bluuebunny/crossref_metadata_2025 huggingface dataset:
Carotid Stenting
Authors: Calvet David , Mas Jean-Louis , Algra Ale , Becquemin Jean-Pierre , Bonati Leo H. , Dobson Joanna , Fraedrich Gustav , Jansen Olav , Mali Willem P. , Ringleb Peter A. , Chatellier Gilles , Brown Martin M. ,   Carotid Stenting Trialists’ Collaboration (CSTC)—Writing Committee:, Calvet D. , Mas J.-L. , Algra A. , Becquemin J.-P. , Bonati L.H. , Dobson J. , Fraedrich G. , Jansen O. , Mali W.P. , Ringleb P.A. , Chatellier G. , Brown M.M. ,   Steering Committee:, Algra A. ,   EVA-3S:, Becquemin J.P. , Chatellier G. , Mas J.-L. ,   SPACE:, Fraedrich G. , Ringleb P.A. , Jansen O. ,   ICSS:, Bonati L. H. , Brown M. M. , Mali W. P. ,   Steering Committees of trials included in CSTC: EVA-3S:, Mas J.-L. , Chatellier G. , Becquemin J.-P. , Bonneville J.-F. , Branchereau A. , Crochet D. , Gaux J. C. , Larrue V. , Leys D. , Watelet J. ,   SPACE:, Hacke W. , Hennerici M. , Allenberg J.R. , Maurer P.C. , Eckstein H.-H. , Zeumer H. , Jansen O. ,   ICSS:, Algra A. , Bamford J. , Beard J. , Bland M. , Bradbury A.W. , Brown M.M. , Clifton A. , Gaines P. , Hacke W. , Halliday A. , Malik I. , Mas J.-L. , McGuire A.J. , Sidhu P. , Venables G.
Published: December 2013

Background and Purpose—

Randomized clinical trials show higher 30-day risk of stroke or death after carotid artery stenting compared with surgery. We examined whether operator experience is associated with 30-day risk of stroke or death in the Carotid Stenting Trialists’ Collaboration database.

Methods—

The Carotid Stenting Trialists’ Collaboration is a pooled individual patient database including all patients recruited in 3 randomized trials of stenting versus endarterectomy for symptomatic carotid stenosis (Endarterectomy Versus Angioplasty in patients with Symptomatic Severe Carotid Stenosis trial, Stent-Protected Angioplasty versus Carotid Endarterectomy trial, and International Carotid Stenting Study). Lifetime carotid artery stenting experience, lifetime experience in stenting procedures excluding the carotid, and annual number of procedures performed within the trial (in-trial volume), divided into tertiles, were used to measure operator experience. The outcome event was the occurrence of any stroke or death within 30 days of the procedure. The analysis was done per protocol.

Results—

Among 1546 patients who underwent carotid artery stenting, 120 (7.8%) had a stroke or death within 30 days of the procedure. The 30-day risk of stroke or death did not differ according to operator lifetime carotid artery stenting experience (
P
=0.8) or operator lifetime stenting experience excluding the carotid (
P
=0.7). In contrast, the 30-day risk of stroke or death was significantly higher in patients treated by operators with low (mean ≤3.2 procedures/y; risk 10.1%; adjusted risk ratio=2.30 [1.36–3.87]) and intermediate annual in-trial volumes (3.2–5.6 procedures/y; 8.4%; adjusted risk ratio=1.93 [1.14–3.27]) compared with patients treated by high annual in-trial volume operators (>5.6 procedures/y; 5.1%).

Conclusions—

Carotid stenting should only be performed by operators with annual procedure volume ≥6 cases per year.
Reconceptualising the Child’s Right to Development: Children and the Capability Approach
Authors: Peleg Noam
Published: December 2013

The article proposes adopting the Capability Approach as a theoretical framework to analyse the child’s right to development. Currently, the child’s right to development is realised as the child’s right to become an adult. This interpretation is problematic on several grounds, primarily its usage of developmental psychology as an underlying narrative to conceptualise childhood and interpret children’s rights, and its lack of respect for children’s agency. Using the Capability Approach’s conception of ‘human development’ as an alternative framework can change the way in which childhood and children’s development are conceptualised and, consequently, change the interpretation of the child’s right to development. It can accommodate simultaneously care for the child’s future and the child’s life at the present; promote respect for a child’s agency and active participation in her own growth; and lay the foundations for developing concrete measures of implementation.
Understanding and Controlling Violence Against the Judiciary and Judicial Officials
Authors: Weiner Neil Alan , Hardenbergh Don
Published: December 2013

According to every available measure, the American judiciary has been and is under attack. Yet there is no research that adequately conceptualizes or explains this violence. There are, however, a number of related ways of examining such violence that seem promising in their capacity to yield basic insights. They also seem promising with respect to their control implications. First, the concepts of institution and workplace provide useful general organizing ideas for advancing our understanding. Second, the environmental and rational-choice approaches provide useful, specific organizing ideas for understanding targeted judicial violence and are also potentially useful approaches for understanding associated nontargeted judicial violence. Third, the protective perspective provides an important way of thinking about and integrating the general and specific organizing ideas into protective operations that can enhance judicial safety. Finally, the protective perspective represents a blend of criminal justice and public health perspectives on the origins and control of violence.
Violence in the Judicial Workplace
Authors: Harris Donald J. , Kirschner Charlotte L. , Rozek Kristina Klatt , Weiner Neil Alan
Published: December 2013

This article reports on a survey of judicial safety conducted in 1999 by the Administrative Office of Pennsylvania Courts. The survey quantified the various types of threats and acts of violence against judges, both inside and outside the courthouse, that occurred within the previous year as the result of discharging official responsibilities. Related questions were asked about law enforcement notification, the degree of physical injuries sustained, and the extent to which such incidents led judges to alter their conduct of judicial business. The statistical data are supplemented with qualitative information from structured, in-depth interviews with a diverse set of judges. A thematic approach was taken in examining the judges' interview responses, from which emerged a series of shared conceptions regarding the causes of violence against judicial officers; the adaptations of court personnel exposed to the risk of harm; and the impediments to effective protection. Conclusions are drawn regarding the state of security in the judicial workplace along with suggestions for future research.
Architectural Design for Security in Courthouse Facilities
Authors: Griebel Michael , Phillips Todd S.
Published: December 2013

There are more than 3000 courthouses in the United States. Even with the recent nationwide emphasis on court facility planning and construction, many courthouses today still are poorly planned to accommodate current security measures and requirements. The design of court facilities is a unique challenge. At the highest level, court security has a simple purpose: to protect the integrity of court processes and proceedings by providing a safe and secure environment. It is critical that courts not be prevented from administering justice. Key elements of physical security discussed in this article include site perimeters and security requirements; security of sensitive areas adjacent to the courthouse; courthouse building design; appropriate location; security needs of the various courts, agencies, and special uses within the courthouse; and an overview of selected security technologies used by security personnel and court staff.
Demonstrating and Assessing Metered-Dose Inhaler–Spacer Technique
Authors: Reznik Marina , Jaramillo Yudilyn , Wylie-Rosett Judith
Published: December 2013

The National Asthma Education and Prevention Program recommends that providers demonstrate and assess metered-dose inhaler–spacer (MDI-S) technique at each medical visit. To examine practice behaviors and perceived barriers to demonstrating and assessing MDI-S technique, we surveyed pediatric providers (n = 114) at an inner-city academic medical center. While 82% of providers demonstrated MDI-S technique, only 5% of providers demonstrate the technique at every visit. Although 67% of providers assessed MDI-S technique, only 13% assess the technique at every visit. None of the providers used MDI-S checklist for assessment. Attendings were more likely than residents to demonstrate with illustrations (24% vs 6%, P = .01) and when patient’s asthma was not well controlled (68% vs 47%, P = .05). Provider-identified barriers included limited access to MDI-S device, lack of time, and inadequate knowledge. Suggestions to address barriers include in-service training, device access, and nurse/health educators to alleviate the time constraints. Clinic modifications and education are needed.
Political consumerism and the decline of class politics in Western Europe
Authors: Ferrer-Fons Mariona , Fraile Marta
Published: December 2013

This article examines whether social class influences the likelihood of engaging in political consumerism in Western Europe. Political consumption is the intentional buying or abstention from buying (boycotting) specific products for political, ethical, or ecological reasons. The interest in analyzing political consumerism lies in substantive and theoretical reasons. First, it is a widespread but not very adequately studied form of noninstitutionalized political participation. Second, various theories claim that class is an inadequate category for explaining political behavior. According to the postmodern theory of social stratification, patterns of consumption are among the key factors that define the new status communities, thus breaking with the traditional logic of social classes. Along the same lines, individualization theory suggests that in contemporary societies, individuals are free to continuously redefine their identity and choose the lifestyle they prefer. We argue that the study of political consumption offers a particularly appropriate case for testing the empirical plausibility of the hypothesis of the ‘decline of class politics’. Multilevel analysis using European Social Survey data reveals, contrary to the above-mentioned postulates, that social class strongly affects the likelihood of being one’s a political consumer.
The storyteller function in contemporary Nigerian narrative
Authors: Krishnan Madhu
Published: December 2013

This paper considers the articulation of orality in contemporary Nigerian writing, focusing on Helon Habila’s Measuring Time (2007) and Chris Abani’s Song for Night (2008), asserting that, through the manipulation of collective engagement in meaning-making, each text functions as a contemporary griot, or repository of communal, cultural history. In contrast to earlier generations’ writing, which relied on the use of folktale, proverb, and linguistic techniques to forge a connection to the oral tradition, contemporary Anglophone African writers, this article argues, inscribe the oral tradition into their work through an epistemic shift that engages with the open signifiers of the communal, highlighting the storyteller function of their works. Both Habila’s and Abani’s novels thus occupy a discursive space which straddles registers, and both function through the art of the storyteller as a means of translating modes of collective address, foregrounding the very act of narration through their textual frames. From these foundational qualities, each work marks a contribution to, and departure from, ongoing debates surrounding the status of orality and writing as a means of cultural memorialization in global Anglophone African literature, a debate made fraught in no small part due to each discursive system’s implication with Enlightenment-driven conceptions of civilization and modernity.
Synthesis and characterisation of poly (lactic acid)/halloysite bionanocomposite films
Authors: De Silva RT , Pasbakhsh Pooria , Goh KL , Chai S-P , Chen J
Published: December 2013

Poly (lactic acid) (PLA)/natural halloysite nanotubes (HNTs) films were prepared by solution casting method to investigate their properties for packaging applications. Tensile test results revealed that the maximum tensile elastic modulus (1.40 ± 0.05 GPa) and tensile strength (52.75 ± 1.80 MPa) were achieved at 5 w/w % of HNTs (in a range of 0–10 w/w % HNT concentrations). A nanoindentation test was performed to confirm the reinforcing effect of HNTs. Analysis of electron micrographs of the fracture surfaces suggested that the reinforcing mechanism was subjected to the interfacial interaction between HNTs and PLA. Infrared spectra revealed that the end hydroxyl groups of PLA chemically interacted with HNTs’ outer surface siloxane groups via hydrogen bonding. In addition, the contact angle test and thermogravimetric analysis were used to investigate the surface wettability and thermal stability of the PLA/HNT films, respectively.
Controlled impact testing of woven fabric composites with and without reinforcing shape-memory alloy wires
Authors: Sofocleous Katerina , Ogin Stephen L , Tsakiropoulos Panos , Draconakis Vassilis , Doumanidis Charalabos
Published: December 2013

Shape-memory alloy composites are relatively new materials and their behaviour is not yet completely understood. The purpose of this work is to minimise the effect of impact damage on their structural performance. To do that, GFRP woven fabric reinforced epoxy composite panels, with and without additional superelastic shape-memory alloy wires, have been impacted at constant velocities using a servo-hydraulic testing machine, and a digital video camera has been used to monitor the impact event. Single, multiple and partial penetration impact tests have been carried out, and the energy absorption and damage development are similar in all cases for the same material. The benefit of using the superelastic shape-memory alloy wires was seen only at high displacements and when the volume fraction of the wires was high.
AC-impedance and dielectric properties of hybrid polymer composites
Authors: Elimat ZM
Published: December 2013

The AC-impedance and dielectric properties of hybrid polymer composites made up of epoxy (diglycidyl ether of bisphenol-A) matrix filled with various zinc oxide concentrations (0, 4.9, 9.9, 14.9 and 19.9 wt%) and reinforced with conductive carbon black nanoparticles (0.1 wt%) have been investigated as a function of fillers concentrations, applied frequency in the range from 20 kHz to1 MHz and temperature in the range from 30℃ to 110℃. The observed data were analyzed using the dielectric permittivity and electric modulus formalisms (i.e. the inverse quantity of complex permittivity). The dielectric constant of the composites increases with increasing temperature and filler concentrations, and this case can be explained by hopping and tunneling processes. The AC-conductivity is apparently enhanced with increasing frequency, temperature, zinc oxide and carbon black fillers. The observed increase in the AC conductivity was explained based on the concept of conductive paths and connections between the zinc oxide–particles and the conductive carbon black–nanoparticles. The activation energy has been estimated from fitting the AC conductivity–temperature data and it was found that it is decreased by the addition of the zinc oxide content in the epoxy matrix reinforced with carbon black, which means that the composites have better electrical conduction. The scanning electron microscopy images revealed that the dispersed zinc oxide-particles and carbon black-nanoparticles were randomly distributed within the epoxy matrix with some paths and surface contacts between the fillings. It was found that the addition of carbon black nanoparticles to epoxy/zinc oxide composites enhances the electrical conduction due to the electronic and impurity contributions.
Minimizing the creep of recycled polypropylene/rubberwood flour composites with mixture design experiments
Authors: Homkhiew Chatree , Ratanawilai Thanate , Thongruang Wiriya
Published: December 2013

Composites of rubberwood flour (RWF) and recycled polypropylene (rPP) were produced into panel samples by using a twin-screw extruder. The effects on creep behavior of mixture fractions of rPP, RWF, maleic anhydride-grafted polypropylene (MAPP), and ultraviolet (UV) stabilizer were studied in a D-optimal mixture design. Creep was significantly affected by the composition. Increasing the fraction of RWF decreased creep, while MAPP and UV stabilizer increased it. The models fitted were used to optimize a desirability score that balanced multiple creep characteristics. The model-based optimal formulation 50.5 wt% rPP, 44.9 wt% RWF, 3.5 wt% MAPP, 0.1 wt% UV stabilizer, and 1.0 wt% lubricant was experimentally validated to have low creep closely matching the model predictions.
Free vibration of laminated orthotropic conical shell on Pasternak foundation by a domain decomposition method
Authors: Wu Shihao , Qu Yegao , Hua Hongxing
Published: December 2013

By a domain decomposition method, free vibration characteristics of laminated orthotropic conical shells resting on Pasternak foundations are analyzed. The conical shell is divided into some conical shell segments in the meridional direction and separated from the geometric boundary and Pasternak foundation; the theoretical model is formulated based on a modified variational functional which includes energy of each conical shell segment, interface potentials (including the boundary potentials) and the energy due to the Pasternak foundation. Numerical comparisons with those published results are made to validate the high accuracy of the present method. The variation of the energy contribution of the shell with different thickness-to-radius ratio, cone angle and fibre orientation against various circumferential wave numbers are presented to help better understand the vibrational characteristics. Moreover, the effects of elastic foundation, boundary condition, stacking sequence and the variations in physical parameters of the shells on the natural frequencies are also investigated.
Dynamic analysis of generally laminated composite beam with a delamination based on a higher-order shear deformable theory
Authors: Jafari-Talookolaei Ramazan-Ali , Abedi Maryam , Kargarnovin Mohammad H , Ahmadian Mohammad T
Published: December 2013

In this study, the dynamic response of the laminated composite beam with arbitrary lay-ups has been investigated within the framework of the third-order shear deformation theory using the finite element method. A new three-nodded finite element compliant with the theory is introduced next. To deal with the dynamic contact between the delaminated segments, unilateral contact constraints are employed in conjunction with Lagrange multiplier method. Furthermore, the Poisson’s effect is incorporated in the formulation of the beam constitutive equation. Also, the higher-order inertia effects and material couplings (flexure–tensile, flexure–twist and tensile–twist couplings) are considered in the formulation. Results are extracted based on two methods namely the Eigen-value techniques for frequencies and the Newmark method to calculate the transient response. Then, the obtained results have been verified with the other results available in the literature and very good agreements have been observed. Furthermore, the new results have been obtained for the case where the excitation was due to a moving/non-moving force.
Thermal conductivity of advanced TiC reinforced metal matrix composites for polymer processing applications
Authors: Wilzer Jens , Windmann Matthias , Weber Sebastian , Hill Horst , Bennekom André van , Theisen Werner
Published: December 2013

Tools used for fabricating polymers are often required to have low thermal conductivities, e.g. for pelletizing, because this lowers the risk of the polymer nozzle being obstructed by molten polymer solidifying as it exits. Latterly, advanced corrosion and wear resistant metal matrix composites (MMCs) are used for pelletizing tools. Therefore, with respect to polymer processing it is important to know how the thermal conductivity of MMC gets influenced by hard phase and metal matrix contribution. In this study, the thermal conductivity of a TiC reinforced corrosion and wear resistant MMC gets analyzed. Especially the influence of chemical interdiffusion between TiC and metal matrix on the resulting thermal conductivity gets analyzed. It is shown that changes in the chemical composition lead to distinct decrease in thermal conductivity of the TiC which has to be considered when MMC thermal conductivities have to be examined.
An Asia-Pacific Core–Periphery Futures Paradox
Authors: Robinson Richard N. S. , Ritchie Brent W. , Kralj Anna , Solnet David J. , Baum Tom , Ford Robert C.
Published: December 2013

Envisaging the future of tourism anywhere is difficult but is amplified when making predictions for the dynamic and rapidly changing Asia-Pacific region. The purpose of this conceptual article is to problematize a 2030 Asia-Pacific tourism future by modeling one polarized and probable scenario, theoretically framed within the mobilities paradigm and the core–periphery model. This scenario proposes that planning for the development of Asia-Pacific tourism will be heavily influenced by a growing tourist trend for experiences in the “pleasure periphery” while the contemporary pattern of increasing urbanization will continue to mobilize the required workforce toward the core. This scenario models divergent tourist and worker mobilities between the core and periphery. By focusing a scenario on this increasingly important discrepancy between labor supply and tourism demand, we can identify the challenges for those areas representative of this divergence that tourism development and destination stakeholders must plan for before 2030.
Segmenting Festival Visitors Using Psychological Commitment
Authors: Lee Jenny (Jiyeon) , Kyle Gerard T.
Published: December 2013

Despite the popularity of festivals and events across destinations, many have failed because of tight budgets and a lack of marketing knowledge. Accordingly, this study aims to assist festival organizers understand more about their target audience. The present study examined the utility of psychological commitment for segmenting festival visitors. We first profiled festival visitors based on their commitment levels and then investigated whether the segments differ in their sociodemographic characteristics, satisfaction, and loyalty. The results demonstrated the presence of three segments, each of which displayed meaningful and significant variation in the intensity of their festival commitment. The groups differed in age, education, and past experience. We also observed that the more committed visitors were to the festival, the higher their overall satisfaction was with the festival experience, and the more likely they were to exhibit loyalty intentions toward the festival. Based on these findings, practical and theoretical insights are provided.
Happiness and Outdoor Vacations Appreciative versus Consumptive Tourists
Authors: Bimonte Salvatore , Faralla Valeria
Published: December 2013

Recently particular attention has been devoted to the relationship between leisure activities and subjective well-being. Less attention has been dedicated to tourism as a life satisfaction domain, despite it being one of the most relevant leisure activities. The aim of this article is to contribute to expanding this line of investigation. Building on the Dunlap and Heffernan hypothesis and employing activity-based segmentation, it verifies to what extent environmental attitudes are related to activities that tourists perform during their vacation, and whether a relationship exists between the activities performed and life satisfaction. The hypothesis is that tourists involved in more appreciative activities are normally more concerned about the environment, more beneficial for host territories, and happier. The article demonstrates that a positive association exists between these aspects and the way tourists “use” nature.
Management of colorectal cancer and diabetes
Authors: Yao Caroline , Nash Guy F , Hickish Tamas
Published: December 2013

Colorectal cancer is associated with diabetes mellitus and both of these common conditions are often managed together by a surgeon. The surgical focus is usually upon cancer treatment rather than diabetes management. The relationship between colorectal cancer and diabetes is a complex one and can raise problems in both diagnosis and the management of patients with both conditions. This literature review explores the relationship between diabetes, diabetic treatment and colorectal cancer and addresses the issues that arise in diagnosing and treating this patient group. By highlighting these difficulties, this review aims to improve understanding and to provide clearer insight into both surgical and non-surgical management.
Persistent fever in a young woman
Authors: Eng Pei Chia , Dorota Dworakowska
Published: December 2013

Drug fever is overlooked. We aim to remind clinicians to consider drug fever as a differential after eliminating other causes.
Examination of the change of the overall heat transfer coefficients of building structures in function of water content
Authors: Lakatos Ákos , Kalmár Ferenc
Published: December 2013

Nowadays, the most applied insulation material in the building sector is the expanded polystyrene. Different types of expanded polystyrene are used but more widely used is the graphite added type. Our research focuses on the analysis of heat conductivity and sorption properties of expanded polystyrene as these two are the most important physical properties from energy saving point of view. In this paper, the variation of heat transfer coefficient of an insulated wall is analysed in function of humidity content of insulation material. Brick and concrete walls with 0.4 m thickness were chosen for substrate and 0.1 m expanded polystyrene (30, 100, 150, 200 and the so-called grey expanded polystyrene) materials were applied as insulating layers. The investigations of sorption behaviour of the materials are important from the point of view of fundamental research and building technology as well. Sorption data taken from our previous measurements results were used for predicting the change of the overall heat transfer coefficients of different wall structures constituted this way.

Practical application: The present technical note is based on our previous measurement results. Water can cause undesirable changes in the building structures and introduced in this article. During the fixing procedure of the additional insulating of a given building bad weather conditions (high relative humidity and/or low external temperature) can dominate. These phenomena can be imagined for building new houses. By the ‘in-building’ of the moisture into the wall structure, numerous and measurable change can happen in the U-value of the building envelope. The presented changes are estimations only, but can be used and can also help for planning and executing the insulating process.
Stereotype Threat and Executive Functions
Authors: Rydell Robert J. , Van Loo Katie J. , Boucher Kathryn L.
Published: December 2013

Stereotype threat research shows that women’s math performance can be reduced by activating gender-based math stereotypes. Models of stereotype threat assert that threat reduces cognitive functioning, thereby accounting for its negative effects. This work provides a more detailed understanding of the cognitive processes through which stereotype threat leads women to underperform at math and to take risks, by examining which basic executive functions (inhibition, shifting, and updating) account for these outcomes. In Experiments 1 and 2, women under threat showed reduced inhibition, reduced updating, and reduced math performance compared with women in a control condition (or men); however, only updating accounted for women’s poor math performance under threat. In Experiment 3, only updating accounted for stereotype threat’s effect on women’s math performance, whereas only inhibition accounted for the effect of threat on risk-taking, suggesting that distinct executive functions can account for different stereotype threat–related outcomes.
Functions of Personal Experience and of Expression of Regret
Authors: Summerville Amy , Buchanan Joshua
Published: December 2013

Although learning and preparing for future behavior are well-established functions of regret, social functions have been largely ignored. We suggest a new model of the functions of regret, the Privately Experienced Versus Expressed Regret model, in which private experience and public expression differentially serve these functions. The current research examined this model using both naturalistic and experimental approaches. In Study 1, we coded tweets about regret posted on social media to examine whether this content emphasized social relationships versus learning and preparation. Study 2 experimentally examined the hypothesized social closeness function for expression of regrets. Study 3 further examined how privately experienced and publicly expressed regrets differ on the social closeness and learning and preparatory functions. Studies 4 and 5 confirmed the specific social closeness function rather than global social benefits. This research suggests that the social expression of regret differs from private experience in both form and function.
Physical Assessment and Anthropometric Measures for Use in Clinical Research Conducted in Critically Ill Patient Populations
Authors: Simpson Fiona , Doig Gordon S. ,   for the Early PN Trial Investigators Group
Published: December 2013

Background: Accurate assessment of nutrition status is essential in identifying subpopulations of critically ill patients who are malnourished and at higher mortality risk. The aim of this analytic observational study was to assess the performance of physical assessment and anthropometric measures commonly used in clinical research. Methods: A prospective study was undertaken in 31 intensive care units (ICUs) with a focus on patients with short‐term contraindications to enteral nutrition. Within 24 hours of admission to the ICU, the following measures were collected: the Subjective Global Assessment components measuring subcutaneous fat loss and muscle wasting, height, weight, mid‐upper‐arm circumference, and triceps skinfold thickness (TSF). Mid‐arm muscle circumference and body mass index (BMI) were calculated. BMI was assessed as a continuous variable and categorized according to the World Health Organization (WHO) categories. The primary outcome was hospital discharge mortality. Results: In total, 1363 patients were enrolled. BMI, analyzed according to WHO categories (P = .09), and TSF (P = .32) failed to demonstrate statistically significant predictive ability. TSF failed to demonstrate statistically significant clinical utility (area under the receiver operating characteristic curve, 0.52; 95% confidence interval, 0.48–0.56). All other individual measures demonstrated statistically significant predictive ability and statistically significant clinical utility. Conclusions: On the basis of the results of our ICU cohort, we recommend caution when using BMI categorized according to WHO definitions. We cannot recommend collection of TSF. More research is required to understand reliability, performance, and use before our results are able to be generalized to other ICU populations.
Director Human Capital, Information Processing Demands, and Board Effectiveness
Authors: Khanna Poonam , Jones Carla D. , Boivie Steven
Published: December 2013

Research on human capital as a source of competitive advantage has focused largely on firm employees. In this article, we argue that outside directors’ general human capital can also be a source of competitive advantage. Firm performance is likely to benefit from directors’ human capital—that is, their prior experience and education—because such human capital is likely to make them more effective at monitoring management and providing advice. Drawing on insights from research on individuals’ cognitive limitations, we further argue that the extent to which the firm is able to benefit from this human capital can be severely limited by the demands for information processing that directors face from their other board positions. Consequently, we find that the benefit of directors’ human capital is contingent upon the information processing load placed upon them from their other board appointments. We find support for our hypotheses using data on over 5,700 directors from 650 firms sampled from the Fortune 1000. This study extends the nascent literature on board human capital by showing that in addition to specific expertise in relevant areas, directors’ general human capital can also help firms create competitive advantage. The theory developed in this article also contributes to the literature on strategic human capital by incorporating the concept of information processing demands, suggesting that not only do such demands leave limited cognitive capacity for directors to focus on the focal firm but also that they can severely diminish the beneficial effects of directors’ general human capital.
Factors Affecting Adoption Decisions
Authors: Ishizawa Hiromi , Kubo Kazuyo
Published: December 2013

As adoption of a child from abroad and from the state’s foster care system is increasingly practiced, prospective adoptive parents now have several options: private domestic, foster care, or international adoption. However, little research has been conducted on the similarities and differences in the characteristics of the child and family and the decision-making process by adoption type. We therefore ask: How are the characteristics of the child and family associated with the type of adoption? And what factors are considered important for adoptive parents in deciding whether to choose private domestic or international adoption? Using the 2007 National Survey of Adoptive Parents, we found that attributes of the child and family differ by the type of adoption, and while adoptive parents expressed a preference to resemble a biologically formed family, the emphasis was placed differently by adoption type.
Reflections on Social Activism in Otolaryngology
Authors: Kopelovich Jonathan C.
Published: December 2013

What is “social activism” to you? For older otolaryngologists, the term is likely to signify the tumult of the 1960s. For incoming generations, this connotation is outdated. Rather, it more broadly reflects concerted efforts to improve the public good. Some ally with existing institutions to work toward incremental progress. Some start new organizations, using technological tools to build networks, marshal resources, and leapfrog hurdles.

Countering these efforts are the ever‐changing challenges of practicing otolaryngology today: electronic health records, shifting incentives, and changes in the practice model. Employment by large conglomerates is more common, decreasing our visibility as community leaders. Burnout is a recognized “hazard,” and budding otolaryngologists are particularly susceptible. Adding one more thing, like social activism, to a full plate seems counterintuitive. But it shouldn't be. You don't need a “bigger” plate to get involved in social causes. Start simple. Find a partner. Scale up. You'll find it rewarding.
Correlation between Nasal Anatomy and Objective Obstructive Sleep Apnea Severity
Authors: Leitzen Keith P. , Brietzke Scott E. , Lindsay Robin W.
Published: December 2013

Objectives

To determine if a correlation exists between nasal anatomical obstruction and obstructive sleep apnea severity as measured by overnight polysomnogram (PSG).

Study Design

Cross‐sectional study.

Setting

Tertiary medical center.

Subjects and Methods

Subjects were recruited immediately prior to an overnight, in‐lab PSG. All subjects who agreed to participate underwent a standardized nasal examination performed by the senior author and then completed the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, the Snore Outcomes Survey (SOS), and the Epworth Sleepiness Scale (ESS) prior to their sleep study. In addition, tonsil size, Mallampati score, Friedman tongue position, neck circumference, uvula length, and occlusion were assessed and documented. Nasal anatomy assessments were then compared with PSG, NOSE, SOS, and ESS results. Bonferroni correction was used to account for multiple comparisons.

Results

One hundred subjects were included in the study. Fifty‐nine subjects (59%) were found to have obstructive sleep apnea syndrome (OSAS) (mean apnea‐hypopnea index, 13.1; range, 0‐64). Severity of OSAS was associated with age (Spearman's ρ = 0.386, P =. 0001). No single nasal anatomy measurement or combined nasal anatomy index was found to correlate with objective sleep‐disordered breathing severity measured by PSG. The sample size should have provided 90% power to detect a significant correlation if one existed. After accounting for multiple comparisons, turbinate hypertrophy was found to correlate with the NOSE score (0.3577, P =. 0305 corrected), and external and internal nasal valve collapse correlated with each other (0.4986, P <. 0001 corrected).

Conclusions

Objectively assessed abnormal nasal anatomy was not found to be significantly correlated with PSG‐measured OSAS severity. Specific objective measurements of obstructive nasal anatomy were correlated to subjective measures of nasal obstruction.
Physician Knowledge of and Attitudes toward the Patient Protection and Affordable Care Act
Authors: Rocke Daniel J. , Thomas Steven , Puscas Liana , Lee Walter T.
Published: December 2013

Objective

To assess otolaryngology physician knowledge of and attitudes toward the Patient Protection and Affordable Care Act (PPACA) and compare the association of bias toward the PPACA with knowledge of the provisions of the PPACA.

Study Design

Cross‐sectional survey.

Setting

Nationwide assessment.

Subjects

Members of the American Academy of Otolaryngology—Head and Neck Surgery.

Methods

Otolaryngology physicians answered 10 true/false questions about major provisions of the PPACA. They also indicated their level of agreement with 9 statements about health care and the PPACA. Basic demographic information was collected.

Results

Email solicitation was sent to 9972 otolaryngologists and 647 responses were obtained (6.5% response rate). Overall correct response rate was 74%. Fewer than 60% of physicians correctly answered questions on whether small businesses receive tax credits for providing health insurance, the effect of the PPACA on Medicare benefits, and whether a government‐run health insurance plan was created. Academic center practice setting, bias toward the PPACA, and Democratic Party affiliation were associated with significantly more correct responses.

Conclusion

Overall physician knowledge of the PPACA is assessed as fair, although better than the general public in 2010. There are several areas where knowledge of physicians regarding the PPACA is poor, and this knowledge deficit is more pronounced within certain subgroups. These knowledge issues should be addressed by individual physicians and medical societies.
Concomitant infection of the tricuspid valve and right ventricle free wall after chest tube insertion in a young patient without predisposing diseases
Authors: Toprak C , Özkan M , Koyuncu A , Kalcik M
Published: December 2013

Infective endocarditis (IE) is one of the most dreaded complications of healthcare-associated bloodstream infection. It is an important and potentially lethal complication of medical care and there is incidence evidence of it in this population. We describe a case of concomitant infection of the tricuspid valve and right ventricle free wall after chest tube insertion for spontaneous pneumothorax in a young patient without predisposing diseases.
The impact of modern treatment principles may have eliminated lithium-induced renal failure
Authors: Aiff Harald , Attman Per-Ola , Aurell Mattias , Bendz Hans , Schön Staffan , Svedlund Jan
Published: December 2013

We have previously shown that lithium can cause end-stage renal disease (ESRD): however, this serious side-effect of lithium in prophylactic treatment of mood disorders may reflect the treatment regime of the 1960s and 1970s. Today’s modern treatment routines, intended to reduce or eliminate lithium-induced ESRD (Li-ESRD), were introduced in Sweden in the early 1980s. The aim of the present study was to test the hypothesis that these routines have eliminated the risk of Li-ESRD. We used the Swedish Renal Registry to identify patients on renal replacement therapy (RRT), treated with dialysis or renal transplantation, with suspected Li-ESRD in two regions of Sweden with altogether about three million inhabitants. We reviewed their medical records to verify the exposure to lithium treatment, the diagnosis of Li-ESRD and the date of starting the lithium treatment. We found 32 RRT patients in whom lithium treatment was the sole or main contributing cause of ESRD. The starting year of their lithium treatment was between 1965–1980 in all patients. No patient started lithium treatment later than 1980. Modern lithium treatment may have eliminated the risk of Li-ESRD. Our findings support the continued use of lithium as a safe drug for the long-term treatment of mood disorders.
Standardized cine-loop documentation in abdominal ultrasound facilitates offline image interpretation
Authors: Dormagen Johann Baptist , Gaarder Mario , Drolsum Anders
Published: December 2013

Background

One of the main disadvantages of conventional ultrasound is its operator dependency, which might impede the reproducibility of the sonographic findings. A new approach with cine-loops and standardized scan protocols can overcome this drawback.

Purpose

To compare abdominal ultrasound findings of immediate bedside reading by performing radiologist with offline reading by a non-performing radiologist, using standardized cine-loop sequences.

Material and Methods

Over a 6-month period, three radiologists performed 140 dynamic ultrasound organ-based examinations in 43 consecutive outpatients. Examination protocols were standardized and included predefined probe position and sequences of short cine-loops of the liver, gallbladder, pancreas, kidneys, and urine bladder, covering the organs completely in two planes. After bedside examinations, the studies were reviewed and read out immediately by the performing radiologist. Image quality was registered from 1 (no diagnostic value) to 5 (excellent cine-loop quality). Offline reading was performed blinded by a radiologist who had not performed the examination. Bedside and offline reading were compared with each other and with consensus results.

Results

In 140 examinations, consensus reading revealed 21 cases with renal disorders, 17 cases with liver and bile pathology, and four cases with bladder pathology. Overall inter-observer agreement was 0.73 (95% CI 0.61–0.91), with lowest agreement for findings of the urine bladder (0.36) and highest agreement in liver examinations (0.90). Disagreements between the two readings were seen in nine kidneys, three bladder examinations, one pancreas and bile system examinations each, and in one liver, giving a total number of mismatches of 11%. Nearly all cases of mismatch were of minor clinical significance. The median image quality was 3 (range, 2–5) with most examinations deemed a quality of 3. Compared to consensus reading, overall accuracy was 96% for bedside reading and 94% for offline reading.

Conclusion

Standardized cine-loop documentation enables accurate offline reading in abdominal ultrasound and shows high agreement with immediate bedside reading.
Methodology discourses as boundary work in the construction of engineering education
Authors: Beddoes Kacey
Published: December 2013

Engineering education research is a new field that emerged in the social sciences over the past 10 years. This analysis of engineering education research demonstrates that methodology discourses have played a central role in the construction and development of the field of engineering education, and that they have done so primarily through boundary work. This article thus contributes to science and technology studies literature by examining the role of methodology discourses in an emerging social science field. I begin with an overview of engineering education research before situating the case within relevant bodies of literature on methodology discourses and boundary work. I then identify two methodology discourses – rigor and methodological diversity – and discuss how they contribute to the construction and development of engineering education research. The article concludes with a discussion of how the findings relate to prior research on methodology discourses and boundary work and implications for future research.
Risk Factors of Subsequent Operations After Primary Anterior Cruciate Ligament Reconstruction
Authors: Csintalan Rick P. , Inacio Maria C.S. , Funahashi Tadashi T. , Maletis Gregory B.
Published: December 2013

Background:

The incidence of nonrevision reoperations after anterior cruciate ligament reconstruction (ACLR) is less commonly studied and quantified.

Purpose:

To describe the incidence of short-term reoperations after primary ACLR for the 4 most common procedures and to evaluate the risk factors associated with these reoperations.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent ACLRs and were enrolled in an ACLR registry between February 2005 and September 2011 were evaluated. First reoperations after primary ACLR performed for the 4 most common procedures (meniscal procedures, cartilage procedures, hardware removal procedures, and arthrofibrosis procedures) were the primary end points of the study. Patient, surgical, surgeon, and hospital risk factors associated with reoperations were evaluated, and Cox regression models were employed. Hazard ratios (HRs) and 95% confidence intervals (CIs) are reported.

Results:

A total of 14,522 ACLRs were identified. The patients had a mean age of 29.4 ± 11.5 years and were mostly male (63.3%) and white (48.3%). The mean follow-up was 1.9 ± 1.5 years (range, 0-6.7 years), and the median time to reoperation was 301 days (interquartile range, 172-515 days). The reoperation rate per 100 person-years of follow-up was 1.1 for meniscal reoperations, 0.3 for cartilage reoperations, 0.4 for hardware removal reoperations, and 0.4 for arthrofibrosis reoperations. Meniscal repair at the index ACLR was a significant risk factor for subsequent meniscal procedures (HR, 4.19; 95% CI, 3.10-5.67). Sports medicine fellowship training of the surgeon (HR, 2.17; 95% CI, 1.01-4.62) and older patient age (≤17 vs ≥26 years) (HR, 0.32; 95% CI, 0.12-0.81) were significant risk factors for cartilage reoperations. Use of allografts (HR, 1.90; 95% CI, 1.10-3.30) and female sex (HR, 1.75; 95% CI, 1.16-2.64) were risk factors for hardware removal reoperations. Female sex (HR, 2.48; 95% CI, 1.66-3.71) and prior surgery (HR, 3.02; 95% CI, 1.39-6.53) were risk factors for subsequent surgery for arthrofibrosis.

Conclusion:

Overall short-term reoperation rates after ACLR are relatively low. Risk factors for subsequent surgery vary depending on the type of surgery evaluated. Some of the risk factors observed for reoperations include previous meniscal repair, female sex, allografts, prior surgery, older patient age, and being operated on by a sports medicine fellowship–trained surgeon.