bluuebunny/crossref_metadata_2025 huggingface dataset:
Micro-particle manipulation by single beam acoustic tweezers based on hydrothermal PZT thick film
Authors: Zhu Benpeng , Xu Jiong , Li Ying , Wang Tian , Xiong Ke , Lee Changyang , Yang Xiaofei , Shiiba Michihisa , Takeuchi Shinichi , Zhou Qifa , Shung K. Kirk
Published: March 2016

Single-beam acoustic tweezers (SBAT), used in laboratory-on-a-chip (LOC) device has promising implications for an individual micro-particle contactless manipulation. In this study, a freestanding hydrothermal PZT thick film with excellent piezoelectric property (d33 = 270pC/N and kt = 0.51) was employed for SBAT applications and a press-focusing technology was introduced. The obtained SBAT, acting at an operational frequency of 50MHz, a low f-number (∼0.9), demonstrated the capability to trap and manipulate a micro-particle sized 10μm in the distilled water. These results suggest that such a device has great potential as a manipulator for a wide range of biomedical and chemical science applications.
Superior unipolar resistive switching in stacked ZrOx/ZrO2/ZrOx structure
Authors: Lin Cheng-Li , Lin Tse-Yu
Published: March 2016

This study investigates the performance of unipolar-switched ZrO2 RRAM, using an oxygen-deficient and amorphous ZrOx capping in a sandwich stack Al/ZrOx/ZrO2/ZrOx/Al structure. Superior high and low resistance switching and a resistance ratio (HRS/LRS) greater than 10 showed excellent dc endurance of 7378 switching cycles and 3.8 × 104 cycles in pulse switching measurements. Recovery behavior, observed in the I-V curve for the SET process (or HRS), led to HRS fluctuations and instability. A new resistance switching model for the stacked ZrO2 RRAM is proposed in this paper. In this model, oxygen-deficient and amorphous ZrOx film, capped on polycrystalline ZrO2 film, plays a key role and acts as an oxygen reservoir in making the oxygen ions redox easily for the SET process and in facilitating re-oxidation for the RESET process, resulting in excellent endurance. By improving the stability and recovery phenomena, engineering parameters of the current control may play a critical role during switching, and they can be correlated to the film’s thickness and the oxygen content of the amorphous ZrOx film.
Charging mechanism of electret film made of potassium-ion-doped SiO2
Authors: Hashiguchi G. , Nakasone D. , Sugiyama T. , Ataka M. , Toshiyoshi H.
Published: March 2016

A charging model is proposed for an electret film made of potassium-ion-doped SiO2 that can be formed between the two opposing micro-electrodes of a micro-electrostatic actuator, separated by a microscopic gap. On the basis of experimental evidence that charging only occurs in the positively biased electrode during the charging process and that the charging polarity is negative, we assumed that the cause of the electret charges is negatively charged oxygen ions residing in the SiO2 film, which arise as a consequence of potassium ion depletion. This assumption was supported by SIMS (Secondary Ion Mass Spectroscopy) analyses that indicate the presence of a depletion region of potassium ions near the interface of the silicon and the oxide film on the positively biased electrode. Calculations of the charged potential using Poisson’s equation with the spatially distributed negative charges in the depletion region showed good agreement with the measured surface potential. It appears that our charging model can consistently elucidate potassium ion electret technology.
Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings
Authors: Brophy Lisa M. , Roper Catherine E. , Hamilton Bridget E. , Tellez Juan José , McSherry Bernadette M.
Published: March 2016

Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings. Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings. Results All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes. Conclusions Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices. What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies. What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature. What are the implications for practitioners? This paper will give healthcare services a deeper insight into how to reduce or eliminate restraint or seclusion from the perspective of those with lived experience.
An assessment of immune and stress responsiveness in Holstein-Friesian cows selected for high and low feed conversion efficiency
Authors: Aleri J. W. , Hine B. C. , Pyman M. F. , Mansell P. D. , Wales W. J. , Mallard B. , Fisher A. D.
Published: March 2016

The objective of this study was to assess the immune and stress responsiveness of cows identified as extremely high and low feed conversion efficiency phenotypes. The study utilised 16 Holstein-Friesian cows in their third to fourth lactation, and identified as having either extremely high (n = 8) or extremely low (n = 8) feed conversion efficiency. A commercial vaccine was used to induce measurable antibody- and cell-mediated adaptive immune responses and assess general immune responsiveness. Stress responsiveness was assessed by measuring changes in plasma cortisol concentrations in response to yarding and handling. No significant differences in antibody- or cell-mediated immune responsiveness were observed between the extreme high and low feed conversion efficiency phenotypes (P = 0.343 and 0.546, respectively). However, results suggested that plasma cortisol concentrations trended higher in the low feed conversion efficiency phenotype cows than their high feed conversion efficiency counterparts (P = 0.079) 48 h post-yarding and handling. A significant negative correlation was observed between antibody-mediated immune responsiveness and stress responsiveness (r = –0.44, P = 0.043) but not with cell-mediated immune responsiveness (r = 0.135, P = 0.309). This study provides preliminary evidence that cows selected for feed conversion efficiency may have improved stress-coping abilities and immune responsiveness.
Cell-type–restricted anti-cytokine therapy: TNF inhibition from one pathogenic source
Authors: Efimov Grigory A. , Kruglov Andrei A. , Khlopchatnikova Zoya V. , Rozov Fedor N. , Mokhonov Vladislav V. , Rose-John Stefan , Scheller Jürgen , Gordon Siamon , Stacey Martin , Drutskaya Marina S. , Tillib Sergei V. , Nedospasov Sergei A.
Published: March 2016

Significance

Anti-cytokine therapy has revolutionized the treatment of autoimmune diseases. However, recent data suggest that cytokines, in particular TNF, produced by various cell types may play distinct and sometimes opposite roles in the inflammatory responses. In certain autoimmune diseases TNF produced by monocytes and macrophages plays a pathogenic role, whereas TNF produced by T cells may be protective. In addition, T-cell–derived TNF is indispensable for resistance to infections, such as tuberculosis. To demonstrate that cell-type–restricted anti-cytokine therapy may be advantageous, we generated bispecific antibodies that neutralize TNF produced by myeloid cells. Cell-targeted inhibition of TNF is more effective than systemic TNF ablation in protecting mice from TNF-mediated hepatotoxicity. This provides a rationale for the development of novel anti-TNF agents.
Novel family of terpene synthases evolved from
trans
-isoprenyl diphosphate synthases in a flea beetle
Authors: Beran Franziska , Rahfeld Peter , Luck Katrin , Nagel Raimund , Vogel Heiko , Wielsch Natalie , Irmisch Sandra , Ramasamy Srinivasan , Gershenzon Jonathan , Heckel David G. , Köllner Tobias G.
Published: March 2016

Significance

Whether insect sesquiterpenes are synthesized de novo, derived from plant precursors, or produced by symbionts is often unknown. We identified an evolutionarily novel terpene synthase gene family in the striped flea beetle, a notorious pest of
Brassica
crops in North America and Asia, and one of these genes was shown to be directly involved in the biosynthesis of the male-specific sesquiterpene aggregation pheromone. Phylogenetic and gene structure analyses indicate that an expansion of the
trans
-isoprenyl diphosphate synthase gene family in the ancestor of the subfamily Galerucinae enabled functional diversification toward this terpene synthase gene family. These insights into how flea beetles synthesize their aggregation pheromones may lead to new approaches for pest management.
Blocking rapid ice crystal growth through nonbasal plane adsorption of antifreeze proteins
Authors: Olijve Luuk L. C. , Meister Konrad , DeVries Arthur L. , Duman John G. , Guo Shuaiqi , Bakker Huib J. , Voets Ilja K.
Published: March 2016

Significance

Controlling ice crystal growth is a grand scientific challenge with major technological ramifications. Some cold-adapted organisms such as fish and arthropods are protected against ice growth by producing antifreeze proteins (AFPs). These AFPs adsorb onto embryonic ice crystals, thereby inhibiting their growth. On a macroscopic level, this is evidenced by ice recrystallization inhibition (IRI) and thermal hysteresis (TH) activity. Our research demonstrates the absence of a clear correlation between TH and IRI activities, and underlines the importance of the extent of supercooling and annealing time on the efficacy of AFPs in blocking ice growth. We emphasize that successful application of AFPs and synthetic analogues in innovative strategies for cryoprotection, cryopreservation, and antiicing technologies requires optimization tailored toward the specific purpose.
Constrained language
Authors: Kruger Haidee , van Rooy Bertus
Published: March 2016

Translation and non-native indigenised varieties of English are produced in contexts where heightened constraints operate on them. Recurrent features of translated language include explicitation, normalisation or conventionalisation, simplification, and homogenisation. Similar features in non-native indigenised varieties of English include hyperclarity, anti-deletion, regularisation, simplification and register shifts. This article adopts a multidimensional approach to analyse a translation corpus and a parallel set of texts from ICE East Africa, with ICE Great Britain as control corpus. The aim is to determine whether translated and non-native indigenised varieties of English resemble each other due to shared constraints related to bilingual language production. The results demonstrate three shared sets of features between translated and non-native indigenised varieties of English: increased formality, explicitation of information through elaboration and specification, and features resulting from processing strain. The most important difference is that translated English uses more complex, compressed syntactic structures for elaboration while the non-native indigenised variety relies more on clausal structures.
Grammatical gender in Romanian-French bilinguals
Authors: Manolescu Amelia , Jarema Gonia
Published: March 2016

We explored the way grammatical gender is represented in the bilingual mental lexicon in order to determine whether the grammatical gender of the first language (L1) affects the production of nouns in the second language (L2). Furthermore, we explored the representation of the Romanian “neuter” gender to see if it is distinct from the masculine and feminine. Romanian-French bilinguals were tested using a picture-naming task in L2 (Experiments 1 and 2) and a translation task from L1 to L2 (Experiment 3). Participants had to use either a bare noun (Condition 1) or a noun phrase (Condition 2). Responses were faster on gender congruent than on gender incongruent stimuli in both conditions, and neuter was found to be distinct from masculine and feminine. These results suggest that grammatical gender information is available at the level of lexical representation and that the bilingual lexicon is structured in a manner that allows information from the lexical level of both languages to interact. They also point to a tripartite gender system in Romanian.
Segmented binaural presentation as a means to examine lexical substructure
Authors: Teddiman Laura , Libben Gary
Published: March 2016

We present an auditory presentation technique called segmented binaural presentation. The technique builds on the dichotic listening paradigm (Shankweiler & Studdert-Kennedy, 1967; Studdert-Kennedy & Shankweiler, 1970) and segmented lexical presentation (Libben, 2003; Betram, Kuperman, Baayen, & Hyönä, 2011). The technique allows the first part of a word to be presented to one ear and the second part of the word to be presented to the other ear. The experimenter may thus manipulate whether a stimulus is segmented in this binaural manner and, if it is segmented, the location of the binaural segmentation within the word. We discuss how the technique may be implemented on the Macintosh platform, using PsyScope and freely available software for audio file creation. We also report on a test implementation of the technique using suffixed and compound English words in a lexical decision task. Results suggest that the technique differentiates between segmentation that occurs within and between compound constituents.
William Henry Fox Talbot (1800–1877) and the “Interim Period” in the history of English etymology
Authors: Liberman Anatoly
Published: March 2016

Henry Fox Talbot, the father of photography, was a polymath, and among his many publications we find works on mathematics, physics, astronomy, chemistry, archeology, ancient history, mythology, and Assyrian cuneiform inscriptions. He was also at home in botany. In 1847 he brought out a thick book titled English Etymologies. His archive at Cambridge allows one to trace the preparatory stages for this work. Talbot’s book is instructive as an example of how some talented, brilliantly educated, and industrious Englishmen in the forties of the nineteenth century went about discovering the origin of Hebrew, Greek, Latin, and English words. Talbot was aware of sound correspondences but did not feel bound by them. A list of his sources gives a good idea of the state of the art in England. Talbot’s etymologies are interesting only from this point of view. They should be studied as we study the efforts of much earlier researchers, that is, as part of the history of science.
Do People Have Insight into their Face Recognition Abilities?
Authors: Palermo Romina , Rossion Bruno , Rhodes Gillian , Laguesse Renaud , Tez Tolga , Hall Bronwyn , Albonico Andrea , Malaspina Manuela , Daini Roberta , Irons Jessica , Al-Janabi Shahd , Taylor Libby C. , Rivolta Davide , McKone Elinor
Published: March 2016

Diagnosis of developmental or congenital prosopagnosia (CP) involves self-report of everyday face recognition difficulties, which are corroborated with poor performance on behavioural tests. This approach requires accurate self-evaluation. We examine the extent to which typical adults have insight into their face recognition abilities across four experiments involving nearly 300 participants. The experiments used five tests of face recognition ability: two that tap into the ability to learn and recognize previously unfamiliar faces [the Cambridge Face Memory Test, CFMT; Duchaine, B., & Nakayama, K. (2006). The Cambridge Face Memory Test: Results for neurologically intact individuals and an investigation of its validity using inverted face stimuli and prosopagnosic participants. Neuropsychologia, 44(4), 576–585. doi:10.1016/j.neuropsychologia.2005.07.001; and a newly devised test based on the CFMT but where the study phases involve watching short movies rather than viewing static faces—the CFMT-Films] and three that tap face matching [Benton Facial Recognition Test, BFRT; Benton, A., Sivan, A., Hamsher, K., Varney, N., & Spreen, O. (1983). Contribution to neuropsychological assessment. New York: Oxford University Press; and two recently devised sequential face matching tests]. Self-reported ability was measured with the 15-item Kennerknecht et al. questionnaire [Kennerknecht, I., Ho, N. Y., & Wong, V. C. (2008). Prevalence of hereditary prosopagnosia (HPA) in Hong Kong Chinese population. American Journal of Medical Genetics Part A, 146A(22), 2863–2870. doi:10.1002/ajmg.a.32552]; two single-item questions assessing face recognition ability; and a new 77-item meta-cognition questionnaire. Overall, we find that adults with typical face recognition abilities have only modest insight into their ability to recognize faces on behavioural tests. In a fifth experiment, we assess self-reported face recognition ability in people with CP and find that some people who expect to perform poorly on behavioural tests of face recognition do indeed perform poorly. However, it is not yet clear whether individuals within this group of poor performers have greater levels of insight (i.e., into their degree of impairment) than those with more typical levels of performance.
Socioeconomic Status Affects Pulmonary Hypertension Disease Severity at Time of First Evaluation
Authors: Talwar Arunabh , Sahni Sonu , Talwar Ankoor , Kohn Nina , Klinger James R.
Published: March 2016

A low socioeconomic status (SES) has been linked to disproportionate access to health care in many diseases, leading to worse disease severity at initial presentation. There is a paucity of these data in the pulmonary hypertension (PHTN) population. We studied the association of SES, as measured by zip code–based median annual household income, with World Health Organization functional class (WHO‐FC) at time of first evaluation in PHTN patients. All patients evaluated at our center with a right heart catheterization revealing a mean pulmonary artery pressure of ≥25 mmHg within 12 months of initial evaluation were considered for the study. Demographics, WHO‐FC, and zip codes were obtained from retrospective chart analysis. The 2010 US census was used to obtain zip code–based annual median income. The income groups were divided into quartiles. Patients were categorized by their WHO‐FC and zip code–derived median income. Similar analyses were conducted for pulmonary arterial hypertension (PAH) patients. Survival was estimated with the Kaplan‐Meier method. Data were analyzed in SAS, and P < 0.05 was considered significant. There were 228 PHTN patients (70 [30.7%] male, 158 [69.3%] female). As median income decreased, the FC at presentation increased, signifying higher disease severity (Spearman correlation: r = −0.161, P < 0.0515). This association between median income groups and WHO‐FC at initial evaluation was significant (χ2 test: P < 0.0168). There were 116 PAH patients (32 [27.6%] male, 84 [72.4%] female). There was again a negative relationship between income and initial FC (Spearman correlation: r = −0.0307, P < 0.0007). A lower SES was associated with worse disease, as measured by WHO‐FC.
The cotriple resolution of differential graded algebras
Authors: Fresse Benoit
Published: March 2016

We consider the cotriple resolution of algebras over operads in differential graded modules. We focus, to be more precise, on the example of algebras over the differential graded Barratt-Eccles operad and on the example of commutative algebras. We prove that the geometric realization of the cotriple resolution (in the sense of model categories) gives a cofibrant resolution functor on these categories of differential graded algebras.
Validity, Reliability, and Responsiveness of SRS-7 as an Outcomes Assessment Instrument for Operatively Treated Patients With Adult Spinal Deformity
Authors: Jain Amit , Lafage Virginie , Kelly Michael P. , Hassanzadeh Hamid , Neuman Brian J. , Sciubba Daniel M. , Bess Shay , Shaffrey Christopher I. , Ames Christopher P. , Scheer Justin K. , Burton Douglas , Gupta Munish C. , Hart Robert , Hostin Richard A. , Kebaish Khaled M.
Published: March 2016

Study Design.

A retrospective analysis.

Objective.

The aim of our study was to compare the normality, concurrent validity, internal consistency, responsiveness, and dimensionality of an item response theory–derived seven-question instrument (SRS-7), against the Scoliosis Research Society-22r (SRS-22r) questionnaire in operatively treated patients with adult spinal deformity (ASD).

Summary of Background Data.

Compared with SRS-22r, SRS-7 (which has been validated in operatively treated patients with adolescent idiopathic scoliosis) has advantages of being short, unidimensional, and linear.

Methods.

A prospective database of ASD patients was queried for patients 18 years or older who were operatively treated, and who answered pre- and postoperative (at 2-year follow-up) SRS-22r questions (n = 276). Corresponding SRS-7 scores were calculated using answers to SRS-22r items 1, 4, 6, 10, 18, 19, and 20. Significance was set at a P value less than 0.01.

Results.

SRS-7 and SRS-22r were normally distributed preoperatively but not postoperatively. SRS-7 and SRS-22r scores had high correlation both preoperatively (r = 0.76, P < 0.01) and postoperatively (r = 0.83, P < 0.01). The internal consistency reliability Cronbach α values were 0.61 (SRS-7) and 0.83 (SRS-22r) preoperatively and 0.91 (SRS-7) and 0.95 (SRS-22r) postoperatively. SRS-7 was found to be more responsive than SRS-22r with measures of effect size: Cohen d = 1.21 versus 1.13, Hedge g = 1.21 versus 1.13, and effect size correlation r = 0.52 versus 0.49. Iterative principal factor analysis of pre- and postoperative scores showed the presence of one dominant latent factor in SRS-7 (unidimensionality) and four latent factors in SRS-22r (multidimensionality).

Conclusion.

SRS-7 is a valid, reliable, responsive, and unidimensional instrument, which can be used as a short-form alternative to the SRS-22r for assessing global changes in patient-reported outcomes over time in patients with ASD.

Level of Evidence: 3
Heparin-Based Polyelectrolyte Complex Enhances the Therapeutic Efficacy of Bone Morphogenetic Protein-2 for Posterolateral Fusion in a Large Animal Model
Authors: Wang Ming , Lam Raymond W.M. , Abbah Sunny A. , Hu Tao , Toh Soo Y. , Cool Simon , Bhakoo Kishore , Li Jun , Goh James C.H. , Wong Hee-Kit
Published: March 2016

Study Design.

The study was based on porcine posterolateral fusion model.

Objective.

The study aims to prove that polyelectrolyte complex (PEC) carrier could enhance the efficacy and safety profile of bone morphogenetic protein-2 (BMP-2).

Summary of Background Data.

BMP-2 was introduced to enhance posterolateral fusion; however, extremely high doses of this molecule were often used which contributed to various complications. This was attributed to the poor modulation capacity of the traditional carrier absorbable collagen sponge (ACS). To reduce the efficacious dose of BMP-2 and its associated complications, heparin-based PEC was introduced.

Methods.

L3/L4 and L5/L6 two-level posterolateral spinal fusion was performed on six pigs using two doses of BMP-2 with PEC or ACS: (1) PEC with 800 μg BMP-2 (n = 2); (2) PEC with 400 μg BMP-2 (n = 2); (3) ACS with 800 μg BMP-2 (n = 1); (4) ACS with 400 μg of BMP-2 (n = 1). The construct was loaded into a rigid bioabsorbable cage for implantation. Fusion rate and quality were assessed 2 months after operation.

Results.

Manual palpation revealed successful fusion in all groups. Radiological fusion score of PEC groups was, however, higher than that of ACS groups. The newly formed bone in PEC groups appeared to be well integrated into the native bone with no overgrowth into the adjacent structure. On comparison, in ACS groups, large gaps were observed between the newly formed bone and the fusion bed with heterotopic ossification into the psoas muscle. The microarchitecture on the newly formed bone in PEC groups was superior to that in ACS groups, which was demonstrated by higher three-dimensional parameters.

Conclusion.

The present study demonstrated that BMP-2 delivered by PEC induced successful posterolateral fusion in porcine model. The efficacy of BMP-2 was improved and bony overgrowth was reduced. The microarchitecture of BMP-2–induced bone tissue was also enhanced by PEC.

Level of Evidence: N/A
Growing Up After Critical Illness: Verbal, Visual-Spatial, and Working Memory Problems in Neonatal Extracorporeal Membrane Oxygenation Survivors*
Authors: Madderom Marlous J. , Schiller Raisa M. , Gischler Saskia J. , van Heijst Arno F.J. , Tibboel Dick , Aarsen Femke K. , IJsselstijn Hanneke
Published: March 2016

Objectives:

To assess neuropsychologic outcome in 17- and 18-year–old neonatal extracorporeal membrane oxygenation survivors.

Design:

A prospective longitudinal follow-up study.

Setting:

Follow-up program at the Erasmus MC-Sophia Children’s Hospital in Rotterdam, The Netherlands.

Patients:

Thirty adolescents 17 or 18 years old, treated between 1991 and 1997, underwent neuropsychologic assessment.

Interventions:

None.

Measurements and Main Results:

Attention, memory, executive functioning, visual-spatial functions, social-emotional functioning, and behavior were assessed with validated instruments, and data were compared with reference data. Included predictors for analysis of adverse outcome were diagnosis, age at start extracorporeal membrane oxygenation, convulsions, and use of antiepileptics. Adolescents’ performance (expressed as mean [sd] z score) was significantly lower than the norm on short-term and long-term verbal memory (z score = −1.40 [1.58], p = 0.016; z score = −1.54 [1.67], p = 0.010, respectively), visual-spatial memory (z score = −1.65 [1.37], p = 0.008; z score = −1.70 [1.23], p = 0.008, respectively), and working memory (32% vs 9% in the norm population). Parents reported more problems for their children regarding organization of materials (z score = −0.60 [0.90]; p = 0.03) and behavior evaluation (z score = −0.53 [0.88]; p = 0.05) on a questionnaire. Patients reported more withdrawn/depressed behavior (z score = −0.47 [0.54]; p = 0.02), somatic complaints (z score = −0.43 [0.48]; p = 0.03), and social problems (z score = −0.41 [0.46]; p = 0.04). Patients reported more positive feelings of self-esteem and an average health status.

Conclusions:

Adolescents treated with neonatal extracorporeal membrane oxygenation are at risk of verbal, visual-spatial, and working memory problems. Future research should focus on 1) the longitudinal outcome of specific neuropsychologic skills in adolescence and adulthood; 2) identifying risk factors of neuropsychologic dysfunction; 3) evaluating to what extent “severity of illness” is responsible for acquired brain injury; and 4) effects of timely cognitive rehabilitation.
Acceptance of lean redesigns in primary care
Authors: Hung Dorothy , Gray Caroline , Martinez Meghan , Schmittdiel Julie , Harrison Michael I.
Published: March 2016

Background:

Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term system transformation. Most research examines Lean intervention to address isolated problems, rather than to achieve broader systemic changes to care delivery. Moreover, no studies examine contextual influences on system-wide Lean implementation efforts in primary care.

Purpose:

The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system.

Methodology/Approach:

Over 100 interviews and focus groups were conducted with frontline physicians, clinical staff, and operational leaders. Data analysis was guided by a modified Consolidated Framework for Implementation Research (CFIR), a popular implementation science framework. On the basis of expert recommendations, the modified framework targets factors influencing the implementation of process redesigns. This modified framework, the CFIR-PR, informed our identification of contextual factors that most impacted Lean acceptance among frontline physicians and staff.

Findings:

Several domains identified by the CFIR-PR were critical to acceptance of Lean redesigns. Regarding the implementation process acceptance was influenced by time and intensity of exposure to changes, “top-down” versus “bottom-up” implementation styles, and degrees of employee engagement in developing new workflows. Important factors in the inner setting were the clinic’s culture and style of leadership, along with availability of information about Lean’s effectiveness. Last, implementation efforts were impacted by individual and team characteristics regarding changed work roles and related issues of professional identity, authority, and autonomy.

Practice Implications:

This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system, special attention is warranted with respect to the implementation approach, internal clinic setting, and implications for professional roles and identities of physicians and staff.
NOVEL RETINAL COMPLICATIONS AFTER ENDOSCOPIC SINUS SURGERY
Authors: Rubaie Khalid Al , Cruz Augusto V. , Ghamdi Mizher Al , Khan Arif O. , Kozak Igor
Published: March 2016

Purpose:

To report a novel intraocular complication of endoscopic sinus surgery.

Methods:

Retrospective case report.

Results:

A 44-year-old otherwise-healthy man underwent endoscopic right ethmoid sinus surgery and immediately developed loss of vision in his right eye. Postoperatively, patient had ipsilateral light perception vision, proptosis, periorbital ecchymosis, and large angle exotropia with virtually no adduction. Orbital computed tomography confirmed violation of the right medial rectus muscle and optic nerve. Dilated fundus examination showed a macular fold with edema and hemorrhages, blockage on angiography of the macula, and subretinal hyperfluorescence in the periphery. After 6 months of observation, his central vision had improved to 20/300 with macular atrophy and choroidal atrophy in the periphery.

Conclusion:

Macular edema, nonperfusion and ischemia, choroidal nonperfusion (Amalric sign), and atrophy can be iatrogenic sequelae of endoscopic ethmoid sinus surgery.
Quality and Health Literacy Demand of Online Heart Failure Information
Authors: Cajita Maan Isabella , Rodney Tamar , Xu Jingzhi , Hladek Melissa , Han Hae-Ra
Published: March 2016

Background:

The ubiquity of the Internet is changing the way people obtain their health information. Although there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown.

Objective:

The purpose of this study is to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online.

Methods:

Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure Web sites. Two independent raters then assessed the quality and health literacy demand of the included Web sites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using 7 established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials.

Results:

A total of 46 Web sites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2%. Finally, the overall mean actionability score was 34.7% ± 28.7%.

Conclusions:

The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality but also the health literacy demand of the information found in their Web sites. This is especially important considering that low health literacy is likely prevalent among the usual audience.
The Expression of Neuropilin-1 in Human Placentas From Normal and Preeclamptic Pregnancies
Authors: Arad Ayala , Nammouz Sherin , Nov Yuval , Ohel Gonen , Bejar Jacob , Vadasz Zahava
Published: March 2016

Preeclampsia (PET) is a hypertensive disorder that affects 2% to 8% of pregnant women. Recent observations support the hypothesis that upregulation of placental anti-angiogenic factors are responsible for the clinical manifestations of the disease. Neuropilin-1 (NP-1) is a transmembrane protein that acts as a coreceptor for vascular endothelial growth factor and as a regulatory protein in the immune system. The aim of the study was to evaluate the expression of NP-1 in PET and normal placentas. Nineteen placental specimens from severe PET pregnancies were compared with 20 placental specimens of women with low-risk pregnancy. All the specimens underwent immunohistochemical staining with anti-human NP-1 antibody. The degree of NP-1 staining was measured both for intensity and extent. Our study demonstrated NP-1 immunoreactivity mainly in the decidual cells, the intermediate trophoblast, and the syncytiotrophoblast, particularly in the areas in the syncytial knots and shed particles. The particles were strongly NP-1 immunoreactive. The expression of NP-1 in the syncytiotrophoblast was lower in placentas of PET compared with control (P=0.017). Shedding of syncytiotrophoblast particles from placenta to maternal blood occurs in normal pregnancies and is enhanced during PET and contributes to the maternal vascular injury that characterizes PET. Our new observation that shows strong NP-1 immunoreactivity of these particles, and decreased NP1 expression in syncytiotrophoblast of PET placentas in comparison to the control group, may imply a role of NP-1 in PET.
Prevalence of Occult Malignancy Within Morcellated Specimens Removed During Laparoscopic Sacrocolpopexy
Authors: Vallabh-Patel Vaneesha , Saiz Cristina , Salamon Charbel , Francis Amanda , Pagnillo Jennifer , Culligan Patrick
Published: March 2016

Objective

This study aimed to determine the prevalence of occult malignancy found in morcellated specimens removed in the context of pelvic organ prolapse repair operations.

Methods

A total of 786 cases were reviewed from a single health system between October 2006 and July 2015. Thorough chart reviews were performed to include pathological specimens. Demographic, perioperative, and postoperative data were collected.

Results

Four occult malignancies were identified including 3 endometrial adenocarcinomas of the uterus and 1 papillary serous carcinoma of the uterus. The overall prevalence of occult malignancy within morcellated specimens was 0.5% (4 of 786). On adopting universal screening with endometrial biopsy, 5 malignancies were identified (5 of 176) before morcellation and no postoperative malignancies in the remaining patients.

Conclusions

Power morcellation is a low-risk procedure with laparoscopic supracervical hysterectomy and sacrocolpopexy. Universal screening is highly effective in detecting occult malignancy and in our small series eliminated the risk; studies in multiple institutions will be needed to determine its effectiveness in other hospital systems.
OncoScape: Exploring the cancer aberration landscape by genomic data fusion
Authors: Schlicker Andreas , Michaut Magali , Rahman Rubayte , Wessels Lodewyk FA
Published: March 2016

Although large-scale efforts for molecular profiling of cancer samples provide multiple data types for many samples, most approaches for finding candidate cancer genes rely on somatic mutations and DNA copy number only. We present a new method, OncoScape, which, for the first time, exploits five complementary data types across 11 cancer types to identify new candidate cancer genes. We find many rarely mutated genes that are strongly affected by other aberrations. We retrieve the majority of known cancer genes but also new candidates such asSTK31andMSRAwith very high confidence. Several genes show a dual oncogene-and tumor suppressor-like behavior depending on the tumor type. Most notably, the well-known tumor suppressorRB1shows strong oncogene-like signal in colon cancer. We applied OncoScape to cell lines representing ten cancer types, providing the most comprehensive comparison of aberrations in cell lines and tumor samples to date. This revealed that glioblastoma, breast and colon cancer show strong similarity between cell lines and tumors, while head and neck squamous cell carcinoma and bladder cancer, exhibit very little similarity between cell lines and tumors. To facilitate exploration of the cancer aberration landscape, we created a web portal enabling interactive analysis of OncoScape results.
A Sister of PIN1 gene in tomato(Solanum lycopersicum)defines organ initiation patterns by maintaining epidermal auxin flux
Authors: Martinez Ciera C. , Koenig Daniel , Chitwood Daniel H. , Sinha Neelima R.
Published: March 2016

The spatiotemporal localization of the plant hormone auxin acts as a positional cue during early leaf and flower organogenesis. One of the main contributors to auxin localization is the auxin efflux carrier PIN-FORMED1 (PIN1). Phylogenetic analysis has revealed that PIN1 genes are split into two sister clades;PIN1and the relatively uncharacterizedSister-Of-PIN1 (SoPIN1). In this paper we identifyentire-2as a loss-of-functionSlSoPIN1a(Solyc10g078370) mutant inSolanum lycopersicum. Theentire-2plants are unable to specify proper leaf initiation leading to a frequent switch from the wild type spiral phyllotactic pattern to distichous and decussate patterns. Leaves inentire-2are large and less complex and the leaflets display spatial deformities in lamina expansion, vascular development, and margin specification. During sympodial growth inentire-2the specification of organ position and identity is greatly affected resulting in variable branching patterns on the main sympodial and inflorescence axes. To understand howSlSoPIN1afunctions in establishing proper auxin maxima we used the auxin signaling reporter DR5::Venus to visualize differences in auxin localization betweenentire-2and wild type. DR5::Venus visualization shows a widening of auxin localization which spreads to subepidermal tissue layers during early leaf and flower organogenesis, showing thatSoPIN1functions to focus auxin signaling to the epidermal layer. The striking spatial deformities observed inentire-2help provide a mechanistic framework for explaining the function of theSoPIN1clade in angiosperm species.

Author Summary

The plant hormone auxin acts as a positional signal in most plant developmental processes. ThePIN-FORMEDfamily of auxin transporters are the main contributors to auxin localization, especiallyPIN-FORMED1, which has been studied extensively in plant model speciesArabidopsis thaliana. Members of the PIN-FORMED gene family have been found in all plant species, but there is a scarcity of mutants described outsideArabidopsis thaliana. UsingSolanum lycopersicum(tomato) as a system, this study identifies a loss of function mutant from theSister-Of-PIN1clade in theSlSoPIN1agene. The characterization of this mutant reveals the role ofSlSoPIN1ain establishing position of organ initiation during shoot and reproductive development, including a role in establishing proper spiral phyllotaxy. We use an auxin visualization technique to concludeSlSoPIN1afunctions in specifying auxin presence in proper cell layers to establish organ and tissue positioning. This work gives further evolutionary context to howPIN-FORMEDgenes act to establish organogenesis in the plant kingdom.
Financing constraints and SME innovation during economic crises
Authors: Madrid-Guijarro Antonia , García-Pérez-de-Lema Domingo , Van Auken Howard
Published: March 2016

Purpose

The purpose of this paper is to provide a better understanding of the determinants of small and medium-sized enterprises (SME) financing constraints and their impacts on investments in innovation. To explicate these factors, the authors use a general definition of innovation, distinguishing between product and process innovations, and highlight the role played by banking relationships.

Design/methodology/approach

On the basis of a literature review covering works specializing in innovation, financing constraints, and SME characteristics, a quantitative study is carried out in Spain, using a sample composed by 267 Spanish SMEs. Information was gathered by applying surveys addressed to the firm managers.

Findings

The findings reveal that financing constraints hinder innovation among Spanish SMEs functioning in hostile environments, though long-term banking relationships can moderate these financing constraints. The longer the duration of a firm’s banking relationship, the fewer financing constraints it faces, because the relationship significantly reduces information asymmetry.

Practical implications

To reduce financing constraints on their innovation, SMEs should establish long relationships and low debt concentration with their main bank. The more banks a firm works with, the greater its financing constraints. The findings have managerial implications, not just for firms but also for government policymakers and providers of consulting services.

Originality/value

This paper provides an in-depth analysis of the factors that affect innovation, along with insights into which financing constraints limit innovation during a severe recession.
Centrolac
Authors: Brenes Esteban R. , Martínez Carlos , Pichardo Caleb A.
Published: March 2016

Purpose

The purpose of this paper is to discuss Centrolac, a Nicaraguan company engaged in processing ultra-pasteurized milk, and provides abundant information for readers to decide on vertical vs horizontal integration to deal with the changing competitive environment. It has been prepared to simplify discussion and knowledge about the competitive field (where to compete); generic cost-leadership and high-perceived-value strategies (how to compete); and the action required to attain positioning (how to implement it).

Design/methodology/approach

The case study is based on primary research conducted in conjunction with the company, including interviews with senior management and a broad document review. Secondary research was also conducted into the relevant environmental, industry and competitor trends and characteristics.

Findings

The case study presents topics of competitive positioning and how current company strategy can have a significant impact on future growth decisions.

Originality/value

This case study is for use in an MBA-level business strategy course with a focus on strategic positioning and growth paths. However, it can also be used for MBA corporate strategy courses in relation to corporate expansion on issues linked to organic growth within the same business (expansion into new dairy products) or vertical integration (integration into dairy-farming).
Support and assist: approaches to mentoring in a yearlong teacher residency
Authors: Roegman Rachel , Reagan Emilie Mitescu , Goodwin A. Lin , Yu Julia
Published: March 2016

Purpose

– The purpose of this paper is to examine mentor teachers’ approaches to mentoring preservice teachers in a yearlong teacher residency program (TRP).

Design/methodology/approach

– This multiple-methods study examined 15 mentor teachers’ approaches over the course of a year in an urban TRP through the lens of Wang and Odell’s (2002) framework for mentoring. Data sources included mentors’ self-assessments over three points in time across one academic year. These self-assessments included numerical ratings of practice (quantitative) as well as open-ended rationales and goal setting (qualitative).

Findings

– Mentors predominately provided support and technical assistance to the residents learning to teach, drawing on humanistic, and situated apprentice perspectives on mentoring. They worked to develop residents’ self-confidence and exposed residents to a range of practices and school contexts. Glimmers of a more critical constructive approach were apparent in some mentors’ discussions of reflection and collaboration.

Research limitations/implications

– This study informs the work of teacher education programs as they develop mentoring structures that align with program visions, expand notions of mentoring, and consider the many roles of a mentor teacher.

Originality/value

– Increased emphasis on clinical experiences for preservice teachers highlights the need to attend to the practices of the mentor teachers with whom they work. These mentors, as field-based teacher educators, play a critical role in teacher education, and teacher education programs need to support their professional development as mentors. Understanding mentors’ approaches to mentoring is necessary in order to provide this support.
Proposing a hybrid method based on DEA and ANP for ranking organizational units and prioritizing human capital management drivers
Authors: Tavakoli Mohammad Mehdi , Shirouyehzad Hadi , Dabestani Reza
Published: March 2016

Purpose

– The purpose of this study is to present a hybrid analytic network process (ANP) and data envelopment analysis (DEA) method for ranking organizational units as well as prioritizing organization’s human capital management criteria.

Design/methodology/approach

– In the proposed DEA model, human capital management criteria are considered as the inputs and organizational commitment considered as the output of DEA model. Afterward, the organizational unit’s efficiency and the weight of human capital management criteria are evaluated through DEA and the data are considered as the basis of ANP model.

Findings

– The results of prioritizing the drivers of human capital management were showed that leadership practices, human capital management and learning capacity are the most important ones. Also, the findings proved that the proposed integrated DEA/ANP can be helpful in managerial issues.

Research limitations/implications

– Filling the super-matrix and designing the questionnaire of ANP have always been the challenge of scholars because of the large number of data it requires. One of the main advantages of the proposed hybrid method in this research is that it resolves the above-mentioned problem of ANP.

Practical implications

– The results of the proposed method may provide managers this opportunity to better analyze the condition of organizational units from human capital management perspective and focus on the most important activities in this context. Moreover, the proposed hybrid method can help scholars to better use both DEA and ANP techniques and obtain more reliable findings.

Originality/value

– In this study, DEA efficiency measures of units, and the weights of inputs and outputs of DEA model are used to fill the super-matrix of ANP. In addition to having a logical approach, this method provides more reliable results and enjoys the advantages of both ANP and DEA techniques.