bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Harms of Direct Oral Anticoagulants in the Elderly for Stroke Prevention in Atrial Fibrillation and Secondary Prevention of Venous Thromboembolism
Authors: Sharma Manuj , Cornelius Victoria R. , Patel Jignesh P. , Davies J. Graham , Molokhia Mariam
Published: May 2015

Background—

Evidence regarding the use of direct oral anticoagulants (DOACs) in the elderly, particularly bleeding risks, is unclear despite the presence of greater comorbidities, polypharmacy, and altered pharmacokinetics in this age group.

Methods and Results—

We performed a systematic review and meta-analysis of randomized trials of DOACs (dabigatran, apixaban, rivaroxaban, and edoxaban) for efficacy and bleeding outcomes in comparison with vitamin K antagonists (VKA) in elderly participants (aged ≥75 years) treated for acute venous thromboembolism or stroke prevention in atrial fibrillation. Nineteen studies were eligible for inclusion, but only 11 reported data specifically for elderly participants. The efficacy in managing thrombotic risks for each DOAC was similar or superior to VKA in elderly patients. A nonsignificantly higher risk of major bleeding than with VKA was observed with dabigatran 150 mg (odds ratio, 1.18; 95% confidence interval, 0.97–1.44) but not with the 110-mg dose. Significantly higher gastrointestinal bleeding risks with dabigatran 150 mg (1.78, 1.35–2.35) and dabigatran 110 mg (1.40, 1.04–1.90) and lower intracranial bleeding risks than VKA for dabigatran 150 mg (0.43, 0.26–0.72) and dabigatran 110 mg (0.36, 0.22–0.61) were also observed. A significantly lower major bleeding risk in comparison with VKA was observed for apixaban (0.63, 0.51–0.77), edoxaban 60 mg (0.81, 0.67–0.98), and 30 mg (0.46, 0.38–0.57), whereas rivaroxaban showed similar risks.

Conclusions—

DOACs demonstrated at least equal efficacy to VKA in managing thrombotic risks in the elderly, but bleeding patterns were distinct. In particular, dabigatran was associated with a higher risk of gastrointestinal bleeding than VKA. Insufficient published data for apixaban, edoxaban, and rivaroxaban indicate that further work is needed to clarify the bleeding risks of these DOACs in the elderly.

Systematic Review Registration—

http://www.crd.york.ac.uk/PROSPERO
. Unique identifier: PROSPERO CRD42014007171/
Unsupervised Exercise and Mobility Loss in Peripheral Artery Disease: A Randomized Controlled Trial
Authors: McDermott Mary M. , Guralnik Jack M. , Criqui Michael H. , Ferrucci Luigi , Liu Kiang , Spring Bonnie , Tian Lu , Domanchuk Kathryn , Kibbe Melina , Zhao Lihui , Lloyd Jones Donald , Liao Yihua , Gao Ying , Rejeski W. Jack
Published: May 2015

Background

Few medical therapies improve lower extremity functioning in people with lower extremity peripheral artery disease (
PAD
). Among people with
PAD
, we studied whether a group‐mediated cognitive behavioral intervention promoting home‐based unsupervised exercise prevented mobility loss and improved functional performance compared to control.

Methods and Results

One hundred ninety‐four
PAD
participants were randomized. During months 1 to 6, the intervention group met weekly with other
PAD
participants and a facilitator. Group support and self‐regulatory skills were used to help participants adhere to walking exercise. Ninety‐percent of exercise was conducted at or near home. The control group attended weekly lectures. During months 6 to 12, each group received telephone contact only. Primary outcomes have been reported. Here we compare changes in exploratory outcomes of mobility loss (the inability to climb a flight of stairs or walk one‐quarter mile without assistance), walking velocity, and the Short Physical Performance Battery. Compared to controls, fewer participants randomized to the intervention experienced mobility loss at 6‐month follow‐up: 6.3% versus 26.5%,
P
=0.002, odds ratio=0.19 (95%
CI
=0.06 to 0.58) and at 12‐month follow‐up: 5.2% versus 18.5%,
P
=0.029, odds ratio=0.24 (95%
CI
=0.06 to 0.97). The intervention improved fast‐paced 4‐m walking velocity at 6‐month follow‐up (
P
=0.005) and the Short Physical Performance Battery at 12‐month follow‐up (
P
=0.027), compared to controls.

Conclusions

In exploratory analyses, a group‐mediated cognitive behavioral intervention promoting unsupervised walking exercise prevented mobility loss and improved functioning at 6‐ and 12‐month follow‐up in
PAD
patients.

Clinical Trial Registration

URL:
http://clinicaltrials.gov
. Unique identifier: NCT00693940.
Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women
Authors: Schmiegelow Michelle D. , Hedlin Haley , Mackey Rachel H. , Martin Lisa W. , Vitolins Mara Z. , Stefanick Marcia L. , Perez Marco V. , Allison Matthew , Hlatky Mark A.
Published: May 2015

Background

It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.

Methods and Results

We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of
cardiovascular disease
or diabetes at baseline. We categorized women by body mass index (

in kg/m
2

) as normal weight (
body mass index
18.5 to <25), overweight (body mass index 25 to <30), or obese (
body mass index
≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow‐up, 1101 women had a first
cardiovascular disease
event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [
HR
] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (
HR
0.92, interaction
P
=0.05). Obese black women without metabolic syndrome had higher adjusted risk (
HR
1.95) than obese white women (
HR
1.07; interaction
P
=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (
HR
1.77) or obese (
HR
2.17) but not in white women who were overweight (
HR
0.98) or obese (
HR
1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity.

Conclusions

Metabolic abnormalities appeared to convey more cardiovascular risk among black women.
Joint Effect of Hypertension and Elevated Serum Phosphorus on the Risk of Mortality in National Health and Nutrition Examination Survey‐III
Authors: Vart Priya , Nigatu Yeshambel T. , Jaglan Ajay , van Zon Sander K. R. , Shafique Kashif
Published: May 2015

Background

Elevated serum phosphorus might aggravate the effect of hypertension on mortality. The objective of this study was to examine the joint effect of hypertension and serum phosphorus on the risk of mortality.

Methods and Results

A large prospective (n=15 833), population‐based cohort of participants from the National Health and Nutritional Examination Survey
III
was examined to test potential synergism between hypertension, elevated serum phosphorus, and the risk of mortality. Interaction on additive scale and multiplicative scale was estimated. After a median follow‐up of 14.3 years, 1691 cases of cardiovascular mortality and 3875 cases of all‐cause mortality were identified. Interaction was observed between hypertension and elevated serum phosphorus on the additive scale for cardiovascular mortality (relative excess risk due to interaction, 0.99, 95%
CI
: 0.06; 1.92, adjusted for age, gender, race, and estimated glomerular filtration rate). No statistically significant interaction was found between hypertension and serum phosphorus for all‐cause mortality on the additive scale. No significant interaction was detected on the multiplicative scale. In sensitivity analysis, excluding participants who died in first 2 years and adjustment for additional confounders resulted in essentially similar findings.

Conclusions

The joint effect of hypertension and elevated serum phosphorus was larger than the sum of the independent effects on cardiovascular mortality but not on all‐cause mortality. Future studies should investigate whether controlling elevated serum phosphorus in hypertensive individuals helps in prevention of extra risk of cardiovascular mortality.
Cardiovascular Disease Performance Measures in the Outpatient Setting in India: Insights From the American College of Cardiology's PINNACLE India Quality Improvement Program (PIQIP)
Authors: Kalra Ankur , Pokharel Yashashwi , Hira Ravi S. , Risch Samantha , Vicera Veronique , Li Qiong , Kalra Ram N. , Kerkar Prafulla G. , Kumar Ganesh , Maddox Thomas M. , Oetgen William J. , Glusenkamp Nathan , Turakhia Mintu P. , Virani Salim S.
Published: May 2015

Background

India has a growing burden of cardiovascular disease (
CVD
), yet data on the quality of outpatient care for patients with coronary artery disease, heart failure, and atrial fibrillation in India are very limited. We collected data on performance measures for 68 196 unique patients from 10 Indian cardiology outpatient departments from January 1, 2011, to February 5, 2014, in the American College of Cardiology's
PINNACLE
(Practice Innovation and Clinical Excellence) India Quality Improvement Program (
PIQIP
).
PIQIP
is India's first national outpatient
CVD
quality‐improvement program.

Methods and Results

In the
PIQIP
registry, we estimated the prevalence of
CVD
risk factors (hypertension, diabetes, dyslipidemia, and current tobacco use) and
CVD
among outpatients. We examined adherence with performance measures established by the American College of Cardiology, the American Heart Association, and the American Medical Association Physician Consortium for Performance Improvement for coronary artery disease, heart failure, and atrial fibrillation. There were a total of 68 196 patients (155 953 patient encounters), with a mean age of 50.6 years (
SD
18.2 years). Hypertension was present in 29.7% of patients, followed by diabetes (14.9%), current tobacco use (7.6%), and dyslipidemia (6.5%). Coronary artery disease was present in 14.8%, heart failure was noted in 4.0%, and atrial fibrillation was present in 0.5% of patients. Among eligible patients, the reported use of medications was as follows: aspirin in 48.6%, clopidogrel in 37.1%, and statin‐based lipid‐lowering therapy in 50.6% of patients with coronary artery disease;
RAAS
(renin–angiotensin–aldosterone system) antagonist in 61.9% and beta‐blockers in 58.1% of patients with heart failure; and oral anticoagulants in 37.0% of patients with atrial fibrillation.

Conclusions

This pilot study, initiated to improve outpatient
CVD
care in India, presents our preliminary results and barriers to data collection and demonstrates that such an initiative is feasible in a resource‐limited environment. In addition, we attempted to outline areas for further improvement in outpatient
CVD
care delivery in India.
Three-Dimensional Structure and Evolution of the Moisture Field in the MJO
Authors: Adames Ángel F. , Wallace John M.
Published: May 2015

The large-scale circulation features that determine the structure and evolution of MJO-related moisture and precipitation fields are examined using a linear analysis protocol based on daily 850- minus 150-hPa global velocity potential data. The analysis is augmented by a compositing procedure that emphasizes the structural features over the Indo-Pacific warm pool sector (60°E–180°) that give rise to the eastward propagation of the enhanced moisture and precipitation.

It is found that boundary layer (BL) convergence in the low-level easterlies to the east of the region of maximum ascent produces a deep but narrow plume of equatorial ascent that moistens the midtroposphere, while weakly diffluent flow above the BL spreads moisture away from the equator. Vertical advection of moisture from this plume of ascent accounts for the eastward propagation of the positive moisture anomalies across the Maritime Continent into the western Pacific. When the convection is first developing over the Indian Ocean, horizontal moisture advection contributes to both the eastward propagation and the amplification of the positive moisture anomalies along the equator to the east of the region of enhanced convection. Neither horizontal advection nor the net moistening from vertical advection and the apparent moisture sink exhibit significant westward tilt with height in the equatorial plane, but when they are superposed they explain the westward tilt of the moisture field. The strong spatial correlation between relative humidity and vertical velocity underscores the important role of equatorial wave dynamics in shaping the structure and evolution of the MJO.
LAPS–LOWICE: A Real-Time System for the Assessment of Low-Level Icing Conditions and Their Effect on Wind Power
Authors: Gregow E. , Bernstein B. , Wittmeyer I. , Hirvonen J.
Published: May 2015

The wind power industry is highly sensitive to weather, and there is a clear impact on turbine efficiency associated with icing, which can cause significant power losses and even result in the total shutdown of wind farms. Therefore, accurate analyses and forecasts of wind- and icing-related meteorological variables are of great importance. To this end, the Local Analysis and Prediction System (LAPS)–LOWICE system has been developed to produce real-time, hourly estimates of the presence, intensity, and impacts of icing on wind power production. As part of this development, it became clear that power losses did not correlate well with measured icing loads but correlated reasonably well with the time history of icing rate in combination with ice loss due to melting, sublimation, and shedding.
Massively Parallel DNA Sequencing Successfully Identified Seven Families With Deafness-Associated MYO6 Mutations
Authors: Miyagawa Maiko , Nishio Shin-ya , Kumakawa Kozo , Usami Shin-ichi
Published: May 2015

Objectives:

To elucidate the involvement of MYO6 mutations, known to be responsible for DFNA22/DFNB37, in Japanese hearing loss patients through the use of genetic analysis.

Methods:

Genomic variations responsible for hearing loss were identified by massively parallel DNA sequencing (MPS) of 63 target candidate genes in 1120 Japanese hearing loss patients, and the detailed clinical features for the patients with MYO6 mutations were collected and analyzed.

Results:

Four mutations were successfully found in 7 families exhibiting autosomal dominant inheritance. All of the patients showed progressive hearing loss, but hearing type and onset age varied. Further, none of the affected patients showed any associated symptoms, such as hypertrophic cardiomyopathy or retinitis pigmentosa.

Conclusions:

MPS is powerful tool for the identification of rare causative deafness gene mutations, such as MYO6. The clinical characteristics noted in the present study not only confirmed the findings of previous reports but provided important new clinical information.
Ethnic-Specific Spectrum of GJB2 and SLC26A4 Mutations
Authors: Tsukada Keita , Nishio Shin-ya , Hattori Mitsuru , Usami Shin-ichi
Published: May 2015

Objective:

The mutation spectrum of the GJB2 and SLC26A4 genes, the 2 most common genes causing deafness, are known to be ethnic specific. In this study, the spectrum of the reported GJB2 and SLC26A4 mutations in different populations are reviewed and considered from a human migration perspective.

Methods:

Fifty-two and 17 articles on GJB2 and SLC26A4 mutations, respectively, were reviewed through the PubMed database from April 1996 to September 2014. The 4 most prevalent mutations were selected and compared. A cluster analysis was subsequently performed for these selected mutations.

Results:

The present review of frequent mutations shows the ethnic-specific GJB2 and SLC26A4 gene mutation spectrum. A cluster analysis of the GJB2 and SLC26A4 genes revealed similarities between ethnic populations.

Conclusion:

The mutation spectrum reviewed in this study clearly indicated that the frequent mutations in the GJB2 and SLC26A4 genes are consistent with the founder mutation hypothesis. A comparison with the Y-chromosome phylogenetic tree indicated that these mutations may have occurred during human migration.
Lipoprotein lipase and atherosclerosis
Authors: Kobayashi Junji , Mabuchi Hiroshi
Published: May 2015

Lipoprotein lipase has long been known to hydrolyse triglycerides from triglycerides-rich lipoproteins. More recently, it has been shown to promote the binding of lipoproteins to various lipoprotein receptors. Evidence is also presented regarding the possible atherogenic role of lipoprotein lipase. In theory, lipoprotein lipase deficiency should help to clarify this question. However, the rarity of this condition means that it has not been possible to conduct epidemiological studies. An alternative approach is to investigate the correlation of lipoprotein lipase with onset of cardiovascular disease in prospective studies in large population-based cohorts. Complementary with this approach, animal models have been used to explore the atherogenicity of lipoprotein lipase expressed by macrophages.
Shaping Politics at Home
Authors: Córdova Abby , Hiskey Jonathan
Published: May 2015

The dramatic rise of democratic regimes around the world has coincided with an equally significant increase in migration, characterized by an unprecedented movement of people from emerging to established democracies. Through analysis of survey data from six Latin American countries, we offer an empirical evaluation of theoretical mechanisms through which migration can shape the political behaviors of non-migrants in sending nations. We find that individuals who have strong cross-border ties that connect them with relatives living in the United States are more likely to participate in local politics, sympathize with a political party, and persuade others to vote for a party. Those effects are influenced by the positive impact of cross-border ties on civic community involvement, political interest, and political efficacy. Moreover, the evidence suggests that frequent usage of the Internet among non-migrants with strong cross-border ties results in increased political knowledge, which contributes to their greater political interest and efficacy.
Education Improves Public Health and Promotes Health Equity
Authors: Hahn Robert A. , Truman Benedict I.
Published: May 2015

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits.
Mechanical behavior in bending deformation of thermoplastic composite laminates with different stacking sequences
Authors: Su Yishi , Zhang Di , Gong Xiaolu , Shen Min
Published: May 2015

This work aims to numerically analyze the mechanical properties of thermoplastic composite laminates with the [0°/90°]4s, [±25°]s4 and [0°/±45°/90°]2s stacking sequences under three-point bending loading. Three-dimensional multilayer structural models of composite laminates are established and then orthotropic elastics, Hill yield criterion and isotropic hardening rule are applied on these structural models of composite laminates to conduct the bending mechanical deformation. Fine enough meshes and reasonable loads and boundary conditions can efficiently reduce the computing cost. Afterwards, three-dimensional fiber–matrix structural models with disordered fiber arrangements of 0°/90°, 25°/−25° and 0°/45° interlaminates at the free edges of composite laminates are also created, in which the boundary conditions are transferred step by step using a three-step structural submodeling. Once more, orthotropic elastics and isotropic hardening are applied on these fiber–matrix structural models. This work provides a good way to understand the bending mechanical behavior of thermoplastic composite laminates with different stacking sequences.
Influence of particle size distribution on properties of SiC particles reinforced aluminum matrix composites with high SiC particle content
Authors: Qu SG , Lou HS , Li XQ
Published: May 2015

In this paper, 60.5–68.0 vol.% SiCp/Al composites were prepared by infiltrating liquid aluminum into preforms. The average diameters of SiC particles used in the particles packing experiments were 45, 8 and 2 µm for the group I preforms, and 75, 8 and 2 µm for the group II preforms. The thermal-mechanical properties of the composites were investigated. The mechanical properties test showed that the tensile strength of the composites was in the range of 212–349 MPa, and the elastic modulus of the composites was greater than 150 GPa. For a given SiC volume fraction, the tensile strength and elastic modulus of the group I composites were greater than that of the group II composites. The thermal properties test revealed that the coefficient of thermal expansion of the composites was in the range of 10.33–12.32 × 10–6/℃, and the measured thermal conductivity of the composites was greater than 85.6 W/(m·℃). The change of the particle size distribution had no effect on the coefficient of thermal expansion, and the coefficient of thermal expansion decreased linearly with the increase of SiC content. An average diameter approach for estimating the thermal conductivity of the composites was proposed in the application of Hasselman-Johnson model. The results indicated that the predictions of the model were in good agreement with the measured thermal conductivity of the composites.
Interlaminar shear behavior of basalt FRP and hybrid FRP laminates
Authors: Wang Xin , Zhao Xing , Wu Zhishen , Zhu Zhongguo , Wang Zihao
Published: May 2015

This paper focuses on the interlaminar shear behavior of basalt fiber reinforced polymer (FRP) laminates impregnated with epoxy and vinyl ester resins as well as hybrid basalt and carbon FRP laminates. Meanwhile, the interlaminar shear behavior of carbon and E-glass FRP laminates was also studied for comparison. The experiments were conducted according to the ASTM-D-2344 standard, and the failure modes, load–deformation (L–D) relationships, and interlaminar shear stress to normalized deformation relationships of various FRP laminates were analyzed. The differences in interlaminar shear behavior among different fibers and resins were identified. The fracture surfaces of the laminate specimens with different fibers were examined by scanning electron microscopy. Furthermore, the hybrid effect on interlaminar shear behavior was discussed and the interlaminar shear strength was predicted based on above analysis. The results show that the L–D relationships of FRP laminates can be classified into three types, which are determined by the interlaminar shear strength between fiber layers and the resin as well as by the failure modes. The interlaminar shear strength of basalt FRP with vinyl ester resin is higher than that of the glass FRP but less than that of the carbon FRP. The adoption of epoxy resin and the hybridization of basalt and carbon fibers can enhance the interlaminar shear strength of basalt FRP. In addition, the scanning electron microscopy images of fracture surfaces of the laminate specimens confirm the differences of interlaminar behavior of various composites. The hybrid effect on the interlaminar shear behavior is reflected in the integration of both advantages of basalt FRP and carbon FRP in the interlaminar shear stress to nominal deformation relationship, which results in both higher interlaminar shear strength at the cracking and the final stages. Finally, the interlaminar shear strength of different FRP laminates can be accurately predicted by the proposed model.
Social Environmental Mining Conflicts in Mexico
Authors: Tetreault Darcy
Published: May 2015

Examination of social environmental conflicts around mining in Mexico indicates that neoliberal reforms have facilitated “accumulation by dispossession,” first by transferring public resources in the form of mineral rights and state-run mining companies to the private sector and second by dispossessing smallholder farmers and indigenous communities of their land, water, and cultural landscapes in order to allow mining companies to carry out their activities. The resistance movements that have emerged to confront this dispossession are led on the local level by people whose livelihoods, health, and cultures are threatened by large-scale mining projects. They reflect “the environmentalism of the poor” in that they seek to keep natural resources outside of the sphere of the capitalist mode of production.

El examen de los conflictos socioambientales en torno a la minería en México indica que las reformas neoliberales han facilitado la “acumulación por desposesión”: primero, transferiendo recursos públicos en forma de concesiones mineras y compañías paraestatales al sector privado y, segundo, despojando a los pequeños agricultures y a las comunidades indígenas de sus tierras, agua y paisajes culturales con el fin de permitirle a las compañías mineras llevar a cabo sus actividades. Los movimientos de resistencia que han surgido para afrontar este despojo están dirigidos en el plano local por personas cuyos medios de subsistencia, su salud y su cultura se ven amenazadas por los proyectos de minería en gran escala. Ellos reflejan “el ecologismo de los pobres” ya que buscan mantener los recursos naturales fuera de la esfera del modo de producción capitalista.
Rubric Use in Formative Assessment
Authors: Greenberg Kathleen P.
Published: May 2015

A detailed rubric initially designed as a scoring instrument for grading APA-style empirical research reports was tested for its ability to help students improve their scientific writing skills. Students who used the rubric while preparing their reports wrote a higher quality report than did students who did not. Students also improved the quality of their own reports after using the rubric to grade a report written by one of their classmates. These findings provide some of the first empirical evidence of the important role that rubrics can play in the process of formative assessment.
Role of Obesity on the Prognosis of Sudden Sensorineural Hearing Loss in Adults
Authors: Hwang Juen‐Haur
Published: May 2015

Objective

To investigate the role of obesity/overweight on the prognosis of sudden sensorineural hearing loss (SSHL).

Study Design

Retrospective cohort study.

Setting

Outpatient department of a community hospital.

Subjects and Methods

We collected 254 adult patients with SSHL from a community hospital. The odd ratios of body mass index (BMI) or obesity/overweight (BMI ≥25 kg/m2) on the recovery of SSHL were evaluated with multivariate logistic regression analysis.

Results

There were 120 (47.2%) patients in the nonobesity group (BMI <25 kg/m2) and 134 (52.8%) patients in the obesity/overweight group (BMI ≥25 kg/m2). The complete and partial recovery rates were 10.0% and 49.2% in the nonobesity group and 9.7% and 47.0% in the obesity/overweight group, respectively. Univariate logistic regression showed that BMI had no significant association with recovery of SSHL (odds ratio [OR] of complete and partial recovery versus no recovery = 1.04, 95% confidence interval [CI] = 0.965‐1.113, P =. 327). Multivariate logistic regression analysis also showed that BMI (OR = 1.04, 95% CI = 0.964‐1.131, P =. 292) was not significantly associated with the recovery of SSHL for all subjects, after adjusting for all considered variables. Also, obesity/overweight (BMI ≥25 kg/m2) had no significant association with the recovery of SSHL.

Conclusion

Obesity/overweight would appear to have no significant effect on the prognosis of SSHL.
An Innovative 3‐dimensional Model of the Epitympanum for Teaching of Middle Ear Anatomy
Authors: Ng Chew Lip , Liu Xuandao , Chee Shuo Chian Jeremy , Ngo Raymond Yeow Seng
Published: May 2015

Objective

To facilitate teaching of the anatomy of the epitympanum, we developed and evaluated the effectiveness of an interactive 3‐dimensional (3D) computer model that can be viewed from all angles.

Study Design

Questionnaire‐based prospective randomized controlled trial.

Setting

Undergraduate medical education program.

Subjects and Methods

The model was created using Google Sketchup, a 3D modeling software. We recruited 72 graduating medical students and randomized them into 2 groups. One group was given the 3D model and reading materials on the epitympanic anatomy (3D group), while the other group relied on reading material and pictures (2‐dimensional [2D] group). A questionnaire and anatomy quiz assessed the utility of the 3D model in learning the anatomy of the epitympanum.

Results

The mean age of the participants was 22 years. There were no statistically significant differences in demographics and previous experience with 3D models. The 3D group was significantly more confident in its ability to identify structures of the epitympanum on pictures and computed tomography scans when compared to the 2D group. Most participants were in favor of the model as a useful learning tool and preferred to use it with an instructor. In the anatomy quiz, the 3D group fared significantly better, achieving a mean score of 65.1% compared to 32.4% in the 2D group (P <. 001).

Conclusion

The 3D teaching model of the epitympanum is efficacious in short‐term recall. By allowing the learner to visualize relations of the epitympanum from all directions, the model aids in appreciation of anatomy and identifications of structures of this region.
Employee Empowerment and Turnover Intention in the U.S. Federal Bureaucracy
Authors: Kim Sun Young , Fernandez Sergio
Published: May 2015

Reducing employee turnover in the U.S. federal government has been an ongoing goal of policymakers in Washington, D.C. A large literature emerging during the last three decades has identified a range of antecedents of turnover intention and actual turnover, including individual characteristics, employee attitudes, organizational conditions, and managerial practices. Little research has been done, however, on the impact of employee empowerment as a multifaceted managerial approach on turnover options in the public sector. This study proposes a theoretical model of the direct and indirect effects of employee empowerment on turnover intention in the U.S. federal bureaucracy. The model is tested using structural equation modeling (SEM) and data from the U.S. Federal Employee Viewpoint Survey (FEVS). The empirical results support the hypothesized model. Employee empowerment has negative direct and indirect effects on turnover intention. In addition, the negative effect is greater on the likelihood of intention to leave to another federal agency and intention to leave the federal government than on the intention to retire.
The Unintended Consequences of the Countercultural Movement of the 1960s
Authors: Stinerock Robert
Published: May 2015

Since the 1960s, the American milieu has evolved in a way that is at once more tolerant, humane, and progressive on the social and cultural fronts and yet more darkly threatening, unforgiving, and malevolent in our economic and business lives. This article offers a single explanation accounting for these two seemingly divergent phenomena. The all-pervasive, unrelenting power of marketing ideology, with its laser-like focus on the consumer and customer satisfaction, is cited as a contributing agent of change in how the affairs of our public institutions, including universities, are now being conducted.
Learning grasps with topographic features
Authors: Fischinger David , Weiss Astrid , Vincze Markus
Published: May 2015

We present a system for grasping unknown objects, even from piles or cluttered scenes, given a point cloud. Our method is based on the topography of a given scene and abstracts grasp-relevant structures to enable machine learning techniques for grasping tasks. We describe how Height Accumulated Features (HAF) and their extension, Symmetry Height Accumulated Features, extract grasp relevant local shapes. We investigate grasp quality using an F-score metric. We demonstrate the gain and the expressive power of HAF by comparing its trained classifier with one that resulted from training on simple height grids. An efficient way to calculate HAF is presented. We describe how the trained grasp classifier is used to explore the whole grasp space and introduce a heuristic to find the most robust grasp. We show how to use our approach to adapt the gripper opening width before grasping. In robotic experiments we demonstrate different aspects of our system on three robot platforms: a Schunk seven-degree-of-freedom arm, a PR2 and a Kuka LWR arm. We perform tasks to grasp single objects, autonomously unload a box and clear the table. Thereby we show that our approach is easily adaptable and robust with respect to different manipulators. As part of the experiments we compare our algorithm with a state-of-the-art method and show significant improvements. Concrete examples are used to illustrate the benefit of our approach compared with established grasp approaches. Finally, we show advantages of the symbiosis between our approach and object recognition.
Sex-related differences in methods of and reasons for suicide in Turkey between 1990 and 2010
Authors: Oner Setenay , Yenilmez Cinar , Ozdamar Kazim
Published: May 2015

Objective

To analyse suicides occurring in Turkey between 1990 and 2010 according to sex, age, reason and method.

Methods

Data concerning suicides occurring in Turkey between 1990 and 2010 were obtained from annual records published by the Turkish Statistical Institute. Data were analysed according to sex, age, reason for suicide and suicide method.

Results

The crude suicide rate was 2.42 per 100 000 population in 1990 and 4.02 per 100 000 population in 2010. The highest number of suicides was seen in those aged 15–24 years. In this age group, the number of suicides in females was significantly higher than in males. The most common suicide method in Turkey was hanging. Men used firearms more frequently than women. All the reasons for suicide occurred in a higher number of males than females; however, the difference between males and females was more significant for economic problems, relationship problems and educational failure. The leading reason for suicide in females was relationship problems.

Conclusion

Detecting population subgroups with a high suicide risk and obtaining regional demographic data are of great importance for future studies on suicide prevention.
Electromagnetic interference shielding properties of nickel-coated carbon fiber veil/acid-functionalized MWCNTs/epoxy multiscale composites
Authors: Chen Wei , Wang Jun , Wang Tao , Wang Junpeng , Zhang Bin
Published: May 2015

The multiscale approach have been adapted to enhance the electromagnetic interference shielding properties of nickel-coated carbon fiber veil epoxy-based composites. The nickel-coated carbon fiber veil/acid functionalized MWCNTs/epoxy multiscale composites were manufactured by impregnating the nickel-coated carbon fiber veils with well dispersed functionalized MWCNTs/epoxy mixture to prepare prepreg followed by vacuum bagging process. It is revealed from the scanning electron microscopy morphology observation of the composites that functionaized MWCNTs act as a bridge to connect nickel-coated carbon fibers and provide additional channels for the electron transfer within the composites. The electrical conductivity of the composites increases with the increasing functionalized MWCNTs loading. When the functionalized MWCNTs loading is increased from 0 wt% to 3 wt%, the electrical conductivity increases from 11.2 to 96.8 S cm−1, the total shielding effectiveness of the composites increases by 18 dB to 56 dB in the X-band (8.2–12.4 GHz) range. Total shielding effectiveness shows is dominated by absorption loss SEA due to the magnetic loss, dielectric loss and multilayer construction of the composites.
Role Differentiation in an Adolescent Victim-Offender Typology
Authors: Drummond Holli , Dizgun John , Keeling David
Published: May 2015

The present study evaluates adolescent victimization and offending using cross-sectional survey data from 1,475 adolescents living in a disadvantaged Comuna in Medellin, Colombia, while paying particular attention to the ways in which both victimization and violent offending are operationalized. We find that 37% of respondents experienced no lifetime victimization, while 60% experienced vicarious, and 4% personal victimization. When restricting violent offending to behavior involving a weapon, the majority of offenders (81%) also experienced victimization while only 33% of victims were also weapons offenders. Our final analysis seeks to identify theoretical conditions which differentiate roles in a victim-offender typology, a result we determine varies significantly depending on how “violent offending” is measured.
What makes feminist knowledge legitimate for therapists? A study of Swedish child psychotherapists
Authors: Eskner Skoger Ulrika , Magnusson Eva
Published: May 2015

This study investigated what it is like to be a feminist clinical psychologist in a country with a long commitment to gender equality. We studied how two Swedish clinical child psychologists committed to promoting gender equality talked about issues of gender and inequality in their clinical work. We identified three interpretative repertoires that formed the basis of these clinicians' talk about gender and gender equality: a repertoire built on ideas about basic inherent differences between boys and girls, but nonetheless valuing boys and girls equally; a repertoire emphasizing similar treatment, built on the assumption that gender is of no importance, and that everybody has equal value; and a repertoire built on views of girls and boys as unequally valued by society at large. Both clinicians drew upon all three repertoires. However, they used the repertoires in starkly different ways depending on whether they assumed that knowledge that presupposes gendered power structures can be considered legitimate professional knowledge.
The Growing Public Health Challenges of Exposure to Ultraviolet Radiation From Use of Indoor Tanning Devices in the United States
Authors: Bowman Diana M. , Lewis Ryan C. , Lee Maximilian S. , Yao Catherine J.
Published: May 2015

Ultraviolet radiation is recognized as a human carcinogen by the International Agency for Research on Cancer, the world’s authority on cancer research. In particular, exposure to ultraviolet radiation can lead to melanoma of the skin, which is the deadliest form of skin cancer in the United States. Yet despite the significant public health burden that is associated with skin cancer in the United States, each year over a million Americans engage in indoor tanning where exposure to artificial ultraviolet radiation occurs. In this article, we argue for an immediate ban on the use of commercial indoor tanning by minors and, based on international precedents, the phasing out of all commercial tanning operations in the United States. We consider the use of indoor tanning devices in the United States, epidemiological data on indoor tanning devices and cancer, regulation of tanning devices, and scientific evidence for increased government intervention.
Rethinking the Measurement of Officer Experience and Its Role in Traffic Stop Searches
Authors: Klahm Charles F. , Tillyer Rob
Published: May 2015

The role officer experience plays in shaping behavioral choices has received considerable attention. Officer experience has most often been captured by measuring years of service in policing literature. Thus, the field’s understanding of how officer experience shapes behavior choices is limited because years of service are not experienced monolithically. The current study employed multivariate, multilevel models to test three research hypotheses based on existing theoretical explanations of police behavior and psychology literature to more fully explore the influence of officer experience on discretionary search behavior. The results indicate that years of service provide an incomplete understanding of how experience motivates behavior in the traffic stop search context. A more complete understanding requires accounting for aspects of exposure to certain situational characteristics, activities undertaken, and work performance, suggesting that failing to incorporate multidimensional operationalizations of experience limits our ability to fully understand the influence of officer experience on decision making.
Precarious everyday agency
Authors: Jokinen Eeva
Published: May 2015

The concept of agency has been used to bridge the gap between micro- and macro-level analyses in social and feminist studies. Giddens proposed the pair of structure and agency; Bourdieu coined the concept of habitus as an interlocutor between the two. Feminist theorisation developed the concepts of social agency as always embodied, of power as subtly inculcated through the body, and of social action as generative. Agency as a productive tool has also been contested: as a tendency to reduce agency to individual sovereignty, as being androcentric, as losing the sight of everyday life events, and as reducing action to human action. This article contributes to the theoretical debates on agency by developing a notion of precarious everyday agency as a subjective interface in contemporary capitalism. It engages with theories of precarisation and modifies them to incorporate fragile, everyday life agency. The modification is achieved by analysing the role and logic of habits in precarisation. The article draws on empirical data comprising a series of group discussions with women who identify themselves as living in a precarious situation. The article shows that the logic of habit is complex and that a habit of habit-breaking can be identified as a crucial aspect of precarious everyday agency.
Respectable families: Discourses on family life, ethnic hierarchies and social positioning
Authors: Peltola Marja
Published: May 2015

Problem-oriented public discourses about families with an immigrant background shape the ways in which these families are seen in society, as well as the social positions it is possible for them to aspire to. Drawing on interview data, this article focuses on how family members with an immigrant background navigate their way through problem-centred discourses when speaking about their own family life. The article suggests that the construct of ‘a respectable family’ acts as a way to counter stereotypes and to claim a more valued position in society, and it can be found in both idealized descriptions of one's own family and in conflict narratives.
Relationship and stage of dementia differences in caregiver perspectives on the meaning of activity
Authors: Roland Kaitlyn P , Chappell Neena L
Published: May 2015

Caregivers of persons living with dementia (PWD) taking cholinesterase inhibitors, who care 3 + h over three days/week, were interviewed. This study uses thematic content analysis to compare responses to the open-ended question “ What do you believe getting involved in activities outside the home means for someone with dementia?” in spouse ( n = 613) and adult–children ( n = 260) caregivers, and across mild ( n = 314) and moderate–severe stages ( n = 280). For adult–children caregivers, activity participation promotes independence in their parents. Spouses describe activity in the context of their relationship with the PWD, and the experience is framed around their continued social roles as a couple. Mild-stage caregivers report the difficulty and negative outcomes (e.g. frustration, stigma) of engaging in activity, while moderate–severe caregivers discuss activity as preserving abilities in PWD and providing connection to cohort. This may indicate areas for improved activity provision and support for spouse (i.e. emotional) and adult–children (i.e. resources) caregivers across dementia stages.
The Importance of Quasi-4D Path-Integrated Dose Accumulation for More Accurate Risk Estimation in Stereotactic Liver Radiotherapy
Authors: Taylor Michael L. , Yeo Unjin A. , Supple Jeremy , Keehan Stephanie , Siva Shankar , Kron Tomas , Pham Daniel , Haworth Annette , Franich Rick D.
Published: May 2015

Intrafraction organ deformation may be accounted for by inclusion of temporal information in dose calculation models. In this article, we demonstrate a quasi-4-dimensional method for improved risk estimation. Conventional 3-dimensional and quasi-4-dimensional calculations employing dose warping for dose accumulation were undertaken for patients with liver metastases planned for 42 Gy in 6 fractions of stereotactic body radiotherapy. Normal tissue complication probabilities and stochastic risks for radiation-induced carcinogenesis and cardiac complications were evaluated for healthy peripheral structures. Hypothetical assessments of other commonly employed dose/fractionation schedules on normal tissue complication probability estimates were explored. Conventional 3-dimensional dose computation may result in significant under- or overestimation of doses to organ at risk. For instance, doses differ (on average) by 17% (σ = 14%) for the left kidney, by 14% (σ = 7%) for the right kidney, by 7% (σ = 9%) for the large bowel, and by 10% (σ = 14%) for the duodenum. Discrepancies in the excess relative risk range up to about 30%. The 3-dimensional approach was shown to result in cardiac complication risks underestimated by >20%. For liver stereotactic body radiotherapy, we have shown that conventional 3-dimensional dose calculation may significantly over-/underestimate dose to organ at risk (90%-120% of the 4-dimensional estimate for the mean dose and 20%-150% for D2%). Providing dose estimates that most closely represent the actual dose delivered will provide valuable information to improve our understanding of the dose response for partial volume irradiation using hypofractionated schedules. Excess relative risks of radiocarcinogenesis were shown to range up to approximately excess relative risk = 4 and the prediction thereof depends greatly on the use of either 3-dimensional or 4-dimensional methods (with corresponding results differing by tens of percent).