bluuebunny/crossref_metadata_2025 huggingface dataset:
Intellectual Profiles in Children With ADHD and Comorbid Learning and Motor Disorders
Authors: Parke Elyse M. , Thaler Nicholas S. , Etcoff Lewis M. , Allen Daniel N.
Published: March 2015

Objective: Neurodevelopmental disorders, including Reading Disorder, Disorder of Written Expression, and Developmental Coordination Disorder, often co-occur with ADHD. Although research has identified increased functional impairment in the presence of these comorbid diagnoses, few direct comparisons of intellectual profiles have been conducted. Thus, the present study examined Wechsler Intelligence Scale for Children–Fourth Edition (WISC-IV) profiles of children with ADHD alone and with comorbid neurodevelopmental disorders. Method: Participants included 296 children with ADHD, ADHD with Developmental Coordination Disorder, and ADHD with Reading Disorder and/or Disorder of Written Expression. Results: Comparisons of these groups suggests children with ADHD and language-based Learning Disorders have poorer working memory than children with only ADHD. Furthermore, children with ADHD and Developmental Coordination Disorder perform relatively better on verbal compared with perceptual reasoning indexes. Conclusion: These intellectual profiles may have utility in identifying cognitive weaknesses inherent to these disorders and may be used to guide treatment intervention.
A Process Evaluation of an Efficacious Family-Based Intervention to Promote Healthy Eating
Authors: Schmied Emily , Parada Humberto , Horton Lucy , Ibarra Leticia , Ayala Guadalupe
Published: March 2015

Entre Familia: Reflejos de Salud was a successful family-based randomized controlled trial designed to improve dietary behaviors and intake among U.S. Latino families, specifically fruit and vegetable intake. The novel intervention design merged a community health worker ( promotora) model with an entertainment-education component. This process evaluation examined intervention implementation and assessed relationships between implementation factors and dietary change. Participants included 180 mothers randomized to an intervention condition. Process evaluation measures were obtained from participant interviews and promotora notes and included fidelity, dose delivered (i.e., minutes of promotora in-person contact with families, number of promotora home visits), and dose received (i.e., participant use of and satisfaction with intervention materials). Outcome variables included changes in vegetable intake and the use of behavioral strategies to increase dietary fiber and decrease dietary fat intake. Participant satisfaction was high, and fidelity was achieved; 87.5% of families received the planned number of promotora home visits. In the multivariable model, satisfaction with intervention materials predicted more frequent use of strategies to increase dietary fiber ( p ≤ .01). Trends suggested that keeping families in the prescribed intervention timeline and obtaining support from other social network members through sharing of program materials may improve changes. Study findings elucidate the relationship between specific intervention processes and dietary changes.
An Evaluation of Group Contingency Interventions
Authors: Ennis Christina R. , Cho Blair Kwang-Sun , George Heather Peshak
Published: March 2015

Group contingencies (GCs) vary in a variety of dimensions that may influence their efficacy and acceptability. This study evaluated the relative impact of four different GC types (independent, interdependent, dependent, and randomized) on classwide appropriate and disruptive student behaviors as well as how implementation of a teacher’s preferred contingency may enhance student behavioral outcomes. Three general education teachers and their students participated in the study. All four GCs resulted in reduced disruption and increased appropriate behavior across all three classrooms with no patterns of differentiation between contingency types. Teachers selected independent or dependent contingencies as their preferred reward system. Implementation of the preferred contingency resulted in further improvements in both classwide behaviors for all classes. Some evidence of generalization and maintenance was noted in all three classrooms.
Experimental study on the compression-after-impact behavior of foam-core sandwich panels
Authors: Wang Jie , Chen Baoxing , Wang Hai , Waas Anthony M
Published: March 2015

This paper presents the experimental results pertaining to the deformation, failure mode, failure mechanism and residual strength for the compression-after-impact tests of woven polymer-based foam-core sandwich panels. Sandwich panels with impact-type damage, inflicted via low-velocity impact, were tested to failure in compression. The optical strain measurement system ARAMIS was used to obtain the complete non-uniform strain and displacement fields of the damaged face-sheet. Consequently, damage in the face-sheets was characterized by fractography. It has been found that the dominant damage mechanism is kink band in the impacted face-sheets due to fiber plastic micro-buckling. Besides, the effects of impactor diameter, impact energy, face-sheet thickness and foam core thickness on the residual strength under in-plane compressive loading were studied. This study will be useful for characterizing and predicting the residual compressive strength and understanding the failure mechanism of woven polymer-based foam-core sandwich panel.
Enduring relations: Exploring a paradox of new materialism
Authors: Fowler Chris , Harris Oliver JT
Published: March 2015

In this article, the authors examine tensions between understandings of material things as either bundles of relations or as things-in-themselves. Rather than take either of these positions, they instead set out an argument for approaches that allow them to modulate between these understandings whilst treating both as relational. Taking such a position allows them to consider how things endure through time without returning to any notion of essence. They explore the theoretical arguments through an analysis of one particular enduring material phenomenon: the Neolithic chambered tomb of West Kennet.
Experiences of autism diagnosis: A survey of over 1000 parents in the United Kingdom
Authors: Crane Laura , Chester James W , Goddard Lorna , Henry Lucy A , Hill Elisabeth
Published: March 2015

A sample of 1047 parents completed an online survey about their experiences and opinions regarding the process of attaining a diagnosis of autism spectrum disorder for their children. The results revealed that parents usually waited a year from when they first had concerns about their child’s development before they sought professional help. On average, there was a delay of around 3.5 years from the point at which parents first approached a health professional with their concerns to the confirmation of an autism spectrum disorder diagnosis. Just over half of the parents surveyed were dissatisfied with the diagnostic process as a whole. Several factors predicted parents’ overall levels of satisfaction with the diagnostic process, including the time taken to receive a diagnosis, satisfaction with the information provided at diagnosis, the manner of the diagnosing professional, the stress associated with the diagnostic process and satisfaction with post-diagnostic support. Post-diagnosis, the support (if any) that was provided to parents was deemed unsatisfactory, and this was highlighted as an area of particular concern among parents.
Investigating novice teacher experiences of the teaching dynamics operating in selected school communities in Finland
Authors: Blomberg Seija , Knight Bruce Allen
Published: March 2015

This study focuses on the lived experiences of five novice teachers during their first academic year of teaching. This article analyzes the experiences of new teachers based on long-term data collection throughout a school year as one means of bridging the gap between teacher preparation and actual teaching practice. The findings indicate that teaching for novices is a demanding task because it centers on complex, interrelated sets of thoughts, actions, and dynamics.
Study on the vibration characteristics of a roller-supporting horizontal centrifugal casting machine
Authors: Li Liuxiang , Jiang Yuanyuan , Li Zhengmei , Zhan Yibin , An Qi
Published: March 2015

It is necessary to do some research on the vibration characteristics of a horizontal centrifugal casting machine for producing furnace tubes since it has significant influence on the final quality of the products. In this paper, vibration characteristics of a roller-supporting horizontal centrifugal casting machine are analysed with transfer matrix method, including critical speeds and unbalance response. The results show that the distribution of the eccentric masses has significant influence on unbalance response. The model established and the results obtained in this paper will be useful for furnace tubes quality improvement.
Mexican mass labor migration in a not-so changing political economy
Authors: Ibarra Armando , Carlos Alfredo
Published: March 2015

This article places Mexican migration in the context of the longue durée of Mexican–U.S. political and economic relations. We argue that 21st-century migration not only has its roots in the 19th century, but very much resembles its early predecessor. The latest wave of migration is just the most recent iteration of a process of hegemonic dominance over Mexico, a process that has been for the most part ongoing since the late 1800s. It continues to be rooted in labor migration caused by unequal economic policy between the two countries. The paper builds upon the empire theory of migration literature in lieu of the neutral-seeming “natural” “push–pull” of markets and living conditions or social capital theories, and provides a more power-driven analysis stressing hegemony and domination in which the United States exerts control over Mexico for the purposes of exploiting cheap labor and raw materials.
“Other Than Mexicans”, “Islamic Fascists” and the transatlantic regulation of risky subjects
Authors: Kyriakides Christopher , Torres Rodolfo D.
Published: March 2015

Post-9/11 significations of “immigration threat” link the policing of the US–Mexico border to the “war on terror” geopolitically such that domestic policies and practices related to the regulation of “undocumented” Latino migrants shape and are shaped by extra-domestic considerations related to the signification of Arab and Muslim communities. In broadening migration analysis, to include a geopolitical dimension, we are able to draw out the changing patterns of racialized population regulation within a given territory of the international state complex. Consequently, extending the geopolitical reach to include US and UK post-9/11 security regimes reveals that the logic underpinning the “Other Than Mexican” immigration category in the US, ostensibly an addition to and extension of the signification of threat posed by Latinos to the US, is neither Latino nor US specific: an idiom of threat is mobilized around “special interest aliens” as perpetrators of risk to the global social order, which broadens the domestic reach of state surveillance. The “war on terror” with related discourses of “anti-fundamentalism” and “islamofascism” specifies that risk averse surveillance documents the “elusive undocumented” carrier of terror threat, guilty by association: a cipher of fear is armed and disarmed, used to legitimate and operationalize surveillance as precautionary intervention. Through an analysis of the signification of immigration threat related to the state of Arizona’s Support Our Law Enforcement and Safe Neighborhoods Act, SB1070 in 2010 with the judicial investigation surrounding the killing of Brazilian migrant Jean Charles de Menezes by Metropolitan police on the London Underground in 2005, this study reveals how the lethal logic of Other Than Mexican regulation underpins the post-9/11 transatlantic politics of racialized risk, reconfiguring state intervention related to the “browning of America” through an “anti-fundamentalist” population control measure.
‘It’s everything else you do…’: Alumni views on extracurricular activities and employability
Authors: Clark Gordon , Marsden Rebecca , Whyatt J Duncan , Thompson Leanne , Walker Marion
Published: March 2015

This article explores students’ extracurricular activities and, uniquely, their short- and long-term effects on employability. Drawing on the literature, six research questions are identified. A questionnaire and interviews with alumni provide the quantitative and qualitative information needed. The effects of different extracurricular activities and the skills and qualities they promote are demonstrated for early- and later-career jobs, as are the complementary effects for employability of degree schemes and extracurricular activities. Alumni who are now recruiters of staff use their double perspective to explain the role extracurricular activities have played in their lives and now as professional recruiters. This article shows how the alumni of any university could share these insights with undergraduates.
Rights, citizenship and political struggle
Authors: Aitchison Guy
Published: March 2015

This paper adds a new perspective to recent debates about the political nature of rights through attention to their distinctive role within social movement practices of moral critique and social struggle. The paper proceeds through a critical examination of the Political Constitutionalist theories of rights politics proposed by Jeremy Waldron and Richard Bellamy. While political constitutionalists are correct to argue that rights are ‘contestable’ and require democratic justification, they construe political activity almost exclusively with reference to voting, parties and parliamentary law-making, neglecting the vital role rights play in political struggle outside and against the official institutions of democratic citizenship. In contrast to the political constitutionalist stress on the patient and reciprocal negotiation of rights within formal electoral processes, this paper locates the political nature of rights in their conflictual logic as ‘claims’ in multiple spheres that function to mobilise oppositional support against powerful adversaries and challenge dominant understandings. An activist citizenship of rights is frequently necessary, it argues, given the structural barriers of power and inequality that distort legislative decision-making and lead to the denial of fundamental moral entitlements to less powerful groups. The paper provides an illustration of activist citizenship taken from a contemporary squatting movement centred around the right to housing, Take Back the Land. In exercising the moral right to housing, for which they demand political recognition, through the occupation of vacant buildings, the practices of Take Back the Land reflect the conflictual dimension of rights as claims in keeping with their historical role in empowering subordinate groups to challenge unjust relations of power and inequality.
A freeform reflector for a light-emitting diode bicycle head lamp
Authors: Wu H , Zhang XM , Ge P
Published: March 2015

We propose a freeform reflector for light-emitting diode bicycle head lamps based on a feedback method. The energy relationship between the solid angle of the light-emitting diode source and the target plane is first established. A reflector is then constructed based on non-imaging optics theory and Snell’s Law. Feedback modifications are applied in accordance with the deviation between the simulated and the desired light distribution. Then the reflector is regenerated and the deviation is minimized after several iterations. A reflector for a bicycle head lamp is designed for the Cree XP-E LED source whose emitting surface is 1.2 mm × 1.2 mm. Simulation results indicate that the light performance can meet the K-mark regulations. The optical utilization factor can be improved from 73% to 80% and the illuminance uniformity is improved by 22%.
C-Reactive Protein and Endovascular Treatment of Lower Limb Peripheral Artery Disease
Authors: Bleda Silvia , de Haro Joaquin , Varela Cesar , Acin Francisco
Published: March 2015

Purpose: To determine if C-reactive protein (CRP) can predict the outcomes of lower extremity endovascular therapy (EVT) in patients with peripheral artery disease and to calculate a cutoff value that may be useful in identifying patients with a higher risk of EVT failure at 1 year. Methods: In this prospective single-center study, 121 patients (94 men; mean age 67.7±9.8 years) undergoing EVT of lower limb lesions in an 18-month period were enrolled as a derivation set. In the subsequent 6 months, 53 patients (39 men; mean age 70.1±10.0 years) were enrolled as the validation set. Blood samples were collected before EVT and at 1 month postintervention from both sets of patients to measure CRP levels. The cohorts were followed for 1 year, and data on reinterventions were recorded. A cutoff CRP value was calculated with the highest sensitivity and specificity for EVT failure based on receiver operator characteristic (ROC) curve analysis. The cutoff value was confirmed in the validation set. Cox proportional hazards analysis was performed to evaluate the independent contribution of CRP levels and other variables to the risk of reintervention; results are given as the hazard ratio (HR) and 95% confidence interval (CI). Results: The area under the ROC curve relating preprocedure CRP levels to 1-year reintervention was 0.77±0.05. The highest likelihood ratio corresponded to a pre-EVT CRP value of 9.8 mg/L (likelihood ratio test=133, df=1, p<0.001). Reintervention before the first year after EVT was related to preprocedure CRP levels (HR 1.1, 95% CI 1.05 to 1.2; p<0.001). These results were confirmed in the validation set (HR 1.1, 95% CI 1.02 to 1.18; p=0.008). Conclusion: CRP values can be used as an independent marker of EVT outcome. Baseline CRP levels >9.8 mg/L indicate increased risk of secondary interventions, which are often open surgical procedures.
Runoff Detected by Magnetic Resonance Angiography as an Indicator for Better Recanalization Outcomes in Below-the-Knee Chronic Total Occlusions in Diabetic Patients
Authors: Zhu Yue-Qi , Wang Jue , Tan Hua-Qiao , Lu Hai-Tao , Liu Fang , Cheng Ying-Sheng , Wei Li-Ming , Zhang Pei-Lei , Zhao Jun-Gong
Published: March 2015

Purpose: To compare the feasibility and efficacy of recanalizing below-the-knee (BTK) chronic total occlusions (CTOs) between patients with good or poor distal runoff based on magnetic resonance angiography (MRA) scans. Methods: Two hundred long-segment BTK CTOs in 171 limbs of 113 diabetic patients (58 men; mean age 69.8±1.9 years) were divided into good distal runoff (GDR: 119 lesions, 98 limbs) or poor distal runoff groups (PDR: 81 lesions, 73 limbs) based on baseline MRA findings. After angioplasty, modified thrombolysis in myocardial ischemia (mTIMI) grades and ankle-brachial index (ABI) were used to assess immediate outcomes. Regularly scheduled duplex or MRA imaging was performed in follow-up. The restenosis and limb salvage rates were compared. Results: The success rates were 93.3% and 87.7% in the GDR and PDR groups, respectively (p=0.21); subintimal angioplasty was more common in the PDR group (93.0% vs. 63.1%, p<0.01). Completion angiography indicated an mTIMI grade 3 blood flow in 71.2% lesions in the GDR patients and in 52.1% in the PDR (p=0.01) group. Improvement in the ABI was greater in the GDR limbs (p<0.001 vs. PDR). Mean imaging follow-up was 10.8±6.9 months in the GDR group and 11.1±6.6 months in the PDR group. Kaplan-Meier analysis showed a better restenosis-free rate in the GDR group (80.6% vs. 61.7%; p=0.02) at 12 months and for lesions with mTIMI grade 3 flow (p<0.01). At 24 months, Kaplan-Meier analysis revealed a better limb salvage rate in the GDR group (84.2% vs. 54.6%; p=0.02). Conclusion: Distal runoff detected using MRA could be a predictor for successful intraluminal recanalization, better distal tissue perfusion, improved long-term patency, and better limb salvage for patients with BTK CTOs.
Initial Clinical Experience With the Zenith Alpha Stent-Graft
Authors: Torsello Giovanni F. , Austermann Martin , Van Aken Hugo K. , Torsello Giovanni B. , Panuccio Giuseppe
Published: March 2015

Purpose: To assess safety and short-term efficacy of endovascular repair of the thoracic aorta with the new Zenith Alpha stent-graft. Methods: Between August 2010 and May 2014, 33 patients (21 men; mean age 73.2±9.0 years) were treated Zenith Alpha stent-graft (group ZA). Outcomes of this group were compared with those of 34 patients (25 men; mean age 70.3±8.5 years) treated contemporaneously with the Zenith TX-2 for the same pathologies (group TX). The primary outcome measure was technical success. Data on iliac tortuosity, minimum access vessel diameter, and previous unsuccessful treatment with other endografts was also recorded. Results: Technical success was 93.9% in group ZA and 91.2% in group TX (p=0.67). There was no case of surgical death or conversion to open repair in either group. Two (6%) type I endoleaks occurred in group ZA and 3 (9%) in group TX (p=0.67). Three patients died within 30 days in group ZA vs. none in group TX (p=0.07). Mean minimum access vessel diameter was significantly smaller (5.07 vs. 6.65 mm, p=0.002) and iliac tortuosity indices significantly higher in group ZA (1.34 vs. 1.25, p=0.02). Access vessel complications occurred in 1 (3%) patient in group ZA and 4 (12%) patients in group TX (p=0.17). Significantly more patients in group ZA (6, 18%) were unsuccessfully treated previously with other endografts vs. none in group TX (p=0.01). Conclusion: The new Zenith Alpha appears to be equally as safe and efficacious as the Zenith TX-2 while being used in patients with demanding access vessel morphology.
Drug-Coated Balloon Dilation Before Carotid Artery Stenting of Post–Carotid Endarterectomy Restenosis
Authors: Piccoli Gianluca , Biondi-Zoccai Giuseppe , Gavrilovic Vladimir , Radici Viviana , Cancelli Iacopo , Frigatti Paolo , Frati Giacomo , Marullo Antonino G. M. , Divis Paolo , Gasparini Daniele
Published: March 2015

Purpose: To investigate if drug-coated balloon (DCB) predilation may improve the efficacy of carotid artery stenting (CAS) for restenosis after carotid endarterectomy (CEA). Methods: Eighteen consecutive patients (11 men; median age 75 years) with significant restenosis within 24 months of CEA were treated with a paclitaxel-coated DCB prior to CAS. Clinical outcomes and stent patency were systematically appraised. Results: All patients were successfully treated according to this clinical protocol. The only complication occurred in a patient who had a transient ischemic attack during prolonged DCB inflation. At a median follow-up of 18 months, no >50% restenosis was observed on duplex ultrasound scans; however, moderate hyperplasia at the proximal stent edge was found in 4 patients. One patient died at 9 months from a myocardial infarction. Conclusion: Despite the small sample size and in keeping with the historically high risk of recurrent restenosis after CAS for CEA restenosis, this case series suggests that DCB dilation followed by CAS for postsurgical restenosis is feasible, safe, and may be associated with favorable clinical outcomes at midterm follow-up.
A Review of Antithrombotic Therapy and the Rationale and Design of the Randomized Edoxaban in Patients With Peripheral Artery Disease (ePAD) Trial Adding Edoxaban or Clopidogrel to Aspirin After Femoropopliteal Endovascular Intervention
Authors: Tangelder Marco J. D. , Nwachuku Chuke E. , Jaff Michael , Baumgartner Iris , Duggal Anil , Adams George , Ansel Gary , Grosso Michael , Mercuri Michele , Shi Minggao , Minar Erich , Moll Frans L.
Published: March 2015

Compared with the coronary setting, knowledge about antithrombotic therapies after endovascular treatment (EVT) is inadequate in patients with peripheral artery disease (PAD). Based on a review of trials and guidelines, which is summarized in this article, there is scant evidence that antithrombotic drugs improve outcome after peripheral EVT. To address this knowledge gap, the randomized, open-label, multinational edoxaban in patients with Peripheral Artery Disease (ePAD) study ( ClinicalTrials.gov identifier NCT01802775) was designed to explore the safety and efficacy of a combined regimen of antiplatelet therapy with clopidogrel and anticoagulation with edoxaban, a selective and direct factor Xa inhibitor, both combined with aspirin. As of July 2014, 203 patients (144 men; mean age 67 years) from 7 countries have been enrolled. These patients have been allocated to once-daily edoxaban [60 mg for 3 months (or 30 mg in the presence of factors associated with increased exposure)] or clopidogrel (75 mg/d for 3 months). All patients received aspirin (100 mg/d) for the 6-month duration of the study. The primary safety endpoint is major or clinically relevant nonmajor bleeding; the primary efficacy endpoint is restenosis or reocclusion at the treated segment(s) measured at 1, 3, and 6 months using duplex ultrasound scanning. All outcomes will be assessed and adjudicated centrally in a masked fashion. The ePAD study is the first of its kind to investigate a combined regimen of antiplatelet therapy and anticoagulation through factor Xa inhibition with edoxaban.
Aortic Hybrid Sutureless Anastomosis on Porcelain Aorta
Authors: Bonvini Stefano , Zavatta Marco , Grego Franco , Piazza Michele
Published: March 2015

Purpose: To describe a hybrid sutureless anastomosis technique between a prosthetic graft, an endograft, and a circumferentially calcified infrarenal aorta. Technique: The technique is demonstrated in a 65-year-old man with flush distal aortoiliac occlusion and patent infrarenal porcelain aorta (IPA). After laparotomy, the IPA was occluded below the renal arteries by inflating an aortic balloon introduced via an axillary access. The IPA was transected in its distal part and aortic thrombectomy performed. A Zenith iliac extension was modified on a back table by cutting the terminal tip; the device was then was inserted and deployed into the IPA in a standard fashion and the sheath removed. A Dacron bifurcated graft was sutured in an end-to-end anastomosis to the endograft and terminal aorta. The 12-month computed tomography scan showed patency of the graft. Conclusions: This sutureless anastomosis technique seems safe and feasible and represents a valid alternative to standard surgical approaches in cases of heavy and circumferentially calcified infrarenal aorta.
Duplex Ultrasound Assessment of Native Stenoses in the Superficial Femoral and Popliteal Arteries
Authors: Macharzina Roland Richard , Schmid Simon F. , Beschorner Ulrich , Noory Elias , Rastan Aljoscha , Vach Werner , Schwarzwälder Uwe , Sixt Sebastian , Bürgelin Karlheinz , Neumann Franz-Josef , Zeller Thomas
Published: March 2015

Purpose: To evaluate duplex ultrasonography (DUS) in the assessment of femoropopliteal stenoses comparing a single native stenosis (SNS) to multisegmental native stenoses (MNS). Methods: Among the 1284 patients treated for atherosclerotic occlusive disease involving the femoropopliteal segment between November 2002 and November 2012, 139 patients (97 men; mean age 68±8 years) with 142 SNS or 143 MNS in 79 and 60 patients, respectively, were eligible for this retrospective analysis. The peak systolic velocity ratios with proximal (PSVRprox) and distal (PSVRdist) reference for the 285 lesions were compared with their respective angiographic stenosis grade as measured by 2 independent readers using quantitative vascular analysis to ensure objectivity. Receiver operating characteristic curve analysis was used to evaluate sensitivity, specificity, and the optimal thresholds of PSV and PSVR for detection of stenoses by grade (>50%, >70%, or >80% diameter stenosis). The area under the curve (AUC) values of dependent and independent receiver operating characteristic curves were compared. Results: For SNS, correlation of PSVRprox to diameter stenosis (R=0.88) was higher (p<0.001) than the correlation for MNS (R=0.78). In the SNS group, the AUC for detecting a >50% (0.99±0.01), >70% (0.98±0.01), and >80% (0.96±0.01) stenosis with PSVRprox was significantly higher than in the MNS group [AUC50% 0.93±0.02 (p=0.01), AUC70% 0.92±0.02 (p=0.02), and AUC80% 0.87±0.03 (p=0.003)]. The optimal thresholds for detecting >50%, >70%, and >80% stenoses for SNS using PSVRprox were 2.6, 3.3, and 3.9, respectively. For MNS, the optimal thresholds of PSVRprox were 2.6, 3.4, and 3.9, respectively, with respective sensitivities of 87%, 81%, and 75%; respective specificities of 93%, 90%, and 82%; negative predictive values of 45%, 64%, and 74%; and positive predictive values of 99%, 95%, and 83%. Conclusion: DUS is an optimal tool for quantification of SNS. However, a multisegment setting has a significant negative impact on the quantification of femoropopliteal artery stenosis.
Spanish-Language Media Entrepreneurship in the Statehouse
Authors: Medina Vidal D. Xavier
Published: March 2015

Little is known about the role of Spanish-language media in the representation of Latino constituencies in statehouses. In this article, I present analyses of elite-level data from the Media and Public Policy in the States: 2011 Survey, which reveal state legislators' attitudes and orientations toward the news media. Building on the view that Spanish-language media provide an important representational link between Hispanic constituents and their political representatives, I argue that the level of media sophistication or “media entrepreneurship” state legislators bring to their representative role is a function of legislators' Spanish media environments. Through statistical tests of the relationships between the Spanish-language media environment, state lawmakers' perceptions of the media's effectiveness, and their use of media tools, I find evidence that district-level Spanish-language media contexts influence lawmakers' level of engagement with the news media.
Latina/o Academics’ Resilient Qualities in Their Linguistically Diverse Practices
Authors: Cavazos Alyssa G.
Published: March 2015

Emphasis placed on academic writing in English may create challenges for multilingual academics as they negotiate diverse languages. Based on personal interviews with bilingual Latina/o academics in rhetoric and composition, this study reveals that their language practices reflect diverse resilient qualities at various stages in their academic career. This process of adaptation illustrates Latina/o academics’ rhetorical awareness of their position in the academy and how resilient language practices help them succeed in higher education.
Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care
Authors: Baer Heather J , Wee Christina C , DeVito Katerina , Orav E John , Frolkis Joseph P , Williams Deborah H , Wright Adam , Bates David W
Published: March 2015

Background:

Primary care providers often fail to identify patients who are overweight or obese or discuss weight management with them. Electronic health record-based tools may help providers with the assessment and management of overweight and obesity.

Purpose:

We describe the design of a trial to examine the effectiveness of electronic health record-based tools for the assessment and management of overweight and obesity among adult primary care patients, as well as the challenges we encountered.

Methods:

We developed several new features within the electronic health record used by primary care practices affiliated with Brigham and Women’s Hospital in Boston, MA. These features included (1) reminders to measure height and weight, (2) an alert asking providers to add overweight or obesity to the problem list, (3) reminders with tailored management recommendations, and (4) a Weight Management screen. We then conducted a pragmatic, cluster-randomized controlled trial in 12 primary care practices.

Results:

We randomized 23 clinical teams (“clinics”) within the practices to the intervention group ( n = 11) or the control group ( n = 12). The new features were activated only for clinics in the intervention group. The intervention was implemented in two phases: the height and weight reminders went live on 15 December 2011 (Phase 1), and all of the other features went live on 11 June 2012 (Phase 2). Study enrollment went from December 2011 through December 2012, and follow-up ended in December 2013. The primary outcomes were 6-month and 12-month weight change among adult patients with body mass index ≥25 who had a visit at one of the primary care clinics during Phase 2. Secondary outcome measures included the proportion of patients with a recorded body mass index in the electronic health record, the proportion of patients with body mass index ≥25 who had a diagnosis of overweight or obesity on the electronic health record problem list, and the proportion of patients with body mass index ≥25 who had a follow-up appointment about their weight or were prescribed weight loss medication.

Lessons learned:

We encountered challenges in our development of an intervention within the existing structure of an electronic health record. For example, although we decided to randomize clinics within primary care practices, this decision may have introduced contamination and led to some imbalance of patient characteristics between the intervention and control practices. Using the electronic health record as the primary data source reduced the cost of the study, but not all desired data were recorded for every participant.

Conclusion:

Despite the challenges, this study should provide valuable information about the effectiveness of electronic health record-based tools for addressing overweight and obesity in primary care.
Approaches to learning among school-aged youth in Nepal: Factor structure of learning behaviors scale scores
Authors: Hamlet Helen S. , Schaefer Barbara A. , Herrick Margaret , Rai Renuka
Published: March 2015

Educational progress and advancement is essential to the social and economical growth in Nepal. With 2015 as the goal date for the Dakar Framework for Action, identification of methods to improve student outcomes is fundamental to this goal. Assessing student learning behaviors in order to strengthen and/or remediate a student’s approach to learning facilitates academic achievement. The Learning Behaviors Scale (LBS) provides a behaviorally based assessment instrument for exploring students’ behaviors in the classroom. This study investigated the factor structure, multidimensional structure, and item endorsement of the LBS for a sample of 223 school-aged Nepalese students. A four-factor structure was revealed for this population. The four factors represent: task approach; emotional negativity/ sojho; task engagement/ thiken; and self-control. In addition, two dimensions of learning behaviors emerge. These represent task approach and level of engagement. Finally, a comparative analysis of the data identified similarities between the US sample and the Nepalese sample. The results of this study indicate a pattern of learning behaviors, as identified by the LBS, which is similar across the two cultures.
Endoscopic closure of persistent gastrocutaneous fistulae, after percutaneous endoscopic gastrostomy (PEG) tube placement, using the over-the-scope-clip system
Authors: Singhal Shashideep , Changela Kinesh , Culliford Andrea , Duddempudi Sushil , Krishnaiah Mahesh , Anand Sury
Published: March 2015

Objectives:

The Over-The-Scope-Clip (OTSC) has had an evolving role in endoscopic closure of gastrointestinal wall defects, in hemostasis of primary or postinterventional bleeding, and approximation of postbariatric surgery defects. Rapid and effective closure of gastrocutaneous (GC) fistulae using this device has been recently described in the literature. The aim of this study was to evaluate the technical feasibility, efficacy and safety of OTSC as an effective tool in the management of persistent GC fistulae secondary to a complication of percutaneous endoscopic gastrostomy (PEG) tube placement.

Method:

In this multicenter prospective observational study, we describe our experience with OTSC in the closure of persistent GC fistulas secondary to PEG tube placement. Patients with GC fistulas were sequentially enrolled with a mean age of 84 years. Primary treatment outcome was the immediate successful closure of GC fistula and resolution of leak. Secondary outcome was no recurrence of the fistula and leaks on follow up.

Results:

A total of 10 patients were enrolled over the study period. Mean age was 84.4 ± 8.75 years. The primary treatment outcome was achieved in all the patients undergoing this intervention. Secondary outcome was observed in 9/10 (90%) subjects. No procedural complications were reported. Larger fistulae (>2.5 cm) and those with significant fibrosis were more difficult to close with the OTSC system. The mean follow-up time after OTSC application was 43.7 ± 20.57 days. A limitation of this study was that there was no control group.

Conclusions:

OTSC application is a safe and effective endoscopic approach for the closure of persistent GC fistulae secondary to a complication of PEG tube placement.
Perceived Openness to Experience Accounts for Religious Homogamy
Authors: Jackson Joshua , Halberstadt Jamin , Jong Jonathan , Felman Hillel
Published: March 2015

Two studies tested the hypothesis that religious homogamy—assortative mating on the basis of religion—can be partly explained by inferences about religious individuals’ openness to experience, rather than attitudes toward religion per se. Results of Study 1 indicated that non-religious participants perceived non-religious targets to be higher in openness and more appealing as romantic partners, with the first effect statistically accounting for the second. Study 2, which manipulated “religious” and “open” behaviors independently, showed that openness guided dating judgments for both non-religious and religious participants, albeit in opposite directions. Thus, regardless of their own religious beliefs, individuals appear to infer the same kind of behaviors from others’ religiosity, behaviors that are seen positively by religious individuals, but negatively by non-religious individuals. These inferences, in turn, partially explain all individuals’ preferences for partners of the same religious orientation.
Effect of comedication of bupropion and other antidepressants on body mass index
Authors: Ravindran Priyadarshini P. , Zang Wenzhao , Renukunta Swetha , Mansour Rick , Denduluri Srinivas
Published: March 2015

Background:

Weight gain as an adverse effect of monotherapy of antidepressant has been well-studied. The effects of augmentation therapy involving multiple antidepressants, on weight changes needs to be adequately addressed.

Objective:

To study the co-medication effects of bupropion in combination with six individual antidepressants on body mass index (BMI) using EMR based data analysis.

Methods:

Allscripts data warehouse was used to identify patients on monotherapy of five selective serotonin reuptake inhibitor (SSRI) drugs, escitalopram, sertraline, citalopram, paroxetine, fluoxetine, one selective norepinephrine reuptake inhibitor (SNRI) duloxetine and the aminoketone, bupropion for at least 180 days. We also identified patients on co-medication of SSRI/SNRI drugs with bupropion. Six ANCOVA models were built to compare the short term effects on BMI, among monotherapy and co-medication groups. The patients’ clinical conditions and demographics were included to account for confounding effects.

Results:

Monotherapy of all the SSRI/SNRI drugs showed significant weight increase, consistent with that of previous studies. The co-medication of bupropion and escitalopram showed a significantly higher increase in BMI than monotherapy (P = 0.0102). The increase in BMI in the other five co-medication groups was not significantly different from their respective monotherapy groups.

Conclusion:

Our study reports an adverse weight gain on co-medication of escitalopram and bupropion, which warrants further validation studies. Considering co-medication effects of antidepressants on weight is important to design robust depression treatment plans.
Training Advanced Practice Providers to Collect Functional Outcomes After Fragility Fractures
Authors: Wang Tiffany L. , Ames Tyler D. , Le Khoi M. , Wee Corinne , Phieffer Laura S. , Quatman Carmen E.
Published: March 2015

Objective:

The objective of this study was to determine whether advanced practice providers could learn to collect objective functional assessment data accurately and efficiently with commercially available devices that measure kinematics and kinetics (Nintendo Wii Balance Board [WBB] and Level Belt [LB]) to aid in the assessment of fall risk and outcomes after fragility fractures.

Methods:

Nine advanced practice providers participated in a 1-hour clinical assessment tools (CATs) training session on equipment use, providing standardized instructions, and practice of the testing procedures. Afterward, they participated in a skills demonstration evaluation and completed a postsession survey.

Results:

Participants successfully achieved a mean of 18.22 (standard deviation 1.56) of 20 performance measures. Of the incomplete or omitted tasks, the majority (10 of 16) occurred within the first of 3 CATs activities. Postsession survey results revealed that 9 of 9 participants reported that the 1 hour provided for training on the CATs was sufficient. All participants reported that after the training, they felt confident they could reliably carry out the tasks to test patients on both the WBB and the LB. The majority of participants reported that they believed that the WBB (7 of 9) and LB (8 out of 9) would be good assets to clinics in assessing patient functionality after fragility fractures.

Conclusion:

These results indicate that advanced practice providers can confidently learn and effectively test patients with the WBB and LB within 1 hour of training. In the future, adoption of CATs in the clinical setting may allow for objective, easy-to-use, portable, noninvasive, and relatively inexpensive measures to assess functional outcomes in patients with fragility fracture.
Grammatical Metaphor
Authors: Ezeifeka Chinwe R.
Published: March 2015

Abstract writing presents problems to budding academics, especially in keeping to the generic structure and the requisite word counts by the various publishers. The article focuses on grammatical metaphor as a systemic resource for achieving proficiency in research abstract writing. Borrowing from Halliday and Matthiessen’s semantic domains beyond the clause and Halliday’s theorizing of the language of science, the article explores the various forms of transferences made possible by the grammar: from logical to experiential, from sequences to figures, elements and things, involving downgrading of linguistic units from higher semantic domains to lower ones. The resulting nominalization is seen as the single most powerful resource for effecting grammatical metaphor of the ideational type through its capacity for lexical packing. The article analyzes five randomly selected undergraduate research abstracts that exhibited an obvious lack of awareness of this systemic resource. By focusing on the sequences of figures from each abstract, comprising various numbers of clause nexuses, the article demonstrates how the judicious use of nominalization can simultaneously achieve word economy and information density, which are obvious marks of proficiency in this academic genre, and strongly recommends this grammatical strategy for students and budding academics.
Are International Undergraduate Students Emerging Adults? Motivations for Studying Abroad
Authors: Wintre Maxine Gallander , Kandasamy A. R. , Chavoshi Saeid , Wright Lorna
Published: March 2015

This qualitative study investigated the decision-making processes underlying international students’ motivation to study abroad and whether they were related to features of Arnett’s definition of emerging adulthood. A total of 64 international undergraduate students (21 men and 43 women) from 26 countries and in different years of study were interviewed while attending a large, ethnically diverse Canadian university. Using thematic analyses, eight underlying themes of motivations were identified, namely, new experiences, education, improved future career and immigration prospects, qualities of the host country, qualities of the institution, financial reasons, location, and friends and relatives in the host country. Many motivational factors to study abroad highlighted and expanded upon characteristics of Arnett’s theory of emerging adulthood, whereas others were unique to international students. Practical implications include providing universities with information that developmentally situates international students, enhancing universities’ ability to assist students to attain their goals for studying abroad.
How I treat priapism
Authors: Anele Uzoma A. , Le Brian V. , Resar Linda M. S. , Burnett Arthur L.
Published: March 2015

Priapism is a disorder of persistent penile erection unrelated to sexual interest or desire. This pathologic condition, specifically the ischemic variant, is often associated with devastating complications, notably erectile dysfunction. Because priapism demonstrates high prevalence in patients with hematologic disorders, most commonly sickle cell disease (SCD), there is significant concern for its sequelae in this affected population. Thus, timely diagnosis and management are critical for the prevention or at least reduction of cavernosal tissue ischemia and potential damage consequent to each episode. Current guidelines and management strategies focus primarily on reactive treatments. However, an increasing understanding of the molecular pathophysiology of SCD-associated priapism has led to the identification of new potential therapeutic targets. Future agents are being developed and explored for use in the prevention of priapism.
Increased mortality in patients with the lupus anticoagulant: the Vienna Lupus Anticoagulant and Thrombosis Study (LATS)
Authors: Gebhart Johanna , Posch Florian , Koder Silvia , Perkmann Thomas , Quehenberger Peter , Zoghlami Claudia , Ay Cihan , Pabinger Ingrid
Published: March 2015

Key Points

New onset of thrombosis is an independent risk factor for increased mortality in LA-positive individuals. Life expectancy in our cohort of patients with LA was worse in comparison with an Austrian reference population.
Fixed points of monotone nonexpansive mappings on a hyperbolic metric space with a graph
Authors: Alfuraidan Monther Rashed , Khamsi Mohamed Amine
Published: March 2015

In this work, we define the concept of G-monotone nonexpansive multivalued mappings defined on a metric space with a graph G. Then we obtain sufficient conditions for the existence of fixed points for such mappings in hyperbolic metric spaces. This is the first kind of such results in this direction.