bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Excision of Posttraumatic Ossifications at the Proximal Hamstrings in Young Athletes
Authors: Orava Sakari , Hetsroni Iftach , Marom Niv , Mann Gideon , Sarimo Janne , Ben-Zvi Ofer , Lempainen Lasse
Published: March 2015

Background:

Proximal hamstring tears can be associated with chronic disability related to the unusual formation of heterotopic ossifications. The role for operative intervention in these circumstances has not been clearly defined.

Purpose/Hypothesis:

The purpose of this study was to describe the surgical management of young athletes who had chronic disability related to proximal hamstring ossifications after eccentric load injuries. The hypothesis was that after surgical excision of posttraumatic heterotopic ossifications at the proximal hamstrings with concomitant repair of the tendons to the ischium, significant functional improvement with low risk of postoperative complications can be expected at minimum 2-year follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

The cases of 11 consecutive male athletes who developed chronic disability associated with heterotopic ossifications at the proximal hamstring muscles after sports-related tears were reviewed. During surgery, the ossified mass was meticulously excised, and the tendons were debrided and fixed to the ischium. At minimum 2-year follow-up, self-reported outcome was rated as excellent, good, moderate, or poor. Operative reports and office visits were reviewed. Activity level before the injury and at latest follow-up was graded with the Tegner scale.

Results:

The median age at injury was 17 years (range, 13-25 years). Sports activities included ice hockey, soccer, track and field athletics, and judo. Mean interval from injury to surgery was 45 months. The smallest ossified mass was 2 × 2 × 4 cm and the largest, 3 × 4 × 9 cm. Median follow-up was 4 years (range, 2-10 years). Six patients had excellent, 1 patient had good, and 4 patients had moderate outcomes; 7 of them were able to return to preinjury activities (Tegner score, 7-10). There were 2 cases of loss of skin sensation at the posterior femoral cutaneous nerve distribution, but neither patient described this as significantly interfering with any activity. All patients had symmetric side-to-side single-legged hop test and a 5 out of 5 on hamstring muscle strength at latest follow-up.

Conclusion:

Heterotopic ossifications that develop at the proximal hamstrings after eccentric load injuries can be associated with significant chronic disability. These cases can be effectively treated by surgical excision of the ossified masses and concomitant debridement with suture fixation of the proximal hamstring tendons to the ischium. Return to preinjury activities is expected in the majority of these cases, with low postoperative risks.
Evaluating Eccentric Hip Torque and Trunk Endurance as Mediators of Changes in Lower Limb and Trunk Kinematics in Response to Functional Stabilization Training in Women With Patellofemoral Pain
Authors: Baldon Rodrigo de Marche , Piva Sara Regina , Scattone Silva Rodrigo , Serrão Fábio Viadanna
Published: March 2015

Background:

Altered movement patterns of the trunk and lower limbs have been associated with patellofemoral pain (PFP). It has been assumed that increasing the strength of the hip and trunk muscles would improve lower limb and trunk kinematics in these patients. However, evidence in support of that assumption is limited.

Purpose:

To determine whether increases in the strength of hip muscles and endurance of trunk muscles in response to functional stabilization training will mediate changes in frontal plane lower limb kinematics in patients with PFP.

Study Design:

Controlled laboratory study.

Methods:

Thirty-one female athletes were randomized to either a functional stabilization training group that emphasized strengthening of the trunk and hip muscles or a standard training group that emphasized stretching and quadriceps strengthening. Patients attended a baseline assessment session, followed by 8 weeks of intervention, and were then reassessed at the end of the intervention period. The potential mediators that were evaluated included eccentric torque of hip muscles and endurance of the trunk muscles. The outcome variables were the lower limb and trunk kinematics in the frontal plane assessed during a single-legged squat task.

Results:

The eccentric strength of the gluteus muscles showed a mediation effect ranging from 18% to 32% on changes to frontal plane kinematics (decreased ipsilateral trunk inclination, pelvis contralateral depression, and hip adduction excursions) observed in the functional stabilization training group after intervention.

Conclusion:

Although the mediation effects were small, the results suggest that improvements in the strength of the gluteus muscles can influence the frontal plane movement patterns of the lower limb and trunk in women with PFP.

Clinical Relevance:

Patients with PFP might benefit from strengthening of the hip muscles to improve frontal plane lower limb and trunk kinematics during functional tasks.
Predictors of Abnormal Neuroimaging of the Brain in Children With Epilepsy Aged 1 Month to 2 Years
Authors: Sanmaneechai Oranee , Danchaivijitr Nasuda , Likasitwattanakul Surachai
Published: March 2015

Neuroimaging should be performed on infants with seizure. However, there are economic limitations in performing neuroimaging in a resource-limited setting. The younger the age, the higher the risk of having abnormal neuroimaging. The aim was to determine frequency and predictors of abnormal neuroimaging in children with epilepsy aged 1 month to 2 years. History, physical examination, electroencephalogram (EEG), and neuroimaging were reviewed. Thirty-seven of 49 (76%) had neuroimaging studies; 19 computed tomography (CT), 14 magnetic resonance imaging (MRI), and 4 had both. Abnormal neuroimaging was found in 19 (51%). Predictors of abnormal neuroimages are developmental delay, abnormal head circumference, and abnormal neurologic examination. Eight children (21%) had lesions on neuroimaging studies that altered or influenced management. Of 8 patients with normal examination and EEG, 1 had a brain tumor and another had arteriovenous malformation. Neuroimaging should be considered as an essential aid in the evaluation of infants with epilepsy, even in a resource-limited setting.
Goniometer Measurements of Oral Labial Angle and Evaluation of Oral Motor Reflexes in Preterm Infants
Authors: Ince Deniz Anuk , Tugcu Ali Ulas , Ecevit Ayşe , Ciyiltepe Muzeyyen , Kurt Abdullah , Abbasoğlu Aslıhan , Tekindal Mustafa Agah , Tarcan Aylin
Published: March 2015

To date, no study has evaluated changes in oral labial angle as preterm infants mature. The main purpose of this study was to document goniometer measurements of the labial angle of the mouth in preterm infants, to assess changes with development, to compare to findings in healthy term infants, and also evaluate oral motor reflexes in these groups. Seventy-eight preterm infants and 45 healthy term infants were recruited for the prospective study. Labial angle was assessed via goniometer, and oral motor reflexes and the volume of milk ingested were evaluated. There was significant difference between term and preterm infants’ labial angles ( P < .01). The distribution of preterm infants’ angles were similar to term infants’ by 36 to 40 weeks’ postmenstrual age. Goniometer measurements of the oral labial angle may reveal oral motor performance in preterm infants and may be relevant for feeding skills assessment in this group of infants.
Improvement in the dynamic responses of the semiempirical vehicle model using the Maxwell force model for the suspension forces
Authors: Na Sang-Do , Yoo Wan-Suk
Published: March 2015

A multi-body vehicle model is more accurate than a lumped-mass model; however, it usually requires a cumbersome process to obtain accurate data for compliant elements such as bushings. To avoid this complex process associated with bushings or kinematic linkages, a semiempirical vehicle model was developed by switching the suspension characteristics to measured kinematic and compliance data. In a semiempirical vehicle model, it is assumed that the inertia effects in the suspension subsystem are ignored by replacing components of the suspension system with massless links. Although this semiempirical vehicle model is simple, it sometimes degrades the accuracy in the dynamic responses compared with those of the multi-body vehicle model. Thus, it is necessary to include the dynamic characteristics of the suspension in an semiempirical vehicle model to increase its accuracy. In this paper, a new technique is proposed that considers the dynamic effect of the suspension system in an semiempirical vehicle model by using the Maxwell force model. By comparing the vertical acceleration with that obtained by the proposed method, the dynamic responses with the semiempirical vehicle model become much closer to those of the multi-body vehicle model. The results show that the force with respect to the suspension’s motion has a strong effect on the dynamic responses, and this relationship becomes important to improve the accuracy of the semiempirical vehicle model.
Loss to follow-up and bias assessment among a cohort of Thai men who have sex with men in Bangkok, Thailand
Authors: Pattanasin Sarika , Wimonsate Wipas , Chonwattana Wannee , Tongtoyai Jaray , Chaikummao Supaporn , Sriporn Anuwat , Sukwicha Wichuda , Mock Philip A , Holtz Timothy H
Published: March 2015

Minimising loss to follow-up is essential to obtain unbiased results. This study aimed to assess factors associated with loss to follow-up and effects on biasing exposure-outcome associations in a cohort of men who have sex with men in Bangkok. We enrolled sexually-active Thai men who have sex with men, at least 18 years old, in a study with four-monthly follow-up visits. At each visit, men answered HIV risk behaviour questions using audio computer-assisted self-interview. Logistic regression was used to evaluate factors associated with loss to follow-up and bias between exposures and prevalent HIV infection were estimated using adjusted relative odds ratios. From 2006 to 2010, we enrolled 1744 men who have sex with men; as of April, 2014, 1256 (72%) had completed at least the month-36 visit; loss to follow-up was 9.6%. Factors independently associated with loss to follow-up were age (18–21 years), education (primary level or less, secondary or vocational education), living outside Bangkok and vicinity, sexual orientation (bisexual, heterosexual), previous HIV testing, HIV infection, and behaviour in the past 4 months (recreational drug use, reporting group sex). An effect of loss to follow-up on factors of prevalent HIV infection was found by sexual orientation (transgender) and unprotected anal intercourse (receptive/insertive). These findings highlight the need to strengthen post-HIV test counselling. Directed counselling for HIV care should be given to young men who have sex with men and recreational drug users.
Coping strategies and behavioural changes following a genital herpes diagnosis among an urban sample of underserved Midwestern women
Authors: Davis Alissa , Roth Alexis , Brand Juanita Ebert , Zimet Gregory D , Van Der Pol Barbara
Published: March 2015

This study focused on understanding the coping strategies and related behavioural changes of women who were recently diagnosed with herpes simplex virus type 2. In particular, we were interested in how coping strategies, condom use, and acyclovir uptake evolve over time. Twenty-eight women screening positive for herpes simplex virus type 2 were recruited through a public health STD clinic and the Indianapolis Community Court. Participants completed three semi-structured interviews with a woman researcher over a six-month period. The interviews focused on coping strategies for dealing with a diagnosis, frequency of condom use, suppressive and episodic acyclovir use, and the utilisation of herpes simplex virus type 2 support groups. Interview data were analysed using content analysis to identify and interpret concepts and themes that emerged from the interviews. Women employed a variety of coping strategies following an herpes simplex virus type 2 diagnosis. Of the women, 32% reported an increase in religious activities, 20% of women reported an increase in substance use, and 56% of women reported engaging in other coping activities. A total of 80% of women reported abstaining from sex immediately following the diagnosis, but 76% of women reported engaging in sex again by the six-month interview. Condom and medication use did not increase and herpes simplex virus type 2 support groups were not utilised by participants. All participants reported engaging in at least one coping mechanism after receiving their diagnosis. A positive diagnosis did not seem to result in increased use of condoms for the majority of participants and the use of acyclovir was low overall.
Young Children Show the Bystander Effect in Helping Situations
Authors: Plötner Maria , Over Harriet , Carpenter Malinda , Tomasello Michael
Published: March 2015

Much research in social psychology has shown that otherwise helpful people often fail to help when bystanders are present. Research in developmental psychology has shown that even very young children help and that the presence of others can actually increase helping in some cases. In the current study, in contrast, 5-year-old children helped an experimenter at very high levels when they were alone but helped significantly less often in the presence of bystanders who were potentially available to help. In another condition designed to elucidate the mechanism underlying the effect, children’s helping was not reduced when bystanders were present but confined behind a barrier and thus unable to help (a condition that has not been run in previous studies with adults). Young children thus show the bystander effect, and it is due not to social referencing or shyness to act in front of others but, rather, to a sense of a diffusion of responsibility.
Pityriasis rosea-like adverse reaction to atenolol
Authors: Güleç Aİ , Albayrak H , Kayapinar O , Albayrak S
Published: March 2015

A 56-year-old female patient was presented with diffuse, bright red to violet colour, scaly patches on trunk and extremities after using a hypertension drug, atenolol. The patient was diagnosed as pityriasis rosea-like adverse reaction to atenolol based on her history, dermatological examination and histopathological findings. To the best of our knowledge, this is the first reported case of pityriasis rosea-like adverse reaction to atenolol that is widely used in hypertension treatment.
Exploration of Conflict Resolution Mechanism based upon the OSCM Model
Authors: Nischal Shivani , Bhalla G. S.
Published: March 2015

No organization is free of conflicts. Nor should they be. Conflicts are an integral part of the functions of the service workers like other organizations because clash of interest is virtually built in the jobs they are expected to perform. So, this research paper actually attempts to explore conflict management mechanism that prevails in public and private sector banking organizations in a comparative form. For this purpose, a total of 20 commercial banks (10 banks each from public and private sectors) have been selected on the basis of highest number of employees’ database from three prosperous regions of Punjab, that is, Amritsar, Jalandhar and Ludhiana. Overall 181 bank managers from the public sector and 184 bank managers from the private sector have been surveyed with the help of pretested structured questionnaire based upon Udai Pareek’s model, that is, Opinion Survey on Conflict Management (OSCM). Results indicated that managers of public and private sector banks both prefer to negotiate first to resolve conflict and are least concerned to follow the withdrawal strategy and defusion strategy to handle conflict in their relative concerns. At last, Independent sample t-test demonstrated statistic significant differences in the opinion of managers employed of these public sector and private sector commercial banks selected under study concerning various conflict management strategies.
Metaphors of Distress
Authors: Kantrowitz-Gordon Ira , Vandermause Roxanne
Published: March 2015

In research on sensitive topics, photo-elicitation can be a profound aid to data collection and interpretation processes. Photo-elicitation methods were used in this manner in a discourse analysis of parents’ distress at least 6 months after preterm birth. After an initial interview, participants were asked to take digital photographs representing their distress and to return for a second interview to discuss the photographs. The elicited photo representations supported participants’ engagement with their current or past distress and generated new meanings from the reappraisal of old photographs. Photo-elicitation demonstrated the embodiment of parents’ distress in the child and the placement of distress in specific locations. Photographs of documents showed the power of the written word in generating and maintaining distress. Participants used existing photographs from their child’s photo history to generate rich metaphors for their distress as parents. These findings have implications for enhancing interpretive health research by incorporating photo-elicitation methods.
Be All that You Can Be
Authors: McDermott Monika L. , Panagopoulos Costas
Published: March 2015

Former military service has long been considered a plus for the résumé of a political candidate, presumably because voters may rely on this information as a shortcut by which to make inferences about the candidates and cast ballots accordingly. Previous research has demonstrated that such heuristics frequently affect vote decisions, but few studies have examined the impact of candidates’ military background on support at the polls; moreover, existing research is largely observational, leaving open crucial questions about causal impact. We build on this work by conducting an original survey experiment imbedded in a national survey in 2008 to test the effects of labeling a candidate an Iraq War veteran. Formulating our hypotheses from known issue and trait stereotypes of the military, we demonstrate that military experience can be helpful to some candidates under some conditions. The experimental evidence we present shows that stereotypes based on both issue position (military intervention) and issue ownership (Republican ties) matter to voters facing a military candidate, but only when that candidate is a Democrat. The results we report support the notion that voters rely on information shortcuts, but we find that there is considerable heterogeneity in the impact of heuristics.
Intergenerational Attachments in Stepfamilies
Authors: Gold Joshua M.
Published: March 2015

This descriptive article addressed attention to current issues and innovative methods by focusing on legitimizing the importance of the step-grandparent relationships in stepfamilies and the offering of a narrative counseling approach to strengthen this stepfamily resource.
“You Think You Know Me, But You Have No Idea”
Authors: Trahan Don P. , Goodrich Kristopher M.
Published: March 2015

This article describes a qualitative project, utilizing grounded theory, to explore the experiences of African American families when one member discloses their identity as lesbian, gay, or bisexual (LGB) or their gender identity as transgender (T). Respondents in this study included the LGBT-identified son or daughter, and a parent, to explore the impact of the disclosure process within African American families in the Southwestern United States. Implications for counseling practice and future research will be explored.
Occupational Outcomes and Return to Running Following Internal Fixation of Ankle Fractures in a High-Demand Population
Authors: Orr Justin D. , Kusnezov Nicholas A. , Waterman Brian R. , Bader Julia O. , Romano David M. , Belmont Philip J.
Published: March 2015

Background:

Literature evaluating surgical outcomes after ankle fixation in an active patient population is limited. This study determined occupational outcomes and return to running following ankle fracture fixation in a military cohort.

Methods:

All service members undergoing ankle fracture fixation at a single military hospital from August 2007 to August 2012 were reviewed. Univariate analysis determined the association between patient demographic information, type of fracture fixation, and the development of posttraumatic ankle arthritis and functional outcomes, including medical separation, return to running, and reoperation. Seventy-two primary ankle fracture fixation procedures were performed on patients with mean age of 29.1 years. The majority of patients were male (88%), were 25 years of age or older (61%), were of junior rank (57%), underwent unimalleolar fracture fixation (78%), and did not require syndesmotic fixation (54%). The average follow-up was 35.9 months.

Results:

The mean time to radiographic union was 8.6 weeks. Twelve service members (17%) were medically separated from the military due to refractory pain following ankle fracture fixation with a minimum of 2-year occupational follow-up. Among military service members undergoing ankle fracture fixation, 64% returned to running. Service members with higher occupational demands had a statistical trend to return to running (odds ratio [OR] 2.49; 95% CI, 0.93-6.68). Junior enlisted rank was a risk factor for medical separation (OR 11.00; 95% CI, 1.34-90.57). Radiographic evidence of posttraumatic ankle osteoarthritis occurred in 8 (11%) service members.

Conclusions:

At mean 3-year follow-up, 83% of service members undergoing ankle fracture fixation remained on active duty or successfully completed their military service, while nearly two-thirds returned to occupationally required daily running.

Level of Evidence:

Level IV, retrospective case series.
A Study of Human Killer Cell Immunoglobulin-Like Receptor and Multidrug Resistance Gene Polymorphisms in Children With Immune Thrombocytopenia
Authors: El-beblawy Nagham Mohamed Samy , Elbarbary Nancy Samir , Kamal Tarek Mostafa , Mahmoud Perehan Mohsen
Published: March 2015

The objective:

This study was undertaken to detect characterization of the different gene polymorphisms in Human killer cell immunoglobulin-like receptor (KIR2) gene and multi-drug resistance (MDR1) gene, among childhood ITP Egyptian patients. In addition to assess the potential role of these polymorphisms in relation to types of ITP and response to different treatment modalities.

Patients and Methods:

A total of 48 pediatric patients with immune thrombocytopenia (ITP; 24 newly diagnosed and 24 chronic) and 35 healthy controls were investigated via polymerase chain reaction-restriction fragment length polymorphism analysis for multidrug resistance (MDR) 1 and killer cell immunoglobulin-like receptor (KIR) 2 genes.

Results:

The frequency of MDR1 gene in patients and control was not significant ( P = .090). The CT genotype was the highest distribution among all ITP cases (62.50%, n = 30) and control (48.60%, n = 17). There was a significant difference in age at diagnosis of MDR1 gene with the CC genotype had the eldest age and lowest initial platelets count ( P = .029 and P = .004). The distribution of KIR2 gene among all patients with ITP and controls was significant ( P = .026) with (KIRDL2−/KIRDS2−) genotype was the most prevalent among patients.

Conclusion:

The frequency of MDR1 polymorphisms was not associated with susceptibility to the development and clinical progression of the disease. However, KIR2 gene polymorphisms were independently associated with childhood ITP in Egyptian patients with highest prevalence among (KIRDL2−/KIRDS2−) genotypes.
Contextualizing the Policy and Pragmatics of Reintegrating Sex Offenders
Authors: Fox Kathryn J.
Published: March 2015

As sanctions for those convicted of sex offenses have increased over recent years, the risk for reoffense presented by social isolation increases. Because most jurisdictions struggle with how best to manage and reintegrate sex offenders, this study analyzes bureaucratic and contextual issues with arranging community-based reintegration programs. Specifically, this qualitative, process-oriented study examines and compares Circles of Support & Accountability (CoSA) programs from the United States (specifically, Vermont) and New Zealand. CoSAs provide support for medium- to high-risk sex offenders as they are released to communities. The programs are compared with regard to their structures, the relationship to Corrections, the role of communities, and core members’ reentry challenges. The implications of each configuration are explored. As most of the existing research on CoSAs is focused on recidivism, and as the U.S. federal government is expanding the use of CoSA, this article fills a void in our understanding of the role that communities can play in reintegrating sexual offenders and how program structures shape reentry.
Roughness evolution in mixed lubrication condition due to mild wear
Authors: Morales-Espejel GE , Brizmer V , Piras E
Published: March 2015

Modelling of surface roughness evolution in time, as a function of the lubrication condition and other operating parameters (i.e. load, sliding/rolling ratio, and initial roughness of both contacting surfaces), is important for the understanding and prediction of various surface damage modes, such as surface distress, wear, and scuffing. Moreover, it is one of the key aspects in understanding friction and running-in phenomena. In the present study, a previously developed model for partial micro-elastohydrodynamic lubrication conditions is combined with a local Archard-type wear model to describe the surface topography evolution during the operation of a rolling/sliding lubricated contact. The model has been compared with a series of experimental results showing similar trends.
Cortical relapses in multiple sclerosis
Authors: Puthenparampil Marco , Poggiali Davide , Causin Francesco , Rolma Giuseppe , Rinaldi Francesca , Perini Paola , Gallo Paolo
Published: March 2015

Background:

Multiple sclerosis (MS) is a white and grey matter disease of the central nervous system (CNS). It is recognized that cortical damage (i.e. focal lesions and atrophy) plays a role in determining the accumulation of physical and cognitive disability that is observed in patients with progressive MS. To date, an association of cortical lesions with clinical relapses has not been described.

Results:

We report clinical and magnetic resonance imaging (MRI) findings of five relapsing–remitting MS (RRMS) patients who had clinical relapses characterized by the acute appearance of cortical symptoms, due to the development of large, snake-like, cortical inflammatory lesions. Symptoms were: acute Wernicke’s aphasia mimicking stroke; agraphia with acalculia, not associated to a motor deficit nor linguistic disturbance; hyposthenia of the left arm, followed by muscle twitching of the hand, spreading to arm and face; acute onset of left lower limb paroxysmal hypertonia; and temporal lobe status epilepticus, with psychotic symptoms.

Conclusions:

Cortical relapses may occur in MS. MRI examination in MS should include sequences, such as double inversion recovery (DIR) or phase sensitive inversion recovery (PSIR), that are aimed at visualizing cortical lesions, especially in the presence of symptoms of cortical dysfunction. Our observation further stresses and extends the clinical relevance of cortical pathology in MS.
The politics of vibrant matter: Consistency, containment and the concrete of Mussolini’s bunker
Authors: Bartolini Nadia
Published: March 2015

This article explores the idea of how vibrancy can be produced. Specifically, the attempt is to investigate the multiplicities of vibrancy by considering one of Mussolini’s bunkers. The author examines the location of the bunker in the EUR ( Esposizione Universale Romana) neighbourhood in Rome, the bunker’s materiality, and the context and social meaning of the bunker through a contemporary art exhibition called ‘Confronti’ (Confrontations) that took place in the bunker in 2009. The article argues that while emphasizing matter’s inherent vibrancy may be useful in some cases, there is also merit in further unpacking the ways in which vibrancy is produced. In this example, the concrete bunker expresses vibrancy through the processes involved in the emergent material form, and in the sustained politics and social considerations embedded in valuing tangible urban heritage.
Seeking rape justice: Formal and informal responses to sexual violence through technosocial counter-publics
Authors: Powell Anastasia
Published: March 2015

Communications technologies are being used in varying ways to perpetrate and extend the harm of sexual violence and harassment against women and girls. Yet little scholarship has explored the uses of communications technologies, to support reporting, investigation and prosecution of sexual assault, nor indeed less formal mechanisms of justice. In this article, I contend that communications technologies are not simply new tools for conventional formal justice, but rather that these technologies are mediating new mechanisms of informal justice outside of the state, in turn challenging meanings of justice in western liberal democracies. In so doing I employ concepts of technosocial practices operating in counter-public online spaces, to explore the potential (and limits) of communications technologies as mediators of rape justice.
An analytical model (7 D.O.F.) for the prediction of the vibration response of cylindrical roller element bearings due to a combined localized defect
Authors: Patel Utkarsh A , Upadhyay Sanjay H
Published: March 2015

This paper presents a mathematical model to investigate a nonlinear vibration behavior of a rotor-bearing system due to combined localized defect of inner race and outer race. Here shaft-rotor bearing system is modeled as a seven degree of freedom. In the mathematical formulation, contacts between rolling elements and inner and outer races are considered as nonlinear springs as well as hysteretic damping is also taken into consideration. The governing equations of motion are formulated using energy approach. Contact force calculation having nonlinearity are solved by using Newton–Raphson method for n-unknown nonlinear simultaneous equations. Equations of motions are solved by implicit type numerical integration method by Newmark integration algorithm. A computer code is developed to simulate the results in the form of time domain and frequency domain. Results are obtained in the form of time domain and frequency domain. The analytical results are also compared with the experimental results.
Energy, exergy and economic analysis of a Diesel engine fueled with castor oil biodiesel
Authors: Meisami Farshad , Ajam Hossein
Published: March 2015

Biodiesel is a renewable, clean-burning Diesel replacement. Biodiesel is made from vegetable oils or animal fats. It can be used as a fuel for vehicles in its pure form, but it is usually used as a Diesel additive to reduce exhaust emissions. Numerous studies have been performed on effects of various biodiesels on engine performance and emissions; however, in those studies, less attention has been paid to the availability (exergy) of engine processes. In this investigation, various biodiesel blends have been tested experimentally on a four-cylinder turbocharged Diesel engine. Engine energy, exergy and economic analysis have been performed using the experimental data. The results showed that the structural oxygen content of biodiesel improves the combustion efficiency. However, the engine’s thermal efficiency decreases due to the lower heating value of the biodiesel. Also, destruction of exergy increases when using biodiesel. Among various biodiesel blends, the 15% biodiesel–Diesel blend shows an optimum condition. In this case, the engine power slightly decreases, and both the thermal efficiency and the exergetic efficiency increase. Also, the highest combustion efficiency was observed. The results of emissions economic analysis showed that all biodiesel blends were more affordable than Diesel fuel. The results of full economic analysis (emissions, fuel cost, fuel consumption and engine power loss) showed that only the 5% biodiesel–Diesel blend was more affordable compared to Diesel.
External evaluation of education and teacher work: The Brazilian case
Authors: Rothen José Carlos , da Cunha Malheiros Santana Andréia
Published: March 2015

This article aims to discuss whether external evaluations are instruments to ensure increased quality of public school education. It is part of a research that investigated how evaluation results and the resulting indices were used in two schools in the state of São Paulo (Brazil). The methodology adopted was the case study, using different methodological tools such as interviews (intended for school coordinators and supervisors), questionnaires (intended for teachers and school directors) and observation of pedagogical meeting schedules. The collected data were analyzed and contextualized from studies by authors such as Afonso (2009), Dale and Robertson (2006), Le Grand (1991) and Neave (1988), among others, who investigated the commodification of education and external evaluations. In conclusion, we noticed that the mere existence of an external evaluation, accompanied by an index, is not sufficient to ensure improved quality of education, as this is done with the participation of parents, a good initial teacher training and investment in their continued training and higher social investments in the communities. External evaluations, contrary to what they promise, have on many occasions enabled increased regulation, ranking and competition, but have decreased the autonomy of schools thereby, reinforcing school inequality.
Effects of Quantitative Linguistic Feedback to Caregivers of Young Children
Authors: Zhang Yiwen , Xu Xiaojuan , Jiang Fan , Gilkerson Jill , Xu Dongxin , Richards Jeffrey A. , Harnsberger James , Topping Keith J.
Published: March 2015

Changes in natural language environments of families receiving quantitative language feedback in Shanghai were investigated. Volunteer parents of 22 children aged 5 to 30 months were recruited from a hospital and a learning center. Quantitative measures of adult word count and conversational turns with children were collected regularly over 6 months. Feedback reports to caregivers included individual family plus group counts. Impact was assessed by changes in quantitative measures and pre–post child language assessments. Overall, families increased word/turn counts significantly during the first 3 months and then regressed to baseline levels. However, parents whose word count output was below median at baseline significantly increased word count output to study conclusion. Adult word and turn counts were related to a subset of language development measures. Quantitative feedback with parent training had a significant impact on adult–child interactions, particularly for below-median families. Larger studies of wider socioeconomic status with control groups are needed.
Carotid Stenting versus Carotid Surgery: A Prospective Cohort Study
Authors: Becquemin Jean-Pierre , Kadi Hassen Ben El , Desgranges Pascal , Kobeiter Hicham
Published: March 2015

Purpose:

To compare the results of carotid stenting and carotid surgery in a consecutive group of 455 patients (482 lesions).

Methods:

Between January 1995 and July 2002, 107 patients (114 lesions) were treated with carotid stenting and 348 patients (368 lesions) with carotid surgery. A cerebral protection device was routinely used in the last 46 stent cases. All patients were followed with duplex examination at 1 and 6 months postoperatively and yearly thereafter.

Results:

The stent and surgery groups were similar in terms of mean age (70.5 and 71.1 years, respectively), sex distribution (men 72% versus 75%), and symptoms (transient ischemic attack [TIA] or minor stroke 32.7% versus 42.2%). Median follow-up was 15 months in stent patients and 14 months in the surgical group. At 1 month postoperatively, there were 7 minor strokes (5 temporary lasting <21 days and 2 persistent) and 1 major stroke in the stent group versus 1 persistent minor stroke in the surgical patients. The overall neurological event rate (including TIA) was 10.5% versus 1.9% (p = 0.0002) in the surgical patients; cardiac morbidity was 3.5% versus 1.6% (p = NS), and the death rate was 0% versus 0.8% (p = NS). The combined permanent stroke/death rate was 2.6% in stent patients and 1.1% in surgery patients (p = NS). During follow-up, the cumulative all stroke rate was 8.8% versus 1.9% (p = 0.001), but the 3-year cumulative survival rate free from ipsilateral major neurological events was 95.2% in stent patients and 96.9% in the surgery cohort (p = NS). There was a 7.5% rate of restenosis in stented arteries versus 1.4% in surgery patients (p = 0.001).

Conclusions:

This series showed encouraging and comparable major stroke and deaths rate of carotid stenting and carotid surgery. However, there was more restenosis in the stented group on midterm follow-up.
Complications after Endovascular Treatment of Thoracic Aortic Aneurysms
Authors: Scharrer-Pamler Reinhard , Kotsis Thomas , Kapfer Xaver , Görich Johannes , Orend Karl-Heinz , Sunder-Plassmann Ludger
Published: March 2015

Purpose:

To retrospectively determine the value of stent-graft repair of descending thoracic aortic aneurysms by analyzing the results and complications.

Methods:

From May 1997 to July 2002, 45 patients (33 men; mean age 69 years, range 31–88) received endovascular treatment for thoracic aortic aneurysms. In 11 patients, emergency treatment was necessary for a contained rupture. The medical records of these patients were reviewed to gather data on the procedures, immediate results, complications, mortality, and survival in follow-up.

Results:

In all cases, the stent-grafts were successfully implanted. In 15 (33%) cases, the subclavian artery was covered by the stent-graft without complications. There was no paraparesis/paraplegia; 2 (4.4%) patients suffered a stroke intraoperatively. The in-hospital mortality was 2.2% (n = 1); 3 (6.7%) patients died within 30 days. Primary endoleaks occurred in 8 (17.8%) cases. Procedural success (technical success without endoleak or death) was 80% (93.3% after primary endoleak repair). During follow-up, 2 (4.4%) secondary endoleaks developed. All endoleaks were treated successfully or sealed spontaneously (n = 2). At a mean 24-month follow-up (range 1–62), 84% of patients were alive.

Conclusions:

The endovascular treatment of thoracic aortic aneurysms appears to be safe and effective, with lower morbidity and mortality than in conventional open operations. For these reasons, endovascular treatment should be administered whenever possible.
Emergency Endovascular Treatment of Traumatic Aortic Arch Rupture with Multiple Arch Vessel Involvement
Authors: Waldenberger Peter , Fraedrich Gustav , Mallouhi Ammar , Jaschke Werner R. , Perkmann Reinhold , Jung Tarzis , Czermak Benedikt V.
Published: March 2015

Purpose:

To report successful endovascular stent-graft placement for emergency treatment of a complex traumatic injury involving the aortic arch and multiple arch vessels.

Case Report:

An 81-year-old man underwent stent-graft placement for a complex traumatic vascular injury. Computed tomography on admission documented a dissection along the course of the aortic arch, intramural hematoma along the ascending aorta, dissection of the innominate artery, and a right subclavian artery pseudoaneurysm. The dissection of the aortic arch and the pseudoaneurysm of the right subclavian artery were treated immediately, the dissection of the innominate artery 7 days later. The patient did not develop any complications. Follow-up studies performed prior to discharge and at 6 and 12 months after the interventions showed successful repair of the complex vascular injuries.

Conclusions:

Traumatic injury of the aortic arch with multiple arch vessel involvement can be treated effectively by means of stent-graft placement.
Transseptal Stent Treatment of Anastomotic Stricture after Repair of Partial Anomalous Pulmonary Venous Return
Authors: Dieter Robert S. , Nelson Brian , Wolff Mathew R. , Thornton Frank , Grist Thomas M. , Cohen Daniel M.
Published: March 2015

Purpose:

To report the endovascular treatment of a stenosis of the pulmonary venous anastomosis following surgical treatment for partial anomalous pulmonary venous return.

Case Report:

A 60-year-old man presented with recurrent pleural effusions after correction of a partial anomalous left pulmonary venous return. Magnetic resonance imaging demonstrated focal stenosis at the anastomosis of the anomalous pulmonary vein to the left atrial appendage. Using a transseptal approach, the pulmonary vein stenosis was accessed and successfully stented. The patient's symptoms improved, and follow-up imaging demonstrated a patent stent without residual pressure gradient.

Conclusions:

Endovascular repair of a stenosis at the anastomosis of an anomalous pulmonary vein is possible and should be considered as a treatment option for this lesion.
Hypotension and Bradycardia after Elective Carotid Stenting: Frequency and Risk Factors
Authors: Mlekusch Wolfgang , Schillinger Martin , Sabeti Schila , Nachtmann Tassilo , Lang Wilfried , Ahmadi Ramazanali , Minar Erich
Published: March 2015

Purpose:

To investigate the frequency of and risk factors for hypotension and bradycardia in response to elective carotid stenting and their association with neurological complications.

Methods:

A retrospective analysis was conducted of 471 patients (321 men; median age 72 years, interquartile range 64–77) who underwent elective carotid artery stenting without cerebral protection for high-grade (>70%) symptomatic (n = 147) or asymptomatic (n=324) internal carotid artery stenosis at a single center. Frequency and potential risk factors for severe hypotension (systolic blood pressure <80 mmHg) or bradycardia (heart rate <50 bpm) were studied.

Results:

Thirty-four (7%) patients had severe hypotension (n=23), bradycardia (n=2), or both (n=9) despite routine premedication with atropine and adequate fluid balance. Intravenous catecholamines (dopamine) were necessary in 8 patients with prolonged hypotension; none of the patients with bradycardia needed pacemaker support. Neurological complications (transient ischemic attack, minor stroke, major stroke, death) occurring in 33 (7%) patients were not significantly associated with hemodynamic instability (4/34 [12%] versus 29/437 [7%], p = 0.26). Age >77 years (fourth quartile; OR 6.40, 95% CI 1.80 to 22.78, p=0.004) and coronary artery disease (OR 2.81, 95% CI 1.29 to 6.14, p=0.010) were associated with an increased adjusted risk for hypotension or bradycardia.

Conclusions:

Hemodynamic instability due to hypotension and bradycardia in response to carotid artery stenting occurs in a relatively low proportion of patients. Elderly patients and those with coronary artery disease are at highest risk. Although the rate of neurological complications was not significantly increased in patients with hemodynamic instability, the higher frequencies of neurological complications in these patients admonish us to be careful.
Carotid Artery Dynamics during Head Movements: A Reason for Concern with Regard to Carotid Stenting?
Authors: Vos A.W. Floris , Linsen Matteus A.M. , Marcus J. Tim , van den Berg Jos C. , Vos Jan Albert , Rauwerda Jan A. , Wisselink Willem
Published: March 2015

Purpose:

To evaluate carotid artery mobility patterns during head movements following carotid angioplasty/stenting (CAS).

Methods:

In 7 patients (all men; mean age 69 years, range 65–76) who had undergone unilateral CAS, 3D time-of-flight magnetic resonance angiography was performed, visualizing both carotid arteries in 5 different head positions (neutral, turned left and right, and bent forward and backward). Maximum intensity projection reconstructions were obtained to measure angulation at the proximal and distal stent junction. Configuration changes of the stented section of the carotid artery and the unstented contralateral artery were judged. Secondly, transverse sections at the level of the carotid bifurcation and at the skull base were used to calculate torsion shear in the common and internal carotid arteries (CCA, ICA) during turned left and right head position. Results were expressed as median (range).

Results:

In neutral head position, maximal angulation at the distal stent junction was 34.3° (32.3°–55.6°). With the head bent forward, this angulation changed to 47.6° (42.6°–85.2°, p=0.028) and when bent backward to 26.5° (25.0°–48.7°, p=0.027). In all patients, configuration changes of the stented sections were absent. The contralateral unstented side showed diffuse configuration changes without specific angulation at one location. With the head turned left and right, the CCA on the stented side was subjected to 28.6° (13.6°–53.7°) and 24.9° (2.0°–50.6°) of torsion shear, respectively. Torsion of the ICA was subsequently 18.1° (12.7°–40.5°) and 15.2° (2.9°–69.4°).

Conclusions:

Following carotid stenting, sharp ICA angulations that are aggravated by forward bending of the head occur at the distal stent junction. The stented section of the carotid artery shows complete lack of flexibility despite highly flexible features of the stents ex vivo. Both the CCA and ICA are subjected to considerable torsion shear with the head turned left and right. This shear is not accommodated by the current stent designs.
New Post-Imaging Software Provides Fast and Accurate Volume Data from CTA Surveillance after Endovascular Aneurysm Repair
Authors: Yeung Kay K. , van der Laan Maarten J. , Wever Jan J. , van Waes Paul F.G.M. , Blankensteijn Jan D.
Published: March 2015

Purpose:

To quantify intra- and interobserver variabilities when measuring total aneurysm volume after endovascular aneurysm repair using the Vitrea 2 System and to compare it in terms of accuracy and processing time with the gold standard methods using the Easy Vision workstation.

Methods:

Total aneurysm volumes from 30 postendograft CTA datasets were randomly selected from a database consisting of ∼400 CTA datasets recorded in 89 patients. The intra- and interobserver variabilities were measured on the Vitrea workstation by 2 investigators. The intermodality variability was calculated for the same measurements using the Easy Vision workstation. The differences of each pair of measurements were plotted against their mean, and the repeatability coefficient (RC) was calculated. The mean differences were also expressed as a percentage of the first measurements.

Results:

The intraobserver mean difference was 1.6 mL (1.4%) with an RC of 10.8 mL (10.1%) and the interobserver mean difference was −1.4 mL (–1.4%) with an RC of 11.7 mL (10.2%). The intermodality mean difference was 1.8 mL (2.0%) with an RC of 15.8 mL (11.1%). The Vitrea workstation required a median of 8 minutes (interquartile range 7–10) for 1 observer and 6 minutes (interquartile range 5–8) for the other to perform a complete volume segmentation of each patient dataset compared to an estimated average of 30 minutes using the Easy Vision workstation.

Conclusions:

The Vitrea workstation provides fast and accurate volume data from spiral CTA follow-up of endovascular aneurysm repair. This software may enhance the acceptability of volume surveillance in daily practice.