bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjusted-Dose Enoxaparin for VTE Prevention in the Morbidly Obese
Authors: Parikh Saumeel , Jakeman Bernadette , Walsh Erin , Townsend Kelly , Burnett Allison
Published: July 2015

Background: Venous thromboembolism (VTE) is a major health problem and common cause of morbidity and mortality in hospitalized patients. While trials in both surgical and medically ill patients have demonstrated efficacy and safety of enoxaparin for VTE prophylaxis (VTEP), they failed to adequately represent morbidly obese (body mass index > 40 kg/m2) patients. Objective: To assess the impact of a weight-adjusted enoxaparin dosing algorithm on anti–factor Xa levels, thrombosis, and bleeding in morbidly obese patients. Methods: A retrospective chart review was conducted, which included morbidly obese patients receiving VTEP with adjusted-dose enoxaparin. Patients received enoxaparin 0.5 mg/kg subcutaneously once or twice daily based on VTE risk. An anti–factor Xa level was drawn 3 to 5 hours after 2 or more consecutive doses. The primary outcome was the percentage of patients achieving target anti–factor Xa levels, defined as 0.2 to 0.6 IU/mL. Secondary outcomes included the incidence of symptomatic VTE and major bleeding. Results: Of the 182 charts reviewed, 141 anti–factor Xa levels from 130 patients met inclusion criteria. The study population was 44% male, and the median body mass index was 45.6 kg/m2. A total of 120 anti–factor Xa levels (85.1%) were within the target prophylactic range. Sixteen anti–factor Xa levels (11.3%) were below target range, and 5 (3.4%) were above range. The only significant difference among the 3 groups was baseline renal function ( P = .035). There were 2 thromboembolic events and 1 major bleed in the study population. Conclusion: A weight-based VTEP dosing strategy for morbidly obese patients is effective without an apparent increase in adverse events.
Multicolor Photodetector of a Single Er3+-Doped CdS Nanoribbon
Authors: Dedong Hou , Ying-Kai Liu , Yu De-Peng
Published: July 2015

Er3+-doped CdS nanoribbons (Er-CdS NRs) are synthesized by thermal evaporation and then characterized by field emission scanning electron microscopy (FE-SEM), high-resolution transmission electron microscopy (HRTEM), photoluminescence (PL), and absorption spectra. The Er-CdS NR photodetector is studied systematically, including spectral response, light intensity response, and photoconductance (G) versus temperature (T). It is found that Er-CdS NR has the ability of detecting multicolor light including blue, red, and near-infrared light with higher responsivity (Rλ) and external quantum efficiency (η). The conductance of Er-CdS NR under dark conditions decreases with increasing temperature in the range of 87–237 K, while its conductance increases with increasing temperature in the range of 237–297 K whenTis larger than 237 K. These results indicated that ionized impurities and the intrinsic excitation are responsible for the conductance change of Er-CdS NR in the dark. The superior performance of the Er-CdS NR device offers an avenue to develop highly sensitive multicolor photodetector applications.
Economic impact of homeopathic practice in general medicine in France
Authors: Colas Aurélie , Danno Karine , Tabar Cynthia , Ehreth Jenifer , Duru Gérard
Published: July 2015

Health authorities are constantly searching for new ways to stabilise health expenditures. To explore this issue, we compared the costs generated by different types of medical practice in French general medicine: i.e. conventional (CM-GP), homeopathic (Ho-GP), or mixed (Mx-GP).

Data from a previous cross-sectional study, EPI3 La-Ser, were used. Three types of cost were analysed: (i) consultation cost (ii) prescription cost and (iii) total cost (consultation + prescription). Each was evaluated as: (i) the cost to Social Security (ii) the remaining cost (to the patient and/or supplementary health insurance); and (iii) health expenditure (combination of the two costs).

With regard to Social Security, treatment by Ho-GPs was less costly (42.00 € vs 65.25 € for CM-GPs, 35 % less). Medical prescriptions were two-times more expensive for CM-GPs patients (48.68 € vs 25.62 €). For the supplementary health insurance and/or patient out-of-pocket costs, treatment by CM-GPs was less expensive due to the lower consultation costs (6.19 € vs 11.20 € for Ho-GPs) whereas the prescription cost was comparable between the Ho-GPs and the CM-GPs patients (15.87 € vs 15.24 € respectively) . The health expenditure cost was 20 % less for patients consulting Ho-GPs compared to CM-GPs (68.93 € vs 86.63 €, respectively). The lower cost of medical prescriptions for Ho-GPs patients compared to CM-GPs patients (41.67 € vs 63.72 €) was offset by the higher consultation costs (27.08 € vs 22.68 € respectively). Ho-GPs prescribed fewer psychotropic drugs, antibiotics and non-steroidal anti-inflammatory drugs.

In conclusions management of patients by homeopathic GPs may be less expensive from a global perspective and may represent an important interest to public health.
Order-preservation of solution correspondence for parametric generalized variational inequalities on Banach lattices
Authors: Wang Yuehu , Zhang Congjun
Published: July 2015

In this paper, several order-theoretic fixed point theorems are proved on Banach lattices. As applications of these fixed point theorems, we study the order-preservation of solution correspondence for parametric generalized variational inequalities. Furthermore, the existence of solutions to equilibrium problems is also examined. Our approach is order-theoretic and all results obtained in this paper do not require the considered mappings to be continuous or semi-continuous with respect to any topology equipped on the underlying space.
Strain gradient elasticity with geometric nonlinearities and its computational evaluation
Authors: Abali B Emek , Müller Wolfgang H , Eremeyev Victor A
Published: July 2015

Background

The theory of linear elasticity is insufficient at small length scales, e.g., when dealing with micro-devices. In particular, it cannot predict the “size effect” observed at the micro- and nanometer scales. In order to design at such small scales an improvement of the theory of elasticity is necessary, which is referred to as strain gradient elasticity.

Methods

There are various approaches in literature, especially for small deformations. In order to include geometric nonlinearities we start by discussing the necessary balance equations. Then we present a generic approach for obtaining adequate constitutive equations. By combining balance equations and constitutive relations nonlinear field equations result. We apply a variational formulation to the nonlinear field equations in order to find a weak form, which can be solved numerically by using open-source codes.

Results

By using balances of linear and angular momentum we obtain the so-called stress and couple stress as tensors of rank two and three, respectively. Since dealing with tensors an adequate representation theorem can be applied. We propose for an isotropic material a stress with two and a couple stress with three material parameters. For understanding their impact during deformation the numerical solution procedure is performed. By successfully simulating the size effect known from experiments, we verify the proposed theory and its numerical implementation.

Conclusion

Based on representation theorems a self consistent strain gradient theory is presented, discussed, and implemented into a computational reality.
Bias Correction Methods Explain Much of the Variation Seen in Breast Cancer Risks of BRCA1/2 Mutation Carriers
Authors: Vos Janet R. , Hsu Li , Brohet Richard M. , Mourits Marian J.E. , de Vries Jakob , Malone Kathleen E. , Oosterwijk Jan C. , de Bock Geertruida H.
Published: July 2015

Purpose

Recommendations for treating patients who carry a BRCA1/2 gene are mainly based on cumulative lifetime risks (CLTRs) of breast cancer determined from retrospective cohorts. These risks vary widely (27% to 88%), and it is important to understand why. We analyzed the effects of methods of risk estimation and bias correction and of population factors on CLTRs in this retrospective clinical cohort of BRCA1/2 carriers.

Patients and Methods

The following methods to estimate the breast cancer risk of BRCA1/2 carriers were identified from the literature: Kaplan-Meier, frailty, and modified segregation analyses with bias correction consisting of including or excluding index patients combined with including or excluding first-degree relatives (FDRs) or different conditional likelihoods. These were applied to clinical data of BRCA1/2 families derived from our family cancer clinic for whom a simulation was also performed to evaluate the methods. CLTRs and 95% CIs were estimated and compared with the reference CLTRs.

Results

CLTRs ranged from 35% to 83% for BRCA1 and 41% to 86% for BRCA2 carriers at age 70 years width of 95% CIs: 10% to 35% and 13% to 46%, respectively). Relative bias varied from −38% to +16%. Bias correction with inclusion of index patients and untested FDRs gave the smallest bias: +2% (SD, 2%) in BRCA1 and +0.9% (SD, 3.6%) in BRCA2.

Conclusion

Much of the variation in breast cancer CLTRs in retrospective clinical BRCA1/2 cohorts is due to the bias-correction method, whereas a smaller part is due to population differences. Kaplan-Meier analyses with bias correction that includes index patients and a proportion of untested FDRs provide suitable CLTRs for carriers counseled in the clinic.
Race and Insurance Differences in the Receipt of Adjuvant Chemotherapy Among Patients With Stage III Colon Cancer
Authors: Murphy Caitlin C. , Harlan Linda C. , Warren Joan L. , Geiger Ann M.
Published: July 2015

Purpose

Although the incidence and mortality of colon cancer in the United States has declined over the past two decades, blacks have worse outcomes than whites. Variations in treatment may contribute to mortality differentials.

Methods

Patients diagnosed with stage III colon cancer were randomly sampled from the SEER program from the years 1990, 1991, 1995, 2000, 2005, and 2010. Patients were categorized as non-Hispanic white (n = 835) or black (n = 384). Treatment data were obtained from a review of the medical records, and these data were verified through contact with the original treating physicians. Log-binomial regression models were used to estimate the association between race and receipt of adjuvant chemotherapy. Effect modification by insurance was assessed with use of single referent models.

Results

Receipt of adjuvant chemotherapy among both white and black patients increased from the period encompassing the years 1990 and 1991 (white, 58%; black, 45%) to the year 2005 (white, 72%; black, 71%) and then decreased in the year 2010 (white, 66%; black, 57%). There were marked racial disparities in the time period of 1990 to 1991 and again in 2010, with black patients less likely to receive adjuvant chemotherapy as compared with white patients (risk ratio [RR], .82; 95% CI, .72 to .93). For black patients, receipt of adjuvant chemotherapy did not differ across insurance categories (RR for private insurance, .80; 95% CI, .69 to .93; RR for Medicare, .84; 95% CI, .69 to 1.02; and RR for Medicaid, .84; 95% CI, .69 to 1.02), although a larger proportion had Medicaid in all years of the study as compared with white patients.

Conclusion

The chemotherapy differential narrowed after the time period of 1990 to 1991, but our findings suggest that the disparity reemerged in 2010. Recent decreases in chemotherapy use may be due, in part, to the economic downturn and an increase in Medicaid coverage.
Thyrospheres From Normal or Malignant Thyroid Tissue Have Different Biological, Functional, and Genetic Features
Authors: Gianì Fiorenza , Vella Veronica , Nicolosi Maria Luisa , Fierabracci Alessandra , Lotta Sonia , Malaguarnera Roberta , Belfiore Antonino , Vigneri Riccardo , Frasca Francesco
Published: July 2015

Context:

Cancer stem cells from several human malignancies, including poorly differentiated thyroid carcinoma and thyroid cancer cell lines, have been cultured in vitro as sphere-forming cells. These thyroid cancer stem cells were proven to be able to reproduce the original tumor in a xenograft orthotopic model.

Objectives:

The objective of the study was to characterize papillary thyroid carcinoma (PTC) spheres from well-differentiated thyroid cancer and normal thyroid (NT) spheres obtained from the contralateral thyroid tissue of the same patient.

Design:

Thyrospheres from PTCs and NTs were isolated.

Main Outcome Measures:

Gene expression analysis by real-time PCR, immunofluorescence studies, and fluorescence-activated cell sorter analysis in thyrospheres from PTCs and NTs have been evaluated.

Conclusions:

Compared with NT spheres, PTC spheres are larger, more irregular, and more clonogenic and have a higher rate of symmetric division. Moreover, PTC spheres express higher levels of stem cell markers and lower levels of thyroid-specific genes compared with NT spheres. Under appropriate conditions, NT spheres differentiated into thyrocytes, whereas PTC spheres did not, displaying a defect in the differentiation potential. Immunofluorescence experiments indicated that, in NT spheres, progenitor cells are mainly present in the sphere core, and the sphere periphery contains thyroid precursor cells already committed to differentiation. PTC spheres are not polarized like NT spheres. Unlike cells differentiated from NT spheres, TSH did not significantly stimulate cAMP production in cells differentiated from PTC spheres. A microarray analysis performed in paired samples (NT and PTC spheres from the same patient) indicated that NT and PTC spheres display a gene expression pattern typical of stem/progenitor cells; however, compared with NT spheres, PTC spheres display a unique gene expression pattern that might be involved in PTC progression.
Cezanne regulates E2F1-dependent HIF2α expression
Authors: Moniz Sonia , Bandarra Daniel , Biddlestone John , Campbell Kirsteen J. , Komander David , Bremm Anja , Rocha Sonia
Published: July 2015

Mechanisms regulating protein degradation ensure the correct and timely expression of transcription factors such as hypoxia inducible factor (HIF). Under normal oxygen tensions, HIFα subunits are targeted for proteasomal degradation mainly by vHL-dependent ubiquitination. Deubiquitinases are responsible for reversing this process. While the mechanism and regulation of HIFα ubiquitin-dependent proteasomal degradation has been the object of many studies, little is known about the role of deubiquitinases. Here we show that HIF2α expression is regulated by the deubiquitinase Cezanne in an E2F1-dependent manner. Knockdown of Cezanne down-regulates HIF2α mRNA, protein and activity independently of hypoxia and proteasomal degradation. Mechanistically, HIF2α gene expression is controlled directly by E2F1, and Cezanne regulates the stability of E2F1. Exogenous E2F1 can rescue HIF2α transcript and protein expression, when Cezanne is depleted. Together these data reveal a novel mechanism for the regulation of HIF2α expression, demonstrating that HIF2α promoter is regulated by E2F1 directly and that Cezanne regulates HIF2α expression via control of E2F1 levels. Our results thus suggest that HIF2α is controlled transcriptionally in a cell cycle dependent manner and in response to oncogenic signalling.
Unconventional calmodulin anchoring site within the AB module of Kv7.2 channels
Authors: Gomis-Perez C. , Alaimo A. , Fernandez-Orth J. , Alberdi A. , Aivar-Mateo P. , Bernardo-Seisdedos G. , Malo C. , Areso P. , Felipe A. , Villarroel A.
Published: July 2015

Calmodulin (CaM) binding to the AB module is critical for multiple mechanisms governing the function of Kv7.2 potassium subunits, which are one of the main components of the non-inactivating K+ M-current, a key controller of neuronal excitability. Structural analysis indicates that the CaM N-lobe engages with helix B, whereas the C-lobe anchors to the IQ site within helix A. Here we report the identification of a novel site between helices A and B that assist in CaM binding, whose sequence is reminiscent of the TW helix within the CaM C-lobe anchoring site of SK2 K+ channels. Mutations that disrupt CaM binding within the TW site, helix B, or helix A yield functional channels, whereas no function is observed when the TW site and helix A, or the TW site and helix B are mutated simultaneously. Our data indicate that the TW is dispensable for function, contributes to the stabilization of the CaM/Kv7.2 complex, and becomes essential when docking to either helix A or helix B is perturbed.
Cytoplasmic LSM-1 protein regulates stress responses through the insulin/IGF-1 signaling pathway in Caenorhabditis elegans
Authors: Cornes Eric , Porta-De-La-Riva Montserrat , Aristizábal-Corrales David , Brokate-Llanos Ana María , García-Rodríguez Francisco Javier , Ertl Iris , Díaz Mònica , Fontrodona Laura , Reis Kadri , Johnsen Robert , Baillie David , Muñoz Manuel J. , Sarov Mihail , Dupuy Denis , Cerón Julián
Published: July 2015

Genes coding for members of the Sm-like (LSm) protein family are conserved through evolution from prokaryotes to humans. These proteins have been described as forming homo- or heterocomplexes implicated in a broad range of RNA-related functions. To date, the nuclear LSm2-8 and the cytoplasmic LSm1-7 heteroheptamers are the best characterized complexes in eukaryotes. Through a comprehensive functional study of the LSm family members, we found that lsm-1 and lsm-3 are not essential for C. elegans viability, but their perturbation, by RNAi or mutations, produces defects in development, reproduction, and motility. We further investigated the function of lsm-1, which encodes the distinctive protein of the cytoplasmic complex. RNA-seq analysis of lsm-1 mutants suggests that they have impaired Insulin/IGF-1 signaling (IIS), which is conserved in metazoans and involved in the response to various types of stress through the action of the FOXO transcription factor DAF-16. Further analysis using a DAF-16::GFP reporter indicated that heat stress-induced translocation of DAF-16 to the nuclei is dependent on lsm-1. Consistent with this, we observed that lsm-1 mutants display heightened sensitivity to thermal stress and starvation, while overexpression of lsm-1 has the opposite effect. We also observed that under stress, cytoplasmic LSm proteins aggregate into granules in an LSM-1-dependent manner. Moreover, we found that lsm-1 and lsm-3 are required for other processes regulated by the IIS pathway, such as aging and pathogen resistance.
Connecting the pieces: Using ORCIDs to improve research impact and repositories
Authors: Baessa Mohamed , Lery Thibaut , Grenz Daryl , Vijayakumar J. K.
Published: July 2015

Quantitative data are crucial in the assessment of research impact in the academic world. However, as a young university created in 2009, King Abdullah University of Science and Technology (KAUST) needs to aggregate bibliometrics from researchers coming from diverse origins, not necessarily with the proper affiliations. In this context, the University has launched an institutional repository in September 2012 with the objectives of creating a home for the intellectual outputs of KAUST researchers. Later, the university adopted the first mandated institutional open access policy in the Arab region, effective June 31, 2014. Several projects were then initiated in order to accurately identify the research being done by KAUST authors and bring it into the repository in accordance with the open access policy.

Integration with ORCID has been a key element in this process and the best way to ensure data quality for researcher’s scientific contributions. It included the systematic inclusion and creation, if necessary, of ORCID identifiers in the existing repository system, an institutional membership in ORCID, and the creation of dedicated integration tools. In addition and in cooperation with the Office of Research Evaluation, the Library worked at implementing a Current Research Information System (CRIS) as a standardized common resource to monitor KAUST research outputs. We will present our findings about the CRIS implementation, the ORCID API, the repository statistics as well as our approach in conducting the assessment of research impact in terms of usage by the global research community.
Systematic Review and Meta-analysis of Prevalence of Coronary Artery Disease in Adult Patients with Cardiac Myxomas
Authors: Silva Matheus , Carneiro Matheus , Nunes Júlio , da Silva Antônio , de Sousa Marcos
Published: July 2015

Background: Studies have reported varied prevalence estimates of coronary artery disease (CAD) in cardiac myxoma patients. We performed a systematic review and meta-analysis of observational studies to summarize the point prevalence of CAD in adults with cardiac myxomas.

Methods and Results: Two independent investigators searched MEDLINE and LILACS databases using the terms "Myxoma”, "Coronary Angiography" and "Coronary Disease" from inception through December 2014 for all relevant studies. We included 6 observational studies. Publication bias was evaluated through Egger's test and Trim and Fill method. A pooled estimate of CAD prevalence with corresponding 95% confidence interval (CI) was calculated based on a random-effects model. The pooled CAD prevalence in adult cardiac myxoma patients was 20.7% with low heterogeneity (I2 = 14.86%).

Conclusions: It is a matter of debate if preoperative coronary angiography must be done as a routine procedure. Although coronary disease and angiographically detectable neovascularity can alter surgical management, more studies are needed to evaluate this question.
Case Report: A case report of dry tap during ventriculostomy
Authors: Munakomi Sunil , Bhattarai Binod
Published: July 2015

Pneumocephalus following ventriculoperitoneal (VP) shunt insertion is an exceptionally rare occurrence. We report such an event after attempting ventricular puncture (ventriculostomy) for VP shunt insertion and then discuss the management of the same. Dry tap can lead to multiple attempts for ventriculostomy with the associated added risks of complications, as well as complicating the subsequent management. In addition, there is an increased risk of tension pneumocephalus, seizure and shunt failure due to a blockage by air bubbles. Our patient presented with features of raised intracranial pressure two months following craniotomy and evacuation of traumatic subdural hematoma. External ventricular puncture revealed egress of CSF under pressure. Upon attempting VP shunting for post-traumatic hydrocephalus, we experienced dry tap during ventricular puncture that complicated further management. We placed the proximal shunt in the presumed location of the foramen of Monro of ipsilateral frontal horn of lateral ventricle and did not remove the external ventricular drain. Post-operative CT scan revealed pneumoventriculi as the cause for the dry tap during ventricular puncture. Patient was managed with 100% oxygen. He showed gradual improvement and was later discharged. This case shows that variations in the procedure, including head down positioning, adequate cruciate dural incision prior to cortex puncture, and avoiding excessive egress of CSF can help to prevent such complications.
Iatrogenic Aortic Transection in a Child
Authors: Sherawat Ram , Sharma Anil , Dixit Sunil , Sharma Mohit , Lukaram Sidarth
Published: July 2015

The accepted treatment for aortic injury has been repair of the injury as soon as possible. Delayed repair is not generally fruitful, but in our case report, delay in the repair of a ligated and transected abdominal aorta is safe and has a potential positive impact on survival and vascular stability/integrity. This case seems worth reporting.
Screening for Familial Thoracic Aortic Aneurysms with Aortic Imaging Does Not Detect All Potential Carriers of the Disease
Authors: Hannuksela Matias , Stattin Eva-Lena , Johansson Bengt , Carlberg Bo
Published: July 2015

Background:
About 20% of patients with thoracic aortic aneurysm or dissection (TAAD) have a first-degree relative with a similar disease. The familial form (FTAAD) of the disease is inherited in an autosomal-dominant pattern. Current guidelines for thoracic aortic disease recommend screening of first-degree relatives of TAAD patients. In known familial disease, screening of both first- and second-degree relatives is recommended. However, the outcomes of such a screening program are unknown.

Methods:
We screened all first- and second-degree relatives in seven families with known FTAAD with echocardiography. No underlying gene defect had been detected in these families.

Results:
Of 119 persons investigated, 13 had known thoracic aortic disease. In the remaining 106 cases, we diagnosed 19 additional individuals with a dilated ascending thoracic aorta; for an autosomal-dominant disease, the expected number of individuals in this group would have been 40 (p<0.0001). Further, only one of the 20 first-degree relatives younger than 40 years had a dilated aorta, although the expected number of individuals with a disease-causing mutation would have been 10.

Conclusions:
In most families with TAAD, a diagnosis still relies on measuring the diameter of the thoracic aorta. We show that a substantial number of previously unknown cases of aortic dilatation can be identified by screening family members. It is, however, not possible to consider anyone free of the condition, even if the aortic diameter is normal, especially at a younger age.
Staged Hybrid Endovascular Repair of a Ruptured Abdominal Aortic Aneurysm with Aortocaval Fistula
Authors: Chung Sandra , Reid Chris , Bandyk Dennis , Barleben Andrew , Lane John
Published: July 2015

There is a growing body of literature expanding the indication of endovascular aneurysm repair, from prophylactic treatment of aneurysms to other indications such as ruptured and complicated ruptured abdominal aneurysms. Concomitant aortocaval fistula is rare, and reports of open and endovascular repair exist. We report a unique hybrid approach to a case of a ruptured abdominal aortic aneurysm with aortocaval fistula, repaired primarily via endovascular approach in a hybrid, two-staged fashion. Representative images are presented in addition to a short review of this pathology.
HCAs acquire work experience in a simulated hospital with manikins at the University of Bedfordshire
Authors: Kpodo Charles , Kemp Anthony , Adams Louise , Burden Barbara
Published: July 2015

Healthcare Assistants (HCAs) are important members of the care team. This article looks at how experience in a simulated hospital can enhance their skills. This is achieved in a safe environment where the only consequence of a mistake is learning.

The simulated hospital at the University of Bedfordshire is an immersive and fully authentic learning experience. It encapsulates a range of clinical areas that allows HCAs and others to work shifts caring for a range of interactive patients. Through focusing on the First Step Competence Checklist developed by the RCN, the simulated hospital allows HCAs to develop their confidence and competence in their caring skills, while also becoming familiar with the totality of the healthcare environment.
Fluid therapy in the field for adult horses: what's realistic and what's not?
Authors: McGovern Kate
Published: July 2015

Fluid therapy in adult horses is almost exclusively administered orally or intravenously. Intermittent oral fluid administration is easily performed in the field provided repeated veterinary visits are an option. For continuous fluid therapy (intravenous (IV) or oral (PO)) it is generally easier for the horse to be transported to a veterinary clinic with on-site nursing care for close monitoring and treatment. However this is not always an option for a variety of reasons. If there is stabling available and personnel capable of nursing the horse, there is much that can be done in the field to administer aggressive fluid therapy.
Teaching Evidence Assimilation for Collaborative Health Care (TEACH) 2009-2014:
Building Evidence-Based Capacity Within Health Care Provider Organizations
Authors: Wyer Peter C. , Umscheid Craig A. , Wright Stewart , Silva Suzana A. , Lang Eddy
Published: July 2015

Background: Clinical guidelines, prediction tools, and computerized decision
support (CDS) are underutilized outside of research contexts, and conventional teaching
of evidence-based practice (EBP) skills fails to change practitioner behavior.
Overcoming these challenges requires traversing practice, policy, and implementation
domains. In this article, we describe a program’s conceptual design, the results of
institutional participation, and the program’s evolution. Next steps include integration
of instruction in principles of CDS.Conceptual Model: Teaching Evidence Assimilation for
Collaborative Health Care (TEACH) is a multidisciplinary annual conference series
involving on- and off-site trainings and facilitation within health care provider
organizations (HPOs). Separate conference tracks address clinical policy and guideline
development, implementation science, and foundational EBP skills. The implementation
track uses a model encompassing problem delineation, identifying knowing-doing gaps,
synthesizing evidence to address those gaps, adapting guidelines for local use,
assessing implementation barriers, measuring outcomes, and sustaining evidence use.
Training in CDS principles is an anticipated component within this track. Within
participating organizations, the program engages senior administration, middle
management, and frontline care providers. On-site care improvement projects serve as
vehicles for developing ongoing, sustainable capabilities. TEACH facilitators conduct
on-site workshops to enhance project development, integration of stakeholder engagement
and decision support. Both on- and off-site components emphasize narrative skills and
shared decision-making.Experience: Since 2009, 430 participants attended TEACH
conferences. Delegations from five centers attended an initial series of three
conferences. Improvement projects centered on stroke care, hospital readmissions, and
infection control. Successful implementation efforts were characterized by strong
support of senior administration, involvement of a broad multidisciplinary constituency
within the organization, and on-site facilitation on the part of TEACH faculty.
Involvement of nursing management at the senior faculty level led to increased presence
of nursing and other disciplines at subsequent conferences.Conclusions: A
multidisciplinary and multifaceted approach to on- and off-site training and
facilitation may lead to enhanced use of research to improve the quality of care within
HPOs. Such training may provide valuable contextual grounding for effective use of CDS
within such organizations.
Multivariate Analysis of Combined Fourier Transform Near-Infrared Spectrometry (FT-NIR) and Raman Datasets for Improved Discrimination of Drying Oils
Authors: Carlesi Serena , Ricci Marilena , Cucci Costanza , La Nasa Jacopo , Lofrumento Cristiana , Picollo Marcello , Becucci Maurizio
Published: July 2015

This work explores the application of chemometric techniques to the analysis of lipidic paint binders (i.e., drying oils) by means of Raman and near-infrared spectroscopy. These binders have been widely used by artists throughout history, both individually and in mixtures. We prepared various model samples of the pure binders (linseed, poppy seed, and walnut oils) obtained from different manufacturers. These model samples were left to dry and then characterized by Raman and reflectance near-infrared spectroscopy. Multivariate analysis was performed by applying principal component analysis (PCA) on the first derivative of the corresponding Raman spectra (1800-750 cm−1), near-infrared spectra (6000–3900 cm−1), and their combination to test whether spectral differences could enable samples to be distinguished on the basis of their composition. The vibrational bands we found most useful to discriminate between the different products we studied are the fundamental v(C C) stretching and methylenic stretching and bending combination bands. The results of the multivariate analysis demonstrated the potential of chemometric approaches for characterizing and identifying drying oils, and also for gaining a deeper insight into the aging process. Comparison with high-performance liquid chromatography data was conducted to check the PCA results.
Goldindec: A Novel Algorithm for Raman Spectrum Baseline Correction
Authors: Liu Juntao , Sun Jianyang , Huang Xiuzhen , Li Guojun , Liu Binqiang
Published: July 2015

Raman spectra have been widely used in biology, physics, and chemistry and have become an essential tool for the studies of macromolecules. Nevertheless, the raw Raman signal is often obscured by a broad background curve (or baseline) due to the intrinsic fluorescence of the organic molecules, which leads to unpredictable negative effects in quantitative analysis of Raman spectra. Therefore, it is essential to correct this baseline before analyzing raw Raman spectra. Polynomial fitting has proven to be the most convenient and simplest method and has high accuracy. In polynomial fitting, the cost function used and its parameters are crucial. This article proposes a novel iterative algorithm named Goldindec, freely available for noncommercial use as noted in text, with a new cost function that not only conquers the influence of great peaks but also solves the problem of low correction accuracy when there is a high peak number. Goldindec automatically generates parameters from the raw data rather than by empirical choice, as in previous methods. Comparisons with other algorithms on the benchmark data show that Goldindec has a higher accuracy and computational efficiency, and is hardly affected by great peaks, peak number, and wavenumber.
Photodegradation in Micellar Aqueous Solutions of Erythrosin Esters Derivatives
Authors: Herculano Leandro Silva , Lukasievicz Gustavo Vinicius Bassi , Sehn Elizandra , Caetano Wilker , Pellosi Diogo Silva , Hioka Noboru , Astrath Nelson Guilherme Castelli , Malacarne Luis Carlos
Published: July 2015

Strong light absorption and high levels of singlet oxygen production indicate erythrosin B as a viable candidate as a photosensitizer in photodynamic therapy or photodynamic inactivation of microorganisms. Under light irradiation, erythrosin B undergoes a photobleaching process that can decrease the production of singlet oxygen. In this paper, we use thermal lens spectroscopy to investigate photobleaching in micellar solutions of erythrosin ester derivatives: methyl, butyl, and decyl esters in low concentrations of non-ionic micellar aqueous solutions. Using a previously developed thermal lens model, it was possible to determine the photobleaching rate and fluorescence quantum efficiency for dye-micelle solutions. The results suggest that photobleaching is related to the intensity of the dye-micelle interaction and demonstrate that the thermal lens technique can be used as a sensitive tool for quantitative measurement of photochemical properties in very diluted solutions.
γ-Glutamyl Transferase Is Associated with Mortality Outcomes Independently of Fatty Liver
Authors: Sung Ki-Chul , Ryu Seungho , Kim Bum-Soo , Cheong Eun Sun , Park Dong-il , Kim Byung I k , Kwon Min-Jung , Wild Sarah H , Byrne Christopher D
Published: July 2015

BACKGROUND

High serum enzyme activity levels of γ-glutamyl transferase (GGT) are associated with increased risk of mortality, but whether this is mediated by fatty liver, as a common cause of high GGT levels, is uncertain. Our aim was to test whether GGT levels are associated with all-cause, cancer, and cardiovascular (CVD) mortality, independently of fatty liver.

METHODS

In an occupational cohort (n = 278 419), causes of death (International Statistical Classification of Diseases and Related Health Problems, 10th revision) were recorded over 7 years. Liver function tests and liver fat [measured by ultrasonographic standard criteria or fatty liver index (FLI)] were assessed at baseline. We used Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% CIs of all-cause, cancer, and CVD mortality for GGT quartiles (with lowest GGT quartile as reference).

RESULTS

There were 136, 167, 265, and 342 deaths across increasing GGT quartiles. After adjusting for liver fat (by ultrasound diagnosis) in the fully adjusted model, all-cause and cancer mortality were increased in the highest GGT quartile [HR 1.50 (95% CI 1.15–1.96) and 1.57 (1.05–2.35), respectively]. For CVD mortality, the hazard was attenuated: HR 1.35 (95% CI 0.72–2.56). After adjusting for FLI in the fully adjusted model, HRs for all-cause, cancer, and CVD mortality were 1.46 (0.72–2.56), 2.03 (1.02–4.03), and 1.16 (0.41,3.24), respectively.

CONCLUSIONS

There were similar hazards for all-cause and cancer mortality and attenuated hazards for CVD mortality for people in the highest GGT quartile, adjusting for fatty liver assessed by either ultrasound or FLI.
Judging authorship in divided cultural work: Broadcast series formats in mid-century idea law
Authors: Heuman Josh
Published: July 2015

In the mid-twentieth century, US courts and legal commentators confronted increasingly prominent problems of idea protection. While not unique in raising such problems, the maturing radio and television broadcasting industry intensified and complicated them – in the unruliness of its idea markets, and the distinctive relation between idea and expression implied in broadcast series formats. Idea law offers a revealing scene of discourse about mid-century broadcast writing – a scene for making sense and value from often ambiguous and ambivalent writing practices. In particular, problems of idea protection and copyright’s idea–expression dichotomy draw out tensions across divisions of writing labour. This article explores how mid-century idea law struggled to account for the economic and cultural value of ideas, in arguments that compose particular but provocative discourses about broadcast authorship. It also points towards some of the broader interest of those arguments – as a particular case study in the fragmentation of authorship, and as a provocative but neglected antecedent for contemporary concerns like amateur participation, recombinatory creativity and even the ‘creative economy’.
Jimmy McGovern through an ethical lens
Authors: Maras Steven
Published: July 2015

Discussion of Jimmy McGovern’s screenwriting tends to focus on the dimensions of politics, class, gender and religion in his work. While none of these concepts should be divorced from a discussion of ethics, what is missing is analysis of McGovern’s writing that ventures to consider it a kind of ‘ethical philosophy’ in its own right. While McGovern has a lot to say about religion and morality, I want to suggest that McGovern is more than a critic of religion, and that his work can be seen in relation to secular ethics. This research proposes an ethical analysis of McGovern’s screenwriting. It suggests that through actions and situations the narrative engages in ethical ‘work’. I explore McGovern’s work in terms of some key ethical concepts such as how we treat others, form judgements, how we balance loyalties and roles and the interrelationship between deception and decency. The focus is on scenes or episodes from the series Cracker (ITV, 1993–2007), Hearts and Minds (Channel 4, 1995) and Accused (BBC, 2010–2012).
Interseções da Pedagogia Universitária com a Biblioteca: Da Pesquisa de Informação à Escrita Académica
Authors: Sanches Tatiana
Published: July 2015

Substituindo o ensino baseado na transmissão e avaliação de conhecimentos, o desenvolvimento de competências tem vindo a ser reconhecido como uma nova expressão da pedagogia do ensino superior, sobretudo desde a implementação do processo de Bolonha. Este artigo pretende observar como a pedagogia universitária atual se encontra na relação com as bibliotecas académicas, nomeadamente na interceção de intenções, práticas e recursos mobilizados para a indução e desenvolvimento de competências informacionais nos alunos. As bibliotecas universitárias, disponibilizando recursos informativos essenciais para a prossecução de objetivos académicos, podem contribuir para a pedagogia universitária assim entendida, através de estratégias que consolidam a eficácia da aprendizagem, no âmbito do movimento leitura‑escrita. O objetivo deste artigo é pois o de refletir sobre a escrita académica e os fatores que a atravessam e a constituem, à luz destes conceitos.
Diálogos Gráficos: A Didática do Ateliê de Arquitetura
Authors: Ortega Artur Renato , Weihermann Silvana , Baibich Tânia Maria
Published: July 2015

Este artigo discute uma didática específica no campo da Pedagogia Universitária, no ensino de graduação do curso de Arquitetura e Urbanismo. Entende o diálogo gráfico como um método de produção e construção do conhecimento, e o desenho como elemento constituinte e determinante do processo, na relação professor‑aluno, no ateliê de projeto. Considera o diálogo gráfico como uma forma de inter‑relacionamento, encontro e responsabilidade, envolvendo sentidos e significados próprios da atividade interativa, da reflexão de idéias e das experiências dos sujeitos. Destaca a importância da prática docente, cujo conhecimento específico necessita da interlocução com os conhecimentos pedagógicos. Reconhece o aluno como participante ativo no processo, tornando‑se um desenhador co‑responsável pela construção do conhecimento, sujeito epistêmico da reflexão‑na‑ação. Acredita que o diálogo gráfico, no estudo da epistemologia da prática, pode constituir o estímulo, sob novas formas de diálogo, em outras áreas do conhecimento, desenhando uma educação de melhor qualidade.
Da Construção à Validação de um Referencial de Competências para uma Licenciatura em Enfermagem
Authors: Mendonça Constança , Huet Isabel , Alves Mariana Gaio
Published: July 2015

Fator determinante para o aumento da empregabilidade dos jovens diplomados, a adoção de estratégias capazes de favorecer uma formação orientada para o desenvolvimento das competências mais valorizadas pelo mercado de trabalho tem vindo a ser uma preocupação transversal às várias Instituições de Ensino Superior (IES) do espaço Europeu. Este artigo descreve o processo de construção e validação de um referencial de competências genéricas essenciais ao adequado desempenho profissional dos licenciados em enfermagem por uma escola superior de saúde nacional. Composto por 59 competências genéricas, o referencial resulta de um trabalho de revisão de literatura, de análise documental e de um estudo de natureza empírica que envolveu a realização de entrevistas (n=3), um inquérito por questionário a docentes (n=12) e diplomados (n=7) da referida Escola e a empregadores (n=3) da profissão, tendo sido por fim sujeito à validação por um perito da área em questão.
Adaptabilidade de Carreira e Autoeficácia na Transição para o Trabalho: O papel da Empregabilidade Percebida – Estudo com Estudantes do Ensino Superior
Authors: Gamboa Vítor , Paixão Olímpio , Palma Ana Isabel
Published: July 2015

A crescente complexidade do mercado de trabalho coloca novos desafios aos processos de inserção profissional dos diplomados do ensino superior, sobretudo num período em que se assiste a uma acentuada retração nas ofertas de emprego disponíveis. No âmbito dos fatores individuais, a adaptabilidade de carreira surge como um processo capaz de facilitar a transição para o mundo do trabalho, sobretudo no que diz respeito aos níveis de confiançacom que os estudantes encaram a resolução das tarefas relativas à procura de emprego e à inserção profissional. Por outro lado, as instituições de ensino superior são cada vez mais chamadas a promover a empregabilidade dos seus alunos, embora ainda não seja suficientemente conhecida a relação entre a empregabilidade percebida e o investimento nas atividades de transição para o mundo do trabalho.Por conseguinte, este estudo teve como principal objetivo analisar o impacto da adaptabilidade de carreira na autoeficácia para a transição para o trabalho, considerando o efeito da empregabilidade percebida, numa amostra de 261 estudantes universitários (80.5% mulheres) com uma média de idades de 22.37 anos (DP = 6.77 anos). Os resultados encontrados sugerem que a adaptabilidade prediz a autoeficácia na transição para o trabalho, sobretudo através das dimensões confiança e curiosidade, e que a relação entre adaptabilidade e autoeficácia é parcialmente mediada pela empregabilidade percebida. Por último, são discutidas as implicações dos resultados para a intervenção vocacional, no âmbito do apoio aos processos de transição para o mundo do trabalho, junto dos estudantes do ensino superior.
El juego como adicción social: crónica de una patología anunciada
Authors: Blanco Miguel Pilar , González Vélez Mercedes , Martos Sánchez Cinta
Published: July 2015

Antecedentes. Desde que en 1977 se legalizaron los juegos de azar en España, éstos han terminado por convertirse en un grave problema psicosocial. Existen conductas de juego que, aunque en sus inicios si le son atribuibles todos los caracteres positivos de esta práctica, con el tiempo terminan perdiendo su identidad, transformándose en un acto totalmente alienante. Objetivos. Conocer la dimensión social del juego determinando cómo está presente en las primeras experiencias con el juego, así como el significado que ésta adquiere, una vez el jugador se ve inmerso en este proceso adictivo. Método. Metodológicamente se ha optado por la perspectiva cualitativa, ya que ésta se muestra mucho más útil a nuestros intereses de estudio. Como base principal, hemos recurrido a la historia de vida, ya que ésta nos permitía conocer la verdadera magnitud que encarna esta problemática desde el punto de vista de los afectados. Resultados. De manera general hemos descubierto como la dimensión social está muy presente en el juego, ya que hemos valorado cómo ésta termina delimitando tanto el proceso de la adicción, como la percepción que se tiene del propio problema. Conclusiones. Destacar que el inicio de esta práctica viene argumentado bajo la idea de que al formar parte de la cotidianidad, el juego se cuela (a edades muy tempranas) en la vida de un ludópata en forma de entretenimiento social. Pero al final, lo que empieza siendo una actividad divertida acaba convirtiéndose en una verdadera problemática social.
Diversidad familiar: una experiencia docente en el grado de trabajo social
Authors: Lorence Lara Bárbara , Pérez Padilla Javier , Menéndez Álvarez-Dardet Susana , Rodríguez Pascual Iván
Published: July 2015

El estudio del cambio familiar, la diversidad familiar y sus implicaciones desde el ámbito asistencial y de los Servicios Sociales es una parte fundamental de la formación del Trabajador Social. Este trabajo propone una experiencia vinculada a la innovación docente que apuesta por el enfoque interdisciplinar y transversal en la formación del trabajador social y tiene por objetivos: (1) describir una actividad formativa investigadora sobre diversidad familiar desarrollada en el Grado de Trabajo Social; y (2) presentar los resultados de investigación de la actividad formativa realizada. Un total de 216 estudiantes participaron recopilando información de 258 personas con edades comprendidas entre los 22 y los 85 años con ayuda de un cuestionario que evalúa aspectos relacionados con el concepto de familia y la aceptación hacia los nuevos modelos familiares. Los resultados de esta actividad mostraron que las personas entrevistadas por el alumnado tomaron en cuenta para definir el concepto de familia criterios funcionales y relacionales. Además, se observó que el grado de aceptación hacia las diversas formas familiares era elevado, aunque se encontraron diferencias en función del perfil del entrevistado. Esta actividad favorece la toma de conciencia por parte del alumnado de la importancia de la investigación social en la práctica profesional así como la existencia de prejuicios ante determinadas situaciones familiares no convencionales.