bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and antifungal susceptibility of Sporothrix species in Jiangxi, central China
Authors: Li Jie , Zhan Ping , Jiang Qing , Gao Yangmin , Jin Yun , Zhang Lei , Luo Yunpeng , Fan Xinyi , Sun Jiufeng , de Hoog Sybren
Published: January 2019

Sporotrichosis is a subcutaneous mycosis caused by traumatic inoculation of pathogenic Sporothrix species. Until recently, Sporothrix globosa was considered as the unique Chinese species causing this disorder. In the present study, 33 clinical Sporothrix strains isolated from Jiangxi, China, were classified and antifungal susceptibility for each strain was determined. Thirteen S. globosa strains and 20 S. schenckii strains were identified by morphology and by multilocus analysis using rDNA ITS, CAL, and EF1α (i.e., internal transcribed spacer, calmodulin and elongation factor-1α). In vitro antifungal susceptibility testing of yeast phases indicated that itraconazole, terbinafine, and posaconazole were most effective against both species, followed by amphotericin B and voriconazole, while fluconazole, 5-fluorocytosine had low efficacy with high MICs. Co-occurrence of S. schenckii and S. globosa in central China may indicate different routes of transmission in this area.
Public Health in the Context of Migration: Ethics Issues Related to Immigrants and Refugees
Authors: Fabi Rachel E.
Published: January 2019

This chapter explores the ethics and public health issues associated with immigrant and refugee populations, both in the United States and globally. People move across borders for a variety of reasons, including the pursuit of economic opportunities, family reunification, or safety from violence. In order to engage with the public health ethics questions related to different types of migration, this chapter delves into the normative positions of cosmopolitanism, nationalism, and communitarianism. These positions are then applied to ethical issues in migration, including human rights, freedom of movement, open borders, and obligations to noncitizens. Finally, this chapter examines the ethical implications of three public health issues: immigrant health screening, immigration detention, and the provision of publicly funded health care to undocumented immigrants.
Assessment in Music Classes in China
Authors: Wang Dennis Ping-Cheng
Published: January 2019

This chapter outlines the historical background and current development of music education assessment in China. Following the revision of the national curriculum guidelines in 2011, the chapter analyzes (1) the value of the national standards at different school levels, (2) how the national standards affect teachers and schools, and (3) how much the teachers read/follow the guidelines in China. This chapter investigates and examines how assessment policy and practice are used in Chinese music classrooms from elementary, middle, and high schools. Furthermore, it discusses how local music teachers assess their music students and the effectiveness of the national curriculum guidelines used in music classes. The author determines that the current practice of music assessment at all school levels in China is too basic and not diversified. Designing a valid assessment that allows students at all levels to demonstrate their learning outcomes seems to be necessary for music education in China.
Item Response Theory and Music Testing
Authors: Wesolowski Brian
Published: January 2019

This chapter presents an introductory overview of concepts that underscore the general framework of item response theory. “Item response theory” is a broad umbrella term used to describe a family of mathematical measurement models that consider observed test scores to be a function of latent, unobservable constructs. Most musical constructs cannot be directly measured and are therefore unobservable. Musical constructs can therefore only be inferred based on secondary, observable behaviors. Item response theory uses observable behaviors as probabilistic distributions of responses as a logistic function of person and item parameters in order to define latent constructs. This chapter describes philosophical, theoretical, and applied perspectives of item response theory in the context of measuring musical behaviors.
Assessment of Preservice Music Educators
Authors: Edmund David C. , Chen-Edmund Jian-Jun
Published: January 2019

This chapter introduces six themes related to the assessment of preservice music teachers. Assessment in music teacher education involves measurement of musical, pedagogical, and dispositional competence. Select criteria for institutional preservice teacher assessment are discussed, including comparisons among programs that prioritize musical performance (i.e., the musician/teacher) and those that prioritize teacher ability before musicianship. Comparisons among standardized knowledge-based and teacher performance assessments are included. Particular skills, abilities, and characteristics may be considered immeasurable. These constitute artistic qualities associated with teaching music. Additional chapter content includes the delineation of critical issues for in-service teacher evaluation and the importance of self-assessment/reflection in preservice teacher preparation.
The Impact of State Testing on American Music Classrooms
Authors: McQuarrie Sarah , Sherwin Ronald
Published: January 2019

This chapter examines the impact that state testing of both music and nonmusic subjects has had on American music classrooms. We sought to identify the effects the American educational assessment movement has had on music teaching and learning in classrooms and rehearsal halls. Beginning with an overview of the movement, and continuing with the response from teachers and students, the results of the assessment movement on teaching and learning are challenged. Our review suggests that state testing has had some positive effects on music education. Nonetheless, it is cautioned that a concerted effort must be made to ensure that state-mandated testing is used to benefit all programs and to promote learning in all areas.
The Status of Arts Assessment in the United States
Authors: McCaffrey Marcia , Lovins Linda
Published: January 2019

Based on data gathered from members of SEADAE, the State Education Agency Directors of Arts Education, the authors report on current priorities and practices in dance, media arts, music, theatre, and visual arts assessment in states across the nation and in Department of Defense schools around the world. With the 2014 publication of the National Core Arts Standards and the then-impending replacement of No Child Left Behind (NCLB) by the Every Student Succeeds Act of 2015 (ESSA), it became clear that conditions and resources at national and state levels had undergone significant change since the completion of the 2008 SEADAE study of arts assessment practices. New questions relative to current policy and practice needed to be addressed in order to inform the approach to and development of state and local assessment in the arts, the outcomes of which must inform and raise the quality of instruction in today’s arts classrooms.
Assessment and Critical Pedagogy
Authors: Abrahams Frank
Published: January 2019

This chapter aligns the tenets of critical pedagogy with current practices of assessment in the United States. The author posits that critical pedagogy is an appropriate lens through which to view assessment, and argues against the hegemonic practices that support marginalization of students. Grounded in critical theory and based on Marxist ideals, the content supports the notion of teaching and learning as a partnership where the desire to empower and transform the learner, and open possibilities for the learner to view the world and themselves in that world, are primary goals. Political mandates to evaluate teacher performance and student learning are presented and discussed. In addition to the formative and summative assessments that teachers routinely do to students, the author suggests integrative assessment, where students with the teacher reflect together on the learning experience and its outcomes. The chapter includes specific examples from the author’s own teaching that operationalize the ideas presented.
Organizational Learning and Multiteam Systems
Authors: DeChurch Leslie A. , Bufton Gina M. , Kay Sophie A. , Velez Chelsea V. , Contractor Noshir
Published: January 2019

Multiteam systems consist of two or more teams, each of which pursues subordinate team goals, while working interdependently with at least one other team toward a superordinate goal. Many teams work in these larger organizational systems, where oft-cited challenges involve learning processes within and between teams. This chapter brings a learning perspective to multiteam systems and a multiteam system perspective to organizational learning. Several classic illustrations of organizational learning—for example, the Challenger and Columbia disasters—actually point to failures in organizational learning processes within and between teams. We offer the focus on intrateam knowledge creation and retention and interteam knowledge transfer as a useful starting point for thinking about how to conceptually and operationally define learning in multiteam systems. Furthermore, we think leadership structures and multiteam emergent states are particularly valuable drivers of learning.
The Visible and the Invisible
Authors: McGuire Coreen , Carel Havi
Published: January 2019

The interplay between assistive technology and disability has received scant attention within disability studies, in part because of the assumption that any consideration of prosthetic technology must represent support of the medical model of disability. In this chapter, the authors challenge that assumption by demonstrating that an understanding of the lived experience of prosthetic use or nonuse can reveal crucial social influences that affect modification or rejection of prescribed technology. Invisible disabilities that are revealed primarily through the addition of body technology provide poignant examples of the crucial role of stigma in the decision to reject or modify technology to “pass” as “normal.” This chapter explores historical failures of assistive technology as failures to understand the subjective experiences of the disabled. By prioritizing a phenomenological understanding of nonuse, the authors explain the lack of fit between prosthetic designs and user experiences and advocate greater user involvement in healthcare design.
Sociopolitical Cleavages in Israel
Authors: Ram Uri
Published: January 2019

This chapter sketches the evolution of the cleavages perspective in Israel and offers a sociohistorical overview of four major cleavages in Israeli society: the national one between Israeli Jews and Palestinian Arabs, the cultural one between secular and religious Jews, the socioeconomic (or class) one between rich and poor, and the ethnic one between Ashkenazi Jews and Mizrahi Jews (or “Westerners” versus “Orientals”). The discussion highlights the measure of coalescence among the cleavages and their compound political impact. It underscores the role played by the cleavages in the “upheaval” transition of governmental power in 1977, from Left (Labor) to Right (Likud), and in the consolidation of a neo-liberal and a neo-colonial political culture in Israel since.
Protein Synthesis and Synapse Specificity in Functional Plasticity
Authors: Raghuraman Radha , Benoy Amrita , Sajikumar Sreedharan
Published: January 2019

This chapter discusses the role of protein synthesis in the maintenance of long-term potentiation (LTP) and its associative properties, synaptic tagging and capture, which are cellular correlates of long-term memory. Starting from a brief overview of the early and late phases of LTP, the chapter discusses various existing models for synaptic activity-induced protein synthesis and its roles in late-LTP. The synaptic tagging and capture and cross-tagging theories are given emphasis, along with the elucidation of local dendritic protein synthesis and its significance in the maintenance of LTP. Inverse synaptic tagging, synaptic competition for plasticity-related proteins, and metaplasticity are also covered. The importance of the balance between proteasomal degradation and synthesis of plasticity-related proteins in persistent potentiation is briefly discussed. This chapter touches upon the physiological implications of epigenetic regulation in the control of neuronal functions and the molecular mechanisms within the neurons that translate epigenetic changes into long-lasting responses.
American Gravemarkers and Memorial Assemblages
Authors: Everett Holly
Published: January 2019

As representations of mourning and beliefs about death, gravemarkers and memorial assemblages (also referred to as spontaneous shrines and makeshift memorials) are often cast in binary opposition, defined by temporal intention on the part of the maker(s). Gravemarkers have been studied for their materialization of ideological, socioeconomic, and aesthetic values and trends. As artifacts intended to be permanent, gradual changes in markers may provide a record of the twin forces of folklore, conservatism and dynamism, at work in shaping themes in funerary practices over time. In contrast to gravemarkers, memorial assemblages are marked as ephemeral, underscoring human mortality. Folkloristic research seeks to understand the participatory and performative nature of both markers and assemblages, noting the memorial, celebratory, and other communicative intentions and possibilities embodied by ritual and assemblage in addition to considerations of form. Moreover, these lieux de memoire are more holistically understood in relation to each other, as elements of dynamic memorial complexes.
Embodied Spatial Practices and the Power to Care
Authors: Paradis Elise , Liew Warren Mark , Leslie Myles
Published: January 2019

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.
Athenian State Finances
Authors: Burke Edmund M.
Published: January 2019

Chapter 11 examines the finances of Classical Athens. Following its defeat at the hands of the Spartans in the Peloponnesian War, Athens had to deal with a number of longer-term fiscal challenges. Most immediately, the loss to Sparta put an end to wealth drawn from the empire in tribute and other sources. By war’s end, the city had exhausted the large reserves it once commanded. Another major challenge was the loss in revenues from the Laurium mines with the flight of the slave labour force. After discussing the challenges and responses of the Athenian state with regards to public finance during the fourth century, the article considers Demosthenes’ views on Athenian state finance as articulated in his speeches.
The Judiciary in Nigeria Since 1999
Authors: Ukata Patrick
Published: January 2019

Since May 1999, the Nigerian judiciary has increasingly been called upon to play a more critical role in interpreting the constitution, ensuring the enforcement of the rule of law and the protection of civil liberties. During this period, Nigerian society has also been confronting serious problems concerning ethnic tensions, endemic corruption, and a weak and oil-dependent economy. The judiciary itself has had to contend with serious problems of its own, including corruption amongst some of its judges. This chapter examines how the judiciary, even while dealing with serious challenges of its own, has been able to play an important role in resolving the disputes within Nigeria’s unfolding democratic experience.
The Political Struggles of Nigerian Labor
Authors: Kraus Jon
Published: January 2019

The chapter examines the political struggles of Nigerian trade unions during the diverse labor regimes since independence. Labor regimes are the complex of laws, institutions, and practices through which the relations between the state, labor, and capital are regulated and contested. Major changes in political regimes and in the economy led to almost continuous trade union challenges to government and company practices from the late 1970s to the present, expressed in numerous general strikes and strike threats against governments. Attempts by a military regime to incorporate/subordinate the union movement within the state’s embrace in 1978 created a new labor regime but had the contradictory effect of strengthening union membership and capabilities. The Nigerian Labour Congress (NLC) and member unions have been banned on two occasions, but union organization, generations of leadership, and combative traditions have enabled the union movement to persist in resisting state policies and employer obstructions. Union resistance often elicited widespread popular support. Democrat governments since 1999 have eliminated statist laws which supported unions, changing the labor regime to favor government and capital, part of overall market liberalization that works to weaken unions. Still, unions retain significant leverage.
Human Rights Status in Nigeria Since Obasanjo’s Second Coming
Authors: Hassan Idayat
Published: January 2019

The departure in 1999 of the military regime in Nigeria restored hope for human rights that was grossly abused by successive military regimes. Regrettably, after eighteen years, it is not yet uhuru for Nigerians. Human rights violations remain rife. Particularly worrying is the government security operatives’ abuse of rights with the resultant casualties. Security agencies have been repeatedly accused of extensive human rights abuses and extrajudicial killings. The number of incidents of human rights violations in Nigeria’s democracy has become a major concern. More disconcerting is that the justice sector has not effectively addressed the issue, largely due to the disregard of lawful processes and orders by the Nigerian state and its machinery. This chapter sets out to analyze and highlight the patent issues of human rights.
The “Resource Curse” and the Constraints on Reforming Nigeria’s Oil Sector
Authors: Usman Zainab
Published: January 2019

This chapter analyzes the dysfunctions of Nigeria’s oil sector, often framed as the “resource curse.” The resource curse thesis has for long been employed to explain the developmental challenges of veteran oil and mineral exporters such as Nigeria. This chapter examines the weaknesses of the resource curse thesis especially its commodity determinism, and argues for a political economy approach for a more encompassing understanding of the political constraints to reforming Nigeria’s oil sector. Using a political settlements framework, the chapter argues that the horizontal elite, vertical societal, and external constraints on successive ruling elites generate suboptimal policy choices for the oil industry. These political constraints generate competitive, distributional, and fiscal pressures from key stakeholders on Nigeria’s ruling elite towards these suboptimal policy choices. The analysis here covers the twenty-first century, from 1999, when Nigeria transitioned to electoral democracy.
Boko Haram
Authors: Comolli Virginia
Published: January 2019

The chapter explores Boko Haram’s regional expansion and links to international jihadi movements such as al-Qaeda in the Maghreb (AQIM) and the Islamic State of Iraq and Syria (ISIS). The chapter highlights how the move beyond Nigeria’s borders is unlikely to have been driven by genuine international or pan-Islamic ambitions but, instead opportunism and the pursuit of its domestic agenda had been at the core of Boko Haram’s interaction with AQIM first and the pledge of allegiance to ISIS later. The chapter also reflects on the repercussions of the insurgency campaign beyond Nigerian borders and the regional dimension of the resulting humanitarian crisis. Responses to such challenges have translated into international efforts to what, however, remains a localized phenomenon.
Ecologies of Rule
Authors: Watts Michael J.
Published: January 2019

This chapter is an exploration of the relations between the country’s ecology, environmental governance, and political economy. It is structured around several themes. First, an analysis of one of Nigeria’s major environmental ecological challenges—the fate of Nigeria’s forests. A second theme places Nigeria’s current environment problems on a larger historical landscape. A third explores the relations between the rise of Nigeria as a petrostate and its calamitous consequences for Nigeria’s environment. And a final section examines two regional insurgencies: the Movement for the Emancipation of the Niger Delta (MEND) in the oil-producing Niger Delta; and Boko Haram in the northern drought-prone savannas. These two episodes of violent politics shed light on the relations between environment, resources, and Nigeria’s political economy; how questions of access to and control over resources and the environment enter into the often violent dynamics of postcolonial Nigerian politics and power.
Technology Interference in Couple and Family Relationships
Authors: Drouin Michelle , McDaniel Brandon T.
Published: January 2019

As mobile technology has become ubiquitous in modern culture, researchers have begun to examine the effects of technology use on couple and family relationships. Researchers have coined the terms “techoference” and “phubbing” to refer to the everyday interruptions in interactions that occur due to attention to or use of technology. Overall, the sum of this research paints a consistent and rather grim picture—use of technology among couples and parents has the potential to create disruptions in interactions that can spur negative feelings (e.g., sadness, rejection, anger) and/or behaviors (e.g., conflict, disengagement, acting out) in both romantic partners and children. Conflicts related to technology interference among romantic partners are related, in turn, to lower levels of relationship satisfaction and co-parenting quality. Thus, despite positive views of technology as a social tool, empirical evidence worldwide suggests that technoference has the potential to negatively impact our most important social relationships.
Britain and Ireland, 100–700 CE
Authors: Petts David
Published: January 2019

This chapter reviews the evidence for the archaeology of early Christianity in Britain and Ireland. Here, the church had its origins in the areas that lay within the Roman Empire in the fourth century but rapidly expanded north and west in the early fifth century following the end of Roman rule. The evidence for church structures is limited and often ambiguous, with securely identifiable sites not appearing to any extent until the seventh century. There is a range of material culture that can be linked to the early church from the fourth to the seventh centuries; in particular, there are strong traditions of epigraphy and increasingly decorative stone carving from most areas. The conversion to Christianity also impacted burial rites, although the relationship between belief and mortuary traditions is not a simple one.
Morphological Theory and Creole Languages
Authors: Luís Ana
Published: January 2019

This chapter explores the interaction between creole morphology and morphological theory by drawing on empirical evidence which illustrates that morphological similarities exist between creoles and non-creoles. Such evidence shows that morphological patterns in creoles may be used for the creation of new lexemes (through word-formation), that morphosyntactic features may be mapped onto existing lexemes (by means of inflection), or that derived words in creoles may be semantically non-compositional while inflected words may exhibit form–meaning mismatches and be part of non-predictable paradigms. Conceptually, the morphological evidence will be used to claim that creole word structure is just as principled as the morphology of non-creole languages, and that it can be naturally accounted for by applying the same formal apparatus that is used for the analysis of non-creole languages.
The impact of implementing a preprinted order form for inpatient management of otherwise healthy children admitted to a tertiary care centre with a diagnosis of bronchiolitis
Authors: Feder Joshua , Bijelic Vid , Barrowman Nick , McDonald Jaime , Murchison Barbara , Jetty Radha , Tjahjadi Anindita , Parker Kristy , Pothos Mary , Pound Catherine M
Published: January 2019

Objective

To examine the effect on length of stay (LOS) of a preprinted order (PPO) set for children admitted to hospital with a diagnosis of bronchiolitis, as well as on quality improvement measures, medical errors, and resource utilization.

Patients and methods

A retrospective chart review was performed of children admitted to the inpatient units at the Children’s Hospital of Eastern Ontario (CHEO) with a discharge diagnosis of bronchiolitis. Primary and secondary outcomes were compared between the pre-PPO (December 1, 2014 to June 30, 2015) and post-PPO (December 1, 2015 to June 30, 2016) periods. The primary outcome was LOS in days. Secondary outcomes included the proportion of quality improvement measures reached, the number of medical errors, and resource utilization.

Results

A total of 245 patients were included; 122 patients from the pre-PPO period (December 1, 2014 to June 30, 2015) and 123 patients from the post-PPO period (December 1, 2015 to June 30, 2016). Mean LOS was 3.1 days (2.7 to 3.5 days) and 2.8 days (2.4 to 3.2 days) in the pre- and post-PPO periods, respectively (multivariate analysis, P-value = 0.13). There were significant differences between the pre- and post-PPO periods in a number of quality improvement measures, although not in the number of medical errors. Significant reductions in oxygen, corticosteroid, antibiotic, and bronchodilator use were noted post-PPO implementation.

Conclusion

Although our bronchiolitis PPO did not significantly shorten LOS, it led to important improvements in quality improvement measures and in resource utilization efficiency.
Association Between Government Health Insurance Status and Physical Activity in American Youth
Authors: Fabricant Peter D. , McLaren Son H. , Suryavanshi Joash R. , Nwachukwu Benedict U. , Dodwell Emily R.
Published: January 2019

Background:

Health insurance plans provide health programming access and affect physical activity levels in American youth, leading to health disparities in American children. The primary purpose of the current study was to investigate the relationship between health insurance status and physical activity level in American youth.

Methods:

A national, United States census weighted cross-sectional survey was performed analyzing 2002 noninstitutionalized children living in the United States between the ages of 10 to 18 years, equally split by age and sex, with state of residency and race/ethnicity proportional to the 2010 census distribution. Multiple linear regression was performed to investigate the relationship between insurance status and activity level (measured by HSS Pedi-FABS activity score) while controlling for relevant demographic and socioeconomic covariables.

Results:

HSS Pedi-FABS activity scores were normally distributed with a mean of 15.4±8.5 points (of 30 possible points). Patients with an insurance status of “government/Medicaid,” “other,” or “none” each demonstrated significantly lower physical activity scores (14.2±8.5 vs. 13.6±9.0 vs. 10.1±8.5) than children with private insurance (16.5±8.2) (one-way ANOVA with Dunnett-adjusted pairwise comparisons, P<0.001), which remained statistically significant while controlling for Area Deprivation Index, age, gender, race/ethnicity, and Body Mass Index (β=−1.8, P<0.001).

Conclusions:

Government/Medicaid health insurance status and lack of health care coverage are associated with low levels of physical activity in American children, even while controlling for socioeconomic confounders. Collaborative work between health care providers and community/ school-based programs may be a reasonable approach to expanding access to recreation, organized sports, and physical activity for publicly and uninsured children.

Level of Evidence:

Level II—Prognostic Study.
The Successful Mechanical Lipectomy Treatment of Cerebral Fat Embolism following Autologous Fat Injection
Authors: Zhou Kena , Cai Congbo
Published: January 2019

Autologous fat injection is becoming a more and more widely accepted procedure in plastic surgery nowadays. Concomitantly, there are many complications. The most serious one is arterial fat embolism, for which there is only poor prognosis and no effective treatment. Here, we report the first case of successful treatment of cerebral fat embolization with the help of mechanical lipectomy. Our patient was found unconscious with left-sided hemiparesis after a facial fat injection surgery 4 hours before. Cerebral artery computed tomography angiography indicated it was multiple fat embolism. Then Solitaire stent (4 × 20 mm) and Solumbra (continuously negative pressure attraction) were utilized for the mechanical extraction of fat emboli. The patient recovered from left-side hemiparesis to muscle strength of Medical Research Council scale grade 4, and National Institutes of Health Stroke Scale score was 0 after 3 months visit. In the cerebral infarction after fat transplantation, mechanical lipectomy can be a novel and significant treatment.
External Validation of ASPECT (Algorithm for Suspected Pulmonary Embolism Confirmation and Treatment)
Authors: Klil-Drori Adi J. , Prajapati Dwip , Liang Zhiying , Wang Meng , Toupin Dominique , Alothman Latifah , Lang Eddy , Suryanarayan Deepa , Tagalakis Vicky
Published: January 2019

Background:

Administrative health care databases are increasingly being used to study pulmonary embolism (PE), but the validity of single PE codes is variable. Using data from Quebec, Canada, we developed ASPECT (Algorithm for Suspected Pulmonary Embolism Confirmation and Treatment), combining 3 components to ascertain confirmed PE: emergency department (ED) diagnoses, imaging codes, and dispensed prescriptions or hospital diagnoses. Herein, we used unrelated administrative health care databases to externally validate ASPECT.

Methods:

We used ED electronic health records (ED-EHRs) to identify all residents of Calgary (Alberta, Canada) with PE codes between January and June, 2016. We applied ASPECT by identifying imaging studies in the ED-EHR, admission diagnoses in linked discharge abstract database and filled prescriptions in linked pharmacy information. Confirmed PE in ASPECT was validated against chart review in the ED-EHR.

Results:

The cohort included 498 patients. Overall, 258 (51.9%) were managed as outpatients and 327 were adjudicated to have confirmed PE; the positive predictive value (PV) of single PE codes was 65.6%. With ASPECT the positive PV was 96.5% [95% confidence interval (CI), 94.4–98.5%] and positive likelihood ratio was 10.9 (95% CI, 6.8–15.1). The negative PV and negative likelihood ratio were 85.1% (95% CI, 80.0–90.2%) and 0.1 (95% CI, 0.0–0.1), respectively. Overall agreement of ASPECT with confirmed PE was 92.2%. Further, ASPECT was similarly robust in inpatients and outpatients and was more precise than any 2-component combination of ASPECT.

Conclusions:

Our findings reiterate the limitations of using single administrative codes for PE and suggest ASPECT as an acceptable tool to study PE.
Assessment of Exocrine Pancreatic Function During Endoscopy in Children
Authors: Horvath Karoly , Mehta Devendra I. , Hill Ivor D.
Published: January 2019

This article will review briefly the physiology of pancreatic enzyme secretion and the role of stimulated endoscopic testing for assessing exocrine pancreatic function. Published studies in both the pediatric and adult literature are reviewed. The technique and utility of endoscopic pancreatic function testing as the method of choice in the differential diagnosis of pancreatic disorders in childhood is described. Finally, emerging, clinically useful markers that can be measured in the pancreatic fluid will be described.
International Medical Graduates and the Integrated Plastic Surgery Residency Match
Authors: Lujan-Hernandez Jorge , Ibrahim Mohamed M. , Taub Peter J.
Published: January 2019

Plastic surgery continues to be one of the most competitive programs into which medical students attempt to match. The reasons for this include the complexity and diversity of cases, the opportunity to interact with multiple specialties, patient and surgeon satisfaction, and the potential for higher compensation compared with other specialties. The disparity between the relatively small number of plastic surgery residency positions and the large number of highly competitive candidates has created challenges for both the applicant and the residency program director. This challenge is even greater for international medical graduates because of traditional preconceived notions about the quality of the applicants. The authors sought to determine existing beliefs about international medical graduates among plastic surgeons.
Classifying Preoperative Opioid Use for Surgical Care
Authors: Vu Joceline V. , Cron David C. , Lee Jay S. , Gunaseelan Vidhya , Lagisetty Pooja , Wixson Matthew , Englesbe Michael J. , Brummett Chad M. , Waljee Jennifer F.
Published: January 2019

Objective:

We characterized patterns of preoperative opioid use in patients undergoing elective surgery to identify the relationship between preoperative use and subsequent opioid fill after surgery.

Background:

Preoperative opioid use is common, and varies by dose, recency, duration, and continuity of fills. To date, there is little evidence to guide postoperative prescribing need based on prior opioid use.

Methods:

We analyzed claims data from Clinformatics DataMart Database for patients aged 18 to 64 years undergoing major and minor surgery between 2008 and 2015. Preoperative use was defined as any opioid prescription filled in the year before surgery. We used cluster analysis to group patients by the dose, recency, duration, and continuity of use. Our primary outcome was second postoperative fill within 30 postoperative days. Our primary explanatory variable was opioid use group. We used logistic regression to examine likelihood of second fill by opioid use group.

Results:

Out of 267,252 patients, 102,748 (38%) filled an opioid prescription in the 12 months before surgery. Cluster analysis yielded 6 groups of preoperative opioid use, ranging from minimal (27.6%) to intermittent (7.7%) to chronic use (2.7%). Preoperative opioid use was the most influential predictor of second fill, with larger effect sizes than other factors even for patients with minimal or intermittent opioid use. Increasing preoperative use was associated with risk-adjusted likelihood of requiring a second opioid fill compared with naive patients [minimal use: odds ratio (OR) 1.49, 95% confidence interval (95% CI) 1.45–1.53; recent intermittent use: OR 6.51, 95% CI 6.16–6.88; high chronic use: OR 60.79, 95% CI 27.81–132.92, all P values <0.001).

Conclusion:

Preoperative opioid use is common among patients who undergo elective surgery. Although the majority of patients infrequently fill opioids before surgery, even minimal use increases the probability of needing additional postoperative prescriptions in the 30 days after surgery when compared with opioid-naive patients. Going forward, identifying preoperative opioid use can inform surgeon prescribing and care coordination for pain management after surgery.
The Adherence of Home Pelvic Floor Muscles Training Using a Mobile Device Application for Women With Urinary Incontinence: A Randomized Controlled Trial
Authors: Araujo Camila C. , Marques Andrea de A. , Juliato Cassia R.T.
Published: January 2019

Objectives

The objective of this study was to evaluate the use of a mobile device application (app) for the treatment of urinary incontinence through adherence to home pelvic floor muscle training (PFMT) and its impact on urinary symptoms.

Methods

This prospective randomized study included women with stress urinary incontinence. They were randomized into 2 groups: the app group, which used an app developed using the same visual component of electromyography as a guide for PFMT and followed exercises shown on the screen, and the control group, which received written instructions with the same protocol as the app group but without the dynamic sequence of PFMT images. Exercises were done twice a day. Reevaluation was repeated at 1, 2, and 3 months after the initial evaluation. Changes in urinary and vaginal symptoms were evaluated using questionnaires, and the Oxford Modified Scale was determined through digital palpation.

Results

Twenty-one women were included in the study (app group, n = 12; control group, n = 09). Adherence (number of repetitions) was higher in the app group at 2 and 3 months after PFMT (P < 0.001), but adherence decrease, especially in the control group, at 1, 2, and 3 months. Vaginal symptoms (P < 0.001), quality of life (P = 0.003), urinary symptoms (P < 0.001), and stress urinary symptoms (P < 0.001) showed improvement comparing baseline and during treatment, but there was no difference between the app and control groups (P values, 0.887, 0.817, 0.573, and 0.825, respectively).

Conclusions

Using the app increased adherence to PFMT in women with urinary incontinence symptoms and improved subjective perception.
Health, Social, and Environmental Factors Associated With Appropriate Nutritional Intake for Healthy Aging
Authors: Lozano Manuel , Manyes Lara , Peiró Juanjo , Ramada José María
Published: January 2019

The World Health Organization and the European Union highlight the role of nutrition to achieve healthy aging, as well as the need for further research into the impact of social, economic, and environmental determinants on diet. The aim of this study was to identify the factors by assessing their impact on healthy aging by measuring the influence on the main validated nutritional indexes. Factors that impair nutrition status include low socioeconomic status, lack of interest in the usual diet, presence of chronic disabling diseases, consumption of drugs for chronic diseases together with lack of autonomy for daily living activities related to feeding themselves, and needing domestic support services.
Measuring the Nutrition Knowledge of Weight Management and Diabetes Risk in a Low Socioeconomic Population
Authors: Burch Hannah , Moore Carolyn E. , Burditt JoAnn , Patterson Mindy A.
Published: January 2019

The purpose of this project was to assess healthy eating knowledge before and after a nutrition education course on basic nutrition, weight management, and type 2 diabetes mellitus risk. Fifty-four low socioeconomic adults attended a 2-hour nutrition education course at a health clinic. The participants received either an English or a Spanish pre- and posttest. A significant increase (P < .001) in nutrition knowledge from pretest (50.9 ± 16.51) to posttest (77.2 ± 13.79) questions was observed. The English version had significantly higher posttest scores than the Spanish version (P = .001). This study demonstrated that nutrition knowledge in a low socioeconomic population can be improved following a nutrition education course.
Kinetics of surface growth with coupled diffusion and the emergence of a universal growth path
Authors: Abi-Akl Rami , Abeyaratne Rohan , Cohen Tal
Published: January 2019

Surface growth by association or dissociation of material on the boundary of a body is ubiquitous in both natural and engineering systems. It is the fundamental mechanism by which biological materials grow, starting from the level of a single cell, and is increasingly applied in engineering processes for fabrication and self-assembly. A significant challenge in modelling such processes arises due to the inherent coupled interaction between the growth kinetics, the local stresses and the diffusing constituents needed to sustain the growth. Moreover, the volume of the body changes not only due to surface growth but also by variation in solvent concentration within the bulk. In this paper, we present a general theoretical framework that captures these phenomena and describes the kinetics of surface growth while accounting for coupled diffusion. Then, by the combination of analytical and numerical tools, applied to a simple growth geometry, we show that the evolution of such growth processes tends towards a universal path that is independent of initial conditions. This path, on which surface growth and diffusion act harmoniously, can be extended to analytically portray the evolution of a body from inception up to a treadmilling state, in which addition and removal of material are balanced.
Manifold cities: social variables of urban areas in the UK
Authors: Barter Edmund , Gross Thilo
Published: January 2019

In the twenty-first century, ongoing rapid urbanization highlights the need to gain deeper insights into the social structure of cities. While work on this challenge can profit from abundant data sources, the complexity of this data itself proves to be a challenge. In this paper, we use diffusion maps, a manifold learning method, to discover hidden manifolds in the UK 2011 census dataset. The census key statistics and quick statistics report 1450 different statistical features for each census output area. Here, we focus primarily on the city of Bristol and the surrounding countryside, comprising 3490 of these output areas. Our analysis finds the main variables that span the census responses, highlighting that university student density and poverty are the most important explanatory variables of variation in census responses.
Looking for alternatives to the superspace description of icosahedral quasicrystals
Authors: Madison A. E. , Madison P. A.
Published: January 2019

A multiple-cell approach is discussed as a possible alternative to the higher dimensional crystallography of icosahedral quasicrystals. It is based on the Socolar–Steinhardt tiling combined with the quasi-unit cell model. Quasi-unit cells fill the space without gaps and overlappings similar to those in periodic crystals. Similarly, the atoms can occupy general and special positions. The alloy stoichiometry and the packing density can be calculated through the relative tile frequencies, which in turn are determined as the components of the Perron–Frobenius eigenvector of the corresponding substitution matrix. The calculation of the diffraction pattern reduces to the Perron projection of a special matrix, the entries of which reflect the contribution of each type of quasi-unit cell to the coherent scattering.
A range-wide domino effect and resetting of the annual cycle in a migratory songbird
Authors: Gow Elizabeth A. , Burke Lauren , Winkler David W. , Knight Samantha M. , Bradley David W. , Clark Robert G. , Bélisle Marc , Berzins Lisha L. , Blake Tricia , Bridge Eli S. , Dawson Russell D. , Dunn Peter O. , Garant Dany , Holroyd Geoff , Horn Andrew G. , Hussell David J. T. , Lansdorp Olga , Laughlin Andrew J. , Leonard Marty L. , Pelletier Fanie , Shutler Dave , Siefferman Lynn , Taylor Caz M. , Trefry Helen , Vleck Carol M. , Vleck David , Whittingham Linda A. , Norris D. Ryan
Published: January 2019

Latitudinal differences in timing of breeding are well documented but how such differences carry over to influence timing of events in the annual cycle of migratory birds is not well understood. We examined geographical variation in timing of events throughout the year using light-level geolocator tracking data from 133 migratory tree swallows (
Tachycineta bicolor
) originating from 12 North American breeding populations. A swallow's breeding latitude influenced timing of breeding, which then carried over to affect breeding ground departure. This resulted in subsequent effects on the arrival and departure schedules at autumn stopover locations and timing of arrival at non-breeding locations. This ‘domino effect’ between timing events was no longer apparent by the time individuals departed for spring migration. Our range-wide analysis demonstrates the lasting impact breeding latitude can have on migration schedules but also highlights how such timing relationships can reset when individuals reside at non-breeding sites for extended periods of time.
Development of behavioural automaticity by extended Pavlovian training in an insect
Authors: Mizunami Makoto , Hirohata Sho , Sato Ai , Arai Ryoichi , Terao Kanta , Sato Misato , Matsumoto Yukihisa
Published: January 2019

The effect of repetitive training on learned actions has been a major subject in behavioural neuroscience. Many studies of instrumental conditioning in mammals, including humans, suggested that learned actions early in training are goal-driven and controlled by outcome expectancy, but they become more automatic and insensitive to reduction in the value of the outcome after extended training. It was unknown, however, whether the development of value-insensitive behaviour also occurs by extended training of Pavlovian conditioning in any animals. Here we show that cricketsGryllus bimaculatusthat had received minimal training to associate an odour with water (unconditioned stimulus, US) did not exhibit conditioned response (CR) to the odour when they were given water until satiation before the test, but those that had received extended training exhibited CR even when they were satiated with water. Further pharmacological experiments suggested that octopamine neurons, the invertebrate counterparts of noradrenaline neurons, mediate US value signals and control execution of CR after minimal training, but the control diminishes with the progress of training and hence the CR becomes insensitive to US devaluation. The results suggest that repetitive sensory experiences can lead to a change from a goal-driven response to a more automatic one in crickets.
Pathogen shifts in a honeybee predator following the arrival of the
Varroa
mite
Authors: Loope Kevin J. , Baty James W. , Lester Philip J. , Wilson Rankin Erin E.
Published: January 2019

Emerging infectious diseases (EIDs) are a global threat to honeybees, and spillover from managed bees threaten wider insect populations. Deformed wing virus (DWV), a widespread virus that has become emergent in conjunction with the spread of the mite
Varroa destructor
, is thought to be partly responsible for global colony losses. The arrival of
Varroa
in honeybee populations causes a dramatic loss of viral genotypic diversity, favouring a few virulent strains. Here, we investigate DWV spillover in an invasive Hawaiian population of the wasp,
Vespula pensylvanica
, a honeybee predator and honey-raider. We show that
Vespula
underwent a parallel loss in DWV variant diversity upon the arrival of
Varroa
, despite the mite being a honeybee specialist. The observed shift in
Vespula
DWV and the variant-sharing between
Vespula
and
Apis
suggest that these wasps can acquire DWV directly or indirectly from honeybees.
Apis
prey items collected from
Vespula
foragers were positive for DWV, indicating predation is a possible route of transmission. We also sought cascading effects of DWV shifts in a broader
Vespula
pathogen community. We identified concurrent changes in a suite of additional pathogens, as well as shifts in the associations between these pathogens in
Vespula
. These findings reveal how hidden effects of the
Varroa
mite can, via spillover, transform the composition of pathogens in interacting species, with potential knock-on effects for entire pathogen communities.