bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive Affect Is Associated With Reduced Fixation in a Realistic Medical Simulation
Authors: Crane Monique F. , Brouwers Sue , Forrest Kirsty , Tan Suyin , Loveday Thomas , Wiggins Mark W. , Munday Chris , David Leila
Published: March 2017

Objective:

This study extends previous research by exploring the association between mood states (i.e., positive and negative affect) and fixation in practicing anesthetists using a realistic medical simulation.

Background:

The impact of practitioner emotional states on fixation is a neglected area of research. Emerging evidence is demonstrating the role of positive affect in facilitating problem solving and innovation, with demonstrated implications for practitioner fixation.

Method:

Twelve practicing anesthetists (4 females; Mage= 39 years; SD = 6.71) were involved in a medical simulation. Prior to the simulation, practitioners rated the frequency they had experienced various positive and negative emotions in the previous three days. During the simulation, the patient deteriorated rapidly, and anesthetists were observed for their degree of fixation. After the simulation, practitioners indicated the frequency of these same emotions during the simulation.

Results:

Nonparametric correlations were used to explore the independent relationships between positive and negative affect and the behavioral measures. Only positive affect impacted the likelihood of fixation. Anesthetists who reported more frequent recent positive affect in the three days prior to the simulation and during the simulation tended to be less fixated as judged by independent raters, identified a decline in patient oxygen saturation more quickly, and more rapidly implemented the necessary intervention (surgical cricothyroidotomy).

Conclusion:

These findings have some real-world implications for positive affect in patient safety.

Application:

This research has broad implications for professions where fixation may impair practice. This research suggests that professional training should teach practitioners to identify their emotions and understand the role of these emotions in fixation.
Work–family interface in the context of career success: A qualitative inquiry
Authors: Beigi Mina , Wang Jia , Arthur Michael B
Published: March 2017

Work–family researchers are increasingly recognizing the need to expand their focus to advance the field. One population largely neglected by work–family researchers is individuals who have been extremely successful in their careers. In addition, organizational career scholars have largely neglected the interplay between employees’ work and family lives. This study contributes to the work–family literature by studying work–family interface (WFI) in the context of career success. We sought to explore the lived experiences of 28 distinguished professors who are among the top 2–5% of scholars in their field, to provide an in-depth understanding of their WFI and the prominent factors affecting it over their careers. Our findings have theoretical implications for both work–family and career success literatures.
Social network factors as mediators of mental health and psychological distress
Authors: Levula Andrew , Harré Michael , Wilson Andrew
Published: March 2017

Background:

Although mental health (MH) is overall strongly associated with psychological distress (PD), this association is very weak for the sample with high PD. This relationship remains understudied.

Aim:

This study examines the association between MH and PD and whether this association is mediated by social network (SN) factors for individuals with high PD.

Method:

Data were taken from the Household Income and Labour Dynamics in Australia study ( N = 756). MH was measured using the MH sub-scale of the general health survey (Short Form (SF)-36) and PD was measured using the Kessler Psychological Distress Scale (K10). The SN measures were derived from the self-completion questionnaire. Using bootstrap mediation analysis, we tested whether the association between MH and PD is mediated by SN factors.

Result:

The correlation between MH and PD was r = −.410 ( p < .001). The mediational analysis results show that social isolation mediates the association between MH and PD with an indirect effect of β = −0.0070 (confidence interval (CI) = −0.0133 to −0.0023). Moreover, social connections also mediated the association between MH and PD with an indirect effect of β = −0.0073 (CI = −0.0141 to −0.0028).

Conclusion:

This study has practical implications for the design of social policies that attempt to reduce social isolation and enhance social connectedness to protect MH.
A Royal English Medieval Astrolabe Made for Use in Northern Italy
Authors: Davis John
Published: March 2017

This article describes a medieval English astrolabe usually known as Mensing-26 and now in the Adler Planetarium and Astronomical Museum in Chicago. Details of its star positions and names, saints feast days, metallurgy, construction, and general style (featuring a “quatrefoil” rete) are examined and used to place the instrument as one of a small group of astrolabes, epitomised by the great Sloane astrolabe, which has been associated with King Edward III. Using this hypothesis, potential original owners of the instrument in c. 1330–1340 are proposed. It is also shown how the astrolabe was later modified to have a second life as a working instrument in Renaissance Florence.
Implications of less tail end water on livelihoods of small farmers in Pakistan
Authors: Ali Akhter , Rahut Dil Bahadur , Imtiaz Muhammad
Published: March 2017

In Pakistan, about 80% of the cropped area is irrigated using canal irrigation, and water availability is closely linked to the location of the farm. Using data collected from 950 farmers through a field survey covering four provinces (Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan), this study aimed to assess the impact of location, that is, ‘head’ versus ‘tail’ on water availability and its impact on crop yield, household income, food security and poverty levels. The censored least absolute deviation was used to estimate farmer participation in water markets, and the propensity score matching was used to assess impacts on yield of wheat and rice, household income and poverty levels as well as land rent and water scarcity. The results show that farmers situated at the head of the water source have higher wheat and rice yields in the range of 2–3 maunds per acre. Household income levels are higher in the range of PKR 8455–14,673, and poverty levels are lower (+3% to 5%). The land rent at the head is higher compared to the tail while water scarcity is also less at the head. The study indicated that farmers’ status plays a major role in land location and access to irrigation water.
Farmer perception of benefits, constraints and opportunities for silvoarable systems
Authors: Graves AR , Burgess PJ , Liagre F , Dupraz C
Published: March 2017

Silvoarable agroforestry integrates the use of trees and arable crops on the same area of land, and such systems can be supported by national governments under the European Union’s (EU) Rural Development Regulations (2014–2020). In order to improve the understanding of farmers’ perceptions of such systems, detailed face-to-face interviews were completed with 15 farmers in Bedfordshire, England. Most of these farmers thought that silvoarable systems would not be profitable on their farms and that benefits would tend to be environmental or social rather than economic. Most farmers also thought that management and use of machinery would become more difficult. They felt that the tree component could potentially disrupt field operations and drainage and expressed concerns over the uncertain and long-term nature of timber revenue and the effect of intercrop yield reductions on crop revenue. Even so, 20% of the farmers stated they would use silvoarable systems if convinced that they were more profitable than conventional arable farming. A further 20% said they would farm the intercrop area belonging to someone else, if the rent was reduced to compensate for crop yield reductions. These results suggest that for most arable farmers, an economic advantage over current practice needs to exist before silvoarable systems are likely to be adopted. However, a minority might rent the crop component of a silvoarable system from another party or implement a full system for perceived environmental or social benefits.
Book Review: Ali Raza, Franziska Roy and Benjamin Zachariah (Eds), The Internationalist Moment: South Asia, Worlds, and World Views, 1917–1939
Authors: Mishra Atul
Published: March 2017

Ali Raza, Franziska Roy and Benjamin Zachariah (Eds), The Internationalist Moment: South Asia, Worlds, and World Views, 1917–1939, New Delhi, SAGE Publications, 2015, xli + 274 pp., ₹723, ISBN-10: 8132119797/ ISBN-13: 978-8132119791.
Book Review: Rina Ramdev, Sandhya Devesan Nambiar and Debaditya Bhattacharya (Eds), Sentiment, Politics, Censorship: The State of Hurt
Authors: Shora Shehla Rashid
Published: March 2017

Rina Ramdev, Sandhya Devesan Nambiar and Debaditya Bhattacharya (Eds), Sentiment, Politics, Censorship: The State of Hurt, New Delhi, SAGE Publications, 2015, 324 pp., ₹895, ISBN-10: 9351503046/ ISBN-13: 978-9351503040.
“The Half Has Never Been Told”: Maritcha Lyons’ Community, Black Women Educators, the Woman’s Loyal Union, and “the Color Line” in Progressive Era Brooklyn and New York
Authors: Johnson Val Marie
Published: March 2017

Schoolteacher Maritcha Lyons was among the pioneering African American women who, in 1892, built one of the first women’s rights and racial justice organizations in the United States, the Woman’s Loyal Union of New York and Brooklyn (WLU). The WLU is recognized for its antilynching work in alliance with Ida B. Wells, and as an organizational springboard to the National Association of Colored Women. This essay examines struggles on “the color line” by Lyons, other WLU members, and women educators, through their community’s engagement in 1880s and 1890s Brooklyn and New York contention over school integration, and a 1903 debate on the founding of the Brooklyn Colored Young Women’s Christian Association. These women’s and their community’s battles against segregation and for separate institutions reveal lesser known aspects of WLU women’s activism, and the complexities of urban racism and Black resistance in the “Progressive Era” that witnessed Reconstruction’s dismantling, lynching, and “Jim Crow.”
A self-adaptive distributed decision support model for Internet of Things applications
Authors: Zhang Lizong , Alharbe Nawaf R , Atkins Anthony S
Published: March 2017

The term of Internet of Things (IoT) is an emerging concept that has already made an impact on many research domains by providing new solutions and ideas. However, we noticed that many IoT applications are more focused on the ‘communication’ part and are still relatively weak in ‘intelligent’ aspects. Consequently, in this paper we proposed an approach for a self-adaptive distributed decision support model to provide more intelligent support for IoT applications. The model is designed with three major approaches: an artificial neural network (ANN) for environment recognition, knowledge merging to create a local knowledge base and expert systems technology for decision making. In addition, a self-adaption feature is introduced to fix any possible improper usage of knowledge that may be caused by inaccuracies in the environment recognition. This strategy was confirmed in an experiment with a local Chinese medical clinical trials centre, in which the results indicate it may improve the accuracy of decisions from 42% to about 85%.
A generalized hierarchical nearly cyclic pursuit for the leader-following consensus problem in multi-agent systems
Authors: Iqbal Muhammad , Leth John , Ngo Trung D
Published: March 2017

In this paper, we solve the leader-following consensus problem using a hierarchical nearly cyclic pursuit (HNCP) strategy for multi-agent systems. We extend the nearly cyclic pursuit strategy and the two-layer HNCP to the generalized L-layer HNCP that enables the agents to rendezvous at a point dictated by a beacon. We prove that the convergence rate of the generalized L-layer HNCP for the leader-following consensus problem is faster than that of the nearly cyclic pursuit. Simulation results demonstrate the effectiveness of the proposed method.
Performance analysis in delayed nonlinear bilateral teleoperation systems by force estimation algorithm
Authors: Azimifar Farhad , Hassani Kamran , Saveh Amir Hossein , Tabatabai Ghomshe Farhad
Published: March 2017

This paper establishes a novel control strategy for a nonlinear bilateral teleoperation system with time delay. Besides position and velocity signals, force signals are additionally utilized in the control scheme. This modification significantly improves the poor transparency during contact with the environment. To eliminate the external force measurement, a force estimation algorithm is proposed for the master and slave robots. The closed loop stability of the nonlinear teleoperation system with the proposed control scheme is investigated through the Lyapunov theory. Furthermore, it is theoretically and experimentally proved that force reflection occurs and transparency is enhanced simultaneously. Consequently, experimental results verify the efficiency of the new control scheme in free motion and during collision of the slave robot with the environment.
Research on dynamic task allocation for multiple unmanned aerial vehicles
Authors: Miao Yongfei , Zhong Luo , Yin Yufu , Zou Chengming , Luo Zhenjun
Published: March 2017

To solve the distributed task allocation problems of search and rescue missions for multiple unmanned aerial vehicles (UAVs), this paper establishes a dynamic task allocation model under three conditions: 1) when new targets are detected, 2) when UAVs break down and 3) when unexpected threats suddenly occur. A distributed immune multi-agent algorithm (DIMAA) based on an immune multi-agent network framework is then proposed. The technologies employed by the proposed algorithm include a multi-agent system (MAS) with immune memory, neighbourhood clonal selection, neighbourhood suppression, neighbourhood crossover and self-learning operators. The DIMAA algorithm simplifies the decision-making process among agents. The simulation results show that this algorithm not only obtains the global optimum solution, but also reduces the communication load between agents.
Effect of exclusion of frequently consumed dietary triggers in a cohort of children with chronic primary headache
Authors: Taheri Sepideh
Published: March 2017

Background:

Although dietary factors are known to trigger headaches, the relationship between food and headache in children remains unclear. This prospective, observational case series aimed to evaluate the effect of exclusion of frequently-consumed foods in a cohort of children with headache.

Methods:

One hundred and fifteen children aged 3–15 (mean 10.5) years with primary headache were followed in a paediatric outpatient clinic. Patients who frequently consumed foods or food additives known to trigger headaches were advised to exclude them for six weeks and to return for follow-up with headache and food diary.

Results:

One hundred patients attended follow-up. Of these 13 (13%) did not respond to dietary exclusion; 87 (87%) achieved complete resolution of headaches by exclusion of 1–3 of the identified food(s). Caffeine was the most common implicated trigger (28), followed by monosodium glutamate (25), cocoa (22), aspartame (13), cheese (13), citrus (10) and nitrites (six). One patient was sensitive to tomatoes.

Conclusions:

This study demonstrates the potential scale and significance of seven frequently consumed foods or food additives as triggers for primary headache in children. Also this is the first study to show that headaches can be triggered by the cumulative effect of a food that is frequently consumed, rather than by single time ingestion.
Do virtual reality games improve mobility skills and balance measurements in community-dwelling older adults? Systematic review and meta-analysis
Authors: Neri Silvia GR , Cardoso Jefferson R , Cruz Lorena , Lima Ricardo M , de Oliveira Ricardo J , Iversen Maura D , Carregaro Rodrigo L
Published: March 2017

Objective:

To summarize evidence on the effectiveness of virtual reality games and conventional therapy or no-intervention for fall prevention in the elderly.

Data sources:

An electronic data search (last searched December 2016) was performed on 10 databases (Web of Science, EMBASE, PUBMED, CINAHL, LILACS, SPORTDiscus, Cochrane Library, Scopus, SciELO, PEDro) and retained only randomized controlled trials.

Review method:

Sample characteristics and intervention parameters were compared, focusing on clinical homogeneity of demographic characteristics, type/duration of interventions, outcomes (balance, reaction time, mobility, lower limb strength and fear of falling) and low risk of bias. Based on homogeneity, a meta-analysis was considered. Two independent reviewers assessed the risk of bias.

Results:

A total of 28 studies met the inclusion criteria and were appraised ( n: 1121 elderly participants). We found that virtual reality games presented positive effects on balance and fear of falling compared with no-intervention. Virtual reality games were also superior to conventional interventions for balance improvements and fear of falling. The six studies included in the meta-analysis demonstrated that virtual reality games significantly improved mobility and balance after 3–6 and 8–12 weeks of intervention when compared with no-intervention. The risk of bias revealed that less than one-third of the studies correctly described the random sequence generation and allocation concealment procedures.

Conclusion:

Our review suggests positive clinical effects of virtual reality games for balance and mobility improvements compared with no-treatment and conventional interventions. However, owing to the high risk of bias and large variability of intervention protocols, the evidence remains inconclusive and further research is warranted.
A randomized controlled feasibility trial exploring partnered ballroom dancing for people with Parkinson’s disease
Authors: Kunkel D , Fitton C , Roberts L , Pickering RM , Roberts HC , Wiles R , Hulbert S , Robison J , Ashburn A
Published: March 2017

Objective:

To determine the feasibility of a Dance Centre delivering a programme of mixed dances to people with Parkinson’s and identify suitable outcomes for a future definitive trial.

Design:

A two-group randomized controlled feasibility trial.

Methods:

People with Parkinson’s were randomized to a control or experimental group (ratio 15:35), alongside usual care. In addition, participants in the experimental group danced with a partner for one hour, twice-a-week for 10 weeks; professional dance teachers led the classes and field-notes were kept. Control-group participants were given dance class vouchers at the end of the study. Blinded assessments of balance, mobility and function were completed in the home. Qualitative interviews were conducted with a subsample to explore the acceptability of dance.

Results:

A total of 51 people with Parkinson’s (25 male) with Hoehn and Yahr scores of 1–3 and mean age of 71 years (range 49–85 years), were recruited to the study. Dance partners were of similar age (mean 68, range 56–91 years). Feasibility findings focused on recruitment (target achieved); retention (five people dropped out of dancing); outcome measures (three measures were considered feasible, changes were recommended). Proposed sample size for a Phase III trial, based on the 6-minute walk test at six months was 220. Participants described dance as extremely enjoyable and the instructors were skilled in instilling confidence and motivation. The main organizational challenges for a future trial were transport and identifying suitable dance partners.

Conclusion:

We have demonstrated the feasibility of conducting the study through a Dance Centre and recommend a Phase III trial.
Region-specific permeability of the blood–brain barrier upon pericyte loss
Authors: Villaseñor Roberto , Kuennecke Basil , Ozmen Laurence , Ammann Michelle , Kugler Christof , Grüninger Fiona , Loetscher Hansruedi , Freskgård Per-Ola , Collin Ludovic
Published: March 2017

The blood–brain barrier (BBB) regulates differing needs of the various brain regions by controlling transport of blood-borne components from the neurovascular circulation into the brain parenchyma. The mechanisms underlying region-specific transport across the BBB are not completely understood. Previous work showed that pericytes are key regulators of BBB function. Here we investigated whether pericytes influence BBB permeability in a region-specific manner by analysing the regional permeability of the BBB in the pdgf-b ret/ret mouse model of pericyte depletion. We show that BBB permeability is heterogeneous in pdgf-b ret/ret mice, being significantly higher in the cortex, striatum and hippocampus compared to the interbrain and midbrain. However, we show that this regional heterogeneity in BBB permeability is not explained by local differences in pericyte coverage. Region-specific differences in permeability were not associated with disruption of tight junctions but may result from changes in transcytosis across brain endothelial cells. Our data show that certain brain regions are able to maintain low BBB permeability despite substantial pericyte loss and suggest that additional, locally-acting mechanisms may contribute to control of transport.
Effects of a 72 hours fasting on brain metabolism in healthy women studied in vivo with magnetic resonance spectroscopic imaging
Authors: Ding Xiao-Qi , Maudsley Andrew A , Schweiger Ulrich , Schmitz Birte , Lichtinghagen Ralf , Bleich Stefan , Lanfermann Heinrich , Kahl Kai G
Published: March 2017

Adaptive response of human brain to stress plays a key role in maintaining health. Knowledge about how stress affects neurometabolism may help to understand adaptive stress responses, and distinguish maladaptation in neuropsychiatric disorders. In this study, neurometabolic responses to fasting stress in healthy women were investigated. Fifteen healthy females were examined for mood and cognition and using whole-brain MR spectroscopic imaging before and immediately after a 72-h fasting. Results were compared to 15 age-matched healthy females who did not taken part in fasting (non-fasting). Maps of the distributions in the brain of N-acetylaspartate (NAA), total choline (tCho), total creatine (tCr), glutamine/glutamate (Glx), and myo-Inositol (mI) were derived. Metabolite concentrations of each brain lobe and cerebellum measured before fasting were compared to those of post-fasting and non-fasting by repeated-measures ANOVA. After fasting, mood scores significantly increased. Glx decreased in all nine brain regions, tCho in eight, NAA in four and tCr in one, with Glx having the greatest change and the frontal lobes being the most affected brain region. In conclusion, fasting directly influences neurometabolism, and the adaptive brain response to maintain energy homeostasis under food deprivation in healthy women is associated with metabolite-selective and region-dependent changes of metabolite contents.
Exploring the Challenges of Divorce on Saudi Women
Authors: Saleh Ramzia Hisham , Luppicini Rocci
Published: March 2017

The aim of this study is to identify the core issues and challenges that divorced Saudi women are facing in Saudi Arabia. A qualitative survey was administered to explore current issues faced by divorced Saudi women living in Saudi Arabia. Findings revealed a multitude of issues currently faced by divorced Saudi women linked to social, economic, psychological, and legal challenges. The discussion of core themes derived from the analysis provides an in-depth picture of challenges faced by divorced Saudi women. This research builds on the growing body of knowledge concerning the challenges of divorced Saudi women in contemporary society.
Traumatic Patellar Dislocation and Cartilage Injury: A Follow-up Study of Long-Term Cartilage Deterioration
Authors: Salonen Essi E. , Magga Teemu , Sillanpää Petri J. , Kiekara Tommi , Mäenpää Heikki , Mattila Ville M.
Published: March 2017

Background:

Patellofemoral cartilage deterioration and osteoarthritis are reported to be associated with recurrent patellar dislocation. However, the association between first-time traumatic patellar dislocation and cartilage deterioration is unknown.

Purpose:

The aim of this study was to assess long-term cartilage deterioration in the patellofemoral and tibiofemoral joint after conservatively treated traumatic lateral patellar dislocation.

Study Design:

Case series; Level of evidence, 4.

Methods:

Twenty patients (mean age, 25 years) who sustained first-time traumatic lateral patellar dislocation with no previous patellofemoral instability symptoms were initially scanned with 1.5-T magnetic resonance imaging (MRI). A follow-up 3-T MRI was conducted, on average, 8 years after first-time lateral patellar dislocation. Subjective instability symptoms and Knee injury and Osteoarthritis Outcome Score were also assessed.

Results:

In the primary MRI, patellofemoral cartilage injury was seen in 14 of 20 patients (70%). Most (14/15) of the injuries were seen in the patellar cartilage, especially at the medial facet. On the follow-up MRI, patellofemoral cartilage deterioration was visible for all patients. The central patella ( P = .005) seemed especially prone to cartilage deterioration during the follow-up. Half of the patients (10/20) had grade 3-4 cartilage lesions in the patellofemoral joint in the follow-up MRI. In the primary MRI, only 1 patient exhibited tibiofemoral joint cartilage lesions, whereas at the time of follow-up, 10 of 20 patients exhibited tibiofemoral cartilage lesions. The majority of these lesions were considered clinically nonsignificant (International Cartilage Repair Society = 1) and were seen in the lateral compartment (6/10, 60%). Of the 14 patients (36%) with injury to the patellar cartilage, 5 reported subsequent instability of the patellofemoral joint, but this was not associated with more significant cartilage deterioration in the follow-up MRI compared with patients without redislocation.

Conclusion:

While recurrent lateral patellar dislocation is known to lead to degenerative process, a single first-time or infrequently recurring traumatic lateral patellar dislocation also seems to be associated with gradual cartilage deterioration. Traumatic lateral patellar dislocation might initiate gradual degeneration of the cartilage in the patellofemoral joint and can lead to the development of generalized knee osteoarthritis. Instability symptoms of the patellofemoral joint, however, were not related to the severity of the deterioration.
A Cadaveric Model Evaluating the Influence of Bony Anatomy and the Effectiveness of Partial Scapulectomy on Decompression of the Scapulothoracic Space in Snapping Scapula Syndrome
Authors: Tahal Dimitri S. , Katthagen J. Christoph , Marchetti Daniel Cole , Mikula Jacob D. , Montgomery Scott R. , Brady Alex , Dornan Grant J. , Millett Peter J.
Published: March 2017

Background:

Snapping scapula syndrome (SSS) is caused by bony and/or soft tissue impingement in the scapulothoracic articulation. Surgical resection of the superomedial angle (SMA) plus bursectomy can provide relief in most cases; however, the amount needed to achieve adequate scapulothoracic space decompression (SSD) is unknown.

Purpose:

The aim of this study was to evaluate the effectiveness of partial scapulectomy and the influence of bony anatomy on SSD. It was hypothesized that the anterior offset and costomedial angle would correlate with the amount of bony resection needed to achieve adequate SSD.

Study Design:

Controlled laboratory study.

Methods:

Twenty pairs (n = 40) of shoulder specimens (mean age, 58 years [range, 41-64 years]; 10 male and 10 female specimens) were included. The scapula shape, medial scapula corpus angle (MSCA), anterior offset, and costomedial angle were obtained from computed tomography scans. Specimens were dissected, and each bare bony scapula was rigidly mounted. Points were collected using a 3-dimensional measuring arm. An SMA point and theoretical resection points (incremental 1-cm points up to 3 cm) proceeding laterally and medially were collected. The scapular plane was interpolated using points from the posterior scapular body. The horizontal distances of the anterior offset and each resection point to the scapular plane were calculated. The difference between the native anterior offset and the offset after resection represented the SSD. Adequate SSD was set at 5 mm. One-way analyses of variance and Pearson correlations were used with statistical significance set at P < .05.

Results:

The maximum SSD with 3-cm resection was significantly correlated with the anterior offset ( R = 0.83, P < .001) as well as the costomedial angle ( R = −0.43, P = .006) but not the MSCA ( R = −0.11, P = .495) or scapula shape ( F2,37= 0.39, P = .681). For the 5 scapulae with an anterior offset of less than 20 mm, a 5-mm SSD was not achieved. For 18 of 30 (60%) scapulae with an anterior offset between 20 mm and 35 mm, 3-cm resection provided at least a 5-mm SSD. For the 5 scapulae with an anterior offset of greater than 35 mm, 2-cm resection resulted in at least a 5-mm SSD in all cases.

Conclusion:

The anterior offset of the scapula appeared to be the most important bony parameter to consider during preoperative planning and the evaluation of SSD with partial scapulectomy.

Clinical Relevance:

The results of this study may help surgeons with preoperative planning of surgical decompression of the scapulothoracic space for patients with symptomatic SSS.
Effect of Pitching Consecutive Days in Youth Fast-Pitch Softball Tournaments on Objective Shoulder Strength and Subjective Shoulder Symptoms
Authors: Skillington S. Andrew , Brophy Robert H. , Wright Rick W. , Smith Matthew V.
Published: March 2017

Background:

The windmill pitching motion has been associated with risk for shoulder injury. Because there are no pitching limits on youth fast-pitch softball pitchers, these athletes often pitch multiple games across consecutive days. Strength changes, fatigue levels, and shoulder pain that develop among female fast-pitch pitchers over the course of consecutive days of pitching have not been investigated.

Hypothesis:

Over the course of 2- and 3-day fast-pitch softball tournaments, pitchers will develop progressive objective weakness and increased subjective shoulder fatigue and pain without complete recovery between days.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Fourteen female fast-pitch softball pitchers between the ages of 14 and 18 years were evaluated for strength and fatigue changes across 2- and 3-day tournaments. At the beginning and end of each day of tournament play, pitchers were asked to quantify shoulder fatigue and shoulder pain levels of their dominant throwing arm using a 10-point visual analog scale (VAS). Shoulder abduction, flexion, external rotation, internal rotation, elbow flexion, and elbow extension strength measurements were gathered using a handheld dynamometer.

Results:

Over the course of an average single day of tournament participation, pitchers developed significant increases in VAS scores for shoulder fatigue (median, 2.0; 95% CI, 1.3-3.0) and pain (median, 1.3; 95% CI, 0.5-2.3) and significant strength loss in all tested motions. Pitchers also developed significant increases in VAS shoulder fatigue (median, 3.5; 95% CI, 1.5-5.5), VAS shoulder pain (median, 2.5; 95% CI, 1.0-4.5), and strength loss in all tested motions over the entire tournament. Shoulder pain, fatigue, and strength do not fully recover between days. The accumulation of subjective shoulder pain and fatigue over the course of tournament play were closely correlated.

Conclusion:

Among youth female fast-pitch softball pitchers, there is a progressive increase in shoulder fatigue, pain, and weakness over the course of 2- and 3-day tournaments without full recovery between consecutive days of pitching.
Radiographic Hip Anatomy Correlates With Range of Motion and Symptoms in National Hockey League Players
Authors: Larson Christopher M. , Ross James R. , Kuhn Andrew W. , Fuller Donnie , Rowley David M. , Giveans M. Russell , Stone Rebecca M. , Bedi Asheesh
Published: March 2017

Background:

Hip disorders in athletes have been increasingly recognized.

Purpose:

To characterize radiographic hip anatomy for National Hockey League (NHL) players and correlate it with hip range of motion and hip symptoms and/or surgery.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Fifty-nine professional hockey players (118 hips) with 1 NHL organization (mean age, 24.2 years; range, 18-36) prospectively underwent history and physician examination by 2 independent orthopaedic surgeons. Current or previous groin and/or hip pain or surgery was noted. Anteroposterior (AP) pelvis and bilateral Dunn lateral radiographs were obtained for all players with assessment of hip morphology by 2 blinded independent orthopaedic surgeons.

Results:

Good to very good reliability of radiographic assessments was noted (intraclass correlation coefficients = 0.749-0.958). Sixty-four percent of athletes had a positive crossover sign, while 86% and 60% had a positive posterior wall sign and a prominent ischial spine sign, respectively. Twenty-one percent of hips demonstrated dysplastic acetabular features (lateral center edge angle <25°). Eighty-five percent and 89% of hips demonstrated cam-type morphology based on alpha angle (>50° Dunn lateral) and head-neck offset, respectively. Good to very good reliability was noted for ROM assessments (intraclass correlation coefficient >0.69). Mean hip flexion was 107.4º ± 6.7º, and mean hip internal rotation was 26.1º ± 6.6º. Thirty-one percent of hips had a history of hip-related pain and/or surgery. Higher AP, Dunn lateral, and maximal alpha angles correlated with decreased hip internal rotation ( P = .004). Greater AP alpha angle correlated with decreased hip extension/abduction ( P = .025), and greater Dunn lateral and maximal alpha angle correlated with decreased hip flexion/abduction ( P = .001). A positive posterior wall sign correlated with increased straight hip abduction, while other radiographic acetabular parameters were not predictive of range of motion. Only decreased hip external rotation and total arc of motion correlated with an increased risk for current or prior hip symptoms or surgery ( P < .001).

Conclusion:

Hip anatomy in NHL players is characterized by highly prevalent cam-type morphology (>85%) and acetabular retroversion (>60%). In addition, acetabular dysplasia (21%) was relatively common. Greater cam-type morphology correlated with decreased hip range of motion, and a positive crossover sign correlated with increased hip abduction. Decreased hip external rotation and total arc of motion were predictive of hip-related pain and/or surgery.
Protein Delivery in the Intensive Care Unit: Optimal or Suboptimal?
Authors: Heyland Daren K. , Weijs Peter J. M. , Coss‐Bu Jorge A. , Taylor Beth , Kristof Arnold S. , O'Keefe Grant E. , Martindale Robert G.
Published: March 2017

Emerging evidence suggests that exogenous protein/amino acid supplementation has the potential to improve the recovery of critically ill patients. After a careful review of the published evidence, experts have concluded that critically ill patients should receive up to 2.0–2.5 g/kg/d of protein. Despite this, however, recent review of current International Nutrition Survey data suggests that protein in critically ill patients is underprescribed and grossly underdelivered. Furthermore, the survey suggests that most of protein administration comes from enteral nutrition (EN) despite the availability of products and protocols that enhance the delivery of protein/amino acids in the intensive care unit (ICU) setting. While future research clarifies the dose, timing, and composition for exogenous protein administration, as well as identification of patients who will benefit the most, ongoing process improvement initiatives should target a concerted effort to increase protein intake in the critically ill. This assertion follows from the notion that current patients are possibly being harmed while we wait for confirmatory evidence. Further research should also develop better tools to enable bedside practitioners to monitor optimal or adequate protein intake for individual patients. Finally, exploring the effect of combining adequate protein delivery with early mobility and/or resistance exercise in the ICU setting has the greatest potential for improving the functional outcomes of survivors of critical illness and warrants further study.
Promoting Stair Climbing in a Worksite and Public Setting: Are Footprints Enough?
Authors: Van Hoecke Ann-Sophie , Seghers Jan , Boen Filip
Published: March 2017

Purpose:

To evaluate the impact of footprints on stair climbing in different settings.

Design:

Interrupted time-series design.

Setting:

A company (stair/elevator choice) and a mall (stair/escalator choice).

Participants:

Employees (n = 5676) and visitors of the mall (n = 12 623).

Intervention:

An intervention comprising 3 consecutive phases was implemented—(1) footprints leading to the stairs were stuck on the floor, (2) a health message referring to the footprints was introduced, and (3) passersby were congratulated for their increased stair use.

Measures:

Stair climbing was observed before (ie, baseline), during, and 6 to 13 weeks after (ie, follow-up) the intervention.

Analysis:

Proportions of stair climbers were compared using χ2 analyses.

Results:

The footprints resulted in a closely significant increase in stair climbing in the company (from 27.7% at baseline to 31.2% in phase 1). However, they did not produce any effect in the mall. Introducing a health message yielded an additional 12.4% increase in stair climbing in the company and a significant 11.4% increase in the mall (22.3% in phase 2). Congratulating people did not further increase stair climbing. At follow-up, the proportions of stair climbers dropped but still exceeded baseline.

Conclusion:

Footprints tend to increase stair climbing in a worksite setting with a stair/escalator choice but not in a public setting with a stair/elevator choice. Adding a meaningful message seems essential to obtain stronger and longer term effects.
Dark Ages Cold Period: A literature review and directions for future research
Authors: Helama Samuli , Jones Phil D , Briffa Keith R
Published: March 2017

Several late Quaternary studies have recorded cold and disturbed climates centred during the mid-first millennium AD and discussed these conditions under the term ‘Dark Ages Cold Period’ (DACP). A review of 114 palaeoclimate papers indicated that cold climates were common in the Northern Hemisphere between AD 400 and 765. There are also suggestions that some regions may have been relatively wet during the DACP, while those around the Mediterranean and the China/Tibetan Plateau indicate coinciding droughts. A set of environmental responses, however, indicate a delayed DACP interval (AD 509–865) postdating the actual climate signal. Previously, the DACP has been linked with the North Atlantic ice-rafting event at about 1400 years ago, while some evidence suggests an involvement of the North Atlantic Oscillation and/or El Niño–Southern Oscillation. More recently, another proposed phase of widespread cooling, the ‘Late Antique Little Ice Age’ (LALIA), overlaps with the DACP and has been tentatively linked with volcanic aerosol and solar irradiance variations reinforcing the climatic downturn since AD 536. Importantly, a higher number of proxy records extending over the first millennium AD is required for more rigorous assessments of climate variability and the forcing during these centuries and to disentangle the DACP and LALIA fingerprints in the proxy data, particularly to determine whether the DACP and the LALIA are distinct features. Also a richer network of both climate and environmental proxies is needed to evaluate the human–environment interactions, during the historical Migration Period, and thus through the DACP.
Effects of phosphodiestrase type 5 inhibitors in epinephrine-induced arrhythmia in rats: Involvement of lactate dehydrogenase and creatine kinase downregulation and adiponectin expression
Authors: Salama AAA , Mostafa RE , Omara EA
Published: March 2017

Cardiac arrhythmia is a common cause of mortality, and its progression may be due to abnormal sympathetic nerve activity and catecholamine release. Besides, lactate dehydrogenase (LDH) and creatine kinase (CK) downregulation and adiponectin expression play important roles in promoting coronary artery disease. The study aimed to examine the possible cardioprotective effect of members of phosphodiesterase type 5 (PDE-5) inhibitors in epinephrine-induced arrhythmia in rats. Arrhythmia was induced by cumulative boluses of epinephrine (4, 8, 16, 32, 64, and 128 mg/kg) given at 10-min intervals. Rats were randomly allocated into five groups. Group I: Normal control group received only saline. Group II: Rats injected with epinephrine and served as arrhythmia group. Groups III, IV, and V: Rats received daily oral sildenafil (0.5 mg/kg), vardenafil (3 mg/kg), and tadalafil (10 mg/kg), respectively, for 30 days prior to epinephrine injections. Injection of epinephrine to rats decreased heart rate and QTc interval but increased RR interval and duration of arrhythmia. Epinephrine group had lower serum reduced glutathione (GSH) and adiponectin levels and higher serum malondialdehyde (MDA), nitric oxide (NO), heart LDH, and CK contents. Histopathological investigations of epinephrine group provoked necrotic changes with strong positive immunoreactivity for caspases-3. While pretreatment of rats with PDE-5 inhibitors improved GSH and adiponectin contents, ameliorated serum MDA and NO levels and heart LDH and CK contents and corrected epinephrine-induced histopathological changes. PDE-5 inhibitors may delay epinephrine-induced arrhythmia through expression of adiponectin and downregulation of heart LDH and CK.
Leveraging electronic health records for predictive modeling of post-surgical complications
Authors: Weller Grant B , Lovely Jenna , Larson David W , Earnshaw Berton A , Huebner Marianne
Published: March 2017

Hospital-specific electronic health record systems are used to inform clinical practice about best practices and quality improvements. Many surgical centers have developed deterministic clinical decision rules to discover adverse events (e.g. postoperative complications) using electronic health record data. However, these data provide opportunities to use probabilistic methods for early prediction of adverse health events, which may be more informative than deterministic algorithms. Electronic health record data from a set of 9598 colorectal surgery cases from 2010 to 2014 were used to predict the occurrence of selected complications including surgical site infection, ileus, and bleeding. Consistent with previous studies, we find a high rate of missing values for both covariates and complication information (4–90%). Several machine learning classification methods are trained on an 80% random sample of cases and tested on a remaining holdout set. Predictive performance varies by complication, although an area under the receiver operating characteristic curve as high as 0.86 on testing data was achieved for bleeding complications, and accuracy for all complications compares favorably to existing clinical decision rules. Our results confirm that electronic health records provide opportunities for improved risk prediction of surgical complications; however, consideration of data quality and consistency standards is an important step in predictive modeling with such data.
Book Review: Alma Harris and Michelle S. Jones (Eds), Leading Futures: Global Perspectives on Educational Leadership
Authors: Chand Vijaya Sherry
Published: March 2017

Alma Harris and Michelle S. Jones (Eds), Leading Futures: Global Perspectives on Educational Leadership, New Delhi: SAGE Publications, 2016, 249 pp.
Evaluation of a medication intensity screening tool used in malignant hematology and bone marrow transplant services to identify patients at risk for medication-related problems
Authors: Lucena Mariana , Bondarenka Carolyn , Luehrs-Hayes Genevieve , Perez Andy
Published: March 2017

Background

In 2014, a screening tool was implemented at Medical University of South Carolina (MUSC) Health to identify patients who are at risk for medication-related events. Patients are classified as high-risk if they meet one of the following criteria: receiving anticoagulation therapy, taking more than 10 scheduled medications upon admission, or readmission within the past 30 days. The goal of this study was to determine risk criteria specific to the malignant hematology (MH) and bone marrow transplant (BMT) patients.

Methods

A retrospective chart review of 114 patients admitted and discharged from the MH/BMT services between 1 September 2015 and 31 October 2015 was performed. A pharmacist-conducted medication history was completed and documented, and all interventions at admission and throughout hospitalization were categorized by severity and by value of service. The primary objective was to evaluate if patients in the MH/BMT services have more medication-related interventions documented upon admission compared with patients who are not screened as high risk. The secondary objectives were to evaluate the different types and severities of interventions made by pharmacists during the entire hospital stay, and to determine if there are certain characteristics that can help identify hematology/oncology high-risk patients.

Results

More interventions documented upon admission in the high-risk group as a whole when compared with the not high-risk group (73 vs. 31), but when normalized per patients in each group, there was an equal number of interventions (1.0). The most common interventions were to modify regimen (36%) and discontinue therapy (16%). The patient characteristics associated with high-risk included neutropenia, lower average platelet counts on admission, and longer length of stay.

Conclusion

The screening tool does not further differentiate an already complex MH/BMT patient population. Pharmacists may be more useful at capturing errors or changes during a patient’s hospital stay instead of upon admission. Thrombocytopenia, neutropenia, and active infections may correlate with higher-risk status.
Interfacial crack arrest in sandwich beams subjected to fatigue loading using a novel crack arresting device – Numerical modelling
Authors: Martakos G , Andreasen JH , Berggreen C , Thomsen OT
Published: March 2017

A novel crack arresting device is implemented in foam-cored composite sandwich beams and tested using the Sandwich Tear Test (STT) configuration. A finite element model of the setup is developed, and the predictions are correlated with observations and results from a recently conducted experimental fatigue test study. Based on a linear elastic fracture mechanics approach, the developed FE model is utilised to simulate crack propagation and arrest in foam-cored sandwich beam specimens subjected to fatigue loading conditions. The effect of the crack arresters on the fatigue life is analysed, and the predictive results are subsequently compared with the observations from the previously conducted fatigue tests. The FE model predicts the energy release rate and the mode mixity based on the derived crack surface displacements, utilising algorithms for the prediction of accelerated fatigue crack growth as well as the strain field evolution in the vicinity of the crack tip on the surface of the sandwich specimens. It is further shown that the developed finite element analysis methodology can be used to gain a deeper insight onto the physics and behavioural characteristics of the novel peel stopper concept, as well as a design tool that can be used for the implementation of crack arresting devises in engineering applications of sandwich components and structures.