bluuebunny/crossref_metadata_2025 huggingface dataset:
American Exceptionalism at the Crossroads: Three Responses
Authors: Cha Taesuh
Published: May 2015

Unlike the immediate post-Cold War era of triumphalism and neoliberal prosperity, the last decade has witnessed the erosion of the ‘unipolar moment’ after the major setbacks of the Iraq and Afghanistan Wars and the financial crisis of 2008. In this context, reconsidering the idea of American exceptional identity is not simply a scholastic exercise, but an urgent practical problem concerning the direction of US leadership in the world. This article presents a review of three representative discourses on American exceptionalism at a critical juncture. First, the neoconservatives Charles W. Dunn et al. and Robert Kagan attempt to reconfirm the virtue of the ‘American Creed’ and reassure the American people that the US will lead the world as it has done. Second, Tony Smith represents a dominant liberal consensus in US academia. Following Louis Hartz, Smith emphasizes not triumphalism, but an historical irony of American liberal identity. Finally, Anatol Lieven, resonating with the ‘multiple traditions’ approach against the liberal consensus school, suggests a more complex understanding of American exceptionalism by analyzing the existence of the ‘antithesis’ or the Jacksonian tradition.
Multi‐Cereal Beverage Fermented by Lactobacillus Helveticus and Saccharomyces Cerevisiae
Authors: Ai Jing , Li Ai‐Li , Su Ben‐Xian , Meng Xiang‐Chen
Published: May 2015

A novel multi‐cereal‐based fermented beverage with suitable aroma, flavor, and pH fermented by lactic acid bacteria and Saccharomyces cerevisiae was developed. Twenty‐seven lactobacilli strains were screened for acid production (pH and titratable acidity) in a mixture of malt, rice, and maize substrates. It was found that Lactobacillus helveticus KLDS1.9204 had the greatest acid production among 27 lactobacilli tested. The fermentation performance of L. helveticus KLDS1.9204 was also assayed and the fermentation parameters were optimized using Plackett–Burman design and steepest ascent method. L. helveticus KLDS1.9204 showed good proteolytic capability, however, the strain could not utilize starch. The optimum substrate consisted of 50% malt (25 g/100 mL), 25% rice (20 g/100 mL), and 25% maize (30 g/100 mL). The inoculum was 5% with a ratio of S. cerevisiae to L. helveticus KLDS1.9204 of 2.5:1. The optimum temperature was 37 °C and the time was 22 h. Lastly, the quality of the multi‐cereal‐based fermented beverage was evaluated. This beverage was light yellow, transparent, and it tasted well with a pleasant acid and a unique flavor of cereals. The beverage was rich in free amino acids and organic acids. The pH and titratable acidity of the beverage were 3.5 and 29.86 °T, respectively. The soluble solids content of the beverage was 6.5 °Brix, and the alcohol content was 0.67%.
Donkey Milk for Manufacture of Novel Functional Fermented Beverages
Authors: Perna Annamaria , Intaglietta Immacolata , Simonetti Amalia , Gambacorta Emilio
Published: May 2015

The aim of this work was to investigate on the functional features of a donkey milk probiotic berevage as a novel food. Particularly, it was to study the decrease of lactose content and the antioxidant activity of standard yogurt (YC) and probiotic yogurt (YP; Lactobacillus acidophilus, Lactobacillus casei) from donkey milk during the storage up to 30 d at 4 ºC. The evolution of lactose content using enzymatic‐spectrophotometric kits was analyzed. Antioxidant activity of yogurt was measured using 2,2’‐azino‐bis‐3‐ethylbenzothiazoline‐6‐sulfonic acid (ABTS), ferric reducing antioxidant power (FRAP), and thiol assays. Parallel consumer sensory studies were carried out as consumer test in order to gain information about the impact of these novel fermented beverages on sensory perceptions. The statistical analysis has shown significant effect of studied factors. The results showed that the lactose content gradually decreased during storage in both yogurts, reaching values of 2.36% and 2.10% in YC and YP, respectively, at 30 d (P < 0.05). During storage of both yogurt types, the antioxidant activity increased, but YP showed a higher antioxidant activity than YC. The results suggest that the antioxidant activity of yogurt samples was affected by cultures of lactic acid bacteria (LAB). We conclude that the fermented donkey milk could be configured as health and nutraceutical food, which aims to meet nutritional requirements of certain consumers groups with lactose or cow milk protein intolerance.
The role of financial analysts in stock market efficiency with respect to annual earnings and its cash and accrual components
Authors: Hollie Dana , Shane Philip B. , Zhao Qiuhong
Published: May 2015

This study examines biases in stock prices and financial analysts' earnings forecasts. These biases take the form of systematic overweighting or underweighting of the persistence characteristics of cash versus accrual earnings components. Our evidence suggests that stock prices tend to overweight and financial analysts tend to underweight these persistence characteristics. Furthermore, we find that analysts' underweighting attenuates stock price overweighting. However, we find little evidence that the overweighting in stock prices attenuates analyst underweighting. This study brings a new perspective to the literature regarding the disciplining role of financial analysts in capital markets.
The functional and clinical relevance of childhood trauma‐related admixture of affective, anxious and psychosis symptoms
Authors: van Nierop M. , Bak M. , de Graaf R. , ten Have M. , van Dorsselaer S. ,   Genetic Risk and Outcome of Psychosis (GROUP) Investigators, van Winkel R.
Published: May 2015

Objective

Previous work has shown that across different patient samples, patients with childhood trauma are more likely to have co‐occurrence of affective, anxious and psychosis symptoms than non‐traumatized patients. However, the clinical relevance of trauma‐related admixture remains to be established.

Method

We examined patients with mood disorder (NEMESIS‐2; n = 1260), anxiety disorder (NEMESIS‐2; n = 896) or psychotic disorder (GROUP; n = 532) in terms of symptom profiles, quality of life (QOL) and social functioning.

Results

Results showed that mood disorder patients with both trauma and co‐occurrence of affective, anxious and psychosis symptoms had a lower QOL (B‐12.6, 95% CI −17.7 to −7.5, P < 0.001), more help‐seeking behaviour [odds ratio (OR) 2.5, 95% CI 1.1–5.7, P = 0.031] and higher prevalence of substance use disorders (OR 7.8, 95% CI 1.1–58.0, P = 0.044), compared with patients without trauma history and symptom admixture (Trauma−/CL−). Similar results were found in patients with an anxiety disorder. Traumatized patients with a psychotic disorder and admixture showed lower QOL (B‐0.6, 95% CI −0.9 to −0.4, P < 0.001), higher prevalence of drug disorders (OR 2.2, 95% CI 1.2–3.9, P = 0.008) and lower global assessment of functioning (B‐12.8, 95% CI −17.1 to −8.5, P < 0.001) than Trauma−/CL− patients.

Conclusion

Stratification according to childhood trauma exposure thus identifies a phenotype characterized by admixture of affective, anxiety and psychotic symptoms that, when combined, has clinical relevance. Identification of functionally meaningful aetiological subgroups may aid clinical practice.
Validation of long‐term survival prediction for scheduled abdominal aortic aneurysm repair with an independent calculator using only pre‐operative variables
Authors: Carlisle J. B. , Danjoux G. , Kerr K. , Snowden C. , Swart M.
Published: May 2015

We observed survival after scheduled repair of abdominal aortic aneurysm in 1096 patients for a median (IQR [range]) of 3.0 (1.5–5.8 [0–15]) years: 943 patients had complete data, 250 of whom died. We compared discrimination and calibration of an external model with the Kaplan–Meier model generated from the study data. Integrated Brier misclassification scores for both models at 1–5 postoperative years were 0.04, 0.08, 0.11, 0.13 and 0.16, respectively. Harrel's concordance index at 1–5 postoperative years was 0.73, 0.71, 0.68, 0.67 and 0.66, respectively. Groups with median 5‐year predicted mortality of 40% (n = 251), 18% (n = 414) and 8% (n = 164) had lower observed mortality than 114 patients with 70% predicted mortality, hazard ratio (95% CI): 0.58 (0.37–0.76), p = 0.0031; 0.30 (0.19–0.48), p = 1.7 × 10−12 and 0.19 (0.13–0.27), p = 1.3 × 10−10, respectively, test for trend p = 5.6 × 10−15. Survival predicted by the external calculator was similar to the Kaplan–Meier estimate.
Mixture regression models for closed population capture–recapture data
Authors: Tounkara Fodé , Rivest Louis‐Paul
Published: May 2015

In capture–recapture studies, the use of individual covariates has been recommended to get stable population estimates. However, some residual heterogeneity might still exist and ignoring such heterogeneity could lead to underestimating the population size (N). In this work, we explore two new models with capture probabilities depending on both covariates and unobserved random effects, to estimate the size of a population. Inference techniques including Horvitz–Thompson estimate and confidence intervals for the population size, are derived. The selection of a particular model is carried out using the Akaike information criterion (AIC). First, we extend the random effect model of Darroch et al. (1993, Journal of American Statistical Association 88, 1137–1148) to handle unit level covariates and discuss its limitations. The second approach is a generalization of the traditional zero‐truncated binomial model that includes a random effect to account for an unobserved heterogeneity. This approach provides useful tools for inference about N, since key quantities such as moments, likelihood functions and estimates of N and their standard errors have closed form expressions. Several models for the unobserved heterogeneity are available and the marginal capture probability is expressed using the Logit and the complementary Log–Log link functions. The sensitivity of the inference to the specification of a model is also investigated through simulations. A numerical example is presented. We compare the performance of the proposed estimator with that obtained under model of Huggins (1989 Biometrika 76, 130–140).
Transitioning to stepfamily life: the influence of closeness with biological parents and stepparents on children's stress
Authors: Jensen Todd M. , Shafer Kevin , Holmes Erin K.
Published: May 2015

Family transitions, such as stepfamily formation, can be a source of stress for adults and children. Yet, the stepfamily literature lacks a focus on factors that influence child stress levels while transitioning to stepfamily life. Using a social support perspective, the purpose of this study was to assess the independent and additive influence of closeness with three common parental figures on retrospective reports of stress experienced by children during stepfamily formation. A sample of 1139 emerging adults from a retrospective, US‐based national quota sample, the Stepfamily Experiences Project, was analysed. Results indicated that parental relationships have independent, not combined, effects on stress. More specifically, we found that greater closeness with resident stepparents and resident biological parents was associated with less stress in children, whereas greater closeness with non‐resident biological parents was associated with slightly greater levels of stress. These findings reflect (i) the primacy of residential relationships in children's stress reduction; (ii) the benefit of parental relationships to children as sources of social support during stressful family transitions; and (iii) the potential for children to experience stressful loyalty binds during stepfamily formation. Implications for social work practice, limitations and future directions for research are discussed.
Federally Qualified Health Centers’ Capacity and Readiness for Research Collaborations: Implications for Clinical‐Academic‐Community Partnerships
Authors: Brandt Heather M. , Young Vicki M. , Campbell Dayna A. , Choi Seul Ki , Seel Jessica S. , Friedman Daniela B.
Published: May 2015

Background:

Federally qualified health centers (FQHCs) provide a health care safety net for underserved populations and contribute unique expertise to research that could further enhance quality of patient care. The purpose of this research was to assess interest in, readiness to, and capacity for conducting research in FQHCs in South Carolina (SC).

Methods:

A Web‐based survey was administered to 20 FQHCs across SC. Fourteen representatives of FQHCs completed the 39‐item survey that assessed research experience and interest, partnerships and funding, barriers and benefits to research participation, training and technical assistance needs, and research capacity.

Results:

FQHCs are interested in conducting research. FQHCs reported that health center leadership, organizational benefit, active engagement of staff, and clear roles for partners were important factors for successful partnerships. Inequity of budget and resources were the greatest challenges encountered. Improved patient outcomes, additional resources for the center, reduction in disparities, and academic partnerships were considered benefits for participation. FQHCs were interested in training and technical assistance opportunities for research funding and best practices for the use of research to inform programs and services.

Conclusions:

FQHCs are willing to collaborate on research. For successful research partnerships, collaborators should understand FQHCs’ challenges and barriers to participation.
Therapeutic Basis of Clinical Pain Modulation
Authors: Kirkpatrick Daniel R. , McEntire Dan M. , Hambsch Zakary J. , Kerfeld Mitchell J. , Smith Tyler A. , Reisbig Mark D. , Youngblood Charles F. , Agrawal Devendra K.
Published: May 2015

Pain is a hallmark of almost all bodily ailments and can be modulated by agents, including analgesics and anesthetics that suppress pain signals in the central nervous system. Defects in the modulatory systems, including the endogenous pain‐inhibitory pathways, are a major factor in the initiation and chronicity of pain. Thus, pain modulation is particularly applicable to the practice of medicine. This review summarizes the existing literature on pain modulation. Here, we critically reviewed the literature from PubMed on pain modulation published primarily within the past 5 years in high impact journals. Specifically, we have discussed important anatomical landmarks of pain modulation and outlined the endogenous networks and underlying mechanisms of clinically relevant pain modulatory methods. The Gate Control Theory is briefly presented with discussion on the capacity of pain modulation to cause both hyper‐ and hypoalgesia. An emphasis has been given to highlight key areas in pain research that, because of unanswered questions or therapeutic potential, merit additional scientific scrutiny. The information presented in this paper would be helpful in developing novel therapies, metrics, and interventions for improved patient management.
How universal are reserve design rules? A test using butterflies and their life history traits
Authors: Bartonova Alena , Benes Jiri , Fric Zdenek Faltynek , Chobot Karel , Konvicka Martin
Published: May 2015

We used butterfly species lists available for a set of 125 Czech Republic National Nature Reserves and Monuments, the highest small‐sized conservation category in the country encompassing practically all biotope types existing in central Europe, to test the validity of generally agreed “reserve design rules” using multivariate ordination analyses. Further, we used ordination analysis of butterfly life history traits to seek for biological mechanisms responsible for butterfly community responses to essentially geometric reserves characteristics. Reserve area, relative perimeter, within reserve habitat heterogeneity, and surrounding landscape compositional and configurational heterogeneity all affected the composition of butterfly assemblages after controlling for effects of geographical position and prevailing biotope type. Species inclining towards large reserves displayed low mobility and high local population density, probably because they require large habitat areas to maintain self‐sustaining populations; such species tend to have restricted distribution in the country and threatened status. Reserves with relatively long boundaries hosted species with high mobility, broad trophic range and long adult period; faunas of such reserves contain high proportions of widespread generalists. Species with narrow trophic ranges inclined towards reserves containing diverse habitats, probably due to requirements for high floristic diversity. Species with short adult flight, low generations number and overwintering in early stages inclined towards reserves situated amidst diverse landscapes, perhaps because such species require finely‐grained mosaics for metapopulation dynamics. Commonly agreed reserve design rules thus hold for Central European butterflies, but different design characteristics are important for individual species, depending on their life histories.
Abundance of common species, not species richness, drives delivery of a real‐world ecosystem service
Authors: Winfree Rachael , W. Fox Jeremy , Williams Neal M. , Reilly James R. , Cariveau Daniel P.
Published: May 2015

Biodiversity‐ecosystem functioning experiments have established that species richness and composition are both important determinants of ecosystem function in an experimental context. Determining whether this result holds for real‐world ecosystem services has remained elusive, however, largely due to the lack of analytical methods appropriate for large‐scale, associational data. Here, we use a novel analytical approach, the Price equation, to partition the contribution to ecosystem services made by species richness, composition and abundance in four large‐scale data sets on crop pollination by native bees. We found that abundance fluctuations of dominant species drove ecosystem service delivery, whereas richness changes were relatively unimportant because they primarily involved rare species that contributed little to function. Thus, the mechanism behind our results was the skewed species‐abundance distribution. Our finding that a few common species, not species richness, drive ecosystem service delivery could have broad generality given the ubiquity of skewed species‐abundance distributions in nature.
RYR1‐related myopathies: a wide spectrum of phenotypes throughout life
Authors: Snoeck M. , van Engelen B. G. M. , Küsters B. , Lammens M. , Meijer R. , Molenaar J. P. F. , Raaphorst J. , Verschuuren‐Bemelmans C. C. , Straathof C. S. M. , Sie L. T. L. , de Coo I. F. , van der Pol W. L. , de Visser M. , Scheffer H. , Treves S. , Jungbluth H. , Voermans N. C. , Kamsteeg E.‐J.
Published: May 2015

Background and purpose

Although several recent studies have implicated RYR1 mutations as a common cause of various myopathies and the malignant hyperthermia susceptibility (MHS) trait, many of these studies have been limited to certain age groups, confined geographical regions or specific conditions. The aim of the present study was to investigate the full spectrum of RYR1‐related disorders throughout life and to use this knowledge to increase vigilance concerning malignant hyperthermia.

Methods

A retrospective cohort study was performed on the clinical, genetic and histopathological features of all paediatric and adult patients in whom an RYR1 mutation was detected in a national referral centre for both malignant hyperthermia and inherited myopathies (2008–2012).

Results

The cohort of 77 non‐related patients (detection rate 28%) included both congenital myopathies with permanent weakness and ‘induced’ myopathies such as MHS and non‐anaesthesia‐related episodes of rhabdomyolysis or hyperCKemia, manifested throughout life and triggered by various stimuli. Sixty‐one different mutations were detected, of which 24 were novel. Some mutations are present in both dominant (MHS) and recessive modes (congenital myopathy) of inheritance, even within families. Histopathological features included an equally wide spectrum, ranging from only subtle abnormalities to prominent cores.

Conclusions

This broad range of RYR1‐related disorders often presents to the general paediatric and adult neurologist. Its recognition is essential for genetic counselling and improving patients' safety during anaesthesia. Future research should focus on in vitro testing by the in vitro contracture test and functional characterization of the large number of RYR1 variants whose precise effects currently remain uncertain.
Dose‐dependent suppression of human photoparoxysmal response with the competitive AMPA/kainate receptor antagonist BGG492: Clear PK/PD relationship
Authors: Kasteleijn‐Nolst Trenité Dorotheé , Brandt Christian , Mayer Thomas , Rosenow Felix , Schmidt Bernd , Steinhoff Bernhard J. , Gardin Anne , Imbert Georges , Johns Donald , Sagkriotis Alexandros , Kucher Klaus
Published: May 2015

Objective

Examine the efficacy of a competitive α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid (AMPA)/kainate glutamate receptor antagonist, selurampanel (BGG492), in the human photostimulation model.

Methods

Patients with epilepsy and a generalized epileptiform electroencephalography response to intermittent photic stimulation (photoparoxysmal response or PPR; diagnosed ≥6 months prior to initial study dosing) were enrolled in a phase II, multicenter, single‐blind, within‐subject, placebo‐controlled proof‐of‐concept (PoC) study. PPR was used as a biomarker to assess the efficacy and safety of BGG492 in three cohorts (cohorts I–III received BGG492 50, 100, and 15 mg, respectively). Primary endpoints were to evaluate the efficacy of single oral BGG492 doses in abolishment of PPR or a relevant reduction of the standardized photoparoxysmal response (SPR), and to evaluate time of onset and duration of response. Secondary endpoints were to evaluate maximal SPR reduction, determine the pharmacokinetic profile of BGG492, explore the pharmacokinetic/pharmacodynamic relationship, and evaluate the safety and tolerability of BGG492.

Results

Ten patients were enrolled, with three participating twice, that is, in two cohorts (n = 13). Treatment with BGG492 resulted in abolition of PPR in seven of 13 patients in a dose‐dependent manner: three, three, and one patient in cohorts I–III, respectively. All patients showed treatment‐related reductions of SPR range of at least three steps in at least one eye condition (eye closure, eyes closed, or eyes open). Generally, onset of the suppressive effect appeared to be within 1–2 h post‐BGG492 dose and continued in three patients at the 50‐ and 100‐mg doses for 29–33 h. Most common adverse events across the BGG492‐treated groups were headache and nasopharyngitis (three patients each), followed by dizziness, fatigue, and diarrhea (two patients each).

Significance

The dose‐dependent positive effect of BGG492 on the PPR and SPR in patients with photosensitive epilepsy in this proof‐of‐concept study supports further investigation of AMPA receptor antagonists in large‐scale phase III trials.
The centrodistal joint interosseous ligament region in the tarsus of the horse: Normal appearance, abnormalities and possible association with other tarsal lesions, including osteoarthritis
Authors: Skelly‐Smith E. , Ireland J. , Dyson S.
Published: May 2015

Reasons for performing study

There have been no detailed descriptions of the radiological appearance of the centrodistal joint interosseous ligament region in horses with and without distal tarsal joint pain.

Objectives

To describe the normal radiological appearance of the centrodistal joint interosseous ligament region; to determine the prevalence of mineralisation or ossification of the interosseous ligament; and to describe radiological abnormalities surrounding the interosseous space and concurrent radiological abnormalities in the tarsus. The association between interosseous ligament region abnormalities and radiological evidence of osteoarthritis of the centrodistal joint was assessed.

Study design

Retrospective study.

Methods

Case records and radiographs of all horses/ponies (n = 700) that underwent radiographic examination of one/both tarsi over 7 years were reviewed. Case history, height, bodyweight and cause(s) of lameness were recorded. Factors associated with abnormalities of the centrodistal interosseous ligament region were assessed using logistic regression analysis.

Results

The normal interosseous space was an oval or circular‐shaped radiolucent area bordered proximally and distally by a rim of bone of uniform opacity and thickness, which varied in thickness among animals. Abnormalities of the interosseous ligament region of the lame(r) limb were evident in 121/700 (17.3%; 95% confidence interval 14.5–20.1%) animals. Increasing bodyweight was associated with decreased odds of interosseous ligament region abnormalities. Forty‐seven animals (6.7%; 95% confidence interval 4.9–8.6%) had radiological evidence of osteoarthritis of the centrodistal joint. A greater proportion of animals with interosseous ligament region abnormalities (36.4%) had radiological evidence of osteoarthritis of the centrodistal joint, compared to those with normal interosseous ligament regions (0.5%; P<0.001). Interosseous ligament region abnormalities and osteoarthritis of the centrodistal joint were not necessarily associated with distal tarsal joint pain.

Conclusions

There is an association between abnormalities of the centrodistal joint interosseous ligament region and osteoarthritis. Radiological evidence of abnormalities of the centrodistal intertarsal ligament region alone or in association with osteoarthritis may be present asymptomatically.
Towards the search of detection in speech‐relevant features for stress
Authors: Rodellar‐Biarge Victoria , Palacios‐Alonso Daniel , Nieto‐Lluis Victor , Gómez‐Vilda Pedro
Published: May 2015

Most of the parameters proposed for the characterization of the emotion in speech concentrate their attention on phonetic and prosodic features. Our approach goes beyond trying to relate the biometrical signature of voice with a possible neural activity that might generate alterations in voice production. A total of 68, acoustical, glottal and biomechanical parameters were extracted from neutral and stressed speeches. The importance of the parameters was evaluated using t‐test, entropy, Receiver Operator Characteristic (ROC) and Wilcoxon methods and support vector machines algorithms for classification. The emotion under study is the stress produced when a speaker has to defend an idea opposite to his/her thoughts or feelings, and this stress is compared to self‐consistent speech. The results show tremor in the vocal folds to be the most relevant feature.
Why have global shark and ray landings declined: improved management or overfishing?
Authors: Davidson Lindsay N K , Krawchuk Meg A , Dulvy Nicholas K
Published: May 2015

Global chondrichthyan (shark, ray, skate and chimaera) landings, reported to the United Nations Food and Agriculture Organization (FAO), peaked in 2003 and in the decade since have declined by almost 20%. In the FAO's 2012 ‘State of the World's Fisheries and Aquaculture’ report, the authors ‘hoped’ the reductions in landings were partially due to management implementation rather than population decline. Here, we tested their hypothesis. Post‐peak chondrichthyan landings trajectories from 126 countries were modelled against seven indirect and direct fishing pressure measures and eleven measures of fisheries management performance, while accounting for ecosystem attributes. We found the recent improvement in international or national fisheries management was not yet strong enough to account for the recent decline in chondrichthyan landings. Instead, the landings declines were more closely related to fishing pressure and ecosystem attribute measures. Countries with the greatest declines had high human coastal population sizes or high shark and ray meat exports such as Pakistan, Sri Lanka and Thailand. While important progress had been made, country‐level fisheries management measures did not yet have the strength or coverage to halt overfishing and avert population declines of chondrichthyans. Increased implementation of legally binding operational fisheries management and species‐specific reporting is urgently required to avoid declines and ensure fisheries sustainability and food security.
A Family Physician's Journey From the Reservation to the White House
Authors: Helminiak Clare
Published: May 2015

There are many challenges faced by family physicians who choose to practice medicine in rural areas with underserved populations. A decision to practice medicine as a physician in the United States Public Health Service, serving American Indians and Alaska Natives, became a fascinating and rewarding journey across the nation and abroad, to the highest levels of government.
Assessing Curriculum Designed to Foster Students’ Entrepreneurial Knowledge and Small Business Skills from a Global Perspective
Authors: Hodges Nancy , Watchravesringkan Kittichai , Yurchisin Jennifer , Hegland Jane , Karpova Elena , Marcketti Sara , Yan Ruoh‐Nan (Terry)
Published: May 2015

The purpose of this paper is to report on outcomes of a 3‐year collaborative project that addresses the need for future professionals with entrepreneurial knowledge and small business skills. The multiphase project involved partnerships developed between textile and apparel faculty at four U.S. universities and faculty in similar programs at universities in Thailand, India, Russia, and South Africa. Based on primary and secondary research conducted with small apparel businesses and entrepreneurs in the five countries during Phase I of the project, eight modules were created for integration into existing textile and apparel courses during Phase II. Phase III focused on the assessment of students’ knowledge and skills following delivery of the modules. This paper reports on the results of module assessment via a repeated measures experiment using pre‐ and postsurveys that included closed‐ and open‐ended questions. Analysis of the quantitative and qualitative data indicated that modules helped to increase students’ entrepreneurial knowledge and small business skills from a global perspective.
Geographic patterns in functional diversity deficits are linked to glacial‐interglacial climate stability and accessibility
Authors: Ordonez Alejandro , Svenning Jens‐Christian
Published: May 2015

Aim

Late Quaternary climate change can be an important determinant of large‐scale species richness patterns, but it is currently unknown if its effects also extend to functional diversity (FD) and thus potentially ecosystem functioning. This study assessed whether deficits in contemporary FD, relative to expectations based on contemporary environmental regions and species richness, were associated with glacial‐interglacial climate stability and accessibility from glacial refugia.

Location

Europe

Methods

Atlas data on distributions of plant species and functional trait information were used to estimate functional richness (FRich) and dispersion (FDisp) for ∼50 × 50 km grid cells across Europe. Maximum expected FD was calculated using both quantile regression and a null‐model approach, with species richness and contemporary environmental regions as constraints. Then, the proportion of the potential FD present in a grid cell – the realized‐to‐potential FD ratio (R/P) – was estimated. Spatial autoregressive modeling with information‐theoretic multi‐model selection were used to estimate the explanatory importance and predictive ability of glacial‐interglacial climate instability and accessibility to recolonization from glacial refugia for R/P ratios.

Results

Minimum and median R/P ratios were 58% and 74% for FRich and 82% and 93% for FDisp, showing that realized FD is often lower than expectations from species richness and contemporary environmental regions. FD deficits were significantly associated with glacial‐interglacial Quaternary climate change (FRich‐R2: 0.52; FDisp‐R2: 0.41), even after accounting for contemporary climate. FRich and FDisp R/P ratios were the highest in areas with low climatic instability and close to the major glacial temperate refuge regions.

Main Conclusions

Realized macro‐scale FD patterns appear to be in moderate disequilibrium with contemporary richness and environmental regions. Importantly, small R/P ratios are significantly associated with both historical and contemporary climate. These findings suggest that future climate change may elicit long‐term functional disequilibria and thus also have long‐term consequences for ecosystem functioning.
Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia
Authors: Barakat LA , Juthani‐Mehta M , Allore H , Trentalange M , Tate J , Rimland D , Pisani M , Akgün KM , Goetz MB , Butt AA , Rodriguez‐Barradas M , Duggal M , Crothers K , Justice AC , Quagliarello VJ
Published: May 2015

Objectives

Outcomes of community–acquired pneumonia (CAP) among HIV‐infected older adults are unclear.

Methods

Associations between HIV infection and three CAP outcomes (30‐day mortality, readmission within 30 days post‐discharge, and hospital length of stay [LOS]) were examined in the Veterans Aging Cohort Study (VACS) of male Veterans, age ≥ 50 years, hospitalized for CAP from 10/1/2002 through 08/31/2010. Associations between the VACS Index and CAP outcomes were assessed in multivariable models.

Results

Among 117 557 Veterans (36 922 HIV‐infected and 80 635 uninfected), 1203 met our eligibility criteria. The 30‐day mortality rate was 5.3%, the mean LOS was 7.3 days, and 13.2% were readmitted within 30 days of discharge. In unadjusted analyses, there were no significant differences between HIV‐infected and uninfected participants regarding the three CAP outcomes (P > 0.2). A higher VACS Index was associated with increased 30‐day mortality, readmission, and LOS in both HIV‐infected and uninfected groups. Generic organ system components of the VACS Index were associated with adverse CAP outcomes; HIV‐specific components were not. Among HIV‐infected participants, those not on antiretroviral therapy (ART) had a higher 30‐day mortality (HR 2.94 [95% CI 1.51, 5.72]; P = 0.002) and a longer LOS (slope 2.69 days [95% CI 0.65, 4.73]; P = 0.008), after accounting for VACS Index. Readmission was not associated with ART use (OR 1.12 [95% CI 0.62, 2.00] P = 0.714).

Conclusion

Among HIV‐infected and uninfected older adults hospitalized for CAP, organ system components of the VACS Index were associated with adverse CAP outcomes. Among HIV‐infected individuals, ART was associated with decreased 30‐day mortality and LOS.
Pharmacokinetics of tenofovir during pregnancy and postpartum
Authors: Best BM , Burchett S , Li H , Stek A , Hu C , Wang J , Hawkins E , Byroads M , Watts DH , Smith E , Fletcher CV , Capparelli EV , Mirochnick M ,   International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) P1026s Team
Published: May 2015

Objectives

Tenofovir disoproxil fumarate (TDF) is increasingly used in the highly active antiretroviral therapy (HAART) regimens of pregnant women, but limited data exist on the pregnancy pharmacokinetics of chronically dosed TDF. This study described tenofovir pharmacokinetics during pregnancy and postpartum.

Methods

International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) P1026s is a prospective, nonblinded pharmacokinetic study of HIV‐infected pregnant women that included a cohort receiving 300 mg TDF once daily. Steady‐state 24‐hour pharmacokinetic profiles were measured at the second and third trimesters, postpartum, and in maternal and umbilical cord samples collected at delivery. Tenofovir was measured by liquid chromatography−mass spectrometry (LC‐MS). The target area under the concentration versus time curve from time 0 to 24 h post dose (AUC) was ≥ 1.99 μg h/mL (nonpregnant historical control 10th percentile).

Results

The median tenofovir AUC was decreased during the second (1.9 μg h/mL) and third (2.4 μg h/mL; P = 0.005) trimesters versus postpartum (3.0 μg h/mL). Tenofovir AUC exceeded the target for two of four women (50%) in the second trimester, 27 of 37 women [73%; 95% confidence interval (CI) 56%, 86%] in the third trimester, and 27 of 32 women (84%; 95% CI 67%, 95%) postpartum (P > 0.05). Median second/third‐trimester troughs were lower (39/54 ng/mL) than postpartum (61 ng/mL). Median third‐trimester weight was greater for subjects below the target AUC versus those above the target (97.9 versus 74.2 kg, respectively; P = 0.006). The median ratio of cord blood to maternal concentrations was 0.88. No infants were HIV infected.

Conclusions

This study found lower tenofovir AUC and troughs during pregnancy. Transplacental passage with chronic TDF use during pregnancy was high. Standard TDF doses appear to be appropriate for most HIV‐infected pregnant women but therapeutic drug monitoring with dose adjustment should be considered in pregnant women with high weight (> 90 kg) or inadequate HIV RNA response.
Major differences in organization and availability of health care and medicines for HIV/TB coinfected patients across Europe
Authors: Mansfeld M , Skrahina A , Shepherd L , Schultze A , Panteleev AM , Miller RF , Miro JM , Zeltina I , Tetradov S , Furrer H , Kirk O , Grzeszczuk A , Bolokadze N , Matteelli A , Post FA , Lundgren JD , Mocroft A , Efsen AMW , Podlekareva DN ,   TB:HIV study group in EuroCoord
Published: May 2015

Objectives

The aim of the study was to investigate the organization and delivery of HIV and tuberculosis (TB) health care and to analyse potential differences between treatment centres in Eastern (EE) and Western Europe (WE).

Methods

Thirty‐eight European HIV and TB treatment centres participating in the TB:HIV study within EuroCoord completed a survey on health care management for coinfected patients in 2013 (EE: 17 respondents; WE:21; 76% of all TB:HIV centres). Descriptive statistics were obtained for regional comparisons. The reported data on health care strategies were compared with actual clinical practice at patient level via data derived from the TB:HIV study.

Results

Respondent centres in EE comprised: Belarus (n = 3), Estonia (1), Georgia (1), Latvia (1), Lithuania (1), Poland (4), Romania (1), the Russian Federation (4) and Ukraine (1); those in WE comprised: Belgium (1), Denmark (1), France (1), Italy (7), Spain (2), Switzerland (1) and UK (8). Compared with WE, treatment of HIV and TB in EE are less often located at the same site (47% in EE versus 100% in WE; P < 0.001) and less often provided by the same doctors (41% versus 90%, respectively; P = 0.002), whereas regular screening of HIV‐infected patients for TB (80% versus 40%, respectively; P = 0.037) and directly observed treatment (88% versus 20%, respectively; P < 0.001) were more common in EE. The reported availability of rifabutin and second‐ and third‐line anti‐TB drugs was lower, and opioid substitution therapy (OST) was available at fewer centres in EE compared with WE (53% versus 100%, respectively; P < 0.001).

Conclusions

Major differences exist between EE and WE in relation to the organization and delivery of health care for HIV/TB‐coinfected patients and the availability of anti‐TB drugs and OST. Significant discrepancies between reported and actual clinical practices were found in EE.
Generalized Gini polarization indices for an ordinal dimension of human well‐being
Authors: Chakravarty Satya R. , Maharaj Bhargav
Published: May 2015

This paper suggests a family of generalized Gini indices of polarization that can be applied to dimensions of human well‐being with ordinal significance such as self‐assessed health data and literacy. We investigate several properties of this general index and characterize it axiomatically. We also look at a quasi‐ordering induced by the generalized Gini indices for ranking alternative distributions of an ordinally measurable dimension. Implications of some of the axioms are also investigated.
Factors influencing mental health nurses' attitudes towards people with mental illness
Authors: Hsiao Chiu‐Yueh , Lu Huei‐Lan , Tsai Yun‐Fang
Published: May 2015

This study aimed to investigate the factors influencing mental health nurses' attitudes towards people with mental illness. A descriptive correlation design was used. A sample of 180 Taiwanese mental health nurses was recruited from mental health‐care settings. Data were analyzed with descriptive statistics, Pearson's product‐moment correlation, Student's t‐test, one‐way anova, and a hierarchical multiple regression analysis. Negative attitudes were found among mental health nurses, especially with respect to individuals with substance abuse compared with those with schizophrenia and major depression. Mental health nurses who were older, had more clinical experiences in mental health care, and demonstrated greater empathy expressed more positive attitudes towards people with mental illness. Mental health nurses working at acute psychiatric units demonstrated more negative attitudes towards mental illness compared with those working in psychiatric rehabilitation units and outpatient clinics or community psychiatric rehabilitation centres. Particularly, length of mental health nursing practice and empathy significantly accounted for mental health nurses' attitudes towards mental illness. Understanding nurses' attitudes and their correlates towards people with mental illness is critical to deliver effective mental health nursing care.
Validation of daily increments and a marine‐entry check in the otoliths of sockeye salmon Oncorhynchus nerka post‐smolts
Authors: Freshwater C. , Trudel M. , Beacham T. D. , Neville C.‐E. , Tucker S. , Juanes F.
Published: May 2015

Juvenile sockeye salmon Oncorhynchus nerka that were reared and smolted in laboratory conditions were found to produce otolith daily increments, as well as a consistently visible marine‐entry check formed during their transition to salt water. Field‐collected O. nerka post‐smolts of an equivalent age also displayed visible checks; however, microchemistry estimates of marine‐entry date using Sr:Ca ratios differed from visual estimates by c. 9 days suggesting that microstructural and microchemical processes occur on different time scales.
Assessing quick wins to protect critical urban infrastructure from floods: a case study in Bangkok, Thailand
Authors: Zevenbergen C. , van Herk S. , Escarameia M. , Gersonius B. , Serre D. , Walliman N. , de Bruijn K.M. , de Graaf R.
Published: May 2015

This paper focuses on the vulnerability and protection of critical urban infrastructure from flooding. It presents a pragmatic and rapid screening procedure, referred to as a ‘Quick Scan methodology’. The purpose of the Quick Scan is to provide guidance for network operators and decision makers on identifying and rating those critical infrastructure networks and hot spot buildings that may be at risk from flooding, and assessing where intervention will be most feasible and cost beneficial – the so‐called quick wins. This approach will support the development of effective interventions to alleviate direct and indirect flood impacts. Workshops and interviews with stakeholders and experts have been organised in pilot cities – Bangkok, Paris and Dordrecht – to test and further develop the Quick Scan and to obtain feedback and lessons learned for the protection of critical urban infrastructure. This paper presents the findings of the stakeholder workshops carried out in the city of Bangkok.
A multi‐scale framework for flood risk analysis at spatially distributed locations
Authors: Speight L.J. , Hall J.W. , Kilsby C.G.
Published: May 2015

This paper presents a multi‐scale framework for flood risk analysis from fluvial and coastal sources at broad (including national) scales. The framework combines an extreme value spatial model of fluvial and coastal flood hazards using the Heffernan and Tawn conditional dependence model, with a new Markov approach to representing the spatial variability of flood defences. The nested multi‐scale structure enables spatial and temporal dependence at a national scale to be combined with detailed local analysis of inundation and damage. By explicitly considering each stage of the process, potential uncertainties in the risk estimate are identified and can be communicated to end users to encourage informed decision making. The framework is demonstrated by application to an insurance portfolio of static caravan sites across the UK worth over £2bn. In the case study, the largest uncertainties are shown to derive from the spatial structure used in the statistical model and limited data on flood defences and receptor vulnerability.
Effective Strategies to Spread Redesigning Care Processes Among Healthcare Teams
Authors: Lavoie‐Tremblay Mélanie , O'Connor Patricia , Lavigne Geneviève L. , Briand Anaïck , Biron Alain , Baillargeon Sophie , MacGibbon Brenda , Ringer Justin , Cyr Guylaine
Published: May 2015

Purpose

The purpose of this study was to describe how spread strategies facilitate the successful implementation of the Transforming Care at the Bedside (TCAB) program and their impact on healthcare workers and patients in a major Canadian healthcare organization.

Design

This study used a qualitative and descriptive design with focus groups and individual interviews held in May 2014. Participants included managers and healthcare providers from eight TCAB units in a university health center in Quebec, Canada. The sample was composed of 43 individuals.

Methods

The data were analyzed using NVivo according to the method proposed by Miles and Huberman.

Findings

The first two themes that emerged from the analysis are related to context (organizational transition requiring many changes) and spread strategies for the TCAB program (senior management support, release time and facilitation, rotation of team members, learning from previous TCAB teams, and engaging patients). The last theme that emerged from the analysis is the impact on healthcare professionals (providing front‐line staff and managers with the training they need to make changes, team leadership, and increasing receptivity to hearing patients’ and families’ needs and requests).

Conclusions

This study describes the perspectives of managers and team members to provide a better understanding of how spread strategies can facilitate the successful implementation of the TCAB program in a Canadian healthcare organization.

Clinical Relevance

Spread strategies facilitate the implementation of changes to improve the quality and safety of care provided to patients.