bluuebunny/crossref_metadata_2025 huggingface dataset:
A fuzzy technique for order preference by similarity to an ideal solution–based quality function deployment for prioritizing technical attributes of new products
Authors: Li Xiuzhen , Ming Xinguo , Song Wenyan , Qiu Siqi , Qu Yuanju , Liu Zhiwen
Published: October 2016

Quality function deployment is a cross-functional decision-making tool that converts customer needs into technical attributes of new products. Fuzzy numbers are usually adopted to evaluate the customer need importance and the customer need–technical attribute relationships. However, the weighted normalized customer need–technical attribute relationship matrix is not always full rank. If the different fuzzy numbers of two technical attributes are defined as the fuzzy negative ideal solutions, both the closeness coefficients are 0, and the traditional technique for order preference by similarity to an ideal solution cannot prioritize the two technical attributes. Actually, the rankings of different fuzzy numbers are not identical. To solve this problem, we present a new technique for order preference by similarity to an ideal solution to prioritize technical attributes in the fuzzy quality function deployment. The fuzzy positive ideal solution, fuzzy negative ideal solution, and distance measurement of the new technique for order preference by similarity to an ideal solution are improved. As a result, the proposed method not only prioritizes various forms of numbers without considering the lower and upper limits, the median, and boundary interval but also deals with the nonfull rank matrix. Besides, the Theory of Inventive Problem Solving is used to solve technical conflicts which are identified by the line-fitting method. The prioritization results from the proposed method can help to reasonably allocate design and manufacturing resources. Finally, a case on phone shell is given to illustrate the application of the proposed quality function deployment method.
Heritability of Intraindividual Mean and Variability of Positive and Negative Affect
Authors: Zheng Yao , Plomin Robert , von Stumm Sophie
Published: October 2016

Positive affect (e.g., attentiveness) and negative affect (e.g., upset) fluctuate over time. We examined genetic influences on interindividual differences in the day-to-day variability of affect (i.e., ups and downs) and in average affect over the duration of a month. Once a day, 17-year-old twins in the United Kingdom ( N = 447) rated their positive and negative affect online. The mean and standard deviation of each individual’s daily ratings across the month were used as the measures of that individual’s average affect and variability of affect. Analyses revealed that the average of negative affect was significantly heritable (.53), but the average of positive affect was not; instead, the latter showed significant shared environmental influences (.42). Fluctuations across the month were significantly heritable for both negative affect (.54) and positive affect (.34). The findings support the two-factor theory of affect, which posits that positive affect is more situational and negative affect is more dispositional.
Mindful interventions: Youth, poverty, and the developing brain
Authors: Choudhury Suparna , Moses Joshua M.
Published: October 2016

Mindfulness meditation is being advocated as a promising new educational, clinical, and social intervention for youth, fueled by new evidence from neuroscience about the benefits of “growing the brain through meditation,” convergent with recent data on developmental neuroplasticity. Although still marginal and in some cases controversial, secular programs of mindfulness have been implemented with ambitious goals of improving attentional focus of pupils, social-emotional learning in “at-risk” children and youth and, not least, to intervene in problems of poverty and incarceration. In this article, we present insights from an ongoing study involving teachers and mentors working with young people using mindfulness education from an emerging project on the social and cultural contexts of “neuroeducation.” Our analysis points to the role of neuroscience in positioning these programs as legitimate and progressive, based on state-of-the-art science. We discuss the tensions arising from their moral reframing of social problems associated with poverty and inequality.
Tephrostratigraphical investigation of lake sediments and a peat bog in Northeastern China since 20,000 years
Authors: Zhao Hongli , Liu Jiaqi , Hall Valerie A , Li Xiaoqiang
Published: October 2016

This is a detailed tephrostratigraphical investigation of late Quaternary deposits in the Longgang and Changbaishan Volcanic Fields of northeastern China. A total of 45 reference samples which were collected from either side of the Chinese/Korean border showed very similar geochemical characteristics to the Millennium eruption of Tianchi Volcano. Through comparing the published data of the glass shards detected in Gushantun with these reference samples, further description is that the glass shards in the sediment of Gushantun came from the Tianchi Volcano eruption in AD 1702, 1668, and 1597. A basaltic tephra layer found in the sediment of Hanlongwan associated with an eruption of the Jinlongdingzi Volcano which happened in 1500–2100 cal. yr BP by comparing with the published data from Sihailongwan and Xiaolongwan. Tianchi and Jinlongdingzi Volcano are both active and erupted several times during the historical period. Reference samples and the tephra layers detected in Hanlongwan, Sihailongwan, Gushantun, Erlongwan, and Xiaolongwan can be used as marker horizons beyond the Longgang Volcanic Field and Changbaishan Volcanic Field, including, for example, in Japan, Korea, nearby coastal area of Russia, and marine records.
Participants’ safety versus confidentiality: A case study of HIV research
Authors: Leyva-Moral Juan Manuel , Feijoo-Cid Maria
Published: October 2016

Background

When conducting qualitative research, participants usually share lots of personal and private information with the researcher. As researchers, we must preserve participants’ identity and confidentiality of the data.

Objective

To critically analyze an ethical conflict encountered regarding confidentiality when doing qualitative research.

Research design

Case study.

Findings and discussion

one of the participants in a study aiming to explain the meaning of living with HIV verbalized his imminent intention to commit suicide because of stigma of other social problems arising from living with HIV. Given the life-threatening situation, the commitment related to not disclosing the participant’s identity and/or the content of the interview had to be broken. To avoid or prevent suicide, the therapist in charge of the case was properly informed about the participant’s intentions. One important question arises from this case: was it ethically appropriate to break the confidentiality commitment?

Conclusion

confidentiality could be broken if a life-threatening event is identified during data collection and participants must know that. This has to be clearly stated in the informed consent form.
Occupational Pattern and Workforce Participation of Women in Indian Rural Punjab: A Caste Perspective
Authors: Baruah Ashapurna
Published: October 2016

The paper examines employment of women in rural Punjab for the period 1993–1994 to 2011–2012. The analysis is done using the unit-level data for five employment rounds of NSS. The NSS rounds prior to 2009–2010 were based on National Classification of Occupation (NCO) 1968, whereas the latest two rounds use NCO 2004. The paper uses the concordance tables (with minor adjustments) to make all rounds comparable. The purpose of the exercise is to examine participation rates and analyze occupational pattern among rural women in the context of growth and structural change in the Punjab economy. The paper finds that structural change has neither improved labour market participation nor quality of employment among rural women during the last two decades. The analysis provides evidence of downward occupational mobility among all women and finds that the caste attribute further intensifies such downward trend, making SC women worse off in terms of occupational outcomes.
Innovation and Employment: A Study of Indian Manufacturing Sector
Authors: Mehta Swati
Published: October 2016

While innovation is widely acclaimed as an important source of productivity and growth, its relationship with employment remained largely ambiguous. The debate assumes importance as the recent past has witnessed economic growth with falling or stagnant employment growth in a large number of countries. The loss of additional employment resulted in widespread inequalities and poverty that put the issue of economic growth in jeopardy. Moreover, there is a need to understand the relationship between innovation, employment and economic growth. This paper is an attempt towards deciphering this relationship to find the way-out for higher economic and employment growth using the case of Indian manufacturing sector. With the motive to find the impact of innovation on employment in different technological-intensive industries, four industries, namely pharmaceuticals (high technology), transport (medium–high technology), ferrous metals (medium–low technology) and textiles (low technology), for the period 2000–2001 to 2013–2014 are examined. It was found that the impact of ‘product innovation’ is positive on employment for different industries. Therefore, there is a need to build the ‘system of innovation’ in such a manner that radical innovations could be produced for long-term growth and employment.
End-of-Life Care Patterns at a Community Hospital: The Rest of the Story
Authors: Waite Kip , Rhule Jane , Bush David , Meisenberg Barry
Published: October 2016

We undertook a retrospective review of a subset of expired patients at our community hospital to evaluate end-of-life care patterns and the use of advanced care planning tools among patients who died in the hospital. These 162 expired patients fell into 1 of the 3 diagnosis-related groups of cardiac, respiratory, or infectious disease. Seventy-nine percent of patients arrived to the hospital with no requested limitations in the extent of resuscitative efforts, even though 98% of all patients had major or extreme severity of illness and risk of mortality scores. The presence of an advance directive requesting a limitation of resuscitative efforts modestly impacted resources and procedures, even though utilization in this group was high. Among the 21% of patients with preexisting limits, 21% requested more aggressive support during their course. Critical care unit utilization was seen in 69% of patients for a median of 48 hours. A request for palliative care consultation was received in 44% of patients but only occurred in 30% of all patients due to the short period between the consultation request and patient death (median 37 hours). Among this group of dying patients, engagement of the palliative care team came too late in the course of many patients, suggesting that automated tools embedded in the electronic medical record might be helpful in the identification of appropriate patients earlier.
Thrombophilic Gene Mutations in Relation to Different Manifestations of Venous Thromboembolism: A Single Tertiary Center Study
Authors: Bezgin Tahir , Kaymaz Cihangir , Akbal Özgür , Yılmaz Fatih , Tokgöz Hacer Ceren , Özdemir Nihal
Published: October 2016

Background:

Venous thromboembolism (VTE) is a common and potentially lethal disorder that manifests mainly as deep vein thrombosis (DVT) of the extremities or pulmonary embolism (PE) and occurs as a consequence of genetic and environmental risk factors. We aimed to assess the role of inherited thrombophilia as a causative or additive factor in the development of VTE.

Methods:

The study included 310 patients (female: 154; mean age: 52.3 ± 16.9 years) with a first episode of VTE and 289 age- and sex-matched healthy controls. All participants underwent screening for thrombophilia-associated polymorphisms including factor V Leiden (FVL), prothrombin G20210A (PTG), factor V H1299 R (factor V HR2), factor XIII V34 L, β-fibrinogen-455 G>A, plasminogen activator inhibitor-1 4G/5G, human platelet antigen-1 a/b, methylene tetrahydrofolate reductase (MTHFR) C677 T, MTHFR A1298C, angiotensin-converting enzyme I/D, apolipoprotein B R3500Q, and apolipoprotein E (Apo E). In addition, serum homocysteine (Hcy) levels were measured.

Results:

In the patient group, 247 (80%) had isolated DVT, 43 (14%) had DVT plus PE, and 20 (6%) had isolated PE. The mean Hcy levels were similar in VTE subgroups and controls. Compared to controls, patients with isolated DVT, DVT plus PE, and isolated PE showed significantly higher frequencies for the following—heterozygous FVL mutation, isolated DVT (28.3%), DVT plus PE (44.2%), isolated PE (50%), controls (8.3%; P < .001); heterozygous PTG mutation, isolated DVT (11.3%), DVT plus PE (20.9%), isolated PE (25%), controls (5.9%; P < .01); Apo E 2/4, isolated DVT (9.7%), DVT plus PE (9.3%), isolated PE (5%), controls (1%; P < .01).The MTHFR A1298C mutation showed a significantly higher frequency in isolated patients with PE than in those with isolated DVT ( P = .006) and in controls ( P = .008). The frequencies of other genetic mutations or polymorphisms showed similar frequencies in all comparisons. In logistic regression analysis, heterozygous FVL mutation was the only independent predictor of VTE (odds ratio: 3.9, 95% confidence interval: 1.3-11.2; P = .012).

Conclusion:

Except than FVL, PTG, and Apo E 2/4 mutations, many of aforementioned thrombophilic factors known to be associated with VTE did not demonstrate any relationship with VTE. Heterozygous mutation of FVL was an independent predictor for VTE.
Mental Health Outcomes for Youth Living in Refugee Camps: A Review
Authors: Vossoughi Nadia , Jackson Yo , Gusler Stephanie , Stone Katie
Published: October 2016

Currently, there are approximately 10.8 million child refugees worldwide. Youth living in refugee camps face a wide range of difficulties placing them at risk for trauma exposure and negative mental health outcomes. However, little is known about the mental health functioning of these youth. The present review provides a systematic review of mental health outcomes for refugee/displaced youth residing in refugee camps. Twenty studies were included in the present review. Among these studies, the prevalence of mental health disorders varied greatly with some studies reporting null effects for disorders like posttraumatic stress disorder and others reporting prevalence as high as 87%. Levels of anxiety, somatic symptoms, depression, and aggression also varied across studies. The results point to the significant need for more research on the mental health of youth residing in refugee camps. Despite the wide range of measurement approaches, the evidence points to a fairly consistent finding of a range of maladjustment problems for youth living in refugee camps. Implications for improving the methodology for investigating mental health are discussed.
Clinical benefits, referral practice and cost implications of an in-hospital pain service: results of a service evaluation in a London teaching hospital
Authors: Sussman Maya , Goodier Elizabeth , Fabri Izabella , Borrowman Jessica , Thomas Sarah , Guest Charlotte , Bantel Carsten
Published: October 2016

Background:

In-hospital pain services (IPS) are commonplace, but evidence of efficacy is inadequate, and patients’ pain management in any hospital ward remains problematic. This service evaluation aimed to measure the effect of a contemporary IPS, its appropriate use and cost-efficacy.

Methods:

Records of 249 adults reviewed by the IPS in an inner London Teaching Hospital over an 8-month period were analysed for demographic data, interventions, workload and change in pain intensity measured by numerical rating scale (NRS). Non-parametric tests were used to evaluate differences between initial and final NRS. Spearman’s rank correlation analysis was used to create a correlation matrix to evaluate associations between all identified independent variables with the change in NRS. All strongly correlated variables (ρ > 0.5) were subsequently included in a binary logistic regression analysis to identify predictors of pain resolution greater than 50% NRS and improvement rather than deterioration or no change in NRS. Finally, referral practice and cost of inappropriate referrals were estimated. Referrals were thought to be inappropriate when pain was not optimised by the referring team; they were identified using a set algorithm.

Results:

Initial median NRS and final median NRS were significantly different when a Wilcoxon signed-rank test was applied to the whole cohort; Z = –5.5 (p = 0.000). Subgroup analysis demonstrated no significant difference in the ‘mild’ pain group; z = –1.1 (p = 0.253). Regression analysis showed that for every unit increase in initial NRS, there was a 62% chance of general and a 33% chance of >50% improvement in final NRS. An estimated annual cost-saving potential of £1546 to £4558 was found in inappropriate referrals and patients experiencing no benefit from the service.

Discussion:

Results suggest that patients with moderate to severe pain benefit most from IPS input. Also pain management resources are often distributed inefficiently. Future research is required to develop algorithms for easy identification of potential treatment responders.
Quantifying Quadriceps Muscle Strength in Patients With ACL Injury, Focal Cartilage Lesions, and Degenerative Meniscus Tears
Authors: Eitzen Ingrid , Grindem Hege , Nilstad Agnethe , Moksnes Håvard , Risberg May Arna
Published: October 2016

Background:

Reduced quadriceps strength influences knee function and increases the risk of knee osteoarthritis. Thus, it is of significant clinical relevance to precisely quantify strength deficits in patients with knee injuries.

Purpose:

To evaluate isokinetic concentric quadriceps muscle strength torque values, assessed both from peak torque and at specific knee flexion joint angles, in patients with anterior cruciate ligament (ACL) injury, focal cartilage lesions, and degenerative meniscus tears.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were synthesized from patients included in 3 previously conducted research projects: 2 prospective cohort studies and 1 randomized controlled trial. At the time of inclusion, all patients were candidates for surgery. Isokinetic concentric quadriceps muscle strength measurements (60 deg/s) were performed at baseline (preoperative status) and after a period of progressive supervised exercise therapy (length of rehabilitation period: 5 weeks for ACL injury, 12 weeks for cartilage lesions and degenerative meniscus). Outcome measures were peak torque and torque at specific knee flexion joint angles from 20° to 70°. All patients had unilateral injuries, and side-to-side deficits were calculated. For comparisons between and within groups, we utilized 1-way analysis of variance and paired t tests, respectively.

Results:

In total, 250 patients were included. At baseline, cartilage patients had the most severe deficit (39.7% ± 24.3%; P < .001). Corresponding numbers for ACL and degenerative meniscus subjects were 21.7% (±13.2%) and 20.7% (±16.3%), respectively. At retest, there was significant improvement in all groups ( P < .001), with remaining deficits of 24.7% (±18.5%) for cartilage, 16.8% (±13.9%) for ACL, and 3.3% (±17.8%) for degenerative meniscus. Peak torque was consistently measured at 60° of knee flexion, whereas the largest mean deficits were measured at 30° at baseline and 70° at retest for the ACL group, at 70° at baseline and retest for the degenerative meniscus group, and at 60° at baseline and at 50° at retest for the cartilage group.

Conclusion:

This study underlines the importance of including torque at specific knee flexion joint angles from isokinetic assessments to identify the most severe quadriceps muscle strength deficits. Furthermore, it confirms the importance of progressive exercise therapy interventions before potential surgery in patients with knee injuries.
A comparison of civil religion and remembrance culture in Germany and Japan
Authors: Schmidt Carmen
Published: October 2016

Japan and Germany were allies during World War II, and both countries committed crimes. Even though the Nazi persecution of Jews in Germany was unprecedented in history, Japan has also been found guilty of serious misdemeanours. Today, Germany acknowledges the magnitude of its responsibility and strives to deal with this legacy. However, in Japan, we find no consensus on dealing with the matter. Nonetheless, it would be short-sighted to conclude that Germany did a better job than Japan from the outset. In analysing the different approaches to remembrance culture in the two countries, we use the theoretical framework ofcivil religionto assess the impacts of the respective civil religions on the culture of commemoration. We hereby analyzed the structural factors as well as the influence of individual political behaviour. Immediately after the war, neither Germany nor Japan were interested in coming to terms with their past. Both countries were subject to Western integration, and both countries experienced remarkable economic growth. One of the major differences between both countries concerns civil religion. While Germany no longer relied on strong nationalism-based politics and instead pursued European integration, in Japan. Shintôism has continued to influence feelings of national belonging, making it more difficult to establish a critical dialogue with the past. Further differences are apparent: the Western origin of Japan’s constitution, the conflicting international environment in Japan, the late regime change, differences in education and, most importantly, the impacts of generational change in Germany. The 1968 student generation strongly condemned Nazi aggression and demanded that the older generation face responsibility, which strongly contributed to a reappraisal of the past in the public sphere.
Least-squares reverse time migration in the presence of density variations
Authors: Yang Jizhong , Liu Yuzhu , Dong Liangguo
Published: October 2016

Least-squares migration (LSM) is commonly regarded as an amplitude-preserving or true amplitude migration algorithm that, compared with conventional migration, can provide migrated images with reduced migration artifacts, balanced amplitudes, and enhanced spatial resolution. Most applications of LSM are based on the constant-density assumption, which is not the case in the real earth. Consequently, the amplitude performance of LSM is not appropriate. To partially remedy this problem, we have developed a least-squares reverse time migration (LSRTM) scheme suitable for density variations in the acoustic approximation. An improved scattering-integral approach is adopted for implementation of LSRTM in the frequency domain. LSRTM images associated with velocity and density perturbations are simultaneously used to generate the simulated data, which better matches the recorded data in amplitudes. Summation of these two images provides a reflectivity model related to impedance perturbation that is in better accordance with the true one, than are the velocity and density images separately. Numerical examples based on a two-layer model and a small part of the Sigsbee2A model verify the effectiveness of our method.
Application of perturbation theory to a P-wave eikonal equation in orthorhombic media
Authors: Stovas Alexey , Masmoudi Nabil , Alkhalifah Tariq
Published: October 2016

The P-wave eikonal equation for orthorhombic (ORT) anisotropic media is a highly nonlinear partial differential equation requiring the solution of a sixth-order polynomial to obtain traveltimes, resulting in complex and time-consuming numerical solutions. To alleviate this complexity, we approximate the solution of this equation by applying a multiparametric perturbation approach. We also investigated the sensitivity of traveltime surfaces in ORT media with respect to three anelliptic parameters. As a result, a simple and accurate P-wave traveltime approximation valid for ORT media was derived. Two different possible anelliptic parameterizations were compared. One of the parameterizations includes anelliptic parameters defined at zero offset: [Formula: see text], [Formula: see text], and [Formula: see text]. Another parameterization includes anelliptic parameters defined for all symmetry planes: [Formula: see text], [Formula: see text], and [Formula: see text]. The azimuthal behavior of sensitivity coefficients with different parameterizations was used to analyze the crosstalk between anelliptic parameters.
Normal moveout velocity ellipse in tilted orthorhombic media
Authors: Ivanov Yuriy , Stovas Alexey
Published: October 2016

Normal moveout (NMO) velocity is a commonly used tool in the seismic industry nowadays. In 3D surveys, the variation of the NMO velocity in a horizontal plane is elliptic in shape for the anisotropy or heterogeneity of any strength (apart from a few exotic cases). The NMO ellipse is used for Dix-type inversion and can provide important information on the strength of anisotropy and the orientation of the vertical symmetry planes, which can correspond, for example, to fractures’ orientation and compliances. To describe a vertically fractured finely layered medium (the fracture is orthogonal to the layering), an anisotropy of orthorhombic symmetry is commonly used. In areas with complicated geology and stress distribution, the orientation of the orthorhombic symmetry planes can be considerably altered from the initial position. We have derived the exact equations for the NMO ellipse in an elastic tilted orthorhombic layer with an arbitrary orientation of the symmetry planes. We have evaluated pure and converted wave modes and determined that the influence of the orientation upon the NMO ellipse for all the waves is strong. We have considered acoustic and ellipsoidal orthorhombic approximations of the NMO ellipse equations, which we used to develop a numerical inversion scheme. We determined that in the most general case of arbitrary orientation of the orthorhombic symmetry planes, the inversion results are unreliable due to significant trade-offs between the parameters. We have evaluated S-wave features such as point singularities (slowness surfaces of the split S-waves cross) and triplications (due to concaveness of the individual S-wave mode slowness surface) and their influence on the NMO ellipse.
High Sclerostin and Dickkopf-1 (DKK-1) Serum Levels in Children and Adolescents With Type 1 Diabetes Mellitus
Authors: Faienza Maria Felicia , Ventura Annamaria , Delvecchio Maurizio , Fusillo Anna , Piacente Laura , Aceto Gabriella , Colaianni Graziana , Colucci Silvia , Cavallo Luciano , Grano Maria , Brunetti Giacomina
Published: October 2016

Context:

Childhood type 1 diabetes mellitus (T1DM) is associated with decreased bone mass. Sclerostin and dickkopf-1 (DKK-1) are Wnt inhibitors that regulate bone formation.

Objective:

To evaluate sclerostin and DKK-1 levels in T1DM children and to analyze the influence of glycemic control on bone health.

Design and setting:

Cross-sectional study conducted at a clinical research center.

Participants:

One hundred and six T1DM subjects (12.2 ± 4 years), 66 on multiple daily injections (MDIs) and 40 on continuous subcutaneous infusion of insulin (CSII), and 80 controls.

Results:

The average bone transmission time (BTT) and amplitude-dependent speed of sound (AD-SoS) z scores were lower in patients with diabetes than in controls. Significantly increased DKK-1 (3593 ± 1172 vs 2652 ± 689 pg/mL; P < 0.006) and sclerostin (29.45 ± 12.32 vs 22.53 ± 8.29; P < 0.001) levels were found in patients with diabetes with respect to controls, particularly in patients on MDI compared with ones on CSII. Glycemic control was improved in CSII patients compared with MDI ones (P < 0.001) and was also associated with significantly higher BMI-SDS (P < 0.002) and BTT z scores (P < 0.02). With adjustment for age, multiple linear regression analysis of DKK-1 and sclerostin as dependent variables showed that levels of glycated hemoglobin, glucose, 25(OH) vitamin D, osteocalcin, and parathyroid hormone; years of diabetes; and BMI-SDS and AD-SoS z score were the most important predictors (P < 0.0001).

Conclusions:

Our study highlighted (1) the high serum levels of DKK-1 and sclerostin in T1DM children and their relationship with altered glycemic control and (2) the effect of CSII on improvement of glycemic control and bone health in T1DM children.
Dried Blood Spot Thyroglobulin as a Biomarker of Iodine Status in Pregnant Women
Authors: Stinca Sara , Andersson Maria , Weibel Sandra , Herter-Aeberli Isabelle , Fingerhut Ralph , Gowachirapant Sueppong , Hess Sonja Y. , Jaiswal Nidhi , Jukić Tomislav , Kusic Zvonko , Mabapa Ngoako Solomon , Nepal Ashwini Kumar , San Luis Teofilo O. L. , Zhen Jia Qing , Zimmermann Michael Bruce
Published: October 2016

Context:

Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies.

Objectives:

Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status.

Design, Setting, and Participants:

Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake.

Main Outcome Measures:

We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb.

Results:

In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative.

Conclusions:

A median DBS-Tg of ∼10 μg/L with <3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.
Anesthesia and Databases: Pediatric Cardiac Disease as a Role Model
Authors: Vener David F. , Pasquali Sara K. , Mossad Emad B.
Published: October 2016

Large data sets have now become ubiquitous in clinical medicine; they are particularly useful in high-acuity, low-volume conditions such as congenital heart disease where data must be collected from many centers. These data fall into 2 categories: administrative data arising from hospital admissions and charges and clinical data relating to specific diseases or procedures. In congenital cardiac diseases, there are now over a dozen of these data sets or registries focusing on various elements of patient care. Using probabilistic statistic matching, it is possible to marry administrative and clinical data post hoc using common elements to determine valuable information about care patterns, outcomes, and costs. These data sets can also be used in a collaborative fashion between institutions to drive quality improvement (QI). Because these data may include protected health information (PHI), care must be taken to adhere to federal guidelines on their use. A fundamental principle of large data management is the use of a common language and definition (nomenclature) to be effective. In addition, research derived from these information sources must be appropriately balanced to ensure that risk adjustments for preoperative and surgical factors are taken into consideration during the analysis. Care of patients with cardiac disease both in the United States and abroad consistently shows wide variability in mortality, morbidity, and costs, and there has been a tremendous amount of discussion about the benefits of regionalization of care based on center volume and outcome measurements. In the absence of regionalization, collaborative learning techniques have consistently been shown to minimize this variability and improve care at all centers, but before changes can be made it is necessary to accurately measure accurately current patient outcomes. Outcomes measurement generally falls under hospital-based QI initiatives, but more detailed analysis and research require Institutional Review Board and administrative oversight. Cardiac anesthesia providers for these patients have partnered with the Society of Thoracic Surgeons Congenital Heart surgeons to include anesthesia elements to help in this process.
DNA damage-induced Lok/CHK2 activation compromises germline stem cell self-renewal and lineage differentiation
Authors: Ma Xing , Han Yingying , Song Xiaoqing , Do Trieu , Yang Zhihao , Ni Jianquan , Xie Ting
Published: October 2016

Stem cells in adult tissues are constantly exposed to genotoxic stress and also accumulate DNA damage with age. However, it remains largely unknown how DNA damage affects both stem cell self-renewal and differentiation. In this study, we show that DNA damage retards germline stem cell (GSC) self-renewal and progeny differentiation in a Lok kinase-dependent manner in the Drosophila ovary. Both heatshock-inducible endonuclease I-CreI expression and X-ray irradiation can efficiently introduce double-strand breaks in GSCs and their progeny, resulting in a rapid GSC loss and a GSC progeny differentiation defect. Surprisingly, the elimination of Lok or its kinase activity can almost fully rescue the GSC loss and the progeny differentiation defect caused by DNA damage induced by I-CreI or X-ray. In addition, the reduction in bone morphogenetic protein signaling and Shotgun expression only makes a limited contribution to DNA damage-induced GSC loss. Finally, DNA damage also decreases the expression of the master differentiation factor Bam in a Lok-dependent manner, which helps explain the GSC progeny differentiation defect. Therefore, this study demonstrates, for the first time in vivo, that Lok kinase activation is required for the DNA damage-mediated disruption of adult stem cell self-renewal and lineage differentiation, and might also offer novel insight into how DNA damage causes tissue aging and cancer formation.
Accuracy of integrated total pelvic floor ultrasound compared to defaecatory MRI in females with pelvic floor defaecatory dysfunction
Authors: Hainsworth Alison J , Pilkington Sophie A , Grierson Catherine , Rutherford Elizabeth , Schizas Alexis M P , Nugent Karen P , Williams Andrew B
Published: October 2016

Objective:

Defaecatory MRI allows multicompartmental assessment of defaecatory dysfunction but is often inaccessible. Integrated total pelvic floor ultrasound (transperineal, transvaginal, endoanal) may provide a cheap, portable alternative. The accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared with defaecatory MRI was assessed.

Methods:

The dynamic images from 68 females who had undergone integrated total pelvic floor ultrasound and defaecatory MRI between 2009 and 2015 were blindly reviewed. The following were recorded: rectocoele, enterocoele, intussusception and cystocoele.

Results:

There were 26 rectocoeles on MRI (49 rectocoeles on ultrasound), 24 rectocoeles with intussusception on MRI (19 rectocoeles on ultrasound), 23 enterocoeles on MRI (24 enterocoeles on ultrasound) and 49 cystocoeles on MRI (35 cystocoeles on ultrasound). Sensitivity and specificity of total pelvic floor ultrasound were 81% and 33% for rectocoele, 60% and 91% for intussusception, 65% and 80% for enterocoele and 65% and 84% for cystocoele when compared with defaecatory MRI. This gave a negative-predictive value and positive-predictive value of 74% and 43% for rectocoele, 80% and 79% for intussusception, 82% and 63% for enterocoele and 48% and 91% for cystocoele.

Conclusion:

Integrated total pelvic floor ultrasound may serve as a screening tool for pelvic floor defaecatory dysfunction; when normal, defaecatory MRI can be avoided, as rectocoele, intussusception and enterocoele are unlikely to be present.

Advances in knowledge:

This is the first study to compare integrated total pelvic floor ultrasound with defaecatory MRI. The results support the use of integrated total pelvic floor ultrasound as a screening tool for defaecatory dysfunction.
Update on novel trends in PET/CT technology and its clinical applications
Authors: Walrand Stephan , Hesse Michel , Jamar François
Published: October 2016

After a brief history of the major evolutions of positron emission tomography since its introduction in 1972, this article reviews the recent improvements and novel trends in positron emission tomography with a special focus on the time of flight that is currently the major research topic. Novel emerging acquisition modalities, such as dual tracer acquisition, inline hadron therapy dose imaging and yttrium-90 imaging are reviewed.
Making sense of the cause of Crohn’s – a new look at an old disease
Authors: Segal Anthony W.
Published: October 2016

The cause of Crohn’s disease (CD) has posed a conundrum for at least a century. A large body of work coupled with recent technological advances in genome research have at last started to provide some of the answers. Initially this review seeks to explain and to differentiate between bowel inflammation in the primary immunodeficiencies that generally lead to very early onset diffuse bowel inflammation in humans and in animal models, and the real syndrome of CD. In the latter, a trigger, almost certainly enteric infection by one of a multitude of organisms, allows the faeces access to the tissues, at which stage the response of individuals predisposed to CD is abnormal. Direct investigation of patients’ inflammatory response together with genome-wide association studies (GWAS) and DNA sequencing indicate that in CD the failure of acute inflammation and the clearance of bacteria from the tissues, and from within cells, is defective. The retained faecal products result in the characteristic chronic granulomatous inflammation and adaptive immune response. In this review I will examine the contemporary evidence that has led to this understanding, and look for explanations for the recent dramatic increase in the incidence of this disease.
Avaliação multicriterial da qualidade em serviços: um estudo de caso em um hotel
Authors: Melo Fagner José Coutinho , Jerônimo Taciana De Barros , Aquino Joás Tomaz de
Published: October 2016

O artigo analisa as variáveis que levam a satisfação da prestação de serviço hoteleiro, utilizando três conceitos: Desdobramento da Função Qualidade (QFD), avaliação do serviço pelo SERVPEF e análise hierárquica de processos (AHP). Pois há uma lacuna deixada por Akao (1990), no QFD que é como analisar a compensação das alternativas entre elas mesmas, de forma que o resultado desta avaliação seja a priorização ou uma ordem de implementação das melhorias do projeto do produto/serviço. Esta lacuna será preenchida com o método AHP, para que ocorra a análise compensatória posicione o hotel de forma mais competitiva em detrimento as empresas concorrentes. Para isso, foi aplicado um questionário com 150 hóspedes e com o gestor do hotel estudo de caso. Após, a coleta de dados foi adotado o QFD que revelou as requisições do cliente, seguido pelo método AHP para priorizar as alternativas de melhoria. A contribuição desta pesquisa é a busca pela adequação dos serviços prestados de acordo com a voz e percepção do cliente destacando o hotel no mercado. E assim, espera-se que os consumidores consigam sentir a melhoria nas dimensões por ele avaliadas como as mais necessárias para a promoção de sua satisfação.
Educação Empreendedora: premissas, objetivos e metodologias
Authors: Schaefer Ricardo , Minello Italo Fernando
Published: October 2016

A importância da educação empreendedora para o desenvolvimento de uma nação tem sido reconhecida em diversos países. Nas últimas décadas, estudos sobre empreendedorismo avançaram em termos de visibilidade e importância, porém o tema da educação empreendedora ainda carece de uma discussão mais sólida, que auxilie no seu amadurecimento, norteamento e disseminação de forma mais eficaz. Com base nessas constatações, este artigo de desenvolvimento teórico tem o objetivo de confrontar e analisar premissas, objetivos e metodologias de educação empreendedora. As suas diferenças em relação à educação tradicional têm gerado a necessidade de novos modelos pedagógicos, compatíveis com as habilidades e atitudes próprias do indivíduo empreendedor. Esta pesquisa aborda a natureza da educação empreendedora, seus aspectos metodológicos, o papel do docente, o ponto de referência que o aluno assume no processo, e práticas didático-pedagógicas desenvolvidas para a aprendizagem empreendedora.
Desenvolvimento da linguagem na primeira infância e estilos linguísticos dos educadores
Authors: Oliveira Keilla Rebeka Simões de , Aquino Fabíola De Sousa Braz , Salomão Nádia Maria Ribeiro
Published: October 2016

El estudio buscó conocer el lenguaje de niños en edad preescolar en el contexto de guardería, y caracterizar los estilos lingüísticos de educadoras en la interacción con estos niños. Participaron en el estudio nueve niños de uno a tres años y sus respectivas educadoras (siete profesoras y seis monitoras). Los datos fueron recolectados a través de nueve observaciones grabadas en video de las interacciones entre los niños y las educadoras en situaciones de juego. Las observaciones tuvieron una duración de 20 minutos, y fueron retirados 10 minutos para la transición de los episodios. Para el análisis de los datos fueron definidas categorías acerca del habla de los niños y de las educadoras. Se encontró que los niños de un año se comunican básicamente por medio de gestos, mientras que en las otras edades predominó la interacción a través del lenguaje oral. Los estilos lingüísticos de las educadoras variaron en función de la edad del niño, siendo predominante el uso de directivos principalmente en las observaciones de los niños de un año. Se evidencia la poca participación de las educadoras en los episodios interactivos, principalmente con los niños de dos y tres años, y el impacto de esos episodios en el aprendizaje y el desarrollo infantil en los años iniciales.
AVALIAÇÃO E FEEDBACK DE DESEMPENHO DE ESTUDANTES NA EDUCAÇÃO A DISTÂNCIA
Authors: Archer Aline Battisti , Crispim Ana Carla , Cruz Roberto Moraes
Published: October 2016

Evaluación del desempeño del estudiante en la educación a distancia es una estrategia utilizada para investigar su rendimiento. Este artículo tiene como objetivo demostrar los aspectos que conforman el proceso de evaluación de desempeño de los estudiantes y sobre todo el uso de la retroalimentación en la distancia. Una revisión teórica sustentada en la investigación se llevó a cabo dos perspectivas de análisis: los coceptos de la evaluación del desempeño y el proceso de retroalimentación del desempeño estudiantil como una parte constitutiva de la evaluación del desempeño en la educación a distancia. Concecptos acerca de evaluación del desempeño son diversos en la literatura científica. Algunos se centran en la interpretación de la representación numérica del rendimiento de los estudiantes, mientras que otros centran sus comentarios en el uso de la retroalimentación como un medio para mejorar el rendimiento. La evaluación del desempeño en la educación a distancia surge de los procesos de interacción entre el profesor y el estudiante, mediada por la tecnología, sino que depende de la retroalimentación para promover la participación en las actividades de enseñanza-aprendizaje. El uso de la retroalimentación en el desempeño del estudiante es um aspecto relevante en el proceso y el rendimiento en vista de la mejora de su desempeño social y profesional. El uso de la estrategia retroalimentación inmediata y informativa con características que facilitan al alumno a seguir el desarrollo de su rendimiento ayuda a identificar lo que necesita ser modificado y perfeccionado en el proceso educativo
La incidencia del entonamiento afectivo y la imitación en el involucramiento visual-social temprano
Authors: Bordoni Mariana , Español Silvia , De Grande Pablo
Published: October 2016

Se realizó un estudio longitudinal cuasi-experimental cuyo objetivo es evaluar los efectos que tiene el entonamiento afectivo en el involucramiento visual infantil. Se analizó la pauta de mirada del bebé (frecuencia y duración promedio de mirada dirigida al experimentador), en el período 6-12 meses, en tres condiciones de interacción social: entonamiento afectivo, imitación e interacción social prototípica. Los resultados de los modelos de regresión lineal muestran que la edad y la condición de interacción operan como factores con efectos independientes en los indicadores de mirada. Durante el período estudiado, tiene lugar un desarrollo general de la pauta de mirada más allá de la condición social de interacción: con la edad la frecuencia aumenta y la duración promedio de la mirada disminuye para todas las condiciones de interacción. El entonamiento afectivo generó menores valores de involucramiento visual del bebé. Se propone que el entonamiento afectivo es una pauta de reciprocidad que permite acompañar la actividad del bebé sin distraer su atención visual que puede, entonces, permanecer orientada al entorno
A interligação entre o intersubjetivo e o intrapsíquico: (im)possibilidades na travessia da adolescência
Authors: Machado Amanda Pacheco , Kother Macedo Mônica Medeiros
Published: October 2016

El presente artículo pretende problematizar los efectos de la sumatoria entre las intensidades intersubjetivas e intrapsíquicas que pueden causar daños a la importante y necesaria experiencia de transición de la infancia a la etapa adulta. A partir de una revisión narrativa de la literatura, se buscó material en los aportes psicoanalíticos y sociológicos sobre cultura, sociedad y adolescencia. Se puede considerar que entrar en la adolescencia se constituye como un importante paso de la condición infantil a la condición adulta que puede desencadenar sufrimiento y angustia al adolescente. Frente a las características de actualidad, se destaca la relevancia de considerar los efectos del campo intersubjetivo en la vivencia de este paso. Los hallazgos permiten indicar los efectos dañinos de la interconexión entre las intensidades intersubjetivas y las condiciones intrapsíquicas cuando en ellas predomina la imposibilidad de metabolizar las intensidades de las experiencias de entrar en la adolescencia. Ante esa precariedad de recursos psíquicos, el adolescente puede recurrir a modalidades de respuesta, como el paso al acto, revelando la ruptura entre el paso de una condición infantil a una condición adulta
Aplicação do Programa Cognitivo-Comportamental Superar para atendimento individual de meninas vítimas de violência sexual: estudos de caso
Authors: Schneider Jaluza Aimée , Habigzang Luísa Fernanda
Published: October 2016

La violencia sexual (VS) contra niños y adolescentes es un grave problema de salud pública que puede acarrear consecuencias negativas para el desarrollo cognitivo, comportamental y emocional. Intervenciones psicoló- gicas basadas en evidencias se volvieron indispensables para el manejo efectivo de síntomas y alteraciones decurrentes de la VS. En Brasil, el Programa de Grupoterapia Cognitivo-Comportamental Superar posee evidencias de efectividad, por lo cual la práctica clínica apunta a la necesidad de intervenciones en el formato individual. El presente artículo pretende presentar la aplicación de este programa en dos casos clínicos en el formato individual. Las jóvenes participantes (9 y 16 años) fueron víctimas de VS intrafamiliar. El proceso terapéutico es descrito y los resultados indicaron la disminución de síntomas de depresión y estrés. Además, antes de la intervención, las jóvenes presentaban criterios diagnósticos para el trastorno del estrés postraumático que no fueron tratados al final de ésta. Se confirmó que el Programa Superar tuvo resultados positivos también en el formato individual