bluuebunny/crossref_metadata_2025 huggingface dataset:
The Policy of the Military “Supporting the Left” and the Spread of Factional Warfare in China’s Countryside: Shaanxi, 1967–1968
Authors: Tanigawa Shinichi
Published: June 2017

The role of the People’s Liberation Army in Cultural Revolution conflicts in China’s provinces, necessitated by the policy of “supporting the left” in early 1967, has been understudied. Using county- and prefectural-level data, this article shows that rural factional warfare spread not because of clashes between factions backed by the Central Cultural Revolution Group and those supported by regional military forces, as an influential view posits, but because of regional military paralysis. The elusive and divisive policy called for rigorous coordination among regional forces, which in turn required clear guidance and leadership from higher authorities. This was especially true for the regional forces whose close-knit ties to local party leadership made them susceptible to local influence and also vulnerable to rebel attacks. But central authorities’ attempt to impose their will on the higher reaches of the regional military bureaucracy left mid- and low-level commands without direction, leading them to indecision and disunity. Rebels took advantage of local military paralysis, looting weapons and waging factional warfare.
Power Moves Beyond Complementarity: A Staring Look Elicits Avoidance in Low Power Perceivers and Approach in High Power Perceivers
Authors: Weick Mario , McCall Cade , Blascovich Jim
Published: June 2017

Sustained, direct eye-gaze—staring—is a powerful cue that elicits strong responses in many primate and nonprimate species. The present research examined whether fleeting experiences of high and low power alter individuals’ spontaneous responses to the staring gaze of an onlooker. We report two experimental studies showing that sustained, direct gaze elicits spontaneous avoidance tendencies in low power perceivers and spontaneous approach tendencies in high power perceivers. These effects emerged during interactions with different targets and when power was manipulated between-individuals (Study 1) and within-individuals (Study 2), thus attesting to a high degree of flexibility in perceivers’ reactions to gaze cues. Together, the present findings indicate that power can break the cycle of complementarity in individuals’ spontaneous responding: Low power perceivers complement and move away from, and high power perceivers reciprocate and move toward, staring onlookers.
Populism in Latin America: Old and new populisms in Argentina and Brazil
Authors: Grigera Juan
Published: June 2017

There has been a renewed interest in populism in Latin America, sparked by the social mobilization against neoliberalism usually referred to as the ‘Pink Tide’. Governments brought to power by the Pink Tide have been successful in reconstructing the conditions of capital accumulation as well as incorporating a new set of social movement demands. This article puts forward an interpretation of ‘Pink Tide neopopulism’ based on a political economy approach. It argues that the two factors of a crisis of neoliberalism in the region and the existence of social movements with unmet demands are not enough to explain the rise and demise of populism. The commodity boom needs to be added as an enabling condition for these transformations. By revisiting the debate in Latin America and proposing a different reading, the article redefines an overloaded term and provides a new analytical viewpoint from which to understand the ‘historical task’ of populism in Brazil and Argentina.
Professional and non-professional raters’ responsiveness to fluency and accuracy in L2 speech: An experimental approach
Authors: Duijm Klaartje , Schoonen Rob , Hulstijn Jan H.
Published: June 2017

It is general practice to use rater judgments in speaking proficiency testing. However, it has been shown that raters’ knowledge and experience may influence their ratings, both in terms of leniency and varied focus on different aspects of speech.

The purpose of this study is to identify raters’ relative responsiveness to fluency and linguistic accuracy in an occupational context, and to investigate whether professional and non-professional raters with a broad exposure to L2 speech demonstrate similar responsiveness to these two aspects. To this end, an experimental approach was applied. Fluency and accuracy were separated and systematically manipulated. As it is known that foreign accentedness of speech influences raters’ judgments, this factor was accounted for. Seventeen responses to a Dutch L2 exam in a vocational context were converted into four different versions manipulated for morpho-syntactical accuracy and/or fluency, and read by a Dutch L2 actor, resulting in 68 stimuli. Fifty-five professional raters and 41 non-trained, potential stakeholders holistically rated all stimuli. All raters had extensive prior exposure to spoken L2 Dutch.

Linear mixed modeling showed that improvement of either fluency or accuracy led to significantly higher ratings by both linguistically trained and non-trained raters. This finding confirms that both groups perceive these aspects to be important features of speaking proficiency. Raters seemed to be more responsive to improvement of accuracy than of fluency. The linguistically non-trained raters seemed to appreciate the fluency improvement more than linguistically trained raters. The linguistically trained raters rewarded morpho-syntactical improvement relatively higher than the non-trained raters. This latter effect was explained by the finding that the linguistically trained raters seemed to be more preoccupied with accuracy, according to their responses to a questionnaire. This result suggests that raters with linguistic expertise were more attentive to accuracy whereas non-trained raters were relatively more attentive to fluency.
Disability and the impact of need for periodontal care on quality of life: A cross-sectional study
Authors: El Tantawi Maha , AlAgl Adel
Published: June 2017

Objective

The need for periodontal care may negatively impact daily life. We compared the need for periodontal care and its impact on daily life between disabled and healthy adults in the Eastern Province, Saudi Arabia.

Methods

In this cross-sectional study of 819 adults, a questionnaire was used to assess personal background factors; the impact of periodontitis on pain, avoiding foods, embarrassment, sleeplessness, work absence, and discontinuing daily activities; and risk factors (smoking, diabetes, toothbrushing, insurance, professional tooth cleaning, and dental visits). The outcome was clinically assessed need for periodontal care impacting daily life. The relationship between the outcome and risk factors adjusted for personal background and disability was assessed using ordinal regression.

Results

Healthy and disabled persons had a high need for periodontal care (66.8%). Current smokers had a higher likelihood and health-insured persons had a lower likelihood of need for periodontal care impacting daily life regardless of whether disability was considered.

Conclusions

Most adults needed periodontal care, and disabled persons experienced a greater impact on life. Current smokers and uninsured persons were more likely to need periodontal care impacting daily life. Our findings are important for the prevention of periodontitis through tobacco cessation and extending insurance coverage.
Effects of Time to Start Training After Acute Patellar Tendon Enthesis Injuries on Healing of the Injury in a Rabbit Model
Authors: Wang Lin , Xiong Kaiyu , Wang Bo , Liang Xiaotian , Li Haiwei , Liu Haitao , He Hui
Published: June 2017

Background:

A patellar tendon injury is a common injury in sports. The optimal time to start training after an acute, proximal patellar enthesis injury is still unclear.

Hypothesis:

The time to start training after an acute, proximal patellar enthesis injury significantly affects healing of the patellar tendon 4 weeks after the injury.

Study Design:

Controlled laboratory study.

Methods:

The left hindlimbs of 35 mature female rabbits were randomly assigned to 5 injury groups including a 4-week natural healing group (NH4W) and 4 training groups that started low-intensity training at 24 hours (POST24), 48 hours (POST48), 72 hours (POST72), and 96 hours (POST96) after an acute patellar tendon injury, with 7 limbs in each group. The right hindlimbs of the NH4W group were used as a control group (CON). An acute, proximal patellar enthesis injury was created in all injury groups. The training groups underwent low-intensity quadriceps training for 2 hours per day and 3 days per week for 4 weeks. Histological and radiographic data were collected and analyzed.

Results:

The cell densities of the training groups were significantly lower than those of the NH4W and CON groups ( P = .01). The fibrocartilage zone was significantly thicker in the POST24, POST48, and POST72 groups compared with the CON and NH4W groups and was the thickest in the POST24 group ( P = .01). The bone surface to bone volume ratio was significantly higher in all the injury groups compared with the CON group and in the POST24 group compared with the other groups ( P = .01). Trabecular thickness was significantly lower in all the injury groups compared with the CON group and in the POST24 group compared with the other groups ( P = .01).

Conclusion:

Resting without training in the first 96 hours after an acute patellar tendon enthesis injury resulted in the best recovery of cell density in the tendon enthesis 4 weeks after the injury. Starting training 96 hours after the injury resulted in the best recovery of fibrocartilage zone thickness. Starting training 48 to 96 hours after the injury resulted in the best healing of the bone component of the attachment site 4 weeks after the injury. The optimal time to start training may be longer than 96 hours after an acute patellar tendon enthesis injury for the best overall healing of the tendon enthesis 4 weeks after the injury.

Clinical Relevance:

A rest of a minimal 72 hours may be needed for the best healing of a patellar tendon enthesis after an acute injury. Future studies are needed to determine the optimal time to start training after an acute patellar tendon injury.
Autograft Versus Allograft for Posterior Cruciate Ligament Reconstruction: An Updated Systematic Review and Meta-analysis
Authors: Belk John W. , Kraeutler Matthew J. , Purcell Justin M. , McCarty Eric C.
Published: June 2017

Background:

Multiple studies have demonstrated a higher risk of graft failure after anterior cruciate ligament reconstruction with allograft, but limited data are available comparing outcomes of posterior cruciate ligament reconstruction (PCLR) with autograft versus allograft.

Purpose:

To compare the clinical outcomes of autograft versus allograft for primary PCLR.

Study Design:

Systematic review.

Methods:

A systematic review was performed by searching PubMed, the Cochrane Library, and EMBASE to locate studies (level of evidence I-III) comparing clinical outcomes of autograft versus allograft in patients undergoing primary PCLR with the conventional transtibial technique. Search terms used were “posterior cruciate ligament,” “autograft,” and “allograft.” Patients were evaluated based on graft failure rate, examination of knee laxity, and patient-reported outcome scores (Lysholm, Tegner, subjective International Knee Documentation Committee [IKDC], and objective IKDC scores).

Results:

Five studies (2 level II, 3 level III) were identified that met inclusion criteria, including a total of 132 patients undergoing PCLR with autograft (semitendinosus-gracilis or bone–patellar tendon–bone) and 110 patients with allograft (tibialis anterior, Achilles tendon, or bone–patellar tendon–bone). No patients experienced graft failure. Average anteroposterior (AP) knee laxity was significantly higher in allograft patients (3.8 mm) compared with autograft patients (3.1 mm) ( P < .01). Subjective IKDC, Lysholm, and Tegner scores improved for both groups across studies, without a significant difference in improvement between groups except in one study, in which Lysholm scores improved to a significantly greater extent in the autograft group ( P < .01).

Conclusion:

Patients undergoing primary PCLR with either autograft or allograft can be expected to experience improvement in clinical outcomes. Autograft patients experienced less AP knee laxity postoperatively, although the clinical significance of this is unclear and subjective outcomes improved substantially and to a similar degree in both groups.
Arsenic and fluoride co-contamination in shallow aquifers from agricultural suburbs and an industrial area of Punjab, Pakistan: Spatial trends, sources and human health implications
Authors:   Qurat-ul-Ain, Farooqi Abida , Sultana Jawairia , Masood Noshin
Published: June 2017

Release of arsenic (As) and fluoride (F−) species into groundwater is a serious health concern around the world. The present study was the first systematic baseline study conducted in Rahim Yar Khan district, Punjab, focusing on As and F− contamination in groundwater. A total of 51 representative groundwater samples comprising of 44 samples from agricultural suburbs and 7 from an industrial base were analysed. Statistical parameters, principal component analysis-multiple linear regression (PCA-MLR) and health risk assessment model were used to investigate the hydro geochemistry, spatial patterns, interrelation, source contribution and associated health risks of high As and F− in groundwater of the study area. Results showed high risk of F− exposure to people of the study area, with all samples exceeding the WHO standard of 1.5 mg/L, and for As, 32.5% of the studied groundwater samples exceeded the WHO standard (10 µg/L). The maximum As (107.23 µg/L) and F− (26.4 mg/L) levels were observed in samples close to the agricultural and smelting areas, implicating the frequent use of fertilizers and influence of industrial effluents in the study area. The PCA-MLR receptor model quantitatively illustrates that the majority of As and F− comes from natural sources, while, among anthropogenic sources, industrial and agricultural activities contributed the most. Health risk assessment revealed a high risk of As and F− contamination to the exposed population; therefore, detailed control strategies and policies are required in order to mitigate the health risks.
A Pain Education Intervention for Patients Undergoing Ambulatory Inguinal Hernia Repair
Authors: Sawhney Monakshi , Watt-Watson Judy , McGillion Michael
Published: June 2017

Background

Inguinal hernia repair is a common ambulatory surgery after which many patients experience moderate to severe post-operative pain. Limited research has examined the effect of education interventions to reduce pain after ambulatory surgery.

Purpose

This trial evaluated the effectiveness of an individualized Hernia Repair Education Intervention (HREI) for patients following inguinal hernia repair.

Method

Pre-operatively, participants (N = 82) were randomized to either the intervention (HREI) or the usual care group. The HREI included written and verbal information regarding managing pain and two telephone support calls (before and after surgery). The primary outcome was WORST 24-h pain intensity on movement on post-operative day 2. Secondary outcomes included pain intensity at rest and movement, pain-related interference with activities, pain quality, analgesics consumed, and adverse effects at post-operative days 2 and 7.

Results

At day 2, the intervention group reported significantly lower scores across pain intensity outcomes, including WORST 24-h pain on movement and at rest (p < 0.001), and pain NOW on movement and at rest (p = 0.001).

Conclusion

These findings suggest that the HREI may improve patients’ pain and function following ambulatory inguinal hernia repair. Further research should examine the effectiveness of an education intervention over a longer period of time.
The Most Common Comorbidities in Dandy-Walker Syndrome Patients: A Systematic Review of Case Reports
Authors: Stambolliu Emelina , Ioakeim-Ioannidou Myrsini , Kontokostas Kimonas , Dakoutrou Maria , Kousoulis Antonis A.
Published: June 2017

Objective:

Dandy-Walker syndrome (DWS) is a rare neurologic multi-entity malformation. This review aimed at reporting its main nonneurologic comorbidities.

Methods:

Following PRISMA guidelines, search in Medline was conducted (2000-2014, keyword: dandy-walker). Age, sex, country, DWS type, consanguinity or siblings with DWS, and recorded coexistent conditions (by ICD10 category) were extracted for 187 patients (46.5% male, 43% from Asia) from 168 case reports.

Results:

Diagnosis was most often set in <1 year old (40.6%) or >12 years old (27.8%). One-third of cases had a chromosomal abnormality or syndrome (n = 8 PHACE), 27% had a cardiovascular condition (n = 7 Patent Ductus Arteriosus), 24% had a disease of eye and ear (n = 9 cataract); most common malignancy was nephroblastoma (n = 8, all Asian). Almost one-fifth had a mental illness diagnosis; only 6.4% had mild or severe intellectual disability.

Conclusion:

The spread of comorbidities calls for early diagnosis and multidisciplinary research and practice, especially as many cases remain clinically asymptomatic for years.
Revisiting the Link Between Economic Distress, Race, and Domestic Violence
Authors: Leguizamon J. Sebastian , Leguizamon Susane , Howden Wesley
Published: June 2017

Male unemployment may decrease the incidence of domestic violence, due to loss of economic power in the relationship, or increase the incidence of domestic violence, due to emotional outbursts fueled by increased stress. We hypothesize that Black men may face a greater loss of expected future earnings after an unemployment shock due to a more unfavorable labor market relative to White men. Consequently, we would expect that Black men would, on net, exhibit a greater reduction (or a smaller increase) in incidences of domestic violence following an employment shock. This study uses mass layoff events reported by the Bureau of Labor Statistics (BLS) at the county level ( N = 3,377) for the years 2003-2008. Mass layoff events occur when a firm lays off at least 50 workers and are uncorrelated with individual-level characteristics ( N = 28,939 events, affecting N = 5,337,481 individuals). Domestic violence data are taken from the National Archive of Criminal Justice and defined as occurring when an accused perpetrator is charged, but not necessarily convicted. We use a multivariate regression model to estimate how differences in the change in reported incidences of domestic violence by race correlate with changes in mass layoffs by race. We control for the poverty rate, real per capita income, percent Black, percent women, and percent of females laid off. The standard errors are clustered at the county level and include county and time dummies to account for regional and time specific trends. We observe that an increase in the number of Blacks subject to a mass layoff event do exert a negative associated influence on domestic violence while layoffs of White men exert a positive influence. Our results shed light on how the influence of economic uncertainty on incidences of domestic violence has been found to be positive in some previous research but negative in other research.
Benner’s Novice to Expert Model: An Application for Simulation Facilitators
Authors: Thomas Christine M. , Kellgren Molly
Published: June 2017

This paper details the application of Benner’s Novice to Expert Model to simulation educator knowledge, skills, and attitude for academic and practice settings. Facilitator development in the use of simulation methods is gaining more attention and support. If simulation is to continue to advance as a discipline, a theoretical basis is needed. The Novice to Expert Model provides the necessary conceptual structure to guide simulation facilitator development and assist in understanding learning trajectory. This theory-based approach that defines and operationalizes the five stages of development provides guidance for development resources, educational programs, and infrastructure needed at various program levels.
Ubiquitous Technology in Healthcare and Teaching-Learning: Scourge or Blessing?
Authors: Yancey Nan Russell
Published: June 2017

The author in this article introduces a discussion of one school of nursing’s efforts integrating telehealth education into undergraduate and graduate curricula using King’s theory of goal attainment as a guide. The introduction shares a story of loss in a rural setting without access to quality healthcare to highlight the blessing technology may be. However, challenges are discussed that arise through the ubiquitous use of technology in person-to-person communication and relationships.
A two-stage approach to the joint analysis of longitudinal and survival data utilising the Coxian phase-type distribution
Authors: Donnelly Conor , McFetridge Lisa M , Marshall Adele H , Mitchell Hannah J
Published: June 2017

The Coxian phase-type distribution is a special type of Markov model which can be utilised both to uncover underlying stages of a survival process and to make inferences regarding the rates of flow of individuals through these latent stages before an event of interest occurs. Such models can be utilised, for example, to identify individuals who are likely to deteriorate faster through a series of disease states and thus require more aggressive medical intervention. Within this paper, a two-stage approach to the analysis of longitudinal and survival data is presented. In Stage 1, a linear mixed effects model is first used to represent how some longitudinal response of interest changes through time. Within this linear mixed effects model, the individuals’ random effects can be considered as a proxy measure for the effect of the individuals’ genetic profiles on the response of interest. In Stage 2, the Coxian phase-type distribution is employed to represent the survival process. The individuals’ random effects, estimated in Stage 1, are incorporated as covariates within the Coxian phase-type distribution so as to evaluate their effect on the individuals’ rates of flow through the system represented by the Coxian. The approach is illustrated using data collected on individuals suffering from chronic kidney disease, where focus is given to an emerging longitudinal biomarker of interest – an individual’s haemoglobin level.
It’s Not in the Curriculum: Adult English Language Teachers and LGBQ Topics
Authors: Rhodes Christy M. , Coda James
Published: June 2017

For adult English language learners, the English language classroom provides a space for students to examine cultural as well other identities. However, discussions often center on racial, rather than sexual identities. In addition, attention to how adult English language instructors engage in classroom practices that focus on sexual identities is often limited. This article examines how adult educators in English language classrooms feel regarding the inclusion of Lesbian, Gay, Bisexual, Queer (LGBQ) topics and materials into their curriculum and instruction. Through a web-based survey, teachers described their beliefs, practices, and challenges in creating lessons and responding to student questions in ways that broke down heteronormativity in the adult English language classroom. Findings add to the limited knowledge of how teachers in post-secondary, English language classrooms create and support a culturally responsive learning environment regarding sexual identities.
Curriculum Issues: The Importance of Selecting Literature for Gifted Learners
Authors: VanTassel-Baska Joyce
Published: June 2017

This column describes criteria for selecting literature for gifted and advanced students in English-language arts. Some of the criteria considered relate to reading level, advanced use of language and vocabulary, multi-cultural literature, employment of an abstract concept, use of advanced literary elements, and exploration of social and emotional issues.
Testing the Importance of Geographic Distance for Social Capital Resources
Authors: Foster Kirk A. , Smith Richard J. , Bell Bethany A. , Shaw Todd C.
Published: June 2017

This study tests the importance of spatial distance from social capital resources for the number of resources accessed. We examine the relationship between the distance to work, religious congregations, and organizations on the level of social capital. Theory posits that increased time spent commuting decreases social capital; we posit that increased distance traveled to sites of social capital generation limits neighborhood social capital but increases capital access at generation sites. We measured social capital with the Resource Generator–United States and used negative binomial regression to estimate the association between distance and number of resources accessed. Social capital resource access is higher with increased distance traveled to civic organizations. Distance from work and religious congregations does not affect social capital; distance to work erodes neighborhood social capital. These findings are counter to current theory and suggest that people are willing to travel to organizations where social capital is built.
Natural Limits of Wealth Inequality and the Effectiveness of Tax Policy
Authors: Condie Scott S. , Evans Richard W. , Phillips Kerk L.
Published: June 2017

This article examines Thomas Piketty’s thesis that there are no natural limits on the accumulation of wealth. We undertake our examination in the context of a simple general equilibrium model with infinitely lived dynasties. We show that extreme wealth accumulation does not happen in general equilibrium unless capital and labor are substitutes, an assumption which also leads to unbalanced growth. We also show that even with unbalanced growth, differences in rates of return and effective labor are not sufficient to cause unbounded inequality. Only permanent savings rate differences can lead to extreme wealth concentration. Finally, we show that while a flat wealth tax will not eliminate extreme wealth concentration, both a graduated wealth tax and a flat income tax will.
A Case of Topical Ruxolitinib Treatment Failure in Alopecia Areata
Authors: Deeb Maya , Beach Renée A.
Published: June 2017

Alopecia areata (AA) is an autoimmune-mediated, nonscarring form of hair loss. Despite its prevalence, current management options are limited, especially when the disease has progressed to alopecia totalis (AT) or alopecia universalis (AU). Recent evidence that janus kinase (JAK) signaling contributes to AA pathogenesis prompted the investigation of JAK inhibitors such as tofacitinib and ruxolitinib as possible oral treatments. However, the potential for significant adverse effects with systemic JAK inhibition makes local administration a more attractive option. Yet, a paucity of data exists on topical JAK inhibition in AA. A success of topical ruxolitinib (0.6% cream) use in a young patient with AU has been reported to date. Here we report the treatment of a 66-year-old with AA with the same formulation of topical ruxolitinib, where it failed to induce hair growth. Our report demonstrates the importance of examining the factors contributing to variation in treatment response in a clinical trial of topical JAK inhibitors in AA. It is likely that both intrinsic factors specific to individual patients and extrinsic factors relating to treatment regimen are involved. Furthermore, characterisation of the specific JAKs overexpressed in AA may better target medication. Finally, this report highlights the need to compare the outcomes of topical vs oral ruxolitinib administration in patients with severe AA, AT, and AU and may support the possibility that extensive disease is more adequately treated with oral administration of ruxolitinib.
Self-injurious behaviors in children with autism spectrum disorder enrolled in the Study to Explore Early Development
Authors: Soke Gnakub Norbert , Rosenberg Steven A , Rosenberg Cordelia Robinson , Vasa Roma A , Lee Li-Ching , DiGuiseppi Carolyn
Published: June 2017

We assessed potential factors associated with “current” or “ever” self-injurious behaviors, reported in the Autism Diagnostic Interview–Revised, among children with autism spectrum disorder (n = 692) from the Study to Explore Early Development. Data on factors examined were obtained from questionnaires, standardized clinical instruments, and birth certificates. We employed a log-binomial regression to assess these associations. Although most associations were quite similar for currently and ever exhibiting self-injurious behaviors, a few differences were noted. We documented previously unreported associations of current self-injurious behaviors with maternal age and cesarean delivery, and ever self-injurious behaviors with maternal age, child sex, gestational age, and maternal race. We also confirmed previously reported associations with adaptive skills, somatic conditions (sleep, gastrointestinal, and sensory abnormalities), and other behavioral problems. These findings are informative for clinical practice and future research.
Complexity as the telos of postmodern planning and design: Designing better cities from the bottom-up
Authors: McGreevy Michael Patrick
Published: June 2017

This article explores the relationship between complexity theory and the analysis, planning and designing of cities, specifically their suburban and neighbourhood subsystems. It argues that while complexity theory is an apposite goal for postmodern urban planning, and it has been influential in the analysis and modelling of urban environments, it has been far less influential in their actual planning and design. In particular, the postmodern era has seen a decline of complexity within urban subsystems, as the self-organised complexity found within the traditional town centre and high street has been progressively superseded by the top-down mechanistic order of the shopping centre. This article argues that postmodern planning has often been an accomplice to this process because its antipathy to spatial determinism and/or the expert as arbitrator of what is right or proper in urban planning has left postmodern planners admiring complexity but not necessarily advocating for it. This has left the design and management of urban subsystems to the demands, choices and purposes of giant corporations, a situation more likely to deliver modernist mechanical order than postmodern complexity.
Bleeding during percutaneous dilatational tracheostomy – What to do while waiting for the surgeon?
Authors: Kaye C , MacLeod I , Dhillon M
Published: June 2017

A patient suffered significant bleeding during an attempt at percutaneous dilatational tracheostomy due to an aberrant anterior jugular vein. Bleeding was controlled with pressure temporarily, but quickly returned necessitating conversion to an open technique. We present an algorithm for the management of significant peri-procedural bleeding during this procedure.
Effectiveness of intra-articular therapies in osteoarthritis: a literature review
Authors: Wehling Peter , Evans Christopher , Wehling Jana , Maixner William
Published: June 2017

Osteoarthritis is a painful, chronic disease with widespread burden on patients, communities, health and social care systems. Conservative therapies, such as nonpharmacological interventions, systemic drug treatment and intra-articular therapies are used before resorting to surgery; nonetheless, disease control often remains inadequate. Recent advances in osteoarthritis management have aimed to provide greater variety of treatment options. Here, we summarize a targeted literature review evaluating efficacy and safety of intra-articular therapies for osteoarthritis.

Injections of intra-articular therapies directly into the joint avoid conventional barriers to joint entry, increase bioavailability and lower systemic toxicity. Intra-articular corticosteroids and hyaluronic acid are established United States Food and Drug Administration (US FDA)/European Medicines Agency (EMA)-approved treatments; however, concerns exist regarding effect duration, safety, effectiveness across populations and heterogeneity.

Newer therapies, such as autologous blood products and mesenchymal stem cells, are in development. Benefits of autologous blood products (e.g. platelet-rich plasma, autologous conditioned serum) include an expected improved safety profile and direct targeting of osteoarthritis-related pathophysiology. Autologous conditioned serum is cell-free and manufactured by a standardized process, whereas platelet-rich plasma composition and characteristics can vary. Currently, only limited efficacy comparisons between these biological treatments can be drawn; long-term clinical and safety studies are needed to increase the efficacy evidence base and earn consideration in treatment frameworks.
The Development of a Glucose Dehydrogenase 3D-Printed Glucose Sensor: A Proof-of-Concept Study
Authors: Adams Anngela , Malkoc Aldin , La Belle Jeffrey T.
Published: June 2017

This work represents a preliminary proof-of-concept design and verification of a 3D-printed glucose biosensor. The proof of concept presented is the first example of glucose dehydrogenase sensor fabricated by a 3D-printer while maintaining similar features to current lab-industry standards. The sensor was verified to detect physiological glucose concentrations between 0 and 400 mg/dL with a linear coefficient as high as .97. This study showed that it was possible to use 3D-printed technology to create a biosensor sensitive to glucose detection. As availability and functionality of 3D-printers expands, this technology has the potential to be an option for diabetes management. This preliminary study shows that the 3D-printed sensor platform holds promise for sensitive glucose detection.
Haemorrhoids: an update on management
Authors: Brown Steven R.
Published: June 2017

Haemorrhoids are common, affecting up to one quarter of all adults according to some estimates. Numerous interventions exist for their management, ranging from topical and medical therapies to outpatient treatments and surgical interventions that aim to fix or excise. Given the polysymptomatic nature of the disease, it is difficult to effectively judge which treatment option is best. Recently introduced novel haemorrhoid management techniques, such as stapled haemorrhoidopexy, Ligasure™ excision and haemorrhoidal artery ligation, aim to reduce harm whilst maintaining or improving on outcome. These new techniques are universally more expensive, and available good quality data suggest the additional cost does not necessarily equate to universally better outcomes compared with traditional older interventions, such as rubber band ligation and excisional haemorrhoidectomy. Whatever the intervention selected for treatment, it is clear that this should be tailored to the individual based on patient choice, convenience and degree of haemorrhoids.
Eluxadoline in irritable bowel syndrome with diarrhea: rationale, evidence and place in therapy
Authors: Barshop Kenneth , Staller Kyle
Published: June 2017

Irritable bowel syndrome (IBS) is the most common gastrointestinal (GI) disorder worldwide, however treatment options for diarrhea-predominant IBS (IBS-D) remain limited. Eluxadoline, a µ- and κ-opioid receptor agonist and δ-opioid receptor antagonist, was recently approved for the treatment of IBS-D. A novel compound first described in 2008, eluxadoline was shown to normalize GI transit, with a subsequent phase I demonstrating its safety and tolerability in healthy adults. In 2016, two randomized, double-blind, placebo-controlled phase III trials studying eluxadoline use at 75 mg and 100 mg twice daily over 26 weeks demonstrated a significant improvement in stool consistency and many global symptoms of IBS. However, the data did not demonstrate a significant advantage over placebo using the United States Food and Drug Administration (US FDA) and European Medicines Agency (EMA) endpoints for abdominal pain. Safety and tolerability data, pooled from both phase II and III studies, suggest that eluxadoline is generally well tolerated with the most common adverse events (AEs) occurring in approximately 3–8% of patients and included nausea, constipation, and abdominal pain. The most common serious adverse event (SAE) is pancreatitis, which had a 0.4% incidence. Recent US FDA reports reporting severe pancreatitis and sphincter of Oddi dysfunction after short-term use of eluxadoline in patients without a gallbladder has added a history of cholecystectomy as an important contraindication. Eluxadoline is also contraindicated in patients with a history of biliary duct obstruction, sphincter of Oddi dysfunction, active alcohol abuse, history of pancreatitis or known pancreatic duct obstruction, severe hepatic impairment, severe or chronic constipation, or known mechanical gastrointestinal obstruction. As a new drug to enter the IBS-D market, the place of eluxadoline in the hierarchy of IBS treatments is still to be determined. In this article, we review the development and clinical trial data behind the approval of eluxadoline with a focus on safety data and its use in clinical practice.
Optimization of constitutive model parameters for simulation of polystyrene concrete subjected to impact
Authors: Yoo Tae Kwang , Qiu Tong
Published: June 2017

This article presents the results of a series of experimental testing and numerical modeling studies to optimize the parameters of a constitutive material model to accurately simulate the behavior of polystyrene crushable concrete during impact loading using LS-DYNA. Quasi-static compression tests and confined drop impact tests were conducted. To model the quasi-static compression tests, the response surface methodology was used to optimize Poisson’s ratio and friction angle in the pseudo-tensor model in LS-DYNA. Using the optimized model parameters, the simulated compression stress versus strain relationship showed an excellent agreement with those from the compression tests. To model the confined drop impact tests, the strain rate sensitivity parameter in LS-DYNA was optimized by comparing the drop impact simulations at different strain rate sensitivity values with the drop impact tests. This study suggests that the pseudo-tensor material model is potentially suitable for modeling crushable concrete. Although the optimized constitutive model parameters are specific for the polystyrene concrete mix used in this study, similar approach can be used to optimize model parameters for other polystyrene concrete mixes.
Comparison of the efficacy of intravenous tranexamic acid with and without topical administration versus placebo in urgent endoscopy rate for acute gastrointestinal bleeding: A double-blind randomized controlled trial
Authors: Tavakoli Nader , Mokhtare Marjan , Agah Shahram , Azizi Ali , Masoodi Mohsen , Amiri Hassan , Sheikhvatan Mehrdad , Syedsalehi Bahare , Behnam Behdad , Arabahmadi Mehran , Mehrazi Maryam
Published: June 2017

Background

Tranexamic acid (TXA), a synthetic antifibrinolytic drug, is effective as a treatment for serious hemorrhage, including bleeding arising from major trauma and post-operative interventions. Significant acute gastrointestinal bleeding may have a poor outcome despite routine medical and endoscopic treatments. The aim of this study was to assess whether early intravenous and/or intravenous plus topical administration of TXA reduces the need for urgent endoscopy for acute gastrointestinal bleeding.

Method

This double-blind randomized clinical trial included 410 patients with proven acute gastrointestinal bleeding. All patients received conventional therapy. The subjects were randomized to three groups: (A) 138 patients received intravenous TXA (1 g q6h); (B) 133 patients received topical TXA (1 g single dose by nasogastric tube) plus systemic TXA; and (C) 139 patients received a placebo (sodium chloride 0.9%) for 24 hours. Subgroup statistical analyses were conducted for urgent endoscopy, mortality, re-bleeding, blood transfusion, endoscopic and/or surgical intervention rates, and health status.

Results

The time to endoscopy was significantly shorter in group C (15.58 ± 7.994, p < 0.001). A need for urgent endoscopy was seen in 14.49%, 10.52%, and 30.21% of patients in groups A, B, and C, respectively ( p < 0.001). No significant statistical differences were seen between treatment groups regarding mortality, re-bleeding, blood transfusion, and endoscopic and/or surgical intervention rates. No thromboembolic event was documented during the 1-week follow up.

Conclusions

Our results showed that the antifibrinolytic properties of TXA can aid in changing an urgent endoscopy to an elective procedure, with better outcomes for both physicians and patients.
The Diagnosis of Mental Disorders Is Influenced by Automatic Causal Reasoning
Authors: Flores Amanda , Cobos Pedro L. , Hagmayer York
Published: June 2017

Causal knowledge has been shown to affect diagnostic decisions. It is unclear, however, how causal knowledge affects diagnosis. We hypothesized that it influences intuitive reasoning processes. More precisely, we speculated that people automatically assess the coherence between observed symptoms and an assumed causal model of a disorder, which in turn affects diagnostic classification. Intuitive causal reasoning was investigated in an experimental study. Participants were asked to read clinical reports before deciding on a diagnosis. Intuitive processing was studied by analyzing reading times. It turned out that reading times were slower when causally expected consequences of present symptoms were missing or effects of absent causes were present. This causal incoherence effect was predictive of participants’ later explicit diagnostic judgments. These and related findings suggest that diagnostic judgments rely on automatic reasoning processes based on the computation of causal coherence. Potential implications of these results for the training of clinicians are discussed.
Analysis of Origins of Admission for Solid Tumor Oncology Inpatients: Disease Severity and Outcomes
Authors: Wee Christopher E. , Goodman Lindsey M. , Varella Leticia , Rybicki Lisa A. , Montero Alberto J. , Estfan Bassam N. , Best Carolyn H. , Stevenson James P.
Published: June 2017

Purpose:

Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes.

Methods:

We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics. Data collected included time of admission, mortality and severity risk scores, and provider type. Risk factors were assessed for clinical outcomes, including activations of the Adult Medical Emergency Team, intensive care unit transfers, in-hospital mortality, and length of stay (LOS).

Results:

Five hundred admissions were included. OSH inpatient transfers had significantly higher disease severity compared with all other origins of admission. OSH inpatient transfers demonstrated significantly longer LOS compared with all other origins of admission, and higher mortality rates compared with the outpatient direct admits and CCF Main Campus ED admits. After adjusting for disease severity and risk of mortality, OSH ED patients remained at higher risk for Adult Medical Emergency Team activation, OSH inpatient transfers had the longest LOS, and CCF Main Campus ED patients had the lowest risk of mortality. Time of admission and provider type were not associated with any of the outcomes.

Conclusion:

Oncology inpatients transferred from an outside health care facility are at higher risk for adverse outcomes. The magnitude of difference is lessened, but still significant, after adjustment for disease severity and risk of mortality.
Early Breeding and Seed Production of Indian Major Carps: Attributes of the Innovation from an Adaptive Trial
Authors: Sahoo P.R , Ananth P.N. , Nandi S. , Sundaray J. K. , Barik N.K. , Jayasankar P.
Published: June 2017

An adaptive trial was undertaken for early breeding of carps in four private hatcheries of Khordha district in the state of Odisha, India. CIFABROODTM, a promising carp brood diet was used to observe the breeding performance and seed production of carps in early monsoon. CIFABROODTM was provided in experimental ponds while farm made feed prepared by the hatchery owners were used in the control ponds. After 45days of feeding, fishes in the trial ponds became mature while in the control ponds fishes were immature. Average fertilization rate was observed to be 88.14% with an average spawn recovery of 2.14 lakh spawn/kg body weight of female. Highest average fertilization rate was found in mrigal followed by rohu and catla. Similarly average spawn recovery per kg of female body weight indicates a highest recovery in rohu followed by mrigal and catla. In turn the spawn buyers had an average survival rate of 42.18% from spawn to fry and 73.5% from fry to fingerling rearing. This adaptive trial has reconfirmed CIFABROODTM as a proven carp brood diet which has shown to impact at all the three crucial stages of seed production. The positive outcomes of the attributes of innovation were highly towards an increased rate of adoption.
Science: Handling information
Authors: Sargent Marianne
Published: June 2017

This is the fourth in a series of extracts from the book, Developing Early Science Skills Outdoors, which explores ideas for providing children with opportunities to learn outside.
Modeling and Simulation of Fiber Bragg Grating (Fbg) as A Strain Sensor
Authors: Bin Jalil Muhammad
Published: June 2017

This study presents the modelling, simulation, and characterization of the Fiber Bragg grating (FBG) on maximum reflectivity, bandwidth, the effect of applied strain to the wavelength shift, ʎB and sensitivity of the wavelength shift with strain for optical sensing system. In this study, a commercial FBG with the center wavelength of 1550nm is used in order to measure the spectral response of FBG to strain. The parameters used in these simulations are the fiber grating length, L ranging from 1 to 10mm, the changes in refractive index, ∆n from 0.0002 to 0.0020, the effective refractive index, is 1.46 and the grating period of FBG,Λ for 530nm in the performance of FBG. The bandwidth and spectrum reflectivity are analyzed from the variation of refractive index and grating length. Simulations on the FBG are carried out using OriginPro 2016 and Microsoft Excel 2010 software. The Excel sheet is used to generate data and the OriginPro 2016 is used to generate the graphs. The results obtained indicates the variation in grating length and refractive index affect the spectral reflectivity and the bandwidth. In addition, results obtained show that the changes in the Bragg wavelength are due to an increase in length of the grating region which due to the applied strain.
Enhanced Content Based Double Encryption Algorithm Using Symmetric Key Cryptography
Authors: Kynshi Junestarfield , Jose Deepa
Published: June 2017

This paper aims to solve the problems of the existing technique of the content based double encryption algorithm using symmetric key cryptography. Simple binary addition, folding method and logical XOR operation are used to encrypt the content of a plaintext as well as the secret key.This algorithm helps to achieve the secure transfer of data throught the network. It solved the problems of the existing algorithm and provides a better solution. The plaintext are encrypted using the above methods and produce a cipher text. The secret key is encrypted and shared through secure network and without knowing the secret key it is difficult to decipher the text. As per expected, enhanced encryption algorithm gives better result than the existing encryption algorithm.