bluuebunny/crossref_metadata_2025 huggingface dataset:
Researching the Reliability of Accreditation Survey Teams: Lessons Learnt When Things Went Awry
Authors: Greenfield David , Pawsey Marjorie , Naylor Justine , Braithwaite Jeffrey
Published: March 2016

Accreditation of health organisations, occurring in over 70 countries, is predicated upon the reliability of survey teams' judgements, but we do not know the extent to which survey teams are reliable. To contribute evidence to this issue, we investigated the reliability of two survey teams simultaneously assessing an organisation. The setting was a large Australian teaching hospital, and data were derived from interviews, observations and survey documents. Participants were from four groups: hospital staff, accreditation agency personnel and surveyors, and research staff. Thematic analysis was employed to identify significant factors that influenced the study. The two survey teams' ratings and recommendations demonstrated high levels of agreement. However, while a common understanding of the study existed, the research was compromised. There were difficulties enacting the study. Contrary to negotiated arrangements, the pressure of the study resulted in surveyors discussing evidence and their interpretation of standards. Uncontrollable circumstances (late changes of personnel), and unexpected events (a breakdown of working relationships), challenged the study. The twin lessons learnt are that a consistent survey outcome is likely to be reached when reliability of process and consistent application of standards are pursued, and research requires negotiating challenges and relationships.
The Quality of Medical Record Documentation and External Cause of Fall Injury Coding in a Tertiary Teaching Hospital
Authors: Cunningham Janet , Williamson Dianne , Robinson Kerin M. , Carroll Rhonda , Buchanan Ross , Paul Lindsay
Published: March 2016

This paper reviews the documentation and coding of External causes of admitted fall cases in a major hospital. Intensive analysis of a random selection of 100 medical records included blind re-coding in the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian Modification (ICD-10-AM), Fifth Edition for External causes to ascertain whether: (i) the medical records contained sufficient information for assignment of specific External cause codes; and (ii) the most appropriate External cause codes were assigned per available documentation. Comparison of the hospital data with the state-wide Victorian Admitted Episodes Database (VAED) data on frequency of use of External cause codes revealed that the index hospital, a major trauma centre, treated comparatively more falls involving steps, stairs and ladders. The hospital sample reflected lower usage, than state-wide, of unspecified External cause codes and Other specified activity codes; otherwise, there was similarity in External cause coding. A comparison of researcher and hospital codes for the falls study sample revealed differences. The ambulance report was identified as the best source of External cause information; only 50% of hospital medical records contained sufficient information for specific code assignation for all three External cause codes, mechanism of injury, place of occurrence and activity at time of injury. Whilst all medical records contained mechanism of falls injury information, 16% contained insufficient details, indicating a deficiency in medical record documentation to underpin external cause coding. This was compounded by flaws in the ICD- 10-AM classification.
Data Quality: Not Selling Ourselves Short
Authors: Jackson Terri
Published: March 2016

Routinely coded hospital data (‘administrative data’) have been criticised as invalid and unreliable, without due regard for how Australian data differ from those of other healthcare systems. The skills and education of coders, degree of professional coding supervision, and the existence and rigour of coding audits all strengthen Australian routine hospital data.
Patient Innovation: An Analysis of Patients' Designs of Digital Technology Support for Everyday Living with Diabetes
Authors: Kanstrup Anne Marie , Bertelsen Pernille , Nøhr Christian
Published: March 2016

The aim of this paper is to identify characteristics of patients' contributions to innovation in health information technology (HIT). The paper outlines a theoretical definition of patient innovation and presents an analysis of four digital prototypes and 22 low-fidelity mock-ups designed by people affected by the chronic illness diabetes mellitus. Seventeen families (a total of 60 people) with one or more diabetic family members participated in design activities in a four-year research project focused on the design of digital support for everyday living with diabetes. Our analysis documented the originality of the analysed patient designs and identified three characteristics of patients' designs: socio-technical networks, objects with associated personal meanings and technology supporting the expression of identity. The paper concludes that patient innovation is defined by what is perceived as new by patients and/or others within the social system of adaptation. The analysed patient designs are original (as distinct from replications of or improvements on known products), and their characteristics are innovative contributions to the social system of everyday living with diabetes (i.e. they are perceived as new to the patients in the research study). The results of the analysis contribute to the credentials of patients as key actors in HIT innovation and call for participatory approaches in health informatics.
Examination of Narratives from Emergency Department Presentations to Identify Road Trauma, Crash and Injury Risk Factors for Different Age Groups
Authors: Mitchell Rebecca J. , Bambach Mike R.
Published: March 2016

Background:

Road trauma represents a high proportion of injury-related emergency department presentations. Narrative text recorded in the emergency department could provide useful information to monitor road trauma and to identify crash and injury risk factors by age group.

Objective:

To examine the Public Health Real-time Emergency Department Surveillance System (PHREDSS) to identify road users (i.e. motor vehicle drivers, motor vehicle passengers, motorcyclists, pedal cyclists and pedestrians), and crash (e.g. vehicle speed) and injury risk factors (e.g. non-restraint use) by age group.

Method:

Narrative text from the PHREDSS in New South wales, Australia, during 1 January 2006 to 31 December 2012 was reviewed.

Results:

A keyword search of all emergency department presentations potentially identified 388,991 road trauma-related presentations and between 6,420 motorbike crashes to 138,889 motor vehicle accident emergency department presentations. Potential crash and injury risk factors were also identified.

Conclusion:

This exploratory study demonstrated the capability of information from PHREDSS to be used to support injury prevention efforts in road safety.
Assignment of Functional Relevance to Genes at Type 2 Diabetes-Associated Loci Through Investigation of β-Cell Mass Deficits
Authors: O'Hare Elizabeth A. , Yerges-Armstrong Laura M. , Perry James A. , Shuldiner Alan R. , Zaghloul Norann A.
Published: March 2016

Type 2 diabetes (T2D) has been associated with a large number of genomic loci, many of which encompass multiple genes without a definitive causal gene. This complexity has hindered efforts to clearly identify functional candidate genes and interpret their role in mediating susceptibility to disease. Here we examined the relevance of individual genes found at T2D-associated loci by assessing their potential contribution to a phenotype relevant to the disease state: production and maintenance of β-cell mass. Using transgenic zebrafish in which β-cell mass could be rapidly visualized in vivo, we systematically suppressed the expression of orthologs of genes found at T2D-associated genomic loci. Overall, we tested 67 orthologs, many of which had no known relevance to β-cell mass, at 62 human T2D-associated loci, including eight loci with multiple candidate genes. In total we identified 25 genes that were necessary for proper β-cell mass, providing functional evidence for their role in a physiological phenotype directly related to T2D. Of these, 16 had not previously been implicated in the regulation of β-cell mass. Strikingly, we identified single functional candidate genes at the majority of the loci for which multiple genes were analyzed. Further investigation into the contribution of the 25 genes to the adaptive capacity of β-cells suggested that the majority of genes were not required for glucose-induced expansion of β-cell mass but were significantly necessary for the regeneration of β-cells. These findings suggest that genetically programmed deficiencies in β-cell mass may be related to impaired maintenance. Finally, we investigated the relevance of our findings to human T2D onset in diabetic individuals from the Old Order Amish and found that risk alleles in β-cell mass genes were associated with significantly younger age of onset and lower body mass index. Taken together, our study offers a functional approach to assign relevance to genes at T2D-associated loci and offers experimental evidence for the defining role of β-cell mass maintenance in genetic susceptibility to T2D onset.
The GATA transcription factor gene gtaG is required for terminal differentiation in Dictyostelium
Authors: Katoh-Kurasawa Mariko , Santhanam Balaji , Shaulsky Gad
Published: March 2016

The GATA transcription factor GtaG is conserved in Dictyostelids and is essential for terminal differentiation in Dictyostelium discoideum, but its function is not well understood. Here, we show that gtaG is expressed in prestalk cells at the anterior region of fingers and in the extending stalk during culmination. The gtaG− phenotype is cell-autonomous in prestalk cells and non-cell-autonomous in prespore cells. Transcriptome analyses reveal that GtaG regulates prestalk gene expression during cell differentiation before culmination and is required for progression into culmination. GtaG-dependent genes include genetic suppressors of the Dd-STATa-defective phenotype (Dd-STATa is also known as DstA) as well as Dd-STATa target-genes, including extracellular matrix genes. We show that GtaG might be involved in the production of two culmination-signaling molecules, cyclic di-GMP (c-di-GMP) and the spore differentiation factor SDF-1, and that addition of c-di-GMP rescues the gtaG− culmination and spore formation deficiencies. We propose that GtaG is a regulator of terminal differentiation that functions in concert with Dd-STATa and controls culmination through regulating c-di-GMP and SDF-1 production in prestalk cells.
Corporate Governance, Accounting Conservatism, and Manipulation
Authors: Caskey Judson , Laux Volker
Published: March 2016

We develop a model to analyze how board governance affects firms’ financial reporting choices and managers’ incentives to manipulate accounting reports. In our setting, ceteris paribus, conservative accounting is desirable because it allows the board of directors to better oversee the firm’s investment decisions. This feature of conservatism, however, causes the manager to manipulate the accounting system to mislead the board and distort its decisions. Effective reporting oversight curtails managers’ ability to manipulate, which increases the benefits of conservative accounting and simultaneously reduces its costs. Our model predicts that stronger reporting oversight leads to greater accounting conservatism, manipulation, and investment efficiency.

This paper was accepted by Mary Barth, accounting.
Backtesting Expected Shortfall: Accounting for Tail Risk
Authors: Du Zaichao , Escanciano Juan Carlos
Published: March 2016

The Basel Committee on Banking Supervision (BIS) has recently sanctioned expected shortfall (ES) as the market risk measure to be used for banking regulatory purposes, replacing the well-known value at risk (VaR). This change is motivated by the appealing theoretical properties of ES as a measure of risk and the poor properties of VaR. In particular, VaR fails to control for “tail risk.” In this transition, the major challenge faced by financial institutions is the unavailability of simple tools for evaluation of ES forecasts (i.e., backtesting ES). The main purpose of this paper is to propose such tools. Specifically, we propose backtests for ES based on cumulative violations, which are the natural analogue of the commonly used backtests for VaR. We establish the asymptotic properties of the tests, and investigate their finite sample performance through some Monte Carlo simulations. An empirical application to three major stock indexes shows that VaR is generally unresponsive to extreme events such as those experienced during the recent financial crisis, whereas ES provides a more accurate description of the risk involved.

This paper was accepted by Neng Wang, finance.
Venture Capital, CEOs’ Sources of Power, and Innovation Novelty at Different Life Stages of a New Venture
Authors: Park Haemin Dennis , Tzabbar Daniel
Published: March 2016

We explore how the mutual dependence between venture capitalists (VCs) and venture CEOs affects the innovation novelty of new ventures at different stages of their lives. Based on a sample of 482 U.S. biotech companies, we find that VCs encourage their investees to pursue risky and novel innovations in the early stage of a new venture, but discourage them from doing so in the late stage of the venture. Furthermore, structurally powerful CEOs, who are in a position to take greater risks, intensify the positive effect of VC funding on innovation novelty in the early stage of a venture. However, such CEOs attenuate the negative effect of VC funding on innovation novelty in the late stage of the venture. In contrast, CEOs whose power derives from their innovation-related expertise typically seek a more balanced approach to innovation. Such CEOs attenuate both the positive effect of VC funding on innovation novelty in the early stage of a venture and the negative effect of VC funding on innovation novelty in the late stage of the venture. This study sheds new light on the VC–CEO relationship and provides insights into how the risk preference and the abilities of mutually dependent actors affect the innovation outcomes of new ventures.
Risk management 4/4. Risk enablement—practical aspects
Authors: Nazarko Linda
Published: March 2016

It is not always possible to enable people with dementia to take risks. Sometimes the risks are so great that the person is in danger. At other times, though, it is possible to work with the person with dementia, his or her family, clinicians and caregivers, to reduce risks and enable the person to experience the best possible quality of life.
Abdominal wall reconstruction
Authors: Stylianides Nicholas , Slade Dominic AJ
Published: March 2016

Abdominal wall hernias can be challenging and complicated to manage. The techniques to deal with them are evolving rapidly with increasing adaptation and utilization in general surgery.
The Liverpool Care Pathway: what went right and what went wrong
Authors: Julia Neuberger Rabbi Baroness
Published: March 2016

The history of the Liverpool Care Pathway shows how the best of intentions, and good guidelines, can be perverted by poor practice, lack of thought, poor training and inadequate communication. Good clinical leadership can encourage high quality care of dying people, whatever guidelines are being used, or not.
The management of bipolar disorder
Authors: Saunders Kate EA , Geddes John R
Published: March 2016

Bipolar disorder is a common mental disorder which is relapsing and remitting in nature. Subsyndromal symptoms are common and associated with poorer outcomes. Management of the disorder can be challenging and depends on the polarity and severity of the mood episode.
Natural Detoxification Capacity to Inactivate Nerve Agents Sarin and VX in the Rat Blood
Authors: Bajgar Jiří , Cabal Jiří , Kassa Jiří , Pavlík Michal
Published: March 2016

Background: The method of continual determination of the rat blood cholinesterase activity was developed to study the changes of the blood cholinesterases following different intervetions. Aims: The aim of this study is registration of cholinesterase activity in the rat blood and its changes to demonstrate detoxification capacity of rats to inactivate sarin or VX in vivo. Methods: The groups of female rats were premedicated (ketamine and xylazine) and cannulated to a. femoralis. Continual blood sampling (0.02 ml/min) and monitoring of the circulating blood cholinesterase activity were performed. Normal activity was monitored 1–2 min and then the nerve agent was administered i.m. (2× LD50). Using different time intervals of the leg compression and relaxation following the agent injection, cholinesterase activity was monitored and according to the inhibition obtained, detoxification capacity was assessed. Results: Administration of sarin to the leg, then 1 and 5 min compression and 20 min later relaxation showed that further inhibition in the blood was not observed. On the other hand, VX was able to inhibit blood cholinesterases after this intervention. Conclusions: The results demonstrated that sarin can be naturally detoxified on the contrary to VX. Described method can be used as model for other studies dealing with changes of cholinesterases in the blood following different factors.
Concha Bullosa Mucopyocele: a Case Report
Authors: Sari Kamran , Gencer Zeliha Kapusuz , Kantekin Yunus
Published: March 2016

Concha bullosa (CB) is among the most common anatomic variations of sinonasal anatomy. Although usually asymptomatic, CB can occasionally cause nasal obstruction or headache. Obstructions within the mucociliary transport system can develop into a mucocele or mucopyocele. A 48-year-old female, with a history of progressive headache and nasal obstruction, was referred to our department. Paranasal sinus tomography revealed a nasal mass in the left nasal cavity resembling a mucopyocele in the middle turbinate. Under general anesthesia, the purulent material was aspirated, and the lateral part of the left turbinate was resected. Mucopyoceles are common within the paranasal sinuses, but uncommon with CB; thus, they should be considered in patients with a large hyperemic nasal mass.
Effect of cattle trampling on ground nesting birds on pastures: an experiment with artificial nests
Authors: Sabatier Rodolphe , Durant Daphné , Ferchichi Sameh , Haranne Khalil , Léger François , Tichit Muriel
Published: March 2016

1. In semi-natural grasslands, nest trampling by cattle can have a strong effect on hatching success but the relationship linking cattle density, incubation time and nest survival has for now only been hypothesized.

2. Based on an experiment with artificial nests, the objective of this study was to test the theoretical model generally used to estimate nest survival. In spring 2009, we conducted a one-month experiment on permanent grasslands of the French western marshlands grazed at three different stocking rates (1 LU.ha-1, 2 LU.ha-1 and 4 LU.ha-1).

3. The results confirmed that trampling depended on stocking rates.

4. Trampling had a major effect on nest survival (32-85% of nests destroyed).

5. The theoretical model classically used by managers and modellers proved to be a good approximation of the dynamics of nest trampling.

6. Synthesis and applications: We conclude that nest trampling has a major impact on nest survival in pastures and that the use of such a model could help managers to define acceptable levels of cattle densities.
Tree diversity in the tropical dry forest of Bannerghatta National Park in Eastern Ghats, Southern India
Authors: Gopalakrishna S. Puttakame , Kaonga M. Leckson , Somashekar R. Kalegowda , Suresh H.Satyanarayana , Suresh R.
Published: March 2016

Tree species inventories, particularly of poorly known dry deciduous forests, are needed to protect and restore forests in degraded landscapes. A study of forest stand structure, and species diversity and density of trees with girth at breast height (GBH) ≥10 cm was conducted in four management zones of Bannerghatta National Park (BNP) in the Eastern Ghats of Southern India. We identified 128 tree species belonging to 45 families in 7.9 hectares. However, 44 species were represented by ≤ 2 individuals. Mean diversity values per site for the dry forest of BNP were: tree composition (23.8 ±7.6), plant density (100.69 ± 40.02), species diversity (2.56 ± 0.44) and species richness (10.48 ± 4.05). Tree diversity was not significantly different (P>0.05) across the four management zones in the park. However, the number of tree species identified significantly (P<0.05) increased with increasing number of sampling sites, but majority of the species were captured. Similarly, there were significant variations (p<0.05) between tree diameter class distributions. Juveniles accounted for 87% of the tree population. The structure of the forest was not homogeneous, with sections ranging from poorly structured to highly stratified configurations. The study suggests that there was moderate tree diversity in the tropical dry thorn forest of Bannerghatta National Park, but the forest was relatively young.
Mechanistic and Correlative Models of Ecological Niches
Authors: Peterson A. Townsend , Papeş Monica , Soberón Jorge
Published: March 2016

The suite of factors that drives where and under what conditions a species occurs has become the focus of intense research interest. Three general categories of methods have emerged by which researchers address questions in this area: mechanistic models of species’ requirements in terms of environmental conditions that are based on first principles of biophysics and physiology, correlational models based on environmental associations derived from analyses of geographic occurrences of species, and process-based simulations that estimate occupied distributional areas and associated environments from assumptions about niche dimensions and dispersal abilities. We review strengths and weaknesses of these sets of approaches, and identify significant advantages and disadvantages of each. Rather than identifying one or the other as ‘better,’ we suggest that researchers take great care to use the method best-suited to each specific research question, and be conscious of the weaknesses of any method, such that inappropriate interpretations are avoided.
Quantitative q-Voronovskaya and q-Grüss–Voronovskaya-type results for q-Szász operators
Authors: Acar Tuncer
Published: March 2016

In the present paper, we mainly study quantitative Voronovskaya-type
theorems for q-Szász operators defined in [20].
We consider weighted spaces of functions and the corresponding
weighted modulus of continuity.
We obtain the quantitative q-Voronovskaya-type theorem and the q-Grüss–Voronovskaya-type theorem in terms of the weighted modulus of continuity of q-derivatives of the approximated function.
In this way, we either obtain the rate of pointwise convergence of q-Szász operators or we present these results for a subspace of continuous functions, although the classical ones are valid for differentiable functions.
Hypereutectic Al2O3/YAG/ZrO2 In Situ Composite Prepared by Horizontal Laser Zone Melting
Authors: Song Kan , Zhang Jun , Liu Lin
Published: March 2016

Al2O3/YAG/ZrO2 eutectic in situ composite has now been considered as the new generation of high-temperature structural material due to its excellent performance even close to its melting point. In this work, hypereutectic Al2O3/YAG/ZrO2 in situ composite is manufactured by the horizontal laser zone melting technique. The relationship between the solidification microstructure and the solidification parameters is studied. The minimum lamellar spacing is as finer as 0.20 μm when the laser scanning rate is 800 μm/s. Compared with eutectic Al2O3/YAG/ZrO2, hypereutectic exhibits more regular and finer microstructure at the similar conditions. Meanwhile, it is found that the lamellar spacing remains almost as constant at a certain high solidification velocity. The maximum hardness and fracture toughness are 15.9 GPa and 4.2 MPa · m1/2, respectively.
Adapting Differential Evolution Algorithms For Continuous Optimization Via Greedy Adjustment Of Control Parameters
Authors: Leon Miguel , Xiong Ning
Published: March 2016

Differential evolution (DE) presents a class of evolutionary and meta-heuristic techniques that have been applied successfully to solve many real-world problems. However, the performance of DE is significantly influenced by its control parameters such as scaling factor and crossover probability. This paper proposes a new adaptive DE algorithm by greedy adjustment of the control parameters during the running of DE. The basic idea is to perform greedy search for better parameter assignments in successive learning periods in the whole evolutionary process. Within each learning period, the current parameter assignment and its neighboring assignments are tested (used) in a number of times to acquire a reliable assessment of their suitability in the stochastic environment with DE operations. Subsequently the current assignment is updated with the best candidate identified from the neighborhood and the search then moves on to the next learning period. This greedy parameter adjustment method has been incorporated into basic DE, leading to a new DE algorithm termed as Greedy Adaptive Differential Evolution (GADE). GADE has been tested on 25 benchmark functions in comparison with five other DE variants. The results of evaluation demonstrate that GADE is strongly competitive: it obtained the best rank among the counterparts in terms of the summation of relative errors across the benchmark functions with a high dimensionality.
Analysis Of Masonry Infilled RC Frame Structures Under Lateral Loading
Authors: Barnaure Mircea , Stoica Daniel Nicolae
Published: March 2016

Partition walls are often made of masonry in Romania. Although they are usually considered non-structural elements in the case of reinforced concrete framed structures, the infill panels contribute significantly to the seismic behaviour of the building. Their impact is difficult to assess, mainly because the interaction between the bounding frame and the infill is an intricate issue. This paper analyses the structural behaviour of a masonry infilled reinforced concrete frame system subjected to in - plane loading. Three numerical models are proposed and their results are compared in terms of stiffness and strength of the structure. The role of the openings in the infill panel on the behaviour is analysed and discussed. The effect of gaps between the frame and the infill on the structural behaviour is also investigated. Comparisons are made with the in-force Romanian and European regulations provisions.
Nano-proximity direct ion beam writing
Authors: Seniutinas Gediminas , Gervinskas Gediminas , Anguita Jose , Hakobyan Davit , Brasselet Etienne , Juodkazis Saulius
Published: March 2016

Focused ion beam (FIB) milling with a 10 nm resolution is used to directly write metallic metasurfaces and micro-optical elements capable to create structured light fields. Surface density of fabricated nano-features, their edge steepness as well as ion implantation extension around the cut line depend on the ion beam intensity profile. The FIB beam intensity cross section was evaluated using atomic force microscopy (AFM) scans of milled line arrays on a thin Pt film. Approximation of two Gaussian intensity distributions describes the actual beam profile composed of central high intensity part and peripheral wings. FIB fabrication reaching aspect ratio of 10 in gold film is demonstrated.
Hybridization of Stochastic Local Search and Genetic Algorithm for Human Resource Planning Management
Authors: Škraba Andrej , Stanovov Vladimir , Semenkin Eugene , Kofjač Davorin
Published: March 2016

Background and Purpose: The restructuring of human resources in an organization is addressed in this paper, because human resource planning is a crucial process in every organization. Here, a strict hierarchical structure of the organization is of concern here, for which a change in a particular class of the structure influences classes that follow it. Furthermore, a quick adaptation of the structure to the desired state is required, where oscillations in transitions between classes are not desired, because they slow down the process of adaptation. Therefore, optimization of such a structure is highly complex, and heuristic methods are needed to approach such problems to address them properly.

Design/Methodology/Approach: The hierarchical human resources structure is modeled according to the principles of System Dynamics. Optimization of the structure is performed with an algorithm that combines stochastic local search and genetic algorithms.

Results: The developed algorithm was tested on three scenarios; each scenario exhibits a different dynamic in achieving the desired state of the human resource structure. The results show that the developed algorithm has successfully optimized the model parameters to achieve the desired structure of human resources quickly.

Conclusion: We have presented the mathematical model and optimization algorithm to tackle the restructuring of human resources for strict hierarchical organizations. With the developed algorithm, we have successfully achieved the desired organizational structure in all three cases, without the undesired oscillations in the transitions between classes and in the shortest possible time.
Nonlinear self adjointness, conservation laws and exact solutions of ill-posed Boussinesq equation
Authors: Yaşar Emrullah , San Sait , Özkan Yeşim Sağlam
Published: March 2016

In this work, we consider the ill-posed Boussinesq equation which arises in shallow water waves and non-linear lattices. We prove that the ill-posed Boussinesq equation is nonlinearly self-adjoint. Using this property and Lie point symmetries, we construct conservation laws for the underlying equation. In addition, the generalized solitonary, periodic and compact-like solutions are constructed by the exp-function method.
Dermatoscopy as a Helpful Tool in Plastic Surgeon’s Practice – A Preliminary Study
Authors: Antoszewski Bogusław , Fijałkowska Marta , Stabryła Piotr , Kasielska-Trojan Anna
Published: March 2016

The aim of the study was to examine the utility of dermatoscopy in plastic surgeons’ practice in pigmented and non-pigmented skin lesions management.

Material and methods. The examined group consisted of 68 patients with 132 lesions (50 women and 18 men) aged from 12 to 75 years (the mean: 47.2 years ± 16.9 years), who underwent dermatoscopy. Dermatoscopic photographs were analysed according to the ABCD and 7-point scales and then, a further treatment (surgical excision, electro resection or regular follow-up and observations) was planned.

Results. The mean score of all lesions according to ABCD scale was 2.34 while in 7-point scale it was 0.62. In male and female groups the number of lesions and their ABCD and 7-point scale scores were similar (p>0.05). Histopathological examination revealed that all excised lesions were benign (compound melanocytic nevi) which corresponded with dermatoscopic evaluation.

Conclusions. Dermatoscopy seems to be helpful in surgeons’ dealing with skin lesions practise and in many cases it enables to choose less invasive technique of lesions’ removal (electro resection), which gives better aesthetic results.
Identifikation von schwer zu versorgenden Regionen in der hausärztlichen Versorgung – welche Faktoren müssen wir berücksichtigen?
Authors: Tangermann Ulla , Kleij Kim-Sarah , Krauth Christian , Eric Amelung Volker
Published: March 2016

Da sich die Versorgungssituation seit Einführung der Bedarfsplanung grundlegend verändert hat, vermag sie die flächendeckende hausärztliche Versorgung heute nicht mehr ausreichend sicherzustellen. Zudem bleiben Indikatoren zur Beschreibung der Versorgungsrealität und zur Bewertung der künftigen Versorgungssituation unberücksichtigt. Daher bedarf es zur künftigen Sicherstellung der hausärztlichen Versorgung einer Ergänzung der Bedarfsplanung durch weitere versorgungsrelevante Faktoren. In diesem Beitrag werden solche Faktoren identifiziert, um somit schwer zu versorgende Regionen bereits frühzeitig zu erkennen.
Phrase frames in English pharmaceutical discourse: a corpus-driven study of intra-disciplinary register variation
Authors: Grabowski Łukasz
Published: March 2016

Focusing on the exploration of intra-disciplinary register variation in the pharmaceutical domain, this corpus-driven study attempts to describe the use, composition and discourse functions of phrase frames, that is, contiguous sequences of words identical except for one (Fletcher, 2002-2007), found in samples of four English pharmaceutical text types, such as patient information leaflets, summaries of product characteristics, clinical trial protocols and chapters/sections from academic textbooks on pharmacology. The study deals with a specific sub-type of phrase frames, that is, 4-word units with a variable slot in the medial position, e.g. be * with caution, to take * medicine. The results showed, among others, that the use and discourse functions of phrase frames vary across pharmaceutical text types, that the correlation between the frequency of phrase frames and their pattern variability may depend on a register or genre, and that it is justified to treat the discourse functions of phrase frames as distinct from those of their textual variants.
Comparative design of the superstructure of timber bridges, using norm np 005 - 2003 and provisions of european standards
Authors: Chiotan Corina , Morlova Dumitru Daniel
Published: March 2016

The norms and standards for design of timber bridges, as well as other structures built from this material, were obsolete, design standards that were used dated from 1978 to 1980. The introduction of European Standards has created a new legislative framework in the field of designing and building timber bridges. Currently the design of such constructions use Norm NP 005-2003 and SR EN 1995-1-1: 2004 Eurocode 5: Design of timber structures. Part 1-1: General. Common rules and rules for buildings, SR EN 1995-2: 2005 Eurocode 5: Design of timber structures. Part 2: Bridges, along with their national annexes. The aim of this paper is to analyze the design of the beams for timber bridges in parallel, using on one hand Norm NP 005 - 2003, and on the other hand provisions of European standards. The design requirements for both norms as well as the results of a case study for a structural element of a timber bridge will be presented.
Resistant multiple sparse canonical correlation
Authors: Coleman Jacob , Replogle Joseph , Chandler Gabriel , Hardin Johanna
Published: March 2016

Canonical correlation analysis (CCA) is a multivariate technique that takes two datasets and forms the most highly correlated possible pairs of linear combinations between them. Each subsequent pair of linear combinations is orthogonal to the preceding pair, meaning that new information is gleaned from each pair. By looking at the magnitude of coefficient values, we can find out which variables can be grouped together, thus better understanding multiple interactions that are otherwise difficult to compute or grasp intuitively. CCA appears to have quite powerful applications to high-throughput data, as we can use it to discover, for example, relationships between gene expression and gene copy number variation. One of the biggest problems of CCA is that the number of variables (often upwards of 10,000) makes biological interpretation of linear combinations nearly impossible. To limit variable output, we have employed a method known as sparse canonical correlation analysis (SCCA), while adding estimation which is resistant to extreme observations or other types of deviant data. In this paper, we have demonstrated the success of resistant estimation in variable selection using SCCA. Additionally, we have used SCCA to find multiple canonical pairs for extended knowledge about the datasets at hand. Again, using resistant estimators provided more accurate estimates than standard estimators in the multiple canonical correlation setting. R code is available and documented at
Foxo3b but not Foxo3a activates cyp19a1a in Epinephelus coioides
Authors: Liu Qiongyou , Zhang Yang , Shi Boyang , Lu Huijie , Zhang Lihong , Zhang Weimin
Published: March 2016

FOXO3 has been shown to be a critical transcription factor for folliculogenesis in mammals, while the information on its roles in reproduction of nonmammalian vertebrates remains scarce. In this study, twofoxo3homologs, namelyfoxo3aandfoxo3b, were identified in a teleost, the orange-spotted grouperEpinephelus coioides. foxo3awas mainly expressed in the central nervous system, ovary, and gut whereasfoxo3bwas expressed ubiquitously in tissues examined. In contrast to the dominant expression of mammalian FOXO3 in germ cells but barely detectable in ovarian follicular cells, immunoreactive Foxo3a and Foxo3b were identified both in the ovarian germ cells and follicular cells. The immunointensities of both Foxo3a and Foxo3b in ovarian follicular cells during vitellogenesis were significantly increased stage-dependently, and co-localized with Cyp19a1a. In the nucleus of ovarian follicular cells, both Foxo3a and Foxo3b immunostaining could be detected at the vitellogenic stages. Transient transfection and EMSA showed that Foxo3a and Foxo3b upregulatedcyp19a1apromoter activitiesin vitrothrough a conserved Foxo-binding site, with the latter being a more potent activator. However, ChIP analysis showed that only Foxo3b binds tocyp19a1aproximal promoter region containing the conserved Foxo-binding site in the vitellogenic ovary. Taken together, these results suggested that Foxo3a and Foxo3b are involved in the ovarian development possibly through regulating the ovarian germ cells as well as follicular cells, and Foxo3b but not Foxo3a may activatecyp19a1ain the ovarian follicular cells during vitellogenesis in the orange-spotted grouper.
Adverse Childhood Experiences and Adult Well-Being in a Low-income, Urban Cohort
Authors: Giovanelli Alison , Reynolds Arthur J. , Mondi Christina F. , Ou Suh-Ruu
Published: March 2016

OBJECTIVE:

This study tests the association between adverse childhood experiences (ACEs) and multidimensional well-being in early adulthood for a low-income, urban cohort, and whether a preschool preventive intervention moderates this association.

METHODS:

Follow-up data were analyzed for 1202 low-income, minority participants in the Chicago Longitudinal Study, a prospective investigation of the impact of early experiences on life-course well-being. Born between 1979 and 1980 in high-poverty neighborhoods, individuals retrospectively reported ACEs from birth to adolescence, except in cases of child abuse and neglect.

RESULTS:

Nearly two-thirds of the study sample experienced ≥1 ACEs by age 18. After controlling for demographic factors and early intervention status, individuals reporting ACEs were significantly more likely to exhibit poor outcomes than those with no ACEs. Those with ≥4 ACEs had significantly reduced likelihood of high school graduation (odds ratio [OR] = 0.37; P < .001), increased risk for depression (OR = 3.9; P < .001), health compromising behaviors (OR = 4.5; P < .001), juvenile arrest (OR = 3.1; P < .001), and felony charges (OR = 2.8; P < .001). They were also less likely to hold skilled jobs (OR = 0.50; P = .001) and to go further in school even for adversity measured by age 5.

CONCLUSIONS:

ACEs consistently predicted a diverse set of adult outcomes in a high-risk, economically disadvantaged sample. Effective and widely available preventive interventions are needed to counteract the long-term consequences of ACEs.
Untapped potential - choose wisely
Authors: Henderson Catharine Anna
Published: March 2016

Based on a personal perspective the author derived from a lecture at the American Public Health Association meeting about the power of a choice which can change the course of history, the author presents a perspective on the choices made regarding ante-natal life and how this effects a loss in human potential and the global health repercussions that can result.
Health, healing and shalom: Frontiers and challenges for Christian health missions, by Bryant L. Myers, Erin Dufault-Hunter, Isaac B. Voss, Eds. Wm Carey Library Press. 2015
Authors: Hale Cynthia B.
Published: March 2016

Health, Healing and Shalom, Frontiers and Challenges for Christian Health Missions seeks to redress the compartmentalization and imbalance of spiritual versus physical care which plagues many in healthcare missions. It provides both a theological basis and practical ideas to enable healthcare missionaries to practice holistic care. Contributors have themselves practiced according to a definition of health as being a state of complete physical, mental, social and spiritual well-being, and not merely the absence of disease. A variety of specialized areas are presented, including short-term missions, Community Health Evangelism, HIV/AIDS, the impact of trauma, and palliative care. This should be exciting reading for those who wish to minister to the whole person, as Jesus did.
Inclusion of physical therapy services on a short term mobile medical mission team to Nicaragua: a qualitative description study of team members’ observations and recommendations for improvement
Authors: Steele Douglas , Beitman Candice
Published: March 2016

Context: Access to physical therapy (PT) services is sorely limited in many developing countries due to the constraints of poverty and regional insufficiency in the number of PT providers. Opportunities exist for physical therapists to participate in short term mobile medical mission (STMMM) efforts to provide PT services in many of those regions. However, there is a relative dearth of research regarding the utility of including PT services in STMMM endeavors.
Objective: The aim of this study was to ascertain the impressions and recommendations of medical mission team members regarding the inclusion of PT services during a STMMM trip to underserved areas of Nicaragua.
Methods:This was a qualitative description study conducted in 2014. Data were derived from interviews with STMMM participants and analyzed using conventional content analysis as described by Hsieh and Shannon.
Results: Emergent themes included evidence of: (1) patient need for and benefit from PT services; (2) team member need for physical therapy services for trip related disorders; and (3) a high prevalence of patient orthopedic disorders related to strenuous activities of daily living. There were also a number of reported limitations in the delivery of PT services including: (1) language barriers; (2) lack of medical provider familiarity with PT capability; and (3) limited means of providing follow-up care. Respondent recommendations included: (1) addition of more translators; (2) inclusion of additional treatment modalities; (3) utilization of Nicaraguan therapists or health care workers to facilitate patient follow-up; and (4) the provision of a comprehensive screening program to improve identification of patients in need of PT services.
Conclusion:This study contributes to the understanding of corollaries associated with the addition of PT services to a STMMM and provides recommendations to improve PT services in that context. Additional research is needed to evaluate the soundness of participant responses and whether this information is transferable to STMMM efforts in other communities. Further research is also needed to establish best PT practices in the STMMM context.
Learning to see
Authors: Paulraj Jessica Merrill
Published: March 2016

A moving account of a nurse's adoption of a severely disabled child, and the unforseen ways this came to deepen her appreciation for her purpose in life and her relationship to God and others.
Interdependence: a new model for the global approach to disability
Authors: Grills Nathan
Published: March 2016

Disability affects over 1 billion people and the WHO estimates that over 80% of individuals with disability live in low and middle income countries, where access to health and social services to respond to disability are limited 1. Compounding this poverty is that medical and technological approaches to disability, however needed, are usually very expensive. Yet, much can be done at low cost to increase the wellbeing of people with disability, and the church and Christians need to take a lead.
The WHO’s definition of disability highlights the challenge to us in global health. It has been defined by the WHO as “the interaction between a person’s impairments and the attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others”2. This understanding of disability requires us to go beyond mere healing and towards inclusion in our response to chronic diseases and disability. This is known as the social model and requires societal attitudinal change and modification of disabling environments in order to facilitate those with disability to be included in our community and churches. These are good responses but the church needs to consider alternative models to those that are currently promoted which strive for independence as the ultimate endpoint.
In this paper I introduce some disability-related articles in this issue and outline an approach that goes beyond the Social Model towards an Interdependence Model which I think is a more Biblical model of disability and one which we Christians and churches in global health should consider. This model would go beyond changing society to accommodate for people with disabilities towards acknowledging they play an important part in our community and indeed in our church. We need those people with disability to contribute, love and bless those with and without disabilities. And of course those with disability need the love, care and acceptance of those without disability. This is the society that is described in the Bible perhaps most clearly in 1 Corinthians 12:12-28. In verse 22 Paul states that those who are seemingly weaker are actually indispensable. When each part plays its role and depends on each other, we are a truly healthy, and a more biblical and better society.
This approach would promote the wellbeing and spiritual health of those people with disability and when undertaken by a church would not necessarily entail a high monetary cost. Ultimately, it promotes the dignity of those with disability as created in God’s image for His purposes.