bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint ultrasound baseline abnormalities predict a specific long-term clinical outcome in systemic lupus erythematosus patients
Authors: Corzo P , Salman-Monte T C , Torrente-Segarra V , Polino L , Mojal S , Carbonell-Abelló J
Published: November 2016

Objective

To describe long-term clinical and serological outcome in all systemic lupus erythematosus (SLE) domains in SLE patients with hand arthralgia (HA) and joint ultrasound (JUS) inflammatory abnormalities, and to compare them with asymptomatic SLE patients with normal JUS.

Methods

SLE patients with HA who presented JUS inflammatory abnormalities (‘cases’) and SLE patients without HA who did not exhibit JUS abnormalities at baseline (‘controls’) were included. All SLE clinical and serological domain involvement data were collected. End follow-up clinical activity and damage scores (systemic lupus erythematosus disease activity index (SLEDAI), Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR)) were recorded. JUS inflammatory abnormalities were defined based on the Proceedings of the Seventh International Consensus Conference on Outcome Measures in Rheumatology Clinical Trials (OMERACT-7) definitions. Statistical analyses were carried out to compare ‘cases’ and ‘controls’.

Results

A total of 35 patients were recruited. The ‘cases’, n = 18/35, had a higher incidence of musculoskeletal involvement (arthralgia and/or arthritis) through the follow-up period (38.9% vs 0%, p = 0.008) and received more hydroxychloroquine (61.1% vs 25.0%, p = 0.034) and methotrexate (27.8% vs 0%, p = 0.046) compared to ‘controls’, n = 17/35. Other comparisons did not reveal any statistical differences.

Conclusions

We found SLE patients with arthralgia who presented JUS inflammatory abnormalities received more hydroxychloroquine and methotrexate, mainly due to persistent musculoskeletal involvement over time. JUS appears to be a useful technique for predicting worse musculoskeletal outcome in SLE patients.
Lenalidomide for refractory cutaneous manifestations of pediatric systemic lupus erythematosus
Authors: Wu E Y , Schanberg L E , Wershba E C , Rabinovich C E
Published: November 2016

Objective

Cutaneous manifestations of pediatric systemic lupus erythematosus cause significant morbidity. Lenalidomide, a thalidomide analogue, has shown promise treating cutaneous lupus erythematosus in adults. Our objective was to evaluate lenalidomide’s efficacy and safety in treating refractory cutaneous manifestations of pediatric systemic lupus erythematosus.

Methods

We performed a retrospective chart review of 10 adolescents who received lenalidomide for recalcitrant cutaneous lupus erythematosus. Information was gathered at drug initiation and 6-month follow-up. The Wilcoxon matched-pairs signed-rank test was used to assess change in quantitative parameters of disease activity.

Results

Nine subjects were girls and six were African-American. Indications for lenalidomide treatment included alopecia, nasal and oral ulcers, extensive malar rash, discoid lesions, bullous lesions, panniculitis, cutaneous vasculitis, and Raynaud’s phenomenon with digital ulcerations. Within 6 months, all patients demonstrated complete or near resolution based on physician report. Prednisone dose decreased from a mean 23.5 mg (SD± 13.3) to 12.25 mg (SD± 9.2) ( P= 0.008). Sedimentation rate decreased from a mean 29 mm/hour (SD± 31.5) to 17 mm/hour (SD± 18.1) ( P= 0.004). Lenalidomide was well tolerated.

Conclusion

Lenalidomide is an effective and safe treatment for a spectrum of dermatological conditions in pediatric systemic lupus erythematosus. Its use may allow a reduction in prednisone dose and decreased disfigurement. Prospective study is needed to clarify lenalidomide’s role in treating cutaneous manifestations of systemic lupus erythematosus.
Comparison of ethnicity, gender, age of onset and outcome in South Africans with systemic lupus erythematosus
Authors: Budhoo A , Mody G M , Dubula T , Patel N , Mody P G
Published: November 2016

Ethnicity, gender and age of onset are reported to influence the expression and outcome of systemic lupus erythematosus. We studied a multi-ethnic cohort of 408 South Africans (91.2% females) comprising 237 (58.1%) Indians, 137 (33.6%) African Blacks, 17 (4.2%) Mixed ethnicity and 17 (4.2%) Whites. The most common manifestations were arthritis (80.6%), photosensitivity (67.2%), oral ulcers (50.0%), malar rash (49.0%) and renal (39.2%). The common laboratory findings were positive anti-nuclear factor (96.8%), haematological (74.8%) and anti-dsDNA antibodies (45.3%). Serositis ( p = 0.002), nephritis ( p = 0.039), leucopaenia ( p = 0.001), haemolytic anaemia ( p = 0.026), anti-dsDNA antibodies ( p = 0.028) and anti-Sm antibodies ( p = 0.050) were more common in African Blacks compared to Indians. Males had increased prevalence of discoid rash ( p = 0.006) and anti-Sm antibodies ( p = 0.016). Discoid rash ( p = 0.018), renal involvement ( p < 0.001), psychosis ( p = 0.028), seizures ( p = 0.020), anti-dsDNA antibodies ( p = 0.009), leucopaenia ( p = 0.006), haemolytic anaemia ( p = 0.017) and thrombocytopaenia ( p = 0.023) were more common with early-onset systemic lupus erythematosus. On multivariate analysis, the independent predictors of death were renal involvement, anti-dsDNA antibodies and seizures. There were 53 (13%) deaths and the five- and 10-year survival was 90.8% and 85.7% respectively, with no differences related to ethnicity or age of onset. In conclusion, we report on the spectrum and outcome of systemic lupus erythematosus in a large South African multi-ethnic cohort.
Extracorporeal Membrane Oxygenation (ECMO) for Lung Injury in Severe Acute Respiratory Distress Syndrome (ARDS): Review of the Literature
Authors: Paolone Summer
Published: November 2016

Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 26% to 58%. Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass circuit that serves as an artificial membrane lung and blood pump to provide gas exchange and systemic perfusion for patients when their own heart and lungs are unable to function adequately. ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure while minimizing iatrogenic ventilator-induced lung injury. In critical care settings, ECMO is proven to improve survival rates and outcomes in patients with severe ARDS. This review defines severe ARDS; describes the ECMO circuit; and discusses recent research, optimal use of the ECMO circuit, limitations of therapy including potential complications, economic impact, and logistical factors; and discusses future research considerations.
Sepsis and Shock Response Team: Impact of a Multidisciplinary Approach to Implementing Surviving Sepsis Campaign Guidelines and Surviving the Process
Authors: Grek Ami , Booth Sandra , Festic Emir , Maniaci Michael , Shirazi Ehsan , Thompson Kristine , Starbuck Angela , Mcree Chad , Naessens James M. , Moreno Franco Pablo
Published: November 2016

The Surviving Sepsis Campaign guidelines are designed to decrease mortality through consistent application of a 7-element bundle. This study evaluated the impact of improvement in bundle adherence using a time-series analysis of compliance with the bundle elements before and after interventions intended to improve the process, while also looking at hospital mortality. This article describes interventions used to improve bundle compliance and hospital mortality in patients admitted through the emergency department with sepsis, severe sepsis, or septic shock. Quality improvement methodology was used to develop high-impact interventions that led to dramatically improved adherence to the Surviving Sepsis Campaign guidelines bundle. Improved performance was associated with a significant decrease in the in-hospital mortality of severe sepsis patients presenting to the emergency department.
Radiographic Analysis of Feet With and Without Morton’s Neuroma
Authors: Naraghi Reza , Bremner Alexandra , Slack-Smith Linda , Bryant Alan
Published: November 2016

Background:

The aim of this research was to investigate the association of various structural measurements of the forefoot with Morton’s neuroma (MN).

Methods:

Weightbearing anteroposterior and lateral foot radiographs of subjects attending the University of Western Australia (UWA) Podiatry Clinic and the first author’s private practice were included in this study. A single assessor measured the following angles: lateral intermetatarsal angle (LIMA), intermetatarsal angle (IMA), hallux valgus angle (HVA), digital divergence between the second and third digits (DD23), digital divergence between the third and fourth digits (DD34) and relative metatarsal lengths of the first to fifth metatarsals (Met1-5), and the effect of MN size as measured by ultrasonograph on digital divergence. Intratester reliability of all radiographic measurements was assessed on all radiographic measurements. The study included 101 subjects, of whom 69 were diagnosed with MN and 32 were control subjects without MN. The mean (± standard deviation) age of MN subjects was 52 (±15) years and for control subjects, 48 (±12) years.

Results:

When comparing all feet, there were no significant differences in the LIMA, HVA, IMA, digital divergence angles and the relative metatarsal distances between subjects with MN and control subjects. No relationship between MN size and digital divergence was found in either foot, or in either neuroma location.

Conclusion:

We were unable to demonstrate any relationship in this study between radiographic metatarsal length and angular measurements in a symptomatic MN group compared to a control group. In addition, we did not find any correlation between the size of MN as measured from ultrasonographic images and radiographic evidence of digital divergence.

Level of Evidence:

Level III, case control study.
Neurogenesis: Regulation by Alternative Splicing and Related Posttranscriptional Processes
Authors: Lara-Pezzi Enrique , Desco Manuel , Gatto Alberto , Gómez-Gaviro María Victoria
Published: November 2016

The complexity of the mammalian brain requires highly specialized protein function and diversity. As neurons differentiate and the neuronal circuitry is established, several mRNAs undergo alternative splicing and other posttranscriptional changes that expand the variety of protein isoforms produced. Recent advances are beginning to shed light on the molecular mechanisms that regulate isoform switching during neurogenesis and the role played by specific RNA binding proteins in this process. Neurogenesis and neuronal wiring were recently shown to also be regulated by RNA degradation through nonsense-mediated decay. An additional layer of regulatory complexity in these biological processes is the interplay between alternative splicing and long noncoding RNAs. Dysregulation of posttranscriptional regulation results in defective neuronal differentiation and/or synaptic connections that lead to neurodevelopmental and psychiatric disorders.
Correlates of Disclosure Cessation After Sexual Assault
Authors: Dworkin Emily R. , Allen Nicole
Published: November 2016

Contacts with responders after sexual assault may influence further disclosure, but this possibility has not been explored empirically. Thus, this study investigates associations between survivors’ contacts with responders and their decisions to discontinue disclosure. Fifty-four college students with a history of unwanted sexual experiences described 94 ordered contacts with responders. Results indicate that survivors’ perceptions of responsiveness were not associated with continued disclosure, but survivors were more likely to continue disclosing when they perceived more rape myth acceptance from responders and when the assault was more recent. These findings highlight survivors’ tenacity in meeting their needs, even after problematic responses.
Development of a systematic approach to pharmaceutical industry’s patient assistance programs on accessing unfunded cancer drugs
Authors: Kletas Victoria , de Lemos Mario
Published: November 2016

Background

New oncology drugs usually become commercially available several months before the funding decisions are made by provincial public payers. Increasingly, patient assistance programs are being set up by pharmaceutical companies in order to facilitate access of their new cancer drugs before public funding decisions are finalized. We discovered that there is a need to keep this information up to date and available in a central repository, thus we have created a centralized patient assistance chart for use by all who require information on accessing unfunded drugs in our province.

Methodology

The project was carried out at a publicly funded provincial cancer care organization that oversees parenteral and oral chemotherapy treatments across our province. The drug information pharmacist at this organization developed a method of scoping information on upcoming therapies by reviewing a series of recommendations made by various organizations that review oncology treatments. A standard process was developed for including information on the patient assistance chart that is available on the organizations website.

Results

As of May 2016, the repository contains information on 47 patient assistance programs involving 24 unfunded antineoplastic drugs for various indications. This compared to (7) when it was maintained by a single centre in 2004 and 10 when the process was first centralized in 2009.

Conclusion

The benefit of patient assistance program availability allows patients to access medications when provincial funding is not available. A standardized approach and methodology to evaluating information was established by our drug information pharmacist; thus allowing for a consistent approach to dissemination of information on assessing unfunded cancer drugs in our province.
Actinometric and biodosimetric evaluation of UV-C dose delivery in annular, Taylor–Coutte and coiled tube continuous systems
Authors: Müller Alexandra , Orlowska Marta , Knörr Michael , Stahl Mario R , Greiner Ralf , Koutchma Tatiana
Published: November 2016

In this study, the evaluation of the performance of two thin-film UV-C reactors (annular and Taylor–Couette) and a coiled tube system is presented using actinometry and biodosimetry methods. The iodide/iodate actinometry method was found suitable for comparison of the efficiency of UV-C dose delivery of the UV-C continuous flow systems. Inactivation kinetics of Escherichia coli ATCC 8739 in quarter-strength Ringer’s solution (absorption coefficient α254 nm ∼ 0 cm−1) at various flow conditions at Reynolds numbers in the range of 26 to 3000 showed a good correlation between the different reactor types. In high UV-C absorbing liquids, the inactivation efficiency increases due to the improved radial mixing. The inactivation performance of the Taylor–Couette system correlates to the annular reactor when no rotation force is applied. The residence time distributions showed the narrowest distribution with the coiled tube system at comparable flow rates. The results indicate that, despite the laminar flow conditions, the performance of the Taylor–Couette unit becomes equal to the turbulent flow conditions of the coiled tube reactor by rotation of the inner cylinder.
The National Infrastructure Reserve Bank
Authors: Hubbard Stephen M.
Published: November 2016

This article examines the implementation of a novel national infrastructure bank (NIB) which coins or “makes” U.S. currency to provide capital for infrastructure loans. This approach eliminates bond expense while reducing long-term life cycle costs caused by deferred maintenance and construction inflation. It also addresses the three main issues that have blocked prior NIB proposals by providing a near zero-cost source of capital, reducing the total size of government employment, and isolating funding from national politics while reducing costs by US$75 to US$220 billion and creating up to three million or more jobs annually.
Intraoperative Diagnosis of Intracardiac Thrombus During Orthotopic Liver Transplantation With Transesophageal Echocardiography: A Case Series and Literature Review
Authors: Dalia Adam A. , Khan Hisham , Flores Antolin S.
Published: November 2016

Anesthesia for orthotopic liver transplantation (OLT) is challenging for any anesthesiologist as the patients undergoing this procedure are among the most critically ill. Adding to the underlying complexity of OLT management is the rare complication of an intracardiac thrombus (ICT). Intracardiac thrombi can present following liver allograft reperfusion resulting in high morbidity and mortality. Currently there is no consensus treatment for ICT, and the gold standard for diagnosis is intraoperative transesophageal echocardiography (TEE); these 2 factors lead to a dangerous amalgam of the difficulty in diagnosing and treating the disease. We describe 2 separate cases in detail of ICT formation during OLT that were recognized and diagnosed with intraoperative TEE. These 2 cases highlight the important role of TEE in the management of ICT. A thorough literature review that follows analyzes our current understanding of ICT during OLT and the vital function of TEE by every anesthesiologists regardless of formal TEE training. Broader use of TEE during all OLTs can help narrow the anesthesiologist’s differential diagnosis during the acute phases of transplantation and should be considered in all liver transplant surgeries.
Concerns With Entertainment-Education: Zombie Pandemic Preparedness and the Unanticipated Promotion of a Weapons Culture
Authors: Houghton Frank , Toms Jeremy , Meratnia Ghazal , Loney Krista , Hopkins Edward , Del Monte Katie
Published: November 2016

Entertainment-education has proved to be an engaging medium through which to explore health and social issues in populations. Given the popularity of the zombie theme in popular culture it is no surprise therefore that the Centers for Disease Control and Prevention adopted this theme in an effort to engage youth and young adults in emergency preparedness. However, an earlier observational study involving elementary school children based on this premise raised concerns that it may have unexpectedly promoted a focus on firearms. A randomized control study involving 89 children (average age 10.4 years) was therefore conducted to explore this possibility in more depth. One group was exposed to a natural disaster scenario, while the other group was exposed to the zombie pandemic theme. When subsequently asked to prepare emergency kit lists, participants in the zombie themed scenario were 15.84 times as likely to include firearms in their lists compared with participants who were exposed to the natural disaster scenario. Although the sample size in this study was small, it is suggested that future interventions using entertainment-education need to explore all aspects of the messages implicit in their chosen medium, rather than just focusing on one element.
Do Small Businesses Respond to a Change in Tax Audit Rules? Evidence from Italy
Authors: Santoro Alessandro
Published: November 2016

Tax evasion by small businesses can be tackled using different approaches. A traditional one recommends to increase the probability of an audit that is perceived by small businesses. Clearly, this entails high administrative and compliance costs. Another possibility is to reduce the room for accounting manipulation by applying more stringent accounting standards. This article uses a panel of administrative data concerning 71,000 Italian small businesses observed in tax years 2005 to 2008. The aim of this article is to evaluate the impact of a reform implemented in 2006. Until 2005, small businesses adopting more stringent accounting standards were granted a special audit regime such that the probability to be audited was particularly low. This regime was repealed in 2006. It is shown that the reform increased profits and turnover, as reported by the subset of businesses that were more likely to perceive the reform as an increase in the probability of an audit.
Development of a Quality-of-Life Measure for Hidradenitis Suppurativa
Authors: Sisic Mia , Kirby Joslyn S. , Boyal Sanwarjit , Plant Lisa , McLellan Chelsea , Tan Jerry
Published: November 2016

Background:

Hidradenitis suppurativa (HS) is a chronic skin disorder with adverse impacts on both physical and psychosocial well-being. There is presently no validated HS-specific quality-of-life (QoL) measure.

Objective:

The objective of this study is to develop a QoL instrument for HS (HS-QoL) in accordance with recommended standards.

Methods:

Patient interviews (concept elicitation) and expert input were used to develop the conceptual framework for outcomes perceived important to patients with HS. A HS-QoL-v1 measure was developed, and cognitive interviews with patients were conducted for pilot testing.

Results:

Concept elicitation interviews with patients with HS (n = 21) generated 12 themes. Most frequently reported were impacts on daily activities and symptoms due to HS. These themes, along with literature review and input from clinical experts, informed development of the HS-QoL-v1. Nine cognitive interviews were conducted in a pilot test and resulted in the HS-QoL-v2 measure.

Conclusion:

The HS-QoL-v2 is a preliminary QoL instrument for which further psychometric validation and establishment of clinimetric properties will be undertaken.
Case Report of Patient With Erythropoietic Protoporphyria and Basal Cell Carcinoma Diagnoses
Authors: Reitmeier Shayne D. , Schacter Brent , Wiseman Marni C.
Published: November 2016

Background:

Basal cell carcinoma (BCC) is the most common nonmelanoma skin cancer. There is a clear association between BCC development and ultraviolet (UV) radiation. Erythropoietic protoporphyria (EPP) is an inherited porphyria disorder that is a result of protoporphyrin accumulation, typically manifesting with phototoxicity.

Case Summary:

We report a case of a 24 year-old man with both EPP and BCC diagnoses. At the age of 4 years, the patient was diagnosed with EPP. The patient presented with a BCC on his nose at age 24 years, despite sun avoidance as the primary treatment for his EPP diagnosis.

Conclusion:

Consider the diagnosis of BCC in a patient with EPP, despite sun avoidance.
Combined influence of couple stress lubricant, recess geometry and method of compensation on the performance of hydrostatic circular thrust pad bearing
Authors: Kumar Vivek , Sharma Satish C
Published: November 2016

This study concerns with the theoretical investigation to show the influence of recess geometry and method of compensation on the performance of recessed hydrostatic circular thrust pad bearing operating with couple stress lubricant. Modified Reynolds equation for couple stress lubricant has been derived using Stokes microcontinuum theory. Stokes theory describes the behavior of fluids consisting of long chain polymer additives having sizes comparable to that of the fluid film thickness. Finite element method technique and commercially available software MATLAB 2013 have been used to solve the modified Reynolds equation and, thus, performance characteristics of bearing have been computed. The performance of capillary- and orifice-compensated hydrostatic thrust pad bearings performance have been compared vis-à-vis to different geometric shapes of recess. Each recess shape has identical ratio of bearing pad area to recess area. It has been observed that the couple stress additives have significant positive influence on the static and dynamic performance of the compensated hydrostatic thrust pad bearing provided that restrictors operates with lower values of the restrictor deign parameter[Formula: see text]. Limiting values of 10 and 5 for restrictor design parameter [Formula: see text] have been noticed for capillary and orifice restrictor; beyond these values of [Formula: see text], use of couple stress lubricant on the performance of hydrostatic thrust pad bearing become insignificant.
Relationship between sliding-induced wear and severity of sliding contact for polyamide 66 filled with hard filler
Authors: Shibata Kei , Fukuda Mei , Yamaguchi Takeshi , Hokkirigawa Kazuo
Published: November 2016

We studied the factors that affect the sliding-induced wear of polyamide 66 (PA66) composites. The dimensionless severity parameter Ssc was defined from the minimum equivalent stress in the sliding contact area and calculated by using approximations. Subsequently, we conducted the friction tests for the PA66 composites filled with hard fillers under dry conditions. The hard fillers included rice bran ceramics particles, glass beads, carbon fibers, and glass fibers. According to the relationship between the wear rate and the severity parameter, the specific wear rate increased exponentially with increasing Ssc for all the materials. Obtaining low-wear PA66 required improving the yield strength and reducing the Young’s modulus and the friction coefficient.
Experimental and numerical investigation of the seismic performance of an A-frame–truss–column hybrid supporting structure
Authors: Yao Zeliang , Lui Eric M
Published: November 2016

A hybrid structural system designed for use in large thermal power plants in China to house air-cooled condenser systems is investigated. The hybrid structure consists of a series of metal A-frames resting on a steel space truss supported by an array of reinforced concrete columns. To gain a better understanding of this structural system, a one-eighth (1:8) scale test structure modeled after a prototype structure was constructed and tested. The test structure was subjected to both free vibration and forced excitation tests with the following objectives: (1) determining its modal properties and seismic response characteristics, (2) gaining insight into its response and most probable failure modes under dynamic excitations, (3) obtaining some useful experimental data for future research, and (4) providing important data to complement the Chinese seismic design code as well as to guide the design of this type of structure in practical engineering applications. The free vibration tests were carried out by inducing an initial displacement to the structure and measuring its natural frequencies and mode shapes. The forced excitation tests consist of a series of quasi-static and pseudo-dynamic tests. For the quasi-static tests, 10 reciprocating displacement excitations with peaks ranging from 6 to 100 mm were used, and for the pseudo-dynamic tests, six ground motions with scaled maximum accelerations ranging from 50 to 800 cm/s2 were employed. Based on the results of these tests, modal properties of the hybrid structure such as natural frequencies, mode shapes, and equivalent damping ratios, as well as some seismic response characteristics such as seismic shears, accelerations, deformations, interstory drifts, roof drifts, and hold-down forces were determined and presented. In addition, nonlinear analysis of the test and prototype structures was conducted using the finite element software ANSYS and compared with the test results. Detailed damage inspection was performed, and important findings were summarized.
The impact of minor trauma on pregnancy
Authors: Schuster Meike , Jaramillo L , Wild J , Mackeen AD , Paglia MJ
Published: November 2016

Purpose

To determine the impact of a single episode of minor trauma during pregnancy on maternal and fetal outcomes.

Methods

This is a retrospective cohort study of pregnant women who experienced minor trauma at ≥24 weeks gestation between 2004 and 2014. The subjects who experienced minor trauma (minor trauma group) were matched by gestational age at the time of minor trauma, body mass index, and age to a cohort of women who did not experience trauma in pregnancy (control group). The primary obstetrical outcome was preterm delivery and the primary neonatal outcomes were APGAR scores and neonatal intensive care unit admission.

Results

There were no significant differences between the two groups with respect to demographics or other risk factors for preterm delivery. Average gestational age at the time of delivery was 39 weeks regardless of whether a woman experienced minor trauma. Preterm delivery occurred more often in the control group (11.8% versus 7.9%, p = 0.0428) as did the rate of neonatal intensive care unit admissions (8.6% versus 5%, p = 0.0273). A subgroup analysis was performed excluding patients with a medically indicated delivery and there was no difference in the rate of preterm delivery (6.4% in the control group, 4% in the minor trauma group, p-value 0.9052). Among women with a spontaneous preterm delivery, the rates of preterm labor (3.0% control versus 2.0% minor trauma, p-value 0.75) and preterm premature rupture of membranes were found to be similar between the two groups (3.8% control versus 2.0% minor trauma PPROM, p-value 0.75).

Conclusions

One episode of minor trauma in pregnancy does not increase the risk for preterm delivery, premature rupture of membranes, or poor neonatal outcomes.
Pre-hospital and emergency department management of pelvic fractures and major trauma centre status: Has practice changed?
Authors: Barnes Jonathan , Thomas Philip , Refaie Ramsay , Gray Andrew
Published: November 2016

Introduction

Pelvic fractures are indicative of high-energy injuries and carry a significant morbidity and mortality and pelvic binders are used to stabilise them in both the pre-hospital and emergency department setting. Our unit gained major trauma centre status in April 2012 as part of a national programme to centralise trauma care and improve outcomes. This study investigated whether major trauma centre status led to a change in workload and clinical practice at our centre.

Methods

A retrospective analysis of all patients admitted with a pelvic fracture for the six-month periods before, after and at one-year following major trauma centre status designation. Data were retrospectively collected from electronic patient records and binder placement assessed using an accepted method. Patients with isolated pubic rami fractures were excluded.

Results

Overall, 6/16 (37.5%) pelvic fracture admissions had a binder placed pre-major trauma centre status, rising to 14/34 (41.2%) immediately post-major trauma centre status and 22/32 (68.8%) ( p = 0.025) one year later. Binders were positioned accurately in 4 patients (80%, one exclusion) pre-major trauma centre status, 12 (92.4%) post-major trauma centre status and 22 (100%) at one year. CT imaging was the initial imaging used in 9 (56.3%) patients pre-major trauma centre status, 29 (85.3%) ( p = 0.04) post-major trauma centre status and 27 (84.4%) at one year.

Discussion

Pelvic fracture admissions doubled following major trauma centre status. Computed tomography, as the initial imaging modality, increased significantly with major trauma centre status, likely a reflection of the increased resources made available with this change. Although binder application rates did not change immediately, a significant improvement was seen after one year, with binder accuracy increasing to 100%. This suggests that although changes in clinical practice often do not occur immediately, with the increased infrastructure and clinical exposure afforded through centralisation of trauma services, they will occur, ultimately leading to improvements in trauma patient care.
Hospitalization costs and estimates of direct and indirect economic losses due to injury sustained in road traffic crashes: Results from a one-year cohort study in three European countries (The REHABILAID project)
Authors: Papadakaki Maria , Stamouli Maria-Aggeliki , Ferraro Ottavia E , Orsi Chiara , Otte Dietmar , Tzamalouka Georgia , von der Geest Marco , Lajunen Timo , Özkan Türker , Morandi Anna , Kotsyfos Vangelis , Chliaoutakis Joannes
Published: November 2016

Introduction

The financial cost of injuries sustained in road traffic crashes is high for victims, families and national budgets, but there is limited information on the cost of injury from the victims’ perspective, especially in terms of the hard-to-reach multi-trauma patient population such as those admitted to the intensive care units of hospitals.

Materials and methods

The current study received funding by the European Commission Directorate-General Mobility and Transport. It is a prospective, prevalence-based, cost-of-illness study. Participants admitted in the intensive care units of seven public hospitals in Greece, Germany and Italy because of injuries from road traffic crashes, during one year, were enrolled in the study. Patients were followed-up for one year after the intensive care unit admission to report emerging direct and indirect costs related to their injury.

Results

A total of 120 people were enrolled. Males, those aged 25–49, motorcyclists and those severely injured (Maximum Abbreviated Injury Scale (MAIS) 3+) with highest severity located at the central part of the body, accounted for the highest percentages of both the direct and indirect injury costs. The highest average direct costs were for females, those aged 50–64, pedestrians and those slightly injured (MAIS 1 or 2) with highest severity at the central region of the body. Males, patients aged 25–49, car passengers and truck drivers as well as those slightly injured (MAIS 1 or 2) with highest severity at multiple locations were over-represented in the average indirect costs.

Conclusions

Those groups that account for a high percentage of injury costs should be targeted in health policy initiatives.
The walkthrough method: An approach to the study of apps
Authors: Light Ben , Burgess Jean , Duguay Stefanie
Published: November 2016

Software applications (apps) are now prevalent in the digital media environment. They are the site of significant sociocultural and economic transformations across many domains, from health and relationships to entertainment and everyday finance. As relatively closed technical systems, apps pose new methodological challenges for sociocultural digital media research. This article describes a method, grounded in a combination of science and technology studies with cultural studies, through which researchers can perform a critical analysis of a given app. The method involves establishing an app’s environment of expected use by identifying and describing its vision, operating model and modes of governance. It then deploys a walkthrough technique to systematically and forensically step through the various stages of app registration and entry, everyday use and discontinuation of use. The walkthrough method establishes a foundational corpus of data upon which can be built a more detailed analysis of an app’s intended purpose, embedded cultural meanings and implied ideal users and uses. The walkthrough also serves as a foundation for further user-centred research that can identify how users resist these arrangements and appropriate app technology for their own purposes.
Research on wear resistance of plasma remelted FeNiCrAl sprayed coating
Authors: Sheng Zhongqi , Zhou Jing , Xuan Jiayao , Wei Shicheng , Wang Yujiang , Liang Yi
Published: November 2016

To improve the microstructure density of high-velocity arc spraying coating and enhance its adhesive strength and wear resistance, a plasma remelting investigation of the FeNiCrAl sprayed coating was carried out in this study. The microstructure and phase composition of the sprayed coating and the remelted coating were compared by using metalloscope, scanning electron microscope and X-ray diffractometer. The microhardness distribution and friction wear characteristics of the plasma remelted FeNiCrAl sprayed coating were investigated by microhardness tester and CETR sliding friction wear testing machine. The results showed that the remelted coating has more compact microstructure and presents metallurgical bonding with the substrate. The generation of hard phases such as (Fe,Cr)7C3 and Cr23C6 as well as solid solution (Fe,Cr) increases the microhardness of the remelted coating significantly, about 1.4 times higher than that of the sprayed coating. According to sliding friction wear test, the abrasion losses of the sprayed coating under 10 N and 20 N loads are 4.6 and 10.5 times higher than those of the remelted coating, indicating the better wear resistance of the remelted coating.
Journalism beyond democracy: A new look into journalistic roles in political and everyday life
Authors: Hanitzsch Thomas , Vos Tim P
Published: November 2016

Journalism researchers have tended to study journalistic roles from within a Western framework oriented toward the media’s contribution to democracy and citizenship. In so doing, journalism scholarship often failed to account for the realities in non-democratic and non-Western contexts, as well as for forms of journalism beyond political news. Based on the framework of discursive institutionalism, we conceptualize journalistic roles as discursive constructions of journalism’s identity and place in society. These roles have sedimented in journalism’s institutional norms and practices and are subject to discursive (re)creation, (re)interpretation, appropriation, and contestation. We argue that journalists exercise important roles in two domains: political life and everyday life. For the domain of political life, we identify 18 roles addressing six essential needs of political life: informational-instructive, analytical-deliberative, critical-monitorial, advocative-radical, developmental-educative, and collaborative-facilitative. In the domain of everyday life, journalists carry out roles that map onto three areas: consumption, identity, and emotion.
Issue and game frames in the news: Frame-building factors in television coverage of the 2014 Scottish independence referendum
Authors: Dekavalla Marina
Published: November 2016

This article explores frame building in Scottish television coverage of the 2014 independence referendum. It uses content analysis of news and current affairs coverage and semi-structured interviews with broadcasters and their sources to explain how factors internal and external to the media may be specifically connected to the prominence of generic issue and game frames in the coverage. It argues that broadcasters’ perception of their role in this event and the powerful influence of political sources were factors that encouraged policy-focused coverage, while the journalistic routine of balance and media organizations’ perceptions of what would attract audiences favoured the strategic game frame.
Numerical analysis of the hydrodynamic performance of perforated caissons using the revised smooth particle hydrodynamics method
Authors: Tang Xiaocheng , Jiang Feng , Chen Hongzhou , Chen Rong , Hao Dongxue , Zhang Xiwen
Published: November 2016

The revised smooth particle hydrodynamics method based on the Riemann solution has been used to simulate the interaction process between waves and perforated caissons. In contrast to wave surfaces and opening boundaries of the flume under different wave conditions, the accuracy of the numerical wave flume is verified, and the numerical results are highly consistent with the linear regular wave theory. The reflection coefficient comparison between the values calculated from the smooth particle hydrodynamics method and the test data shows good agreement. The smooth particle hydrodynamics method adopted in this article can be employed to study the reflection coefficient of perforated caissons under conditions of non-overtopping, unbreaking waves. The effects of the related factors on the reflection coefficient are also investigated, including the relative dissipation chamber width B/ L and the wave steepness H/ L. The wave surface and velocity vector distribution of water particles surrounding the wave dissipation chamber are discussed, including the vortex flow and wave reflux caused by the wave dissipation chamber, which play a significant role in wave energy consumption. The results of this investigation can be used in the hydrodynamic design of perforated caissons and may provide a reference for offshore structural engineering structures.
The Safety and Efficacy of Irreversible Electroporation for Large Hepatocellular Carcinoma
Authors: Zeng Jianying , Liu Guifeng , Li Zhong-hai , Yang Yi , Fang Gang , Li Rong-rong , Xu Ke-cheng , Niu Lizhi
Published: November 2016

This study aimed to investigate the safety and effectiveness of irreversible electroporation ablation for unresectable large liver cancer. Fourteen patients were enrolled: 8 with large hepatocellular carcinoma (tumor diameter: 5.1-11.5 cm) and 6 with medium hepatocellular carcinoma (tumor diameter: 3.0-4.1 cm). All patients received percutaneous irreversible electroporation ablation. Ablation time and the incidence of complications were assessed by a t test. Post-irreversible electroporation and regular contrast-enhanced computerized tomography scans were performed to investigate the effect of tumor size (large vs medium) on irreversible electroporation treatment efficacy; 4-table data were assessed using a Fisher exact test. The 14 patients completed irreversible electroporation ablation successfully. In the large hepatocellular carcinoma group, no major complications occurred in the perioperative period. Minor complications comprised bloating, hypokalemia, edema, low white blood cells, and blood clotting abnormalities. All complications were mild and improved after symptomatic treatment. The frequency of minor complications was not significantly different ( P > .05) compared with the medium hepatocellular carcinoma group. The average follow-up time was 2.8 ± 2.1 months and complete ablation was achieved in 25% (2/8; residual = 75%). For the patients with medium hepatocellular carcinoma, the mean follow-up time was 4.3 ± 3.2 months; the rate of complete ablation was 66.6% (4/6; residual rate = 33.3%). The complete ablation rate was not statistically different between the 2 groups ( P > .05). Irreversible electroporation ablation for unresectable large hepatocellular carcinoma is safe, with no major complications. Short-term efficacy is relatively good; however, long-term efficacy remains to be explored.
Results of Ultrasound-Guided Foam Sclerotherapy of the Great Saphenous Vein With New Parameters of the Technique
Authors: Baeshko A. , Shestak N. , Korytko S.
Published: November 2016

Aim:

To report the outcome of a series of patients with chronic venous disease due to incompetence of the great saphenous vein (GSV) managed by ultrasound-guided foam sclerotherapy (USGFS).

Design:

Controlled clinical trial with maximum 5-year follow-up of results of USGFS of the GSV with new parameters of the procedure.

Materials and Methods:

This research analyzes the results of USGFS of the GSV (395 GSV) and its tributaries in 326 patients with varicose veins of the lower extremities over the period from January 2009 to January 2014 with the following parameters of the procedure: 60° limb elevation, calf bandage, and cooled foam injection.

Results:

Ultrasound control of 395 GSV after the first injection of sclerosant from the sixth to the eighth day revealed GSV occlusion in the femoral segment with the absence of reflux in 94.9% of cases (375 GSV). After 5-year follow-up, GSV occlusion was diagnosed in 91.9% of cases.

Conclusion:

Our improved technique of foam sclerotherapy allows improving immediate and long-term results. This technique is characterized by the low incidence of side effects and complications.
Sentencing Transferred Juveniles in the Adult Criminal Court
Authors: Lehmann Peter S. , Chiricos Ted , Bales William D.
Published: November 2016

Much prior research has demonstrated that race and ethnicity are associated with harsher punishment outcomes among adult defendants in the criminal court. However, few studies have explored these disparities in the sentencing of juvenile offenders who have been transferred to the adult court, and this research has reported conflicting findings. Moreover, the ways in which offenders’ race and ethnicity may interact with their sex, age, and offense type have yet to be explored among this population. Analysis of defendants sentenced in Florida ( N = 30,913) reveals that Black transferred juveniles are more likely to be sentenced to jail or prison and are given longer prison sentences than Whites, but Hispanic youth are only penalized in the sentence to jail. Interaction analyses suggest that Black males are sentenced particularly harshly regardless of age, and the effects of race and ethnicity are conditioned by a violent, sex, or drug offense.
Endovascular treatment of vein of Galen aneurysmal malformation using rapid ventricular pacing: A case report
Authors: Ramgren Birgitta , Rask Olof , Gelberg Jan , Liuba Petru , Undrén Per , Wassélius Johan
Published: November 2016

The treatment of choice of vein of Galen aneurysmal malformation (VGAM) involves endovascular procedures that can be difficult to perform in high-flow fistulas. We describe the use of rapid ventricular pacing (RVP), a well-known cardiologic technique, to safely treat a high-flow fistula in an infant with VGAM.
Wayside detection of faults in railway axle bearings using time spectral kurtosis analysis on high-frequency acoustic emission signals
Authors: Amini Arash , Entezami Mani , Huang Zheng , Rowshandel Hamed , Papaelias Mayorkinos
Published: November 2016

Typical railway wheelsets consist of wheels, axle and axle bearings. Faults can develop on any of the aforementioned components, but the most common are related to wheel and axle bearing defects. The continuous increase in train operating speeds means that failure of an axle bearing can lead to serious derailments, causing loss of life and severe disruption in the operation of the network, damage to the track and loss of confidence in rail transport by the general public. The rail industry has focused on the improvement of maintenance and remote condition monitoring of rolling stock to reduce the probability of failure as much as realistically possible. Current wayside systems such as hot axle box detectors and acoustic arrays may fail to detect defective bearings. This article discusses the results of wayside high-frequency acoustic emission measurements performed on freight rolling stock with artificially induced damage in axle bearings in Long Marston, UK. Time spectral kurtosis is applied for the analysis of the acoustic emission data. From the results obtained, it is evident that time spectral kurtosis is capable of distinguishing the axle bearing defects from the random noises produced by different sources such as the wheel–rail interaction, braking and changes in train speed.
Experimental study on the influence of air injection on unsteady cloud cavitating flow dynamics
Authors: Zhang Naimin , Zhao Yang , Wei Haipeng , Chen Guanghao
Published: November 2016

The main purpose of this study was to investigate the influence of air-injection technique on unsteady cloud cavitating flow dynamics. High-speed camera and pressure measurement system are used to record ventilated cavitation images and wall-pressure fluctuation in a convergent–divergent channel, respectively. The measured ventilated cavitation evolution process and corresponding wall-pressure fluctuation are compared with those obtained under non-ventilation condition. The results show that air-injection technique can significantly suppress pressure pulses induced by cavity collapse. Furthermore, by increasing ventilation rate, the time evolution of cavitation tends to be more stable, the wall-pressure fluctuation magnitude is reduced significantly, and the cloud shedding frequency is reduced, which is believed to be related to the interaction between injected air and re-entrant flow.