bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Differences in Early Cardiovascular and All-Cause Hospitalization Outcomes After Surviving Firearm Injury
Authors: Zuo Yi , Pino Elizabeth C , Vyliparambil Mrithyunjay , Kalesan Bindu
Published: March 2018

The majority of the burden of firearm injury in the United States is on men as compared to women. There is limited evidence regarding sex differences in short-term hospitalization outcomes after surviving firearm injury. The risk of cardiovascular and all-cause hospital readmission, length of stay (LOS), and costs within 180 days after surviving an index firearm injury was compared between males and females. A claims-based, retrospective, cohort study was performed using Nationwide Readmission Database (2013–2014) to obtain a cohort of patients who survived an index hospitalization of firearm injury. The analysis was performed in August 2017. Cox proportional hazard regression models were used to estimate hazard ratio (HR) and 95% confidence intervals (95% CIs). Among 17,594 males and 2,289 females discharged alive after index firearm injury hospitalization, 14.4% and 13.2% were readmitted within 180 days. Within 180 days, the risk of cardiovascular readmission was 3.3 times greater among males versus females (HR = 3.34, 95% CI [1.18, 9.44]. Risk of all-cause readmission among males was greater at 90 days (HR = 1.40, 95% CI [1.04, 1.87]. Patients surviving a firearm injury have a substantial risk of subsequent hospitalizations. Cardiovascular readmissions are greater among males than females during the first 6 months after injury and may be indicative of a continuing long-term risk of health and patient outcomes that contributes to the overall burden of firearm injury.
Reflections and Review on the Audit Procedure
Authors: de Kleijn Renske , Van Leeuwen Anouschka
Published: March 2018

Arguably, quality assurance is more complicated in qualitative studies than in quantitative studies. Several procedures for quality assurance are available, among which the audit procedure as proposed by Akkerman, Admiraal, Brekelmans, and Oost. In this article, we reflect on this procedure based on our own experiences as well as based on a review of studies in which the audit procedure was employed. More specifically, we discuss (1) the choice for an auditor and the relationship between auditee and auditor and (2) the function of the audit. We propose that future auditees (a) explicitly report on the auditee–auditor relationship, (b) explicitly report on the function of their audit, and (c) have their audit trail documents available for review. With this methodological position paper, we aim to contribute to the current call to make social science studies and their conclusions more transparent and thereby to enhance the quality of qualitative studies.
Model-mediated teleoperation with improved stability
Authors: Song Jingzhou , Ding Yukun , Shang Zhihao , Liang Ji
Published: March 2018

Model-mediated teleoperation has been developed to improve both transparency and stability in teleoperation. It uses local model of remote environment to provide non-delayed force feedback rather than using delayed force signals from slave side and thus is robust to arbitrary time delay. However, updating parameters in the local model may cause sudden force change during the operation. Meanwhile, the undesirable deep penetration or overlarge contact force may occur on the slave side due to the modeling error. Both of them will jeopardize the system stability. In this article, we propose a novel force-based model updating algorithm, which restrains the abrupt force caused by parameter updating. The update efficiency has been greatly improved by comparing with the existing solution; meanwhile, it ensures a stable human–machine interaction at the same time. Then, a new adaptive impedance controller that restricts both overlarge force and penetration is introduced. The obtained results on a one-degree of freedom contact experiment with a delay of 5 s demonstrate the superiority of proposed approaches in comparison with state-of-the-art methods.
A recursive Bayesian approach to small fatigue crack propagation and detection modeling
Authors: Smith Reuel , Modarres Mohammad , Droguett Enrique López
Published: March 2018

Engineers have witnessed much advancement in the study of fatigue crack detection and propagation modeling. More recently, the use of certain damage precursors such as acoustic emission signals to assess the integrity of structures has been proposed for application to prognosis and health management of structures. However, due to uncertainties associated with small crack detection of damage precursors and crack size measurement errors of the detection technology used, applications of prognosis and health management assessments have been limited. In this article, a methodology is developed for the purpose of assessment of crack detection and propagation parameters and the minimization of uncertainties including detection and sizing errors associated with a series of known crack detection and propagation models that use acoustic emission as the precursor to fatigue cracking. The methodology is facilitated by the Bayesian inference of a joint-likelihood model which includes sizing and detection models. Examples where several dog-bone Al 7075T6 specimens are tested to produce fatigue crack initiation and propagation data and estimates based on remaining useful life support the effectiveness and usefulness of the proposed methodology.
Complex regional pain syndrome acute care pathways in England: Do they exist and what do they look like?
Authors: Gillespie Sharon , Cowell Fiona , McCabe Candy , Goebel Andreas
Published: March 2018

Introduction

Complex Regional Pain Syndrome is a condition with a high degree of morbidity and health costs to the National Health Service (NHS), characterised by persistent pain, sensory, motor, trophic and autonomic signs and symptoms. The British Orthopaedic Association (BOA) and the Royal College of Physicians (RCP) have recommended treatment guidelines and care pathways for the management of acute Complex Regional Pain Syndrome. The objective of this scoping exercise was to use Freedom of Information (FOI) requests to ascertain whether NHS Trusts in England had such pathways and what they looked like.

Methods

FOI requests were sent to 126 English NHS Trusts on 9 March 2017 on behalf of the Complex Regional Pain Syndrome Clinical and Research Network UK, asking: “What does your acute Complex Regional Pain Care Syndrome pathway look like?”

Results

Replies were received by 95 NHS Trusts and of these 84 had relevant services but (82%) had no pathway or agreed initial management.

Conclusions

It appears to be common for no acute care pathway to exist for CRPS in NHS Trusts in England despite it being a domain in BOA national guidelines. The Royal College of Physicians guidelines also recommend integrated MDT care. Consequentially, BOA and Royal College of Physicians standards in acute CRPS management are not yet being followed in most acute NHS Trusts in England providing trauma care. Where there is a pathway agreed, it is rarely integrated and truly multidisciplinary.
Accuracy Beyond ISO: Introducing a New Method for Distinguishing Differences Between Blood Glucose Monitoring Systems Meeting ISO 15197:2013 Accuracy Requirements
Authors: Pardo Scott , Shaginian Rimma M. , Simmons David A.
Published: March 2018

Background:

Diabetes treatment is intended to maintain near-normal glycemic levels. Self-monitoring of blood glucose (SMBG) allows patients to track their BG levels compared with glycemic targets and is associated with improved health outcomes. Because of the importance of SMBG, it is essential that results are accurate to prevent errors in nutritional intake and drug dosing. This study presents a new methodology to evaluate the accuracy of BG monitoring systems (BGMSs).

Methods:

Sensitivity analyses were performed using real and simulated BGMS data to compute probabilities that, for any BG value, the BGMS result would be within prescribed error bounds and confidence limits compared with laboratory reference values. Multiple BG value ranges were used.

Results:

Probability curves were created using data from 3 simulated BGMSs and anonymized data from 3 real-world BGMSs. Accuracy probability curves from capillary fingertip blood samples (actual clinical data) showed that all 3 real-world BGMSs met EN ISO 15197:2015 accuracy criteria, since 99.63%, 99.63%, and 99.81% of results from the 3 BGMSs were within ±15 mg/dL or ±15% of reference for BG <100 mg/dL and ≥100 mg/dL, respectively. However, there was identifiable variability between BGMSs if BG was <70 mg/dL; one BGMS showed further reductions in accuracy if BG was <50 mg/dL.

Conclusions:

Probability curves highlight the importance of BGMS accuracy to help achieve optimal glycemic control while avoiding hypoglycemia or hyperglycemia. This may be especially significant in very low BG ranges where small errors in BGMS measurements can have substantial impacts on patient-related outcomes, including hypoglycemia risk.
Further Evidence of Severe Allergic Contact Dermatitis From Isobornyl Acrylate While Using a Continuous Glucose Monitoring System
Authors: Kamann Stefanie , Aerts Olivier , Heinemann Lutz
Published: March 2018

In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA). Subsequently they showed by means of gas chromatography-mass spectrometry that this substance is present in the case of the glucose sensor attached by an adhesive to the skin. We report three additional cases from Germany, including a 10-year-old boy, suffering from severe allergic contact dermatitis to IBOA.
The Promise and Perils of Wearable Physiological Sensors for Diabetes Management
Authors: Schwartz Frank L. , Marling Cynthia R. , Bunescu Razvan C.
Published: March 2018

Development of truly useful wearable physiologic monitoring devices for use in diabetes management is still in its infancy. From wearable activity monitors such as fitness trackers and smart watches to contact lenses measuring glucose levels in tears, we are just at the threshold of their coming use in medicine. Ultimately, such devices could help to improve the performance of sense-and-respond insulin pumps, illuminate the impact of physical activity on blood glucose levels, and improve patient safety. This is a summary of our experience attempting to use such devices to enhance continuous glucose monitoring–augmented insulin pump therapy. We discuss the current status and present difficulties with available devices, and review the potential for future use.
Effectiveness of Valgus Offloading Knee Braces in the Treatment of Medial Compartment Knee Osteoarthritis: A Systematic Review
Authors: Gohal Chetan , Shanmugaraj Ajaykumar , Tate Patrick , Horner Nolan S. , Bedi Asheesh , Adili Anthony , Khan Moin
Published: March 2018

Context:

Knee osteoarthritis affects 9.3 million adults over age 45 years in the United States. There is significant disability associated with this condition. Given the potential complications and the significant cost to the health care system with the dramatic increase in total knee arthroplasties performed for this condition, assessment of the efficacy of nonoperative modalities, such as offloading knee braces, is essential as part of optimizing nonoperative treatment for this condition.

Objective:

To determine the effectiveness of valgus offloader braces in improving clinical outcomes for patients with medial compartment knee osteoarthritis.

Data Sources:

Three databases (PubMed, MEDLINE, and EMBASE) were searched from database inception through July 28, 2017.

Study Selection:

Studies reporting outcomes of valgus offloader knee braces in the treatment of medial compartment knee osteoarthritis were included.

Study Design:

Systematic review.

Level of Evidence:

Level 4.

Data Extraction:

Data pertaining to demographics, descriptive statistics, and clinical outcomes were extracted from the included studies. The methodological quality of included studies was evaluated.

Results:

A total of 31 studies were included, with a total of 619 patients. The majority of studies reported improved pain outcomes using valgus offloader braces. However, variable results were reported as to whether valgus offloader braces significantly improved functional outcomes and stiffness. Offloader bracing was more effective at reducing pain when compared with neutral braces or neoprene sleeves.

Conclusion:

Valgus offloader bracing is an effective treatment for improving pain secondary to medial compartment knee osteoarthritis. The literature remains unclear on the effectiveness of valgus offloader braces with regard to functional outcomes and stiffness. Larger prospective randomized trials with consistent outcome assessment tools and consideration of patient compliance would be beneficial to more accurately determine treatment effects of valgus offloader bracing.
Guideline-adherence regarding critical time intervals in the German Chest Pain Unit registry
Authors: Vafaie Mehrshad , Hochadel Matthias , Münzel Thomas , Hailer Birgit , Schumacher Burghard , Heusch Gerd , Voigtländer Thomas , Mudra Harald , Haude Michael , Barth Sebastian , Schmitt Claus , Darius Harald , Maier Lars S , Katus Hugo A , Senges Jochen , Giannitsis Evangelos
Published: March 2018

Background:

Since 2008, the German Cardiac Society certified 256 Chest Pain Units (CPUs). Little is known about adherence to recommended performance measures in patients with suspected acute coronary syndrome (ACS) presenting to CPUs. We investigated guideline-adherence regarding critical time intervals and selected performance measures in German Chest Pain Units.

Methods:

From 2008 to 2014, 23,804 consecutive patients with suspected ACS were prospectively enrolled in the Chest Pain Unit registry of the German Cardiac Society.

Results:

Median time from symptom onset to first medical contact was 2 h in patients with ST-elevation myocardial infarction (STEMI) and 4 h in patients with unstable angina and non-STEMI (NSTEMI). In patients with STEMI, median time from hospital admission to percutaneous coronary intervention (PCI) was 40 min and median time from first medical contact to PCI was 1 h 35 min. Primary PCI was performed in 94.7% of patients with STEMI, 70.0% of patients with NSTEMI and 37.4% of patients with unstable angina. PCI was performed during the first 24 h in 79.5% of patients with NSTEMI and the first 72 h in 89.0% of patients with unstable angina. Electrocardiograms were performed in 99.5% after a median of 6 min after admission and obtained within 10 min in 71%. Interestingly, 56.1% of patients were found to have non-ACS diagnoses, underlining the importance of access to additional diagnostic modalities including echocardiography, stress testing or computed tomography.

Conclusions:

Guideline-adherence regarding critical time intervals and primary PCI rates is good in German Chest Pain Units. More than half of patients admitted with suspected ACS had non-ACS diagnoses. Improvements in pre-hospital time delays through public awareness programmes are warranted.
On the measurement of conspiracy beliefs
Authors: Enders Adam M. , Smallpage Steven M.
Published: March 2018

Are so-called “birthers” best thought of as true conspiracy theorists, or are they merely partisans expressing a sharp dislike of Barack Obama? Recent work on conspiracy beliefs finds that “birthers” are the product of partisan and ideological motivated reasoning. In this manuscript, we explore how the measurement strategies we employ on public opinion surveys may influence the substantive conclusions we draw about conspiratorial beliefs, rumors, and misinformation. We find that partisan stimuli influence reported beliefs in several different conspiracy theories, and, subsequently, the relationships between individual stated beliefs in those conspiracy theories. The implications of these findings are discussed.
Doing data differently? Developing personal data tactics and strategies amongst young mobile media users
Authors: Selwyn Neil , Pangrazio Luci
Published: March 2018

Large amounts of personal data are generated through young people’s engagements with mobile media, with these data increasingly (re)used by advertisers, content developers and other third parties to profile, predict and position individuals. This has prompted growing concerns over the ability of mobile media users to develop informed stances towards how and why their data is being used, i.e. to build ‘conscious’ and/or ‘resistant’ forms of ‘data agency’. This paper explores ways of developing the critical consciousness and resistant practices of young mobile media users towards personal data. Drawing on research with 27 young people (aged 13–17 years), the paper describes efforts to make representations of third party use of personal data openly available as a basis from which to develop data-savvy tactics and strategies. The results of these interventions – while only partially successful – offer valuable insights into the technical, social and cultural issues that shape young people’s engagement with personal data. The paper concludes by considering how concerns over data agency might be better aligned with the realities of young people’s mobile media use.
Studying Celebrity Practices on Twitter Using a Framework for Measuring Media Richness
Authors: Tanupabrungsun Sikana , Hemsley Jeff
Published: March 2018

Social media enables the performative actions needed for celebrities to build and maintain audiences. Platforms like Twitter mediate identity construction and interaction with fans while enabling environments that are co-constructed by celebrities, fans, and the platform itself. We use the theoretical lens of media richness to study the ways that different types of celebrities enact “micro-celebrity” by mapping three richness dimensions (contextual, interactional, and informational) into groupings of Twitter’s affordances. Utilizing crowdsourcing and regression analysis, we systematically weigh each affordance and generate richness scores for each dimension, for each tweet. Using these richness scores, we find that performance of different types of celebrity requires different affordance mixtures, and that these mixtures reflect differences in the environments within which celebrities operate. Our research contributes to work at the intersection of Twitter affordances and celebrity studies in new media, and provides a framework for generating richness scores.
Scorpion Venom Causes Apoptosis by Increasing Reactive Oxygen Species and Cell Cycle Arrest in MDA-MB-231 and HCT-8 Cancer Cell Lines
Authors: Al-Asmari Abdulrahman Khazim , Riyasdeen Anvarbatcha , Islam Mozaffarul
Published: March 2018

Objectives.

The objective of this study was to examine the effect of scorpion venoms on cancer cell progression, apoptosis, and cell cycle arrest. Scorpion venoms are known to possess numerous bioactive compounds that act against cancer progression by inducing apoptosis. In this study, we have taken the venoms from the following 2 species of scorpion— Androctonus crassicauda and Leiurus quinquestriatus—and tested the anticancer properties of the venom against breast and colorectal cancer cell lines.

Methods.

Milking of scorpion venom and culturing the breast and colorectal cancer cell lines were done according to the standard procedure. The venom cytotoxicity was assessed by MTT methods, and the cellular and nuclear changes were studied with phase contrast and propidium iodide staining, respectively. The cell cycle arrest and accumulation of reactive oxygen species were analyzed on a Muse cell analyzer.

Results.

The venoms exerted cytotoxic effects on breast and colorectal cell lines in a dose- and time-dependent manner. Enhanced apoptotic cells, increase in reactive oxygen species, and cell cycle arrest were observed after challenging these cell lines with scorpion venoms.

Conclusions.

Scorpion venom induces apoptosis in breast and colorectal cell lines as reflected by the changes in the cell morphology and cell cycle studies. Furthermore, a high percentage of total reactive oxygen species as well as apoptotic cells also contribute to cell death as observed after venom treatments. To the best of authors’ knowledge, this is the first scientific evidence demonstrating the induction of apoptosis and cell cycle arrest by these species of scorpion venoms.
The Distinction of Hot Herbal Compress, Hot Compress, and Topical Diclofenac as Myofascial Pain Syndrome Treatment
Authors: Boonruab Jurairat , Nimpitakpong Netraya , Damjuti Watchara
Published: March 2018

This randomized controlled trial aimed to investigate the distinctness after treatment among hot herbal compress, hot compress, and topical diclofenac. The registrants were equally divided into groups and received the different treatments including hot herbal compress, hot compress, and topical diclofenac group, which served as the control group. After treatment courses, Visual Analog Scale and 36-Item Short Form Health survey were, respectively, used to establish the level of pain intensity and quality of life. In addition, cervical range of motion and pressure pain threshold were also examined to identify the motional effects. All treatments showed significantly decreased level of pain intensity and increased cervical range of motion, while the intervention groups exhibited extraordinary capability compared with the topical diclofenac group in pressure pain threshold and quality of life. In summary, hot herbal compress holds promise to be an efficacious treatment parallel to hot compress and topical diclofenac.
Borrowing Benefits: Group Treatment With Clinical Emotional Freedom Techniques Is Associated With Simultaneous Reductions in Posttraumatic Stress Disorder, Anxiety, and Depression Symptoms
Authors: Church Dawson , House Dennis
Published: March 2018

Clinical Emotional Freedom Techniques (EFT) is an evidence-based treatment for depression and anxiety. The current study sought to elucidate the relationship between posttraumatic stress disorder (PTSD), depression, and anxiety in a nonclinical population. The sample (N = 81) comprised participants at five 2-day EFT workshops. All groups used an EFT protocol called Borrowing Benefits, in which the group facilitator works with a single client while other participants self-apply EFT. Participants were assessed on 9 specific conditions as well as on the breadth (Positive Symptom Total [PST]) and depth (General Symptom Index [GSI]) of psychological distress. Physical pain and addictive cravings were also assessed. Significant reductions were observed in all measures (P < .03). Associations between PST, GSI, and PTSD were significant (P < .026). Participants maintained all gains at 6-month follow-up (P < .02) with the exception of the Hostility subscale, while Cohen’s d = 0.54 indicated a moderate treatment effect for PTSD. The relationship between psychological and physiological conditions identified in this study is consistent with that found in other studies. Group treatment is cost-effective and efficient, and the efficacy of EFT in groups indicates the utility of the Borrowing Benefits technique.
Protective Effect of Kolaviron on Cyclophosphamide-Induced Cardiac Toxicity in Rats
Authors: Omole Joseph Gbenga , Ayoka Oladele Abiodun , Alabi Quadri Kunle , Adefisayo Modinat Adebukola , Asafa Muritala Abiola , Olubunmi Babalola Olusegun , Fadeyi Benson Akinloye
Published: March 2018

Background.

Cyclophosphamide (CP) is a nitrogen mustard alkylating drug used for the treatment of chronic and acute malignant lymphomas, myeloma, leukemia, neuroblastoma, adenocarcinoma, retinoblastoma, breast carcinoma, and immunosuppressive therapy. Despite its vast therapeutic uses, it is known to cause severe cardiac toxicity. Kolaviron (KV), a Garcinia kola seed extract containing a mixture of flavonoids, is reputed for its antioxidant and membrane stabilizing properties.

Objective.

This study investigated the protective effect of KV on CP-induced cardiotoxicity in rats.

Methods.

Thirty rats were used, and they were divided into 6 groups of 5 rats each. Group I received 2 mL/kg propylene glycol orally for 14 days; group II received CP (50 mg/kg/d, intraperitoneally [i.p.]) for 3 days; groups III and IV received 200 and 400 mg/kg/d KV, respectively, orally for 14 days and groups V and VI were pretreated with 200 and 400 mg/kg/d KV, respectively, orally for 14 days followed by CP (50 mg/kg/d, i.p.) for 3 days.

Results.

CP treatment resulted in a significantly lower food consumption and body weight in rats. The lactate dehydrogenase and creatine kinase enzymes in cardiac tissues of rats treated with CP were significantly higher. In cardiac tissues, 3-day doses of CP resulted in significantly higher heart weight, cardiac troponin I, myeloperoxidase, malondialdehyde, hydrogen peroxide and lower superoxide dismutase, catalase, glutathione peroxidase activities, and reduced glutathione levels. Histological examination of cardiac tissues showed sign of necrosis of myocardium after CP treatment. However, administration of KV at 200 and 400 mg/kg for 14 days prior to CP treatment, increase food consumption, body weight, and attenuates the biochemical and histological changes induced by CP.

Conclusions.

These results revealed that KV attenuates CP-induced cardiotoxicity by inhibiting oxidative stress and preserving the activity of antioxidant enzymes.
A rare case of a synchronous endometrioid adenocarcinoma of the ovary and of eutopic endometrium in a patient with endometriosis
Authors: Tsuari Mmaselemo , Siebert Igno , Soeters Robbert
Published: March 2018

Malignant transformation of endometriosis is a rare, documented complication of endometriosis. Endometriosis shares characteristics with malignancy and has biological systems central to its progression and malignant transformation. Evidence has emerged on the role of the fallopian tube in endometriosis and ovarian cancer. This has led to a paradigm shift in how the fallopian tube is viewed. This is a case of endometrioid adenocarcinoma of the ovary arising from endometriosis, occurring synchronously in eutopic endometrium. There is agreement on the risk factors of malignant transformation of endometriosis which should assist in clinical vigilance and screening of ovarian cancer associated with endometriosis. Although most ovarian malignancies require aggressive therapy, endometriosis-associated ovarian cancer appears to be less aggressive, is diagnosed early and has a better prognosis and overall survival.
Histogenesis and classification of diffuse and cystic uterine adenomyosis
Authors: Nishida Masato , Itagaki Hiroya , Otsubo Yasuo , Ichikawa Ryota , Arai Yuko , Sakanaka Miyako
Published: March 2018

Purpose:

Recently, focal adenomyosis was classified into three subtypes according to magnetic resonance imaging findings: connected to the endometrium (subtype I), connected to the perimetrium (subtype II), and not connected to either the endometrium or the perimetrium (subtype III). However, diffuse adenomyosis and cystic adenomyosis have not been investigated. We attempted to classify diffuse-type adenomyosis and cystic-type adenomyosis according to magnetic resonance imaging findings and verified the validity of the previous classification of focal adenomyosis.

Methods:

A total of 1504 cases of adenomyosis (focal, n = 1093; nodular, n = 15; diffuse, n = 383; cystic, n = 13) shown in magnetic resonance imaging findings of patients who underwent conservative surgical treatment from 2002 to 2016 at our hospital were reviewed according to the criteria of Kishi.

Results:

Of the 383 patients with diffuse adenomyosis, 272 (70.8%) were classified as subtype I, while all cases of cystic-type adenomyosis developed in the lateral wall of the uterus were classified as subtype III.

Conclusion:

Our findings indicate that diffuse adenomyosis develops from the same mechanism as focal adenomyosis subtype I. In addition, we consider that subtype III has greater relationship with cystic adenomyosis than the other types.
Does bicep pathology affect rotator cuff repair outcomes?
Authors: Keong Mak Wai , Tjoen Denny Lie Tijauw
Published: March 2018

Introduction:

Rotator cuff (RC) tears are common and a frequent cause of dysfunction in the shoulder, especially with progression of age. Biceps pathology occurs concomitantly and its relationship with RC tears has been well described. However, the study of biceps intervention affecting outcomes of RC repair is limited. We aim to study the effect of biceps tenotomy in RC repair after matching for cuff tear size.

Methods:

We collected data of 24 consecutive patients undergoing RC repair and biceps tenotomy and matched them with patients undergoing RC repair only ( n = 24). The groups were matched for age, RC tear size, and presence of subscapularis tears. All patients of this study underwent RC repair under a single surgeon. Patient demographics and outcome measures in the form of range of motion (ROM) pain scores and validated shoulder scores (Constant shoulder score, Oxford score, and University of California Los Angeles shoulder score) were collected preoperative and at predetermined fixed intervals up to 2 years postoperatively. We then compared the two groups using a mixed analysis of variance design so as to identify any possible differences.

Results:

Patients from both groups demonstrated significant improvement in ROM, lower pain scores, and improvement in functional outcomes ( p < 0.05). Patients with biceps intervention demonstrated equivalent outcomes postoperatively up to 2 years with no statistical differences ( p > 0.05).

Conclusion:

Arthoscopic RC repair is an effective intervention for improving ROM, reducing pain, and improving function. Concomitant biceps procedure did not negatively impede recovery or affect outcomes.
Higher sensitivity of swab polymerase chain reaction compared with tissue cultures for diagnosing periprosthetic joint infection
Authors: Omar Mohamed , Petri Maximilian , Hawi Nael , Krettek Christian , Eberhard Jörg , Liodakis Emmanouil
Published: March 2018

Purpose:

The aim of this study was to assess the diagnostic accuracy of swab polymerase chain reaction (PCR) compared with tissue culture as the current gold standard.

Methods:

Forty-one consecutive patients were prospectively enrolled undergoing revision arthroplasty due to septic and aseptic reasons. Infection classification was done according to the criteria of the Musculoskeletal Infection Society. Intraoperatively, tissue samples of the periprosthetic membrane were collected for culture analysis, and swabs were taken from the accessible implant surface to perform 16S ribosomal RNA PCR. The diagnostic performance of swab PCR and tissue cultures was determined.

Results:

Of the 41 patients, 53.7% ( n = 22) had a periprosthetic joint infection (PJI) and 46.3% ( n = 19) an aseptic loosening. Swab PCR showed a higher sensitivity than tissue cultures (86.4% vs. 68.2%), while the specificity was equal (89.5%). The area under the curve was 0.79 for tissue cultures and 0.88 for swab PCR.

Conclusions:

In this first investigation of swab PCR for diagnosing PJI, this procedure revealed a higher sensitivity for diagnosing PJI compared with tissue cultures. Because swab PCR is easily implementable and does not require special equipment, it can potentially improve the diagnosis of PJI.
The Stereotype Content of Sexual Orientation
Authors: Mize Trenton D. , Manago Bianca
Published: March 2018

The stereotype content model provides a powerful tool to examine influential societal stereotypes associated with social groups. We theorize how stereotypes of gender, sexuality, and a group’s status in society combine to influence societal views of sexual orientation groups—placing particular emphasis on stereotypes of warmth and competence. In two survey experiments, we collect quantitative measures of stereotype content and open-response items on the stereotypes of bisexual individuals. We predict—and find—that gay men and lesbian women face disadvantaging stereotypes; bisexual men and women, however, face the most severely negative stereotypes of any sexual orientation group—with aggregate judgments of low warmth and competence. In the second study, using a diverse sample, we show that stereotypes about sexual orientation groups are largely culturally consensual. We conclude by emphasizing the importance of comparative approaches that consider both advantaged and disadvantaged groups to fully contextualize stereotypes of minority groups.
Effects of Patient Safety Culture on Patient Satisfaction With Radiological Services in Nigerian Radiodiagnostic Practice
Authors: Okafor Chioma Henrietta , Ugwu Anthony C , Okon Ime Edet
Published: March 2018

Introduction:

Patient safety culture is believed to be the first step toward improvement in quality of health-care delivery which will impact patient satisfaction.

Objective:

To assess the effect of patient safety culture on patient satisfaction in radiodiagnostic practice.

Method:

Two validated questionnaires via Hospital Survey on Patient Safety Culture by Agency of Health Research and Quality and patient satisfaction questionnaire by Hays were administered to radiodiagnostic staff and patients who came for diagnostic care, respectively. These questionnaires were based on 5-point Likert scale. Questionnaires on patient safety culture and patient satisfaction were administered to 80 radiology health workers and 376 patients of radiology, respectively. Simple random sampling was used to enlist the participants for patient satisfaction while a population study was carried out to enlist patient safety culture participants. Data were analyzed using SPSS version 17.

Results:

Response rate for patient safety culture questionnaires was 94.6%, while that of patient satisfaction was 62.8%. Among the survey items of patient safety, teamwork has the highest positive response of 76.5%, while staffing has the least, 30%. Overall patient safety culture was 53.7%. The survey item with highest positive response in patient satisfaction survey was patient-provider relationship (80%), while service cost-effectiveness has the least of 59%. Overall patient satisfaction with radiological services was 72.6%. There is no correlation between patient safety culture and patient satisfaction.

Conclusion:

Even though there is an excellent level of patient satisfaction in this study, it is not related to the practice of patient safety culture in radiodiagnostic unit.
Frailty Syndrome: Nursing Interventions
Authors: Uchmanowicz Izabella , Jankowska-Polańska Beata , Wleklik Marta , Lisiak Magdalena , Gobbens Robbert
Published: March 2018

Background

Frailty syndrome is now becoming a challenge for multidisciplinary teams. Frailty assessment in elderly patients is recommended due to the associated cascade of irreversible alterations that ultimately result in disability.

Aims

The purpose of this article is to identify interventions, which can be implemented and performed by nurses as part of a multidisciplinary plan. Nursing strategies related to nutrition, polypharmacy, adherence to treatment, falls, exercise, and mood and cognitive intervention are described.

Design

Discussion paper.

Data sources

Relevant and up-to-date literature from PubMed, MEDLINE, and Scopus databases regarding the selected issues, such as nutritional status, polypharmacy, falls, physical activity, and cognitive functions.

Conclusion

Frailty is considered preventable or even reversible with the appropriate interventions, which can help maintain or even restore physical abilities, cognitive function, or nutritional status in frail elderly patients. Hence, the nursing interventions are significant in clinical practice and should be implemented for frail patients.

Implications for nursing

Health-care providers, especially nurses, in their clinical practice should recognize not only elderly patients but also elderly patients with concurrent frailty, requiring intensified therapeutic interventions tailored to their individual needs. Frailty syndrome is undoubtedly a challenge for multidisciplinary teams providing health care for geriatric patients.
Reducing Potentially Preventable Dental Hospitalizations of Young Children: A Community-Level Analysis
Authors: Rogers J.G. , Adams G.G. , Wright F.A.C. , Roberts-Thomson K. , Morgan M.V.
Published: March 2018

An increasing number of Australians are being admitted to hospitals and day procedure centers to have dental treatment under a dental general anesthetic (DGA). Children younger than 2 y are having DGAs. These operations are costly and, although there have been improvements in safety, are not without risk. Most DGAs in children are to treat dental caries and have been defined as potentially preventable dental hospitalizations (PPDHs). This article reports on an analysis of the impact of access to community water fluoridation (CWF), availability of oral health professionals (OHPs), and socioeconomic status (SES) on PPDHs of 0- to 4-y-olds in 2012–2013 in Victoria, Australia. Data on these variables were obtained at the community (postcode) level. From the negative binomial multivariate analysis, each of the 3 independent variables was independently significantly associated with PPDHs at the postcode level. Children residing in postcodes without CWF on average had 59% higher rates than those with access (incident rate ratio [IRR], 1.59; P < 0.0001), children in postcodes with the lowest level of availability of OHPs had 65% higher rates than those with the highest access (IRR, 1.65; P < 0.0001), and children living in the most disadvantaged SES quintiles had 57% higher rates than children in the most advantaged quintiles (IRR, 1.57; P < 0.0001). There was a stepwise social gradient by SES quintile. In analysis of access to CWF and SES status, children without access to CWF had 86% higher PPDH rates than children with access (IRR, 1.86; P < 0.0001). In summary, no access to CWF, poor availability of OHPs, and lower SES status were independently associated with higher PPDH rates among 0- to 4-y-olds in Victoria at the postcode level. The study highlights the importance of considering 3 interacting factors—access to CWF, access to OHPs, and SES—in efforts to reduce PPDH rates in young children.

Knowledge Transfer Statement: Extending access to water fluoridation, increasing the availability of dental services, and raising disadvantaged families’ socioeconomic status are each likely to decrease the rate of dental general anesthetics in young children.
First year post-stroke healthcare costs and fall-status among those discharged to the community
Authors: Walsh Mary E , Sorensen Jan , Galvin Rose , Williams David JP , Harbison Joseph A , Murphy Sean , Collins Ronan , McCabe Dominick JH , Crowe Morgan , Horgan N Frances
Published: March 2018

Introduction

Falls are common post-stroke events but their relationship with healthcare costs is unclear. The aim of this study was to examine the relationship between healthcare costs in the first year after stroke and falls among survivors discharged to the community.

Patients and methods

Survivors of acute stroke with planned home discharges from five large hospitals in Ireland were recruited. Falls and healthcare utilisation data were recorded using inpatient records, monthly calendars and post-discharge interviews. Cost of stroke was estimated for each participant from hospital admission for one year. The association of fall-status with overall cost was tested with multivariable linear regression analysis adjusting for pre-stroke function, stroke severity, age and living situation.

Results

A total of 109 stroke survivors with complete follow-up data (mean age = 68.5 years (SD = 13.5 years)) were included. Fifty-three participants (49%) fell following stroke, of whom 28 (26%) had recurrent falls. Estimated mean total healthcare cost was €20,244 (SD=€23,456). The experience of one fall and recurrent falls was independently associated with higher costs of care (p = 0.02 and p < 0.01, respectively).

Discussion

The observed relationship between falls and cost is likely to be underestimated as aids and adaptions, productivity losses, and nursing home care were not included.

Conclusion

This study points at differences across fall-status in several healthcare costs categories, namely the index admission, secondary/tertiary care (including inpatient re-admissions) and allied healthcare. Future research could compare the cost-effectiveness of inpatient versus community-based fall-prevention after stroke. Further studies are also required to inform post-stroke bone-health management and fracture-risk reduction.
A Longitudinal 1H-MRS Study of the Anterior Cingulate Gyrus in Child and Adolescent Victims of Multiple Forms of Violence
Authors: Milani Ana Carolina Coelho , Foerster Bernd , Cogo-Moreira Hugo , Farias Thiago Michel de Brito , Salido Francisco , Carrete Henrique , Mello Marcelo Feijo , Jackowski Andrea Parolin
Published: March 2018

Background

The anterior cingulate gyrus is involved in the extinction of conditioned fear responses and is implicated in the pathophysiology of posttraumatic stress disorder. The expression of N-acetylaspartate and choline may be altered in the anterior cingulate gyri of children and adolescents with posttraumatic stress disorder.

Methods

We conducted a proton magnetic resonance spectroscopy study, longitudinally investigating N-acetylaspartate/creatine and choline/creatine ratios in the anterior cingulate gyri of children and adolescents, aged from 8 to 12 years, who had been exposed to various forms of violence or were non-trauma control. Based on baseline posttraumatic stress symptoms (“sub-clinical”), participants were divided into two groups: posttraumatic stress (n = 19) and control (n = 19). Proton magnetic resonance spectroscopy scans were repeated a year later in trauma exposed participants. Trauma assessments included the Childhood Trauma Questionnaire.

Results

Exploratory analyses revealed a significant negative correlation between follow-up anterior cingulate gyrus N-acetylaspartate/creatine and Childhood Trauma Questionnaire scores in posttraumatic stress (r = −0.62, p = 0.01) but not control group (r = 0.16, p = 0.66). However, we found no significant differences in anterior cingulate gyrus N-acetylaspartate/creatine or choline/creatine between posttraumatic stress and control. In addition, there were no significant effects of time, group, or time-by-group interactions.

Conclusions

In this pediatric population, anterior cingulate gyrus N-acetylaspartate/creatine and choline/creatine were not affected by posttraumatic stress and on average these metabolites remained stable over time. However, the study provided intriguing preliminary evidence revealing that participants suffering from posttraumatic stress at baseline have shown, a year later, reduced anterior cingulate gyrus N-acetylaspartate/creatine among those with high trauma severity. This pilot evidence warrants replication in future studies to confirm these findings and to determine the longitudinal effects and interactions between childhood posttraumatic stress and trauma.
Emission of Biophotons and Adjustable Sounds by the Fascial System: Review and Reflections for Manual Therapy
Authors: Bordoni Bruno , Marelli Fabiola , Morabito Bruno , Sacconi Beatrice
Published: March 2018

Every body structure is wrapped in connective tissue or fascia, creating a structural continuity that gives form and function to every tissue and organ. The fascial tissue is uniformly distributed throughout the body, enveloping, interacting with and permeating blood vessels, nerves, viscera, meninges, bones and muscles, creating various layers at different depths and forming a tridimensional metabolic and mechanical matrix. This article reviews the literature on the emission of biophotons and adjustable sounds by the fascial system, because these biological changes could be a means of local and systemic cellular communication and become another assessment tool for manual (therapy) practitioners. This is the first article that discusses these topics in a single text, attempting to bring such information into an area of application that is beneficial to osteopaths, chiropractors, and manual therapists.
Chemical Composition, Antioxidant and Antibacterial Activity of Bunium persicum, Eucalyptus globulus, and Rose Water on Multidrug-Resistant Listeria Species
Authors: Sharafati Chaleshtori Farhad , Saholi Mohamad , Sharafati Chaleshtori Reza
Published: March 2018

This research was aimed at investigating the antioxidant and antibacterial activity of Bunium persicum, Eucalyptus globulus, and rose water on multidrug-resistant Listeria species. The antibiotic resistance of Listeria spp obtained from seafood samples were determined by the Kirby-Bauer method. The antioxidant and antibacterial activity of the essential oils and extracts were evaluated using ferric reducing antioxidant power and microdilution methods, respectively. A total 2 samples (1.88%) were positive for Listeria spp. L monocytogenes was found to be resistant to ampicillin, amoxicillin/clavulanic acid, penicillin, vancomycin, and kanamycin. B persicum essential oil showed the greatest antioxidant activity (248.56 ± 1.09 µM Fe2+/g). The E globulus essential oil showed consistently strong antimicrobial activity against L monocytogenes and L grayi, while rose water showed no antimicrobial activity against any of the tested bacterial strains. The results showed that after adding the B persicum and E globulus essential oils to bacteria, the cell components’ release increased significantly.
The Interrelated Physiological and Psychological Effects of EcoMeditation
Authors: Groesbeck Gary , Bach Donna , Stapleton Peta , Blickheuser Katharina , Church Dawson , Sims Rebecca
Published: March 2018

This study investigated changes in psychological and physiological markers during a weekend meditation workshop (N = 34). Psychological symptoms of anxiety, depression, posttraumatic stress disorder (PTSD) and happiness were assessed. Physiological markers included cortisol, salivary immunoglobulin A (SigA), heart rate variability (HRV), blood pressure (BP), and resting heart rate (RHR). On posttest, significant reductions were found in cortisol (−29%, P < .0001), RHR (−5%, P = .0281), and pain (−43%, P = .0022). Happiness increased significantly (+11%, P = .0159) while the increase in SigA was nonsignificant (+27%, P = .6964). Anxiety, depression, and PTSD all declined (−26%, P = .0159; −32%, P = .0197; −18%, P = .1533), though changes in PTSD did not reach statistical significance. No changes were found in BP, HRV, and heart coherence. Participants were assessed for psychological symptoms at 3-month follow-up, but the results were nonsignificant due to inadequate sample size (n = 17). EcoMeditation shows promise as a stress-reduction method.