bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and Enablers to Direct Observation of Trainees’ Clinical Performance: A Qualitative Study Using the Theoretical Domains Framework
Authors: Cheung Warren J. , Patey Andrea M. , Frank Jason R. , Mackay Meredith , Boet Sylvain
Published: August 2018

Purpose

Direct observation is essential to assess and provide feedback to medical trainees. However, calls for its increased use in medical training persist as learners report that direct observation occurs infrequently. This study applied a theory-driven approach to systematically investigate barriers and enablers to direct observation in residency training.

Method

From September 2016 to July 2017, semistructured interviews of faculty and residents at The Ottawa Hospital were conducted and analyzed. An interview guide based on the theoretical domains framework (TDF) was used to capture 14 domains that may influence direct observation. Interview transcripts were independently coded using direct content analysis, and specific beliefs were generated by grouping similar responses. Relevant domains were identified based on the frequencies of beliefs reported, presence of conflicting beliefs, and perceived influence on direct observation practices.

Results

Twenty-five interviews (12 residents, 13 faculty) were conducted, representing 10 specialties. Ten TDF domains were identified as influencing direct observation: knowledge, skills, beliefs about consequences, social/professional role and identity, intention, goals, memory/attention/decision processes, environmental context and resources, social influences, and behavioral regulation. Discord between faculty and resident intentions, coupled with social expectations that residents should be responsible for ensuring that observations occur, was identified as a key barrier. Additionally, competing demands identified across multiple TDF domains emerged as a pervasive theme.

Conclusions

This study identified key barriers and enablers to direct observation. These influencing factors provide a basis for the development of potential strategies aimed at embedding direct observation as a routine pedagogical practice in residency training.
Quantitative Characteristics of Consecutive Lengthening Episodes in Early-onset Scoliosis (EOS) Patients With Dual Growth Rods
Authors: Agarwal Aakash , Goswami Ankur , Vijayaraghavan Govindaraja Perumal , Srivastava Abhishek , Kandwal Pankaj , Nagaraja Upendra Bidre , Goel Vijay K. , Agarwal Anand K. , Jayaswal Arvind
Published: August 2018

Study Design.

A prospective single-center study.

Objective.

The aim of this study was to record the characteristic forces and lengths observed during distraction episodes in early-onset scoliosis (EOS), and analyze their interdependencies on the key variability among the patients.

Summary of Background Data.

The goal of the growing-rod technique is to achieve deformity correction alongside maintaining growth of the spine. The deformity correction is achieved during the initial surgery, but follow-up distraction episodes are necessary to maintain the growth. The key variables, under the control of a surgeon, that affect the growth are the applied distraction forces and the distraction lengths. Since the advent of dual growth rod technique, there have been many studies exploring the relationship between these and the actual growth. However, there is sparse evidence on the actual magnitude of distraction forces, and none on its association with patient's parameters such as sex, age, and deformity.

Methods.

In a consecutive series of 47 patients implanted with dual growth rods, the distraction forces (in N) and the lengths (in mm) achieved during each distraction episode and compared against the episode-specific demographics. The values obtained from each side, that is, concave and convex sides, were averaged to calculate the mean. Statistical analysis was performed using t-distribution because for each normalized time points (distraction episode).

Results.

In cumulative, the distraction force increased by an amount of 268%, with 120% increase in the early stages (distractions episodes 1–6) and 68% increase in the later stages (distractions episodes 6–11), whereas the cumulative decrease in the length over 11 distractions episodes was 47%, with 34% and 20% in the early and later stages, respectively. The study does not identify any significant trend with respect to sex, age, and deformity.

Conclusion.

The distraction force and the length increased and decreased respectively with every consecutive distraction episode, with no correlation to sex, age, extent of deformity, or the extent of correction.

Level of Evidence: 5
Complication and Failures of Central Vascular Access Device in Adult Critical Care Settings*
Authors: Takashima Mari , Schults Jessica , Mihala Gabor , Corley Amanda , Ullman Amanda
Published: August 2018

Objectives:

To examine the proportion and rate of central venous access device failure and complications across central venous access device types in adult intensive care.

Data Sources:

A systematic search was undertaken in the electronic databases Cochrane Central Register of Controlled Trials, Embase, U.S. National Library of Medicine National Institutes of Health, and Cumulative Index to Nursing and Allied Health in September 2017.

Study Selection:

Included studies were of observational (prospective and retrospective) or interventional design and reported central venous access device failure and complications in adult ICU settings. Studies were excluded if they were published prior to November 2006 or not reported in English. Two reviewers independently screened articles, assessed eligibility, extracted data, and assessed risk of bias.

Data Extraction:

Data were extracted on the primary outcome, central venous access device failure, and secondary outcomes: central venous access device complications (central line-associated bloodstream infection, catheter-related bloodstream infection, catheter-related thrombosis, occlusion, catheter removal due to suspected infection, dislodgement, breakage, and local infection). Patient and device data and study details to assess the study quality were also extracted.

Data Synthesis:

A total of 63 studies involving 50,000 central venous access devices (396,951 catheter days) were included. Central venous access device failure was 5% (95% CI, 3–6%), with the highest rates and proportion of failure in hemodialysis catheters. Overall central line-associated bloodstream infection rate was 4.59 per 1,000 catheter days (95% CI, 2.31–6.86), with the highest rate in nontunneled central venous access devices. Removal of central venous access device due to suspected infection was high (17%; 20.4 per 1,000 catheter days; 95% CI, 15.7–25.2).

Conclusions:

Central venous access device complications and device failure is a prevalent and significant problem in the adult ICU, leading to substantial patient harm and increased healthcare costs. The high proportion of central venous access devices removed due to suspicion of infection, despite low overall central line-associated bloodstream infection and catheter-related bloodstream infection rates, indicates a need for robust practice guidelines to inform decision-making surrounding removal of central venous access devices suspected of infection.
Single-stage Total Cranial Vault Remodeling for Correction of Turricephaly: Description of a New Technique
Authors: Rottgers Stephen Alex , Ganske Ingrid , Citron Isabelle , Proctor Mark , Meara John G.
Published: August 2018

Background:

Turricephaly is considered one of the most difficult cranial deformities to correct as addressing cranial height can result in increased intracranial pressure. We describe a new technique of total calvarial remodeling with bony transposition to simultaneously correct turricephaly and brachycephaly while preserving intracranial volume.

Methods:

A retrospective review of patients undergoing single-stage cranial vault remodeling by a single surgeon (J.G.M.) at a single center between 2007 and 2015 was performed. The procedure consists of a frontal bandeau followed by a 1 cm 360o axial strip craniectomy. The strip is then rotated 90 degrees into a coronal orientation and interposed between fronto-parietal and parito-occipital segments. Modification for occipital widening can also be performed.

Results:

Six patients with turribrachycephaly underwent the procedure over the 8-year period. Four patients were operated at less than 1 year of age, one patient underwent surgery at 2 years, and one at 9 years. Mean operative time was 4 hours, and mean transfusion was 300cc. There were no major complications. Mean cranial height reduction achieved was 1.6 cm (range, 1.0–2.0 cm), and mean anterior–posterior expansion was 3.4 cm (range, 2.3–4.5 cm). Patients also showed improvement in supraorbital retrusion.

Conclusion:

Single-stage cranial vault remodeling with axial strip craniectomy and coronal interposition is safe and allows for simultaneous correction of turricephaly and brachycephaly while preserving intracranial volume.
Quality of Life of the Plastic Surgeon in the Midwest of Brazil
Authors: de Arruda Fabiano Calixto , de Paula Paulo Renato , Porto Celmo Celeno
Published: August 2018

Background:

The quality of life theme is much studied in the area of plastic surgery; however, there are few studies on the quality of life of plastic surgeons. The main aim of this study was to describe the quality of life of the plastic surgeon in Center-West of Brazil.

Methods:

A cross-sectional study was performed of plastic surgeons in the greater state of Goias, Center-West of Brazil, registered until January 2015. A sample with power of 80%, 115 surgeons from 163 WHOQOL-BREF, and a social-demographic and professional questionnaire were used as instruments. The data were compared between qualitative variables of the questionnaire and WHOQOL-BREF using the Mann-Whitney and Kruskal-Wallis tests.

Results:

One hundred sixteen surgeons answered; for WHOQOL-BREF, domain statistics were as follows: physical, 57.85; psychological, 62.9; social, 74.13; and environment, 68.56. The higher scores in each domain were related: physical: monthly income higher than US$ 11,200, more than 10 years of experience, weekly work hours lower than 40, being an associate or full member, and more than 4 surgeries/week; psychological: man, married, and having only private patients; social: man, monthly income higher than US$15,000, more than 20 years of experience, and weekly work hours lower than 40; and environment: monthly income higher than US$15,000, more than 10 years of experience, weekly work hours lower than 60, and more than 4 surgeries/week.

Conclusion:

The study demonstrates that the youngest surgeon, with a duration of less than 10 years, has the worst quality of life.
Prevalence and risk factors of hepatitis B and C viruses among haemodialysis patients: a multicentric study
Authors: Ali Niyaz , Hussain Wajid , Hayat Azam , Shah Tariq , Wen Ronghui , Zeb Ifra , Abdul Malik Attiya , Ramzan Rahdia , Rehman Mujaddad-ur , Khan Ibrar
Published: August 2018

Background

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are important causes of morbidity and mortality among haemodialysis (HD) patients and create problems in the management of patients in the renal dialysis units, as patients with chronic renal failure do not absolutely clear these viral infections.

Aim

The aim of the study is molecular detection of HBV and HCV and their possible risk factors among the HD patients in northern Pakistan.

Materials and methods

A cross-sectional study was conducted from November 2013 to June 2014. The infections were investigated through serological and molecular techniques.

Results

The overall prevalence of HBV among the five HD centres was 7.5%. The main risk factors were HD centre (26.66%), history of blood transfusion (20%), dental procedure (13.33%) and time duration on HD (6.66%). However, the overall prevalence of HCV among the five HD centres was 19.58%. The main risk factors included HD centre (25.53%), history of blood transfusion (25.53%), dental procedure (10.64%), surgical treatment (6.38%), patients treated abroad (6.38%) and time duration on HD (4.25%).

Conclusion

The high prevalence of hepatitis viruses among HD patients of northern Pakistan indicates a close relation between HD centres and hepatitis virus transmission. Therefore, preventive control measures are essential to reduce hepatitis transmission in HD centres.
Combination Oral Chelation in Adult Patients With Transfusion-dependent Thalassemia and High Iron Burden
Authors: Hammond John , Thompson Alexis A. , Fogel Mark A. , Hammond Katherine , Kokroko Jolene , Kwiatkowski Janet L.
Published: August 2018

An open-label, pilot study was conducted to evaluate deferasirox/deferiprone combination chelation therapy in adult patients with transfusion-dependent thalassemia and severe iron overload. Enrollment proved difficult. Nine patients (median age, 27.4 y; ferritin, 4965 ng/mL; liver iron concentration, 28.5 mg/g dry weight; cardiac T2*, 13.3 ms) received treatment. Two were withdrawn for treatment-related adverse effects. Arthralgia (4 patients) and gastrointestinal symptoms (5 patients) were common; no episodes of neutropenia/agranulocytosis occurred. Adherence difficulties were common. Of 6 patients with 12 to 18 months follow-up, 3 showed improvement in cardiac T2* and 2 in liver iron. Combination oral chelation may be effective but adverse effects and adherence challenges may limit efficacy.
Weekly Rituximab Followed by Monthly Rituximab Treatment for Autoimmune Disease Associated With RAS-associated Autoimmune Leukoproliferative Disease
Authors: Toyoda Hidemi , Deguchi Takao , Iwamoto Shotaro , Kihira Kentaro , Hori Hiroki , Komada Yoshihiro , Hirayama Masahiro
Published: August 2018

Recently, a new disease of lymphocyte homeostasis caused by somatic mosaicism for the RAS mutation has been discovered (known as RALD, RAS-associated leukoproliferative disorder). Since few cases have been reported in literature, the prognosis and standard treatment for autoimmune diseases associated with RALD remain poorly understood. Standard rituximab therapy (375 mg/m2 for 4 wk) is effective in patients with autoimmune diseases, but early recurrences are common. We highlight the potential for monthly administration of rituximab in a patient with autoimmune thrombocytopenia and hemolytic anemia associated with RALD. RALD was diagnosed in an 11-year-old girl following a 9-year history of severe hepatosplenomegaly and autoimmune cytopenias. Genetic analyses confirmed somatic mosaicism for the G13C KRAS mutation without an autoimmune lymphoproliferative syndrome–related gene mutation. Rituximab therapy was used because of the refractory character of the autoimmune cytopenias which failed to respond to steroids and other immunosuppressive agents. Her treatment consisted of weekly infusions of rituximab for 4 weeks followed by monthly rituximab for 11 months. She maintained her response in hematologic parameters for 2 years after monthly rituximab was ceased and her scores representing quality of life were improved. Rituximab could improve clinical responses and quality of life of the patients with RALD.
Successful Use of EPOCH-R in 2 Young Adult Patients With Burkitt Lymphoma and Acute Kidney Injury: A Case Report
Authors: Ross Savannah , Eisenman Kristen , Maloney Kelly W.
Published: August 2018

Pediatric Burkitt lymphoma has historically been treated with intensive methotrexate-based chemotherapy, which improves patient survival while causing severe toxicities. Young patients typically have better outcomes with intensive therapies, while adults and immunocompromised patients have higher toxicities and worse outcomes. Newer treatment regimens, including etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab (EPOCH-R), show promise for these patients. However, few studies exist to demonstrate efficacy and improved toxicity profile with EPOCH-R. We present 2 cases: a 25-year-old male with Down syndrome and an 18-year-old male with Burkitt lymphoma and significant renal injury who were successfully treated with EPOCH-R with minimal toxicities.
Multicenter Validation of the Vasoactive-Ventilation-Renal Score as a Predictor of Prolonged Mechanical Ventilation After Neonatal Cardiac Surgery*
Authors: Cashen Katherine , Costello John M. , Grimaldi Lisa M. , Narayana Gowda Keshava Murty , Moser Elizabeth A. S. , Piggott Kurt D. , Wilhelm Michael , Mastropietro Christopher W.
Published: August 2018

Objectives:

We sought to validate the Vasoactive-Ventilation-Renal score, a novel disease severity index, as a predictor of outcome in a multicenter cohort of neonates who underwent cardiac surgery.

Design:

Retrospective chart review.

Setting:

Seven tertiary-care referral centers.

Patients:

Neonates defined as age less than or equal to 30 days at the time of cardiac surgery.

Interventions:

Ventilation index, Vasoactive-Inotrope Score, serum lactate, and Vasoactive-Ventilation-Renal score were recorded for three postoperative time points: ICU admission, 6 hours, and 12 hours. Peak values, defined as the highest of the three measurements, were also noted. Vasoactive-Ventilation-Renal was calculated as follows: ventilation index + Vasoactive-Inotrope Score + Δ creatinine (change in creatinine from baseline × 10). Primary outcome was prolonged duration of mechanical ventilation, defined as greater than 96 hours. Receiver operative characteristic curves were generated, and abilities of variables to correctly classify prolonged duration of mechanical ventilation were compared using area under the curve values. Multivariable logistic regression modeling was also performed.

Measurements and Main Results:

We reviewed 275 neonates. Median age at surgery was 7 days (25th–75th percentile, 5–12 d), 86 (31%) had single ventricle anatomy, and 183 (67%) were classified as Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Category 4 or 5. Prolonged duration of mechanical ventilation occurred in 89 patients (32%). At each postoperative time point, the area under the curve for prolonged duration of mechanical ventilation was significantly greater for the Vasoactive-Ventilation-Renal score as compared to the ventilation index, Vasoactive-Inotrope Score, and serum lactate, with an area under the curve for peak Vasoactive-Ventilation-Renal score of 0.82 (95% CI, 0.77–0.88). On multivariable analysis, peak Vasoactive-Ventilation-Renal score was independently associated with prolonged duration of mechanical ventilation, odds ratio (per 1 unit increase): 1.08 (95% CI, 1.04–1.12).

Conclusions:

In this multicenter cohort of neonates who underwent cardiac surgery, the Vasoactive-Ventilation-Renal score was a reliable predictor of postoperative outcome and outperformed more traditional measures of disease complexity and severity.
Modified Temporalis Muscle Flap for Eyelid Reanimation
Authors: Evrenos Mustafa Kürşat , Bali Zülfükar Ulaş , Yaman Murat , Yoleri Levent
Published: August 2018

The reanimation of both upper and lower paralytic eyelids requires dynamic procedures for longevity of correction. Temporalis muscle ensures the criteria for reanimation and is used widely as a result. Many modifications were described to improve the success of the classical technique. One of these modifications was reported by the senior author in 1999. Twice as much muscle mass (in thickness) to the upper eyelid than the lower was taken and passed submuscularly 5 to 6 mm away from the limbus and a thinner split was passed subcutaneously beneath the lower cilia. The aim of this study was to present the outcomes of the technique after 38 operations with 37 patients and to describe deep temporalis musculofascial-fatty flap to recover depression of temporalis muscle split donor area. Seventeen lower eyelids were evaluated as mild, 12 were as moderate, and 9 were as severe ectropion. One upper eyelid was evaluated as mild, 14 were as moderate, and 23 were as severe lagophthalmos preoperatively. Mean follow-up time was 28.8 months. Five patients had mild ectropion and 2 patients had mild lagophthalmos postoperatively at last follow-up. Two patients needed medial canthal tendon reinsertion secondary to relaxation of fixation suture at medial canthus. All patients tolerated the procedure and all complaints were resolved without creating a notable cosmetic deformity.
The Coexistence of Growth Hormone-Producing Pituitary Adenoma and Rathke Cleft Cyst: How Can We Diagnosis Preoperation?
Authors: Tang Chao , Qiao Liang , Zhong Chunyu , Yang Jin , Zhu Junhao , Ma Chiyuan
Published: August 2018

Pituitary adenoma (PA) rarely coexists with Rathke's cleft cyst (RCC). Previously, only 13 cases of patients with growth hormone (GH)-producing PA and concomitant RCC have been reported. Here, the authors report a 54-year-old female patient with a GH-secreting PA coexisting with an RCC. Acromegaly was diagnosed according to the physical examination and endocrine data. Preoperatively, the coronal magnetic resonance imaging (MRI) contained 2 different signal intensities, these unusually MRI findings for the intrasellar mass were rarely. According to our clinical experience for diagnosis of PA and RCC, besides GH-producing PA in this case, but the possibility of concomitant RCC should be considered. One-and-a-half nostril endoscopic transsphenoidal approach was performed. Intraoperatively, the adenoma was successfully removed and a large amount of grayish fluid from the cyst was released. The endocrine testing was normal soon after the operation and the patient remained well for a follow-up period of 3 months. The postoperative MRI (obtained 3 months after surgery) showed no intrasellar and suprasellar mass. The authors retrospectively analyzed the all 14 cases of concomitant GH-secreting PAs and RCCs and summarized MRI characteristics. When preoperative MRI contained 2 different signal intensities, one mass lesion showed low or isointense signal on the T1-weighted and T2-weighted images, whereas the other lesion showed low signal on the T1-weighted images and hyperintense on the T2-weighted images, the collision MRI features may be helpful for the preoperative diagnosis of concomitant PAs and RCCs.
Police Interactions Among Neuropathologically Confirmed Dementia Patients
Authors: Liljegren Madeleine , Landqvist Waldö Maria , Rydbeck Robert , Englund Elisabet
Published: August 2018

Objective:

The aim of this study was to investigate and compare the prevalence and recurrence of police interaction (PI) with patients diagnosed with dementia. We also aimed to study the reason behind the PI, the time of occurrence of PI, and potential consequences of the PI.

Methods:

For this retrospective medical records’ review, we included 281 cases with a neuropathologic dementia diagnosis from the Department of Pathology, Region Skane/Lund University, between 1967 and 2013. The diagnoses were Alzheimer disease, frontotemporal lobar degeneration, vascular dementia, and mixed dementia. A prerequisite was that extensive clinical investigation and follow-up had been conducted at the Department of Geriatric Psychiatry in Lund.

Results:

Of the 281 patients studied, 50 (18%) had a history of interacting with the police during the course of their disease. Frontotemporal dementia patients had a relatively higher prevalence of PI and more often due to criminal behavior. The recurrence of PIs differed among the groups; frontotemporal dementia patients exhibited a higher PI recurrence compared with the other groups.

Conclusions:

The patterns of PIs differ between the frontotemporal dementia and Alzheimer disease patients. Knowledge about such differences may be of value for the police, the judiciary system, and the society in general.
John Arthur Joseph Pateman. 18 May 1926—18 May 2011
Authors: Scazzocchio Claudio
Published: August 2018

John Pateman was a distinguished British microbial geneticist. He came from a working-class area of London and a non-academic background. His earliest contribution to genetics was the discovery (together with John Fincham) of intracistronic complementation, an important phenomenon to understand the relationship of genetic information and protein structure; this at a time when the actual coding relationships of DNA and proteins were not yet worked out. Later on, he and his students made a fundamental contribution to the understanding of control of gene expression in eukaryotic microorganisms, providing some of the earliest examples of positive control. This work also led to the discovery of a new enzyme cofactor, the only one discovered through purely genetic evidence. He worked at various universities in Britain and Australia and trained a number of students who further developed the subject.
An amplicon-based sequencing framework for accurately measuring intrahost virus diversity using PrimalSeq and iVar
Authors: Grubaugh Nathan D , Gangavarapu Karthik , Quick Joshua , Matteson Nathaniel L. , De Jesus Jaqueline Goes , Main Bradley J , Tan Amanda L , Paul Lauren M , Brackney Doug E , Grewal Saran , Gurfield Nikos , Van Rompay Koen KA , Isern Sharon , Michael Scott F , Coffey Lark L , Loman Nicholas J , Andersen Kristian G
Published: August 2018

How viruses evolve within hosts can dictate infection outcomes; however, reconstructing this process is challenging. We evaluated our multiplexed amplicon approach - PrimalSeq - to demonstrate how virus concentration, sequencing coverage, primer mismatches, and replicates influence the accuracy of measuring intrahost virus diversity. We developed an experimental protocol and computational tool (iVar) for using PrimalSeq to measure virus diversity using Illumina and compared the results to Oxford Nanopore sequencing. We demonstrate the utility of PrimalSeq by measuring Zika and West Nile virus diversity from varied sample types and show that the accumulation of genetic diversity is influenced by experimental and biological systems.
Dopamine neurons projecting to medial shell of the nucleus accumbens drive heroin reinforcement
Authors: Corre Julie , van Zessen Ruud , Loureiro Michaël , Patriarchi Tommaso , Tian Lin , Pascoli Vincent , Lüscher Christian
Published: August 2018

The dopamine (DA) hypothesis posits the increase of mesolimbic dopamine levels as a defining commonality of addictive drugs, initially causing reinforcement, eventually leading to compulsive consumption. While much experimental evidence from psychostimulants supports this hypothesis, it has been challenged for opioid reinforcement. Here, we use genetically encoded DA and calcium indicators as well as cFos to reveal that heroin activates DA neurons located in the medial part of the VTA, preferentially projecting to the medial shell of the nucleus accumbens (NAc). Chemogenetic and optogenetic manipulations of VTA DA or GABA neurons establish a causal link to heroin reinforcement. Inhibition of DA neurons blocked heroin self-administration, while heroin inhibited optogenetic self-stimulation of DA neurons. Likewise, heroin occluded the self-inhibition of VTA GABA neurons. Together, these experiments support a model of disinhibition of a subset of VTA DA neurons in opioid reinforcement.
Dynamic self-organized error-correction of grid cells by border cells
Authors: Pollock Eli , Desai Niral , Wei Xue-xin , Balasubramanian Vijay
Published: August 2018

Grid cells in the entorhinal cortex are believed to establish their regular, spatially correlated firing patterns by path integration of the animal’s motion. Mechanisms for path integration, e.g. in attractor network models, predict stochastic drift of grid responses, which is not observed experimentally. We demonstrate a biologically plausible mechanism of dynamic self-organization by which border cells, which fire at environmental boundaries, can correct such drift in grid cells. In our model, experience-dependent Hebbian plasticity during exploration allows border cells to learn connectivity to grid cells. Border cells in this learned network reset the phase of drifting grids. This error-correction mechanism is robust to environmental shape and complexity, including enclosures with interior barriers, and makes distinctive predictions for environmental deformation experiments. Our work demonstrates how diverse cell types in the entorhinal cortex could interact dynamically and adaptively to achieve robust path integration.
Mentoring and gender: perception is not reality
Authors: Welsh Elizabeth Torney , Diehn Erica W.
Published: August 2018

Purpose

The purpose of this paper is to explore whether the disconnect between mentoring theory, which posits that women receive less workplace mentoring than men, and empirical results, which have found that women report equivalent or more mentoring received than men, is due to differences in perception rather than in actual mentoring provided.

Design/methodology/approach

Using an MTurk sample of working adults (n=251), a 2 (protégé/participant gender: male/female) × 2 (mentor gender: male/female) × 3 (amount of mentoring: high/medium/low) between-subjects experimental design was tested. This approach held relationship characteristics constant, allowing for an examination of the role of gender in mentoring perceptions.

Findings

Gender was associated with the way protégés viewed a mentoring relationship and their reports of mentoring received. When identical relationships were described, women were more likely than men to identify a senior colleague as a mentor, and protégés in heterogeneous gender mentoring relationships reported more mentoring received than those in homogeneous gender relationships.

Research limitations/implications

When examining mentoring, perceptual differences need to be considered before drawing conclusions.

Practical implications

This study calls into question findings of equivalent mentoring – refocusing attention on the importance of informal mentoring for improving women’s workplace outcomes.

Originality/value

Using an experimental design that holds relationship characteristics constant, this study is able to examine whether perceptions of mentoring are affected by gender. No study has previously done so, and results from the current study help to explain why there has been a disconnect between theory and empirical results.
Impact of supplier development on supplier’s performance
Authors: Lee Alfred Bo Shing , Chan Felix T.S. , Pu Xiaodie
Published: August 2018

Purpose

The purpose of this paper is to explore the impact of supplier development (SD) on supplier’s performance by sharing implicit knowledge in mentorship under the influence of supplier’s organizational culture (OC).

Design/methodology/approach

A survey questionnaire was employed to collect data from 226 employees of participating suppliers after conducting mentorship training at the suppliers’ site. The data were analyzed by the partial least squares structural equation modeling with software SmartPLS Ver. 3.0.

Findings

The empirical analysis indicates that SD by mentorship partially mediates the total effects of OC – power distance and uncertainty avoidance – on performance. It completely mediates the collaborative culture on performance.

Originality/value

This study may confirm that the SD program by mentorship is a viable strategy to enhance the performance of supply chain partners and the selection of suppliers.
Deployment-to-dwell metrics and supply-based force sustainment
Authors: Evans Sarah E. , Steeger Gregory
Published: August 2018

Purpose

In the present fast-paced and globalized age of war, special operations forces have a comparative advantage over conventional forces because of their small, highly-skilled units. Largely because of these characteristics, special operations forces spend a disproportionate amount of time deployed. The amount of time spent deployed affects service member’s quality of life and their level of preparedness for the full spectrum of military operations. In this paper, the authors ask the following question: How many force packages are required to sustain a deployed force package, while maintaining predetermined combat-readiness and quality-of-life standards?

Design/methodology/approach

The authors begin by developing standardized deployment-to-dwell metrics to assess the effects of deployments on service members’ quality of life and combat readiness. Next, they model deployment cycles using continuous time Markov chains and derive closed-form equations that relate the amount of time spent deployed versus at home station, rotation length, transition time and the total force size.

Findings

The expressions yield the total force size required to sustain a deployed capability.

Originality/value

Finally, the authors apply the method to the US Air Force Special Operations Command. This research has important implications for the force-structure logistics of any military force.
Connecting social and environmental policy in Australia: Collateral gains or collateral damage?
Authors: Marston Greg , Stark Alastair , Matthews Tony , Baker Douglas
Published: August 2018

Climate change research relating to “co‐benefits” suggests that the facilitation of social‐welfare outcomes through environmental policy offers a powerful means of incentivising climate change action. Concerns about social‐welfare, however, are often used to undermine climate change policies, typically through political claims that low‐to‐middle‐income households should not shoulder the costs of greater policy alignment between social and environmental objectives. Integrating the social into the environmental can therefore, on the one hand, lead to “co‐benefits” as each agenda promotes the other in political discourse, or alternatively to collateral damage if the policy objectives are framed as incompatible. This article explores both scenarios through two case studies of energy policy in Australia. The findings show that social‐welfare concerns can be a powerful discursive tool with the potential to facilitate political consensus, but also that this potential is not being fully realised, primarily because environmental concerns suffer when attempts are made to integrate the two areas discursively.
Adverse Effect of Antithrombotic Medications on Bleeding Events and Comparison of Antithrombotic Agents in Hemodialysis Patients
Authors: Daimon Shoichiro
Published: August 2018

Antithrombotic medications (AM) are mandatory for many hemodialysis patients, but the bleeding risk associated with this therapy is elevated. The frequency of bleeding events requiring discontinuation of AM, cessation of heparin use, and/or hospitalization was compared between hemodialysis patients with and without AM. All the hemodialysis patients in our clinic were investigated. AM were prescribed in 130 of 222 patients. Except for patients with cilostazol, those with AM had significantly more frequent bleeding events than those without AM (P < 0.01). Bleeding event frequency per 10 000 days of aspirin, clopidogrel, cilostazol, and warfarin prescription was 7.37, 5.95, 2.41, and 9.81, respectively, when restricted to administration of a single AM, which was 4.96, 2.87, 0.7, and 16.06, respectively. In patients without AM, it was 0.91. The bleeding risk associated with AM is elevated in hemodialysis patients and differs markedly depending on the agent used, with the lowest risk associated with cilostazol.
Measuring radiologist workload: Progressing from RVUs to study ascribable times
Authors: Pitman Alexander , Cowan Ian A , Floyd Richard A , Munro Philip L
Published: August 2018

Introduction

The need to measure reporting workload in teaching departments remains a current pertinent need. In Australia, the Pitman–Jones reporting RVUs have been in the public domain since 2003 (revised in 2009). These are expressed in arbitrary units. In New Zealand, single‐site Christchurch Hospital reporting times have been validated and placed in the public domain. Concurrently, the RANZCR has been developing a formulaic descriptor lexicon for imaging studies (the Body System Framework). There is a need to bring these three strands of work together into a common public resource. In 2015, under the auspices of the Chief Accreditation Officer, RANZCR convened the Radiologist Workload Working Group. The goal of the group was to develop a robust method of measuring radiologist workload in teaching departments in Australia and New Zealand for the RANZCR accreditation processes of teaching departments as training sites. This paper concerns itself with one aspect of the group's work, namely reaching a consensus on radiologist study ascribable times for common imaging studies.

Method

The BSF examination descriptors were reduced to a smaller, generic dataset of descriptors at the expense of loss of specificity. BSF study ascribable times had been previously obtained by stopwatch observation. The dataset was harmonized with the Christchurch descriptors to ensure commonality of case mix. The two lead authors reached an approximate consensus study ascribable time for each descriptor in agreement with the BSF and Christchurch data. Specifically, the Christchurch reporting times were relied on extensively to validate the new dataset's study ascribable times. The first draft of descriptors and times was tabled at the meetings of the RANZCR Radiologist Workload Working Group, and was progressively refined by iterative consensus.

Results

The output of the Radiologist Workload Working Group comprises a simplified modality‐based table of robust descriptors and ‘best estimate’ corresponding study ascribable times. These can be used with the extant Pitman–Jones methodology in order to estimate the reporting workload of a medical imaging teaching department in units of time. As a first for Australia and New Zealand, nuclear medicine and PET study ascribable times have been incorporated and balanced against radiology study ascribable times.

Conclusion

The RANZCR 2016 study ascribable times are ready for use by the Australian and New Zealand radiologist and nuclear medicine specialist community. We hope these times will also stimulate further data collection in our two countries towards a robust, bi‐national study ascribable times database.
“The why and the white”: Racism and curriculum reform in British geography
Authors: Esson James
Published: August 2018

This article intervenes in recent debates over the whiteness of the higher education geography curriculum. Focusing on UK‐based universities, I examine the why and the white in the question “Why is our geography curriculum so white?” It is argued that the answer is coloniality‐induced institutional racism. I propose that engaging with insights from critical race theory, social justice and decolonial scholarship could help British geography to more effectively challenge racism, and other forms of dehumanisation, in our institutional arrangements and teaching practices.
Effects of a social tutor on participation, sense of community and learning in online university courses
Authors: Cacciamani Stefano , Cesareni Donatella , Perrucci Vittore , Balboni Giulia , Khanlari Ahmad
Published: August 2018

Recently, Computer Supported Collaborative Learning researchers have become interested in the notion of scripting and assigning roles to students enrolled in online courses, in order to increase their engagement in collaborative activities. This study aimed to investigate whether assigning a role called social tutor to a student enrolled in an online university course can promote 1) peers’ participation in online discussions, 2) the development of a Sense of Community (SC), consisting of three factors: membership, fulfilment of needs and goal achievement and mutual influence of the individual/group, and 3) effective learning. The participants were 53 undergraduate students who enrolled in an online course, and were divided into two groups: 1) a group of 29 students with a social tutor and 2) a group of 24 students with no social tutor. The results indicate that students’ participation as well as the membership factor of SC improved only in the group that the social tutor was present. In contrast, the scores on the other two SC factors improved regardless of the presence of a social tutor. Moreover, the results show no difference between these two groups in terms of students’ grades in the final examination. The importance of a social tutor in the design of effective online university courses is discussed.
Treatment of β654‐thalassaemia by TALENs in a mouse model
Authors: Fang Yudan , Cheng Yan , Lu Dan , Gong Xiuli , Yang Guanheng , Gong Zhijuan , Zhu Yiwen , Sang Xiao , Fan Shuyue , Zhang Jingzhi , Zeng Fanyi
Published: August 2018

Objectives

This study explored whether TALENs‐mediated non‐homologous end joining (NHEJ) targeting the mutation site can correct the aberrant β‐globin RNA splicing, and ameliorate the β‐thalassaemia phenotype in β654 mice.

Material and methods

TALENs vectors targeted to the human β‐globin gene (HBB) IVS2‐654C >T mutation in a mouse model were constructed and selected to generate double heterozygous TALENs+/β654 mice. The gene editing and off‐target effects were analysed by sequencing analysis. β‐globin expression was identified by RT‐PCR and Western blot analysis. Various clinical indices including haematologic parameters and tissue pathology were examined to determine the therapeutic effect in these TALENs+/β654 mice.

Results

Sequencing analysis revealed that the HBB IVS2‐654C >T point mutation was deleted in over 50% of the TALENs+/β654 mice tested, and off‐target effects were not detected. RT‐PCR and Western blot analysis confirmed the expression of normal β‐globin in TALENs+/β654 mice. The haematologic parameters were significantly improved as compared with their affected littermates. The proportion of nucleated cells in bone marrow was considerably decreased, splenomegaly with extramedullary haematopoiesis was reduced, and significant decreases in iron deposition were seen in spleen and liver of the TALENs+/β654 mice.

Conclusion

These results suggest effective treatment of the anaemia phenotype in TALENs+/β654 mice following deletion of the mutation site by TALENs, demonstrating a simple and straightforward strategy for gene therapy of β654‐thalassaemia in the future.
Identification and handling of intensifiers for enhancing accuracy of Urdu sentiment analysis
Authors: Mukhtar Neelam , Khan Mohammad Abid , Chiragh Nadia , Nazir Shah
Published: August 2018

Just like other languages, a large number of intensifiers are used in Urdu language. There may be a single occurrence of an intensifier or there may be multiple consecutive occurrences. While performing sentiment analysis of Urdu text, these intensifiers need special treatment for obtaining more accurate results, which is the main focus of this research work. A wide coverage Urdu sentiment lexicon is developed where intensifiers are identified and placed in a separate file. While developing Urdu sentiment analyser, rules are specifically formulated for assigning polarities to the intensifiers in text, if they are surrounded by the positive or negative words. Results show that the method proved to be effective in attaining the correct classification of Urdu sentences as positive, negative, or neutral, compared with traditional methods. Implementation of rules for intensifiers increased the accuracy of Urdu sentiment analyser from 78.33% to 83.42%, which is a statistically significant improvement. It is concluded that intensifiers cannot be ignored while performing sentiment analysis. Effective handling of intensifiers can significantly improve the performance of sentiment analyser.
Where to seat the applicant? How spatial distance influences the effect of self‐promotion on interviewer evaluations
Authors: Schreurs Bert , Hamstra Melvyn , Segers Mien , Schmitte Katharina
Published: August 2018

In high‐stakes contexts such as job interviews, people seek to be evaluated favorably by others and they attempt to accomplish such favorable judgments particularly through self‐promotional behaviors. We sought to examine the persuasiveness of job candidates’ self‐promotion by examining job applicants’ subjective hireability from the perspective of construal‐level theory. Construal‐level theory states that perceptions occur from different levels of psychological distance (i.e., distal vs. proximal). This distance is created by other dimensions of distance (e.g., spatial or social distance) and affects how individuals construe incoming information. From a large distance, people more readily process abstract information, whereas from a close distance, people more readily process concrete information. Specifically, construal compatibility occurs when abstract versus concrete features of a stimulus match the psychological distance experienced by message‐recipients. Construal compatibility (vs. incompatibility) makes evaluations (e.g., of messages) more favorable. To apply this principle to self‐promotion, we created self‐promotional videos of a job interview, in which the applicant sat either far away from or close to the hiring manager (manipulating psychological distance); the applicant, then, used either direct or indirect self‐promotion (manipulating message construal level). The results showed participants reported stronger intention to hire the applicant when distance matched (vs. did not match) the type of self‐promotion the applicant used.
Mechanistic insight, diagnosis, and treatment of ammonia‐induced hepatic encephalopathy
Authors: Fiati Kenston Samuel Selorm , Song Xin , Li Zhou , Zhao Jinshun
Published: August 2018

Hepatic encephalopathy is a neuropsychological syndrome due to biochemical disturbance of brain function in advanced liver disease patients. Diagnosis and treatment of the condition is very demanding and has negative toll on finances with increased healthcare utilization. The pathophysiology is not completely understood; however, there is evidence that ammonia plays an important role in the etiology. Conventional methods of solely relying on blood ammonia level to diagnose hepatic encephalopathy did not help much; likewise, the use of lactulose alone in treating hepatic encephalopathy has also been discouraged. This paper analyzed the current knowledge regarding the mechanism of how ammonia disrupts the normal brain function as well as the use of latest diagnosing tools including those under development to evaluate the neuropsychiatric state of patients and their quality of life. The efficacies of lactulose and rifaximin combination for short‐term and long‐term treatment in addition to nutritional interventions and other drugs undergoing clinical trials were also reviewed.