bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffuse Subcutaneous Emphysema and Pneumomediastinum Secondary to a Minor Blunt Chest Trauma
Authors: Storz Maximilian Andreas , Heymann Eric P. , Exadaktylos Aristomenis K.
Published: March 2017

Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall. Computed tomography (CT) demonstrated right-sided costal fractures (ribs 7 to 9), with diffuse subcutaneous emphysema and pneumomediastinum due to laceration of the visceral and parietal pleura and the adjacent lung parenchyma. In addition, a small ipsilateral pneumothorax was found. Surprisingly, the clinical status was only minimally affected by mild to moderate pain and minor functional impairment.
Unusual Case of Osseointegrated Dental Implant Migration into Maxillary Sinus Removed 12 Years after Insertion
Authors: Laureti Mauro , Ferrigno Nicola , Rosella Daniele , Papi Piero , Mencio Francesca , De Angelis Francesca , Pompa Giorgio , Di Carlo Stefano
Published: March 2017

Displacement of dental implants into the maxillary sinus is not an uncommon event in implant dentistry and may lead to serious complications, such as sinusitis. To avoid systemic problems, performing the removal of the foreign body as soon as possible is suggested. Despite the fact that early implants dislocation has been reported several times, late migration into maxillary sinus has been described by just a few studies. The purpose of this study was to report a rare case of dental implant migration into maxillary sinus after 12 years of function. A 61-year-old woman came to our attention in June 2015 after being visited by an otolaryngologist and being diagnosed with sinusitis and presence of a foreign body into the right maxillary sinus. A panoramic radiograph and a CT scan showed the migration of dental implant sited in 1.6 positions into the maxillary sinus. The implant was removed following a Caldwell-Luc procedure under local anesthesia. Postoperative course was uncomplicated and the patient reported no symptoms of sinusitis after 12 months of follow-up.
Disrupting Androgen Receptor Signaling Induces Snail-Mediated Epithelial–Mesenchymal Plasticity in Prostate Cancer
Authors: Miao Lu , Yang Lin , Li Rui , Rodrigues Daniel N. , Crespo Mateus , Hsieh Jer-Tsong , Tilley Wayne D. , de Bono Johann , Selth Luke A. , Raj Ganesh V.
Published: March 2017

Epithelial-to-mesenchymal plasticity (EMP) has been linked to metastasis, stemness, and drug resistance. In prostate cancer, EMP has been associated with both suppression and activation of the androgen receptor (AR) signaling. Here we investigated the effect of the potent AR antagonist enzalutamide on EMP in multiple preclinical models of prostate cancer and patient tissues. Enzalutamide treatment significantly enhanced the expression of EMP drivers (ZEB1, ZEB2, Snail, Twist, and FOXC2) and mesenchymal markers (N-cadherin, fibronectin, and vimentin) in prostate cancer cells, enhanced prostate cancer cell migration, and induced prostate cancer transformation to a spindle, fibroblast-like morphology. Enzalutamide-induced EMP required concomitant suppression of AR signaling and activation of the EMP-promoting transcription factor Snail, as evidenced by both knockdown and overexpression studies. Supporting these findings, AR signaling and Snail expression were inversely correlated in C4-2 xenografts, patient-derived castration-resistant metastases, and clinical samples. For the first time, we elucidate a mechanism explaining the inverse relationship between AR and Snail. Specifically, we found that AR directly repressed SNAI1 gene expression by binding to specific AR-responsive elements within the SNAI1 promoter. Collectively, our findings demonstrate that de-repression of Snail and induction of EMP is an adaptive response to enzalutamide with implications for therapy resistance. Cancer Res; 77(11); 3101–12. ©2017 AACR.
Mediastinal Mass in a Patient with Colorectal Cancer: A Diagnostic Challenge
Authors: Martins Cláudio , Sousa Paula , Araújo Tarcísio , Castro-Poças Fernando , Pedroto Isabel
Published: March 2017

The differential diagnosis of mediastinal masses involves many benign and malignant conditions, such as lymphadenopathies and cystic lesions. Metastatic mediastinal adenopathies are usually due to lung, esophagus, and stomach cancer and, rarely, due to colorectal cancer. Gastrointestinal duplication cysts are uncommon inherited lesions usually diagnosed during childhood and may involve the esophagus in 20% of cases. In adults, they are usually asymptomatic and diagnosed incidentally. We report the case of a 54-year-old male who recently underwent sigmoidectomy due to an obstructive colon adenocarcinoma. Staging computed tomography scan showed a hypodense lesion in the posterior mediastinum suggestive of metastatic adenopathy. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion with intramural location in the upper esophagus, suggestive of a duplication esophageal cyst. Given the oncologic background and to exclude metastatic disease, endoscopic ultrasound-guided fine needle aspiration was performed, and a mucinous fluid was aspirated. The cytologic examination supported the ultrasonographic diagnostic hypothesis. This case highlights the role of endoscopic ultrasound in the differential diagnosis of mediastinal masses, particularly in oncologic patients, in order to rule out more ominous lesions.
Treatment of Postoperative Leaks of the Upper Gastrointestinal Tract with Colonic Self-Expandable Metal Stents
Authors: Sousa Paula , Castanheira António , Martins Diana , Pinho Juliana , Araújo Ricardo , Cancela Eugénia , Ministro Paula , Silva Américo
Published: March 2017

Introduction: The use of self-expandable metal stents (SEMS) for the treatment of postoperative leaks of the upper gastrointestinal tract is already established. However, there are discrepancies between the relatively small caliber of the esophageal stents available and the postsurgical luminal size, which may determine an inadequate juxtaposition. As colonic stents have a bigger diameter, they might be more adequate. Additionally, stents with a larger diameter might have a lower risk of migration. Materials and Methods: The aim of this study was to evaluate the efficacy and complications associated with the use of colonic fully covered SEMS (FSEMS) in the treatment of postoperative leaks in critical patients. All patients with postoperative leaks of the upper gastrointestinal tract treated with colonic stents (Hanarostent® CCI) between 2010 and 2013 were retrospectively included. Results: Four patients with postoperative leaks were treated with colonic SEMS. The underlying surgeries were a gastric bypass, an esophagogastrectomy for Boerhaave syndrome, a primary repair of esophagopleural fistula due to Boerhaave syndrome, and an esophagectomy due to esophageal cancer. The leaks were detected on average 17 days after the initial surgery. All patients needed admission to a critical care unit after index surgery. Stent placement was technically feasible in all patients. The median residence time of the stents was 7 weeks, and no complications were verified when they were removed. There were no cases of stent migration. The treatment was successful in all patients, with complete healing of the leaks. Discussion and Conclusions: The placement of colonic FSEMS seems to be successful and safe in the treatment of postoperative leaks of the upper gastrointestinal tract.
Pulse Pressure, Instead of Brachium-Ankle Pulse Wave Velocity, is Associated with Reduced Kidney Function in a Chinese Han Population
Authors: Jia Linpei , Zhang Weiguang , Ma Jie , Chen Xizhao , Chen Lei , Li Zuoxiang , Cai Guangyan , Huang Jing , Zhang Jinping , Bai Xiaojuan , Feng Zhe , Sun Xuefeng , Chen Xiangmei
Published: March 2017

Background/Aims: In this study, we aim to investigate the association between renal function and arterial stiffness in a Chinese Han population, and further to discuss the effects of smoking on renal function. Methods: We collected the data of the brachium-ankle pulse wave velocity (baPWV), blood pressure, blood chemistry and smoking status. Then, the multiple linear regression was done to explore the relationship between estimated glomerular filtration (eGFR) and baPWV. Further, the parameters were compared among the four groups divided according to the quartiles of baPWV. Finally, the baPWV, eGFR and albuminuria values were compared between smokers and non-smokers. Results: baPWV is associated with eGFR in the correlation analysis and univariate linear regression model. After adjustment, the pulse pressure (PP) instead of baPWV showed a significant association with eGFR. Nevertheless, the eGFR values differed among the four baPWV groups; the baPWV values were significantly higher in the subjects at the CKD (eGFR<60 mL/min/1.73 m2) and the early CKD stage (eGFR60–80 mL/min/1.73 m2). The baPWV values and the ratio of proteinuria were significantly increased in smokers. Conclusion: PP but not baPWV is a predictor of declined renal function. Smokers have worse arterial stiffness and worse renal function.
Epistemological Ambivalence: Richard Rorty on Religion and Public Discourse
Authors: Reynolds Terrence
Published: March 2017

The late Richard Rorty famously argued that faith-based positions grounded in comprehensive worldviews or unassailable texts served as ‘conversation-stoppers’ and should be excluded from the public sphere. This article argues that Rorty’s position flies in the face of his own postmodern epistemology as well as his insistence on the humility and virtues that should attend the collective pursuit of the social good. It suggests that there are two Rortys at work and that his epistemological ambivalence undermines the force of his argument.
Bayān Yasn: State of the Art
Authors: König Götz
Published: March 2017

The Nask Bayān, once part of the so called Greater (Sasanian) Avesta, but now lost, became a central issue of discussion in the Avestan Studies over the last 15 years. These discussions tried to clarify its relation to the collection of the Yašts (and to the Xorde Avesta) and to reconstruct types of a liturgical celebration of this Bayān Nask or of parts of it. The following article gives an overview on the recent research. It gives also some new suggestions concerning the structure of the collection of the Yašts.
The Iraqi Kurdistan in the Post-Saddam Era: Security, Natural Resources and Foreign Policy Activism
Authors: Akreyi Hemin R. Akram
Published: March 2017

This paper examines the role of security and the factor of natural resources in strengthening the Iraqi Kurdistan Region’s foreign relations. The author finds that, in the post-Saddam period, despite countless obstacles from various sides, the KRG has managed to use security/stability and the oil and gas of the Region to develop and strengthen its foreign relations to a significant extent, which just a few years ago was nearly impossible for a federated unit, such as the Kurdistan Region in Iraq, to achieve.
Hobbes’s De Corpore on Modalities and Its Contemporary Critiques
Authors: Pécharman Martine
Published: March 2017

Hobbes considered as unambiguous and unproblematic his demonstration in De Corpore that every effect past, present or future is necessary, since it always requires a sufficient cause that cannot be sufficient without being necessary, so that nothing is possible which will not be actual at some time. Now, this approach to necessity and possibility was received by his contemporary readers as missing its aim. Two immediate criticisms of De Corpore by Moranus and Ward exhibit from this viewpoint an interesting difference as to their common argument that only hypothetical necessity can result from Hobbes’s premises. My essay relates this argumentative difference to the absence (Moranus) or presence (Ward) in the background of the free-will dispute between Hobbes and Bramhall. From there, I examine also different interpretations of the ‘hypothetical necessity-argument’ in the indirect critical reception of De Corpore, when the target is Hobbes’s necessitarianism in the controversy with Bramhall, based on significant material from his De Corpore project. Remarkably, although Leibniz agrees with Bramhall that Hobbes only proves a hypothetical necessity, Leibniz’s understanding of hypothetical necessity is not that of Bramhall. Another striking difference is displayed in the use of the ‘hypothetical necessity-argument’ by More, which as it were blurs the connection of the free-will issue with Hobbes’s general doctrine of causality.
Erratum for “Two new species of Eugenia (Myrtaceae) from Central Amazonia, Brazil”
Authors: DE SOUZA MARIA ANÁLIA D. , SCUDELLER VERIDIANA V. , DE MENDONÇA MARIA SÍLVIA
Published: March 2017

N/A
A new species of Aframomum (Zingiberaceae) from D.R. Congo
Authors: FISCHER EBERHARD , KIRUNDA BEN , EWANGO CORNEILLE , LEAL MIGUEL , KUJIRAKWINJA DEO , BAMBA ARCEL , PLUMPTRE ANDREW J.
Published: March 2017

Aframomum ngamikkense, a new species from the Misotshi-Kabogo Massif in the Albertine Rift, Eastern D.R. Congo, is described and illustrated. It differs from the superficially similar A. pseudostipulare in the shorter and obtuse ligules up to 5 mm long (vs. acute and up to 10 mm long), and the indistinctly 3-lobed apex of the stamen (vs. distinctly 3-lobed).
Three new species of Cheilolejeunea (Spruce) Steph. (Lejeuneaceae, Marchantiophyta) from Neotropics
Authors: BASTOS CID JOSÉ PASSOS , SCHÄFER-VERWIMP A.
Published: March 2017

Three new species of the genus Cheilolejeunea are described and illustrated: C. cyrtolejeuneoides sp. nov. and C. grosseoleosa sp. nov. both from Brazil, and C. azureomontana sp. nov. from Jamaica. Cheilolejeunea cyrtolejeuneoides is similar to C. holostipa and C. insecta but mainly differing by autoicous plants and deeply bifid underleaves; Cheilolejeunea grosseoleosa is characterized by dioicous plants, small size, strongly crenulate keel, and differs mainly from other species of the genus by its single large coarsely segmented oil body per cell, composed only of 4‒6 globules; Cheilolejeunea azureomontana is characterized by autoicous plants, leaves spreading, spathulate to slightly obovate leaf lobe, basal cells forming a poorly differentiated vitta, and cells toward margin obliquely arranged. The number of Cheilolejeunea species worldwide is estimated at 140–150.
Review of Pennella Oken, 1816 (Copepoda: Pennellidae) with a description of Pennella benzi sp. nov., a parasite of Escolar, Lepidocybium flavobrunneum (Pisces) in the northwest Atlantic Ocean
Authors: HOGANS W. E.
Published: March 2017

The genus Pennella Oken, 1816, mesoparasitic copepods from marine fish and mammals, is reviewed with the objective of determining the validity of members of the genus. Details of the external morphological structures of the adult female are presented. Pennella species are differentiated based on a combination of characters: the type of host parasitized, overall length of the parasite, shape, size and configuration of cephalothoracic papillae, segmentation of the first and second antenna, holdfast horn number, shape and configuration, and structure of the abdominal plumes. A new species of Pennella, Pennella benzi sp. nov., is described from the escolar, Lepidocybium flavobrunneum in the northwest Atlantic. Pennella balaenoptera Koren & Danielssen, 1877 is reported from the harbor porpoise (Phocaena phocaena) in the Bay of Fundy, a new locality record. The validity of 44 species is assessed; nine species (P. balaenoptera Koren & Danielssen, 1877, P. benzi sp. nov., P. diodontis Oken, 1816, P. exocoeti (Holten, 1802), P. filosa Linnaeus, 1758, P. hawaiiensis Kazachenko & Kurochkin, 1974, P. instructa Wilson, 1917, P. makaira Hogans, 1988 and P. sagitta Linnaeus, 1758) are considered substantiated and valid; six species (P. elegans Gnanamuthu, 1957, P. longicauda Gnanamuthu, 1957, P. platycephalus Gnanamuthu, 1957, P. remorae Murray, 1856, P. robusta Gnanamuthu, 1957, and P. selaris Kirtisinghe, 1964) exhibit unique characteristics, but are based on descriptions of single specimens, have not been found since the original reports and are considered as species inquirendae; the remaining species are unsubstantiated and invalid based on inadequate or missing original descriptions, or are designated as synonyms of valid species. A key to the valid species of the genus is provided.
Nereididae (Annelida: Phyllodocida) of the Persian Gulf and Gulf of Oman, including description of two new species and 11 new records
Authors: BONYADI-NAEINI ALIEH , RASTEGAR-POUYANI NASRULLAH , RASTEGAR-POUYANI ESKANDAR , GLASBY CHRISTOPHER J. , RAHIMIAN HASSAN
Published: March 2017

Currently, only 31 nereidid species are known from the Persian Gulf and Gulf of Oman. The present study was carried out in order to investigate the poorly known diversity of nereidid polychaetes from seas of the southern coasts of Iran. Specimens were collected from 23 locations along the intertidal zones of the two water bodies. Among the 26 species found: two are new, and are described here, including Simplisetia qeshmensis sp. nov. and Neanthes biparagnatha sp. nov.; 11 are new geographical records. Neanthes biparagnatha sp. nov. is most similar to N. deplanata (Mohammed, 1971), which is also found in the Persian Gulf, but can be most easily distinguished from it by the presence of bars in addition to cones in Area IV of the pharynx. Simplisetia qeshmensis sp. nov. may be distinguished from its closest congener, S. erythraeensis (Fauvel, 1918), also reported from the Persian Gulf, by having a greater number of paragnaths in Area I of the pharynx, an additional type of chaeta (homogomph spinigers) in the ventral neuropodial fascicle and having a reduced notopodial lobe in posterior chaetigers. The list of new records includes: one species from both areas, Neanthes glandicincta (Southern, 1921); eight species from the Persian Gulf, Leonnates decipiens Fauvel, 1929, Neanthes acuminata (Ehlers, 1868), Neanthes sp., Neanthes sp. cf. N. acuminata, Nereis sp. cf. N. pelagica Linnaeus, 1758, Perinereis cultrifera (Grube, 1840) species complex., Pseudonereis trimaculata (Horst, 1924), Pseudonereis sp. cf. P. variegata (Grube, 1857) and two from the Gulf of Oman, Leonnates persicus Wesenberg-Lund, 1949 and Perinereis kuwaitensis Mohammed, 1970. The present study brings to 40 the number of nereidid species currently known from the Persian Gulf and Gulf of Oman. A taxonomic key to nereidid species from the intertidal zones of the Persian Gulf and Gulf of Oman is presented to facilitate future investigations.
Total Exchange Flow, Entrainment, and Diffusive Salt Flux in Estuaries
Authors: Wang Tao , Geyer W. Rockwell , MacCready Parker
Published: March 2017

The linkage among total exchange flow, entrainment, and diffusive salt flux in estuaries is derived analytically using salinity coordinates, revealing the simple but important relationship between total exchange flow and mixing. Mixing is defined and quantified in this paper as the dissipation of salinity variance. The method uses the conservation of volume and salt to quantify and distinguish the diahaline transport of volume (i.e., entrainment) and diahaline diffusive salt flux. A numerical model of the Hudson estuary is used as an example of the application of the method in a realistic estuary with a persistent but temporally variable exchange flow. A notable finding of this analysis is that the total exchange flow and diahaline salt flux are out of phase with respect to the spring–neap cycle. Total exchange flow reaches its maximum near minimum neap tide, but diahaline salt transport reaches its maximum during the maximum spring tide. This phase shift explains the strong temporal variation of stratification and estuarine salt content through the spring–neap cycle. In addition to quantifying temporal variation, the method reveals the spatial variation of total exchange flow, entrainment, and diffusive salt flux through the estuary. For instance, the analysis of the Hudson estuary indicates that diffusive salt flux is intensified in the wider cross sections. The method also provides a simple means of quantifying numerical mixing in ocean models because it provides an estimate of the total dissipation of salinity variance, which is the sum of mixing due to the turbulence closure and numerical mixing.
Matthew 9:9–17 and the Divine Bridegroom of Hosea
Authors: Eagy Ryan
Published: March 2017

Jesus’s use of the bridegroom imagery is usually connected to the divine bridegroom in the OT through systematic or biblical theological categories. This article argues that Matthew’s use of Hosea 6:6 in Matt 9:13 is an indicator that readers should understand Jesus’s bridegroom metaphor in Matt 9:15 as a claim to occupying the same role as the divine bridegroom of Hos 2:16. By following two lines of reasoning—the unity of Matt 9:9–17 and the literary and textual connections between Hos 6:6 and Hos 2:16—this paper will seek to demonstrate this high Christological claim was intentional in Matthew’s account.
The Intricacies of User Adjustments of Alerting Thresholds
Authors: Meyer Joachim , Sheridan Thomas B.
Published: March 2017

Objective:

We address the question of necessary conditions for users to adjust system settings, such as alarm thresholds, correctly.

Background:

When designing systems, we need to decide which system functions users should control. Giving control to users empowers them, but users must have the relevant information and the ability to adjust settings correctly for their control to be beneficial.

Method:

Using the example of adjusting an alerting threshold, we analyze the conditions for when users can and when they cannot possibly adjust threshold settings adequately.

Results:

We identify two obstacles that limit users’ ability to adjust thresholds adequately: (a) the difficulty of determining the correct threshold settings, especially because of users’ strong response to false positive indications, and (b) the difficulty of collecting the information necessary for setting the threshold.

Conclusion:

Users often cannot identify the optimal settings for a system, so it is unlikely that they choose adequate system settings.

Application:

System designers must consider the difficulties users face and analyze them explicitly when deciding on user involvement in processes.
Imagining Her Future: Diversity in Mothers’ Socialization Goals for Their Adolescent Daughters
Authors: Ramirez Jennifer , Oshin Linda , Milan Stephanie
Published: March 2017

According to developmental niche theory, members of different cultural and ethnic groups often have distinct ideas about what children need to become well-adapted adults. These beliefs are reflected in parents’ long-term socialization goals for their children. In this study, we test whether specific themes that have been deemed important in literature on diverse families in the United States (e.g., Strong Black Woman [SBW], marianismo, familismo) are evident in mothers’ long-term socialization goals. Participants included 192 mothers of teenage daughters from a low-income city in the United States (58% Latina, 22% African American, and 20% European American [EA]/White). Socialization goals were assessed through a q-sort task on important traits for a woman to possess and content analysis of open-ended responses about what values mothers hoped they would transmit to their daughters as they become adults. Results from ANCOVAs and logistic regression indicate significant racial/ethnic differences on both tasks consistent with hypotheses. On the q-sort task, African American mothers put more importance on women possessing traits such as independence than mothers from other racial/ethnic groups. Similarly, they were more likely to emphasize self-confidence and strength in what they hoped to transmit to their daughters. Contrary to expectation, Latina mothers did not emphasize social traits on the q-sort; however, in open-ended responses, they were more likely to focus on the importance of motherhood, one aspect of marianismo and familismo. Overall, results suggest that these mothers’ long-term socialization goals incorporate culturally relevant values considered important for African American and Latino families.
TESOL Teachers’ Engagement with the Native Speaker Model: How Does Teacher Education Impact on Their Beliefs?
Authors: Nguyen Mai Xuan Nhat Chi
Published: March 2017

This research investigates non-native English teachers’ engagement with the native speaker model, i.e. whether they agree/disagree with measuring English teaching and learning performance against native speaker standards. More importantly, it aims to unearth the impact of teacher education on teachers’ attitudes and beliefs about “native-speakerness”. Data were gathered from an online survey delivered to 85 Vietnamese TESOL teachers who had completed one of 19 Master’s level TESOL programmes offered overseas and in Vietnam, followed by in-depth interviews with 20 participants. The results revealed that teacher education strengthened the teachers’ beliefs about the linguistic diversity of English and led them to question the native and non-native divide by providing relevant input and opportunities to engage in critical discussion on nativeness, as well as fruitful learning experience. However, language proficiency is an area where “native-speakerness” still dominates, and where teacher education did not exert much influence. These findings shed light on the role of TESOL teacher training in influencing teacher beliefs about the native speaker model, and suggest that teacher education programmes dedicate more space for teachers to critically explore the construct of language teacher proficiency.
Rotor spinning transfer channel design optimization via computational fluid dynamics
Authors: Lin Huiting , Bergadà Josep M , Zeng Yongchun , Akankwasa Nicholus T , Zhang Yuze , Wang Jun
Published: March 2017

The conventional rotor spinning unit generates flow vortices in the transfer channel upstream region which affect the fiber configuration and consequently yarn properties. Geometry and spinning parameters such as transfer channel length, inlet width, rotor outlet pressure, opening roller speed, and diameter were found to be key parameters influencing airflow characteristics. To reduce the flow vortices in the upper stream region, modifications of the transfer channel were proposed, and their airflow fields were analyzed using computational fluid dynamics. Three designs were studied: a round transfer channel inlet, a bypass channel for extra air supply, and one with both the bypass and the round inlet. Analysis of airflow revealed that the design with both round transfer channel inlet and a bypass proved to be very effective in properly directing the flow and minimizing vortices. The design was also characterized by smoother velocity streamlines and maximum mass flow across the transfer channel. A conventional rotor spinning unit was modified in which a round transfer channel inlet corner and a bypass channel were utilized to conduct the experimental tests. Three sets of yarn samples were produced using the conventional and modified rotor spinning units under different rotor speed conditions. Yarn properties were tested. Properties such as tenacity, CVm%, and thin and thick places of the spun yarns produced by the new design improved compared to that of the conventional yarn.
Medicaid Managed Care and the Health Care Utilization of Foster Children
Authors: Palmer Makayla , Marton James , Yelowitz Aaron , Talbert Jeffery
Published: March 2017

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large enough to contain a sufficient number of foster children for such analysis. Using administrative Medicaid data from Kentucky, we use retrospective difference-in-differences analysis to compare the outpatient utilization of foster children transitioned to MMC in one region of the state with foster children in the rest of the state who remained in fee-for-service coverage. We find that the transition to MMC led to a 4 percentage point reduction in the probability of having any monthly outpatient utilization. We also estimate that MMC leads to a reduction in outpatient spending.
Design and control of a tendon-driven continuum robot
Authors: Li Minhan , Kang Rongjie , Geng Shineng , Guglielmino Emanuele
Published: March 2017

Continuum robots are suitable for operating in unstructured environments owing to their intrinsic compliance. This paper presents a novel tendon-driven continuum robot equipped with two modules and a compliant backbone formed by helical springs. Each module is driven by four parallel arranged tendons to implement a redundant actuation system that guarantees dexterous motions of the robot. A position feedback controller for the continuum robot is then developed, and a quadratic programming algorithm is incorporated into the controller to achieve a smooth configuration of the robot. Experiments results show that the control method has good trajectory tracking performance against external disturbances.
Development of the Systems Thinking Scale for Adolescent Behavior Change
Authors: Moore Shirley M. , Komton Vilailert , Adegbite-Adeniyi Clara , Dolansky Mary A. , Hardin Heather K. , Borawski Elaine A.
Published: March 2017

This report describes the development and psychometric testing of the Systems Thinking Scale for Adolescent Behavior Change (STS-AB). Following item development, initial assessments of understandability and stability of the STS-AB were conducted in a sample of nine adolescents enrolled in a weight management program. Exploratory factor analysis of the 16-item STS-AB and internal consistency assessments were then done with 359 adolescents enrolled in a weight management program. Test–retest reliability of the STS-AB was .71, p = .03; internal consistency reliability was .87. Factor analysis of the 16-item STS-AB indicated a one-factor solution with good factor loadings, ranging from .40 to .67. Evidence of construct validity was supported by significant correlations with established measures of variables associated with health behavior change. We provide beginning evidence of the reliability and validity of the STS-AB to measure systems thinking for health behavior change in young adolescents.
The psychological impact of prolonged disorders of consciousness on caregivers: a systematic review of quantitative studies
Authors: Soeterik Sonja M , Connolly Sarah , Playford E Diane , Duport Sophie , Riazi Afsane
Published: March 2017

Objective:

Systematic review of the nature, frequency and severity of psychological experiences of people who have a close relationship with a person with a prolonged disorder of consciousness.

Data sources:

Cochrane Library, Web of Science, PsycINFO, PubMed, Embase®, MEDLINE®, Allied and Complementary Medicine™, were searched from inceptions until December 2016 with additional hand searching of reference lists of included articles.

Review methods:

Studies were included that used quantitative methodologies and psychological measures to investigate experiences. The PRISMA statement was followed with inclusion criteria set a priori. A data synthesis summarized psychological constructs studied.

Results:

A total of 18 studies (ranging between n = 16–487 participants) met the inclusion criteria with 15 of 18 studies focused on the primary caregiver. A total of 23 standardized psychological measures were identified to assess four primary psychological constructs: Loss and grief, psychological wellbeing changes, burden and use of coping strategies.

Conclusions:

Small sample sizes, limited variables and reliance on observational methods affected quality. Caregivers do find ways to manage independently, but some exhibit clinically significant psychological distress that does not change over time alone and may get worse.
‘Doing with …’ rather than ‘doing for …’ older adults: rationale and content of the ‘Stay Active at Home’ programme
Authors: Metzelthin Silke F , Zijlstra Gertrud AR , van Rossum Erik , de Man-van Ginkel Janneke M , Resnick Barbara , Lewin Gill , Parsons Matthew , Kempen Gertrudis IJM
Published: March 2017

Background:

Owing to increasing age, accidents or periods of illness, home care services are provided to community-dwelling older adults. Traditionally, these services focus on doing things for older adults rather than with them; though from a rehabilitative perspective, it is important to assist older adults to attain and maintain their highest level of functioning. Consequently, a re-orientation of home care services is required away from treating disease and creating dependency towards focusing on capabilities and opportunities and maximising independence. To achieve this behavioural change in home care professionals, the ‘Stay Active at Home’ programme was developed.

Aims and methods:

The aim of this article is to give a detailed description of the rationale and content of the ‘Stay Active at Home’ programme by making use of the TIDieR (Template for Intervention Description and Replication) Checklist.

Approach:

‘Stay Active at Home’ is a comprehensive training programme that aims to equip home care professionals (i.e. community nurses and domestic support workers) with the necessary knowledge, attitude, skills and social and organisational support to deliver day-to-day services at home from a more rehabilitative perspective. More specifically, home care professionals are expected to deliver goal-oriented, holistic and person-centred services focusing on supporting older adults to maintain, gain or restore their competences to engage in physical and daily activities so that they can manage their everyday life as independently as possible.
Facilitating integrated delivery of services across organisational boundaries: Essential enablers to integration
Authors: Best Stephanie
Published: March 2017

Introduction

Integrating services is a key tenet to developing services across the United Kingdom. While many aspects of integration have been explored, how to facilitate integration of services remains unclear.

Method

An exploratory qualitative study was undertaken in 2015 to explore occupational therapists’ perceptions on integrating service provision across health and social care organisational boundaries. The views of practitioners who had experienced integration were sought on a range of aspects of integrating services. This paper focuses on the facilitators for delivering integration and the essential enablers are identified.

Findings

Numerous factors were noted to facilitate integration and three essential enablers were highlighted. Leadership, communication and joint education were recognised as playing a central role in integrating services across organisational boundaries; without these three essential enablers, integration is liable to fail.

Conclusion

Integration is a process rather than an event; continued emphasis will be required on leadership, communication and joint education to progress integration achievements made to date.
A numerical prediction of flexural strength probability for NBG-18 nuclear grade graphite using strength pair model
Authors: Bansal Manik , Singh Indra Vir , Mishra Bhanu K , Sharma Kamal , Khan IA
Published: March 2017

In this work, a strength pair model has been proposed for the numerical prediction of flexural strength probability of NBG-18 nuclear grade graphite. The input to the proposed model is a random strength pair of tensile and compressive strengths whose value is based on its probability of occurrence in the experimental data. A finite element–based deterministic numerical approach has been implemented. To account for the large difference in tensile and compressive strengths, Drucker–Prager failure criteria has been implemented. The failure envelope of the Drucker–Prager failure criteria is assumed to have uniaxial fit with Mohr–Coulomb model in the principal stress space. A total of 292 simulations with random pairs of tensile and compressive strength are performed on a three-point bend specimen to obtain a set of flexural strength data. The flexural strength data obtained through numerical simulations are fitted using normal and Weibull distributions. The flexural strength probability obtained from the proposed model is found on conservative side. A goodness-of-fit test concludes that Weibull distribution fits the numerical data better than normal distribution.
Allograft Augmentation of Hamstring Autograft for Younger Patients Undergoing Anterior Cruciate Ligament Reconstruction: Clinical and Cost-Effectiveness Analyses
Authors: Jacobs Cale A. , Burnham Jeremy M. , Makhni Eric C. , Malempati Chaitu S. , Swart Eric C. , Johnson Darren L.
Published: March 2017

Background:

Younger patients and those with smaller hamstring autograft diameters have been shown to be at significantly greater risk of graft failure after anterior cruciate ligament (ACL) reconstruction. To date, there is no information in the literature about the clinical success and/or cost-effectiveness of increasing graft diameter by augmenting with semitendinosus allograft tissue for younger patients.

Hypothesis:

Hybrid hamstring grafts are a cost-effective treatment option because of a reduced rate of graft failure.

Study Design:

Cohort study (economic and decision analysis); Level of evidence, 3.

Methods:

We retrospectively identified patients younger than 18 years who had undergone ACL reconstruction by a single surgeon between 2010 and 2015. During this period, the operating surgeon’s graft selection algorithm included the use of bone–patellar tendon–bone (BTB) autografts for the majority of patients younger than 18 years. However, hamstring autografts (hamstring) or hybrid hamstring autografts with allograft augment (hybrid) were used in skeletally immature patients and in those whom the surgeon felt might have greater difficulty with postoperative rehabilitation after BTB graft harvest. Patient demographics, graft type, graft diameter, the time the patient was cleared to return to activity, and the need for secondary surgical procedures were compared between the hamstring and hybrid groups. The clinical results were then used to assess the potential cost-effectiveness of hybrid grafts in this select group of young patients with an ACL injury or reconstruction.

Results:

This study comprised 88 patients (hamstring group, n = 46; hybrid group, n = 42). The 2 groups did not differ in terms of age, sex, timing of return to activity, or prevalence of skeletally immature patients. Graft diameters were significantly smaller in the hamstring group (7.8 vs 9.9 mm; P < .001), which corresponded with a significantly greater rate of graft failure (13 of 46 [28.3%] vs 5 of 42 [11.9%]; P = .049). As a result of the reduced revision rate, the hybrid graft demonstrated incremental cost savings of US$2765 compared with the hamstring graft, and the hybrid graft was the preferred strategy in 89% of cases.

Conclusion:

Driven by increased graft diameters and the reduced risk of revision, hybrid grafts appear to be a more cost-effective treatment option in a subset of younger patients with an ACL injury.
All-Inside, All-Epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Athletes: Return to Sport, Incidence of Second Surgery, and 2-Year Clinical Outcomes
Authors: Cordasco Frank A. , Mayer Stephanie Watson , Green Daniel W.
Published: March 2017

Background:

Anterior cruciate ligament (ACL) injuries in skeletally immature athletes are increasing.

Purpose:

To evaluate the 2-year clinical outcomes of all-inside, all-epiphyseal ACL reconstruction in skeletally immature athletes with 3 to 6 years of remaining growth, with a focus on return to sport and the incidence of second surgery.

Study Design:

Case series; Level of evidence, 4.

Methods:

Twenty-three skeletally immature athletes were prospectively evaluated after all-epiphyseal ACL reconstruction utilizing a hamstring autograft. The athletes’ age, sex, sport, mechanism of injury, radiographs, and magnetic resonance imaging (MRI) findings were noted. The evaluation included a physical examination, KT-1000 arthrometer measurements, isokinetic testing, and validated outcome scores. Standing radiographs and spoiled gradient recalled echo MRI scans were obtained at 6, 12, and 24 months postoperatively. A quality of movement assessment and return-to-sport performance analysis were also performed.

Results:

Of the 23 athletes, 6 were female (mean age, 11.3 years), and 17 were male (mean age, 12.6 years). At a minimum follow-up of 2 years (range, 24-45 months), the mean International Knee Documentation Committee score was 94.6 ± 4.9, the mean Lysholm score was 97.9 ± 4.0, the mean Marx activity rating scale score was 13.4 ± 3.6, and the mean Hospital for Special Surgery Pediatric Functional Activity Brief Scale score was 23.9 ± 7.0. Lachman and pivot-shift test results were negative in all patients. The mean side-to-side difference on the KT-1000 arthrometer was 0.9 ± 0.5 mm and less tight on the operated side. No significant growth disturbances were noted; however, 6 athletes had a leg-length discrepancy of more than 5 mm (range, 6-18 mm). Two patients had overgrowth in the femur of more than 15 mm (16 mm and 18 mm). Two athletes (8.7%) required second surgery. The mean time to return to unrestricted activity was 13.5 months (range, 8-22 months).

Conclusion:

The all-inside, all-epiphyseal ACL reconstruction technique using a hamstring autograft demonstrates excellent subjective and objective clinical outcomes in skeletally immature athletes without physeal arrest.
Reliability of Life Satisfaction Measures in Middle School Students
Authors: Reckart Hannah , Huebner E. Scott , Hills Kimberly J.
Published: March 2017

A total of 248 students from one Southeastern U.S. middle school responded to measures of global and domain-based life satisfaction on three occasions, reflecting 5-month, 7-month, and 1-year time intervals. Alpha coefficients were all above .80 for each global and domain-based score on each occasion. The test–retest coefficients were variable, underscoring the importance of contextual factors in life satisfaction reports. Nevertheless, with the exception of the Friends domain, the retest coefficients for the global and domain-based scores all exceeded .50 across all three intervals, suggesting a moderate degree of stability yet potential sensitivity to changing life circumstances.
Assessing Selenium, Manganese, and Iodine Status in Pediatric Patients Receiving Parenteral Nutrition
Authors: Johnsen Jacob Clarke , Reese Susan Anne , Mackay Mark , Anderson Collin R. , Jackson Daniel , Paul Irasema Libertad
Published: March 2017

Background: Pediatric patients who are receiving parenteral nutrition (PN) unsupplemented with trace minerals can become deficient. Due to shortages in trace mineral products and the 2004 American Society for Parenteral and Enteral Nutrition report stating that individualized trace element supplementation may be warranted, a review was conducted concerning the trace minerals selenium (Se), manganese (Mn), and iodine (I). Method: A retrospective review of pediatric patients receiving PN that contained Se and Mn was conducted to determine if a difference existed between them and patients receiving PN without Se and Mn. Statistical analysis was done to assess a difference between trace mineral levels and the time to deficiency between supplemented and unsupplemented patients. Unsupplemented I patients had urine I levels assessed to determine deficiencies in patients receiving PN. Results: Plasma Se levels were measured at a mean of 20 days for supplemented patients (n = 131) and 19 days for nonsupplemented patients (n = 57) with no difference between groups (P = .2973). Plasma Mn levels were measured at a mean of 28 days, showing no statistical difference (P = .721). Of the 177 nonsupplemented I patients, 74% demonstrated I deficiencies without supplementation. Conclusions: Time to the development of a Se, Mn, or I deficiency is important to guide supplementation of exclusive PN in children when trace mineral products are short in supply. Our retrospective experience supports assessment of the trace minerals Se at 21 days and Mn at 30 days. It also suggests that some pediatric patients receiving PN are deficient in I.
Stalking Victimization in LGBTQ Adults: A Brief Report
Authors: Langenderfer-Magruder Lisa , Walls N. Eugene , Whitfield Darren L. , Kattari Shanna K. , Ramos Daniel
Published: March 2017

Stalking is often considered to be a form of interpersonal violence; yet, despite an increase in lesbian, gay, bisexual, transgender, and queer (LGBTQ)-specific research on other forms of interpersonal violence, such as intimate partner violence and sexual assault, there is a relative lack of literature on stalking victimization of LGBTQ individuals, particularly as it relates to gender identity. This is problematic given the results of numerous studies indicating LGBTQ individuals, and transgender individuals in particular, experience victimization in various forms and contexts at alarming rates. In the current study, we examined secondary data to determine the prevalence of lifetime stalking victimization and subsequent police reporting in a large community-based sample of LGBTQ individuals living in Colorado ( N = 1,116). In addition, using chi-square analyses, we examined independence of stalking experiences and police reporting by both gender identity ( transgender, cisgender male, cisgender female) and sexual orientation ( gay, lesbian, bisexual, heterosexual, queer, other). Approximately 15% of the total sample reported ever experiencing stalking; yet, only about one quarter of those who were stalked reported it to police. Although no statistically significant differences emerged by gender identity or sexual orientation, transgender, bisexual, and queer participants had the highest prevalence of lifetime stalking victimization. Moreover, these groups reported the lowest prevalence of reporting their victimization to the police. We provide suggestions to improve the development of research on this topic including a need for an inclusive definition of stalking and studies using larger, representative samples to better discern potential significant differences in stalking experiences of LGBTQ persons.