bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum theophylline after multiple dosing with transdermal gels in cats
Authors: Barnoski Jacob , Lee-Fowler Tekla M , Boothe Dawn M , Behrend Ellen N
Published: May 2018

Objectives

Our objectives were, first, to determine if therapeutic serum theophylline concentrations could be achieved using long-term, once-daily dosing of transdermal theophylline and, secondarily, to evaluate the difference between two transdermal theophylline formulations.

Methods

Seven healthy cats, 1–10 years of age, were evaluated in a two-way, randomized, double-blinded, crossover study. Participants received transdermal theophylline at 15 mg/kg for 21 days in either pluronic lecithin organogel (PLO) or Lipoderm formulation. On day 22, blood was collected 2, 6, 14 and 24 h after dosing. After a 14 day washout period, blood was collected to verify non-detectible theophylline concentrations. The alternate formulation was administered for 21 days, and sampling was repeated. Serum theophylline concentrations were determined using an automated immunoassay. Serum concentrations were compared between formulations using a two-way random-measures ANOVA and over time within a formulation using a repeated-measures ANOVA.

Results

Therapeutic serum theophylline concentrations were achieved for 2/7 cats in each group. Of 56 serum theophylline measurements obtained, only seven (13%) were within the therapeutic range. No significant difference was detected in drug concentrations achieved by the transdermal formulations at any time point. In addition, no significant difference in serum theophylline concentrations was noted between time points for PLO ( P = 0.751) or Lipoderm ( P = 0.107).

Conclusions and relevance

Once-daily transdermal dosing of theophylline does not reliably achieve therapeutic concentrations. Individual cats may achieve therapeutic concentrations. No significant difference was noted between PLO and Lipoderm formulations. Therefore, transdermal theophylline formulations should not be considered as a first-line therapy in feline asthma patients.
Hip surgeons and leg length inequality after primary hip replacement
Authors: Loughenbury Faye A , McWilliams Anthony B , Stewart Todd D , Redmond Anthony C , Stone Martin H
Published: May 2018

Background:

This study reports the results of 2 separate surveys of British Hip Society (BHS) members relating to leg length inequality (LLI) after primary total hip replacement (THR).

Survey 1:

Investigates the members’ opinions on the effect of LLI on the outcome of THR and explores the acceptable limits of LLI.

Survey 2:

Reports on the intraoperative techniques currently used by BHS members to minimise LLI after THR.

Results - Survey 1:

97% of all surgeons completing the survey believed that LLI can affect the outcome of THR.

Results - Survey 2:

All surgeons reported using at least 1 intraoperative technique for assessing leg length with a median of 5 techniques. Over 50% of surgeons use 2 or more tests.

Conclusion - Survey 1:

89% of surgeons agreed that 15 mm of LLI after primary uncomplicated THR was always acceptable. 90% of surgeons felt that LLI more than 22.74 mm was never acceptable.

Conclusion - Survey 2:

Despite the multiple published papers on various methods of assessing leg length intraoperatively, the problem of LLI post THR persists. This study highlights the need for further research to develop a simple intraoperative technique with high accuracy and reproducibility.
Liposomal bupivacaine reduces opioid consumption and length of stay in patients undergoing primary total hip arthroplasty
Authors: VanWagner Michael J , Krebs Nathan M , Corser William , Johnson Christopher N
Published: May 2018

Background:

Optimising postoperative pain management after total hip arthroplasty (THA) has been associated with improved patient outcomes. However, conclusions regarding the role of liposomal bupivacaine (LB) during THA remain mixed. The purpose of this study was to determine whether substituting a standard intraoperative wound infiltrate with LB as part of a multimodal pain management protocol would decrease subsequent opioid consumption and overall length of hospital stay in patients undergoing primary THA.

Methods:

Data was retrospectively collected on 170 consecutive patients who underwent primary THA at a single institution from January 2014 to October 2014. Outcomes from the first 85 patients who received intraoperative LB were compared to the prior 85 patients who received a standard intraoperative “cocktail” without LB. The remainder of the multimodal pain management protocol was identical between groups.

Results:

Total continuous and categorical postoperative hospital opioid consumption rates in the LB subgroup were significantly lower than the non-LB subgroup ( p < 0.001). The use of LB was associated with a relative reduction in opioid consumption on the day of surgery ( p = 0.001), postoperative day 1 ( p < 0.001), postoperative day 2 ( p < 0.001) and postoperative day 3 ( p < 0.001). Patients who received LB had decreased length of stay ( p = 0.001) and were discharged on lower doses of opioids.

Conclusion:

Substituting to LB from a standard wound infiltrate during primary THA, in addition to our standard multimodal pain management protocol, resulted in significantly lower postoperative opioid consumption and decreased length of stay.
The effect of altering head length on corrosion using a material loss method
Authors: Lanting Brent A , Wood Thomas J , Young Sam , Van Citters Douglas W , MacDonald Steven J , Howard James L , Teeter Matthew G
Published: May 2018

Introduction:

Corrosion at head neck taper junctions in total hip arthroplasty has increasingly been reported in the literature. Debate persists as to the exact causes and clinical significance of corrosion. Increased offset and head length has been correlated with an increased risk of tribocorrosion due to an adverse mechanical environment. The purpose of this study is to assess the effect of head length on corrosion of a metal-on-polyethylene articulation.

Methods:

Retrievals from a single institution of 28-mm cobalt chromium alloy heads with a 12/14 taper from a single manufacturer were studied. Corrosion of femoral head bores were studied utilising a material loss method. Testing was performed using co-ordinate measuring for maximum linear wear depth.

Results:

56 heads were examined with lengths of either −3, 0, +4 or +8 mm and all had been in situ for a minimum of 2 years. There were no significant differences in mean maximum linear wear depth (MLWD) ( p = 0.6545). There was no correlation found between MLWD and the time implants were in situ (Spearman coefficient −0.1157) and no significant difference seen between high or standard offset stems ( p = 0.1336).

Conclusion:

In contrast to studies using qualitative methodologies, there was no correlation between head length and material loss when confined to a 28-mm head. Broad application of this outcome should be cautioned against as this study examined 1 taper construct and a metal-on-polyethylene articulation.
Hip morphology predicts posterior hip impingement in a cadaveric model
Authors: Morris William Z , Fowers Cody A , Weinberg Douglas S , Millis Michael B , Tu Leigh-Anne , Liu Raymond W
Published: May 2018

Introduction:

Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits.

Methods:

Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured.

Results:

External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from −0.39 to −0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta −0.35, p = 0.005).

Discussion:

Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.
Variable pricing and change in alpine skiing attendance
Authors: Haugom Erik , Malasevska Iveta
Published: May 2018

In this article, we examine two aspects of the relation between variable intra-week pricing and alpine skiing attendance at three ski resorts in Norway. First, we study what affects the probability of increased skiing frequency during the midweek if the price is reduced in this period compared to the regular (weekend) price. Second, we examine the cannibalization effect from a lower midweek price on the weekend skiing activity. Our results show that the probability of increased midweek skiing at a lower price is significantly influenced by age and income. The probability that cannibalization occurs is significantly influenced by skiing interest and family status.
Using drawings to understand the child’s experience of child-centred care on admission to a paediatric high dependency unit
Authors: Foster Mandie , Whitehead Lisa
Published: May 2018

Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child’s perspective. An interpretive thematic approach was used where the child was asked to draw a picture of ‘a person in the hospital’ that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of ‘participation versus protection’ and ‘child as becoming versus child as being’ will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.
Examining Technical Efficiency in Indian Agricultural Production Using Production Frontier Model
Authors: Pradhan Kailash Chandra , Mukherjee Shrabani
Published: May 2018

The study estimates the technical efficiency (TE) of agricultural production in India using production frontier model for both cross-section and panel data for the years 1999 and 2007. Given the persistent low productivity of agriculture in India, there is a serious need to identify the determining factors for technological lock-in for agricultural production in order to accelerate sustainable productivity and technical efficiency. The model claims that farmer’s education, household’s production process, proportion of irrigated area covered by canals, availability of wells, yielding variety of lands, government services, agricultural expenditure by local government and women reservations in local government significantly contribute to efficiency in resource utilization in farm production. Traditional techniques such as ‘learning by doing’ is, generally, preferred than the adoption of new technologies for agricultural production. It makes a constraint of technological lock-in.

JEL: C23, C33, D20, O13
Radiological risks assessment of building materials ingredients: Palm oil clinker and fuel ash
Authors: Karim M. R. , Khandaker M. U. , Asaduzzaman Kh. , Razak H. A. , Yusoff S. B.
Published: May 2018

Technical benefits relevant to the use of palm oil clinker (POC) and fuel ash (POFA) in building materials has been well documented. However, the radiological health hazards caused by the incorporation of POC and POFA as an ingredient of building materials have not been studied so far. The radioactivity levels were measured by γ-ray spectrometry using hyper-pure germanium (HPGe) detector. The activity concentration of 226Ra and 232Th in POC and POFA was found to be in the ranges of 5.56 ± 0.23 to 9.03 ± 0.21 and 4.21 ± 0.03 to 7.98 ± 0.19 Bq kg−1, respectively, and these values were lower than the world average values of 50 Bq kg−1 for building materials. The 40K value was within the range of 413.01 ± 1.78 to 604.66 ± 2.18 Bq kg−1. Several radiological parameters and hazard indices, i.e. radium equivalent activity, absorbed dose rate and annual effective dose etc. were calculated for the evaluation of the potential radiological hazards. The obtained values fall within the recommended limit set by various international organizations. Since the activity levels of 226Ra, 232Th and 40K in POC and POFA were significantly lower than the corresponding literature data for other ingredients of building materials, it indicates that POC and POFA are safe to be used in concrete construction.
Beyond the hashtag: Circumventing content moderation on social media
Authors: Gerrard Ysabel
Published: May 2018

Social media companies make important decisions about what counts as “problematic” content and how they will remove it. Some choose to moderate hashtags, blocking the results for certain tag searches and issuing public service announcements (PSAs) when users search for troubling terms. The hashtag has thus become an indicator of where problematic content can be found, but this has produced limited understandings of how such content actually circulates. Using pro-eating disorder (pro-ED) communities as a case study, this article explores the practices of circumventing hashtag moderation in online pro-ED communities. It shows how (1) untagged pro-ED content can be found without using the hashtag as a search mechanism; (2) users are evading hashtag and other forms of platform policing, devising signals to identify themselves as “pro-ED”; and (3) platforms’ recommendation systems recirculate pro-ED content, revealing the limitations of hashtag logics in social media content moderation.
To comment or not to comment: Examining the influences of anonymity and social support on one’s willingness to express in online news discussions
Authors: Wu Tai-Yee , Atkin David J
Published: May 2018

This study examines the effects of online anonymity and different sources of social influence on the Spiral of Silence phenomenon in online news discussions about abortion. The results ( N = 339) substantiated that technical anonymity predicts one’s perceived anonymity, but only the latter significantly increases one’s willingness to post personal opinions in the comment sections. Perceived support from other commenters was also found to reduce the online Spiral of Silence phenomenon. With fear of isolation, moreover, the state-based approach is verified to be more robust than the trait-like approach, advancing Noelle-Neumann’s original conceptualization. Study findings thus offer support for a more comprehensive conceptualization of Spiral of Silence components operating in online contexts.
Mechanical behaviour of additively manufactured lunar regolith simulant components
Authors: Goulas Athanasios , Binner Jon GP , Engstrøm Daniel S , Harris Russell A , Friel Ross J
Published: May 2018

Additive manufacturing and its related techniques have frequently been put forward as a promising candidate for planetary in-situ manufacturing, from building life-sustaining habitats on the Moon to fabricating various replacements parts, aiming to support future extra-terrestrial human activity. This paper investigates the mechanical behaviour of lunar regolith simulant material components, which is a potential future space engineering material, manufactured by a laser-based powder bed fusion additive manufacturing system. The influence of laser energy input during processing was associated with the evolution of component porosity, measured via optical and scanning electron microscopy in combination with gas expansion pycnometry. The compressive strength performance and Vickers micro-hardness of the components were analysed and related back to the processing history and resultant microstructure of the lunar regolith simulant build material. Fabricated structures exhibited a relative porosity of 44–49% and densities ranging from 1.76 to 2.3 g cm−3, with a maximum compressive strength of 4.2 ± 0.1 MPa and elastic modulus of 287.3 ± 6.6 MPa, the former is comparable to a typical masonry clay brick (3.5 MPa). The additive manufacturing parts also had an average hardness value of 657 ± 14 HV0.05/15, better than borosilicate glass (580 HV). This study has shed significant insight into realising the potential of a laser-based powder bed fusion additive manufacturing process to deliver functional engineering assets via in-situ and abundant material sources that can be potentially used for future engineering applications in aerospace and astronautics.
Dementia and detectives: Alzheimer’s disease in crime fiction
Authors: Orr David MR
Published: May 2018

Fictional representations of dementia have burgeoned in recent years, and scholars have amply explored their double-edged capacity to promote tragic perspectives or normalising images of ‘living well’ with the condition. Yet to date, there has been only sparse consideration of the treatment afforded dementia within the genre of crime fiction. Focusing on two novels, Emma Healey’s Elizabeth is Missing and Alice LaPlante’s Turn of Mind, this article considers what it means in relation to the ethics of representation that these authors choose to cast as their amateur detective narrators women who have dementia. Analysing how their narrative portrayals frame the experience of living with dementia, it becomes apparent that features of the crime genre inflect the meanings conveyed. While aspects of the novels may reinforce problem-based discourses around dementia, in other respects they may spur meaningful reflection about it among the large readership of this genre.
Unsteady disturbances in micro Rayleigh-Bénard flows using direct simulation Monte Carlo method
Authors: Fang Y , Liou WW
Published: May 2018

The direct simulation Monte Carlo method is applied in this paper to simulate the micro Rayleigh-Bénard convection for the Rayleigh number of 10,159 and the Knudsen number of 0.01 in a time-dependent manner. A monatomic gas is enclosed between two infinite, parallel plates with the bottom plate at a higher temperature. Cases of three different computational domain sizes in the horizontal directions are simulated. Evolutions of the convective flow unsteady disturbances patterns and the wall heat transfer are studied in detail. Three stages of distinct flow characteristics can be identified as the flows develop from an initially uniform state. In the first stage, the heat is transferred mainly by conduction. The onset of the vortical flow structures marks the beginning of the second stage. Significant differences in the flow and the heat transfer characteristics are observed in the third stage of the three simulated flows. It is found that the simulated microflows develop vortex rolls that advect along the plates at uniform speeds, which has not been reported previously.
Detection of double defects for plate-like structures based on a fuzzy c-means clustering algorithm
Authors: Chen Shaojie , Zhou Shaoping , Chen Chaofeng , Li Yong , Zhai Shuangmiao
Published: May 2018

A variety of signal processing algorithms have been proposed to detect and locate defects in plate-like structures. However, the signal-to-noise ratio in these algorithms is too small especially in the reflection wave from the boundary, which further degrades the accuracy of localization of defects. A novel method for localization of defects is proposed in this article, based on the direct wave and fuzzy c-means clustering algorithm. To verify its effectiveness, experiments using the parallel linear and circular array are conducted, respectively. The experimental results show that the proposed method not only accurately locates single defect but also locates double defects in plate-like structures, and by comparing with the current discrete elliptic imaging algorithm, its location error of single defect is reduced from 20–25 mm to 0–3 mm and double defects is also reduced from 60–90 mm to 0–3 mm.
Luminous flux to input power ratio, power factor and harmonics when dimming high-pressure sodium and LED luminaires used in road lighting
Authors: Djuretic A , Skerovic V , Arsic N , Kostic M
Published: May 2018

This paper presents experimentally obtained luminous flux to input power characteristics of high-pressure sodium and LED luminaires used in road lighting, confirming that when applying dimming scenarios more percentage energy savings can be achieved by an LED than by a corresponding high-pressure sodium lighting installation. However, both workshop and field experiments showed that the tested LED drivers (of either standard or improved dimming characteristics) have the disadvantage of poor power factors (down to 0.67) at low light levels achieved by dimming. In addition, an increased presence of current harmonics and high values of the current total harmonic distortion were noticed at low light levels, representing another serious disadvantage of LED technology regarding power quality. The relevant electrical characteristics of commonly used LED drivers were analysed in detail and the reasons for the poor power quality when dimming LED luminaires were recognised. A new generation of LED drivers with a considerably narrower range of input (AC) voltage will allow acceptable power factors and limited emissions of current harmonics to be achieved in practically all lighting regimes.
Why Latin@s Become Greek: Exploring Why Latin@s Join Latino Greek-Letter Organizations
Authors: Arellano Lucy
Published: May 2018

This study explored the reasons Latin@s join Latino fraternities and Latina sororities at a university in the southwestern United States. Via a phenomenological approach, it uncovered the unique placement of Latino Greek-letter organizations and their role in the success of Latin@ students by embodying the intersectionality of academics, social interaction, accountability, community service, cultural congruency, and brotherhood/sisterhood. Findings highlight the concepts of social isolation, navigation, sense of belonging, Latino culture, and “Not Greek. Latin@ Greek.”
Axillo-Axillary Artery Bypass With Coil Embolization of the Innominate Artery for a Traumatic Innominate Artery Aneurysm: A Case Report
Authors: Sugisawa Ryota , Sano Masaki , Yamamoto Naoto , Inuzuka Kazunori , Tanaka Hiroki , Saito Takaaki , Katahashi Kazuto , Yata Tatsuro , Kayama Takafumi , Yamanaka Yuta , Takeuchi Hiroya , Unno Naoki
Published: May 2018

Background:

Innominate artery aneurysm (IAA) is a rare cervical artery aneurysm. Although atherosclerosis is its most common cause, IAAs due to cervical injury are often reported. Operative indications for IAAs include rupture or symptomatic aneurysm, saccular aneurysm, aneurysm with a diameter of 3 cm or greater, and aneurysmal change of the origin of the innominate artery. Although the ligature of the innominate artery or open surgical repair is well described, the usefulness of endovascular repair has also recently been reported. Herein, we report a case of traumatic IAA with infection in the cervical region after tracheostomy.

Case Presentation:

A 40-year-old man with cholecystolithiasis planned to undergo laparoscopic cholecystectomy at another hospital. Urgent tracheostomy was performed because of laryngeal edema at the induction of general anesthesia. Enhanced computed tomography angiography 1 week after the tracheostomy revealed a saccular IAA. The patient was deemed to be at high risk for aneurysm rupture and was referred to our hospital. Preoperative Matas test, Allcock test, and innominate arterial stump pressure measurement were performed to assess the cerebral blood flow and ischemic tolerance of the brain. These examinations showed the patency of the circle of Willis. An axillo-axillary artery bypass with coil embolization of the innominate artery was performed to avoid postoperative vascular graft infection. No postoperative complications such as infection or cerebral infarction occurred. Magnetic resonance imaging angiography performed 6 months after surgical treatment showed that the aneurysm had disappeared, and patency of the bypass graft was present. There were no postoperative complications, such as neurological deficits or graft infection, at more than 5 years after surgery.

Conclusions:

We report a successfully treated case of IAA after tracheostomy. Axillo-axillary artery bypass with coil embolization of the innominate artery is an effective treatment of IAA with cervical infection.
Perspectives on the State of the Art (and Science) of Selected Life-Span Services
Authors: Agran Martin , Spooner Fred , Brown Fredda , Morningstar Mary , Singer George H. S. , Wehman Paul
Published: May 2018

At the 2016 TASH Conference in St. Louis, a research colloquium was held that focused on the state of selected life-span services for people with severe disabilities. Topics addressed by leading experts in the field included inclusion, teaching academic skills, family support, challenging behavior, supported employment, and voting. This article summarizes the information presenters shared at the colloquium. The presenters prepared a short response with a minimum number of citations based on the material they presented, which focused on the description of the practice, extent to which practices are implemented, challenges to implementing the practice, and recommended practices. Although all contributors suggested that much progress has been made, they concurred that there is still much to do in serving people with severe disabilities and their families.
The First Year as Teachers Assigned to Elementary and Middle-School Special Education Classrooms
Authors: Gee Kathy , Gonsier-Gerdin Jean
Published: May 2018

The purpose of this qualitative study was to examine the experiences and perceptions of 10 first-year teachers who had been trained to provide evidence-based practices, including integrated services and supports, and subsequently took jobs in self-contained, special education elementary and middle-school classrooms designated for students with “moderate/severe disabilities.” A collective case study design was used to follow the teachers over the course of their first year of teaching. The narrative and teacher-reported data demonstrated their accomplishments, the joys of their work with the children and families, and their growth in confidence levels. The data also revealed their frustrations with some of the systemic issues they faced. Many of the difficulties stemmed from the lack of a shared vision between the teachers and their school administrators and systems. Implications for policy and practice regarding the segregation of students with severe disabilities and their teachers are discussed, as well as issues related to the evaluation of special education teachers and the induction of new special education teachers.
The Effect of Political Skill on Work Role Performance and Intention to Leave: A Moderated Mediation Model
Authors: García-Chas Romina , Neira-Fontela Edelmira , Varela-Neira Concepción , Curto-Rodríguez Eduardo
Published: May 2018

Although political skill has received extensive and growing attention over the past decade, to date most research has focused on its direct relationship with individual outcomes. Only recently, a few researchers have begun to investigate the intermediate linkages between political skill and its outcomes. Based on social support and resources conservation theories, the current study explores the mediating role of perceived organizational support (POS) in the relationships between political skill and two relevant outcomes: work role performance (data provide by two different sources) and intention to leave. Moreover, it examines the moderating role of political skill in the relationships POS-work role performance and POS-intention to leave. Results, in a sample of engineers, support the proposed relationship except for the moderating role of political skill in the relationship POS-intention to leave. This research contributes to the political skill and POS literatures and, hopefully, it will stimulate more interest in these important areas of inquiry.
Lonely at the Top: How Do Senior Leaders Navigate the Need to Belong?
Authors: Zumaeta Jessy
Published: May 2018

Despite the considerable literature on leadership, very little research explores how leaders experience their role, especially in senior-level positions. This study examines the socioemotional costs of being a high-ranking leader in a corporate context. In-depth interviews with C-suite executives were conducted revealing that loneliness is a professional hazard. Top executives are more prone to be lonely due to the pressures of the role: increased social distance, lack of social support, and exhaustion related to the role. Two ongoing conflicts in the position (Role vs. Person and Distance vs. Closeness) and four coping strategies were identified (mental and physical disconnection, healthy lifestyle, support from one’s network, and affecting and influencing others). Finally, the research revealed that some organizational conditions could also increase the risk of loneliness at the top (e.g., high–power distance culture). This study provides an empirical foundation to manage top executives’ behavior and well-being. Leaders and HR practitioners should raise awareness and take action to contribute to senior managers’ welfare, and ultimately, to organizational success.
Development of a Laparoscopic Box Trainer Based on Open Source Hardware and Artificial Intelligence for Objective Assessment of Surgical Psychomotor Skills
Authors: Alonso-Silverio Gustavo A. , Pérez-Escamirosa Fernando , Bruno-Sanchez Raúl , Ortiz-Simon José L. , Muñoz-Guerrero Roberto , Minor-Martinez Arturo , Alarcón-Paredes Antonio
Published: May 2018

Background. A trainer for online laparoscopic surgical skills assessment based on the performance of experts and nonexperts is presented. The system uses computer vision, augmented reality, and artificial intelligence algorithms, implemented into a Raspberry Pi board with Python programming language. Methods. Two training tasks were evaluated by the laparoscopic system: transferring and pattern cutting. Computer vision libraries were used to obtain the number of transferred points and simulated pattern cutting trace by means of tracking of the laparoscopic instrument. An artificial neural network (ANN) was trained to learn from experts and nonexperts’ behavior for pattern cutting task, whereas the assessment of transferring task was performed using a preestablished threshold. Four expert surgeons in laparoscopic surgery, from hospital “Raymundo Abarca Alarcón,” constituted the experienced class for the ANN. Sixteen trainees (10 medical students and 6 residents) without laparoscopic surgical skills and limited experience in minimal invasive techniques from School of Medicine at Universidad Autónoma de Guerrero constituted the nonexperienced class. Data from participants performing 5 daily repetitions for each task during 5 days were used to build the ANN. Results. The participants tend to improve their learning curve and dexterity with this laparoscopic training system. The classifier shows mean accuracy and receiver operating characteristic curve of 90.98% and 0.93, respectively. Moreover, the ANN was able to evaluate the psychomotor skills of users into 2 classes: experienced or nonexperienced. Conclusion. We constructed and evaluated an affordable laparoscopic trainer system using computer vision, augmented reality, and an artificial intelligence algorithm. The proposed trainer has the potential to increase the self-confidence of trainees and to be applied to programs with limited resources.
A Critique of Recent Epidemiologic Studies of Cancer Mortality Among Nuclear Workers
Authors: Scott Bobby R.
Published: May 2018

Current justification by linear no-threshold (LNT) cancer risk model advocates for its use in low-dose radiation risk assessment is now mainly based on results from flawed and unreliable epidemiologic studies that manufacture small risk increases (ie, phantom risks). Four such studies of nuclear workers, essentially carried out by the same group of epidemiologists, are critiqued in this article. Three of the studies that forcibly applied the LNT model (inappropriate null hypothesis) to cancer mortality data and implicated increased mortality risk from any radiation exposure, no matter how small the dose, are demonstrated to manufacture risk increases for doses up to 100 mSv (or 100 mGy). In a study where risk reduction (hormetic effect/adaptive response) was implicated for nuclear workers, it was assumed by the researchers to relate to a “strong healthy worker effect” with no consideration of the possibility that low radiation doses may help prevent cancer mortality (which is consistent with findings from basic radiobiological research). It was found with basic research that while large radiation doses suppress our multiple natural defenses (barriers) against cancer, these barriers are enhanced by low radiation doses, thereby decreasing cancer risk, essentially rendering the LNT model to be inconsistent with the data.
A reliability analysis method including confidence level and probability reliability under epistemic and aleatory uncertainty
Authors: Xue Xiao-Feng , Feng Yun-Wen , Lu Cheng
Published: May 2018

Reliability analysis is a synthesis problem affected by both epistemic and aleatory uncertainties, due to the difficulties such as lack of statistical data and insufficient subjective information, which implies that the reliability analysis method has been seriously restricted in engineering applications. The reliability analysis results are expressed as evidence layer and probability layer here, and an analysis method based on hybrid evidence and probability is presented. First, the evidence layer of epistemic uncertainties has been constructed based on evidence theory. In the independence case of evidence variables, the joint basic probability assignment of the focal element is expressed as the product of all the evidence variables’ basic probability assignments involved; in the dependence case of evidence variables, the joint basic probability assignment of the focal element is derived through ellipsoid equation. Then, according to the limit state function characteristics, an analytic or numerical method is employed for the failure probability calculation, and the probability layer of aleatory uncertainty has been constructed. Finally, the probability calculation result with maximum credibility is chosen, and the corresponding focal element including the evidence variables is regarded as the design scheme. Numerical and engineering examples show the feasibility and effectiveness of the proposed method.
Memory-based reinforcement learning algorithm for autonomous exploration in unknown environment
Authors: Dooraki Amir Ramezani , Lee Deok Jin
Published: May 2018

In the near future, robots would be seen in almost every area of our life, in different shapes and with different objectives such as entertainment, surveillance, rescue, and navigation. In any shape and with any objective, it is necessary for them to be capable of successful exploration. They should be able to explore efficiently and be able to adapt themselves with changes in their environment. For successful navigation, it is necessary to recognize the difference between similar places of an environment. In order to achieve this goal without increasing the capability of sensors, having a memory is crucial. In this article, an algorithm for autonomous exploration and obstacle avoidance in an unknown environment is proposed. In order to make our self-learner algorithm, a memory-based reinforcement learning method using multilayer neural network is used with the aim of creating an agent having an efficient exploration and obstacle avoidance policy. Furthermore, this agent can automatically adapt itself to the changes of its environment. Finally, in order to test the capability of our algorithm, we have implemented it in a robot similar to a real model, simulated in the robust physics engine simulator of Gazebo.
Telehealth intervention for Latina breast cancer survivors: A pilot
Authors: Meneses Karen , Gisiger-Camata Silvia , Benz Rachel , Raju Dheeraj , Bail Jennifer R , Benitez Tanya J , Pekmezi Dorothy , McNees Patrick
Published: May 2018

Aim:

This study was a pilot test of the Latina Breast Cancer Survivorship Intervention, a survivorship self-management intervention delivered via telephone.

Materials and methods:

This study used a wait-list control design with random assignment to either (1) support and early education or (2) support and delayed education. Latina breast cancer survivors were recruited through the Florida Cancer Data System Registry. Latinas with stage I–III breast cancer who completed primary cancer treatment 3 years prior to study enrollment were eligible. The Latina Breast Cancer Survivorship Intervention consisted of three education sessions delivered weekly via telephone and six telephone support calls, both delivered by a native Spanish speaker. Primary outcome variables included physical well-being, emotional well-being, fatigue, pain, and depressive symptoms. Data collection occurred at baseline, 3 months, and 6 months.

Results:

In total, 40 Latina breast cancer survivors who were middle-aged to older, married, with health insurance, and Spanish as preferred language enrolled in the Latina Breast Cancer Survivorship Intervention. Data were analyzed using mean change scores. Overall, physical and emotional well-being remained similar over time with well-being scores poorer compared with the general population. Pain levels improved over 6 months and showed a high effect size. Fatigue scores improved at 3 months and showed a moderate effect size. Depressive symptoms remained elevated but were not clinically significant.

Conclusion:

Telephone-based Latina Breast Cancer Survivorship Intervention reached Latina breast cancer survivors for survivorship education and support. Self-management of pain and fatigue showed improvement over time.
Women in university hockey demonstrate knowledge discordant with attitudes regarding concussions
Authors: Jorgensen Melanie , Laurence Michelle , Quesnele Jairus , Baldisera Tara , Grenier Sylvain
Published: May 2018

Objective

To examine the knowledge and attitudes about sport-related concussion among university athletes.

Design

Cross-sectional study.

Setting

Validated survey instrument.

Subjects

Seventy-two university soccer, hockey, and basketball athletes (28 males, 44 females).

Main outcome measures

Total athlete knowledge scores and attitude scores were measured and average scores were also determined for each sport, sex, and combinations of sport and sex.

Results

The average athlete knowledge total score was 28.9 ± 2.8 ( SD) out of a possible 35, and the average attitude total score was 76.4 ± 11.8 ( SD) out of a possible 98. Correlations between athlete knowledge scores and athlete attitude scores were positive in the all male athlete sample ( r = 0.09, n = 28, p = .65). The same correlation in the all female athlete sample was negative ( r = −.33, n = 44, p < .05). Sixteen athletes suffered a total of 21 concussions in the 2015–2016 playing season.

Conclusions

The present sample of university athletes have higher knowledge scores but poorer attitude about concussions. Knowledge regarding concussion did not translate into improved attitudes particularly for female hockey athletes. Coaches should consider concussion education focused on communicating facts, as well as contextual interventions and practical athlete responses to injury. Interventions should consider the differences between male and female athlete reporting tendencies in this demographic. Appropriate detection and reporting systems may help to overcome poor reporting behaviors.
Novel use of Cytosorb™ haemadsorption to provide biochemical control in liver impairment
Authors: Dhokia VD , Madhavan D , Austin A , Morris Craig G
Published: May 2018

We describe the use of Cytosorb™, a synthetic extracorporeal haemoperfusion adsorption column, in the management of two patients with drug induced cholestasis and a third with alcoholic hepatitis and subsequent acute on chronic liver failure. Cytosorb was used in these patients to remove bilirubin and bile acids by supporting impaired excretory hepatic function, alleviating symptoms with the intention of serving as a bridge to endogenous recovery. The first two cases demonstrate favourable biochemical and symptomatic responses; the third case demonstrated a good biochemical response but subsequently died from the complications of multiple organ failure. These cases suggest Cytosorb™ be evaluated as an adjunct to support liver excretory functions in other arenas, such as acute liver failure or overdose. It remains unclear whether extracorporeal therapies removing liver toxins allow faster or more complete spontaneous recovery of endogenous function.
School accreditation scheme reduces childhood obesity in Hong Kong
Authors: Fu Yuk Ching Alex , To Kit Ching , Tao Wing Yan , Kwan Kai Ming Andrew , Lee Yuen Ho , Fung Yu Kei Anne , Ching Cheuk Tuen Regina , Chung Wai Hung Thomas
Published: May 2018

Childhood obesity is an increasing threat to the health of primary school students in Hong Kong. Obesity results from energy excess from food relative to energy expenditure through physical activity. In Hong Kong, a whole day primary schooling policy has been implemented since 1993 and today most primary school students have their lunch on campus and some also purchase snacks and drinks from school tuck shops or vending machines. The EatSmart School Accreditation Scheme (ESAS) aiming at combating childhood obesity was launched in 2009/2010. Professional (health promotion, dietary, programme, etc.) support is provided to help schools formulate policies, introduce structures and implement measures to help students develop the habit of healthy eating. The aim of this study is to investigate the change of childhood obesity (including overweight) rates over time among schools awarded with ESAS accreditation. Seven-year retrospective data on obesity status were obtained for the period 2007/2008–2013/2014 (number of students = 113,322, number of measurements = 314,746) from all 105 ESAS-accredited schools. Before schools were geared up for the accreditation scheme obesity rates were fairly stable (slope test p > 0.05) among their student population ranging from 23.2% to 21.9%, whereas the rates dropped significantly (slope test p < 0.05) from 21.9% to 19.3% after intervention. For ESAS-accredited schools, there was an average annual reduction of 0.49% point in obesity rate which was 0.18% point higher than that of 0.31% point among non-ESAS-accredited schools. These results show that schools achieving ESAS accreditation are associated with a bigger improvement in the student obesity problem.
Analysis of a school-based health education model to prevent opisthorchiasis and cholangiocarcinoma in primary school children in northeast Thailand
Authors: Laithavewat Luxana , Grundy-Warr Carl , Khuntikeo Narong , Andrews Ross H. , Petney Trevor N. , Yongvanit Puangrat , Banchonhattakit Pannee , Sithithaworn Paiboon
Published: May 2018

Infection with the liver fluke Opisthorchis viverrini is the major causative factor inducing cholangiocarcinoma in the Mekong region of Southeast Asia. Northeast Thailand has the highest incidence of this cancer worldwide leading to about 20,000 deaths every year. Infection with the liver fluke comes from eating raw or undercooked fish, a tradition in this area that can potentially be countered by education programs at school level. Here we develop a school-based health education model, based on protection motivation theory (PMT), including module design, learning materials, student activities, and capacity building amongst teachers. This education program was applied and tested in primary school to pupils (9–13 years) in Khon Kaen province, northeast Thailand. Using a randomized control trial, four schools served as intervention groups ( n = 118 pupils) and another four acted as controls ( n = 113 pupils). Based on PMT constructs, we found that the pupils in the intervention group had significantly greater knowledge and perceived the severity, vulnerability, response efficacy, and self-efficacy parameters concerning the dangers of eating raw fish and of developing cholangiocarcinoma than those in the control schools ( p < 0.05). All of the PMT constructs measured were significantly intercorrelated with each other ( p < 0.001). At the same time, some background knowledge, from community-based education programs, was present in the control schools. The result from this initial study suggests that PMT can be used to predict protective attitude as well as behavior changes in evaluating the consequence of school health intervention programs.