bluuebunny/crossref_metadata_2025 huggingface dataset:
A Preliminary Study on the Effect of Computer-Aided Designed and Manufactured Orthoses on Chronic Plantar Heel Pain
Authors: Gatt Alfred , Grech Mark , Chockalingam Nachiappan , Formosa Cynthia
Published: May 2017

Introduction. Chronic plantar heel pain (CPHP) is a significant, painful condition referring to a range of undifferentiated foot conditions that affect the heel of the foot. Method. Participants presenting with CPHP of more than 6 months’ duration were recruited on a first through the door basis. Computer-Aided Design and Computer-Aided Manufactured (CAD-CAM) orthoses were designed and constructed for each participant, then dispensed as per normal practice. Pre- and postintervention assessment of pain was performed at baseline and after 6 weeks of use, utilizing the pain subset of the Foot Function Index (FFI). Results. There was a significant reduction in the mean pain scores for all participants in all constructs of the FFI. Total FFI score was also significant ( P = .003). Conclusion. CAD-CAM orthoses have the potential to become a treatment modality of choice in CPHP since they have resulted in a significant improvement in heel pain after only 6 weeks’ use.

Levels of Evidence: Therapeutic, Level IV: Prospective, comparative trial
Perceiving Animacy From Deformation and Translation
Authors: Kawabe Takahiro
Published: May 2017

In a cartoon, we often receive an animacy impression from a dynamic nonanimate object, such as a sponge or a flour sack, which does not have an animal-like shape. We hypothesize that the animacy impression of a nonanimal object could stem from dynamic patterns that are possibly fundamental for biological motion perception. Here we show that observers recognize the animacy of human jump actions from the combination of deformation and translation. We extracted vertical motion vectors from the uppermost and lowermost points in point-light jumper stimuli and assigned the vectors to a uniform rectangle. The participants’ task was to rate the animacy and jump impressions for the rectangle. Results showed that both animacy and jump impressions for the rectangle movements were comparable to those for the original point-light movements. The impressions decreased for stimuli having a deformation or translation component alone, which was extracted from the original motion vectors. By mathematically simulating deformation and translation in a human jump, we also found that the temporal relation between deformation and translation plays a critical role in the determination of jump impressions but only has a moderate effect for animacy impressions. On the basis of the results, we discuss how cartoon techniques take advantage of the properties of biological motion perception.
Teaching teachers about retirement and investments: A comparison of three interventions
Authors: Lucey Thomas , Meyers Derek J H , Smith Ryan
Published: May 2017

The authors describe a project that compared the effects of three interventions on the retirement investment knowledge of public school teachers in the Midwest. They interpret outcomes from three different interventions (online training, site-based workshop, and hybrid of online and site-based). While the study results indicate that program participants increased their investment and retirement knowledge of content presented in the measured approaches, the differences in gains between the interventions were not significant. The authors call for additional research into the investment and retirement education of teachers that employs larger samples and uses valid and reliable instrumentation.
Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies
Authors: Fallon Marie T , Albert Lux Eberhard , McQuade Robert , Rossetti Sandro , Sanchez Raymond , Sun Wei , Wright Stephen , Lichtman Aron H , Kornyeyeva Elena
Published: May 2017

Background:

Opioids are critical for managing cancer pain, but may provide inadequate relief and/or unacceptable side effects in some cases.

Objective:

To assess the analgesic efficacy of adjunctive Sativex (Δ9-tetrahydrocannabinol (27 mg/mL): cannabidiol (25 mg/mL)) in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy.

Methods:

This report describes two phase 3, double-blind, randomized, placebo-controlled trials. Eligible patients had advanced cancer and average pain numerical rating scale (NRS) scores ≥4 and ≤8 at baseline, despite optimized opioid therapy. In Study-1, patients were randomized to Sativex or placebo, and then self-titrated study medications over a 2-week period per effect and tolerability, followed by a 3-week treatment period. In Study-2, all patients self-titrated Sativex over a 2-week period. Patients with a ≥15% improvement from baseline in pain score were then randomized 1:1 to Sativex or placebo, followed by 5-week treatment period (randomized withdrawal design).

Results:

The primary efficacy endpoint (percent improvement (Study-1) and mean change (Study-2) in average daily pain NRS scores) was not met in either study. Post hoc analyses of the primary endpoints identified statistically favourable treatment effect for Sativex in US patients <65 years (median treatment difference: 8.8; 95% confidence interval (CI): 0.00–17.95; p = 0.040) that was not observed in patients <65 years from the rest of the world (median treatment difference: 0.2; 95% CI: −5.00 to 7.74; p = 0.794). Treatment effect in favour of Sativex was observed on quality-of-life questionnaires, despite the fact that similar effects were not observed on NRS score. The safety profile of Sativex was consistent with earlier studies, and no evidence of abuse or misuse was identified.

Conclusions:

Sativex did not demonstrate superiority to placebo in reducing self-reported pain NRS scores in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy, although further exploration of differences between United States and patients from the rest of the world is warranted.
Medicaid Expansion Produces Long-Term Impact on Insurance Coverage Rates in Community Health Centers
Authors: Huguet Nathalie , Hoopes Megan J. , Angier Heather , Marino Miguel , Holderness Heather , DeVoe Jennifer E.
Published: May 2017

Background:It is crucial to understand the impact of the Affordable Care Act (ACA). This study assesses changes in insurance status of patients visiting community health centers (CHCs) comparing states that expanded Medicaid to those that did not. Methods: Electronic health record data on 875,571 patients aged 19 to 64 years with ≥ 1 visit between 2012 and 2015 in 412 primary care CHCs in 9 expansion and 4 nonexpansion states. We assessed changes in rates of total, uninsured, Medicaid-insured, and privately insured primary care and preventive care visits; immunizations administered, and medications ordered. Results: Rates of uninsured visits decreased pre- to post-ACA, with greater drops in expansion (−57%) versus nonexpansion (−20%) states. Medicaid-insured visits increased 60% in expansion states while remaining unchanged in nonexpansion states. Privately insured visits were 2.7 times higher post-ACA in nonexpansion states with no increase in expansion states. Comparing 2015 with 2014: Uninsured visit rates continued to decrease in expansion (−28%) and nonexpansion states (−19%), Medicaid-insured rates did not significantly increase, and privately insured visits increased in nonexpansion states but did not change in expansion states. Conclusions: Medicaid expansion and subsidies to purchase private coverage likely increased the accessibility of health insurance for patients who had previously not been able to access coverage.
Stress and Response to Treatment: Insights From a Pilot Study Using a 4-week Contemplative Self-Healing Meditation Intervention for Posttraumatic Stress in Breast Cancer
Authors: Offidani Emanuela , Peterson Janey C. , Loizzo Joseph , Moore Anne , Charlson Mary E.
Published: May 2017

Along with symptoms of anxiety and depression, many breast cancer survivors experience symptoms of posttraumatic stress disorder (PTSD) that may worsen in the setting of other stressful life events. The aim of this pilot study was to evaluate whether a 4-week version of our Contemplative Self-Healing program would have different effects in reducing PTSD symptoms between breast cancer survivors with or without chronic stress at baseline. PTSD symptoms were measured using the Impact of Events scale (IES). A linear mixed model analysis was used to evaluate within patients changes in IES score. Results showed that breast cancer patients who were experiencing chronic stress reported greater improvement in IES score than those without chronic stress. Our preliminary findings shed light on the need to evaluate life stressors in breast cancer patients. Evaluating chronic stress may be essential in predicting which cancer patients may benefit most from a psychological intervention.
The Gordian Knot: Regulatory Relationship and Legal Education
Authors: Maharg Paul
Published: May 2017

This article is a version of themes presented at a plenary lecture given at the 2016 Legal Education Conference at the Chinese University of Hong Kong. Regulation of legal education is becoming increasingly important as regulation becomes more complex and intrusive in educational design and practice. As a consequence of pressures upon regulators from government, consumer groups, educational institutions, the profession and other stakeholders, there has been an increase in the number and size of reports and reviews as regulators and accreditors seek to position and re-position their practices within the regulatory field. In that field, regulatory relationship is one aspect of the regulation of legal education that is insufficiently researched and understood. This article seeks to explore models by which the relationship between regulators and legal educators can be improved. It begins by summarizing some of the regulatory literature on legal education, and suggesting that a complexity theory approach in safety regulation could be used in legal education. An example of regulatory relationship between educational institution and regulator will be described and aspects analyzed; in the final section, I outline possible ways forward for regulators and legal educators.
Investigation of morphological, rheological, and mechanical properties of cyclic olefin copolymer/poly(ethylene-co-vinyl acetate) blend films
Authors: Durmus Ali , Alanalp Mine B , Aydin Ismail
Published: May 2017

In this study, cyclic olefin copolymer/poly(ethylene- co-vinyl acetate) 90/10, 80/20, and 70/30 blends were prepared by melt processing in a twin screw extruder equipped with a cast film haul-off unit to make films. Microstructural, rheological, mechanical, and viscoelastic properties of film samples were investigated by various tests performed in scanning electron microscope, rotational rheometer, dynamic mechanical analyzer, and tensile test machine. We observed that the films exhibited characteristic immiscible “matrix–droplet” or “cocontinuous” blend morphology, depending on the sample composition. Based on the melt rheology and dynamic mechanical analyzer tests, we found that poly(ethylene- co-vinyl acetate) addition changed the viscoelastic properties of cyclic olefin copolymer such as increasing short-term creep strain and relaxation time but reducing relaxation rate in solid state. One can conclude that such effects became more pronounced by adding a compatibilizer (PE-g-MA) at 50% of poly(ethylene- co-vinyl acetate) present in the composition. We also found that poly(ethylene- co-vinyl acetate) addition into cyclic olefin copolymer reduced the Young’s modulus and yield stress and increased the strain at break for the blends.
The effect of initial teaching on evaluation of left ventricular volumes by cardiovascular magnetic resonance imaging: comparison between complete and intermediate beginners and experienced observers
Authors: Hedström Erik , Ishida Masaki , Sepúlveda-Martínez Alvaro , Ryd Daniel , Sperling Johannes , Engblom Henrik , Nagel Eike
Published: May 2017

Background

High reproducibility and low intra- and interobserver variability are important strengths of cardiac magnetic resonance (CMR). In clinical practice a significant learning curve may however be observed. Basic CMR courses offer an average of 1.4 h dedicated to lecturing and demonstrating left ventricular (LV) function analysis. The purpose of this study was to evaluate the effect of initial teaching on complete and intermediate beginners’ quantitative measurements of LV volumes and function by CMR.

Methods

Standard clinical cine CMR sequences were acquired in 15 patients. Five observers (two complete beginners, one intermediate, two experienced) measured LV volumes. Before initial evaluation beginners read the SCMR guidelines on CMR analysis. After initial evaluation, beginners participated in a two-hour teaching session including cases and hands-on training, representative for most basic CMR courses, after which it is uncertain to what extent different centres provide continued teaching and feedback in-house. Dice Similarity Coefficient (DSC) assessed delineations. Agreement, accuracy, precision, repeatability and reliability were assessed by Bland-Altman, coefficient of variation, and intraclass correlation coefficient methods.

Results

Endocardial DSC improved after teaching (+0.14 ± 0.17;p < 0.001) for complete beginners. Low intraobserver variability was found before and after teaching, however with wide limits of agreement. Beginners underestimated volumes by up to 44 ml (EDV), 27 ml (ESV) and overestimated LVM by up to 53 g before teaching, improving to an underestimation of up to 9 ml (EDV), 7 ml (ESV) and an overestimation of up to 30 g (LVM) after teaching. For the intermediate beginner, however, accuracy was quite high already before teaching.

Conclusions

Initial teaching to complete beginners increases accuracy for assessment of LV volumes, however with high bias and low precision even after standardised teaching as offered in most basic CMR courses. Even though the intermediate beginner showed quite high accuracy already before teaching, precision did generally not improve after standardised teaching. To maintain CMR as a technique known for high accuracy and reproducibility and low intra- and inter-observer variability for quantitative measurements, internationally standardised training should be encouraged including high-quality feedback mechanisms. Objective measurements of training methods, training duration and, above all, quality of assessments are required.
Patient-centered primary care for adults at high risk for AUDs: the Choosing Healthier Drinking Options In primary CarE (CHOICE) trial
Authors: Bradley Katharine A. , Ludman Evette Joy , Chavez Laura J. , Bobb Jennifer F. , Ruedebusch Susan J. , Achtmeyer Carol E. , Merrill Joseph O. , Saxon Andrew J. , Caldeiro Ryan M. , Greenberg Diane M. , Lee Amy K. , Richards Julie E. , Thomas Rachel M. , Matson Theresa E. , Williams Emily C. , Hawkins Eric , Lapham Gwen , Kivlahan Daniel R.
Published: May 2017

Background

Most patients with alcohol use disorders (AUDs) never receive alcohol treatment, and experts have recommended management of AUDs in primary care. The Choosing Healthier Drinking Options In primary CarE (CHOICE) trial was a randomized controlled effectiveness trial of a novel intervention for primary care patients at high risk for AUDs. This report describes the conceptual and scientific foundation of the CHOICE model of care, critical elements of the CHOICE trial design consistent with the Template for Intervention Description and Replication (TIDieR), results of recruitment, and baseline characteristics of the enrolled sample.

Methods

The CHOICE intervention is a multi-contact, extended counseling intervention, based on the Chronic Care Model, shared decision-making, motivational interviewing, and evidence-based options for managing AUDs, designed to be practical in primary care. Outpatients who received care at 3 Veterans Affairs primary care sites in the Pacific Northwest and reported frequent heavy drinking (≥4 drinks/day for women; ≥5 for men) were recruited (2011–2014) into a trial in which half of the participants would be offered additional alcohol-related care from a nurse. CHOICE nurses offered 12 months of patient-centered care, including proactive outreach and engagement, repeated brief motivational interventions, monitoring with and without alcohol biomarkers, medications for AUDs, and/or specialty alcohol treatment as appropriate and per patient preference. A CHOICE nurse practitioner was available to prescribe medications for AUDs.

Results

A total of 304 patients consented to participate in the CHOICE trial. Among consenting participants, 90% were men, the mean age was 51 (range 22–75), and most met DSM-IV criteria for alcohol abuse (14%) or dependence (59%). Many participants also screened positive for tobacco use (44%), depression (45%), anxiety disorders (30-41%) and non-tobacco drug use disorders (19%). At baseline, participants had a median AUDIT score of 18 [Interquartile range (IQR) 14–24] and a median readiness to change drinking score of 5 (IQR 2.75–6.25) on a 1–10 Likert scale.

Conclusion

The CHOICE trial tested a patient-centered intervention for AUDs and recruited primary care patients at high risk for AUDs, with a spectrum of severity, co-morbidity, and readiness to change drinking.

Trial registration The trial is registered at clinicaltrial.gov (NCT01400581).
An Etomidate Analogue With Less Adrenocortical Suppression, Stable Hemodynamics, and Improved Behavioral Recovery in Rats
Authors: Wang Bin , Yang Jun , Chen Jun , Kang Yi , Yang Ling-Hui , Liu Jin , Zhang Wen-Sheng
Published: May 2017

BACKGROUND:

ET-26 hydrochloride (ET-26HCl) is a novel etomidate analogue designed to alleviate the adrenocortical suppression caused by etomidate while retaining the rapid sedative-hypnotic onset and stable hemodynamic features of etomidate. This study compared the anesthetic effect, hemodynamic stability, and recovery profiles of ET-26HCl, etomidate, and the sedative-hypnotic drug propofol in rats.

METHODS:

The metabolic half-life of ET-26HCl was determined in vitro using high performance liquid chromatography analysis of samples of rat plasma and liver homogenates taken from 3 animals. Hypnotic median effective doses (HD50) of ET-26HCl, etomidate, and propofol were determined by up-and-down methods. Anesthesia effect and mean arterial pressure were estimated using equivalent intravenous (IV) doses of propofol, etomidate, and ET-26HCl in the rats. Serum concentrations of corticosterone were analyzed by enzyme-linked immunosorbent assay. The ability of rats to recover from the sedative-hypnotic effects of the drugs was evaluated using open field and Morris water maze tests at equipotent doses of propofol, etomidate, ET-26HCl, and normal saline.

RESULTS:

The metabolic half-life of ET-26HCl was 81 ± 6 minutes in rat plasma and 126 ± 12 minutes in incubation liver homogenate (mean ± standard deviation), respectively. In vivo experiments showed that the potency of ET-26HCl to cause a loss of righting reflex in rats was 3 times lower than that of etomidate in the rats. IV propofol caused a greater decrease in mean arterial pressure relative to the baseline (−27.9 mm Hg) than did ET-26HCl (−10.7 mm Hg) and etomidate (−19.4 mm Hg) at equipotent doses. Serum corticosterone levels after drug administration were significantly higher in the ET-26HCl group than in the etomidate group at equivalent doses when measured 15 (P < .001), 30 (P < .001), and 60 (P = .002) minutes after stimulation with adrenocorticotropic hormone (ACTH1–24). Recovery of spatial orientation from anesthesia induced by an IV bolus injection was faster with ET-26HCl than with propofol, but recovery of spontaneous activity was slower.

CONCLUSIONS:

ET-26HCl has anesthetic potency and hemodynamic stability similar to etomidate, but it caused less adrenocortical hormone synthesis suppression than etomidate and faster spatial orientation recovery from anesthesia than propofol, which was similar to etomidate.
Cerebral Oxygen Saturation in Children With Congenital Heart Disease and Chronic Hypoxemia
Authors: Kussman Barry D. , Laussen Peter C. , Benni Paul B. , McGowan Francis X. , McElhinney Doff B.
Published: May 2017

BACKGROUND:

Increased hemoglobin (Hb) concentration accompanying hypoxemia is a compensatory response to maintain tissue oxygen delivery. Near infrared spectroscopy (NIRS) is used clinically to detect abnormalities in the balance of cerebral tissue oxygen delivery and consumption, including in children with congenital heart disease (CHD). Although NIRS-measured cerebral tissue O2 saturation (ScO2) correlates with arterial oxygen saturation (SaO2), jugular bulb O2 saturation (SjbO2), and Hb, little data exist on the interplay between these factors and cerebral O2 extraction (COE). This study investigated the associations of ScO2 and ΔSaO2−ScO2 with SaO2 and Hb and verified the normal range of ScO2 in children with CHD.

METHODS:

Children undergoing cardiac catheterization for CHD were enrolled in a calibration and validation study of the FORE-SIGHT NIRS monitor. Two pairs of simultaneous arterial and jugular bulb samples were drawn for co-oximetry, calculation of a reference ScO2 (REF CX), and estimation of COE. Pearson correlation and linear regression were used to determine relationships between O2 saturation parameters and Hb. Data were also analyzed according to diagnostic group defined as acyanotic (SaO2 ≥ 90%) and cyanotic (SaO2 < 90%).

RESULTS:

Of 65 children studied, acceptable jugular bulb samples (SjbO2 absolute difference between samples ≤10%) were obtained in 57 (88%). The ΔSaO2−SjbO2, ΔSaO2−ScO2, and ΔSaO2−REF CX were positively correlated with SaO2 and negatively correlated with Hb (all P < .001). Although by diagnostic group ScO2 differed statistically (P = .002), values in the cyanotic patients were within the range considered normal (69% ± 6%). COE estimated by the difference between arterial and jugular bulb O2 content (ΔCaO2−CjbO2, mL O2/100 mL) was not different for cyanotic and acyanotic patients (P = .10), but estimates using ΔSaO2−SjbO2, ΔSaO2−ScO2, or ΔSaO2−ScO2/SaO2 were significantly different between the cyanotic and acyanotic children (P < .001).

CONCLUSIONS:

Children with adequately compensated chronic hypoxemia appear to have ScO2 values within the normal range. The ΔSaO2−ScO2 is inversely related to Hb, with the implication that in the presence of reduced Hb, particularly if coupled with a decreased cardiac output, the ScO2 can fall to values associated with brain injury in laboratory studies.
Osmoregulation, bioenergetics and oxidative stress in coastal marine invertebrates: raising the questions for future research
Authors: Rivera-Ingraham Georgina A. , Lignot Jehan-Hervé
Published: May 2017

Osmoregulation is by no means an energetically cheap process, and its costs have been extensively quantified in terms of respiration and aerobic metabolism. Common products of mitochondrial activity are reactive oxygen and nitrogen species, which may cause oxidative stress by degrading key cell components, while playing essential roles in cell homeostasis. Given the delicate equilibrium between pro- and antioxidants in fueling acclimation responses, the need for a thorough understanding of the relationship between salinity-induced oxidative stress and osmoregulation arises as an important issue, especially in the context of global changes and anthropogenic impacts on coastal habitats. This is especially urgent for intertidal/estuarine organisms, which may be subject to drastic salinity and habitat changes, leading to redox imbalance. How do osmoregulation strategies determine energy expenditure, and how do these processes affect organisms in terms of oxidative stress? What mechanisms are used to cope with salinity-induced oxidative stress? This Commentary aims to highlight the main gaps in our knowledge, covering all levels of organization. From an energy-redox perspective, we discuss the link between environmental salinity changes and physiological responses at different levels of biological organization. Future studies should seek to provide a detailed understanding of the relationship between osmoregulatory strategies and redox metabolism, thereby informing conservation physiologists and allowing them to tackle the new challenges imposed by global climate change.
Construction of Functional Biomaterials by Biomolecular Self-Assembly
Authors: Matsuura Kazunori
Published: May 2017

This account discusses construction strategies for various functional biomaterials based on the designed self-assembly of biomolecules. Novel glycoclusters with regular intervals were developed by self-assembly of carbohydrate-conjugated oligodeoxyribonucleotides (ODNs) with the half-sliding complementary ODNs. Complexes of carbohydrate-modified DNA and lectin afforded a new regulation system for gene expression. DNA three-way junctions bearing self-complementary sticky-ends were self-assembled into nanometer-to-micrometer-sized spherical structures depending on the concentration. The three-way component design was extended to the design of an artificial trigonal peptide conjugate. The trigonal peptide conjugates bearing β-sheet-forming peptides or glutathione self-assembled into nano-sized spherical assemblies. Self-assembly of β-annulus peptide derived from tomato bushy stunt virus afforded artificial viral capsids, which can encapsulate and be modified with various molecules.
A semi-automatic method for the extraction of the portal venous input function in quantitative dynamic contrast-enhanced CT of the liver
Authors: Gill Andrew B , Hilliard Nicholas J , Hilliard Simon T , Graves Martin J , Lomas David J , Shaw Ashley
Published: May 2017

Objective:

To aid the extraction of the portal venous input function (PVIF) from axial dynamic contrast-enhanced CT images of the liver, eliminating the need for full manual outlining of the vessel across time points.

Methods:

A cohort of 20 patients undergoing perfusion CT imaging of the liver was examined. Dynamic images of the liver were reformatted into contiguous thin slices. A region of interest was defined within a transverse section of the portal vein on a single contrast-enhanced image. This region of interest was then computationally projected across all thin slices for all time points to yield a semi-automated PVIF curve. This was compared against the “gold-standard” PVIF curve obtained by conventional manual outlining.

Results:

Bland–Altman plots of curve characteristics indicated no substantial difference between automated and manual PVIF curves [concordance correlation coefficient in the range (0.66, 0.98)]. No substantial differences were shown by Bland–Altman plots of derived pharmacokinetic parameters when a suitable kinetic model was applied in each case [concordance correlation coefficient in range (0.92, 0.95)].

Conclusion:

This semi-automated method of extracting the PVIF performed equivalently to a “gold-standard” manual method for assessing liver function.

Advances in knowledge:

This technique provides a quick, simple and effective solution to the problems incurred by respiration motion and partial volume factors in the determination of the PVIF in liver dynamic contrast-enhanced CT.
CT features in surgically proven cases of ovarian torsion—a pictorial review
Authors: Dhanda Sunita , Quek Swee T , Ting Mok Y , Rong Clement Y H , Ting Eric Y S , Jagmohan Pooja , Wee Bernard
Published: May 2017

Ovarian torsion is a surgical emergency characterized by a partial or complete rotation of the ovarian vascular pedicle, causing obstruction to venous outflow followed by arterial inflow. Clinically, ovarian torsion frequently mimics other causes of acute pelvic pain such as appendicitis, diverticulitis, renal colic etc. Ultrasonography is the first-line imaging modality of choice for evaluation of ovarian torsion. MRI is useful as a problem-solving tool in patients with equivocal or non-diagnostic ultrasonography studies. CT is ordinarily not utilized in a young female with suspected ovarian torsion due to the radiation dose. However, the significant expansion in use of CT imaging in emergency departments for female patients presenting with acute abdominal pain has increased the likelihood that ovarian torsion may be first seen on CT. In addition, a non-specific clinical presentation may lead to an initial imaging with CT rather than ultrasonography. Ultrasound features of the ovarian torsion are well known and sufficiently described across literature as compared with the CT scan findings. In view of the increasing usage of CT as the modality of choice in emergency settings, it is imperative for the radiologist to familiarize with the CT features of ovarian torsion. An early correct diagnosis by the radiologist in clinically unsuspected cases, facilitating a prompt surgery to restore the ovarian blood flow can prevent permanent irreversible damage. There is limited published data available on the CT features of ovarian torsion. This pictorial essay illustrates CT findings with histological correlation of surgically proven ovarian torsion in our institution. These patients were primarily investigated with CT scan for acute pelvic pain ascribed to non-gynaecological causes such as bowel or urinary tract lesions.
N is for the nose and nostrils…
Authors: Hammond Paula , Lillie Stephen
Published: May 2017

This month, we continue our series that takes the form of an extended alphabetical adventure around the body, helping children to get to know themselves a little better.
Advocating for children
Authors: Webb Penny
Published: May 2017

Standing up for the rights of those we care for involves much more than publicly expressing an opinion from atop a soapbox. In reality, we are all campaigners.
The places we humans inhabit
Authors: Chalmers Debbie
Published: May 2017

Develop children's knowledge and understanding, and encourage creativity and imagination while exploring the houses, home and habitats humans build and use around the world.
Comparison of the Economic Feasibility between Conventional and Vacuum Drying for 4/4 Red Oak
Authors: Brenes-Angulo Oxana , Bond Brian , Kline Earl , Quesada-Pineda Henry
Published: May 2017

Vacuum drying of wood is a method to reduce drying time and inventory; however, there is limited information regarding the economic feasibility for vacuum drying 4/4 red oak compared with traditional drying methods. The benefits of this technology, mainly dramatically reduced drying times and higher flexibility, must be weighed against the higher initial capital investment. The goal of this project was to compare the economic feasibility, using capital budgeting techniques, of conventional drying and vacuum drying for 4/4 red oak lumber. The analysis was conducted for two actual flooring manufacturers. Conventional drying for this analysis was considered to be air-drying plus kiln drying, which is commonly done with red oak. The vacuum technology considered used hot platens for heating the wood. Species, thickness, drying methods, and lumber demand compared, both drying methods (conventional and vacuum drying) were determined to be economically feasible. However, vacuum drying had a slightly higher net present value, cost–benefit ratio, and sensitivity analysis than conventional drying, making it a slightly better investment for drying 4/4 red oak. The initial tied-up inventory and its respective cost in the conventional drying scenario represents an opportunity cost that can be recovered using vacuum drying. This recovered cost can result in freed capital that can be invested elsewhere to increase competitiveness.
Corporate Social Responsibility in the Wood-Based Panel Industry: Main Strategies from Four Enterprises in China
Authors: Lu Feifei , Wen Zuomin , D'Amato Dalia , Toppinen Anne
Published: May 2017

With economic globalization and the diffusion of corporate social responsibility (CSR), firms are increasingly moving from using reactive to more proactive strategies in their environmental, social, and governance (ESG) strategies. Wood-based panel processing enterprises, which are particularly sensitive to environmental and social issues, are increasingly developing their CSR strategies. Previous research on environmental protection and responsibility in this industry focused mainly on single aspects, such as the control of volatile noxious gases, while neglecting comprehensive social environmental responsibility strategies, especially in emerging economies. This article adopts a case study approach that analyzes the main CSR strategies of four leading Chinese wood-based panel processing enterprises. The study provides a reference for similar enterprises in China and other developing economies on CSR/ESG strategies. Even though context specific, our findings can provide further impetus for research and discussion on other emerging economies that share similar institutional characteristics.
RUMO AOS ENCANTOS DO MUNDO O CONCEITO DE VIAGEM NA PEREGRINAÇÃO
Authors: Lima Francisco Ferreira de
Published: May 2017

O narrador da Peregrinação é marcado por um irresistivel azer de viajar, o qual é sempre justificado por uma pessoa, pela miséria ou para escapar da morte. Alguns dos mecanismos que transformam esse texto em questão são discutidos neste artigo.
Collagen Turnover Markers in Relation to Future Cardiovascular and Noncardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis
Authors: Duprez Daniel A , Gross Myron D , Sanchez Otto A , Kizer Jorge R , Ix Joachim H , Lima Joao , Tracy Russell P , Jacobs David R
Published: May 2017

BACKGROUND

Sustained remodeling of extracellular matrix can compromise organs and tissues. Procollagen type III N-terminal propeptide (PIIINP) and collagen type I carboxy-terminal telopeptide (ICTP) reflect collagen synthesis and degradation. We studied their predictive value for future death and disease.

METHODS

A total of 3068 men and women in the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease (CVD) and in generally good health had a baseline blood sample taken for ICTP and PIIINP. Median follow-up was 13.0 years. Among 4 primary outcomes, CVD events (n = 697) were adjudicated, death (n = 571) was by death certificate, and chronic inflammatory–related severe hospitalization and death (ChrIRD, n = 726) and total cancer (n = 327) were classified using International Classification of Diseases codes. We used Poisson regression to study baseline ICTP and PIIINP relative to these outcomes.

RESULTS

Mean (SD) PIIINP was 5.47 (1.95) μg/L and ICTP was 3.37 (1.70) μg/L. PIIINP and ICTP were highly correlated with each other and with estimated glomerular filtration rate (eGFR). Adjustment for age and eGFR attenuated relative risks, remaining 20%–30% per SD of both PIIINP and ICTP in prediction for total death and ChrIRD, and of PIIINP for cancer, with little additional attenuation by adjusting for risk factors and inflammatory biomarkers. CVD outcome was generally unrelated to PIIINP but became marginally inversely related to ICTP in the most adjusted model.

CONCLUSIONS

The collagen biomarkers PIIINP and ICTP, in part through pathophysiologically parallel associations with renal function, predicted ChrIRD and total death. Moreover, PIIINP predicted future cancer. These collagen markers may help differentiate healthy from unhealthy aging.
Francisco Giner y el descubrimiento moderno del paisaje de España
Authors: Ortega Cantero Nicolás
Published: May 2017

Francisco Giner de los Ríos (1839-1915), fundador en 1876 de la Institución Libre de Enseñanza, inició, en los últimos decenios del siglo XIX, un verdadero descubrimiento del paisaje de España. Planteó una nueva visión del paisaje español, que incorporó la perspectiva del paisajismo geográfico moderno, inicialmente promovido por Humboldt. Esta nueva perspectiva atribuyó a ese paisaje un conjunto de valores culturales que se consideraron expresivos de la propia historia y de la identidad colectiva o nacional derivada de ella. Giner y sus colaboradores de la Institución Libre de Enseñanza vieron en el paisaje español (y sobre todo en el paisaje de Castilla y la Sierra de Guadarrama) un verdadero símbolo nacional.
Panenteísmo y mística activa en «A don Francisco Giner de los Ríos», de Antonio Machado
Authors: Prieto de Paula Ángel Luis
Published: May 2017

El poema necrológico que dedica Antonio Machado a Francisco Giner de los Ríos es un retrato moral del homenajeado, pero también una proyección de la personalidad del poeta, que presta su voz para que el muerto exponga a sus discípulos el núcleo de su doctrina. El tema de la composición constituye un modelo ético en el que se confunden dos propuestas morales hasta convertirse en una sola: la del «santo laico» que ha prevalecido como denominador común de algunos reformadores de la España contemporánea, quienes, ante el ocaso de las creencias tradicionales, habilitaron una nueva religión racional y sin dogmas, pero con estrictos principios de comportamiento.
Francisco Giner de los Ríos o el arte de forjar almas
Authors: González Geraldo José Luis , Rincón Igea Benito del
Published: May 2017

Este trabajo tiene por objeto dibujar el perfil educador de Francisco Giner de los Ríos, el hombre más carismático de la Institución Libre de Enseñanza. Apoyándonos sobre todo en el testimonio escrito de algunos de sus discípulos más cualificados, estas páginas reflejan la actividad de un maestro universitario a pie de obra. Giner superó el horizonte de su época porque se opuso al memorismo estéril y construía el saber con sus discípulos, planteando problemas e invitando a encontrar soluciones. Era, en definitiva, un educador moderno, de corte europeo. Y lo era allá donde estuviera; por eso, con su buen hacer pero, sobre todo, con su ser, iluminó una herencia pedagógica de cuatro décadas, ya en el siglo XX. Que a los educadores de hoy, bien entrado el XXI, nos sirva para reforzar nuestra responsabilidad y redoblar esfuerzos en la tarea, seguramente, más comprometida que existe.
SURFACE CONSOLIDATION OF WALL PAINTINGS USING LIME NANO-SUSPENSIONS
Authors: Vojtěchovský Jan
Published: May 2017

Within the field of the conservation of historical and cultural monuments, lime nanosuspensions are still a relatively new and unexplored material. This study examines their effect on the consolidation of architectural surfaces and, consequently, on wall paintings. Previous experiments showed that considerably deteriorated materials may not be adequately strengthened using only lime nano-suspensions. Therefore, the effects of their admixtures and gradual applications with silicic acid esters were examined. For verification, a simulation of a deteriorated lime-based paint layer was created on panels of plaster. The results of the consolidation were subsequently studied using objective (peeling test, water absorption capacity test, measuring colour changes using a mobile spectrophotometer) and subjective methods (comparison of visual changes to a set standard and by testing cohesion using a cotton swab). The microstructure of a consolidated paint layer was studied with a scanning electron microscopy. Tests proved that with either individual lime-alcoholic suspensions or with successive applications and mixtures of silicic acid esters it is feasible to achieve good consolidation results, whilst the alkoxysilane content of the agent indisputably increases the consolidating effect of these materials.
Digital Self-promotion for the Underdog Author: Creative Opportunities and Experimentation
Authors: Flahive Grace
Published: May 2017

This paper addresses a lack of originality in the online self-promotion of many mid-list, indie and self-published authors, investigating the strategies of authors who are making more creative use of digital technologies for their self-promotion. This research provides a practical point of guidance to other authors of fiction wishing to innovate in this way.
The literature review provides an overview of changes in global media consumption following the digital revolution. This research suggests that creative digital promotional projects might be a low-cost, high impact way of overcoming some of the resulting challenges.
Primary research is undertaken in the form of case studies, profiling three authors’ promotional projects. The effectiveness of their projects is measured in terms of increased reader/author engagement, increased online visibility, book sales, and more.
Overhead Perturbation Training
Authors: Burne Graham , Tack Christopher
Published: May 2017

OVERHEAD PHYSICAL PERFORMANCE OF THE UPPER LIMB IS PREDICATED ON VARIOUS FACTORS INCLUDING PROPRIOCEPTION, KINESTHESIA, AND MUSCLE ACTIVITY AROUND THE GLENOHUMERAL AND SCAPULOTHORACIC JOINTS. SUSTAINING SUFFICIENT NEUROMUSCULAR CONTROL ALLOWS OPTIMAL PERFORMANCE TO OCCUR, WHILE REDUCING RISK OF INJURY. CONVERSELY, BOTH FACTORS ARE REDUCED IN THE PRESENCE OF AN INJURY SHOWING THEIR IMPORTANCE IN REHABILITATION. OVERHEAD PERTURBATION TRAINING ALLOWS CONTROLLED EXPOSURE OF THE ATHLETE TO POSITIONS OF VULNERABILITY TO ALLOW FACILITATION OF ADAPTIVE RESPONSES TO IMPROVE RESPONSE TO EXTERNAL PERTURBATIONS OF LIMB POSITION. THIS TECHNIQUE ALLOWS DEVELOPMENT OF NEUROMUSCULAR CONTROL PATTERNS THAT MAY REDUCE INJURY.
Study of the Elastic Shear Modulus of Bío Bío Sand Using Bender Elements in an Oedometer
Authors: Ayala Juan L. , Villalobos Felipe A. , Alvarado Giovanny
Published: May 2017

The objective of the paper is to study the shear stiffness of Bío Bío sand. To this end, a system to measure the travel time of shear waves in Bío Bío sand samples using bender elements was designed and setup in an adapted oedometer device. Measurements were carried out for sand samples with different relative density, pressure/deformation, diameter/height, dry/saturated and varying the frequency, amplitude, and type of the triggered electric signals. The shear wave velocity and elastic shear modulus increased with relative density and effective vertical stress as previously found by other authors. In addition, Hardin type empirical formulas for estimating the elastic shear modulus are used to compare with the experimental results. Estimations proved to be good only in loading for effective vertical stresses around 100 kPa, since underestimation and overestimation of the shear modulus occurred for stresses below and above that value, respectively. Soil shear stiffness during unloading/reloading cycles was underestimated with the expressions used for loading.
A Mogi-Type True Triaxial Testing Apparatus for Rocks With Two Moveable Frames in Horizontal Layout for Providing Orthogonal Loads
Authors: Shi L. , Li X. , Bing B. , Wang A. , Zeng Z. , He H.
Published: May 2017

The Mogi-type true triaxial apparatus (TTA) for rocks provides numerous advantages in terms of complexity, loading capacity, permeability measurement, and cost. However, the spring support design limits the improvements to the loading capacity and stiffness of the vertical frame, which are essential in acquiring the complete stress-strain behavior of relatively large specimens. In this paper, a new TTA achieved by modifying the original Mogi-type design with two moveable frames in a horizontal layout is developed. In addition to the design of stiffer frames with low moving resistance, such a modification provides convenience for experimental operation. Moreover, a positioning device built in the triaxial vessel enables the accurate placing of the specimen. Technical details, including off-center loading, end friction effect, and strain measurement are carefully examined. Calibration and repeatability tests show that the apparatus is stable and reliable. The apparatus is used to conduct tests to examine the influence of intermediate principal stress on the mechanical behaviors of marble. The results demonstrate that, in addition to strength, some other characteristics, including brittleness, fracture angle, volumetric modulus, and stress at the onset of dilatancy of marble also increase initially, but subsequently decrease with an increase of intermediate principal stress. The measurement of the permeability of mudstone during compression reveals that the increase in permeability is closely related to the dilatancy of the mudstone.
Assessment of Low-Temperature Cracking in Asphalt Materials Using an Acoustic Emission Approach
Authors: Sun Z. , Behnia B. , Buttlar W. G. , Reis H.
Published: May 2017

An acoustic emission (AE)-based approach to evaluate low-temperature cracking susceptibility of both asphalt binders and asphalt mixtures is presented. The AE binder testing approach consists of a thin film of asphalt binder bonded to a granite substrate exposed to decreasing temperatures ranging from 20°C to −50°C. Because of the differential thermal contraction between the granite substrate and the asphalt binder, thermal cracks develop in the asphalt binder. The initiation/propagation of these thermal cracks leads to a release of mechanical elastic energy in the material, i.e., acoustic emission activity that is recorded and used in determining the embrittlement temperature of the binder material. The AE-based embrittlement temperature showed excellent correlations with thermal cracking predictions based upon the binder rheological properties. Similar results were also obtained when asphalt concrete mixture samples were exposed to temperatures ranging from 20°C to −50°C. The AE-based approach for low-temperature characterization of binders and asphalt concrete mixtures is a rapid and reliable testing method that yields results with better repeatability (lower coefficient of variation) than the traditionally used methods based upon the binder rheological properties. Current results using AE source location also indicate that the AE approach could be used to quantitative evaluate the effectiveness of rejuvenators on aged asphalt pavements.
Development and Psychometric Properties of the Standardized Assessment of Severity of Personality Disorder (SASPD)
Authors: Olajide Kike , Munjiza Jasna , Moran Paul , O'Connell Lesley , Newton-Howes Giles , Bassett Paul , Akintomide Gbolagade , Ng Nicola , Tyrer Peter , Mulder Roger , Crawford Mike J.
Published: May 2017

Personality disorder (PD) is increasingly categorized according to its severity, but there is no simple way to screen for severity according to ICD-11 criteria. We set out to develop the Standardized Assessment of Severity of Personality Disorder (SASPD). A total of 110 patients completed the SASPD together with a clinical assessment of the severity of personality disorder. We examined the predictive ability of the SASPD using the area under the ROC curve (AUC). Two to four weeks later, 43 patients repeated the SASPD to examine reliability. The SASPD had good predictive ability for determining mild (AUC = 0.86) and moderate (AUC = 0.84) PD at cut points of 8 and 10, respectively. Test-retest reliability of the SASPD was high (intraclass correlation coefficient = 0.93, 95% CI [0.88, 0.96]). The SASPD thus provides a simple, brief, and reliable indicator of the presence of mild or moderate PD according to ICD-11 criteria.