bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethical aspects of caregivers’ experience with persons with dementia at mealtimes
Authors: Hammar Lena Marmstål , Swall Anna , Meranius Martina Summer
Published: May 2015

Background:

Persons with dementia are at risk of malnutrition and thus in need of assistance during mealtimes. Research suggest interventions for caregivers to learn how to facilitate mealtimes and eating, while other suggest a working environment enabling the encounter needed to provide high-quality care. However, the phenomenon of caring for this unique population needs to be elucidated from several perspectives before suggesting suitable implications that ensure their optimal health.

Objectives:

To illustrate the meanings within caregivers’ experiences of caring for persons with dementia during mealtime situations. We also measured weight and food intake among individuals with dementia to explain better the phenomenon of caring for them during mealtimes.

Methods:

Mixed method including focus group interviews with seven caregivers analyzed using phenomenological hermeneutics. In addition, for nine persons with dementia, weight and food intake were collected and descriptive statistics were calculated.

Ethical considerations:

Ethical review was obtained from an ethics committee, and all caregivers signed a consent form after being informed on the issue of research ethics. Relatives for persons with dementia were informed and signed the consent. In addition, throughout the study, the persons’ expressions were observed aiming to respect their vulnerability, integrity, and dignity.

Findings:

One theme emerged from interviews (struggling between having the knowledge and not the opportunity), which was built upon three subthemes (being engaged and trying; feeling abandoned and insufficient; being concerned and feeling guilty). Seven of nine persons with dementia lost a minimum of 1.3 kg of weight and ate a maximum of 49.7% of the food served.

Conclusion:

Caregivers struggle because they have knowledge about how to provide high-quality care but are unable to provide this care due to organizational structures. The weight loss and insufficient eating among the persons with dementia may support this conclusion. Sufficient time for adequate care should be provided.
Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia
Authors: Ohn Mar Saw , Malhi Fatehpal , Syed Rahim Syed Hamid , Chua Chin Tong , Sidhu Sarjeet Singh , Sandheep Sugathan
Published: May 2015

This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity ( P < .001), age between 50 and 54 years ( P < .01), lower self-health rating ( P < .05), education level of diploma or professional degree ( P < .05), employment as professionals or entrepreneurs ( P < .05), and the use of hormone replacement therapy ( P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).
Communicating About Water Issues in Australia
Authors: ElSawah Sondoss , McLucas Alan , Mazanov Jason
Published: May 2015

Background. Unlike traditional communication approaches, simulation/gaming has the capacity to communicate about the complexity and uncertainty aspects of managing natural resources in engaging and informative ways.

Purpose. This article aims to present a system dynamics-based framework for using simulation/gaming to communicate about complex water issues

Method. We used communication about water resources issues in the Australian Capital Territory as a case study to support the development and implementation of the modelling framework.

Results. Three scenarios are designed and analysed to challenge the mental models that stakeholders may have about the effects of various water policies.

Contribution. The system dynamics-based simulation/gaming framework contributes to communicating about complex water resources issues.
Watch This! A Guide to Implementing Video Modeling in the Classroom
Authors: Wynkoop Kaylee Stahr
Published: May 2015

The video modeling (VM) teaching strategy is one in which a student watches a video of someone performing a specific behavior, skill, or task and is then expected to complete the behavior, skill, or task. This column discusses the variety of ways in which VM has been documented within the literature and supports teacher interest in the strategy by providing a step-by-step guide to implementing the intervention. Video modeling may have great promise for teaching students with disabilities, particularly those with autism, to acquire new skills across a wide range of skill areas.
Death and the Workplace
Authors: Thompson Neil , Bevan Dan
Published: May 2015

It is well known that bereavement presents major challenges of adjustment to the individuals so affected, but what is much less well recognized is the major challenges bereavement can present to organizations in general and their managers and human resources professionals in particular. This article explores the significance of death for the workplace and argues that organization that fail to give adequate attention to such matters will be poorly placed when it comes to promoting workplace well-being.
Variability and consistency in mechatronic design
Authors: Lettner Daniela , Hehenberger Peter , Nöhrer Alexander , Anzengruber Klaus , Grünbacher Paul , Mayrhofer Michael , Egyed Alexander
Published: May 2015

Mechatronic products combine hardware and software; and today, much of software engineering is directly or indirectly involved to support mechatronic design. Due to the high level of standardization, especially among its hardware, the design of mechatronic products is strongly characterized by integrating standardized components and thus seems an ideal environment for product line engineering techniques, which allow dealing with the variability of reusable components if fully definable a priori. However, while many aspects of mechatronic design are standardized, there is also the need for the continuous construction of new components. However, today, it is difficult to seamlessly integrate the reuse of standardized components with the development of new components. This article presents a model-based approach for integrating component variants with user-defined components to better support the mechatronic design process. We present a combination of existing approaches addressing certain needs of the mechatronic design domain, for example, the integration of components is ensured through incremental consistency checking. Our approach is illustrated using the example of a basic articulated robot.
A Comparative Analysis of the Equity Outcomes in Three Sugarcane–Ethanol Systems
Authors: Hodbod Jennifer , Tomei Julia , Blaber-Wegg Tina
Published: May 2015

This article identifies equity outcomes associated with three biofuel systems in Brazil, Ethiopia, and Guatemala. Acknowledging that winners and losers are socially and politically generated, the article identifies some of the factors behind the distribution of winners and losers along different stages of three sugarcane–ethanol supply chains. Analyzing the outcomes for equity within each case study reveals an uneven distribution that, we argue, is related to the procedure and structure of the given sugarcane–ethanol system, and the recognition of the impacts on different actors within those structures. Increasing equity in sugarcane–ethanol systems will require greater openness in decision-making processes, in order that multiple voices are taken into account in the promotion, production, and consumption of biofuels—particularly those of smaller and less powerful actors.
Prospective, Multicenter Evaluation of Allogeneic Bone Matrix Containing Viable Osteogenic Cells in Foot and/or Ankle Arthrodesis
Authors: Jones Carroll P. , Loveland Jeffrey , Atkinson Brent L. , Ryaby James T. , Linovitz Raymond J. , Nunley James A.
Published: May 2015

Background:

Cellular bone allograft (CBA) possesses osteogenic, osteoinductive, and osteoconductive elements essential for bone healing. The purpose of this study was to assess the safety and effectiveness of CBA in foot and/or ankle arthrodeses.

Methods:

A prospective, multicenter, open-label clinical trial using CBA was performed. At 6 weeks and at 3, 6, and 12 months, imaging was performed and the subject’s pain, function, and quality of life (QOL) status (Visual Analog Scale, American Orthopaedic Foot & Ankle Society Hindfoot Scale, and the Short Form 36) were recorded. The per protocol population consisted of 92 patients at 6 months and 76 patients at 12 months, with 153 and 129 total arthrodeses, respectively.

Results:

At 6 months, fusion rates were 68.5% for all patients and 81.1% for all joints; at 12 months, rates were 71.1% and 86.8%, respectively. Certain high-risk subjects (eg, with diabetes or obesity) had fusion rates comparable to those of normal patients. Statistically significant improvements in pain, function, and QOL were observed, and fusion correlated with both function and QOL outcomes at 6 and 12 months. There were no adverse events attributable to CBA.

Conclusion:

Fusion rates using CBA were higher than or comparable to fusion rates with autograft that have been reported in the recent literature, and CBA fusion rates were not adversely affected by several high-risk patient factors. CBA was a safe and effective graft material to achieve fusion in patients with compromised bone healing and may provide an effective autograft replacement for foot and/or ankle arthrodeses.

Level of Evidence:

Level II, prospective study.
The Métier of Living
Authors: Baldacchino John
Published: May 2015

In art, what appears to be a condition for change is almost always strategically expedient. This is especially the case when one positions art and change within a prosthetic space. Charles Garoian lays claim to this strategy by posing prosthesis as the fourth dimension that follows a third synthetic stage that dialectically binds a thesis to its antithesis. Re-reading Garoian’s claims against the Soviet and Neo-Liberal renditions of Hegel’s theory of the dialectic, this article argues that such claims could reduce art’s space to a prosthetic synthesis that risks pedagogical and aesthetic ossification. Given the performative élan by which Garoian invests education, this appears paradoxical, especially in terms of the personal dimension by which he invests his art as a métier of living and surviving a history that is firmly marked by the devastation of genocide. Strangely, this paradox is what gives us the ability and power by which we could seek a counter- Bildung. As this article’s author puts it, in art, such a counter- Bildung takes the form of unlearning by which one would exit the predicament of instrumental reason. For unlearning to become possible, prosthetic syntheses must be reversed by making of arts education a case for synthetic prostheses. Only then could Garoian’s performative method begin to assert an inverse positioning that would effectively counter the instrumentalization of the dialectic, and with it, that of history and art.
Swarm Intelligence as a Prosthetic Capacity
Authors: Rolling James Haywood
Published: May 2015

Swarm intelligence is the production of generative social space, the agency to “create and open spaces into which existing knowledge can extend, interrelate, coexist, and where new ideas and relationships can emerge prosthetically.” Swarm intelligence is argued to be a liminal, proximal, and distal zone of collective human development wherein memories and experience are made “prosthetic” in both the verb and noun sense of the word—that is, as an adaptive and potentially pedagogical capacity enabling the assimilation of supplemental patterns of behavior and thought, as well as the accommodation of the extant social archaeologies and emerging architectures that might further constitute our identities.
Binge Eating Among Racial Minority Groups in the United States
Authors: Jennings Karen M. , Kelly-Weeder Susan , Wolfe Barbara E.
Published: May 2015

BACKGROUND: Binge eating (BE) is a disordered eating behavior that has been linked to the development of eating disorders and obesity, with the latter being a condition with higher prevalence rates among some racial minority groups. Although researchers have begun to examine characteristics of BE among racial minority groups, it is unclear how these differ from White populations. OBJECTIVE: This article provides an integrative review of published literature within the past decade reporting on the characteristics of BE in minority compared with White racial groups. METHOD: Health care computerized databases were searched using key terms. RESULTS: Eighteen research studies met the inclusion criteria. More than half of the studies reviewed reported racial differences in some aspect of BE; however, heterogeneity in the definition and measurement of BE limits the ability to compare findings across studies. CONCLUSIONS: BE is reported across racial groups. To determine whether meaningful differences in BE exist by race, further studies using the same conceptual and operational definitions of BE are needed.
Valvular Heart Disease and Postoperative Considerations
Authors: Miller Steve , Flynn Brigid Colleen
Published: May 2015

Despite increasing trends in catheter-based cardiac surgical procedures, more than 278 000 Americans had traditional cardiac surgery in 2013. Of those surgical procedures, approximately 133 000 involved valvular repair or replacement. Aortic valve replacement was by far the most common valvular operation, followed by mitral valve repair or replacement. This review article will discuss characteristics of valvular pathologies and postoperative concerns for each the 4 cardiac valves.
Intensive Care Unit Management of Transcatheter Aortic Valve Recipients
Authors: Lo Joyce , Hill Charles
Published: May 2015

Severe aortic stenosis is an increasingly prevalent disease that continues to be associated with significant mortality. Transcatheter aortic valve replacements have been used as an alternative to surgical aortic valve replacement in high-risk patients with multiple comorbidities. In this review, we discuss postoperative considerations pertinent to the successful management of these complicated patients in the intensive care unit.
Routine Postoperative Care of Patients Undergoing Coronary Artery Bypass Grafting on Cardiopulmonary Bypass
Authors: Lighthall Geoffrey K. , Olejniczak Megan
Published: May 2015

The postoperative course of a patient undergoing cardiac surgery (CS) is dictated by a largely predictable set of interactions between disease-specific and therapeutic factors. ICU personnel need to quickly develop a detailed understanding of the patient’s current status and how critical care resources can be used to promote further recovery and eventual independence from external support. The goal of this article is to describe a typical operative and postoperative course, with emphasis on the latter, and the diagnostic and therapeutic options necessary for the proper care of these patients. This paper will focus on coronary artery bypass grafting as a model for understanding the course of CS patients; however, many of the principles discussed are applicable to most cardiac surgery patients.
The Temporal Construal of Customer Satisfaction
Authors: Pizzi Gabriele , Marzocchi Gian Luca , Orsingher Chiara , Zammit Alessandra
Published: May 2015

Traditional customer satisfaction research considers satisfaction judgments invariant to temporal distance. We conduct two experiments and a field study to show that the amount of time elapsed between a service consumption experience and its evaluation influences satisfaction judgments. We show that consumers rely on concrete attributes to represent near-past (NP) experiences and on abstract attributes to represent distant-past (DP) experiences (i.e., different construal levels). The findings indicate that construal mechanisms generate intertemporal shifts in the importance of the attributes driving satisfaction over time (Study 1), in the weights assigned to abstract and concrete attributes of a past service experience (Study 2), and in overall satisfaction judgments when abstract and concrete attributes perform differently (Study 3). Overall, the results provide support for the idea that satisfaction judgments shift over time as a result of the different psychological mechanisms that are activated as a function of the time elapsing between the service experience and its evaluation. Managers are advised to adopt longitudinal approaches to customer satisfaction measurement: An immediate assessment to capture customers’ evaluations of the performance of the concrete details of the experience and a delayed assessment to measure customer satisfaction with more abstract and goal-related features of the experience.
Visual Heteromasculinities Online
Authors: Cover Rob
Published: May 2015

This article presents a critical account of heterosexual men’s online sex webcam performances in terms of the capacity for challenging or disrupting heteronormativity and opening the field for the representation of a greater range of heterosexualities. Using a narrative analysis of selected examples of heterosexual performances on visual sex sites, it is argued that a deeply felt attachment to heterosexual identity coexists in complex, critical, and potentially disruptive ways with a contemporary, online approach to diverse, individualized sexual practices. Investigating examples of male performers who articulate an avowed heterosexual identity but perform acts for a gay male spectatorship and engage in practices such as self-penetration that are discursively marked by nonheterosexuality, this article explores the potential for the productive disruption of normative views of masculine heterosexuality without the need to resort to a free-floating argument for sexual fluidity. It is argued that, while heteronormativity is disrupted in such sites, masculinity has the capacity to reincorporate nonheterosexual behaviors and acts.
Pulmonary cowpox in cats: five cases
Authors: McInerney Jennie , Papasouliotis Kostas , Simpson Kerry , English Kate , Cook Simon , Milne Elspeth , Gunn-Moore Danièlle A
Published: May 2015

Case series summary

This case series documents five cases of pneumonia (with pleural effusion in three cases) caused by cowpox virus (CPxV) in domestic cats. Predisposition to pneumonia may have resulted from mixed infections in two cases (feline herpesvirus and Bordetella bronchiseptica in one cat, and Mycoplasma species in the other).

Relevance and novel information

As well as diagnostic confirmation by previously described methods of virus isolation from skin lesions, and demonstration of pox virions in skin samples using electron microscopy and inclusion bodies in histological preparations, this is the first report of diagnosis by virus isolation from bronchoalveolar lavage fluid or pleural fluid, and demonstration of inclusion bodies in cytological preparations. This is also the first series to report treatment with interferon omega (IFN-ω). Two cats survived, both of which had been treated with IFN-ω. As CPxV represents a serious zoonotic risk it is an important differential diagnosis of pneumonia in cats.
Airflow characteristics generated by fabric air dispersion ventilation
Authors: Wang Xiaoli , Li Angui
Published: May 2015

The air distribution characteristics of a fabric air dispersion system (FADS) were investigated experimentally in a full-scale chamber. The jet supply velocity and outlet orientation were selected as the major factors that affect the FADS airflow field. The FADS airflow structure was described and verified in a visualization experiment and compared with the air patterns of the traditional rectangular, circular nozzle and linear slot diffusers. The induction and flow junction phenomena were analysed under different combinations of outlet orientations. Experimental results showed that this induction phenomenon can create more airflow patterns and that the FADS can meet different requirements in practical engineering. The turbulence intensity of the air supply orifices, the maximum velocity decay, and the self-similarity of the velocity profiles were examined through velocity field measurements. Our research illustrated the advantages of two-dimensional flow characteristics of the FADS model that can be treated as a plane free jet in the developed region. The phenomenon we studied should provide useful guide for the application of the FADS to heating, ventilation, and air-conditioning systems.
Building Relationships with diverse students and families: A funds of Knowledge Perspective
Authors: Reyes Iliana , Da Silva Iddings Ana Christina , Feller Nayalin
Published: May 2015

The purpose of this study was to examine how preservice teachers, from a funds of knowledge perspective, in a community-based early childhood teacher preparation programme learned about the language and (bi)literacy development of young English emergent bilinguals. Through a series of in-depth home observations their early childhood education (ECE) coursework preservice teachers reflected on young children's literacy learning and family literacy practices. We followed case studies of six participating preservice teachers who were placed with families with children enrolled in preschool programmes as part of their field experience. A research team composed of two university professors and two graduate students gathered a variety of data during one academic year. Data sources include field notes, video and audio recordings and children's emergent literacy samples from six family home interactions by the preservice teachers with their assigned case study families. During these family home visits, preservice teachers conducted observations and documented their respective case study child's language development and the family's literacy practices. The focus of the analysis entailed an ongoing examination of how preservice teachers' reflections and the home family literacy interactions helped deepen their understanding of funds of knowledge and cultural practices. We found that their extensive and consistent experiences, interacting with the families for one academic year, allowed them to reflect on how their views of those interactions had evolved. In all cases, the preservice teachers we interviewed commented on how they appreciated having the opportunity to interact with the children, their parents and family in various nonschool-related contexts. For these preservice teachers, there was gradual, uneven and continuous learning about funds of knowledge that challenged the ways and possibilities of embracing this perspective as part of their professional experience.
The analytical–Continental divide: Styles of dealing with problems
Authors: Donahue Thomas J. , Ochoa Espejo Paulina
Published: May 2015

What today divides analytical from Continental philosophy? This paper argues that the present divide is not what it once was. Today, the divide concerns the styles in which philosophers deal with intellectual problems: solving them, pressing them, resolving them, or dissolving them. Using ‘the boundary problem’, or ‘the democratic paradox’, as an example, we argue for two theses. First, the difference between most analytical and most Continental philosophers today is that Continental philosophers find intelligible two styles of dealing with problems that most analytical philosophers find unintelligible: pressing them and resolving them. Second, when it comes to a genuine divide in which not understanding the other side’s basic philosophical purposes combines with disagreement on fundamental questions of doctrine, the only such divide today is that between those analytical philosophers who tend to solve problems and those Continental philosophers who tend to press problems (roughly, the heirs of Derrida). It is among these subgroups that there is a real philosophical divide today. So the analytical–Continental divide is more a matter of style than of substance; but as we try to show, differences in style shape differences over substance.
Mental Health Consequences of Childhood Physical Abuse in Chinese Populations
Authors: Ip Patrick , Wong Rosa S. , Li Sophia L. , Chan Ko Ling , Ho Frederick K. , Chow Chun-bong
Published: May 2015

Objective:

Childhood physical abuse (CPA) can lead to adverse mental health outcomes in adulthood, but its potential impact on Chinese populations is still unclear. This meta-analysis is the first to examine the association between CPA and mental health outcomes in Chinese populations.

Study Design:

Studies published before December 31, 2014 were identified from Embase, CINAHL, Scopus, PsycINFO, PubMed, and Chinese National Knowledge Infrastructure databases. Studies with data on the association between CPA and mental health outcomes from Chinese subjects were included. Twenty-four studies were initially identified but two were excluded because of poor quality. Two reviewers independently extracted data to generate summary effect sizes using a random-effects meta-analytic model. A priori subgroup and sensitivity analyses were performed to evaluate heterogeneity and bias in these studies.

Results:

Our meta-analysis of 22 studies found a significant positive association between CPA and overall mental health outcomes among all Chinese subjects (pooled effect size: odds ratio [ OR] = 2.16, 95% confidence interval [CI] = [1.87, 2.49]) and among community samples (pooled effect size: OR = 2.06, 95% CI [1.71, 2.48]). Based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria, CPA was more strongly associated with Axis II ( OR = 2.62, 95% CI [2.13, 3.22]) than Axis I disorders ( OR = 1.85, 95% CI [1.58, 2.17]).

Conclusions:

The detrimental effects of CPA on mental health outcomes in Chinese populations were comparable to, if not more than, the West. Contrary to the Chinese belief that physical punishment is a safe way to discipline children, our findings highlight the potential harm to mental health and the need to change this parenting practice.
The Circadian Gene Clock Plays an Important Role in Cell Apoptosis and the DNA Damage Response In Vitro
Authors: Wang Fan , Li Caiyan , Yongluo  , Chen Lvan
Published: May 2015

The Clock gene, an indispensable component of the circadian clock, not only modulates circadian oscillations but also regulates organismal function. We examined whether silencing the expression of the human Clock gene in glioma cells influences cell growth and induces apoptosis after irradiation. Silencing the expression of Clock in a human glioma cell line (U87MG), but not in a control glioma cell line, resulted in increased apoptosis and cell cycle arrest. Moreover, silencing Clock expression altered the expression of apoptosis-related genes. The protein levels of c-Myc and Cyclin B1 were downregulated, but those of p53 were upregulated, in human Clock-silenced U87MG cells compared with control cells. Our results suggest that the circadian gene human Clock may play an important role in carcinogenesis by inhibiting apoptotic cell death via attenuating proapoptotic signaling.
Dilemmas of a Newly Recruited Academic Qualified Professor
Authors: Agrawal Anand
Published: May 2015

This case describes the situation of a newly recruited academic professor who volunteered to teach a course on Research Methods to first-term MBA students in a practitioner-oriented case method Business School. Research Methods is a unique course due to its relevance not only in business but also across all graduate programs. Instructional and managerial concerns highlighted in the case relate to new faculty member orientation, course allocation, and contrary teaching philosophies of different professors in a school that are relevant for educational leaders. The need to analyze this case from the perspectives of both the professor and the dean makes it not only interesting but also useful for management teams in higher education institutes that are responsible for change management.
What’s Under Your Bed? A Fundraising Fiasco
Authors: Carver Cynthia L. , Klein C. Suzanne , Gistinger Maria A.
Published: May 2015

Student clubs and sports often struggle to raise funds. With limited revenue streams, coaches or advisors and parents routinely find themselves managing candy sales, car washes, raffles, and ticketed fundraisers to support programming. In this case of a swim team fundraiser, school leaders see the range of problems that can occur when a routine practice—extracurricular fundraising—goes awry. With Cressey’s fraud triangle as a backdrop, readers learn to deter and prevent financial mismanagement and fraud through the development of internal operating procedures and oversight.
Mothers of Sexual Assault Victims
Authors: Clevenger Shelly
Published: May 2015

The sexual assault of a child has a profound impact on not just the child, but those closest to them. This research examined the ways that women react and cope with the sexual assault of their child within the framework of their role as mothers, or how they are able to “do mother” in the aftermath of the assault. A total of 21 mothers who had a child sexually assaulted were interviewed across the state of Illinois. The experiences of these women are presented and discussed within the feminist literature regarding the societal role of mother.
Transvenous embolization of cavernous sinus dural arteriovenous fistula through a thrombosed inferior petrosal sinus utilizing 3D venography
Authors: Srivatanakul Kittipong , Osada Takahiro , Aoki Rie , Sorimachi Takatoshi , Matsumae Mitsunori
Published: May 2015

Objective

We report a new technique in approaching the cavernous sinus through an occluded inferior petrosal sinus (IPS) using three-dimensional (3D) venography.

Case presentation

A patient diagnosed with arteriovenous fistula of the right cavernous sinus underwent transvenous embolization. The IPS was not detectable on angiogram. Retrograde injection of contrast with 3D imaging of the internal jugular vein clearly demonstrated the remnant of the IPS. By referring to the images obtained, catheterization of the cavernous sinus by way of the IPS was performed without difficulties.

Conclusion

Three-dimensional venography for detecting the entrance to the IPS is a useful method and easy to perform. We believe that this technique should be considered whenever the access to an occluded IPS is necessary.
Perspectives on endovascular training in traditional 5+2 vascular surgery fellowship training programs
Authors: Carruthers Thomas N , Shahmohammadi Kaveh , Farber Alik , Rybin Denis , Doros Gheorghe , McPhee James T , Kalish Jeffrey E , Eslami Mohammad H
Published: May 2015

This study aimed to compare expectations and experiences of fellows to those of faculty in vascular surgery fellowship programs with regard to endovascular training. Anonymous surveys were sent to fellows (n = 235) and program directors (n = 147), with 79 fellows and 65 faculty members responding. Fellows noted higher expectations of their endovascular skills prior to starting fellowship than the faculty group reported expecting. Faculty assessed fellows' pre-training endovascular skills at a significantly lower level than the fellows' self-assessment. Fellows were significantly less satisfied with the structured aspects of endovascular training than the faculty believed them to be. Only 3% of fellows vs. 32% of faculty felt that the presence of an endovascular simulator affected how residents ranked fellowship programs during the match. In conclusion, incoming fellows in vascular surgery fellowship programs have high expectations of themselves, but may overestimate their actual pre-training endovascular skills. Fellows desire more structured endovascular training, which is not recognized by faculty. Endovascular simulators are valued, but may not be a significant draw in the match process.
Assessing treatment effects with surrogate survival outcomes using an internal validation subsample
Authors: Zee Jarcy , Xie Sharon X ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: May 2015

Background

In studies with surrogate outcomes available for all subjects and true outcomes available for only a subsample, survival analysis methods are needed that incorporate both endpoints in order to assess treatment effects.

Methods

We develop a semiparametric estimated likelihood method for the proportional hazards model with discrete time data and a binary covariate of interest. Our proposed method allows for real-time validation of surrogate outcomes and flexible censoring mechanisms.

Results

Our proposed estimator is consistent and asymptotically normal. Through numerical studies, we showed that our proposed method for estimating a covariate effect is unbiased compared to the naïve estimator that uses only surrogate endpoints and is more efficient with moderate missingness compared to the complete-case estimator that uses only true endpoints. We further demonstrated the advantages of our proposed method in comparison with existing approaches when there is real-time validation. We also illustrated the use of our proposed method by estimating the effect of gender on time to detection of Alzheimer’s disease using data from the Alzheimer’s Disease Neuroimaging Initiative.

Conclusion

The proposed method is able to account for the uncertainty of surrogate outcomes using a validation subsample of true outcomes in estimating a binary covariate effect. The proposed estimator can outperform standard semiparametric survival analysis methods and can therefore save on costs of a trial or improve power in detecting treatment effects.
The ethics of metaphor as a research tool
Authors: Manhas Kiran Pohar , Oberle Kathleen
Published: May 2015

The interpretive and subjective nature of qualitative research has led to growing utilization of arts-based strategies for data collection, analysis and dissemination. The defining characteristic of all such strategies is that they are largely subjective and intended to invoke personal responses in the ‘audience.’ Following that direction, many qualitative researchers are using metaphor to capture themes emerging from their analysis. In this article, we explore ethical aspects of using metaphor in describing results of qualitative health research and illustrate some of the complexities using a case study of research conducted by one of the authors. Our analysis is designed to sensitize researchers and ethics reviewers to some unique ethical issues inherent to this approach towards data analysis and presentation. Issues related to participant dignity, respect and vulnerability led us to suggest that researchers should take these points into consideration in designing their research and seeking informed consent. Metaphors can be linguistic devices, but also conceptual aids that help develop patterns in analysis or that facilitate re-interpretation. However, there is a thin line between artistic licence for better expression and distorting the participants’ actual experience and meanings. Researchers, and reviewers, must be aware of the danger to participant dignity and integrity when aesthetics overshadow actuality. The use of metaphor may also trigger tensions between researchers and participants, especially if member checking is used. The implications of participant withdrawal must be considered and conveyed to ethics reviewers and participants. It is important to have a plan in place for dealing with some of these issues. These should be detailed in the proposal and communicated to participants. Institutional research ethics boards should, on their part, be prepared to ask questions if such details are lacking in the proposal.
From obedience to contagion: Discourses of power in Milgram, Zimbardo, and the Facebook experiment
Authors: Recuber Timothy
Published: May 2015

When the public outcry concerning the ‘Facebook experiment’ began, many commentators drew parallels to controversial social science experiments from a prior era. The infamous Milgram (1963) and Zimbardo (1973) experiments concerning the social psychology of obedience and aggression seemed in some ways obvious analogs to the Facebook experiment, at least inasmuch as all three violated norms about the treatment of human subjects in research. But besides that, what do they really have in common? In fact, a close reading of Milgram, Zimbardo, and the Facebook experiment reveals something about the way power—both as a subject of scholarly inquiry and as an element wielded by researchers—is conceptualized today. Although all three experiments were, in essence, measuring the researchers’ ability to induce an emotional or behavioral change in subjects, the Facebook experiment did much more than the others to hide such considerations and naturalize the exercise of power at work in that study. This paper thus argues that the invisibility of power in the discourse of the Facebook experiment demonstrates, in miniature, the more insidious elements of big data as a whole.
Type 1 innate lymphoid cells contribute to the pathogenesis of chronic hepatitis B
Authors: Yang Zhiqing , Tang Tengqian , Wei Xiaolin , Yang Shuang , Tian Zhiqiang
Published: May 2015

Innate lymphoid cells (ILCs) function in producing effector cytokines in response to pathogenic infections. However, the roles and related mechanisms of the ILC subpopulations, ILC1 and ILC2, which mirror Th1 and Th2 in adaptive immunity, remain unclear. In this study, we found the markedly elevated levels of the ILC1 transcription factor T-bet, the effector cytokine IFN-γ and the IL/receptor signaling molecules IL-12/IL-12R, which are indispensable for ILC1 differentiation, in the helper ILCs of chronic hepatitis B (CHB) patients. The elevated level of the ILC1 population was significantly associated with hepatic damage in CHB patients, and was not related to telbivudine treatment. In contrast, although we also observed elevated levels of ILC2-related factors, including IL-33, ST2, GATA3 and IL-13 in helper ILCs, the extent of elevation shown by each was lower than that shown by the ILC1-related factors. Furthermore, the activity of the ILC2s did not correlate with either HBV copies or liver damage. The findings of this study suggest potential pro-inflammatory roles for ILC1s in CHB pathogenesis, potentiating these cells and their related molecules as targets of diagnostic, prognostic and/or therapeutic strategies for hepatitis B.
Prescribing in end of life care
Authors: Campbell Rachel , Watson Professor Max
Published: May 2015

Prescribing drugs for patients at the end of life can be fraught with difficulties. Treatment goals change and new medications are introduced that are not used regularly by GPs. A good understanding of prescribing in the palliative care setting is an essential component of delivering high-quality care to those approaching the end of life. Pertinent to general practice is the reality that GPs may experience times when they have very few ‘palliative’ patients. Conversely, there are periods when a GP may have several complex patients who require end of life care and consequently a GP may have to ‘skill up’ very rapidly.
Docetaxel and its potential in the treatment of refractory esophagogastric adenocarcinoma
Authors: Ford Hugo , Gounaris Ioannis
Published: May 2015

Adenocarcinomas of the esophagus and stomach are a major cause of cancer-related morbidity and mortality worldwide. For patients with advanced disease, first-line chemotherapy with platinum–fluoropyrimidine combinations prolongs survival, but inevitably the disease progresses with a median progression-free survival of approximately 6 months. At the time of progression, approximately 40–50% of patients remain fit and eligible for second-line treatment. Docetaxel has been extensively studied in this chemorefractory setting, mostly in small single arm studies, either as a single agent or in combination with platinum agents, fluoropyrimidines or anthracyclines. However, two randomized controlled trials published since 2012 have convincingly shown that treatment with docetaxel modestly prolongs survival compared with best supportive care alone. Moreover, treatment with docetaxel is associated with relief from cancer-related constitutional and gastrointestinal symptoms with manageable, predominantly haematological, toxicity. Therefore, it represents a valuable treatment option for patients with relapsed esophagogastric cancer. Nevertheless, in view of the short survival time for the majority of these patients, further research is necessary to identify, on the one hand, combinations with targeted agents that will further improve outcomes and, on the other, biomarkers that will allow selection of those patients most likely to benefit.
Which assessment tools address the categories of the Brief ICF Core Set for Hand Conditions?
Authors: van de Ven-Stevens Lucelle AW , Kus Sandra , Graff Maud , Geurts Alexander CH
Published: May 2015

Introduction

The purpose of this study was to explore whether assessment tools address aspects that are relevant according to the Brief ICF Core Set for Hand Conditions (BICF-CS).

Methods

Assessment tools meant to assess functioning and/or environmental factors in adults with hand conditions were reviewed. MEDLINE and CINAHL databases, previously published reviews, the book Clinical Assessment Recommendations of the ASHT, and websites of assessment tools were used for the content comparison and linking to the 23 categories of the BICF-CS. The updated version of the linking rules was applied by two reviewers.

Results

Forty-six assessment tools, known within the areas of hand therapy and hand surgery, were linked to the 23 categories of the BICF-CS. Regarding Body functions and body structures, the categories that were most frequently addressed were b730 “Muscle power functions,” b280 “Sensation of pain,” b710 “Mobility of joint functions, ” and s730 “Structure of upper extremity. ” Regarding Activities and Participation, d440 “Fine hand use” was addressed mostly and 25 assessment tools (with a total of 146 items) were linked to this category. Regarding Environmental Factors, only one assessment tool was identified that could be linked to two categories. Fifteen points of discussion were encountered in the linking process.

Conclusions

Content comparison of 46 assessment tools revealed that 19 of the 23 categories of the BICF-CS were addressed. The environmental factors were hardly addressed.
Cortical desmoids in adolescent top-level athletes
Authors: Tscholl Philippe M , Biedert Roland M , Gal Imre
Published: May 2015

Two adolescent, highly active athletes are presented with unspecific symptoms of anterior knee pain. Conventional radiographs and magnetic resonance imaging (MRI) showed a suspicious but pathognomonic cortical irregularity of the dorsal, medial femoral condyle. Cortical desmoid is one of the most common incidental osseous findings on conventional radiographs and MRI of the knee. It often needs no follow-up examination in asymptomatic patients. Malignancy needs however to be ruled out.
Cold spray deposition of hydroxyapatite powder onto magnesium substrates for biomaterial applications
Authors: Hasniyati M. , Zuhailawati H. , Sivakumar R. , Dhindaw B. K. , Noor S. N. F. M.
Published: May 2015

A simple, modified, cold spray process was developed in which hydroxyapatite powder was coated onto pure magnesium substrates preheated to 350 or 550°C and ground to either 240 or 2000 grit surface roughness, with stand-off distances of 20 or 40 mm. The procedure was repeated five and 10 times. The hydroxyapatite coatings did not show any phase changes. Atomic force microscopy revealed a uniform coating topography, and scanning electron microscopy revealed good bonding between the coated layers and the substrates. As the p values were < 0·05, all factors except the number of sprays were considered to be significant. The response optimiser indicated that a 22·7 mm stand-off distance, a 649·2 grit surface roughness and a 496°C substrate heating temperature produced good hydroxyapatite coatings of 46·3 μm thickness, 436·5 MPa nanohardness and 43·9 GPa elastic modulus. The modified cold spray technique with substrate heating showed promising results in terms of product coating thickness and mechanical properties.
Preliminary study of cold spraying using radial supersonic nozzle
Authors: Klinkov S. V. , Kosarev V. F. , Zaikovskii V. N.
Published: May 2015

The paper deals with the problem of coating production on internal pipe surfaces by the cold spraying. It reports on a new assembly design with a radial supersonic nozzle that greatly facilitates the application of aluminium, copper and nickel coatings onto internal pipe surfaces. Visualisation and Pitot tube measurements of the airflow produced by the nozzle assembly assist to predict the range of internal pipe diameters, in which the pipes could be successfully coated from the inside using the designed instrument. The velocity of aluminium particles has been measured at the exit from the radial nozzle and calculated the particle velocities under the actual cold spray conditions. Finally, the mass and energy consumption characteristics of the process and the deposition efficiencies achievable under typical experimental conditions have been calculated. Those calculations have allowed us to evaluate the cost of potential introduction of the cold spray process into pipe production.
Inhibition of G9a methyltransferase stimulates fetal hemoglobin production by facilitating LCR/γ-globin looping
Authors: Krivega Ivan , Byrnes Colleen , de Vasconcellos Jaira F. , Lee Y. Terry , Kaushal Megha , Dean Ann , Miller Jeffery L.
Published: May 2015

Key Points

The G9a methyltransferase inhibitor UNC0638 increased pancellular expression of HbF to levels greater than 30% in adult human erythroblasts. UNC0638 altered globin locus epigenetic status/protein occupancy favoring LCR interaction with fetal genes at the expense of adult genes.
Staging of lung cancer: the role of noninvasive, minimally invasive and invasive techniques
Authors: Stamatis Georgios
Published: May 2015

Accurate staging and restaging of primary tumour and mediastinal nodes in patients with lung cancer is of significant importance. For primary tumours, computed tomography (CT) scans of the chest are recommended. Positron emission tomography (PET) imaging should be used in patients with curative intent treatment to evaluate metastatic disease. Diagnosis of the primary tumour should be performed using bronchoscopy or CT-guided transthoracic needle aspiration. In patients with enlarged mediastinal nodes and no distant metastasis, invasive staging of the mediastinum is required. For suspicious N2 or N3 disease, endoscopic needle techniques, such as endobronchial ultrasound and transbronchial needle aspiration, oesophageal ultrasound and fine needle aspiration, or a combination of both, are preferred to any surgical staging technique. In cases of suspicious nodes and negative results using needle aspiration techniques, invasive surgical staging using mediastinoscopy or video-assisted thoracic surgery should be performed. In central tumours or N1 nodes, preoperative invasive staging is indicated.

Restaging after induction therapy remains a controversial topic. Today, neither CT, PET nor PET/CT scans are accurate enough to make final further therapeutic decisions for mediastinal nodal involvement. An invasive technique providing cytohistological information is still recommended.