bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Affecting Foot Self-Care Practices in Individuals with Diabetes Mellitus Living in an Asian Population - A Quantitative Study
Authors: Cuttilan Amit N. , Sayampanathan Andrew A. , Pearce Christopher J.
Published: October 2016

Category:

Diabetes

Introduction/Purpose:

Diabetic foot complications and subsequent lower limb amputations commonly occur in diabetic patients due to poor foot care. We aimed to understand the extent of proper footcare practices and to identify the factors which influence these among diabetic patients in a multi-ethnic Asian population.

Methods:

A cross-sectional multi-centre quantitative study was performed. Inclusion criteria was all patients attending hospital outpatients clinics for diabetes. Patients were only excluded if they were unable to understand basic English. Demographic information, medical history (including formal assessment for peripheral neuropathy) and Nottingham Assessment of Functional Footcare (NAFF) scoreswere collected. All data was analysed using SPSS Version 21.

Results:

350 valid responses were obtained. The mean NAFF score was 49.6±7.19. Univariate analysis revealed that ethnically non-Chinese patients had significantly better scores than did Chinese patients. After linear regression analysis, a statistically significant correlation with better foot care practices was found for patients with higher education levels, active employment and the presence of previous diabetic foot complications.

Conclusion:

The mean NAFF scores in our study were lower than those published in other populations which may in part account for the huge burden of diabetic foot disease in Singapore. Patients appear to start to look after their feet better only after suffering a complication.Cultural and financial factors probably account for the differences in our risk factor findings and those published in other populations. Future studies should i evaluate the effectiveness of targeted interventions for the specific groups that we have identified who have poorer NAFF scores.
First Metatarsophalangeal Arthrodesis Fixation with an Intramedullary System
Authors: Álvarez M. Concepción Castro , Luque Juan M. Morell , Pérez Vicente J. López , González Oscar Escudero , García Félix Castillo , Andrade Cristóbal Martínez , Zabala Ibon López
Published: October 2016

Category:

Midfoot/Forefoot

Introduction/Purpose:

Artrhrodesis is a commonly and successfully used procedure to deal with advanced hallux rigidus, severe hallux valgus, inflammatory and posttraumatic arthritis and as a salvage of previous failed surgeries. Many different techniques, in terms of joint preparation and fixation constructs, have been reported. The purpose of this study is to evaluate our short time results with an intramedullary device to perform the first metatarsophalangeal (MTP) arthrodesis.

Methods:

A descriptive observational study with prospective follow-up was developed. We included 21 arthrodesis using an Intramedullary Fusion Device, which consists in a 6.5 mm intramedullary metatarsal implant and a hooked 4.0 mm lag screw. The indications were hallux rigidus grade 4 in 10 cases, severe hallux valgus in 7, two patients with hallux varus and two cases of salvage surgery of a previous Keller Brandes. Clinical outcomes were assessed with American College of Foot and Ankle Surgeons (ACFAS) scoring scale preoperatively and at the time of the radiological fusion. The degree of satisfaction of patients was also evaluated using the Coughlin and Mann scale.

Results:

Fusion was achieved at five to twelve weeks in 19 patients. The grade of satisfaction was excellent and good in 18 patients. In two cases, implant breakage occurred. ACFAS score improved 40 points respect to preoperative status. No complications related to infection were reported.

Conclusion:

Dorsal plate fixation augmented with plantar lag screw fixation is nowadays the reference technique to perform first MTP arthrodesis, nevertheless titanium staples and crossed screws have also reported good results. In these constructs, sometimes is necessary a second surgery to remove some disturbing material. An intramedullary device would avoid the soft tissue irritation due to the underlying material and seems reliable to provide a strong fixation to achieve early MTP fusion with good short-term evolution.
Mid-Term Follow-Up of the Result of Periarticular Osteotomy in Treating Asymmetrical Ankle Arthritis
Authors: Zhu Yuan
Published: October 2016

Category:

Ankle Arthritis

Introduction/Purpose:

A retrospective control study to evaluate periarticular osteotomy in treating asymmetrical ankle arthritis.

Methods:

Fifty-two consecutive patients with asymmetrical ankle arthritis were collected between 2009 and 2012. Forty-two of them were followed up. All the cases were performed the surgery of periarticular osteotomy including supramalleolar tibial osteotomy in 14 cases, supramalleolar tibial and fibular osteotomy in 5 cases, supramalleolar osteotomy combined with calcaneal osteotomy in 23 cases. Thirty cases got ligament reconstruction procedures. The age of surgery ranged from 31 to 70 years old (mean, 55.5). According to the Takakura classification of ankle arthritis, there were 16 cases in grade Ⅲa, and 26 cases in grade Ⅲb. The AOFAS-HA score and radiographic examinations including TAS and TLS were recorded and compared before and after surgery. Magnetic resonance imaging of the ankles were obtained before and after surgery (midterm result) in fifteen patients to evaluated the condition of the cartilage.

Results:

The average follow-up time was 44.5 months (36 to 75 months). All the patients got complete bone healing with an average healing time of 8 weeks. Average postoperative AOFAS -HA score by the last followup was 76.6±4.4 (compare with 35.7±5.6 preoperatively). Delayed wound healing occurred in 5 cases and was solved by wound care. All the cases had improvements in Takakura ankle arthritis classification by the last follow-up after surgery. Twenty-two patients felt the result of excellent, 20 felt good. The radiological assessment by the last followup showed no worsening of the ankle arthritis grade. None of these patients received or want to receive further surgeries such as ankle arthrodesis or ankle replacement.

Conclusion:

Periarticular osteotomy is a sound method in treating asymmetrical arthritis of the ankle in the midterm followup. This procedure can alter or decrease the contact pressures on the degenerated cartilage with mechanical realignment and can prolong the life span of the ankle itself.
Pain After Forefoot Surgery Comparing Day-Surgery and Conventional Hospitalization
Authors: Besse Jean-Luc , Chaudier Philippe , Bourdin Muriel , Gauthier Jerome , Fessy Michel-Henry
Published: October 2016

Category:

Midfoot/Forefoot

Introduction/Purpose:

At present, there are no guidelines for foot-surgery procedures that can be performed in day-surgery. The aim of our study was to evaluate early postoperative pain after forefoot day-surgery compared to a conventional hospitalization. The hypothesis was that patients operated in day-surgery showed as much pain as those hospitalized, without more complications.

Methods:

All patients operated for forefoot surgery by one senior surgeon (JLB) were included; those eligible for day-surgery according to SFAR (French Society of Anesthesia and Reanimation) recommendations were operated in day-surgery. Patients were distributed into 4 groups according to surgical procedure: 1.minor procedure (isolated lesser ray) – 2.light (isolated first ray) – 3.intermediate (first ray plus one or two lesser rays) – 4.complex (all forefoot). Patients living alone, further than 50 kilometres from our hospital, or in group 4 were hospitalized for 48 hours. The study included 317 patients; 40% were operated on in day-surgery. Those hospitalized were significantly older (60±3.8 versus 55±3.9, p=0.0006) and with higher ASA scores (p=0.0024) without difference in comorbidity. Main etiology was hallux valgus (70% in both groups); revision surgery counted for 9% of etiologies in the day-surgery versus 14% in the hospitalization group.

Results:

The highest daily pain rate was on day 1 (4.2/10±2.5 in day-surgery versus 4.4/10±2.4 in hospitalization, p=0.53) without significant difference between groups. Pain was evaluated as extreme (≥8/10) by 9% of patients in day-surgery versus 11% of those hospitalized. We found a statistically significant difference at day 0 for the light surgical procedures (category 2), with higher pain in day-surgery (4.4± 2.4 versus 3.3± 2.5, p=0.02). Concerning anaesthesia, time to recovery of sensitivity after nerve block was comparable regardless of the type of hospitalization or surgical procedure (6.0 hours ± 3.7 in day-surgery versus 5.8 hours ± 5.4, p=0.9). One patient in the day-surgery group had crossover for bleeding. Concerning the self-assessment questionnaire, patients operated in day-surgery described significantly more alertness and attention disturbances following surgery (p=0.01), and more frequent disappearance of pain after day 7 (p=0.02).

Conclusion:

There was no significant difference in pain or complications between groups. All patients were very satisfied. We can then reasonably recommend performing forefoot day-surgery in good collaboration with the anaesthetist and patient, without exposing the latter to greater pain and further complications.
Plantar Fasciitis Treatment With Particulated Human Amniotic Memebrane
Authors: Garras David N. , Scott Ryan T.
Published: October 2016

Category:

Basic Sciences/Biologics

Introduction/Purpose:

Plantar Fasciitis is the most common cause of heel pain in adults, and is estimated to affect nearly 1 million patients annually. Conservative treatments include rest, orthotics, night splint, stretching and non-steroidal anti- inflammatory drugs and are successful in nearly 90% of patients. However, more invasive treatments are required for patients whose symptoms persist greater than six months. Fetal tissues, including the umbilical cord (UC) and amniotic membrane (AM) have been increasingly used to modulate healing in different parts of the body over the last two decades. These tissues have been demonstrated to possess anti-inflammatory and anti-scarring properties in addition to containing growth factors, cytokines, and matrix components to promote healing, and offer a potential therapy for plantar fasciitis.

Methods:

In this series, we aim to evaluate the efficacy of cryopreserved, particulate UC/AM tissues as a treatment for plantar fasciitis as well as to determine if multiple injections provide an even greater benefit compared to a single injection. A multicenter prospective study was performed where patients were randomized to receive 25, 50, or 100 mg UC/AM tissue and either a single injection or two injections (at baseline and six weeks). All injections were administered under ultrasound guidance into the plantar fascia. At six, 12, and 18 weeks, patients returned and data on foot pain as well as the FAAM questionnaire were collected.

Results:

Interim six-week data for 18 patients has been collected. Patient foot pain was found to be reduced by approximately 50% from baseline (7.1 to 3.5 on a 10 point scale). FAAM scores also improved significantly. All patients showed variable degrees of improvement with no patients showing any deterioration.

Conclusion:

Hanselman et al evaluated the safety and efficacy of cryopreserved, particulate human amniotic membrane (cHAM) injections against a corticosteroid. They found cHAM injections safe and comparable to corticosteroids. In addition, the outcomes suggested a possible additive effect, with multiple injections of cHAM tissue showing a greater improvement in foot pain. The finding of our study are similar to the average verbal percentage improvement compared to baseline reported by Hanselman et al for the cHAM study group (46% improvement at six weeks). Overall, a total of 60 subjects will be enrolled in the present study.
Subtalar Arthrodesis in Patients With Avascular Necrosis of the Talus
Authors: Pellegrini Manuel J. , Schiff Adam P. , Dekker Travis J. , Easley Mark E. , DeOrio James K. , Nunley James A. , Adams Samuel B.
Published: October 2016

Category:

Hindfoot

Introduction/Purpose:

Avascular necrosis (AVN) of the talus can lead to subtalar arthritis, pain, and decreased function. Isolated subtalar arthrodesis has been attempted in these patients, potentially allowing re-vascularization of the talus from calcaneal bone ingrowth while preserving the tibiotalar joint. The purpose of this study is to determine the union rate and complications of subtalar arthrodesis in patients with AVN of the talus.

Methods:

After obtaining IRB approval, a retrospective review of subtalar arthrodeses performed at a single academic institution, from 2000 to 2014, was conducted. Patients were included if they had a preoperative diagnosis of avascular necrosis of the talus, underwent subtalar arthrodesis and had a minimum follow up of 12 months. Exclusion criteria include: age younger of 18 years, incomplete clinical and radiological data or those whom underwent a concomitant tibiotalar arthrodesis.

Results:

Twelve patients with a mean age of 46.6 ± 13.9 years were included in the study. The fusion rate was 58% with a mean time to fuse of 35 weeks (range, 14-146). Seventeen percent of the patients had diabetes or vascular disease and an additional 17% had a positive history for tobacco use. The overall complication rate was 67% (8 patients). Five patients progressed to non-union (42%) and three of them underwent revision to tibiotalocalcaneal arthrodesis. Two patients (17%) had progression of AVN, one of which necessitated a tibiotalocalcaneal arthrodesis. Two patients (17%) developed a wound dehiscence that healed uneventfully with local wound care and oral antibiotics administration. One patient (8%) underwent hardware removal.

Conclusion:

With a fusion rate as low as 58% and a 67% complication rate, caution should be exhibited when considering an isolated subtalar arthrodesis in the setting of AVN of the talus. In selected cases, consideration should be given to extending the arthrodesis site to include the tibiotalar or talonavicular joint or revascularization procedures such as concomitant vascularized bone grafts.
The Use of a Cellular Bone Allograft Containing Multipotent Adult Progenitor Cells for Foot and Ankle Arthrodeses
Authors: Adams Samuel B. , White Peter , Gross Christopher E. , Parekh Selene G.
Published: October 2016

Category:

Basic Sciences/Biologics

Introduction/Purpose:

Arthrodesis procedures are commonplace in foot and ankle surgery. Unfortunately, nonunion rates have been reported to be as high as 40%. To combat nonunion, autograft bone is often used but has been associated with morbidity and poor cell quality. Therefore, the use of cellular bone allograft (CBA) has become commonplace. Traditional CBAs are osteoconductive, osteoinductive and the cellular component is typically osteogenic but not angiogenic. The added property of angiogenesis may be beneficial in achieving fusion. The purpose of this study was to determine the efficacy of a CBA composed of MAPC-class cells that have both osteogenic and angiogenic properties.

Methods:

The CBA (map3, RTI Surgical, Alachua, FL) was used in 41 distinct foot and ankle arthrodesis sites in 37 consecutive patients with a mean age of 52 years (range, 19-88). In all cases the graft was interposed between the prepared bone surfaces prior to hardware placement. All patients were followed until fusion occurred or a revision procedure was performed in cases of nonunion. Successful fusion required >50% osseous bridging on CT scan and the presence of bridging bone without signs of nonunion on plain radiographs. Additionally, successful fusion required resolution of preoperative symptoms and maintenance of fixation across all treated joints.

Results:

Overall, fusion was achieved in 88% (36/41) arthrodesis sites. There were 11 patients/sites of previous nonunion. In these revision cases, the fusion rate was 82% (9/11). There were no complications attributed to the use of map3.

Conclusion:

Fusion rates using map3 were higher than or comparable to fusion rates with autograft that have been reported in the recent literature. Map3 was a safe and effective graft material to achieve fusion and may provide an effective autograft replacement for foot and/or ankle arthrodeses.
Use of the Tendoscopic Modified Das De Procedure for Recurrent Peroneal Tendon Dislocation
Authors: Nishimura Akinobu , Nakazora Shigeto , Ito Naoya , Sudo Akihiro , Kato Ko
Published: October 2016

Category:

Sports

Introduction/Purpose:

Traumatic peroneal tendon dislocation is an uncommon lesion that mainly affects young adults. It occurs most frequently during sports activities and generally during an ankle sprain. Unfortunately, most cases lead to recurrent peroneal tendon dislocation (RPTD). Therefore, most cases need operative treatments. Many surgical techniques for the treatment of RPTD have been described. One of the most popular operative procedures is the modified Das De procedure, which is the superior peroneal retinaculum (SPR) repair. Since 2014, we have performed the procedure along with tendoscopy. The purpose of this study is a preliminary report on the tendoscopic modified Das De procedure.

Methods:

We performed surgery for RPTD in 5 consecutive patients (4 men and 1 woman, mean age 21.4 years). All the patients were injured during sports activities. This procedure was performed with the patient in the lateral decubitus position. Two portals were made. Three anchors were inserted in the fibula. An 18-gauge needle, into which a shuttle relay had been looped (2-0 Prolene), was used to thread through the SPR. Six passes were made (Image), and the sutures were tightened in order to reattach the SPR to the fibula. A knotless anchor was screwed into the lateral aspect of the fibula to allow for suturing by using the bridge technique. For postoperative care, a short-leg cast was applied for 3 weeks. The patients were allowed partial and full weight bearing at 2 and 3 weeks, respectively. Evaluation parameters included the operation time, complications, return to regular sports activities, and recurrence.

Results:

The mean operation time was 88.8 minutes (range: 69–125 minutes), which was relatively longer than that of our previous open modified Das de procedure (mean: 40.0 minutes). However, compared with the initial cases, recent cases tended to have shorter surgical times. No complications occurred. All the patients could return to regular sports activities within 4 months after surgery. No recurrence was observed during the follow-up period (mean: 11.4 months; range: 9–14 months).

Conclusion:

The tendoscopic modified Das De procedure for RPTD required a longer operation time compared to open surgeries. However, the operation time is expected to be shortened as the surgeon gains experience. In addition, this procedure was not associated with any early severe complications and allowed patients to return to sports activities within a short period. Long-term studies involving a large number of cases are needed. However, this procedure is an attractive option because it is less invasive and has achieved similar results as those in open procedures.
Neuroinflammatory and morphological changes in late-life
depression: the NIMROD study
Authors: Su Li , Faluyi Yetunde O. , Hong Young T. , Fryer Tim D. , Mak Elijah , Gabel Silvy , Hayes Lawrence , Soteriades Soteris , Williams Guy B. , Arnold Robert , Passamonti Luca , Rodríguez Patricia Vázquez , Surendranathan Ajenthan , Bevan-Jones Richard W. , Coles Jonathan , Aigbirhio Franklin , Rowe James B. , O'Brien John T.
Published: October 2016

We studied neuroinflammation in individuals with late-life, depression, as a
risk factor for dementia, using [11C]PK11195 positron emission
tomography (PET). Five older participants with major depression and 13
controls underwent PET and multimodal 3T magnetic resonance imaging (MRI),
with blood taken to measure C-reactive protein (CRP). We found significantly
higher CRP levels in those with late-life depression and raised
[11C]PK11195 binding compared with controls in brain regions
associated with depression, including subgenual anterior cingulate cortex,
and significant hippocampal subfield atrophy in cornu ammonis 1 and
subiculum. Our findings suggest neuroinflammation requires further
investigation in late-life depression, both as a possible aetiological
factor and a potential therapeutic target.
HEAT repeats – versatile arrays of amphiphilic helices working in crowded environments?
Authors: Yoshimura Shige H. , Hirano Tatsuya
Published: October 2016

Cellular proteins do not work in isolation. Instead, they often function as part of large macromolecular complexes, which are transported and concentrated into specific cellular compartments and function in a highly crowded environment. A central theme of modern cell biology is to understand how such macromolecular complexes are assembled efficiently and find their destinations faithfully. In this Opinion article, we will focus on HEAT repeats, flexible arrays of amphiphilic helices found in many eukaryotic proteins, such as karyopherins and condensins, and discuss how these uniquely designed helical repeats might underlie dynamic protein–protein interactions and support cellular functions in crowded environments. We will make bold speculations on functional similarities between the action of HEAT repeats and intrinsically disordered regions (IDRs) in macromolecular phase separation. Potential contributions of HEAT–HEAT interactions, as well as cooperation between HEATs and IDRs, to mesoscale organelle assembly will be discussed.
ELYS regulates the localization of LBR by modulating its phosphorylation state
Authors: Mimura Yasuhiro , Takagi Masatoshi , Clever Michaela , Imamoto Naoko
Published: October 2016

Lamin B receptor (LBR), an inner nuclear membrane (INM) protein, contributes to the functional integrity of the nucleus by tethering heterochromatin to the nuclear envelope. We have previously reported that the depletion of embryonic large molecule derived from yolk sac (ELYS; also known as AHCTF1), a component of the nuclear pore complex, from cells perturbs the localization of LBR to the INM, but little is known about the underlying molecular mechanism. In this study, we found that the depletion of ELYS promoted LBR phosphorylation at the residues known to be phosphorylated by cyclin-dependent kinase (CDK) and serine/arginine protein kinases 1 and 2 (SRPK1 and SRPK2, respectively). These phosphorylation events were most likely to be counter-balanced by protein phosphatase 1 (PP1), and the depletion of PP1 from cells consistently caused the mislocalization of LBR. These observations point to a new mechanism regulating the localization of LBR, which is governed by an ELYS-mediated phosphorylation network. This phosphorylation-dependent coordination between INM proteins and the nuclear pore complex might be important for the integrity of the nucleus.
Acid sphingomyelinase is required for cell surface presentation of Met receptor tyrosine kinase in cancer cells
Authors: Zhu Linyu , Xiong Xiahui , Kim Yongsoon , Okada Naomi , Lu Fei , Zhang Hui , Sun Hong
Published: October 2016

Receptor tyrosine kinases (RTKs) are embedded in the lipid bilayer of the plasma membrane, but the specific roles of various lipids in cell signaling remain largely uncharacterized. We have previously found that acid sphingomyelinase (ASM; also known as SMPD1) regulates the conserved DAF-2 (the ortholog IGF-1R in mammals) RTK signaling pathway in Caenorhabditis elegans. How ASM and its catalytic products, ceramides, control RTK signaling pathways remain unclear. Here, we report that ASM regulates the homeostasis of Met, an RTK that is frequently overexpressed in various cancers. Inactivation of ASM led to a rapid loss of Met from the plasma membrane, reduced Met phosphorylation and activation, and induced Met accumulation in the trans-Golgi network (TGN). However, trafficking of integrin β3 and vesicular stomatitis virus glycoprotein (VSVG) was largely unaffected. Knockdown of syntaxin 6 (STX6) also blocked the Golgi exit of Met. Depletion of either ASM or STX6 led to aberrant trafficking of Met to lysosomes, promoting its degradation. Our studies reveal that ASM and ceramides, together with STX6 and cholesterol, constitute a new regulatory mechanism for the exit of Met from the Golgi during its biosynthetic route, which is used to rapidly replenish and regulate the plasma membrane levels of Met in various cancer cells.
Nuclear alignment in myotubes requires centrosome proteins recruited by nesprin-1
Authors: Espigat-Georger Aude , Dyachuk Vyacheslav , Chemin Cécile , Emorine Laurent , Merdes Andreas
Published: October 2016

Myotubes are syncytial cells generated by fusion of myoblasts. Among the numerous nuclei in myotubes of skeletal muscle fibres, the majority are equidistantly positioned at the periphery, except for clusters of multiple nuclei underneath the motor endplate. The correct positioning of nuclei is thought to be important for muscle function and requires nesprin-1 (also known as SYNE1), a protein of the nuclear envelope. Consistent with this, mice lacking functional nesprin-1 show defective nuclear positioning and present aspects of Emery–Dreifuss muscular dystrophy. In this study, we perform small interfering RNA (siRNA) experiments in C2C12 myoblasts undergoing differentiation, demonstrating that the positioning of nuclei requires PCM-1, a protein of the centrosome that relocalizes to the nuclear envelope at the onset of differentiation in a manner that is dependent on the presence of nesprin-1. PCM-1 itself is required for recruiting proteins of the dynein–dynactin complex and of kinesin motor complexes. This suggests that microtubule motors that are attached to the nuclear envelope support the movement of nuclei along microtubules, to ensure their correct positioning in the myotube.
Innate preference and learning of colour in the male cotton bollworm Helicoverpa armigera
Authors: Satoh Aya , Kinoshita Michiyo , Arikawa Kentaro
Published: October 2016

We investigated the ability of colour discrimination and learning in male adults of nocturnal cotton bollworm moth, Helicoverpa armigera, under a dim light condition. The naïve moths preferred blue and discriminated the innately preferred blue from several shades of grey indicating that the moths have colour vision. After being trained for 2 days to take nectar at yellow, an innately non-preferred colour, moths learned to select yellow over blue. The choice distribution between yellow and blue changed significantly from that of naïve moths. However, the dual choice distribution of the trained moths was not significantly biased to yellow: the preference for blue is robust. We also tried to train moths to grey, which was not successful. The limited ability to learn colours suggests that H. armigera may not strongly rely on colours when searching for flowers in the field, although they have basic property of colour vision.
Developing Cost-Effective Inspection Sampling Plans for Energy-Efficiency Programs at Southern California Edison
Authors: So Kut C. , Wu Edward
Published: October 2016

This paper summarizes the results of the development and implementation of a decision model for a major California utility company. The company’s program managers use the model to select the most cost-effective sampling inspection plan for managing a portfolio of energy-efficiency programs. The decision model can be used to evaluate the performance of possible sampling strategies based on historical data. We illustrate the application of our decision model to a specific program. We further highlight several key implementation success factors and discuss the benefits that the utility company accrued from using the decision model.
Patient experiences of a lipoprotein apheresis service
Authors: Datta Dev , Watkins Suzanne
Published: October 2016

Lipoprotein apheresis involves the extracorporeal removal of low-density lipoprotein cholesterol and other atherogenic lipoproteins from the blood. It is a lifesaving treatment for patients with very high low-density lipoprotein levels which cannot be sufficiently lowered by lipid-lowering drugs and diet. However, it is an invasive, repetitive and chronic treatment under taken at fortnightly intervals on an outpatient basis, meaning that patients need considerable commitment to undertake the treatment. The Lipoprotein Apheresis Unit at University Hospital Llandough is one of only eight centres in the UK, and has undertaken patient research to evaluate the service, so that changes can be implemented to ensure the service meets the needs and expectations of patients. The survey showed that patients consider apheresis treatment to be an important and beneficial part of their health care. The majority of patients (68%) reported that their general health had improved since starting lipoprotein apheresis treatment and the other 32% reported that their general health remained the same.
What should midwives know about Zika virus infection?
Authors: Turienzo Cristina Fernandez , Brown Michael
Published: October 2016

There is currently a large-scale epidemic of Zika virus infection in the Americas. For most people, infections caused by Zika virus lead to a mild and short-lived illness, but Zika has now been confirmed as the cause of fetal microcephaly and other birth defects, and it has been linked to certain neurological disorders. This article offers some insight into Zika virus infection, management of women who are pregnant or planning a pregnancy, and the implications of Zika virus for practising midwives in the UK.
Getting to grips with Statistics: Understanding variables
Authors: Campbell Malcolm
Published: October 2016

It is fundamental, when undertaking research, to understand the discipline of Statistics—what it is, the key concepts and approaches, statistical tests and how to choose them, and how to write up your findings. Statistics can be used to summarise quantitative data and generalise findings. Types of variables will determine how they are analysed statistically; categorical variables may be dichotomous, nominal or ordinal, which are analysed in different ways, while interval/ratio variables for numerical data are analysed in the same way. Understanding the basics of how to present and interpret data is essential in any field of research.
Non-Hodgkin lymphoma in adults: a guide for practice nurses
Authors: Perry Margaret
Published: October 2016

Practice nurses have a valuable role to play in instigating earlier diagnosis in patients with possible symptoms of non-Hodgkin lymphoma, and supporting those undergoing treatment, writes Margaret Perry

Non-Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system and accounts for approximately 85% of cancers of this type. This article—part one in a two-part series, the second part of which will consider Hodgkin lymphoma—outlines the causes and possible risk factors for non-Hodgkin lymphoma, diagnosis, treatment and management and prognosis. It aims to provide nurses with insight into the disease, to enhance their knowledge of a complex condition and increase their confidence in treating patients in primary care. Practice nurses can play a vital role in instigating earlier diagnosis and treatment when they encounter patients with suspicious symptoms, and can offer support to those undergoing treatment.
Communicating the importance of pre-exposure rabies vaccination
Authors: Brewer Catherine
Published: October 2016

Health professionals providing travel advice must understand the purpose and regime of recommendations for pre- and post-rabies exposure and communicate them to travellers, including new guidance from Public Health England, writes Catherine Brewer

Rabies is an acute viral encephalomyelitis caused by members of the lyssavirus genus. The rabies virus attacks the central nervous system, resulting in progressive inflammation of the spinal cord and brain ( National Travel Health Network and Centre, 2016 ). Once symptoms develop, rabies is almost always fatal; however, it is vaccine-preventable. Having a full understanding of the gravity of the disease, plus the purpose and regime of the pre- and post-exposure recommendations, and communicating these clearly, will allow travellers to make informed decisions. It is also vital that people know what to do if they have a potential exposure, and receive the correct post-exposure treatment, regardless of their vaccination status.
Diagnosis and management of childhood asthma in primary care
Authors: Lo David , Gaillard Erol , Gaillard Brigitte , Bullous Louise
Published: October 2016

Diagnosing asthma in children is challenging, but information obtained from clinical history and objective lung function testing should help nurses determine probability and adopt a stepwise approach, write Dr David Lo, Dr Brigitte Gaillard, Louise Bullous and Dr Erol Gaillard

Although asthma is the most common non-communicable disease of childhood, there is no standardised definition nor gold-standard test available to diagnose the condition. Asthma is a complex airways disorder where genetic, environmental and host immunity are likely to play a part. Misdiagnosis in children is common, although objective lung function tests aid accuracy, when combined with a clinical history. Adopting a stepwise approach to achieving complete, or good, control of symptoms enhances management and regular treatment reviews should include provision of mutually-agreed, written personalised asthma action plans, which should also be given to children's schools. When control is poor or diagnosis uncertain, patients should be referred to specialist care.
Research Roundup
Authors: Winter George
Published: October 2016

George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference isprovided.
A Case of Manifesting Carrier with DMD Phenotype
Authors: Anand Akshay , Vinish Monika , Prabhakar Sudesh
Published: October 2016

A case of a 35-year old female with a history of proximal weakness in lower limbs and bulkiness of both calves manifesting before ten years of age was reported. Clinical findings were suggestive of muscular dystrophy. Genetic analysis using polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP) and direct sequencing revealed several point mutations, which account for dystrophin dysfunction and DMD type pathogenesis.
Derecho a la intimidad en las redes sociales de internet en Colombia.
Authors: Castro Jaramillo Ángela María
Published: October 2016

El artículo ilustra uno de los temas más controversiales, en términos de lo jurídico y la comunicación, presentes en los inicios del siglo XXI: las redes sociales en Internet, que surgen como una respuesta a la naturaleza humana de comunicarse y de establecer vínculos personales, profesionales y sentimentales. Puesto que no existe una relación personal y directa con la persona con quien se está interactuando, puede haber lugar a vulneración de derechos fundamentales que se relacionan con el fuero interno de las personas. En el marco virtual de las redes sociales, es fácil proyectar un perfil que refleje una identidad que, en algunos casos, no corresponde a la realidad. El ambiente interactivo virtual se presta para que la persona que está al otro lado del computador suplante una identidad, como sucede con los individuos que solicitan amistad de personas con fines delictivos y ponen en riesgo la integridad y honra de las personas. La afectación del derecho a la intimidad desde las redes sociales es evidente, sea por terceros o por la misma persona titular que expone su vida privada sin medir las consecuencias y el impacto social, dada la rapidez de la difusión de la información que permite Internet.
Minería aurífera ilegal en el resguardo indígena alto Andágueda.
Authors: Echeverry Osorio Diana Lorena , Díaz Ricardo Sandra
Published: October 2016

El resguardo indígena embera katío del río Alto Andágueda está siendo afectado por uno de los problemas nacionales más importantes, denominado minería ilegal, lo cual altera los componentes sociales, culturales, económicos y ambientales de los nativos del lugar y vulnera sus derechos fundamentales. Esto trae como consecuencia la presencia de delitos conexos como extorsión, explotación infantil y violación, entre otros, además de una nefasta destrucción del ambiente, por lo que amerita una revisión de responsabilidades y participación de las entidades comprendidas en las ramas del poder público colombiano para atender la problemática en este resguardo indígena.
Ecologia morfofuncional de plântulas de 15 espécies da Floresta Atlântica Sergipana
Authors: Matos Ilaíne Silveira , Landim Myrna Friederichs
Published: October 2016

Em Sergipe a Floresta Atlântica encontra-se hoje fragmentada e reduzida a apenas 9% da sua cobertura original. O estudo da ecologia morfofuncional de plântulas nesse ecossistema é importante para a taxonomia, silvicultura e ecologia, possibilitando a identificação das plântulas no campo, requisito necessário para o entendimento da regeneração e sucessão vegetal. Neste estudo, foram descritas a germinação e a morfologia de plântulas de 15 espécies de um remanescente florestal sergipano, sendo também analisadas as relações entre biometria das sementes, morfologia das plântulas e outros atributos ecológicos. Do total de espécies analisadas 40% foram classificadas como fanero-epígeo-foliáceas, 26,7%, como cripto-hipógeo-armazenadoras, 26,7% como fanero-epígeo-armazenadoras e 6,6% como fanero-hipógeo-armazenadoras. A existência de relações entre a biometria da semente, o tipo morfofuncional de plântula e os atributos ecológicos das espécies analisadas corroborou os resultados obtidos em outras florestas tropicais, indicando que a morfologia da plântula é fortemente direcionada pelas características do nicho de regeneração.
A New Hermas Papyrus Fragment in Paris
Authors: Batovici Dan
Published: October 2016

This article offers an edition of P.Weill I 96, containing sections of a 2nd (or late 1st) century AD work, the Shepherd of Hermas. It belongs to the École Pratique des Hautes Études in Paris, but is hosted at the Institut de papyrologie de la Sorbonne. Since it was shown to be part of the same codex leaf as the B fragment of P.Prag. I 1, the Prague fragments are re-edited here as well.
Response to K. Bartol, ‘P.Oxy. LXIV 4410, Fr. 1 and 2.1–5’
Authors: Perale Marco
Published: October 2016

The current note is a response to K. Bartol’s arguments against my readings of P.Oxy. LXIV 4410. It questions her interpretation of fr. 1 and suggests an alternative way of understanding the expression πρόβα κατωτέρω in fr. 1.2.
Catalogue of the Evidence for Presocratics in the Herculaneum Papyri
Authors: Vassallo Christian
Published: October 2016

This article provides the first complete catalogue of the evidence for pre- Socratic philosophers handed down by the Herculaneum papyri. The Index Praesocraticorum Philosophorum Herculanensis (IPPH) aims to lay the foundations for a systematic analysis of the Traditio Praesocratica within Epicureanism. The list of the testimonia is updated to the current state of the research and to the most recent critical reconstructions of each papyrus entailed in such an inquiry.
A Receipt and Credit Note from Sixth-Century Hermopolis
Authors: Gonis Nikolaos
Published: October 2016

Revised edition of a fragmentary text concerning for the reimbursement of one solidus to an oil-worker, issued by Zacharias, vir clarissimus.
Automation of the test procedure for accelerated aging of implant packages
Authors: Koker Liane , Nagel Jörg A. , Schulz Bernhard , Ritter Fabian , Vollmannshauser Stefan , Besser Heino , Gengenbach Ulrich
Published: October 2016

An automated accelerated aging test procedure is presented to estimate the lifetime of implant packages regarding
hermeticity. Intruding humidity is captured automatically in packages at two elevated temperatures using a resonant
circuit comprised of capacitive humidity sensor and coil in coupling with an external coil. Described are the test stand
setup including sensor calibration and evaluation, data acquisition and processing. In a first application the safe and
reliable operation of the setup is demonstrated.
Technology Licensing between Rival Firms in Presence of Asymmetric Information
Authors: Sen Neelanjan , Bhattacharya Sukanta
Published: October 2016

This paper investigates the possibility of licensing between rival firms in a Cournot duopoly market. Unlike Heywood, Li, and Ye (2014. “Per Unit vs. Ad Valorem Royalties under Asymmetric Information.” International Journal of Industrial Organization 37:38–46), the cost information of the licensee is private in the pre-licensing stage. If inspection of the licensee’s technology is not possible by the licensor i) technology is never transferred from the low-cost firm (licensor) to the high-cost firm (licensee) via fixed-fee and ii) in the case of royalty licensing technology will be transferred only if the cost difference between the firms is sufficiently high. Moreover, under fixed-fee and royalty licensing, the licensee will always allow the licensor to inspect its technology, if inspection is possible. If inspection is undertaken by the licensor, technology will be transferred i) if the cost difference is low via fixed fee and ii) always via royalty.
Implementing CEFR principles in introductory Norwegian language courses for international students: Opportunities and challenges
Authors: Wapinska Ewa
Published: October 2016

This article describes some of the opportunities and challenges presented by beginners’ courses in Norwegian for international students offered by the Department of Linguistics and Scandinavian Studies at the University of Oslo. Teaching approaches and course content are examined in relation to CEFR levels A1, A2 and B1 and the CEFR’s main objectives. The aim is to invite the reader to share in dynamic and communicative task- and learner-oriented practices, with a particular focus on the benefits of extensive use of the target language – in this case Norwegian. Various target language strategies and activities can be used to adjust and develop concrete context-relevant descriptors in today’s multicultural and multilingual academic environment. Finally, the article shows how to help students and teachers to benefit from good practice and how to apply systematic and sustainable assessment strategies during the initial stages of learning a new language in the host country.
EPOS – the European e-portfolio of languages
Authors: Kühn Bärbel
Published: October 2016

Democratic principles and human rights, the core values of the Council of Europe, informed the development of the
Using the ELP as a basis for self- and peer assessment when selecting “best” work in modern-language degree programmes
Authors: Dalziel Fiona , Davies Gillian , Han Amy
Published: October 2016

The European Language Portfolio (ELP) was designed as a tool that “supports reflective learning and fosters the development of learner autonomy” (Little 2009,
Biografische Methoden der Kompetenzanalyse für die Reflexion von Sprachkompetenz–Portfolioarbeit in der Praxis
Authors: Reil Kirstin
Published: October 2016

Im Rahmen von Fremdsprachenunterricht werden unterschiedliche Instrumente eingesetzt, die der Förderung der Selbstreflexion dienen und damit die Kompetenzorientierung fördern (Checklisten, Lerntagebücher etc.). Sie sind Bestandteil der Arbeit mit dem biografischen Teil des Europäischen Sprachenportfolios. Studierende sollen dazu angeregt werden, ihre Sprachkompetenzen benennen und einschätzen zu können und auf dieser Basis ihre Lernziele zu definieren und weitere Lernschritte zu planen. Dabei steht die Handlungsorientierung im Vordergrund.

Sprachkompetenzen werden häufig in formalen Lernarrangements erworben. Hierüber können Studierende leicht Auskunft geben, weil die Dauer, der Inhalt und ein (formales) Ergebnis dokumentierbar sind. Ein Großteil der Kompetenzen wird jedoch informell erworben. Um ein genaueres Bild dieser Kompetenzen zu erhalten, bedarf es Unterstützungsformen und Methoden, um Handlungssituationen zu erinnern und zu beschreiben, in denen diese Kompetenzen erworben bzw. angewendet wurden. Der Einsatz entsprechender Methoden im Sprachunterricht bedeutet, informell erworbene Kompetenzen in einer formalen Lernumgebung zu thematisieren und liefert gleichzeitig Möglichkeiten, verschiedene Sprachkompetenzbereiche weiter zu fördern. In diesem Beitrag werden verschiedene biografische Methoden vorgestellt, die im Rahmen des außercurricularen Sprachenprogramms FremdsprachenPlus an der Hochschule Bremen angewendet werden.
The role of second language in higher education: A case study of German students at a Dutch university
Authors: Zijlmans Lidy , Neijt Anneke , van Hout Roeland
Published: October 2016

This article reports on an investigation of the challenges and benefits of university students taking a degree course in a language other than their mother tongue. Our study was conducted from the point of view of the non-native students themselves, and our primary concern was the role of language. We investigated the academic achievement of German students studying in a Dutch-English academic environment. Dutch is the main language of instruction, and English the main language of the literature used. In search of predictors for successful learning of Dutch (our first research question), LexTALE tests were administered to determine linguistic competence in the students’ first language, German, and their second language, English. In addition, we collected data on their educational background and language learning history. None of the LexTALE scores stood out as ‘the’ predictor for success in learning Dutch; German was a slightly better predictor than English. The best predictor appeared to be the students’ general educational level, expressed in mean grades for final exams in secondary education. We then studied the role of proficiency in the foreign languages needed for academic success. Language data on L3 Dutch were gathered at the start and were compared to study results after the first six months and at the end of the first year. The level of Dutch as a second language correlated with study results, expressed in ECTS; the correlation was even higher with mean grades on exams. This indicates that language proficiency does play a role in study success.
Multivariate measures of concordance for
copulas and their marginals
Authors: Taylor M. D.
Published: October 2016

Building upon earlier work in which axioms were formulated for multivariate measures of concordance,
we examine properties of such measures. In particular,we examine the relations between the measure
of concordance of an n-copula and the measures of concordance of the copula’s marginals.
Die Trollfrau als kultureller Katalysator in der Illuga saga Gríðarfóstra
Authors: Schäfke Werner
Published: October 2016

This article introduces the model of the semiosphere developed by Yuri Lotman for cultural studies to the study of Icelandic sagas. The semiosphere helps analyzing value systems in such narrative texts. The semiosphere focuses on dynamic processes and thus better fits to describing narrative texts – that by definition contain a dynamic sequence of events – than static structuralist models do.

The analysis of Illuga saga Gríðarfóstra with help of the semiosphere-model shows that the value system of the saga criticizes rigid aristocratic societal structures in favor for a more liberal system, in which the able individual can rise to higher ranks. Furthermore, the saga addresses female sexual morality: women are supposed to be monogamous, and not enjoy sexual intercourse. Illuga saga thus aligns with most value systems found in the Fornaldarsǫgur. However, in contrary to the female passiveness demanded by most Fornaldarsǫgur, Illuga saga welcomes female agency and even aggressiveness.