bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonlinear dynamic probabilistic design of turbine disk-radial deformation using extremum response surface method-based support vector machine of regression
Authors: Fei Cheng-Wei , Tang Wen-Zhong , Bai Guang-Chen
Published: April 2014

In order to improve the computational efficiency of nonlinear dynamic probabilistic design for aeroengine typical components, a probabilistic design method–extremum response surface method-based support vector machine of regression was proposed. By taking support vector machine of regression as an extremum response surface function, the mathematical model of surface method-based support vector machine of regression was established. The probabilistic design of turbine disk-radial deformation was accomplished based on the surface method-based support vector machine of regression fully considering the influences of the nonlinearity of material property and the dynamic of heat load and mechanical load. The analysis results show that the probabilistic distribution and inverse probabilistic features of input–output parameters and the major factors (rotor speed and gas temperature) are gained legitimately, which provide the useful reference for disk design and blade-tip clearance control more effective of high-pressure turbine). Through the comparison of methods, surface method-based support vector machine of regression is demonstrated to hold high efficiency and high precision in nonlinear dynamic probabilistic design of aeroengine typical components. Moreover, the proposed surface method-based support vector machine of regression is promising to provide a useful insight for disk dynamic optimal design and blade-tip clearance control of aeroengine high-pressure turbine.
Multidimensional poverty measurement in Europe: An application of the adjusted headcount approach
Authors: Whelan Christopher T , Nolan Brian , Maître Bertrand
Published: April 2014

As awareness of the limitations of relying solely on income to measure poverty has become more widespread, attention has been increasingly focused on multi-dimensional approaches, to the point where the European Union (EU) has adopted a multidimensional poverty and social exclusion target for 2020. The rationale advanced is that the computation of a multidimensional poverty index is an effective way of communicating in a political environment, and a necessary tool in order to monitor 27 different national situations. In contrast with the rather ad hoc way in which the EU 2020 poverty target has been framed and rationalized, the adjusted head count ratio applied here has a number of desirable axiomatic properties. It constitutes a significant improvement on union and intersection approaches and allows for the decomposition of multidimensional poverty in terms of dimensions of deprivation and socio-economic attributes. Since understanding poverty as multidimensional does not necessarily require constructing a multidimensional poverty index, on the basis of our analysis we provide a more general consideration of the value of developing a multidimensional index of poverty for the EU.
Market managers and market moderators: Early childhood education and care provision, finance and regulation in the United Kingdom and United States
Authors: McLean Caitlin
Published: April 2014

Market-based approaches to service provision are heterogeneous. The point is often lost in comparative welfare state research due to the dominance of the welfare regime approach, which emphasizes the prevailing locus of provision (state, market or family) over other dimensions of a mixed economy: finance and regulation. Comparing the cases of the British and American approaches to early childhood education and care, this paper argues that these broadly similar ‘liberal’ welfare regimes exhibit qualitatively different approaches to market-based service provision – market manager (UK) versus market moderator (US) – through the state’s role as financier and regulator. Evidence is drawn from a variety of primary and secondary sources, including prior academic studies, national policy documents, and national and international statistics.
Welfare regime, welfare pillar and southern Europe
Authors: Minas Christos , Jacobson David , Antoniou Efi , McMullan Caroline
Published: April 2014

This paper uses a variety of methods of statistical cluster analysis to examine how EU countries (other than the new East European members) are grouped. Using the four dimensions, family, market vs state, religion and clientelism, the results of the analysis are that Southern European/Mediterranean (SE/M) countries form a distinct cluster that, both in its existence and in its difference from the conservative cluster, contradicts the notion of ‘three worlds of welfare capitalism’. In addition Ireland, though not geographically contiguous, falls into the SE/M grouping.
Worlds of welfare in time: A historical reassessment of the three-world typology
Authors: Danforth Benjamin
Published: April 2014

Gøsta Esping-Andersen’s ‘three worlds’ typology has become one of the principal heuristics for examining modern welfare states. Despite its widespread adoption, however, few efforts have been made to assess the typology’s validity across time. To gauge its historical relevance, this study examines welfare state data for each 5-year interval from 1950 to 2000 for evidence of tripartite clustering. Using two forms of cluster analysis – an agglomerative hierarchical approach and a model-based approach – on each of these cross-sections, this study finds that Esping-Andersen’s typological framework is largely incapable of identifying a lasting and meaningful three-world arrangement. To detect such a configuration, this study shows that the framework must be extended to include new dimensions relating to social services, gender, poverty, and activation. When this extended framework is employed, this study identifies three worlds of welfare that first began emerging by 1975, became salient by 1980, and had firmed by 1985.
Silibinin modulates caudal-type homeobox transcription factor (CDX2), an intestine specific tumor suppressor to abrogate colon cancer in experimental rats
Authors: Sangeetha N , Nalini N
Published: April 2014

To authenticate the colon cancer preventive potential of silibinin, the efficacy of silibinin needs to be tested by evaluating an organ-specific biomarker. The aim of this study was to evaluate the impact of silibinin on the colonic expression of the caudal-type homeobox transcription factor (CDX2) an intestine specific tumor suppressor gene and its downstream targets in the colon of rats challenged with 1,2 dimethyl hydrazine (DMH). Rats of groups 1 and 2 were treated as control and silibinin control. Rats under groups 3 and 4 were given DMH (20 mg/kg body weight (b.w.) subcutaneously) once a week for 15 consecutive weeks from the 4th week of the experimental period. In addition, group 4 rats alone were treated with silibinin (50 mg/kg b.w. per os) everyday throughout the study period of 32 weeks. Histological investigation and messenger RNA and protein expression studies were performed in the colonic tissues of experimental rats. Findings of the study revealed that DMH administration significantly decreased the expression of CDX2 and Guanylyl cyclase C ( GCC) in the colon of experimental rats. Further the decreased levels of CDX2 protein, colonic mucin content, and increased number of mast cells in the colon of DMH alone-administered rats reflects the onset of carcinogenesis. The pathological changes caused due to CDX2 suppression were attenuated by silibinin supplementation.
Multivariate tests based on interpoint distances with application to magnetic resonance imaging
Authors: Marozzi Marco
Published: April 2014

The multivariate location problem is addressed. The most familiar method to address the problem is the Hotelling test. When the hypothesis of normal distributions holds, the Hotelling test is optimal. Unfortunately, in practice the distributions underlying the samples are generally unknown and without assuming normality the finite sample unbiasedness of the Hotelling test is not guaranteed. Moreover, high-dimensional data are increasingly encountered when analyzing medical and biological problems, and in these situations the Hotelling test performs poorly or cannot be computed. A test that is unbiased for non-normal data, for small sample sizes as well as for two-sided alternatives and that can be computed for high-dimensional data has been recently proposed and is based on the ranks of the interpoint Euclidean distances between observations. Five modifications of this test are proposed and compared to the original test and the Hotelling test. Unbiasedness and consistency of the tests are proven and the problem of power computation is addressed. It is shown that two of the modified interpoint distance-based tests are always more powerful than the original test. Particularly, the modified test based on the Tippett criterium is suggested when the assumption of normality is not tenable and/or in case of high-dimensional data with complex dependence structure which are typical in molecular biology and medical imaging. A practical application to a case-control study where functional magnetic resonance imaging is used is discussed.
Assessing the inter-rater agreement for ordinal data through weighted indexes
Authors: Marasini Donata , Quatto Piero , Ripamonti Enrico
Published: April 2014

Assessing the inter-rater agreement between observers, in the case of ordinal variables, is an important issue in both the statistical theory and biomedical applications. Typically, this problem has been dealt with the use of Cohen’s weighted kappa, which is a modification of the original kappa statistic, proposed for nominal variables in the case of two observers. Fleiss (1971) put forth a generalization of kappa in the case of multiple observers, but both Cohen’s and Fleiss’ kappa could have a paradoxical behavior, which may lead to a difficult interpretation of their magnitude. In this paper, a modification of Fleiss’ kappa, not affected by paradoxes, is proposed, and subsequently generalized to the case of ordinal variables. Monte Carlo simulations are used both to testing statistical hypotheses and to calculating percentile and bootstrap-t confidence intervals based on this statistic. The normal asymptotic distribution of the proposed statistic is demonstrated. Our results are applied to the classical Holmquist et al.’s (1967) dataset on the classification, by multiple observers, of carcinoma in situ of the uterine cervix. Finally, we generalize the use of s* to a bivariate case.
Bayesian latent structure modeling of walking behavior in a physical activity intervention
Authors: Lawson Andrew B , Ellerbe Caitlyn , Carroll Rachel , Alia Kassandra , Coulon Sandra , Wilson Dawn K , VanHorn M Lee , George Sara M St.
Published: April 2014

The analysis of walking behavior in a physical activity intervention is considered. A Bayesian latent structure modeling approach is proposed whereby the ability and willingness of participants is modeled via latent effects. The dropout process is jointly modeled via a linked survival model. Computational issues are addressed via posterior sampling and a simulated evaluation of the longitudinal model’s ability to recover latent structure and predictor effects is considered. We evaluate the effect of a variety of socio-psychological and spatial neighborhood predictors on the propensity to walk and the estimation of latent ability and willingness in the full study.
Retinal microvascular damage and vasogenic edema produced by Clostridium perfringens type D epsilon toxin in rats
Authors: Finnie John W. , Manavis Jim , Casson Robert J. , Chidlow Glyn
Published: April 2014

When the brain is exposed to large circulating levels of Clostridium perfringens type D epsilon toxin (EXT), microvascular damage with resulting severe, generalized, vasogenic edema seems to be principally responsible for the ensuing acute, and frequently fatal, neurologic disorder. However, although the blood–retinal barrier resembles in many respects the blood–brain barrier, retinal changes in livestock with acute epsilon intoxication have not, to the authors’ knowledge, been previously reported. In rats given an acute dose of ETX, retinal microvascular endothelial injury led to widespread vasogenic edema as assessed immunohistochemically by marked plasma albumin extravasation. As laboratory rodents are a good model of the domestic livestock disease produced by ETX, it is probable that the latter sustain some visual deficit when exposed to large doses of this potent neurotoxin.
The Influences of Teacher Delivery and Student Progress on Experienced Teachers’ Perceptions of Teaching Effectiveness
Authors: MacLeod Rebecca B. , Nápoles Jessica
Published: April 2014

The purpose of this replication and extension study was to examine how teacher delivery and student progress influenced experienced teachers’ perceptions of overall teaching effectiveness. Participants ( N = 60 experienced music teachers) viewed 12 private lesson excerpts that included four separate conditions: (a) high teacher delivery and more student progress, (b) high teacher delivery and less student progress, (c) low teacher delivery and more student progress, and (d) low teacher delivery and less student progress. Participants rated teacher delivery, student progress, student musicianship, teacher knowledge of subject matter, and overall teaching effectiveness for each private lesson excerpt. Teaching excerpts with high teacher delivery were rated as more effective than excerpts with low teacher delivery, irrespective of student progress. Results of a multiple regression indicated that teacher delivery was the largest predictor for experienced teachers’ ratings of overall teaching effectiveness, followed closely by student progress.
Sirolimus Immunoprophylaxis and Renal Histological Changes in Long-Term Cardiac Transplant Recipients
Authors: White Michel , Boucher Anne , Dandavino Raymond , Fortier Annik , Pelletier Guy B. , Racine Normand , Ducharme Anique , de Denus Simon , Carrier Michel , Collette Suzon
Published: April 2014

Background: The effects of sirolimus (SIR), as a substitution for calcineurin inhibitor (CNI) immunoprophylaxis, on renal function in very-long-term cardiac transplant recipients have been a matter of controversy. Objective: To assess the impacts of SIR as a substitution for CNI on renal function up to 24 months in long-term cardiac recipients as well as the renal histological changes in patients with suspected CNI-induced nephrotoxicity. Methods: A total of 23 cardiac transplant recipients aged 57.7 ± 11.2 years, 91 months post–cardiac transplantation were recruited; 15 patients were randomized to CNI-free immune suppression with SIR, and 8 patients were allocated to continue their CNI regimens. Serum creatinine and calculated serum creatinine clearance were measured at prespecified time points up to 24 months. Renal structure and function were assessed by renal biopsies, renal ultrasound, and magnetic resonance imaging at baseline. Results: There were no significant changes in creatinine clearance during the course of the study in patients treated with SIR. However, SIR-treated patients exhibited a significant decrease in 24-hours and nighttime systolic and diastolic blood pressures. Typical findings of significant hypertensive renal disease were detected in 9 of the 11 (82%) patients. Features of chronic CNI toxicity were detected in 6 (55%) patients. Conclusions: There is a very high rate of hypertensive renal disease concomitantly with some degree of CNI toxicity in long-term cardiac transplant recipients with renal dysfunction. This very high rate of hypertension-related disease may limit the impact of SIR on improving renal function long term following cardiac transplantation.
Colesevelam, Ezetimibe, and Patients With Type 2 Diabetes Mellitus
Authors: Swindle Jason P. , Ye Xin , Mallick Rajiv , Song Rui , Horstman Thomas , Bays Harold E.
Published: April 2014

Background:Despite the prevalence of therapies available to patients at highest coronary heart disease risk, only a minority of type 2 diabetes mellitus (T2DM) patients reach desired cholesterol treatment levels, with limited data regarding their outcomes. Objective: To examine “real-world” effectiveness of initiating treatment with either colesevelam or ezetimibe among individuals with evidence of T2DM and hypercholesterolemia (HCh). Key outcomes included treatment patterns and cardiovascular (CV) events. Methods: This retrospective administrative claims-based study utilized medical, pharmacy, and enrollment data linked to laboratory results information from a large United States health plan (January 1, 2006, to March 31, 2011) and included individuals with recorded evidence of T2DM and HCh. The index date was the date of first pharmacy claim for colesevelam or ezetimibe, with cohort assignment based on index medication. Assessments included baseline characteristics, follow-up treatment patterns, and composite CV event, with propensity score matching to correct for sample selection bias. Results: In total, 4231 individuals were identified with evidence of HCh and T2DM (ezetimibe n = 3384; colesevelam n = 847). After matching, the baseline characteristics between cohorts were rendered to be similar. Mean days of persistent medication use was lower with colesevelam compared with ezetimibe ( P < 0.001). Compared with ezetimibe, a smaller percentage of individuals in the colesevelam cohort experienced a follow-up composite CV event, and adjusted Cox model results suggested decreased risk (hazard ratio = 0.58; P = 0.004) of a follow-up composite CV event. Conclusion: In this health care database analysis among patients with HCh and T2DM, colesevelam was associated with decreased risk of a composite CV event compared with ezetimibe, despite lower persistence.
Outcomes of an Agency-Developed Treatment Foster Care Model for Adolescents
Authors: Bishop-Fitzpatrick Lauren , Jung Nahri , Nam Ilsung , Trunzo Annette C. , Rauktis Mary Elizabeth
Published: April 2014

Adolescents constitute a large proportion of youth in foster care, but few foster care models specifically concentrate on their developmental or treatment needs. This study examined outcomes for an agency-developed, theoretically based treatment foster care (TFC) model using de-identified administrative data from 612 youth discharged from care over a 3-year period using a structural equation modeling path analysis. Results indicate that youth enrolled in Pressley Ridge Treatment Foster Care (PR-TFC) improve in functioning from entry to discharge and that, overall, youth in PR-TFC treatment typically improve in day-to-day functioning as they age, and youth who enter the PR-TFC homes at an older age generally function better at discharge than younger youth who stayed comparable amounts of time. Additional results indicate that older youth, youth with a greater number of clinical diagnoses, youth with a lower pre-test Child and Adolescent Functional Assessment Scale (CAFAS) score, and youth of color spent more time in care, while older youth, youth with fewer clinical diagnoses, youth with lower pre-test CAFAS scores, and European American youth had lower post-test CAFAS scores, indicating better functioning at discharge. This article also provides an example of how administrative data can be used to develop practice-based evidence for a treatment model.
Proximity, Candidates, and Presidential Power
Authors: Elgie Robert , Bucur Cristina , Dolez Bernard , Laurent Annie
Published: April 2014

We examine the impact of direct presidential elections on legislative party systems. We argue that presidential power (PRESPOW) shapes the effective number of presidential candidates in a way that has a reductive effect on the legislative party system within an intermediary range of PRESPOW. We also argue that this proposition should be tested solely on the population of countries with direct presidential elections. We find that the effect of presidential coattails is less important than has typically been suggested and that we need to think carefully about how to capture variation in PRESPOW when trying to estimate its effect.
The combination of weekly trastuzumab plus vinorelbine may be preferable regimen in HER-2 positive breast cancer patients with brain metastasis
Authors: Mutlu Hasan , Büyükçelik Abdullah
Published: April 2014

Brain metastasis is one of the most important life-threatening conditions in patients with metastatic HER-2 positive breast cancer. A lot of conventional chemotherapeutic and antibody-based regimens used routinely in treatment of the patients with breast cancer are not effective due to blood–brain barrier. In our cases, we reported on three HER-2 positive breast cancer patients with brain metastasis who were offered a combination of weekly trastuzumab plus vinorelbine after brain metastasis. In our cases, the progression-free survival were 12, 16 and 9 months for Case 1, Case 2 and Case 3, respectively. In Case 1, there was no progression in the brain. In Case 3, we did not detect any progress but the patient died due to cerebrovascular embolic events. After local treatment, the combination of weekly trastuzumab plus vinorelbine may be an effective alternative regimen in HER-2 positive breast cancer patients with brain metastases.
The Activity Profile of Home Nurses
Authors: De Vliegher Kristel , Declercq Anja , Aertgeerts Bert , Gosset Christiane , Heyden Isabelle , Moons Philip
Published: April 2014

The role of home nurses as providers of health care has changed and will continue to change. To guide appropriate decision making and future policy planning, it is important to have a clear picture of the activity profile of home nurses. A systematic literature review was conducted in the databases Cinahl, Cochrane, Embase, and Medline for the literature published between January 1990 and November 2013. Nine reports were identified: six quantitative studies and three literature reviews. Home nurses provide multidimensional care. However, a glaring omission in these reports was a consideration of the physiological aspects of home care. This is probably due to the questionable validity of existing nursing intervention classification schemes and the lack of scientific evidence on technical and complex interventions in home nursing care.
Home Care Program Reduces Hospital Readmissions in Patients With Congestive Heart Failure and Improves Other Associated Indicators of Health
Authors: Maliakkal Anto V. , Sun Amy Z.
Published: April 2014

The objective of this study is to analyze the impact of home care services on patients with congestive heart failure. After receiving home care services, the mean hospitalization rate for patients decreased as did symptoms such as paroxysmal nocturnal dyspnea, orthopnea, dyspnea upon exertion, and pedal edema. Home care resulted in a statistically significant increase in adherence for recommended medication regimen and diet/fluid restrictions and a significant improvement in functional capacity class. The data seem to suggest that a proper home care service can reduce the number of hospitalizations and increase the overall quality of life for patients with congestive heart failure. This will simultaneously reduce the ever-increasing health expenditures and appears to be a preferable cost-effective route to care for these patients.
Home Health Care Nurses’ Perceptions of Heart Failure Home Health Care
Authors: Saunders Mitzi M.
Published: April 2014

High-quality nursing care in the home setting is one approach to improving outcomes in patients with heart failure (HF). This study describes home health care nursing care of patients with HF from the perspectives of home health care nurses (HHNs). Using an emergent, qualitative design, 14 HHNs were interviewed and six major themes emerged: (1) HF care is unique, (2) HF patients’ needs exceed imposed limitations, (3) listening to HF patients is key, (4) HF education is critical, (5) eyes and ears of physicians, and (6) high reward/high commitment. Overall, HHNs felt that patients with HF have nursing care needs that exceed imposed limitations on HHN services. HHNs need time to educate patients and family caregivers about HF.
Consumer Processing of Interior Service Environments
Authors: Orth Ulrich R. , Wirtz Jochen
Published: April 2014

Visual appeal is an important consideration in the design of interior service environments because attractiveness influences consumer behavior. Employing both an experiment and a field study, we show that visual complexity reduces a service environment’s attractiveness. Furthermore, we find that the complexity-attractiveness relationship is mediated by processing fluency and its instantaneous affective companion, pleasure. Our findings provide novel insights into the underlying process mechanism involved in channeling the effect of visual complexity on attractiveness. Furthermore, both studies confirm that customers’ field dependence moderates the complexity-fluency relationship and that shopping motivation (i.e., hedonic vs. utilitarian shopping goals) moderates the fluency-pleasure relationship. Our findings suggest that it is generally better to reduce the complexity of interior service environments. To achieve this, service firms should reduce the number of objects in the environment, enhance the visual organization and symmetry of their arrangement, and use fewer colors, textures, and materials.
Exome sequencing in single cells from the cerebrospinal fluid in multiple sclerosis
Authors: Kemppinen AK , Baker A , Liao W , Fiddes B , Jones J , Compston A , Ban M , Sawcer S
Published: April 2014

Background:

Genome-wide association studies (GWAS) have identified over 100 germline variants that influence susceptibility to multiple sclerosis, most of which map within or near to genes with immunological function. However, the role of somatic mutations in multiple sclerosis has not been investigated.

Objective:

The objective of this paper is to explore the role that somatic mutations might play in the development of multiple sclerosis.

Methods:

We exome-sequenced in total 21 individual CD4+ lymphocytes isolated from cerebrospinal fluid of two patients. In addition we sequenced DNA from the patients’ peripheral blood to serve as germline reference.

Results:

In comparison with the respective germline sequence, each cell differed at an average of 1784 positions, but as anticipated subsequent analysis confirms that most, if not all, of these potential mutations are likely to represent artefacts generated during the amplification of a single genome and/or by sequencing. Fifty-six of the potential mutations were predicted to have likely functional effects on genes that have previously been implicated by GWAS, including three in the CD6 gene.

Conclusion:

More robust methods applied to larger numbers of cells will be needed to define the role of somatic mutations.
Responder definition of the Multiple Sclerosis Impact Scale physical impact subscale for patients with physical worsening
Authors: Phillips Glenn A , Wyrwich Kathleen W , Guo Shien , Medori Rossella , Altincatal Arman , Wagner Linda , Elkins Jacob
Published: April 2014

Background:

The 29-item Multiple Sclerosis Impact Scale (MSIS-29) was developed to examine the impact of multiple sclerosis (MS) on physical and psychological functioning from a patient’s perspective.

Objective:

To determine the responder definition (RD) of the MSIS-29 physical impact subscale (PHYS) in a group of patients with relapsing–remitting MS (RRMS) participating in a clinical trial.

Methods:

Data from the SELECT trial comparing daclizumab high-yield process with placebo in patients with RRMS were used. Physical function was evaluated in SELECT using three patient-reported outcomes measures and the Expanded Disability Status Scale (EDSS). Anchor- and distribution-based methods were used to identify an RD for the MSIS-29.

Results:

Results across the anchor-based approach suggested MSIS-29 PHYS RD values of 6.91 (mean), 7.14 (median) and 7.50 (mode). Distribution-based RD estimates ranged from 6.24 to 10.40. An RD of 7.50 was selected as the most appropriate threshold for physical worsening based on corresponding changes in the EDSS (primary anchor of interest).

Conclusion:

These findings indicate that a ≥7.50 point worsening on the MSIS-29 PHYS is a reasonable and practical threshold for identifying patients with RRMS who have experienced a clinically significant change in the physical impact of MS.
Indicated pressure-based data-driven diesel engine NOx modeling
Authors: Benatzky Christian , Stadlbauer Stephan , Formentin Simone , Schilling Alexander , Alberer Daniel
Published: April 2014

This article addresses the design and evaluation of virtual NO x sensors for heavy-duty off-road diesel engines based on static polynomial black box modeling. Three approaches, differing in the chosen sets of regressors, are analyzed regarding their NO x prediction capability. As regressor sets only quantities available on standard production-type electronic control units, features extracted from the in-cylinder pressure trace via singular value decomposition extended by the engine speed as well as geometric values from the pressure trace and heat release curves are utilized, respectively. It is shown that while each of the approaches alone has its drawbacks, a systematic combination, especially of the first two methods, results in high-accuracy NO x models while at the same time keeping the number of regressors low.
International students and their experiences of Personal Development Planning
Authors: Baker Kate L , Perkins Joy , Comber Darren PM
Published: April 2014

Taught postgraduate students are a unique group, undergoing a short, intensive period of study. Many taught postgraduate students are international, engaging for the first time with new learning approaches, including Personal Development Planning (PDP). This article provides analysis of the views of international taught postgraduates about the place and value of PDP within the academic curriculum, an area that has received scant attention in the research literature on PDP. A total of 41 students from 17 countries studying at five universities were interviewed. Responses revealed that these students were able to identify their development needs and the perceived employability benefits of engaging with PDP as part of, and beyond, their Master’s programme. There were strong indications that international taught postgraduates do not need to be convinced of the value of PDP, a point not frequently associated with PDP engagement at undergraduate level. We conclude that international taught postgraduates recognise the value of PDP, and that PDP is more likely to appeal to international taught postgraduates’ own agendas if it is underpinned by a strong employability focus. In particular, PDP resources developed specifically to meet the needs of international taught postgraduates and integrated into the curriculum appear essential.
Why students consider terminating their studies and what convinces them to stay
Authors: Xuereb Sharon
Published: April 2014

A substantial proportion of students doubt whether they should continue their studies, and are consequently more likely to withdraw. In the study described in this article, undergraduates who reported they doubted gave their reasons why they did, outlined support they received and stated why they ultimately decided to continue with their studies. A total of 176 psychology undergraduates answered open-ended questions in a questionnaire. Findings for traditional and non-traditional students were compared. The most common reasons for doubting were an academic workload perceived as too high and course-related problems. Friends and family were the most commonly cited sources of support. Students’ main reasons for continuing with their studies were to achieve their end goal and to finish what they had started. These findings are discussed in light of what universities can do to prevent and manage doubting.
Stepping Up to the Challenge
Authors: Bergman Jacqueline J. , Briggs Marilyn M. , Beall Deborah L. , Curwood Sandy , Gray Pilar , Soiseth Scott , Taylor Rodney K. , Zidenberg-Cherr Sheri
Published: April 2014

A statewide professional development program was developed and implemented throughout California for school nutrition directors with the goal of creating healthy school environments and regional networks for collaboration and healthy school environment sustainability. Needs of school nutrition directors were identified through a needs assessment questionnaire. Results of the needs assessment questionnaire ( n = 256) identified (a) planning cost-effective menus; (b) reducing calories, sodium, saturated fat, and trans fat in menus; and (c) using U.S. Department of Agriculture foods cost-effectively as the most useful topics. Highest rated topics informed the content of the professional development program. A post–professional development questionnaire identified key “insights, inspirations, and strategies” as (a) marketing of school foods program, (b) expansion of salad bars, and (c) collaboration with community partners. A 6-month follow-up questionnaire identified that 86% of participants made progress toward implementing at least one of their five insights, inspirations, and strategies in their school districts. Most common areas that were implemented were marketing and branding (32%), revamping salad bars (18%), and motivating staff (16%). School and Community Actions for Nutrition survey analysis showed a significant increase in the use of marketing methods in school nutrition programs from baseline to 6-month post–program implementation ( p = .024).
A strategy for integrating essential three-dimensional microphysiological systems of human organs for realistic anticancer drug screening
Authors: Heylman Christopher , Sobrino Agua , Shirure Venktesh S , Hughes Christopher CW , George Steven C
Published: April 2014

Cancer is one of the leading causes of morbidity and mortality around the world. Despite some success, traditional anticancer drugs developed to reduce tumor growth face important limitations primarily due to undesirable bone marrow and cardiovascular toxicity. Many drugs fail in clinical development after showing promise in preclinical trials, suggesting that the available in vitro and animal models are poor predictors of drug efficacy and toxicity in humans. Thus, novel models that more accurately mimic the biology of human organs are necessary for high-throughput drug screening. Three-dimensional (3D) microphysiological systems can utilize induced pluripotent stem cell technology, tissue engineering, and microfabrication techniques to develop tissue models of human tumors, cardiac muscle, and bone marrow on the order of 1 mm3 in size. A functional network of human capillaries and microvessels to overcome diffusion limitations in nutrient delivery and waste removal can also nourish the 3D microphysiological tissues. Importantly, the 3D microphysiological tissues are grown on optically clear platforms that offer non-invasive and non-destructive image acquisition with subcellular resolution in real time. Such systems offer a new paradigm for high-throughput drug screening and will significantly improve the efficiency of identifying new drugs for cancer treatment that minimize cardiac and bone marrow toxicity.
More Alike Than Different
Authors: Mencl Jennifer , Lester Scott W.
Published: April 2014

The purpose of this study was to extend generations research by investigating similarities and differences regarding the importance generations place on the presence of various workplace characteristics. We hypothesized (1) that similarities in the importance of workplace factors between generations would be more prevalent than differences and (2) that the importance of the workplace factors would have consistently similar or different moderating effects among generations on the relationships between employee perceptions of the factors at their organizations and employee attitudes. As expected, results showed the generations were similar on 7 of the 10 work values examined. Findings also revealed similarities and differences between the generations for the factors as moderators, although more differences than similarities were present from these analyses. Implications of these findings as well as directions for future research are discussed.
Promotion of Long-Term Adherence to a Healthy Lifestyle
Authors: Johnston Craig A. , Moreno Jennette P.
Published: April 2014

The prevalence of chronic diseases including dyslipidemia has increased as the prevalence of healthy lifestyles has decreased. Intensive interventions targeting lifestyle management of chronic diseases have proven effective in producing meaningful outcomes in research settings. However, it is not clear whether the comprehensive and intensive components of these interventions could be translated into real-world clinical and community settings. There are certain barriers that health care providers should consider when counseling patients.
Defining the Role of the Academic Neurohospitalist in Residency Education
Authors: Velez-Ruiz Naymee , Khan Jaffar , Greene James G.
Published: April 2014

Objective:

We sought to better understand the potential impact of the burgeoning neurohospitalist model of inpatient care on education of neurology residents and to better define possible roles for “neurohospitalists” in residency education.

Method:

We designed a brief qualitative open-ended survey directed toward academic leaders in neurology and distributed it by e-mail to every academic neurology department in the United States and Canada.

Results:

Of 83 respondents, 36 (43%) had an active neurohospitalist program and only 10% felt certain they would not have 1 within the next 5 years. All respondents expected to have residents continue to be involved with inpatient care. The main perceived advantage for resident education associated with neurohospitalists was inpatient care expertise, and the main expected disadvantage was decreased exposure to subspecialty attendings. The majority anticipated positive impact on all Accreditation Council for Graduate Medical Education core competencies predominantly based on neurohospitalists’ expertise in the inpatient setting.

Conclusion:

The majority of academic neurology departments are expected to have a neurohospitalist program within the next 5 years. There are several perceived advantages and disadvantages to such a program for education of neurology residents. In general, the impact of these programs is expected to improve resident education. Regardless of expectations, neurohospitalists will likely play a prominent role in the education of the next generation of neurologists.
Prediction scores or gastroenterologists’ Gut Feeling for triaging patients that present with acute upper gastrointestinal bleeding
Authors: de Groot NL , van Oijen MGH , Kessels K , Hemmink M , Weusten BLAM , Timmer R , Hazen WL , van Lelyveld N , Vermeijden JR , Curvers WL , Baak LC , Verburg R , Bosman JH , de Wijkerslooth LRH , de Rooij J , Venneman NG , Pennings M , van Hee K , Scheffer RCH , van Eijk RL , Meiland R , Siersema PD , Bredenoord AJ
Published: April 2014

Introduction

Several prediction scores for triaging patients with upper gastrointestinal (GI) bleeding have been developed, yet these scores have never been compared to the current gold standard, which is the clinical evaluation by a gastroenterologist. The aim of this study was to assess the added value of prediction scores to gastroenterologists’ Gut Feeling in patients with a suspected upper GI bleeding.

Methods

We prospectively evaluated Gut Feeling of senior gastroenterologists and asked them to estimate: (1) the risk that a clinical intervention is needed; (2) the risk of rebleeding; and (3) the risk of mortality in patients presenting with suspected upper GI bleeding, subdivided into low, medium, or high risk. The predictive value of the gastroenterologists’ Gut Feeling was compared to the Blatchford and Rockall scores for various outcomes.

Results

We included 974 patients, of which 667 patients (68.8%) underwent a clinical intervention. During the 30‐day follow up, 140 patients (14.4%) developed recurrent bleeding and 44 patients (4.5%) died. Gut Feeling was independently associated with all studied outcomes, except for the predicted mortality after endoscopy. Predictive power, based on the AUC of the Blatchford and Rockall prediction scores, was higher than the Gut Feeling of the gastroenterologists. However, combining both the Blatchford and Rockall scores and the Gut Feeling yielded the highest predictive power for the need of an intervention (AUC 0.88), rebleeding (AUC 0.73), and mortality (AUC 0.71 predicted before and 0.77 predicted after endoscopy, respectively).

Conclusions

Gut Feeling is an independent predictor for the need of a clinical intervention, rebleeding, and mortality in patients presenting with upper GI bleeding; however, the Blatchford and Rockall scores are stronger predictors for these outcomes. Combining Gut Feeling with the Blatchford and Rockall scores resulted in the most optimal prediction.
Gluteal-fold adipofascial perforator flap transposition for rectourethral fistula reconstruction
Authors: Fujioka Masaki , Hayashida Kenji , Norooka Sin , Saijo Hiroto , Kuwabara Kaoru , Nonaka Takashi , Hayashi Mikio
Published: April 2014

If a rectourinary fistula does not close spontaneously, it requires surgical closure. We present our experience of rectourethral fistula reconstruction using a gluteal-fold perforator flap, resulting in a successful outcome. The patient was a 64-year-old man with prostate cancer who underwent radical prostatectomy. However, he developed rectourinary fistula, which required surgical closure. A dissection was undertaken to divide the fistula tract, and the rectal and urethral defect were closed. A 12.0×3.0 cm gluteal-fold adipofascial perforator flap was harvested and placed in the space between the rectum and urethra. The viability of lap was favourable, without infection or necrosis. The patient could walk the next day, and was discharged 2 weeks later without fecaluria or liquid stool. We conclude that the gluteal-fold adipofascial perforator flap offers excellent functional advantages in rectourethral fistula reconstruction with minimal morbidity at the donor site.
An assessment on the quality of abstracts presented at the British Association of Urological Surgeons annual meeting
Authors: Jones JET , Lam JHP , Stewart GD , McNeill SA , Laird A
Published: April 2014

Objectives:

To assess the quality of abstracts presented at the British Association of Urological Surgeons (BAUS) annual meeting using standardized reporting guidelines and examine whether abstract quality is associated with conversion to full-text publication.

Materials and methods:

Two standardized assessment forms based on CONSORT/STROBE guidelines were used to score abstracts from the 2009 BAUS meeting retrospectively. A high score ratio was defined as >50% of criteria. Kaplan–Meier analysis examined effect of score ratio on time to publication; logistic regression examined predictive potential of variables including; session topic, study design, country of origin and number of institutions to high score ratio and the effects the above factors and a high score ratio on the likelihood of full-text publication.

Results:

In total, 127 abstracts were included. The mean score ratio was 63.6% (SD 13.3%) for observational studies and 62.7% (SD 9.5%) for randomized controlled trials (RCTs). Nine RCT abstracts and 91 non-RCT abstracts achieved a high score ratio. Abstract topic, study design, country of origin and number of institutions did not predict a high score ratio or subsequent full-length publication using multivariate logistic regression. Full-length publication was achieved for 43 (33.9%) abstracts. Mean time to publication was 17.2 months. Abstract quality did not predict time to publication ( p=0.706).

Conclusion:

BAUS abstracts are of high quality, and compare favourably with other urological meetings. While abstract quality does not independently predict full-length publication, most abstracts do not progress to full-length publication and thus we advocate the use of standardized reporting guidelines to ensure accurate interpretation of study methodology and results.
The Management Impact of Elected Leaders
Authors: Williams Melissa , Baghurst Timothy
Published: April 2014

The study of management has focused increasingly on the specific and unique demands of the government/public sector. Government agencies function in political turmoil which is most experienced by career employees and staff who remain despite changing administrations. Using a qualitative phenomenological research design, this study sought to understand and explain the experiences of government employees working under the management of elected leaders at various Offices of the Attorney General. Ten staff ranging from assistant attorneys general to administrative assistants were interviewed to solicit their perceptions on being managed by a popularly elected leader. Analyses resulted in four themes of necessity: (a) consistent delivery of management, (b) consistent levels of communication, (c) stronger presence of the AG as leader/manager, and (d) removing stagnation of agency progress. Findings suggest that elected leaders should actively work to assist in the management of government employees by increasing transition communication, maintaining regular communication directly with the agency, and supporting a management program for current and potential managers. The study offers a new perspective regarding the challenges elected leaders face when beginning to lead and the frustrations the employees have in knowing what the elected leader is doing.
Incidence of Kaposi’s Sarcoma and Associated Mortality in Fresno, California, 1998 to 2012
Authors: Mu Anandit , Rutledge Jared , Mills Paul , Paul Simon
Published: April 2014

Objective:

The incidence of Kaposi's sarcoma (KS) decreased dramatically after the introduction of highly active antiretroviral therapy (HAART). This study determined the ongoing incidence of and mortality from KS in HIV-infected adults from 1998–2012 in Fresno County, California. The role of virologic control and immune reconstitution was assessed.

Methods:

Incident cases were identified from the state Electronic HIV/AIDS Reporting System (EHARS), the California Cancer Registry, and hospital records of the county HIV treatment center.

Results:

From 1998–2012, the average incidence of KS was 0.51 cases per 100,000 person-years. Of the 66 cases of KS there were 20 deaths, with 85% of the mortality occurring in the first 12 months. Among patients on HAART achieving HIV RNA <400 copies/uL, but with a <50 cell/uL increase in CD4 count there was no improvement in mortality.

Conclusions:

The incidence of KS remains stable since 1998 with a 12-month mortality of 30%.
The New Governance Approach to the Devolution of Corporate Governance
Authors: Rahim Mia
Published: April 2014

The moral arguments associated with justice, fairness and communitarianism have rejected the exclusivity of cost–benefit analysis in corporate governance. Particularly, the percepts of new governance (NG) have included distributive aspects in efficiency models focused on maximizing profits. While corporate directors were only assigned to look after the return of investment within the traditional framework of corporate governance (CG), NG has created the scope for them to look beyond the set of contractual liabilities. This article explores how and how far NG notions have contributed to the devolution of CG to create internal strategies focusing on actors, ethics and accountability in corporate self-regulation.