bluuebunny/crossref_metadata_2025 huggingface dataset:
MVClustViz
Authors: De Sagar S. , Mishra Minati , Dehuri Satchidananda
Published: March 2014

In the visual data mining, visualization of clusters is a challenging task. Although lots of techniques already have been developed, the challenges still remain to represent large volume of data with multiple dimension and overlapped clusters. In this paper, a multivariate clusters visualization technique (MVClustViz) has been presented to visualize the centroid-based clusters. The geographic projection technique supports multi-dimension, large volume, and both crisp and fuzzy clusters visualization. This technique is most suitable for range analysis of defense related data.
Using Semantics to Discover Web Services Based on Partial Data
Authors: Ferreira da Silva Catarina , Melo Paulo , Rupino da Cunha Paulo , Milheiro Pedro , Ghodous Parisa
Published: March 2014

The authors developed an algorithm and a proof-of-concept tool to help business analysts search a pool of hundreds or thousands of services to find the closest ones to their needs when they are composing business processes, even when an exact match does not exist. The authors achieve this by semantically annotating the services with properties from an ontology, while, traditionally, only the concepts are used. This enables them to generate finer-grained partial semantic mappings between a query and the signature of the services published in a registry, despite potentially different parameter cardinalities and types. Their searches return a ranked list of those services available in the registry that most closely match the query specification. The analyst can then study the hits to see which of the suggested alternatives is more convenient. Such an approach is fundamental to effectively manage reuse in large service-oriented deployments, where the number of services in the registry becomes too voluminous for browsing individually or even syntactic searches that rely on some degree of memorization by the analyst.
Proposal for Integration of Bioethics in Phase I Undergraduate Medical Curriculum in India
Authors: Hadimani Chetana P.
Published: March 2014

Bioethics is now regarded as an integral part of contemporary medical education across the world. This proposal of integration of Bioethics in phase one undergraduate medical curriculum is, to bridge the gap between classroom learning, bedside application and further in community practice to give better health care and a good harmony between Doctors and Society. This aims in covering the curricular approaches in order to enforce values of bioethical principles in medical practice.
Medical Student Introduction to ‘Patient Centred Healthcare' Through a ‘Constructivist' Learning Session in Cardiology
Authors: Pathania Monika , Chaturvedi Aditi , Biswas Rakesh
Published: March 2014

To compare constructivist and traditional power point teaching modalities in a cardiology workshop for medical undergraduates. The purpose of introducing the constructivist method was to activate the cognitive domain of the students and promote self learning. A cross sectional qualitative and quantitative study was planned on hundred, second and third professional medical students (III to IX semester) who were screened to participate. Topics discussed with the constructivist method were clinical case discussion, basic and advanced cardiac life support, electrocardiography, and community cardiology. The traditional power point method topics discussed were cardiac surgeries, paediatric cardiology and advanced diagnostic cardiology. Assessment on feedback of the students and interpretation of the interviews of medical educators, students and patients and grading of lectures from 0-10 was undertaken. Seventy two percent liked the active participation of students in the constructivist method of teaching. Seventy two percent of the participants found power point presentations as monotonous and no different from the usual didactic lectures conducted in the class room teaching. There was an up gradation of scores after the teaching sessions for clinical case discussion, ECG, BLS/ACLS and cardiac surgeries. The medical educators also found the constructivist method of teaching more practical. Constructivist method of teaching may be regarded as a new better way of teaching medical students as it considers the students as adult learners and promotes self learning.
Art of Healing, Medicine and Humanity
Authors: Imam Parvez
Published: March 2014

Medicine is the art of relieving others of their suffering. It requires technology and methodologies that science has helped us develop. However the understanding of pain and its impact in peoples' lives and on the society as a whole is often missed out in the skewed focus on the search for happiness (“Definition of happiness - state (British & World English),” n.d.). Pain is an important symptom that serves as a warning as well as a pointer for an illness. Here the authors re-examine the reasons that connect pain and suffering to artists and healers as well as the connection between an artist and a healer. It also dwells on the age old science versus arts argument and its validity.
Dam Burst of Emotion
Authors: Ahmad Ayesha
Published: March 2014

WHO estimates that every year around 15 million babies are born preterm. Of these, around 1 million babies die due to complications of preterm birth. Survival is dependent on the quality of health care available to these babies. It is estimated that more than 3/4th of babies can be salvaged by timely and appropriate care. The author considered herself to be one of the privileged members of society, being a doctor themselves, living in a metropolitan society and having access to the best healthcare in the country. However, this overconfidence was rudely shaken when they ran from one hospital to another in search of a ventilator for their as yet unborn baby. The author's pregnancy and child birth brought them closer to the millions of parents who undergo the trauma of having a premature baby.
The Quality of Portuguese Obesity Websites
Authors: Martins Diana Clarisse Pires , Soares Sandra Emanuela da Silva , Monteiro de Jesus Marta Maria , Gomes Joana Isabel Almendra , Dias Tânia Gisela Miranda , Fernandes António José Gonçalves , Ferro-Lebres Vera
Published: March 2014

The objective of this study was to evaluate the quality of Portuguese obesity websites. A cross-sectional, quantitative and observational study was designed. The evaluation of 127 sites found using the Google in “Advanced Search” option “pages in Portuguese”, country “Portugal” was performed. The quality criteria used in this study resulted from the merger/adaptation from several authors previously published. The information on obesity was evaluated according to the Scottish Intercollegiate Guidelines Network: Management of Obesity, a National Clinical Guideline, 2010. The quality criteria most mentioned in the websites, were the purpose (80.3%) and authority (73.2%). On the other hand, the editorial review (7.9%) and references (15.7%) were mentioned in the narrowest websites. The websites analyzed had a mean quality score of 5.2 points (± 2.1) out of 11. A significant correlation was found between the score of information on obesity and quality score for adults group (0.282) and both ages group (0.437). In Portugal, the websites that provide information on obesity had, generally, a low quality score.
Knowledge, attitude and practices on anti-tobacco measures imposed under the Cigarette and Other Tobacco Products Act among adult males in rural areas of Tamil Nadu, India
Authors: Annadurai Kalaivani , Danasekaran Raja , Mani Geetha
Published: March 2014

Assessment of knowledge and attitude of adult men towards anti-tobacco measures will help us further in strengthening of regulatory activities and thereby reducing the prevalence of tobacco use. The objective of the present study was i) to assess the knowledge of men towards anti-tobacco measures imposed under Cigarette and Other Tobacco Products Act 2003 and its association with their socio-demographic factors; and ii) to study the attitudes and practice of men towards anti-tobacco measures imposed under COTPA 2003. A cross-sectional study was done among 714 males aged 18 years and above in Vadagarai village of Thiruvallur district of Tamil Nadu and interviewed with pretested questionnaire. The study was done during March to September 2009. Majority of them were aware and favoring the act, i.e. 96.2% of the study population were aware of the COTPA 2003 and 95.24% were favoring the act. Most of them felt that anti-tobacco measures did not have any impact among tobacco users. Preventive steps like behavioral change communication, fiscal measures and further more strong enforcement of the act will be needed to decrease the prevalence further.
Measurements of total hydroxyl radical reactivity during CABINEX 2009 – Part 1: field measurements
Authors: Hansen R. F. , Griffith S. M. , Dusanter S. , Rickly P. S. , Stevens P. S. , Bertman S. B. , Carroll M. A. , Erickson M. H. , Flynn J. H. , Grossberg N. , Jobson B. T. , Lefer B. L. , Wallace H. W.
Published: March 2014

Abstract. Total hydroxyl radical (OH) reactivity was measured at the PROPHET (Program for Research on Oxidants: PHotochemistry, Emissions, and Transport) forested field site in northern Michigan during the 2009 Community Atmosphere–Biosphere INteraction EXperiment (CABINEX). OH reactivity measurements were made with a turbulent-flow reactor instrument at three heights from the forest floor above (21 and 31 m) and below (6 m) the canopy at three different time periods during the CABINEX campaign. In addition to total OH reactivity measurements, collocated measurements of volatile organic compounds (VOCs), inorganic species, and ambient temperature were made at the different heights. These ancillary measurements were used to calculate the total OH reactivity, which was then compared to the measured values. Discrepancies between the measured and calculated OH reactivity, on the order of 1–24 s−1, were observed during the daytime above the canopy at the 21 and 31 m heights, as previously reported for this site. The measured OH reactivity below the canopy during the daytime was generally lower than that observed above the canopy. Closer analysis of the measurements of OH reactivity and trace gases suggests that the missing OH reactivity could come from oxidation products of VOCs. These results suggest that additional unmeasured trace gases, likely oxidation products, are needed to fully account for the OH reactivity measured during CABINEX.
Countergradient heat flux observations during the evening transition period
Authors: Blay-Carreras E. , Pardyjak E. R. , Pino D. , Alexander D. C. , Lohou F. , Lothon M.
Published: March 2014

Abstract. Gradient-based turbulence models generally assume that the buoyancy flux ceases to introduce heat into the surface layer of the atmospheric boundary layer in temporal consonance with the gradient of the local virtual potential temperature. Here, we hypothesize that during the evening transition a delay exists between the instant when the buoyancy flux goes to zero and the time when the local gradient of the virtual potential temperature indicates a sign change. This phenomenon is studied using a range of data collected over several Intensive Observational Periods (IOPs) during the Boundary Layer Late Afternoon and Sunset Turbulence field campaign conducted in Lannemezan, France. The focus is mainly on the lower part of the surface layer using a tower instrumented with high-speed temperature and velocity sensors. The results from this work confirm and quantify a flux-gradient delay. Specifically, the observed values of the delay are ~30–80 min. The existence of the delay and its duration can be explained by considering the convective time scale and the competition of forces associated with the classical Rayleigh–Bénard problem. This combined theory predicts that the last eddy formed while the sensible heat flux changes sign during the evening transition should produce a delay. It appears that this last eddy is decelerated through the action of turbulent momentum and thermal diffusivities, and that the delay is related to the convective turn – over time – scale. Observations indicate that as horizontal shear becomes more important, the delay time apparently increases to values greater than the convective turnover time-scale.
Nonlinear interaction of gravity waves in a nonisothermal and dissipative atmosphere
Authors: Huang K. M. , Zhang S. D. , Yi F. , Huang C. M. , Gan Q. , Gong Y. , Zhang Y. H.
Published: March 2014

Abstract. Starting from a set of fully nonlinear equations, this paper studies that two initial gravity wave packets interact to produce a third substantial packet in a nonisothermal and dissipative atmosphere. The effects of the inhomogeneous temperature and dissipation on interaction are revealed. Numerical experiments indicate that significant energy exchange occurs through the nonlinear interaction in a nonisothermal and dissipative atmosphere. Because of the variability of wavelengths and frequencies of interacting waves, the interaction in an inhomogeneous temperature field is characterised by the nonresonance. The nonresonant three waves mismatch mainly in the vertical wavelengths, but match in the horizontal wavelengths, and their frequencies also tend to match throughout the interaction. Below 80 km, the influence of atmospheric dissipation on the interaction is rather weak due to small diffusivities. With the further propagation of wave above 80 km, the exponentially increasing atmospheric dissipation leads to the remarkable decay and slowly upward propagation of wave energy. Even so, the dissipation below 110 km is not enough to decrease the vertical wavelength of wave. The dissipation seems neither to prevent the interaction occurrence nor to prolong the period of wave energy exchange, which is different from the theoretical prediction based on the linearised equations. The match relationship and wave energy evolution in numerical experiments are helpful in further investigating interaction of gravity waves in the middle atmosphere based on experimental observations.
Greenhouse gas emissions from rewetted bog peat extraction sites and a Sphagnum cultivation site in Northwest Germany
Authors: Beyer C. , Höper H.
Published: March 2014

Abstract. During the last three decades, an increasing area of drained peatlands was rewetted. This was done with the objective to convert these sites from sources back to sinks or, at least, to much smaller sources of greenhouse gases (GHG). However, available data is still scarce, especially on the long-term climatic effects of rewetting of temperate bogs. Moreover, first field trials are established for Sphagnum cultivating (paludiculture) on wet bog sites and an assessment of the climate impact of such measures has not been studied yet. We conducted a field study on the exchange of carbon dioxide, methane and nitrous oxide at three rewetted sites with a gradient from dry to wet conditions and at a Sphagnum cultivation site in NW Germany over more than two years. Gas fluxes were measured using transparent and opaque closed chambers. The ecosystem respiration (CO2) and the net ecosystem exchange (CO2) were modelled in high time resolution using automatically monitored climate data. Measured and modelled values fit very well together (R2 between 0.88 and 0.98). Annually cumulated gas flux rates, net ecosystem carbon balances (NECB) and global warming potential (GWP) balances were determined. The annual net ecosystem exchange (CO2) varied strongly at the rewetted sites (from –201.7 ± 126.8 to 29.7 ± 112.7 g CO2-C m–2 a–1) due to different weather conditions, water level and vegetation. The Sphagnum cultivation site was a sink of CO2 (–118.8 ± 48.1 and −78.6 ± 39.8 g CO2-C m–2 a–1). The yearly CH4 balances ranged between 16.2 ± 2.2 and 24.2 ± 5.0 g CH4-C m–2 a–1 at two inundated sites, while one rewetted site with a comparatively low water level and the Sphagnum farming site show CH4 fluxes close to zero. The net N2O fluxes were low and not significantly different between the four sites. The annual NECB at the rewetted sites was between –183.8 ± 126.9 and 51.6 ± 112.8 g CO2-C m–2 a–1 and at the Sphagnum cultivating site –114.1 ± 48.1 and –75.3 ± 39.8 g CO2-C m–2 a–1. The yearly GWP100 balances ranged from –280.5 ± 465.2 to 644.5 ± 413.6 g CO2-eq. m–2 a–1 at the rewetted sites. In contrast, the Sphagnum farming site had a cooling impact on the climate in both years (–356.8 ± 176.5 and –234.9 ± 145.9 g CO2-C m–2 a–1). If the exported carbon through the harvest of the Sphagnum biomass and the additional CO2 emission from the decay of the organic material is considered, the NECB and GWP100 balances are near neutral. Peat mining sites are likely to become net carbon sinks and a peat accumulating ("growing") peatland within 30 years after rewetting, but the GWP100 balance may still be positive. A recommended measure for rewetting is to achieve a water level of a few centimetres below ground surface. Sphagnum farming is a climate friendly alternative to conventional commercial use of bogs. A year round constant water level of a few centimetres below ground level should be maintained.
Towards an improved organic carbon budget for the western Barents Sea shelf
Authors: Pathirana I. , Knies J. , Felix M. , Mann U.
Published: March 2014

Abstract. There is generally a lack of knowledge on how marine organic carbon accumulation is linked to vertical export and primary productivity patterns in the Arctic Ocean. Despite the fact that annual primary production in the Arctic has increased as a consequence of shrinking sea ice, its effect on flux, preservation, and accumulation of organic carbon is still not well understood. In this study, a multi-proxy geochemical and organic-sedimentological approach is coupled with organic facies modelling, focusing on regional calculations of carbon cycling and carbon burial on the western Barents Shelf between northern Scandinavia and Svalbard. OF-Mod 3-D, an organic facies modelling software tool, is used to reconstruct and quantify the marine and terrestrial organic carbon fractions and to make inferences about marine primary productivity changes across the marginal ice zone (MIZ). By calibrating the model against an extensive set of sediment surface samples, we improve the Holocene organic carbon budget for ice-free and seasonally ice-covered areas in the western Barents Sea. The results show that higher organic carbon accumulation rates in the MIZ are best explained by enhanced surface water productivity compared to ice-free regions, implying that shrinking sea ice may reveal a significant effect on the overall organic carbon storage capacity of the western Barents Sea shelf.
Theory of Mind as a Pedagogical Tool
Authors: Zunshine Lisa
Published: March 2014

Zunshine demonstrates how a cognitive narratological perspective on theory of mind (i.e., our evolved cognitive capacity to see people's observable behavior in terms of their underlying mental states, such as thoughts, feelings, desires, and intentions) offers an instructor a new tool for collaborative classroom exploration of representations of fictional consciousness. In particular, Zunshine tells of her experience of asking students to write up “missing” passages from Edith Wharton's short story “Xingu,” following their discussion of the story's construction of social minds, an approach that draws on theoretical perspectives that either directly represent theory of mind (Zunshine's “sociocognitive complexity” and Alan Palmer's “intermental thinking”) or are highly compatible with it (Suzanne Keen's “strategic empathizing”). Having used research on theory of mind to teach a wide range of texts on both graduate and undergraduate levels, Zunshine centers her article on the immediate classroom payoffs of this approach as well as its relationship with other, more established pedagogical strategies.
Where Readers MeetThe Road:
Authors: Michelson David
Published: March 2014

This article reports on a class project designed to help undergraduates learn about individual differences and personality in the evolutionary study of literature. Drawing on an anonymous packet that included a classmate's answers to personality, reading style, reading preference, and demographic questionnaires, students analyzed a classmate's liking of and responses to reading Cormac McCarthy's popular novel The Road. The project helped students go beyond interpretative approaches to the novel by examining the pressure points where individual differences affect a reader's fictional experience. It also appears to have successfully taught students to assess how well a concrete individual case stands up to scientific theories and tools designed to measure broad-based generalities. In doing so, students learned about theoretical and methodological differences between the sciences and the humanities as well as the real-world complexity of a reader's responses to a novel.
The Market Potential of Grape Waste Alternatives
Authors: Dwyer Kyle , Hosseinian Farah , Rod Michel
Published: March 2014

During wine production, approximately 25% of the grape weight results in by-product/waste (termed ‘pomace’ which is comprised of skins and seeds). Currently, most pomace is being composted to be reintroduced into the vineyards to complete the carbon cycle. Due to the increasing consumer demand for the use of natural over synthetic compounds, and because of increased attention to sustainability of agricultural practices (Fontana, Antoniolli, & Bottini, 2013), there is a vast array of applications for grape pomacebioactives including: functional foods (dietary fiber + polyphenols), food processing (biosurfactants), cosmetics (grapeseed oil + antioxidants), pharmaceutical/biomedical (pullulan) and supplements (grape pomace powder). To date, there has been no assessment as to the market potential for value-added usage of grape pomace. This paper seeks to address this gap. The annual production of grape pomace along with its multitude of applications, create an opportunity to discover an unexploited market with great commercial potential.
MODELS OF COVARIANCE FUNCTIONS OF GAUSSIAN RANDOM FIELDS ESCAPING FROM ISOTROPY, STATIONARITY AND NON NEGATIVITY
Authors: Gregori Pablo , Porcu Emilio , Mateu Jorge
Published: March 2014

This paper represents a survey of recent advances in modeling of space or space-time Gaussian Random Fields (GRF), tools of Geostatistics at hand for the understanding of special cases of noise in image analysis. They can be used when stationarity or isotropy are unrealistic assumptions, or even when negative covariance between some couples of locations are evident. We show some strategies in order to escape from these restrictions, on the basis of rich classes of well known stationary or isotropic non negative covariance models, and through suitable operations, like linear combinations, generalized means, or with particular Fourier transforms.
An Overview on Gripping Force Measurement at the Micro and Nano-Scales Using Two-Fingered Microrobotic Systems
Authors: Boudaoud Mokrane , Regnier Stephane
Published: March 2014

Two-fingered micromanipulation systems with an integrated force sensor are widely used in robotics to sense and control gripping forces at the micro and nano-scales. They became of primary importance for an efficient manipulation and characterization of highly deformable biomaterials and nanostructures. This paper presents a chronological overview of gripping force measurement using two-fingered micromanipulation systems. The work summarizes the major achievements in this field from the early 90s to the present, focusing in particular on the evolution of measurement technologies regarding the requirements of microrobotic applications. Measuring forces below the microNewton for the manipulation of highly deformable materials, embedding force sensors within microgrippers to increase their dexterity, and reducing the influence of noise to improve the measurement resolution are among the addressed challenges. The paper shows different examples of how these challenges have been addressed. Resolution, operating range and signal/noise ratio of gripping force sensors are reported and compared. A discussion about force measurement technologies and gripping force control is performed and future trends are highlighted.
A Fast Approach to Arm Blind Grasping and Placing for Mobile Robot Transportation in Laboratories
Authors: Liu Hui , Stoll Norbert , Junginger Steffen , Thurow Kerstin
Published: March 2014

This paper presents a fast approach to organizing arm grasping and placing manipulations for mobile robot transportation systems in life science laboratories. The approach builds a blind framework to realize the robot arm operations without integrating any other sensors or recognizing computation, but only adopting the robot's existing on-board ultrasonic sensors originally installed for collision avoidance. To achieve high-precision indoor positioning performance for the proposed blind arm strategy, a hybrid method is proposed, including a StarGazer system for all laboratory environments and an ultrasonic sensor-based component for the local areas where the arm operations are expected. At the same time, two error-correcting algorithms are presented for the improvement of the high-precision localization and the selection of the robot arm operations. In addition, the architecture of all the robotic controlling centres and their key APIs are also explained. Finally, an experiment proves that the proposed blind strategy is effective and economically viable for the laboratory automation.
Good Criteria for Supply Chain Performance Measurement
Authors: Kusrini Elisa , Subagyo  , Masruroh Nur Aini
Published: March 2014

This paper discusses good criteria for a supply chain performance measurement model and their level of importance. The criteria were obtained from results of previous research findings and recommendations from several researchers. The criteria are divided into two categories, namely efficient and effective. To examine which criteria can be used to assess a supply chain performance measurement model, a survey was conducted by distributing questionnaires to supply chain actors from different industry fields (both manufacturing and services) in Indonesia using random sampling techniques. Data analysis using pairwise comparisons with an analytical Hierarchy Process model showed that efficient criteria were more important than effective criteria. Efficient criteria consisted of three sub-criteria: the amount of data is not too much and low cost and output is presented in a simple form. Effective criteria consisted of the criteria in the order of importance as follows: clarity, validity, comprehensiveness, responsiveness and dynamics. Further research is needed for developing a model that meets these criteria
RELAÇÃO ENTRE O CONDICIONAMENTO FÍSICO E A IDADE NO DESEMPENHO DE EQUIPES DE CORRIDA DE AVENTURA
Authors: Palermo Márcio de Avila , Coelho Fernanda Dapper , Gorski Tatiane , Coertjens Marcelo , Kruel Luiz Fernando Martins
Published: March 2014

O objetivo deste estudo foi correlacionar valores de consumo máximo deoxigênio (VO2máx) e variáveis avaliadas no segundo limiar ventilatório (2ºLV) de equipesde Corrida de Aventura. Seis equipes realizaram teste progressivo em esteira paradeterminação do VO2máx e do 2ºLV. Não foram encontradas diferenças significativas entreas médias das equipes e sua correlação com o desempenho foi baixa. Bons coeficientesforam encontrados entre idade e desempenho para navegadores (r =-0,77) e mulheres(r = -0,90; p<0,05). Apesar do condicionamento físico ser requisito ao esporte, a experiênciados navegadores e da mulher pode ter contribuído para o desempenho das equipes.
Consistency of Interrater Scoring of Student Performances of Osteopathic Manipulative Treatment on COMLEX-USA Level 2-PE
Authors: Sandella Jeanne M. , Smith Larissa A. , Dowling Dennis J.
Published: March 2014

Context: Assessment of osteopathic manipulative treatment (OMT) is included in the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE). The scores earned for OMT should be equivalent among all raters regardless of which technique is scored or which rater is scoring the performance. As a quality assurance measure, selected examination dates and the encounters within the administration of COMLEX-USA Level 2-PE are scored by 2 raters: first by a “live” rater and next by a quality assurance rater. Neither rater knows if he or she is the first or second rater.

Objective: To compare candidate's scores recorded for OMT on COMLEX-USA Level 2-PE to determine whether differences exist among raters and techniques scored.

Methods: The authors evaluated candidate performances that took place from July through November 2012. For each performance, 2 raters scored the same technique or different techniques using the OMT scoring rubric. Discrepancies between scores were compared using t tests. Statistical significance was set at P<.05 for most analyses.

Results: Of the 708 performances, there was no statistically significant difference in scoring whether the OMT raters scored the same technique or different techniques when the students performed more than 1. There were no statistically significant differences between these results and instances when only a single technique was performed and scored.

Conclusion: The present study provides reliability evidence for the use of the global OMT scoring tool in the evaluation of OMT in COMLEX-USA Level 2-PE.
Concurrent Validity of the Osteopathic General Surgery In-Service Examination
Authors: Falcone John L. , Rosen Marc E.
Published: March 2014

Context: Performance on the Osteopathic General Surgery In-Service Examination (ISE) has been shown to improve over time for osteopathic general surgery residents. The training level–specific concurrent validity of the ISE, however, has not been evaluated.

Objective: To investigate whether residents' scores will improve as they move from level 1 through level 5 of the ISE.

Methods: In this retrospective study, performance on the ISE was obtained from the American College of Osteopathic Surgeons for all of the osteopathic general surgery residency programs from 2008 through 2012. The weighted raw score and standardized score performance mean and standard deviation were determined across training levels. One-way t tests were performed between residency years and ISE scores. Parametric statistics were calculated with α set to .05.

Results: The authors evaluated 1952 examinations during the study period. Of the 49 programs screened, 33 (67.3%) met inclusion criteria for the present study. Analysis of variance tests showed that there was significant variation in raw and standardized outcomes between residency levels (both P<.001). One-tailed t tests for both raw and standardized outcomes showed that all scores' differences between examinee levels were statistically significant (P<.001), with the exception of raw scores between level 4 and level 5 examinees (P=.20).

Conclusion: There is near-uniform concurrent validity of the ISE by osteopathic general surgery training level. This psychometric characteristic supports the construct validity of this standardized test.
Keyboard Data Entry Use Among Osteopathic Medical Students and Residents
Authors: Helstrom Julia M. , Langenau Erik E. , Sandella Jeanne M. , Mote Beth L.
Published: March 2014

Context: Candidates taking the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) are currently evaluated on their ability to document clinical findings using a handwritten postencounter note. However, keyboard data entry is increasingly used for medical documentation.

Objective: To determine the use and perception of keyboard data entry among osteopathic medical students and residents in educational and clinical settings.

Methods: A Web-based survey regarding frequency of and preference for keyboard data entry was distributed to 9801 osteopathic medical students, 17,268 osteopathic residents, and 34 clinical deans of colleges of osteopathic medicine (COMs). In addition, 31 COMs' clinical skills center directors were contacted to participate in a telephone survey about the use of keyboard data entry in their centers.

Results: A total of 1711 students, 1198 residents, 14 clinical deans, and 17 clinical skills center directors responded to the surveys. The majority of students (872 [51%]) reported using electronic keyboard data entry at their COM's clinical skills center for postencounter notes. Among respondents, 379 students (23%), 77 residents (9%), and 1 clinical dean reported that electronic keyboard data entry is never or rarely used during clinical rotations. Most trainees (1592 students [93%], 864 residents [94%]) reported that they were either comfortable or very comfortable with typing. Given the option of recording methods for SOAP (subjective, objective, assessment, plan) note findings on the COMLEX-USA Level 2-PE, 7 clinical deans were unsure of their students' preferences, while the remaining favored keyboard data entry (5) over handwriting (2). The majority of student and resident respondents would choose keyboard data entry (1009 [60%] and 511 [55%], respectively).

Conclusion: Osteopathic medical students and residents are comfortable with typing; they are exposed to and would prefer using an electronic form of entry for medical documentation. These results support a conversion from written postencounter notes to keyboard data entry of notes on the COMLEX-USA Level 2-PE.
Citation and Correction of Deficiencies in Osteopathic Graduate Medical Education Programs: Opportunities for Improvement
Authors: Pierson Alisa
Published: March 2014

Since 2008, the American Osteopathic Association has gathered data on osteopathic graduate medical education program compliance with the association's correction of deficiencies processes. The purpose of the current article is to look at those data to discover trends and identify patterns and areas for improvement for osteopathic graduate medical education. In addition to providing quantitative data, the author also uses qualitative data to explain why corrective action plans are recommended for denial.
AOA Continuing Medical Education
Authors: Rodgers Delores J.
Published: March 2014

The author provides an update on the current continuing medical education (CME) cycle, which began on January 1, 2013, and will end on December 31, 2015. The author also highlights changes to the CME process and the re-engineering of the CME program for the current cycle. Topic areas include recent changes in CME policies and the challenges associated with awarding and recording credits for the 2013-2015 CME cycle. In addition, the article provides information regarding online CME.
Double–Contrast‐Enhanced Sonography for Diagnosis of Rectal Lesions With Pathologic Correlation
Authors: Lu Man , Yan Brain , Song Jun , Ping Wu , Yue Lin-Xian , Song Bin
Published: March 2014

Objectives

Transabdominal sonography with a gastrointestinal contrast agent has been widely used in China for investigation of digestive disorders. Double–contrast‐enhanced sonography combines a gastrointestinal luminal contrast agent with an intravenous contrast agent for imaging of lesions. The purpose of this pilot study was to assess the value of double–contrast‐enhanced sonography for preoperative diagnosis of rectal lesions.

Methods

We conducted a prospective single‐center study using double–contrast‐enhanced sonography of rectal lesions. Patients were administered both rectal and intravenous contrast agents, and imaging was performed transabdominally, transanally, and transrectally. Morphologic characteristics and perfusion parameters were compared between histologically proven adenocarcinomas, adenomas, and inflammatory masses. Perfusion parameters were analyzed with time‐intensity curves, measuring the contrast arrival time, time to peak, peak intensity, and area under the curve of the lesions and normal rectal tissue.

Results

From January 2009 to September 2012, 420 patients were recruited, with 227 patients meeting inclusion/exclusion criteria and having 232 rectal lesions analyzed (172 rectal adenocarcinomas, 45 adenomas, and 15 inflammatory masses). Adenocarcinomas had variable enhancement patterns. Adenomas were all hypoenhanced in a homogeneous pattern. Inflammatory masses had a hyperenhanced rim with no central enhancement. Time‐intensity curve perfusion parameters (arrival time, time to peak, peak intensity, and area under the curve) of rectal adenocarcinomas, adenomas, and inflammatory masses were significantly different compared to normal rectal tissue (P < .05). The differences in the arrival time, peak intensity, and time to peak among the different lesions were also significant (P < .05).

Conclusions

Double–contrast‐enhanced sonographic assessment of morphologic enhancement patterns combined with vascularity parameters may help differentiate benign and malignant rectal lesions.
Do Echo‐Enhanced Needles Make a Difference in Sonographically Guided Vascular Access?
Authors: Crum Todd , Adhikari Srikar , Lander Lina , Blaivas Michael
Published: March 2014

Objectives

The purpose of this study was to compare sonographically guided vascular access using standard and echo‐enhanced needles in a variety of tissue‐simulating vascular phantoms.

Methods

We conducted a prospective single‐blinded observational study at an academic medical center. All participants performed real‐time sonographically guided vascular access using both a standard 18‐gauge needle and an echo‐enhanced needle in both in‐plane and out‐of plane approaches on 3 different vascular access phantoms. The outcome measures included time to dye flash, first‐pass success, visibility of the needle tip at the time of puncture, total number of attempts, number of redirections, and incidence of posterior wall penetration.

Results

A total of 408 sonographically guided cannulations were performed by 34 participants. The time from needle stick to dye flash, first‐pass success, and the total number of attempts were not significantly different between the two needles (P> .05). The tip of the needle was seen at the time of puncture in 79% of attempts with the standard needle (95% confidence interval [CI], 68%–86%) and in 86% of attempts with the echo‐enhanced needle (95% CI, 76%–92%), although this difference was not significant (P= .103). The posterior wall was penetrated with the standard needle in 14% of attempts (95% CI, 9.6%–20%) and in 6% of attempts with the echo‐enhanced needle (95% CI, 3.5%–11%), and the difference was significant (P < .02).

Conclusions

Echo‐enhanced needles decreased the incidence of posterior wall punctures when compared to standard needles during sonographically guided vascular access. However, there were no significant differences in other sonographically guided vascular access metrics.
Bayesian Probability of Malignancy With BI‐RADS Sonographic Features
Authors: Bouzghar Ghizlane , Levenback Benjamin J. , Sultan Laith R. , Venkatesh Santosh S. , Cwanger Alyssa , Conant Emily F. , Sehgal Chandra M.
Published: March 2014

Objectives

The purpose of this study was to develop a quantitative approach for combining individual American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) sonographic features of breast masses for assessing the overall probability of malignancy.

Methods

Sonograms of solid breast masses were analyzed by 2 observers blinded to patient age, mammographic features, and lesion pathologic findings. BI‐RADS sonographic features were determined by using American College of Radiology criteria. A naïve Bayes model was used to determine the probability of malignancy of all the sonographic features together and with age and BI‐RADS mammographic features. The diagnostic performance for various combinations was evaluated by using the area under the receiver operating curve (Az).

Results

Sonographic features had high positive and negative predictive values. The Az values for BI‐RADS sonographic features for the 2 observers ranged from 0.772 to 0.884, which increased to 0.866 to 0.924 when used with patient age and BI‐RADS mammographic features. The benefit of adding age and mammographic information was more marked for the observer with lower initial diagnostic performance. Age‐specific analysis showed that diagnostic performance varied with age, with higher performance for patients aged 45 years and younger and patients older than 60 years compared to those aged 46 to 60 years. In 85% of cases, the diagnosis of the observers matched. When the consensus between the observers was used for diagnostic decisions, a high level of diagnostic performance (Az, 0.954) was achieved.

Conclusions

A naïve Bayes model provides a systematic approach for combining sonographic features and other patient characteristics for assessing the probability of malignancy to differentiate malignant and benign breast masses.
Feasibility of Detection of the 3‐Vessel and Trachea View Using 3‐Dimensional Sonographic Volumes
Authors: Weissmann-Brenner Alina , Zajicek Michal , Weisz Boaz , Pretorius Dolores H. , Achiron Reuven , Gindes Liat
Published: March 2014

Objectives

The purpose of this study was to investigate the ability to depict the 4‐chamber and 3‐vessel and trachea views of the fetal heart using 3‐dimensional sonography.

Methods

Three‐dimensional color Doppler volumes of the fetal heart were acquired prospectively in 31 fetuses between 19 and 25 gestational weeks. The initial plane consisted of the 4‐chamber view. Postprocessing included navigation within the volume solely in plane A in the caudal direction to visualize the stomach and in the cephalic direction to the plane of the 3‐vessel and trachea view to visualize the pulmonary artery, the aorta, the V shape and color of the arches, the superior vena cava, and the trachea. The feasibility of showing these organs was evaluated.

Results

The estimated time for volume acquisition and manipulation was about 60 seconds. The detection rates for the 4‐chamber view, stomach, 3‐vessel view, trachea, and V sign were 100%, 93.5%, 92.0%, 77.4%, and 83.9%, respectively, with interobserver agreement of 0.76 to 1.0.

Conclusions

We describe a simple technique in which a single sweep on 3‐dimensional sonography starting at the level of the 4‐chamber view can visualize the situs, stomach, 4‐chamber view, and transverse view of the outflow tracts of the heart.
Borderline Amniotic Fluid Index and Its Relation to Fetal Intolerance of Labor
Authors: Wood S. Lindsay , Newton J. Michael , Wang Li , Lesser Karen
Published: March 2014

Objectives

To determine whether a borderline amniotic fluid index (AFI) in the third trimester is associated with an increased rate of cesarean delivery for fetal intolerance of labor, meconium‐stained amniotic fluid, and intrauterine growth restriction, among other adverse perinatal outcomes.

Methods

Patients with a diagnosis of a borderline AFI between January 2008 and August 2012 were identified. Antepartum, delivery, and neonatal data were collected and compared to a cohort with a normal AFI.

Results

We enrolled 739 patients, including 177 with a borderline AFI (>5 and <10 cm) and 562 with a normal AFI (≥10–24 cm); 360 patients delivered at University of Arizona Medical Center, and 379 delivered at St Joseph's Hospital. Combined and individual analyses of each center revealed no significant difference in fetal intolerance of labor (P = .19) or cesarean delivery for fetal intolerance (P = .074) between cohorts. In both settings, patients with a borderline AFI were more likely than those with a normal AFI to undergo antepartum testing (P < .001). A statistically significant increase in intrauterine growth restriction in the borderline AFI group was noted, with a calculated risk ratio of 13.76 (P < .001). There was no difference between groups for meconium‐stained amniotic fluid (P = .23), neonatal intensive care unit admission (P = .054), preterm delivery (P = .31), or operative vaginal delivery (P = .45).

Conclusions

The findings of this study suggest that there is no difference in the rate of fetal intolerance of labor in pregnancies with a borderline AFI and those with a normal AFI. Pregnancies complicated by a borderline AFI are more likely to undergo antepartum testing, yet the benefit is unclear. Significantly more patients with a borderline AFI had underlying growth restriction, which may provide a useful tool for risk stratification in the management of a borderline AFI.
Using SomaticSniper to Detect Somatic Single Nucleotide Variants
Authors: Larson David E. , Abbott Travis E. , Wilson Richard K.
Published: March 2014

Detecting somatic single nucleotide variants (SNVs) is an essential component of cancer research with next‐generation sequencing data. This unit describes how to run the SomaticSniper somatic SNV detector and then filter the output to eliminate most false positives. It also includes support protocols detailing the compilation of the software. Curr. Protoc. Bioinform. 45:15.5.1‐15.5.8. © 2014 by John Wiley & Sons, Inc.
BreakDancer: Identification of Genomic Structural Variation from Paired‐End Read Mapping
Authors: Fan Xian , Abbott Travis E. , Larson David , Chen Ken
Published: March 2014

The advent of next‐generation sequencing data has made it possible to cost‐effectively detect and characterize genomic variation in human genomes. Structural variation, including deletion, duplication, insertion, inversion, and translocation, is of great importance to human genetics due to its association with many genetic diseases. BreakDancer is a bioinformatics tool that relates paired‐end read alignments from a test genome to the reference genome for the purpose of comprehensively and accurately detecting various types of structural variation. Curr. Protoc. Bioinform. 45:15.6.1‐15.6.11. © 2014 by John Wiley & Sons, Inc.
Parameterization of ice fall speeds in midlatitude cirrus: Results from SPartICus
Authors: Mishra Subhashree , Mitchell David L. , Turner David D. , Lawson R. P.
Published: March 2014

The climate sensitivity predicted in general circulation models can be sensitive to the treatment of the ice particle fall velocity. In this study, the mass‐weighted ice fall speed (Vm) and the number concentration ice fall speed (Vn) in midlatitude cirrus clouds are computed from in situ measurements of ice particle area and number concentration made by the two‐dimensional stereo probe during the Small Particles In Cirrus field campaign. For single‐moment ice microphysical schemes, Vm and the ice particle size distribution effective diameter De were parameterized in terms of cloud temperature (T) and ice water content (IWC). For two‐moment schemes, Vm and Vn were related to De and the mean maximum dimension¯D, respectively. For single‐moment schemes, although the correlations of Vm and De with T were higher than the correlations of Vm and De with IWC, it is demonstrated that Vm and De are better predicted by using both T and IWC. The parameterization relating Vm to T and IWC is compared with another scheme relating Vm to T and IWC, with the latter based on millimeter cloud radar measurements. Regarding two‐moment ice microphysical schemes, a strong correlation was found between De and Vm and between¯D and Vn owing to their similar weightings by ice particle mass and number concentration, respectively. Estimating Vm from De makes Vm a function of IWC and projected area, realistically coupling Vm with both the cloud microphysics and radiative properties.