bluuebunny/crossref_metadata_2025 huggingface dataset:
Disability, Quality of Life, and Pain Coping in Pediatric Migraine: An Observational Study
Authors: Orr Serena L. , Christie Suzanne N. , Akiki Salwa , McMillan Hugh J.
Published: April 2017

Objectives:

The objective was to examine the relationship between disability, health-related quality of life (HrQoL), and pain coping in pediatric migraineurs.

Method:

Eighty-five patients with migraine were recruited from Pediatric Neurology clinics. Participants completed the Pediatric Migraine Disability Assessment Scale, the Pediatric Quality of Life Inventory, the Pain Coping Questionnaire, and the Pain Catastrophizing Scale. Means were compared to published norms using t-tests. Spearman correlations and logistic regression were used to explore the relationships between the variables.

Results:

Mean HrQoL scores were lower than norms for controls and chronically ill pediatric patients ( P < .0001). Patients reported lower mean pain coping scores and higher mean pain catastrophizing scores than norms ( P < .0001). After controlling for age and sex, only the relationship between disability and HrQoL remained significant (OR = 0.91, 95% CI: 0.86-0.95).

Conclusion:

Pediatric patients with migraine report lower HrQoL, fewer pain coping strategies and more catastrophizing than controls, while disability is inversely associated with HrQoL.
A Study of Hyponatremia in Acute Encephalitis Syndrome: A Prospective Study From a Tertiary Care Center in India
Authors: Misra Usha Kant , Kalita Jayantee , Singh Rajesh Kumar , Bhoi Sanjeev Kumar
Published: April 2017

Purpose:

To evaluate the frequency and causes of hyponatremia in acute encephalitis syndrome (AES) and its effect on outcome.

Patients and Methods:

Consecutive patients with AES were subjected to neurological evaluation including Glasgow Coma Scale, focal weakness, movement disorder, and reflex changes. The etiology of AES was based on blood and cerebrospinal fluid enzyme-linked immunosorbent assay and polymerase chain reaction. We have categorized patients into neurological or systemic AES. Hyponatremia was diagnosed if 2 consecutive serum sodium levels were below 135 mEq/L, 24 hours apart. Serum and urinary osmolality and electrolytes were measured on alternate days. Fluid intake, output, and body weight were measured daily. The hyponatremia was categorized into syndrome of inappropriate secretion of antidiuretic hormone (SIADH), cerebral salt wasting (CSW), or miscellaneous group. Outcome at 1 month was assessed by modified Rankin scale.

Results:

Of 79 patients, 34 had neurologic AES and 45 had systemic AES; 22 (27.8%) patients had hyponatremia. The neurologic AES as compared to systemic AES was more commonly associated with hyponatremia (38.2% vs 20%, P = .07), need longer hospitalization (25.0 vs 12.5 days, P = .003), and longer time for sodium correction (13.3 vs 8.2 days, P = .05). The hyponatremia was due to CSW in 12 patients, SIADH in 2 patients, and indeterminate in 8 patients. Thirty-six patients had poor outcome (15 died) and 43 had good outcome which was not related to hyponatremia.

Conclusion:

Hyponatremia occurs in one-third of patients with AES, being commoner in neurologic AES, and CSW is the commonest cause.
Gender and the MBA: Differences in Career Trajectories, Institutional Support, and Outcomes
Authors: Patterson Sarah E. , Damaske Sarah , Sheroff Christen
Published: April 2017

This study asks how men’s and women’s careers diverge following MBA graduation from an elite university, using qualitative interview data from 74 respondents. We discover men and women follow three career pathways post-graduation: lockstep (stable employment), transitory (3 or more employers), and exit (left workforce). While similar proportions of men and women followed the lockstep pathways and launched accelerated careers, sizable gender differences emerged on the transitory pathway; men’s careers soared as women’s faltered on this path—the modal category for both. On the transitory path, men fared much better than women when moving to new organizations, suggesting that gender may become more salient when people have a shorter work history with a company. Our findings suggest that clear building blocks to promotions reduce gender bias and ambiguity in the promotion process, but multiple external moves hamper women, putting them at a clear disadvantage to men whose forward progress is less likely to be stalled by such moves.
Surface contamination of cars: A review
Authors: Gaylard Adrian P , Kirwan Kerry , Lockerby Duncan A
Published: April 2017

This review surveys the problem of surface contamination of cars, which poses a growing engineering challenge to vehicle manufacturers, operators and users. Both the vision of drivers and the visibility of vehicles need to be maintained under a wide range of environmental conditions. This requires managing the flow of surface water on windscreens and side glazing. The rate of deposition of solid contaminants on glazing, lights, licence plates and external mirrors also needs to be minimised. Maintaining vehicle aesthetics and limiting the transfer of contaminants to the hands and clothes of users from soiled surfaces are also significant issues. Recently, keeping camera lenses clean has emerged as a key concern, as these systems transition from occasional manoeuvring aids to sensors for safety systems. The deposition of water and solid contaminants on to car surfaces is strongly influenced by unsteady vehicle aerodynamic effects. Airborne water droplets falling as rain or lifted as spray by tyres interact with wakes, vortices and shear flows and accumulate on vehicle surfaces as a consequence. The same aerodynamic effects also control the movement of surface water droplets, rivulets and films; hence, particular attention is paid to the management of surface water over the front side glass and the deposition of contaminants on the rear surfaces. The test methods used in the automotive industry are reviewed, as are the numerical simulation techniques.
Solid nanoparticle and gaseous emissions of a diesel engine with a diesel particulate filter and use of a high-sulphur diesel fuel and a medium-sulphur diesel fuel
Authors: Doozandegan Mahdi , Hosseini Vahid , Ehteram Mohammad Ali
Published: April 2017

High-sulphur and medium-sulphur diesel fuels are still used in several countries. Although diesel particulate filter technology for on-road diesel engines has existed since 1989, the availability of high-sulphur and medium-sulphur diesel fuels in the market causes delays in the use of catalysed filter technologies. However, the situation in places such as Tehran is considered unhealthy because of particles and black carbon, and full distribution of ultra-low-sulphur diesel is awaited eagerly. The purpose of this study is to investigate the effect of the sulphur content in fuels on the gaseous and solid exhaust emissions of a 220 kW Euro II engine equipped with a sintered metal active–passive filter, focusing on the regeneration phenomenon. The results show that the efficiency for filtering the maximum number of particles was 99.9% and that the average was above 99% for steady-state operating conditions for both high-sulphur diesel (7700 ppm) and medium-sulphur diesel (229 ppm). The removal efficiency of the particle mass was low in the case of high-sulphur diesel owing to the sulphate condensate collection effect as the result of using a non-heated sample line. During regeneration, the number of particles increased in comparison with that in the filtration phase but the total number of emitted particles was less than the engine baseline value. The results for both fuels were the same, and the only measurable difference was the high sulphur dioxide production in the high-sulphur diesel during regeneration. This study demonstrates the potential of this type of filter technology for the effective removal of solid particles independent of the sulphur content of the fuel. With the exception of the decrease in the removal efficiency of the particle mass and the high sulphur dioxide production, no other notable difference was observed to be caused by the change in the sulphur content of the diesel fuel.
A time-space synchronized fluid-structure coupling algorithm for the prediction of wing flutter
Authors: Zhong Jize , Xu Zili
Published: April 2017

A fast dynamic mesh technology by our research group has been applied in the time synchronized fluid-structure coupling. It is found that flow mesh update after the convergent calculation of the flow will induce excessive iterations in the computation of flow increasing the computing time of fluid-structure coupling. To reduce the computing time, a time-space synchronized fluid-structure coupling algorithm was developed in this paper based on the pre-existing time synchronized method and the fast dynamic mesh technology. The wing vibration and flow mesh deformation were computed using the fast dynamic mesh technology after each iteration in the calculation of the flow. Namely, the flow and the wing vibration were solved in space synchronization. The calculating convergence of the flow and the wing vibration were both achieved through iterations every time step. Namely, the flow and the wing vibration were solved in time synchronization. Thus, the flow and the wing vibration are coupled both in time and space synchronization. The flutter boundary of wing 445.6 was predicted using the present algorithm. The calculated results compare well with the experimental data and the computing time was almost reduced by 75%.
Predicting Ideological Prejudice
Authors: Brandt Mark J.
Published: April 2017

A major shortcoming of current models of ideological prejudice is that although they can anticipate the direction of the association between participants’ ideology and their prejudice against a range of target groups, they cannot predict the size of this association. I developed and tested models that can make specific size predictions for this association. A quantitative model that used the perceived ideology of the target group as the primary predictor of the ideology-prejudice relationship was developed with a representative sample of Americans ( N = 4,940) and tested against models using the perceived status of and choice to belong to the target group as predictors. In four studies (total N = 2,093), ideology-prejudice associations were estimated, and these observed estimates were compared with the models’ predictions. The model that was based only on perceived ideology was the most parsimonious with the smallest errors.
Electrophysiological dysfunction induced by anti-ribosomal P protein antibodies injection into the lateral ventricle of the rat brain
Authors: Gaburo N , de Carvalho J Freire , Timo-Iaria C , Bueno C , Reichlin M , Viana V S T , Bonfá E
Published: April 2017

Objective

Anti-ribosomal P antibodies (anti-P) are strongly associated with neuropsychiatric lupus. This study was designed to determine whether these antibodies are capable of causing electro-oscillogram (EOSG) and behavior alterations in rats.

Methods

IgG fraction anti-P positive and affinity-purified anti-P antibodies were injected intraventricularly in rats. Sequential cortical and subcortical EOSGs were analyzed during 30 days. IgG anti-Ro/SS-A and normal IgG were used as controls.

Results

All 13 animals injected with IgG anti-P demonstrated a high prevalence of polyspikes, diffusely distributed in hippocampal fields and cerebral cortex. These abnormalities persisted approximately a month. Remarkably, an identical electrical disturbance was observed with the inoculation of affinity-purified anti-P antibodies. The EOSG alterations were associated with behavioral disorders with varying degrees of severity in every animal injected with anti-P. In contrast, no changes in EOSG or behavioral disturbances were observed in the control group.

Conclusion

Our study indicates that anti-P antibodies can directly induce electrophysiological dysfunction in central nervous system particularly in hippocampus and cortex associated with behavior disturbances.
A critical analysis of the tools to evaluate neuropsychiatric lupus
Authors: Clark K E N , Clark C N , Rahman A
Published: April 2017

Neuropsychiatric symptoms occur commonly in patients with systemic lupus erythematosus, but they are not always due to active disease. It is crucial to identify cases that are due to active systemic lupus erythematosus so that appropriate treatment can be instituted. There is no single serological or imaging test that distinguishes active neuropsychiatric systemic lupus erythematosus from neuropsychiatric manifestations caused by other factors such as infection. Most patients with neuropsychiatric systemic lupus erythematosus have generalised features of disease activity. Raised anti-dsDNA and low C3 complement levels are often seen, but are not an invariable guide. The presence of antiphospholipid antibodies is more suggestive of thrombotic than inflammatory causation. A number of other autoantibody tests have been proposed as biomarkers for neuropsychiatric systemic lupus erythematosus, but results in clinical studies have been inconsistent and none has so far entered routine clinical practice. Cerebrospinal fluid features and magnetic resonance imaging appearances are non-specific in neuropsychiatric systemic lupus erythematosus, but are useful in excluding other causes of neuropsychiatric symptoms. Newer magnetic resonance imaging sequences show promise for distinguishing new neuropsychiatric systemic lupus erythematosus activity from previous damage and recent research suggests these may correlate with changes in cognitive function in patients with systemic lupus erythematosus. However, formal cognitive testing is seldom carried out in the acute setting.
Avoiding diagnostic pitfalls in neuropsychiatric lupus: the importance of attribution
Authors: Hanly J G
Published: April 2017

Neuropsychiatric events in systemic lupus erythematosus patients may present a diagnostic and therapeutic challenge. Common and heterogeneous, their characterization and attribution to systemic lupus erythematosus and non-systemic lupus erythematosus is important and derived from clinical assessment, selection and interpretation of investigations. A standardized approach to assigning attribution has been used in recent studies. The current therapies are largely empiric, based upon known disease mechanisms and treatment of other serious organ disease in systemic lupus erythematosus. Further insight on the immunopathogenetic mechanisms and clinical outcome of neuropsychiatric systemic lupus erythematosus is required to inform the design and execution of therapeutic clinical trials.
Gestational outcomes in patients with neuropsychiatric systemic lupus erythematosus
Authors: de Jesus G R , Rodrigues B C , Lacerda M I , dos Santos F C , de Jesus NR , Klumb E M , Levy R A
Published: April 2017

This study analyzed maternal and fetal outcomes of pregnancies of neuropsychiatric systemic lupus erythematosus patients followed in a reference unit. This retrospective cohort study included 26 pregnancies of patients seen between 2011 and 2015 included with history and/or active neuropsychiatric systemic lupus erythematosus among 135 pregnancies. Three patients had active neuropsychiatric systemic lupus erythematosus at conception, but only one remained with neurological activity during gestation, characteristically related to the inadvertent suspension of medications. Twenty six percent of the newborns were small for gestational age and 40% of live births were premature, with no neonatal death or early complications of prematurity. Preeclampsia was diagnosed in nine pregnancies, with two cases of early severe form that resulted in intrauterine fetal death. Patients with neuropsychiatric systemic lupus erythematosus had more prematurity and preeclampsia compared to patients without neuropsychiatric disease. However, when concomitant lupus nephritis was excluded, the gestational results of neuropsychiatric systemic lupus erythematosus patients were more favorable.
Neuropsychiatric SLE: from animal model to human
Authors: Pikman R , Kivity S , Levy Y , Arango M-T , Chapman J , Yonath H , Shoenfeld Y , Gofrit S G
Published: April 2017

Animal models are a key element in disease research and treatment. In the field of neuropsychiatric lupus research, inbred, transgenic and disease-induced mice provide an opportunity to study the pathogenic routes of this multifactorial illness. In addition to achieving a better understanding of the immune mechanisms underlying the disease onset, supplementary metabolic and endocrine influences have been discovered and investigated. The ever-expanding knowledge about the pathologic events that occur at disease inception enables us to explore new drugs and therapeutic approaches further and to test them using the same animal models. Discovery of the molecular targets that constitute the pathogenic basis of the disease along with scientific advancements allow us to target these molecules with monoclonal antibodies and other specific approaches directly. This novel therapy, termed “targeted biological medication” is a promising endeavor towards producing drugs that are more effective and less toxic. Further work to discover additional molecular targets in lupus’ pathogenic mechanism and to produce drugs that neutralize their activity is needed to provide patients with safe and efficient methods of controlling and treating the disease.
Long-term neurodevelopmental outcome of children born to prospectively followed pregnancies of women with systemic lupus erythematosus and/or antiphospholipid syndrome
Authors: Nalli C , Iodice A , Andreoli L , Galli J , Lojacono A , Motta M , Fazzi E , Tincani A
Published: April 2017

Background

Systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are autoimmune diseases that affect women of childbearing age. Maternal IgG antiphospholipid antibodies (aPL) can cross the placenta during pregnancy and theoretically reach the fetal brain. Some studies showed an increased number of learning disabilities in these children.

Objectives

To evaluate the long-term neurodevelopmental outcome of 40 children (median age 7.4 years) born to mothers with SLE and/or APS carrying positive IgG aPL during the third trimester of pregnancy.

Methods

Children were checked for neurological physical exam and intellectual/cognitive functioning by the Wechsler scale for corrected age. We submitted to the mothers the Child Behavior CheckList (CBCL) and a homemade set of questions created by pediatric neurologists.

Results

In all children neurological physical exam and intelligence levels were found to be normal. A cognitive impairment or a discrepant cognitive profile was found in 3 (7%) and 11 (28%) children, respectively. Learning disabilities were diagnosed in 3 children (19% of school-age children), all born to mothers with triple aPL positivity. A history of epilepsy was shown in four children (10%). Conclusions: Children born to women with SLE and/or APS may need a long-term follow-up focusing on milestones of neurodevelopment in order to detect and correct any alteration as early as possible.
Functional Foods: The New Secret of the Health Conscious Indian Women!!
Authors: Kapoor Deepa , Munjal Alka
Published: April 2017

In India, with growing disposable income and increased urbanization and health consciousness among people, the demand for functional foods is emerging. Consumers are more proactive about their health and this in turn has stirred the global market for functional foods and beverages. This article attempts to segment consumers using cluster analysis on the basis of their health orientation and perception towards functional foods. Correlation has been employed to measure the relation between health orientation and functional foods perception. The research has been carried out using primary data collected from 150 women respondents in Delhi NCR. Data analysis showed there is low correlation between health orientation and functional foods perception. Gym instructors and nutritionists are found to be the most important source of information for functional foods. Women respondents have been segmented into three distinct groups showing varied attitudes towards functional foods and health orientation. Among demographic characteristics, age affects the attitude towards self-health and consumption of functional foods.
KIF13B-NRG1 Gene Fusion and KRAS Amplification in a Case of Natural Progression of Lung Cancer
Authors: Xia Daniel , Le Long Phi , Iafrate Anthony John , Lennerz Jochen
Published: April 2017

An 85-year-old woman with a history of several primary lung cancers presented with liver metastases. The primary lung cancers were all managed surgically and the patient did not receive adjuvant or neoadjuvant therapy prior to presenting with metastases. Comparison of molecular testing results from the most recent primary and the liver metastases demonstrated ( a) a clonal relationship between the 2 cancers and ( 2) the presence of a KIF13B-NRG1 fusion and KRAS amplification unique to the metastases. When integrated, the molecular surgical pathology findings in this case illustrate the extent of “oncogenic drive” in preterminal lung cancer.
Effect of Bipartite Hallucal Sesamoid on Hallux Valgus Surgery
Authors: Park Young Hwan , Jeong Chan Dong , Choi Gi Won , Kim Hak Jun
Published: April 2017

Background:

Bipartite hallucal sesamoids are often found in patients with hallux valgus. However, it is unknown whether bipartite hallucal sesamoids affect the results of hallux valgus surgery or not. The purpose of the present study was to evaluate the outcomes of chevron osteotomy for hallux valgus with and without bipartite hallucal sesamoid.

Methods:

A total of 152 patients (168 feet) treated with distal or proximal chevron osteotomy for hallux valgus constituted the study cohort. The 168 feet were divided into 2 groups: bipartite hallucal sesamoid (31 feet) and without bipartite hallucal sesamoid (137 feet). Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), tibial sesamoid position, and first metatarsal length were measured for radiographic outcomes and the American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) score was measured for clinical outcomes.

Results:

All radiographic measurements and the AOFAS score showed significant ( P < .05) improvement at the time of final follow-up compared with preoperative measurements in both groups. No significant differences ( P > .05) were found between the 2 groups in terms of HVA, IMA, DMAA, tibial sesamoid position, metatarsal shortening, and AOFAS score on final follow-up.

Conclusions:

This study suggests that bipartite hallucal sesamoids do not affect the results of hallux valgus surgery.

Level of Evidence:

Level III, retrospective comparative study.
Vibration isolation in neonatal transport by using a quasi-zero-stiffness isolator
Authors: Zhou Jiaxi , Wang Kai , Xu Daolin , Ouyang Huajiang , Fu Yimei
Published: April 2017

New-born infants are likely to suffer excessive vibration during neonatal transport, but there is no effective method to attenuate the transmission of vibration from the ambulance floor to an infant. This would be particularly detrimental to premature or sick new-born babies. In this paper, a quasi-zero-stiffness (QZS) vibration isolation method is proposed to improve the comfort of the infant in an incubator. The infant compartment is supported by quasi-zero-stiffness isolators, which are realized each by combining a pair of mutually repelling permanent magnets in parallel connection with a coil spring, and their parameters are obtained by design optimization to maximize the displacement range with smaller stiffness than that of the coil spring. A lumped-mass model of the transport incubator is developed, and the vibration isolation performance is estimated in terms of displacement and acceleration transmissibility. Numerical results reveal that a comparatively heavy damping is needed to completely avoid the jump phenomenon inherent in polynomial nonlinearity and suppress resonance, and thus achieve smooth and effective vibration attenuation starting from an ultra-low frequency. Under a random disturbance, magnification of vibration is observed in the original transport incubator, but notable attenuations of root mean square (RMS) acceleration and displacement in the modified one, which indicates that the proposed quasi-zero-stiffness isolator should be a good solution to eliminate vibration-induced injuries in neonatal transport.
Bioinformatics Education in Pathology Training: Current Scope and Future Direction
Authors: Clay Michael R , Fisher Kevin E
Published: April 2017

Training anatomic and clinical pathology residents in the principles of bioinformatics is a challenging endeavor. Most residents receive little to no formal exposure to bioinformatics during medical education, and most of the pathology training is spent interpreting histopathology slides using light microscopy or focused on laboratory regulation, management, and interpretation of discrete laboratory data. At a minimum, residents should be familiar with data structure, data pipelines, data manipulation, and data regulations within clinical laboratories. Fellowship-level training should incorporate advanced principles unique to each subspecialty. Barriers to bioinformatics education include the clinical apprenticeship training model, ill-defined educational milestones, inadequate faculty expertise, and limited exposure during medical training. Online educational resources, case-based learning, and incorporation into molecular genomics education could serve as effective educational strategies. Overall, pathology bioinformatics training can be incorporated into pathology resident curricula, provided there is motivation to incorporate, institutional support, educational resources, and adequate faculty expertise.
Ultrasound-Diagnosed Tibia Stress Fracture: A Case Report
Authors: Amoako Adae , Abid Ayesha , Shadiack Anthony , Monaco Robert
Published: April 2017

Stress fractures are a frequent cause of lower extremity pain in athletes, and especially in runners. Plain imaging has a low sensitivity. Magnetic resonance imaging (MRI) or bone scan scintigraphy is the criterion standard, but expensive. We present the case of a young female distance runner with left shin pain. Plain radiography was unremarkable. Ultrasound showed focal hyperechoic elevation of the periosteum with irregularity over the distal tibia and increased flow on Doppler. These findings were consistent with a distal tibia stress fracture and confirmed by MRI. Examination of our case will highlight the utility of considering an ultrasound for diagnosis of tibial stress fracture.
False-Positive Cases of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomographic Scans in Metastasis of Esophageal Cancer
Authors: Yamatsuji Tomoki , Ishida Naomasa , Takaoka Munenori , Hayashi Jiro , Yoshida Kazuhiro , Shigemitsu Kaori , Urakami Atsushi , Haisa Minoru , Naomoto Yoshio
Published: April 2017

Of 129 esophagectomies at our institute from June 2010 to March 2015, we experienced three preoperative positron emission tomography-computed tomographic (PET/CT) false positives. Bone metastasis was originally suspected in 2 cases, but they were later found to be bone metastasis negative after a preoperative bone biopsy and clinical course observation. The other cases suspected of mediastinal lymph node metastasis were diagnosed as inflammatory lymphadenopathy by a pathological examination of the removed lymph nodes. Conducting a PET/CT is useful when diagnosing esophageal cancer metastasis, but we need to be aware of the possibility of false positives. Therapeutic decisions should be made based on appropriate and accurate diagnoses, with pathological diagnosis actively introduced if necessary.
Congenital Hepatic Cyst
Authors: Recinos Aldo , Zahouani Tarik , Guillen Juan , Rajegowda Benamanahalli
Published: April 2017

Congenital hepatic cyst is a rare and nonsymptomatic condition in infants and children. Its incidence is 2.5% in the postnatal life with a much lower incidence in the prenatal period. Incidental finding on antenatal imaging is the most common presentation. We present a case of a newborn in whom fetal ultrasound detected a cyst within the fetal liver. Postnatal imaging revealed a liver cyst in the right lobe of the liver, with no other intrahepatic structure affected. Liver function tests were abnormal, but the patient was asymptomatic. Posterior follow-up imaging showed a minor decrease in size. Management of congenital hepatic cyst is usually conservative, done with periodic ultrasound monitoring. However, surgical treatment is the mainstay of treatment when hydrops, progressive enlargement, hemorrhage, torsion, or compression of adjacent structures occurs. Malignant transformation can occur, but it is extremely rare. Partial or total removal of the cyst is the preferred treatment in neonates with a large lesion.
Ruins in the landscape: Tourism and the archaeological heritage of Chinchero
Authors: Garcia Pablo
Published: April 2017

Aggressive heritage policies implemented by the state in the Peruvian highland town of Chinchero are severing the local population from their material past through processes of de-territorialization and displacement involved in the appropriation of archaeological spaces for tourism exploitation. This management is having an effect on local identity and how residents engage with their landscape. The landscape of the Inca ruins has traditionally been used in different ways and bears the traces of historical relationships, practices and events through which people have constructed a sense of place. Additionally, archaeological heritage management is changing how time is experienced in the landscape and showing how the process of ‘cleaning-up’ ruins to remove evidence of recent human activities and tidy up fallen stones can remove a sense of time and process for tourist visitors. These ethnographic observations are used to develop new ideas about how we can understand time and change in archaeological heritage sites.
Reverse deep drawing process: Material anisotropy and work-hardening effects
Authors: Ben Othmen Khadija , Sai Kacem , Manach Pierre-Yves , Elleuch Khaled
Published: April 2017

The present work aims to study the constitutive models’ influence on the reverse deep drawing simulation of cylindrical cups. Several constitutive laws were considered to predict the combined effects of anisotropy as well as the changes in strain path direction of the stainless steel. To this end, a number of models were used, worth mentioning among which are the isotropic with nonlinear kinematic hardening laws, along with the isotropic von Mises and anisotropic Hill’48 yield criteria. For the models’ parameters identification, uniaxial tensile and shear tests at several orientations to the rolling direction as well as reversed shear tests were carried out. Then, a subsequent comparison between experimental data and numerical simulations of reverse deep drawing tests were performed, using the finite element code Abaqus/Explicit. On the basis of the major reached results, it has been found that for the first stage, whatever the yield criteria used and for all the hardening models, the numerical punch-force evolution correlates well with the experimental one. For the second stage, the punch-force evolution was found to be remarkably more influenced by the yield criteria than by the kinematic laws. The major strain distribution greatly depends on the yield criteria. Meanwhile, it was slightly linked to the work hardening.
Effects of frequency on hysteretic heating and fatigue life of unreinforced injection molded polyamide 66 spur gears
Authors: Kodeeswaran M , Verma Arnika , Suresh R , Senthilvelan S
Published: April 2017

Gears are subjected to different rotational speeds/frequencies during their service life. The effect of the rotational speed on the performance of a metal gear is insignificant; however, it affects the thickness of the lubricant film. Polymer gears generate hysteretic self-heating because of the viscoelastic behavior of the material, thereby limiting their performance and usage in applications. The injection molded polyamide 66 spur gears were loaded by ground steel gear at different torques and frequencies using in-house realized servo motor driven gear test rig. Bidirectional loads at frequencies 2, 5, and 7.5 Hz and unidirectional loads at double the frequencies (4, 10, and 15 Hz) were applied on the polymer gears. The surface temperature of the gear due to the material hysteretic self-heating was continuously monitored and was recorded using an infrared thermal camera. Torque applied and angular displacement of the gear mesh were acquired to plot a hysteresis loop. The hysteresis loop area and surface temperature increase with the increase in the torque. Moreover, the bidirectional loads induce higher temperature than the unidirectional loads. This is because the gear tooth deflection increases under the bidirectional loads compared to that under the unidirectional loads for the tested frequencies. The fatigue life of the polymer gears was evaluated at higher frequency for different torques and was compared with that obtained at lower frequency. The gears tested at frequencies 15 and 7.5 Hz under unidirectional and bidirectional loads, respectively, exhibited inferior fatigue life compared to that at 10 and 5 Hz under unidirectional and bidirectional loads, respectively, because the temperature of the gear increases (30.6% and 43.7% for unidirectional and bidirectional loads, respectively) at higher frequencies. Both thermomechanical and root crack failures were observed under the bidirectional loads, whereas the gears exhibited only the root crack failures under the unidirectional loads. The failure morphology studied using the scanning electron microscope indicated straight root crack with overlapping fractured surfaces under both the bidirectional and unidirectional loads.
Participatory theatre for transformative social research
Authors: Erel Umut , Reynolds Tracey , Kaptani Erene
Published: April 2017

Reflecting on the transformative potential of participatory theatre methods for social research, the article draws on a project with ethnically diverse migrant mothers in London. The research reframes the experiences and practices of socially and ethnically marginalized migrant mothers as active interventions into citizenship. We also challenge recurring public discourses casting migrant mothers as threats to social and cultural cohesion who do not contribute but instead draw on the resources of the welfare state. We highlight how participatory theatre methods create spaces for the participants to enact social and personal conflicts. It also validates migrant mothers’ subjugated knowledges of caring and culture work creating new forms of citizenship. By enacting different versions of collective stories, the theatre sessions therefore become rehearsals for socio-political transformations.
Spaces of sovereignty: A tale of an unrecognized Palestinian village in Israel
Authors: Milner Elya L , Yacobi Haim
Published: April 2017

This article discusses the spatial and political dimensions of an unrecognized Arab village in Israel, which is a subject of houses demolition during the last decade, taking part in parallel to a legal struggle for recognition. This case is part of a wide political act in Israel, where Palestinians are rendered ‘criminal’ and their spaces illegitimate. We will suggest that the unrecognized villages cannot be seen solely as a product of planning policies, but are essential to the understanding of the ways in which Israeli sovereignty is embodied. We will discuss the case using legal documents regarding the latest petition made to the High Court of Justice. Through those documents, we will try to analyse the ways in which Israeli sovereignty is being embodied using theoretical tools by Carl Schmitt and his debate with Hans Kelsen. At the conclusions, we will suggest some thoughts regarding the possibilities of resistance.
Of good plants and useless weeds: Planning as a technology of the gardening state
Authors: Kamete Amin Y
Published: April 2017

The article deploys Bauman’s metaphor of the ‘gardening’ state to consider the imbrication of planning and the dark side of modernity. It interrogates the public production and defence of urban spaces suitable for people deemed to have value. Using empirical material from urban Zimbabwe, I frame planning as a spatial technology of the gardening state and peer into its handling of informality under two main themes: first, the perception, construction and designation of ‘weeds’, and second, the declaration and treatment of the ‘weeds’. Situating Bauman’s metaphor in the nexus between planning, the state and informality, I conclude that the metaphor paints a helpful but inadequate picture. I argue that while the metaphor is helpful with regards to the first theme, refinements are needed in its application to the second. Rather than see planning enforcement as a rational-scientific practice, a nuanced conceptualisation is needed that explicitly acknowledges the messy business of politics.
Radiation Awareness for Endovascular Abdominal Aortic Aneurysm Repair in the Hybrid Operating Room. An Instant Patient Risk Chart for Daily Practice
Authors: de Ruiter Quirina M. , Gijsberts Crystel M. , Hazenberg Constantijn E. , Moll Frans L. , van Herwaarden Joost A.
Published: April 2017

Purpose: To determine which patient and C-arm characteristics are the strongest predictors of intraoperative patient radiation dose rates (DRs) during endovascular aneurysm repair (EVAR) procedures and create a patient risk chart. Methods: A retrospective analysis was performed of 74 EVAR procedures, including 16,889 X-ray runs using fixed C-arm imaging equipment. Four multivariate log-linear mixed models (with patient as a random effect) were constructed. Mean air kerma DR (DRAK, mGy/s) and the mean dose area product DR (DRDAP, mGycm2/s) were the outcome variables utilized for fluoroscopy as differentiated from digital subtraction angiography (DSA). These models were used to predict the maximum radiation duration allowed before a 2-Gy skin threshold (for DRAK) or a 500-Gycm2 threshold (for DRDAP) was reached. Results: The strongest predictor of DRAK and DRDAP for fluoroscopy imaging was the radiation protocol, with an increase of 200% when changing from “low” to “medium” and 410% from “low” to “normal.” The strongest predictors of DRAK and DRDAP for DSA were C-arm angulation, with an increase of 47% per 30° of angulation, and body mass index (BMI), with an increase of 58% for every 5-point increase in BMI. Based on these models, a patient with a BMI of 30 kg/m2, combined with 45° of rotation and a field size of 800 cm2 in the medium fluoroscopy protocol has a predicted DRAK of 0.39 mGy/s (or 85.5 minutes until the 2-Gy skin threshold is reached). While using comparable settings but switching the acquisition to a DSA with a “2 frames per second” protocol, the predicted DRAK will be 6.6 mGy/s (or 5.0 minutes until the 2-Gy threshold is reached). Conclusion: X-ray radiation DRs are constantly fluctuating during and between patients based on BMI, the protocols, C-arm position, and the image acquisitions that are used. An instant patient risk chart visualizes these radiation dose fluctuations and provides an overview of the expected duration of X-ray radiation, which can be used to predict when follow-up dose thresholds are reached during abdominal endovascular procedures.
Does Everything That’s Counted Count? Value of Inflammatory Markers for Following Therapy and Predicting Outcome in Diabetic Foot Infection
Authors: Ong Eric , Farran Sumaya , Salloum Michelle , Gardner Summer , Giovinco Nicholas , Armstrong David G. , Matthias Kathryn R. , Nix David E. , Al Mohajer Mayar
Published: April 2017

To assess the severity of inflammation associated with diabetic foot infection (DFI), values of inflammatory markers such as white blood count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil to lymphocyte ratio (NLR) are often measured and tracked over time. It remains unclear if these markers can aid the clinician in the diagnosis and management of DFI, and ensure more rational use of antibiotics. Hospitalized adult patients (n = 379) with DFI were retrospectively assessed for abnormal inflammatory markers, correlation between values of inflammatory markers, and clinical diagnosis on initial admission and on last follow-up. At admission, WBC, ESR and NLR were each elevated in patients with osteomyelitis and only ESR was significantly elevated in patients with soft tissue infection only. Only WBC was significantly elevated in patients with osteomyelitis compared with uninfected diabetic feet on last follow-up. Considering the predictive performance of these inflammatory markers, they demonstrated excellent positive predictive value at admission, and excellent negative predictive value at the last follow-up visit. Moreover, the number of elevated markers was further associated with probability of infection both at admission and last follow-up.
From Systematic Review to Call for Action
Authors: Sawin Erika Metzler , Sobel Linda L. , Annan Sandra L. , Schminkey Donna L.
Published: April 2017

Introduction:

Intimate partner violence (IPV) is a global public health and criminal justice concern with significant impacts; especially high rates are seen among rural Hispanic American (HA) communities, the fastest growing population in the United States. They experience additional barriers to care including extreme poverty, lesser education, gender norms, and language and immigration issues.

Method:

A systematic literature review was conducted using Cooper’s framework to identify evidence supporting associations between interventions and prevention, reduction, and elimination of IPV among rural HA women. Searches conducted on databases including CINAHL, PubMed, Medline, Women’s Studies International, MedicLatina, and JSTOR used the MeSH terms Hispanic Americans (Latino/a and Hispanic), domestic violence, and intimate partner violence. Selected studies were published between January 1, 2000, and January 1, 2014.

Results:

Of the 617 yielded articles, only 6 met the inclusion criteria. Of these, none closely examined rurality or provided valid and reliable measures of outcomes, instead reporting program descriptions and suggested interventions. We identify key findings to guide program, screening, and tool development.

Conclusion:

Our study identifies a gap in knowledge, research, and effective practices and issues a call for action to create evidence-based tools to prevent, reduce, and eliminate IPV in these underserved populations.
Louis-Léopold-Xavier-Édouard Ollier (1830-1900): An Innovative Orthopedic Surgeon
Authors: Laios Konstantinos , Markatos Konstantinos , Androutsos George
Published: April 2017

Louis-Léopold-Xavier-Édouard Ollier (1830-1900) was a pioneer in orthopedics considered as the founder of modern orthopedic surgery. He was a skillful and experimenter surgeon. He invented many new surgical techniques in orthopedic surgery and many new surgical instruments. His most known discovery is Ollier’s disease.
Endoscopic ultrasound-guided hepaticogastrostomy versus percutaneous transhepatic drainage for malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatography: a retrospective expertise-based study from two centers
Authors: Sportes Adrien , Camus Marine , Greget Michel , Leblanc Sarah , Coriat Romain , Hochberger Jürgen , Chaussade Stanislas , Grabar Sophie , Prat Frédéric
Published: April 2017

Background:

Percutaneous transhepatic biliary drainage (PTBD) is widely performed as a salvage procedure in patients with unresectable malignant obstruction of the common bile duct (CBD) after failed endoscopic retrograde cholangiopancreatography (ERCP) or in case of surgically altered anatomy. Endoscopic ultrasound-guided hepaticogastrostomy (EU-HGS) is a more recently introduced alternative to relieve malignant obstructive jaundice. The aim of this prospective observational study was to compare the outcome, efficacy and adverse events of EU-HGS and PTBD.

Methods:

From April 2012 to August 2015, consecutive patients with malignant CBD obstruction who underwent EU-HGS or PTBD in two tertiary-care referral centers were included. The primary endpoint was the clinical success rate. Secondary endpoints were technical success, overall survival, procedure-related adverse events, incidence of adverse events, and reintervention rate.

Results:

A total of 51 patients (EU-HGS, n = 31; PTBD, n = 20) were included. Median survival was 71 days (range 25–75th percentile; 30–95) for the EU-HGS group and 78 days (range 25–75th percentile; 42–108) for the PTBD group ( p = 0.99). Technical success was achieved in all patients in both groups. Clinical success was achieved in 25 (86%) of 31 patients in the EU-HGS group and in 15 (83%) of 20 patients in the PTBD group ( p = 0.88). There was no difference in adverse events rates between the two groups (EU-HGS: 16%; PTBD: 10%) ( p = 0.69). Four deaths within 1 month (two hemorrhagic and two septic) were considered procedure related (two in the EU-HGS group and two in the PTBD group). Overall reintervention rate was significantly lower after EU-HGS ( n = 2) than after PTBD ( n = 21) ( p = 0.0001). Length of hospital stay was shorter after EU-HGS (8 days versus 15 days; p = 0.002).

Conclusions:

EU-HGS can be an effective and safe mini invasive-procedure alternative to PTBD, with similar success and adverse-event rates, but with lower rates of reintervention and length of hospitalization.
Trauma or tumour: giant cell tumour of distal biceps tendon sheath, an unusual cause of elbow pain
Authors: Fawi Hassan M.T. , Dojcinov Stefan , Lyons Kathleen , Matthews Timothy J.W.
Published: April 2017

We report the case of a middle-age lady who presented following minor trauma, with dominant-sided anterior elbow pain and swelling of 6 months in duration. She was assessed clinically, and underwent investigations, which confirmed features consistent with giant cell tumour (GCT) of distal biceps tendon sheath. She underwent uneventful en-bloc excisional surgery. She did not have radiotherapy. She is now 5 years postoperatively asymptomatic, with full function, and with no signs of recurrence.
Management of painful reverse shoulder arthroplasty
Authors: Ekelund Anders L.
Published: April 2017

Even though reverse shoulder arthroplasty is a very successful procedure, painful complications occur. During the initial postoperative years, the most common reasons for pain are instability, postoperative fracture of the acromion or spine, and periprosthetic infection. Later, aseptic loosening, with humeral loosening being more frequent that glenoid loosening, can be a source of pain and reduction in function. A careful patient history, clinical examination, plain radiographs, computed tomography and blood tests give an explanation for the pain in most cases. The majority of these complications can be successfully treated, maintaining a functional reverse shoulder arthroplasty. However, if all examinations are normal, it is important to remember that nonshoulder conditions such as tumour of the lung or degenerative changes of the cervical spine can give shoulder pain.