bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Melanoma of the Petrous Temporal Bone
Authors: McJunkin Jonathan L. , Wiet Richard J.
Published: January 2019

Melanoma is a malignant tumor of melanocytes that is predominantly found in the skin. In rare cases, it arises from mucosal melanocytes. We describe a case of a solitary melanoma of the petrous apex of the temporal bone in a 67-year-old woman who presented with sudden hearing loss, aural fullness, and headaches, all on the right side. Magnetic resonance imaging identified a mass located at the right petrous apex; the lesion was hyperintense on T1-weighted imaging and isointense on T2 weighting, and it enhanced brightly with gadolinium contrast. The patient underwent removal of the lesion via a transcochlear approach with facial nerve translocation. Intra- and postoperative pathology identified a poorly differentiated malignancy consistent with a melanoma. Further investigations found no evidence of metastasis. Given a concern for residual disease, the patient was treated with radiation to the primary site. To the best of our knowledge, only 1 other case of primary melanoma of the petrous apex has been described in the literature.
Nasal Myiasis: A Case Report
Authors: White Zrria L. , Chu Michael W. , Hood Richard J.
Published: January 2019

Nasal myiasis is a rare condition, with only a few reported cases and no treatment consensus. We propose a conservative treatment approach with saline irrigation and debridement. Two patients in the ICU of Norfolk General Hospital, a tertiary academic referral center, presented simultaneously with nasal myiasis. Both patients were negative for necrotic masses or tumors, and neither patient had any contributory medical comorbidities. Both patients were treated conservatively with a single dose of pyrantel pamoate, daily sinus irrigation with saline, and daily bedside endoscopic debridement. After 2 days, the nasal myiasis resolved, and both patients recovered without sequelae. We conclude that this conservative, nonsurgical approach to management is both safe and effective.
Primary Sinonasal Meningioma in a Child
Authors: Mondal Dodul , Jana Manisha , Kumar Sur Prabir , Khan Ebnam Murshed
Published: January 2019

Meningiomas are common intracranial extra-axial masses. They are rarely encountered in extracranial locations; when they are, the most common head and neck locations are the paranasal sinuses and the temporal bone. Meningiomas in children are very rare, especially in the neonatal period. The clinical presentation and clinical findings are often nonspecific. The diagnosis can be established by imaging and histopathologic examination with immunohistochemistry. We describe a case of primary sinonasal meningioma in a 2-year-old boy whose onset of symptoms had begun during the neonatal period. We discuss the clinical features, imaging results, and histopathologic and immunohistochemical findings in this case.
Use of Tragal Cartilage Grafts in Rhinoplasty: An Anatomic Study and Review of the Literature
Authors: Rabie Amr N. , Chang Jerry , Ibrahim Ahmed M.S. , Lee Bernard T. , Lin Samuel J.
Published: January 2019

We conducted a cadaveric study to determine the size of cartilage grafts that can be taken from the tragus without distorting tragal anatomy. Our subjects included 7 fresh cadavers—3 male and 4 female (age at death: 61 to 87 yr). Tragal cartilage grafts were harvested while leaving the lateral 3 mm of the tragal cartilage in situ to preserve the anatomic shape of the tragus. The grafts were measured and their dimensions recorded. The craniocaudal dimensions of the tragal cartilages ranged from 15 to 30 mm (mean: 21.6), and the width of each specimen ranged from 10 to 23 mm (mean: 15.3). The thickness of the cartilage was approximately 1 mm. The grafts were slightly curved along their long axis. We also review the literature regarding the dimensions of different grafts used in rhinoplasty, knowledge of which can help in preoperative planning. Tragal cartilage grafts have been used as shield, alar contour, alar batten, lateral crural onlay, dorsal onlay, and infratip lobule grafts. When a straight and/or thick graft is needed, two strips of tragal cartilage can be sutured in a mirror-image configuration.
Onodi Cell Mucocele: Case Report and Review of the Literature
Authors: Lee John M. , Au Michael
Published: January 2019

Onodi cell mucoceles are rare entities that can cause devastating ocular complications if not treated promptly. Delays in the diagnosis are possible because of the wide range of differential diagnoses of unilateral retrobulbar optic neuropathy. We describe a new case of Onodi cell mucocele in a 39-year-old woman, and we present a comprehensive review of the literature on this entity. To the best of our knowledge, no review of Onodi cell mucoceles has been previously published. Our review found that 69% of patients with an Onodi cell mucocele experienced an improvement in vision after surgical decompression. The vast majority of these patients underwent endoscopic decompression; the timing of surgical decompression did not appear to affect outcomes in terms of vision. Onodi cell mucocele requires a high degree of clinical suspicion for diagnosis and a multidisciplinary approach to management that involves primary care physicians, ophthalmologists, and otolaryngologists. Early surgical treatment via an endoscopic approach is recommended for most patients, regardless of the duration of their ophthalmologic signs and symptoms.
Sensorineural Hearing Loss after Otitis Media with Effusion and Subacute Mastoiditis after Viral Infections of the Upper Respiratory Tract: A Comparative Study of Conservative and Surgical Treatment
Authors: Wilhelm Thomas , Stelzer Tim , Hagen Rudolf
Published: January 2019

Involvement of the middle ear after viral infections of the upper airways may lead to serous otitis media with effusion in the absence of bacterial infection. This can be accompanied by a concomitant shading of the mastoid air cells, which could manifest as a reduced opacity on computed tomography (CT) in the absence of a history of chronic mastoiditis or acute inflammatory signs. This can lead to a subsequent impairment of inner ear function. CT scans reveal an extended pneumatization of the temporal bones in affected patients. Inner ear hearing impairment can probably be attributed to a concomitant labyrinthine reaction—the so-called toxic inner ear lesion. If no remission occurs within 5 days after initial conservative treatment (paracentesis or hemorrheologic infusions), surgical treatment with a mastoidectomy can accelerate hearing restoration. We conducted a retrospective, nonrandomized study of short- and long-term hearing outcomes in patients with a toxic inner ear lesion who had been treated with conservative measures alone (CONS group) or with surgery (SURG group) in a tertiary care referral center. Our study group was made up of 52 consecutively presenting patients (57 ears) who had been seen over a 10-year period; there were 20 patients (21 ears) in the CONS group and 32 patients (36 ears) in the SURG group. Initially, 15 CONS patients (75%) and 18 SURG patients (56%) complained of dizziness or a balance disorder. The initial averaged sensorineural hearing loss (over 0.5, 1.0, 2.0, and 3.0 kHz) was 32.4 ± 15.6 dB in the CONS group and 35.4 ± 12.0 dB in the SURG group. At follow-up (mean: 31.7 mo), the SURG group experienced a significantly greater improvement in hearing (p = 0.025). We conclude that patients with viral otitis media and concomitant noninflammatory mastoiditis with impairment of inner ear function (sensorineural hearing loss) experience a better hearing outcome when a mastoidectomy is performed during primary treatment.
Validation of Olfactory Threshold Testing Methods
Authors: Hirsch Alan , Roussos Alexander , Freels Sally
Published: January 2019

In patients with chemosensory complaints, a head-to-head comparison of unilateral olfaction threshold testing with the Phenyl Ethyl Alcohol Smell Threshold Test (PEA) and the OLFACT-RL Odor Threshold Test (OLFACT-RL) was undertaken. The charts of 23 consecutive patients presenting with chemosensory complaints seen at the Smell and Taste Treatment and Research Foundation were reviewed and information extracted per Institutional Review Board guidelines. All patients had undergone olfactory testing with the PEA test and the OLFACT-RL test in accordance with their published administration manuals. Using Spearman correlation coefficients to measure the statistical correlation between tests, we found evidence of a correlation between PEA and OLFACT-RL values on the left side only, overall (r = 0.49, p = 0.0184); in those who had hyposmia and did not have anosmia (r = 0.42, p = 0.0668); in those who did not have burning mouth syndrome (r = 0.46, p = 0.0304); and in those who did not have dysosmia (r = 0.47, p = 0.0553). There is no evidence of a correlation on the right side. The correlation for the left nostril suggests that these tests may be interchangeable. However, lack of correlation with the right nostril requires further investigation.
Breast Cancer Metastases to the Head and Neck: Case Series and Literature Review
Authors: Tracy Jeremiah C. , Mildenhall Nicholas R. , Wein Richard O. , O'Leary Miriam A.
Published: January 2019

Breast cancer is the most common cancer in women and is the second most common cause of cancer-related death. Despite the relatively high prevalence of this disease, breast cancer manifestations in the head and neck are relatively rare. Supraclavicular lymphadenopathy and bony metastases to the mandible and maxilla are the most common manifestation of breast cancer in the head and neck. Head and neck metastases are the first presentation of distant disease in approximately one-third of cases. The prognosis of breast cancer with distant metastases to the head and neck is generally poor, and the management of these lesions is controversial. Overall extent of disease and individual patient prognosis must guide treatment decisions. Atypical cases including maxillary sinus mass, jugular foramen mass, and dermal metastases are presented. Metastatic breast cancer is a rare diagnosis in the head and neck, yet metastatic disease from an infraclavicular primary deserves inclusion on any comprehensive differential diagnosis list. In women, breast carcinoma is the most common infraclavicular primary to metastasize to the head and neck.
Balloon Dilation of the Eustachian Tube: 12‐Month Follow‐up of the Randomized Controlled Trial Treatment Group
Authors: Anand Vijay , Poe Dennis , Dean Marc , Roberts William , Stolovitzky Pablo , Hoffmann Karen , Nachlas Nathan , Light Joshua , Widick Mark , Sugrue John , Elliott C. Layton , Rosenberg Seth , Guillory Paul , Brown Neil , Syms Charles , Hilton Christopher , McElveen John , Singh Ameet , Weiss Raymond , Arriaga Moises , Leopold John
Published: January 2019

Objective

Obstructive eustachian tube dysfunction (OETD) affects up to 5% of adults; however, available treatment strategies have limitations. It was previously reported that balloon dilation of the eustachian tube (BDET) with the eustachian tube balloon catheter + medical management (MM) results in a significantly higher proportion of subjects with normalized tympanograms versus MM alone at 6‐ and 24‐week follow‐up. The current analysis extends these initial findings by investigating the durability of BDET + MM treatment outcomes through 52 weeks.

Study Design

Prospective cohort follow‐up study from the treatment group in a previously reported multicenter randomized controlled trial.

Setting

Twenty‐one investigational sites across the United States.

Subjects and Methods

Here we report on secondary and exploratory endpoints for patients with OETD who previously failed MM and were randomized to the BDET + MM cohort. Analyses of tympanogram outcomes are reported by ear, unless specified otherwise, as a more accurate measure of durability of the procedure over time.

Results

Among subjects randomized to BDET + MM, the overall number with normalized tympanograms and ETDQ‐7 scores (Eustachian Tube Dysfunction Questionnaire–7) remained comparable to those reported at 6‐ versus 52‐week follow‐up: tympanograms, 73 of 143 (51.0%) versus 71 of 128 (55.5%); ETDQ‐7, 79 of 142 (55.6%) versus 71 of 124 (57.3%). The overall number of ears with normalized tympanograms also remained comparable, with 117 of 204 (57%) versus 119 of 187 (63.6%).

Conclusions

The present study suggests that the beneficial effects of BDET + MM on tympanogram normalization and symptoms of subjects with refractory OETD demonstrate significant durability that is clinically relevant through 52 weeks.
Biosorption of reactive yellow dye by malt bagasse
Authors: da Silva Bruna C , Zanutto Adriane , Pietrobelli Juliana MTA
Published: January 2019

This research evaluated the biosorption potential of the 134% Yellow Reafix BR2 dye by the malt bagasse. Tests were conducted at batch conditions, under controlled agitation, pH, and temperature. The biosorbent was characterized through scanning electron microscopy and Fourier transform infrared spectroscopy, before and after biosorption. Malt bagasse presented a point of zero charge at 6.75. In the process variables evaluation, there was a greater biosorption potential in acidic pH, without a significant influence of size on the biosorbent particles. The equilibrium time was achieved in 360 min, with approximately 93% removal at the evaluated temperatures. The experimental data were best represented by the pseudo-second-order model. Biosorption was characterized as spontaneous and endothermic, with indicative of physical. Considering the equilibrium, the Langmuir isotherm was the one that best fit the experimental data, with a maximum biosorption capacity of 68.75 mg g–1 (at 303 K and pH 2). The removal suffered no significant interference with the presence of another dye nor with the increase of ionic strength. Thus, the malt bagasse shows potential to be used as a biosorbent in treatment systems of industrial effluents.
Being Brothers or Pretending To Be: Merchants, Artisans, Inn-keepers, Painters & Brothers in Seventeenth-Century Rome
Authors: Borello Benedetta
Published: January 2019

How important was it for merchants, artisans, inn-keepers and painters to have brothers and to work with them? By cross-referencing different sources (states of souls, testaments, inventories, court papers, compilations of legal and notary deeds), this article seeks to answer the question by taking some crucial aspects into consideration: daily life in the family home and other forms of cohabitation, the transmission of work tools and of vocations, the training of new generations and the support provided to family members in trouble. Seventeenth-century Rome is an interesting vantage point from which to investigate the importance of brothers' companies. The presence of the Papal Roman court extended employment opportunities, not only for courtiers, artists and servants who moved from one embassy to another and from one cardinal's court to another, but also for all those men (more men than women) on the margins who were able to earn some money from the conspicuous consumption of the upper classes. The flexibility of the labour market and the widespread phenomenon of male cohabitation could undermine the strength of family companies.
Traditions of Armed Volunteering and Radical Politics in Southern Europe: A Biographical Approach to Garibaldinism
Authors: Acciai Enrico
Published: January 2019

Historiography rarely concerns itself with investigating the capacity that war volunteering has to endure and persist across time; that is, not only the continuation of memories passed down from one generation of fighters to another, but also its ability to reactivate itself as soon as a new movement of volunteers begins. Between the nineteenth and twentieth centuries, there were successive generations of volunteers who, as well as wearing the Garibaldian red shirt and aligning themselves with that tradition, were also political activists belonging to extreme left-wing organizations. In these cases, it was not only that Garibaldinism was considered to be an important part of the political horizon, but also – and this is what will be explored in this article – that there was a tradition of war volunteering that was passed down through generations and that was clearly linked to the Garibaldian red-shirt tradition. The article will follow Amilcare Cipriani’s biography. A young Garibaldi volunteer, he soon moved towards internationalism (he was one of the defenders of the Paris commune) and lived a good part of his life moving continuously between Europe and Northern Africa. At the end of the century, in 1897, he was amongst the principle actors in a Garibaldian campaign that would pave the way for the next steps in the red-shirt volunteering tradition.
Balanced single-vector co-delivery of VEGF/PDGF-BB improves functional collateralization in chronic cerebral ischemia
Authors: Marushima Aiki , Nieminen Melina , Kremenetskaia Irina , Gianni-Barrera Roberto , Woitzik Johannes , von Degenfeld Georges , Banfi Andrea , Vajkoczy Peter , Hecht Nils
Published: January 2019

The myoblast-mediated delivery of angiogenic genes represents a cell-based approach for targeted induction of therapeutic collateralization. Here, we tested the superiority of myoblast-mediated co-delivery of vascular endothelial growth factor-A (VEGF) together with platelet-derived growth factor-BB (PDGF-BB) on transpial collateralization of an indirect encephalomyosynangiosis (EMS) in a model of chronic cerebral ischemia. Mouse myoblasts expressing a reporter gene alone (empty vector), VEGF, PDGF-BB or VEGF and PDGF-BB through a single bi-cistronic vector (VIP) were implanted into the temporalis muscle of an EMS following permanent ipsilateral internal carotid artery occlusion in adult, male C57BL/6N mice. Over 84 days, myoblast engraftment and gene product expression, hemodynamic impairment, transpial collateralization, angiogenesis, pericyte recruitment and post-ischemic neuroprotection were assessed. By day 42, animals that received PDGF-BB in combination with VEGF (VIP) showed superior hemodynamic recovery, EMS collateralization and ischemic protection with improved pericyte recruitment around the parenchymal vessels and EMS collaterals. Also, supplementation of PDGF-BB resulted in a striking astrocytic activation with intrinsic VEGF mobilization in the cortex below the EMS. Our findings suggest that EMS surgery together with myoblast-mediated co-delivery of VEGF/PDGF-BB may have the potential to serve as a novel treatment strategy for augmentation of collateral flow in the chronically hypoperfused brain.
Magnetic resonance imaging findings in idiopathic sudden sensorineural hearing loss
Authors: Clyde Joseph W , Patel Vijay A , Kanekar Sangam , Isildak Huseyin
Published: January 2019

Background

The unpredictability in presenting signs and symptoms of idiopathic sudden sensorineural hearing loss (SSNHL) presents a notable diagnostic challenge for clinicians. Previous studies have confirmed the potentially important role of magnetic resonance imaging (MRI) in the diagnosis and prognostication of idiopathic SSNHL to guide definitive medical therapy, but correlations of these findings with outcomes remain controversial.

Purpose

To evaluate and identify magnetic resonance imaging (MRI) findings associated with idiopathic sudden sensorineural hearing loss (SSNHL).

Material and Methods

Sixty-eight patients with a documented diagnosis of idiopathic SSNHL and 20 controls underwent 1.5-T or 3-T MRI of the brain. Age, gender, ethnicity, associated co-morbidities, and audiometry findings were also recorded. Statistical analysis was performed to compare outcome measures between idiopathic SSNHL and control groups.

Results

The mean age of the cohort was 57 ± 17 years, with a male-to-female ratio of 1:1.1. MRI findings include 25.0% ( P = 1.000) with chronic microangiopathic disease, 14.7% ( P = 0.165) with temporal bone aberrations, 13.2% ( P = 0.165) with facial and/or vestibulocochlear nerve complex changes, 11.8% ( P = 1.000) with venous malformations, 8.8% ( P = 0.104) with arterial malformations, and 8.8% ( P = 0.184) with cerebral and/or brainstem parenchymal disease.

Conclusion

Arteriovenous malformations and central neurologic disease are not directly associated with idiopathic SSNHL on MRI. However, visualized signal changes of inner ear structures and facial/vestibulocochlear nerve complex support previously postulated theories, which include viral as well as inflammatory processes in the development of idiopathic SSNHL.
Meta-analysis of the efficacy of sexual intercourse for distal ureteric stones
Authors: Xu Bin , Yan Huilei , Zhang Xuebao , Cui Yuanshan
Published: January 2019

Objective

This meta-analysis was performed to evaluate the efficacy of sexual intercourse for treatment of distal ureteral stones.

Methods

Randomized controlled trials (RCTs) of sexual intercourse for treatment of distal ureteral stones were searched using PubMed, EMBASE, and the Cochrane Controlled Trials Register.

Results

Three RCTs comprising 240 patients were included in the meta-analysis, which showed that sexual intercourse was effective in treating distal ureteral stones. The expulsion rate of distal ureteral stones at the second week (odds ratio [OR] = 6.61, 95% confidence interval [CI]: 3.66 to 11.94), expulsion rate of distal ureteral stones at the fourth week (OR = 4.00, 95% CI: 2.09 to 7.64), and number of analgesic injections (mean difference [MD] = −0.79, 95% CI: −1.51 to −0.08) indicated that sexual intercourse was more effective than placebo. However, the mean expulsion time of distal ureteral stones (MD = −3.98, 95% CI: −8.77 to 0.81) showed no difference between sexual intercourse and placebo.

Conclusions

Compared with placebo, sexual intercourse exhibited greater efficacy for the treatment of distal ureteral stones, whilst potentially alleviating pain.
Fracture and dislocation of lumbar vertebrae with entrapment of small bowel: A case report and literature review
Authors: Jing Xiaowei , Gong Zhiyuan , Zhang Ning , Chen Gang , Li Fangcai , Chen Qixin , Xu Zhengkuan , Zhang Rui
Published: January 2019

Traumatic incarceration of the small bowel accompanied by vertebral fractures and dislocation is rare and usually misdiagnosed until laparotomy. This report presents a rare case of jejunum entrapment between lumbar spine fractures. A 43-year-old man was clamped between two railway tracks on the upper abdomen and lower back. Following ineffective conservative treatment, he underwent a laparotomy due to the development of guarding and rebound tenderness. Loss of vitality of the jejunal loop, which was incarcerated between the L3 and L4 vertebrae, was observed. The necrotic bowel was removed and end-to-end anastomosis was performed. When his condition was stable, anterior and posterior lumbar fixation surgery was performed. The patient had no abdominal complications and lower limb nerve function deficiency during the follow-up period. A review of the literature since 1979 on incarceration of the bowel associated with lumbar fracture and dislocation identified 12 cases: five patients showed persistent neurological symptoms, but none of the patients died as a result of their injuries. It should be borne in mind that patients with hyperextension or flexion-distraction injury of the lumbar spine could show symptoms of intestinal obstruction and bowel incarceration. Enhanced computed tomography or magnetic resonance imaging will be helpful for diagnosis.
A Marvelous Machine: Creative Approaches to Securing Funding and Building Public Support for Streetcar Projects in Four U.S. Cities
Authors: Wood James P. , Brown Jeffrey R.
Published: January 2019

The resurgence of streetcars in American cities has presented planners and civic leaders with a novel means of transportation and redevelopment for cities, many of which have a history of failed regional transit votes and suburban domination of regional planning bodies. To overcome these political and financial obstacles, supporters have engaged in a host of creative strategies to satisfy or bypass streetcar critics. Using a case study of four American cities with recently built streetcars (Atlanta, Cincinnati, Kansas City, and Tucson), this paper explores these strategies from the perspective of streetcar supporters. Results indicate streetcar projects in these cities were pursued in part because each city had faced at least one failed rail-transit vote in recent years (usually involving light rail). Supporters of streetcar plans anticipated vocal citizen opposition based on those past failures; however, in most cases this did not materialize to the expected degree. This suggests that narrowly focused and lower-cost streetcar projects can avoid the contentious opposition of pricey regional light-rail proposals by offering a different product and/or seeking fewer local dollars. Results also indicate widespread distrust for regional planning structures and a willingness of local boosters to bypass those entities and apply directly for federal funds. Although not all four cities ended up with the streetcar they envisioned, the findings nevertheless document an eagerness on the part of proponents to seek transit projects that transform public opinion, circumvent a burdensome regional planning process, and take advantage of a national funding environment willing to fund streetcars in urban areas.
Segment-Based Approach for Assessing Hazard Risk of Coastal Highways in Hawai‘i
Authors: Togia Harrison , Francis Oceana P. , Kim Karl , Zhang Guohui
Published: January 2019

Hazards to roadways and travelers can be drastically different because hazards are largely dependent on the regional environment and climate. This paper describes the development of a qualitative method for assessing infrastructure importance and hazard exposure for rural highway segments in Hawai‘i under different conditions. Multiple indicators of roadway importance are considered, including traffic volume, population served, accessibility, connectivity, reliability, land use, and roadway connection to critical infrastructures, such as hospitals and police stations. The method of evaluating roadway hazards and importance can be tailored to fit different regional hazard scenarios. It assimilates data from diverse sources to estimate risks of disruption. A case study for Highway HI83 in Hawai‘i, which is exposed to multiple hazards, is conducted. Weakening of the road by coastal erosion, inundation from sea level rise, and rockfall hazards require adaptation solutions. By analyzing the risk of disruption to highway segments, adaptation approaches can be prioritized. Using readily available geographic information system data sets for the exposure and impacts of potential hazards, this method could be adapted not only for emergency management but also for planning, design, and engineering of resilient highways.
Biomechanical Comparison of 3 Novel Repair Techniques for Radial Tears of the Medial Meniscus: The 2-Tunnel Transtibial Technique, a “Hybrid” Horizontal and Vertical Mattress Suture Configuration, and a Combined “Hybrid Tunnel” Technique
Authors: Buckley Patrick S. , Kemler Bryson R. , Robbins Colin M. , Aman Zachary S. , Storaci Hunter W. , Dornan Grant J. , LaPrade Robert F.
Published: January 2019

Background:

Historically, radial meniscal tears were treated with partial or near-total meniscectomy, which usually resulted in poor outcomes. Radial meniscal tears function similar to a total meniscectomy and are challenging to treat. Repair of radial meniscal tears should be performed to prevent joint deterioration and the need for salvage procedures in the future.

Purpose/Hypothesis:

The purpose was to compare 3 repair techniques for radial tears of the medial meniscus: the 2-tunnel, hybrid, and hybrid tunnel techniques. It was hypothesized that there would be no differences among the 3 groups in regard to gapping and ultimate failure strength.

Study Design:

Controlled laboratory study.

Methods:

Thirty human male cadaver knees (10 matched pairs, n = 20; 10 unpaired, n = 10) were used to compare the 2-tunnel, hybrid, and hybrid tunnel repairs. A complete radial tear was made at the midbody of the medial meniscus. Repairs were performed according to the described techniques. Specimens were potted and mounted on a universal material testing machine where each specimen was cyclically loaded for 1000 cycles before experiencing a pull to failure. Gap distances at the tear site, ultimate failure load, and failure location were measured and recorded.

Results:

After 1000 cycles of cyclic loading, there were no significant differences in displacement among the 2-tunnel repair (3.0 ± 1.7 mm), hybrid repair (3.0 ± 0.9 mm), and hybrid tunnel repair (2.3 ± 1.0 mm; P = .4042). On pull-to-failure testing, there were also no significant differences in ultimate failure strength among the 2-tunnel repair (259 ± 103 N), hybrid repair (349 ± 149 N), and hybrid tunnel repair (365 ± 146 N; P = .26). However, the addition of vertical mattress sutures to act as a “rip stop” significantly reduced the likelihood of the sutures pulling through the meniscus during pull-to-failure testing for the hybrid and hybrid tunnel repairs (4 of 16, 25%) as compared with the 2-tunnel repair (7 of 9, 78%; P = .017).

Conclusion:

The results showed equivalent biomechanical testing with regard to gap distance and pull-to-failure strength among the 3 repairs. The addition of the vertical mattress sutures to act as a rip stop was effective in preventing meniscal cutout through the meniscus.

Clinical Relevance:

Effective healing of radial meniscal tears after repair is paramount to prevent joint deterioration and symptom development. Each tested repair showed a biomechanically equivalent and stable construct to use to repair radial meniscal tears. The authors recommend that rip stop vertical mattress sutures be used, especially in poor-quality meniscal tissue, to prevent suture cutout.
Swallowing Impairments Increase Emotional Burden in Spousal Caregivers of Older Adults
Authors: Shune Samantha E. , Namasivayam-MacDonald Ashwini M.
Published: January 2019

Objective: The aim of this study was to determine the type and extent of caregiver burden uniquely experienced by spousal caregivers of older adults with dysphagia. Method: Using the Round 1 surveys from the National Health and Aging Trends Study and the National Study of Caregiving, we analyzed data on 422 community-dwelling older adults and their spousal caregivers. Results: Approximately 17% of care recipients reported swallowing difficulties. Logistic regression analysis revealed that caregivers of spouses with dysphagia were significantly more likely to experience emotional burden, p = .038; odds ratio (OR) = 2.06; 95% confidence interval (CI): [1.04, 4.09]. Of those spouses caring for partners with dysphagia who reported emotional burden, nearly 70% rated the burden moderate to severe. Discussion: Dysphagia in community-dwelling older adults is associated with increased emotional burden among spousal caregivers. Given the intricate relationship between the health and well-being of both members of the caregiving dyad, these findings support the need for interventions that prioritize dyadic health.
The Effects of Flow, Emotional Engagement, and Motivation on Success in a Gamified Online Learning Environment
Authors: Özhan Şeyma Çağlar , Kocadere Selay Arkün
Published: January 2019

This study aimed to examine the factors that explain academic success in a gamified online learning environment considering flow, emotional engagement, and motivation. The gamified online learning environment was used by 40 undergraduate students, and the data gathered from them. A hypothetical path model showing the interaction of variables with each other was suggested and tested. The experience of flow and emotional engagement in the gamified learning setting had a highly significant impact on motivation. Furthermore, it was concluded that flow increased academic success through increasing motivation. In line with numerous studies in the literature, motivation was determined to have a positive effect on academic success. In addition, the results show that flow and emotional engagement explained 68% of variance of motivation; flow, emotional engagement, and motivation explained 22% of variance of academic success. It is suggested that subsequent studies should focus on the establishment and testing of models that would help to explain success in gamified settings which should incorporate game elements and player types in the structural model.
The Phase-Shifting Effect of Bright Light Exposure on Circadian Rhythmicity in the Human Transcriptome
Authors: Kervezee Laura , Cuesta Marc , Cermakian Nicolas , Boivin Diane B.
Published: January 2019

Light is a potent synchronizer of the central circadian clock; however, the effect of light exposure on peripheral gene expression is largely unknown. The objective of this study was to explore the effect of bright light exposure on genome-wide peripheral gene expression levels during a 4-day simulated night shift protocol in which the habitual sleep period is delayed by 10 h. Eleven healthy participants (mean age, 24 years; range, 18-30; 10 men/1 woman) were studied under controlled laboratory conditions. Three participants were exposed to bright light (~6,500 lux) for 8 h during the nightly waking period, while the other 8 were maintained in dim-light conditions (~10 lux). At baseline and on the fourth day after the shift in the sleep period, blood samples were collected during two 24-h measurement periods. RNA was extracted from peripheral blood mononuclear cells (PBMCs) and used to obtain transcriptomic data. Using 2 independent approaches to determine phase shifts among rhythmically expressed genes after the shifted sleep schedule compared with baseline, we found that the average phase delay in the bright light group was approximately 8 to 9 h, whereas the average phase delay in the control group was approximately 1 to 2 h, both at the group level and at the individual level. In line with these findings, further analysis using partial least squares regression indicated that the peripheral circadian transcriptome of PBMCs was predictive of the phase of the central circadian pacemaker after only 3 days of bright light exposure. These results indicate that bright light exposure exerts a phase-shifting effect on the circadian transcriptome in PBMCs with a magnitude similar to its effect on the central circadian clock.
Characteristics of Intimate Partner Violence in China: Gender Symmetry, Mutuality, and Associated Factors
Authors: Chen Mengtong , Chan Ko Ling
Published: January 2019

The primary research focus on female victims of intimate partner violence (IPV), coupled with a lack of discussion on mutual violence between intimate partners, has affected our understanding of IPV in China. In the current study, we aim to examine gender symmetry and mutuality in IPV in China. We also produce the first age-specific and gender-specific prevalence estimates for different types of IPV. The associations between IPV, demographic factors, personal factors, and relationship factors are also examined. We analyzed a set of data from 7,466 households in six regions in China collected between 2009 and 2010. Three-way cross-tab analyses and multinomial logistic regressions were performed to examine the prevalence of IPV in the preceding year by gender and age groups and its associations with different individual and relationship factors, respectively. For sexual violence and severe physical assault and injury, most victims experienced unidirectional violence. For psychological aggression and minor physical assault, mutual violence was more likely to occur among intimate partners. Gender symmetry was found in regard to physical assault and psychological aggression. There is gender asymmetry in sexual violence between Chinese intimate partners. Older individuals are less likely to be victims or perpetrators of IPV or to be involved in mutual violence. Factors associated with IPV show that mutual violence is generally analogous to violence perpetration. To prevent IPV, it is important to understand gender symmetry and mutuality of IPV in China. We need to involve both men and women in violence prevention and develop age-appropriate programs in the future.
The good principal: A case study of early-career charter principals’ role conceptualizations
Authors: Truong Felicia R.
Published: January 2019

Up to 75 percent of charter principals in the United States leave the role within five years. Understanding how early-career principals conceptualize the role could help strengthen principal preparation and in-service training. This study analyzed early-career charter principals’ descriptions of the principalship in order to understand their framework for what it means to be a good principal. A qualitative case study was used, focused on semi-structured interviews with 15 charter school principals. Charter school principals in this study primarily defined being a ‘good’ principal using examples and descriptions of soft skills and personality traits.
Prediction of machining performance using RSM and ANN models in hard turning of martensitic stainless steel AISI 420
Authors: Zerti Abderrahmen , Yallese Mohamed Athmane , Zerti Oussama , Nouioua Mourad , Khettabi Riad
Published: January 2019

The purpose of this experimental work is to study the impact of the machining parameters ( Vc, ap, and f) on the surface roughness criteria ( Ra, Rz, and Rt) as well as on the cutting force components ( Fx, Fy, and Fz), during dry turning of martensitic stainless steel (AISI 420) treated at 59 hardness Rockwell cone. The machining tests were carried out using the coated mixed ceramic cutting-insert (CC6050) according to the Taguchi design (L25). Analysis of the variance (ANOVA) as well as Pareto graphs made it possible to quantify the contributions of ( Vc, ap, and f) on the output parameters. The response surface methodology and the artificial neural networks approach were used for output modeling. Finally, the optimization of the machining parameters was performed using desirability function (DF) minimizing the surface roughness and the cutting forces simultaneously. The results indicated that the roughness is strongly affected by the feed rate ( f) with contributions of (80.71%, 80.26%, and 81.80%) for ( Ra, Rz, and Rt) respectively, and that the depth of cut ( ap) is the factor having the major influence on the cutting forces ( Fx = 53.76%, Fy = 50.79%, and Fz = 65.31%). Furthermore, artificial neural network and response surface methodology models correlate very well with experimental data. However, artificial neural network models show better accuracy. The optimum machining setting for multi-objective optimization is Vc = 80 m/min, f = 0.08 mm/rev and ap = 0.141 mm.
Optimal control of a novel uninterrupted multi-speed transmission for hybrid electric mining trucks
Authors: Yang Weiwei , Liang Jiejunyi , Yang Jue , Zhang Nong
Published: January 2019

Considering the energy consumption and specific performance requirements of mining trucks, a novel uninterrupted multi-speed transmission is proposed in this paper, which is composed of a power-split device, and a three-speed lay-shaft transmission with a traction motor. The power-split device is adapted to enhance the efficiency of the engine by adjusting the gear ratio continuously. The three-speed lay-shaft transmission is designed based on the efficiency map of traction motor to guarantee the drivability. The combination of the power-split device and three-speed lay-shaft transmission can realize uninterrupted gear shifting with the proposed shift strategy, which benefits from the proposed adjunct function by adequately compensating the torque hole. The detailed dynamic models of the system are built to verify the effectiveness of the proposed shift strategy. To evaluate the maximum fuel efficiency that the proposed uninterrupted multi-speed transmission could achieve, dynamic programming is implemented as the baseline. Due to the “dimension curse” of dynamic programming, a real-time control strategy is designed, which can significantly improve the computing efficiency. The simulation results demonstrate that the proposed uninterrupted multi-speed transmission with dynamic programming and real-time control strategy can improve fuel efficiency by 11.63% and 8.51% compared with conventional automated manual transmission system, respectively.
Pressure mode analysis of nonuniform cross-sectional pipes and preliminary evaluation of a pogo suppressor
Authors: Lee SangGu , Lee SiHun , Shin SangJoon , Kim Youdan , Lee Soogab
Published: January 2019

The pogo phenomenon is a type of instability that arises when the longitudinal modes of a space launch vehicle fuselage resonate with the pressure modes of the feedline in its propulsion system, with such resonance re-exciting the fuselage structure. To analyze this phenomenon, this paper specifically focuses on an analysis of the pressure modes in the space shuttle interpump line included in the LOX engine system. Because the interpump line is connected to pipes in different cross-sectional areas, the pressure modes are analyzed as a nonuniform cross-sectional pipe. Further, by applying a pogo suppressor in the feedline system, the possibility of preventing the pogo phenomenon is demonstrated. In order to design the suppressor, the resistive accumulator inertance, compliance, and resistance are considered as variables. Resistive accumulator compliance and inertance are determined and the pressure perturbation of the engine is prevented by lowering the inlet pressure amplitude of the high-pressure oxidizer pump (HPOP) in the space shuttle LOX system interpump line. When the resistive accumulator resistance is increased, the pressure frequencies of the interpump line gradually decrease, avoiding the resonance region with the fuselage. As a result, the resonance region with the fuselage is prevented by varying the pressure amplitude and natural frequencies of the interpump line. In this way, the capability of the present pogo suppression is evaluated.
Residential segregation in Mithi and Karachi, Pakistan
Authors: Hasan Arif
Published: January 2019

This paper responds to the article by Gayatri Singh, Trina Vithayathil and Kanhu Charan Pradhan on residential segregation by caste in urban India, in this issue of Environment and Urbanization. It compares caste-based residential segregation in India and Pakistan, focusing on Mithi and Karachi in Pakistan. The paper discusses how political change, migration, violence, and religious and ethnic identity in Karachi have shaped preferences on where different castes and religious minorities wish to reside. Meanwhile, in Mithi, where capitalism is not fully developed, caste continues to determine where one can live.
Reasons for delayed antiretroviral therapy (ART) initiation in the era of early ART initiation guidelines: a retrospective service evaluation
Authors: Lee Ming J , Venturelli Serena , McKenna Wayne , Teh Jhia , Negedu Ojali , Florman Katia EH , Musbahi Esra , Bailey Angela C , Mackie Nicola E , Fox Julie , Fidler Sarah
Published: January 2019

Following changes in national antiretroviral therapy (ART) guidelines removing the CD4 threshold for initiation of ART, we evaluated the time to ART initiation and reasons for delayed or non-initiation. A retrospective notes review of 292 newly diagnosed HIV-positive individuals attending two London clinics between August 2015 and December 2016 was performed. Two hundred and fifty-four of 292 (87%) individuals started ART. Median time to ART initiation was 29 days (range: 0–514). Thirty of 292 (13%) did not start ART. Rates of virological suppression at six months were similar regardless of time to ART initiation. People who inject drugs (16.7% vs. 3.6%) (p = 0.009), having a higher median baseline CD4 cell count (500 vs. 388 cells/mm3, p = 0.001), and having gastrointestinal/liver co-morbidities (23% vs. 9%, p = 0.001) were associated with delayed ART initiation. The cohort not on ART had a higher median baseline CD4 cell count (500 vs. 388 cells/mm3, p < 0.001). Documented reasons for delayed or ART non-initiation included patient’s choice, prolonged adjustment periods, and difficulty leaving work. We conclude that delayed or non-initiation of ART was associated with injecting drug use and prolonged adjustment to a new HIV diagnosis. Clinician factors may include lack of urgency with higher baseline CD4 cell counts. Improved linkage to care and drug services pathways may encourage timely ART initiation.
Enhanced surveillance of syphilis cases among men who have sex with men in London, October 2016–January 2017
Authors: Rana Sangeeta , Macdonald Neil , French Patrick , Jarman Jay , Patel Sheel , Portman Mags , Suchak Tara , Sullivan Ann , White John , Crook Paul
Published: January 2019

Syphilis rates have been increasing in men who have sex with men (MSM) in London. To describe risk behaviour and refine public health interventions, we conducted prospective enhanced surveillance of new syphilis cases in MSM attending selected London sexual health clinics (SHCs) between October 2016 and January 2017. Sexual health advisors (SHAs) completed 107 questionnaires. Eighteen per cent of respondents reported always using condoms, with lower use in HIV-positive (8%, 4/53) than HIV-negative men (33%, 14/52). Almost half of respondents reported condomless sero-discordant sex (46%, 33/72). The most frequent means of meeting new partners reported were venues (80%, 76/95), particularly bars or clubs (34%, 32/95), and apps or websites (79%, 75/95). Nearly a third of respondents reported engaging in group sex (32%, 30/95). Almost half reported drug use during sex (47%, 46/98), with HIV-positive men more likely to report use of the three main ‘chemsex’ drugs. The majority of respondents preferred health promotion information from SHAs (63%, 58/92) compared to other sources such as Google/Wikipedia and apps. Prevention activity should continue to focus on condomless sex, serosorting, multiple and overlapping partners, and chemsex. SHCs, particularly those serving HIV-positive men, are important sources for sexual health promotion advice.
An experience-independent inverse design optimization method of compressor cascade airfoil
Authors: Zhu Yujie , Ju Yaping , Zhang Chuhua
Published: January 2019

Most of the inverse design methods of turbomachinery experience the shortcoming where the target aerodynamic parameters need to be manually specified depending on the designers’ experience and insight, making the design result aleatory and even deviated from the real optimal solution. To tackle this problem, an experience-independent inverse design optimization method is proposed and applied to the redesign of a compressor cascade airfoil in this study. The experience-independent inverse design optimization method can automatically obtain the target pressure distribution along the cascade airfoil through the genetic algorithm, rather than through the manual specification approach. The shape of cascade airfoil is then solved by the adjoint method. The effectiveness of the experience-independent inverse design optimization method is demonstrated by two inverse design cases of the compressor cascade airfoil, i.e. the inverse design of only the suction surface and the inverse design of both the suction and pressure surfaces. The results show that the proposed inverse design method is capable of significantly improving the aerodynamic performance of the compressor cascade. At the examined flow condition, a thin airfoil profile is beneficial to flow accelerations near the leading edge and flow separation avoidance near the trailing edge. The proposed inverse design method is quite generic and can be extended to the three-dimensional inverse design of advanced compressor blades.