bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons from Lithuania: A pedagogical approach in teaching improvisation
Authors: Hedden Debra
Published: April 2017

The purpose of this study was to uncover the approach that a professor in Lithuania utilized in successfully teaching undergraduate music education majors how to improvise during a one-semester course. The research questions focused on the participant’s philosophy of teaching and learning, his methods for motivating students, the learning experiences he provided, and pedagogy that provided sequence of instruction and learning activities for the students. The research design consisted of a qualitative case study approach in which I interviewed the participant formally (three lengthy interviews), informally (seven casual conversations), and made six 90-minute observations of his improvisation classes. Inductive data analysis was employed to identify emergent themes. Those themes included (a) the freedom to create, (b) the act of convincing the students to engage, (c) the establishment of expectations, (d) the pedagogy and sequence of instruction that precipitated skill acquisition, and (e) the classroom environment that enhanced improvisational outcomes. The implications for teacher education are discussed.
Foam sclerotherapy of the great saphenous vein in association with pre-terminal saphenous junction ligation/division as an office-based procedure: 12-Month results
Authors: Leo Moro , Stefano Ricci , Raffaele Antonelli Incalzi
Published: April 2017

Objective

Ultrasound-guided foam sclerotherapy (UGFS) – one of the most frequently recommended methods for treating great saphenous vein incompetence – is easy and inexpensive. However, it achieves a lower occlusion rate compared to endovenous thermal ablation. The application of UGFS to pre-terminal great saphenous vein interruption, eliminating the saphenous stem wash out effect, enhances the short-term occlusion rate. This study explores the results of this technique at 12 months.

Method

Thirty great saphenous veins (28 patients) with junction incompetence, with calibres >6 mm and >30 cm reflux stem length were submitted to echo-guided pre-terminal great saphenous vein interruption and foam great saphenous vein occlusion. Participants were subjected to a 12-month post-operative review by ultrasound assessment of great saphenous vein occlusion and terminal stump stability. Comparisons were made between pre-operative and 12-month Validation of Venous Clinical Severity Score (VCSS), photopletismography, Aberdeen questionnaire and complications.

Results

After 12 months, 28/30 great saphenous veins remained occluded (93%). One complete and one partial recanalization did not require retreatment. Four saphenous stumps showed a reflux during Valsalva (one due to recanalization, one limited to the stump, two with reflux in the anterior accessory saphenous vein). VCSS improved from 3.33 ± 1.64 to 0.67 ± 1.21 ( p < 0.05). Aberdeen questionnaire scores decreased from 9.44 ± 6.18 to 2.47 ± 3.77 ( p < 0.05). For photopletismographic examination, the mean venous refilling time (normal value: > 25 s) improved from 17.94 ± 11.97 to 31.4 ± 11.99 ( p < 0.05).

Conclusion

Applying pre-terminal great saphenous vein interruption to UGFS of the saphenous stem achieved an occlusion rate at one year similar to that of endovenous thermal ablation. The procedure is simple, effective, office based, and may be used as a 10-min prolongation to a phlebectomy.
Changes in physical activity following total hip or knee arthroplasty: a matched case-control study from the EPIC-Norfolk cohort
Authors: Smith Toby , Withers Thomas , Luben Robert , Sackley Catherine , Jones Andy , MacGregor Alex
Published: April 2017

Objective:

To assess self-reported physical activity changes pre- compared to post-operatively in patients undergoing total hip or knee arthroplasty, and to compare this to an age- and gender-matched cohort of people who have not undergone arthroplasty.

Design:

Population-based prospective cohort study.

Setting:

Norfolk, United Kingdom.

Subjects:

People who had undergone hip or knee arthroplasty, compared to an age- and gender-matched non-arthroplasty cohort.

Intervention:

Primary total hip or knee arthroplasty.

Main measures:

Physical activity, measured using the EPIC Physical Activity Questionnaire (EPAQ2).

Results:

A total of 400 people from the EPIC-Norfolk community cohort were identified who had undergone hip or knee arthroplasty. In all, 767 people were identified to form an age- and gender-matched non-arthroplasty cohort. Mean post-operative follow-up was 43 months post-total hip and 41 months post-total knee arthroplasty. There was a statistically significant reduction from pre- to post-arthroplasty in the number of flights of stairs climbed weekly (hip: mean difference (MD): 6.8; P < 0.01; knee: MD: 10.2; P < 0.01), duration of walking (hip: MD: 1.4 hours/week; P = .02; knee: MD: 2.2 hours/week; P < 0.01) and duration of total recreational activity (hip: MD: 1.1 hours/week; P = 0.02). Compared to the non-arthroplasty cohort, duration of physical activity was lower post-total hip arthroplasty (MD: 1.8 hours/week; P = 0.01). The number of flights of stairs climbed weekly (MD: 12.0; P < 0.01), total recreational activity (MD: 1.7 hours/week; P = 0.04) and physical activity energy expenditure (MD: 5.7 Mets-hours/week; P = 0.05) were lower for people post-total knee arthroplasty compared to the matched controls.

Conclusions:

Physical activity did not increase, and in some instances decreased, following total hip or knee arthroplasty.
British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017
Authors: McAllister-Williams R Hamish , Baldwin David S , Cantwell Roch , Easter Abby , Gilvarry Eilish , Glover Vivette , Green Lucian , Gregoire Alain , Howard Louise M , Jones Ian , Khalifeh Hind , Lingford-Hughes Anne , McDonald Elizabeth , Micali Nadia , Pariante Carmine M , Peters Lesley , Roberts Ann , Smith Natalie C , Taylor David , Wieck Angelika , Yates Laura M , Young Allan H ,   endorsed by the British Association for Psychopharmacology
Published: April 2017

Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, owing to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders.
Effect of doxazosin on stress reactivity and the ability to resist smoking
Authors: Verplaetse Terril L , Weinberger Andrea H , Oberleitner Lindsay M , Smith Kathryn MZ , Pittman Brian P , Shi Julia M , Tetrault Jeanette M , Lavery Meaghan E , Picciotto Marina R , McKee Sherry A
Published: April 2017

Preclinical findings support a role for α1-adrenergic antagonists in reducing nicotine-motivated behaviors, but these findings have yet to be translated to humans. The current study evaluated whether doxazosin would attenuate stress-precipitated smoking in the human laboratory. Using a well-validated laboratory analogue of smoking-lapse behavior, this pilot study evaluated whether doxazosin (4 and 8 mg/day) versus placebo attenuated the effect of stress (vs neutral imagery) on tobacco craving, the ability to resist smoking and subsequent ad-libitum smoking in nicotine-deprived smokers ( n=35). Cortisol, adrenocorticotropin, norepinephrine, epinephrine, and physiologic reactivity were assessed. Doxazosin (4 and 8 mg/day vs placebo) decreased cigarettes per day during the 21-day titration period. Following titration, doxazosin (4 and 8 mg/day vs placebo) decreased tobacco craving. During the laboratory session, doxazosin (8 mg/day vs placebo) further decreased tobacco craving following stress versus neutral imagery. Doxazosin increased the latency to start smoking following stress, and reduced the number of cigarettes smoked. Dosage of 8 mg/day doxazosin increased or normalized cortisol levels following stress imagery and decreased cortisol levels following neutral imagery. These preliminary findings support a role for the noradrenergic system in stress-precipitated smoking behavior, and support further development of doxazosin as a novel pharmacotherapeutic treatment strategy for smoking cessation.
Can multiphase dynamic CT angiography provide a better assessment of aortic dissection compared with the standard triphasic protocol?
Authors: Lu Chun-yan , Diao Yi-ke , Guo Ying-qiang , Zhang Xiao-hui , Bai Hong-li , Li Zhen-lin
Published: April 2017

Background

Acute aortic dissection (AD) is a life-threatening medical emergency. It has been debated whether the multiphase dynamic computed tomography angiography (CTA) protocol is superior to the standard triphasic protocol for revealing the characteristics of AD.

Purpose

To examine two multiphase dynamic protocols, Dynamic four-dimensional (4D) CTA using the shuttle mode and Flash 4D CTA using the high-pitch mode for the assessment of AD and to compare them with the standard triphasic protocol.

Material and Methods

A total of 54 consecutive patients were randomly and equally assigned to three groups and scanned with a second-generation DSCT scanner. Groups A, B, and C were assessed with the Dynamic 4D CTA in the shuttle mode, the Flash 4D CTA in the high-pitch mode, and the standard triphasic acquisition protocol, respectively. Image quality of all patients was evaluated. The effective radiation dose (ED) was recorded.

Results

In 54 patients, CTA images could display the true and false lumens, the intimal flap, the entry tear, and branch vessel involvement in the AD. Compared with group C, additional diagnostic information was obtained in groups A and B, including the dynamic enhancement delay between the true and false lumens (A = 18, B = 18); the presence of membrane oscillation (A = 8, B = 14); dynamic ejection of the contrast material from the true lumen into the false lumen (A = 6, B = 7); and the dynamic obstruction of the left renal artery (B = 2). The ED in these three groups was significantly different ( P < 0.05).

Conclusion

Compared to the standard triphasic protocol, the multiphase dynamic CTA protocol is feasible and is able to reveal additional diagnostic information. Therefore, we recommend using the high-pitch, dual-source multiphase dynamic CTA to assess ADs.
Vasa Vasorum Arteriopathy: Relationship With Systemic Arterial Hypertension and Other Vascular Lesions in Cats
Authors: Kohnken R. , Scansen B. A. , Premanandan C.
Published: April 2017

The vasa vasorum is a delicate network of small arterioles that supplies nutrients to the adventitia and outer media of large arteries. In humans, dysfunction of the vasa vasorum contributes to the pathogenesis of aortic dissection and atherosclerosis. Twenty-four cats from 1 to 18 years of age were prospectively evaluated. Cases were divided into 3 cohorts—with systemic hypertension, without systemic hypertension, and uncertain. Histologic sections of the aorta and main pulmonary artery, as well as sections of kidney and lung, were blindly examined by 2 pathologists. The severity of vasa vasorum arteriopathy was compared to the presence of renal arteriosclerosis, aortic medial degeneration, subintimal fibroplasia of the main pulmonary artery, and blood pressure. We found that vasa vasorum arteriopathy correlated strongly with hypertensive status, degree of renal arteriosclerosis, and lesions in the great vessels. The positive predictive value of a severe vasa vasorum score for systemic hypertension was 84.6%. Lesions of vasa vasorum arteriopathy were predictive of renal arteriosclerosis with 100% sensitivity and 64.7% specificity. The positive predictive value of a severe vasa vasorum score for the presence of aortic lesions was 69.2% vs 91.6% for lesions in the main pulmonary artery. The vasa vasorum appears to be an important responder to systemic hypertension in cats, and arteriopathy of this vascular bed has significant implications for the integrity of the great vessels.
Definitions and participant characteristics of frequent recurrent headache types in clinical trials: A systematic review
Authors: Aguila Maria-Eliza R , Rebbeck Trudy , Mendoza Kristofferson G , De La Peña Mary-Grace L , Leaver Andrew M
Published: April 2017

Background

Clear definitions of study populations in clinical trials may facilitate application of evidence to clinical populations. This review aimed to explore definitions of study populations in clinical trials on migraine, tension-type headache, cluster headache, and cervicogenic headache.

Methods

We performed a systematic review of clinical trials investigating treatment efficacy for migraine, tension-type headache, cluster headache, and cervicogenic headache. We extracted data on diagnosis, inclusion criteria and baseline headache characteristics.

Results

Of the 229 studies reviewed, 205 studies (89.5%) defined their populations in adherence to the International Classification of Headache Disorders (ICHD) criteria. Some studies ( n = 127, 55.5%) specified diagnosing through interview, clinical examination and diary entry. The most commonly reported inclusion criteria were pain intensity for migraine and tension-type headache studies ( n = 123, 66.1% and n = 21, 67.7%, respectively), episode frequency ( n = 5, 71.4%) for cluster headache studies, and neck-related pain for cervicogenic headache studies ( n = 3, 60%). Few studies reported details on the extent to which diagnostic criteria were present at baseline.

Conclusions

ICHD is routinely used in defining populations in headache studies. Details of baseline headache characteristics were not as consistently reported.
Effectiveness of Neuromuscular Training Based on the Neuromuscular Risk Profile
Authors: Hewett Timothy E. , Ford Kevin R. , Xu Yingying Y. , Khoury Jane , Myer Gregory D.
Published: April 2017

Background:

The effects of targeted neuromuscular training (TNMT) on movement biomechanics associated with the risk of anterior cruciate ligament (ACL) injuries are currently unknown.

Purpose/Hypotheses:

To determine the effectiveness of TNMT specifically designed to increase trunk control and hip strength. The hypotheses were that (1) TNMT would decrease biomechanical and neuromuscular factors related to an increased ACL injury risk and (2) TNMT would decrease these biomechanical and neuromuscular factors to a greater extent in athletes identified as being at a high risk for future ACL injuries.

Study Design:

Controlled laboratory study.

Methods:

Female athletes who participated in jumping, cutting, and pivoting sports underwent 3-dimensional biomechanical testing before the season and after completing TNMT. During testing, athletes performed 3 different types of tasks: (1) drop vertical jump, (2) single-leg drop, and (3) single-leg cross drop. Analysis of covariance was used to examine the treatment effects of TNMT designed to enhance core and hip strength on biomechanical and neuromuscular characteristics. Differences were also evaluated by risk profile. Differences were considered statistically significant at P < .05.

Results:

TNMT significantly increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. Athletes with a high risk before the intervention (risk profile III) had a more significant treatment effect of TNMT than low-risk groups (risk profiles I and II).

Conclusion:

TNMT significantly improved proximal biomechanics, including increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. TNMT that focuses exclusively on proximal leg and trunk risk factors is not, however, adequate to induce significant changes in frontal-plane knee loading. Biomechanical changes varied across the risk profile groups, with higher risk groups exhibiting greater improvements in their biomechanics.
Perceived status and value
Authors: Heikkinen Juho , Isomöttönen Ville
Published: April 2017

This article examines how students in a multidisciplinary project-based learning course involving real customers perceive their interactions with their customers. The authors conducted a qualitative study and analysed students’ learning reports by means of a thematic network analysis. The analysis shows how students perceive their status in relation to their customers and how their perceptions of their work affect how they see the value of the projects. The authors consider their empirical findings in the context of the existing literature on university–industry collaboration and thereby summarize different scenarios of the contrasting working practices and priorities in academia and industry. Based on the observed similarities between their own analysis and results reported in the literature, the authors recommend that project-based learning researchers should pay greater attention to research done on university–industry collaboration.
Spermatocytic Tumor With Sarcoma: A Rare Testicular Neoplasm
Authors: Stueck Ashley E. , Grantmyre John E. , Wood Lori A. , Wang Cheng , Merrimen Jennifer
Published: April 2017

Spermatocytic tumor, formerly known as spermatocytic seminoma, is an uncommon testicular neoplasm which is a distinct clinicopathologic entity from classic seminoma. These tumors are not associated with germ cell neoplasia in situ, other germ cell tumors, or isochromosome 12p. Although typically, these tumors have an excellent prognosis occasional cases are associated with sarcoma and have a very poor prognosis. We present a case of spermatocytic tumor with sarcoma showing a chondrosarcomatous component, discuss the pathologic findings and differential diagnosis and provide follow-up information.
Drinking Motives as a Moderator of the Relationship Between Dating Violence Victimization and Alcohol Problems
Authors: Haynes Ellen E. , Strauss Catherine V. , Stuart Gregory L. , Shorey Ryan C.
Published: April 2017

The present study sought to examine whether drinking motives (i.e., coping, social, conformity, and enhancement) moderated the relationship between physical, sexual, and psychological dating violence victimization and alcohol-related problems in a sample of drinking college women ( N = 177). Results demonstrated that coping and social drinking motives moderated the relationship between sexual victimization and alcohol problems; conformity, social, and enhancement drinking motives moderated the relationship between alcohol-related problems and physical victimization; no significant findings were evident for psychological aggression victimization. Our results partially support the self-medication model of alcohol use, and this may be particularly relevant to sexual victimization.
Piston ring–liner lubrication and tribological performance evaluation: A review
Authors: Delprete Cristiana , Razavykia Abbas
Published: April 2017

Internal combustion engines are at present used as the major power sources for transportation and power generator. Improvement of the internal combustion engine efficiency is expected due to strict environmental standards and energy costs. Any reduction in oil consumption, friction power losses and emissions results in improving engines’ performance and durability. Automotive industries have intense passion to increase engines’ efficiency to meet the fuel economy and emission standards. Many studies have been conducted to develop reliable approaches and models to understand the lubrication mechanisms and calculate power losses. This review paper summarizes the synthesis of the main technical aspects considered during modeling of piston ring–liner lubrication and friction losses investigations. The literature review highlights the effects of piston ring dynamics, components geometry, lubricant rheology, surface topography and adopted approaches, on frictional losses contributed by the piston ring-pack.
Social capital and fear of crime in Brisbane
Authors: Sargeant Elise , Liu Yifan , St John Nathan , Fong Hong Nga , Huu Tracy , Chen Jie , Mazerolle Lorraine
Published: April 2017

Social capital is upheld for its value in explaining variations in crime across place. Collective efficacy is understood to be the superlative link between less effectual components of neighbourhood social capital (such as social ties and reciprocity) and lower rates of crime. The current study examines the value of neighbourhood social capital in explaining another community attribute associated with neighbourhoods: fear of crime. We conduct a secondary analysis of survey data collected from over 2000 people clustered in 82 Statistical Local Areas in Brisbane, Australia, to examine the correlates of fear of crime. We find that when comparing elements of social capital, the agentic element of social capital – collective efficacy – has the strongest relationship to reduced fear of crime.
Design, functionality, and validity of the SWInCaRe, a web-based application used to administer cancer registry records
Authors: Benedetto Giovanni , Prima Alessia Di , Sciacca Salvatore , Grosso Giuseppe
Published: April 2017

We described the design of a web-based application (the Software Integrated Cancer Registry—SWInCaRe) used to administer data in a cancer registry and tested its validity and usability. A sample of 11,680 records was considered to compare the manual and automatic procedures. Sensibility and specificity, the Health IT Usability Evaluation Scale, and a cost-efficiency analysis were tested. Several data sources were used to build data packages through text-mining and record linkage algorithms. The automatic procedure showed small yet measurable improvements in both data linkage process and cancer cases estimation. Users perceived the application as useful to improve the time of coding and difficulty of the process: both time and cost-analysis were in favor of the automatic procedure. The web-based application resulted in a useful tool for the cancer registry, but some improvements are necessary to overcome limitations observed and to further automatize the process.
Impact of a scribe program on patient throughput, physician productivity, and patient satisfaction in a community-based emergency department
Authors: Shuaib Waqas , Hilmi John , Caballero Joshua , Rashid Ijaz , Stanazai Hashim , Tawfeek Kerolos , Amari Ahmed , Ajanovic Alan , Moshtaghi Alex , Khurana Anjit , Hasabo Hesham , Baqais Abdulrehman , Szczerba Arthur J , Gaeta Theodore J
Published: April 2017

Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods. Patient throughput metrics were (1) door-to-room time, (2) room-to-doc time, (3) door-to-doc time, (4) doc-to-disposition time, and (5) length of stay for discharged/admitted patients. Our secondary outcome was physician productivity, which was calculated by measuring total patients seen per hour and work relative value units per hour. Additionally, we calculated the time-motion analysis in minutes to measure the emergency department physician’s efficiency by recording the following: (1) chart preparation, (2) chart review, (3) doctor–patient interaction, (4) physical examination, and (5) post-visit documentation. Finally, we measured patient satisfaction as provided by Press Ganey surveys. Data analysis was conducted in 12,721 patient encounters in the pre-scribe cohort, and 13,598 patient encounters in the post-scribe cohort. All the patient throughput metrics were statistically significant (p < 0.0001). The patients per hour increased from 2.3 ± 0.3 pre-scribe to 3.2 ± 0.6 post-scribe cohorts (p < 0.001). Total work relative value units per hour increased from 241(3.1 ± 1.5 per hour) pre-scribe cohort to 336 (5.2 ± 1.4 per hour) post-scribe cohort (p < 0.001). The pre-scribe patient satisfaction was high and remained high in the post-scribe cohort. There was a significant increase in the clinician providing satisfactory feedback from the pre-scribe (3.9 ± 0.3) to the post-scribe (4.7 ± 0.1) cohorts (p < 0.01). We describe a prospective trial of medical scribe use in the emergency department setting to improve patient throughput, physician productivity, and patient satisfaction. We illustrate that scribe use in community emergency department is feasible and results in improvement in all three metrics
Using Cases in Political Science: Reflections on Keith Dowding’s The Philosophy and Methods of Political Science
Authors: Ryan Matthew
Published: April 2017

This short response presses further on considerations about the N of cases and so-called qualitative and quantitative evidence in political research. I ask whether Dowding’s critique of the claims of causal process-tracing is relevant to case studies as they appear in real-life political science. I argue that choosing a case is an integral part of performing a case study and case studies in reality are always situated within research designs that are attentive to a case’s relationship to others. Dowding’s work in my view could be complemented by a further elaboration of its pragmatic implications for how we consider and favour certain approaches to sampling and types of data in our field. In widening the debate, I ask why systematic reviews and meta-analyses are conspicuous by their absence in political science. Finally, I return to a discussion of what this means for disciplinary culture and cumulative advancement of disciplinary knowledge.
The Data Science of Politics
Authors: Margetts Helen
Published: April 2017

This article engages with the methods content in Dowding’s book, examining the underlying assumptions regarding political science methodology and data and arguing that these issues deserve a more central role. In particular, the new possibilities for generation and analysis of large-scale data sources from political activity is driving methodological change, requiring a variety of multi-disciplinary expertise, and presenting new ethical challenges. Expansion of the toolkit of political science methodologies to incorporate the growing field of computational social science, or social data science, draws new scientists into the analysis of politics – such as mathematicians, computer scientists and physicists – who bring their own philosophy and practice of theory building, explanation and approach, which may shape the discipline in the future.
So Much to Say: Response to Commentators
Authors: Dowding Keith
Published: April 2017

This article responds to the comments on my book The Philosophy and Methods of Political Science. It clarifies my attitudes to isms, explains why I do not think causal explanation is the only type of scientific explanation and suggests that type-level explanation of background structural conditions is explanatory although not what we ordinarily think of as causal explanations; in doing so, it defends formal models. It clarifies what I mean by prediction and why this is necessary, although not sufficient for explanation, and discusses the relationship of type and token explanation to large- and small-N research. It also discusses bias, case selection, big data, the qualitative–quantitative distinction and replicability. It concludes by arguing that interpretative approaches are spot on when they claim that the nature of language is important for understanding society but only over looped terms and not all scientific discourse.
Text and Mobile Media Smoking Cessation Service for Young Adults in South Texas: Operation and Cost-Effectiveness Estimation
Authors: Ramirez Amelie G. , Chalela Patricia , Akopian David , Munoz Edgar , Gallion Kipling J. , Despres Cliff , Morales Jafet , Escobar Rodrigo , McAlister Alfred L.
Published: April 2017

To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments were achieved for 798 participants with a mean age of 29.3 years. Seven-month texted follow-up found that 21% (171) of the enrollees reported abstinence at that point. This is consistent with high rates of success found in studies of telephone counseling for young adults and confirms that text and mobile media service specifically designed for young adults provide a feasible and potentially cost-effective approach to promoting cessation.
Major Limb Outcomes Following Lower Extremity Endovascular Revascularization in Patients With and Without Diabetes Mellitus
Authors: Shammas Andrew N. , Jeon-Slaughter Haekyung , Tsai Shirling , Khalili Houman , Ali Mujtaba , Xu Hao , Rodriguez Gerardo , Cawich Ian , Armstrong Ehrin J. , Brilakis Emmanouil S. , Banerjee Subhash
Published: April 2017

Purpose: To determine whether diabetes mellitus has an independent impact on major limb outcomes at 1 year after endovascular treatment of lower extremity peripheral artery disease (PAD). Methods: The study involved 1906 consecutive patients (mean age 66 years; 1469 men) enrolled in the observational Excellence in Peripheral Artery Disease (XLPAD) registry ( ClinicalTrials.gov identifier NCT01904851) between January 2005 and October 2015 after undergoing index endovascular procedures in 2426 limbs for arterial occlusive disease. Patient outcomes included 12-month target limb amputation (above ankle) and target limb revascularization as well as all-cause death. Kaplan-Meier analysis and adjusted Cox proportional hazard models were used for time-to-event analysis of outcomes for the entire study sample as well as for the critical limb ischemia (CLI) and claudication subgroups. Results of the Cox regression models are reported as the hazard ratio (HR) and 95% confidence interval (CI). Results: Diabetics undergoing endovascular procedures had higher rates of comorbid conditions (p<0.001), CLI (p<0.001), heavily calcified lesions (p=0.002), multivessel disease (p=0.030), and fewer infrapopliteal runoff vessels (p<0.001). Regression analysis after adjusting for confounders revealed significantly higher target limb major amputation in diabetics compared with nondiabetics (HR 5.02, 95% CI 1.44 to 17.56, p=0.011). However, repeat revascularization rates were similar. When considering CLI and claudication subgroups, diabetes was associated with a nonsignificant increased risk of 12-month major amputation only for patients presenting with CLI (HR 3.48, 95% CI 0.97 to 12.51, p=0.056). Diabetes was also associated with an increased risk of 12-month all-cause mortality in the overall study sample (HR 4.64, 95% CI 2.01 to 10.70, p<0.001) and in the CLI subgroup (HR 14.15, 95% CI 3.16 to 63.32, p<0.001) but not in the claudication subgroup (HR 1.42, 95% CI 0.45 to 4.54, p=0.552). Conclusion: Diabetes increases the risk of major amputation and all-cause death at 12 months following endovascular revascularization in patients with symptomatic PAD. These risks are especially heightened in patients presenting with CLI.
Serum carotenoid interactions in premenopausal women reveal α-carotene is negatively impacted by body fat
Authors: Nuss Emily Taylor , Valentine Ashley R , Zhang Zhumin , Lai HuiChuan Jennifer , Tanumihardjo Sherry A
Published: April 2017

Increasing body mass indices (BMIs) across the globe reflect pandemic shifts towards habitual positive energy imbalances. Excess body fat in individuals is often associated with high-energy and high-fat diets scanty in fresh produce. Carotenoids are fat-soluble pigments plentiful in many fruits and vegetables. They are well-known for provitamin A and antioxidant functions, but little research has been done related to carotenoid-body mass interactions. Serum carotenoids were analyzed relative to body fat to determine correlations between major serum carotenoids, retinol, BMI, fat mass, and lean mass. Healthy women ( n = 76), 19–50 years old, were categorized into two comparison groups determined by percent body fat measured by air displacement plethysomography (BOD POD®), i.e. <31% and ≥31% fat mass. Anthropometric and three-day diet records were completed for BMI and nutrient intake calculations, respectively. Serum α-carotene concentrations were strongly inversely associated with all measures of body composition ( P < 0.001 α-carotene) controlling for dietary intake and age, while β-carotene, lutein, and lycopene were not ( P > 0.05). Dietary intake between groups did not differ, including carrot consumption (a high dietary source of α-carotene). These results confirm previous carotenoid-health research and propose the need for further investigation of potential protective roles that α-carotene may perform for optimal health. Serum α-carotene may provide a deeper and clinically relevant purpose, beyond previous suggestions for its use as a biomarker for fruit and vegetable consumption, in that α-carotene may be a biomarker for chronic disease risk frequently linked with obesity.

Impact statement

Carotenoids are important pigments in fruit and vegetables and found in human serum. This study isolated a negative relationship between serum α-carotene and body fatness. As humans begin to live over a century, determining biomarkers of ultimate health is important. α-Carotene does not have the same distribution in the food supply as β-carotene and therefore is often overlooked in surveys. In part, this is due to the fact that β-carotene provides two molecules of vitamin A, while α-carotene provides one upon central cleavage. This study shows a very clear association between α-carotene and body fatness, which appears to go beyond its fat-soluble nature. Dietary intake data were not able to explain the association. Further work is needed to determine what dietary components infer health benefits.
Promoting Access to Common Core Mathematics for Students with Severe Disabilities Through Mathematical Problem Solving
Authors: Spooner Fred , Saunders Alicia , Root Jenny , Brosh Chelsi
Published: April 2017

There is a need to teach the pivotal skill of mathematical problem solving to students with severe disabilities, moving beyond basic skills like computation to higher level thinking skills. Problem solving is emphasized as a Standard for Mathematical Practice in the Common Core State Standards across grade levels. This article describes a conceptual model for teaching mathematical problem solving to students with severe disabilities based on research from a multiyear project. The model proposed incorporates schema-based instruction combined with evidence-based practices for teaching academics to this population, and includes technology supports and self-monitoring. The purpose is to teach students to recognize underlying problem structures in word problems for better generalizability to real-world situations. This article outlines the existing evidence for teaching problem solving to students with disabilities, the conceptual model for teaching mathematical problem solving to students with severe disabilities, and the implications of the model for practitioners and future researchers.
Survey on coexistence of heterogeneous wireless networks in 2.4 GHz and TV white spaces
Authors: Zhang Duzhong , Liu Quan , Chen Lin , Xu Wenjun
Published: April 2017

Given the unprecedentedly dense deployment of wireless networks due to the proliferation of inexpensive, widely available wireless devices in the limited spectrum bands, many of these wireless networks should operate at least partially overlapped or even on the same spectrum band. Incompatible communication pattern of different networks with different applications (e.g. Internet of Things, wireless sensor networks and individual wireless communication) would cause serious wireless networks coexistence problem. For the representative, two bands, 2.4 GHz industrial, scientific and medical band and the TV white spaces, effective signalling protocols, as well as radio resource allocation mechanisms could achieve an efficient and fair utilization of spectrum. In this survey, we report and analyse the recent technical advance and development of coexistence protocols. Aiming at tracing the latest developments in this field, we attempt to deliver a comprehensive coverage on existing literatures with a proper technical depth to introduce the design idea and philosophy and analyse the pros and cons of each surveyed coexistence solution. We also discuss a number of important and relevant research challenges that have not been addressed in the existing literatures and that deserve further research attention and investigation.
Energy-aware data compression and transmission range control for energy-harvesting wireless sensor networks
Authors: Yi Jun Min , Oh Eom Ji , Noh Dong Kun , Yoon Ikjune
Published: April 2017

Energy-harvesting nodes are now being employed in wireless sensor networks to extend the lifetime of the network by harvesting energy from the surrounding environments. However, unpremeditated energy consumption can incur energy problems, such as the blackout of nodes (due to their exceeding energy consumption over the amount of harvested energy) or inevitable disposal of harvested energy (in excess of the battery capacity). In this article, we propose an adaptive data compression and transmission range extension scheme that minimizes the blackout of sensor nodes and increases the amount of data collected at the sink node using the harvested energy efficiently. In this scheme, each node estimates the amount of harvested and consumed energy. When it determines that its remaining energy will exceed its storage capacity, it exploits the energy to compress the data or increase the transmission range. At this point, of the two methods, the method that can more effectively increase the network performance can be selected. The results of experiments conducted indicate that the proposed scheme significantly reduces the extent of node blackouts and increases the data collection rate of the sink node.
Patient-specific prediction of functional recovery after stroke
Authors: Douiri Abdel , Grace Justin , Sarker Shah-Jalal , Tilling Kate , McKevitt Christopher , Wolfe Charles DA , Rudd Anthony G
Published: April 2017

Background and aims

Clinical predictive models for stroke recovery could offer the opportunity of targeted early intervention and more specific information for patients and carers. In this study, we developed and validated a patient-specific prognostic model for monitoring recovery after stroke and assessed its clinical utility.

Methods

Four hundred and ninety-five patients from the population-based South London Stroke Register were included in a substudy between 2002 and 2004. Activities of daily living were assessed using Barthel Index) at one, two, three, four, six, eight, 12, 26, and 52 weeks after stroke. Penalized linear mixed models were developed to predict patients’ functional recovery trajectories. An external validation cohort included 1049 newly registered stroke patients between 2005 and 2011. Prediction errors on discrimination and calibration were assessed. The potential clinical utility was evaluated using prognostic accuracy measurements and decision curve analysis.

Results

Predictive recovery curves showed good accuracy, with root mean squared deviation of 3 Barthel Index points and a R2 of 83% up to one year after stroke in the external cohort. The negative predictive values of the risk of poor recovery (Barthel Index <8) at three and 12 months were also excellent, 96% (95% CI [93.6–97.4]) and 93% [90.8–95.3], respectively, with a potential clinical utility measured by likelihood ratios (LR+:17 [10.8–26.8] at three months and LR+:11 [6.5–17.2] at 12 months). Decision curve analysis showed an increased clinical benefit, particularly at threshold probabilities of above 5% for predictive risk of poor outcomes.

Conclusions

A recovery curves tool seems to accurately predict progression of functional recovery in poststroke patients.
Remembering lives, changing regimes: An analysis of Hungarian obituaries (1961–2000)
Authors: Nagy Zsófia
Published: April 2017

The article examines the obituaries appearing in the Hungarian daily Népszabadság during the second half of the twentieth century. Positing the obituaries as activities of social memory, the article has a dual focus. First, it looks at how the authoritarian Kádár-regime’s metaproject of creating the archetypical socialist identity is reflected in the obituaries. Second, it examines the frictions created by the state’s efforts in establishing taboos with regard to certain junctures in the country’s history, and how these principles interact with practices of communicative memory. The analysis is contextualized by examples of post-socialist memories after the regime change in the article.
The Role of Mountains as Refugia for Biodiversity in Brazilian Caatinga
Authors: Lopes Sérgio de Faria , Ramos Maiara Bezerra , Almeida Gilbevan Ramos de
Published: April 2017

The relationship between how humans and altitude influence the structure of plant communities has been poorly investigated and particularly so in semiarid ecosystems. Understanding the processes that affect plant community structure is essential for sustaining the biodiversity found in altitudinal refugia of the Brazilian Caatinga. In this study, we investigated the influence of altitudinal gradients and human impacts on floristic composition and structure of a shrubby-arboreal community in northeastern Brazil. We recorded a total of 68 tree species in 45 randomly sampled 4 × 50 m plots in three different altitudinal levels (Level 1, Level 2, and Level 3). The species clearly separated among the altitudes studied when the abundance data were analyzed (Bray–Curtis, Nonmetric Multidimensional Scaling). Whittaker plots indicated that Level 3 (highest) had more species and greater evenness and thus greater diversity. On the other hand, Level 1 (lowest) had lower diversity with greater dominance of a few pioneer species. Our results indicated that higher altitudes appear to function as refugia for many plant species (unique species and species shared with Atlantic Forest), which results in greater specie richness. However, high levels of human disturbance at lower altitudinal levels contribute to lower diversity due to the competitive abilities and dominance of pioneer tree species. The maintenance of these altitudinal Caatinga refugia is important and should be a priority for the implementation of new protected areas in the semiarid region of Brazil.
Pulmonary venous remodeling in COPD‐pulmonary hypertension and idiopathic pulmonary arterial hypertension
Authors: Andersen Kasper Hasseriis , Andersen Claus Bøgelund , Gustafsson Finn , Carlsen Jørn
Published: April 2017

Pulmonary vascular arterial remodeling is an integral and well‐understood component of pulmonary hypertension (PH). In contrast, morphological alterations of pulmonary veins in PH are scarcely described. Explanted lungs (n = 101) from transplant recipients with advanced chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary arterial hypertension (IPAH) were analyzed for venous vascular involvement according to a pre‐specified, semi‐quantitative grading scheme, which categorizes the intensity of venous remodeling in three groups of incremental severity: venous hypertensive (VH) grade 0 = characterized by an absence of venous vascular remodeling; VH grade 1 = defined by a dominance of either arterialization or intimal fibrosis; and VH grade 2 = a substantial composite of arterialization and intimal fibrosis. Patients were grouped according to clinical and hemodynamic characteristics in three groups: COPD non‐PH, COPD‐PH, and IPAH, respectively. Histological specimens were examined by a cardiovascular pathologist blinded to clinical and hemodynamic data. Pathological alterations of pulmonary veins were present in all hemodynamic groups, with the following incidences of VH grade 0/1/2: 34/66/0% in COPD non‐PH; 19/71/10% in COPD‐PH; and 11/61/28% in IPAH. In COPD, explorative correlation analysis of venous remodeling suggested a modest positive correlation with systolic and mean pulmonary artery pressure (P = 0.032, respectively) and an inverse modest correlation with diffusion capacity for carbon monoxide (P = 0.027). In addition, venous remodeling correlated positively with the degree of arterial remodeling (P = 0.014). In COPD‐PH and IPAH, advanced forms of pulmonary venous remodeling are present, emphasizing that the disease is not exclusively restricted to arterial lesions. In addition, venous remodeling may be related to the hemodynamic severity, but more rigorous analysis is required to clearly define potential relationships.
Does increased standardisation in health care mean less responsiveness towards individual patients’ expectations? A register-based study in Swedish primary care
Authors: Glenngård Anna Häger , Anell Anders
Published: April 2017

Objective:

We explore whether standardisation in health care based on evidence on group level and a public health perspective is in conflict with responsiveness towards individual patient’s expectations in Swedish primary care.

Methods:

Using regression analysis, we study the association between patient views about providers’ responsiveness and indicators reflecting provider’s adherence to evidence-based guidelines, controlled for characteristics related to providers, including patient mix and degree of competition facing providers. Data were taken from two Swedish regions in years 2012 and 2013.

Results:

Patients’ views about responsiveness are positively correlated with variables reflecting provider’s adherence to evidence-based guidelines regarding treatment of elderly and risk groups, drug reviews and prescription of antibiotics. A high overall illness, private ownership and a high proportion of all visits being with a doctor are positively associated with patient views about responsiveness. The opposite relation was found for a high social deprivation among enrolled individuals and size of practice. There was no systematic variation with respect to the degree of competition facing providers.

Conclusion:

Results suggest that responsiveness towards individual patient expectations is compatible with increased standardisation in health care. This is encouraging for health care providers as they are challenged to balance increased demands from both patients and payers.