bluuebunny/crossref_metadata_2025 huggingface dataset:
Features of Water Cooperatives: A Comparative Study of Finland and Kenya
Authors: Arvonen Vesa , Kibocha Samuel N. , Katko Tapio S. , Pietilä Pekka
Published: June 2017

There are several ways of arranging rural water supply. One of these is through water cooperatives that have been established to provide water supply, irrigation, and/or sewerage services. Water cooperatives are found in developed countries such as Finland, Denmark, Austria, Canada, and United States, and in developing countries in South America, such as Bolivia and Chile. Water cooperatives or their equivalent organizations that exist in Kenya are called self-help water projects. Yet, surprisingly little attention has been paid to this option even in countries with rich tradition of cooperatives in other sectors. In this study, Finland and Kenya were selected for a comparative analysis of the identified features of water cooperatives. Best practices observed in the features with differences could be shared between the two countries.
Prognostic Impact of Urokinase Plasminogen Activator Receptor Expression in Pancreatic Cancer: Malignant Versus Stromal Cells
Authors: de Geus Susanna WL , Baart Victor M , Boonstra Martin C , Kuppen Peter JK , Prevoo Hendrica AJM , Mazar Andrew P , Bonsing Bert A , Morreau Hans , van de Velde Cornelis JH , Vahrmeijer Alexander L , Sier Cornelis FM
Published: June 2017

The urokinase plasminogen activator receptor (uPAR) has been proposed as a potential prognostic factor for various malignancies. The aim of this study is to assess the prognostic value of uPAR expression in neoplastic and stromal cells of patients with pancreatic adenocarcinoma. Urokinase plasminogen activator receptor expression was determined by immunohistochemistry in 122 pancreatic ductal adenocarcinomas. Kaplan-Meier and Cox regression analyses were used to determine the association with survival. Respectively 66%, 82% and 62% of patients with pancreatic cancer expressed uPAR in neoplastic cells, stromal, and in both combined. Multivariate analysis showed a significant inverse association between uPAR expression in both neoplastic and stromal cells and overall survival. The prognostic impact of uPAR in stromal cells is substantial, but not as pronounced as that of uPAR expression in neoplastic cells. This study suggests a role for uPAR as a biomarker to single out higher risk subgroups of patients with pancreatic cancer.
Pesticide Exposure and Health Problems Among Female Horticulture Workers in Tanzania
Authors: Mrema Ezra Jonathan , Ngowi Aiwerasia Vera , Kishinhi Stephen Simon , Mamuya Simon Henry
Published: June 2017

Commercialization of horticulture farming, expansion of farms, and the practice of monoculture favor the proliferation of pests, which in turn increases the need for pesticides. Increased exposure to pesticides is associated with inadequate knowledge on the hazardous nature of pesticides, poor hygiene practices, lack of availability of washing facilities, and insufficient adherence to precautionary instructions on pesticide labels. Mitigating the risks posed by pesticides is considered a less compelling interest than alleviating poverty. Women working in horticulture in Tanzania usually have low levels of education and income and lack decision-making power even on matters relating to their own health. This contributes to pesticide exposure and other health challenges. Because of multiple factors, some of which act as study confounders, few studies on exposure to pesticides and health effects have been conducted among women. This review identified factors that contribute to the increased health effects among women working in the horticultural industry and how these effects relate to pesticide exposure.
Pacing Spikes All Over
Authors: Shurrab Mohammed , Pagacz Teresa , Shauer Ayelet , Lashevsky Ilan , Newman David , Crystal Eugene
Published: June 2017

Ventricular safety pacing (VSP) is used to avoid cross talk by delivering ventricular stimulus shortly after an atrial-paced event if ventricular-sensed event occurs. Although VSP is a protective feature that exists for decades in different pacing devices, there are some reports of unfavorable outcomes of this algorithm. More so, health care providers sometimes face difficulties in interpreting and dealing with VSP strips. This case report discusses an important pacemaker algorithm and encourages further attention to possible pitfalls and hence avoids unnecessary interventions.
New insights into the burden and costs of multiple sclerosis in Europe: Results for Italy
Authors: Battaglia Mario , Kobelt Gisela , Ponzio Michela , Berg Jenny , Capsa Daniela , Dalén Johan ,   The European Multiple Sclerosis Platform
Published: June 2017

Introduction:

In order to estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated.

Objectives and methods:

This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption and work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in EUR 2015.

Results:

A total of 1010 patients (mean age = 45 years) participated in Italy. In total, 94% were below retirement age, and of these, 56% were employed. Employment was related to disability, and MS affected productivity at work in 77% of the patients. Overall, 96% and 65% of the patients experienced fatigue and cognitive difficulties as a problem, respectively. Mean utility and total annual costs were 0.735 and €22,900 at Expanded Disability Status Scale (EDSS) of 0–3, 0.534 and €40,100 at EDSS of 4–6.5, and 0.135 and €53,300 at EDSS of 7–9. The mean cost of a relapse was estimated to be €2600.

Conclusion:

This study illustrates the burden of MS on Italian patients and provides current data on MS that are important for the development of health policies.
New insights into the burden and costs of multiple sclerosis in Europe: Results for Poland
Authors: Selmaj Krzysztof , Kobelt Gisela , Berg Jenny , Orlewska Ewa , Capsa Daniela , Dalén Johan ,   The European Multiple Sclerosis Platform
Published: June 2017

Background:

In order to estimate the value of interventions in multiple sclerosis (MS) – where lifetime costs and outcomes cannot be observed – outcome data have to be combined with costs. This requires that cost data be regularly updated.

Objective and methods:

This study is part of a cross-sectional retrospective study in 16 European countries collecting current data on resource consumption, work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in 2015 Polish Zloty (PLN).

Results:

A total of 411 MS patients (mean age = 40 years) participated in Poland; 94% were below retirement age, and of these, 59% were employed. Employment was related to disability, and MS affected productivity for 85% of those working. Overall, 97% and 71% of patients experienced fatigue and cognition as important problems, respectively. Mean utility and total annual costs were 0.686 and 48,700 PLN at Expanded Disability Status Scale (EDSS) 0–3, 0.521 and 59,200 PLN at EDSS 4–6.5 and 0.208 and 81,600 PLN at EDSS 7–9, respectively. The average cost of a relapse was 3,900 PLN.

Conclusion:

This study illustrates the burden of MS on Polish patients and provides current data that are important for developing health policies.
New insights into the burden and costs of multiple sclerosis in Europe: Results for Spain
Authors: Oreja-Guevara Celia , Kobelt Gisela , Berg Jenny , Capsa Daniela , Eriksson Jennifer ,   The European Multiple Sclerosis Platform
Published: June 2017

Introduction:

In order to estimate the value of interventions in multiple sclerosis (MS) where lifetime costs and outcomes cannot be observed, outcome data have to be combined with costs. This requires that cost data be regularly updated.

Objectives and methods:

This study is part of a cross-sectional retrospective study in 16 countries collecting data on resource consumption, work capacity, health-related quality of life (HRQoL) and prevalent symptoms for patients with MS. Descriptive analyses are presented by level of severity, from the societal perspective, in EUR 2015.

Results:

A total of 462 patients (mean age 43 years) participated in Spain; 96% were below retirement age and of these, 45% were employed. Employment was related to disability, and MS affected productivity at work for 72% of those working. Overall, 92% and 64% of patients experienced fatigue and cognitive difficulties as a problem, respectively. Mean utility and total annual costs were estimated at 0.772 and €20,600 at Expanded Disability Status Scale (EDSS) 0–3, 0.486 and €48,500 at EDSS 4–6.5 and 0.182 and €68,700 at EDSS 7–9, respectively. The mean cost of a relapse was €2050.

Conclusion:

This study illustrates the burden of MS on Spanish patients and provides current data that are important for development of health policies.
Varicella-zoster meningovasculitis in a multiple sclerosis patient treated with natalizumab
Authors: Mulero Patricia , Auger Cristina , Parolin Laura , Fonseca Elena , Requena Manuel , Rio Jordi , Tintoré Mar , Rovira Alex , Montalban Xavier
Published: June 2017

Background:

Natalizumab is associated with the occasional occurrence of progressive multifocal leukoencephalopathy (PML). While natalizumab-associated PML is well described in multiple sclerosis (MS) patients, herpes and other infections have rarely been reported.

Objective:

To report a case of varicella-zoster (VZV) meningovasculitis in a MS patient treated with natalizumab.

Methods:

Case report.

Results:

A 48-year-old woman diagnosed with MS in treatment with natalizumab (Expanded Disability Status Scale (EDSS): 4.0). After 72 infusions, she complained of a holocraneal headache and a new unsteady gait with diplopia (EDSS: 5.0). A brain and spinal cord magnetic resonance (MR) scan showed a multifocal leptomeningeal enhancing nodular lesions and an angiography revealed irregularity of the proximal segments of cerebral arteries. Testing for VZV DNA by polymerase chain reaction (PCR) amplification was positive in cerebrospinal fluid. Treatment with endovenous acyclovir was started. After clinical improvement (EDSS: 4.5), treatment with natalizumab was restarted associated with oral acyclovir as prophylaxis.

Conclusion:

Neurologists should be aware of other possible neuroinfections besides PML in MS patients under natalizumab.
Story Blocks
Authors: Maxwell Deborah , Speed Chris , Pschetz Larissa
Published: June 2017

Digital technology is changing, and has changed the ways we create and consume narratives, from moving images and immersive storyworlds to digital long-form and multi-branched story experiences. At the same time, blockchain, the technology that underpins cryptocurrencies such as Bitcoin, is revolutionizing the way that transactions and exchanges occur. As a globally stored and collaboratively written list of all transactions that have ever taken place within a given system, the blockchain decentralizes money and offers a platform for its creative use. There are already examples of blockchain technologies extending beyond the realm of currency, including the decentralization of domain name servers that are not subject to government takedown and identity management and governance. By framing key blockchain concepts with past and present storytelling practices, this article raises questions as to how the principles and implementation of such distributed ledger technologies might be used within contemporary writing practices – that is, can we imagine stories as a currency or value system? We present three experiments that draw on some of the fundamental principles of blockchain and Bitcoin, as an instantiation of a blockchain implemented application, namely, (1) the ledger, (2) the blocks and (3) the mining process. Each low-fi experiment was intentionally designed to be very accessible to take part in and understand and all were conducted as discrete workshops with different sets of participants. Participants included a cohort of design students, technology industry and design professionals and writing and interaction design academics. Each experiment raised a different set of reflections and subsequent questions on the nature of digital, the linearity (or not) of narratives and collaborative processes.
‘Live and local’?
Authors: Murray Simone , Weber Millicent
Published: June 2017

Literary festivals throughout the English-speaking world have been enthusiastic adopters of digital technology: uploading podcasts of author talks, posting videos of panel sessions to video-sharing sites such as YouTube, inviting guest bloggers to comment on proceedings and encouraging live-tweeting as a means of reinforcing audience members’ participatory agency. Such innovations serve to expand festivals’ reach to encompass dispersed audiences and, moreover, increase the longevity of previously transient events. They hence provide evidence to justify writers’ festivals’ claims on public funding as well as to delineate vibrant online and offline bookish communities of interest. However, wholesale uptake of digital technology destabilizes some previous givens of the literary festival as they have coalesced since the phenomenon’s 1980s efflorescence. The concept of authorship undergoes profound changes in a climate of online performativity, constant availability to readerships and digitally diminished ‘aura’. Equally, previously passive audiences are reconceptualized as amateur critics, co-publicists and even co-publishers in the case of crowdsourced subscription publishing. Festival programming may be sampled live or archived, and audiences are only partially tethered to a particular geographical location – a disarticulation taken to another level by emerging online-only writers’ festivals such as the #TwitterFiction Festival and the Digital Writers’ Festival. What are the implications of these shifts for our conceptualization of 21st-century literary community? This article seeks to address this question by proposing a theoretical framework for examining the digital/literary festival interface, analyzing a wide range of terrestrial and online-only festivals and underpinning this analysis with empirical audience interviewing conducted at multiple Australian and UK writers’ festivals and book towns. In bringing together these strands, the article presents a detailed picture of an important and currently underexplored dimension of the public encounter with literature at a moment of profound digital change.
Elementary physical educators’ positioning in teaching English language learners
Authors: Sato Takahiro , Walton-Fisette Jennifer , Kim Insook
Published: June 2017

Public schools in the United States (US) have become more linguistically diverse. With the rise of English as a global language, English Language Learners (ELLs) experience “transnationalism”, which requires them to gain a critical and reflective knowledge of diverse cultures and the valuing of a new language and culture. Many teachers do not recognize the importance of language as a tool for teaching academic subjects. Teachers struggle to shape and guide conversations using language to help ELLs further their development. The purpose of this study was to explore elementary physical education (PE) teachers’ experiences with teaching ELLs. Based on positioning theory, this study employed an interpretive case study research design. Six PE teachers volunteered to participate in the study. Data were collected from a survey questionnaire, face-to-face interviews and follow-up e-mails. Three major interrelated and complex themes emerged from the data analysis. These recurrent themes were (a) race and cultural-based stereotype, (b) social inclusion and communication challenges, and (c) PE teachers’ learning experiences. Although each of the PE teachers expressed the view that there were challenges in working with ELLs, they believed that they should implement effective pedagogical methods (inclusive pedagogy), address social justice and diversity issues of ELLs, and develop a positive learning atmosphere for all students.
Who or what has agency in the discussion of antimicrobial resistance in UK news media (2010–2015)? A transitivity analysis
Authors: Collins Luke Curtis , Jaspal Rusi , Nerlich Brigitte
Published: June 2017

The increase in infections resistant to the existing antimicrobial medicines has become a topic of concern for health professionals, policy makers and publics across the globe; however, among the public there is a sense that this is an issue beyond their control. Research has shown that the news media can have a significant role to play in the public’s understanding of science and medicine. In this article, we respond to a call by research councils in the United Kingdom to study antibiotic or antimicrobial resistance as a social phenomenon by providing a linguistic analysis of reporting on this issue in the UK press. We combine transitivity analysis with a social representations framework to determine who and what the social actors are in discussions of antimicrobial resistance in the UK press (2010–2015), as well as which of those social actors are characterised as having agency in the processes around antimicrobial resistance. Findings show that antibiotics and the infections they are designed to treat are instilled with agency, that there is a tension between allocating responsibility to either doctors-as-prescribers or patients-as-users and collectivisation of the general public as an unspecified ‘we’: marginalising livestock farming and pharmaceutical industry responsibilities.
Evaluation of spatiotemporal trends and predictive modeling of non-accidental trauma utilizing geographical information systems
Authors: Smith Michael R , Shvilkina Tatyana , Pavalonis Albert G , Amberger Melissa A , Onursal Elif M , Long Zachary , Vanderet Danielle , Kollipara Karishma , Esposito Christopher , DiRusso Stephen M , Verrier Ronald , Baltazar Gerard , Davis Robert L
Published: June 2017

Background

Acts of violence can be considered random when viewed singularly, but are appreciable as patterns and clusters of an epidemic. Violence begets violence: it has been shown that people exposed to violence are more likely to harm themselves, their families, and members of the community. Our previous manuscript on this subject demonstrated distinct clusters of violent trauma, where each subtype appeared to have its own domain.

Methods

The location, date, time of day, and mechanism of injury of all non-accidental trauma patients from 1 January 2008 to 31 December 2013 were collected and analyzed. Kernel density analysis was used to identify areas of increased activity and these were compared by year. The areas identified were mapped by their latitude and longitude. The data for the year 2013 were used to determine the potential for the predictive value of the prior 5 years.

Results

Definite trends can be observed in the temporal distribution of trauma, with a higher incidence of violent trauma occurring between 6 pm and 6 am during the 6-year period. Seasonal variation of higher amounts of violent trauma is also observed from April through August. Predictive modeling did not yield significant results for the following year or for the following month using Crimestat software.

Conclusion

Discernable trends of trauma are able to be demonstrated based upon the identifiable clusters of assault but these clusters do not remain constant from year to year. Predictive modeling can assist with the identification of elevated incidents of activity, however has poor predictive value for the entirety of the year. The use of the Crimestat Time Series Forecasting Module is best served with the early indication of large changes in assault patterns. Further study and improved collaboration with the local police precincts and surrounding trauma centers is required to treat the epidemic of violence.
Tourists’ perspectives on hard and soft services toward rural tourism destination competitiveness: Community support as a moderator
Authors: Lo May-Chiun , Chin Chee-Hua , Law Fung-Yee
Published: June 2017

Rural tourism is an integrated part in the services field, and this industry has long been recognized as a valuable tool for economic development in rural destinations. However, the multiplying growth of rural tourism destinations has led to a stiff competition among the industry. Thus, the identification of tourists’ perspective on the hard and soft services components toward the development of rural tourism is a key element in surviving into the rapid tourism competition. The pivotal role of community support as an integral part of tourism product in ensuring sustainable development of rural tourism destination would also being the key indicator for the development of rural tourism. Hence, this study highlighted the importance of tourists’ perspective on hard services (tourism infrastructure and accommodation) and soft services (range of activities and special events) toward the competitiveness of rural tourism destination’s development with community support who act as a moderator. A total of 314 respondents comprising tourists who visited Kampung Semadang, Kampung Telaga Air, and Kubah National Park ( Kampung Matang), Kuching, Sarawak has voluntarily participated in this study. To assess the developed model, SmartPLS 2.0 (M3) is applied based on path modeling and bootstrapping. Interestingly, the findings revealed that tourists are more concerned about the quality of accommodation, infrastructure, range of activities, and special events for the development of tourism destination competitiveness in rural tourism destination. In addition, tourists also believed that the existence of community support is crucial in moderating the relationship between accommodation quality and tourism destination competitiveness. This study further discussed on the implications of the findings, limitations, and directions for future research.
Combustion and soot modelling of a high-pressure and high-temperature Dodecane spray
Authors: Aubagnac-Karkar Damien , Michel Jean-Baptiste , Colin Olivier , Darabiha Nasser
Published: June 2017

Diesel engines are known to be one of the main sources of soot particle emission in the atmosphere. The norms to restrain these emissions have created a need of accurate soot models for piston engine emissions prediction in the automotive industry. This article addresses this question by coupling a sectional soot model with a tabulated combustion model for Reynolds-averaged Navier–Stokes simulations of the engine combustion network Spray A, a high-pressure Dodecane spray with conditions very similar to diesel engine sprays. The sectional soot model, which has already been used in diesel engines Reynolds-averaged Navier–Stokes simulations with a simpler combustion model, is implemented in the IFP-C3D Reynolds-averaged Navier–Stokes computational fluid dynamics code. At each time and location, transport equations are solved for several soot sections, including source terms for collisional and chemical processes. The soot model is here coupled to the approximated diffusion flame – presumed conditional moment model, which is a tabulated combustion model. It allows to represent the minor species required by the soot model with a much lower computational cost than a kinetic solver and includes complex turbulence–chemistry interactions. The predictions of these models agree with the experimental measurements for most of the Spray A cases for flame structure and soot production. These results show that detailed soot models can be coupled to tabulated combustion models with good results in turbulent flames.
Communication technology use and study skills
Authors: Thompson Penny
Published: June 2017

Research suggests a negative relationship between frequent use of communication technologies, such as text messaging and social network sites, and academic performance, but the nature of the relationship needs to be explored in greater detail. This study explored the relationship between use of communication technologies and self-reported study skills. A total of 74 first-year university students completed the online Learning and Study Strategies Inventory and reported on how frequently they used text messaging, instant messaging, and online social networks such as Facebook. Correlation analysis indicated a negative relationship between frequency of communications technology use and the Learning and Study Strategies Inventory measure of Concentration. While the study does not prove a causal relationship, it provides more detail on the specific study skills challenges students may be facing when they interrupt their studying with frequent online social communication. This increased understanding can help educators tailor study skills interventions and support more directly to students’ needs.
Flexible multivariate nonlinear models for bioequivalence problems
Authors: Willemsen Sten P , Russo Cibele M , Lesaffre Emmanuel , Leão Dorival
Published: June 2017

Modelling the concentration of a drug in the bloodstream over time is usually done using compartment models. In pharmacokinetic data, they turn into highly nonlinear mixed-effects models (NLMEMs) when we take the heterogeneity between subjects into account. Fitting of NLMEMs can be difficult and may involve complex algorithms, with convergence critically depending on the initial values and maybe requiring data transformations. In this article, we propose a flexible alternative to the usual parametric compartment models, inspired by the Multivariate SuperImposition by Translation and Rotation (MSITAR) model but adapted to be applicable in this new field. A fully parametric one-compartment NLMEM is considered for comparison. We make use of a Bayesian approach and illustrate the method on a real dataset where the interest lies in contrasting the average and individual bioequivalence of a test and reference formulation of an anti-hypertensive drug.
U.S. Senators on Twitter: Asymmetric Party Rhetoric in 140 Characters
Authors: Russell Annelise
Published: June 2017

The U.S. Senate is a party-polarized institution where divisive political rhetoric stems from the partisan divide. Senators regularly chastise political opponents, but not all senators are equally critical. Research finds that elite party polarization is asymmetrical with greater divergence by Republicans, so I expect Republican senators to mimic that trend with higher levels of partisan rhetoric. To assess the variance in partisan rhetoric, I catalogue senators’ Twitter activity during the first 6 months of the 113th and 114th Congresses, and find that Republicans are more likely to name-call their Democratic opponents and to make expressions of intraparty loyalty, particularly when they are the minority party.
Delayed maintenance modelling considering speed restriction for a railway section
Authors: Shang Hui , Bérenguer Christophe , Andrews John
Published: June 2017

The deterioration of track geometry depends on several factors of which the speed of the train is one. Imposing a speed restriction can slow down the track deterioration and allows a longer survival time before a serious condition is achieved. Preventive maintenance delays can be authorized during the survival time. However, speed restrictions also reduce the system throughput. On the other hand, a longer interval between preventive maintenance activities has a lower maintenance action cost and it also enables grouping the maintenance activities to save set-up costs as well as system downtime. If the repair delay is too long, it may cause unacceptable conditions on the track and lead to higher maintenance costs and accidents. Therefore, it is interesting to assess the effect of a speed restriction on the delayed maintenance strategies for a railway track section. We want to solve a maintenance optimization problem to find the optimal tuning of the maintenance delay time and imposition of a speed restriction. To this aim, a delayed maintenance model is developed, in which track deterioration depends on the train speed and the number of passing trains. The model is used to determine an optimal speed restriction strategy and a preventive repair delay for the optimization of the system benefit and unavailability. Coloured Petri Nets are adopted to model the maintenance and operation of the railway track section. The Coloured Petri Net model describes the gradual track deterioration as a stochastic process. Different speed restriction policies and maintenance delay strategies are modelled and activated by the observed component states. Monte Carlo simulations are carried out to estimate the maintenance cost, the system benefit and the system downtime under different policies. Numerical results show the maintenance decision variable trade-off.
How did you hear the news? The role of traditional media, social media, and personal communication in flashbulb memory
Authors: Talarico Jennifer M , Kraha Amanda , Self Heather , Boals Adriel
Published: June 2017

Flashbulb memories are at the intersection of public and private event memory. We investigated whether the source of news (traditional media, social media, or another person) shaped how people remembered learning of an event. Individuals were asked how they learned of Osama bin Laden’s assassination immediately after the event and 7, 42, 224, or 365 days later. Initial memory reports from those who learned from traditional media showed enhanced phenomenological features (i.e., a sense of recollection and vividness) relative to those who learned from social media or from another person. Both phenomenological and metacognitive (i.e., belief in the memory’s accuracy) features of memory reports decreased over time; however, there were no differences as a function of source. Consistency of the memory reports did not differ as a function of time or source. Although sources differed as a function of social group salience, these differences did not seem to influence memory.
Solidarity, dark solidarity, the commons and the university
Authors: Moroz Jacek , Szwabowski Oskar
Published: June 2017

Since the late 20th century, the Solidarity breakthrough of the Polish social movement has been a huge political success. Solidarity, as a specific idea, has become not only a social and political power, but also a more profound category of ethical discourse. Therefore, especially in terms of Polish public awareness, solidarity is one of the most popular theoretical notions, which is used in many different social contexts. Divergent political ideologies develop and use the language of solidarity as a tool to create divisions in society. The language of solidarity seems to create additional difficulties because it is used by conservative, neo-liberal and leftist parties. This language does not have its own identity or meaning. Considering the problems involved in the category of solidarity, the authors want to move the debate around this concept onto grounds for discussion about the university and the concept of the commons. Their research is located in the field of the philosophy of education, but they refer their reflections also to some empirical works.
A New Mobile Application for Standardizing Diabetic Foot Images
Authors: Yap Moi Hoon , Chatwin Katie E. , Ng Choon-Ching , Abbott Caroline A. , Bowling Frank L. , Rajbhandari Satyan , Boulton Andrew J. M. , Reeves Neil D.
Published: June 2017

Background:

We describe the development of a new mobile app called “FootSnap,” to standardize photographs of diabetic feet and test its reliability on different occasions and between different operators.

Methods:

FootSnap was developed by a multidisciplinary team for use with the iPad. The plantar surface of 30 diabetic feet and 30 nondiabetic control feet were imaged using FootSnap on two separate occasions by two different operators. Reproducibility of foot images was determined using the Jaccard similarity index (JSI).

Results:

High intra- and interoperator reliability was demonstrated with JSI values of 0.89-0.91 for diabetic feet and 0.93-0.94 for control feet.

Conclusions:

Similarly high reliability between groups indicates FootSnap is appropriate for longitudinal follow-ups in diabetic feet, with potential for monitoring pathology.
Before-After Study of an Electronic Order Set for Reversal of Vitamin K Antagonist–Associated Intracerebral Hemorrhage
Authors: Vitt Jeffrey R. , Do Lynn V. , Shah Nirav H. , Fong Gary , Nguyen Nicole Y. , Kim Anthony S.
Published: June 2017

Background:

Vitamin K antagonist (VKA)–associated intracerebral hemorrhages (ICHs) are more likely to expand and are associated with higher mortality than primary ICH. Prompt reversal of anticoagulant effect with prothrombin complex concentrate (PCC) may promote hemostasis and decrease hematoma expansion. The aim of this study was to evaluate the impact of an electronic order set designed to standardize and facilitate more timely reversal of coagulopathy in VKA-associated ICH.

Methods:

We identified all adults who received PCC for VKA-associated ICH from June 2012 to June 2015 at University of California San Francisco Medical Center, which included a period before and after an electronic order set became available in 2014. We abstracted baseline demographics and clinical data from electronic health records. The primary outcome was time from radiographic identification of ICH to administration of PCC.

Results:

Thirty-one patients received PCC for VKA-associated ICH, including 17 patients before and 14 patients after the order set became available. Baseline demographics and clinical features were similar. Order set use was associated with a significant decrease in the time from identification of ICH on imaging to the administration of PCC (median 83 vs 45 minutes; P = .02), more accurate dosing (29.4% vs 92.9%; P < .01), and a shorter time from the PCC order to follow-up international normalized ratio (INR) testing (median 164 vs 85 minutes, P = .001).

Conclusion:

An electronic order set for administering PCC for VKA-associated ICH was associated with significantly faster time to PCC administration and increased dosing accuracy.
Osteochondritis Dissecans: Etiology, Pathology, and Imaging with a Special Focus on the Knee Joint
Authors: Bruns Juergen , Werner Mathias , Habermann Christian
Published: June 2017

This article is a review of the current understanding of the etiology, pathogenesis, and how to diagnose and treat knee osteochondritis dissecans (OCD) followed by an analysis of and outcomes of the treatments available. OCD is seen in children and adolescents with open growth plates (juvenile OCD) and adults with closed growth plates (adult OCD). The etiology of OCD lesions remains unclear and is characterized by an aseptic necrosis in the subchondral bone area. Mechanical factors seem to play an important role. Clinical symptoms are unspecific. Thus, imaging techniques are most important. Regarding treatment, a tremendous number of publications exist. Spontaneous healing is expected unless there is an unstable fragment, and treatment involves rest and different degrees of immobilization until healing. Patients with open physes and low-grade lesions have good results with conservative therapy. When surgery is necessary, the procedure depends on the stage and on the state of the cartilage. With intact cartilage, retrograde procedures are favorable. When the cartilage is damaged, several techniques can be used. While techniques such as drilling and microfracturing produce reparative cartilage, other techniques reconstruct the defect with additional osteochondral grafts or cell-based procedures such as chondrocyte transplantation. There is a tendency toward better results when using procedures that reconstruct the bone and the cartilage and there is also a trend toward better long-term results when comorbidities are treated. Severe grades of osteoarthrosis are rare.
Application of intravoxel incoherent motion (IVIM) magnetic resonance imaging in the evaluation of primitive brain tumours
Authors: Catanese A , Malacario F , Cirillo L , Toni F , Zenesini C , Casolino D , Bacci A , Agati R
Published: June 2017

Intravoxel incoherent motion is a potential non-invasive diagnostic tool in brain tumours, without any clear guidelines for its evaluation yet. In our study, we compare intravoxel incoherent motion with dynamic susceptibility contrast magnetic resonance imaging in the quantification of tumour tissue blood perfusion in 28 patients affected by brain tumours, highlighting the issues encountered during the acquisition set-up and post-processing steps. Intravoxel incoherent motion is a new imaging tool and an alternative technique to dynamic susceptibility contrast-magnetic resonance imaging which is of considerable interest at present. This is partly because it does not require the use of a contrast agent and relies on the intrinsic properties of motion in the capillaries of the spins. Compared to dynamic susceptibility contrast-magnetic resonance imaging, the intravoxel incoherent motion technique is also characterised by better resolution because the gadolinium-based contrast agent bolus used in the standard technique results in a variation by more than 50% of the signal coming from the brain. Finally, intravoxel incoherent motion is more sensitive to the incoherent motion that originates from small capillary vessels, while the dynamic susceptibility contrast signal is also contaminated by the input from larger arteries and veins, which may result in an overestimation of the blood volume. Although there are limitations due to the heterogeneity of the sample considered in our study, intravoxel incoherent motion has been shown to be an accurate noninvasive radiological biomarker, useful to distinguish between low and high grade glial tumours.
Clinicopathological and imaging features of lipoastrocytoma: Case report
Authors: Sivaraju Laxminadh , Aryan Saritha , Ghosal Nandita , Hegde Alangar S
Published: June 2017

Lipidized tumors of the central nervous system are very uncommon, with only a few cases described. We report a case of a 25-year-old woman with a tumor involving the left premotor area. She underwent gross total excision. Histologically, the tumor was composed of glial fibrillary acidic protein-positive glial cells with areas of lipidization. A diagnosis of lipoastrocytoma was rendered. At three-year follow-up she was doing well, supporting the presumed favorable prognosis of these uncommon tumors. Absence of xanthochromic appearance, mitotic activity, necrosis and poor reticulin activity are the differentiating features from the pleomorphic xanthoastrocytoma. We highlighted that these tumors involve the adult and pediatric population and distribute in both supratentorial and infratentorial compartments as well as in the spinal cord.
Susac syndrome misdiagnosed as multiple sclerosis with exacerbation by interferon beta therapy
Authors: Algahtani Hussein , Shirah Bader , Amin Muhammad , Altarazi Eyad , Almarzouki Hashem
Published: June 2017

Susac syndrome is a rare autoimmune disorder characterised by the clinical triad of encephalopathy, retinopathy (branch retinal artery occlusions) and hearing loss. The diagnosis of Susac syndrome may be difficult initially, and it is not uncommon for patients with Susac syndrome to be misdiagnosed with multiple sclerosis. In this case report, we describe a patient who was diagnosed as having multiple sclerosis for three years, with further deterioration after starting treatment with interferon beta-1a. The patient had the triad of encephalopathy, branch retinal artery occlusions and sensorineural hearing loss. She had the classic magnetic resonance imaging appearance, with normal magnetic resonance imaging of the spinal cord and absence of oligoclonal bands in the cerebrospinal fluid. Our patient responded well to treatment with a combination therapy and discontinuation of interferon beta-1a. Our observations raise awareness about the importance of the early and correct diagnosis of Susac syndrome, which usually affects young patients, with an excellent prognosis if treated aggressively at an early stage of the disease. Susac syndrome is underdiagnosed and is not uncommonly misdiagnosed as multiple sclerosis. Susac syndrome is a great mimicker of multiple sclerosis, and establishing diagnostic criteria for this syndrome is very useful. In any patient presenting with a progressive disabling neurological disorder associated with callosal lesions and/or hearing loss, and/or visual loss especially in women, Susac syndrome should be suspected.
Consensus statement for non-hormonal-based treatments for menopausal symptoms
Authors: Woyka Jane
Published: June 2017

Since the June 2014 consensus statement published in Post Reproductive Health we have had definitive guidelines on menopause treatment from the National Institute for Clinical Excellence in November 2015. These included robust and evidence based information about many non-estrogen based treatments, which are particularly useful for patients who do not wish to take hormone replacement therapy, or who have medical contraindications to hormonal therapy such as hormone dependent cancers. Whilst none of these therapies is as effective as hormones, we must be able to advise patients about them and recommend which treatments may be helpful for individual women.
Writing a New Reputation: Liminality and Bicultural Identity in Chimamanda Adichie’s Americanah
Authors: Amonyeze Chinenye
Published: June 2017

Turner’s liminality describes a phase in social life wherein the confrontation between activity which has no structure and its structured results produces in men their highest pitch of self-consciousness. Ifemelu is one of the faces of America’s growing youth immigrants whose liminal state is suspended between social structures in a state of continuous transition. The article examines Chimamanda Adichie’s modern mythic characters as positive models of Nigerian immigration responding to negative racial stereotypes. The essay analyzes how Americanah, as a fiction of reputation management, renegotiates image rights of immigrants and minorities on a humanistic template engendering social compact of respect and mutual understanding. Adichie’s redemptive narrative stresses the bicultural fix of economic exiles, affirming vision of a new cultural space for Africans at home and in the Diaspora. Focusing on the survival and agency of Black immigrants, Adichie advocates immigrants’ proud avowal of their bicultural identity in a neo-colonial space.
The Effectiveness of Bioskills Training for Simulated Open Lumbar Laminectomy
Authors: Boody Barrett S. , Rosenthal Brett D. , Jenkins Tyler J. , Patel Alpesh A. , Savage Jason W. , Hsu Wellington K.
Published: June 2017

Study Design:

Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center.

Objectives:

To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training.

Methods:

Twenty participants comprising senior medical students and orthopedic surgical residents. Participants were randomized to control (n = 9) or intervention (n = 11) groups controlling for level of experience (medical students, junior resident, or senior resident). The intervention group underwent a 40-minute bioskills training module, while the control group spent the same time with self-directed study. Pre- and posttest performance was self-reported by each participant (Physician Performance Diagnostic Inventory Scale [PPDIS]). Objective outcome scores were obtained from a blinded fellowship-trained attending orthopedic spine surgeon using Objective Structured Assessment of Technical Skills (OSATS) and Objective Decompression Score metrics.

Results:

When compared with the control group, the intervention group yielded a significant mean improvement in OSATS ( P = .022) and PPDIS ( P = .0001) scores. The Objective Decompression Scores improved in the intervention group with a trend toward significance ( P = .058).

Conclusions:

We conclude that a concise lumbar laminectomy bioskills training session can be a useful educational tool for to augment clinical education. Although no direct clinical correlation can be concluded from this study, the improvement in trainee’s technical and procedural skills suggests that Sawbones training modules can be an efficient and effective tool for teaching fundamental spine surgical skills outside of the operating room.
High Prevalence of Nontraumatic Shoulder Pain in a Regional Sample of Female High School Volleyball Athletes
Authors: Frisch Kayt E. , Clark Jacob , Hanson Chad , Fagerness Chris , Conway Adam , Hoogendoorn Lindsay
Published: June 2017

Background:

Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants.

Purpose:

To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players. A secondary goal was to determine whether high repetition volumes correlated with an increased likelihood of experiencing pain.

Study Design:

Descriptive epidemiology study.

Methods:

A self-report survey focusing on the prevalence of pain not associated with a traumatic event in female high school youth volleyball players was developed. Survey questions were formulated by certified athletic trainers, experienced volleyball coaches, and biomechanics experts. Surveys were received from 175 healthy, active high school volleyball players in Iowa, South Dakota, and Minnesota.

Results:

Forty percent (70/175) of active high school volleyball players remembered experiencing shoulder pain not related to traumatic injury, but only 33% (23/70) reported taking time off to recover from the pain. Based on these self-reported data, activities associated with significantly increased risk of nontraumatic shoulder pain included number of years playing competitive volleyball ( P = .01) and lifting weights out of season ( P = .001). Players who reported multiple risk factors were more likely to experience nontraumatic shoulder pain.

Conclusion:

When using time off for recovery as the primary injury criterion, we found that the incidence of shoulder pain is more than twice as high as the incidence of injury reported by previous studies. Findings also indicated that the incidence of shoulder pain may be correlated with volume of previous volleyball experience.