bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of antenatal reflex DNA screening for Down’s syndrome
Authors: Wald Nicholas J , Bestwick Jonathan P
Published: April 2015

Objective

Maternal plasma DNA analysis has a high but imperfect antenatal Down’s syndrome screening performance. We aimed to determine the effect of combining DNA testing with current tests.

Methods

In our modelled screening protocol, women provide two samples, one serum sample for a Combined test, and a plasma sample for a possible DNA test. Women with a Combined test risk above a specified level have a DNA test using the plasma sample without the need to recall them for another sample and counselling (ie. in a reflex manner). Women with a failed DNA test after a second attempt using a fresh plasma sample have an Integrated test. Screening performance was estimated according to the proportion of women reflexed to DNA testing and compared with universal DNA testing.

Results

Reflexing 10% of women to a DNA test yields a 91% detection rate (DR) for a 0.025% false-positive rate (FPR) and no failed tests, compared with a 98% DR, 0.2% FPR and a 2.5% test failure rate with universal DNA testing (94% for 0.046% if 20% reflexed). DNA test failure rate has little influence on screening performance

Conclusion

Reflex DNA testing substantially reduces the FPR with a relatively small loss in detection compared with universal DNA testing, and reduces patient anxiety by avoiding the recall of women for DNA testing.
A qualitative study of sexual minority young people’s experiences of computerised therapy for depression
Authors: Lucassen Mathijs FG , Hatcher Simon , Fleming Theresa M , Stasiak Karolina , Shepherd Matthew J , Merry Sally N
Published: April 2015

Objective:

To describe the experiences of lesbian, gay, bisexual or sexual minority youth who used a form of computerised therapy (Rainbow SPARX) for depression.

Methods:

25 adolescents (20 with significant depressive symptoms) who had trialled Rainbow SPARX took part in semi-structured interviews. The general inductive approach was used to analyse interview data.

Results:

Feedback consisted of five main themes: ‘appealing aspects’; ‘applying it to real life’; ‘things to improve’; ‘aspects that did not appeal’; and ‘other themes’. Young people suggested that there should be more sexuality-specific (‘rainbow’) content in the computer program. Seventeen participants thought computerised therapy helped them feel better or less depressed.

Conclusions:

Consumer perspectives are increasingly being sought and this user input is especially useful for improving services. Our study provides important in-depth feedback on Rainbow SPARX from the perspective of sexual minority youth, and it highlights that computerised therapies can be successfully modified for groups traditionally under-served by mainstream mental health interventions.
The phenomenon of sling-shot buckling in stacked piezoelectric structures
Authors: Pavlou Michael J , Bottega William J
Published: April 2015

The behavior of stacked structures consisting of two centrally adhered beam-plates of different lengths and piezoelectric materials is studied for the case when they are subjected to a uniform electric field. A variational formulation is presented based on the properties of the individual substructures, and yields the self-consistent governing equations and constitutive relations for the piezoelectric laminate, as well as the associated boundary and matching conditions. The stability of equilibrium configurations is assessed through evaluation of the second variation of the potential energy under perturbation. The resulting stability function, together with the total potential energy, admits prediction of the behavior of the structure under a changing electric field. A closed form analytical solution is obtained, and numerical simulations based on this solution are presented which reveal the characteristic behavior of the piezoelectric laminate. A critical electric field is identified analytically, and it is shown that stacked structures comprised of certain combinations of piezoelectric materials exhibit sling-shot buckling (an instability where the deflection of the structure dynamically slings from one direction to the opposite direction) when the critical electric field is achieved. A parameter study demonstrates the dependence of the critical electric field on the geometric and material properties of the system.
Morphing thickness in airfoils using pneumatic flexible tubes and Kirigami honeycomb
Authors: Sun Jian , Scarpa Fabrizio , Liu Yanju , Leng Jinsong
Published: April 2015

The work describes a concept to morph the thickness of airfoils using a combination of pneumatic flexible tubes within a Kirigami honeycomb configuration that represents the wingbox structure. The configuration of the honeycomb/inflatable tube structure is composed by a pair of flexible tubes sandwiched between two custom honeycomb layouts. At zero input pressure, the tube assumes a sinusoidal shape, which is reduced to a straight configuration and increase of the airfoil thickness when pressure is applied. An analytical model is developed for design purposes to consider the actuation authority and thickness change provided by the system proposed. The results are benchmarked against experimental tests carried out on a reduced-scale demonstrator.
Building a Tier 2 Intervention
Authors: Kelley Elizabeth S. , Goldstein Howard
Published: April 2015

This article highlights the development process and data-driven decisions that characterized a 5-year iterative process of development and evaluation of a Tier 2 early language curriculum, Story Friends. This curriculum was specifically designed to be effective and feasible for high fidelity implementation in preschool settings. Vocabulary and comprehension lessons were embedded within storybooks. The stories and lessons were prerecorded so adults could easily administer the intervention to groups of three or four children. The development and selection of stories, intervention targets, instructional components, measurement schemes, and training materials were improved in response to data and feedback from an array of implementers. A series of research designs were used as the intervention was scaled up as warranted by efficacy results. The process of iterative development and refinement described in this article is one that is needed to avoid premature and expensive evaluations of underdeveloped treatments that too often produce weak intervention effects.
Does the Cambridge Automated Neuropsychological Test Battery (CANTAB) Distinguish Between Cognitive Domains in Healthy Older Adults?
Authors: Lenehan Megan E. , Summers Mathew J. , Saunders Nichole L. , Summers Jeffery J. , Vickers James C.
Published: April 2015

The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a semiautomated computer interface for assessing cognitive function. We examined whether CANTAB tests measured specific cognitive functions, using established neuropsychological tests as a reference point. A sample of 500 healthy older ( M = 60.28 years, SD = 6.75) participants in the Tasmanian Healthy Brain Project completed battery of CANTAB subtests and standard paper-based neuropsychological tests. Confirmatory factor analysis identified four factors: processing speed, verbal ability, episodic memory, and working memory. However, CANTAB tests did not consistently load onto the cognitive domain factors derived from traditional measures of the same function. These results indicate that five of the six CANTAB subtests examined did not load onto single cognitive functions. These CANTAB tests may lack the sensitivity to measure discrete cognitive functions in healthy populations or may measure other cognitive domains not included in the traditional neuropsychological battery.
Development of a Short Form of the Five-Factor Borderline Inventory
Authors: DeShong Hilary L. , Mullins-Sweatt Stephanie N. , Miller Joshua D. , Widiger Thomas A. , Lynam Donald R.
Published: April 2015

The Five-Factor Borderline Inventory (FFBI) is a 120-item dimensional measure of borderline personality disorder (BPD) that was developed from the description of BPD from the perspective of the Five-Factor Model. The FFBI includes 12 subscales and 1 total score. The current study created a short form of the FFBI (FFBI-SF) using item response theory analyses based on an undergraduate student sample that completed the FFBI. Based on the results, the final FFBI-SF included 48 items, with 4 items per subscale. The construct validity of the short form was compared with the original FFBI in five additional samples. The FFBI-SF showed strong convergence with other BPD scales and comparable convergent and discriminant validity with the FFM compared with the FFBI. The correlational profiles generated by the total score and subscales were highly convergent. Results of the current study suggest that the FFBI-SF may be an accessible and useful assessment tool of BPD.
Nonlinear transient response of rough symmetric two lobe hole entry hybrid journal bearing system
Authors: Sharma Satish C , Kushare Prashant B
Published: April 2015

The present paper describes the effect of surface roughness orientation pattern on the nonlinear transient response of symmetric two lobe capillary compensated hole entry hybrid journal bearing. Nonlinear equations of motion have been solved with the Runge-Kutta method. The stability of the journal bearing system has been studied by obtaining the journal center motion trajectories. The results of the study reveal that the surface roughness pattern significantly changes the stability of capillary compensated two lobe hole entry hybrid journal bearing. Hence, from the bearing stability point of view, a proper selection of the surface roughness pattern and bearing geometry is essential.
Fractional direct and inverse models of the dynamics of a human arm
Authors: Ventura André , Tejado Inés , Valério Duarte , Martins Jorge
Published: April 2015

When developing control architectures for physical human–robot interaction, it is often necessary to use a model of the human operator. This paper presents a comparative study of both direct and inverse models of the human arm at the elbow joint, relating the force at the hand with the arm angle and vice versa. Specifically, models of integer and fractional (commensurable and non-commensurable) nature are identified from the experiments. Likewise, for comparison purposes, neural networks models are also obtained. Taking into account their parameter variability, it is shown that fractional models are more adequate to describe human arm behaviour; they are simpler, more exact and with less parameter uncertainty.
Anti-Basal Ganglia Antibodies and Streptococcal Infection in ADHD
Authors: Aguilera-Albesa Sergio , Crespo-Eguílaz Nerea , Del Pozo José Luis , Villoslada Pablo , Sánchez-Carpintero Rocío
Published: April 2015

Objective: Group A Streptococcus has been associated with ADHD, tic disorders (TD), and obsessive–compulsive disorder (OCD) through anti-basal ganglia antibodies (ABGA). Method: We investigated the association between ABGA and streptococcal exposure with behavioral, motor, and cognitive measures in 38 children with ADHD not comorbid to OCD or TD (nc-ADHD) and in 38 healthy children. An additional group of 15 children with TD and/or OCD was examined. Results: ABGA titers were present in 3% of nc-ADHD patients and controls but in 27% of TD and/or OCD patients. Evidence of streptococcal exposure was similar between ADHD patients and controls living in the same urban area. Behavioral, motor, and cognitive measures were not associated with anti-streptococcal antibodies. Conclusion: ABGA do not distinguish nc-ADHD from controls. The differences in the frequency of streptococcal exposure in previous studies are determined by the dynamic nature of the infection rather than the behavioral phenotype of ADHD.
Effects of misaligned rails on the friction force–displacement curves of a linear ball bearing system in low-speed operation
Authors: Ohta Hiroyuki , Sato Yusuke , Ueki Yusuke
Published: April 2015

This paper investigates the effects of misaligned rails on the friction force–displacement curves of a linear ball bearing system (which consists of two sets of deep groove type non-recirculating linear ball bearings, a table and a bed). Experiments showed that the measured friction force–displacement curves, of the linear ball bearing system, with aligned rails were rectangular-shaped hysteresis loops, while the corresponding curves with misaligned rails were trapezoidal-shaped hysteresis loops. In addition, the hysteresis loop area increased as the distance between table side rails decreased. Next, calculations for the total friction force expression due to differential slip and elastic hysteresis loss, including the effects of the misaligned rails, are presented. It was confirmed that the calculated total friction force–displacement curves closely matched the measured friction force–displacement curves for both the aligned and misaligned rail cases.
Rising powers and state transformation: The case of China
Authors: Hameiri Shahar , Jones Lee
Published: April 2015

This article draws attention to the transformation of statehood under globalisation as a crucial dynamic shaping the emergence and conduct of ‘rising powers’. That states are becoming increasingly fragmented, decentralised and internationalised is noted by some international political economy and global governance scholars, but is neglected in International Relations treatments of rising powers. This article critiques this neglect, demonstrating the importance of state transformation in understanding emerging powers’ foreign and security policies, and their attempts to manage their increasingly transnational interests by promoting state transformation elsewhere, particularly in their near-abroad. It demonstrates the argument using the case of China, typically understood as a classical ‘Westphalian’ state. In reality, the Chinese state’s substantial disaggregation profoundly shapes its external conduct in overseas development assistance and conflict zones like the South China Sea, and in its promotion of extraterritorial governance arrangements in spaces like the Greater Mekong Subregion.
Fascin Overexpression Promotes Cholangiocarcinoma RBE Cell Proliferation, Migration, and Invasion
Authors: Zhao Haiying , Yang Fuquan , Zhao Wenyan , Zhang Chunjv , Liu Jingang
Published: April 2015

Fascin is overexpressed in various tumor tissues and is closely related to tumor metastasis and invasion. However, the role of fascin in cholangiocarcinoma RBE cells has not been clearly reported. This study aimed to establish a cholangiocarcinoma cell line with stable and high expression of fascin to observe the effect of fascin on cell proliferation, migration, and invasion. A fascin overexpression vector, pcDNA3.1-Fascin, was constructed and transfected into the human cholangiocarcinoma RBE cell line. The results of real-time polymerase chain reaction, Western blot, and immunofluorescence indicated that fascin was steadily and highly expressed in RBE cells. The results of 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide and colony formation assay indicated that upregulated fascin expression could enhance cholangiocarcinoma cell proliferation. The results of wound healing assay and transwell assay indicated that fascin could promote cholangiocarcinoma cell migration and invasion, and a further study found that the nuclear factor-κB signaling pathway was activated after upregulation of fascin, whereas E-cadherin expression in these cells was significantly decreased. Additionally, E-cadherin expression was significantly increased after inhibiting nuclear factor-κB activity using inhibitor or small interfering RNA, and E-cadherin expression was decreased by fascin overexpression after nuclear factor-κB inhibition, suggesting that nuclear factor-κB signaling pathway was not involved in the regulation of E-cadherin by fascin. In summary, the results of this study demonstrated that fascin effectively promoted cholangiocarcinoma RBE cell proliferation, migration, and invasion. This study provides evidence for fascin as a potential target in the treatment of cholangiocarcinoma.
Critical Action Research in Human Resource Development
Authors: Githens Rod Patrick
Published: April 2015

Critical approaches to HRD do not focus solely on improving organizational performance; instead, they address previously undiscussable issues such as power, politics, class, alternative work structures, sexism, racism, and heterosexism. As critical HRD often seeks to raise problems instead of immediately solve them, it is sometimes criticized for being elitist or detached from practice. This article addresses how critical approaches to action research can allow practitioners and researchers to integrate critical approaches into actual practice. Critical action research provides a mechanism for ensuring that critical HRD research is grounded in the realities of real-world practice. A model is presented for considering practitioner-oriented research in HRD, which forms the theoretical basis for using action research as a methodological stance for critical HRD. An overview is provided of foundational literature of critical HRD and action research, followed by a discussion of the practical implications for conducting critical action research within the HRD field.
Serious Gamification
Authors: Roth Steffen
Published: April 2015

We challenge the idea of the paradoxical nature of the concept serious games and ask how researchers and designers need to conceive of serious games so that they at all appear paradoxical. To develop and answer this question, we draw on a theory–method that considers all forms of observation as paradoxical. We then use the tetralemma, a structure from traditional Indian logics, to resolve the paradox of serious games into this larger paradox of observation. Consequently, serious games may only be considered a paradox if we presume realities and define games as deviations therefrom. The increasing gamification of society, however, does not allow realities to be defined in contrast to games anymore. We therefore conclude that serious games do not represent particularly paradoxical forms of games, but rather next levels of reflexivity in communication design and in the self-definitions of next societies.
Inquiry in television cooking shows
Authors: Matwick Kelsi , Matwick Keri
Published: April 2015

This article raises the important question as to why cooking, a seemingly mundane practice, performs social and cultural functions that go much beyond cooking, cooking instructions, and food preparation, and specifically how it functions in a media context. By integrating theories about inquiry, discourse analysis, gender, and sociolinguistics, the article makes an important contribution to the growing literature on contemporary discourse in the media. The research was conducted on popular television cooking channels, the Food Network and the Cooking Channel, and involved close analyses of a sample of instructional cooking shows. The article is an exploration of social and communicative dynamics inherent in cooking, especially from the public discourse of contemporary cooking shows.
Combination therapy in chronic kidney disease?
Authors: Juncos Luis I. , Caputo Joaquin
Published: April 2015

The renin-angiotensin system (RAS) plays a fundamental role in preserving the circulation and yet, it may be injurious to heart and blood vessels and may also allow, and sometimes hasten, kidney disease progression. Thus, effective RAS inhibition may be a major pharmacologic necessity to control hypertension, to decrease cardiovascular complication, and to inhibit kidney disease progression. Unfortunately, the beneficial effects attained in the management of renal disease sometimes are incomplete. The reasons for these inadequate outcomes may include angiotensin escape or excessive local angiotensin production. Two pharmacologic strategies have been proposed to overcome this drawback including higher than recommended doses of RAS inhibitors and the combination of two different RAS inhibitors. However, three large studies have shown that these more intensive pharmacologic approaches should be treated with caution when applied to high-risk patients, as organ perfusion may fall to critical levels that may cause severe complications. Nevertheless, intensive RAS inhibition (including combination therapy) may be the sole alternative in patients with chronic kidney disease (CKD) in whom other therapeutics options have failed. In these cases, adequate precautions including close clinical and laboratory follow up should prevent major complications.
Training of Carbohydrate Estimation for People with Diabetes Using Mobile Augmented Reality
Authors: Domhardt Michael , Tiefengrabner Martin , Dinic Radomir , Fötschl Ulrike , Oostingh Gertie J. , Stütz Thomas , Stechemesser Lars , Weitgasser Raimund , Ginzinger Simon W.
Published: April 2015

Background: Imprecise carbohydrate counting as a measure to guide the treatment of diabetes may be a source of errors resulting in problems in glycemic control. Exact measurements can be tedious, leading most patients to estimate their carbohydrate intake. In the presented pilot study a smartphone application (BEAR), that guides the estimation of the amounts of carbohydrates, was used by a group of diabetic patients. Methods: Eight adult patients with diabetes mellitus type 1 were recruited for the study. At the beginning of the study patients were introduced to BEAR in sessions lasting 45 minutes per patient. Patients redraw the real food in 3D on the smartphone screen. Based on a selected food type and the 3D form created using BEAR an estimation of carbohydrate content is calculated. Patients were supplied with the application on their personal smartphone or a loaner device and were instructed to use the application in real-world context during the study period. For evaluation purpose a test measuring carbohydrate estimation quality was designed and performed at the beginning and the end of the study. Results: In 44% of the estimations performed at the end of the study the error reduced by at least 6 grams of carbohydrate. This improvement occurred albeit several problems with the usage of BEAR were reported. Conclusions: Despite user interaction problems in this group of patients the provided intervention resulted in a reduction in the absolute error of carbohydrate estimation. Intervention with smartphone applications to assist carbohydrate counting apparently results in more accurate estimations.
DialBetics With a Multimedia Food Recording Tool, FoodLog
Authors: Waki Kayo , Aizawa Kiyoharu , Kato Shigeko , Fujita Hideo , Lee Hanae , Kobayashi Haruka , Ogawa Makoto , Mouri Keisuke , Kadowaki Takashi , Ohe Kazuhiko
Published: April 2015

Background: Diabetes self-management education is an essential element of diabetes care. Systems based on information and communication technology (ICT) for supporting lifestyle modification and self-management of diabetes are promising tools for helping patients better cope with diabetes. An earlier study had determined that diet improved and HbA1c declined for the patients who had used DialBetics during a 3-month randomized clinical trial. The objective of the current study was to test a more patient-friendly version of DialBetics, whose development was based on the original participants’ feedback about the previous version of DialBetics. Method: DialBetics comprises 4 modules: data transmission, evaluation, exercise input, and food recording and dietary evaluation. Food recording uses a multimedia food record, FoodLog. A 1-week pilot study was designed to determine if usability and compliance improved over the previous version, especially with the new meal-input function. Results: In the earlier 3-month, diet-evaluation study, HbA1c had declined a significant 0.4% among those who used DialBetics compared with the control group. In the current 1-week study, input of meal photos was higher than with the previous version (84.8 ± 13.2% vs 77.1% ± 35.1% in the first 2 weeks of the 3-month trial). Interviews after the 1-week study showed that 4 of the 5 participants thought the meal-input function improved; the fifth found input easier, but did not consider the result an improvement. Conclusions: DialBetics with FoodLog was shown to be an effective and convenient tool, its new meal-photo input function helping provide patients with real-time support for diet modification.
Postsecularism as colonialism by other means
Authors: Bugyis Eric
Published: April 2015

The claim that we are entering a “postsecular” age supposedly marks a new openness toward public religion, which was expected to wither as societies modernized. Similarly, postcolonial theory has attempted to think through the public resurgence of indigenous culture after the collapse of “Western” political regimes, which also predicted and prescribed its privatization. Drawing on the work of Partha Chatterjee, this paper argues that the “postsecular,” particularly as it is deployed by Jürgen Habermas and Alasdair MacIntyre, seeks to seduce religious believers and practitioners into just this same logic of self-colonization so that they might be recognized as defenders of an increasingly insecure, liberal nation-state against those who might seek to take advantage of its vulnerability.
The Hispanic pharmacist: Value beyond a common language
Authors: Cipriano Gabriela C , Andrews Carlota O
Published: April 2015

Objective:

To highlight the added value of bilingual Hispanic pharmacists in the care of Hispanic patients by sharing their patients’ language and culture.

Inability to speak and/or write in the patients’ native language severely impairs our best efforts to deliver good health care. This is a widely recognized cause of non-compliance or less than favorable possible health outcomes in Hispanic patients. What has received less attention, however, is that the ability to speak Spanish alone may not remove completely the barrier for non-compliance among Hispanics. Bilingual Spanish–English pharmacists do not have the language barrier, but if they do not recognize and accept cultural differences, their impact in their patients’ response may still be limited.

Conclusion:

It is time to recognize the added value of Hispanic pharmacists to Hispanic patients’ health outcomes. Understanding and sharing a culture allows the pharmacist to make medication education and interventions relevant to the patient and spark interest in their own health care. Thus, in caring for the health of our patients, cultural barriers may be more challenging to conquer than language barriers; deep appreciation and acceptance of our patients’ belief system cannot be acquired by just reading about it, having a computerized program, or hiring an interpreter.
Forecasting the 2012 and 2014 Elections Using Bayesian Prediction and Optimization
Authors: Rigdon Steven E. , Sauppe Jason J. , Jacobson Sheldon H.
Published: April 2015

This article presents a data-driven Bayesian model used to predict the state-by-state winners in the Senate and presidential elections in 2012 and 2014. The Bayesian model takes into account the proportions of polled subjects who favor each candidate and the proportion who are undecided, and produces a posterior probability that each candidate will win each state. From this, a dynamic programming algorithm is used to compute the probability mass functions for the number of electoral votes that each presidential candidate receives and the number of Senate seats that each party receives. On the final day before the 2012 election, the model gave a probability of (essentially) one that President Obama would be reelected, and that the Democrats would retain control of the U.S. Senate. In 2014, the model gave a final probability of .99 that the Republicans would take control of the Senate.
Instructional Ventures
Authors: Prus Robert , McLuhan Arthur
Published: April 2015

Beyond promoting a mode of ethnographic inquiry that is conceptually informed and rigorously attentive to the actualities of human lived experience, this article encourages a more sustained, comparative analysis of the ways that administrators and instructors deal with education as a collectively developed venture. After (a) establishing an analytic frame for a more comprehensive approach to education as a socially engaged process, this article focuses on (b) the administration of educational programs and (c) providing instruction as activity “in the making,” using an ethnographic study of two Protestant Christian seminaries as an empirical, illustrative case. While providing an agenda for examining the ways that people generate and sustain instructional ventures in any educational context, the material presented here also represents an important focal point for theoretically, conceptually, and methodologically integrating research that attends to the ways that instructional (administrative and teaching) activities are accomplished in practice.
Time Pressure and Challenge Appraisal as Predictors of Job Satisfaction
Authors: Malik Saleem Akhtar
Published: April 2015

The study has been conducted to investigate the impact of time pressure and challenge appraisal on job satisfaction experienced by Pakistani university teachers in the twin cities of Islamabad and Rawalpindi. It is the first study which has investigated the relationships between time pressure, challenge appraisal, and job satisfaction in the backdrop of a poly-chronic society and compared the findings with those of a study carried out in a mono-chronic society. Data were collected through a survey by administering questionnaires to the respondents. The findings reveal that Pakistani respondents experience a lesser level of time pressure when compared with the German respondents. Also, there has been lesser variability in time pressure of Pakistani respondents in comparison with the German respondents. The study also finds that, like their German counterparts, Pakistani university teachers consider time pressure as a challenge-related stress. The correlation between time pressure and challenge shows a lower degree of relationship in case of Pakistani respondents compared with a moderate degree for German respondents.
Leaving the Faith
Authors: Glass Jennifer L. , Sutton April , Fitzgerald Scott T.
Published: April 2015

Research revealing associations between Conservative Protestantism and lower socioeconomic status is bedeviled by questions of causal inference. Religious switching offers another way to understand the causal ordering of religious participation and demographic markers of class position. In this article, we look at adolescents who change their religious affiliation across four waves of data from the National Longitudinal Study of Adolescent Health (Add Health) and then observe their transition to adulthood using four crucial markers—completed educational attainment, age at first marriage, age at first birth, and income at the final wave. Results show that switching out of a Conservative Protestant denomination in adolescence can alter some, but not all, of the negative consequences associated with growing up in a Conservative Protestant household. Specifically, family formation is delayed among switchers, but early cessation of education is not.
Utilizing Multidimensional Measures of Race in Education Research
Authors: Irizarry Yasmiyn
Published: April 2015

Education scholarship on race using quantitative data analysis consists largely of studies on the black-white dichotomy and, more recently, on the experiences of students within conventional racial-ethnic categories (white, Hispanic/Latina/o, Asian, black). Despite substantial shifts in the racial and ethnic composition of American children, studies continue to overlook the diverse racialized experiences for students of Asian and Latina/o descent, the racialization of immigration status, and the educational experiences of Native American students. This study provides one possible strategy for developing multidimensional measures of race using large-scale datasets and demonstrates the utility of multidimensional measures for examining educational inequality, using teacher perceptions of student behavior as a case in point. With data from the first grade wave of the Early Childhood Longitudinal Study, Kindergarten Cohort of 1998–1999, I examine differences in teacher ratings of “externalizing problem behaviors” and “approaches to learning” across 14 racialized subgroups at the intersections of race, ethnicity, and immigrant status. Results show substantial subgroup variation in teacher perceptions of problem and learning behaviors and highlight key points of divergence and convergence within conventional racial-ethnic categories.
Exploring Client-Centered Care Experiences in In-Patient Rehabilitation Settings
Authors: Bamm Elena L. , Rosenbaum Peter , Wilkins Seanne , Stratford Paul , Mahlberg Nadilein
Published: April 2015

Patient or client-centered care has been widely accepted as an essential component of health care delivery in many countries. Few studies explore actual implementation of client-centered principles and clients’ and health care providers’ (HCPs) experiences with these approaches. Our objective was to explore current models of delivery of rehabilitation services from the perspectives of patients, families, and HCPs. We conducted semistructured interviews with patients, families, and HCPs of one of four rehabilitation facilities in South-Central Ontario, Canada. Being on common grounds/Working toward client set goals was the main category identified by both clients and HCPs. Although successful partnerships were created, the majority of clients assumed a passive position. Clients needed more information about the rehabilitation progression and alternative treatment options. The results of the study suggest that we need to encourage and educate clients to become motivated, well-informed, proactive participants in their care.
Effects of welding parameters on fibre laser lap weldability of galvanised DP1000 steel
Authors: Wei S. T. , Liu R. D. , Lv D. , Lin L. , Lu X. F. , Ding S. W.
Published: April 2015

A 1000 MPa galvanised dual phase steel was fibre laser lap welded by different welding parameters. The surface appearance, cross-section macrostructure and tensile shear properties of laser lap welds were evaluated. The different methods for improving the laser lap weldability of galvanised steel were analysed. The results showed that the increasing laser power resulted in the formation of the keyhole, which could be used as the escape route for the vapourised zinc formed at the faying surface. Therefore, the weld defects, such as spatter, cavity and blow hole, were eliminated, and the full penetrated laser lap welds with smooth surface appearances were acquired. A proper joint gap also worked as the escape route for the zinc vapour and led to the formation of sound welds. Adding proper preheating procedures improved the mechanical properties of the welds to some degree, but weld defects still existed owing to the residual zinc.
Inclusions, microstructure and properties of flux copper backing submerged arc weld metal
Authors: Yan N. , Yu S. F. , Chen Y.
Published: April 2015

This paper investigates the effect of Ce on inclusions, microstructure and mechanical properties of the weld metal in flux copper backing submerged arc welding. The results show, with the addition of Ce in weld metal, the inclusions are mainly composed of Al2O3, MnO, SiO2, TiO, Ce2S3, CeS and Ce2O2S compound, and the proportion of the inclusions of < 1.0 μm in size increased. In competitive nucleation, acicular ferrite nucleates on the oxysulphides of Ce and inhibits the formation of proentectoid ferrite and ferrite side plate. This led to a high proportion of acicular ferrite, good mechanical properties of weld metal. A small lattice disregistry between CeS, Ce3S4, Ce2O2S and acicular ferrite contributed to low energy for nucleation of acicular ferrite.
Decreasing cost effectiveness of testing for latent TB in HIV in a low TB incidence area
Authors: Capocci Santino , Smith Colette , Morris Stephen , Bhagani Sanjay , Cropley Ian , Abubakar Ibrahim , Johnson Margaret , Lipman Marc
Published: April 2015

Testing for latent tuberculosis infection (LTBI) in HIV-infected persons in low tuberculosis (TB) incidence areas is often recommended. Using contemporary, clinical data, we report the yield and cost-effectiveness of testing all HIV attendees, two current UK strategies and no LTBI testing.

Economic modelling was performed utilising 10-year follow up data from a large HIV clinical cohort. Outcomes were numbers of cases of active TB and incremental cost per quality-adjusted life year (QALY) gained.

Between 2000 and 2010, 256 people were treated for TB/HIV co-infection. 72 (28%) occurred ≥3 months after HIV diagnosis and may have been prevented by LTBI testing. Between 2000 and 2005, the incremental cost per QALY gained for the British HIV Association (BHIVA) and UK National Institute of Care Excellence (NICE) strategies, and testing all clinic attendees was €6270, €6998 and €33 473, respectively. These rose to €9332, €32 564 and €74 067, respectively, between 2005 and 2010. Probabilistic sensitivity analysis suggested that at a threshold of €24 000 per additional QALY, the most cost-effective strategies would be NICE or testing all in 2000–2005 and BHIVA during 2005–2010.

Both UK testing regimens missed cases but are cost-effective compared with no testing. Using recent data, they all became more expensive, suggesting that alternative or more targeted TB testing strategies must be considered.
Antagonistic implications of sarcopenia and abdominal obesity on physical performance in COPD
Authors: van de Bool Coby , Rutten Erica P.A. , Franssen Frits M.E. , Wouters Emiel F.M. , Schols Annemie M.W.J.
Published: April 2015

Decreased physical performance due to loss of muscle mass (i.e.sarcopenia) is prevalent in ageing and appears more pronounced in chronic disease. A comprehensive profile of the sarcopenic phenotype in chronic obstructive pulmonary disease (COPD) is not yet available. The aim of the present study was to characterise prevalence, functional implications and predictive value of sarcopenia with or without abdominal obesity in Dutch COPD patients eligible for pulmonary rehabilitation.

505 COPD patients (aged 37–87 years; 57% male) underwent assessment of lung function, body composition and physical functioning, before entering pulmonary rehabilitation. Sarcopenia was assessed by appendicular skeletal muscle index (ASMI) and abdominal obesity by android/gynoid percentage fat mass (A/G%FM) using dual energy X-ray absorptiometry.

86.5% of patients were sarcopenic and showed lower physical functioning, while coexistent abdominal obesity (78.0%) resulted in higher physical functioning. Implications on endurance were less pronounced in women. The predictive value for physical functioning was higher for the “three-compartment” model (ASMI, bone mineral content and A/G%FM) than the “two-compartment” model (fat-free mass index and fat mass index) or “one-compartment” model (body mass index).

In patients eligible for pulmonary rehabilitation, sarcopenia is highly prevalent in all body mass index categories and associated with impaired strength, and in men also with decreased endurance. Abdominal obesity seems to have protective effects on physical functioning. ASMI is a better predictor for physical functioning than fat-free mass index.
Airflow limitation by the Global Lungs Initiative equations in a cohort of very old adults
Authors: Turkeshi Eralda , Vaes Bert , Andreeva Elena , Matheï Catharina , Adriaensen Wim , Van Pottelbergh Gijs , Degryse Jean-Marie
Published: April 2015

The cut-off for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) defining airflow limitation for chronic obstructive pulmonary disease (COPD) is still contested. We assessed airflow limitation prevalence by the lower limit of normal (LLN) of Global Lungs Initiative (GLI) 2012 reference values and its predictive ability for all-cause mortality and hospitalisation in very old adults (aged ≥80 years) compared with the fixed cut-off.

In a Belgian population-based prospective cohort of 411 very old adults, airflow limitation prevalence by the 5th percentile of GLI 2012 z-scores (GLI-LLN) and fixed cut-off (0.70) were compared with COPD reported by general practitioners (GPs). Survival and Cox regression multivariable analysis assessed the association of airflow limitation by both cut-offs with 5-year all-cause mortality and first hospitalisation at 3 years.

9.2% had airflow limitation by GLI-LLN and 27% by fixed cut-off, without good agreement (kappa coefficient ≤0.40) with GP-reported COPD (9%). Only airflow limitation by GLI-LLN was independently associated with mortality (adjusted hazard ratio 2.10, 95% CI 1.30–3.38). FEV1/FVC <0.70 but ≥GLI-LLN (17.8%) had no significantly higher risk for mortality or hospitalisation.

In a cohort of very old adults, airflow limitation by GLI-LLN has lower prevalence than by fixed cut-off, independently predicts all-cause mortality and does not miss individuals with significantly higher all-cause mortality and hospitalisation.
Understanding asthma-specific quality of life: moving beyond asthma symptoms and severity
Authors: Stucky Brian D. , Sherbourne Cathy D. , Edelen Maria Orlando , Eberhart Nicole K.
Published: April 2015

This study identifies the unique contributions of asthma severity, symptoms, control and generic measures of quality of life (QoL) to asthma-specific QoL, as measured by the 12-item RAND Negative Impact of Asthma on Quality of Life scale (RAND-IAQL-12).

Using a sample of 2032 adults with asthma, we conducted multiple regression analyses that sequentially examined hypothesised predictors of asthma-specific QoL. The change in variance accounted for and total unique variance accounted for is calculated as hypothesised predictors are added in each step.

Our results indicate that asthma severity and asthma symptoms are strong predictors of asthma-specific QoL only when not controlling for aspects of asthma control. In regression models that include other aspects of asthma control, the contributions of both asthma symptoms and severity were substantially reduced, with asthma control and aspects of QoL related to social roles and activities emerging as the strongest predictors of asthma-specific QoL.

These findings suggest that researchers measuring the impact of asthma on QoL should also consider the importance of asthma control as measured by the RAND Asthma Control Measure (RAND-ACM) and generic QoL scales that measure aspects of daily life that are uniquely affected by asthma.
Effect of initial calorie intake via enteral nutrition in critical illness: a meta-analysis of randomised controlled trials
Authors: Tian Feng , Wang Xinying , Gao Xuejin , Wan Xiao , Wu Chao , Zhang Li , Li Ning , Li Jieshou
Published: April 2015

Introduction

Guidelines support the use of enteral nutrition to improve clinical outcomes in critical illness; however, the optimal calorie and protein intake remains unclear. The purpose of this meta-analysis was to quantitatively analyze randomised controlled trials with regard to clinical outcomes related to varying calorie and protein administration in critically ill adult patients.

Method

We searched Medline, EMBASE, and Cochrane databases to identify randomised controlled trials that compared the effects of initially different calorie and protein intake in critical illness. The risk ratio (RR) and weighted mean difference with 95% confidence intervals (CI) were calculated using random-effects models. The primary endpoint was mortality; secondary endpoints included infection, pneumonia, gastrointestinal intolerance, hospital and intensive care unit lengths of stay, and mechanical ventilation days.

Results

In the eight randomised controlled trials that enrolled 1,895 patients there was no statistical difference between the low-energy and high-energy groups in mortality (RR, 0.90; 95% CI, 0.71 to 1.15; P = 0.40), infection (RR, 1.09; 95% CI, 0.92 to 1.29; P = 0.32), or the risk of gastrointestinal intolerance (RR, 0.84; 95% CI, 0.59 to 1.19; P = 0.33). In subgroup analysis, the low-energy subgroup, fed 33.3 to 66.6% of goal energy, showed a lower mortality than the high-energy group (RR, 0.68; 95% CI, 0.51 to 0.92; P = 0.01). The improvements in mortality and gastrointestinal intolerance were absent when calorie intake was >66.6% of goal energy in the low-energy group. High-energy intake combined with high-protein intake reduced the infections (RR, 1.25; 95% CI, 1.04 to 1.52; P = 0.02); however, when the daily protein intake was similar in both groups, a high-energy intake did not decrease the infections. No statistical differences were observed in other secondary outcomes.

Conclusion

This meta-analysis indicates that high-energy intake does not improve outcomes and may increase complications in critically ill patients who are not malnourished. Initial moderate nutrient intake (33.3 to 66.6% of goal energy), compared to high energy, may reduce mortality, and a higher protein intake combined with high energy (≥0.85 g/kg per day) may decrease the infection rate. However, the contribution of energy versus protein intake to outcomes remains unknown.
Leprous lesion presents enrichment of opportunistic pathogenic bacteria
Authors: Silva Paulo ES , Costa Patrícia S , Ávila Marcelo P , Suhadolnik Maria Luíza S , Reis Mariana P , Salgado Ana Paula C , Lima Mário FR , Chartone-Souza Edmar , Nascimento Andréa MA
Published: April 2015

Leprosy is a chronic infectious disease that remains a major challenge to public health in endemic countries. Increasing evidence has highlighted the importance of microbiota for human general health and, as such, the study of skin microbiota is of interest. But while studies are continuously revealing the complexity of human skin microbiota, the microbiota of leprous cutaneous lesions has not yet been characterized. Here we used Sanger and massively parallel small sub-unit rRNA (SSU) rRNA gene sequencing to characterize the microbiota of leprous lesions, and studied how it differs from the bacterial skin composition of healthy individuals previously described in the literature. Taxonomic analysis of leprous lesions revealed main four phyla: Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria, with Proteobacteria presenting the highest diversity. There were considerable differences in the distribution of Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria, with the first two phyla enriched and the other markedly diminished in the leprous lesions, when compared with healthy skin. Propionibacterium, Corynebacterium and Staphylococcus, resident and abundant in healthy skin, were underrepresented in skin from leprous lesions. Most of the taxa found in skin from leprous lesions are not typical in human skin and potentially pathogenic, with the Burkholderia, Pseudomonas and Bacillus genera being overrepresented. Our data suggest significant shifts of the microbiota with emergence and competitive advantage of potentially pathogenic bacteria over skin resident taxa.