bluuebunny/crossref_metadata_2025_split huggingface dataset:
A different training model for adolescent medicine: a PhD program in Turkey, where adolescent medicine is not currently a sub-specialty at this stage
Authors: Akgül Sinem , Kanbur Nuray , Derman Orhan 
Published: June 2015

Abstract
Adolescent medicine is currently not a certified subspecialty by the Ministry of Health in Turkey. Until recently, no subspecialty education was available for pediatricians interested in pursuing a career in this field. To compensate for the lack of training opportunities in the field, to meet the needs of adolescents and to increase research and strengthen scientific knowledge in the area of adolescent medicine, a doctoral program was established in 2004 by the Division of Adolescent Medicine under the Institute of Child Health at Hacettepe University in Ankara. This paper discusses the opportunities provided by the program, describing the pros and cons of such a course and what the program aims to achieve. This unique program provides pediatricians with extended postgraduate, subspecialty education in adolescent health care. We believe that the adolescent medicine PhD program at Hacettepe University could be a model for educating health care professionals in this field in other countries where there are not established fellowship programs.
LEAH interdisciplinary training program
Authors: Robbins Cynthia L. , Rickert Vaughn D. 
Published: June 2015

Abstract
This article describes the Leadership Education in Adolescent Health (LEAH) interdisciplinary training program in the United States. The Maternal and Child Health Bureau authorized by legislation provides monies to train leaders in adolescent health through a competitive grant process. Currently, seven academic medical centers have funding to provide leadership in adolescent health (LEAH) training in five core disciplines: medicine, nursing, psychology, social work and nutrition. LEAH training programs both ensure high clinical competence in core disciplines serving adolescents and prepare trainees for leadership positions in adolescent health and public health care realms. Together, these programs trained almost 1000 long-term trainees across these five disciplines, and graduates from these programs are working in 45 of the 50 states within the United States. About 90% of these graduates are working with maternal and child/adolescent health populations, and almost all have held leadership positions in the areas of public health, advocacy, public policy, academic medical centers and/or clinical care settings.
Training international medical graduate clinical fellows: the challenges and opportunities for adolescent medicine programs
Authors: Goldberg Eudice 
Published: June 2015

Abstract
Adolescent medicine achieved accreditation status first in the United States in 1994 and then in Canada in 2008 and even if it is not an accredited subspecialty in most other Western nations, it has still become firmly established as a distinct discipline. This has not necessarily been the case in some developing countries, where even the recognition of adolescence as a unique stage of human development is not always acknowledged. The program at SickKids in Toronto has prided itself in treating its international medical graduates (IMG) clinical fellows the same as their Canadian subspecialty residents by integrating them seamlessly into the training program. Although this approach has been laudable to a great extent, it may have fallen short in formally acknowledging and addressing the challenges that the IMG trainees have had to overcome. Moving forward, faculty must be trained and supports instituted that are geared specifically towards these challenges. This must be done on a formal basis to ensure both the success of the trainees as well as the overall enrichment of the fellowship training programs.
Adolescent health in Asia: insights from Singapore
Authors: Oh Jean-Yin , Rajasegaran Kumudhini 
Published: June 2015

AbstractThe introduction of adolescent medicine as a medical subspecialty in Singapore was a welcome in an evolving health care system that is unique in terms of both efficiency, in financing and the results achieved in community health outcomes. The Ministry of Health (MOH) already recognized the need to accommodate the health care concerns related to adolescent psychosocial health risk behaviors and an increased prevalence of young people living with chronic illness. The challenge for the pioneer team of physicians trained in adolescent medicine was to develop and sustain a model of care that integrated (i) core clinical services that include quality measures of care to adolescents; (ii) professional development and capacity building needing an expansive teaching agenda at every level of health education; (iii) strong inter-sectorial collaborations within hospital and community partners; and (iv) robust research and evaluation strategies that keep clinical practice relevant and evidence based.
Ultrasound-Assisted Aqueous Extraction of Oil and Carotenoids from Microwave-Dried Gac (Momordica cochinchinensis Spreng) Aril
Authors: Kha Tuyen C. , Nguyen Minh H. , Roach Paul D. , Stathopoulos Costas E. 
Published: June 2015

Abstract
The study aimed to optimise the ultrasound-assisted aqueous extraction of oil, β-carotene and lycopene from powdered microwave-dried gac arils. Ultrasound power, extraction time, powder particle size and the ratio of water to gac powder during the extraction, the centrifugal force used to recover the extracted components were investigated. Microwave-drying followed by aqueous extraction without ultrasound-assistance and air-drying followed by aqueous extraction with or without ultrasound-assistance was also carried out for comparisons. The gac material left behind after the extractions was also investigated using scanning electron microscopy (SEM). The results showed that ultrasound power of 32 W/g of aril powder, extraction time of 20 min, powder particle sizes of 0.3–0.5 mm, a ratio of water to powder of 9 g/g and a centrifugal force of 6,750×g gave optimal extraction efficiencies for oil (90%), β-carotene (84%) and lycopene (83%), and the oil had a low peroxide value (PV) of 2.2 meq/kg. The SEM analysis confirmed that the combination of microwave-drying followed by ultrasound-assisted aqueous extraction caused strong disruption of the gac aril cellular structures, which was consistent with the high extraction of oil, β-carotene and lycopene obtained with the combination. It was concluded that gac oil containing high amounts of β-carotene and lycopene and having a low PV could be extracted using microwave-drying and ultrasound-assisted aqueous extraction.
Leibnizian Rejection of Standard Thought Experiments against Identity of Indiscernibles
Authors: Maunu Ari 
Published: June 2015

Abstract
It is argued that from a genuine Leibnizian point of view the well-known thought experiment, call it BTE, involving a possible world with only two exactly similar objects, cannot be used to refute Leibniz’s principle of the identity of indiscernibles (LIdI). If the claim that there are two objects in BTE is based on primitive thisnesses, the Leibnizian objection is that there are no such things; and even if there were, then, quite generally, something true of one object – that it has its primitive thisness – would not be true of the other. Secondly, if the duality claim is based on a primitive, irreducible relation of distinctness, the Leibnizian objection is that there are no irreducible relations. Finally, if it is said that the (putatively) two objects in BTE cannot be separately individuated, then BTE is not a counter-example to LIdI, because if there is no individuation, there are no individuals either, while LIdI presupposes that there are individuals.
Curiosity Kills the Categories: A Dilemma about Categories and Modality
Authors: Allen Sophie R. 
Published: June 2015

Abstract
This paper argues that it is implausible to treat philosophical categories as if they exist as a matter of necessity, and implausible to deny that they do. The former because it restricts the modal range which can be characterized, thereby violating the principle of plenitude with respect to all possibilities; and the latter because it results in there being no stable, univocal way of characterizing those very possibilities, resulting in the range of what there is becoming a pluralist patchwork of distinct and potentially incompatible collections of categories which lack any unifying ontological principle. Some potential responses to this observation are then briefly explored, including restricting categories or modality by stipulation, treating categories as instrumental, or finding a way in which the apparently competing systems of categories can be unified.
Russellian Monism and Epistemic Pessimism
Authors: Gundersen Ståle 
Published: June 2015

AbstractRussellian monism is any view that proposes that we cannot solve the mind-body problem because natural science cannot tell us about the aspects of physical reality that are necessary to know to explain consciousness. I argue that Russellian monism should be combined with the Heil-Martin theory about dispositions. However, this combination becomes a theory with some profound epistemic pessimistic consequences, namely that we cannot bridge the explanatory gap between physical and conscious states and that we cannot solve the other minds problem. However, this epistemic pessimism does not constitute an unacceptable kind of “mystery-mongering” because we can also find analogous results in the well-established sciences. This may make it easier to accept Russellian monism’s epistemic pessimism.
The Large-Scale Soil Box: A New Device for Testing the Performance of Buried Pipe
Authors: Crowley Raphael W. , Bloomquist David , Konn Victor , Faraone Zachary , Pasken Kenneth A. 
Published: June 2015

Abstract
A new apparatus that measures pipe deflection as a function of simulated overburden stress is described—the large-scale soil box (LSSB). While the LSSB is similar to previous quasi-full scale instruments, it is capable of load testing two pipes simultaneously while monitoring deflection along their crowns. A series of tests were conducted on 24 and 36-in., 10-ft-long pipe sections. Pipe material varied throughout testing; materials included polyvinylchloride (PVC), high-density polyethylene (HDPE), steel, and aluminum. During load application, lasers allowed for deflection curves to be developed for each of the pipes as a function of simulated overburden produced via constrained lift bags. Analysis of the results appeared to indicate that loading in the LSSB is not necessarily uniform. This is likely due to non-uniform soil densities that were present prior to testing even though strict procedures and quality control checks were used prior to each test. Therefore, it would be difficult to use data from a device like this as a comparison against finite element models. However, results from these tests still may be used to assess the relative levels of effect of different pipe types and installation procedures.
Exclusion of Thrombocytopenia as a Contraindication for Invasive Radiofrequency Ablation in a Patient with Paroxysmal Atrial Fibrillation by Using Magnesium Anticoagulation Instead of EDTA: Another Case of Anticoagulant-Induced Pseudo-Thrombocytopenia
Authors: Kohlschein Peter , Bänsch Dietmar , Dreißiger Katrin , Schuff-Werner Peter 
Published: June 2015

<p class="p1"><span class="s1">Thrombocytopenia might be an exclusion criterion for invasive radiofrequency catheter ablation; therefore it is necessary to differentiate between pseudo-thrombocytopenia and a low platelet count due to other etiologies.</span></p><p class="p1"><span class="s2">A 69-year-old female presented to the cardiology department with recurrent atrial fibrillation that was resistant to conventional drug treatment. The initial laboratory findings were within the normal ranges, except for low platelet counts that occurred without a specific bleeding history. The reason for thrombocytopenia was anticoagulant-induced in vitro aggregation of platelets in the presence of EDTA as well as in citrated blood samples. As recently communicated, magnesium anticoagulated blood samples prevent platelet aggregation in individuals with anticoagulant-associated pseudo-thrombocytopenia. Although its aggregation-inhibiting effect is known from previous clinical observations, magnesium sulphate has not been introduced as an anticoagulant in analytical medicine.</span></p><p class="p1"><span class="s1">Based on our observations, blood anticoagulated with magnesium sulphate is recommended to verify low routine platelet counts before final clinical decisions are made. </span></p>
Thrombocytopenia Associated with Perceval Sutureless Aortic Valve Replacement in Elderly Patients: A Word of Caution
Authors: Albacker Turki B. 
Published: June 2015

<p class="p1"><span class="s1"><strong>Objective:</strong> The aim of this study was to report for the first time the phenomenon of thrombocytopenia associated with the use of sutureless aortic valve replacements (AVR), and try to find an explanation for its occurrence.</span></p><p class="p1"><span class="s2"><strong>Methods:</strong> The data was collected retrospectively for all patients who had sutureless AVR (7 patients) and was compared to patients who underwent sutured AVR (22 patients) by the same surgeon between February 2012 and November 2013. </span></p><p class="p1"><span class="s1"><strong>Results:</strong> Cardiopulmonary bypass and cross-clamp durations were shorter in the sutureless group (96.4 min, <br /> 70.6 min) compared to the sutured group (128.3 min, 97.3 min), <br /> (<em>P</em> = .04, <em>P</em> = .003) respectively. Mean transvalvular gradients were lower in the sutureless group (mean = 9.6 mmHg) compared to the sutured group (mean = 17.3 mmHg). Platelet levels were significantly lower in the Perceval patients compared to the Enable patients and sutured valves. Platelet transfusion was higher for sutureless valves (6.5 units versus 5.4 units for the sutured group, <em>P</em> = .63), especially the Perceval valve (7.6 units versus 5.3 for the Enable valve, <em>P</em> = .35), but was not statistically significant. Packed red blood cells (PRBCs) transfusion was significantly higher in the sutureless group (6 units versus 3.1 for the sutured group, <em>P</em> = .002). </span></p><p class="p1"><span class="s1"><strong>Conclusion:</strong> The implantation of sutureless aortic valves, especially the Perceval valve, was associated with a significant drop in platelet count postoperatively with slow recovery and higher PRBCs transfusion requirements. Extreme caution should be taken before the routine use of these valves in elderly patients who are already at risk of thrombocytopenia postoperatively. </span></p>
Phase I/II Study of Weekly Oraxol for the Second-Line Treatment of Patients With Metastatic or Recurrent Gastric Cancer
Authors: Lee Keun-Wook , Lee Kyung Hee , Zang Dae Young , Park Young Iee , Shin Dong Bok , Kim Jin Won , Im Seock-Ah , Koh Sung Ae , Yu Kyung-Sang , Cho Joo-Youn , Jung Jin-A , Bang Yung-Jue 
Published: June 2015

Abstract

Lessons Learned
Oraxol, a novel oral formulation of paclitaxel, displayed modest efficacy as second-line chemotherapy for gastric cancer. Considering its favorable toxicity profiles, further studies are warranted in various solid tumors including gastric cancer.

Background.
Oraxol consists of paclitaxel and HM30181A, a P-glycoprotein inhibitor, to increase the oral bioavailability of paclitaxel. This phase I/II study (HM-OXL-201) was conducted to determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of Oraxol. In addition, we investigated the efficacy and safety of Oraxol as second-line chemotherapy for metastatic or recurrent gastric cancer (GC).

Methods.
In the phase I component, paclitaxel was orally administered at escalating doses (90, 120, or 150 mg/m2 per day) with a fixed dose (15 mg/day) of HM30181A. Oraxol was administrated 6 times per cycle (days 1, 2, 8, 9, 15, and 16) every 4 weeks. In the phase II component, the efficacy and safety of Oraxol were evaluated.

Results.
In the phase I component, the MTD could not be determined. Based on toxicity and pharmacokinetic data, the RP2D of oral paclitaxel was determined to be 150 mg/m2. In the phase II component, 4 of 43 patients (9.3%) achieved partial responses. Median progression-free survival and overall survival were 2.6 and 10.7 months, respectively. Toxicity profiles were favorable, and the most common drug-related adverse events (grade ≥3) were neutropenia and diarrhea.

Conclusion.
Oraxol exhibited modest efficacy and favorable toxicity profiles as second-line chemotherapy for GC.
exemplo de mudança de código no romance de Clarice Lispector
Authors: Oliveira Solange Ribeiro de 
Published: June 2015

Um duplo movimento, apoiado pela interação contextual, caracteriza o processo de mudança do código característico dos romances de Clarice Lispector. Por um lado, itens léxicos de conotações normalmente positivas ou negativas invertem essas posições no subsistema do romance. Por outro lado, itens geralmente não asssociados com valores positivos ou negativos assumem um dos dois. Cada grupo de palavras se associa a algumas imagens. Dentro dele, podem-se encontrar subgrupos contrastantes. Essa estrutura semântica extremamente dinâmica parece transmitir um convite à reconsideração de certas posturas epistemológicas e ideológicas implícitas no código convencional.
Objective classification of latent behavioral states in bio‐logging data using multivariate‐normal hidden Markov models
Authors: Phillips Joe Scutt , Patterson Toby A. , Leroy Bruno , Pilling Graham M. , Nicol Simon J. 
Published: June 2015

Analysis of complex time‐series data from ecological system study requires quantitative tools for objective description and classification. These tools must take into account largely ignored problems of bias in manual classification, autocorrelation, and noise. Here we describe a method using existing estimation techniques for multivariate‐normal hidden Markov models (HMMs) to develop such a classification. We use high‐resolution behavioral data from bio‐loggers attached to free‐roaming pelagic tuna as an example. Observed patterns are assumed to be generated by an unseen Markov process that switches between several multivariate‐normal distributions.Our approach is assessed in two parts. The first uses simulation experiments, from which the ability of the HMM to estimate known parameter values is examined using artificial time series of data consistent with hypotheses about pelagic predator foraging ecology. The second is the application to time series of continuous vertical movement data from yellowfin and bigeye tuna taken from tuna tagging experiments. These data were compressed into summary metrics capturing the variation of patterns in diving behavior and formed into a multivariate time series used to estimate a HMM. Each observation was associated with covariate information incorporating the effect of day and night on behavioral switching.Known parameter values were well recovered by the HMMs in our simulation experiments, resulting in mean correct classification rates of 90–97%, although some variance–covariance parameters were estimated less accurately. HMMs with two distinct behavioral states were selected for every time series of real tuna data, predicting a shallow warm state, which was similar across all individuals, and a deep colder state, which was more variable. Marked diurnal behavioral switching was predicted, consistent with many previous empirical studies on tuna.HMMs provide easily interpretable models for the objective classification of many different types of noisy autocorrelated data, as typically found across a range of ecological systems. Summarizing time‐series data into a multivariate assemblage of dimensions relevant to the desired classification provides a means to examine these data in an appropriate behavioral space. We discuss how outputs of these models can be applied to bio‐logging and other imperfect behavioral data, providing easily interpretable models for hypothesis testing.
Bony Exostosis After Treatment of Gingival Recession With Subepithelial Connective Tissue Graft and Enamel Matrix Derivative
Authors: Lang Melissa S. , Barritt Laura C. 
Published: June 2015

Introduction: Biologic materials, such as enamel matrix derivative (EMD), are often used to improve the regenerative outcome of periodontal treatment. On occasion, unintended effects of such treatment may occur. To the best of the authors’ knowledge, this is the first case report to document the development and treatment of a bony exostosis subsequent to a subepithelial connective tissue (CT) graft with the addition of EMD.Case Presentation: A healthy female patient received a CT graft and the application of EMD for the treatment of gingival recession at a maxillary premolar. In the following year, a bony exostosis developed and was excised using a piezoelectric surgical device and examined histologically. At the 1‐year follow‐up, the lesion had not recurred.Conclusion: The use of EMD in conjunction with a CT graft represents a new potential contributing factor in the etiology of bony exostoses occurring after gingival augmentation procedures that warrants additional investigation.
Functional Task Constraints Foster Enhanced Postural Control in Children With Cerebral Palsy
Authors: Schmit Jennifer M. , Riley Michael , Cummins-Sebree Sarah , Schmitt Laura , Shockley Kevin 
Published: June 2015

BackgroundPostural instability is a classical characteristic of cerebral palsy (CP), but it has not been examined during functional play activity. Recent work has demonstrated that when motor tasks are made functionally more relevant, performance improves, even in children with movement pathology. It is possible that in a disease state, the underlying control mechanisms that are associated with healthy physiology must be elicited.ObjectiveThe study objective was to explore the utility of the functional play task methodology as a more rich and interpretable approach to the quantification of postural instability in children with CP.DesignPostural stability measures obtained from a cross-sectional cohort of children with CP (n=30) were compared with stability measures taken from children with typical development (n=30) during a single measurement period.MethodsPostural stability data were obtained with a portable force platform system. Postural sway was quantified during a precision manual functional play task. A baseline condition (no task) also was included. Postural sway variability and postural sway regularity were analyzed with analyses of variance.ResultsThere was an apparent difference in postural control (greater irregularity, greater sway variability) during quiet stance between children with CP and peers with typical development; this difference was mitigated during the performance of the precision functional play task.LimitationsA small and nonprobability sample of convenience may limit the findings of this study.ConclusionsThe findings illustrate flexibility and adaptability in the postural control system despite the pathological features associated with CP.