bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Influence of an E-Learning Sensory Processing-Based Module for Graduate Level Occupational Therapy Students on Clinical Reasoning: A Pilot Study
Authors: Gee Bryan M. , Strickland Jane , Thompson Kelly , Miller Lucy Jane
Published: January 2017

The purpose of this study was to explore the effectiveness of a series of online, module-based instructional reusable learning objects (RLOs) targeted at entry-level, 1st year, Master of Occupational Therapy students. The content of the RLOs addressed knowledge and implementation of A SECRET, a parental reasoning approach for children with a sensory processing disorder, specifically sensory over responsiveness. Nine RLOs were developed and embedded within a commonly used learning management system. Participants (n=8) were evaluated regarding their ability to discriminate between appropriate and inappropriate A SECRET strategies using a selected-response assessment. The participants’ overall average score was 68%, a positive finding given the novelty of the instruction, assessment, and the content.
Diagnostic Ability of Retinal Nerve Fiber Layer Thickness Deviation Map for Localized and Diffuse Retinal Nerve Fiber Layer Defects
Authors: Shin Joong Won , Seong Mincheol , Lee Jung Wook , Hong Eun Hee , Uhm Ki Bang
Published: January 2017

Purpose. To evaluate the diagnostic ability of the retinal nerve fiber layer (RNFL) deviation map for glaucoma with localized or diffuse RNFL defects. Methods. Eyes of 139 glaucoma patients and 165 healthy subjects were enrolled. All participants were imaged with Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA). A RNFL defect was defined as at least 10 contiguous red (<1% level) superpixels in RNFL deviation map. The area, location, and angular width of RNFL defects were automatically measured. We compared sensitivities, specificities, and area under the receiver operating characteristic curves (AUCs) of RNFL deviation map and circumpapillary RNFL thickness for localized and diffuse RNFL defects. Subgroup analysis was performed according to the severity of glaucoma. Results. For localized defects, the area of RNFL defects (AUC, 0.991; sensitivity, 97%; specificity, 90%) in deviation map showed a higher diagnostic performance (p=0.002) than the best circumpapillary RNFL parameter (inferior RNFL thickness; AUC, 0.914; sensitivity, 79%; specificity, 92%). For diffuse defects, there was no significant difference between the RNFL deviation map and circumpapillary RNFL parameters. In mild glaucoma with localized defect, RNFL deviation map showed a better diagnostic performance than circumpapillary RNFL measurement. Conclusions. RNFL deviation map is a useful tool for evaluating glaucoma regardless of localized or diffuse defect type and has advantages over circumpapillary RNFL measurement for detecting localized RNFL defects.
Roles of miR-17-92 Cluster in Cardiovascular Development and Common Diseases
Authors: Gu Huanyu , Liu Zhuyuan , Zhou Lei
Published: January 2017

MicroRNAs (miRNAs and miRs) are a large class of noncoding, single-stranded, small RNA molecules. The precise control of their expression is essential for keeping tissue homeostasis and normal development of organisms. Thus, unbalanced expression of miRNAs is a hallmark of many diseases. Two to dozens of miRNAs can form into a miRNA cluster, and the miR-17-92 cluster is one of them. Although firstly described as an oncogenic miRNA cluster, the miR-17-92 cluster has also been found to play critical role in normal cardiac development and cardiovascular disease. This review focuses on the characteristics and functions of miR-17-92 cluster in heart.
Evaluating Hand Function in Clients with Trigger Finger
Authors: Langer Danit , Maeir Adina , Michailevich Michael , Luria Shai
Published: January 2017

Background. Trigger finger (TF) is a common hand pathology frequently encountered in hand clinics. Occupational therapists predominantly assess TF symptoms as opposed to using standardized hand functioning assessments. The purpose of this study was to assess the construct validity of dexterity and grip strength assessments for clients with TF. Method. Sixty-three participants with TF and 66 healthy controls were administered the Functional Dexterity Test (FDT), Purdue Pegboard Test (PPT), and Jamar® Hydraulic Hand Dynamometer (JD) and completed the Disabilities of Arm Shoulder and Hand questionnaire (DASH). TF symptoms were graded using the Quinnell classification. Results. Statistically significant differences were found between the groups in dexterity and grip strength. A statistically significant difference between the three TF grades was found on the PPT. All three test scores were moderately correlated with the DASH scores. Conclusion. This study provides innovative evidence for the validity of common hand function assessments for individuals with TF and recommends incorporating these tools in clinical practice. Further research is needed with larger samples and better representation of each TF clinical grade.
Cytotoxicity of Etch-and-Rinse, Self-Etch, and Universal Dental Adhesive Systems in Fibroblast Cell Line 3T3
Authors: Pupo Yasmine Mendes , Bernardo Cintia Fernanda de Freitas , de Souza Francielly Fernanda de Freitas A. , Michél Milton Domingos , Ribeiro Camila Nunes de Morais , Germano Sandro , Maluf Daniela Florencio
Published: January 2017

The aim of this study was to evaluate in fibroblast cultures the direct cytotoxic effects of etch-and-rinse, self-etch, and universal adhesive systems. The sterile glass cover slips (n=3) were then immersed in culture medium to obtain the eluates for the experimental groups: (1) Adper™ Single Bond 2; (2) Ambar; (3) Adper™ Scotchbond™ Multi-Purpose; (4) Scotchbond™ Universal; (5) Ambar Universal; and (6) OptiBond All-In-One. As a negative control, sterile glass cover slips were immersed in culture medium only. After 24 h, the eluate obtained was applied on fibroblast culture. Cell viability and cell morphology were evaluated by MTT assay and SEM, respectively. Data were analyzed by Kruskal–Wallis and Mann–Whitney tests (α=0.05). All adhesive systems except universal reduced cell viability in 3T3 cells to between 26.04% and 56.57%, and Scotchbond Universal and Ambar Universal reduced cell viability to 2.13% and 3.57%, respectively, when compared to the negative control. Cytoplasmic membrane shrinkage and cell-free areas with residual membrane fragments from dead cells were observed. In conclusion, improvements in universal adhesive system formulations and their mechanisms of action are not accompanied by increased toxicity compared with those in other systems, warranting commitment to the use of these dentin-pulp complexes.
IKBKE Is Required during KRAS-Induced Pancreatic Tumorigenesis
Authors: Rajurkar Mihir , Dang Kyvan , Fernandez-Barrena Maite G. , Liu Xiangfan , Fernandez-Zapico Martin E. , Lewis Brian C. , Mao Junhao
Published: January 2017

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest malignancies lacking effective therapeutic strategies. Here, we show that the noncanonical IκB-related kinase, IKBKE, is a critical oncogenic effector during KRAS-induced pancreatic transformation. Loss of IKBKE inhibits the initiation and progression of pancreatic tumors in mice carrying pancreatic-specific KRAS activation. Mechanistically, we demonstrate that this protumoral effect of IKBKE involves the activation of GLI1 and AKT signaling and is independent of the levels of activity of the NF-κB pathway. Further analysis reveals that IKBKE regulates GLI1 nuclear translocation and promotes the reactivation of AKT post-inhibition of mTOR in PDAC cells. Interestingly, combined inhibition of IKBKE and mTOR synergistically blocks pancreatic tumor growth. Together, our findings highlight the functional importance of IKBKE in pancreatic cancer, support the evaluation of IKBKE as a therapeutic target in PDAC, and suggest IKBKE inhibition as a strategy to improve efficacy of mTOR inhibitors in the clinic. Cancer Res; 77(2); 320–9. ©2017 AACR.
Space and Objects: On the Phenomenology and Cognitive Neuroscience of Anomalous Perception in Schizophrenia (Ancillary Article to EAWE Domain 1)
Authors: Silverstein Steven M. , Demmin Docia , Skodlar Borut
Published: January 2017

Background/Aims: Perception of space and objects is a traditional focus within phenomenology, and disturbances in these aspects of perception among people with schizophrenia have long been discussed within phenomenological psychiatry. Despite this, there has been little empirical work on the causes and effects of most of these perceptual alterations in people with schizophrenia. Progress towards this goal can be accelerated by the use of EAWE (Examination of Anomalous World Experience), an interview-based tool to elicit, categorize, and quantify abnormal perceptual and other experiential phenomena. Methods: In this brief paper, we review the main types of disturbances in space and object perception in schizophrenia - as described by phenomenologists, clinicians from other theoretical orientations, and experimental psychopathologists - as a first step in a research agenda to achieve a better integration of the clinical and experimental literatures. Results/Conclusion: This review indicates that in some cases the cognitive and neurobiological mechanisms of altered space and object perception in schizophrenia are relatively well understood, while in other cases there exist only plausible hypotheses. In still other cases, however, almost nothing is known. Moreover, a fundamental hypothesis of phenomenological psychiatry - that perceptual changes are related to disturbances in the sense of self - has yet to be investigated actively. From this context, we offer suggestions for future research and suggest general research designs that may be useful for advancing progress in this area.
Thyroidopathy and Age-Related Macular Degeneration: Is There Any Correlation
Authors: Chatziralli Irini , Mitropoulos Panagiotis G. , Niakas Dimitrios , Labiris Georgios
Published: January 2017

Purpose: The purpose of this study was to evaluate whether inherent sociodemographic parameters, lifestyle features, as well as medical data may be potential risk factors for the presence of age-related macular degeneration (AMD). Methods: Participants in our study were 114 patients with AMD, 63 males and 51 females, and 100 control subjects without any ocular disease. Demographic data, lifestyle data, medical history, and comorbidities were recorded and analyzed as potential risk factors for the presence of AMD. Results: There was no statistically significant difference between patients and controls regarding age, gender, smoking, alcohol consumption, walking, exercise, presence of hypertension, diabetes mellitus, myoskeletal problems, migraine, and cancer. Marital status, higher educational level, cardiovascular disorders, and thyroidopathy were found to be significantly associated with AMD. Conclusions: Apart from already reported risk factors for AMD, thyroidopathy was associated with AMD.
Salivary Testosterone during the Minipuberty of Infancy
Authors: Contreras Maria , Raisingani Manish , Chandler Donald Walt , Curtin William D. , Barillas Julia , Brar Preneet Cheema , Prasad Kris , Shah Bina , David Raphael
Published: January 2017

Background: The hypothalamic-pituitary-gonadal axis is transiently activated during the postnatal months in boys, a phenomenon termed “minipuberty” of infancy, when serum testosterone (T) increases to pubertal levels. Despite high circulating T there are no signs of virilization. We hypothesize that free T as measured in saliva is low, which would explain the absence of virilization. Methods: We measured serum total T and free T in saliva using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in 30 infant boys, aged 1–6 months, and in 12 adolescents, aged 11–17 years. Results: Total serum T in all infants was, as expected, high (172 ± 78 ng/dL) while salivary T was low (7.7 ± 4 pg/mL or 0.45 ± 0.20%). In contrast, salivary T in the adolescents was much higher (41 ± 18 pg/mL or 1.3 ± 0.36%) in relation to their total serum T (323 ± 117 ng/dL). We provide for the first time reference data for salivary T in infants. Conclusion: Measurement of salivary T by LC-MS/MS is a promising noninvasive technique to reflect free T in infants. The low free T explains the absence of virilization. The minipuberty of infancy is more likely of intragonadal than peripheral significance.
Anesthesia Technique and Outcomes of Mechanical Thrombectomy in Patients With Acute Ischemic Stroke
Authors: Bekelis Kimon , Missios Symeon , MacKenzie Todd A. , Tjoumakaris Stavropoula , Jabbour Pascal
Published: January 2017

Background and Purpose—

The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke.

Methods—

We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database. An instrumental variable (hospital rate of general anesthesia) analysis was used to simulate the effects of randomization and investigate the association of anesthesia technique with case-fatality and length of stay.

Results—

Among 1174 patients, 441 (37.6%) underwent general anesthesia and 733 (62.4%) underwent conscious sedation. Using an instrumental variable analysis, we identified that general anesthesia was associated with a 6.4% increased case-fatality (95% confidence interval, 1.9%–11.0%) and 8.4 days longer length of stay (95% confidence interval, 2.9–14.0) in comparison to conscious sedation. This corresponded to 15 patients needing to be treated with conscious sedation to prevent 1 death. Our results were robust in sensitivity analysis with mixed effects regression and propensity score–adjusted regression models.

Conclusions—

Using a comprehensive all-payer cohort of acute ischemic stroke patients undergoing mechanical thrombectomy in New York State, we identified an association of general anesthesia with increased case-fatality and length of stay. These considerations should be taken into account when standardizing acute stroke care.
A checklist of the Syrphidae (Diptera) of Spain, Andorra and Gibraltar
Authors: RICARTE ANTONIO , ÁNGELES MARCOS-GARCÍA M.
Published: January 2017

Hoverflies are relevant to pollination, predation, phytophagy and decomposition processes and they are also used as bioindicators. The numerous recent advances in the study of Spanish hoverflies and the absence of species lists for the Spanish provinces prompted us to update the national catalogue and fill in the gap at the provincial level. Andorra and Gibraltar are also included in this review. A total of 421 species of 72 genera are included in the present catalogue (417 species in Spain; 86 in Andorra; 43 in Gibraltar). León (182 spp), Salamanca (143 spp), Madrid (134 spp), Ciudad Real (124 spp) and Huesca (121 spp) are the Spanish provinces with the highest numbers of species recorded. The Balearic Islands have 81 species and the Canary Islands 41, with one and 11 endemic species respectively. The richest hoverfly genera in Spain are Cheilosia (56 spp), Merodon (40 spp plus 1 sp from Gibraltar) and Eumerus (38 spp plus 1 sp from Gibraltar), all of them being Eristalinae; within the Syrphinae, Paragus is the richest genus (18 spp). The possibility of elaborating regional (provincial) species lists from the information provided in the present study also contributes to ‘Syrph the Net, the database of European Syrphidae’ as a tool for assessment of habitat conservation in Spain.
Comments on the genus Zalarnaca Gorochov, 2005 (Orthoptera: Gryllacrididae: Gryllacridinae) with two new combinations and two new synonyms
Authors: SHI FUMING , DU BAOJIE , BIAN XUN
Published: January 2017

Two new combinations of the genus Zalarnaca Gorochov, 2005 are reported and illustrated, i.e. Zalarnaca (Glolarnaca) sinica (Li, Liu & Li, 2016) com. nov.; Zalarnaca (Glolarnaca) hainanica (Li, Liu & Li, 2016) com. nov. Also two synonyms are confirmed: Prosopogryllacris chinensis Li, Liu & Li, 2016 synonymized with Eugryllacris elongata Bian & Shi, 2016, and Prosopogryllacris incisa Li, Liu & Li, 2016 synonymized with Eugryllacris longifissa Bian & Shi, 2016. All material examined is deposited in the Museum of Hebei University.
A new species of Lucasioides Kwon (Isopoda: Oniscidea: Agnaridae) from China
Authors: LI WEICHUN
Published: January 2017

Lucasioides nudus sp. n. is described from Jiangxi Province, China. The new species can be diagnosed by the cephalon having a well-developed median lobe, the pereonite 1 with acutely postero-lateral corners and sinuous posterior margin of epimeron, the male pleopod 1 endopod without setules, and the bilobed exopod with the outer lobe much shorter and broader than the acute triangular inner lobe.
Combined Effect of ENSO-Like and Atlantic Multidecadal Oscillation SSTAs on the Interannual Variability of the East Asian Winter Monsoon
Authors: Hao Xin , He Shengping
Published: January 2017

Using long-term observational data and numerical model experiments, this study found that the Atlantic multidecadal oscillation (AMO) affects the influence of ENSO-like sea surface temperature anomalies (SSTAs, which contain the variability of both El Niño–Southern Oscillation and Pacific decadal oscillation) on the interannual change in the East Asian winter monsoon (EAWM). In the observations, the out-of-phase relationship between the variations in ENSO and the EAWM was significantly intensified when the AMO and ENSO-like SSTAs were in phase. Warmer-than-normal winters occurred across East Asia when the ENSO-like SSTAs and AMO were positively in phase, with a significantly weakened Siberian high and anomalous anticyclones over the western North Pacific. The opposite patterns occurred under negative in-phase conditions. In contrast, when the ENSO-like and AMO SSTAs were out of phase, the anomalies related to the EAWM tended to exhibit relatively weaker features. Numerical model experiments confirmed these observational results. When the models were perturbed with warm ENSO-like SSTAs and warm AMO SSTAs, the atmosphere showed a weakened Siberian high, strong anticyclonic anomalies over the Philippine Sea, a weakened East Asian trough, and dominant positive temperature anomalies over East Asia, implying a weaker EAWM. Reverse responses to negative in-phase temperature anomalies were observed. However, the atmospheric signals that responded to the out-of-phase conditions were less robust. This phenomenon may be attributed to the superposition of the interannual variability of the EAWM caused by ENSO-like SSTAs upon the influence of AMO on background Eurasian climate and the Walker circulation response to the heating source provided by the AMO, which induced changes in ENSO-like variability through the surface wind anomalies and modulated the anomalous anticyclone/cyclone over the Philippine Sea in warm–cold ENSO-like events.
Modeling Surface Runoff and Water Fluxes over Contrasted Soils in the Pastoral Sahel: Evaluation of the ALMIP2 Land Surface Models over the Gourma Region in Mali
Authors: Grippa Manuela , Kergoat Laurent , Boone Aaron , Peugeot Christophe , Demarty Jérôme , Cappelaere Bernard , Gal Laetitia , Hiernaux Pierre , Mougin Eric , Ducharne Agnès , Dutra Emanuel , Anderson Martha , Hain Christopher ,   ALMIP2 Working Group
Published: January 2017

Land surface processes play an important role in the West African monsoon variability. In addition, the evolution of hydrological systems in this region, and particularly the increase of surface water and runoff coefficients observed since the 1950s, has had a strong impact on water resources and on the occurrence of floods events. This study addresses results from phase 2 of the African Monsoon Multidisciplinary Analysis (AMMA) Land Surface Model Intercomparison Project (ALMIP2), carried out to evaluate the capability of different state-of-the-art land surface models to reproduce surface processes at the mesoscale. Evaluation of runoff and water fluxes over the Mali site is carried out through comparison with runoff estimations over endorheic watersheds as well as evapotranspiration (ET) measurements. Three remote-sensing-based ET products [ALEXI, MODIS, and Global Land Evaporation Amsterdam Model (GLEAM)] are also analyzed. It is found that, over deep sandy soils, surface runoff is generally overestimated, but the ALMIP2 multimodel mean reproduces in situ measurements of ET and water stress events rather well. However, ALMIP2 models are generally unable to distinguish among the two contrasted hydrological systems typical of the study area. Employing as input a soil map that explicitly represents shallow soils improves the representation of water fluxes for the models that can account for their representation. Shallow soils are shown to be also quite challenging for remote-sensing-based ET products, even if their effect on evaporative loss was captured by the diagnostic thermal-based ALEXI. A better representation of these soils, in soil databases, model parameterizations, and remote sensing algorithms, is fundamental to improve the estimation of water fluxes in this part of the Sahel.
Projecting and Attributing Future Changes of Evaporative Demand over China in CMIP5 Climate Models
Authors: Liu Wenbin , Sun Fubao
Published: January 2017

Atmospheric evaporative demand plays a pivotal role in global water and energy budgets, and its change is very important for drought monitoring, irrigation scheduling, and water resource management under a changing environment. Here, future changes of pan evaporation Epan, a measurable indicator for atmospheric evaporative demand, are first projected and attributed over China through a physically based approach, namely, the PenPan model, forced with outputs from 12 state-of-the-art climate models from phase 5 of the Coupled Model Intercomparison Project. An equidistant quantile mapping method was also used to correct the biases in GCMs outputs to reduce uncertainty in Epan projection. The results indicated that Epan would increase during the periods 2021–50 and 2071–2100 relative to the baseline period 1971–2000 under the representative concentration pathway (RCP) 4.5 and 8.5 scenarios, which can mainly be attributed to the projected increase in air temperature and vapor pressure deficit over China. The percentage increase of Epan is relatively larger in eastern China than in western China, which is due to the spatially inconsistent increases in air temperature, net radiation, wind speed, and vapor pressure deficit over China. The widely reported “pan evaporation paradox” was not well reproduced for the period 1961–2000 in the climate models, before or after bias correction, suggesting discrepancy between observed and modeled trends. With that caveat, it was found that the pan evaporation has been projected to increase at a rate of 117–167 mm yr−1 K−1 (72–80 mm yr−1 K−1) over China using the multiple GCMs under the RCP 4.5 (RCP 8.5) scenario with increased greenhouse gases and the associated warming of the climate system.
Assessing the Influence of Upper-Tropospheric Troughs on Tropical Cyclone Intensification Rates after Genesis
Authors: Fischer Michael S. , Tang Brian H. , Corbosiero Kristen L.
Published: January 2017

The role of upper-tropospheric troughs on the intensification rate of newly formed tropical cyclones (TCs) is analyzed. This study focuses on TCs forming in the presence of upper-tropospheric troughs in the North Atlantic basin between 1980 and 2014. TCs were binned into three groups based upon the 24-h intensification rate starting at the time of genesis: rapid TC genesis (RTCG), slow TC genesis (STCG), and neutral TC genesis (NTCG). Composite analysis shows RTCG events are characterized by amplified upper-tropospheric flow with the largest upshear displacement between the TC and trough of the three groups. RTCG events are associated with greater quasigeostrophic (QG) ascent in upshear quadrants of the TC, forced by differential vorticity advection by the thermal wind, especially around the time of genesis. This pattern of QG ascent closely matches the RTCG composite of infrared brightness temperatures.

Conversely, NTCG events are associated with an upper-tropospheric trough that is closest to the TC center. The distribution of QG ascent in NTCG events becomes increasingly asymmetric around the time of genesis, with a maximum that shifts downshear of the TC center, consistent with infrared brightness temperatures. It is hypothesized that the TC intensification rate after tropical cyclogenesis, in environments of upper-tropospheric troughs, is closely linked to the structure and temporal evolution of the upper-level trough. The TC–trough configurations that provide greater QG ascent to the left of, and upshear of, the TC center feature more symmetric convection and faster TC intensification rates.
A practical tool for monitoring the performance of measuring systems in a laboratory network: report of an ACB Working Group
Authors: Ayling Pete , Hill Robert , Jassam Nuthar , Kallner Anders , Khatami Zahra
Published: January 2017

Background

A logical consequence of the introduction of robotics and high-capacity analysers has seen a consolidation to larger units. This requires new structures and quality systems to ensure that laboratories deliver consistent and comparable results.

Methods

A spreadsheet program was designed to accommodate results from up to 12 different instruments/laboratories and present IQC data, i.e. Levey-Jennings and Youden plots and comprehensive numerical tables of the performance of each item. Input of data was made possible by a ‘data loader’ by which IQC data from the individual instruments could be transferred to the spreadsheet program on line.

Results

A set of real data from laboratories is used to populate the data loader and the networking software program. Examples are present from the analysis of variance components, the Levey-Jennings and Youden plots.

Conclusions

This report presents a software package that allows the simultaneous management and detailed monitoring of the performance of up to 12 different instruments/laboratories in a fully interactive mode. The system allows a quality manager of networked laboratories to have a continuous updated overview of the performance. This software package has been made available at the ACB website.
Signals, Decisions, and Strategy: The Submarine Hunt in the Sognefjord 1972
Authors: Holst Johan Jørgen
Published: January 2017

The present study describes the events in the Norwegian west-coast Sognefjord in November 1972. The possible presence of an unidentified submarine presented an inexperienced government with a complicated set of strategic assessments. The choices made appear to have been based on an inadequate understanding of the chances of success as the latter were seriously circumscribed by the physical characteristics of the waters involved. Even if Norway had possessed the means of detecting and identifying the mystical submarine, serious doubts are raised about the wisdom of pursuing the maximalist objectives which the government announced. The decision-making in the crisis reflects little deliberate calculation of costs and risks, and did not focus on how losses could be cut when it became clear that the submarine would escape. The information policy added to the perception of loss and tended to feed unrealistic expectations about what could be achieved.
Counseling Psychology and Substance Use
Authors: Martin Jessica L. , Burrow-Sánchez Jason J. , Iwamoto Derek K. , Glidden-Tracey Cynthia E. , Vaughan Ellen L.
Published: January 2017

Substance use is a pervasive public health problem for which millions of Americans will access treatment. Training, practice, and research in substance use traditionally have not been a focus for counseling psychologists. Thus, many in our field do not feel adequately trained to work with clients who have substance use disorders. Counseling psychologists need to remain viable in a rapidly changing health care environment where treatment for substance use and mental health disorders have parity with other medical treatments. The goal of this article is a call to the profession to increase our presence in the field of substance use alongside other health care providers. We discuss how this objective can be accomplished through training, practice, and research that will not only enhance our competence, but further solidify our value in the health care marketplace.
The Sensitivity of Response Measures of Alphanumeric Legibility to Variations in Dot Matrix Display Parameters
Authors: SNYDER HARRY L.
Published: January 2017

This research evaluated the sensitivity of four observer response measures to variations in the character size and dot luminance of a dot matrix display. Specifically, the research determined the sensitivity of recognition accuracy, response time, tachistoscopic recognition accuracy, and threshold visibility. Alphanumeric characters were presented to six subjects in noncontextual form on a variable-parameter CRT display programmed and driven by a minicomputer.

Recognition accuracy (percent correct response) was found to be the response measure that is most sensitive to the display parameters of character size and dot luminance. Character size, dot luminance, and viewing distance proved to have consistent and significant effects at viewing distances greater than 1.52 m. At lesser viewing distances, these parameters had little effect.

The results suggest that there is no major difference between the display requirements for computer-generated dot matrix displays versus those for conventional CRT displays.
EFL Learners in the Digital Age: An Investigation into Personal and Educational Digital Engagement
Authors: Şahin Kızıl Aysel
Published: January 2017

To gauge the success of integrating technology into classrooms which is among the popular topics in the field of language learning, there is a need to understand how end users, language learners, use technology and bear the characteristics of digital learner as claimed for the current generation of learners. To this end, this study collected data through a survey design from 1163 university level English as a Foreign Language (EFL) learners to provide cross-cultural, empirical evidence towards building an accurate picture of EFL learners in the digital age. Data were analysed through factor analysis to identify meaningful patterns of technology use, descriptive statistics and correlations to explore the relationships between technology use patterns, language achievement and digital characteristics. Findings suggest that EFL learners are digital learners at a moderate level and the range of technology tools used both for daily and language learning purposes is not as broad as claimed for their generation. The results of the study carry implications for EFL practitioners aiming at better understanding current EFL learners and providing them with technology-integrated language instruction properly.
No Excess Risk of Adverse Birth Outcomes in Populations Living near Special Waste Landfill Sites in Scotland
Authors: Morris S E , Thomson A O W , Jarup L , de Hoogh C , Briggs D J , Elliott P
Published: January 2017

A recent study showed small excess risks of low birth weight, very low birth weight and certain congenital anomalies in populations living near landfill sites in Great Britain. The objective of the current study was to investigate the risk of adverse birth outcomes associated with residence near special waste landfill sites in Scotland. We studied risks of adverse birth outcomes in populations living within 2 km of 61 Scottish special waste landfill sites operational at some time between 1982 and 1997 compared with those living further away. 324,167 live births, 1,849 stillbirths, and 11,138 congenital anomalies (including terminations) were included in the study. Relative risks were computed for all congenital anomalies combined, some specific anomalies and prevalence of stillbirth and low and very low birth weight (< 2500 g and < 1500 g). For all anomalies combined, relative risk of residence near special waste landfill sites was 0.96 (99% confidence interval 0.89 to 1.02) adjusted for confounders. Adjusted risks were 0.71 (0.36 to 1.42) for neural tube defects, 1.03 (0.85 to 1.26) for cardiovascular defects, 0.84 (0.58 to 1.22) for hypospadias and epispadias (with no excess of surgical corrections), 0.78 (0.27 to 2.23) for abdominal wall defects (1.32 (0.42–4.17) for hospital admissions), 1.22 (0.28 to 5.38) for surgical correction of gastroschisis and exomphalos and 1.01 (0.96 to 1.07) and 1.01 (0.90 to 1.15) for low and very low birth weight respectively. There was no excess risk of stillbirth. In conclusion, we found no statistically significant excess risks of congenital anomalies or low birth weight in populations living near special waste landfill sites in Scotland.
Non-Attendance at Secondary Prevention Clinics: The Effect on Lipid Management
Authors: McLeod A L , Brooks L , Taylor V , Wylie A , Currie P F , Dewhurst N G
Published: January 2017

Background: Secondary prevention of coronary artery disease is effective in reducing morbitiy and mortality. Our aim was to assess lipid management following non-attendance to a hospital based secondary prevention clinic Methods: Data were collected over 5 years on statin usage and total cholesterol levels for patients with coronary artery disease following attendance at a cardiac nurse led outpatient clinic. Lipid levels were taken from a central laboratory database, for both patients discharged from clinic and non-attenders. Results: From 935 inpatients discharged from hospital, 248 (29%) defaulted from outpatient follow up. Lipid lowering drug usage was similar (72% vs. 74% for non-attenders, p=NS). Attenders at the nurse led outpatient clinic were more likely to achieve a total cholesterol <5mmol/L at discharge than non-attenders (70% vs. 43%;p<0.001), with a lower mean total cholesterol (4.75 ± 0.06 mmol/L vs. 5.33±0.08 mmol/L; p<0.001). Non-attenders subsequently had a greater number of cholesterol measurements than those who were discharged from the hospital based clinic (range 0–12, c2 23.8 on 12df, p<0.05). Lipid profiles in hospital non-attenders remained inferior with fewer achieving a total cholesterol <5mmol/L (61% vs. 78%; p<0.001), and having greater mean total cholesterol levels (4.85 ± 0.06 mmol/L vs. 4.52 ± 0.05 mmol/L; p< 0.001). Conclusions: Patients defaulting from hospital follow up have higher total cholesterols with fewer at target level compared to attenders. Though non-attenders receive subsequent lipid measurement, inferior lipid profiles persist compared to patients who completed hospital follow up to be discharged. Further implementation strategies are needed with regard to lipid management in this patient group.
What Happens When GPs Proactively Prescribe NRT Patches in a Disadvantaged Community
Authors: Copeland L , Robertson R , Elton R
Published: January 2017

Background and Aims: The high prevalence of smoking in disadvantaged communities gives serious cause for concern in terms of adverse effects on health and social outcomes. In Scotland, smoking—related lung cancer rates are particularly high and compare less favourably with the rest of the UK and Europe. GPs are increasingly being recognised as having an important role in smoking cessation and are allowed to prescribe NRT to those on a low income. This study aimed to follow up a group patients from a disadvantaged area who had been prescribed nicotine patches by their GP. Methods: An initial self-complete questionnaire gathered details on age, sex, motivation, marital status, employment history, contact with other smokers, concern about weight gain, and nicotine dependence. (Nicotine dependence was assessed by using the Tagerstrom Test). Follow up was carried out at three months after commencing NRT prescription. Data was also gathered from patient case notes as to whether the participant had a smoking-related diagnosis, periods of depression, drug and/or alcohol problems. Outcome was measured in terms of “smoke the same”, “smoke less” and “stopped”. The statistical methods used for testing each factor against smoking were Spearman rank correlation, chi-squared test for trend and Kruskal-Wallis test. Basic descriptive statistics were used to report general outcomes of the study. Results: The study enrolled 120 patients but 19 were lost to follow up. Out of 101 who used their prescription, 35 were smoking the same, 46 were smoking less and 20 had stopped. The variables most strongly affecting outcome were age, with older smokers having more success (p<0.001), and those who had a diagnosis of depression having a worse outcome in terms of smoking cessation (p<0.05). Conclusion: This study's findings indicate that encouraging GPs to take a proactive approach in prescribing NRT is effective, even in an area of socio-economic deprivation, and particularly with older smokers.
Walking at Work: A Pedometer Study Assessing the Activity Levels of Doctors
Authors: Atkinson J , Goody R B , Walker CA
Published: January 2017

Background: The World Health Organisation cites a sedentary lifestyle as one of the top ten causes of morbidity and mortality worldwide.4 A recent, large-scale clinical study showed that brisk walking and vigorous exercise are associated with substantial (and similar) reductions in the incidence of coronary heart disease,6 Current guidelines suggest 10,000 steps per day as an appropriate activity target for healthy adults.7 Aims: This study aims to assess whether doctors are meeting this daily walking target during working-hours, and whether additional out-of-hours exercise is required. Methods: 16 doctors from St. John's Hospital in Livingston (comprising 4 Medical Consultants, 4 Surgical Consultants, 4 Medical PRHOs and 4 Surgical PRHOs) each used a belt-worn pedometer to record all steps made during 5 consecutive day shifts. Stride length and total daily steps were recorded. Steps made out-with working hours were not counted. Total steps and hours worked were recorded at the end of each day. Results: Average daily steps recorded were 7907 (Medical PRHOs), 5068 (Surgical PRHOs), 4822 (Surgical Consultants) and 4647 (Medical Consultants). P values of <0.1 were obtained for the variation in steps between the Medical PRHOs and both the Consultant Surgeons and Consultant Physicians. Distance walked per shift varied from 3.84 (Consultant Physicians) to 6.85 kilometres (Medical PRHOs). Conclusion: Walking at work does provide a substantial proportion of a doctor's recommended daily activity quota. However, it is still necessary to engage in additional, out-of-hours exercise in order to consistently meet the current recommendations for physical exercise.
Plasma Radioactivity following Oral Administration of 57Co-Labelled Vitamin B12
Authors: Finney R. D. , Payne R. W.
Published: January 2017

Levels of plasma radioactivity were measured 8 1/2 hours after an oral dose of 1 μg of 57Co-labelled vitamin B12. The oral test dose was followed after 2 hours by a large parenteral dose (1,000 μg) of non-radioactive vitamin B12. The results of this test have been compared with the results of the urinary excretion (Schilling test) in 14 normal subjects and in 14 patients suffering from pernicious anaemia (in 10 of whom the test was later repeated with added hog intrinsic factor).

Very low levels of plasma radioactivity were found in patients suffering from pernicious anaemia (less than 0.21% of the administered dose per litre of plasma); much higher levels of radioactivity (more than 0.95% of administered radioactivity per litre of plasma) were found in normal subjects. Levels of plasma radioactivity approaching but not quite reaching the normal range were found in patients with pernicious anaemia when the test was repeated with the addition of hog intrinsic factor.

It is concluded that this test provides a simple, rapid, semi-quantitative method of assessing the absorption of vitamin B12 from the gastro-intestinal tract. In our view, it is likely to supplant the Schilling test for routine use in a busy general hospital.
Psychiatric Morbidity among Service Wives: A Pilot Study
Authors: Grubb A. B. A. , Keddie K. M. G. , Munro A. N.
Published: January 2017

The incidence of psychiatric morbidity in a group of naval wives is compared with that of civilian wives of the same age. Reference to hospital in-patient and out-patient facilities is used to define a case. The x2 test of statistical significance is applied to the results, which demonstrate a significantly higher incidence of morbidity in the wives of naval personnel.
The Use of Computers in Assessment of Medical Students
Authors: Lennox B. , Wallace Agnes A. C.
Published: January 2017

The principal use of computing in medical examinations is in the marking of MCQ papers. The computing problems in this are relatively straightforward, and the major difficulty lies in producing answer sheets in machine-readable form.

The three main systems, hole-poking card, mark-sense cards and mark-sense sheets are discussed and compared in some detail.

The possible establishment of a central service which will undertake computer marking for Britain is discussed briefly.

A short account is given of a marking system recently introduced in Glasgow.
Red Cell Glutathione in Anaemia
Authors: Hopkins J. , Tudhope G. R.
Published: January 2017

Erythrocyte reduced glutathione (GSH) has been measured in 17 normal subjects and in 70 patients with anaemia of various causes; the red cells of most of the anaemic patients contained abnormally high levels of GSH. In the group of cases of untreated megaloblastic anaemia in which the haemoglobin concentration was less than 8.0 g. per 100 ml., there was an inverse relationship between the erythrocyte GSH level and the haemoglobin concentration. During initial therapy in megaloblastic anaemia, as the haemoglobin concentration increased, the GSH level decreased towards normal; the time taken for the GSH level to reach a value 2 standard deviations above the normal mean was inversely related to the initial haemoglobin concentration. In the red cells of patients with anaemia there was no correlation between the GSH level and the activity of glutathione peroxidase. The significance of these findings is discussed.
Amplification Systems in Immunity
Authors: Weir D. M.
Published: January 2017

The role of chemical messengers is considered in relation to the initiation and amplification of the immune response. The roles of pre-existing tissue factors of the complement, clotting and Kinin systems, are considered and the additional effects of the chemical mediators produced by activated lymphocytes and tissue breakdown products are described.

The final expression of the immune response appears to depend on complex inter-relationships between these factors and the cells of the lymphoid tissues. Understanding of their actions might be expected to be of value in manipulating the cell-mediated immune response in various disease states.
Assessment of Severity of Haemolytic Disease of the Newborn at Time of Birth
Authors: MacDougall Jean Y. , Black M. D.
Published: January 2017

A new cord blood factor has been suggested as a measure of the seventy of haemolytic disease of the newborn at birth. One hundred and seventy three cases of Rhesus iso-immunisation have been classified as mild, moderate and severe according to the readings of Optical Density Difference of bilirubin in the liquor amnii and correlated with the cord blood haemoglobin, cord blood serum bilirubin, and the new cord blood factor. The new cord blood factor gave the best correlation.
Septicaemia
Authors: McAllister T. A.
Published: January 2017

Septicaemia still presents a major diagnostic and therapeutic challenge to the clinician. Most cases are hospital-acquired and the reasons for their increasing prevalence are discussed, with reference to predisposing factors and opportunistic infections. The pathology and bacteriology of proven cases (positive blood cultures) in 1974 in a modern children's and maternity hospital complex are presented. Gram-positive and Gram-negative varieties are compared and the molecular biology and mechanisms of endo- and exotoxaemia described.

Successful therapy demands correct choice of antibiotic and the development of shock requires skilled supportive measures. For the former a rational scheme is outlined and a plea is made for collection of data for this purpose. Polypharmacy is deprecated and either an aminoglycoside or a cephalosporin forms the mainstay of therapy. The emergence of Bacteroides sp. in cases of abdominal and puerperal sepsis necessitates addition of a lincomycin or metronidazole. Superinfection with systemic candidiasis requires 5-fluorocytosine.
Sexual Problems Referred to a Scottish Psychiatric Service
Authors: Scott I. G. , Alexander D. A.
Published: January 2017

The demand for help with sexual problems is increasing, but it is difficult to obtain basic data about the incidence of certain disorders and the characteristics of those patients who do present. This paper presents relevant data from referrals to a regional psychiatric service. Greater awareness of the nature of the demand may provide assistance to those engaged in the training of personnel who will be required to deal with such problems.
Neonatal Screening for Hypothyroidism in Scotland: Results of a Pilot Study
Authors: Sutherland R. M. , Ratcliffe J. G. , Kennedy R. , Stevenson J. S. , Patrick M. Jean , Ferguson-Smith M. A.
Published: January 2017

We have assessed the feasibility of screening for neonatal hypothyroidism based on thyroxine (T4) or thyrotrophin (TSH) assays on dried blood spots collected for the phenylketonuria (PKU) screening programme in Scotland. The TSH assay was both more sensitive and specific than T4 in detecting primary hypothyroidism and was sufficiently rugged and rapid for routine application. Using a labelled antibody assay for TSH, 99.7 per cent of the first 30,000 babies tested had values less than 25 mU/l, and 0.24 per cent had values between 25 and 50 mU/l. Of the 11 suspected positives (TSH>50 mU/l), nine were confirmed on serum specimens as primary hypothyroidism (prevalence 1:3,300) and the two false positives (0.007% of total) were explicable by inappropriate time of sampling. No false negatives have so far been identified. The median time to detection by blood spot assay was 16 days (range 6 to 22 days). Five of the nine cases were not suspected clinically at the time of screening. It is concluded that TSH fulfils most of the criteria for an ideal screening test for primary hypothyroidism and a screening programme based on blood spot TSH will allow therapy to be commenced within one month of birth.
Morphological Studies in a Case of Thyrotoxicosis Complicated by Lithium Therapy for Bipolar Depression
Authors: McLaren Kathryn M. , Toft A. D. D.
Published: January 2017

The histological and ultrastructural features of the thyroid in a case of thyrotoxicosis complicated by lithium therapy (for bipolar depression) are described. Despite the bizarre and disturbing pathological appearances, it is proposed that their interpretation should be modified in view of the biosynthetic block imposed by lithium administration. The cellular appearances are considered to reflect a hyperplastic state with coincidental impairment of synthetic activity, and not to represent a neoplastic process. The use of lithium in the management of psychiatric illness if increasing. It is important to be aware of the possible effect of the drug not only on thyroid function but also on the histopathological appearances of the thyroid when interpreting any associated or incidental lesion of the gland.