bluuebunny/crossref_metadata_2025 huggingface dataset:
Invisible Compromises
Authors: Reade Carol , Thorp Robbin , Goka Koichi , Wasbauer Marius , McKenna Mark
Published: August 2015

The purpose of this article is to challenge organizational scholars, management educators, and business leaders to consider more deeply the impact of global business activities on local ecosystems. Drawing on the management, sustainability, and entomology literature, we illustrate the complex relationship between global business and biodiversity loss through the lens of the commercial bumble bee trade. Global firms in this trade rear and supply bees for greenhouse crop pollination. We build on a well-known global strategy framework used in management education by adding a sustainability dimension, and offering propositions for the relationship between global business strategy and the strength of environmental sustainability. We conclude that a locally responsive, place-sensitive business strategy supports the strongest degree of environmental sustainability, and addresses the invisible compromises to ecosystem health that may result from the efforts of global firms to provide otherwise beneficial products and services.
Revisiting “Measuring What Matters
Authors: Davis Robert C. , Ortiz Christopher W. , Euler Samantha , Kuykendall Lorrianne
Published: August 2015

The job of the police has become increasingly complex as the role of the police has expanded to incorporate new responsibilities ranging from the creation of police-community partnerships to dealing with mentally ill persons in more humane and effective ways. It is no longer enough to measure response time, arrests, and clearance rates. Police managers need to know whether their agencies have the confidence of the community, whether members of the public believe that they are being treated fairly when they request services or when they are stopped by an officer, whether leadership is creating a positive work environment and culture of integrity, and whether services are being provided in a cost-efficient manner. In this article, we give a short history of performance measures for policing. We then describe a project that is attempting to develop a standardized suite of performance measures that are well tested, reliable, inexpensive, and easy to use. Field-tests found that the producing this richer set of performance measures is feasible for a diverse set of police agencies.
Injectable anaesthesia for adult cat and kitten castration: effects of medetomidine, dexmedetomidine and atipamezole on recovery
Authors: Bruniges Natalie , Taylor Polly M , Yates David
Published: August 2015

Objectives

Rapid recovery from injectable anaesthesia benefits cat shelter neutering programmes. The effects of medetomidine, dexmedetomidine and atipamezole on recovery were evaluated in adult cats and kittens (⩽6 months old).

Methods

One hundred healthy male cats (age range 2–66 months, weight range 0.7–5.3 kg) admitted forneutering were randomly allocated to groups of 25. Anaesthesia was induced with 60 mg/m2 ketamine, 180 µg/m2 buprenorphine, 3 mg/m2 midazolam and either 600 µg/m2 medetomidine (groups M and MA) or 300 µg/m2 dexmedetomidine (groups D and DA) intramuscularly (IM). Groups MA and DA also received 1.5 mg/m2 atipamezole IM after 40 mins. Preparation time, surgical time, and times to sternal recumbency and standing were recorded. Data were analysed using the Kruskall–Wallis test, unpaired t-tests and ANOVA. Statistical significance was deemed to be P ⩽0.05.

Results

Groups did not differ significantly in age, body weight, preparation or surgical time. The time to sternal recumbency in group MA (64 ± 34 mins) was less than in group M (129 ± 32 mins), and in group DA it was less than in group D (54 ± 6 mins vs 110 ± 27 mins) ( P <0.001). There were no differences in duration of recovery to sternal recumbency between groups M and D or MA and DA. The time to standing in group MA (79 ± 51 mins) was less than in group M (150 ± 38 mins) ( P <0.001), and in group DA it was less than in group D (70 ± 22 mins vs 126 ± 27 mins) ( P <0.01). Time to standing in group D (126 ± 27 mins) was less than in group M (150 ± 38 mins) (P <0.05). Time to standing in groups DA and MA were not different. Kittens recovered faster than adults after atipamezole. Minimal adverse effects were seen.

Conclusions and relevance

Atipamezole reliably reduced recovery time after anaesthesia incorporating either dexmedetomidine or medetomidine; however, the choice of dexmedetomidine or medetomidine had little effect. Recovery was faster in kittens.
Slipped capital femoral epiphysis in 17 Maine Coon cats
Authors: Borak Danilo , Wunderlin Nadja , Brückner Michael , Schwarz Günter , Klang Andrea
Published: August 2015

Objectives

From May 2009 to January 2015, 208 Maine Coon cats presented to the Tierklinik Hollabrunn – a small animal referral and first-opinion centre – and 17 (8.17%) cats were diagnosed with a slipped capital femoral epiphysis (SCFE). Over the same time period, 29 (0.67%) of 4348 cats (all breeds) were diagnosed with SCFE.

Methods

Clinical and orthopaedic examinations and diagnostic imaging were performed on all affected Maine Coons. Age at first presentation, sex, body weight, body condition score (BCS), unilateral or bilateral manifestation of the disease, activity level and duration of lameness, age at neutering and known family history of disease were recorded. Sixteen of 17 Maine Coons were surgically treated. Surgically removed femoral tissue samples were histologically examined in 13 cases.

Results

The mean age at first presentation was 21.47 months; male to female ratio was 16:1; mean body weight was 7.5 kg (range 5.3–9.3 kg); and mean BCS was 5.06/9.0. Seven cats were bilaterally affected; the median duration of decreased activity level and lameness was 2 weeks; mean age at neutering was 7.7 months (range 3.0–12.0 months); and four cats were littermates. Fourteen femoral head and neck ostectomies, eight total hip replacements and one primary fixation were performed. All 13 histologically available samples confirmed the diagnosis of SCFE.

Conclusions and relevance

To date, SCFE has been reported only occasionally in Maine Coon cats. However, the results of this study showed that Maine Coons were approximately 12-fold more likely to develop SCFE than the overall population of cats presenting to the Tierklinik Hollabrunn over the same time period. Male sex, neutering, delayed physeal closure and breed-specific high body weight may play an important role in the pathogenesis of SCFE in Maine Coon cats.
Quantitative elastohydrodynamic film forming for a gear oil with complex shear-thinning
Authors: Bair Scott , Habchi Wassim , Sperka Petr , Hartl Martin
Published: August 2015

Perhaps the most thorough characterization of the elevated pressure properties of any commercial EHL lubricant is presented here for a gear oil. Compressibility, thermal conductivity, and low-shear viscosity were measured. Of particular interest is the shear dependence of viscosity, measured across four decades of stress, which shows two transitions each with a specific value of power-law exponent. An attempt to capture a suspected third transition at very high stress resulted in mechanical degradation of the liquid in the viscometer. Numerical simulations of a point contact between a steel ball and a glass disc showed good agreement over a range of slide-to-roll ratio for the measured central thickness. The agreement for the minimum thickness was excellent. A new result is that shear-thinning of a higher molecular weight component that occurs from 3 to 200 kPa had little effect on the film thickness and could therefore be neglected in a film thickness calculation.
Annihilation anxiety and crime
Authors: Robinson Robin A , Gadd David
Published: August 2015

This article explores the psychoanalytic construct of annihilation anxiety in order to develop a more thoroughgoing engagement between criminological theory and contemporary psychoanalysis. Though a few criminologists have commented on crime, scapegoating and retribution using classic psychoanalytic ideas, we bring Hurvich’s current empirical work on annihilation anxiety to the discourse. Beginning with his definition of annihilation anxiety as ‘fears of being overwhelmed, merged, penetrated, fragmented, and destroyed’, we apply Hurvich’s measures to reactions to crime and insecurity and interpersonal, collective and international crime. We discuss doing criminology interpretively, applied to the dynamic connections between crime and reactions to it, including political and policy responses. We conclude that criminologists could and should help distinguish between potential and imminent threats, to advance a post-positivist approach to crime and other security threats. We argue that such an approach moves criminology toward a social science more humane and pragmatic for its conscious engagement with unconscious fears harboured amidst the purportedly rational calculi of justice.
Translanguaging in multimodal Macao posters: Flexible versus separate multilingualism
Authors: Zhang Hong , Chan Brian Hok-Shing
Published: August 2015

Aims:

This paper suggests a framework of separate and flexible multilingualism to describe multilingual phenomena in Macao. The aims are to capture both conventional and creative language practice and to explore what exactly is the state of multilingualism in modern Macao under the context of globalization, and more specifically how we can capture variation in multilingual practice.

Methodology:

The objectives are achieved by analyzing the interplay and distance between languages in multilingual texts, focusing on the multimodality and intertextuality of the texts.

Data and analysis:

The database is a collection of 300 posters for cultural and entertainment events in Macao. The distance of languages is analyzed at the unit level in multimodal texts; separate and flexible multilingualism are exemplified and further elaborated.

Conclusions:

Multilingualism in Macao is mainly characterized by separate multilingualism, where different languages are demarcated clearly. However, Macao is undergoing a significant process of globalization, accompanied by a huge flow of people, and concomitantly flexible multilingualism is emergent and coexistent with separate multilingualism. Flexible multilingualism is often manifested in translanguaging. The various practices of translanguaging are performances of creativity and they show criticality by problematizing the widely accepted essentialist conceptions on boundaries between languages and modes.

Originality:

This paper extends the framework of separate and flexible multilingualism to explain multilingual practice in general. We analyze multimodal data using a combined method of multimodality and multilingualism while focusing on the linguistic elements. The paper treats the posters as a special and less studied type of linguistic landscape in Macao, and it provides an original and realistic interpretation of the written multilingual linguistic landscape in a unique Chinese city.

Significance:

This paper provides a new way of understanding multilingualism; translanguaging is broadened to account for written data. Multilingualism can be understood better by observing language-related practice in multimodal texts.
The unstated politics of stranger making in Europe: A brutal kindness
Authors: Nicolson Michelle , de Oliveira Andreotti Vanessa , Mafi Boby Fortune
Published: August 2015

Drawing on the works of Ahmed, Balibar and Appadurai, this article explores the complex dynamics of stranger making in Europe, with particular focus on the status of immigrants who are marked by systemic racialization. The article offers brief analyses of a series of ‘critical incidents’ to illustrate contemporary enactments of stranger making politics in order to examine how theorizations of race and racialization may be shifting in European contexts. It argues that specific notions of nationalism and national identity are being re-configured in the current neoliberal climate of European Union austerity and civil unrest to reify a national ‘us’ against those who must be made ‘stranger’.
An experimental investigation of parameters effect on laser forming of Al6061-T6 sheets
Authors: Roohi Amir H , Moslemi Naeini H , Hoseinpour Gollo M
Published: August 2015

Laser forming, which is categorized as a thermal forming process, is used in forming and bending of metallic and non-metallic sheets. Laser beam irradiation causes a localized temperature increase and a localized mechanical strength decrease. In this article, the effects of four process parameters, comprising laser power, scan velocity, the number of scan passes, and sheet thickness, on laser forming of Al6061-T6 sheets are studied. A design of experiment, including response surface methodology, is carried out to limit the experimental runs and costs and to identify the parameter effects on the bending angle of the sheet. Experiment results show that bending angle increases due to the decrease of scan velocity and sheet thickness. In addition, laser power and number of scan passes have a direct relation with a final sheet forming.
Criminogenic conditions, bribery and the economic crisis in the EU: A macro level analysis
Authors: Alibux Ayreen N.R.N.
Published: August 2015

Financial crime in the form of misconduct, fraud and corruption is widely seen as having triggered the financial crisis that has pushed the Western world into an economic crisis. This paper explores possible relations between conditions that might trigger financial crime (criminogenic conditions) in the years preceding the 2008 crisis, the level of bribery in a country in 2007 and the severity of the economic crisis in the European Union in the period 2008–12 at a macro level. The results suggest that the presence of a number of criminogenic conditions such as banks that are too big to fail, a high level of inequality and free market principles is positively related to the severity of the crisis in the European Union, whereas mixed evidence is found for high levels of bribery.
Expanding the scope of sentencing research: Determinants of juvenile and adult punishment in the Netherlands
Authors: Wermink Hilde , Johnson Brian D. , Nieuwbeerta Paul , de Keijser Jan W.
Published: August 2015

Research on legal and extralegal disparity in criminal sentencing has been conducted primarily in the United States, and, to a lesser extent, in select European nations. Largely separate research literatures have developed around juvenile and adult sentencing decisions, and few studies examine both prosecutorial and judicial punishment outcomes. This study examines the effects of diverse legal and socio-demographic characteristics on both prosecutorial and judicial punishments, for both juveniles and adults. It assesses the broad generalizability of prior research and theorizing, analyzing punishment outcomes for all criminal suspects registered by the Public Prosecutor’s Office in the Netherlands in 2007. Results indicate that offense, case-processing and criminal history characteristics weigh heavily in prosecutorial and judicial decision-making. There are also direct effects of age, gender and nationality on both prosecutorial and sentencing decisions, for both juvenile and adult offenders, in the Dutch justice system. These findings are discussed in relation to the broad discretion exercised by Dutch court actors and the paper concludes with recommendations for future sentencing research in international contexts.
Should universities promote employability?
Authors: McCowan Tristan
Published: August 2015

Employability is becoming increasingly central to the mission and functioning of universities, spurred on by national and supranational agencies, and the demands of marketisation. This article provides a response to the normative dimensions of the question, progressing through four stages: first, there is a brief consideration of the meaning and manifestations of employability and the historical conditions underpinning its emergence; second, the question is addressed of whether employability is a desirable societal and individual aim per se; third, there is a discussion of the fundamental purpose of the university, drawing on the well-known accounts of Newman and Collini, before – fourth – addressing the principal question of whether and in what way employability might fit within that purpose. It is argued that employability is a valid aim of universities only in so far as it is consistent with the central purpose of the institution to foster human understanding through open-ended enquiry. Further questions are discussed, namely, whether other social institutions are better equipped to promote employability, possible costs for the university, the ethical dimension and differences between public and private institutions.
Impact of the Intra- and Inter-observer Variability in the Delineation of Parotid Glands on the Dose Calculation During Head and Neck Helical Tomotherapy
Authors: Piotrowski T. , Gintowt K. , Jodda A. , Ryczkowski A. , Bandyk W. , Ba¸k B. , Adamczyk M. , Skorska M. , Kazmierska J. , Malicki J.
Published: August 2015

The intra- and inter-observer variability in delineation of the parotids on the kilo-voltage computed tomography (kVCT) and mega-voltage computed tomography (MVCT) were examined to establish their impact on the dose calculation during adaptive head and neck helical tomotherapy (HT). Three observers delineated left and right parotids for ten randomly selected patients with oropharynx cancer treated on HT. The pre-treatment kVCT and the MVCT from the first fraction of irradiation were selected to delineation. The delineation procedure was repeated three times by each observer. The parotids were delineated according to the institutional protocol. The analyses included intra-observer reproducibility and inter-structure, -observer and -modality variability of the volume and dose. The differences between the left and right parotid outlines were not statistically significant ( p > 0.3). The reproducibility of the delineation was confirmed for each observer on the kVCT ( p > 0.2) and on the MVCT ( p > 0.1). The inter-observer variability of the outlines was significant ( p < 0.001) as well as the inter-modality variability ( p < 0.006). The parotids delineated on the MVCT were 10% smaller than on the kVCT. The inter-observer variability of the parotids delineation did not affect the average dose ( p = 0.096 on the kVCT and p = 0.176 on the MVCT). The dose calculated on the MVCT was higher by 3.3% than dose from the kVCT ( p = 0.009). Usage of the institutional protocols for the parotids delineation reduces intra-observer variability and increases reproducibility of the outlines. These protocols do not eliminate delineation differences between the observers, but these differences are not clinically significant and do not affect average doses in the parotids. The volumes of the parotids delineated on the MVCT are smaller than on the kVCT, which affects the differences in the calculated doses.
Case Series of HIV Infection–Associated Arteriopathy
Authors: Orrapin Saritphat , Reanpang Termpong , Orrapin Saranat , Arwon Supapong , Kattipathanapong Thanate , Lekwanavijit Suree , Rerkasem Kittipan
Published: August 2015

Patients infected with human immunodeficiency virus (HIV) can present with 4 pathology types: drug-induced vasospasm (ergotism), arterial limb ischemia, critical limb ischemia, and aneurysm. Although these problems are common vascular problems, they result in increased morbidity and mortality in HIV-infected patients, especially aneurysm. Patients with these problems tend to be diagnosed with difficulty because of atypical symptoms and signs. Because of lack of data in treatment outcome literature, our report explores and provides information on HIV infection-related arteriopathy. There were 17 patients in our 5-year review. There was no death in patients except the aneurysm type. The survival of aneurysm patients was significantly lower than from other pathologies ( P = .003). Our case series showed good short-term outcome, and patients were not at risk for less beneficial surgical procedures.
Pathogenesis and Management of Buerger’s Disease
Authors: Liew Ngoh Chin , Lee Limi , Nor Hanipah Zubaidah , Gee Tikfu , Jabar Mohd Faisal
Published: August 2015

Buerger’s disease or thromboangiitis obliterans causes pain, ulceration, or gangrene in the lower or upper extremity. It is associated with chronic cigarette smoking and is believed to be an immune mediated vasculitis. The pathogenesis is still unknown but recent postulate of its association with odontal bacteria has generated much renewed interest. Despite its recognition more than a century ago, little progress has been made in its treatment. Until the pathogenesis is elucidated, abstinence from cigarette is the only effective therapy.
Occupational Therapists’ Views of Nussbaum’s Life Capability
Authors: Mousavi Tahmineh , Dharamsi Shafik , Forwell Susan , Dean Elizabeth
Published: August 2015

Life Capability is the first and most fundamental of Nussbaum’s 10 Central Human Functional Capabilities (CHFCs). This capability refers to a person having a quality life of normal duration. The purpose of this study was to explore the views’ of occupational therapists about Life Capability, specifically, their perspectives of this capability and its perceived relevance to practice. Semi-structured interviews with 14 occupational therapists in British Columbia, Canada, were conducted and thematically analyzed. Within this Canadian context, three themes emerged regarding occupational therapists’ views about Life Capability: basic human right, quality of life, and longevity. Occupational therapists appear to view Life Capability as being consistent with the values of the occupational therapy profession. Nussbaum’s other CHFCs warrant study to explore the degree to which the Capabilities Approach could complement existing occupational therapy theories, science, and practice.
Levels of Guardianship in Protecting Youth Against Exposure to Violence in the Community
Authors: Ahlin Eileen M. , Lobo Antunes Maria João
Published: August 2015

Using hierarchical generalized linear modeling and the Project on Human Development in Chicago Neighborhoods data, the authors examine whether different types of guardianship protect youth against exposure to violence in the neighborhood while controlling for situations where exposure is most likely to occur. Protective family management practices and internal locus of control significantly reduce exposure to community violence. Contrary to expectations, however, neighborhood collective efficacy exerted no effect. The findings emphasize the importance of considering family management practices and individual characteristics as protective factors against harmful environments. Further, guardianship is not restricted to external informal agents of control.
Energy dissipation characteristics of sharp-edged orifice plate
Authors: Wanzheng Ai
Published: August 2015

The energy loss coefficient, relating directly to the energy dissipation ratio, is an important index of this energy dissipater. In this article, this coefficient and its affecting parameters were analyzed by theoretical considerations, and their relationships were obtained by numerical simulations. It could be concluded that the energy loss coefficient of sharp-edged orifice plate and its backflow region length were mainly dominated by the contraction ratio of the orifice plate. Sharp-edged orifice plate’s energy loss coefficient and its backflow region length all increase slightly with the increase in its thickness. When Reynolds number is in the range of 9.00×104–10.3×106, Reynolds number has little impacts on energy loss coefficient and backflow region length. Two empirical expressions, relating to backflow region length and energy loss coefficient, respectively, were presented.
Informed consent and the Facebook emotional manipulation study
Authors: Flick Catherine
Published: August 2015

This article argues that the study conducted by Facebook in conjunction with Cornell University did not have sufficient ethical oversight, and neglected in particular to obtain necessary informed consent from the participants in the study. It establishes the importance of informed consent in Internet research ethics and suggests that in Facebook’s case (and other, similar cases), a reasonable shift could be made from traditional medical ethics ‘effective consent’ to a ‘waiver of normative expectations’, although this would require much-needed change to the company’s standard practice. Finally, it gives some practical recommendations for how to implement such consent strategies, and how the ethical oversight gap between university-led research and industry-led research can be bridged, potentially using emerging Responsible Research and Innovation frameworks which are currently gathering momentum in Europe.
Bereaved participants’ reasons for wanting their real names used in thanatology research
Authors: Scarth Bonnie J
Published: August 2015

This research ethics article focuses on an unexpected finding from my Master’s thesis examining bereaved participants’ experiences of taking part in sensitive qualitative research: some participants wanted their real names used in my written dissertation and any subsequent empirical publications. While conducting interviews for my thesis and explaining the consent process, early responses highlighted the problematic notion of anonymity for participants engaged in qualitative research. Several participants asserted the significance of immortalizing their deceased loved ones in the pages of my thesis, retaining ownership over their words and maintaining a public attachment to their personal identity. The preliminary responses also resonate with concerns regarding the ethics of assigning pseudonyms and anonymity to participants in qualitative research. Themes in the extant literature tend to centre on issues of researchers’ accountability and transparency towards participants or respect. The present article contributes to the debates surrounding anonymity and confidentiality within qualitative research, and also expands on specific issues pertaining to bereavement research ethics.
Osteoporosis
Authors: Wersocki Emily , Paskins Zoe
Published: August 2015

Osteoporosis is a skeletal disease that is characterised by reduced bone mass resulting in a propensity to fractures. These fractures can decrease a patient’s quality of life through fracture-related pain, interventions to treat fractures and subsequent loss of independence. Treatment and management of osteoporosis and its consequences are a significant financial burden on the NHS. This article will discuss how to identify those at risk of osteoporosis, how to assess this risk and what actions to take based on current national and international guidelines.
Ramucirumab for advanced gastric cancer or gastro-oesophageal junction adenocarcinoma
Authors: Young Kate , Smyth Elizabeth , Chau Ian
Published: August 2015

Ramucirumab, a fully humanized monoclonal antibody directed against vascular endothelial growth factor receptor 2, is the first targeted agent to have demonstrated an improvement in survival, as a single agent or in combination, in a molecularly unselected population in gastro-oesophageal cancer. Now that second-line treatment is routinely considered for patients with advanced gastro-oesophageal cancer, ramucirumab, with its favourable toxicity profile compared with cytotoxic treatment, provides a valuable additional treatment option.
Inconsistencies in reporting risk information: a pilot analysis of online news coverage of West Nile Virus
Authors: Birnbrauer Kristina , Frohlich Dennis Owen , Treise Debbie
Published: August 2015

West Nile Virus (WNV) has been reported as one of the worst epidemics in US history. This study sought to understand how WNV news stories were framed and how risk information was portrayed from its 1999 arrival in the US through the year 2012. The authors conducted a quantitative content analysis of online news articles obtained through Google News ( N = 428). The results of this analysis were compared to the CDC’s ArboNET surveillance system. The following story frames were identified in this study: action, conflict, consequence, new evidence, reassurance and uncertainty, with the action frame appearing most frequently. Risk was communicated quantitatively without context in the majority of articles, and only in 2006, the year with the third-highest reported deaths, was risk reported with statistical accuracy. The results from the analysis indicated that at-risk communities were potentially under-informed as accurate risks were not communicated. This study offers evidence about how disease outbreaks are covered in relation to actual disease surveillance data.
De Quervain’s syndrome: It may not be an isolated pathology
Authors: Redvers-Chubb Karen
Published: August 2015

Introduction

This paper details a retrospective review of patients’ records diagnosed with de Quervain’s syndrome following a traumatic event but no history of repetitive strain.

Methods

Data analysis of 41 patients was performed. The inclusion criteria were pain over first dorsal compartment, pain on resisted extensor pollicis brevis and/or abductor pollicis longus, and a positive Finkelstein’s test. The assessment included a subjective history to establish a repetitive activity or a traumatic incident and diagnostic tests to establish possible instability or osteoarthritis.

Results

There were 13 men and 28 women with an age range from 20 to 72 years. Statistical analysis was undertaken using Fisher’s Exact tests. 46.3% ( n = 19) of 41 patients had a ligament injury diagnosed after the de Quervain’s. 94.7% ( n = 18) of 19 patients with ligament instability had a history of trauma, and this was statistically significant. Clinically significant was that 82.9% ( n = 34) of 41 patients demonstrated extensor carpi ulnaris (ECU) muscle weakness, but there was no statistical significant correlation between ECU weakness and ligament instability. Patients could have ECU weakness without ligament instability; however, patients with ligament instability appeared more likely to have ECU weakness.

Conclusions

The results would suggest that de Quervain’s syndrome, in a proportion of patients, could be secondary to underlying wrist pathology due to previous trauma. If the patient does not report a true repetitive strain history, a more thorough assessment may need to be undertaken to establish if there is any underlying pathology.
Tibiotalocalcaneal Arthrodesis Using a Nitinol Intramedullary Hindfoot Nail
Authors: Hsu Andrew R. , Ellington J. Kent , Adams Samuel B.
Published: August 2015

Tibiotalocalcaneal (TTC) arthrodesis using an intramedullary hindfoot nail is a common procedure for deformity correction and the treatment of combined tibiotalar and subtalar end-stage arthritis. Nonunion at one or both fusion sites is a difficult complication that can result in reoperation, significant morbidity, and below-knee amputation. There is currently a need for sustained compression across fusion sites using a TTC hindfoot nail with good mechanical stability. The DynaNail TTC Fusion System (MedShape, Inc, Atlanta, GA) uses an internal nitinol compression element to apply sustained compression across the tibiotalar and subtalar joints after surgery. In preliminary clinical cases, we have found that the nail is safe, reliable, and has promising clinical and radiographic results in settings of hindfoot arthritis, complex deformity, Charcot arthropathy, and talar avascular necrosis.

Levels of Evidence: Expert opinion, Level V
Trends of Concurrent Ankle Arthroscopy at the Time of Operative Treatment of Ankle Fracture
Authors: Ackermann Jakob , Fraser Ethan J. , Murawski Christopher D. , Desai Payal , Vig Khushdeep , Kennedy John G.
Published: August 2015

Background. The purpose of this study was to report trends associated with concurrent ankle arthroscopy at the time of operative treatment of ankle fracture. Method. The current procedural terminology (CPT) billing codes were used to search the PearlDiver Patient Record Database and identify all patients who were treated for acute ankle fracture in the United States. The Medicare Standard Analytic Files were searchable between 2005 and 2011 and the United Healthcare Orthopedic Dataset from 2007 to 2011. Annual trends were expressed only between 2007 and 2011, as it was the common time period among both databases. Demographic factors were identified for all procedures as well as the cost aspect using the Medicare data set. Results. In total, 32 307 patients underwent open reduction internal fixation (ORIF) of an ankle fracture, of whom 313 (1.0%) had an ankle arthroscopy performed simultaneously. Of those 313 cases, 70 (22.4%) patients received microfracture treatment. Between 2005 and 2011, 85 203 patients were treated for an ankle fracture whether via ORIF or closed treatment. Of these, a total of 566 patients underwent arthroscopic treatment within 7 years. The prevalence of arthroscopy after ankle fracture decreased significantly by 45% from 2007 to 2011 ( P < .0001). When ORIF and microfracture were performed concurrently, the total average charge for both procedures drops to $4253.00 and average reimbursement to $818.00 compared with approximately $4964.00 and $1069.00, respectively, when they were performed subsequently. Conclusion. Despite good evidence in favor of arthroscopy at the time of ankle fracture treatment, it appears that only a small proportion of surgeons in the United States perform these procedures concurrently.

Levels of Evidence: Therapeutic, Level IV: Retrospective
The Symmetric Nature of Evaluative Memory Associations
Authors: Kim Jeehye Christine , Sweldens Steven , Hütter Mandy
Published: August 2015

Changing attitudes by repeated co-occurrences of initially neutral stimuli (conditioned stimuli [CSs]) with affective entities (unconditioned stimuli [USs]) is called evaluative conditioning (EC). The vast majority of EC procedures in the literature are “forward” in nature, presenting the CS before the US. Scant empirical research into the issue has argued that forward procedures are more effective than backward procedures, but this research suffers from methodological issues while a meta-analysis indicated no difference. Two experiments show that backward conditioning procedures are equally effective in changing attitudes as forward conditioning procedures. Memory measures show that memory associations are equally strong from the CSs to the USs as from the USs to the CSs, irrespective of the presentation order (forward vs. backward) of the stimuli. Together the data support the proposition that the associations generated by EC are symmetric and bidirectional, rather than unidirectional, in nature.
Clinical learning during night call versus day work: Perceptions of interns
Authors: Qin Yan , Lie Desiree Annabel Seow Lan , Wong Kok Seng
Published: August 2015

Introduction:

Clinical learning during night call has been shown to be less efficient and effective than during the day among residents. Strategies are needed to address the gap between night-time and daytime learning. We conducted a survey study to examine perceptions of night-time compared with daytime learning among Internal Medicine interns, and asked for suggestions to address this gap.

Method:

This is a cross-sectional survey study conducted on a single class of 47 interns from Singapore General Hospital in December 2013. Interns anonymously completed a modified previously published 25-item survey. A total of 23 items asked for ratings of learning during the day versus the night using a 5-point Likert scale. The remaining two open-ended questions invited respondents to suggest improvements for teaching and learning. Analysis was done by descriptive statistics for the Likert-scale items, and thematic coding by two coders for narrative responses.

Results:

Response rate was 70% (33/47). Interns rated learning during the day more positively than during night call for 23 of 23 (100%) items, with 22 out of 23 items showing significant difference. Among the 33 respondents, 20 provided narrative responses. Three major themes emerged: increasing manpower, allowing patient follow-up after night call, and more time for bedside teaching in the daytime.

Conclusion:

Our study confirms that learning during night call is perceived as less effective than during the day. We further extended this finding to offer alternate strategies to enhance clinical learning among interns.
Gastric residual volume management in critically ill mechanically ventilated patients: A literature review
Authors: Guo Bing
Published: August 2015

Measured gastric residual volume (GRV) is most commonly used as a marker to guide enteral feeding rate and prevention of pulmonary aspiration in gastric-fed, mechanically ventilated intensive care unit patients. However, there is little consensus on the practice standard, and controversies exist regarding its implications.

A total of 17 papers were reviewed to evaluate the factors affecting the accuracy of GRV measurement, GRV measurement practices, and its correlations with clinically important complications. Multiple factors affect the accuracy of GRV measurement. GRV threshold and assessment frequency remain undefined. No direct correlation between measured GRV and incidences of pulmonary aspiration or pneumonia was found. However, higher incidences of pulmonary aspiration were observed in cases of higher GRV.

Not measuring GRV could result in patient harm. Reducing GRV prior to position change and procedures associated with high risk for regurgitation could prevent aspiration incidences.
Examining political mobilization of online communities through e-petitioning behavior in We the People
Authors: Dumas Catherine L , LaManna Daniel , Harrison Teresa M , Ravi SS , Kotfila Christopher , Gervais Norman , Hagen Loni , Chen Feng
Published: August 2015

This study aims to reveal patterns of e-petition co-signing behavior that are indicative of the political mobilization of online “communities”. We discuss the case of We the People, a US national experiment in the use of social media technology to enable users to propose and solicit support for policy suggestions to the White House. We apply Baumgartner and Jones's work on agenda setting and punctuated equilibrium, which suggests that policy issues may lie dormant for periods of time until some event triggers attention from the media, interest groups, and elected representatives. In the case study presented, we focus on 21 petitions initiated during the week after the Sandy Hook shooting (14–21 December 2012) in opposition to gun control or in support of policy proposals that are alternatives to gun control, which we view as mobilized efforts to maintain stability and equilibrium in a policy system threatening to change. Using market basket analysis and social network analysis we found a core group of petitions in the “support law-abiding gun owners” theme that were highly connected and four “communities” of e-petitioners mobilizing in opposition to change in gun control policies and in favor of alternative proposals.
Consequences of objective self-awareness during exercise
Authors: Cornick Jessica E , Blascovich Jim
Published: August 2015

Although exercise is recommended by healthcare professionals for nearly everyone, adverse reactions can occur following exercising for some overweight individuals. The reported study investigated the cardiovascular consequences of exercise in a stressful environment. In all, 60 females completed two baseline and one biking (i.e. ergometer) periods while cardiovascular and self-report measures were recorded. Findings indicated that those who are more self-aware showed cardiovascular response patterns indicative of threat. Additionally, post-task exercise self-efficacy levels predicted intentions to exercise at a demanding level in the coming week. These findings suggest exercise may exacerbate health issues for some individuals for whom it is recommended.
Caring for Them Like Family
Authors: Dow Dawn Marie
Published: August 2015

Scholars examining kin and community care have often sought to identify the relative importance of structural and cultural factors on the use and availability of these networks, but research has yielded unclear results in the case of child care. Cultural theories focus on how values, beliefs, and practices lead to differences in kin and community care; structural theories focus on how educational attainment, income, inherited power or inequality, and family structure lead to such differences. Using interviews with 60 African American middle- and upper-middle-class mothers, the author examines their preferences for kin and community members’ assistance in caring for their children. Although participants often had the resources to hire child care providers from the market, they also had access to, and preferred, kin and community networks of care. By examining participants’ accounts of their child care choices, the author identified four factors that influenced their orientations to kin: (1) participants’ experiences growing up with kin and community networks, (2) the current availability of these networks, (3) concerns about racial bias among market-based child care providers, and (4) the cost and benefits that came from using these networks. Although using kin and community care is often associated with structural factors, these data reveal a more complicated relationship between structure and culture.
Portfolio of Outpatients Attending Centre for Urban Health, Madhya Pradesh, Central India
Authors: Gupta Arti , Reddy B. Venkatashiva , Nagar Mukesh Kumar , Chandel Ajeet , Bali Surya
Published: August 2015

Background:

Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community-based surveys, facility-based data provide a good alternative. The aim of this study was to describe the morbidity profile of patients attending the Centre for Urban Health All India Institute of Medical Sciences (AIIMS) Bhopal (CUHA).

Methodology:

A record-based descriptive study was carried out in the CUHA Bhopal, Madhya Pradesh, Central India. Information on age, gender, residence, new case, and principal diagnosis were extracted from the outpatient registers for the period between January 2014 and December 2014. Only newly registered patients for the study year (2014) were included. Descriptive analysis was done.

Results:

A total of 6685 new episodes of illnesses were treated. Adults (>15 years) constituted about 85.0%. Overall, the respiratory disorders were the most common (27.2%) followed by the digestive disorders (10.9%), circulatory disorders (9.9%), musculoskeletal disorders (8.8%), and infectious and parasitic disorders (7.4%).

Conclusion:

This study gives a brief description of the morbidity profile of patients attending a primary health care center over a period of 1 year. This knowledge would help in planning health services to meet the patients’ needs and help in training health staff.
Breast Papillomas
Authors: Bloom Christine
Published: August 2015

The detection of intraductal breast papillomas can be difficult; however, it is very important for diagnosis and treatment. Although intraductal papillomas are usually benign growths, a small percentage may be malignant. No imaging modality can distinguish between benign and malignant papillomas; that is done only with a biopsy. The symptoms vary greatly, ranging from asymptomatic to nipple discharge to a palpable mass. Multiple modalities, including mammography and ductography, have been used to identify papillomas, while magnetic resonance imaging is used to further evaluate known papillomas. Sonography has been proven crucial in identifying these masses, thereby providing information for proper treatment including ultrasound-guided biopsies. The uses of various sonographic techniques, such as color Doppler, harmonic imaging, ballottement, use of stand-off pads, echo palpation, and elastography, have improved the detection of these masses.
Collagen–hyaluronic acid based interpenetrating polymer networks as tissue engineered heart valve
Authors: Nazir R.
Published: August 2015

Currently, custom made heart implants suffer from critical imperfections in terms of mechanical incompatibility and uncontrolled degradation rate, which leads to premature in vivo failure. Interpenetrating polymer networks (IPNs) are a success story in drug delivery and regenerative medicine where they offer fascinating morphologies and tailored properties like controlled degradation rate. This review will critically discuss the current state of the art with respect to the two most important biopolymers found in heart valve, i.e. collagen and hyaluronic acid formulated IPNs as tissue engineered heart valve (TEHV). Comparison of the existing experimental approaches and recent technical challenges will be demonstrated. Finally, multifaceted proposals for improvements in design and performance of TEHVs will be presented as a route map for future research.
Hydroxyurea with AKT2 inhibition decreases vaso-occlusive events in sickle cell disease mice
Authors: Barazia Andrew , Li Jing , Kim Kyungho , Shabrani Namrata , Cho Jaehyung
Published: August 2015

Key Points

Coadministration of HU and an AKT2 inhibitor has beneficial effects on acute vaso-occlusive events and survival in SCD mice.
Clinical highlights: messages from Munich
Authors: Vogiatzis Ioannis , Marvisi Maurizio , Coolen Johan , Gasparini Stefano , Antoniou Katerina M. , Stallberg Bjorn , Bjerg Anders , Herth Felix J.F. , Clini Enrico
Published: August 2015

This article reviews a selection of presentations in the area of clinical problems that were presented at the 2014 European Respiratory Society International Congress in Munich, Germany. We review the most recent and relevant topics of interest in the area of clinical respiratory medicine, encompassing novel reports and studies that are of particular interest to healthcare professionals. Topics ranging from basic science to translation research are presented and discussed in the context of the most up-to-date literature. In particular, the reviewed topics deal with chronic obstructive pulmonary disease and asthma, idiopathic pulmonary fibrosis (pathogenesis and therapy), advances in functional chest imaging, interventional pulmonology, pulmonary rehabilitation, and chronic care.
Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD
Authors: McNamara Renae J. , Elkins Mark R. , Ferreira Manuela L. , Spencer Lissa M. , Herbert Robert D.
Published: August 2015

This study aimed to determine the smallest worthwhile effect of land-based and water-based pulmonary rehabilitation on 6-min walk distance among people with chronic obstructive pulmonary disease (COPD).

Using a benefit–harm trade-off method, people with COPD who had completed two baseline 6-min walk tests at the commencement of outpatient pulmonary rehabilitation were presented with two scenarios: 8 weeks of land-based and 8 weeks of water-based pulmonary rehabilitation. Participants were guided through an iterative process allowing them to progressively refine their estimates of the smallest improvement due to each form of rehabilitation that would outweigh the associated costs, risks and inconvenience presented in the scenario.

100 people with COPD participated (mean±sdage 72±9 years, forced expiratory volume in 1 s 54±16% predicted and baseline 6-min walk distance 377±101 m). For land-based pulmonary rehabilitation, the median smallest worthwhile effect was 20 m (95% CI 15–37 m). For water-based pulmonary rehabilitation, the median smallest worthwhile effect was 26 m (95% CI 15–33 m). These estimates did not differ significantly (p=0.10).

People with COPD typically perceive that pulmonary rehabilitation would be worthwhile if it increased the 6-min walk distance by about 6%. The smallest worthwhile effects of land- and water-based pulmonary rehabilitation were similar.