bluuebunny/crossref_metadata_2025 huggingface dataset:
ПАТОБІОМЕХАНІЧНІ ПОРУШЕННЯ ТА МЕТОДИ КОРЕКЦІЇ ПРИ ПЕРВИННОМУ ГОНАРТРОЗІ У ПАЦІЄНТІВ ПОХИЛОГО ВІКУ
Authors: Bakalyuk T. G. , Misula I. R. , Stelmakh H. O. , Zawidniuk Yu. V. , Maxiv H. Ya. , Zhevoronko N. B.
Published: January 2019

В осіб похилого та старечого віку проблема остеоартрозу (ОА) набуває особливого значення у зв’язку з супутніми захворюваннями та інволютивними змінами в організмі. Патологія колінних суглобів спричиняє зміни функціонування всього опорно-рухового апарату, в першу чергу хребта. Підбір для хворих на ОА реабілітаційних комплексних програм, які дозволять відновити статико-динамічні властивості кістково-м’язової системи, і будуть мати одночасно протизапальну, знеболювальну та антиспазмолітичну дію, залишається актуальним завданням. Все це спонукає до пошуку шляхів корекції патобіомеханічних порушень при проведенні реабілітації хворих на ОА колінних суглобів в похилому віці.

Мета роботи – патогенетичне обґрунтування застосування реабілітаційного комплексу із включенням методик для корекції патобіомеханічних порушень у хворих на первинний гонартроз в похилому віці на амбулаторному етапі реабілітації.

Матеріали і методи. У дослідженні брали участь 42 хворих на первинний гонартроз із неспецифічним больовим синдромом у поперековому відділі хребта, які знаходились на амбулаторному етапі реабілітації. Середній вік становив (65,13±0,31) р., тривалість захворювання – (9,24±0,42) р. Пацієнти були поділені на 2 групи, реабілітаційні комплекси відрізнялись за методиками застосування об’ємного пневмопресингу.

Результати. Встановлено достовірне (р<0,05) зменшення больового синдрому як у суглобі, так і в поперековому відділі хребта, покращення функціональної активності, тонусу м’язів та фізичної працездатності при застосуванні запропонованого реабілітаційного комплексу із корекцією патобіомеханічних порушень.

Висновки. На основі отриманих результатів запропоновано диференційований підхід до призначення реабілітаційних заходів у хворих на первинний гонартроз залежно від патобіомеханічних порушень. За допомогою комбінованої методики застосування об’ємного пневмопресингу локально на колінні суглоби та на м’язи спини усуваються зміни в м’язовому апараті колінних суглобів та хребта.
СУЧАСНІ АСПЕКТИ РЕАБІЛІТАЦІЇ ДІТЕЙ ІЗ SPINA BIFIDA
Authors: Boyarchuk O. R. , Hlushko K. T. , Svirska N. M. , Kovalyov V. V. , Shylo O. R.
Published: January 2019

Спинномозкова грижа є однією з найпоширеніших вроджених вад, що полягає у поєднаному ураженні органів і систем та спричиняє ранню постійну недієздатність і навіть смерть. Лікування та реабілітація дітей зі Spina bifida є складним та довготривалим процесом, що потребує залучення та співпраці лікарів різних спеціальностей.

Метою нашої роботи було проаналізувати літературні дані щодо сучасних можливостей покращення якості життя дітей з розщілиною хребта. До найпоширеніших проблем у дітей з цією патологією належать обмеження чи повна відсутність рухливості, зниження шкірної чутливості та утворення ран і пролежнів, розвиток гідроцефалії, нейрогенні розлади сечового міхура та кишечника, що часто супроводжуються нетриманням сечі та випорожнень; у тяжких випадках спостерігаються когнітивні розлади. Обмеження чи відсутність фізичної активності призводить до ожиріння і пов’язаних із ним ускладнень. Забезпечення здатності самостійно пересуватися та покращення фізичної активності знижує ризик ожиріння та поліпшує соціальні контакти й якість життя. Реабілітація нейрогенних розладів сечового міхура забезпечується чистою періодичною катетеризацією, проведенням лікувальної фізкультури та фізіотерапії. Вправи лікувальної фізкультури спрямовані на зміцнення м’язів тазового дна. Різновид фізіотерапії залежить від виду нейрогенного сечового міхура. Одним і з ефективних методів корекції розладів сечовипускання є метод біологічного зворотного зв’язку. Він у досить простий спосіб дозволяє навчити дитину координувати роботу м’язів тазового дна.

Висновок. Реабілітація дітей із spina bifida є довготривалою і багатоцільовою роботою, яка у значній мірі залежить від стану дитини та потребує мультидисциплінарного ведення. Об’єднання зусиль лікарів та батьків, використання сучасних методів реабілітації можуть покращити якість життя дітей із spina bifida.
ТРОМБОФІЛІЯ, УСКЛАДНЕНА РЕЦИДИВУЮЧОЮ ТРОМБОЕМБОЛІЄЮ ЛЕГЕНЕВОЇ АРТЕРІЇ – КЛІНІЧНИЙ ВИПАДОК ІЗ АНАЛІЗОМ СУЧАСНИХ ДІАГНОСТИЧНО-ЛІКУВАЛЬНИХ АЛГОРИТМІВ ВЕДЕННЯ ХВОРИХ
Authors: Shved M. I. , Kovbasa N. M. , Geryak S. M. , Lypovetska S. Y. , Levytska L. V. , Prokopovich O. A. , Sydorenko O. L.
Published: January 2019

Венозний тромбоз і емболія (ВТЕ) – одне з найтяжчих за перебігом і загрозливих для життя ускладнень.

Мета дослідження – проаналізувати сучасні підходи до діаґностики і лікування хворих із тромбофілією, ускладненою рецидивуючою тромбоемболією легеневої артерії, на основі власного клінічного випадку.

Результати. Для оцінки ризику ВТЕ у госпіталізованих пацієнтів терапевтичного профілю доцільно вико­ристо­вувати шкалу Падуа, а при повторних ВТЕ/ТЕЛА, особливо у пацієнтів молодого віку, показане обов’язкове обстеження з метою підтвердження/виключення вродженої або набутої тромбофілії, що визначає програму профілактики повторних ВТЕ. У хворих з діагностованою тромбофілією необхідно використовувати персоніфікований підхід до вибору антикоагулянтних засобів профілактики. Показання для застосування прямих чи непрямих анти­коагулянтних засобів визначаються наявністю у пацієнта певної форми тромбофілії. Лише використання такого діагностичного алгоритму дозволяє своєчасно призначити таким пацієнтам адекватну профілактичну антикоагулянтну терапію, що підтверджує описаний нами клінічний випадок.

Висновок. Велика частота захворюваності на ВТЕ, недостатні знання практикуючих лікарів щодо діагностики самої хвороби, визначення її причин і клінічних форм, а також неоднозначність отриманих результатів різних програм лікування і профілактики ВТЕ/ТЕЛА обґрунтовують необхідність проведення додаткових багатоцентрових клінічних досліджень та більш широкого обговорення даної проблеми в лікарському середовищі.
Estratégias enunciativas na releitura do modo de dizer jornalístico: o caso Estado de Minas
Authors: Barreto Paulo Jefferson Pereira
Published: January 2019

Ao se pautar pela análise da capa de uma das edições do jornal Estado de Minas, este artigo pretende investigar os efeitos de sentido construídos pela releitura no modo de dizer jornalístico, comumente associado às primeiras páginas de jornais impressos. Trata-se de uma capa publicada em novembro de 2015 pelo referido jornal, cuja grande característica é a composição gráfica, radicalmente diferente do modelo tradicional de capas de jornais, e o jogo intertextual e discursivo estabelecido com a letra da canção Que país é esse?, da banda Legião Urbana. Assim, recorre-se ao aporte teórico-metodológico da semiótica discursiva, especialmente no tocante aos estudos sobre o sincretismo em textos verbo-visuais. Isso porque, ao que parece, a mobilização de determinadas estratégias enunciativas, associadas às mudanças na composição plástica de textos dessa natureza, podem criar simulacros pouco prováveis para o discurso jornalístico, forjando efeitos de literariedade, relações interdiscursivas e alusões intertextuais que reconfiguram o modo de dizer do enunciador jornal e a maneira como os conteúdos são apresentados ao enunciatário-leitor.
Semiótica discursiva e comunicação: questões sobre linguagem, texto e interação
Authors: Mendes Conrado Moreira
Published: January 2019

No presente artigo, articulam-se os campos da semiótica discursiva e da comunicação em torno dos conceitos de linguagem, texto e interação. Para tanto, em primeiro lugar, aborda-se o papel da linguagem como principal ponto de interseção entre essas duas áreas. Posteriormente, considera-se a constituição do viés comunicacional, graças ao qual se constrói o objeto desse campo para, em seguida, localizar o papel da semiótica como dinâmica da comunicação, sob a perspectiva dessa última. Logo depois, inverte-se essa lógica e se concebe uma noção semiotizada de comunicação (como processo, práxis), segundo a qual, o texto é muito mais que um objeto de onde se depreende a significação; pelo texto, para além da significação stricto sensu, depreende-se o simulacro de todos os elementos do processo comunicativo. Finalmente, aborda-se a relação entre comunicação e semiótica a partir do conceito de interação, considerando-se a especificidade de como cada campo encara tal conceito, para, então, apresentar os quatro regimes de interação e sentido concebidos pela sociossemiótica de Eric Landowski: a programação, a manipulação, o ajustamento e o acidente, os quais constituem uma sintaxe geral da interação.
O exercício do acontecimento: estetização da violência em Pulp Fiction
Authors: Silva Gabriela Dos Santos e , Queiroz Zeno
Published: January 2019

Com base principalmente na teoria tensiva desenvolvida por Claude Zilberberg, este artigo tem como principal meta averiguar quais procedimentos cinematográficos são adotados no filme Pulp Fiction para modular os efeitos de sentido causados pela violência, a fim de examinar os modos como extensidade e intensidade se articulam na construção do espaço tensivo do enunciado fílmico e como isso repercute na experiência estética do enunciatário. Inicialmente, percebe-se que a violência se insere em um regime fundado na regularidade, de forma que as variações intensivas são controladas pela dimensão da extensidade, dificilmente havendo uma saturação de intensidade e, portanto, jamais sendo atribuído à violência um estatuto de acontecimento. Valendo-se, assim, de alguns mecanismos fílmicos, que pretendemos descrever, Tarantino parece investir em andamentos, tonicidades, temporalidades e espacialidades adequados para o exercício da inteligibilidade, isto é, lança mão de procedimentos que promovem mais a apreensão cognitiva das cenas de violência do que a sua experiência afetiva, o que permitiria ao enunciatário fruir a obra preponderantemente na dimensão racional. Dessa maneira, a partir de estudos semióticos bastante recentes e, a nosso ver, extremamente adequados aos nossos propósitos, intencionamos ampliar o campo de discussão acerca de um aspecto muito peculiar do trabalho de Quentin Tarantino e lançar luz sobre questões que podem – e devem – ser desenvolvidas em pesquisas futuras.
Análise semiótica de um espaço de ensino teórico/prático da arquitectura
Authors: Marcos Isabel
Published: January 2019

Se queremos passar da apreensão intuitiva das diferenças espacio-culturais ao conhecimento metodológico do espaço encarnado na nossa vivência, vejamos um exemplo relativamente simples de uma análise semiótica. O objecto desta análise é a minha sala de aula teórica / prática de arquitectura na ESBAL (Escola Superior de Belas-Artes de Lisboa) em 1985. Aqui os métodos da semiótica do espaço permitem-nos aceder ao conhecimento e ao funcionamento deste espaço. Este artigo está organizado em três grandes partes: o plano da expressão (análise dos topos – A), o plano do conteúdo (análise do fazer – B) e a relação do plano da expressão e do conteúdo (a Semiose e a Geografia Sémica – C).
Longitudinal Trajectories of Fasting Plasma Glucose and Risks of Cardiovascular Diseases in Middle Age to Elderly People Within the General Japanese Population: The Suita Study
Authors: Ogata Soshiro , Watanabe Makoto , Kokubo Yoshihiro , Higashiyama Aya , Nakao Yoko M. , Takegami Misa , Nishimura Kunihiro , Nakai Michikazu , Kiyoshige Eri , Hosoda Kiminori , Okamura Tomonori , Miyamoto Yoshihiro
Published: January 2019

Background

Few previous studies used information on changes in fasting plasma glucose (
FPG
) assessed at multiple points in time in relationship to cardiovascular disease (
CVD
) incidence. The present study aimed to identify subgroups of
FPG
trajectories with assessing
CVD
incidence.

Methods and Results

The present study was based on the Suita study, a population‐based cohort study in Japan. The primary outcome was incidence of the first
CVD
events consisting of stroke and coronary heart diseases between 1989 and 2013. The main exposure was
FPG
assessed every 2 years. We used joint latent class mixed models to derive
FPG
trajectories over time while evaluating cumulative incidence of
CVD
, and categorized participants into several subgroups based on those trajectories and cumulative incidence. We observed 356 and 243
CVD
events during the median follow‐up of 17.2 and 20.2 years among 3120 men and 3482 women, respectively. The joint latent mixed models found 3 subgroups in men and 2 subgroups in women. Of the 3 subgroups in men, 1 subgroup had
FPG
levels that increased sharply (96.5–205.0 mg/dL from aged 40 to 80 years) and higher
CVD
cumulative incidence. Of the 2 subgroups in women, 1 subgroup had
FPG
levels that increased sharply (97.7–190.5 mg/dL from aged 40 to 80 years) and tended to have slightly higher
CVD
incidence compared with the other subgroup.

Conclusion

It can be important to manage
CVD
risk factors especially for people whose
FPG
trajectories sharply increased to prevent
CVD
.
Turbulence Variations in the Upper Troposphere in Tropical Cyclones from NOAA G-IV Flight-Level Vertical Acceleration Data
Authors: Molinari John , Rosenmayer Michaela , Vollaro David , Ditchek Sarah D.
Published: January 2019

The NOAA G-IV aircraft routinely measures vertical aircraft acceleration from the inertial navigation system at 1 Hz. The data provide a measure of turbulence on a 250-m horizontal scale over a layer from 12.8- to 14.8-km elevation. Turbulence in this layer of tropical cyclones was largest by 35%–40% in the inner 200 km of radius and decreased monotonically outward to the 1000-km radius. Turbulence in major hurricanes exceeded that in weaker tropical cyclones. Turbulence data points were divided among three regions of the tropical cyclone: cirrus canopy; outside the cirrus canopy; and a transition zone between them. Without exception, turbulence was greater within the canopy and weaker outside the canopy. Nighttime turbulence exceeded daytime turbulence for all radii, especially within the cirrus canopy, implicating radiative forcing as a factor in turbulence generation. A case study of widespread turbulence in Hurricane Ivan (2004) showed that interactions between the hurricane outflow channel and westerlies to the north created a region of absolute vorticity of −6 × 10−5 s−1 in the upper troposphere. Outflow accelerated from the storm center into this inertially unstable region, and visible evidence for turbulence and transverse bands of cirrus appeared radially inward of the inertially unstable region. It is argued that both cloud-radiative forcing and the development of inertial instability within a narrow outflow layer were responsible for the turbulence. In contrast, a second case study (Isabel 2003) displayed strong near-core turbulence in the presence of large positive absolute vorticity and no local inertial instability. Peak turbulence occurred 100 km downwind of the eyewall convection.
Temporal and Spatial Characteristics of Short-Term Cloud Feedback on Global and Local Interannual Climate Fluctuations from A-Train Observations
Authors: Yue Qing , Kahn Brian H. , Fetzer Eric J. , Wong Sun , Huang Xianglei , Schreier Mathias
Published: January 2019

Observations from multiple sensors on the NASA Aqua satellite are used to estimate the temporal and spatial variability of short-term cloud responses (CR) and cloud feedbacks λ for different cloud types, with respect to the interannual variability within the A-Train era (July 2002–June 2017). Short-term cloud feedbacks by cloud type are investigated both globally and locally by three different definitions in the literature: 1) the global-mean cloud feedback parameter λGG from regressing the global-mean cloud-induced TOA radiation anomaly ΔRG with the global-mean surface temperature change ΔTGS; 2) the local feedback parameter λLL from regressing the local ΔR with the local surface temperature change ΔTS; and 3) the local feedback parameter λGL from regressing global ΔRG with local ΔTS. Observations show significant temporal variability in the magnitudes and spatial patterns in λGG and λGL, whereas λLL remains essentially time invariant for different cloud types. The global-mean net λGG exhibits a gradual transition from negative to positive in the A-Train era due to a less negative λGG from low clouds and an increased positive λGG from high clouds over the warm pool region associated with the 2015/16 strong El Niño event. Strong temporal variability in λGL is intrinsically linked to its dependence on global ΔRG, and the scaling of λGL with surface temperature change patterns to obtain global feedback λGG does not hold. Despite the shortness of the A-Train record, statistically robust signals can be obtained for different cloud types and regions of interest.
Energetics of Eddy–Mean Flow Interactions along the Western Boundary Currents in the North Pacific
Authors: Yan Xiaomei , Kang Dujuan , Curchitser Enrique N. , Pang Chongguang
Published: January 2019

The energetics of eddy–mean flow interactions along two western boundary currents of the North Pacific, the Kuroshio and Ryukyu Currents, are systematically investigated using 22 years of numerical data from the Ocean General Circulation Model for the Earth Simulator (OFES). For the time-mean and time-varying flow fields, all the energy components and conversions exhibit inhomogeneous spatial distributions. In the two currents, complex cross-stream and along-stream variations are seen in the eddy–mean flow energy conversions. East of Taiwan, the kinetic energy is mainly transferred from the mean flow to the eddy field through barotropic instability, whereas the baroclinic energy conversions form a meridional dipole structure caused by the topographic constraint. In the northern area, particularly, the eddy field drains 2.25 × 108 W of kinetic energy and releases 2.82 × 108 W of available potential energy when interacting with the mean flow, indicating that mesoscale eddies impinging on the Kuroshio decay with baroclinic inverse energy cascades. In the Ryukyu Current, inverse energy conversions from the eddy field to the mean flow also dominate the power transfer in the subsurface layer. The eddy field transfers 0.16 × 108 W of kinetic energy and 1.89 × 108 W of available potential energy to the mean flow, suggesting that meososcale eddies play an important role in maintaining the velocity and hydrographic structure of the current. In other areas, both barotropic and baroclinic instabilities contribute to the generation of eddy kinetic energy with the latter one providing more than 3 times as much power as the former one.
A Method for Reconstruction of Anterior Commissure Glottal Webs With Endoscopic Fibro-Mucosal Flaps
Authors: Zeitels Steven M. , Hillman Robert E.
Published: January 2019

Background:

Anterior-commissure (AC) cicatrization and web formation is a difficult problem that can result from a variety of clinical scenarios. An advancement-rotation flap utilizing papillomatous epithelium and subepithelial fibrous tissue has been previously described. For patients in whom there was not excessive redundant papillomatosis covering the AC web, including other clinical scenarios, a microlaryngoscopic procedure was designed to lengthen the glottal/subglottal aperture using substantial local fibro-mucosal tissue. Although it has been done for over a decade, this approach is not widely known and to our knowledge not photo-documented.

Study Design:

Retrospective.

Material and Methods:

An analysis was done with Institutional Review Board approval that identified 42 patients who underwent 53 procedures to treat AC webs, which were reconstructed with local soft-tissue flaps and without any device/stent to maintain the glottal aperture. The microlaryngoscopic method and technical nuances for this approach with and without diseased epithelium are described and photo-documented. Tactical mucosal incisions were made to facilitate advancement and/or rotation of fibro-mucosal flaps with enough length to resurface the medial aspect of 1 vocal fold. The scarred submucosal soft tissue in the AC region was separated with cold instruments, and the flaps were sutured in position. Variations of this method are demonstrated mobilizing fibro-mucosal soft tissue from different locations, including the web itself, contralateral vocal fold, infrapetiole region, and/or the inner aspect of the thyroid lamina below the anterior-commissure tendon.

Results:

Of the 53 cases in which anterior commissure glottal webs were reconstructed with endoscopic fibro-mucosal flaps, 31 of 53 had recurrent respiratory papillomatosis (RRP). Redundant RRP comprised the majority of the flap in 14 of 31 RRP cases. Fibro-mucosal tissue without a substantial amount of disease occurred in 17 of 31 RRP cases. Of the remaining 22 AC web cases, the primary diagnoses observed were: glottic cancer = 7 of 22, intraepithelial dysplasia = 10 of 22, glottic trauma = 3 of 22, congenital = 1 of 22, and radiotherapy = 1 of 22.

Conclusion:

Endolaryngeal utilization of local fibro-mucosal tissue to lengthen the glottal/subglottal aperture for AC webs is an effective strategy. It can be done without using devices or keels for webs that are congenital or from nonsurgical trauma, idiopathic disease, or postsurgical traumatic cicatrization of the anterior commissure subsequent to treatment of epithelial disease (eg, cancer, dysplasia, and RRP). Normalizing the architecture of the anterior commissure was a valuable asset in patients who require future treatment of epithelial diseases, especially in an office-based setting.
Leveraging Policy Implementation for Social Justice: How School Leaders Shape Educational Opportunity When Implementing Policy for English Learners
Authors: Mavrogordato Madeline , White Rachel S.
Published: January 2019

Purpose: School leaders become arbiters of educational opportunity by shaping how policies are implemented within their buildings. Yet the role that school leaders play in enacting policies designed to expand equity for historically marginalized groups of students such as English learners (ELs) has received little attention in the research literature. This study examines the role that school leaders play in enabling or obstructing social justice by examining how leaders implement one policy, that which dictates the process of exiting students from EL status and reclassifying them as English proficient. Research Method: We conducted qualitative case studies of eight elementary schools across four districts in Texas, each of which included an observation of the year-end meetings when committees review EL students’ files and make reclassification decisions, as well as a semistructured focus group interview. Findings: School leaders both enable and obstruct practices that reflect social justice leadership while implementing reclassification policy, but lack awareness that they are doing so. Policy understanding and approach to implementation mediated the ways in which school leaders were able to leverage policy implementation to enable social justice and promote equity. Implications: We draw upon research findings to provide a framework for helping school leaders leverage policy implementation to enact social justice in their schools.
‘Prophets in the pay of state’: The institutionalization of the middle-class habitus in schooling between 1880 and 2010
Authors: De Keere Kobe , Spruyt Bram
Published: January 2019

Although it is well established that contemporary school-based pedagogy continues to be primarily oriented towards a middle-class habitus, little research has documented how crucial elements of such habitus, like an expressive self-conception and emotional management, became integrated in the educational institute and its philosophy. Therefore, this article reconstructs how the current middle-class habitus was institutionalized and what type of personality structuring it eventually replaced. We study the shifts in pedagogical ideas, the role of education and the position of teachers and relate these to structural factors such as state-formation and changing class structures. We draw on the process-relational approach of Elias and Bourdieu and perform a content analysis of 480 pedagogical advice articles published in Flanders (Belgium) between 1880 and 2010, to demonstrate how a discourse of formalization and self-control has been substituted by a more informalized and expressive view. We conclude with a reflection on the impact of such an expressive pedagogical regime on the reproduction of class inequality.
‘New’ Social Theory? Abbott and Social Studies of Finance
Authors: Newton Tim
Published: January 2019

This article uses an analysis of social studies of finance to explore Andrew Abbott’s ideas about how we construct ‘new’ social theory. Drawing on Abbott, it is argued that social studies of finance tend as much towards the recycling of existing conjecture as the presentation of markedly novel argument. Yet Abbott’s position also questions such potential critique by suggesting that theoretical recycling and recombination represent ‘normal’, and often creative, academic behaviour.
What Is Central to Political Belief System Networks?
Authors: Brandt Mark J. , Sibley Chris G. , Osborne Danny
Published: January 2019

A central challenge for identifying core components of a belief system is examining the position of components within the structure of the entire belief system. We test whether operational (i.e., positions on issues) or symbolic (i.e., affective attachments to political groups and labels) components are most central by modeling a political belief system as a network of interconnected attitudes and beliefs. Across seven waves of representative panel data from New Zealand, we find that symbolic components are more central than operational components ( ds range = 0.78-0.97). Symbolic components were also closer than operational components in the network to self-reported voting ( d = −2.43), proenvironmental actions ( ds = −1.71 and −1.63), and religious behaviors ( d = −0.74). These findings are consistent with perspectives that emphasize the importance of symbolic politics in tying belief systems together and motivating behavior, and further the link between political belief system research and network science.
Sacred Excess: Organizational Ignorance in an Age of Toxic Data
Authors: Schwarzkopf Stefan
Published: January 2019

Actors in data-intensive industries at times deliberately induce and reproduce organizational ignorance by engaging in over-production of data. This observation leads the paper to make two claims. First, members of these industries fetishize data excess not in order to reduce, but in order to reproduce and stabilize organizational ignorance. Second, in this process of fetishization, organizational ignorance gives rise to forms of collective effervescence similar to that found in totemistic religions. This effervescence allows organizational actors to draw defining lines around that which is marked as awe-inspiring, dangerous and off-limits, namely the sacred. In reviewing organizational ignorance from the perspective of the sacred, this paper proposes that, paradoxically, contemporary forms of data creation allow companies and industries to organize themselves around ignorance as opposed to the promise of knowledge and insight. The paper uses this theoretical proposal in order to outline the contours of an alternative ontology of organizational ignorance, one that understands this phenomenon in terms of excessive presence of data and information.
Common dedication to facilitating good dying experiences: Qualitative study of end-of-life care professionals’ attitudes towards voluntary assisted dying
Authors: Blaschke Sarah-May , Schofield Penelope , Taylor Keryn , Ugalde Anna
Published: January 2019

Background:

Debate about appropriate and ethically acceptable end-of-life choices is ongoing, which includes discussion about the legalization of voluntary assisted dying. Given health professionals’ role in caring for patients at the end life, their stance towards assisting a person with dying can have implications for policy development and implementation in jurisdictions where law changes are being considered.

Aim:

To explore end-of-life care professionals’ attitudes towards voluntary assisted dying 6 months prior to vote on legalization.

Design:

Qualitative study using textual data collected through semi-structured interviews. Purposive sampling strategy used to collect a broad representation of perspectives. Audio-recorded interviews were transcribed verbatim and subjected to qualitative descriptive analysis techniques.

Participants:

A total of 16 health professionals with experience in caring for people with life-limiting illness.

Results:

Participants reported two overarching positions grounded in differing moral philosophies with compelling arguments both for and against legalization of voluntary assisted dying. A third and common line of argument emerged from areas of shared concern and uncertainty about the practical consequences of introducing voluntary assisted dying. While a diversity of opinion was evident, all participants advocated for more public education and funding into end-of-life care services to make high-quality care equitable and widely available.

Conclusion:

Common dedication to reducing suffering and facilitating good dying experiences exists among experts despite their divergent views on voluntary assisted dying. Ongoing engagement with stakeholders is needed for practical resolution in the interest of developing health policy for best patient care.
Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction With a Modified Docking Technique With and Without Suture Augmentation
Authors: Leasure Jeremi , Reynolds Kerisimasi , Thorne Marc , Escamilla Rafael , Akizuki Ken
Published: January 2019

Background:

Throwing athletes with ulnar collateral ligament (UCL) injury and symptomatic valgus instability can expect to return to the same or higher level of play. Reconstruction with tendon graft is the dominant method of surgical treatment. Recent evidence suggests that spanning the joint with a suture anchored on both sides is biomechanically equivalent to reconstruction, with faster time to return to play. The authors developed a hybrid UCL reconstruction technique augmented with a suture brace to improve joint stability.

Purpose/Hypothesis:

The purpose of this study was to biomechanically evaluate a hybrid reconstruction technique and compare its performance to reconstruction without augmentation. The authors hypothesized that (1) both groups would lose stability after the simulated tear and regain stability with treatment, (2) the suture augmentation would improve stability, and (3) the addition of the suture anchors near the bone tunnels would not decrease the strength of the hybrid reconstruction.

Study Design:

Controlled laboratory study.

Methods:

Ten matched pairs of cadaveric arms were dissected to expose the UCL. Each elbow was mounted on a test frame at 90° of flexion. A cyclic valgus rotational torque was applied to the humerus with the UCL in its intact state and repeated in its surgically torn state. Finally, each specimen received either a hybrid reconstruction with suture brace or a reconstruction and was again put through the cyclic protocol, followed by a valgus rotation load-to-fail protocol.

Results:

Gap formation in the torn state for the reconstruction and hybrid reconstruction groups (0.9 ± 0.1 mm and 0.8 ± 0.1 mm, respectively) was significantly higher ( P = .009 and P = .0002) than in the intact state (0.6 ± 0.2 mm and 0.6 ± 0.3 mm, respectively). After the procedures, the hybrid group showed greater resistance to gapping ( P = .017) as compared with the reconstruction group (0.4 ± 0.2 mm and 0.6 ± 0.1 mm). During load to failure, no hybrid reconstructions failed from bone fracture or screw pullout. No statistical differences were found for failure torque ( P = .058) and stiffness ( P = .101). Gap at 10 N·m was significantly lower ( P = .014) for the hybrid reconstruction group than for the reconstruction group.

Conclusion:

The current study showed that hybrid reconstruction with suture bracing replicated the time-zero strength of traditional UCL reconstruction and may be more resistant to joint gapping during low cyclic load and load to failure. The combination of the bone tunnels and fixation screw holes did not appear to weaken the construct.

Clinical Relevance:

This study demonstrated that reconstruction with suture bracing has important time-zero stability and strength as compared with the gold standard of UCL reconstruction. This technique may be useful for throwing athletes who need UCL reconstruction.
Developing an applied algorithm for multi-trip vehicle routing problem with time windows in urban waste collection: A case study
Authors: Babaee Tirkolaee Erfan , Abbasian Parvin , Soltani Mehdi , Ghaffarian Seyed Ali
Published: January 2019

This paper studies a multi-trip vehicle routing problem with time windows specifically related to urban waste collection. Urban waste collection is one of the municipal activities with large costs and has many practical difficulties. In other words, waste collection and disposal is a costly task due to high operating expenses (fuel, maintenance, recycling, manpower, etc.) and small improvements in this field can result in tremendous savings on municipal expenditure. In the raised problem, the goal is to minimize total cost including traversing cost, vehicle employment cost, and exit penalty from permissible time windows. In this problem, the waste is deposited at the points indicating the demand nodes, in which each demand shows the volume of generated waste. Considering multiple trips for vehicles and time windows are the most critical features of the problem, so that the priorities of serving some specific places such as hospitals can be observed. Since vehicle routing problems (VRP) belongs to NP-hard problems, an efficient simulated annealing (SA) is proposed to solve the problem. The computational results show that our proposed algorithm has a great performance in a short computational time in comparison with the CPLEX solver. Finally, in order to demonstrate the applicability of the model, a case study is analyzed in Iran, and the optimal policies are presented.
Comparative experimental and numerical study on energy consumption of track-pin rubber bushing for high-speed tracked vehicles
Authors: Chen Bing , Zhang Lijie , Feng Zhanzong , Du Yuanyuan , Mo Wei , Tamma Kumar K
Published: January 2019

During the running of high-speed tracked vehicles, the energy loss due to the rotation and tension-compression deformation of the rubber bushing between the track pin and the track plate causes the largest proportion of energy consumption in tracked vehicle propulsion systems; therefore, it is critical to study energy consumption of this component as it is the largest amount of energy loss of the system. First, the theoretical modeling and analysis of the torsional hysteresis and the tension-lag of the hanging glue on the pin of the track pin are conducted. Both energy loss of torsional hysteresis and energy loss of the hysteresis of tension and pressure are obtained when the rubber bushings pass the sprocket, the road wheel, and the idler. Second, a new and novel rubber bushing model based upon the rubber bushing elastic element, the friction element, and the viscoelastic element is proposed. Then the parameters (such as the static elastic stiffness and the maximum friction) of each unit are identified according to the dynamic characteristic experiment. Finally, the numerical simulation results of MATLAB with different stiffness and damping coefficient in addition to tension and compression energy consumption under different frequencies are obtained, and the comparisons are basically consistent with the experimental results; the average errors are less than 8%. The present analytical calculation model is practically useful and can meet the requirements of engineering applications.
The paths of offender rehabilitation and the European dimension of punishment: New challenges for an old ideal?
Authors: Martufi Adriano
Published: January 2019

In recent years, the aim of offender rehabilitation has grown to become one of the most prominent features of European penal policy. European legal texts, however, lack a clear definition of this concept, thus leaving to supranational Courts the responsibility of clarifying its meaning. This article analyses the case law of European Court of Human Rights and the Court of Justice of the European Union as regards rehabilitation. It argues that the Europeanization of criminal justice is generally contributing to a re-conceptualization of this aim of punishment with relevant implications for the national criminal justice system and its actors. Finally, the article underscores the differences in the approach to rehabilitation between the two Courts, trying to assess their potential impact on national law and their significance in the broader context of European penal policy.
Observations From the Architects of the Fields of Learning Disabilities and Emotional/Behavioral Disabilities
Authors: Chamberlain Steven P.
Published: January 2019

In 2010, Intervention in School and Clinic undertook a project to interview “giants” in the fields of learning disabilities and emotional/behavioral disabilities. The purpose of the interviews was to document the perspectives and reflections of leaders who had contributed to their respective fields over several decades (i.e., in most instances spanning back to the 1950s or 1960s) in order to provide a historical context for current and future professionals to envision a successful future. Contributors were asked to discuss their careers and their historical perspectives about their fields and to focus on areas of success and struggles. Interviews from 29 contributors were reviewed for this article, which focuses on concerns and reasons for optimism in both fields. Themes across interviews are described, along with highlights of contributors’ observations.
Percutaneous, Intra-articular, Chevron Osteotomy (PeICO) for the Treatment of Hallux Valgus: A Cadaveric Study
Authors: Del Vecchio Jorge Javier , Ghioldi Mauricio Esteban , Uzair Anuar Emanuel , Chemes Lucas Nicolás , Manzanares-Céspedes María Cristina , Dealbera Eric Daniel , Dalmau-Pastor Miki
Published: January 2019

Background:

Percutaneous surgery is experiencing sustained growth based on third-generation techniques. This cadaveric study was designed with the main goal of exploring the risk of iatrogenic tendon and neurovascular lesions and defining the safe zones in a percutaneous, intra-articular, chevron osteotomy (PeICO) procedure, as well as assessing the accuracy of the osteotomy itself.

Methods:

Eight feet from below-knee fresh-frozen specimens were selected. After the procedure, the specimens were dissected, and structures were inspected for damage.

Results:

The results of the safety measurements were as follows: (1) distance between portal 1 (P1) and the lateral border of the extensor hallucis longus (EHL) tendon: average 17.6 mm (range 12.7-21.3); (2) distance between P1 and the dorsomedial digital nerve (DMDN): average 7.2 mm (range 1.6-10.4); (3) distance between P1 and the metatarsophalangeal joint: average 15.7 mm (range 9.4-20.5); distance between portal 2 (P2), or the osteosynthesis portal, and the metatarsophalangeal joint: average 25.5 mm (range 22-30.4); distance between P2 and the lateral border of the EHL tendon: average 12.7 mm (range 8-16.7); and distance between P2 and the DMDN: average 4.1 mm (range 1.7-8.2). There were no iatrogenic injuries. The osteotomy angulation in the sagittal plane (reproducibility) average was 85.6 degrees.

Conclusion:

There were no iatrogenic injuries on this cadaveric study of PeICO.

Clinical Relevance:

This study will help orthopedic surgeons understand the risks of performing percutaneous surgery by mimicking an accepted open technique (chevron).
Outcome After Surgical Treatment of Calcaneal Osteomyelitis
Authors: Waibel Felix W. A. , Klammer Alexander , Götschi Tobias , Uçkay Ilker , Böni Thomas , Berli Martin C.
Published: January 2019

Background:

Surgical procedures for calcaneal osteomyelitis are partial calcanectomy (PC), total calcanectomy (TC), and below-knee amputation (BKA). With calcaneal osteomyelitis, limb-saving surgery was described to have secondary BKA rates of 4% to 20%, while secondary amputation rates after BKA are unknown. The aim of this study was to describe and compare overall revision and secondary amputation rates for each surgical option in our institution’s cohort and to identify risk factors for secondary amputation.

Methods:

Fifty patients treated between 2002 and 2017 were included. Revisions, secondary amputations, and possible risk factors for secondary amputation and overall revision were statistically analyzed.

Results:

Minor revisions rates were 57.1% in PCs, 100% in TCs, and 27.8% in BKAs. Secondary amputation was performed in 28.6% of the PCs, in 50% of the TCs, and in 5.6% of the BKAs. No statistically significant differences between overall revision and secondary amputation rates were found. C-reactive protein values greater than 5 mg/L at the index procedure were significantly associated with overall revision while we could not identify risk factors for secondary amputation.

Conclusion:

This study represents the largest group of patients treated for calcaneal osteomyelitis in the literature. In limb-preserving surgical options, secondary BKA rates are higher than previously known. Primary BKA is a procedure with a low reamputation rate of 5.6%. PC can be considered, with 28.6% needing more proximal amputation. In TC, all patients underwent revision surgery and 50% had to undergo secondary BKA. Therefore, we hesitate to consider total calcanectomy as a surgical option in calcaneal osteomyelitis anymore.

Level of Evidence:

Level IV, case series.
Comparison of Institutionally Reared and Maltreated Children on Socioemotional and Biological Functioning
Authors: Perry Nicole B. , DePasquale Carrie E. , Fisher Philip H. , Gunnar Megan R.
Published: January 2019

The current study compared behavioral and adrenocortical functioning of maltreated ( N = 91) and comparably aged (1.5–3 years) institutionally-reared children soon after (1.5–2.5 months) placement in foster care or adoptive homes, respectively. Foster and adoptive parents reported on the children’s socioemotional competence and behavior problems, experimenters scored fear and positive affect to laboratory tasks, and diurnal cortisol measures were obtained. We sought to address whether these early contexts, characterized by different types of neglect and deprivation, have differential effects on young children’s development. We found little support for the argument that either context results in uniformly poorer functioning soon after removal from adversity. Maltreated children were less fearful and more positive when exposed to both positive and novel events than institutionally-reared children. However, maltreated children were reported to have more behavior problems than did institutionally-reared children, and institutionally-reared children showed more typical declines in cortisol throughout the day than the maltreated children. These findings increase our ability to construct more targeted and effective interventions for these populations.
Collaboration for children with complex needs: What adolescents, parents, and practitioners tell us
Authors: Van Dongen Thirsa , Sabbe Bernard , Glazemakers Inge
Published: January 2019

Children with complex needs require coordinated care and collaboration between the different sectors in child mental health care. These needs and service issues are individually defined and therefore challenging for the mental health system to respond effectively. Different barriers at the organizational and policy level to initiate and maintain collaborative relationships are reported. This research explores the reality of working with a protocol for collaboration (Client Network Consultation (CNC)) by questioning the experiences of adolescents, parents, and practitioners. A qualitative design with semistructured individual interviews is used, guided by the questions from the Wraparound Fidelity Index. Useful and practical insights on effective collaboration result from the in-depth analysis of the interviews. A neutral chairperson, the presence of specialist practitioners, visualization, participation of adolescents, and parents are among the effective elements reported. Some challenges remain; the principle of equality, monitoring the action points resulting from the collaboration and effective crisis management seem very difficult to fully achieve in practice. These results present experiences from adolescents, parents, and practitioners to support an effective collaborative process for working together with children and families with complex needs.
Trust management in social Internet of vehicles: Factors, challenges, blockchain, and fog solutions
Authors: Iqbal Razi , Butt Talal Ashraf , Afzaal Muhammad , Salah Khaled
Published: January 2019

The Internet of things is the next stage in the evolution of the Internet that is being materialized with the integration of billions of smart objects. The state-of-the-art communication technologies have enabled the previously isolated devices to become an active part of the Internet. This constant connectivity opens new avenues for novel applications such as the realization of social Internet of things and its subdomain the social Internet of vehicles. Socializing requires sharing of information that entails trust, especially in an open and broad social environment. This article highlights the key factors involved in conceptualizing an efficient trust model for social Internet of vehicles. Furthermore, it focuses on the unique challenges involved in designing the trust models for social Internet of vehicles. Several trust models exist in literature; however, most of the existing trust models are specific to their domains, for example, Internet of things, social Internet of things, or general vehicular networks. This article presents a brief review of the trust models that have the potential to be implemented in Social Internet of vehicles. Finally, the authors present an overview of how trending concepts and emerging technologies like blockchain and fog computing can assist in developing a trust-based social Internet of vehicles model for high-efficiency, decentralized architecture and dynamic nature of vehicular networks.