bluuebunny/crossref_metadata_2025 huggingface dataset:
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Authors: Bruscaglioni Livia
Published: March 2017

The chapter investigates the dynamic of encounters between staff and patients in two case studies on hospital organisation, taking special account of the emotional and psychological aspects associated with practices in the use of organisational space. By drawing on two empirical cases set in different hospital contexts (the waiting rooms of two outpatients wards and an emergency unit), analysis is made of two examples of practices which represent express violations of the rules on the use of space by patients and their relatives. Violations that could be analysed as demand of engagement - by patients and relatives - in the process of care. In these empirical cases the governance defensive reaction strategies used by hospital staff in their interaction with waiting patients is shown in light of the rules that define the behaviour acceptable for patients and relatives. The study is based on a qualitative methodological approach using the techniques of observation and in-depth interviews with hospital staff, patients and relatives.
Mobility in Healthcare
Authors: Gürsel Güney
Published: March 2017

Mobility is the blossoming technology of our era. Mobile devices, especially smart phones, tablets, phablets are becoming common, and they are being a part of us as we carry all the time with us. Business discovered the easy-to-reach-customer facility of mobility and companies focus on this area. Scientific research focused on this area as well. Using the facilities provided with all the time with us mobile devices, especially healthcare can gain tremendous advances and have already done in some applications. Remote healthcare, decreased costs, advanced healthcare access, prioritizing the patients, can be given as examples to the advances that have been gained. As the mobile healthcare applications becoming common, there exists a danger of abuse and misuse. The need for regulations has emerged. The purpose of this study is to give basic information and vision about the usage of mobility in medical domain to ease healthcare and make it more effective. The mobile technologies used in the healthcare information systems, together with the challenges, problems and regulations, is explained.
Patient Safety in Community Care
Authors: Eason Ken , Waterson Patrick
Published: March 2017

The increasing number of elderly people in need of health and social care is putting pressure on current services to develop better ways of providing integrated care in the community. It is a widely held belief that e-health technologies have great potential in enabling and achieving this goal. This chapter reviews a number of technologies used for this purpose: telecare, telehealth, telemedicine, electronic patient record systems, and technologies to support mobile working. In each case, technocentric-design approaches have led to problematic implementations and failures to achieve adoption into the routine of delivering healthcare. An examination of attempts to implement major changes in the service delivery of integrated care shows that e-health technologies can be successfully implemented when they are seen as an intrinsic part of the creation of a complete system. However, the design process required for successful delivery of these services is challenging; it requires sustained and integrated development work by clinical staff and technologists coordinating their work on process changes, organisational developments, and technology implementations.
Effect of TiB2 Content on Microstructure and Hardness of In Situ TiB2 Reinforced High Zinc Content Al-Zn-Mg-Cu-Zr Composite Materials
Authors: Li He , Chai Li Hua , Chen Zi Yong , Wang Hai Jing , Jin Tou Nan
Published: March 2017

TiB2p/Al-10Zn-1.7Mg-1.0Cu-0.12Zr composite was prepared by synthesis of in-situ Al-TiB2 master alloy, high purity aluminum, pure zinc, pure magnesium, Al-50 wt% Cu and Al-4 wt% Zr master alloys. The mass fraction of TiB2 particles was varied from 0% to 9.14%. SEM and TEM were applied to evaluate the microstructure and phase component. HB hardness test were carried out on hardness value of the matrix alloy and the composite. The results showed that TiB2 particles uniformly distributed in the composite and well combined with the matrix alloy. The average grain size of the composites decreased from 110.35μm to 52.07μm when the TiB2 particles is 4.47%, and the grain size changed slightly when TiB2 content increased further. The hardness value of the composites which raised from 189HB to 206HB is superior to that of the matrix alloy. As the content of TiB2 particles increased, HB hardness value also increased.
Unidirectional Abaca Fiber Reinforced Thermoplastic Starch Composite
Authors: Vasquez Jasmin Z. , Diaz Leslie Joy L.
Published: March 2017

Unidirectional abaca fiber reinforced thermoplastic starch composite was prepared via compression molding by varying the fiber volume fraction, compression pressure and fiber treatment. Factorial analysis at 95% confidence level has shown that changing fiber volume from 5% to 10% has a significant effect on the tensile strength of the composite. A treatment-pressure interaction was also found to have significant effect on the tensile strength of the composite. Result of tensile test showed that composite fabricated using 6.89 MPa (1000 psi) compression pressure, 10% fiber volume, and treated fibers exhibited the highest tensile strength of 19.73MPa while composite fabricated using 6.89 MPa (1000 psi) compression pressure, 10% fiber volume and untreated fibers exhibited only a tensile strength of 12.30 MPa. Scanning electron microscopy (SEM) on the transverse cross section has shown that alkali treatment was able to improve the interfacial bond between the fibers and the thermoplastic starch matrix resulting to an increase in strength of the composite fabricated at 6.89 MPa (1000 psi). However, using a compression pressure of 13.79 MPa (2000 psi) during fabrication induced damage, i.e. internal cracking, on the alkali treated fibers, thereby reducing the strength of the composite.
Neuropsychiatric symptoms and diagnosis of grey matter heterotopia: A case-based reflection
Authors: Lippi Gian
Published: March 2017

Neuropsychiatric symptoms can be related to less common underlying neuropsychiatric conditions – in this case report, the condition discussed is that of grey matter heterotopia (GMH). The patient presented with a history of prominent aggression, impulsivity and manipulative and attention-seeking behaviour. Episodes of depression and incidents of deliberate self-harm and suicide attempts had been reported. Neuropsychiatric symptoms included anxiety, a labile mood, delusional thinking and auditory hallucinations. Testing revealed some cognitive difficulties and severe impairment of frontal lobe functions. A magnetic resonance imaging (MRI) scan of his brain revealed the presence of GMH, which had previously been misdiagnosed as tuberous sclerosis. An MRI scan of the brain is the special investigation of choice for the correct diagnosis of GMH. The pathognomonic finding is that of heterotopic grey matter abnormally located within areas of white matter. Defective foetal neuronal migration between the third and fifth month of pregnancy can lead to GMH, which can present later on in childhood or adolescence with epilepsy, intellectual impairment or reading difficulties. During the late teenage years or early adulthood, a wide variety of neuropsychiatric symptoms may be present, which can lead to diagnostic difficulties.
Dos siglos de revitalización en la iconografía del Monasterio de El Escorial, 1600-1800
Authors: Chías Navarro Pilar
Published: March 2017

A lo largo de los reinados de los Austrias Menores la larga sombra del rey fundador se fue diluyendo, y con ella la influencia de sus panegiristas y de la iconografía inicial del Monasterio que lo convirtieran en un símbolo de la Contrarreforma y del poder de la monarquía española. La relación que tuvieron con el edificio los sucesores de Felipe II y más tarde los primeros Borbones fue muy variada, y ello se debió tanto a sus preferencias respecto al uso estacional en los Reales Sitios, como a cuestiones de gusto y comodidad. Como consecuencia, durante los siglos XVII y XVIII las imágenes del Monasterio se actualizaron y completaron con otras que describían los elementos nuevos, y con vistas del interior y del exterior. De ellas trata la presente investigación, así como de su vinculación con la mentalidad y estética de cada época y con las técnicas de reproducción disponibles.
Representando la estructura. Reflexiones sobre la obra de Arthur Vierendeel “La construction architecturale en fonte, fer et acier”
Authors: López-César Isaac , Estévez-Cimadevilla Javier
Published: March 2017

En 1902 Arthur Vierendeel publicaba su libro “La construction architecturale en fonte, fer et acier” en el que describía gráficamente la anatomía constructiva de los que él consideró los edificios más significativos de la primera etapa de la arquitectura del hierro. El presente artículo pretende poner en valor los aspectos más relevantes de esta obra poco conocida y, sin embargo, de un alto valor historiográfico. Asimismo, pretende resaltar y focalizar en los dibujos de Vierendeel su espíritu conciliador en la dicotomía arquitecto-ingeniero propia del S. XIX.
Arquitectura tectónica en la vega de Granada. Los secaderos de tabaco. Percepción y expresión gráfica
Authors: García Nofuentes Juan Francisco , Martínez-Ramos e Iruela Roser
Published: March 2017

La arquitectura industrial embrionaria que exhiben los secaderos de tabaco en la Vega de Granada, forma parte de aquella categoría constructiva relacionada con el nudo textil semperiano, con la articulación; lo que para Frampton representa la conciliación entre lo estereotómico y lo tectónico. La arquitectura es gravedad y la articulación tectónica expresa la transición de lo telúrico y la masa a la ligereza y la inmaterialidad. La percepción de la arquitectura tectónica de los secaderos a través de la mirada, nos permite adivinar la masa, la ligereza, la textura, el tiempo, la luz incluso el olor y la edad del material utilizado.
La carencia que tiene la visión en cuanto a sentir la tangibilidad de los materiales, es suplida por el dibujo, el cual se convierte para el arquitecto en una herramienta de la mirada para el análisis y el conocimiento. El dibujo es el instrumento de aprendizaje de la percepción.
The Effect of Information Feedback in Construction Bidding
Authors: Soo Alexander , Oo Bee
Published: March 2017

With the goal to achieve efficiency in bidding competitions, many codes of bidding procedure recommend clients provide contractors with bidding feedback information. Contractors strive to bid competitively via learning based on their experiences in past bidding attempts. The level of bidding feedback information, however, varies across clients. In many cases, clients do not provide feedback or provide insufficient feedback to contractors. Focussing on two information feedback conditions (full and partial), we examine: (i) the changes in bidding trend over time, and (ii) the effects of bidding feedback information on bidders’ competitiveness in bidding. Data were gathered using a bidding experiment that involved student (inexperienced) bidders with a construction project management background. The results show that the variations in bids over time for full information feedback condition are statistically significant, but not for bids from bidders with partial bidding feedback information. Bidders with full bidding feedback information are more competitive than those with partial bidding feedback information. The findings add to both our theoretical and empirical understanding of construction bidding: an understanding of the process of changes in the price of building work, and how the process can be manipulated through the release of bidding feedback information.
Comparison of ozone profiles and influences from the tertiary ozone maximum in the night-to-day ratio above Switzerland
Authors: Moreira Lorena , Hocke Klemens , Kämpfer Niklaus
Published: March 2017

Abstract. Stratospheric and middle mesospheric ozone profiles have been continually measured by the GROMOS (GROund-based Millimeter-wave Ozone Spectrometer) microwave radiometer since 1994 above Bern, Switzerland (46.95° N, 7.44° E, 577 m). GROMOS is part of the Network for the Detection of Atmospheric Composition Change (NDACC). A new version for the retrieval of ozone profiles has been developed with the aim to improve the altitude range of retrieval profiles. GROMOS profiles from this new retrieval version have been compared to coincident ozone profiles obtained by the satellite limb sounder Aura/MLS. The study covers the stratosphere and middle mesosphere from 50 to 0.05 hPa (from 21 to 70 km) and extends over the period from July 2009 to November 2016, which results in more than 3500 coincident profiles available for the comparison. GROMOS and Aura/MLS profiles agree within 3 % for the altitude range from 25 to 55 km, with standard deviations of the mean relative differences around 5 % from 30 to 40 km and tending to 10 % towards the lower and upper stratosphere. Above the stratosphere, the mean relative differences and its standard deviations are increasing with altitude up to 50 % at 70 km. In addition, we have observed the annual variation of nighttime ozone in the middle mesosphere, at 0.05 hPa (70 km), characterised by the enhancement of ozone during wintertime for both ground-based and space-based measurements. This behaviour is explained by the middle mesospheric maximum of ozone (MMM). On the other hand, the amplitude of the diurnal variation, night-to-day ratio (NDR), is not as strong as the observed one at higher latitudes, nevertheless we observe the winter anomaly of the night-to-day ratio.
Re(Examining) Relations between CHC Broad and Narrow Cognitive Abilities and Reading Achievement
Authors: McGill Ryan J.
Published: March 2017

Previously, Evans and colleagues (2001) utilized simultaneous multiple regression to examine relations between Cattell-Horn-Carroll (CHC; Schneider & McGrew, 2012) broad and narrow cognitive abilities and reading achievement across the school age span. Although their findings suggest that many broad/narrow abilities had clinically significant effects on reading achievement they failed to account for the potential moderating effects of the general factor. To account for these effects, the current study employed hierarchical multiple regression analysis to reexamine the relationships between CHC dimensions and reading achievement after controlling for the effects of the general factor with 4,722 participants ages 6-18 from the Woodcock Johnson III Psychoeducational Battery (WJ III; Woodcock, McGrew, & Mather, 2001a). Results from the present study indicate that the full scale GIA composite (as a proxy for g) consistently accounted for large effects across the school age span for all of the reading achievement variables that were assessed. Among the broad and narrow abilities, only Gc consistently accounted for meaningful proportions of reading scores beyond g. As a consequence, researchers are encouraged to give greater consideration to the dimensionality of broad and narrow CHC measures when examining cognitive-achievement relationships or they may risk over-interpreting the predictive effects associated with these indices. Potential implications for clinical application of CHC theory are also discussed.
System of common courts in the Free City of Danzig (1920-1939)
Authors: Maciejewski Tadeusz
Published: March 2017

W niniejszym artykule zaprezentowane zostały częściowe wyniki szerszych badań prowadzonych nad historią sądownictwa powszechnego w Wolnym Mieście Gdańsku. Przyczyniły się one do pogłębienia wiedzy w zakresie badanego zagadnienia. Określono podstawy prawne funkcjonowania sądownictwa w WM Gdańsku, a dokonując ich analizy poszerzono wiedzę na temat struktury sądownictwa, pozycji sędziów oraz kompetencji różnego rodzaju sądów: Sądu Najwyższego, Sądu Krajowego z jego wydziałami, sądów urzędniczych, ławniczych, przysięgłych oraz sądów dla nieletnich.
POSITIVE TOLERANCE AND SOLIDARITY. A PARADIGM CHANGE TO COUNTER THE “GLOBALIZATION OF INDIFFERENCE”
Authors: Hermida del Llano Cristina
Published: March 2017

The 21st century is witness to a globalization of indifference that derives from an erroneous understanding of the concepts of tolerance and solidarity, which especially affects immigrants. Here, we analyze the importance of immigrants achieving a true cultural integration within the European Union. We advocate for minority rights, and freedom to congregate, worship and to speak one’s own language. This requires a broader discourse on identifying the structure factors that underlie discrimination and creating policies to facilitate equality of opportunity and outcome. The essential task is to decide what constitutes the maximum acceptance of diversity, and what is the minimum acceptance. Tolerance should be considered as being distinct from the sentiment of indifference. One should turn to positive tolerance and the value of solidarity as a relational concept, as these two are the cornerstones for the construction of a democratic Europe that is both coherent and truly capable of resolving the issues concerning migration in the European Union.
POSSIBLE LEGAL REGULATIONS ON REGIONALIZATION IN ROMANIA
Authors: Popescu Ljungholm Doina
Published: March 2017

In the present study I have in view the fulfillment of the regionalizing process by retrospection to the four processes in the European Union, but also on the regionalization made by France and Poland, from which Romania could take some important outlines so as to legislate, implicitly by reforming the Constitution, the most preformat possible regional system for the country, in the present social and economic context, as a normal consequence of democratic devotion. I suggested the defining of the new regional local authorities, their responsibilities, the relations that will be stated in the relations with the existing local authorities, in relation with the central ones, their number, so as to lead to the unitary development, as much as possible, of all the regions. The dedication of decentralization as a constitutional principle comes to show our vocation and affiliation to the European culture values and the standards foreseen by the Local Autonomy Charta.
Lithospheric structure ofIberia andMorocco using finite‐frequencyRayleigh wave tomography from earthquakes and seismic ambient noise
Authors: Palomeras I. , Villaseñor A. , Thurner S. , Levander A. , Gallart J. , Harnafi M.
Published: March 2017

We present a new 3‐D shear velocity model of the western Mediterranean from the Pyrenees, Spain, to the Atlas Mountains, Morocco, and the estimated crustal and lithospheric thickness. The velocity model shows different crustal and lithospheric velocities for the Variscan provinces, those which have been affected by Alpine deformation, and those which are actively deforming. The Iberian Massif has detectable differences in crustal thickness that can be related to the evolution of the Variscan orogen in Iberia. Areas affected by Alpine deformation have generally lower velocities in the upper and lower crust than the Iberian Massif. Beneath the Gibraltar Strait and surrounding areas, the crustal thickness is greater than 50 km, below which a high‐velocity anomaly (>4.5 km/s) is mapped to depths greater than 200 km. We identify this as a subducted remnant of the NeoTethys plate referred to as the Alboran and western Mediterranean slab. Beneath the adjacent Betic and Rif Mountains, the Alboran slab is still attached to the base of the crust, depressing it, and ultimately delaminating the lower crust and mantle lithosphere as the slab sinks. Under the adjacent continents, the Alboran slab is surrounded by low upper mantle shear wave velocities (Vs < 4.3) that we interpret as asthenosphere that has replaced the continental margin lithosphere which was viscously removed by Alboran plate subduction. The southernmost part of the model features an anomalously thin lithosphere beneath the Atlas Mountains that could be related to lateral flow induced by the Alboran slab.
Solar and lunar tidal variabilities in GPS‐TEC and geomagnetic field variations: Seasonal as well as during the sudden stratospheric warming of 2010
Authors: Sridharan S.
Published: March 2017

The Global Positioning System (GPS) deduced total electron content (TEC) data at 15°N (geomagnetic), which is the northern crest region of equatorial ionization anomaly, are used to study solar and lunar tidal variabilities during the years 2008 and 2009 and also during the 2009–2010 winter, when a major sudden stratospheric warming (SSW) event has occurred. The diurnal and semidiurnal tidal amplitudes show semiannual variation with maximum amplitudes during February–March and September–November, whereas terdiurnal tide is larger during April–September. They show significant longitudinal variability with larger (smaller) amplitudes over 250°E–150°E (200°E–250°E). Lunar semidiurnal tidal amplitudes show sporadic enhancements during northern winter months and negligible amplitudes during northern summer months. They also show notable longitudinal variabilities. The solar migrating tides DW1 and SW2 show semiannual variation with larger amplitudes during spring equinox months, whereas TW3 maximizes during northern summer. DW2 shows larger amplitudes during summer months. During the SSW, except TW3, the migrating tides DW1 and SW2 show considerable enhancements. Among solar nonmigrating tides, SW1, TW2, and DS0 show larger enhancements. Solar tides in TEC and equatorial electrojet strength over Tirunelveli vary with the time scale of 60 days during October 2009–March 2010 similar to ozone mass mixing ratio at 10 hPa, and this confirms the vital role of ozone in tidal variabilities in ionospheric parameters. Lunar tidal amplitudes in changes in horizontal component of geomagnetic field (ΔH) are larger over Tirunelveli, a station near dip equator. Solar semidiurnal tides in ΔH have larger amplitudes than lunar tides over polar stations, Mawson and Godhavn.
Dynamics of Andaman Sea circulation and its role in connecting the equatorial Indian Ocean to the Bay of Bengal
Authors: Chatterjee Abhisek , Shankar D. , McCreary J. P. , Vinayachandran P. N. , Mukherjee A.
Published: March 2017

Circulation in the Bay of Bengal (BoB) is driven not only by local winds, but are also strongly forced by the reflection of equatorial Kelvin waves (EKWs) from the eastern boundary of the Indian Ocean. The equatorial influence attains its peak during the monsoon‐transition period when strong eastward currents force the strong EKWs along the equator. The Andaman Sea, lying between the Andaman and Nicobar island chains to its west and Indonesia, Thailand, and Myanmar to the south, east, and north, is connected to the equatorial ocean and the BoB by three primary passages, the southern (6°N), middle (10°N), and northern (15°N) channels. We use ocean circulation models, together with satellite altimeter data, to study the pathways by which equatorial signals pass through the Andaman Sea to the BoB and associated dynamical interactions in the process. The mean coastal circulation within the Andaman Sea and around the islands is primarily driven by equatorial forcing, with the local winds forcing a weak sea‐level signal. On the other hand, the current forced by local winds is comparable to that forced remotely from the equator. Our results suggest that the Andaman and Nicobar Islands not only influence the circulation within the Andaman Sea, but also significantly alter the circulation in the interior bay and along the east coast of India, implying that they need to be represented accurately in numerical models of the Indian Ocean.
Characterizing convective cold pools
Authors: Drager Aryeh J. , van den Heever Susan C.
Published: March 2017

Cold pools produced by convective storms play an important role in Earth's climate system. However, a common framework does not exist for objectively identifying convective cold pools in observations and models. The present study investigates convective cold pools within a simulation of tropical continental convection that uses a cloud‐resolving model with a coupled land‐surface model. Multiple variables are assessed for their potential in identifying convective cold pool boundaries, and a novel technique is developed and tested for identifying and tracking cold pools in numerical model simulations. This algorithm is based on surface rainfall rates and radial gradients in the density potential temperature field. The algorithm successfully identifies near‐surface cold pool boundaries and is able to distinguish between connected cold pools. Once cold pools have been identified and tracked, composites of cold pool evolution are then constructed, and average cold pool properties are investigated. Wet patches are found to develop within the centers of cold pools where the ground has been soaked with rainwater. These wet patches help to maintain cool surface temperatures and reduce cold pool dissipation, which has implications for the development of subsequent convection.
A new process sensitivity index to identify important system processes under process model and parametric uncertainty
Authors: Dai Heng , Ye Ming , Walker Anthony P. , Chen Xingyuan
Published: March 2017

A hydrological model consists of multiple process level submodels, and each submodel represents a process key to the operation of the simulated system. Global sensitivity analysis methods have been widely used to identify important processes for system model development and improvement. The existing methods of global sensitivity analysis only consider parametric uncertainty, and are not capable of handling model uncertainty caused by multiple process models that arise from competing hypotheses about one or more processes. To address this problem, this study develops a new method to probe model output sensitivity to competing process models by integrating model averaging methods with variance‐based global sensitivity analysis. A process sensitivity index is derived as a single summary measure of relative process importance, and the index includes variance in model outputs caused by uncertainty in both process models and their parameters. For demonstration, the new index is used to assign importance to the processes of recharge and geology in a synthetic study of groundwater reactive transport modeling. The recharge process is simulated by two models that convert precipitation to recharge, and the geology process is simulated by two models of hydraulic conductivity. Each process model has its own random parameters. The new process sensitivity index is mathematically general, and can be applied to a wide range of problems in hydrology and beyond.
ApproximateBayesian computation methods for daily spatiotemporal precipitation occurrence simulation
Authors: Olson Branden , Kleiber William
Published: March 2017

Stochastic precipitation generators (SPGs) produce synthetic precipitation data and are frequently used to generate inputs for physical models throughout many scientific disciplines. Especially for large data sets, statistical parameter estimation is difficult due to the high dimensionality of the likelihood function. We propose techniques to estimate SPG parameters for spatiotemporal precipitation occurrence based on an emerging set of methods called Approximate Bayesian computation (ABC), which bypass the evaluation of a likelihood function. Our statistical model employs a thresholded Gaussian process that reduces to a probit regression at single sites. We identify appropriate ABC penalization metrics for our model parameters to produce simulations whose statistical characteristics closely resemble those of the observations. Spell length metrics are appropriate for single sites, while a variogram‐based metric is proposed for spatial simulations. We present numerical case studies at sites in Colorado and Iowa where the estimated statistical model adequately reproduces local and domain statistics.
Simulation of the cumulative hydrological response to green infrastructure
Authors: Avellaneda P. M. , Jefferson A. J. , Grieser J. M. , Bush S. A.
Published: March 2017

In this study, we evaluated the cumulative hydrologic performance of green infrastructure in a residential area of the city of Parma, Ohio, draining to a tributary of the Cuyahoga River. Green infrastructure included the following spatially distributed devices: 16 street‐side bioretention cells, 7 rain gardens, and 37 rain barrels. Data consisted of rainfall and outfall flow records for a wide range of storm events, including pretreatment and treatment periods. The Stormwater Management Model was calibrated and validated to predict the hydrologic response of green infrastructure. The calibrated model was used to quantify annual water budget alterations and discharge frequency over a 6 year simulation period. For the study catchment, we observed a treatment effect with increases of 1.4% in evaporation, 7.6% in infiltration, and a 9.0% reduction in surface runoff. The hydrologic performance of green infrastructure was evaluated by comparing the flow duration curve for pretreatment and treatment outfall flow scenarios. The flow duration curve shifted downward for the green infrastructure scenario. Discharges with a 0.5, 1, 2, and 5 year return period were reduced by an average of 29%. Parameter and predictive uncertainties were inspected by implementing a Bayesian statistical approach.
Tropical precipitation extremes: Response to SST‐induced warming in aquaplanet simulations
Authors: Bhattacharya Ritthik , Bordoni Simona , Teixeira João
Published: March 2017

Scaling of tropical precipitation extremes in response to warming is studied in aquaplanet experiments using the global Weather Research and Forecasting (WRF) model. We show how the scaling of precipitation extremes is highly sensitive to spatial and temporal averaging: while instantaneous grid point extreme precipitation scales more strongly than the percentage increase (∼7% K−1) predicted by the Clausius‐Clapeyron (CC) relationship, extremes for zonally and temporally averaged precipitation follow a slight sub‐CC scaling, in agreement with results from Climate Model Intercomparison Project (CMIP) models. The scaling depends crucially on the employed convection parameterization. This is particularly true when grid point instantaneous extremes are considered. These results highlight how understanding the response of precipitation extremes to warming requires consideration of dynamic changes in addition to the thermodynamic response. Changes in grid‐scale precipitation, unlike those in convective‐scale precipitation, scale linearly with the resolved flow. Hence, dynamic changes include changes in both large‐scale and convective‐scale motions.
Predictors of Premature Match Closure in Youth Mentoring Relationships
Authors: Kupersmidt Janis B. , Stump Kathryn N. , Stelter Rebecca L. , Rhodes Jean E.
Published: March 2017

Although mentoring is a popular and effective means of intervention with youth, the positive effects of mentoring can be diminished by premature match closure of relationships. Program, mentor, and mentee characteristics were examined as predictors of premature match closure. Secondary data analyses were conducted on a large national database of mentoring programs consisting of match and youth risk information from 170 mentoring programs and 6468 matches from across the U.S. Premature closure was associated with mentee age at match inception and 19 individual mentee characteristics. The set of mentee characteristics were examined as part of a cumulative risk index encompassing seven conceptually combined categories including family background characteristics, school functioning problems, engagement in risky health behaviors, self‐regulation difficulties, engagement in illegal or criminal activities, and internalizing and externalizing behavior problems. Both the age of mentees when matched and the cumulative risk index score significantly predicted premature closure. Results are discussed in terms of directions for future research and suggestions for enhancing mentoring program practices.
Depression Treatment by Non‐Mental‐Health Providers: Incremental Evidence for the Effectiveness of Listening Visits
Authors: Brock Rebecca L. , O'Hara Michael W. , Segre Lisa S.
Published: March 2017

Maternal depression is a prevalent public health problem, particularly for low‐income mothers of young children. Intervention development efforts, which often focus on surmounting instrumental barriers to care, have not successfully engaged and retained women in treatment. Task‐sharing approaches like Listening Visits (LV) could overcome key instrumental and psychological barriers by leveraging the access of trusted, community caregivers to deliver treatment. A recent randomized controlled trial (RCT) demonstrated the efficacy of LV delivered by non‐mental‐health providers as compared to usual care. The present report presents results from a follow‐up phase of that RCT during which participants who had completed LV were followed for an additional 8 weeks and completed measures of depression and quality of life. In addition, participants who were initially randomized to the wait‐list control group received LV and were assessed. Treatment gains previously observed in participants completing LV were enhanced during the 8‐week follow‐up period. Participants receiving LV during the follow‐up period experienced significant improvement in depressive symptoms. Results demonstrate the sustainability of LV delivered by non‐mental‐health providers, and provide preliminary evidence for the replicability of this approach in a sample of predominately low‐income pregnant women and mothers of young children.
Pediatric patients undergoing hematopoietic stem cell transplantation can greatly benefit from a novel once‐daily intravenous busulfan dosing nomogram
Authors: Rhee Su‐jin , Lee Ji Won , Yu Kyung‐Sang , Hong Kyung Taek , Choi Jung Yoon , Hong Che Ry , Park Kyung Duk , Shin Hee Young , Song Sang Hoon , Kang Hyoung Jin , Lee Howard
Published: March 2017

Busulfan, a bifunctional alkylating agent, has been used as a conditioning regimen prior to allogeneic hematopoietic stem cell transplantation (HSCT). The aim of this study was to derive a novel once‐daily intravenous (IV) busulfan dosing nomogram for pediatric patients undergoing HSCT using a population pharmacokinetic (PK) model. A population PK analysis was performed using 2183 busulfan concentrations in 137 pediatric patients (age: 0.6‐22.2 years), who received IV busulfan once‐daily for 4 days before undergoing HSCT. Based on the final population PK model, an optimal once‐daily IV busulfan dosing nomogram was derived. The percentage of simulated patients achieving the daily target area under the concentration‐time curve (AUC) by the new nomogram was compared with that by other busulfan dosing regimens including the FDA regimen, the EMA regimen, and the empirical once‐daily regimen without therapeutic drug monitoring (TDM). A one‐compartment open linear PK model incorporating patient's body surface area, age, dosing day, and aspartate aminotransferase as a significant covariate adequately described the concentration–time profiles of busulfan. An optimal dosing nomogram based on the PK model performed significantly better than the other dosing regimens, resulting in >60% of patients achieving the target AUC while the percentage of patients exceeding the toxic AUC level was kept <25% during the entire treatment period. A novel once‐daily busulfan dosing nomogram for pediatric patients undergoing HSCT is useful for clinicians, particularly in a setting where TDM service is not readily available or to optimize the dose on day 1.
Natural history of chronic myelomonocytic leukemia treated with hypomethylating agents
Authors: Alfonso Ana , Montalban‐Bravo Guillermo , Takahashi Koichi , Jabbour Elias J. , Kadia Tapan , Ravandi Farhad , Cortes Jorge , Estrov Zeev , Borthakur Gautam , Pemmaraju Naveen , Konopleva Marina , Bueso‐Ramos Carlos , Pierce Sherry , Kantarjian Hagop , Garcia‐Manero Guillermo
Published: March 2017

Hypomethylating agents (HMA) are the most commonly used therapeutic intervention in chronic myelomonocytic leukemia (CMML). Due to the lack of CMML‐specific clinical trials, the impact of these agents in the natural history of CMML is not fully understood. We present the largest retrospective series of CMML (n = 151) treated with HMA. Mean age at diagnosis was 69 years (range 50‐88). According to the CMML‐specific prognostic scoring system (CPSS): 17 (15%) were low‐risk, 45 (39%) intermediate‐1 risk, 42 (36%) intermediate‐2, and 12 (10%) high‐risk. 35 (23%) patients received single agent azacitidine, 73 (48%) single agent decitabine, and 43 (29%) combinations. With a median follow‐up of 17 months, overall response rate (ORR) was 75%, with 41% achieving complete response (CR). Median overall survival (OS) was 24 months (95%CI: 20‐28) and event‐free survival 14 months (95%CI: 11‐17). By multivariate analysis, age < 70 years, higher levels of hemoglobin, absence of blast in peripheral blood and lower CPSS cytogenetic risk predicted for better OS. CR was significantly higher in those patients treated with decitabine (58.3%) when compared with azacitidine (20.6%) (P < .001). 13 patients (9%) received allo‐SCT after a median of 4 cycles of HMA. 66 patients (50%) had HMA failure: 26 primary (34%) and 50 secondary (66%), including 35 (46%) that transformed to AML. Outcomes after HMA failure were poor with OS of 7 months (95%CI: 3‐12). In conclusion, HMA are effective in CMML but new agents and combinations are needed. This data could be a benchmark for further drug development in CMML.
Long term impact of hyperleukocytosis in newly diagnosed acute myeloid leukemia patients undergoing allogeneic stem cell transplantation: An analysis from the acute leukemia working party of the EBMT
Authors: Canaani Jonathan , Labopin Myriam , Socié Gerard , Nihtinen Anne , Huynh Anne , Cornelissen Jan , Deconinck Eric , Gedde‐Dahl Tobias , Forcade Edouard , Chevallier Patrice , Bourhis Jean H. , Blaise Didier , Mohty Mohamad , Nagler Arnon
Published: March 2017

Up to 20% of acute myeloid leukemia (AML) patients present initially with hyperleukocytosis, placing them at increased risk for early mortality during induction. Yet, it is unknown whether hyperleukocytosis still retains prognostic value for AML patients undergoing hematopoietic stem cell transplantation (HSCT). Furthermore, it is unknown whether hyperleukocytosis holds prognostic significance when modern molecular markers such as FLT3‐ITD and NPM1 are accounted for. To determine whether hyperleukocytosis is an independent prognostic factor influencing outcome in transplanted AML patients we performed a retrospective analysis using the registry of the acute leukemia working party of the European Society of Blood and Marrow Transplantation. A cohort of 357 patients with hyperleukocytosis (159 patients with white blood count [WBC] 50 K‐100 K, 198 patients with WBC ≥ 100 K) was compared to 918 patients without hyperleukocytosis. Patients with hyperleukocytosis were younger, had an increased rate of favorable risk cytogenetics, and more likely to be FLT3 and NPM1 mutated. In multivariate analysis, hyperleukocytosis was independently associated with increased relapse incidence (hazard ratio [HR] of 1.55, 95% confidence interval [CI], 1.14‐2.12; P = .004), decreased leukemia‐free survival (HR of 1.38, 95% CI, 1.07‐1.78; P = .013), and inferior overall survival (HR of 1.4, 95% CI, 1.07‐1.84; P = .013). Hyperleukocytosis retains a significant prognostic role for AML patients undergoing HSCT.
Renal outcomes in patients with AL amyloidosis: Prognostic factors, renal response and the impact of therapy
Authors: Kastritis Efstathios , Gavriatopoulou Maria , Roussou Maria , Migkou Magdalini , Fotiou Despina , Ziogas Dimitrios C , Kanellias Nikos , Eleutherakis‐Papaiakovou Evangelos , Panagiotidis Ioannis , Giannouli Stavroula , Psimenou Erasmia , Marinaki Smaragdi , Apostolou Theofanis , Gakiopoulou Hariklia , Tasidou Anna , Papassotiriou Ioannis , Terpos Evangelos , Dimopoulos Meletios A.
Published: March 2017

A staging system for patients with renal AL amyloidosis, based on eGFR (<50 ml/min/1.73 m2) and proteinuria (≥5 g/day) at diagnosis, as well as criteria for renal progression (≥25% eGFR reduction) and response (≥30% reduction of proteinuria without renal progression) were recently proposed. We validated these criteria in a cohort of 125 patients with renal AL amyloidosis, mostly treated with bortezomib or lenalidomide. We confirmed the prognostic value of the renal staging system but also identified the limitations of renal progression criteria which are based only on eGFR reduction. We identified the ratio of 24h proteinuria to eGFR as a sensitive marker of renal risk which also accounts for changes in both proteinuria and eGFR: 24h proteinuria/eGFR ratio <30 (in mg/ml/min/1.73 m2) was associated with a 2‐year progression to dialysis rate of 0% compared to 9% for a ratio of 31‐99 and 35% for a ratio ≥100 (P < .001). In landmark analysis, patients who achieved a reduction of this ratio by at least 25% or ≤100 (if initially >100) at 3 months had a 2‐year progression to dialysis of 0% vs 24% for patients who either did not reduce to or still had a ratio >100 (P = .001); similar results were obtained by applying the same criteria at 6 months; thus, the evaluation of treatment effect on renal function may be identified early. Furthermore, primary bortezomib‐based therapy was more effective than lenalidomide‐based therapy, in terms of renal outcomes, especially in patients at intermediate renal risk, but without affecting overall survival.
The fat‐but‐fit paradigm within the context of cognitive function
Authors: Edwards Meghan K. , Loprinzi Paul D.
Published: March 2017

Objective

To evaluate the association of the Fat‐but‐Fit paradigm with cognitive function in an older adult population.

Methods

Data from the 1999–2002 National Health and Nutrition Examination Survey were used (N = 2,336 adults 60–85 yrs). Physical activity was assessed via open‐ended questions asking about participation in 48 leisure‐time activities over the previous 30 days. Using Metabolic Equivalent of Task calculations for each activity, participants were classified as either active or inactive. Participants were then classified into one of six groups (Normal BMI and Inactive [referent], Overweight BMI and Inactive, Obese BMI and Inactive, Normal BMI and Active, Overweight BMI and Active, Obese BMI and Active), based on their activity status and body mass index (BMI). The Digit Symbol Substitution Test (DSST) was employed to assess cognitive function.

Results

Compared to those who had a normal BMI and were inactive (referent), those who had a normal BMI and were active had a 4‐unit higher DSST score (β = 4.0; 95% CI: 1.0–6.9; P = 0.009); those with an overweight BMI and active had a 4.5‐unit higher DSST score (β = 4.5; 95% CI: 1.3–7.6; P = 0.008); and those who had an obese BMI and active had a 3.7‐unit higher DSST score (β = 3.7; 95% CI: 0.96–6.4; P = 0.01).

Conclusion

Being active, regardless of weight classification (normal, overweight, or obese) was positively associated with cognitive function in this sample of older adults. This suggests that perhaps the best strategy to promote cognitive health in this population may be to encourage adequate levels of physical activity.
2D:4D digit ratio is associated with cognitive decline but not frailty in community‐dwelling older adults
Authors: Gonçalves Celina , Coelho Tiago , Machado Sérgio , Rocha Nuno Barbosa
Published: March 2017

Objectives

To understand the relation between 2D:4D ratio, frailty, and cognitive decline in community‐dwelling elderly people.

Methods

A total of 175 community‐dwelling elderly people were included. To determine frailty, participants completed the Tilburg Frailty Indicator (TFI) and the Survey of Health, Ageing and Retirement in Europe (SHARE‐FI). Cognitive functioning was determined using the Mini‐Mental State Examination (MMSE). 2D and 4D finger lengths of each hand were measured using a scanner. Barthel Index, Lawton, and Brody scale were also completed for each participant to determine the level of daily living functioning.

Results

We did not find any correlations between 2D:4D ratio and frailty measures. We found a significant correlation between 2D:4D ratio and MMSE scores in the women sampled.

Conclusions

We cannot ascertain any contribution of prenatal exposure to androgens to the frailty status of community‐dwelling elderly people. We found that reduced prenatal exposure to testosterone in women may contribute to the prevention of cognitive decline in elderly women.
Normal IQ is possible in Smith‐Lemli‐Opitz syndrome
Authors: Eroglu Yasemen , Nguyen‐Driver Mina , Steiner Robert D. , Merkens Louise , Merkens Mark , Roullet Jean‐Baptiste , Elias Ellen , Sarphare Geeta , Porter Forbes D. , Li Chumei , Tierney Elaine , Nowaczyk Małgorzata J. , Freeman Kurt A.
Published: March 2017

Children with Smith‐Lemli‐Opitz syndrome (SLOS) are typically reported to have moderate to severe intellectual disability. This study aims to determine whether normal cognitive function is possible in this population and to describe clinical, biochemical and molecular characteristics of children with SLOS and normal intelligent quotient (IQ). The study included children with SLOS who underwent cognitive testing in four centers. All children with at least one IQ composite score above 80 were included in the study. Six girls, three boys with SLOS were found to have normal or low‐normal IQ in a cohort of 145 children with SLOS. Major/multiple organ anomalies and low serum cholesterol levels were uncommon. No correlation with IQ and genotype was evident and no specific developmental profile were observed. Thus, normal or low‐normal cognitive function is possible in SLOS. Further studies are needed to elucidate factors contributing to normal or low‐normal cognitive function in children with SLOS.
Alu‐mediated deletion of PIGL in a Patient with CHIME syndrome
Authors: Knight Johnson Amy , Schaefer Gerald Bradley , Lee Jennifer , Hu Ying , del Gaudio Daniela
Published: March 2017

CHIME syndrome is a rare autosomal recessive neuroectodermal disorder associated with biallelic mutations in PIGL. To date, six molecularly confirmed cases of CHIME syndrome have been reported. Here, we report the seventh patient with biallelic PIGL mutations associated with CHIME syndrome and describe the first characterization of an intragenic deletion in PIGL. Our characterization of the deletion breakpoint junction demonstrated that the breakpoints occurred within Alu repeats and the deletion was most likely mediated by a microhomology event. Analysis of PIGL genomic sequences for repetitive elements demonstrated that Alu repeats represent ∼34% of its intronic sequence, suggesting that the genomic architecture may predispose the gene to disease‐causing copynumber changes. Taken together, these findings indicate that patients with a clinical diagnosis of CHIME syndrome and a single identifiable mutation in PIGL warrant further investigation for copynumber changes involving PIGL.