bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensory Imagery in Individuals who Are Blind and Sighted: Examining Unimodal and Multimodal Forms
Authors: Eardley Alison F. , Pring Linda 
Published: December 2018

Introduction Previous research has suggested that visual images are more easily generated, more vivid, and more memorable than other sensory modalities. This research examined whether or not imagery is experienced in similar ways by people with and without sight. Specifically, the imageability of visual, auditory, and tactile cue words was compared. The degree to which images were multimodal or unimodal was also examined. Methods Twelve participants who were totally blind from early infancy and 12 sighted participants generated images in response to 53 sensory and nonsensory words, rating imageability and the sensory modality, and describing images. From these 53 items, 4 subgroups of words that stimulated images that were predominantly visual, tactile, auditory, and low-imagery were created. Results T-tests comparing imageability ratings from blind and sighted participants found no differences for auditory and tactile words (both p > .1). Nevertheless, although participants without sight found auditory and tactile images equally imageable, sighted participants found images in response to tactile cue words harder to generate than visual cue words (mean difference: −0.51, p = .025). Participants with sight were also more likely to develop multisensory images than were participants without sight (both U ≥ 15.0, N1 = 12, N2 = 12, p ≤.008). Discussion For both the blind and sighted groups, auditory and tactile images were rich and varied, and similar language was used. Sighted participants were more likely to generate multimodal images, and this was particularly the case for tactile words. Nevertheless, cue words that resulted in multisensory images were not necessarily rated as more imageable. The discussion considers whether or not multimodal imagery represents a method of compensating for impoverished unimodal imagery. Implications for practitioners Imagery is important not only as a mnemonic in memory rehabilitation, but also in everyday uses for modes such as autobiographical memory. This research emphasizes the importance of not only auditory and tactile sensory imagery, but also spatial imagery for people without sight.
The Influence of Need-Supportive Teacher Behavior on the Motivation of Students with Congenital Deafblindness
Authors: Haakma Ineke , Janssen Marleen , Minnaert Alexander 
Published: December 2018

Introduction Research has indicated that need-supportive learning environments positively influence students’ motivation. According to self-determination theory, a need-supportive learning environment is one in which teachers provide structure, autonomy support, and involvement, and thereby support their students’ psychological needs for competence, autonomy, and relatedness. In this study, we aimed to explore whether teachers of students with congenital deafblindness provide such an environment and how they adjust their need-supportive teaching to these students. Methods We conducted an in-depth analysis of teacher-student interactions using a multiple-case-study design. We analyzed videos of teacher-student interactions from the perspective of self-determination theory. Results We found that successful need support for this group requires careful adjustments for each individual student. Only if the provision of structure, autonomy support, and involvement is tailored to the student can a positive influence on motivation be noticed. Another important finding is that teachers provide more structure and involvement than autonomy support. Discussion This study showed that need-supportive teaching is important in the education of students with congenital deafblindness. By using video analysis, we were able to point out teaching strategies that led to greater motivation for these students. Implications for practitioners Motivation is a prerequisite for learning, and teachers’ behavior might add to that motivation. This study showed that need support leads to enhanced motivation in students with congenital deafblindness. We provided practical insights that teachers can use to create need-supportive learning environments for these students.
Revolutionizing Estimation and Inference for Program Evaluation Using Bayesian Methods
Authors: Vollmer Lauren , Finucane Mariel , Brown Randall 
Published: December 2018

Background: Policy makers seek to replace the “thumbs up–thumbs down” of conventional hypothesis testing with statements about the probability that program effects on key outcomes exceed policy-relevant thresholds. Objective: We develop a Bayesian model that addresses the shortcomings of a typical frequentist approach to estimating the effects of the Comprehensive Primary Care (CPC) initiative, a Centers for Medicare and Medicaid Services demonstration. We compare findings from the two approaches to illustrate the relative merits of introducing additional assumptions through Bayesian methods. Research design: We apply Bayesian and frequentist methods to estimate the effects of CPC on total Medicare expenditures per beneficiary per month for Medicare beneficiaries attributed to participating practices. Under both paradigms, we estimated program effects using difference-in-differences regressions comparing the change in Medicare expenditures between baseline and follow-up for Medicare patients attributed to 497 primary care practices participating in CPC to Medicare patients attributed to 908 propensity score-matched comparison practices. Results: Results from the Bayesian and frequentist models are comparable for the overall sample, but in regional subsamples, the Bayesian model produces more precise etimates that exhibit less variation over time. The Bayesian results also permit probabilistic inference about the magnitudes of effects, offering policy makers the ability to draw conclusions about practically meaningful thresholds. Conclusions: Carefully developed Bayesian models can enhance precision and plausibility and offer a more nuanced understanding of where and when program effects occur, without imposing undue assumptions. At the same time, these methods frame conclusions in flexible, intuitive terms that respond directly to policy makers’ needs.
Examining the relationships between environmental barriers and leisure in community-dwelling individuals living with stroke
Authors: Tang Ada , Sun Billy , Pang Marco YC , Harris Jocelyn E 
Published: December 2018

Objective: To characterize environmental barriers to leisure participation among individuals living with stroke; examine relationships between environmental barriers and leisure interest and satisfaction; and investigate participant factors associated with the perception of environmental barriers. Design: Survey. Setting: Community. Participants: Convenience sample of 51 community-dwelling adults less than six months post stroke. Interventions: Not applicable. Main outcome measure(s): Craig Hospital Inventory of Environmental Factors-Short Form. Results: Physical and structural environmental barriers were reported as the most frequent and large barrier to leisure participation ( n = 26 (51%) rated as “monthly or more,” n = 12 (24%) rated as “big problem”). While attitude and support and policy barriers were not as commonly encountered, participants labeled these as “big problem(s)” (attitude and support n = 6 (12%), policy n = 7 (14%)). The presence of depressive symptoms was associated with the frequency in which attitudinal and support (rho = 0.50, P < 0.001), physical and structural (rho = 0.46, P < 0.001), and service and assistance (rho = 0.28, P = 0.04) barriers were reported, as well as magnitude of attitude and support barriers (rho = 0.48, P < 0.001). In multivariable regression analysis, depressive symptoms and walking capacity explained 21% of the variance of the frequency of attitude and support barriers ( P = 0.004), where depressive symptoms was an independent correlate ( P = 0.004). No other factors were associated with environmental barriers to leisure participation. Conclusion: Individuals with stroke report frequent and large physical and structural environmental barriers to leisure participation, which may be associated with the presence of depressive symptoms.
Quality improvement priorities for safer out-of-hours palliative care: Lessons from a mixed-methods analysis of a national incident-reporting database
Authors: Williams Huw , Donaldson Sir Liam , Noble Simon , Hibbert Peter , Watson Rhiannon , Kenkre Joyce , Edwards Adrian , Carson-Stevens Andrew 
Published: December 2018

Background: Patients receiving palliative care are often at increased risk of unsafe care with the out-of-hours setting presenting particular challenges. The identification of improved ways of delivering palliative care outside working hours is a priority area for policymakers. Aim: To explore the nature and causes of unsafe care delivered to patients receiving palliative care from primary-care services outside normal working hours. Design: A mixed-methods cross-sectional analysis of patient safety incident reports from the National Reporting and Learning System. We characterised reports, identified by keyword searches, using codes to describe what happened, underlying causes, harm outcome, and severity. Exploratory descriptive and thematic analyses identified factors underpinning unsafe care. Setting/participants: A total of 1072 patient safety incident reports involving patients receiving sub-optimal palliative care via the out-of-hours primary-care services. Results: Incidents included issues with: medications (n = 613); access to timely care (n = 123); information transfer (n = 102), and/or non-medication-related treatment such as pressure ulcer relief or catheter care (n = 102). Almost two-thirds of reports (n = 695) described harm with outcomes such as increased pain, emotional, and psychological distress featuring highly. Commonly identified contributory factors to these incidents were a failure to follow protocol (n = 282), lack of skills/confidence of staff (n = 156), and patients requiring medication delivered via a syringe driver (n = 80). Conclusion: Healthcare systems with primary-care-led models of delivery must examine their practices to determine the prevalence of such safety issues (communication between providers; knowledge of commonly used, and access to, medications and equipment) and utilise improvement methods to achieve improvements in care.
Alcohol intake and risk of systemic lupus erythematosus: a Mendelian randomization study
Authors: Bae S C , Lee Y H 
Published: December 2018

Objectives This study aimed to examine whether alcohol intake is causally associated with systemic lupus erythematosus (SLE). Methods We performed a two-sample Mendelian randomization (MR) analysis using the inverse-variance weighted (IVW), weighted median, and MR-Egger regression methods. We used the publicly available summary statistics of alcohol intake frequency from the UK Biobank genome-wide association studies (GWASs; n = 336,965) as the exposure and an SLE GWAS consisting of 1311 SLE and 1783 control subjects of European descent as the outcome. Results We selected 20 single nucleotide polymorphisms (SNPs) associated with alcohol intake frequency at genome-wide significance as instrumental variables to improve inference. The IVW method found no evidence to support a causal association between alcohol intake and SLE (beta = –0.413, SE = 0.513, p = 0.421). The MR-Egger regression revealed that directional pleiotropy was unlikely to bias the result (intercept = 0.031, p = 0.582). The MR-Egger analysis found no causal association between alcohol intake and SLE (beta = –1.494, SE = 1.996, p = 0.464). Likewise, the weighted median approach also did not provide evidence of a causal association between alcohol intake and SLE (beta = –0.538, SE = 0.574, p = 0.349). The MR estimates determined using the IVW, weighted median, and MR-Egger regression methods were consistent and results from a “leave-one-out” analysis demonstrated that no single SNP was driving the IVW point estimate. Conclusions The results of MR analysis do not support a causal inverse association between alcohol intake and SLE occurrence.
Comparing Cephalic Index and Midsagittal Vector Analysis in Assessing Morphology in Sagittal Synostosis: A CT-Based Morphometric Analysis
Authors: Hong Brian Y. , Ho Emily S. , Zellner Elizabeth , Phillips John H. , Forrest Christopher R. 
Published: December 2018

Introduction: Assessment of cranial dysmorphism in sagittal synostosis is often subjective but objective measures can be applied. These include cephalic index (CI) and midsagittal vector analysis (MSVA). Objective: To assess discriminant validity, construct validity, and responsiveness of CI and MSVA measured from computed tomography (CT) in patients with sagittal synostosis. Methods: Patients with nonsyndromic isolated sagittal synostosis with complete preoperative (n = 30) and postoperative (n = 13) CT data were included. Age-matched control group (n = 24) comprised of normocephalic patients who underwent CT for reasons related to trauma. Outcome Measures: Retrospective CT evaluation of CI and MSVA was conducted and correlated with a dysmorphism numeric rating scale (D-NRS) that measured surgeon-rated severity of sagittal synostosis. Responsiveness of CI and MSVA was evaluated using dysmorphism global rating of change (D-GRC). Results: Thirty patients with sagittal synostosis were demographically similar to 24 normocephalic patients. The difference in CI and MSVA was statistically significant between normocephalic and scaphocephalic patients. Cephalic index had a good correlation with D-NRS ( r = −0.665, ρ = −0.667), but not with MSVA ( r = 0.250, ρ = 0.203). Change in CI ( r = 0.738, ρ = 0.657) was well correlated with D-GRC, but not with MSVA ( r = −0.409, ρ = −0.301). Conclusion: Cephalic index appears to quantify the severity of sagittal synostosis better than MSVA. Cephalic index also has better responsiveness than MSVA to measure a reduction in severity of disease; however, MSVA is a better descriptive craniometric measurement. Midsagittal vector analysis was able to quantify the shift in morphology in sagittal synostosis following surgical treatment.
Sequence effect in the treatment of proliferative diabetic retinopathy with intravitreal ranibizumab and panretinal photocoagulation
Authors: Cao Guofan , Xu Xiangzhong , Wang Chenghu , Zhang Shu 
Published: December 2018

Purpose: To compare the outcome of the sequence in the two treatments (intravitreal ranibizumab and panretinal photocoagulation) in high-risk proliferative diabetic retinopathy. Methods: This retrospective study included 35 patients with newly diagnosed high-risk proliferative diabetic retinopathy in 43 eyes; 18 (22 eyes) received intravitreal ranibizumab before panretinal photocoagulation (intravitreal ranibizumab+ group), while the other 17 (21 eyes) received panretinal photocoagulation before intravitreal ranibizumab (panretinal photocoagulation+ group). Each subject received three intravitreal ranibizumabs that were interleaved with three panretinal photocoagulations. The first treatment (either intravitreal ranibizumab or panretinal photocoagulation) was done 1 week before the second one. The interval between intravitreal ranibizumabs was 4 weeks, panretinal photocoagulation was 2 weeks. The power and pulse duration were determined based upon the status of each retinal spot before each panretinal photocoagulation. The retinal non-perfusion region was measured with fundus fluorescein angiography before and 1 month after the final treatment. The central macular thickness was measured with optical coherence tomography within 1 week before the first treatment, before each panretinal photocoagulation, and 1 month after the final intravitreal ranibizumab. Results: The panretinal photocoagulation energy required for effective treatment was lower in intravitreal ranibizumab+ group in the first and second sessions and in total energy (p < 0.05). Central macular thickness reduction before the second panretinal photocoagulation session was significant in the intravitreal ranibizumab+ group (p < 0.05). Conclusion: The sequence used in intravitreal ranibizumab+ group showed clear advantages over that in panretinal photocoagulation+ group in the treatment of proliferative diabetic retinopathy, not only in the use of lower energy for panretinal photocoagulation but also in the more rapid regression of neovascularization and less need of additional treatment.
Usefulness of telemedicine for home ventilator-dependent children
Authors: Muñoz-Bonet Juan I , López-Prats José L , Flor-Macián Eva M , Cantavella Teresa , Bonet Laura , Domínguez Amparo , Brines Juan 
Published: December 2018

Introduction Medical care for ventilator-dependent children must avoid hospital confinement, which is detrimental to the patient, their family and Paediatric Intensive Care Unit. Our objective was to assess the role of telemedicine in facilitating early and permanent discharge of such patients to home care. Methods This was a prospective clinical study (2007–2017) in tracheotomised ventilator-dependent children. We used a Big Data Telemedicine home system (Medlinecare 2.1) from the Paediatric Intensive Care Unit. Specialised home-nursing services were available. Clinical events were analysed using the Chi-square test (significance p < 0.05). Families subsequently completed a satisfaction survey. The Paediatric Intensive Care Unit management indicators were analysed. Results All of our ventilator-dependent children were included ( n=12). At time of discharge from the Paediatric Intensive Care Unit, they all required continuous mechanical ventilation and met the criteria of groups I–III of the OTA classification. In the first two years there were 141 events; the main cause was respiratory (69.5%, p < 0.001) and telemedicine was the main care approach (86.5%, p < 0.001). Eleven events required hospitalisation (7.8%) but 38 (27.0%) hospitalisations were avoided. The emergency readmission time accounted for 0.99% of the total time. Six patients were decannulated, and one patient died due to primary cardiac arrest. All the families considered that the telemedicine had helped to avoid hospital visits, was not an intrusion into their privacy, and improved the child’s safety and quality of life. An improvement in Paediatric Intensive Care Unit indicators was achieved. Discussion Telemedicine facilitated early and permanent discharge of our ventilator-dependent children to home care without affecting their quality of care.
Contribution of alcohol and drug co-use to substance use problems: Data from a nationally-representative sample of US adults who have never been to treatment
Authors: Karriker-Jaffe Katherine J. , Subbaraman Meenakshi S. , Greenfield Thomas K. , Kerr William C. 
Published: December 2018

Aims: Combined use of alcohol with drugs elevates risk for problems including injury and driving while intoxicated. We assessed contributions of heavy drinking (5+ drinks for men/4+ for women), drug use (cannabis and other drugs) and simultaneous co-use to DSM-5 alcohol use disorder (AUD) and drug abuse (DA). We expected co-use to increase risk for AUD and DA. Methods: Using population-weighted data from adults in the 2014–2015 National Alcohol Survey who had never been to treatment ( N = 3386 drinkers, 50% male, 13% Hispanic, 11% Black, mean age 45 years; N = 439 drug users, 56% male, 20% Hispanic, 15% Black, mean age 36), we tested hypotheses using logistic regression adjusting for demographics, family history of alcohol problems and impulsivity. Results: Ten percent of drinkers and 26% of drug users met criteria for mild AUD; <1% of drinkers and 4% of drug users met criteria for DA. Heavy drinking significantly increased risk for AUD, as did monthly or weekly use of cannabis. When simultaneous co-use was added, increased risk associated with cannabis use was reduced to non-significance. Weekly cannabis use, weekly use of other drugs and simultaneous drug and alcohol co-use were associated with significantly elevated risk of DA. In bivariate analyses, simultaneous co-use was associated with significantly greater endorsement of each of the separate AUD and DA symptom domains, including alcohol craving, tolerance and withdrawal, as well as drug and alcohol social and physical health problems. Conclusion: Healthcare providers should screen for simultaneous co-use of alcohol and drugs to help identify patients who may benefit from substance abuse treatment.
Numerical studies of transmission loss performances of asymmetric Helmholtz resonators in the presence of a grazing flow
Authors: Lu Zhengli , Pan Weichen , Guan Yiheng 
Published: December 2018

As a typical noise-attenuating device, Helmholtz resonators are widely implemented in aero-engines and gas turbines to decrease the transmission of acoustic noise. However, an asymmetric Helmholtz resonator could be designed and implemented due to the limited space available in the engines. To examine and optimize the noise-attenuating performances of the asymmetric resonator, comparison studies are performed. For this, a two-dimensional frequency-domain model of a cylindrical duct with a grazing flow is developed. An asymmetric Helmholtz resonator is attached as a side branch. The model containing the linearized Navier–Stokes equations is validated first by comparing the predicted results with the experimental ones available in the literature. Further validation is conducted by comparing the results of an asymmetric resonator with the analytical ones available in the literature. The effects of (1) neck offset distance from the center of the resonator cavity denoted by [Formula: see text] and (2) the grazing flow Mach number [Formula: see text] are evaluated. It is shown that as the grazing flow Mach number is increased, the resonant frequencies and the maximum transmission losses are dramatically varied for a given [Formula: see text]. As [Formula: see text] is increased from 0 to 0.5 and [Formula: see text], the resonant frequencies and the maximum transmission losses are increased. However, when [Formula: see text] is lower than 0.07, i.e. [Formula: see text], the transmission loss performances are almost unchanged with [Formula: see text] increased. The optimum design of the asymmetric resonator is shown to give rise to the resonant frequency being shifted by 10% and 2–5 dB more transmission loss at higher Mach number. Finally, visualization of vortex shedding formed at the neck of the asymmetric resonator confirms that acoustical energy is transformed into kinetic energy and absorbed by the surrounding air. This study opens up a numerical design approach to optimize an asymmetric resonator.