bluuebunny/crossref_metadata_2025 huggingface dataset:
Turnover Intentions and Work Motivations of Millennial Employees in Federal Service
Authors: Ertas Nevbahar
Published: June 2015

In the face of looming retirements in the federal service, retaining and motivating the next generation of workers has emerged as a critical concern for human resource professionals in federal agencies. While a growing body of work provides advice and strategies on making government work more inviting for the members of the Millennial generation, those born after 1982, not much is known about the turnover intentions of those already in public service. Do Millennial workers in the federal agencies resemble older workers in terms of their work motivations and turnover intentions? This study compares Millennial and older generation workers in U.S. federal agencies, in terms of their turnover intentions and work motivations. The analyses show that they are more likely than their older counterparts to report an intention to leave their jobs, and most work attributes do not matter more for Millennial workers’ decisions to leave.
Migration Policy in the New Ecuadorean Constitution
Authors: Ramírez G. Jacques P.
Published: June 2015

Ecuador’s new constitution, approved in 2008, establishes the basis for a new model of the nation-state, characterized as progressively transnational, that attempts to protect both Ecuadoreans living abroad and foreigners residing in the country. It recognizes the right to migrate and the transnational family and advocates universal citizenship, the free movement of all inhabitants of the planet, and the eventual end of the status of foreigner as an element of the transformation of unequal relations between countries.

En la nueva constitución de la República del Ecuador, probada en el año 2008, se sienta las bases de un nuevo modelo de Estado-Nación de carácter cada vez más transnacional que intenta velar por las y los ecuatorianos radicados en el exterior, así como por las personas extranjeras residentes en el país. Reconoce el derecho a migrar, la familia transnacional, ciudadanía universal, la libre movilidad de todos los habitantes del planeta y el progresivo fin de la condición de extranjero como elemento transformador de las relaciones desiguales entre los países.
Coverage of the Phineas Gage Story in Introductory Psychology Textbooks
Authors: Griggs Richard A.
Published: June 2015

Most introductory textbooks discuss the story of Phineas Gage and his terrible accident in which he survived a three-and-a-half-foot-long tamping iron that weighed 13¼ pounds exploding through his head. Twenty-three current introductory textbooks were analyzed for the accuracy of their coverage of Gage’s subsequent (post-accident) history and psychosocial recovery and for inclusion of recently discovered photos of Gage and the most recent digital reconstruction of the path of the tamping iron through his head. Although coverage was generally accurate when included, only half a dozen textbooks discussed Gage’s subsequent history or recovery. Inclusion of the photos and recent modeling work was also lacking. Explanations for these coverage deficiencies and suggestions for improved coverage for teachers and textbook authors are offered.
The actor does not judge
Authors: Lederman Shmuel
Published: June 2015

Hannah Arendt’s conceptualization of political judgement has been a source of much scholarly investigation and debate in recent decades. Underlying the debate is the assumption that at least in her early writings, Arendt had an actor’s theory of judgement. In this article I challenge this common assumption. As I attempt to demonstrate, it relies on a misunderstanding, not only of Arendt’s conception of judgement, but also of her conception of agents in the public realm. Once we discard the assumption of an actor’s theory of judgement, I argue, some important issues in Arendt’s theory of judgement are resolved, enabling us to perceive it as a unified, rather than self-contradictory, theory of judgement.
Responding to -isms
Authors: Speer Susan A.
Published: June 2015

I discuss the contribution of the articles to existing literatures, and their implications for (1) our understanding of the analytic tractability of -isms, and (2) managing and challenging -isms.
“It’s not just words coming from the mouth”
Authors: Sabey Allen K. , Rauer Amy J. , Haselschwerdt Megan L.
Published: June 2015

Compassionate love is an important characteristic of healthy close relationships. However, we know little about how compassionate love is behaviorally manifested. Furthermore, compassionate love may be uniquely experienced among older couples, as age-related challenges may require adjustments by spouses in providing more care for one another. Through interviews with 63 older married couples, this exploratory study examined the behavioral component of compassionate love among older couples as reported from the recipients’ perspective. From the qualitative data analysis, 11 behavioral domains were identified, including caring for physical health and helping with household tasks. The examples varied greatly in magnitude and meaningfulness, from willingly moving around the country to fixing breakfast. Further, couples frequently highlighted acts related to their increasing age-related challenges, underscoring the importance of taking a life-span approach to the study of compassionate love. The results may be useful to further develop interventions promoting compassionate love, especially among older couples.
Exploring the effect of individual differences on self-efficacy in getting information
Authors: Yan Yalan , Zha Daochen , Yan An , Zhang Qin
Published: June 2015

Self-efficacy in getting information, which is defined as individuals’ judgments of their own capabilities to search, compare and evaluate information they need, is critical given the negative effects of information overload in the modern information society. This study focuses on digital library users with the purpose of identifying the user groups with lower levels of self-efficacy in getting information so as to provide insights for targeted user training. Specifically, this study explores the effect of individual differences on self-efficacy in getting information in terms of gender, current position, field and experience with using the digital library. The findings suggest that there are no significant differences between male and female users regarding self-efficacy in getting information. Undergraduate students as well as master or doctoral students and the users coming from the fields of arts and humanities as well as social sciences perceive lower levels of self-efficacy in getting information. The users who have longer experience with using the digital library perceive higher levels of self-efficacy in getting information. These findings and implications are discussed.
Are perioperative near-infrared spectroscopy values correlated with clinical and biochemical parameters in cyanotic and acyanotic infants following corrective cardiac surgery?
Authors: Ersoy Cihangir , Özyüksel Arda , Alkan Bozkaya Tijen , Karaaslan Pelin , Örmeci Tuğrul , Ündar Akif , Akçevin Atıf , Türkoğlu Halil
Published: June 2015

Background:

Near-infrared spectroscopy (NIRS) is a useful non-invasive tool for monitoring infants undergoing cardiac surgery. In this study, we aimed to determine the NIRS values in cyanotic and acyanotic patients who underwent corrective cardiac surgery for congenital heart diseases.

Methods:

Thirty consecutive infants who were operated on with the diagnosis of ventricular septal defect (n=15) and tetralogy of Fallot (n=15) were evaluated retrospectively. A definitive repair of the underlying cardiac pathology was achieved in all cases. A total of six measurements of cerebral and renal NIRS were performed at different stages of the perioperative period. The laboratory data, mean urine output and serum lactate levels were evaluated along with NIRS values in each group.

Results:

The NIRS values differ in both groups, even after the corrective surgical procedure is performed. The recovery of renal NIRS values is delayed in the cyanotic patients.

Conclusion:

Even though definitive surgical repair is performed in cyanotic infants, recovery of the renal vasculature may be delayed by up to two days, which is suggestive of a vulnerable period for renal dysfunction.
Minimized extracorporeal circulation is improving outcome of coronary artery bypass surgery in the elderly
Authors: Freundt Miriam , Ried Michael , Philipp Alois , Diez Claudius , Kolat Philipp , Hirt Stephan W , Schmid Christof , Haneya Assad
Published: June 2015

Advanced age is a known risk factor for morbidity and mortality after coronary artery bypass grafting (CABG). Minimized extracorporeal circulation (MECC) has been shown to reduce the negative effects associated with conventional extracorporeal circulation (CECC). This trial assesses the impact of MECC on the outcome of elderly patients undergoing CABG. Eight hundred and seventy-five patients (mean age 78.35 years) underwent isolated CABG using CECC (n=345) or MECC (n=530). The MECC group had a significantly shorter extracorporeal circulation time (ECCT), cross-clamp time and reperfusion time and lower transfusion needs. Postoperatively, these patients required significantly less inotropic support, fewer blood transfusions, less postoperative hemodialysis and developed less delirium compared to CECC patients. In the MECC group, intensive care unit (ICU) stay was significantly shorter and 30-day mortality was significantly reduced [2.6% versus 7.8%; p<0.001]. In conclusion, MECC improves outcome in elderly patients undergoing CABG surgery.
Impact of CCSVI on cerebral haemodynamics: a mathematical study using MRI angiographic and flow data
Authors: Müller LO , Toro EF , Haacke EM , Utriainen D
Published: June 2015

Background

The presence of abnormal anatomy and flow in neck veins has been recently linked to neurological diseases. The precise impact of extra-cranial abnormalities such as stenoses remains unexplored.

Methods

Pressure and velocity fields in the full cardiovascular system are computed by means of a global mathematical model that accounts for the relationship between pulsating cerebral blood flow and intracranial pressure.

Results

Our model predicts that extra-cranial strictures cause increased pressure in the cerebral venous system. Specifically, there is a predicted pressure increase of about 10% in patients with a 90% stenoses. Pressure increases are related to significant flow redistribution with flow reduction of up to 70% in stenosed vessels and consequent flow increase in collateral pathways.

Conclusions

Extra-cranial venous strictures can lead to pressure increases in intra-cranial veins of up to 1.3 mmHg, despite the shielding role of the Starling resistor. The long-term clinical implications of the predicted pressure changes are unclear.
Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams
Authors: Carugo Dario , Ankrett Dyan N , Zhao Xuefeng , Zhang Xunli , Hill Martyn , O’Byrne Vincent , Hoad James , Arif Mehreen , Wright David DI , Lewis Andrew L
Published: June 2015

Objective

To compare foam bubble size and bubble size distribution, stability, and degradation rate of commercially available polidocanol endovenous microfoam (Varithena®) and physician-compounded foams using a number of laboratory tests.

Methods

Foam properties of polidocanol endovenous microfoam and physician-compounded foams were measured and compared using a glass-plate method and a Sympatec QICPIC image analysis method to measure bubble size and bubble size distribution, Turbiscan™ LAB for foam half time and drainage and a novel biomimetic vein model to measure foam stability. Physician-compounded foams composed of polidocanol and room air, CO2, or mixtures of oxygen and carbon dioxide (O2:CO2) were generated by different methods.

Results

Polidocanol endovenous microfoam was found to have a narrow bubble size distribution with no large (>500 µm) bubbles. Physician-compounded foams made with the Tessari method had broader bubble size distribution and large bubbles, which have an impact on foam stability. Polidocanol endovenous microfoam had a lower degradation rate than any physician-compounded foams, including foams made using room air (p < 0.035). The same result was obtained at different liquid to gas ratios (1:4 and 1:7) for physician-compounded foams. In all tests performed, CO2 foams were the least stable and different O2:CO2 mixtures had intermediate performance. In the biomimetic vein model, polidocanol endovenous microfoam had the slowest degradation rate and longest calculated dwell time, which represents the length of time the foam is in contact with the vein, almost twice that of physician-compounded foams using room air and eight times better than physician-compounded foams prepared using equivalent gas mixes.

Conclusion

Bubble size, bubble size distribution and stability of various sclerosing foam formulations show that polidocanol endovenous microfoam results in better overall performance compared with physician-compounded foams. Polidocanol endovenous microfoam offers better stability and cohesive properties in a biomimetic vein model compared to physician-compounded foams. Polidocanol endovenous microfoam, which is indicated in the United States for treatment of great saphenous vein system incompetence, provides clinicians with a consistent product with enhanced handling properties.
Do Social Resources Protect Against Lower Quality of Life Among Diverse Young Adolescents?
Authors: Scott Sarah M. , Wallander Jan L. , Elliott Marc N. , Grunbaum Jo Anne , Chien Alyna T. , Tortolero Susan , Cuccaro Paula , Schuster Mark A.
Published: June 2015

We examined whether social resources from the family and the community moderate the risk associated with low socioeconomic status (SES) for reduced quality of life (QL) among youth across racial/ethnic groups. Data were from 4,824 fifth-grade youth (age [Formula: see text] = 11.1, SD = 0.6; 49% females) in the Healthy Passages™ study (2004-2006) located in Birmingham, Alabama; Los Angeles County, California; and Houston, Texas. Youth reported their QL using the Pediatric Quality of Life Inventory Version 4.0 and the Global Self-Worth subscale of the Self-Perception Profile and their status for hypothesized protective social mechanisms. Overall, family cohesion, parental nurturance, other adult, and peer support were positively associated with QL across racial/ethnic groups. There were few significant interactions, but all suggested that higher SES youth benefited more than lower SES youth. In fact, family cohesion among African American youth and other adult support among Hispanic youth differentiated QL at higher, but not lower SES. Further research should examine other risk contexts and seek to inform targeted prevention efforts.
Celebrating libraries in 20 years of democracy
Authors: Satgoor Ujala
Published: June 2015

Since the establishment of the first public library in 1818, the South African library and information services landscape has also been a reflection of the socio-political order and developments in the country. This article presents an historical perspective as well as an overview of libraries in South Africa since 1994, the context within which libraries function, library governance and legislative framework, government funding for redress, library technologies, library and information services education and the professional association. The article further highlights the importance of libraries in meeting the goals of the national development agenda towards entrenching a strong democracy and an educated and informed nation.
Money Talks or Millennials Walk
Authors: McGinnis Johnson Jasmine , Ng Eddy S.
Published: June 2015

The nonprofit sector has become increasingly reliant on paid professional staff and now faces competition from the private and public sectors, which often pay higher to attract and retain workers. Although Millennials are attracted to nonprofit work, there are concerns that they will not remain committed to the nonprofit workforce due to low pay. We analyzed data from the 2011 Young Nonprofit Professionals Network Survey to examine the relationship between pay, perceptions of equitable pay, and sector-switching intentions among Millennial nonprofit workers. Although two thirds of the respondents indicate sector-switching intentions, we found no evidence that Millennial nonprofit workers, who are purported to value extrinsic and materialistic rewards, expressed sector-switching intentions on account of pay. However, pay influences the sector-switching intentions of Millennial nonprofit managers and those with advanced education. Our results suggest that the nonprofit sector may be facing challenges in attracting and retaining Millennial managers because of low pay.
“That’s Just How It Is”
Authors: Tolman Deborah L. , Davis Brian R. , Bowman Christin P.
Published: June 2015

In this mixed-methods study, we adopted a feminist theoretical lens in conceptualizing gender as hierarchical and complementary ideologies—femininity and masculinity—that are fundamental constituents of institutionalized heterosexuality as a way to understand the persistence of gender inequity in adolescents’ heterosexual relationships. In Study 1, we conducted separate analyses for girls and boys to evaluate whether masculinity ideology for boys and femininity ideology for girls account for boys’ endorsement of male coercion and for girls’ endorsement of feminine conventions in heterosexual relationships with a sample of 250 tenth-grade students ( n = 144 girls). Masculinity ideology proved to be as strong or stronger than femininity ideology in predicting these respective outcomes. In Study 2, we sought to understand this pattern through a thematically informed narrative analysis of interviews with 53 of the Study 1 participants ( n = 35 girls) on their beliefs about and experiences with sexual expression and heterosexual relationships. Girls described the dual task of managing boys’ masculinity as well as their own femininity. Boys, by contrast, described girls’ femininity in instrumental terms for the management of their own masculinity. Integration of these results provides greater insight into how institutionalized heterosexuality is reproduced through the functioning of these hierarchical complementary gender ideologies.
ALC status in in-patient mental health settings
Authors: Little Jerrica , Hirdes John P. , Daniel Imtiaz
Published: June 2015

This article examines the characteristics associated with Alternate Level of Care (ALC) status in mental health in-patient units across Ontario. Using assessment information from the Resident Assessment Instrument–Mental Health, the prevalence of ALC episodes, resource utilization associated with ALC, and demographic and diagnostic characteristics of ALC patients are examined. The effective management of ALC patients should be an important priority for all stakeholders involved in mental health services delivery in Canada.
The Effect of Child Sexual Abuse on Men
Authors: O’Leary Patrick , Easton Scott D. , Gould Nick
Published: June 2015

Child sexual abuse (CSA) is a trauma that affects males in substantial numbers, sometimes in ways that are gender-specific (e.g., compromised masculine identity, confusion regarding sexuality). Much of the identification of the male-specific outcomes has been derived from practitioner experience and small qualitative studies. The current study explores gender-specific outcomes and describes the development of a scale to measure the effects of CSA on men. First, qualitative interviews with 20 men who were sexually abused in childhood were thematically analyzed. The emergent themes of sexuality, self-concept, psychological and emotional well-being, and social functioning were used to construct a 30-item instrument which was later completed by 147 men with histories of CSA. The dimensionality of the 30 items was then assessed for suitability as scales using confirmatory factor analysis (CFA). The final instrument, the Male Sexual Abuse Effects Scale (MSAES), combines three subscales: Negative Identity, Guilt and Self-Blame, and Psychological and Emotional Well-Being. Items concerning masculine identity were shown to be valid in the scale. MSAES scores were compared with the General Health Questionnaire–28 (GHQ-28) and found to be significantly correlated. GHQ-28 clinical thresholds were applied to differentiate clinical from nonclinical cases; an independent-samples t test showed that the clinical cases from the GHQ-28 had high scores on the MSAES. The new scale has the potential to help clinicians and researchers identify men who have been severely affected by CSA and who should be of clinical concern.
Success With Extended-Infusion Meropenem After Recurrence of Baclofen Pump-Related Achromobacter Xylosoxidans Meningitis in an Adolescent
Authors: Nichols Kristen R. , Knoderer Chad A. , Jackson Nicholas G. , Manaloor John J. , Christenson John C.
Published: June 2015

A 13-year-old female experienced a recurrence of baclofen pump-related central nervous system (CNS) infection caused by Achromobacter, despite absence of retained foreign material. Due to the failure of meropenem (120 mg/kg/d in divided doses every 8 hours and infused over 30 minutes) in the initial infection, the dose was infused over 4 hours during the recurrence. Meropenem is an antibiotic for which efficacy is time dependent, and 4-hour versus 30-minute infusions have been shown to prolong the time the concentration of the antibiotic exceeds the minimum inhibitory concentration (MIC) of the organism at the site of infection (T>MIC). Meropenem serum concentrations were obtained and indicated that T>MIC was at least 75% of the dosing interval. Our patient improved with no noted recurrences or adverse effects on the extended-infusion meropenem regimen. Utilization of extended-infusion beta-lactam dosing whenever possible in the treatment of serious infections caused by gram-negative organisms should be considered, as this dosing appears to be safe and improves the probability of achieving pharmacokinetic/pharmacodynamic goals.
Antimicrobial Stewardship in the Emergency Department
Authors: Bishop Bryan M.
Published: June 2015

Antimicrobial resistance is a national public health concern. Misuse of antimicrobials for conditions such as upper respiratory infection, urinary tract infections, and cellulitis has led to increased resistance to antimicrobials commonly utilized to treat those infections, such as sulfamethoxazole/trimethoprim and flouroquinolones. The emergency department (ED) is a site where these infections are commonly encountered both in ambulatory patients and in patients requiring admission to a hospital. The ED is uniquely positioned to affect the antimicrobial use and resistance patterns in both ambulatory settings and inpatient settings. However, implementing antimicrobial stewardship programs in the ED is fraught with challenges including diagnostic uncertainty, distractions secondary to patient or clinician turnover, and concerns with patient satisfaction to name just a few. However, this review article highlights successful interventions that have stemmed inappropriate antimicrobial use in the ED setting and warrant further study. This article also proposes other, yet to be validated proposals. Finally, this article serves as a call to action for pharmacists working in antimicrobial stewardship programs and in emergency medicine settings. There needs to be further research on the implementation of these and other interventions to reduce inappropriate antimicrobial use to prevent patient harm and curb the development of antimicrobial resistance.
Rational Use of Second-Generation Antipsychotics for the Treatment of ICU Delirium
Authors: Mo Yoonsun , Yam Felix K.
Published: June 2015

Delirium, described as an acute neuropsychiatric syndrome, occurs commonly in critically ill patients and leads to many negative outcomes including increased mortality and long-term cognitive deficits. Despite the lack of clinical data supporting the use of antipsychotics for the management of intensive care unit (ICU) delirium, pharmacological interventions are often needed to control acutely agitated patients. Given that the most current guidelines do not advocate the use of haloperidol for either the prevention or treatment of ICU delirium due to a lack of evidence, second-generation antipsychotics (SGAs) have been commonly used as alternatives to haloperidol for ICU patients with delirium. Nonetheless, the evidence supporting the use of SGAs to treat ICU delirium remains limited. This review is designed to assess the available clinical evidence and highlights the different neuropharmacological and safety properties of SGAs in order to guide the rational use of SGAs for the treatment of ICU delirium.
Social Capital and Implementation of Subsidized Fertilizer Programme for Small Farmers
Authors: Rustinsyah
Published: June 2015

A government programme for rural farmers in Indonesia is often implemented poorly in many villages. However, there is always a village that manages to implement the programme better than the others. The objective of the research is to understand the functioning of the subsidized fertilizer programme in a village that is considered to be a good example of the programme. This research also wants to know what role social capital plays towards it and in what ways it can be used for increasing effectiveness of the programme. The research was conducted from May to October 2013, by observing and interviewing all the stakeholders, in order to determine the best strategies to implement the programme. The results of this article are: (a) The implementation of the subsidized fertilizer programme in the village can run smoothly because of the involvement of social capital in the Rencana Definitif Kebutuhan Kelompok ‘the definite plan of the group needs’ preparation and fertilizer distribution; (b) the agricultural system with various time and cropping patterns need to be taken into account, as it causes differences in fertilizer needs.
Perceptions of Depression and Access to Mental Health Care Among Latino Immigrants
Authors: Martinez Tyson Dinorah , Arriola Nora B. , Corvin Jaime
Published: June 2015

Compared with non-Latino Whites, Latino immigrants have a lower prevalence of depression. However, they are also less likely to seek professional mental health services. Our objective was to compare and contrast perceptions of depression and access to mental health care among four of the largest Latino immigrant subgroups in Florida (Puerto Rican, Cuban, Mexican, and Colombian). We conducted a total of 120 interviews (30 men and women from each subgroup). Thematic analysis of qualitative data revealed that participants across the four groups were aware of the signs and symptoms of depression and had similar perceptions of depression. However, notable differences by subgroup emerged with regard to perceptions of access to mental health care. We suggest that the variation stems from differences in life experiences and the immigration context. Understanding the variances and nuances of Latino immigrants’ cultural construction of depression and immigration experience will enable practitioners to better serve this community.
Elucidating a Goal-Setting Continuum in Brain Injury Rehabilitation
Authors: Hunt Anne W. , Le Dorze Guylaine , Trentham Barry , Polatajko Helene J. , Dawson Deirdre R.
Published: June 2015

For individuals with brain injury, active participation in goal setting is associated with better rehabilitation outcomes. However, clinicians report difficulty engaging these clients in goal setting due to perceived or real deficits (e.g., lack of awareness). We conducted a study using grounded theory methods to understand how clinicians from occupational therapy facilitate client engagement and manage challenges inherent in goal setting with this population. Through constant comparative analysis, a goal-setting continuum emerged. At one end of the continuum, therapists embrace client-determined goals and enable clients to decide their own goals. At the other, therapists accept preset organization-determined goals (e.g., “the goal is discharge”) and pay little attention to client input. Although all participants aspired to embrace client-determined goal setting, most felt powerless to do so within perceived organizational constraints. Views of advocacy and empowerment help to explain our findings and inform more inclusive practice.
Evidence-Based Practice for Teachers of Children With Autism
Authors: Lubas Margaret , Mitchell Jennifer , De Leo Gianluca
Published: June 2015

Evidence-based practice related to autism research is a controversial topic. Governmental entities and national agencies are defining evidence-based practice as a specific set of interventions that educators should implement; however, large-scale efforts to generalize autism research, which are often single-subject case designs, may be a setback in the field. Children on the autism spectrum can experience a very broad range of difficulties with social interactions, managing behaviors, and communicating; similarly, they may experience a wide range of comorbidities. In addition, different environmental considerations come into play for each child. Such challenges to generalizing research are important to acknowledge so that research will be used to inform, not to dictate, the interventions that educators select. The process of identifying and implementing evidence-based practices for children with autism spectrum disorders is a dynamic one that requires educators to adapt interventions to meet students’ individual needs.
Tweets, Texts, and Tablets
Authors: Bruhn Allison Leigh , Waller LaNeisha , Hasselbring Ted S.
Published: June 2015

Students with behavior problems often lack the self-regulation skills necessary for success. One strategy shown to improve these skills is self-monitoring. Traditionally, self-monitoring has been done using paper and pencil, with some sort of prompt to complete the procedures. Prompts have involved teacher cues as well as technology. Current innovation has resulted in using technology to both prompt and record self-monitored behaviors. This column explores the literature on technology-based self-monitoring, describes steps in the self-monitoring process with considerations for incorporating technology, and offers a classroom example of a student with attention-deficit/hyperactivity disorder using a self-monitoring application (i.e., app) on an iPad to improve behavior.
Evolution of reflexive signals using a realistic vocal tract model
Authors: Warlaumont Anne S , Olney Andrew M
Published: June 2015

We introduce a model of the evolution of reflexive primate signals that incorporates a realistic vocal tract model for generating the signals. Signaler neural networks receive signal types as inputs and produce vocal tract muscle activations as outputs. These muscle activations are input to a model of the primate vocal tract, generating real sounds. Receiver neural networks receive spectrograms of these sounds as inputs and produce signal type classifications as outputs. Incorporating a realistic vocal tract has a substantial effect on the types of signals that can evolve. Compared to a model with abstract signals, the realistic model signals are more similar and have more correlated elements. The realistic, embodied model also exhibits more variability in rate of adaptation, usually adapting more slowly. This may be explained by the more jagged fitness landscapes in the realistic model. The realistic signals also tend to be quiet. Environmental noise results in louder signals but makes the evolutionary process even slower and less robust. These results indicate that signal evolution with a more realistic genotype–phenotype mapping can differ substantially from evolution with abstract signals. Including realistic signal generation mechanisms may enable computational models to provide greater insights into natural signal evolution.
Arthroscopic Evaluation of Impingement and Osteochondral Lesions in Chronic Lateral Ankle Instability
Authors: Odak Saurabh , Ahluwalia Raju , Shivarathre Deepak G. , Mahmood Atif , Blucher Nicola , Hennessy Michael , Platt Simon
Published: June 2015

Background:

Anterolateral impingement associated with intra-articular synovitis, scarring, and fibrosis is a less recognized feature in patients with chronic lateral ankle instability. The aim of our study was to ascertain the incidence of intra-articular synovitis, osteochondral lesions (OCLs), impingement lesions (both intra- and extra-articular), and other associated pathologies in patients undergoing modified Broström-Gould ankle ligament reconstruction.

Methods:

We performed a retrospective review of all patients who underwent arthroscopically assisted modified Broström-Gould ankle ligament reconstruction for symptomatic recurrent ankle instability. Patients who had previous ankle surgery or inflammatory arthropathy were excluded. Ankle arthroscopy was performed prior to reconstruction in all patients. Data were obtained from clinical and radiological records including magnetic resonance imaging scans. Arthroscopic findings were recorded in detail intraoperatively. A total of 100 patients (53 females and 47 males) with an average age of 37 years (range, 15-65 years) were reviewed over a 10-year period.

Results:

Sixty-three patients (63%) had intra-articular synovitis mostly in the anterior and/or anterolateral compartment, which required arthroscopic debridement. Seventeen patients (17%) were found to have OCLs, and 12 (12%) patients had anterior bony impingement lesions.

Conclusion:

This study found a high incidence of anterior/anterolateral synovitis in patients with chronic lateral ankle instability. However, there was a relatively low incidence of anterior bony impingement lesions or OCLs in our series.

Level of Evidence:

Level IV, retrospective case series.
Beaming for Charcot Foot Reconstruction
Authors: Jones Carroll P.
Published: June 2015

Charcot arthropathy commonly affects the midfoot and is often an extremely difficult and challenging surgical problem. Operative treatment with medial column arthrodesis using large intramedullary bolts or screws is an evolving and increasingly popular technique called “beaming.” The technique is described here.

Level of Evidence: Level V, expert opinion.
Concurrent Validity of New Subscale Scores for the Booklet Category Test
Authors: McNally Shannon , Dsurney John , McGovern Jessica , DeFilippis Nick , Chan Leighton
Published: June 2015

The Booklet Category Test (BCT) is a neuropsychological test of cognitive dysfunction that provides only one overall error score indicative of global impairment. It does not, however, delineate specific domains that might be impaired. The aim of this study is to concurrently validate 13 new BCT subscales using legacy instruments in patients with nonpenetrating traumatic brain injury (TBI). Eighty-nine patients with mild, moderate, and severe TBI completed a battery of neuropsychology tests. Partial correlations controlling for age were performed and there were significant correlations between the a priori selected scores from legacy measures of major cognitive domains and both BCT total errors and subscale scores. Additional analysis showed that several subscales were able to differentiate between performance levels on the legacy measures. Overall, our results showed that the subscales measured cognitive skills beyond global impairment, supporting the use of the BCT subscales in a population with TBI.
Early Numerical Competencies in 4- and 5-Year-Old Children With Autism Spectrum Disorder
Authors: Titeca Daisy , Roeyers Herbert , Desoete Annemie
Published: June 2015

Studies comparing mathematical abilities of children with autism spectrum disorder (ASD) and typically developing children are hitherto scarce, inconclusive, and mainly focusing on elementary school children or adolescents. The present study wants to gain insight into the foundation of mathematics by looking at preschool performances. Five early numerical competencies known to be important for mathematical development were examined: verbal subitizing, counting, magnitude comparison, estimation, and arithmetic operations. These competencies were studied in 20 high-functioning children with ASD and 20 age-matched control children aged 4 and 5 years. Our data revealed similar early number processing in children with and without ASD at preschool age, meaning that both groups did not differ on the foundation of mathematics development. Given the pervasiveness and the family impact of the condition of ASD, this is an important positive message for parents and preschool teachers. Implications and several directions for future research are proposed.
Brass in brake linings: Key considerations for its replacement
Authors: Baklouti Mouna , Cristol Anne-Lise , Elleuch Riadh , Desplanques Yannick
Published: June 2015

Following the ban of its use in brake linings, asbestos has been replaced by various materials based on industrial feedback and trial and error, but without any real understanding of how it affects contact during braking. As copper too will be prohibited in a few years' time, we set out to study the influence of one of its alloys, namely brass. A simplified brass-containing material was developed for this purpose. This material has an anisotropic microstructure and consequently exhibits anisotropic mechanical behavior and increased thermal diffusivity. It displays good tribological behavior at moderate and high temperatures. A surface analysis shows that the contact area is very effective at trapping third bodies and developing secondary plateaus, which provide good conditions for stabilizing friction to a high degree, even at high temperatures.
Telemedicine in US Army soldiers with type 1 diabetes
Authors: Choi Y Sammy , Cucura Jon , Jain Ram , Berry-Caban Cristobal
Published: June 2015

A retrospective study of a telemedicine clinic for active duty US Army soldiers with type 1 diabetes was conducted. Fifty-one consecutive patients (mean age 33.9 years) were enrolled into the clinic. All soldiers with known or newly diagnosed type 1 diabetes received three weekly office visits for intensive diabetes education. After this, all communication occurred via a messaging system consisting of texting, web-based download, and/or email to a diabetes management team. For urgent matters, 24/7 direct paging or telephone access was provided. Routine adjustments in insulin dosing were accomplished via email. Soldiers were followed for a mean of 17.1 months. Baseline, three-month, and end of study glycated hemoglobin (A1C) values were 9.8, 7.3, and 6.9, respectively. There were no significant differences in end of study A1C levels between patients with known vs. newly diagnosed type 1 diabetes, nor were there any differences between those patients who received insulin via pump therapy vs. multiple daily injections. Telemedicine was safe and effective in lowering A1C levels in US Army soldiers with type 1 diabetes.
Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model
Authors: Ben-Assuli Ofir , Leshno Moshe
Published: June 2015

In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians’ diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments.
100 million strong: A case study of group identification and deindividuation on Imgur.com
Authors: Mikal Jude P , Rice Ronald E , Kent Robert G , Uchino Bert N
Published: June 2015

Online groups can become communities, developing group identification and fostering deindividuation. But is this possible for very large, anonymous groups with low barriers to entry, highly constrained formats, and great diversity of content? Applying social identity theory and social identification and deindividuation effects theory, this study assesses influences on group identification and deindividuation in the case of Imgur.com . Respondents reported slightly positive levels of the three forms of group identification, but mixed levels of two forms of deindividuation. As argued by proponents of computer-mediated communication, demographics play only a minor role on these outcomes. More involved usage, such as direct access and commenting on images, is more associated with these outcomes, while more basic usage, such as total hours and reading comments, has little influence. Deindividuation is positively associated with group identification.
A longitudinal assessment of sleep variables during exacerbations of chronic obstructive pulmonary disease
Authors: Vanaparthy R , Mota P , Khan R , Ehsan M , Qureshi A , ZuWallack R , Leidy N
Published: June 2015

Although sleep disturbance is common in chronic obstructive pulmonary disease (COPD), relatively little is known on the effect of the exacerbation on sleep quality. Accordingly, we longitudinally assessed sleep variables during exacerbations and clinical stability. This is a sub-study of a larger observational analysis. Inclusion criteria were clinically stable COPD and two or more clinical exacerbations in the preceding 12 months. Patients were followed for approximately 6 months and during this time the following were recorded daily: (1) COPD exacerbations, which were determined in two ways, clinically and symptom defined using the exacerbations of chronic pulmonary disease tool (EXACT); (2) daytime sleepiness, which was measured using the Stanford Sleepiness Scale; (3) subjective awakenings, which was measured from a sleep diary; and (4) sleep duration, efficiency, and objective awakenings, which was measured from actigraphy. These variables for exacerbation and non-exacerbation days were compared. Seventeen patients (9 male, age 63 ± 12 years, forced expiratory volume in 1 second 52 ± 20%) entered data over 135 ± 18 days. During this time, 15 patients had 27 symptom-defined exacerbations and 8 had 9 clinically reported exacerbations. Symptom-defined exacerbation days were 26% of the total study days. More daytime sleepiness, decreased total sleep time (TST), and decreased sleep efficiency (SE) were present during exacerbations compared with clinical stability ( p < 0.001). These disturbances tended to be greater during clinically reported exacerbations than during unreported events ( p < 0.05). Increased daytime sleepiness, less TST, and poorer SE are present during COPD exacerbations.
Evaluating a Quality Improvement Program for Cervical Cancer Screening at an Urban Safety Net Clinic
Authors: Hills Robin L. , Kulbok Pamela A. , Clark Myra
Published: June 2015

This article evaluates a quality improvement program for improving guideline-consistent cervical cancer screening practices in an urban safety net clinic. Quality improvement initiatives that combine policy with practice are particularly timely in light of the alignment of cervical cancer screening guidelines released in 2012 by the most influential national organizations. A descriptive comparison design was employed using the Healthy People 2020 target of 93% screened according to guidelines. Provider-, patient-, and workflow-based strategies included (1) addition of a clinical decision support system, (2) provider educational outreach, (3) patient reminder letters, and (4) development of a clinic procedure manual. Through the application of an established quality measurement tool, three quality indicators were measured: screened according to evidence-based guidelines, not screened, and screened more frequently than recommended. Data from the sample (N = 1,032) were collected at baseline and 12 months postimplementation. Each quality indicator category was significant at follow-up. Patients screened according to guidelines nearly doubled while the number of underscreened patients was reduced by nearly half. Similarly, there was a threefold decrease in patients screened more frequently than recommended. Clinical administrators, quality improvement specialists, and health care providers in primary care settings can use the strategies implemented in this study as a starting point for continuous quality improvement initiatives for cervical cancer screening.
Upregulation of Leucine Zipper Protein mRNA in Hepatocellular Carcinoma Associated With Poor Prognosis
Authors: Li Guangbing , Yuan Li , Liu Dejie , Liu Jun
Published: June 2015

Background:

Leucine zipper protein (LUZP) plays key roles in development. Overexpression of LUZP was documented in several types of solid tumors. In this study, expression of LUZP messenger RNA (LUZP mRNA) in human hepatocellular carcinoma (HCC) was examined, and the correlations of LUZP mRNA level with patients’ characteristics and prognosis were also investigated.

Methods:

Total RNA was extracted from HCC and paired noncancerous liver tissues of 77 patients. Expression of LUZP mRNA in the tissues was determined by real-time quantitative reverse transcriptase polymerase chain reaction. Using average LUZP mRNA level in noncancerous liver tissues as the cutoff, patients with HCC were categorized into high-expression group and low-expression group. Correlations of LUZP mRNA with clinical parameters were analyzed. Overall survival of the patients in the 2 groups was analyzed by Kaplan-Meier method.

Results:

The LUZP mRNA level was significantly higher in HCC samples than in the noncancerous liver tissues (1.87 ± 0.11 vs 0.58 ± 0.05, P < .01). Significant differences were found between the 2 groups in terms of portal vein invasion, Tumor Lymph Node Metastasis (TNM) stage, and recurrence of HCC. The current study failed to find significant differences between the 2 groups in clinical characteristics such as age, gender, lymph node metastasis, hepatitis B virus infection, family HCC history, and alcohol intake. Overall survival in high-expression group was 12 months while that in the low-expression group was 34 months ( P = .03).

Conclusion:

The LUZP mRNA is a prognostic indicator in HCC, and overexpression is associated with poor prognosis in patients with HCC.
Alginate and DNA Gels Are Suitable Delivery Systems for Diabetic Wound Healing
Authors: Tellechea Ana , Silva Eduardo A. , Min Jianghong , Leal Ermelindo C. , Auster Michael E. , Pradhan-Nabzdyk Leena , Shih William , Mooney David J. , Veves Aristidis
Published: June 2015

Diabetic foot ulcers (DFU) represent a severe health problem and an unmet clinical challenge. In this study, we tested the efficacy of novel biomaterials in improving wound healing in mouse models of diabetes mellitus (DM). The biomaterials are composed of alginate- and deoxyribonucleic acid (DNA)-based gels that allow incorporation of effector cells, such as outgrowth endothelial cells (OEC), and provide sustained release of bioactive factors, such as neuropeptides and growth factors, which have been previously validated in experimental models of DM wound healing or hind limb ischemia. We tested these biomaterials in mice and demonstrate that they are biocompatible and can be injected into the wound margins without major adverse effects. In addition, we show that the combination of OEC and the neuropeptide Substance P has a better healing outcome than the delivery of OEC alone, while subtherapeutic doses of vascular endothelial growth factor (VEGF) are required for the transplanted cells to exert their beneficial effects in wound healing. In summary, alginate and DNA scaffolds could serve as potential delivery systems for the next-generation DFU therapies.