bluuebunny/crossref_metadata_2025 huggingface dataset:
Using controversy as a teaching tool
Authors: Richardson Joan
Published: November 2017

In a time of hyperpolarization and hyper partisanship, preparing students to deliberate about their differences becomes even more important. In this interview, Diana Hess, dean of the School of Education at the University of Wisconsin-Madison and co-author of The Political Classroom, describes the challenge of ensuring that students have access to multiple and competing viewpoints about issues of public importance. In her research with co-author Paula McAvoy, Hess said she learned that students value hearing their teachers’ viewpoints as long as teachers aren’t pressing those views on students but that hearing a teacher’s viewpoint didn’t often change a student’s own opinion.
Politicizing pedagogy
Authors: Kolluri Suneal
Published: November 2017

Recent scholarship on civic education has introduced some useful ways to engage students in learning about controversial topics, debating them, and participating in democratic life. However, while those are valuable tools for active citizenship, they’re not sufficient. Democratic education should focus on issues that matter intensely to students’ local communities, the author argues, and it should be grounded in the core skills of the academic disciplines. To illustrate, he describes a social studies unit he taught at an urban high school in Oakland, Calif., focusing on a pair of competing narratives about the crack epidemic of the 1990s, with attention to the ways in which public perceptions depend on the source of the given argument and the context from which it originates.
Preparing teachers in a divided society
Authors: Pace Judith L.
Published: November 2017

In a divisive age, how do we support beginning teachers in taking up the challenge of teaching controversial topics and creating classroom environments that promote civil discourse? For insights, the author looked to the work of teacher educators in Northern Ireland, a region that is still affected by many generations of intense sectarian conflict. Their practices, she argues, offer timely lessons to educators in the U.S.
Effects of Phase Aberration and Phase Aberration Correction on the Minimum Variance Beamformer
Authors: Chau Gustavo , Dahl Jeremy , Lavarello Roberto
Published: November 2017

The minimum variance (MV) beamformer has the potential to enhance the resolution and contrast of ultrasound images but is sensitive to steering vector errors. Robust MV beamformers have been proposed but mainly evaluated in the presence of gross sound speed mismatches, and the impact of phase aberration correction (PAC) methods in mitigating the effects of phase aberration in MV beamformed images has not been explored. In this study, an analysis of the effects of aberration on conventional MV and eigenspace MV (ESMV) beamformers is carried out. In addition, the impact of three PAC algorithms on the performance of MV beamforming is analyzed. The different beamformers were tested on simulated data and on experimental data corrupted with electronic and tissue-based aberration. It is shown that all gains in performance of the MV beamformer with respect to delay-and-sum (DAS) are lost at high aberration strengths. For instance, with an electronic aberration of 60 ns, the lateral resolution of DAS degrades by 17% while MV degrades by 73% with respect to the images with no aberration. Moreover, although ESMV shows robustness at low aberration levels, its degradation at higher aberrations is approximately the same as that of regular MV. It is also shown that basic PAC methods improve the aberrated MV beamformer. For example, in the case of electronic aberration, multi-lag reduces degradation in lateral resolution from 73% to 28% and contrast loss from 85% to 25%. These enhancements allow the combination of MV and PAC to outperform DAS and PAC and ESMV in moderate and strong aberrations. We conclude that the effect of aberration on the MV beamformer is stronger than previously reported in the literature and that PAC is needed to improve its clinical potential.
Canguilhem’s Critique of Kant: Bringing Rationality Back to Life
Authors: Brilman Marina
Published: November 2017

Canguilhem’s contemporary relevance lies in how he critiques the relation between knowledge and life that underlies Kantian rationality. The latter’s Critique of Pure Reason and Critique of Judgment represent life in the form of an exception: life is simultaneously included and excluded from understanding. Canguilhem’s critique can be grouped into three main strands of argument. First, his reference to concepts as preserved problems breaks with Kant’s idea of concepts regarding the living as a ‘unification of the manifold’. Second, Canguilhem’s vital normativity represents life as the potential to resist normative orders that judge the living, relegating Kant’s ‘lawfulness of the contingent’ to a ‘mediocre regularity’. Third, Canguilhem’s introduction of the environment as a ‘category of contemporary thought’ decentres the living/knowing subject and introduces contingency. His idea of the ‘knowledge of life’ leads to the conclusion that life is the condition of possibility of rationality, rather than rationality’s ‘blind spot’.
Midterm Clinical Results in Rugby Players Treated With the Bristow Procedure
Authors: Kawasaki Takayuki , Hasegawa Yoshinori , Kaketa Takefumi , Shiota Yuki , Gonda Yoshinori , Sobue Shogo , Kobayashi Hideo , Yamakawa Jun , Itoigawa Yoshiaki , Kaneko Kazuo
Published: November 2017

Background:

Although surgical shoulder stabilization by coracoid transfer is effective for collision athletes and has a low reinjury rate, no reports have described the midterm results of this procedure in specific patient cohorts of sufficient number or provided subjective assessments of these patients.

Purpose:

To evaluate midterm results after treatment of shoulder instability with the Bristow procedure in a large cohort of rugby players.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included 176 shoulders of 152 competitive rugby players who underwent shoulder stabilization surgery (Bristow procedure with Bankart repair) with a mean follow-up of 4 years (minimum of 2 years) in our institute. The primary outcome measure was the difference in the presurgical and postsurgical functional Rowe score and Western Ontario Shoulder Instability index (WOSI) score and factors affecting these scores. Complication rates and associated factors were also investigated.

Results:

In total, 176 shoulders of 152 patients underwent the Bristow procedure with Bankart repair, and 93.2% of the players returned to their preinjury competition level at a mean of 6.3 months postoperatively. All Rowe and WOSI scores were significantly improved after surgery. The numbers of shoulders with functional failure as indicated by the Rowe score, WOSI score, and inability to return to the previous level of play were 28 (15.9%), 54 (30.7%), and 12 (6.8%), respectively. Multiple logistic regression analyses demonstrated that reinjury after surgery (odds ratio [OR] = 35.1) and the number of shoulder dislocations (OR = 11.2-11.4) negatively affected the competition level after return to play, while reinjury (OR = 11.1-17.8), the number of shoulder subluxations (OR = 1.1-2.9), injury in the dominant shoulder (OR = 1.2-2.2), and large bone defects (OR = 1.1-11.5) negatively affected functional scores. Reinjury after shoulder stabilization occurred in 6 of 176 shoulders (3.4%). Multiple logistic regression analysis demonstrated that reinjury after surgery occurred more frequently in players at lower versus higher grade levels of competition (OR = 21.0). Although differences were not significant, a trend was noted toward higher postoperative reinjury rates in forward players, those in the upper categories (professional and college), and those with injury in the nondominant shoulder.

Conclusion:

The Bristow procedure provides good midterm outcomes for competitive collision athletes, while postsurgical reinjury, the number of preoperative dislocations and subluxations, and large bone defects negatively affect postsurgical shoulder function. This information may be useful for treatment of shoulder dislocations in collision athletes.
Economie des changements climatiques et structuration du champ de l’économie
Authors: Huet Pauline
Published: November 2017

This article deals with the Economics of Climate Change (ECC). This research area emerged in the mid-1970s and has grown exponentially since the mid-2000s. This paper is based on Richard Whitley’s characterisation of the general economic field as a ‘partitioned bureaucracy’, which makes a distinction between the centre and peripheral areas. We use bibliometric data to highlight the structure of the ECC and measure to what extent Whitley’s category helps to understand this field better. To complete these quantitative data we use qualitative data, collected via survey and interviews, and we analyse scientific publications. With the help of this combination of data, we are able to provide some explanation of the structuration of the ECC, as well as the role of interdisciplinarity and links with the political field in this process. We also provide insights about the rise of climate change and global warming in the social hierarchy of objects in economics.
Measuring Argumentation Skills Through a Game-Enhanced Scenario-Based Assessment
Authors: Song Yi , Sparks Jesse R.
Published: November 2017

This project aimed to develop an engaging formative assessment that simulates the social and dialogic processes that are often missing in traditional instruction and assessment of argumentation. In this article, we describe the design of an argumentative reasoning task within a scenario-based assessment enhanced with game elements ( Seaball—Semester at Sea). This Seaball task requires students to classify foods as “junk food” or not, by identifying relevant evidence to support their decisions and evaluating reasoning errors in others’ arguments. Data from a small-scale study of 42 middle school students revealed that students performed significantly better on questions requiring selection of appropriate evidence than questions requiring identification of logical fallacies. Additionally, students’ total scores were significantly correlated with external measures of argumentation skills, and with teacher’s ratings of their argumentative writing skills. Survey indicated that students perceived the game-enhanced scenario-based assessment as engaging. Implications for formative assessment are discussed.
Dual- and Polytobacco/Nicotine Product Use Trends in a National Sample of High School Students
Authors: Merianos Ashley L. , Mancuso Tierney F. , Gordon Judith S. , Wood Kelsi J. , Cimperman Katherine A. , Mahabee-Gittens E. Melinda
Published: November 2017

Purpose:

The study purpose was to examine changes in patterns of ever and current dual- and polyproduct use over time and to examine demographic and modifiable risk factors including tobacco smoke exposure (TSE).

Design:

A secondary analysis of the 2013 to 2015 National Youth Tobacco Survey data.

Setting:

Nationwide high schools were selected.

Subjects:

A total of 31 022 high school students.

Measures:

Ever and current (past 30 days) tobacco/nicotine product use, home tobacco/nicotine product use, TSE and e-cigarette vapor exposure, and demographic characteristics were measured.

Analysis:

Multivariable logistic regression and multinomial logistic regression models.

Results:

Of the students, 9.4% were ever dual users and 18.6% were ever poly users. Rates of ever/current use of e-cigarettes and hookah increased from 2013 to 2015 (all Ps < .001). In 2015, participants were 4.8 times (95% confidence interval [CI], 4.5-5.2) and 4.0 times (95% CI, 3.5-4.4) more likely to report ever/current e-cigarette use and 1.61 times (95% CI, 1.5-1.7) and 1.48 times (95% CI, 1.3-1.7) more likely to report ever/current hookah use. Participants reporting TSE were 15.4 times (95% CI, 11.5-21.0) more likely to report current poly use, and those with e-cigarette exposure were 10.4 times (95% CI, 7.8-13.8) more likely to report current poly use.

Conclusion:

From 2013 to 2015, rates of ever and current use of e-cigarettes and hookah increased. Tobacco smoke and e-cigarette exposure were associated with higher rates of dual and poly use. Prevention efforts targeting these products are needed.
Processing of thermoplastic matrix composites through automated fiber placement and tape laying methods
Authors: Yassin Khaled , Hojjati Mehdi
Published: November 2017

Fiber-reinforced composite materials are replacing metallic components due to their higher specific strength and stiffness. Automation and thermoplastics emerged to overcome the time and labor intensive manual techniques and the long curing cycles associated with processing thermoset-based composites. Thermoplastics are processed through fusion bonding which involves applying heat and pressure at the interface. Together with automated techniques (such as automated fiber placement, and automated tape laying), a fast, clean, out-of-autoclave, and automated process can be obtained. A detailed review of thermoplastic composites processing through automated methods is presented. It sheds the light on the materials used and the different heat sources incorporated with the pros and cons of each, with concentration mainly on hot gas torch, laser, and ultrasonic heating. A thorough illustration of the several mechanisms involved in a tow/tape placement process is tackled such as heat transfer, intimate contact development, molecular interdiffusion, void consolidation and growth, thermal degradation, crystallization, and so on. Few gaps and recommendations are included related to materials, laser heat source, heat transfer model, and the use of silicone rubber rollers. A review of optimization studies for tape placement processes is summarized including the main controllable variables and product quality parameters (or responses), with some of the major findings for laser and hot gas torch systems being presented. Both mechanical and physical characterizations are also reviewed including several testing techniques such as short beam shear, double cantilever beam, lap shear, wedge peel, differential scanning calorimetry, and so on. Challenges, however, still exist, such as achieving the autoclave-level mechanical properties and complying with the porosity levels required by the aerospace industry. More work is still necessary to overcome these challenges as well as increase the throughput of the process before it can be totally commercialized.
Reverse syphilis screening algorithm fails to demonstrate cost effectiveness in persons living with HIV
Authors: Eaton Ellen F , Joe Winston , Kilgore Meredith L , Muzny Christina A
Published: November 2017

Although the reverse syphilis screening algorithm is more efficient than the traditional algorithm, it may lead to exorbitant costs for health systems serving persons living with HIV needing annual syphilis screening. Alternatively, the traditional screening algorithm is cost saving in many scenarios.
Real-time modeling, control and optimization of turbo-machinery auxiliary plants
Authors: D’Adamio Pierluca , Galardi Emanuele , Meli Enrico , Nocciolini Daniele , Pugi Luca , Rindi Andrea
Published: November 2017

In the Oil & Gas industry, the testing of auxiliary lubrication plants represents a mandatory preliminary activity before the whole turbo-machinery train (including the auxiliary lubrication plant) can be put in operation. To this end, the employment of both efficient and accurate plant models becomes very important to synthesize satisfactory control strategies for both testing and normal operation purposes. This way, many benefits (e.g. in terms of safety, times and costs of execution) can be achieved. Therefore, this article focuses on the development of innovative and efficient real-time models and control architectures to describe and regulate the auxiliary lubrication systems. All the new strategies have been validated through accurate real experimental campaign and real-time hardware. According to the Bond-Graph modeling strategy, an efficient lumped parameter model of the lube oil console has been built to properly optimize the description of such system and the efficiency of the control strategies. The code has been compiled and uploaded on a commercial real-time platform that has been used to regulate the pressure control valve of the physical plant (to this aim, a new regulator has been developed). In particular, the control was designed according to a novel model-based methodology, including both identification and control optimization techniques (based on flexible simplex techniques). The comparison between the data obtained from the simulated system and the ones acquired from the physical plant shows the good agreement, reliability and efficiency of the proposed model and the control strategy. Both the modeling approach and the control strategy have been developed in collaboration with Baker and Hughes General Electric, while the experimental data were acquired in a plant located in Massa (Italy).
Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa
Authors: Dzifa D , Boima V , Yorke E , Yawson A , Ganu V , Mate-Kole C
Published: November 2017

Although it was previously believed that systemic lupus erythematosus was uncommon among Africans, it has become increasingly apparent that the incidence is higher, and socioeconomic challenges such as physician shortages, poor medical facility access, and poor health literacy may worsen prognosis. This retrospective study examines characteristics and outcomes of hospitalized systemic lupus erythematosus patients over a two-year period and serves as a baseline for comparison for future studies to examine the outcomes with the provision of more dedicated care. There were 51 patient admissions over a two-year period, with a mean duration from start of illness to admission of approximately two years. Duration of admission ranged from one to 140 days with a mean period of 26.12 days (SD ± 26.6). There were 22 deaths (43.1% of admissions), which were mainly due to infections and renal complications. Factors associated with risk of death in regression analysis were: infections, fever, disease flare, musculoskeletal involvement, amenorrhea, depression, a clinical finding of hepatomegaly, and chest infection. Understanding the effect and outcome of systemic lupus erythematosus across different countries can elucidate the role of genetic, environmental, and other causative factors in the progression of the disease.
Near infrared spectral radiation properties of different liquid hydrocarbon fuels
Authors: Ai Qing , Liu Meng , Sun Fengxian , Liu Chao , Xia Xinlin
Published: November 2017

A double-thickness transmission model for a three-layer structure combined with a genetic algorithm was adopted to determine the spectral radiation properties of liquids. The reliability of this model was illustrated by the good agreement between the optical constants measured and that from the references. Then the spectral radiation properties of three typical liquid hydrocarbon fuels (diesel, gasoline, and jet fuel) available in China were measured in the wavelength range of 1000–2100 nm from room temperature to 423 K. Results indicate that the optical constants of these fuels are related to the fuel composition, wavelength, and temperature. At room temperature, the absorption index of the low carbon fuel (gasoline) was smaller than that for the high carbon fuels (diesel and jet fuel) in the wavelength range of 1100–1450 nm and 1700–2000 nm and larger in other bands. From room temperature to 423 K, the absorption index increased with temperature by a maximum rate of 50% per degree for the low carbon fuel, while it presents different trends for the high carbon fuel. The absorption index of the diesel decreased with temperature by a maximum rate of 40% per degree, while there exists a turning point for that of jet fuel at 1685 nm. For all these fuels, the temperature influence on the refractive index was not obvious, as the changing rate only reaches up to 3% per degree.
An Aristotelian view of therapists' practice in multifamily therapy for young adults with severe eating disorders
Authors: Brinchmann Berit Støre , Moe Cathrine , Valvik Mildrid Elisabeth , Balmbra Steven , Lyngmo Siri , Skarbø Tove
Published: November 2017

Background:

Eating disorders are serious conditions which also impact the families of adult patients. There are few qualitative studies of multifamily therapy with adults with severe eating disorders and none concerning the practice of therapists in multifamily therapy.

Objectives:

The aim of the study is to explore therapists’ practice in multifamily therapy.

Research design and participants:

A grounded theory approach was chosen. Data were collected through participant observation in two multifamily therapy groups and qualitative interviews with the therapists in those groups.

Ethical considerations:

The study conforms to the principles outlined in the Declaration of Helsinki. All participants in the multifamily therapy groups received information about the research project and signed consent forms. The data are treated confidentially and anonymised.

Findings:

The core category was identified as ‘having many strings to one’s bow’, consisting of three subcategories: ‘planning and readjusting’, ‘developing as therapist and team’ and ‘regulating the temperature of the group’. This article discusses the empirical findings in the frame of Aristotelian virtue ethics.
‘It's all about the Benjamins’: Infringement notices and young people in New South Wales
Authors: Brown David , Cunneen Chris , Russell Sophie
Published: November 2017

This article provides a brief analysis of the place, role and purpose of monetary penalties and their theoretical underpinnings. Against this critique of financial penalties and the revenue ('the Benjamins') 1 that flows from penalty infringement notices, the article examines the six-fold growth in penalty infringement notices 2 issued to children and young people in NSW between 1998 and 2013. It outlines the disproportionate impact of monetary penalties on them and the increasing displacement of diversionary options, raising questions about the appropriateness of issuing infringement notices to children and young people. This article also addresses positive developments in relation to children and young people, including the introduction of Work and Development Orders (WDOs) in NSW.
Becoming me: How transgender teens navigate the Family Court System
Authors: Hughes Julie
Published: November 2017

Transgender minors are among the most vulnerable, discriminated against and disenfranchised of adolescents, and Australian law imposes a heavy yoke should they wish to begin treatment for gender dysphoria. Even with the full support of health professionals and parents, Australia takes the unique worldwide stance of requiring court approval. A way must be made to spare transgender teenagers from this fearsome, embarrassing and expensive court process. Informed consideration is important, but a multi-disciplinary tribunal could offer this, while minimising the stress and expense. This article begins and ends with Arnold’s story – a snapshot of a transgender teen, facing the Family Court and wanting to ‘become me’.
Patient and Provider Perspectives on a Mind–Body Program for Grieving Older Adults
Authors: Bui Eric , Chad-Friedman Emma , Wieman Sarah , Grasfield Rachel H. , Rolfe Allison , Dong Melissa , Park Elyse R. , Denninger John W.
Published: November 2017

Background:

Spousal bereavement in older age is a major stressor associated with an increase in both mental and physical problems. The Stress Management and Resiliency Training: Relaxation Response Resiliency Program (SMART-3RP) is an 8-week multimodal mind–body program that targets stress and has been found efficacious in decreasing the mental and physical manifestations of stress in varied populations. This qualitative study sought to investigate the relevance, credibility, and feasibility of the SMART-3RP in the community.

Methods:

Focus groups were conducted among both older widowed adults and providers who support them in the community (eg, chaplains, hospice bereavement coordinators). Transcripts were coded independently by coders trained in qualitative research. Codebooks were created based on both general themes and detailed subthemes present in the transcripts.

Results:

Findings from 4 focus groups revealed a general convergence between the needs of recently widowed older adults reported by widow(er)s and community providers alike and needs identified in the literature. Several components of the SMART-3RP target many of these needs (eg, social support, stress awareness, coping skills), making both community providers and widow(er)s report that the SMART-3RP is logical (89%) and would be helpful (100%) and successful in reducing symptoms (78%). Additionally, all widow(er)s reported a willingness to participate (100%). Feedback from the focus groups was used to adapt the SMART-3RP to improve its relevance to grief-related stress.

Conclusions:

Our findings suggest that the SMART-3RP may be helpful in decreasing somatic and psychological distress in older adults who have lost a spouse.
Teachers’ Daily Negative Emotions in Interactions With Individual Students in Special Education
Authors: Koenen Anne-Katrien , Vervoort Eleonora , Kelchtermans Geert , Verschueren Karine , Spilt Jantine L.
Published: November 2017

To understand and support teacher–student interactions, there is a need for research on teachers’ daily emotions in interactions with students. Therefore, this study investigated the development of teachers’ negative emotions in interactions with individual students with attachment problems. Using a 3-week diary study, data were collected from 71 teacher–student dyads in special education schools for students with emotional and behavioral disorders. Overall, the development of both activating (e.g., anger) and deactivating (e.g., helplessness) negative emotions was low and stable over time. Teachers with high self-efficacy and teachers with a high supportive teaching style were less likely to experience intensity of and variability in negative emotions. Student maladjustment and teachers’ depersonalization attitudes were positively associated with more activating negative emotions. Beginning teachers reported more deactivating negative emotions. The study highlights the need of emotion-focused interventions for teachers to promote positive interactions between teachers and individual students.
Arias-Stella Reaction With Signet Ring–Like Cell Histomorphology
Authors: Hernandez Andrea , Chiaffarano Jeanine , Mittal Khushbakhat , Marcus Alan
Published: November 2017

Cells with their nucleus pushed to the periphery in a crescent-like fashion by intracytoplasmic vacuole(s) are referred to as signet ring cells when the vacuole(s) contain mucin and signet ring–like cells when they are empty or contain a material other than mucin. Signet ring cells are commonly associated with adenocarcinomas. These cells are uncommon in the endometrium and have been found to be associated with both malignant and benign processes. We report the first case of signet ring–like cells within endometrial glands with Arias-Stella reaction.
Clinicopathologic Features of Benign Neurogenic Tumor of Urinary Bladder
Authors: Lee Cheol , Kim Bohyun , Song Boram , Park Jeong Hwan , Moon Kyung Chul
Published: November 2017

Background. Benign neurogenic tumor involving the urinary bladder is a very rare and heterogeneous disease group. The clinical and radiological diagnosis may be difficult because of the disease’s rarity and the histological similarities of each disease especially in needle biopsy specimens. However, accurate diagnosis is very important because the clinical course of each disease, even within the same diseases, is quite variable. In this study, we investigated 7 benign neurogenic tumors to better understand the rare disease entity in the urinary bladder by analyzing histological and immunohistochemical findings and comparing clinicopathologic features. Methods. We collected the cases by searching the medical records database of Seoul National University Hospital from 2000 to 2016. Results. We identified 3 ganglioneuromas, 2 schwannomas, 1 neurofibroma, and 1 granular cell tumor involving the urinary bladder. There were some limitations for the initial clinical and radiological diagnosis and even pathologic diagnosis using needle biopsy specimens. One infant patient was diagnosed radiologically with rhabdomyosarcoma, but the final diagnosis changed to ganglioneuromatosis. The initial needle biopsy diagnosis of 2 ganglioneuroma cases showed neurofibroma. All patients underwent a local resection, and 1 granular cell tumor patient suffered with pain because of a recurrent tumor. One neurofibromatosis patient had a lesion appear 34 months after the bladder operation, so he underwent repeated debulking operations, but he was diagnosed with malignant transformation after 8 years. Conclusions. An understanding of benign neurogenic tumors involving the urinary bladder and the sharing of rare experiences surrounding them are required to provide accurate diagnoses.
Teasing Transcription: Iterations in the Liminal Space Between Voice and Text
Authors: Cannon Susan Ophelia
Published: November 2017

These pieces of writing and the corresponding collection of objects were born out of what was supposed to be a traditional qualitative research project. At the transcription stage, I got caught. Tied up. I couldn’t make what I was supposed to be making, so this was made instead. Through technological, material, poetic, and artistic shifts, I considered what it might mean to transform an interview from conversation, to sound bite, to various versions of 0000s and 1111s, and perhaps back again. Ten re/presentations of a single interview were created. From these re/presentations, I considered how validity and reliability privilege cold and static representations and how other versions (some of which were also cold, if not static) might work to disrupt our notions of re/search and re/presentation. And, then I wondered how/why all this might come to matter.
Targeted Sequencing of Malignant Supratentorial Pediatric Brain Tumors Demonstrates a High Frequency of Clinically Relevant Mutations
Authors: Cole Bonnie L , Pritchard Colin C , Anderson Maia , Leary Sarah ES
Published: November 2017

Pediatric brain tumors cause more deaths than any other childhood malignancy, and the identification of potentially actionable genomic alterations in this rare heterogeneous group of tumors may improve treatment and outcome. The genetic landscape of common posterior fossa tumors has been described in the past several years, yet the classification of malignant pediatric supratentorial tumors remains controversial. Next-generation sequencing (NGS) is a promising tool to evaluate multiple genes concurrently. The clinical utility of NGS has not been proven in pediatric brain tumors. We identified patients diagnosed with high-grade supratentorial pediatric brain tumors resected between 2008 and 2012 at our institution. DNA from 12 formalin-fixed paraffin-embedded tumor samples from 9 patients was analyzed, including 3 paired samples from diagnosis and relapse. A panel of 194 cancer-related genes was sequenced using targeted next-generation deep sequencing. Genetic findings were correlated with histology, immunohistochemistry, treatment, and survival. We found one or more pathologic genetic change (mutation, amplification, or deletion) in 8 of 9 (89%) of patients studied. Epidermal Growth Factor Receptor ( EGFR) mutations were found in 3 patients, 2 of which had an exon 20 insertion not previously described in pediatric malignancy. Additional genetic changes were found in EGFR and Platelet-Derived Growth Factor Receptor Alpha ( PDGFRA) at relapse not present in the initial samples. Familial cancer predisposition syndromes were suggested by mutations found in 3 genes in 4 patients, including TP53, MSH2, and CHEK2. Seven of 9 patients in this study died of their disease. In summary, targeted deep sequencing may be used in rare pediatric brain tumors to identify driver mutations for targeted therapy, suggest constitutional and familial testing for cancer predisposition syndromes, and select molecular targets worthy of further study.
Consider the eye in preventive healthcare – ocular findings, intraocular pressure and Schirmer tear test in ageing cats
Authors: Sandhas Ellen , Merle Roswitha , Eule J Corinna
Published: November 2017

Objectives

Geriatric health screening in cats is highly recommended. However, information about normal and abnormal findings is scarce, especially regarding the eyes of ageing cats. This prospective study examined the influence of the ageing process on vision and ocular structures in older cats.

Methods

A total of 209 cats (aged 9–24 years) underwent physical examination, vision assessment, slit lamp biomicroscopy and ophthalmoscopy. Systolic blood pressure (SBP) measurement, Schirmer tear test (STT) reading and rebound tonometry were performed. Systemic disease was not a criterion for exclusion.

Results

Vision was good in 157/209 cats (75.1%) and impaired in 52/209 cats (24.9%). Increasing age and the occurrence of vision impairment were not statistically associated ( P = 0.053). Retinal oedema, retinal haemorrhage and/or retinal detachment (19 cats) and glaucoma (12 cats) were the most common findings in vision impaired cats. Increasing age was significantly associated with the occurrence of lenticular sclerosis ( P = 0.01) and attenuated retinal vessels ( P = 0.02). Increasing age and SBP were significantly associated with the occurrence of retinal detachment, haemorrhage and oedema ( P <0.001 each). In cats without evidence of hypertensive ocular damage, younger cats had a tendency for higher SBP values than older cats, although this difference was not significant. Mean intraocular pressure (IOP) was 16.5 ± 5.0 mmHg. Age did not significantly affect the IOP values ( P = 0.54). Mean STT was 15.8 ± 4.8 mm/min. The STT was found to increase with age ( P = 0.025).

Conclusions and relevance

Although vision impairment is not a clinical sign of old age in cats, age-related changes may contribute to vision-threatening diseases. This study contributes to preventive healthcare by examining the influence of the ageing process on vision and ocular structures in older cats.
Procedural justice and global order: Explaining African reaction to the application of global protection norms
Authors: Dembinski Matthias
Published: November 2017

Persistent tensions between the international norm of state sovereignty and emerging human rights norms, including the Responsibility to Protect and the protection of civilians during international peacekeeping, raise the question of when and under what circumstances local and regional actors are more likely to respect global norms. These tensions are particularly stark in Africa. On the one hand, African states and regional organizations were among the first proponents of liberal protection norms in the non-Western world. On the other hand, many African leaders view state sovereignty as indispensable. Building on established empirical justice research in neighboring fields, this article makes an important contribution to the literature by demonstrating that African states are more likely to accept interventionist human rights norms when standards of procedural justice have been observed. The article demonstrates the relevance of procedural justice by examining the puzzle of divergent African reactions to two similar instances of regime change in Libya and the Ivory Coast that were enforced by extra-continental actors in the name of global protection norms.
A prospective study exploring the construct and predictive validity of the COM-B model for physical activity
Authors: Howlett Neil , Schulz Joerg , Trivedi Daksha , Troop Nicholas , Chater Angel
Published: November 2017

This study examined the constructs of capability, opportunity and motivation from the COM-B model and their influence on moderate-to-vigorous physical activity. Using a prospective survey design, 186 healthy adults completed measures representing the theoretical domains framework mapped to the COM-B, and moderate-to-vigorous physical activity 1 week later. The main indicators for the COM constructs were ‘habits’ (Capability), ‘subjective norms’ (Opportunity) and ‘exercise self-identity’ (Motivation). Motivation (77%) and moderate-to-vigorous physical activity (50%) were strongly predicted, with Capability and Motivation as key drivers of behaviour. Motivation was a strong mediator for Capability on behaviour. Future research should consider this approach for other populations and behaviours.
Why do they do it? Assessing self-report physical activity behavior and quality of life in individuals with multiple sclerosis
Authors: Fasczewski Kimberly S , Rothberger Sara M , Gill Diane L
Published: November 2017

Physical activity has been shown to effectively aid multiple sclerosis symptom management; however, individuals with multiple sclerosis tend to be inactive physically. Developing effective, sustainable, physical activity interventions involves first understanding motivators for physical activity. Open-ended surveys exploring physical activity motivators were collected from 215 individuals with multiple sclerosis. Responses indicate that self-efficacy and internalized motivation derived from physical activity outcomes were motivators for physical activity, and physical activity was cited as increasing overall quality of life. Future physical activity interventions should incorporate methods for building self-efficacy for physical activity and focus on increasing awareness of the long-term physical benefits derived from physical activity.
European cardiovascular nurses’ and allied professionals’ knowledge and practical skills regarding cardiopulmonary resuscitation
Authors: Pettersen Trond R , Mårtensson Jan , Axelsson Åsa , Jørgensen Marianne , Strömberg Anna , Thompson David R , Norekvål Tone M
Published: November 2017

Purpose:

Cardiopulmonary resuscitation (CPR) remains a cornerstone in the treatment of cardiac arrest, and is directly linked to survival rates. Nurses are often first responders and need to be skilled in the performance of cardiopulmonary resuscitation. As cardiopulmonary resuscitation skills deteriorate rapidly, the purpose of this study was to investigate whether there was an association between participants’ cardiopulmonary resuscitation training and their practical cardiopulmonary resuscitation test results.

Methods:

This comparative study was conducted at the 2014 EuroHeartCare meeting in Stavanger ( n=133) and the 2008 Spring Meeting on Cardiovascular Nursing in Malmö ( n=85). Participants performed cardiopulmonary resuscitation for three consecutive minutes CPR training manikins from Laerdal Medical®. Data were collected with a questionnaire on demographics and participants’ level of cardiopulmonary resuscitation training.

Results:

Most participants were female (78%) nurses (91%) from Nordic countries (77%), whose main role was in nursing practice (63%), and 71% had more than 11 years’ experience ( n=218). Participants who conducted cardiopulmonary resuscitation training once a year or more ( n=154) performed better regarding ventilation volume than those who trained less (859 ml vs. 1111 ml, p=0.002). Those who had cardiopulmonary resuscitation training offered at their workplace ( n=161) also performed better regarding ventilation volume (889 ml vs. 1081 ml, p=0.003) and compression rate per minute (100 vs. 91, p=0.04) than those who had not.

Conclusion:

Our study indicates a positive association between participants’ performance on the practical cardiopulmonary resuscitation test and the frequency of cardiopulmonary resuscitation training and whether cardiopulmonary resuscitation training was offered in the workplace. Large ventilation volumes were the most common error at both measuring points.
Tied to the worldly work of writing: Parent as ethnographer
Authors: Barrett Elizabeth
Published: November 2017

Parent narratives have contributed to ethnographic accounts of the lives of children with autism, but there are fewer examples of parents producing their own autoethnographies. This article explores the affordances of an online blog for enabling a parent of a child with autism to produce a written record of practice which may be considered ‘autoethnographic’. Richardson’s framework for ethnography as Creative Analytic Process (CAP) is applied to extracts from a blog post in order to consider its contribution, reflexivity, aesthetic merit and impact. The article addresses the methodological and ethical implications of reconceptualizing parents as researchers and the potential contribution of new writing platforms to the development of auto/ethnography.
Methods for displaying and calibration of Cox proportional hazards models
Authors: Bharat Chrianna I , Murray Kevin , Cripps Edward , Hodkiewicz Melinda R
Published: November 2017

Cox proportional hazards modelling is a widely used technique for determining relationships between observed data and the risk of asset failure when model performance is satisfactory. Cox proportional hazards models possess good explanatory power and are used by asset managers to gain insight into factors influencing asset life. However, validation of Cox proportional hazards models is not straightforward and is seldom considered in the maintenance literature. A comprehensive validation process is a necessary foundation to build trust in the failure models that underpin remaining useful life prediction. This article describes data splitting, model discrimination, misspecification and fit methods necessary to build trust in the ability of a Cox proportional hazards model to predict failures on out-of-sample assets. Specifically, we consider (1) Prognostic Index comparison for training and test sets, (2) Kaplan–Meier curves for different risk bands, (3) hazard ratios across different risk bands and (4) calibration of predictions using cross-validation. A Cox proportional hazards model on an industry data set of water pipe assets is used for illustrative purposes. Furthermore, because we are dealing with a non-statistical managerial audience, we demonstrate how graphical techniques, such as forest plots and nomograms, can be used to present prediction results in an easy to interpret way.
CT Dental Artifact: Comparison of an Iterative Metal Artifact Reduction Technique with Weighted Filtered Back-Projection
Authors: Diehn Felix E , Michalak Gregory J , DeLone David R , Kotsenas Amy L , Lindell E Paul , Campeau Norbert G , Halaweish Ahmed F , McCollough Cynthia H , Fletcher Joel G
Published: November 2017

Background

Dental hardware produces streak artifacts on computed tomography (CT) images reconstructed with the standard weighted filtered back projection (wFBP) method.

Purpose

To perform a preliminary evaluation of an iterative metal artifact reduction (IMAR) technique to assess its ability to improve anatomic visualization over wFBP in patients with dental amalgam or other hardware.

Material and Methods

CT images from patients with dental hardware were reconstructed using wFBP and IMAR software and soft-tissue or bone window/level settings. The anatomy most affected by metal artifacts was identified. Two neuroradiologists determined subjective and objective imaging features, including overall metal artifact score (1 = severe artifacts, 5 = no artifacts), soft-tissue visualization score of the most-compromised structure, and artifact length along the skin surface. CT numbers were used to quantify artifact severity.

Results

Twenty-four patients were included. IMAR improved overall metal artifact score in 18/24 cases (median =2 ± 0.9 vs. 1 ± 0.6, P < 0.001). Mean CT number in the most-affected anatomical structure significantly improved with IMAR (94.6 vs. 219 HU, P = 0.002) and length of affected skin surface decreased (40.4 mm vs. 118.7 mm, P < 0.001). However, osseous/dental artifactual defects were found in 22/24 cases with IMAR vs. 11/24 with wFBP.

Conclusion

IMAR software reduced metal artifact both subjectively and objectively and improved visualization of adjacent soft tissues. However, it produced a higher rate of artifactual defects in the teeth and bones than wFBP. Our findings support the use of IMAR as a valuable complement to, but not a replacement for, standard wFBP image reconstruction.
Diagnostic Accuracy of 3 Physical Examination Tests in the Assessment of Hip Microinstability
Authors: Hoppe Daniel J. , Truntzer Jeremy N. , Shapiro Lauren M. , Abrams Geoffrey D. , Safran Marc R.
Published: November 2017

Background:

Hip microinstability is a diagnosis gaining increasing interest. Physical examination tests to identify microinstability have not been objectively investigated using intraoperative confirmation of instability as a reference standard.

Purpose:

To determine the test characteristics and diagnostic accuracy of 3 physical examination maneuvers in the detection of hip microinstability.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

A review was conducted of 194 consecutive hip arthroscopic procedures performed by a sports medicine surgeon at a tertiary-care academic center. Physical examination findings of interest, including the abduction–hyperextension–external rotation (AB-HEER) test, the prone instability test, and the hyperextension–external rotation (HEER) test, were obtained from prospectively collected data. The reference standard was intraoperative identification of instability based on previously published objective criteria. Test characteristics, including sensitivity, specificity, positive and negative predictive values, and accuracy, were calculated for each test as well as for combinations of tests.

Results:

A total of 109 patients were included in the analysis. The AB-HEER test was most accurate, with a sensitivity of 80.6% (95% CI, 70.8%-90.5%) and a specificity of 89.4% (95% CI, 80.5%-98.2%). The prone instability test had a low sensitivity (33.9%) but a very high specificity (97.9%). The HEER test performed second in both sensitivity (71.0%) and specificity (85.1%). The combination of multiple tests with positive findings did not yield significantly greater accuracy. All tests had high positive predictive values (range, 86.3%-95.5%) and moderate negative predictive values (range, 52.9%-77.8%). When all 3 tests had positive findings, there was a 95.0% (95% CI, 90.1%-99.9%) chance that the patient had microinstability.

Conclusion:

The AB-HEER test most accurately predicted hip instability, followed by the HEER test and the prone instability test. However, the high specificity of the prone instability test makes it a useful test to “rule in” abnormalities. A positive result from any test predicted hip instability in 86.3% to 90.9% of patients, but a negative test result did not conclusively rule out hip instability, and other measures should be considered in making the diagnosis. The use of these tests may aid the clinician in diagnosing hip instability, which has been considered a difficult diagnosis to make because of its dynamic nature.