bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated manual transmission with a torque gap filler Part 2: control and experimental validation
Authors: Amisano Fabrizio , Galvagno Enrico , Velardocchia Mauro , Vigliani Alessandro
Published: July 2014

This paper deals with the control logic of an automated manual transmission with a torque gap filler and the experimental validation of the transmission dynamic model and of its control. The equations of motion of the transmission system, derived in Part 1 of this two-part study and there used to demonstrate the effect of the torque gap filler on the vehicle’s longitudinal dynamics, are here rearranged and utilized to develop the control algorithm for the transmission actuators. The controller design is carried out, separating the gearshift phase into seven different subphases characterizing the operations of an automated manual transmission with a torque gap filler. For each phase, the targets are discussed; moreover, the equations used to compute the torque reference values of the engine, the clutch and the brake are derived. Finally, the trigger conditions, which determine the change from one phase to the other, are also reported. The rigid-body hypothesis, which was initially adopted for the transmission components, is here abandoned, with the aim of simulating the first torsional mode of the transmission. Therefore, a more detailed model was implemented, and it is used to test in simulations the performance of the developed controller. Finally, experimental data are presented from two vehicles, one with the torque gap filler module, and the other equipped with a traditional transmission, used to demonstrate the vehicle’s dynamic performance enhancement obtained owing to the powershift module; moreover, data are used for experimental validation of both the transmission model and the control strategy.
Styling of cars: is there a relationship between the style of cars and the culture identity of a specific country?
Authors: Bluntzer Jean-Bernard , Ostrosi Egon , Sagot Jean-Claude
Published: July 2014

Today, with globalization, an important characteristic of a car’s brand should be its clear and precise identity. In order to obtain a successful brand, company managers should continuously be innovative without forgetting the product history of the brand and should use the culture of the country as a value system and as an inspirational background. The goal of this paper is to analyse the relationship between the car’s style and some implicit references such as the culture identity of a specific country. The analysis is carried out on the basis of the extracted data on and study of characteristic styling lines of the cars. French cars (Peugeot, Citroën and Renault) as well as German cars (Volkswagen) are selected and analysed. It is found that specific styling lines are particular to French cars. From this analysis, it is concluded that a French style identity is implicitly embedded in the car’s design.
Iso-stoichiometric fuel blends: characterisation of physicochemical properties for mixtures of gasoline, ethanol, methanol and water
Authors: Pearson Richard J , Turner James WG , Bell Arthur , de Goede Stefan , Woolard Chris , Davy Martin H
Published: July 2014

When appropriately sourced, bioethanol and biodiesel fuels provide an opportunity for nations to increase their energy independence or to reduce greenhouse gas emissions by supplying energy-dense fuels which are miscible with fossil-derived gasoline and diesel. These fuels can be used in low concentrations in vehicles with no modifications; in the case of ethanol, only minor changes in the fuel system materials together with a low-cost alcohol sensor are necessary for compatibility with a high concentration. Ethanol provides the beneficial property of having a high research octane number which can be exploited at the high-load operating conditions in modern pressure-charged spark ignition engines. However, the availability of sustainable feedstocks constrains the supply of biofuels, and this limits the level at which they are able to displace fossil fuels. The miscibility of methanol with both ethanol and gasoline enables the penetration of alcohols in the fuel pool to be increased. The present work describes the properties of specific mixtures of gasoline, ethanol and methanol which are blended to be iso-stoichiometric and iso-energetic replacements for mixtures of gasoline and ethanol. A simple analytical approach to the formulation of these ternary blends is described on the basis of the volumetric energy density of the pre-blended components, and a number of further physicochemical properties are characterised, including their stoichiometries, vapour pressures, distillation characteristics and propensities to phase separate. Data on the octane numbers of the blends are reported. The properties of quaternary iso-stoichiometric blends of water, gasoline, ethanol and methanol (the so-called hydrous ternary blends) are also examined.
Numerical prediction of the viscoelastic deformation of seat foam in response to long-term driving
Authors: Oh Jeong Seok , Kim Dae-Young , Kim Tae Hyung , Kim Heon Young , Lee Sung Hyun , Choi Kwon Yong
Published: July 2014

The aim of this paper is to carry out a quantitative evaluation of the time-dependent mechanical characteristics of seat foam and to suggest a process for predicting the viscoelastic deformation of the seat assembly in response to long-term driving. Several tests were conducted to obtain the mechanical properties of the seat components, and the test data were applied in the construction of the material models of the foam pad, the slab foam and the seat cover. An explicit solver (PAM-COMFORT® from ESI) was used to analyse and construct the seat assembly model, and we assumed that the time-dependent behaviour of the seat foam is based on degradation of the material. To describe the behaviour, we used time-dependent stress–strain relationships to account for the viscoelastic characteristics of the seat foam to enable the PAM-COMFORT solver to be used. On multiplying the normalized relaxation modulus by the stress–strain relation, the time-dependent stress–strain relationships can be obtained. In this approach, the material modelling is not a direct method to describe the viscoelasticity using a built-in material model in the commercial program. In order to verify the process, an indenter was used to apply a compressive load to the seat, and the time dependences of the applied load and the deformation were measured experimentally and compared with the results of the numerical analysis. There was good agreement between the experimental results and the numerical analysis results.
Large-eddy simulations of diesel spray with a fine grid in a constant-volume vessel
Authors: Zhou Lei , Luo Kai Hong , Shuai Shi Jin , Xie Mao Zhao
Published: July 2014

In this study, a numerical methodology is developed to simulate liquid fuel spray, break-up and evaporation under high-temperature high-pressure diesel-engine-like conditions. First, the influence of the number of parcels on liquid fuel spray is studied using the Lagrangian parcel approach in an extended KIVALES code (the large-eddy simulation version of the KIVA code). In this study, Eulerian–Lagrangian momentum coupling is considered, incorporating the turbulent dispersion velocity in the spray source term. The study shows that a small number of parcels (about 5000 parcels) cannot represent the overall liquid fuel and droplet distributions. Increasing the number of parcels can enhance the vapour penetration length, but 40,000 parcels can effectively simulate the fuel spray with a fine grid of about 6 × 106 in our study. Use of the fine grid means that more information about the small-scale eddy structures can be obtained, especially in the vicinity of the nozzle. In addition, accurate large-eddy simulations are also used to study the influence of the swirl velocity. Subgrid turbulent dispersion associated with the subgrid turbulent kinetic energy is also found to be influential. Three zero-equation subgrid-scale models, namely the Smagorinsky model, the dynamic Smagorinsky model and the wall-adapting local-eddy-viscosity model, are compared in the study. In addition, the effect of incorporating an algebraic subgrid kinetic energy model into these subgrid-scale models is investigated. It is concluded that the algebraic subgrid kinetic energy model should be used with any of the above zero-equation subgrid-scale models to improve the quantitative predictions, even when the fine grid is used.
Towards a better energy efficiency through a systems approach in an industrial forklift system
Authors: Minav Tatiana A , Schimmel Thomas , Murashko Kirill , Åman Rafael , Pyrhönen Juha J , Pietola Matti
Published: July 2014

The purpose of this study is to improve the potential energy recovery to electric energy in an electrohydraulic forklift system. The initial result achieved for the energy saving ratio after structural optimization is 40%. Component optimization is applied to the tested drive; this consists of an electric servomotor with direct torque control which is directly running a reversible hydraulic pump. According to the study, the energy efficiency and the energy recovery from the electrohydraulic forklift system can be increased by 11%. New ideas and directions for further research were obtained during the study.
Effects of advanced injection strategies on the in-cylinder air–fuel homogeneity of diesel engines
Authors: Dimitriou Pavlos , Peng Zhijun , Wang Weiji , Gao Bo , Wellers Matthias
Published: July 2014

The air–fuel mixing quality in the combustion chamber of a diesel engine is very critical for controlling the ignition and the combustion quality of direct-injection diesel engines. With a view to understanding the air–fuel mixing behaviour and the effect of the mixture quality on the emissions formation, an innovative approach with a new quantitative factor of the in-cylinder air–fuel homogeneity, called the homogeneity factor, was used, and its characteristics under various injection conditions were analysed with computational fluid dynamics simulations. By investigating the effect of advanced injection strategies on the homogeneity of the mixture and the emissions production, the study suggested that the homogeneity factor is greatly affected by the pulse number of injections, the injection timing and the dwell angle between two injections. The more advanced the injection taking place in the cylinder, the earlier the air–fuel mixing quality reaches a high level. Although the homogeneity factor is not sufficiently precise by itself to reflect the emissions formation, the results demonstrated that most often, the higher the homogeneity available in the cylinder, the more nitrogen oxides and the less soot were formed.
Analysis of transmission error depending on compressor working conditions
Authors: Yakupov RR , Mustafin TN , Nalimov VN , Khamidullin MS , Khisameev IG
Published: July 2014

Rotary compressors are widely used due to their reliability, ease in operation, relative simplicity in design and high efficiency. In the present article, a method has been proposed for the analysis of the rotors’ meshing conditions in the rotary machines without rotor timing gears, taking into account the actual profile clearances. Employment of the results obtained will help to analyze and improve the rotor profiles and further to optimize the algorithm of underrating, thus improving operational characteristics of newly developed compressors.
Early warning system for potential train collisions: Enhancing safety levels of high-speed trains
Authors: Jiang Liu , Bai-gen Cai , Jian Wang
Published: July 2014

Collision avoidance support for high-speed trains is a major safety target for railway operators. This paper presents a new concept for a train collision early warning system (TCEWS) that addresses the problem of train-to-train collisions. Similar to existing collision avoidance systems used by railway networks, the TCEWS approach allows drivers to “see” its neighborhood leading target train and have up-to-date and accurate knowledge of the traffic situation in the vicinity. However, the system architecture and operational principles of TCEWS have certain differences. The core idea is to build a system that is independent of the current railway signaling-based systems, e.g. the Chinese Train Control System level-2 or level-3. With additional sensors and prior information from the electronic track map database, the Global Navigation Satellite System is able to provide the ability for train state detection and collision risk assessment without relying on Automatic Train Protection or other existing train-borne equipments. Wireless communication enables the state of the train to be monitored and an early warning to be issued due to cooperation between the train and trackside facilities. The system components and working principles of the TCEWS are detailed in this paper, and the characteristics and advantages are summarized by comparisons with collision avoidance systems in railway and other transport modes. Implementation and field test of TCEWS on the Hankou–Yichang Railway are introduced and analyzed. It is demonstrated that the TCEWS has sufficient capability to be a “safety overlay” system on top of existing railway signaling systems, and has huge potential in ensuring safety levels of high-speed railways using the Global Positioning System, the BeiDou Navigation Satellite System or other global navigation satellite systems.
Traction, curving and surface damage of rails, Part 2: Rail damage
Authors: Grassie Stuart L
Published: July 2014

The tangential forces on a rail resulting from a combination of traction and curving are considered. These forces are a significant component of both wear and shakedown. These two simple mechanisms can be used to understand most types of damage that occur on both rails and wheels.
A novel periodic boundary condition for computational hemodynamics studies
Authors: Bahramian Fereshteh , Mohammadi Hadi
Published: July 2014

In computational fluid dynamics models for hemodynamics applications, boundary conditions remain one of the major issues in obtaining accurate fluid flow predictions. For major cardiovascular models, the realistic boundary conditions are not available. In order to address this issue, the whole computational domain needs to be modeled, which is practically impossible. For simulating fully developed turbulent flows using the large eddy simulation and dynamic numerical solution methods, which are very popular in hemodynamics studies, periodic boundary conditions are suitable. This is mainly because the computational domain can be reduced considerably. In this study, a novel periodic boundary condition is proposed, which is based on mass flow condition. The proposed boundary condition is applied on a square duct for the sake of validation. The mass-based condition was shown to obtain the solution in 15% less time. As such, the mass-based condition has two decisive advantages: first, the solution for a given Reynolds number can be obtained in a single simulation because of the direct specification of the mass flow, and second, simulations can be made more quickly.
Spectrum of mucocutaneous manifestations in human immunodeficiency virus-infected patients and its correlation with CD4 lymphocyte count
Authors: Fernandes Michelle S , Bhat Ramesh M
Published: July 2014

In this study, 100 HIV-positive cases (63 men, 37 women) with skin findings were included. The mean CD4 T cell count was 253 cells/mm3. A total of 235 dermatological manifestations were seen. The common infectious dermatoses were candidiasis (21%), Staphylococcal skin infections (20%), dermatophytoses (14%) and herpes zoster (6%). Among the non-infectious dermatoses were papular pruritic eruptions (20%), xerosis/ichthyosis (20%) and seborrhoeic dermatitis (16%). Statistically significant association ( p < 0.05) with CD4 T cell count was seen in pyodermas, dermatophytoses and papular pruritic eruptions. Adverse drug reactions, diffuse hair loss, straightening of hairs and pigmentary changes were also noted. Although there was an absence of Kaposi’s sarcoma in our study, a case of verrucous carcinoma of penis was noted.
HIV care engagement within 30 days after hospital discharge among patients from a Thai tertiary-care centre
Authors: Ayudhya Daruni Phalakawong Na , Khawcharoenporn Thana
Published: July 2014

A cohort study was conducted to assess the rate of follow-up visit within 30 days after hospital discharge and to determine factors associated with no follow-up among Thai HIV-infected adults during the period from November 2012 to October 2013. Of the 120 eligible patients, 76 (63%) were males, median age was 40 years, and 57 (48%) were newly diagnosed with HIV infection. The rate of follow-up within 30 days after hospital discharge was 69%. Independent factors associated with no follow-up were no caregiver (adjusted odds ratio [aOR] 7.82; p = 0.002), age (aOR 1.06; p = 0.007 for each year younger), being immigrant (aOR 5.10; p = 0.03) and monthly household income less than $US 300 (aOR 2.99; p = 0.04). These findings suggest the need for interventions to improve care engagement including close monitoring for follow-up, pre-discharge financial and medical coverage planning, assessment for the need for caregiver and patient education about the importance of care engagement.
Vaginal douching and sexually transmitted infections among female sex workers: a cross-sectional study in three provinces in China
Authors: Li Jing , Jiang Ning , Yue Xiaoli , Gong Xiangdong
Published: July 2014

Though vaginal douching is a common practice among female sex workers that could increase the risk of HIV and adverse reproductive health outcomes, it has drawn limited attention. From November 2010 to January 2011, a convenience sample of female sex workers was recruited in three cities in China. Face-to-face interviews were conducted to gather socio-demographic and behavioural information. Blood samples were collected for syphilis serological tests. Endo-cervical swabs were collected and tested for Neisseria gonorrhoeae and Chlamydia trachomatis by polymerase chain reaction. A logistic regression model was used to determine factors associated with vaginal douching and the association between vaginal douching and sexually transmitted infection. A total of 1032 eligible female sex workers were enrolled. The overall prevalence of any sexually transmitted infection (syphilis, Chlamydia trachomatis or Neisseria gonorrhoeae) and vaginal douching with disinfectant were 23.4% and 23.1%, respectively. Factors independently associated with douching practice included study sites, venue types, ethnicity, having regular partner and sexually transmitted infection history. No significant association was found between vaginal douching and current sexually transmitted infection. Vaginal douching with disinfectant after sex with clients seemed to be a prevalent practice among female sex workers in China. Prevention programmes targeting female sex workers should incorporate components about the adverse health outcomes associated with vaginal douching.
Urinary protein-to-creatinine ratio versus 24-h proteinuria in the screening for nephropathy in HIV patients
Authors: Antonello Vicente Sperb , Poli-De-Figueiredo Carlos Eduardo , Antonello Ivan Carlos Ferreira , Tovo Cristiane Valle
Published: July 2014

To determine the correlation between protein-to-creatinine ratio and 24-h urinary protein, proteinuria was measured in 45 patients attending a public HIV clinic in Porto Alegre, Brazil, using 24-h urinary protein excretion (24hUP) and urinary protein-to-creatinine ratio. Spearman’s correlation test was done to evaluate the association between spot protein-to-creatinine ratio and 24hUP. The limits of agreement between the two methods were analysed by the Bland–Altman method. For protein excretion <1 g/day, limits (95%) of agreement of protein-to-creatinine ratio and 24hUP were +0.112 and −0.097 g/day. A strong correlation ( r = 0.957) was found between protein-to-creatinine ratio and 24hUP excretion. The conclusion is that the protein-to-creatinine ratio in spot urine specimens is an accurate, convenient and reliable screening method to estimate the urinary protein excretion in HIV patients to detect abnormal urinary protein loss. Further studies are required to evaluate renal disease in HIV patients with chronic renal disease and higher urinary protein excretion.
Malignant lues in an immunocompetent patient
Authors: Alves João , António Ana Marta , Matos Diogo , Coelho Ricardo , Cachão Pedro
Published: July 2014

Malignant lues is a rare form of secondary syphilis mostly associated with HIV infection. It is an uncommon presentation of syphilis even rarer in immunocompetent patients. We present the case of a 57-year-old homosexual man referred to our department due to a 4-month history of a disseminated, slightly painful, nodular-ulcerative cutaneous eruption associated with low-grade fever, malaise and aesthenia. Regarding the clinical features and serological and histopathological findings, the diagnosis of syphilis maligna was assumed. Serology for HIV was repeatedly negative. This case is interesting, not only because a very uncommon form of secondary syphilis was identified but also for being diagnosed in an immunocompetent patient. Lack of awareness of this type of presentation delays the diagnosis and treatment, leading to an increase in morbidity and spread of infection.
Stimulus Typicality Determines How Broadly Fear Is Generalized
Authors: Dunsmoor Joseph E. , Murphy Gregory L.
Published: July 2014

The ability to represent knowledge at the category level promotes the transfer of learning. How this ability integrates with basic forms of conditioned learning is unknown but could explain why conditioned fear is overgeneralized after aversive experiences. We examined the impact of stimulus typicality—an important determinant of category-based induction—on fear learning and generalization. Typicality is known to affect the strength of categorical arguments; a premise involving typical exemplars (e.g., sparrow) is believed to apply to other members, whereas a premise about atypical exemplars (e.g., penguin) generalizes more narrowly to similar items. We adopted this framework to human fear conditioning and found that fear conditioned to typical exemplars generalized more readily to atypical members than vice versa, despite equal feature overlap across conditions. These findings have implications for understanding why some fearful events lead to broad overgeneralization of fear whereas others are regarded as isolated episodes.
Don’t Look at My Answer
Authors: Hembacher Emily , Ghetti Simona
Published: July 2014

Preschoolers’ ability to introspect and make decisions on the basis of these introspections has traditionally been questioned. The present research introduces a novel paradigm to examine the development of the connection between subjective uncertainty about memory and decision making in preschoolers. Three-, 4-, and 5-year-olds ( N = 81) encoded items presented once or twice. They then completed a forced-choice test, provided confidence judgments for each response, and decided whether to select or exclude answers to be evaluated for the possibility of reward. Four- and 5-year-olds, but not 3-year-olds, reported lower certainty for incorrect and weaker memories than for correct and stronger memories, and they judiciously excluded their least confident memories, which resulted in accuracy gains for selected memories; these findings highlight age-related improvements in introspection on memory accuracy. Among accurate responses only, even 3-year-olds excluded their least confident answers, which suggests that the connection between uncertainty and decision making precedes the ability to monitor memory accuracy.
Numerical prediction of cooling losses in a high-pressure gas turbine airfoil
Authors: Montis M , Ciorciari R , Salvadori S , Carnevale M , Niehuis R
Published: July 2014

Numerical investigations of the flow past a film-cooled nozzle guide vane cascade were conducted to determine the influence of coolant ejection on profile loss. The film cooling on the suction surface as well as the trailing edge bleeding was simulated at engine representative main flow Reynolds and Mach numbers, varying the coolant ejection rate. Experiments carried out in a high-speed wind tunnel provided a comprehensive test case to verify the capability of the numerical models to correctly reproduce the flow phenomena taking place in the vane passage. Results show that the main features of the flow, such as aerodynamic loading, flow separation, and loss distribution in the wake of the airfoil can be quite accurately predicted without excessive computational effort using a standard RANS SST model, which proved to be a reliable and more adequate alternative to the widely used models based on simple control volume analysis.
Construing the reader: A multidisciplinary approach to journalistic texts
Authors: Jaakola Minna , Töyry Maija , Helle Merja , Onikki-Rantajääskö Tiina
Published: July 2014

In order to compare the relationship between the intended aims of journalists and the journalistic texts produced, this article develops further the notion of the reader in two directions: first, as an intended ‘model reader’ of a media concept that is collectively construed in the editorial process and, second, as a ‘construed reader’ that is analyzed from the texts. Media concept and model reader are concepts and tools for making visible and analyzing the goals, values, content and organization of work in media organizations, whereas with the concept of a construed reader it is possible to assess the texts as outcomes of the editorial process and in this way compare them with the intentions. The construed reader in the text is analyzed from the viewpoint of cognitive grammar theory and its ‘dimensions of construal’ in which ‘specificity’, ‘focusing’ and ‘perspective’ are used as linguistic tools for analysis. The case study data come from a Finnish third-sector magazine.
Intelligence audit: Planning and assessment of organizational intelligence systems
Authors: Carvalho Andrea V. , Esteban-Navarro Miguel
Published: July 2014

This paper presents a methodology to audit the functioning of an organizational intelligence system that covers all human, informational, technological and procedural elements involved. The methodological process is based in a triangulation of data, qualitative techniques and perspectives, organized in three phases: exploratory, intermediate and focused. A literature review, a participant observation and a case study in the intelligence department of a Spanish private security company are carried out. The results enabled the authors to propose the preference for an operational advisory audit, the operational principles, the procedures to define priority elements and aspects to be audited, the stages and the activities to be carried out, and the techniques and instruments for the collection and analysis of information. The intelligence audit makes it possible to identify the active elements and the relevant actions in the intelligence system and understand how they function within the framework of their relationships with the organization to which it belongs and its environment. The intelligence system should be audited by paying attention to strategic business processes and taking into account the organizational structure, procedures, culture and information behaviour involved. The proposed intelligence audit can be applied to the planning and assessment of any kind of organization due to its comprehensiveness and flexibility.
Mary’s Little Worlds
Authors: Van Steenwinkel Iris , Van Audenhove Chantal , Heylighen Ann
Published: July 2014

With the case study presented in this article we explore how people with dementia experience and use their environment to expand our understanding of how architectural environments can improve their well-being. We focus on how relationships between people and spaces change for people with dementia. Using a qualitative analysis of three in-depth interviews with a woman living with dementia, we obtained an insider’s perspective and a rich account of the changes in her life, including her lived experiences and interventions in her home environment. We contend that looking at people with dementia in relation to and interaction with their environment, combined with an explorative research approach, might reveal multiple and innovative possibilities in designing for people with dementia. To that end, and to build on existing architectural expertise, we suggest focusing on architectural ordering principles across different cases.
Self-Reflective Meaning Making in Troubled Times
Authors: Thomas Emily J. , Levack William M. M. , Taylor William J.
Published: July 2014

Our aim with this article is to clarify the concept of change in self-identity following traumatic brain injury (TBI). We used concept analysis methodology—predominantly concept clarification. We identified 110 articles using a systematic literature search, and used critical appraisal, content analysis, and analytical questioning to explore attributes and boundaries. A reported change in self-identity is the ultimate expression of a variety of cognitive, psychological, and social sequelae of TBI. We present an integrative model of this process, identifying three potential levels of change: (a) component parts (egocentric self, sociocentric self, and “identity as shared with others”); (b) integral processes (self-awareness and expression via meaningful occupation and narratives); and (c) whole-system disruption. Change in self-identity after TBI is a highly individualistic process. The driver of this process is “self-reflective meaning making,” giving a purpose and direction in life, providing motivation and goals for future behavior.
Grandmothers Raising Grandchildren With Disabilities
Authors: Kresak Karen E. , Gallagher Peggy A. , Kelley Susan J.
Published: July 2014

Sources of support and quality of life of 50 grandmother-headed families raising grandchildren with and without disabilities were examined. Comparative analyses revealed significant differences between grandmothers raising grandchildren with and without disabilities in regard to sources of support and family quality of life. Informal support was significantly higher for grandmothers raising grandchildren without disabilities. In addition, grandmothers raising grandchildren without disabilities rated satisfaction with all aspects of family quality of life except parenting as significantly higher than grandmothers raising grandchildren with disabilities. Correlational analyses showed a moderate correlation between sources of support and family quality of life for both groups of grandmothers. While total informal social support was significantly correlated with satisfaction ratings of family quality of life for both groups of grandmothers, total formal support was significantly correlated with satisfaction ratings of family quality of life only for grandmothers raising grandchildren with disabilities. Multiple regression analyses revealed a significant relationship between presence of child disability and satisfaction ratings of family quality of life.
Designing Studies to Evaluate Parent-Mediated Interventions for Toddlers With Autism Spectrum Disorder
Authors: Siller Michael , Morgan Lindee , Turner-Brown Lauren , Baggett Kathleen M. , Baranek Grace T. , Brian Jessica , Bryson Susan E. , Carter Alice S. , Crais Elizabeth R. , Estes Annette , Kasari Connie , Landa Rebecca J. , Lord Catherine , Messinger Daniel S. , Mundy Peter , Odom Samuel L. , Reznick J. Steven , Roberts Wendy , Rogers Sally J. , Schertz Hannah H. , Smith Isabel M. , Stone Wendy L. , Watson Linda R. , Wetherby Amy M. , Yoder Paul J. , Zwaigenbaum Lonnie
Published: July 2014

Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a multitude of novel scientific challenges. The Autism Speaks Toddler Treatment Network (ASTTN) was formed in 2007 to provide an infrastructure for ongoing communication between the investigators of eight research projects evaluating parent-mediated interventions for toddlers with ASD. The present article describes and compares the research studies of the ASTTN; highlights specific challenges with regard to research design, participants, recruitment, eligibility criteria, enrollment, and intervention approach; and outlines practical considerations that may guide the next generation of parent-mediated intervention studies involving toddlers with ASD.
School Nurses’ Familiarity and Perceptions of Academic Accommodations for Student-Athletes Following Sport-Related Concussion
Authors: Weber Michelle L. , Welch Cailee E. , Parsons John T. , McLeod Tamara C. Valovich
Published: July 2014

The purpose of this study was to evaluate school nurses’ familiarity and perceptions regarding academic accommodations for student-athletes following sport-related concussion. School nurses ( N = 1,246) accessed the survey School Nurses’ Beliefs, Attitudes and Knowledge of Pediatric Athletes with Concussions (BAKPAC-SN). The BAKPAC-SN contained several questions pertaining to concussion management and academic accommodations. There were significant differences regarding personal experience as well as familiarity of academic accommodations ( p < .001) between school nurses who work at a school that employs an athletic trainer and school nurses who work at a school that does not employ an athletic trainer. There were significant weak positive relationships between years of experience and familiarity with academic accommodations ( r = .210, p < .001), 504 plans ( r = .243, p < .001), and individualized education plans ( r = .205, p < .001). School nurses employed at a single school were significantly more familiar with academic accommodations ( p = .027) and 504 plans ( p = .001) than school nurses employed at multiple schools. Health care professionals should collaborate to effectively manage a concussed patient and should consider academic accommodations to ensure whole-person health care.
Representing Latinos
Authors: Wallace Sophia J.
Published: July 2014

Using an original data set of roll call votes and bill co-sponsorships across three high salience issues (immigration, labor, and education) and one low salience issue (social security), this article analyzes the 111th Congress to assess representation of Latinos. Partisanship is the key determinant in member behavior on voting, not the member’s race or ethnicity or constituent demographics. For bill co-sponsorships, Latino members are only more active on high salience issue areas compared with non-Latino members. Increases in Latino population do not influence behavior. The results also indicate that African American and Democratic legislators offer Latinos considerable amounts of substantive representation.
Jaw Cysts Diagnosed in an Italian Population Over a 20-Year Period
Authors: Del Corso Giacomo , Righi A. , Bombardi M. , Rossi B. , Dallera V. , Pelliccioni G. A. , Marchetti C. , Foschini M. P.
Published: July 2014

Background. Cysts of the jaws (JCs) are an important topic of oral pathology, but few epidemiological data are present in the literature, in particular about the potential of recurrence. The aim of this study was to describe a case series of JCs from a single institution, evaluating the frequency, the site, the age distribution, and the percentage of recurrence of all types of JCs. Methods. All JCs present in the histological records of the Section of Anatomic Pathology of the University of Bologna at Bellaria Hospital from 1992 to 2012 were retrieved. Results. A total of 1136 jaws cysts were obtained, of which 1117 (98.3%) were odontogenic and 19 (1.7%) were nonodontogenic. About odontogenic cysts (OCs), the most frequent was the radicular cyst (538 cases), followed by parakeratinized keratocystic odontogenic tumor (pKOT, 193 cases) and dentigerous cyst (120 cases). Among pKOT, 21 out of 193 cases (10.89%) showed a recurrence after a mean time of 4.5 years (range, 1-12 years). During follow-up (mean 11 years, range 1-19 years), all 3 cases of botrioid cysts, 12 out of 46 cases of unicystic ameloblastoma (26.09%), 2 out of 20 cases of calcifying OCs (10%) and 2 out of 538 cases of radicular cyst (0.37%) showed a recurrence. Conclusion. Our study confirms that the distribution pattern of JCs in Italy is relatively similar to other studies worldwide and emphasizes the importance of recognizing the different histological types of JCs for their potential local aggressive behavior.
Colonic Cribriform Carcinoma, a Morphologic Pattern Associated With Low Survival
Authors: Lino-Silva Leonardo Saul , Salcedo-Hernández Rosa Angelica , Herrera-Gómez Angel , Padilla-Rosciano Alejandro , Ramírez-Jaramillo Manuel , Herrera-Goepfert Roberto E. , Meneses-García Abelardo
Published: July 2014

Colorectal carcinoma is one of the most common cancers in the human body. Colorectal carcinoma is a heterogeneous disease with variegated morphological patterns; some have shown themselves to have prognostic value. The World Health Organization classification recognizes many histological variants associated with adverse prognostic factors, one is the cribriform colonic carcinoma (CCC). In this work, we analyzed 18 cases of CCC compared with 228 conventional adenocarcinomas of colon, with the hypotheses that CCC compared with non-CCC have worse prognosis and decreased overall survival. CCC represent 7.3% of all colonic adenocarcinomas in this series, it presents in a median age of 56.3 years, all cases are in clinical stage III and IV, all invade subserosal adipose tissues or serosa, 90% have >5 positive lymph nodes and 89% have lymphovascular invasion. These known adverse prognostic factors reflect a lower 5-year survival, stage by stage, than conventional intestinal-type adenocarcinoma (56.8% vs 83.3%, P = .035). Cribriform carcinoma is a morphologic pattern that is underrecognized; in this work, we demonstrate its association with low survival, extensive lymphovascular invasion, and extensive lymph node metastasis, strong indicators of aggressive disease. Their proper recognition is mandatory to increase the number of cases and series to support our findings and include it in the current classifications.
Outcomes Following Microfracture in Grade 3 and 4 Articular Cartilage Lesions of the Ankle
Authors: Clanton Thomas O. , Johnson Nicholas S. , Matheny Lauren M.
Published: July 2014

Background:

The purpose of this study was to document outcomes following microfracture of articular cartilage lesions of the ankle. Our hypothesis was that patients who underwent ankle microfracture would have good to excellent outcomes.

Methods:

This study was institutional review board approved. Patients older than 18 years who underwent ankle microfracture surgery for Outerbridge grade 3 or 4 articular cartilage lesions, by a single surgeon, were included. Detailed intraoperative findings were documented at surgery. Patients completed a questionnaire with Foot and Ankle Disability Index (FADI), Lysholm, Tegner, and patient satisfaction with outcome. All data were collected prospectively and stored in a data registry and retrospectively reviewed. Forty patients (21 males, 19 females, mean age = 42 years [range, 19-65 years]) were included in this study. Thirteen (33%) had previous ankle surgery. Follow-up was obtained for 94% of patients (n = 34). Mean follow-up time was 26 months (range, 12-48 months).

Results:

Mean talar defect size was 70 mm2 (range, 4-300 mm2). Mean tibia defect size was 31 mm2 (range, 8-54 mm2). Four patients (10.5%) required subsequent surgery following microfracture surgery. Mean time to second surgery was 17 months (range, 4-32 months). Mean Lysholm score was 74 (range, 31-96). Mean FADI Activities of Daily Living (ADL) was 81 (range, 33-99), FADI Sport was 62 (range, 13-100), and FADI total score was 77 (range, 28-98). Median Tegner was 4 (range, 0-10). Median patient satisfaction was 8 (range, 3-10). Patients who had previous ankle surgery had significantly lower outcome scores versus patients who did not have previous ankle surgery for FADI ADL (70 vs 81, P = .029) and FADI Total (51 vs 77, P = .028). Days from injury to surgery were correlated with age at surgery ( r = .323, P = .042) and negatively correlated with FADI ADL ( r = −.431, P = .014), FADI Sport ( r = −.490, P = .004), FADI Total ( r = −.429, P = .014), and Tegner ( r = −.402, P = .023).

Conclusion:

Patients who underwent microfracture for grade 3 or 4 ankle articular cartilage lesions had high patient satisfaction. Patients who had previous ankle surgery had lower postoperative ankle function; however, patient satisfaction remained high. This study supports microfracture for treatment of grade 3 and 4 ankle articular cartilage lesions.

Level of Evidence:

Level IV, case series.
Subtalar Joint Configuration on Weightbearing CT Scan
Authors: Colin Fabrice , Horn Lang Tamara , Zwicky Lukas , Hintermann Beat , Knupp Markus
Published: July 2014

Background:

Standard values that describe the morphology of the subtalar (ST) joint have previously been obtained from cadaveric studies or by using conventional unloaded radiographs. It is known that these parameters differ significantly from those measured in vivo and in loaded images, limiting the diagnostic value of the previously published morphological parameters in the literature. However, the morphology of the ST joint clearly affects its function. The objective of this study was to determine the morphology of the posterior facet of the ST joint using loaded computed tomography (CT) images and to describe the different configurations found in asymptomatic patients.

Methods:

A weightbearing CT scan was performed on 59 patients without any history of hindfoot and ankle pathology. The shape of the posterior facet and the subtalar vertical angle (SVA) were measured in 3 different coronal planes of the ST joint.

Results:

The posterior facet was concave in 88% and flat in 12%. The posterior facet was oriented in valgus in 90% and varus in 10% when measured in the middle coronal plane. However, the SVA changed depending on which coronal plane it was measured in.

Conclusion:

We believe it is important to get a better insight into the morphological parameters of the ST joint.

Clinical Relevance:

Knowledge of subtalar joint morphology could help clarify why certain failures have occurred in reconstructive hindfoot surgery and thus might help plan the surgical procedure to reduce these failures in the future.
Comparison of the Self-Reported Foot and Ankle Score (SEFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS)
Authors: Cöster Maria C. , Rosengren Björn E. , Bremander Ann , Brudin Lars , Karlsson Magnus K.
Published: July 2014

Background:

The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure, while the American Orthopedic Foot and Ankle Society Score (AOFAS) is a clinician-based score, both used for evaluation of foot and ankle disorders. The purpose of this study was to compare the psychometric properties of these 2 scoring systems.

Methods:

A total of 95 patients with great toe disorders and 111 patients with ankle or hindfoot disorders completed the 2 scores before and after surgery. We evaluated time to complete the scores in seconds, correlations between scores with Spearman’s correlation coefficient ( rs), floor and ceiling effects by proportion of individuals who reached the minimum or maximum values, test–retest reliability and interobserver reliability by intraclass correlation coefficient (ICC), internal consistency by Cronbach’s coefficient alpha (CA), and responsiveness by effect size (ES). Data are provided as correlation coefficients, means, and standard deviations.

Results:

SEFAS was completed 3 times faster than AOFAS. The scores correlated with an rs of .49 for great toe disorders and .67 for ankle/hindfoot disorders (both P < .001). None of the scores had any floor or ceiling effect. SEFAS test–retest ICC values measured 1 week apart were .89 for great toe and .92 for ankle/hindfoot disorders, while the corresponding ICC values for AOFAS were .57 and .75. AOFAS interobserver reliability ICC values were .70 for great toe and .81 for ankle/hindfoot disorders. SEFAS CA values were .85 for great toe and .86 for ankle/hindfoot disorders, while the corresponding CA values for AOFAS were .15 and .42. SEFAS ES values were 1.15 for great toe and 1.39 for ankle/hindfoot disorders, while the corresponding ES values for AOFAS were 1.05 and 1.73.

Conclusion:

As SEFAS showed similar or better outcome in our tests and was completed 3 times faster than AOFAS, we recommend SEFAS for evaluation of patients with foot and ankle disorders.

Level of Evidence:

Level II, prospective comparative study.
Stealing Wages From Immigrants
Authors: DeVaro Jed
Published: July 2014

In California, ongoing concerns about employers stealing wages from undocumented immigrant workers (who are reluctant to report employer violations because they want to minimize contact with legal authorities) have led to two “antiretaliation” laws passed in 2013 (Assembly Bill 263 and Senate Bill 666) designed to protect workers. This article describes wage stealing (when, how, why and to whom it happens) and its consequences and evaluates various solutions to the problem, including the recent California legislation.
Hot Flashes in Relation to Breast Cancer Endocrine Therapy
Authors: Van Der Wall Ana
Published: July 2014

Women undergoing endocrine therapy for breast cancer often experience hot flashes. As part of a performance improvement project, 14 patients were surveyed to determine who is at risk for hot flashes during endocrine therapy. This information encourages the education of patients, increases compliance with therapy, and improves quality of life.
Bipolar Disorder in Children With ADHD: A Clinical Sample Study
Authors: Donfrancesco Renato , Di Trani Michela , Andriola Elda , Leone Daniela , Torrioli Maria G. , Passarelli Francesca , DelBello Melissa P.
Published: July 2014

Objective: To explore the impact of early-onset bipolar disorder (pediatric bipolar disorder [PBD]) on ADHD. Method: We compared ADHD symptom severity, ADHD subtype distribution, and rates of comorbid and familial psychiatric disorders between 49 ADHD children with comorbid PBD and 320 ADHD children without PBD. Results: Children with ADHD and PBD showed higher scores in the Hyperactive and Inattentive subscales of the ADHD Rating Scale, than children with ADHD alone. The frequency of combined subtype was significantly higher in ADHD children with PBD, than in those with ADHD alone. ADHD children with PBD showed a higher rate of familial psychiatric disorders than ADHD children without PBD. The rate of conduct disorder was significantly greater in children with PBD and ADHD compared with children with ADHD alone. Conclusion: ADHD along with PBD presents with several characteristics that distinguish it from ADHD alone, suggesting that these may be distinct disorders.