bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Mobile Software Development Company
Authors: Velozo Rodrigo Augusto Peres , Montanha Gustavo Kimura
Published: January 2017

The mobile technology became an important tool for nowadays society, allowing fast and easy access to information, becoming useful on both the user's professional and personal life. However, the mobile environment involves many technologies, turning into a complex subject for software development, where it's necessary to pay attention to many variables in order to ensure the project's quality. Therefore, the present study was conducted with a mobile software development company, analyzing and contributing to the company's activity in order to identify common problems related to an application management and development. It was found issues related to the software interface and quality control processes, also covering the migration from a local database to a cloud service.
Critical Review of Tourism in India
Authors: Baporikar Neeta
Published: January 2017

Tourism plays a pivotal role in socio-economic development. It fosters international understanding, trust among people and brings many social benefits. According to United Nations World Tourism Organization, travel and tourism can be part of the solution to world problems of poverty employment and sustainability. Today, tourism has grown to become a major social and economic force and it is a well-known fact. Hence, it certainly is an activity of global importance and significance. With abundant nature's gift, one of the oldest culture and civilization India as tourist destination is in an envious position to locus itself as one of the best global destination by adopting innovative and holistic tourism policies. Through exploratory and descriptive examination and in depth literature review of policy documents and reports, the aim of this chapter is review critically the tourism policies and intends to suggest new avenues and innovations in tourism.
Adequacy of Government Policy on Ecotourism
Authors: Jha Ajeya , Shenga Sherap , Mishra Somnath , Mishra Manjushree
Published: January 2017

Sikkim is known as a natural and ideal destination for the tourists looking for exotic and varied experiences. The study explores the adequacy of the policy in the context of eco-tourism principles espoused by eco-tourism society (TES) which are - minimize physical, social and psychological impact, Build environmental and cultural awareness, Provide positive experiences for both visitors and hosts, Produce direct financial benefits for conservation, and Recognize the rights and spiritual beliefs of the Indigenous People. Methodology used is case study for based on a structured questionnaire with 55 statements (on Likert scale) responded by the civil officers of the state government involved with eco-tourism policy and its implementation. To make it more meaningful one sample t-test has been conducted to test hypotheses. It concludes that the policy document has areas with distinct adequacies and inadequacies. The purpose of the study is to identify inadequacies that need to be addressed to make the policy document holistic and help in facilitating its proper implementation.
Cardiac Remodeling Under Hyperoxic Conditions
Authors: Panguluri Siva Kumar
Published: January 2017

Cardiovascular complications and arrhythmias account for high mortality in cardiopulmonary patients in intensive care unites (ICU) and critical care unites. Patients in ICU are often administered with 100% oxygen for treatment with many diseases. According to American Heart Association (AHA), more than 2200 deaths related to cardiac failure are reported every day with an average of 1 in every 39 seconds. Cardiomyopathy is also reported in many diseased conditions including acute lung injury, diabetes, obesity, hypertension, and cancer. Recent studies indicate that hyperoxia induces cardiac injury due to dysfunctional lung and compromised pulmonary functioning. The exact mechanism of cardiovascular complications in ICU/ critical care remains unknown. This review will discuss the effect of hyeproxia on cardiac remodeling with more emphasis on ventricular and electrical remodeling. Understanding the exact mechanism of hyperoxia induced cardiomyopathy is not only important to understand the disease development and progression but also open new avenues for targeted therapy.
Advancements in Cardiovascular Diagnostics
Authors: Li Yan , Fang Karen L. , Huang Zhi , Lu Yun , Zhang Bin , Yao Yali
Published: January 2017

The cardiology diagnostic are the methods of identifying current or past heart conditions, which can advise caregivers on patient diagnosis and provide a proper therapy plan, nowadays couple new diagnostic methods have been developed and some of them like radionuclide myocardial perfusion imaging, coronary computed tomography angiogram, cardiac magnetic resonance imaging, intravascular ultrasonography, optical coherence tomography, intravascular thermography, intravascular elastography, and near-infrared spectroscopy have been approved for clinical use. Not only the advanced technologies, the new biomarkers, and genetic markers may provide new potential targets for the diagnosis, therapy, and prevention of heart diseases.
Recent Innovations in Coronary Stents
Authors: Sengupta Poulomi
Published: January 2017

In heart diseases, there are frequent incidents of narrowing or blocking coronary arteries by fatty plaque deposition. As a result, blood pressure rises and the arteries weaken. This can lead to rapid rupture of the blood vessels, also known as heart attack or brain stroke. In some cases the arteries lose elasticity over old age. Heart stent or coronary stent inserts in the blocked/fragile region of coronary artery. It helps to expand the artery to allow free flow of blood and consequently, reduces blood pressure. Over past 20 years there are many modifications and innovations in the field of cardiac stents, in this chapter we will discuss few of those.
Nanoparticle-Based Drug Delivery Systems for Cardiovascular Applications
Authors: Patel Arti , Pathak Yashwant V.
Published: January 2017

Nanomedicine has vastly improved the treatment and diagnosis of many cardiovascular conditions such as atherosclerosis, myocardial ischemia, myocardial infarction, restenosis, and thrombosis. A few nanoparticle drug delivery systems that are currently being tested and used in clinical trials include lipid-based drug delivery, controlled drug release, and specific targeting. The chapter describes the various drug delivery methods, the various nanoparticles, and their application on specific cardiovascular conditions. This chapter compiles examples of specific clinical trials that are being conducted, using nanoparticles for therapy of cardiovascular conditions.
The Effects of Social and Demographic Factors on Cardiovascular Disease
Authors: Min Hosik
Published: January 2017

The chapter investigates the effects of social and demographic factors on cardiovascular disease (CVD) controlling health related factors. The data used in this study is the National Health and Nutrition Examination Survey data, and are merged the three waves, 2009-2010, 2011-2012, and 2013-2014. The logit regression analysis is used as a statistical model, and the results of this study confirm the significant associations with CVD in age, race/ethnicity, marital status, and educational attainment as expected ways. Health behaviors also show significant and strong relationships with CVD, which support the current prevention and intervention programs' strategy that focuses on changing lifestyles on an individual and a community level. The results of the social and demographic factors on CVD confirm that having CVD is not only a medical or biological process but also a social outcome. Thus, a better understanding of the social and demographic factors on CVD helps us to not only reduce the mortality rate, but also develop more effective policies and programs.
Forensic Assessment of Natural Unexpected Cardiovascular Death
Authors: Javan Gulnaz T. , Finley Sheree J. , Ozsoy Sait
Published: January 2017

In the United States, sudden unexpected deaths attributable to diseases of the cardiovascular system account for almost 50% of all natural deaths with up to 600,000 deaths per year. Over the past decade, substantial developments have been made to provide definitive determinations in the diagnosis of cardiac death for adjudication in the criminal justice system and closure for decedent's families. In order to make postmortem diagnostic determinations, coordinated multidisciplinary efforts include collaboration between clinical and forensic pathologists. Forensic protocols include examination of the heart, histological sampling, toxicology testing, and molecular analyses. Lack of alternative diagnoses generally prompts pathologists to report sudden cardiac arrest as the main cause of death in many cases even though the accuracy of this finding might be in question; therefore, a forensic pathologist should examine unexplained cases of death in more depth to avoid this possible misdiagnosis.
Exploring the Impact of Tourism to the Sustainable Development of Mountain Regions
Authors: Tsiaras Stefanos
Published: January 2017

Sustainable development is difficult to be achieved in mountain regions because of their sensitivity to climate change. The rapid development of mountain tourism worldwide during the last years makes the goal for sustainable mountain tourism even more challenging. Key factor to the development of mountain tourism in Europe was the function of ski centres. According to the spirit of the Brundtland Report ski centres are not in general sustainable, because they may have economic benefits but they negatively affect the other two pillars of sustainability: environment and society. The present paper focuses on a ski resort in Greece, attempting to assess the impact of mountain tourism on the sustainable development of the area. Ski resorts played a crucial role to the bloom of mountain tourism in Greece. Its evolution is a relatively recent phenomenon which has been affected by the economic crisis that afflicts the country in the past years. Demographic data compared with tourism indicators were used to assess the environmental impact of tourism in the area. Moreover, meteorological data were used in order to examine the correlation of climatic conditions and the number of visitors. The results show that the ski centre in Elatohori despite the economic benefits has a major environmental impact, especially because of the increased carbon emissions caused by the visitors of the area. Additionally, the climatic conditions (precipitation and temperature, especially the absolute maximum air temperature) affect the number of visitors.
Regional Sustainability
Authors: Koliouska Christiana , Andreopoulou Zacharoula , Misso Rosa , Borelli Irene Paola
Published: January 2017

Regional sustainability promotes an integrated approach to planning and development in regional communities. European Union legislative acts bring together all levels of government to achieve a holistic approach to sustainability using Information and Communication Technologies tools for better delivery of services. Today, there has been observed an increasing interest in applying e-government to different business sectors such as the environmental sector. Sustainable management of National Forest Parks relies on a complete understanding of the goods and services, which are provided to the society. This paper aims to study e-government websites concerning the 10 Greek National Forest Parks and analyse the websites as to their qualitative and quantitative features. Then, the electronic services model adoption of the websites is assessed. The e-government websites are classified in electronic services adoption stages starting from a simple presence of the government agency in the Internet to the total electronic services integration through multiple ICT tools and applications provision according to content features accomplished by the websites. The findings can be helpful for managers, policy makers, web designers, environmentalists and government agencies.
Does Economic Crisis Force to Consumption Changes Regarding Fruits and Vegetables?
Authors: Vlontzos George , Duquenne Marie Noelle , Haas Rainer , Pardalos Panos M.
Published: January 2017

This study focuses on consumers' behaviour towards Fruits and Vegetables (FVs) under economic crisis. The implementation of both factor analysis and logistic regression reveals discrete consumer groups, affected and not affected by the ongoing economic crisis. Interviewees were selected randomly. In total, 250 questionnaires were completed and 238 of them were used for computations. There are two consumer groups, one affected by the crisis and one which did not. For the former, the price criterion prevails, while for the latter parameters like locality of production and heath concerns lead them to purchasing decisions. The economic crisis has reduced the quantities of FVs being consumed, and the retail chain stores fail to meet the criteria of locality and secure traceability procedures about the origin of the products. Nevertheless, educated consumers with higher incomes prefer to visit super markets, while elderly people with low incomes prefer grocery stores and open markets.
Instrumented Color Determination and Sensory Analysis of Tomato Fruits (Lycopersicum Esculentum Mill)
Authors: de Almeida Celina , Dal Fabbro Inacio Maria , Gazzola Jonathan
Published: January 2017

This research work reports the evaluation of tomato fruits (Lycopersicum esculentum Mill) by means of sensory analysis as well as through instrumented color determination aiming of establishing some correlations between the results yielded by the two methods. Nowadays tomato fruits selection and sorting are based on the uniformity of physiological maturity which is considered adequate for harvesting. The sensory analysis was carried by selecting a group of trained volunteers applying a non-structured scale. The instrumental readings were carried using a “Macbeth” HUNTERLab equipment at five selected points on the transversal fruit axis. The sensory color determination indicated no significant differences (p = 0.05) between the following groups of days: 1, 3 and 5; 5 and 8; 10 and 12; and 12, 15, 17 and 19, however it indicated the occurrence of differences between the groups. Tomato fruits showed moderately characteristic colors between the 10th and 12th days and very characteristic colors from the 12thday.
Modern Research Methodologies for the Determination of the Heavy Metals Accumulation in the Soil
Authors: Popa Maria , Popa Dorin
Published: January 2017

The present paper approaches a usual problem in the industrialised area, respectively Zlatna Area in Romania. The aim of this research is to establish the heavy metal soil contamination degree using modern research methods namely spectrometric and stripping methods. The results pointed out very high exceeding values, especially in the case of lead and copper, in the studied area. Moreover, the mobility and the availability of heavy metals decreases when pH increases. Findings suggest that the use of modern technologies have good results regarding the determination of the heavy metals in the soil.
Examining the Contributing Factors for Cloud Computing Adoption in a Developing Country
Authors: Yaokumah Winfred , Amponsah Rebecca Adwoa
Published: January 2017

The growth in cloud computing adoption is phenomenal in organizations worldwide due mainly to its potential to increase productivity and enhance efficiency in business operations. However, cloud adoption is very low in many organizations in the developing countries. To gain insights into organizations' behavioral intention and usage behavior of cloud computing, based on the Extended Unified Technology Acceptance and Use Theory, the current study investigated the effects of technological, organizational, and environmental factors on cloud adoption in organizations. Using samples from five industry sectors and by employing the Structural Equation Model, the study found that facilitating conditions, habit, performance expectancy, and price value had positive and significant effect on behavioral intention to use cloud computing. But, effort expectancy, social influence, lack of motivation, and inadequate security were found to be barriers to cloud adoption. These findings could contribute toward better formulation of planning guidelines for successful adoption of cloud computing.
Design and Implementation of Multi-Agent Online Auction Systems in Cloud Computing
Authors: Yu Hongyan , Patnaik Srikanta , Ji Shenjia , Jia Liguo , Yang Tengxiao
Published: January 2017

Due to the high maintenance cost of traditional online auction system, poor load balance ability and down problems occurring in the peak value of system access, this paper aims to propose a solution to transit from traditional online auction system to cloud computing to get higher work efficiency, lower expenditure and less energy cost. The GAE platform is used to deploy application of the overall framework of online auction system in cloud computing, including development environment as well as online auction system components, and software architecture. The online auction negotiation algorithms in cloud computing are also proposed. Based on these key technologies, the business processes of the online auction system in cloud computing is designed, including users' login system, starting an auction, bidding processes, online auction data storage, and logout system. The online auction system constructed on GAE platform with cloud computing resources and storage ability can reduce the pressure of terminal equipment, which is more robust than traditional online auction system facing users' changeable needs in the process of online auction.
Mediatized Witnessing and the Ethical Imperative of Capture
Authors: Scott Sasha A Q
Published: January 2017

What does it mean to witness in an age saturated with media technology? This paper argues the need to rescue witnessing as a concept from its conflation with the watching and passive consumption of events. As an inherently political practice, the mediatization of witnessing is bound within questions of ethics and morality and has the potential to realign power and control in society. This article explores these issues through the witnessing of public death events: those shocking, exceptional and morally significant deaths that become ‘public' through their mediation, observing that the continuous and contiguous production and consumption of media content has given rise to new performative rituals of local witnessing for (potentially) global audiences. I argue that the mediatization of witnessing serves to increase our moral awareness of seeing, rendering an ethical imperative of capture on those that witness, and thereby closing the veracity gap between events and their meaning.
Interaction on Instagram?
Authors: Russmann Uta , Svensson Jakob
Published: January 2017

This paper directs attention to the use of Instagram by political parties in the Swedish national elections in 2014. It investigates how political parties made use of Instagram – a platform centered around images – when engaging in interaction with their followers on the platform. Therefore, the paper analysis Instagram images including their captions and comments (posts) that Swedish parties have published four weeks prior to Election Day. A particular focus is on the deliberative potential of Instagram. The results suggest that not much changes on Instagram compared to other social media platforms: Political parties hardly used Instagram to interact with their followers and the few interactions taking place on parties Instagram accounts did not contribute to the exchange of relevant and substantive information about politics (i.e., deliberation). Interaction and deliberation is also not enhanced by the images.
Generic E-Assessment Process Development based on Reverse Engineering
Authors: Hajjej Fahima , Hlaoui Yousra Bendaly , Ben Ayed Leila Jemni
Published: January 2017

The e-assessment, as an important part of any e-learning system, faces the same challenges and problems such as problems related to portability, reusability, adaptability, integration and interoperability. Therefore, we need an approach aiming to generate a general process of the e-assessment. The present study consists of the development of a generic e-assessment process which should be adapted to any learner profile. This e-assessment process is implemented as a composite cloud service which could be invoked by any existing LMS regardless of its environment. The authors are brought the abstraction defined by a workflow about proposing a development approach based on the Reverse Engineering and the cloud environment. To attempt these goals, they have studied the e-assessment politics of different existing LMSs to generate their e-assessment activities. These activities composing the generic e-assessment process using the Reverse Engineering and based on a set of mapping rules. Then, the authors have proposed a pedagogical scenario linking the generated, e-activities in an abstract manner using the concept of workflow. To specify this e-assessment workflow process, they use UML activity diagram language. Finally, to implement their approach, the authors have used the technology of cloud computing services
An Evaluation Framework for Selecting Collaboration Systems for Student Teamwork
Authors: Shen Yide , Li Lei , Zheng Guangzhi , Guo Rong
Published: January 2017

Collaboration technologies play an increasingly important role in student teamwork in universities. With the proliferation of collaboration systems on the market and the wide range of features they offer, choosing an appropriate system can be an overwhelming task for college students. In this paper, the authors present an empirical study that aimed to help college instructors and students assess and select appropriate collaboration systems for their teamwork needs. They first identified and ranked the important features of collaboration systems for students through a web-based survey. Based on the survey results, the authors built an evaluation framework, in the form of weighted scoring tables, to help students systematically choose technologies that met their collaborative needs. They further demonstrated how to use those scoring tables for an undergraduate capstone class that had a term-long team project. The implications and future directions of the authors' study are also discussed.
And Action! Live in Front of the Camera
Authors: Friedländer Mathilde B.
Published: January 2017

The arising knowledge society seems to produce its own digital services. In the last few years, with social live streaming services a new type of synchronous social media emerged. What functions do such services offer? What information need and information behavior do users of this services exhibit? Method: As a heuristic theoretical basis, the Information Service Evaluation (ISE) model was applied to analyze YouNow as a case study of this kind of new social media. The evaluation is based on an online-survey among YouNow's users as well as observations of the live-streams. Results. YouNow is mainly used by adolescents and young adults. For this group, it is important to interact with friends, be a part of the community and find ways of self-expression. This is exactly what YouNow offers its users. Most of them enjoy the functions of the service. The experience of “flow” was sometimes perceived. Possible law infringements (such as copyright and personality rights violations) were detected.
From MOOCs to MOOPILs
Authors: Irby Beverly J. , Sutton-Jones Kara L. , Lara-Alecio Rafael , Tong Fuhui
Published: January 2017

This article includes a discussion of the growing use of virtual professional development and learning for educators. Next the authors describe virtual professional development and learning within the context of a U.S. federally-funded Investing in Innovation (i3) grant, English Language and Literacy Acquisition-Validation (ELLA-V), and the need for a new understanding of such on an informal and individual basis. The proposed concept is a Massive Open Online Professional Informal Individual Learning (MOOPIL). Lastly, the authors provide an example of a MOOPIL from the ELLA-V grant which is called ELLA-Virsity—a collection of short professional development webinars for teachers and school leaders who work with English language learners.
Plasma Cocaine Metabolite and Liver CYP450 3A4 Isoenzyme Levels as Indicators of Cocaine Dependence in Rats Treated with Nutritional Supplements
Authors: Gardner Natwaine Sherune , Luke Kedon JS , Wheatley Andrew O. , De La Haye Winston G. , Bahado-Singh Perceval , Dilworth Lowell , McGrowder Donovan A. , Barton Everard , Young Lauriann Elizabeth , Salako-Akande Ajibike , Morrison Errol , Eldemire-Shearer Denise , Lowe Henry , Asemota Helen N.
Published: January 2017

The effects that chronic cocaine administration (CCA) have on craving, cocaine metabolite concentrations and cytochrome P450 3A4 isoenzyme (CYP450 3A4) activities in Sprague-Dawley rats following the administration of Salako Nutritional Supplements (SNS) were examined. Five groups of fifty rats were used to assess the effect of the SNS following CCA. Craving was analyzed for each rat using a Conditioned Place Preference protocol. Blood samples were obtained at regular intervals and used to measure cocaine plasma metabolite levels. CYP450 3A4 activity was determined in the liver. Administration of the SNS reduced craving of cocaine significantly, upon discontinuing cocaine in the rats. Blood plasma analysis showing higher benzoylecgonine equilibrium and the CYP450 3A4 levels demonstrated that the SNS possibly aided in the removal of the stored metabolites indicative of increased metabolism of cocaine, enhanced by the Supplements. Results indicate that the SNS formulation reduces craving caused by CCA by increasing the liver CYP450 3A4 activity, resulting in better plasma clearance.
Performance Benchmarking of Indian Life Insurers
Authors: Sinha Ram Pratap , Datta Nitish
Published: January 2017

In the last one decade, the life insurance companies operating in India have made significant progress in terms of business consolidation. In view of the same, it is of interest to make an enquiry about the operating performance of these companies. The present paper compares fifteen life insurance companies operating in India for the period 2005-06 to 2009-10 using the Hybrid Efficiency Model (Tone,2004). The Hybrid Model provides a unified framework for the estimation of technical efficiency integrating the radial and non-radial characterisation of inputs and outputs. The results from the study indicate that out of the fifteen in-sample life insurance companies, the number of technically efficient life insurers declined from 9 in 2005-06 to 4 in 2006-07 and further to 3 in 2007-08 and 2008-09. However, in 2009-10 the number increased to 5. The mean technical efficiency scores of the in-sample life insurers declined sharply between 2005-06 and 2006-07 and improved somewhat thereafter. However, it again declined in 2009-10 implying a greater divergence in performance.
Cooperation and Free Riding in Cyber Security Information-Sharing Programs
Authors: Naugle Asmeret Bier , Silva Austin , Aamir Munaf
Published: January 2017

Even with substantial investment in cyber defense, the risk of harm from cyber attacks is significant for many organizations. Multi-organization information-sharing programs have the potential to improve cyber security at relatively low cost by allowing organizations that face similar threats to share information on vulnerabilities, attacks, and defense strategies. The dynamics of an information-sharing program are likely to depend heavily on interactions between human decision makers. This article describes a system dynamics model of an information-sharing program. The model incorporates decision-making strategies of managers and cyber defenders in each participating organization. The model was used to assess how free-riding behavior is likely to affect the success of a multi-organization information-sharing program. Results shows that free riding may make information sharing more volatile and less beneficial early on, but other factors, including cost savings and the perceived utility of shared information, are likely to create success later in the time horizon.
Geometric Representations Built with GeoGebra for Improving the Visualization and Reasoning Cognitive Process
Authors: Orozco Claudia , Morales-Morgado Erla M.
Published: January 2017

It is well known that Mathematical Software can be an appropriate tool to improve the teaching-learning mathematic process. This Software allows the teacher and student to build certain geometric facts and consequently, to visualize them. This makes possible to concretize certain abstract mathematic concepts and facilitate their comprehension. However, some are expensive and some people do not have access to it. This paper presents the use of geometric configurations built with GeoGebra as a tool for teaching the definition of vector and its operations. These are Open Educational Resources (OERs), and they were built under the Open Knowledge scheme, so everyone to have access to them. The goal is to investigate, in this context, the possible implicit effects that these OERs have as a didactic strategy to improve the visualization and reasoning cognitive processes. The results of the tests performed show that, in this case, the use of the proposal favored the learning of the presented concepts.
Status of Non-Functional Requirements in Mobile Application Development
Authors: Gupta Varun , Chopra Raj Kumar , Chauhan Durg Singh
Published: January 2017

Non-functional requirements determine the acceptance of the software application amongst its stakeholders apart from the desired functionality yet they are mostly neglected by the software development organizations. Efforts are made to enhance the success rate of the mobile app product; however, there is a lack of empirical studies available for analyzing the contribution of nonfunctional requirements towards the product success. In order to suggest mechanisms for improving product success rates, it is important to undertake the empirical study through surveys and case studies in industrial settings to analyze the software development practices focused on non-functional requirements. The analysis of data collected through empirical methods suggests that non-functional requirements are handled in the rough adhoc fashion and the number of implemented non-functional requirements is less with respect to number of implemented functional requirements. The contribution of non-functional requirements to overall development cost and time is lesser due to lesser number of requirements that undergo implementation but will grow to higher extend as their number will increase. The impact of non-functional requirements on product success rates, failure rates, overall cost and development time varies with type of development, size of organization and complexity of the undertaken mobile app projects.
Association between depression in carers and malnutrition in children aged 6 months to 5 years
Authors: Motlhatlhedi Keneilwe , Setlhare Vincent , Ganiyu Adewale , Firth Jacqueline
Published: January 2017

Background:  Childhood malnutrition is an important risk factor for child mortality and underlies close to 50% of child deaths worldwide. Previous studies have found an association between maternal depression and child malnutrition, but it is not known whether this association exists in Botswana. In addition, previous studies excluded non-maternal primary caregivers (PCGs). It is unclear whether the association between primary caregiver depression and child malnutrition remains when non-maternal PCGs are included.Aim: The aim of this study was to determine if there is an association between PCG depression and malnutrition in children aged between 6 months and 5 years in Mahalapye, Botswana.Setting: The study was conducted in the child welfare clinics of Xhosa and Airstrip clinics, two primary health care facilities in Mahalapye, Botswana.Methods: This was a case control study. Cases were malnourished children aged between 6 months and 5 years, and controls were non-malnourished children matched for age and gender. The outcome of interest was depression in the PCGs of the cases and controls, which was assessed using the Patient Health Questionnaire 9 (PHQ 9), a depression screening tool.Results: From a sample of 171 children, 84 of whom were malnourished, we found that the malnourished children were significantly more likely to have depressed PCGs (odds ratio = 4.33; 95% CI: 1.89, 9.89) than non-malnourished children in the 6-month to 5-year age group; the PCGs of malnourished children also had lower educational status.Conclusion: This study found a significant association between PCG depression and child malnutrition.
Evaluation of hypofunctioning thyroid nodules with technetium-99m MIBI and ultrasonography
Authors: Farate Abubakar , Gutta Aadil A. , De Graaf Karien , Mdaka Trevor
Published: January 2017

Background: Fine needle aspiration cytology (FNAC) cannot reliably differentiate follicular adenoma from follicular carcinoma (FC), which requires histological evidence of capsular or vascular invasion. FC is the most predominant thyroid cancer in our loco-regional environment, indicating the need for improvement in preoperative diagnostic accuracy of thyroid nodules to ensure appropriate and timely interventions.Objective: The purpose of this study was to assess the role of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy and ultrasonography (USG) in the differential diagnosis of thyroid nodules.Methods: Forty-two patients with hypofunctioning thyroid nodules were prospectively studied with 99mTc-MIBI scintigraphy and USG to differentiate benign from malignant nodules. An injection of 740 MBq of 99mTc-MIBI was intravenously administered, followed by semiquantitative analysis of dual-phase scans using a 4-point (0 to 3) scoring system. USG was subsequently performed and interpretation was based on some sonographic criteria for malignancy. In the following days and weeks, patients underwent FNAC followed by surgery and histopathologic examination.Results: All malignant nodules were positive on 99mTc-MIBI and all but two malignant nodules were positive on USG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy are, respectively, 100%, 70%, 65%, 100%, and 81% for 99mTc-MIBI scintigraphy; 87%, 78%, 68%, 91% and 81% for USG; and 83%, 100%, 100%, 96% and 64% for FNAC. There was no statistically significant difference between 99mTc-MIBI scintigraphy and USG performance for both benign (p = 0.317) and malignant (p = 0.573) nodules.Conclusion: 99mTc-MIBI scintigraphy and USG are important imaging modalities in the evaluation of thyroid nodules, particularly follicular neoplasms which are frequently associated with non-diagnostic cytology.
Initial Experience with a Cone-beam Breast Computed Tomography-guided Biopsy System
Authors: Seifert Posy J , Morgan Renee C , Conover David L , Arieno Andrea L
Published: January 2017

Objective:

To evaluate our initial experience with a cone-beam breast computed tomography (BCT)-guided breast biopsy system for lesion retrieval in phantom studies for use with a cone-beam BCT imaging system.

Materials and Methods:

Under the Institutional Review Board approval, a phantom biopsy study was performed using a dedicated BCT-guided biopsy system. Fifteen biopsies were performed on each of the small, medium, and large anthropomorphic breast phantoms with both BCT and stereotactic guidance for comparison. Each set of the 45 phantoms contained masses and calcification clusters of varying sizes. Data included mass/calcium retrieval rate and dose and length of procedure time for phantom studies.

Results:

Phantom mass and calcium retrieval rate were 100% for BCT and stereotactic biopsy. BCT dose for small and medium breast phantoms was found to be equivalent to or less than the corresponding stereotactic approach. Stereotactic-guided biopsy dose was 34.2 and 62.5 mGy for small and medium breast phantoms, respectively. BCT-guided biopsy dose was 15.4 and 30.0 mGy for small and medium breast phantoms, respectively. Both computed tomography biopsy and stereotactic biopsy study time ranged from 10 to 20 min.

Conclusion:

Initial experience with a BCT-guided biopsy system has shown to be comparable to stereotactic biopsy in phantom studies with equivalent or decreased dose.
The prevalence of obesity documentation in Primary Care Electronic Medical Records
Authors: Mattar Ahmed , Carlston David , Sariol Glen , Yu Tongle , Almustafa Ahmad , Melton Genevieve , Ahmed Adil
Published: January 2017

Background: Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient’s problem list for patients with eligible body mass indexes (BMI) as contained in the patients’ electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels.

Method: This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used.

Results: Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling.

Conclusion: Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese.
Development and Feasibility of a Real-Time Clinical Decision Support System for Traumatic Brain Injury Anesthesia Care
Authors: Kiatchai Taniga , Colletti Ashley , Lyons Vivian , Grant Rosemary , Vavilala Monica , Nair Bala
Published: January 2017

Background: Real-time clinical decision support (CDS) integrated with anesthesia information management systems (AIMS) can generate point of care reminders to improve quality of care. Objective: To develop, implement and evaluate a real-time clinical decision support system for anesthetic management of pediatric traumatic brain injury (TBI) patients undergoing urgent neurosurgery.

Methods: We iteratively developed a CDS system for pediatric TBI patients undergoing urgent neurosurgery. The system automatically detects eligible cases and evidence-based key performance indicators (KPIs). Unwanted clinical events trigger and display real-time messages on the AIMS computer screen. Main outcomes were feasibility of detecting eligible cases and KPIs, and user acceptance.

Results: The CDS system was triggered in 22 out of 28 (79%) patients. The sensitivity of detecting continuously sampled KPIs reached 93.8%. For intermittently sampled KPIs, sensitivity and specificity reached 90.9% and 100%, respectively. 88% of providers reported that CDS helped with TBI anesthesia care.

Conclusions: CDS implementation is feasible and acceptable with a high rate of case capture and appropriate generation of alert and guidance messages for TBI anesthesia care.
The influence of snow sublimation and meltwater evaporation on δD of water vapor in the atmospheric boundary layer of central Europe
Authors: Christner Emanuel , Kohler Martin , Schneider Matthias
Published: January 2017

Abstract. Post-depositional fractionation of stable water isotopes due to fractionating surface evaporation introduces uncertainty to various isotope applications such as the reconstruction of paleotemperatures, paleoaltimetry, and the investigation of groundwater formation. In this study, we investigate isotope fractionation at snow-covered moisture sources by combining 17 months of observations of isotope concentration ratios [HD16O] ∕ [H216O] in low-level water vapor in central Europe with a new Lagrangian isotope model. The isotope model is capable of reproducing variations of the observed isotope ratios with a correlation coefficient R of 0.82. Observations from 38 days were associated with cold snaps and moisture uptake in snow-covered regions. Deviations between modeled and measured isotope ratios during the cold snaps were related to differences in skin temperatures (Tskin). Analysis of Tskin provided by the Global Data Assimilation System (GDAS) of the NCEP implies the existence of two regimes of Tskin with different types of isotope fractionation during evaporation: a cold regime with Tskin < Tsubl,max = −7.7 °C, which is dominated by non-fractionating sublimation of snow, and a warmer regime with Tsubl,max < Tskin < 0 °C, which is dominated by fractionating evaporation of meltwater. Based on a sensitivity study, we assess an uncertainty range of the determined Tsubl,max of −11.9 to −2.9 °C. The existence of the two fractionation regimes has important implications for the interpretation of isotope records from snow-covered regions as well as for a more realistic modeling of isotope fractionation at snow-covered moisture sources. For these reasons, more detailed experimental studies at snow-covered sites are needed to better constrain the Tsubl,max and to further investigate isotope fractionation in the two regimes.
Linkages between land initialization of the NASA-Unified WRF v7 and biogenic isoprene emission estimates during the SEAC4RS and DISCOVER-AQ
airborne campaigns
Authors: Huang Min , Carmichael Gregory R. , Crawford James H. , Wisthaler Armin , Zhan Xiwu , Hain Christopher R. , Lee Pius , Guenther Alex B.
Published: January 2017

Abstract. Land and atmospheric initial conditions of the Weather Research and Forecasting (WRF) model are often interpolated from a different model output. We perform case studies during NASA's SEAC4RS and DISCOVER-AQ Houston airborne campaigns, demonstrating that initializing the Noah land surface model directly using a coarser resolution dataset North American Regional Reanalysis (NARR) led to significant positive biases in the coupled NASA-Unified WRF (NUWRF, version 7)'s (near-) surface air temperature and planetary boundary layer height (PBLH) around the Missouri Ozarks and Houston, Texas, as well as poorly partitioned latent and sensible heat fluxes. Replacing the land initial conditions with the output from a long-term offline Land Information System (LIS) simulation can effectively reduce the positive biases in NUWRF's surface air temperature fields by ~ 2 °C. We also show that the LIS land initialization can modify the surface air temperature errors almost ten times as effectively as applying a different atmospheric initialization method. The LIS-NUWRF based isoprene emission calculations by the Model of Emissions of Gases and Aerosols from Nature (MEGAN, version 2.1) are at least 20 % lower than those computed using the NARR-initialized NUWRF run, and are closer to the aircraft observation-derived emissions. Higher resolution MEGAN calculations are prone to amplified errors on small scales, possibly resulted from some limitations of MEGAN's parameterization and its inputs' uncertainty. This study emphasizes the importance of proper land initialization to the coupled atmospheric weather modeling and the follow-on emission modeling, which we anticipate to be also critical to accurately representing other processes included in air quality modeling and chemical data assimilation. Having more confidence in the weather inputs is also beneficial for determining and quantifying the other sources of uncertainties (e.g., parameterization, other input data) of the models that they drive.
Towards a simple representation of chalk hydrology in land surface modelling
Authors: Rahman Mostaquimur , Rosolem Rafael
Published: January 2017

Abstract. Modelling and monitoring of hydrological processes in the unsaturated zone of chalk, a porous medium with fractures, is important to optimize water resource assessment and management practices in the United Kingdom (UK). However, incorporating the processes governing water movement through a chalk unsaturated zone in a numerical model is complicated mainly due to the fractured nature of chalk that creates high-velocity preferential flow paths in the subsurface. In general, flow through a chalk unsaturated zone is simulated using the dual-porosity concept, which often involves calibration of a relatively large number of model parameters, potentially undermining applications to large regions. In this study, a simplified parameterization, namely the Bulk Conductivity (BC) model, is proposed for simulating hydrology in a chalk unsaturated zone. This new parameterization introduces only two additional parameters (namely the macroporosity factor and the soil wetness threshold parameter for fracture flow activation) and uses the saturated hydraulic conductivity from the chalk matrix. The BC model is implemented in the Joint UK Land Environment Simulator (JULES) and applied to a study area encompassing the Kennet catchment in the southern UK. This parameterization is further calibrated at the point scale using soil moisture profile observations. The performance of the calibrated BC model in JULES is assessed and compared against the performance of both the default JULES parameterization and the uncalibrated version of the BC model implemented in JULES. Finally, the model performance at the catchment scale is evaluated against independent data sets (e.g. runoff and latent heat flux). The results demonstrate that the inclusion of the BC model in JULES improves simulated land surface mass and energy fluxes over the chalk-dominated Kennet catchment. Therefore, the simple approach described in this study may be used to incorporate the flow processes through a chalk unsaturated zone in large-scale land surface modelling applications.
The Impact of Accounting Conservatism and Voluntary Disclosure on the Cost of Capital of Industrial Companies in Jordan
Authors: Warad Heba S , Al-Debi'e Prof. Dr. Mamoun M
Published: January 2017

This study aims at examining the impact of accounting conservatism and voluntary disclosure on the cost of capital of industrial companies in Jordan during the period (2009-2013). Panel OLS regression analysis was employed to test the hypotheses of the study. The results of the full sample model revealed that accounting conservatism and voluntary disclosure have significant negative impacts on the firms’ cost of capital.Furthermore, the results of the sub-samples which distinguish between large and small, as well as between high and low leverage firms showed that the sub-sample of large and small firms conforms to the full sample results.  Across the sub-sample of high leverage firms, the results showed that only voluntary disclosure has a significant negative impact on the firm’s cost of capital. On the other hand, only accounting conservatism has a significant negative impact on the firm’s cost of capital across the sub-sample of low leverage firms.