bluuebunny/crossref_metadata_2025 huggingface dataset:
Food safety, agro-industries, and China’s international trade: A standard-based approach
Authors: Augustin-Jean Louis , Xie Lei
Published: June 2018

Economic sociology views markets as organizations characterized by power relations. In this framework, competition is not only for price or quality, but also for market structures, including norms and standards. Food standards, therefore, are not only public goods or tools to protect domestic markets, but they also aim to redesign the rules of the market and provide a competitive advantage to firms and national industries: they are part of the politicization of science. This article argues that China is participating in this form of competition. Since its WTO membership, it has gradually learnt the rules of globalization and has implemented many global standards to benefit from international trade. In recent years, however, it has assumed a more proactive role in reframing international standards of agro-food markets in general and food safety in particular, despite existing problems in its domestic food markets. Three case studies – milk imports; the diplomatic and trade competition for the implementation of a ractopamine (an additive in pig and cattle feed) standard; and the current negotiations for new international standards for cotton – show how China is using different strategies and methods to redesign the shape of international trade.
Self-adaptive grasp analysis of a novel under-actuated cable-truss robotic finger
Authors: Qiao Shangling , Guo Hongwei , Liu Rongqiang , Huang Yong , Deng Zongquan
Published: June 2018

This paper presents the self-adaptive grasp of a novel cable-driven finger, which is an underactuated finger comprising cable-truss units. The underactuated cable-truss finger uses tendon-pulley transmission and parallel four-linkage mechanism to realize grasps. The working principle of the underactuated cable-truss finger and the self-adaptation at the grasp-closing stage are introduced. A self-adaptive grasping model is constructed to analyze the self-adaptation, and a new analysis method that considers the position and posture of grasping point in distal phalange is proposed. A new generalized coordinate, which directly shows the contacting position and the relative angular displacement in the distal phalange, is established. The expression of general static grasping force is established by using the virtual work principle, which reveals the relationship among the driving force, the equivalent torques on joints and the grasping forces. The workspace of the underactuated cable-truss finger and distributions of grasping force in new generalized coordinate are assessed through numerical analysis. The balance conditions of the self-adaptive grasp and the corresponding statuses are theoretically illustrated. Valid and adequate self-adaptive grasping experiments are conducted to verify the accuracy of self-adaptive grasping analysis.
Continence technologies whitepaper: Informing new engineering science research
Authors: Culmer Pete , Alazmani Ali , Bryant Mike , Mancuso Elena , King Sarah , Mapunde Vee , Jeays-Ward Katherine , Heron Nicola , Pearson Russell , Vollebregt Paul F , Corner Lynne , Day Richard
Published: June 2018

Advances in healthcare technology for continence have historically been limited compared to other areas of medicine, reflecting the complexities of the condition and social stigma which act as a barrier to participation. This whitepaper has been developed to inspire and direct the engineering science community towards research opportunities that exist for continence technologies that address unmet needs in diagnosis, treatment and long-term management. Our aim is to pinpoint key challenges and highlight related research opportunities for novel technological advances. To do so, we draw on experience and expertise from academics, clinicians, patients and patient groups linked to continence healthcare. This is presented in four areas of consideration: the clinical pathway, patient perspective, research challenges and effective innovation. In each we introduce seminal research, background information and demonstrative case-studies, before discussing their relevance to engineering science researchers who are interested in approaching this overlooked but vital area of healthcare.
Factors associated with linkage to care for HIV patients in Tajikistan
Authors: Alaei Arash , Nautiyal Nisheet , Mishkin Kathryn , Saifuddin Karimov D , Saidi Dilshod , Alaei Kamiar
Published: June 2018

There is a growing human immunodeficiency virus (HIV) epidemic in Tajikistan. This paper presents factors associated with linkage to HIV care among people aged 15 years and older in Tajikistan. This retrospective cross-sectional study used the Tajikistan Ministry of Health HIV registry data from patients diagnosed with HIV at age 15 years or older from 2000 to 2016. Chi squared tests and logistic regression models tested factors associated with linkage to care. A multivariable logistic regression model examined effect modifications. While linkage to care had an overall increase from 2000 to 2016, the odds of linkage were lower among certain sub-groups including among people in Dushanbe, men, people engaging in sex work, injection drug users, and older people. Regional differences exist with linkage to care, occurring least frequently in Dushanbe. While access to care and quality of care have increased significantly over time, findings suggest that linkage to care is low, especially in the capital city where many services are provided. Evaluation focusing on acceptability of HIV services should be undertaken to understand why certain people do not link with services. Additional research about the types of barriers to linking with HIV care is needed to increase linkage to HIV care.
Eating time in Santiago, Chile: A trade-off between norms and biological and social requirements
Authors: Giacoman Claudia
Published: June 2018

This article aims to understand the underlying social mechanisms of timed eating schedules. Starting from 24 group interviews carried out in Santiago, Chile, this paper postulates that eating meals to a fixed schedule largely depends on the importance that an individual assigns to social norms on eating times, since this norm can be modified when the individual is alone or upon the emergence of compelling bodily, family and productive demands. The results shown in this paper contribute to an understanding of how the time aspect of eating food is subjectively experienced and present an invitation to rethink food de-structure thesis.
Calcium
Authors: Eich Torsten , Ståhle Magnus , Gustafsson Bengt , Horneland Rune , Lempinen Marko , Lundgren Torbjörn , Rafael Ehab , Tufveson Gunnar , Zur-Mühlen Bengt von , Olerud Johan , Scholz Hanne , Korsgren Olle
Published: June 2018

Background:

Effective digestive enzymes are crucial for successful islet isolation. Supplemental proteases are essential because they synergize with collagenase for effective pancreatic digestion. The activity of these enzymes is critically dependent on the presence of Ca2+ ions at a concentration of 5–10 mM. The present study aimed to determine the Ca2+ concentration during human islet isolation and to ascertain whether the addition of supplementary Ca2+ is required to maintain an optimal Ca2+ concentration during the various phases of the islet isolation process.

Methods:

Human islets were isolated according to standard methods and isolation parameters. Islet quality control and the number of isolations fulfilling standard transplantation criteria were evaluated. Ca2+ was determined by using standard clinical chemistry routines. Islet isolation was performed with or without addition of supplementary Ca2+ to reach a Ca2+ of 5 mM.

Results:

Ca2+ concentration was markedly reduced in bicarbonate-based buffers, especially if additional bicarbonate was used to adjust the pH as recommended by the Clinical Islet Transplantation Consortium. A major reduction in Ca2+ concentration was also observed during pancreatic enzyme perfusion, digestion, and harvest. Additional Ca2+ supplementation of media used for dissolving the enzymes and during digestion, perfusion, and harvest was necessary in order to obtain the concentration recommended for optimal enzyme activity and efficient liberation of a large number of islets from the human pancreas.

Conclusions:

Ca2+ is to a large extent consumed during clinical islet isolation, and in the absence of supplementation, the concentration fell below that recommended for optimal enzyme activity. Ca2+ supplementation of the media used during human pancreas digestion is necessary to maintain the concentration recommended for optimal enzyme activity. Addition of Ca2+ to the enzyme blend has been implemented in the standard isolation protocols in the Nordic Network for Clinical Islet Transplantation.
Personality as an Antecedent of Impulsive Buying Behaviour: Evidence from Young Indian Consumers
Authors: Sofi Shakeel Ahmad
Published: June 2018

The main aim of this research was to examine the effect of intrinsic attributes on impulsive buying behaviour among young consumers with special reference to Indian context. After employing exploratory factor analysis and confirmatory factor analysis on select consumers under the study, results showed that personality significantly shapes impulsive buying predispositions. Furthermore, select personality dimensions vis-à-vis expressive propensity, pleasure-seeking propensity, sociableness, emotional stability, conscientiousness and conserving propensity have significant bearing on the outcome of impulsive buying behaviour. In the current study, some of the select personality attributes comprising of expressive propensity, pleasure-seeking propensity and sociableness have been found to have positive effect on impulsiveness while other factors, namely, emotional stability, conscientiousness and conserving propensity have negative effect on the impulsiveness. These findings are paramount both from the perspective of consumer welfare advocates and corporates and could largely support them in their respective endeavours.
Marital Violence During War Conflict: The Lived Experience of Syrian Refugee Women
Authors: Al-Natour Ahlam , Al-Ostaz Samar Mohammad , Morris Edith J.
Published: June 2018

Introduction: Marital violence increases during times of war. This study aims to describe the lived experience of marital violence toward Syrian refugee women during the current war in Syria. Design: A descriptive phenomenological research methodology was used to conduct semistructured interviews with 16 purposively selected Syrian refugee women residing in displacement centers in Jordan. Colaizzi’s steps of data analysis were used. Results: Four themes identified were identified: (1) Loss, insecurity, and suffering; (2) Shame and humiliation; (3) Justifying and enduring marital violence; and (4) Ways of coping with marital violence. Conclusion: The Syrian War conflict changed women’s lifeway and created a context for marital violence. Study findings suggests addressing marital violence during wartime and allocating resources to provide care and support of victims of violence in the displaced countries.
Intergenerational Transmission of Physical and Emotional Sibling Violence: A Potential Connection to Elder Abuse
Authors: Perkins Nathan H. , Spira Marcia , Key Julie Erin
Published: June 2018

This article focuses on the persistence of physical and emotional sibling violence through the life course and its potential connection to elder abuse. Theories relevant to the linkage between sibling violence and elder abuse are presented and discussed. Highlighted is the need for future studies to examine the association between these forms of family violence in order for preventative and intervention mechanisms to be created and implemented. Implications for practice include the need to assess physical and emotional sibling violence as a potential risk factor for elder abuse.
Beyond the Child’s Age at Placement: Risk and Protective Factors in Preadoption Breakdown in Portugal
Authors: Barbosa-Ducharne Maria , Marinho Sylvie
Published: June 2018

Purpose:

The main goals were to determine the incidence of preadoption breakdown in Portugal, describe preadoptive parents’ reasons for ending placement, compare intact/disrupted placements, and identify adoption disruption risk and protective factors.

Method:

A matched design involving a case file analysis of 71 disrupted and 71 intact preadoptive placements was used.

Results:

The accumulated incidence of preadoption disruption was 5.8%. Adoptive parents’ motives for requesting removal included the child’s behavior, their own parenting limitations, and dissatisfaction with professional interventions. These three domains were present in the group comparisons and explained 54% of the variance, predicting group membership for 80.8% cases.

Conclusion:

Besides age at placement, other risk factors related to the child, the adopters, and the professional practices help to gain a more complete understanding of adoption disruption.
“Home Is Where My Couch Is”: The Role of Possessions in the Process of Moving and Adjusting to Continuing Care Retirement Communities
Authors: Green Ohad , Ayalon Liat
Published: June 2018

We examined the role of possessions in the process of moving and adjusting to continuing care retirement communities (CCRCs). Totally, 59 CCRC residents in 12 CCRCs were interviewed. We categorized three main types of residents: “I want it all,” “I want it that way,” and “I want to break free.” Each type experienced differently the role that objects play in (a) the reasons for moving, (b) choosing a CCRC and a specific apartment, (c) organizing one’s belongings in preparation for relocation, and (d) adjusting to the new apartment. Most residents were attached to their belongings and reported having great difficulty leaving them behind. Our findings suggest that while older adults should be given every possible opportunity to make their own choices about their belongings, it is also necessary to balance between the desire to maintain continuity with their past, and the limited space of a CCRC apartment.
Reliability and Validity of the Checklist for Function-Focused Care in Service Plans
Authors: Resnick Barbara , Galik Elizabeth , Boltz Marie , Holmes Sarah , Fix Steven , Lewis Regina , Vigne Erin
Published: June 2018

The purpose of this study was to test the reliability and validity of the Checklist for Function-Focused Care in Service Plans. Function-focused care is a care approach that optimizes function and physical activity during all care interactions. This study used baseline data from the first cohort of the study titled Dissemination and Implementation of Function-Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT). A total of 242 participants were recruited from 26 assisted living facilities. The majority of participants were White, female, and unmarried. There was support for internal consistency with an alpha coefficient of .96, interrater reliability with a correlation of .80, construct validity based on Rasch analysis and INFIT statistics ranging from 0.69 to 1.29, and a significant association with function-focused care activities. Although there is some support for reliability and validity of the measure, modifications are recommended to add more challenging items.
Latent Profile Analyses of Depressive Symptoms in Younger and Older Oncology Patients
Authors: Saracino Rebecca M. , Cham Heining , Rosenfeld Barry , J. Nelson Christian
Published: June 2018

The aging of America will include a significant increase in the number of older patients with cancer, many of whom will experience significant depressive symptoms. Although geriatric depression is a well-studied construct, its symptom presentation in the context of cancer is less clear. Latent profile analysis was conducted on depressive symptoms in younger (40-64 years) and older (≥65 years) patients with cancer ( N = 636). The sample was clinically heterogeneous (i.e., included all stages, dominated by advanced stage disease). Participants completed questionnaires including the Center for Epidemiological Studies Depression Scale, which was used for the latent profile analysis. A four-class pattern was supported for each age group. However, the four-class pattern was significantly different between the younger and older groups in terms of the item means within each corresponding latent class; differences were primarily driven by severity such that across classes, older adults endorsed milder symptoms. An unexpected measurement issue was uncovered regarding reverse-coded items, suggesting that they may generate unreliable scores on the Center for Epidemiological Studies Depression Scale for a significant subset of patients. The results indicate that cancer clinicians can expect to see depressive symptoms along a continuum of severity for patients of any age, with less severe symptoms among older patients.
Mothers’ Perspectives on Managing the Developmental Delay of a Child With Considerations for Contextual Influences and Maternal Functioning
Authors: McKechnie Anne Chevalier , Waldrop Julee , Matsuda Yui , Martinez Maria , Fields Carrie , Baker Maureen J. , Beeber Linda
Published: June 2018

Developmental delay in very young children is trending upward. Maternal depressive symptoms are known to negatively impact child development and may also impact family management of the child’s condition. Research on family management guided this second phase of a sequential mixed methods study. The purpose of this study was to explore mothers’ perceptions of family management of their children’s developmental delays. Mothers of very young children who received early intervention services were interviewed. A team-based content analysis approach revealed key findings: (a) views of the child that were not holistic, (b) condition management ability was informed by what the mother thought her child needed, (c) views of condition impact were related to adapting to possible child outcomes and experiences of isolation, and (d) parental/caregiver mutuality was impaired by conflict. Understanding perceptions of family management and influence of depressive symptoms in this context is essential to extend assessment and intervention.
The Role of Felt or Enacted Criticism in Parents’ Decision Making in Differing Contexts and Communities: Toward a Formal Grounded Theory
Authors: Neill Sarah J. , Coyne Imelda
Published: June 2018

Felt or enacted criticism was identified as a significant influence on White British parents’ decision making during acute childhood illness in a substantive grounded theory “Containing acute childhood illness within family life.” These parents sought to avoid further criticism, sometimes leading to delayed consultation. Using Glaserian grounded theory principles, we conducted a secondary analysis of data from three studies, to establish the transferability and modifiability of the original theory to other settings and communities in Ireland and England. Felt or enacted criticism was found to operate across the childhood age range, social groups, and settings. Parent’s strategies to avoid criticism reduced contacts with health professionals, access to support and, more worryingly, communication about their child’s health. These findings demonstrate the wider applicability, or “work” in Glaser’s terms, of the concept in the English speaking Western world. Findings indicate the need for nurses to identify and mitigate sources of criticism.
Letermovir associated hepatic transaminitis: A case report
Authors: Geswein Laura
Published: June 2018

Letermovir is an antiviral agent recently approved by the Food and Drug Administration for prophylaxis of cytomegalovirus infection in adult patients that are cytomegalovirus-seropositive recipients of an allogeneic hematopoietic stem cell transplant. Liver toxicity was not observed in the clinical trials that led to its approval. This report highlights a case of letermovir associated transaminitis with successful rechallenge through peak and recovery of the hepatic serum enzymes. Because there is currently no published evidence to support the adverse event, the temporal relationship and response to rechallenge that was observed is essential to establishing the probable causality in this case.
Experiences of Donating Personal Data to Mental Health Research: An Explorative Anthropological Study
Authors: Sleigh Joanna
Published: June 2018

Technological developments, such as the advent of social networking sites, apps, and tracking ‘cookies’, enable the generation and collection of unprecedented quantities of rich personal and behavioural data, opening up a vast new resource for mental health research. Despite these non-traditional health-related data already forming a vital foundation of many new research avenues, little analysis has been done focusing on the experiences, motivations, and concerns of the individuals already engaged in data sharing and donation practices. This explorative study aims to investigate the experiences of individuals voluntarily donating their data to mental health research, specifically through the open data initiative OurDataHelps.org , which aims to develop effective suicide prevention tools. Qualitative semi-structured interviews and participant observation were used on a small sample of participants, yielding 3 key findings: (1) The relationship between participants and their data traces fluctuated between unconscious agency and hyper awareness through curatorship. (2) Despite having concerns about privacy and surveillance, participants were driven by altruistic motivations to engage with health researchers valued by their community, in the hope that their personal information could be of some benefit to future avenues of research. (3) In most cases represented in this sample group, motivation was found to stem from personal experiences with mental health, suicide, and loss. In the suicide survivor community, the experience of data donation is often valued as a method for emotional processing of a loss, connecting with the experiences of others, or as a way of regaining a sense of ‘purpose’. By understanding the motivations of individual participants, future projects can ensure that data donation processes are a positive experience and ultimately, increase and sustain the huge potential resources for health researchers worldwide.
Fostering Landscape Identity Through Participatory Design With Indigenous Cultures of Australia and Aotearoa/New Zealand
Authors: Marques Bruno , Grabasch Greg , McIntosh Jacqueline
Published: June 2018

To recognize the significance of indigenous cultures and their landscapes as well as to appraise these places, identification and evaluation have to focus on indigenous worldviews rather than on the deeply embedded Western civilization ideals and values of the design. Australian Aboriginal and New Zealand’s Maori cultures are genuinely rooted in experiential interrelationships with land with a particular orientation toward relationship and time entrenched in cosmology, narrative, and place. This article explores a participatory design strategy that facilitates and benefits indigenous cultures in Australia and Aotearoa/New Zealand. Using a design-led research approach, this study endeavors to nurture capacity building within “traditional custodians” in order to contribute to the sustainability of rural communities as well as caring for landscape. The article also introduces a framework better suited to nurturing and managing cultural landscapes. This framework demonstrates the potential to simultaneously empower indigenous cultures to protect things that matter but also to enhance their economic, political, and social freedom as they understand it through the lens of their own cultural values.
Early childhood teacher cultural Otherness and belonging
Authors: Arndt Sonja
Published: June 2018

Early childhood education settings are arguably places of community, togetherness and belonging. But what if they are not? What if individuals’ senses of identity, place or reality clash, do not fit or, worse, repel or offend? This article picks up on the largely under-researched area of teachers’ belonging and sense of cultural identity in early childhood settings. It argues for the critical importance of elevating and paying attention to teachers’ subject formation and identity. Drawing on some of the concerns and common conceptions of cultural Otherness in early childhood education, the article uses Kristeva’s foreigner lens and her theory on the subject in process to argue that teachers’ sense of belonging, of their own cultural identity and place, in their teaching team and in their early childhood setting is critical for an overall sense of openness and belonging throughout the setting. Teachers are commonly called on to nurture children’s and their families’ cultural identities. The sense of belonging intended through such practices depends on teacher attitudes and orientations to cultural Otherness that go beyond the surface – that allow for the difficult, complicated, unpredictable processes of becoming part of a centre community. This article offers a challenge to rethink teacher Otherness, for the (re-)elevation of their own sense of belonging in early childhood settings and teaching teams.
Primary Care Providers’ Attitudes Related to LGBTQ People: A Narrative Literature Review
Authors: Aleshire Mollie E. , Ashford Kristin , Fallin-Bennett Amanda , Hatcher Jennifer
Published: June 2018

The purpose of this article is to review the current literature describing primary care providers’ (PCPs) attitudes related to lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) people. LGBTQ individuals experience significant health disparities, and these inequities may be better understood via an ecological systems framework. PCPs’ actual or perceived discriminatory attitudes can lead to suboptimal treatment or health outcomes for LGBTQ people. A review of the literature from 2005 through January 2017 was completed using the Cumulative Index for Nursing and Allied Health Literature and PubMed (Medline) databases. The purpose, sample, measure(s), design, findings, strengths, and weaknesses of each study were examined; and findings were synthesized, summarized, and critically appraised. Eight articles were eligible for review. There was significant heterogeneity in the studies’ purposes, research questions, LGBTQ population(s) of focus, and findings. Many PCPs’ attitudes toward LGBTQ people were positive, but a minority of each studies’ participants had negative attitudes toward LGBTQ people. Stigma and health care barriers negatively affect LGBTQ health. Interventions must address LGBTQ health disparities at the individual, mesosytem, exosystem, and macrosystem levels. Research, education, and practice strategies all must be integrated across socioecological levels as components of a population-based approach to eliminate health disparities for LGBTQ persons.
Neural network–based terminal sliding mode applied to position/force adaptive control for constrained robotic manipulators
Authors: Cao Chongzhen , Wang Fengqin , Cao Qianlei , Sun Hui , Xu Wei , Cui Mengrong
Published: June 2018

This study considers the control problem of constrained robotic manipulators with dynamic uncertainties. A new force/position control strategy is proposed based upon terminal sliding mode and neural network. The terminal sliding mode combines position tracking with velocity tracking, and the neural network estimates unknown dynamics. Then, an adaptive control law is utilized to ensure finite-time convergent performance of position tracking and boundedness of contacting force tracking. Compared with existing force/position control strategies, the proposed strategy ensures the convergent performance without nominal model of the system dynamics. Simulation analysis verifies that the proposed strategy is effective.
Research on road traffic congestion index based on comprehensive parameters: Taking Dalian city as an example
Authors: Wang Wan-Xiang , Guo Rui-Jun , Yu Jing
Published: June 2018

Traffic congestion index reflects the state of traffic flow. The detection and analysis on traffic congestion index can be used to estimate the operation status of roads, to plan and organize road traffic for traffic managers, and to make the reasonable decisions of travelers to travel. The traffic conditions of several evaluation indexes were analyzed. Based on the theory of fuzzy mathematics, some membership functions of the evaluating indexes were designed. Three calculation methods of traffic congestion index were proposed. Their calculation results were compared mutually. The conclusion revealed that using saturation calculated by the corresponding service level of traffic congestion index not well reflect the traffic situation, what’s more, travel speed is used to calculate the congestion index of the first method. Using comprehensive parameters can calculate the congestion index of the third method. Both them are roughly similar and in line with the actual traffic phenomenon.
Remaining useful life prediction for power-shift steering transmission based on fusion of multiple oil spectra
Authors: Yan Shu-Fa , Ma Biao , Zheng Chang-Song
Published: June 2018

Remaining useful life prediction is a critical issue to fault diagnosis and health management of power-shift steering transmission. Power-shift steering transmission wear, which leads to the increase of wear particles and severe wear afterwards, is a slow degradation process, which can be monitored by oil spectral analysis, but the actual degree of the power-shift steering transmission degradation is often difficult to evaluate. The main purpose of this article is to provide a more accurate remaining useful life prediction methodology for power-shift steering transmission compared to relying solely on an individual spectral oil data. Our methodology includes multiple degradation data fusion, degradation index construction, degradation modelling and remaining useful life estimation procedures. First, the robust kernel principal component analysis is used to reduce the data dimension, and the state space model is utilized to construct the wear degradation index. Then, the Wiener process–based degradation model is established based on the constructed degradation index, and the explicit formulas for several important quantities for remaining useful life estimation such as the probability density function and cumulative distribution function are derived. Finally, a case study is presented to demonstrate the applicability of the proposed methodology. The results show that the proposed remaining useful life prediction methodology can objectively describe the power-shift steering transmission degradation law, and the predicted remaining useful life has been extended as 65 Mh (38.2%) compared with specified maintenance interval. This will reduce the maintenance times of power-shift steering transmission life cycle and finally save the maintenance costs.
The effects of windblown sand on the deterioration of mural paintings in cave 285, in Mogao caves, Dunhuang
Authors: Mikayama Akane , Hokoi Shuichi , Ogura Daisuke , Okada Ken , Su Bomin
Published: June 2018

The Mogao caves in Dunhuang are a UNESCO World Heritage Site located in the inland desert region of China. Within this site, cave 285 is one of the most important caves. Because a great deal of deterioration has taken place within this cave, a large amount of research has been carried out on the environmental effects of these changes. Results show that the east wall has been least affected by moisture, solar radiation, and daylight compared to the other walls and ceiling. However, the effects of deterioration, including scratches, detachment, and discoloration, are nevertheless seen on the east wall. In this study, we investigated the effects of adhesion and the collision of windblown sand as factors contributing to the deterioration of the east wall. We conclude that sand blown by high-velocity wind has led to detachment, flaking, and losses to the east wall including fading of the paintings.
Outcomes and Complications of Balloon and Conventional Functional Endoscopic Sinus Surgery
Authors: Chaaban Mohamad R. , Rana Nikunj , Baillargeon Jacques , Baillargeon Gwen , Resto Vicente , Kuo Yong-Fang
Published: June 2018

Background

Since the Food and Drug Administration approval of balloon sinuplasty (BSP) in 2005, no nationally representative population-based studies have examined the outcomes and adverse events of BSP.

Objective

To assess the rates of complications and revision surgery in patients who received BSP, functional endoscopic sinus surgery (FESS), or a hybrid procedure.

Methods

Using one of the nation’s largest commercial insurance databases, we conducted a retrospective cohort study of pediatric and adult patients diagnosed with chronic rhinosinusitis between 2011 and 2014 who underwent BSP, conventional FESS, or a hybrid procedure. The primary outcomes were surgical complication and revision rates within 6 months of initial surgery.

Results

A total of 16,040 patients who underwent sinus surgery were included. Overall, 2,851 patients underwent BSP, 11,955 underwent conventional FESS, and 1 234 underwent a hybrid procedure. BSP surgery was more likely to have been performed in an office setting (86.53%) compared to FESS (0.74%). The complication rate was 5.26% for BSP and 7.35% for conventional FESS. Revision rates were 7.89% for BSP, 16.85% for FESS, and 15.15% for a hybrid procedure.

Conclusion

Despite the low overall risk, major complications occur with BSP including cerebrospinal fluid leak, pneumocephalus, orbital complications, and severe bleeding. Otolaryngologists should discuss these risks with their patients. Prospective studies are still needed to compare outcomes of BSP with those of FESS.
Paths and Challenges toward Making Futures More of a Science: Introducing the C-K Approach to Designing Original and Robust Futures
Authors: Corsi Patrick
Published: June 2018

Developing a theoretical foundation toward establishing a futures science requires reconstructing original roots, whereby this field is conceptualized at higher generality levels. This article aims to provide a unifying framework for expressing any of the futures (from possible to plausible, plausible to undecidable) plus the mechanisms for manipulating these futures, with a view to promoting genuine futures thinking. Despite more than sixty years of studies about “the future,” the logical status of future-based conceptualizations still remains, at best, unclear. This article proposes to fill the continuity gap through designing a generative mechanism for expanding futures concepts based on formal theory. We use the well-developed Concept-Knowledge theory from Mines ParisTech, founded on set theory without the axiom of choice. The space K represents known/knowable things (present and past facts, available knowledge, what is known-to-be-known/to-be-not-known). The space C of concepts represents what is undecidable, neither provable nor unprovable at a given time. The C-K operating mechanism logically expands C concepts relatively to K, until they result in a conjunction with K—that is, become possible—possibly requiring extra development work. The article illustrates the approach on a series of field cases, whereby the path to futures robustness starts upstream at undecidable stages, as if to open up vast conceptual reservoirs of “futurabilities”—a foundational step transcending traditional futures studies. Futuring becomes a constructive and generative process, potentially leading to accepting infinities of futures formulations, where generativity is monitored as a design-oriented logic working on knowledge. Such an approach should improve the foresight practice.
The Effect of Social Class on Agency and Communion: Reconciling Identity-Based and Rank-Based Perspectives
Authors: Aydin Anna Lisa , Ullrich Johannes , Siem Birte , Locke Kenneth D. , Shnabel Nurit
Published: June 2018

How does social class affect people’s goals in social interactions? A rank-based perspective suggests actors from higher social classes (compared to lower social classes) have more agentic and less communal goals when interacting with same class or unspecified others. Focusing on targets’ social class, an identity-based perspective suggests the reverse: Actors should more strongly endorse communal (agentic) goals toward illegitimately lower class (higher class) compared to illegitimately higher class (lower class) targets, regardless of actors’ own social class. Three preregistered experiments ( N = 2,023) manipulated actor’s social class and the nature of the target (illegitimately higher/lower class, same class, unspecified) and measured participants’ goals in imagined interactions using the Circumplex Scales of Intergroup Goals. The identity-based perspective received strong support: Across studies, actors expressed stronger agentic (communal) goals toward higher class (lower class) targets. The rank-based perspective received limited support, with relatively low-class (vs. relatively high-class) actors expressing stronger communal goals toward same-class targets.
Hemoglobin spray as adjunct therapy in complex wounds: Meta-analysis versus standard care alone in pooled data by wound type across three retrospective cohort controlled evaluations
Authors: Elg Fredrik , Hunt Sharon
Published: June 2018

Objectives:

Low tissue oxygenation is a predictor of healing outcomes in complex wounds. Adjunct hemoglobin to aid oxygen diffusion has been demonstrated to achieve superior healing outcomes; however, the relative healing benefit across different wound types and evaluations has not yet been estimated. This article does this for the first time.

Methods:

Data were pooled from previously published real world controlled evaluations, three retrospective cohort controlled studies of a variety of wounds within standard care across hospital and primary care in the North of England in patients with diabetic foot ulcers (n = 40), chronic wounds (n = 100), and sloughy wounds (n = 200). Wounds were equally distributed between adjunct hemoglobin and control and the hemoglobin spray was used as per instructions for use and applied twice weekly, mostly for the duration of the wounds in all three evaluations. Wound healing over 26 weeks was the primary outcome in each of the evaluations, with additional healing and quality of life indicators including pain, wound size, slough coverage, wound exudate levels, adverse events, and dressing regimen used, over time. Each wound type with 10 or more patients in both the standard care alone and adjunctive hemoglobin groups (n = 257/73% of patients) was evaluated.

Results:

Cox proportional hazards log-rank regressions demonstrated significantly higher weekly chance of healing in each wound type (β, 95% range, sample, p): trauma 1.55 (1.23–1.96, n = 110, p < 0.001), diabetic foot ulcers 2.39 (1.52–3.75, n = 60, p = 0.01), venous leg ulcers 4.98 (1.69–14.7, n = 33, p = 0.04), burns 1.82 (1.11–2.99, n = 30, p = 0.02), and post-surgical wounds 2.75 (1.53–4.96, n = 24, p = 0.001). Results on additional healing indicators were consistent with the main findings. Notably, controlling for ischemia in diabetic foot ulcers resulted in an increased β of 5.68 (2.33–13.86, n = 29, p < 0.001).

Conclusion:

Adjunct hemoglobin spray, when implemented within standard care, is likely to achieve substantial healing benefits to patients, in particular for diabetic foot ulcers, venous leg ulcers, and post-surgical wounds.
Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training
Authors: Chen Sarah A. , Ong Chin Siang , Malguria Nagina , Vricella Luca A. , Garcia Juan R. , Hibino Narutoshi
Published: June 2018

Purpose:

Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction.

Description:

Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction.

Evaluation:

Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation.

Conclusions:

Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.
Adverse Events Among Patients With Diabetes and Ambulatory Practice Characteristics: Evidence From a Nationally Representative Survey
Authors: Gabriel Meghan Hufstader , Atkins Danielle , Chisholm Latarsha , Noblin Alice
Published: June 2018

Medications are the most common treatment modality for diabetes; however, medications may lead to inadvertent injury. Reducing adverse events in patients with diabetes is an important health care goal. Using pooled data from the 2011-2013 National Ambulatory Medical Care Survey, this cross-sectional, observational study explored univariate associations between patient safety for patients with diabetes as measured by adverse events and practice characteristics, including health information technology capabilities. This study found that the overall rate of adverse events among adults with diabetes is 7%, inclusive of injury, poisoning, or adverse effect of medical/surgical care or medicinal drug. We find evidence that e-prescribing, seeing a primary care provider, and being an established patient are associated with less adverse events.
Midterm outcome of fourth-generation ceramic-on-ceramic bearing surfaces in revision total hip arthroplasty
Authors: Chang Jun-Dong , Kim In-Sung , Mansukhani Sameer Ajit , Sharma Vishwas , Lee Sang-Soo , Yoo Je-Hyun
Published: June 2018

Purpose:

The purpose of this study is to evaluate the clinical and radiologic outcomes after revision total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) bearing surfaces.

Methods:

A total of 52 revision THAs (28 men and 19 women) using the fourth-generation CoC bearing surfaces were retrospectively evaluated. Both acetabular cup and femoral stem were revised in all cases. The mean follow-up period was 7.3 years (range, 4.0–9.9 years). The clinical results with Harris hip score (HHS), Western Ontario McMaster Osteoarthritis Index (WOMAC), and radiologic outcomes were evaluated.

Results:

At the final follow-up examination, the average HHS was 90.4 (range, 67–100). The average WOMAC pain and physical function score were 2.8 (range, 0–12) and 16.4 (range, 0–42), respectively. Complications were observed in 10 hips (19.2%). However, there were no bearing surface-related complications, and no cases of dislocation and squeaking. Retroacetabular pelvic osteolysis without cup loosening was observed in one hip at the final follow-up. However, no hip showed radiographic signs of cup loosening, vertical or horizontal acetabular cup migrations, and changes of inclinations during the follow-up period.

Conclusion:

Our data showed that clinical and radiologic outcomes after revision THA using fourth-generation CoC bearing were favorable. Hence, revision THA with the use of CoC bearing surfaces can be preferentially considered. Further studies with long-term follow-up data are warranted.
Factors Influencing the Changes in Masticatory Performance: The Suita Study
Authors: Kosaka T. , Kida M. , Kikui M. , Hashimoto S. , Fujii K. , Yamamoto M. , Nokubi T. , Maeda Y. , Hasegawa Y. , Kokubo Y. , Watanabe M. , Higashiyama A. , Miyamoto Y. , Ono T.
Published: June 2018

Introduction:

Although previous studies have identified various factors related to masticatory performance, which factors affect longitudinal changes in masticatory performance have not been clarified.

Objectives:

We aimed to clarify factors involved in changes to masticatory performance and construct models from factors related to masticatory performance in a longitudinal study of a general urban population in Japan.

Methods:

A total of 1,005 Japanese subjects (411 men, 594 women; mean age at baseline, 65.7 ± 7.7 years; mean follow-up period, 5.0 ± 0.9 years) were included in the Suita study. These subjects participated in dental checkups both at baseline (June 2008–December 2011) and at follow-up (June 2013–January 2017). The number of functional teeth and occlusal support areas was recorded and the latter assessed using the Eichner index. Subjects’ periodontal status was evaluated based on the Community Periodontal Index. Masticatory performance was determined using test gummy jelly. Factors affecting masticatory performance at follow-up and the degree of their effect were investigated by multiple linear regression analysis.

Results:

In multiple linear regression analysis with masticatory performance at follow-up as the dependent variable, baseline age, masticatory performance, number of functional teeth, and maximum bite force were significant independent variables. The results of multiple linear regression analyses by occlusal support at baseline identified only maximum bite force at baseline in subjects who were Eichner A and baseline age, masticatory performance, and number of functional teeth in subjects who were Eichner B as significant independent variables concerning masticatory performance at follow-up.

Conclusion:

Our study showed a relationship between longitudinal changes in masticatory performance and age, number of functional teeth, and maximum bite force and furthermore showed that the effects of these factors vary according to the residual number of occlusal support areas.

Knowledge Transfer Statement:

Patients and clinicians should recognize the importance of objective and quantitative assessment for chewing efficiency and understand that various factors are related to longitudinal changes in masticatory performance. The results of this study can provide basic data for preventing or improving the decline in masticatory performance for elderly people with varying numbers of occlusal support areas.
How bacteria hack the matrix and dodge the bullets of immunity
Authors: Paulsson Magnus , Riesbeck Kristian
Published: June 2018

Haemophilus influenzae,Moraxella catarrhalisandPseudomonas aeruginosaare common Gram-negative pathogens associated with an array of pulmonary diseases. All three species have multiple adhesins in their outer membrane,i.e.surface structures that confer the ability to bind to surrounding cells, proteins or tissues. This mini-review focuses on proteins with high affinity for the components of the extracellular matrix such as collagen, laminin, fibronectin and vitronectin. Adhesins are not structurally related and may be lipoproteins, transmembrane porins or large protruding trimeric auto-transporters. They enable bacteria to avoid being cleared together with mucus by attaching to patches of exposed extracellular matrix, or indirectly adhering to epithelial cells using matrix proteins as bridging molecules. As more adhesins are being unravelled, it is apparent that bacterial adhesion is a highly conserved mechanism, and that most adhesins target the same regions on the proteins of the extracellular matrix. The surface exposed adhesins are prime targets for new vaccines and the interactions between proteins are often possible to inhibit with interfering molecules,e.g. heparin. In conclusion, this highly interesting research field of microbiology has unravelled host–pathogen interactions with high therapeutic potential.