bluuebunny/crossref_metadata_2025 huggingface dataset:
A marginalized two-part model for longitudinal semicontinuous data
Authors: Smith Valerie A , Neelon Brian , Preisser John S , Maciejewski Matthew L
Published: July 2015

In health services research, it is common to encounter semicontinuous data, characterized by a point mass at zero followed by a right-skewed continuous distribution with positive support. Examples include health expenditures, in which the zeros represent a subpopulation of patients who do not use health services, while the continuous distribution describes the level of expenditures among health services users. Longitudinal semicontinuous data are typically analyzed using two-part random-effect mixtures with one component that models the probability of health services use, and a second component that models the distribution of log-scale positive expenditures among users. However, because the second part conditions on a non-zero response, obtaining interpretable effects of covariates on the combined population of health services users and non-users is not straightforward, even though this is often of greatest interest to investigators. Here, we propose a marginalized two-part model for longitudinal data that allows investigators to obtain the effect of covariates on the overall population mean. The model additionally provides estimates of the overall population mean on the original, untransformed scale, and many covariates take a dual population average and subject-specific interpretation. Using a Bayesian estimation approach, this model maintains the flexibility to include complex random-effect structures and easily estimate functions of the overall mean. We illustrate this approach by evaluating the effect of a copayment increase on health care expenditures in the Veterans Affairs health care system over a four-year period.
The Biological Basis of Learning
Authors: Rodgers David L.
Published: July 2015

Background:Brain-based learning (BBL), also referred to as educational neuroscience, examines learning as a biological process. Teaching to support BBL requires blending of understanding of neuroscience with the practice of education. With BBL, the learning environment is designed to enhance the brain’s natural ability to learn.

Aim: This manuscript describes the fundamentals of brain-based learning, translates the basic tenets of BBL to the simulation learning environment, and presents practical application strategies for simulation-based learning.

Method: Focusing on the work of Renate and Geoffrey Caine, this article examines their approach to BBL, including the three core elements of brain-based learning experience: orchestrated immersion in complex environments, relaxed alertness, and active processing. The three elements of the Caine and Caine model are well-embedded in the larger BBL literature and have particular utility with simulation-based education.

Results: The three core elements of BBL have direct application to simulation as a teaching and learning practice. This paper presents several specific strategies designed to enhance both the simulation event experience and the debriefing.

Conclusion: The simulation learning environment can be adapted to capitalize on the tenets of BBL. Several instructional strategies are available to enhance the biological process of learning while utilizing simulation-based learning practices.
The Child Welfare Cartel
Authors: Stoesz David
Published: July 2015

The probity of the Children’s Bureau’s National Child Welfare Workforce Institute (NCWWI) is examined with respect to the status of child welfare as well as the performance of social work education. By requiring that funding go only to accredited schools of social work, which is not authorized by relevant provisions of the Social Security Act, NCWWI effectively establishes a cartel that excludes other disciplines. Alternatives to improve child welfare services and staff training are considered.
Piloting a Collaboration Between Education and Broadcast Journalism in Taiwan
Authors: Wu Leon Yufeng , Chang Chun-Yen , Liu Hsiang-Hu , Wu Pin-Hsuan , Lei Ya-Chi , Lu Hsin-Yen
Published: July 2015

In Taiwan, the production of science news would benefit by cooperation between communication (e.g., the news production team) and science education (e.g., instructional designers and scientists involved). The news production team is skilled in exposing stories vividly to motivate audiences, whereas the science education team carefully curates the scientific and instructional content. Therefore, we started the Different Science News project, which strives to align the above features of science news production. Through using concurrent, local, and concise materials that occur in daily lives, we hope to promote the public understanding of science.
The Link Between ADHD and the Risk of Sexual Victimization Among College Women
Authors: Snyder Jamie A.
Published: July 2015

Using data from a nationally representative sample of college women, the current study examines attention deficit hyperactivity disorder (ADHD) as a potential risk factor in the prediction of sexual victimization among college women and as an extension of the lifestyles/routine activities framework. The findings indicate that college women with ADHD experienced sexual victimization at significantly higher rates than college women without ADHD. Furthermore, ADHD emerged as a significant predictor of sexual victimization across models. The lifestyles/routine activities theory also received general support, particularly for the concepts of exposure, proximity, and guardianship. This research suggests that other risk factors outside the lifestyles/routine activities framework are important in the prediction of sexual victimization in college women.
Outcomes of hospitalized neutropenic oncology patients with Pseudomonas aeruginosa bloodstream infections: focus on oral fluoroquinolone conversion
Authors: Yan Lily Z , Herrington Jon D
Published: July 2015

Background

Pseudomonas aeruginosa bacteremia is a major cause of morbidity and mortality, especially in neutropenic oncology patients. Few studies have been published in the last decade on treatment outcomes of neutropenic oncology patients with Pseudomonas aeruginosa bacteremia. In addition, there is a lack of data addressing the role of oral fluoroquinolones in this patient setting.

Methods

A retrospective chart review from 1999 to 2013 was conducted at a large academic medical center in neutropenic oncology patients with documented Pseudomonas aeruginosa bacteremia, who were initially treated with intravenous anti-pseudomonal antibiotics and then converted to an oral anti-pseudomonal fluoroquinolone. Patients were evaluated for the rate of cure and for the time from onset of intravenous antibiotic therapy to conversion to oral fluoroquinolones.

Results

Twenty-nine patients with Pseudomonas aeruginosa bacteremia were evaluated. The median absolute neutrophil count at the time of the first positive blood culture was 50 cells/mm3, and the median duration of time below an absolute neutrophil count of 1000 cells/mm3 was five days. The change to oral fluoroquinolones occurred at a median (range) of six (2–18) days after initiation of intravenous antibiotics and at a median absolute neutrophil count of 2610 (110–24790) cells/mm3. The initial cure was 93.1%, while ultimate cure was 91.7%.

Conclusion

Converting to oral fluoroquinolones after initial intravenous antibiotic therapy for Pseudomonas aeruginosa bacteremia in clinically stable neutropenic oncology patients appears to achieve successful outcomes. However, prospective trials are needed to validate these results in neutropenic oncology patients with Pseudomonas aeruginosa bacteremia who are converted to oral fluoroquinolones.
Long-Term Refugee Health
Authors: Nelson-Peterman Jerusha L. , Toof Robin , Liang Sidney L. , Grigg-Saito Dorcas C.
Published: July 2015

Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old ( n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health.
Analysing European gender equality policies abroad: A reflection on methodology
Authors: Debusscher Petra
Published: July 2015

Can gender equality quality criteria developed for assessing EU internal policies be used unequivocally for evaluating EU external policies? Or might a methodological adaptation be necesary? To engage with this dilemma, the author evaluates the two-dimensional quality model of Krizsan and Lombardo and examines what a reorientation of the model would entail to better allow for the analysis of gender policy implemented outside of Europe. The author argues that to allow for an in-depth analysis of EU gender policy abroad, the model’s procedural criteria ‘empowerment of women’s rights advocates’ and ‘transformation with reference to the prevailing context’ need to be brought centre stage and mainstreamed throughout the research design. The author suggests doing this by explicitly involving the views of gender activists from the national context in the analysis and using their perspectives as a touchstone for the evaluation of quality. To examine the proposed methodological model’s suitability for analysing the quality of gender policies in EU external relations, this operationalization is applied to the case of EU–South African development cooperation. The article concludes that the inclusion of gender advocates’ perspectives is necessary to avoid stereotypical, paternalist and Eurocentric ideas about the meaning of gender equality abroad and allow for a contextually grounded reflexivity on the quality of gender policy. Finally, it is argued that it is the role of feminist research to enhance women’s capacity for self-determination methodologically and to hear the voices of national actors that might otherwise not be heard in EU external relations.
Effect of bi-directional operation on rolling-sliding wear of wheel steel under variable amplitude loading
Authors: Zeng Dongfang , Lu Liantao , Zhang Jiwang , Jin Xuesong , Zhu Minhao
Published: July 2015

The objective of this paper was to investigate the wear behaviour of railway wheel steel under the combined condition of bi-directional operation and variable amplitude loading. Rolling-sliding wear tests show that the wear rate of the wheel disc significantly drops at the moment of the bi-directional operation, and then it rises with the increase in reversed rolling cycles until a steady wear state is reached. When the test was conducted under the combined condition of the bi-directional operation and a two-step loading, the wear rate of the wheel disc after bi-directional operation decreases with the increase in the first step contact stress. These wear behaviours can be explained by the variation of the reversed plastic deformation and the movement of wave structure produced by the bi-directional operation. The wave structure moves down with the increase in reversed rolling cycles due to the reduction of the resistance to reversed plastic deformation. This reduces the resistance to the propagation of surface cracks and leads to the increase of wear rate. The resistance to reversed plastic deformation rises with the increase in the first step contact stress, which makes the wave structure move towards to the worn surface and reduces the wear rate of the wheel steel.
Study on material transfer in the process of contact strips rubbing against a contact wire with electric current
Authors: Hu Y , Chen GX , Gao GQ , Wu GN , Zhang WH , Zhou ZR
Published: July 2015

A series of experimental tests on a block-on-ring tester were carried out to obtain a new understanding of severe material transfer in the process of contact strips rubbing against a contact wire with electric current. Three types of contact strip materials including an aluminum-based strip, a copper-based strip, and a pure carbon strip are tested in electric sliding against two contact wire materials including a pure copper contact wire and a copper–silver alloy contact wire. Test results show that there are serious material transfers in these three different friction couples in electric sliding. The aluminum-based strip has the severest material transfer, followed by the copper-based strip. The pure carbon strip has the minimum material transfer. It is found that the material transfer increases with the increase of the sliding speed, the arc discharge intensity, and the contact pressure. In the presence of electric current, contact strip materials are always transferred to the contact wire.
Systemic connective tissue features in women with fibromuscular dysplasia
Authors: O’Connor Sarah , Kim Esther SH , Brinza Ellen , Moran Rocio , Fendrikova-Mahlay Natalia , Wolski Kathy , Gornik Heather L
Published: July 2015

Fibromuscular dysplasia (FMD) is a non-atherosclerotic disease associated with hypertension, headache, dissection, stroke, and aneurysm. The etiology is unknown but hypothesized to involve genetic and environmental components. Previous studies suggest a possible overlap of FMD with other connective tissue diseases that present with dissections and aneurysms. The aim of this study was to investigate the prevalence of connective tissue physical features in FMD. A total of 142 FMD patients were consecutively enrolled at a single referral center (97.9% female, 92.1% of whom had multifocal FMD). Data are reported for 139 female patients. Moderately severe myopia (29.1%), high palate (33.1%), dental crowding (29.7%), and early-onset arthritis (15.6%) were prevalent features. Classic connective features such as hypertelorism, cleft palate, and hypermobility were uncommon. The frequency of systemic connective tissue features was compared between FMD patients with a high vascular risk profile (having had ⩾1 dissection and/or ⩾2 aneurysms) and those with a standard vascular risk profile. A history of spontaneous pneumothorax (5.9% high risk vs 0% standard risk) and atrophic scarring (17.6% high risk vs 6.8% standard risk) were significantly more prevalent in the high risk group, p<0.05. High palate was observed in 43.1% of the high risk group versus 27.3% in the standard risk group, p=0.055. In conclusion, in a cohort of women with FMD, there was a prevalence of moderately severe myopia, high palate, dental crowding, and early-onset osteoarthritis. However, a characteristic phenotype was not discovered. Several connective tissue features such as high palate and pneumothorax were more prominent among FMD patients with a high vascular risk profile.
Validation of the School-age Assessment of Attachment in a short-term longitudinal study
Authors: Crittenden Patricia , Robson Katrina , Tooby Alison
Published: July 2015

This study tested the validity of the School-aged Assessment of Attachment (SAA) in terms of matches from the well-validated Preschool Assessment of Attachment (PAA) to the SAA 6 months later. It also addressed validity in terms of mental health services and measures of stress, depression and anxiety.

Hypotheses:

Children’s SAA classifications were predicted to match their 6 months’ previous PAA classifications and indicators of maternal, child and family stress. The study used a two-group comparative design, involving normative and clinical children and their mothers.

Method:

The participants were 50 children between 5.5 and 5.9 years of age. Each child participated with his or her mother in a PAA, and then 6 months later each child responded to the SAA story cards as well as self-report assessments of stress, anxiety and depression.

Results:

Concordance of A, B, C and A/C attachment classifications was found between the PAA and SAA in 34 of 48 children. There was a strong relation between referral status (clinical or normative) and both PAA and SAA attachment classifications. In every non-matching case, a normative child had an attachment classification indicative of risk, indicating that the direction of errors was false positives as opposed to false negatives.

Conclusions:

This evidence supports the validity and clinical utility of the SAA.
Complete resolution of acute subdural hematoma in an elderly patient with the subdural evacuating port system
Authors: Carr Steven B , Bolles Gene E
Published: July 2015

A 79-year-old patient on an antiplatelet medication presented to the emergency department following a fall at home. She was found to have an enlarging mixed density acute subdural hematoma with significant mass effect and impaired neurologic status and was successfully treated with a subdural evacuating port system drain placement. The patient had rapid and complete radiographic resolution of the hematoma and return to her premorbid neurologic status. A craniotomy, and the associated risks, was avoided. Elderly patients are at particular risk for developing subdural hematomas given the high rates of receiving antiplatelet and anticoagulation therapies, risk for falls, and difficulties with safe ambulation and independent living. Twist drill craniostomy drainage through catheter or subdural evacuating port system placement has been used effectively in the treatment of liquefied older chronic or subacute subdural hematomas. However, acute subdural hematomas, when large or symptomatic enough to require evacuation have historically been treated by craniotomy. Craniotomy in elderly patients with a subdural hematoma has significant risks and typically requires several days of hospitalization and intensive care, which was avoided in this patient. Subdural evacuating port system drain placement can be an effective treatment option in some elderly patients with acute subdural hematomas, which have a significant hypodense component.
Women’s talk, mothers’ work: Korean mothers’ address terms, solidarity, and power
Authors: Kim Minju
Published: July 2015

This study analyzes 400 minutes of natural conversations between Korean married women and investigates their interactions with focus on their use of address terms to index closeness. In particular, it examines the emergence of the female solidarity term caki ‘you’, and demonstrates solidarity’s entailment of power. Traditionally, Korean women with children have been addressed by reference to their children’s names (e.g. ‘Ken’s mom’) even by her friends. Caki, which allows friends to directly address each other, has become a popular alternative, indicating solidarity. In addition, contrary to their traditional dismissal as gossip, Korean mothers’ conversations and networks have become a socially recognized form of power, called the ‘Married Women’s Network’, for sharing valuable information, particularly on children’s education. Therefore, women’s use of the solidarity term caki may also be motivated by a power factor to stay integrated in the mothers’ network, demonstrating Tannen’s ‘paradox of power and solidarity’.
What Happens in the Writers’ Room Stays in the Writers’ Room? Professional Authority in Lyle v. Warner Bros.
Authors: Heuman Josh
Published: July 2015

After her termination as a Friends writers’ assistant, Amaani Lyle filed suit for harassment and discrimination. In response, writers defended their professional authority over the writing process, facing two related tensions. First, Lyle v. Warner Bros. emphasized frictions between artistic freedom and social responsibility, amid concerns about a lack of diversity among writers. Second, the case also spotlighted the ambivalence of writers’ artistic status, within a collaborative and vertically integrated system of production. Focusing on problems of organization and profession, this article explores writers’ negotiations of these tensions as negotiations of their role in a complex industry.
Improving the conductivity of polyaniline-coated polyester textile by optimizing the synthesis conditions
Authors: Hoghoghifard Sedigheh , Mokhtari Hossein , Dehghani Sajjad
Published: July 2015

Conducting polyaniline-coated polyester textiles have attracted much attention due to their wide range of surface resistivity. The surface resistivity depends strongly on the polymerization condition. In this work, polyaniline coated on textile by in situ chemical polymerization method. The influence of substrate modification, synthesis condition, and especially redoping procedure on the surface resistivity of polyaniline-coated textile was investigated and an optimum condition specified. The obtained results indicate that polymerization in an ice-water bath and in a monomer:oxidant:HCl molar ratio equal to 1:1:7 for about 4–6 h decreases the surface resistivity significantly. Furthermore, the experimental results show that etching the surface of textile and redoping procedure with concentrated HCl vapor can decrease the surface resistivity, in a short time.
Acceptance and Commitment Therapy in the Treatment of Depression Related to Military Sexual Trauma in a Woman Veteran
Authors: Hiraoka Regina , Cook Andrew J. , Bivona Jenny M. , Meyer Eric C. , Morissette Sandra B.
Published: July 2015

Depression is commonly reported by Veterans who have experienced military sexual trauma (MST). An increasing body of literature supports the use of Acceptance and Commitment Therapy (ACT) for the treatment of depression among civilians and military Veterans; however, additional research is needed, particularly among people exposed to trauma. This clinical case study describes the application of ACT with a 21-year-old woman Veteran who sought treatment for depression related to MST. The Veteran’s depression symptoms decreased substantially over the course of therapy. Moreover, she demonstrated increased ability to attend to the present moment, tolerate feelings of uncertainty, and make decisions consistent with her chosen values. Treatment implications of these findings are discussed, with an emphasis on the unique aspects of using ACT in the treatment of MST-related depression among Veterans.
Predictive Value of Upper Limb Muscles and Grasp Patterns on Functional Outcome in Cervical Spinal Cord Injury
Authors: Velstra Inge-Marie , Bolliger Marc , Krebs Jörg , Rietman Johan S. , Curt Armin
Published: July 2015

Objective. To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper limb function and independence in activities of daily living (ADLs) and to assess the predictive value of qualitative grasp movements (QlG) on upper limb function in individuals with acute tetraplegia. Method. As part of a Europe-wide, prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI. For prediction of upper limb function and ADLs, a logistic regression model and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used. Results. Logistic regression and URP-CTREE revealed that a combination of ISNCSCI and GRASSP muscles (to a maximum of 4) demonstrated the best prediction (specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with the QlG predictors for upper limb function showed similar results. Conclusion. Prediction of upper limb function can be achieved through a combination of defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A combination of a limited number of proximal and distal muscles along with an assessment of grasping movements can be applied for clinical decision making for rehabilitation interventions and clinical trials.
Reduced Voluntary Activation During Brief and Sustained Contractions of a Hand Muscle in Secondary-Progressive Multiple Sclerosis Patients
Authors: Wolkorte Ria , Heersema Dorothea J. , Zijdewind Inge
Published: July 2015

Background. Secondary-progressive multiple sclerosis (SPMS) patients have structural cortical damage resulting in increased compensatory cortical activity during (submaximal) performance. However, functional effects of changed cortical output are difficult to measure. The interpolated-twitch technique allows for measurement of voluntary activation (VA) necessary for force production. This study aimed to determine VA, force, and muscle fatigue during brief and sustained contractions in SPMS patients. Because fatigue effects are not confined to the motor system, we additionally examined fatiguing effects on cognitive performance. Methods. Twenty-five SPMS and 25 sex-, age-, and education-matched participants performed brief (5 seconds) and sustained (2 minutes) maximal index finger abductions. To evaluate VA, double-pulse twitches were evoked before, during, and after contractions. Additionally, data were compared with data obtained in relapsing–remitting multiple sclerosis (RRMS) patients. Subjects also performed choice-reaction time tasks before and after the sustained contraction. Results. During brief contractions, VA (85% vs 94%, P = .004) and force (25 N vs 32 N, P = .011) were lower for SPMS patients than controls. During sustained contractions, VA ( P = .001) was also lower, resulting in greater force decline (73% vs 63%, P < .001) and reduced peripheral fatigue (19% vs 50%, P < .001). Comparisons with RRMS resulted in lower VA, greater force decline, and greater estimated central fatigue in SPMS. SPMS patients were slower ( P < .001) and made more errors ( P < .001) than controls, but neither group reduced their performance after the sustained contraction. Conclusion. SPMS patients had lower VA than RRMS patients and controls. The importance of voluntary activation for muscle force and fatigability warrants targeted rehabilitation strategies.
Enduring Divisions: Critique, Method, and Questions of Value in the Sociology of Literature
Authors: Barnwell Ashley
Published: July 2015

The sociology of literature has a troubled history. Across the past 50 years, proposal after proposal has attempted to develop a method and bridge the cultural division between the social sciences and literary studies. Focusing on the most recent attempt to revitalise the field, this article examines the legacy of the ‘two cultures’ in current debates about the politics and value of method. Departing from the Marxist tone of preceding arguments, James F. English’s (2010) description of the sociology of literature bears the influence of the recent turn away from critique toward alternative modes of inquiry. Tracing the logic of this turn, my article questions whether an opposition between critical and ‘new’ genres is a useful step forward for the sociology of literature or a continuation of the two cultures divide its intervention aims to rethink. Furthermore, it considers what is at stake in recent disciplinary representations of critical sociology and the intellectual fate of ideology critique.
The view from above (and below): A comparison of American, British, and Arab news coverage of US drones
Authors: Sheets Penelope , Rowling Charles M , Jones Timothy M
Published: July 2015

In recent years, the United States has significantly expanded its use of drone warfare. Experts are divided: some defend drones as a legal, effective way to target terrorists while others suggest drones are inaccurate and contribute to anti-Americanism. In addition, international public opinion differs starkly with Americans largely supportive of the program while publics across the globe condemn it. Suspecting news coverage might play a pivotal role in these differences, the authors explored the framing of the US drone program in American, British, and Arab news coverage. Consistent with research on social identity theory and ethnocentrism in news, they find that US coverage was more likely to frame the policy favorably – emphasizing its legality, strategic value and technological sophistication while downplaying civilian deaths – while British and, to a greater extent, Arab coverage was more critical. The authors discuss how these findings build on existing theory and explore the implications for US drone policy.
Combined radiological-endoscopic management of difficult bile duct stones: 18-year single center experience
Authors: Cannavale Alessandro , Bezzi Mario , Cereatti Fabrizio , Lucatelli Pierleone , Fanello Gianfranco , Salvatori Filippo Maria , Fanelli Fabrizio , Fiocca Fausto , Donatelli Gianfranco
Published: July 2015

Objectives:

Clinical evidence regarding radiological–endoscopic management of intrahepatic bile duct stones is currently lacking. Our aim is to report our 18-year experience in combined radiological–endoscopic management of intrahepatic difficult bile duct stones.

Methods:

From June 1994 to June 2012, 299 symptomatic patients with difficult bile duct stones were admitted to our institution. Percutaneous transhepatic cholangiography (PTC)/biliary drainage/s was performed, dilating the PTC track to 10 or 16 French within 3–7 days. Afterward we carried out percutaneous transhepatic cholangioscopy (PTCS) with electrohydraulic lithotripsy (EHL) and/or interventional radiology techniques. Follow up was made with clinical/laboratory tests and ultrasound (US). We retrospectively analyzed our radiological–endoscopic approach and reported our technical and clinical outcomes.

Results:

Complete stone clearance was achieved in 298 patients after a maximum of 4 consecutive sessions. Most patients (64.6%) were treated with PTCS/EHL alone, while the remaining with radiological techniques alone (26%) or a combination of both techniques (13.3%). Recurrence of stones occurred in 45 cases (15%, Tsunoda class III and class IV) within 2 years and were successfully retreated. Major adverse events were: 5 (1.6%) cases of massive bleeding that required embolisation, 2 (0.66%) perforations of the common bile duct and 31 cases (10.3%) of acute cholangitis managed with medical therapy or intervention.

Conclusion:

After 18 years of experience we demonstrated that our combined radiological–endoscopic approach to ‘difficult bile duct stones‘ may result in both immediate and long-term clearance of stones with a low rate of adverse events.
Pattern of Fascicular Involvement in Midportion Achilles Tendinopathy at Ultrasound
Authors: Counsel Peter , Comin Jules , Davenport Marcus , Connell David
Published: July 2015

Background:

The Achilles tendon is composed of fascicles from the soleus and gastrocnemius muscles, which are identifiable as discrete components at anatomical dissection.

Hypothesis:

The pattern of fascicular involvement in Achilles tendinopathy may be characterized at ultrasound, and this characterization is reliable between different observers.

Study Design:

Cross-sectional diagnostic study.

Level of Evidence:

Level 3.

Methods:

One hundred cases of Achilles tendinopathy were retrospectively evaluated by 2 blinded musculoskeletal radiologists. Using a short-axis anatomical map, each case was categorized as involving the fascicular territories of the medial head of gastrocnemius, lateral head of gastrocnemius, soleus, or combinations of these, or as indeterminate.

Results:

Both radiologists agreed on the fascicular involvement pattern in 93 of 100 cases; 20 involved only medial gastrocnemius territories, 8 lateral gastrocnemius, 15 soleus, 3 medial and lateral gastrocnemius, 21 medial gastrocnemius and soleus, 9 soleus and lateral gastrocnemius, and 16 the entire tendon, and 1 case was classified as indeterminate. In 7 cases, the interpretations were discordant. The kappa value was calculated as 0.92 (95% CI, 0.86-0.98) in keeping with a high level of interobserver agreement.

Conclusion:

As assessed at ultrasound, most cases of Achilles tendinopathy involve the medial head of gastrocnemius and/or soleus fascicles.

Clinical Relevance:

The provided observational data will increase understanding of patterns of Achilles tendinopathy.
Impure or Just Weird? Scenario Sampling Bias Raises Questions About the Foundation of Morality
Authors: Gray Kurt , Keeney Jonathan E.
Published: July 2015

Moral psychologists have used scenarios of abuse and murder to operationalize harm and chicken-masturbation and dog-eating to operationalize impurity. These scenarios reveal different patterns of moral judgment across harm and purity, ostensibly supporting distinct moral mechanisms, modules, or “foundations.” However, these different patterns may stem not from differences in moral content per se but instead from biased sampling that confounds content with weirdness and severity. Supporting this hypothesis, frequently used impurity scenarios are weirder and less severe than both harm scenarios (Study 1) and participant-generated impurity scenarios (Study 2). Weirdness and severity—not content—also appear to drive differences between act and character evaluations (Study 3). Also problematic for modular accounts are extremely high correlations between harm and impurity ( rs > .86), and findings that harm scenarios assess impurity better than researcher-devised impurity scenarios. Overall, patterns of moral judgment previously ascribed to distinct moral mechanisms may reflect domain-general moral cognition.
Disconfirming Moral Foundations Theory on Its Own Terms
Authors: Gray Kurt , Keeney Jonathan E.
Published: July 2015

People see immorality in sin and sex, but is “purity” a unique type of moral content, with unique cognition? Domain-general accounts—and parsimony—suggest that all moral content is processed similarly and that “purity” is merely a descriptive label. Conversely, domain-specific theories (e.g., moral foundations theory [MFT]) argue for a special purity module. Consistent with domain-general accounts, we demonstrated that purity concerns are not distinguished from harm concerns—in either MFT or naturalistic scenarios—and that controlling for domain-general dimensions eliminates effects previously ascribed to moral “modules.” Here, we reaffirm the strength of our data, exploring how issues raised by Graham reflect only weaknesses in MFT. Importantly, we identify several clear contradictions between Graham’s comment and past-published accounts of MFT. To the extent that MFT stands by its published stimuli, methodologies, and theoretical assumptions, we believe that we have disconfirmed MFT on its own terms.
Frailty and Short-Term Outcomes in Patients With Hip Fracture
Authors: Kistler Elizabeth A. , Nicholas Joseph A. , Kates Stephen L. , Friedman Susan M.
Published: July 2015

Objectives:

To assess the prevalence of frailty and its ability to predict short-term outcomes in older patients with hip fracture.

Design:

Prospective cohort study.

Setting:

University-affiliated community hospital.

Participants:

Thirty-five patients aged ≥65 treated with hip fracture.

Measurements:

Frailty was assessed using the 5 criteria of the Fried Frailty Index, modified for a post-fracture population. Cognitive impairment was assessed with the Montreal Cognitive Assessment (MoCA). The primary outcome was overall hospital complication rate. Secondary outcomes were length of stay (LOS) and specific complications. Differences between the frail and the non-frail were identified using chi-square analysis and analysis of variance (ANOVA) for categorical and continuous variables, respectively.

Results:

Eighteen (51%) participants were frail. Seventeen (49%) had ≥1 hospital complication. Twelve (67%) frail patients versus 5 (29%) non-frail patients had a complication ( P = .028). Mean LOS was longer in patients with frailty (7.3 ± 5.9 vs 4.1 ± 1.2 days, P = .038). Most were frail for the weakness criterion (94%), and few were frail for the physical activity criterion (9%). Excluding these criteria, we developed a 3-criteria frailty index (shrinking, exhaustion, and slowness) that identified an increased risk of complications (64.7% vs 33.3%, P = .061) and LOS (7.4 ± 6.1 vs 4.2 ± 1.3 days, P = .040) in participants with frailty. Among non-frail participants with a high MoCA score of ≥20 (n = 12), 2 (17%) had complications compared to 10 (71%) frail participants with a low MoCA score (n = 14).

Conclusion:

Frailty is common in older patients with hip fracture and associated with increased LOS and postoperative complications. A low MoCA score, a hypothesized marker of more advanced cognitive frailty, may further increase risk. Frailty assessment has a role in prognostic discussion and care planning. The 3-criteria frailty index is an easily used tool with potential application in clinical practice.
Personality and Utilization of Prostate Cancer Testing
Authors: Neeme Marko , Aavik Anu , Aavik Toivo , Punab Margus
Published: July 2015

The present study represents the first instance in which participants’ personalities have been systematically measured in relation with prostate cancer (PCa) screening behavior. Cross-sectional data were collected between 2010 and 2011 in Estonia. Subjects were 371 men, 62 of whom were first-time patients of andrology clinic, and 309 were men of probability sample. Neuroticism had a significant inverse association with past, present, and future attendance. In contrary, conscientiousness had a significant positive association with PCa testing attendance in the past and present, and intention to attend PCa testing in the future. In conclusion, as PCa screening is no longer recommended by specialists, it becomes more important to offer personality-based counseling for age-eligible men.
Practicing on Newly Dead
Authors: Abraham Jewel
Published: July 2015

A newly dead cadaver simulation is practiced on the physical remains of the dead before the onset of rigor mortis. This technique has potential benefits for providing real-life in-situ experience for novice providers in health care practices. Evolving ethical views in health care brings into question some of the ethical aspects associated with newly dead cadaver simulation in terms of justification for practice, autonomy, consent, and the need of disclosure. A clear statement of policies and procedures on newly dead cadaver simulation has yet to be implemented. Although there are benefits and disadvantages to an in-situ cadaver simulation, such practices should not be carried out in secrecy as there is no compelling evidence that suggests such training as imperative. Secrecy in these practices is a violation of honor code of nursing ethics. As health care providers, practitioners are obliged to be ethically honest and trustworthy to their patients. The author explores the ethical aspects of using newly dead cadaver simulation in training novice nursing providers to gain competency in various lifesaving skills, which otherwise cannot be practiced on a living individual. The author explores multiple views on cadaver simulation in relation to ethical theories and practices such as consent and disclosure to family.
Pregnancy through the Lens of Iranian Women with HIV
Authors: Behboodi-Moghadam Zahra , Khalajinia Zohre , Nasrabadi Ali-Reza Nikbakht , Mohraz Minoo , Gharacheh Maryam
Published: July 2015

To explore the experience of pregnancy among Iranian women with HIV, 12 HIV-infected pregnant women who referred to counseling center for behavioral diseases in Imam Khomeini Hospital were recruited through purposive sampling. Data were collected by face-to-face, semi-structured interview and were analyzed using conventional content analysis method. Four main themes emerged from the data: fear and hope, stigma and discrimination, marital life stability, and trust in God. Despite concerns about mother-to-child transmission of HIV, and uncertain life span, HIV-infected women tended to continue their pregnancy, and having children was viewed as a window of hope for them.
Psychological, Social, and Spiritual Effects of Contraceptive Steroid Hormones
Authors: Klaus Hanna , Cortés Manuel E.
Published: July 2015

Governments and society have accepted and enthusiastically promoted contraception, especially contraceptive steroid hormones, as the means of assuring optimal timing and number of births, an undoubted health benefit, but they seldom advert to their limitations and side effects. This article reviews the literature on the psychological, social, and spiritual impact of contraceptive steroid use. While the widespread use of contraceptive steroid hormones has expanded life style and career choices for many women, their impact on the women's well-being, emotions, social relationships, and spirituality is seldom mentioned by advocates, and negative effects are often downplayed. When mentioned at all, depression and hypoactive sexual desire are usually treated symptomatically rather than discontinuing their most frequent pharmacological cause, the contraceptive. The rising incidence of premarital sex and cohabitation and decreased marriage rates parallel the use of contraceptive steroids as does decreased church attendance and/or reduced acceptance of Church teaching among Catholics.

Lay summary

While there is wide, societal acceptance of hormonal contraceptives to space births, their physical side effects are often downplayed and their impact on emotions and life styles are largely unexamined. Coincidental to the use of “the pill” there has been an increase in depression, low sexual desire, “hook-ups,” cohabitation, delay of marriage and childbearing, and among Catholics, decreased church attendance and reduced religious practice. Fertility is not a disease. Birth spacing can be achieved by natural means, and the many undesirable effects of contraception avoided.
Melphalan, prednisone, and thalidomide vs melphalan, prednisone, and lenalidomide (ECOG E1A06) in untreated multiple myeloma
Authors: Stewart A. Keith , Jacobus Susanna , Fonseca Rafael , Weiss Matthias , Callander Natalie S. , Chanan-Khan Asher A. , Rajkumar S. Vincent
Published: July 2015

Key Points

In a randomized phase 3 trial, overall response rates, PFS, and overall survival were similar between MPT-T and mPR-R. Toxicity with both regimens was common, but mPR-R was better tolerated, and patients on the mPR-R regimen reported better quality of life.
Window of opportunity to achieve major outcomes in early rheumatoid arthritis patients: how persistence with therapy matters
Authors: Contreras-Yáñez Irazú , Pascual-Ramos Virginia
Published: July 2015

Introduction

Benefits of disease-modifying anti-rheumatic drugs (DMARD) in early rheumatoid arthritis patients (ERAP) will be achieved if patients follow prescribed treatment. Objective was to investigate whether timing of first non-persistence period and/or duration of persistence during the first 4 years of follow-up predicted disease outcomes at the 5th year in a cohort of ERAP, initiated in 2004.

Patients and Methods

Up to February 2015, charts of 107 ERAP with at least 5 years of follow-up and prospective 6-month assessments of disease activity, disability and persistence were reviewed. Non-persistence was defined as omission of DMARD and/or corticosteroids for at least 7 consecutive days; regarding methotrexate, one weekly missing dose was considered non-persistence. Persistence was recorded through an interview (up to 2008) and thereafter through a questionnaire; persistence duration was recorded in months of continuous medicationtaking. At the 5th year, disease activity was defined according to Disease Activity Score (DAS)28, and disability according to Health Assessment Questionnaire (HAQ). Descriptive statistics and linear and Cox regression analyses were used.

Results

At study entry, patients were more frequently middle-aged (39.1 ± 13.3 years) and female (88.8 %), as well as more likely to have high disease activity and disability. Over the first 4 years of follow-up, 54.2 % of the patients had indications for oral corticosteroids and all traditional DMARDs. Almost 70 % had at least one period of non-persistence, and their follow-up (median, 25th–75th interquartile range) to first non-persistence period was 13 months (1–31). Persistence duration during the first 4 years predicted subsequent DAS28 (in addition to gender and baseline DAS28) and HAQ (in addition to age). During the 5th year, 68 patients (56 women) achieved sustained remission (DAS28 < 2.6). In female population (n = 95), baseline DAS28 (odds ratio [OR], 0.65; 95 % confidence interval [CI], 0.50–0.83; p = 0.001) and persistence duration (OR, 1.04; 95 % CI, 1–1.08; p = 0.05) were predictors. Also, 84 patients achieved sustained function (HAQ <0.21), and baseline DAS28 and age were the only predictors. Timing of first non-persistence period did not impact outcomes.

Conclusions

Persistence duration with DMARDs within the first 4 years of RA predicted subsequent favorable outcomes in ERAP; additional predictors were younger age, male gender and lower disease activity at diagnosis.
Fixed points of monotone mappings and application to integral equations
Authors: Bachar Mostafa , Khamsi Mohamed Amine
Published: July 2015

In this work, we discuss the existence of fixed points of monotone nonexpansive mappings defined on partially ordered Banach spaces. This work is a continuity of the previous works of Ran and Reurings, Nieto et al., and Jachimsky done for contraction mappings. As an application, we discuss the existence of solutions to an integral equations.
Smart Align—a new tool for robust non-rigid registration of scanning microscope data
Authors: Jones Lewys , Yang Hao , Pennycook Timothy J. , Marshall Matthew S. J. , Van Aert Sandra , Browning Nigel D. , Castell Martin R. , Nellist Peter D.
Published: July 2015

Many microscopic investigations of materials may benefit from the recording of multiple successive images. This can include techniques common to several types of microscopy such as frame averaging to improve signal-to-noise ratios (SNR) or time series to study dynamic processes or more specific applications. In the scanning transmission electron microscope, this might include focal series for optical sectioning or aberration measurement, beam damage studies or camera-length series to study the effects of strain; whilst in the scanning tunnelling microscope, this might include bias-voltage series to probe local electronic structure. Whatever the application, such investigations must begin with the careful alignment of these data stacks, an operation that is not always trivial. In addition, the presence of low-frequency scanning distortions can introduce intra-image shifts to the data. Here, we describe an improved automated method of performing non-rigid registration customised for the challenges unique to scanned microscope data specifically addressing the issues of low-SNR data, images containing a large proportion of crystalline material and/or local features of interest such as dislocations or edges. Careful attention has been paid to artefact testing of the non-rigid registration method used, and the importance of this registration for the quantitative interpretation of feature intensities and positions is evaluated.