bluuebunny/crossref_metadata_2025 huggingface dataset:
On the Applicability of the Cascade Fold to Parabolic Dishes
Authors: Greschik G. , Park K.C. , Namba H. , Sato T.
Published: January 2017

This paper addresses some issues related to the deployability of a class of foldable parabolic reflectors. In particular, it is shown that, if global symmetry is maintained, the involved kinematic constraints require some of the foldable panels to pass kinematic bifurcation points in order for the deployment to complete. This constraint is pivotal in determining the deployment characteristics of parabolic and non-parabolic dishes alike. For parabolic reflectors of more than two panels per segment it is shown that the symmetric trapezoid shapes of the tessellations need to be relaxed to enable deployment.
Combination therapy with venlafaxine and carbamazepine in depressive patients not responding to venlafaxine: pharmacokinetic and clinical aspects
Authors: Ciusani Elio , Zullino Daniele F. , Eap Chin B. , Brawand-Amey Marlyse , Brocard Murielle , Baumann Pierre
Published: January 2017

The chiral antidepressant venlafaxine (VEN) is both a serotonin and a norepinephrine uptake inhibitor. CYP2D6 and CYP3A4 contribute to its metabolism, which has been shown to be stereoselective. Ten CYP2D6 genotyped and depressive (F32x and F33x, ICD-10) patients participated in an open study on the pharmacokinetic and pharmacodynamic consequences of a carbamazepine augmentation in VEN non-responders. After an initial 4-week treatment with VEN (195 ± 52 mg/day), the only poor metabolizer out of 10 depressive patients had the highest plasma concentrations of S-VEN and R-VEN, respectively, whereas those of R-O-demethyl-VEN were lowest. Five non-responders completed the second 4-week study period, during which they were submitted to a combined VEN-carbamazepine treatment. In the only non-responder to this combined treatment, there was a dramatic decrease of both enantiomers of VEN, O-demethylvenlafaxine, N-desmethylvenlafaxine and N,O-didesmethylvenlafaxine in plasma, which suggests non-compliance, although metabolic induction by carbamazepine cannot entirely be excluded. The administration of carbamazepine [mean ± SD, range: 360 ± 89 (200–400) mg/day] over 4 weeks did not result in a significant modification of the plasma concentrations of the enantiomers of VEN and its O- and N-demethylated metabolites in the other patients. In conclusion, these preliminary observations suggest that the combination of VEN and carbamazepine represents an interesting augmentation strategy by its efficacy, tolerance and absence of pharmacokinetic modifications. However, these findings should be verified in a more comprehensive study.
Tragedy in the Courts of the Lord: A Socio-Literary Reading of the Death of Nadab and Abihu
Authors: Houston Walter
Published: January 2017

Aaron should be seen as the tragic hero of the story in Leviticus 10. He is affected not merely by the death of his sons, but also by its shameful circumstances, and the disgrace is emphasized by Moses' conduct. He is caught in an unwinnable contest of honour with the deity; but ultimately he should be seen as being to blame for his own tragedy, owing to his countenance for idolatry among the people. The theme of the father being disgraced by his sons is very widespread in the narrative of the Hebrew Bible; its popularity in the socio-cultural milieu may be accounted for as a means of harmonizing conflicting feelings about powerful families.
Amos among the ‘Dead Prophets Society’: Re-Reading the Lion's Roar
Authors: Linville James R.
Published: January 2017

Amos 3.3–8 is usually interpreted as the historical prophet's self-justification before a hostile crowd. I employ this passage in a similar manner, but restrict the confrontation to a literary world created by a post-monarchic body of scribes and interpreters. These I label the ‘Dead Prophets Society’ (with apologies to the makers of the film Dead Poets Society). Their audience must supply the answers to the character Amos's interrogation on behalf of the textual audience. This situation forms the basis of a ‘trap’ which forces the guild to confront their own limitations vis-à-vis the ancient prophets, and still identify with Amos and experience the imperative nature of prophecy that the passage depicts.
The Ass of a Mare and Other Scandals
Authors: Potthast-Jutkeit Barbara
Published: January 2017

This study is concerned with attitudes towards marriage and sexuality in nineteenth-century Paraguay and with the impact of politics and legislation on these issues. Analyzing the politics of the Paraguayan dictators Francia and Carlos Antonio López and confronting these with census data as well as parish and court records suggests that although laws and social politics could hardly change deep-rooted patterns of behavior they could nevertheless strengthen prevailing trends. Census data for the mid-nineteenth century reveal a very high proportion of female-headed households and illegitimate births, especially in the capital. In the Paraguayan case these phenomena cannot be attributed to economic modernization but only to better work opportunities for women in the urban centers. These results also lead to the rejection of the theory that present Paraguayan family structures are primarily the result of the demographic imbalance of the sexes after the Triple-Alliance-War. They show that female-headed households and illegitimate births were already prevailing in Paraguay before the cataclysm.
Sexual Politics, Race and Bastard-Bearing in Nineteenth-Century Brazil
Authors: Kuznesof Elizabeth Anne
Published: January 2017

In the nineteenth century some 20–60% of the Brazilian population was born outside of wedlock and for the white population the proportion was about 30%. Higher proportions of both colored and white single mothers were found in urban than in rural or suburban areas of São Paulo in 1836. However, illegitimacy was invariably higher for the colored population in whatever location. Nevertheless, unmarried white mothers had significantly more illegitimate births per single mother than did the unmarried colored mothers and demonstrated persistance over time in this behavior. This non-marrying behavior and single motherhood was nevertheless joined to a cultural ideology and legal system in which marriage and legitimacy were strong positive values. Nineteenth-century baptism records of illegitimate and “natural” free children in São Cristovão, Rio de Janeiro demonstrate the presence of fathers at 27% of baptisms and of grandparents at near 40% of baptisms. Maternal grandmothers were especially important. Neither fathers nor grandparents appeared at slave baptisms–which in São Cristovão were 100% illegitimate–though godparents were almost always present.
The Protoindustrial Household Economy: Toward a Formal Analysis
Authors: Pfister Ulrich
Published: January 2017

Several recent studies on the household structure and the demographic evolution of protoindustrial communities in early modern Europe contradict important tenets of protoindustry theory as it has emerged from the writings of Braun, Mendels, Medick, and Levine. The present study develops a conceptual framework of the protoindustrial household economy based on a simple model of the decision-making process by which rural households allocate their labor to agricultural and protoindustrial activities. Its application to the class-specific location of protoindustrial activities, to the demographic corollaries of protoindustrialization, to age- and gender-specific work roles as well as to patterns and strategies of life cycles suggests its capacity to interpret in a coherent fashion a wide variety of seemingly contradictory empirical evidence.
Household Change and Racial Inequality in Economic Well-Being, 1960 to 1980
Authors: Wojtkiewicz Roger A.
Published: January 2017

The 1960s and 1970s in the United States were marked by major demographic changes. Marriage was delayed, divorce increased, fertility decreased, and there was a relative increase in nonmarital fertility. These changes led to an increase in female household headship which acted to decrease economic well-being in the population. The changes also led to a decrease in the number of children in households which acted to increase economic well-being. These two household composition changes varied by race. As a result, increased female headship and decreased number of children affected more than levels of economic well-being, the changes affected racial inequality in economic well-being as well.
Little Newspaper Coverage for Lt. Governor Candidates
Authors: Freedman Eric , Thai Daniel
Published: January 2017

Nominees for lieutenant governor received little or no attention in 2002 in capital dailies in seven states. References that appeared were often cursory, treating candidates as “invisipols.”
Media Use Affects Perception of Environmental Hazards
Authors: Riffe Daniel
Published: January 2017

Residents of environmentally distressed counties in Appalachia showed the dominance of television news as a source of health-related and medical research news. Hazards perceived as serious were correlated with the use of newspapers, television and radio.
Folk and Clinical Medical Utilization Patterns Among Mejicano Migrant Farmworkers
Authors: Slesinger Doris P. , Richards Michael
Published: January 2017

Each year, migrant workers from south Texas and Mexico travel north more than 2,000 miles for seasonal work in agriculture. They carry with them knowledge of both basic folk medicine and clinical medicine. This paper investigates migrants' utilization of folk healing and clinical medicine in both the sending and receiving states. Two methods of collecting data were employed: (a) a structured interview with a 10% stratified random sample of the workers when in Wisconsin and (b) an intensive ethnographic study of health behavior of 12 families when residing both in Wisconsin and Texas. Findings suggest that specific patterns of utilization depend mainly on structural conditions such as geographic location and availability of folk or clinical medical services and on the nature of the illness to be cured, and depend secondarily on sex, age, income, and educational level. For the migrants, there is little incompatibility between medical systems; people move easily between one and the other, often supplementing one with the other.
Effect of Various Methods of Fat Harvesting and Reinjection
Authors: Shiffman Melvin A.
Published: January 2017

Introduction:

Autologous fat transplantation is an excellent tool for filling defects and augmenting tissue. The literature has provided a variety of reports with different degrees of success or failure. The procedure is operator dependent and relies on the techniques of harvesting, cleansing, and reinjection. The author evaluates the various techniques to see their effect on the viability of the fat cells.

Materials and Methods:

Fat was removed from 4 patients for collection and reinjection by use of various cannulas, needles, suction pressures, and centrifugation. External ultrasound was evaluated before the operation, as was the use of the ratchet gun for injection. The fat was routinely cleansed of blood and tumescent solution products by means of washing with normal saline and then decanting repeatedly until the infranatant solution was clear.

Results:

Histologic examination of the fat cells showed that the central core of fat and edges of the core had 95–100% intact cells (presumably viable) in every specimen except when a −700 mm Hg vacuum was used for fat collection and cell damage was >10%. Preoperative external ultrasound did not appear to damage the fat cells but did disrupt some of the fibrous tissue holding the fat cells in large bundles.

Discussion:

The variety of techniques used to collect, clean, and reinject fat do not damage the fat cells except for the collection of fat in a −700 mm Hg vacuum. External ultrasound before the operation does not destroy fat cells but produces smaller bundles of fat. The ratchet gun does not result in increased fat cell loss.
Strategie Discursive De Professionnels De La Representation
Authors: Ubbiali Georges
Published: January 2017

The Discursive Strategies of Professional Union Representatives. This study examines arguments concerning the replacement of labor union activists by professional labor union employees, a modification supposedly associated with the current crisis of labor unions. The Job position of labor union organizer is analyzed through its historical development. An empirical research in the field with two labor federations was carried out to reconstitute the stages of a union career. The central part of the recherche consists of the production of interviews with union representatives. This social-historical approach reveals the fragile and unfinished character of the professionalization of labor union management. Careers, Identity, Trade, Professionalization, Full-Time Unionists, Union Members, Union Representatives.
Perception of Pediatric Neurology Among Non-neurologists
Authors: Jan Mohammed M. S.
Published: January 2017

Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management ( P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training. ( J Child Neurol 2004;19:1—5).
Guidelines for Resuscitation in the Delivery Room of Extremely Preterm Infants
Authors: Verlato Giovanna , Gobber Daniela , Drago Donatella , Chiandetti Lino , Drigo Paola
Published: January 2017

Ethical problems related to intensive care of extremely preterm newborns of ≤ 25 weeks' gestational age and at risk of disability have been extensively debated. The Bioethical Committee of the Department of Paediatrics of the University Hospital of Padua organized and started a multidisciplinary group to release guidelines to help staff facing problems related to prematurity. The vitality limit, survival, outcome, and ethical aspects were analyzed. Consequently, we suggest the following: at 22 weeks' gestational age, the deliverance of comfort care only; at 23 weeks, in the presence of detectable vital signs, the practice of immediate intubation, respiratory support, and a reassessment of the neonatal conditions; and at 24 weeks, the provision of intubation, ventilatory support, and cardiovascular resuscitation. If the clinical age and anamnestic gestational age are different, we proceed according to the more advanced one. The importance of providing parents with correct information and the role of comfort care are outlined. ( J Child Neurol 2004;19:31—34).
Surface Carboxymethylation of a Chitin Hydrogel
Authors: Wan Andrew C. A. , Khor Eugene , Hastings Garth W.
Published: January 2017

A chitin hydrogel was modified to give a bilayer structure comprised of a surface layer of carboxymethyl-chitin and bulk chitin within. By gradually increasing the sodium hydroxide concentration used in the activation step of the reaction, thickness of the carboxymethyl layer with accompanying swellability was varied. These bilayer hydrogels showed distinct morphological differences between the surface and bulk regions, visualized with a basic dye test and verified by FT-IR. Carboxymethylation was found to increase the lysozyme susceptibility of these hydrogels. These modified hydrogels have potential in orthopedics applications where enhanced water swellability and calcium affinity imparted by surface carboxymethylation are desirable properties.
The Ethics of Ordinary Time
Authors: Luthringer George F.
Published: January 2017

The Cruzan case portrayed ethics as high drama, an intense public struggle over the central issue of when it is right to withdraw nutrition support. There are, however, other, quieter ethical struggles that confront nutrition support teams daily and reach to the very core of each individual's integrity and character. These recurring dilemmas are no less powerful in their impact upon patient care and caregivers and no less potentially destructive to relationships and self‐esteem. This is ethics in ordinary time.
Female Drug Offenders: HIV-Related Risk Behavior, Self-Perceptions and Public Health Implications
Authors: Brewer, Victoria E. , Marquart, James W. , Mullings, Janet L. , Crouch Ben
Published: January 2017

One-third of women entering U.S. prisons between 1986 and 1991 were drug offenders (Bureau of Justice Statistics 1993). In turn, between 1991 and 1995, the number of HIV-positive prisoners grew at about the same rate (38%) as the overall prison population (36%) (BJS 1997). This paper describes 188 drug-offending females upon admission to a state prison, with an emphasis on their self-reported HIV-related behavioral histories. We analyze the self-reported health histories, drug and sexual high-risk behaviors, and self-perceptions of risk of these women. We also examine their attitudes toward drugs and alcohol as a personal problem and toward treatment, as compared to property and violent offenders.

We find that drug-offending females have histories of multiple HIV/AIDS-related risk behaviors, yet perceive their HIV infection risk as low. Unlike women incarcerated for property or violent offenses, a significant propor tion of drug offenders with personal drug and alcohol problems is interested in participating in substance abuse treatment. These findings support our contention that correctional administrators have a narrow, yet critical, window of opportunity to provide drug and alcohol treatment, AIDS education, and self-efficacy training to these women during their few years of incarceration.
A Test of Gottfredson's Theory Using a Ten-Year Longitudinal Study
Authors: Helwig Andrew A.
Published: January 2017

Occupational aspirations of a longitudinal sample of students were examined over a ten-year time period, from second to twelfth grade. Hypotheses from Gottfredson's theory of career development (1981, 1996) and from social learning theory (Lent, Brown & Hackett, 1994) were examined. The social value of children's occupational aspirations increased into the early high school years and started to fall by their senior year in high school when internal, unique personal factors were more evident in occupational aspirations as Gottfredson would predict. Through eighth grade, about 40 percent of boys and up to 20 percent of girls held occupational aspirations that could be classified as fantasy. Social learning theory suggests that children would relinquish fantasy occupational aspirations with age because of self-awareness and knowledge of the world of work. This change was evident as a significant shift toward more realistic occupational aspirations occurred during the late high school years.
The graduate labour market in the UK
Authors: Pearson Richard
Published: January 2017

This article maps the changing supply and demand for graduates in the 1990s. Demand growth is likely to continue into the 1990s, but the growth in the supply of graduates will come to a halt. It will not, however, go into decline as a result of the demographic downturn. 1992 will see an increase in international mobility adding to the complexity of the labour market in the 1990s. Graduates, higher education and employers will all have to adjust to this increasingly complex market in the 1990s if shortages and graduate underemployment are to be minimized.
Emergent research alliances
Authors: Webster Andrew J. , Constable Julian P.
Published: January 2017

This article reports on a research project that is being conducted by the Science and Technology Studies Unit, operating within the Anglia Higher Education College in Cambridge, UK, into a new type of collaborative relationship that is being developed between multinational companies and university science departments.
First Prize for technology transfer
Authors: Duff E.J.
Published: January 2017

Dr Eddie Duff and Dr Roger Hambleton have recently won first prize in the Technology Transfer Section of the UK Academic Enterprise Competition with their invention of the Lantor Cube. Here Eddie Duff discusses the invention and the competition.
Conference reports
Authors: Pearce Carol
Published: January 2017

Third National PICKUP in Universities Conference, Bath, UK, 18–20 September 1989
Humanizing the workforce
Authors: Eggins Heather
Published: January 2017

Skills Development for the 1990s, Hatfield, Herts, 21 June 1989
CIEC 1997 — Selected Papers
Authors: Grayson Lawrence P.
Published: January 2017

Lawrence Grayson is a past president of the American Society for Engineering Education. He has served as editor of the CIEC Proceedings since it began in 1976. He is currently Director, Program Monitoring and Information Technology, US Department of Education, Washington, DC 20202, USA. E-mail: l.grayson@ieee.org .
Re-Engineering Cooperative Education Learning
Authors: Duwart Ellen J. , Canale Richard L.
Published: January 2017

The authors set out the importance of the inter-relationship between engineering education and practice, in the context of the US Accreditation Board for Engineering and Technology's Engineering Criteria 2000. They suggest that cooperative education can play a key role in filling the gap between theory and application in the teaching of engineering students, and point out that their proposals, although made in the specific context of the USA, have international relevance as the trend towards ‘globalization’ reduces national distinctions. The paper examines the learning needs of engineering students, lists the key challenges facing educational institutions, presents a model of the cooperative education process, and illustrates it with a case example of cooperative education in practice in the Electrical and Computer Engineering programme at Northeastern University.
Effective Use of Industrial Advisory Boards
Authors: Buchanan Walter W. , Bostwick Willard D.
Published: January 2017

The Technology Accreditation Commission (TAC) of the US Accreditation Board for Engineering and Technology (ABET) stipulates that each accredited programme must have an industrial advisory committee composed of industrial representatives. However, how do we ensure that these committees contribute significantly to the growth and development of engineering technology programmes as a means of ensuring technical currency of the programme and the maintenance of close liaison with the employing industries?
Principles of Lean Manufacturing
Authors: Holloway L. E. , Hall A.
Published: January 2017

Lean manufacturing is a philosophy for continually eliminating waste. The practice of this philosophy requires both a management structure and a manufacturing technical structure that facilitate identifying wastes in the firm's operations, focuses management efforts on improving processes to reduce or eliminate any waste elements, and maintains the improvements through a focus on standards for all elements of manufacturing. This paper identifies the types of wastes in manufacturing. It then shows how lean manufacturing focuses on these wastes through employee involvement in continuous improvement of standards, visual management techniques to help identify wastes (deviations from standard), quality at the source techniques that focus on eliminating wastes of defects, and ‘pull’ production control methods that can be used to reduce wastes of inventory and to expose wastes hidden by high inventories.
Russian—UK Academic—Industrial Collaboration
Authors: Taylor J. R.
Published: January 2017

A collaborative programme is described that was established in 1997 between academic and industrial partners in Russia and the UK, and is supported by the British Council, to provide an active training ground for students from the Institute of Physics and Technology, Dolgoprudnyi. Imperial College's Femtosecond Optics Group has made available training course and laboratory facilities in association with IP Fibre Devices in the UK who have given financial and equipment support for the project as well as actively participating in the training programme through hosting students at their R&D facility The overall programme was conceived by the IRE Polus Company in Moscow, in an effort to maintain a mechanism to train students in key technological areas that will be of vital importance to the development of an internationally competitive associated Russian industrial base.
Support for Entrepreneurship at the University of Twente
Authors: van der Sijde P.C. , van Alsté J.A.
Published: January 2017

The authors describe the University of Twente (UT) as an innovative and entrepreneurial university. In demonstration of this approach, they discuss the ways in which the University participates in the encouragement of individual and institutional entrepreneurial activity and disseminates expert knowledge on issues relating to entrepreneurship. Graduates as well as faculty can benefit from UT schemes for entrepreneurs, and the establishment of a Student Entrepreneurship Centre is underway. The paper concludes with two case studies of projects which have followed the progression from a research unit or activity at UT into a limited company. The authors argue that higher education institutions must adopt active policies to enable both students and staff to initiate entrepreneurial activities.
Technology Transfer from University to SMEs
Authors: Thomson H. G.
Published: January 2017

The author summarizes current strategies at the University of Strathclyde in Scotland which respond to the need to collaborate effectively with local small and medium-sized enterprises (SMEs). These strategies are the results of four key policy strands: networking with local development agencies to improve industrial liaison; licensing IPR to SMEs; supporting initiatives from academic staff who wish to establish an institute or research centre which would address near-market needs of a local industry sector; and encouraging SMEs to collaborate with universities through national and international schemes.
Knowledge discovery and data mining in toxicology
Authors: Helma Christoph , Gottmann Eva , Kramer Stefan
Published: January 2017

Knowledge discovery and data mining tools are gaining increasing importance for the analysis of toxicological databases. This paper gives a survey of algorithms, capable to derive interpretable models from toxicological data, and presents the most important application areas.

The majority of techniques in this area were derived from symbolic machine learning, one commercial product was developed especially for toxicological applications. The main application area is presently the detection of structure-activity relationships, very few authors have used these techniques to solve problems in epidemiological and clinical toxicology.

Although the discussed algorithms are very flexible and powerful, further research is required to adopt the algorithms to the specific learning problems in this area, to develop improved representations of chemical and biological data and to enhance the interpretability of the derived models for toxicological experts.
Data mining and electroencephalography
Authors: Flexer Arthur
Published: January 2017

An overview of data mining (DM) and its application to the analysis of DM and electroencephalography (EEG) is given by: (i) presenting a working definition of DM, (ii) motivating why EEG analysis is a challenging field of application for DM technology and (iii) by reviewing exemplary work on DM applied to EEG analysis. The current status of work on DM and EEG is discussed and some general conclusions are drawn.
Statistical description of interrater variability in ordinal ratings
Authors: Nelson Jennifer C , Pepe Margaret S
Published: January 2017

Ordinal categorical assessments are common in medical practice and in research. Variability in such measurements amongst raters making the assessments can be problematic. In this paper we consider how such variability can be described statistically. We review three current approaches, including kappa-type statistics, loglinear models for agreement, and latent class agreement models, and discuss their limitations. We present a new graphical approach to describing interrater variability that involves a simple frequency distribution display of the category probabilities. The method enables description of interrater variability when raters are a random sample from some population as opposed to the traditional setting in which only a few selected raters provide assessments. Advantages of this approach relative to current approaches include the following: (1) it provides a simple visual summary of the rating data, (2) description is closely linked to familiar methods for describing variability in continuous measurements, (3) interpretation is straightforward, and (4) a large sample of raters can be accommodated with ease. We illustrate the method on simulated ordinal data representing radiologists' ratings of mammography images and on rating data from a national image reading study of mammography screening.
Bayesian variable selection in the accelerated failure time model with an application to the surveillance, epidemiology, and end results breast cancer data
Authors: Zhang Zhen , Sinha Samiran , Maiti Tapabrata , Shipp Eva
Published: January 2017

Accelerated failure time model is a popular model to analyze censored time-to-event data. Analysis of this model without assuming any parametric distribution for the model error is challenging, and the model complexity is enhanced in the presence of large number of covariates. We developed a nonparametric Bayesian method for regularized estimation of the regression parameters in a flexible accelerated failure time model. The novelties of our method lie in modeling the error distribution of the accelerated failure time nonparametrically, modeling the variance as a function of the mean, and adopting a variable selection technique in modeling the mean. The proposed method allowed for identifying a set of important regression parameters, estimating survival probabilities, and constructing credible intervals of the survival probabilities. We evaluated operating characteristics of the proposed method via simulation studies. Finally, we apply our new comprehensive method to analyze the motivating breast cancer data from the Surveillance, Epidemiology, and End Results Program, and estimate the five-year survival probabilities for women included in the Surveillance, Epidemiology, and End Results database who were diagnosed with breast cancer between 1990 and 2000.
Spatially-dependent Bayesian model selection for disease mapping
Authors: Carroll Rachel , Lawson Andrew B , Faes Christel , Kirby Russell S , Aregay Mehreteab , Watjou Kevin
Published: January 2017

In disease mapping where predictor effects are to be modeled, it is often the case that sets of predictors are fixed, and the aim is to choose between fixed model sets. Model selection methods, both Bayesian model selection and Bayesian model averaging, are approaches within the Bayesian paradigm for achieving this aim. In the spatial context, model selection could have a spatial component in the sense that some models may be more appropriate for certain areas of a study region than others. In this work, we examine the use of spatially referenced Bayesian model averaging and Bayesian model selection via a large-scale simulation study accompanied by a small-scale case study. Our results suggest that BMS performs well when a strong regression signature is found.
Bayesian negative-binomial-family-based multistate Markov model for the evaluation of periodic population-based cancer screening considering incomplete information and measurement errors
Authors: Hsu Chen-Yang , Yen Ming-Fang , Auvinen Anssi , Chiu Yueh-Hsia , Chen Hsiu-Hsi
Published: January 2017

Population-based cancer screening is often asked but hardly addressed by a question: “How many rounds of screening are required before identifying a cancer of interest staying in the pre-clinical detectable phase (PCDP)?” and also a similar one related to the number of screens required for stopping screening for the low risk group. It can be answered by using longitudinal follow-up data on repeated rounds of screen, namely periodic screen, but such kind of data are rather complicated and fraught with intractable statistical properties including correlated multistate outcomes, unobserved and incomplete (censoring or truncation) information, and imperfect measurements. We therefore developed a negative-binomial-family-based discrete-time stochastic process, taking sensitivity and specificity into account, to accommodate these thorny issues. The estimation of parameters was implemented with Bayesian Markov Chain Monte Carlo method. We demonstrated how to apply this proposed negative-binomial-family-based model to the empirical data similar to the Finnish breast cancer screening program.
Passages on Brazilian scientific cinema
Authors: de Almeida Jane , da Silva Cicero Inacio , Suppia Alfredo , Stalbaum Brett
Published: January 2017

The article examines the conditions of production and recognition of scientific cinema in Brazil by comparing three distinct moments and contexts: the first moment takes place in the nineteenth century, and it is related to the contribution of a Brazilian astronomer otherwise little known to Brazilian film scholars, the second addresses Benedito Junqueira Duarte’s voluminous mid-twentieth-century filmography, and the third moment documents recent scientific film experiences within ultra high resolution movies transmitted over photonic networks. Future trajectories for aesthetic concerns and practical issues such as the archiving of ultra high definition cinema are usefully informed by these histories of scientific cinema, even as a current generation of multidisciplinary teams including scientists, filmmakers, computer scientists, and network engineers reinvent, rediscover, and necessarily expand the scientific cinema toward concerns of real time collaboration and teaching.
A Green Health Education Approach to Health Promoting Schools
Authors: Lau Tl , Kwan Sc , Lee A , Chan ECC , Yuen Sk
Published: January 2017

Since the Education Commission of the Hong Kong Special Administrative Region had proposed the educational reform in 2000, there is a new direction for school curriculum development. Lok Wah Catholic Primary School was one of the schools taking the health promoting school approach for educational reform. This paper aims to share information on how the School implemented the “Green Health Education Approach” to create a healthy learning environment for students.
Risk for Health Care–Associated Bloodstream Infections in Pediatric Oncology Patients With Various Malignancies
Authors: Thurman Cara B. , Abbott Maura , Liu Jinfang , Larson Elaine
Published: January 2017

This was a retrospective cohort study to identify the rates, predictors, and outcomes of health care–associated bloodstream infections (HA-BSI) among children with solid tumors, lymphoma, lymphoid leukemia, and myeloid leukemia. The study population included 4500 children ≤18 years old at a pediatric hospital in New York City from 2006 to 2014. A total of 147 HA-BSI cases were identified; using multivariable logistic regression modeling, children with a hematologic diagnosis (lymphoma, lymphoid leukemia, myeloid leukemia) were at greater risk for HA-BSI than those with a solid tumor diagnosis (all P values <.0001). The odds of mortality for patients with HA-BSI were 6.98 (95% confidence interval 3.02-16.10) times that of those without HA-BSI. Although malignancy type was identified as risk factor for HA-BSI, there was no significant difference in overall mortality from HA-BSI by tumor type ( P = .51).
Evaluation of a Hepatitis C Patient Management Program at a University Specialty Pharmacy
Authors: Zaepfel Michelle , Cristofaro Lisa , Trawinski Allison , McCarthy Katharine , Rightmier Elizabeth , Khadem Tina
Published: January 2017

Background: The University of Rochester (UR) Specialty Pharmacy hepatitis C patient management program offers a unique advantage of being integrated within the same health system as the University of Rochester Medical Center (URMC) Gastroenterology and Hepatology division. Objective: The primary purpose of this study was to assess treatment success through the incidence of achieving a sustained virological response (SVR) in patients served by the UR Specialty Pharmacy versus other nonintegrated pharmacies. Methods: This was a single-center retrospective cohort study in adult patients of URMC Gastroenterology and Hepatology prescribed hepatitis C treatment between January 1, 2014, and July 15, 2015. The incidence of SVR, adherence, delay in therapy initiation, early treatment discontinuation, rate of attainment of viral load measurement post–therapy completion, and predictors associated with treatment outcome were assessed. Results: A total of 414 patients were prescribed hepatitis C virus treatment during the study period; 137 did not initiate therapy. The rate of SVR was 93% among patients at the UR Specialty Pharmacy and 89% at nonintegrated pharmacies ( P = 0.357). Adherence to therapy was 100% and 97% at the UR Specialty Pharmacy and nonintegrated pharmacies, respectively ( P = 0.046). Conclusions: The UR Specialty Pharmacy was associated with a 93% SVR rate and significantly greater adherence compared with nonintegrated pharmacies. Larger studies are needed to determine if a significant difference in SVR exists between integrated and nonintegrated pharmacies. This study provides a framework for other institutions to justify developing integrated hepatitis C specialty pharmacy services and evaluate their success.
Comparing the Frequencies of Contraindicated Drug-Drug Interactions Between Differing Antiretroviral Regimens in HIV-Infected Patients
Authors: Jakeman Bernadette , Nasiri Mona , Ruth Lindsey , Morse Caroline , Mahatme Sheran , Patel Nimish
Published: January 2017

Background: HIV-infected patients receiving antiretroviral therapy (ART) are at risk for contraindicated drug-drug interactions (XDDIs). Objective: This study compared the frequency of XDDIs between different types of ART regimens. Methods: A retrospective cohort study was performed among adult HIV-infected patients receiving care at either the Upstate New York Veterans’ Healthcare Administration or the University of New Mexico Truman Health Services between 2000 and 2013. The cohort consisted of patients receiving traditional ART regimens composed of 2 nucleoside reverse transcriptase inhibitors plus either a nonnucleoside reverse transcriptase inhibitor (NNRTI), a protease inhibitor (PI), or an integrase strand transfer inhibitor (INSTI). The primary outcome was the presence of XDDIs. Lexi-Interact was used to define XDDIs. Results: Of the 1329 patients who met inclusion criteria, 45.7%, 34.2%, and 20.1% were receiving an NNRTI-, PI-, or INSTI- based ART regimen, respectively. Among the 128 (9.6%) patients with an XDDI, more than half (53.9%) had an interaction involving ART. The presence of XDDIs was highest for PI-based regimens (16.3%) compared with INSTI- (7.9%) and NNRTI-based (5.4%) regimens; P < 0.001. The variables independently associated with XDDIs were ART regimen type (prevalence ratio [PR] = 1.91; 95% CI = 1.51-2.40, P < 0.001), use of ≥6 non-HIV medications (PR = 5.84; 95% CI = 3.92-8.71, P < 0.001), and age ≥40 years (PR = 1.62; 95% CI = 0.92-2.86, P = 0.10). Conclusion: The probability of XDDIs varies as a function of ART regimen type, advanced age, and use of multiple non-HIV medications.
Effect of Suture Caliber and Number of Core Strands on Repair of Acute Achilles Ruptures: A Biomechanical Study
Authors: Backus Jonathon D. , Marchetti Daniel Cole , Slette Erik L. , Dahl Kimi D. , Turnbull Travis Lee , Clanton Thomas O.
Published: January 2017

Background:

Controversy exists regarding the ideal Achilles rupture treatment; however, operative treatment is considered for athletes and active patients. The ideal repair construct is evolving, and the effect of suture caliber or number of core strands has not been studied.

Methods:

Simulated mid-substance Achilles ruptures were performed in 24 cadavers. Specimens were randomized to three 6-core-strand style repair constructs: (1) 4 No. 2 sutures and two 2-mm tapes (2T); (2) 2 No. 2 sutures and four 2-mm tapes (4T); (3) 12 (double-6-strand) strand repair (12 No. 2-0 sutures [12S]). Repairs were subjected to a cyclic loading protocol representative of postoperative rehabilitation. These data were compared to a previously published standard open repair technique (6-core strands with No. 2 sutures) on 9 specimens tested under the same conditions.6

Results:

No significant elongation differences were observed between the repair groups and the previously published standard repair group in the first 2 stages of the simulated rehabilitation protocol. Both the 2T and 12S repairs survived a significantly greater number of cycles to failure ( P = 0.0005, P = 0.0267, respectively) and had a significantly higher failure load ( P = .0005, P = .0118, respectively) compared to the previously published data. These 2 constructs consistently survived the advanced stages of the simulated rehabilitation protocol. The majority of repairs failed at the knots.

Conclusions:

In this study, the 2T and 12S constructs survived the later stages of our simulated rehabilitation protocol, suggesting that they may be able to accommodate a more aggressive clinical rehabilitation protocol. Substituting suture-tape for 2 core strands or doubling the core strands with a smaller-caliber suture created a biomechanically stronger construct.

Clinical Relevance:

Achilles repair with an added nonabsorbable, high–tensile strength tape allowed for a stronger construct that may allow for a more aggressive, early rehabilitation protocol and earlier return to function.
Outcome-Based Quality Improvement in the Information Age
Authors: Shaughnessy Peter W. , Crisler Kathryn S. , Schlenker Robert E.
Published: January 2017

The outcomes movement in home health care is expanding rapidly, with strong support from both the industry and Medicare. The Federal government has proposed requiring all Medicare-certified agencies to collect data items from the Outcome and Assessment Information Set (OASIS) to form the basis for standardized riskadjusted outcome reporting as part of a systematic outcome-based quality improvement (OBQI) approach. In addition to contributing to improving patient outcomes, OASIS data items, when combined with other assessment information, utilization data, and cost information, can provide home health care agencies with a powerful integrated information set for internal management and strategic planning.
The Role of Home Health Care in Disease Management
Authors: Finkelstein Susan F.
Published: January 2017

Disease management has been considered the key to controlling costs associated with chronic disease while providing patients with the highest quality care throughout the continuum of their disease process. As acquired immunodeficiency syndrome (AIDS) has become a more chronic and less acute disease, care of the AIDS patient requires an interdisciplinary team of health care prof essionals who possess a specialized knowledge base overseeing all health care activities throughout the illness. The difficulty lies in providing adequate data to payers that substantiates the effectiveness of disease management, especially home care's role. Johns Hopkins Home Care Group, Inc {JHHCG} partnered with Johns Hopkins Moore Clinic (Moore Clinic) to define a program that would demonstrate that AIDS patients could be cared for costeffectively under a capitated system while providing the highest possible level of care and the highest quality of life.
The ABCs of Value Creation: Why Nurses Should Be Excited About Cost Accounting
Authors: Jessup Stephen , Storfjell Judith Lloyd
Published: January 2017

Nurses do not have a rich tradition for financial management, even with respect to their own occupational domains. Now there are new tools that make the mastery offinancial management and especially cost management accessible and reasonable. These tools are just in time, because the marketplace is demanding that prof essional nurses be skilled in cost management. The premier tool for achieving relevant, comprehensive cost management is activity-based costing, and nurses will do well to give it serious consideration.
Development Exactions as Growth Management and Local Infrastructure Finance Tools
Authors: Peddle Michael T. , Lewis John L.
Published: January 2017

Development exactions, or impact fees, have exploded in popularity over the past 20 years or so. Impact fees provide an often politically palatable alternative means of financing the infrastructure needs generated by new growth. In addition, impact fees can improve the concurrency between development and the availability of local services, through altering the pace and/or pattern of growth. Nevertheless, some equity concerns remain with respect to the effect impact fees can have on housing affordability for the young and the poor. Despite these concerns, the use of impact fees can be expected to expand in the future, with greater attention to incorporating social exactions into impact fee systems.
State and Local Opportunities in Environmental Policy: Cleaning up the Potomac and Anacostia Rivers
Authors: Abel Troy D. , Hennessey J. Thomas
Published: January 2017

Since 1970, much of state and local activity in environmental protection involved implementing or enforcing national mandates. Recent developments in the United States suggest that some subnational jurisdictions have taken and are taking significant steps to address local environmental problems within, and beyond, national mandates. This suggests that there may be opportunities for state and local governments to address emerging local environmental policy issues. With any opportunity to address emerging local environmental policy issues is the question, Can state and local governments effectively implement new strategies to address emerging environmental issues? This article examines two cases where state and local governments have taken and are taking a prominent role in addressing water quality problems. The cases, although different in time and focus, argue that state and local governments can, and have, provided leadership on such issues. Much of the early effort to push for national environmental mandates was based on the assumption that state and local governments were incapable of addressing the environmental challenges facing them. The two cases presented in this article suggest that more than national mandates are required to overcome local limits. Among the required components for successful state and local government efforts suggested by these cases are experimentation, innovative combinations of public and private organizations at the local and state levels, and flexible federal support for local action.