bluuebunny/crossref_metadata_2025 huggingface dataset:
Observing crosswind over urban terrain using scintillometer and Doppler lidar
Authors: van Dinther D. , Wood C. R. , Hartogensis O. K. , Nordbo A. , O'Connor E. J.
Published: April 2015

Abstract. In this study, the crosswind (wind component perpendicular to a path, U⊥) is measured by a scintillometer and estimated with Doppler lidar above the urban environment of Helsinki, Finland, for 15 days. The scintillometer allows acquisition of a path-averaged value of U⊥ (U⊥), while the lidar allows acquisition of path-resolved U⊥ (U⊥ (x), where x is the position along the path). The goal of this study is to evaluate the performance of scintillometer U⊥ estimates for conditions under which U⊥ (x) is variable. Two methods are applied to estimate U⊥ from the scintillometer signal: the cumulative-spectrum method (relies on scintillation spectra) and the look-up-table method (relies on time-lagged correlation functions). The values of U⊥ of both methods compare well with the lidar estimates, with root-mean-square deviations of 0.71 and 0.73 m s−1. This indicates that, given the data treatment applied in this study, both measurement technologies are able to obtain estimates of U⊥ in the complex urban environment. The detailed investigation of four cases indicates that the cumulative-spectrum method is less susceptible to a variable U⊥ (x) than the look-up-table method. However, the look-up-table method can be adjusted to improve its capabilities for estimating U⊥ under conditions under for which U⊥ (x) is variable.
Electrostatic double layers as auroral particle accelerators – a problem
Authors: Bryant D. A. , Courtier G. M.
Published: April 2015

Abstract. A search of the Annales Geophysicae database shows that double layers and other quasi-static electric potential structures have been invoked hundreds of times since the year 2000 as being the agents of auroral electron acceleration. This is despite the fact that energy transfer by conservative fields has been known for some 200 years to be impossible. Attention is drawn to a long-standing interpretation of the acceleration process in terms of the dynamic fields of electrostatic waves.
Reconciling single-chamber Mg / Ca with whole-shell δ18O in surface to deep-dwelling planktonic foraminifera from the Mozambique Channel
Authors: Steinhardt J. , Cléroux C. , de Nooijer L. J. , Brummer G.-J. , Zahn R. , Ganssen G. , Reichart G.-J.
Published: April 2015

Abstract. Most planktonic foraminifera migrate vertically through the water column during life, meeting a range of depth-related conditions as they grow and calcify. For reconstructing past ocean conditions from geochemical signals recorded in their shells, it is therefore necessary to know vertical habitat preferences. Species with a shallow habitat and limited vertical migration will reflect conditions of the surface mixed layer and short-term and mesoscale (i.e. seasonal) perturbations therein. Species spanning a wider range of depth habitats, however, will contain a more heterogeneous, intra-specimen variability (e.g. Mg / Ca and δ18O), which is less for species calcifying below the thermocline. Obtained single-chamber Mg / Ca ratios are combined with single-specimen δ18O and δ13C of the surface-water inhabitant Globigerinoides ruber, the thermocline-dwelling Neogloboquadrina dutertrei and Pulleniatina obliquiloculata, and the deep dweller Globorotalia scitula from the Mozambique Channel. Species-specific Mg / Ca, δ13C and δ18O data combined with a depth-resolved mass balance model confirm distinctive migration and calcification patterns for each species as a function of hydrography. Whereas single-specimen δ18O rarely reflects changes in depth habitat related to hydrography (e.g. temperature), measured Mg / Ca of the last chambers can only be explained by active migration in response to changes in temperature stratification. Foraminiferal geochemistry and modelled depth habitats shows that the single-chamber Mg / Ca and single shell δ18O are in agreement with each other and in line with the changes in hydrography induced by eddies.
Inter-decadal changes in the intensity of the Oxygen Minimum Zone off Concepción, Chile (~ 36° S) over the last century
Authors: Srain B. , Pantoja S. , Sepúlveda J. , Lange C. B. , Muñoz P. , Summons R. E. , McKay J. , Salamanca M.
Published: April 2015

Abstract. We reconstructed oxygenation changes in the Oxygen Minimum Zone of the upwelling ecosystem off Concepción (36° S), Chile, using inorganic and organic proxies in a sediment core covering the last ca. 110 years of sedimentation in this area. Authigenic enrichments of Mo, U and Cd were observed between ca. 1935–1971 CE indicating a prolonged period of more reduced conditions in bottom waters and surface sediments. Significant positive correlations (p < 0.05; Spearman) between redox sensitive metals, algal sterols, biomarkers of anaerobic microorganisms, and archaeal glycerol dialkyl glycerol tetraether indicated a coupling among bottom water oxygen depletion, and increased primary and export production, suggesting that the period with low O2 of ca. 35 years, follows low frequency inter-decadal variation of the Pacific Decadal Oscillation, which may have resulted in O2 depletion over the entire continental shelf off Concepción. Taken together with the concurrent increase in sedimentary molecular indicators of anaerobic microbes allow us to suggest that the prokaryote community has been influenced by changes in oxygenation of the water column.
Inter-comparison of energy balance and hydrological models for land surface energy flux estimation over a whole river catchment
Authors: Guzinski R. , Nieto H. , Stisen S. , Fensholt R.
Published: April 2015

Abstract. Evapotranspiration (ET) is the main link between the natural water cycle and the land surface energy budget. Therefore water-balance and energy-balance approaches are two of the main methodologies for modelling this process. The water-balance approach is usually implemented as a complex, distributed hydrological model, while the energy-balance approach is often used with remotely sensed observations of, for example, the land surface temperature (LST) and the state of the vegetation. In this study we compare the catchment-scale output of two remote sensing models based on the two-source energy-balance (TSEB) scheme, against a hydrological model, MIKE SHE, calibrated over the Skjern river catchment in western Denmark. The three models utilize different primary inputs to estimate ET (LST from different satellites in the case of remote sensing models and modelled soil moisture and heat flux in the case of the MIKE SHE ET module). However, all three of them use the same ancillary data (meteorological measurements, land cover type and leaf area index, etc.) and produce output at similar spatial resolution (1 km for the TSEB models, 500 m for MIKE SHE). The comparison is performed on the spatial patterns of the fluxes present within the catchment area as well as on temporal patterns on the whole catchment scale in 8-year long time series. The results show that the spatial patterns of latent heat flux produced by the remote sensing models are more similar to each other than to the fluxes produced by MIKE SHE. The temporal patterns produced by the remote sensing and hydrological models are quite highly correlated (r ≈ 0.8). This indicates potential benefits to the hydrological modelling community of integrating spatial information derived through remote sensing methodology (contained in the ET maps derived with the energy-balance models, satellite based LST or another source) into the hydrological models. How this could be achieved and how to evaluate the improvements, or lack of thereof, is still an open research question.
Stream temperature prediction in ungauged basins: review of recent approaches and description of a new physically-based analytical model
Authors: Gallice A. , Schaefli B. , Lehning M. , Parlange M. P. , Huwald H.
Published: April 2015

Abstract. The development of stream temperature regression models at regional scales has regained some popularity over the past years. These models are used to predict stream temperature in ungauged catchments to assess the impact of human activities or climate change on riverine fauna over large spatial areas. A comprehensive literature review presented in this study shows that the temperature metrics predicted by the majority of models correspond to yearly aggregates, such as the popular annual maximum weekly mean temperature (MWMT). As a consequence, current models are often unable to predict the annual cycle of stream temperature, nor can the majority of them forecast the interannual variation of stream temperature. This study presents a new model to estimate the monthly mean stream temperature of ungauged rivers over multiple years in an Alpine country (Switzerland). Contrary to the models developed to date, which mostly rely upon statistical regression to express stream temperature as a function of physiographic and climatic variables, this one rests upon the analytical solution to a simplified version of the energy-balance equation over an entire stream network. This physically-based approach presents some advantages: (1) the functional form linking stream temperature to the predictor variables is directly obtained from first principles, (2) the spatial extent over which the predictor variables are averaged naturally arises during model development, and (3) the regression coefficients can be interpreted from a physical point of view – their values can therefore be constrained to remain within plausible bounds. The evaluation of the model over a new freely available data set shows that the monthly mean stream temperature curve can be reproduced with a root mean square error of ±1.3 °C, which is similar in precision to the predictions obtained with a multi-linear regression model. We illustrate through a simple example how the physical basis of the model can be used to gain more insight into the stream temperature dynamics at regional scales.
Levee reliability analyses for various flood return periods – a case study in southern Taiwan
Authors: Huang W.-C. , Yu H.-W. , Weng M.-C.
Published: April 2015

Abstract. In recent years, heavy rainfall conditions have caused disasters around the world. To prevent losses by floods, levees have often been constructed in inundation-prone areas. This study performed reliability analyses for the Chiuliao First Levee in southern Taiwan. The failure-related parameters were the water level, the scouring depth, and the in situ friction angle. Three major failure mechanisms were considered: the slope sliding failure of the levee and the sliding and overturning failures of the retaining wall. When the variability of the in situ friction angle and the scouring depth are considered for various flood return periods, the variations of the factor of safety for the different failure mechanisms show that the retaining wall sliding and overturning failures are more sensitive to the change of the friction angle. When the flood return period is greater than 2 years, the levee could fail with slope sliding for all values of the water level difference. The results of levee stability analysis considering the variability of different parameters could aid engineers in designing the levee cross sections, especially with potential failure mechanisms in mind.
Soil surface roughness: comparing old and new measuring methods and application in a soil erosion model
Authors: Thomsen L. M. , Baartman J. E. M. , Barneveld R. J. , Starkloff T. , Stolte J.
Published: April 2015

Abstract. Quantification of soil roughness, i.e. the irregularities of the soil surface due to soil texture, aggregates, rock fragments and land management, is important as it affects surface storage, infiltration, overland flow, and ultimately sediment detachment and erosion. Roughness has been measured in the field using both contact methods (such as roller chain and pinboard) and sensor methods (such as stereophotogrammetry and terrestrial laser scanning (TLS)). A novel depth-sensing technique, originating in the gaming industry, has recently become available for earth sciences: the Xtion Pro method. Roughness data obtained using various methods are assumed to be similar; this assumption is tested in this study by comparing five different methods to measure roughness in the field on 1 m2 agricultural plots with different management (ploughing, harrowing, forest and direct seeding on stubble) in southern Norway. Subsequently, the values were used as input for the LISEM soil erosion model to test their effect on the simulated hydrograph at catchment scale. Results show that statistically significant differences between the methods were obtained only for the fields with direct seeding on stubble; for the other land management types the methods were in agreement. The spatial resolution of the contact methods was much lower than for the sensor methods (10 000 versus at least 57 000 points per square metre). In terms of costs and ease of use in the field, the Xtion Pro method is promising. Results from the LISEM model indicate that especially the roller chain overestimated the random roughness (RR) values and the model subsequently calculated less surface runoff than measured. In conclusion, the choice of measurement method for roughness data matters and depends on the required accuracy, resolution, mobility in the field and available budget. It is recommended to use only one method within one study.
Overseas Postgraduates’ Experience of Learning: A Phenomenographic Study
Authors: Zhao Xiantong
Published: April 2015

Although the subject – conceptions of learning – has been a significant research area in the phenomenographic tradition, little could be found for overseas students, especially Chinese postgraduates. The present research is a small scale study, which recruited five postgraduates, including three students pursuing their masters’ degree and two doctoral students. The findings show that there are, in general, four conceptions of learning; encompassing learning as knowledge accumulation, applying, obtaining new perspectives, and a communicational process. Representing the internal relationship between different conceptions, the outcome space has finally been established based on these, which was then analysed within a two-dimensional framework. The results show that all of the postgraduates have good experience of learning.
Femtosecond Laser-Assisted Cataract Surgery in Alport Syndrome with Anterior Lenticonus
Authors: Ecsedy Monika , Súndor Gúbor L. , Takúcs Úgnes I. , Krúnitz Kinga , Kiss Zoltún , Kolev Krasimir , Nagy Zoltún Z.
Published: April 2015

Purpose

To report the surgical treatment of 3 eyes of 2 patients with bilateral anterior lenticonus due to Alport syndrome using femtosecond laser-assisted cataract surgery (FLACS).

Methods

Two patients with Alport syndrome presented to our department due to anterior lenticonus in both eyes. We performed FLACS with posterior chamber lens implantation in both eyes of one patient and in one eye of the other patient. Anterior segment morphologic changes were visualized with a Scheimpflug camera, and anterior segment optical coherence tomography preoperatively and 3 months after surgery. Ultrastructure of the cut capsule edges was observed with scanning electron microscopy and compared to the edge of femtosecond laser capsulotomy performed on an otherwise healthy patient with cataract (control).

Results

The intraocular lens (IOL) postoperative positioning parameters met the international requirements of aspherical and wavefront customized IOLs (tilt <10 degree, decentration <800 μm). Scanning electron microscopy revealed the same characteristics of the cut capsule edges in the Alport and in the control eyes.

Conclusions

Femtosecond laser cataract surgery can be a safe and successful method for optical rehabilitation of anterior lenticonus in patients with Alport syndrome.
Prospective Evaluation of Short and Mid-Term Outcomes of Total Hip Arthroplasty Using the Accolade™ Stem
Authors: Pierce Todd P. , Jauregui Julio J. , Cherian Jeffrey J. , Elmallah Randa D.K. , Robinson Kristin , Mont Michael A.
Published: April 2015

Purpose

Cementless press-fit total hip arthroplasty (THA) with the Accolade stem (Stryker Accolade™ TMZF, Mahwah, New Jersey) has demonstrated variable implant survivorship and outcomes. The purpose of this study was to analyse the: 1) implant survivorship; 2) complications; 3) functional outcomes; 4) overall quality of life; and 5) patient expectations and satisfaction following THA with this particular press-fit stem.

Methods

A prospectively collected database of 222 patients who underwent THA at 7 institutions between 2006 and 2009 using the Accolade stem (Stryker Inc. Mahwah, New Jersey) was evaluated. Harris Hip Score (HHS) and SF-12 were used to assess the outcomes at 2- and 5-year follow-up. Kaplan-Meier survivorship was calculated at 5 years of follow-up.

Results

The 5-year aseptic and all-cause survivorship rates were 99.4% (95% CI, 96.3 to 99.9%) and 97.9% (95% CI, 94.6 to 99.2%), respectively. At 2 and 5 years postoperatively, the patients demonstrated a mean HHS of approximately 89 points and 92 points, respectively. The mental and physical components of the SF-12 mean score increased with the physical component having a more marked increase. The mental and physical components of the SF-12 score increased to a mean of 46 and 45 points at 2 and 5 years, respectively. At 2-year follow-up, over 90% of patients were satisfied with their outcome in a majority of areas surveyed.

Discussion

Our results suggest that the use of this press-fit construct results in tremendous improvements in functional and quality of life outcomes, along with excellent survivorship at short- and mid-term follow-up.
Biventricular Failure in Dextro-transposition of the Great Arteries Corrected with the Mustard Procedure: VAD Support of the Systemic Ventricle is Enough
Authors: Schweiger Martin , Falk Volkmar , Biry Mirko , Hübler Michael , Wilhelm Markus J.
Published: April 2015

Introduction

Miniaturization and surgical progress in the field of ventricular assist device (VAD) therapy will lead to an increasing use in grown-up patients with congenital heart disease (GUCH). VAD implantation in such patients, especially biventricular VAD (BVAD) placement, can be very challenging, potentially associated with high morbidity and mortality.

Methods and Results

We report on a 47-year-old male patient in terminal biventricular failure with pulmonary hypertension 40 years after a Mustard procedure. The patient was successfully provided with a HVAD (HeartWare; HeartWare Inc., Framingham, MA, USA) into the systemic ventricle as bridge to transplantation, with the sub-pulmonary ventricle left unsupported.

Discussion

We present our institutional strategy for VAD selection in these patients and highlight intra-corporeal VAD implantation technique.
Use of Double-Lumen Peripherally Inserted Central Catheters for Safer Perioperative Management of Esophageal Cancer Patients
Authors: Fukuda Shuichi , Nakajima Kiyokazu , Miyazaki Yasuhiro , Takahashi Tsuyoshi , Kurokawa Yukinori , Yamasaki Makoto , Miyata Hiroshi , Takiguchi Shuji , Mori Masaki , Doki Yuichiro
Published: April 2015

Purpose

As a step to large-scale clinical trials, we conducted a small-scale exploratory study to clarify whether the secondary lumen of the double-lumen (DL) peripherally inserted central catheters (PICCs) could perform as well as the secondary lumen of the DL centrally inserted central catheters (CICCs), with an acceptable complication rate in the perioperative surgery period.

Methods

Forty thoracic esophageal cancer patients requiring central venous catheterization during the perioperative period were assigned to the DL-PICC (4.5-French, 60-cm) group or the DL-CICC (16-gauge, 30-cm) group, with 1:1 randomization. The primary endpoint was the completion rate of continuous catecholamine infusion via the secondary lumen during the observation period.

Results

Thirty-two cases (14 cases in the PICC group and 18 cases in the CICC group) were analyzed. Continuous catecholamine infusion via the secondary lumen was completed in all 32 cases. No major complications related to PICC/CICC placement/maintenance were noted in the groups during the median observation period of 6 days.

Conclusions

The secondary lumen of the DL-PICCs performed as well as the secondary lumen of the DL-CICCs with acceptable safety during the relatively short perioperative period of these thoracic esophageal cancer patients (UMIN Clinical Trial Registry UMIN000008131).
A Case of Hodgkin Lymphoma in a Patient with a History of Bone Pain and an Initial Diagnosis of Chronic Osteomyelitis
Authors: Griguolo Gaia , Mazzucchelli Luca , Cavalli Franco , Ceriani Luca , Zucca Emanuele , Stathis Anastasios
Published: April 2015

Hodgkin lymphoma (HL) is an uncommon monoclonal lymphoid malignancy consisting of 2 main entities: classical HL and nodular lymphocyte predominant. Hodgkin lymphoma usually presents with peripheral lymphadenopathies, while extranodal involvement is rare. Prevalent osseous presentation is rare and still misdiagnosed, despite improvements in diagnostic techniques. Here we report the case of a 30-year-old man with multifocal HL bone involvement initially misdiagnosed as chronic recurrent osteomyelitis. This case emphasizes the difficulties in the diagnosis of HL presenting with bone pain and with radiologic skeletal findings not specific for lymphoma. These patients often have diagnostic delays and misdiagnosis. Repeated investigations and clinical suspicion of unusual presentations may be helpful in order to establish a correct diagnosis and start an effective treatment in this highly curable disease.
Outcome of Crizotinib Treatment in a Young Woman with Heavily Pretreated ROS1-positive Lung Cancer
Authors: Petreni Paolo , Mazzoni Francesca , Meoni Giulia , Lunghi Alice , Cecere Fabiana Letizia , Muto Andrea , Di Costanzo Francesco
Published: April 2015

Non-small-cell lung cancer is a term that encompasses a number of subtypes of lung cancer. In recent years, several intracellular pathways have been studied in order to discover a potential target for novel anticancer therapies such as anaplastic lymphoma kinase (ALK) and reactive oxygen species 1 (ROS1). Increased interest in oncologic treatment research has resulted from the observation that ALK- and ROS1-associated tyrosine kinases show molecular analogies in some of their domains. This discovery led to the hypothesis that target therapy against ALK translocation could have efficacy also in ROS1-positive tumors. Crizotinib is an oral tyrosine kinase inhibitor that binds the ALK tyrosine kinase domain, blocking its function. We report the case of a woman with heavily pretreated metastatic lung adenocarcinoma harboring ROS1 positivity who experienced a prolonged and dramatic clinical benefit from crizotinib therapy.
Knowledge Production through Interdisciplinary Skills
Authors: Chitakunye Pepukayi , Takhar-Lail Amandeep
Published: April 2015

This study contributes to existing methodological knowledge by showing how a transformed research methods curriculum, which is beyond the milieu of schooling, can engage postgraduate students in a critical dialogue on how knowledge is produced in industry and higher education. Initial insights are drawn from two interpretive studies that employed interdisciplinary methods, and guidelines are developed to encourage educators and industry experts to be reflexive about producing knowledge that is needed for managerial decision making. Further insights were also drawn from in-depth interviews with 20 postgraduate students and six research supervisors across different universities. The findings demonstrate how the adoption of interdisciplinary research skills is interconnected with moving research students from a position of being disengaged to being engaged when conducting research, and consequently producing managers that are better equipped to deal with the challenges facing industry in a globalized business environment. The authors argue that by embracing traditional and innovative interdisciplinary research skills in the research methods curricula, future managers are presented with richer information that will help to solve industry-related problems. It is further argued that this will also help to sharpen the skills needed in emerging economies to deal with challenges in the world of work.
Research Note: Relationship versus Transactional Marketing in Travel and Tourism Trade Shows
Authors: Oromendía Ainhoa Rodriguez , Paz María Dolores Reina , Rufín Ramón
Published: April 2015

The hypothetical mix of relationship marketing and transactional marketing perspectives is a major theme in the general literature that should be researched in relation to tourism and travel shows. This issue is addressed in the present paper which analyses the effect of managing relationships among three partners (trade organizer, exhibitor and end customer) on the exhibitor's performance during the fair, and comparing that effect with the influence of transactional marketing management, in which business performance depends on conventional tools. The results point to an overbalance on the side of transactional marketing in the case of tourism and travel exhibitors. By contrast, in the case of the business-to-business relationship between trade show organizers and exhibitors, the weight of relationship marketing seems to be comparatively higher and, most relevant, to affect the exhibitor's performance in terms of their business with end customers during the show.
Why Do They Choose a SPA Destination? The Case of Japanese Tourists
Authors: Kamata Hiromi , Misui Yuki
Published: April 2015

The purpose of this study is to segment Japanese spa tourists according to push motivation using a factor-cluster market segmentation approach. The study examines why these tourists choose spa destinations from among the numerous available tourism options, and what kind of attractiveness they seek. The authors derive 7 factors from 44 motivation items by factor analysis and the tourists are segmented into five clusters. Their analysis reveals that these tourists chose spa destinations when they were in search of a ‘soothing’ experience, one of the seven factors considered specific to spas. The answer to the question on the kind of attractiveness sought varied by segment.
DESENVOLVIMENTO DA COMPETÊNCIA SUSTENTABILIDADE E APRENDIZAGEM ORGANIZACIONAL À LUZ DA TEORIA DA RACIONALIDADE
Authors: Cella-de-Oliveira Flávio Augusto , Takahashi Adriana Roseli Wunsch
Published: April 2015

O presente artigo consiste em um ensaio teórico o qual se pauta na teoria da racionalidade de Guerreiro-Ramos (1966) para discutir a sustentabilidade organizacional enquanto uma competência organizacional, que é desenvolvida pelo processo de aprendizagem organizacional. Após a teoria da racionalidade foram discutidas as competências e aprendizagem organizacional que deram base para o estudo da sustentabilidade organizacional, a qual é visualizada enquanto uma competência organizacional a ser desenvolvida pelos processos de aprendizagem. Posteriormente a esta discussão chegou-se ao objetivo do artigo, que é: a construção de um quadro de análise para a investigação sobre como a racionalidade predominante, impacta no processo de aprendizagem organizacional e no desenvolvimento da competência sustentabilidade organizacional. Foram estabelecidas três proposições teóricas que orientam e subsidiam a discussão em torno da sustentabilidade organizacional e os condicionantes para o seu desenvolvimento.
ESCALA DE CONSUMO SUSTENTÁVEL: UM ESTUDO COMPARATIVO ENTRE ALUNOS E PROFESSORES DA UNIVERSIDADE FEDERAL DE CAMPINA GRANDE – PB
Authors: De Oliveira Verônica Macário , Correia Suzanne Érica Nóbrega , Gomez Carla Regina Pasa
Published: April 2015

As práticas cotidianas de consumo estão no mainstream das discussões sobre desenvolvimento sustentável desde a década de 1990. Constatou-se que elas são insustentáveis em decorrência dos impactos socioambientais que causam. Modificá-las, portanto, passou a ser considerado como um dos principais objetivos do desenvolvimento sustentável. O passo inicial a ser dado, nesse sentido, é conhecer e avaliar as práticas cotidianas de consumo da sociedade com o intuito de verificar as suas tendências para adoção de padrões e níveis de consumo conscientes. Nesse sentido, Ribeiro e Veiga (2011) desenvolveram uma Escala de Consumo Sustentável que busca avaliar a atitudes e o comportamento dos consumidores em termos de consumo consciente, a partir de quatro dimensões: consciência ecológica, economia de recursos, reciclagem e frugalidade. Portanto, o objetivo deste estudo foi realizar um estudo comparativo entre as atitudes e comportamentos de consumo de alunos e professores da Universidade Federal de Campina Grande – PB, a partir da Escala de Consumo Sustentável proposta por Ribeiro e Veiga (2011). Para tanto, em termos metodológicos, realizou-se uma Survey de natureza quantitativa e descritiva. Os resultados demonstram que ambos os grupos pesquisados não apresentam atitudes e comportamentos de consumo considerados como amplamente benéficos para o meio ambiente nas dimensões avaliadas. Este fato é inquietante, considerando-se que a amostra investigada faz parte de uma Instituição de Ensino Superior (IES), onde opiniões são formadas e compartilhadas. Tais evidências demonstram a necessidade de ações voltadas à formação de uma cultura de consumo sustentável com investimentos focados em mudanças mais amplas que envolvam o contexto social.
O TURISMO INDÍGENA E SUA INFLUÊNCIA NO DESENVOLVIMENTO LOCAL SUSTENTÁVEL: UM ESTUDO NA RESERVA INDÍGENA SÃO MARCOS - RORAIMA
Authors: Brandão Cristiane Nascimento , Barbieri José Carlos , João Cristina De Moura
Published: April 2015

Pesquisadores têm debatido os efeitos do turismo sobre as culturas indígenas. Para os povos indígenas, o turismo traz efeitos positivos como oportunidade de desenvolvimento econômico, melhoria na qualidade de vida e emprego. Por outro lado, pode gerar efeitos negativos, como a destruição da cultura e degradação do meio ambiente. Iniciativas baseadas nos princípios do desenvolvimento local sustentável são incentivadas de modo a preservar aspectos culturais, ambientais e econômicos das comunidades. Utilizando-se abordagem qualitativa, essa pesquisa teve como objetivo analisar a influência do turismo no desenvolvimento local sustentável das comunidades indígenas da Reserva Indígena São Marcos. Como resultado, verificou-se que o turismo é organizado e coordenado pelos próprios indígenas, sem qualquer apoio da FUNAI ou qualquer outro órgão governamental. O turismo proporcionou incremento na renda dos moradores, bem como novos postos de trabalho. Segundo os indígenas, a infraestrutura incipiente e a falta de regulamentação do turismo em área indígena, são consideradas os principais entraves para o crescimento da atividade. Apesar dos desafios encontrados, os povos indígenas entendem que o turismo tem colaborado para o desenvolvimento local das comunidades.
The Emerging Use of Platelet-Rich Plasma in Musculoskeletal Medicine
Authors: Bashir Jamil , Panero Alberto J. , Sherman Andrew L.
Published: April 2015

Platelet-rich plasma (PRP) is one of many new developments within the expanding field of regenerative medicine. Specialists in areas such as orthopedics, physical medicine and rehabilitation, and rheumatology have been exploring the benefits of this novel therapy. Although PRP therapy remains controversial and has minimal clinical trial support, the use of orthobiologics such as PRP continues to advance as patients seek nonsurgical approaches to acute and chronic musculoskeletal injury and disease. However, academic acceptance as well as insurance reimbursement remain reliant on solid and repeatable positive results from large clinical trials. The authors summarize the evolution of PRP therapy and report on its status.
J Am Osteopath Assoc. 2015;115(1):24-31 doi:10.7556/jaoa.2015.004
Atypia of Undetermined Significance and Follicular Lesions of Undetermined Significance
Authors: Kamaya Aya , Lewis Gloria Huang , Liu Yi , Akatsu Haruko , Kong Christina , Desser Terry S.
Published: April 2015

Objectives

To determine whether radiologic assessment of thyroid nodules can potentially help guide clinical management after a cytologic diagnosis of atypia of undetermined significance or a follicular lesion of undetermined significance.

Methods

We identified 41 patients with 41 thyroid nodules initially diagnosed as atypia or follicular lesions of undetermined significance on fine‐needle aspiration that were subsequently definitively diagnosed by either surgical resection or repeated fine‐needle aspiration. All sonograms of nodules were reviewed by 2 blinded board‐certifiedradiologists. Lesions were assessed in 3 ways: (1) Mayo pattern classification as benign, indeterminate, or worrisome for malignancy (Ultrasound Q 2005; 21:157–165); (2) thyroid imaging reporting and data system scores (scale of 1–5) based on 2 different previously published scoring criteria (Park et al [Thyroid 2009; 19:1257–1264] and Kwak et al [Radiology 2011; 260:892–899]); and (3) binary classification as benign or malignant.

Results

Of the 41 nodules, 25 had benign histologic findings, and 16 were malignant. Mayo pattern classification was 100% accurate for the benign score. Lesions with a Mayo score of indeterminate were malignant in 21% of cases (6 of 28) and benign in 79% (22 of 28). Lesions with a Mayo score of malignant were malignant in 91% of cases (10 of 11) and benign in 9% (1 of 11). Thyroid imaging reporting and data system scores had area under the receiver operating characteristic curve values of 0.827 for Park scores and 0.822 for Kwak scores. Radiologist binary classification of thyroid nodules showed 88% overall accuracy.

Conclusions

Radiologist assessment of thyroid nodules in cases of atypia of undetermined significance or follicular lesions of undetermined significance is highly predictive of the final diagnosis and can help guide management of thyroid nodules of these pathologic types.
Sonographic Evaluation of the Treatment Response in Patients With Immunoglobulin G4–Related Disease of the Submandibular Glands
Authors: Asai Satomi , Sato Shinji , Okami Kenji , Takanashi Noboru , Umezawa Kazuo , Damdinsuren Anar , Matsushita Hiromichi , Nakamura Naoya , Suzuki Yasuo , Miyachi Hayato
Published: April 2015

Objectives

To evaluate the usefulness of sonography for monitoring the response to glucocorticoid treatment in patients with immunoglobulin G4 (IgG4)–related disease.

Methods

We conducted a retrospective study using sonography in 12 patients with bilateral swollen submandibular glands who had a diagnosis of IgG4‐related disease based on an elevated serum IgG4 level (>135 mg/dL) and histopathologic findings between January 2010 and December 2012. Among these patients, 6 were treated with prednisolone, and the other 6 were placed under observation. B‐mode sonographic examinations of the submandibular glands were performed with or without color Doppler imaging at the initial examination and 6 months later. Findings were compared between the groups (treated and untreated), and their relationship with the treatment response of the primarily involved organs was investigated.

Results

In the treated group, the submandibular glands of all 6 patients decreased in both size and volume after treatment (average volume ± SD, 27,449.7 ± 24,227.6 to 4609.7 ± 1911.4 mm3; P = .004). The internal echo texture, characterized by multiple hypoechoic foci scattered against a heterogeneous hyperechoic background of submandibular tissue with demarcated hyperechoic lines, with or without hypoechoic tumor formation, disappeared or was obscured in all cases. In addition, the blood flow signals were reduced in all 3 patients who underwent color Doppler sonography, and the response observed on sonography was found to correlate with the IgG4 level and recovery of specific organ involvement. In contrast, in the untreated group, the submandibular glands showed a tendency to increase in both size and volume (average volume, 9326.3 ± 3054.8 to 12,217.4 ± 4605.5 mm3; P= .2) without a decrease in the blood flow signals.

Conclusions

Sonography is considered useful for evaluating the response to glucocorticoid therapy in patients with IgG4‐related disease of the submandibular glands.
Sonographically Based Diagnosis of Contralateral Malignancy in Preoperative Patients With Papillary Thyroid Microcarcinoma
Authors: Kim Dong Wook , Park Ha Kyoung , Ha Tae Kwun , Kim Sang Hyo , Jung Soo Jin , Kim Do Hun , Bae Sang Kyun
Published: April 2015

Objectives

We aimed to assess the usefulness of sonographically based diagnosis to predict whether contralaterally located dominant thyroid nodules are malignant or benign in patients with known papillary thyroid microcarcinoma.

Methods

We studied 143 patients with primary papillary thyroid microcarcinoma who underwent preoperative thyroid sonography. Each dominant thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by a single radiologist: benign, probably benign, borderline, possibly malignant, and malignant. We calculated the efficacy of sonographic diagnosis for contralateral malignancy by using histopathologic or long‐term sonographic follow‐up results as reference standards.

Results

Of the 143 primary papillary thyroid microcarcinomas, 17 showed satellite carcinomas; hence, the bilaterality rate in all patients was 11.9% (17 of 143). Real‐time sonography of the contralateral thyroid yielded no thyroid nodules (n = 55) and benign (n = 52), probably benign (n = 10), borderline (n = 13), possibly malignant (n = 4), and malignant (n = 9) nodules. When the borderline sonographic class was excluded, the sensitivity, specificity, positive and negative predictive values, and accuracy of sonographic diagnosis for detecting contralateral malignancy were 86.7%, 100%, 100%, 98.3%, and 98.5%, respectively. Within individual sonographic classes for the dominant thyroid nodules, the diagnostic accuracy rates for classes IV and V (possibly malignant and malignant) were higher than those for other classes.

Conclusions

Sonographically based diagnosis may be helpful for detection of contralateral malignancy in preoperative patients with papillary thyroid microcarcinoma.
Implementation and Assessment of a Curriculum for Bedside Ultrasound Training
Authors: Turner Elizabeth E. , Fox J. Christian , Rosen Mark , Allen Angela , Rosen Sasha , Anderson Craig
Published: April 2015

Objectives

This study assessed a curriculum for bedside ultrasound (US) and compared outcomes from 2 common training pathways.

Methods

The program consisted of e‐learning paired with expert‐led hands‐on training administered to pulmonary/critical care and cardiology fellows with no prior formal training in bedside US. This “simulation‐based learner” group completed a survey of attitudes and confidence before and after training, and knowledge and skills were assessed after training. The surveys and scores of the simulation‐based learners were compared to the scores of “experts,” who were US‐trained emergency physicians, and “apprentice learners,” who were intensivist physicians informally trained in bedside US on the job during fellowships.

Results

There was a significant difference in the self‐reported level of prior training between the groups (simulation‐based learners, 2.8; apprentice learners, 3.7; experts, 4.1, on a scale of 1–5 [P= .02]) but no difference in the interest level or perceived importance of bedside US. The study curriculum was successful, as shown by scores that exceeded the comparison groups in the cardiac and pulmonary courses (cardiac: simulation‐based learners, 80%; apprentice learners, 73%; experts, 62% [P= .001]; pulmonary: 84%, 75%, and 72%, respectively [P =.02]). The simulation‐based learners gained confidence in skills, whereas the comparison groups lost confidence after testing (P < .005); however, the simulation‐based learners gained confidence in US subject areas that were not taught (abdomen [P <.002] and miscellaneous [P =.005]).

Conclusions

The simulation‐based learner curriculum resulted in comparable or greater knowledge and confidence in each area of US versus the comparison groups. Findings of overgeneralization of confidence highlight the importance of quality assurance and supervision in bedside US training programs.
Impact of Accreditation Training for Residents on Sonographic Quality in Gynecologic Emergencies
Authors: Popowski Thomas , Huchon Cyrille , Fathallah Khadija , Falissard Bruno , Dumont Alexandre , Fauconnier Arnaud
Published: April 2015

Objectives

To assess the impact of an educational intervention based on an original accreditation training program on the quality of emergency sonography performed by obstetrics and gynecology (Ob/Gyn) residents.

Methods

We conducted a prospective before‐after study on residents who performed bedside standardized sonographic examinations as first‐line investigations in patients seen at our gynecologic emergency department. In both periods, the residents followed a 1‐hour class taught by a board‐certified Ob/Gyn sonography expert (opinion leader) and received a written standardized imaging protocol. An accreditation training process was implemented for the new residents at the beginning of the second period: 5 complete sonographic examinations were required for each resident, and facilitated feedback from the opinion leader was performed using a dedicated sonographic quality score. During both periods, all consecutive sonograms were collected and stored. The primary outcome was the sonographic quality score. A mixed model for repeated measures was used to compare scores in both periods from 20 consecutive sonographic examinations performed by 5 residents who were different in each period.

Results

The mixed model analysis showed an increase in quality scores in the post–accreditation training compared to the pre–accreditation training period (estimated coefficient ± SD, 4.13 ± 0.51; t = 8.16). The sonographic examination order also had a significant effect in both periods (estimated coefficient ± SD, 0.11 ± 0.03; t = 3.99).

Conclusions

An accreditation training process including facilitated feedback from a local opinion leader improved the quality of sonographic examinations performed by Ob/Gyn residents in women presenting to a gynecologic emergency department.
Abnormal Umbilical Artery Doppler Findings in the Recipient Twin Before Laser Surgery for Twin‐Twin Transfusion Syndrome
Authors: Patel Shivani , Quintero Rubén A. , Kontopoulos Eftichia V. , Korst Lisa M. , Llanes Arlyn , Chmait Ramen H.
Published: April 2015

Objectives

In twin‐twin transfusion syndrome (TTTS), persistent absent or reversed end‐diastolic flow in the umbilical artery is a rare finding in the recipient twin, and the clinical implications of this finding are not well characterized. We sought to study the clinical importance of abnormal umbilical artery Doppler waveforms in recipient twins and determine the perinatal survival of these twins after laser surgery.

Methods

A retrospective study of patients with TTTS treated with laser surgery between 2006 and 2012 was conducted. Recipient twins with absent or reversed umbilical artery end‐diastolic flow on preoperative sonography were identified, and clinical and perinatal outcomes were compared to the remaining cohort. Statistical analyses were performed with Fisher exact and χ2 tests.

Results

Of 369 consecutive TTTS cases, 14 (3.8%) had absent or reversed umbilical artery end‐diastolic flow in the recipient twin. The rate of hydrops was higher in this group compared to those without absent or reversed flow (35.7% [5 of 14] versus 10.1% [36 of 355]; P = .0125). The rate of recipient twin growth restriction was also higher in the absent or reversed flow group (28.6% [4 of 14] versus 3.9% [14 of 355]; P = .0029). There was an increased rate of recipient fetal demise within 24 hours after surgery in those with absent or reversed flow (21.4% [3 of 14] versus 2.5% [9 of 355]; P = .0078), although there was no statistical difference in 30‐day survival between the groups (78.6% [11 of 14] versus 89.9% [319 of 355]; P = .1751).

Conclusions

Doppler findings of absent or reversed umbilical artery end‐diastolic flow are rare in recipient twins. Although immediate post–laser surgery survival is relatively decreased in this group, overall perinatal survival rates appear to be favorable.
Fetal Thymus Volume Estimation by Virtual Organ Computer‐Aided Analysis in Normal Pregnancies
Authors: Re Claudia , Bertucci Emma , Weissmann-Brenner Alina , Achiron Reuven , Mazza Vincenzo , Gindes Liat
Published: April 2015

Objectives

The thymus has a pyramidal shape, which is best shown in coronal planes. The aim of this study was to evaluate the potential of virtual organ computer‐aided analysis to estimate fetal thymus volume in normal pregnancies.

Methods

Three‐dimensional volume data sets from the axial upper mediastinal section were acquired from 37 normal pregnancies between 12 and 35 weeks' gestation. Thymus volume was calculated by virtual organ computer‐aided analysis by 2 separate examiners. In 12 cases, volumes were also acquired with 4‐dimensional sonography and spatiotemporal image correlation software to assess the variability in thymus size between the systolic and diastolic periods of fetal heart motion. Linear regression analysis was used to assess the relationship between the fetal thymus volume and gestational age. Paired Student t tests were used to evaluate both the level of agreement for interobserver and intraobserver variability and the difference between diastolic and systolic thymus volumes.

Results

Identification of the borders of the thymus and calculation of its volume were successful in 28 patients (77.7%). Statistically significant linear growth of the thymus during pregnancy, from 12 to 35 weeks, was found. The growth coefficient for each gestational age was 0.43 (95% confidence interval, 0.355 to 0.504; P < .001). The difference in thymus size between systole and diastole was minor (0.0798 cm3; 95% confidence interval, –0.044 to 0.203 cm3). Interobserver and intraobserver variability was not statistically significant.

Conclusions

Although the thymus has a complex shape, it was possible to determine its borders and to calculate its volume by virtual organ computer‐aided analysis in 77.7% of cases. Linear growth during pregnancy was found, and the minor changes during systole and diastole could be explained by condensation of the soft tissue of the thymus secondary to cardiac activity.