Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?

Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery.     

Regional diversification and green employment in US metropolitan areas

Adapting or supplanting production and distribution systems to accommodate new criteria of environmental sustainability entails the search for and the recombination of know-how from a variety of domains. How this process plays out in different areas depends crucially on the specific composition of local economic activities. This paper contributes this debate by analysing whether and to what extent regional industrial and occupational diversification affects the change in green employment across 363 Metropolitan Statistical Areas (MSAs) in the United States between 2006 and 2014. Our findings suggest that industrial unrelated variety within MSAs is a positive and significant predictor of green employment growth whereas related variety has very little impact. Conversely, both related and unrelated diversification across occupations are positively associated with green employment growth. The analysis also uncovers heterogeneity across existing, new and evolving green jobs.     

An integrated model of school students’ academic achievement and life satisfaction. Linking soft skills,extracurricular activities,self-regulated learning,motivation, and emotions

The role of soft skills at school is still debated, but they have emerged as important factors for students’ academic achievement and life satisfaction. This study focuses on the combined influence of soft skills (in terms of adaptability, curiosity, leadership, initiative, perseverance, and social awareness), extracurricular activities, achievement emotions, self-regulated learning, motivation, and cognitive abilities on academic achievement and life satisfaction. A sample of 603 students (5th to 12th graders) participated in the study. The results of a Bayesian path analysis based on meta-analytical priors show that soft skills were (i) directly positively associated with students’ achievement emotions, self-regulated learning, motivation, and life satisfaction and (ii) indirectly related with academic achievement through the mediation of self-regulated learning and motivation. On the other hand, only soft skills and achievement emotions were directly related to life satisfaction. Extracurricular activities showed a positive association with both soft skills and cognitive abilities. These results are the first to demonstrate the importance of soft skills and extracurricular activities when integrating all the above-mentioned factors in a model of students’ academic achievement and life satisfaction.

     

Rational addiction and cultural goods: the case of the Italian theatregoer

This paper tests whether demand for theatre in Italy is consistent with the model of rational addiction presented in Becker and Murphy (J Polit Econ 96(4):675–700, 1988). Data from a novel 34-year panel on regional annual theatre attendance are used to estimate market demand. Four models are applied to investigate the demand function, and all of these also include per capita income and other control variables as regressors. The first two models are estimated to check whether theatregoers are myopically addicted to theatre. The results suggest that the theatre is an addictive good because past consumption (and prices) significantly raises the marginal utility of current consumption. The third model tests the rational addiction hypothesis, which assumes that future attendance also influences current attendance, whilst past and future prices influence current attendance only indirectly through their impact on past and future attendances. However, our most highly specified model, introducing past and future prices, demonstrates that Italian theatregoers are not myopic but fully rational as outlined in Becker and Murphy (1988). The results demonstrate that the rational addiction hypothesis is applicable not only to “harmful” addictions such as alcohol, cigarettes and drug consumption, but also to “beneficial” addictions, such as theatre attendance. This result has important policy implications because theatre is one of the most subsidised performing arts in Italy; if theatregoers are fully rational, policy makers can influence theatre attendance using alternative policy instruments (price and income), thereby reducing government expenditure on theatre subsidies.     

Participation in asynchronous online discussion forums does improve student learning of gross anatomy

Asynchronous online discussion forums are common in blended learning models and are popular with students. A previous report has suggested that participation in these forums may assist student learning in a gross anatomy subject but it was unclear as to whether more academically able students post more often or whether participation led to improved learning outcomes. This study used a path model to analyze the contribution of forum participation, previous academic ability, and student campus of enrolment to final marks in a multicampus gross anatomy course for physiotherapy students. The course has a substantial online learning management system (LMS) that incorporates asynchronous forums as a learning tool, particularly to answer learning objectives. Students were encouraged to post new threads and answer queries in threads started by others. The forums were moderated weekly by staff. Discussion forums were the most used feature of the LMS site with 31,920 hits. Forty‐eight percent of the students posted at least once with 186 threads initiated by students and a total of 608 posts. The total number of posts made a significant direct contribution to final mark (P = 0.008) as did previous academic ability (P = 0.002). Although campus did not contribute to final mark, there was a trend for students at the campus where the course coordinator was situated to post more often than those at the other campus (P = 0.073). These results indicate that asynchronous online discussion forums can be an effective tool for improving student learning outcomes as evidenced by final marks in gross anatomy teaching. Anat Sci Educ. 7: 71–76. © 2013 American Association of Anatomists.     

Knowledge systematisation,reconfiguration and the organisation of firms and industry: The case of design

The paper explores two pathways that are crucial for making knowledge economically useful – knowledge systematisation and knowledge reconfiguration – and analyses how their interplay enables the emergence of a new business function or activity. Knowledge systematisation is the abstraction and diffusion of operative principles to the effect of expanding to broader remits practices that had been initially conceived for a narrow purpose. Knowledge reconfiguration involves the conversion and formalisation of these novel practices within existing firm and industry organisation. Using the design activity as a lens, and drawing on primary and secondary interviews and archival data on the home furnishing sectors in Italy, our case study articulates the processes that facilitate the abstraction of general rules from novel practices and the changes that are necessary, both within firm and industry organisation, to foster their diffusion.     

Acute effects of whole-body vibration on running gait in marathon runners

Abstract

The aim of this study was to investigate the effects of a single bout of whole-body vibration (WBV) on running gait. The running kinematic of sixteen male marathon runners was assessed on a treadmill at iso-efficiency speed after 10 min of WBV and SHAM (i.e. no WBV) conditions. A high-speed camera (210 Hz) was used for the video analysis and heart rate (HR) was also monitored. The following parameters were investigated: step length (SL), flight time (FT), step frequency (SF), contact time (CT), HR and the internal work (W_INT). Full-within one-way analysis of variance (ANOVA) of the randomised crossover design indicated that when compared to SHAM conditions, WBV decreased the SL and the FT by ~4% (P < 0.0001) and ~7.2% (P < 0.001), respectively, and increased the SF ~4% (P < 0.0001) while the CT was not changed. This effect occurred during the first minute of running: the SL decreased ~3.5% (P < 0.001) and SF increased ~3.3% (P < 0.001). During the second minute the SL decreased ~1.2% (P = 0.017) and the SF increased ~1.1% (P = 0.02). From the third minute onwards, there was a return to the pre-vibration condition. The W_INT was increased by ~4% (P < 0.0001) during the WBV condition. Ten minutes of WBV produced a significant alteration of the running kinematics during the first minutes post exposure. These results provide insights on the effects of WBV on the central components controlling muscle function.     

From new imported inputs to new exported products. Firm-level evidence from Sweden

This paper investigates the determinants of the propensity of firms to export new products, and focuses on the role of new imported inputs. Importing offers access to new technologies and better combination of inputs that can lead to new or improved products for the export markets. Based on a sample of more than 14,000 Swedish manufacturing firms over the period 2001–2012, we show that importing new inputs is a key determinant of firms’ propensity to add new products to their export portfolio, even after controlling for multinationality, patenting activity, productivity and a number of other firm characteristics. This is mainly due to the import of new intermediate inputs and it is stronger for smaller firms.     

Thermo-formation process of plastic shells for winter sport boots for improved comfort

We have performed a study on the thermo-formation process of plastic shells of boots for winter sports. The aim of the work has been to determine how the process parameters can improve the ergonomic and thermal comfort for athletes and winter sports participants. We have found that the initial deformation and memory effect are strongly influenced by the type of thermoplastic material used, heating time and cooling procedure. We have also found that the ovens currently used for this process are not correctly designed to obtain an efficient heat transfer and, therefore, a heating time of at least 12 min is necessary to achieve an average deformation of more than 2 mm. The measure of the boot flexural stiffness has shown that there are no changes in the load–deflection behavior after the thermo-formation process of a ski boot made of thermoplastic polyurethane. We have also found that the thermo-formation process decreases the pressure on skier’s feet of more than five times and, therefore, improves the comfort of the skier.