bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Outcomes of Tibialis Posterior Tendoscopy With Comparison to Magnetic Resonance Imaging
Authors: Gianakos Arianna L. , Ross Keir A. , Hannon Charles P. , Duke Gavin L. , Prado Marcelo P. , Kennedy John G.
Published: March 2015

Background:

The purpose of the current study was to report functional outcomes of tendoscopy for treatment of tibialis posterior tendon pathology as well as compare its diagnostic capability with magnetic resonance imaging (MRI).

Methods:

Clinical records and MRI of 12 patients who underwent tendoscopy of the tibialis posterior tendon (TPT) were retrospectively reviewed. Mean follow-up was 31 months (range, 26-43 months). Preoperative MRI findings were compared with tendoscopic findings to assess the diagnostic agreement between each modality. Functional outcomes were assessed using the Foot and Ankle Outcome Score (FAOS) and Short Form-12 (SF-12) General Health Questionnaire pre- and postoperatively. Mean patient age was 43 years (range, 17-63 years). Mean duration of preoperative symptoms was 15.5 months (range, 3-36 months).

Results:

Pathologies addressed via tendoscopy included tenosynovitis, tendinosis, stenosis, tendon subluxation, and partial thickness tear (via mini-arthrotomy). Preoperative MRI findings were in agreement with tendoscopic findings in 8 of 12 cases (67%). Tendoscopy diagnosed and allowed access for treating pathology that was missed on MRI in the remaining four cases. The FAOS improved from a mean preoperative score of 58 (range, 36-78) to a mean postoperative score of 81 (range, 44-98) ( P < .01). The SF-12 score improved from a mean preoperative score of 34 (range, 13-51) to a mean postoperative score of 51 (range, 21-76) ( P = .01).

Conclusions:

Although MRI is considered an effective imaging technique for tendon pathology, tendoscopy may be a more sensitive diagnostic tool. Tendoscopy was an effective minimally invasive tool to diagnose and treat tibialis posterior tendon pathology resulting in functional improvements in the short-term for early stage TPT dysfunction. Further studies comparing tendoscopy with traditional open approaches are warranted.

Level of Evidence:

Level IV case series.
Image encryption technique based on fractional chaotic time series
Authors: Wu Guo-Cheng , Baleanu Dumitru , Lin Zhen-Xiang
Published: March 2015

Chaos in discrete fractional maps has been reported very recently. In this study, the chaotic time series of fractional order is used in the scrambling technique and a novel image encryption scheme is designed. The fractional difference order and the chaotic coefficient play crucial roles in controlling chaotic behaviors. The encrypted results are analyzed, which shows that the encryption scheme is highly secure.
Linear impulsive control system with impulse time windows
Authors: Feng Yuming , Yu Junzhi , Li Chuandong , Huang Tingwen , Che Hangjun
Published: March 2015

We formulate the linear impulsive control systems with impulse time windows. Different from the most impulsive systems where the impulses occur at fixed time or when the system states hit a certain hyperplane, the impulse time in the presented systems might be uncertain, but limited to a small time interval, i.e. a time window. Compared with the existing impulsive systems, the systems with impulse time windows is of practical importance. We then study the asymptotic stability of the case of linear systems and obtain several stability criteria. Numerical examples are given to verify the effectiveness of the theoretical results.
Preteen Boys, Body Image, and Eating Disorders
Authors: Wright Jan , Halse Christine , Levy Gary
Published: March 2015

In recent years, academic and public attention has increasingly focused on the issue of men’s preoccupation with body image and the increasing incidence of eating disorders among men. Although most of this focus has been on young and adult males, media discourse has tended to extend explanations for men’s aspirations for social body ideals to explanations for eating disorders in young boys. In this article, we take a critical look at the way the boys/body image/eating disorder nexus has been represented in some of the mainstream media. In particular, we propose that the boys/body image/eating disorder nexus has been constituted as a truth that tends to underplay the complexity of the relationship between eating disorders and boys’ dissatisfaction with their bodies, as recognized by researchers and health practitioners, and as evident from our own study of preteen boys diagnosed with an eating disorder. In this article, we use interviews with the six boys and their mothers collected for our study to construct short family biographies. These biographies are used to illustrate the complexity of the boys’ experience of an eating disorder and to trouble the certainty with which the media discourse explaining boys’ eating disorders is constituted.
Cryosurgery in association with itraconazole for the treatment of feline sporotrichosis
Authors: de Souza Clarissa Pimentel , Lucas Ronaldo , Ramadinha Regina HR , Pires Tifanny BCP
Published: March 2015

Objectives

We evaluated the efficacy of cryosurgery in association with itraconazole for the treatment of feline sporotrichosis. We also compared the length of treatment protocol with others reported in the literature.

Methods

Cats naturally infected with fungi of the Sporothrix schenckii complex were evaluated. Diagnosis was confirmed by cytology and fungal culture. Prior to the cryosurgical procedure, every animal was receiving itraconazole 10 mg/kg/day PO, for different time periods. The same protocol was maintained until 4 weeks after complete healing of the lesions.

Results

Eleven of 13 cats were considered clinically cured. The treatment duration ranged from 14–64 weeks (median 32 weeks).

Conclusions and relevance

The combination of cryosurgery and itraconazole was effective in treating cases of feline sporotrichosis and decreased the treatment length compared with protocols using only medication.
A narrative analysis of spiritual distress in geriatric physical rehabilitation
Authors: Mundle Robert
Published: March 2015

Drawing upon narrative data generated in a semi-structured interview with an 82-year-old female patient in geriatric physical rehabilitation, this clinical case study provides a detailed example of recognizing, assessing, and addressing spiritual distress as a symptom of physical pain. Data analysis focused on narrative content as well as on the interactive and performative aspects of narrating spiritual health issues in a close reading of two “attachment narratives.” Results support the “narrative turn” in healthcare, including the therapeutic benefits of empathic listening as “narrative care” in geriatric rehabilitation and in healthcare in general.
Identity as “knowing your place”: The narrative construction of space in a healthcare profession
Authors: van Vuuren Mark , Westerhof Gerben J
Published: March 2015

The construction of space in which a story takes place can have important consequences for the evaluation of health interventions. In this article, we explore the ways professionals narratively position themselves in a situation, treating identity literally as “knowing one’s place.” More specifically, we explore the spatial language health professionals use to describe their work. Using descriptions of professionals in a drug habilitation organization, we illustrate how they use route (i.e. an active tour through the space), survey (i.e. a stationary viewpoint from above), and gaze perspectives (i.e. a stable viewpoint onto a place) to explain the work situations they encounter. Each of these perspectives facilitates a different mode of evaluation in terms of distance, emotion, and identity. We propose opportunities for research and implications of the ways in which spaces and spatial perspectives set the scene in the narratives of healthcare professionals.
“Hell no, they’ll think you’re mad as a hatter”: Illness discourses and their implications for patients in mental health practice
Authors: Ringer Agnes , Holen Mari
Published: March 2015

This article examines how discourses on mental illness are negotiated in mental health practice and their implications for the subjective experiences of psychiatric patients. Based on a Foucauldian analysis of ethnographic data from two mental health institutions in Denmark—an outpatient clinic and an inpatient ward—this article identifies three discourses in the institutions: the instability discourse, the discourse of “really ill,” and the lack of insight discourse. This article indicates that patients were required to develop a finely tuned and precise sense of the discourses and ways to appear in front of professionals if they wished to have a say in their treatment. We suggest that the extent to which an individual patient was positioned as ill seemed to rely more on his or her ability to navigate the discourses and the psychiatric setting than on any objective diagnostic criteria. Thus, we argue that illness discourses in mental health practice are not just materialized as static biomedical understandings, but are complex and diverse—and have implications for patients’ possibilities to understand themselves and become understandable to professionals.
Challenging the status and constructing the culture of an indigenous group: Attention paid to YLE Sápmi radio digital news in Finland
Authors: Kortelainen Terttu , Länsman Anni-Siiri
Published: March 2015

The purpose of this research is to study the attention paid by the YLE Sápmi radio audience to news published on the website. The study is based on the attention economic theory. YLE Sápmi is a regional indigenous radio channel of the public Finnish Broadcasting Company YLE. The attention data consist of web comments and Facebook likes. The most commented news focused on the Sámi area or culture, often associated with ethnic tensions. On the radio website, the comments were from time to time highly controversial, while Facebook likes show support towards positive cultural developments. This study contributes to knowledge on the research potential of the attention data on social media websites. This research method not only enables the study of themes interesting for the audience, but also how the media itself channels discussions in certain directions.
An east-facing anidolic daylighting system on a tropical urban house
Authors: Binarti Floriberta , Satwiko Prasasto
Published: March 2015

Sustainable core daylighting is expected to provide comfortable and healthy daylight in dense urban areas. One system, an anidolic daylighting system is a promising solution, however, it is still not widespread because of several complications. This paper presents an application of an affordable anidolic daylighting system on a tropical urban house designed with a simple edge-ray approach. This approach has created a parabolic collector for east-facing (azimuth 85°) anidolic daylighting system to improve the daylighting level of a room with high external obstruction. Simulation results and short-term monitoring before and after the construction have indicated successful application of an anidolic daylighting system for improving daylighting performance, especially before 13:00, without increasing indoor air temperature. The results have shown a strong hourly illuminance profile. To improve the indoor illuminance after 13:00 and the hourly illuminance profile, an east-facing anidolic daylighting system collector can be combined with a west-facing collector.
Theoretical and experimental investigation of viscoelastic serial robotic manipulators with motors at the joints using Timoshenko beam theory and Gibbs–Appell formulation
Authors: Korayem MH , Shafei AM , Doosthoseini M , Absalan F , Kadkhodaei B
Published: March 2015

In this article, the mathematical modeling of n-viscoelastic-link robotic manipulators based on the Gibbs–Appell formulation and the assumed mode method is developed. The elastic properties of the links are modeled according to the Timoshenko beam theory and its associated mode shapes. Also the dynamic effects of the motors at the joints are fully taken into consideration. In the mathematical modeling, the effects of torsion, extensional deformation, bending in two directions, structural damping, and viscous air as well as the gravity effects have also been considered. A recursive algorithm based on 4 × 4 transformation matrices has been developed to ease the derivation of motion equations. The mismatch between the high-speed vibrations of flexible robotic arms and the low-speed operation of the software and hardware interface in the computer and the experimental setup is a serious obstacle for the measuring and controlling of such systems. So, to verify the simulation results and the results obtained from the experimental test bed, high-speed digital-to-analog converter components on an electronic interface board are used in conjunction with the National Instrument’s LABVIEW software package.
A procedure for the constitutive analysis of creep phenomena in polymeric materials
Authors: Carniel Emanuele Luigi , Hrelja D , Zulian D , Modesti M
Published: March 2015

A specific procedure is proposed for the univocal and fast identification of viscoelastic parameters of polymeric materials by the processing of experimental results from creep tests. Mechanical tests were developed on polymethylmethacrylate and polycarbonate samples according to different stress and temperature conditions. The creep stresses and the temperatures were defined to characterize the mechanical response within the standard domain of application of the specific polymeric materials. The experimental data were post-processed to provide the experimental relationship between creep modulus and time at the different temperatures. Such experimental relationship was interpreted by specific model formulations, which were developed starting from the standard theory of linear visco-elasticity. Elastic and viscous parameters were identified by the minimization of discrepancy between model and experimental results. The trend of constitutive parameters with temperature was finally evaluated.
Characterization of Al–Al2O3 composite prepared using reinforced fused deposition pattern in investment casting
Authors: Singh Sunpreet , Singh Rupinder
Published: March 2015

The commercially available techniques for developing aluminium matrix composite can be broadly classified into two categories namely liquid-state and solid-state processing. In the category of liquid-state processing, modified investment casting process has ability to produce complex and near net shape geometries of aluminium matrix composite for various industrial applications. In the present research work, an effort has been made to characterize the Al–Al2O3 based composites prepared with modified investment casting process. Initially, two reinforced fused deposition modeling filaments consisting of 60% nylon 6 + 30% Al + 10% Al2O3 (by percentage weight) and 60% nylon 6 + 28% Al + 12% Al2O3 (by percentage weight) proportions were prepared in wire form on single screw extruder of L/D 20. After this, reinforced patterns fabricated on existing fused deposition modeling system (using newly prepared filaments) were used as master pattern in modified investment casting process. Finally prepared castings were characterized by scanning electron microscope, EDS, X-ray diffraction analysis, and optical microscopy. Tribological analysis has been made on the finally prepared castings to investigate the affect of filament proportion and fused deposition modeling system density on their wear resistance. The result of study suggests that wear resistance of the finally prepared castings was increased with increase in percentage weight of Al2O3 particle in filament and density of fused deposition modeling pattern.
Preparation and In Vitro Evaluation of Antitumor Activity of TGFαL3-SEB as a Ligand-Targeted Superantigen
Authors: Yousefi Forough , Mousavi Seyed Fazlollah , Siadat Seyed Davar , Aslani Mohammad Mehdi , Amani Jafar , Rad Hamid Sedighian , Fooladi Abbas Ali Imani
Published: March 2015

Tumor-targeted superantigens (TTSs) have been used to treat a variety of tumors in preclinical studies. The TTS utilizes the powerful T-cell activation strategy by means of staphylococcal enterotoxins (SEs) as superantigens (Sags) to target tumor cells. Monoclonal antibodies and tumor-related ligands have been used as targeting molecules of Sag. In this study, we assessed the antitumor potency of tumor-targeted superantigen (TTS) strategy to design and produce fusion protein as a new antitumor candidate. The third loop (L3) of transforming growth factor α (TGF-α) was genetically conjugated to staphylococcal enterotoxin type B (TGFαL3-SEB), and its in vitro antitumor activity against murine breast cancer cells (A431 cell line) was evaluated. We designed and prepared TGFαL3-SEB chimeric protein and evaluated superantigenic activity, binding property to cancer cells, overexpression of epidermal growth factor receptor (EGFR), and in vitro antitumor activities. Cloning of tgfαl3-seb was confirmed by colony-polymerase chain reaction, enzymatic digestion, and sequencing. The recombinant TGFαL3-SEB fusion protein with molecular weight of 31 kDa was expressed and confirmed by anti-His Western-blot analysis. The TGFαL3-SEB fusion protein attached to A431 cell line with proper affinity and induced dose-dependent cytotoxicity against EGFR-expressing cancer cells in vitro. The TGFαL3-SEB chimeric protein exhibited potent in vitro antitumor activity. Our findings indicated that TGFαL3-SEB may be a promising anticancer candidate in cancer immunotherapy, and further studies are required to explore its potential in vivo therapeutic applications.
Tumor Hypoxia Response After Targeted Therapy in EGFR-Mutant Non-Small Cell Lung Cancer
Authors: Arvold Nils D. , Heidari Pedram , Kunawudhi Anchisa , Sequist Lecia V. , Mahmood Umar
Published: March 2015

Hypoxia is associated with resistance to radiotherapy and chemotherapy. Functional imaging of hypoxia in non-small cell lung cancer (NSCLC) could allow early assessment of tumor response and guide subsequent therapies. Epidermal growth factor receptor (EGFR) inhibition with erlotinib reduces hypoxia in vivo. [18F]-Fluoromisonidazole (FMISO) is a radiolabeled tracer that selectively accumulates in hypoxic cells. We sought to determine whether FMISO positron emission tomography (FMISO-PET) could detect changes in hypoxia in vivo in response to EGFR-targeted therapy. In a preclinical investigation, nude mice with human EGFR-mutant lung adenocarcinoma xenografts underwent FMISO-PET scans before and 5 days after erlotinib or empty vehicle initiation. Descriptive statistics and analysis of variance (ANOVA) tests were used to analyze changes in standardized uptake value (SUV), with pooled analyses for the mice in each group (baseline, postvehicle, and posterlotinib). In a small correlative pilot human study, patients with EGFR-mutant metastatic NSCLC underwent FMISO-PET scans before and 10 to 12 days after erlotinib initiation. Changes in SUV were compared to standard chest computed tomography (CT) scans performed 6 weeks after erlotinib initiation. The mean (±standard error of the mean; SUVmean) of the xenografts was 0.17 ± 0.014, 0.14 ± 0.008, and 0.06 ± 0.004 for baseline, postvehicle, and posterlotinib groups, respectively, with lower SUVmean among the posterlotinib group compared to other groups ( P < .05). Changes on preclinical PET imaging were striking, with near-complete disappearance of FMISO uptake after erlotinib initiation. Two patients were enrolled on the pilot study. In the first patient, SUVmean increased by 21% after erlotinib, with progression on 6-week chest CT followed by death after 4.8 months. In the second patient, SUVmean decreased by 7% after erlotinib, with regression on 6-week chest CT accompanied by clinical improvement; the patient had stable disease at 14.5 months. In conclusion, we observed that FMISO-PET can detect changes in hypoxia levels after EGFR-directed therapy in EGFR-mutant NSCLC. Further study is warranted to determine its utility as an imaging biomarker of early response to EGFR-directed therapy.
Changes in Bacterial Profiles and Antibiotic Sensitivity Before and After Wound Bed Preparation for Diabetic Foot Ulcers
Authors: Wang Guangyu , Tian Jinghua , Zhu Lv-yun , Yang Shaoling , Ding Yi , Kang Yudong , Wang Fusheng , Wang Yu , Dong Yu , Li Yong , Xu Xuying
Published: March 2015

We aimed to investigate the characteristics of bacterial profiles and antibiotic sensitivity in diabetic foot ulcers before and after wound bed preparation. This study involved 423 diabetic patients with Wagner grades 1 to 4 foot ulcers. Secretion culture was performed before wound bed preparation. The observation endpoint was when the wound showed a tendency toward healing and a specialist determined that stopping antibiotic treatment would not affect wound healing. A second secretion culture was performed after the observation endpoint. We obtained results from both secretion cultures from 411 patients. The proportion of multi-drug-resistant (MDR) gram-positive bacteria was 22.0% and 47.8% before and after treatment, respectively; that for gram-negative bacteria was 3.5% and 19.2%, respectively ( P < .05). Pretreatment antibiotic sensitivity of staphylococci and other gram-positive bacteria was 48.7% and 44.8%, respectively; the rates decreased significantly after treatment to 36.8% ( P = .031) and 34.8% ( P = .027), respectively. Pretreatment antibiotic sensitivity of common and nonfermenting rare gram-negative bacteria was 55.4% and 54.6%, respectively, which decreased substantially after treatment to 33.2% ( P = .002) and 32.9% ( P = .003), respectively. Wound healing was achieved in 92.7% of patients. Pretreatment and posttreatment C-reactive protein levels were 124.759 ± 71.58 mg/dL and 82.8 ± 53.61 mg/dL, respectively ( P < .05). In conclusion, following wound bed preparation for diabetic foot ulcers, MDR bacteria numbers were increased and antibiotic sensitivity was decreased; inflammation was decreased. These findings warrant future studies for confirmation.
N-3-(oxododecanoyl)-L-homoserine lactone promotes the induction of regulatory T-cells by preventing human dendritic cell maturation
Authors: Li Youqiang , Zhou Huayou , Zhang Yunyan , Chen Cha , Huang Bin , Qu Pinghua , Zeng Jianming , E Shunmei , Zhang Xuan , Liu Jianping
Published: March 2015

N-3-(Oxododecanoyl)-L-homoserine lactone (C12) is a small bacterial signaling molecule secreted by Pseudomonas aeruginosa (PA), which activates mammalian cells through TLR4-independent mechanisms. C12 acts as an immunosuppressant and it has been shown to modulate murine bone marrow-derived dendritic cell-mediated T-helper 2 (Th2) cell polarizations in vitro. In the present study, we initially examined the impact of C12 on the maturation of human monocyte-derived dendritic cells (Mo-DCs) and the induction of regulatory T-cells (iTregs) in culture. Our findings demonstrate that C12-treated Mo-DCs failed to undergo lipopolysaccharide (LPS)-induced maturation. At the molecular level, C12 blocked the upregulation of surface molecules, including CD11c, HLA-DR, CD40, and CD80, and it switched to an interleukin (IL)-10high, IL-12p70low phenotype. Moreover, C12 selectively inhibited the capacity of Mo-DCs to stimulate the proliferation of allogeneic CD4+ T-cells. Otherwise, the C12-treated Mo-DCs promoted the generation of CD4+CD25+Foxp3+-induced regulatory T-cells (iTregs) and enhanced their IL-10 and transforming growth factor (TGF)-β production associated with reduced interferon (IFN)-γ and IL-12p70 production. These findings provide new insights towards understanding the persistence of chronic inflammation in PA infection.
Detection of Changes in Surgical Difficulty
Authors: Zheng Bin , Jiang Xianta , Atkins M. Stella
Published: March 2015

Background. Assessing the workload of surgeons requires technology to continuously monitor surgeons’ behaviors without interfering with their performance. We investigated the feasibility of using eye-tracking to reveal surgeons’ response to increasing task difficulty. Methods. A controlled study was conducted in a simulated operating room, where 14 subjects were required to perform a laparoscopic procedure that includes 9 subtasks. The subtasks could be divided into 3 types with different levels of task difficulty, calculated by the index of task difficulty (ID) proposed by Fitts in 1954. Pupillary responses of subjects in performing the procedure were recorded using Tobii eye-tracking equipment. Peak pupil dilation and movement time were compared between subtasks with different IDs as well as between fast moving and slow aiming phases within each subtask. Results. When the task difficulty was increased, task completion time increased. Meanwhile, the subjects’ peak pupil size also increased. As the entire procedure was performed continuously, we found that pupil responses were not only affected by the ID in the current subtask but also influenced by subtasks before and after. Discussion. Decomposing a surgical procedure into meaningful subtasks and examining the surgeon’s pupil response to each subtask enables us to identify the challenging steps within a continuous surgical procedure. Psychomotor evidence on surgeon’s performance may lead to an innovation for designing a task-specific training curriculum.
Palmar arch anatomy: Ajmer Working Group classification
Authors: Gokhroo Rajendra , Bisht Devendra , Gupta Sajal , Kishor Kamal , Ranwa Bhanwar
Published: March 2015

Introduction

Forearm arteries are frequently used as workhorse site for cardiac catheterization, bypass grafting and haemodialysis access. There is paucity of data on palmar circulation in live human being and only cadaveric data are available till date. We, therefore, made an attempt to look at the various patterns of sufficient or insufficient palmar arch circulation and various anomalies of forearm arteries, to discuss their clinical implications.

Methods and results

We obtained the forearm and hand arteriograms of patients (n = 302) through radial (n = 200) and ulnar routes (n = 102). Modified Allen’s test was normal in all of our patients. On the basis of predetermined parameters angiograms were analysed and findings were divided into three groups. These three groups were further classified as type A, type B, type C superficial palmar arch.

Conclusion

We concluded that type A superficial palmar arch is most suitable for providing adequate collateral circulation in case of harvesting of forearm vessel, whereas type C superficial palmar arch appears to be highly susceptible for digital ischemia in case of radial or ulnar artery occlusion. Modified Allen’s test alone is not justifiable for documenting good collateral circulation and it should be supplemented by other tests to document good collateral circulation before proceeding to any radical procedure.
It does not add up: Comparing episodic and general leadership ratings
Authors: Hoption Colette
Published: March 2015

In review of the extant leadership literature, assumptions inherent to behaviorally based leadership studies and transformational leadership in particular, have received attention. This study empirically investigated the following assumption: leadership ratings are based on cumulative experience with one’s leader. Ratings from 143 employed adults were collected each working day, and before and after the work week began and ended. Multivariate repeated measures ANCOVA showed that daily transformational leadership ratings were relatively stable, and significantly lower than transformational leadership ratings collected at the beginning and end of the work week. These results suggest that employees’ leadership ratings are not based on their cumulative experience with leaders, thus begging the question, “Upon what evidence do employees base their leadership ratings?” I argue that key instances of leadership disproportionately influence leadership ratings. In addition to challenging transformational leadership theory and proposing areas for future transformational leadership research, this study urges the field to (1) be more cautious in drawing conclusions about the importance of frequency of leadership behaviors and (2) emphasize when – not how frequently, leadership behaviors were enacted.
Pushing a stone up a hill: A case study of the working environment of South African academics
Authors: Portnoi Laura M.
Published: March 2015

South African higher education has been experiencing profound and vigorous transformations in the post-apartheid era. At the same time, global trends toward competition and employment equity contribute to the complexities of the country’s higher education environment. These global and local developments combine to impact the working environment of South African academics. This qualitative study employed a phenomenological approach to explore the ‘lived’ experiences of 20 South African academics operating within this changing academic workplace at a case study institution. Although the findings pointed to several ‘pull’ factors representing positive aspects of the university’s working environment, six ‘push’ factors emerged as the study’s most salient and robust research findings: (1) lack of induction/training, (2) working with underprepared students, (3) unmanageable workloads, (4) issues of race and power, (5) challenges for female academics, and (6) frustrations regarding slow institutional change. An additional key theme centered on findings related to potential decisions to depart from the institution or academia. When combined with prior research, the findings suggest an imperative for South African higher education institutions to focus on improving the environment in which academic staff conduct their work, particularly given the post-apartheid impetus to transform institutions for both equity and global competition purposes.
A multi-constrained maintenance scheduling optimization model for a hydrocarbon processing facility
Authors: Ahmed Qadeer , Moghaddam Kamran S , Raza Syed A , Khan Faisal I
Published: March 2015

A maintenance scheduling optimization model considering equipment risk, total maintenance cost, system reliability and availability is proposed. This work is motivated by gas processing operator’s concern of high maintenance cost, poor availability and reliability caused by inefficient maintenance scheduling. The approach presented in this article addresses the optimization of maintenance cost by efficiently scheduling maintenance task subject to reliability and availability constraints. Four maintenance actions are considered for each equipment, namely, corrective, replacement, maintenance and inspection. The proposed solution develops maintenance schedules for complex repairable system with equipment operating in series. Two single-objective, nonlinear mathematical models are presented to find the optimal maintenance cost subject to reliability and system reliability subject to availability constraint. A goal programming model is also proposed to simultaneously deal with multiple criteria based on their importance and defined goals. A gas absorption system of a hydrocarbon processing facility is used to ensure the practicality of the proposed formulation to real industry problems. A comparison of existing and proposed formulation is carried out to show that the proposed optimization approach is an efficient method for optimizing maintenance schedules and flexibility to adjust schedules in a complex operating system.
The Death of the Letter? Epistolary Intent, Letterness and the Many Ends of Letter-Writing
Authors: Stanley Liz
Published: March 2015

Is the letter now ‘dead’, in terminal decline because of the impact of new digital technologies? Such arguments raise important points. However, they fail to distinguish between prevailing genre conventions for letter-writing in different time periods and the underlying ‘epistolary intent’ and ‘letterness’ involved, and so overstate the newness of the changes discussed. Examples of over-time departures from ‘the letter’ but which display clear epistolary intent and deploy inventive forms of letterness are discussed, including the letters of Olive Schreiner, St Paul’s epistles, communications between Roman legionaries, Second World War love letters, an exchange involving mathematicians, and student emails.
Patient-centred discourse in sexual and reproductive health consultations
Authors: de Silva Joyce Helen , Slade Diana , Bateson Deborah , Scheeres Hermine , McGregor Jeannette , Weisberg Edith
Published: March 2015

There is an increasing recognition internationally of the critical impact of communication within healthcare. The link between ineffective communication, patient dissatisfaction and critical incidents is well established. Family Planning New South Wales (FPNSW) has sought to address patient-centred care and communication in its policy platform. This article reports on research conducted within FPNSW, which analysed the discourse features that constituted effective doctor–patient1 communication in sexual and reproductive health consultations. The principal aim of the research was to understand how effectively messages were conveyed and received and to what degree patients were active participants in their own sexual healthcare. Analysed consultations were characterised by extremely high levels of communicative competence on the part of the doctors who integrated medical expertise with the development of interpersonal relationships with patients, thus positioning patients as active contributors to the consultations and to decisions about their ongoing treatment. The detailed linguistic analysis identified characteristic features of patient-centred communication that are essential to patient-centred care. These interactions demonstrate that communicating care is just as important as delivering care and involves a drawing together of the medical and the interpersonal in consultations. The article details strategies for interweaving medical knowledge and establishing rapport that can inform practitioner communication practices across different healthcare contexts.
Translating What Works
Authors: Phillips Lawrence S. , Barb Diana , Yong Chun , Tomolo Anne M. , Jackson Sandra L. , Olson Darin E. , Rhee Mary K. , Duva Ingrid M. , He Qing , Long Qi
Published: March 2015

Background:

The most efficacious strategies to improve diabetes control include case management, health care team changes, patient education, and facilitated transmission of patient data to clinicians (“facilitated relay”), but these strategies have not been translated to permit general use in clinical practice.

Methods:

A web-based decision support program was developed to include these features, and assessed in patients who had A1c ≥7.0% despite using metformin with/without sulfonylureas or insulin. Staff entered patients’ glucose data, obtained management recommendations, reviewed the plan with a clinician, and discussed the new plan with patients.

Results:

113 subjects were 96% male and 32% black, with average age 65.6 years and BMI 32.8. During prior primary care, A1c averaged 8.32 ± 0.16% (SEM). In all patients, baseline A1c was 8.18 ± 0.11%, and decreased to 7.54 ± 0.12%, 7.16 ± 0.13%, and 7.54 ± 0.16% at 3, 6, and 12 months, respectively, all P < .001. In 42 subjects who provided glucose data and made requested changes in medications, A1c was 8.12 ± 0.09% at baseline and fell to 7.29 ± 0.11%, 6.98 ± 0.10%, and 7.05 ± 0.10% at 3, 6, and 12 months, respectively, all P < .001. Chart review of 16 subjects followed for 12 months demonstrated that hypoglycemia (symptoms and/or glucose <70 mg/dl) averaged less than 1 episode/patient/month, and there was no severe hypoglycemia.

Conclusions:

A novel decision support program improved A1c with little hypoglycemia. Use of this approach should allow primary care teams to keep patients well controlled, and reduce the need for specialist referrals.
Model-Based Cognitive Neuroscience Approaches to Computational Psychiatry
Authors: Wiecki Thomas V. , Poland Jeffrey , Frank Michael J.
Published: March 2015

Psychiatric research is in crisis. We highlight efforts to overcome current challenges by focusing on the emerging field of computational psychiatry, which might enable the field to move from a symptom-based description of mental illness to descriptors based on objective computational multidimensional functional variables. We survey recent efforts toward this goal and describe a set of methods that together form a toolbox to aid this research program. We identify four levels in computational psychiatry: (a) behavioral tasks that index various psychological processes, (b) computational models that identify the generative psychological processes, (c) parameter-estimation methods concerned with quantitatively fitting these models to subject behavior by focusing on hierarchical Bayesian estimation as a rich framework with many desirable properties, and (d) machine-learning clustering methods that identify clinically significant conditions and subgroups of individuals. As a proof of principle, we apply these methods to two different data sets. Finally, we highlight challenges for future research.
Patient-Reported Outcomes and Their Predictors at Minimum 10 Years After Anterior Cruciate Ligament Reconstruction
Authors: Magnussen Robert A. , Verlage Megan , Flanigan David C. , Kaeding Christopher C. , Spindler Kurt P.
Published: March 2015

Background:

Long-term results after anterior cruciate ligament (ACL) reconstruction are being reported with greater frequency, allowing a detailed analysis of long-term patient-reported outcomes and predictors.

Purpose:

To summarize expected patient-reported outcomes at a minimum 10 years following ACL reconstruction and to explore patient and surgical factors that affect these results.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Prospective studies detailing patient-reported outcomes with a minimum follow-up of 10 years were identified. Average scores for each outcome measure were calculated. Factors identified in each paper as predictors of patient-reported outcomes were identified and described.

Results:

Thirteen studies met inclusion and exclusion criteria. Lysholm scores were reported in 317 of 406 patients (78.1%) in 6 studies, with a mean score of 91.7 ± 11.2. Subjective International Knee Documentation Committee scores were reported in 1726 of 2611 patients (66.1%) in 5 studies, with a mean score of 84.2 ± 15.5. Cincinnati knee scores were reported in 1323 of 1801 patients (73.5%) in 3 studies, with a mean score of 87.4 ± 14.4. Tegner activity scores were reported in 728 of 914 patients (79.6%) in 8 studies, with a mean score of 5.1. There was mixed evidence that meniscectomy and articular cartilage damage were associated with poorer patient-reported outcomes. Patient sex and graft choice did not affect patient-reported outcomes.

Conclusion:

Patient-reported outcomes are generally good at a minimum of 10 tears following ACL reconstruction. Further large prospective studies with regression modeling and consistent outcome reporting will clarify predictors of outcomes.
Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight
Authors: Mathewson Karen J. , Pyhälä Riikka , Hovi Petteri , Räikkönen Katri , Van Lieshout Ryan J. , Boyle Michael H. , Saigal Saroj , Morrison Katherine M. , Kajantie Eero , Schmidt Louis A.
Published: March 2015

Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood.
Prognostic value of FDG-PET prior to autologous stem cell transplantation for relapsed and refractory diffuse large B-cell lymphoma
Authors: Sauter Craig S. , Matasar Matthew J. , Meikle Jessica , Schoder Heiko , Ulaner Gary A. , Migliacci Jocelyn C. , Hilden Patrick , Devlin Sean M. , Zelenetz Andrew D. , Moskowitz Craig H.
Published: March 2015

Key Points

FDG-PET–assessed response to ST according to Deauville criteria predicts outcome post-ASCT for rel/ref DLBCL.
Hematopoietic stem cells: concepts, definitions, and the new reality
Authors: Eaves Connie J.
Published: March 2015

Hematopoietic stem cell (HSC) research took hold in the 1950s with the demonstration that intravenously injected bone marrow cells can rescue irradiated mice from lethality by reestablishing blood cell production. Attempts to quantify the cells responsible led to the discovery of serially transplantable, donor-derived, macroscopic, multilineage colonies detectable on the spleen surface 1 to 2 weeks posttransplant. The concept of self-renewing multipotent HSCs was born, but accompanied by perplexing evidence of great variability in the outcomes of HSC self-renewal divisions. The next 60 years saw an explosion in the development and use of more refined tools for assessing the behavior of prospectively purified subsets of hematopoietic cells with blood cell–producing capacity. These developments have led to the formulation of increasingly complex hierarchical models of hematopoiesis and a growing list of intrinsic and extrinsic elements that regulate HSC cycling status, viability, self-renewal, and lineage outputs. More recent examination of these properties in individual, highly purified HSCs and analyses of their perpetuation in clonally generated progeny HSCs have now provided definitive evidence of linearly transmitted heterogeneity in HSC states. These results anticipate the need and use of emerging new technologies to establish models that will accommodate such pluralistic features of HSCs and their control mechanisms.
Planning for the future workforce in hematology research
Authors: Hoots W. Keith , Abkowitz Janis L. , Coller Barry S. , DiMichele Donna M.
Published: March 2015

The medical research and training enterprise in the United States is complex in both its scope and implementation. Accordingly, adaptations to the associated workforce needs present particular challenges. This is particularly true for maintaining or expanding national needs for physician-scientists where training resource requirements and competitive transitional milestones are substantial. For the individual, these phenomena can produce financial burden, prolong the career trajectory, and significantly influence career pathways. Hence, when national data suggest that future medical research needs in a scientific area may be met in a less than optimal manner, strategies to expand research and training capacity must follow. This article defines such an exigency for research and training in nonneoplastic hematology and presents potential strategies for addressing these critical workforce needs. The considerations presented herein reflect a summary of the discussions presented at 2 workshops cosponsored by the National Heart, Lung, and Blood Institute and the American Society of Hematology.
Controllable photoluminescence enhancement of CdTe/CdS quantum dots thin films incorporation with Au nanoparticles
Authors: Wang Hongyu , Xu Ling , Zhang Renqi , Ge Zhaoyun , Zhang Wenping , Xu Jun , Ma Zhongyuan , Chen Kunji
Published: March 2015

Au nanoparticles (Au NPs)/CdTe/CdS QDs nanocomposite films were fabricated by deposition of Au NPs and layer-by-layer self-assembly of colloidal CdTe/CdS QDs. Photoluminescence (PL) spectra showed that Au NPs incorporation resulted in an increase of PL intensity about 16-fold compared with that of the samples without Au NPs. PL enhancement of Au NPs/CdTe/CdS QDs nanocomposite films can be controlled by tuning the thickness of spacer layer between the metal nanoparticles (MNPs) and QDs. Optical absorption spectra exhibited the incorporation of Au NPs boosted the absorption of Au NPs/CdTe/CdS QDs nanocomposite films. The results of finite-difference time-domain (FDTD) simulation indicated that the increased sizes of Au NPs resulted in stronger localization of electric field, which boosted the PL intensity of QDs in the vicinity of Au NPs. We thought that these were mainly attributed to localized SP enhancement effects of the Au NPs. Our experiment results demonstrated that Au NPs/QDs nanocomposite films would be a promising candidate for optoelectronic devices application.

PACS

78.55.-m; 82.33.Ln; 68.65.Hb
Ultradeep analysis of tumor heterogeneity in regions of somatic hypermutation
Authors: Spence Janice M , Spence John P , Abumoussa Andrew , Burack W Richard
Published: March 2015

Tumor heterogeneity is of growing importance in the treatment of cancers. Mutational hot spots are prime locations for determining number and proportions of low variant allele frequency (VAF) tumor subclones by next generation sequencing. Low VAF detection is complicated by poor mapping efficiency in regions with high mutation density. Our Deep-Drilling with iterative Mapping (DDiMAP) method retains variant allele patterns to aid in single nucleotide variation detection and generation of additional reference alleles, with remapping increasing coverage of highly mutated regions to capture data critical to heterogeneity analysis and enhancing sensitivity. DDiMAP outputs variant patterns with frequencies, enabling rapid phylogenetic analysis of ongoing mutation.