bluuebunny/crossref_metadata_2025 huggingface dataset:
To see, or not to see, that is the question: can public disclosure really improve transparency between medicine and the pharmaceutical industry?
Authors: Smith Geoffrey P
Published: April 2014

Objective:

To critically review the potential effect of the public reporting of pharmaceutical company payments to healthcare professionals on the relationship between medicine and industry.

Method:

This review is based on an examination of the ‘Transparency Model’ put out recently for consultation by Medicines Australia.

Results:

Public reporting in itself will neither sharpen the boundaries between medicine and the pharmaceutical industry nor restore public confidence.

Conclusions:

Focusing on payments for clinical research and on the larger payments to healthcare professionals would lead to a better understanding of the interplay between science and marketing.
Activity-based funding: implications for mental health services and consultation-liaison psychiatry
Authors: Wand Anne
Published: April 2014

Objective:

The aim of this paper is to inform mental health professionals about Activity-based funding (ABF) and the implications for data collection and clinical practice, in particular for consultation-liaison (CL) psychiatry.

Conclusions:

Activity-based funding may provide an opportunity for mental health services to be more equitably resourced, but much needs to be done to demonstrate that the funding model works in mental health. It is important to ensure that data collected is meaningful and accurate and reflects the diverse roles of mental health clinicians, including in CL. Inpatient and community services should be integrated in the model, as well as safeguards against potential abuse. Clinicians, in partnership with initiatives such as the Australian Mental Health Outcomes and Classification Network, are best placed to guide the development of an ABF system for mental health which appropriately recognises the complexity and variability between patients in different settings.
Feasibility study of utilizing superelastic shape memory alloy plates in steel beam–column connections for improved seismic performance
Authors: Moradi Saber , Alam M Shahria
Published: April 2014

Steel moment-resisting frames are prone to extensive damage in seismically active zones. Large permanent deformations in structural members following strong earthquakes can be mitigated using smart materials such as shape memory alloys. In this article, three-dimensional finite element analyses are conducted to study the seismic performance of beam–column connections incorporating shape memory alloy plates. Eight beam–column connection subassemblies with shape memory alloy plates in the plastic hinge of beam were analyzed under cyclic loading. Based on the numerical results, the recentering properties of superelastic shape memory alloy plates were found to be effective in reducing the residual drifts of a flange plate beam–column connection, while displaying an excellent ductility. In addition, shape memory alloy plates could prevent the occurrence of local buckling and damage in structural members. The new self-centering connections could also exhibit a good energy dissipation capability.
Improved sound transmission loss in an automotive component using piezoceramic patches and dissipative shunt circuits
Authors: Rocha Téo L , Dias Milton
Published: April 2014

Noise in a vehicle is generally caused by the vibration of various automotive components, such as the dashboard, door panels, and roof. For example, vibrations caused by the engine may cause a dash panel to vibrate leading to noise in the vehicle cabin. The control of such noise and vibration may be achieved by placing a viscoelastic or other suitable damping material on the automotive component; however, conventional damping materials usually have a high density, which can lead to significant increases in the overall mass of the sound insulation system. A lightweight alternative employs piezoceramic patches connected to a resistor–inductor circuit, where the mechanical vibration, converted into electrical energy by the piezoceramic, is dissipated in the form of thermal heat through the resistor. The presence of an inductive element allows the system to perform in the vicinity of a mode of the vibrating structure, in an effect similar to a resonant vibration absorber. In this work, the damping capacity of this resonant electrical circuit is demonstrated in a dash panel installed between coupled reverberant and anechoic rooms for assessments of sound transmission loss. Finite element simulation and theoretical analysis are used to support the choice of the electrical component values and the correct placement for piezoelectric patches. The resulting sound transmission control is compared to baseline measurements with conventional viscoelastic material thermally bonded to the panel surface. The work is concluded with a discussion on the achieved results and mass saving benefits of the proposed damping technique.
The problem of wave propagation in magneto-rotating orthotropic non-homogeneous medium
Authors: Mahmoud SR , Abd-Alla AM , Tounsi Abdelouahed , Marin M
Published: April 2014

The present investigation is concerned with a study effect of rotation and magnetic field on the plane deformation and the corresponding stresses in hollow elastic cylinder rotating about its axis with a constant angular velocity. The material of the cylinder is assumed to the non-homogeneous and orthotropic. Results of this paper are presented graphically and then compared with others in the absence of magnetic field, rotation and non-homogeneity. The results indicate that the effect of rotation and non-homogeneity are very pronounced. The variation of stresses and displacements has been shown graphically.
The Joint Effect of Bilingualism and ADHD on Executive Functions
Authors: Mor Billy , Yitzhaki-Amsalem Sarin , Prior Anat
Published: March 2014

Objective: The current study investigated the combined effect of ADHD, previously associated with executive function (EF) deficits, and of bilingualism, previously associated with EF enhancement, on EF. Method: Eighty University students, Hebrew monolinguals and Russian Hebrew bilinguals, with and without ADHD participated. Inhibition tasks were a Numeric Stroop task and a Simon arrows task. Shifting tasks were the Trail Making Test (TMT) and a task-switching paradigm. Results: Participants with ADHD performed worse than controls, but we did not find a bilingual advantage in EF. The negative impact of ADHD was more pronounced for bilinguals than for monolinguals, but only in interference suppression tasks. Bilingual participants with ADHD had the lowest performance. Conclusion: Bilingualism might prove to be an added burden for adults with ADHD, leading to reduced EF abilities. Alternatively, the current findings might be ascribed to over- or under-diagnosis of ADHD due to cultural differences between groups. These issues should be pursued in future research.
Understanding and Measuring Functional Impairment in Diverse Children With ADHD
Authors: Haack Lauren M. , Gerdes Alyson C. , Lawton Kathryn E. , Schneider Brian W.
Published: April 2014

Objective: The current study sought to develop a culturally appropriate measure of functional impairment related to ADHD for diverse families, as research suggests that functional impairment may be a more culturally universal construct than symptomatology. Method: Seventy-four low-acculturated Latino parents (49 mothers and 25 fathers) of school-aged children provided quantitative and qualitative responses about problem recognition after viewing a language-free video of a child displaying symptoms and behaviors consistent with ADHD. Results: Thirty-two items were developed for the ADHD-FX scale based on most common responses given from participants. The scale is available in Spanish and English and instructs parents to consider how much each item affects their child in his or her everyday life (from 0 = not at all to 3 = a lot). Conclusions: The scale can provide an overall impairment score, as well as subscale scores in the theoretically derived domains of academic, peer, and familial impairment. (J. of Att. Dis. 2016; 20(6) 487-500)
Successful treatment of fingolimod-associated macular edema with intravitreal triamcinolone with continued fingolimod use
Authors: Thoo Sophie , Cugati Sudha , Lee Andrew , Chen Celia
Published: April 2014

The occurrence of macular edema as an adverse effect of fingolimod is well documented. Treatment modalities used to manage fingolimod-associated macular edema (FAME) have included nonsteroidal anti-inflammatory agents and sub-tenon injection. We describe two cases where intravitreal injection is used to successfully treat FAME in patients who were previously unsuccessfully treated with topical nonsteroidal anti-inflammatories.
Make a sound garden grow
Authors: Frith Jordan , Ahern Kati Fargo
Published: April 2014

The Walkman and iPod have often been viewed as individualizing technologies. People use these forms of mobile media to impart a sound track of their own choosing over their experience of physical space. However, newer mobile projects have examined the links that tie mobile media and sound to experiences of movement. These projects focus on the collaborative construction of shared soundscapes through mobile media, in a sense responding to the individualizing tendencies of dominant auditory mobile media. This article draws from literature in sound studies, media studies, and locative media art to examine these relatively new forms of what we call social soundscaping. Through our analysis, we show the potential for new mobile sound practices that allow for the more participatory production of public soundscapes.
Segmenting Taiwanese tourists to China by ethnic identity and generation
Authors: Chen Chun-Chu , Wang Yao-Chin , Lin Yueh-Hsiu , Jiang Jingxian “Kelly”
Published: April 2014

This research intends to segment Taiwanese tourists to China by ethnic identity and generation. Based on Prentice’s ((2004) Tourist familiarity and imagery, Annals of Tourism Research, 31(4), 923–945, (2006) Evocation and experiential seduction: updating choice-sets modeling, Tourism Management, 27, 1153–1170) work that suggests customers who are more emotionally attached to a destination have more positive destination images, this research proposes that Taiwanese holding different identities and belonging to different generations have different destination images of China. The results show that those who tend to identify themselves as Chinese in Taiwan have more positive destination images of China than those who tend to identify themselves as Taiwanese, while younger generations in Taiwan have more neutral perceptions of China as a tourist destination. As the heterogeneity of Taiwanese market is identified in this research, marketing strategies focusing on different segments of Taiwanese tourists to China are suggested in this research.
Local status and power in area-based health improvement partnerships
Authors: Powell Katie , Thurston Miranda , Bloyce Daniel
Published: April 2014

Area-based initiatives have formed an important part of public policy towards more socio-economically deprived areas in many countries. Co-ordinating service provision within and across sectors has been a common feature of these initiatives. Despite sustained policy interest in area-based initiatives, little empirical work has explored relations between area-based initiative providers, and partnership development within this context remains under-theorised. This article addresses both of these gaps by exploring partnerships as a social and developmental process, drawing on concepts from figurational sociology to explain how provider relations develop within an area-based initiative. Qualitative methods were used to explore, prospectively, the development of an area-based initiative targeted at a town in the north west of England. A central finding was that although effective delivery of area-based initiatives is premised on a high level of co-ordination between service providers, the pattern of interdependencies between providers limits the frequency and effectiveness of co-operation. In particular, the interdependency of area-based initiative providers with others in their organisation (what is termed here as ‘organisational pull’) constrained the ways in which they worked with providers outside of their own organisations. ‘Local’ status, which could be earned over time, enabled some providers to exert greater control over the way in which provider relations developed during the course of the initiative. These findings demonstrate how historically constituted social networks, within which all providers are embedded, shape partnership development. The theoretical insight developed here suggests a need for more realistic expectations among policymakers about how and to what extent provider partnerships can be managed.
The experiences of close persons caring for people with chronic kidney disease stage 5 on conservative kidney management: Contested discourses of ageing
Authors: Low Joe , Myers Jason , Smith Glenn , Higgs Paul , Burns Aine , Hopkins Katherine , Jones Louise
Published: April 2014

Chronic kidney disease stage 5 is a global health challenge in the context of population ageing across the world. The range of treatment options available to patients at all ages has increased and includes transplantation and dialysis. However, these options are often seen as inappropriate for older frailer patients who are now offered the option of conservative kidney management, which is presented as a non-invasive alternative to dialysis, involving symptom management and addressing psychosocial needs. In this study, we conducted qualitative interviews with 26 close persons caring for someone with chronic kidney disease stage 5 in the United Kingdom to investigate how conservative kidney management interacted with implicit ideas of ageing, in both the experience of conservative kidney management and the understanding of the prognosis and future care of the kidney disease. Our findings highlighted participant confusion about the nature of conservative kidney management, which stems from an initial lack of clarity about how conservative kidney management differed from conventional treatments for chronic kidney disease stage 5. In particular, some respondents were not aware of the implicit palliative nature of the intervention or indeed the inevitable end-of-life issues. Although these findings can be situated within the context of communication failure, we would further argue that they also bring to the surface tensions in the discourses surrounding ageing and old age, drawing on the use of a ‘natural’ and a ‘normal’ paradigm of ageing. In the context of chronic kidney disease stage 5, more patients are being dialysed at older ages, but conservative kidney management is being advanced as a better option than dialysis in terms of quality of life and experience. However, in doing so, conservative kidney management implicitly draws on a notion of older age that echoes natural ageing rather than advocate a more interventionist approach. The role of discourses of ageing in the provision of treatments for conservative kidney management has not previously been acknowledged, and this article addresses this gap.
Successful foot salvage with microvascular flaps in diabetic patients
Authors: Eskelinen E. , Kaartinen I. , Kääriäinen M. , Kuokkanen H.
Published: April 2014

Background and Aims:

Complex nontraumatic foot lesions often lead to major lower-limb amputation in diabetic patients. We aimed to evaluate outcome of free flap transfer in such cases.

Materials and Methods:

A total of 11 consecutive diabetic patients, hospitalized between 2007 and 2012 at a university central hospital for a free flap transfer, were followed until September 2013. Amputation-free survival, patient survival, and complete wound healing were defined as primary endpoints. Healing time of tissue lesions was analyzed. All pre- and postoperative data were retrospectively collected from hospital charts.

Results:

Complete tissue healing at 6 and 12 months after free flap transfer were 55% (6/11) and 82% (9/11), respectively. The median time to complete tissue healing was 123 days (range, 45–207 days). Overall limb salvage, survival, and amputation-free survival rates at 12 months were 90%, 91%, and 82%, respectively. The clinically important endpoint, namely, amputation-free survival with completely healed wounds, was attained in 9 of 11 patients at 1 year.

Conclusion:

Free tissue transfer enables successful wound healing and limb salvage rather than amputation in selected diabetic patients with difficult-to-heal wounds. Complete healing of tissue lesions is slow even after successful surgery. Preoperative assessment of the condition of patients is the key to success.
The life-course offending trajectories of football hooligans
Authors: Piquero Alex R , Jennings Wesley G , Farrington David P
Published: April 2014

Football hooliganism has long occupied the social, media, and political landscapes of fans around the world. In this study, we use data from the Cambridge Study in Delinquent Development, a longitudinal study of a large sample of males followed from childhood to late middle adulthood, to examine the relationship between involvement in football hooliganism and both conviction frequency and conviction trajectories. Results show that, although hooligans differ from non-hooligans on several childhood and teenage risk factors, and that they also incur many more convictions than their non-hooligan counterparts, these relationships do not hold after carefully matching hooligans and non-hooligans on key risk factors. Football hooliganism, for the most part, seems to be part of a constellation of antisocial behaviors that also includes criminal offending.
West of Indianola, Iowa
Authors: Denzin Norman K.
Published: March 2014

The author rewrites his family history through memories of his mother. These memories are captured in three photographic images which record the slow disintegration of his family over two decades.
Beyond the Test Score
Authors: Treviño Ernesto , Scheele Judith , Flores Stella M.
Published: April 2014

Using both quantitative and qualitative analyses, we examine the role of a college access intervention in the enrollment and persistence outcomes of low-income students in Chile modeled partially after a Texas admissions program. We find that, although students from the program have a mean cumulative GPA significantly lower than that of their peers who entered college through the regular admissions system, most program students nevertheless meet the institution’s academic requirements. Qualitative evidence collected through student interviews presents some of the personal challenges and struggles that these students face when making the transition from high school to university while also highlighting the role of the program in student decisions to persist in college through the end of the first year.
Gravity influence on the performance of micro direct methanol fuel cell
Authors: Fu Wenting , Yuan Zhenyu , Zhang Yufeng , Wang Zi , Liu Xiaowei
Published: April 2014

The influence of gravity on mass transport and micro direct methanol fuel cell performance is presented in this article. A multi-physics three-dimensional model calculated by COMSOL Multiphysics is established. The results show that gravity significantly affects the distribution of pressure and methanol concentration. To verify the simulation, a self-breathing transparent micro direct methanol fuel cell with horizontal orientation and vertical orientation is designed, fabricated and tested. The polarization curves of horizontal orientation exhibit the best performance with the power density of 25.57 mW cm−2. Moreover, the cell placed with horizontal orientation exhibits faster CO2 emission velocity than that of the cell with vertical orientation.
Risk Factors of Smoking Among Health Care Professionals
Authors: Shahbazi Sara , Arif Ahmed A. , Portwood Sharon G. , Thompson Michael E.
Published: April 2014

Background: Health care professionals (HCPs) play a vital role at various levels of smoking cessation programs to reduce tobacco use in general populations. However, their smoking habits may limit their ability to intervene with their patients who smoke. Aims: To determine prevalence rates of current smoking and examine sociodemographic and work-related factors associated with current smoking among HCPs. Methods: A statewide survey was conducted in a representative sample of 4 groups of HCPs, physicians, nurses, respiratory therapists, and occupational therapists, with active licenses in Texas in 2003. Weighted prevalence estimates of current smoking rates were computed. Survey logistic regression analysis was used to investigate associations between individual characteristics and current smoking. Results: There were 3600 HCPs included in the analysis. The overall prevalence of current smoking was 9% with the highest prevalence (16%) recorded among respiratory therapists and the lowest prevalence (3%) recorded among physicians. In the multivariable logistic regression analysis non-Hispanic white HCPs were almost 4 times as likely to be current smokers (adjusted odds ratio= 3.95, 95% confidence interval = 1.24-12.59) and those working for 50 hours or more per week were twice as likely to be current smokers (adjusted odds ratio = 2.07, 95% CI = 1.20-3.57). Compared with physicians, all other HCP groups had significantly greater odds of currently smoking. HCPs who were female and resided or worked in rural settings had higher smoking rates in univariable analysis only ( P < .05). Conclusions: Smoking is prevalent among certain HCP groups. Working long hours was identified as an important occupational factor associated with current smoking.
Friendship Is the Ocean
Authors: Schuh Mary C. , Sundar Vidyalakshmi , Hagner David C.
Published: April 2014

Youth with disabilities, compared with their typical peers, have a higher likelihood of dropping out of school and experience poorer transition outcomes. Evidence supports programs and interventions focusing on inclusive education and leadership skills results in successful transition to college and career. This article describes the experiences of six youth with and without disabilities as they participate in the Youth Empowerment Series, a project helping students navigate the path to postsecondary education and/or employment. A phenomenological approach and photoelicitation was used to gather information about participant’s transition experiences. Findings suggest participants valued forming personal connections and friendships as they entered adulthood. Themes included acceptance, leadership, self-advocacy, inclusion, and planning for future goals. Participants were aware of transition needs and goals and had an understanding of the support systems needed to reach their goals. Future research on the role of friendship networks in transition planning as a natural support is warranted.
Fresh Osteochondral Allograft Transplantation for Osteochondritis Dissecans of the Knee
Authors: Sadr Kamran N. , Pulido Pamela , McCauley Julie C. , Bugbee William
Published: April 2014

Objectives:

Osteochondritis dissecans (OCD) of the knee can be difficult to treat. Cartilage restoration techniques are often indicated when the lesion or fragment cannot be salvaged. Fresh osteochondral allograft (OCA) transplantation can restore both bone and cartilage defect as a treatment modality. We hypothesize that osteochondral allografting is a successful method for treating osteochondritis dissecans of the knee.

Methods:

Between 1983 and 2010, 164 patients (181 knees) underwent OCA for OCD of the femoral condyle(s) (type III or IV). Minimum two-year follow-up was available on 149 patients (165 knees). Median age was 25 years (range, 14 to 55) and 73% were male. Mean allograft size was 7.2 cm2(range, 2 to 23 cm2). Evaluation included frequency and type of reoperations, modified Merle d’Aubigné-Postel (18-point) scale, International Knee Documentation Committee (IKDC) pain and function scores, and Knee Society function (KS-F) score. Clinical failure was defined as revision OCA or conversion to arthroplasty. Graft survivorship was determined.

Results:

Median follow-up time was 7.7 years (range, 2 to 28.4 years). 78% had more than 5-year follow-up. Fifty-one of 165 knees (31%) had reoperations, of which 21 (13%) were classified as allograft failures (13 OCA revisions, 5 UKA, and 3 TKA). OCA survivorship was 93% at 5 years, 87% at 10 years, and 77% at 20 years. Of the 144 knees whose grafts were still in situ, 91% were rated good/excellent, 8% were rated fair, and 1% was rated poor. Mean modified Merle d’Aubigné-Postel (18-point) scale was 17, mean IKDC pain and function scores were 2 and 8, and mean KS-F score was 93. 88% of patients reported satisfaction.

Conclusion:

Osteochondral allograft transplantation was an effective treatment for osteochondritis dissecans of the knee, with significant improvement in pain and function scores and high patient satisfaction. Graft survivorship was 87% at 10 years.
Meniscal Allograft Transplantation Reoperation Rates, Operative Findings, and Survival Analysis: A Review of 200 Consecutive Transplants at Minimum Two-year Follow-up
Authors: McCormick Francis , Harris Joshua David , Frank Rachel M. , Hussey Kristen Elizabeth , Wilson Hillary , Gupta Anil Kumar , Abrams Geoffrey D. , Bach Bernard R. , Cole Brian J.
Published: April 2014

Objectives:

Reoperation rates for meniscal allograft surgery (MAT) are high with a 70% survival rate at 10 years. The indications and findings for secondary surgery are not well characterized. The purpose of this study is to quantify the percentage of transplants requiring a re-operation, to characterize the operative findings, perform a survival analysis, and perform a case-control analysis if an early return to surgery is predictive of failure.

Methods:

A retrospective review of prospectively collected data from a single-surgeon was performed. Inclusion period was 2003-2011.. The number of patients returning to the OR and the findings at surgery were recorded. A meniscal transplant survival curve, the duration between transplantation and return to OR, and an odds-ratio of risk for failure for those requiring a re-operation in the perioperative period were calculated.

Results:

Two hundred patients underwent a MAT during the study period. 38% were isolated; 62% had concomitant procedures. Sixty-four (32%) patients returned to the operating room, of which 38 (59%) were for a meniscal? debridement. The mean duration to secondary surgery was 21 months, with 73% within 2 years. One hundred seventy-two (86%) patients were evaluated at a mean 59 months (Range 24-118 months). Eight went on to require a revision MAT or total knee replacement (4.7%). Patients requiring secondary surgery within two years had an 8.4 odds-ratio for future failure (95% CI 1.6-43.4 p.007).

Conclusion:

In the largest consecutive series reported in the literature, meniscal allograft transplantation (MAT) has a 95% success rate a mean of approximately five years. There is a 32% reoperation rate, with meniscal debridement the most common secondary surgical treatment.
Biomechanical Consequences of a Complete Radial Tear Adjacent to the Medial Meniscus Posterior Root Attachment Site
Authors: LaPrade Robert F. , Padalecki Jeffrey Ryan , Jansson Kyle , Smith Sean , Dornan Grant , Pierce Casey , Wijdicks Coen A.
Published: April 2014

Objectives:

Complete radial tears near the medial meniscus posterior root attachment site disrupt the circumferential integrity of the meniscus ( similar to a posterior root avulsion). These tears can compromise the circumferential integrity and have been reported in biomechanical studies to simulate the meniscectomized state. The purpose of the study was to quantify the tibiofemoral contact load and contact area changes that occur in cadaveric knees from complete posterior horn radial tears and subsequent repairs of the medial meniscus adjacent to the posterior root attachment site.

Methods:

Six non-paired fresh-frozen human cadaveric knees each underwent 45 different testing conditions: 9 medial meniscus conditions (intact, root avulsion, root repair, serial radial tear and in-situ repair at 3, 6, and 9 mm from the root attachment site) at 5 flexion angles (0°, 30°, 45°, 60° and 90°); under a 1000-N axial load. Tekscan sensors were used to measure contact area and pressure in the medial and lateral compartments.

Results:

The medial meniscus root avulsion and all radial tear conditions resulted in significantly decreased contact area and increased mean contact pressure compared with the intact state for knee flexion angles beyond 0° (P < .05). Medial Compartment Contact Area Individual comparisons of meniscus conditions for results at 30°, 45°, 60° and 90° of flexion demonstrated the following. At each angle, the root avulsion and 3, 6 and 9 mm radial tears resulted in a significant reduction (range 33%-45% decrease) in medial compartment contact area. Medial Compartment Contact PressureIndividual comparisons of meniscus conditions were performed at 30°, 45°, 60° and 90° of flexion. At each angle, the root avulsion and all radial tears resulted in a significant increase in average contact pressure (range 46%-110%) when compared to the intact meniscus. Root Repair and In-situ Repairs The root repair and in-situ repairs restored contact area and pressure to levels statistically indistinguishable from the intact meniscus, and increased contact area and decreased contact pressure when compared to the corresponding tear conditions (Figure).

Conclusion:

Posterior horn radial tears adjacent to the medial meniscus root that extend to the meniscocapsular junction can lead to derangement of the loading profiles of the medial compartment that are similar to a root avulsion. Repair of these radial tears with an in-situ pullout technique restored joint mechanics to the intact state. Clinical Relevance Complete radial tears of the posterior horn of the medial meniscus, are biomechanically equivalent to root avulsions and could potentially lead to medial compartment arthrosis. An in-situ repair offers an alternative treatment to meniscectomy and can reestablish the posterior anchor point, thus improving load distribution in the medial compartment.
Results of Non-operative and Operative Management Of Apophyseal Avulsion Fractures of the Hip and Pelvis in Adolescent Athletes
Authors: Heyworth Benton E. , Bonner Bryant , Suppan Catherine A. , Kocher Mininder S. , Yen Yi-Meng , Micheli Lyle J.
Published: April 2014

Objectives:

Apophyseal avulsion fractures of the hip and pelvis occur almost exclusively in the adolescent population, with greater numbers being seen recently as the popularity and intensity of youth sports increases. Limited evidence exists detailing the demographics or distribution of these fractures by injury site. The goal of the current study was to present a comprehensive perspective on 437 of these fractures, including the indications and clinical course of 25 cases that underwent surgical intervention.

Methods:

All cases of an apophyseal avulsion fracture of the hip or pelvis between the years of 1981-2012 at a tertiary care pediatric center underwent radiographic and chart review, including operative details for that sub-population. Demographic data was analyzed, along with radiographic displacement, healing times, and return to sports for both groups.

Results:

413 patients underwent definitive non-operative treatment, 72% of which were male. The mean age was 14.5 years. The anatomic site of injury was well-distributed: AIIS 29%, ASIS 27%, ischial tuberosity 17%, lesser trochanter 15%, and iliac crest 11%. Half of all injuries occurred during one of three different athletic activities (soccer 26%, track 13%, baseball/softball 11%), with a wide range of sports in the overall cohort. In the 287 nonop cases with adequate follow up data to confirm mean radiographic union and time of return to sports (RTS), healing occurred at 2.7 months and RTS at 2.8 months respectively. The mean age of the cohort of 25 patients who ultimately required operative treatment was 15.7 years, with 72% of cases being initially treated with nonoperative measures. The ischial tuberosity was the most common (64%) anatomic site with others including AIIS 16%, iliac crest 16%, and ASIS 4%. Excision of the apophyseal fragment was the intervention pursued for 48% of cases, with the mean time to union of 4.8 months in 11 cases which underwent fixation and had adequate follow up data.

Conclusion:

In over 400 cases of apophyseal avulsion fractures in an adolescent population, 94% were successfully treated nonoperatively, with mean times of healing and return to sports under 3 months. Most cases requiring surgery failed primary conservative care, many of which underwent fragment excision, rather than fixation, due to the chronic nature of their preoperative period. Better understanding of the rare indications for early fixation and functional outcome measures of both nonoperative and operative management of these injuries is warranted, particularly given their increasing frequency paralleling a rise in overuse and youth sports injuries.
Clinical Outcomes Following the Latarjet Procedure in Contact and Collision Athletes
Authors: Privitera David M. , Siegel Elana J. , Higgins Laurence D.
Published: April 2014

Objectives:

Although there are several reports of clinical outcomes after the Latarjet procedure for recurrent anterior glenohumeral instability, the literature is sparse for these Latarjet outcomes in the strictly contact or collision-type sport athletes who have significant glenoid deficiency and/or failed previous stabilization surgery. The purpose of this study was to evaluate the clinical and functional results of these contact or collision athletes who underwent a Latarjet for symptomatic instability with glenoid bone loss or failed stabilization surgery, using modern instability outcome measures.

Study Design:

Case series, Level of evidence, 4.

Methods:

Sixty-one consecutive contact and/or collision athletes (64 shoulders) treated with an open Latarjet procedure for recurrent anterior glenohumeral instability with significant glenoid bony deficiency and/or failed prior stabilization were retrospectively identified from two surgeons’ practices. Thirty-nine patients and 42 shoulders (66%) were evaluated at a mean follow-up of 46 months (range: 24-95), whose an average age of surgery of 25.9 years (range: 16-47). Primary outcome measures were the Western Ontario Shoulder Instability Index (WOSI), American Shoulder and Elbow Society Questionnaire (ASES), Visual Analogue Scale, and return to sporting activity. IRB approval was granted for this study.

Results:

Thirty-seven of forty-two shoulders (88%) were perceived as stable to these athletes. Two patients experienced subluxation events at 18 and 24 months after their Latarjet procedures. These 2 patients underwent further surgery including an arthroscopic debridement with biceps tenodesis and the other a revision stabilization Eden-Hybinette procedure, performed at 22 and 29 months after their Latarjets, respectively. One additional patient underwent surgery for hardware removal with arthroscopic debridement, with no reports of concomitant instability. Average WOSI and ASES scores for 42 shoulders were 76.5% (range: 6.4-100%, +/- 24.4) and 89.9 (range: 21.7-100, +/- 17.3). The average VAS score was 1.1. Fifty-four percent (21/39) of the athletes returned to their preoperative sports level, 18% (7/39) decreased their activity level in the same sport, 13% (5/39) changed sports and 15% (6/39) decreased level and changed sport, or stopped sports altogether.

Conclusion:

At a minimum of 2 year follow-up, 72 % of contact/collision athletes returned to their original sport, whereas 28% had to change their sport type after their Latarjet, or stop sporting activities altogether. Failure by subluxation occurred in 4.8% of shoulders (at an average of 21 months); 88% reported their shoulder as feeling stable with average WOSI and ASES scores of 76.5% and 89.9 respectively. In this challenging group of patients, the Latarjet procedure successfully restores stability in 88% of cases; 72% return to their pre-operative sport type.
A Retrospective Analysis of Abdominal Competency Scores to Improve Clinical Education in a Sonography Program
Authors: Michael Kim , Wampler Kathryn , Shostrom Valerie K. , Boals Marilee , Anderson Joseph C.
Published: April 2014

Classroom examinations and a passing score on a sonography certification examination are means to assess a student’s retention of material presented during didactic education and further studying. Typically, however, clinical competencies are graded based on actual observation of scanning skills and the ability to identify specific organs and associated abnormalities. We are reporting an analysis of the data collected from students’ completed abdominal competency evaluations over the past four years to determine what organ was the easiest to learn to scan, what organ was the most difficult to learn to scan, and in what organ(s) was pathology most often recognized or missed.
Biomarkers of terminal complement activation confirm the diagnosis of aHUS and differentiate aHUS from TTP
Authors: Cataland Spero R. , Holers V. Michael , Geyer Susan , Yang Shangbin , Wu Haifeng M.
Published: April 2014

Key Points

Biomarkers of complement activation can confirm the diagnosis of aHUS. Complement biomarkers may be useful to differentiate aHUS from TTP.
TNT003, an inhibitor of the serine protease C1s, prevents complement activation induced by cold agglutinins
Authors: Shi Ju , Rose Eileen L. , Singh Andrew , Hussain Sami , Stagliano Nancy E. , Parry Graham C. , Panicker Sandip
Published: April 2014

Key Points

Cold agglutinin–driven classical pathway activity terminates prior to the initiation of the terminal cascade in CAD patient blood. By inhibiting cold agglutinin–mediated complement deposition on the cellular membrane, TNT003 prevents RBCs from being phagocytosed.
Bifunctional drugs for the treatment of asthma and chronic obstructive pulmonary disease
Authors: Page Clive , Cazzola Mario
Published: April 2014

Over the last decade, there has been a steady increase in the use of fixed-dose combinations of drugs for the treatment of a range of diseases, including hypertension, cancer, AIDS, tuberculosis and other infectious diseases. It is now evident that patients with asthma or chronic obstructive pulmonary disease (COPD) can also benefit from the use of fixed-dose combinations, including combinations of a long-acting β2-agonist and an inhaled corticosteroid, and combinations of long-acting β2-agonists and long-acting muscarinic receptor antagonists. In fact, there are now a number of “triple-inhaler” fixed-dose combinations under development, with the first such triple combination having been approved in India. This use of combinations containing drugs with complementary pharmacological actions in the treatment of patients with asthma or COPD has also led to the discovery and development of drugs having two different primary pharmacological actions in the same molecule, which we have called “bifunctional drugs”. In this review, we discuss the state of the art of these new bifunctional drugs as novel treatments for asthma and COPD that can be categorised as bifunctional bronchodilators, bifunctional bronchodilator/anti-inflammatory drugs and bifunctional anti-inflammatory drugs.
mtDNA haplogroup and single nucleotide polymorphisms structure human microbiome communities
Authors: Ma Jun , Coarfa Cristian , Qin Xiang , Bonnen Penelope E , Milosavljevic Aleksandar , Versalovic James , Aagaard Kjersti
Published: April 2014

Background

Although our microbial community and genomes (the human microbiome) outnumber our genome by several orders of magnitude, to what extent the human host genetic complement informs the microbiota composition is not clear. The Human Microbiome Project (HMP) Consortium established a unique population-scale framework with which to characterize the relationship of microbial community structure with their human hosts. A wide variety of taxa and metabolic pathways have been shown to be differentially distributed by virtue of race/ethnicity in the HMP. Given that mtDNA haplogroups are the maternally derived ancestral genomic markers and mitochondria’s role as the generator for cellular ATP, characterizing the relationship between human mtDNA genomic variants and microbiome profiles becomes of potential marked biologic and clinical interest.

Results

We leveraged sequencing data from the HMP to investigate the association between microbiome community structures with its own host mtDNA variants. 15 haplogroups and 631 mtDNA nucleotide polymorphisms (mean sequencing depth of 280X on the mitochondria genome) from 89 individuals participating in the HMP were accurately identified. 16S rRNA (V3-V5 region) sequencing generated microbiome taxonomy profiles and whole genome shotgun sequencing generated metabolic profiles from various body sites were treated as traits to conduct association analysis between haplogroups and host clinical metadata through linear regression. The mtSNPs of individuals with European haplogroups were associated with microbiome profiles using PLINK quantitative trait associations with permutation and adjusted for multiple comparisons. We observe that among 139 stool and 59 vaginal posterior fornix samples, several haplogroups show significant association with specific microbiota (q-value < 0.05) as well as their aggregate community structure (Chi-square with Monte Carlo, p < 0.005), which confirmed and expanded previous research on the association of race and ethnicity with microbiome profile. Our results further indicate that mtDNA variations may render different microbiome profiles, possibly through an inflammatory response to different levels of reactive oxygen species activity.

Conclusions

These data provide initial evidence for the association between host ancestral genome with the structure of its microbiome.
Study of Helicobacter pylori genotype status in cows, sheep, goats and human beings
Authors: Momtaz Hassan , Dabiri Hossein , Souod Negar , Gholami Mohsen
Published: April 2014

Background

Helicobacter pyloriis one of the most controversial bacteria in the world causing diverse gastrointestinal diseases. The transmission way of this bacterium still remains unknown. The possibility of zoonotic transmission ofH. pylorihas been suggested, but is not proven in nonprimate reservoirs. In the current survey, we investigate the presence ofH. pyloriin cow, sheep and goat stomach, determine the bacterium virulence factors and finally compare the humanH. pylorivirulence factors and animals in order to examine whetherH. pylorimight be transmitted from these animals to human beings.

Methods

This cross- sectional study was performed on 800 gastric biopsy specimens of cows, sheep, goats and human beings. The PCR assays was performed to detection ofH. pylori,vacAandcagAgenes. The PCR products of Ruminant’s samples with positiveH. pyloriwere subjected to DNA sequencing analysis. Statistical tests were applied for data analysis.

Results

Overall 6 (3%) cows, 32 (16%) sheep and 164 (82%) human beings specimens were confirmed to beH. pyloripositive; however we were not able to detect this bacterium in all 200 goat samples. ThevacA s1a/m1awas the predominantH. pylorigenotype in all three kinds of studied population. There was 3.4–8.4% variability and 92.9-98.5% homology between sheep and human samples.

Conclusions

Considering the high sequence homology among DNA ofH. pyloriisolated from sheep and human, our data suggest that sheep may act as a reservoir forH. pyloriand in the some extent share the ancestral host for the bacteria with human.
Novel mutations of PKD genes in the Czech population with autosomal dominant polycystic kidney disease
Authors: Obeidova Lena , Elisakova Veronika , Stekrova Jitka , Reiterova Jana , Merta Miroslav , Tesar Vladimir , Losan Frantisek , Kohoutova Milada
Published: April 2014

Background

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder caused by mutation in either one of two genes,PKD1andPKD2. High structural and sequence complexity ofPKDgenes makes the mutational diagnostics of ADPKD challenging. The present study is the first detailed analysis of bothPKDgenes in a cohort of Czech patients with ADPKD using High Resolution Melting analysis (HRM) and Multiplex Ligation-dependent Probe Amplification (MLPA).

Methods

The mutational analysis ofPKDgenes was performed in a set of 56 unrelated patients. For mutational screening of thePKD1gene, the long-range PCR (LR-PCR) strategy followed by nested PCR was used. Resulting PCR fragments were analyzed by HRM; the positive cases were reanalyzed and confirmed by direct sequencing. Negative samples were further examined for sequence changes in thePKD2gene by the method of HRM and for large rearrangements of bothPKD1andPKD2genes by MLPA.

Results

Screening of thePKD1gene revealed 36 different likely pathogenic germline sequence changes in 37 unrelated families/individuals. Twenty-five of these sequence changes were described for the first time. Moreover, a novel large deletion was found within thePKD1gene in one patient. Via the mutational analysis of thePKD2gene, two additional likely pathogenic mutations were detected.

Conclusions

Probable pathogenic mutation was detected in 71% of screened patients. Determination ofPKDmutations and their type and localization within corresponding genes could help to assess clinical prognosis of ADPKD patients and has major benefit for prenatal and/or presymptomatic or preimplantational diagnostics in affected families as well.
Hardy personality and burnout syndrome among nursing students in three Brazilian universities—an analytic study
Authors: da Silva Rodrigo Marques , Goulart Carolina Tonini , Lopes Luis Felipe Dias , Serrano Patrícia Maria , Costa Ana Lucia Siqueira , de Azevedo Guido Laura
Published: March 2014

Background

Nursing students may exhibit the characteristics of resistance to stress, such as hardiness, which can reduce the risk of burnout. However, we found only one published study about these phenomena among nursing students. Thus, we investigated the association between hardiness and burnout in such students.

Methods

An analytic, cross-sectional study was conducted among 570 nursing students from three Brazilian universities. Data were collected relating to sociodemographic characteristics, hardiness, and burnout, which we analyzed using inferential statistics.

Results

We observed that 64.04% of nursing students in the sample had a high level of emotional exhaustion, 35.79% had a high level of cynicism, and 87.72% had a low level of professional efficacy: these are dimensions of burnout. We also found that 48.77% had a high level of control, 61.40% a high level of commitment, and 35.44% a high level of challenge: these are dimensions of hardiness. Only 24.74% of the students experienced burnout, and 21.93% met the criteria for a hardy personality. There was a statistically significant difference between the frequency of hardiness and burnout (p = 0.033), with 68.00% of hardy students not exhibiting burnout.

Conclusions

Although nursing students live with educational stressors, burnout was not preponderant in our sample students; this may be linked to hardiness. Thus, given its benefits to student life and health, we recommend the development of strategies to promote hardiness among nursing students.