bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical properties and morphology of polypropylene/poly(acrylonitrile–butadiene–styrene) nanocomposites
Authors: Ibrahim Mohamad Al Hafiz , Hassan Azman , Wahit Mat Uzir , Hasan Mahbub , Mokhtar Munirah
Published: May 2016

Polypropylene (PP)/poly(acrylonitrile–butadiene–styrene) (ABS) blends containing montmorillonite (MMT) compatibilized with polypropylene-grafted maleic anhydride were prepared by melt extrusion using twin screw extruder followed by injection molding. Mechanical properties were evaluated through tensile, flexural, and impact testing. The microstructure and formation of nanocomposites were assessed by scanning and transmission electron microscopy and X-ray diffraction (XRD). Incorporation of polypropylene-grafted maleic anhydride and MMT into PP/ABS blend led to higher strength and stiffness but at the expense of toughness. Scanning electron micrographs revealed a fine and homogeneous dispersion of ABS phase in PP matrix. Both XRD and transmission electron microscopic analysis revealed the formation of intercalated clay silicate layer in PP/ABS nanocomposites.
The Scale of Mission-Embeddedness as a Nonprofit Revenue Classification Tool: Different Earned Revenue Types, Different Performance Effects
Authors: Levine Daniel Jamie , Kim Mirae
Published: May 2016

Nonprofits rely on earned revenue to remain sustainable. Prior studies have generally aggregated all earned revenue and evaluated its influence on financial sustainability. Our study takes a different approach, assessing the effects of three different types of earned revenue on an immediate program outcome. We use Cultural Data Project data from 2,000 arts and culture nonprofits from 2004-2012. We find that embedded and integrated earned revenue are linked to better program outcomes while external earned revenue is related to poorer program outcomes. Results depend on type (performing vs. visual arts) and funding structure (donative vs. commercial).
Optimal Distinctiveness Signals Membership Trust
Authors: Leonardelli Geoffrey J. , Loyd Denise Lewin
Published: May 2016

According to optimal distinctiveness theory, sufficiently small minority groups are associated with greater membership trust, even among members otherwise unknown, because the groups are seen as optimally distinctive. This article elaborates on the prediction’s motivational and cognitive processes and tests whether sufficiently small minorities (defined by relative size; for example, 20%) are associated with greater membership trust relative to mere minorities (45%), and whether such trust is a function of optimal distinctiveness. Two experiments, examining observers’ perceptions of minority and majority groups and using minimal groups and (in Experiment 2) a trust game, revealed greater membership trust in minorities than majorities. In Experiment 2, participants also preferred joining minorities over more powerful majorities. Both effects occurred only when minorities were 20% rather than 45%. In both studies, perceptions of optimal distinctiveness mediated effects. Discussion focuses on the value of relative size and optimal distinctiveness, and when membership trust manifests.
Walking a mile in their shoes: Developing pre-service music teachers’ empathy for ELL students
Authors: Zhang Yiyue
Published: May 2016

In recent decades, music educators have become increasingly aware of the English Language Learner (ELL) population due to mainstreaming and inclusion policies. Meanwhile, the need for adequately preparing pre-service music teachers has become a focal point for music teacher preparation programs in the United States. In this article, I will 1) discuss the importance of developing pre-service music teachers’ empathy for ELL students; 2) offer suggestions for developing empathic pre-service music teachers; and 3) describe how a classroom cultural immersion experience can help pre-service music teachers to develop their empathy as well as increase their awareness of effective teaching strategies for ELL students. Through a short-term classroom cultural immersion experience, pre-service music teachers in the U.S. learned what it was like to be an ELL; as a result of their experience, they became more culturally and linguistically responsive. They deepened their level of empathy for ELLs, and expanded their knowledge base of techniques for effective music teaching.
Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis
Authors: Cottrell Michelle A , Galea Olivia A , O’Leary Shaun P , Hill Anne J , Russell Trevor G
Published: May 2016

Objective:

To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population.

Data sources:

Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions.

Review methods:

Two reviewers screened 5913 abstracts where 13 studies ( n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black ‘Checklist for Measuring Quality’ tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI).

Results:

Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I2=93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I2=58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I2=10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI −0.10–0.37, I2 = 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI −0.27–1.60, I2=96%) following intervention.

Conclusions:

Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.
Preferred Reporting Items for Studies Mapping onto Preference-Based Outcome Measures: The MAPS Statement
Authors: Petrou Stavros , Rivero-Arias Oliver , Dakin Helen , Longworth Louise , Oppe Mark , Froud Robert , Gray Alastair
Published: May 2016

Background. “Mapping” onto generic preference-based outcome measures is increasingly being used as a means of generating health utilities for use within health economic evaluations. Despite the publication of technical guides for the conduct of mapping research, guidance for the reporting of mapping studies is currently lacking. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a new checklist that aims to promote complete and transparent reporting of mapping studies. Methods. In the absence of previously published reporting checklists or reporting guidance documents, a de novo list of reporting items was created by a working group comprised of 6 health economists and 1 Delphi methodologist. A 2-round, modified Delphi survey with representatives from academia, consultancy, health technology assessment agencies, and the biomedical journal editorial community was used to identify a list of essential reporting items from this larger list. Results. From the initial de novo list of 29 candidate items, a set of 23 essential reporting items was developed. The items are presented numerically and categorized within 6 sections, namely: (i) title and abstract; (ii) introduction; (iii) methods; (iv) results; (v) discussion; and (vi) other. The MAPS statement is best applied in conjunction with the accompanying MAPS explanation and elaboration document. Conclusions. It is anticipated that the MAPS statement will improve the clarity, transparency, and completeness of reporting of mapping studies. To facilitate dissemination and uptake, the MAPS statement is being co-published by 7 health economics and quality-of-life journals, and broader endorsement is encouraged. The MAPS working group plans to assess the need for an update of the reporting checklist in 5 years.
Emotional Reactions to Employee Theft and the Managerial Dilemmas Small Business Owners Face
Authors: Kennedy Jay P. , Benson Michael L.
Published: May 2016

Employee theft is one of the most harmful crimes that can occur to a small business. Research on this crime has focused primarily on its financial impact and how to prevent it. However, like other forms of crime, employee theft also has more personal and subjective effects on victims. To date, these aspects of employee theft victimization have been largely ignored. We address this gap in the literature by exploring the emotional consequences of employee theft as experienced by the owners of small businesses. Guided by grounded theory methodology, we conducted a series of in-person interviews with the owners of small businesses to gain a better understanding of the total impact of employee theft. Analysis of interviews indicated that victimized business owners experienced a range of cognitive and emotional reactions to theft. At times, these reactions were severe, and they were exacerbated if the victim had a strong emotional connection with the offender.
Efficacy and Safety of a Colistin Loading Dose, High-Dose Maintenance Regimen in Critically Ill Patients With Multidrug-Resistant Gram-Negative Pneumonia
Authors: Elefritz Jessica L. , Bauer Karri A. , Jones Christian , Mangino Julie E. , Porter Kyle , Murphy Claire V.
Published: May 2016

Introduction:

Emergence of multidrug-resistant (MDR) gram-negative (GN) pathogens and lack of novel antibiotics have increased the use of colistin, despite unknown optimal dosing. This study aimed to evaluate the safety and efficacy of a colistin loading dose, high-dose (LDHD) maintenance regimen in patients with MDR-GN pneumonia.

Methods:

A retrospective cohort analysis was performed comparing critically ill patients with MDR-GN pneumonia pre- and postimplementation of a colistin LDHD guideline with a primary outcome of clinical cure. Safety was assessed using incidence of acute kidney injury (AKI) based on RIFLE (risk, injury, failure, loss, end-stage renal disease) criteria.

Results:

Seventy-two patients met the inclusion criteria (42 preimplementation and 30 postimplementation). Clinical cure was achieved in 23 (55%) patients in the preimplementation group and 20 (67%) patients in the postimplementation group ( P = .31). AKI occurred in 50% of the patients during the preimplementation period and 58% during the postimplementation period ( P = .59) with no difference in initiation rates of renal replacement therapy.

Conclusion:

The increased clinical cure rate after implementation of the colistin LDHD guideline did not reach statistical significance. The LDHD guideline, however, was not associated with an increased incidence of AKI, despite higher intravenous colistin doses. Opportunity exists to optimize colistin dosage while balancing toxicity, but larger studies are warranted.
Hopf bifurcation character of an interactive vehicle–road shimmy system under bisectional road conditions
Authors: Daogao Wei , Tong Jiang , Changhe Chen , Yibin Jiang , Ning Pan , Zhijie Pan
Published: May 2016

The adhesion coefficients of a bisectional road have significant coupled influences on the shimmy characteristics of the front wheels of a vehicle. A four-degree-of-freedom model for a representative sport utility vehicle was established. This model considered the adhesion coefficients of a bisectional road and the friction of the steering system of the suspension. The existence and stability of the system’s limit cycles were qualitatively determined using the Hopf bifurcation theorem and the centre manifold theory based on the model. The influences of the adhesion coefficients on the Hopf bifurcation characteristics of the system were calculated using a numerical method. The results showed that the road adhesion coefficient μ1 of the left front wheel and the road coefficient μ2 of the right front wheel significantly affected the vehicle shimmy and coupling relationship when different. Keeping μ1 at a certain value, the swing angles and the angular velocities of the two front wheels consistently decreased when μ2 decreased. The phenomenon repeatedly occurred when the difference Δ μ between the adhesion coefficients increased. Moreover, the discrepancy between the amplitude of the left front wheel and the amplitude of the right front wheel is much more apparent when both the adhesion coefficients are larger. Good agreement between the shimmy characteristics of the two wheels was also found when comparing the results using the centre manifold reduced-dimensions method with the numerical method. Furthermore, a higher reduced order caused the reduced system to be closer to the original system.
From Game Design to Service Design
Authors: Klapztein Sol , Cipolla Carla
Published: May 2016

Background. Game designers have long been developing strategies to foster engagement, pleasure and a variety of sensations in game experiences, increasingly applying their research to areas beyond games. This has led to a growing recognition of the use of game elements in non-game settings. In parallel, service designers have been seeking to improve user experience and engagement in services.

Method. Drawing on relevant literature about game design, the authors develop a framework that gathers a variety of game design research endeavors to form a practical tool to support service development from a user experience perspective. Its application is exemplified and simulated in a methodological approach to Action Design Research on a selected service.

Results. The service is then analyzed and compared ‘before and after’ the utilization of the framework, with no measurement of results. At last, a simplified method to gamify services, the GSF Application Model, is presented,

Conclusions. This article presents and describes the development of the Gamification Service Framework, an IT artifact designed to solve a class of problems related to the service field: the gamification of services. The central aim is to provide a new tool for service designers to use game design concepts in their practices, by structuring services in an analogous way to games.
The Japan HOspice and Palliative Care Evaluation Study 3: Study Design, Characteristics of Participants and Participating Institutions, and Response Rates
Authors: Aoyama Maho , Morita Tatsuya , Kizawa Yoshiyuki , Tsuneto Satoru , Shima Yasuo , Miyashita Mitsunori
Published: May 2016

This article describes the whole picture of Japan HOspice and Palliative Care Evaluation Study 3 (J-HOPE3 Study) including study design and demographic data. The aims of the J-HOPE3 study were to (1) evaluate the process, structure, and outcome of palliative care in the following care settings: acute hospitals, inpatient hospice/palliative care units (PCUs), and home hospice services; (2) examine bereaved family members’ self-reported psychosocial conditions, such as grief and depression, as bereavement outcomes; (3) provide data to ensure and improve the quality of care provided by participating institutions through feedback concerning results for each institution; and (4) perform additional studies to explore specific clinical research questions. We conducted a cross-sectional, anonymous, self-report questionnaire survey involving patients’ bereaved family members in 20 acute hospitals, 133 PCUs, and 22 home hospice services between May and July 2014. Two types of questionnaires were used: main and specific studies questionnaires. The questionnaire was sent to totally 13 584, and 10 157 returned the questionnaire. The analysis included 9126 family members’ questionnaires from acute hospitals, PCUs, and home hospice services. Respondents’ average age was 61.6 years, 55% were women, and 40% had been married to the deceased. With respect to the characteristics of participating institutions, most institutions did not have religious affiliations, and most PCUs and home hospice services provided bereavement care. These results of the analysis of common and additional questionnaires could play an important role in clinical settings, quality improvement, research, and public accountability.
Self-Reported Quality of Life and Symptom Burden in Ambulatory Patients With Multiple Myeloma on Disease-Modifying Treatment
Authors: Kiely Fiona , Cran Alison , Finnerty Deirdre , O’Brien Tony
Published: May 2016

Background:

Knowledge of health-related quality of life (QoL) of patients with multiple myeloma on disease-modifying treatments is limited.

Aim:

(1) Determine symptom prevalence in patients with multiple myeloma on disease-modifying treatment. Identify the range and nature of these symptoms within the dimensions of physical, psychological, social, and financial well-being. (2) Measure self-reported QoL. (3) Compare the above-mentioned parameters to the general population and patients with advanced cancer.

Method:

Adults with multiple myeloma on disease-modifying treatment, attending the hematology day unit in a tertiary referral center from November 2012 to January 2013, were eligible for inclusion in a cross-sectional quantitative survey. Consenting patients completed 2 validated questionnaires, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) supplemented by the myeloma-specific module (EORTC QLQ-MY20) and the Hospital Anxiety Depression Score (HADS).

Results:

Forty-one patients were included for analysis: 59% were male and 41% were female. Mean age was 63.7 years (range 46-86, standard deviation 11.24). The QoL scores were significantly lower than the general population and comparable to those with advanced cancer. The most commonly reported physical symptoms were pain (66%), fatigue (63%), and dyspnea (51%). About 54% of the patients were burdened by financial worries. Anxiety (30%) and depression (37%) were prevalent.

Conclusion:

Patients with myeloma on disease-modifying treatment have a lower QoL than the general population and are symptomatic across physical, psychological, financial, and social domains. A holistic approach to patient care is warranted, and patients may benefit from specialist palliative care input.
Never Too Much? The Curvilinear Relationship Between Empowering Leadership and Task Performance
Authors: Lee Soojin , Cheong Minyoung , Kim Myungsun , Yun Seokhwa
Published: May 2016

Although empowering leadership is generally considered to be a desirable leadership approach, its effectiveness has been questioned and the response is mixed. Integrating the “Too-Much-of-a-Good-Thing” effect and dual task processing, this study examines the relationship between empowering leadership and task performance. Specifically, we suggest a curvilinear relationship between empowering leadership and employee task performance. Further, applying a leadership contingency perspective, we propose that the curvilinear relationship between empowering leadership and employee task performance is moderated by employee learning orientation. Using survey data from 137 supervisor–subordinate dyads, our results show that the inverted U-shaped relationship between empowering leadership and employee task performance is moderated by employee learning orientation. Theoretical and practical implications are discussed.
Hypercalcaemia in cats
Authors: Finch Natalie C
Published: May 2016

Practical relevance:

Calcium is essential for many normal physiological processes within the body. Aberrations in calcium homeostasis leading to hypercalcaemia can result in clinical signs such as polyuriav and polydipsia, lethargy and weakness due to depressed excitability of muscle and nervous tissue, and gastrointestinal (GI) signs due to effects on GI smooth muscle. Hypercalcaemia in cats is mostly idiopathic, with chronic kidney disease and neoplasia also being common causes.

Clinical challenges:

Hypercalcaemia can be a diagnostic challenge and a good understanding of the regulation of calcium homeostasis can aid in interpreting results of diagnostic tests. Furthermore, the management approach may depend on the underlying cause of hypercalcaemia, and also its severity and chronicity.

Audience:

This review offers a comprehensive discussion of the regulation of calcium homeostasis, with a focus on the normal response to hypercalcaemia. It also discusses the diagnostic approach to, and management of, hypercalcaemia in cats, as well as specific aetiologies. This is relevant to all clinicians working with feline patients.

Evidence base:

The review draws evidence from peer-reviewed publications and also the author’s own clinical experience.
Practical urinalysis in the cat
Authors: Reppas George , Foster Susan F
Published: May 2016

Series outline:

This is the second article in a two-part series on urinalysis in the cat. The specific focus is urine microscopic examination. Part 1, which appeared in the March 2016 issue, discussed urine macroscopic examination.

Practical relevance:

Urinalysis is an essential procedure in feline medicine but often little attention is paid to optimising the data yielded or minimising factors that can affect the results.

Clinical challenges:

For the best results, appropriately collected urine should be prepared promptly by specialist laboratory personnel for the relevant tests and assessed by a clinical pathologist. This is invariably impractical in clinical settings but careful attention can minimise artefacts and allow maximum useful information to be obtained from this seemingly simple process.

Audience:

Clinical pathologists would be familiar with the information provided in this article, but it is rarely available to general or specialist practitioners, and both groups can potentially benefit.

Equipment:

Most of the required equipment is routinely available to veterinarians. However, instructions have been provided to give practical alternatives for specialist procedures in some instances.

Evidence base:

The evidence base for feline microscopic urinalysis is quite poor and information has largely been extrapolated from the human literature. Information from feline studies has been included where available. In addition, practical clinicopathological and clinical observations are provided.
Case-based clinical reasoning in feline medicine
Authors: Whitehead Martin L , Canfield Paul J , Johnson Robert , O’Brien Carolyn R , Malik Richard
Published: May 2016

Aim:

This is Article 3 of a three-part series on clinical reasoning that encourages practitioners to explore and understand how they think and make case-based decisions. It is hoped that, in the process, they will learn to trust their intuition but, at the same time, put in place safeguards to diminish the impact of bias and misguided logic on their diagnostic decision-making.

Series outline:

Article 1, published in the January 2016 issue of JFMS, discussed the relative merits and shortcomings of System 1 thinking (immediate and unconscious) and System 2 thinking (effortful and analytical). In Article 2, published in the March 2016 issue, ways of managing cognitive error, particularly the negative impact of bias, in making a diagnosis were examined. This final article explores the use of heuristics (mental short cuts) and illness scripts in diagnostic reasoning.
2016 AAFP Guidelines for the Management of Feline Hyperthyroidism
Authors: Carney Hazel C , Ward Cynthia R , Bailey Steven J , Bruyette David , Dennis Sonnya , Ferguson Duncan , Hinc Amy , Rucinsky A Renee
Published: May 2016

Clinical context:

Since 1979 and 1980 when the first reports of clinical feline hyperthyroidism (FHT) appeared in the literature, our understanding of the disease has evolved tremendously. Initially, FHT was a disease that only referral clinicians treated. Now it is a disease that primary clinicians routinely manage. Inclusion of the measurement of total thyroxine concentration in senior wellness panels, as well as in diagnostic work-ups for sick cats, now enables diagnosis of the condition long before the cat becomes the classic scrawny, unkempt, agitated patient with a bulge in its neck. However, earlier recognition of the problem has given rise to several related questions: how to recognize the health significance of the early presentations of the disease; how early to treat the disease; whether to treat FHT when comorbid conditions are present; and how to manage comorbid conditions such as chronic kidney disease and cardiac disease with treatment of FHT. The 2016 AAFP Guidelines for the Management of Feline Hyperthyroidism (hereafter referred to as the Guidelines) will shed light on these questions for the general practitioner and suggest when referral may benefit the cat.

Scope:

The Guidelines explain FHT as a primary disease process with compounding factors, and provide a concise explanation of what we know to be true about the etiology and pathogenesis of the disease. The Guidelines also: Distill the current research literature into simple recommendations for testing sequences that will avoid misdiagnosis and separate an FHT diagnosis into six clinical categories with associated management strategies. Emphasize the importance of treating all hyperthyroid cats, regardless of comorbidities, and outline the currently available treatments for the disease. Explain how to monitor the treated cat to help avoid exacerbating comorbid diseases. Dispel some of the myths surrounding certain aspects of FHT and replace them with an evidence-based narrative that veterinarians and their practice teams can apply to feline patients and communicate to their owners.

Evidence base:

To help ensure better case outcomes, the Guidelines reflect currently available, evidenced-based knowledge. If research is lacking, or if a consensus does not exist, the expert panel of authors has made recommendations based on their extensive, cumulative clinical experience.
Simplified finite element method analysis of ultra-high-performance fibre-reinforced concrete columns under blast loads
Authors: Xu Juechun , Wu Chengqing , Li Jun , Cui Jintao
Published: May 2016

Ultra-high-performance fibre-reinforced concrete has exceptional mechanical properties including high compressive and tensile strength as well as high fracture energy. It has been proved to be much higher blast resistant than normal concrete. In this article, flexural behaviours of ultra-high-performance fibre-reinforced concrete columns were investigated through full-scale tests. Two 200 mm × 200 mm × 2500 mm columns with and without axial loading were investigated under three-point bending tests, and their load–displacement relationships were recorded and the moment curvatures were derived. The derived moment curvature relationships of ultra-high-performance fibre-reinforced concrete columns were then incorporated into a computationally efficient one-dimensional finite element model, which utilized Timoshenko beam theory, to determine flexural response of ultra-high-performance fibre-reinforced concrete columns under blast loading. After that, the one-dimensional finite element model was validated with the real blast testing data. The results show good correlation between the advanced finite element model and experimental results. The feasibility of utilizing the one-dimensional finite element model for simulating both high-strength reinforced concrete and ultra-high-performance fibre-reinforced concrete columns against blast loading conditions is confirmed.
The cybercultural moment and the new media field
Authors: Stevenson Michael
Published: May 2016

This article draws on Pierre Bourdieu’s field theory to understand the regenerative “belief in the new” in new media culture and web history. I begin by noting that discursive constructions of the web as disruptive, open, and participatory have emerged at various points in the medium’s history, and that these discourses are not as neatly tied to economic interests as most new media criticism would suggest. With this in mind, field theory is introduced as a potential framework for understanding this (re)production of a belief in the new as a dynamic of the interplay of cultural and symbolic forms of capital within the new media field. After discussing how Bourdieu’s theory might be applied to new media culture in general terms, I turn to a key moment in the emergence of the new media field—the rise of cybercultural magazines Mondo 2000 and Wired in the early 1990s—to illustrate how Bourdieu’s theory may be adapted in the study of new media history.
Border thinking and disidentification: Postcolonial and postsocialist feminist dialogues
Authors: Tlostanova Madina , Thapar-Björkert Suruchi , Koobak Redi
Published: May 2016

In the context of the continuing dominance of delocalised Western feminist theoretical models, which allow the non-Western and not quite Western ‘others’ to either be epistemically annihilated or appropriated, it becomes crucial to look for transformative feminist theoretical tools which can eventually help break the so-called mere recognition patterns and move in the direction of transversal dialogues, mutual learning practices and volatile but effective feminist coalitions. Speaking from the position of postcolonial and postsocialist feminist others vis-a-vis the dominant Western/Northern gender studies mainstream, and drawing on examples from a broad range of social contexts (from the Armenian queer social movement to a recent Indian gang rape controversy), the authors of this article address the validity of two such transformative feminist tools: border thinking that operates on a more general theoretical level, and disidentification that offers a more praxial operational realisation of the border principle.
Residents’ perceptions of film-induced tourism: A Portuguese case study
Authors: Mendes Raquel , Vareiro Laurentina , Ferreira André Rafael
Published: May 2016

Film-induced tourism has various socio-cultural, economic and environmental impacts on local destinations. Considering that destination managers and tourism development authorities aim to plan for optimal tourism development, and at the same time wish to minimize the negative impacts of this development on the local communities, monitoring residents’ opinions of perceived impacts is a good way of incorporating their reaction into tourism planning and development. This study’s main objective is to explore residents’ perceptions of film-induced tourism and the impacts of filmmaking on the development of a destination. Specifically, the research examines residents’ perceptions of filmmaking impacts on two Portuguese municipalities (Arcos de Valdevez and Estremoz) given their features in two popular television soap operas. Data is collected by means of an Internet survey, in which residents’ perceptions of these impacts are solicited. Residents generally agree that the recording and exhibition of the television soap operas are important to the municipality, and contribute to the increased number of tourists. Given that residents consider that the positive impacts are more significant than the negative impacts, they would support the recording of other television series in their municipalities. Although perceptions of residents from Arcos de Valdevez and Estremoz were similar, some significant differences were found.
Serum advanced glycation endproducts are associated with left ventricular dysfunction in normal glucose metabolism but not in type 2 diabetes: The Hoorn Study
Authors: Linssen Pauline BC , Henry Ronald MA , Schalkwijk Casper G , Dekker Jacqueline M , Nijpels Giel , Brunner-La Rocca Hans-Peter , Stehouwer Coen DA
Published: May 2016

Objective:

To investigate whether serum advanced glycation endproducts are associated with left ventricular systolic and diastolic function in participants with normal glucose metabolism, impaired glucose metabolism and type 2 diabetes mellitus.

Methods:

Participants from a cross-sectional, population-based study ( n = 280 with normal glucose metabolism, n = 171 with impaired glucose metabolism, n = 242 with type 2 diabetes mellitus) underwent echocardiography. Serum protein-bound advanced glycation endproducts [i.e. Nε-(carboxymethyl)lysine, pentosidine and Nε-(carboxyethyl)lysine] were measured. Linear regression analyses were used and stratified according to glucose metabolism status.

Results:

In normal glucose metabolism, higher Nε-(carboxymethyl)lysine and pentosidine levels were associated with worse diastolic function (left atrial volume index and left atrial volume × left ventricular mass index product term) and higher Nε-(carboxymethyl)lysine and Nε-(carboxyethyl)lysine levels with worse systolic function (ejection fraction). In impaired glucose metabolism, a similar pattern emerged, though less consistent. In type 2 diabetes mellitus, these associations were non-existent for diastolic function or even reversed for systolic function.

Conclusion:

This suggests that serum advanced glycation endproducts are associated with impaired left ventricular function in normal glucose metabolism, but that with deteriorating glucose metabolism status, serum advanced glycation endproducts may not mirror heart failure risk.
Immunoisolation to prevent tissue graft rejection: Current knowledge and future use
Authors: David Anu , Day James , Shikanov Ariella
Published: May 2016

This review focuses on the concept of immunoisolation and how this method has evolved over the last few decades. The concept of immunoisolation came out of the need to protect allogeneic transplant tissue from the host immune system and avoid systemic side effects of immunosuppression. The latter remains a significant hurdle in clinical translation of using tissue transplants for restoring endocrine function in diabetes, growth hormone deficiency, and other conditions. Herein, we review the most significant works studying the use of hydrogels, specifically alginate and poly (ethylene glycol), and membranes for immunoisolation and discuss how this approach can be applied in reproductive biology.
An Exploration of the Effects of Tibetan Yoga on Patients’ Psychological Well-Being and Experience of Lymphoma: An Experimental Embedded Mixed Methods Study
Authors: Leal Isabel , Engebretson Joan , Cohen Lorenzo , Fernandez-Esquer Maria Eugenia , Lopez Gabriel , Wangyal Tenzin , Chaoul Alejandro
Published: May 2016

As an emergent care model combining conventional with complementary therapies, integrative interventions challenge evaluation, necessitating approaches capable of capturing complex, multilevel interactions. This article evaluates the effects of a Tibetan yoga intervention on lymphoma patients’ quality of life and cancer experience. Our methodological aims were to explore differences in therapeutic effect between treatment and control group using qualitative data, and explain equivocal findings between data sets. Use of both data transformation techniques—qualitizing and quantitizing—within an experimental embedded design comparing and integrating data between data sets and treatment groups allowed us to develop this innovative evaluative approach. Findings clarify convergence and divergence between data sets, explore participants’ complex cancer experience, and capture dimensions and intervention effects inaccessible through either method alone.
Media representation of regulated incivilities: Relevant actors, problems, solutions and the role played by experts in the Flemish press
Authors: Di Ronco Anna
Published: May 2016

This article analyses the representations of regulated nuisance in a section of Flemish newspapers over time. It identifies the groups of people who have been successful in conveying messages in and through Flemish press news, and explores the way they have represented problems of, and suggested solutions to, regulated incivilities over the years. Furthermore, against the backdrop of newsmaking criminology, it considers whether and how crime and justice experts have contributed to shaping the Flemish media discourse on regulated incivilities over time. Overall the analysis of press news has found that the press, by giving coverage to the voices of local institutional actors, has promoted the criminalization of nuisance and, especially, of physical incivilities. The views of criminological experts, by contrast, have remained marginal. The article concludes by suggesting how such findings present a new set of empirical and conceptual challenges for newsmaking criminology, and more generally, for public criminology.
The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial
Authors: Mousa Nasser , Abdel-Razik Ahmed , Zaher Ashraf , Hamed Magdy , Shiha Gamal , Effat Narmin , Elbaz Sherif , Elhelaly Rania , Hafez Mohamed , El-Wakeel Niveen , Eldars Waleed
Published: May 2016

Background:

Minimal hepatic encephalopathy (MHE) has a far-reaching impact on quality and function ability in daily life and may progress to overt hepatic encephalopathy. There is a synergistic effect between systemic oxidative stress and ammonia that is implicated in the pathogenesis of hepatic encephalopathy. The aim of this study is to investigate the effectiveness of oral supplementation of antioxidants and zinc gluconate on MHE versus lactulose.

Methods:

Our study included 58 patients with cirrhosis diagnosed as having MHE by neuropsychometric tests, including number connection test part A (NCT-A), digit symbol test (DST) and block design tests (BDTs). Patients were randomized to receive 175 mg zinc gluconate, 50,000 IU vitamin A, 500 mg vitamin C and 100 mg vitamin E once daily plus lactulose, dose 30–60 ml/day for 3 months [group A ( n = 31)] or initiated and maintained on lactulose dose 30–60 ml/day for 3 months [group B ( n = 27)]. Neuropsychometric tests and laboratory investigations were repeated after 3 months of therapy.

Results:

Compared with the baseline neuropsychometric tests, a significant improvement was reported in patients with MHE after 3 months of antioxidant and zinc therapy (group A) versus patients with lactulose therapy (group B) (NCT-A, p <0.001; DST, p = 0.006; BDT, p < 0.001). Antioxidant and zinc supplementation significantly decreased arterial ammonia level, alanine aminotransferase (ALT), aspartate aminotransferase (AST) ( p < 0.001) and improved Child–Pugh score in MHE after 3 months of therapy ( p= 0.024).

Conclusion:

Antioxidant and zinc supplementation can improve MHE in patients with liver cirrhosis.
Endoscopic ultrasound-assisted gastrointestinal hemostasis: an evolving technique
Authors: Jain Deepanshu , Thosani Nirav , Singhal Shashideep
Published: May 2016

Gastrointestinal bleeding can range from grossly visible blood in stool or vomitus to microscopic bleed. However, any kind of bleeding can lead to potential life-threatening consequences. A small proportion of patients with gastrointestinal bleeding remain refractory to initial endoscopic hemostasis. While some are successfully managed by repeat endoscopic intervention, a few fail to respond or are not amenable to endoscopic hemostasis. As of now, the next level of intervention is passed on to either surgeons or interventional radiologists. There is new evidence suggesting the increased utility of endoscopic ultrasound (EUS) in diagnosis and treatment of culprit vascular lesions across the gut. In addition, EUS-assisted technique has also been used in the primary prevention of bleeding from gastroesophageal varices. In this review article, we have summarized case series and reports describing the use of EUS-assisted hemostasis. Indications, techniques, complications and success rates reported are discussed. While most of the authors describe their experience with primary and secondary treatment of gastric varices, treatment of other gastrointestinal lesions with EUS assisted hemostatic techniques is also discussed.
Depressive Symptoms, Emotion Dysregulation, and Bulimic Symptoms in Youth With Type 1 Diabetes
Authors: Young-Hyman Deborah L. , Peterson Claire M. , Fischer Sarah , Markowitz Jessica T. , Muir Andrew B. , Laffel Lori M.
Published: May 2016

This study evaluated the associations between depressive symptoms, emotion dysregulation and bulimic symptoms in youth with type 1 diabetes (T1D) in the context of the diagnosis and treatment of T1D. Study participants were 103 youth in 2 distinct groups: newly diagnosed (New) or transitioning to pump therapy (continuous subcutaneous insulin infusion [CSII]; “Pump”), who completed questionnaires regarding symptoms of depression, emotion dysregulation, and bulimia. Glycemic control (A1c), height, weight, and questionnaires were evaluated within 10 days of diagnosis (n = 58) or at education/clinic visit before starting insulin utilizing CSII (n = 45). In the newly diagnosed group, only depression accounted for significant variance in bulimia scores (β = .47, P < .01). For the group with disease treatment experience (Pump), but not for the newly diagnosed group (New), greater depressive symptoms and emotion dysregulation were associated with greater bulimic symptoms. Depressive symptoms and emotion dysregulation, an indicator of poor coping/behavioral control, could help explain adoption of disordered eating behaviors in youth with T1D who are transitioning to pump therapy.
Thymic Cyst Popping Up in a Patient With Congenital Heart Disease
Authors: Kanakis Meletios A. , Danias Peter G. , Chatzis Andrew C.
Published: May 2016

The unusual case of a thymic cyst emerging and rapidly expanding, mimicking hence a right atrial aneurysm in an asymptomatic patient with congenital heart disease is presented.
Selective Use of the Blalock-Taussig Shunt and Right Ventricle-to-Pulmonary Artery Conduit During the Norwood Procedure
Authors: Murthy Raghav , Sebastian Vinod A. , Huang Rong , Guleserian Kristine J. , Forbess Joseph M.
Published: May 2016

Background:

The single ventricle reconstruction trial showed better one-year transplant-free survival for the right ventricle-to-pulmonary artery (RV-to-PA) conduit over the modified Blalock-Taussig shunt (mBTS) at Norwood operation. However, concerns remain about the long-term effects of a neonatal ventriculotomy. In our institution, we have used specific selection criteria for the use of mBTS in the Norwood operation.

Methods:

We reviewed 122 consecutive neonates undergoing the Norwood procedure from December 2006 to December 2013. We used the following criteria to select our source of pulmonary blood flow: (1) presence of a dominant morphologic left ventricle; (2) presence of antegrade blood in an ascending aorta that is greater than 3 mm; and (3) presence of significant large “crossing coronaries” on ventricle. All patients who met any of the above 3 criteria underwent an mBTS while the remaining patients underwent an RV-to-PA conduit.

Results:

Seventy-five (61.5%) patients had the RV-to-PA conduit and 47 (38.5%) patients had an mBTS. The overall surgical mortality was 9%. Mean follow-up interval was 23.5 months. Actuarial transplant-free survival was similar at 12, 24, 36, and 48 months in both the mBTS group and the RV-to-PA conduit group. In the RV-to-PA conduit group, actuarial transplant-free survival was 73% at 12 months, 71% at 24 months, 71% at 36 months, and 67% at 48 months, while in the mBTS group, actuarial transplant-free survival was 82% at 12 months, 75% at 24 months, 75% at 36 months, and 75% at 48 months.

Conclusion:

Our selection criteria for mBTS have allowed us to obtain equivalent transplant-free survival at 12, 24, 36, and 48 months when compared to the RV-to-PA conduit group.
Utility of Multimodality Imaging in the Morphologic Characterization of Anomalous Aortic Origin of a Coronary Artery
Authors: Lee Simon , Uppu Santosh C. , Lytrivi Irene D. , Sanz Javier , Weigand Justin , Geiger Miwa K. , Shenoy Rajesh U. , Farooqi Kanwal , Nguyen Khanh H. , Parness Ira A. , Srivastava Shubhika
Published: May 2016

Background:

Anomalous aortic origin of a coronary artery from the wrong Sinus of Valsalva (AAOCA) is a rare congenital anomaly and is associated with sudden cardiac death. Morphologic features considered to be “high risk” are significant luminal narrowing, acute coronary angulation at its origin, intramural course, and long interarterial course. A consistent approach for characterization of these features is lacking.

Methods:

A retrospective single-center review of all patients diagnosed with AAOCA using echocardiogram and computed tomography (CT)/magnetic resonance imaging (MRI) studies was performed. Twenty-nine patients were identified (25 using CT and 4 using MRI) with subsequent three-dimensional data sets. The MRI data sets lacked adequate resolution and were excluded. Twenty-five patients (median age 15.1, range 10-39.5 years, 72% male) were further analyzed using echocardiogram and CT. Morphologic assessment focused on luminal stenosis, coronary angulation, and interarterial length. Additional morphologic features focusing on cross-sectional area and degree of ellipticity were also assessed.

Results:

Echocardiography tended to yield smaller measurements compared to CT and had poor interobserver reproducibility for measurements pertaining to the narrowest proximal and distal coronary segments. Computed tomography showed good inter-/intraobserver reproducibility for the same. Agreement between both modalities for coronary angulation at its origin was excellent. There was good agreement for measurements of interarterial length between echocardiography and CT, but echocardiography had superior reproducibility. Assessment of luminal cross-sectional area and elliptical shape by CT had excellent inter-/intraobserver reproducibility.

Conclusion:

The combination of echocardiography and CT characterizes morphologic features of anomalous origin of the coronary artery more reliably than either modality alone.
Surgical Repair of 115 Patients With Anomalous Aortic Origin of a Coronary Artery From a Single Institution
Authors: Mainwaring Richard D. , Murphy Daniel J. , Rogers Ian S. , Chan Frandics P. , Petrossian Edwin , Palmon Michal , Hanley Frank L.
Published: May 2016

Objectives:

Anomalous aortic origin of a coronary artery (AAOCA) has been associated with myocardial ischemia and sudden death. The past decade has provided important insights into the natural history and typical patterns of presentation. However, there are also a number of unresolved controversies regarding the indications for surgery and the efficacy of that surgery. The purpose of this study was to review our surgical experience with AAOCA in 115 patients at a single institution.

Design:

One hundred and fifteen patients have undergone surgical repair of AAOCA at our institution. There were 82 males and 33 females, and the median age at surgery was 16 years. Fifty-nine patients had preoperative symptoms of myocardial ischemia, including 56 with exertional chest pain or syncope and 3 sudden death events. Twenty-four patients had associated congenital heart defects. Seven patients had an associated myocardial bridge.

Results:

Surgical repair was accomplished by unroofing of an intramural coronary in 86, reimplantation in 9, and pulmonary artery translocation in 20. There has been no early or late mortality. Fifty-seven (97%) of the 59 symptomatic patients have been free of any cardiac symptoms postoperatively. Two patients had recurrent symptoms and underwent reoperation (one had revision of the initial repair and one had repair of a myocardial bridge).

Conclusions:

Surgical repair of AAOCA can be safely performed and is highly efficacious in relieving symptoms of myocardial ischemia. The two “surgical failures” in this series had an anatomic basis and underscore the need to reassess both the proximal and distal anatomy in these patients.