bluuebunny/crossref_metadata_2025 huggingface dataset:
Leakage Sign for Primary Intracerebral Hemorrhage
Authors: Orito Kimihiko , Hirohata Masaru , Nakamura Yukihiko , Takeshige Nobuyuki , Aoki Takachika , Hattori Gousuke , Sakata Kiyohiko , Abe Toshi , Uchiyama Yuusuke , Sakamoto Teruo , Morioka Motohiro
Published: March 2016

Background and Purpose—

Recent studies of intracerebral hemorrhage treatments have highlighted the need to identify reliable predictors of hematoma expansion. Several studies have suggested that the spot sign on computed tomographic angiography (CTA) is a sensitive radiological predictor of hematoma expansion in the acute phase. However, the spot sign has low sensitivity for hematoma expansion. In this study, we evaluated the usefulness of a novel predictive method, called the leakage sign.

Methods—

We performed CTA for 80 consecutive patients presenting with spontaneous intracerebral hemorrhage. Two scans were completed: CTA phase and delayed phase (5 minutes after the CTA phase). By comparing the CTA phase images, we set a region of interest with a 10-mm diameter and calculated the Hounsfield units. We defined a positive leakage sign as a >10% increase in Hounsfield units in the region of interest. Additionally, hematoma expansion was determined on plain computed tomography at 24 hours in patients who did not undergo emergent surgery.

Results—

Positive spot signs and leakage signs were present in 18 (22%) patients and 35 (43%) patients, respectively. The leakage sign had higher sensitivity (93.3%) and specificity (88.9%) for hematoma expansion than the spot sign. The leakage sign, but not the spot sign, was significantly related with poor outcomes (severely disabled, vegetative state, and death) in all of the patients (
P
=0.03) and in patients with a hemorrhage in the putamen (
P
=0.0016).

Conclusions—

The results indicate that the leakage sign is a useful and sensitive method to predict hematoma expansion.
Safety of Endovascular Thrombectomy in Patients Receiving Non–Vitamin K Antagonist Oral Anticoagulants
Authors: Purrucker Jan C. , Wolf Marcel , Haas Kirsten , Rizos Timolaos , Khan Shujah , Dziewas Rainer , Kleinschnitz Christoph , Binder Andreas , Gröschel Klaus , Hennerici Michael G. , Lobotesis Kyriakos , Poli Sven , Seidel Günter , Neumann-Haefelin Tobias , Ringleb Peter A. , Heuschmann Peter U. , Veltkamp Roland
Published: March 2016

Background and Purpose—

Prospective data on the safety of endovascular thrombectomy in acute stroke patients on non–vitamin K antagonist oral anticoagulants are lacking.

Methods—

Prospective multicenter observational study. Patients with ischemic stroke undergoing thrombectomy with or without preceding thrombolysis were enrolled into the Registry of Acute Ischemic Stroke Under New Oral Anticoagulants. Baseline characteristics and functional outcome at 3 months were assessed. Hemorrhagic transformation and symptomatic intracranial hemorrhage were analyzed. Reperfusion was graded using the modified Thrombolysis in Cerebral Infarction score.

Results—

Of 28 patients treated with thrombectomy, 5 had received also systemic thrombolysis (18%). Intracranial hemorrhage was observed in 46%, but symptomatic intracranial hemorrhage occurred only in 1 patient. Successful reperfusion (Thrombolysis in Cerebral Infarction score, 2b–3) was achieved in 59%. At 3 months, 19% had a modified Rankin Scale score of 0 to 2, and mortality was 26%.

Conclusions—

Thrombectomy in non–vitamin K antagonist oral anticoagulant patients seems safe although a comparatively high rate of asymptomatic hemorrhagic transformation was noted. Confirmation in larger prospective controlled cohorts is necessary.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01850797.
Exploring the Space of Viable Configurations in a Model of Metabolism–Boundary Co-construction
Authors: Agmon Eran , Gates Alexander J. , Churavy Valentin , Beer Randall D.
Published: March 2016

We introduce a spatial model of concentration dynamics that supports the emergence of spatiotemporal inhomogeneities that engage in metabolism–boundary co-construction. These configurations exhibit disintegration following some perturbations, and self-repair in response to others. We define robustness as a viable configuration's tendency to return to its prior configuration in response to perturbations, and plasticity as a viable configuration's tendency to change to other viable configurations. These properties are demonstrated and quantified in the model, allowing us to map a space of viable configurations and their possible transitions. Combining robustness and plasticity provides a measure of viability as the average expected survival time under ongoing perturbation, and allows us to measure how viability is affected as the configuration undergoes transitions. The framework introduced here is independent of the specific model we used, and is applicable for quantifying robustness, plasticity, and viability in any computational model of artificial life that demonstrates the conditions for viability that we promote.
Active Shape Discrimination with Compliant Bodies as Reservoir Computers
Authors: Johnson Chris , Philippides Andrew , Husbands Philip
Published: March 2016

Compliant bodies with complex dynamics can be used both to simplify control problems and to lead to adaptive reflexive behavior when engaged with the environment in the sensorimotor loop. By revisiting an experiment introduced by Beer and replacing the continuous-time recurrent neural network therein with reservoir computing networks abstracted from compliant bodies, we demonstrate that adaptive behavior can be produced by an agent in which the body is the main computational locus. We show that bodies with complex dynamics are capable of integrating, storing, and processing information in meaningful and useful ways, and furthermore that with the addition of the simplest of nervous systems such bodies can generate behavior that could equally be described as reflexive or minimally cognitive.
The Responsibility to Protect and Obama’s Red Line on Syria
Authors: Nahlawi Yasmine
Published: March 2016

The 21 August 2013 chemical attack on Ghouta led to the mobilisation of the international community after long international paralysis towards the ongoing conflict in Syria. It is unclear, however, why or under what legal basis states chose to react to Syria’s use of chemical weapons in exclusion to other mass atrocity crimes committed within the country. This article evaluates the legal underpinnings of President Obama’s ‘red line’ on the use of chemical weapons in Syria in the context of R2P. It notes that while all states condemned the Ghouta attack and called for accountability in this regard, only a minority of states shared the United States’ position that chemical weapons constituted a red line in their own right. Overall, it is maintained that the ‘red line’ phenomenon was case-specific to the Syrian conflict, reflecting geopolitical interests of world powers rather than signifying a new precedent for R2P’s application.
Description of Basiria birjandiensis n. sp (Nematoda: Tylenchidae) from South Khorasan province with a checklist of the family Tylenchidae Örley 1880 from Iran
Authors: ALVANI SOMAYE , MAHDIKHANI-MOGHADAM ESMAT , ROUHANI HAMID , MOHAMMADI ABBAS , KARSSEN GERRIT
Published: March 2016

In order to identify plant–parasitic nematodes (family Tylenchidae Örley 1880) associated with Ziziphus zizyphus in Iran, 360 soil and root samples were collected from South Khorasan province during 2012–2014. Herein, a new species of Basiria and several known members of the family Tylenchidae are reported. B. birjandiensis n. sp. is characterized by short body length (584–748 µm [660.6±72.3]), lip region with flat apex, stylet 11–12 µm (11.3±0.5), excretory pore position varying from isthmus level to the middle of the basal bulb (78–91 µm from the anterior end of the body), post–vulval uterine sac 8–14 µm (10.7±1.9) long, filiform tail (151–181 µm, c= 3.7–4.2, c´= 14.3–17.2) and body annuli 0.5–1 µm (0.6±0.1) wide. A checklist of Tylenchidae species from Iran is also presented.
Cultural Identity and Adaptation of Mainland Chinese Immigrants in Hong Kong
Authors: Ngo Hang-yue , Li Hui
Published: March 2016

In this study, we develop a conceptual model to investigate how immigrants’ cultural identity is related to their sociocultural adaptation and life satisfaction in the host society. In our model, we include two types of cultural identity (i.e., identity with the local society and with the home country), which are expected to have differential impacts on the outcome variables. We further propose that assimilation attitude and perception of discrimination serve as potential mediators in the above relationships. Several hypotheses are formulated and tested with a data set collected from a survey of 501 new immigrants from Mainland China to Hong Kong. The results of structural equation modeling indicate that local identity is positively related to assimilation attitude, which is then associated with sociocultural adaptation and life satisfaction of the respondents. Additionally, Mainland identity is found to be positively associated with immigrants’ perceived discrimination, which is then negatively associated with their sociocultural adaptation and life satisfaction.
Extracting Spurious Latent Classes in Growth Mixture Modeling With Nonnormal Errors
Authors: Guerra-Peña Kiero , Steinley Douglas
Published: March 2016

Growth mixture modeling is generally used for two purposes: (1) to identify mixtures of normal subgroups and (2) to approximate oddly shaped distributions by a mixture of normal components. Often in applied research this methodology is applied to both of these situations indistinctly: using the same fit statistics and likelihood ratio tests. This can lead to the overextraction of latent classes and the attribution of substantive meaning to these spurious classes. The goals of this study are (1) to explore the performance of the Bayesian information criterion, sample-adjusted BIC, and bootstrap likelihood ratio test in growth mixture modeling analysis with nonnormal distributed outcome variables and (2) to examine the effects of nonnormal time invariant covariates in the estimation of the number of latent classes when outcome variables are normally distributed. For both of these goals, we will include nonnormal conditions not considered previously in the literature. Two simulation studies were conducted. Results show that spurious classes may be selected and optimal solutions obtained in the data analysis when the population departs from normality even when the nonnormality is only present in time invariant covariates.
From Artisanal to CAD-CAM Blocks
Authors: Mainjot A.K. , Dupont N.M. , Oudkerk J.C. , Dewael T.Y. , Sadoun M.J.
Published: March 2016

Indirect composites have been undergoing an impressive evolution over the last few years. Specifically, recent developments in computer-aided design–computer-aided manufacturing (CAD-CAM) blocks have been associated with new polymerization modes, innovative microstructures, and different compositions. All these recent breakthroughs have introduced important gaps among the properties of the different materials. This critical state-of-the-art review analyzes the strengths and weaknesses of the different varieties of CAD-CAM composite materials, especially as compared with direct and artisanal indirect composites. Indeed, new polymerization modes used for CAD-CAM blocks—especially high temperature (HT) and, most of all, high temperature–high pressure (HT-HP)—are shown to significantly increase the degree of conversion in comparison with light-cured composites. Industrial processes also allow for the augmentation of the filler content and for the realization of more homogeneous structures with fewer flaws. In addition, due to their increased degree of conversion and their different monomer composition, some CAD-CAM blocks are more advantageous in terms of toxicity and monomer release. Finally, materials with a polymer-infiltrated ceramic network (PICN) microstructure exhibit higher flexural strength and a more favorable elasticity modulus than materials with a dispersed filler microstructure. Consequently, some high-performance composite CAD-CAM blocks—particularly experimental PICNs—can now rival glass-ceramics, such as lithium-disilicate glass-ceramics, for use as bonded partial restorations and crowns on natural teeth and implants. Being able to be manufactured in very low thicknesses, they offer the possibility of developing innovative minimally invasive treatment strategies, such as “no prep” treatment of worn dentition. Current issues are related to the study of bonding and wear properties of the different varieties of CAD-CAM composites. There is also a crucial need to conduct clinical studies. Last, manufacturers should provide more complete information regarding their product polymerization process, microstructure, and composition, which significantly influence CAD-CAM material properties.
Cash for care under the NDIS: Shaping care workers’ working conditions?
Authors: Macdonald Fiona , Charlesworth Sara
Published: March 2016

The Australian National Disability Insurance Scheme (NDIS) introduces a national cash-for-care model for disability support and care. The NDIS has been hailed as a significant advance in social care provision for people with disability, bringing both additional funding and choice and control. However, little attention has been paid to how the shift to a cash-for-care system will impact on the working conditions of disability support workers. The international literature suggests three main factors shape better or poorer employment outcomes for workers in cash-for-care schemes: the extent to which cost containment underpins scheme design; the regulation and monitoring of care delivery; and the regulation of care employment. In this article, we explore these factors through an analysis of the planning, design and initial implementation of the NDIS and make a preliminary assessment of how the new scheme might shape care workers’ employment conditions.
Power and Persuasion
Authors: Dowding Keith
Published: March 2016

In familiar accounts of power, if agent i can induce j to change their beliefs then i has power over j to induce belief change. Does that mean that all deliberation is simply a power game? This article examines two connected ‘reliability conditions’ that distinguish when such persuasion is coercive or manipulative: common reason and the intentions of the persuader. It considers three problems, (1) testimony, (2) authority, (3) trust, and why these do not belie the account. While the conditions are strict and perhaps no actual deliberation or persuasion fully abides by them, they constitute normative conditions for making judgements about the degree of manipulation in any deliberation. I also briefly consider the power of discourse as an activity in itself.
The Long-term Effects of Parental Incarceration
Authors: Gaston Shytierra
Published: March 2016

Researchers have linked parental incarceration to a host of short-term, negative consequences for children and adolescents. However, it is unclear whether offspring experience some of these consequences, particularly depressive symptoms, as adults, especially racial/ethnic minorities who disproportionately experience parental incarceration. The present study uses data from Add Health to investigate whether parental incarceration during childhood or adolescence predicts depressive symptoms between ages 24 and 34 and whether race/ethnicity moderates this relationship. Results indicate that parental incarceration is associated with long-term consequences for some offspring, but not others. Specifically, respondents whose parent was first incarcerated before birth or age 1 appear to be at risk for adult depressive symptoms. Furthermore, the moderation analysis reveals similarities in the effects of parental incarceration across racial/ethnic groups. Findings from this study suggest that parental incarceration might be associated with long-term mental health consequences only for certain subgroups.
Is Religious Coping a Moderator Of Perceived Control and Panic Symptoms in African American Adults?
Authors: Richards Allyn E. , Petrie Jenny M. , Chapman L. Kevin
Published: March 2016

Extant research has established a strong association between perceived control and anxiety; however, limited work has examined perceived control within the context of fear-based anxiety disorders and in ethnic minority populations. Further, scant attention has been paid to protective factors that may moderate the relationship between perceived control and anxiety. The current study investigated the relationship between perceived control, positive religious coping, and panic-related fears in a community-based African American adult sample ( N = 91, mean age = 38, 91% female). Results from hierarchical linear regression indicated that perceived control significantly predicted all panic subscales (i.e., total panic symptoms, agoraphobic fears, social phobia fears, interoceptive fears); however, positive religious coping moderated only the relationship between perceived control and agoraphobic fears. Simple slopes analyses revealed that increased levels of positive religious coping resulted in a strengthened negative relationship between perceived control and agoraphobic fears.
Quality of Quality Accounts: transparency of public reporting of Never Events in England. A semi-quantitative and qualitative review
Authors: Wahid Nazurah NN Abdul , Moppett Sarah H , Moppett Iain K
Published: March 2016

Objectives

To describe the quality of reporting and investigation into surgical Never Events in public reports.

Design

Semi-quantitative and qualitative review of published Quality Accounts for three years (2011/2–2013/14). Data on Never Events were compared with previously collated Never Events rates. Quality of reported investigations was assessed using the London Protocol.

Setting

English National Health Service.

Participants

All English acute hospital trusts.

Main outcome measures

Quality of Never Event reporting.

Results

Quality Accounts were available for all Trusts for all three years, of which 342 referred to years when a surgical Never Event had occurred. A total of 125 of 342 (37%) accounts failed to report any or all Never Events that had occurred; 13/342 (4%) provided full disclosure; 197 (58%) reported that some investigation had taken place. Of these 197, 61 (31%) were limited in scope; 61 (31%) were categorised as detailed reports. Task and Technology factors were the commonest factor (103/211 (49%)) Identified in investigations, followed by Individual factors (48/211 (23%)). Team and Work environment factors were identified in 29/211 (14%) and 23/211 (11%), respectively. Organisational and Management 5/211 (2%) factors were rarely identified, and the Institutional context was never discussed.

Conclusions

Reporting of Never Events and their investigations by English NHS Trusts in their Quality Accounts is neither consistently transparent nor adequate. As with clinical error, the true root causes are likely to be organisational rather than individual.
Political scandal at the end of ideology? The mediatized politics of the Bo Xilai case
Authors: Meng Bingchun
Published: March 2016

In this article, I use the high-profile Bo Xilai case to illustrate the dialectics of media and politics in contemporary China. I start by explaining some of the similarities and key differences between mediatized politics in the West and in China. This leads to an emphasis on the ideological dimension of media logic that is largely missing from discussions derived from a liberal democratic context. I then analyze the dialectics of the mediatized ideological struggle and politicized media logic running through the Bo Xilai scandal. In the last section, I summarize the theoretical contributions that the Chinese case makes to the study of mediatized politics.
Personal agency in children
Authors: Brummert Lennings Heidi Isabel , Bussey Kay
Published: March 2016

The aim of this study is to develop a multidimensional measure for assessing children’s personal agency to handle parental conflict through their coping self-efficacy beliefs (Bandura, 1997). Coping self-efficacy beliefs are individuals’ perceived ability to motivate themselves, access cognitive resources, and perform the actions required to take control of stressful situations. This study examines the psychometric properties and validation of the newly created Parental Conflict Coping Self-Efficacy Scale (PCC-SES). The study was based on 663 children, in grades 5 and 7 and their mothers. An exploratory factor analysis and confirmatory factor analysis through structural equation modeling supported the structure of the PCC-SES. The PCC-SES’s structure was facilitated by three global strategies, namely Proactive Behavior (problem solving and seeking social support), Avoiding Maladaptive Cognitions (avoiding preoccupation, avoiding self-blame and distancing) and Avoiding Maladaptive Behavior (avoiding aggression and avoiding overinvolvement).
Epidemiology of Wire‐Bristle Grill Brush Injury in the United States, 2002‐2014
Authors: Baugh Tiffany P. , Hadley Jamie B. , Chang C. W. David
Published: March 2016

Objectives

The purpose of this study was to investigate the epidemiology of wire‐bristle grill brush injury.

Study Design and Setting

Cross‐sectional analysis of national databases; literature review.

Subjects and Methods

The Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) was used to derive a national weighted estimate of emergency department visits for wire bristle injury from 2002 to 2014. Date, location of injury, demographics, and outcomes were analyzed. A literature search and a consumer‐reported injury database (SaferProducts.gov) were interrogated to provide ancillary sources of data.

Results

A total of 43 cases were found within the NEISS database, which extrapolated to an estimated 1698 (95% confidence interval, 1468‐1927) emergency department visits nationwide. In the NEISS database, the mean age was 30 years, and the sex distribution of the patients was similar (21 males vs 22 females). The most common location of injury was the oropharynx in both the NEISS database (23 of 43, 53.4%) and the literature review (11 of 36, 30.5%). However, the oral cavity was the most frequent site in the consumer‐reported SaferProducts.gov database (9 of 24, 37.5%). The majority of patients in the NEISS were treated in the emergency department (31 of 43, 69.7%). Raw case counts were highest in June, July, and August, with the highest number of events in the month of July.

Conclusion

Injury from wire‐bristle grill brush is uncommon but prevalent during certain seasons. Otolaryngologists play an important in the diagnosis and treatment of these injuries. Awareness among consumers and product manufacturers is necessary to promote safety.
Anatomic Changes Caused by Endoscopic Endonasal Transsphenoidal Surgery and Their Effects on Nasal Functions
Authors: Kim Do Hyun , Hong Yong‐Kil , Jeun Sin‐Soo , Park Yong Jin , Kim Soo Whan , Cho Jin Hee , Kim Boo Young , Han Sungwoo , Jung Young Hoon , Lee Yong Joo , Kim Sung Won
Published: March 2016

Objective

We evaluated postoperative changes in nasal cavity dimensions and their effects on nasal functions and symptoms.

Study Design

Case series with chart review.

Setting

Tertiary referral center.

Subjects and Methods

We studied patients who underwent binostril, 4‐hand endoscopic endonasal transsphenoidal approach surgery with the bilateral modified nasoseptal rescue flap technique. Pre‐ and postoperative paranasal computed tomography scans were used to assess nasal cavity dimensional changes at 4 levels. We also performed several pre‐ and postoperative tests, including the Connecticut Chemosensory Clinical Research Center test and the Cross‐Cultural Smell Identification Test (n = 119) to evaluate olfactory functions. Also, the Nasal Obstruction Symptoms Evaluation, the Sino‐Nasal Outcome Test–20, and a visual analog scale were used (n = 157) to record subjective symptoms. We compared these data with the pre‐ and postoperative nasal cavity dimensions.

Results

Two‐dimensional objective increases in nasal passage dimensions were evident postoperatively (all cross‐sectional areas, P <. 001, except choana and left inferior turbinate). However, these did not correlate with subjectively assessed symptoms (Nasal Obstruction Symptoms Evaluation, all cross‐sectional areas, P ≥. 05, except right middle turbinate; Sino‐Nasal Outcome Test–20, all cross‐sectional areas, P ≥. 05) or olfactory dysfunction evaluated with the Connecticut Chemosensory Clinical Research Center test (all cross‐sectional areas, P ≥. 05) or the Cross‐Cultural Smell Identification Test (all cross‐sectional areas, P ≥. 05).

Conclusion

Endoscopic endonasal transsphenoidal approach surgery altered the patients’ nasal anatomy, but the changes in nasal cavity dimensions did not affect nasal functions and symptoms. These results will help surgeons to appropriately expose the surgical field during endoscopic endonasal transsphenoidal approach surgery.
Modeled Analysis of Entrance of Colloid Suspensions into the Middle Ear Cavity
Authors: Ariana Bahar , Geerse Simon , Schot Linda J. , Bos Lieuwe D. J.
Published: March 2016

Otic suspensions have a positive effect on the duration of otorrhea in children with a tympanostomy tube. It is still questionable how eardrops reach the middle ear. We hypothesized that otic suspensions do not pass the tympanostomy tube if the middle ear is dry but pass by diffusion when wet. The median concentration of Evans blue (colorant) in the middle ear was <15.6 mg/mL (lower limit of quantification) when diffusion was impossible but 45.3 µg/mL when diffusion was possible (P =. 01). When the outward flow was increased to 0.1 mL/h, the concentration of Evans blue in the middle ear increased significantly (P =. 03). With further‐increasing outward flows, the concentration of Evans blue decreased linearly (β = −144, P <. 001, R
2 = 0.44). We conclude that diffusion is the mechanism by which otic suspensions enter the middle ear in children with tympanostomy tubes and otorrhea.
Postoperative Calcium Management in Same‐Day Discharge Thyroid and Parathyroid Surgery
Authors: Nelson Kurt L. , Hinson Andrew M. , Lawson Bradley R. , Middleton Derek , Bodenner Donald L. , Stack Brendan C.
Published: March 2016

Objective

To describe a safe and effective postoperative prophylactic calcium regimen for same‐day discharge thyroid and parathyroid surgery.

Study Design

Case series with chart review.

Setting

Tertiary referral academic institution.

Subjects and Methods

In total, 162 adult patients who underwent total thyroidectomy, completion thyroidectomy, unilateral parathyroidectomy, parathyroidectomy with bilateral neck exploration, or revision parathyroidectomy were identified preoperatively to be candidates for same‐day discharge. All patients in this study were successfully discharged the same day on our standard prophylactic calcium regimen.

Results

Less than 1% (1/162) of patients re‐presented to the hospital within 30 days of surgery, and that patient was successfully discharged from the emergency department after negative workup for hypocalcemia. There was no significant difference between preoperative and postoperative calcium levels in the total/completion thyroidectomy groups (9.3 vs 9.2 mg/dL, respectively; P =. 14). The average postoperative calcium level in the parathyroid group was well within normal limits (9.5 mg/dL), and the difference in postoperative calcium levels between revision and primary parathyroidectomy cases was not significantly different (P =. 34).

Conclusion

The reported calcium regimen demonstrates a safe, effective, and objective means of postoperative calcium management in outpatient thyroid and parathyroid surgery in appropriately selected patients.
Oral Antibiotic Use for Otitis Media with Effusion
Authors: Roditi Rachel E. , Liu C. Carrie , Bellmunt Angela M. , Rosenfeld Richard M. , Shin Jennifer J.
Published: March 2016

Objectives

(1) To evaluate the probability of antibiotic administration associated with ICD‐9 diagnosis of otitis media with effusion (OME) in the absence of acute otitis media, (2) to determine whether usage varies according to visit setting, and (3) to ascertain if practice gaps are such that future practice changes might be measured.

Study Design

Cross‐sectional analysis of an administrative database.

Setting

Ambulatory visits in the United States.

Subjects and Methods

National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005‐2010; univariate, multivariate, and stratified analyses of antibiotic usage were performed. The study population was restricted to children without acute or unspecified otitis media. The primary outcome was the probability of oral antibiotic administration when OME was diagnosed. The impact of the location of service and subspecialty care was also analyzed.

Results

Data from 1,390,404,196 pediatric visits demonstrated that oral antibiotics were administered for 32% of visits with an OME diagnosis, even in the absence of acute otitis media (odds ratio, 4.31; 95% confidence interval: 2.88‐6.44; P <. 001). The highest antibiotic administration was seen in the emergency department (risk difference, 37.1%; number needed to harm, 3). No significant increased risk of antibiotic usage was seen during otolaryngology visits. Diagnoses of infections at nonotologic sites were associated with a 1.98 to 26.60 increase in odds of oral antibiotic administration.

Conclusion

Oral antibiotics continue to be administered in children with OME in the absence of acute infection, with risk varying by location of service. There is a potential opportunity for quality improvement through reducing antibiotic administration for pediatric OME.
Retrospective Review of Management and Outcomes of Pediatric Descending Mediastinitis
Authors: Wilson Caleb D. , Kennedy Kenneth , Wood Joshua W. , Kumar T. K. Susheel , Stocks Rose Mary S. , Thompson Rebecca E. , Thompson Jerome W.
Published: March 2016

Objectives

To review the management and outcomes of pediatric patients treated for descending mediastinitis at a single institution and contribute to an updated mortality rate.

Study Design

Case series with chart review.

Setting

Tertiary care pediatric hospital.

Subjects and Methods

This study is a 19‐patient case series of all patients treated for descending mediastinitis at a tertiary pediatric hospital from 1997 to 2015, and it serves as an update to the case series published from this institution in 2008. Review of management included time to diagnosis, time to surgery, surgical procedures performed, and antibiotics administered. The primary outcomes measured were length of hospitalization and mortality.

Results

In addition to 8 previously reported patients, we identified 11 pediatric patients treated for descending mediastinitis in the period of review. All 19 patients were <18 months old, and all survived their hospitalization. Fourteen patients underwent surgical drainage at least twice. The median length of hospital stay was 15 days. Retropharyngeal abscess was the source of infection in 16 of 19 patients, and methicillin‐resistant Staphylococcus aureus (MRSA) was the isolated organism in 14 of 15 positive cultures.

Conclusion

This review represents the largest reported series of pediatric patients with descending mediastinitis. With 100% survival, our results suggest that pediatric descending mediastinitis can be safely managed by prompt surgical drainage. Broad‐spectrum antibiotics covering MRSA and a low threshold for repeat surgical intervention have been an important part of our successful approach and may decrease length of stay.
Endocrinopathy and Aging in Ferrets
Authors: Bakthavatchalu V. , Muthupalani S. , Marini R. P. , Fox J. G.
Published: March 2016

Ferrets have become more popular as household pets and as animal models in biomedical research in the past 2 decades. The average life span of ferrets is about 5-11 years with onset of geriatric diseases between 3-4 years including endocrinopathies, neoplasia, gastrointestinal diseases, cardiomyopathy, splenomegaly, renal diseases, dental diseases, and cataract. Endocrinopathies are the most common noninfectious disease affecting middle-aged and older ferrets. Spontaneous neoplasms affecting the endocrine system of ferrets appear to be increasing in prevalence with a preponderance toward proliferative lesions in the adrenal cortex and pancreatic islet cells. Diet, gonadectomy, and genetics may predispose ferrets to an increased incidence of these endocrinopathies. These functional proliferative lesions cause hypersecretion of hormones that alter the physiology and metabolism of the affected ferrets resulting in a wide range of clinical manifestations. However, there is an apparent dearth of information available in the literature about the causal relationship between aging and neoplasia in ferrets. This review provides a comprehensive overview of the anatomy and physiology of endocrine organs, disease incidence, age at diagnosis, clinical signs, pathology, and molecular markers available for diagnosis of various endocrine disorders in ferrets.
Clonality Testing in Veterinary Medicine
Authors: Keller S. M. , Vernau W. , Moore P. F.
Published: March 2016

The accurate distinction of reactive and neoplastic lymphoid proliferations can present challenges. Given the different prognoses and treatment strategies, a correct diagnosis is crucial. Molecular clonality assays assess rearranged lymphocyte antigen receptor gene diversity and can help differentiate reactive from neoplastic lymphoid proliferations. Molecular clonality assays are commonly used to assess atypical, mixed, or mature lymphoid proliferations; small tissue fragments that lack architecture; and fluid samples. In addition, clonality testing can be utilized to track neoplastic clones over time or across anatomic sites. Molecular clonality assays are not stand-alone tests but useful adjuncts that follow clinical, morphologic, and immunophenotypic assessment. Even though clonality testing provides valuable information in a variety of situations, the complexities and pitfalls of this method, as well as its dependency on the experience of the interpreter, are often understated. In addition, a lack of standardized terminology, laboratory practices, and interpretational guidelines hinders the reproducibility of clonality testing across laboratories in veterinary medicine. The objectives of this review are twofold. First, the review is intended to familiarize the diagnostic pathologist or interested clinician with the concepts, potential pitfalls, and limitations of clonality testing. Second, the review strives to provide a basis for future harmonization of clonality testing in veterinary medicine by providing diagnostic guidelines.
The Effects of Orthographic Pattern Intervention on Spelling Performance of Students With Reading Disabilities
Authors: Squires Katie E. , Wolter Julie A.
Published: March 2016

Although the orthographic processing skill of recognizing and producing letters and letter patterns has been established as an important skill for developing spelling, a majority of the research focus has been on early orthographic intervention that did not progress beyond the unit of the letter. The purpose of this article is to provide a best evidence synthesis of current high-quality, peer-reviewed, experimental or control studies on spelling interventions with a focus on orthographic patterns ( N = 5). This small synthesis revealed that spelling interventions with an orthographic pattern focus appear to contribute to the significant improvement of spelling skills in kindergarten through ninth-grade students with and at risk for reading disabilities. Several intervention approaches with varying methods to improve orthographic pattern knowledge were considered and were related to moderate to large effect sizes on standardized measures of spelling. Thus, the reviewed interventions appear to reflect educationally significant changes in orthographic pattern knowledge that transferred beyond that of taught spelling words.
Talk to me! Possibilities of constructing children’s voices in the domestic research context
Authors: Noppari Elina , Uusitalo Niina , Kupiainen Reijo
Published: March 2016

This self-reflective article explores the possibilities of producing children’s ‘voice’ in the domestic research context. We look at producing voices as the process of giving an account of children’s meaning making and life. We examine the methodological challenges of producing voices in the home environment from three perspectives: power, trust and ethics. The findings presented in the article are based on an ongoing longitudinal study of Finnish children’s media environments, which began in 2007 and will continue through 2016.
Comparative study of transparent polyimides derived from bis(ether anhydride)s and bis(ester anhydride)s using 2,2′-bis(trifluoromethyl)biphenyl-4,4′-diamine
Authors: Zhou Yu , Chen Guofei , Wang Wei , Song Liping , Fang Xingzhong
Published: March 2016

Two series of polyimides (PIs) derived from bis(ether anhydride)s and bis(ester anhydride)s using 2,2′-bis(trifluoromethyl)biphenyl-4,4′-diamine were synthesized via solution polycondensation. The poly(ether imide)s could be formed by the conventional one-step method, while the poly(ester imide)s were only afforded by the two-step procedure. The resulting PIs had glass transition temperatures ( Tgs) in the range of 224–320°C and exhibited good mechanical properties with tensile strength in the range of 80.5–96.5 MPa, tensile moduli 2.7–6.9 GPa, and elongations at break 1.5–17.3%. It was found that the PIs derived from bis(ether anhydride)s showed higher thermal stability, better solubility, and transparency but lower Tg and higher water absorption compared with bis(ester anhydride)-based PIs due to the different ether and ester linkages.
Characterizing Information Processing With a Mobile Device: Measurement of Simple and Choice Reaction Time
Authors: Burke Daniel , Linder Susan , Hirsch Joshua , Dey Tanujit , Kana Daniel , Ringenbach Shannon , Schindler David , Alberts Jay
Published: March 2016

Information processing is typically evaluated using simple reaction time (SRT) and choice reaction time (CRT) paradigms in which a specific response is initiated following a given stimulus. The measurement of reaction time (RT) has evolved from monitoring the timing of mechanical switches to computerized paradigms. The proliferation of mobile devices with touch screens makes them a natural next technological approach to assess information processing. The aims of this study were to determine the validity and reliability of using of a mobile device (Apple iPad or iTouch) to accurately measure RT. Sixty healthy young adults completed SRT and CRT tasks using a traditional test platform and mobile platforms on two occasions. The SRT was similar across test modality: 300, 287, and 280 milliseconds (ms) for the traditional, iPad, and iTouch, respectively. The CRT was similar within mobile devices, though slightly faster on the traditional: 359, 408, and 384 ms for traditional, iPad, and iTouch, respectively. Intraclass correlation coefficients ranged from 0.79 to 0.85 for SRT and from 0.75 to 0.83 for CRT. The similarity and reliability of SRT across platforms and consistency of SRT and CRT across test conditions indicate that mobile devices provide the next generation of assessment platforms for information processing.
ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease
Authors: Sparkes Andrew H , Caney Sarah , Chalhoub Serge , Elliott Jonathan , Finch Natalie , Gajanayake Isuru , Langston Catherine , Lefebvre Hervé P , White Joanna , Quimby Jessica
Published: March 2016

Practical relevance:

Chronic kidney disease (CKD) is one of the most commonly diagnosed diseases in older cats. In most cats, CKD is also a progressive disease and can be accompanied by a wide range of clinical and clinicopathological changes. These ISFM Consensus Guidelines have been developed by an independent panel of clinicians and academics to provide practical advice on the diagnosis and management of this complex disease.

Clinical challenges:

Although CKD is a common clinical problem in cats, the manifestations of disease vary between individuals. Thus there is a need for careful and repeat evaluation of cats with CKD and adjustment of therapy according to individual needs. In addition to addressing problems arising from CKD and improving quality of life (QoL) for the patient, therapy may also target slowing the underlying progression of disease and hence prolonging life. While maintaining QoL is of paramount importance in our patients, this can be challenging when multiple therapies are indicated. In some cases it is necessary to prioritise therapy, given an understanding of what is likely to most benefit the individual patient.

Evidence base:

In preparing these Guidelines, the Panel has carefully reviewed the existing published literature, and has also graded the quality of evidence for different interventions to help to provide practical recommendations on the therapeutic options for feline CKD. This is a field of veterinary medicine that has benefited from some excellent published clinical research and further research findings will undoubtedly modify the recommendations contained in these Guidelines in the future.
Voiced inner dialogue as relational reflection-on-action: The case of middle managers in health care
Authors: Holton Judith A , Grandy Gina
Published: March 2016

We look to the experiences of middle managers in a health-care setting to empirically develop and explore the concept of voiced inner dialogue. Voiced inner dialogue is conceptualised as a form of reflection-on-action whereby fragments of narrative self-reflection reveal an organisation’s unspoken backdrop conversation or interpersonal mush. The normalised intensity that characterises many health-care settings, an artefact of increased governmentality and responsibilisation, leaves middle managers experiencing increased work and personal pressures. The interpersonal mush in this context is centred upon individuals’ felt disconnect between espoused and enacted organisational values. Voiced inner dialogue was triggered in dialogic conversation with the researchers, a type of participant-focused reflexivity. From our qualitative analysis, we present three themes to illuminate how organisational context can inform the creation and maintenance of interpersonal mush, impeding managers’ reflection. Voiced inner dialogue offers an opportunity for managers stuck in the silence of interpersonal mush to engage in reflection-on-action. We conclude with the implications for reflection, reflexivity and management learning.
Plasma levels of endothelial and B-cell-derived microparticles are restored by fingolimod treatment in multiple sclerosis patients
Authors: Zinger Anna , Latham Sharissa L , Combes Valery , Byrne Scott , Barnett Michael H , Hawke Simon , Grau Georges E
Published: March 2016

Background:

No molecular marker can monitor disease progression and treatment efficacy in multiple sclerosis (MS). Circulating microparticles represent a potential snapshot of disease activity at the blood brain barrier.

Objectives and methods:

To profile plasma microparticles by flow cytometry in MS and determine how fingolimod could impact endothelial microparticles production.

Results:

In non-treated MS patients compared to healthy and fingolimod-treated patients, endothelial microparticles were higher, while B-cell-microparticle numbers were lower. Fingolimod dramatically reduced tumour necrosis factor (TNF)-induced endothelial microparticle release in vitro.

Conclusion:

Fingolimod restored dysregulated endothelial and B-cell-microparticle numbers, which could serve as a biomarker in MS.
Experimental investigation on strengthening of infilled frame structures by profiled steel sheet shear walls
Authors: Feng Ningning , Cao Pingzhou , Wu Kai , Zhang Pengcheng
Published: March 2016

This article presents an experimental study on seismic performance of three reinforced concrete frames. Three 1/3-scale, one-bay, two-story specimens are constructed and tested in the test. One specimen is bare; another is reinforced by profiled steel sheet shear walls; the third one is filled with infill walls and reinforced by profiled steel sheet shear walls. Experiment investigates some characteristics of three test specimens, such as strength, stiffness, and energy dissipation. Test results show that these characteristics of infilled frame structure have been improved prominently. Comparing with the bare and the second specimen, the strength is enhanced by 307.3% and 109.28%, the stiffness is increased by 103.17% and 12.27%, and cumulative energy is improved by 291.37% and 106.45%, respectively. The results indicate that profiled steel sheet shear walls can cooperate with infill walls effectively and improve seismic performance of reinforced concrete frame structure significantly. The seismic strengthening method, profiled steel sheet shear walls reinforce infilled frame structures, is proved to be efficient.
Structural damage identification based on cuckoo search algorithm
Authors: Xu HJ , Liu JK , Lu ZR
Published: March 2016

A method for structural damage identification based on cuckoo search algorithm is presented. The nonlinear objective function for the damage identification problem is established by utilizing modal assurance criteria and structural natural frequencies. Then, the cuckoo search algorithm is adopted to detect local damages by solving the objective function. Two numerical examples are studied to investigate the efficiency and correctness of the proposed method. Meanwhile, a laboratory work is conducted for further verification. The simulation and experiment results show that the present method can produce more accurate damage identification results even under measurement noise, comparing with genetic algorithm.
Panel zone behavior of diaphragm-through connection between concrete-filled steel tubular columns and steel beams
Authors: Wu Liao , Chen Zhihua , Rong Bin , Luo Song
Published: March 2016

The diaphragm-through connections are some of the most widespread connections between concrete-filled steel tubular columns and steel beams. In this work, five tee-shaped diaphragm-through connections were fabricated so that they comply with the principle of “strong members and weak panel zone.” Low-frequency cyclic loading was applied to the specimens to investigate the panel zone behavior of the connections. Based on the test results, the force transfer mechanism and the effect of different factors on the panel zone shear capacity were analyzed. In addition, different methods of calculating the panel zone shear strength were compared with the experimental data. The results show that the shear capacity of the panel zone of the connection is borne mainly by the steel tube webs and the core concrete. The steel frame composite with steel tube flanges and diaphragms strengthens the plastic deformation ability after yielding. It was found that in the existing computational methods for panel zone shear capacity of the connection, the calculated results are in agreement with the test results for the shear capacity of the steel tube webs, but the predicted values are not consistent with the concrete component capacity.
Ultimate bending capacities of steel pipelines under combined loadings
Authors: Wang Hui-Ping , Li Xin , Zhou Jing
Published: March 2016

This article derives analytical solutions for steel pipelines subjected to combined bending moments, axial forces, and internal pressure by considering the effect of ovalization on the plastic region. Both lower and upper bound solutions are proposed based on the selection of a general modulus of pipe material. The ultimate bending capacity, as well as the moment–curvature relationship, can be obtained from the analytical solutions. A comparison of the analytical solutions with the experimental and numerical results finds the bending capacities and the moment–curvature curves in good agreement. Therefore, the proposed analytical solutions can be used to study the behavior of steel pipelines subjected to combined loadings.