bluuebunny/crossref_metadata_2025 huggingface dataset:
A Shallow Cumuliform Snowfall Census Using Spaceborne Radar
Authors: Kulie Mark S. , Milani Lisa , Wood Norman B. , Tushaus Samantha A. , Bennartz Ralf , L’Ecuyer Tristan S.
Published: February 2016

The first observationally based near-global shallow cumuliform snowfall census is undertaken using multiyear CloudSat Cloud Profiling Radar observations. CloudSat snowfall observations and snowfall rate estimates from the CloudSat 2C-Snow Water Content and Snowfall Rate (2C-SNOW-PROFILE) product are partitioned between shallow cumuliform and nimbostratus cloud structures by utilizing coincident cloud category classifications from the CloudSat 2B-Cloud Scenario Classification (2B-CLDCLASS) product. Shallow cumuliform (nimbostratus) snowfall events comprise about 36% (59%) of snowfall events in the CloudSat snowfall dataset. The remaining 5% of snowfall events are distributed between other categories. Distinct oceanic versus continental trends exist between the two major snowfall categories, as shallow cumuliform snow-producing clouds occur predominantly over the oceans. Regional differences are also noted in the partitioned dataset, with over-ocean regions near Greenland, the far North Atlantic Ocean, the Barents Sea, the western Pacific Ocean, the southern Bering Sea, and the Southern Hemispheric pan-oceanic region containing distinct shallow snowfall occurrence maxima exceeding 60%. Certain Northern Hemispheric continental regions also experience frequent shallow cumuliform snowfall events (e.g., inland Russia), as well as some mountainous regions. CloudSat-generated snowfall rates are also partitioned between the two major snowfall categories to illustrate the importance of shallow snow-producing cloud structures to the average annual snowfall. While shallow cumuliform snowfall produces over 50% of the annual estimated surface snowfall flux regionally, about 18% (82%) of global snowfall is attributed to shallow (nimbostratus) snowfall. This foundational spaceborne snowfall study will be utilized for follow-on evaluative studies with independent model, reanalysis, and ground-based observational datasets to characterize respective dataset biases and to better quantify CloudSat snowfall detection and quantitative snowfall estimate uncertainties.
Calibrating field practicum assessment in social work education with a competency-based evaluation tool in Hong Kong
Authors: Chow Esther OW , Cheung Chau-Kiu , Chan Gloria Hongyee
Published: February 2016

As social work is an international profession, it is necessary to establish the validity of assessment of the field practicum of students for the purpose of professional accreditation. This study calibrates an indigenous assessment tool, the Social Work Practicum Assessment (SWPA), developed in Hong Kong with a competency-based evaluation (CBE) tool popularized in North America, using data collected from 171 social work final-year undergraduates. The results demonstrate convergence between the SWPA and CBE when rated by field instructors and were greater when the student-assessed CBE was higher. Alternatively, the student-assessed CBE displayed greater convergence with the instructor-rated CBE when the indigenous assessment was higher. The positive results imply the generalizability of the assessments across places.
The Postcolonial Female “Bildung” in Lawrence Hill’s The Book of Negroes
Authors: Oduwobi Oluyomi , Sewlall Harry , Abodunrin Femi
Published: February 2016

This article positions itself in the literary representations of the convergence of slavery, migration, race, gender, growth, and the African identity in a neo-slave narrative. It concerns itself with the examination of Lawrence Hill’s The Book of Negroes as a female bildungsroman written from a postcolonial perspective. The novel centers on the growth and experiences of the female protagonist, Aminata Diallo, an African slave who eventually becomes a notable personality involved in the registration of the Black Loyalists on their passage to Nova Scotia (Canada) in the aftermath of the American Revolutionary War (1775-1783). In addition, she assists in the resettlement of the Loyalists in Sierra Leone and testifies in London on behalf of the abolitionists against the trans-Atlantic slave trade. As a result, this study highlights the intersection of history and literature in addition to the experiences of Africans in the diaspora who struggle with character development and identity in different societies.
Inflammatory Response Influences Treatment of Localized Aggressive Periodontitis
Authors: Allin N. , Cruz-Almeida Y. , Velsko I. , Vovk A. , Hovemcamp N. , Harrison P. , Huang H. , Aukhil I. , Wallet S.M. , Shaddox L.M.
Published: February 2016

We previously reported a systemic hyperinflammatory response to bacterial lipopolysaccharide (LPS) in children with localized aggressive periodontitis (LAP). Additionally, different levels of this response were observed within the LAP group. It is unknown whether this hyperinflammatory response influences the clinical response to periodontal treatment in these children. Therefore, the goal of this study was to evaluate the influence of LPS responsiveness present prior to treatment on the clinical response to treatment within the LAP cohort. Prior to treatment, peripheral blood was collected from 60 African American participants aged 5 to 21 y, free of systemic diseases, and diagnosed with LAP. Blood was stimulated with ultrapure LPS from Escherichia coli, and Luminex assays were performed to quantify 14 cytokine/chemokine levels. Principal component and cluster analyses were used to find patterns of cytokine/chemokine expression among participants and subdivide them into clusters. Three distinct clusters emerged among LAP participants: a high responder group (high level of response for INFg, IL6, and IL12p40), a mixed responder group (low for some and high for other cytokines/chemokines), and a low responder group (low overall cytokine/chemokine response). Periodontal clinical parameters were compared among these groups prior to and 3, 6, and 12 mo following treatment with mechanical debridement and systemic antibiotics. High responders presented the lowest reductions in clinical parameters after treatment, whereas the low responders presented the highest reductions. In our LAP participants, distinct patterns of LPS response were significantly predictive of changes in clinical parameters after treatment. Future studies are needed to evaluate the underlying mechanisms predicting the heterogeneity of LAP activity, severity, and response to treatment ( ClinicalTrials.gov NCT01330719).
Success of 6-mm Implants with Single-Tooth Restorations
Authors: Sahrmann P. , Naenni N. , Jung R.E. , Held U. , Truninger T. , Hämmerle C.H.F. , Attin T. , Schmidlin P.R.
Published: February 2016

The aim of the study was to test whether implants of 6 mm in length perform equally well as 10-mm implants in terms of survival and marginal bone-level changes when supporting single crowns. Patients with a posterior single-tooth gap were randomly allocated to either the placement of a 6-mm (test) or 10-mm implant (control). The treatment protocol allowed for internal sinus lift but not for lateral bone augmentation. After a healing period of 10 wk, implants were loaded with screw-retained single crowns. Survival rates, number of pockets ≥5 mm, and bleeding-on-probing were assessed clinically. The change of marginal bone level and crown-to-implant ratios were analyzed by 2 examiners. Longitudinal intragroup analyses for marginal bone levels were performed applying the Wilcoxon signed rank test. Intergroup differences at baseline and at 3 y were compared using the Mann-Whitney U test. The effect of implant length and crown-to-implant ratio on changes of marginal bone level also was determined. Of 94 implants placed (47 test and 47 control), 78 implants (40 test and 38 control) were available for follow-up examination at 3 y of loading. One test implant was lost during the second year. Hence, implant survival was not significantly different between the 2 groups after 3 y (98% test; 100% control). We found no significant change in the crestal bone level from baseline to 3 y for test and control implants with −0.19 ± 0.62 mm and −0.33 ± 0.71 mm, respectively. The intergroup difference was not significant. Crown-to-implant ratios were not associated with a statistically significant difference in marginal bone loss. However, the number of sites with pockets ≥5 mm was significantly higher in the test group. Based on the 3-y assessment, the use of 6-mm implants can be considered a viable option when reconstructing posterior single tooth gaps (German Clinical Trials Registry: DRKS00006290).
Sedentary Behaviors by Type of Day and Physical Activity in Spanish Adolescents
Authors: Abarca-Sos Alberto , Bois Julien E. , Aibar Alberto , Antonio Julián José , Generelo Eduardo , Zaragoza Javier
Published: February 2016

The aim of this study was to analyze the relationship between TV and computer use, study time, and physical activity, with regard to gender, school, and weekday/weekend. Adolescents ( N = 1,609; M age = 14.5 yr., SD = 1.3) reported on physical activity, sedentary behavior, their parents' employment, and environmental factors. The relationship between PA and screen media behaviors was negative on weekdays, while no relationship was found at weekends. Only 30.7% of adolescents met the screen media guidelines on weekdays and 14.6% at weekends. Girls spent more time on study, only showing a positive relationship with physical activity on weekdays. Each type of sedentary behavior has different correlates for weekdays and weekends.
Measuring Attitudes Toward Nursing Safety Violations
Authors: Adachi Yuko , Usui Shinnosuke , Nakagami-Yamaguchi Etsuko , Fujinaga Kumiko , Park Keunsik , Nakamura Kazunori , Nakatani Tatsuya
Published: February 2016

This study measured implicit and explicit attitudes toward major nursing safety violations using the Implicit Association Test (IAT) and self-reported questionnaires, respectively. Experiment 1 sampled nursing students ( n = 71), and Experiment 2 sampled patient safety nurses ( n = 38). Although reaction time to IAT stimuli of major nursing safety violations was quicker than of general nursing behaviors, error trials did not reveal a significant difference between IAT stimuli of major nursing safety violations and of general nursing behaviors in Experiment 1. Explicit attitude was related with intention to violate safety protocols in Experiment 1. In Experiment 2, both reaction time and error trials showed significant differences between IAT stimuli of major nursing safety violations and of general nursing behaviors. This was interpreted in that patient safety nurses had formed a firm implicit attitude, unlike the nursing students; however, the findings suggested that attitudes were not related to violations in nursing.
Relationship Between Resilience and Coping Strategies in Competitive Sport
Authors: Secades Xabel García , Molinero Olga , Salguero Alfonso , Barquín Roberto Ruíz , de la Vega Ricardo , Márquez Sara
Published: February 2016

Resilience is important in sport performers to withstand the pressure they experience. This study analyzed the relationship among resilient qualities and coping strategies in 235 Spanish athletes (126 males, 109 females; M age = 20.7 yr) who practiced different sports (79.1% team sports, 20.9% individual sports). They were evaluated at the beginning of the last competitive mesocycle and after an important competition. Coping strategies and level of resilient qualities were measured by the Coping Inventory for Competitive Sport and the Resilience Scale. There was no significant difference in resilience scores between evaluations performed during the last mesocycle or competition. A significant increase occurred in the scores for emotion-oriented and distraction-oriented coping during competition. Resilience scores correlated positively to task-oriented coping and negatively to disengagement- and distraction-oriented coping during both periods. Analysis of variance indicated that athletes with high individual resilient qualities reached higher scores in task-oriented coping, using to a lower extent disengagement- and distraction-oriented coping. Results obtained suggest that resilient characteristics may associate in athletes to the use of more potentially adaptative coping strategies.
Rational Thinking and Belief in Psychic Abilities
Authors: Stone Anna
Published: February 2016

Previous research has shown that lay believers in psychic abilities are more prone to intuitive thinking, less inclined to rational thinking, and have an external locus of control, compared to non-believers. Psychic practitioners, however, may have different characteristics. Psychic practitioners ( n = 31; M age = 42.7 yr., SD = 13.1), lay believers ( n = 33; M age = 33.0 yr., SD = 10.3), and non-believers ( n = 31; M age = 34.4 yr., SD = 15.4) completed questionnaires measuring thinking styles, locus of control, and psychic belief. Comparisons of lay believers with non-believers confirmed previous observations: believers had a higher propensity for intuitive thinking, lower propensity for rational thinking, and more external locus of control. In contrast, practitioners were equivalent to non-believers in rational thinking and had the highest internal locus of control. This highlights the importance of considering level of involvement with psychic practice in understanding the thinking styles of believers. Results suggested that practitioners may have rationalized their beliefs and constructed a coherent model of psychic phenomena that satisfies a propensity for rational thinking within a community of belief.
Psychological Type of Person-Centered Counselors
Authors: Robbins Mandy , Turley Joanne
Published: February 2016

There are various models and approaches to counseling and psychotherapy. Important characteristics of therapists include psychological type. This study aimed to investigate the psychological type profile of person-centered counselors. The psychological type of 85 counselors (63 women, 22 men) was measured with the Francis Psychological Type Scales (FPTS). Results indicate that the FPTS can reliably measure psychological type among counselors, and the most common psychological type was introvert, intuitive, feeling, and judging (INFJ). The relation of these psychological types with a person-centered approach is further discussed.
Construct Validity of the Children’s Coping Strategies Scale (CCSS)
Authors: Ouyang Xiangzi , Xin Tao , Chen Fu
Published: February 2016

There has been debate regarding the factor structure of the Children's Coping Strategies Scale (CCSS); in most previous studies there were different subscales, representing coping strategies. However, according to the theoretically multidimensional construct of coping, coping consists of an adaptive process and uses the lowest possible level of coping strategy. Accordingly, this study applies a new method of multidimensional item response theory (MIRT) to testing the latent structure of teenagers’ coping strategies and to improve the construct validity of the CCSS. The participants were 1,138 16-year-old high school students (48.2% female, 51.8% male) studying arts and science. This study compares three different model types: a unidimensional model, a simple multidimensional construct model, and a bifactor model. The results indicate that the latent structure of CCSS is not only described by specific coping strategies (e.g., rumination) but also by a general adaptation process, which is consistent with theoretical understandings of coping. Furthermore, the five-factor model, which contains a “reflection” dimension, is more suitable for Chinese teenagers.
Virtue ethics and church planting: A critical assessment and reevaluation of church planting utilizing Alasdair MacIntyre’s After Virtue
Authors: Niebauer Michael
Published: February 2016

This article proposes a critical reevaluation of church planting utilizing the philosophical area of virtue ethics. The article begins first with a critique of modern church planting based primarily upon Alasdair MacIntyre’s assessment of the social sciences in After Virtue. MacIntyre’s critique of the social sciences as having the potential to be both manipulative and overconfident bears striking parallels to the current moral issues surrounding church planting. Such a critique paves the way for a rehabilitation of the practice of church planting. The second part of this article begins a process of rebuilding an understanding of church planting from the ground up. Utilizing a Thomistic understanding of virtue, I will demonstrate how the individual missional actions that compromise church planting are in accordance with our natural and supernatural ends, and thus promote human flourishing. Following this, I will begin to build a definition of church planting coherent with Alasdair MacIntyre’s notion of a practice (activities with goods internal to them). Such a definition necessitates the need for the practice of church planting to be authorized by Scripture, church, and tradition. Last, I will show how the practice of church planting must be embedded within the broader narrative of the church and the individual Christian life.
Situated affect and collective meaning: A community perspective on processes of value creation and commercialization in enthusiast-driven fields
Authors: Brinks Verena
Published: February 2016

The concept of “communities of practice” enjoys great popularity in economic geography dealing with the question of how novelty comes into the world. However, while the role of communities in innovation processes is increasingly recognized, their function in terms of commercialization of generated new ideas remains a kind of blind spot in most existing studies. The article focuses on the transformation of “affects” into “interests” and “demands” and traces how meanings and values are produced out of affective situations experienced by geographically widely dispersed community participants. The paper connects empirical findings from three case studies of enthusiast-driven “communities of interest” (case modding, fingerboarding and geocaching) with a theoretically grounded perspective on practices of collective value creation. By following pragmatic approaches, the article presents three intertwining dimensions of valuation practices— sensemaking, sacralization and commodification—and illustrates how “markets” emerge out of communities' activities.
Harmonising devolved responsibility for biosecurity governance: The challenge of competing institutional logics
Authors: Higgins Vaughan , Bryant Melanie , Hernández-Jover Marta , McShane Connar , Rast Luzia
Published: February 2016

Harmonisation of disease management practices across global space and the devolution of responsibility to a broader range of actors are two increasingly important approaches for ordering biosecurity governance. While these forms of ordering have been examined individually, the social science biosecurity literature provides limited insights into how they interact and interfere with one another, and the consequences for biosecurity implementation. This paper draws upon an institutional logics approach to examine the different and competing logics through which government agencies, industry bodies and farming enterprises engage in biosecurity. It focuses specifically on the ways in which these logics pose challenges for harmonisation of biosecurity as well as create alternative spaces of negotiation for making life safe. Through the analysis of policy documents and semi-structured interviews with government and industry stakeholders, as well as with beef producers, we identify three institutional logics being the neoliberal, productivist and agrarian logics. We argue that the existence of multiple logics poses significant challenges for efforts to achieve improved harmonisation of biosecurity in an environment of devolved responsibility to industry, farming bodies and producers. In this context, greater emphasis by stakeholders on the productivist logic holds the most potential for improving biosecurity implementation in that it works with existing agricultural circulations and flows, and with producers' herd health practices.
Clarifying the disagreements on various reuse options: Repair, recondition, refurbish and remanufacture
Authors: Gharfalkar Mangesh , Ali Zulfiqur , Hillier Graham
Published: February 2016

Earth’s natural resources are finite. To be environmentally sustainable, it may not only be necessary to use them ‘efficiently’ but also ‘effectively’. While we consider ‘repair’, ‘recondition’, ‘refurbish’ and ‘remanufacture’ to be ‘reuse’ options, not all researchers agree. Also, there is lack of clarity between the different options that are likely to be challenging for both; the policy makers who formulate policies aimed to encourage ‘reuse’ of ‘waste’ products and for decision makers to initiate appropriate action for recovering ‘reusable resources’ from ‘waste streams’. This dichotomy could result into more ‘waste’ to landfill. A systematic analysis of peer reviewed literature is conducted to understand inconsistencies and/or lack of clarity that exist between the definitions or descriptions of identified `reuse’ options. This article proposes a ‘hierarchy of reuse options’ that plots the relative positions of identified ‘reuse’ options vis-à-vis five variables, namely work content, energy requirement, cost, performance and warranty. Recommendations are made on how to incentivise original equipment manufacturers (OEMs) to ‘remanufacture’. Finally, an alternative ‘Type II Resource Effective Close-loop Model’ is suggested and a conceptual ‘Type II/2 Model of Resource Flows’ that is restricted to the use of environmentally benign and renewable resources is introduced. These suggestions are likely to help decision makers to prioritise between ‘reuse’ options, drive resource effectiveness and also environmental sustainability.
Adapting Minority Group Threat to Examine the Social Control of Sexual Orientation Bias
Authors: Stacey Michele
Published: February 2016

Blalock proposed that the threat of a minority group toward a majority in sheer size, economic competition, or power will result in an increase in discrimination toward that group. His original formulation of this theory of minority group threat, and its subsequent extensions, has focused almost exclusively on racial minority–majority relationships; however, Blalock asserted that his theory would apply to any minority–majority group relationship. Extensions to religious groups have shown this is likely the case. The current analysis assesses a further extension of minority group threat by reframing the arguments of the theory and adding two additional sources of threat to examine sexual orientation bias. Data from the Uniform Crime Reports Hate Crime Statistics program are used to assess whether the minority group threat hypotheses explain the reporting of sexual orientation bias crimes. The findings indicate that the original formulation of Blalock’s theory does not suffice to explain the reporting of anti–Lesbian, Gay, and Bisexual bias crime, but the proposed extensions may explain some of this variation.
Social Workers’ Reflections on the Therapeutic Encounter With Elder Abuse and Neglect
Authors: Goldblatt Hadass , Band-Winterstein Tova , Alon Sara
Published: February 2016

The aim of this qualitative study was to explore social workers’ reflections on their experience of the therapeutic encounter with victims and perpetrators of elder abuse and neglect. The research questions were as follows: How do social workers tune themselves toward the therapeutic encounter with elder abuse? How do they position themselves vis-à-vis the clients? How do social workers describe the meaning of the intervention both for the clients and for themselves? What is the added value of the therapeutic encounter in this field for the social workers? Participants were 17 experienced women social workers, who worked with abusers and with abused and neglected older adults in Israel. Data were collected via in-depth semi-structured interviews, which were later transcribed and content analyzed. Two main themes emerged from the findings, emphasizing two key aspects of the social workers’ reflective process experienced during the therapeutic encounter: (a) focus on the client: “This is the journey of their lives”—reflection on the therapeutic “journey”; (b) focus on the social worker’s inner and professional world: “‘There is nothing to be done’ is no longer in my vocabulary”—a personal and professional maturation process. The social workers expressed a positive attitude toward their elder clients. A unique dialogue developed in the therapeutic encounter, whereby the social workers considered any change as valuable if it allowed the elders a sense of control and self-worth, whereas the social workers were enriched by the elders’ life experience, and matured both personally and professionally. Thus, both sides benefited from this reciprocal relationship. Implications for further research and practice are discussed.
My Better Self
Authors: Lavy Shiri , Littman-Ovadia Hadassah
Published: February 2016

Character strengths are hypothesized to contribute to human thriving. However, the effects of their use on individuals’ behaviors and attitudes at work, an important domain of modern life, have rarely been studied. In the present study, we examined associations of employees’ use of character strengths at work with productivity, organizational citizenship behavior (OCB), and job satisfaction. Based on the broaden-and-build theory of positive emotions, we suggested a multiple mediation model demonstrating how these associations are mediated by positive affect and engagement. Participants ( N = 1,095) completed measures of strengths use, work productivity, OCB, job satisfaction, positive affect, and work engagement. As hypothesized, using strengths at work was associated with productivity, OCB, and job satisfaction, and these associations were mediated by higher positive emotions and engagement. The findings highlight the potential benefits of encouraging employees to use their strengths and point to positive affect and work engagement as mediating these effects.
Investigation of the effects of acrylamide applied during pregnancy on fetal brain development in rats and protective role of the vitamin E
Authors: Erdemli ME , Turkoz Y , Altinoz E , Elibol E , Dogan Z
Published: February 2016

A liberal amount of acrylamide (AA) is produced as a result of frying or baking foods in high temperatures, and individuals take certain amounts of AA everyday by consuming these food items. Pregnant women are also exposed to AA originating from food during pregnancy and their fetus are probably affected. The rats were divided into five different groups: control (C), corn oil (CO), vitamin E (Vit E), AA, and Vit E + AA, with eight pregnant rats in each group. On the 20th day of pregnancy, fetuses were removed and brain tissues of fetuses were examined for biochemical and histological changes. AA caused degeneration in neuron structures in fetal brain tissue and caused hemorrhagic damages; dramatically decreased brain-derived neurotrophic factor levels; increased malondialdehyde, total oxidant capacity levels; and decreased reduced glutathione and total antioxidant capacity levels ( p < 0.05). On the other hand, it was determined that the Vit E, a neuroprotectant and a powerful antioxidant, suppressed the effects of AA on fetal development and fetal brain tissue damage for the above-mentioned parameters ( p < 0.05). It is recommended to consume food containing Vit E as a protection to minimize the toxic effects of food-oriented AA on fetus development due to the widespread nature of fast-food culture in today’s life and the impossibility of protection from AA toxicity.
The Others and Their Stories
Authors: Berto Luigi Andrea
Published: February 2016

The ninth century was a fundamental period for the history of Naples. Newly untethered from Constantinople and trying to forge a stable state, the Campanian city faced a complex political landscape in Southern Italy. The Frankish conquest of the Lombard kingdom and the weakening of the Byzantine Empire, which allowed the Saracens to seize Sicily, reshaped the South into a region dominated by several competing protagonists. Naples resisted conquest at the hands of the neighbouring Lombards of Benevento while simultaneously maintaining peaceful relationships with the two empires and the Saracens. The goal of this article is to examine how Neapolitan authors portrayed Byzantines, Franks, Lombards and Saracens, and what they knew about them. In particular, it will focus on the Gesta Episcoporum Neapolitanorum ( Deeds of the Neapolitan Bishops) by John the Deacon—the main Neapolitan source for that epoch.
Trends in Methodological Quality in Controlled Trials of Psychological and Social Interventions
Authors: Sundell Knut , Åhsberg Elizabeth
Published: February 2016

Objective:

There is substantial evidence that poorly designed and reported research can mislead decision making in clinical care. This review investigates the methodological quality of Swedish trials of a wide array of psychological and social interventions.

Method:

The review includes 302 articles published in peer-reviewed journals during 1990–2014, which evaluated a psychological or social intervention; included a randomized or nonrandomized control group with a pre–post- or pre-follow-up design; and targeted individuals in order to prevent or rehabilitate from physical, psychological, or social problems. The results are based on the information reported in the articles.

Results:

Overall, methodological quality increased with time. However, more recent studies contained methodological deficits. For example, few had used blinded data collectors, reported power analyses, or searched for adverse events.

Conclusion:

The results indicate a potential risk of biased results in both older and newer trials. Possible implications for practice and research are discussed.
Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams
Authors: O’Mahony Sean , Johnson Tricia J. , Amer Shawn , McHugh Marlene E. , McHenry Janet , Fosler Laura , Kvetan Vladimir
Published: February 2016

Background:

Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service.

Objective:

To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center.

Methods:

The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests.

Results:

Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different.

Conclusion:

Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.
Is There a Place for Humor in Hospice Palliative Care? Volunteers Say “Yes”!
Authors: Claxton-Oldfield Stephen , Bhatt Anamika
Published: February 2016

A survey was conducted to examine the frequency, acceptability, and functions of humor between hospice palliative care volunteers and their patients, from the volunteers’ perspective. Thirty-two volunteers completed the survey, which was developed for this study. The results revealed that most patients and volunteers initiated humor either “often” or “sometimes” in their interactions. Over half of the volunteers considered humor to be either “very important” or “extremely important” in their interactions with patients (42% and 13%, respectively), with the patient being the determining factor as to whether and when it is appropriate or not (ie, volunteers take their lead from their patients). Volunteers mentioned a number of functions that humor serves within their patient interactions (eg, to relieve tension, to foster relationships/connections, and to distract). Laughter and humor fulfills one of the main goals of hospice palliative care, namely, improving patients’ overall quality of life.
Dinutuximab
Authors: Ploessl Cady , Pan Alice , Maples Kathryn T. , Lowe Denise K.
Published: February 2016

Objective: To review the pharmacology, pharmacokinetics, efficacy, safety, dosage and administration, and formulary considerations for dinutuximab. Data Sources: MEDLINE was searched (1964 to January 2016) using the terms ch14.18, dinutuximab, immunotherapy, and neuroblastoma. Other information was identified from package insert, Biologics License Application, abstracts, news releases, and ClinicalTrials.gov. Study Selection and Data Extraction: Identified English-language articles were reviewed. Selected studies included phase I through III. Data Synthesis: High-risk neuroblastoma is primarily a childhood cancer with 5-year survival rates of 40% to 50%. Treatment for high-risk neuroblastoma includes induction chemotherapy, surgery, myeloablative chemotherapy with autologous hematopoietic stem cell transplant, and radiation therapy. For patients achieving clinical remission, limited treatments exist for preventing relapse. Dinutuximab is a chimeric, human-murine, anti-GD2 monoclonal antibody approved in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), aldesleukin (interleukin-2 [IL-2]), and isotretinoin (13-cis-retinoic acid [RA]) for maintenance treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to first-line multiagent, multimodality therapy. In phase III trials, dinutuximab increased 2-year event-free survival and overall survival when compared to standard treatment. Severe adverse effects of dinutuximab include pain, hypersensitivity reactions, capillary leak syndrome, and hypotension. Conclusions: Dinutuximab is the first anti-GD2 monoclonal antibody approved in combination with GM-CSF, IL-2, and RA for maintenance treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to first-line multiagent, multimodality therapy. Ongoing research will determine if dinutuximab could be used earlier in treatment, in nonresponders to initial therapies, in combination with chemotherapy, or in other cancers.
A Collaborative Assessment Among 11 Pharmaceutical Companies of Misinformation in Commonly Used Online Drug Information Compendia
Authors: Randhawa Amarita S. , Babalola Olakiitan , Henney Zachary , Miller Michele , Nelson Tanya , Oza Meerat , Patel Chandni , Randhawa Anupma S. , Riley Joyce , Snyder Scott , So Sherri
Published: February 2016

Background: Online drug information compendia (ODIC) are valuable tools that health care professionals (HCPs) and consumers use to educate themselves on pharmaceutical products. Research suggests that these resources, although informative and easily accessible, may contain misinformation, posing risk for product misuse and patient harm. Objective: Evaluate drug summaries within ODIC for accuracy and completeness and identify product-specific misinformation. Methods: Between August 2014 and January 2015, medical information (MI) specialists from 11 pharmaceutical/biotechnology companies systematically evaluated 270 drug summaries within 5 commonly used ODIC for misinformation. Using a standardized approach, errors were identified; classified as inaccurate, incomplete, or omitted; and categorized per sections of the Full Prescribing Information (FPI). On review of each drug summary, content-correction requests were proposed and supported by the respective product’s FPI. Results: Across the 270 drug summaries reviewed within the 5 compendia, the median of the total number of errors identified was 782, with the greatest number of errors occurring in the categories of Dosage and Administration, Patient Education, and Warnings and Precautions. The majority of errors were classified as incomplete, followed by inaccurate and omitted. Conclusion: This analysis demonstrates that ODIC may contain misinformation. HCPs and consumers should be aware of the potential for misinformation and consider more than 1 drug information resource, including the FPI and Medication Guide as well as pharmaceutical/biotechnology companies’ MI departments, to obtain unbiased, accurate, and complete product-specific drug information to help support the safe and effective use of prescription drug products.
Troubling appropriations: JS Mill, liberalism, and the virtues of uncertainty
Authors: Philips Menaka
Published: February 2016

Described as the ‘exemplary liberal’, John Stuart Mill is employed to support a dizzying array of different, even competing visions of liberalism. That he has been so widely appropriated is certainly a result of the plural perspectives and tensions embedded in Mill’s political writings. Yet, while Mill scholars have generally been attuned to these tensions, contemporary critics of liberalism have been less careful in their uses of his work. Mill is used as an archetype of liberalism, and is often depicted as a less complex thinker than is justified. He is now a popular target in debates concerning the dilemmas of liberal individualism, and the inadequacies of liberal approaches to culture, harm, and to progress in the context of empire. Such studies present Mill as a thinker driven by ideological certainty, whereas he is more appropriately regarded as someone moved by political uncertainty. Drawing on his Autobiography, I recover Mill’s appreciation for the uncertainties of political thought and action to provide a more complex, and capacious view of Mill’s work than is allowed in contemporary studies of liberalism. My examination thus troubles those contemporary appropriations, and suggests that scholarly focus on liberalism can unduly restrict interpretive work in political theory.
A rare localization of pure dermoid cyst in the frontal bone
Authors: Splendiani Alessandra , Bruno Federico , Mariani Silvia , La Marra Alice , Capretti Ilaria , Di Cesare Ernesto , Masciocchi Carlo
Published: February 2016

We report the case of an 84-year-old woman who came to our attention with right palpebral edema associated with pain in the omolateral fronto-orbital region. The patient underwent an MRI scan that revealed a rounded, extracerebral intradiploic cystic lesion with dyshomogeneous signal intensity. Computed tomography (CT) imaging was also performed with reformatted 3D reconstruction. Post-surgical histologic analysis confirmed the diagnosis of intradiploic dermoid cyst. We here report the case and discuss epidemiology, imaging features and work-up of this pathological entity.
MR imaging findings of endophthalmitis
Authors: Radhakrishnan Rupa , Cornelius Rebecca , Cunnane Mary Beth , Golnik Karl , Morales Humberto
Published: February 2016

Endophthalmitis is a sight-threatening ophthalmologic emergency. The clinical diagnosis is often challenging, and delayed diagnosis may exacerbate the poor visual prognosis. B-scan ultrasonography or spectral domain optical coherence tomography are imaging aids at the clinician’s office. Cross-sectional imaging such as CT and particularly MRI can also help in the assessment of disease extent or complications. MR imaging findings are rarely described in the literature. Here, we discuss the spectrum of imaging findings of endophthalmitis and correlate them with key anatomic and pathophysiologic details of the globe. Early disease is often subtle on MR imaging with thick uveal enhancement, while advanced disease demonstrates retinal/choroidal detachment, vitreal exudates and peribulbar inflammation. Other noninfectious inflammatory diseases of the globe can show similar findings; however, MR diffusion-weighted images help identify infectious exudates and evaluate response to therapy. Knowledge of the spectrum of imaging findings of this disease is important for radiologists and help in the management decision process.
Duration of anticoagulation after isolated pulmonary embolism
Authors: Palareti Gualtiero , Cosmi Benilde , Antonucci Emilia , Legnani Cristina , Erba Nicoletta , Ghirarduzzi Angelo , Poli Daniela , Testa Sophie , Tosetto Alberto , Pengo Vittorio , Prandoni Paolo
Published: February 2016

In the D-dimer and ULtrasonography in Combination Italian Study (DULCIS), serial D-dimer measurement in combination with assessment of residual thrombosis (in patients with deep vein thrombosis (DVT)) identified patients who safely discontinued anticoagulation after an unprovoked venous thromboembolism (VTE).

In this subgroup analysis, the value of D-dimer tests was assessed in patients with isolated pulmonary embolism (PE) compared with those with DVT, with or without PE (DVT/PE). The DULCIS database was reanalysed in relation to this target.

26.8% of the DULCIS patients had isolated PE as the index event; this was more prevalent in females (34.1%) than in males (21.1%; p<0.0001). The rate of positive D-dimer was similar in isolated PE and DVT/PE. The rate of recurrences was not different in isolated PE or DVT/PE patients (4.8% ppyversus3.8% ppy; nonsignificant) who stopped anticoagulation for negative D-dimer, but it was markedly high (11.2% ppy; p<0.0001) in those with isolated PE who remained without anticoagulation despite positive D-dimer. Recurrences were more frequently new isolated PE in patients with isolated PE than with DVT/PE (six (46.2%) out of 13versustwo (7.4%) out of 27; p=0.0085).

Serial D-dimer assessment can inform on the risk of recurrent VTE and help determine the duration of anticoagulation in patients with isolated PE.
PICADAR: a diagnostic predictive tool for primary ciliary dyskinesia
Authors: Behan Laura , Dimitrov Borislav D. , Kuehni Claudia E. , Hogg Claire , Carroll Mary , Evans Hazel J. , Goutaki Myrofora , Harris Amanda , Packham Samantha , Walker Woolf T. , Lucas Jane S.
Published: February 2016

Symptoms of primary ciliary dyskinesia (PCD) are nonspecific and guidance on whom to refer for testing is limited. Diagnostic tests for PCD are highly specialised, requiring expensive equipment and experienced PCD scientists. This study aims to develop a practical clinical diagnostic tool to identify patients requiring testing.

Patients consecutively referred for testing were studied. Information readily obtained from patient history was correlated with diagnostic outcome. Using logistic regression, the predictive performance of the best model was tested by receiver operating characteristic curve analyses. The model was simplified into a practical tool (PICADAR) and externally validated in a second diagnostic centre.

Of 641 referrals with a definitive diagnostic outcome, 75 (12%) were positive. PICADAR applies to patients with persistent wet cough and has seven predictive parameters: full-term gestation, neonatal chest symptoms, neonatal intensive care admittance, chronic rhinitis, ear symptoms, situs inversus and congenital cardiac defect. Sensitivity and specificity of the tool were 0.90 and 0.75 for a cut-off score of 5 points. Area under the curve for the internally and externally validated tool was 0.91 and 0.87, respectively.

PICADAR represents a simple diagnostic clinical prediction rule with good accuracy and validity, ready for testing in respiratory centres referring to PCD centres.
Radiologic–pathologic discordance in biopsy-proven usual interstitial pneumonia
Authors: Yagihashi Kunihiro , Huckleberry Jason , Colby Thomas V. , Tazelaar Henry D. , Zach Jordan , Sundaram Baskaran , Pipavath Sudhakar , Schwarz Marvin I. , Lynch David A.
Published: February 2016

The aim of this study was to compare the clinical, radiological and histological findings in a large population of subjects enrolled during a multicentre study of idiopathic pulmonary fibrosis, with a focus on discordance between imaging and histologic diagnoses of usual interstitial pneumonia (UIP).

Two independent radiologists retrospectively reviewed 241 subjects who underwent high-resolution computed tomography (HRCT) and surgical lung biopsies. HRCT findings were classified as UIP, possible UIP and inconsistent with UIP. Histological findings were classified as definite, probable, possible and not UIP.

Of the 241 cases, 102 (42.3%) had HRCT findings of UIP, 64 (26.6%) had possible UIP and 75 (31.1%) were inconsistent with UIP. Among those with UIP on HRCT, 99 (97.1%) had histologically definite or probable UIP (concordant group), and 71 (94.7%) of those with “inconsistent” HRCT features had histologically definite or probable UIP (discordant group). Discordant subjects were slightly younger and less likely to be smokers than concordant subjects, but no survival differences were identified.

In this population of patients enrolled with a diagnosis of idiopathic pulmonary fibrosis, 94.7% of those with HRCT findings “inconsistent with UIP” demonstrated histological UIP. This suggests that the term “inconsistent with UIP” is misleading.
Pulmonary rehabilitation in lymphangioleiomyomatosis: a controlled clinical trial
Authors: Araujo Mariana S. , Baldi Bruno G. , Freitas Carolina S.G. , Albuquerque André L.P. , Marques da Silva Cibele C.B. , Kairalla Ronaldo A. , Carvalho Celso R.F. , Carvalho Carlos R.R.
Published: February 2016

Lymphangioleiomyomatosis (LAM) is a cystic lung disease frequently associated with reduced exercise capacity. The aim of this study was to assess safety and efficacy of pulmonary rehabilitation in LAM.

This controlled clinical trial included 40 patients with LAM and a low physical activity level. The pulmonary rehabilitation programme comprised 24 aerobic and muscle strength training sessions and education. The primary outcome was exercise capacity (endurance time during a constant work rate exercise test). Secondary outcomes included health-related quality of life (St George's Respiratory Questionnaire (SGRQ)), 6-min walking distance (6MWD), dyspnoea, peak oxygen consumption (V′O2), daily physical activity (pedometer), symptoms of anxiety and depression, lung function and peripheral muscle strength (one-repetition maximum).

The baseline characteristics were well balanced between the groups. The pulmonary rehabilitation group exhibited improvements in the following outcomesversuscontrols: endurance time (median (interquartile range) 169 (2–303) sversus−33 (−129–39) s; p=0.001), SGRQ (median (interquartile range) −8 (−16–2)versus2 (−4–5); p=0.002) and 6MWD (median (interquartile range) 59 (13–81) mversus20 (−12–30) m; p=0.002). Dyspnoea, peakV′O2, daily physical activity and muscle strength also improved significantly. No serious adverse events were observed.

Pulmonary rehabilitation is a safe intervention and improves exercise capacity, dyspnoea, daily physical activity, quality of life and muscle strength in LAM.