bluuebunny/crossref_metadata_2025 huggingface dataset:
Cocreation Culture in Health Care Organizations
Authors: Sharma Shikha , Conduit Jodie
Published: August 2016

Both health care practice and academe recognize that organizations should modify their business practices to adopt cocreative behaviors and a service-dominant orientation. However, research has provided little understanding of the organizational culture that supports and facilitates cocreation. Contemporary organizational culture models are constrained from explaining cocreation, as they differentiate between an internal and external focus and do not acknowledge the interconnectedness of all actors across traditional organizational boundaries. This research conceptualizes organizational culture from a service-dominant perspective and provides a framework for a cocreation culture type. It utilizes two case studies in the health care industry, inclusive of 10 in-depth interviews and six focus groups, to conduct a systematic inductive approach to concept development. The findings reveal that a cocreation culture comprises five core cocreation behaviors: coproduction, codevelopment, coadvocacy, colearning, and cogovernance. Additionally, a series of supportive cocreation behaviors stimulate the interactive nature of cocreation: dialogue, shared market intelligence, mutual capability development, and shared decision-making. These behaviors are underpinned by organizational values of mutual respect, empowerment, and mutual trust. Health care practitioners are encouraged to create opportunities for customers to participate in cocreation activities related to their own treatment plans, ongoing strategic planning, and promotion and governance of the organization.
Evaluating Educational Interventions That Induce Service Receipt
Authors: Bowden A. Brooks , Shand Robert , Belfield Clive R. , Wang Anyi , Levin Henry M.
Published: August 2016

Educational interventions are complex: Often they combine a diagnostic component (identifying student need) with a service component (ensuring appropriate educational resources are provided). This complexity raises challenges for program evaluation. These interventions, which we refer to as service mediation interventions, affect additional resources students receive that mediate the impact measured. Evaluations of these types of programs that solely report effects are potentially misleading. Cost-effectiveness analysis clarifies the importance of assessing service-mediated receipt for evaluation purposes. We illustrate our argument empirically from City Connects, a comprehensive student support intervention. We find that the direct costs of the program represent only one-third of the total change in resource use by program participants required to produce impacts. Evaluative statements of service mediation interventions should be accompanied by information on the full costs to achieve effects. Many interventions might be structured in this way and require evaluation that includes an economic perspective.
Case Report of Calciphylaxis Secondary to Calcium and Vitamin D3 Supplementation
Authors: Storan Eoin R. , O’Gorman Susan M. , Murphy Annette , Laing Mary
Published: August 2016

Background:

Calciphylaxis is a rare disorder that is very unusual outside the setting of end-stage kidney disease.

Case Summary:

A 64-year-old woman with normal renal function presented with painful leg ulcers. She had previously received 300 000 IU of vitamin D3 followed by daily calcium and vitamin D3 supplementation. A skin biopsy was consistent with calciphylaxis, and she was treated with sodium thiosulphate infusions and wound debridement.

Conclusion:

Calcium and vitamin D3 supplements are widely prescribed. We report a case of calciphylaxis triggered by calcium and vitamin D3 supplementation in a patient with none of the typical risk factors. Our patient had an excellent response to treatment with sodium thiosulphate.
Consent after Montgomery: What next for healthcare professionals?
Authors: White Philippa
Published: August 2016

The standard of care for consent to treatment has moved to the ‘prudent patient’ or ‘Montgomery’ standard, following the case of Montgomery v Lanarkshire (2015). The standard of care for treatment itself remains the ‘prudent practitioner’ or Bolam Standard following Bolam v Friern Hospital Management Committee (1957). What does this splitting of the legal standard of care for consent mean for the health professionals who deliver care to patients, and what does it mean for the quality of information patients now ought to expect to receive when they consent to treatment? This article considers the advent of true legal ‘informed consent’ into UK healthcare practice, and what it means for information provision to patients from an allied health professional medicolegal perspective.
Natives and tourists of prosumer capitalism: On the varied pro-prosumer activities of producers exemplified in the Polish pop culture industry
Authors: Siuda Piotr , Troszynski Marek
Published: August 2016

This article pertains to the concept of prosumer capitalism, a term which refers to practices among companies of using consumers’ unpaid work (prosumption refers to the mixing of consumption and production). In the literature, this type of capitalism has been treated generally; how pro-prosumer activities differ among producers has been overlooked. This article illustrates these differences by showing the ways in which Polish pop culture producers approach prosumption. The research was conducted through in-depth interviews with representatives from different Polish popular culture companies and the results show that prosumption orientation is determined by what is being produced – films, games, comics, books, television programmes, or music. Producers of video games and comics are most prosumption-oriented – in other words, they may be called ‘natives’ of prosumption – in contrast to ‘tourists’, such as producers of films, television programmes, and books. This article shows that developing the concept of prosumer capitalism requires that consideration as to the prosumer orientations of producers should be specified on a case-by-case basis.
Colourising daylight in buildings: Visual responses in a daylit room supplemented with colour-changing light-emitting diode luminaires
Authors: Gou Zhonghua
Published: August 2016

This research proposes the use of colour-changing light-emitting diode (LED) luminaires to supplement daylight for more sensory working or living environments. An experiment was conducted to examine a room lit by a mixture of natural light from window walls and artificial light from LED luminaires which could be programmed to produce four colour lights: orange (correlated colour temperature around 2000 K), yellow (around 3000 K), green (around 7000 K) and blue (around 8000 K). Participants were required to answer questions pertaining to function (naturalness of selected objects) and sensation (brightness, relaxation, pleasantness and interest). Generally, when daylight was mixed with warm colour, such as orange or yellow, the room was more interesting. Further comparison pointed out that the green light might have a negative effect for daylight perception. The most important finding is that when daylight was supplemented with the blue LED luminaires, the room was most relaxing, pleasing and natural, which was preferred by participants. The findings of this research would inform architects, designers to decide on how to use coloured luminaires as a supplementary light source for daylight to enhance sensory experience in buildings.
A simplified model for evaluating the energy saving potential of adopting demand controlled ventilation in office buildings in Hong Kong
Authors: Jia Jie , Lee Wai-Ling , Chen Hua , Li Han
Published: August 2016

Demand controlled ventilation (DCV) to conserve energy while maintaining an acceptable indoor environment has been used for over 30 years. However, little work has been done on evaluating its energy saving potential in cooling dominant office buildings in subtropical climate. In this study, the energy saving potential of DCV system for use in six representative office buildings in Hong Kong was investigated by simulations. Simulation validation was done based on in situ measurements and site surveys. The findings show that, based on their original design conditions, the use of DCV could lead to 12.5–26.1% energy saving. To facilitate quick estimation of the energy saving potential of DCV system, further simulations were performed for the development of a simplified model. The simplified model relates the energy saving potential to key air-conditioning system and design parameters. Based on the simplified model, sensitivity analysis was conducted to quantify the influences of different parameters on the energy saving potential of DCV system. The developed model method can be used for prediction on the energy saving potential in a wider application of DCV in Hong Kong.
Screening diabetes mellitus 2 based on electronic health records using temporal features
Authors: Pimentel Angela , Carreiro André V , Ribeiro Rogério T , Gamboa Hugo
Published: August 2016

The prevalence of type 2 diabetes mellitus is increasing worldwide. Current methods of treating diabetes remain inadequate, and therefore, prevention with screening methods is the most appropriate process to reduce the burden of diabetes and its complications. We propose a new prognostic approach for type 2 diabetes mellitus based on electronic health records without using the current invasive techniques that are related to the disease (e.g. glucose level or glycated hemoglobin (HbA1c)). Our methodology is based on machine learning frameworks with data enrichment using temporal features. As as result our predictive model achieved an area under the receiver operating characteristics curve with a random forest classifier of 84.22 percent when including data information from 2009 to 2011 to predict diabetic patients in 2012, 83.19 percent when including temporal features, and 83.72 percent after applying temporal features and feature selection. We conclude that he pathology prediction is possible and efficient using the patient’s progression information over the years and without using the invasive techniques that are currently used for type 2 diabetes mellitus classification.
Popular apps on the medical category targeting patients and the general public in the United Kingdom: Do they conform to the Health On the Net Foundation principles?
Authors: Ben-Mussa Ali , Paget Anthony M
Published: August 2016

Smartphones with their rising popularity and versatile software ‘apps’ have great potential for revolutionising healthcare services. However, this was soon overshadowed by concerns highlighted by many studies over quality. These were subject and/or discipline specific and mostly evaluated compliance with a limited number of information portrayal standards originally devised for health websites. Hence, this study aimed to take a broader approach by evaluating the most popular apps categorised as medical in the United Kingdom for compliance with all of those standards systematically using the Health On the Net (HON) Foundation principles.

The study evaluated top 50 free and paid apps of the ‘medical’ category on both iTunes and Google stores for evidence of compliance with an app-adapted version of the HON Foundation code of conduct. The sample included 64 apps, 34/64 (53%) were on Google Play and 36/64 (56%) were free. None of the apps managed to comply with the entire eight principles. Compliance with seven principles was achieved by only one app (1.6%), and the rest were compliant with three, two, and one (14.7%, 27%, and 38%, respectively).

In conclusion, this study demonstrated that most popular apps on the medical category that are available in the United Kingdom do not meet the standards for presenting health information to the public, and this is consistent with earlier studies. Improving the situation would require raising the public awareness, providing tools that would assist in quality evaluation, encouraging developers to use robust development process, and facilitating collaboration and engagement among the stakeholders.
Out of bounds? How Gawker’s outing a married man fits into the boundaries of journalism
Authors: Tandoc Edson C , Jenkins Joy
Published: August 2016

Gawker ignited a controversy when it published an article about a married Conde Nast executive who allegedly sought the services of a gay escort. The popular blog eventually removed the article following condemnation from readers and other journalists. Guided by the frameworks of boundary work and field theory, this study analyzed 65 news articles and 2203 online comments and found that journalists and audiences problematized Gawker’s identity as a journalistic organization and evaluated the article based on traditional standards of newsworthiness, audiences asserted their role in journalism’s larger interpretive community, and that the larger interpretive community assessed the article based on the ethics of outing. Investigating the discourse generated by this critical incident is important because it identifies where journalists and readers draw the boundaries of legitimate journalism, specifies the place of ethics in boundary discourse, and informs journalistic practice about the phenomenon of outing in the news.
Aristotle and the problem of oligarchic harm: Insights for democracy
Authors: Arlen Gordon
Published: August 2016

This essay identifies ‘oligarchic harm’ as a dire threat confronting contemporary democracies. I provide a formal standard for classifying oligarchs: those who use personal access to concentrated wealth to pursue harmful forms of discretionary influence. I then use Aristotle to think through both the moral and the epistemic dilemmas of oligarchic harm, highlighting Aristotle’s concerns about the difficulties of using wealth as a ‘proxy’ for virtue. While Aristotle’s thought provides great resources for diagnosing oligarchic threats, it proves less useful as a guide to democratic institutional design. Aristotle raises a deep-seated objection to democratic forms of ‘rule by the poor.’ A successful response to oligarchy must move beyond Aristotle’s objection and affirm the demos’ tripartite status as many, free, and poor. I briefly outline the terms of this ‘new’ mixed regime: one that seeks to tame oligarchy through a mixture of aggregative, deliberative, and plebeian institutions.
Exploring the nature of visual fixations on other pedestrians
Authors: Fotios S , Uttley J , Fox S
Published: August 2016

How we look at other people may affect conclusions drawn about the effect of changes in lighting when this task needs to be done after dark. This paper reports further analysis of the distance and duration of fixation on other pedestrians, updating a previous review by considering a greater number of fixations and by examining the influence on these of other characteristics such as the relative direction of travel. This analysis provides further support for a tendency to fixate others at a distance of 15 m and for a duration of 500 ms.
A rapid joining scheme based on fuzzy logic for highly dynamic IEEE 802.15.4e time-slotted channel hopping networks
Authors: Duy Thang Phan , Dinh Thanh , Kim Younghan
Published: August 2016

The IEEE 802.15.4e standard is an amendment of the IEEE 802.15.4-2011 protocol by introducing time-slotted channel hopping access behavior mode. However, the IEEE 802.15.4e only defines time-slotted channel hopping link-layer mechanisms without an investigation of network formation and communication scheduling which are still open issues to the research community. This article investigates the network formation issue of the IEEE 802.15.4e time-slotted channel hopping networks. In time-slotted channel hopping networks, a joining node normally takes a long time period to join the network because the node has to wait until there is at least one enhanced beacon message advertised by synchronized nodes (synchronizers) in the network on its own synchronization channel. This leads to a long joining delay and high energy consumption during the network formation phase, especially so in highly dynamic networks in which nodes join or rejoin frequently. To enable a rapid time-slotted channel hopping network formation, this article proposes a new design for slotframe structure and a novel adaptive joining scheme based on fuzzy logic. Our proposed scheme enables a synchronizer to be able to adaptively determine an appropriate number of enhanced beacons it should advertise, based on the number of available synchronizers in the network, so that joining nodes can achieve a short joining time while energy consumption of enhanced beacon advertisement at the synchronizers is optimized. Through extensive mathematical analysis and experimental results, we show that the proposed scheme achieves a significant improvement in terms of joining delay compared to state-of-the-art studies.
Zero-effort projection for sensory data reconstruction in wireless sensor networks
Authors: Zhou Xiancun , Ling Haibo
Published: August 2016

Compressive sensing is a promising technique for data gathering in large-scale wireless sensor networks. Existing compressive sensing–based data gathering techniques still follow sampling than compression paradigm. In this article, we proposed a random sampling zero-encoding data gathering scheme for wireless sensor networks, which exploits virtual Gaussian energy diffusion model to obtain sampling and compression data gathering. Our proposed data gathering model not only can make simultaneous sampling and compression but also do not need to assign projection matrix to each sensor node. Our scheme can efficiently resolve two types of sensor networks’ data gathering problems: recover missing sensory data and extend monitoring field using incomplete random sampling. Extensive experimental results show that our proposed random sampling zero-encoding data gathering model has good performance for reconstructing the sensory data in wireless sensor networks.
Design of a mass-customization-based cost-effective Internet of Things sensor system in smart building spaces
Authors: Park Sanguk , Park Sangmin , Byun Jinsung , Park Sehyun
Published: August 2016

In the coming Internet of Things era, billions of users and devices will be connected to the Internet; this will lead beyond the era of super-connection to the era of super-fusion. In this era, it is more important than ever to design a highly scalable Internet of Things infrastructure by mass customization for cost-effective production of exponentially increasing numbers of Internet of Things systems to provide more intelligent service in smart spaces. The purpose of this article is the design of mass-customization-based Internet of Things system through three-level analysis of the building; it proposes a new concept of a systematic design for providing economical Internet of Things systems for intelligent service in smart building spaces through three-level analysis comprising environmental-, service-, and functional-level analyses.
E2Rebot: A robotic platform for upper limb rehabilitation in patients with neuromotor disability
Authors: Fraile Juan C , Pérez-Turiel Javier , Baeyens Enrique , Viñas Pablo , Alonso Rubén , Cuadrado Alejandro , Franco-Martín Manuel , Parra Esther , Ayuso Laureano , García-Bravo Francisco , Nieto Félix , Laurentiu Lipsa
Published: August 2016

The use of robotic platforms for neuro-rehabilitation may boost the neural plasticity process and improve motor recovery in patients with upper limb mobility impairment as a consequence of an acquired brain injury. A robotic platform for this aim must provide ergonomic and friendly design, human safety, intensive task-oriented therapy, and assistive forces. Its implementation is a complex process that involves new developments in the mechanical, electronics, and control fields. This article presents the end-effector rehabilitation robot, a 2-degree-of-freedom planar robotic platform for upper limb rehabilitation in patients with neuromotor disability after a stroke. We describe the ergonomic mechanical design, the system control architecture, and the rehabilitation therapies that can be performed. The impedance-based haptic controller implemented in end-effector rehabilitation robot uses the information provided by a JR3 force sensor to achieve an efficient and friendly patient–robot interaction. Two task-oriented therapy modes have been implemented based on the “assist as needed” paradigm. As a result, the amount of support provided by the robot adapts to the patient’s requirements, maintaining the therapy as intensive as possible without compromising the patient’s health and safety and promoting engagement.
Multi-routing planning design of Y-type urban rail transit
Authors: Zhao Xinmiao , Sun Quanxin , Zhu Yuting , Ding Yong , Ma Cunrui , Chen Zhijie
Published: August 2016

A Y-type urban rail transit is composed of a trunk and a branch, and the passenger demand has the characteristics of multidirectional and unbalanced. It is important to design routing planning of Y-type urban rail transit and provide reasonable service for passengers with acceptable operational cost. In this study, a routing planning design model was proposed for Y-type urban rail transit aimed at minimizing the passenger travel time and train operating distance. The decision variables of the model were the locations of turn-backs and the departure frequencies of the train routings in the multi-routing planning. The constraints of passenger demand and line condition were considered. The multi-objective model was turned into a single-objective model by giving weight values to the objectives. Then a genetic algorithm was applied to obtain optimal solutions of the proposed model. Finally, a case study was conducted, and the optimal solutions under different forms of multi-routing planning with different weight values were analyzed. The results showed that when the weight of the passenger travel time increased to a certain level, the optimal solution changed from a two-routing planning to a three-routing planning, and the latter one could better meet the characteristics of the passenger.
Results of open pararenal abdominal aortic aneurysm repair: single centre series and pooled analysis of literature
Authors: van Lammeren Guus W , Ünlü Çağdaş , Verschoor Sjoerd , van Dongen Eric P , Wille Jan , van de Pavoordt Eric DWM , de Vries-Werson Debbie AB , De Vries Jean-Paul PM
Published: August 2016

Objectives

Endovascular treatment of pararenal abdominal aortic aneurysm has gained terrain over the past decade, despite the substantial need for reinterventions during follow-up. However, open repair is still a well-established treatment option. With the current study we report the results of a consecutive series of elective primary open pararenal abdominal aortic aneurysm repair in a tertiary vascular referral centre, combined with an overview of current literature and pooled data analysis of perioperative mortality of open and endovascular pararenal abdominal aortic aneurysm repair.

Methods

A retrospective analysis of a prospective database of all elective open pararenal abdominal aortic aneurysm repairs in the St. Antonius Hospital between 2005 and 2014 was performed. Primary endpoint was 30-day mortality. Secondary endpoints were 30-day morbidity, new onset dialysis, reintervention free survival, and overall survival during follow-up.

Results

Between 2005 and 2014, 214 consecutive patients underwent elective open pararenal abdominal aortic aneurysm repair. Mean age was 69.8 (±7.1) years, 82.7% (177/214) were men, and mean abdominal aortic aneurysm diameter was 62 (±11) mm. Thirty-day mortality was 3.4%. Thirty-day morbidity was 27.1%, which predominantly consisted of pneumonia (18.7% (40/214)), cardiac events (3.3% (7/214)), and new onset dialysis (2.8% (6/214)). Estimated five-year overall survival rate was 74.2%. 0.9% (2/214) of patients required abdominal aortic aneurysm-related reintervention, and an additional 2.3% (5/214) required surgical repair of an incisional hernia. Pooled analysis of literature revealed a 30-day mortality of 3.0% for open pararenal repair and 1.9% for fenestrated endovascular repair.

Conclusion

Open pararenal abdominal aortic aneurysm repair in the era of increasing endovascular options results in acceptable perioperative morbidity and mortality rates. Mid-term reintervention rate is low compared to fenestrated endovascular aneurysm repair. Expertise with open repair still remains essential for treatment of pararenal abdominal aortic aneurysms in the near future, especially for those patients that are declined for endovascular treatment.
Outcome of partial repair of massive rotator cuff tears with and without human tissue allograft bridging repair
Authors: Pandey Radhakant , Tafazal Suhayl , Shyamsundar Srinivasan , Modi Amit , Singh Harvinder Pal
Published: August 2016

Background

The surgical management of massive rotator cuff tears remains a challenge. It is suggested that, even in a massive tear that appears irreparable, attempting to repair it as much as possible can be helpful in improving functional outcomes. However the results can be short term and variable. The purpose of our study was to determine if human tissue allograft bridged repair of massive irreparable rotator cuff tears to achieve a complete repair produces similar outcomes compared to partial repair alone.

Methods

We prospectively reviewed outcome scores in 13 patients who underwent partial repair alone for massive irreparable rotator cuff tears and compared them to 13 patients who had partial repairs bridged with allograft. Oxford and Constant scores were compared pre-operatively and at a minimum follow-up of 2 years (range 2 years to 5 years).

Results

The mean improvement in the Constant score at final follow-up compared to pre-operative scores was 27.7 points in the partial repair group and 42.8 points in the allograft group ( p < 0.01). The Oxford Shoulder Score improved mean of 19.3 points in the partial repair group and 29 points in the allograft group ( p < 0.02) at 2 years.

Conclusions

Human tissue matrix allograft provides a better outcome for open bridging of irreparable rotator cuff tears than partial repair alone.
Significance and Reliability of MARD for the Accuracy of CGM Systems
Authors: Reiterer Florian , Polterauer Philipp , Schoemaker Michael , Schmelzeisen-Redecker Guenther , Freckmann Guido , Heinemann Lutz , del Re Luigi
Published: August 2016

Background:

There is a need to assess the accuracy of continuous glucose monitoring (CGM) systems for several uses. Mean absolute relative difference (MARD) is the measure of choice for this. Unfortunately, it is frequently overlooked that MARD values computed with data acquired during clinical studies do not reflect the accuracy of the CGM system only, but are strongly influenced by the design of the study. Thus, published MARD values must be understood not as precise values but as indications with some uncertainty.

Data and Methods:

Data from a recent clinical trial, Monte Carlo simulations, and assumptions about the error distribution of the reference measurements have been used to determine the confidence region of MARD as a function of the number and the accuracy of the reference measurements.

Results:

The uncertainty of the computed MARD values can be quantified by a newly introduced MARD reliability index (MRI), which independently mirrors the reliability of the evaluation. Thus MARD conveys information on the accuracy of the CGM system, while MRI conveys information on the uncertainty of the computed MARD values.

Conclusions:

MARD values from clinical studies should not be used blindly but the reliability of the evaluation should be considered as well. Furthermore, it should not be ignored that MARD does not take into account the key feature of CGM sensors, the frequency of the measurements. Additional metrics, such as precision absolute relative difference (PARD) should be used as well to obtain a better evaluation of the CGM performance for specific uses, for example, for artificial pancreas.
Five-Year Follow-up of Knee Joint Distraction: Clinical Benefit and Cartilaginous Tissue Repair in an Open Uncontrolled Prospective Study
Authors: van der Woude Jan-Ton A.D. , Wiegant Karen , van Roermund Peter M. , Intema Femke , Custers Roel J.H. , Eckstein Felix , van Laar Jaap M. , Mastbergen Simon C. , Lafeber Floris P.J.G.
Published: August 2016

Objective

In end-stage knee osteoarthritis, total knee arthroplasty (TKA) may finally become inevitable. At a relatively young age, this comes with the risk of future revision surgery. Therefore, in these cases, joint preserving surgery such as knee joint distraction (KJD) is preferred. Here we present 5-year follow-up data of KJD.

Design

Patients ( n = 20; age <60 years) with conservative therapy resistant tibiofemoral osteoarthritis considered for TKA were treated. Clinical evaluation was performed by questionnaires. Change in cartilage thickness was quantified on radiographs and magnetic resonance images (MRI). The 5-year changes after KJD were evaluated and compared with the natural progression of osteoarthritis using Osteoarthritis Initiative data.

Results

Five-years posttreatment, patients still reported clinical improvement from baseline: ΔWOMAC (Western Ontario and McMaster Universities Arthritis Index) +21.1 points (95% CI +8.9 to +33.3; P = 0.002), ΔVAS (visual analogue scale score) pain −27.6 mm (95%CI −13.3 to −42.0; P < 0.001), and minimum radiographic joint space width (JSW) of the most affected compartment (MAC) remained increased as well: Δ +0.43 mm (95% CI +0.02 to +0.84; P = 0.040). Improvement of mean JSW (x-ray) and mean cartilage thickness (MRI) of the MAC, were not statistically different from baseline anymore (Δ +0.26 mm; P = 0.370, and Δ +0.23 mm; P = 0.177). Multivariable linear regression analysis indicated that KJD treatment was associated with significantly less progression in mean and min JSW (x-ray) and mean cartilage thickness (MRI) compared with natural progression (all Ps <0.001).

Conclusions

KJD treatment results in prolonged clinical benefit, potentially explained by an initial boost of cartilaginous tissue repair that provides a long-term tissue structure benefit as compared to natural progression. Level of evidence, II.
Magnetic Resonance Imaging Score and Classification System (AMADEUS) for Assessment of Preoperative Cartilage Defect Severity
Authors: Jungmann Pia M. , Welsch Götz H. , Brittberg Mats , Trattnig Siegfried , Braun Sepp , Imhoff Andreas B. , Salzmann Gian M.
Published: August 2016

Objective

To design a simple magnetic resonance (MR)–based assessment system for quantification of osteochondral defect severity prior to cartilage repair surgery at the knee.

Design

The new scoring tool was supposed to include 3 different parameters: (1) cartilage defect size, (2) depth/morphology of the cartilage defect, and (3) subchondral bone quality, resulting in a specific 3-digit code. A clearly defined numeric score was developed, resulting in a final score of 0 to 100. Defect severity grades I through IV were defined. For intra- and interobserver agreement, defects were assessed by 2 independent readers on preoperative knee MR images of n = 44 subjects who subsequently received cartilage repair surgery. For statistical analyses, mean values ± standard deviation (SD), interclass correlation coefficients (ICC), and linear weighted kappa values were calculated.

Results

The mean total Area Measurement And DEpth & Underlying Structures (AMADEUS) score was 48 ± 24, (range, 0-85). The mean defect size was 2.8 ± 2.6 cm2. There were 36 of 44 full-thickness defects. The subchondral bone showed defects in 21 of 44 cases. Kappa values for intraobserver reliability ranged between 0.82 and 0.94. Kappa values for interobserver reliability ranged between 0.38 and 0.85. Kappa values for AMADEUS grade were 0.75 and 0.67 for intra- and interobserver agreement, respectively. ICC scores for the AMADEUS total score were 0.97 and 0.96 for intra- and interobserver agreement, respectively.

Conclusions

The AMADEUS score and classification system allows reliable severity encoding, scoring and grading of osteochondral defects on knee MR images, which is easily clinically applicable in daily practice.
An epidural arteriovenous fistula studied with time-resolved imaging of contrast kinetics (TRICKS) sequence
Authors: Romano Andrea , Consoli Arturo , Tari Capone Francesca , Biraschi Francesco , Suma Giacomo , Mangiafico Salvatore , Bozzao Alessandro
Published: August 2016

We describe the use of time-resolved MR angiography in the diagnosis of cervical epidural arteriovenous fistula before final diagnosis and embolization was achieved by digital subtraction angiography. A 42-year-old woman was referred to us because of headache and dizziness, in addition to radiculopathy of the right superior limb. Angiographic examinations documented a direct high-flow arteriovenous fistula between the right vertebral artery and the cervical epidural venous plexus. The point of fistula was located in the upper third of the cervical segment below the C2 arch. Time-resolved MR angiography might add important information in case of suspected arteriovenous fistula, helpful both for therapeutic decisions and follow-up.
Reduction of psycho-spiritual distress of an elderly with advanced congestive heart failure by life review interview in a palliative care day center
Authors: Chan Kwok-Ying , Lau Vikki Wai-Kee , Cheung Ka-Chi , Chang Richard Shek-Kwan , Chan Man-Lui
Published: August 2016

Objectives:

Major depression is common in patients hospitalized with congestive heart failure and is independently associated with increased re-hospitalization and mortality.

Methods:

Hereby, we report the treatment for an elderly congestive heart failure patient with frequent emergency department visits having major depression and hopelessness.

Results:

Treatment outcomes measured showed that depressed scores of psychosocial needs were reduced with life review interview therapy in a palliative care day center.

Conclusion:

We hypothesize that multidisciplinary team’s approach to treatment was important for this case.
Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics
Authors: Grossi Enzo , Melli Sara , Dunca Delia , Terruzzi Vittorio
Published: August 2016

Objectives:

Autism spectrum disorder is a neurodevelopmental condition that typically displays socio-communicative impairment as well as restricted stereotyped interests and activities, in which gastrointestinal disturbances are commonly reported. We report the case of a boy with Autism Spectrum Disorder (ASD) diagnosis, severe cognitive disability and celiac disease in which an unexpected improvement of autistic core symptoms was observed after four months of probiotic treatment.

Method:

The case study refers to a 12 years old boy with ASD and severe cognitive disability attending the Villa Santa Maria Institute in resident care since 2009. Diagnosis of ASDs according to DSM-V criteria was confirmed by ADOS-2 assessment (Autism Diagnostic Observation Schedule). The medication used was VSL#3, a multi-strain mixture of ten probiotics. The treatment lasted 4 weeks followed by a four month follow-up. The rehabilitation program and the diet was maintained stable in the treatment period and in the follow up. ADOS-2 was assessed six times: two times before starting treatment; two times during the treatment and two times after interruption of the treatment.

Results:

The probiotic treatment reduced the severity of abdominal symptoms as expected but an improvement in Autistic core symptoms was unexpectedly clinically evident already after few weeks from probiotic treatment start. The score of Social Affect domain of ADOS improved changing from 20 to 18 after two months treatment with a further reduction of 1 point in the following two months. The level 17 of severity remained stable in the follow up period. It is well known that ADOS score does not fluctuate spontaneously along time in ASD and is absolutely stable.

Conclusions:

The appropriate use of probiotics deserves further research, which hopefully will open new avenues in the fight against ASD.
False-positive magnetic resonance imaging findings in follow-up of pediatric patients with tumors of the central nervous system
Authors: De Oliveira Satiro Nakamura , Gonzalez-Gomez Ignacio , Panigrahy Ashok , Krieger Mark , McComb Gordon , Finlay Jonathan L , Dhall Girish
Published: August 2016

Management of patients with central nervous system tumors relies largely on magnetic resonance imaging scans to document disease progression or recurrence. The finding of new lesions always presents the challenge of differentiating between post-surgical changes, radiation necrosis, gliosis, and tumor, submitting these patients to more aggressive therapy and more toxicity. We reviewed the medical records of three patients with primary central nervous system tumors treated at the Children’s Hospital Los Angeles who had new false-positive magnetic resonance imaging findings suggestive of tumor recurrence. All of them had complete total resection of primary tumor, had received involved-field radiation therapy, had biopsies confirming absence of viable tumor, and all three patients are long-term survivors. These cases exemplify that not everything that enhances on brain or spine magnetic resonance imaging is viable tumor, and a biopsy should always be considered in the decision-making process in evaluation of potentially recurrent central nervous system tumors in pediatric patients. A step-wise approach for such challenging cases is presented in this article.
Ungual fibroma in 12-year-old boy with hypomelanotic macules, intellectual disability and attention deficit hyperactivity disorder—possible tuberous sclerosis
Authors: Glavan Nedeljka , Ljubičić-Bistrović Ivana , Grahovac Blaženka , Traven Luka , Sasso Anton , Jonjić Nives
Published: August 2016

Objective:

To report a case of a 12-year-old boy with intellectual disability and attention deficit hyperactivity disorder, who came to surgery for an examination due to a minor bulge on the left thumb, which had been growing for the previous month. His mother denied any trauma.

Methods:

After the removal of the clinically ambiguous bulge and a pathohistological confirmation that it was a periungual fibroma, complete patient analysis was performed due to the presence of hypomelanotic macules and a suspected tuberous sclerosis.

Results:

Considering the presence of hypomelanotic macules, as one of the main criteria, possible TS diagnosis was set.

Conclusion:

Early detection of the symptoms of TS enables a timely provision of protocols for further patient monitoring, which affects the patient’s morbidity and mortality.
A cross-modal feedback scheme for control of prosthetic grasp strength
Authors: Kaneris Ioannis , Gibson Alison , Artemiadis Panagiotis
Published: August 2016

Introduction

Given the lack of haptic feedback inherent in prosthetic devices, a natural and adaptable feedback scheme must be implemented. While multimodal feedback has proven successful in aiding dexterous performance, it can be mentally tasking on the individual. Conversely, cross-modal schemes relying on sensory substitution have proven to be equally effective in aiding task performance without cognitively burdening the user to the same degree.

Objectives

This experiment investigated the effectiveness of the cross-modal feedback scheme through using audio feedback to represent prosthetic grasping strength during dynamic control of a prosthetic hand.

Methods

A total of five individuals participated in two sets of experiments (four subjects in the first, one subject in the second). Participants were asked to control the grasping strength exerted by a prosthetic hand while using real-time audio feedback in order to reach up to three different levels of force within a trial set.

Results

The cross-modal feedback scheme successfully provided users with the robust ability to modulate grasping strength in real-time using only audio feedback.

Conclusion

Audio feedback effectively conveys haptic information to the user of a prosthetic hand. Retention of the training knowledge is evident and can be generalized to perform new (i.e. untrained) tasks.
A Contextual Analysis of Implementation Challenges of Small-Scale Mining Laws in Ghana
Authors: Asamoah Kwame , Osei-Kojo Alex
Published: August 2016

This study examines the implementation challenges of small-scale mining laws in the Bekwai Municipality of Ghana. The study adopted the qualitative approach using a case study design. Primary data were obtained through in-depth interviews and focus group discussions. Among others, this study found that illegal mining is a formidable challenge to the implementation of small-scale mining laws in the Bekwai Municipality. The study also found that scarcity of logistical and human resources undermines the implementation of small-scale mining laws in the Municipality.
Sustainability in Higher Education
Authors: Reza Mohammad Imam Hasan
Published: August 2016

Sustainability describes how a system remains diverse and productive; this is the potential for long-term maintenance of well-being having ecological, economic, political, and cultural dimensions. Education for sustainable development (ESD) emphasizes on including the key sustainable development issues into teaching and learning, that is, climate change, disaster risk reduction, biodiversity, poverty reduction, and sustainable consumption. This effort requires effective pedagogy to ensure a participatory teaching and learning method that will motivate and empower future leaders to ensure sustainability in their social systems. Malaysia has incorporated the principles of Agenda 21 as one of the important sustainable development documents into its national planning process. However, the effectiveness of these teaching–learning programs, and their effective pedagogical approaches and endpoints are not satisfactorily ensured. Therefore, at first, this article reviews the existing various programs and research activities of public and private higher educational institutions in Malaysia that address sustainability. It then discusses the pedagogical approaches of these programs and how they are related to the key concept of the ESD. Finally, some conclusions and recommendations have been suggested to improve the initiatives to develop a scientifically sound and effective pedagogy for the ESD programs in higher education systems in Malaysia.
From “Healthy Eating” to a Holistic Approach to Current Food Environments
Authors: Traverso-Yepez Martha , Hunter Kelly
Published: August 2016

The consumption of the industrial diet—characterized by highly processed, low-nutrient foods and the reduced intake of produce in its natural state, such as fruits and vegetables—is generating a large number of health and environmental concerns in the developed world. In the meantime, the public health response to food-related health issues typically focuses on healthy eating, despite the growing amount of research showing the complexity of food environments. In this article, we discuss the limitations and fragmented perspective of current “healthy eating” strategies and the obvious disconnect between public health interventions and broader food environments. We outline the transformation of food environments in recent decades and how this is shaped by shifting ways of life and forms of governance built on neoliberal principles, which in turn influence individuals’ food practices. By availing of critical social theory, we suggest that the potential for change should involve a systemic, ecological understanding of the complexities involved, exposing the interdependencies within broader socioeconomic, cultural, and political contexts and current food systems processes and environments.
Individual Hearing Loss
Authors: Santurette Sébastien , Dau Torsten , Christensen-Dalsgaard Jakob , Tranebjærg Lisbeth , Andersen Ture , Poulsen Torben
Published: August 2016

It is well-established that hearing loss does not only lead to a reduction of hearing sensitivity. Large individual differences are typically observed among listeners with hearing impairment in a wide range of suprathreshold auditory measures. In many cases, audiometric thresholds cannot fully account for such individual differences, which make it challenging to find adequate compensation strategies in hearing devices. How to characterize, model, and compensate for individual hearing loss were the main topics of the fifth International Symposium on Auditory and Audiological Research (ISAAR), held in Nyborg, Denmark, in August 2015. The following collection of papers results from some of the work that was presented and discussed at the symposium.
Changes in Income-Based Gaps in Parent Activities With Young Children From 1988 to 2012
Authors: Kalil Ariel , Ziol-Guest Kathleen M. , Ryan Rebecca M. , Markowitz Anna J.
Published: August 2016

Numerous studies show large differences between economically advantaged and disadvantaged parents in the quality and quantity of their engagement in young children’s development. This “parenting gap” may account for a substantial portion of the gap in children’s early cognitive skills. However, researchers know little about whether the socioeconomic gap in parenting has increased over time. The present study investigates this question, focusing on income- and education-based gaps in parents’ engagement in cognitively stimulating activities with preschool-aged children. We draw on data from four national studies conducted over 25 years. We found a decrease in income-based gaps in children’s book ownership and library attendance but increasing income-based gaps for several other parent behaviors, including reading and telling stories to children and teaching children letters, words, and numbers. Income-based gaps in children’s participation in out-of-home cultural activities also increased. Results for education-based gaps were similar. These gaps largely arose from top-income families pulling away from their middle- and low-income counterparts.
Socioeconomic Gaps in Early Childhood Experiences
Authors: Bassok Daphna , Finch Jenna E. , Lee RaeHyuck , Reardon Sean F. , Waldfogel Jane
Published: August 2016

This study compares the early life experiences of kindergarteners in 1998 and 2010 using two nationally representative data sets. We find that (a) young children in the later period are exposed to more books and reading in the home, (b) they have more access to educational games on computers, and (c) they engage with their parents more, inside and outside the home. Although these increases occurred among low- and high-income children, in many cases the biggest changes were seen among the lowest-income children. Our results indicate narrowing but still large early childhood parental investment gaps. In addition, socioeconomic gaps in preschool participation grew over this period, despite substantial investments in public preschool. Implications for early socioeconomic achievement gaps are discussed.
Facilitating the Transition to Kindergarten
Authors: Little Michael H. , Cohen-Vogel Lora , Curran F. Chris
Published: August 2016

Leveraging data from two nationally representative cohorts from the ECLS-K (Early Childhood Longitudinal Study–Kindergarten), we examine the types of transition practices that schools use to ease children’s adjustment to formal schooling. The transition to kindergarten is a critical juncture in a child’s life that entails a host of social, behavioral, and academic changes. We find a modest increase between the two cohorts in the number of transition practices that schools offer children and their families, although we also find that fewer of these practices are offered in traditionally underserved schools. We conclude with a discussion of the implications of these findings and suggest areas for future research.