bluuebunny/crossref_metadata_2025 huggingface dataset:
Considering chance in quality and safety performance measures: an analysis of performance reports by boards in English NHS trusts
Authors: Schmidtke Kelly Ann , Poots Alan J , Carpio Juan , Vlaev Ivo , Kandala Ngianga-Bakwin , Lilford Richard J
Published: April 2016

Objectives

Hospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so it is necessary to distinguish signals from noise (chance). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions.

Methods

Thirty English NHS trusts were selected at random and their board papers retrieved. Charts depicting quality and safety were identified. Categorical discriminations were then performed to document the methods used to present quality and safety data in board papers, with particular attention given to whether and how the charts depicted the role of chance, that is, by including control lines or error bars.

Results

Thirty board papers, containing a total of 1488 charts, were sampled. Only 88 (6%) of these charts depicted the role of chance, and only 17 of the 30 board papers included any charts depicting the role of chance. Of the 88 charts that attempted to represent the role of chance, 16 included error bars and 72 included control lines. Only 6 (8%) of the 72 control charts indicated where the control lines had been set (eg, 2 vs 3 SDs).

Conclusions

Hospital board members are expected to consider large amounts of information. Control charts can help board members distinguish signals from noise, but often boards are not using them. We discuss demand-side and supply-side barriers that could be overcome to increase use of control charts in healthcare.
Low and moderate doses of caffeine late in exercise improve performance in trained cyclists
Authors: Talanian Jason L. , Spriet Lawrence L.
Published: April 2016

The aim of the present study was to assess if low and moderate doses of caffeine delivered in a carbohydrate-electrolyte solution (CES) late in exercise improved time-trial (TT) performance. Fifteen (11 male, 4 female) cyclists (age, 22.5 ± 0.9 years; body mass, 69.3 ± 2.6 kg; peak oxygen consumption, 64.6 ± 1.9 mL·min−1·kg−1) completed 4 double-blinded randomized trials. Subjects completed 120 min of cycling at ∼60% peak oxygen consumption with 5 interspersed 120-s intervals at ∼82% peak oxygen consumption, immediately followed by 40-s intervals at 50 W. Following 80 min of cycling, subjects either ingested a 6% CES (PL), a CES with 100 mg (low dose, 1.5 ± 0.1 mg·kg body mass−1) of caffeine (CAF1), or a CES with 200 mg (moderate dose, 2.9 ± 0.1 mg·kg body mass−1) of caffeine (CAF2). Following the 120-min cycling challenge, cyclists completed a 6-kJ·kg body mass−1 TT. There was no difference between respiratory, heart rate, glucose, free fatty acid, body mass, hematocrit, or urine specific gravity measurements between treatments. The CAF2 (26:36 ± 0:22 min:s) TT was completed faster than CAF1 (27:36 ± 0:32 min:s, p < 0.05) and both CAF1 and CAF2 TTs were completed faster than PL (28:41 ± 0:38 min:s, p < 0.05). Blood lactate was similar between trials and rose to a greater extent during the TT (p < 0.05). In summary, both doses of caffeine delivered late in exercise improved TT performance over the PL trial and the moderate dose (CAF2) improved performance to a greater extent than the low dose (CAF1).
Some Conditions for Characterizing Anchor Points
Authors: Mostafaee Amin , Soleimani-Damaneh Majid
Published: March 2016

The set of anchor points is an important subset of the set of extreme efficient points of the production possibility set (PPS) in data envelopment analysis (DEA). In this paper, some new results, under variable returns to scale (VRS) assumption, are given which characterize these points from different points of view. First, we prove two necessary and sufficient conditions leading to geometrical characterizations. Afterwards, four sufficient conditions are given with respect to the level values of the supporting hyperplanes, infeasibility of the super efficiency models, maximum/minimum data, and zero data. Some of the given conditions can be checked without solving any mathematical programming problems. Also, some of them can be tested by solving standard DEA models. The investigated conditions are useful in designing pre-processors and heuristics.
Dominance Relationship Among the Retailer’s Strategies Under the Semi-Stackelberg Newsvendor Situation with Quantity Discounts
Authors: Won Youkyung
Published: March 2016

In this paper, we investigate the retailer’s behavior under the supplier-driven semi-Stackelberg newsvendor situation in which (i) the supplier plays as a semi-Stackelberg leader with or without his discounts schedule being offered to the retailer, (ii) the retailer plays as a Stackelberg follower with or without her discounts schedule being offered to the end customer, and (iii) neither party has perfect information on the endogenous price-dependent demand function or exogenous probability distribution of demand. In this situation, the retailer’s concern is identifying the dominant strategy by which she can safely implement her own scheme for customer discounts regardless of the order quantity rather than finding the best strategy yielding the optimal order quantity that maximizes her expected profit. We show that a consistent dominance relationship exists among the retailer’s strategies when the newsvendor chooses to offer progressive multiple discounts to customers regardless of the supplier’s strategy of offering the retailer either all-units discounts or no-discounts.
Surface Effects on Buckling of Double Nanobeam System Based on Nonlocal Timoshenko Model
Authors: Hosseini S. A. H. , Rahmani O.
Published: March 2016

This paper is concerned with the surface effect on the buckling behavior of double nanobeam system using the nonlocal Timoshenko beam theory. The size effect is taken into consideration by using the Eringen’s nonlocal elasticity theory and the exact solution for buckling loads for simply supported boundary condition is presented. Influences of various parameters such as stiffness constant, nonlocal parameter, shear effect and buckling mode number are investigated. Also for the sake of validation, the present results are compared with those obtained from the Euler–Bernoulli model. It is shown that the proposed nonlocal model is able to produce results with high accuracy and it can be used as a benchmark in future studies on buckling of nano-sandwich structures.
Analyses of Stiffened Plates Resting on Viscoelastic Foundation Subjected to a Moving Load by a Cell-Based Smoothed Triangular Plate Element
Authors: Dang-Trung H. , Luong-Van H. , Nguyen-Thoi T. , Ang K. K.
Published: March 2016

A cell-based smoothed three-node Mindlin plate element (CS-MIN3) based on the first-order shear deformation theory (FSDT) was recently proposed for static and dynamic analyses of Mindlin plates. The CS-MIN3 overcomes shear-locking phenomena and has a faster convergence compared with the original MIN3. In addition, the CS-MIN3 uses only three-node triangular elements that can be easily generated automatically for arbitrary complicated geometric domains. This paper extends the CS-MIN3 by integrating itself with the Timoshenko beam element to give a new stiffened plate element for static, free vibration and dynamic responses of stiffened plates resting on viscoelastic foundation subjected to a moving load. The viscoelastic foundation is modeled by discrete springs and dampers, and the displacement compatible condition between the plate and the stiffener is imposed. Some benchmark numerical examples were performed to illustrate the good agreement of the CS-MIN3 results with those by other methods in the literature to illustrate its accuracy and reliability. In addition, some new numerical examples that consider the effects of stiffeners on the behaviors of plate resting on viscoelastic foundation are conducted. The results demonstrate the expected properties in which the deflection of the stiffened plate resting on viscoelastic foundation can be reduced significantly.
AN EFFECTIVE TECHNOLOGY TO EVALUATE VIBRATION COMFORTABILITY OF HUMAN BODY BASED ON NEAR-INFRARED SPECTROSCOPY
Authors: LI XIAOLING , JIANG YING , WU JIUHUI , HONG JUN
Published: March 2016

In the biomedical field, Near-Infrared Spectroscopy (NIRS) is often used to determine the physiological information by the noninvasive detection of the regional tissue oxygen saturation (rSO2). Because the fatigue degree of body could be obviously demonstrated by the oxygen saturation under different vibration conditions, an effective technology to evaluate the vibration comfortability by rSO2 is innovatively proposed in this paper. Without losing generality, the vibration comfortability is analyzed by taking the driving position for example. Different from much more factors in previous approaches, only four main body factors, i.e., brain, musculus biceps brachii, erector spinae and biceps femoris, and three main influence factors on vibration comfortability, i.e., acceleration, frequency, and exposure time, are taken into account in our technology. Under different conditions of the three vibration factors, the rSO2 for the four body factors is detected one by one. Then the relationship among the rSO2, subjective feeling, and the vibration parameters can be obtained by the least square method, and the quantitative evaluation model on vibration comfortability is established. It is found experimentally that the rSO2 trends of musculus biceps brachii, erector spinae and biceps femoris are all greatly increased with the acceleration and frequency, but brain is decreasing obviously. Through our experiment it is verified that this technology can be used in objectively and effectively evaluating under different vibration conditions. This novel technology could provide theoretical support for vibration comfortability assessment and have potential applications in other relative fields.
DESIGN, FABRICATION, AND TEST OF A NOVEL CLAMPER FOR AORTIC CROSS-CLAMPING IN MINIMALLY INVASIVE CARDIAC SURGERY
Authors: FARKOUSH SIAMAK HAJIZADEH , ABOLFATHI NABIOLLAH , MEHMANESH HORMOZ , NAJARIAN SIAMAK
Published: March 2016

One of the main procedures in the most minimally invasive cardiothoracic surgery is clamping the ascending aorta to disconnect the heart from circulation. In this paper, a new aortic clamping instrument which is applicable in minimally invasive cardiac surgery has been presented. The instrument consists of a parallelogram mechanism for opening and closing the jaws, a detachable holder with a two degree of freedom joint that makes the precise position and orientation of the jaws and leaves the clamping component in the patient’s body to make the inserting port free, and a handle for easy manipulation. In vitro test has been performed to evaluate the performance of the clamper compared to the conventional clampers. For this purpose, the force required for aortic cross-clamping and the maximum aortic displacement have been studied in four groups including parallel clamper and conventional clamper with angles of 1[Formula: see text], 2[Formula: see text], and 3[Formula: see text] between jaws, with 10 bovine aorta specimens in each group. These experiments show that the amount of required force for cross-clamping by using the parallel clamper, is statistically significant ([Formula: see text]) compared with the conventional clampers. Also, the increase of angle between jaws makes a significant increase in the percentage of aortic displacement.
sEMG ACTIVITIES OF THE THREE HEADS OF THE TRICEPS BRACHII MUSCLE DURING CRICKET BOWLING
Authors: ALI MD. ASRAF , SUNDARAJ KENNETH , AHMAD R. BADLISHAH , AHAMED NIZAM UDDIN , ISLAM MD. ANAMUL , SUNDARAJ SEBASTIAN
Published: March 2016

The aim of the present study was to analyze the surface electromyography (sEMG) activities generated by the three heads of the triceps brachii (TB) muscle among the different phases during fast and spin bowling. sEMG signals from the lateral, long and medial heads of the TB from 20 bowlers were measured individually during bowling. To analyze the sEMG activities, the root mean square (RMS) value in each bowling phase for every trial per bowler was calculated from the sEMG signals from the three heads of the TB. Higher sEMG activities at the three heads of the TB were found during the fifth phase followed by the sixth, seventh, third, fourth, second and first phases in both types of bowling. sEMG activities were significantly different among the three heads of the TB and among the seven bowling phases for both bowling types at an alpha level of [Formula: see text]. These findings will be of particular importance for assessing different physical therapies for the three headed TB muscle which can improve the performance in ball delivery of cricket bowlers.
Impulsive Pedipulation of a Spherical Object with 3D Goal Position by a Humanoid Robot: A 3D Targeted Kicking Motion Generator
Authors: Cisneros Rafael , Yokoi Kazuhito , Yoshida Eiichi
Published: March 2016

This paper describes an algorithm that enables a humanoid robot to perform an impulsive pedipulation task on a spherical object in the environment; that is, by using its feet to exert an impulsive force capable of driving the object to a 3D goal position while achieving certain motion characteristics. This is done by planning a suitable motion for the legs of the humanoid, capable to exert the required impact conditions on the spherical object while maintaining the dynamic stability of the robot. As an example of this algorithm implementation we consider the free kick in soccer and take it as a case study. Finally, we provide some simulation and experimental results that intend to show the validity of this algorithm.
Measuring the Cost Effects of Modular Product Architectures — A Conceptual Approach
Authors: Skirde Henning , Kersten Wolfgang , Schröder Meike
Published: March 2016

Modular product architectures offer a solution for the trade-off between offering the market a wide variety of products and improving a company’s internal cost situation. However, individual cost effects that determine the extent to which modularity should be applied to product architecture are widely unknown in industry. In this paper, we develop a conceptual approach to provide suggestions for improving an examined modular product architecture from a cost perspective. Our work makes an important contribution: The conceptual approach accentuates which steps are necessary in order to recommend whether the product architecture’s current degree of modularity should be enhanced or diminished.
EXPLORATION VS. EXPLOITATION AND HOW VIDEO GAME DEVELOPERS ARE ABLE TO COMBINE THE TWO
Authors: WIKHAMN BJÖRN REMNELAND , STYHRE ALEXANDER , LJUNGBERG JAN , SZCZEPANSKA ANNA MARIA
Published: March 2016

This paper reports an in-depth qualitative study about innovation work in the Swedish video game industry. More specifically, it focuses on how video game developers are building ambidextrous capabilities to simultaneously addressing explorative and exploitative activities. The Swedish video game industry is a particularly suitable case to analyze ambidexterity, due to it’s extreme market success and continuous ability to adapt to shifts in technologies and demands. Based on the empirical data, three ambidextrous capabilities are pointed out as particularly valuable for video game developers; (1) the ability to separate between a creative work climate and the effectiveness in project organizing; (2) the balancing of inward and outward ideation influences, and (3) the diversity in operational means and knowledge paired with shared goals and motivations, derived from the love of video games and video game development.
ENHANCING THE OUTCOMES IN R&D COLLABORATIVE PROJECTS: AN EMPIRICAL ANALYSIS OF THE MIDDLE EBRO VALLEY IN SPAIN
Authors: VICENTE-OLIVA SILVIA , MARTÍNEZ-SÁNCHEZ ÁNGEL , BERGES-MURO LUIS
Published: March 2016

The collaboration for developing research and development (R&D) projects highlights the importance to access new external knowledge. Drawing from a mixed-methods approach in a sample of projects carried out by Spanish firms, our key findings show that every project’s dimension of absorptive capacity is related to collaborative performance in different ways. Organisations with capability difficulties to transform external knowledge enhanced their R&D projects’ outcomes by collaborating more intensively. However, it is the ability to exploit that external knowledge into innovation which could be the key to obtain outcomes and support to R&D programs. The regional particularities have showed new ways to collaborate due to the innovation culture in the Middle Ebro Valley.
Studying the effects of the heat stress on the various layers of human skin using damage function
Authors: Aijaz Mir , Khanday M. A.
Published: March 2016

This paper develops a model to identify the effects of thermal stress on temperature distribution and damage in human dermal regions. The design and selection of the model takes into account many factors effecting the temperature distribution of skin, e.g., thermal conductance, perfusion, metabolic heat generation and thermal protective capabilities of the skin. The transient temperature distribution within the region is simulated using a two-dimensional finite element model of the Pennes’ bioheat equation. The relationship between temperature and time is integrated to view the damage caused to human skin by using Henriques’ model Henriques, F. C., Arch. Pathol. 43 (1947) 489–502]. The Henriques’ damage model is found to be more desirable for use in predicting the threshold of thermal damage. This work can be helpful in both emergency medicines as well as to plastic surgeon in deciding upon a course of action for the treatment of different burn injuries.
Prospects for Sino-Turkish Relations
Authors: Honghui Pan
Published: March 2016

This article addresses the major opportunities and challenges facing Sino-Turkish relations, an important relationship often neglected by scholars and practitioners of international relations. While identifying the two dominant challenges facing the two ancient civilizations, i.e. the Xinjiang Uighur issue and unbalanced trade favoring China, this article maintains that the two countries enjoy vast room for cooperation both economically and geopolitically. Their cooperation in China’s Xinjiang Uighur Autonomous Region can also result in a win-win situation, with Turkey making better use of its psychological linkage to the local Uighurs to increase its investment in infrastructure and China winning more Uighur identification with the central government by enhancing the local economy and living standards. In the international arena, though a comprehensive partnership of security cooperation has yet to develop, both countries have been engaged in ever closer cooperation as evidenced by Turkey’s intensifying efforts to join the Chinese-led Shanghai Cooperation Organization and Chinese companies’ active participation in Turkey’s many military projects. Nevertheless, given the relatively small size of the Turkish economy and its decades-long dependence on Western powers in security, economic, and cultural terms, the future Sino-Turkish relationship will remain largely a function of their respective relations with the West.
Human Spinal Motor Control
Authors: Nielsen Jens Bo
Published: March 2016

Human studies in the past three decades have provided us with an emerging understanding of how cortical and spinal networks collaborate to ensure the vast repertoire of human behaviors. Humans have direct cortical connections to spinal motoneurons, which bypass spinal interneurons and exert a direct (willful) muscle control with the aid of a context-dependent integration of somatosensory and visual information at cortical level. However, spinal networks also play an important role. Sensory feedback through spinal circuitries is integrated with central motor commands and contributes importantly to the muscle activity underlying voluntary movements. Regulation of spinal interneurons is used to switch between motor states such as locomotion (reciprocal innervation) and stance (coactivation pattern). Cortical regulation of presynaptic inhibition of sensory afferents may focus the central motor command by opening or closing sensory feedback pathways. In the future, human studies of spinal motor control, in close collaboration with animal studies on the molecular biology of the spinal cord, will continue to document the neural basis for human behavior.
Behavioral Nutrition Interventions Using e- and m-Health Communication Technologies: A Narrative Review
Authors: Olson Christine M.
Published: March 2016

e- and m-Health communication technologies are now common approaches to improving population health. The efficacy of behavioral nutrition interventions using e-health technologies to decrease fat intake and increase fruit and vegetable intake was demonstrated in studies conducted from 2005 to 2009, with approximately 75% of trials showing positive effects. By 2010, an increasing number of behavioral nutrition interventions were focusing on body weight. The early emphasis on interventions that were highly computer tailored shifted to personalized electronic interventions that included weight and behavioral self-monitoring as key features. More diverse target audiences began to participate, and mobile components were added to interventions. Little progress has been made on using objective measures rather than self-reported measures of dietary behavior. A challenge for nutritionists is to link with the private sector in the design, use, and evaluation of the many electronic devices that are now available in the marketplace for nutrition monitoring and behavioral change.
Forest Management, Public Goods, and Optimal Policies
Authors: Ollikainen Markku
Published: March 2016

This review examines the provision of public goods and the prevention of negative externalities in forest management. It focuses on three issues: (a) biodiversity conservation and maintenance, (b) the role of forestry in carbon policies, and (c) internalizing negative water externalities. Public goods and negative externalities appear differently under different forest management regimes. A distinction is made between even-aged management, defined by the rotation framework, and uneven-aged management, defined by continuous cover models. Although the review focuses mostly on analytical models, it briefly considers recent numerical models relying on the detailed description of forest management. Both conventional instruments and new payments for ecosystem services are discussed.
Resource-Dependent Livelihoods and the Natural Resource Base
Authors: Robinson Elizabeth J.Z.
Published: March 2016

The natural resource base, terrestrial and marine, provides rural households in lower-income countries with income, food, shelter, and medicines, which are variously gathered and hunted in common lands and waters. These resources may be actively managed, either by the government or local community; or they may be de facto open access, with little effort by governments to prevent what may be de jure illegal extraction. This review appraises the literature that encompasses the direct value of wild resources to rural households, the extent to which these resources mitigate poverty and inequality, and the importance of the institutional context. More recent literature increasingly addresses competing demands on the resource base, which both supports nearby livelihoods and enhances ecosystem services such as biodiversity; and the extent to which initiatives such as community-based payments for ecosystem services change how people interact with the resource base.
Thiopurines in the Management of Crohn’s Disease: Safety and Efficacy Profile in Patients with Normal TPMT Activity—A Retrospective Study
Authors: Benmassaoud Amine , Xie Xuanqian , AlYafi Motaz , Theoret Yves , Bitton Alain , Afif Waqqas , Bessissow Talat
Published: March 2016

Background and Aims.Thiopurines are used in the treatment of Crohn’s disease (CD) and thiopurine S-methyltransferase (TPMT) activity can guide thiopurine dosing to avoid adverse events. This retrospective study evaluated the safety and efficacy of starting thiopurines at low dose versus full dose in patients with CD and normal TPMT.Methods.This was a single center retrospective study including adult CD patients with normal TPMT levels (≥25 nmol/hr/g Hgb) who were followed for 1 year. Patients started at full dose of azathioprine (2–2.5 mg/kg) or 6-mercaptopurine (1–1.5 mg/kg) were compared to patients started at low dose. Harvey-Bradshaw index, treatment failure, and drug-related adverse events were recorded.Results.Our study included 134 patients. Both groups had similar incidences of drug-related adverse events and discontinuation of therapy due to side effects. Fifty-six percent of all adverse events occurred within 31 days and 92% occurred within 3 months of therapy. Clinical response favored the full-dose group at 6 months (69% versus 27%,p=0.0542).Conclusions.Our study indicates that it is safe to start patients on full-dose thiopurine when they have a normal TPMT given its very similar toxicity profile to patients started on low dose. This may also positively impact efficacy.
Simulation of Chloride Diffusion in Cracked Concrete with Different Crack Patterns
Authors: Wang Xiao-Yong , Zhang Li-Na
Published: March 2016

Chloride-induced corrosion of steel rebar is one of the primary durability problems for reinforced concrete structures in marine environment. Furthermore, if the surfaces of concrete structures have cracks, additional chloride can penetrate into concrete through cracked zone. For chloride ingression into cracked concrete, former researches mainly focus on influence of crack width on chloride diffusion coefficients. Other crack characteristics, such as chloride depth, crack shape (equal-width crack or tapered crack), crack density, and spacing, are not studied in detail. To fill this gap, this paper presents a numerical procedure to simulate chloride ingression into cracked concrete with different crack geometry characteristics. Cracked concrete is divided into two parts, sound zone and cracked zone. For stress-free concrete, the diffusion coefficient of sound zone is approximately assumed to be the same as sound concrete, and the diffusion coefficient of cracked zone is expressed as a piecewise function of crack width. Two-dimensional finite element method is used to determine chloride concentration. It is found that, with the increasing of crack width, crack depth, and crack amount, chloride ingression will aggravate. The analysis results generally agree with experimental results.
Iron Doped SBA-15 Mesoporous Silica Studied by Mössbauer Spectroscopy
Authors: Laskowski Łukasz , Laskowska Magdalena , Jelonkiewicz Jerzy , Galkowski Tomasz , Pawlik Piotr , Piech Henryk , Doskocz Marek
Published: March 2016

Mesoporous silica SBA-15 containing propyl-iron-phosphonate groups were considered to confirm their molecular structure. To detect the iron-containing group configuration the Mössbauer spectroscopy was used. Both mesoporous silica SBA-15 containing propyl-iron-phosphonate groups and pure doping agent (iron acetylacetate) were investigated using Mössbauer spectroscopy. The parameters such as isomer shift, quadrupole splitting, and asymmetry in57Fe Mössbauer spectra were analyzed. The differences in Mössbauer spectra were explained assuming different local surroundings of Fe nuclei. On this base we were able to conclude about activation of phosphonate units by iron ions and determinate the oxidation state of the metal ion. To examine bonding between iron atoms and phosphonic units the resonance Raman spectroscopy was applied. The density functional theory (DFT) approach was used to make adequate calculations. The distribution of active units inside silica matrix was estimated by comparison of calculated vibrational spectra with the experimental ones. Analysis of both Mössbauer and resonance Raman spectra seems to confirm the correctness of the synthesis procedure. Also EDX elemental analysis confirms our conclusions.
Lichtheimia ramosa: A Fatal Case of Mucormycosis
Authors: Mouronte-Roibás Cecilia , Leiro-Fernández Virginia , Botana-Rial Maribel , Ramos-Hernández Cristina , Lago-Preciado Guillermo , Fiaño-Valverde Concepción , Fernández-Villar Alberto
Published: March 2016

Mucormycosis due toLichtheimia ramosais an infrequent opportunistic infection that can potentially be angioinvasive when affecting inmunocompromised hosts. We present a fatal case of mucormycosis, affecting a 56-year-old male with diabetes mellitus and siderosis, initially admitted to our hospital due to an H1N1 infection. The subject’s clinical condition worsened and he finally died because of a necrotizing bilateral pneumonia with disseminated mycotic thromboses due toLichtheimia ramosa, which is an emerging Mucoralean fungus. This is an infrequent case because of the extent to which it affected a subject without overt immunocompromise. This case underlines the importance of an early premortem diagnosis and treatment in order to prevent rapid progression of this disease, as well as the need of considering mucormycosis when facing subjects with multiple emboli and fever unresponsive to usual antimicrobials.
Relationship between Neuropathic Pain and Obesity
Authors: Hozumi Jun , Sumitani Masahiko , Matsubayashi Yoshitaka , Abe Hiroaki , Oshima Yasushi , Chikuda Hirotaka , Takeshita Katsushi , Yamada Yoshitsugu
Published: March 2016

Objectives. Overweight negatively affects musculoskeletal health; hence obesity is considered a risk factor for osteoarthritis and chronic low back pain. This was conducted to determine if obesity affects neuropathic pain, usually considered unrelated to the weight-load on the musculoskeletal system.Methods. Using a cut-off body mass index value of 25, 44 patients with neuropathic pain were grouped into a “high-BMI” group and a “normal-BMI” group.Results. The numeric rating scale of the high-BMI group was significantly higher than that of the normal-weight group (P<0.05). The total NPSI scores were significantly higher (P<0.01), and the paroxysmal pain and the negative symptoms were more serious in the high-BMI group than in the normal-BMI group. The high-BMI subjects also had significantly higher SF-MPQ scores (P<0.05). However, both physical and mental health status on the SF-36 were comparable between the groups.Discussion. Neuropathic pain that did not arise from musculoskeletal damage was higher in the high-BMI patients. Paroxysmal pain was more severe, suggesting that neural damage might be aggravated by obesity-associated inflammation. These findings should have needed to be confirmed in future studies.
A Bayesian Approach for Evaluation of Determinants of Health System Efficiency Using Stochastic Frontier Analysis and Beta Regression
Authors: Şenel Talat , Cengiz Mehmet Ali
Published: March 2016

In today’s world, Public expenditures on health are one of the most important issues for governments. These increased expenditures are putting pressure on public budgets. Therefore, health policy makers have focused on the performance of their health systems and many countries have introduced reforms to improve the performance of their health systems. This study investigates the most important determinants of healthcare efficiency for OECD countries using second stage approach for Bayesian Stochastic Frontier Analysis (BSFA). There are two steps in this study. First we measure 29 OECD countries’ healthcare efficiency by BSFA using the data from the OECD Health Database. At second stage, we expose the multiple relationships between the healthcare efficiency and characteristics of healthcare systems across OECD countries using Bayesian beta regression.
Hybrid Adsorptive and Oxidative Removal of Natural Organic Matter Using Iron Oxide-Coated Pumice Particles
Authors: Kaplan Bekaroglu Sehnaz Sule , Yigit Nevzat Ozgu , Harman Bilgehan Ilker , Kitis Mehmet
Published: March 2016

The aim of this work was to combine adsorptive and catalytic properties of iron oxide surfaces in a hybrid process using hydrogen peroxide and iron oxide-coated pumice particles to remove natural organic matter (NOM) in water. Experiments were conducted in batch, completely mixed reactors using various original and coated pumice particles. The results showed that both adsorption and catalytic oxidation mechanisms played role in the removal of NOM. The hybrid process was found to be effective in removing NOM from water having a wide range of specific UV absorbance values. Iron oxide surfaces preferentially adsorbed UV280-absorbing NOM fractions. Furthermore, the strong oxidants produced from reactions among iron oxide surfaces and hydrogen peroxide also preferentially oxidized UV280-absorbing NOM fractions. Preloading of iron oxide surfaces with NOM slightly reduced the further NOM removal performance of the hybrid process. Overall, the results suggested that the tested hybrid process may be effective for removal of NOM and control disinfection by-product formation.
Spontaneous Knee Ankylosis through Heterotopic Ossification after Total Knee Arthroplasty
Authors: Boulezaz Samuel , Gibon Emmanuel , Loriaut Philippe , Casabianca Laurent , Rousseau Romain , Dallaudiere Benjamin , Pascal-Moussellard Hugues
Published: March 2016

This paper reports on a case of total ankylosis of the knee after a cruciate-sacrificing cemented total knee arthroplasty (TKA). An 82-year-old female patient previously underwent primary TKA for osteoarthritis twenty years ago in our institution. She had recovered uneventfully and returned to her regular activities. There was no history of postsurgical trauma; however, she progressively lost knee range of motion. Radiographs revealed severe bridging heterotopic ossification.
Calculation of Axial Compression Capacity for Square Columns Strengthened with HPFL and BSP
Authors: Huang Hua , Xi Kailin , Zhang Yu , Shi Jinghui , Liu Boquan
Published: March 2016

The load carrying capacity and failure mechanism of 8 square columns strengthened with high-performance ferrocement laminate (HPFL) and bonded steel plates (BSP) were analyzed on the basis of experiments on the axial compression performance of these columns. Results show that the reinforcing layer worked together with the original columns as a whole, and the load-bearing capacity significantly increased. When failure of the strengthened column occurred, the mortar and concrete were crushed and bulged outward in the middle of the columns, the angle bars and longitudinal steel bars buckled, and some stirrups were pulled out. The chamfering of angle bar momentously affected the primary damage of steel strand. The values of the strength reduction factor and pressure effective utilization coefficient of the mortar were suggested. Based on the experiments and existing tests of 35 columns strengthened with HPFL, equations for the axial compression bearing capacity were proposed and all calculation results agreed well with testing results. Therefore, the calculation method could be used in the capacity design of axial compression strengthened columns.
Hepatitis B Awareness and Knowledge in Asian Communities in British Columbia
Authors: Yau Alan Hoi Lun , Ford Jo-Ann , Kwan Peter Wing Cheung , Chan Jessica , Choo Queenie , Lee Tim K. , Kwong Willie , Huang Alan , Yoshida Eric
Published: March 2016

Background.Our study examined hepatitis B virus (HBV) awareness and knowledge in Asian communities in British Columbia (BC).Methods.A statistical random sample representation of Chinese, Korean, Filipino, South Asian, and Southeast Asian populations in Greater Vancouver was surveyed by telephone. Multiple logistic regression analysis was performed to identify predictors of HBV knowledge.Results.General awareness of HBV was reported in 78.8% (798/1013). HBV awareness was the highest in Chinese (89%) and Filipino (88%) populations and the lowest in the South Asian (56%) population. “Reasonable” knowledge of HBV was elicited in 76.8% (778/1013). Higher HBV knowledge was associated with younger age (p=0.014), higher education (p<0.0001), Chinese ethnicity (p<0.0001), and use of media (p=0.01) and Internet (p=0.024) for health information. Compared to the Chinese (OR = 1.0) population, “reasonable” knowledge of HBV was lower in Korean (OR = 0.3, 95% CI: 0.1–0.5), Filipino (OR = 0.3, 95% CI: 0.2–0.6), South Asian (OR = 0.3, 95% CI: 0.2–0.4), and Southeast Asian (OR = 0.3, 95% CI: 0.1–0.6) populations. 54.8% (555/1013) felt that HBV education was inadequate and 80.1% (811/1013) preferred HBV education in their native languages.Conclusion.Compared to the Chinese population, other Asian communities in BC have lower HBV awareness and knowledge. Public education should target older and less educated and Korean, Filipino, South Asian, and Southeast Asian populations in their native languages via media and Internet.
Apical External Root Resorption and Repair in Orthodontic Tooth Movement: Biological Events
Authors: Feller Liviu , Khammissa Razia A. G. , Thomadakis George , Fourie Jeanine , Lemmer Johan
Published: March 2016

Some degree of external root resorption is a frequent, unpredictable, and unavoidable consequence of orthodontic tooth movement mediated by odontoclasts/cementoclasts originating from circulating precursor cells in the periodontal ligament. Its pathogenesis involves mechanical forces initiating complex interactions between signalling pathways activated by various biological agents. Resorption of cementum is regulated by mechanisms similar to those controlling osteoclastogenesis and bone resorption. Following root resorption there is repair by cellular cementum, but factors mediating the transition from resorption to repair are not clear. In this paper we review some of the biological events associated with orthodontically induced external root resorption.
Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study
Authors: Orita Sumihisa , Yamashita Masaomi , Eguchi Yawara , Suzuki Miyako , Inoue Gen , Miyagi Masayuki , Watanabe Tomoko , Ozawa Tomoyuki , Kamoda Hiroto , Ishikawa Tetsuhiro , Aoki Yasuchika , Ito Toshinori , Kubota Go , Suzuki Munetaka , Yamauchi Kazuyo , Hanaoka Eiji , Sakuma Yoshihiro , Shimbo Jun , Oikawa Yasuhiro , Suzuki Takane , Takahashi Kazuhisa , Ohtori Seiji
Published: March 2016

We investigated the efficacy of pregabalin (PGB) for neuropathic leg pain in lumbar spinal stenosis (LSS) patients with disturbed activities of daily living (ADL)/quality of life (QOL) in a prospective observational study. Subjects were a total of 104 LSS patients with neuropathic pain (NeP) in leg and neurological intermittent claudication (IMC) refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) for at least a month. NeP was identified using screening tool, Pain DETECT questionnaire. Visual analog scale (VAS) scores and responses to the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were assessed before and 6 weeks after PGB treatment initiation. Changes in IMC distance and adverse events were also recorded. PGB significantly improved their VAS scores for pain and sleep quality (P<0.001). With respect to JOABPEQ, significant improvements were observed with regard to the following dimensions: pain-related disorders (P<0.01), lumbar spine dysfunction (P=0.031), gait disturbance (P=0.028), and psychological disorders (P=0.014). The IMC distance showed an improvement tendency after PGB treatment, albeit with no significance (P=0.063). Minor adverse events such as dizziness were observed. PGB can be effective for neuropathic leg pain refractory to NSAIDs in LSS patients, resulting in not only pain control but also improving lower back pain-related ADL/QOL scores.
Acupoints Stimulation for Anxiety and Depression in Cancer Patients: A Quantitative Synthesis of Randomized Controlled Trials
Authors: Wang Tao , Deng Renli , Tan Jing-Yu , Guan Feng-Guang
Published: March 2016

This study aims at concluding the current evidence on the therapeutic effects of acupoints stimulation for cancer patients with anxiety and depression. Randomized controlled trials using acupoints stimulation for relieving anxiety and/or depression in cancer patients were searched, and 11 studies were finally included, of which eight trials compared acupoints stimulation with standard methods of treatment/care, and acupoints stimulation showed significantly better effects in improving depression than using standard methods of treatment/care. Four studies compared true acupoints stimulation with sham methods, and no significant differences can be found between groups for either depression or anxiety, although the pooled effects still favored true intervention. For the five studies that evaluated sleep quality, the results were conflicting, with three supporting the superiority of acupoints stimulation in improving sleep quality and two demonstrating no differences across groups. Acupoints stimulation seems to be an effective approach in relieving depression and anxiety in cancer patients, and placebo effects may partially contribute to the benefits. However, the evidence is not conclusive due to the limited number of included studies and the clinical heterogeneity identified among trials. More rigorous designed randomized, sham‐controlled studies are necessary in future research.
Diagnosis and Management of Barrett’s Esophagus: A Retrospective Study Comparing the Endoscopic Assessment of Early Esophageal Lesions in the Community versus a Specialized Center
Authors: Rayner-Hartley Erin , Takach Oliver , Galorport Cherry , Enns Robert A.
Published: March 2016

Specialized endoscopic evaluation for patients with Barrett’s esophagus (BE) is well supported; however, no studies have shown that centers with expertise provide better quality care for BE with high-grade dysplasia or early adenocarcinoma. In this study, the investigators aimed to evaluate the management and clinical course for patients treated in a community practice versus a specialized BE center.Methods. A retrospective analysis of referrals from the community to our specialized center for evaluation of BE at St Paul’s Hospital Division of Gastroenterology between January 2007 and February 2014 was performed. Subjects were patients who were referred for BE and dysplasia and subsequently reevaluated by endoscopy. The pathology and endoscopy reports from the community and our center were reviewed. Inclusion criteria were as follows: being ≥ 19 years old and pathologic diagnosis of BE or dysplasia in the community. Exclusion criteria were as follows: incomplete pathology data or incomplete endoscopy reports from the community physicians.Results. A total of 77 patients were reviewed. The staging of 28.9% of patients referred from the community was changed from the initial pathological diagnosis. 18.4% of these patients were upstaged. Using Fischer’s exact test, we showed that, in our specialized center, endoscopic impressions correlated significantly with pathology results (p<0.0001).
A Study on the Determination of Korea Affecting Tropical Cyclone Center for Best Tracking
Authors: Cha Yumi , Kim Jinyeon , Kang Kiryong , Kang Nam-Young , Yun Won-Tae
Published: March 2016

The establishment of an independent tropical cyclone (TC) position is suggested for the purpose of constructing TC best track data of the Korea Meteorological Administration. The best track process was designed with five basic stages: database, potential interval (PI), optimization, smoothing, and metadata. The PI was newly devised as a tool for expressing the uncertainty in the location of the center of the TC. This PI determined the minimum range at which the center of the TC can be adjusted and based on the analysis manual for each dataset used in the TC best tracking. Furthermore, the PI can be optimized by the differential application of the range depending on the reliability of the data. By smoothing all TC centers within the optimized PI, a best track can be produced more stably. Therefore, the analysis can be less subjective even when the determination of the TC center is difficult. For three typhoon cases that had affected Korea in 2013 (LEEPI, KONG-REY, and DANAS), best tracks were obtained based on the suggested analysis stages and verified. The results showed that the PI was relatively large in the early development and weakening stage of the TC or when the estimation of the TC center was difficult because of interactions with the land. And the best tracking was performed well with reasonable applicability.
A Novel Blind Source Separation Algorithm and Performance Analysis of Weak Signal against Strong Interference in Passive Radar Systems
Authors: Li Chengjie , Zhu Lidong , Xie Anhong , Luo Zhongqiang
Published: March 2016

In Passive Radar System, obtaining the mixed weak object signal against the super power signal (jamming) is still a challenging task. In this paper, a novel framework based on Passive Radar System is designed for weak object signal separation. Firstly, we propose an Interference Cancellation algorithm (IC-algorithm) to extract the mixed weak object signals from the strong jamming. Then, an improved FastICA algorithm withK-means cluster is designed to separate each weak signal from the mixed weak object signals. At last, we discuss the performance of the proposed method and verify the novel method based on several simulations. The experimental results demonstrate the effectiveness of the proposed method.
Gastrocolic Fistula: A Shortcut through the Gut
Authors: Forbes Nauzer , Al-Dabbagh Raed , Lovrics Peter , Morgan David
Published: March 2016

Gastrocolic fistulas are observed in association with several conditions. Traditionally, peptic ulcer disease was commonly implicated in the formation of gastrocolic fistulas; however, this is now a rare etiology. Here, we present a case of gastrocolic fistula secondary to peptic ulcer disease alone, in addition to reviewing the literature and providing options for diagnosis and treatment.
Facial Expression Overrides Lumbopelvic Kinematics for Clinical Judgements about Low Back Pain Intensity
Authors: Courbalay A. , Deroche T. , Descarreaux M. , Prigent E. , O'Shaughnessy J. , Amorim M.-A.
Published: March 2016

Background.Through real-time behavioral observation systems, pain behaviors are commonly used by clinicians to estimate pain intensity in patients with low back pain. However, little is known about how clinicians rely on pain-related behaviors to make their judgment. According to the Information Integration Theory (IIT) framework, this study aimed at investigating how clinicians value and integrate information from lumbopelvic kinematics (LK), a protective pain behavior, and facial expression intensity (FEI), a communicative pain behavior, to estimate pain in patients with chronic low back pain (cLBP).Methods.Twenty-one experienced clinicians and twenty-one novice clinicians were asked to estimate back pain intensity from a virtual character performing a trunk flexion-extension task.Results.Results revealed that both populations relied on facial expression and that only half of the participants in each group integrated FEI and LK to estimate cLBP intensity. Among participants who integrated the two pain behaviors, averaging rule predominated among others. Results showed that experienced clinicians relied equally on FEI and LK to estimate pain, whereas novice clinicians mostly relied on FEI.Discussion.The use of additive rule of integration does not appear to be systematic when assessing others’ pain. When assessing pain intensity, communicative and protective pain behaviors may have different relevance.