bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability and Validity Evidence for the Hawaii Early Learning Profile, Birth-3 Years
Authors: Li Zijia , Gooden Caroline , Toland Michael D.
Published: November 2018

This study provides preliminary evidence for reliability and validity of the Hawaii Early Learning Profile Strands 0-3 (HELP Strands 0-3), an assessment instrument for young children. First, the degree of interobserver agreement for a sample of representative HELP items was examined; results indicated that HELP scoring was dependable and consistent across 82 providers. Second, content validity was evaluated by having 12 early childhood experts align HELP items with their related strands (i.e., specific developmental areas) and rank the developmental order of items within each strand. The experts agreed with the HELP item-to-strand alignment and with the developmental order of items. Finally, convergent and discriminant validity evidence was provided by correlating HELP domain scores with Battelle Developmental Inventory–Second Edition (BDI-2) domain scores. Evidence for convergent validity was found between similar domains; discriminant validity was evidenced by low correlations between unrelated domains of HELP and BDI-2.
“More Like a Real Human Being”: Humanizing Historical Artists Through Remote Service-Learning
Authors: Gasper-Hulvat Marie
Published: November 2018

Background: In a digital age, service-learning partner organizations can expand beyond geographical locations accessible to the students. Particularly within fields digitizing archival sources, including art history, many learning outcomes achieved in traditional on-site service-learning programs can also result from remote access to staff and materials at non-local partner organizations. Purpose: This study analyzed the impact of a remote service-learning project between an upper division contemporary art history course at a regional university in Ohio and the Archives of American Art in Washington, D.C. Methodology/Approach: Over 3 consecutive years, the students used digitized visual and audio archival materials to edit transcripts of oral histories for web publication. At the conclusion of the project, the students conducted focus group interviews to analyze their perceptions of learning outcomes. Findings/Conclusions: Qualitative analysis of the interview transcripts yielded four primary themes in the data: disciplinary understanding, transferrable skill development, critical decision making, and emotional knowledge. Implications: Remote service-learning can facilitate many of the same learning outcomes as on-site experiences.
Clinical features of cats with aqueous tear deficiency: a retrospective case series of 10 patients (17 eyes)
Authors: Uhl Lisa K , Saito Akihiko , Iwashita Hiroko , Maggs David J , Mochel Jonathan P , Sebbag Lionel
Published: November 2018

Objectives

The aim of this study was to describe the clinical findings, diagnostic test results and response to therapy of cats with Schirmer tear test 1 (STT-1) values below the reference interval.

Methods

The medical records of three institutions were searched for cats with ocular surface disease and STT-1 values <9 mm/min, confirmed at two or more separate visits.

Results

Ten cats (17 eyes) were included. The mean ± SD (range) age and STT-1 values in affected eye(s) were 6.1 ± 5.7 (0.2–16) years and 2.4 ± 3.1 (0–8) mm/min, respectively. Concurrent ocular surface disease was bilateral in 5/10 cats. Clinical signs included conjunctivitis (14/17 eyes), corneal ulceration (6/17 eyes), non-ulcerative keratitis (4/17 eyes), symblepharon (4/17 eyes), eosinophilic keratitis (3/17 eyes), corneal sequestrum (3/17 eyes), corneal fibrosis (2/17 eyes) and meibomitis (2/17 eyes). Management included: topically applied lacrimomimetics, antiviral drugs, corticosteroids or immunomodulatory drugs; orally administered famciclovir; or surgical procedures, in various combinations. Response to therapy (defined as an increase in STT-1 value of ⩾5 mm/min) was transient (seen at a single reassessment) in 65% of eyes and sustained (seen at ⩾2 consecutive reassessments) in 18% of eyes.

Conclusions and relevance

Clinical features seen in cats with low STT-1 values are described, although the association between aqueous deficiency and the reported ocular changes is unknown at this time. We encourage clinicians to assess the tear film in cats with ocular surface disease, and initiate therapy with lacrimomimetics if STT-1 values are repeatedly below normal. Such information will further define aqueous tear deficiency in cats, providing a better understanding of disease prevalence, pathogenesis and treatment.
The serum albumin threshold for increased perioperative complications after total hip arthroplasty is 3.0 g/dL
Authors: Nelson Charles L , Kamath Atul F , Elkassabany Nabil M , Guo Zhenggang , Liu Jiabin
Published: November 2018

Introduction:

Low serum albumin is associated with higher perioperative complications following total hip arthroplasty (THA). The distinct threshold for a significant rise in perioperative complications has not been defined for THA. The purpose of this study was to define the threshold at which perioperative complications rise after THA.

Methods:

We analysed the American College of Surgeons NSQIP database from 2006 to 2013. Our study cohort included unilateral primary THA with reported preoperative albumin levels. Patients were stratified by albumin level. We analysed mortality and 6 composite complication variables (any complication, any complication without transfusion, wound infection, systemic infection, cardiac/pulmonary complications, and any major complication). All data analysis was executed in STATA statistical software. Multivariable logistic regression analysis was used to adjust for odds ratios.

Results:

The final cohort included 24,586 patients who were stratified based upon serum albumin levels. Odds ratios after multivariable regression adjustment for age, gender, race, body mass index, ASA classification, and Charlson Comorbidity Index indicated a trend to elevated odds of complication for all composite complications (3 of which were statistically significant) when serum albumin level was <3.0 g/dL.

Conclusion:

Low serum albumin is associated with increased perioperative complications following THA. The threshold associated with an increase in major perioperative complications appears to be an albumin level of <3.0 g/dL. With attempts to correct modifiable risk factors prior to surgery, the threshold value at which perioperative complications increase is important to define.
Functional outcome of total hip arthroplasty after a previous hip arthroscopy: a retrospective comparative cohort study
Authors: Jain Mikhil V , Rajpura Asim , Kumar Venkatesan Sampath , Shaw Debbie , Najjar Majeed Al , Kalsi Navjit K , Hakimi Mounir , Selvaratnam Veenesh , Jackson Richard , Board Tim N
Published: November 2018

Background:

Despite patients demonstrating significant short-term clinical improvement from a hip arthroscopy (HA), a number of patients progress to significant osteoarthritis of the hip requiring total hip arthroplasty (THA). This study aims to evaluate if there is any difference in the functional outcome of patients undergoing THA after a previous hip arthroscopy compared to patients undergoing THA for primary osteoarthritis of the hip.

Methods:

Between 2010 and 2013, in a group of 414 patients who underwent hip arthroscopy, we identified 18 patients who underwent a subsequent uncemented THA. These formed the study group. During the same period, 625 patients underwent an uncemented THA performed for primary OA, of which 63 patients were matched to the study group for age, follow-up and implants used. These formed the control group. Pre-op and post-op Oxford Hip Scores (OHS) were recorded for all patients.

Results:

A mean follow-up of 26.5 and 26.3 months was observed in the study and control groups respectively. The median (interquartile ranges) preoperative OHS were 14 (8.25, 17.0) and 18.5 (13.25, 24.75) in the 2 groups. Corresponding postoperative scores were 40 (31.25, 45) and 46 (43, 48). Median difference between the preoperative and postoperative OHS was 27 (19, 31) and 25 (18.25, 31). Adjusting for the pre-treatment scores, the postoperative scores in the study arm were significantly lower than for the control arm with an estimate (SE) of −0.464 ( p = 0.012). Post-hoc power analysis showed that the study was sufficiently powered to detect a meaningful difference in scores.

Conclusion:

Total hip arthroplasty after hip arthroscopy leads to satisfactory functional outcomes. However, the functional outcome in this group is significantly worse than in a matched cohort of patients undergoing THA for osteoarthritis. There was no difference in the rate of complications between the 2 groups.
Integrated learning in a drug and alcohol university degree for Aboriginal and Torres Strait Islander adults: a case study
Authors: Lee KS Kylie , Harrison Michelle , Wilson Scott , Miller Warren , Perry Jimmy , Conigrave Katherine M.
Published: November 2018

Aboriginal and Torres Strait Islander (Indigenous) health professionals working in the alcohol and other drugs field perform a complex role in tackling substance misuse and related harms. Professional training and development opportunities for these “frontline” Indigenous alcohol and other drugs staff is key to prevent burnout and to allow them to work to their full potential. However, there are many barriers for those seeking to improve their skills. A number of teaching approaches have been described as important, but we were unable to identify peer-reviewed publications that detail the optimal approach to tailor university learning to meet the needs of Indigenous alcohol and other drugs health professionals. This article reflects on the experience of providing one such programme: a graduate diploma in Indigenous health and substance use, designed and delivered specifically for Aboriginal and Torres Strait Islander mature-aged students.
Re-peopling in a settler-colonial context: the intersection of Indigenous laws of adoption with Canadian immigration law
Authors: Bhatia Amar
Published: November 2018

This article examines the intersection of Indigenous and Canadian ways of making and maintaining relations through the specific examples of adoption and immigration. Canada and all Indigenous societies assert the authority to re-people themselves. Unlike Canada, Indigenous peoples must do so in the face of ongoing settler colonialism. I argue that Indigenous peoples and nations have authority to regulate these matters under Indigenous laws and systems of treaty relations. However, Canadian laws and policies have served to obscure this authority. I argue that non-metaphorical decolonization requires the continued exercise of Indigenous authority over “peopling” powers. These powers necessarily include authority over adoption at societal, familial, and individual levels via, respectively, ongoing treaty relations and customary membership. Adoption has formed part of this resistance but remains limited by Canadian sovereignty and the state’s assertions of control over borders and immigration.
Epitope-Based Peptide Vaccine Against Fructose-Bisphosphate Aldolase of Madurella mycetomatis Using Immunoinformatics Approaches
Authors: Mohammed Arwa A , ALnaby Ayman MH , Sabeel Solima M , AbdElmarouf Fagr M , Dirar Amina I , Ali Mostafa M , Khandgawi Mustafa A , Yousif Abdelhameed M , Abdulgadir Eman M , Sabahalkhair Magdi A , Abbas Ayman E , Hassan Mohammed A
Published: November 2018

Background:

Mycetoma is a distinct body tissue destructive and neglected tropical disease. It is endemic in many tropical and subtropical countries. Mycetoma is caused by bacterial infections ( actinomycetoma) such as Streptomyces somaliensis and Nocardiae or true fungi ( eumycetoma) such as Madurella mycetomatis. To date, treatments fail to cure the infection and the available marketed drugs are expensive and toxic upon prolonged usage. Moreover, no vaccine was prepared yet against mycetoma.

Aim:

The aim of this study is to predict effective epitope-based vaccine against fructose-bisphosphate aldolase enzymes of M. mycetomatis using immunoinformatics approaches.

Methods and materials:

Fructose-bisphosphate aldolase of M. mycetomatis sequence was retrieved from NCBI. Different prediction tools were used to analyze the nominee’s epitopes in Immune Epitope Database for B-cell, T-cell MHC class II and class I. Then the proposed peptides were docked using Autodock 4.0 software program.

Results and conclusions:

The proposed and promising peptides KYLQ show a potent binding affinity to B-cell, FEYARKHAF with a very strong binding affinity to MHC I alleles and FFKEHGVPL that shows a very strong binding affinity to MHC II and MHC I alleles. This indicates a strong potential to formulate a new vaccine, especially with the peptide FFKEHGVPL which is likely to be the first proposed epitope-based vaccine against fructose-bisphosphate aldolase of M. mycetomatis. This study recommends an in vivo assessment for the most promising peptides especially FFKEHGVPL.
The Temporal Relationship Between Medicaid Payment Acceptance and the Implementation of Medication-Assisted Drug Treatment
Authors: Guerrero Erick G , Garner Bryan R , Cook Benjamin , Kong Yinfei , Vega William A
Published: November 2018

Objective:

To examine the temporal relationship of Medicaid funding on the implementation of evidence-based practices (EBPs) in outpatient substance use disorder (SUD) treatment.

Methods:

We examined data from 61 publicly funded SUD treatment programs in 2011 and 2013 using crossed-lagged regressions. We tested the impact of Medicaid payment acceptance on 2 measures of EBP implementation—contingency management treatment (CMT) and medication-assisted treatment (MAT).

Results:

Medicaid payment acceptance at wave 1 was not associated with implementation of CMT at wave 2 (standardized estimate = 0.170, SE = 0.208, P > .05). However, Medicaid payment acceptance at wave 1 was associated with implementation of MAT at wave 2 (standardized estimate = 0.880, SE = 0.047, P < .001).

Conclusions:

Medicaid payment acceptance has a temporal relationship with the implementation of MAT in SUD treatment programs serving one of the largest racial/ethnic minority communities in the United States.
Atmospheric Impacts on Daytime Urban Heat Island
Authors: Krüger Eduardo , Drach Patricia , Emmanuel Rohinton
Published: November 2018

Daytime urban heat island effects can be weak compared to night time and even reversed (as in the case of cool islands, where urban locations display lower temperatures than at a rural site), mostly due to shading effects from buildings, vegetation, and other possible obstructions. The study of the relationship between the sky-view factor, an indicator of urban geometry in terms of sky openness, and urban heat island intensity generally focus on night time periods; only a few report on the daytime effect of the SVF. Such effect will also vary according to background atmospheric conditions of the period of measurements. This article is a commentary on a recent publication by the authors on a study of diurnal intra-urban temperature differences in a location with Koeppen’s Cfb climate.
Symbols and world politics: Towards a long-term perspective on historical trends and contemporary challenges
Authors: Linklater Andrew
Published: November 2018

The role of symbols in world politics remains on the margins of the study of international relations. There has been no systematic discussion of how to promote theoretically informed empirical analyses of their role in earlier epochs and in the current era. This article defends a long-term perspective on symbols that emphasises their relationship with the overall historical trend towards societies of greater magnitude and destructive power. It advances a preliminary classification of analytically distinguishable core symbols in order to support future inquiries into symbols in state-organised societies and symbols that have been central to attempts to create wider solidarities. A long-term perspective on symbolic realms is important in order to understand the relationship between ‘national’ and ‘cosmopolitan symbols’ in the current era. Current challenges in the symbolic sphere illustrate more general trends in human societies, namely, problems in constructing wider symbolic frameworks that permit closer cooperation between groups in the context of increasing levels of interconnectedness.
Do international institutions matter? Socialization and international bureaucrats
Authors: Murdoch Zuzana , Kassim Hussein , Connolly Sara , Geys Benny
Published: November 2018

A key component of (neo-)functionalist and constructivist approaches to the study of international organizations concerns staff socialization. Existing analyses of how, or indeed whether, staff develop more pro-internationalist attitudes over time draw predominantly on cross-sectional data. Yet, such data cannot address (self-)selection issues or capture the inherently temporal nature of attitude change. This article proposes an innovative approach to the study of international socialization using an explicitly longitudinal design. Analysing two waves of a large-scale survey conducted within the European Commission in 2008 and 2014, it examines the beliefs and values of the same individuals over time and exploits exogenous organizational changes to identify causal effects. Furthermore, the article theorizes and assesses specified scope conditions affecting socialization processes. Showing that international institutions do, in fact, influence value acquisition by individual bureaucrats, our results contest the widely held view that international organizations are not a socializing environment. Our analysis also demonstrates that age at entry and gender significantly affect the intensity of such value change.
Brachial artery intima–media thickness and grayscale texture changes in patients with peripheral artery disease receiving supervised exercise training in the PROPEL randomized clinical trial
Authors: Berroug Jack , Korcarz Claudia E , Mitchell Carol KC , Weber JoAnne M , Tian Lu , McDermott Mary M , Stein James H
Published: November 2018

We performed an exploratory analysis to evaluate the effects of a treadmill exercise program on brachial artery (BA) intima–media thickness (IMT) and three BA grayscale ultrasound measures that may indicate subclinical arterial injury. Data were from a clinical trial in individuals with peripheral artery disease who were randomly assigned to treadmill exercise training or attention control. B-mode ultrasonography was performed at baseline and after 26 weeks. BA IMT, grayscale median (GSM), entropy, and gray-level difference statistic-contrast (GLDS-CON) were measured by a single reader. The 184 participants were (mean (SD)) 66.7 (8.2) years old and had an ankle–brachial index of 0.70 (0.18). Exercise training was associated with a 0.01 (0.06) mm ( p = 0.025) reduction in BA IMT compared to 0.00 (0.05) mm ( p = 0.807) in the control group (between-group p = 0.061). BA GSM, entropy, and GLDS-CON did not change significantly with exercise. Improvements in the 6-minute walk distance correlated with increases in resting BA blood flow ( r = 0.23, p = 0.032), flow-mediated dilation ( r = 0.24, p = 0.022), diameter ( r = 0.29, p = 0.005), entropy ( r = 0.21, p = 0.047), and GLDS-CON ( r = 0.22, p = 0.041). In a post hoc analysis, BA IMT improved significantly with treadmill exercise training but did not change with attention control; however, the between-group difference did not reach statistical significance. With exercise, improvements in the 6-minute walk distance were associated with improved endothelial function, increased resting blood flow, and BA dilation, as well as higher grayscale entropy and GLDS-CON, indicating that lower extremity exercise is associated with salutary changes in upper-extremity arterial wall structure and function. ClinicalTrials.gov Identifier: NCT01408901
‘Bizarre Sapphic midlife crisis’: (Re)thinking LGBTQ representation, age and mental health
Authors: Turner Georgina
Published: November 2018

This article looks at viewers’ responses to the romance between two older women on the BBC medical drama Holby City. In the context of a continuing lack of representation of (older) women-loving women, viewers of all ages describe a transformative experience, with an emphasis on positive mental health outcomes – yet older women also orient to something implicitly problematic about this being the case. This is premised, I suggest, in the foregrounding of youth and adolescence in academic and public discussions of the role of the media in sexual self-realisation. The research demonstrates the need for qualitative case studies capturing LGBTQ portrayals, taking account of the experiences of older viewers, and of network television even in a fragmented and queer(er) digital market.
“Thank god for Deadspin”: Interlopers, metajournalistic commentary, and fake news through the lens of “journalistic realization”
Authors: Eldridge Scott A
Published: November 2018

Interlopers are a class of digital-peripheral journalists and outlets who position their work as journalism, but who have struggled to be recognized as such. While we have long acknowledged journalism’s place online, as digital-peripheral journalists interlopers face challenges when it comes to appreciating their work as news and their contributions as journalism. This article argues their contributions warrant further evaluation as the journalistic field continues to confront change and engage new approaches to journalism, and as interlopers continue to produce news. Using Deadspin’s coverage of the Sinclair Broadcast Group as an exemplar of such contributions, this article details an approach which accounts for interlopers’ unique approaches to news, locating in broader news discourse measures of “journalistic realization” as a legitimating discourse. Its findings tentatively suggest a weakening of historically hardened boundaries between journalism’s core and its periphery, and argue for continued, nuanced exploration of the nature of the journalistic field.
Care needs of people with dementia in the peri-operative environment: A systematic review
Authors: Diaz-Gil Alicia , Brooke Joanne , Kozlowska Olga , Pendlebury Sarah , Jackson Debra
Published: November 2018

The care of people with dementia within the hospital setting is challenging for healthcare professionals. Hospital design and services are not optimized for people with dementia, owing to the lack of preparation of healthcare professionals and the busy environment of the acute hospital. The peri-operative environment may present particular difficulties but little is known about the experience and care of people with dementia in this setting. The aim of this review was to examine the care of surgical patients who have dementia and their family members in peri-operative environments and describe strategies adopted by healthcare professionals. A systematic search of the following databases was completed: BNI, CINAHL, PubMED and PsychINFO in accordance with PRISMA guidelines. Data were extracted and analysed within a thematic analysis framework as described by Braun and Clarke . Ten papers based on eight studies were included, five (n = 355,010 participants) containing quantitative data and five reporting qualitative data (n = 395 participants). People with dementia who go undergo surgery experienced higher adverse post-operative outcomes such as respiratory problems or urinary tract infections. The key elements in surgical care for people with dementia included: health assessment throughout the surgical trajectory (pre-, intra- and post-operative) and the resources used by healthcare professionals in the peri-operative care. Healthcare professionals reported difficulties in the completion of health assessments due to the cognitive status of people with dementia and a lack of skills in dementia management. The use of restraints was still a common practice and a source of conflict. Dementia-specific training and guidelines focused on the care of surgical patients who have dementia in peri-operative environments are required to improve care and post-operative outcomes. More research is required to develop effective interventions to improve care and decrease the risk of complications for people with dementia in the peri-operative care environment.
Reimagining the colonial wilderness: ‘Africa’, imperialism and the geographical legerdemain of the Vorrh
Authors: Saunders Robert A.
Published: November 2018

Novelists and other cultural producers have long employed the African continent as a palimpsest to construct fantastical tales. From Sir John Mandeville to Joseph Conrad, Africa’s blank spaces on the map have been filled with monstrous creatures that fuel the western imagination. As a consequence, this constant othering of the so-called ‘Dark Continent’ has had a deleterious impact for African states and their citizenries, as spectacularly evidenced in U.S. President Donald Trump’s now-infamous labelling of the entire continent as a host of ‘shithole countries’. This article wrestles with the continuation of this trend in popular culture via an empirical examination of the speculative fiction of the British novelist and performance artist, B. Catling. Publishing in 2015, The Vorrh is the first of the three novels set in a parallel Africa, specifically a former German colony that is home to remnants of the Garden of Eden. Focusing on the enchanted forest known as the Vorrh and the colony’s (fictional) capital, Essenwald, this article employs methods drawn from geocriticism and popular geopolitics to interrogate Catling’s built-world. This is done with the aim of connecting structures of iteration in the representation of fictional ‘Africas’ to the West’s imperially inflected geopolitical codes towards the actual physical and human geographies that constitute the world’s second largest and most populous continent.
Salvage Pulmonary Operations Following Stereotactic Body Radiotherapy for Small Primary and Metastatic Lung Tumors: Evaluation of the Operative Procedures
Authors: Hamakawa Hiroshi , Takahashi Yutaka , Sakanoue Ichiro , Saito Tomoki , Date Naoki , Tomii Keisuke , Katakami Nobuyuki , Imagunbai Toshiyuki , Kokubo Masaki
Published: November 2018

Stereotactic body radiotherapy is an alternative treatment option for small-sized, primary lung cancers and pulmonary metastatic diseases. In the case of local relapse after stereotactic body radiotherapy, salvage pulmonary resection is considered cautiously. However, no study has described the difficulty of the salvage operations. This study aimed to assess the difficulty associated with salvage operative procedures. Eight patients who developed local relapse after stereotactic body radiotherapy and had undergone salvage pulmonary operations were enrolled in this study (stereotactic body radiotherapy group). Additionally, 439 patients who underwent video-assisted thoracoscopic lobectomy without previous stereotactic body radiotherapy were enrolled as the standard operative control group (non-stereotactic body radiotherapy group). In the stereotactic body radiotherapy group, 1 of the 8 patients had undergone lobectomy with composite resection of the third and fourth ribs. Of the 8 patients, 6 had undergone video-assisted thoracoscopic lobectomy and 1 had been inoperable because of rapid tumor progression. The operation time and the incision length of the utility port were apt to be longer in the stereotactic body radiotherapy group than in the non-stereotactic body radiotherapy group. On the contrary, the duration of drain placement and the length of hospital stay after the operation were not different. Thus, the salvage pulmonary operations were performed in the usual video-assisted thoracoscopic lobectomy approach, but slightly complicated than the standard video-assisted thoracoscopic lobectomy. Although to decide the indication of salvage operation might be difficult, it could be a feasible treatment option in local relapse after stereotactic body radiotherapy.
Primary user characterization for cognitive radio wireless networks using long short-term memory
Authors: Hernández Johana , López Danilo , Vera Nelson
Published: November 2018

Cognitive radio is a paradigm that proposes managing the radio electric spectrum dynamically by integrating the spectrum sensing, decision-making, sharing, and mobility stages. In the decision-making stage, the best available channel is selected for transmitting secondary user data in an opportunistic fashion, and the success of that stage depends on the efficiency of the primary user characterization model. Use of the long short-term memory technique based on the deep learning concept is proposed in order to reduce the forecasting error present in the future estimation of primary users in the GSM and WiFi frequency bands. The results show that long short-term memory has the capacity needed to improve channel use forecasting significantly more than other methods such as multilayer perceptron neural networks, Bayesian networks, and adaptive neuro-fuzzy inference systems (ANFIS-Grid). It is concluded that although long short-term memory exhibits better performance generating forecasts for time series, computing complexity is higher due to the existence of input, forget, and output gates within the neural structure; therefore, implementation is feasible in cognitive radio networks based on centralized network topologies.
Pelvic and Lower Gastrointestinal Tract Anatomical Characterization of the Average Male
Authors: Saffarzadeh Mona , Eckert Chad E. , Nagle Deborah , Weaner Lauren S. , Waters Gregory S. , Levine Edward A. , Weaver Ashley A.
Published: November 2018

Objective. Colorectal surgeons report difficulty in positioning surgical devices in males, particularly those with a narrower pelvis. The objectives of this study were to (1) characterize the anatomy of the pelvis and surrounding soft tissue from magnetic resonance and computed tomography scans from 10 average males (175 cm, 78 kg) and (2) develop a model representing the mean configuration to assess variability. Methods. The anatomy was characterized from existing scans using segmentation and registration techniques. Size and shape variation in the pelvis and soft tissue morphology was characterized using the Generalized Procrustes Analysis to compute the mean configuration. Results. There was considerable variability in volume of the psoas, connective tissue, and pelvis and in surface area of the mesorectum, pelvis, and connective tissue. Subject height was positively correlated with mesorectum surface area (P = .028, R2 = 0.47) and pelvis volume ( P = .041, R2 = 0.43). The anterior-posterior distance between the inferior pelvic floor muscle and pubic symphysis was positively correlated with subject height ( P = .043, r = 0.65). The angle between the superior mesorectum and sacral promontory was negatively correlated with subject height ( P = .042, r = −0.65). The pelvic inlet was positively correlated with subject weight ( P = .001, r = 0.89). Conclusions. There was considerable variability in organ volume and surface area among average males with some correlations to subject height and weight. A physical trainer model created from these data helped surgeons trial and assess device prototypes in a controllable environment.
“Why Don’t You Go Into Suburbs? Why Are You Targeting Us?”: Trust and Mistrust in HIV Vaccine Trials in South Africa
Authors: Thabethe Siyabonga , Slack Catherine , Lindegger Graham , Wilkinson Abigail , Wassenaar Douglas , Kerr Philippa , Bekker Linda-Gail , Mngadi Kathy , Newman Peter A.
Published: November 2018

Trust is a key element of high-quality stakeholder relations, which are themselves essential for the success of HIV vaccine trials. Where trust is absent, community stakeholders might not volunteer to become involved in key trial activities, and potential participants might not volunteer for enrollment. We explored site staff and Community Advisory Board (CAB) members’ experiences of trust/mistrust among community members and potential participants. We analyzed 10 focus group discussions with site staff and CAB members at two active South African HIV vaccine trial sites. We report on key characteristics perceived to contribute to the trustworthiness of communicators, as well as factors associated with mistrust. Attributes associated with trustworthy communicators included shared racial identity, competence, and independence (not being “captured”). Key foci for mistrust included explanations about site selection, stored samples, vaccination, and Vaccine Induced Sero-Positivity (VISP). Our findings suggest that community members’ trust is not necessarily global, in which trials are trusted or not; rather, it appears fairly nuanced and is impacted by various perceived attributes of communicators and the information they provide. We make recommendations for clinical trial site stakeholders invested in building trust and for future research into trust at these sites.
Long-term Patient-Reported Outcomes After Surgery for Hypothenar Hammer Syndrome
Authors: Demetri Leah , Lans Jonathan , Gottlieb Rachel , Dyer George S. M. , Eberlin Kyle R. , Chen Neal C.
Published: November 2018

Background: This study aims to describe the long-term patient-reported outcomes after surgery for hypothenar hammer syndrome (HTHS) and to identify factors associated with inferior outcomes. Methods: We retrospectively identified 27 patients who underwent surgical intervention for HTHS from 2002 to 2016. Fifteen patients (56%) completed outcome questionnaires: Quick Disabilities of the Arm, Shoulder, and Hand, Cold Intolerance Symptom Severity (CISS) survey, Patient-Reported Outcomes Measurement Information System Upper Extremity Computer Adaptive Test, and Patient-Reported Outcomes Measurement Information System Pain Interference Computer Adaptive Test. The median questionnaire follow-up was 7.2 years (interquartile range, 3.1-9.9). Outcomes were compared across different surgical techniques, and the influence of patient-related factors on outcomes was also evaluated. Results: Six (40%) patients experienced complete symptom resolution, 6 (40%) had improvement without complete resolution, 1 (7%) had resolution followed by recurrence, and 2 (13%) reported no improvement. The most common symptom after surgical intervention was cold intolerance. Questionnaire scores were similar across ligation, direct repair, and vein graft vascular reconstruction. Patients had better CISS scores if they had surgery on their nondominant hand (13.2 vs 38.6) and did not have a manual labor job (18.1 vs 40.5). Conclusions: Surgery for HTHS leads to moderate long-term improvement in patient-reported outcomes. Different surgical techniques yield similar symptomatic relief. Manual labor and surgery of the dominant hand are associated with worse CISS scores.
Revision Total Wrist Arthroplasty Due to Polyethylene Wear, Metallosis-Induced Carpal Tunnel Syndrome, Distal Ulnar Impingement, and Fourth Carpometacarpal Joint Pain: Case Report and Pitfalls to Avoid
Authors: Nunez Fiesky A. , Wright Lauren , Kilpatrick Scott E. , Seitz William H.
Published: November 2018

Background: Total wrist arthroplasty (TWA) is indicated to alleviate pain secondary to arthritis while preserving wrist motion. Despite vigilant measures, TWAs are susceptible to complications. The current case illustrates an array of preventable complications which are addressed through operative technique in a revision setting. Case presentation: The patient was a 72-year-old man who presented with chronic pain at the fourth carpometacarpal joint (CMCJ) and distal radioulnar joint with paresthesias in the median nerve distribution. Surgery was undertaken to address the following complications secondary to a previous TWA: impingement of the native distal ulna on the prosthesis, carpal tunnel due to metallosis and polyethylene synovitis, loose carpal component, and prominent screw at the fourth CMCJ. Surgical correction included open carpal tunnel release with extensive flexor tenosynovectomy, distal ulna resection and implant arthroplasty with shortening, revision of carpal component with bone grafting, and shortening of the ulnar screw to avoid crossing the fourth CMCJ. Within 6 months of the procedure, the patient reported resolution of neuropathic symptoms and pain-free motion of the wrist. Discussion: Preventable complications associated with TWA are individually highlighted. In addition, we compare and contrast our approach and surgical technique to current reported literature. Overall, we provide education and guidance to avoid possible TWA pitfalls. Conclusion: With this case report, we hope to increase TWA knowledge with emphasis on the requirements of judicious patient selection, preoperative planning, meticulous surgical technique, and complication awareness for subsequent optimization of wrist function, stability, and durability.
The Use of Telemedicine Decreases Unnecessary Hand Trauma Transfers
Authors: Tripod Morgan , Tait Mark , Bracey John , Sexton Kevin , Beck William , Wyrick Theresa O.
Published: November 2018

Purpose: The Arkansas Hand Trauma Telemedicine Program (AHTTP) is a novel telemedicine system that was developed in 2014 within a rural state to address the growing need of access to hand trauma care with one trauma center that cares for mangling hand injuries. The purpose is to compare transfers for hand injuries prior to and after the implementation of this system. Methods: The hospital institutional database was queried for all transfers to a level 1 medical center in the state from 2012 to 2015, allowing the comparison of data prior to and after the institution of the AHTTP. Patient disposition from the emergency department was categorized to evaluate the impact of AHTTP. Distance, mode of transport, and transport cost were assessed. Findings: There were 202 transfers for the treatment of isolated hand trauma (92 from 2012 to 2013 and 110 from 2014 to 2015). Prior to the institution of AHTTP, transfer patients were admitted 47.8% of the time compared with 68.2% of the time after the development of the program ( P = .02). The approximate cost of transport for patients who were discharged home directly from the emergency department was 38.5% (US $47,233) of the total costs for the 2012-2013 period and was 21.4% (US $34,017) of the costs for the 2014-2015 period ( P < .0001). Conclusions: There was a statistically significant decrease in the number of unnecessary transfers and transportation costs after the telemedicine program was started. The implementation of AHTTP in a rural state reduced health care costs and improved the efficiency of hand specialty care.
Impact of Handedness on Disability After Unilateral Upper-Extremity Peripheral Nerve Disorder
Authors: Philip Benjamin A. , Kaskutas Vicki , Mackinnon Susan E.
Published: November 2018

Background: Impairment of the dominant hand should lead to greater disability than impairment of the nondominant hand, but few studies have tested this directly, especially in the domain of upper-extremity peripheral nerve disorder. The aim of this study was to identify the association between hand dominance and standardized measures of disability and health status after upper-extremity peripheral nerve disorder. Methods: An existing database was reanalyzed to identify the relationship between affected-side (dominant vs nondominant) on individuals with unilateral upper-extremity peripheral nerve disorder (N = 400). Primary measure of disability was the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: We found no differences in standardized measures of disability or health status between patients with affected dominant hand and patients with an affected nondominant hand. However, a post hoc exploratory analysis revealed that patients with an affected dominant hand reported substantially reduced ability to perform 2 activities in the DASH questionnaire: “write” and “turn a key.” Conclusions: Following unilateral upper-extremity peripheral nerve disorder, impairment of the dominant hand (compared with impairment of the nondominant hand) is associated with reduced ability to perform specific activities, but this reduced ability is not reflected in standardized measures of disability and health status. To adequately identify disability following unilateral impairment of the dominant hand with the DASH, individual items must be used instead of the total score. New or alternative measures are also recommended.
A Prospective Evaluation of the Effect of Supervised Hand Therapy After Carpal Tunnel Surgery
Authors: Gil Joseph A. , Weiss Barrett , Kleiner Justin , Akelman Edward , Weiss Arnold-Peter C.
Published: November 2018

Background: The objective of this investigation is to examine the effect of postoperative therapy after routine carpal tunnel release. Our hypothesis was that supervised hand therapy does not improve outcomes after routine carpal tunnel release. Methods: Patients with carpal tunnel syndrome were randomly assigned to one of 3 groups based on the last digit of their medical record numbers to one of 3 groups: standard 6-week postoperative rehabilitation (standard therapy), expedited one-session postoperative rehabilitation group (expedited therapy), and no postoperative rehabilitation group (no therapy). The primary outcome measures were Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and return to work. The outcome questionnaire was completed preoperatively, at the 2-week follow-up visit, and monthly to 6 months after surgery. Results: All 3 treatment groups had similar mean QuickDASH scores preoperatively. At 1- to 6-month follow-up, all 3 groups had similar QuickDASH scores at each visit, and all showed a significant decline from baseline (preoperative) QuickDASH score. Overall, QuickDASH score decreased significantly from a preoperative visit mean of 42.7 to a final postoperative (visit 8) mean of 6.69. There was no significant difference in the mean QuickDASH score among all 3 groups at 6-month follow-up. There was no significance in the time of return to work among the 3 groups (standard therapy, 21.8 days; expedited therapy, 20.9 days; no therapy, 16.6 days). Conclusions: This investigation adds evidence that supervised hand therapy does not improve the outcomes of routine carpal tunnel surgery as measured by QuickDASH and return to work.
Social Rewards: From Basic Social Building Blocks to Complex Social Behavior
Authors: Tamir Diana I. , Hughes Brent L.
Published: November 2018

Humans are social creatures, engaging almost constantly in social behaviors that serve ultimate social goals, such as forming strong bonds with one another. However, most social behaviors provide only incremental progress toward an ultimate goal. Instead, the drive to engage in any individual social act may derive from its proximal value rather than its ultimate goal. Thus, this proximal value forms the foundation on which the complexities of human sociality are built. We describe two complementary approaches for using proximal social rewards to understand social behaviors and their ultimate goals: (a) decontextualizing social rewards—paring down complex social interactions can help identify which basic building blocks remain valuable even in minimalistic contexts—and (b) recontextualizing social rewards—reintroducing motivational and contextual factors into the study of social experience can help identify how proximal rewards serve their ultimate function. We discuss how this dual-approach framework can inform future research by bridging basic social building blocks and real-world social goals.
Statistical analysis plan for pooled individual patient data from two landmark randomized trials (INTERACT2 and ATACH-II) of intensive blood pressure lowering treatment in acute intracerebral hemorrhage
Authors: Moullaali Tom J , Wang Xia , Martin Renee' H , Shipes Virginia B , Qureshi Adnan I , Anderson Craig S , Palesch Yuko Y
Published: November 2018

Background

There is persistent uncertainty over the benefits of early intensive systolic blood pressure lowering in acute intracerebral hemorrhage. In particular, over the timing, target, and intensity of systolic blood pressure control for optimum balance of potential benefits (i.e. functional recovery) and risks (e.g. cerebral ischemia).

Aims

To determine associations of early systolic blood pressure lowering parameters and outcomes in patients with a hypertensive response in acute intracerebral hemorrhage. Secondary aims are to identify the modifying effects of patient characteristics and an optimal systolic blood pressure lowering profile.

Methods

Individual participant data pooled analyses of two large, multicenter, randomized controlled trials specifically undertaken to assess the effects of early intensive systolic blood pressure reduction on clinical outcomes in acute intracerebral hemorrhage: the Intensive Blood Pressure in Acute Intracerebral Hemorrhage Trial (INTERACT2) and the Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-II) trial. Combined data will include baseline characteristics; systolic blood pressure in the first 24 h; process of care measures; and key efficacy and safety outcomes.

Outcomes

The primary outcome is functional recovery, defined by an ordinal distribution of scores on the modified Rankin scale at 90 days post-randomization. Secondary outcomes include various standard binary cut-points for disability-free survival on the modified Rankin scale, and health-related quality of life at 90 days. Safety outcomes include symptomatic hypotension requiring corrective therapy and early neurologic deterioration within 24 h, and deaths, any serious adverse event, and cardiac and renal serious adverse events, within 90 days.

Discussion

A pre-determined protocol was developed to facilitate successful collaboration and reduce analysis bias arising from prior knowledge of the findings.

Clinical trial registration

URL: http://www.clinicaltrials.gov . Unique identifiers for INTERACT2 (NCT00716079) and ATACH-II (NCT01176565).
Joint optimization of components redundancy, spares inventory and repairmen allocation for a standby series system
Authors: Zhao Xian , Zhang Jing , Wang Xiaoyue
Published: November 2018

In the past, redundancy, inventory and maintenance are often considered separately to improve the system availability. Recently, a few joint optimization papers have emerged, but they only considered hot-standby redundancy, one-for-one-ordering inventory policy and the case of single repairman. In order to deepen the previous research, this article formulates a joint optimization model of components redundancy, spares inventory and repairmen allocation for a standby series system with an objective of maximizing system availability. As to the components redundancy, hot-standby, warm-standby and cold-standby are considered, respectively. A more general batching ordering inventory policy is adopted and the number of repairmen is added as a new element. By continuous time Markov process, related reliability probability indices are derived. Then the mathematical model is constructed and branch-and-bound method is employed to solve the optimal solution. Finally, we conduct analysis and comparison for different numerical examples and obtain the following results: cold-standby and warm-standby redundancy yield higher availabilities compared to hot-standby under the same conditions. The optimal batch ordering inventory policy is better than optimal one-for-one-ordering inventory policy if the spares replenishment rate is not high enough. Moreover, an optimal number of repairmen, which is always more than one, can be achieved to enhance the efficiency of maintenance.