bluuebunny/crossref_metadata_2025 huggingface dataset:
Food activists, consumer strategies, and the democratic imagination: Insights from eat-local movements
Authors: Huddart Kennedy Emily , Parkins John R. , Johnston Josée
Published: July 2016

Scholars remain divided on the possibilities (and limitations) of conceptualizing social change through a consumer-focused, “shopping for change,” lens. Drawing from framing theory and the concept of the democratic imagination, we use a case study of “eat-local” food activism to contribute to this debate. We ask two questions: first, how do activists in the local food movement come to diagnose and critique the conventional industrial food system? and second, what roles do they envision for participants in the sustainable food movement? We address these questions by drawing from activist interview data (n = 57) and participant observation of the eat-local movement in three Canadian cities. Our findings illuminate a mixed picture of possibilities and limitations for consumer-based projects to foster social change. On the one hand, the diagnostic frames presented by food activists suggest skills in critical thinking, attention to structural injustice, and widespread recognition of the importance of collective mobilization. This framing suggests a politically thick democratic imagination among eat-local activists. In contrast, when it comes to thinking about prescriptions for change, activist understandings draw from individualistic and market-oriented conceptualizations of civic engagement, which indicates a relatively thin democratic imagination. These findings demonstrate that despite the sophisticated understandings and civic commitment of movement activists, the eat-local movement is limited by a reliance on individual consumption as the dominant pathway for achieving eco-social change.
The role of the Bologna Process in defining Europe
Authors: Kushnir Iryna
Published: July 2016

The question of what Europe is remains under-explored in the literature on European matters, and this suggests a need to formulate a definition of ‘Europe’. This paper suggests that it is not possible to resolve the problem of the meaning of Europe without considering its higher education developments. The Bologna Process is a recent European intergovernmental higher education project having the aim of forming the European Higher Education Area by making degrees compatible in its signatory countries. In addition, other countries beyond this Area also intend to adopt the Bologna Process in order to converge their higher education structures. It is argued that the Bologna Process is an essential consideration in approaching the definition of Europe because it expands European borders and promotes the idea of a common European identity within them. These changes are supplemented by building up tensions in the development of territory–identity compatibility in the growing European community. The difficulty, if not impossibility, of solving these problems makes Europe dynamic in the Bologna Process, and suggests the depth of the meaning the borders, delineated by the Bologna Process, convey.
Prediction of landing gear loads using machine learning techniques
Authors: Holmes Geoffrey , Sartor Pia , Reed Stephen , Southern Paul , Worden Keith , Cross Elizabeth
Published: July 2016

This article investigates the feasibility of using machine learning algorithms to predict the loads experienced by a landing gear during landing. For this purpose, the results on drop test data and flight test data will be examined. This article will focus on the use of Gaussian process regression for the prediction of loads on the components of a landing gear. For the learning task, comprehensive measurement data from drop tests are available. These include measurements of strains at key locations, such as on the side-stay and torque link, as well as acceleration measurements of the drop carriage and the gear itself, measurements of shock absorber travel, tyre closure, shock absorber pressure and wheel speed. Ground-to-tyre loads are also available through measurements made with a drop test ground reaction platform. The aim is to train the Gaussian process to predict load at a particular location from other available measurements, such as accelerations, or measurements of the shock absorber. If models can be successfully trained, then future load patterns may be predicted using only these measurements. The ultimate aim is to produce an accurate model that can predict the load at a number of locations across the landing gear using measurements that are readily available or may be measured more easily than directly measuring strain on the gear itself (for example, these may be measurements already available on the aircraft, or from a small number of sensors attached to the gear). The drop test data models provide a positive feasibility test which is the basis for moving on to the critical task of prediction on flight test data. For this, a wide range of available flight test measurements are considered for potential model inputs (excluding strain measurements themselves), before attempting to refine the model or use a smaller number of measurements for the prediction.
Lewis Minkin’s Labours: The Developing Party–Trade Union Relationship
Authors: Wickham-Jones Mark
Published: July 2016

In this article, I examine critically the themes raised by Lewis Minkin in his 2014 volume about Labour politics, The Blair Supremacy, within the context of his earlier work concerning the party’s relationship with its affiliated trade unions. I outline his argument concerning the development of party management, especially that regarding ‘a Blair coup’. I discuss the role of norms in political explanation, the importance of formal rules in understanding Labour politics, the significance of wider changes to the party’s character, how best to conceptualise the nature of Tony Blair’s leadership, and, finally, the historical development of the party’s trajectory. I conclude with an overall assessment of Minkin’s corpus and some pointers as to an alternative conceptualisation of Labour’s relationship with its affiliated unions.
The Power of Digital Storytelling as a Culturally Relevant Health Promotion Tool
Authors: Briant Katherine J. , Halter Amy , Marchello Nathan , Escareño Monica , Thompson Beti
Published: July 2016

Digital storytelling is an emergent method in health promotion. It addresses health inequities by combining technology with the voices of members of vulnerable, often underrepresented populations. The overall goal of this pilot project was to explore if digital storytelling could be a culturally relevant health promotion tool for Hispanics/Latinos to share their experiences with cancer, or other diseases. Promotores participated in a train-the-trainer workshop. Community members worked with trained promotores to create digital stories through community workshops. We conducted one-on-one interviews with digital story creators to elicit perspectives and assess their experience. One overarching theme among storytellers was the power of storytelling. Supporting subthemes that emerged in the interviews were (1) connection and communication, (2) lack of opportunities and barriers to telling stories, and (3) potential for disease prevention awareness and education. This study found digital storytelling to be culturally relevant for Hispanics/Latinos of Mexican origin. For these storytellers it was a uniquely valuable tool for sharing personal stories of overcoming or managing health issues. Participants found the digital story experience to be positive and beneficial. It provided a healing outlet to reflect on a difficult experience and find support within one’s own community.
Public Policy Involvement by Certified Health Education Specialists
Authors: Mahas Rachel , Van Wasshenova Emily , Everhart F. Jeannine , Thompson Amy , Boardley Debra
Published: July 2016

Background. Advocating for health-related activities is an essential part of being a health educator and knowing how to advocate is an important part of the Certified Health Education Specialist (CHES) exam. However, based on previous research, there may be a gap between knowing how to and actually participating in public policy activities. The purpose of this study was to determine public policy involvement of CHES. Method. Surveys were mailed to a random sample of 500 CHES (41% response rate). Results. The highest selected public policy activities by CHES were the following: voting at an election (88.9%), contacting a public office (49%), and providing policy-related information (42.9%). The number of locations CHES individuals selected in having training on advocacy was a predictive factor in their confidence to perform advocacy. Positive correlations between perceived knowledge and effectiveness of the public policy process and self-reported involvement in public policy were found. Conclusion. Although there is moderate self-reported involvement in public policy activities, more emphasis needs to be placed on raising the confidence of CHES to perform advocacy-related activities in the field.
From Ticks and Tocks to Budges and Nudges
Authors: Gilmore James N.
Published: July 2016

This article uses the emergence of smartwatch models from 2012 to 2015—including the Pebble Watch, Android Wear, and Apple Watch—to explore the relationship between “instants” and “information.” Through a focus on the ways in which smartwatches notify, buzz, and otherwise touch the skin, this article develops the idea of the “haptic instant” as a key feature of this technology. The haptic instant, in calling attention to the delivery of news alerts, e-mails, personal communication, and other notifications to the wearer’s wrist, is part of the larger formation of bodies capable of living in a culture increasingly reliant on computer information systems for the management of daily life.
Computed Tomography Perfusion, Magnetic Resonance Imaging, and Histopathological Findings After Laparoscopic Renal Cryoablation: An In Vivo Pig Model
Authors: Nielsen Tommy Kjærgaard , Østraat Øyvind , Graumann Ole , Pedersen Bodil Ginnerup , Andersen Gratien , Høyer Søren , Borre Michael
Published: July 2016

The present study investigates how computed tomography perfusion scans and magnetic resonance imaging correlates with the histopathological alterations in renal tissue after cryoablation. A total of 15 pigs were subjected to laparoscopic-assisted cryoablation on both kidneys. After intervention, each animal was randomized to a postoperative follow-up period of 1, 2, or 4 weeks, after which computed tomography perfusion and magnetic resonance imaging scans were performed. Immediately after imaging, open bilateral nephrectomy was performed allowing for histopathological examination of the cryolesions. On computed tomography perfusion and magnetic resonance imaging examinations, rim enhancement was observed in the transition zone of the cryolesion 1week after laparoscopic-assisted cryoablation. This rim enhancement was found to subside after 2 and 4 weeks of follow-up, which was consistent with the microscopic examinations revealing of fibrotic scar tissue formation in the peripheral zone of the cryolesion. On T2 magnetic resonance imaging sequences, a thin hypointense rim surrounded the cryolesion, separating it from the adjacent renal parenchyma. Microscopic examinations revealed hemorrhage and later hemosiderin located in the peripheral zone. No nodular or diffuse contrast enhancement was found in the central zone of the cryolesions at any follow-up stage on neither computed tomography perfusion nor magnetic resonance imaging. On microscopic examinations, the central zone was found to consist of coagulative necrosis 1 week after laparoscopic-assisted cryoablation, which was partially replaced by fibrotic scar tissue 4 weeks following laparoscopic-assisted cryoablation. Both computed tomography perfusion and magnetic resonance imaging found the renal collecting system to be involved at all 3 stages of follow-up, but on microscopic examination, the urothelium was found to be intact in all cases. In conclusion, cryoablation effectively destroyed renal parenchyma, leaving the urothelium intact. Both computed tomography perfusion and magnetic resonance imaging reflect the microscopic findings but with some differences, especially regarding the peripheral zone. Magnetic resonance imaging seems an attractive modality for early postoperative follow-up.
The Farmers’ Improvement Society and the Women’s Barnyard Auxiliary of Texas
Authors: Roberts Andrea R.
Published: July 2016

Historians have brought attention to African-American women’s contributions to planning including housing and social service program delivery. This article builds upon that scholarship by adding the work of the Farmers’ Improvement Society and its Women’s Barnyard Auxiliary, both of which were Progressive-era African American mutual aid groups. This article explores the potential importance of these organizations to planning practice and scholarship; sheds light on the unique approach to planning employed by poor and rural people in mutual aid groups; and challenges popular assumptions about similar Progressive Era, “Uplift Movement” groups.
Hiking
Authors: Mitten Denise , Overholt Jillisa R. , Haynes Francis I. , D’Amore Chiara C. , Ady Janet C.
Published: July 2016

Research has connected sedentary lifestyles with numerous negative health outcomes, including a significant increased risk for mortality. Many health care professionals seek ways to help clients meet physical activity guidelines recommended by the Office of Disease Prevention and Health Promotion, the World Health Organization, and the American College of Sports Medicine in order to promote active lifestyles and improve overall wellness. Hiking is a cost-effective intervention that encourages people to be physically active while spending time in nature. Time in nature can lead to health benefits through contact with the natural elements, participation in physical activity, restoration of mental and emotional health, and time with social contacts. Benefits may be immediate, such as decreased blood pressure, decreased stress levels, enhanced immune system functioning, and restored attention, or transpire over time, such as weight loss, decreased depression, and overall wellness. Health care providers are ideally positioned to recommend and prescribe hiking to clients. Federal, state, and local natural resource agencies are beginning to partner with health care professionals to promote outdoor nature-related activities. Examples of successful doctor and other health care practitioner partnership programs are described, along with tips for getting started.
Prediction and reduction in vehicle noise by frequency response function–based substructuring
Authors: Noh Hee-Min
Published: July 2016

The purpose of this study was to use a hybrid frequency response function–based substructuring synthesis method to predict the structure-borne noise of a vehicle frame resulting due to excitation by the engine and to develop a noise reduction method for optimizing the subframe model. The finite element models of the subframe were first verified by comparing their natural frequencies and frequency response functions with those of the real subframe models. Several substructures were then defined and the vehicle interior noises were predicted using the hybrid frequency response function–based substructuring synthesis method. Based on the prediction results, different target frequency ranges were selected, and different methods for optimizing the subframe model to reduce noise were investigated within the selected frequency ranges. Finally, the subframe modes within the selected frequency ranges were analyzed and new noise reduction models were developed by modifying the thickness of parts of the original subframe.
Flow-induced noise simulation using detached eddy simulation and the finite element acoustic analogy method
Authors: Liu Kai , Zhou Shaoqi , Li Xuexin , Shu Xiumei , Guo Lianhuan , Li Jin , Zhang Xueyan
Published: July 2016

Signals in long-distance pipes are complex due to flow-induced noise generated in special structure, and the computation of these noise sources is difficult and time-consuming. To address this problem, a hybrid method based on computational fluid dynamics and Lighthill’s acoustic analogy theory is proposed to simulate flow-induced noise, with the results showing that the method is sufficient for noise predictions. The proposed method computes the turbulent flow field using detached eddy simulation and then calculates turbulence-generated sound using the finite element acoustic analogy method, which solves acoustic sources as volume sources. The velocity field obtained in the detached eddy simulation computation provides the sound source through interpolation between the computational fluid dynamics and acoustic meshes. The hybrid method is validated and assessed by comparing data from the cavity in pipe and large eddy simulation results. The peak value of flow-induced noise calculated at the monitor point is in good agreement with experimental data available in the literature.
The language of leadership in Laos
Authors: Case Peter , Connell John G. , Jones Michael J.
Published: July 2016

This paper responds to recent calls in the leadership studies literature for anthropologically informed empirical research on leadership phenomena in non-Western and non-Anglophone settings. The authors have worked extensively on rural development projects in Laos and draw on ethnographic ‘observant-participation’ and interview data to explore how leadership is construed in a contested terrain where traditional concepts intersect with those of official government and international development agencies. A theoretical discussion of linguistic relativity and the socially constitutive nature of language in general is offered as background justification for studying the language of leadership in context. The anthropological distinction between etic and emic operations is also introduced to differentiate between various interpretative positions that can be taken in relation to the fieldwork and data discussed in this paper. The study shows how difficult it can be for native Lao speakers to find words to describe leadership or give designations to ‘leaders’ outside of officially sanctioned semantic and social fields. A key finding of the study is that, viewed from the perspective of the Lao People’s Revolutionary Party, authority and leadership are coextensive. This social fact is reflected in the linguistic restrictions on what can and cannot be described as leadership in Laos.
Minimally invasive stabilization of the distal radioulnar joint: a cadaveric study
Authors: de Vries E. N. , Walenkamp M. M. J. , Mulders M. A. M. , Dijkman C. D. , Strackee S. D. , Schep N. W. L.
Published: July 2016

This study describes a minimally invasive procedure for stabilization of the distal radioulnar joint, using a suture-button construct placed percutaneously in the direction of the distal oblique bundle in the distal interosseous membrane. In five cadaveric specimens, placement of the suture-button suspension system reduced dorsal displacement of the radius in an unstable distal radioulnar joint to baseline values, both in neutral position and in pronation and supination. These results indicate the possibility of minimally invasive treatment for distal radioulnar joint instability.
Effect of ice on pain after corticosteroid injection in the hand and wrist: a randomized controlled trial
Authors: An T. W. , Boone S. L. , Boyer M. I. , Gelberman R. H. , Osei D. A. , Calfee R. P.
Published: July 2016

This prospective, randomized controlled study was designed to determine if applying ice to the site of corticosteroid injections in the hand and wrist reduces post-injection pain. Patients receiving corticosteroid injections in the hand or wrist at a tertiary institution were enrolled. Subjects were randomized to apply ice to the injection site and take scheduled over-the-counter analgesics ( n = 36) or take scheduled over-the-counter analgesics alone ( n = 32). There were no significant differences in the mean pain score between the two groups at any time-point (pre-injection or 1–5 days post-injection). In regression modelling, the application of ice did not predict pain after injection. Visual analogue pain scores increased at least 2 points (0–10 scale) after injection in 17 out of 36 patients in the ice group versus ten out of 32 control patients. We conclude that the application of ice in addition to over-the-counter analgesics does not reduce post-injection pain after corticosteroid injection in the hand or wrist.

Level of Evidence: I Therapeutic Study
Children with multiple sclerosis should not become therapeutic hostages
Authors: Rose Klaus , Müller Thomas
Published: July 2016

Background:

Both the United States (US) Food and Drug Administration (FDA) and the European Union (EU) European Medicines Agency (EMA) order pediatric clinical trials as a condition for approval of new compounds. We evaluate clinical value and likelihood of sufficient recruitment for pediatric multiple sclerosis (pMS) studies and discuss US and EU pediatric legislation with pMS as a paradigm.

Methods:

We analyzed pMS clinical trials requested by the FDA and the EMA and industry-sponsored pMS studies registered on www.clinicaltrials.gov and www.clinicaltrialsregister.eu .

Results:

The FDA demands four and the EMA 15 pMS trials

Conclusions:

pMS is rare. Neither FDA nor EMA prioritize compounds for potential benefit in pMS. The EMA in particular orders multiple pMS studies, which will probably not recruit enough patients. Therefore, it is likely that the pMS trial outcomes will not be relevant for evidence-based medicine analyses, clinical practice and a pMS label for the respective drug. EMA requests for multiple pediatric studies have been described in metastasized adolescent melanoma, another very rare pediatric disease. The terms ‘ghost studies’ and ‘therapeutic hostages’ have been proposed for such trials and children whose parents are lured into permitting study participation. Clinical studies are not ethical if the probability is high that they will not provide reasonable outcomes. For now, pMS clinicians will have to continue to use new MS drugs in children off-label. They might consider a more proactive international coordinating role in prioritizing and testing new MS compounds in children.
Neratinib in HER-2-positive breast cancer: results to date and clinical usefulness
Authors: Chan Arlene
Published: July 2016

The management of HER-2-positive breast cancer has improved significantly with the use of targeted agents to the HER-2 signaling pathway. Despite the improved survival achieved with the use of trastuzumab and chemotherapy in both the adjuvant and metastatic setting, patients may still recur or progress; whilst preclinical data demonstrate that these cancer cells remain addicted to the HER-2 oncogene. Neratinib, an oral small molecule tyrosine-kinase inhibitor has efficacy in the metastatic and adjuvant setting of patients who have previously received trastuzumab-based treatment. Diarrhea, being a class effect of tyrosine-kinase inhibitor, is the most common side effect seen following neratinib administration, but recent data suggests that a prophylactic loperamide regimen can reduce the incidence of grade 3 diarrhea. Phase I through to III clinical trials of neratinib will be reviewed, with discussion of the postulated mechanism underlying diarrheal events and its management.
Screening for Diabetic Retinopathy Using a Portable, Noncontact, Nonmydriatic Handheld Retinal Camera
Authors: Zhang Wenlan , Nicholas Peter , Schuman Stefanie Gail , Allingham Michael John , Faridi Ambar , Suthar Tushar , Cousins Scott William , Prakalapakorn Sasapin Grace
Published: July 2016

Background:

Diabetic retinopathy (DR) is a leading cause of low vision and blindness. We evaluated the feasibility of using a handheld, noncontact digital retinal camera, Pictor, to obtain retinal images in dilated and undilated eyes for DR screening. We also evaluated the accuracy of ophthalmologists with different levels of training/experience in grading these images to identify eyes with vision-threatening DR.

Methods:

A prospective study of diabetic adults scheduled to have dilated eye exams at Duke Eye Center from January to May 2014 was conducted. An imager acquired retinal images pre- and postdilation with Pictor and selected 1 pre- and 1 postdilation image per eye. Five masked ophthalmologists graded images for gradability (based on image focus and centration) and the presence of no, mild, moderate, or severe nonproliferative DR (NPDR) or proliferative DR (PDR). Referable disease was defined as moderate or severe NPDR or PDR on image grading. We evaluated feasibility based on the graders’ evaluation of image gradability. We evaluated accuracy of identifying vision-threatening disease (severe NPDR or PDR documented on dilated clinical examination) based on the graders’ sensitivity and specificity of grading referable disease.

Results:

Images were gradable in 86-94% of predilation and 94-97% of postdilation photos. Compared to the dilated clinical exam, overall sensitivity for identifying vision-threatening DR was 64-88% and specificity was 71-90%.

Conclusions:

Pictor can capture retinal images of sufficient quality to screen for DR with and without dilation. Single retinal images obtained using Pictor can identify eyes with vision-threatening DR with high sensitivity and acceptable specificity compared to clinical exam.
Alone, Unhappy, and Demotivated
Authors: Uziel Liad
Published: July 2016

This study explored how a mind-set associated with being alone affects self-regulation among individuals varying in neuroticism. Neuroticism is associated with a dualistic approach to the social world—evaluation apprehension alongside need for approval. Consequently, in public contexts, neuroticism leads individuals to experience low pleasantness alongside high motivation. The impact of neuroticism on behavior alone is rarely studied. However, the absence of a social motivator (i.e., potential for approval) should bring neuroticism to be associated with low pleasantness alongside low motivation. Three studies supported these predictions using an alone/public social context mind-set manipulation. Higher neuroticism was associated with lower declared willingness to exert effort (Study 1) and with lower actual effort expenditure (Studies 2a, 2b) in an alone mind-set than in a public mind-set. Additionally, across conditions, neuroticism was associated with low pleasantness. Thus, neuroticism reduces individuals’ willpower in the context of merely thinking about being alone.
The potential of venetoclax (ABT-199) in chronic lymphocytic leukemia
Authors: Itchaki Gilad , Brown Jennifer R.
Published: July 2016

Venetoclax (VEN, ABT-199/GDC-0199) is an orally bioavailable BH3-mimetic that specifically inhibits the anti-apoptotic B-cell lymphoma/leukemia 2 (BCL2) protein. Although BCL2 overexpression is not genetically driven in chronic lymphocytic leukemia (CLL), it is nearly universal and represents a highly important and prevalent mechanism of apoptosis evasion, making it an attractive therapeutic target. This review summarizes the role of BCL2 in CLL pathogenesis, the development path targeting its inhibition prior to VEN, and the preclinical and clinical data regarding the effectiveness and safety of VEN. We further strive to contextualize VEN in the current CLL treatment landscape and discuss potential mechanisms of resistance.
Adjunctive intra-coronary imaging for the assessment of coronary artery disease
Authors: Shah Nikunj , Ussen Bassey , Mahmoudi Michael
Published: July 2016

Atherosclerotic coronary artery disease remains a leading cause of worldwide morbidity and mortality. Invasive angiography currently remains the gold standard method of diagnosing and treating coronary disease; however, more sophisticated adjunctive interventional technologies have been developed to combat the inter and intra-observer variability frequently encountered in the assessment of lesion severity. Intravascular imaging now plays a key role in optimising percutaneous coronary interventions and provides invaluable information as part of the interventional cardiologist’s diagnostic arsenal. The principles, technical aspects and uses of two modalities of intracoronary imaging, intravascular ultrasound and optical coherence tomography, are discussed. We additionally provide examples of cases where the adjunctive intracoronary imaging was superior to angiography alone in successfully identifying and treating acute coronary syndromes.
Setting up clinical research studies in the National Health Service in England
Authors: Whitburn Jessica , Singh Surjeet , Sooriakumaran Prasanna
Published: July 2016

Starting and conducting clinical trials in England can be a complicated and time-consuming process. Before your study can begin it is necessary to gain approval from the appropriate regulatory bodies. Prior to March 2016, studies required National Health Service (NHS) permission (also referred to as Research and Development (R&D) approval) obtained via the National Institute for Health Research (NIHR) Coordinated System for gaining NHS Permission (CSP). Since March 2016, a new streamlined system has been introduced with the aim of making it easier to gain regulatory approvals. Now studies must go through the process of Health Research Authority (HRA) approval. In this article we review the process of gaining HRA approval in England. The article is aimed at junior researchers to help them understand the application process, and to give tips on how to succeed in gaining approval.
An ‘equity’ domain could strengthen the utility of a framework for assessing care coordination for Australian Aboriginal families
Authors: Chamberlain Catherine R , MacLean Sarah , Bawden Glenda , Kelaher Margaret , Munro-Harrison Emily , Boyle Jacqueline , Freeman Kate
Published: July 2016

Improving the health of Aboriginal people is a national priority and improving coordination of services for Aboriginal families is critical to achieving this goal. A care coordination framework has been developed from a limited range of clinical settings. We reflect on the utility of this framework for assessing service coordination for Aboriginal families in Australia. We conducted stakeholder consultation, service mapping and in-depth interviews with service providers and an Aboriginal mother, using a tool based on the framework domains. A fragmented range of services support Aboriginal families with complex and changing needs, highlighting the importance of care coordination. Relationships underpinned care coordination; however, we identified few opportunities for developing relationships and several factors that undermined relationships, including unclear accountability mechanisms, resource constraints, anxiety about follow-up and transfer of information to child protection. The Care Coordination Framework enabled a ‘systems-perspective’ of the main care coordination domains for Aboriginal families from individual experiences. However, there were some limitations in capturing subtle historical and cultural dimensions affecting care coordination in this context where health care practice in large institutions is framed by the dominant culture. An additional ‘equity’ domain would capture these dimensions, address a growing international policy challenge and strengthen the framework.
Patellar Articular Overlap on MRI Is a Simple Alternative to Conventional Measurements of Patellar Height
Authors: Munch Jacqueline L. , Sullivan Jaron P. , Nguyen Joseph T. , Mintz Douglas , Green Daniel W. , Shubin Stein Beth E. , Strickland Sabrina
Published: July 2016

Background:

Patella alta describes an abnormally high-riding patella in relationship to the femur and has been shown to correlate with patellofemoral pain, instability, chondromalacia, and arthrosis. Conventional measurements of patella alta involve multiple measurements and are often not defined on cross-sectional imaging as related to radiographs.

Hypothesis:

Patellar articular overlap on sagittal magnetic resonance imaging (MRI) will correlate well with conventional measurements of patella alta as measured by a standardized technique defined by our group.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

MRIs of 239 knees were reviewed by 3 attending surgeons with practices focusing on patellofemoral disease, as well as 2 sports medicine fellows and 1 musculoskeletal radiologist. Measurements included articular overlap, percentage of articular coverage, Caton-Deschamps index, Blackburne-Peel index, and modified Insall-Salvati index.

Results:

Interrater reliability was high for Caton-Deschamps, Blackburne-Peel, and modified Insall-Salvati indices (intraclass correlation coefficient [ICC], 0.877, 0.828, and 0.787, respectively). Articular overlap and percentage articular coverage correlated well with each other (ICC, 0.961; P < .001) and with the Caton-Deschamps (overlap r = –0.271, P < .001; coverage r = –0.131, P = .037) and Blackburne-Peel (overlap r = 0.343, P < .001; coverage r = –0.238, P < .001) indices. Articular overlap and percentage coverage failed to correlate with the modified Insall-Salvati index (overlap r = –0.117, P = .091; coverage r = 0.007, P = .918).

Conclusion:

Patellar articular overlap and percentage of patellar articular coverage show promise as a simpler alternative to conventional, ratio-based measurements of patellar height. Future studies are needed to evaluate the range of normal and the relationship to our traditionally used measurements.
Comparing China’s Claims and Policies in the East and South China Seas: Implications for Regional Security
Authors: Yang Fang , Li Mingjiang
Published: July 2016

What is the long-term impact of China’s territorial and maritime security policy in East Asia on regional security? To address this question, we compared China’s claims and actual policies related to the East China Sea and South China Sea and explored the motivations behind Beijing’s position and behaviour in the two disputes. More specifically, we examined a few interrelated issues: (a) similarities and differences in China’s claims in these two disputes from historical and legal perspectives, (b) China’s strategic and security calculations and its changing tactics in handing these two disputes in the past few years and (c) the major factors affecting China’s behaviour in the two disputes. Our conclusion is that China is unlikely to make any major concessions in the near future, and that regional security in East Asia will remain fraught with many uncertainties for a fairly long period of time.
Celtic and Aboriginal Pathways toward a Contemporary Ecospirituality
Authors: Effa Allan
Published: July 2016

In the fifth century a contextualized expression of Christianity emerged in Ireland that profoundly revitalized the church across Europe. The encounter of St. Patrick’s Gospel proclamation with the Irish sense of natural mysticism and sacredness of the world produced an expression of faith that was decidedly earth-affirming. Themes of ecospirituality emerged from this Gospel-culture encounter that are shared with the aboriginal cultures of North America. As we seek to re-express Christian faith in response to today’s ecological crisis, we may shape our conversation by the insights gained by the Christian encounter with Celtic and aboriginal cultures.
The inflammasome pathway in stable COPD and acute exacerbations
Authors: Faner Rosa , Sobradillo Patricia , Noguera Aina , Gomez Cristina , Cruz Tamara , López-Giraldo Alejandra , Ballester Eugeni , Soler Nestor , Arostegui Juan I. , Pelegrín Pablo , Rodriguez-Roisin Roberto , Yagüe Jordi , Cosio Borja G. , Juan Manel , Agustí Alvar
Published: July 2016

Chronic obstructive pulmonary disease (COPD) is characterised by pulmonary and systemic inflammation that bursts during exacerbations of the disease (ECOPD). The NLRP3 inflammasome is a key regulatory molecule of the inflammatory response. Its role in COPD is unclear.

We investigated the NLRP3 inflammasome status in: 1) lung tissue samples from 38 patients with stable COPD, 15 smokers with normal spirometry and 14 never-smokers; and 2) sputum and plasma samples from 56 ECOPD patients, of whom 41 could be reassessed at clinical recovery.

We observed that: 1) in lung tissue samples of stable COPD patients, NLRP3 and interleukin (IL)-1β mRNA were upregulated, but both caspase-1 and ASC were mostly in inactive form, and 2) during infectious ECOPD, caspase-1, oligomeric ASC and associated cytokines (IL-1β, IL-18) were significantly increased in sputum compared with clinical recovery.

The NLRP3 inflammasome is primed, but not activated, in the lungs of clinically stable COPD patients. Inflammasome activation occurs during infectious ECOPD. The results of this study suggest that the inflammasome participates in the inflammatory burst of infectious ECOPD.
An Asian viewpoint on the use of vitamin D and calcium in osteoporosis treatment: Physician and patient attitudes and beliefs
Authors: Chan Siew Pheng , Scott Boyd B , Sen Shuvayu S
Published: July 2016

Background

Osteoporosis treatment guidelines recommend calcium and vitamin D supplementation for both prevention as well as treatment, however, compliance with these guidelines is often unsatisfactory. This study investigated the opinion of Asian physicians and Asian patients regarding vitamin D and calcium and patients' use of both.

Methods

Physicians selected from Malaysia, Taiwan, Philippines, Korea and Singapore were asked to grade the significance of vitamin D and calcium in the treatment of osteoporosis and their patients' use of these supplements. In addition, physicians recruited seven eligible osteoporotic women to answer a questionnaire to determine their use of vitamin D and calcium, and their attitudes and beliefs regarding these supplements.

Results

In total, 237 physicians and 1463 osteoporosis patients completed the questionnaire. The results revealed that 22% of physicians in Malaysia, 12% in Taiwan, 72% in the Philippines, 50% in Korea and 24% in Singapore rated the importance of vitamin D supplementation as being extremely important. For calcium, 27% of physicians in Malaysia, 30% in Taiwan, 80% in the Philippines, 50% in Korea and 38% in Singapore rated the importance as being extremely important. Forty-three percent of patients in Malaysia, 38% in Taiwan, 73% in the Philippines, 35% in Korea and 39% in Singapore rated the importance of vitamin D as being extremely important. For calcium, 69% of patients in Malaysia, 58% in Taiwan, 90% in the Philippines, 70% in Korea and 55% in Singapore rated the importance as being extremely important. In addition, results of the patient questionnaire revealed that only a very small number regularly took both supplements. In addition, the results indicated that, with the exception of patients from the Philippines, the majority of patients had no or infrequent discussion with their physician about vitamin D and calcium.

Conclusions

There is generally suboptimal appreciation by both physicians and patients of the importance of vitamin D and calcium for maintenance of bone health as reflected in the low number of patients who reported regularly taking these supplements. Recognition of this problem should translate to appropriate action to improve education for both physicians and patients, with a goal to increase use of these supplements among Asian patients with osteoporosis.
Does osteoporosis predispose falls? a study on obstacle avoidance and balance confidence
Authors: Smulders Ellen , van Lankveld Wim , Laan Roland , Duysens Jacques , Weerdesteyn Vivian
Published: July 2016

Background

Osteoporosis is associated with changes in balance and physical performance and has psychosocial consequences which increase the risk of falling. Most falls occur during walking; therefore an efficient obstacle avoidance performance might contribute to a reduction in fall risk. Since it was shown that persons with osteoporosis are unstable during obstacle crossing it was hypothesized that they more frequently hit obstacles, specifically under challenging conditions.

The aim of the study was to investigate whether obstacle avoidance ability was affected in persons with osteoporosis compared to a comparison group of a community sample of older adults.

Methods

Obstacle avoidance performance was measured on a treadmill and compared between persons with osteoporosis (n = 85) and the comparison group (n = 99). The obstacle was released at different available response times (ART) to create different levels of difficulty by increasing time pressure. Furthermore, balance confidence, measured with the short ABC-questionnaire, was compared between the groups.

Results

No differences were found between the groups in success rates on the obstacle avoidance task (p = 0.173). Furthermore, the persons with osteoporosis had similar levels of balance confidence as the comparison group (p = 0.091). The level of balance confidence was not associated with the performance on the obstacle avoidance task (p = 0.145).

Conclusion

Obstacle avoidance abilities were not impaired in persons with osteoporosis and they did not experience less balance confidence than the comparison group. These findings imply that persons with osteoporosis do not have an additional risk of falling because of poorer obstacle avoidance abilities.
Meat consumption and risk of primary hip and knee joint replacement due to osteoarthritis: a prospective cohort study
Authors: Wang Yuanyuan , Simpson Julie Anne , Wluka Anita E , English Dallas R , Giles Graham G , Graves Stephen , Cicuttini Flavia M
Published: July 2016

Background

There is emerging evidence for a beneficial effect of meat consumption on the musculoskeletal system. However, whether it affects the risk of knee and hip osteoarthritis is unknown. We performed a prospective cohort study to examine the relationship between meat consumption and risk of primary hip and knee replacement for osteoarthritis.

Methods

Eligible 35,331 participants were selected from the Melbourne Collaborative Cohort Study recruited during 1990-1994. Consumption of fresh red meat, processed meat, chicken, and fish was assessed using a food frequency questionnaire. Primary hip and knee replacement for osteoarthritis during 2001-2005 was determined by linking the cohort records to the Australian National Joint Replacement Registry.

Results

There was a negative dose-response relationship between fresh red meat consumption and the risk of hip replacement (hazard ratio (HR) 0.94 per increase in intake of one time/week, 95% confidence interval (CI) 0.89-0.98). In contrast, there was no association with knee replacement risk (HR 0.98, 95% CI 0.94-1.02). Consumption of processed meat, chicken and fish were not associated with risk of hip or knee replacement.

Conclusion

A high level consumption of fresh red meat was associated with a decreased risk of hip, but not knee, joint replacement for osteoarthritis. One possible mechanism to explain these differential associations may be via an effect of meat intake on bone strength and hip shape. Further confirmatory studies are warranted.
DIRECT trial. Diverticulitis recurrences or continuing symptoms: Operative versus conservative Treatment. A MULTICENTER RANDOMISED CLINICAL TRIAL
Authors: van de Wall Bryan JM , Draaisma Werner A , Consten Esther CJ , van der Graaf Yolanda , Otten Marten H , de Wit G Ardine , van Stel Henk F , Gerhards Michael F , Wiezer Marinus J , Cense Huib A , Stockmann Hein BAC , Leijtens Jeroen WA , Zimmerman David DE , Belgers Eric , van Wagensveld Bart A , Sonneveld Eric DJA , Prins Hubert A , Coene Peter PLO , Karsten Tom M , Klaase Joost M , Statius Muller Markwin G , Crolla Rogier MPH , Broeders Ivo AMJ ,   the Dutch Diverticular Disease (3D) Collaborative Study Group
Published: July 2016

Background

Persisting abdominal complaints are common after an episode of diverticulitis treated conservatively. Furthermore, some patients develop frequent recurrences. These two groups of patients suffer greatly from their disease, as shown by impaired health related quality of life and increased costs due to multiple specialist consultations, pain medication and productivity losses.

Both conservative and operative management of patients with persisting abdominal complaints after an episode of diverticulitis and/or frequently recurring diverticulitis are applied. However, direct comparison by a randomised controlled trial is necessary to determine which is superior in relieving symptoms, optimising health related quality of life, minimising costs and preventing diverticulitis recurrences against acceptable morbidity and mortality associated with surgery or the occurrence of a complicated recurrence after conservative management.

We, therefore, constructed a randomised clinical trial comparing these two treatment strategies.

Methods/design

The DIRECT trial is a multicenter randomised clinical trial. Patients (18-75 years) presenting themselves with persisting abdominal complaints after an episode of diverticulitis and/or three or more recurrences within 2 years will be included and randomised. Patients randomised for conservative treatment are treated according to the current daily practice (antibiotics, analgetics and/or expectant management). Patients randomised for elective resection will undergo an elective resection of the affected colon segment. Preferably, a laparoscopic approach is used.

The primary outcome is health related quality of life measured by the Gastro-intestinal Quality of Life Index, Short-Form 36, EQ-5D and a visual analogue scale for pain quantification. Secondary endpoints are morbidity, mortality and total costs. The total follow-up will be three years.

Discussion

Considering the high incidence and the multicenter design of this study, it may be assumed that the number of patients needed for this study (n = 214), may be gathered within one and a half year.

Depending on the expertise and available equipment, we prefer to perform a laparoscopic resection on patients randomised for elective surgery. Should this be impossible, an open technique may be used as this also reflects the current situation.

Trial Registration

(Trial register number: NTR1478)
Leiomyoma of the bladder presenting as acute urinary retention in a female patient: urodynamic analysis of lower urinary tract symptom; a case report
Authors: Matsushima Masashi , Asakura Hirotaka , Sakamoto Hirofumi , Horinaga Minoru , Nakahira Yoko , Yanaihara Hitoshi
Published: July 2016

Background

Most bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare. Leiomyoma of the bladder is the most common benign neoplasm. We present a case of leiomyoma of the bladder presenting with acute urinary retention in a female patient and report on the post-operative change in urodynamic findings. To our knowledge, few cases of this kind have been reported.

Case Presentation

A 56-year-old woman presented with acute urinary retention. Evaluations including ultrasound, magnetic resonance imaging, cystoscopy, and urodynamics contributed to a diagnosis of leiomyoma of the bladder. Various medications were ineffective for solving her lower urinary tract symptoms; therefore, a transurethral resection was performed. The final pathological report was leiomyoma. After the operation, her symptoms resolved; this improvement was confirmed by an urodynamic analysis. The postoperative urodynamics demonstrated a lower frequency of detrusor overactivity during filling cystometry and an increase in the uroflow rate, with reduced detrusor pressure in a pressure flow study.

Conclusions

Leiomyoma of the bladder can cause female outlet obstruction. A review of the literature and disease management is discussed.