bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care
Authors: Bartholdson Cecilia , Sandeberg Margareta af , Lützén Kim , Blomgren Klas , Pergert Pernilla
Published: June 2015

Background:

How well ethical concerns are handled in healthcare is influenced by the ethical climate of the workplace, which in this study is described as workplace factors that contribute to healthcare professionals’ ability to identify and deal with ethical issues in order to provide the patient with ethically good care.

Objectives:

The overall aim of the study was to describe perceptions of the paediatric hospital ethical climate among healthcare professionals who treat/care for children with cancer.

Research design:

Data were collected using the Hospital Ethical Climate Survey developed by Olsson as a separate section in a questionnaire. Descriptive statistics were used to analyse perceptions of the ethical climate.

Participants and research context:

Physicians, nurses and nurse-aides (n = 89) from three paediatric units participated in this study: haematology/oncology, chronic diseases and neurology.

Ethical considerations:

The study was approved by the regional ethical review board.

Findings:

Different perceptions of the ethical climate were rated as positive or negative/neutral. Nurses’ ratings were less positive than physicians on all items. One-third of the participants perceived that they were able to practice ethically good care as they believed it should be practised.

Discussion:

Differences in professional roles, involving more or less power and influence, might explain why physicians and nurses rated items differently. A positive perception of the possibility to practice ethically good care seems to be related to inter-professional trust and listening to guardians/parents. A negative/neutral perception of the possibility to practice ethically good care appears to be influenced by experiences of ethical conflicts as well as a lack of ethical support, for example, time for reflection and discussion.

Conclusion:

The two-thirds of participants who had a negative/neutral perception of the possibility to practice ethically good care are at risk of developing moral stress. Clinical ethics support needs to be implemented in care where important values are at stake.
Equitable Distribution of Public Hospitals According to Health Needs in Malaysia
Authors: Gan Saw Chien , Chan Chee Khoon , Hoe Victor Chee Wai , Ng Chiu-Wan
Published: June 2015

The goal of ensuring geographic equity of health care can be achieved if the geographic distribution of health care services is according to the health needs. This study aims to examine whether acute Ministry of Health hospital beds are distributed according to population health needs in various states within Peninsular Malaysia. The health needs of each state are indicated by the crude death rate. Comparisons of the share of hospital beds to that of population with differential health needs were assessed using concentration curve and index. In most years between 1995 and 2010, the distribution of hospital beds in Peninsular Malaysia were concentrated among states with higher health needs. This is in line with the principle of vertical equity and could be one advantage of a central federal government that can allocate health care resources to prioritize states with higher health care needs.
Influence of Ankle Position and Radiographic Projection Angle on Measurement of Supramalleolar Alignment on the Anteroposterior and Hindfoot Alignment Views
Authors: Barg Alexej , Amendola Richard L. , Henninger Heath B. , Kapron Ashley L. , Saltzman Charles L. , Anderson Andrew E.
Published: June 2015

Background:

Using digitally reconstructed radiographs (DRRs), we determined how changes in the x-ray beam projection angle from the horizon, tibiotalar joint angle, and axial rotation of the foot influenced measurements of the medial distal tibial angle (MDTA) on the anteroposterior (AP) and hindfoot alignment views (HAV).

Methods:

Seven cadaver foot-ankle specimens were scanned by computed tomography (CT) at fixed tibiotalar joint positions, ranging from 15 degrees of dorsiflexion to 25 degrees of plantarflexion. DRRs were created from each CT scan to simulate alterations in the horizontal projection angle (0 to 25 degrees) and foot axial rotation (–30 to 30 degrees). The MDTA was measured on each DRR and compared with that quantified on the baseline HAV and AP view.

Results:

Altering the horizontal projection angle by ≥5 degrees and >10 degrees significantly altered the MDTA for the AP view and the HAV, respectively. Shifting dorsiflexion and plantarflexion caused minor changes in the MDTA that were only statistically significant for the HAV. Axial rotation significantly changed the MDTA on both views, but deviations were more pronounced for the HAV.

Conclusions:

Compared with the HAV, the MDTA on the AP view was less sensitive to changes in foot-ankle position. However, increasing the tilt of the x-ray beam from the horizon altered the MDTA on the AP view substantially.

Clinical Relevance:

To avoid misinterpretation of the MDTA, we recommend using the AP view to quantify supramalleolar alignment as it is less sensitive to changes in positioning of the foot-ankle. When acquiring an AP film, the x-ray beam should be directed along the horizon to ensure consistent assessment of the MDTA across patients.
Multi-objective optimization of a hybrid electromagnetic suspension system for ride comfort, road holding and regenerated power
Authors: Ataei Mansour , Asadi Ehsan , Goodarzi Avesta , Khajepour Amir , Khamesee Mir Behrad
Published: June 2015

This paper reports work on the optimization and performance evaluation of a hybrid electromagnetic suspension system equipped with a hybrid electromagnetic damper. The hybrid damper is configured to operate with hydraulic and electromagnetic components. The hydraulic component produces a large fail-safe baseline damping force, while the electromagnetic component adds energy regeneration and adaptability to the suspension. For analyzing the system, the electromagnetic component was modeled and integrated into a 2DOF quarter-car model. Three criteria were considered for evaluating the performance of the suspension system: ride comfort, road holding and regenerated power. Using the genetic algorithm multi-objective optimization (NSGA-II), the suspension design was optimized to improve the performance of the vehicle with respect to the selected criteria. The multi-objective optimization method provided a set of solutions called Pareto front in which all solutions are equally good and the selection of each one depends on conditions and needs. Among the given solutions in the Pareto front, a small number of cases, with different design purposes, were selected. The performances of the selected designs were compared with two reference systems: a conventional and a nonoptimized hybrid suspension system. The results show that the ride comfort and road holding qualities of the optimized hybrid system are improved, and the regenerated power is considerably increased.
Can Environmental Aesthetics Promote Corporate Sustainability?
Authors: Waistell Jeff
Published: June 2015

Environmental aesthetics (EA) extends appreciation beyond art to the natural environment through an engagement with and sensory immersion in the natural world that privileges its aesthetic value. The purpose of this article is to ascertain the extent to which EA can promote corporate sustainability. As management scholars have only just begun to address this issue, the article reviews both management and wider aesthetics and sustainability literatures. The review concludes that EA can promote corporate sustainability but only when it is qualified by insights from ecology and ethics. There are recommendations for managers to facilitate EA and for researchers to undertake empirical studies in this field.
The Equity of Local Sales Tax Distributions in Urban, Suburban, Rural, and Tourism Rich Counties in North Carolina
Authors: Afonso Whitney
Published: June 2015

The use of local options sales taxes (LOSTs) is creating largely unexplored equity concerns with regard to the revenue raising capabilities of different local governments. This article focuses on differences among urban, suburban, and rural counties; the impact of proximity to urban (or retail) centers; and the impact of LOST decisions on tourism rich counties, a new category of local governments. Using data from 2003 to 2009 on all 100 North Carolina counties and a spatial Durbin error panel model, I identify factors relating to LOST revenue raising capacity (RRC). The results indicate that tourism rich counties have the greatest LOST capacity, suburban counties have the least, and there is a penalty for bordering an urban county. However, statistically significant differences in the RRC of the four types of counties disappear once property taxes are included in the mix.
Efficacy of intravesical pentosan polysulfate sodium in cats with obstructive feline idiopathic cystitis
Authors: Delille Mareike , Fröhlich Laura , Müller Ralf S , Hartmann Katrin , Dorsch Roswitha
Published: June 2015

Objectives

Obstructive feline idiopathic cystitis is a common emergency in small animal practice. There is evidence for a defective glycosaminoglycan layer in the urinary bladder of affected cats. The aim of this study was to investigate the effect of intravesical pentosan polysulfate sodium (PPS) in cats with obstructive feline idiopathic cystitis in a randomised, placebo-controlled, blinded clinical study.

Methods

Thirty-five cats with obstructive feline idiopathic cystitis were enrolled into the study. On day 0, cats were randomised to receive either 30 mg PPS in saline (18 cats) or saline alone as placebo (17 cats) at the time of indwelling urinary catheter placement and then after 24 and 48 h. The catheter was clamped for 30 mins after administration before connecting it to a sterile urine collection system. The procedure was repeated after 24 and 48 h, and then the indwelling catheter was removed. Treatment success was assessed via the incidence of recurrent urethral obstruction, results of a scoring system for physical examination and daily urinalysis from day 0 to 5.

Results

Recurrent urethral obstruction occurred in 3/18 cats of the verum group and 3/17 of the placebo group ( P = 1.000). The verum group showed a significantly lower degree of microscopic haematuria between day 5 and day 0 ( P ⩽0.05). The placebo group showed a significantly lower degree of dipstick haematuria between day 5 and day 0 ( P ⩽0.05). There was no difference in the clinical score between the groups in the investigated time period.

Conclusions and relevance

Intravesical instillation of PPS three times within 48 h in the chosen dose had no influence on the incidence of recurrent urethral obstruction and clinical signs in cats with obstructive feline idiopathic cystitis.
What do we know about feline leishmaniosis?
Authors: Soares Carla Sofia Alves , Duarte Sofia Cancela , Sousa Sérgio Ramalho
Published: June 2015

According to the World Health Organization (WHO), endemic areas of leishmaniosis have spread and the number of reported cases has increased. Europe is one of the continents with greatest risk of the re-emergence of this zoonosis. The significance of the cat as a reservoir of Leishmania species and not simply an accidental host seems to be gaining ground, mainly because: (i) cats can present increased seropositivity between serological analyses, but the pattern of seropositivity is not consistent between cats; (ii) cats can be infected for some months and thus are available for sandflies; and (iii) cats transmit the Leishmania species agent in a competent form. Furthermore, cats have behavioural characteristics that contribute to infection by Leishmania infantum and, as such, feline leishmaniosis (FeL) has been reported worldwide. When clinical signs of FeL are present, they are non-specific and frequently occur in other feline diseases. If they go undiagnosed, they can contribute to an underestimation of the actual occurrence of the disease in cats. The low seroprevalence titres, along with the commonly asymptomatic infection in cats, can further contribute to the underestimation of FeL occurrence. This work aims to raise awareness about FeL among veterinarians by providing a review of the current status of FeL infection caused by L infantum worldwide, the major clinicopathological features of infection, along with recent developments on FeL diagnosis, treatment and prevention.
“Take it outside!” National identity contestation in the foreign policy arena
Authors: Hintz Lisel
Published: June 2015

Turkey’s Islamist-rooted Adalet ve Kalkınma Partisi (Justice and Development Party) aggressively pursued European Union accession as a primary pillar of foreign policy, only to swing sharply away from the West in subsequent years. Actor- and party-based Islamist identity approaches cannot account for Turkey’s initial European Union-centric orientation, while domestic politics and economic arguments fail to explain the timing of the shift eastward and its domestic repercussions. Examining the advantages that foreign policy offers as an alternative arena in which elites can politicize identity debates helps to distill this complexity. This article argues that elites choose to take their national identity contests to the foreign policy arena when identity gambits at the domestic level are blocked. By taking its pursuit of hegemony for Ottoman Islamism “outside” through aggressive European Union accession measures, the Justice and Development Party could weaken domestic challengers supporting a competing, Republican Nationalist proposal for identity, and broaden support for Ottoman Islamism at home. The theory of identity hegemony developed here thus explains the counter-intuitive finding that Turkey’s European Union-oriented policy helped make possible the rise of Ottoman Islamism. Turkey offers an ideal empirical window onto these dynamics because of recent and dramatic shifts in the dynamics of its public identity debates, and because Turkey’s identity is implicated in multiple international roles, such as North Atlantic Treaty Organization ally, European Union candidate country, Organization of Islamic Cooperation member, and aspirant regional power broker. The framework developed fills a gap in existing scholarship by closing the identity–foreign policy circle, analytically linking the spillover of national identity debates into foreign policy with the changes in the contours of these debates produced by their contestation in this alternative arena.
The effect of perceived psychological need support on amotivation in physical education
Authors: Jackson-Kersey Rachel , Spray Christopher
Published: June 2015

Physical educators have a responsibility to create a learning environment that is viewed as supportive of students’ psychological needs and which helps reduce amotivation. The aim of the current study was to examine the effects of students’ perceived need support on four dimensions of amotivation in physical education (PE) ( deficiency in ability beliefs, deficiency in effort beliefs, insufficient task values and unappealing task characteristics). A longitudinal design was employed with three assessment points over a 6-week unit of work in cricket. Surveys were conducted with 162 boys (mean age = 14 years, SD = 0.87) over three consecutive PE lessons in weeks one, three and five. At the start of the study, multilevel modelling analyses showed all three types of perceived need support negatively predicted unappealing task characteristics and insufficient task values. Over time, perceived autonomy, competence and relatedness support negatively predicted change in unappealing task characteristics but did not significantly predict change in deficiency in ability beliefs, deficiency in effort beliefs and insufficient task values. Overall, the findings suggest that if students perceive their teacher to provide inadequate support for their basic psychological needs, PE tasks become less appealing over time, thus reinforcing the importance of teachers in ameliorating the development of specific amotivated behaviours in PE.
“Tele-rounding” with a remotely controlled mobile robot in the neonatal intensive care unit
Authors: Garingo Arlene , Friedlich Philippe , Chavez Thomas , Tesoriero Linda , Patil Shilpa , Jackson Paige , Seri Istvan
Published: June 2015

Objective: To investigate the feasibility of ‘tele-rounding’ in the neonatal intensive care. Methods: In this prospective study utilizing telemedicine technology in the NICU for daily patient bedside rounds (‘tele-rounds’), twenty pairs of neonates were matched according to gestational age, diagnoses, and disease severity. One patient was cared for by the on-site NICU team lead by an on-site neonatologist. The other patient was cared for by the on-site team but led by an off-site neonatologist using a remote-controlled robot. Patient rounding data, clinical outcomes, length of stay, and hospital costs were compared between the two groups. Parents and staff were also surveyed about their satisfaction with telemedicine. Results: Except for one parameter, no significant differences in care or outcomes were found between patients cared for by either neonatologist. The exception was the time the off-site neonatologist spent on the patient encounter compared to the on-site neonatologist (median [interquartile range]), (5 minutes [5, 6] vs. 8 minutes [7, 10.5], p = 0.002). This difference was due primarily to time needed to operate and maneuver the robot or occasionally to slower or dropped connection to the Internet. There were positive perceptions of telemedicine among both parents and NICU staff. Conclusion: As long as direct bedside care providers are available, remote-controlled, robotic telemedicine technology can be utilized by neonatologists to perform daily patient rounds in the neonatal intensive care unit.
Teledermatology-directed surgical care is safe and reduces travel
Authors: Vedire Kirtana , Joselow Andrew L , Markham Craig M , Raugi Gregory J
Published: June 2015

Methods

We conducted a retrospective chart review and identified 186 Veterans in the VA Corporate Data Warehouse as having malignant melanomas or severely dysplastic nevi during the four-year period of observation from 1 July 2009 to 30 June 2013 and met inclusion and exclusion criteria for analysis.

Results

Three hundred and sixty-six surgical procedures were performed for diagnosis and treatment of these conditions including biopsy and wide-local excision, of which 189 carefully selected cases were performed by primary care clinicians with 2.0% biopsy complication rate and a 7.7% wide-local excision complication rate. Cases not performed by primary care providers were referred to specialists (e.g. dermatologists, general surgeons or specialty surgeons) who had a 2.5% complication rate in biopsies and wide-local excision complication rate of 13.5% in severely dysplastic nevi and pTis and pT1a lesions and a 10.7% complication rate for lesions pT1b and greater.

Discussion

These results show that a significant fraction of surgical procedures for diagnosis and treatment of malignant melanoma and severely dysplastic nevi can be safely performed in rural clinics by trained primary care providers.
Compliance with dental treatment recommendations by rural paediatric patients after a live-video teledentistry consultation: A preliminary report
Authors: McLaren Sean W , Kopycka-Kedzierawski Dorota T
Published: June 2015

Objective

The purpose of this research was to assess the compliance rate with recommended dental treatment by rural paediatric dental patients after a live-video teledentistry consultation.

Methods

A retrospective dental chart review was completed for 251 rural paediatric patients from the Finger Lakes region of New York State who had an initial teledentistry appointment with a paediatric dentist located remotely at the Eastman Institute for Oral Health in Rochester, NY. The recommended treatment modalities were tabulated and comprehensive dental treatment completion rates were obtained.

Results

The recommended treatment modality options of: treatment in the paediatric dental clinic; treatment using nitrous oxide anxiolysis; treatment with oral sedation; treatment in the operating room with general anaesthesia; or teleconsultation were identified for the 251 patients. Compliance rates for completed dental treatment based on initial teleconsultation recommendations were: 100% for treatment in the paediatric dental clinic; 56% for nitrous oxide patients; 87% for oral sedation; 93% for operating room; and 90% for teleconsultations. The differences in the compliance rates for all treatment modalities were not statistically significant (Fisher’s exact test, p > 0.05).

Conclusions

Compliance rates for completed comprehensive dental treatment for this rural population of paediatric dental patients were quite high, ranging from 56% to 100%, and tended to be higher when treatment was completed in fewer visits. Live-video teledentistry consultations conducted among rural paediatric patients and a paediatric dentist in the specialty clinic were feasible options for increasing dental treatment compliance rates when treating complex paediatric dental cases.
Research funding for telemedicine: an Australian perspective
Authors: Barnett Adrian G , Campbell Megan J , Burns Clare L
Published: June 2015

Winning research funding is one of the most difficult challenges faced by researchers, especially with falling success rates and shrinking budgets. Telemedicine researchers can find it especially hard to win funding as they are often researching small changes to the health system that whilst important for patient care are often not as competitive as proposals that promise to cure diseases. In a climate of both tight health funding and tight research funding, telemedicine researchers should emphasise the potential for their research to add value and lower costs in order to increase their chances of winning funding.
Impact of cool roof on energy consumption for a railway station
Authors: Ma Weiwu , Xiang Chuping , Li Liqing , Liu Gang
Published: June 2015

The roof reflectance surface and skylight shade reflectance are two significant factors affecting air-conditioning energy consumption and indoor lighting in a single-storey large volume building, such as a railway station. Based on qualitative analysis on the effect of cool roof on building performance, a model of a large tall railway station built in the software EnergyPlus was verified by field data. The model was applied to analyse the effect of cool roof reflectance and skylight shade reflectance on the installed capacity of air-conditioning system, lighting energy consumption and indoor thermal comfort under different climates. The results show that the high reflectance surface of opaque cool roof is beneficial by reducing the energy consumption for indoor cooling and the installed capacity of air-conditioning system and improve the indoor thermal comfort in summertime. However, the opposite is true in wintertime, and this could consequently lead to more annual energy consumption. The high reflectance of skylights could reduce the energy consumption for cooling in summer and limit the energy consumption for heating and lighting in winter, thus reducing the annual energy consumption by a large amount. This study indicates that the local climates and the inherent characteristics of roof structure should be considered in the practical use of cool roof technology.
Early urinary angiotensinogen excretion in critically ill neonates
Authors: Wang Qing , Li Mengxia , Li Xiaozhong , Pan Jian , Wang Jian , Feng Xing , Li Yanhong
Published: June 2015

Introduction:

Urinary angiotensinogen is considered a reliable biomarker for intrarenal renin–angiotensin system activity. The aims of this study were to assess the urinary angiotensinogen level during the first day of life and to evaluate its correlation with renal function in critically ill neonates.

Methods:

Urinary angiotensinogen concentration during the first 24 hours of life was measured in 98 critically ill neonates. Neonatal renal function was assessed by urinary levels of cystatin-C, albumin and α1-microglobulin and urinary electrolyte excretion.

Results:

Urinary angiotensinogen level decreased with increasing gestational age and body weight in critically ill neonates ( P<0.001). After adjustment for gestational age, urinary angiotensinogen level correlated with urinary fractional excretion of sodium and urinary levels of cystatin-C and α1-microglobulin. Multivariate linear regression identified a significant impact of urinary cystatin-C on urinary angiotensinogen level ( P<0.001). Furthermore, urinary angiotensinogen was significantly increased in neonates with a urinary cystatin-C-to-creatinine ratio ⩾2500 ng/mg, which was the optimal cut-off value to predict acute kidney injury in our previous study.

Conclusions:

The urinary angiotensinogen level correlates with the overall maturity of renal function during the early postnatal period in critically ill neonates and an increased urinary angiotensinogen level might reflect renal injury in immature neonates.
Known for My Strengths
Authors: Carter Erik W. , Boehm Thomas L. , Biggs Elizabeth E. , Annandale Naomi H. , Taylor Courtney E. , Loock Aimee K. , Liu Rosemary Y.
Published: June 2015

Can young people with intellectual and developmental disabilities be known for their strengths? This mixed-method study explored the strengths of 427 youth and young adults with intellectual disability and/or autism (ages 13-21) from the vantage point of their parents. Using the Assessment Scale for Positive Character Traits–Developmental Disabilities (ASPeCT-DD), parents identified numerous strengths across multiple domains and factors. Every young person in the sample was described as having at least one strength ( Mdn = 20, range 1-26), and their strength-related profiles varied widely. Higher ratings of strengths were predicted by greater involvement in community activities and use of speech as the primary mode of communication. Challenging behaviors predicted lower ratings of strengths. These findings challenge prevailing deficit-based views of young people with intellectual and developmental disabilities and offer a promising alternative for describing transition-age youth in terms of the strengths they bring to activities and relationships. We offer recommendations for future research and practice.
Assisted coiling using LEO Baby or LVIS Jr stents: Report of six cases
Authors: Negrotto Matías , Crosa Roberto , Casagrande Walter
Published: June 2015

Background and purpose

Endovascular treatment of broad-neck, complex cerebral aneurysms is a challenging issue. Placement of a stent over the aneurysm neck and secondary coil embolization prevents coil migration and allows dense packing of the coils. Another challenge is represented by distal aneurysms situated in small vessels. In these cases, the use of little stents, which we are going call ministents, could be a good decision. These low-profile intracranial ministents can be deployed into arteries with diameters between 1.5 and 3.10 mm and delivered through microcatheters with an internal diameter of 0.0165 inches, which allows easier navigation in small-sized, delicate vessels. We present six cases of wide-neck aneurysms, with small parental arteries less than 2.5 mm using a low-profile ministent system (LEO Baby and LVIS Jr) plus coil embolization.

Materials and methods

We retrospectively reviewed patients in whom LEO Baby or LVIS Jr stent was used for the treatment of intracranial aneurysms. Five aneurysms were treated during 2013–2014 in our service using the LEO Baby stent and one aneurysm using LVIS Jr. Stent-assisted coil embolization was performed using the jailing technique in all cases. Clinical and angiographic findings, procedural data, and follow-up are reported.

Results

Six consecutive patients were included in this study. Four patients presented with subarachnoid hemorrhage in the subacute–chronic phase and two patients had unruptured aneurysms. Two of the six aneurysms were located at branches of the sylvian artery, one at the basilar artery, two at the anterior communicating artery, and one at the P1–P2 artery. The procedures were successful. Six-month control digital subtraction angiograms were obtained in all cases; they demonstrated complete occlusion of the aneurysms in all instances. All patients had good clinical outcomes on follow-up, as measured with the Glasgow Outcome Scale and Modified Rankin Scale.

Conclusions

The results of this small study show that the LEO Baby and LVIS Jr ministents could be safe and efficient for endovascular treatment of intracranial broad-neck aneurysms situated in small arteries.
The safety and efficacy of preoperative embolization of meningioma with N-butyl cyanoacrylate
Authors: Ishihara Hideaki , Ishihara Shoichiro , Niimi Jun , Neki Hiroaki , Kakehi Yoshiaki , Uemiya Nahoko , Kohyama Shinya , Yamane Fumitaka , Kato Hiroshi , Suzuki Tomonari , Adachi Jun-ichi , Mishima Kazuhiko , Nishikawa Ryo
Published: June 2015

Objective

Preoperative embolization of meningioma is commonly performed; however, there is no consensus on the best embolic material to reduce intraoperative blood loss and surgery time.

Method

We retrospectively assessed the safety and efficacy of 56 cases of preoperative embolization of the middle meningeal artery with N-butyl cyanoacrylate (NBCA) in 105 cases of surgery for meningioma. We also defined a blood loss to tumor volume ratio to compensate for bias caused by tumor volume, and analyzed limited cases (the embolized group n = 52, the non-embolized group n = 21) of the convexity, the parasagittal region, the falx, and the sphenoidal ridge.

Result

The blood loss to tumor volume ratio was significantly less in the embolized group ( p < 0.007). Preoperative embolization could be useful for cases with the external carotid artery as the dominant feeder vessel ( p < 0.02); however, the efficacy decreased for cases with an internal carotid artery feeder. Transient complications occurred in four cases (hemiparesis secondary to edema: two cases; intratumoral bleeding: one case; trigeminal nerve disorder: one case). The cases that showed a postoperative increase in edema or intratumoral bleeding were large tumors with the early filling of veins. For such cases, surgeons should pay close attention to slow injection speed and higher NBCA viscosity, not to cause the occlusion of draining vessels.

Conclusion

Tumor embolization with NBCA can be safely performed, and the procedure significantly reduces intraoperative blood loss.
Numerical modeling of rock fracture and fragmentation under impact loading using discrete element method
Authors: Chi Enan , Zhao Mingsheng , Liu Jun , Kang Qiang
Published: June 2015

The fracture and fragmentation of rock materials are basic and important problem in geomechanics and blasting engineering. An approach, which can simulate the process of fracture and fragmentation of rock materials, is introduced in this work. A beam–particle model is first introduced in the frame of the discrete element method. In the beam–particle model, the neighboring elements are connected by beams. Consequently, a beam network is formed in the particle system. The strength characteristics of rock materials are reflected by the beam network. The strength criterion was then built to verify whether a beam exists or not. The process of rock fracture and fragmentation is described by the gradual disappearance of beams. Finally, two cases were presented to indicate the validity of the method proposed in this work.
Non-equilibrium steady states of entangled polymer mixtures under shear flow
Authors: Guo Xiao-Wei , Yang Wen-Jing , Xu Xin-Hai , Cao Yu , Yang Xue-Jun
Published: June 2015

By solving the full equations of an extended two-fluid model in two dimensions, we give the first numerical study revealing non-equilibrium steady states in sheared entangled polymer mixtures. This research provides answers for some fundamental questions in sheared binary mixtures of entangled polymers. Our results reveal that non-equilibrium steady states with finite domain size do exist, and apparent scaling exponents [Formula: see text] and [Formula: see text] are found over six decades of shear rate. Since the wall effects get involved in our simulations, the dependence of average domain size on system size cannot be strictly eliminated. In addition, as an obvious influence of viscoelasticity, the polymer viscosity [Formula: see text] appears to induce linear translation of the fitted lines. Through two-dimensional numerical simulations, we show the detailed dynamic evolution of microstructure in binary polymer mixtures with asymmetric composition under shear flow. It is found that the phase patterns are significantly different from symmetric fluids studied previously. Finally, we also identify the importance of wall effects and confirm the irreplaceable role of inertia for a non-equilibrium steady state.
The role of kinesitherapy and electrotherapeutic procedures in non-operative management of patients with intermittent claudications
Authors: Marković Miroslav D , Marković Danica M , Dragaš Marko V , Končar Igor B , Banzić Igor L , Ille Mihailo E , Davidović Lazar B
Published: June 2015

Purpose

To examine the effects of physical therapy (kinesitherapy and electrotherapeutic procedures) on the course of peripheral arterial occlusive disease by monitoring the changes in values of claudication distance and ankle-brachial indexes.

Methods

Prospective randomized study included 47 patients with peripheral arterial occlusive disease manifested by intermittent claudications associated with ankle-brachial indexes values ranging from 0.5 to 0.9. Patients from the first group (25 pts) were treated with medicamentous therapy, walking exercises beyond the pain threshold, dynamic low-burden kinesi exercises and electrotherapeutic ageneses (interference therapy, diadynamic therapy, and electromagnetic field), while the second group of patients (22 pts) was treated with “conventional” non-operative treatment – medicamentous therapy and walking exercises. The values of newly established absolute claudication distance and ankle-brachial indexes were measured.

Findings

Significant increase of absolute claudication distance in both groups of patients was registered, independently of therapeutic protocol applied ( p < 0.001), as well as the increase in the claudication distance interval in the physical therapy group. There was no significant increase in ankle-brachial indexes values in both groups of patients.

Conclusion

Methods of physical therapy presented valuable supplement in non-operative treatment of peripheral arterial occlusive disease patients, improving their functional ability and thus postponing surgical treatment. However, further investigations including larger number of patients are needed.
In vivo flexor tendon forces generated during different rehabilitation exercises
Authors: Edsfeldt S. , Rempel D. , Kursa K. , Diao E. , Lattanza L.
Published: June 2015

We measured in vivo forces in the flexor digitorum profundus and the flexor digitorum superficialis tendons during commonly used rehabilitation manoeuvres after flexor tendon repair by placing a buckle force transducer on the tendons of the index finger in the carpal canal during open carpal tunnel release of 12 patients. We compared peak forces for each manoeuvre with the reported strength of a flexor tendon repair. Median flexor digitorum profundus force (24 N) during isolated flexor digitorum profundus flexion and median flexor digitorum superficialis force (13 N) during isolated flexor digitorum superficialis flexion were significantly higher than during the other manoeuvres. Significantly higher median forces were observed in the flexor digitorum superficialis with the wrist at 30° flexion (6 N) compared with the neutral wrist position (5 N). Median flexor digitorum profundus forces were significantly higher during active finger flexion (6 N) compared with place and hold (3 N). Place and hold and active finger flexion with the wrist in the neutral position or tenodesis generated the lowest forces; isolated flexion of these tendons generated higher forces along the flexor tendons.

Level of evidence: III (controlled trial without randomization)
Physicians’ Management Practices and Perceived Health Risks When Postconcussion Symptoms Persist
Authors: Rose Sean C. , Fischer Anastasia N. , Heyer Geoffrey L.
Published: June 2015

Background:

Concussion guidelines recommend physical and cognitive rest until all postconcussion symptoms resolve, in part because of potential health risks, including catastrophic injury related to a second impact. However, when postconcussion symptoms persist for weeks or months, these risks are poorly characterized.

Hypothesis:

Physicians’ perceived health risks and management strategies for patients with persistent postconcussion symptoms will vary.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

A survey of the physician members of the American College of Sports Medicine assessed the perceived health risks related to advancing activity, the indications for neuroimaging, and the referral patterns for patients with persistent postconcussion symptoms.

Results:

A total of 572 physicians completed the survey (response rate, 27.2%). The majority of physicians recommended physical rest (97.4%) and cognitive rest (93.8%) within the first week of injury. Perceived health risks related to advancing activity in the symptomatic patient differed at 2 weeks versus 3 months after injury ( P < 0.001 for all comparisons). Respondents from the United States were more likely to list second impact syndrome as a potential health risk at 2 weeks compared with respondents from other countries ( P = 0.04). The majority (56%) responded that the risk of second impact syndrome remains until all symptoms resolve. When postconcussion symptoms persist beyond 1 month, 61.9% of physicians responded that neuroimaging is indicated. Approximately 60% of respondents had access to a multidisciplinary concussion clinic within 60 miles of their practice.

Conclusion:

When postconcussion symptoms persist, the perceived health risks, management practices, and access to multidisciplinary care vary among physicians.
Assessment of activity and outcome from a one-stop clinic for men with suspected prostate cancer: Five years’ experience
Authors: Shah Jyoti
Published: June 2015

Objective:

We have set up a weekly one stop prostate specific antigen (PSA) clinic to evaluate men with suspected prostate cancer (CaP) and report our five years of experience.

Methods:

Patients with an elevated PSA result, abnormal digital rectal examination, or worrisome symptoms were booked into this clinic. Prostate biopsy was done on the same day, if required. The clinic is run by a single consultant urological surgeon and an advanced nurse practitioner. A database of all patients attending this clinic has been maintained.

Results:

A total of 729 patients were seen. Rates of non-attendance were low at 2–5 patients each year, and 50.9%–67.1% of patients had a biopsy. Of these, 46.8%–56.1% were diagnosed with CaP, given their results and appropriately treated after multi-disciplinary meeting (MDT) discussion within 15 days. Patients who did not have a cancer diagnosis received a phone call from the consultant at a median time of 2.5 days. Patient and general practitioner (GP) satisfaction levels with this service were high.

Conclusions:

The one-stop clinic is feasible, efficient in quickly reassuring men without cancer, allows rapid diagnosis and starts treatment within 15 days for those who need it. This clinic reduces waiting times and the number of follow-up visits, and is highly acceptable to patients and GPs.
Effects of contour propagation and background corrections in different MRI flow software packages
Authors: Boye D , Springer O , Wassmer F , Scheidegger S , Remonda L , Berberat J
Published: June 2015

Background

Velocity-encoded magnetic resonance imaging (VENC-MRI) is a commonly used technique in cardiac examinations. This technique utilizes the phase shift properties of protons moving along a magnetic field gradient. VENC-MRI offers a unique way of measuring the severity of valve regurgitation by directly quantifying the regurgitation flow volume.

Purpose

To compare flow analysis results of different software programs and to assess the effect of background correction in sample patient cases.

Material and Methods

A phantom was built out of Polymethyl methacrylate (PMMA) which provides tubes of different diameters. These tubes can be connected to an external water circuit to generate a water flow inside the tubes. Expected absolute flow quantities inside the tubes were determined from preset tube- and flow-parameters. Different flow conditions were measured with a VENC-MRI sequence and the images evaluated using different software packages. In a second step six randomly selected patients showing different degrees of aortic insufficiency were evaluated in clinical terms.

Results

The contour propagation algorithms used in the software packages performed differently even on static phantom geometry. In terms of clinical evaluation the software packages performed similarly. Enabling background correction or leaving out manual correction of propagated contours changed results for severity of aortic insufficiency.

Conclusion

Turning on background correction and manual correction of propagated contours in MRI flow volume measurements is strongly recommended.
Where Can I Find a Library? Examining Access to Library Services in Asante Akyem North Municipality
Authors: Frimpong Kwarteng
Published: June 2015

The link between access to better libraries and students’ achievement has long been proven. But to residents in the Asante Akyem North Municipality, the benefits libraries offer remain illusory because of limited access. Using cross-sectional research design, the article examines staffing, collections, funding, library facilities, user perceptions, and the extent of utilization of the few libraries in the municipality. The author finds an indescribable deficit in the provision of library and information services, and attributes this primarily to an apparent lack of recognition of the important place libraries occupy in education delivery and knowledge acquisition.
What Makes Mathematics Manipulatives Effective? Lessons From Cognitive Science and Montessori Education
Authors: Laski Elida V. , Jor’dan Jamilah R. , Daoust Carolyn , Murray Angela K.
Published: June 2015

Manipulatives are ubiquitous in early childhood classrooms; yet, findings regarding their efficacy for learning mathematics concepts are inconsistent. In this article, we present four general principles that have emerged from cognitive science about ways to ensure that manipulatives promote learning when used with young children. We also describe how Montessori instruction offers a concrete example of the application of these principles in practice, which may, in turn, explain the high levels of mathematics achievement among children who attend Montessori programs during early childhood. The general principles and concrete examples presented in this article should help early childhood programs maximize the benefits of using manipulatives for developmentally appropriate mathematics instruction.
Abusing Good Intentions
Authors: Bereczkei Tamas , Szabo Zsolt Peter , Czibor Andrea
Published: June 2015

The present study aims to understand how Machiavellians switch from one kind of response to another in different circumstances to maximize their profit. We set up a specific experimental paradigm that involved both a cooperative and competitive version of a public goods game. We found that Machiavellianism accounts for the total amount of money paid by the players ( N = 144) across five rounds in the cooperative but not in the competitive game. Compared with the others, individuals with higher scores on Mach scale contributed less to the public goods in the cooperative condition, but no difference was found in the competitive condition. Finally, this relationship was influenced by the sequence of the games. These results indicate that Machiavellians skillfully evaluate social environments and strive to exploit those with abundant contributions to public goods.
Targeting Biased Emotional Attention to Threat as a Dynamic Process in Time
Authors: Zvielli Ariel , Amir Iftach , Goldstein Pavel , Bernstein Amit
Published: June 2015

Recent findings suggest biases of emotional attention (BEA) may be expressed dynamically, fluctuating from moment to moment between overengagement and avoidance of emotional stimuli. We attempted to modify these temporal dynamics of BEA to threat among trait-anxious adults ( N = 61) using Attention Feedback Awareness and Control Training (A-FACT). A-FACT is a novel intervention methodology that delivers real-time feedback to a person concurrent with her/his dynamic BEA expression. We found that relative to a placebo control condition, A-FACT led to significantly reduced BEA dynamics toward and away from threat, temporal variability in BEA, and emotional reactivity to an anxiogenic stressor. Findings illustrate that BEA may be optimally conceptualized and quantified as a dynamic process in time and that intervention methods sensitive to and capable of targeting BEA process dynamics in real time—as in A-FACT—represent a promising new direction for cognitive bias modification research.
Has the airway microbiome been overlooked in respiratory disease?
Authors: Salami Olawale , Marsland Benjamin J
Published: June 2015

Editorial summary

The respiratory disease field is changing because of recent advances in our understanding of the airway microbiome. Central to this is dysbiosis, an imbalance of microbial communities that can lead to and flag inflammation in the airways. The increasing momentum of research in this area holds promise for novel treatment strategies.
Neurl4 contributes to germ cell formation and integrity inDrosophila
Authors: Jones Jennifer , Macdonald Paul M.
Published: June 2015

Primordial germ cells (PGCs) form at the posterior pole of the Drosophila embryo, and then migrate to their final destination in the gonad where they will produce eggs or sperm. Studies of the different stages in this process, including assembly of germ plasm in the oocyte during oogenesis, specification of a subset of syncytial embryonic nuclei as PGCs, and migration, have been informed by genetic analyses. Mutants have defined steps in the process, and the identities of the affected genes have suggested biochemical mechanisms. Here we describe a novel PGC phenotype. When Neurl4 activity is reduced, newly formed PGCs frequently adopt irregular shapes and appear to bud off vesicles. PGC number is also reduced, an effect exacerbated by a separate role for Neurl4 in germ plasm formation during oogenesis. Like its mammalian homolog, Drosophila Neurl4 protein is concentrated in centrosomes and downregulates centrosomal protein CP110. Reducing CP110 activity suppresses the abnormal PGC morphology of Neurl4 mutants. These results extend prior analyses of Neurl4 in cultured cells, revealing a heightened requirement for Neurl4 in germ-line cells in Drosophila.
Coco is a dual-activity modulator of TGF-β signaling
Authors: Deglincerti Alessia , Haremaki Tomomi , Warmflash Aryeh , Sorre Benoit , Brivanlou Ali H.
Published: June 2015

The TGFβ signaling pathway is a critical regulator of developmental processes and disease. The activity of TGFβ ligands is modulated by various families of soluble inhibitors that interfere with the interactions between ligands and receptors. In an unbiased, genome-wide RNAi screen to identify genes involved in ligand-dependent signaling, we unexpectedly identified the BMP/Activin/Nodal inhibitor Coco as an enhancer of TGFβ1 signaling. Coco synergizes with TGFβ1 in both cell culture and Xenopus explants. Molecularly, Coco binds to TGFβ1 and enhances TGFβ1 binding to its receptor Alk5. Thus, Coco acts both as an inhibitor and an enhancer of signaling depending on the ligand it binds. This finding raises the need for a global reconsideration of the molecular mechanisms regulating TGFβ signaling.