bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of three types of intubation stylets for tracheal intubation with a McGrath MAC® video laryngoscope by novice intubators in simulated cervical immobilisation: A randomised crossover manikin study
Authors: Kim Sung-Wook , Kim Ji-Hoon , Kim Young-Min , Park Jung Taek , Choi Seung Pill
Published: January 2018

Introduction:

Tracheal intubation using video laryngoscopes has been a better approach for trauma patients requiring cervical immobilisation. The aim of this study was to compare the time to successful intubation by novice intubators using three types of intubation stylets with the new McGrath MAC video laryngoscope in a manikin model.

Methods:

This was a randomised crossover manikin study. The participants performed tracheal intubations using three intubation stylets (arcuate shape malleable stylet, McGrath MAC-shaped malleable stylet and McGrath MAC-shaped rigid stylet) in a difficult airway model with cervical immobilisation. The order of the stylets was randomised. The primary outcome was the time to successful intubation. The secondary outcomes were the overall success rates, incidence of dental trauma and ease of intubation. All intubation attempts were assessed by trained assistants. The data were analysed using a multilevel model followed by Tukey’s post hoc test.

Results:

A total of 68 nurses participated in this study. The time to successful intubation of the McGrath MAC-shaped malleable stylet was significantly shorter than that of the arcuate shape malleable stylet (24.5 (18.0–51.0) s vs 31.5 (21.0–89.0) s, p = 0.005). The overall success rate of the McGrath MAC-shaped malleable stylet was also higher than that of the arcuate shape malleable stylet ( p = 0.047). The participants indicated that intubation was easier using the McGrath MAC-shaped malleable stylet compared with the other stylets.

Conclusion:

The McGrath MAC-shaped malleable stylet, when used by novice intubators, may be an optimal stylet shape for tracheal intubation using the McGrath MAC in cervical immobilisation.
Predicting Adverse Perioperative Events in Patients Undergoing Primary Cleft Palate Repair
Authors: Basta Marten N. , Fiadjoe John E. , Woo Albert S. , Peeples Kenneth N. , Jackson Oksana A.
Published: January 2018

Objective:

This study aimed to identify risk factors for adverse perioperative events (APEs) after cleft palatoplasty to develop an individualized risk assessment tool.

Design:

Retrospective cohort.

Setting:

Tertiary institutional.

Patients:

Patients younger than 2 years with cleft palate. Interventions: Primary Furlow palatoplasty between 2008 and 2011.

Main Outcome Measure(s):

Adverse perioperative event, defined as laryngo- or bronchospasm, accidental extubation, reintubation, obstruction, hypoxia, or unplanned intensive care unit admission.

Results:

Three hundred patients averaging 12.3 months old were included. Cleft distribution included submucous, 1%; Veau 1, 17.3%; Veau 2, 38.3%; Veau 3, 30.3%; and Veau 4, 13.0%. Pierre Robin (n = 43) was the most prevalent syndrome/anomaly. Eighty-three percent of patients received reversal of neuromuscular blockade, and total morphine equivalent narcotic dose averaged 0.19 mg/kg. Sixty-nine patients (23.0%) had an APE, most commonly hypoventilation (10%) and airway obstruction (8%). Other APEs included reintubation (4.7%) and laryngobronchospasm (3.3%). APE was associated with multiple intubation attempts (odds ratio [OR] = 6.6, P = .001), structural or functional airway anomaly (OR = 4.5, P < .001), operation >160 minutes (OR = 2.2, P = .04), narcotic dose >0.3 mg/kg (OR = 2.3, P = .03), inexperienced provider (OR = 2.1, P = .02), and no paralytic reversal administration (OR = 2.0, P = .049); weight between 9 and 13 kg was protective (OR = 0.5, P = .04). Patients were risk-stratified according to individual profiles as low, average, high, or extreme risk (APE 2.5%-91.7%) with excellent risk discrimination (C-statistic = 0.79).

Conclusions:

APE incidence was 23.0% after palatoplasty, with a 37-fold higher incidence in extreme-risk patients. Individualized risk assessment tools may enhance perioperative clinical decision making to mitigate complications.
Consensus at Home, Opposition Abroad: Officials, Foreign Sources, and US News Coverage of Drone Warfare
Authors: Rowling Charles M. , Sheets Penelope , Pettit William , Gilmore Jason
Published: January 2018

This study examines the process and conditions under which U.S. news coverage aligns with—or challenges—the communications of government officials, focusing on the issue of U.S. drone warfare. White House, military, congressional, and press communications during President Obama’s first 5 years in office are analyzed to assess how the policy has been framed among officials and covered within the press. Evidence indicates that news coverage was significantly more critical of the policy than what was expressed among officials. In particular, despite near consensus at home, journalists exercised considerable discretion, consistently locating and amplifying oppositional voices from abroad in news coverage.
A Groundhog Moment: Examination of a Pivotal Emotional Singularity
Authors: Townsend Thomas
Published: January 2018

In this article, the author dissects and refracts a single, defining moment in his life using autoethnography and the lenses of specific communication and social theories. The author mines the moment in first, second, and third person to uncover the different responses to overwhelming emotions ranging from the noble to the shameful in response to his father’s “coming out of the closet.” A torrent of emotion took the author by surprise and is the total moment of his analysis in this article. The author scrutinizes the multiple ways in which this moment was a release, a turning point, an ending, a beginning, bittersweet, hateful and hate filled, selfish, guilt ridden, and loving. Through multiple retellings of the event, like the film Groundhog Day, the author presents the moment in different narrative formats, from multiple perspectives, with relevant quotations and passages to thoroughly dissect the emotional layers.
Initial romiplostim dosing and time to platelet response in patients with treatment refractory immune thrombocytopenia
Authors: DasGupta Ryan K , Levine Lauren , Wiczer Tracy , Cataland Spero
Published: January 2018

Background/rationale

Romiplostim is a thrombopoietin receptor agonist recommended as a second-line therapy for immune thrombocytopenia. An initial dose of 1 mcg/kg/week subcutaneously with weekly 1 mcg/kg dose escalation is recommended per package labeling. Optimizing romiplostim dosing for hospitalized, corticosteroid- and intravenous immunoglobulin-refractory patients with severe thrombocytopenia secondary to immune thrombocytopenia may be critical for improving platelet responses, reducing the risk of bleeding, and decreasing hospital length of stay. Limited data are available evaluating the efficacy and safety of higher initial doses.

Objective

The primary objective of this study was to compare the time to platelet ≥ 10 × 109/L between patients who received an initial romiplostim dose of ≥2 mcg/kg/week compared to the standard initial dose of 1 mcg/kg/week. Secondary objectives included time to platelet response ≥ 30 × 109/L and ≥50 × 109/L, percentage of patients achieving platelet responses, hospital length of stay, and incidence of adverse events and bleeding complications.

Methods

This was a retrospective, single-center, cohort study including hospitalized adults with corticosteroid- and intravenous immunoglobulin-refractory immune thrombocytopenia. A baseline platelet < 10 × 109/L was required. Patients were stratified by their initial romiplostim dose into Cohort 1 (1 mcg/kg/week) and Cohort 2 (≥2 mcg/kg/week). A review of electronic medical records and descriptive statistics generated findings.

Results

A total of 18 patients were included, 4 in Cohort 1 and 14 in Cohort 2. Patients in Cohort 2 had a median initial dose of 4.5 mcg/kg/week. Patients in Cohort 2 achieved a platelet ≥ 10 × 109/L in a median of 2 days versus 4.5 days for Cohort 1. More patients in Cohort 2 achieved a platelet ≥ 30 × 109/L (42.9% vs. 25%) and platelet ≥ 50 × 109/L (28.6% vs. 25%). The median hospital length of stay was shorter in Cohort 2 (13.5 vs. 20 days). Clinically relevant nonmajor bleeding was noted less frequently in Cohort 2 (28.6% vs. 75%), while major bleeding was more frequent in Cohort 2 (14.3% vs. 0%). No thrombotic events occurred.

Conclusion

Our study suggests that higher initial romiplostim doses may be safe for hospitalized patients with treatment-refractory immune thrombocytopenia. Compared to Food and Drug Administration-approved dosing, higher initial doses may shorten time to platelet responses and hospital length of stay. Further large-scale studies are needed to confirm these findings.
Neisseria gonorrhoeae–Induced Inflammatory Pyroptosis in Human Macrophages is Dependent on Intracellular Gonococci and Lipooligosaccharide
Authors: Ritter Jessica Leigh , Genco Caroline Attardo
Published: January 2018

Neisseria gonorrhoeae, the human obligate pathogen responsible for the sexually transmitted disease gonorrhea, has evolved several mechanisms to evade the host immune response. One such mechanism is the modulation of host cell death pathways. In this study, we defined cell death pathways induced by N gonorrhoeae in human monocyte-derived macrophages (MDMs). In a dose-dependent manner, N gonorrhoeae stimulation of MDMs resulted in caspase 1 and 4–dependent cell deaths, indicative of canonical and noncanonical pyroptosis, respectively. Internalization of bacteria or stimulation with lipooligosaccharide (LOS) specifically induced pyroptosis in MDMs and increased secretion of IL-1β. Collectively, our results demonstrate that N gonorrhoeae induces inflammatory pyroptosis in human macrophages due in part to intracellular LOS. We propose that this in turn may exacerbate inflammatory outcomes observed during mucosal infection.
Very Rare Presentation of Cerebrovascular Accident in 20-Year-Old Man With Familial Mediterranean Fever—Case Report
Authors: Aghdashi Miramir , Seidmardani Seyed-Mostafa , Vossoughian Sara , Seyed Mokhtari Seyed Arman
Published: January 2018

Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever accompanied by serosal, synovial, or cutaneous inflammation. The central nervous system (CNS) is rarely involved in FMF. The CNS involvement includes demyelinating lesions, posterior reversible encephalopathy syndrome, pseudotumor cerebri, optic neuritis, and cerebral vasculitis. Here, we present a 20-year-old man, a known case of FMF with abrupt left-sided hemiparesis. Brain magnetic resonance imaging revealed right periventricular infarction. Normal echocardiography ruled out cardioembolism, and thrombophilia workup was negative. Therefore, FMF-induced cerebrovascular accident was considered. Although rare, CNS involvement as a result of FMF disease should also be considered when encountering patients with FMF and CNS manifestations.
First Time Isolation of Mycobacterium hassiacum From a Respiratory Sample
Authors: Deinhardt-Emmer Stefanie , Höring Steffen , Mura Christian , Hillemann Doris , Hermann Beate , Sachse Svea , Bohnert Jürgen , Löffler Bettina
Published: January 2018

We describe the first isolation of Mycobacterium hassiacum, a rapid-growing, partial acid-resistant mycobacterium, in a respiratory specimen from a patient with exacerbated chronic obstructive pulmonary disease. To provide therapeutic recommendation for future cases, antibiotic susceptibility testing of 3 clinical isolates was performed by broth microdilution. All strains tested showed susceptibility to clarithromycin, imipenem, ciprofloxacin, and doxycycline. The role of M hassiacum as a respiratory pathogen remains unclear and needs to be evaluated by future reports.
Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique
Authors: Saliba Issam , Sabbah Valérie , Poirier Jackie Bibeau
Published: January 2018

Objective:

To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome.

Study design:

This is a retrospective study.

Methods:

This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA) to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes’ head as a partial ossicular replacement prosthesis.

Results:

The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52) compared with 40% in the TORP-S group (n = 29). However, the adult cohort shows 79.3% in the TORP-F group (n = 52) compared with 43.75% in the TORP-S group (n = 25). These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group ( P = .03).

Conclusions:

The interposition of a fat graft between the legs of the titanium implants (TORP-F) provides superior hearing results compared with a standard procedure (TORP-S) in pediatric and adult populations because of its better stability in the oval window niche.
How Transnational Mothering is Seen to be ‘Troubling’: Contesting and Reframing Mothering
Authors: Juozeliūnienė Irena , Budginaitė Irma
Published: January 2018

This article aims to examine how changes in mothering induced by international migration become transformed into ‘troubles’. Based on the analysis of 79 selected articles on transnational families published between 2004 and 2013 in national press and Internet media portals in Lithuania, along with interviews with transnational mothers conducted between 2008 and 2014, the authors raise questions about how changes in mothering due to migration come to be constructed as troubles and how mothers who emigrate to work abroad while their children remain living in the country of origin engage in mothering display. The authors bridge Goffman’s theoretical ideas with the current frame of family display suggested by Finch to extend the understanding about the ways the scripts of ‘good mothering’ are both referenced and transformed through multi-local interactions. The analysis of the portrayal of transnational mothers in mass media demonstrates how mothering across borders is scripted. The cases discussed by the authors show the way transnational mothers respond to the discrediting scripts and normalize troubles, investing in bringing new meanings to mothering. The analysis of newly emerging transnational practices gives empirical evidence to the assumption that transnational mothers do not simply ‘follow’ scripts but also shift them and create new stories of mothering.
Numerical and experimental investigation of modal-energy-based damage localization for offshore wind turbine structures
Authors: Li Yingchao , Zhang Min , Yang Wenlong
Published: January 2018

Offshore wind turbine structures are prone to deterioration and damage during their service life in harsh marine environment. To explore highly efficient and robust damage detection methods for offshore wind turbine structures, three well-known modal strain energy indices are reviewed first and then a new index named total modal energy method is proposed. The innovation of the new index is the simultaneous use of modal strain energy and modal kinetic energy. To investigate the feasibility and robustness of the four modal-energy-based methods, numerical and experimental studies are conducted on a tripod-type offshore wind turbine structure with simulated and measured data. It is indicated that all the four modal-energy-based methods work well with limited incomplete modal data, especially for the single-damage cases. While for the cases of multiple damage locations, the new total modal energy index significantly outperforms the traditional modal strain energy indices. Moreover, high robustness is shown for the indices, when the measured mode shapes of undamaged and damaged structures are polluted with the same noise level. However, when their noise levels have some difference, two of the modal strain energy indices turn invalid, but the new total modal energy index still shows stronger robustness. As frequencies are also used in the total modal energy index, its robustness to the noise in modal frequencies is also studied. It is shown that the results are slightly affected by the measurement noise in modal frequencies. Besides, the influence of finite element modeling errors is also investigated with both simulated and experimental data. Results show that all the four modal-energy-based methods are all very stable and insensitive to certain modeling errors. So, finite element model updating is not necessary in the test structure herein.
“News comes across when I’m in a moment of leisure”: Understanding the practices of incidental news consumption on social media
Authors: Boczkowski Pablo J , Mitchelstein Eugenia , Matassi Mora
Published: January 2018

Incidental consumption of news on social media has risen in recent years, particularly among young people. Previous studies have characterized what the main dimensions and effects of this phenomenon are. In this article, we complement that literature by looking at how this phenomenon unfolds. Inspired by practice theory, we aim to answer two questions: (1) what are the practices that subtend incidental news consumption on social media among young people? and (2) What are the social consequences of these practices? We draw upon 50 in-depth interviews with respondents aged 18–29 years from Argentina. Our findings show the existence of (1) strong connections between technology and content, “anywhere and anytime” coordinates, derivative information routines, and increasingly mediated sociability and (2) fragmentary reading patterns, loss of hierarchy of the news, and coexistence of editorial, algorithmic, and social filtering. We conclude by elaborating on the empirical and theoretical implications of these findings.
Conflicted conservatives, punitive views, and anti-Black racial bias 1974–2014
Authors: Brown Elizabeth K , Socia Kelly M , Silver Jason R
Published: January 2018

Research suggests that the views of “conflicted conservatives,” Americans who self-identify as conservative but express support for liberal governmental policies and spending, are particularly important in policymaking and politics because they are politically engaged and often act as swing voters. We examine punitive views among conflicted conservatives and other political subgroups in three distinct periods in the politics of punishment in America between 1974 and 2014. In particular, we consider the punitive views of conflicted conservatives relative to consistent conservatives, moderates, and liberals. Given the barrier that racialized typifications of violent crime may pose to current criminal justice reform efforts, we also explore the role of anti-Black bias in predicting punitive views among White Americans across political subgroups. Our overall findings indicate that conflicted conservatives are like moderates in their support for the death penalty and like consistent conservatives on beliefs about court harshness. These findings, and supplemental analyses on punitive views and voting behaviors across political subgroups, call into question whether conflicted conservatives have acted as critical scorekeepers on penal policy issues. We also find that anti-Black racism was significantly related to punitive views across political subgroups and among liberals in particular.
Making sense of life without parole in China
Authors: Smith Tobias , Jiang Su
Published: January 2018

In 2015, the People’s Republic of China introduced the sentence of lifelong imprisonment for a single, non-violent crime: corruption. Although life without the possibility of parole statutes were increasingly common in the US and across the world by the late 20th century, this is the first such statute ever introduced in China. While introducing the new punishment for corruption, China, the world’s leading executioner, retained the death penalty for corruption as well. This study examines the reasons for China’s adoption of life without the possibility of parole and situates China in global debates about the punitive turn and capital punishment. It also provides insights for understanding how the adoption of life without the possibility of parole fits into a wider constellation of penal practices.
Spark ignition and early flame development of lean mixtures under high-velocity flow conditions: An experimental study
Authors: Sayama Shogo , Kinoshita Masao , Mandokoro Yoshiyuki , Fuyuto Takayuki
Published: January 2018

This study set out to experimentally investigate spark ignition and the subsequent early flame development of lean air–fuel mixtures of A/ F = 20–30 under high-velocity flow conditions using a uniquely designed swirl chamber. The swirl chamber realizes a high-velocity flow of 65 m/s at the spark plug gap, as well as internal temperature and pressure histories that are equivalent to those of spark-ignition engines, being equipped with an optically accessible engine. The designed swirl chamber clearly captures the characteristic behavior of the spark channels and flames in the vicinity of the spark plug. The results show that the spark channels stretch downstream following the flow and are subject to short circuits or restrikes. In the case of a high ignition energy of 200 mJ, short circuits of the spark channels occur in the early part of the discharge, while restrikes occur in the later parts. With a decrease in the ignition energy, restrikes occur in the earlier parts of the discharge. With a low ignition energy of 65 mJ, restrikes can occur immediately after the electrical breakdown without any significant spark stretch. At a sufficiently low dilution degree of A/ F = 20, flames can hold behind the ground electrode of the spark plug, which significantly suppresses the cycle dispersion while also enhancing the combustion in the early stage. With further air dilution, that is, A/ F > 20, flames develop, flowing downstream without flame holding. However, temporal flame attachment to the ground electrode is observed during the discharge duration even at A/ F = 30, while the attached flames eventually blow off downstream at the end of the spark discharge.
Are Teens Being Unfairly Punished? Applying the Dual Systems Model of Adolescent Risk-Taking to Sexting Among Adolescents
Authors: Rhyner Katlin J. , Uhl Carolyn A. , Terrance Cheryl A.
Published: January 2018

The current review frames an understanding of ‘sexting’ among adolescents within the dual systems model of adolescent risk-taking. Adolescent sexting has been growing in popularity in recent years. When adolescents share sexual images, they face the possibility of serious consequences in the United States, such as being added to the sex offender registry. The dual systems model of adolescent risk-taking suggests teenagers engage in risky behavior due to the under development of impulse control and a peak in reward sensitivity. It is argued that the possible legal consequences of teenage sexting do not fit the developmental level of teenagers.
On the energy required to maintain an ocean mirror using the reflectance of foam
Authors: Garciadiego Ortega Eduardo , Evans Julian RG
Published: January 2018

Among the various interventions proposed to remediate the health and security effects of climate change by solar radiation protection is the proposal to enhance natural ocean whitecap formation. Compared to other solar protection interventions, this is technically simple and quickly terminated. However, it has a drawback: even if the energy be obtained from wind or wave, the power demand to maintain a foam raft determines the capitalization of equipment. The average power demand is inversely related to foam lifetime which can be prolonged by surfactants preferably derived from ingenerate resources. Here, we estimate the associated energy and power demands by identifying the parameters that can be adjusted to moderate the capital cost of implementation. Before dividing by efficiency factors, the range of power demand for an intermediate areal energy requirement of 5 MJ/km2 of ocean varies from 6 to 30 W/km2 for foam lifetime of 10–2 days. The most likely route to deployment is through merchant ship lubrication using bubbly liquids which both reduces fuel consumption and creates an extended wake and is perhaps an example of technical symbiosis.
Police performance regimes and police activity: Compstat in Paris and London compared
Authors: de Maillard Jacques
Published: January 2018

This paper analyses the implementation of Compstat-like processes in two large European police organizations: the Metropolitan Police Service in London and the Préfecture de police in Paris. Compstat-like processes are characterized by processes framed by performance indicators and targets, performance assessment sessions, units dedicated to the collection and analysis of performance data, and information processing requiring the use of crime data. Such processes raise two broad sets of questions. First, do these innovations lead to tighter or more encompassing crime control strategies? Second, does the old command-and-control organizational model of police departments emerge reinforced, or does innovation foster the emergence of a new, more deliberative, problem-solving style of management? The paper analyses the mix of common features (limited geographical decentralization, increasing internal accountability based on the centrality of quantitative data, the prioritizing of crime reduction, and the influence of new technologies on how data is used) and differences (the range of indicators used, broader in London, and the management styles, more in line with a neo-managerial impetus in London). Interpreting these contrasts requires an analytical framework combining both the administrative, political and cultural traditions in the two police forces and the intentional projects carried out by political and professional actors.
Adapting a Technology-Based Implementation Support Tool for Community Mental Health: Challenges and Lessons Learned
Authors: Livet Melanie , Fixsen Amanda
Published: January 2018

With mental health services shifting to community-based settings, community mental health (CMH) organizations are under increasing pressure to deliver effective services. Despite availability of evidence-based interventions, there is a gap between effective mental health practices and the care that is routinely delivered. Bridging this gap requires availability of easily tailorable implementation support tools to assist providers in implementing evidence-based intervention with quality, thereby increasing the likelihood of achieving the desired client outcomes. This study documents the process and lessons learned from exploring the feasibility of adapting such a technology-based tool, Centervention, as the example innovation, for use in CMH settings. Mixed-methods data on core features, innovation–provider fit, and organizational capacity were collected from 44 CMH providers. Lessons learned included the need to augment delivery through technology with more personal interactions, the importance of customizing and integrating the tool with existing technologies, and the need to incorporate a number of strategies to assist with adoption and use of Centervention-like tools in CMH contexts. This study adds to the current body of literature on the adaptation process for technology-based tools and provides information that can guide additional innovations for CMH settings.
Resorbable Self-Locking Implant for Lung Lobectomy Through Video-Assisted Thoracoscopic Surgery: First Live Animal Application
Authors: Guedes Rogério Luizari , Höglund Odd Viking , Brum Juliana Sperotto , Borg Niklas , Dornbusch Peterson Triches
Published: January 2018

The aim of this pilot test was to test a new self-locking resorbable implant for hilum occlusion during a video-assisted thoracoscopic lung lobectomy in a surviving pig model. Once the thoracic cavity was assessed and structures identified, the right middle lobe and its respective hilum were exposed. The implant was introduced with a semiclosed loop through a working channel and positioned around the pulmonary lobe. Occlusion was performed with a conventional Crile forceps and a laparoscopic Kelly forceps. Lobe section was done with laparoscopic Metzenbaum scissors and tissue removal through the dorsal access. No signs of pneumothorax or bleeding were observed during a 60-day follow-up. Necropsy findings showed minimal pleuritis in caudal access and in the lobar stump. A granulomatous formation was found around a dense, amorphous material, which was identified as remains of a small part of the implant. Histopathological findings showed signs of a chronic healing process without other alterations. The resorbable implant LigaTie appears to exhibit similar handling and application characteristics during surgery as nonsurgical tie wraps. The resorbable implant avoids the uncontrolled substances not suitable for implants of conventional ties. The results of this pilot test suggested the resorbable implant’s mechanical properties provided effective tissue support to complete the healing of the pulmonary hilum.
The Feasibility of Community-Based, Supervised Exercise Programs to Engage and Monitor Patients in a Postrehabilitation Setting
Authors: Marshall Timothy F. , Groves Jay R. , Holan George P. , Lacamera Jonathan , Choudhary Shaloo , Pietrucha Ronald J. , Tjokro Moorissa
Published: January 2018

Objective. To evaluate the feasibility of disease-specific, community-based supervised exercise programs (CSEPs) to improve biometric and functional outcomes among persons with a variety of chronic medical conditions. Design. Feasibility, cohort study. Subjects were recruited through community placed flyers and provider offices. Exercise programs consisted of aerobic and resistance training that adhered to American College of Sports Medicine guidelines. A Wilcoxon signed rank test was used to assess program outcomes. Setting. Ten, community-based, medical fitness centers. Subjects. A total of 382 total participants. The number of participants in each CSEP ranged from 38 to 119. Individuals were 18 years of age or older and treated for various chronic medical conditions. Results. Varied by cohort, but generally consisted of ( a) favorable changes in body composition (  P < .05), ( b) significant improvements in submaximal exercise tolerance and functional outcome measures (  P < .05), and (3) significant increase in self-reported exercise behaviors (  P < .05). Conclusion. CSEPs improve outcomes in patients with chronic medical conditions and may be relevant within the continuum of care in outpatient rehabilitation medicine, particularly among bundled or value-based payment models. Further research is needed to evaluate outcomes from CSEPs versus controls.
Establishing Proof of Concept for Clinical Processes in Lifestyle Medicine
Authors: Egger Garry , Stevens John , Ganora Christopher
Published: January 2018

Lifestyle medicine is a relatively new discipline, designed to improve the management of lifestyle and environmentally induced chronic diseases. As such it is evolving new skills, tools, and procedures. But these are often not assessed for their potential before being adopted in practice. Proof of concept (PoC) is an initial stage of testing characteristic of new product or process development in the commercial world. It can be equally applied to new processes and practices in lifestyle medicine.
Semantic isometry for 3-D shape correspondence
Authors: Pan Xiang , Cui Ying
Published: January 2018

Isometry has been widely used in corresponding problem with pose variation. However, most existing methods are causing wrong correspondences due to the ambiguity of geodesic distance. This article introduces the semantic isometry to three-dimensional shape correspondence and proposes a new framework called detection–recognition–correspondence. The idea of semantic isometry is to embed the semantic information and statistical learning through sparse correspondence for better performance. Feature point detection is first utilized to extract the salient feature point of the three-dimensional shapes. Then, instead of finding correspondence pairs directly by minimizing the isometric error of the detected feature points, the semantic labels of these feature points are recognized using the support vector machine. The semantic label is used to perform a priority-driven isometric correspondence.The highly reliable corresponding pairs are then obtained to serve as the further constraint in the following corresponding process. During the experiments, the robustness of the proposed algorithm is verified by different kinds of three-dimensional dynamic models, including some very challenging data with pose variation and missing parts. Moreover, the proposed framework can greatly improve the corresponding accuracy over the existing state-of-the-art algorithms.
How to do high-quality clinical research 1: First steps
Authors: Sandercock Peter , Whiteley William
Published: January 2018

This is the first paper in a series of five on how to do good quality clinical research. It sets the scene for the four papers that follow. The aims of the series are to: promote reliable clinical research to inform clinical practice; help people new to research to get started (at any stage of their career); create teaching resources for experienced researchers; and help clinicians working in resource-poor settings to conduct research. We set out in this paper the skills clinicians need to run research projects that are relevant to their clinical practice. We focus on how to get the right training in research methodology, choose and refine a good research question, and then how to ensure the methods and data analysis plan are correct for the question being asked.
Exploring self through memory: Narratives of Punjabi and Sindhi Partition survivors
Authors: Patwardhan Ninad , Kulkarni Mrinmoyi
Published: January 2018

The reciprocal association between working self and autobiographical retrieval is illustrated in the self-memory system model. This study attempted to investigate the self-memory system model in the context of memories of the 1947 Partition of British India. This event, which dramatically altered the lives of many survivors, generated indelible memories. In this study, the published Partition narratives of displaced Punjabi and Sindhi survivors were content analyzed, and themes were extracted. The working self of the Partition survivors triggered recall of this event, whose evaluation varied along three dimensions, namely, avoidance, rumination, and reflection. The theme of repression was central to avoidance narratives. Furthermore, rumination narratives were marked by nostalgia and a sense of alienation. Finally, the themes of cognitive reappraisal, self-complexity, and self-discrepancy resolution surfaced in reflection narratives. The emerging research findings highlight the centrality of emotion regulation in autobiographical retrieval and its implications for well-being.
Evaluation of a multi-layered health promotion approach in rural China
Authors: Tian Xiangyang , Yan Liping , Zhao Genming , Wang Liang , Cheng Yulan , Lu Yong , Southerland Jodi
Published: January 2018

Background:

To explore the effectiveness of a multi-layered health promotion approach in rural China.

Methods:

A two-year intervention was applied to the 18 intervention rural villages while the 18 controls received standard health communication materials. Data were collected at baseline and post-intervention respectively to evaluate the effectiveness.

Results:

All intervention villages had developed healthy policies addressing prioritized health issues such as livestock captivity, garbage disposal, etc.; however, no healthy policies had been developed in the controls. The two-week morbidity rate and incidence of diarrhea of the intervention villages decreased to 13.4% from 18.5% ( p = 0.009), and to 9.5% from 13.0% ( p = 0.038), respectively, whereas no statistically significant change was found in the controls. The knowledge about hepatitis B and rabies transmission had increased significantly among the intervention villagers (hepatitis B from 27.5% to 34.4%, p = 0.005; rabies from 12.0% to 24.6%, p < 0.001) but not in the control for rabies ( p > 0.05). Among both intervention and control groups, the proportion of proper hand-washing and chopping board use increased significantly (all p < 0.01). Greater changes had been found in physical inactivity and alcohol drinking among the intervention group than the control. No change was found in smoking rate among both groups. Score values (mean ± SD) for environmental quality, livestock captivity, and vector density (e.g., mosquitoes, flies, rats, and cockroaches) increased significantly from 2.8 ± 0.9 to 3.4 ± 0.7, from 1.9 ± 0.9 to 2.5 ± 0.9, and from 0.6 ± 0.9 to 1.8 ± 0.4, respectively ( p < 0.05) in the intervention villages.

Conclusions:

The two-year multi-layered health promotion approach shows real promise in empowering the rural communities to take control over, and protect their own health.
Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy of the Lesser Toes: Learning Curve
Authors: Krenn Sabine , Albers Sascha , Bock Peter , Mansfield Clemens , Chraim Michel , Trnka Hans-Joerg
Published: January 2018

Background. Minimally invasive surgery has a shorter surgical time, and in this study we focus on minimally invasive distal metatarsal metaphyseal osteotomy (DMMO). The operation seems to be less complex but requires a high learning curve. We report on our first patients to underline the need for extensive training and great awareness for the risks in the early learning stages. Methods. We evaluated 27 patients (mean age = 60.9 years) with a mean follow-up time of 7.2 months. Indication was metatarsalgia, intractable plantar keratosis, and the (sub-)luxation of the metatarsophalangeal joint. Clinical results were evaluated with the 12-item Short Form (SF-12), Foot Function Index (FFI), Foot and Ankle Ability Measure (FAAM), and the American Orthopaedic Foot and Ankle Score (AOFAS). Radiographs and pedobarographic analysis were obtained. Results. Scores ranged closely to standard value (AOFAS 88.07 points; FFI 93%; FAAM 36.4 points; SF-12 31.27 points). Pedobarography showed significant differences in several forefoot areas. We encountered nonunion/malunion and necrosis of the metatarsal head. Conclusions. The aim of this study was to demonstrate the need for intensive training before practicing DMMO. Results show that minimally invasive DMMO requires a high learning curve. Correct handling of the burr is associated with a lot of training. Wrong handling can lead to nonunion/malunion or necrosis.

Levels of Evidence: Therapeutic, Level IV: Case series
Single-photon emission tomography imaging in patients with Lyme disease treated with human embryonic stem cells
Authors: Shroff Geeta
Published: January 2018

Aim

The purpose of this study was to evaluate the longitudinal changes in brain perfusion in patients with Lyme disease treated with human embryonic stem cells.

Material and methods

The study included 59 (age range 41.68 ± 16.37 years) patients with Lyme disease whose single-photon emission tomography imaging was performed before and after the human embryonic stem cell therapy. Technetium-hexa methyl propylene aminoxime single-photon emission tomography imaging was used to assess the hypoperfused lesions/regions in the brain prior to the therapy, as well as the improvement in perfusion after human embryonic stem cell treatment.

Results

After receiving human embryonic stem cell therapy, single-photon emission tomography imaging reflects a significant (>60%) improvement in 43 patients along with moderate (30–60%) and mild (<30%) improvement in 12 and four patients, respectively. The cerebral perfusion flow improved and the degree of hypoperfusion in the other regions significantly decreased after the human embryonic stem cell therapy. Interpretation of single-photon emission tomography imaging of brain images (before and after therapy) clearly presented the changes in color at various brain regions which represent the improvements in patients.

Conclusion

Single-photon emission tomography imaging could be used as a potential diagnostic tool to assess the response of Lyme disease patients to human embryonic stem cell therapy.
Failure and impact resistance analysis of plain and fiber-reinforced-polymer confined concrete cylinders under axial impact loads
Authors: Pham Thong M , Chen Wensu , Hao Hong
Published: January 2018

This study conducts an experimental and numerical investigation on the failure and impact resistance of plain and fiber-reinforced polymer-confined concrete. The impact resistance of concrete cylinders wrapped with different types of fibers including carbon fiber and glass fiber is examined. Drop-weight tests are utilized to conduct the impact tests while the numerical simulation is conducted using LS-DYNA. The experimental and numerical results have proved that fiber-reinforced polymer can be efficiently used to improve the impact resistance of concrete cylinders. In general, fiber-reinforced polymer ruptures at a lower strain than those in static tests and the rupture strain of glass fiber is much higher than that of carbon fiber. The findings in the experimental tests are confirmed by the numerical results. Glass fiber, therefore, exhibits a much better performance than carbon fiber. It is recommended to use glass fiber to enhance the impact resistance of concrete structures strengthened with fiber-reinforced polymer. In addition, the stress evolution of the specimens is analyzed to investigate the failure mechanism.
Discursive strategies and ideologies in selected newspaper reports on the Nigerian-Cameroonian Bakassi peninsula border conflict
Authors: Igwebuike Ebuka Elias
Published: January 2018

News reporting on conflict situations mainly manipulates discursive and representational strategies in portraying people, actions and events either negatively or positively based on certain prejudiced ideologies. This article examines salient discursive strategies deployed by Nigerian and Cameroonian newspapers to represent socio-political ideologies in their reports on the Bakassi Peninsula border conflict. Data comprise 127 instances of discourse strategies drawn from two Nigerian and two Cameroonian English-medium national newspapers published between August 2006 and August 2010. By integrating insights from van Dijk’s Critical Discourse Analysis, findings reveal that both countries’ reports create polarity of positive in-group and negative out-group ideologies through seven discursive strategies which include slanted headlining, negative labelling, evidentiality, number game, hyperbolism, victimization and depersonalization. The strategies embody ideological prejudices of positive self- and negative other-representations which are rife in both nations’ news reports on the disputed Peninsula.
Ethical political economy: Lessons from the Malay world’s Hikayat Abdullah (1849)
Authors: Chong Alan
Published: January 2018

According to Munshi Abdullah, the author of the Hikayat Abdullah (Annals of Abdullah), ‘knowledge and skill are the ladder to riches, and riches lead to greatness. Of a truth, all things created by Allah in this world have their value which can be reckoned in terms of money; learning alone commands a price which no man can determine’ (Abdullah, 1970: 40). This empowerment of ethical behaviour through the disciplining of the mind in the practice of principles frames the Hikayat’s approach to the practice of mercantilism and good government in the service of commerce. This article interprets the dimensions of this 19th-century Asian vision and uncovers three themes related to the maritime Silk Road: impartial administration of law and order, beneficent autocracy and the proper prioritization of wealth and good manners.
Injury Recurrence Among High School Athletes in the United States: A Decade of Patterns and Trends, 2005-2006 Through 2015-2016
Authors: Welton K. Linnea , Kraeutler Matthew J. , Pierpoint Lauren A. , Bartley Justin H. , McCarty Eric C. , Comstock R. Dawn
Published: January 2018

Background:

As participation in high school athletics increases, so does the number of adolescents experiencing sports-related injury. Understanding injury patterns is an important component to developing and evaluating prevention and rehabilitation programs.

Purpose:

To analyze recurrent injury rates and patterns among high school athletes, to compare recurrent injuries with new injuries, and to evaluate injury trends over time.

Study Design:

Descriptive epidemiology study.

Methods:

High school sports injury data on 24 sports were collected from 2005-2006 through 2015-2016 via the High School RIO (Reporting Information Online) surveillance system. Injury rates were calculated as number of injuries per 10,000 athletic exposures (AEs). Injury rate ratios and injury proportion ratios (IPRs) were calculated to compare differences among subgroups.

Results:

Overall, 78,005 injuries were sustained during 40,195,806 AEs, for an injury rate of 19.41 per 10,000 AEs. Of these, 69,821 (89.5%) were new injuries, and 8184 (10.5%) were recurrent. The ankle was the most commonly injured body part among recurrent injuries, while the head/face was the most common body part that sustained new injuries. Ligament sprains were more often recurrent, while concussions were more commonly diagnosed as new, although concussions represented 16.7% of recurrent injuries. Trends for recurrent injuries over time were relatively stable. The proportion of athletes who had >3 weeks of time loss or medical disqualification (15.8% vs 13.3%; IPR, 1.19; 95% CI, 1.13-1.26) or who voluntarily withdrew from sport (2.5% vs 1.1%; IPR, 2.33; 95% CI, 2.00-2.73) was significantly greater for recurrent injuries than new injuries. Furthermore, a greater proportion of recurrent injuries resulted in surgery (8.1% vs 6.0%; IPR, 1.34; 95% CI, 1.24-1.46).

Conclusion:

Although only 10.5% of all injuries were recurrent, they more frequently resulted in missing >3 weeks of playing time and were more often managed surgically when compared with new injuries. The rate of recurrent injuries has not increased over the past decade.