bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of alcohol consumption and smoking on disease damage in systemic lupus erythematosus: data from the Korean Lupus Network (KORNET) registry
Authors: Kim S-K , Lee S-S , Choe J-Y , Park S-H , Lee H
Published: May 2017

Background

We assessed correlations of smoking habits and alcohol consumption with disease activity or damage in patients with systemic lupus erythematosus (SLE).

Methods

A total of 505 patients with SLE were enrolled in the Korean Lupus Network (KORNET) SLE registry from January 2014 to January 2016. Disease activity and organ damage were measured by the SLE Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index, respectively. Multivariate logistic regression analysis was used to analyze associations with cutaneous lesions.

Results

There were no differences in SLEDAI-2K and SLICC/ACR damage indices according to either smoking status or alcohol consumption. More frequent cutaneous damage was observed in current alcohol drinkers compared with non-current alcohol drinkers ( p = 0.020). Cutaneous damage was significantly associated with alcohol consumption (odds ratio (OR) 4.048, 95% confidence interval (CI) 1.251–12.102, p = 0.020). Both low (1–5 glasses/week) and high (≥6 glasses/week) amounts of alcohol consumption had a significant impact on cutaneous damage compared with the absence of current alcohol consumption ( p = 0.033 and p = 0.027, respectively). Pairwise comparison of alcohol consumption and smoking status with cutaneous damage showed that only alcohol consumption was significantly associated with the presence of cutaneous damage, compared with non-current alcohol consumption and non-current smoking (OR 3.513, 95% CI 1.130–10.920, p =0.030).

Conclusions

Current alcohol consumption, but not smoking, might influence the development of cutaneous damage in patients with SLE.
Modeling agreement on bounded scales
Authors: Vanbelle Sophie , Lesaffre Emmanuel
Published: May 2017

Agreement is an important concept in medical and behavioral sciences, in particular in clinical decision making where disagreements possibly imply a different patient management. The concordance correlation coefficient is an appropriate measure to quantify agreement between two scorers on a quantitative scale. However, this measure is based on the first two moments, which could poorly summarize the shape of the score distribution on bounded scales. Bounded outcome scores are common in medical and behavioral sciences. Typical examples are scores obtained on visual analog scales and scores derived as the number of positive items on a questionnaire. These kinds of scores often show a non-standard distribution, like a J- or U-shape, questioning the usefulness of the concordance correlation coefficient as agreement measure. The logit-normal distribution has shown to be successful in modeling bounded outcome scores of two types: (1) when the bounded score is a coarsened version of a latent score with a logit-normal distribution on the [0,1] interval and (2) when the bounded score is a proportion with the true probability having a logit-normal distribution. In the present work, a model-based approach, based on a bivariate generalization of the logit-normal distribution, is developed in a Bayesian framework to assess the agreement on bounded scales. This method permits to directly study the impact of predictors on the concordance correlation coefficient and can be simply implemented in standard Bayesian softwares, like JAGS and WinBUGS. The performances of the new method are compared to the classical approach using simulations. Finally, the methodology is used in two different medical domains: cardiology and rheumatology.
Promoting structural effects of covariates in the cure rate model with penalization
Authors: Fan Xinyan , Liu Mengque , Fang Kuangnan , Huang Yuan , Ma Shuangge
Published: May 2017

Cure rate models have been widely adopted for characterizing survival data that have long-term survivors. Under a mixture cure rate model where the population is a mixture of cured and susceptible subjects, a primary goal is to study covariate effects on the cure probability and survival function of the susceptible subjects. In this article, we propose a penalization method for estimating the mixture cure rate model where we explicitly consider the structural effects of covariates. The proposed method is more informative than the standard estimations and more flexible than the existing works on structural effects. Depending on data characteristics, we develop different penalties and corresponding computational algorithms. Simulation shows that the proposed method outperforms the alternatives by more accurately estimating parameters and identifying relevant variables. Two breast cancer datasets, one with low-dimensional clinical variables and the other with high-dimensional genetic variables, are analyzed.
Perception of futile care and caring behaviors of nurses in intensive care units
Authors: Rostami Somaye , Esmaeali Ravanbakhsh , Jafari Hedayat , Cherati Jamshid Yazdani
Published: May 2017

Objectives:

Futile medical care is considered as the care or treatment that does not benefit the patient. Staff of intensive care units experience moral distress when they perceive the futility of care. Therefore, this study aimed to determine the relationship between perceptions of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units.

Method:

This correlation, analytical study was conducted with 181 nursing staff of the intensive care units of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. The data collection tool included a three-part questionnaire containing demographic characteristics form, perception of futile care questionnaire, and caring behaviors inventory. To analyze the data, statistical tests and central indices of tendency and dispersion were investigated using SPSS, version 19. Pearson’s correlation coefficient, partial correlation, t-test, and analysis of variance tests were performed to assess the relationship between the variables.

Ethical considerations:

The study was reviewed by the ethics committee of the Mazandaran University of Medical Sciences. Informed consent was obtained from participants.

Results:

Our findings illustrated that the majority of nurses (65.7%) had a moderate perception of futile care, and most of them (98.9%) had desirable caring behaviors in taking care of patients in the final stages of life. The nurses believed that psychosocial aspects of care were of utmost importance. There was a significant negative relationship between perception of futile care and caring behavior.

Conclusion:

Given the moderate perception of nurses concerning futile care, and its negative impact on caring behaviors toward patients, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care.
The Social History of a Genre
Authors: Orsini Francesca
Published: May 2017

Tales are ubiquitous in the literary culture of pre-modern North India, as elsewhere, and they come in all shapes, languages and inflections. For this reason, tracking them allows us to travel into and across most of the milieux of this multilingual literary culture. But precisely because of their ubiquity, when we move from the micro level of individual texts to the macro level of literary culture and historical processes, it becomes difficult to say anything more than ‘they were there, they circulated, they usually retold the same stories in new ways or mixed familiar elements to produce new narratives’. Yet if we pay precise attention to their articulation and re-articulation of cultural and social imaginaries, the particular linguistic textures and aesthetic emphasis, material form and evidence of patronage, the shifting extent of circulation and popularity, we can use the longuedurée history of the katha genre to illuminate the historical dynamics of cultural and aesthetic change in the region in ways that intersect, connect and question macro-historical narratives of dynastic and epochal change.
Effect of Food Subsidies on Micronutrient Consumption
Authors: Muchomba Felix M. , Kaushal Neeraj
Published: May 2017

In this article, we study the effect of an exogenous increase in wheat and rice price subsidy to poor families resulting from a targeted food price subsidy programme in India called the Targeted Public Distribution System (TPDS) on micronutrient intake in low-income families. Descriptive results show that wheat and rice have one of the lowest micronutrient density scores, suggesting that these are poor suppliers of micronutrients. Empirical analysis suggests that the increase in monthly per capita subsidy amount of ₹15–18 resulting from the TPDS expansion lowered calcium intake by 12–14 per cent and had negligible to small (often negative) effects on the consumption of most micronutrients.
Validation of an improved Anaplasma antibody competitive ELISA for detection of Anaplasma ovis antibody in domestic sheep
Authors: Mason Kathleen L. , Gonzalez Michael V. , Chung Chungwon , Mousel Michelle R. , White Stephen N. , Taylor Joshua B. , Scoles Glen A.
Published: May 2017

An accurate and simple-to-perform new version of a competitive ELISA (cELISA) kit that became commercially available in 2015 for testing of cattle for antibody to Anaplasma marginale was validated for detection of Anaplasma ovis antibody in domestic sheep. True positives and negatives were identified using nested PCR (nPCR) as the gold standard. Negative bovine control sera supplied with the kit were used to calculate % inhibition (%I), designated bovine control ELISA (BcELISA), and this was compared to %I calculated from negative ovine sera derived from hand-raised, pathogen-free sheep, designated ovine control ELISA (OcELISA). The receiver operating characteristics area under the curve was 1.0 with a p value <0.001 regardless of the source of the control sera. The cutoff values for negative BcELISA and OcELISA were <30%I and <27%I, respectively. Our work confirmed that this Anaplasma antibody cELISA kit version 2 can be used with the serum controls supplied in the kit to test for A. ovis antibody in domestic sheep. Furthermore, this work confirmed the historically high infection prevalence (>93%) at the U.S. Sheep Experiment Station (Dubois, Idaho), in spite of efforts to reduce the possibility for iatrogenic transmission there, suggesting high levels of tick-borne transmission.
Intercultural/Multilingual Couples
Authors: Tien Nai Chieh , Softas-Nall Lia , Barritt Julie
Published: May 2017

The present qualitative study aimed to better understand common themes in the experiences of intercultural/multilingual couples through a phenomenological approach. Saturation was reached after interviewing eight couples (16 participants in total). Eight common themes related to cultural differences and four related to language differences were found to influence couples’ relationships and communication in this qualitative study. Affection expression, gender roles, religious preferences, importance of food, residency decisions, child-rearing practices, extended family, and handling of finances were all emerged themes of cultural negotiations. In terms of language, communicating with extended family, expressing self and communicating in second language, learning a different language, and lost in translation emerged as themes. Finally, implications for family and couples’ counselors are reviewed.
A new role for evoked potentials in MS? Repurposing evoked potentials as biomarkers for clinical trials in MS
Authors: Hardmeier Martin , Leocani Letizia , Fuhr Peter
Published: May 2017

Evoked potentials (EP) characterize signal conduction in selected tracts of the central nervous system in a quantifiable way. Since alteration of signal conduction is the main mechanism of symptoms and signs in multiple sclerosis (MS), multimodal EP may serve as a representative measure of the functional impairment in MS. Moreover, EP have been shown to be predictive for disease course, and thus might help to select patient groups at high risk of progression for clinical trials. EP can detect deterioration, as well as improvement of impulse propagation, independently from the mechanism causing the change. Therefore, they are candidates for biomarkers with application in clinical phase-II trials. Applicability of EP in multicenter trials has been limited by different standards of registration and assessment.
Why the salience of social divisions matters in party systems: Testing the interactive hypothesis in South Africa
Authors: Ferree Karen , Gibson Clark , Hoffman Barak
Published: May 2017

Scholars have long argued social diversity, and electoral institutions interactively shape party systems: diversity has little effect on the effective number of parties (ENP) in single member plurality (SMP) systems but increases ENP in proportional ones. We argue instead that where diversity is salient enough to generate demand for parties, it also hinders strategic coordination, preventing SMP rules from reducing the number of parties and producing a correlation between diversity and ENP. In contrast, non-salient forms of diversity have little impact regardless of institutional rules. We test this intuition using data from South Africa’s municipal mixed-member system and explore its highly salient racial cleavage and less salient ethnic one. We find racial diversity correlates with ENP in SMP systems while ethnic diversity correlates with ENP in neither SMP nor proportional representation systems. Our study contributes to mounting evidence questioning the interactive hypothesis and points to the importance of the salience of social divisions in shaping party systems.
Political solidarity through action (and inaction): How international relations changed intracultural perceptions in Ukraine
Authors: Chayinska Maria , Minescu Anca , McGarty Craig
Published: May 2017

The present research sought to explain the mechanisms behind rival Ukrainian solidarity campaigns advocating protection of the minority Crimean Tatars in the immediate aftermath of Russia’s 2014 annexation of the Crimean peninsula. Adapting the social identity model of helping and solidarity we propose that political solidarity is a form of collective action in which allies can align their aspirational identities to the oppressed group’s political loyalties through a process of disidentification from powerful outgroups. We proposed and found supportive evidence ( N = 657) for the notion that both action (facilitation pathway) and inaction (inhibitory pathway) to support the Crimean Tatars were derived from disidentification from the European Union or the Russian-Federation-dominated Customs Union and are mediated by perception of the Crimean Tatars’ loyalties towards Russia and Ukraine. The findings provide initial evidence for a new understanding of political mobilization in support of third parties as a group-level emergent phenomenon in the context of identity threat.
Dosimetric Evaluation of a Flexible Dual Balloon-Constructed Applicator in Treating Anorectal Cancer
Authors: Kuo Hsiang-Chi , Mehta Keyur J. , Yaparpalvi Ravindra , Lee Alan , Mynampati Dinesh , Bodner William , Garg Madhur , Huang David , Tomé Wolfgang A. , Kalnicki Shalom
Published: May 2017

Background and Purpose:

To assess the dosimetric flexibility of a dual balloon brachytherapy applicator developed for the treatment of anorectal lesions.

Materials and Methods:

Different amounts of water were infused into the inner and outer balloon separately to study the asymmetrical distribution of the catheter, the radial distance of the active source channel to the inner surface of the global target volume , the space between the active source channels, and their dosimetric impact to target tissues and uninvolved rectum.

Results:

Increasing inner balloon volume directly increased both the space between the active source channels and the radial distance of the active source channel to the inner surface of the global target volume. The space between the active source channels and the percentage of global target volume received 150% or more of the prescribed dose to target had a strong inverse correlation (−0.881/ P = .007, −0.976/ P = .001, respectively) with the radial distance of the active source channel to the inner surface of the global target volume. Conformity index, dose to 2 cm3 of rectum, and total reference air kerma were strongly correlated with the radial distance of the active source channel to the inner surface of the global target volume, with values of 0.952 ( P = .001), 0.833 ( P = .015), and 0.922 ( P = .002), respectively. Percentage of global target volume received 150% or more of the prescribed dose was significantly correlated with the space between the active source channels (0.81/ P = .022), and conformity index was strongly inversely correlated with the space between the active source channels (−0.833/ P = .015).

Conclusion:

The dual balloon-constructed Anorectal Applicator offers a flexible way to adjust the distances of the active source positions to the target in relation to uninvolved rectal wall. This flexibility simplifies planning which results in a highly conformal dose distribution to the target lesion while minimizing dose to normal rectal tissue.
CT Angiography of Peripheral Arterial Disease by 256-Slice Scanner: Accuracy, Advantages and Disadvantages Compared to Digital Subtraction Angiography
Authors: Mishra Atul , Jain Narendra , Bhagwat Anand
Published: May 2017

Background:

Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision.

Purpose:

The aim of this retrospective study was to compare the CT angiograms (CTAs) of all cases of PAOD done by 256-slice CT scanner at a tertiary care vascular center and comparing these images with the digital subtraction angiograms (DSAs) of these patients.

Materials and Methods:

The retrospective study included 53 patients who underwent both CTA and DSA at our center over a period of 3 years from March 2013 to March 2016.

Results:

The CTA showed high sensitivity (93%) and specificity (92.7%) for overall assessment of degree of stenosis in a vascular segment in cases of aortic and lower limb occlusive disease. The assessment of lesions of infrapopliteal segment was comparatively inferior (sensitivity 91.6%, accuracy 73.3%, and positive predictive value 78.5%), more so in the presence of significant calcification. The advantages of CTA were its noninvasive nature, ability to image large area of body, almost no adverse effects to the patients, and better assessment of vessel wall disease. However, the CTA assessment of collaterals was inferior with a sensitivity of only 62.7% as compared to DSA. Overall, 256-slice CTA provides fast and accurate imaging of vascular tree which can restrict DSA only in few selected cases as a problem-solving tool where clinico-radiological mismatch is present.
The “Spinner” Illusion: More Dots, More Speed?
Authors: Ashida Hiroshi , Ho Alan , Kitaoka Akiyoshi , Anstis Stuart
Published: May 2017

The perceived speed of a ring of equally spaced dots moving around a circular path appears faster as the number of dots increases (Ho & Anstis, 2013, Best Illusion of the Year contest). We measured this “spinner” effect with radial sinusoidal gratings, using a 2AFC procedure where participants selected the faster one between two briefly presented gratings of different spatial frequencies (SFs) rotating at various angular speeds. Compared with the reference stimulus with 4 c/rev (0.64 c/rad), participants consistently overestimated the angular speed for test stimuli of higher radial SFs but underestimated that for a test stimulus of lower radial SFs. The spinner effect increased in magnitude but saturated rapidly as the test radial SF increased. Similar effects were observed with translating linear sinusoidal gratings of different SFs. Our results support the idea that human speed perception is biased by temporal frequency, which physically goes up as SF increases when the speed is held constant. Hence, the more dots or lines, the greater the perceived speed when they are moving coherently in a defined area.
Cost‐effectiveness of biological treatment sequences for fistulising Crohn’s disease across Europe
Authors: Baji Petra , Gulácsi László , Brodszky Valentin , Végh Zsuzsanna , Danese Silvio , Irving Peter M , Peyrin‐Biroulet Laurent , Schreiber Stefan , Rencz Fanni , Lakatos Péter L , Péntek Márta
Published: May 2017

Background

In clinical practice, treatment sequences of biologicals are applied for active fistulising Crohn’s disease, however underlying health economic analyses are lacking.

Objective

The purpose of this study was to analyse the cost‐effectiveness of different biological sequences including infliximab, biosimilar‐infliximab, adalimumab and vedolizumab in nine European countries.

Methods

A Markov model was developed to compare treatment sequences of one, two and three biologicals from the payer’s perspective on a five‐year time horizon. Data on effectiveness and health state utilities were obtained from the literature. Country‐specific costs were considered. Calculations were performed with both official list prices and estimated real prices of biologicals.

Results

Biosimilar‐infliximab is the most cost‐effective treatment against standard care across the countries (with list prices: €34684–€72551/quality adjusted life year; with estimated real prices: €24364–€56086/quality adjusted life year). The most cost‐effective two‐agent sequence, except for Germany, is the biosimilar‐infliximab–adalimumab therapy compared with single biosimilar‐infliximab (with list prices: €58533–€133831/quality adjusted life year; with estimated prices: €45513–€105875/quality adjusted life year). The cost‐effectiveness of the biosimilar‐infliximab–adalimumab–vedolizumab three‐agent sequence compared wit biosimilar‐infliximab –adalimumab is €87214–€152901/quality adjusted life year.

Conclusions

The suggested first‐choice biological treatment is biosimilar‐infliximab. In case of treatment failure, switching to adalimumab then to vedolizumab provides meaningful additional health gains but at increased costs. Inter‐country differences in cost‐effectiveness are remarkable due to significant differences in costs.
Migrant Teachers’ Perceptions of the South African Mathematics Curriculum and Their Experiences in Teaching in the Host Country
Authors: Makonye Judah Paul
Published: May 2017

This article investigates the tensions experienced by Zimbabwean immigrant teachers in teaching mathematics in South Africa. It explores their views on the South African mathematics curriculum and how they are treated at their work stations. The study is significant because thousands of Zimbabwean mathematics and science teachers recently moved to teach in South Africa. To date, very little research has been done on how these teachers have settled at their new workplaces. Bernstein’s framework of curriculum classification and framing informs the study. Interviews were conducted on three Zimbabwean teachers who have been teaching mathematics in South African schools since 2008. To triangulate the data, a focus group interview was held with four teachers. The study showed that the teachers found it compulsive to compare some aspects of the South African curriculum with those from their home country. It showed that initially, the teachers had challenges in adapting to the new cuIrriculum, such as understanding the philosophy of continuous assessment. Although they meet some challenges at the beginning, in time some of the immigrant teachers adjust. They come to appreciate the strengths and merits of the South African mathematics curriculum. Implications for the study on immigrant teachers to the South African education system and the wider education community are suggested.
Can Empowerment and Organizational Support for Development Stem Turnover? It Depends on Power Distance
Authors: Wilson Morgan S. , Chaudhry Anjali
Published: May 2017

Research on the effects of psychological empowerment and organizational support for development (OSD) on turnover reveals mixed findings. Based on attraction–selection–attrition theory, we developed a model that examines individual-level power distance as a moderator of the relationships between psychological empowerment and turnover and OSD and turnover. Using a sample of 240 employees of a US software development company in India, we found that psychological empowerment was associated with higher turnover for high power distance employees and lower turnover for low power distance employees. Additionally, OSD was associated with higher turnover for high power distance individuals.
Targeting the interleukin-1 pathway in patients with hematological disorders
Authors: de Mooij Charlotte E. M. , Netea Mihai G. , van der Velden Walter J. F. M. , Blijlevens Nicole M. A.
Published: May 2017

Interleukin-1α (IL-1α) and IL-1β are potent inflammatory cytokines that activate local and systemic inflammatory processes and are involved in protective immune responses against infections. However, their dysregulated production and signaling can aggravate tissue damage during infection, inflammatory diseases, and chemotherapy-induced intestinal mucositis. Additionally, cytokines of the IL-1 family play an important role in homeostatic as well as “emergency” hematopoiesis and are involved in the pathogenesis of several myeloid and lymphoid hematological malignancies. In the pathogenesis of intestinal mucositis and graft-versus-host disease (GVHD), these cytokines are considered pivotal during the initiation as well as propagation phase, and insights from animal studies suggest that targeting the IL-1 pathway can significantly ameliorate mucositis and GVHD. Moreover, IL-1α and IL-1β might prove to be valuable targets for both prevention and treatment of cancer and cancer therapy–related complications, and the first clinical studies have already been performed in the setting of hematological malignancies. In this review, we will discuss the role of cytokines of the IL-1 family in hematological malignancies, chemotherapy-induced intestinal mucositis, and GVHD, and speculate on possibilities of therapeutically targeting the IL-1 pathway in hematological patients.
Feasibility of a Centralized Clinical Trials Coverage Analysis: A Joint Initiative of the American Society of Clinical Oncology and the National Cancer Institute
Authors: Szczepanek Connie M. , Hurley Patricia , Good Marjorie J. , Denicoff Andrea , Willenberg Kelly , Dawson Casey , Kurbegov Dax
Published: May 2017

Purpose:

Clinical trial billing compliance is a challenge that is faced by overburdened clinical trials sites. The requirements place institutions and research sites at increased potential for financial risk. To reduce their risk, sites develop a coverage analysis (CA) before opening each trial. For multisite trials, this translates into system-wide redundancies, inconsistencies, trial delays, and potential costs to sites and patients. These factors exacerbate low accrual rates to cancer clinical trials. ASCO and the National Cancer Institute (NCI) collaborated to address this problem.

Methods:

An ASCO Research Community Forum working group proposed the concept of providing centrally developed CAs to research sites at protocol startup. The group collaborated with NCI and billing compliance experts to hold a symposium for key stakeholders to share knowledge, build skills, provide tools to conduct centralized CAs, and strategize about the next steps.

Results:

Forty-eight attendees, who represented a range of stakeholders, participated in the symposium. As a result of this initiative, NCI directed the Cancer Trials Support Unit to convene a working group with NCI’s National Clinical Trials Network (NCTN) and Community Oncology Research Program (NCORP) to develop tools and processes for generating CAs for their trials. A CA template with core elements was developed and is being adapted in a pilot project across NCTN Group and NCORP Research Bases.

Conclusion:

Centralized CAs for multisite trials—using standardized tools and templates—are feasible. They have the potential to reduce risk for patients and sites, forecast budget needs, and help decrease trial startup times that impede patient access and accrual to clinical trials.
Literary Trespassing in Susan Abulhawa's Mornings in Jenin and Sayed Kashua's Second Person Singular
Authors: Ebileeni Maurice
Published: May 2017

This article focuses on a rare leitmotif in literary productions by Palestinians. Both Susan Abulhawa's Mornings in Jenin and Sayed Kashua's Second Person Singular present Arab characters who, under unusual circumstances, impersonate or literally acquire the identity of the Israeli-Jewish other. In the fictional creations of Ismael/David and Amir/Yonatan, Abulhawa and Kashua, respectively, construe characters whose existence blurs the borderline between various versions of today's Palestinian Arab and mainstream projections of its Israeli-Jewish counterpart. These characters represent, as the article demonstrates, the authors' attempts to work out the implications of the idea that — as a result of the historical events of Israeli Independence and the consequent Palestinian Nakba — the collision of two national yearnings has created a liminal space in which both Israeli and Palestinian narratives gradually infiltrate one another, developing an inextricable and dynamic bond between the Palestinian identity and its counterpart.
Victims of our own success
Authors: Sanders David
Published: May 2017

The NHS is approaching 70, but retirement is not appealing.
‘Trade-off’?!
Authors: Marx Clare
Published: May 2017

Cancer care cannot be improved at the expense of elective surgery.
Lasers in surgery
Authors: Winter George
Published: May 2017

If you don’t need the laser, should you still use it? George Winter investigates.
Full-text publication rates of orthopaedic trainees' abstracts at a regional research meeting
Authors: Hindi F , D Marsland , A Mumith , SL Hodkinson , HP Taylor
Published: May 2017

What proportion of abstracts submitted in one deanery meeting succeed, and why?
Agreement between examiners in wet lab assessment of cardiothoracic trainees
Authors: Smelt J , Valencia O , Nowell J , Roberts N , Jahangiri M
Published: May 2017

Is there such a thing as non-biased, accurate and validated measurement of surgical acumen?
Haven’t you got a home to go to?
Authors: Wheeler Robert
Published: May 2017

Each month we take a close look at a recent legal case with implications for the surgical profession.
Treasures from the Collections
Authors: Hogan Corinne
Published: May 2017

Anatomie très utile: 'The anatyme of the inwarde partis of man and woman'.
Slop’s dinner date with paranoia
Authors: Slop
Published: May 2017

Is the riskiest business of surgery best left to the young blades?
Hard Brexit: Will there be consequences for UK dentistry?
Authors: Wilson Nairn HF
Published: May 2017

Brexit will be a significant event, the outcomes and consequences of which are impossible to predict fully. However, it is safe to say that things will change, some at a cost, while hopefully others will be made to work to the advantage of the UK. Dentistry will not be immune to Brexit-related changes. Indeed, with the anticipated ‘hard’ Brexit, the profession and the provision of oral healthcare in the UK will face a number of changes, some of which will pose challenges but hopefully also provide not-to-be-missed opportunities for the profession. A failure to respond positively to Brexit developments may disadvantage us all.
Do specialists give consistent advice to primary care colleagues on antibiotic use in patients receiving bisphosphonates?
Authors: Mulcahy Mike
Published: May 2017

Since 2003, the dental profession has been challenged by the introduction of drugs, such as bisphosphonates, designed to protect bone mass in the face of pathological and physiological disease changes, including osteoporosis, Paget’s disease and metastatic malignancies. These conditions change the normal dynamic restructuring of bones by osteoblasts and osteoclasts, resulting in less bone resorption by osteoclasts. 1 However, they are also associated with osteonecrosis and current guidelines are inconsistent as to whether antibiotics should be used prophylactically. We present the results of a survey of the advice oral surgeons would give to PDCPs treating patients receiving bisphosphonates, and discuss the implications for patient care.
Guía de Práctica Clínica para el manejo nutricional de personas con Fibrosis Quística (GPC-FQ)
Authors: Garriga María , Horrisberger Adriana , Ruiz de las Heras de la Hera Arantza , Catalán Natalia , Fernández Gloria , Suárez Marta , Porras Nuria , Monje Laura
Published: May 2017

La fibrosis quística (FQ) es una enfermedad multiorgánica, hereditaria, autosómica y recesiva cuyos problemas más frecuentes están relacionados con las alteraciones de los pulmones y del páncreas exocrino. El objetivo de esta guía es establecer unas pautas en la práctica clínica para el manejo nutricional de personas con FQ, pudiéndose encontrar recomendaciones sobre la evaluación del estado clínico-nutricional (anamnesis, exploración física, composición corporal, bioquímica, función pulmonar, valoración dietético-nutricional, función del páncreas y malabsorción intestinal, y valoración de enfermedades asociadas), tratamiento nutricional de la enfermedad y sus síntomas (estado nutricional y pérdida de peso, intervención nutricional, suplementación con vitaminas y minerales, tratamiento de insuficiencia pancreática, diabetes, y enfermedad hepática), y otras circunstancias (embarazo, lactancia, y trasplante pulmonar). La guía ha sido elaborada mediante revisión simple por un grupo de expertos/as que tomó decisiones a través del consenso para ayudar en la toma de decisiones de los profesionales implicados en la atención de pacientes. Esta guía ha sido revisada y aprobada por el Comité Científico de la Fundación Española de Dietistas-Nutricionistas (FEDN). La guía no pretende ser de obligado cumplimiento ni sustituye el juicio clínico del personal sanitario.
Abandono de la terapia nutricional y pérdida de peso en pacientes bariátricos: Cohorte retrospectiva en Lima, Perú
Authors: Giacchetti-Vega Monica , Baquerizo-vonBerswordts Pamela , Carbone-Moane Camila , Bernabé-Ortiz Antonio
Published: May 2017

Introducción: El objetivo de este trabajo fue determinar la proporción de pacientes que cumplen criterios internacionales de gastrectomía en manga, así como estimar la asociación entre porcentaje de pérdida de peso con tasa de abandono del tratamiento nutricional.Materiales y métodos: Cohorte retrospectiva realizada con historias clínicas de pacientes con gastrectomía en manga entre 2008-2014 en una clínica privada. Hubo dos variables resultado de interés: los criterios de inclusión para cirugía bariátrica según criterios internacionales (IMC ≥40 kg/m2 o ≥ 35 kg/m2 con comorbilidades) y el abandono antes o durante (inasistencia  ≥ 60 días desde la consulta previa sin recibir alta [IMC < 25]) del tratamiento nutricional. La exposición fue el porcentaje de peso perdido en las primeras cinco semanas después de la cirugía (< 10% vs. ≥ 10%). Se utilizaron modelos de regresión de Poisson. Se calcularon riesgos relativos e intervalos de confianza al 95% (IC95%). Resultados: La muestra incluyó 423 historias clínicas, 294 (69,5%) mujeres, edad media 39,2 (±12,3) años. 117 (27,7%) cumplieron requisitos para cirugía y 48 de esos 117 (41%) abandonaron el tratamiento nutricional antes de iniciarlo. Los pacientes que perdieron ≥10% de peso en el primer mes tuvieron un 90% menos de riesgo de abandonar la terapia nutricional que los que perdieron <10% del peso (RR =0,10; IC95%: 0,01–0,68), ajustando por sexo y edad.Conclusión: La mayoría de pacientes bariátricos no cumple los requisitos internacionales. Una mayor pérdida de peso en el primer mes se asoció a un menor abandono del tratamiento nutricional.
Influencia del estado nutricional sobre el equilibrio postural en niños: un estudio piloto
Authors: Guzmán-Muñoz Eduardo , Valdés-Badilla Pablo , Concha-Cisternas Yeny , Méndez-Rebolledo Guillermo , Sazo-Rodríguez Sergio
Published: May 2017

Introducción: El aumento de masa corporal puede afectar la realización de tareas funcionales como el equilibrio y propiciar el riesgo de caídas y lesiones, sin embargo las pruebas en niños son limitadas. El propósito de este estudio fue determinar la influencia del estado nutricional sobre el equilibrio postural en niños entre 6 y 9 años de edad.Material y métodos: Estudio piloto descriptivo transversal. Se evaluaron 71 niños en cuanto a peso, talla y equilibrio medido con ojos abiertos (OA) y cerrados (OC) sobre una plataforma de fuerza. Se consideraron las variables del centro de presión (CP): área, velocidad media, velocidad mediolateral y velocidad anteroposterior. Se realizó una regresión lineal ajustando por sexo utilizando como variable respuesta las variables del CP y como variable explicativa el sobrepeso/obesidad frente a normopeso.Resultados: Los niños con sobrepeso/obesidad presentan mayores valores en las variables velocidad media OA (β = 0,018; p = 0,005), velocidad mediolateral OA (β = 0,122; p = 0,005), velocidad anteroposterior OA (β = 0,041; p  < 0,001), velocidad media OC (β = 0,009; p  < 0,001), velocidad mediolateral OC (β = 0,067; p  < 0,001) y velocidad anteroposterior OC del CP (β = 0,409; p  < 0,001). Además, se observaron correlaciones significativas entre el aumento del IMC y el deterioro del equilibrio postural (p < 0,05).Conclusión: Los niños con sobrepeso y obesidad situados entre 6 y 9 años presentan un equilibrio postural más bajo que los normopesos. Con los ojos cerrados, la variable sexo también influye en el control de la postura.
Construcción/invención emergente de poblaciones desiguales en la educación latinoamericana
Authors: Aguilar Nery Jesús
Published: May 2017

En este texto se indaga la emergencia de la construcción/invención de poblaciones “desiguales” en Latinoamérica, enfocando tres tradiciones nacionales: Argentina, Brasil, y México. Se compara quiénes han sido denominados como desiguales en la investigación educativa, y bajo qué categorías, esto como un indicador para la comprensión del fenómeno de las desigualdades educativas en la región entre las décadas de 1960 y 1970. Se concluye que las reglas utilizadas para ampliar la inclusión, la igualdad o la equidad son, al mismo tiempo, estándares y divisiones, que implican la construcción de sistemas de razonamiento que incluyen tanto como excluyen.
KAJI EKSPERIMENTAL RUNNING-IN PADA KONTAK ROLLING-SLIDING PASANGAN MATERIAL ALUMINIUM DENGAN BAJA S45C
Authors: Supriyana Nana , Londa Petrus , Hidayat Taufiq , Jamari Jamari , Nugroho Sri
Published: May 2017

Keausan yang terjadi pada komponen di sistem permesinan dapat mengakibatkan penurunan kemampuan kerja komponen tersebut (kegagalan kerja komponen). Banyak penyebab yang menimbulkan terjadinya keausan diantaranya adalah kualitas material, kondisi pelumasan, perlakuan pengoperasian komponen terutama pada saat pertama kali komponen permesinan berkontak (running-in) dan lain sebagainnya. Berbagai cara untuk mendeteksi fenomena keausan yang terjadi pada komponen terutama yang berkontak dan bergerak, salah satunya adalah melalui eksperimen. Salah satu parameter untuk mendeteksi adanya gejala keausan adalah perubahan nilai koefisien gesek yang terjadi ketika komponen berkontak dan bergerak. Penelitian ini membahas pengaruh penerapan nilai sr yang berbeda terhadap perubahan nilai koefisien gesek pada fase running-in pada material aluminium dan baja S45C. Peralatan yang digunakan dalam eksperimen ini menggunakan alat uji two disc tribometer. kondisi standar eksperimen nilai slip-roll ratio (sr) 0%, 40%,80% dan 100%, beban tekan 4 kg serta kondisi pelumasan menggunakan minyak pelumas dengan SAE 15W-40. Dimensi benda uji masing-masing disc berdiameter 50 mm, benda uji dengan material aluminium permukaan singgungnya dibuat rata dan pada spesimen dengan material baja S45C dibuat radius dengan jari-jari 5 mm, sedangkan waktu eksperimen adalah selama 60 detik dan setiap 10 detik dilakukan pengukuran kekasaran permukaan pada spesimen yang rata. Hasil eksperimen memperlihatkan perubahan nilai koefisien gesek mempunyai tren menurun seiring waktu running-in yang terus berjalan, perubahan ini diakibatkan beberapa puncak asperiti mulai terpangkas dan jumlah asperiti yang terdeformasi mulai berkurang, kemudian nilai koefisien gesek mulai bergerak turun dan mencapai kondisi rata inilah kondisi steady state karena pada kondisi ini energi yang dikeluarkan untuk melawan gaya gesek yang terjadi relatif lebih sedikit dibanding diawal gerakan dan berkontak. Nilai kekasaran permukaan spesimen juga mengalami perubahan dan hampir semua penurunan nilai kekasaran terjadi pada setiap penerapan nilai sr yang berbeda dan perubahannya menurun sampai kondisi steady state tercapai.
PERANCANGAN KURSI AUTISME UNTUK MOBIL SEBAGAI ALAT BANTU TERAPI AUTISME
Authors: Naufal Gostsa Khusnun , Raswan Awan , Suryo Sumar Hadi , Jamari Jamari , Haryanto Ismoyo
Published: May 2017

Children with autism tend to have hyperactivity, children will tend to be difficult to control. This is certainly an issue when children are in vehicles, especially cars. There are some events related to the automobile accident caused hyperactivity of children with autism. When the children in the car tends to move on, even disturb concentration the driver. Not many safety features on the car is intended for children with autism. Research safety equipment as well as therapeutic tools for children with autism that will be done is a  autism car seat. This tool serves as an extra seat that is able to bind to safely and comfortably seat a child with autism to a primary car seat. This tool is also able to provide autism therapy with the principles of deep pressure when used, generating deep pressure with adjustable pressurized balloon. The tool is attached directly to the car seat with a harness, and then the car safety belt is used as the main security of these devices. Design tools for  autism car seat through stages: preparation of product definition and technical specifications  autism car seat , the design of a product concept for  autism car seat, designing products for  autism car seat , as well as preparation of documents for the manufacture of autism car seats
IDENTIFIKASI MATERIAL DAN KERUSAKAN DISC REFINER AIRAGHI DI PT. PURA NUSA PERSADA UNIT PAPER MILL 8 KUDUS
Authors: Sofyarto Bakti , Bayuseno Athanasius Priharyoto , Nugroho Sri
Published: May 2017

Refining adalah proses penggilingan bubur serat lanjut untuk menghasilkan bubur serat yang lebih halus. Setelah itu bubur serat tersebut diolah kembali dengan cara dipotong dan digiling dengan menggunakan 2 buah pisau pemotong yang berbentuk bilah plat (disc plate atau disc refiner). Masalah yang dihadapi pada proses refining adalah kegagalan pada pisau disc refiner akibat proses abrasif dan keausan. Tujuan penelitian ini adalah melakukan identifikasi material disc refiner yang digunakan, studi metallografi terhadap material disc refiner yang digunakan, menentukan dan mencari penyebab terjadinya kerusakan pada disc refiner ,memberikan rekomendasi pada perusahaan mengenai disc refiner yang terbaik. Diperlukan pengujian dari yang paling sederhana sampai diperlukan alat yang canggih mulai dari uji percik dengan melihat percikan material, pengamatan struktur micro , mencari tahu besarnya kekerasan dan kandungan komposisi kimia yang terdapat pada material dan selanjutnya dibandingkan dengan data pembanding standar. Hasil penelitian menyimpulkan bahwa dari disc refiner airaghi yang dipakai di unit paper mill 8 merupakan material Stainless steel UNS S41000, dengan kerusakan seperti serration dan deformasi platis. Pemilihan pola disc refiner yang disesuaikan dengan kondisi pulp, di PT PNP PM 8 Kudus yang cocok adalah menggunakan pola dengan 3 bagian Breaker bar, Intermediate bar dan Fine bar.
PENGEMBANGAN DISAIN TUNGKU BAHAN BAKAR KAYU RENDAH POLUSI DENGAN MENGGUNAKAN DINDING BETON SEMEN
Authors: Yunianto Bambang , Sinaga Nazarudin , S.A.K Ramanda
Published: May 2017

Kelangkaan minyak tanah dipasaran dan harga yang mahal mendorong masyarakat kususnya masyarakat pedesaan kembali ke penggunaan kayu bakar untuk  keperluan memasak. Hal ini mendorong peningkatan polusi asap, akibat penggunaan tungku yang sederhana. Dengan penelitian ini dikembangkan disain tungku yang lebih efisien dan  rendah polusi.    Dalam penelitian ini digunakan  tungku modifikasi dengan dinding tungku dari beton cor semen dan isolator udara dalam dinding. Pengujian tungku dilakukan dengan memanaskan air hingga 98 C pada dua panci (29 cm dan 37 cm) serta menggunakan kayu bakar pada dua tingkat kekeringan (16 % dan 24 %). Dari hasil pengujian diketahui bahwa pemanasan air dengan panci kecil (29 cm) dan kayu kering (16 %) menghasilkan efisiensi terbaik (20 %). Sedangkan pada panci besar (37 cm) dan kayu basah (24 %) menghasilkan efisiensi terendah 16 %.  Dari pengujian tersebut diatas, tungku dinding beton cor semen, tetap masih lebih tinggi jika dibandingkan dengan tungku tradisional yang hanya mempunyai efisiensi  13 %. Mengkaji data pengujian yang dihasilkan, kami tim peneliti berkesimpulan bahwa prototipe tungku ini layak digunaan di masarakat pedesaan dan industri kecil.
PERBANDINGAN PRODUK RODA GIGI UKM DAN RODA GIGI ORIGINAL EQUIPMENT MANUFACTURER (OEM) UNTUK PRODUK RODA GIGI TRANSMISI SEPEDA MOTOR
Authors: Ismail Rifky
Published: May 2017

Roda gigi merupakan salah satu komponen mesin yang kompleks dalam proses perancangan dan pembuatannya. Hingga saat ini, Usaha Kecil dan Menengah (UKM) produsen komponen otomotif di Jawa Tengah belum mempu memproduksi roda gigi untuk sistem transmisi sepeda motor yang mampu memenuh standar perusahaan otomotif nasional atau mampu menjadi komponen after sales di pasar komponen purna jual. Berdasarkan survey yang dilakukan di pasar purna jual di Semarang terhadap produk roda gigi transmisi sepeda motor, roda gigi transmisi yang dijual merupakan produk Original Equipment Manufacturer (OEM) atau produk impor dari China dan Taiwan. Berdasarkan survey di UKM, roda gigi yang diproduksi UKM lebih mengarah pada pesanan yang spesifik (customized) dan belum menjadi produk massal. Penelitian ini mencoba mendorong UKM untuk memproduksi roda gigi yang dapat diproduksi massal dan memberikan pesasanan secara kontinyu. UKM produsen roda gigi di Kecamatan Juwana, Kab. Pati, diberikan order pembuatan roda gigi untuk sistem transmisi sepeda motor. Produk roda gigi yang dihasilkan UKM ini kemudian dianalisa dan dibandingkan dengan produk roda gigi OEM. Hasil yang dibandingkan adalah uji komposisi, struktur mikro, nilai kekerasan dan kekasaran permukaan. Analisa perbandingan menunjukkan bahwa proses manufaktur roda gigi produk UKM hingga saat ini lebih menonjolkan aspek kemiripan bentuk dan geometri dengan roda gigi produk original equipment manufacturer (OEM) tetapi belum diikuti dengan kajian mengenai teknologi pengerasan permukaan, teknik pengaturan kekasaran permukaan dan pengujian running-in roda gigi. Kelemahan ini menjadikan produk roda gigi UKM masih belum dapat bersaing di pasar domestik