bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Summer Response of the East Asian Summer Monsoon to Atmospheric CO2 Forcing and Subsequent Sea Surface Warming
Authors: Chen Jinqiang , Bordoni Simona
Published: May 2016

The early summer regional climate change of the East Asian summer monsoon (EASM) is investigated in the phase 5 of the Coupled Model Intercomparison Project (CMIP5) archive. In the greenhouse gas–forced scenario, reduction of radiative cooling and increase in continental surface temperature occur much more rapidly than changes in sea surface temperatures (SSTs). Without changes in SSTs, the early summer rainfall in the monsoon region decreases (increases) over ocean (land) in most models. On longer time scales, as SSTs increase, rainfall changes are opposite. The total response to atmospheric CO2 forcing and subsequent SST warming is a large (modest) increase in rainfall over ocean (land) in the EASM region. Dynamic changes, in spite of significant contributions from the thermodynamic component, play an important role in setting up the spatial pattern of precipitation changes. Early summer rainfall anomalies over east China are a direct consequence of local land–sea contrast, while changes in the large-scale oceanic rainfall band are closely associated with the displacement of the larger-scale North Pacific subtropical high (NPSH). Ad hoc numerical simulations with the AM2.1 general circulation model show that topography and SST patterns play an important role in early summer rainfall changes in the EASM region.
Parental-leave rich and parental-leave poor: Inequality in Canadian labour market based leave policies
Authors: McKay Lindsey , Mathieu Sophie , Doucet Andrea
Published: May 2016

Canada has two parental leave benefit programs for the care of a newborn or adopted child: a federal program, and, since 2006, a provincial program in Québec. Informed by a social reproduction framework, this article compares access to parental leave benefits between Québec and the rest of Canada by family income and by its two different programs. Our analysis of quantitative data reveals that maternal access to leave benefits has improved dramatically over the past decade in the province of Québec, especially for low-income households. By contrast, on average 38% of mothers in the rest of Canada are consistently excluded from maternity or parental benefits under the federal program. We argue that one key explanation for the gap in rates of access to benefits between the two programs and between families by income is difference in eligibility criteria. In Canada, parental leaves paid for by all employers and employees are unevenly supporting the social reproduction of higher earners. Our article draws attention to the need for greater public and scholarly scrutiny of social class inequality effects of parental leave policy.
Britain's influence in the EU
Authors: Menon Anand , Salter John-Paul
Published: May 2016

How much influence does the UK have in Europe? How has this changed? We argue that the UK has tended to view its relationship with the EU in transactional terms, and that this has led to a dominant understanding framed in terms of ‘costs’ and ‘benefits.’ However, thinking more broadly gives a more nuanced picture of British influence. Thus, we approach this question from two directions: examining the historical record of the UK's role in the development of the EU and the single market; and looking at the ways in which British politicians and officials exert influence in the current political structure. We argue that although the UK has generally had a good track record of success, this has often been threatened by domestic political difficulties – as the current referendum debate shows.
Immigration, free movement and the EU referendum
Authors: Portes Jonathan
Published: May 2016

Immigration and free movement are central issues in the UK's referendum on EU membership. Although free movement was a founding principle of the EU, it only became of central economic and political importance after the expansion of the EU eastward in 2004. For the UK, the economic impacts of recent EU migration appear to have been relatively benign, even for the low paid and low skilled. The UK's recent ‘renegotiation’, which focused on the largely irrelevant issue of ‘benefit tourism’, will make little difference. A vote to Leave, however, will potentially take us into new territory for UK immigration policy,
Free movement of services, migration and leaving the EU
Authors: Barnard Catherine , Ludlow Amy
Published: May 2016

For many people the key question in the referendum is whether a vote to leave will enable the UK to take back control of its borders. So for them the focus is primarily on Article 45 on the Treaty of the Functioning of the European Union (TFEU) which allows free movement of workers. But for individuals much movement to other EU Member States is covered by Article 56 TFEU on the free movement of services. This article will argue that empirical research shows that there is in fact an interesting link between temporary migration under Article 56 TFEU and ultimately permanent migration under Article 45 TFEU. Brexit has the potential profoundly to affect both.
Vividness of Object and Spatial Imagery
Authors: Blazhenkova Olesya
Published: May 2016

Vividness is one of the fundamental characteristics of visual mental imagery. The first research goal was to examine whether vividness that refer to imagery of pictorial object (color, texture, or shape) versus spatial (three dimensional structure, location, or mechanism) properties constitute separate vividness dimensions. The second goal was to develop a vividness questionnaire separately assessing dimensions of imagery vividness. In Study 1, 111 students ( M age = 21.8 years, SD = 1.3) evaluated the vividness of imagery evoked by nine object and nine spatial items from the pilot version of the new Vividness of Object and Spatial Imagery (VOSI) questionnaire, completed a self-report assessment of object and spatial imagery, and rated their aptitudes in art and science. Analysis indicated that imagery vividness comprised object and spatial dimensions. Object vividness items were positively associated with the self-report measure and ratings of artistic abilities, whereas spatial vividness items were positively associated with self-report measure and ratings of science abilities. In Study 2, an independent sample of 205 students ( M age = 21 years, SD = 1.7) completed the second version of the VOSI, art and science aptitude ratings, and a number of self-report and performance measures assessing object and spatial imagery. Object and spatial imagery vividness items loaded on factors with 28 retained items; this two-factor vividness model fit the data better than a unidimensional vividness model. The questionnaire had satisfactory Cronbach’s α for object vividness scale (.88) and for spatial vividness scale (.85). Correlational analyses supported convergent and discriminative validity of the VOSI. While object imagery vividness and spatial imagery vividness share some underlying vividness variance, they are dissociated into separate dimensions.
An Exploratory Study Investigating the Effects of Barefoot Running on Working Memory
Authors: Alloway Ross G. , Alloway Tracy Packiam , Magyari Peter M. , Floyd Shelley
Published: May 2016

The aim of the present study was to compare the potential cognitive benefits of running barefoot compared to shod. Young adults ( N = 72, M age = 24.4 years, SD = 5.5) ran both barefoot and shod on a running track while stepping on targets (poker chips) and when not stepping on targets. The main finding was that participants performed better on a working memory test when running barefoot compared to shod, but only when they had to step on targets. These results supported the idea that additional attention is needed when running barefoot to avoid stepping on objects that could potentially injure the foot. Significant increases in participant's heart rate were also found in the barefoot condition. No significant differences were found in participants' speed across conditions. These findings suggested that working memory may be enhanced after at least 16 minutes of barefoot running if the individual has to focus attention on the ground.
Forensic and Anthropological Application of Body Asymmetry: A Comment on Gutnik et al. (2015)
Authors: Krishan Kewal , Kanchan Tanuj
Published: May 2016

The present communication describes the application of bilateral asymmetry in forensic casework and anthropological research. Bilateral asymmetry is normal in the human body. The body’s asymmetry is attributable to genetic and environmental (evolutionary) reasons. Handedness is a factor related to bilateral asymmetry. Gutnik et al. (2015) supported previous research, showing that the dominant side of the body is stronger than the other side due to additional stress and strain, and thus has augmented musculature and increased mass. The note is intended to elaborate on the applications of body asymmetry in forensic and anthropological practice.
The Puzzle of Tourism Demand at Destinations Hosting UNESCO World Heritage Sites
Authors: Ribaudo Giorgio , Figini Paolo
Published: May 2016

The study develops a comprehensive picture of tourism demand trends at UNESCO World Heritage Sites (WHSs) with the aim of providing evidence of any growth in demand for specific destinations after the listing of their sites. In contrast to previous literature, this article focuses on the smallest statistical unit (the municipality) to examine WHS impact on the destination. Analyzing 16 Italian WHSs, we show the most relevant trends in hospitality demand, comparing tourism flows at destinations before and after listing. Data show that, on average, growth rates of tourism demand in the 5 years after WHS listing are not higher than growth rates in the 5 years before the listing, but a number of different patterns emerge. The policy and managerial implications of such findings are straightforward: at least for a mature destination like Italy, there is no statistical evidence that WHS listing is associated with accelerating market growth rates.
Child and Case Influences on Recidivism in a Statewide Dissemination of Multisystemic Therapy for Juvenile Offenders
Authors: Connell Christian M. , Steeger Christine M. , Schroeder Jennifer A. , Franks Robert P. , Tebes Jacob Kraemer
Published: May 2016

Multisystemic Therapy (MST) is an evidence-based treatment for high-risk youth and their families shown to reduce subsequent delinquent activity. This study investigated (a) rearrest rates of a statewide MST dissemination and (b) the relation of child, family, and case characteristics to rearrest rates following receipt of MST. Analyses examined outcomes for 633 youth following referral to MST. Separate models examined predictors of general rearrest of any type and of more serious misdemeanor or felony arrests. Sixty-five percent of youth experienced a new arrest of any type within 12 months of MST initiation; fewer (53%) experienced a misdemeanor or felony charge in that time frame. Recipients who were younger, had an externalizing behavior disorder, and had a greater number and severity of pre-MST charges were more likely to recidivate. Findings highlight potential child and case factors that may account for variability in treatment effects when MST is implemented broadly within a system.
The Effects of Insurance Status and Medical Need on Community-Based Health Care Access Among Jail Detainees With Serious Mental Illnesses
Authors: O’Grady Caitlin L. , Swartz James A.
Published: May 2016

The present study assessed factors affecting patterns of pre-incarceration medical service access and use among jail detainees with serious mental illnesses and co-occurring substance use disorders. Multivariable logistic and negative binomial models controlling for socio-demographic and psychodiagnostic factors assessed the extent to which insurance status and medical need significantly affected having a regular health care place/provider and number of emergency and non-emergency care visits in the year prior to detention. The results indicated having insurance was associated with decreased emergency care use and increased access to routine medical care. In comparison with insurance status, medical need was a more important determinant of the frequency of both routine and emergency medical care visits. We believe the results broadly support Medicaid expansion under the Affordable Care Act, as well as its provisions for medical homes for offender populations.
Team Manager’s Implementation, High Performance Work Systems Intensity, and Performance: A Multilevel Investigation
Authors: Pak Jongwook , Kim Seongsu
Published: May 2016

Recently, capturing within-organization variability during the implementation of high performance work systems (HPWS) has received considerable attention; however, the source of such variability has rarely been considered. If the utilization of HPWS is positively related to performance outcomes, examining factors contributing to an effective implementation may yield significant theoretical and practical implications. For this purpose, this study extends the extant HPWS literature in two ways. First, we attempt to conceptualize team-level HPWS intensity and identify antecedents of variance across teams. Specifically, we regard the visible role of team managers in the process of HPWS implementation as a primary interpretive filter that makes team members perceive differences in HPWS intensity, which in turn affects team performance. Second, we posit that if human resources (HR) policies are viewed as an exchange agreement between the organization and its employees, then a team manager more actively enforcing espoused HR practices may positively influence the sense of human resource management (HRM)–induced psychological contract fulfillment of team members, which in turn influences individual in-role performance and organizational citizenship behavior (OCB). Our hypotheses are tested with data from 183 matched responses from 51 teams, and the results generally support both the team-level and multilevel hypotheses. We discuss the theoretical and managerial implications of our study.
Psychosocial Well-Being in Children of Same-Sex Parents: A Longitudinal Analysis of Familial Transitions
Authors: Potter Daniel , Potter Emma C.
Published: May 2016

Families in the United States are increasingly diverse, which has given rise to questions about the consequences these new family forms have for children’s outcomes. This study uses a life course perspective to examine the association between family transitions, nontraditional family structures (with particular attention to same-sex parent families), and children’s psychosocial well-being. The Early Childhood Longitudinal Study–Kindergarten cohort was used to examine children’s externalizing well-being, internalizing well-being, and interpersonal skills. Results indicate that nontraditional family structures are associated with poorer psychosocial well-being, but this is largely accounted for by changes and transitions experienced in the creation of new families. The findings provide a critical look at the assumptions embedded in arguments focused solely on family structure, and joins other research in calling attention to the importance of family processes for understanding the well-being of children.
Psychometric Properties of the Spiritual Care-Giving Scale–Arabic Version in Saudi Nursing Students
Authors: Cruz Jonas Preposi , Alshammari Farhan , Colet Paolo C.
Published: May 2016

Aim: To evaluate the psychometric properties of an Arabic version of the Spiritual Care-Giving Scale (SCGS) in a sample of Saudi nursing students. Method: A convenience sample of 202 Saudi nursing students was included in this descriptive cross-sectional study. The 35-item Arabic version of the SCGS (SCGS-A) was tested for internal consistency, stability reliability, content validity, and construct validity. Findings: The SCGS-A manifested acceptable internal consistency and stability reliability with computed Cronbach’s alpha ranges from .84 to .94, and an intraclass correlation coefficient of .97. The item-level content validity index ranged from .83 to 1, and the scale-level content validity index (average) was .98. The principal component analysis revealed five dominant components with eigenvalues greater than 1, and a cumulative contribution rate of 62.0%. The five factors were moderately to strongly correlated ( r = .29-.56; p < .001) with each other and with the overall SCGS-A score ( r = .57-.77; p < .001). Conclusion: The SCGS-A manifested an acceptable reliability and validity in Saudi nursing students, which supports its sound psychometric properties. With the establishment of this valid and reliable tool, timely and accurate assessment of student nurses’ perceptions about spirituality and spiritual care can be facilitated.
Research and application of improved thin-layer element method of aero-engine bolted joints
Authors: Yao Xingyu , Wang Jianjun , Zhai Xue
Published: May 2016

A new dynamic modeling method called the improved thin-layer element method is proposed to apply to the aero-engine bolted joints. The thin-layer elements are partitioned based on the interface contact stress distribution. In addition, the material parameters of the partitioned thin-layer elements are determined by the bolted joints stiffness technique and the fractal contact theory without the experimental results, which allows the engineer to estimate the dynamic characteristics of whole structure before the physical prototype is available. First, the modeling principles of the improved thin-layer element method are studied and the bolted joints stiffness is analyzed. Next, the material parameters of the partitioned thin-layer elements are determined on the basis of the interface contact stress distribution characteristics of the bolted joints. Finally, this method is applied to the simulative casing bolted joints structure and the results are compared with the experimental results in order to verify the proposed method. The results indicate that the improved thin-layer element method is more accurate than the thin-layer elements method, and the material parameters of the partitioned thin-layer elements can be expressed by the structural parameters of the aero-engine bolted joints without updating based on the experiment.
Applied Use of Safety Event Occurrence Control Charts of Harm and Non-Harm Events: A Case Study
Authors: Robinson Susan N. , Neyens David M. , Diller Thomas
Published: May 2016

Most hospitals use occurrence reporting systems that facilitate identifying serious events that lead to root cause investigations. Thus, the events catalyze improvement efforts to mitigate patient harm. A serious limitation is that only a few of the occurrences are investigated. A challenge is leveraging the data to generate knowledge. The goal is to present a methodology to supplement these incident assessment efforts. The framework affords an enhanced understanding of patient safety through the use of control charts to monitor non-harm and harm incidents simultaneously. This approach can identify harm and non-harm reporting rates and also can facilitate monitoring occurrence trends. This method also can expedite identifying changes in workflow, processes, or safety culture. Although unable to identify root causes, this approach can identify changes in near real time. This approach also supports evaluating safety or policy interventions that may not be observable in annual safety climate surveys.
Predicting Mental Health Based on Partners’ Marital Distress
Authors: Hammett Julia F. , Castañeda Donna M. , Ulloa Emilio C.
Published: May 2016

Since marital distress is a multidimensional phenomenon, research efforts directed at identifying meaningful groups of individuals with common characteristics based on their dissatisfaction in various relationship domains are important. In addition, it is important to examine this association not only among White majority-group couples but also among other ethnic groups, such as Mexican American couples, who may differ in terms of cultural values and customs. A latent profile analysis (LPA) of Caucasian and Mexican American newlyweds’ ( N = 278) self-reported marital distress identified four such groups. These groups showed a continuum of dissatisfaction as well as varying degrees of differences in partners’ views of traditional versus nontraditional gender roles. The classes resulting from the LPA were related to individuals’ mental health. Those individuals who found themselves in groups with higher distress also experienced higher levels of anxiety and depression than those individuals who found themselves in groups with lower distress. Although more research is clearly needed among larger and more diverse samples, the present findings may be useful to the field of marriage and family therapy in that they may guide prevention and intervention efforts in the field of marital distress and mental health.
Epithelial Inclusion Cyst in Conjunctival Melanoma
Authors: Esposito Evangelina , Zoroquiain Pablo , Mastromonaco Christina , Morales Melina C. , Belfort Neto Rubens , Burnier Miguel
Published: May 2016

Conjunctival melanoma is the second most common conjunctival malignancy. Its differential diagnosis with other conjunctival melanocytic neoplasms is inherently difficult. The presence of epithelial cysts is a useful feature in conjunctival tumors and favors a benign lesion. Herein 2 cases of conjunctival melanoma with cysts are presented. To the best of our knowledge, this is the first series of conjunctival melanoma with epithelial inclusion cysts. This series emphasizes the importance of considering several malignant features when reviewing conjunctival melanocytic lesions, as malignancy can exist even in the presence of epithelial inclusion cysts.
A Comparative Study of Intraoperative Cytology and Frozen Sections of Sclerosing Pneumocytoma
Authors: Wu Chih-Ying , Wang John , Chang Nien-Yi
Published: May 2016

Sclerosing pneumocytoma (SP) is a rare benign neoplasm of the lung. Conservative surgical excision is curative with an excellent prognosis. Preoperative diagnosis of SP can be difficult. Thus, intraoperative frozen sections play a crucial role in guiding surgical management. However, the interpretation of frozen section can be challenging due to freezing artifact. Intraoperative cytology provides a complementary and better morphological detail. In this study, we review and compare the intraoperative cytology and frozen section of 14 cases of SP. SP is characterized by containing 2 cell types: round stromal cells and cuboidal surface cells. The round stromal cells were small with uniform nuclei and inconspicuous nucleoli. The cuboidal surface cells were more differentiated into type II pneumocytes and showed slightly larger in size with intranuclear inclusions. The immunocytochemical double-labeling staining could display 2 distinct population of vimentin-positive round stromal cells and cytokeratin 7–positive cuboidal surface cells. Recognition of the cytological features of SP circumvents the frozen section artifact and is a useful adjunct to the frozen section in leading to the correct diagnosis of SP.
Early Patient Satisfaction Results on a Modern Generation Fixed-Bearing Total Ankle Arthroplasty
Authors: Oliver Shelley M. , Coetzee J. Chris , Nilsson Lawrence J. , Samuelson Kathryn M. , Stone Rebecca M. , Fritz Jacquelyn E. , Giveans M. Russell
Published: May 2016

Background:

This study presents patient-reported outcomes and patient satisfaction data for the largest series of US patients undergoing modern fixed-bearing total ankle arthroplasty (TAA).

Methods:

We retrospectively reviewed the records of 300 consecutive patients who underwent 321 modern, fixed-bearing TAAs at a single institution. Veterans Rand 12-Item Health Survey (VR-12), Ankle Osteoarthritis Scale (AOS), and the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot score were collected preoperatively and at subsequent follow-up appointments. A patient satisfaction survey was also distributed to each patient postoperatively. Of the 321 TAAs, 245 (232 patients) had a minimum of 2-year follow-up and a complete data set. Furthermore, 192 patients underwent concomitant procedures. The average follow-up was 38.9 months (24-84.5). Eight patients have been lost to follow-up (7 deceased and 1 refused further follow-up).

Results:

The mean AOFAS score preoperatively was 41.1 and at latest follow-up was 84.6 ( P < .01). The mean VR-12 score was 29.7 (Physical) and 54.1 (Mental) preoperatively and 42.7 (Physical) and 55.7 (Mental) at latest follow-up ( P < .01 and P > .05, respectively). AOS pain and disability scores improved significantly after TAA ( P < .01). The patient satisfaction survey indicated that 84% experienced very good to excellent pain relief, 78% reported improved ability to perform daily tasks, and 54% indicated improvement in their ability to perform heavy work or recreational activities. In addition, 94% would probably or definitely have the procedure on the contralateral ankle. Two patients underwent revision TAA at a minimum of 36 months; 8 patients failed the primary TAA and were converted to ankle fusions at a mean of 20.1 months (6.1-46.1).

Conclusion:

Early results of a large series of a modern TAA system demonstrate improvement in patient satisfaction, quality of life, activity, and pain for patients with end-stage ankle arthritis. Early revision was due to infection or loosening of the tibial component.

Level of Evidence:

Level IV, case series.
Exploring Changes in Interagency Collaboration Following AIDS United’s Positive Charge
Authors: Jain Kriti M. , Maulsby Cathy , Kinsky Suzanne , Khosla Nidhi , Charles Vignetta , Riordan Maura , Holtgrave David R.
Published: May 2016

Background. Many out-of-care people living with HIV have unmet basic needs and are served by loosely connected agencies. Prior research suggests that increasing agencies’ coordination may lead to higher quality and better coordinated care. This study examines four U.S. interagency networks in AIDS United’s HIV linkage and retention in care program. This study explores changes in the networks of implementing agencies. Methods. Each network included a lead agency and collaborators. One administrator and service provider per agency completed an online survey about collaboration prior to and during Positive Charge. We measured how many organizations were connected to one another through density, or the proportion of reported connections out of all possible connections between organizations. Network centralization was measured to investigate whether this network connectivity was due to one or more highly connected organizations or not. To compare collaboration by type, density and centralization were calculated for any collaboration and specific collaboration types: technical assistance, shared resources, information exchange, and boosting access. To characterize the frequency of collaboration, we examined how often organizations interacted by “monthly or greater” versus “less than monthly.” Results. Density increased in all networks. Density was highest for information exchange and referring clients. When results were restricted to “monthly or greater,” the densities of all networks were lower. Conclusions. This study suggests that a targeted linkage to care initiative may increase some collaboration types among organizations serving people living with HIV. It also provides insights to policy makers about how such networks may evolve.
Systematic Behavioral Observation for Emergent Team Phenomena
Authors: Waller Mary J. , Kaplan Seth A.
Published: May 2016

The use of moving images to generate data for behavioral analysis has long been a methodology available to organizational researchers. In this article, we draw from previous research in team dynamics to describe and discuss various methodological approaches to using video recorded behavior as a source of quantitative data. More specifically, we identify and examine key decision points for researchers and illustrate benefits and drawbacks to consider. The article concludes with suggestions for ways in which quantitative video-based approaches could be improved.
Female Genital Cutting Restricts Sociosexuality Among the Igbo People of Southeast Nigeria
Authors: Onyishi Ike E. , Prokop Pavol , Okafor Chiedozie O. , Pham Michael N.
Published: May 2016

Female genital cutting (FGC) involves partial or total removal of the external female genitalia and causes detrimental effects on woman’s physical and psychological health. Estimates suggest that 130 million women and girls have experienced FGC worldwide. A frequently cited reason for performing this procedure is to restrict female sexuality. To test this idea, we examined women’s willingness to engage in uncommitted sexual relations (sociosexuality) among the traditional Igbo community in Southeastern Nigeria, a region in which FGC is prevalent. Women with FGC reported more restricted sociosexuality in all three domains (attitude, behavior, and desire) compared to women without FGC. Our results suggest that FGC significantly restricts female extra-pair behavior. We provide evidence that this practice is partially attributable to sexual conflict over reproduction by decreasing paternity uncertainty and increasing the reproductive costs to women.
Innovation the Cleveland Clinic Way
Authors: Brown David
Published: May 2016

Innovation the Cleveland Clinic Way: Powering Transformation by Putting Ideas to Work, a 10 chapter book with three appendices, provides health practitioners a way to plan, develop, and implement their ideas in health care settings to transform the delivery of health and human services programs. The book provides health professionals with suggestions to improve programs and services within the health care delivery system.
Iatrogenic Injury to the Median Nerve During Palmaris Longus Harvest
Authors: Choo Joshua , Wilhelmi Bradon J. , Kasdan Morton L.
Published: May 2016

Background: A rare and disastrous complication of harvesting a tendon graft is the misidentification of the median nerve for the palmaris longus. Methods: The authors report a referred case in which the median nerve was harvested as a free tendon graft. Results: Few reports of this complication are found in the literature despite the frequency of palmaris longus tendon grafting and the proximity of the palmaris tendon to the median nerve. Given the obvious medicolegal implications, the true incidence of this complication is difficult to assess. Discussion: Safe harvesting of the palmaris longus mandates a thorough understanding of the relevant anatomy, in particular the proper differentiation between nerve and tendon and recognition of when the palmaris longus tendon is absent. Techniques to facilitate proper identification of the palmaris longus are outlined.
MyDiabetesMyWay
Authors: Wake Deborah J. , He Jinzhang , Czesak Anna Maria , Mughal Fezan , Cunningham Scott G.
Published: May 2016

MyDiabetesMyWay (MDMW) is an award-wining national electronic personal health record and self-management platform for diabetes patients in Scotland. This platform links multiple national institutional and patient-recorded data sources to provide a unique resource for patient care and self-management. This review considers the current evidence for online interventions in diabetes and discusses these in the context of current and ongoing developments for MDMW. Evaluation of MDMW through patient reported outcomes demonstrates a positive impact on self-management. User feedback has highlighted barriers to uptake and has guided platform evolution from an education resource website to an electronic personal health record now encompassing remote monitoring, communication tools and personalized education links. Challenges in delivering digital interventions for long-term conditions include integration of data between institutional and personal recorded sources to perform big data analytics and facilitating technology use in those with disabilities, low digital literacy, low socioeconomic status and in minority groups. The potential for technology supported health improvement is great, but awareness and adoption by health workers and patients remains a significant barrier.
Spontaneous Iliopsoas Muscle Hemorrhage Secondary to Ibrutinib (Imbruvica; Pharmacyclics)
Authors: Sarcon Anna , Botta Gregory P. , Patel Nikunj , Saven Alan
Published: May 2016

Ibrutinib (Imbruvica; Pharmacyclics) is the first Food and Drug Administration–approved inhibitor of Burton’s tyrosine kinase (BTK). Attenuation of BTK signaling ultimately leads to inhibition of B-cell proliferation and apoptosis. After a series of clinical trials, the Food and Drug Administration approved ibrutinib in patients with relapsed chronic lymphocytic leukemia in 2014 and Waldenström’s macroglobulinemia in 2015. Those trials included rare grade 3+ hemorrhagic events associated with ibrutinib. Herein, we report a unique presentation of back pain due to iliopsoas muscle hemorrhage in a patient with Waldenström’s macroglobulinemia after initiation of ibrutinib.
Occupational Stress and Health Outcomes Comparison of Faculty Teaching in Online, On-Ground, and Mixed Working Environments
Authors: Cameron Ginger D. , Wagenfeld Morty , Danawi Hadi , Gordon Monica , Heick Rebecca , Crommett April
Published: May 2016

This quantitative cross-sectional comparative study used the National Institute for Occupational Safety and Health occupational stress model to determine if stress levels and associated health outcomes vary among university educators based on work environment. Occupational stress has been identified as the most damaging form of stress, leading to lost work hours, low productivity, numerous health issues, and high health care costs. This study used a survey of 1,000 university instructors within the United States comparing undergraduate online educators who work remotely, undergraduate educators who work in an on-ground university, and undergraduate educators in a mixed environment. There was a significant difference in self-reported stress levels across groups, with on-ground educators experiencing more stress than online educators. No significant difference existed in health outcomes across groups.
Effect of single and dual renin-angiotensin blockade on stroke in patients with and without diabetes in VALIANT
Authors: Abdul-Rahim Azmil H , Docherty Kieran F , Skali Hicham , Køber Lars , Dickstein Kenneth , Maggioni Aldo P , Mareev Viacheslav , Zannad Faiez , Velazquez Eric J , Califf Robert M , Pfeffer Marc A , Solomon Scott D , Lees Kennedy R , McMurray John JV
Published: May 2016

Introduction

Concern has been raised about a possible increase in risk of stroke in patients with diabetes treated with the combination of the renin-inhibitor aliskiren and an angiotensin converting enzyme inhibitor or angiotensin receptor blocker. We compared the rate of stroke in patients with and without diabetes treated with single or dual renin-angiotensin system blockade after acute myocardial infarction.

Patients and methods

We performed a post hoc analysis of the Valsartan in Acute Myocardial Infarction trial in which 14,703 patients with heart failure, left ventricular systolic dysfunction or both, were randomised to captopril (C), valsartan (V) or both (C + V) after 0.5–10 days after acute myocardial infarction and followed for a median of 2.1 years. We used Cox proportional-hazard regression to estimate the hazard ratios [HR (95% CI)] of stroke in each treatment group.

Results

Among patients with diabetes, 60/1303 (4.6%) receiving captopril, 60/1337 (4.5%) valsartan and 41/1340 (3.1%) valsartan plus captopril suffered a stroke: V + C versus V or C HR 0.68 (0.47–0.96), p = 0.03. The corresponding numbers in patients without diabetes were 106/3606 (2.9%), 97/3572 (2.7%) and 99/3545 (2.8%): V + C versus V or C HR 0.99 (0.78–1.26), p = 0.92 (interaction p = 0.08).

Conclusion

The risk of stroke after myocardial infarction in patients with diabetes was lower in patients treated with both an angiotensin converting enzyme inhibitor and angiotensin receptor blocker than in patients receiving either monotherapy.
Targeted Therapy for Metastatic Urothelial Cancer: A Work in Progress
Authors: Plimack Elizabeth R. , Geynisman Daniel M.
Published: May 2016

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A 64-year-old man presented to the clinic to discuss treatment options for progressive metastatic urothelial carcinoma (UC). At age 57 years, he underwent cystoprostatectomy for bacillus Calmette-Guérin–refractory, high-grade noninvasive UC. He was well until age 61 years, when he developed a left upper-tract UC. He underwent left nephroureterectomy, revealing locally advanced high-grade UC invading the renal parenchyma (pT3). Postoperatively, his renal function precluded adjuvant cisplatin-based chemotherapy. He enrolled onto a clinical trial of autologous cellular immunotherapy targeting human epidermal growth factor receptor 2, for which he was eligible on the basis of human epidermal growth factor receptor 2 positivity (≥ 1+ by immunohistochemistry) in his nephrectomy tumor specimen. He was randomly assigned to observation. Two years later, he developed a left pelvic mass. Biopsy confirmed metastatic high-grade UC. He was briefly treated with gemcitabine and carboplatin, but this was discontinued as a result of rapid symptomatic and radiographic progression at 8 weeks. He underwent palliative radiation to the left pelvic mass to relieve symptoms of pain and leg edema and subsequently elected to enroll onto a clinical trial of a programmed death 1 inhibitor. Concurrently, his previously obtained pelvic mass biopsy sample was sent for panel-based genomic profiling. He now returns for his first restaging evaluation. Imaging shows marked progression on study with new metastases to the liver as well as progressive edema and pain in the left leg, limiting ambulation. Review of his now-available genomic testing results reveals alterations in HRAS (G12D) and ATR (S296, Q257). He elected to enroll onto a single-arm, open-label trial of a farnesyl transferase inhibitor for patients with HRAS mutations.
GPR30 Promotes Prostate Stromal Cell Activation via Suppression of ERα Expression and Its Downstream Signaling Pathway
Authors: Jia Bona , Gao Yu , Li Mingming , Shi Jiandang , Peng Yanfei , Du Xiaoling , Klocker Helmut , Sampson Natalie , Shen Yongmei , Liu Mengyang , Zhang Ju
Published: May 2016

Cancer-associated fibroblasts (CAFs) play a vital role in malignant transformation and progression of prostate cancer (PCa), and accumulating evidence suggests an enhancing effect of estrogens on PCa. The present study aimed to investigate the possible origin of prostate CAFs and the effects of estrogen receptors, G protein-coupled receptor 30 (GPR30) and estrogen receptor (ER)-α, on stromal cell activation. High expression of fibroblast activation protein (FAP), CD44, and nonmuscle myosin heavy chain B (SMemb) accompanied by low expression of smooth muscle differentiation markers was found in the stromal cells of PCa tissues and in cultured human prostate CAFs. Additionally, SMemb expression, which is coupled to cell phenotype switching and proliferation, was coexpressed with FAP, a marker of activated stromal cells, and with the stem cell marker CD44 in the stromal cells of PCa tissue. Prostate CAFs showed high GPR30 and low ERα expression. Moreover, GPR30 was coexpressed with FAP, CD44, and SMemb. Furthermore, the study demonstrated that the overexpression of GPR30 or the knockdown of ERα in prostate stromal cells induced the up-regulation of FAP, CD44, Smemb, and the down-regulation of smooth muscle markers. The conditioned medium from these cells promoted the proliferation and migration of LNCaP and PC3 PCa cells. GPR30 knockdown or ERα overexpression showed opposite effects. Finally, we present a novel mechanism whereby GPR30 limits ERα expression via inhibition of the cAMP/protein kinase A signaling pathway. These results suggest that stem-like cells within the stroma are a possible source of prostate CAFs and that the negative regulation of ERα expression by GPR30 is centrally involved in prostate stromal cell activation.
Basking hamsters reduce resting metabolism, body temperature and energy costs during rewarming from torpor
Authors: Geiser Fritz , Gasch Kristina , Bieber Claudia , Stalder Gabrielle L. , Gerritsmann Hanno , Ruf Thomas
Published: May 2016

Basking can substantially reduce thermoregulatory energy expenditure of mammals. We tested the hypothesis that the largely white winter fur of hamsters (Phodopus sungorus), originating from Asian steppes, may be related to camouflage to permit sun basking on or near snow. Winter-acclimated hamsters in our study were largely white and had a high proclivity to bask when resting and torpid. Resting hamsters reduced metabolic rate (MR) significantly (>30%) when basking at ambient temperatures (Ta) of ∼15 and 0°C. Interestingly, body temperature (Tb) also was significantly reduced from 34.7±0.6°C (Ta 15°C not basking) to 30.4±2.0°C (Ta 0°C basking), which resulted in an extremely low (<50% of predicted) apparent thermal conductance. Induced torpor (food withheld) during respirometry at T­a 15°C occurred on 83.3±36.0% of days and the minimum torpor MR was 36% of basal MR at an average Tb of 22.0±2.6°C; movement to the basking lamp occurred at Tb<20.0°C. Energy expenditure for rewarming was significantly reduced (by >50%) during radiant heat-assisted rewarming, however, radiant heat per se without an endogenous contribution by animals did not strongly affect metabolism and Tb during torpor. Our data show that basking substantially modifies thermal energetics in hamsters, with a drop of resting Tb and MR not previously observed and a reduction of rewarming costs. The energy savings afforded by basking in hamsters suggest that this behaviour is of energetic significance not only for mammals living in deserts where basking is common, but also for P. sungorus and likely other cold-climate mammals.
Hox genes and evolution
Authors: Hrycaj Steven M. , Wellik Deneen M.
Published: May 2016

Hoxproteins are a deeply conserved group of transcription factors originally defined for their critical roles in governing segmental identity along the antero-posterior (AP) axis inDrosophila. Over the last 30 years, numerous data generated in evolutionarily diverse taxa have clearly shown that changes in the expression patterns of these genes are closely associated with the regionalization of the AP axis, suggesting thatHoxgenes have played a critical role in the evolution of novel body plans within Bilateria. Despite this deep functional conservation and the importance of these genes in AP patterning, key questions remain regarding many aspects ofHoxbiology. In this commentary, we highlight recent reports that have provided novel insight into the origins of the mammalianHoxcluster, the role ofHoxgenes in the generation of a limbless body plan, and a novel putative mechanism in whichHoxgenes may encode specificity along the AP axis. Although the data discussed here offer a fresh perspective, it is clear that there is still much to learn aboutHoxbiology and the roles it has played in the evolution of the Bilaterian body plan.
pyGeno: A Python package for precision medicine and proteogenomics
Authors: Daouda Tariq , Perreault Claude , Lemieux Sébastien
Published: May 2016

pyGeno is a Python package mainly intended for precision medicine applications that revolve around genomics and proteomics. It integrates reference sequences and annotations from Ensembl, genomic polymorphisms from the dbSNP database and data from next-gen sequencing into an easy to use, memory-efficient and fast framework, therefore allowing the user to easily explore subject-specific genomes and proteomes. Compared to a standalone

program, pyGeno gives the user access to the complete expressivity of Python, a general programming language. Its range of application therefore encompasses both short scripts and large scale genome-wide studies.
Asset sources of competitive advantage of SMEs from high-tech sector in the region of greater Poland
Authors: Gajowiak Małgorzata
Published: May 2016

The article tackles the question of the ever-growing importance of soft factors of production in the process of competitive advantage for contemporary enterprises. This condition has resulted from turbulent environment characterized by increasing competition, generalized uncertainty and information asymmetry. Based on the above assumption during 2013–2014 a research project was carried out on the role of intangible resources in the process of gaining advantage over competitors in high-tech companies from Greater Poland. The study was carried out for the given population and conducted using the CATI method. On the basis of responses to the questions in the survey, one can conclude that these companies implement modern management paradigm and its activities are based largely on soft resources, which are impossible to be copied and on skills in the form of human capital, propensity for learning and the social capital of employees. The findings of the project can serve as a valuable clue for those companies which at the moment do not demonstrate a prospective approach to achieving entrepreneurial categories in practice.
Optimization of the variables selection in the process of real estate markets rating
Authors: Renigier-Biłozor Małgorzata , Biłozor Andrzej
Published: May 2016

The growing significance of the real estate market prompts investors to search for factors and variables which support cohesive analyses of real estate markets, market comparisons based on diverse criteria and determination of market potential. The specificity of the real estate market is determined by the unique attributes of property. The Authors assume that developing real estate market ratings identifies the types of information and factors which affect decision-making on real estate markets. The main objective of  real estate market ratings is to create a universal and standardized classification system for evaluating the real estate market. One of the most important problems in this area is collecting appropriate features of real estate market and development dataset. The main problem involves the selection and application of appropriate features, which would be relevant to the specificity of information related to the real estate market and create a kind of coherent system aiding the decision-making process. The main aim of this study is the optimization of  set of variables that were used to develop the real estate market ratings.  For this purpose, Hellwig’s method of integral capacity of information was applied. In this particular case, the method shows what set of variables provides information most sufficiently. The results lead to obtaining the necessary set of features that constitute essential information which describes the situation on the local real estate market.
You have an identity
Authors: Bissett Julie
Published: May 2016

National Smile Month is celebrating its 40th anniversary and at the helm of the oral health awareness drive is ground-breaking dental nurse Janet Goodwin. Here, the President of the Oral Health Foundation reveals why she believes your time has come
A guide to fluoride
Authors: MacLeavy Christine
Published: May 2016

Christine MacLeavy looks at the science behind the mineral in all its guises
Treating dentine hypersensitivity
Authors: Davidson Michael
Published: May 2016

Dental nurses are now part of the team dealing with patients in need of this kind of treatment, says dentist Michael Davidson
In the driving seat
Authors: Ellwood Fiona , Smith Louise , Palethorpe Faye
Published: May 2016

Dental nurses Louise Smith and Faye Palethorpe talk to Fiona Elwood about moving up a gear in their career, their experiences of fluoride varnish application and prevention in practice