bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicopathologic features of minute pulmonary meningothelial-like nodules
Authors: Asakawa Ayaka , Horio Hirotoshi , Hishima Tsunekazu , Yamamichi Takashi , Okui Masayuki , Harada Masahiko
Published: September 2017

Purpose

Minute pulmonary meningothelial-like nodules are incidentally discovered in lung specimens. We analyzed the clinicopathologic features of 14 cases identified in surgically resected lungs.

Methods

Among patients who underwent lung resection in our hospital from October 2007 to March 2016, 14 were found to have minute pulmonary meningothelial-like nodules. The clinical parameters, radiologic findings, and pathologic features of these patients were retrospectively reviewed using the medical records.

Results

The patients included 4 men and 10 women, with a mean age of 69 years (range 53–82 years). The coexisting main disease was adenocarcinoma in 8 patients, squamous cell carcinoma in 1, atypical adenomatous hyperplasia in 1, and metastatic pulmonary tumor in 3. In one patient, the minute pulmonary meningothelial-like nodules presented as multiple lung nodules on chest computed tomography. The median size of the nodules was 1.4 mm (range 0.3–6.0 mm). Similar to meningioma, one case had immunoreactivity to progesterone receptor and epithelial membrane antigen, although the minute pulmonary meningothelial-like nodules were not associated with a meningioma.

Conclusions

The relationship between minute pulmonary meningothelial-like nodules and meningioma should be investigated. If minute pulmonary meningothelial-like nodules are found on preoperative computed tomography, thoracoscopic lung biopsy is helpful for differential diagnosis.
Validation of an assessment tool for pre-operative EVAR planning
Authors: Fatic Nikola , Normahani Pasha , Mars Dejan , Standfield Nigel J , Jaffer Usman
Published: September 2017

Introduction:

Current methods of teaching endovascular aortic aneurysm repair (EVAR) planning involve non-criteria-based observations that lack validity. The primary aim of this study was to validate an EVAR Planning Objective Structured Assessment of Skill (EpOSAS) tool for the assessment of pre-operative EVAR planning skills.

Methods:

Content analysis was performed in order to inform the formulation of EpOSAS domains. Thirty-five participants planned two cases of infra-renal abdominal aortic aneurysm for EVAR, using the OsiriX 7 platform. EVAR planning measurements, with accompanying screenshots, were uploaded onto an electronic data collection sheet. Performance was assessed by three blinded assessors using the EpOSAS tool. Construct and concurrent validity were evaluated.

Results:

Inter-observer reliability for the three assessors for total EpOSAS scores was high (Cronbach’s α 0.89). There were statistically significant differences in total EpOSAS scores between the different experience groups, demonstrating construct validity (Novice (5.3, IQR 5-5.3), Intermediate (15.3, IQR 14.8-16.8) and Experts (17.5, IQR 17-17.7), p<0.001). A statistically significant correlation was found between total EpOSAS scores and percentage error in measurements, demonstrating concurrent validity (Spearman’s rank correlation coefficient: R=-0.250, p<0.001). Receiver-operator characteristics analysis established a cut-off point of 16 out of 18 for determining competence.

Conclusion:

We have developed and validated a tool that can be used for the assessment of pre-operative EVAR planning skills.
Mediating influence of crime type on victim satisfaction with police services
Authors: Kumar TK Vinod
Published: September 2017

Different crimes have their own unique characteristics. Victim needs and experiences vary across crime types. However, there has been a tendency for the criminal justice system to treat victims as a homogeneous entity and respond to victims of different types of crimes in a routine manner. This is especially true in a developing country like India. This study, using victim survey data from India, examines whether the crime type (property crime or violent crime) has a mediating influence on the relation between the quality of procedure and outcome of police response on the one hand, and victim satisfaction on the other. The study concludes that the type of crime has a mediating effect on the relation between interpersonal justice, information justice and outcome, and the satisfaction of victims with services provided by the police.
Impact on dose and image quality of a software-based scatter correction in mammography
Authors: Monserrat Teresa , Prieto Elena , Barbés Benigno , Pina Luis , Elizalde Arlette , Fernández Belén
Published: September 2017

Background

In 2014, Siemens developed a new software-based scatter correction (Progressive Reconstruction Intelligently Minimizing Exposure [PRIME]), enabling grid-less digital mammography.

Purpose

To compare doses and image quality between PRIME (grid-less) and standard (with anti-scatter grid) modes.

Material and Methods

Contrast-to-noise ratio (CNR) was measured for various polymethylmethacrylate (PMMA) thicknesses and dose values provided by the mammograph were recorded. CDMAM phantom images were acquired for various PMMA thicknesses and inverse Image Quality Figure (IQFinv) was calculated. Values of incident entrance surface air kerma (ESAK) and average glandular dose (AGD) were obtained from the DICOM header for a total of 1088 pairs of clinical cases. Two experienced radiologists compared subjectively the image quality of a total of 149 pairs of clinical cases.

Results

CNR values were higher and doses were lower in PRIME mode for all thicknesses. IQFinv values in PRIME mode were lower for all thicknesses except for 40 mm of PMMA equivalent, in which IQFinv was slightly greater in PRIME mode. A mean reduction of 10% in ESAK and 12% in AGD in PRIME mode with respect to standard mode was obtained. The clinical image quality in PRIME and standard acquisitions resulted to be similar in most of the cases (84% for the first radiologist and 67% for the second one).

Conclusion

The use of PRIME software reduces, in average, the dose of radiation to the breast without affecting image quality. This reduction is greater for thinner and denser breasts.
‘Let the miserable wrestle with his own shadows’: The beleaguered Edwardian male author in Oliver Onions’ ‘The Beckoning Fair One’
Authors: Brennan Zoe
Published: September 2017

This article argues that the much-anthologised ghost story ‘The Beckoning Fair One’ (1911) by Oliver Onions is usefully read as engaging with a number of contemporary anxieties centred on the Edwardian male writer. Onions stresses the economic and psychological cost to his protagonist, Oleron, of remaining true to his artistic conscience in an increasingly commercial publishing environment. I consider shifting ideas about gender roles that include the promotion of an ‘imperial’ masculinity of a type antithetical to the artistic identity. I also explore Oleron's attitude towards an admirer, a New Woman-type journalist and contrast her with a spectral femme fatale who represents for him a muse from an earlier time. This belief in the ghost leads to a breakdown which I frame in terms of Edwardian models of manliness and hysteria. This is a novel approach insofar as the few discussions of the story to date tend to focus on its hallucinatory qualities rather than Onions’ engagement with debates of the day.
The West, Texas, ammonium nitrate explosion: A failure of regulation
Authors: Babrauskas Vytenis
Published: September 2017

On 17 April 2013, the West Fertilizer Company’s ammonium nitrate storage building exploded, killing 15 persons and injuring over 200. Numerous Federal and State agencies regulated the facility. But none of the agencies demonstrated a viable understanding of what is liable to cause accidental ammonium nitrate explosions, nor what is needed to prevent these. Specifically, none of them recognized the fact that ammonium nitrate fertilizer explosion accidents, when they occur, are inevitably the consequence of an uncontrolled fire and that such fires can be precluded by well-known fire safety measures. In fact, existing regulations have generally focused on everything but features needed to make such storage facilities incapable of sustaining an uncontrolled fire. Ammonium nitrate manufacturers, however, did have technical knowledge concerning safety and were aware of the ineffectiveness of governmental regulations. Espousing proper Product Stewardship principles by the manufacturers would have precluded selling dangerous chemicals to buyers who cannot safely store them.
Investigation findings and lessons learned in the west fertilizer explosion
Authors: Davis Scott , DeBold Tom , Marsegan Claudio
Published: September 2017

On 17 April 2013, an explosion occurred at the West Fertilizer Company storage and distribution facility in West, Texas. The explosion at West Fertilizer resulted from an intense fire in the seed and storage area of the facility that led to the detonation of approximately 30 tons of ammonium nitrate stored inside a wooden receiving bin. The explosion occurred while emergency services personnel were responding to a fire at the facility. Fifteen people were killed, more than 250 were injured, and numerous buildings were damaged or destroyed. This article presents the results of our investigation into the cause and origin of the explosion event, which included (1) early video footage which showed the room where the initial fire originates and (2) applying advanced blast techniques to determine the quantity of ammonium nitrate that likely detonated during the blast. These techniques included near-field blast effects (e.g. the resulting crater left by the blast) as well as the far-field blast damage resulting in the neighboring community.
A preliminary study of wildland fire pattern indicator reliability following an experimental fire
Authors: Simeoni Albert , Owens Zachary C , Christiansen Erik W , Kemal Abid , Gallagher Michael , Clark Kenneth L , Skowronski Nicholas , Mueller Eric V , Thomas Jan C , Santamaria Simon , Hadden Rory M
Published: September 2017

An experimental fire was conducted in 2016, in the Pinelands National Reserve of New Jersey, to assess the reliability of the fire pattern indicators used in wildland fire investigation. Objects were planted in the burn area to support the creation of the indicators. Fuel properties and environmental data were recorded. Video and infrared cameras were used to document the general fire behavior. This work represents the first step in the analysis by developing an experimental protocol suitable for field studies and describing how different fire indicators appeared in relation to fire behavior. Most of the micro- and macroscale indicators were assessed. The results show that some indicators are highly dependent on local fire conditions and may contradict the general fire spread. Overall, this study demonstrates that fire pattern indicators are a useful tool for fire investigators but that they must be interpreted through a general analysis of the fire behavior with a good understanding of fire dynamics.
Mechanism for localized floor burn-through
Authors: Hill Stephen M , Sheppard David T , Grove Brian S
Published: September 2017

This article presents a series of experimental tests that demonstrated that localized floor burn-through can be caused by certain ordinary combustible materials. The article discusses the mechanisms required to obtain this burn-through phenomena. It also discusses the factors that fire investigators can look for to help determine whether this phenomenon may have occurred.
Characterization and thermal degradation kinetics of thermoplastic polyimide based on BAPP
Authors: Su Xu , Xu Yong , Li Linshuang , Song Chaoran
Published: September 2017

Two kinds of thermoplastic polyimides (PIs) were synthesized via a two-step method with 2,2-bis[4-(4-aminophenoxy)phenyl]propane (BAPP), 4,4′-oxydianiline (ODA) diamine, and 3,3′,4,4′-benzophenonetetracarboxylic dianhydride (BTDA), and their thermal degradation kinetics was studied by thermogravimetric analysis at different heating rates under nitrogen. Derivative thermogravimetric analysis curves indicated a simple, single-stage degradation process in PI BTDA-BAPP and a two-stage degradation process in PI BTDA-ODA-BAPP. The activation energies ( Eas) of the thermal degradation reaction were determined by the Flynn–Wall–Ozawa and Kissinger–Akahira–Sunose methods without a knowledge of the kinetic reaction mechanism. By comparing the values of Ea and weight loss temperatures, it was demonstrated that the thermal stability of PI BTDA-ODA-BAPP was superior to that of PI BTDA-BAPP.
Precise vibrating electrochemical machining of a diamond-shaped hole with side-wall insulation
Authors: Wang Feng , Zhao Jianshe , Lv Yanming , Yang Zhenwen , Gan Weimin , Tian Zongjun
Published: September 2017

Electrochemical machining has the advantage of being free of cathode loss, thermal stress, and residual stress, and is suitable for high precision machining of metal structures. Localization of anodic dissolution can be significantly improved by the side-wall insulation of the cathode. However, for shaped-hole machining, the removal of electrolytic products in the machining gap becomes problematic with the increase of machining depth, which may hinder the machining process. The application of vibration to the cathode in an electrochemical machining is considered an effective approach because the frontal gap is periodically changed by the vibration; therefore, the removal of electrolytic products and the refreshment of electrolyte are facilitated. This study is aimed at finding a suitable method for diamond-shaped hole fabrication using electrochemical machining. The influence of vibrating feed, cathode with and without side-wall insulation on the machining stability and accuracy were studied based on the machining system developed in this study. The experimental results reveal that the machining accuracy of the diamond-shaped hole can be improved remarkably by reducing the width of the tool edge. Meanwhile, the machining stability can be improved significantly with a reasonable vibrating feed mode.
Pollution caused by finance and the relative policy analysis in China
Authors: He Yaping , Sheng Pengfei , Vochozka Marek
Published: September 2017

In China, where environmental regulations are less strict, finance would cause pollution to rise by promoting the growth of polluting industries. Exploiting a Chinese dataset over the period 2004–2014, 1% increase in the finance measured by credits to GDP, would cause pollution to rise by 4.29%, which is fairly large and cannot be ignored, and the results is robust when finance is measured by deposits to GDP. Thus, it is concluded that policies focused on pollution reduction would be ineffective and that policies on promoting finance would fall short of their intention to stimulate economic growth.
Economic Integration in the Six Middle Eastern Gulf Countries: A Look from the Perspective of Money Demand
Authors: Azar Samih Antoine , Asrawi Fadi , Gharzuddine Emad
Published: September 2017

The six Middle Eastern Gulf countries, comprising Bahrain, the Kingdom of Saudi Arabia, Kuwait, Oman, Qatar and the United Arab Emirates (UAE) are contemplating, and experimenting with, many varieties of economic integration. The question arises whether they form an optimum currency area. The traditional approach deals with the real side of the economy, such as factor mobility, wage and price flexibility, the size and concentration of intraregional trade, the presence of different inflation/unemployment trade-offs, the elimination of transaction costs and better informational content of prices. The approach in this article is different and dwells upon the financial and monetary sides. The article studies whether there are long-run empirical, stable and parsimonious money demand functions (MDF) within each of these six countries. In addition, a panel long-run MDF is estimated. The results will determine whether the loss of an important tool of economic stabilisation in a monetary union, which is monetary policy, is compensated by a more effective fiscal policy. The article concludes that a monetary union is not commendable, unless fiscal restraints are applied thoroughly on all the six countries involved.
India–Canada Relations: The Nuclear Energy Aspect
Authors: Banerjee Stuti
Published: September 2017

The India–Canada relationship has witnessed a number of highs and lows despite the two nations sharing common political views. This is perhaps best seen in the civil nuclear cooperation shared between the two. It is interesting to note that the relation between the two nations fractured twice due to nuclear issues in the past; today, nuclear cooperation is an important pillar, helping them to cement a new partnership. This article is an attempt to trace the civil nuclear relationship between India and Canada and to chart its future path. It has to be understood that the nuclear agreement between India and Canada is not restricted in its scope to just benefits for the two countries in developing nuclear technology and trade. It has larger economic and strategic benefits. India’s growing political and economic strength is promising. It is in Canada’s interest to pursue a closer relationship with India. It is in India’s interest to further strengthen this partnership in view of the resources and technology that Canada could provide India to achieve its development goals, especially its green agenda as ratified under the Paris Climate Change Agreement (2015).
Civic Duty and Political Preference Formation
Authors: Mullinix Kevin J.
Published: September 2017

While a sense of civic duty has long been perceived as important for political participation, little is known about its implications for political preference formation. I argue that civic duty has salubrious effects for opinion formation by dampening partisan distortions in decision making. I theorize that a heightened sense of civic duty stimulates a motivation to form “accurate” opinions and, in doing so, diminishes the effects of partisan motivated reasoning. Using survey experiments focused on tax and education policies, I provide evidence that when civic norms are accentuated, at times, people shirk party endorsements and incorporate substantive policy information in preference formation. The implications for citizen competence and public opinion in democratic politics are discussed.
Assisting Clients and Their Families Cope With Mental Health–Related Stressors of Type 1 Diabetes
Authors: Sartor Teri Ann , Cosma Alexandria C.
Published: September 2017

An individual diagnosed with type 1 diabetes (T1D) typically relies on medical professionals for support and assistance. The family of the person with T1D is an important source of emotional support. While medical doctors are frequently the primary service provider, counselors may be better equipped to provide the emotional support needed for adjustment. Through acknowledging key aspects of the diagnosis and its symptoms, counselors can support patients with T1D and their families psychologically in the adjustment process.
Avatar Creation: The Social Construction of “Beauty” in Second Life
Authors: Mills Hailey L.
Published: September 2017

Rooted in the theory of Social Construction of Reality and informed by media portrayal of female beauty and virtual community research, this study examined how beauty is socially constructed by gatekeepers in Second Life. A content analysis of 360 still images of female avatars was conducted to understand the extent to the beauty types that appear in the virtual world. Findings suggest trendy and sex kitten/sensual beauty types were the most-portrayed beauty types. Most female avatars had the ideal body size and light colored skin. In addition, this study found a significant difference in beauty type among different types of products.
Mechanics of fiber composites with fibers resistant to extension and flexure
Authors: Zeidi Mahdi , Kim Chun IL
Published: September 2017

A model of elastic solids reinforced with fibers resistant to extension and bending is formulated in finite-plane elastostatics. The linear theory of the proposed model is also derived through which a complete analytical solution is obtained. The presented model can serve as an alternative two-dimensional Cosserat theory of non-linear elasticity.
Effects of high hydrostatic pressure on the functional and rheological properties of the protein fraction extracted from pine nuts
Authors: Cao Baiying , Fang Li , Liu Chunlei , Min Weihong , Liu Jingsheng
Published: September 2017

High hydrostatic pressure treatments could increase the protein solubility (200 MPa), water holding capacity (400 MPa), and oil holding capacity (400 MPa) of pine nuts protein fractions, respectively. The exposed sufhydryl content for albumin was highest at 100 MPa while for other fractions it was 400 MPa, contrary for total sufhydryl content—generally it was at 100 MPa, except glutelin (400 MPa). Pine nuts protein fractions demonstrated the typical behavior of weak gels (G′ > G″). After the treatments of high hydrostatic pressure the specific surface area of pine nuts protein particle was increased upon pressure, and the surface of protein became rough which increased the particle size. The functional groups of protein were found to be unchanged, but the characteristic peaks of pine nuts protein moved to a low-band displacement and the value of peaks was amplified accordingly to the pressure. The high hydrostatic pressure treatments were found to improve the functional properties of pine nuts protein isolates by enhancing the heat-induced gel strength of pine nuts protein isolates which make proteins more stretchable. These results suggest that high hydrostatic pressure treatments can increase the functional properties and alter the rheological properties of pine nuts protein fractions which will broaden its applications in food industry.
Aspect and tense attrition in Russian-German bilingual speakers
Authors: Dragoy Olga , Virfel Ekaterina , Yurchenko Anna , Bastiaanse Roelien
Published: September 2017

Purpose:

The impact of second language (L2) on first language (L1), known as L2 transfer, has been suggested as a fundamental driving force of L1 attrition. The goal of this study was to test the differential attrition of verb aspect and tense in L1 (Russian) under the influence of L2 (German) grammatical properties. We also investigated whether the age of bilingualism onset and the amount of exposure to L1 modulate this L2 transfer effect.

Methodology:

We tested sentence processing in 30 adult Russian monolingual participants and 30 L1 attritors – Russian-German bilingual speakers – with early versus late bilingualism onset and with low versus high amounts of exposure to L1. Participants heard grammatically correct sentences, sentences with aspect violations and sentences with tense violations, and were asked to detect errors.

Data and Analysis:

The accuracy of participants’ responses was analysed using generalized linear mixed-effects modelling in R.

Findings:

The L2 transfer effect was found, but was strongly modulated by the amount of L1 exposure: only bilinguals with little exposure to L1 showed greater attrition of L1 aspect compared to L1 tense. Moreover, the age of bilingualism onset proved to be more critical than the L2 transfer effect: an earlier bilingualism onset resulted in greater attrition of both aspect and tense in L1.

Originality:

The study provided new evidence about the differential impact of the grammatical similarity between L1 and L2, the age of bilingualism onset and the amount of L1 exposure on aspect and tense processing in L1 attritors.

Implications:

Our findings suggest that greater L1 use after immigration helps bilingual speakers to be less susceptible to L2 transfer and prevents attrition of L1-specific grammatical categories. Also, a general decline in processing verbal morphology is more likely to occur in speakers with an early rather than a late onset of bilingualism.
Cross-language correspondences in the face of change: Phonetic independence versus convergence in two Korean-Mandarin bilingual communities
Authors: Schertz Jessamyn , Kang Yoonjung , Han Sungwoo
Published: September 2017

Aims and Objectives/Purpose/Research Questions:

We investigate the robustness of cross-language phonetic correspondences in two bilingual communities over time, focusing on whether corresponding sounds (e.g. Mandarin /s/ and Korean /s’/) remain coupled in the face of language change, or whether the categories diverge over time in younger, more proficient bilinguals.

Design/Methodology/Approach:

We quantify the extent of assimilation versus independence of categories across languages by comparing bilinguals’ production of place of articulation and laryngeal contrasts in Mandarin and Korean sibilants. Distinct language-internal changes were expected on each dimension.

Data and analysis:

107 speakers varying in age (aged 19–83), gender, and dialect participated in the study. Acoustic measurements (center of gravity of frication, voice onset time) and statistical analyses were performed on a total of ~11,000 tokens.

Findings/Conclusions:

The extent of cross-language independence differed on the two dimensions. Corresponding segments across the two languages remained tightly coupled in terms of place of articulation, even in the face of change; on the other hand, a language-internal change in the Korean laryngeal contrast left corresponding Mandarin segments unaffected, resulting in divergence of originally corresponding categories. We also found unpredicted changes on each dimension, and these changes progressed concurrently in the two languages.

Originality:

The study of correspondences in the context of independent sound change provides a unique perspective from which to evaluate the robustness of cross-language interaction, and the parallel analysis of two separate dimensions in two communities adds to the generalizability of results.

Significance/Implications:

Most changes occurred concurrently in the two languages, suggesting that similar phonetic categories across languages can remain tightly coupled, even in highly proficient bilinguals where phonetic independence is expected. However, one of the primary expected changes (voice onset time merger in Korean) did not affect corresponding segments in Mandarin, indicating that the extent of cross-language independence in phonetic correspondences may differ even within the same population. We discuss potential reasons for the different results.
From Strategic Retweets to Group Hangs: Writers’ Room Twitter Accounts and the Productive Ecosystem of TV Social Media Fans
Authors: Navar-Gill Annemarie
Published: September 2017

In the current participatory television environment, social media serves both a social backchannel for interactions between audience members and a direct line of communication between audiences and production. Because audience activity on social media becomes part of the media brand, it is a priority for the industry to achieve some level of control/influence on that activity. In this article, I discuss writers’ room Twitter accounts as a space used to model and reinforce fan behavior that serves industry interests, arguing that these accounts serve industry needs through the behaviors they promote and recognize. Through analysis of three writers’ room Twitter accounts—for Jane the Virgin, Faking It, and Orange Is the New Black—I show how this process works, as well as the ways in which a show’s individual industrial context shapes the type of fan that is hailed.
Utility of Montreal Cognitive Assessment in Differentiating Dementia With Lewy Bodies From Alzheimer’s Dementia
Authors: Yamamoto Erin , Mourany Lyla , Colleran Rosemary , Whitman Christine , Tousi Babak
Published: September 2017

Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) are the 2 most common neurodegenerative dementias. Identification of patients with DLB is necessary to guide appropriate clinical management and medication trials. Patients with DLB are reported to perform poorly on tasks of visuospatial and executive function, compared to patients with AD who perform poorly on memory tasks. Using the Montreal Cognitive Assessment, we found that patients with DLB (n = 73) had statistically significant lower performance in clock drawing (visuospatial and executive function) and higher performance in delayed recall (memory) subscores compared to patients with AD (n = 57). This score pattern should raise suspicion for a DLB diagnosis at initial evaluation of patients with dementia.
Increasing Burden of Complex Multimorbidity Across Gradients of Cognitive Impairment
Authors: Koroukian Siran M. , Schiltz Nicholas K. , Warner David F. , Stange Kurt C. , Smyth Kathleen A.
Published: September 2017

Introduction:

This study evaluates the burden of multimorbidity (MM) across gradients of cognitive impairment (CI).

Methods:

Using data from the 2010 Health and Retirement Study, we identified individuals with no CI, mild CI, and moderate/severe CI. In addition, we adopted an expansive definition of complex MM by accounting for the occurrence and co-occurrence of chronic conditions, functional limitations, and geriatric syndromes.

Results:

In a sample of 18 913 participants (weighted n = 87.5 million), 1.93% and 1.84% presented with mild and moderate/severe CI, respectively. The prevalence of most conditions constituting complex MM increased markedly across the spectrum of CI. Further, the percentage of individuals presenting with 10 or more conditions was 19.9%, 39.3%, and 71.3% among those with no CI, mild CI, and moderate/severe CI, respectively.

Discussion:

Greater CI is strongly associated with increased burden of complex MM. Detailed characterization of MM across CI gradients will help identify opportunities for health care improvement.
Using Data for School Change: The Discipline Equity Audit and School Climate Survey
Authors: Gullo Gina Laura
Published: September 2017

Using data effectively is a critical skill for the modern school leaders. This case presents a school district where local interest groups are demanding changes regarding school safety and inclusion. Students have the opportunity to respond to a disciplinary equity audit and school climate survey. While interpreting and using data in a meaningful manner, students are challenged to evaluate the quality and efficacy of the presented data. The case also confronts students with race-related concerns that are often present in urban school districts. Students must exit their comfort zones in order to work as effective school leaders.
Integrating Health Coaching With a Medical Fitness Program to Treat Chronic Health Conditions
Authors: Roy Brad , Roberts Pam , Lisowski Cathy , Kaye Miranda P. , Sforzo Gary A.
Published: September 2017

Medical fitness and health/wellness coaching (HWC) are emerging health care trends but potential synergistic effects are yet to be studied. Purpose. To determine the impact of integrating HWC within a community-based medical fitness program for patients with chronic health conditions. Methods. A before and after clinical trial, examining 3 frequency levels of coaching sessions, with Journey-to-Wellness (J2W) participants (N = 1306) who were predominately female (76%), aged 12 to 87 years (mean ± SD = 53.54 ± 14.34 years), and referred by their health care provider. Over 3 months, J2W emphasized HWC, exercise, nutrition counseling, and group/interactive events. HWC averaged 4.4 ± 2.5 sessions and was analyzed at 3 levels (0-3; 4-6; 6+ sessions). Pre-post measures were Patient Health Questionnaire (PHQ-9), Positivity, General Anxiety Disorder (GAD-7), Dartmouth Quality of Life (QoL), Lifestyle Nutrition Behavior (LNB), Pain, exercise minutes, weight, waist circumference, and systolic/diastolic blood pressures. Results. J2W intervention significantly (P < .01) improved all outcomes. Between 20% and 43% improvements were observed for PHQ-9, GAD-7, QoL while LNB improved 7.5%, and biometrics between 1% and 2.2%. Greater frequency of HWC enhanced J2W effect for PHQ-9 and QoL with weight and GAD approaching significance. Conclusion. J2W programming produced measurable improvement in health metrics, with greater HWC frequency adding to these beneficial effects, providing a powerful community-based health intervention.
Combatting counterfeit drugs: Case studies of Cambodia, Vietnam and Thailand
Authors: Kuanpoth Jakkrit
Published: September 2017

Medicines can save lives only if they are safe, efficacious, of good quality and affordable. The use of unsafe, substandard, ineffective and counterfeit drugs can be harmful to the health of the users and the public. Governments have an obligation to ensure the safety, efficacy and quality of the drugs available to the public by regulating the manufacturing and distribution of drugs and by exercising legal power to control the proliferation of unsafe counterfeit medicines. This article surveys the factual and legal issues surrounding counterfeit drugs in three countries, namely Cambodia, Vietnam and Thailand, in order to determine the magnitude and characteristics of the drug counterfeiting problem within the Southeast Asian region.
Treatment outcomes from forensic intellectual disability services: The perspectives of patients and their family/carers
Authors: Chester Verity , Geach Nicole , Morrissey Catrin
Published: September 2017

Introduction:

Research investigating the treatment outcomes of forensic intellectual and developmental disability (FIDD) services has largely focused on the perspectives of clinicians and researchers. This study sought the perspectives of patients and family/carers on the outcomes important to them.

Methods:

Semi-structured consultation groups were conducted with patients in FIDD services ( n = 21) and family carers ( n = 6). Interview data were content analysed, and outcomes identified fell into three main domains (effectiveness, safety and patient experience).

Results:

The consultations identified outcome domains not considered in the published literature. Patients and carers also had differential perspectives on treatment outcomes commonly reported within literature. Illustrative quotes are used to evidence the domains.

Discussion:

This study is the first to investigate the outcomes of relevance to patients and their families. These views have been incorporated into an outcomes framework which will form the foundation of future prospective outcome studies.
Statistical inference for masked interval data with Weibull distribution under simple step-stress test and tampered failure rate model
Authors: Azizi Fariba , Haghighi Firoozeh , Ghadiri Elahe , Torabi Leila
Published: September 2017

In this article, we consider the planning of simple step-stress life test in the presence of competing risks with the possibility of masked causes of failure and interval censoring. It is assumed that the competing risks have independent Weibull distribution with the common shape parameter, but different scale parameters and a tampered failure rate model is hold. Maximum likelihood estimates of the model parameters are obtained for both cases, with and without masking. An expectation–maximization algorithm is used to estimate maximum likelihood estimates based on the masked data. For the case without masking, the Fisher information matrix is derived, and the problem of choosing the optimal test plan is considered using variance-optimality as well as determinant-optimality criteria. Through Monte Carlo simulations, the precision of the estimates is assessed and the optimal test plans are compared. Finally, the results are illustrated with an example.
The return of a former foe: syphilis with antiphospholipid syndrome as a cause of acute stroke
Authors: Noakes Daniela , Evans Katherine , Pathansali Rohan
Published: September 2017

This article highlights a rare complication of syphilis infection and the importance of including syphilis and antiphospholipid antibody testing in the acute stroke screen..
Burns from ignited household aerosols in the kitchen: a case series
Authors: Dinesh Anant , Polanco Thais , Engdahl Ryan
Published: September 2017

Aerosol sprays are commonly used products in daily living. Aerosols in kitchen products have prompted for use of ‘food grade’ or chemically inert propellants; however, they commonly contain gases or gaseous mixtures such as butane, propane and dimethyl ether that are flammable. When such sprays are used near heat sources, such as kitchen appliances, combustibles in these products can result in ignition and burn injury. Given the ubiquity of such sprays, surprisingly burns sustained from household aerosols are not characterised in the literature. We conducted a retrospective search of all burn patients treated at our hospital which contains a burn unit. Three patients were identified with burn wounds due to household aerosol sprays. All three occurred in the kitchen. and were characterized as first-degree and second-degree burns over the head and neck or upper extremities with one requiring inpatient admission. Where it may be perceived a cause of minor injury, household aerosol burns may result in significant burn injury and hospital admission. Household aerosols and burn injury are reviewed.
Change in Function, Pain, and Quality of Life Following Structured Nonoperative Treatment in Patients With Degenerative Cervical Myelopathy: A Systematic Review
Authors: Tetreault Lindsay A. , Rhee John , Prather Heidi , Kwon Brian K. , Wilson Jefferson R. , Martin Allan R. , Andersson Ian B. , Dembek Anna H. , Pagarigan Krystle T. , Dettori Joseph R. , Fehlings Michael G.
Published: September 2017

Study Design:

Systematic review.

Objectives:

The objective of this study was to conduct a systematic review to determine (1) change in function, pain, and quality of life following structured nonoperative treatment for degenerative cervical myelopathy (DCM); (2) variability of change in function, pain, and quality of life following different types of structured nonoperative treatment; (3) differences in outcomes observed between certain subgroups (eg, baseline severity score, duration of symptoms); and (4) negative outcomes and harms resulting from structured nonoperative treatment.

Methods:

A systematic search was conducted in Embase, PubMed, and the Cochrane Collaboration for articles published between January 1, 1950, and February 9, 2015. Studies were included if they evaluated outcomes following structured nonoperative treatment, including therapeutic exercise, manual therapy, cervical bracing, and/or traction. The quality of each study was evaluated using the Newcastle-Ottawa Scale, and strength of the overall body of evidence was rated using guidelines outlined by the Grading of Recommendation Assessment, Development and Evaluation Working Group.

Results:

Of the 570 retrieved citations, 8 met inclusion criteria and were summarized in this review. Based on our results, there is very low evidence to suggest that structured nonoperative treatment for DCM results in either a positive or negative change in function as evaluated by the Japanese Orthopaedic Association score.

Conclusion:

There is a lack of evidence to determine the role of nonoperative treatment in patients with DCM. However, in the majority of studies, patients did not achieve clinically significant gains in function following structured nonoperative treatment. Furthermore, 23% to 54% of patients managed nonoperatively subsequently underwent surgical treatment.
Guidelines for the Management of Degenerative Cervical Myelopathy and Spinal Cord Injury: An Introduction to a Focus Issue
Authors: Fehlings Michael G. , Kwon Brian K. , Tetreault Lindsay A.
Published: September 2017

Study Design:

Introduction to a guidelines project.

Objectives:

The objective of this focus issue is to present guidelines that outline how to best manage patients with degenerative cervical myelopathy (DCM) and spinal cord injury (SCI). Topics addressed in this focus issue include: 1) management strategies for patients with mild, moderate and severe DCM; and 2a) timing of surgical decompression; b) the use of methylprednisolone sodium succinate; c) the type and timing of anticoagulation strategies; d) the role of magnetic resonance imaging in clinical decision making and outcome prediction; and e) the type and timing of rehabilitation in patients with SCI.

Methods:

Systematic reviews were conducted to address key clinical questions and to synthesize the current body of evidence. A multidisciplinary guideline development group used the results of these reviews, along with their clinical expertise, to develop clinical practice guidelines, in a process that adhered to methodology proposed by the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) Working Group.

Results:

The multidisciplinary guideline development group combined the systematic review findings with their clinical expertise and opinions to formulate recommendations on how to manage patients with DCM and SCI.

Conclusions:

These guidelines will serve as tools to assist clinicians in their decision making by offering a perspective that combines the available evidence, expertise from a variety of clinicians, and patient values.
Nonoperative Versus Operative Management for the Treatment Degenerative Cervical Myelopathy: An Updated Systematic Review
Authors: Rhee John , Tetreault Lindsay A. , Chapman Jens R. , Wilson Jefferson R. , Smith Justin S. , Martin Allan R. , Dettori Joseph R. , Fehlings Michael G.
Published: September 2017

Study Design:

Systematic review (update).

Objective:

Degenerative cervical myelopathy (DCM) is a progressive degenerative spine disease that is increasingly managed surgically. The objective of this study is to determine the role of nonoperative treatment in the management of DCM by updating a systematic review published by Rhee and colleagues in 2013. The specific aims of this review were (1) to determine the comparative efficacy, effectiveness, and safety of nonoperative and surgical treatment; (2) to assess whether myelopathy severity differentially affects outcomes of nonoperative treatment; and (3) to evaluate whether activities or minor injuries are associated with neurological deterioration.

Methods:

Methods from the original review were used to search for new literature published between July 20, 2012, and February 12, 2015.

Results:

The updated search yielded 2 additional citations that met inclusion criteria and compared the efficacy of conservative management and surgical treatment. Based on a single retrospective cohort, there were no significant differences in posttreatment Japanese Orthopaedic Association (JOA) or Neck Disability Index scores or JOA recovery ratios between patients treated nonoperatively versus operatively. A second retrospective study indicated that the incidence rate of hospitalization for spinal cord injury was 13.9 per 1000 person-years in a nonoperative group compared with 9.4 per 1000 person-years in a surgical group (adjusted hazard ratio = 1.57; 95% confidence interval = 1.11-2.22; P = .011).

Conclusion:

Nonoperative management results in similar outcomes as surgical treatment in patients with a modified JOA ≥ 13, single-level myelopathy and intramedullary signal change on T2-weighted magnetic resonance imaging. Furthermore, patients managed nonoperatively for DCM have higher rates of hospitalization for spinal cord injury than those treated surgically. The overall level of evidence for these findings was rated as low.
Enterovirus-Human Rhinovirus: A Rare Cause of Acute Respiratory Distress Syndrome
Authors: Soni Parita , Rai Anand , Aggarwal Nidhi , Kamholz Stephan , Yoon Taek , Kupfer Yizhak
Published: September 2017

A 22-year-old Asian woman presented with respiratory distress, cough, and wheezing for 1 week. Prior history included asthma and Turner syndrome. On presentation to the emergency department, the patient was hypotensive, tachycardic, tachypneic, with an oxyhemoglobin saturation in the mid 80% range while breathing ambient air. Chest radiograph revealed pulmonary vascular congestion and a left lower lobe infiltrate. Endotracheal intubation, mechanical ventilation, and vasopressors were initiated. Empiric therapy for community-acquired pneumonia was administered utilizing broad-spectrum intravenous antibiotics. Routine sputum culture was negative for pathogens. Nasopharyngeal swab submitted for multiplex amplified nucleic acid testing yielded enterovirus-human rhinovirus (EV-HRV). Thus, the diagnosis of EV-HRV pneumonia complicated by acute respiratory distress syndrome (ARDS) was established. Multiple attempts to wean from the ventilator were unsuccessful, and a tracheostomy was performed. This report highlights EV-HRV as a cause of severe ARDS and prolonged respiratory failure in adults.
Median Arcuate Ligament Syndrome: It Is Not Always Gastritis
Authors: Kuruvilla Aneesh , Murtaza Ghulam , Cheema Ayesha , Arshad Hafiz Muhammad Sharjeel
Published: September 2017

Median arcuate ligament syndrome is a rare disorder that is clinically characterized by the triad of postprandial abdominal pain, weight loss, and often an abdominal bruit due to compression of the celiac artery by the median arcuate ligament. Given the nonspecific symptoms, this is a rare and difficult diagnosis to obtain. We present a patient with nonspecific abdominal pain in whom etiology was ultimately determined to be median arcuate ligament syndrome.
Too Many Choices Confuse Patients With Dementia
Authors: Hamdy R. C. , Lewis J. V. , Kinser A. , Depelteau A. , Copeland R. , Kendall-Wilson T. , Whalen K.
Published: September 2017

Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused.
Distance delivery of a parent-implemented language intervention for young boys with fragile X syndrome
Authors: Bullard Lauren , McDuffie Andrea , Abbeduto Leonard
Published: September 2017

Background

In addition to significant cognitive delays, boys with fragile X syndrome display phenotypic characteristics that include delays in language, inattention, social anxiety, and escape-maintained challenging behaviors. Despite these challenges, families affected by fragile X syndrome often have limited access to center-based intervention programs.

Methods

The present study utilized a multiple baseline design across participants to examine the preliminary effectiveness of a 12-week, parent-implemented spoken language intervention for three 5- to 7-year-old boys with fragile X syndrome. The goal of the intervention was to teach the biological mothers of each boy to use a set of verbally responsive language support strategies while participating in shared book reading activities with her child. All aspects of the intervention, including pre- and post-treatment measures, were delivered into the family’s home via distance video teleconferencing.

Results

Results from this study provide preliminary support for the efficacy of this parent-implemented language intervention approach by demonstrating generalized improvements in both targeted maternal strategy use and measures of child spoken language.

Conclusions

The present study expands upon prior language intervention research utilizing distance delivery of services for families affected by fragile X syndrome. Additionally, the study provides early support for the feasibility of collecting pre- and post-treatment assessments at a distance.