bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-Cloud, Boundary Layer, and Sea Ice Interactions over the Southern Ocean during Winter
Authors: Wall Casey J. , Kohyama Tsubasa , Hartmann Dennis L.
Published: March 2017

During austral winter, a sharp contrast in low-cloud fraction and boundary layer structure across the Antarctic sea ice edge is seen in ship-based measurements and in active satellite retrievals from Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations ( CALIPSO), which provide an unprecedented view of polar clouds during winter. Sea ice inhibits heat and moisture transport from the ocean to the atmosphere, and, as a result, the boundary layer is cold, stable, and clear over sea ice and warm, moist, well mixed, and cloudy over open water. The mean low-cloud fraction observed by CALIPSO is roughly 0.7 over open water and 0.4–0.5 over sea ice, and the low-cloud layer is deeper over open water. Low-level winds in excess of 10 m s−1 are common over sea ice. Cold advection off of the sea ice pack causes enhanced low-cloud fraction over open water, and thus an enhanced longwave cloud radiative effect at the surface. Quantitative estimates of the surface longwave cloud radiative effect contributed by low clouds are presented. Finally, 10 state-of-the-art global climate models with satellite simulators are compared to observations. Near the sea ice edge, 7 out of 10 models simulate cloudier conditions over open water than over sea ice. Most models also underestimate low-cloud fraction both over sea ice and over open water.
Retrieving Fall Streaks within Cloud Systems Using Doppler Radar
Authors: Pfitzenmaier Lukas , Dufournet Yann , Unal Christine M. H. , Russchenberg Herman W. J.
Published: March 2017

The interaction of ice crystals with supercooled liquid droplets in mixed-phase clouds leads to an enhanced growth of ice particles. However, such processes are still not clearly understood although they are important processes for precipitation formation in midlatitudes. To better understand how ice particles grow within such clouds, changes in the microphysical parameters of a particle population falling through the cloud have to be analyzed. The Transportable Atmospheric Radar (TARA) can retrieve the full 3D Doppler velocity vector based on a unique three-beam configuration. Using the derived wind information, a new fall streak retrieval technique is proposed so that microphysical changes along those streaks can be studied. The method is based on Doppler measurements only. The shown examples measured during the Analysis of the Composition of Clouds with Extended Polarization Techniques (ACCEPT) campaign demonstrate that the retrieval is able to capture the fall streaks within different cloud systems. These fall streaks can be used to study changes in a single particle population from its generation (at cloud top) until its disintegration. In this study fall streaks are analyzed using radar moments or Doppler spectra. Synergetic measurements with other instruments during ACCEPT allow the detection of liquid layers within the clouds. The estimated microphysical information is used here to get a better understanding of the influence of supercooled liquid layers on ice crystal growth. This technique offers a new perspective for cloud microphysical studies.
Local Intraluminal Irrigation With Argatroban During Free Flap Repair in a Patient With Heparin-Induced Thrombocytopenia
Authors: Macias David , Kwon Daniel I. , Walker Paul C. , Peterson Nathaniel R.
Published: March 2017

Objective:

This study describes a case of a successful free flap repair using argatroban for local intraluminal irrigation as a substitute to heparin in a patient with heparin-induced thrombocytopenia.

Methods:

Case report and review of literature.

Results:

The patient had an uneventful postoperative course, and the free flap survived without complications.

Conclusions:

The use of argatroban during microvascular surgery is likely to be safe and simple and may be effective in preventing micro-thrombotic complications during microvascular surgery, and it should be considered as an alternative to heparinized saline for local intraluminal irrigation.
Effect of an iPad-Based Intervention to Improve Sexual Health Knowledge and Intentions for Contraceptive Use Among Adolescent Females at School-Based Health Centers
Authors: Mesheriakova Veronika V. , Tebb Kathleen P.
Published: March 2017

Objectives: The use of effective contraception can decrease the incidence of unplanned pregnancy among adolescents. This study aims to examine the effectiveness of an iPad-based application (app) on improving adolescent girls’ sexual health knowledge and on its ability to influence their intentions to use effective contraception. Study Design: This was a prospective study of girls aged 12 to 18 years recruited from 3 school-based health centers in California. Results: A total of 120 racially/ethnically diverse participants used the iPad app; 54% were sexually active, with only 26% using effective contraception at baseline. The average score on baseline sexual health knowledge assessment was 58%. After using the app, 68% of the sexually active participants reported intention to use effective contraception in the future, and sexual health knowledge improved significantly to 79% ( P < .001). Conclusions: This iPad-based app is a promising intervention to educate adolescents about sexual health and support them in selecting an effective contraception method.
Current Knowledge and Practice of Pediatric Providers in Umbilical Cord Blood Banking
Authors: Armstrong Amy E. , Fonstad Rachel , Spellman Stephen , Tullius Zoe , Chaudhury Sonali
Published: March 2017

More than 35 000 umbilical cord blood (UCB) transplants have been performed worldwide, prompting the development of private and public banks to collect and store UCB cells. We hypothesized that pediatricians, who are uniquely poised to discuss UCB banking (UCBB) during prenatal or sibling visits, rarely do so. Through distribution of a 26-question electronic survey to general and subspecialty pediatric providers, we assessed baseline knowledge and conversations about UCBB. A total of 473 providers completed the survey; only 22% of physicians ever discussed UCBB with expectant parents. The majority responded that autologous UCB transplants were indicated in malignant (73%) and nonmalignant (61%) conditions; however, these are rare indications. Providers practicing >10 years were more likely to address UCBB ( P ≤ .001), whereas younger and female general pediatric providers were significantly less likely ( P < .001). Overall, pediatric providers rarely speak to families about UCBB, and we believe that they can be better informed to its current clinical utility.
Children’s recency tendency: A cross-linguistic study of Persian, Kurdish and English
Authors: Mehrani Mehdi B. , Peterson Carole
Published: March 2017

In the present cross-linguistic study two experiments were conducted to investigate the effects of age and linguistic background on response tendencies of preschoolers toward forced-choice questions. A total of 163 2- to 5-year-old children, including 63 Persian speakers, 57 Kurdish speakers and 43 English speakers, were asked a set of forced-choice, two option questions about familiar and unfamiliar objects. The results showed that, regardless of their linguistic background, children displayed a recency tendency in response to forced-choice questions. In addition, younger children exhibited a stronger tendency and this tendency was more pronounced when children were asked questions about unfamiliar objects. The findings suggest that recency tendency is a universal phenomenon. However, it grows weaker as children’s age increases. The mechanism of a recency tendency along with implications of the use of forced-choice questions with children is discussed.
A reconciliation most desirable: Shame, narcissism, justice and apology
Authors: Muldoon Paul
Published: March 2017

This paper seeks to draw attention to the narcissistic dimensions of the reconciliation movement in Australia and, more specifically, to the way in which the desire to ‘make innocent’ compromises the attempt to ‘make amends’ and construct a just polity. Building upon some early work by Anthony Moran (1998) and Elizabeth Povinelli (1998), it sets out to defend two claims: firstly, that the intensity of the desire for reconciliation in Australia (and conceivably in other settler colonial states as well) is attributable to the sense of shame arising from the collapse of the national ego ideal; and secondly, that the real target of the reparative efforts undertaken under the auspices of reconciliation is the healing of the ‘narcissistic injury’ inflicted by the failure of the assimilation project and the assertion of Aboriginal separateness.
Allergic and Infective Rhinosinusitis: Differential Diagnosis and Interrelationship
Authors: Mabry Richard L.
Published: March 2017

Despite the growing emphasis on sinus surgery, the management of chronic or recurrent sinus problems remains multifaceted and should include consideration of contributory, correctable medical factors. Accurate differentiation between infective or allergic rhino‐sinusitis is often difficult if based only on history and physical examination. The character (and culture results) of mucus obtained from the sinus ostia region by endoscopy may confirm an infective problem, whereas positive results of specific allergy tests, supported by history, will confirm the presence of significant allergy. If complicating Infection is not appropriately controlled, allergic management of rhinosinusitis will yield results that are less than optimum. Failure to recognize and treat contributory allergy may jeopardize the results of sinus surgery performed to resolve chronic infection.
Observations on the Response of the Nasal Mucosa to Allergens
Authors: Naclerio Robert M. , Baroody Fuad M.
Published: March 2017

Allergic rhinitis is the sixth most prevalent chronic health condition in the United States. To study the pathogenesis of the allergic response, we have used a model of nasal provocation with antigen. During the initial reaction of an allergic subject to allergen provocation, increases occur in the levels of histamine, tryptase, and prostaglandin D2. This pattern of mediator release, combined with histologic evidence of mast‐cell degranulation, strongly supports the role of the mast cell in the acute allergic reaction. The response to antigen, however, does not end with mast‐cell degranulation. Hours after challenge we observed the spontaneous recurrence of symptoms and Increased responsiveness to antigenic and nonantigenic stimuli. Our central hypothesis is that cellular infiltration and activation after antigen challenge are responsible for the observed increase in nasal reactivity. The predominant cells in nasal lavage 24 hours after challenge are eosinophils and neutrophils, whereas the predominant cell in the mucosa is the CD4+ lymphocyte. An early step in the movement of cells from the peripheral blood involves adhesion between circulating leukocytes and the endothelium. Evidence suggests that vascular endothelial adhesion molecule may be responsible in part for the selective adherence of eosinophils to the endothelium.
The Effect of “Anonymous Reviewer”: A Study of Anonymity, Affect Intensity, and Message Valence in the Cyberspace
Authors: Hong Cheng , Li Cong
Published: March 2017

This study aims to illustrate how anonymity, together with affect intensity and message valence, affects message receivers’ responses. A 2 (anonymous vs. revealed identity) × 2 (low vs. high affect intensity) × 2 (positive vs. negative valence) between-subjects experiment was conducted. It was found that when message affect intensity was low, an anonymous message was more effective in generating trust toward the message and message processing depth than a message with an identified sender. However, such a difference was insignificant when affect intensity was high. Moreover, a significant interaction effect between affect intensity and message valence was found on message processing depth. When affect intensity was high, a positive message elicited more message processing. When affect intensity was low, there was no significant difference between positive and negative messages.
Optimal placement of sensors and piezoelectric friction dampers in the pipeline networks based on nonlinear dynamic analysis
Authors: Shokouhi Seyed KS , Yuan Yong , Zhu Hongping
Published: March 2017

Experiences of past earthquakes demonstrate that pipeline systems have no proper performance when exposed to severe earthquakes. In this study, sensor and damper placement approaches are presented for doing reliable health monitoring and seismic retrofitting of the piping networks. Since most of the available sensor placement methods are based on modal analysis results, the authors propose a new scheme that relies on the nonlinearity which utilizes nonlinear time history analysis results, and genetic algorithm is selected to act as the methodology of optimization as well. The results demonstrate that the proposed optimal sensor configuration strategy is more accurate and efficient than the extended modal assurance criterion method. To assess the number of sensors, a sensitivity analysis is undertaken in which the number of sensors computed optimally by the proposed algorithm contains the least convergence error. In addition, the number of iterations and the time consumed in the proposed approach are considerably less than the extended modal assurance criterion method. Moreover, the efficiency of the proposed sensor placement scheme was compared with a new algorithm proposed by Sun and Büyüköztürk, named discrete artificial bee colony, where the simulation result demonstrates high accuracy of the proposed sensor configuration approach. The initial time history analysis results show the vulnerable points of the system, which destroyed due to the applied seismic waves. Hence, to enhance the seismic performance of the system, piezoelectric friction dampers are optimally placed, where it can be clearly seen that the optimal arrangement of piezoelectric friction dampers in the piping system can significantly decrease the seismic response.
Signs of the feminization of sociology in Turkey: Transformation of gender composition and possible scenarios
Authors: Ünal Serdar , Binay Berivan
Published: March 2017

Recently, both in Turkey and the international arena, there has been a remarkable increase in the number and visibility of women among students and academic personnel, particularly in specific areas of higher education. In this respect, this article provides a gender-based picture of students and academic personnel in undergraduate and graduate sociology programs in Turkey and identifies the direction of the gender-based changes in these programs over the last 20 years in quantitative/demographic terms. The article also attempts to assess, within the framework of qualitative/cultural changes, the current and potential changes and transformations in the methodological practices of the discipline, as well as in the discipline’s present and future basic fields of interest and study. To this end, and within the scope of discussions in the literature regarding the feminization of certain academic disciplines, the article focuses on where sociology in Turkey currently stands in this respect, and on possible future scenarios regarding this discipline.
A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores
Authors: Sattin Davide , Lovaglio Piergiorgio , Brenna Greta , Covelli Venusia , Rossi Sebastiano Davide , Duran Dunja , Minati Ludovico , Giovannetti Ambra Mara , Rosazza Cristina , Bersano Anna , Nigri Anna , Ferraro Stefania , Leonardi Matilde
Published: March 2017

Objective:

The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method.

Design:

Cross sectional design/methodological study.

Setting:

Inpatient, neurological unit.

Participants:

A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013.

Intervention:

All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures.

Main outcome measures:

Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis.

Results:

Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems.

Conclusion:

The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.
Imaging angiogenesis using 68Ga-NOTA-PRGD2 positron emission tomography/computed tomography in patients with severe intracranial atherosclerotic disease
Authors: Shu Shi , Zhang Li , Zhu Yi Cheng , Li Fang , Cui Li Ying , Wang Hao , Sun Yi , Wu Pei Lin , Zhu Zhao Hui , Peng Bin
Published: March 2017

Angiogenesis is a critical compensation route, which has been demonstrated in the brain following ischemic stroke; however, few studies have investigated angiogenesis in chronic intracranial atherosclerosis disease (ICAD). We used 68Ga-NOTA-PRGD2 positron emission tomography/computed tomography based imaging to detect angiogenesis in chronic ICAD and to explore the factors that may have affected it. A total of 21 participants with unilateral severe chronic ICAD were included in the study. Of the 21 participants, 19 were men; the mean (SD) age was 52 (15) years. In 18 participants, we observed elevated 68Ga-NOTA-PRGD2 uptake in the peri-infarct, subcortical, and periventricular regions of the lesioned side, with a higher 68Ga-NOTA-PRGD2 SUVmax compared to that in the contralateral hemisphere (0.15 vs. 0.06, p=0.001). The 18F-FDG PET SUVmax was significantly lower on the lesioned side (11.28 vs. 13.92, p=0.001). Subgroup analyses revealed that the recent group (<6 months) had a higher lesion-to-contralateral region ratio SUVmax than the remote group (>6 months) (6.73 vs. 2.36, p<0.05). Our results provide molecular imaging evidence of angiogenesis in patients with severe chronic ICAD. Furthermore, the extent of angiogenesis in chronic ICAD may be affected by the post-qualified event time interval, and not by infarction itself or the severity of the arterial lesion.
Secondary and 2-Year Outcomes of a Sexual Assault Resistance Program for University Women
Authors: Senn Charlene Y. , Eliasziw Misha , Hobden Karen L. , Newby-Clark Ian R. , Barata Paula C. , Radtke H. Lorraine , Thurston Wilfreda E.
Published: March 2017

We report the secondary outcomes and longevity of efficacy from a randomized controlled trial that evaluated a novel sexual assault resistance program designed for first-year women university students. Participants ( N = 893) were randomly assigned to receive the Enhanced Assess, Acknowledge, Act (EAAA) program or a selection of brochures (control). Perception of personal risk, self-defense self-efficacy, and rape myth acceptance was assessed at baseline; 1-week postintervention; and 6-, 12-, 18-, and 24-month postrandomization. Risk detection was assessed at 1 week, 6 months, and 12 months. Sexual assault experience and knowledge of effective resistance strategies were assessed at all follow-ups. The EAAA program produced significant increases in women’s perception of personal risk, self-defense self-efficacy, and knowledge of effective (forceful verbal and physical) resistance strategies; the program also produced decreases in general rape myth acceptance and woman blaming over the entire 24-month follow-up period. Risk detection was significantly improved for the intervention group at post-test. The program significantly reduced the risk of completed and attempted rape, attempted coercion, and nonconsensual sexual contact over the entire follow-up period, yielding reductions between 30% and 64% at 2 years. The EAAA program produces long-lasting changes in secondary outcomes and in the incidence of sexual assault experienced by women students. Universities can reduce the harm and the negative health consequences that young women experience as a result of campus sexual assault by implementing this program. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/page/pwq/suppl/index .
Conflicts and con-fusions confounding compassion in acute care: Creating dialogical moral space
Authors: Jones Jenny , Strube Petra , Mitchell Marion , Henderson Amanda
Published: March 2017

Background:

Compassion, understood as empathy for another who is experiencing physical, mental, emotional and/or spiritual suffering, is an essential element of our shared understandings of nursing and the constitution of the professional nurse.

Theoretical foundation:

Charles Taylor account of ethics which concerns ‘what or who is it good to be’ rather than the predominant analytical moral philosophy approach which concentrates on ‘what ought one to do’ is the core concern of this discussion. An ontological appreciation of our shared human condition is the premise upon which the discussion is based.

Discussion:

This article proposes that concept by opening a dialogical space, nurses can engage in reflection and sense making wherein they explore individually and collectively the conflicts and confusions encountered in their day-to-day work. Through their dialogues, nurses – individually and collectively – orient and reorient themselves and each other towards what they see as meaningful and purposeful in their lives and in doing so they are well positioned to reaffirm their commitment to compassion as a value which both anchors and orients their day-to-day work.

Implications:

The provision of opportunities in the workplace, in the form of dialogue, to articulate often unspoken assumptions and frameworks in which nursing work is carried out can not only initiate the building of pathways of support but also assist nurses reaffirm their compassion – arguably the essence of their nursing practice.
The Effects of LCZ696 in Patients With Hypertension Compared With Angiotensin Receptor Blockers
Authors: Zhao Yang , Yu Heng , Zhao Xu , Ma Ruixin , Li Ningyin , Yu Jing
Published: March 2017

LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor, has been demonstrated to have greater advantages in the treatment of heart failure compared with angiotensin-converting enzyme inhibitors, enalapril, or angiotensin receptor blockers (ARBs). However, studies that compared the efficacy and safety of LCZ696 against valsartan in patients with hypertension are limited. To provide further evidence for the benefits of LCZ696 and to make this assessment, a meta-analysis of randomized controlled trials (RCTs) was performed. The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, PubMed, and ClinicalTrials.gov were searched for RCTs. Twelve studies involving 3816 patients were eligible for inclusion. Seven studies compared LCZ696 with valsartan, and 5 studies compared LCZ696 with olmesartan. LCZ696 showed a significantly greater reduction in systolic blood pressure (BP; mean difference [MD] = −5.43 mm Hg; 95% confidence interval [CI]: −6.36 to −4.49 mm Hg; P < .001), diastolic BP (MD = −2.34 mm Hg; 95% CI: −2.67 to −2.01 mm Hg; P < .001), 24-hour ambulatory systolic BP (MD = −3.57 mm Hg, 95% CI: −4.29 to −2.85 mm Hg; P < .001), and 24-hour ambulatory diastolic BP (MD = −1.32 mm Hg, 95% CI: −1.77 to −0.78 mm Hg; P < .001) from the baseline than ARBs. LCZ696 was more effective in reducing BP (odds ratio [OR] = 5.34; 95% CI: 4.49-6.36; P < .01) and had a higher rate of BP control compared with ARBs (OR = 1.52; 95% CI: 1.37-1.69; P < .01). LCZ696 had no difference in the incidence of adverse events (OR = 1.05; 95% CI: 0.94-1.18; P = .38) or serious adverse events (OR = 0.80; 95% CI: 0.51-1.24; P = .31) compared to ARBs. This meta-analysis revealed that LCZ696 has a greater antihypertensive efficacy and an equal tolerability profile.
“I Tried to Resist and Avoid Bad Friends”
Authors: Gibbs Andrew , Jewkes Rachel , Sikweyiya Yandisa
Published: March 2017

Urban informal settlements are sites of high HIV incidence and intimate partner violence (IPV). Young men in these contexts often draw on a youthful hypermasculinity that prioritize sexual dominance and displays of violence, although many aspire to a traditional masculinity, which is less violent and uses economic provision and social dominance to control women. Working with young men, we undertook a gender transformative and livelihood strengthening intervention to reduce HIV risk and IPV perpetration. We sought to understand how the wider social context shaped the project’s outcomes. We undertook thirty-eight in-depth interviews and three focus groups postintervention. We conducted thematic analysis using Campbell and Cornish’s conceptualization of social contexts: material–political context, relational–network context, and symbolic context to understand how contexts shaped outcomes. For the material–political context, livelihoods improved, but the continued high levels of unemployment meant that while men may have earned more they did not establish a new relationship to the economy; they still struggled to get jobs and only secured precarious and unfulfilling work. In the relational–network context, men’s main partners and family were supportive of men’s attempts to change, however only narrowly toward a traditional masculinity. Men’s peers were major barriers to men’s attempts to change. In the symbolic context, the accessibility of a “traditional” masculinity provided a resource for men to draw on, which contrasted with the youthful hypermasculinity. We argue that in these informal settlements the social contexts only enabled certain forms of change to occur for young men, limiting the potential for more radical gender equitable transformations.
Comparability of Fidelity Measures for Assessing Tier 1 School-Wide Positive Behavioral Interventions and Supports
Authors: Mercer Sterett H. , McIntosh Kent , Hoselton Robert
Published: March 2017

Several reliable and valid fidelity surveys are commonly used to assess Tier 1 implementation in School-Wide Positive Behavioral Interventions and Supports (SWPBIS); however, differences across surveys complicate consequential decisions regarding school implementation status when multiple measures are compared. To address this concern, the current study (a) provides updated convergent validity estimates for five fidelity measures, (b) tests mean differences in scores and reports the percentages of schools meeting recommended implementation criteria by measure, and (c) investigates sensitivity of the measures to differences between schools at varied levels of implementation. Across most surveys, convergent validity estimates were moderate ( r = .59–.71), and mean differences were negligible for all surveys other than the School-Wide Evaluation Tool (SET), on which higher scores were more likely to be obtained. Despite higher average scores, the SET classified similar percentages of schools as adequately implementing compared with other measures with a 70% implementation criterion, but fewer schools when compared with measures with an 80% criterion. Compared with other measures, the PBIS Self-Assessment Survey (SAS) was more sensitive to differences among schools at higher levels of implementation. Implications for SWPBIS research and fidelity assessment are discussed.
First Tarsometatarsal Joint Derotational Arthrodesis for Flexible Hallux Valgus: Results from Follow-Up of 3–8 Years
Authors: Klemola T. , Savola O. , Ohtonen P. , Ojala R. , Leppilahti J.
Published: March 2017

Purpose:

We report 3- to 8-year follow-up results for the first tarsometatarsal joint derotational arthrodesis.

Methods:

A total of 70 patients (88 feet) with symptomatic flexible hallux valgus were operated between 2003 and 2009. In all, 66 patients (94.3%) with 84 (95.5%) feet were enrolled in retrospective analysis; of those, 58 (87.9%) patients with 76 (90.5%) feet were followed for a mean of 5.1 (range: 3.0–8.3) years. Preoperative, 6 week postoperative, and late follow-up weightbearing radiographs were evaluated along with clinical examination and questionnaires.

Results:

The mean hallux valgus angle improved 13.4° (95% confidence interval: 11.6–15.1, p < .001) at the latest follow-up, while the mean intermetatarsal angle correction was 4.5° (95% confidence interval: 3.7–5.2, p < .001). There were three (4.0%) nonunions, and seven (9.2%) feet needed reoperation during follow-up.

Conclusion:

First tarsometatarsal joint derotational arthrodesis is an effective procedure for correcting flexible hallux valgus deformity and provides a satisfactory long-term outcome.
The Introduction of Adult Appendicitis Score Reduced Negative Appendectomy Rate
Authors: Sammalkorpi H. E. , Mentula P. , Savolainen H. , Leppäniemi A.
Published: March 2017

Background and Aims:

Implementation of a clinical risk score into diagnostics of acute appendicitis may provide accurate diagnosis with selective use of imaging studies. The aim of this study was to prospectively validate recently described diagnostic scoring system, Adult Appendicitis Score, and evaluate its effects on negative appendectomy rate.

Material and Methods:

Adult Appendicitis Score stratifies patients into three groups: high, intermediate, and low risk of appendicitis. The score was implemented in diagnostics of adult patients suspected of acute appendicitis in two university hospitals. We analyzed the effects of Adult Appendicitis Score on diagnostic accuracy, imaging studies, and treatment. The study population was compared with a reference population of 829 patients suspected of acute appendicitis originally enrolled for the study of construction of the Adult Appendicitis Score.

Results:

This study enrolled 908 patients of whom 432 (48%) had appendicitis. The score stratified 49% of all appendicitis patients into high-risk group with specificity of 93.3%. In the low-risk group, prevalence of appendicitis was 7%. The histologically confirmed negative appendectomy rate decreased from 18.2% to 8.7%, p<0.001, compared to the original dataset.

Conclusion:

Adult Appendicitis Score is a reliable tool for stratification of patients into selective imaging, which results in low negative appendectomy rate.
Using Text Message Surveys to Evaluate a Mobile Sexual Health Question-and-Answer Service
Authors: Willoughby Jessica Fitts , L’Engle Kelly Ladin , Jackson Kennon , Brickman Jared
Published: March 2017

Text message programs for sexual health are becoming increasingly popular as practitioners aim to meet youth on media they use frequently. Two-way mobile health (mHealth) interventions allow for feedback solicitation from participants. This study explores the use of a text message survey to assess demographics and program feedback from users of an adolescent sexual health text message question-and-answer service. Development and feasibility of the short-message service survey are discussed. The text message survey achieved a 43.9% response rate, which is comparable to response rates of surveys conducted via other methods. When compared to respondents who used the service and completed an online in-school questionnaire, text survey respondents were more likely to be female and older. They also reported higher service satisfaction. Results have implications for text message service providers and researchers. This article examines a community application of a new intervention strategy and research methodology.
Sociodemographic and Health Profile of Heterosexual Men Living With HIV in Ontario, Canada
Authors: Wheeler Kristen M. , Antoniou Tony , Gardner Sandra , Light Lucia , Grewal Ramandip , Globerman Jason , Husbands Winston , Burchell Ann N. ,   for the OHTN Cohort Study Team
Published: March 2017

In Ontario, Canada, the number of heterosexual men living with HIV has increased over time, yet they remain an understudied population. The study objective was to describe the sociodemographic and clinical characteristics of this population, using data from a multisite clinical cohort of patients receiving HIV care. Sociodemographic and clinical characteristics of men interviewed between 2010 and 2012 were compared according to their self-identified sexual orientation, followed by multivariable linear and logistic regression to assess the association of sexual orientation with CD4 cell count, viral load, hepatitis C co-infection, self-rated health, and mental health concerns after adjustment for covariates. A total of 552 men identified as heterosexual, 2,023 as gay, and 171 as bisexual. Compared to gay and bisexual men, heterosexual men were more likely to have been born outside of Canada (34.8%); more likely to report African, Caribbean, or Black ethnicity (26.4%) or Indigenous ethnicity (13.6%); and more likely to have low socioeconomic status (59.5% earning less than $20,000 per year), and/or a history of injection drug use (31.7%). Relative to gay men, heterosexual men had 5.19 times the odds of co-infection with hepatitis C virus regardless of injection drug use history (95% confidence interval = 3.87-6.96), and 40% lower odds of rating their health as excellent or good (95% confidence interval = 0.50-0.84). HIV-positive heterosexual men in Ontario constituted a socially marginalized group characterized by a high prevalence of injection drug use history and hepatitis C co-infection.
Shear wave elastography: Can it be a new radiologic approach for the diagnosis of erectile dysfunction?
Authors: Turkay Rustu , Inci Ercan , Yenice Mustafa Gurkan , Tugcu Volkan
Published: March 2017

Introduction

Erectile dysfunction (ED) is a common health problem among males, and radiology has limited use in its diagnosis and treatment. Shear wave elastography (SWE) is a new sonographic technique. In this study, we examined the significance of SWE in the diagnosis of ED.

Methods

The study included a total number of 70 participants. The mean age of the participants was 54.14 ± 8.03 years (range: 39 and 71 years old). We composed two groups. Group 1 had 35 patients who presented to the urology clinic in our hospital complaining of ED, and had a score of 17 or lower from the International Index of Erectile Function (IIEF) questionnaire. Group 2 consisted of 35 healthy volunteers who did not have ED. SWE measurements were performed from corpus cavernosum penis in both groups, and the results were noted. Differences between the groups were evaluated statistically.

Results

The difference between the mean SWE measurements of two groups (Group 1: 20.94 ± 6.23 kPa and group 2: 24.63 ± 7.58 kPa) was found to be statistically significant ( p = 0.027; p < 0.05). For a cut-off value of 17.1 kPa, the SWE method has specificity, sensitivity, positive predictive value, and negative predictive value regarding diagnosis of ED as 94.29%, 34.29%, 85.71%, and 58.93%, respectively. The mean age of the groups did not show a statistically significant difference ( p = 0.287; p > 0.05).

Conclusions

Due to its high specificity and positive predictive value, SWE can offer useful data in the radiologic evaluation of ED cases.
Liposomal irinotecan in gemcitabine-refractory metastatic pancreatic cancer: efficacy, safety and place in therapy
Authors: Kipps Emma , Young Kate , Starling Naureen
Published: March 2017

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. The majority of patients are diagnosed with locally advanced or metastatic disease with a prognosis of short months. Therapeutic options are limited and until recently, there was no standard second-line chemotherapy option. Liposomal constructs have been engineered to encapsulate chemotherapy thereby preventing premature metabolism, improving distribution and minimizing toxicity. Favourable preclinical data on liposomal irinotecan and early phase trials, led to a recently published phase III trial of liposomal irinotecan in combination with fluorouracil and folinic acid in patients with metastatic PDAC, who progressed after gemcitabine-based chemotherapy. As a direct result, the United States Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved the use of liposomal irinotecan in this setting. However, first-line treatment options for this disease now include the combination regimen, FOLFIRINOX, in patients with good performance status, and the role of second-line combination treatment with liposomal irinotecan in this setting is unclear. Recent advances have changed the therapeutic landscape, as clinicians are now able to choose a sequential approach to treatment tailored to the individual patient characteristics. This article reviews current treatment options for metastatic PDAC and focuses on the efficacy, safety and place in therapy of liposomal irinotecan.
A New Optimized Percutaneous Access System for CIPII
Authors: Garcia-Verdugo Rosa , Erbach Michael , Schnell Oliver
Published: March 2017

In recent years, continuous intraperitoneal insulin infusion (CIPII) has become a favored treatment alternative for patients with subcutaneous insulin resistance, mainly due to its ability of mimicking physiological conditions of insulin absorption. CIPII has been shown to improve glycemic control as well as to reduce hypoglycemic events and to lead to increased patient satisfaction and quality of life (QoL). Among CIPII delivery systems, Diaport stands out due to its low side effects, its demonstrated clinical efficacy and the potential for integration into closed-loop systems.
Commentary Regarding Shapiro, “Nonadjunctive Use of Continuous Glucose Monitors for Insulin Dosing: Is It Safe?”
Authors: Price David
Published: March 2017

The FDA recently expanded the approved use of Dexcom’s G5 Mobile continuous glucose monitoring (CGM) system to allow for diabetes treatment decisions. This decision is expected to reduce the burden of SMBG testing and increase the adoption and persistent use of CGM. The safety of nonadjunctive CGM use was questioned because of sporadic large discrepancies between CGM and SMBG values. These data were viewed in the context of complaints found in the FDA MAUDE database and social media postings. This commentary provides additional perspective on the inferences that can be drawn from these reports and the risk of nonadjunctive use of CGM data.
A multicentre validation of the 1-min sit-to-stand test in patients with COPD
Authors: Crook Sarah , Büsching Gilbert , Schultz Konrad , Lehbert Nicola , Jelusic Danijel , Keusch Stephan , Wittmann Michael , Schuler Michael , Radtke Thomas , Frey Martin , Turk Alexander , Puhan Milo A. , Frei Anja
Published: March 2017

Our aim was to comprehensively validate the 1-min sit-to-stand (STS) test in chronic obstructive pulmonary disease (COPD) patients and explore the physiological response to the test.

We used data from two longitudinal studies of COPD patients who completed inpatient pulmonary rehabilitation programmes. We collected 1-min STS test, 6-min walk test (6MWT), health-related quality of life, dyspnoea and exercise cardiorespiratory data at admission and discharge. We assessed the learning effect, test–retest reliability, construct validity, responsiveness and minimal important difference of the 1-min STS test.

In both studies (n=52 and n=203) the 1-min STS test was strongly correlated with the 6MWT at admission (r=0.59 and 0.64, respectively) and discharge (r=0.67 and 0.68, respectively). Intraclass correlation coefficients (95% CI) between 1-min STS tests were 0.93 (0.83–0.97) for learning effect and 0.99 (0.97–1.00) for reliability. Standardised response means (95% CI) were 0.87 (0.58–1.16) and 0.91 (0.78–1.07). The estimated minimal important difference was three repetitions. End-exercise oxygen consumption, carbon dioxide output, ventilation, breathing frequency and heart rate were similar in the 1-min STS test and 6MWT.

The 1-min STS test is a reliable, valid and responsive test for measuring functional exercise capacity in COPD patients and elicited a physiological response comparable to that of the 6MWT.
Follow-up of patients with uncontrolled asthma: clinical features of asthma patients according to the level of control achieved (the COAS study)
Authors: Munoz-Cano Rosa , Torrego Alfons , Bartra Joan , Sanchez-Lopez Jaime , Palomino Rosa , Picado Cesar , Valero Antonio
Published: March 2017

Our aim was to study the asthma control achieved in patients with uncontrolled asthma who had received appropriate treatment according to the Global Initiative for Asthma (GINA) 2010 (valid at the time the study was designed), and to analyse the factors associated with a lack of asthma control.

This was a multicentre study in routine clinical practice performed in patients with uncontrolled asthma according to GINA 2010. At visit 1, we recorded demographics, asthma characteristics and spirometry. We assessed asthma control using GINA 2010 criteria and the Asthma Control Test (ACT). Treatment was optimised according to GINA 2010. At visit 2, 3 months later, we reassessed spirometry, asthma control and factors associated with failure to achieve control.

We recruited 1299 patients with uncontrolled asthma (mean age 46.5±17.3 years, 60.7% women, 25.8% obese). The mean percentage of predicted forced expiratory volume in 1 s was 76.4±12.8% and the mean post-bronchodilator increase was 14.9±6.8%. We observed poor agreement between ACT and GINA 2010 when evaluating asthma control (kappa = −0.151). At visit 2, asthma in 71.2% of patients was still not fully controlled. Patients whose asthma remained uncontrolled were older, had a higher body mass index, greater disease severity, longer disease evolution and worse lung function.

After treatment optimisation, most patients did not achieve optimal control according to GINA 2010. Risk factors for failure to achieve asthma control were time of disease evolution, severity, age, weight and lung function impairment (excluded in the GINA 2014).
Luseogliflozin reduces epicardial fat accumulation in patients with type 2 diabetes: a pilot study
Authors: Bouchi Ryotaro , Terashima Masahiro , Sasahara Yuriko , Asakawa Masahiro , Fukuda Tatsuya , Takeuchi Takato , Nakano Yujiro , Murakami Masanori , Minami Isao , Izumiyama Hajime , Hashimoto Koshi , Yoshimoto Takanobu , Ogawa Yoshihiro
Published: March 2017

Background

Accumulation of epicardial fat (EF) is associated with increased cardio-metabolic risks and coronary events, independently of traditional cardiovascular risk factors. Therefore, the reduction of EF volume (EFV) may be associated with reduced cardio-metabolic risks and future cardiovascular events. Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce body fat including visceral fat and cardiovascular events in patients with type 2 diabetes. However, it has still been unknown whether SGLT2 inhibitors can reduce EFV.

Methods

Type 2 diabetic patients with HbA1c 6.5–9.0% and body mass index (BMI, kg/m2) ≥25.0 were enrolled in this single arm pilot study. Participants were administered luseogliflozin 2.5 mg daily and the dosage was tolerated to be increased up to 5.0 mg daily. EFV [median (interquartile range), cm3] was measured by magnetic resonance imaging. Primary endpoint was the decrease in EFV at 12 weeks. Visceral fat area (VFA, cm2) and liver attenuation index (LAI) measured by the abdominal computed tomography, and skeletal muscle index (SMI) and body fat (%) measured by the whole body dual-energy X-ray absorptiometry were also determined at baseline and at 12 weeks.

Results

Nineteen patients (mean age: 55 ± 12 years; 26% female) completed this study. Luseogliflozin treatment significantly reduced EFV at 12 weeks [117 (96–136) to 111 (88–134), p = 0.048]. The body weight, BMI, systolic and diastolic blood pressure, HbA1c, fasting plasma glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, SMI, and body fat were significantly reduced by luseogliflozin at 12 weeks. The reduction of EFV was significantly correlated with the reduction of C-reactive protein (r = 0.493, p = 0.019). Neither VFA nor LAI were significantly reduced by the luseogliflozin treatment. No severe adverse events were observed.

Conclusions

Our data suggest that luseogliflozin could reduce the EFV in parallel with the improvement of systemic micro-inflammation and the reduction of body weight in Japanese patients with type 2 diabetes. The reduction of muscle mass after the administration of SGLT2 inhibitors may require a particular attention.

Trial registration umin.ac.jp, UMIN000019072
Copper nano-sol loaded woven fabrics: structure and color characterization
Authors: Kanade Pragnya , Patel Bharat
Published: March 2017

Nano technology is an upcoming branch where lot of research work is being done with the intention of improving/changing properties of the materials. In this study polyester, cotton and polyester-cotton blended fabrics were coated with copper nano particles by pad-dry-cure technique. The morphology of nano-composite fabrics characterized using scanning electron microscope reveals that nanoparticles were dispersed on the fabric samples. The elemental analysis for confirming the presence of copper in the fabric samples was done using the Fourier transform infrared spectroscopy and energy dispersive X-ray spectroscopy techniques. The X-ray diffraction analysis of the fabric samples helped to unveil that incorporation of copper nano particles increased the d-spacing value in polyester fabric to a greater extent in comparison to the cotton and polyester-cotton blended fabrics. The nano treated woven fabric samples were dyed using myrobolan; a natural dye. The samples were evaluated in terms of colourimetric parameters and colour fastness. The copper nano-sol treatment was found to improve both K/S and colour fastness.