output has been limited to theatre or the intensive care unit. However, non-invasive cardiac output estimation is now readily available, and its application may have wider benefit in the emergency setting. The non-invasive ultrasonic cardiac output monitor (USCOM) was investigated to determine its learning curve and inter-rater reliability. Four trainee operators each performed stroke volume measurements on 25 volunteers, compared to an experienced operator pre- and post-passive leg raise. Inter-rater reliability was then assessed on 24 acute emergency in-patients. Mean percentage difference in stroke volume decreased from 19% (95% confidence intervals 14–23) across volunteers 1–5, to 6% (4–8) for the last 5 volunteers scanned. Consequently, on acute emergency in-patients, excellent inter-rater reliability (Lin’s concordance correlation coefficient (ρc) 0.96 (0.92–0.98)) and agreement of a change ≥10% in stroke volume following passive leg raise on 23/24 cases were found. Following a training period of less than 5 h, USCOM stroke volume measurements demonstrated excellent inter-rater reliability.
Manganese toxicity in critical care: Case report, literature review and recommendations for practice
Authors: Walter Edward , Alsaffar Sinan , Livingstone Callum , Ashley Sarah L
Published: December 2015

We present the case of a 62-year-old man on the intensive care unit with pancreatitis. Since early in his admission, and for the remainder of his prolonged stay in intensive care, he has received parenteral nutrition for intestinal failure. The whole blood manganese concentration was significantly increased after 2½ months of parenteral nutrition (PN). Three months into his stay, he developed a resting tremor and extra-pyramidal dyskinesia. In the absence of other neurological symptoms, and with no history of essential tremor, Parkinsonism or cerebral signs, hypermanganesaemia was presumed to be the cause. We review manganese metabolism and toxicity in patients who are fed with parenteral nutrition and review the current recommendations and guidelines.
An update on the role of testosterone replacement therapy in the management of hypogonadism
Authors: Hackett Geoffrey
Published: December 2015

While US testosterone prescriptions have tripled in the last decade with lower trends in Europe, debate continues over the risks, benefits and appropriate use of testosterone replacement therapy (TRT). Some authors blame advertising and the availability of more convenient formulations whilst other have pointed out that the routine testing of men with erectile dysfunction (a significant marker of cardiovascular risk) and those with diabetes would inevitably increase the diagnosis of hypogonadism and lead to an increase in totally appropriate prescribing. They commented that this was merely an appropriate correction of previous underdiagnosis and undertreatment by adherence to evidence-based guidelines. Urologists and primary care physicians are the most frequent initiators of TRT, usually for erectile dysfunction. Benefits are clearly established for sexual function, increase in lean muscle mass and strength, mood and cognitive function, with possible reduction in frailty and osteoporosis. There remains no evidence that TRT is associated with increased risk of prostate cancer or symptomatic benign prostatic hyperplasia, yet the decision to initiate and continue therapy is often decided by urologists. The cardiovascular issues associated with TRT have been clarified by recent studies showing clearly that therapy associated with clear rise in testosterone levels are associated with reduced mortality. Studies reporting to show increased risk have been subject to flawed designs with inadequate baseline diagnosis and follow-up testing. Effectively they have compared nontreated patients with undertreated or on-compliant subjects involving a range of different therapy regimens. Recent evidence suggests long acting injections may be associated with decreased cardiovascular risk but the transdermal route may be associated with potentially relatively greater risk because of conversion to dihydrotestosterone by the effect of 5α reductase in skin. The multiple effects of TRT may add up to a considerable benefit to the patient that might be underestimated by the physician primarily concerned with his own specialty. This paper will attempt to identify who should be treated, and how they should be treated safely to achieve best outcomes, based on a comprehensive MEDLINE and EMBASE and Cochrane searches on hypogonadism, TRT and cardiovascular safety from May 2005 to May 2015. This revealed 1714 papers with 52 clinical trials and 32 placebo-controlled randomized, controlled trials.
The Impact of Nitinol Staples on the Compressive Forces, Contact Area, and Mechanical Properties in Comparison to a Claw Plate and Crossed Screws for the First Tarsometatarsal Arthrodesis
Authors: Aiyer Amiethab , Russell Nicholas A. , Pelletier Matthew H. , Myerson Mark , Walsh William R.
Published: December 2015

Background. The optimal fixation method for the first tarsometatarsal arthrodesis remains controversial. This study aimed to develop a reproducible first tarsometatarsal testing model to evaluate the biomechanical performance of different reconstruction techniques. Methods. Crossed screws or a claw plate were compared with a single or double shape memory alloy staple configuration in 20 Sawbones models. Constructs were mechanically tested in 4-point bending to 1, 2, and 3 mm of plantar displacement. The joint contact force and area were measured at time zero, and following 1 and 2 mm of bending. Peak load, stiffness, and plantar gapping were determined. Results. Both staple configurations induced a significantly greater contact force and area across the arthrodesis than the crossed screw and claw plate constructs at all measurements. The staple constructs completely recovered their plantar gapping following each test. The claw plate generated the least contact force and area at the joint interface and had significantly greater plantar gapping than all other constructs. The crossed screw constructs were significantly stiffer and had significantly less plantar gapping than the other constructs, but this gapping was not recoverable. Conclusions. Crossed screw fixation provides a rigid arthrodesis with limited compression and contact footprint across the joint. Shape memory alloy staples afford dynamic fixation with sustained compression across the arthrodesis. A rigid polyurethane foam model provides an anatomically relevant comparison for evaluating the interface between different fixation techniques. Clinical Relevance. The dynamic nature of shape memory alloy staples offers the potential to permit early weight bearing and could be a useful adjunctive device to impart compression across an arthrodesis of the first tarsometatarsal joint.

Levels of Evidence: Therapeutic, Level V: Bench testing
Physiological responses and political behavior: Three reproductions using a novel dataset
Authors: Knoll Benjamin R , O’Daniel Tyler J , Cusato Brian
Published: December 2015

One of the most provocative recent findings in our understanding of political behavior is the link between physiological responses to environmental stimuli and political attitudes and behavior. This line of research holds much promise in explaining some of the foundational evolutionary origins of basic political orientations. Much of this recent research focused specifically on skin conductance response to threatening and disgusting stimuli, however, is based on analyses of a data collection sample of approximately 200 study participants drawn from the same community at a single point in time. Herein we attempt to reproduce many of the basic findings of recent research on skin conductance response and political behavior using data collected from a novel and unique dataset in a different context. In brief, we fail to reproduce many of the basic findings from this incipient line of research which suggests that the link between skin conductance and political behavior may be more contingent than previously assumed.
Household context and individual departure: The case of escape in three ‘unfree’ East Asian populations, 1700–1900
Authors: Dong Hao , Campbell Cameron , Kurosu Satomi , Lee James Z
Published: December 2015

In the past, many people were ‘unfree’ in the sense that their movement was restricted, and migration without permission was regarded and recorded as ‘escape’. Even though such escape was common in the past, historical studies mostly neglect this form of migration. This article examines escape in historical East Asia, focusing on the influence of household context and individual characteristics on the chances of escape, taking advantage of large-scale individual panel datasets from three adjacent ‘unfree’ populations from northeast China, southeast Korea and northeast Japan in the 18th and 19th centuries. We identify similar temporal, spatial and age patterns of escape, and also similar patterns of associations between chances of escape and household context. In particular, the presence of dependent children and elderly in the household makes individuals less likely to escape. Other patterns of association also highlight the importance of gender and social class. Despite significant differences in political, social and community contexts across these three East Asian populations, the empirical comparisons suggest important commonalities in terms of motivation driven by shared understandings of obligation to others.
A Probation Profanation
Authors: Steinmetz Kevin F. , Anderson Jamilya O.
Published: December 2015

Racial and ethnic disparities in criminal justice have received increasing scrutiny recently. Little attention, however, has been directed toward understanding inequality in the area of probation. The current study addresses this dearth through two analyses of 14,365 probation cases. The first involves a logistic regression analysis, which examines race/ethnicity against probation failure. Using probation success as a control outcome, the second analysis uses a multinomial regression to examine the effects of race and ethnicity across four types of probation failure—administrative failure and revocations resulting from technical violations, new felonies, and new misdemeanors. Across both models, racial/ethnic categorization were found to be significantly and positively associated with probation failure outcomes. In addition, the standardized coefficients indicate that Black and Hispanic racial/ethnic categorization presented a moderate to strong effect sizes across outcomes studied. The strongest effect sizes for these two variables were found in the multinomial model within the administrative failure outcome. Across both models, other racial categorization (Asian/Pacific Islander or Native American/Alaskan Native) was statistically significant but consistently produced some of the weakest effect sizes. Potential explanations for these findings are offered along with a discussion of study limitations, future research suggestions, and policy implications.
A Dream of a School
Authors: Leshem Shosh , Zion Noa , Friedman Ariel
Published: December 2015

In this study, we examined how student teachers in their first year of a teacher education program develop insights of their ideal school and desired teaching by designing a model of a school that incorporated ideological, pedagogical, physical, and interpersonal aspects. Twenty projects of ideal schools were analyzed. The findings reveal that student teachers at their initial stages of teacher education, when exposed to dissonances at the boundary between different social worlds, can develop complex understanding if they are provided with contexts that allow such spaces. We conclude that teacher educators can exploit incidents of conflict and friction as learning opportunities and thus enhance deeper learning.
Variation in Follow-Up Visit Practices Across Clinicians and Conditions
Authors: Liu Caterina Yuan , Gonzales Ralph
Published: December 2015

Background:

Specialty care access is increasingly constrained due to increasing demand for specialty care. Although much attention has been placed on the initial referral decision, much less is known about follow-up visit patterns. We examined the patterns of follow-up visits for new patients to a university-based cardiology practice and identified independent predictors of follow-up visits.

Methods:

This is a retrospective cohort study of new patient visits using electronic medical record data. The primary outcome was a follow-up visit.

Results:

Substantial variation in practice patterns by provider persisted after accounting for patient and disease factors. Most follow-up care was concentrated in a small population of patients.

Conclusion:

Specialty care follow-up visits may represent a significant opportunity for standardization and quality improvement, and further studies are warranted to understand follow-up visits in specialty care.

Implications:

Better understanding of between-provider differences could identify ways to reduce unnecessary follow-up visits.

Level of Evidence:

Single-institution study.
Ultrasound Accuracy of Liver Length Measurement With Cadaveric Specimens
Authors: Riestra-Candelaria Bárbara L. , Rodríguez-Mojica Wilma , Vázquez-Quiñones Luis E. , Jorge Juan Carlos
Published: December 2015

The liver is one of the principal organs in the body and is involved in over 500 physiological functions related to metabolism, digestion, immunity, and storage of nutrients. Given that there are a number of approaches to measure liver length through diagnostic 2D sonography, this work was undertaken to determine the most accurate measurement of this organ. Cadaveric specimens (n = 21) were employed to assess measurements in the midclavicular line (MCL) and the midaxillary line (MAL). Each measurement was calculated in anteroposterior (AP) and craniocaudal (CC) planes. In addition, in situ measurements were obtained by accessing the organ through the anterior thoracoabdominal wall. Statistical differences were detected between MCL and MAL measurements ( P < .05), and a positive correlation between MAL CC and in situ anterior measurements were noted (r = 0.97). Liver size, as assessed through in situ measurements, varied as a funtion of BMI and waist circumference ( P < .05). It is concluded that the craniocaudal measurement of the right lobe of the liver in the midaxillary line, from the uppermost right hemi-diaphragm to the inferior tip of the right lobe through a horizontal line parallel to the anterior liver wall, is the most accurate measurement of the organ by sonography.
Circular RNA enrichment in platelets is a signature of transcriptome degradation
Authors: Alhasan Abd A. , Izuogu Osagie G. , Al-Balool Haya H. , Steyn Jannetta S. , Evans Amanda , Colzani Maria , Ghevaert Cedric , Mountford Joanne C. , Marenah Lamin , Elliott David J. , Santibanez-Koref Mauro , Jackson Michael S.
Published: December 2015

Key Points

Circular RNAs are hugely enriched in platelets compared with nucleated cell types. Lack of enrichment in megakaryocte progenitors implicates degradation of platelet linear RNAs.
Epigenetics and approaches to targeted epigenetic therapy in acute myeloid leukemia
Authors: Wouters Bas J. , Delwel Ruud
Published: December 2015

Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. AML is a heterogeneous malignancy characterized by distinct genetic abnormalities. Recent discoveries have highlighted an additional important role of dysregulated epigenetic mechanisms in the pathogenesis of the disease. In contrast to genetic changes, epigenetic modifications are frequently reversible, which provides opportunities for targeted treatment using specific inhibitors. In this review, we will provide an overview of the current state of epigenetics and epigenetic therapy in AML and will describe perspectives on how to identify promising new approaches for epigenetic targeted treatment.