bluuebunny/crossref_metadata_2025 huggingface dataset:
Structures at Risk During Percutaneous Screw Fixation for Talonavicular Fusion
Authors: Lee Sung Ro , Stibolt Davis , Patel Harshadkumar , Abyar Eldar , Moon Andrew , Naranje Sameer , Shah Ashish
Published: August 2018

Background:

Talonavicular (TN) fusion using screws dorsomedially and dorsolaterally can cause neurovascular injury. The purpose of our cadaveric study was to evaluate the safety of percutaneous screw insertion in relation to dorsal neurovascular structures.

Methods:

Ten fresh-frozen cadaver legs were used for this study. Percutaneous cannulated screws were inserted to perform isolated TN arthrodesis. The screws were inserted at 3 consistent sites: a “medial screw” at the dorsomedial navicular where it intersected at the medial plane of the first cuneiform, a “central screw” at the edge of the dorsal navicular between the medial and intermediate cuneiforms, and a “lateral screw” at the edge of the dorsal navicular between the intermediate and lateral cuneiforms. Superficial and deep dissections were carried out to identify any injured nerves, arteries, and/or tendons.

Results:

The medial screw injured the anterior tibialis tendon in 2 cases (20%), the central screw injured the extensor hallucis longus tendon in 3 cases (30%), and the lateral screw injured the anterior branch of the superior peroneal nerve (SPN), the lateral branch of the SPN, and the medial branch of the distal peroneal nerve (DPN) once each in a total of 3 cases (30%). Despite no direct injury, the central screw indicated a potential risk of neurovascular injury: closest distance to the anterior SPN was 2 mm and to the medial DPN 2 mm.

Conclusion:

Although neurovascular injury risk exists for all of these screw placements, TN fusion with a central screw introduced a potentially decreased risk of neurovascular injury at the expense of increased risk of tendon injury compared to the lateral screw.

Clinical Relevance:

Based on these results, we recommend a careful dissection be performed prior to percutaneous screw insertion.
Outcome Following a Modified Broström Procedure and Arthroscopic Debridement of Medial Gutter Osteoarthritis Combined With Chronic Ankle Instability
Authors: Cho Byung-Ki , Shin Young-Duck , Park Hyun-Woo
Published: August 2018

Background:

There is limited information regarding the outcomes of operative treatment for ankle instability with coexisting arthritic changes in the medial gutter. This study was performed to evaluate the intermediate-term clinical and radiological outcomes following a modified Broström procedure and arthroscopic debridement in middle-aged patients with combined medial gutter osteoarthritis and chronic ankle instability.

Methods:

Twenty-two patients with medial gutter osteoarthritis related to chronic lateral ankle instability were followed for more than 3 years after operative treatment. All patients showed medial joint space narrowing of Takakura stage II at the time of surgery. The clinical evaluation consisted of the American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) for medial ankle pain during walking, and Foot and Ankle Ability Measure (FAAM).

Results:

Mean AOFAS and FAAM scores significantly improved from 51.2 and 45.7 points preoperatively to 80.3 and 78.4 points at final follow-up, respectively ( P < .001). Although mean pain-VAS significantly improved from 6.8 points to 3.5 points ( P < .001), 8 patients (36.4%) complained of gait discomfort with considerable pain of 4 or more points. There was only 1 patient (4.5%) with recurrent ankle instability, while 6 patients (27.3%) showed a progression of arthritis stage.

Conclusions:

Modified Broström procedure combined with arthroscopic debridement appears to be an effective operative option for medial gutter osteoarthritis secondary to chronic ankle instability. Despite the onset of arthritis, most patients were able to achieve significant improvement in reducing pain while eliminating instability.

Level of Evidence:

Level IV, retrospective case series.
Angiotensin-Converting Enzyme Inhibitors Provide Better Long-Term Survival Benefits to Patients With AMI Than Angiotensin II Receptor Blockers After Survival Hospital Discharge
Authors: Choi In Suck , Park Ie Byung , Lee Kiyoung , Ahn Tae Hoon , Kim Ju Han , Ahn Youngkeun , Chae Sung-Chull , Kim Hyo-Soo , Kim Young Jo , Cho Myeong Chan , Kim Chong Jin , Jeong Myung Ho , Lee Dae Ho
Published: August 2018

Aim:

Renin–angiotensin–aldosterone system inhibitors (RASIs) are widely used in high-risk cardiovascular (CV) diseases, including acute myocardial infarction (AMI). However, it is not yet clear which class of RASIs provides specific benefits to patients with AMI. The present study aimed to evaluate whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) had any different effects on long-term CV and all-cause mortality in patients with AMI who received either agent from admission and were discharged alive from the hospital.

Methods:

We analyzed data of patients with AMI from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry. Cardiovascular and all-cause mortality at 12 months after AMI were assessed.

Results:

Among 12 481 patients with AMI who were discharged alive, RASI treatment was as follows: ACEIs (n = 5910), ARBs (n = 4009), and no RASI (n = 2562). After adjustment for multiple factors, compared with no RASI therapy, ACEI therapy was associated with lower hazard ratios (HRs) for 1-year CV and total mortality rates, whereas ARB therapy was not. In a direct comparison, compared with ARB treatment, ACEI treatment was associated with lower HRs (95% confidence interval) for CV and total mortality: 0.562 (0.420-0.753) and 0.567 (0.451-0.713), respectively. The superiority of ACEI to ARB was also observed across several subgroups. The mortality differences between the 2 treatment groups were reproduced in a propensity-score matched analysis (n = 2855 each).

Conclusions:

Our study of a recent AMI registry data revealed that ACEI therapy in patients with AMI was associated with better long-term survival benefits than ARB therapy.
Autoethnography as Pedagogy: Writing the “I” in IR
Authors: Barr Michael
Published: August 2018

While autoethnography has established itself as a research method, its utility in the classroom remains underexplored. Many writers use autoethnography to describe their roles as educators and students but far fewer detail an actual autoethnographic course. I analyze a highly original MA-level class on autoethnography in international relations. Students report that the course had the “potential to revolutionize” learning and teaching as a means of questioning themselves in relation to the social and political worlds they studied. Autoethnography has transformed the way we approach ourselves and our research; it is now time we let it change how we teach.
Adults’ Knowledge, Attitudes, and Willingness to Interact With Patients Suffering From Mental Illness in Jeddah City
Authors: Aljedaani Shafeah M.
Published: August 2018

BACKGROUND: Mental illness is a serious health problem. Understanding the views of different communities toward patients with mental illness is important in understanding how communities deal with these patients. AIM: To investigate Saudi adults’ knowledge, attitudes, and willingness to interact with patients with mental illness. METHOD: The study followed a quantitative approach, a descriptive correlation design. RESULTS: The study results indicate that while participants had knowledge and positive attitudes toward certain aspects, they had negative knowledge and attitudes regarding other aspects. Most participants (61.1%) mentioned that the cause of mental illness is biological, 61.9% stated that medication is a useful way to treat patients with mental illness, and 90% believed that patients with mental illness deserve respect. Furthermore, 35.8% of participants believed that patients with mental illness had a tendency toward dangerous and aggressive behavior, whereas 33.2% believed that the community is safer if patients with mental illness are kept in hospitals. There was a positive correlation between knowledge and attitudes toward patients with mental illness ( r = .305, p < .01). On the other hand, the study found that there is a statistically significant and negative correlation among adults’ attitudes and their readiness to interact with patients. CONCLUSIONS: The study will ideally encourage stakeholders to design and initiate an educational strategic program at the community level in order to improve community members’ awareness and attitudes and enhance their readiness to interact with patients with mental illness.
Seroprevalence and Associated Risk Factors of Hepatitis B Virus Infection Among Children in Enugu Metropolis
Authors: Ezeilo Maryann Chinenye , Engwa Godwill Azeh , Iroha Romanus Ifeanyi , Odimegwu Damian Chukwu
Published: August 2018

Background:

Though measures are being put in place for the management of Hepatitis B virus (HBV) infection in Nigeria, children remain the most vulnerable to develop chronic hepatitis. Routine screening in children is therefore necessary for effective control. However, the performance of the commonly used immunochromatographic test (ICT) strips has been challenging. Also, identifying the risk factors of transmission in this age group is of importance for the implementation of preventive measures. Hence, the goal of this study was to assess the test performance of the routinely used ICT strip and identify the associated clinical manifestations and risk factors of HBV.

Methods:

A cross sectional study involving 270 children below six years of age was conducted at ESUTH and Favor Child Pediatrics Hospital in Enugu, Nigeria. The subjects were screened for HBV by ICT and ELISA assays and a structured questionnaire was used to obtain participants data including demographic, socioeconomic, signs and symptoms, risk factors and vaccination.

Results:

BBased on ELISA, 31 out of 270 children were positive for HBV with an infection rate of 11.5%. ICT kit showed a low sensitivity of 51.6% in diagnosing HBV but was highly specific (100%) and accurate (94.4%). HBV infection was not associated with sex (χ2: 0.209; p = 0.401). The prevalence of HBV infection was similar in all the age group and HBV infection was not associated (χ2: 2.099; p = 0.914) with age group. All the clinical manifestations were not associated ( p > 0.05) with HBV infection. Blood transfusion, shared items, tattoo marks and history of surgery associated significantly ( p < 0.05) with HBV infections having odd ratios of 4.247, 4.224, 3.134 and 3.195 respectively. The vaccination rate was 55.2% (159/270) and only 3 (1.1%) out of 159 vaccinated subjected contracted the infection (OR: 0.068, p < 0.0001).

Conclusions:

HBV was prevalent (11.5%) in children below six years old in Enugu metropolis. Moreover, the routinely used ICT test was less reliable than ELISA in diagnosis HBV infection. More so, shared items, blood transfusion, tattooing and history of surgery were potential risk factors while vaccination served as a protective factor against the infection.
Predictors of Emergent Emergency Department Visits and Costs in Community-Dwelling Older Adults
Authors: Coe Antoinette B , Moczygemba Leticia R , Ogbonna Kelechi C , Parsons Pamela L , Slattum Patricia W , Mazmanian Paul E
Published: August 2018

Background:

The number of yearly emergency department (ED) visits by older adults in the United States has been increasing.

Purpose:

The objectives were to (1) describe the demographics, health-related variables, and ED visit characteristics for community-dwelling older adults using an urban, safety-net ED; (2) examine the association between demographics, health-related variables, and ED visit characteristics with emergent vs nonemergent ED visits; and (3) examine the association between demographics, health-related variables, ED visit characteristics, and ED visit costs.

Methods:

A cross-sectional, retrospective analysis of administrative electronic medical record and billing information from 2010 to 2013 ED visits (n = 7805) for community-dwelling older adults (⩾65 years old) from an academic medical center in central Virginia was conducted.

Results:

Most of the ED visits were by women (62%), African Americans (75%), and approximately 50% of ED visits were nonemergent (n = 3871). Men had 1.2 times the odds of an emergent ED visit (95% confidence interval [CI]: 1.02-1.37). The ED visits by white patients had 1.3 times the odds of an emergent ED visit (95% CI: 1.09-1.57) and 14% higher costs (white race: 95% CI: 1.07-1.21) compared with African American patients. Emergent ED visits were 60% more likely to have higher costs than nonemergent visits (95% CI: 1.52-1.69). White race and arrival by ambulance were associated with both emergent ED visits and higher total ED visit costs in this sample of ED visits by community-dwelling older adults.

Conclusions:

Strategies to maximize opportunities for care in the primary care setting are warranted to potentially reduce nonemergent ED utilization in community-dwelling older adults.
Interdisciplinary case discussions as a training modality to teach cultural formulation in child mental health
Authors: Rousseau Cécile , Johnson-Lafleur Janique , Papazian-Zohrabian Garine , Measham Toby
Published: August 2018

The DSM-5 Cultural Formulation Interview (CFI) may become an important tool to help operationalize culture in the clinical realm. However, challenges exist in teaching its use to avoid the risk of stereotyping and oversimplification, which could result in misunderstanding and stigma. The aim of this article is to document whether the CFI can be taught using regular Interdisciplinary Case Discussion Seminars (ICDSs), proposed as continuing education in child mental health and as part of clinical rotations for new trainees. During a two-year evaluative research project, ICDSs were held monthly in three different primary care settings servicing recent immigrants in Montreal, Canada. ICDSs were recorded and analyzed to examine their effect on the cultural formulation process and focus groups were conducted to explore the subjective experience of the participant trainees and professionals. Results suggest that ICDSs are a helpful way to teach the use of the CFI. The group discussions helped participants to better capture the complexity of the cultural and social experience of the child and family by moving away from simple identity assignations, supporting an inquiry into structural dimensions, and considering stigma and inequality in their formulation. The multiple levels of diversity (individual, disciplinary, and interinstitutional) represented in the discussion groups helped clinicians to understand the cultural formulation as situated in a specific relational context and a particular moment and, in so doing, helped trainees to avoid cultural formulations that essentialize culture.
Cultural revitalization and the ontology of communicative spaces: ‘Mobile coordinating’ among Guaraní
Authors: Wagner Sarah
Published: August 2018

Much ICT-related cultural revitalization research in indigenous contexts concerns the production and circulation of traditional and indigenous language content matter. Drawing on ethnographic research with Guaraní communities in Tarija Department, Bolivia, this article argues for the significance of everyday, intracommunity communicative spaces to cultural revitalization. I describe how Guaraní renegotiate and delimit ICT practices – with respect to changing group norms on appropriate communication mediums – to safeguard relaxed, responsive and face-to-face communicative spaces. In the context of this research, the sentiment of togetherness reinforced by such communicative spaces was what underlay and incited cultural practices. This opens up important issues for cultural revitalization research relating to the ontology of ICT-mediated communicative spaces and the processes through which these are renegotiated and decolonized.
Words also make us: Enhancing the sociology of embodiment with cultural psychology
Authors: Lignier Wilfried
Published: August 2018

We still lack an operational theory for a complete analysis of early socialization processes. Bourdieu has stressed their bodily dimension but has done so at the expense of more symbolic aspects. This theoretical option corresponds to a very general goal of the Bourdieusian theory of practice: analysing sociality without suffering an intellectualist bias. However, symbolic activity and socializing language in particular can be approached as a practical phenomenon (i.e. habitual, informal, unconscious, etc.). From this viewpoint, the sociology of embodiment may have much to learn from cultural psychology, which has focused on early language as it is naturally performed – when people speak to children, and when children speak. The work of cultural psychologists on the role of everyday words and narratives in the making of the self can be extended through a sociological ethnography of language. The features and interests of such an ethnography are discussed in the final section of the article, on the basis of fieldwork conducted in a nursery. This final development illustrates and analyses the concrete appropriation of caregiver injunctions by 2- to 3-year-old children.
Learning how to lead police investigations
Authors: Nilsen Jon-Andre , Aaserud Terje , Filstad Cathrine
Published: August 2018

The aim of this article was to investigate how police investigation leaders learn leadership and whether the facilitation of learning activities and learning methods might bridge the well-known gap between teaching and learning leadership. Using action research, we constructed an ‘i-leader’ learning pool consisting of police investigation leaders. The pool provided interactive and collaborative learning activities that included reflection, knowledge sharing and social support. Participants were receptive to this learning initiative, but also argued that ‘learning by doing’ is most important because it allows for communication and cooperation between colleagues in the context of their everyday leadership practice. They acknowledged the need for reflection and argued that the pool provides important reflection time, which they lack in their everyday practice. Participants also found the learning methods, particularly the ‘group support methodology’ and the new network useful for their own leadership development. However, using these new learning methods ‘back home’ was more challenging. Participants did not have time to prioritize and develop this new network. Providing learning methods and building a network takes time and must be relevant to everyday leadership practice. The significance of their leadership practice and how to accumulate experience as the basis for reflection was acknowledged, but still needs to be applied within leadership practice. Bridging the gap between teaching and learning is not just about providing learning and reflection methods, but also about learning how to apply new knowledge through experience, where reflection ensures that learning in practice is not ‘due to change’.
Theoretical advances and problems in the sociology of punishment
Authors: Garland David
Published: August 2018

The last twenty years have seen a remarkable increase in the extent and range of “punishment and society” scholarship. Together with this quantitative expansion, there have also been important qualitative developments in research, analysis and explanation – many of which can be counted as scientific advances. This article specifies a number of dimensions along which theory, method and data in this field have been improved and also identifies some continuing challenges and problems. Examples from the literature on the emergence of “mass incarceration” and the nature of the “war on drugs” are used to indicate the range of theoretical resources that scholars in this field have developed and to point to empirical and theoretical questions that remain to be resolved.
Speculating on tentacular infrastructures
Authors: Bocarejo Diana
Published: August 2018

Trains, water pipes and many other infrastructures whisper, and sometimes even roar. There is the sound of metal gripping water tanks, the echoes of deep wells, the soothing sounds of rivers stifled in irrigation ditches, and the sudden rumble of the train. The visual and audible life of infrastructures reverberates through the landscape of the immense green banana and palm oil plantations of the Zona Bananera, Colombia. Walking what was before a banana emporium built by the United Fruit Company involves knowing how to move within infrastructures. This ethnographic photo-essay is a reflection on the everyday becoming of both infrastructure and peasant zoneros. ‘The Octopus’, as the United Fruit Company is still called by locals, expanded its tentacles through a wide variety of materials. As much as tentacles can violently suffocate they can also be tamed and tricked. By repurposing infrastructures speculative and creative lives are lived, felt and imagined.
Testing Mark-all-that-apply Measures of Sexual Orientation and Gender Identity
Authors: Brenner Philip S. , Bulgar-Medina Justine
Published: August 2018

Many social identities (e.g., race, ethnicity) are measured using mark-all-that-apply (MATA) questions because they allow survey respondents to account for the multiple, nonexclusive ways in which they identify themselves. We test the use of MATA measures of sexual orientation and gender identity and compare them with forced choice (FC), an alternative format using a series of yes-or-no questions. Respondents, including an oversample of lesbian, gay, bisexual, and queer (LGBQ) individuals, participated in a 2 × 3 factorial survey experiment. For the first factor, we hypothesize that respondents randomly assigned to FC will report a higher count of identities than those assigned to MATA. For the second factor, we hypothesize that increased topic salience will help LGBQ respondents in particular to overcome poor question design. Findings suggest that MATA and FC measure comparably when question writing best practices are followed, but topic salience can yield higher data quality when poorly formatted questions are used.
Transcranial Direct Current Stimulation May Improve Cognitive-Motor Function in Functionally Limited Older Adults
Authors: Manor Brad , Zhou Junhong , Harrison Rachel , Lo On-Yee , Travison Thomas G. , Hausdorff Jeffrey M. , Pascual-Leone Alvaro , Lipsitz Lewis
Published: August 2018

Objective. To determine the effects of a transcranial direct current stimulation (tDCS) intervention with the anode placed over the left dorsolateral prefrontal cortex (dlPFC) and cathode over the right supraorbital region, on cognition, mobility, and “dual-task” standing and walking in older adults with mild-to-moderate motor and cognitive impairments. Methods. A double-blinded, block-randomized, sham-controlled trial was conducted in 18 nondemented, ambulatory adults aged ⩾65 years with slow walking speed (⩽1.0 m/s) and “executive” dysfunction (Trail Making Test B score ⩽25th percentile of age- and education-matched norms). Interventions included ten 20-minute sessions of tDCS or sham stimulation. Cognition, mobility, and dual-task standing and walking were assessed at baseline, postintervention, and 2 weeks thereafter. Dual tasking was also assessed immediately before and after the first tDCS session. Results. Intervention compliance was high (mean ± SD = 9.5 ± 1.1 sessions) and no unexpected or serious side effects were reported. tDCS, compared with sham, induced improvements in the Montreal Cognitive Assessment total score ( P = .03) and specifically within the executive function subscore of this test ( P = .002), and in several metrics of dual-task standing and walking ( P < .05). Each of these effects persisted for 2 weeks. tDCS had no effect on the Timed Up-and-Go test of mobility or the Geriatric Depression Scale. Those participants who exhibited larger improvements in dual-task standing posture following the first tDCS session exhibited larger cognitive-motor improvements following 2 weeks of tDCS ( P < .04). Interpretation. tDCS intervention designed to stimulate the left dorsolateral prefrontal cortex may improve executive function and dual tasking in older adults with functional limitations.
Effects of Antiretroviral Therapy on Sperm DNA Integrity of HIV-1-Infected Men
Authors: Savasi Valeria , Oneta Monica , Laoreti Arianna , Parisi Francesca , Parrilla Bina , Duca Piergiorgio , Cetin Irene
Published: August 2018

HIV-1-affected couples’ desire to have children and free sexual intercourses with the use of pre-exposure prophylaxis for the negative partner has emerged as an alternative option to assisted reproduction in aviremic patients under highly active antiretroviral therapy (HAART). It is already known that sperm quality may be impaired in HIV-infected men. The underlying physiopathological mechanism is still debated. The aim of this study was to evaluate the effects of HAART on sperm DNA fragmentation, comparing HIV-1-infected patients taking HAART versus naïve HIV-1-infected patients. This is a prospective case-control study. Sperm nuclear DNA fragmentation rate was evaluated by the sperm chromatin dispersion test in 77 HIV-infected men: 53 HIV-1 patients receiving HAART (Group 1) versus 24 naïve HIV-1 patients not receiving HAART (Group 2). Complete semen analysis was performed according to WHO 2010 recommendations. Patients with HBV infection or HCV infection coinfections and genital tract infections wre excluded. All the patients did not present any clinical signs of their disease. Seminal parameters were examined in the two groups, showing no significant differences. Increased sperm DNA fragmentation > 30% was demonstrated in 67.9% of patients in Group 1 and 37.5% of patients in Group 2, respectively ( p = .02). A positive but nonsignificant trend toward increased fragmentation was reported with advancing patients’ age. In conclusion, sperm nuclear fragmentation rate is increased in HIV-1-infected patients taking HAART compared to HIV-1 patients not receiving HAART.
Physician Extenders in Hand Surgery: The Patient’s Perspective
Authors: Manning Blaine T. , Bohl Daniel D. , Luchetti Timothy J. , Christian David R. , Fernandez John J. , Cohen Mark S. , Wysocki Robert W.
Published: August 2018

Background: Physician extenders, such as physician assistants (PAs) and nurse practitioners (NPs), have been incorporated into health systems in response to the rising demand for care. There is a paucity of literature regarding patient perspectives toward physician extenders in hand surgery. Methods: We anonymously surveyed 939 consecutive new patients before their clinic visit. Our questionnaire assessed patient perspectives toward physician extenders, including optimal scope of practice, the effect of the extender when choosing a hand surgeon, and pay equity for the same clinical services. Results: Of 939 patients, 784 (84%) responded: 54% were male and 46% were female with a mean age of 44.1 years. Most (65%) patients consider the extender’s training background when choosing a hand surgeon, with 31% of all patients considering PAs to have higher training than NPs and 17% the reverse. Patients responded that certain services should be physician-provided, including determining the need for advanced imaging (eg, magnetic resonance imaging), follow-up for abnormal diagnostics, and new patient visits. Patients were amenable to services being extender-provided, including minor in-office procedures, preoperative teaching, and postoperative clinic visits. Patients lacked a consensus toward reimbursement equity for hand surgeons and physician extenders providing the same clinical services. Conclusions: Our data suggest that patients presenting to a hand surgeon are comfortable receiving direct care from a physician extender in many, but not all, circumstances. Hand surgeons can use these data when deciding how to use extenders to optimize patient satisfaction and practice efficiency as health care systems become increasingly consumer-focused and value-based.
Repeated Whole-Body Exposure to Low-Dose Radiation Combined With Topical Application of Basic Fibroblast Growth Factor and Zinc Accelerates Wound Healing in Diabetic Rats
Authors: Zhang Hai-feng , Cheng Jie , Lv You , Li Feng-sheng , He Guang-yu , Wang Brain , Cai Lu , Guo Wei-ying
Published: August 2018

We reported the acceleration of skin wound healing in diabetic rats by repeated exposure to low-dose radiation (LDR). Here, we explored whether the wound healing could be further improved when LDR was combined with a topical application of basic fibroblast growth factor (bFGF) or zinc. Wounds were established on the backs of type 1 diabetic rats induced by a single injection of streptozotocin. Rats were treated daily with normal saline (Diabetes), LDR, bFGF, zinc, or combined 3 treatments for 5 consecutive days with a 2-day break between each consecutive 5-day treatment. Changes in wound size, histopathology, and microvessel density were assessed on days 5, 10, and 15, respectively, once treatment is started. All treatment regimens significantly accelerated skin wound healing, tissue remodeling, and new vessel formation compared to diabetes group. However, the combined LDR plus bFGF and zinc provided a better beneficial effect on wound healing than either one of these treatments alone. Further, we found that the effects of LDR and bFGF were similar, whereas zinc alone induced a weaker response. Our results suggest that whole-body LDR plus the topical application of bFGF and zinc can further accelerate wound healing in diabetic rats.
Triggered or routine site monitoring visits for randomised controlled trials: results of TEMPER, a prospective, matched-pair study
Authors: Stenning Sally P , Cragg William J , Joffe Nicola , Diaz-Montana Carlos , Choudhury Rahela , Sydes Matthew R , Meredith Sarah
Published: August 2018

Background/aims

In multi-site clinical trials, where trial data and conduct are scrutinised centrally with pre-specified triggers for visits to sites, targeted monitoring may be an efficient way to prioritise on-site monitoring. This approach is widely used in academic trials, but has never been formally evaluated.

Methods

TEMPER assessed the ability of targeted monitoring, as used in three ongoing phase III randomised multi-site oncology trials, to distinguish sites at which higher and lower rates of protocol and/or Good Clinical Practice violations would be found during site visits. Using a prospective, matched-pair design, sites that had been prioritised for visits after having activated ‘triggers’ were matched with a control (‘untriggered’) site, which would not usually have been visited at that time. The paired sites were visited within 4 weeks of each other, and visit findings are recorded and categorised according to the seriousness of the deviation. The primary outcome measure was the proportion of sites with ≥1 ‘Major’ or ‘Critical’ finding not previously identified centrally. The study was powered to detect an absolute difference of ≥30% between triggered and untriggered visits. A sensitivity analysis, recommended by the study’s blinded endpoint review committee, excluded findings related to re-consent. Additional analyses assessed the prognostic value of individual triggers and data from pre-visit questionnaires completed by site and trials unit staff.

Results

In total, 42 matched pairs of visits took place between 2013 and 2016. In the primary analysis, 88.1% of triggered visits had ≥1 new Major/Critical finding, compared to 81.0% of untriggered visits, an absolute difference of 7.1% (95% confidence interval −8.3%, +22.5%; p = 0.365). When re-consent findings were excluded, these figures reduced to 85.7% versus 59.5%, (difference = 26.2%, 95% confidence interval 8.0%, 44.4%; p = 0.007). Individual triggers had modest prognostic value but knowledge of the trial-related activities carried out by site staff may be useful.

Conclusion

Triggered monitoring approaches, as used in these trials, were not sufficiently discriminatory. The rate of Major and Critical findings was higher than anticipated, but the majority related to consent and re-consent with no indication of systemic problems that would impact trial-wide safety issues or integrity of the results in any of the three trials. Sensitivity analyses suggest triggered monitoring may be of potential use, but needs improvement and investigation of further central monitoring triggers is warranted. TEMPER highlights the need to question and evaluate methods in trial conduct, and should inform further developments in this area.
Neuritis and vinblastine-induced axonal transport disruption lead to signs of altered dorsal horn excitability
Authors: Satkeviciute Ieva , Dilley Andrew
Published: August 2018

Background

Many patients with neuropathic pain present without signs of nerve injury on routine clinical examination. Some of these patients may have inflamed peripheral nerves (neuritis). In this study, we have examined whether neuritis causes changes within the dorsal horn that may contribute to a central pain mechanism. Comparisons have been made to a model of axonal transport disruption induced using vinblastine, since neuritis disrupts such processes.

Results

At the peak of cutaneous hypersensitivities, recordings from wide dynamic range neurons revealed increases in wind-up following neuritis but not vinblastine treatment. Ongoing activity from these neurons was unchanged. Vinblastine treatment caused a reduction in the responses of wide dynamic range neurons to noxious mechanical stimulation of the receptive field. The response of neurons to innocuous mechanical stimulation was also reduced in wide dynamic range neurons that were at a depth ≥550 µm following vinblastine treatment. An examination of the superficial dorsal horn revealed an increase in c-Fos–positive neurons in both groups following electrical stimulation of the sciatic nerve. The area of dorsal horn expressing substance P was also decreased following vinblastine treatment.

Conclusion

These findings indicate that a minor nerve insult, such as neuritis, can lead to changes within the dorsal horn that are consistent with a central neuropathic pain mechanism.
Exhibiting memory: Temporary, mobile, and participatory memorialization and the Let Paul Robeson Sing! exhibition
Authors: Rhodes Mark Alan
Published: August 2018

Since his first interactions with Welsh miners striking in London in 1929, Paul Robeson has been considered by some as an “honorary Welshman.” While the African American actor, athlete, activist, singer, and scholar never lived in Wales, he did have various interactions in Wales throughout his life. This special relationship persists on the memorial landscape of the country in various ways, but none as extensive as the Let Paul Robeson Sing! exhibition. This article extends beyond an overview of the exhibition to identify it as an example of exceptional memorialization techniques. Combining the concepts of participatory, temporary, and mobile memorialization, in order to commemorate Paul Robeson through a sensorial, spatially, and conceptually diverse program, Let Robeson Sing! exhibits memory through a unique and engaging memorial landscape. This article situates the exhibition within the techniques of participatory, temporary, and mobile memorialization, and how the combination of the three provides a unique, effective, and affective form of commemorating Paul Robeson in Wales.
What is the role of bronchial thermoplasty in the management of severe asthma?
Authors: O’Reilly Aoife , Lane Stephen
Published: August 2018

Asthma is a common chronic inflammatory condition of the airways. Conventional therapy comprises inhaled corticosteroid and bronchodilators as well as trigger avoidance and management of comorbid conditions. A small group remain symptomatic despite these strategies and novel therapies have been developed. Bronchial thermoplasty is a nonpharmacological therapy which targets airway smooth muscle to improve asthma control. Clinical trials to date have shown the efficacy and safety of bronchial thermoplasty with a persistent effect on extended follow up. Questions remain regarding the exact mechanism of action of bronchial thermoplasty, the cost effectiveness of the procedure and the ideal criteria for patient selection.
Population balance modeling for air–water bubbly flow in a vertical U-bend
Authors: Huang Yichuan , Zhu Hongye , Yang Xingtuan , Tu Jiyuan , Jiang Shengyao
Published: August 2018

Bubbly flow in U-bend is widely encountered in two-phase flow systems because of its compactness and high heat transfer coefficient. The modeling of phase distributions, velocity fields, and interfacial area concentration in the U-bend is crucial for the analysis of mass, momentum, and energy transportation processes in the equipment. However, this subject has not received enough attention yet. In this paper, the combination of population balance model and two-fluid model was used in the simulation of air–water bubbly flow in a U-bend with 24 mm inner diameter and 96 mm curvature. The homogeneous multiple size group model was used to solve the population balance equation and reconstruct the bubble size distribution function. The phase distribution at 0°, 90°, and 180° was predicted and the results showed that the superficial velocities of gas and liquid phase were the control parameters. Under higher gas superficial velocity, the buoyant force is dominant and makes the bubbles concentrate on the outer side of the tube wall; while under lower gas superficial velocity, the centrifugal force is dominant and makes the bubbles concentrate on the inner side of the tube wall. These results met well with the experimental results of Usui.
Patch Pumps: Are They All the Same?
Authors: Heinemann Lutz , Waldenmaier Delia , Kulzer Bernd , Ziegler Ralph , Ginsberg Barry , Freckmann Guido
Published: August 2018

Insulin pumps are used by a steadily increasing number of patients with diabetes. Avoiding certain disadvantages of conventional pumps (ie, the insulin infusion set) might make pump therapy even more attractive. Patch pumps are usually attached by means of an adhesive layer to the skin and have several additional advantages (smaller, more discrete, easier to use, and cheaper than conventional insulin pumps). This review provides a general overview of patch pumps, the technologies used, basic clinical requirements, why a number of developments failed, which clinical studies are needed to provide sufficient evidence for their usage, which costs are associated, what the patient preferences are (which might differ between certain patient groups), and what is the future of patch pumps (ie, artificial pancreas systems).
Conflicts Between Humans and Terrestrial Vertebrates: A Global Review
Authors: Torres Denise F. , Oliveira Eduardo S. , Alves Rômulo R. N.
Published: August 2018

Conflicts between human beings and wild animals have been recorded in many parts of the world and mainly involve damage to crops, predation of domestic animals, and attacks on humans. This study presents, by means of a literature review, a worldview of such conflicts and their implications. The results found 262 species of terrestrial vertebrates recorded in conflicts with humans, of which 53 are included in the list of threatened species. The results indicated that damage to agricultural crops and attacks on domestic animals are the most common factors of conflicts and that socioeconomic factors seem to be correlated with their incidence. Studies aimed at finding more efficient ways to reduce conflicts and lessen the impact on animal populations are relevant to the search for a more peaceful coexistence between humans and wild animals.
Pediatric Benign Paranasal Sinus Osteoneogenic Tumors: A Case Series and Systematic Review of Outcomes, Techniques, and a Multiportal Approach
Authors: Badran Karam W. , Suh Jeffrey D. , Namiri Nikan , Wrobel Bozena , Ference Elisabeth H.
Published: August 2018

Background

Pediatric benign paranasal sinus osteoneogenic tumors have previously been difficult to treat due to the surgical constraints of the developing skull. Progression may lead to intracranial complications or orbital and optic nerve compression.

Objective

To assess the presentation and management of benign paranasal sinus osteoneogenic tumors.

Methods

Systematic review of the symptoms and surgical treatment of these lesions, and a case series of 2 adolescents with osteomas impinging on the orbit treated with a multiportal approach.

Results

Forty-eight cases of osteomas, osteoblastoma, or osteoid osteomas were reviewed from 43 articles. The average age was 14 years, 67% of tumors were osteomas, and 48% were greater than 3 cm in longest dimension. Compared to osteoblastomas, osteomas had a greater male to female ratio (4.3:1; P = .02), presented at older age ( P = .03) with a smaller tumor burden ( P = .003), and had prior trauma or surgery ( P < .001). The ethmoid, frontal, maxillary, and sphenoid sinuses were affected in decreasing order of frequency. A purely endoscopic sinus surgery approach was taken in 31% of cases, open approach in 62% of cases, and combined approach in 7% of cases. Osteoblastoma patients had a 32% rate of recurrence, compared to only 3% among osteoma patients. On univariate logistics regression of patient demographics, tumor characteristics, and surgical approaches predictive of surgical outcomes, only tumor type was predictive of postoperative recurrence (odds ratio: 0.07; 95% confidence interval, 0.007–0.77; P = .029).

Conclusion

There was no association between surgical approach and postoperative complications or rate of recurrence. However, a transnasal and transorbital multiportal approach avoids facial incisions.
Battle of the Mondrians: Investigating the Role of Unpredictability in Continuous Flash Suppression
Authors: Han Shui’Er , Alais David , Blake Randolph
Published: August 2018

In continuous flash suppression (CFS), a dynamic sequence of Mondrian patterns presented to one eye suppresses a static target in the other eye for several seconds at a time. Its effectiveness has been linked to low-level properties such as spatial frequency and orientation, but the role of higher order influences remains unstudied. Here, using a tracking paradigm, we asked if the spatial and temporal predictability of the Mondrian sequence affects CFS dynamics. Predictable temporal sequences were regularly updated every 100 ms or modulated sinusoidally in pixel luminance at 2 Hz. Unpredictable temporal sequences were irregularly updated or had stochastic pixel luminance changes across time. To vary spatial predictability, sequences were either updated with different Mondrian patterns or had a fixed spatial pattern. We found a modest effect of spatial uncertainty when the target modulation was low (0.125 Hz) but not temporal uncertainty, which had no significant effects regardless of target modulation. Similar results were obtained when we pitted the standard Mondrian sequence against sequences with a fixed spatial pattern and temporally low-pass filtered sequences in a binocular rivalry paradigm. Thus, not only was the effect of information predictability was modest and spatial, but it was also dependent on the presence of higher temporal frequencies. Together, the results demonstrate the significance of low-level properties in affecting CFS dynamics and the possible involvement of pattern structure masking in CFS.
Endovenous Celon radiofrequency-induced thermal therapy of great saphenous vein: A retrospective study with a 3-year follow-up
Authors: Quehe Philippe , Alavi Zarrin , Kurylo-Touz Tatiana , Saliou Anne-Helene , Badra Ali , Baudino Laurent , Gladu Gurven , Ledan Frederik , Haudebourg Raphaël , Gestin Simon , Bressollette Luc
Published: August 2018

Objective:

Our main objective was to evaluate the short- and long-term efficacy of Celon radiofrequency-induced thermal therapy for endovenous treatment of incompetent great saphenous vein. The secondary objectives were to report on possible short-term side effects and complications.

Methods:

This was a retrospective study of 112 consecutive patients included between 2013 and June 2015. These patients were treated (146 great saphenous vein, C2–C6) either at the hemodynamic room using local anesthesia or at the operating theater under general anesthesia with or without phlebectomy. All patients received radiofrequency-induced thermal therapy at 18 W power, 1 s/cm pullback rate and 5–7 pullbacks per segment of 10 cm (i.e. maximum 10 pullbacks). A clinical follow-up via ultrasound monitoring was done at 1 week, 1 month, 6 months, 1 year, 2 years and 3 years.

Results:

The 3-year survival occlusion rate was 96.71% and 98% for overall and radiofrequency-induced thermal therapy patients, respectively. No major side effects were observed. A case of endovenous heat-induced thrombosis was reported. Slight neurological disorders were reported (0.88%).

Conclusion:

Our unit’s endovenous Celon radiofrequency-induced thermal therapy of incompetent great saphenous vein was efficient, well tolerated, without major side effects. Moreover, in order to reduce possible neurological disorders, we advise multiple pullbacks at 1 s/cm and using tumescence anesthesia.
Fatigue 1–5 years after lung transplantation: A multicenter cross-sectional cohort study
Authors: Forsberg Anna , Lennerling Annette , Kisch Annika , Jakobsson Sofie
Published: August 2018

The aim of this study was to investigate the prevalence of fatigue among lung recipients 1–5 years after transplantation (LuTx) and to explore its relationship to distressing symptoms such as dyspnea, sleep problems, pain, and decreased appetite, as well as psychological and transplant specific wellbeing. A cross-sectional, multicenter cohort study was conducted. A total of 117 lung recipients with a mean age of 54 years ( SD 13 years) who were due for their annual follow-up were included at 1 year ( n = 35), 2 years ( n = 28), 3 years ( n = 23), 4 years ( n = 20), and 5 years ( n = 11) after lung transplantation. Several instruments were used: the Multidimensional Fatigue Inventory, the Organ Transplant and Symptom Well-being Instrument (OTSWI), the Pain-O-Meter, and the Psychological General Well-Being Index. Overall 56% reported high or severe fatigue. The Psychological General Well-Being sum score makes the strongest contribution ( p < .0001) to explaining the variance in general fatigue (Beta –.628). The results of the study indicate that efforts both to identify fatigue and to test interventions are needed after LuTx.