bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey on the Current State of Endotracheal Intubation Among the Critically Ill
Authors: Seisa Mohamed O. , Gondhi Venkatesh , Demirci Onur , Diedrich Daniel A. , Kashyap Rahul , Smischney Nathan J.
Published: June 2016

Objectives:

In the last decade, the practice of intubation in the intensive care unit (ICU) has evolved. To further examine the current intubation practice in the ICU, we administered a survey to critical care physicians.

Design:

Cross-sectional survey study design.

Setting:

Thirty-two academic/nonacademic centers nationally and internationally.

Measurements and Main Results:

The survey was developed among a core group of physicians with the assistance of the Survey Research Center at Mayo Clinic, Rochester, Minnesota. The survey was pilot tested for functionality and reliability. The response rate was 82 (51%) of 160 among the 32 centers. Although propofol was the induction drug of choice, there was a significant difference with actual ketamine use and those who indicated a preference for it (ketamine: 52% vs 61%; P < .001). The most common airway device used for intubation was direct laryngoscopy (Miller laryngoscope blade) at 56 (68%) followed by video laryngoscopy at 26 (32%). Most (>90%) indicated that they have a difficult airway cart, but only 55 (67%) indicated they have a documented plan to handle a difficult airway with even lower results for documented review of adverse events (49%).

Conclusion:

Although propofol was the induction drug of choice, ketamine was a medication that many preferred to use, possibly relating to the fact that the most common complication postintubation is hypotension. Direct laryngoscopy remains the primary airway device for endotracheal intubation. Finally, although the majority stated they had a difficult airway cart available, most did not have a documented plan in place when encountering a difficult airway or a documented process to review adverse events surrounding intubation.
Victim Characteristics, Situational Factors, and the Lethality of Urban Gun Violence
Authors: Altheimer Irshad , Schaible Lonnie M. , Klofas John , Comeau Michelle
Published: June 2016

The objective of this study is to hone in on the contextual, social, and individual characteristics that influence lethal outcomes across shootings. Although most criminological research focuses on differential outcomes for gun violence relative to nongun violence, we argue that great insight can be drawn through examining shootings in isolation. We focus on five ways that shooting outcomes vary: the number of shots fired, the number of times the victim was hit, where the victim was hit, the number of victims that were hit, and whether the shooting resulted in a fatality. Building on the adversary effects hypothesis and public health research on the impact of gunshot wound volume and location, we examine the factors that account for variation across shooting outcomes. Our analysis of data from the Rochester Shooting Database suggests that both adversary effects and random factors influence shooting outcomes. In addition, the results also reveal that adversary effects are more important during some stages of a shooting than others. The implications of these findings are discussed.
Identity and Personality Influences on Donating Money, Time, and Blood
Authors: White Katherine M. , Poulsen Brooke E. , Hyde Melissa K.
Published: June 2016

Building on previous research that examined role identity in relation to volunteering, this study explored the impact of identity and personality for three giving behaviors: donating money, volunteering time, and donating blood. This study examined the contribution of general identity as a helpful person, role identity specific to each behavior, and personality traits of conscientiousness and agreeableness within the decision-making framework of the theory of planned behavior (TPB). Participants ( N = 203) completed a questionnaire measuring role identity (general and behavior specific), conscientiousness and agreeableness, and the TPB constructs of attitude, subjective norm, perceived behavioral control, and intention to donate. Three months later, participants reported whether they had engaged in each behavior. The results demonstrated that identity as a donor (i.e., specifically of money, time, or as a blood donor) emerged as more important in determining people’s giving actions than general role identity as a helpful person or global personality characteristics.
MEMS gyroscope/TAM-integrated attitude estimation based on moving horizon estimation
Authors: Huang Jingli , Zhao Guorong , Zhang Xiangyu
Published: June 2016

To improve the accuracy of the attitude sensor micro electro mechanical system gyroscope in low cost satellite, a nonlinear moving horizon estimation algorithm based on micro-electro mechanical system gyroscope/three-axis magnetometer is proposed in this paper. First, a quaternion micro-electro mechanical system gyroscope/three-axis magnetometer-integrated attitude estimation model is established so as to improve the accuracy of micro-electro mechanical system gyroscope. Thanks to the concealment and autonomy, these two low cost sensors have great potential in the military area. Second, taking advantage of optimal problem in coping with constraints, a real time moving horizon estimation algorithm with equality constraint is designed to deal with the disability of solving quaternion normalization analytically in the frame work of Kalman. In this algorithm, Gauss–Newton iterative method is used to obtain the optimal state estimation in the “window”. Meanwhile, strong tracking filter of arrival cost is designed outside of the “window” to enhance system robustness for that three-axis magnetometer is vulnerable to external interference. Third, the proposed MHE is applied in the micro-electro mechanical system gyroscope/three-axis magnetometer attitude estimation system. The simulation results show that the method has higher accuracy and robustness.
Optimization design of unitized panels with stiffeners in different formats using the evolutionary strategy with covariance matrix adaptation
Authors: Yang Weizhu , Yue Zhufeng , Li Lei , Yang Fan , Wang Peiyan
Published: June 2016

Curvilinear stiffener concept has been introduced to aircraft panel structures most recently for possible further weight reduction during optimization design. However, due to enlarged design space and high design complexity, more computational time is needed to optimize curvilinearly stiffened panels. Considering the requirement for both lighter structure and less design time, optimization designs of a unitized panel with stiffeners in three different formats, i.e. curvilinear, oblique, and evenly distributed straight, are conducted under various loading conditions to figure out which stiffener format should be selected in a real design environment. Four single loading cases with different compression-shear ratios and a set of multiple load cases are considered. Evolution strategy with covariance matrix adaption is combined with sequential quadratic programming to seek out the optimum structure with minimum mass taking into account buckling and strength constraints. Comparative analysis of the optimization results indicates that evenly distributed straight format is suitable for compression-dominant loading conditions whereas curvilinear format become superior in case that shear loading is considerable or multiple biaxial compression and shear loads are applied. Besides, curvilinear format adds more design flexibilities to the stiffeners, which enables them to play a more important role in the optimized structures. Furthermore, evolution strategy with covariance matrix adaption is found to be more efficient than particle swarm optimization for this optimization problem. This study can provide a useful guidance for future optimization design of aircraft structures.
Does Infrastructure Affect Human Development? Evidences from Odisha, India
Authors: Mohanty Amar Kumar , Nayak Narayan Chandra , Chatterjee Bani
Published: June 2016

In pursuit of achieving and maintaining high human development, infrastructure is said to play a critical role. The present paper examines the spatial disparities in infrastructural facilities and human development across 30 districts of Odisha, and consequently, tries to find out the impact of infrastructure on human development in the state. The study records significant regional disparities in the level of human development as well as infrastructural development in Odisha. It applies panel data model to examine the effects of composite infrastructure index and its individual components on human development and its three dimensions. The study establishes close linkage between infrastructure and human development. Telecommunication, postal services, village electricity, banking, school, PTR and drinking water facilities play significant roles in the process of attaining high level of human development. The less developed districts of Odisha are primarily dominated by tribal population. In order to achieve high and sustained human development, the state needs to prioritize its efforts towards infrastructure creation for these regions.
Assessing India’s Progress towards an Open Defecation Free Nation
Authors: Shukla Vachaspati
Published: June 2016

The census 2011 based information on basic amenities offers an opportunity to assess India’s progress towards access to toilet facility, the first step to end the open defecation, with a decade long Total Sanitation Campaign underway. Evaluating the data of census 2001 and 2011, it turns out that progress in this sphere is slow and non-inclusive. It entirely excludes poorest states with high incidence of toilet deprivation. Progress towards this in India offers a case where the fraction of households without toilet facility decreased along with an increase in its number. The article argues that increase in the number of households without toilet facility is indicative of big policy failure. It suggests that government should take appropriate measures to put an end to open defecation. At the end, article proposes that the performance evaluation in this regard may not merely be based on fraction but aggregate number as well.
Periodic structure with interconnected nonlinear electrical networks
Authors: Yan Linjuan , Bao Bin , Guyomar Daniel , Lallart Mickaël
Published: June 2016

This article aims at investigating the filtering abilities of periodic structures with nonlinear interconnected synchronized switch damping on inductor electrical networks. Periodic structures without electrical networks themselves naturally have the function of filtering since the structure response breaks into pass bands and stop bands when the structure is excited by an external force with multiple or varying frequencies. Introduction of linear electrical networks in the periodic structure makes stop bands of the structure wider than that of the structure without electrical networks. However, nonlinear piezoelectric electrical networks may have better effect on the mechanical wave attenuation than linear piezoelectric electrical networks in terms of frequency band. Therefore, this article proposes a piezoelectric periodic structure with nonlinear interconnected synchronized switch damping on short-circuit/synchronized switch damping on inductor electrical network. A transfer matrix formulation including the interconnected electrical network is also proposed for deriving the characteristics of elastic wave propagation. The results show that the proposed technique permits enhancing the damping abilities in particular frequency bands compared to electrically independent periodic cells, which, combined with structural tailoring, would allow achieving high damping performance.
“Your Professor Will Know You as a Person”
Authors: Chory Rebecca M. , Offstein Evan H.
Published: June 2016

Over the past 30 years, several management educators have urged faculty to reexamine their relationships with students. To do this, many have proposed novel metaphors to reconceptualize the faculty-to-student relationship. These include embracing students not as pupils to be taught but rather as clients, consumers, and even employees. At the heart of these metaphors, though, is a subtle and not-so-subtle pressure to build more intimate, personal, and close relationships with students. As more and more stories surface in the scholarly and practitioner press about “close relationships” that have devolved into sad and disappointing outcomes for students, faculty, and universities, it is necessary to revisit the core assumption that closer is better. In this essay, we describe the forces driving more personal relationships between faculty and students. Next, we question the assumptions along with the unintended consequences of adopting more intimate relationships with students. Finally, we conclude by challenging management educators to rethink the notion of professional calling along with the notion of pedagogical caring. To be sure, we offer some prescriptions and principles to help management educators navigate the student–faculty relationship—a relationship, we believe, more in flux now than in any other time in the history of higher education.
Low-velocity impact response of sandwich composites with different foam core configurations
Authors: Al-Shamary Aidel Kadum Jassim , Karakuzu Ramazan , Özdemir Okan
Published: June 2016

In this study, the low-velocity impact response of sandwich composites consisting of different foam core configurations is investigated experimentally. Polyvinyl chloride foam core and glass fibers were used as core material and face sheets, respectively. A number of tests under various impact energy levels for three different sandwich composite configurations were conducted with Ceast 9350 Fractovis Plus impact testing machine in order to improve the energy absorption capacity of sandwich composites panels. Absorbed energies, maximum loads and the maximum deflection of sandwich panels were obtained for each impact energy level. As the impact energy was increased, fiber fractures at face sheets, delaminations between glass-epoxy layers, core fractures, and indentations failures were observed by visual inspection. According to the obtained results, the sandwich composite with proposed new foam core design with two internal face sheets exhibits high energy absorption capacity compared to sandwich panels formed by sandwiching a polyvinyl chloride foam core between glass fabric face sheets. Maximum contact force values decrease by increase of number of core material.
Post-colonialism perspectives on educational competition
Authors: Yeh Chuan-Rong
Published: June 2016

Educational competition has always been the puzzle issue of educational researches. In this article, I analyze several aspects of educational competition within the perspective of post-colonialism discourse. In the political aspect, Taiwanese education is linked with political power, to present the post-colonial spirit by continuing dynastic change. In the economic aspect, education is considered as an effective investment to increase economic prosperity and development. However, a successful post-colonial revolution could not ensure that education and the economy would therefore develop in tandem. In the cultural aspect, racial/cultural differences are easily regarded as the result of educational achievement differences. Schooling praxis could also enlarge the educational advantage gap between the majority and minority. In the spatial aspect, education is a colonized space, no matter whether in curriculum knowledge or in pedagogical praxis. However, beside the binary opposition’s perspective, there also exists a third space. These spaces are in competition with each other. In the conclusion to this article, the development and application of post-colonialism discourse in education and research topics of educational competition will be clearly stated. Inspirations and reflections on educational research from the post-colonialism discourse perspective related to Taiwan will also be presented.
The Places Where Audience Studies and Production Studies Meet
Authors: Mayer Vicki
Published: June 2016

Audience studies and production studies have had largely separate trajectories in research, despite their shared grounded theory agendas and research methods. Drawing on a larger ethnography of media audiences and producers, this article shows how the human subjects of audience studies and production studies might be studied together to reveal the power relations involved in mass media production processes. In this particular case study, fans and extras for the television series Treme (2010–2013) shared a discourse around the place of viewing and making which strove to articulate a common culture despite the real hierarchical barriers between audiences and production personnel.
The State of the Science on Sensory Factors and Their Impact on Daily Life for Children
Authors: Dunn Winnie , Little Lauren , Dean Evan , Robertson Sara , Evans Benjamin
Published: June 2016

The objective of this study was to identify and synthesize research about how sensory factors affect daily life of children. We designed a conceptual model to guide a scoping review of research published from 2005 to October 2014 (10 years). We searched MEDLINE, CINAHL, and PsycINFO and included studies about sensory perception/processing; children, adolescents/young adults; and participation. We excluded studies about animals, adults, and review articles. Our process resulted in 261 articles meeting criteria. Research shows that children with conditions process sensory input differently than peers. Neuroscience evidence supports the relationship between sensory-related behaviors and brain activity. Studies suggest that sensory processing is linked to social participation, cognition, temperament, and participation. Intervention research illustrates the importance of contextually relevant practices. Future work can examine the developmental course of sensory processing aspects of behavior across the general population and focus on interventions that support children’s sensory processing as they participate in their daily lives.
An improved turbulence model for separation flow in a centrifugal pump
Authors: Ren Yun , Zhu Zuchao , Wu Denghao , Mu Jiegang , Li Xiaojun
Published: June 2016

For the stable and reliable operation of centrifugal pump, the transient flow must be studied and the separation region should be avoided. Three-dimensional, incompressible, steady, and transient flows in a centrifugal pump at specific speed within 74 were numerically studied using shear stress transport k- ω turbulence model, and an improved explicit algebraic Reynolds stress model–rotation-curvature turbulence model was proposed by considering the effects of rotation and curvature in the impeller passages in this work. Steady and transient computations were conducted to compare with the experiments. The comparison of pump hydraulic performance showed that the explicit algebraic Reynolds stress model–rotation-curvature turbulence model was better than the original model, especially between 0.6 QBEP and 1.2 QBEP; the improved model could enhance the head prediction of pump by about 1%–7% than that with the original model. Then, the visualization of the vortex evolution was observed to validate the unsteady simulations. Good agreement was investigated between calculations and visualizations. It is indicated that the explicit algebraic Reynolds stress model–rotation-curvature model can successfully capture the separation flow.
Citizenship education for proactive democratic life in rural communities
Authors: Waterson Robert A , Moffa Eric D
Published: June 2016

To assist rural teachers in fostering students’ democratic skills and dispositions, this article examines the convergence of literature on citizenship education, rural communities, and rural education and extrapolates the challenges and possibilities of rural citizenship education for proactive democratic life. Four assertions are elicited from a review of the literature to bring about cognizance to rural citizenship education for K-12 teachers and teacher educators: (a) civic republican notions of citizenship likely dominate rural communities, but liberal citizenship discourses may offer meaningful pathways for a proactive democratic life; (b) rural individualism must be assessed for its strengths and weaknesses; (c) economic hardships can lead to political distrust, but can also become fuel for citizen empowerment; and (d) rural social norms can jeopardize educational goals, so they must be acknowledged. Each assertion is accompanied by a discussion to elucidate the assertion and make recommendations on how to utilize rural possibilities to improve citizenship education. This article contributes to context-specific citizenship instruction and, therefore, the possibility of stronger democratic relationships in rural communities.
Experimental studies of an inertial-elastic rotating wing in air and vacuum
Authors: Jankauski Mark , Shen IY
Published: June 2016

A two-axis rotation stage was constructed to replicate the large amplitude rotations of an insect wing. A wing was constructed with a strain gage mounted near the root to identify strain. An inertial-elastic model was used to predict temporal strain during various rotation trajectories. Single-axis rotations were considered, and multi-axis rotations were investigated to exploit phenomena related to geometric coupling. Experiments were conducted in air and in vacuum to decouple aerodynamic and inertial-elastic forces. It was found aerodynamic forces constitute maximally 15% of the strain, suggesting that an inertial-elastic model is appropriate in certain contexts. It was determined that inertial forces were dominant in the pitch-roll and roll-yaw configuration, whereas gyroscopic forces were dominant in the pitch-yaw configuration. Theoretic predictions match experimental results fairly well. The inertial-elastic rotating model may be used to inform flapping wing micro aerial vehicle designers moving forth, particularly in the design of strain-based control systems.
On the wake pattern of symmetric airfoils for different incidence angles at Re = 1000
Authors: Kurtulus Dilek Funda
Published: June 2016

In the current study, numerical simulations are performed in order to investigate effects of incidence angle and airfoil thickness on alternating vortex pattern of symmetric airfoils at Re = 1000. This alternating vortex pattern is found to be significantly varying in shape as the incidence angle increases. The results are obtained with 1° increment from 0° to 41° and then with 10° increment from 40° until 180°. The instantaneous and mean vortex patterns are investigated around 2% thick (NACA 0002) and 12% thick (NACA 0012) airfoils. The mean lift, drag, and pitching moment coefficients in addition to Strouhal number are computed and compared with the results available in literature. It is found that the wake behind the airfoil exhibits a continuous vortex shedding pattern below 8° incidence angle for NACA 0002 and below 7° incidence angle for NACA 0012 at Re = 1000. The wake structures are classified into five different modes according to their pattern obtained from instantaneous and mean vorticity fields by also taking into account the amplitude spectrum of the lift coefficient, the instantaneous and mean aerodynamic force coefficients, velocity fields, and the longitudinal and lateral vortex spacings.
Interactive Spaced Online Education in Pediatric Trauma
Authors: Shenoi Rohit , Rubalcava Daniel , Naik-Mathuria Bindi , Sloas Harold A. , Delemos David , Xu Linzhi , Mendez Donna
Published: June 2016

Pediatric resident trauma education is suboptimal due to lack of a curriculum and limited trauma experience and education resources. The objective of the study was to test knowledge retention and acceptability of interactive spaced education (ISE) in pediatric trauma. Prospective, randomized trial involving 40 physicians in a pediatric emergency department was used. Instrument was comprised of 48 multiple-choice questions (evaluative component) and answer critiques (educational component) on pediatric trauma divided into two modules. The instrument was assessed for test–retest reliability, item difficulty, and construct validity. Intervention consisted of online administration of each module as eight spaced emails (3 questions each) over a course of 4 weeks and was repeated after 2 and 4 months. Participants received an answer critique on committing to an answer. Primary outcome was difference in mean percentage of correct answers at 2 and 4 months versus baseline. Paired t test and effect size (d) were performed. Secondary outcome was exit-survey of ISE acceptability. There was significant improvement at 2 months (8.0, 95% confidence intervel [CI] = [3.6, 12.5], d = 0.75), but improvement at 4 months (1.6, 95% CI = [−4.5, 7.7], d = 0.18) was not significant. Sixty percent would retake and recommend ISE to others. Interactive, spaced education improves knowledge in pediatric trauma and is well accepted. Studies are required to determine the optimal spacing interval for this form of education.
Prevesical Calcification and Hydronephrosis in a Girl Treated for Vesicoureteral Reflux
Authors: Kuipers Sarah , van der Horst Eric H. J. R. , Verbeke Jonathan I. M. L. , Bökenkamp Arend
Published: June 2016

The endoscopic STING procedure using Deflux is a common and minimal invasive treatment for vesicoureteral reflux. Herein we present the case of an 11-year-old girl with loin pain and de novo hydronephrosis and megaureter on the left. Ultrasound and plain abdominal X-ray demonstrated a calcification at the ureterovesical junction. She had been treated with Deflux injections 5 years before. The clinical quiz addresses the differential diagnosis, workup, and pathogenesis of calcifications at the ureterovesical junction following endoscopic reflux therapy.
Autologous hematopoietic cell transplantation for HIV-related lymphoma: results of the BMT CTN 0803/AMC 071 trial
Authors: Alvarnas Joseph C. , Le Rademacher Jennifer , Wang Yanli , Little Richard F. , Akpek Gorgun , Ayala Ernesto , Devine Steven , Baiocchi Robert , Lozanski Gerard , Kaplan Lawrence , Noy Ariela , Popat Uday , Hsu Jack , Morris Lawrence E. , Thompson Jason , Horowitz Mary M. , Mendizabal Adam , Levine Alexandra , Krishnan Amrita , Forman Stephen J. , Navarro Willis H. , Ambinder Richard
Published: June 2016

Key Points

Autologous hematopoietic cell transplantation is safe and effective in patients with HIV-related lymphoma who meet standard transplant criteria. Patients with HIV-related lymphomas should not be precluded from participating in AHCT clinical trials.
Integrated mate-pair and RNA sequencing identifies novel, targetable gene fusions in peripheral T-cell lymphoma
Authors: Boddicker Rebecca L. , Razidlo Gina L. , Dasari Surendra , Zeng Yu , Hu Guangzhen , Knudson Ryan A. , Greipp Patricia T. , Davila Jaime I. , Johnson Sarah H. , Porcher Julie C. , Smadbeck James B. , Eckloff Bruce W. , Billadeau Daniel D. , Kurtin Paul J. , McNiven Mark A. , Link Brian K. , Ansell Stephen M. , Cerhan James R. , Asmann Yan W. , Vasmatzis George , Feldman Andrew L.
Published: June 2016

Peripheral T-cell lymphomas (PTCLs) represent a heterogeneous group of T-cell malignancies that generally demonstrate aggressive clinical behavior, often are refractory to standard therapy, and remain significantly understudied. The most common World Health Organization subtype is PTCL, not otherwise specified (NOS), essentially a “wastebasket” category because of inadequate understanding to assign cases to a more specific diagnostic entity. Identification of novel fusion genes has contributed significantly to improving the classification, biologic understanding, and therapeutic targeting of PTCLs. Here, we integrated mate-pair DNA and RNA next-generation sequencing to identify chromosomal rearrangements encoding expressed fusion transcripts in PTCL, NOS. Two of 11 cases had novel fusions involving VAV1, encoding a truncated form of the VAV1 guanine nucleotide exchange factor important in T-cell receptor signaling. Fluorescence in situ hybridization studies identified VAV1 rearrangements in 10 of 148 PTCLs (7%). These were observed exclusively in PTCL, NOS (11%) and anaplastic large cell lymphoma (11%). In vitro, ectopic expression of a VAV1 fusion promoted cell growth and migration in a RAC1-dependent manner. This growth was inhibited by azathioprine, a clinically available RAC1 inhibitor. We also identified novel kinase gene fusions, ITK-FER and IKZF2-ERBB4, as candidate therapeutic targets that show similarities to known recurrent oncogenic ITK-SYK fusions and ERBB4 transcript variants in PTCLs, respectively. Additional novel and potentially clinically relevant fusions also were discovered. Together, these findings identify VAV1 fusions as recurrent and targetable events in PTCLs and highlight the potential for clinical sequencing to guide individualized therapy approaches for this group of aggressive malignancies.
Cannabinoid Receptor 2 as Antiobesity Target: Inflammation, Fat Storage, and Browning Modulation
Authors: Rossi Francesca , Bellini Giulia , Luongo Livio , Manzo Iolanda , Tolone Salvatore , Tortora Chiara , Bernardo Maria Ester , Grandone Anna , Conforti Antonella , Docimo Ludovico , Nobili Bruno , Perrone Laura , Locatelli Franco , Maione Sabatino , del Giudice Emanuele Miraglia
Published: June 2016

Context:

Obesity is associated with a low-grade inflammatory state and adipocyte (ADP) hyperplasia/hypertrophy. Obesity inhibits the “browning” of white adipose tissue. Cannabinoid receptor 2 (CB2) agonists reduce food intake and induce antiobesity effect in mice. A common missense CB2 variant, Q63R, causes CB2-reduced function.

Objective:

To evaluate the influence of CB2 receptor on the modulation of childhood obesity and of ADP activity and morphology.

Design:

CB2-Q63R variant was analyzed in obese Italian children. The effects of an inflammatory stimulus and those of drugs selectively acting on CB2 were investigated on in vitro ADPs obtained from mesenchymal stem cells of adult healthy donors or from sc adipose biopsies of adult nonobese and obese subjects.

Setting:

Department of Women, Child and General and Specialist Surgery of the Second University of Naples.

Patients or Other Participants:

A total of 501 obese Italian children (age 11 ± 2.75). Twelve healthy bone marrow donors (age 36.5 ± 15); and 17 subjects, 7 lean (age 42 ± 10) and 10 obese (age 37.8 ± 12) underwent sc adipose tissue biopsies.

Main Outcome Measures:

Effects of CB2 stimulation on adipokine, perilipin, and uncoupling protein-1 expression.

Results:

The less-functional CB2-R63 variant was significantly associated with a high z-score body mass index. CB2 blockade with AM630 reverse agonist increased inflammatory adipokine release and fat storage and reduced browning. CB2 stimulation with JWH-133 agonist reversed all of the obesity-related effects.

Conclusion:

CB2 receptor is a novel pharmacological target that should be considered for obesity.
Going for the Gold: The Redistributive Agenda Behind Market-Based Health Care Reform
Authors: Evans Robert G.
Published: June 2016

Political conflict over the respective roles of the state and the market in health care has a long history. Current interest in market approaches represents the resurgence of ideas and arguments that have been promoted with varying intensity throughout this century. (In practice, advocates have never wanted a truly competitive market, but rather one managed by and for particular private interests.) Yet international experience over the last forty years has demonstrated that greater reliance on the market is associated with inferior system performance—inequity, inefficiency, high cost, and public dissatisfaction. The United States is the leading example. So why is this issue back again? Because market mechanisms yield distributional advantages for particular influential groups. (1) A more costly health care system yields higher prices and incomes for suppliers—physicians, drug companies, and private insurers. (2) Private payment distributes overall system costs according to use (or expected use) of services, costing wealthier and healthier people less than finance from (income-related) taxation. (3) Wealthy and unhealthy people can purchase (real or perceived) better access or quality for themselves, without having to support a similar standard for others. Thus there is, and always has been, a natural alliance of economic interest between service providers and upper-income citizens to support shifting health financing from public to private sources. Analytic arguments for the potential superiority of hypothetical competitive markets are simply one of the rhetorical forms through which this permanent conflict of economic interest is expressed in political debate.
Managed Care and Medicare Reform
Authors: Oberlander Jonathan B.
Published: June 2016

A primary goal of many Medicare reform proposals is to move program beneficiaries into managed care plans operated by private insurance companies. Advocates contend that managed care based reforms? This article summarizes the claims that are made for and against incorporating managed care into Medicare, and reviews evidence from the program’s experience with HMOs on financial savings, benefit coverage, and quality of care. This evidence raises concerns regarding the ability of HMOs to provide adequate care for chronically ill Medicare patients. Moreover, there is considerable uncertainty about the future performance of managed care plans. I therefore conclude that policy makers should move cautiously in embracing managed care and that Medicare should not adopt financial incentives, such as vouchers, that are intended to push beneficiaries into HMOs. However, Medicare beneficiary enrollment in managed care plans is likely to increase substantially in coming years regardless of public policy. It is therefore critical for Medicare to pursue policies that protect the quality of care for elderly and disabled patients in managed care plans; curtail excessive payments to HMOs that result from favorable selection of healthier enrollees; and preserve the current fee-for-service Medicare program. plans, especially health maintenance organizations (HMOs), can save substantial money for the federal government, while also improving the quality of medical care and scope of covered benefits for Medicare enrollees. Should Medicare follow the private sector by adopting managed care–
Markets and Public Programs: Insights from Oregon and Tennessee
Authors: Gold Marsha
Published: June 2016

Medicaid is the major national program promoting access to care for low-income populations, but the program also is a federal-state partnership. With costs rising and universal access still a remote objective, many states have turned to market-based strategies involving managed care, with the goals of generating savings for the state, improving access for Medicaid beneficiaries, and sometimes, expanding coverage to those who were previously uninsured. Yet Medicaid is a complex social insurance system that over time has been used to finance a variety of needs, often using cross-subsidies. In addition, states vary in both the scope of their Medicaid programs and the sophistication of the skills and resources they can bring to bear in shaping them. Understanding how these influence the ability to implement market-based strategies in Medicaid and what the effects of these strategies appear to be is of crucial importance because most states now include some features of this approach in their programs.

This article builds on two parallel state efforts to construct health reform for low-income populations using the Medicaid program, with a view to identifying what we can learn about issues related to their implementation and effects. Specifically, the article describes the early experiences of Oregon and Tennessee with health reform based on the Medicaid program under federal Section 1115 waivers. The analysis is drawn largely from in-depth case studies based on document review and site visits to each state in late 1994 to assess their first-year experience, with limited follow-up in August 1996.

In sum, the analysis suggests that Medicaid managed care and market strategies in concept are neither “magic bullets” nor “poison pills” for achieving public policy objectives. The way these strategies are formed, the context in which they are conceived, and the way in which they are implemented can markedly influence their accomplishments. As a public program, Medicaid has features that influence the development of market strategies and their ultimate effects. These include objectives that are broad in scope, multifaceted, and sometimes are not explicitly acknowledged, or that conflict; political processes that influence the speed and form of implementation; and administrative features both external and internal to the program that constrain the flexibility of the design and adoption. These features apply to all states, but they often operate differently in each.

Many of these concerns also exist in Medicaid fee for service. Thus our research suggests that in moving to managed care and market-based solutions, states gain some tools but remain faced with the same challenge: How to achieve more for less and for whom, when support falls short of the amount needed to achieve policy goals.
The Medicaid Managed Care Policy Consensus for Welfare Recipients: A Reflection of Traditional Welfare Concerns
Authors: Grogan Colleen M.
Published: June 2016

An Aid to Families with Dependent Children (AFDC)–Medicaid managed care policy consensus has emerged in the American states. Although there are two main organizational forms—primary care case management and risk-based capitation models—states are converging on the risk-based approach for their AFDC recipients. Risk-based Medicaid managed care for AFDC recipients assumes a distinct purpose and meaning. The reform is not just about cost control and improving access but about enduring welfare concerns: deservingness, need, and empowerment. Despite recent federal policies that have essentially severed the eligibility link between AFDC and Medicaid, state policy elites still conceive of poor families on Medicaid as a “welfare” group. Assumptions about the need for behavior modification and the need to integrate this group into “mainstream” America shape perceptions about why Medicaid managed care is appropriate for AFDC-Medicaid recipients.
Tcf7l1 protects the anterior neural fold from adopting the neural crest fate
Authors: Mašek Jan , Machoň Ondřej , Kořínek Vladimír , Taketo M. Mark , Kozmik Zbyněk
Published: June 2016

The neural crest (NC) is crucial for the evolutionary diversification of vertebrates. NC cells are induced at the neural plate border by the coordinated action of several signaling pathways, including Wnt/β-catenin. NC cells are normally generated in the posterior neural plate border, whereas the anterior neural fold is devoid of NC cells. Using the mouse model, we show here that active repression of Wnt/β-catenin signaling is required for maintenance of neuroepithelial identity in the anterior neural fold and for inhibition of NC induction. Conditional inactivation of Tcf7l1, a transcriptional repressor of Wnt target genes, leads to aberrant activation of Wnt/β-catenin signaling in the anterior neuroectoderm and its conversion into NC. This reduces the developing prosencephalon without affecting the anterior-posterior neural character. Thus, Tcf7l1 defines the border between the NC and the prospective forebrain via restriction of the Wnt/β-catenin signaling gradient.
Nonlinear Optical (NLO) Response of Pristine and Functionalized Dodecadehydrotribenzo[18]annulene ([18]DBA): A Theoretical Study
Authors: Kamalinahad Saeedeh , Solimannejad Mohammad , Shakerzadeh Ehsan
Published: June 2016

The structural, electronic, and nonlinear optical (NLO) properties of pristine dodecadehydrotribenzo[18]annulene ([18]DBA) functionalizing with the alkali metal atom (Li and Na), NH2 and NO2 functional groups and its location are inspected through density functional theory (DFT) calculations. The NBO analysis indicates that functionalizing [18]DBA caused increasing charge transfer (CT) and introduced a new acceptor–donor model for NLO materials due to the structure with of π-electron of [18]DBA. The results demonstrate that the functional groups notably narrow the energy gap of [18]DBA, and the electronic character of [18]DBA is sensitive to the functional groups. Furthermore the considered functional groups enhance the static first and second hyperpolarizability of [18]DBA. Interestingly, replacement of H atom by Na and NO2 in [18]DBA leads to large static first hyperpolarizability (β0) values of 3977.40 and 3722.56 au and very great static second hyperpolarizability (γtot) 980380.40 and 752886.20 au, respectively, which is the largest among the considered functionalizing structures. Also transition energies (ΔE) decrease due to functionalizing, and the best location for functionalizing is position 2.
Η ιστοσελίδα codeacademy ως εργαλείο για την εκμάθηση προγραμματισμού
Authors: Θεοφανέλλης Τιμολέων
Published: June 2016

Ο προγραμματισμός ηλεκτρονικών υπολογιστών αποτελεί μια σημαντική δεξιότητα καθώς μέσα από αυτόν προάγεται ένας διαφορετικός τρόπος σκέψης και επίλυσης προβλημάτων. Το διαδίκτυο παρέχει πληθώρα από δυνατότητες που μπορεί να βοηθήσουν στην εκμάθηση του προγραμματισμού. Στην εργασία αυτή παρουσιάζονται αυτές οι δυνατότητες που παρέχει η ιστοσελίδα codeacademy, ενώ δίνεται έμφαση στην αξία και την αξιοποίηση τους. Πέρα από αυτό προτείνεται η αξιοποίηση των MOOCs και τα πλεονεκτήματα που προσφέρουν στον εκπαιδευόμενο που εξασκείτε στον προγραμματισμό. Επιπλέον προτείνει η αξιοποίηση αλληλεπιδραστικών περιβαλλόντων (πλατφόρμες) με εκπαιδευτικό προσανατολισμό που οργανώνει ο ίδιος. Ο εκπαιδευτικός που διδάσκει προγραμματισμό και ο εκπαιδευόμενος που μαθαίνει είναι χρήσιμο να γνωρίζουν τις δυνατότητες αυτές και να αξιοποιούν όποιες από αυτές τους βοηθούν να επιτύχουν στους στόχους τους καλύτερα.
Critical issues in the Supervision of Post-Graduate Dissertations in Distance Education Environments
Authors: Quan- Baffour Kofi Poku , Vambe Maurice Taonezvi
Published: June 2016

The main aim of this paper to identify, explain and advance as best practice, the principles of an alternative framework of postgraduate supervision in the context of distance education. This framework, we describe as Dynamic facilitation. The paper starts with a critique of the African Union Commission Plan of Action of the Second Decade for Education in Africa (2006-2015), highlighting the document’s unfortunate silence on the role of distance education in Africa’s Higher education. We suggest that this silence is due to African educationists’ reliance on old theories of learning and supervising dissertations whose main limitations are their narrow definition of higher education as residential university, and also the dominance
ascribed to the pedagogic role of supervisors in the Behaviourist and Cognitive theories of learning. We critique these theories for their inherent limitations and proceed to suggest that the context of distance education has its unique features and particularities that must be robustly engaged with, in the areas of learning and supervising of postgraduate dissertations. We then propose ‘dynamic facilitation’ as a type of supervision suited to distance education contexts. Our basic argument is that dynamic facilitation empowers postgraduate students because it allows for their initiative in generating new knowledge systems. We conclude by suggesting that dynamic facilitation takes into account the ‘distance-ness’ between supervisor and the supervised; it integrates methods of assessment ranging from the main dissertation, to
continual self-reflective assessment achieved through maintaining journal notes on work done and portfolio of the supervised’s experience during the process of supervision.

Key words: Supervision, Distance Education, Post-Graduate, Critical, Dissertation, Context, Dynamic facilitation.
Factors Influencing the Completion of Dissertations by Students of Post-Graduate Diploma in Education (PGDE) by Distance Learning in South-western Nigeria
Authors: Olakulehin Felix Kayode , Ojo Olugbenga David
Published: June 2016

This paper reports the outcome of a primary quantitative investigation into the factors responsible for the completion or otherwise of dissertation reports by postgraduate distance learning students in Nigeria. The study set out to determine the reasons why many postgraduate distance learners fail to complete their dissertations after the course work. Using a structured questionnaire designed on a five-Point Likert-type scale, the researchers captured the opinions of some postgraduate distance learners about the factors affecting their completion of their research work.The analysis of the study was done using simple percentages and it was found that many of the respondents had difficulty with statistical analysis; some others had problems identifying suitable research topics and supervisor problem, among others, constituted the major challenges facing many of the respondents. The study concluded with some recommendations on how theadministration of research work or dissertation writing by distance learners can be improved.Keywords: dissertation, statistical analysis; research, postgraduate distance learners
Μαθηματική Προτυποποίηση μέσω Προβλημάτων Ελεύθερου Συνόρου
Authors: Τζελέπης Αλκιβιάδης
Published: June 2016

Τα προβλήματα ελεύθερου συνόρου αποτελούν ένα μαθηματικό πεδίο έρευνας που χαρακτηρίζεται από την εμφάνιση συνόρων, των οποίων η θέση είναι άγνωστη εκ των προτέρων. Τα ελεύθερα σύνορα χωρίζουν χωρικές-χρονικές περιοχές με διαφορετικές ιδιότητες. Κλασικό παράδειγμα αποτελεί η στερεοποίηση του νερού, όπου η θέση του συνόρου μεταξύ νερού και πάγου δεν είναι καθορισμένη, αλλά αλλάζει κατά τη διάρκεια της διαδικασίας. Ελεύθερα σύνορα προκύπτουν φυσικά κατά τη μαθηματική προτυποποίηση μιας μεγάλης ποικιλίας επιστημονικών και τεχνολογικών διεργασιών, όπως για παράδειγμα στον τομέα της μεταποίησης υλικών (χύτευση χάλυβα, κρυσταλλική και δενδρική ανάπτυξη), στη βιολογία (δυναμική των πληθυσμών, ανάπτυξη βακτηριδίων), στη θεωρία της καύσης, σε προβλήματα αντίδρασης-διάχυσης, στην ηλεκτροχημεία ή στη ροή ρευστών διαμέσου πορωδών μέσων.
Επιρροή και Εμπιστοσύνη στα Κοινωνικά Δίκτυα
Authors: Βουτσκόγλου Ειρήνη
Published: June 2016

Οι ορισμοί του Influencer ποικίλουν χωρίς να διαφέρουν ιδιαίτερα. Influential ή Influencer είναι αυτός που μπορεί να μας επηρεάσει, κι είναι ήδη αρκετά τα εργαλεία που αναλαμβάνουν την απόδειξη ενός τέτοιου χαρακτηρισμού. Εμπιστοσύνη είναι ένα ειδικό επίπεδο υποκειμενικής πιθανότητας κατά το οποίο ένα αρχικό σύστημα θα εκτελέσει μία συγκεκριμένη ενέργεια πριν μπορέσουμε να παρακολουθήσουμε αυτή την ενέργεια και σε ένα πλαίσιο όπου επηρεάζεται η δική μας δραστηριότητα.
Why do health visitors screen mothers and not fathers for depression in the postnatal period?
Authors: Whitelock Amanda
Published: June 2016

Traditionally, health visitors have focused on maternal wellbeing and child health, which explains why paternal postnatal depression (PND) has been comparatively unrecognised by this group of health professionals. This small study sought to identify why health visitors carry out PND screening using a tool such as the Edinburgh Postnatal Depression Scale and provide emotional support for mothers and not fathers, despite literature highlighting the need for both mothers and fathers with poor mental health to be signposted to mental health services and offered emotional support. The majority of participants in this study identified that they do not routinely consider fathers' emotional health, and believe that their role as a health visitor should continue to be child- and mother-focused, despite knowing that paternal mental health consistently correlates with child health and wellbeing ( Fatherhood Institute, 2012 ).