bluuebunny/crossref_metadata_2025 huggingface dataset:
Multivariate robust estimation of inequality indices
Authors: Lara Alvarez Jorge
Published: October 2015

Purpose

– The data employed to measure income inequality usually come from household surveys, which commonly suffer from atypical observations such as outliers and contamination points. This is of importance since a single atypical observation can make classical inequality indices totally uninformative. To deal with this problem, robust univariate parametric or ad hoc procedures are commonly used; however, neither is fully satisfactory. The purpose of this paper is to propose a methodology to deal with this problem.

Design/methodology/approach

– The author propose two robust procedures to estimate inequality indices that can use all the information from a data set, and neither of them rely on a parametric distributional assumption. The methodology performs well irrespectively of the size and quality of the data set.

Findings

– Applying these methods to household data for UK (1979) and Mexico (2006 and 2011), the author find that for UK data the Gini, Coefficient of Variation and Theil Inequality Indices are over estimated by between 0.02 and 0.04, while in the case of Mexico the same indices are over estimated more deeply, between 0.1 and almost 0.4. The relevance of including atypical observations that follow the linear pattern of the data are shown using the data from Mexico (2011).

Research limitations/implications

– The methodology has two main limitations: the procedures are not able to identify a bad leverage outlier from a contamination point; and in the case that the data has no atypical observations, the procedures will tag as atypical a very small fraction of observations.

Social implications

– A reduction in the estimate of inequality has important consequences from a policy maker perspective. First, ceteris paribus, the optimal amount of resources destinated to directly address inequality/poverty. Those “extra” resources can be destinated to promote growth. Notice that this is a direct consequence of having a more egalitarian economy than previously thought, this is due to the fact that poor people will actually enjoy a bigger share of any national income increment. This also implies that, in order to reduce poverty, public policies should focus more on economic growth.

Originality/value

– To the knowledge, in the inequality literature this is the first methodology that is able to identify outliers and contamination points in more than one direction. That is, not only at the tails of the distribution, but on the whole marginal distribution of income. This is possible via the use of other variables related to income.
A new simple shear deformation theory for free vibration analysis of isotropic and FG plates under different boundary conditions
Authors: Mahi Amale , Adda Bedia El Abbas , Tounsi Abdelouahed , Benkhedda Amina
Published: October 2015

Purpose

– A new simple parametric shear deformation theory applicable to isotropic and functionally graded plates is developed. This new theory has five degrees of freedom, provides parabolic transverse shear strains across the thickness direction and hence, it does not need shear correction factor. Moreover, zero-traction boundary conditions on the top and bottom surfaces of the plate are satisfied rigorously. The paper aims to discuss these issues.

Design/methodology/approach

– Material properties are temperature-dependent and vary continuously through the thickness according to a power law distribution. The plate is assumed to be initially stressed by a temperature rise through the thickness. The energy functional of the system is obtained using Hamilton’s principle. Free vibration frequencies are then calculated using a set of characteristic orthogonal polynomials and by applying Ritz method for different boundary conditions.

Findings

– In the light of good performance of the present theory for all boundary conditions considered, it can be considered as an excellent alternative to some two-dimensional (2D) theories for approximating the tedious and time consuming three-dimensional plate problems.

Originality/value

– To the best of the authors’ knowledge and according to literature survey, almost all published higher order shear deformation theories have been limited to simply supported boundary conditions and without taking into account the thermal stresses effects. The existing 2D shear deformation theories of Reddy, Karama and Touratier can be easily recovered. Furthermore, this feature can be highly appreciated in an iterative design process where a large number of derived plate models can be tested by selecting only two parameters in a simple polynomial function which is computationally efficient. Finally, new results are presented to show the effect of material variation, and temperature rise on natural frequencies of the FG plate for different boundary conditions.
Multi objective optimization of ECG process under fuzzy environment
Authors: Bose G K
Published: October 2015

Purpose

– In the present research work electrochemical grinding (ECG) process is applied to machine Al2O3/Al interpenetrating phase composite. The purpose of this paper is to present a new approach to optimize the ECG process parameters while machining alumina-aluminum (Al2O3– Al) interpenetrating phase composites (IPC) used in automotive, aircraft and manufacture of space ships applying Taguchi-based experimental studies and fuzzy multi-criteria decision-making techniques.

Design/methodology/approach

– The present work identifies the process variables that have significant consequences during ECG of Al2O3/Al IPC. The Taguchi L9orthogonal array is selected for design of experiments and the analysis is carried out following signal to noise ratio. The analysis of variance is carried out to establish the factors that significantly influence the responses. The present work also investigates the multi objective optimization of ECG process parameters using VIseKriterijumsa Optimizacija I Kompromisno Resenje (VIKOR) and Grey relational analysis (GRA) to establish the reference ranking from a set of alternatives in the presence of conflicting criteria.

Findings

– Material removal rate, surface finish, overcut and cutting force are shown to depend on the type of electrolyte, supply voltage, depth of cut and electrolyte flow rate. It is found that voltage and electrolyte concentration are important. The optimal machining parameter combination for ECG process is determined using fuzzy set theory, VIKOR and GRA. Substantial improvement in machining performance takes place.

Practical implications

– A variety of manufacturing techniques are available for processing of Al2O3– Al metal matrix composites. Generally manufacturers favor low cost modus operandi. Therefore ECG process is the best alternative for processing of MMCs in the present commercial sectors. The experimental investigation approach can act as useful and an efficient guideline for manufacturing.

Originality/value

– The characteristic features of the ECG process are reflected through Taguchi design-based experimental studies with various process parametric combinations. Application of multi-response optimization technique for evaluation of best parametric combination for machining Al2O3– Al IPC material using ECG process is a first-of-its-kind approach in literature.
Ethnic segmentation in marketing: a tool for social domination in France
Authors: Zouaghi Sondes
Published: October 2015

Purpose

– This paper aims to deal with the issue of researchers’ responsibility for the dissemination of ideologies which have led to the cultural marginalisation and categorisation of minority social groups into a dominant/dominated relationship in France. One telling example is the way ethnic segmentation – as now used in marketing – finds its roots in the colonial paradigm.

Design/methodology/approach

– A critical and analytical review of the literature on ethnic marketing.

Findings

– The current paradigm which splits the world into centre and periphery or dominant and dominated, in the French context, is not the only existing one. In the framework of postcolonial studies, researchers in marketing now approach the ethnic market by being as close to consumers as possible and by adapting their methodology to the Consumer Culture Theory.

Originality/value

– Some researchers have become aware that the feeling of ethnic self-identification would not exist without the involvement of the dominant group who imposes their view on minorities. As to multicultural individuals, minorities have to adjust to a great variety of social situations by drawing from a set of available cultural identities. It is therefore more a question of multiple selves than ethnic identity. Multicultural individuals create their own identity and co-create new social categories from the grey area between dominant and dominated groups. The postcolonial approach raises the question as to whether ethnicity is a mere ideological construct with no underlying reality but the actual domination of minorities.
Reduction of Food Loss and Waste: An Exaggerated Agitation
Authors: Koester Ulrich
Published: October 2015

There is increasing public concern about the present state of food loss and waste (FLW). Numerous studies convey the message that there is a high potential to save food in order to improve food security, efficiency of resource use and to generate positive environmental effects. However, the evidence has not been well investigated. The widely accepted definition of FLW and the collected data do not inform equally well on the potential contributions of FLW reductions. This article focuses on the potential for FLW reductions to improve food security. It is argued that the underlying definition exaggerates the actual amount of FLW that could be used to feed humans. Most studies use volume measures to aggregate FLW along the supply chain and across food items, which is highly questionable; we cannot reasonably add together tonnes of meat and potatoes. Likewise, meat products at different stages along the supply chain are different economic goods and can hardly be aggregated meaningfully in volume terms. Moreover, present research often neglects the economic costs incurred in reducing FLW. Moving the product from the field or stable to households requires additional complementary resources to store, trade, process and prepare the final food.
Nicotine delivery, retention and pharmacokinetics from various electronic cigarettes
Authors: St.Helen Gideon , Havel Christopher , Dempsey Delia A. , Jacob Peyton , Benowitz Neal L.
Published: October 2015

Aims

To measure the systemic retention of nicotine, propylene glycol (PG) and vegetable glycerin (VG) in electronic cigarette (e‐cigarette) users, and assess the abuse liability of e‐cigarettes by characterizing nicotine pharmacokinetics.

Design

E‐cigarette users recruited over the internet participated in a 1‐day research ward study. Subjects took 15 puffs from their usual brand of e‐cigarette. Exhaled breath was trapped in gas‐washing bottles and blood was sampled before and several times after use.

Setting

San Francisco, California, USA.

Participants

Thirteen healthy, experienced adult e‐cigarette users (six females and seven males).

Measurements

Plasma nicotine was analyzed by gas chromatography–mass spectrometry (GC‐MS/MS) and nicotine, VG and PG in e‐liquids and gas traps were analyzed by LC‐MS/MS. Heart rate changes and subjective effects were assessed.

Findings

E‐cigarettes delivered an average of 1.33 (0.87‐1.79) mg [mean and 95% confidence interval (CI)] of nicotine, and 93.8% of the inhaled dose, 1.22 (0.80‐1.66) was systemically retained. Average maximum plasma nicotine concentration (Cmax) was 8.4 (5.4–11.5) ng/ml and time of maximal concentration (Tmax) was 2–5 minutes. One participant had Tmax of 30 minutes. 84.4% and 91.7% of VG and PG, respectively, was systemically retained. Heart rate increased by an average of 8.0 beats per minute after 5 minutes. Withdrawal and urge to smoke decreased and the e‐cigarettes were described as satisfying.

Conclusions

E‐cigarettes can deliver levels of nicotine that are comparable to or higher than typical tobacco cigarettes, with similar systemic retention. Although the average maximum plasma nicotine concentration in experienced e‐cigarette users appears to be generally lower than what has been reported from tobacco cigarette use, the shape of the pharmacokinetic curve is similar, suggesting addictive potential.
Feasibility of intercostal blood flow measurement by echo‐Doppler technique in healthy subjects
Authors: de Bisschop Claire , Montaudon Michel , Glénet Stéphane , Guénard Hervé
Published: October 2015

Intercostal artery blood flow supplies the external and internal intercostal muscles, which are inspiratory and expiratory muscles. Intercostal blood flow measured by the echo‐Doppler (ED) technique has not previously been reported in humans. This study describes the feasibility of this measurement during free and loaded breathing in healthy subjects. Systolic, diastolic and mean blood flows were measured in the eighth dorsal intercostal space during free and loaded breathing using the ED technique. Flows were calculated as the product of the artery intraluminal surface and blood velocity. Ten healthy subjects (42 ± 13·6 years) were included. Integrated electromyogram (iEMG), arterial pressure, cardiac frequency and breathing pattern were also recorded. Mean blood flows were 3·5 ± 1·2 ml min−1 at rest, 6 ± 2·6 ml min−1 while breathing through a combined inspiratory and expiratory resistance and 4·0 ± 1·3 ml min−1 1 min after unloading. Diastolic blood flow was about one‐third the systolic blood flow. The changes in blood flows were consistent with those in iEMG. No change in mean blood flow was observed between inspiration and expiration, suggesting a balance in the perfusion of external and internal muscles during breathing. In conclusion, ED is a feasible technique for non‐invasive, real‐time measurement of intercostal blood flow in humans. In healthy subjects, mean blood flow appeared tightly matched to iEMG activity. This technique may provide a way to assess the vascular adaptations induced by diseases in which respiratory work is increased or cardiac blood flow altered.
The impact of venous occlusion per se on forearm muscle blood flow: implications for the near‐infrared spectroscopy venous occlusion technique
Authors: Cross Troy J , Sabapathy Surendran
Published: October 2015

The purpose of this study was to examine the effect of venous occlusion per se on forearm muscle blood flow, as determined by the near‐infrared spectroscopy (NIRS) venous occlusion technique (NIRS‐VOT). NIRS data were obtained from the flexor digitorum superficialis (FDS) muscle on the dominant arm of 16 young, ostensibly healthy participants (14 men and two women; 30 ± 6 year; 73 ± 7 kg). Participants completed a series of five venous occlusion trials while seated at rest, and a series of 12 venous occlusion trials during a reactive hyperaemia induced by 5 min of forearm arterial occlusion. The NIRS‐VOT was used to assess FDS muscle blood flow (), beat‐by‐beat, over the first four cardiac beats during venous occlusions. was also reported as a cumulative value, wherein the first two, first three and first four cardiac beats were used to calculate muscle blood flow. We observed that was highest when calculated over the first cardiac beat during venous occlusions performed at rest and throughout reactive hyperaemia (P<0·05). Moreover, the inclusion of more than one cardiac beat in the calculation of underestimated muscle blood flows, irrespective of the prevailing level of arterial inflow. These findings support the idea that venous occlusion per se affects the measurement of via the NIRS‐VOT. Accordingly, it is recommended that is determined over the first cardiac beat when using the NIRS‐VOT to assess microvascular blood flow of human forearm muscles.
A systematic review of outcome measures used in clinical trials of treatment interventions following traumatic dental injuries
Authors: Sharif Mohammad Owaise , Tejani‐Sharif Ambareen , Kenny Kate , Day Peter F.
Published: October 2015

Background

Traumatic dental injuries (TDI) are common, and appropriate treatment will maximize the chances of maintaining teeth in function while safeguarding their longevity and aesthetics. Subjectively, it appears that outcome measures used in studies investigating TDI are numerous and diverse.

Objectives

To undertake a systematic review of the outcomes used in clinical trials of treatment interventions following TDI.

Data sources

The MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and EMBASE databases were searched up to June 2014. Reference lists of eligible studies were cross‐checked to identify additional studies and strategies to identify grey literature and ongoing trials were employed.

Study selection

Two authors independently assessed studies for inclusion and undertook data extraction. The study designs included were as follows: systematic reviews with/without meta‐analyses, randomized and pseudo‐randomized controlled trials and controlled clinical trials. There were no language restrictions.

Results

Ten studies confined to two types of TDI were included: avulsion (5) and non‐vital immature permanent incisor teeth (5). The outcomes reported predominantly concentrated on injury activity and the physical consequence of injury. There was little consistency between studies for the length of follow up, the time points at which outcomes were evaluated or the methods used to measure them.

Conclusions

There is significant heterogeneity in outcomes reported for TDI in the literature. These findings preclude meaningful meta‐analysis between studies. Future clinical studies need to consider collecting a more consistent and wider range of outcomes, which should include one or more from each of the following domains: health resources utilisation, adverse effects and quality of life and family outcome.

There is a clear need for the development of a Core Outcome Set for TDI using robust and established methodology, thus optimizing the value of future research.
Intermodal Transport as a Regional Development Strategy: The Case of Italian Freight Villages
Authors: Monios Jason
Published: October 2015

This paper examines the development of intermodal transport operations at freight villages in Italy. Quantitative data on public and private investment and ownership in each of the 25 Italian freight villages are analysed to identify relevant issues, which are then explored through five qualitative case studies. The research considers how intermodal transport stimulation links national modal shift policy with regional economic development strategies based on the promotion of logistics growth. The research identifies a misalignment between national and regional scales, as funding based on national policy does not align with port and freight village planning strategies developed at the regional level. From an operational perspective, this misalignment is exacerbated by the often adversarial relations between ports and intermodal terminals, in addition to the fragmented nature of the Italian freight sector. Even with a national policy to promote freight villages with intermodal terminals and a dedicated funding stream to support this network of approved sites, operational issues mean that establishing intermodal shuttles remains a difficult and marginal enterprise, particularly in the case of southern Italy due to its location on the periphery of intra‐European freight flows.
HISTORICAL UNDERSTANDING AND HISTORICAL INTERPRETATION AS CONTEXTUALIZATION
Authors: MITROVIĆ BRANKO
Published: October 2015

This article discusses the theoretical problems pertaining to the relationship between historical contextualization and historical understanding and interpretation. On the one hand, there is the view that documents need to be understood in relation to their historical context; on the other, it is not clear how a historian can get out of his or her own historical context in order to be able to engage with the conceptual frameworks, beliefs, or ways of reasoning that are radically different from his or her own. The paper proposes a resolution to this dilemma; its upshot is that historical understanding is constituted by contextualization.
STALINISM IN RETROSPECT: HANNAH ARENDT
Authors: BAEHR PETER
Published: October 2015

Established writers whose reputation is affixed to a particular line of argument are typically ill disposed to change their minds in public. Some authors sincerely believe that the historical record vindicates them. Others are determined that the historical record will vindicate them. Still others ignore the historical record. Among students of totalitarianism, no one had more at stake reputationally than Hannah Arendt. It is not just that The Origins of Totalitarianism (1951) established her as the premier thinker on its topic. It is also that totalitarianism, as she understood it, ribbons through all of her subsequent books, from the discussion of “the social” in The Human Condition (1958) to the analysis of thinking in the posthumously published The Life of the Mind (1978). How ready was she to adapt or to change entirely arguments she had first formulated as early as the mid‐to‐late 1940s? “Stalinism in Retrospect,” her contribution to Columbia University's Seminar on Communism series, offers a rare opportunity to answer, at least partially, this question.

Arendt's foil was the publication of recent books on Stalin and the Stalin era by three Russian witnesses: Nadezhda Mandelstam, Roy Medvedev, and Aleksandr Solzhenitsyn. According to Arendt, the books meshed with her own theoretical conception of Bolshevism while changing the “whole taste” of the period: they contained new insights into the nature of totalitarian criminality and evil. “Stalinism in Retrospect” documents Arendt's arguments and challenges to them by a number of the seminar's participants. Of particular note is the exchange between her and Zbigniew Brzezinski, an expert on the Soviet Union, a major interpreter of totalitarianism in his own right, and soon to be President Carter's National Security Advisor (January 1977–January 1981). Notes by the editor, Peter Baehr, offer a critical context for understanding Arendt's argument.
Motor neuron disease: current management and future prospects
Authors: Simon N. G. , Huynh W. , Vucic S. , Talbot K. , Kiernan M. C.
Published: October 2015

Motor neuron disease (MND) is characterised by progressive neurological deterioration and coexistence of upper and lower motor neuron signs. Over the past decade, evidence has emerged of unique pathophysiological processes, including glutamate‐mediated excitotoxicity, which has resulted in the development of novel diagnostic investigations and uncovered potential therapeutic targets. Advances in genetics, including the recently discovered C9orf72 gene, have radically changed the pathological mindset, from MND being classified as a neuromuscular disease to one that MND forms a continuum with other primary neurodegenerative disorders, including frontotemporal dementia. The present review will highlight the improvements that have occurred in clinical care, in conjunction with recent scientific developments.
Disseminated Mycobacterium haemophilum skeletal disease in a patient with interferon‐gamma deficiency
Authors: Otome O. , O'Reilly M. , Lim L.
Published: October 2015

Disseminated non‐tuberculous mycobacterial (NTM) infection is rare in immunocompetent adults. Anti‐interferon‐gamma (IFN‐γ) autoantibodies have recently been associated with NTM infections, particularly in patients of Asian ethnicity. We describe a case of disseminated Mycobacterium haemophilum skeletal infection due to anti IFN‐γ autoantibodies in a 71‐year‐old Cambodian man. He responded to a combination of anti‐mycobacterial antibiotics without requirement for immunomodulator therapy. Testing for acquired IFN‐γ deficiency due to IFN‐γ autoantibodies should be considered when standard tests for immunodeficiency are negative in patients with unusual or severe opportunistic infections, including NTM.
Compliance of males with stage 1 testicular germ cell tumours on an active surveillance protocol
Authors: Honeyball F. , Murali‐Ganesh R. , Hruby G. , Grimison P.
Published: October 2015

The aim of this retrospective study was to determine the rate of compliance among 57 males with stage 1 testicular germ cell tumours on an active surveillance protocol at a single Australian centre. At median follow up of 24 months, 81% had adequate compliance with the follow‐up regimen, 12% were lost to follow up, and 16% relapsed; none between protocol visits. Active surveillance is an acceptable alternative to adjuvant therapy for stage 1 testicular germ cell tumours, with reduced toxicity for most and equivalent survival, but requires efforts to maintain adequate compliance with follow up to avoid late detection of recurrence.
Single‐phase slack‐based centralized DEA for resource reallocation
Authors: Yu Ming‐Miin , Hsiao Bo
Published: October 2015

Data envelopment analysis (DEA) is an effective method for measuring the relative efficiency of a set of homogeneous decision‐making units (DMUs). Yu et al.’s study proposed an extended centralized DEA (CDEA) model that utilizes a two‐phase process for reallocating resources to project not only in each DMU (e.g., branch company) but also in the central DMU (e.g., headquarters, central authority) on the production frontier. However, evaluating the two‐phase model using the approach of Yu et al. may present some challenges because of inconsistent benchmarks. To solve this issue, we modified a single‐phase slack‐based CDEA that considers transfer‐in and transfer‐out slacks to facilitate the reallocation and adjustment of resources. Our modified single‐phase slack‐based CDEA is demonstrated with a numerical example illustrating input resource reallocation. Results show that the modified single‐phase CDEA model is effective to deal with a more realistic inconsistency reference set and provide much more reallocation ability than the two‐phase approach.
Effect of an educational intervention on parental readiness for premature infant discharge from the neonatal intensive care units
Authors: Chen Yongfeng , Zhang Jun , Bai Jinbing
Published: October 2015

Aim

To examine the effect of an educational intervention on parental readiness for premature infant discharge from neonatal intensive care units.

Background

Low readiness for discharge can result in negative healthcare outcomes for infants and their parents. However, few studies have examined the effect of discharge education programmes on parental readiness for premature infant discharge in Chinese critical care settings.

Design

A quasi‐experimental study.

Methods

Between October 2011–March 2012, 154 parents of premature infants were recruited from neonatal intensive care units of two tertiary hospitals in Central China. These parents were assigned to either the intervention or control group based on their entry order. Parents in the intervention group received two sessions of 60‐minute discharge education along with hospital routine care; parents in the control group only received hospital routine care. Parental readiness for discharge and quality of discharge education were assessed on the day of infant discharge from neonatal intensive care units. Independent samples t‐test and linear regression were used to analyse the data.

Results

Parental readiness for premature infant discharge was in the moderate level. Independent samples t‐test showed that both mean scores of parental discharge readiness and discharge teaching quality from the intervention group were significantly higher than those in the control group. Linear regression analysis showed that discharge teaching quality explained 39·7% of the variance in parental readiness for premature infant discharge.

Conclusion

Discharge education can improve parental readiness for premature infant discharge. Quality of discharge teaching can significantly predict parental readiness for premature infant discharge.
Joint attention behaviours in people with profound intellectual and multiple disabilities: the influence of the context
Authors: Neerinckx Heleen , Maes Bea
Published: October 2015

Background

In spite of the profound cognitive and physical problems, people with profound intellectual and multiple disabilities (PIMD) are able to develop joint attention behaviours (JAB) and benefit from positive interactions.

Aims

To investigate which context factors influence the JAB of people with PIMD.

Method

Based on video recordings of 45 participants, JAB and context factors were analysed.

Results

An unstructured interaction situation produced the most responses of a person with PIMD, whereas a structured interaction situation produced the most initiatives. Furthermore, the familiarity of the partner and the familiarity of objects used in the interaction had no influence on the JAB. The sensitivity of the interaction partner was positively related to the presence of JAB.

Conclusions

Interaction partners of people with PIMD should be aware of both the ability of people with PIMD to use JAB and the influence of different context factors on these JAB.
Do Banks Price Litigation Risk in Debt Contracting? Evidence from Class Action Lawsuits
Authors: Yuan Qingbo , Zhang Yunyan
Published: October 2015

Class action lawsuits can be detrimental to debtholders because they deteriorate defendant firms’ financial position and lower these firms’ value. This study examines whether banks price their borrowers’ litigation risk in debt contracting. We find that banks charge 19% higher interest spreads on loans to lawsuit firms after litigation. In addition, banks monitor lawsuit firms more closely by using tighter non‐price terms. The results are robust after correcting for possible endogeneity issues using the propensity score matching approach. We further find that the effects of lawsuit filing are more pronounced for firms with weaker corporate governance. Following a lawsuit in the industry, banks also perceive an increased likelihood of litigation for industry peer firms and adjust price and non‐price terms accordingly. Finally, we find that the magnitude of the lawsuit filing effect is greater for firms with lower ex‐ante litigation risk. Taken as a whole, our findings suggest that banks, as informed stakeholders, perceive litigation risk to be detrimental and price this risk in debt contracting.
Point‐by‐Point Radiofrequency Ablation Versus the Cryoballoon or a Novel Combined Approach: A Randomized Trial Comparing 3 Methods of Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation (The Cryo Versus RF Trial)
Authors: HUNTER ROSS J. , BAKER VICTORIA , FINLAY MALCOLM C. , DUNCAN EDWARD R. , LOVELL MATTHEW J. , TAYEBJEE MUZAHIR H. , ULLAH WAQAS , SIDDIQUI M. SHOAIB , McLEAN AILSA , RICHMOND LAURA , KIRKBY CLAIRE , GINKS MATTHEW R. , DHINOJA MEHUL , SPORTON SIMON , EARLEY MARK J. , SCHILLING RICHARD J.
Published: October 2015

The CRYO Versus RF Trial

Introduction

Catheter ablation of paroxysmal AF using the Cryoballoon (CRYO) has yielded similar success rates to conventional wide encirclement using radiofrequency catheter ablation (RFCA), but randomized data are lacking. Pilot data suggested a high success rate with a combined approach (COMBINED) using wide encirclement with RFCA followed by 2 CRYO applications to each vein. We compared these 3 strategies in a randomized controlled trial.

Methods and Results

Patients undergoing first time paroxysmal AF ablation were randomized to RFCA, CRYO, or COMBINED. Patients were followed up at 3, 6, and 12 months with 7 days of ambulatory ECG monitoring. Success was defined as freedom from arrhythmia without antiarrhythmic drugs after a single procedure. A total of 237 patients were randomized. Success at 1 year was achieved in 47% in the RFCA group, 67% in the CRYO group, and 76% in the COMBINED group (P < 0.001 for RFCA vs. CRYO, P<0.001 for RFCA vs. COMBINED, and P = 0.220 for CRYO vs. COMBINED). Procedure time was 211 (IQR 174–256) minutes for RFCA compared to 167 (136–202) minutes for CRYO and 278 (243–327) minutes for COMBINED (P < 0.001 for RFCA vs. COMBINED, RFCA vs. CRYO, and CRYO vs. COMBINED groups).

Conclusions

Pulmonary vein isolation for paroxysmal AF is faster with CRYO and results in a higher single procedure success rate than conventional point by point RFCA. The COMBINED approach was not superior to CRYO alone.
Electrocardiographic and Electrophysiological Characteristics of Atrial Tachycardia With Early Activation Close to the His‐Bundle
Authors: MADAFFARI ANTONIO , GROßE ANETT , BRUNELLI MICHELE , FROMMHOLD MARKUS , DÄHNE TANJA , ORETO GIUSEPPE , RAFFA SANTI , GELLER J. CHRISTOPH
Published: October 2015

P‐Wave and Ablation in Para‐Hisian Atrial Tachycardia

Introduction

Radiofrequency (RF) ablation of atrial tachycardia (AT) with earliest activation at the His‐bundle may be associated with the risk of AV block, and detection of this AT origin using the electrocardiogram (ECG) would be helpful in planning ablation. Aim of this study was to characterize the P‐wave morphology and intracardiac electrograms at the successful ablation site for this group of ATs.

Methods

All consecutive patients undergoing ablation for AT with earliest activation at the His‐bundle were included. Twelve‐lead ECG and intracardiac electrograms were analyzed.

Results

A total of 33 patients underwent successful ablation. The P‐wave and the PR interval during AT (cycle length 460 ± 88, range 360–670 milliseconds) were significantly shorter compared to sinus rhythm 87 ± 18 vs. 117 ± 23 and 131 ± 37 vs. 170 ± 47 milliseconds, respectively, P < 0.01. In 28 patients (85%), the P‐wave was biphasic (–/+) or triphasic (+/–/+) in the precordial leads, especially V4‐V6, and in 25 patients (76%) it was biphasic (–/+) or triphasic (+/–/+) in the inferior leads. RF was delivered at the following locations: noncoronary aortic cusp (NCC) in 24 patients, antero‐septal left atrium in 4, supero‐septal right atrium in 3, left coronary cusp in 1, and between the right coronary cusp and the NCC in 1. Atrial bipolar electrograms at the successful ablation site preceded the P‐wave by 38 ± 11 (range 10–60) milliseconds, and AT termination was obtained after a mean RF energy time of 10 ± 8 (range 2–31) seconds.

Conclusion

A characteristic narrow and biphasic (–/+) or triphasic (+/–/+) P‐wave in the inferior and precordial leads reliably identifies the group of AT arising from the para‐Hisian region.
Unmet medical needs for chronic spontaneous urticaria patients: highlighting the real‐life clinical practice in Taiwan
Authors: Cho Y.‐T. , Pao Y.‐C. , Chu C.‐Y.
Published: October 2015

Background

Treatment guidelines for chronic spontaneous/idiopathic urticaria (CSU) are available; however, only 50% of patients are well controlled with approved doses of H1‐antihistamines, and certain patients remain symptomatic despite receiving up to 4× the approved dose of H1‐antihistamines plus H2‐antihistamines and/or leucotriene‐receptor antagonists.

Objectives

To highlight real‐life clinical practice in Taiwan and to understand the unmet medical needs of CSU patients.

Methods

A nationwide cross‐sectional, observational survey of 50 dermatologists and 200 CSU patients was conducted between June 2013 and November 2013. Face‐to‐face interviews of dermatologists and online interviews of CSU patients were conducted independently.

Results

Dermatologists reported that dermographism and blood tests were the most commonly used diagnostic methods to confirm the diagnosis. The key driving factor for most clinic‐based dermatologists (70%) in choosing a treatment was ‘response to my medicines’, and most preferred H1‐antihistamines and steroids for treating CSU patients, whereas most hospital‐based dermatologists (85%) gave higher priority to ‘severity and impact of the conditions’. Patients were reported to have high psychological pressures and significant impact of CSU on their daily activity. In addition, CSU patients were not satisfied with their current treatment and 69% of patients switched their first‐consulted physician. Furthermore, lack of information and concerns about side‐effects were major factors which held back patients from seeking Western treatment.

Conclusions

There is an unmet medical need of CSU patients in Taiwan highlighting gaps among guidelines, real‐life clinical practice, patients' perceptions and patients' knowledge of their disease.
A baby with an oral surprise
Authors: Rakhra Jus , Agrawal Rajiv , Chin Michael , Hibbert Sally , Widmer Richard P
Published: October 2015

See Answer
Multicoloured papules on the neck
Authors: Carvalho Sandrina , Machado Susana , Pinto‐Almeida Teresa , Selores Manuela
Published: October 2015

See Answer
Enhancing Asthma Self‐Management in Rural School‐Aged Children: A Randomized Controlled Trial
Authors: Horner Sharon D. , Brown Adama , Brown Sharon A. , Rew D. Lynn
Published: October 2015

Purpose

To test the effects of 2 modes of delivering an asthma educational intervention on health outcomes and asthma self‐management in school‐aged children who live in rural areas.

Methods

Longitudinal design with data collected 4 times over 12 months. The target sample was composed of children in grades 2‐5 who had a provider diagnosis of asthma. Elementary schools were stratified into high or low socioeconomic status based on student enrollment in the free or reduced‐cost lunch program. Schools were then randomly assigned to 1 of 3 treatment arms: in‐school asthma class, asthma day camp, or the attention‐control group.

Findings

Sample retention was good (87.7%) and equally distributed by study arm. Improvements in emergency department visits and office visits were related to attending either the asthma class or asthma day camp. Asthma severity significantly decreased in both asthma treatment groups. Other factors such as hospitalizations, parent asthma management, and child asthma management improved for all groups.

Conclusions

Both asthma class and asthma day camp yielded significant reductions in asthma severity. There were reductions in the emergency department and office visits for the 2 asthma arms, and hospitalizations declined significantly for all groups. Asthma self‐management also improved in all groups, while it was somewhat higher in the asthma arms. This may be due to the attention being drawn to asthma management by study participation and the action of completing questionnaires about asthma management, asthma symptoms, and health outcomes.
Hero Worship: The Elevation of the Human Spirit
Authors: Allison Scott T. , Goethals George R.
Published: October 2015

In this article, we review the psychology of hero development and hero worship. We propose that heroes and hero narratives fulfill important cognitive and emotional needs, including the need for wisdom, meaning, hope, inspiration, and growth. We propose a framework called the heroic leadership dynamic (HLD) to explain how need‐based heroism shifts over time, from our initial attraction to heroes to later retention or repudiation of heroes. Central to the HLD is idea that hero narratives fulfill both epistemic and energizing functions. Hero stories provide epistemic benefits by providing scripts for prosocial action, by revealing fundamental truths about human existence, by unpacking life paradoxes, and by cultivating emotional intelligence. To energize us, heroes promote moral elevation, heal psychic wounds, inspire psychological growth, and exude charisma. We discuss the implications of our framework for theory and research on heroism, leadership processes, and positive psychology.
Redrawing the Boundaries of Language Teacher Cognition: Language Teacher Educators’ Emotion, Cognition, and Activity
Authors: GOLOMBEK PAULA R.
Published: October 2015

This article, grounded in a Vygotskian sociocultural perspective, details the self‐inquiry of a language teacher educator who examined her emotional dissonance regarding her mediation of the reflection journals of a teacher learner teaching an ESL class during an internship. Data from the teacher learner's reflection journals and the teacher educator's responses were analyzed to characterize the teacher learner's approach to writing the journals and the teacher educator's written responses. The teacher learner was interviewed retrospectively about her conceptualization of and past history with journal writing, her sense, and perezhivanie concerning journal writing. The analysis showed how recognizing the cause of her emotional dissonance and its effect on her mediation enabled the teacher educator to reframe her understanding of the teacher learner as a learner, and it explored the role of reflection journals in the learning‐to‐teach process. The article calls for a redefinition of language teacher cognition that integrates the interaction of both language teacher learner and teacher educator emotion and cognition activated in and shaped by their interactions in the learning‐to‐teach experience.
Beyond Cognition to Commitment: English Language Teaching in South Korean Primary Schools
Authors: MOODIE IAN , FERYOK ANNE
Published: October 2015

In order to understand teacher cognition—the thoughts, beliefs, and knowledge of language teachers—it is helpful to understand why people commit to language teaching in the first place. However, few studies of language teachers have directly examined the nature and development of commitment in language teachers, across their language learning, teacher education, and teaching experience within their context. This study aims to do just that. Four primary school teachers in South Korea participated—two experienced teachers and two novice teachers—who at the time of the study were teaching English as a foreign language. Data from reflective writing, interviews, and classroom observations from a wider 18‐month study on language teacher cognition and development were iteratively analyzed for the aims of this study. The findings show that commitment transfers between language learning and teaching through both positive and negative experiences, involves multiple and evolving intentions and mindsets in language teaching, and occurs in action in particular contexts. The findings also show that the teachers’ early commitment to language learning contributed to their commitment to act on improving their English proficiency and classroom practices through professional development. The study concludes with implications and research suggestions.
Reclaiming the Relevance of L2 Teacher Education
Authors: JOHNSON KAREN E.
Published: October 2015

This article lays out a theoretical argument for empirical research that focuses on what happens inside the practices of L2 teacher education. Central to this argument is that it is inside these practices—the dialogic interactions between teacher educators and teachers—where teacher educators can see, support, and enhance the professional development of L2 teachers. Grounded in a Vygotskian sociocultural theoretical perspective on teacher learning (Johnson, 2009), data from an innovative teacher education practice highlight the quality and character of the collaborative teaching–learning relationships (obuchenie) that unfold in this practice and the role of the teacher educator in providing expert mediation to support novice teachers’ emerging conceptualizations of, and initial attempts at, enacting L2 teaching. The article concludes with a call for empirical attention to the design, enactment, and outcomes of the practices of L2 teacher education as essential in order to reclaim the relevance of L2 teacher education in and for the professional development of L2 teachers.
The Role of Teachers’ Future Self Guides in Creating L2 Development Opportunities in Teacher‐Led Classroom Discourse: Reclaiming the Relevance of Language Teacher Cognition
Authors: KUBANYIOVA MAGDALENA
Published: October 2015

Understanding the relationship between teachers’ use of language in teacher‐led discourse (TLD; Toth, 2008) and opportunities for L2 development is a well‐established area of SLA research. This study examines one teacher's role in creating such opportunities in TLD in her EFL classes in a state secondary school by examining the inner resources that informed her interactional practices. The database comprises audiorecordings of TLD from eight lessons, pre‐ and post‐observation interviews, ethnographic field notes from multiple school visits, and repeated ethnographic interviews with the teacher. The results from a close analysis of TLD and a grounded theory analysis of the ethnographic data show that the teacher's future self guides, conceptualized as language teachers’ possible selves (Kubanyiova, 2009), had a critical influence on how she navigated classroom interaction and the L2 development opportunities that arose as a result. The findings offer new insights into the types of professional development opportunities needed to transform teachers’ discourse. By bridging two domains of inquiry—SLA and language teacher cognition—in a single study, this article sets a new research agenda in applied linguistics and responds to calls for increasing its relevance to the real world (Bygate, 2005; Ortega, 2012a).
Emergence of new virulent populations of apple scab from nonagricultural disease reservoirs
Authors: Lemaire Christophe , De Gracia Marie , Leroy Thibault , Michalecka Monika , Lindhard‐Pedersen Hanne , Guerin Fabien , Gladieux Pierre , Le Cam Bruno
Published: October 2015

Plant pathogens adapt readily to new crop varieties in agrosystems, and it is crucial to understand the factors underlying the epidemic spread of new virulent strains if we are to develop more efficient strategies to control them.

In this study we used multilocus microsatellite typing, molecular epidemiology tools and a large collection of isolates from cultivated, wild and ornamental apples to investigate the origin of new virulent populations of Venturia inaequalis, an ascomycete fungus causing apple scab on varieties carrying the Rvi6 resistance gene.

We demonstrated a common origin at the European scale of populations infecting apples (Malus × domestica) carrying the Rvi6 resistance and Malus floribunda, the progenitor of the Rvi6 resistance. Demographic modeling indicated that the Rvi6‐virulent lineage separated several thousands of years ago from populations infecting non‐Rvi6 hosts, without detectable gene flow between the two lineages.

These findings show that ‘breakdowns’ of plant resistance genes can be caused by the selection and migration of virulent genotypes from standing genetic variation maintained in environmental disease reservoirs, here ornamental crabapples. This work stresses the need to take better account of pathogen diversity in resistance screenings of breeding lines and in resistance deployment strategies, in order to enhance sustainable disease management.