bluuebunny/crossref_metadata_2025 huggingface dataset:
Holocene vegetation and climate variability in the winter and summer rainfall zones of South Africa
Authors: Zhao Xueqin , Dupont Lydie , Schefuß Enno , Meadows Michael E , Hahn Annette , Wefer Gerold
Published: January 2016

To better understand Holocene vegetation and hydrological changes in South Africa, we analyzed pollen and microcharcoal records of two marine sites GeoB8331 and GeoB8323 from the Namaqualand mudbelt offshore the west coast of South Africa covering the last 9900 and 2200 years, respectively. Our data corroborate findings from literature that climate developments apparently contrast between the summer rainfall zone (SRZ) and winter rainfall zone (WRZ) over the last 9900 years, especially during the early and middle Holocene. During the early Holocene (9900–7800 cal. yr BP), a minimum of grass pollen suggests low summer rainfall in the SRZ, and the initial presence of Renosterveld vegetation indicates relatively wet conditions in the WRZ. Toward the middle Holocene (7800–2400 cal. yr BP), a rather moist savanna/grassland rich in grasses suggests higher summer rainfall in the SRZ resulting from increased austral summer insolation and a decline of fynbos vegetation accompanied by an increasing Succulent Karoo vegetation in the WRZ, which possibly suggests a southward shift of the Southern Hemisphere westerlies. During the last 2200 years, a trend toward higher aridity was observed for the SRZ, while the climate in the WRZ remained relatively stable. The ‘Little Ice Age’ (ca. 700–200 cal. yr BP) was rather cool in both rainfall zones and drier in the SRZ while it was wetter in the WRZ.
An immune regulatory CCT repeat containing oligodeoxynucleotide capable of causing hair loss in male mice
Authors: Xu Y , Liu J , Hua L , Xiao Y , Tian Y , Guo S , Zhang X , He C , Wang L , Yu Y
Published: January 2016

An oligodeoxynucleotide with CCT repeats (CCT ODN) has been found in our previous study to selectively downregulate Toll-like receptor 7/9 (TLR7/9)-mediated immune responses both in vitro and in vivo. In this study, we unexpectedly found that CCT ODN induced severe patchy hair loss around the mouth in male F1 mice (female Balb/c × male C57BL/6) with lupus-like nephritis induced by injecting allogenic lymphocytes and also in male Balb/c mice, but not in female F1 mice and Balb/c mice and either gender of C57BL/6 mice. Increased infiltration of natural killer group 2, member D (NKG2D+) cells in hair loss skin and upregulated interferon-gamma (IFN-γ) messenger RNA expression in cultured splenocytes were observed in male Balb/c mice. The CCT ODN-conditioned supernatants of cultured mouse splenocytes caused catagen-like changes to hair follicles (HFs). We hypothesized that the CCT ODN could induce patchy hair loss in the male mice with certain genetic traits by mobilizing NKG2D+ cells to HFs and by inducing the production of IFN-γ from immune cells. Taken together these data indicated that a gender and genetic preference of immune-regulatory oligonucleotides is causing unexpected clinical situations such as hair loss.
Autoimmune congenital heart block: complex and unusual situations
Authors: Brito-Zerón P , Izmirly PM , Ramos-Casals M , Buyon JP , Khamashta MA
Published: January 2016

Autoimmune congenital heart block (ACHB) is an immune-mediated cardiac disease included among the manifestations collectively referred to as neonatal lupus. The placental transference of maternal Ro/La autoantibodies may damage the conduction tissues during fetal development leading to blocking of signal conduction at the atrioventricular (AV) node in an otherwise structurally normal heart. Irreversible complete AV block is the main cardiac manifestation of ACHB, but some babies may develop endocardial fibroelastosis, valvular insufficiency, and/or frank cardiomyopathies with significantly reduced cardiac function requiring transplant. The severity of ACHB is illustrated by a global mortality rate of 20% and pacemaker rates of at least 64%, often within the first year of life. This review analyses the main complex and/or unusual clinical situations associated with ACHB, including unusual maternal immunological profiles, infrequent maternal autoimmune diseases, cardiac damage unrelated to AV block, fetal invasive management, late complications after birth, risk of congenital heart block (CHB) in ovodonation and in vitro fertilization techniques, the role of maternal features other than autoimmunity, the influence of the birth order or the risk of CHB in twins and triplets.
Chinese SLE Treatment and Research group (CSTAR) registry VII: prevalence and clinical significance of serositis in Chinese patients with systemic lupus erythematosus
Authors: Zhao J , Bai W , Zhu P , Zhang X , Liu S , Wu L , Ma L , Bi L , Zuo X , Sun L , Huang C , Tian X , Li M , Zhao Y , Zeng X ,   CSTAR co-authors
Published: January 2016

Objectives

To investigate both the prevalence and clinical characteristics of serositis in Chinese patients with systemic lupus erythematosus (SLE) in a large cohort in the Chinese SLE Treatment and Research group (CSTAR) database.

Methods

A prospective cross-sectional study of patients with SLE was conducted based on the data from the CSTAR registry. Serositis was defined according to the 1999 revised American College of Rheumatology (ACR) criteria for SLE – that is, pleuritis/pleural effusion and/or pericarditis/pericardial effusion detected by echocardiography, chest X-ray or chest computerized tomography (CT) scan. Peritonitis/peritoneal effusion were confirmed by abdominal ultrasonography. We analysed the prevalence and clinical associations of serositis with demographic data, organ involvements, laboratory findings and SLE disease activity.

Results

Of 2104 patients with SLE, 345 were diagnosed with serositis. The prevalence of lupus nephritis (LN), interstitial lung disease and pulmonary arterial hypertension, as well as the presence of leukocytopenia, thrombocytopenia, hypocomplementemia and anti-dsDNA antibodies was significantly higher in patients with serositis ( P < 0.05). Significantly higher SLE disease activity scores were found in patients with serositis compared to those patients without serositis ( P < 0.05). Lupus-related peritonitis had similar clinical manifestations and laboratory profiles as serositis caused by SLE.

Conclusions

There is a significant association of nephropathy, interstitial lung disease, pulmonary arterial hypertension, hypocomplementemia, leukocytopenia, thrombocytopenia and elevated anti-dsDNA antibodies with serositis. The results suggest that higher SLE disease activity contributes to serositis development, and should be treated aggressively.
Neurologic amebiasis caused by Balamuthia mandrillaris in an Indian flying fox (Pteropus giganteus)
Authors: Crossland Nicholas A. , Ali Ibne , Higbie Christine , Jackson Jonathan , Pirie Gordon , Bauer Rudy
Published: January 2016

A 4–5-month-old intact male Indian flying fox ( Pteropus giganteus) was presented to the Baton Rouge Zoo’s veterinary hospital with an acute onset of obtundation that was diagnosed with amebic encephalitis. Histologic examination revealed numerous amebic trophozoites within necrotic foci, affecting the occipital cerebrum and surrounding the mesencephalic aqueduct. The etiologic agent, Balamuthia mandrillaris, was determined by multiplex quantitative real-time polymerase chain reaction, immunohistochemistry, and indirect fluorescent antibody test. The current report documented a case of amebic encephalitis within the order Chiroptera.
Timing and Outcome of Referral to the First Stand-Alone Palliative Care Center in the Eastern Mediterranean Region, the Palliative Care Center of Kuwait
Authors: Al-Saleh Khaled , Al-Awadi Ahmad , Soliman Najla A. , Mostafa Sobhy , Mostafa Mohammad , Mostafa Wafaa , Alsirafy Samy A.
Published: January 2016

Background:

Compared to other regions of the world, palliative care (PC) in the Eastern Mediterranean region is at an earlier stage of development. The Palliative Care Center of Kuwait (PCC-K) was established a few years ago as the first stand-alone PC center in the region. This study was conducted to investigate the timing of referral to the PCC-K and its outcome.

Methods:

Retrospective review of referrals to the PCC-K during its first 3 years of action. Late referral was defined as referral during the last 30 days of life.

Results:

During the 3-year period, 498 patients with cancer were referred to the PCC-K of whom 467 were eligible for analysis. Referral was considered late in 58% of patients. Nononcology facilities were more likely to refer patients late when compared to oncology facilities ( P = .033). The palliative performance scale (PPS) was ≤30 in 59% of late referrals and 21% in earlier referrals ( P < .001). Among 467 referred patients, 342 (73%) were eligible for transfer to the PCC-K, 102 (22%) were ineligible, and 23 (5%) died before assessment by the PCC-K consultation team. From the 342 eligible patients, the family caregivers refused the transfer of 64 (19%) patients to the PCC-K.

Conclusion:

Patients are frequently referred late to the PCC-K. Further research to identify barriers to PC and its early integration in Kuwait is required. The PPS may be useful in identifying late referrals.
A Survey of Hospice Volunteer Coordinators: Training Methods and Objectives of Current Hospice Volunteer Training Programs
Authors: Brock Cara M. , Herndon Christopher M.
Published: January 2016

Introduction:

Currently more than 5800 hospice organizations operate in the United States.1 Hospice organizations are required by the Centers for Medicare and Medicaid Services (CMS) to use volunteers for services provided to patients.2 Although CMS regulates the amount of hours hospice volunteers should provide, there are currently no national requirements for objectives of training.3 The purpose of this study was to gather information from a sample of hospices regarding volunteer coordinator background, current training for volunteers, importance of training objectives, and any comments regarding additional objectives.

Methods:

Representative state hospice organizations were contacted by e-mail requesting their participation and distribution of the survey throughout their member hospices. The survey asked demographical questions, along with ratings of training components based on perceived level of importance and time spent on each objective.

Results:

A total of 90 surveys were received, and the response rate was undeterminable. Results showed the majority of hospices were nonprofit, had less than 100 currently trained volunteers, and maintained an average daily patient census of less than 50. Questions regarding training programs indicated that most use live lecture methods of approximately 19 hours or less in duration. Overall, responding hospice organizations agreed that all objectives surveyed were important in training volunteers.

Conclusion:

The small number of respondents to this survey makes generalization nationwide difficult, however it is a strong starting point for the development of further surveys on hospice volunteer training and achieving a standardized set of training objectives and delivery methods.
Encouraging Students to Consider Music Education as a Future Profession
Authors: Porter Ann M. , Payne Phillip D. , Burrack Frederick W. , Fredrickson William E.
Published: January 2016

The purpose of this study was to examine the attitudes, communication, and opportunities provided by music teachers to encourage consideration of the music teaching profession. Survey participants ( N = 436) were music educators from the Southeast (235), Midwest (51), and Southwest (149) National Association for Music Education regions of the United States. Fifty-two percent of respondents reported encouraging students to explore the music teaching profession, one third reported uncertainty about their encouragement of a music education career, and 21% indicated active discouragement. Personal job satisfaction, student music abilities, and constraints/forces outside the profession were factors for respondents who discourage students from the profession. A majority reported providing opportunities to explore the profession as a viable career option and those experiences reflected the authentic practices of the teaching profession. Professional development opportunities for in-service teachers in the encouragement of students toward music teaching should be strongly considered.
Canadian Provincial Correctional Officers
Authors: Ricciardelli Rosemary
Published: January 2016

Prison environments are structured by hierarchical relations of power and real, or perceived, risk. I use data derived from in-depth semi-structured interviews with 44 male correctional officers (COs) employed or previously employed in Canadian provincial prisons to reveal how their work environment shapes their masculinities and understandings of vulnerabilities—risk perceptions, insecurities, and uncertainties. I argue that the processes of self-regulation used by COs to construct strategies of risk avoidance also achieve and affirm masculinities. As such, I explore COs’ understandings of masculinities in light of culturally, politically, or societally induced vulnerabilities and how they reestablish their masculinities as they engage in processes of risk avoidance. Findings are discussed in relation to how constructions of masculinities and the mitigation of vulnerability and risk are symbiotic processes, where COs appropriate strategies of risk negation.
Portrayals of Masculinity in “Guy Movies”
Authors: Zeglin Robert J.
Published: January 2016

Masculinity, an expression of sexual identity, is typically considered the enactment of male identity. The current analysis is a deductive summative content analysis of three popular “guy movies” using the Conformity to Masculine Norms Inventory (CMNI). Results indicated that Emotional Control, Risk-Taking, Violence, and Dominance were the most frequently represented CMNI factors. Winning, Self-Reliance, Playboy, Primacy of Work, Power Over Women, Disdain for Homosexuals, and Pursuit of Status were significantly less frequently displayed. Analysis of the four salient factors indicated that these qualities can be conceptualized as positive and prosocial masculine norms. This suggests that “guy movies” earn that title not because they display gratuitous and stereotypical masculinity but because they allow the viewer to identify with the positive qualities of his own masculinity. The concept of viewer–character dissonance is proposed as a possible explanation.
Donation Motivations
Authors: Barber Michael
Published: January 2016

Understanding why donors give money to legislative candidates is vital for assessing how money influences politics. In this paper, I test theories of why political action committees (PACs) and individuals, the two largest sources of campaign money, contribute to legislative candidates. Using a variety of data at the state and federal level, I show dramatic differences between individual and PAC contribution patterns. An original survey of donors in the 2012 election cycle shows that individuals consistently rank ideological concerns as highly important when deciding where to give. Finally, using two different within-legislator designs, I show a causal relationship between incumbency, ideology, and contributions. These results provide the most direct and comprehensive test of contributor motivations to date.1
Tubular Pyloric Gland Adenoma of the Left and Right Hepatic Ducts
Authors: Hatzibougias Dimitris I. , Fouzas Ioannis , Bobos Mattheos , Papanikolaou Vasileios , Daoudaki Maria , Kotoula Vasiliki , Hytiroglou Prodromos , Albores-Saavedra Jorge
Published: January 2016

Pyloric gland adenomas (PGAs) of the extrahepatic biliary system are rare lesions. We report a case of a tubular PGA that led to biliary obstruction. The tumor was located at the confluence of the right and left hepatic ducts, extending to the left hepatic duct. The tumor cells expressed MUC6 and MUC5AC. MUC1 and CD10 were focally positive. MUC2, p53, and CDX2 were not expressed. The Ki67 positivity was estimated at <15%. None of the KRAS, NRAS, BRAF, EGFR coding regions resulted in clinically relevant amino acid substitutions. SNP rs1050171 (EGFR p.Q787Q, silent mutation) corresponding to c.2361G>A transition in exon 20 was noticed. Awareness of this rare lesion is important for pathologists and clinicians alike, because it may cause significant morphologic and clinical difficulties, especially when presenting as an obstructive mass. Because of the possible risk of evolving malignancy, surgical resection is recommended whenever possible.
Hybrid material and foundation damping of Timoshenko beams
Authors: Zamani HA , Aghdam MM
Published: January 2016

In this paper, vibration suppression of shear deformable beams with hybrid material-foundation viscoelastic damping is studied. The precise behavior of viscoelastic polymeric structures is taken into consideration by Boltzmann superposition integral and utilizing dynamic mechanical analysis (DMA) results while foundation viscoelasticity is adapted by Kelvin-Voigt model. The integro-partial differential equations of motion are derived based on the Timoshenko theory via Hamilton principle. Assessment of the solution procedure is carried out by comparison with elastic Timoshenko and viscoelastic Euler-Bernoulli cases. Transient response, natural frequency and modal loss factor are attained by Fourier transform, weighted residual method and numerical iterative algorithm. Influences of hybrid viscoelastic damping, foundation properties, geometrical parameters and boundary conditions on vibration characteristics and dynamic response are investigated via comprehensive parametric study. Due to the absence of similar results in the literature, this paper is likely to fill a gap in the state of the art of this problem.
An intelligent performance degradation assessment method for bearings
Authors: Jiang Huiming , Chen Jin , Dong Guangming , Wang Ran
Published: January 2016

Bearings are one of the most frequently used components in the rotatory machinery, so the performance degradation assessment of bearings plays an important role in the prognostics and health management of systems. Hidden Markov model (HMM) is a widely applied data-driven model used for bearing performance degradation assessment and has many successful applications. A normal HMM needs to be trained in advance, which has close relationship with the evaluation system. However, the trained HMM is quite influenced by many issues, such as the data integrity and the feature space. In this paper, an intelligent bearing performance degradation assessment method based on HMM and nuisance attribute projection (NAP) is proposed. The proposed method can combine the information from the experimental data and the real-time data effectively and assess the performance since the beginning of the monitoring. The effectiveness of the proposed method is verified through an accelerated life test of rolling element bearings.
Top-story mass dampers for seismic control of the first triplet of vibration modes of two-way asymmetric-plan buildings
Authors: Lin Jui-Liang
Published: January 2016

Using an inertial part of a building structure as a tuned mass damper (TMD) has been shown to have economic advantages in terms of required materials and space for installing and operating a TMD in a building. This study suggests either designing the top story of a new asymmetric-plan building or adding a purposely designed story atop an existing asymmetric-plan building as a TMD to protect the building against earthquakes. This novel TMD, called a top-story mass damper (TSMD), is formulated using the three-degree-of-freedom modal properties of the first triplet of vibration modes of the original two-way asymmetric-plan building. The so-called first triplet of vibration modes are the first dominant modes in each of the three directions, i.e., the two horizontal translations and one vertical rotation. The proposed TSMD is intended to suppress the vibrations resulting from the first triplet of vibration modes that are generally most significant in overall seismic responses. The effectiveness of the TSMD is verified by investigating the frequency response functions and seismic responses of one single-story and one 20-story two-way asymmetric-plan buildings.
Effects of the leucovorin shortage: Pilot study investigating cost, efficacy, and toxicity comparison of low fixed-dose versus body surface area-adjusted leucovorin dosing in patients with resectable colon or metastatic colorectal cancer
Authors: Shank Brandon R , Seung Amy H , Kinsman Katharine , Newman Matthew J , Donehower Ross C , Burton Bradley
Published: January 2016

Purpose

As a result of the leucovorin shortage, we switched from BSA-adjusted to low fixed-dose leucovorin in patients with colon cancer receiving fluorouracil-containing therapy.

Methods

A retrospective, pilot study of adults receiving intravenous leucovorin as part of a fluorouracil-containing treatment was conducted including individuals with stage II or III colon or newly diagnosed metastatic colorectal cancer. One low fixed-dose (leucovorin 50 mg) patient was matched by the investigator to one BSA-adjusted (leucovorin 200–500 mg/m2/dose) patient on disease stage and age. The objectives were to compare cost of alternative dosing strategies as well as efficacy and adverse event rates. Only patients being treated in the first-line metastatic colorectal cancer setting were included in the efficacy analysis.

Results

Fifty-eight patients were included. Leucovorin cost was reduced by 7- to 14-fold, and we were able to conserve a total of 1580–3400 doses of leucovorin by changing to fixed-dose (estimated from 200 mg/m2 or 400 mg/m2 dosing strategies, respectively). No statistically significant differences in progression-free survival ( p = 0.254), overall survival ( p = 0.923), or complications resulted.

Conclusion

Our decision to reduce the dose of leucovorin allowed us to conserve supply and control cost. The small sample size did not allow us to detect differences in efficacy or adverse event rates, and thus a larger study would be required to confirm our findings that efficacy was not compromised nor adverse effects greater.
Environmental Management Evolution Framework
Authors: Ormazabal Marta , Rich Eliot , Sarriegi Jose M. , Viles Elisabeth
Published: January 2016

Environmental management has become a fundamental concern for organizations, customers, and citizens, yet there are few environmental management metrics that guide toward environmental excellence. This research presents a detailed qualitative model of the evolution of environmental management of a firm through the definition of maturity stages and causal influences. The model provides a technique for assessing maturity stages as well as steps that can assist or negate their ecological advancement. The causal-based classification helps companies to understand the need for nontechnical elements in the process, such as top management commitment. This article also contributes to the literature on integrative multimethod research, as it brings together several approaches to environmental management.
Dehexing Postwar West Balkan Masculinities
Authors: Dumančić Marko , Krolo Krešimir
Published: January 2016

Focusing on Bosnia, Croatia, and Serbia, this article examines film and music that emerged in the region since the end of the Yugoslav Wars of Succession. We analyze how the uncertainties of the postwar era facilitated a dynamic field of cultural contestation in which the music and film industries simultaneously challenge and affirm normative masculine sociocultural roles. Although traditional norms have not lost their primacy in public life, we emphasize the fact that attitudes toward masculinity have, in general, become increasingly ambiguous and multivalent. While local sociological studies accurately observe that violence and intolerance constitute central traits for the majority of men in the West Balkans, our research reflects on how popular culture complicates the idea that postwar West Balkan masculinities have remained uniform, static, and defined exclusively by aggression. We thus focus on the most popular musical and cinematic productions that embody the tension inherent in the contemporary representations of West Balkan masculinity. From our examples, it becomes clear that generalized instability attending new market economies and postwar political turmoil have indeed created a context within which national gender norms have entered a state of flux.
Catastrophic Snow Globes as Oneiric and Mnemonic Gadgets
Authors: Freeman Lindsey A.
Published: January 2016

While at first glance, snow globes might seem trite or trivial objects, on closer reflection, they are revealed to be symbolic realms that provide clues to the desires, dreams, nightmares, and memories of the cultures that produce them. When we consider snow globes as products and reflections of the social world and the individual’s place within it, it is not surprising that some artists and designers use these objects to depict some of the darker sides of contemporary life. Considered in this essay are snow globes of catastrophe, representing loss and malevolence, which trouble the notion of snow globes as comforting keepsakes. Here, I argue for a reading of snow globes as oneiric and mnemonic gadgets that magnify our human dramas and disasters, induce memory, melancholy, and nostalgia, and allow us to see our fears and our nightmares more clearly, exposing the relationships between matter and memory, objects and persons.
Exploring the Afterlife
Authors: Vanolo Alberto
Published: January 2016

Cultural understandings of the Afterlife are often embedded in spatial thinking and spatial metaphors. This article, first develops an understanding of the Afterlife as a relational virtual space populated by absent presences. Second, the article explores the possibility of investigating the Afterlife with ethnographical approaches. Exploring three fictional vignettes, the article discusses alternative spatialities of the Afterlife, in order to emphasize the pervasiveness of spatial thinking in conceptualizations of apparently nonspatial phenomena, and to challenge dichotomist spatial interpretations of presences/absences, the living and the postliving and life/Afterlife.
Cerebrospinal fluid lipocalin 2 in patients with clinically isolated syndromes and early multiple sclerosis
Authors: Khalil M , Renner A , Langkammer C , Enzinger C , Ropele S , Stojakovic T , Scharnagl H , Bachmaier G , Pichler A , Archelos JJ , Fuchs S , Seifert-Held T , Fazekas F
Published: January 2016

Background:

Lipocalin 2 (LCN2) may be involved in the immunopathogenesis of multiple sclerosis (MS) and might further impact on iron homoeostasis. Brain iron accumulates in MS; however, the association to iron-related proteins is still unsolved.

Objective:

To investigate cerebrospinal fluid (CSF) and serum LCN2, transferrin (Trf) and ferritin in early MS in relation to disease evolution and longitudinal brain iron accumulation.

Methods:

We analysed CSF and serum LCN2 by enzyme-linked immunosorbent assay (ELISA) and Trf and ferritin by nephelometry in 55 patients (45 clinically isolated syndrome (CIS), 10 MS, median clinical follow-up 4.8 years) and 63 controls. In patients, we assessed sub-cortical grey matter iron by 3T magnetic resonance imaging (MRI) R2* relaxometry (median imaging follow-up 2.2 years).

Results:

Compared to controls serum ( p < 0.01), CSF ( p < 0.001) LCN2 and CSF Trf ( p < 0.001) levels were reduced in the patients. CSF LCN2 correlated with CSF Trf ( r = 0.5, p < 0.001). In clinically stable patients, CSF LCN2 levels correlated with basal ganglia iron accumulation ( r = 0.5, p < 0.05). In CIS, higher CSF LCN2 levels were associated with conversion to clinically definite MS ( p < 0.05).

Conclusion:

We demonstrate altered LCN2 regulation in early MS and provide first evidence for this to be possibly linked to both clinical MS activity and iron accumulation in the basal ganglia.
Ideological alternative? Analyzing Alternative für Deutschland candidates’ ideal points via black box scaling
Authors: Jankowski Michael , Schneider Sebastian , Tepe Markus
Published: January 2016

This study applies black box scaling to the German Longitudinal Election Study candidate survey 2013 to shed light on an emerging right-wing party in Germany, the Alternative für Deutschland (AfD). The scaling procedure extracts two meaningful and robust ideological dimensions described as socialism versus liberalism and libertarian versus authoritarian. Placing the ideal point of candidates from all parties into this two-dimensional space shows that AfD candidates are significantly more market liberal than Christian Democratic Union candidates but not more authoritarian. On these grounds, the AfD can hardly be regarded as a right-wing extremist party. Yet exploring ideological heterogeneity within parties indicates that East German AfD candidates are generally more authoritarian than their West German colleagues, highlighting a potential source of the party’s recent shift from primarily Eurosceptic toward more nationalist conservative positions.
Multiple biomarkers for mortality prediction in peripheral arterial disease
Authors: Amrock Stephen M , Weitzman Michael
Published: January 2016

Few studies have assessed which biomarkers influence mortality risk among those with peripheral arterial disease (PAD). We analyzed data from 556 individuals identified to have PAD (i.e. ankle–brachial index ⩽0.9) with available measurements of C-reactive protein, the neutrophil-to-lymphocyte ratio (NLR), homocysteine, and the urinary albumin-to-creatinine ratio (UACR) in the 1999–2004 National Health and Nutrition Examination Survey. We investigated whether a combination of these biomarkers improved the prediction of all-cause and cardiovascular mortality beyond conventional risk factors. During follow-up (median, 8.1 years), 277 of 556 participants died; 63 deaths were attributed to cardiovascular disease. After adjusting for conventional risk factors, Cox proportional-hazards models showed the following to be most strongly associated with all-cause mortality (each is followed by the adjusted hazard ratio [HR] per 1 standard deviation increment in the log values): homocysteine (1.31), UACR (1.21), and NLR (1.20). UACR alone significantly predicted cardiovascular mortality (1.53). Persons in the highest quintile of multimarker scores derived from regression coefficients of significant biomarkers had elevated risks of all-cause mortality (adjusted HR, 2.45; 95% CI, 1.66–3.62; p for trend, <0.001) and cardiovascular mortality (adjusted HR, 2.20; 95% CI, 1.02–4.71; p for trend, 0.053) compared to those in the lowest two quintiles. The addition of continuous multimarker scores to conventional risk factors improved risk stratification of all-cause mortality (integrated discrimination improvement [IDI], 0.162; p<0.00001) and cardiovascular mortality (IDI, 0.058; p<0.00001). In conclusion, the addition of a continuous multimarker score to conventional risk factors improved mortality prediction among patients with PAD.
‘You just deal with it. You have to when you’ve got a child’: A narrative analysis of mothers’ accounts of how they coped, both during an abusive relationship and after leaving
Authors: Jones Alexandra , Vetere Arlene
Published: January 2016

A narrative analysis explored the accounts of eight mothers, each of whom had left an abusive relationship at least 12 months previously. Existing research investigating the strategies used by women to cope with domestic violence rarely considers women in their capacity as mothers. Furthermore, women’s lives after leaving an abusive relationship have received limited research attention. Thus, this study aimed to understand how women described coping with domestic violence and mothering their children, both during an abusive relationship and after leaving. The analysis focused on how the eight participants described their experiences (narrative form) as well as what they talked about (narrative content). Three types of narrative form were identified: (1) ‘The story told to help others’, (2) ‘The story too difficult to tell’ and (3) ‘Where’s my story going?’ Each woman spoke about the contextual factors that influenced whether she coped with domestic violence by seeking support from others, changing her thinking or changing her behaviour. Caring for their children was a major source of support for all the women both during their relationship and after leaving. The findings indicate that mothers who have been abused by their intimate partner may come into contact with a wide range of social and emergency support services. Implications for clinical practice, service delivery and service development relate to the different ways of supporting women in talking about abuse and also the need to recognise trauma in parents.
Self-esteem, social participation, and quality of life in patients with multiple sclerosis
Authors: Mikula Pavol , Nagyova Iveta , Krokavcova Martina , Vitkova Marianna , Rosenberger Jaroslav , Szilasiova Jarmila , Gdovinova Zuzana , Stewart Roy E , Groothoff Johan W , van Dijk Jitse P
Published: January 2016

The aim of this study is to explore whether self-esteem and social participation are associated with the physical and mental quality of life (Physical Component Summary, Mental Component Summary) and whether self-esteem can mediate the association between these variables. We collected information from 118 consecutive multiple sclerosis patients. Age, gender, disease duration, disability status, and participation were significant predictors of Physical Component Summary, explaining 55.4 percent of the total variance. Self-esteem fully mediated the association between social participation and Mental Component Summary (estimate/standard error = −4.872; p < 0.001) and along with disability status explained 48.3 percent of the variance in Mental Component Summary. These results can be used in intervention and educational programs.
‘Power’ is that which remains to be explained: Dispelling the ominous dark matter of critical planning studies
Authors: Metzger Jonathan , Soneryd Linda , Tamm Hallström Kristina
Published: January 2016

The purpose of this article is to contribute to the development of new theoretical and methodological resources for analysing power dynamics in planning studies. Our overarching aim is to demystify the concept of ‘power’ and what it purports to be describing, making those practices grouped under this label more tangible and, hence, also more readily contestable. Investigating how the effects we label as power are produced, instead of using ‘power’ as an all-covering explanation of societal events, demands a conceptualization of power as the outcome of social processes rather than as a causal variable behind them. An empirical study of a referendum regarding a major urban development in a Swedish suburban municipality illustrates how strong assumptions regarding the dominance of, for example, pre-existing powerful actor-constellations or purely economic relations are not always very helpful, highlighting the need for more acute attentiveness to the micro-physics of power.
Adaptation luminance simulation for CIE mesopic photometry system implementation
Authors: Uchida T , Ayama M , Akashi Y , Hara N , Kitano T , Kodaira Y , Sakai K
Published: January 2016

A simulation method to determine adaptation luminance is proposed for implementation of the CIE mesopic photometry system. The simulation takes four factors into account: luminance distribution, eye movement of observers, surrounding luminance effect and area of measurement. Each factor is modelled as a two-dimensional geometrical function. The method determines an adaptation luminance for the area of measurement through four calculation steps. The simulation method was applied to examples of luminance distributions of outdoor lit scenes and the results were compared with possible simple predictors of adaptation luminance. The comparisons suggest that the average luminance of the area of measurement can be considered as a good approximation in most of the cases. Exceptions are scenes for pedestrians in which there are many bright sources surrounding the area of measurement.
Incident Reporting by Health-Care Workers in Noninstitutional Care Settings
Authors: Campbell Colleen L.
Published: January 2016

Patient-perpetrated violence and aggression toward health-care workers, specifically in noninstitutional health-care settings, cause concerns for both health-care providers and the clients whom they serve. Consequentially, this presents a public affairs problem for the entire health-care system, which the current research has failed to adequately address. While the literature overwhelmingly supports the assertion that accurate incident reporting is critical to fully understanding patient violence and aggression toward health-care providers, there is limited research examining provider decision making related to reporting incidents of patient violence and aggression targeted toward the provider. There is an even greater paucity of research specifically examining this issue in noninstitutional health-care settings. It is therefore the objective of this review to examine this phenomenon across disciplines and service settings in order to offer a comprehensive review of incident reporting and to examine rationales for providers reporting or failing to report instances of patient violence and aggression toward health-care providers.
So Much to Read, So Little Time
Authors: Rayner Keith , Schotter Elizabeth R. , Masson Michael E. J. , Potter Mary C. , Treiman Rebecca
Published: January 2016

The prospect of speed reading—reading at an increased speed without any loss of comprehension—has undeniable appeal. Speed reading has been an intriguing concept for decades, at least since Evelyn Wood introduced her Reading Dynamics training program in 1959. It has recently increased in popularity, with speed-reading apps and technologies being introduced for smartphones and digital devices. The current article reviews what the scientific community knows about the reading process—a great deal—and discusses the implications of the research findings for potential students of speed-reading training programs or purchasers of speed-reading apps. The research shows that there is a trade-off between speed and accuracy. It is unlikely that readers will be able to double or triple their reading speeds (e.g., from around 250 to 500–750 words per minute) while still being able to understand the text as well as if they read at normal speed. If a thorough understanding of the text is not the reader’s goal, then speed reading or skimming the text will allow the reader to get through it faster with moderate comprehension. The way to maintain high comprehension and get through text faster is to practice reading and to become a more skilled language user (e.g., through increased vocabulary). This is because language skill is at the heart of reading speed.
Smartphones and Patient Care
Authors: Goldfarb Jeremy , Kayssi Ahmed , Devon Karen , Rossos Peter G. , Cil Tulin D.
Published: January 2016

Background. Text messaging (texting) has become a routine medium of communication in society. However, its use among clinicians has not been fully characterized. We explored general surgery residents’ practices and views on texting for patient-related communication. Methods. An email survey was distributed to all general surgery residents at a large Canadian medical school. Results. Overall, 46 (57%) of those surveyed responded. All used texting for patient-related communication. Eleven percent of residents did not have a password on their cell phone and 89% did not have encrypted phones. Texting was the most common way (41%) by which residents communicated routine patient-related information with staff physicians. Most (85%) residents agreed that texting enhances patient care. The majority (66%) did not know if their hospital had a policy on texting and were unaware of legislation surrounding texting in patient care (89%). Conclusions. Most general surgery residents use texting for communication of routine patient-related care issues. However, they acknowledge concerns regarding the security of this medium.
State Britain and the Art of (Im)proper Democratic Protest
Authors: Pilcher Jeremy
Published: January 2016

The installation of Mark Wallinger’s State Britain in the Duveen Galleries of Tate Britain recreated Brian Haw’s protest opposite the Houses of Parliament, which had largely been dismantled by the police under the Serious Organised Crime and Police Act 2005. Wallinger’s work bisected a boundary created by the Act inside which the police could be given greater than usual powers to control demonstrations. The intersection exemplified how, when understood in terms of the performative after Jacques Derrida, art may unsettle the ways in which both the law and aesthetics work to protect the political establishment.
From the brachial plexus to the hand, multiple connections between the median and ulnar nerves may serve as bypass routes for nerve fibres
Authors: Yang H. , Gil Y. , Kim S. , Bang J. , Choi H. , Lee H.Y.
Published: January 2016

Axons from the median and ulnar nerves can pass to each other through aberrant connections between them. Multiple interconnections between the nerves may provide a detour route for nerve fibres going to the hand. We investigated the incidence of variations and the associations between them in 90 cadaveric upper limbs. In 91% of upper limbs, one to five variations were found, with several statistically significant associations. The contribution of the C8 nerve to the lateral cord was positively associated with an accessory contribution of the lateral cord to the ulnar nerve. The latter variation showed positive association with the occurrence of any of the variations in the hand itself. Ulnar innervation of the superficial head of the flexor pollicis brevis was positively associated with the Riche-Cannieu communication. The co-existence of the variations and their associations may be the explanation for unusual clinical findings related to median and ulnar conduction, which appear contrary to anatomical knowledge.
Recovery of rock climbing performance after surgical reconstruction of finger pulleys
Authors: Bouyer M. , Forli A. , Semere A. , Chedal Bornu B. J. , Corcella D. , Moutet F.
Published: January 2016

This study evaluated recovery of sport performance and correction of bowstringing after surgical reconstruction of closed finger pulley rupture in high-level rock climbers. A total of 38 patients treated with an extensor retinaculum graft were assessed. The mean follow-up time was 85 months, and 30 patients returned to their previous climbing level. The mean total active motion score was 96% of the opposite side. All patients had an excellent Buck-Gramcko score. There was no significant difference in grip strength and tip pinch strength in the crimp position between the injured side and the opposite side. A total of 31 patients were examined with ultrasonography. In 18, flexor bowstringing effects had returned to near-normal values. There was an association between rock climbing level recovery and the flexor bowstringing correction (odds ratio, 6.9; 95% confidence interval, 1.1–42.8). If flexor bowstringing was corrected, patients were more likely to regain their preinjury sport performance. The ultrasonography measurement was a useful tool for predicting functional recovery.

Level of evidence: 4
Replantation of digits: a review of predictive factors for survival
Authors: Breahna A. , Siddiqui A. , Fitzgerald O’Connor E. , Iwuagwu F. C.
Published: January 2016

The survival of 75 consecutive digital replantations carried out between 2006 and 2010 at a regional hand centre in the United Kingdom was determined. The patient demographics, mechanism of injury, co-morbid factors, operative and post-operative details were extracted and reviewed from the medical and hand therapy notes. Predictive factors of survival were determined by using univariate and multivariate statistical analysis. The survival rate was 70%. Arterial thrombosis was the leading cause of replant failure, followed by venous congestion. Smoking, level of amputation, number of nerves repaired, warm ischaemia time and timing of replantation were independent predictors of replant survival. However, only warm ischaemia time less than 6 hours and 30 minutes and replantations done within ‘office hours’ showed significance on multivariate logistic regression. Our study suggests that replantations done in daylight hours, when feasible, with rested staff and a full complement of the theatre team are likely to have better outcomes.

Level of evidence: Level IV case series
Clinicians Report Difficulty Limiting Low-Value Services in Daily Practice
Authors: Grover Michael , McLemore Ryan , Tilburt Jon
Published: January 2016

Health care services that increase costs but fail to improve health are of low value. Limiting low-value services has potential to decrease health care expenditures by eliminating waste. We examined the opinions of Continuing Medical Education attendees about the “Choosing Wisely” campaign and decreasing use of potentially unnecessary services of low value. We compared our attendees’ responses to those of participants who completed a survey a year earlier. Respondents acknowledged waste of resources as a common and serious problem and noted frequent opportunities to address low-value services with their patients. They also reported limited ability to successfully reduce unnecessary services in daily clinical care. Lack of familiarity with “Choosing Wisely” may be related.
Bloating
Authors: Naseri Mohsen , Babaeian Mahmoud , Ghaffari Farzaneh , Kamalinejad Mohammad , Feizi Awat , Mazaheri Mohammad , Mokaberinejad Roshanak , Adibi Peyman
Published: January 2016

Bloating and abdominal distention are common complaints present in quite a number of organic and functional diseases. An important subject in traditional Persian medicine is digestive disorders, particularly bloating and its etiology. This is a literature review study conducted on The Canon in Medicine written by Avicenna and using the keywords: bloating, gas. In this article, causes for bloating, according to Avicenna, include diet causes, inappropriate lifestyle, gastrointestinal, and miscellaneous reasons. These were compared with causes suggested in modern medicine. Avicenna classifies causes based on the place of origin into upper part of the abdomen (stomach) and intestinal part of the abdomen. Also, 38 medicinal plants used as remedies were listed. Modern scientific data support all bloating causes that have been mentioned in the canon. Obviously, some causes such as uterine disorders and posterior nasal discharge need to be studied further.
Parent Reports of Exclusive Breastfeeding After Attending a Combined Midwifery and Chiropractic Feeding Clinic in the United Kingdom
Authors: Miller Joyce , Beharie Monica Christine , Taylor Alison M. , Simmenes Elisabeth Berg , Way Susan
Published: January 2016

This service evaluation investigated an interdisciplinary allied professional health care strategy to address the problem of suboptimal breastfeeding. A clinic of midwives and chiropractors was developed in a university-affiliated clinic in the United Kingdom to care for suboptimal feeding through a multidisciplinary approach. No studies have previously investigated the effect of such an approach. The aim was to assess any impact to the breastfeeding dyad and maternal satisfaction after attending the multidisciplinary clinic through a service evaluation. Eighty-five initial questionnaires were completed and 72 (85%) follow-up questionnaires were returned. On follow-up, 93% of mothers reported an improvement in feeding as well as satisfaction with the care provided. Prior to treatment, 26% of the infants were exclusively breastfed. At the follow-up survey, 86% of mothers reported exclusive breastfeeding. The relative risk ratio for exclusive breastfeeding after attending the multidisciplinary clinic was 3.6 (95% confidence interval = 2.4-5.4).