bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in Music Player Listening Level as a Function of Campus Location
Authors: Park Yunea , Guercio Diana , Ledon Victoria , Le Prell Colleen G.
Published: November 2016

Background:There has been significant discussion in the literature regarding music player use by adolescents and young adults, including whether device use is driving an increase in hearing loss in these populations. While many studies report relatively safe preferred listening
levels, some studies with college student participants have reported listening habits that may put individuals at risk for noise-induced hearing loss (NIHL) if those listening habits continue over the long term.Purpose:The goal of the current investigation was to extend listening level
data collection sites from urban city settings studied by others to a more rural campus setting.Research Design:This was a prospective study.Study Sample:Participants were 138 students on the University of Florida campus (94 males, 44 females), 18 years or older (mean = 21 years;
range: 18‐33 years).Data Collection and Analysis:In this investigation, the current output level (listening level) was measured from personal listening devices used by students as they passed by a recruiting table located in one of three areas of the University of Florida campus.
One location was in an open-air campus square; the other two locations were outside the campus recreation building (“gym”) and outside the undergraduate library, with participants recruited as they exited the gym or library buildings. After providing written informed consent, participants
completed a survey that included questions about demographics and typical listening habits (hours per day, days per week). The output level on their device was then measured using a “Jolene” mannequin.Results:Average listening levels for participants at the three locations
were as follows: gym: 85.9 ± 1.4 dBA; campus square: 83.3 ± 2.0 dBA; library: 76.9 ± 1.3 dBA. After adjusting to free-field equivalent level, average listening levels were gym: 79.7 ± 1.4 dBA; campus square: 76.9 ± 2.1 dBA; library: 70.4 ± 1.4 dBA.
There were no statistically significant differences between male and female listeners, and there were no reliable differences as a function of race. After accounting for daily and weekly use patterns, 5% were deemed at risk based on the criteria put forward by the Occupational Safety and Health
Administration, and 9% were deemed at risk based on the guidance provided by the National Institute for Occupational Safety and Health.Conclusions:Some 5‐10% of the participants were deemed at risk; this finding is consistent with other studies using similar methods. It is possible
that the same listeners would have selected different listening levels in other noise backgrounds, however. This unknown variable makes it difficult to estimate risk with a single listening level measurement.
The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review
Authors: Agmon Maayan , Lavie Limor , Doumas Michail
Published: November 2016

Background:Degraded hearing in older adults has been associated with reduced postural control and higher risk of falls. Both hearing loss (HL) and falls have dramatic effects on older persons’ quality of life (QoL). A large body of research explored the comorbidity between
the two domains.Purpose:The aim of the current review is to describe the comorbidity between HL and objective measures of postural control, to offer potential mechanisms underlying this relationship, and to discuss the clinical implications of this comorbidity.Data Collection and
Analysis:PubMed and Google Scholar were systematically searched for articles published in English up until October 15, 2015, using combinations of the following strings and search words: for hearing: Hearing loss, “Hearing loss,” hearing, presbycusis; for postural control:
postural control, gait, postural balance, fall, walking; and for age: elderly, older adults.Results:Of 211 screened articles, 7 were included in the systematic review. A significant, positive association between HL and several objective measures of postural control was found in all
seven studies, even after controlling for major covariates. Severity of hearing impairment was connected to higher prevalence of difficulties in walking and falls. Physiological, cognitive, and behavioral processes that may influence auditory system and postural control were suggested as potential
explanations for the association between HL and postural control.Conclusions:There is evidence for the independent relationship between HL and objective measures of postural control in the elderly. However, a more comprehensive understanding of the mechanisms underlying this relationship
is yet to be elucidated. Concurrent diagnosis, treatment, and rehabilitation of these two modalities may reduce falls and increase QoL in older adults.
PIXEL ANALYSIS OF PHOTOSPHERIC SPECTRAL DATA. I. PLASMA DYNAMICS
Authors: Rasca Anthony P. , Chen James , Pevtsov Alexei A.
Published: November 2016

Recent observations of the photosphere using high spatial and temporal resolution show small dynamic features at or below the current resolving limits. A new pixel dynamics method has been developed to analyze spectral profiles and quantify changes in line displacement, width, asymmetry, and peakedness of photospheric absorption lines. The algorithm evaluates variations of line profile properties in each pixel and determines the statistics of such fluctuations averaged over all pixels in a given region. The method has been used to derive statistical characteristics of pixel fluctuations in observed quiet-Sun regions, an active region with no eruption, and an active region with an ongoing eruption. Using Stokes I images from the Vector Spectromagnetograph (VSM) of the Synoptic Optical Long-term Investigations of the Sun (SOLIS) telescope on 2012 March 13, variations in line width and peakedness of Fe i 6301.5 Å are shown to have a distinct spatial and temporal relationship with an M7.9 X-ray flare in NOAA 11429. This relationship is observed as stationary and contiguous patches of pixels adjacent to a sunspot exhibiting intense flattening in the line profile and line-center displacement as the X-ray flare approaches peak intensity, which is not present in area scans of the non-eruptive active region. The analysis of pixel dynamics allows one to extract quantitative information on differences in plasma dynamics on sub-pixel scales in these photospheric regions. The analysis can be extended to include the Stokes parameters and study signatures of vector components of magnetic fields and coupled plasma properties.
EFFECT OF SURFACE-MANTLE WATER EXCHANGE PARAMETERIZATIONS ON EXOPLANET OCEAN DEPTHS
Authors: Komacek Thaddeus D. , Abbot Dorian S.
Published: November 2016

Terrestrial exoplanets in the canonical habitable zone may have a variety of initial water fractions due to random volatile delivery by planetesimals. If the total planetary water complement is high, the entire surface may be covered in water, forming a “waterworld.” On a planet with active tectonics, competing mechanisms act to regulate the abundance of water on the surface by determining the partitioning of water between interior and surface. Here we explore how the incorporation of different mechanisms for the degassing and regassing of water changes the volatile evolution of a planet. For all of the models considered, volatile cycling reaches an approximate steady state after

. Using these steady states, we find that if volatile cycling is either solely dependent on temperature or seafloor pressure, exoplanets require a high abundance (

of total mass) of water to have fully inundated surfaces. However, if degassing is more dependent on seafloor pressure and regassing mainly dependent on mantle temperature, the degassing rate is relatively large at late times and a steady state between degassing and regassing is reached with a substantial surface water fraction. If this hybrid model is physical, super-Earths with a total water fraction similar to that of the Earth can become waterworlds. As a result, further understanding of the processes that drive volatile cycling on terrestrial planets is needed to determine the water fraction at which they are likely to become waterworlds.
EXPERIMENTAL INVESTIGATION OF IRRADIATION-DRIVEN HYDROGEN ISOTOPE FRACTIONATION IN ANALOGS OF PROTOPLANETARY HYDROUS SILICATE DUST
Authors: Roskosz Mathieu , Laurent Boris , Leroux Hugues , Remusat Laurent
Published: November 2016

The origin of hydrogen in chondritic components is poorly understood. Their isotopic composition is heavier than the solar nebula gas. In addition, in most meteorites, hydrous silicates are found to be lighter than the coexisting organic matter. Ionizing irradiation recently emerged as an efficient hydrogen fractionating process in organics, but its effect on H-bearing silicates remains essentially unknown. We report the evolution of the D/H of hydrous silicates experimentally irradiated by electrons. Thin films of amorphous silica, amorphous “serpentine,” and pellets of crystalline muscovite were irradiated at 4 and 30 keV. For all samples, irradiation leads to a large hydrogen loss correlated with a moderate deuterium enrichment of the solid residue. The entire data set can be described by a Rayleigh distillation. The calculated fractionation factor is consistent with a kinetically controlled fractionation during the loss of hydrogen. Furthermore, for a given ionizing condition, the deuteration of the silicate residues is much lower than the deuteration measured on irradiated organic macromolecules. These results provide firm evidence of the limitations of ionizing irradiation as a driving mechanism for D-enrichment of silicate materials. The isotopic composition of the silicate dust cannot rise from a protosolar to a chondritic signature during solar irradiations. More importantly, these results imply that irradiation of the disk naturally induces a strong decoupling of the isotopic signatures of coexisting organics and silicates. This decoupling is consistent with the systematic difference observed between the heavy organic matter and the lighter water typically associated with minerals in the matrix of most carbonaceous chondrites.
Aortic Root Enlargement or Sutureless Valve Implantation?
Authors: Baikoussis Nikolaos G. , Dedeilias Panagiotis , Argiriou Michalis
Published: November 2016

Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging issue. The importance of prosthesisâ€“patient mismatch (PPM) post aortic valve replacement (AVR) is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR) and the transcatheter valve implantation (TAVI).
Treatment of Pediatric Open Supracondylar Humerus Fractures: Case Report
Authors: Al-Sadek Tabet A. , Niklev Desislav , Al-Sadek Ahmed
Published: November 2016

BACKGROUND: Open supracondylar fractures of the humerus are rare in children, and the treatment strategy for these fractures is yet to be standardised.AIM: We present the case of a 7-year-old boy with open supracondylar humerus fracture that was managed with an external wrist fixator.CASE PRESENTATION: A 7-year-boy was brought to our department with pain in the right arm after a fall from a height about 3 hours before admission. On examination, the elbow was found to be markedly swollen with restriction of movement of the right arm. A 4-cm-wide wound was also observed on the flexural aspect of the elbow, indicating severe contamination of the fractured site. Neurological examination revealed restriction of hand movement and decreased sensations, which suggested the possibility of nerve injuries.CONCLUSION: A good clinical outcome was achieved in this case, without the development of any complications over a 6-month follow-up period.
Discovery of a New World ladybird beetle Nephaspis indus Gordon, 1996 (Coleoptera: Coccinellidae: Scymnini) on the Island of Taiwan
Authors: Chen Xiaosheng , Xie Xiufeng , Ren Shunxiang , Wang Xingmin
Published: November 2016

Nephaspis indus Gordon, 1996 was imported into Taiwan from Hawaii in 1990 as a biological control agent for the spiralling whitefly, Aleurodicus dispersus Russell, 1965 (Hemiptera: Aleyrodidae). However, its establishment was not known prior to this study.

Nephaspis indus Gordon, 1996, a natural enemy of Aleurodicus dispersus Russell (Hemiptera: Aleyrodidae) native to the Neotropical region, is recorded as established in Taiwan for the first time. The present paper provides a detailed further description and illustrations of the adult. Diagnostic characters for the genus and species are given and the nomenclature of this species is also discussed.
Lupus Myocarditis: Initial Presentation and Longterm Outcomes in a Multicentric Series of 29 Patients
Authors: Thomas Guillemette , Cohen Aubart Fleur , Chiche Laurent , Haroche Julien , Hié Miguel , Hervier Baptiste , Costedoat-Chalumeau Nathalie , Mazodier Karine , Ebbo Mikael , Cluzel Philippe , Cordel Nadège , Ribes David , Chastre Jean , Schleinitz Nicolas , Veit Véronique , Piette Jean-Charles , Harlé Jean-Robert , Combes Alain , Amoura Zahir
Published: November 2016

Objective.

Cardiac involvement during systemic lupus erythematosus (SLE) may include the pericardium, myocardium, valvular tissue, and coronary arteries. The aim of this study was to describe the clinical, biological, and radiological presentation of lupus myocarditis (LM) as well as the treatment response and longterm outcomes.

Methods.

We conducted a multicentric retrospective study of LM from January 2000 to May 2014.

Results.

Twenty-nine patients (3 men and 26 women) fulfilled the inclusion criteria (median age at the diagnosis of SLE: 30 yrs, range 16–57). Myocarditis was the first sign of SLE in 17/29 cases (58.6%). Troponin was elevated in 20/25 cases. Electrocardiogram results were abnormal in 25/28 cases. Echocardiography revealed low (≤ 45%) left ventricular ejection fraction (LVEF; 19/29, 66%) and pericardium effusion (20/29, 69%). Cardiac magnetic resonance imaging revealed delayed gadolinium enhancement in 9/13 patients (69%). Patients were treated with corticosteroids (n = 28), cyclophosphamide (CYC; n = 16), intravenous immunoglobulins (n = 8), and/or mycophenolate mofetil (n = 2). The median followup was 37 months. One month after the beginning of the treatment, 10/23 patients (43%) who had undergone echocardiography had an LVEF ≥ 55%. At the end of followup, 21/26 patients (81%) exhibited an LVEF ≥ 55%. Three patients died during followup, and 2 died from LM.

Conclusion.

LM is a severe manifestation of SLE. It can be the first manifestation of the disease or it can occur during followup, in particular in untreated patients. However, the longterm prognosis is typically positive. Patients with less severe disease exhibited good LVEF recovery without CYC.
Les guérisseurs traditionnels et leur pratique thérapeutique « syncrétique » en milieu urbain au Kazakhstan
Authors: Jumageldinov Askar
Published: November 2016

Les guérisseurs traditionnels au Kazakhstan sont reconnus comme représentants de la médecine « alternative ». Notre objectif était d’étudier leur pratique en milieu urbain et d’analyser la valeur thérapeutique de leurs méthodes de traitement en lien avec les traditions culturelles et religieuses. Dans ce but, nous avons interviewé deux guérisseuses et observé leurs séances de traitement à Astana. L’analyse a montré que le syncrétisme était une caractéristique fondamentale de leur pratique. Cette dernière permet de combiner plusieurs méthodes thérapeutiques pour donner un traitement satisfaisant, et ainsi de résoudre les problèmes des patients.
Les rapports sociaux dans le transfert culturel
Authors: Delanoë Daniel , Moro Marie Rose
Published: November 2016

Contrairement au contre-transfert culturel, le transfert culturel a été peu étudié. Défini comme les réactions du collectif qui est dans le patient au collectif qui est dans le thérapeute, il demeure un continent noir de la psychanalyse et de l’ethnopsychanalyse. Nous proposons de considérer le transfert culturel comme une relation sociale, mise en jeu dans la consultation transculturelle, et traversée de rapports sociaux, lesquels sont généralement hiérarchiques. Nous proposons une problématisation du transfert culturel autour de cinq logiques structurant les relations entre les groupes d’appartenance des patients et des thérapeutes : la relation de pouvoir entre thérapeute et patient, la relation humanitaire prise entre solidarité et inégalité, les relations postcoloniales entre anciens colonisés et anciens colonisateurs, les rapports sociaux racialisés, la domination culturelle mondialisée. Ces dimensions invitent à parler de transfert socio-culturel plus que d’un transfert culturel.
La querelle père/oncle maternel chez les migrants kongos en France
Authors: Ntondo Bubote Eugène
Published: November 2016

Les sociétés matrilinéaires s’inscrivent dans une dichotomie entre le père et l’oncle maternel dans la fonction, le rôle et le statut auprès de l’enfant. Chez les Kongo, cet antagonisme a connu une émergence rapide dès le premier contact de cultures : la rencontre des missionnaires occidentaux. Les questions identitaires, y compris celles liées aux diverses transmissions, alimentent cette polémique. Dans la migration en France, plus que dans le contexte initial des migrants Kongo, la perception de la filiation biologique, instituée et narcissique est édictée par les normes du pays d’accueil. L’adulte s’y positionne dans la proximité de l’enfant, intronisé et porté par les exigences sociales et juridiques de cette culture seconde. Ce rapprochement repousse le lien avunculaire aux frontières de la migration. Dans cette conception nouvelle, le père s’installe en tiers, séparant la dyade mère enfant. Il prend place dans une triangulation différente de celle qui intégrait le frère de la mère. La présente réflexion interroge la querelle dans le contexte migratoire. Elle tente d’en dégager les enjeux anthropologiques, psychologiques et interculturels. Cinq cas cliniques vont illustrer ces réalités familiales.
Améliorer l’alliance thérapeutique avec enfants et familles en situation interculturelle
Authors: Sturm Gesine , Bonnet Sylvie , Gouzvinsk Françoise , Pinquier Anne , Guerraoui Zohra , Raynaud Jean-Philippe
Published: November 2016

Dans cet article, nous présentons un dispositif d’intervention interculturelle qui a été créé au Service Universitaire Psychiatrie de l’Enfant et de l’Adolescent (SUPEA) de l’-hôpital la Grave à Toulouse afin d’améliorer l’alliance thérapeutique entre familles et soignants dans le contexte des prises en charges des enfants au niveau du Centre Médico-Psychologique (CMP). Ce dispositif vise à améliorer l’alliance thérapeutique entre les familles suivis au CMP. La présentation est complétée par une illustration clinique d’une prise en charge en dispositif interculturel.
Elephant grass silage with the addition of crambe bran conjugated to different specific mass
Authors: Cardoso Arilson Moraes , Araújo Saulo Alberto do Carmo , Rocha Norberto Silva , Domingues Felipe Nogueira , Azevedo Jorge Cardoso de , Pantoja Lilian De Araújo
Published: November 2016

This study aimed to evaluate the effects of inclusion of crambe bran concentrations (Crambe abyssinica Hochst.) with different specific masses in elephant grass silage (Penninsetum purpureum Schum.). For that, the bromatological and microbiological compositions of the experimental silages were determined. We used 48 mini silos distributed in a completely randomized design, arranged in a factorial 4 × 3, four levels of inclusion of crambe bran (0; 10; 20 and 30%) and three specific masses (400; 500 and 600 kg MN m-3), with four replications. After 240 days of fermentation the silos were opened. It was observed linear effect on DM, CP, NDFap, ADFap, HEM, LIG, NFC, TC and population of bacteria that produce lactic acid with the addition of crambe meal. There was interaction between the crambe bran factors and specific masses on the values of pH and N-NH3. For MM variables and yeast count there was a negative linear effect due to the evaluated specific mass. The inclusion of crambe bran helps to increase the fermentative profile and the bromatological composition of elephant grass silages studied, and the best results were obtained with the addition of 30% of this coproduct, based on the natural matter.
Impact of internal governance on creating entrepreneurial universities: a study based on Sri Lankan universities
Authors: Perera L. N. S. , Senarath S. A. C. L.
Published: November 2016

Becoming an entrepreneurial university is the key strategy that needs to be adopted by public universities at present. When becoming an entrepreneurial university they need to adopt innovative and entrepreneurial approaches in the provision of their products and services and develop partnerships, networks and other relationships with public and private organizations. To adopt for all these internal governance structure (university structure and leadership) of the public universities plays a key role. This research intends to identify how far Sri Lankan public universities organizational structure and entrepreneurial leadership behavior has supported on becoming entrepreneurial universities. The study has developed two hypothesis and primary data collected from four public universities has been analyzed through regression analysis. Finally, outcomes of this research identified that university structure has a significant negative impact in the process of becoming an entrepreneurial university as well as entrepreneurial leadership behavior is still lacking from Sri Lankan context.
Mislabelling of Döner kebab sold in Italy
Authors: Liuzzo Gaetano , Rossi Roberto , Giacometti Federica , Piva Silvia , Serraino Andrea , Mescolini Giulia , Militerno Gianfranco
Published: November 2016

The aim of this study was to assess whether Döner kebabs sold in Italy comply with legal labelling requirements. A checklist of EU labelling requirements was drawn up and nine labels of Döner kebab marketed in the province of Modena were collected to evaluate the mandatory information laid down in article 9 of Regulation (EU) No 1169/2011 together with the mandatory requirements of Regulation (EC) 853/2004 for meat preparations. The study showed that different additives are commonly used in Döner kebabs, including E 621 (monosodium glutamate). This additive is not included among the ingredients authorized for the meat preparation food category. Eight frozen Döner kebab samples were taken and a visual assessment and a histologic examination were performed to verify potential changes in the meat’s inner muscle fibre structure that could allow the product to be considered among meat preparations or meat products. The Döner kebab labels showed several systematically deficient regulatory requirements in both extrinsic defects (not related to food composition) and aspects concerning the protection of consumers’ health. Histological examination showed that the tissue was moderately swollen, but the muscle fibre structure was intact. Kebab can be reasonably classified as a meat preparation thereby precluding the use monosodium glutamate (E 621) as an ingredient.
First multi-year retrospective study on Vibrio parahaemolyticus and Vibrio vulnificus prevalence in Ruditapes philippinarum in Sacca di Goro, Italy
Authors: Serratore Patrizia , Ostanello Fabio , Passalacqua Pier Luca , Zavatta Emanuele , Bignami Giorgia , Serraino Andrea , Giacometti Federica
Published: November 2016

The present work describes a retrospective study aiming to verify a possible correlation between the environmental conditions (temperature, salinity and dissolved oxygen), the abundance of Vibrio spp., and the prevalence of V. parahaemolyticus and V. vulnificus in the Manila clam R. philippinarum harvested in Sacca di Goro, Emilia-Romagna Region, Northern Italy. On the whole, 104 samples, collected in the period 2007-2015 and submitted to microbiological analyses (isolation and genotyping), have been reconsidered for Vibrio spp. load, V. parahaemolyticus prevalence (total, gene marker toxRP; potentially pathogenic, gene markers tdh and/or trh) and V. vulnificus prevalence (total, gene markers vvhA and hsp) together with environmental data obtained from the monitoring activity of the Emilia-Romagna Regional Agency for the prevention, the environment and the energy (ARPAE). Environmental data have been processed to calculate the median of each, assessing the seasonal range of seawater temperature (warmer months: April-October, T°C >16.45°C; cooler months November-March, T°C 27 psu), and dissolved oxygen (< or >8.2 mg/L). Total V. vulnificus, total and potentially pathogenic V. parahaemolyticus were present respectively in the 11.5%, 29.8% and 6.7% of the samples. The Vibrio spp. load (mean value of 4.69±0.65 log10 CFU g-1) and the prevalence of potentially pathogenic V. parahaemolyticus, were not significantly correlated to the environmental conditions (P>0.05), whereas the prevalence of both total V. vulnificus and total V. parahaemolyticus was significantly higher in the warmer period (P<0.05), without correlation with salinity and dissolved oxygen values (P>0.05).
Effect of a phenolic extract from olive vegetation water on fresh salmon steak quality during storage
Authors: Miraglia Dino , Esposto Sonia , Branciari Raffaella , Urbani Stefania , Servili Maurizio , Perucci Simona , Ranucci David
Published: November 2016

This study aimed to evaluate the antioxidant and antimicrobial effects of a phenolic extract from olive vegetation water on fresh salmon steaks stored at 4°C under modified atmosphere. Twenty-four salmon steaks were respectively immersed in solutions of the diluted phenolic extract at 1.5 g/L (A), 3 g/L (B), and water only as a control (CTR), packaged within a protective atmosphere (70% carbon dioxide, 25% nitrogen and 5% oxygen) and then stored at 4°C. After 2 h, and 3 and 6 days of storage, the fish samples were analysed for the total viable count, Enterobacteriaceae count, pH, colour (CIE L*a*b* colour system), phenolic composition, α-tocopherol content, antioxidant activity by DPPH˙ (2,2-diphenyl-1- picrylhydrazyl) assay and thiobarbituric reactive substances (TBARS). A 3 g/L phenolic extract contributed positively to the hygienic quality of the salmon by reducing the microbial growth during storage. The treated samples were slightly yellower than the CTR but only at the beginning of storage. The flesh contained 6.2% of the total polyphenols present in the initial solutions, with various percentages of the single fractions. After 6 days storage, the α- tocopherol content in the CTR and A samples was statistically lower than the B group which also showed the lowest DPPH˙ and TBARS values. In conclusion, the phenolic extract increased the microbiological quality and antioxidant concentration and decreased the lipid oxidation of salmon steaks during storage at 4°C under modified atmosphere.
Risk assessment in the recovery of food for social solidarity purposes: preliminary data
Authors: Milicevic Vesna , Colavita Giampaolo , Castrica Marta , Ratti Sabrina , Baldi Antonella , Balzaretti Claudia M.
Published: November 2016

The most recent study, conducted by Politecnico of Milan, on food surplus management in Italy, entitled Surplus Food Management Against Food Waste, shows that in the Italian food supply chain, the food surplus is around to 5.5 million tons/year, and the amount of food wasted is around to 5.1 million tons/year. During 2015, the charitable organizations (COs) belonging to Italian Food Bank Network, active in recovering and distributing food for social solidarity’s purposes, reused 381.345 tons of food from 2.292 donors. The main supplying sources of the Banco Alimentare Network are: food industries, organized large-scale retail trade and collective catering service. The aim of this study was to analyze several aspects of the food surplus recovery thanks to the collaboration with the Fondazione Banco Alimentare Onlus (FBAO) and Caritas Italiana. In particular, two main features were analyzed in the food recovery chain: i) the microbiological profiles of specific food categories recovered from catering service with the aim to evaluate their conformity in relation to food safety and process criteria. For this purpose 11 samples were analyzed in four different moments: -­‐ T0: same day of the collection; -­‐ T1: after four hours of storage at 4°C; -­‐ T2: 24 hours from the collection (storage at 4°C); -­‐ T3: after four days at frozen storage (-18°C). For all samples several were investigated microbiological parameters: enumeration of Mesophilic aerobic bacteria (AFNOR 3M 01/1-09/89), enumeration of Enterobacteriaceae (AFNOR 3M 01/06-09/97), enumeration of E. coli (AFNOR 3M 01/08-06/01), enumeration of coagulase-positive Staphylococci AFNOR 3M 01/ 9-04/03 A), enumeration of Bacillus cereus (UNI EN ISO 7932:2005), research of Salmonella spp. (UNI EN ISO 6579 (2008b) and research of Listeria monocytogenes (AFNOR BRD 07/4-09/98 (AFNOR, 2010a)). Furthermore, ii) the volunteer’s knowledge on the correct hygienic procedures during the recovery, were evaluated by the 71 questionnaires with the aim to prevent foodborne diseases. The results show that the recovery of surplus from catering service and their reuse at COs should be planned with correct procedures, and the volunteer’s knowledge on the hygienic aspects appear to be a critical point. The recovery and the charitable activities require an appropriate assessment and careful risk analysis, in order to manage the complexity of no profit organization.
Core Stability Exercise Versus General Exercise for Chronic Low Back Pain
Authors: Coulombe Brian J. , Games Kenneth E. , Neil Elizabeth R. , Eberman Lindsey E.
Published: November 2016

Reference: Wang XQ, Zheng JJ, Yu ZW, et al. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082.

Clinical Questions: Is core stability exercise more effective than general exercise in the treatment of patients with nonspecific low back pain (LBP)?

Data Sources: The authors searched the following databases: China Biological Medicine disc, Cochrane Library, Embase, and PubMed from 1970 through 2011. The key medical subject headings searched were chronic pain, exercise, LBP, lumbosacral region, and sciatica.

Study Selection: Randomized controlled trials comparing core stability exercise with general exercise in the treatment of chronic LBP were investigated. Participants were male and female adults with LBP for at least 3 months that was not caused by a specific known condition. A control group receiving general exercise and an experimental group receiving core stability exercise were required for inclusion in the meta-analysis. Core stability was defined as the ability to ensure a stable neutral spine position, but the type of exercise was not specified. Outcome measures of pain intensity, back-specific functional status, quality of life, and work absenteeism were recorded at 3-, 6-, and 12-month intervals.

Data Extraction: The study design, participant information, description of interventions in the control and experimental groups, outcome measures, and follow-up period were extracted. The mean difference (MD) and 95% confidence interval (CI) were calculated to evaluate statistical significance. Risk of bias was assessed using the Cochrane Collaboration Recommendations, and all articles were rated as high risk for other bias with no further explanation given.

Main Results: Five studies involving 414 patients were included. Four studies assessed pain intensity using the visual analog scale or numeric rating scale. In the core stability exercise group, the reduction in pain was significant at 3 months (MD = −1.29, 95% CI = −2.47, −0.11; P = .003) but not at 6 months (MD = −0.50, 95% CI = −1.36, 0.35; P = .26). Functional status was improved at 3 months (MD = −7.14, 95% CI = −11.64, −2.65; P = .002) but not at 6 months (MD = −0.50, 95% CI = 0.36, 0.35; P = .26) or 12 months (MD = −0.32, 95% CI = −0.87, 0.23; P = .25). All of the included studies assessed back-specific functional status: 4 used the Oswestry Disability Index and 1 used the Roland-Morris Disability Questionnaire. Patients in the core stability exercise groups experienced improved functional status versus the general exercise group at 3 months (MD = −7.14, 95% CI = −11.64, −2.65; P = .002); no results were recorded at 6 or 12 months.

Conclusions: In the short term, core stability exercise was more effective than general exercise for decreasing pain and increasing back-specific functional status in patients with LBP.
Competition-Level Differences on the Lower Quarter Y-Balance Test in Baseball Players
Authors: Butler Robert J. , Bullock Garrett , Arnold Todd , Plisky Phillip , Queen Robin
Published: November 2016

Context:

Decreased performance in dynamic balance has previously been associated with a history of ulnar collateral ligament injury in baseball players. Previous research on dynamic balance in soccer players has shown that test performance depends on competition level. However, dynamic balance has yet to be examined in baseball players.

Objective:

To understand normative values and determine differences in dynamic balance, as measured by the Lower Quarter Y-Balance Test, across competition levels in baseball players.

Design:

Cross-sectional study.

Setting:

Preseason physical examinations.

Patients or Other Participants:

Dynamic balance was measured in 88 high school (HS), 78 collegiate (COL), and 90 professional (PRO) baseball players.

Main Outcome Measure(s):

All participants completed the Lower Quarter Y-Balance Test using the standard protocol. In unilateral stance, they reached with 1 foot in the anterior, posteromedial, and posterolateral directions. We calculated 1-way analyses of variance to compare performance, composite score, and reach asymmetry for each direction as well as the sum of the asymmetry values (P < .05). Composite score was calculated by averaging the maximum normalized reach scores. Reach asymmetry was determined by calculating bilateral differences in reach ability.

Results:

In comparison with the HS and COL groups, the PRO players exhibited greater posteromedial (P < .01; effect size index [ESI]HS = 1.06, ESICOL = 0.95) and posterolateral reach (P < .01; ESIHS = 0.82, ESICOL = 0.84) as well as a greater composite score (P < .01; ESIHS = 0.60, ESICOL = 0.87). In contrast, HS baseball players exhibited increased anterior reach (P < .01; ESICOL = 0.60, ESIPRO = 0.39) compared with the COL and PRO cohorts. No significant differences in reach asymmetry were observed among groups.

Conclusions:

Lower extremity dynamic balance performance differed based on the baseball players' competition level. These baseline data may be helpful in identifying low-performing athletes who might benefit from neuromuscular interventions.
Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa
Authors: Goie Thea T. , Naidoo Mergan
Published: November 2016

Background: Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM).Methods: An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa.Results: Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p < 0.05).Conclusion: The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.
Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital
Authors: Jose JV , Jose M , Devi P , Satish R
Published: November 2016

Aims:

To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN) in the nephrology department of a tertiary care hospital.

Materials and Methods:

A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February–July 2015). Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost.

Results:

Of 100 patients, 50 were above 60 years and 75 were male. Ninety-seven patients had hypertension, which was the most common comorbidity. The majority (60 patients) belonged to Stage 5 DN and 59 patients were on dialysis. The mean number of drugs per patient was 7.60 ± 2.44. The total monthly cost per patient amounted to INR 24,203.27 with total direct cost of INR 21,013.90 (87%) and indirect cost of INR 3189.30 (13%). The monthly cost of dialysis and pharmacotherapy per patient were INR 9060.00 (37%) and INR 2535.98 (11%), respectively. Stage of DN (unstandardized coefficient, B = 7553.96, 95% confidence interval [CI] [6175.09–8932.82], P < 0.001) was a significant determinant of total cost. Number of drugs (B = 636.694, 95% CI [335.670–937.718], P < 0.001) and stage of DN (B = 852.986, 95% CI [297.043–1408.928], P = 0.003) were predictors of cost of pharmacotherapy.

Conclusion:

Stage of DN and number of drugs prescribed were major determinants of cost of pharmacotherapy.
Postradiotherapy small cell neuroendocrine carcinoma of base of tongue
Authors: Jha V , Sharma P , Yadav AK , Mandal AK
Published: November 2016

Small cell neuroendocrine carcinoma (NEC) of the tongue is an extremely rare entity with only seven cases reported in literature till date. These are high-grade tumors with a dismal prognosis. There is much ambiguity regarding the classification, treatment protocols and prognostic factors of these tumors due to the paucity of studies. We describe an exceptionally rare and unusual case of small cell NEC of the base of tongue arising in an elderly man 6 years after receiving radiotherapy for the treatment of squamous cell carcinoma at the same site. The diagnosis was confirmed on histopathological examination and supported by immunohistochemical positivity for neuron-specific enolase, synaptophysin, chromogranin, pan-cytokeratin, and cytokeratin 7. To the best of our knowledge, this is the first case of intraoral NEC arising many years later within the irradiated field of the initial tumor.
Primary Sjogren's syndrome presenting as hypokalemic paralysis
Authors: Goroshi M , Khare S , Jamale T , Shah NS
Published: November 2016

Primary Sjögren's syndrome (pSS) primarily involves exocrine glands, and renal tubular acidosis (RTA) is seen in one-third of the cases. RTA with hypokalemic paralysis as a presenting feature of pSS is described in few case reports in literature. We report 13 cases who presented as hypokalemic paralysis, and on evaluation were diagnosed to be pSS, as per the diagnostic criteria laid by the Sjögren's International Collaborative Clinical Alliance (2012). All patients were female, with a mean age at presentation being 33.1 ± 8.22 years (range, 25–48 years). Eleven patients had a complete distal RTA and two patients had incomplete distal RTA at the time of presentation. 62% (8/13) of patients had no signs and symptoms of exocrine gland involvement. All the cases were managed with oral alkali therapy, and six patients received additional immunomodulating agents. No improvement in renal tubular dysfunction (in the form of a reduction in the alkali dose) after immunomodulating therapy was observed over a mean follow-up of 2.8 years. Renal tubular dysfunction can be the presenting manifestation of pSS. It is important to consider the possible presence of this disorder in adults with otherwise unexplained distal RTA or hypokalemia.
Quantifying the Seafood Consumption Patterns of Recreational Anglers in Charleston and Berkeley Counties, South Carolina
Authors: Perkinson Matthew T. , Faith Trevor D. , Vahey Grace M. , Vena John E. , Williams Edith M.
Published: November 2016

This study was designed to provide self-reported data on the frequency of fish consumption and shellfish consumption in Charleston and Berkeley (CB) counties, South Carolina. While commercial fishing and recreational fishing have played an important role in the culture and history of the area, information on the specific patterns of consumption by recreational anglers has been previously unavailable. The pilot data presented here will help determine the feasibility of a large-scale survey of seafood consumption in coastal South Carolina. The study's sampling frame consisted of CB county anglers who had purchased a recreational saltwater fishing license for the 2005/2006 year with oversampling in North Charleston. Survey recipients were asked to provide information on fish consumption and shellfish consumption, general angling habits, perception of water and fishing quality, and demographics. Of the 2500 individuals who were sent questionnaires, about one-fourth responded. Respondents were generally white, middle, or upper class and highly educated. The majority fished by boat and most often ate flounder, spotted sea trout, and red drum. Most respondents ate shrimp several times a month and also supplemented their recreational catch with seafood purchased from grocery stores, markets, and restaurants. Almost all respondents had eaten some seafood in the last year, and more than one-fourth ate seafood twice a week or more. Most anglers responded positively about the area's fishing and water qualities, but many referred to areas where they would hesitate to eat their catch. Further research may need to incorporate direct distribution of surveys to underrepresented groups and financial incentives to encompass a more diverse population of anglers.
Evaluating the Effect of Oxygen Concentrations on Antibiotic Sensitivity, Growth, and Biofilm Formation of Human Pathogens
Authors: Gupta Shilpi , Laskar Nozrin , Kadouri Daniel E.
Published: November 2016

Standard antimicrobial susceptibility tests are performed in vitro under normal room oxygen conditions to predict the in vivo effectiveness of antimicrobial therapy. The aim of this study was to conduct a comprehensive analysis of the effect of different oxygen levels on the antibiotic susceptibility of two strains of Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae. It was found that anoxic conditions caused reduced sensitivity of bacteria to aminoglycoside antibiotics in four of six bacteria used in the study. In addition, oxygen limitation decreased the susceptibility of P. aeruginosa strains and K. pneumoniae strains to piperacillin/tazobactam and azithromycin, respectively. In contrast, five of six bacteria became more susceptible to tetracycline antibiotics under oxygen-limiting conditions. Our data highlight the importance of considering the potential in vivo oxygen levels within the infection site when setting susceptibility breakpoints for evaluating the therapeutic potential of a drug and its effect on antibiotic sensitivity of the pathogen.
Characterizations of Outer Generalized Inverses
Authors: Wang Long , Castro-Gonzalez Nieves , Chen Jianlong
Published: November 2016

LetRbe a ring andb,c∊R. In this paper, we give some characterizations of the (b,c)-inverse in terms of the direct sum decomposition, the annihilator, and the invertible elements. Moreover, elements with equal (b,c)-idempotents related to their (b,c)-inverses are characterized, and the reverse order rule for the (b,c)-inverse is considered.
Mind the Gap
Authors: Fairbanks Terry , Savage Erica , Adams Katie , Wittie Michael , Boone Edna , Hayden Andrew , Barnes Janey , Hettinger Zach , Gettinger Andrew , Ratwani Raj
Published: November 2016

Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs.

Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment.

Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps.

Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs.

Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Citation: Ratwani R et al.: Review to identify usability and safety challenges and practices during EHR implementation.