bluuebunny/crossref_metadata_2025 huggingface dataset:
Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention
Authors: Lawton Rebecca , O'Hara Jane Kathryn , Sheard Laura , Armitage Gerry , Cocks Kim , Buckley Hannah , Corbacho Belen , Reynolds Caroline , Marsh Claire , Moore Sally , Watt Ian , Wright John
Published: February 2017

Objective

To evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention.

Design

A multicentre cluster randomised controlled trial.

Setting

Clusters were 33 hospital wards within five hospitals in the UK.

Participants

All patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition.

Intervention

The ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings.

Measurements

Primary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS).

Results

Intervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention.

Limitations

Adherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure.

Conclusions

Patients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components.

Trial registration number

ISRCTN07689702; pre-results.
Revised Framingham Stroke Risk Profile to Reflect Temporal Trends
Authors: Dufouil Carole , Beiser Alexa , McLure Leslie A. , Wolf Philip A. , Tzourio Christophe , Howard Virginia J. , Westwood Andrew J. , Himali Jayandra J. , Sullivan Lisa , Aparicio Hugo J. , Kelly-Hayes Margaret , Ritchie Karen , Kase Carlos S. , Pikula Aleksandra , Romero Jose R. , D’Agostino Ralph B. , Samieri Cécilia , Vasan Ramachandran S. , Chêne Genevieve , Howard George , Seshadri Sudha
Published: February 2017

Background:

Age-adjusted stroke incidence has decreased over the past 50 years, likely as a result of changes in the prevalence and impact of various stroke risk factors. An updated version of the Framingham Stroke Risk Profile (FSRP) might better predict current risks in the FHS (Framingham Heart Study) and other cohorts. We compared the accuracy of the standard (old) and of a revised (new) version of the FSRP in predicting the risk of all-stroke and ischemic stroke and validated this new FSRP in 2 external cohorts, the 3C (3 Cities) and REGARDS (Reasons for Geographic and Racial Differences in Stroke) studies.

Methods:

We computed the old FSRP as originally described and a new model that used the most recent epoch-specific risk factor prevalence and hazard ratios for individuals ≥55 years of age and for the subsample ≥65 years of age (to match the age range in REGARDS and 3C studies, respectively) and compared the efficacy of these models in predicting 5- and 10-year stroke risks.

Results:

The new FSRP was a better predictor of current stroke risks in all 3 samples than the old FSRP (calibration χ
2
of new/old FSRP: in men: 64.0/12.1, 59.4/30.6, and 20.7/12.5; in women: 42.5/4.1, 115.4/90.3, and 9.8/6.5 in FHS, REGARDS, and 3C, respectively). In the REGARDS, the new FSRP was a better predictor among whites compared with blacks.

Conclusions:

A more contemporaneous, new FSRP better predicts current risks in 3 large community samples and could serve as the basis for examining geographic and racial differences in stroke risk and the incremental diagnostic utility of novel stroke risk factors.
Serum Acylcarnitines and Risk of Cardiovascular Death and Acute Myocardial Infarction in Patients With Stable Angina Pectoris
Authors: Strand Elin , Pedersen Eva R. , Svingen Gard F. T. , Olsen Thomas , Bjørndal Bodil , Karlsson Therese , Dierkes Jutta , Njølstad Pål R. , Mellgren Gunnar , Tell Grethe S. , Berge Rolf K. , Svardal Asbjørn , Nygård Ottar
Published: February 2017

Background

Excess levels of serum acylcarnitines, which are intermediate products in metabolism, have been observed in metabolic diseases such as type 2 diabetes mellitus. However, it is not known whether acylcarnitines may prospectively predict risk of cardiovascular death or acute myocardial infarction in patients with stable angina pectoris.

Methods and Results

This study included 4164 patients (median age, 62 years; 72% men). Baseline serum acetyl‐, octanoyl‐, palmitoyl‐, propionyl‐, and (iso)valerylcarnitine were measured using liquid chromatography/tandem mass spectrometry. Hazard ratios (
HR
s) and 95%
CI
s for quartile 4 versus quartile 1 are reported. The multivariable model included age, sex, body mass index, fasting status, current smoking, diabetes mellitus, apolipoprotein A1, apolipoprotein B, creatinine, left ventricular ejection fraction, extent of coronary artery disease, study center, and intervention with folic acid or vitamin B6. During median 10.2 years of follow‐up, 10.0% of the patients died of cardiovascular disease and 12.8% suffered a fatal or nonfatal acute myocardial infarction. Higher levels of the even‐chained acetyl‐, octanoyl‐, and palmitoyl‐carnitines were significantly associated with elevated risk of cardiovascular death, also after multivariable adjustments (
HR
[95%
CI
]: 1.52 [1.12, 2.06];
P
=0.007; 1.73 [1.23, 2.44];
P
=0.002; and 1.61 [1.18, 2.21];
P
=0.003, respectively), whereas their associations with acute myocardial infarction were less consistent.

Conclusions

Among patients with suspected stable angina pectoris, elevated serum even‐chained acylcarnitines were associated with increased risk of cardiovascular death and, to a lesser degree with acute myocardial infarction, independent of traditional risk factors.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00354081.
Preprocedural Prediction Model for Contrast‐Induced Nephropathy Patients
Authors: Yin Wen‐jun , Yi Yi‐hu , Guan Xiao‐feng , Zhou Ling‐yun , Wang Jiang‐lin , Li Dai‐yang , Zuo Xiao‐cong
Published: February 2017

Background

Several models have been developed for prediction of contrast‐induced nephropathy (
CIN
); however, they only contain patients receiving intra‐arterial contrast media for coronary angiographic procedures, which represent a small proportion of all contrast procedures. In addition, most of them evaluate radiological interventional procedure‐related variables. So it is necessary for us to develop a model for prediction of
CIN
before radiological procedures among patients administered contrast media.

Methods and Results

A total of 8800 patients undergoing contrast administration were randomly assigned in a 4:1 ratio to development and validation data sets.
CIN
was defined as an increase of 25% and/or 0.5 mg/dL in serum creatinine within 72 hours above the baseline value. Preprocedural clinical variables were used to develop the prediction model from the training data set by the machine learning method of random forest, and 5‐fold cross‐validation was used to evaluate the prediction accuracies of the model. Finally we tested this model in the validation data set. The incidence of
CIN
was 13.38%. We built a prediction model with 13 preprocedural variables selected from 83 variables. The model obtained an area under the receiver‐operating characteristic (
ROC
) curve (
AUC
) of 0.907 and gave prediction accuracy of 80.8%, sensitivity of 82.7%, specificity of 78.8%, and Matthews correlation coefficient of 61.5%. For the first time, 3 new factors are included in the model: the decreased sodium concentration, the
INR
value, and the preprocedural glucose level.

Conclusions

The newly established model shows excellent predictive ability of
CIN
development and thereby provides preventative measures for
CIN
.
Evolution of Joint-Level Control for Quadrupedal Locomotion
Authors: Moore Jared M. , McKinley Philip K.
Published: January 2017

We investigate a hierarchical approach to robot control inspired by joint-level control in animals. The method combines a high-level controller, consisting of an artificial neural network (ANN), with joint-level controllers based on digital muscles. In the digital muscle model (DMM), morphological and control aspects of joints evolve concurrently, emulating the musculoskeletal system of natural organisms. We introduce and compare different approaches for connecting outputs of the ANN to DMM-based joints. We also compare the performance of evolved animats with ANN-DMM controllers with those governed by only high-level (ANN-only) and low-level (DMM-only) controllers. These results show that DMM-based systems outperform their ANN-only counterparts while also exhibiting less complex ANNs in terms of the number of connections and neurons. The main contribution of this work is to explore the evolution of artificial systems where, as in natural organisms, some aspects of control are realized at the joint level.
An Aramaic Magic Bowl for Fertility and Success in Childbirth: Lisboa, Museu da Farmácia (Lisbon, Pharmacy Museum), Inv. No. 10895
Authors: Bhayro Siam
Published: January 2017

This article presents the editio princeps of an Aramaic magic bowl housed in the Pharmacy Museum (Museu da Farmácia), Lisbon. It contains a spell that seeks to grant success in conception and childbirth for Mihranahid daughter of Aḥat. The spell includes what may be the earliest attested quotation of Gen. 30.22, as well as the often-quoted Zech. 3.2. It also contains an unambiguous rendering of the ‘Your face is the face’ formula.
A systematic evaluation of immunoassay point-of-care testing to define impact on patients’ outcomes
Authors: Pecoraro Valentina , Banfi Giuseppe , Germagnoli Luca , Trenti Tommaso
Published: January 2017

Background

Point-of-care testing has been developed to provide rapid test results. Most published studies focus on analytical performance, neglecting its impact on patient outcomes.

Objective

To review the analytical performance and accuracy of point-of-care testing specifically planned for immunoassay and to evaluate the impact of faster results on patient management.

Methods

A search of electronic databases for studies reporting immunoassay results obtained in both point-of-care testing and central laboratory scenarios was performed. Data were extracted concerning the study details, and the methodological quality was assessed. The analytical characteristics and diagnostic accuracy of six points-of-care testing: troponin, procalcitonin, parathyroid hormone, brain natriuretic peptide, C-reactive protein and neutrophil gelatinase-associated lipocalin were evaluated.

Results

A total of 116 scientific papers were analysed. Studies measuring procalcitonin, parathyroid hormone and neutrophil gelatinase-associated lipocalin reported a limited impact on diagnostic decisions. Seven studies measuring C-reactive protein claimed a significant reduction of antibiotic prescription. Several authors evaluated brain natriuretic peptide or troponin reporting faster decision-making without any improvement in clinical outcome. Forty-four per cent of studies reported analytical data, showing satisfactory correlations between results obtained through point-of-care testing and central laboratory setting. Half of studies defined the diagnostic accuracy of point-of-care testing as acceptable for troponin (median sensitivity and specificity: 74% and 94%, respectively), brain natriuretic peptide (median sensitivity and specificity: 82% and 88%, respectively) and C-reactive protein (median sensitivity and specificity 85%).

Conclusions

Point-of-care testing immunoassay results seem to be reliable and accurate for troponin, brain natriuretic peptide and C-reactive protein. The satisfactory analytical performance, together with an excellent practicability, suggests that it could be a consistent tool in clinical practice, but data are lacking regarding the patient outcomes.
Measuring Resilience
Authors: Hoffman Robert R. , Hancock P. A.
Published: January 2017

Objective:

As human factors and ergonomics (HF/E) moves to embrace a greater systems perspective concerning human–machine technologies, new and emergent properties, such as resilience, have arisen. Our objective here is to promote discussion as to how to measure this latter, complex phenomenon.

Background:

Resilience is now a much-referenced goal for technology and work system design. It subsumes the new movement of resilience engineering. As part of a broader systems approach to HF/E, this concept requires both a definitive specification and an associated measurement methodology. Such an effort epitomizes our present work.

Method:

Using rational analytic and synthetic methods, we offer an approach to the measurement of resilience capacity.

Results:

We explicate how our proposed approach can be employed to compare resilience across multiple systems and domains, and emphasize avenues for its future development and validation.

Conclusion:

Emerging concerns for the promise and potential of resilience and associated concepts, such as adaptability, are highlighted. Arguments skeptical of these emerging dimensions must be met with quantitative answers; we advance one approach here.

Application:

Robust and validated measures of resilience will enable coherent and rational discussions of complex emergent properties in macrocognitive system science.
Validation of a Measure of Chinese Outpatients’ Satisfaction in the Taiwan Setting
Authors: Stanworth James O. , Hsu Ryan Shuwei , Warden Clyde A.
Published: January 2017

The medical services market is rapidly expanding around the world, following the experience of the industrialized Western economies. Cultural differences make existing assumptions about health care quality risky to export, leading to an increasing interest in understanding patient satisfaction with care within non-Western contexts. Within the Greater China region, both Western and traditional Chinese medicine coexist, yet there is a lack of research instruments that include distinct values of Chinese patients. This article reports the development of a measure of Chinese patient satisfaction with outpatient care. We describe the foundation of the scale in a qualitative report that includes 8 dimensions of Chinese patient satisfaction. A sample of 400 Chinese patients completed the final instrument. A quantitative analytical procedure leads to a 6-dimension and 27-item instrument to measure Chinese patients’ satisfaction with outpatient care. Our proposed instrument has good internal consistency supporting the use of the instrument in contexts where Chinese patients are being treated.
Nothing Will Work Unless You Did: The Predictors of Postprison Employment
Authors: Duwe Grant , Clark Valerie A.
Published: February 2017

Using multiple measures of postprison employment (finding a job, hours worked, and wages earned), we examined the predictors of postrelease employment outcomes for 15,111 prisoners released from Minnesota prisons between 2007 and 2010. Similar to existing research, employment rates for these former prisoners following their release from prison were higher than their preprison rates. Unlike previous research, however, we found the postprison employment rate did not return to preprison levels, but instead remained relatively flat after 2½ years. Moreover, the results showed the number of interventions in which prisoners participated significantly improved their chances of finding a job, hours worked, and wages earned. These effects were not confined to education and employment programming as positive results were also observed for other interventions such as substance abuse treatment, prison visitation, and cognitive-behavioral therapy.
Adaptive vibration control of a flexible marine riser via the backstepping technique and disturbance adaptation
Authors: Guo Fang , Liu Yu , Zhao Zhijia , Luo Fei
Published: January 2017

This paper proposes an adaptive boundary control for vibration suppression of a flexible marine riser system. The dynamic model of the riser system is described in the form of a nonlinear nonhomogeneous hyperbolic partial differential equation and four ordinary differential equations. In a proper mathematical manner, the backstepping technique, Lyapunov’s direct method, and the adaptive technique are utilized to design an adaptive boundary control for the vibration suppression of the riser system, and also for the global stabilization of the riser within a small neighbourhood of its original position. In addition, a parameter adaptive law is designed to compensate for the system parametric uncertainties and a disturbance adaptation law is proposed to eliminate the effects of boundary disturbance. The uniformly bounded stability of the closed-loop riser system is achieved through rigorous Lyapunov analysis with no discretization or simplification of the partial differential equation dynamics model of the system. Simulation results are presented to illustrate the effectiveness of the proposed control.
Behavioural Asset Pricing: Review and Synthesis
Authors: Chandra Abhijeet , Thenmozhi M.
Published: January 2017

This article presents an overview of literature on behavioural and experimental asset pricing theory. We systematically review the evolution and current development of behavioural asset pricing models as an alternate approach to asset pricing in financial economics literature. A review and synthesis of research carried out in behavioural finance spreading across theoretical, empirical and experimental approaches are presented to understand the behavioural dimension of pricing of financial assets. From theoretical perspective, behavioural asset pricing models try to adopt additional behavioural variables into asset pricing process. In terms of empirical investigation perspective, it is documented that econometric and computational advancement takes its biggest place ever in financial literature when compared with the other field. Our review underlines the fact that the direction of advancing a methodology is changing from financial literature to economics due to the fact that there is huge account of raw data available to analyze. Future research direction should be judging the empirical power of the asset pricing models and their role in practice for incorporating a new dimension to the model. The distinctiveness of the study is that this is the first attempt to review literature written on behavioural asset pricing models in the form of structural empirical review. In doing so, the historical perspective of the concept and the place it will take in future are clarified and the way further researches will be conducted are explored.

JEL: E03, G02, G12
Decentralised and Effective Forest Resource Governance in India
Authors: Suresh Lavanya
Published: January 2017

Within the context of decentralised environmental governance, this article seeks to answer the question which institutional arrangements may be most effective in delivering the promise of better community-centred forest governance. The specific objective is to analyse the impact that decentralisation of resource management has on the effectiveness of forest governance. Using a comparative case study framework, the article finds that decentralisation functions better when nested structures with a plurality of bodies are in operation. However, the case studies also highlight the need for constant monitoring as a necessarily ongoing crucial process to protect the ecological sustainability of forest resource governance as well as strengthening equitable social structures at the village level.
Systemic activation of Toll-like receptor 2 suppresses mitochondrial respiration and exacerbates hypoxic–ischemic injury in the developing brain
Authors: Mottahedin Amin , Svedin Pernilla , Nair Syam , Mohn Carl-Johan , Wang Xiaoyang , Hagberg Henrik , Ek Joakim , Mallard Carina
Published: January 2017

Infection and inflammation are known risk factors for neonatal brain injury. Mycoplasma and Gram-positive bacteria, for which Toll-like receptor 2 (TLR2) plays a key role in recognition and inflammatory response, are among the most common pathogens in the perinatal period. Here, we report that systemic activation of TLR2 by Pam3CSK4 (P3C) increases neural tissue loss and demyelination induced by subsequent hypoxia–ischemia (HI) in neonatal mice. High-resolution respirometry of brain isolated mitochondria revealed that P3C suppresses ADP-induced oxidative phosphorylation, the main pathway of cellular energy production. The results suggest that infection and inflammation might contribute to HI-induced energy failure.
Relational Group Psychotherapy: An Overview: Part I: Foundational Principles and Practices
Authors: Billow Richard M.
Published: January 2017

By our theories, techniques, personality, and spontaneous behaviour, we define how group relationships, and experiences are to be regarded, and the emotional depth to which exchanges may be considered. In a three-part series, I present an overview of my approach to relationally based group psychotherapy. I assume that the need for ‘truth’, that is, emotional meaning is primary organizer of group formation and process. Individuals and groups cycle through an interactive interplay of mental states, both to seek and avoid truth seeking,

Topics introduced in Part I include a brief introduction to relational theory and its historical foundation; the efficacy of combined-individual psychotherapy; the centrality and activity of the therapist; and the description of some key foundational concepts: ‘G’ (urge to group), emotional truth and falsity, interplay of mental categories, basic affects (Bion’s LHK), and passion.
The Use of a Bar Model Drawing to Teach Word Problem Solving to Students With Mathematics Difficulties
Authors: Morin Lisa L. , Watson Silvana M. R. , Hester Peggy , Raver Sharon
Published: February 2017

For students with mathematics difficulties (MD), math word problem solving is especially challenging. The purpose of this study was to examine the effects of a problem-solving strategy, bar model drawing, on the mathematical problem-solving skills of students with MD. The study extended previous research that suggested that schematic-based instruction (SBI) and cognitive strategy instruction (CSI) delivered within an explicit instruction framework can be effective in teaching various math skills related to word problem solving. A multiple-baseline design replicated across groups was used to evaluate the effects of the intervention of bar model drawing on math problem-solving performance of students with MD. Student achievement was measured in terms of increased correct use of cognitive strategies and overall accuracy of math word problem solving. Results showed that bar modeling drawing is an effective strategy for increasing elementary students’ accuracy in solving math word problems and their ability to use cognitive strategies to solve the problems.
Can “Cleaned and Greened” Lots Take on the Role of Public Greenspace?
Authors: Heckert Megan , Kondo Michelle
Published: January 2017

Cities are increasingly greening vacant lots to reduce blight. Such programs could reduce inequities in urban greenspace access, but whether and how greened lots are used remains unclear. We surveyed three hundred greened lots in Philadelphia for signs of use and compared characteristics of used and nonused lots. We found physical signs of use that might be found in yard space, such as barbeques, picnic benches, and swings, on approximately 10 percent of lots. Logistic regression showed that population density was the only statistically significant predictor of lot use. Findings suggest that greened lots could provide direct use benefits to neighbors.
The Effect of Hypertensive Disorders of Pregnancy on the Risk of ADHD in the Offspring
Authors: Böhm Stefanie , Curran Eileen A. , Kenny Louise C. , O’Keeffe Gerard W. , Murray Deirdre , Khashan Ali S.
Published: February 2017

Objective: Evidence suggests that perinatal factors may contribute to the development of ADHD. Our objective was to examine the association between hypertensive disorders of pregnancy (HDP) and ADHD, and behavioral difficulties among 7-year-old children. Method: The study cohort consisted of 13,192 children (weighted = 13,500) who participated in the Millennium Cohort Study (MCS) at age 7. HDP (raised blood pressure, preeclampsia, eclampsia, and toxemia) were reported by mothers 9 months postdelivery. ADHD was reported by parents at age 7 years. Weighted logistic regression models were used to assess the association. Results: In all, 1,069 (7.9%) women reported HDP and 166 (1.2%) children had an ADHD diagnosis. There was a significant association between HDP and ADHD (adjusted odds ratio [OR] = 1.78, 95% confidence interval [CI] = [1.03, 3.07]). Conclusion: These findings suggest that HDP is associated with an increased risk of ADHD. It is important to confirm this in larger cohorts and to understand the biological basis of this association.
Mixed Emotions: Toward a Phenomenology of Blended and Multiple Feelings
Authors: Heavey Christopher L. , Lefforge Noelle L. , Lapping-Carr Leiszle , Hurlburt Russell T.
Published: January 2017

After using descriptive experience sampling to study randomly selected moments of inner experience, we make observations about feelings, including blended and multiple feelings. We observe that inner experience usually does not contain feelings. Sometimes, however, feelings are directly present. When feelings are present, most commonly they are unitary. Sometimes people experience separate emotions as a single experience, which we call a blended feeling. Occasionally people have multiple distinct feelings present simultaneously. These distinct multiple feelings can be of opposite valence, with one pleasant and the other unpleasant. We provide examples that inform theories of emotions and discuss the important role observational methodology plays in the effort to understand inner experience including feelings.
Severe muscle fasciculations and tremor in a cat with hypochloraemic metabolic alkalosis secondary to duodenal obstruction
Authors: Jukes Alison , Gunew Marcus , Marshall Rhett
Published: January 2017

Case summary

An 18-month-old, female spayed, Australian Mist cat presented with a 24 h history of muscle tremors and inappetence progressing to collapse with generalised muscle fasciculations. The cat was diagnosed with a hypochloraemic metabolic alkalosis due to a duodenal foreign body found to be a trichobezoar at coeliotomy. The cat made a complete recovery after enterotomy to remove the trichobezoar, with cessation of neuromuscular clinical signs and normalisation of its electrolyte and acid–base imbalances.

Relevance and novel information

Muscle fasciculations and tremors in cats can be caused by intoxications, metabolic derangements, encephalomyelitis, feline hyperaesthesia syndrome and cerebellar diseases. The presenting clinical signs of severe muscle fasciculations and tremors have not previously been reported in association with an intestinal obstruction in the cat.
Lower limb fractures associated with multiligament knee injury
Authors: Stagnaro Joaquin , Yacuzzi Carlos , Barla Jorge , Zicaro Juan Pablo , Costa-Paz Matias
Published: January 2017

Objectives:

Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries.

Methods:

A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed.

Results:

Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months.

Conclusion:

Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.
Osteochondral Defects of the Knee treated with Mosaicplasty. Results at Eight Years of Follow-Up
Authors: Zicaro Juan Pablo , Romoli Agustin Molina , Revah Mariano Agustin , Dere Juan Jose , Yacuzzi Carlos , Costa-Paz Matias
Published: January 2017

Objectives:

There are several surgical options described for osteochondral defects of the knee depending on the size, location and condition of subchondral bone. The main indication for a mosaicplasty procedure is a less than 4 cm2 femoral condyle lesion. The purpose of this study was to analyze a series of patients treated with mosaicplasty with average eight years of follow-up.

Methods:

We retrospectively evaluated sixty-two patients with osteochondral defects of the knee who underwent a mosaicplasty between 2001 and 2014 with a minimum follow-up of 2 years. Patients were evaluated using the Lysholm score, International Knee Documentation Committee Score (IKDC) and Kellgren-Lawrence radiographic scale.

Results:

The mean Lysholm score was 80.1 and IKDC was 66.7. Forty-two patients had isolated mosaicplasty and 20 patients presented an associated surgical procedure (osteotomy, ACL reconstruction, meniscectomy). There were no significant differences between the Lysholm and IKDC scores in these two groups.

Conclusion:

We consider that mosaicplasty is a satisfactory procedure with good functional results in patients with focal articular cartilage lesions of the knee.
Labral Healing
Authors: Catan Agustín , Vilaseca Tomas , Arroquy Damián , Carboni Martín , Guiñazú Jorge Eduardo , Orlowsky Belén , Irigoitia Nicolas , Chahla Jorge
Published: January 2017

Objectives:

The purpouse of this study was to evaluate MRI images of labral repair after one year, trying to stablish MRI images as a reliable tool for the diagnosis of labral healing.

Methods:

One hundred and sixty-two patients presenting with femoroacetabular impingement that underwent an arthroscopic surgery were treated between 2012 and 2015. Of these, 124 met the selection criteria and were included in this study. Only patients with 12 months of follow up and labral repair were included. Patients with previous hip surgery were excluded. Coronal, sagittal and axial MRI cuts were evaluated by three independent observers, an arthroscopic hip surgery, a fellow in hip arthroscopic surgery and a musculoeskeletal radiologist.

Results:

on regard of our statistics 68% of the patients had labral healing images, 16% had no healing signals and 16% unsatisfactory images. Just in the 47% the observers had a 100% of agreement. Interobserver variation was: intraobserver agreement was 94% ( arthroscopic surgeon), 72 % (radiologist), 67 % (fellow).

Conclusion:

The main finding of this study was that a high inter and intraobserver variability was found when analysing the healing status of hip repaired labrums. Assessment of labrum healing after an arthroscopic repair should not only rely on imaging methods and therefore should be concurrently performed with a comprehensive physical examination.
Prenatal Sonographic Detection of Ebstein’s Anomaly
Authors: Root Mariah C. , Fisher Kelsy L.
Published: February 2017

Ebstein’s anomaly is a rare type of congenital heart defect characterized by a malformation of the tricuspid valve and the right side of the heart. This case study presents a well-documented case of Ebstein’s anomaly that was diagnosed prenatally using sonography. The ability of prenatal sonography to detect and accurately diagnosis this case allowed for a change in the management of the pregnancy to properly evaluate the condition and prepare for treatment. In addition, information regarding Ebstein’s anomaly is reviewed and specifically addresses etiology, symptoms, diagnosis, treatment, characteristic sonographic appearance, and common differential diagnoses.
Testicular Phantom Use in Sonography Education: Bridging the Classroom and Clinical Experience
Authors: Pessin Yosefa J. , Tang-Simmons Jason
Published: February 2017

Simulation allows educators to teach important skills outside the clinical environment. The objective of this study was to evaluate advantages of a testicular phantom scanning workshop in a sonography curriculum and ascertain if it is a beneficial teaching tool. Students participated in a workshop facilitated by registered sonographers using testicular phantoms and ultrasound machines. Students provided anonymous feedback. All participants found this activity helpful. Sixty-seven percent indicated that the phantom reflected a good representation of a real patient. Ninety percent indicated that scanning skills improved and the workshop positively affected their confidence in performing the examination. More than 90% reported greater confidence in describing the examination to a patient. Ninety-five percent reported increased knowledge of sonographic anatomy and identification of testicular structures. These sonography students perceived the testicular simulation workshop as a positive learning experience that increased confidence and skills in testicular scanning and as a viable tool for teaching testicular sonography.
Identifying functional defects in patients with immune dysregulation due to LRBA and CTLA-4 mutations
Authors: Hou Tie Zheng , Verma Nisha , Wanders Jennifer , Kennedy Alan , Soskic Blagoje , Janman Daniel , Halliday Neil , Rowshanravan Behzad , Worth Austen , Qasim Waseem , Baxendale Helen , Stauss Hans , Seneviratne Suranjith , Neth Olaf , Olbrich Peter , Hambleton Sophie , Arkwright Peter D. , Burns Siobhan O. , Walker Lucy S. K. , Sansom David M.
Published: February 2017

Key Points

New approaches to identifying functionally relevant mutations in CTLA-4 deficiency syndromes. Measuring responses to stimulation and degradation distinguishes between CTLA-4 and LRBA mutations.
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary
Authors: Vogelmeier Claus F. , Criner Gerard J. , Martinez Fernando J. , Anzueto Antonio , Barnes Peter J. , Bourbeau Jean , Celli Bartolome R. , Chen Rongchang , Decramer Marc , Fabbri Leonardo M. , Frith Peter , Halpin David M.G. , López Varela M. Victorina , Nishimura Masaharu , Roche Nicolas , Rodriguez-Roisin Roberto , Sin Don D. , Singh Dave , Stockley Robert , Vestbo Jørgen , Wedzicha Jadwiga A. , Agusti Alvar
Published: January 2017

This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. The most significant changes include: 1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; 2) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; 3) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; 4) nonpharmacologic therapies are comprehensively presented and; 5) the importance of comorbid conditions in managing COPD is reviewed.
Paleobathymetry of a Pliocene Voutes coast (Heraklion, Crete).
Authors: Agiadi K. , Koskeridou E. , Triantaphyllou M. , Karakitsios V.
Published: January 2017

The fish otolith assemblages identified in the Zanclean sediments of Voutes section (Heraklion, Crete) are analyzed in order to estimate the depth of deposition. The assemblages indicate that Voutes area was in fact a coast inhabited by a neritic fish fauna with significant mesopelagic component, mostly Myctophids. The benthic and benthopelagic group exhibits great diversity. In the late Zanclean, the study area corresponds to a deep neritic environment, which gradually uplifts. At the end of the Zanclean, Voutes area becomes a very shallow coast, as shown by the increased contribution to the assemblage by members of the Gobiid family, as well as the notable presence of Bothidae. Thereafter, the area deepens again, as the shallow benthic-benthopelagic component significantly decreases. This is consistent with the appearance of Pteropods and reaches a peak during the deposition of diatomites at maximum depth. At the upper part of the section, the sea bottom depth decreases again to allow for the deposition of marls with various molluscs remains, where Gadids and Gobiids again reappear. Finally, the upper diatomitic horizon is characterized by a rather poor fish fauna. These observations allow reconstructing the evolution of Voutes coastal area during the latest Zanclean until the Piacenzian.
Protection and Concervation of Agia Eirini Gorge Geotope, West of the Samaria National Park, Western Crete
Authors: Bizoura A. , Manutsoglou E.
Published: January 2017

The unique in beauty and scientific interest geotope of Agia Eirini gorge is located at the western side of the White Mountains, in the Prefectural Administration of Chania. It is part of the European path E4, has a length of 7,5 kilometers and its northern entry is located at Agia Eirini village, 43 km far from Chania. It is part of the “Lefka Ori” Natura 2000 region (Code GR 4340008), part of the Samaria National Park and α Wild Life Shelter. The gorge crosses the metamorphic carbonate rocks of the Trypali Unit (age up to Middle Triassic) and the units of the Phyllite Nappe. The gorge represents a fault zone with a NNE – SSW direction, following the general direction of the large faults that cut the Mesozoic formations of the region. Along this path a lot of tectonic features can be regarded and studied, so the gorge can be characterized as a natural laboratory for the understanding of the terms fault and fault zone. In this study, using GIS, an information system for the gorge of Agia Eirini is organized and the combination of thematic maps revealed a delimitation problem of the protected area.
Sedimentation processes and palaeographic evolution of Makrilia Pliocene deposits, SE Crete.
Authors: Moforis L. , Kostopoulou S. , Panagopoulos G. , Pyliotis I. , Triantaphylou M. , Manoutsoglou E. , Zelilidis A.
Published: January 2017

Detailed sedimentological analysis in Makrylia cross-section deposits showed at least five coarsening-upward cycles that were developed in a shelf environment. The main lithology is sandy silt and the sediments were transported as homogenous suspension in a low energy environment that deposited in a shallow water basin. The content of calcium carbonate (CaCO3) is low and tends to increase to the coarsegrained clasts. Organic carbon (TOC) measurements showed the presence of many samples with high content in TOC suggesting potential hydrocarbon source rocks. There is mostly a negative correlation between CaCO3 and TOC introducing generally anoxic conditions. Biostratigraphic analysis showed that the studied deposits are of Pliocene age that were precipitated in alternating conditions of oxic- anoxic events. According to the above results and taking into account previous results from the surrounding sediments it seems that the studied deposits accumulated in a shallow, low energy, intra-mountain basin at the margins of the main Ierapetra basin.
Landslide inventory using GISMA techniques.
Authors: Kordouli M. , Kavoura Kat. , Nikolakopoulos K. , Sabatakakis N.
Published: January 2017

The use of GIS for various types of data is considered to be of high importance, mainly  because  it  is  bringing  together  information  from  multiple  sources.  In addition, the new Internet technologies and applications of global world maps, like Google  Maps,  give  the  opportunity  to  build  systems  that  the  geographical information can be recorded and administrated by many users from anywhere. This kind  of  GIS  systems  is  suitable  for  Business  Administration,  or  Science,  or Government Organizations, which need GIS systems with multiple users from many places  and  multiple  kind  of  information.  This  system  is  defined  as  GISΜΑ (Geographic Information System Multi Administration). In GISMA many users may input  the  data  and  use  the  information  from  different  distance.  Each  user  has specific permissions of use of data as the administrator sets.  In  this  work,  the  basic  principles  and  rules  of  a  building  GISMA  system  are evaluated and an application is presented based on data and GIS techniques for the slope instability studies. Data obtained from historical landslide occurrences were verified with new locations obtained from high resolution orthophotos and Google Earth  application.  Landslide  areas  were  mapped  using Arc  Map  and  finally  the Landslide Inventory for the Achaia’s Prefecture was created.
An application of GIS analysis on structural data from metamorphic rocks in Santorini Island.
Authors: Marsellos Α. Ε. , Foster D. A. , Min K. , Kidd W. S.F. , Garver J. , Kyriakopoulos K.
Published: January 2017

The Santorini volcanic island is located in the northern Cretan Sea and is part of the ecent subduction-related volcanic arc. The opening of Cretan Sea is the result of extension associated with a series of ductile and brittle detachment faults developed since the Middle Miocene. A detachment between two exhumed metamorphic units is exposed at Athinios, on Santorini Island. Two exhumed metamorphic units are identified that show evidence of similar brittle deformation, but distinctive ductile and ductile-brittle structures. Different thermal histories indicate that a Miocene metamorphic unit is juxtaposed structurally below an Eocene metamorphic unit. In this paper, a prediction map of structural observations in Athinios is generated with statistical and GIS software, and shows a spatial distribution consistent with the exposure of two metamorphic units.  K-Mean Cluster analysis using SPSS software on lineation azimuths of the metamorphic rock units shows two populations with center values of 347.2o ± 0.73o degrees (NNW to N) and 003.4o ± 0.83o degrees (N to NNE). NNW-lineation (arc-parallel extension) population belongs to the lower Miocene metamorphic unit and the NNE-lineation represents the Eocene metamorphic unit that was affected by arc-normal extension. A geostatistical map of ordinary Kriging type displays the possible exposed tectonic contacts. This methodology provides  a  structural  prediction  map  that  after  field  verification  facilitates  efficient structural and thermochronological sampling.
A mineralogical study of pigments used in two Iakovidis paintings: Verification of artwork authenticity using Raman micro-spectroscopy method.
Authors: Kougemitrou I. , Economou G. , Giovanopoulos J. , Baziotis I. , Leontakianakos G. , Stathopoulos V.
Published: January 2017

For the purpose of the current study, we examined two paintings, an original and a fake one, entitled “Still life with grapes”, and claimed both to be created from the Greek Painter G. Iakovidis. The current Research Project has been carried out at the Centre Nikias, an innovative Research Centre specialised on certification, maintenance and restoration of art works. Raman spectroscopic analysis has been carried to verify the authenticity of the used pigments and also the originality of the two paintings. The Raman spectra acquired confirmed four different colours in both painting`s pigments: red, blue, white and yellow. For the first painting Cinnabar for the red pigment, Ultramarine for the blue pigment, White earths for the white pigment and Yellow ochre for the yellow pigment. In the second painting the colours used verified as synthetic pigments. We identified the presence of Cadmium red for the red colour, Cobalt blue for the blue pigment, Zinc white for the white and Cadmium yellow for the yellow one.
"Extractive Industries Transparency Initiative - EITI" Outlook on the explotation of Albanian mineral resources
Authors: Shehu Ar. , Shehu Ag.
Published: January 2017

Albania is focusing its efforts in the achievement of medium and long-term development objectives, particularly so its goals for European integration and the processes to this end. Local and foreign investments and projects in the Extractive industry are growing in the last years. Statistical data and references show an increased level of production and payments made to the state. Income from hydrocarbon sector constitutes the most important part of these payments, followed by the mining sector for the production of construction materials.The level of production and income recorded in these sectors is increasing. Proof of this are the payments made to the government by the extractive industry year after year, thus showing consistency of the economic sector and a moderate impact on the state budget and other macroeconomic indicators.Joining this initiative comes as a continuation of reforms undertaken for this purpose, in order to increase the transparency for all payments made to the Albanian State by the Extractive Industry. It follows the path of a broad program of economic, financial and institutional reform where transparency and proper management of natural resources have a particular importance. These two factors are essential for sustainable development. The new Mining Law and other by-laws, in addition to other changes required by legal improvements and economic development of the country, reflect the requirements of this initiative.