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(1) Background: The standard surgical approach to amputation has failed to evolve significantly over the past century. Consequently, standard amputations often fall short with regard to improving the quality of life (QoL) for patients. A modified lower extremity amputation technique incorporating agonist–antagonist myoneural interface (AMI) constructs provides patients with a novel alternative to standard amputation and, to-date, has demonstrated overall significant improvements in their physical and mental wellbeing. (2) Methods: Five PROMs surveys, (1) EQ-5D-3L, (2) Lower Extremity Functional Scale (LEFS), (3) PROMIS-57, (4) Short Form-36 (SF-36), and (5) Sickness Impact Profile (SIP), were administered to our research cohort pre-operatively (baseline) and at various timepoints post-operatively. (3) Results: The cohort’s baseline and 12-month post-operative responses were compared to determine score improvement. Significant improvements were demonstrated across all survey domains (p < 0.05). (4) Conclusions: Modified lower extremity amputation with AMI construction has the potential to provide amputees with increased quality of life when compared to the pre-operative state. However, further investigation is necessary to determine whether the patient-reported outcome measures of the AMI amputee cohort are superior to those who receive a standard amputation.

(1) Background: The standard surgical approach to amputation has failed to evolve significantly over the past century. Consequently, standard amputations often fall short with regard to improving the quality of life (QoL) for patients. A modified lower extremity amputation technique incorporating agonist–antagonist myoneural interface (AMI) constructs provides patients with a novel alternative to standard amputation and, to-date, has demonstrated overall significant improvements in their physical and mental wellbeing. (2) Methods: Five PROMs surveys, (1) EQ-5D-3L, (2) Lower Extremity Functional Scale (LEFS), (3) PROMIS-57, (4) Short Form-36 (SF-36), and (5) Sickness Impact Profile (SIP), were administered to our research cohort pre-operatively (baseline) and at various timepoints post-operatively. (3) Results: The cohort’s baseline and 12-month post-operative responses were compared to determine score improvement. Significant improvements were demonstrated across all survey domains (p < 0.05). (4) Conclusions: Modified lower extremity amputation with AMI construction has the potential to provide amputees with increased quality of life when compared to the pre-operative state. However, further investigation is necessary to determine whether the patient-reported outcome measures of the AMI amputee cohort are superior to those who receive a standard amputation.

The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations. This paper reviews and summarizes the differences across 16 of these criteria enacted by 89 WIC administrative agencies: the 50 states, the District of Columbia, five US Territories, and 33 Indian Tribal Organizations. Vendor selection and authorization criteria varied across WIC agencies without any consistent pattern. The wide variations in criteria and policies raise questions about the rational for inconsistency. Some of these variations, in combination, may result in reduced access to WIC-approved foods and beverages by WIC participants. For example, minimum square footage and/or number of cash register criteria may limit vendors to larger retail operations that are not typically located in high-risk, under-resourced communities where WIC vendors are most needed. Results highlight an opportunity to convene WIC stakeholders to review variations, their rationale, and implications thereof especially as this process could result in improved policies to ensure and improve healthy food and beverage access by WIC participants. More work remains to better understand the value of state WIC vendor authorization authority, particularly in states that have provided stronger monitoring requirements. This work might also examine if and how streamlining WIC vendor criteria (or at least certain components of them) across regional areas or across the country could provide an opportunity to advance interstate commerce and promote an equitable supply of food across the food system, while ensuring the protection for local, community-oriented WIC vendors.

Measurement invariance of a one-factor model of effortful control (EC) was tested for 853 low-income preschoolers ( M age = 4.48 years). Using a teacher-report questionnaire and seven behavioral measures, configural invariance (same factor structure across groups), metric invariance (same pattern of factor loadings across groups), and partial scalar invariance (mostly the same intercepts across groups) were established across ethnicity (European Americans, African Americans and Hispanics) and across sex. These results suggest that the latent construct of EC behaved in a similar way across ethnic groups and sex, and that comparisons of mean levels of EC are valid across sex and probably valid across ethnicity, especially when larger numbers of tasks are used. The findings also support the use of diverse behavioral measures as indicators of a single latent EC construct.

The community-building functions of socialization, mutual support, social control, and social participation are derived and tested in relation to the development of consumer loyalty and a consumer's willingness to pay more for the retailer's product. Empirical results indicate that the development of community is not, ceteris paribus, always a positive thing. Of the four core functions, retailer socialization and mutual support relate positively to consumer willingness to pay more. In addition, while retailer socialization and social participation relate positively to consumer loyalty, retailer social control relates negatively to consumer loyalty. Theoretical and managerial implications are discussed.

This article looks closely at two types of errors children have been shown to make with universal quantification—Exhaustive Pairing (EP) errors and Underexhaustive errors—and asks whether they reflect the same underlying phenomenon. In a large-scale, longitudinal study, 140 children were tested 4 times from ages 4 to 7 on sentences involving the universal quantifier every. We find an interesting inverse relationship between EP errors and Underexhaustive errors over development: the point at which children stop making Underexhaustive errors is also when they begin making EP errors. Underexhaustive errors, common at early stages in our study, may be indicative of a non-adult, non-exhaustive semantics for every. EP errors, which emerge later, and remain frequent even at age 7, are progressive in nature and were also found with adults in a control study. Following recent developmental work (Drozd and van Loosbroek 2006; Smits 2010), we suggest that these errors do not signal lack of knowledge, but may stem from independent difficulties appropriately restricting the quantifier domain in the presence of a salient, but irrelevant, extra object. This article is part of the special collection: Acquisition of Quantification

Background Three-dimensional ultrasound (3DUS) at simulation compared to 3DUS at treatment is an image guidance option for partial breast irradiation (PBI). This study assessed if user dependence in acquiring and contouring 3DUS (operator variability) contributed to variation in seroma shifts calculated for breast IGRT. Methods Eligible patients met breast criteria for current randomized PBI studies. 5 Operators participated in this study. For each patient, 3 operators were involved in scan acquisitions and 5 were involved in contouring. At CT simulation (CT1), a 3DUS (US1) was performed by a single radiation therapist (RT). 7 to 14 days after CT1 a second CT (CT2) and 3 sequential 3DUS scans (US2a,b,c) were acquired by each of 3 RTs. Seroma shifts, between US1 and US2 scans were calculated by comparing geometric centers of the seromas (centroids). Operator contouring variability was determined by comparing 5 RT’s contours for a single image set. Scanning variability was assessed by comparing shifts between multiple scans acquired at the same time point (US1-US2a,b,c). Shifts in seromas contoured on CT (CT1-CT2) were compared to US data. Results From an initial 28 patients, 15 had CT visible seromas, met PBI dosimetric constraints, had complete US data, and were analyzed. Operator variability contributed more to the overall variability in seroma localization than the variability associated with multiple scan acquisitions (95% confidence mean uncertainty of 6.2 mm vs. 1.1 mm). The mean standard deviation in seroma shift was user dependent and ranged from 1.7 to 2.9 mm. Mean seroma shifts from simulation to treatment were comparable to CT. Conclusions Variability in shifts due to different users acquiring and contouring 3DUS for PBI guidance were comparable to CT shifts. Substantial inter-observer effect needs to be considered during clinical implementation of 3DUS IGRT.

Based on Shulman's (1991) model, one elementary and two secondary teachers from The Roeper School for gifted students present instructional dilemmas that exemplify the complex nature of teaching. A description of the model and process of case writing establishes the context. Each teacher-authored case is followed by expert commentaries from within and outside the field of gifted education. The commentaries serve to extend our thinking about the dilemmas embedded in each case and raise questions for further reflection. The editors welcome correspondence on the potential usefulness of instructional cases and commentaries for supporting reflective practice among pre-service and practicing teachers of the gifted and encouraging dialogue among practitioners and researchers in gifted education and in the subject matter fields.