bluuebunny/crossref_metadata_2025 huggingface dataset:
I potenziali evocati pudendi, i potenziali evocati motori del muscolo bulbocavernoso e il test della tumescenza peniena notturna nella diagnosi di impotenza in pazienti con sclerosi multipla
Authors: Ghezzi A. , Malvestiti G.M. , Zaffaroni M. , Broggini P. , De Francesco O. , Pozzi E. , Roggia A.
Published: November 2018

Pudendal evoked potentials, motor evoked potentials of the bulbocavernosus muscle to magnetic stimulation and bulbocavernosus reflex were recorded in 34 MS patients: responses were delayed in 26, 20 and 3 cases respectively. No relationship was found between neurophysiological abnormalities and the presence or severity of erectile dysfunction, showing that these tests have little diagnostic usefulness in MS patients with impotence. Nocturnal penile tumescence test was assessed in 14 cases: the test was normal in 10 patients, with no additional diagnostic help.
L'autotrasfusione nella chirurgia della ipertrofia prostatica: Esperienza in un Ospedale periferico
Authors: Arena F. , Corvi A. , Nicotera C. , Peracchia G. , Tagliaferri C. , Cortellini P.
Published: November 2018

Autotransfusion and hemodiluition before surgery reduce the risk of infection and alloimmunisation and allow a considerable saving of homologous blood. The Authors describe their personal experience on the use of preoperative hemodiluition over the last two years in 59 patients who underwent prostatectomy. The blood was taken in the early post-operative period. Only three patients (5.1%), were submitted to homologous blood transfusion. As far as the results are concerned, the hematocrit (which indicates the degree of E.D.) never fell below 28%. All patients showed normal post-surgery development. We stress the safety of this method particularly in urological surgery in peripheral hospitals where the quick availability of blood is essential and where there is a high risk of thromboembolism.
Treatment of benign prostatic hyperplasia with high intensity focused ultrasound: A review
Authors: Pycha A. , Madersbacher S. , Schatzl G. , Marberger M.
Published: November 2018

The aim of this manuscript is to provide insights into the theoretical and practical foundations of high intensity focused ultrasound (HIFU), a novel minimally invasive treatment option for benign prostatic hyperplasia (BPH). We therefore briefly review the physics of HIFU, the results of experimental studies, the histological impact of HIFU on the human prostate and clinical data so far available with this new technique.
Come valutare i risultati di una sperimentazione clinica: Assessing results of clinical trials
Authors: Pappagallo G.L. , Vinante O.
Published: November 2018

The basic aspects to be taken into consideration when assessing clinical trials are discussed, with reference to both the method set up and assessment of the results. Evaluation of the methods should take into account: a) study plausibility and relevance, b) adequacy of the aims, study programme and end points, c) coherence of selection criteria with the study aims, d) correctness and adequacy of procedures for assigning treatments, with any masking procedures if necessary, e) correctness and adequacy of sample size and statistical analysis procedures. Assessment of results should take into account: a) if data are clearly summed up in tables and graphs, b) if the analysis is based on “intention to treat” or “by treatment”, c) if statistical test results are correctly written, if the test used is one or two tail, if confidence limits are given, d) if the clinical relevance of any positive result is mentioned, e) if any positive result comes from a series of multiple comparisons or from a subgroup analysis.
L'idea per una ricerca clinica: An idea for clinical research
Authors: Montorsi F. , Guazzoni G. , Trimboli F. , Rigatti P. , Pizzini G. , Miani A.
Published: November 2018

An idea for clinical research mostly springs from personal clinical experience. Attentive reading of scientific reports and attending congresses with a high scientific content provide further food for thought. Research material must be critically assessed to make sure it contains something of real scientific interest.
L'immagine nella comunicazione scritta: Images in written reports
Authors: Gaboardi F. , Bozzola A.
Published: November 2018

The Authors consider the role of photographs, drawings and/or tables in written reports. The aim of an image is to “launch a message to the reader”. The necessary characteristics of drawings, tables and numerical data are therefore described, whereby an appropriate, precise, legible, understandable message, capable of being memorised, can be presented to the reader. The importance of careful statistical assessment is also underlined and the various forms for graphically presenting statistical data are given.
L'analisi del DNA mediante citometria a flusso nei tumori superficiali della vescica: DNA analysis through flow cytometry in superficial bladder tumours
Authors: Pianon R. , D'Amico A. , Rahmati M. , Paganelli A. , Schiavone D. , Azzolina L.S. , Erbici L , Mobilio G.
Published: November 2018

The aim of this work is to try to characterize the prognostic value of DNA flow cytometry in superficial bladder tumours and to try to indicate this investigation in clinical practice. The Authors review results reported in literature and those relative to their experience. Data investigation shows that this test has prognostic significance because it is correlated with the stage and grade of the tumour. The correlation with the clinical development of the tumour is not clear in the Authors’ experience. The Authors think that flow cytometry does not have a precise role in clinical practice.
Indici di proliferazione (Ki 67, TLI) ed espressione della p53. Esperienza personale: Proliferation indices (Ki 67, TLI) and p53 expression. Personal experience
Authors: Monica B. , Minari R.
Published: November 2018

The Authors report their experience on the study of urothelial bladder cancer by determining the overexpression of p53, DNA-content by flow-cytometry, Ki 67, TLI and cytofluorimetric S-phase in 81 patients. Ki 67, DNA content and p53 overexpression are statistically related with histologic grade, unlike TLI and S-phase. TLI, overexpression of p53 and Ki 67 are statistically related with stage, whereas ploidy and S-phase do not show any relation with stage. The Authors discuss these findings.
Leiomioma renale gigante. Descrizione di un caso: Giant renal leiomyoma: Case report
Authors: Marzorati G. , Pachera F. , Costantini M. Caroli
Published: November 2018

Giant renal leiomyoma is a rare benign tumour with a prevalently smooth muscular component; its clinical aspect and radiological and histological aspects are described. Renal leiomyoma should always be considered in differential diagnosis of a renal mass and surgical exploration is necessary to obtain the histological evidence.
La sindrome di Reifenstein: Evoluzione, trattamento e decorso di un caso clinico particolare: Reifenstein's syndrome: Development, treatment and course of a special clinical case
Authors: Bocchi A. , Giannotti G.
Published: November 2018

The Authors describe the clinical case of a patient with Reifenstein's syndrome who presented other diseases (breast cancer, Berger's syndrome, renal insufficiency). For the treatment they utilised a scrotal tubular flap prepared in another hospital 15 years before.
Su di un caso di liposarcoma renale: Considerazioni diagnostiche e terapeutiche: A case of renai liposarcoma: Clinical and therapeutic considerations
Authors: D'ascenzo R. , Crescenzi A. , Bartoli R. , Valenti P.
Published: November 2018

The Authors report a case of renal liposarcoma 1.5 cm in diameter, found in a 45-year-old woman with a normal contralateral kidney. Since diagnosis was not completely clear after preoperative imaging-studies, like intravenous pyeloureterography, computed tomography and selective arteriography, an open biopsy was performed after the renal vessels were clamped: the intraoperative frozen-section report was benign lipomathoid lesion and an enucleo-resection was performed. The final pathological findings were of a well-differentiated renal liposarcoma with typical lipoblastic cell. Diagnosis and treatment are briefly discussed with reference to recent literature.
Prevalence and incidence of enuresis before puberty
Authors: Trombetta C , Savoca G. , Siracusano S. , Belgrano E.
Published: November 2018

— A mixed study of prevalence and incidence of enuresis carried out at schools in the province of Sassari was planned over a 2-year period. 734 children aged between 3 and 11 years from 3 schools representative of the urban, suburban and rural areas of Sassari, were selected by “cluster” sampling. In this first stage of the project a study of prevalence on children aged 3, 6 and 9 years was carried out. The second stage encompassed a 2-year longitudinal study on those selected in the first stage and provided incidence data pertinent to children aged 4, 7 and 10 years. At the end of the second year of follow-up incidence data relative to children aged 5, 8 and 11 years will be available. Information about children's families and possible urologic disease was collected by means of a questionnaire. Urologic examination then followed. Cross sectional study. In the 73 children aged 3 years, who attended nursery schools, 7 cases of enuresis (9.6%) were ascertained. In the 306 6-year-old children of the first year of primary school, 22 cases of enuresis (7.2%) were observed. In the 355 9-year-old students of the fourth year of primary school, 10 cases (2.8%) were reported. Focusing on the geographical origin of the students, we observed 11 cases of enuresis (5.2%) in cluster I (suburban quarter), 11 cases (6.3%) in cluster II (urban area), and 17 cases (4.9%) in cluster III (rural area). Follow-up. No case of enuresis was observed among the nursery school children (aged 4 years); 2 new cases (0.7%) were ascertained in the 7-year-old group. In the group of children aged 10, only 1 new case (0.57%) was encountered. Taking into account the results of every single cluster, we observed 2 new cases (0.99%) in cluster I, one (0.61%) new case in cluster II and no cases in cluster III. Prevalence of enuresis reached 5.3% in the whole sample, showed a progressive decrease from the younger to the older age group (9.6% in 3-year-olds; 7.2% in 6-year-olds and 2.8% in 9-year-olds), with a clear though not significant male predominance. When data were analysed according to geographical “clusters” a higher prevalence of enuresis was observed among subjects living in the urban area (cluster II). Our results did not differ significantly from those collected by other Authors in similar surveys (Bloom 1993).
Laser treatment of benign prostatic hypertrophy
Authors: Guazzieri S. , Cecchetti W. , Meneguolo M. , D'incà G. , Bertoldin R.
Published: November 2018

— Laser treatment of benign prostatic hypertrophy (BPH) has gradually become more widespread over the last few years. In the USA it is considered an alternative to endoscopic resection as far as insurance payments are concerned. Different methods are used but the most common and suitable one for urologists is the removal and coagulation of the prostatic tissue under visual control (VLAP or ELAP). The Authors report their personal experience in this type of treatment where good results are due to: 1) combination of a powerful, stable laser source 2) durable side-emission contact fibre 3) laser resector, which also in the absence of epicystostomy maintains a good flow during the operation. However, “laser resection” should still be considered an experimental procedure to be used for randomised protocols or on selected patients (high risk of bleeding, Jehovah's witnesses, carriers of pace-maker, etc.).
Retroperitoneal fibrosis
Authors: Mensi M. , Peirano P. , Cebrelli T. , Ravasi S.
Published: November 2018

— The etiology of retroperitoneal fibrosis has still not been clarified. We report our experence in support of the periaortitis hypothesis. Atherosclerosis of the aorta and Plaque rupture lead to liberation of the ceroid, through the awentitia into the periaortic tissue. This results in a chronic inflammatory process.
The association of radical prostatectomy and adjuvant hormone therapy can represent a valid option in the treatment of locally advanced prostatic cancer (T3b-c)?
Authors: Passavanti G. , Pizzuti V. , Bragaglia A. , Costantini F.M. , Paolini R.
Published: November 2018

Locally advanced prostatic cancer is a pathological condition not uncommonly found, especially during radical prostatectomy due to an understaged pathology. It is therefore important to find a pattern of therapeutic behaviour in order to be able to offer the patient the most suitable treatment. An analysis of current case histories tallies with other recent statistical evaluations and allows us to state with increasing certainty that the combination of radical prostatectomy, when technically feasible, with a supporting hormone therapy offers numerous advantages in terms of life span, free-from-disease intervals and quality of life compared to the single therapies. It is therefore interesting to examine the role that such therapy plays in the treatment of locally advanced prostatic cancer.
Urodynamics in Benign Prostatic Hypertrophy: Arguments “against”
Authors: Giambroni L.
Published: November 2018

Many of our colleagues believe that in the evaluation of patients with BPH-related cervico-urethral obstruction, pressure-flow urodynamics should only be performed as an optional test and should not be considered as part of the routine diagnostic process. They argue that correct diagnosis is based on accurate medical history, rectal examination, uroflow measurements and post-voiding residual volume. They also object that urodynamics literature is largely retrospective and is based on the experience of individual Centres. It reports a reduction in incorrect indications for TURP in patients subjected to routine pressure-flow evaluation; this reduction, however, is only minimal. They argue that despite pressure-flow urodynamics now being a standardized procedure, the data it provides and their analysis vary among the different Centres, thus producing discrepancies in performance and reproducibility. The invasiveness and high costs related to this procedure do not justify its routine use.
Ureteral laparoscopic surgery: 5 years experience
Authors: Belgrano E. , Trombetta C. , Lodolo C.
Published: November 2018

The main problem in surgically treating ureteral pathologies is the choice of approach. In this study we describe our experience in 8 cases of laparoscopic surgery. Two of these cases involved vesico-ureteral reflux, two retroperitoneal fibrosis, two ureterocele in a poorly functioning duplicated kidney and the last two cases dealt with ureteral obstruction from locally advanced pelvic neoplasia. The most widely performed ureteral laparoscopic procedures in the world are also reviewed.
Laparoscopic treatment of renal cysts: 5 years experience
Authors: Trombetta C. , Liguori G.
Published: November 2018

Simple renal cysts are a very common disease. They can be single or multiple, mono or bilateral and are generally symptomatic. Recurrent and symptomatic renal cysts can be managed surgically by the laparoscopic approach. In this report we describe our five-year experience with laparoscopic renal cyst resection through transperitoneal and extraperitoneal approach. Laparoscopy can be considered a safe treatment in the case of benign recurrent and complicated cysts.
Ormond's disease: Definizione e cenni anatomici del retroperitoneo: Ormond's disease: Definition and anatomic outlines of the retroperitoneum
Authors: Schiavone D. , Carluccio G.
Published: November 2018

A presentation is given of the stages through which Ormond in 1962 managed to define Idiopathic Retroperitoneal Fibrosis (RPF), thereby giving it a precise clinical identity while the disease became known with his name. In the following years Ormond examined some etiopathogenetic hypotheses and showed that the etiology of RPF was still unknown, even if in some cases the cause had been traced to some medicines, such as methysergide, which were thought to act as haptens. The anatomical limits of the retroperitoneum and its structures are then outlined, in particular the retroperitoneal connective tissue.
Ormond's disease: Aspetti anatomo-patologici: Ormond's disease: Histopathological features
Authors: Chilosi M. , Mariuzzi G.
Published: November 2018

Histopathological studies have significantly contributed to clarifing the pathogenetic mechanisms of idiopathic retroperitoneal fibrosis (Ormond's disease), confirming in most cases its inflammatory nature. In this review we describe the principal pathologic features of the lesion, describing the different inflammatory and fibrogenic cell components. In addition, the differential diagnosis of Ormond's disease and the clinical role of histopathology and immunophenotypical analysis are briefly discussed.
Ricostruzione dei genitali maschili per gangrena di Fournier. Presentazione di un caso: Reconstruction of male genitals due to Fournier's gangrene. Case presentation
Authors: Zumbo G. , Saraceno D.
Published: November 2018

A recent case of Fournier's gangrene is reported, which had a dramatic onset and progression. The highly satisfactory reconstruction of the scrotum and covering of the penile shaft are described.
Nurses’ Knowledge and Attitudes Toward Complementary and Alternative Medicine for Adult Patients With Cancer in Bandung, West Java, Indonesia: A Qualitative Study
Authors: Christina Juliana , Abigail Wendy , Cuthbertson Lesley A. , Whitehead Dean
Published: November 2018

The aim of this study was to explore nurses’ knowledge and attitudes toward the use of complementary and alternative medicine (CAM) among cancer patients in a palliative care setting. A descriptive qualitative approach was used in this study. Semistructured interviews were conducted with 10 nurses recruited using purposive sampling. The data were analyzed using an inductive semantic approach. Thematic analysis identified that nurses possess limited knowledge of CAM. Nurses were skeptical toward CAM and less confident to recommend its use. Four main themes (and two subthemes) emerged: Understanding of CAM, Hesitative Attitudes, Personal Experience, and Preferences in Learning about CAM. There is a need to integrate CAM topics into nursing education programs in order to develop nurses’ knowledge and build positive attitudes toward CAM use. Sufficient knowledge and positive attitudes toward CAM would support safety and quality of care in management of patients with cancer who use or are contemplating using CAM.
Electrospun porous hybrid CuO/CdO nanofibers using carboxylic-functionalized poly(arylene ether ketone)s as a template for glucose determination
Authors: Wang Yongpeng , Liu Mengzhu , Lu Dayong , Zhang Haibo
Published: November 2018

As a high performance polymer, PCA-poly(arylene ether ketone) (PAEK) was first used as a template to fabricate hybrid copper oxide (CuO)/cadmium oxide (CdO) nanofibers (NFs) via electrospinning and subsequent calcination. Porous NFs with a mean diameter of 463 nm were obtained. The formation of morphology was decided by the ion exchange reaction between the functional groups on polymer template and metal ions, which was proved by Fourier transform infrared spectra. Energy-dispersive X-ray spectrometer and X-ray powder diffractometry spectra demonstrated the obtained substance was CuO/CdO compound. The products were then investigated in detail for direct electrocatalytic oxidation of glucose, which was evaluated by cyclic voltammetry and chronoamperometry. Results revealed a similar anti-interference, higher sensitive, and faster response of glucose than the fibers produced from traditional template at +0.40 V. The improved performances were ascribed to the porous morphology which increased the surface-to-volume ratio. The porous morphology was found to be decided by the immobilization of metal ions onto PCA-PAEK. In conclusion, the functional group on PCA-PAEK side chain was the decisive factor to prepare CuO/CdO NFs with special morphology and good electrooxidation performances.
The danger of virtuosity
Authors: Leech-Wilkinson Daniel
Published: November 2018

This Afterword to the special issue on Virtuosity takes the main contributions to the issue as a starting-point for a discussion of the normality of virtuosity, the anxieties it creates for performers, and the politics of virtuosity. Conclusions from Izabela Wagner’s (2015) study of the training of violin virtuosi are outlined. The relationship between virtuosity and conformity is considered. And suggestions are offered for increased virtuosity of creativity in the performance of western classical scores.
Training Needs of Professionals and the Family-Centered Approach in Spain
Authors: Vilaseca Rosa M. , Galván-Bovaira M. J. , González-del-Yerro A. , Baqués N. , Oliveira C. , Simó-Pinatella D. , Giné C.
Published: November 2018

The systemic, ecological, family-centered approach (FCA) has been shown to be the most effective approach to follow worldwide. In Spain, however, the expert-centered approach remains in force and determines the actions of professionals. The objective of this study is to present the training needs perceived by professionals in six early intervention (EI) centers in Spain in which a research process was introduced, namely, the FCA. Two focus groups were held. The needs stated by professionals were for more knowledge about the philosophy of the approach: supervision, learning in reference centers, and exchange sessions with families as the most appropriate training methods; the observation of role models; collaboration between professionals and the trainer as effective instructional designs; and organizational aspects such as training within the work day. A discussion of the results is carried out in the context of current literature and the practical implications are explored.
Self-Regulation, Engagement, and Developmental Functioning in Preschool-Aged Children
Authors: Coelho Vera , Cadima Joana , Pinto Ana Isabel , Guimarães Cristiana
Published: November 2018

Self-regulation can be relevant for engagement, as children need to be able to modulate behaviors and control attention to be engaged. Although previous studies focus on the relation between self-regulation and engagement, little is known about this subject in children with disabilities or at risk. This study analyzes relations between self-regulation and engagement in inclusive preschool settings, considering children’s developmental functioning (DF). The main goal is to examine whether DF moderates the relation between self-regulation and engagement. Participants include three groups of children: with disabilities ( n = 54), at risk ( n = 78), and typically developing ( n = 115). DF was assessed with a short version of the Matrix for Assessment of Activities and Participation; self-regulation with Head-Toes-Knees-Shoulders; and engagement with Child Observation in Preschool. Results indicated that higher levels of self-regulation were related to higher levels of engagement. A moderation effect between self-regulation and DF was also found: in the group of children with disabilities, the influence of self-regulation on engagement was larger. This highlights the relevance of promoting self-regulation, particularly in children with lower DF.
Comparative Results of Percutaneous Calcaneal Osteotomy in Correction of Hindfoot Deformities
Authors: Gutteck Natalia , Zeh Alexander , Wohlrab David , Delank Karl-Stefan
Published: November 2018

Background:

Calcaneal osteotomies are often required in the correction of hindfoot deformities. The traditional open techniques, which include a lateral or oblique incision, are occasionally associated with wound healing problems and neurovascular injury.

Methods:

A total of 122 consecutive patients who underwent a calcaneal osteotomy for hindfoot realignment treatment were included. Fifty-eight patients were operated using an open incision technique and 64 patients (66 feet) using a percutaneous technique. Clinical and radiologic assessments were performed preoperatively, at 6 weeks, and 1 year postoperatively.

Results:

The American Orthopaedic Foot & Ankle Society scale scores and visual analog scale pain scores improved in both groups postoperatively. The difference between the groups was not significant. The results of the radiologic measurements pre- and postoperatively were not significantly different. No pseudarthrosis occurred in either group. The comparison of both groups showed a significantly lower risk for wound healing problems in the percutaneous group. The hospitalization time was significantly shorter in the percutaneous group.

Conclusion:

Because of the excellent results with the percutaneous calcaneal osteotomy, the authors feel encouraged to establish this procedure as a standard technique for calcaneus osteotomy, especially patients at high risk for wound healing problems.

Level of Evidence:

Level III, comparative series.
Phakic intraocular lens as a temporary barrier in aphakic Descemet’s membrane endothelial keratoplasty
Authors: Shweikh Yusrah , Vasquez-Perez Alfonso , Allan Bruce D
Published: November 2018

Background:

Descemet’s membrane endothelial keratoplasty has a lower risk of endothelial rejection than Descemet’s stripping automated endothelial keratoplasty. In aphakic eyes requiring endothelial transplantation, approaches aimed at reducing the risk of posterior graft dislocation in Descemet’s stripping automated endothelial keratoplasty are not transferable to Descemet’s membrane endothelial keratoplasty.

Technique:

Here we describe the use of an implantable collamer lens placed over the iris to provide a temporary intraoperative platform, to facilitate graft unfolding and to avoid posterior graft dislocation in an aphakic, vitrectomised eye with a fixed, dilated pupil in a young patient with chronic uveitis and previous failed Descemet’s stripping automated endothelial keratoplasty.
Feasibility of 3D-printed models of the proximal femur to real bone: a cadaveric study
Authors: Sallent Andrea , Seijas Roberto , Pérez-Bellmunt Albert , Oliva Eulalia , Casasayas Oriol , Escalona Carles , Ares Oscar
Published: November 2018

Introduction:

3D technology has increased popularity during the past decade due to recent advancements and has been described as a useful tool in several fields of medicine including orthopaedic surgery. Applications include preoperative planning, custom-made implants, patient-specific guides, etc. The aim of this study was to evaluate the similarity between 3D-printed models and cadaveric femoral heads, based on CT scans.

Methods:

Cadaveric study of 12 male hips. Computed tomography (CT) was performed and through a semi-automatic segmentation process created the 3D model. Using a 3D printer, the model was printed in ABS plastic. 1 observer performed several measurements in the cadaver, and a 2nd observer performed the same measurements in the 3D-printed model. A 3rd observer compared both measurements and performed the statistical analysis.

Results:

There were no significant differences in the measurements of bony structures between the cadaveric specimens and the 3D-printed model ( p > 0.05 in all cases). We found significant differences when comparing measurements containing a soft tissue element, for example the dimensions of the cartilage covered femoral head ( p < 0.0001).

Conclusions:

3D-printed models of the hip are accurate and feasible to the real bone and can thus be reliable for preoperative planning or other uses that may arise in orthopaedic surgery. Presence of cartilage must be considered when creating the 3D model from CT that considers bone but not cartilage.
Exploring gender habits: A practical epistemology analysis of exergaming in school
Authors: Maivorsdotter Ninitha , Quennerstedt Mikael
Published: November 2018

Digitisation is an ongoing process in society as well as in physical education (PE) and research has identified digital technologies as a trend that influences the PE curriculum. A number of studies have explored the topic from different angles, although very few have empirically looked at the critical aspects of digitised PE in educational practice. This is particularly striking when it comes to issues of gender. Against this background, the aim of the paper is to explore gender habits in a digitised PE practice. A transactional approach, drawing on the work of the pragmatist feminist Shannon Sullivan, is used in the study. The data consists of video- and audio-recordings of ongoing video gaming organised by the PE teacher. A practical epistemology analysis is employed to explore the teenagers’ gender habits in depth. In the analysis, it is clear that the use of exergames in school reinforces traditional gender habits, rather than weakening them. This is particularly evident when the teenagers play in single sex groups. This is also the case when playing in mixed gender groups, although here some changes in gender habits can be identified. However, gender habits are not easily transformed and the findings support the argument that deliberate teaching is important when issues of gender are raised in practice.
The games they play: Observations of children with autism spectrum disorder on the school playground
Authors: Gilmore Sean , Frederick Lindsay K , Santillan Lupita , Locke Jill
Published: November 2018

The playground may be an important context to examine the social functioning of children with autism spectrum disorder. Previous literature on playground peer engagement has used quantitative methods, but there is limited research using qualitative observations to understand the nuances of playground behavior. Using a mixed-methods approach, 55 elementary school–aged children with autism spectrum disorder who are primarily included in general education settings were observed on the school playground using the Playground Observation of Peer Engagement. Quantitative and qualitative data were examined using a mixed-methods approach. The results showed that children with autism spectrum disorder: engage in solitary and peripheral activities; demonstrate appropriate initiations and responses to peers; display self-stimulatory, motoric behaviors most frequently during solitary activities; and often have neutral affect on the playground. These findings suggest that intervention and supports for children with autism spectrum disorder may be important to deliver at recess to address peer engagement.
Improving Health Promotion Through the Integration of Technology, Crowdsourcing, and Social Media
Authors: Conrad Eric J. , Becker Mikaela , Powell Brent , Hall Kelly Corrine
Published: November 2018

As Internet accessibility and technological innovations continue to increase communication, new opportunities have emerged to leverage these tools to improve health promotion practice. Advances and utilization of collaborative Internet communication, or social media, have provided global connectivity on an unprecedented scale. Using these innovations to leverage the collective intellect of online communities for specific goals, crowdsourcing is an approach that has the potential to solve complex public health problems. Due to the novelty of crowdsourcing implementations and the relative infancy of its application within public health, it is necessary to examine examples to facilitate practitioner conceptualization and application. This article details the development and application of a crowdsourced effort leveraging social media and technology to assist in relief efforts during Hurricane Harvey. Furthermore, the article presents examples corresponding to a typology of crowdsourcing for public health, including Knowledge Discovery and Management, Distributed Human Intelligence Tasking, Broadcast Search, and Peer-Vetted Creative Production problems. Leveraging these innovative applications has positive implications for health promotion practice, including improved intervention development and evaluation, increased multidisciplinary collaboration, and enhanced facilitation of communication, information exchange, and support.
Reduced free‐living activity levels in pulmonary arterial hypertension patients
Authors: Halliday Stephen J. , Shi Huang , Brittain Evan L. , Hemnes Anna R.
Published: November 2018

We conducted a survey of pulmonary arterial hypertension (PAH) patients and healthy controls who use either a smartphone or wearable fitness device that tracks daily step count. We found that PAH patients have markedly reduced activity levels compared to controls, after controlling for confounders.
Validation of a claims‐based algorithm to identify patients with chronic thromboembolic pulmonary hypertension using electronic health record data
Authors: Teal Simon , Auger William R. , Hughes Rodney J. , Ramey Dena Rosen , Lewis Kelly S. , O'Brien Gerald , Yaldo Avin , Burton Tanya M. , Bancroft Tim , Seare Jerry , Fabian Joerg
Published: November 2018

This study aimed to validate an algorithm developed to identify chronic thromboembolic pulmonary hypertension (CTEPH) among patients with a history of pulmonary embolism. Validation was halted because too few patients had gold‐standard evidence of CTEPH in the administrative claims/electronic health records database, suggesting that CTEPH is underdiagnosed.
Detection of Hepatitis C Virus-RNA in Saliva from Chronically HCV-Infected Patients
Authors: Pastore L. , Fiore J.R. , Tateo M. , Benedittis M. DE , Petruzzi M. , Casalino C. , Genchi C. , Muzio L. LO , Angarano G. , Serpico R.
Published: November 2018

The possibility of the non-parenteral Hepatitis C Virus (HCV) transmission is supported by the demonstration that the actual virus is present in several body fluids, including saliva. From a review of the literature many investigators have found the presence of HCV-RNA in saliva, however, widely contrasting results emerge, with detection rates ranging from 0–100%. To further examine HCV salivary shedding, saliva samples were collected from 46 chronically HCV-infected patients and tested for HCV-RNA and occult blood. Quantification and genotyping of serum HCV-RNA were also carried out for each patient. HCV-RNA was detected in 39.13% of the saliva samples. The viral salivary shedding was significantly related to viraemia levels, serum viral genotype and the presence of salivary occult blood. Our findings indicate that the HCV salivary shedding occurs in about one third of HCV-infected patients, but seem to suggest that it is unlikely when the serum viral genotype is 3a. Moreover, blood leakage into the oral cavity is possibly the main source of the salivary HCV-RNA. Although the occurrence of the viral salivary shedding does not necessarily mean that HCV trasmission occurs by saliva, our results suggest the need for further investigations into the biological factors possibly involved in HCV mucosal transmission related to both the source and the exposed subjects.
Using user-generated content data to analyze tourist mobility between hotels and attractions in cities
Authors: Jin Cheng , Xu Jing
Published: November 2018

Attractions and hotels are the two most important elements in tourism activities. However, there is a lack of in-depth analysis of tourist mobility between hotels and attractions. Meanwhile, new means of data collection are opening up opportunities for disclosing the mobility patterns between hotels and attractions. This paper aims at analyzing the network structures and mobility models of tourist mobility from attractions to hotels (TMAH) and tourist mobility from hotels to attractions (TMHA), by using the user-generated content data collated from an open tourism web service. Then the differences between the two tourist mobilities are compared. Through the empirical study of Nanjing, it is found that the influence of distance on the two mobilities is different. The distance has a significant influence on TMAH, and the mobility conforms to the power law distribution. TMHA is more influenced by the ranks of hotels and attractions, and the mobility confirms to the gravity model. The highlight of this paper is to use the new network data to reveal the network structure and mobility laws of the special tourist mobility between hotels and attractions from the perspective of difference comparison.
Novel characterization techniques for cultural heritage using a TEM orientation imaging in combination with 3D precession diffraction tomography: a case study of green and white ancient Roman glass tesserae
Authors: Nicolopoulos Stavros , Das Partha P. , Bereciartua Pablo J. , Karavasili Fotini , Zacharias Nikolaos , Gómez Pérez Alejandro , Galanis Athanassios S. , Rauch Edgar F. , Arenal Raúl , Portillo Joaquim , Roqué-Rosell Josep , Kollia Maria , Margiolaki Irene
Published: November 2018

We present new transmission electron microscopy (TEM) based electron diffraction characterization techniques (orientation imaging combined with 3D precession electron diffraction tomography-ADT) applied on cultural heritage materials. We have determined precisely unit cell parameters, crystal symmetry, atomic structure, and orientation/phase mapping of various pigment/opacifier crystallites at nm scale which are present in green and white Roman glass tesserae. Such TEM techniques can be an alternative to Synchrotron based techniques, and allow to distinguish accurately at nm scale between different crystal structures even in cases of same/very close chemical composition, where is also possible to visualize between different crystal orientations and amorphous/crystalline phases. This study additionally demonstrates that although opacifiers in green and white tesserae are found to have average Pb2Sb2O7 cubic and CaSb2O6 trigonal structures, their pyrochlore related framework can host many other elements like Cu, Ca, Fe through ionic exchanges at high firing temperatures which in turn may also contribute to the tesserae colour appearance.
Regional Body Fat Changes and Metabolic Complications in Children With Dunnigan Lipodystrophy-Causing LMNA Variants
Authors: Patni Nivedita , Li Xilong , Adams-Huet Beverley , Vasandani Chandna , Gomez-Diaz Rita A , Garg Abhimanyu
Published: November 2018

Context

Familial partial lipodystrophy, Dunnigan variety (FPLD2) is a rare autosomal-dominant disorder due to heterozygous missense lamin A/C (LMNA) mutations. Subjects with FPLD2 gradually lose fat from the upper and lower extremities but gain fat in the face and neck around puberty. However, the precise onset of body fat changes and metabolic complications during childhood remains unknown.

Objective

To compare metabolic parameters and regional body fat in children with FPLD2 with the sex- and age-matched controls from the National Health and Nutrition Examination Survey (NHANES) 2005 to 2010.

Methods

We measured fasting serum triglycerides, glucose, and skinfold thicknesses in all children (aged 1 to 18 years) harboring FPLD2-causing LMNA mutations and determined regional body fat by dual-energy X-ray absorptiometry in those aged ≥8 years.

Results

Thirty-two affected females and 14 males participated. The lower limb fat in all affected females, except one, was below or equal to the first percentile and in two affected males was below the fifth percentile for NHANES. One female subject with FPLD2 followed from age 6 to 16 years revealed marked loss of extremity fat much before thelarche. Serum triglycerides were higher in females with FPLD2 aged 7 to 18 years compared with controls (median 208 vs 70 mg/dL; P < 0.0001) and showed inverse correlation with extremity skinfolds. Serum triglycerides in males with FPLD2 were not significantly different than controls.

Conclusions

The onset of fat loss from the extremities, especially in girls with FPLD2, occurs well before the onset of puberty. High serum triglycerides are seen in young females with FPLD2 with severe loss of fat from the extremities.
Returning to Sport After Gymnastics Injuries
Authors: Sweeney Emily A. , Howell David R. , James David A. , Potter Morgan N. , Provance Aaron J.
Published: November 2018

Acute and overuse injuries are a common experience for artistic gymnasts; however, this population has unique needs when returning to their sport after an injury due to the technical demands imposed during gymnastics. We reviewed the current literature regarding return to play (RTP) in artistic gymnasts and developed four goals: 1) to define the guiding principles used to determine RTP in sports, 2) to identify factors that affect recovery progression among gymnasts, 3) to determine how different injury types affect RTP protocols, and 4) to create structured RTP protocols specific to gymnasts based on sex and body part injured. By establishing these guidelines, we hope to provide guidance to medical providers through a standardized approach for returning gymnasts to their sport.
Incidence, Diagnosis, and Management of Injury in Sport Climbing and Bouldering: A Critical Review
Authors: Jones Gareth , Schöffl Volker , Johnson Mark I.
Published: November 2018

Competition climbing will debut as an Olympic sport at the 2020 summer games in Tokyo. The aim of this article is to critically review research on the incidence of injury in sport climbing and bouldering. The pathophysiology and clinical presentation of finger and shoulder injuries is discussed. A semisystematic approach in reviewing literature on incidence was applied. Articles were identified after searches of the following electronic databases: Discover, Academic Search Complete (EBSCO), PubMed, Embase, SPORTDiscus, and ScienceDirect. Despite methodological shortcomings of the included studies, we estimated the mean ± SD of the incidence rate of injury in sport climbing and bouldering from the eight studies to be 2.71 ± 4.49/1000 h. Differential diagnosis and the clinical management of finger and shoulder injuries in climbers are challenging. An updated diagnostic and therapeutic algorithm for the clinical management of finger injuries in climbers is presented.
Comparison of Exclusive Double Poling to Classic Techniques of Cross-country Skiing
Authors: STÖGGL THOMAS , OHTONEN OLLI , TAKEDA MASAKI , MIYAMOTO NAOTO , SNYDER CORY , LEMMETTYLÄ TEEMU , LINNAMO VESA , LINDINGER STEFAN JOSEF
Published: November 2018

Introduction

This study aimed to 1) determine basic physiological demands during a simulated on-snow cross-country skiing (XCS) race when using grip-waxed skis (all classic XCS techniques [CLASSIC]), versus glide-waxed skis for exclusive double poling (DP) and 2) analyze in which track sections DP is different from CLASSIC under controlled gliding conditions in elite junior and senior skiers.

Methods

Nineteen male and female elite XC skiers performed 1) two randomized simulated XCS races over 5.3 km using DP or CLASSIC measuring section times, V˙O2, HR, blood lactate, and RPE; and 2) V˙O2peaktests using diagonal stride and DP on treadmill.

Results

The total group showed no differences in performance or physiological responses between DP and CLASSIC. Elite male skiers achieved improved (~23 s,P< 0.05), male juniors equal (P> 0.05) and females worse (~43 s,P< 0.05) performance with DP versus CLASSIC. Flat and undulating terrain favored DP in men, whereas uphill favored CLASSIC in females (~60 s). Uphill sections showed the greatest group differences. Greater RPE was found in the arms during DP, whereas RPE was greater in the legs using CLASSIC. V˙O2peakin DP was ~95% of V˙O2max.

Conclusions

Male skiers demonstrated superior performance with exclusively using DP on a Fédération International de Ski regulation-compliant XCS track, whereas junior males achieved similar, and females’ weaker performance using DP versus CLASSIC. The greatest potential in females is in uphill sections where they distinctly lose time. Exclusive DP might only be beneficial in athletes with high upper-body capacity, and double-pole–specific training and technique. To generalize the findings of the current study, further analysis of snow conditions and course topography is required.
The emergence of shell shock during the First World War: challenges for mental health care
Authors: Nolan Peter
Published: November 2018

Peter Nolan discusses the main issues around shell shock, its management during and after the First World War, and how mental health care changed for the better
Loneliness and mental health
Authors: Barber Chris
Published: November 2018

The phenomenon and experience of loneliness and its links with mental health issues has received increased attention over the past two years, partly because of the work started by the late Jo Cox (MP) before her murder in 2016. This article seeks to explore this phenomenon and experience within the context of mental ill health and suggests ways in which nurses can help and support those who are experiencing loneliness.
Eating psychopathology of staff working with patients with an eating disorder
Authors: Brouwer Katharine , Willoughby Kate
Published: November 2018

Background:

Evidence suggests that social comparison is a predictor of increased body dissatisfaction and body dissatisfaction, in turn, is a predictor of increased eating psychopathology (weight and shape management behaviour). This has been explored in the general population but not in a population of staff working with patients with an eating disorder, who may be particularly vulnerable to the development of eating psychopathology.

Aims:

To explore the relationship between social comparison, body dissatisfaction and eating psychopathology in female staff working with patients with an eating disorder.

Method:

A cross-sectional questionnaire design was used with 131 clinical staff working with patients with an eating disorder and a comparison group of 131 adult women who do not work with this population.

Findings:

Findings were surprising and showed a deviation from the norm as staff engaged in significantly lower levels of weight and shape management behaviours compared to the non-staff group.

Conclusion:

The use of weight and shape management behaviours are significantly lower in staff working with patients with an eating disorder compared to the typical population, despite having more opportunity for social comparison. Psychological theories are used to offer an explanation for this finding.
Education and clinical professional development in Penang, Malaysia
Authors: Perry Matt , Reynolds Louise , Clare Judith
Published: November 2018

Background:

This study considers the impact of the Intermediate Ambulance Care (IAC) Course on the development of pre-hospital care practice in Penang, Malaysia and considers how the course contributes to professional development. The research question asks what impact the education programme has had on a rapidly changing emergency medical service.

Methods:

Using a qualitative methodology—focused ethnography—data were collected from interviews, participation and observation of pre-hospital emergency care providers and medical professionals in Penang, Malaysia.

Results:

Four themes were identified which describe how the participants' values and beliefs contribute to the increasing professionalisation of their role in health care.

Conclusion:

As well as increasing paramedic knowledge, there was an observable change in participants' values and beliefs about pre-hospital care and health outcomes. This has contributed to the professional development currently being experienced in pre-hospital care in Penang, Malaysia.