bluuebunny/crossref_metadata_2025 huggingface dataset:
Hidden Lesions of the Posterior Horn of the Medial Meniscus
Authors: Sonnery-Cottet Bertrand , Conteduca Jacopo , Thaunat Mathieu , Gunepin François Xavier , Seil Romain
Published: February 2014

Background:

Anterior cruciate ligament (ACL) tears are frequently associated with meniscal lesions. Despite improvements in meniscal repair techniques, failure rates remain significant, especially for the posterior horn of the medial meniscus.

Purpose:

To determine whether a systematic arthroscopic exploration of the posterior horn of the medial meniscus with an additional posteromedial portal is useful to identify otherwise unrecognized lesions.

Study Design:

Case series; Level of evidence, 4.

Methods:

In a consecutive series of 302 ACL reconstructions, a systematic arthroscopic exploration of the posterior horn of the medial meniscus was performed. The first stage of the exploration was achieved through anterior visualization via a standard anterolateral portal. In the second stage, the posterior horn of the medial meniscus was visualized posteriorly via the anterolateral portal with the scope positioned deep in the notch. In the third stage, the posterior horn was probed through an additional posteromedial portal. A χ2 test and logistic regression analysis were performed to determine if the time from injury to surgery was associated with the meniscal tear pattern.

Results:

A medial meniscal tear was diagnosed in 125 of the 302 patients (41.4%). Seventy-five lesions (60%) located in the meniscal body were diagnosed at the first stage of the arthroscopic exploration. Fifty lesions located in the ramp area were diagnosed: 29 (23.2%) at the second stage and 21 lesions (16.8%) at the third stage after minimal debridement of the superficial soft tissue layer. The latter type of lesion is called a “hidden lesion.” Altogether, the prevalence of ramp lesions in this population was 40%. Meniscal body lesions (odds ratio, 2.6; 95% confidence interval, 1.18-5.18; P < .02) were found to be significantly correlated with a longer delay between injury and surgery.

Conclusion:

Posterior visualization and posteromedial probing of the posterior horn of the medial meniscus can help in discovering a higher rate of lesions that could be easily missed through a standard anterior exploration. In numerous cases, these lesions were “hidden” under a membrane-like tissue and were discovered after minimal debridement through a posteromedial portal.
In Search of the Optimal Number of Response Categories in a Rating Scale
Authors: Lee Jihyun , Paek Insu
Published: February 2014

Likert-type rating scales are still the most widely used method when measuring psychoeducational constructs. The present study investigates a long-standing issue of identifying the optimal number of response categories. A special emphasis is given to categorical data, which were generated by the Item Response Theory (IRT) Graded-Response Modeling (GRM). Along with number of categories (from 2 to 6), two scale characteristics of scale length ( n = 5, 10, and 20 items) and item discrimination (high/medium/low) were examined. Results of this study show that there was virtually no difference in psychometric properties of the scales using 4, 5, or 6 categories. Most deteriorating change was observed when the number of response categories reduced from 3 to 2 points in all six psychometric measures. Small moderating effects by scale length and item discrimination seem to be present, that is, a slightly larger impact on the psychometric properties by changing the number of response categories in a shorter and/or highly discriminating scale. This study concludes with the suggestion that a caution should be made if a scale has only 2 response categories but that limitation may be overcome by manipulating other scale features, namely, scale length or item discrimination.
Affected or Detached? Gendered Emotional Reactions to School Shootings
Authors: Nurmi Johanna
Published: February 2014

This article explores whether gendered norms and beliefs about emotions persist, as people relive and recount unexpected incidents of mass violence. The emotional expressions of men and women after two school shootings in Finland are examined and compared, based on qualitative interviews with local residents and crisis workers. Two emotional orientations in relation to school shootings were identified: being affected and being detached. Women were associated more with being emotionally affected and men with being detached. However, there was not always a consensus on how gendered individuals should express emotion in the aftermath of a school shooting.
Exploring the Challenges Faced by Latinas Experiencing Intimate Partner Violence
Authors: Postmus Judy L. , McMahon Sarah , Silva-Martinez Elithet , Warrener Corinne D.
Published: February 2014

This article explores the help-seeking challenges faced by a community sample of 25 Latina intimate partner violence (IPV) survivors. We include the experiences of Latinas who sought help from IPV services and those who did not. Additionally, we utilize an ecological framework to highlight the barriers that are present at multiple levels for Latinas who seek assistance, and we include their recommendations for increasing access. The information provided by these Latina survivors afford social workers the opportunity to address the barriers experienced by them as well as the opportunity to take a proactive stance in further enhancing services available in the community.
Management Practice Variation in Tax Increment Financing Districts
Authors: Hall Jeremy L. , Bartels Christopher E.
Published: February 2014

Research into tax increment financing (TIF) effectiveness has yielded mixed results, often under extensive controls. Until recently, no study had considered or controlled for the potential effects of internal management practices, including preproject planning and postimplementation performance measurement on TIF performance. This study draws on evidence from 72 TIF projects in the Dallas–Fort Worth (DFW) Metroplex to subject the recently proposed administrative theory of TIF performance to empirical validation. Regression analysis is used to determine the correlation between two key TIF district management practices (preimplementation risk assessment and postimplementation performance measurement) and project performance. The authors empirically examine differences in management practices across TIF districts within the same regional economy, and findings lend support to the theory that TIF management practices play an important role, alongside other factors, in determining project performance.
“Feeling Poor”
Authors: Karraker Amelia
Published: February 2014

Objective: This study examines the relationship between perceived economic position (PEP), objective socioeconomic status, and environmental mastery among older Americans. Method: Using data from the National Social Life, Health, and Aging Project (NSHAP), I examine (a) whether PEP is associated with environmental mastery even after accounting for objective economic status and (b) whether the relationship between PEP and mastery varies by reference group (peers, Americans). Results: High PEP is associated with higher mastery while low PEP is associated with lower mastery, even after controlling for objective economic status. In general, the relationship between PEP and mastery does not vary whether PEP relative to peers or PEP relative to American families is examined. Discussion: These analyses provide insights into the important role of social comparisons in the connection between socioeconomic status and psychological well-being in the later life course.
Study on the theory, method and model for mechanical dynamic assembly reliability optimization
Authors: Fei Chengwei , Tang Wenzhong , Bai Guangchen
Published: February 2014

To improve the performance and reliability of gas turbine like an aeroengine, the multi-object multi-discipline (MOMD) reliability optimization design of high press turbine (HPT) blade-tip radial running clearance (BTRRC) was first accomplished based on the mechanical dynamic assembly reliability (MDAR) theory and distributed collaborative response surface method (DCRSM). Four optimization models of MDAR were developed based on the features of assembly machinery and the thought of DCRSM, which are, respectively, called as the direct reliability optimization model (denoted by M1), the multilayer reliability optimization models (denoted by M2), the direct reliability optimization model-based probabilistic analysis (denoted by M3), and the multilayer reliability optimization model-based probabilistic analysis (denoted by M4). Through the MDAR optimization design of BTRRC by the four standard optimization models, some conclusions are drawn as follows: (1) the DCRSM is proved to be effective and feasible for MOMD MDAR optimization design with high computational efficiency and precision; (2) all the reliability optimization results of BTRRC and assembly objects satisfy the requirements of optimization design, and the optimized BTTRC variations are reduced by about 10% and obey the normal distribution, which are quite promising in improving the design and control of HPT BTRRC; (3) in computational efficiency, the computing time of M1 and M3 is far less than those of M2 and M4, meanwhile M3 and M4 are superior to M1 and M2; (4) in computational accuracy, M1 and M2 are better than M3 and M4, as well as M2 and M4 are higher than M1 and M3 theoretically. The presented study does not only fulfill the HPT BTRRC dynamic assembly design from a probabilistic optimization perspective and improve the performance and reliability of gas turbine engine, but also provides a promising approach and four valuable optimization models for MDAR optimization design. Besides, the present efforts are of great significance in enriching the theory and method of mechanical reliability design.
Type synthesis of four-degree-of-freedom parallel mechanisms using valid arrays and topological graphs with digits
Authors: Lu Yi , Wang Ying , Ding Ling
Published: February 2014

The type synthesis of four-degree-of-freedom parallel mechanisms using valid arrays and the valid topology graphs with digits is studied. First, the 12 contracted graphs without any binary links for type synthesis of the four-degree-of-freedom parallel mechanisms are constructed. Second, a complicated derivation of topology graphs with digit is transformed into a simple derivation of array, many valid arrays are derived, and many invalid arrays and invalid topology graphs with digit are determined and removed from the arrays using a compiled program. Third, many valid topology graphs with digit with various basic links are derived from the valid arrays, and the 46 different four-degree-of-freedom parallel mechanisms are synthesized using the valid topology graphs with digit and arrays, in which eight existing four-degree-of-freedom parallel mechanisms are included. Finally, the degree of freedoms of synthesized parallel mechanisms are calculated to verify the correction and effectiveness of type synthesis approach using valid arrays and the valid topology graphs with digit.
A novel 4-UPU translational parallel mechanism with fault-tolerant configurations
Authors: Qu Haibo , Fang Yuefa , Guo Sheng , Ye Wei
Published: February 2014

This paper aims at designing a pure translational parallel mechanism constructed by UPU (universal-prismatic-universal joint) kinematic limbs. First, the typical problem of unexpected rotations is pointed out from analyzing the typical 3-UPU parallel mechanism, and the reason for unexpected rotations of parallel mechanism constructed by UPU kinematic limbs is analyzed. Then, in order to design a pure translational parallel mechanism constructed by UPU without the unexpected rotations, the 2-UPU single loop is chosen as the basic structure to construct the 4-UPU translational parallel mechanism. Each 2-UPU single loop can be used to constrain a rotation about an axis of the linear complexes, which defined the unexpected rotations. Therefore, a novel type of 4-UPU pure translational parallel mechanism with redundant actuations is proposed. Since the existence of redundantly actuated kinematic limb, this proposed parallel mechanism possesses analytical forward kinematics, and its singularity can be avoided completely. Finally, the workspace and fault-tolerant performance are analyzed. When the proposed 4-UPU parallel mechanism is located in a fault-tolerant configuration, the moving platform can still possess movable ability to realize the given task even if one kinematic limb is in locked-joint failure mode, and the fault-tolerant workspace is obtained.
Overcoming post-communist labour weakness: Attritional and enabling effects of multinationals in Central and Eastern Europe
Authors: Lee Aleksandra Sznajder , Trappmann Vera
Published: February 2014

We use micro-level analysis of developments in the steel sector in Poland, Romania and Slovakia to examine the effects of multinational corporations on trade unions in Central and Eastern Europe. We argue that unions’ weakness can be attributed to their strategies during the restructuring and privatization processes of post-communist transition. Tactics used for union regeneration in the West are less appropriate in the East, but revival may be possible because the power of transnational capital forces unions to focus their efforts on articulating workers’ interests. We examine the emerging system of industrial relations in the sector and explore the development of capabilities needed to overcome post-communist legacies.
Water management and agricultural intensification of rice farming at the late-Neolithic site of Maoshan, Lower Yangtze River, China
Authors: Zhuang Yijie , Ding Pin , French Charles
Published: February 2014

Intensifying water management for rice farming and related land use involves increasing labour investment in transforming local landscapes. By applying geoarchaeological investigation at the well-preserved late-Neolithic rice paddy site of Maoshan, Lower Yangtze River, during the excavation, this study provides detailed information of the changing relationship between water management, agricultural intensification, environmental change and social evolution during the critical time period of the late Holocene. It illustrates that the intensification of rice farming was facilitated by successful water management and landscape management in most time, and it was the combined effect of gradually increasing aridity, fluctuating sea-level patterns and increasing labour investment in water management that led to the eventual abandonment of the paddy field at the end of the Neolithic in this region. This study therefore draws attention from large-scale sites to small-scale, but economically important, sites in enhancing our understanding of the dynamic relationship between human societies and environmental changes during the late Holocene in this region.
Survival analysis with functional covariates for partial follow-up studies
Authors: Fang Hong-Bin , Wu Tong Tong , Rapoport Aaron P , Tan Ming
Published: February 2014

Predictive or prognostic analysis plays an increasingly important role in the era of personalized medicine to identify subsets of patients whom the treatment may benefit the most. Although various time-dependent covariate models are available, such models require that covariates be followed in the whole follow-up period. This article studies a new class of functional survival models where the covariates are only monitored in a time interval that is shorter than the whole follow-up period. This paper is motivated by the analysis of a longitudinal study on advanced myeloma patients who received stem cell transplants and T cell infusions after the transplants. The absolute lymphocyte cell counts were collected serially during hospitalization. Those patients are still followed up if they are alive after hospitalization, while their absolute lymphocyte cell counts cannot be measured after that. Another complication is that absolute lymphocyte cell counts are sparsely and irregularly measured. The conventional method using Cox model with time-varying covariates is not applicable because of the different lengths of observation periods. Analysis based on each single observation obviously underutilizes available information and, more seriously, may yield misleading results. This so-called partial follow-up study design represents increasingly common predictive modeling problem where we have serial multiple biomarkers up to a certain time point, which is shorter than the total length of follow-up. We therefore propose a solution to the partial follow-up design. The new method combines functional principal components analysis and survival analysis with selection of those functional covariates. It also has the advantage of handling sparse and irregularly measured longitudinal observations of covariates and measurement errors. Our analysis based on functional principal components reveals that it is the patterns of the trajectories of absolute lymphocyte cell counts, instead of the actual counts, that affect patient’s disease-free survival time.
Optimal selection of individuals for repeated covariate measurements in follow-up studies
Authors: Reinikainen Jaakko , Karvanen Juha , Tolonen Hanna
Published: February 2014

Repeated covariate measurements bring important information on the time-varying risk factors in long epidemiological follow-up studies. However, due to budget limitations, it may be possible to carry out the repeated measurements only for a subset of the cohort. We study cost-efficient alternatives for the simple random sampling in the selection of the individuals to be remeasured. The proposed selection criteria are based on forms of the D-optimality. The selection methods are compared with the simulation studies and illustrated with the data from the East–West study carried out in Finland from 1959 to 1999. The results indicate that cost savings can be achieved if the selection is focused on the individuals with high expected risk of the event and, on the other hand, on those with extreme covariate values in the previous measurements.
The Right to a Privilege? Homonormativity and the Recognition of Same-Sex Couples in Europe
Authors: Ammaturo Francesca Romana
Published: February 2014

The Council of Europe (CoE) and its judicial body, the European Court of Human Rights, are at the forefront of the debate for the redefinition of the notion of ‘family’ in relation to the inclusion of same-sex couples. The recent jurisprudence has demonstrated a change in the Court’s approach to the question of what counts as a family, by terms of Article 12 of the European Convention on Human Rights. This much-anticipated development, nonetheless, begs the question of how the ‘right to marry and found a family’ might prove to be a privilege rather than a right. This article tries to shed light on the contradictions underpinning the expansion of the concept of family in the context of the CoE, suggesting the existence of a conflation of both heteronormative and homonormative narratives of kinship in the construction of a notion of the ‘family’ that encompasses same-sex couples.
Race, Party, and the Consequences of Restricting Early Voting in Florida in the 2012 General Election
Authors: Herron Michael C. , Smith Daniel A.
Published: February 2014

In mid-2011, the Florida legislature reduced the state’s early voting period from fourteen days to eight and eliminated the final Sunday of early voting. We compare observed voting patterns in 2012 with those in the 2008 General Election and find that racial/ethnic minorities, registered Democrats, and those without party affiliation had significant early voting participation drops and that voters who cast ballots on the final Sunday in 2008 were disproportionately unlikely to cast a valid ballot in 2012. Florida’s decision to truncate early voting may have diminished participation rates of those already least likely to vote.
How Do Kidnappers Kill Hostages? A Comparison of Terrorist and Criminal Groups
Authors: Phillips Everard M.
Published: February 2014

This study explores how hostages are murdered during a kidnapping for ransom. A multi-dimensional scaling procedure was used to explore the homicidal behavior of kidnappers. Three styles of homicide, labeled as execution, manual, and slaughter, were identified. Each varied in the degree of expressive/instrumental aggression and planned or spontaneous violence. Classification of the sample data found that 46.4% of kidnapping homicides were characterized by instrumental violence labeled as execution style, whereas 42.9% were characterized by hostile violence that was spontaneous and less reliant on using a weapon (manual style). These observations related to the type of group conducting the kidnapping for ransom.
Fixing the mirrors: A feasibility study of the effects of dance movement therapy on young adults with autism spectrum disorder
Authors: Koch Sabine C , Mehl Laura , Sobanski Esther , Sieber Maik , Fuchs Thomas
Published: February 2014

From the 1970s on, case studies reported the effectiveness of therapeutic mirroring in movement with children with autism spectrum disorder. In this feasibility study, we tested a dance movement therapy intervention based on mirroring in movement in a population of 31 young adults with autism spectrum disorder (mainly high-functioning and Asperger’s syndrome) with the aim to increase body awareness, social skills, self–other distinction, empathy, and well-being. We employed a manualized dance movement therapy intervention implemented in hourly sessions once a week for 7 weeks. The treatment group (n = 16) and the no-intervention control group (n = 15) were matched by sex, age, and symptom severity. Participants did not participate in any other therapies for the duration of the study. After the treatment, participants in the intervention group reported improved well-being, improved body awareness, improved self–other distinction, and increased social skills. The dance movement therapy–based mirroring approach seemed to address more primary developmental aspects of autism than the presently prevailing theory-of-mind approach. Results suggest that dance movement therapy can be an effective and feasible therapy approach for autism spectrum disorder, while future randomized control trials with bigger samples are needed.
The influence of maternal language responsiveness on the expressive speech production of children with autism spectrum disorders: A microanalysis of mother–child play interactions
Authors: Walton Katherine M , Ingersoll Brooke R
Published: February 2014

Adult responsiveness is related to language development both in young typically developing children and in children with autism spectrum disorders, such that parents who use more responsive language with their children have children who develop better language skills over time. This study used a micro-analytic technique to examine how two facets of maternal utterances, relationship to child focus of attention and degree of demandingness, influenced the immediate use of appropriate expressive language of preschool-aged children with autism spectrum disorders (n = 28) and toddlers with typical development (n = 16) within a naturalistic mother–child play session. Mothers’ use of follow-in demanding language was most likely to elicit appropriate expressive speech in both children with autism spectrum disorders and children with typical development. For children with autism spectrum disorders, but not children with typical development, mothers’ use of orienting cues conferred an additional benefit for expressive speech production. These findings are consistent with the naturalistic behavioral intervention philosophy and suggest that following a child’s lead while prompting for language is likely to elicit speech production in children with autism spectrum disorders and children with typical development. Furthermore, using orienting cues may help children with autism spectrum disorders to verbally respond.
Socioeconomic inequalities in mortality in 16 European cities
Authors: Borrell Carme , Marí-Dell’olmo Marc , Palència Laia , Gotsens Mercè , Burström BO , Domínguez-Berjón Felicitas , Rodríguez-Sanz Maica , Dzúrová Dagmar , Gandarillas Ana , Hoffmann Rasmus , Kovacs Katalin , Marinacci Chiara , Martikainen Pekka , Pikhart Hynek , Corman Diana , Rosicova Katarina , Saez Marc , Santana Paula , Tarkiainen Lasse , Puigpinós Rosa , Morrison Joana , Pasarín M Isabel , Díez Èlia
Published: February 2014

Aims: To explore inequalities in total mortality between small areas of 16 European cities for men and women, as well as to analyse the relationship between these geographical inequalities and their socioeconomic indicators. Methods: A cross-sectional ecological design was used to analyse small areas in 16 European cities (26,229,104 inhabitants). Most cities had mortality data for a period between 2000 and 2008 and population size data for the same period. Socioeconomic indicators included an index of socioeconomic deprivation, unemployment, and educational level. We estimated standardised mortality ratios and controlled for their variability using Bayesian models. We estimated relative risk of mortality and excess number of deaths according to socioeconomic indicators. Results: We observed a consistent pattern of inequality in mortality in almost all cities, with mortality increasing in parallel with socioeconomic deprivation. Socioeconomic inequalities in mortality were more pronounced for men than women, and relative inequalities were greater in Eastern and Northern European cities, and lower in some Western (men) and Southern (women) European cities. The pattern of excess number of deaths was slightly different, with greater inequality in some Western and Northern European cities and also in Budapest, and lower among women in Madrid and Barcelona. Conclusions: In this study, we report a consistent pattern of socioeconomic inequalities in mortality in 16 European cities. Future studies should further explore specific causes of death, in order to determine whether the general pattern observed is consistent for each cause of death.
Transnational higher education as a hybrid global/local space: A case study of a Malaysian-Australian joint venture
Authors: Sidhu Ravinder K. , Christie Pam
Published: February 2014

One aspect of transnational education that is anticipated to grow in prominence is the international branch campus. This article is a case study of Monash University Malaysia, a Malaysian-Australian transnational education alliance which has achieved a measure of success in a field fraught with risk. It offers an analysis of the dynamic interplay between global processes and the logics of practice of situated national and institutional interests. The article shows that global processes such as marketization are realized in specifically local conditions. The joint venture was able to find its market in the particular configurations of the Malaysian postcolonial state, ethno-nationalism and neoliberalization.
Redefining virality in less broad strokes: Predicting viral behavioral intentions from motivations and uses of Facebook and Twitter
Authors: Alhabash Saleem , McAlister Anna R
Published: February 2014

With the growing sophistication of social media, virality of online content has become an indicator of online message effectiveness. We argue for a comprehensive definition that extends virality to social networking and microblogging sites, by emphasizing users’ behaviors beyond shear access and viewership. Across two studies, we investigate viral behavioral intentions (VBIs) toward pro-social messages shared on Facebook and Twitter. We further explore how motivations and uses of Facebook and Twitter predict VBIs toward messages shared on these websites.
Effect of aging treatment on the crushing behavior of aluminum 6061 alloy tube
Authors: Farshidi MH
Published: February 2014

The effect of heat treatment on the axial crushing behavior of thin-walled aluminum 6061 alloy tubes is studied in this work. For this purpose, thin-walled grooved specimens were subjected to different aging heat treatments to obtain different work hardening behaviors. Afterward, quasi-static axial compression tests were achieved to evaluate the crushing behavior. Additionally, a finite element method simulation was employed to determine the distributions of stress, strain, and imposed damage during axial compression. Results show that the optimum energy absorption characteristics can be obtained using moderated strain hardening exponent, “ n”. Low strain hardening exponent results in the fracture of tube during axial compression while high strain hardening exponent causes lowered absorbed energy. On comparing the results of experiments and finite element method simulations, the fracture of tube during axial compression can be predicted using a simple fracture criterion.
A replication of Hofstede’s uncertainty avoidance dimension across nationally representative samples from Europe
Authors: Minkov Michael , Hofstede Geert
Published: February 2014

Despite the great interest in Hofstede’s dimensions of national culture, some of them have not been replicated with nationally representative samples. In this study, we use 2010 European Social Survey data for 25 European countries and Israel and obtain a close replication of Hofstede’s uncertainty avoidance ( r = 0.81, p < 0.001, n = 17) with strong face validity, internal reliability, and similar predictive properties to those of the original measure. The replication and our analysis elucidate the nature of uncertainty avoidance as a dimension of national culture and expose some misconceptions about it.
Prediction and Stratification of Upper Limb Function and Self-Care in Acute Cervical Spinal Cord Injury With the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP)
Authors: Velstra Inge-Marie , Bolliger Marc , Tanadini Lorenzo Giuseppe , Baumberger Michael , Abel Rainer , Rietman Johan S. , Curt Armin
Published: February 2014

Background. There is inherent heterogeneity within individuals suffering from cervical spinal cord injury (SCI), and early prediction of upper limb function and self-care is challenging. As a result, considerable uncertainty exists regarding the prediction of functional outcome following cervical SCI within 1 year of injury. Objective. To evaluate the value of Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) in predicting upper limb function and self-care outcomes in individuals with cervical SCI. Method. A prospective longitudinal multicenter study was performed. Data from the GRASSP, the Spinal Cord Independence Measure (SCIM III), and the American Spinal Injury Association (ASIA) Impairment Scale were recorded at 1, 6, and 12 months after cervical SCI. For prediction of functional outcome at 6 and 12 months, a logistic regression model, receiver operating characteristics (ROC), and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used with 8 different predictor variables. Results. Logistic regression analysis, ROC analysis, and URP-CTREE all revealed that the strength subtest within GRASSP is the strongest predictor for upper limb function and self-care outcomes. URP-CTREE provides useful information on the distribution of different outcomes in acute cervical SCI and can be used to predict cohorts with homogeneous outcomes. Conclusion. The GRASSP at 1 month can accurately predict upper limb function and self-care outcomes even in a heterogeneous group of individuals across a wide spectrum of neurological recovery. The application of URP-CTREE can reveal the distribution of outcome categories and, based on this, inform trial protocols with respect to outcomes analysis and patient stratification.
Chronic complete thrombosis of abdominal aortic aneurysm: An unusual presentation of an unusual complication
Authors: Pejkic Sinisa , Opacic Dragan , Mutavdzic Perica , Radmili Oliver , Krstic Nevena , Davidovic Lazar
Published: February 2014

Although mural thrombosis frequently accompanies aneurysmal disease, complete thrombosis is distinctly unusual complication of abdominal aortic aneurysm (AAA). A case study of a patient with chronic, asymptomatic complete thrombosis of a large juxtarenal AAA is presented along with a literature review and discussion of the potential secondary complications, mandating aggressive management of this condition. A 67-year-old man with multiple atherogenic risk factors and unattended complaints consistent with a recent episode of a transient right hemispheric ischemic attack was referred to our clinic with a diagnosis of a thrombosed AAA established by computed tomography. Duplex ultrasonography and aortography confirmed the referral diagnosis and also revealed near occlusion of the left internal carotid artery. The patient underwent a two-stage surgery, with preliminary left-sided carotid endarterectomy followed three days later by an aneurysmectomy and aortobifemoral reconstruction. He had an uncomplicated recovery and was discharged home on postoperative day 7, remaining asymptomatic at the 42-month follow-up. Complete thrombosis is an uncommon presentation of AAA and may be clinically silent. It is frequently associated with other manifestations of generalized atherosclerosis. Radical open repair yields durable result and is the preferred treatment modality.
Factors associated with persistent poorly controlled diabetes mellitus: Clues to improving management in patients with resistant poor control
Authors: Crowley Matthew J , Holleman Rob , Klamerus Mandi L , Bosworth Hayden B , Edelman David , Heisler Michele
Published: February 2014

Objectives

Patients with persistent poorly controlled diabetes mellitus (PPDM), defined as an uninterrupted hemoglobin A1c >8.0% for ≥1 year despite standard care, are at high risk for complications. Additional research to define patient factors associated with PPDM could suggest barriers to improvement in this group and inform the development of targeted strategies to address these patients’ resistant diabetes.

Methods

We analyzed patients with type 2 diabetes from a multi-site randomized trial. We characterized patients with PPDM relative to other patients using detailed survey data and multivariable modeling.

Results

Of 963 patients, 118 (12%) had PPDM, 265 (28%) were intermittently poorly controlled, and 580 (60%) were well-controlled. Patients with PPDM had younger age, earlier diabetes diagnosis, insulin use, higher antihypertensive burden, higher low-density lipoprotein cholesterol, and lower statin use relative to well-controlled patients. Among patients with objective adherence data (Veterans Affairs patients), a larger oral diabetes medication refill gap was associated with PPDM.

Discussion

Strategies are needed to target-specific barriers to improvement among patients whose diabetes is resistant to standard diabetes care. Our data suggest that strategies for targeting PPDM should accommodate younger patients’ lifestyles, include medication management for insulin titration and comorbid disease conditions, and address barriers to self-management adherence.
Evaluation of leadership practices: how to develop a vision
Authors: Martin Jacqueline S. , McCormack Brendan , Fitzsimons Donna , Spirig Rebecca
Published: February 2014

Leadership competencies and more specifically a strategic vision are essential to managing increasingly complex healthcare organisations and change. However, Switzerland, like many other countries, has identified a lack of leadership skills among nurse leaders. Therefore the Royal College of Nursing’s (RCN) Clinical Leadership Programme has been adapted, implemented and evaluated in the Swiss nursing context. The aim of this qualitative study was to evaluate the Leadership Programme’s support for vision development. In-depth interviews with six nurse leaders, who were purposefully selected according to the quantitative results of the overall mixed-methods evaluation project were included. Interviews were audio-recorded and transcribed prior to qualitative content analysis. Findings showed the different approaches used in the process of vision formation. Some used cognitive-analytical techniques and proceeded very methodically and systematically, whereas others described a more intuitive approach. Some also used a combination of both approaches. Participants experienced fostering and hindering factors on different levels – personal as well as organisational. The identified factors in vision development may be helpful in the planning of educational programmes to facilitate visionary skills among nurse leaders. Vision formation requires time for reflection and the ability of creative thinking, which is distinct from day-to-day management tasks.
Discrimination of low- and high-demand modes of safety-instrumented systems based on probability of failure on demand adaptability
Authors: Liu Yiliu
Published: February 2014

Probability of failure on demand is commonly used to measure the performance of safety-instrumented systems in the low (frequency) demand mode, while probability of failure per hour is taken as the measure in the high-demand mode. In current IEC 61508, once per year of the demand frequency is regarded as the borderline between two modes. However, few explanations can be found about why the borderline is here. This study focuses on the intermediate area of the two demand modes, examines the adaptability of probability of failure on demand with demand rates and then proposes a discrimination criteria of demand modes based on the analysis for the adaptability of probability of failure on demand with the Markov method. According to these criteria, in the high-demand mode where probability of failure on demand is not an effective measure, the equipment has higher probability to fall in hazard before a proof test when the safety-instrumented system is unavailable, and otherwise, the safety-instrumented system runs in the low-demand mode. The mean downtime of the safety-instrumented system before its failure is revealed in a proof test can help to locate the borderline, which is thus influenced by the configurations of safety-instrumented systems.
Timed Sollerman hand function test for analysis of hand function in normal volunteers
Authors: Singh H. P. , Dias J. J. , Thompson J. R.
Published: February 2014

This study describes the development and application of the timed Sollerman hand function test in normal volunteers and the effect of age, gender, dominance and handedness on hand function. A total of 100 volunteers (50 men and 50 women) aged between 20 to 70 years were asked to complete the Sollerman hand function test. We measured the time taken to complete the 20 tasks using seven grips. Volunteers completed the tasks a mean of 20 seconds quicker with the dominant than with the nondominant hand. Individuals who are strongly right-handed showed a pronounced difference taking less time with the dominant hand. Women took less time to complete all tasks in age groups 30 to 40 years, than women in age groups 20 to 30 years and beyond 40 years using the dominant hand. Men also showed worsening performance with age. The centile curves of the total time taken to complete all 20 Sollerman tasks between the ages of 20 to 70 years will allow investigators to adjust their findings for age before attributing observed differences to disease or its treatment.
Intraocular pressure-lowering efficacy and safety of bimatoprost 0.03% therapy for primary open-angle glaucoma and ocular hypertension patients in China
Authors: Wang Kaidi , Xu Li , Yuan Zhilan , Yao Ke , Zhao Junmei , Xu Liang , Fang Aiwu , Zhang Mingzhi , Wu Lingling , Ji Jian , Hou Jiamin , Liu Qing , Sun Xinghuai
Published: February 2014

Background

To report the clinical outcomes in Chinese patients with primary open-angle glaucoma and ocular hypertension treated with bimatoprost 0.03% therapy.

Methods

Two hundred sixty-three Chinese patients with primary open-angle glaucoma and ocular hypertension who needed initial or additional intraocular pressure (IOP) lowering were recruited in this prospective, open-label, multicenter clinical study and were treated with bimatoprost 0.03%. Patients received bimatoprost 0.03% as initial, replacement or adjunctive IOP-lowering therapy, and follow-up visits were performed at week 1, and month 1 and 3 of the bimatoprost treatment. The efficacy outcome measure was the post-treatment IOP level. The safety outcome measures included the rate of medication-related symptoms, physical signs, reported adverse events, and the level of conjunctival hyperemia.

Results

Among 240 patients who could be categorized by pre-existing therapies and the bimatoprost therapy regimen in the study, IOP values observed in all medication conditions showed significant IOP reduction at all study visits compared with baseline. At 3 months, 8.0 ± 3.7 mmHg (32.0%) reduction in IOP was observed in treatment-naive patients after bimatoprost monotherapy; in the patients previously on various therapy regimens, 1.9 ± 2.8 mmHg (9.5%) to 6.4 ± 6.1 mmHg (24.8%) additional IOP lowering was achieved after switching to bimatoprost monotherapy or bimatoprost combination therapy. The most common adverse event was conjunctival hyperemia, mainly of trace and mild intensity.

Conclusions

Our results show that bimatoprost 0.03% was effective in lowering IOP with favorable safety in Chinese primary open-angle glaucoma and ocular hypertension patients.
Optimization for peptide sample preparation for urine peptidomics
Authors: Sigdel Tara K , Nicora Carrie D , Hsieh Szu-Chuan , Dai Hong , Qian Wei-Jun , Camp David G , Sarwal Minnie M
Published: February 2014

Analysis of native or endogenous peptides in biofluids can provide valuable insights into disease mechanisms. Furthermore, the detected peptides may also have utility as potential biomarkers for non-invasive monitoring of human diseases. The non-invasive nature of urine collection and the abundance of peptides in the urine makes analysis by high-throughput ‘peptidomics’ methods , an attractive approach for investigating the pathogenesis of renal disease. However, urine peptidomics methodologies can be problematic with regards to difficulties associated with sample preparation. The urine matrix can provide significant background interference in making the analytical measurements that it hampers both the identification of peptides and the depth of the peptidomics read when utilizing LC-MS based peptidome analysis. We report on a novel adaptation of the standard solid phase extraction (SPE) method to a modified SPE (mSPE) approach for improved peptide yield and analysis sensitivity with LC-MS based peptidomics in terms of time, cost, clogging of the LC-MS column, peptide yield, peptide quality, and number of peptides identified by each method. Expense and time requirements were comparable for both SPE and mSPE, but more interfering contaminants from the urine matrix were evident in the SPE preparations (e.g., clogging of the LC-MS columns, yellowish background coloration of prepared samples due to retained urobilin, lower peptide yields) when compared to the mSPE method. When we compared data from technical replicates of 4 runs, the mSPE method provided significantly improved efficiencies for the preparation of samples from urine (e.g., mSPE peptide identification 82% versus 18% with SPE; p = 8.92E-05). Additionally, peptide identifications, when applying the mSPE method, highlighted the biology of differential activation of urine peptidases during acute renal transplant rejection with distinct laddering of specific peptides, which was obscured for most proteins when utilizing the conventional SPE method. In conclusion, the mSPE method was found to be superior to the conventional, standard SPE method for urine peptide sample preparation when applying LC-MS peptidomics analysis due to the optimized sample clean up that provided improved experimental inference from the confidently identified peptides.
Approximate solutions to variational inequality over the fixed point set of a strongly nonexpansive mapping
Authors: Iemoto Shigeru , Hishinuma Kazuhiro , Iiduka Hideaki
Published: February 2014

Variational inequality problems over fixed point sets of nonexpansive mappings include many practical problems in engineering and applied mathematics, and a number of iterative methods have been presented to solve them. In this paper, we discuss a variational inequality problem for a monotone, hemicontinuous operator over the fixed point set of a strongly nonexpansive mapping on a real Hilbert space. We then present an iterative algorithm, which uses the strongly nonexpansive mapping at each iteration, for solving the problem. We show that the algorithm potentially converges in the fixed point set faster than algorithms using firmly nonexpansive mappings. We also prove that, under certain assumptions, the algorithm with slowly diminishing step-size sequences converges to a solution to the problem in the sense of the weak topology of a Hilbert space. Numerical results demonstrate that the algorithm converges to a solution to a concrete variational inequality problem faster than the previous algorithm.

MSC:47H06, 47J20, 47J25.
Complex realities: community engagement for a paediatric randomized controlled malaria vaccine trial in Kilifi, Kenya
Authors: Angwenyi Vibian , Kamuya Dorcas , Mwachiro Dorothy , Kalama Betty , Marsh Vicki , Njuguna Patricia , Molyneux Sassy
Published: February 2014

Background

Community engagement (CE) is increasingly promoted for biomedical research conducted in resource poor settings for both intrinsic and instrumental purposes. Given the potential importance of CE, but also complexities and possibilities of unexpected negative outcomes, there is need for more documentation of CE processes in practice. We share experiences of formal CE for a paediatric randomized controlled malaria vaccine trial conducted in three sites within Kilifi County, Kenya.

Methods

Social scientists independent of the trial held in-depth individual interviews with trial researchers (n = 5), community leaders (n = 8) and parents (15 with enrolled children and 4 without); and group discussions with fieldworkers (n = 6) and facility staff (n = 2). We conducted a survey of participating households (n = 200) and observed over 150 CE activities.

Results

The overall CE plan was similar across the three study sites. The majority of respondents felt that CE activities helped to clear pre-existing concerns and misconceptions, and increase familiarity with and trust in trial staff. Challenges included: some community leaders attempting to exert pressure on people to enrol; local wording in information sheets and consent forms feeding into serious anxieties about the trial; and concerns about reduced CE over time. Negative effects of these challenges were mitigated through changes to on-going CE activities, and final information sharing and consent being conducted individually by trained clinical staff. One year after enrolment, 31% (n = 62) of participants’ parents reported malaria prevention as the main aim of the activities their children were involved in, and 93% wanted their children to remain involved.

Conclusion

The trial teams’ goals for CE were relatively clear from the outset. Other actors’ hopes and expectations (like higher allowances and future employment) were not openly discussed, but emerged over the course of engagements. Encouraging open discussion of all actors’ intentions and goals from the outset takes time, risks raising expectations that cannot be met, and is complex. However, doing so in future similar trials may allow successes here to be built upon, and some challenges to be minimized or avoided.

Trial registration

ClinicalTrials.gov NCT00866619 (registration 19-Mar-2009).