bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated With Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery
Authors: Webster Kate E. , Nagelli Christopher V. , Hewett Timothy E. , Feller Julian A.
Published: May 2018

Background:

Anterior cruciate ligament (ACL) injury has a significant psychological effect, and a negative psychological state is a commonly cited reason for a reduction or cessation of sports participation after ACL reconstruction (ACLR) surgery.

Purpose:

To identify factors that contribute to an athlete’s psychological readiness to return to sport (RTS) after ACLR.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A cohort of 635 athletes (389 male, 246 female) who underwent ACLR and had been cleared to RTS completed the Anterior Cruciate Ligament–Return to Sport After Injury (ACL-RSI) scale at an average 12 months (range, 11-24 months) after surgery. Demographics (age, sex), sporting outcomes (preinjury frequency), surgical timing (injury to surgery interval), clinical factors (laxity), functional measures (single-limb hop symmetry), and symptoms of pain and function (International Knee Documentation Committee subjective) were also taken, and univariate and multiple regression models were used to determine the association between these and the psychological readiness of the athlete to RTS (ACL-RSI scores). Data for the entire cohort were initially analyzed; then, patients were grouped according to whether they had returned to competitive sport, and the analysis repeated for each group (return/nonreturn).

Results:

Univariate analysis for the entire group showed that all of the following had a positive effect on psychological readiness: male sex (β = 5.8; 95% CI, 2-10), younger age (β = −0.2; 95% CI, –0.4 to 0.01), a shorter interval between injury and surgery (β = −0.1; 95% CI, −0.1 to −0.02), a higher frequency of preinjury sport participation (β = 5.4; 95% CI, 2-9), greater limb symmetry (β = 0.5; 95% CI, 0.3-0.6), and higher subjective knee scores (β = 1.3; 95% CI, 1.1-1.4). In the multivariate model, subjective knee scores and age significantly accounted for 37% of the variance in psychological readiness ( r2 = 0.37, P < .0001). The only difference between the groups who had and had not returned to sport was that female sex was a significant contributor for the nonreturn group.

Conclusion:

Self-reported symptoms and function were most associated with psychological readiness to RTS after ACLR surgery. Male patients who participated frequently in sport before ACL injury had higher psychological readiness. Conversely, female patients had a more negative outlook and may therefore benefit more from interventions designed to facilitate a smooth transition back to sport.
Evaluation of optional fee structures for solid waste management in China
Authors: Wu Yun-ga , Chu Zhu-jie , Zhuang Jun
Published: May 2018

A municipal solid waste fee has become an important means for the implementation of the waste management rendered by the government all around the world. Based on the ecological environmental compensation theory, this article constructs an analytical framework of waste charging from the perspective of public policy evaluation, to carry on the comprehensive comparison and analysis to the operability, feasibility, validity, rationality, and universality of the two modes of waste charging: Ration charge and unit-pricing modes. The results indicate that in the cities with large amounts of waste production, long time of waste charging, and high disposal rate, pilot projects should be carried out; and the government needs to improve the construction of associated laws and regulations.
Early Prediction of Intensive Care Unit–Acquired Weakness: A Multicenter External Validation Study
Authors: Witteveen Esther , Wieske Luuk , Sommers Juultje , Spijkstra Jan-Jaap , de Waard Monique C. , Endeman Henrik , Rijkenberg Saskia , de Ruijter Wouter , Sleeswijk Mengalvio , Verhamme Camiel , Schultz Marcus J. , van Schaik Ivo N. , Horn Janneke
Published: May 2018

Objectives:

An early diagnosis of intensive care unit–acquired weakness (ICU-AW) is often not possible due to impaired consciousness. To avoid a diagnostic delay, we previously developed a prediction model, based on single-center data from 212 patients (development cohort), to predict ICU-AW at 2 days after ICU admission. The objective of this study was to investigate the external validity of the original prediction model in a new, multicenter cohort and, if necessary, to update the model.

Methods:

Newly admitted ICU patients who were mechanically ventilated at 48 hours after ICU admission were included. Predictors were prospectively recorded, and the outcome ICU-AW was defined by an average Medical Research Council score <4. In the validation cohort, consisting of 349 patients, we analyzed performance of the original prediction model by assessment of calibration and discrimination. Additionally, we updated the model in this validation cohort. Finally, we evaluated a new prediction model based on all patients of the development and validation cohort.

Results:

Of 349 analyzed patients in the validation cohort, 190 (54%) developed ICU-AW. Both model calibration and discrimination of the original model were poor in the validation cohort. The area under the receiver operating characteristics curve (AUC-ROC) was 0.60 (95% confidence interval [CI]: 0.54-0.66). Model updating methods improved calibration but not discrimination. The new prediction model, based on all patients of the development and validation cohort (total of 536 patients) had a fair discrimination, AUC-ROC: 0.70 (95% CI: 0.66-0.75).

Conclusions:

The previously developed prediction model for ICU-AW showed poor performance in a new independent multicenter validation cohort. Model updating methods improved calibration but not discrimination. The newly derived prediction model showed fair discrimination. This indicates that early prediction of ICU-AW is still challenging and needs further attention.
Synthesis of phosphoric acid-treated sugarcane bagasse cellulose nanocrystal and its thermal properties enhancement for poly(lactic acid) nanocomposites
Authors: Gan Ivy , Chow Wen Shyang
Published: May 2018

Poly(lactic acid) (PLA) nanocomposites film reinforced with cellulose nanocrystals (CNCs) extracted from sugarcane bagasse fibre (SBF) was prepared by solvent casting method. The CNCs were obtained through alkaline treatment followed by sulphuric acid hydrolysis or phosphoric acid hydrolysis. The aim of this work was to evaluate the feasibility of utilizing phosphoric acid (mild acid) to extract CNC from the SBF. The properties of the CNC were investigated by transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared (FTIR) spectroscopy. The thermal properties of the PLA/CNC nanocomposites were characterized using thermogravimetric analyser (TGA). TEM results demonstrated that the CNC having diameter of 5.5–6.2 nm and length of 235–300 nm. Results from XPS characterization have confirmed the existence of both sulphate group and phosphate group in the H2SO4-treated CNC (S-CNC) and H3PO4-treated CNC (P-CNC). FTIR results indicated that the presence of hydrogen bonding and chemical interaction between PLA and CNC. The thermal stability of PLA/P-CNC-10 is higher than that of PLA/S-CNC-10 nanocomposites attributed to the char formation of P-CNC in the PLA matrix.
Characterization of multilayered carbon-fiber–reinforced thermoplastic composites for assembly process
Authors: Vu Ngoc-Hung , Pham Xuan-Tan , François Vincent , Cuillière Jean-Christophe
Published: May 2018

The aim of this research work is to characterize the mechanical behavior of multilayered carbon-fiber–reinforced polyphenylene sulfide composites with the application to assembly process of nonrigid parts. Two anisotropic hyperelastic material models were investigated and implemented in Abaqus as a user-defined material. An inverse characterization method was applied to identify the parameters of these material models. Finite element simulations at finite strains of a flexible composite sheet were carried out. Numerical results of sheet deformation were compared with the experimental results in order to evaluate the appropriateness of the material models developed for this application.
An experimental study of a flow-accelerating hydrokinetic device
Authors: Mannion Brian , McCormack Vincent , Kennedy Ciaran , Leen Seán B , Nash Stephen
Published: May 2018

Tidal energy researchers and developers use experimental testing of scaled devices as a method of evaluating device performance. Much of the focus to date has been on horizontal axis turbines. This study is focused on a novel vertical axis turbine which incorporates variable-pitch blades and a flow accelerator. The research involves laboratory testing of scale model devices in a recirculating flume. Computational fluid dynamic modelling is used to reproduce the measured flow data to investigate disparities in experimental data. The results show that the device is capable of achieving localised flow acceleration of up to a factor of 2 above the freestream velocity and achieved a mechanical power efficiency of 40%.
Understanding and diagnosing the potential for bias when using machine learning methods with doubly robust causal estimators
Authors: Bahamyirou Asma , Blais Lucie , Forget Amélie , Schnitzer Mireille E
Published: May 2018

Data-adaptive methods have been proposed to estimate nuisance parameters when using doubly robust semiparametric methods for estimating marginal causal effects. However, in the presence of near practical positivity violations, these methods can produce a separation of the two exposure groups in terms of propensity score densities which can lead to biased estimates of the treatment effect. To motivate the problem, we evaluated the Targeted Minimum Loss-based Estimation procedure using a simulation scenario to estimate the average treatment effect. We highlight the divergence in estimates obtained when using parametric and data-adaptive methods to estimate the propensity score. We then adapted an existing diagnostic tool based on a bootstrap resampling of the subjects and simulation of the outcome data in order to show that the estimation using data-adaptive methods for the propensity score in this study may lead to large bias and poor coverage. The adapted bootstrap procedure is able to identify this instability and can be used as a diagnostic tool.
Adiaspiromycosis in a wild European rabbit, and a review of the literature
Authors: Hughes Katherine , Borman Andrew M.
Published: May 2018

Adiaspiromycosis is a mycotic infection caused by thermally dimorphic fungi classified as Emmonsia parva and E. crescens (formerly Chrysosporium spp.) until recently, when new classifications were proposed. We document the pathologic findings in a severe case of adiaspiromycosis, with lymph node involvement, in a wild European rabbit ( Oryctolagus cuniculus). The rabbit exhibited granulomatous pneumonia with tracheobronchial lymph node enlargement. Histopathologically, the lung was expanded by myriad, densely cellular, heterophilic and granulomatous foci, surrounding bi- to trilaminar adiaspores. Adiaspore density was considered to be similar in all lung lobes. In the left caudal lung lobe, 80 adiaspores were counted in a 50-mm2 area using digital image analysis. The mean and median adiaspore diameters were 240 ± 52 μm and 255 μm, respectively. Tracheobronchial lymph nodes exhibited moderate numbers of similar adiaspores. PCR amplification of DNA extracted from microdissected adiaspores failed to identify Emmonsia spp.–specific DNA. These data suggest that adiaspiromycosis may result in severe granulomatous pneumonia in wild European rabbits. Although confirmation of the etiologic agent by PCR using DNA extracted from formalin-fixed tissue is not always successful, digital image analysis can be used to aid accurate assessment of adiaspore density and morphology.
Three-dimensional design of a large-displacement morphing wing droop nose device
Authors: Vasista Srinivas , Nolte Felix , Monner Hans Peter , Horst Peter , Burnazzi Marco
Published: May 2018

The numerical three-dimensional structural design of a large-displacement flexible morphing wing leading edge, otherwise known as a droop nose, is presented in this article. The droop nose is an essential component of a novel internally blown high-lift system for a transport aircraft to delay stall and reduce internal compressor requirements. A design chain consisting of optimization procedures was used to arrive at the structural design of the droop nose composed of a composite fiberglass skin with integral stringers and supporting kinematic mechanisms. The optimization tools aim to produce a design with minimal error to the critical target shapes. A maximum final error of 10.09 mm between calculated and target trajectories of the stringers was found after the kinematic optimization stage. After inputting the kinematic optimization results into the skin optimization stage and solving, a maximum error in the order of 13 mm and curvature difference 0.0028 1/mm were calculated, occurring in the outboard region. Prior two-dimensional analyses with similar shape deviations showed 0.4% lift reduction though further three-dimensional investigations are required. Concepts for integrating industrial requirements abrasion and lightning strike protection and in-flight de-icing into a multifunctional skin show promise and the resulting aerodynamic surface quality was found to be adequate.
The Journey From Instrumental to Elementary General Music Education: How to Succeed in a New Specialization
Authors: Kuebel Christa R.
Published: May 2018

For various reasons, instrumentalist music education majors may find themselves teaching in an elementary general music classroom. Based on research and experience, this article will discuss why the transition from instrumental to elementary general music education may occur as well as offer suggestions to support instrumentalists new to the elementary general music classroom.
Understanding Conceptualizations of Pregnancy and Planning for Pregnancy Among Adolescent Girls and Young Women in Harare, Zimbabwe
Authors: Tinago Chiwoneso B. , Ingram Lucy Annang , Frongillo Edward A. , Blake Christine E. , Engelsmann Barbara , Simmons David
Published: May 2018

Zimbabwe has one of the highest rates of maternal mortality, yet little is understood about adolescent girls’ and young women’s perspectives on pregnancy or planning for pregnancy. The research study took an emic approach to understand and describe how adolescent girls and young women (14–24 years) in Harare, Zimbabwe, conceptualize pregnancy and planning for pregnancy and how these conceptualizations inform pregnancy decisions. Semi-structured, in-depth, qualitative interviews were conducted with adolescent girls and young women ( N = 48) and data were analyzed thematically using NVivo 10. Pregnancy was conceptualized across nine themes: carrying a child and oneself, growing a family, motherhood, the best time for pregnancy, pregnancy decision makers, who is responsible for the pregnancy, pregnancy burden, pregnancy dangers, and increase in social status with pregnancy. Planning for pregnancy was conceptualized during the prepregnancy, pregnancy, and postpregnancy phases. Findings emphasize considering sociocultural views concerning pregnancy and including social networks in maternal health efforts.
Assessing Protective Factors for Adolescent Offending: A Conceptually Informed Examination of the SAVRY and YLS/CMI
Authors: Viljoen Jodi L. , Bhanwer Aisha K. , Shaffer Catherine S. , Douglas Kevin S.
Published: May 2018

Although the Structured Assessment of Violence Risk in Youth (SAVRY) and the Youth Level of Service/Case Management Inventory (YLS/CMI) are among the most widely used adolescent risk assessment tools, they conceptualize and measure strengths differently. As such, in this study, we compared the predictive validity of SAVRY Protective Total and YLS/CMI Strength Total, and tested conceptual models of how these measures operate (i.e., risk vs. protective effects, direct vs. buffering effects, causal models). Research assistants conducted 624 risk assessments with 156 youth on probation. They rated protective factors at baseline, and again at 3-, 6-, 9-, and 12-month follow-up periods. The SAVRY Protective Total and YLS/CMI Strength Total inversely predicted any charges in the subsequent 2 years (area under the curve scores = 0.61 and 0.60, respectively, p < .05). Furthermore, when adolescents’ protective total scores increased, their self-reported violence decreased, thus providing evidence that these factors might play a causally relevant role in reducing violence. However, protective factors did not provide incremental validity over risk factors. In addition, because these measures are brief and use a dichotomous rating system, they primarily captured deficits in protective factors (i.e., low scores). This suggests a need for more comprehensive measures.
Novel Biomarkers for Coronary Restenosis Occurrence After Drug-Eluting Stent Implantation in Patients With Diabetes Having Stable Coronary Artery Disease
Authors: Gabbasov Zufar , Kozlov Sergey , Melnikov Ivan , Byazrova Svetlana , Saburova Olga , Prokofieva Lyudmila , Caprnda Martin , Curilla Eduard , Gaspar Ludovit , Rodrigo Luis , Kruzliak Peter , Smirnov Vladimir
Published: May 2018

The purpose of the study was to assess whether the occurrence of restenosis is associated with CD45+ platelet count and neutrophil to lymphocyte ratio in patients with type 2 diabetes mellitus (DM) after drug-eluting stent (DES) implantation for stable coronary artery disease (CAD). The study comprised 126 patients, including 55 patients with type 2 DM and stable CAD who underwent elective coronary artery stenting with DES and follow-up angiography within 6 to 12 months. Blood samples were collected from each patient on the morning of the coronary angiography procedure. The variables related to in-stent restenosis were selected by logistic regression analysis. The logistic regression analysis showed that 2 inflammatory factors, CD45+ platelet count (odds ratio [OR] = 4.51, 95% confidence interval [CI]: 1.50-13.50, P = .007) and neutrophil to lymphocyte ratio (OR = 3.09, 95% CI: 1.05-9.10, P = .04), were significantly associated with the risk of in-stent restenosis after stenting with DES in patients with stable CAD and type 2 DM. A receiver operator characteristic curve analysis indicated that the area under the curve was 0.83% (0.05%; P < .001), which showed that the logistic model had good predictive accuracy (based on CD45+ platelet count and neutrophil to lymphocyte ratio) for the risk of in-stent restenosis development in DES in patients with CAD and type 2 DM. Two novel biomarkers of restenosis, CD45+ platelet count and neutrophil to lymphocyte ratio, may be effectively used to predict in-stent restenosis after DES implantation in patients with CAD and type 2 DM.
Neutral Masculinity: An Analysis of Parliamentary Debates on Austria’s Neutrality Law
Authors: Löffler Marion
Published: May 2018

After World War II, postfascist Austria went through a transitional period of nation building. While the political parties (re)installed the democratic institutions and supported the idea of an independent Austria, they still disagreed on the nature of the “Austrian nation.” Moreover, the postwar period experienced a “crisis of masculinity” caused by the Allied occupation which signaled that Austria had lost the war. The official rhetoric, in contrast, claimed Austria’s status as a victim of Hitler’s aggression and hence, as a land not defeated, but liberated by the Allied forces. Self-victimization delegitimated both German nationalism and heroic masculinity. This article analyzes two debates on the neutrality act in the Austrian parliament in 1955, with a particular focus on the discursive construction of “neutral masculinity” as novel political identity and potential solution to the “masculinity crisis.” It deals with the question whether neutral masculinity contributed to a postheroic society and to “gender democracy.”
So What Do You Do? Exploring Evaluator Descriptions of Their Work
Authors: Mason Sarah , Hunt Ashley
Published: May 2018

To progress as a field, evaluators must be able to describe their work to nonevaluators, and to persuade an audience they have something unique and valuable to offer. Yet anecdotal reports suggest many evaluators have difficulty describing their work. Through 42 interviews with practicing evaluators, we aimed to better understand evaluators’ experiences discussing their work, examining how evaluators describe their work to nonevaluators and the perceived challenges they face doing so. Findings suggest there are common threads linking evaluator descriptions of their work, with many evaluators presenting evaluation as a tool to help social programs, policies, and organizations. And, although many evaluators described layperson reactions that centered on confusion, disinterest, and fear, others also described experiences characterized by understanding, interest, and gratitude. Strategies for enhancing communication in this domain are described.
Influence of Nitrosative Stress on Fatigue During Childhood Leukemia Treatment
Authors: Hockenberry Marilyn J. , Moore Ida M. (Ki) , Scheurer Michael E. , Hooke Mary C. , Taylor Olga A. , Koerner Kari M. , Gundy Patricia M. , Pan Wei
Published: May 2018

The focus on a cure for childhood leukemia over the last three decades has resulted in survival rates of more than 80%. However, efforts to manage leukemia-treatment symptoms have not kept pace with new therapies. Symptom toxicity during treatment can result in complications, treatment delays, and therapy dose reductions. Compromise in therapy can negatively influence the quality of life and, even more notably, jeopardize chances for long-term survival. This study examined biologic mechanisms that influence fatigue caused by increased reactive oxidative species (ROS) or actual failure of the antioxidant defense system due to genetic variation by investigating reactive nitrosative species, a “downstream” consequence of ROS. The specific aims of this study were to characterize the trajectory of nitrosative stress during acute lymphoblastic leukemia treatment and evaluate the influence of nitrosative stress on fatigue. A repeated measures design was used to evaluate the fatigue experienced by 186 children and adolescents, 3–18 years of age, with a diagnosis of leukemia during the most intense phase of treatment. An established biomarker of nitrosative stress, protein 3-nitrotyrosine (3NT) residues in the cerebral spinal fluid, was evaluated at diagnosis, postinduction, and consolidation phases of treatment. Higher fatigue was associated with higher 3NT levels at the beginning of treatment. Two distinct groups of children experienced either consistently high or consistently low 3NT levels across the treatment trajectory, from diagnosis to 12 months postinduction. Findings from this study support continued exploration into the phenotypic biochemical mechanisms that influence a reactive response to childhood cancer treatment.
Clinical accuracy of a patient-specific femoral osteotomy guide in minimally-invasive posterior hip arthroplasty
Authors: Schneider Adrian K , Pierrepont Jim W , Hawdon Gabrielle , McMahon Stephen
Published: May 2018

Introduction:

Patient specific guides can be a valuable tool in improving the precision of planned femoral neck osteotomies, especially in minimally invasive hip surgery, where bony landmarks are often inaccessible. The aim of our study was to validate the accuracy of a novel patient specific femoral osteotomy guide for THR through a minimally invasive posterior approach, the direct superior approach (DSA).

Methods:

As part of our routine preoperative planning 30 patients underwent low dose CT scans of their arthritic hip. 3D printed patient specific femoral neck osteotomy guides were then produced. Intraoperatively, having cleared all soft tissue from the postero-lateral neck of the enlocated hip, the guide was placed and pinned onto the posterolateral femoral neck. The osteotomy was performed using an oscillating saw and the uncemented hip components were implanted as per routine. Postoperatively, the achieved level of the osteotomy at the medial calcar was compared with the planned level of resection using a 3D/2D matching analysis (Mimics X-ray module, Materialise, Belgium).

Results:

A total of 30 patients undergoing uncemented Trinity acetabular and TriFit TS femoral component arthroplasty (Corin, UK) were included in our analysis. All but one of our analysed osteotomies were found to be within 3 mm from the planned height of osteotomy. In one patient the level of osteotomy deviated 5 mm below the planned level of resection.

Conclusion:

Preoperative planning and the use of patient specific osteotomy guides provides an accurate method of performing femoral neck osteotomies in minimally invasive hip arthroplasty using the direct superior approach.

Level of evidence:

IV (Case series)
Outcomes of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty in elderly patients
Authors: Moreta Jesús , Uriarte Iker , Ormaza Amaia , Mosquera Javier , Iza Kattalin , Aguirre Urko , Legarreta María José , Martínez-De Los Mozos José Luis
Published: May 2018

Introduction:

The objective was to evaluate clinical and radiological outcomes of Vancouver B2 and B3 periprosthetic femoral fractures in patients older than 65 years treated at our institution from 2000 to 2014. We compared the most common methods of fixation: a modular tapered rectangular titanium stem versus a monoblock tapered stem.

Methods:

A retrospective review was performed with a minimum follow-up time of 2 years. Patient mobility in the period prior to the fracture and after fracture healing and functional results was assessed according to the Harris Hip Score.

Results:

A total of 43 Vancouver B2 and B3 periprosthetic fractures fulfilled the inclusion criteria (31 type B2 and 13 type B3). The mean age was 78 years old (66–88 years). The mean follow-up time was 5 years (range 2–12 years). A Wagner stem was used in 19 patients and a modular rectangular stem was implanted in 24 patients. Although fracture union was achieved in 93% of the cases, the mean Harris Hip Score was 73 (34–87) and 41.9% of the patients did not return to their previous ambulatory levels ( p = 0.0049). Dislocation was the most common complication (16.3%). We have found association ( p = 0.07) between subsidence with a mean of 4.14 mm and dislocation. No difference was observed between B2 and B3 fractures or between modular and monoblock stems.

Discussion:

Although we reported good results of fracture healing, there were functional impairment and a high rate of complications, especially dislocation, in Vancouver B2 and B3 periprosthetic fractures in elderly patients.
Combined effect of surface roughness and pressure-dependent viscosity over couple-stress squeeze film lubrication between circular stepped plates
Authors: Hanumagowda BN , Raju BT , Santhosh Kumar J , Vasanth KR
Published: May 2018

In this paper, the effect of surface roughness and pressure-dependent viscosity over couple-stresses squeeze film lubrication between circular stepped plates is studied. The modified average Reynolds equation is derived for the one-dimensional roughness structures, namely the radial roughness pattern and azimuthal roughness pattern. Modified equations for the nondimensional pressure, load-carrying capacity, and nondimensional squeeze film time are obtained. Also, the obtained results of our study for some special cases are compared with the previously published smooth surface case, and the results are found to be in very good agreement. It is observed that, one-dimensional azimuthal (radial) roughness pattern on the rough circular stepped plate increases (decreases) the load-carrying capacity and the squeeze film time as compared to the smooth case.
Efficacy of Cladribine Tablets in high disease activity subgroups of patients with relapsing multiple sclerosis: A post hoc analysis of the CLARITY study
Authors: Giovannoni Gavin , Soelberg Sorensen Per , Cook Stuart , Rammohan Kottil W , Rieckmann Peter , Comi Giancarlo , Dangond Fernando , Hicking Christine , Vermersch Patrick
Published: May 2018

Background:

In the CLARITY (CLAdRIbine Tablets treating multiple sclerosis orallY) study, Cladribine Tablets significantly improved clinical and magnetic resonance imaging (MRI) outcomes (vs placebo) in patients with relapsing-remitting multiple sclerosis.

Objective:

Describe two clinically relevant definitions for patients with high disease activity (HDA) at baseline of the CLARITY study (utility verified in patients receiving placebo) and assess the treatment effects of Cladribine Tablets 3.5 mg/kg compared with the overall study population.

Methods:

Outcomes of patients randomised to Cladribine Tablets 3.5 mg/kg or placebo were analysed for subgroups using HDA definitions based on high relapse activity (HRA; patients with ⩾2 relapses during the year prior to study entry, whether on DMD treatment or not) or HRA plus disease activity on treatment (HRA + DAT; patients with ⩾2 relapses during the year prior to study entry, whether on DMD treatment or not, PLUS patients with ⩾1 relapse during the year prior to study entry while on therapy with other DMDs and ⩾1 T1 Gd+ or ⩾9 T2 lesions).

Results:

In the overall population, Cladribine Tablets 3.5 mg/kg reduced the risk of 6-month-confirmed Expanded Disability Status Scale (EDSS) worsening by 47% vs placebo. A risk reduction of 82% vs placebo was seen in both the HRA and HRA + DAT subgroups (vs 19% for non-HRA and 18% for non-HRA + DAT), indicating greater responsiveness to Cladribine Tablets 3.5 mg/kg in patients with HDA. There were consistent results for other efficacy endpoints. The safety profile in HDA patients was consistent with the overall CLARITY population.

Conclusion:

Patients with HDA showed clinical and MRI responses to Cladribine Tablets 3.5 mg/kg that were generally better than, or at least comparable with, the outcomes seen in the overall CLARITY population.
The Developmental Check-In: Development and initial testing of an autism screening tool targeting young children from underserved communities
Authors: Janvier Yvette M , Coffield Caroline N , Harris Jill F , Mandell David S , Cidav Zuleyha
Published: May 2018

Children with autism spectrum disorder from low-income, minority families or those with limited English proficiency are diagnosed at a later age, or not at all, compared with their more advantaged peers. The Developmental Check-In is a new tool that could potentially be used to screen for autism that uses pictures to illustrate target behaviors. It was developed to enhance early identification of autism spectrum disorder in low literacy groups. The Developmental Check-In was tested in a sample of 376 children between the ages of 24 and 60 months, from underserved communities. It showed good ability to discriminate autism spectrum disorder from non-autism spectrum disorder (area-under-the-curve = 0.75) across the full age range represented in the sample. Twenty-six of the 28 Developmental Check-In items predicted the presence of autism spectrum disorder. Findings suggest that this pictorial tool may reduce linguistic and health literacy demands when screening for autism among vulnerable populations.
Effects of air relative humidity and ventilation rate on particle concentrations within a reduced-scale room
Authors: Yang Tsz Yi , Riskowski Gerald L. , Chang Audrey Ching-Zu
Published: May 2018

An improved understanding of particle movement in ventilated rooms would help reduce airborne disease transmission in healthcare facilities. More empirical data are needed on the movement of small particles in rooms to investigate effects of air relative humidity (RH) and air exchange rates. In this study, small particles were injected into a reduced-scale room, and the particulate mass (PM) concentrations were measured at 12 interior locations in the room as well as at the ventilation air exhaust. The particulates were certified 'plain surface' melamine (polymethylenemelamine) microspheres (1.51 g cm−3 density; 1.98 µm diameter) with hydrophilic surfaces. Experiments were conducted using three conditions of ventilation rate (4, 6 and 8 air changes h−1 (ACH)) and two RH levels (35% and 70%). Increasing the ventilation rate did not significantly decrease PM concentrations in the interior room area, but significantly decreased exhaust air PM concentrations. RH did not affect room PM concentrations for any of the ventilation rates. RH did not affect exhaust air PM concentrations for the 4 ACH or 8 ACH ventilation rates, but the exhaust air PM concentrations were higher at low RH than at high RH for 6 ACH. Regardless of ventilation rate and RH, PM concentrations were uniform throughout the room interior (potentially occupied) zone.
Do norms travel? The case of gender in Danish development cooperation
Authors: Engberg-Pedersen Lars
Published: May 2018

Questioning diffusion and translation as central concepts describing how norms influence policies, the article analyses the drafting process of a recent gender equality policy in Danish development cooperation. Three global norms (gender mainstreaming, sexual and reproductive health and rights, and women’s empowerment) and their influence on the policy are examined, and it is argued that the contingency of policymaking circumscribes the role of global norms. A variety of intra- and extra-organizational factors affect the drafting of the policy, and it is the interaction between these factors and the norms, rather than diffusion or translation of global norms, that best describes the normative influence on Danish gender equality policy.
A cross-sectional study of family caregiver burden and psychological distress linked to frailty and functional dependency of a relative with advanced dementia
Authors: Abreu Wilson , Tolson Debbie , Jackson Graham A , Costa Nilza
Published: May 2018

Psychological health of caregivers of people with dementia is a major public concern. This study sought to determine the relationship between caregiver burden, psychological distress, frailty and functional dependency of a relative with advanced dementia. Persons with dementia and their caregivers (102 dyads) participated in this Portuguese community based cross-sectional study. Data were collected using the Clinical Dementia Rating Scale, a sociodemographic questionnaire, the Zarit Burden Interview, the Brief Symptoms Inventory and the Edmonton Frail Scale. Alzheimer's disease was the most common type of dementia among the recipients of care, who showed moderate (42.2%) to severe (52.9%) dementia. Among them 35.3% exhibited moderate and 45.1% severe frailty. Family caregivers reported moderate (76.5%) to severe burden (18.6%). Psychological distress was very high among family caregivers. Results show that people with dementia exhibited moderate (35.3%) or severe frailty (45.1%) and that a severe frailty was found in people with moderate dementia. A one-way ANOVA was conducted between the Global Severity Index and some sociodemographic variables. ANOVA reached p < .01 for employment status of the caregiver, assistance and professional support, and psychiatric history; and p = 0.01 for caregiver age and years of caregiving. Although caregivers reported benefit from the supportive approach offered by the multidisciplinary home care team, high levels of distress and associated burden were found, which might decrease their capacity to care for the person with dementia and their own health and well-being.
Building a Pathway to Engineering: The Influence of Family and Teachers Among Mexican-Origin Undergraduate Engineering Students
Authors: Mein Erika , Esquinca Alberto , Monarrez Angelica , Saldaña Claudia
Published: May 2018

This study draws on sociocultural perspectives of identity to understand the ways in which Mexican-origin undergraduate students are recruited into the “figured world” of engineering. The analysis of in-depth, ethnographically situated interviews with 14 participants revealed three sets of recurrent discourses in students’ accounts of their pathways to engineering: discourses about the family and the “choice” to study engineering, discourses about childhood activities tied to engineering aspirations, and discourses about teacher support to become an engineer.
Bursting Fracture of Balloon-Expandable Stent and Pseudoaneurysm Formation in the Left Common Iliac Artery and Endovascular Treatment With Graft Stent
Authors: Kim Min , Lee Dae In , Lee Ju-Hee , Lee Sang Yeub , Bae Jang-Whan , Hwang Kyung-Kuk , Kim Dong-Woon , Cho Myeong-Chan , Kim Sangmin
Published: May 2018

Purpose:

To report successful endovascular treatment of a previously implanted balloon-expandable stent bursting fracture with concomitant large pseudoaneurysm formation in the left common iliac artery (LCIA).

Case Report:

A 72-year-old man had been previously treated with balloon-expandable stents for severe stenotic lesion in the LCIA and left external iliac artery. Seven years later, the patient complained pain in both lower legs and back. Angiography demonstrated a 3.5-cm-sized pseudoaneurysm in the LCIA with embedded metal fragments around the lesion. An endovascular treatment was selected using a limb extension graft for endovascular aortic aneurysm repair. The device was successfully deployed, and no endoleak was observed. At 1-month follow-up, computed tomography scan confirmed patency of the implanted stent graft devices in the LCIA and the absence of any endoleak.

Conclusion:

Endovascular approach using a limb extension graft stent for endovascular aortic aneurysm repair can be used for treating stent fracture-related pseudoaneurysm in the common iliac artery.
Decoding the Dynamics of Social Identity Threat in the Workplace: A Within-Person Analysis of Women’s and Men’s Interactions in STEM
Authors: Hall William , Schmader Toni , Aday Audrey , Croft Elizabeth
Published: May 2018

The present research examined whether women’s daily experience of social identity threat in science, technology, engineering, and math (STEM) settings is triggered by a lack of acceptance during workplace conversations with male colleagues that then predicts daily experiences of burnout. To test these hypotheses, participants from two samples ( N = 389) rated their daily interactions with colleagues across 2 weeks. Results revealed that (1) women reported greater daily experiences of social identity threat on days when their work conversations with men cued a lack of acceptance, (2) these daily fluctuations of social identity threat predicted feelings of mental burnout, and (3) these effects were not found among men or for nonwork-relevant conversations. Additional analyses showed that these results were not driven by highly hostile workplace conversations between men and women, nor were they accounted for by individual differences in women’s sensitivity to perceiving gender bias, status differences, or by women being explicitly undermined by colleagues.
Rethinking Research Ethics, Power, and the Risk of Visibility in the Era of the “Alt-Right” Gaze
Authors: Massanari Adrienne L.
Published: May 2018

This essay explores what the “alt-right” (White ethnonationalist, fascist, misogynistic, and anti-intellectual communities) means for social media researchers in terms of research ethics, risk, and visibility. First, it outlines how #Gamergate and #OperationDiggingDiGRA indicated that academic researchers could be targets of their hostility. This essay then draws on the work of Foucault and Mulvey to theorize how far-right groups have a kind of “gaze.” Then, it discusses how far-right extremism requires rethinking ethical questions around researchers and participants. Finally, some thoughts are offered as to what this means for how individuals, organizations, disciplines, and institutions can support research into these spaces.
Ethics Are Admin: Australian Human Research Ethics Review Forms as (Un)Ethical Actors
Authors: Whelan Andrew
Published: May 2018

In Australian universities, social research projects secure institutional approval as ethical through research ethics committees, and are defined and communicated to these committees through standardized local application forms. In organizational terms, ethics are instituted first as an administrative ritual anterior to research, and routinely elided as such. The documentation constituting this ritual thus bears scrutiny, in terms of what it says and what it does, and in turn, what it requires applicants to say and do. Such scrutiny is a means of fleshing out the standard critique of prospective ethics review from social media researchers: that the opportunity for a proper conversation about research ethics in the community of researchers is supplanted by an administrative exercise in “box ticking.” This paper discusses these ethics application forms, attending specifically to the ethical consequences of the stance they require the applicant to take with respect to prospective research participants, and the implications of their formulation of research as a process of data extraction.
Simulating the Fidelity of Data for Large Stimulus Set Sizes and Variable Dimension Estimation in Multidimensional Scaling
Authors: Hout Michael C. , Cunningham Corbin A. , Robbins Arryn , MacDonald Justin
Published: May 2018

Multidimensional scaling (MDS) is a statistical technique commonly used to model the psychological similarity among sets of stimulus items. Typically, MDS has been used with relatively small stimulus sets (30 items or fewer), in part due to the laborious nature of computational analysis and data collection. Modern computing power and newly advanced techniques for speeding data collection have made it possible to conduct MDS with many more stimuli. However, it is as yet unclear if MDS is as well-equipped to model the similarity of large stimulus sets as it is for more modest ones. Here, we conducted 337,500 simulation experiments, wherein hypothetical “true” MDS spaces were created, along with error-perturbed data from simulated “participants.” We examined the fidelity with which the spaces resulting from our “participants” captured the organization of the “true” spaces, as a function of item set size, amount of error in the data (i.e., noise), and dimensionality estimation. We found that although higher set sizes decrease model fit (i.e., they produce increased “stress”), they largely tended to increase determinacy of MDS spaces. These results are predicated, however, on the appropriate estimation of dimensionality of the MDS space. We argue that it is not only reasonable to adopt large stimulus set sizes but tends to be advantageous to do so. Applying MDS to larger sets is appealing, as it affords researchers greater flexibility in stimulus selection, more opportunity for exploration of their stimuli, and a higher likelihood that observed relationships are not due to stimulus-specific idiosyncrasies.
Fibular Collateral Ligament: Varus Stress Radiographic Analysis Using 3 Different Clinical Techniques
Authors: Kane Patrick W. , Cinque Mark E. , Moatshe Gilbert , Chahla Jorge , DePhillipo Nicholas N. , Provencher Matthew T. , LaPrade Robert F.
Published: May 2018

Background:

Fibular collateral ligament (FCL) tears are challenging to diagnose. Left untreated, FCL tears lead to residual ligament instability and increased joint loading on the medial compartment of the knee. Additionally, when a concomitant anterior cruciate ligament (ACL) reconstruction is performed, increased forces on reconstruction grafts occur, which may lead to premature graft failure. Stress radiographs constitute a reliable and validated technique for the objective assessment of a complete grade III FCL tear.

Purpose:

To evaluate side-to-side difference (SSD) values of lateral compartment gapping on varus stress radiographs in patients with a grade III injury to the FCL. Additionally, to evaluate the reliability and reproducibility of 3 different measurement techniques that used various radiographic reference points.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Inclusion criteria were patients who sustained an FCL with or without a concomitant ACL injury and underwent a combined FCL + ACL reconstruction between 2010 and 2016. Patients were excluded if they had a complete posterolateral corner injury, open physes, intra-articular fracture, meniscal root tear, other ligament injury, or prior surgery on either knee. All FCL tears were diagnosed with a clinical varus stress examination at 0° and 20° of knee flexion and varus stress radiographs at 20° of knee flexion measured in 3 different locations. The SSD for lateral compartment gapping was obtained from the varus stress radiographs and then statistically compared for interrater and intrarater reliability.

Results:

A total of 98 consecutive patients (50 males, 48 females; 13 isolated FCL injuries, 85 combined ACL + FCL injuries) with mean age 33.6 years (range, 18-69 years) were included. Measurement techniques 1, 2, and 3 had mean ± SD lateral compartment SSDs of 2.4 ± 0.20 mm, 2.2 ± 0.20 mm, and 2.0 ± 0.03 mm, respectively (no significant differences). Interrater reliabilities for the 3 measuring techniques were 0.83, 0.86, and 0.91, respectively, while intrarater reliabilities were 0.99, 0.77, and 0.99, respectively.

Conclusion:

This study demonstrated a lower SSD value of 2.2 mm to be consistent with a grade III FCL tear on clinician-applied varus stress radiographs in the clinical setting. Although all SSD measurement locations had excellent reliability, the method using the midpoint of the lateral tibial plateau was found to be the most reproducible.
Outcomes With a Self-Fitting Hearing Aid
Authors: Keidser Gitte , Convery Elizabeth
Published: May 2018

Self-fitting hearing aids (SFHAs)—devices that enable self-directed threshold measurements leading to a prescribed hearing aid (HA) setting, and fine-tuning, without the need for professional support—are now commercially available. This study examined outcomes obtained with one commercial SFHA, the Companion (SoundWorld Solutions), when support was available from a clinical assistant during self-fitting. Participants consisted of 27 experienced and 25 new HA users who completed the self-fitting process, resulting in 38 user-driven and 14 clinician-driven fittings. Following 12 weeks’ experience with the SFHAs in the field, outcomes measured included the following: coupler gain and output, HA handling and management skills, speech recognition in noise, and self-reported benefit and satisfaction. In addition, the conventionally fitted HAs of 22 of the experienced participants who had user-driven fittings were evaluated. Irrespective of HA experience, the type of fitting (user- or clinician-driven) had no significant effect on coupler gain, speech recognition scores, or self-reported benefit and satisfaction. Users selected significantly higher low-frequency gain in the SFHAs when compared with the conventionally fitted HAs. The conventionally fitted HAs were rated significantly higher for benefit and satisfaction on some subscales due to negative issues with the physical design and implementation of the SFHAs, rather than who drove the fitting process. Poorer cognitive function was associated with poorer handling and management of the SFHAs. Findings suggest that with the right design and support, SFHAs may be a viable option to improve the accessibility of hearing health care.