bluuebunny/crossref_metadata_2025 huggingface dataset:
A Guided Wave Sensor Enabling Simultaneous Wavenumber-Frequency Analysis for Both Lamb and Shear-Horizontal Waves
Authors: Ren Baiyang , Cho Hwanjeong , Lissenden Cliff
Published: March 2017

Guided waves in plate-like structures have been widely investigated for structural health monitoring. Lamb waves and shear horizontal (SH) waves, two commonly used types of waves in plates, provide different benefits for the detection of various types of defects and material degradation. However, there are few sensors that can detect both Lamb and SH waves and also resolve their modal content, namely the wavenumber-frequency spectrum. A sensor that can detect both waves is desirable to take full advantage of both types of waves in order to improve sensitivity to different discontinuity geometries. We demonstrate that polyvinylidene difluoride (PVDF) film provides the basis for a multi-element array sensor that detects both Lamb and SH waves and also measures their modal content, i.e., the wavenumber-frequency spectrum.
Performance Analysis of Different Backoff Algorithms for WBAN-Based Emerging Sensor Networks
Authors: Khan Pervez , Ullah Niamat , Ali Farman , Ullah Sana , Hong Youn-Sik , Lee Ki-Young , Kim Hoon
Published: March 2017

The Carrier Sense Multiple Access with Collision Avoidance (CSMA/CA) procedure of IEEE 802.15.6 Medium Access Control (MAC) protocols for the Wireless Body Area Network (WBAN) use an Alternative Binary Exponential Backoff (ABEB) procedure. The backoff algorithm plays an important role to avoid collision in wireless networks. The Binary Exponential Backoff (BEB) algorithm used in different standards does not obtain the optimum performance due to enormous Contention Window (CW) gaps induced from packet collisions. Therefore, The IEEE 802.15.6 CSMA/CA has developed the ABEB procedure to avoid the large CW gaps upon each collision. However, the ABEB algorithm may lead to a high collision rate (as the CW size is incremented on every alternative collision) and poor utilization of the channel due to the gap between the subsequent CW. To minimize the gap between subsequent CW sizes, we adopted the Prioritized Fibonacci Backoff (PFB) procedure. This procedure leads to a smooth and gradual increase in the CW size, after each collision, which eventually decreases the waiting time, and the contending node can access the channel promptly with little delay; while ABEB leads to irregular and fluctuated CW values, which eventually increase collision and waiting time before a re-transmission attempt. We analytically approach this problem by employing a Markov chain to design the PFB scheme for the CSMA/CA procedure of the IEEE 80.15.6 standard. The performance of the PFB algorithm is compared against the ABEB function of WBAN CSMA/CA. The results show that the PFB procedure adopted for IEEE 802.15.6 CSMA/CA outperforms the ABEB procedure.
An Adaptive Damping Network Designed for Strapdown Fiber Optic Gyrocompass System for Ships
Authors: Sun Jin , Xu Xiaosu , Liu Yiting , Zhang Tao , Li Yao , Tong Jinwu
Published: March 2017

The strapdown fiber optic gyrocompass (strapdown FOGC) system for ships primarily works on external horizontal damping and undamping statuses. When there are large sea condition changes, the system will switch frequently between the external horizontal damping status and the undamping status. This means that the system is always in an adjustment status and influences the dynamic accuracy of the system. Aiming at the limitations of the conventional damping method, a new design idea is proposed, where the adaptive control method is used to design the horizontal damping network of the strapdown FOGC system. According to the size of acceleration, the parameters of the damping network are changed to make the system error caused by the ship’s maneuvering to a minimum. Furthermore, the jump in damping coefficient was transformed into gradual change to make a smooth system status switch. The adaptive damping network was applied for strapdown FOGC under the static and dynamic condition, and its performance was compared with the conventional damping, and undamping means. Experimental results showed that the adaptive damping network was effective in improving the dynamic performance of the strapdown FOGC.
Formulating Assessment Indices and Strategies for the Transition to Local Industrial Development in Taoyuan City, Taiwan
Authors: Pan Yung-Cheng , Chiu Yin-Hao
Published: March 2017

Local industries are crucial for enhancing urban competitiveness and are closely related to national economic performance. To sustainably develop local industries, a set of assessment indices should be formulated in addition to factors such as geographical environments, cultural history, development processes, and industrial structures for governments to promote development policies while satisfying the goal of sustainable industrial development. This study first adopted the fuzzy Delphi method to construct the indices for assessing local industrial development, referred to the action plans for the six key industries formulated by the Executive Yuan of Taiwan, and subsequently integrated the analytic hierarchy process and analytic network process to determine the order of priority for policies facilitating local industrial development for future reference. The results indicated that infrastructure, innovative research and development, and government policies are crucial bases for local industrial development. Furthermore, this study adopted Taoyuan to verify these indices and compiled expert suggestions to indicate that the government should prioritize the development of the biotechnology, green energy, and medical care industries. When developing local industries in the future, a set of assessment standards and policy analyses should be established for the government to enhance local industrial development and thus increase international competitive advantages by fully ascertaining the factors for industrial success and the characteristics of local advantages.
Interaction of Type IV Toxin/Antitoxin Systems in Cryptic Prophages of Escherichia coli K-12
Authors: Wen Zhongling , Wang Pengxia , Sun Chenglong , Guo Yunxue , Wang Xiaoxue
Published: March 2017

Toxin/antitoxin (TA) systems are widespread in prokaryotic chromosomes and in mobile genetic elements including plasmids and prophages. The first characterized Type IV TA system CbtA/CbeA was found in cryptic prophage CP4-44 in Escherichia coli K-12. Two homologous TA loci of CbtA/CbeA also reside in cryptic prophages of E. coli K-12, YkfI/YafW in CP4-6 and YpjF/YfjZ in CP4-57. In this study, we demonstrated that YkfI and YpjF inhibited cell growth and led to the formation of “lemon-shaped” cells. Prolonged overproduction of YkfI led to the formation of “gourd-shaped” cells and immediate cell lysis. YafW and YfjZ can neutralize the toxicity of YkfI or YpjF. Furthermore, we found that YkfI and YpjF interacted with cell division protein FtsZ in E. coli, but ectopic expression in Pseudomonas and Shewanella did not cause the formation of “lemon-shaped” cells. Moreover, deletion of all of the three toxin genes together decreased resistance to oxidative stress and deletion of the antitoxin genes increased early biofilm formation. Collectively, these results demonstrated that the homologous Type IV TA systems in E. coli may target cell division protein FtsZ in E. coli and may have different physiological functions in E. coli.
Linking Forest Cover to Water Quality: A Multivariate Analysis of Large Monitoring Datasets
Authors: Brogna Delphine , Michez Adrien , Jacobs Sander , Dufrêne Marc , Vincke Caroline , Dendoncker Nicolas
Published: March 2017

Forested catchments are generally assumed to provide higher quality water. However, this hypothesis must be validated in various contexts as interactions between multiple land use and land cover (LULC) types, ecological variables and water quality variables render this relationship highly complex. This paper applies a straightforward multivariate approach on a typical large monitoring dataset of a highly managed and densely populated area (Wallonia, Belgium; 10-year dataset), quantifying forest cover effects on nine physico-chemical water quality variables. Results show that forest cover explains about one third of the variability of water quality and is positively correlated with higher quality water. When controlling for spatial autocorrelation, forest cover still explains 9% of water quality. Unlike needle-leaved forest cover, broad-leaved forest cover presents an independent effect from ecological variables and explains independently 4.8% of water quality variability while it shares 5.8% with cropland cover. This study demonstrates clear independent effects of forest cover on water quality, and presents a method to tease out independent LULC effects from typical large multivariate monitoring datasets. Further research on explanatory variables, spatial distribution effects and water quality datasets could lead to effective strategies to mitigate pollution and reach legal targets.
Drought Characteristic Analysis Based on an Improved PDSI in the Wei River Basin of China
Authors: Zou Lei , Xia Jun , She Dunxian
Published: March 2017

In this study, to improve the efficiency of the original Palmer Drought Severity Index (PDSI_original), we coupled the Soil and Water Assessment tool (SWAT) and PDSI_original to construct a drought index called PDSI_SWAT. The constructed PDSI_SWAT is applied in the Wei River Basin (WRB) of China during 1960–2012. The comparison of the PDSI_SWAT with four other commonly used drought indices reveals the effectiveness of the PDSI_SWAT in describing the drought propagation processes in WRB. The whole WRB exhibits a dry trend, with more significant trends in the northern, southeastern and western WRB than the remaining regions. Furthermore, the drought frequencies show that drought seems to occur more likely in the northern part than the southern part of WRB. The principle component analysis method based on the PDSI_SWAT reveals that the whole basin can be further divided into three distinct sub-regions with different drought variability, i.e., the northern, southeastern and western part. Additionally, these three sub-regions are also consistent with the spatial pattern of drought shown by the drought frequency. The wavelet transform analysis method indicates that the El Niño-Southern Oscillation (ENSO) events have strong impacts on inducing droughts in the WRB. The results of this study could be beneficial for a scientific water resources management and drought assessment in the current study area and also provide a valuable reference for other areas with similar climatic characteristics.
Nasopharyngeal Non-Intestinal-Type Adenocarcinoma: A Case Report and Updated Review of the Literature
Authors: Jain C. , Caulley L. , Macdonald K.I. , Purgina B. , Lai C.K. , Esche B. , Johnson-Obaseki S.
Published: March 2017

Background: Non-intestinal-type adenocarcinoma is a malignancy traditionally found in the sinonasal cavity. To our knowledge, this case is the first reported of this rare condition originating in the nasopharynx. Case Presentation: A 67-year-old woman with nasopharyngeal non-intestinal-type adenocarcinoma, with an accompanying parapharyngeal mass received primary radiation treatment for both lesions. Her tumour subsequently persisted, with a concomitant conversion in pathology from a low- to a high-grade malignancy. Results: Non-intestinal-type and intestinal-type adenocarcinomas of the nasopharynx are extremely rare tumours and do not appear in the World Health Organization classification system. We review the pathophysiologic features of these malignancies and propose modifications to the current classification system. Conclusions: Non-intestinal-type adenocarcinoma should be included in the differential diagnosis of nasopharyngeal masses. In our experience, this tumour in this location showed a partial response to primary radiation but later converted from a low- to a high-grade adenocarcinoma.
Is There a Sex Effect in Colon Cancer? Disease Characteristics, Management, and Outcomes in Routine Clinical Practice
Authors: Quirt J.S. , Nanji S. , Wei X. , Flemming J.A. , Booth C.M.
Published: March 2017

Introduction: The incidence of colon cancer varies by sex. Whether women and men show differences in extent of disease, treatment, and outcomes is not well described. We used a large population-based cohort to evaluate sex differences in colon cancer. Methods: Using the Ontario Cancer Registry, all cases of colon cancer treated with surgery in Ontario during 2002–2008 were identified. Electronic records of treatment identified use of surgery and adjuvant chemotherapy. Pathology reports for a random 25% sample of all cases were obtained, and disease characteristics, treatment, and outcomes in women and men were compared. A Cox proportional hazards model was used to identify factors associated with overall (os) and cancer-specific survival (css). Results: The study population included 7249 patients who underwent resection of colon cancer; 49% (n = 3556) were women. Stage of disease and histologic grade did not vary by sex. Compared with men, women were more likely to have right-sided disease (55% vs. 44%, p ≤ 0.001). Surgical procedure and lymph node yield did not differ by sex. Adjuvant chemotherapy was delivered to 18% of patients with stage ii and 64% of patients with stage iii disease; when adjusted for patient- and disease-related factors, use of adjuvant chemotherapy was similar for women and men [relative risk: 0.99; 95% confidence interval (ci): 0.94 to 1.03]. Adjusted analyses demonstrated that os [hazard ratio (hr): 0.80; 95% ci: 0.75 to 0.86] and css (hr: 0.82; 95% ci: 0.76 to 0.90) were superior for women compared with men. Conclusions: Long-term survival after colon cancer is significantly better for women than for men, which is not explained by any substantial differences in extent of disease or treatment delivered.
Trastuzumab in Metastatic Breast Cancer after Complete Remission: An Expensive Commitment for an Entire Life?
Authors:   Current Oncology Editorial Office
Published: March 2017

Metastatic breast cancer has consistently been considered an incurable disease. [...]
A Canadian Perspective on the Subcutaneous Administration of Rituximab in Non-Hodgkin Lymphoma
Authors: MacDonald D. , Crosbie T. , Christofides A. , Assaily W. , Wiernikowski J.
Published: March 2017

Rituximab is widely used for the treatment of non-Hodgkin lymphoma, being a key component in most therapeutic regimens. Administration of the intravenous (IV) formulation is lengthy and places a significant burden on health care resources and patient quality of life. A subcutaneous (sc) formulation that provides a fixed dose of rituximab is being examined in a number of studies. Results indicate that the pharmacokinetics are noninferior and response rates are comparable to those obtained with the IV formulation. Moreover, the sc formulation is preferred by patients and health care providers and reduces administration and chair time. Additional advantages include a lesser potential for dosing errors, shorter preparation time, reduced drug wastage, and fewer infusion-related reactions. Despite the success of the sc formulation, correct administration is needed to reduce administration-related reactions. By using a careful procedure, the sc formulation can be given safely and effectively, potentially reducing the burden on health care resources and improving quality of life for patients.
Successful Treatment of Gastrointestinal Mucormycosis in an Adult with Acute LeukemiA: Case Report and Literature Review
Authors: Alghamdi A. , Lutynski A. , Minden M. , Rotstein C.
Published: March 2017

Mucormycosis has emerged as an important cause of invasive fungal infection in patients with hematologic malignancies. Gastrointestinal mucormycosis is an unusual presentation of this invasive fungal infection, and it causes considerable morbidity and mortality. Such outcomes are due in part to a nonspecific presentation that results in delays in diagnosis and treatment. Successful treatment of gastrointestinal mucormycosis involves surgical debridement and appropriate antifungal therapy.
Discovery of Water at High Spectral Resolution in the Atmosphere of 51 Peg b
Authors: Birkby J. L. , Kok R. J. de , Brogi M. , Schwarz H. , Snellen I. A. G.
Published: March 2017

We report the detection of water absorption features in the day side spectrum of the first-known hot Jupiter, 51 Peg b, confirming the star–planet system to be a double-lined spectroscopic binary. We use high-resolution (

100,000),

spectra taken with CRIRES/VLT to trace the radial-velocity shift of the water features in the planet’s day side atmosphere during 4 hr of its 4.23 day orbit after superior conjunction. We detect the signature of molecular absorption by water at a significance of

at a systemic velocity of

km s−1, coincident with the 51 Peg host star, with a corresponding orbital velocity

km s−1. This translates directly to a planet mass of

, placing it at the transition boundary between Jovian and Neptunian worlds. We determine upper and lower limits on the orbital inclination of the system of

. We also provide an updated orbital solution for 51 Peg b, using an extensive set of 639 stellar radial velocities measured between 1994 and 2013, finding no significant evidence of an eccentric orbit. We find no evidence of significant absorption or emission from other major carbon-bearing molecules of the planet, including methane and carbon dioxide. The atmosphere is non-inverted in the temperature–pressure region probed by these observations. The deepest absorption lines reach an observed relative contrast of

with respect to the host star continuum flux at an angular separation of 3 milliarcseconds. This work is consistent with a previous tentative report of K-band molecular absorption for 51 Peg b by Brogi et al.
A Search for Kilonovae in the Dark Energy Survey
Authors: Doctor Z. , Kessler R. , Chen H. Y. , Farr B. , Finley D. A. , Foley R. J. , Goldstein D. A. , Holz D. E. , Kim A. G. , Morganson E. , Sako M. , Scolnic D. , Smith M. , Soares-Santos M. , Spinka H. , Abbott T. M. C. , Abdalla F. B. , Allam S. , Annis J. , Bechtol K. , Benoit-Lévy A. , Bertin E. , Brooks D. , Buckley-Geer E. , Burke D. L. , Rosell A. Carnero , Kind M. Carrasco , Carretero J. , Cunha C. E. , D’Andrea C. B. , Costa L. N. da , DePoy D. L. , Desai S. , Diehl H. T. , Drlica-Wagner A. , Eifler T. F. , Frieman J. , García-Bellido J. , Gaztanaga E. , Gerdes D. W. , Gruendl R. A. , Gschwend J. , Gutierrez G. , James D. J. , Krause E. , Kuehn K. , Kuropatkin N. , Lahav O. , Li T. S. , Lima M. , Maia M. A. G. , March M. , Marshall J. L. , Menanteau F. , Miquel R. , Neilsen E. , Nichol R. C. , Nord B. , Plazas A. A. , Romer A. K. , Sanchez E. , Scarpine V. , Schubnell M. , Sevilla-Noarbe I. , Smith R. C. , Sobreira F. , Suchyta E. , Swanson M. E. C. , Tarle G. , Walker A. R. , Wester W. ,   (DES Collaboration)
Published: March 2017

The coalescence of a binary neutron star pair is expected to produce gravitational waves (GW) and electromagnetic radiation, both of which may be detectable with currently available instruments. We describe a search for a predicted r-process optical transient from these mergers, dubbed the “kilonova” (KN), using griz broadband data from the Dark Energy Survey Supernova Program (DES-SN). Some models predict KNe to be redder, shorter-lived, and dimmer than supernovae (SNe), but the event rate of KNe is poorly constrained. We simulate KN and SN light curves with the Monte-Carlo simulation code SNANA to optimize selection requirements, determine search efficiency, and predict SN backgrounds. Our analysis of the first two seasons of DES-SN data results in 0 events, and is consistent with our prediction of 1.1 ± 0.2 background events based on simulations of SNe. From our prediction, there is a 33% chance of finding 0 events in the data. Assuming no underlying galaxy flux, our search sets 90% upper limits on the KN volumetric rate of 1.0

Gpc−3 yr−1 for the dimmest KN model we consider (peak i-band absolute magnitude

mag) and 2.4

Gpc−3 yr−1 for the brightest (

mag). Accounting for anomalous subtraction artifacts on bright galaxies, these limits are ∼3 times higher. This analysis is the first untriggered optical KN search and informs selection requirements and strategies for future KN searches. Our upper limits on the KN rate are consistent with those measured by GW and gamma-ray burst searches.
Recovering Interstellar Gas Properties with Hi Spectral Lines: A Comparison between Synthetic Spectra and 21-SPONGE
Authors: Murray Claire E. , Stanimirović Snežana , Kim Chang-Goo , Ostriker Eve C. , Lindner Robert R. , Heiles Carl , Dickey John M. , Babler Brian
Published: March 2017

We analyze synthetic neutral hydrogen (H i) absorption and emission spectral lines from a high-resolution, three-dimensional hydrodynamical simulation to quantify how well observational methods recover the physical properties of interstellar gas. We present a new method for uniformly decomposing H i spectral lines and estimating the properties of associated gas using the Autonomous Gaussian Decomposition (AGD) algorithm. We find that H i spectral lines recover physical structures in the simulation with excellent completeness at high Galactic latitude, and this completeness declines with decreasing latitude due to strong velocity-blending of spectral lines. The temperature and column density inferred from our decomposition and radiative transfer method agree with the simulated values within a factor of

for the majority of gas structures. We next compare synthetic spectra with observations from the 21-SPONGE survey at the Karl G. Jansky Very Large Array using AGD. We find more components per line of sight in 21-SPONGE than in synthetic spectra, which reflects insufficient simulated gas scale heights and the limitations of local box simulations. In addition, we find a significant population of low-optical depth, broad absorption components in the synthetic data which are not seen in 21-SPONGE. This population is not obvious in integrated or per-channel diagnostics, and reflects the benefit of studying velocity-resolved components. The discrepant components correspond to the highest spin temperatures (

), which are not seen in 21-SPONGE despite sufficient observational sensitivity. We demonstrate that our analysis method is a powerful tool for diagnosing neutral interstellar medium conditions, and future work is needed to improve observational statistics and implementation of simulated physics.
Outplacement in the Defence Sector Environment
Authors: Binková Kristýna , Bednář Zdeněk
Published: March 2017

The article deals with ways to help soldiers with the integration into the labour market after leaving the military service. Its aim is to describe the current state of knowledge in conditions of the Czech defence department and methods of so called outplacement in selected European countries. Within the description of the current situation in the Czech Republic, the article focuses on the training of a professional soldier, retraining courses and other measures that are implemented. While processing the text, literature search, analysis of legislative and statistical documents and direct interviews with experts from the Ministry of Defence and other experts from foreign ministries and institutions of the defence department were applied. The article provides a summary of the pros and cons of preparation of soldier for a career in the civilian sector in the Czech Republic, and submits suggestions for improving the current situation.
From Bombing to Targeted Killings: Transformations of the US Fighting Against Global Terrorism
Authors: Eichler Jan , Stejskalová Kristýna
Published: March 2017

The aim of the article is to compare foreign policy of G. W. Bush jr. and Barack Obama in terms of use of military force. Transition from ground operations to targeted killings is demonstrated on three military operations - Operation Enduring Freedom, Operation Iraqi Freedom and Operation Inherent Resolve. The shift from bombers to drones had several reasons, mainly changing features of the threat. Authors are asking questions why and how did change the US fight against global terrorism with respect to military technologies and how is this change reflected in US fight against the threat of Islamic state.
The Effect of Widespread Pain on Knee Pain Worsening, Incident Knee Osteoarthritis (OA), and Incident Knee Pain: The Multicenter OA (MOST) Study
Authors: Carlesso Lisa C. , Niu Jingbo , Segal Neil A. , Frey-Law Laura A. , Lewis Cora E. , Nevitt Michael C. , Neogi Tuhina
Published: March 2017

Objective.

Whether widespread pain (WSP) affects the risk of developing knee pain or knee osteoarthritis (OA) is unknown and could enhance understanding of pain mechanisms in OA.

Methods.

Subjects from the Multicenter OA (MOST) study, a US National Institutes of Health–funded prospective cohort of older adults with or at risk of knee OA, were characterized regarding WSP, defined as pain above and below the waist on both sides of the body and axially using a standard homunculus, excluding knee pain at 60 months (baseline). Followup occurred 2 years later. We assessed the relation of WSP to odds of knee pain worsening (≥ 2-point increase in the Western Ontario and McMaster Universities Arthritis Index pain subscale) using logistic regression, and to odds of incident radiographic knee OA (ROA; Kellgren-Lawrence arthritis scale ≥ grade 2 of either knee among those free of ROA at baseline) and incident consistent frequent knee pain (CFKP; knee pain on most days during the past month among participants free of knee pain at baseline) in 1 or both knees using multinomial regression adjusting for potential confounders.

Results.

There were 1752 participants available for analysis [mean age (SD) 67.0 yrs (7.7), body mass index 30.5 kg/m2(5.9), 59% women]. Baseline presence of WSP was not associated with worsened knee pain (adjusted OR 1.15, 95% CI 0.89–1.48, p = 0.30), ROA (adjusted OR 0.86, 95% CI 0.46–1.63, p = 0.65), or incident CFKP (adjusted OR 1.69, 95% CI 0.96–2.96, p = 0.07).

Conclusion.

WSP was not significantly associated with worsening knee pain, incident ROA, or CFKP. Development of knee pain and ROA does not appear to be influenced by underlying WSP.
Incidence hospitalière des taux annuels d’hospitalisation pour maladies thromboemboliques veineuses en France et aux USA
Authors: Quantin Catherine , Allaert F. A. , Benzenine E.
Published: March 2017

Objectif : Décrire l’incidence hospitalière et les taux annuels d’hospitalisation pour maladies thromboemboliques veineuses (MTEV), thromboses veineuses profondes (TVP) et embolies pulmonaires (EP) chez les patients hospitalisés dans les hôpitaux français et américains. Méthodes : Les statistiques sont issues des bases nationales de données transmises et validées par les établissements de santé ayant une activité d’hospitalisation en médecine, chirurgie, obstétrique (MCO). La comparaison a été réalisée avec les données du Centers for Disease Control and Prevention issues du National Hospital Discharge Survey (NHDS) sur la base de la Classification Internationale des Maladies (CIM). Résultats : Les résultats portent sur l’ensemble des hospitalisations aux USA et en France durant la période d’étude. Aux États-Unis, l’incidence hospitalière des MVTE est de 1,4 %, celle des TVP de 0,9 % et celle des EP de 0,7 %. En France, elles sont respectivement de 1,0 %, 0,6 % et de 0,5 %. Les taux annuels d’hospitalisation globaux sont respectivement de 274, 179 et 139 pour 100 000 habitants en France et de 239, 146 et 121 pour 100 000 habitants aux USA. Dans les deux pays et selon des proportions comparables, les taux annuels d’hospitalisation pour MVTE augmentent avec l’âge mais diffèrent peu en fonction du sexe. Conclusion : Les MTEV sont présentes en France comme aux USA dans 1 % de l’ensemble des séjours hospitaliers et sont à l’origine d’un taux annuel d’hospitalisations qui dépasse 200 pour 100 000 habitants. L’importance de ces incidences annuelles doit conduire à s’interroger sur la qualité de la prévention mise en place et/ou sur son efficacité en pratique libérale mais aussi à l’hôpital et requière que des politiques de prévention plus volontaristes et plus systématiques soient mises en œuvre tant dans l’intérêt des personnes que de l’économie de la Santé.
Le processus de privatisation du secteur des établissements d’hébergement pour personnes âgées dépendantes
Authors: Delouette Ilona , Nirello Laura
Published: March 2017

L’objet de cet article est de décortiquer le processus de privatisation du secteur des EHPAD. L’analyse s’appuie sur une série d’entretiens réalisée auprès d’acteurs clés du domaine et sur l’étude d’un corpus de rapports d’institutions publiques et privées. Nous montrons que la privatisation du secteur est encouragée par les pouvoirs publics au travers de plusieurs dispositifs. D’abord, dès 1997, les régulateurs du champ construisent un rapport de concurrence entre les différents types d’établissements du secteur (public, économie sociale, privé lucratif) en abrogeant la relation privilégiée qu’ils entretenaient avec les acteurs traditionnels non lucratifs, et en ouvrant les financements publics aux établissements privés lucratifs. Les autorités de tarification imposent aussi, au travers des instruments de financement, une médicalisation des établissements menant à une standardisation de leurs activités. Ces normes favorisent le développement des groupes lucratifs tout en affaiblissant les acteurs traditionnels de l’économie sociale et du public, moins armés face aux nouvelles règlementations et ainsi affaiblis financièrement. Nous observons aussi une concentration économique des groupes d’EHPAD résultant d’incitations publiques et de leur mise en concurrence face à un faible nombre de nouvelles places autorisées. La concentration ouvre enfin la voie à une financiarisation progressive des établissements qu’ils soient privés lucratifs ou de l’économie sociale. La privatisation du secteur s’opère donc par le biais de la croissance du privé lucratif face à un tarissement de l’économie sociale et du public, par l’incorporation des normes du privé par les gestionnaires du champ et, par la privatisation des financements des établissements.
Les hôpitaux militaires français : quel est l’impact des opérations extérieures sur l’organisation ?
Authors: Despatin Jane , Nakhla Michel , Auroy Yves , Wable Éric
Published: March 2017

Les hôpitaux militaires français ont fait l’objet d’un rapport de la Cour des comptes établissant un déficit budgétaire important. Ce rapport soulève la question de la juste prise en compte des activités de défense dans le bilan financier de ces hôpitaux. Dans cet article, nous proposons d’étudier l’impact de la participation des personnels hospitaliers aux opérations extérieures sur le bloc opératoire afin de comprendre les implications des missions de défense pour l’organisation en terme d’activité de soin et donc de recettes. Notre étude repose sur une étude qualitative de ces questions, basée sur l’analyse de 27 entretiens menés au près de personnels hospitaliers, ainsi que sur une étude quantitative basée sur une simulation du processus chirurgical dans deux des neuf hôpitaux militaires. Les résultats de l’étude quantitative et qualitative convergent pour établir que la participation des personnels hospitaliers aux opérations extérieures peut induire une réduction variable de l’activité chirurgicale. Notre étude permet également d’établir que certaines stratégies organisationnelles mises en place par les personnels peuvent favoriser la résilience de l’hôpital sollicité pour les opérations extérieures. Au-delà du cadre des hôpitaux militaires, notre étude présente un intérêt méthodologique pour améliorer le financement des activités hors-soins (enseignement, recherche et missions d’intérêt général) et étudier la résilience à l’hôpital.
Predictor of Self-Perceived Nursing Competency Among New Nurses in Taiwan
Authors: Chen Shu-Hwa , Chen Mei-Fang , Kuo Mei-Ling , Li Yi-Hui , Chiang Ming-Chu
Published: March 2017

The aim of this article is to identify the factors that predict self-perceived nursing competency among new nurses in Taiwan. This quantitative cross-sectional survey was performed with a convenience sample of 105 new nurses. Data were collected with questionnaires. Multiple linear regression showed perceived benefit of preceptor policies to nursing capacity and age accounted for 21.1% of the variance in dependent variables for self-perceived nursing competency importance. Satisfaction with current preceptor, satisfaction with current nursing job, and participation in interprofessional education conferences accounted for 22% of the variance in dependent variables for self-perceived nursing competency adequacy. The results could be a reference to design nursing education curricula that improve clinical training and retention of new nurses.

J Contin Educ Nurs.
2017;48(3):129–137.
El papel de la naturaleza física y biológica en la sociología de Norbert Elias. Entre el naturalismo y el sociologismo
Authors: Romero Moñivas Jesús
Published: March 2017

Este artículo tiene como objetivo desarrollar aquellos aspectos de la obra de Norbert Elias en los que entran en juego consideraciones acerca de la naturaleza físico-cosmológica y la naturaleza biológica en su comprensión de la sociedad y del ser humano. Su interés en las ciencias físico-naturales se descubre en gran parte de su producción escrita, especialmente en sus trabajos dedicados a la emergencia cosmológica de los diferentes niveles de la realidad y en lo que respecta a las discusiones acerca de la naturaleza humana. Puede concluirse que el papel de la naturaleza en Elias es ambivalente y bascula entre el naturalismo y el sociologismo, con puntos de contacto y colisión con ambos.
Considerações sobre a federalização e a gestão compartilhada do território na Amazônia brasileira
Authors: Rocha Gilberto de Miranda , Gonçalves Sabrina Fortes e Silva
Published: March 2017

A federalização do território tem sido, desde a década de 1970, um instrumento jurídico e político utilizado, no âmbito da organização do Estado brasileiro, por diferentes governos (militares e civis) para implementar a integração regional e garantir a apropriação e o uso dos recursos naturais da região. Durante, pelo menos os últimos quarenta anos, a intervenção federal constituiu-se como alicerce de sucessivos planos, programas e projetos de desenvolvimento regional. As reformas políticas e institucionais estabelecidas com a promulgação da Constituição Federal de 1988 redefiniram as relações intergovernamentais. A gestão compartilhada do território emerge como proposição a partir de então, apontando para a valorização das esferas de governo subnacionais (estados e municípios) em assuntos pertinentes à organização territorial, à regulação do uso dos recursos naturais e a mecanismos de regulação social e política.
Shanghai et Guangzhou sont les deux agglomérations urbaines les plus peuplées du monde
Authors: Moriconi-Ebrard François , Perez Joan
Published: March 2017

La mise à jour des populations des agglomérations de la base de données Geopolis montre que les deux agglomérations les plus peuplées de la Planète sont désormais situées en Chine. En 2010, avec 79,7 millions d’habitants urbanisés d’un seul tenant, Shanghai pulvérise le record détenu auparavant par Tokyo. La deuxième agglomération du monde est la conurbation de Guangzhou-Shenzhen, qui atteint 47,5 millions d’habitants. Cet article explique tout d’abord pourquoi ces chiffres ne sont pas – et ne peuvent pas - être officiels, au regard des fondements confirmatoires de la définition de la ville en Chine, qui s’opposent à la dimension exploratoire des statistiques dans les sciences humaines occidentales. L’article rappelle ensuite brièvement la définition morphologique et la méthodologie utilisée, en rapport avec les sources dont on dispose aujourd’hui sur la Chine. Les résultats présentés esquivent le piège trivial des superlatifs qui envahissent trop facilement la littérature sur les plus grandes villes du monde au préjudice de la compréhension plus générale de ce phénomène. Pour ce faire, la taille des agglomérations Chinoises est d’abord relativisée à celle du pays, aux choix de développement récents opérés par le gouvernement, et enfin à la place de cette civilisation dans l’histoire urbaine plurimillénaire de l’humanité. L’approche morphologique met aussi en lumière la forme nouvelle, résolument polycentrique et plus extensive, que prennent depuis quelques années toutes les grandes métropoles de la planète. Par leurs tailles exceptionnelles, les agglomérations de Shanghai et de Guangzhou nous donnent finalement à réfléchir sur des définitions, des concepts et des défis qui dépassent largement le seul Empire du Milieu.
Can Ratio of Neutrophil-Tolymphocyte Count and Erythrocyte Sedimentation Rate in Diabetic Foot Infection Predict Osteomyelitis and/or Amputation?
Authors: Yapıcı Oktay , Berk Hande , Öztoprak Nefise , Seyman Derya , Tahmaz Alper , Merdin Alparslan
Published: March 2017

The aim of this study was to search for any relations between the neutrophil-tolymphocyte ratio (NLR) and the development of osteomyelitis and the need for amputation in patients with diabetic foot infection (DFI). All data included DFI patients who were hospitalized in our Infectious Diseases Clinic between 2012 and 2015 and who were classified according to International Classification Disease Code System. 75 patients were analyzed in the study. The DFI patients were stratified into 3 groups of whom had amputation procedure, whom had only debridement/drainage procedure and whom had any surgery procedure. Sidac post hoc analysis was used to perform the effects of NLR, C-reactive protein, erythrocyte sedimentation rate and glycosylated hemoglobin on the surgery procedure status. The DFI patients were also stratified into two another separate group for another analysis to search for the effect of NLR values on the development of osteomyelitis. The mean value of NLR in the amputated patients’ group (15.7 ± 10.3 was significantly higher than those with debridement procedure (9.9 ± 5.6) and those without any surgery (6.0 ± 2.8) (p = 0.001). NLR values were also found significantly higher in patients with osteomyelitis in the second analysis (p = 0.004). In this study, the NLR was found to have a predictive value on the development of osteomyelitis and on the progression to amputation in patients with DFI.
Motor-Neuron Pool Excitability of the Lower Leg Muscles After Acute Lateral Ankle Sprain
Authors: Klykken Lindsey W. , Pietrosimone Brian G. , Kim Kyung-Min , Ingersoll Christopher D. , Hertel Jay
Published: March 2017

Context: Neuromuscular deficits in leg muscles that are associated with arthrogenic muscle inhibition have been reported in people with chronic ankle instability, yet whether these neuromuscular alterations are present in individuals with acute sprains is unknown.

Objective: To compare the effect of acute lateral ankle sprain on the motor-neuron pool excitability (MNPE) of injured leg muscles with that of uninjured contralateral leg muscles and the leg muscles of healthy controls.

Design: Case-control study.

Setting: Laboratory.

Patients or Other Participants: Ten individuals with acute ankle sprains (6 females, 4 males; age = 19.2 ± 3.8 years, height = 169.4 ± 8.5 cm, mass = 66.3 ±11.6 kg) and 10 healthy individuals (6 females, 4 males; age = 20.6 ± 4.0 years, height = 169.9 ± 10.6 cm, mass = 66.3 ± 10.2 kg) participated.

Intervention(s): The independent variables were group (acute ankle sprain, healthy) and limb (injured, uninjured). Separate dependent t tests were used to determine differences in MNPE between legs.

Main Outcome Measure(s): The MNPE of the soleus, fibularis longus, and tibialis anterior was measured by the maximal Hoffmann reflex (Hmax) and maximal muscle response (Mmax) and was then normalized using the Hmax:Mmax ratio.

Results: The soleus MNPE in the ankle-sprain group was higher in the injured limb (Hmax:Mmax = 0.63; 95% confidence interval [CI], 0.46, 0.80) than in the uninjured limb (Hmax:Mmax = 0.47; 95% CI, 0.08, 0.93) (t6 = 3.62, P = .01). In the acute ankle-sprain group, tibialis anterior MNPE tended to be lower in the injured ankle (Hmax:Mmax = 0.06; 95% CI, 0.01, 0.10) than in the uninjured ankle (Hmax:Mmax = 0.22; 95% CI, 0.09, 0.35), but this finding was not different (t9 = −2.01, P = .07). No differences were detected between injured (0.22; 95% CI, 0.14, 0.29) and uninjured (0.25; 95% CI, 0.12, 0.38) ankles for the fibularis longus in the ankle-sprain group (t9 = −0.739, P = .48). We found no side-to-side differences in any muscle among the healthy group.

Conclusions: Facilitated MNPE was present in the involved soleus muscle of patients with acute ankle sprains, but no differences were found in the fibularis longus or tibialis anterior muscles.
Absorption of Iontophoresis-Driven 2% Lidocaine With Epinephrine in the Tissues at 5 mm Below the Surface of the Skin
Authors: Draper David O. , Coglianese Mark , Castel Chris
Published: March 2017

Context: In a recent study, we were unable to measure lidocaine in the human calf at a 5-mm depth via iontophoresis. We surmised that this might be due to a lack of epinephrine in the compound. Because epinephrine is a vasoconstrictor, it might allow the drug to pass beyond the capillaries and be delivered to the deeper tissues.

Objective: To determine if iontophoresis could deliver lidocaine with epinephrine 5 mm under the surface of human skin, as measured by microdialysis.

Design: Descriptive laboratory study.

Setting: Therapeutic modalities research laboratory.

Patients or Other Participants: Ten volunteers (5 males, 5 females; age, 15–28 years) with less than 5 mm of adipose tissue in the area we measured and with no allergies to lidocaine participated. The measurement area had been free of any injury, swelling, or infection for at least 3 months before the study.

Intervention(s): We inserted a microdialysis probe 0.5 cm under the skin of the right lower leg. Next, microdialysis was performed through this area for 60 minutes, which allowed local skin blood flow to return to baseline. We then performed iontophoresis at 40 mA/min using 2 mL of 2% lidocaine. Iontophoresis was performed over this area for 10.5 minutes to collect the lidocaine samples. After this stage, the electrode was left in place for another 50 minutes for a total of 60 minutes.

Main Outcome Measure(s): The samples of the drug were analyzed via reverse-phase high-performance liquid chromatography (RP-HPLC) in the chemistry department.

Results: The RP-HPLC analysis confirmed the presence of lidocaine in all 10 participants. The mean concentration of lidocaine detected at the 5-mm depth was calculated as 3.63 mg/mL (greater than 18% of delivered concentration).

Conclusions: We found that 2% lidocaine can be delivered up to 5 mm below the surface of the skin when the drug compound contains epinephrine and when passive delivery occurs for at least 50 minutes after the active delivery has terminated.
Certified Athletic Trainers' Knowledge of Methicillin-Resistant Staphylococcus aureus and Common Disinfectants
Authors: Kahanov Leamor , Gilmore Elizabeth J. , Eberman Lindsey E. , Roberts Jeffrey , Semerjian Tamar , Baldwin Linda
Published: March 2017

Context: Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly common in athletic settings. The MRSA knowledge and infection-control practices of certified athletic trainers (ATs) and the cleanliness of the athletic training room are important factors in preventing MRSA infections.

Objective: To assess knowledge of MRSA and the use of common disinfectants among ATs and to explore their infection-control practices.

Design: Cross-sectional study.

Setting: High school and collegiate athletic training rooms.

Patients or Other Participants: A total of 163 ATs from National Collegiate Athletic Association Divisions I, II, and III and high schools, representing all 10 National Athletic Trainers' Association districts.

Main Outcome Measure(s): Frequencies, analyses of variance, and χ2 tests were used to assess current practices and opinions and relationships between factors.

Results: Methicillin-resistant Staphylococcus aureus was perceived as a national problem by 92% of respondents; 57% perceived MRSA as a problem in their practice setting. Most respondents had treated general infections (88%), staphylococcal infections (75%), and MRSA infections (57%). Male sex was associated with treating all 3 types of infections (χ2 test, P < .05). Noncurriculum education was associated with a lack of recognition of environmental issues as risk factors and with the use of isopropyl alcohol for disinfection (χ2 test, P < .05). For example, 10% of respondents did not recognize that contaminated whirlpools can be a source of MRSA infection. Respondents also incorrectly identified effective cleaning solutions. Thirty percent of respondents cleaned their hands frequently or sometimes before treating each athlete and 35% cleaned their hands sometimes, occasionally, or never after seeing each athlete.

Conclusions: The majority of ATs were informed about MRSA and made correct disinfection choices. However, improvements are still needed, and not all ATs were using proper disinfection practices.
Overcoming Barriers to Implementation of Evidence-Based Practice Concepts in Athletic Training Education: Perceptions of Select Educators
Authors: Manspeaker Sarah , Van Lunen Bonnie
Published: March 2017

Context: The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making.

Objective: To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers.

Design: Qualitative interviews of emergent design with grounded theory.

Setting: Undergraduate CAATE-accredited athletic training education programs.

Patients or Other Participants: Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± 7.06.

Data Collection and Analysis: Interviews were conducted to evaluate perceived barriers and strategies for overcoming these barriers to implementation of evidence-based concepts in the curriculum. Interviews were explored qualitatively through open and axial coding. Established themes and categories were triangulated and member checked to determine trustworthiness.

Results: Educators identified 3 categories of need for EBP instruction: respect for the athletic training profession, use of EBP as part of the decision-making toolbox, and third-party reimbursement. Barriers to incorporating EBP concepts included time, role strain, knowledge, and the gap between clinical and educational practices. Suggested strategies for surmounting barriers included identifying a starting point for inclusion and approaching inclusion from a faculty perspective.

Conclusions: Educators must transition toward instruction of EBP, regardless of barriers present in their academic programs, in order to maintain progress with other health professions' clinical practices and educational standards. Because today's students are tomorrow's clinicians, we need to include EBP concepts in entry-level education to promote critical thinking, inspire potential research interest, and further develop the available body of knowledge in our growing clinical practice.