bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) criteria for classification of rheumatoid arthritis in an Indian population
Authors: Kedar M. V. V. Pavan , Acharya Raviraja V. , Prakashini K. 
Published: December 2016

Background & objectives:
The 1987 American College of Rheumatology (ACR) criteria were criticised for classifying patients only in the late stage. The 2010 ACR/European League against Rheumatism (ACR/EULAR) classification criteria for rheumatoid arthritis (RA) were thus formulated to recognize the early stage of disease with high sensitivity. This pilot study was designed to estimate and compare the sensitivities of the 1987 ACR and 2010 ACR/EULAR classification criteria for RA.

Methods:
In a tertiary care hospital, the medical records of 97 patients diagnosed with RA were reviewed. Case study forms were filled with relevant clinical data and investigation results after reviewing each medical record. The radiographs of hands were also reviewed. To each case, both the 1987 ACR and the 2010 ACR/EULAR criteria were applied and the results of the classification were noted.

Results:
The sensitivity of the 2010 ACR/EULAR criteria was found to be 79.38 per cent [95% confidence interval (CI) = 71.33-87.43%] and the sensitivity of the 1987 ACR criteria was found to be 63.92 per cent (95% CI = 54.36-73.48%). The difference in the sensitivities was significant (P< 0.01). There was a significant rise in sensitivity of the 2010 ACR/EULAR criteria when patients having anti-cyclic citrullinated peptide (CCP) titres were analysed.

Interpretation & conclusions:
The 2010 ACR/EULAR criteria were found to be more sensitive than the 1987 ACR criteria possibly owing to features of the criteria. Anti-CCP titres were found to increase the sensitivity of the 2010 ACR/EULAR criteria.
Validity and Reliability of a Tool to Assess Quality Improvement Knowledge and Skills in Pediatrics Residents
Authors: Doupnik Stephanie K. , Ziniel Sonja I. , Glissmeyer Eric W. , Moses James M. 
Published: December 2016

ABSTRACT

Background
Residency programs are expected to educate residents in quality improvement (QI). Effective assessments are needed to ensure residents gain QI knowledge and skills. Limitations of current tools include poor interrater reliability and requirement for scorer training.

Objective
To provide evidence for the validity of the Assessment of Quality Improvement Knowledge and Skills (AQIKS), which is a new tool that provides a summative assessment of pediatrics residents' ability to recall QI concepts and apply them to a clinical scenario.

Methods
We conducted a quasi-experimental study to measure the AQIKS performance in 2 groups of pediatrics residents: postgraduate year (PGY) 2 residents who participated in a 1-year longitudinal QI curriculum, and a concurrent control group of PGY-1 residents who received no formal QI training. The curriculum included 20 hours of didactics and participation in a resident-led QI project. Three faculty members with clinical QI experience, who were not involved in the curriculum and received no additional training, scored the AQIKS.

Results
Complete data were obtained for 30 of 37 residents (81%) in the intervention group, and 36 of 40 residents (90%) in the control group. After completing a QI curriculum, the intervention group's mean score was 40% higher than at baseline (P &lt; .001), while the control group showed no improvement (P = .29). Interrater reliability was substantial (κ = 0.74).

Conclusions
The AQIKS detects an increase in QI knowledge and skills among pediatrics residents who participated in a QI curriculum, with better interrater reliability than currently available assessment tools.
Geriatrics Curricula for Internal and Family Medicine Residents: Assessing Study Quality and Learning Outcomes
Authors: Cheng Huai Yong , Davis Molly 
Published: December 2016

ABSTRACT

Background
Prior reviews of geriatrics curricula for internal medicine (IM) and family medicine (FM) residents have not evaluated study quality or assessed learning objectives or specific IM or FM competencies.

Objective
This review of geriatrics curricula for IM and FM residents seeks to answer 3 questions: (1) What types of learning outcomes were measured? (2) How were learning outcomes measured? and (3) What was the quality of the studies?

Methods
We evaluated geriatrics curricula that reported learning objectives or competencies, teaching methods, and learning outcomes, and those that used a comparative design. We searched PubMed and 4 other data sets from 2003–2015, and assessed learning outcomes, outcome measures, and the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and Best Evidence Medical Education (BEME) methods.

Results
Fourteen studies met inclusion criteria. Most curricula were intended for IM residents in the inpatient setting; only 1 was solely dedicated to FM residents. Median duration was 1 month, and minimum geriatrics competencies covered were 4. Learning outcomes ranged from Kirkpatrick levels 1 to 3. Studies that reported effect size showed a considerable impact on attitudes and knowledge, mainly via pretests and posttests. The mean MERSQI score was 10.5 (range, 8.5–13) on a scale of 5 (lowest quality) to 18 (highest quality).

Conclusions
Few geriatrics curricula for IM and FM residents that included learning outcome assessments were published recently. Overall, changes in attitudes and knowledge were sizeable, but reporting was limited to low to moderate Kirkpatrick levels. Study quality was moderate.
Training Family Medicine Residents to Perform Home Visits: A CERA Survey
Authors: Sairenji Tomoko , Wilson Stephen A. , D'Amico Frank , Peterson Lars E. 
Published: December 2016

ABSTRACT

Background
Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training.

Objective
To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors.

Methods
This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers.

Results
There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits.

Conclusions
There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.
Naive Fault Trees for Safety Evaluations in Early Project Phase
Authors: Rajabalinejad Mohammad 
Published: December 2016

<p>Naive Fault Trees (NFT) aim to extend the application of Fault Trees (FT) and make them appealing for system designers in the early project life cycle. NFT use input intervals and values to estimate the frequency of a top event. This extension facilitates the assignment of failure probability to basic events when exact data is difficult to find, unavailable or even not existent. The formulation of the problem and results are presented in this paper through an application to a real-world example.</p>ed from different candidates contain ample information, which might not appear evident at first sight. The complexity of the situation requires an intelligent extraction of the information from the data. An analysis tool <em>IndEva</em>was developed to handle this complexity and provide an accurate, detailed and reliable evaluation of inspection systems and personnel. Besides the plain evaluation regarding the fulfilment of the qualification requirements, critical test flaws as well as test block sections, which are likely to cause false positive indications can be identified. Statistic results display the dependency of the system performance on various parameters and parameter combinations to provide a clear picture of the performance. Country-specific evaluation standards can be applied and compared, especially with regard to the continuous improvement of the qualification methodology.<p> </p>
Economic Integration and the Appalachian Experience in the Rust Belt-Sun Belt Transition
Authors: James Autumn C. , James Ryan D. 
Published: December 2016

Abstract
For a number of decades, Appalachia has been a region that has lacked the growth and development that neighboring regions have experienced. Interestingly, in the past thirty years, as investment relocated during the Rust Belt-Sun Belt Transition, evidence of Appalachian integration into the national economy has begun to emerge. This inclusion, however, is generally confined to Northern and Southern Appalachia, and is not fully understood. To explore the nature of this integration, this paper uses geographic visualization and a two-way ANOVA on capital, labor, and technology measures. Results indicate that Appalachian counties continued to lag in these neoclassical factors of growth when compared to non-Appalachian, Rust Belt, or Sun Belt counties, though the Appalachian lag effect lessened over time.
Imprisoning Appalachia: The Socio-Economic Impacts of Prison Development
Authors: Perdue Robert Todd , Sanchagrin Kenneth 
Published: December 2016

AbstractIn the last twenty-five years, the number of prisons in Central Appalachia has grown dramatically. Seeking to bring jobs and development to their communities, policymakers tend to view the industry as an economic lifeline. The passage of time allows us to critically evaluate the impacts of prison development in Central Appalachia, and here we analyze per capita income, poverty, and unemployment rate changes in counties that have opened a prison since 1989. We find little evidence to support the claim that prisons are engines of growth. Unemployment rates are lower in counties containing a prison, however, per capita income is also lower, while poverty rates are higher. Coupling these findings with the opportunity costs of adopting this strategy rather than others leads to the conclusion that policymakers would be well served using great caution before pursuing this development pathway.
Using Relationships as Resources in Social Impact Investing: Examining a Local Food Movement in Appalachia
Authors: Farley Kathryn Webb , Bush Carrie Blanchard 
Published: December 2016

AbstractTo better understand the implementation of investments aimed at producing sustainable food systems across rural counties in Appalachia, particularly during the early phase of the movement, this study explores the perceptions of fifteen organizations that received grant funding. Studying local food systems is of interest because they have the unique characteristic of encompassing multiple aspects of social impact investing, including goals that may be seen as important to Appalachian communities: farming practices that benefit the environment, economic sustainability for local residents, and building the capacity of local organizations. Although grants may provide opportunities to make significant headway toward community economic and social goals, establishing the appropriate relationships may be a challenge for local organizations. Thus the goal of this research is to gain insight into how the grantees used various relationships among community-based organizations (i.e., businesses and farmers, educational institutions, government agencies, intermediary organizations and non-profits) and leveraged different types of capital (i.e., financial, informational, material, and giving capital) in the effort to establish a local food system within Appalachia.
From Tula Chico to Chichén Itzá: Implications of the Epiclassic Sculpture of Tula for the Nature and Timing of Tula-Chichén Contact
Authors: Jordan Keith 
Published: December 2016

AbstractIn the last four decades, a number of archaeologists and art historians have posited that “Toltec” Chichén Itzá (Yucatán, Mexico) flourished during the ninth and tenth centuries A.D. They argued that because the “Toltec” style in Yucatán predated the Tollan phase at Tula (Hidalgo, Mexico), most of the style features shared between the cities originated with the Maya. Here, I examine the relevance of the Epiclassic relief sculpture of Tula Chico for the timing and nature of contact between Tula and Chichén Itzá. The presence of reliefs of reclining figures in clear “Toltec” style at Tula Chico in contexts predating their occurrence at Chichén Itzá suggests that claims for a predominantly Maya origin for that style stand in need of revision. Such a rethinking is supported by other fragmentary images from Tula Chico (eagles and Venus symbols), as well as by new studies of ceramic materials and chronology at Chichén Itzá. It is clear that Tula was an active participant in whatever interactions led to similar visual arts at Chichén Itzá, and at least some of the shared iconography has temporal priority at Tula.
A First Report of Variscite Tairona Artifacts (A.D. 1100-1600) from the Sierra Nevada de Santa Marta, Colombia, and Its Implications for Precolumbian exchange Networks in the Region
Authors: Acevedo Natalia , Weber Marion , García-Casco Antonio , Proenza Joaquín Antonio , Sáenz Juanita , Cardona Agustín 
Published: December 2016

AbstractArchaeometric analyses (Raman Spectroscopy Analysis, X-Ray Diffraction, and Electron Microprobe Analysis) of greenstone beads of the precolumbian Tairona culture (A.D. 1100–1600) of the Sierra Nevada de Santa Marta, Colombia, have revealed that they are made of variscite-group minerals. These beads were curated at the Museo del Oro, Bogotá, and the Archaeology Laboratory of the Universidad del Norte, Barranquilla. Variscite minerals of the variscite-strengite series are rare in nature, and therefore provenance data of source material are useful for the development of intercultural influence models. The abundance of this rare material in prehistoric Colombian collections strongly indicates not only that this material had important symbolic and prestige value for ancient Tairona societies (Nahuange and Tairona periods) but also that these societies participated in ancient trade routes, including, at least, the Andes of present-day Colombia and Venezuela, and the southern Caribbean coast.
“Since both of us are using antiretrovirals, we have been supportive to each other”: facilitators and barriers of pre‐exposure prophylaxis use in heterosexual HIV serodiscordant couples in Kisumu, Kenya
Authors: Patel Rena C , Stanford‐Moore Gaelen , Odoyo Josephine , Pyra Maria , Wakhungu Imeldah , Anand Keerthana , Bukusi Elizabeth A , Baeten Jared M , Brown Joelle M 
Published: December 2016

IntroductionSince 2015, the World Health Organization recommends pre‐exposure prophylaxis (PrEP) for all persons at substantial risk for HIV, including HIV‐uninfected partners in serodiscordant relationships in resource‐limited settings. As PrEP moves from clinical trials to real‐world use, understanding facilitators of and barriers to PrEP initiation and adherence is critical to successful PrEP implementation and rollout.MethodsWe conducted 44 in‐depth individual or couple interviews with 63 participants (30 without HIV and 33 with HIV) enrolled in the Partners Demonstration Project in Kisumu, Kenya, between August and September 2014. The semi‐structured interviews discussed the following: 1) perceived advantages and disadvantages of antiretroviral therapy (ART)/PrEP; 2) reasons for accepting or declining ART/PrEP and 3) influence of prevention of transmission to partner or infant on ART/PrEP use. Transcripts from the interviews were iteratively analyzed using inductive content analysis.ResultsOur study identified three key factors that may facilitate initiation of PrEP in this population. First, participants using PrEP felt reduced stress and increased trust in their HIV serodiscordant relationships. Second, greater community‐wide knowledge of PrEP was thought to likely increase PrEP acceptance. Third, greater education and counselling by providers on PrEP use was also considered to likely increase the adoption of PrEP. We also identified three key barriers to initiation of and adherence to PrEP. First, most participants who declined PrEP expressed doubts about the relative additional effectiveness of PrEP in combination with other prevention tools. Second, perceived stigma related to PrEP use was an important barrier to PrEP initiation. Third, many struggled with overcoming perceived side effects or logistical challenges of taking daily PrEP, particularly when they themselves were not ill.ConclusionsLeveraging the facilitators and overcoming barriers to PrEP uptake may enhance the successful rollout of PrEP among HIV serodiscordant couples in Kenya and other areas in sub‐Saharan Africa, thereby reducing sexual transmission of HIV. Further research focused on how best to provide counselling on combination HIV prevention tools in the context of PrEP use is a crucial next step to delivering PrEP.
A new Cu(TiBNx) alloy film for boosting the per-watt illuminance of high power LEDs
Authors: Lin Chon-Hsin 
Published: December 2016

Abstract
In this study, a new Cu(TiBN
x
) alloy film has been explored and utilized as a flexible heat dissipation layer for the substrate of high power LEDs to boost their per-watt illuminance by reducing the thermal resistance and increasing the thermal conductivity of the substrate. The new film is a Cu-alloy seed layer fabricated by co-sputtering Cu and TiB in an N2 atmosphere on a Ta/polyimide (Ta/PI) substrate. The film was then annealed at 340 °C for 1 h without noticeable Cu oxide formation around the film-substrate interface. The new film exhibits low resistivity, high thermal conductivity and low thermal resistance, rendering a substantially higher per-watt illuminance for LEDs that utilize the film as their additional heat dissipation layer. The experimental results gained in the study appear to confirm the new Cu(TiBN
x
) film as a good candidate material, at least, for boosting the per-watt illuminance of high power LEDs.
Assessing ionospheric response during some strong storms in solar cycle 24 using various data sources
Authors: Habarulema John Bosco , Katamzi Zama Thobeka , Sibanda Patrick , Matamba Tshimangadzo Merline 
Published: December 2016

AbstractWe present an analysis of a regional ionospheric response during six strong storms (−200 nT ≤Dst≤−100 nT) that occurred in 2012 for the geographic latitudinal coverage of 10°S–40°S within a longitude sector of 10°E–40°E. Although these storms occurred during the same solar activity period and were all coronal mass ejection driven, their impacts and associated features on the ionosphere have been found different due to different contributing factors to their driving mechanisms. With the exception of one case, the rest of the storm periods were characterized by positive storm effects during the main and (or) recovery phases with varying physical mechanisms including low‐latitude electrodynamics, neutral composition changes, and traveling ionospheric disturbances (TIDs). The common result to all the analyzed strong storms was the presence of large‐scale TIDs during the storm main phases. Using total electron content data derived from the Global Navigational Satellite System (GNSS) observations and radio occultation (RO) electron density data on a regional scale, we have attempted to investigate meridional and vertical propagation of TIDs simultaneously during the strong storms. We have showed that it is possible to identify vertical motion of TIDs using RO data in cases when equatorward TIDs, as revealed by GNSS total electron content data, are present. RO results were compared to ionosonde data, and both data sources gave vertical velocities below 100 m/s of the associated TIDs.
Scalings for the Alfvén‐cyclotron instability: Linear dispersion theory and hybrid particle‐in‐cell simulations
Authors: Gary S. Peter , Fu Xiangrong , Cowee Misa M. , Winske Dan , Liu Kaijun 
Published: December 2016

AbstractThe Alfvén‐cyclotron instability is driven by an ion temperature anisotropy such that T⊥/T|| >1 where ⊥ and || denote directions perpendicular and parallel to a uniform background magnetic field Bo, respectively. The computations presented here consider a model of a magnetized, homogeneous, collisionless plasma. Two representations of the proton velocity distribution are considered: a single bi‐Maxwellian and a magnetospheric‐like configuration of two components, a more dense, relatively cool, isotropic component and a less dense, relatively hot, bi‐Maxwellian component which drives the instability. Only wave propagation parallel to Bo is considered. Using numerical solutions of the full kinetic linear dispersion equation, concise analytic expressions for the scaling of the dimensionless maximum instability growth rate and the corresponding dimensionless real frequency are derived as functions of three dimensionless variables: the hot proton temperature anisotropy, the relative hot proton density, and the hot proton β||. Furthermore, using one‐dimensional hybrid particle‐in‐cell simulations of this same instability, a third relation for the scaling of the maximum amplitude of the dimensionless fluctuating magnetic field energy density is derived.
LEOPARD: A grid‐based dispersion relation solver for arbitrary gyrotropic distributions
Authors: Astfalk Patrick , Jenko Frank 
Published: December 2016

AbstractParticle velocity distributions measured in collisionless space plasmas often show strong deviations from idealized model distributions. Despite this observational evidence, linear wave analysis in space plasma environments such as the solar wind or Earth's magnetosphere is still mainly carried out using dispersion relation solvers based on Maxwellians or other parametric models. To enable a more realistic analysis, we present the new grid‐based kinetic dispersion relation solver LEOPARD (Linear Electromagnetic Oscillations in Plasmas with Arbitrary Rotationally‐symmetric Distributions) which no longer requires prescribed model distributions but allows for arbitrary gyrotropic distribution functions. In this work, we discuss the underlying numerical scheme of the code and we show a few exemplary benchmarks. Furthermore, we demonstrate a first application of LEOPARD to ion distribution data obtained from hybrid simulations. In particular, we show that in the saturation stage of the parallel fire hose instability, the deformation of the initial bi‐Maxwellian distribution invalidates the use of standard dispersion relation solvers. A linear solver based on bi‐Maxwellians predicts further growth even after saturation, while LEOPARD correctly indicates vanishing growth rates. We also discuss how this complies with former studies on the validity of quasilinear theory for the resonant fire hose. In the end, we briefly comment on the role of LEOPARD in directly analyzing spacecraft data, and we refer to an upcoming paper which demonstrates a first application of that kind.