bluuebunny/crossref_metadata_2025 huggingface dataset:
Facilitated Individualized Education Planning
Authors: Mason Carolyn Q. , Goldman Samantha E.
Published: August 2016

Facilitated individualized education planning (FIEP) presents an alternative to formalized dispute resolution procedures, which can have damaging financial and relational consequences for families and schools. Although recommended as an alternative dispute resolution practice, minimal research has examined its implementation and evaluation. In this study, we described where and how FIEP was being implemented and what types of data state educational agencies (SEAs) implementing FIEP were collecting. In two phases, we contacted representatives of each SEA in the United States, asking them to complete a survey on their state’s use of FIEP, and then to share outcome and participant feedback data and data collection forms. From 43 responses in the first phase, we found that almost half of SEAs are using FIEPs ( n = 24), and of those not currently using FIEP, 12 were considering implementing the practice in the future. In the second phase of the study, we found that six states that responded to the request for data captured similar content on meeting outcomes and participant feedback. Outcome data provided preliminary, initial evidence for the potential effectiveness of FIEP in achieving positive outcomes in the form of agreement or consensus regarding IEPs. Implications for practice, research, and policy are discussed.
Implementation of collaborative multidisciplinary design optimization for conceptual design of a complex engineering product
Authors: Safavi Edris , Tarkian Mehdi , Ölvander Johan , Nadali Najafabadi Hossein , Munjulury Raghu Chaitanya
Published: August 2016

This study investigates the performance of the collaborative multidisciplinary design optimization framework and how it facilitates the knowledge integration process. The framework is used to design and optimize an innovative concept of a tidal water power plant. The case study helps to highlight the challenges that may occur during implementation. The result is presented as a modified framework with less implementation difficulties. The improved framework shows significant reduction in design time and improvement in collaborative design optimization for a design team. The geometry of the product is optimized to minimize weight and maximize the power generated by the turbine with respect to some mechanical constraints.
Intergroup Bias in Parliamentary Rule Enforcement
Authors: Hjorth Frederik
Published: August 2016

Political actors are often assigned roles requiring them to enforce rules without giving in-groups special treatment. But are such institutional roles likely to be successful? Here, I exploit a special case of exogenously assigned intergroup relations: debates in the Danish Parliament, in which Parliament chairmen drawn from parliamentary parties enforce speaking time. Analyzing 5,756 speeches scraped from online transcripts, I provide evidence that speech lengths are biased in favor of the presiding chairman’s party. On average, speakers of the same party as the presiding chairman give 5 percent longer speeches and are 5 percent more likely to exceed the speaking time limit. The paper contributes to the extant literature by demonstrating political intergroup bias in a natural setting, suggesting that group loyalties can supersede institutional obligations even in a “least likely” context of clear rules, complete observability, and a tradition of parliamentary cooperation.
Challenging the Uniformity Myth in Career Counseling Outcome Studies
Authors: Verbruggen Marijke , Dries Nicky , Van Laer Koen
Published: August 2016

This study aimed to challenge the “uniformity myth” in career counseling outcome studies—that is, a tendency toward studying career counseling clients as homogenous, implicitly assuming that the same outcomes would be beneficial to all clients. To this end, we examined the role of clients’ initial career counseling goals. We hypothesized that a client’s career counseling goals would affect (1) which outcomes the client is likely to attain through career counseling and (2) which outcomes he or she would most benefit from (in terms of improved well-being). Hypotheses were tested using data from a three-wave study with Flemish adult career counseling clients. We included six potential career counseling goals and corresponding outcomes: (1) increasing self-awareness, (2) increasing opportunity awareness, (3) making a career decision, (4) finding a new job, (5) improving work–family balance, and (6) improving work relationships. We found that clients were more likely to attain outcomes that matched their initial career counseling goals and less likely to attain other outcomes. In addition, goal attainment (i.e., the attainment of outcomes that match a client’s initial goals)—but not nongoal attainment (i.e., the attainment of outcomes that do not correspond to a client’s initial goals)—related to clients’ subsequent career and life satisfaction. Implications for career counseling research and practice are discussed.
Sagittal Distal Tibial Articular Angle and the Relationship to Talar Subluxation in Total Ankle Arthroplasty
Authors: Veljkovic Andrea , Norton Adam , Salat Peter , Abbas Kaniza Zahra , Saltzman Charles , Femino John E. , Phisitkul Phinit , Amendola Annunziato
Published: August 2016

Background:

Longevity of total ankle replacement (TAR) depends heavily on anatomic alignment. The lateral talar station (LTS) classifies the sagittal position of the talus relative to the tibia. We hypothesized that correcting the sagittal distal tibial articular angle (sDTAA) during TAR would anatomically realign the tibiotalar joint and potentially reduce the risk of prosthesis subluxation.

Methods:

The LTS (millimeters) and sDTAA (degrees) were measured twice by 2 blinded observers using weight-bearing lateral ankle radiographs obtained before (n = 96) and after (n = 94) TAR, with excellent interobserver and intraobserver reliability (correlation coefficient >0.9).

Results:

Preoperative LTS was as follows: anterior (60.4%), posterior (27.1%), and neutral (12.5%). A strong preoperative correlation was found between LTS and sDTAA ( r = 0.81; P < .0001). In ankles that were initially anterior and became less anterior postoperatively (n = 41), LTS decreased from an average 8.1 mm to 6.5 mm and the LTS changed 1.1 mm per degree of sDTAA change. In ankles that were initially posterior (n = 25), LTS increased from an average of −5.1 mm to −2.8 mm and the LTS changed 0.6 mm per degree of sDTAA change. The correlation between LTS and sDTAA was reduced postoperatively ( r = 0.62; P < .0001).

Conclusions:

Our results suggest that rather than following generic recommendations, the surgeon should customize the sagittal distal tibial cut to the individual patient based on the preoperative LTS in order to achieve neutral TAR alignment.

Level of Evidence:

Level III, retrospective comparative series.
When Two Worlds Collide: A Story About Collaboration, Witnessing, and Life Story Research With Soldiers Returning From War
Authors: Carless David , Douglas Kitrina
Published: August 2016

The story we share here stems from our research with British military personnel who are adapting to life with a physical and/or psychological disability after serving in the Iraq or Afghanistan wars. Throughout our research, we have struggled to answer the kinds of questions that plague qualitative researchers: How might we gain insights into intense, traumatic, even life-changing experiences? Should we be inviting individuals to recount or revisit such potent moments from their lives? What interpretive framework might we draw on to make sense of what are sometimes senseless experiences? How can we share any ensuing understanding with others without diluting, diminishing, or disrespecting the lives of soldiers or their families? The story we share here—which responds to Denzin’s challenge to reanimate life and Erickson’s provocation to do so with greater modesty, visibility, and reflexivity—offers one answer to these questions.
Psychometric Properties of the Weiss Functional Impairment Rating Scale: Evidence for Utility in Research, Assessment, and Treatment of ADHD in Emerging Adults
Authors: Canu Will H. , Hartung Cynthia M. , Stevens Anne E. , Lefler Elizabeth K.
Published: August 2016

Objective: The current study examines psychometric properties of the Weiss Functional Impairment Rating Scale (WFIRS), a measure of adult ADHD-related impairment. It is a self-report questionnaire that provides a metric of overall life impairment and domain-specific dysfunction. Method: Using data from a large ( N = 2,093), multi-institution sample of college students and including a subsample of collateral informants ( n = 262), a series of analyses were conducted. Results: The WFIRS demonstrated robust internal reliability, cross-informant agreement on par or superior to other measures of ADHD symptomatology and impairment, and concurrent validity. The WFIRS was not shown to be uniquely associated with ADHD, as internalizing symptoms also associated with the total and domain scores. Conclusion: The use of the WFIRS in identifying ADHD-related impairment in emerging adults appears to be psychometrically supported, and will prove useful to clinicians and researchers.
Evidence-Based Interventions Are Necessary but Not Sufficient for Achieving Outcomes in Each Setting in a Complex World
Authors: Wandersman Abraham , Alia Kassandra , Cook Brittany S. , Hsu Lewis L. , Ramaswamy Rohit
Published: August 2016

Many evaluations of programs tend to show few outcomes. One solution to this has been an increasing prominence of the movement that requires programs to implement evidence-based interventions (EBIs). But in a complex world with complex organizations and complex interventions, many challenges have arisen to the implementation of EBIs with fidelity to achieve outcomes at scale. This includes challenges to achieving outcomes in each setting. In this article, we propose the use of empowerment evaluation and one of its major approaches (Getting To Outcomes [GTO]) as a promising method to address the challenges, and GTO can help organizations achieve outcomes by leading them through a set of “accountability questions” for implementing EBIs in their particular setting. These questions can be asked at multiple levels (e.g., national, state, and local organizations) responsible for achieving outcomes. Although we illustrate the possibilities with examples from health care and public health, the potential strategies can be applied to many areas of health and human services and education.
High-dose erythropoietin in patients with progressive multiple sclerosis: A randomized, placebo-controlled, phase 2 trial
Authors: Schreiber Karen , Magyari Melinda , Sellebjerg Finn , Iversen Pernille , Garde Ellen , Madsen Camilla Gøbel , Börnsen Lars , Romme Christensen Jeppe , Ratzer Rikke , Siebner Hartwig Roman , Laursen Bjarne , Soelberg Sorensen Per
Published: August 2016

Background:

Erythropoietin (EPO) is a part of an endogenous neuroprotective system in the brain and may address pathophysiological mechanisms in progressive multiple sclerosis (MS).

Objective:

To evaluate a treatment effect of EPO on progressive MS.

Methods:

This was a single-center, randomized, double-blind, placebo-controlled phase 2 trial, in which 52 patients with secondary or primary progressive MS were allocated to treatment with recombinant EPO (48,000 IU) or placebo, administered intravenously 17 times during 24 weeks. Patients had an Expanded Disability Status Score (EDSS) from 4 to 6.5 and clinical progression without relapses in the 2 preceding years. The primary outcome was the change in a composite measure of maximum gait distance, hand dexterity, and cognition from baseline to 24 weeks.

Results:

A total of 50 patients completed the study. Venesection was performed often but no thromboembolic events occurred. We found no difference in the primary outcome between the EPO and the placebo group using the intention-to-treat principle ( p = 0.22). None of the secondary outcomes, neither clinical nor magnetic resonance imaging (MRI) measures showed any significant differences.

Conclusion:

This study provides class II evidence that treatment with high-dose EPO is not an effective treatment in patients with moderately advanced progressive MS.
Improvement of spasticity following intermittent theta burst stimulation in multiple sclerosis is associated with modulation of resting-state functional connectivity of the primary motor cortices
Authors: Boutière Clémence , Rey Caroline , Zaaraoui Wafaa , Le Troter Arnaud , Rico Audrey , Crespy Lydie , Achard Sophie , Reuter Françoise , Pariollaud Fanelly , Wirsich Jonathan , Asquinazi Patrick , Confort-Gouny Sylviane , Soulier Elisabeth , Guye Maxime , Pelletier Jean , Ranjeva Jean-Philippe , Audoin Bertrand
Published: August 2016

Background:

Intermittent theta burst stimulation (iTBS) of the primary motor cortex improves transiently lower limbs spasticity in multiple sclerosis (MS). However, the cerebral mechanisms underlying this effect have never been investigated.

Objective:

To assess whether modulation of spasticity induced by iTBS is underlined by functional reorganization of the primary motor cortices.

Methods:

A total of 17 patients with MS suffering from lower limbs spasticity were randomized to receive real iTBS or sham iTBS during the first half of a 5-week indoor rehabilitation programme. Spasticity was assessed using the Modified Ashworth Scale and the Visual Analogue Scale at baseline, after the stimulation session and at the end of the rehabilitation programme. Resting-state functional magnetic resonance imaging (fMRI) was performed at the three time points, and brain functional networks topology was analysed using graph-theoretical approach.

Results:

At the end of stimulation, improvement of spasticity was greater in real iTBS group than in sham iTBS group ( p = 0.026). iTBS had a significant effect on the balance of the connectivity degree between the stimulated and the homologous primary motor cortex ( p = 0.005). Changes in inter-hemispheric balance were correlated with improvement of spasticity (rho = 0.56, p = 0.015).

Conclusion:

This longitudinal resting-state fMRI study evidences that functional reorganization of the primary motor cortices may underlie the effect of iTBS on spasticity in MS.
Impact factor method for design of bridge foundations under ship collisions
Authors: Wang Junjie , Song Yanchen , Yu Zhiran
Published: August 2016

Due to the complexity involved and limited study on the topic, the equivalent static method, adopted in the current codes for structural design of bridges under ship collisions, does not take into account the dynamic amplification effect correctly. In this article, impact factor method is proposed to estimate the response of bridge’s piers and foundations, as a better alternative of the equivalent static method. Through refined numerical simulations of ship-rigid wall collisions for nine typical ships under various impact velocities, 81 impact force time-histories are obtained. The period-dependent impact factor is defined, and empirical function of it is proposed and parameters in the empirical function are determined by the 81 sample impact force time-histories. Finally, both impact factor method and dynamic time-history method are used to estimate the responses of piers and foundations of two example bridges, and the precision of impact factor method is discussed.
Prediction of convective heat transfer coefficients for the upper respiratory tracts of rat, dog, monkey, and humans
Authors: Ito Kazuhide , Mitsumune Koki , Kuga Kazuki , Phuong Nguyen L , Tani Kenji , Inthavong Kiao
Published: August 2016

In vivo studies involving mammal surrogate models for toxicology studies have restrictions related to animal protection and ethics. Computer models, i.e., in silico models, have great potential to contribute towards essential understanding of heat and mass transfer phenomena in respiratory tracts in place of in vivo and in vitro studies. Here, we developed numerical upper airway models of a rat, a dog, a monkey, and two humans by using computed tomography data and then applied computational fluid dynamics analysis. Convective heat transfer coefficients were precisely analysed as a function of breathing airflow rate. Based on the computational fluid dynamics simulation results, the correlations between Nusselt ( Nu) number and the product of the Reynolds ( Re) and Prandtl ( Pr) numbers were summarized. The heat transfer efficiency (order of hc and correlation of Nu and RePr) in the upper airway of the dog seems to match those of the human models. On the other hand, the results for the rat and monkey showed clear differences compared with those of human models. The identified fundamental qualities of convective heat transfer phenomena in airways for rats, dogs, monkeys, and humans, have enabled discussions about quantitative differences of heat and mass transfer efficiency between different animals/species.
Onset and progression of soot in high-pressure n-dodecane sprays under diesel engine conditions
Authors: Pandurangi Sushant S , Bolla Michele , Wright Yuri M , Boulouchos Konstantinos , Skeen Scott A , Manin Julien , Pickett Lyle M
Published: August 2016

Soot onset in n -dodecane sprays is investigated both experimentally, by means of high-speed imaging data from the Sandia spray combustion vessel, and numerically, using the conditional moment closure combustion model and an integrated two-equation soot model in a Reynolds-averaged Navier–Stokes framework. Five operating conditions representative of modern diesel engines are studied at constant density (22.8 kg/m3) with variations in ambient oxygen concentration and temperature. The reference case at 15% O2 and 900 K is compared with measurements in terms of the evolving soot mass distribution and spatiotemporal distributions of formaldehyde and polycyclic aromatic hydrocarbons obtained by 355-nm laser-induced fluorescence (polycyclic aromatic hydrocarbons represented by C2H2 in simulation) and soot optical thickness ( KL) signal obtained by diffused back-illumination extinction imaging. All operating points are validated in terms of ignition delay and lift-off length, soot onset time and location, soot mass evolution, and peak location. Measurements show that time lag between ignition and soot onset is considerably increased by a reduction in ambient oxygen or temperature. The trend of this time lag is captured very well by the simulations, as is the evolving axial distribution of soot, despite the simple soot model employed. Building on the good agreement between spatiotemporal distributions in experiment and simulation, further results from the latter are extracted to provide insight into relevant processes. The advancing soot tip lags behind the fuel–vapor spray tip due to soot oxidation. Tracking the Lagrangian time history of notional fluid particles from the soot onset location back to the injector orifice reveals that their trajectories evolve along rich conditions (φ > 1.5) throughout the entire path. Overall, novel insights obtained from experiments with respect to soot and soot precursor evolutions are complemented by simulations using the integrated conditional moment closure/soot modeling approach, showing encouraging results for prediction and understanding of transient soot processes in high-pressure diesel sprays.
Clinical Presentation of Anxiety in Parkinson’s Disease
Authors: Lutz Sara G. , Holmes Jeffrey D. , Ready Emily A. , Jenkins Mary E. , Johnson Andrew M.
Published: August 2016

Up to 40% of all individuals with Parkinson’s disease (PD) are estimated to experience anxiety that interferes with daily functioning. This article describes research regarding the presentation of anxiety in PD and the influence anxiety has on participation in this population. A scoping review identified 1,635 articles, of which 49 met the inclusion criteria. This review identified that anxiety in PD is often associated with a range of clinical correlates related to demographic and clinical characteristics (age, gender, disease stage, duration, progression), motor symptoms (tremor, bradykinesia, dystonia, freezing of gait, symptom severity), treatment-related complications (on/off fluctuations, on with dyskinesia, unpredictable off), and non-motor symptoms (sleep abnormalities, fatigue, cognitive impairment, depression). These findings can be used to increase clinicians’ awareness toward the specific clinical correlates linked to anxiety in PD so that mental health concerns can be detected and addressed more readily in practice.
Leaders on the Front Line—Managing Emotion for Ethical Decision Making
Authors: Tenuto Penny L. , Gardiner Mary E. , Yamamoto Julie K.
Published: August 2016

To build capacity for students in educational leadership programs, we developed a teaching case study focused on managing emotion for ethical decision making in supervision of personnel. The case offers troubling encounters between a secondary assistant principal and a novice teacher, a veteran teacher, and a veteran administrator. Scenarios include issues of confidentiality, politics, and the tension between educators’ professional ethical principles and an established more laissez-faire school climate and culture. Readers are guided to consider the role of emotion in leadership and how self-reflection can be used as a process for managing emotion.
To Plan or Not to Plan, That Is the Question
Authors: Dolph David A.
Published: August 2016

Strategic planning is a process utilized by numerous organizations, including K-12 school boards, intent on improvement and reform. A thoughtful strategic planning process can help develop a board’s desired future driven by goals and strategies aimed at progress. However, improvement processes such as strategic planning are challenging. In fact, they are even more difficult in the context of political or interpersonal conflict. This case describes a superintendent’s efforts to convince her divided board of education to become involved and utilize strategic planning for school improvement in their district in a politically charged environment.
Poverty, Privilege, and Political Dynamics Within Rural School Reform
Authors: Mette Ian M. , Biddle Catharine , Mackenzie Sarah V. , Harris-Smedberg Kathy
Published: August 2016

This case was written to help prepare teacher-leaders, principals, and central office administrators, particularly those in rural and economically marginalized settings, who are expected to lead teachers and stakeholders in their community through increasingly stressed economic conditions. The intent of the case study is for educators to examine the impact privilege has on the often White, middle-class mind-set of educators, particularly when supporting economically marginalized communities. Educators studying this case should examine the role that poverty, privilege, and politics play in school leadership, specifically when thinking about school reform and community improvement efforts.
Lifestyle Medicine in an Academic/Hospital Context
Authors: Guthrie George E.
Published: August 2016

The effective integration of lifestyle medicine into allopathic practices is an evolving necessity driven by limited resources and escalating costs. Efforts in the Florida Hospital system graduate medical education (GME) department to meet this challenge may be instructive to others. Efforts include the hiring of an experienced dietician with a focus on a whole food plant based diet and a patient engagement tool to identify areas where patients are ready to make change. Billing is done using existing finance structure with the goal of decreasing the overall cost of providing care within a Clinically Integrated Network (CIN) context. Additionally, one GME clinician’s experience in clinical lifestyle based intervention identifies and comments on several practical clinical factors for bringing effective behavior change to individual patients: patient readiness, a knowledgeable health care provider, adequate time, as well as the effectiveness of the intervention.
A multicentre survey of the condition of ultrasound probes
Authors: Dudley Nicholas J , Woolley Darren J
Published: August 2016

Background

The implementation of quality assurance for ultrasound scanners in the United Kingdom is patchy, but government appointed bodies require quality assurance and there are regulatory requirements for maintenance and inspection of equipment. Previous studies have shown high fault rates in ultrasound probes; some of these studies used electronic probe testers, but there is good evidence that over 90% of faults may be detected using simple methods. We aimed to conduct a multicentre survey of the condition of probes, using visual inspection and assessing the in-air reverberation.

Methods

Visitors to the stand run by Multi-Medix Ltd at the BMUS Annual Scientific Meeting in 2014 were invited to participate in the study. One or both of the authors visited participants, performing a visual inspection of probes for evidence of damage or wear and inspecting the in-air reverberation pattern for uniformity. Probes were classified using a risk-based traffic light system: green—no fault found; amber—fault found; further action required but the probe need not be removed from use; red—the probe should be removed from use due to physical or clinical diagnostic risks.

Results

Twelve sites and 219 probes were included in the survey. Sixty-three percent of probes were classified as green; 25% as amber and 13% as red.

Conclusion

More than one in three probes were faulty. Simple tests, at minimal cost, have the potential to demonstrate over 90% of probe faults, making it possible for employers to comply with their duties defined by regulations, national standards and professional guidelines.
The Disgust Box: a novel approach to illustrate water contamination with feces
Authors: Jannat Kaniz , Rahman Mahfuzur , Unicomb Leanne , Levine David
Published: August 2016

Inadequate drinking water, sanitation, and hand hygiene are responsible for approximately 800,000 deaths per year in low- and middle-income countries. We evaluated the benefits of a behavior change communication method to motivate water treatment practices in urban low income communities in Dhaka, Bangladesh. To motivate people to chlorinate their water we used a device called the ‘Disgust Box’. This box provides a vivid demonstration of how piped water is contaminated with feces. Most of the respondents were able to recall the Disgust Box demonstration at both 4-month and 1-year follow-up qualitative assessments. At 4 months, the majority of participants stated that they still felt disgusted by the demonstration and mentioned it as a motivator for water chlorination. However, after one year, despite being able to recall the demonstration, disgust was no longer mentioned as a motivator to chlorinate water. The Disgust Box has the potential to be an effective communication method and is more likely to work if it is part of an intervention that includes repeated presentations and a more attractive water treatment option.
Using Schools of Nursing to Help Fill the Gap
Authors: Resha Cheryl
Published: August 2016

The shortage of school nurses, school nurses covering multiple buildings, and the expanded role of the school nurse has called for innovative ideas to meet the growing health care needs of youth. Partnering with local schools of nursing may be a welcomed strategy. This brief article will share the benefits of hosting student nurses as well as identify ways to begin these partnerships.
Using the Framework for 21st-Century School Nursing Practice in Daily Practice
Authors: Maughan Erin D. , Duff Carolyn , Wright Janet
Published: August 2016

NASN recently developed a Framework for 21st-Century School Nursing Practice (Framework) to guide school nursing activities. The principles and components of the Framework can be used as a guide in achieving high-quality school nurse practice. The purpose of this article is to share how school nurses can use the Framework in their daily practice, invite nurses to identify one new way the Framework can be used in your practice this school year, and implement and evaluate the change.
Compensatory Conscientiousness Redux
Authors: Nickel Lauren B. , Iveniuk James , Roberts Brent W.
Published: August 2016

The present study attempted to closely replicate Roberts, Smith, Jackson, and Edmonds (2009) who found, in part, a compensatory effect such that individuals with spouses higher in conscientiousness reported higher self-rated health and fewer physical limitations in the Health and Retirement Study. Using similarly structured data from the National Social Life, Health, and Aging Project ( N = 953), the current study found results largely consistent with the original study such that partner conscientiousness predicted both self-rated health and physical limitations, and husbands’ conscientiousness and neuroticism interacted when predicting wives’ self-rated health. A discussion of the usefulness of statistical significance versus effect size in replication follows.
The Happiness Gap Between Conservatives and Liberals Depends on Country-Level Threat
Authors: Onraet Emma , Van Assche Jasper , Roets Arne , Haesevoets Tessa , Van Hiel Alain
Published: August 2016

In the present study, we investigated the much debated “happiness gap” between conservatives and liberals, approaching the issue from a multilevel person × context perspective. More specifically, we investigated whether this relationship depends on country-level threat. We used individual-level data for right-wing attitudes and psychological well-being from 94 large, representative samples collected worldwide (total N = 137,890) and objective indicators of country-level threat as the contextual variable. Our results suggest that, especially in countries characterized by high levels of threat, individuals with right-wing attitudes experienced greater well-being than individuals with left-wing attitudes. In countries with a low level of threat, this relationship was considerably weaker or even absent. Our findings corroborate the view that right-wing attitudes may serve a self-protective function, helping individuals to manage and cope with threat.
Do arterial stiffness and wave reflection underlie cardiovascular risk in ethnic minorities?
Authors: Faconti Luca , Nanino Elisa , Mills Charlotte E , Cruickshank Kennedy J
Published: August 2016

Increasing evidence indicates that remarkable differences in cardiovascular risk between ethnic groups cannot be fully explained by traditional risk factors such as hypertension, diabetes or dislipidemia measured in midlife. Therefore, the underlying pathophysiology leading to this “excess risk” in ethnic minority groups is still poorly understood, and one way to address this issue is to shift the focus from “risk” to examine target organs, particularly blood vessels and their arterial properties more directly. In fact, structural and functional changes of the vascular system may be identifiable at very early stages of life when traditional factors are not yet developed. Arterial stiffening, measured as aortic pulse wave velocity, and wave reflection parameters, especially augmentation index, seem to be an important pathophysiological mechanism for the development of cardiovascular disease and predict mortality independent of other risk factors. However, data regarding these arterial indices in ethnic minorities are relatively rare and the heterogeneity between populations, techniques and statistical methods make it difficult to fully understand their role.
Using low-cost Android tablets and instructional videos to teach clinical skills to medical students in Kenya: a prospective study
Authors: O’Donovan James , Ahn Roy , Nelson Brett D , Kagan Calvin , Burke Thomas F
Published: August 2016

Objectives

To assess the feasibility and impact of using a low-cost Android tablet to deliver clinical skills training to third-year medical students in Kenya.

Design

A prospective study using a low cost tablet called ‘connecTAB’, which was designed and manufactured specifically for areas with low bandwidth. Instructional video tutorials demonstrating techniques of cardiovascular and abdominal clinical examinations were pre-loaded onto the tablet.

Setting

Maseno University School of Medicine, Western Kenya.

Participants

Fifty-one third-year medical students from Maseno University School of Medicine were subjects in the study. Twenty-five students were assigned to the intervention group and 26 to the control group.

Main outcome measures

At the start of the study, students from both groups completed an Observed Structured Clinical Examination (OSCE) of the cardiovascular and abdominal evaluations. Students who were allocated to the intervention group then received the connecTAB, whereas students in the control group did not. After a period of three weeks, students from both groups completed a post-study OSCE for both the cardiovascular and abdominal evaluations.

Results

There were significantly higher improvements in the scores for both cardiovascular and abdominal examinations ( p < 0.001) within the group who received the e-tablets as compared to the control group.

Conclusion

The study suggests that access to connecTAB improves clinical education and efficacy and holds promise for international training in both medical and allied healthcare professional spheres in resource-limited settings.
Successful treatment of urodynamic detrusor over-activity in a young patient with Myasthenia gravis using pretibial nerve stimulation with follow-up to two years
Authors: Antoniou A , Mendez Rodrigues J , Comi N
Published: August 2016

Lesson

We report a rare case of Myasthenia gravis and overactive bladder successfully treated with pretibial nerve stimulation.
Takayasu’s arteritis in an adult female from Cameroon: diagnosis via Doppler echocardiography
Authors: Aminde Leopold N , Noubiap Jean Jacques N , Takah Noah , Njim Tsi , Dzudie Anastase
Published: August 2016

Lesson

Takayasu arteritis is rare in black people. Doppler echocardiography may assist in its diagnosis with good response to steroids.
When are medical apps medical? Off-label use and the Food and Drug Administration
Authors: Krieger William H
Published: August 2016

People have a love/hate relationship with rapidly changing healthcare technology. While consumer demand for medical apps continues to grow as rapidly as does supply (there are over 100,000 health, wellness and medical applications, or ‘apps’ on the market), healthcare professionals and safety experts worry about the impact of these apps on the health consumer. In response to the rapidly growing mobile healthcare sector, the Food and Drug Administration has put forth guidelines to regulate ‘mobile medical apps’ (MMAs), those health-related apps that are (self) designated as medical devices. In this article, I argue that this decision, to only regulate apps that bill themselves as medical devices, will create a market for ‘off-label’ app use. Further, I will talk about the oft used analogy between off-label apps and off-label pharmaceuticals, showing that off-labeling apps will provide patients none of the benefits that come with a physician prescribing a drug off-label, while exposing the mobile healthcare consumer to significant risks that go significantly beyond those that we know of (and must accept) from prescription drugs. Recognizing that the Food and Drug Administration is not going to be able to significantly change its policies on oversight, I will suggest specific actions to at least mitigate some of the risks associated with off-label app use.
Understanding Functional and Divisional Organizational Structure
Authors: Fairfield Kent D.
Published: August 2016

Most management students have had limited exposure to issues concerning organizational structure. This exercise offers a brief in-class experience of the differences of working in a functional structure versus a divisional structure. The instructor guides students to think about certain events, or challenges, confronting their simulated organization. Some of these challenges are best handled by a functional organizational structure, while others are much more taxing if organized that way. Conversely, a divisional organization can produce agile responses to certain initiatives but poses difficulties in coordinating across multiple divisions. Students can begin to sense how structure exerts a major influence on decision making.
Bioglass in Alveolar Bone Regeneration in Orthodontic Patients
Authors: El Shazley N. , Hamdy A. , El-Eneen H.A. , El Backly R.M. , Saad M.M. , Essam W. , Moussa H. , El Tantawi M. , Jain H. , Marei M.K.
Published: August 2016

This study was designed as a split-mouth randomized controlled clinical trial to evaluate the effects of a novel bioactive glass scaffold—tailored amorphous multiporous (TAMP)—for the preservation of alveolar bone following tooth extraction in class II orthodontic patients. TAMP scaffolds were prepared and sterilized. Patients were screened for eligibility, and 6 patients accounting for 14 extraction sockets were included in this stage. Sockets were randomly allocated to either control (left empty) or test (grafted with TAMP scaffold particles). Follow-up was done after 1, 2, 4, 8, and 12 to 17 wk with digital periapical radiographs to evaluate changes in crestal bone height and bone mineral density (BMD), 3-dimensional volumetric analysis of impression casts, and histologic analysis of core biopsies. Furthermore, alveolar bone marrow mesenchymal stem cells were cultured from control and test sockets following biopsy retrieval to evaluate the ability of TAMP bioactive glass scaffolds to recruit host progenitor cells. Results showed that sockets grafted with TAMP bioactive glass scaffolds better preserved height after 3 mo where mesially 57.1% of test cases showed preservation of socket height, compared with 28.6% of control cases. Distally, this was 42.9% of test cases versus none of the control cases. Regarding BMD, the test sides had higher BMD in all 3 sections of the socket, with the greatest reduction in BMD found in the coronal third. Results were not statistically significant. Histologically, sockets grafted with TAMP bioactive glass scaffolds showed a distinct pattern of bone healing characterized by vertical trabeculae and large vascularized marrow spaces with sockets showing corticalization. Volumetric analysis showed a better preservation of socket contour with TAMP bioactive glass scaffolds. TAMP bioactive glass scaffolds appeared to enhance the recruitment of stem cells from the grafted sockets. In conclusion, TAMP scaffolds appear to better preserve alveolar bone following extraction and allow for a more active bone modeling and remodeling process( ClinicalTrials.gov identifier:NCT01878084).

Knowledge Transfer statement: The results of this study set the stage for the recommended use of novel biomimetic scaffolds, such as the tailored amorphous multiporous bioactive glass for preservation of the socket following extraction. This can be valuable for patients and clinicians alike when deciding on long-term prosthetic alternatives that not only result in immediate bone preservation but will accommodate the dynamic nature of bone.
Comparison of survival between radiation therapy and trans-oral laser microsurgery for early glottic cancer patients; a retrospective cohort study
Authors: De Santis R. J. , Poon I. , Lee J. , Karam I. , Enepekides D. J. , Higgins K. M.
Published: August 2016

Background

The literature reports various treatment methodologies, such as trans-oral laser microsurgery, radiation therapy, total/partial laryngectomies, and concurrent radiation chemotherapy for patients with early larynx cancer. However, at the forefront of early glottis treatment is trans-oral laser microsurgery and radiation therapy, likely due to better functional and survival outcomes. Here we conduct the largest Canadian head-to-head comparison of consecutive patients treated with either radiation therapy or trans-oral laser microsurgery. Additionally, we compare these two treatments and their 5-year survival rates post treatment to add to the existing literature.

Methods

Charts of patients who were diagnosed with early glottic cancer between 2006 and 2013 were reviewed. Seventy-five patients were identified, and split into 2 groups based on their primary treatment, trans-oral laser microsurgery and radiation therapy. Kaplan–Meier survival curves, life-tables, and the log-rank statistic were reported to determine if there was a difference between the two treatment groups and their disease-specific survival, disease-free survival, and total laryngectomy-free survival. Additionally, each different survival analysis was stratified by potential confounding variables, to help conclude which treatment is more efficacious in this population.

Results

The 5-year disease-specific survival rate is 93.3 % σ = 0.063 and 90.8 % σ = 0.056 for patients treated with trans-oral laser microsurgery and radiation therapy, respectively ( χ2 < 0.001, p = 0.983). The disease free survival rate is 60.0 % (σ =0.121) for patients treated with trans-oral laser microsurgery, and 67.2 % (σ = 0.074) for those who received RT ( χ2 = 0.19, p = 0.663). Additionally, the total laryngectomy-free survival rate is 84.1 % (σ = 0.1) and 79.1 % (σ = 0.072) for patients’ early glottic cancer treated by trans-oral laser microsurgery and radiation therapy, respectively ( χ2 = 0.235, p = 0.628). Chi-square analysis of age-group versus treatment group ( χ2 = 6.455, p = 0.04) and T-stage versus treatment group ( χ2 = 11.3, p = 0.001) revealed a statistically significant relationship, suggesting survival analysis should be stratified by these variables. However, after stratification, there was no statistically significant difference between the trans-oral laser microsurgery and radiation therapy groups in any of the survival analyses.

Conclusion

No difference was demonstrated in the 5-year disease-specific survival, disease-free survival, and total laryngectomy-free survival, between the RT and TLM treatment groups. Additionally, both groups showed similar 5-year survival after stratifying by confounding variables.
Draft genome sequence of Mycobacterium rufum JS14T, a polycyclic-aromatic-hydrocarbon-degrading bacterium from petroleum-contaminated soil in Hawaii
Authors: Kwak Yunyoung , Li Qing X. , Shin Jae-Ho
Published: August 2016

Mycobacterium rufum JS14T (=ATCC BAA-1377T, CIP 109273T, JCM 16372T, DSM 45406T), a type strain of the species Mycobacterium rufum sp. . belonging to the family Mycobacteriaceae, was isolated from polycyclic aromatic hydrocarbon (PAH)-contaminated soil in Hilo (HI, USA) because it harbors the capability of degrading PAH. Here, we describe the first genome sequence of strain JS14T, with brief phenotypic characteristics. The genome is composed of 6,176,413 bp with 69.25 % G + C content and contains 5810 protein-coding genes with 54 RNA genes. The genome information on M. rufum JS14T will provide a better understanding of the complexity of bacterial catabolic pathways for degradation of specific chemicals.
Seismic reservoir characterization using the multiattribute rotation scheme: Case study in the South Falkland Basin
Authors: Alvarez Pedro , Farrer Bruce , Oyetunji Doyin
Published: August 2016

Estimating information about reservoir properties from seismic data is a key challenge in exploration and in the appraisal and production of hydrocarbons. We discuss how to perform quantitative reservoir characterization by integrating well-log and seismic-inversion data through the application of the multiattribute rotation scheme (MARS). This method is a hybrid rock-physics/statistical approach that uses a global search algorithm to estimate a customized transform for each geologic setting in order to predict petrophysical properties from elastic attributes. The transform is computed using measured and/or rock-physics-modeled well-log information and is posteriorly applied to seismically derived elastic attributes to predict the spatial distribution of petrophysical reservoir properties. This workflow was applied on the Darwin Field, located in the South Falkland Basin, which consists of two adjacent tilted fault blocks: Darwin East, which contains the discovery well 61/17-1, and Darwin West, which remains untested. The resulting rock-property volumes (water saturation, clay content, and total porosity) characterize the heterogeneity of the reservoir and were used to delineate the extension of the proven reservoir and to delineate other potential plays in the area. In addition, these property volumes can be used as inputs for static model generation and reserve estimation, as well as to optimize the exploration and exploitation plan for the area.
Quantitative interpretation using inverse rock-physics modeling on AVO data
Authors: Jensen Erling Hugo , Johansen Tor Arne , Avseth Per , Bredesen Kenneth
Published: August 2016

Quantitative seismic interpretation has become an important and critical technology for improved hydrocarbon exploration and production. However, this is typically a resource-demanding process that requires information from several well logs, building a representative velocity model, and, of course, high-quality seismic data. Therefore, it is very challenging to perform in an exploration or appraisal phase with limited well control. Conventional seismic interpretation and qualitative analysis of amplitude variations with offset (AVO) are more common tools in these phases. Here, we demonstrate a method for predicting quantitative reservoir properties and facies using AVO data and a rock-physics model calibrated with well-log data. This is achieved using a probabilistic inversion method that combines stochastic inversion with Bayes' theorem. The method honors the nonuniqueness of the problem and calculates probabilities for the various solutions. To evaluate the performance of the method and the quality of the results, we compare them with similar reservoir property predictions obtained using the same method on seismic-inversion data. Even though both approaches use the same method, the input data have some fundamental differences, and some of the modeling assumptions are not the same. Considering these differences, the two approaches produce comparable predictions. This opens up the possibility to perform quantitative interpretation in earlier phases than what is common today, and it might provide the analyst with better control of the various assumptions that are introduced in the work process.