bluuebunny/crossref_metadata_2025 huggingface dataset:
Up to a quarter of patients with certain chronic recalcitrant tendinopathies may have central sensitisation: a prospective cohort of more than 300 patients
Authors: Wheeler Patrick C
Published: September 2018

Introduction:

To identify the possible prevalence of ‘central sensitisation’, in patients with chronic recalcitrant lower limb tendinopathy conditions, with the Central Sensitisation Inventory (CSI) questionnaire.

Methods:

Patients with chronic lower limb tendinopathy conditions treated within a single hospital outpatient clinic specialising in tendinopathy were identified from clinical records. As part of routine care, self-reported numerical markers of pain, global function (using the EuroQol-5D (EQ-5D) questionnaire) and the CSI score to investigate the possibility of central sensitisation were completed.

Results:

A total of 312 suitable patients with chronic lower limb tendinopathy and similar conditions were identified, who had completed a CSI questionnaire. Of these, 108 presented with greater trochanteric pain syndrome, 12 with patella tendinopathy, 33 with non-insertional Achilles tendinopathy, 48 with insertional Achilles tendinopathy and 110 with plantar fasciitis. A total of 66% of the patients were female, the median age was 54.9 years and the median duration of symptoms was 24 months. There was a median CSI score of 25%, with statistically significant differences noted between the different conditions studied. Overall, 20% of patients scored above a threshold of 40% on CSI questionnaire, indicating that central sensitisation was possible. Greater trochanteric pain syndrome and plantar fasciitis had the highest proportions in the conditions studied. Weak correlations were found between CSI and other pain scores studied.

Conclusion:

The CSI questionnaire may identify up to a quarter of patients with some chronic lower limb tendinopathy and associated conditions as being more likely to have central sensitisation, and these proportions differed between conditions. The clinical significance of this is unclear, but worth further study to see if/how this may relate to treatment outcomes. These are results from a single hospital clinic dealing with patients with chronic tendinopathy, and comparison with a control group is currently lacking. However, on the information presented here, the concept of central sensitisation should be considered in patients being treated for chronic tendinopathy.
Characterisation of health literacy strengths and weaknesses among people at metabolic and cardiovascular risk: Validity testing of the Health Literacy Questionnaire
Authors: Debussche Xavier , Lenclume Victorine , Balcou-Debussche Maryvette , Alakian Danielle , Sokolowsky Claude , Ballet Delphine , Elsworth Gerald R , Osborne Richard H , Huiart Laetitia
Published: September 2018

Objectives:

Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. The assessment of health literacy profiles in a population is potentially crucial to respond to health needs. The Health Literacy Questionnaire explores nine dimensions of health literacy and has been shown to display robust psychometric properties. The aim was to test the validity of the multidimensional Health Literacy Questionnaire and to describe the health literacy profiles in a French population at risk of cardiovascular disease.

Methods:

Data were collected using self-administered questionnaires from 175 participants attending health education and support programmes in local associations of patients in Paris. Analysis included scale reliability, confirmatory factor analysis, and health literacy profiles via descriptive statistics.

Results:

In confirmatory factor analysis, the nine-factor structure was close to the original Health Literacy Questionnaire. A nine-factor confirmatory factor analysis model was fitted to the 44 items with no cross-loadings or correlated residuals allowed. Given the restricted nature of the model, the fit was satisfactory: χ2WLSMV(866 df) = 1383.81, p = 0.0000, comparative fit index = 0.925, Tucker–Lewis index = 0.918, root mean square error of approximation = 0.058, weighted root mean square residual = 1.175. Composite reliability ranged from 0.77 to 0.91. Among the 9 scales of the Health Literacy Questionnaire, the highest scores were found for scale 1 ‘Feeling understood and supported by healthcare professionals’ and scale 9 ‘Understand health information enough to know what to do’ and the lowest for scale 2 ‘Having sufficient information to manage my health’ and scale 7 ‘Navigating the healthcare system’.

Conclusion:

The French version of the Health Literacy Questionnaire was shown to be psychometrically robust with good reliability. In the context of France, the 9 scales of Health Literacy Questionnaire allow a thorough assessment of health literacy strengths and weaknesses to respond to health literacy needs and improve the accessibility of health information and services.
A system-wide transformation towards integrated care in the Basque Country: A realist evaluation
Authors: Urtaran-Laresgoiti Maider , Álvarez-Rosete Arturo , Nuño-Solinís Roberto
Published: September 2018

Introduction

In 2010, in a context of severe economic recession, the Basque Government launched the Strategy to tackle the challenge of chronicity in the Basque Country to transform the Basque health system to cope with the challenges of chronicity, ageing, health system fragmentation and sustainability in the long run.

Methods

A realist evaluation has been conducted, and through a combination of research methods, information has been analysed to identify context, mechanisms and outcomes. The research provides a snapshot of the experience of a system-wide, complex health system transformation, which aims to identify ‘what has worked, for whom and under what circumstances’. Twenty-two semi-structured interviews held between June 2015 and December 2016, allowed us to obtain both retrospective and real-time accounts on the transformation phenomenon.

Results

Research pointed out that system-wide transformation requires time, effort, leadership, vision and narrative, as well as commitment, inclusiveness, collaborative decision-making processes with local implementers, ‘muddling through’ and constant learning. Key levers to shake and shift the health and social care systems towards closer alignment, coordination and integration to meet the needs of people include promoting collaborative relationships between health professionals to ensure care continuity, developing new staff roles, investing in integrated electronic health records, stratifying the population by risk and facilitating bottom-up innovation.

Discussion

Research has shown that system-wide changes in health and social care have been viable in the Basque Health System, although the interplay between context, mechanisms and outcomes is more complex than expected, leading to many unexpected factors, patterns and relationships.
Can Spouses Buffer the Impact of Discrimination on Depressive Symptoms? An Examination of Same-sex and Different-sex Marriages
Authors: Donnelly Rachel , Robinson Brandon A. , Umberson Debra
Published: September 2018

Discrimination due to personal characteristics (e.g., gender, sexuality, appearance) is a common yet stressful experience that is detrimental to mental health. Prior work has not considered how spouses in same- and different-sex marriages help each other cope with discrimination despite the importance of marriage for managing stress and adversity. We analyze survey data collected from both spouses in same-sex and different-sex marriages within the United States (N = 836 individuals) to examine whether support from spouses weakens the impact of discrimination on depressive symptoms. Results suggest that discrimination contributes to depressive symptoms, but greater support from spouses buffers the mental health consequences of discrimination. Individuals in same-sex marriages report more spousal support than individuals in different-sex marriages, even after accounting for experiences of discrimination. Same-sex couples may get needed spousal support, whereas women married to men receive the least spousal support and may be vulnerable to stressors that challenge mental health.
The Impact of Marketing Mix on the Competitive Advantage of the SME Sector in the Al Buraimi Governorate in Oman
Authors: Al Badi Khalid Suidan
Published: September 2018

This study aims to highlight the role of marketing mix (product, price, place, and promotion) on achieving the competitive advantage in the small and medium enterprise (SME) sector in the Al Buraimi Governorate in Oman. This article states the significance of competitive advantage in achieving marketing goals and gaining the satisfaction of customers by using marketing mix concept. A descriptive analysis approach is used to analyze the collected data regarding the level of impact of the marketing mix (product, price, place, and promotion), on the competitive advantage of the SME sector in Al Buraimi. The data have been collected through the use of a questionnaire that is distributed to SMEs in the Al Buraimi region according to the Oman Chamber of Commerce and Industry (OCCI). There were 100 SMEs selected randomly; however, only 75 questionnaires were processed due to missing data. According to the data analysis, the results show that all of marketing mix elements (product, price, place, and promotion) have a significant impact on achieving competitive advantage in the case of Al Buraimi’s SMEs ( p value for all marketing mix elements is less than α = .05). The most effective element when it comes to achieving competitive advantage is price. The SME sector in Al Buraimi should develop its product’s quality, distribution channels, and promotion policies to face the local and international competitors. The marketing mix and competitive advantage represent a relatively new orientation in Al Buraimi’s SME sector.
A theoretical analysis and finite element simulation of fixator–bone system stiffness on healing progression
Authors: Li Jianfeng , Zhao Xia , Hu Xiaojie , Tao Chunjing , Ji Run
Published: September 2018

Introduction:

The unilateral external fixator has become a quick and easy application for fracture stabilization of the extremities; the main value for evaluation of mechanical stability of the external fixator is stiffness. The stiffness property of the external fixator affects the local biomechanical environment of fractured bone.

Methods:

In this study, a theoretical model with changing Young’s modulus of the callus is established by using the Castigliano’s theory, investigating compression stiffness, torsional stiffness and bending stiffness of the fixator–bone system during the healing process. The effects of pin deviation angle on three stiffness methods are also investigated. In addition, finite element simulation is discussed regarding the stress distribution between the fixator and bone.

Results:

The results reveal the three stiffness evaluation methods are similar for the fixator–bone system. Finite element simulation shows that with increased healing time, the transmission of the load between the fixator and bone are different. In addition, the finite element analyses verify the conclusions obtained from the theoretical model.

Conclusions:

This work helps orthopedic doctors to monitor the progression of fracture healing and determine the appropriate time for removal of a fixation device and provide important theoretical methodology.
Preparation and thermal insulation performance of cast-in-situ phosphogypsum wall
Authors: Li Yubo , Dai Shaobin , Zhang Yichao , Huang Jun , Su Ying , Ma Baoguo
Published: September 2018

Introduction:

The mass accumulation of phosphogypsum has caused serious environmental pollution, which has become a worldwide problem. Gypsum is a kind of green building material, which is lighter, has better heat and sound insulation performance, and is easier to recycle compared to cement. The application of cast-in-situ phosphogypsum wall could consume a large amount of pollutant, and improve the efficiency of building construction.

Methods:

The preparation and thermal insulation performance of cast-in-situ phosphogypsum wall were investigated. The property of phosphogypsum–fly ash–lime (PFL) triad cementing materials, the adaptability of retarders and superplasticizers, and the influences of vitrified microsphere as aggregates were explored. Thus, the optimum mix was proposed. Thermal insulation performance tests and ANSYS simulation of this material was carried out.

Results:

Optimal structures based on heat channels and the method of calculation determining related parameters were proposed, which achieved a 12.3% reduction in the heat transfer coefficient of the wall.

Conclusion:

With good performance, phosphogypsum could be used in cast-in-situ walls. This paper provides the theoretical basis for the preparation and energy-saving application of phosphogypsum in the walls of buildings.
Mechanical property research of different materials for supporting rings
Authors: Chen Shenglai , Yang Min , Zhang Xinong
Published: September 2018

Introduction:

Supporting rings are becoming more widely applied as an assistant structural support. However, during the engineering design and optimization process, many tests are necessary to understand the mechanical properties of different materials and the different section shape for supporting rings.

Methods:

The key problem is to measure the radial force caused by elongation under the axes’ pressure. This cannot be measured directly through the use of sensors. The previous, simple method was to position a transfer bar into the hole on the supported wall, or use a strain gauge, which changes the contact boundary. A new method called the “semi-ring method” is proposed.

Results:

The problem can be solved well and the feasibility of this method is shown from an example of its application.

Conclusions:

An innovative method is applied in test of mechanical performance for PTFE and butyl rubber material adopted in four kinds of section shape structure supporting rings. The results and analysis can provide some beneficial references for structure design.
A thermodynamic and kinetic study of trace iron removal from aqueous cobalt sulfate solutions using Monophos resin
Authors: Wang Guangxin , Zhao Yunchao , Yang Bin , Song Yongfa
Published: September 2018

Background:

High purity cobalt has many important applications, such as magnetic recording media, magnetic recording heads, optoelectronic devices, magnetic sensors, and integrated circuits, etc. To produce 5N or higher purity cobalt in an electro-refining process, one of the challenges is to effectively reduce the Fe content of aqueous cobalt salt solution before electrolysis. This paper describes thermodynamic and kinetic investigations of the Fe adsorption process of a new sulfonated monophosphonic resin with the trade mark Monophos.

Methods:

Five cobalt sulfate solutions of different Co concentrations were prepared. Fe ions were removed from the solutions by ion exchange method using Monophos resin. Chemical analysis was carried out using a Perkin Elmer ICP-OES.

Results:

The initial Fe concentrations of about 0.9–2.0 mg/L can be reduced to about 0.3–0.8 mg/L, which is equivalent to an Fe removal rate of 60–67%. The Langmuir isothermal adsorption model applies well to the Fe removal process. A second-order type based on McKay equation fits better with experimental data than other kinetic models. The kinetic curve can be divided into two sections. For t < 30 min, particle diffusion may act as the controlling step, whereas chemical reaction may control the Fe adsorption process in the section t > 30 min.

Conclusions:

Monophos resin is effective for the removal of trace Fe from cobalt sulfate solution. This ion exchange process obeys the Langmuir isothermal adsorption model and the McKay equation of second-order kinetics.
Study on super-long deep-hole drilling of titanium alloy
Authors: Liu Zhanfeng , Liu Yanshu , Han Xiaolan , Zheng Wencui
Published: September 2018

Introduction:

In this study, the super-long deep-hole drilling of a titanium alloy was investigated.

Methods:

According to material properties of the titanium alloy, an experimental approach was designed to study three issues discovered during the drilling process: the hole-axis deflection, chip morphology, and tool wear.

Results:

Based on the results of drilling experiments, crucial parameters for the super-long deep-hole drilling of titanium alloys were obtained, and the influences of these parameters on quality of the alloy’s machining were also evaluated.

Conclusions:

Our results suggest that the developed drilling process is an effective method to overcome the challenge of super-long deep-hole drilling on difficult-to-cut materials.
Microstructure and optical properties of ZnO nanorods prepared by anodic arc plasma method
Authors: Li Kan , Wei Zhiqiang , Zhu Xueliang , Zhao Wenhua , Zhang Xudong , Jiang Jinlong
Published: September 2018

Introduction:

A one-dimensional ZnO nanostructure is a versatile and multifunctional n-type semiconductor. In this paper, ZnO nanorods were successfully prepared by the anodic arc plasma method in an oxidizing atmosphere.

Methods:

The composition, morphology, crystal microstructure, and optical properties of ZnO nanorods were characterized by using X-ray diffraction (XRD), high-resolution transmission electron microscopy (HRTEM) and the corresponding selected-area electron diffraction (SAED), X-ray energy dispersive spectrometry (XEDS), ultraviolet-visible (UV-VIS) spectroscopy, Raman scattering spectrum (Raman), and photoluminescence spectrum (PL).

Results:

The experiment results show that ZnO nanorods synthesized by this method possess hexagonal wurtzite crystal structure with good crystallization, no other impurity phases are observed, the crystalline size is about 18 nm, and the lattice constant distortion occurs compared to that of bulk ZnO. The morphology of the sample is a rod-like shape, the length ranges from 100 nm to 300 nm, the average diameter is approximately 20 nm, and the aspect ratio is relatively high. The UV-VIS absorption spectrum occurs red shift, The Raman spectrum further demonstrates that the major peaks are assigned to ZnO optical vibrational modes, and the PL spectrum exhibits coexistence properties of ultraviolet (UV) and green emission.

Conclusions:

The results prove that ZnO nanorods with hexagonal wurtzite crystal structure were successfully prepared by the anodic arc plasma method in an oxidizing atmosphere.
Interfacial damage identification of steel and concrete composite beams based on piezoceramic wave method
Authors: Yan Shi , Dai Yong , Zhao Putian , Liu Weiling
Published: September 2018

Introduction:

Steel-concrete composite structures are playing an increasingly important role in economic construction because of a series of advantages of great stiffness, good seismic performance, steel material saving, cost efficiency, convenient construction, etc. However, in service process, due to the long-term effects of environmental impacts and dynamic loading, interfaces of a composite structure might generate debonding cracks, relative slips or separations, and so on, lowering the composite effect of the composite structure.

Methods:

In this paper, the piezoceramics (PZT) are used as transducers to perform experiments on interface debonding slips and separations of composite beams, respectively, aimed at proposing an interface damage identification model and a relevant damage detection innovation method based on PZT wave technology.

Results:

One part of various PZT patches was embedded in concrete as “smart aggregates,” and another part of the PZT patches was pasted on the surface of the steel beam flange, forming a sensor array.

Conclusions:

A push-out test for four specimens was carried out and experimental results showed that, under the action of the external loading, the received signal amplitudes will increasingly decrease with increase of debonding slips along the interface. The proposed signal energy-based interface damage detection algorithm is highly efficient in surface state evaluations of composite beams.
Effects of diffusion process on potential induced degradation of silicon solar cells
Authors: Gou Xianfang , Li Xiaoyan , Wang Shaoliang , Huang Xixi , Zhou Su , Dong Xuxin
Published: September 2018

Background:

Potential induced degradation (PID) has recently been identified as one of the most important degradation mechanisms for silicon solar cells. It is widely considered that PID is closely related with the manufacture and application period of solar modules.

Methods:

In this study, the effects of diffusion sheet resistance on PID were verified and explained by testing the emitter doping profile, the minority carrier lifetime, the emitter saturation current, the electrical performance of different cells, and the PID process.

Results:

With increasing sheet resistance of cells, the depth and saturation current density of the emitter both decreased, and the cell efficiency increased, whereas the PID phenomenon became serious.

Conclusions:

It was found that higher sheet resistance or thinner P–N junction could lead to higher PID sensitivity. Therefore, more attention should be paid to PID phenomenon as the photovoltaic industry develops in the direction of high sheet resistance.
Nonlinear dynamic analysis and hypernormal form of truss core sandwich plates
Authors: Li Jing , Guo Ziyu , Quan Yinzhu , Li Jian
Published: September 2018

Introduction:

Truss core material, which is a new type of ultra-light material with comprehensive properties, is used in the aerospace industry. The aim of this paper is to investigate the dynamic behavior of three-dimensional Kagome sandwich plates with truss core under transverse and in-plane excitation in the case of 1:1 internal resonance.

Methods:

Firstly, the averaged equation is obtained by means of the method of multiple scales. Then, the nonlinear system is analyzed applying the theory of normal form. Eventually, we analyze the dynamic behavior, mainly periodic motions, for the truss core sandwich panels by using numerical simulation.

Results:

Numerical results are presented here for the nonlinear dynamic behavior of the model of truss core sandwich plates, which provides theoretical guidance to vibration control.

Conclusions:

Considerable insight has been gained concerning the sign of parameter of the model controlled by material property.
Surface modification of bacterial cellulose aerogels by ARGET ATRP
Authors: Liu Xinhua , Li Yong , Chu Zhaoyang , Fang Yinchun , Zheng Hongliang
Published: September 2018

Introduction:

Bacterial cellulose (BC) aerogels have received more and more attention due to their renewability, biodegradability and other excellent properties in recent years. Modification of BC aerogels using different methods would expand their applications. However, many problems exist for these modifications, such as a low grafting ratio, the larger dosage of metal catalyst required and so on. Activator regeneration by electron transfer (ARGET) for atom transfer radical polymerization (ATRP) is a novel ATRP method which could significantly reduce the amount of metal catalyst required and achieve a high grafting ratio.

Methods:

Novel nanostructured BC aerogels containing epoxy groups were prepared by the ARGET ATRP method. BC aerogels were functionalized with initiating sites by reaction with 2-bromoisobutyryl bromide (BiBBr), and followed by ARGET ATRP reaction with glycidyl methacrylate (GMA) which was catalyzed by copper(II) bromide (CuBr2) and N,N,N',N,'N"-pentamethyldiethylenetriamine (PMDETA), and then reduced by vitamin C. BC aerogels containing epoxy groups (BC-g-PGMA) were obtained after freeze-drying. The influence factors of the solvent ratio of N,N-dimethyl formamide (DMF)/toluene, monomer concentration, the concentration of CuBr2, the molar ratio of vitamin C (Vc)/CuBr2,reaction temperature and time on the grafting ratio were investigated.

Results:

The results showed that the optimal DMF and toluene volume ratio was 2:1, the optimal monomer and CuBr2 concentration were 2 mol/l and 1.5 mmol/l. The optimal molar ratio of PMDETA/CuBr2 and Vc/CuBr2 were 4:1 and 1:1. The optimal reaction temperature and time were 60°C and 9 h. Scanning electron microscopy (SEM) images showed that GMA was strongly adhered onto the surface and inside of the BC pellicle.

Conclusions:

GMA was self-grown on the BC surface and achieved the high grafting ratio of 1052.7% under optimal conditions. The BC-g-PGMA aerogels containing the epoxy groups will provide wider application prospects in drug release, enzyme fixed, functional materials and other fields.
Covalent immobilization of coagulation factor VIII on magnetic nanoparticles for aptamer development
Authors: Tabarzad Maryam , Sharafi Zeinab , Javidi Jaber
Published: September 2018

Introduction:

Magnetic nanoparticles (MNPs) are one of the most useful particulate systems in analytical applications such as specific aptamer selection. Proteins are the most noted targets of aptamer selection. Generally, covalently immobilized protein coated MNPs are more stable structures.

Methods:

In this study, coagulation factor VIII (FVIII) was immobilized on MNPs. A silica coating provided isocyanate functional groups was considered to interact covalently with reactive groups of the protein, resulting in a stable protein immobilization. The reactions was run in dried toluene. At end, these MNPs were applied for affinity determination of a previously selected FVIII specific aptamers.

Results:

Immobilization of 1 mg FVIII (~ 3 nmol) on 5 mg particles was achieved with no significant particle aggregation. Using a fluorescence-based method, affinity measurement resulted in a calculated dissociation constant of 120 ± 5.6 nM for the FVIII-specific aptamer to the FVIII-coated MNPs.

Conclusion:

The final product could be a suitable protein-coated solid support for magnetic-based aptamer selection processes.
Vacuum-assisted closure versus moist dressings in the treatment of diabetic wound ulcers after partial foot amputation: A retrospective analysis in 65 patients
Authors: Sukur Erhan , Akar Abdulhalim , Uyar Ahmet Çagrı , Cicekli Ozgur , Kochai Alauddin , Turker Mehmet , Topcu Huseyin Nevzat
Published: September 2018

Purpose:

Changes in weight-bearing patterns after partial foot amputations may lead to new localized high-pressure points and keratosis due to ulcerations in patients with neuropathies and hypovascular limbs. As a result, diabetic foot ulcers (DFUs) after partial foot amputations are very complex. The aim of this study was to compare the effectiveness of vacuum-assisted closure (VAC) therapy with conventional moist wound dressings in the treatment of diabetic wound ulcers after partial foot amputations.

Methods:

Sixty-five diabetic patients with a DFU, who had previously undergone partial foot amputation surgery, were assigned to treatment with VAC (group A: 31 patients) or conventional wound moist dressing (group B: 34 patients). The final results were considered as failed treatment if reamputation was required. Conversely, reaching 90% of wound granulation was considered to be a successful endpoint.

Results:

The average time to reach 90% granulation tissue was significantly lower in group A (7.8 ± 1.2 weeks vs. 11.1 ± 1.2 weeks; p < 0.001). However, there was no significant difference regarding the reamputation requirements; 38.7% (12 patients) in group A and 41.2% (14 patients) in group B, ( p = 0.839).

Conclusion:

The results of this study allowed us to conclude that VAC therapy system appears to be an effective treatment for patients with complex DFUs who had previously undergone partial foot amputation.
A Characterization of Sensory and Motor Neural Dysfunction in Patients Undergoing Hip Arthroscopic Surgery: Traction- and Portal Placement–Related Nerve Injuries
Authors: Carreira Dominic S. , Kruchten Matthew C. , Emmons Brendan R. , Startzman Ashley N. , Martin RobRoy L.
Published: September 2018

Background:

There is a paucity of prospectively collected data as they relate to nerve injuries after hip arthroscopic surgery. Studies describing the relationship of neurological injuries to portal placement and the duration and magnitude of traction force with regular and standardized patient follow-up protocols are limited.

Purpose/Hypothesis:

The purpose of this study was to characterize nerve deficits in a series of patients undergoing hip arthroscopic surgery as these deficits relate to axial traction and portal placement. It was hypothesized that in patients who presented without nerve deficits after surgery, the magnitudes of traction-related measurements would exceed previous recommendations based on expert opinion (<50 lb). Additionally, it was hypothesized that sensory disturbance would commonly be observed (≥16%) localized to the distal anterolateral thigh related to portal placement.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 45 patients scheduled to undergo hip arthroscopic surgery between July 2012 and February 2014 were included in this study. Traction force was measured and recorded every 5 minutes during surgery, and patients were assessed by a physical examination for deficits in light touch sensitivity at all lower extremity dermatomes preoperatively and at 3 weeks, 6 weeks, 3 months, and 1 year postoperatively. Patients were also tested for strength deficits and rated on the manual muscle testing grading scale. Patients reported modified Harris Hip Score (mHHS), Hip Outcome Score–Activities of Daily Living and –Sport subscales (HOS-ADL and HOS-Sport, respectively), Short Form–12 (SF-12) mental and physical component summaries, and international Hip Outcome Tool–12 (iHOT-12) scores preoperatively and at 1 year postoperatively.

Results:

Thresholds for maximum traction force, mean traction force, duration of traction, and traction impulse were 120 lb, 82 lb, 61 minutes, and 7109 lb·min, respectively, below which no patients presented with sensory or motor dysfunction thought to be related to traction. A minority (17.8%) of patients presented with highly localized, distal anterolateral sensory deficits suggestive of injuries related to portal placement, and 2.2% of patients presented with perineal numbness localized to the distribution of the pudendal nerve. All nerve deficits had resolved by 1-year follow-up.

Conclusion:

This study suggests that it may be possible to apply more axial traction force for a longer duration than expert opinion has previously suggested, without significant and, in the majority of cases (82.2%), any traction-related short-term complications. Transient traction- and portal placement–related nerve injuries after hip arthroscopic surgery may be more frequent (31.1% in this study) than have been reported historically.
Individual and Environmental Determinants of Provider Continuity Among Urban Older Adults With Heart Failure: A Retrospective Cohort Study
Authors: Ryvicker Miriam , Russell David
Published: September 2018

Objective: Continuity in patient–provider relationships is important to providing high-quality care for older adults with chronic conditions. We investigated individual and environmental determinants of provider continuity for office-based physician visits among urban older adults with heart failure. Method: We linked Medicare claims with data on neighborhood characteristics for a retrospective cohort of community-dwelling Medicare beneficiaries with heart failure in New York City ( N = 50,475). Results: Mean continuity using the Bice–Boxerman index was 0.33 ( SD = 0.22) (possible range of 0 [no continuity] to 1 [perfect continuity]). Multivariable regression indicated that provider continuity was higher among older, female, and dually eligible beneficiaries. Those with more chronic conditions had higher continuity, controlling for number of medical specialties seen. Continuity was lower for beneficiaries in neighborhoods with high median income and high primary care density. Conclusion: Individual and environmental predictors of provider continuity among urban older adults with heart failure could help to identify those at risk of care fragmentation.
Casting off the Shackles: Re-narrativizing Discrepant Terrains of Memories with Lived Experiences in A. B. Yehoshua’s Facing the Forests
Authors: Anam
Published: September 2018

The ever-increasing human migration with fast-eroding bonds often leads to development of social clusters which tend to produce stereotypes about other groups of people. One among the many factors responsible for such ghettoization is not ignorance but a version of knowledge that does not take us beyond ourselves. Speaking about the role of writer as “the conscience of the nation,” S. Yizhar, an Israeli writer and politician, says that a writer is a mutation. Literature is one such powerful tool to transcend cultural boundaries which takes us beyond ourselves and reaches to the other side. Holding the case of Israeli–Palestinian contestation as one such manifestation of cultural ghettoization, the article argues for the need to render open the mental borders to move beyond prejudices. Taking A. B. Yehoshua’s Facing the Forests as a point of departure, it highlights the potential of dialog as a powerful antidote to social violence between the two communities of Arabs and Israelis and lays bare its importance in the direction of peaceful coexistence.

The article is divided into three sections; the first section introduces the cultural location of Yehoshua and his narrative set in the Israeli landscape of the 1960s. The second section explores the use of symbolism in the narrative to cull out the dormant meanings and analyzes the multiple layers of the text. The third and last section projects the idea of re-narrativization as an important tool of re-inscribing history with alternative versions. It draws strength from those Arab–Jewish encounters that are not necessarily troubling. The conclusion sums up the essential findings of the study, elucidating the role of literature and intellectuals in difficult times.
Open Educational Resources: The New Frontier
Authors: Kruger Jessica Sloan , Abramovich Samuel
Published: September 2018

Open educational resources (OERs) are materials that are available freely to students and faculty. While the concept of OERs was created about 10 years ago, the field of public health and health education has not widely adopted these materials. This article discusses the positive benefits of OERs to students and faculty, along with some of the potential challenges faced by adopting OERs. Ultimately, OERs could prove to be a solution to ensuring up-to-date information reaches students, faculty, and practitioners in the field and offer textbooks at a reasonable cost for students.
Decoding the Paradox of Dividend Policy: An Empirical Study on Indian Banking Sector
Authors: Patnaik B. Chandra Mohan , Das Chandrabhanu
Published: September 2018

The dividend policy has often been treated as the most complicated and intriguing aspects in corporate finance. Profitability was always cited as the main source of confidence for dividend payments. Numerous articles written on the dividend policy explored several of its other determinants. The most popular Lintner’s Dividend Model has been assessed and applied by researchers in different sectors including the banking sector in India. The results from the banking sector also confirmed to a greater extent the accuracy of Lintner’s Dividend Model. Although Lintner’s Dividend Model had its firm footing in the Indian banking industry, the model has not much explored about liquidity constraints, ownership and managerial efficiency. The above-mentioned predictors are important in the present scenario where many public sector banks paid dividends while having high nonperforming assets. Recently the government has announced a dividend cut for 16 public sector banks due to high level of stressed assets. Hence, profitability and stressed assets are the paradoxical aspects in the dividend policy for the banking industry. Findings from this study have evidence of substantial influence of liquidity constraints, ownership and managerial efficiency and their influence on the dividend policy.
Ketamine, but Not the NMDAR Antagonist Lanicemine, Increases Prefrontal Global Connectivity in Depressed Patients
Authors: Abdallah Chadi G. , Dutta Arpan , Averill Christopher L. , McKie Shane , Akiki Teddy J. , Averill Lynnette A. , William Deakin J. F.
Published: September 2018

Background

Identifying the neural correlates of ketamine treatment may facilitate and expedite the development of novel, robust, and safe rapid-acting antidepressants. Prefrontal cortex (PFC) global brain connectivity with global signal regression (GBCr) was recently identified as a putative biomarker of major depressive disorder. Accumulating evidence have repeatedly shown reduced PFC GBCr in major depressive disorder, an abnormality that appears to normalize following ketamine treatment.

Methods

Fifty-six unmedicated participants with major depressive disorder were randomized to intravenous placebo (normal saline; n = 18), ketamine (0.5 mg/kg; n = 19), or lanicemine (100 mg; n = 19). PFC GBCr was computed using time series from functional magnetic resonance imaging scans that were completed at baseline, during infusion, and at 24-h posttreatment.

Results

Compared to placebo, ketamine significantly increased average PFC GBCr during infusion ( p = 0.01) and at 24-h posttreatment ( p = 0.02). Lanicemine had no significant effects on GBCr during infusion ( p = 0.45) and at 24-h posttreatment ( p = 0.23) compared to placebo. Average delta PFC GBCr (during minus baseline) showed a pattern of positively predicting depression improvement in participants receiving ketamine ( r = 0.44; p = 0.06; d = 1.0) or lanicemine ( r = 0.55; p = 0.01; d = 1.3) but not those receiving placebo ( r = −0.1; p = 0.69; d = 0.02). Follow-up vertex-wise analyses showed ketamine-induced GBCr increases in the dorsolateral, dorsomedial, and frontomedial PFC during infusion and in the dorsolateral and dorsomedial PFC at 24-h posttreatment ( corrected p < 0.05). Exploratory vertex-wise analyses examining the relationship with depression improvement showed positive correlation with GBCr in the dorsal PFC during infusion and at 24-h posttreatment but negative correlation with GBCr in the ventral PFC during infusion ( uncorrected p < 0.01).

Conclusions

In a randomized placebo-controlled approach, the results provide the first evidence in major depressive disorder of ketamine-induced increases in PFC GBCr during infusion and suggest that ketamine’s rapid-acting antidepressant properties are related to its acute effects on prefrontal connectivity. Overall, the study findings underscore the similarity and differences between ketamine and another N-methyl-D-aspartate receptor antagonist while proposing a pharmacoimaging paradigm for the optimization of novel rapid-acting antidepressants prior to testing in costly clinical trials.
The Impact of Formative Computer-Based Testing on Learners’ Anxiety and Performance on the American Registry for Diagnostic Medical Sonography Examination
Authors: Wilson Michelle
Published: September 2018

The intent of this research was to evaluate the effects of computerized mock examinations on student performances during the preparatory stage for a national board examination. Three measures were used: web-based surveys, student data from the ExamSim software (treatment group), and American Registry for Diagnostic Medical Sonography (ARDMS) examination scores. Three research questions were posed: (1) What are the differences in ARDMS scores between the treatment and control groups? Mean scores showed that the treatment group scored significantly higher than the control group on the ARDMS examination. (2) To what degree did the scores and time invested on the ExamSim software predict performance on the ARDMS examination? A multiple linear regression was conducted, and the result was significant, with time and software scores accounting for 37.6% of the variance in ARDMS scores. (3) How did utilizing a formative computer-based assessment change perceived testing anxiety levels during the test preparatory phase? The result of the dependent sample t test was significant. Self-perceived scores at posttreatment were lower than self-perceived scores at pretreatment.
Risk-adapted survival benefit of IMRT in early-stage NKTCL: a multicenter study from the China Lymphoma Collaborative Group
Authors: Wu Tao , Yang Yong , Zhu Su-Yu , Shi Mei , Su Hang , Wang Ying , He Xia , Xu Li-Ming , Yuan Zhi-Yong , Zhang Li-Ling , Wu Gang , Qu Bao-Lin , Qian Li-Ting , Hou Xiao-Rong , Zhang Fu-Quan , Zhang Yu-Jing , Zhu Yuan , Cao Jian-Zhong , Lan Sheng-Min , Wu Jun-Xin , Hu Chen , Qi Shu-Nan , Chen Bo , Li Ye-Xiong
Published: September 2018

This study evaluated the survival benefit of intensity-modulated radiation therapy (IMRT) compared with 3-dimension conformal radiation therapy (3D-CRT) in a large national cohort of patients with early-stage extranodal nasal-type natural killer/T-cell lymphoma (NKTCL). This retrospective study reviewed patients with early-stage NKTCL treated with high-dose radiation therapy (RT; ≥45 Gy) at 16 Chinese institutions. Patients were stratified into 1 of 4 risk groups based on the number of risk factors: low risk (no factors), intermediate-low risk (1 factor), intermediate-high risk (2 factors), and high-risk (3-5 factors). Of the 1691 patients, 981 (58%) received IMRT, and 710 (42%) received 3D-CRT. Unadjusted 5-year overall survival (OS) and progression-free survival (PFS) were 75.9% and 67.6%, respectively, for IMRT compared with 68.9% (P = .004) and 58.2% (P < .001), respectively, for 3D-CRT. After propensity score match and multivariable analyses to account for confounding factors, IMRT remained significantly associated with improved OS and PFS. The OS and PFS benefits of IMRT persisted in patients treated with modern chemotherapy regimens. Compared with 3D-CRT, IMRT significantly improved OS and PFS for high-risk and intermediate-high–risk patients but provided limited benefits for low-risk or intermediate-low–risk patients. A risk-adapted survival benefit profile of IMRT can be used to select patients and make treatment decisions.
Imetelstat, a telomerase inhibitor, is capable of depleting myelofibrosis stem and progenitor cells
Authors: Wang Xiaoli , Hu Cing Siang , Petersen Bruce , Qiu Jiajing , Ye Fei , Houldsworth Jane , Eng Kevin , Huang Fei , Hoffman Ronald
Published: September 2018

Clinical trials of imetelstat therapy have indicated that this telomerase inhibitor might have disease-modifying effects in a subset of patients with myelofibrosis (MF). The mechanism by which imetelstat induces such clinical responses has not been clearly elucidated. Using in vitro hematopoietic progenitor cell (HPC) assays and in vivo hematopoietic stem cell (HSC) assays, we examined the effects of imetelstat on primary normal and MF HSCs/HPCs. Treatment of CD34+ cells with imetelstat reduced the numbers of MF but not cord blood HPCs (colony-forming unit–granulocyte/macrophage, burst-forming unit–erythroid, and colony-forming unit–granulocyte/erythroid/macrophage/megakaryocyte) as well as MF but not normal CD34+ALDH+ cells irrespective of the patient’s mutational status. Moreover, imetelstat treatment resulted in depletion of mutated HPCs from JAK2V617F+ MF patients. Furthermore, treatment of immunodeficient mice that had been previously transplanted with MF splenic CD34+ cells with imetelstat at a dose of 15 mg/kg, 3 times per week for 4 weeks had a limited effect on the degree of chimerism achieved by normal severe combined immunodeficiency repopulating cells but resulted in a significant reduction in the degree of human MF cell chimerism as well as the proportion of mutated donor cells. These effects were sustained for at least 3 months after drug treatment was discontinued. These actions of imetelstat on MF HSCs/HPCs were associated with inhibition of telomerase activity and the induction of apoptosis. Our findings indicate that the effects of imetelstat therapy observed in MF patients are likely attributable to the greater sensitivity of imetelstat against MF as compared with normal HSCs/HPCs as well as the intensity of the imetelstat dose schedule.
New Approaches to the Management of Adult Acute Lymphoblastic Leukemia
Authors: Bassan Renato , Bourquin Jean-Pierre , DeAngelo Daniel J. , Chiaretti Sabina
Published: September 2018

Traditional treatment regimens for adult acute lymphoblastic leukemia, including allogeneic hematopoietic cell transplantation, result in an overall survival of approximately 40%, a figure hardly comparable with the extraordinary 80% to 90% cure rate currently reported in children. When translated to the adult setting, modern pediatric-type regimens improve the survival to approximately 60% in young adults. The addition of tyrosine kinase inhibitors for patients with Philadelphia chromosome–positive disease and the measurement of minimal residual disease to guide risk stratification and postremission approaches has led to additional improvements in outcomes. Relapsed disease and treatment toxicity—sparing no patient but representing a major concern especially in the elderly—are the most critical current issues awaiting further therapeutic advancement. Recently, there has been considerable progress in understanding the disease biology, specifically the Philadelphia-like signature, as well as other high-risk subgroups. In addition, there are several new agents that will undoubtedly contribute to additional improvement in the current outcomes. The most promising agents are monoclonal antibodies, immunomodulators, and chimeric antigen receptor T cells, and, to a lesser extent, several new drugs targeting key molecular pathways involved in leukemic cell growth and proliferation. This review examines the evidence supporting the increasing role of the new therapeutic tools and treatment options in different disease subgroups, including frontline and relapsed or refractory disease. It is now possible to define the best individual approach on the basis of the emerging concepts of precision medicine.
Disrupting Hedgehog Cardin–Weintraub sequence and positioning changes cellular differentiation and compartmentalization in vivo
Authors: Kastl Philipp , Manikowski Dominique , Steffes Georg , Schürmann Sabine , Bandari Shyam , Klämbt Christian , Grobe Kay
Published: September 2018

Metazoan Hedgehog (Hh) morphogens are essential regulators of growth and patterning at significant distances from their source, despite being produced as N-terminally palmitoylated and C-terminally cholesteroylated proteins, which firmly tethers them to the outer plasma membrane leaflet of producing cells and limits their spread. One mechanism to overcome this limitation is proteolytic processing of both lipidated terminal peptides, called shedding, but molecular target site requirements for effective Hh shedding remained undefined. In this work, by using Drosophila melanogaster as a model, we show that mutagenesis of the N-terminal Cardin–Weintraub (CW) motif inactivates recombinant Hh proteins to variable degrees and, if overexpressed in the same compartment, converts them into suppressors of endogenous Hh function. In vivo, additional removal of N-palmitate membrane anchors largely restored endogenous Hh function, supporting the hypothesis that proteolytic CW processing controls Hh solubilization. Importantly, we also observed that CW repositioning impairs anterior/posterior compartmental boundary maintenance in the third instar wing disc. This demonstrates that Hh shedding not only controls the differentiation of anterior cells, but also maintains the sharp physical segregation between these receiving cells and posterior Hh-producing cells.