bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice
Authors: Li Jiaxin , Zhuo Shijie , Chen Binghong , Liu Yang , Wu Hong
Published: September 2019

Objective

This study was performed to summarize our experience and investigate the safety and efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice.

Methods

Thirteen patients with malignant obstructive jaundice who underwent laparoscopic modified loop cholecystojejunostomy from March 2015 to March 2016 were retrospectively reviewed. The patients’ characteristics, operation time, postoperative intestinal recovery time, length of hospital stay, postoperative bilirubin level, and complications were analyzed.

Results

The patients were followed up as outpatients for 2 years. Nine patients with pancreatic head carcinoma, one patient with periampullary carcinoma, and three patients with distal bile duct carcinoma successfully underwent laparoscopic modified loop cholecystojejunostomy. The mean operation time was 176 ± 45 minutes, and the mean length of hospital stay was 9.5 ± 2.8 days. The serum total bilirubin concentration and gamma-glutamyl transferase concentration significantly decreased on postoperative day 7. The median follow-up time was 7 months. No patients developed bile leakage or required a reoperation.

Conclusions

Laparoscopic modified loop cholecystojejunostomy is not only safe and minimally invasive, but it is also feasible for patients with malignant obstructive jaundice.
Serum vascular endothelial growth factor level is elevated in patients with impaired glucose tolerance and type 2 diabetes mellitus
Authors: Sun Xiaomeng , Zhang Heng , Liu Jia , Wang Guang
Published: September 2019

Objective

This study was performed to investigate the serum vascular endothelial growth factor (VEGF) levels in Chinese patients with impaired glucose tolerance (IGT) and newly diagnosed type 2 diabetes mellitus (T2DM).

Methods

A total of 189 subjects (41 controls, 40 patients with IGT, and 108 patients with newly diagnosed T2DM) were recruited. Serum VEGF levels were determined by ELISA; other metabolic parameters were assessed by standard laboratory methods.

Results

There were significant differences in serum VEGF levels among the T2DM, IGT, and control groups (T2DM vs. controls: 72.00 [45.40, 98.35] pg/mL vs. 53.10 [36.30, 116.25] pg/mL; IGT vs. controls: 78.17 [55.52, 137.25] pg/mL vs. 53.10 [36.30, 116.25] pg/mL). Moreover, serum VEGF levels were positively associated with the homeostasis model assessment for insulin resistance (HOMA-IR) value. Multiple linear regression analysis indicated that the HOMA-IR value was an independent risk factor for elevated serum VEGF level.

Conclusions

Both IGT and T2DM patients exhibited increased serum VEGF levels, compared with controls; increased serum VEGF level was positively associated with the HOMA-IR value. Therefore, the increased serum VEGF level might partially result from increased insulin resistance in these patients.
A patient with severe acute pancreatitis who was successfully rescued by multiple disciplinary teams: a case report
Authors: Zheng Linhui , Deng Jun , Long Xinhua , Zeng Yuanlin
Published: September 2019

Severe acute pancreatitis (SAP) is a type of acute abdominal disease. SAP has a high incidence, rapid progression, many complications, high mortality rate (as high as 30%–50%), and is difficult to treat, accounting for approximately 5% to 10% cases of acute pancreatitis. We report diagnosis and treatment of a case of SAP, including a combination of the relevant guidelines and our experience. The patient, who was a 42-year-old woman, was admitted to our hospital after suffering from abdominal pain in the upper abdomen for 1 day. The results of a computed tomography scan in the upper abdomen showed changes in the pancreas accompanied by acute fluid accumulation. The blood amylase level was 1150 U/L. The patient was treated at our Gastroenterology Department for 5.5 months, and received 22 blood transfusions (including red blood cell suspension, plasma, cryoprecipitate, and platelets), four surgical operations, three angiographic interventions, and two times of embolization for hemostasis. We successfully rescued this patient with SAP using minimally invasive, staged, multidisciplinary, and diversified treatment modalities.
Taxonomy design methodologies: Emergent research for knowledge management domains
Authors: Tucker Virginia M.
Published: September 2019

A knowledge management research study was integrated into a consulting internship for three students in an MLIS programme, working under the direction of a faculty member. The project scope was to organise knowledge across all academic disciplines, as represented in university structures, in support of the consulting client’s software analytics tools for scholarly journal publishers. The study team’s original research contribution was a four-phase design and validation approach to taxonomy creation, using extant research methods in concert. The students learned to bridge their coursework knowledge into a knowledge management environment in industry and to apply data collection and analysis methods to a novel research project.
Improvements on overlapping unstructured grids
Authors: Xuan Chuanwei , Han Jinglong
Published: September 2019

Improvements on the efficiency of overlapping unstructured grids have been done in several ways. First of all, the traditional hole mapping method was improved to save physical memories. Then, the wall distance calculation was greatly accelerated by taking advantage of neighbor-to-neighbor searching technique. Besides, extra enhancements have been done to the process of donor cell search for a better performance. During hole cutting, for Cartesian grids generated to approximate the wall surface, just those intersecting with the wall surface were detected and stored. Relative positions of those stored Cartesian cells were used to determine which nodes are inside the wall. Fringe nodes served as the initial front to iteratively optimize the overlapping area with the wall distance criterion. The improved overlapping technique featured in less physical memory occupation, higher efficiency of wall distance calculation, and faster donor cell search. Last but not least, three typical flow examples demonstrated the efficiency of the method developed in the work.
Investigation on the effect of complex impeller on vibration characteristics for a high-speed centrifugal pump
Authors: Yuan Ye , Yuan Shouqi , Tang Lingdi
Published: September 2019

In this article, to improve the vibration characteristics of a high-speed centrifugal pump, two new types of complex impeller were designed for replacing the original long-blade impeller. The experimental apparatus of pump vibration was designed and used to test the vibration signals of the model pump with the original impeller in frequency field. The vibration amplitude of 0.12 mm/s2 is observed on the shaft rotating frequency, while the amplitudes of 0.04 mm/s2, 0.14 mm/s2, and 0.2 mm/s2 respectively on the conditions of 0.8 QN, QN, and 1.2 QN appear on the impeller blade passing frequency. The computational fluid dynamics method was used to study internal flow characteristics in the pumps with three impellers for mitigating the pump vibration. Steady pressure nephogram shows big pressure difference existed in the complex-impeller pump, which means that the complex impeller can provide the high-lift water. Addition of the splitter blade can make the pressure-fluctuation amplitude of model pump to reduce obviously by the unsteady time–frequency analyses. Furthermore, two complex impellers were machined and used to conduct the contrast experiment on the vibration characteristics between the pumps with the original impeller and complex impeller. The results reveal that the water head of pump with the complex impeller is higher than that of the original pump, which verifies the simulated results. Meanwhile, the complex impeller has a positive effect on the decrease of pump vibration on the frequency domain, especially on the blade passing frequency the vibration amplitudes decrease by 0.08 mm/s2.
Novel nano-hydroxyapatite-silica–added glass ionomer cement for dental application: Evaluation of surface roughness and sol-sorption
Authors: Moheet Imran Alam , Luddin Norhayati , Ab Rahman Ismail , Masudi Sam’an Malik , Kannan Thirumulu Ponnuraj , Abd Ghani Nik Rozainah Nik
Published: September 2019

The aim of this study was to synthesize and characterize nano-hydroxyapatite-silica (nano-HA-Si) particle, followed by the evaluation of surface roughness and sol-sorption property of conventional glass ionomer cement (cGIC) with the addition of nano-HA-Si. Nano-HA-Si was synthesized by one-pot sol–gel technique. It was then characterized using Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscope, and transmission electron microscope. Experimental nano-HA-Si–added GIC (nano-HA-Si-GIC) was prepared by adding 10% by weight ratio of nano-HA-Si to cGIC powder. The surface roughness of the samples was analyzed using tactile profilometer. Mass stabilization techniques were used to assess sol-sorption. The 10% nano-HA-Si-GIC samples were successfully fabricated. Nano-HA-Si-GIC reported lower surface roughness (0.13 ± 0.01 μm) as compared to cGIC (0.16 ± 0.03 μm). Nano-HA-Si-GIC reported an increase in sol-sorption when compared to cGIC. Incorporation of nano-HA-Si into the formulation of cGIC enhances their physical properties and with slight increase in sol-sorption property. Nano-HA-Si-GIC has the ability to enhance the characteristics of glass ionomer dental restorative materials. Hence, it can be suggested as a potential future restorative material in dentistry.
Type 2 diabetes and colorectal cancer screening: Findings from the English Longitudinal Study of Ageing
Authors: von Wagner Christian , Cadar Dorina , Hackett Ruth A , Demakakos Panayotes , Beeken Rebecca J , Cooper Bailey Stacy , Wolf Michael , Steptoe Andrew , Renzi Cristina , Stoffel Sandro T
Published: September 2019

Objectives

Type 2 diabetes has been identified as a risk factor for colorectal cancer, but little is known about whether it influences participation in colorectal cancer screening programmes. This study tested the extent to which Type 2 diabetes is negatively associated with colorectal cancer screening uptake.

Methods

We analysed individual data of screening eligible men and women aged 60–75 without cancer diagnosis from wave 6 of the English Longitudinal Study of Ageing (collected 2012–2013), to investigate whether Type 2 Diabetes influences colorectal cancer screening behaviour independently of demographic characteristics, body mass index, socio-economic status and other chronic diseases.

Results

Individuals who reported to have Type 2 diabetes or had glycated haemoglobin (HbA1c) levels of 48 mmol/mol or higher were less likely to have ever completed a screening test (faecal occult blood test; 62.8% vs. 75.8%, p < 0.01) or to be up-to-date with their biennial screening invitation (60.2% vs. 72.0%, p < 0.05). The negative associations of Type 2 diabetes on colorectal cancer screening were found both in unadjusted and adjusted regression models.

Conclusions

Future qualitative and quantitative research should identify reasons for this discrepancy, to inform interventions to increase screening uptake in this high-risk population.
Total Factor Productivity Growth of Indian General Insurance Companies in the Recent Period: A Bootstrapped Approach
Authors: Sinha Ram Pratap
Published: September 2019

This study estimates Malmquist index of total factor productivity change of 14 major general insurers in India over the period 2009–10 to 2016–17 over 7 annual windows.

The study decomposes total factor productivity index into its constituent components, using several approaches including Färe et al. (1989, Productivity Developments in Swedish Hospitals: A Malmquist Output Index Approach. Carbondale: Department of Economics, Southern Illinois University; 1992, Journal of Productivity Analysis 3(1): 85–101), Färe et al. (1994, American Economic Review 84(1): 66–83), Ray and Desli (1997, American Economic Review 87(5): 1033–39) and Wheelock and Wilson (1999, Journal of Money, Credit and Banking 31(2): 212–23). Furthermore, the study uses bootstrap data envelopment analysis (DEA) method to obtain bias-corrected point and interval estimates of Malmquist index and its components. Finally, the study makes a comparison of productivity performance between public and private sector insurers. The results indicate a modest growth in total factor productivity during the period contributed mainly by efficiency changes. The private sector insurers performed better than the public sector in terms of productivity growth. The variations in productivity performance indicate that insurer scale of activity can affect their performance.

JEL Classification: G-23, C-61, D-21
An Update on the Relevance of the Life Course Perspective for Social Work
Authors: Hutchison Elizabeth D.
Published: September 2019

In recent years, the life course perspective has received increasing support from researchers across a number of behavioral science disciplines. The purpose of this article is to examine the relevance to social work of selected findings of the last 15 years of empirical investigation of life course concepts and themes. This discussion is organized around five basic concepts (cohorts, transitions, trajectories, life events, and turning points) and six interrelated themes (interplay of human lives and historical time, timing of lives, linked or interdependent lives, human agency in making choices, diversity in life course trajectories, and developmental risk and protection). Implications of life course theory and research for social work are overviewed.
Spatial pseudo-rigid body model for the analysis of a tubular mechanical metamaterial
Authors: Broeren Freek GJ , van der Wijk Volkert , Herder Just L
Published: September 2019

In this paper, a pseudo-rigid body model is proposed for the analysis of a spatial mechanical metamaterial and its application is demonstrated. Using this model, the post-buckling behavior of the mechanical metamaterial can be determined without the need to consider the whole elastic structure, e.g., using finite-element procedures. This is done by analyzing a porous cylindrical mechanical metamaterial using a rigid body mechanism, consisting of rigid squares that are connected at their corners. Stiffness in this model comes from torsion springs placed at the connections between rigid parts. The theory of the model is presented and the results of two versions of this model are compared through experiments. One version describes the metamaterial in the free state, while the other, more extended, version includes clamped boundaries, matching the conditions of the experimental set-up. It is shown that the mechanical behavior of the spatial metamaterial is captured by the models and that the shape of the metamaterial in the deformed state can be obtained from the more extended model.
Growing Equity and Health Equity in Perilous Times: Lessons From Community Organizers
Authors: Minkler Meredith , Rebanal R. David , Pearce Robin , Acosta Maria
Published: September 2019

Although a growing body of evidence underscores the contributions of community-based participatory research, community coalitions and other community engagement approaches to addressing health equity, one of the most potent forms of engagement—community organizing—has attracted far less attention in our field. Yet, organizing by and for communities, to build power, select issues, develop and use strategies, and take action to address the goals they collectively have set, may offer important lessons for public health professionals in these fraught times. We share, largely in their own words, the experiences and reflections of ~140 grassroots organizers across the United States who attended regional convenings of organizers in 2017, planned and run by four leading community capacity and base-building organizations, and where diverse organizers shared strategies that work, challenges faced, and the deep concerns among their already often disenfranchised communities in the contemporary sociopolitical and cultural context. After briefly reviewing some of community organizing’s core tenets and complexities, we share our qualitative research methods and key findings about the primary cross-regional concerns raised (mass incarceration, voter suppression, and immigrant rights), the themes that emerged (e.g., centering leadership by women of color and of using a health lens to frame community issues), as well as the challenges faced (e.g., the retraumatization often experienced by organizers and the difficulties in building alliances between groups “that have been taught to distrust each other”). We conclude by discussing how many of the promising practices and lessons shared by the community organizers might enhance our own field’s health equity-focused efforts, particularly if we take seriously one of their most bedrock messages: that there can be no health equity without racial equity and social justice, and that to get to health equity, we must first address equity writ large, particularly in troubling times.
Power Dynamics in Community-Based Participatory Research: A Multiple–Case Study Analysis of Partnering Contexts, Histories, and Practices
Authors: Wallerstein Nina , Muhammad Michael , Sanchez-Youngman Shannon , Rodriguez Espinosa Patricia , Avila Magdalena , Baker Elizabeth A. , Barnett Steven , Belone Lorenda , Golub Maxine , Lucero Julie , Mahdi Ihsan , Noyes Emma , Nguyen Tung , Roubideaux Yvette , Sigo Robin , Duran Bonnie
Published: September 2019

Community-based participatory research has a long-term commitment to principles of equity and justice with decades of research showcasing the added value of power-sharing and participatory involvement of community members for achieving health, community capacity, policy, and social justice outcomes. Missing, however, has been a clear articulation of how power operates within partnership practices and the impact of these practices on outcomes. The National Institutes of Health–funded Research for Improved Health study (2009-2013), having surveyed 200 partnerships, then conducted seven in-depth case studies to better understand which partnership practices can best build from community histories of organizing to address inequities. The diverse case studies represented multiple ethnic–racial and other marginalized populations, health issues, and urban and rural areas and regions. Cross-cutting analyses of the qualitative results focus on how oppressive and emancipatory forms of power operate within partnerships in response to oppressive conditions or emancipatory histories of advocacy within communities. The analysis of power was conducted within each of the four domains of the community-based participatory research conceptual model, starting from how contexts shape partnering processes to impact short-term intervention and research outputs, and contribute to outcomes. Similarities and differences in how partnerships leveraged and addressed their unique contexts and histories are presented, with both structural and relational practices that intentionally addressed power relations. These results demonstrate how community members draw from their resilience and strengths to combat histories of injustice and oppression, using partnership principles and practices toward multilevel outcomes that honor community knowledge and leadership, and seek shared power, policy, and community transformation changes, thereby advancing health equity.
Kidney allograft dysfunction due to ipsilateral thigh arteriovenous graft
Authors: Agrawal Nikhil , Garg Neetika , Adapa Sreedhar , Cardarelli Francesca
Published: September 2019

Arteriovenous graft in the thigh is used not infrequently for hemodialysis. Outcomes with this lower extremity dialysis access are generally comparable to upper extremity access and superior to long-term catheter use. However, it could have significant implications in a patient getting a kidney transplant. Here we describe a case of thigh arteriovenous graft causing kidney allograft dysfunction in a new transplant recipient, and this resolved with graft ligation.
Communicative and globalizing impacts of food labels: an Australian study
Authors: Xu Elaine , Lee Terence
Published: September 2019

This article analyzes the impacts of the Australian Federal Government’s food labeling reforms on the formation of food practices and the market for local food products. It considers how the inclusion of product and ingredient origin information blurs the distinction between ‘domestic’ and ‘foreign’ food products, and foregrounds different ‘support local’ behaviors. Findings from the study highlight the influence of structural and cultural factors, complemented by the strategic use of media tools, in shaping how food labels function as mechanisms to mediate domestic and transnational food practices. Retail concentration, support for the ‘buy local’ discourse, and the mediating influence of supermarket food media are presented as key factors that underpin the diffusion of and the demand for branded products and local food products in Australia. The impacts of the food origin labeling regulations on Australia’s highly concentrated grocery retail sector and export markets for Australian food products are also discussed.
Emotional functioning and the development of internalizing and externalizing problems in young boys with and without autism spectrum disorder
Authors: Li Boya , Bos Marieke GN , Stockmann Lex , Rieffe Carolien
Published: September 2019

Children with autism spectrum disorder are at risk of developing internalizing and externalizing problems. However, information on early development of behavior problems and the contributing role of emotional functioning in preschool children with autism spectrum disorder is scarce. This study collected data of boys with and without autism spectrum disorder ( N = 156; age: 2–6 years) over three consecutive years (three waves), about their internalizing and externalizing symptoms and emotional functioning (i.e. emotion control, recognition, and vocabulary), using parent-report questionnaires. No age effect was found on internalizing or externalizing problems for boys with and without autism spectrum disorder. Boys with autism spectrum disorder displayed more behavior problems than their typically developing peers and showed lower levels of emotional functioning. Better emotion control and improved emotion recognition were associated with a decrease in problem behaviors for boys with and without autism spectrum disorder, whereas improved emotion vocabulary was uniquely related to a decrease in externalizing problems in boys with autism spectrum disorder. Our findings suggest that boys with and without autism spectrum disorder showed similar developmental courses of internalizing and externalizing problems. However, lower levels of emotional functioning were already more pronounced in boys with autism spectrum disorder at a young age. This contributes to higher levels of behavior problems.
Outlaw girls escape from prison: Gender, resistance and playfulness
Authors: Emmerich Fabienne
Published: September 2019

Prison resistance practices are increasingly understood as gendered and linked to subjectivation. This article builds on this growing body of knowledge, but with a different and largely under explored focus, namely the confrontational resistance practices of women political prisoners. The objective is to explore how gendered resistance practices disrupt dominant constructions of gender through the lens of the hidden preparations and implementation of a historical women’s escape. This is done through a gendered analysis of narrative and auto/biographical material of a 1976 prison break in Germany, in which four women of the Red Army Faction (RAF) and June 2nd Movement (J2M) escaped from the women’s prison in West Berlin. Drawing on the works of poststructuralist feminists, the article expands our theoretical understanding of resistance to include the recognition of playfulness and laughter in the processes of subjectivation. It argues that opening up gendered resistance practices to play and laughter, lets us see the women’s escape as a subversive reversal of the heroic, masculine prison break, in which their subjectivity as revolutionary violent women is revealed.
The effect of stroboscopic effect on human health indicators
Authors: Zhao X , Hou D , Lin Y , Xu W
Published: September 2019

The stroboscopic effect from LED light sources can become considerable in working environments. Therefore, this study aims to explore the short-term health effect of a temporal light artefact. The experiment was carried out featuring 10 university students. Three frequencies and three modulation depths were assessed. Psychological reaction was evaluated through subjective scales, while physiological parameters were also collected for mutual validation and analysis. It was found that when the conditions are in the high-risk zone defined by IEEE Standard 1789-2015, subjects considered these conditions to be unacceptable and reported discrete spatial movement and higher visual fatigue levels. Supported by psychological and physiological evidence, it is suggested that such fatigue is caused by a higher chance of flicker. Invisible flicker also significantly affected alpha and beta wave power density, suggesting that a strobe of low frequency could potentially decrease drowsiness and increase cortical arousal. Some limitations to the work performance of this study are also discussed.
Botulinum toxin type A suppresses arterial vasoconstriction by regulating calcium sensitization and the endothelium-dependent endothelial nitric oxide synthase/soluble guanylyl cyclase/cyclic guanosine monophosphate pathway: An in vitro study
Authors: Hu Liang , Feng Ya , Liu Wuchao , Jin Lingjing , Nie Zhiyu
Published: September 2019

Botulinum toxin type A (BTX-A) is a potent neurotoxin that causes relaxation of striated muscle by inhibiting the release of acetylcholine at the neuromuscular junction. Some studies have suggested that BTX-A treatment for Raynaud syndrome is safe and effective with few adverse reactions. However, the underlying mechanism remains unclear. In the present study, we used both arterial rings isolated from rabbits and human microvascular endothelial cells (HMEC-1) to evaluate the mechanism underlying the effects of BTX-A on arterial vasoconstriction induced by 5-hydroxytryptamine. The roles of calcium sensitization and the endothelial nitric oxide synthase (eNOS)/soluble guanylyl cyclase (sGC)/cyclic guanosine monophosphate (cGMP) pathway were investigated. BTX-A caused a concentration-dependent decrease in the contraction of endothelium-intact arteries and significantly reduced calcium sensitization in the arteries. Inhibitors of eNOS (L-NAME) and sGC (methylene blue) both significantly abolished the vasodilatory action of BTX-A. Furthermore, BTX-A increased eNOS activity and the cGMP level in dose- and time-dependent manners and increased eNOS and sGC protein levels in a time-dependent manner in HMEC-1. Taken together, these findings indicate that BTX-A suppresses arterial vasoconstriction by regulating smooth muscle calcium sensitization and the eNOS/sGC/cGMP pathway.

Impact statement

Raynaud syndrome (RS), usually caused by cold or mental stress, may lead to cyanosis and reactive hyperemia accompanied by pain or paresthesia. Although a variety of drugs have been used to alleviate the symptoms, the effects have not been satisfactory, so there is an urgent need to explore new alternative treatments. The present study investigated the mechanism underlying the effects of botulinum toxin type A (BTX-A) on arterial vasoconstriction, which may provide new approaches for RS. We found that BTX-A suppresses arterial vasoconstriction by regulating smooth muscle calcium sensitization and the endothelial nitric oxide synthase (eNOS)/soluble guanylyl cyclase (sGC)/cyclic guanosine monophosphate (cGMP) pathway. These findings clarify the underlying mechanism of the effects of BTX-A on arterial vasoconstriction and provide new theoretical support for the use of BTX-A on RS. It may also help us to develop new medicines which regulate calcium sensitization and the eNOS/sGC/cGMP pathway against RS.
Lived Experiences of a Community: Merging Interpretive Phenomenology and Community-Based Participatory Research
Authors: Bush Erin J. , Singh Reshmi L. , Kooienga Sarah
Published: September 2019

Community-based participatory research (CBPR) and interpretive phenomenology, when merged, can provide insight into the experiences of a homogenous community. The purpose of this manuscript is 2-fold. First, we aim to provide a conceptual view of merging methodological approaches of phenomenology and CBPR. Principles of interpretive phenomenology, the philosophical stance, and the qualitative analysis methodology, as well as how interpretive phenomenology is complementary to CBPR, are reviewed. Second, the utility, rationale, and feasibility of merging these diverse approaches are explored. For illustrative purposes, exemplars from a Parkinson’s disease stakeholder study are used to discuss aims, methods, and results. Focus group data collection strategies and the use of Template Analysis as an analytic tool are also described. Themes that materialized from the data focused on support group experiences for this rural community. In keeping with interpretive phenomenology, the researchers’ interpretation of these themes led to the understanding of an overall essence, or essential theme, of this community’s lived experiences.
Regressor-free adaptive fuzzy force tracking control of redundant robot manipulator for task space
Authors: Chu Chia-Hung , Lee Ching-Hung
Published: September 2019

In this study, an adaptive fuzzy force control of a redundant robot manipulator experiencing system uncertainties and operating in an unknown environment is proposed. This is important not only to provide additional control flexibility for complicated tasks but also to avoid the joint limit of a robot in implementing better dynamics and kinematics. The relation between the task and joint spaces is discussed to derive a dynamic model for force tracking controller design. To treat the system uncertainties, an adaptive fuzzy system approach is established to achieve the adaptive position and force controller design based on a regressor-free approach. Considering that the stiffness coefficient of the environment is assumed to be unknown, the gradient descent method is used to estimate this coefficient to achieve adaptive force tracking. A stability analysis of the closed-loop system and the corresponding update laws are given by the Lyapunov stability theorem. Finally, several apposite simulations using the KUKA lightweight robot are performed to validate our approach and demonstrate the performance and effectiveness of the proposed regressor-free adaptive fuzzy force controller.
Association of Splenic Rupture and Infectious Mononucleosis: A Retrospective Analysis and Review of Return-to-Play Recommendations
Authors: Sylvester Jillian E. , Buchanan Benjamin K. , Paradise Scott L. , Yauger Joshua J. , Beutler Anthony I.
Published: September 2019

Background:

Infectious mononucleosis is typically a self-limited disease commonly affecting young adults. Splenic rupture is a rare but serious complication affecting 0.1% to 0.5% of patients with mononucleosis. Current guidelines (based on published case reports) recommend complete activity restriction for 3 weeks after onset of mononucleosis symptoms to reduce rupture risk. We examined actual timing of mononucleosis-associated splenic injury using a large repository of unpublished patient data.

Hypothesis:

The risk of splenic injury after infectious mononucleosis will remain elevated longer than previously estimated.

Study Design:

Retrospective case series.

Level of Evidence:

Level 4.

Methods:

The Military Health System Management Analysis and Reporting Tool (M2) was used to conduct a retrospective chart review. Coding records of TRICARE beneficiaries aged 5 to 65 years between 2006 and 2016 were screened. Patients diagnosed with both splenic injury and mononucleosis-like symptoms were identified, and their medical records were reviewed for laboratory confirmation of infection and radiographically evident splenic injury.

Results:

A total of 826 records of splenic injury were found in M2. Of these, 42 cases met the study criteria. Mean time to splenic injury was 15.4 (±13.5) days. Only 73.8% (n = 31) of injuries occurred within 21 days, and 90.5% (n = 38) of splenic injuries occurred within 31 days of symptom onset.

Conclusion:

A substantial number of splenic injuries occur between 21 and 31 days after symptom onset. While most splenic injuries were atraumatic, consideration should be given to extending return-to-play guidelines to 31 days after symptom onset to minimize risk. Risk of chronic pain after splenic injury may be higher than previously believed.

Clinical Relevance:

The risk for postmononucleosis splenic injuries remains elevated longer than current guidelines suggest. Restricting activity for 31 days after mononucleosis symptom onset may reduce the risk of splenic injury.
Perception of Pitch and Time in the Structurally Isomorphic Standard Rhythmic and Diatonic Scale Patterns
Authors: Wen Olivia Xin , Krumhansl Carol Lynne
Published: September 2019

The three experiments reported here investigate how pitch and time interact in perception using the standard rhythmic pattern and the diatonic scale pattern, which share the intervallic structure of 2 2 1 2 2 2 1. They share a number of theoretical properties, including being cyclic with seven unique rotations. Experiment 1 measured rhythmic stability by dynamically accenting each of the events in each rhythm, called the probe accent; listeners rated how well the probe accent fit the rhythm. Listeners heard the rhythms in subgroups and with reference to a syncopation-shifted metrical hierarchy. Experiment 2 used the probe tone technique to measure the tonal stability of each tone in each mode beginning and ending on C. Higher ratings were given to tones earlier in the contexts and tones closer to C on both the chroma circle and the circle of fifths; influences were also found of tonal hierarchies of diatonic scales with corresponding accidentals. A measure of similarity derived from the probe ratings found the same order for the rhythms and modes which matched theoretical proposals of inter-rhythm and inter-mode distances. Experiment 3 presented all combinations of rhythms and modes; listeners judged how well the rhythm fit the mode. These judgments did not depend on the intervallic isomorphism between tone duration and interval size. Instead, the judgments depended on whether tonally stable events occurred where accents were judged as fitting well with the rhythm. Overall, the standard and diatonic patterns follow different perceptual hierarchies while sharing similar cognitive principles between rhythms, between modes, and across dimensions.
Critical Fluctuations as an Early-Warning Signal for Sudden Gains and Losses in Patients Receiving Psychotherapy for Mood Disorders
Authors: Olthof Merlijn , Hasselman Fred , Strunk Guido , van Rooij Marieke , Aas Benjamin , Helmich Marieke A. , Schiepek Günter , Lichtwarck-Aschoff Anna
Published: September 2019

Whereas sudden gains and losses (large shifts in symptom severity) in patients receiving psychotherapy appear abrupt and hence may seem unexpected, hypotheses from complex-systems theory suggest that sudden gains and losses are actually preceded by certain early-warning signals (EWSs). We tested whether EWSs in patients’ daily self-ratings of the psychotherapeutic process predicted future sudden gains and losses. Data were collected from 328 patients receiving psychotherapy for mood disorders who completed daily self-ratings about their therapeutic process using the Therapy Process Questionnaire (TPQ). Sudden gains and losses were classified from the Problem Intensity scale of the TPQ. The other items of the TPQ were used to compute the EWSs. EWSs predicted an increased probability for sudden gains and losses in a 4-day predictive window. These results show that EWSs can be used for real-time prediction of sudden gains and losses in clinical practice.
Inhibitory effect of edaravone on systemic inflammation and local damage in skeletal muscles following long-term ischemia to murine hind limb
Authors: Yokoyama Hirokazu , Tsujii Masaya , Iino Takahiro , Nakamura Tomoki , Sudo Akihiro
Published: September 2019

Purpose:

The purpose of this study was to evaluate local and systemic pathology in a murine model of ischemia–reperfusion (I/R) injury induced by long-term application of a tourniquet on the hind limbs and to assess the protective effects of edaravone, a potent systemic scavenger of free radicals, using this model.

Methods:

Sixty C57BL6 mice were divided in two groups, with one group receiving a 3 mg/kg intraperitoneal injection of edaravone and the other group receiving an identical amount of saline 30 min before ischemia under deep anesthesia. The left thigh of each animal was constricted for 4 h with a 4.5-oz. orthodontic rubber band to induce ischemia; 4 h was the critical duration for skeletal muscles. After ischemia, specimens of skeletal muscles, both kidneys, and plasma were collected at 0, 2, 12, 24, 48, and 72 h. Injury to the skeletal muscles and vacuolar degeneration of the kidneys were histologically assessed. Additionally, apoptosis of skeletal muscle cells was assessed by analysis of caspase 3/7 activity and TUNEL staining. Plasma tumor necrosis factor (TNF)-α levels were measured using an enzyme-linked immunosorbent assay kit.

Results:

Skeletal muscles exhibited prominent injury of myofibers at 12 h after I/R injury, with clear upregulation of plasma TNF-α expression and histologic evidence of tubular dysfunction of the kidneys. Plasma TNF-α levels declined and histologic renal damage was ameliorated in edaravone-treated mice, but treatment did not protect skeletal muscle following ischemia for 4 h. Nonetheless, compared with group S, expression of the apoptosis marker caspase 3/7 was significantly inhibited in the skeletal hind limb muscles of Ed-group mice affected by reperfusion injury following ischemia for 4 h.

Conclusion:

The present study demonstrated that edaravone is a potentially useful drug for systemic or local treatment of reperfusion injury resulting from long-term ischemia.
Analysis of 90-Day Readmissions After Total Shoulder Arthroplasty
Authors: Chung Andrew S. , Makovicka Justin L. , Hydrick Thomas , Scott Kelly L. , Arvind Varun , Hattrup Steven J.
Published: September 2019

Background:

The number of total shoulder arthroplasty (TSA) procedures performed annually is increasing as a result of an aging population and an increased access to subspecialty-trained upper extremity arthroplasty surgeons. An up-to-date analysis of the incidence of, risk factors for, and reasons for 90-day readmissions in primary anatomic TSA has yet to be performed.

Purpose:

To characterize 90-day readmissions on a national level. An understanding of these data will help to predict resource utilization and expenses in shoulder arthroplasty.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

All adult patients undergoing elective primary TSA in 2014 who were included in the National Readmission Database were included in the analysis. Two cohorts were created according to 90-day readmission status. Multivariable analysis was then performed to determine predictors of 90-day readmissions. Reasons for 30-, 60-, and 90-day readmissions were identified, and total hospital resource utilization was calculated.

Results:

An estimated 26,023 patients were identified. The 30-, 60-, and 90-day rates of readmissions were 0.6%, 1.2%, and 1.7%, respectively. There was no difference in comorbidity burden between the cohorts. Medicare payer status (odds ratio [OR], 1.63; 95% CI, 1.00-2.65; P = .05), transfer to a skilled nurse facility (OR, 1.50; 95% CI, 1.05-2.14; P = .02), and chronic obstructive pulmonary disease (OR, 1.32; 95% CI, 1.04-1.66; P = .02) were identified as predictors of 90-day readmission. Female sex decreased odds of 90-day readmission (OR, 0.72; 95% CI, 0.59-0.87; P = .001). Ninety-day readmissions were associated with significant cost increases ( P < .001). The most common identifiable reason for related readmissions was a hardware-related complication at all time points.

Conclusion:

While uncommon, 90-day readmissions after primary TSA are associated with significant patient morbidity and ultimately substantial hospital costs. Truncating readmission analysis at a 30-day period will miss most arthroplasty-related hospital readmissions.
Trends in Concomitant Meniscal Surgery Among Pediatric Patients Undergoing ACL Reconstruction: An Analysis of ABOS Part II Candidates From 2000 to 2016
Authors: Cruz Aristides I. , Gao Burke , Ganley Theodore J. , Pennock Andrew T. , Shea Kevin G. , Beck Jennifer J. , Ellis Henry B.
Published: September 2019

Background:

Rates of anterior cruciate ligament (ACL) reconstruction among pediatric and adolescent patients are increasing. Limited knowledge exists about population-level rates of concomitant meniscal surgery in this age group.

Purpose/Hypothesis:

This study sought to examine trends in concomitant meniscal procedures and describe short-term complications in pediatric and adolescent patients undergoing ACL reconstruction. We hypothesized that overall meniscal surgery rates are increasing and that the likelihood of performing meniscal repair or meniscectomy is associated with patient- and surgeon-specific factors.

Study Design:

Cross-sectional study.

Methods:

We queried ACL procedures in patients younger than 19 years reported by American Board of Orthopaedic Surgery (ABOS) part II examination candidates from 2000 to 2016. Regression models examined associations between patient and surgeon characteristics, year of surgery, follow-up time, meniscal procedure type, and number and type of complications.

Results:

A total of 9766 cases were identified. Females represented 46% (n = 4468) of included cases. Mean patient age was 16.1 years (SD, 1.62 years; range, 0-18 years). The rate of concomitant ACL-meniscal procedures increased from the years 2000 to 2016 (49%-60%; P = .005). Surgeons with sports medicine (+7.0%) or pediatric orthopaedic fellowship (+6.6%) training had a higher likelihood of reporting a concomitant ACL-meniscal procedure ( P = .003 and .006, respectively). Sports medicine–trained surgeons were more likely to perform meniscal repair compared with meniscectomy (+3.0%; P = .016). Younger patient age was associated with increased likelihood of undergoing meniscal repair compared with meniscectomy. Overall reported complication rate was 12.8%. Notable reported complications included infection (1.61%), arthrofibrosis (1.14%), and deep venous thrombosis or pulmonary embolism (0.11%). Sports medicine and pediatric orthopaedic fellowship training was associated with higher rates of reporting postoperative stiffness and/or arthrofibrosis.

Conclusion:

Among ABOS part II candidates, concomitant ACL-meniscal surgery has become more common than isolated ACL procedures. Procedures involving sports medicine fellowship–trained surgeons and younger patients were associated with increased rates of meniscal repair compared with meniscectomy. Pediatric orthopaedic and sports medicine training was associated with a greater likelihood of being involved in a concomitant ACL-meniscal procedure of any kind, and surgeons with such training also reported a higher incidence of postoperative stiffness and/or arthrofibrosis in patients.
Schooling During the Great Recession: Patterns of School Spending and Student Achievement Using Population Data
Authors: Shores Kenneth , Steinberg Matthew P.
Published: September 2019

The Great Recession was the most severe economic downturn in the United States since the Great Depression. Using data from the Stanford Education Data Archive (SEDA), we describe the patterns of math and English language arts (ELA) achievement for students attending schools in communities differentially affected by recession-induced employment shocks. Employing a difference-in-differences strategy that leverages both cross-county variation in the economic shock of the recession and within-county, cross-cohort variation in school-age years of exposure to the recession, we find that declines in student math and ELA achievement were greater for cohorts of students attending school during the Great Recession in communities most adversely affected by recession-induced employment shocks, relative to cohorts of students that entered school after the recession had officially ended. Moreover, declines in student achievement were larger in school districts serving more economically disadvantaged and minority students. We conclude by discussing potential policy responses.
Setting Up Shop for Israel Advocacy—Diaspora “Retailers” and the Israeli “Wholesalers” in the Early Years of Israeli Diplomacy
Authors: Aridan Natan
Published: September 2019

This article focuses on the immediate repercussions of a reconstituted Jewish State after “2,000 years” on its relations with Diaspora Jewry and its diplomatic relations epitomized by American and Anglo Jewry. The Jewish Agency and Zionist organizations, once effective and indispensable former “retailers” were inexorably and painfully usurped by the new “wholesaler”, the Government of Israel and its diplomats who now appealed directly to all willing to contribute to strengthening Israel, irrespective of their past or present affiliations with the Zionist movement. Israeli diplomats viewed the Zionist organizations as the board of a company, which had been nationalized, had much goodwill, an immense pool of experience, some capital, but no clear idea about what to do with themselves. The path to reach a modus vivendi on delegating and authorizing responsibilities on public relations and Israel advocacy was acrimonious.
Geontographies: On Elizabeth Povinelli’s Geontologies: A Requiem for Late Liberalism
Authors: Johnson Elizabeth R , Kindervater Garnet , Todd Zoe , Yusoff Kathryn , Woodward Keith , Povinelli Elizabeth A
Published: September 2019

This forum brings together perspectives from geography, philosophy, and political science to reflect on Elizabeth Povinelli’s, 2016 book, Geontologies: A Requiem for Late Liberalism. Contributions come from both junior and senior scholars across a range of interests and backgrounds. Elizabeth Povinelli’s Geontologies is the fourth in her series on Dwelling in Late Liberalism that began in 1994 with Labor’s Lot: The Power, History and Culture of Aboriginal Action. In this latest text, she offers a retheorization of power and governance that challenges Foucauldian biopolitics. In its place, Povinelli maps a mode of power that she calls geontopower: a power that operates over the distinction between Life and Nonlife. Together with accounts of ethnographic encounters in Indigenous Australia, Povinelli’s text weaves together political theory, anthropology, philosophy, and cultural studies. With consequences for human geographers as well as thinkers concerned with the Anthropocene, climate change, and new materialism, Povinelli’s work connects the experience of late liberalism and settler colonialism across space, place, and matter.