bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of stick–slip transitions in mixed-friction predictions of heavily loaded cam–roller contacts
Authors: Alakhramsing Shivam S , de Rooij Matthijn B , van Drogen Mark , Schipper Dirk J
Published: July 2018

A load-sharing-based mixed lubrication model, applicable to cam–roller contacts, is developed. Roller slippage is taken into account by means of a roller friction model. Roughness effects in the dry asperity contact component of the mixed lubrication model are taken into account by measuring the real surface topography. The proportion of normal and tangential load due to asperity interaction is obtained from a dry contact stick–slip solver. Lubrication conditions in a cam–roller follower unit, as part of the fuel injection equipment in a heavy-duty diesel engine, are analyzed. Main findings are that stick–slip transitions (or variable asperity contact friction coefficient) are of crucial importance in regions of the cam where the acting contact forces are very high. The contact forces are directly related to the sliding velocity/roller slippage at the cam–roller contact and thus also to the static friction mechanism of asperity interactions. Assuming a constant asperity contact friction coefficient (or assuming that gross sliding has already occurred) in highly loaded regions may lead to large overestimation in the minimal required cam–roller contact friction coefficient in order to keep the roller rolling. The importance of including stick–slip transitions into the mixed lubrication model for the cam–roller contact is amplified with decreasing cam rotational velocity.
Dimethyl fumarate–associated transient bone marrow oedema syndrome
Authors: Triplett James , Vijayan Srimathy , Prince Richard , Kermode Allan
Published: July 2018

Background:

Dimethyl fumarate (DMF) is a commonly used and effective treatment for relapsing and remitting multiple sclerosis. Its use results in impairment of the transcription factor nuclear factor erythroid-derived 2 (E2)-related factor (Nrf2), which is involved in both immunomodulation and bone health. DMF has not previously been reported to cause bone marrow complications, though other fumarates including tenofovir have. The mechanism of fumarate-associated bone toxicity remains unclear with altered osteoblastic gene expression and function suggested.

Methods:

We present a case of a 54-year-old female with relapsing remitting multiple sclerosis (RRMS) treated for 30 months with DMF who developed relapsing atraumatic lower limb bone pain.

Results:

Serial imaging revealed multifocal areas of bone marrow oedema and trabecular fractures. The patient was diagnosed with transient bone marrow oedema syndrome. Management consisted of cessation of therapy and treatment with the pro-osteobalstic agent denosumab.

Conclusion:

In this instance of DMF-associated bone marrow oedema, cessation of DMF and treatment with denosumab resulted in symptomatic improvement. DMF therapy may potentially result in bone marrow oedema due to inhibition of common upstream signalling pathways, including the Nrf2 signalling pathway.
Multiple sclerosis disease progression: Contributions from a hypoxia–inflammation cycle
Authors: Yang Runze , Dunn Jeff F
Published: July 2018

Hypoxia has been associated with multiple sclerosis (MS) and is an important area of research. Hypoxia can exacerbate inflammation via the prolylhydroxylase pathway. Inflammation can also trigger hypoxia by damaging mitochondria and endothelial cells to impair blood flow regulation. We hypothesize that there is a “hypoxia–inflammation cycle” in MS which plays an important role in MS disease progression. Therapies that break this cycle may be an interesting area of exploration for treatment of MS.
Impairments of executive function in young children referred to child psychiatric outpatient clinic
Authors: Huhdanpää Hanna , Klenberg Liisa , Westerinen Hannu , Bergman Paula Hannele , Aronen Eeva Tuulikki
Published: July 2018

Few studies have reported on the quantity and quality of executive function (EF) deficits in young children referred to child psychiatric outpatient clinic with multiple psychiatric symptoms. We evaluated the EF deficits with the Attention and Executive Function Rating Inventory–Preschool (ATTEX-P) filled out by day care teachers for 4- to 7-year-old clinical group ( n = 171) and reference group ( n = 709). Family background information was collected from all families by parent questionnaire. Diagnoses of the referred children were collected from medical records. Clinical group exhibited higher mean ranks across the ATTEX-P Total score and all nine subscales than reference group ( p < .001). Most of the children in the clinical group (58.5%) showed a significant amount of EF deficits (ATTEX-P Total score over clinical cut-off) including distractibility (55.6%) and impulsivity (53.8%) regardless of their diagnoses. In a multiple logistic regression model (controlling for age, gender and parental education), children in the clinical group had increased risk (odds ratio (OR)) = 10.6, 95% confidence interval (CI) = [6.88, 16.2], p < .001) for scoring over the clinical cut-off point on the ATTEX-P Total score. Assessment of EFs should be a routine part of the treatment plan in young children referred to child psychiatric outpatient clinic as it may guide the treatment choices.
Say cheese? The connections between positive facial expressions in student identification photographs and health care seeking behavior
Authors: Cross Marie P , Pressman Sarah D
Published: July 2018

This study examined whether positive facial expressions in student identification photographs were connected with a health-relevant behavior: visits to a health care center in the last year for preventive and non-preventive (e.g. illness, injury) purposes. Identification photographs were coded for degree of smile. Smiling participants were more likely to have sought preventive care versus those not smiling in their photographs, but there was no difference in non-preventive (i.e. ill health) visits. This study shows for the first time that smiling in photographs may be related to healthy behavior and complements past work connecting smiling to positive psychosocial and health outcomes.
“Please do not act violently towards the staff”: Expressions and causes of anger, violence, and aggression in Israeli cancer patients and their families from the perspective of oncologists
Authors: Granek Leeat , Ben-David Merav , Bar-Sela Gil , Shapira Shahar , Ariad Samuel
Published: July 2018

Expressions of anger within the healthcare context are a common occurrence, particularly in clinical situations where patients can experience emotional distress in the face of illness. The purpose of this study was to examine one aspect of this phenomenon by looking at expressions and causes of anger among Israeli cancer patients and their families from the perspective of oncologists who treat them. Twenty-two Israeli oncologists were interviewed from three oncology centers between March 2013 and June 2014. The grounded theory method was used to collect and analyze the data. Our study revealed that oncologists are exposed to and cope with expressions and acts of anger, aggression, and violence from some of their cancer patients and their families. The causes of this anger include physician blame, unrealistic treatment expectations, perceived errors in communication, and lack of follow up with bereaved families. Our study also revealed that the cultural context affected patient–physician interactions, including anger. This context included a culture that has open interpersonal boundaries and is family-oriented; a multicultural society that includes citizens with different cultural norms and expectations around cancer care; and a strained healthcare system that leaves oncologists limited in time and resources, including limited access to palliative care. Policy implications include reducing oncologist workload by hiring more mental health professionals, having translators available on site to help with language barriers, reducing administrative burdens, and incorporating palliative care widely to help with the psychosocial and physical care of patients and families.
Process Evaluation of an Early Care and Education Intervention: The California Childhood Obesity Research Demonstration Study (CA-CORD)
Authors: Lin Shih-Fan , Binggeli-Vallarta Amy , Cervantes Griselda , Angulo Janette , Moody Jamie S. , McKenzie Thomas L. , Horton Lucy A. , Ayala Guadalupe X.
Published: July 2018

Given the widespread use of out-of-home child care in the United States, early care and education (ECE) providers offer ideal settings to promote health behaviors among Hispanic/Latino children whose obesity prevalence remains high. This study details the process evaluation of ECE intervention strategies of a childhood obesity research demonstration study (California Childhood Obesity Research Demonstration [CA-CORD]) to prevent and control obesity among Hispanic/Latino children aged 2 to 12 years. Participating ECE providers received the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) materials and action planning sessions with a trained interventionist; Sports, Play, and Active Recreation for Kids (SPARK) physical activity (PA), health behavior, and body mass index assessment trainings; and health behavior toolkit, cooking kit, water dispensers, and posters to promote healthy eating, PA, water consumption, and quality sleep. Intervention logs and director/lead teacher interviews evaluated how well 14 center-based and 9 private ECE providers implemented policy, system, and environmental changes. NAP SACC was implemented with higher fidelity than other strategies, and participation in SPARK trainings was lower than health behavior trainings. ECE directors/lead teachers reported that the intervention activities and materials helped them promote the targeted behaviors, especially PA. Results demonstrated that the use of NAP SACC, trainings, and toolkit had high fidelity and were potentially replicable for implementation in ECE settings among Hispanic/Latino communities.
Rebuilding Finance’s “Action Man” through CNBC’s The Closing Bell
Authors: Cormany Diane L.
Published: July 2018

CNBC’s The Closing Bell contributed to the expansion of finance capital in the late twentieth century through its televisual emphasis on incremental market change that functions affectively to call for action. Such emphasis on short-term stock movement was called into question during the 2008 global financial crisis. However, detailed analysis demonstrates that The Closing Bell did not alter course. I argue that its ongoing focus on incremental movement has worked affectively to shore up a masculinized culture of finance during a period that demanded structural reform.
A virtual slotframe technique for reliable multi-hop IEEE 802.15.4e time-slotted channel hopping network
Authors: Ha Yuvin , Chung Sang-Hwa
Published: July 2018

Time-slotted channel hopping is one of the medium access control modes defined in IEEE 802.15.4e. Although time-slotted channel hopping provides high reliability, it cannot be achieved automatically. A time-slotted channel hopping should be configured properly according to the dynamic changes in a network. When new devices participate in the network or the data traffic is increased, link allocation may not be possible due to the fixed slotframe length. The simplest way to acquire additional links is to change the length. However, the conventional method to change this length involves significant overhead and the possibility of link failures. In this article, we evaluate the performance of the conventional IEEE 802.15.4e method and analyze the problems that can occur when changing the slotframe length. To resolve these problems, we propose a virtual slotframe technique that forms a logical slotframe by connecting multiple slotframes. A slot scheduler will then perceive the virtual slotframe as merely a long slotframe. The devices can translate the schedules made for the longer slotframe into real links using the virtual slotframe technique. These features allow the time-slotted channel hopping network to allocate additional slots without reconfiguration. The simulation results show that the proposed technique is a maximum of 18 times and an average of 10 times faster than the conventional method.
Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States
Authors: Sharma Akshay , Kahle Erin M. , Sullivan Stephen P. , Stephenson Rob
Published: July 2018

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.
Stability of total prostate-specific antigen and free prostate-specific antigen after 10 years’ storage
Authors: Simanek Vaclav , Topolcan Ondrej , Karlikova Marie , Dolejsova Olga , Fuchsova Radka , Kinkorova Judita , Slouka David , Kucera Radek
Published: July 2018

Introduction:

PSA is a serine protease composed of 240 amino acids in a single polypeptide chain and is a routine parameter in prostate cancer diagnostics. The aim of our study was to test the long-term stability of tPSA and fPSA after 10 years’ storage at −80°C.

Materials and methods:

We analyzed two aliquots from 55 serum samples. The first was assayed in routine testing at the time of establishing the diagnosis. The second was thawed for further testing after approximately 10 years’ storage at −80°C. The mean of storage time was 10.41 years (min–max: 9.35–11.40 years). We compared the results of tPSA and fPSA. We calculated the fPSA/tPSA ratio and compared the results of clinical evaluation. Serum tPSA and fPSA levels were assayed using chemiluminescent kits Access Hybritech PSA and free PSA. All measurements were performed using the instrument UniCel® DxI 800.

Results:

tPSA decreased 3.59% on average with a correlation r=0.9213, and fPSA increased at an average of 2.41% with a correlation r=0.9338. The fPSA/tPSA ratio increased 0.80% on average with a correlation r=0.9174. On clinical evaluation, five samples had fallen to a less malignant category and three samples had risen to a higher malignant category compared with the original results.

Conclusion:

The stability of tPSA and fPSA levels in serum is sufficient after 10 years’ storage at −80°C. Calculation of the fPSA/tPSA ratio is not recommended due to the change in the category of malignancy of 15% of the samples.
Understanding carer resilience in Duchenne muscular dystrophy: A systematic narrative review
Authors: Glover Suzanne , Hendron Jill , Taylor Brian , Long Maggie
Published: July 2018

Objectives

This review synthesizes recent research on resilience in those who care for a family member with Duchenne muscular dystrophy, identifying the challenges and potential factors moderating resilience.

Methods

This systematic narrative review is informed by searches on six bibliographic databases between January and June 2016. Forty-one articles were identified to meet the inclusion criteria, and findings were synthesised around three key themes.

Results

Those who care for someone with Duchenne muscular dystrophy have been described as resilient through building strength in facing the adversity of caring. The main predictors of carer resilience were the child’s level of disability, perception of the caring experience and family functioning. The outcomes of resilience were identified as better psychological and physical health as well as psychological adaption. Coping abilities and social support, influenced by individual and environmental factors contribute to resilience.

Discussion

Research suggested that some carers have the ability to build resilience over time, although limited understanding of coping with the emotional experience of Duchenne muscular dystrophy is conveyed. Social support appears to be a protective factor for Duchenne muscular dystrophy carers but further research is required on its relationship with resilience.
A case of ANCA-associated vasculitis presenting de novo in pregnancy, successfully treated with rituximab
Authors: Pefanis A , Williams DS , Skrzypek H , Fung A , Paizis K
Published: July 2018

Antineutrophil cytoplasm antibody (ANCA)-associated vasculitides are rare small vessel vasculitides of unknown cause. The pathogenic role of MPO-ANCA in the vasculitides has been supported using various animal models, with B-cells playing a role in the disease pathogenesis. Pregnancy in the presence of an autoimmune disease such as vasculitis is often associated with significant morbidity. Little is known about the outcomes when women present with de novo vasculitis during pregnancy, and the appropriate management of such presentations is unclear. We describe a case of a 33-year-old female presenting in her second pregnancy with new onset ANCA vasculitis at 12 weeks’ gestation. She was successfully treated with prednisolone and rituximab, and delivered a healthy 2.8 kg boy at 36 weeks’ gestation with no clinical manifestations of vasculitis or neutropenia in the neonate.
Pregnancy in women known to be living with a single kidney
Authors: Steele Samantha EJ , Terry Jayne E , Page Louise M , Girling Joanna C
Published: July 2018

There is a paucity of data on pregnancy outcome in women living with a single kidney from all causes. Current thinking is extrapolated from living kidney donors, a group biased by strict selection criteria. We present a cohort of 26 women with a solitary functioning kidney; 11 women had an acquired single kidney of whom only 1 was a living donor and 15 had a congenital single kidney. Median time living with a single kidney was 28 years. None booked with hypertension or proteinuria. Urinary tract infection complicated 50% of pregnancies. Worryingly, 35% developed pre-eclampsia, gestational proteinuria or gestational hypertension. We propose pre-conceptual counselling, education on how to protect their single kidney, pre eclampsia prophylaxis with low-dose aspirin and close monitoring for urinary tract infection, hypertension and proteinuria with lower thresholds for pharmaceutical management. We have devised a Patient Information leaflet – ‘Living with a single kidney, pregnancy and beyond’.
An Appraisal-Driven Componential Approach to the Emotional Brain
Authors: Sander David , Grandjean Didier , Scherer Klaus R.
Published: July 2018

This article suggests that methodological and conceptual advancements in affective sciences militate in favor of adopting an appraisal-driven componential approach to further investigate the emotional brain. Here we propose to operationalize this approach by distinguishing five functional networks of the emotional brain: (a) the elicitation network, (b) the expression network, (c) the autonomic reaction network, (d) the action tendency network, and (e) the feeling network, and discuss these networks in the context of the affective neuroscience literature. We also propose that further investigating the “appraising brain” is the royal road to better understand the elicitation network, and may be key to revealing the neural causal mechanisms underlying the emotion process as a whole.
Investigating Emotions as Functional States Distinct From Feelings
Authors: Adolphs Ralph , Andler Daniel
Published: July 2018

We defend a functionalist approach to emotion that begins by focusing on emotions as central states with causal connections to behavior and to other cognitive states. The approach brackets the conscious experience of emotion, lists plausible features that emotions exhibit, and argues that alternative schemes (e.g., focusing on feelings or on neurobiology as the starting point) are unpromising candidates. We conclude with the benefits of our approach: one can study emotions in animals; one can look in the brain for the implementation of specific features; and one ends up with an architecture of the mind in which emotions are fully accommodated through their relations to the rest of cognition. Our article focuses on arguing for this general approach; as such, it is an essay in the philosophy of emotion rather than in the psychology or neuroscience of emotion.
Emotion and the Interactive Brain: Insights From Comparative Neuroanatomy and Complex Systems
Authors: Pessoa Luiz
Published: July 2018

Although emotion is closely associated with motivation, and interacts with perception, cognition, and action, many conceptualizations still treat emotion as separate from these domains. Here, a comparative/evolutionary anatomy framework is presented to motivate the idea that long-range, distributed circuits involving the midbrain, thalamus, and forebrain are central to emotional processing. It is proposed that emotion can be understood in terms of large-scale network interactions spanning the neuroaxis that form “functionally integrated systems.” At the broadest level, the argument is made that we need to move beyond a Newtonian view of causation to one involving complex systems where bidirectional influences and nonlinearities abound. Therefore, understanding interactions between subsystems and signal integration becomes central to unraveling the organization of the emotional brain.
Components, Networks, and Their Interactions
Authors: Ellsworth Phoebe C.
Published: July 2018

Some thoughts on the nature of networks, the prevalence of emotional experiences, and the importance of new questions.
Identifying Emotional Specificity in Complex Large-Scale Brain Networks
Authors: Koelsch Stefan
Published: July 2018

The target article is well in accordance with recent theoretical advances considering the complex large-scale brain network organization underlying emotions. Given current limitations of the methods in brain science, however, research is faced with the difficult question as to how it will be possible to elucidate the complex nonlinear interactions, the neurotransmitters involved, and the excitatory or inhibitory nature of neural processes underlying human emotion in such networks. Moreover, while investigating the network properties of neural processes underlying emotions, it is also important to keep in mind that specific brain structures, or specific brain networks, generate specific emotions. Thus, while aiming at elucidating complex large-scale brain networks of emotion, it is important to identify emotional specificity of, or within, these networks.
Comment: Two Challenges for Adolphs and Andler’s Functionalist Theory of Emotions
Authors: Scarantino Andrea
Published: July 2018

Adolphs and Andler’s methodological functionalism recommends that affective science focuses on what emotions do rather than on what emotions are physically constituted by or how emotions feel. In addition, it is suggested that the functional roles of emotions should be extrapolated from a set of “features” emotions intuitively appear to have. In this brief commentary, I discuss both prescriptions, focusing on the concept of function and on the role folk psychological platitudes should play in a functionalist theory of emotions.
Brain Networks, Emotion Components, and Appraised Relevance
Authors: Sander David , Grandjean Didier , Scherer Klaus R.
Published: July 2018

Modeling emotion processes remains a conceptual and methodological challenge in affective sciences. In responding to the other target articles in this special section on “Emotion and the Brain” and the comments on our article, we address the issue of potentially separate brain networks subserving the functions of the different emotion components. In particular, we discuss the suggested role of component synchronization in producing information integration for the dynamic emergence of a coherent emotion process, as well as the links between incentive salience (“wanting”) and concern-relevance in the elicitation of emotion.
Integrating Perspectives on Affective Neuroscience: Introduction to the Special Section on the Brain and Emotion
Authors: Hamann Stephan
Published: July 2018

In this special section, three target articles present three different perspectives on emotion and how it is implemented in the human brain. Fundamental issues are discussed such as the nature and organization of emotion’s representation in the brain and the best approaches for elucidating emotion’s neural basis. Comments and author replies further discuss these issues and explore their interconnections. A common theme of the target articles and commentaries is that multiple approaches and perspectives must be integrated across all levels of analysis to understand the neural basis of emotion.
Scoping review: Diagnosis and management of periprosthetic joint infection in elbow arthroplasty
Authors: Watts AC , Duckworth AD , Trail IA , Rees J , Thomas M , Rangan A
Published: July 2018

Background

Total elbow arthroplasty is an effective treatment for patients with painful elbow arthritis. Infection can be a serious complication. The aim of this scoping review was to document the available evidence on periprosthetic elbow infection.

Methods

A search of Medline, Embase and PubMed was performed; two authors screened results independently. Systematic reviews, randomised controlled trials, cohort studies, case–control studies and case series including periprosthetic elbow infection were eligible.

Results

A total of 46 studies were included. The median rate of periprosthetic elbow infection reported from recent published studies is 3.3%. The most commonly identified causative organisms are Staphylococcus aureus and Staphylococcus epidermidis. Risk factors include younger age, rheumatoid arthritis, obesity, previous surgery or infection to the elbow, and postoperative wound complications. Debridement, antibiotics and implant retention results in implant survival rates of 50–90%. Two-stage revision results in improved functional outcome scores, but with recurrent infection rates of 12–28%.

Conclusions

Total elbow arthroplasty carries a higher risk of infection when compared to other major joint replacements. The current body of literature is limited and is almost exclusively low volume retrospective case series. The best management of periprosthetic elbow infection is difficult to determine, but two-stage revision appears to be the gold standard.
Price Fairness in the Era of the Sharing Economy
Authors: Chark Robin
Published: July 2018

The meaning of price fairness in the sharing economy is examined in four experiments. The results suggest that the sharing economy evokes communal norms that make customers more sensitive to the unfairness of demand-based pricing. Specifically, the four studies demonstrate that (a) framing demand-based pricing as a surcharge is perceived as less fair than framing it as a foregone discount when used by a family on Airbnb but not when used by a hotel on Expedia or a hotel on Airbnb; (b) the effect of host (family vs. hotel) on the perceived fairness of surcharges is diminished when the surcharge is justified with an exchange good (free wifi service) but not when it is justified by a communal good (free cooking instruction); (c) the interaction of host by type of extra good on perceived price fairness is mediated by the activation of communal (vs. exchange) norms; and (d) the host-by-framing interaction has similar effects on booking intention as it does on perceived price fairness.
EU Directives on maternity leave
Authors: de la Corte Rodríguez Miguel
Published: July 2018

The EU Directives on maternity leave adopt a single social risk approach, focusing primarily on the protection of the delivering worker’s incapacity to work during pregnancy and after giving birth. They justify maternity leave on the basis of the vulnerability of these workers and provide for a leave of at least 14 weeks. However, recent case law of the CJEU questions whether maternity leave is consistent with this approach and respects the principle of non-discrimination on grounds of sex. This article challenges the EU Directives on maternity leave and seeks to find out to what extent they are based on a coherent single social risk approach, by examining not only EU and national legal sources but also medical literature. It concludes that the approach adopted by these Directives is not sufficiently consistent because for most women the period of incapacity for work will not last longer than 6 weeks after childbirth (puerperium), much shorter than the minimum 14-week period. The fact that maternity leave is a right of mothers and that in most instances a substantial part of the leave is only devoted to the care of the newborn is creating unsatisfactory effects on both mothers and fathers.
The relation between body fat distribution, plasma concentrations of adipokines and the metabolic syndrome in patients with clinically manifest vascular disease
Authors: Schrover Ilse M , van der Graaf Yolanda , Spiering Wilko , Visseren Frank LJ
Published: July 2018

Introduction

We evaluated the relationship between adipokine plasma concentrations and body fat distribution and the metabolic syndrome.

Methods

In a cohort of 1215 patients with clinically manifest vascular disease the relation between subcutaneous adipose tissue, visceral adipose tissue, waist circumference, body mass index and plasma concentrations of adipsin, chemerin, monocyte chemoattractant protein-1, migration inhibitory factor, nerve growth factor, resistin, plasma amyloid A1, adiponectin, leptin, plasminogen activator inhibitor-1 and hepatic growth factor were cross-sectionally assessed with linear regression and adjusted for age and gender. The relation between adipokines and the metabolic syndrome was cross-sectionally evaluated using logistic regression. An adipokine profile was developed to measure the effect of combined rather than single adipokines.

Results

Adiposity was related to higher nerve growth factor, hepatic growth factor, migration inhibitory factor, leptin and adipsin and with lower chemerin, plasminogen activator inhibitor-1, resistin, plasma amyloid A1 and adiponectin. The strongest positive relations were between body mass index and adipsin (β 0.247; 95% CI 0.137–0.356) and leptin (β 0.266; 95% CI 0.207–0.324); the strongest negative relations were between body mass index and plasma amyloid A1 (β –0.266; 95% CI –0.386 to –0.146) and visceral adipose tissue and adiponectin (β –0.168; 95% CI –0.226 to –0.111). There was no relation between subcutaneous adipose tissue and adipokines. Odds for the metabolic syndrome were higher with each 1 SD higher hepatic growth factor (OR 1.21; 95% CI 1.06–1.38) and leptin (OR 1.26; 95% CI 1.10–1.45) and lower with each 1 SD higher adiponectin (OR 0.73; 95% CI 0.64–0.83) and resistin (OR 0.85; 95% CI 0.74–0.97). The adipokine profile was related to the metabolic syndrome (OR 1.03; 95% CI 1.00–1.06).

Conclusion

Plasma concentrations of adipokines are related to obesity and body fat distribution. The relation between adipokine concentrations and the metabolic syndrome is independent of visceral adipose tissue.
Is the Kidney Donor Risk Index a Useful Tool in Non-US Patients?
Authors: Young Ann , Knoll Greg A. , McArthur Eric , Dixon Stephanie N. , Garg Amit X. , Lok Charmaine E. , Lam Ngan N. , Kim S. Joseph
Published: July 2018

Background:

Deceased donor kidney allocation in the United States is guided by the Kidney Donor Risk Index (KDRI). The generalizability of the KDRI beyond the United States has not been widely studied.

Objective:

To assess the generalizability of the KDRI in a cohort of non-US (Canadian) deceased donor kidney transplant recipients.

Design:

Population-based retrospective cohort study.

Setting:

Ontario, Canada.

Patients:

Recipients of deceased donor kidneys from January 1, 2005, to March 31, 2011.

Methods:

Using administrative data, we analyzed a cohort of deceased donor kidney recipients in Ontario, Canada. The Kaplan-Meier method and Cox proportional hazards models were used to assess the relationship between KDRI and the outcomes of graft loss and death. KDRI was modeled continuously and categorically. The ability of models with KDRI to predict recipient outcomes beyond donor age was also explored. Model discrimination was assessed using c-statistics, evaluated at 5 years of follow-up.

Results:

A total of 1299 consecutive deceased donor kidney transplant recipients were included. The median follow-up was 5.5 years. Mean donor age increased from 27 to 64 years across ascending KDRI quintiles. The adjusted relative hazards (95% confidence interval) for total graft loss from Q2 to Q5 (referent = Q1) were 1.27 (0.89-1.80), 1.58 (1.13-2.22), 1.43 (1.01-2.02), and 2.15 (1.54-2.99), respectively. Increased relative hazards across KDRI quintiles were also observed for death-censored graft loss, but not death with graft function. All-cause mortality was increased for the highest KDRI quintile only. In this cohort, a model with KDRI performed better than a model with donor age alone ( P = .009).

Limitations:

Large health care databases may have precluded the complete capture of covariate data.

Conclusions:

In conclusion, the KDRI is generalizable to Canadian patients in Ontario and may help inform risk assessment beyond donor age. The performance of KDRI in other non-US settings, and the need for additional model refinement, warrants further study.
Desacralized law, disenchanted society: A major transition in Ch’u T’ung-tsu’s historical studies
Authors: Du Yue
Published: July 2018

In this study, I examine four major books written by a renowned Chinese historian, Ch’u T’ung-tsu, and describe a profound transition over the course of his studies. I argue that the isomorphism between Confucian doctrines and Chinese social structure in two earlier books, Feudal Society in China, and Law and Society in Traditional China, disappears completely in his last book, Local Government in China under the Ch’ing, which exclusively focuses on informal relationships and deviant behaviors in China’s bureaucratic system. The current study traces this transition by carefully examining Ch’u’s Western influences, represented by Maine’s work in Ancient Laws, and Ch’u’s subsequent ‘failed effort’ in his third book, Han Society Structure. I maintain that Ch’u’s Western academic influences could best be characterized as the desacralization of law, with an exclusive focus on social structure. When the formal structure of kinship groups and social classes failed to explain the maintenance of social order in the Han dynasty, Ch’u turned away from formal structure and pursued studies on informal structure and deviance.
Variation in the education gradient of body weight in contemporary China
Authors: Luo Weixiang , Xie Yu
Published: July 2018

Using data from the 1991–2009 China Health and Nutrition Surveys, this paper examines the temporal–spatial variation in the education gradient of body weight relative to height among Chinese adults, and how the variation is associated with levels of economic development. We find different variation patterns for men and women. For women, the education gradient in body weight shifted from being positive to being negative over time for China as a whole, as well as across regions with different levels of economic development. In contrast, for men, higher education remained consistently associated with higher body weight over the 18-year period studied in China as a whole, as well as across regions with different levels of economic development.
A neoclassical realist explanation of Indonesia’s involvement in Muslim-related secessions in non-Muslim countries
Authors: Sari Angguntari C
Published: July 2018

This article attempts to test the ethnic ties theory and provides an alternative explanation for why Indonesia as the largest Muslim country in the world has been inconsistent in its support for Muslim separatists. In this article, I use a Mill’s method of most similar system design and examine variation in Indonesia’s foreign policy towards Muslim secessionism taking place in non-Muslim countries over time. Since Indonesia’s independence in 1945, it has frequently supported the non-Muslim host states, has supported the Muslim separatists on some occasions, and has either adopted an ambivalent foreign policy/supported both the host states and separatist groups or adopted a neutral stance/neither supported the host states nor the separatist groups on other occasions. I suggest a neoclassical realist explanation and argue that specific foreign policy outcomes in the context of Muslim separatists versus non-Muslim host states are shaped by the perception of leading policy makers on the extent to which support for the conflicting parties in the secessionist conflicts can hinder or facilitate the achievement of vital national interests and ultimately the state’s international as well as the level of domestic political constraints specifically the public demand to assist the separatist movements.
New Tools for Measuring Global Academic Performance
Authors: Abubakar Ahmed , Hilman Haim , Kaliappen Narentheren
Published: July 2018

The study is on performance measurement in academia. It aims at developing and validating the measurement scale for the performance of higher institutions. The items were developed based on the extant literature. Data were collected via an online survey in which a questionnaire link was sent to 269 vice chancellors/presidents of the sampled universities. A total of 133 responses were retrieved at the end of the data collection period. This study used proportionate random sampling for sample selection. The goodness of measures was checked via field experts, academicians, and data analysis with SPSS. Overall, the alpha coefficient was .974. The outcome of exploratory factor analysis (EFA) exposed all factors loaded more than 0.50. The results revealed that the instrument was reliable and valid. Hence, the instrument developed was suitable to be used in examining the performance of higher institutions.
Resting Pain Level as a Preoperative Predictor of Success With Indirect Decompression for Lumbar Spinal Stenosis: A Pilot Study
Authors: Khalsa Amrit S. , Eghbali Areian , Eastlack Robert K. , Tran Stacie , Akbarnia Behrooz A. , Ledesma Justin B. , Mundis Gregory M.
Published: July 2018

Study Design:

Retrospective review of a single institution.

Objective:

To determine if resting leg pain level is a predictor of success for indirect decompression in the setting of lumbar spinal stenosis, with lower levels of rest pain correlating with greater likelihood of successful indirect decompression.

Methods:

Reviewed anterior or lateral lumbar interbody fusions from T12 to L5-S1 patients with a posterior-based pedicle screw-rod construct. Patients were separated into 2 groups based on a preoperative response to Oswestry Disability Index (ODI) Question 7 regarding level of pain at rest in the supine position. Responses of 0 to 2 (minimal rest pain) were group 1 (n = 54) and responses of 3 to 5 (significant rest pain) were group 2 (n = 16).

Results:

Preoperative difference was detected between groups 1 and 2, in ODI (38 vs 63, P < .001) and Numeric Rating Scale (NRS) back (6.8 vs 7.9, P = .023). Three-month NRS leg and back scores were significantly lower in group 1 (leg, 1.9 vs 4.8, P < .001; back, 3.5 vs 6.4, P = .001). A significant difference was further noted in the percentage decrease in NRS leg and back scores from pre- to 3 months postoperatively between groups 1 and 2 (leg, 68.4% vs 22.7%, P < .001; back, 40.0% vs 7.4%, P = .012). Group 1 reached minimal clinically important difference for leg pain more often than group 2 (83.3% vs 43.8%, P = .001).

Conclusion:

Preoperative assessment of rest pain level in the supine position has a significant association with reduction in NRS leg and back scores in patients undergoing indirect decompression for lumbar spinal stenosis. This tool may successfully indicate which patients will be candidates for indirect decompression with interbody fusion from an anterior or lateral approach.
Arthroscopic Primary Repair of Proximal Anterior Cruciate Ligament Tears: With or Without Additional Suture Augmentation?
Authors: Jonkergouw Anne , van der List Jelle P. , DiFelice Gregory S.
Published: July 2018

Objectives:

Over the last years, arthroscopic primary repair of anterior cruciate ligament (ACL) tears has shown excellent results owing to appropriate patient selection (only repairing proximal ACL tears and good tissue quality), minimal invasive surgery (arthroscopy) and focus on early range of motion. Some surgeons have repaired proximal ACL tears without suture augmentation while others have used internal suture augmentation to reinforce and thus protect the repaired ligament during range of motion. No studies have yet compared the two surgical techniques. The objective of this study was to compare failure rates, reoperation rates and patient-reported outcomes of arthroscopic primary repair with versus without suture augmentation.

Methods:

A retrospective search for all patients treated with suture anchor arthroscopic primary ACL repair between April 2008 and June 2016 was performed. All patients with isolated proximal ACL tears (type I) were included. Since the development of internal suture augmentation, this reinforcement was added to the repaired ACLs. Minimum follow-up length was 1.0 years.

Results:

A total of 56 patients were included (mean age 33 years (range: 14 - 57), 59% male) of which 28 (50%) patients received additional suture augmentation. Mean follow-up was 2.3 years (range: 1.0-9.2). Six of all patients had reruptured their repaired ACL (10.7%), of which four underwent uncomplicated ACL reconstruction and two were treated conservatively. Four reruptures were initially treated with primary repair only (4/28, 14.3%) and two patients with additional suture augmentation (2/28, 7.1%; p = 0.431). During follow-up, three patients underwent reoperation (5.4%; two for medial meniscus tear (one in each group) and one for tibial suture anchor removal of the suture augmentation). Patient-reported outcomes have so far been collected in 20 patients without reruptures (currently collecting), with mean Lysholm score of 96, modified Cincinnati 94, SANE 93, pre-injury Tegner 6.7, postoperative Tegner 6.3 and subjective IKDC 91. Objective IKDC was A in 90%, B in 5%, C in 5%.

Conclusion:

In this study, the total failure rate of arthroscopic primary ACL repair was 10.7% and was lower with additional suture augmentation (7.1%) than primary repair alone (14.3%). Patients with failed ACL repair underwent uncomplicated primary ACL reconstruction. We recommend adding suture augmentation in high-risk patients (i.e. adolescents, ones with hyperlaxity, high contact sports), to protect the repaired ligament, especially during early range of motion. These data support treating type I proximal ACL tears with arthroscopic primary repair.
Which Factors Increase the Risk of Re-Operation after Meniscus Surgery in the Skeletally Immature?
Authors: Patel Neeraj M. , Mundluru Surya , Beck Nicholas , Ganley Theodore J.
Published: July 2018

Objectives:

The purpose of this study is to determine which factors heighten the risk for subsequent operations in skeletally immature patients undergoing meniscus surgery.

Methods:

A retrospective institutional database of 1,063 meniscus surgeries performed between 2000 and 2015 was reviewed. All procedures were performed in skeletally immature patients. Demographic and intra-operative information was recorded, as were concurrent injuries or operations and subsequent surgeries. Univariate analysis consisted of chi-square and independent-samples t-tests. Multivariate logistic regression was then performed to control for confounding factors.

Results:

The mean age at initial surgery was 13.4 years (standard deviation, SD, 2.2 years) and the average follow-up duration was 47 months (SD 54 months). Overall, 314 patients (29.5%) required repeat surgical intervention. 36% of all females required subsequent surgery compared to 26% of males (p<0.01). Discoid menisci underwent repeat operation more frequently than non-discoid menisci (35% vs. 27%, p=0.01). After accounting for confounders in a multivariate model, females had 2.2 times the odds of repeat surgery than males (95% CI 1.4-3.3, p<0.01) and each year of increasing age resulted in 1.3 times higher odds (95% CI 1.1 -1.4, p<0.01). The odds of subsequent surgeries were 4.2 times higher in those with flap tears (95% CI 1.8-9.7, p<0.01) and 2.9 times higher for discoid menisci (95% CI 1.4-6.0, p<0.01). Concomitant anterior cruciate ligament rupture or tibial spine fracture decreased the risk of needing additional surgeries in univariate analysis, but lost statistical significance in the multivariate model.

Conclusion:

Even when accounting for other factors in a multivariate model, female sex, increasing age, flap tears, and discoid meniscus were risk factors for subsequent procedures after meniscus surgery in skeletally immature patients. The re-operation rate in this population may be higher than previously reported. This study describes, for the first time, risk factors for repeat operations in skeletally immature patients undergoing meniscus surgery. These results can be used to counsel and monitor patients accordingly.