bluuebunny/crossref_metadata_2025 huggingface dataset:
Hibah (Gift inter vivos) by Parent in Favour of Some Children to the Exclusion of the Others under Islamic Law
Authors: Hj Ibrahim Badruddin
Published: February 2017

This study examines issues arising from gift giving (hibah) by a parent to one or more of his/her children to the exclusion of the others under Islamic law in general and as applied to Muslims in Malaysia in particular. Does a parent have an absolute right to dispose of property to his/her children by means of hibah without concern for fairness to the other children? Is hibah a valid and acceptable practice in a modern Muslim society? Is the core issue one of an individual’s absolute property rights or is it restrained by the principle of fairness in dealing with properties? This study will attempt to provide a right and acceptable guidance with respect to the disposal of property to children by means of hibah.
New species of Leleja (Orthoptera: Gryllinae; Gryllini) with first female description for the genus
Authors: TAN MING KAI , ARTCHAWAKOM TAKSIN
Published: February 2017

Following the recent discovery of a new genus from Thailand, a new species of Leleja Gorochov 2016 was discovered from Sakaerat Environmental Research Station in the same province: Leleja khao sp. n. Despite their close proximity between their known distributions, Leleja khao sp. n. differs from the type species by the male genitalia and also their natural habitat. The female for the genus is also described here for the first time.
Taxonomy of 'Euconnus complex'. Part XI. Status of Euconophron and Scopophus (Coleoptera, Staphylinidae, Scydmaeninae)
Authors: JAŁOSZYŃSKI PAWEŁ
Published: February 2017

Euconophron was described over a century ago and includes over 120 nominal species, being the third largest subgenus of Euconnus. However, its diagnosis remains unclear. Western Palaearctic species seem to form a homogenous group characterized by emarginate or bifurcate aedeagal apex, whereas exotic members of this subgenus show a great diversity in external and genital characters. Moreover, Scopophus, a Nearctic subgenus of Euconnus, and at least some species placed in Euconnus s. str. outside Europe seem to be very similar to Euconophron. In the present paper the status of Euconophron and Scopophus is verified on the basis of morphological structures of their type species, i.e., Scydmaenus promptus Coquerel (the type species of Euconophron) and Euconnus affinis Casey (the type species of Scopophus), each represented by respective type specimens. It is concluded that: i) the redescription of Scydmaenus promptus published by H. Franz was based on a misidentified specimen; ii) Euconophron can be maintained as a separate subgenus if unique characters of western Palaearctic species are included in its diagnosis; iii) Scopophus is a junior synonym of Euconnus s. str.; iv) status of species currently placed in Euconophron that occur outside western Palaearctic seems dubious, some of them may belong in Euconnus s. str. (this problem requires further study and species redescriptions); v) Euconnus s. str. and Euconophron may be closely related. Emended diagnosis of Euconophron is given, and lectotypes are designated for Scydmaenus promptus and Euconnus affinis.
Description of four new species of Ochlerini from South America (Hemiptera: Pentatomidae: Discocephalinae)
Authors: CAMPOS LUIZ ALEXANDRE , ROELL TALITA
Published: February 2017

The tribe Ochlerini Rolston was proposed in 1981 to house 23 genera of Neotropical pentatomids, most of them containing few species and poorly represented in entomological collections. After a quarter century of accumulated taxonomic knowledge the tribe totals 36 genera and 133 species, but a number of taxa still require revision or remain undescribed. Here we describe and illustrate four new species from South America, Cromata flavida sp. nov., Lincus curvatus sp. nov., Ocellatocoris longirostris sp. nov., and Xynocoris ecuadorensis sp. nov. The specimens of L. curvatus and X. ecuadorensis were collected on oil palms (OxG hybrids, Elaeis oleifera x Elaeis guineensis) affected by the lethal wilt (marchitez sorpresiva) disease.
A new species of Megatibicen endemic to Mescalero-Monahans shinnery sands (Hemiptera: Auchenorrhyncha: Cicadidae)
Authors: COLE JEFFREY A.
Published: February 2017

Megatibicen harenosus sp. n. is described from the Mescalero-Monahans shinnery sands of New Mexico and Texas, U.S.A. The new species is diagnosed from similar species, especially M. tremulus which it resembles closely, by male genital morphology, color pattern, calling song, and ecology. Seven characters from the male calling song are described from analysis of field recordings, of which all four temporal song characters are significantly different from M. tremulus. With one of the most southwestern distribution of any Megatibicen species, M. harenosus is a new addition to the rich, endemic, and understudied Mescalero-Monahans shinnery sands biota. The possibility that M. harenosus and M. tremulus are sister species is raised. The ecological, biological, and evolutionary species concepts support species status for M. harenosus, and an hypothesis of peripatric speciation in peripheral isolation is advanced.
A Physically Based Autoconversion Parameterization
Authors: Lee Hyunho , Baik Jong-Jin
Published: February 2017

A physically based parameterization for the autoconversion is derived by solving the stochastic collection equation (SCE) with an approximated collection kernel. The collection kernel is constructed using the terminal velocity of cloud droplets and the collision efficiency between cloud droplets that is obtained using a particle trajectory model. The new parameterization proposed in this study is validated through comparison with results obtained by a bin-based direct SCE solver and other autoconversion parameterizations using a box model. The autoconversion-related time scale and drop number concentration are employed for the validation. The results of the new parameterization are shown to most closely match those of the direct SCE solver. It is also shown that the dependency of the autoconversion rate on drop number concentration in the new parameterization is similar to that in the direct SCE solver, which is partially caused by the shape of drop size distribution. The new parameterization and other parameterizations are implemented into a cloud-resolving model, and idealized shallow warm clouds are simulated. The autoconversion parameterizations that yield the small (large) autoconversion rate tend to predict large (small) cloud optical thickness, small (large) cloud fraction, and small (large) surface precipitation amount. Cloud optical thickness and cloud fraction are changed by up to ~45% and ~20% by autoconversion parameterizations, respectively. The new parameterization tends to yield the moderate autoconversion rate among the autoconversion parameterizations. Moreover, it predicts cloud optical thickness, cloud fraction, and surface precipitation amount that are generally the closest to those of the bin microphysics scheme.
Office-based Electromyography-guided Botulinum Toxin Injection to the Cricopharyngeus Muscle: Optimal Patient Selection and Technique
Authors: Kim Min-Su , Kim Go-Woon , Rho Young-Soo , Kwon Kee-Hwan , Chung Eun-Jae
Published: February 2017

Objectives:

This retrospective study was carried out to investigate the effectiveness and safety of office-based electromyography-guided injection of botulinum toxin in the cricopharyngeus muscle of patients who did not show upper esophageal sphincter passage in a swallowing study in spite of maximal swallowing rehabilitation.

Methods:

Thirty-six patients who showed no or limited ability to oral feed after maximum swallowing rehabilitation were enrolled. Video fluoroscopic swallowing study, flexible endoscopic evaluation of swallowing, disability rating scale, penetration aspiration score, and National Institutes of Health swallowing safety scale were used in the evaluation of dysphagia.

Results:

Success was defined as nondependence on gastrostomy for patients who previously were dependent on gastrostomy and improvement in disability rating scale score after botulinum toxin injections. The total success rate was 63.9%. The complication rate was very low, with only 1 patient showing temporary unilateral vocal fold paralysis. Botulinum toxin injection was more effective in patients with cranial nerve IX or X palsy than in those without it ( P = .006).

Conclusions:

This procedure can be a simple, safe, and effective tool in patients with cricopharyngeal dysfunction after swallowing rehabilitation, especially for cranial nerve IX or X palsy.
Colonial Plunder and the Failure of Restitution in Postwar Korea
Authors: Kim Christine
Published: February 2017

This article evaluates the US ‘Monuments Men’ operations in Korea, focusing on wartime and postwar efforts undertaken by the government of the USA to preserve and restore artwork seized by Japan. The Asian initiative, conceived a year after the European model was established, likewise drew upon cultural, intellectual, and academic resources. Yet fundamental differences in personnel, perceptions of Korean cultural backwardness, prevailing imperialist attitudes, and Cold War sensibilities rendered a very different kind of project. Ultimately the ‘Monuments Men’ succeeded primarily in preserving the cultural patrimony of Japan, but it failed to recover any plundered objects from Korea, or the rest of Asia for that matter. Focusing on the US deliberations regarding repatriation of Korean looted art, this article lays bare both the US preoccupation with maintaining the national interests of its newest ally, and exposes an understanding of East Asian cultural hierarchy that privileged Japan’s artistic achievement and modern society above all.
Ethnic Diversity and Social Capital in the Russian Context
Authors: Tatarko Alexander , Mironova Anna , van de Vijver Fons J. R.
Published: February 2017

We examined the link between ethnic diversity and social capital to test Putnam’s hypothesis on the negative impact of ethnic diversity on social capital. Data came from a representative survey in two multicultural regions of Russia ( N = 2,061). To assess the level of ethnic diversity, an ethnic diversity index was calculated using data from the latest National Population Census in Russia. Data were analyzed using two-level structural equation modeling. The results did not confirm Putnam’s hypothesis and showed that ethnic diversity, as assessed in the latest National Population Census in Russia, was not negatively related to social capital in Russia. We argue that the long-standing ethnic diversity in Russia is positively related to informal sociability, and does not affect generalized trust and community organizational life. It is concluded that Putnam’s hypothesis does not have universal validity, presumably because the link between diversity and social capital is moderated by various regional and national characteristics.
Accuracy of Predictive Equations for Energy Expenditure in Mexicans Living With HIV/AIDS With and Without Antiretroviral Therapy
Authors: Osuna‐Padilla Iván Armando , Aguilar‐Vargas Adriana , Villazón‐De la Rosa Andrea , Ablanedo‐Terrazas Yuria , Vargas‐Infante Yetlanezi , Reyes‐Terán Gustavo
Published: February 2017

Introduction: Determination of the resting energy expenditure (REE) is essential for planning nutrition therapy in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) to help to improve their nutrition status. We aim to evaluate the agreement and accuracy of prediction equations that estimate the REE in a Mexican population with a diagnosis of HIV/AIDS with and without antiretroviral therapy (ART). Methods: A cross‐sectional study in Mexican patients with HIV/AIDS with and without ART. Weight, height, and body composition measured with dual‐energy x‐ray absorptiometry were evaluated. The REE was determined with indirect calorimetry and estimated using the Mifflin–St Jeor (MSJ), Harris‐Benedict (HB), Schofield 1 and 2, Cunningham, Melchior 91, Melchior 93, and Batterham equations. The Bland‐Altman method assessed agreement between the real and estimated values, and the percent difference between these values was used to assess the prediction accuracy. Results: Sixty‐five adults without ART and 102 adults with ART were included. The mean REE (kcal/kg) was 24.8 ± 2.4 and 23.8 ± 3.6 in patients without and with ART, respectively. Good agreement and reliability were observed in the HB (intraclass correlation coefficient [ICC], 0.75; P < .05), Batterham (ICC, 0.79; P < .05), Schofield 1 (ICC, 0.74; P < .05), and Schofield 2 (ICC, 0.78; P < .05) results in individuals without ART. In individuals with ART, good agreement and reliability were observed with the HB equation (ICC, 0.76; P < .05). The MSJ equation showed good agreement with poor reliability (ICC, 0.05; P < .05). Conclusion: The equations with the best agreement and accuracy were Schofield 2, Batterham, and HB in individuals without ART and HB and MSJ in the population with ART.
Two-way cultural transfer: the case of the Israeli TV series BeTipul and its American adaptation In Treatment
Authors: Sela-Sheffy Rakefet
Published: February 2017

BeTipul, the first Israeli TV series purchased by American television, and its American adaptation, In Treatment, provide an intriguing case of bidirectional (peripheral-global) cultural transfer. Focusing on the psychotherapy content of the show, this article examines the effect of foreignness versus compatibility it generated in the two different reception spaces. In America, the adaptation strategies and critics’ response to the remake reveal a smooth naturalization in the target setting, whereas in the (source) Israeli setting critics’ commentaries and anonymous online comments to the original series reveal that it was conceived from the outset as an American-like production made in Israel – evaluated either positively, as matching international standards, or negatively, as a cultural pretense. The antagonism between Israeli viewers of this show illustrates the powerful ‘foreignness effect’ associated with psychotherapy images in the local culture, inciting a social contest between elitist and mass audience.
Recurrence of glioblastoma is associated with elevated microvascular transit time heterogeneity and increased hypoxia
Authors: Stadlbauer Andreas , Mouridsen Kim , Doerfler Arnd , Bo Hansen Mikkel , Oberndorfer Stefan , Zimmermann Max , Buchfelder Michael , Heinz Gertraud , Roessler Karl
Published: February 2017

Dynamic susceptibility contrast (DSC) perfusion MRI provide information about differences in macro- and microvasculature when executed with gradient-echo (GE; sensitive to macrovasculature) and spin-echo (SE; sensitive to microvasculature) contrast. This study investigated whether there are differences between macro- and microvascular transit time heterogeneity (MVTH and µVTH) and tissue oxygen tension (PO2mit) in newly-diagnosed and recurrent glioblastoma. Fifty-seven patients with glioblastoma (25 newly-diagnosed/32 recurrent) were examined with GE- and SE-DSC perfusion sequences, and a quantitative blood-oxygen-level-dependent (qBOLD) approach. Maps of MVTH, µVTH and coefficient of variation (MCOV and µCOV) were calculated from GE- and SE-DSC data, respectively, using an extended flow-diffusion equation. PO2mit maps were calculated from qBOLD data. Newly-diagnosed and recurrent glioblastoma showed significantly lower ( P ≤ 0.001) µCOV values compared to both normal brain and macrovasculature (MCOV) of the lesions. Recurrent glioblastoma had significantly higher µVTH ( P = 0.014) and µCOV ( P = 0.039) as well as significantly lower PO2mit values ( P = 0.008) compared to newly-diagnosed glioblastoma. The macrovasculature, however, showed no significant differences. Our findings provide evidence of microvascular adaption in the disorganized tumor vasculature for retaining the metabolic demands in stress response of therapeutically-uncontrolled glioblastomas. Thus, µVTH and PO2mit mapping gives insight into the tumor microenvironment (vascular and hypoxic niches) responsible for therapy resistance.
Open access and open data on natural disasters
Authors: De Giusti Marisa R. , Villarreal Gonzalo L. , Nusch Carlos J. , Pinto Analía V. , Lira Ariel J.
Published: February 2017

After a flood which devastated the city of La Plata (Argentina) in April 2013, a survey of the water situation in the region revealed that relevant studies and projects related with this area were scattered and lacked visibility. This prompted academic, scientific, technologic, and governmental institutions to take action and work together to compile, organize, and disseminate available data in an unprecedented response to an environmental disaster in the region. For this purpose, a dedicated collection was created in the SEDICI, the institutional repository for the Universidad Nacional de La Plata, and subsequently, the Observatorio Medioambiental La Plata (OMLP), a repository for data on environmental research, was launched. This document describes these collaboration initiatives which aim to anticipate and reduce the impact of natural disasters, their main characteristics, their resources, and their current progress. Projects driven by the OMLP are also described, along with a description of their technical and infrastructure deployment as per the open access policies.
A low invasiveness patient’s specific template for spine surgery
Authors: Azimifar Farhad , Hassani Kamran , Saveh Amir Hossein , Tabatabai Ghomshe Farhad
Published: February 2017

Free-hand pedicle screw placement is still conventional in surgery, although it has potentially high risks. The surgical procedures such as pedicle screw placement are usually designed based on medical imaging, but during surgery, the procedures are not normally followed due to the fact that some points are missed in two-dimensional images and seen only during surgery. In this regards, some highly accurate computer-assisted systems have been proposed and are currently used. Moreover, it is possible to reduce or completely avoid hand working by applying modern digital technology. Therefore, using these technologies has remarkable advantages. In this study, we have presented a new approach of pedicle screw placement in the lumbar and sacral regions using a specific drill guide template. The template was created by additive manufacturing technology and was verified in a clinical study as well. The main aim of this research includes the following: design, analyze, manufacture and evaluate the accuracy of a new patient-specific drill guide template, for lumbar pedicle screw placement, and compare the template to the free-hand technique under fluoroscopy supervision. Our results show that the incidence of cortex perforation is substantially reduced compared to existing methods. Finally, we believe that this approach remarkably lowers the incidence of cortex perforation and could be potentially used in clinical applications, particularly in certain selected cases.
Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces?
Authors: La Forgia Ambar , Maeda Jared Lane K. , Banthin Jessica S.
Published: February 2017

As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these “vertically” integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.
Theorizing Black (African) Transnational Masculinities
Authors: Pasura Dominic , Christou Anastasia
Published: February 2017

Just as masculinity is crucial in the construction of nationhood, masculinity is also significant in the making and unmaking of transnational communities. This article focuses on how black African men negotiate and perform respectable masculinity in transnational settings, such as the workplace, community, and family. Moving away from conceptualizations of black transnational forms of masculinities as in perpetual crisis and drawing on qualitative data collected from the members of the new African diaspora in London, the article explores the diverse ways notions of masculinity and gender identities are being challenged, reaffirmed, and reconfigured. The article argues that men experience a loss of status as breadwinners and a rupture of their sense of masculine identity in the reconstruction of life in the diaspora. Conditions in the hostland, in particular, women’s breadwinner status and the changing gender relations, threaten men’s “hegemonic masculinity” and consequently force men to negotiate respectable forms of masculinity.
Queering Prison Masculinity
Authors: Hefner M. Kristen
Published: February 2017

Gender, sex, and sexuality are fluid, socially constructed aspects of social life that are organized differently based on the context in which individuals’ lives are situated. Of particular interest in this study is how gender, sex, and sexuality are constructed and organized in single-sex correctional institutions. Using in-depth interviews conducted with fourteen heterosexual male inmates, this research explores how sexuality is organized within the prison environment. Drawing on queer theory, this article problematizes the idea of a heterosexual/homosexual binary. Specifically, the study illustrates that inmates often blur the boundaries between male and female, heterosexual and homosexual, illustrating the flexibility and volatility of traditional binary gendered and sexualized social categories, providing a richer understanding of how social inequalities are created and maintained within the prison context.
The impact of subjective cognitive fatigue and depression on cognitive function in patients with multiple sclerosis
Authors: Golan Daniel , Doniger Glen M , Wissemann Karl , Zarif Myassar , Bumstead Barbara , Buhse Marijean , Fafard Lori , Lavi Idit , Wilken Jeffrey , Gudesblatt Mark
Published: February 2017

Background:

The association between subjective cognitive fatigue and objective cognitive dysfunction in patients with multiple sclerosis (PwMS) has been studied, with conflicting results.

Objective:

To explore the impact of fatigue on cognitive function, while controlling for the influence of depression, disability, comorbidities, and psychotropic medications.

Methods:

PwMS completed a computerized cognitive testing battery with age- and education-adjusted cognitive domain scores. Disability (Expanded Disability Status Scale (EDSS)), cognitive fatigue, and depression were concurrently evaluated.

Results:

In all, 699 PwMS were included. Both cognitive fatigue and depression were significantly and negatively correlated with the same cognitive domains: information processing speed, executive function, attention, motor function, and memory (−0.15 ⩽ r ⩽ −0.14 for cognitive fatigue; −0.24 ⩽ r ⩽ −0.19 for depression). Multivariate analysis revealed significant but small independent correlations only between depression and neuropsychological test results, while cognitive fatigue had no independent correlation with objective cognitive function except for a trend toward impaired motor function in highly fatigued PwMS. Depression and cognitive fatigue accounted for no more than 6% of the variance in objective cognitive domain scores.

Conclusion:

Cognitive fatigue is not independently related to objective cognitive impairment. Depression may influence cognitive function of PwMS primarily when it is severe. Cognitive impairment in PwMS should not be ascribed to fatigue or mild depression.
Analysis of tourism demand serial dependence structure for forecasting
Authors: Zhu Liang , Lim Christine , Xie Wenjun , Wu Yuan
Published: February 2017

This study aims to extend knowledge of serial dependence structure in tourism demand modelling and make a contribution to tourism forecasting with the use of copula method. Analysis of serial dependence can reveal the impact of current tourism demand on the future. This is important for tourism demand forecasting, as the prediction of future tourism demand relies highly on the historical demand information. However, serial dependence, especially its structure, has received very little attention in previous tourism research. The copula method is flexible as it provides various functions to specify different serial dependence structures and allows arbitrary distributions of tourism demand. We used five types of copulas to analyse two-dimensional serial dependence structure for 10 arrivals series to Singapore. The empirical findings show that serial dependence structures of arrivals can be non-linear. Additionally, the Student- t copula generates forecasts of tourism demand with higher accuracy than the autoregressive integrated moving average (ARIMA) and seasonal ARIMA models.
Difference in bilateral digital volume pulse as a novel non-invasive approach to assessing arteriosclerosis in aged and diabetic subjects: A preliminary study
Authors: Wu Hsien-Tsai , Lee Kuan-Wei , Pan Wen-Yao , Liu An-Bang , Sun Cheuk-Kwan
Published: February 2017

Objective:

This study aimed at validating photoplethysmography for assessing bilateral blood pressure differences through investigating the correlations of digital volume pulse with arteriosclerosis risk.

Methods:

Totally, 111 subjects (70 healthy and 41 diabetic) were recruited. Demographic, blood pressure and anthropometric data were recorded. Blood was collected for determining serum cholesterol, total triglyceride, total cholesterol, high-/low-density lipoprotein cholesterol, fasting blood sugar and glycated haemoglobin concentrations. Arterial stiffness was assessed with electrocardiogram-based pulse wave velocity, crest time and inter-digital volume pulse differences.

Results:

Receiver operating characteristic curve demonstrated high inter-digital volume pulse difference sensitivity to glycated haemoglobin level over 6.5%. Linear regression analysis demonstrated significant correlation between inter-digital volume pulse difference and electrocardiogram-based pulse wave velocity ( r = 0.692, p < 0.001). Compared with electrocardiogram-based pulse wave velocity, inter-digital volume pulse difference exhibited highly significant correlations with age, glycated haemoglobin level, pulse pressure, total cholesterol/high-density lipoprotein ratio, crest time, high-density lipoprotein and systolic blood pressure (all ps < 0.001).

Conclusion:

In conclusion, the results not only demonstrated successful application of a novel non-invasive waveform contour index, inter-digital volume pulse difference, in differentiating young from aged subjects and patients with good diabetic control from those with poor diabetic control but also validated its use in identifying arteriosclerosis risks. The results, therefore, endorse its domestic application as non-invasive tool for arteriosclerosis risk screening.
The predictive value of an adjusted COPD assessment test score on the risk of respiratory-related hospitalizations in severe COPD patients
Authors: Sloots Joanne M , Barton Christopher A , Buckman Julie , Bassett Katherine L , Palen Job van der , Frith Peter A , Effing Tanja W
Published: February 2017

We evaluated whether a chronic obstructive pulmonary disease (COPD) assessment test (CAT) with adjusted weights for the CAT items could better predict future respiratory-related hospitalizations than the original CAT. Two focus groups (respiratory nurses and physicians) generated two adjusted CAT algorithms. Two multivariate logistic regression models for infrequent (≤1/year) versus frequent (>1/year) future respiratory-related hospitalizations were defined: one with the adjusted CAT score that correlated best with future hospitalizations and one with the original CAT score. Patient characteristics related to future hospitalizations ( p ≤ 0.2) were also entered. Eighty-two COPD patients were included. The CAT algorithm derived from the nurse focus group was a borderline significant predictor of hospitalization risk (odds ratio (OR): 1.07; 95% confidence interval (CI): 1.00–1.14; p = 0.050) in a model that also included hospitalization frequency in the previous year (OR: 3.98; 95% CI: 1.30–12.16; p = 0.016) and anticholinergic risk score (OR: 3.08; 95% CI: 0.87–10.89; p = 0.081). Presence of ischemic heart disease and/or heart failure appeared ‘protective’ (OR: 0.17; 95% CI: 0.05–0.62; p = 0.007). The original CAT score was not significantly associated with hospitalization risk. In conclusion, as a predictor of respiratory-related hospitalizations, an adjusted CAT score was marginally significant (although the original CAT score was not). ‘Previous respiratory-related hospitalizations’ was the strongest factor in this equation.
Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma: An observational comparative study
Authors: Ramadan Wijdan H , Sarkis Aline T
Published: February 2017

Numerous patients with chronic obstructive pulmonary disease (COPD) and asthma do not use inhaler devices properly, which can contribute to poor disease control. The objective of this study is to assess the technical and safety use of dry powder inhalers (DPIs) versus pressurized metered-dose inhalers (MDIs) in adult patients with COPD or asthma in Lebanon. A concurrent, prospective comparative observational study was conducted at one hospital and 15 community pharmacies in Lebanon. Over a period of 18 months, 246 questionnaires were filled. Patients included were adults with COPD or asthma. Answers were entered into the Statistical Package for Social Sciences software and excel sheet. T-test and correlation were used to analyze the results; 67.8% and 38.4% of those using DPIs and MDIs, respectively, performed the exact technical steps adequately ( p = 0.003, relative risk: 2.134, 95% confidence interval: 0.910–4.842). When compared to MDI, a higher percentage of DPI users found their devices easy to use. Moreover, 81.4% of the MDI users found difficulty in coordinating between pressing the canister and inhaling. Rates of exacerbations were significantly higher in MDIs vs. DPI users (59.4% vs. 21.7%). Overall, 44.31% of patients did not receive education from their healthcare professionals about the devices. A significant number of COPD/asthma adult patients do not use their devices properly. Even though DPIs were significantly easier to use, proper education on the technical use of all types of inhalers is needed.
Validity and reliability of strain gauge measurement of volitional quadriceps force in patients with COPD
Authors: Machado Rodrigues Fernanda , Demeyer Heleen , Hornikx Miek , Camillo Carlos Augusto , Calik-Kutukcu Ebru , Burtin Chris , Janssens Wim , Troosters Thierry , Osadnik Christian
Published: February 2017

This study investigated the validity and reliability of fixed strain gauge measurements of isometric quadriceps force in patients with chronic obstructive pulmonary disease (COPD). A total cohort of 138 patients with COPD were assessed. To determine validity, maximal volitional quadriceps force was evaluated during isometric maximal voluntary contraction (MVC) manoeuvre via a fixed strain gauge dynamometer and compared to (a) potentiated non-volitional quadriceps force obtained via magnetic stimulation of the femoral nerve (twitch (Tw); n = 92) and (b) volitional computerized dynamometry (Biodex; n = 46) and analysed via correlation coefficients. Test–retest and absolute reliability were determined via calculations of intra-class correlation coefficients (ICCs), smallest real differences (SRDs) and standard errors of measurement (SEMs). For this, MVC recordings in each device were performed across two test sessions separated by a period of 7 days ( n = 46). Strain gauge measures of MVC demonstrated very large correlation with Tw and Biodex results ( r = 0.86 and 0.88, respectively, both p < 0.0001). ICC, SEM and SRD were numerically comparable between strain gauge and Biodex devices (ICC = 0.96 vs. 0.93; SEM = 8.50 vs. 10.54 N·m and SRD = 23.59 vs. 29.22 N·m, respectively). The results support that strain gauge measures of quadriceps force are valid and reliable in patients with COPD.
Barriers to Offering Vasectomy at Publicly Funded Family Planning Organizations in Texas
Authors: White Kari , Campbell Anthony , Hopkins Kristine , Grossman Daniel , Potter Joseph E.
Published: February 2017

Few publicly funded family planning clinics in the United States offer vasectomy, but little is known about the reasons this method is not more widely available at these sources of care. Between February 2012 and February 2015, three waves of in-depth interviews were conducted with program administrators at 54 family planning organizations in Texas. Participants described their organization’s vasectomy service model and factors that influenced how frequently vasectomy was provided. Interview transcripts were coded and analyzed using a theme-based approach. Service models and barriers to providing vasectomy were compared by organization type (e.g., women’s health center, public health clinic) and receipt of Title X funding. Two thirds of organizations did not offer vasectomy on-site or pay for referrals with family planning funding; nine organizations frequently provided vasectomy. Organizations did not widely offer vasectomy because they could not find providers that would accept the low reimbursement for the procedure or because they lacked funding for men’s reproductive health care. Respondents often did not perceive men’s reproductive health care as a service priority and commented that men, especially Latinos, had limited interest in vasectomy. Although organizations of all types reported barriers, women’s health centers and Title X-funded organizations more frequently offered vasectomy by conducting tailored outreach to men and vasectomy providers. A combination of factors operating at the health systems and provider level influence the availability of vasectomy at publicly funded family planning organizations in Texas. Multilevel approaches that address key barriers to vasectomy provision would help organizations offer comprehensive contraceptive services.
Countries with women inequalities have higher stroke mortality
Authors: Kim Young Dae , Jung Yo Han , Caso Valeria , Bushnell Cheryl D , Saposnik Gustavo
Published: February 2017

Background

Stroke outcomes can differ by women’s legal or socioeconomic status.

Aim

We investigated whether differences in women’s rights or gender inequalities were associated with stroke mortality at the country-level.

Methods

We used age-standardized stroke mortality data from 2008 obtained from the World Health Organization. We compared female-to-male stroke mortality ratio and stroke mortality rates in women and men between countries according to 50 indices of women’s rights from Women, Business and the Law 2016 and Gender Inequality Index from the Human Development Report by the United Nations Development Programme. We also compared stroke mortality rate and income at the country-level.

Results

In our study, 176 countries with data available on stroke mortality rate in 2008 and indices of women’s rights were included. There were 46 (26.1%) countries where stroke mortality in women was higher than stroke mortality in men. Among them, 29 (63%) countries were located in Sub-Saharan African region. After adjusting by country income level, higher female-to-male stroke mortality ratio was associated with 14 indices of women’s rights, including differences in getting a job or opening a bank account, existence of domestic violence legislation, and inequalities in ownership right to property. Moreover, there was a higher female-to-male stroke mortality ratio among countries with higher Gender Inequality Index (r = 0.397, p < 0.001). Gender Inequality Index was more likely to be associated with stroke mortality rate in women than that in men (p < 0.001).

Conclusions

Our study suggested that the gender inequality status is associated with women’s stroke outcomes.
Ulnar head replacement and sigmoid notch resurfacing arthroplasty with a lateral meniscal allograft: ‘calamari procedure’
Authors: Kakar S. , Noureldin M. , Elhassan B.
Published: February 2017

We report the outcomes of ulnar head replacement with concomitant resurfacing of the sigmoid notch with a lateral meniscal allograft that attempted to recreate the palmar and dorsal radioulnar ligaments in four patients. Patients’ ranges of motion, grip strength, postoperative complications and radiographs were assessed. The mean follow-up was 20 (range 12–28) months. There was an increase in postoperative range of motion with an average increase in grip strength of 43% to the unaffected extremity. All patients experienced marked reduction in their postoperative pain. No patients reported symptoms of implant instability. Distal ulna implant arthroplasty with a lateral meniscal allograft gives favourable short-term outcomes.

Level of evidence: IV
Outbreak of pertussis among healthcare workers in a hospital maternity unit
Authors: Petridou Christina , Gray Hazel , Heard Michael , Sugden Lorna , Davis-Blues Karen , Cortes Nick , Edwards Mary , Saeed Kordo
Published: February 2017

In December 2015, an outbreak of pertussis was detected among staff working in the Maternity Unit of a district general hospital in Hampshire. This occurred in the background of increased pertussis activity in the community. The outbreak occurred over the Christmas holiday period causing staff shortages at a time when the departments were already overstretched. The high prevalence of upper respiratory tract infections at the time were difficult to distinguish from pertussis. This paper describes the outbreak, infection control measures implemented and the learning points.
Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation Among Patients With Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study
Authors: Najafi Bijan , Talal Talal K. , Grewal Gurtej Singh , Menzies Robert , Armstrong David G. , Lavery Lawrence A.
Published: February 2017

Objective:

People with diabetic peripheral neuropathy (DPN) often exhibit deteriorations in motor-performance mainly due to lack of plantar-sensation. The study explored effectiveness of plantar electrical-stimulation therapy to enhance motor-performance among people with DPN.

Design and methods:

Using a double-blinded model, 28 volunteers with DPN (age: 57.8 ± 10.2 years) were recruited and randomized to either intervention (IG: n = 17) or control (CG: n = 11) group. Both groups received identical plantar-stimulation devices for six weeks of daily use at home; however, only the IG devices were set to deliver stimulation. Balance (ankle, hip, and center of mass [COM] sway) and gait (stride velocity [SV], stride time [ST], stride length [SL], and cadence) were measured using validated wearable sensors. Outcomes were assessed at baseline and at six-week. Clinical assessment including vascular as measured by ankle-brachial-index (ABI) and plantar-sensation as quantified by vibratory plantar threshold (VPT) were also measured at baseline and six weeks.

Results:

No difference were observed between groups for baseline characteristics ( P > .050). Posttherapy, ankle and COM sway with eyes open were significantly improved ( P < .05, Cohen’s effect size d = 0.67-0.76) in the IG with no noticeable changes in CG. All gait parameters were significantly improved in the IG with highest effect size observed for cadence ( d = 1.35, P = .000). Results revealed improvement in VPT ( P = .004, d = 1.15) with significant correlation with stride velocity improvement ( r = .56, P = .037). ABI was improved in the IG in particulate among those with ABI>1.20 ( P = .041, d = 0.99)

Conclusion:

This study suggests that daily home use of plantar electrical-stimulation may be a practical means to enhance motor-performance and plantar-sensation in people with DPN.
The Diagnostic Utility of Computer-Assisted Auscultation for the Early Detection of Cardiac Murmurs of Structural Origin in the Periodic Health Evaluation
Authors: Viviers Pierre L. , Kirby Jo-Anne H. , Viljoen Jeandré T. , Derman Wayne
Published: February 2017

Background:

Identification of the nature of cardiac murmurs during the periodic health evaluation (PHE) of athletes is challenging due to the difficulty in distinguishing between murmurs of physiological or structural origin. Previously, computer-assisted auscultation (CAA) has shown promise to support appropriate referrals in the nonathlete pediatric population.

Hypothesis:

CAA has the ability to accurately detect cardiac murmurs of structural origin during a PHE in collegiate athletes.

Study Design:

Cross-sectional, descriptive study.

Level of Evidence:

Level 3.

Methods:

A total of 131 collegiate athletes (104 men, 28 women; mean age, 20 ± 2 years) completed a sports physician (SP)–driven PHE consisting of a cardiac history questionnaire and a physical examination. An independent CAA assessment was performed by a technician who was blinded to the SP findings. Athletes with suspected structural murmurs or other clinical reasons for concern were referred to a cardiologist for confirmatory echocardiography (EC).

Results:

Twenty-five athletes were referred for further investigation (17 murmurs, 6 abnormal electrocardiographs, 1 displaced apex, and 1 possible case of Marfan syndrome). EC confirmed 3 structural and 22 physiological murmurs. The SP flagged 5 individuals with possible underlying structural pathology; 2 of these murmurs were confirmed as structural in nature. Fourteen murmurs were referred by CAA; 3 of these were confirmed as structural in origin by EC. One such murmur was not detected by the SP, however, and detected by CAA. The sensitivity of CAA was 100% compared with 66.7% shown by the SP, while specificity was 50% and 66.7%, respectively.

Conclusion:

CAA shows potential to be a feasible adjunct for improving the identification of structural murmurs in the athlete population. Over-referral by CAA for EC requires further investigation and possible refinements to the current algorithm. Further studies are needed to determine the true sensitivity, specificity, and cost efficacy of the device among the athletic population.

Clinical Relevance:

CAA may be a useful cardiac screening adjunct during the PHE of athletes, particularly as it may guide appropriate referral of suspected structural murmurs for further investigation.
From “connected presence” to “panoptic presence”: Reframing the parent–child relationship on mobile instant messaging uses in the Chinese translocal context
Authors: Yu Qian , Huang Peiying , Liu Liming
Published: February 2017

In the high-speed translocal social setting, intergenerational solidarity is arguably weakening in Chinese society. The proposed study adopts an interactionist perspective, using semistructured interviews as well as communicative behavior records provided by interviewees to analyze the interactions between young adults and their geographically distant parents through a mobile instant messaging (MIM) service application. Taking WeChat as a case, this study focuses specifically on the use of MIM to manage and maintain parent–child relationships in a translocal context. Findings confirm the interaction patterns of “connected presence” and further suggest an emerging “panoptic-presence” consciousness among the young adults, leading to a performative mode of interaction with their parents. Meanwhile, though individualism prevails among the younger generation, family values and norms rooted in traditional Chinese culture are found to be both explicitly and implicitly practiced. Limitations and future directions are also discussed.
CAHPS and Comments
Authors: Martino Steven C , Shaller Dale , Schlesinger Mark , Parker Andrew M , Rybowski Lise , Grob Rachel , Cerully Jennifer L , Finucane Melissa L
Published: February 2017

Objectives:

To investigate whether content from patient narratives explains variation in patients’ primary care provider (PCP) ratings beyond information from the closed-ended questions of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey and whether the relative placement of closed- and open-ended survey questions affects either the content of narratives or the CAHPS composite scores.

Methods:

Members of a standing Internet panel (N = 332) were randomly assigned to complete a CAHPS survey that was either preceded or followed by a set of open-ended questions about how well their PCP meets their expectations and how they relate to their PCP.

Results:

Narrative content from healthier patients explained only an additional 2% beyond the variation in provider ratings explained by CAHPS composite measures. Among sicker patients, narrative content explained an additional 10% of the variation. The relative placement of closed- and open-ended questions had little impact on narratives or CAHPS scores.

Conclusion:

Incorporating a protocol for eliciting narratives into a patient experience survey results in minimal distortion of patient feedback. Narratives from sicker patients help explain variation in provider ratings.
Life satisfaction in persons with severe stroke – A longitudinal report from the Sunnaas International Network (SIN) stroke study
Authors: Langhammer Birgitta , Sunnerhagen Katharina S , Stanghelle Johan K , Sällström Susanne , Becker Frank , Fugl-Meyer Kerstin
Published: February 2017

Introduction

The overall aim of the present study was to explore perceived life satisfaction in persons with stroke, from admission to specialised rehabilitation until follow up 1 year post-discharge. The secondary aim was to evaluate possible external and internal explanatory factors for perceived life satisfaction.

Patients and methods

A prospective, descriptive study of specialised rehabilitation of persons with stroke. Persons with a primary diagnosis of stroke were enrolled in the study.

Results

Overall, total score on LiSat-11 showed that life was perceived as satisfying by 11% on admission, 21% at discharge, 25% at 6 and 31% at 12 months after discharge from rehabilitation, reported by 230 participating persons with stroke. Repeated measurement indicated significant differences of total life satisfaction between clinics, also when controlled for disability and severity. The items “sexual life,” “health,” and “vocational life”/“financial” were most dissatisfying at the various reported time points. The linear regression analysis revealed an equal amount of internal and external explanatory factors at the different time points, explaining between 16% and 41% of the variations.

Discussion and conclusion

The perceived life satisfaction was reported as low/dissatisfying at the four stated time points in all the participating clinics. Four items were especially vulnerable post-stroke: vocational situation, sexual life, physical health and mental health. Both internal and external factors contributed to life satisfaction, such as gender, severity of stroke, marital status, country, models of rehabilitation, occupational status, length of stay (LOS), number of therapies and hours in therapy. However, there were significant differences between clinics, indicating that unidentified factors may also influence life satisfaction.