bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective analysis of the associations and effectiveness of performing therapeutic drug monitoring in pregnant HIV-positive women in two large centres in Manchester
Authors: Whitfield Thomas , Dessain Amabel , Taylor Kelly , McQuillan Orla , Kingston Margaret , Ajdukiewicz Katherine
Published: June 2016

There is no proven benefit for the routine use of therapeutic drug monitoring in HIV-positive pregnant women either for improving viral control or preventing mother-to-child transmission. This analysis reviewed a cohort of 171 HIV-positive pregnant women delivering between 1 January 2008 and 28 May 2013 to first establish which baseline characteristics are associated with having therapeutic drug monitoring performed, and whether therapeutic drug monitoring was associated with improved HIV control during pregnancy or mother-to-child transmission. Therapeutic drug monitoring was performed in 39% ( n = 66) of patients; it was associated with baseline characteristics of poor adherence to therapy (therapeutic drug monitoring 23% versus non-therapeutic drug monitoring 10%, p = 0.025) and the use of protease inhibitors (therapeutic drug monitoring 94% versus non-therapeutic drug monitoring 77%, p = 0.005). By multivariate analysis therapeutic drug monitoring was associated with medication alterations during pregnancy (therapeutic drug monitoring 68% versus non-therapeutic drug monitoring 12%, p = < 0.001), but not associated with any difference in viral load breakthrough during pregnancy (therapeutic drug monitoring 12% versus non-therapeutic drug monitoring 7%, p = 0.456) and viral load detectable at birth (therapeutic drug monitoring 14% versus non-therapeutic drug monitoring 9%, p = 0.503). There were no instances of mother-to-child transmission. Therapeutic drug monitoring’s association with medication changes is postulated as partially causal in this cohort. There was no evidence of any association with improved control or reduced transmission of HIV to advocate routine therapeutic drug monitoring use.
Repeated administration of ethambutol in therapeutic dose causes testes alteration and spermatogenesis disruption in Wistar rats
Authors: Shayakhmetova GM , Bondarenko LB , Voronina AK , Matvienko AV , Kitam V , Kovalenko VM
Published: June 2016

Ethambutol (EMB) is conventionally used to treat tuberculosis and atypical Mycobacterium infections in combination with other antimycobacterial drugs. Eventually, EMB testicular toxicity has not been explored extensively yet. The aim of the study is to evaluate testicular toxicity of EMB. We explored the impact of EMB on male rats’ fertility, testosterone level and germ cells state, testicular pro- and anti-oxidant status and DNA damage, as well as identified EMB effects on cytochrome P-450 2E1 (CYP2E1) both with computer simulation and in vivo. We demonstrated that EMB administration to male rats decreased in epididymal sperm count (19%) and fertility index (53%). These events were accompanied by reduction in serum testosterone content (1.6 times) and appearance of spermatogenic epithelium damages. It was also found in testes the intensification of lipid peroxidation, decrease in reduced glutathione content and changes in DNA fragmentation. Additionally, computer simulation showed direct interaction of EMB with CYP2E1 active site and heme. On the top of this, we demonstrated that level of testicular CYP2E1 messenger RNA in EMB-treated rats was increased 8.7 folds and p-nitrophenol hydroxylase activity in testes rose three folds. As this shows, EMB-caused CYP2E1 induction, oxidative stress, and apoptosis in the testes contribute to inhibition of steroidogenesis enzymes and spermatogenesis disruption.
Measuring Regional Variations of Entrepreneurial Intent in India
Authors: Valliere Dave
Published: June 2016

This study reports the first use of a newly developed approach to measuring entrepreneurial intent (EI) among regional populations in India. An improved EI scale is needed to avoid the problems that undermine previous attempts to accurately measure EI—especially the confounding of intentions with similar but theoretically distinct constructs such as beliefs, attitudes and expectations. This new 12-item scale is employed to measure EI levels of 335 participants in three regions of India: Mumbai, Kolkata and Chennai. Moderately high levels of EI are observed in each location, but the level in Kolkata is found to be significantly higher than the other two regions, contrary to popular expectations. The use of this improved scale is recommended to researchers and policymakers interested in entrepreneurship in India.
Early detection of autism spectrum disorder in young isiZulu-speaking children in South Africa
Authors: Chambers Nola J , Wetherby Amy M , Stronach Sheri T , Njongwe Nonyameko , Kauchali Shuaib , Grinker Richard R
Published: June 2016

Culturally appropriate tools are needed for detecting symptoms of autism spectrum disorder in young South African children. The objectives of this study were to (1) adapt and translate into isiZulu existing measures for detecting early signs of autism spectrum disorder, (2) use the measures to characterize and compare behavioural profiles of young isiZulu-speaking children with and without autism spectrum disorder and (3) compare symptom profiles across sampling procedures. Measures were translated and adapted into isiZulu and used to evaluate 26 isiZulu-speaking children, 15 children with no reported developmental concerns and 11 referred for suspected autism spectrum disorder. A video-recorded observation of children and caregivers in their home environment was also made. Based on best-estimate diagnoses, 10 children were classified as autism spectrum disorder and 16 as non-autism spectrum disorder. The children with autism spectrum disorder presented with significantly more autism spectrum disorder red flags than the non-autism spectrum disorder group according to parent report and systematic ratings of red flags. Significant correlations between parent report and observational measures of red flags were observed. More red flags were observed during structured evaluations than home observations in the autism spectrum disorder group. Findings provide a foundation for tool translation and adaptation in South Africa and identifying social communication markers to detect autism spectrum disorder in young isiZulu-speaking children.
Streamlined reporting of forensic evidence in England and Wales
Authors: Sallavaci Oriola
Published: June 2016

Streamlined Forensic Reporting (SFR) is a case management procedure recently introduced in the criminal justice system in England and Wales. It involves a proportionate use and staged producing of the forensic evidence at court, by means of abbreviated forensic reports, depending on whether the defence will agree or take issue with the forensic evidence that the prosecution intends to rely upon. SFR aims to achieve an early identification of the real issues in the case and to reduce costs and delays associated with the use of forensic evidence in criminal proceedings. This paper analyses the most significant aspects of the SFR procedure. It argues that, while SFR offers several advantages, the inappropriate use of SFR and case fragmentation in terms of investigation and preparation of forensic work within the background of cost-cutting pressures, could threaten the delivery of justice and the role of forensic evidence in criminal proceedings.
Diabetes mellitus is associated with adverse structural and functional cardiac remodelling in chronic heart failure with reduced ejection fraction
Authors: Walker Andrew MN , Patel Peysh A , Rajwani Adil , Groves David , Denby Christine , Kearney Lorraine , Sapsford Robert J , Witte Klaus K , Kearney Mark T , Cubbon Richard M
Published: June 2016

Background:

Diabetes mellitus is associated with an increased risk of death and hospitalisation in patients with chronic heart failure. Better understanding of potential underlying mechanisms may aid the development of diabetes mellitus–specific chronic heart failure therapeutic strategies.

Methods:

Prospective observational cohort study of 628 patients with chronic heart failure associated with left ventricular systolic dysfunction receiving contemporary evidence-based therapy. Indices of cardiac structure and function, along with symptoms and biochemical parameters, were compared in patients with and without diabetes mellitus at study recruitment and 1 year later.

Results:

Patients with diabetes mellitus (24.2%) experienced higher rates of all-cause [hazard ratio, 2.3 (95% confidence interval, 1.8–3.0)] and chronic heart failure–specific mortality and hospitalisation despite comparable pharmacological and device-based therapies. At study recruitment, patients with diabetes mellitus were more symptomatic, required greater diuretic doses and more frequently had radiologic evidence of pulmonary oedema, despite higher left ventricular ejection fraction. They also exhibited echocardiographic evidence of increased left ventricular wall thickness and pulmonary arterial pressure. Diabetes mellitus was associated with reduced indices of heart rate variability and increased heart rate turbulence. During follow-up, patients with diabetes mellitus experienced less beneficial left ventricular remodelling and greater deterioration in renal function.

Conclusion:

Diabetes mellitus is associated with features of adverse structural and functional cardiac remodelling in patients with chronic heart failure.
Ex Vivo Resection and Renal Autotransplantation for the Treatment of a Large Renal Vein Aneurysm Causing Recurrent Pulmonary Embolism and a Coexisting Vascular Malformation
Authors: Özyüksel Arda , Aktaş Sema , Çalıs Elif , Erol Cengiz , Sevmiş Şinasi
Published: June 2016

A 36-year-old young woman with a medical history of recurrent pulmonary embolism and chronic pelvic pain was admitted to our hospital. Contrast-enhanced imaging techniques revealed a large left renal vein aneurysm with a coexisting vascular mass. The patient was operated on electively, and the left kidney was autotransplanted to the right ileac fossa following the ex vivo resection of the vascular mass and the left renal vein aneurysm. Herein, we report an unusual coexistence of a vascular mass and recurrent pulmonary embolism treated successfully with our surgical treatment strategy.
Ruptured Juxtarenal Abdominal Aortic Aneurysm Treated With a Fenestrated EVAR Graft Intended for a Different Patient
Authors: Al-Jundi Wissam , Elboushi Amro , Lees Tim , Williams Robin
Published: June 2016

Treatment of juxtarenal abdominal aortic aneurysms (AAAs) remains challenging. A 79-year-old male who had infrarenal endovascular repair of abdominal aortic aneurysm (EVAR) 13 years previously presented with leaking juxtarenal AAA. Emergency fenestrated EVAR (FEVAR) was performed utilizing a stent graft designed and built for a different patient. Despite the need to embolize the celiac artery prior to covering it with the stent graft in order to achieve adequate proximal seal, the patient had uneventful recovery.
Illuminating the Context and Circumstances of Male Couples Establishing a Sexual Agreement in Their Relationship
Authors: Mitchell Jason W. , Lee Ji-Young , Woodyatt Cory , Bauermeister José , Sullivan Patrick , Stephenson Rob
Published: June 2016

A sexual agreement is an explicit mutual understanding made between two partners about which sexual and relational behaviors they agree to engage in within and/or outside of their relationship. Factors that prompt male couples to form a sexual agreement and under what circumstances remain underinvestigated, yet are important considerations for development of couples-based sexual health and HIV prevention interventions. By using thematic analysis with qualitative dyadic data from a convenience sample of 29 HIV-negative male couples, the present study sought to describe the timing and investigate the context and circumstances that led male couples to establish a sexual agreement in their relationship at both the individual and couple levels, and by agreement type. Themes identified for when a sexual agreement was formed included within the first 6 months, and after 6 months in the relationship. Themes related to context and circumstances of couples’ sexual agreement formation were as follows: (a) desire for sexual exploration, (b) arisen circumstances or events with other men, (c) influences from past relationship(s) and/or other couples (i.e., peers), (d) to protect against HIV, and (e) purposeful conversations versus understood. Findings suggest HIV prevention efforts should include skill-building exercises to help improve communication and promote sex positivity within male couples’ relationships.
Effect of size sprinkled heat exchange surface on developing boiling
Authors: Kracík Petr , Baláš Marek , Lisý Martin , Pospíšil Jiří
Published: June 2016

This article presents research of sprinkled heat exchangers. This type of research has become rather topical in relation to sea water desalination. This process uses sprinkling of exchangers which rapidly separates vapour phase from a liquid phase. Applications help better utilize low-potential heat which is commonly wasted in utility systems. Low-potential heat may increase utilization of primary materials. Our ambition is to analyse and describe the whole sprinkled exchanger. Two heat exchangers were tested with a similar tube pitch: heat exchanger no. 1 had a four-tube bundle and heat exchanger no. 2 had eight-tube bundle. Efforts were made to maintain similar physical characteristics. They were tested at two flow rates (ca 0.07 and 0.11 kg s−1 m−1) and progress of boiling on the bundle was observed. Initial pressure was ca 10 kPa (abs) at which no liquid was boiling at any part of the exchanger; the pressure was then lowered. Other input parameters were roughly similar for both flow rates. Temperature of heating water was ca 50°C at a constant flow rate of ca 7.2 L min−1. Results of our experiments provide optimum parameters for the given conditions for both tube bundles.
RETRACTED: The reliability estimation for the braking system of high-speed electric multiple units based on Bayes and GO method
Authors: Yang Jianwei , Zhao Chunqing , Zhu Aihua , Yao Dechen , Wu Huijie
Published: June 2016

At the request of the Authors, the following article has been retracted.

Yang, Jianwei, Zhao, Chunqing, Zhu, Aihua, Yao, Dechen and Wu, Huijie (2016) The reliability estimation for the braking system of high-speed electric multiple units based on Bayes and GO method Advances in Mechanical Engineering published 21 June 2016. doi: 10.1177/1687814016654825
Oral Competency of ESL/EFL Learners in Sri Lankan Rural School Context
Authors: Samaranayake Sarath Withanarachchi
Published: June 2016

This study investigates the current teaching trends and practices in teaching oral English in rural Sinhala-medium schools in Sri Lanka and their relevance to the current theoretical, empirical, and pedagogical perspectives of second-language acquisition (SLA). The present study, which was conducted in two Sri Lankan Sinhala-medium rural schools, is a case study in which the classroom observation, interviewing of the participants, and videotaping of students’ interaction were included as data collection tools. The spoken data were analyzed using the Communicative Orientation of Language Teaching (COLT) scheme designed by Fröhlich, Spada, and Allen, while the numerical data obtained from the structured speaking test ( Cambridge Key English for Schools Test) were analyzed using independent samples t test. The findings of the study indicate that the instructional method used by English teachers does not provide the learners with adequate input of the target language to improve their oral communication skills in rural school contexts. As a result, a majority of students from rural schools in Sri Lanka demonstrate a limited or a low proficiency level in oral communication in English. Therefore, possible reasons for the lack of greater awareness towards more communicative teaching are discussed, and suggestions for promoting changes in teaching English as a Foreign Language (EFL) in rural school contexts are offered.
Antibody-mediated immune suppression is improved when blends of anti-RBC monoclonal antibodies are used in mice
Authors: Bernardo Lidice , Amash Alaa , Marjoram Danielle , Lazarus Alan H.
Published: June 2016

Key Points

Effective inhibition of immunization by polyclonal IgG can be recapitulated by a blend of monoclonal antibodies to different epitopes.
Time-dependent changes in mortality and transformation risk in MDS
Authors: Pfeilstöcker Michael , Tuechler Heinz , Sanz Guillermo , Schanz Julie , Garcia-Manero Guillermo , Solé Francesc , Bennett John M. , Bowen David , Fenaux Pierre , Dreyfus Francois , Kantarjian Hagop , Kuendgen Andrea , Malcovati Luca , Cazzola Mario , Cermak Jaroslav , Fonatsch Christa , Le Beau Michelle M. , Slovak Marilyn L. , Levis Alessandro , Luebbert Michael , Maciejewski Jaroslaw , Machherndl-Spandl Sigrid , Magalhaes Silvia M. M. , Miyazaki Yasushi , Sekeres Mikkael A. , Sperr Wolfgang R. , Stauder Reinhard , Tauro Sudhir , Valent Peter , Vallespi Teresa , van de Loosdrecht Arjan A. , Germing Ulrich , Haase Detlef , Greenberg Peter L.
Published: June 2016

Key Points

Hazards regarding mortality and leukemic transformation in MDS diminish over time in higher-risk but remain stable in lower-risk patients. This change of hazard indicates time-dependent attenuation of power of basal risk scores, which is relevant for clinical decision making.
multiDE: a dimension reduced model based statistical method for differential expression analysis using RNA-sequencing data with multiple treatment conditions
Authors: Kang Guangliang , Du Li , Zhang Hong
Published: June 2016

Background

The growing complexity of biological experiment design based on high-throughput RNA sequencing (RNA-seq) is calling for more accommodative statistical tools. We focus on differential expression (DE) analysis using RNA-seq data in the presence of multiple treatment conditions.

Results

We propose a novel method, multiDE, for facilitating DE analysis using RNA-seq read count data with multiple treatment conditions. The read count is assumed to follow a log-linear model incorporating two factors (i.e., condition and gene), where an interaction term is used to quantify the association between gene and condition. The number of the degrees of freedom is reduced to one through the first order decomposition of the interaction, leading to a dramatically power improvement in testing DE genes when the number of conditions is greater than two. In our simulation situations, multiDE outperformed the benchmark methods (i.e. edgeR and DESeq2) even if the underlying model was severely misspecified, and the power gain was increasing in the number of conditions. In the application to two real datasets, multiDE identified more biologically meaningful DE genes than the benchmark methods. An R package implementing multiDE is available publicly at http://homepage.fudan.edu.cn/zhangh/softwares/multiDE.

Conclusions

When the number of conditions is two, multiDE performs comparably with the benchmark methods. When the number of conditions is greater than two, multiDE outperforms the benchmark methods.
Chemical characterisation of archaeological glasses from the Hellenistic site of Jebel Khalid, Syria by electron probe microanalysis
Authors: Reade Wendy J. , Privat Karen L.
Published: June 2016

Background

Jebel Khalid is a single period Hellenistic site on the west bank of the Euphrates River in northern Syria. The occupation of the site dates from the early 3rd century BCE until its abandonment in the late 70s BCE. The so-called Governor’s Palace, an administrative centre on the Acropolis of the site, overlooked this walled Greek garrison city. A considerable quantity of glass, predominantly drinking bowls, was excavated from this building complex. This study concerns the elemental analysis of glass samples from this assemblage by electron probe microanalysis (SEM-WDS).

Results

The preliminary analyses presented in this report reveal that the Jebel Khalid glasses are of the silica-soda-lime type fluxed with mineral soda, typical of late 1st millennium BCE glass composition. Manganese was employed as the chief decolourant. Glass compositions of monochrome bowls, core-formed and mosaic glass vessels are very similar, despite the different forms, colours and manufacturing techniques of the vessels.

Conclusions

While the production centre for the Jebel Khalid glass remains elusive, the similarity to other published Hellenistic glasses from Greek mainland sites, Rhodes, Tel Anafa in Israel, and Gordion in central Turkey, indicates a tightly controlled composition with comparable batch ingredients. Without more comparative material of this date from the Near East and Greece, it is difficult to determine whether production of the vessel glass from this Seleucid site in the Near East occurred in the Aegean region or the Syro-Palestinian Levant, or both. Vessel style and archaeological context lean towards an Aegean connection, but until more comparative glass is analysed, and trace element and isotope data are considered, questions of primary and secondary production remain unresolved.
Platelet activation and platelet–leukocyte interaction in generalized aggressive periodontitis
Authors: Zhan Yalin , Lu Ruifang , Meng Huanxin , Wang Xian’e , Hou Jianxia
Published: June 2016

Generalized aggressive periodontitis (GAgP) is an inflammatory disease of host response to bacterial challenge. To explore the role of platelets in host–microbial interactions in patients with periodontitis, 124 patients with GAgP and 57 healthy subjects were enrolled. Reliable indicators of subclinical platelet functional status, platelet count (PLT), platelet large cell ratio (PLCR), and mean platelet volume (MPV), were significantly lower in the GAgP group than in the control group and were negatively correlated with clinical periodontal parameters. The levels of important cytosolic protein in neutrophils, calprotectin (S100A8/A9) in plasma, and gingival crevicular fluid (GCF) were significantly higher in patients with GAgP compared with healthy subjects. Moreover, the GCF calprotectin level was negatively correlated with PLCR and MPV values. To explore the possible mechanisms of changes in platelet indices in periodontitis, flow cytometry analysis was performed, and patients with GAgP were found to have a higher status of platelet activation compared with healthy controls. Porphyromonas gingivalis (P. gingivalis) and recombinant human S100A8/A9 (rhS100A8/A9) induced platelet activation and facilitated platelet–leukocyte aggregate formation in whole blood of healthy subjects. In response to P. gingivalis and rhS100A8/A9, platelets from patients with GAgP increased activation and increased formation of platelet–leukocyte aggregates compared with those from healthy subjects. Platelet aggregates and platelets attached to leukocytes were found on gingival tissues from patients with GAgP, suggesting that decreased platelet size and count in the circulation might be related to consumption of large, activated platelets at inflamed gingiva. Platelets may have a previously unrecognized role in host response to periodontal infection.
South African Breast Cancer and HIV Outcomes Study: Methods and Baseline Assessment
Authors: Cubasch Herbert , Ruff Paul , Joffe Maureen , Norris Shane , Chirwa Tobias , Nietz Sarah , Sharma Vinay , Duarte Raquel , Buccimazza Ines , Čačala Sharon , Stopforth Laura W. , Tsai Wei-Yann , Stavsky Eliezer , Crew Katherine D. , Jacobson Judith S. , Neugut Alfred I.
Published: June 2016

Purpose

In low- and middle-income, HIV-endemic regions of sub-Saharan Africa, morbidity and mortality from the common epithelial cancers of the developed world are rising. Even among HIV-infected individuals, access to antiretroviral therapy has enhanced life expectancy, shifting the distribution of cancer diagnoses toward non–AIDS-defining malignancies, including breast cancer. Building on our prior research, we recently initiated the South African Breast Cancer and HIV Outcomes study.

Methods

We will recruit a cohort of 3,000 women newly diagnosed with breast cancer at hospitals in high (average, 20%) HIV prevalence areas, in Johannesburg, Durban, Pietermaritzburg, and Empangeni. At baseline, we will collect information on demographic, behavioral, clinical, and other factors related to access to health care. Every 3 months in year 1 and every 6 months thereafter, we will collect interview and chart data on treatment, symptoms, cancer progression, comorbidities, and other factors.

We will compare survival rates of HIV-infected and uninfected women with newly diagnosed breast cancer and their likelihood of receiving suboptimal anticancer therapy. We will identify determinants of suboptimal therapy and context-specific modifiable factors that future interventions can target to improve outcomes. We will explore molecular mechanisms underlying potentially aggressive breast cancer in both HIV-infected and uninfected patients, as well as the roles of pathogens, states of immune activation, and inflammation in disease progression.

Conclusion

Our goals are to contribute to development of evidence-based guidelines for the management of breast cancer in HIV-positive women and to improve outcomes for all patients with breast cancer in resource-constrained settings.
Fear of Treatments Surpasses Demographic and Socioeconomic Factors in Affecting Patients With Breast Cancer in Urban South Africa
Authors: Rayne Sarah , Schnippel Kathryn , Firnhaber Cynthia , Wright Kathryne , Kruger Deirdre , Benn Carol-Ann
Published: June 2016

Purpose

Breast cancer is the most common cause of cancer in women in South Africa, and often patients present late. There is little understanding of the psychosocial stresses affecting women with breast cancer in Africa.

Methods

A questionnaire was distributed to 263 patients with breast cancer at two sites (one government and one private facility) in Johannesburg. Self-reported levels of fear were recorded on summative scales and their relationship to demographic variables assessed through univariable and multivariable modified Poisson regression.

Results

Fears related to treatments and prognosis, particularly radiation, loss of hair, and loss of breast, were far stronger than those related to socioeconomic barriers. Relative risk (RR) of most fears was higher in women younger than age 40 years, including treatment affordability (RR, 1.80; 95% CI, 1.26 to 2.56), hair loss (RR, 1.48; 95% CI, 1.12 to 2.95), and surgery (RR, 1.31; 95% CI, 1.02 to 1.68). Difficulty taking time off work predicted fear of job loss (RR, 2.59; 95% CI, 1.59 to 4.21) and missing appointments because of transport (RR, 2.46; 95% CI, 1.52 to 3.96) or family commitments (RR, 2.46; 95% CI, 1.52 to 3.96). Women with dependents and black women were more afraid of dying (RR, 1.73; 95% CI, 1.03 to 2.90; and RR, 1.79; 95% CI, 1.33 to 2.24, respectively); however, socioeconomic status in this sample was a strong confounder of race and explained most of the racial differences in levels of fear.

Conclusion

The most significant fears around breast cancer were related to treatment modalities and adverse effects rather than transport, financial, or work concerns. Young age and job insecurity were predictive of increased fears. Education about treatments has a key role to play in improving access to breast cancer care in South Africa.
Disconnecting Consciousness: Is There a Common Anesthetic End Point?
Authors: Hudetz Anthony G. , Mashour George A.
Published: June 2016

A quest for a systems-level neuroscientific basis of anesthetic-induced loss and return of consciousness has been in the forefront of research for the past 2 decades. Recent advances toward the discovery of underlying mechanisms have been achieved using experimental electrophysiology, multichannel electroencephalography, magnetoencephalography, and functional magnetic resonance imaging. By the careful dosing of various volatile and IV anesthetic agents to the level of behavioral unresponsiveness, both specific and common changes in functional and effective connectivity across large-scale brain networks have been discovered and interpreted in the context of how the synthesis of neural information might be affected during anesthesia. The results of most investigations to date converge toward the conclusion that a common neural correlate of anesthetic-induced unresponsiveness is a consistent depression or functional disconnection of lateral frontoparietal networks, which are thought to be critical for consciousness of the environment. A reduction in the repertoire of brain states may contribute to the anesthetic disruption of large-scale information integration leading to unconsciousness. In future investigations, a systematic delineation of connectivity changes with multiple anesthetics using the same experimental design, and the same analytical method will be desirable. The critical neural events that account for the transition between responsive and unresponsive states should be assessed at similar anesthetic doses just below and above the loss or return of responsiveness. There will also be a need to identify a robust, sensitive, and reliable measure of information transfer. Ultimately, finding a behavior-independent measure of subjective experience that can track covert cognition in unresponsive subjects and a delineation of causal factors versus correlated events will be essential to understand the neuronal basis of human consciousness and unconsciousness.
Low-Cost Simulation to Teach Anesthetists’ Non-Technical Skills in Rwanda
Authors: Skelton Teresa , Nshimyumuremyi Isaac , Mukwesi Christian , Whynot Sara , Zolpys Lauren , Livingston Patricia
Published: June 2016

BACKGROUND:

Safe anesthesia care is challenging in developing countries where there are shortages of personnel, drugs, equipment, and training. Anesthetists’ Non-technical Skills (ANTS)—task management, team working, situation awareness, and decision making—are difficult to practice well in this context. Cesarean delivery is the most common surgical procedure in sub-Saharan Africa. This pilot study investigates whether a low-cost simulation model, with good psychological fidelity, can be used effectively to teach ANTS during cesarean delivery in Rwanda.

METHODS:

Study participants were anesthesia providers working in a tertiary referral hospital in Rwanda. Baseline observations were conducted for 20 anesthesia providers during cesarean delivery using the established ANTS framework. After the first observation set was complete, participants were randomly assigned to either simulation intervention or control groups. The simulation intervention group underwent ANTS training using low-cost high psychological fidelity simulation with debriefing. No training was offered to the control group. Postintervention observations were then conducted in the same manner as the baseline observations.

RESULTS:

The primary outcome was the overall ANTS score (maximum, 16). The median (range) ANTS score of the simulation group was 13.5 (11–16). The ANTS score of the control group was 8 (8–9), with a statistically significant difference (P = .002). Simulation participants showed statistically significant improvement in subcategories and in the overall ANTS score compared with ANTS score before simulation exposure.

CONCLUSIONS:

Rwandan anesthesia providers show improvement in ANTS practice during cesarean delivery after 1 teaching session using a low-cost high psychological fidelity simulation model with debriefing.
Identifying Efficiently and Economically Operated Hospitals: The Prospects and Pitfalls of Applying Frontier Regression Techniques
Authors: Chirikos Thomas N.
Published: June 2016

This article examines whether policy makers can make immediate use of recently developed frontier regression techniques to identify efficient hospitals primarily for rate setting purposes. This new approach is applied to data on Florida hospitals for the period 1982–1993 to appraise how well it performs in gauging variations in hospital costs and efficiency. This appraisal suggests that frontier methods are quite promising, but that they may not yield sufficiently unambiguous results to serve the short-term needs of hospital regulators interested in scaling reimbursement rates to the efficiency with which hospitals deliver services. Other policy-relevant strengths and weaknesses of frontier techniques are also discussed.
A Blueprint for Linking Academic Oncology and the Community
Authors: Linggood Rita , Govern Frank , Coleman C. Norman
Published: June 2016

The processes by which academic medicine will train the next generation of physicians and develop new knowledge have brought to the forefront the relationship between academic medical centers and community hospitals and practitioners. Over the past thirteen years, the Harvard Medical School Joint Center for Radiation Therapy (JCRT) has developed an integrated radiation oncology program designed to serve simultaneously the needs of the community, teaching hospitals, medical schools, and faculty. The structure and function of this program are described here, as are the challenges posed by the highly competitive health care marketplace. We believe that long-term vision should guide short-term goals. The success of academic-community collaborative programs depends not only on the good will and vision of the participants but also on the medical administration, academic leadership, policy makers, and politicians who define the principles and rules by which cooperation within the health care industry occurs.
Easy-to-Read Consumer Communications: A Missing Link in Medicaid Managed Care
Authors: Root Jane , Stableford Sue
Published: June 2016

Effective consumer communication is key to successfully moving Medicaid recipients into managed care systems and realizing the promised cost savings from the upheaval. Yet, little attention has been paid to educating these consumers with easy-to-read materials. The Maine Area Health Education Center (AHEC) Health Literacy Center,1 with the support of the Center for Health Care Strategies, Inc., addressed the problem by offering three national skills training workshops called Writing for the Medicaid Market. The training was marketed to public and private organizations providing Medicaid managed care services, including state Medicaid officials, health benefit counselor staff (enrollment brokers), managed care plan (HMO) staff, and consumer advocates. The training addressed the core issue in health literacy: the mismatch between the low literacy skills of the target population and the high reading level of most health and managed care materials. Posttraining survey data revealed that training was successful in skill building, but also that it addressed only the tip of the iceberg. Faulty and/or nonexistent communication planning limits the success not only of Medicaid, but of other large health and social programs as well. The authors outline the broad scope of the national health literacy problem, share their posttraining survey data, discuss lessons extrapolated from both their data and their experience, and propose a national agenda to address a vast and generally ignored public problem.
Aurora A kinase regulates proper spindle positioning in C. elegans and in human cells
Authors: Kotak Sachin , Afshar Katayon , Busso Coralie , Gönczy Pierre
Published: June 2016

Accurate spindle positioning is essential for error-free cell division. The one-cell Caenorhabditis elegans embryo has proven instrumental for dissecting mechanisms governing spindle positioning. Despite important progress, how the cortical forces that act on astral microtubules to properly position the spindle are modulated is incompletely understood. Here, we report that the PP6 phosphatase PPH-6 and its associated subunit SAPS-1, which positively regulate pulling forces acting on spindle poles, associate with the Aurora A kinase AIR-1 in C. elegans embryos. We show that acute inactivation of AIR-1 during mitosis results in excess pulling forces on astral microtubules. Furthermore, we uncover that AIR-1 acts downstream of PPH-6–SAPS-1 in modulating spindle positioning, and that PPH-6–SAPS-1 negatively regulates AIR-1 localization at the cell cortex. Moreover, we show that Aurora A and the PP6 phosphatase subunit PPP6C are also necessary for spindle positioning in human cells. There, Aurora A is needed for the cortical localization of NuMA and dynein during mitosis. Overall, our work demonstrates that Aurora A kinases and PP6 phosphatases have an ancient function in modulating spindle positioning, thus contributing to faithful cell division.
Αντώνιος Μομφερράτος
Authors: ΦΙΛΑΔΕΛΦΕΥΣ Αλέξανδρος
Published: June 2016

no abstract
Ένα χειρόγραφο της «Γεωγραφίας Φυσικοπολιτικής» του Ψαλίδα
Authors: Κεχαγιόγλου Γιώργος
Published: June 2016

No abstract
Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system
Authors: Jobanputra Kiran , Greig Jane , Shankar Ganesh , Perakslis Eric , Kremer Ronald , Achar Jay , Gayton Ivan
Published: June 2016

By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. 85 record “pairs” for 32 patients with 26 data items (temperature and symptoms) per pair were analysed. The average agreement between sources was 85%, ranging from 69% to 95% for individual variables. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge differences in organisational culture between the technology and humanitarian worlds. This investment is essential for establishing a shared vision on deliverables, urgency, and ownership of product.
Some generalizations of the Eneström–Kakeya theorem
Authors: Nwaeze Eze R.
Published: June 2016

Let p(z) = a0 + a1z + a2z2 + ... + anzn be a polynomial of degree n; where the coefficients aj, j = 0, 1, 2, ..., n, are real numbers. We impose some restriction on the coefficients and then prove some extensions and generalizations of the Eneström–Kakeya theorem.
Nonhomogeneous linear differential polynomials generated by solutions of complex differential equations in the unit disc
Authors: Belaïdi Benharrat
Published: June 2016

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On the correlation structures of multivariate skew-normal distribution
Authors: Käärik Ene , Käärik Meelis , Maadik Inger-Helen
Published: June 2016

Skew-normal distribution is an extension of the normal distribution where the symmetry of the normal distribution is distorted with an extra parameter. A multivariate skew-normal distribution has been parametrized differently to stress different aspects and constructions behind the distribution. There are several possible parametrizations available to define the skew-normal distribution. The current most common parametrization is through Ω and α, as an alternative, parametrization through Ω and δ can be used if straightforward relation to marginal distributions is of interest. The main problem with {Ω, δ}-parametrization is that the vector δ cannot be chosen independently of Ω. This motivated us to investigate what are the possibilities of choosing δ under different correlation structures of Ω. We also show how the assumptions on structure of δ and Ω affect the asymmetry parameter α and correlation matrix R of corresponding skew-normal random variable.
Diametral strong diameter two property of Banach spaces is stable under direct sums with 1-norm
Authors: Haller Rainis , Pirk Katriin , Põldvere Märt
Published: June 2016

We prove that the diametral strong diameter 2 property of a Banach space (meaning that, in convex combinations of relatively weakly open subsets of its unit ball, every point has an "almost diametral" point) is stable under 1-sums, i.e., the direct sum of two spaces with the diametral strong diameter 2 property equipped with the 1-norm has again this property.
Comparative analysis of the elements of attack and defence in men’s and women’s games in the Estonian volleyball highest league
Authors: Stamm Raini , Stamm Meelis , Torilo Doris , Thomson Kaivo , Jairus Alexander
Published: June 2016

The aim of this study was to analyse the differences between men’s and women’s teams of the Estonian highest league in attack, serve, block, defence and serve reception. The sample consisted of 5 men’s and 5 women’s teams of the Estonian volleyball highest league in the 2014/2015 season. To collect data, two game videos of each team were watched; from them tempo of attack, type of attack, block and serve, and the results of defence and cover were registered. In addition, statistics created by the Data Volley and Volleysoft 6–3 programs on the basis of expert assessments were used to estimate the efficiency of volleyball elements and results of reception. SPSS Statistics 23 version for Windows was used to construct frequency tables and multinomial logistic regression analysis was applied to find the probable frequencies of the activities analysed. The results revealed that in Estonian men’s highest league games quick tempo 1 attacks were used statistically significantly more often than in women’s games. Men were more proficient at attack and used a vigorous spike more often than women. For both genders, double block was the most often used block type. Broken double block was more common to men than to women. The serve type most often used by men was the power jump serve, followed by the tactical float serve. Women most often used the standing serve and, as second, the jump float serve. Men made more serve errors than women did. The percentage of ace serves was also higher in women than in men.In defence, the percentage of the ball remaining in play was higher in women than in men, and women’s defence cover was more efficient than men’s. As a result of attack cover, the ball remained in play nearly by half more frequently in women’s than in men’s games. Nonetheless, women scored fewer points as a result of attack cover. Serve reception in the Estonian highest league was better in men, and men made statistically significantly fewer errors in reception than women did.
The Use of A Formative Assessment In Progressive Leader Development
Authors: Martin Ira H. , Goulet Laurel , Martin JennyMae K. , Owens Jake
Published: June 2016

As institutions continue to place value on developing leaders, it becomes increasingly important to effectively assess students’ leadership skills. The development and subsequent use of a formative competency based leader assessment was used with (N=124) sophomore students at a small military college in the Northeast United States with a mission toward leadership. Results highlight the effectiveness of a formative assessment to develop leader skills with an undergraduate population. Relevant application for institutions of higher learning will be discussed
Leadership Education for the Volatile, Uncertain, Complex, and Ambiguous Now: A Challenge to the Field
Authors: Carvan Moreen Travis
Published: June 2016

Edgar Schein (2004) proposed that leading was in the midst of an evolutionary shift in which the primary challenge would be to sustain a culture of learning in an emerging “age of perpetual learning and change. What learning is required through leadership education to address this challenge? What design will assure that these learning outcomes are attained? What practice would demonstrate that the outcomes persist and have meaning? In distinguishing the process of “education” from the process of “learning”, what are the implications of the reciprocity of development, learning, education and the practice of leading for the design of a theory of leadership education able to assure necessary outcomes for leadership in a context that is perpetually volatile, uncertain, complex, and ambiguous?
How Does Learning in Leadership Work? A Conceptual Change Perspective
Authors: Grimes Matthew W.
Published: June 2016

As the field of leadership education continues to prioritize learning in leadership, it is important to ask the question: What do we know about the learning process itself? Conceptual change, a learning framework used in educational psychology, can help to explain learning in leadership. Research on conceptual change in the social sciences is emergent and ripe for further exploration. Until the results of such research are readily available, there are some pedagogical tools produced by conceptual change researchers that leadership educators might find valuable in curriculum design. This paper introduces conceptual change theory and research to leadership educators as a viable framework from which to research learning in leadership, and presents pedagogical tools that encourage deeper learning through conceptual change
Unraveling the Leadership Dichotomy in the Classroom and Beyond
Authors: Omilion-Hodges Leah M. , Wieland Stacey M. B.
Published: June 2016

As teachers of leadership, we have noticed that our students often get “stuck” thinking about leadership in overly simplistic ways that dichotomize task and relationship-orientations, often resulting in overly simplistic understandings of leadership processes. In this reflective essay, we draw upon two approaches to leadership theory—leadership psychology and discursive leadership—to consider why the leadership dichotomy occurs and provide ideas for how leadership instructors might restructure and refocus their courses to help students transcend it to develop more reflexive, contextualized understandings of leadership. We suggest four ideas for innovating leadership pedagogy: 1) rethink the typical chronological organization, 2) challenge students to identify leadership myths, 3) engage students in applied leadership contexts, and 4) emphasize leadership as a communicative practice.