bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic relaxation analysis of composite sandwich annular sector plate with viscoelastic core
Authors: Salehi M , Marashizadeh P , Abshirini M
Published: July 2015

The three-layer annular composite sandwich sector plate is investigated numerically using the dynamic relaxation method. The upper and lower faces consist of un-symmetrical rectangular orthotropic laminates, and the core is based on viscoelastic material. The non-linear governing equations are considered using the first-order shear deformation theory and large deflection type of deformation. The constitutive relations of sandwich are presented for laminated faces, and the linear viscoelastic core is considered for the Boltzmann superposition principle. The dynamic relaxation iterative procedure in conjunction with finite-difference discretization is performed for the solution of the governing equations. Under uniform lateral pressure as well as clamped and simply supported edged constraints, the plate deformation is predicted for different times. In order to verify the dynamic relaxation algorithm, the elastic sector plate is compared with finite element solutions, and it is established that the correlations are very satisfactory. The dimensionless deflections, stress resultants, and stress couples of sandwich plates with viscoelastic core are illustrated to show the creep behavior of the plate with an increase in time.
Mechanical characterization of asymmetric high density polyethylene/hemp composite sandwich panels with and without a foam core
Authors: Kavianiboroujeni Azam , Cloutier Alain , Rodrigue Denis
Published: July 2015

This work investigates the effects of different design parameters such as hemp content in the skins (10–40% wt.), layer thickness (1 and 2 mm), and foaming agent content in the core (0% wt., 0.6% wt. and 1.2% wt.) on the flexural properties of three layer sandwich panels of hemp and high density polyethylene produced by compression molding. The results show that hemp content was the most significant parameter for the flexural properties of these panels. In addition, it was found that specific modulus and strength (per unit weight) were 30% and 36% higher when using a foam core, respectively.
Gluteal Augmentation With Liquid Silicone of Unknown Purity Causes Granulomas in an Adult Female
Authors: Nasseri Eiman
Published: July 2015

Background:

A 39-year-old woman presented with a history of relapsing painful erythema and progressive fibrosis of the lower back. Upon questioning, the patient admitted to receiving liquid silicone (LS) injections for gluteal augmentation abroad and was diagnosed with silicone migration, granulomatous reaction, and fibrosis of the lower back.

Objective:

To review the history of LS injections for cosmetic soft tissue augmentation (STA) as well as its complications and potential treatments.

Methods:

The author reviewed articles that involved the use of LS for STA and summarized their findings.

Results:

The author summarizes the various treatments that have been described for inflammatory reactions following LS injection.

Conclusion:

The growth of cosmetic medical tourism and its inherent lack of after-care as well as patients’ ability to obtain restricted products at home raise the likelihood of encountering granulomatous or fibrotic reactions to fillers during consultations. Physicians should have a structured approach to these patients.
Outer retinal changes following acute optic neuritis
Authors: Al-Louzi Omar A , Bhargava Pavan , Newsome Scott D , Balcer Laura J , Frohman Elliot M , Crainiceanu Ciprian , Calabresi Peter A , Saidha Shiv
Published: July 2015

Background:

Retinal nerve fiber and ganglion cell+inner plexiform (GCIP) layer thinning following multiple sclerosis-related acute optic neuritis (AON) is well described. However, whether AON results in changes in the inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL) and/or photoreceptor segment (PS) layers remains undetermined.

Objectives:

The objective of this paper is to determine if INL+OPL and/or ONL+PS changes occur following AON.

Methods:

Thirty-three AON patients underwent serial optical coherence tomography (OCT) and visual function testing (mean follow-up: 25 months). Longitudinal changes in retinal layer thickness were analyzed using mixed-effects linear regression.

Results:

Four months following AON, the mean decrease in GCIP thickness relative to baseline was 11.4% ( p < 0.001). At four months, a concomitant 3.4% increase in average ONL+PS thickness was observed ( p < 0.001). The percentage decrease in GCIP thickness and increase in ONL+PS thickness were strongly correlated ( r = −0.70; p < 0.001). Between months 4 to 12, ONL+PS thickness declined and, at 12 months, was no longer significantly different from baseline (mean change: 0.5%; p = 0.37). Similar, albeit less robust, changes in the INL+OPL were observed.

Conclusions:

Following AON, dynamic changes occur in the deep retinal layers, which are proportional to GCIP thinning. These novel findings help further our understanding of the biological and/or anatomical sequelae resulting from AON.
Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging
Authors: Pekcevik Yeliz , Mitchell Charles H , Mealy Maureen A , Orman Gunes , Lee In H , Newsome Scott D , Thompson Carol B , Pardo Carlos A , Calabresi Peter A , Levy Michael , Izbudak Izlem
Published: July 2015

Background:

Although spinal magnetic resonance imaging (MRI) findings of neuromyelitis optica (NMO) have been described, there is limited data available that help differentiate NMO from other causes of longitudinally extensive transverse myelitis (LETM).

Objective:

To investigate the spinal MRI findings of LETM that help differentiate NMO at the acute stage from multiple sclerosis (MS) and other causes of LETM.

Methods:

We enrolled 94 patients with LETM into our study. Bright spotty lesions (BSL), the lesion distribution and location were evaluated on axial T2-weighted images. Brainstem extension, cord expansion, T1 darkness and lesion enhancement were noted. We also reviewed the brain MRI of the patients during LETM.

Results:

Patients with NMO had a greater amount of BSL and T1 dark lesions ( p < 0.001 and 0.003, respectively). The lesions in NMO patients were more likely to involve greater than one-half of the spinal cord’s cross-sectional area; to enhance and be centrally-located, or both centrally- and peripherally-located in the cord. Of the 62 available brain MRIs, 14 of the 27 whom were NMO patients had findings that may be specific to NMO.

Conclusions:

Certain spinal cord MRI features are more commonly seen in NMO patients and so obtaining brain MRI during LETM may support diagnosis.
Magnetic resonance imaging of the cervical spinal cord in multiple sclerosis at 7T
Authors: Dula Adrienne N , Pawate Siddharama , Dortch Richard D , Barry Robert L , George-Durrett Kristen M , Lyttle Bailey D , Dethrage Lindsey M , Gore John C , Smith Seth A
Published: July 2015

Background:

The clinical course of multiple sclerosis (MS) is mainly attributable to cervical and upper thoracic spinal cord dysfunction. High-resolution, 7T anatomical imaging of the cervical spinal cord is presented. Image contrast between gray/white matter and lesions surpasses conventional, clinical T1- and T2-weighted sequences at lower field strengths.

Objective:

To study the spinal cord of healthy controls and patients with MS using magnetic resonance imaging at 7T.

Methods:

Axial (C2–C5) T1- and T2*-weighted and sagittal T2*-/spin-density-weighted images were acquired at 7T in 13 healthy volunteers (age 22–40 years), and 15 clinically diagnosed MS patients (age 19–53 years, Extended Disability Status Scale, (EDSS) 0–3) in addition to clinical 3T scans. In healthy volunteers, a high-resolution multi-echo gradient echo scan was obtained over the same geometry at 3T. Evaluation included signal and contrast to noise ratios and lesion counts for healthy and patient volunteers, respectively.

Results/conclusion:

High-resolution images at 7T exceeded resolutions reported at lower field strengths. Gray and white matter were sharply demarcated and MS lesions were more readily visualized at 7T compared to clinical acquisitions, with lesions apparent at both fields. Nerve roots were clearly visualized. White matter lesion counts averaged 4.7 vs 3.1 (52% increase) per patient at 7T vs 3T, respectively ( p=0.05).
Antibodies to myelin oligodendrocyte glycoprotein in aquaporin 4 antibody seronegative longitudinally extensive transverse myelitis: Clinical and prognostic implications
Authors: Cobo-Calvo Álvaro , Sepúlveda María , Bernard-Valnet Raphael , Ruiz Anne , Brassat David , Martínez-Yélamos Sergio , Saiz Albert , Marignier Romain
Published: July 2015

Objective:

We aimed to investigate the frequency and clinical significance of antibodies to myelin oligodendrocyte glycoprotein (MOG-abs) in patients who presented with a first episode of seronegative aquaporin 4 antibody (AQP4-ab) longitudinally extensive transverse myelitis (LETM).

Methods:

Epidemiological, clinical, and paraclinical data of 56 patients from three European centres were analysed. Patients were retrospectively tested for MOG-abs and AQP4-abs, by cell-based assays.

Findings:

Thirteen (23.2%) patients were MOG-ab positive. Among the 56 patients, six (10.7%) converted to neuromyelitis optica (NMO), one (1.8%) to multiple sclerosis (MS), nine (16.1%) had recurrent LETM, and 40 (71.4%) remained as monophasic LETM. Compared with seronegative patients, those with MOG-abs were younger (median: 32.5 vs 44 years; p=0.007), had cerebrospinal fluid pleocytosis more frequently (94% vs 45%, p=0.003) and had better outcome (median Expanded Disability Status Scale (EDSS) 2.0 vs 3.0, p=0.027). MOG-ab positive patients also showed an increase risk of optic neuritis relapse and NMO conversion ( p=0.010).

Conclusion:

Patients with MOG-abs in AQP4-ab seronegative LETM have clinical distinctive features, higher risk of optic neuritis relapses, and better outcome than patients seronegative.
Multi-parametric structural magnetic resonance imaging in relation to cognitive dysfunction in long-standing multiple sclerosis
Authors: Daams Marita , Steenwijk Martijn D , Schoonheim Menno M , Wattjes Mike P , Balk Lisanne J , Tewarie Prejaas K , Killestein Joep , Uitdehaag Bernard MJ , Geurts Jeroen JG , Barkhof Frederik
Published: July 2015

Background:

Cognitive deficits are common in multiple sclerosis. Most previous studies investigating the imaging substrate of cognitive deficits in multiple sclerosis included patients with relatively short disease durations and were limited to one modality/brain region.

Objective:

To identify the strongest neuroimaging predictors for cognitive dysfunction in a large cohort of patients with long-standing multiple sclerosis.

Methods:

Extensive neuropsychological testing and multimodal 3.0T MRI was performed in 202 patients with multiple sclerosis and 52 controls. Cognitive scores were compared between groups using Z-scores. Whole-brain, white matter, grey matter, deep grey matter and lesion volumes; cortical thickness, (juxta)cortical and cerebellar lesions; and extent and severity of diffuse white matter damage were measured. Stepwise linear regression was used to identify the strongest predictors for cognitive dysfunction.

Results:

All cognitive domains were affected in patients. Patients showed extensive atrophy, focal pathology and damage in up to 75% of the investigated white matter. Associations between imaging markers and average cognition were two times stronger in cognitively impaired patients than in cognitively preserved patients. The final model for average cognition consisted of deep grey matter DGMV volume and fractional anisotropy severity (adjusted R²=0.490; p<0.001).

Conclusion:

From all imaging markers, deep grey matter atrophy and diffuse white matter damage emerged as the strongest predictors for cognitive dysfunction in long-standing multiple sclerosis.
Nursing futility, managing medicine: Nurses’ perspectives on the transition from life-prolonging to palliative care
Authors: Broom Alex , Kirby Emma , Good Phillip , Lwin Zarnie
Published: July 2015

The shift from life-prolonging and palliative care can be fraught with interpersonal complexities as patients face dilemmas around mortality and the dying process. Nurses can play a central role in managing these moments, often with a focus on promoting and enhancing communication around: the meaning of palliative care, the nature of futility and the dying process more broadly. These sites of nurse–patient communication can be highly charged and pose unique challenges to nurses including how to balance nursing perspectives versus those of other stakeholders including doctors. Here, drawing on interviews with nurses, we explore their accounts of communication about futility and the process of transitioning to palliative care. The interviews reveal nurses’ perspectives on the following: the art of conversing around futility and managing patient resistance, the influence of guilt and individual biographies in shaping communication, the importance of non-verbal and the informal in communication, the impact of conflicting organisational expectations on nurses and the process of learning to effectively communicate. We argue that these transitional moments articulate important, and at times problematic, aspects of contemporary nursing and nurse–medical relations.
Propulsion architectures using mechanical energy storage
Authors: Raghavan Madhusudan
Published: July 2015

Alternative propulsion architecture systems are described and evaluated from the standpoint of efficiency and potential for use as mechanical energy storage systems in automobiles. Air hybrids are studied and modeling/simulation results are presented along with experimental data from a test bed to assess round-trip efficiencies of such storage systems. A possible architectural scheme is proposed for the use of compressed air for rapid energy recharge. This is followed by an assessment of hydraulic hybrids and flywheel hybrids. These systems are sized for comparable applications. Simulations are then used to objectively compare losses in these systems and to estimate operating round-trip efficiencies in energy storage applications.
Framing Edward Snowden: A comparative analysis of four newspapers in China, United Kingdom and United States
Authors: Di Salvo Philip , Negro Gianluigi
Published: July 2015

This article sheds light on the framing of Edward Snowden in four newspapers in three different countries. The authors analysed online editions of a major American daily ( The New York Times), one prominent European newspaper ( The Guardian), one mouthpiece of the Chinese Communist Party ( The People’s Daily) and The South China Morning Post. The study seeks to explore how the role of Edward Snowden was framed and how digital whistleblowing was descripted by newspapers with different levels of Internet control, perception and culture on whistleblowing. The research is based on the framework proposed by a recent study of the framing of Bradley Manning. The results of a content analysis will present to what extent the press supported or criticized the role of Edward Snowden and his revelations. This article used four out of its five categories (‘Hero’, ‘Victim’, ‘Villain’, ‘Whistle-Blower’) plus a new addition of ‘Mole’, proposed by the authors. The findings provide evidence of the differences in the framing of Edward Snowden and the rhetoric behind reporting about whistleblowers and Internet governance.
Defining health risk by media template: Hong Kong’s news discourse of the Swine Flu pandemic
Authors: Chan Chi Kit
Published: July 2015

In the risk society that has resulted from modernization, power rests with those who define risks. In the midst of uncertainties and controversies surrounding unpredictable risks, the news value of objectivity becomes a key justification for news organizations and journalists narrating speculation of social risks in news discourses. I shed light on the theorization of ‘media template’, and construct a three-step model to examine how highly unknown social risks are constructed as social facts in the process of news-making. News discourse first represents a simplified and distorted ‘lesson learnt’ from a past exemplary event of concerned social risk. Second, it marginalizes meanings other than those constructed by that exemplar. Last, the news discourse ‘repairs’ its narration when contradictory evidence emerges. I explicate the model by demonstrating how Hong Kong’s news discourse about the Swine Flu pandemic in 2009 drew upon the exemplar of the Severe Acute Respiratory Syndrome epidemic in 2003. I also discuss the implications of media template to news construction of social risks with reference to the theoretical underpinnings of risk society.
Intermedia agenda-setting in a multimedia news environment
Authors: Vonbun Ramona , Königslöw Katharina Kleinen-von , Schoenbach Klaus
Published: July 2015

This article analyzes intermedia agenda-setting processes during a national election campaign of 38 newspapers, online news sites, TV news programs, as well as a wire service, through semi-automatic content analysis and time series analysis. The theoretical assumption was that intermedia agenda-setting is determined by the production structures of certain media types, the opinion-leader role of specific media outlets, and issue-specific characteristics. The findings suggest that, despite previous evidence to the contrary, intermedia agenda-setting also occurs during election campaigns, with a short time lag of 1 day. Additionally, a medium’s opinion-leader role depends strongly on issue-specific characteristics, such as obtrusiveness and proximity, mediating the intermedia agenda-setting process. And the traditional role of print media as intermedia agenda-setters is found to be challenged by online news sites.
The changing interaction of ethnic and socio-economic segregation in England and Wales, 1991–2011
Authors: Harris Richard , Johnston Ron , Manley David
Published: July 2015

Following the publication of the 2001 and 2011 Census data, considerable attention has been given to patterns of ethnic residential segregation within the UK. The evidence contributes to debates about integration; however, as Kapoor (2013) has argued, discussion about it also risks promoting the idea that what we measure is voluntary segregation, arising from the outcome of residential choices and a preference to live with one's ethno-cultural peers. In reality, ethnic and social segregation overlap and are easily confounded; it is important to pay attention to where they geographically coincide. In this paper we use an area typology to assess whether minority ethnic groups are disproportionately concentrated in neighbourhoods in England and Wales containing the lowest proportions of their adult populations in full-time employment, and evaluate how those concentrations have changed between 1991 and 2011. We consider the (residential) exposure of the ethnic groups to the White British and also to each other, and identify the groups affected by the persistence of economic disadvantage. The analysis shows that patterns of ethnic segregation intersect strongly with neighbourhoods of socio-economic disadvantage, with inequalities in the labour market and the increase of part-time working suggested as contributing factors. A decreased exposure to the White British is an increased characteristic of the disadvantaged neighbourhoods where minority groups live. However, exposure between those groups has increased.
Here I am: Authenticity and self-branding on travel blogs
Authors: van Nuenen Tom
Published: July 2015

This article examines the discursive structure of several popular travel blogs to understand the relationship between authenticity and self-branding. Instances of present-day “canonical” blogs are examined, showing up high on Google searches, attracting significant audiences, and featuring on “best of” lists presented by other websites. Through a discourse analysis of the blog’s About pages, it is shown that professional bloggers reconcile the search for a self-dependent and inward-turned existential authenticity with the performance of self-branding techniques. Bloggers construct an image of a resilient self in times of hardship, while acting as travel and life coaches and ensuring their readers that such a nomadic lifestyle is attainable for anyone who really wants it. Simultaneously, there is an unmistakable influence of socio-economic resources that these travelers have at their disposal. The enmeshing of authenticity and self-branding results in a discourse in which it is possible to both sell and become oneself.
Sublime perversions: Capturing the uncanny affects of queer temporalities in Mississippian ruins
Authors: Arjona Jamie M
Published: July 2015

During the 19th century, sublime depictions of North American mounds captivated Euro-American colonists and Romantic travelers. Settlers frequently embedded farms and homesteads into the material fabric of these Indigenous ruins across the American Bottom region and surrounding uplands, uncovering traces of antiquity in the process. Focusing on the Emerald mound site and broader mound discourses, I examine how material intimacies underlying this 19th-century phenomenon periodically corrupted Romantic sensibilities. Specifically, I highlight aspects of archival and spatial data that capture fleeting moments when mound intercourse generated uncanny affects and queer temporalities. I argue that in moments when uncanny affects haunted colonial homes, Indigenous histories queered the tense of settler colonialism.
Social work practice research innovation, implementation and implications: A case of ‘Cooperative Grounded Inquiry’ with formerly abused women in Hong Kong
Authors: Kong Sui-Ting
Published: July 2015

There is a notable ethical, epistemological and practical need to recognize formerly abused women’s central role in developing domestic violence services and related knowledge. For achieving social work professional accountability, methodological innovations that facilitate participation of different stakeholders in domestic violence services are required. Instead of polarizing domestic violence service providers and users, this article aims at providing deeper thoughts on methodological innovation that can facilitate coparticipation and partnership in domestic violence social work practice research. I propose a rigorous merging of Cooperative Inquiry and Grounded Theory Methodology to produce a Cooperative Grounded Inquiry which can cast light onto the promotion of participation and knowledge making in domestic violence social work services. This methodology was applied in working with formerly abused women in Hong Kong and has generated useful working principles for further application of the methodology.
Challenges and coping strategies of refugees: Exploring residual Liberian refugees’ experiences in Ghana
Authors: Dako-Gyeke Mavis , Adu Ernestina
Published: July 2015

This study explored the challenges and coping strategies among Liberian refugees in Ghana. Using a qualitative research design, 40 participants were purposively recruited at a refugee settlement in Ghana. Four focus group discussions and sixteen in-depth interviews were conducted. The focus group discussions and in-depth interviews were audio-taped, transcribed, coded, and analyzed thematically based on the objectives of the study. The findings indicated that the refugees experienced challenges related to disruption in social networks, disputes over resources, high rate of unemployment, and increased level of criminal activities. The study also revealed that the refugees included in this study resorted to religion, spirituality, and income earning activities as their coping strategies. The findings offer insights for social workers, policy actors, and future research.
Educating competitive teachers for a competitive nation?
Authors: Rönnström Niclas
Published: July 2015

The aim of this article is to discuss recent Swedish teacher education investments and reforms, and the work of teachers in response to globalisation within the context of modern social imaginaries. I briefly outline Charles Taylor’s concept of modern social imaginaries, and I examine the character of recent Swedish teacher education, teacher education reform and the work expected of teachers. I conclude that economic imaginaries are given primacy: aims and reforms are primarily linked to economic imaginaries of the competitive nation; economic norms are given primacy in the governance of schools and education; globalised and economic standards of quality and success are increasing in importance; and the concern about how to make teacher education an attractive career investment for groups the state finds important to attract to teaching is held to be vital for the quality in outcomes of education. I critically discuss the underlying globalist imaginary I think underpins Swedish education reform in the global era, and transform the teacher into a scientifically grounded economic agent for market integration and the competitive edge of the Swedish nation. I address the question of whether the modern social imaginary of democracy and citizenship should be restored and cosmopolitised in education and teacher education and in relation to the expected work of teachers rather than be reduced to or transformed into economic worldviews and agency in the era of globalisation.
The role of examples, current designs and ideas for a cosmopolitan design of education
Authors: Roth Klas
Published: July 2015

This paper discusses the value and importance of examples in Kantian terms, and how students can cultivate their moral disposition through the use of examples in education. It is argued that students should not just copy or imitate examples automatically, nor appraise them unreflectively and uncritically. They should instead be enabled to think for themselves in the position of the other and consistently, through the use of examples. This paper also discusses the extent to which students in teacher education programmes in Sweden were enabled to cultivate a moral disposition through the use of literature which unveils a design of education in national, European and cosmopolitan terms. However, since it seems that they lacked such opportunities it is argued that they were not enabled to cultivate their moral disposition through the use of the above-mentioned literature.
Transnational policy discourses on teacher education: A cosmopolitan perspective
Authors: Wahlström Ninni
Published: July 2015

In this article, I analyse some of the transnational ‘authoritative’ policy documents on teacher education and teacher development from a cosmopolitan perspective. The purpose is to explore the possibilities for analysing the characteristics of teacher education and the role of the teacher in transnational texts from a cosmopolitan perspective in order to explore the field of tension between an economic cosmopolitan approach and a moral cosmopolitan approach to justice. Mainly drawing on Amartya Sen and Martha Nussbaum, I argue that it is possible to go beyond a limited economic perspective in order to make an alternative approach to teacher education visible, where the possibility to revitalize and reconstruct local school activities is in focus. One conclusion is that teacher education in transnational policy texts can be understood both within a ‘reification discourse’ and within a ‘reflexivity discourse’. An important distinction between the two discourses is the understanding of critical reflections as related to evidence-based standards or to an understanding of an individual’s positionality, relationality and historicity.
Baby Factories in Nigeria
Authors: Makinde Olusesan Ayodeji , Olaleye Olalekan , Makinde Olufunmbi Olukemi , Huntley Svetlana S. , Brown Brandon
Published: July 2015

Baby factories and baby harvesting are relatively new terms that involve breeding, trafficking, and abuse of infants and their biological mothers. Since it was first described in a United Nations Educational, Scientific and Cultural Organization report in Nigeria in 2006, several more baby factories have been discovered over the years. Infertile women are noted to be major patrons of these baby factories due to the stigmatization of childless couples in Southern Nigeria and issues around cultural acceptability of surrogacy and adoption. These practices have contributed to the growth in the industry which results in physical, psychological, and sexual violence to the victims. Tackling baby factories will involve a multifaceted approach that includes advocacy and enacting of legislation barring baby factories and infant trafficking and harsh consequences for their patrons. Also, programs to educate young girls on preventing unwanted pregnancies are needed. Methods of improving awareness and acceptability of adoption and surrogacy and reducing the administrative and legal bottlenecks associated with these options for infertile couples should be explored to diminish the importance of baby factories.
Building a Better Speed Trap: Measuring Policy Adoption Speed in the American States
Authors: Mallinson Daniel J.
Published: July 2015

A comparative approach to studying the spread of policy innovations has recently yielded new and interesting results, as well as theoretical advancements, for policy diffusion research. Specifically, punctuated equilibrium theory has been offered as an explanation for why some policies spread quickly, while others do so normally, and still others are adopted very slowly. Studies of adoption speed, however, currently rely on careful case selection or a dichotomous categorization of adoptions as fast or slow to test why policies diffuse at different speeds. Building on this foundational work, I propose a method for measuring adoption speed as a continuous concept, so that it can be modeled directly as an important outcome of interest to diffusion scholars. I then use the new measure to evaluate how adoption speed varies across time and policy domain. I further demonstrate the utility of the measure as a dependent variable by replicating past results, including the interactive effect of complexity and salience on adoption speed and positive effect of federal incentives, as well as finding preliminary evidence that policy clusters spread more rapidly than the average stand-alone policy.
Fractionated Lung IMPT Treatments
Authors: Dowdell Stephen , Grassberger Clemens , Sharp Greg , Paganetti Harald
Published: July 2015

Treatment uncertainties in radiotherapy are either systematic or random. This study evaluates the sensitivity of fractionated intensity-modulated proton therapy (IMPT) lung treatments to systematic and random setup uncertainties. Treatments in which single-field homogeneity was restricted to within ±20% (IMPT20%) were compared to full IMPT (IMPTfull) for 10 patients with lung cancer. Four-dimensional Monte Carlo calculations were performed using patient computed tomography geometries with ±5 mm systematic or random setup uncertainties applied over a 35 × 2.5Gy(RBE) treatment course. Fifty fractionated courses were simulated for each patient using both IMPT delivery methods with random setup uncertainties applied each fraction and for 3 energy-dependent spot sizes (big spots, σ≈18-9 mm; intermediate spots, σ≈11-5 mm; and small spots, σ≈4-2 mm). These results were compared to Monte Carlo recalculations of the original treatment plan assuming zero setup uncertainty. Results are presented as the difference in equivalent uniform dose (ΔEUD), V95 (ΔV95), and target dose homogeneity (ΔD1-D99). Over the whole patient cohort, the ΔEUD was 2.0 ± 0.5 (big spots), 1.9 ± 0.7 (intermediate spots), and 1.3 ± 0.4 (small spots) times more sensitive to ±5 mm systematic setup uncertainties in IMPTfull compared to IMPT20%. IMPTfull is 1.9 ± 0.9 (big spots), 2.1 ± 1.1 (intermediate spots), and 1.5 ± 0.6 (small spots) times more sensitive to random setup uncertainties than IMPT20% over a fractionated treatment course. The ΔV95 is at least 1.4 times more sensitive to systematic and random setup uncertainties for IMPTfull for all spot sizes considered. The ΔD1-D99 values coincided within uncertainty limits for both IMPT delivery methods for the 3 spot sizes considered, with higher mean values always observed for IMPTfull. The paired t-test indicated that variations observed between IMPTfull and IMPT20% were significantly different for the majority of scenarios. Significantly larger variations were observed in ΔEUD and ΔV95 in IMPTfull lung treatments in addition to higher mean ΔD1−D99. The steep intra-target dose gradients in IMPTfull make it more susceptible to systematic and random setup uncertainties.
Spectral Imaging Technology-Based Evaluation of Radiation Treatment Planning to Remove Contrast Agent Artifacts
Authors: Yi-qun Xu , Wei Liu , Xin-ye Ni
Published: July 2015

Objective:

This study employs dual-source computed tomography single-spectrum imaging to evaluate the effects of contrast agent artifact removal and the computational accuracy of radiotherapy treatment planning improvement.

Method:

The phantom, including the contrast agent, was used in all experiments. The amounts of iodine in the contrast agent were 30, 15, 7.5, and 0.75 g/100 mL. Two images with different energy values were scanned and captured using dual-source computed tomography (80 and 140 kV). To obtain a fused image, 2 groups of images were processed using single-energy spectrum imaging technology. The Pinnacle planning system was used to measure the computed tomography values of the contrast agent and the surrounding phantom tissue. The difference between radiotherapy treatment planning based on 80 kV, 140 kV, and energy spectrum image was analyzed.

Results:

For the image with high iodine concentration, the quality of the energy spectrum-fused image was the highest, followed by that of the 140-kV image. That of the 80-kV image was the worst. The difference in the radiotherapy treatment results among the 3 models was significant. When the concentration of iodine was 30 g/100 mL and the distance from the contrast agent at the dose measurement point was 1 cm, the deviation values ( P) were 5.95% and 2.20% when image treatment planning was based on 80 and 140 kV, respectively. When the concentration of iodine was 15 g/100 mL, deviation values ( P) were −2.64% and −1.69%.

Conclusion:

Dual-source computed tomography single-energy spectral imaging technology can remove contrast agent artifacts to improve the calculated dose accuracy in radiotherapy treatment planning.
CyberKnife Stereotactic Ablative Radiotherapy as an Option of Treatment for Patients With Prostate Cancer Having Oligometastatic Lymph Nodes
Authors: Napieralska Aleksandra , Miszczyk Leszek , Stąpór-Fudzińska Małgorzata
Published: July 2015

The aim of this study was to evaluate the effectiveness of CyberKnife-based stereotactic ablative radiotherapy on prostate cancer lymph node metastases. Our material consisted of 18 patients with 31 metastatic lymph nodes irradiated between 2011 and 2014 using CyberKnife-based stereotactic ablative radiotherapy. Patients were irradiated using fraction dose varied from 6 to 15 Gy (median 10), to the total dose of 24 to 45 Gy (median 30). Irradiated lymph node size varied from 0.4 to 4.0 cm. In all, 9 patients had single lymph node metastasis and 9 patients had metastases of 2 to 4 lymph nodes. Prostate-specific antigen concentration before radiotherapy varied from 0.01 to 15.58 (mean 6.97; median 4.66). All patients at the time of radiotherapy and follow-up received androgen deprivation therapy. Mann-Whitney U, Kaplan-Meier method, and log-rank tests were used in statistical analysis. We obtained the following results: after CyberKnife stereotactic ablative radiotherapy, prostate-specific antigen concentration dropped in majority of cases and during the last control varied from 0.00 to 258.00 (median 2.5), and was lower in patients without dissemination to other organs ( P = .01). Complete regression was found in 12 lesions, stable disease in 13, and progression in 4. In 7 patients, the dissemination to other organs occurred. Our results allow us to conclude that CyberKnife stereotactic ablative radiotherapy of prostate cancer lymph node oligometastases gives good local control and relatively good prostate-specific antigen response.
Naturopathic Oncology Modified Delphi Panel
Authors: Hill Jacob , Hodsdon Wendy , Schor Jacob , McKinney Neil , Rubin Daniel , Seely Dugald , Parmar Gurdev , Birdsall Tim , Alschuler Lise , Lamson Davis , Birdsall Shauna , Zwickey Heather
Published: July 2015

Naturopathic oncology is a relatively new and emerging field capable of providing professional integrative or alternative services to cancer patients. Foundational research is critical to identify topics in the clinical and research development of naturopathic oncology for future growth of the field. Study design. This study implements a modified Delphi protocol to develop expert consensus regarding ethics, philosophy, and research development in naturopathic oncology. Methods. The modified protocol implements a nomination process to select a panel of 8 physicians and to assist in question formulation. The protocol includes an in-person discussion of 6 questions with multiple iterations to maintain the concept of the Delphi methodology as well as a postdiscussion consensus survey. Results. The protocol identified, ranked, and established consensus for numerous themes per question. Underlying key topics include integration with conventional medicine, evidence-based medicine, patient education, patient safety, and additional training requirements for naturopathic oncologists. Conclusions. The systematic nomination and questioning of a panel of experts provides a foundational and educational resource to assist in clarification of clinical ethics, philosophy, and research development in the emerging field of naturopathic oncology.
Ubiquitin-specific protease 28 is overexpressed in human glioblastomas and contributes to glioma tumorigenicity by regulating MYC expression
Authors: Wang Zengwu , Song Qimin , Xue Jian , Zhao Yumei , Qin Shiqiang
Published: July 2015

The transcription factor MYC, which is dysregulated in the majority of gliomas, is difficult to target directly. Deubiquitinase ubiquitin-specific protease 28 (USP28) stabilizes oncogenic factors, including MYC. However, the contribution of USP28 in tumorigenesis, particularly in glioma, is unknown. Here, we determined the expression of USP28 and assessed its clinical significance in human glioma. We found that USP28 is overexpressed in human glioma but not in normal brain tissue. The level of USP28 protein expression in human glioma tissues was directly correlated with glioma grade. Meanwhile, the level of USP28 protein expression in human glioblastoma tissues was inversely correlated with patient survival. Enforced USP28 expression promotes SW1783 glioma cell proliferation. Moreover, gliomas that arose from USP28-transfected SW1783 cells displayed tumorigenicity in nude mouse model systems. Inhibition of USP28 expression in glioblastoma U373 cells suppressed anchorage-independent growth in vitro and tumorigenicity in vivo. Furthermore, USP28 regulates the expression of MYC protein, which is essential in USP28-induced cell growth in glioma cells. These results showed that USP28 is overexpressed in human glioblastomas and it contributes to glioma tumorigenicity. Therefore, USP28 could be a new target of therapy for human malignant glioma.
Laparoscopic Repair of Primary Inguinal Hernia Performed in Public Hospitals or Low-Volume Centers Have Increased Risk of Reoperation for Recurrence
Authors: Andresen Kristoffer , Friis-Andersen Hans , Rosenberg Jacob
Published: July 2015

Background. Inguinal hernia repair is traditionally carried out as either open or laparoscopic repair. Laparoscopic repair has been shown to be superior in terms of pain and discomfort, but has a higher risk of reoperation. Quality of inguinal hernia repair is related to factors such as method of repair, characteristics of patients, and possibly the annual volume of procedures performed by a center. The aim of this study was to test the hypothesis that hospital volume and type of hospital (private vs public) could influence the reoperation rate for recurrence as a marker of surgical quality of care. Methods. This study was based on data from the Danish Hernia Database covering the period from January 1, 1998, to December 31, 2013. Hernia repairs included in this study were laparoscopic repair of primary, inguinal hernias in the elective setting, performed on adult male patients. Results. A total of 14 532 laparoscopic repairs were included for analysis. Centers reporting less than 50 procedures a year had a significantly higher cumulative reoperation rate compared with centers reporting more than 50 procedures a year (9.97% vs 6.06%), P < .0001. Private centers had a lower cumulative reoperation rate compared with public centers: 5.36% versus 8.53%, P ≤ .0001. Type of center and center volume were both independent risk factors for reoperation in a Cox regression model. Conclusion. Hospital volume had an effect on the reoperation rate for recurrence after laparoscopic inguinal hernia repair. Furthermore, private centers performed better than public centers irrespective of volume.
Identification of Key Proteins in Human Epithelial Cells Responding to Bystander Signals From Irradiated Trout Skin
Authors: Furlong Hayley , Smith Richard , Wang Jiaxi , Seymour Colin , Mothersill Carmel , Howe Orla
Published: July 2015

Radiation-induced bystander signaling has been found to occur in live rainbow trout fish ( Oncorhynchus mykiss). This article reports identification of key proteomic changes in a bystander reporter cell line (HaCaT) grown in low-dose irradiated tissue-conditioned media (ITCM) from rainbow trout fish. In vitro explant cultures were generated from the skin of fish previously exposed to low doses (0.1 and 0.5 Gy) of X-ray radiation in vivo. The ITCM was harvested from all donor explant cultures and placed on recipient HaCaT cells to observe any change in protein expression caused by the bystander signals. Proteomic methods using 2-dimensional (2D) gel electrophoresis and mass spectroscopy were employed to screen for novel proteins expressed. The proteomic changes measured in HaCaT cells receiving the ITCM revealed that exposure to 0.5 Gy induced an upregulation of annexin A2 and cingulin and a downregulation of Rho-GDI2, F-actin-capping protein subunit beta, microtubule-associated protein RP/EB family member, and 14-3-3 proteins. The 0.1 Gy dose also induced a downregulation of Rho-GDI2, hMMS19, F-actin-capping protein subunit beta, and microtubule-associated protein RP/EB family member proteins. The proteins reported may influence apoptotic signaling, as the results were suggestive of an induction of cell communication, repair mechanisms, and dysregulation of growth signals.
Pain-free treadmill exercise for patients with intermittent claudication: Are there gender differences?
Authors: Dipnarine Krishna , Barak Sharon , Martinez Coleen A , Carmeli Eliezer , Stopka Christine B
Published: July 2015

Intermittent claudication, a common symptom of peripheral arterial disease, results in insufficient blood flow and oxygen supply to lower extremity muscles. Compared to men, women with peripheral arterial disease have a higher rate of mobility loss with peripheral arterial disease due to poorer lower extremity functioning. This study evaluates the effect of supervised pain-free treadmill exercise on improving performance in women with intermittent claudication due to peripheral arterial disease in comparison to men. A total of 26 participants (women, n = 9, 34.62%; mean age = 67.58 ± 5.59 years; averaging 23.46 ± 3.91 visits and 10.46 ± 0.99 weeks in the program) diagnosed with peripheral arterial disease, with symptoms of intermittent claudication, partook in a 45 min treadmill walk, twice per week, below the participant’s minimal pain threshold. Female participants’ change scores showed 752%, 278% and 115% improvement in mean walking distance, duration and rate, respectively. Men improved 334%, 149% and 80%, respectively. Significant differences (p < 0.05) in pre and post measurements within each group support positive outcomes. No significant differences between groups were observed (Cohen’s d effect size > 0.80). Our results suggest that women reap similar benefits from this low-intensity treadmill program in comparison to men.
Project risk management in educational organizations
Authors: Eger Ludvík , Egerová Dana
Published: July 2015

The past 20 years have been a period of reforms for school systems in Visegrad countries. However, the successful implementation of educational reforms requires effective leaders and managers and, to produce effective leaders, changes in the system of leadership and management programmes need to be adopted. From 2004, the Czech Republic saw a growth of school project activities, with educational projects becoming important tools for supporting innovations in teaching and learning processes. Despite the new system of leadership development, there was a gap between level of headteachers’ competencies and the competency required to manage educational projects successfully. This study focuses on the leadership competencies of project management, particularly risk management, in the context of educational organizations. The survey data were collected through interviews with headteachers, senior teachers and project managers in 118 educational subjects from nine regions of the Czech Republic. The research team acquired data from 300 educational projects. The key findings show that headteachers have difficulty in managing the risks of educational projects. Survey results also indicate that a very high level of risk occurred in 8% of the examined projects, and medium risk, in 27%. It is suggested that training and knowledge-transfer programmes about project management, including risk management, should become priorities when preparing headteachers for their role.
Bourdieu’s distinction between rules and strategies and secondary principal practice
Authors: Anderson Karen
Published: July 2015

This paper reviews a selection of literature on secondary principal practice from which to propose an approach for further research. The review demonstrates that applications of Bourdieu’s theory of practice have contributed to understandings about secondary principal practice, and that the distinction he made between rules and strategies has the potential to provide a useful approach to gaining new understandings of everyday secondary principal practice. The paper signals that it is timely to undertake research into secondary principal practice in Aotearoa New Zealand, and that applying Bourdieu’s conceptualising of strategies to this research has the potential to reveal some of the unconscious, unstated and less visible practices of everyday leadership. Further, applying Bourdieu’s theory of practice to analysing and explaining this data on secondary principal practice may reveal new insights about what secondary principals do and why.
School improvement in high-capacity schools
Authors: Mitchell Coral , Sackney Larry
Published: July 2015

Although school improvement continues to present as an unresolved educational problem, the required changes are relatively straightforward. Essentially, schools need to be retooled with students’ experiences and high-quality instruction at the center of the design. In this article, we present the findings of research into the leadership of high-capacity learning community schools, wherein the design features yielded school-wide improvement in teaching and learning. Specifically, educational leadership emerged organically throughout the school, and the school leaders took a collaborative, learning-oriented approach to regulating, coordinating, expanding and protecting professional practice. These leadership activities reflected the ontology of living systems, as different from managed systems, and enabled the leaders to create an environment within which authentic teaching and rich learning flourished.