bluuebunny/crossref_metadata_2025 huggingface dataset:
National Trends in Statin Medication Prescribing in Patients With a History of Stroke or Transient Ischemic Attack
Authors: Snyder Brittany M. , Soric Mate M.
Published: July 2019

Background:

Guidelines support statin therapy post-stroke or transient ischemic attack (TIA); however, previously reported utilization rates are suboptimal.

Objective:

This study investigates the incidence of statin usage in patients with a documented stroke or TIA while identifying predictors of statin use.

Methods:

A retrospective, cross-sectional study utilizing data from the National Ambulatory Medical Care Survey.

Results:

A total of 2963 unweighted visits were included in the analysis, representing a total of 52 645 000 office visits when weighted. Statin therapy was initiated or continued in 35.7% (95% confidence interval [CI]: 32.4-39.0%) of office visits. Upon multivariate analysis, positive predictors of statin therapy included a diagnosis of hyperlipidemia (odds ratio [OR]: 3.60; 95% CI: 2.40-5.41), angiotensin-converting enzyme inhibitor (ACE-I) therapy (OR: 2.52; 95% CI: 1.69-3.76), aspirin therapy (OR: 2.02; 95% CI: 1.40-2.93), and clopidogrel therapy (OR: 2.60; 95% CI: 1.69-4.02). Negative predictors of statin therapy included office visits with neurologists when compared to visits with primary care practitioners (OR: 0.55; 95% CI: 0.33-0.90) and office visits in rural areas when compared to office visits in urban areas (OR: 0.64; 95% CI: 0.41-0.99).

Conclusion:

Various factors impact statin therapy use with overall utilization being suboptimal, highlighting an opportunity for medication optimization.
Midlife Adults’ Daily Support to Children and Parents: Implications for Diurnal Cortisol
Authors: Fuentecilla Jamie L. , Liu Yin , Huo Meng , Kim Kyungmin , Birditt Kira S. , Zarit Steven H. , Fingerman Karen L.
Published: July 2019

Objectives: We examined whether providing daily support to generations above and below has a differential impact on midlife adults’ diurnal cortisol. Method: Midlife adults ( N = 151) from the Family Exchanges Study Wave 2 reported daily practical support, emotional support, and advice to adult children and aging parents and collected saliva samples four times a day for 4 days. Results: Midlife adults experienced steeper cortisol awakening responses and steeper declines in cortisol (favorable cortisol functioning) on days when they provided support to children. Yet, they experienced higher overall cortisol levels (unfavorable cortisol functioning) on days when they provided support to aging parents. Discussion: Providing daily support to children may be rewarding to midlife adults, but support to parents may be associated with physiological stress. Findings advance understanding of midlife adults’ helping behaviors to multiple generations and carry implications for older adults’ well-being by encouraging effective support strategies.
The knowledge preservation problem in the nuclear industry and the role of Web-based tools in its solution
Authors: Geraskin N.I. , Kulikov E.G. , Glebov V.B.
Published: July 2019

This case study analyses an application of distance training in the practice of nuclear knowledge preservation. The purpose of the research is to evaluate the potential of distance training in solving the problem of knowledge preservation in the nuclear industry. Thirty specialists from different European countries participated in the pilot training experiments. It was found that the efficacy of distance training depends directly on the convenience and ease of the knowledge transmission process, the possibility for the trainees to combine training with their professional activities, the ability to work independently and a conscious desire on the part of trainees to improve their professional competencies. The study included a comprehensive evaluation of the distance training platform Cyber Learning Platform for Network Education and Training (CLP4NET) in the context of nuclear knowledge preservation. It was found that CLP4NET provided a friendly interface, was relatively easy to use and allowed an extensive application of interactive data representation forms and ample communication between training participants.
A methodology to analyze the vehicle vibration response to deformable terrain stiffness and damping properties
Authors: Taghavifar Hamid , Rakheja Subhash
Published: July 2019

A dynamic soil–wheel interaction model that considers energy loss due to soil compaction during multiple trafficking can potentially yield an enhanced understanding of vibration responses of a vehicle traversing the deformable terrains. This article presents a practical methodology for modeling the vehicle ride vibration responses, while interacting with deformable terrain irregularities. The proposed formulations incorporate adaptive contact patch and tire deflection in addition to soil sinkage using the Bekker’s pressure–sinkage relationship. The effect of repeated passes of the driven as well as driving wheels on effective stiffness and damping of the soil is also incorporated in the proposed formulations considering a tire slip term by adoption of the Holm’s theory. An in-plane 4-degrees-of-freedom vehicle model is formulated considering a generic compliant tire coupled with the deformable soil model and MSC ADAMS multibody dynamic model is employed for the co-simulations and validation purpose. The coupled terrain–vehicle is analyzed to determine chassis vibration responses together with variations in the dynamic tire–terrain contact force in the time and frequency domains. The results suggested that the root mean square vertical and pitch chassis acceleration responses of the vehicle operating on a deformable terrain are lower than those obtained for the undeformable terrain. The ratio of the dynamic tire force to the static load, a measure of road holding of the vehicle, however, tends to be higher for the deformable terrain. Both the road holding and root mean square chassis acceleration responses, invariably, show a significant increase with increase in the vehicle forward speed. The proposed methodology may serve as an important tool for assessing the vibration exposure of operators and for deriving optimal suspension designs for vehicles operating on deformable terrains.
Improved zinc ion transportation in gel polymer electrolyte upon the addition of nano-sized SnO2
Authors: Sai Prasanna CM , Austin Suthanthiraraj S
Published: July 2019

Nanocomposite gel polymer electrolytes (NCGPEs) consisting of Zn(OTf)2 salt solution in 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ionic liquid (EMIMTFSI), entrapped in poly(vinyl chloride) (PVC)/poly(ethyl methacrylate) (PEMA) matrices, and dispersed with different concentrations of tin oxide (SnO2) nanofiller were prepared by simple solution casting method. The free-standing film of the composite gel polymer electrolyte (GPE) exhibited an optimum ionic conductivity value of 4.92 × 10−4 Scm−1 at ambient temperature. The gel composites developed predominant amorphous phase and porous morphologies, thus supporting the high ionic conduction as confirmed from X-ray diffraction (XRD) and scanning electron microscopic (SEM) studies. The complex formation properties of the materials were evaluated by attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectroscopy technique. The dispersion of nanofillers in GPEs improved the thermal behavior of the composite system to 185°C, which was ascertained by thermogravimetric (TG) analysis. The electrochemical stability window of approximately 4.37 V with feasible plating/stripping process of zinc metal on stainless steel electrode was analyzed by voltammetric studies and all these features suggested the possibility of exploiting NCGPE films as electrolytes in batteries.
A comparative approach to enhance the electrical performance of PEDOT:PSS as transparent electrode for organic solar cells
Authors: Borazan Ismail , Bedeloğlu Ayşe Celik , Demir Ali
Published: July 2019

In this article, the improvement in electrical performance of poly(3,4-ethylenedioxythiophene)–poly(styrenesulfonate) (PEDOT:PSS) as the transparent electrode doped with different additives (ethylene glycol (EG), isopropyl alcohol) or treatment of sulfuric acid was enhanced that organic solar cells (OSCs) were produced by using poly(3-hexylthiophene-2,5-diyl):[6,6]-phenyl C61 butyric acid methyl ester. OSCs were fabricated by the doped or treated PEDOT:PSS films as transparent electrodes. The photoelectrical measurements were carried out and the effects of doping or treatment were compared. As a result, EG-added PEDOT:PSS electrode showed the best power conversion efficiency value of 1.87% among the PEDOT:PSS anodes.
Perception of Harms and Benefits of Electronic Cigarettes Among Adult Malaysian Men: A Comparison by Electronic Cigarette Use and Smoking Status
Authors: Chan Caryn Mei Hsien , Ab Rahman Jamalludin , Tee Guat Hiong , Wee Lei Hum , Ho Bee Kiau , Robson Noor Zurani Md Haris , Draman Shamsul , Ling Miaw Yn Jane , Kuang Hock Lim ,   Dip Public Health, Yusoff Muhammad Fadhli , Kartiwi Mira , Ab Rahman Norny Syafinaz , Nik Mohamed Mohamad Haniki
Published: July 2019

Little is known about the perceptions of harm and benefit associated with the use of e-cigarettes in Malaysia. This was a cross-sectional analysis of a nationally representative sample comprising 1987 males (≥18 years of age). Current, former, and never users of conventional cigarettes and/or e-cigarettes participated in a questionnaire study conducted via face-to-face interviews. The relationship between participant characteristics and perceptions of harm and benefit of e-cigarettes were determined with multivariable logistic regression. There were 950 current, 377 former, and 660 never users of e-cigarettes. Government employees (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.29-2.66, P = .001), private sector employees (OR = 1.67, 95% CI = 1.27-2.18, P = .001), and the self-employed people (OR = 1.68, 95% CI = 1.31-2.17, P = .001) were more likely to perceive e-cigarettes as more harmful than conventional cigarettes compared with respondents who were not wage earners. All current users in the form of e-cigarette users (OR = 7.87, 95% CI = 3.23-19.18), conventional cigarette smokers (OR = 1.80, 95% CI = 1.39-2.33), and dual users (OR = 8.59, 95% CI = 4.76-15.52) were more likely to perceive e-cigarettes as useful in quitting conventional cigarette smoking compared with former and never users. Our findings constitute an important snapshot into the perceptions of e-cigarette harms and benefits, which could inform targeted public health messaging strategies.
Immunohistochemical analysis of pigment cell tumors in two cyprinid species
Authors: Siniard Wesley C. , Sheley Matthew F. , Stevens Brittany N. , Parker-Graham Christine A. , Roy Melissa A. , Sinnott Devinn M. , Watson Katherine D. , Marinkovich Matt J. , Robertson Jessica A. , Frei Samuel , Soto Esteban
Published: July 2019

Pigment cell tumors, also known as chromatophoromas, are cutaneous spindle cell neoplasms originating from pigment cells (chromatophores) in the dermis of teleosts, amphibians, and reptiles. Chromatophoromas share similar histologic morphology to other spindle cell tumors and are not always pigmented. Therefore, immunohistochemical analysis may be useful in distinguishing these neoplasms from tumors of other cellular origin when poorly pigmented. We performed 3 immunohistochemistry assays (PNL-2, melan A, and SOX10) on 8 cutaneous neoplasms from 8 teleosts diagnosed as chromatophoromas based on histologic morphology. Semiquantitative analysis of immunoreactivity was evaluated on each immunohistochemical assay using a 0–3 scale. PNL-2 exhibited mild-to-moderate (1 or 2) immunoreactivity in 7 of the cases, and resident chromatophores (internal control) were also immunoreactive in these cases. Melan A exhibited mild-to-moderate (1 or 2) immunoreactivity in 4 cases (and with resident chromatophores in these cases); SOX10 was not immunoreactive in any cases. Our results indicate that PNL-2 may be a useful marker in teleosts to distinguish tumors of chromatophore origin. Melan A could also be useful, but appears to be less sensitive, and SOX10 is likely not a useful marker for these neoplasms in teleosts.
Measuring Grit in Adolescents With and Without Disabilities
Authors: Lombardi Allison R. , Rifenbark Graham G. , Freeman Jennifer , Harvey Michael W.
Published: July 2019

In recent policy initiatives focused on college and career readiness, Grit is often lumped with other noncognitive skills deemed as important. Yet, very little is known about the relationship between Grit and disability among adolescents. In this study, we examine measurement invariance of the Grit scale in a sample of adolescents with and without disabilities ( n = 5,039). Findings show the scale functions similarly for students with and without disabilities, and the Perseverance factor of Grit significantly predicted grade point average for both groups. Implications for practice suggest use of the scale in school-wide data collection efforts that might be driven by college and career readiness policy initiatives that emphasize measuring noncognitive skills in all students, and an age-appropriate transition assessment in secondary special education.
Initial study of internally embedded shear-mode piezoelectric transducers for the detection of joint defects in laminate structures
Authors: Altammar Hussain , Dhingra Anoop , Salowitz Nathan
Published: July 2019

There has been recent interest in embedding sensor networks into bondlines to create intelligent materials that can detect, report, and potentially respond to their state. This article presents an initial, large-scale investigation into embedding shear-mode (d15) lead zirconate titanate piezoelectric transducers into the bondline of laminate structures, near the centerline, for the ultrasonic detection of joint defects. The study included analysis of dispersion curves, multiphysics numerical simulations, and experimental results for an aluminum–epoxy–aluminum laminate structure. Analysis of the time of flight and displacement profiles confirmed that antisymmetric waves were generated and propagated through the structure. Simulations were performed for models containing disbonds, through-thickness cracks, and voids with experimental validation of a specimen containing a void to evaluate the effectiveness of d15 lead zirconate titanates embedded in a bondline as actuators and sensors for damage detection. The results were examined by looking at the cross-sectional deformation in simulations, and the signal changes were evaluated by calculating the root mean square deviation damage index and inspecting attenuation and phase shift in pristine and damaged structures. It was found that the d15 shear-mode lead zirconate titanates actuated and sensed antisymmetric waves that were sensitive to all types of damages considered.
Unmet Expectations in Health Care Settings: Experiences of Transgender and Gender Diverse Adults in the Central Great Plains
Authors: Meyer Heather M. , Mocarski Richard , Holt Natalie R. , Hope Debra A. , King Robyn E. , Woodruff Nathan
Published: July 2019

Transgender and gender diverse (TGD) individuals face a long-term, multifaceted process if they choose to begin a gender affirmation journey. Decisions to go on hormone therapy and/or have a surgical procedure necessitate the TGD individual to set up an appointment with a health care provider. However, when TGD patients interact with health care practitioners, problems can arise. This article documents and categorizes the types of unmet expectations that are common in the TGD patient–health care provider social dynamic in the Central Great Plains of the United States. Utilizing a community-based participatory research model, qualitative in-depth interviews were conducted with 27 TGD individuals about their health care experiences. From this, the researchers identified four main themes of unmet expectations: probing, gatekeeping, stigmatizing stance, and misgendering/deadnaming. Steps that can be taken by both the health care provider and the TGD individual to have a more successful encounter are discussed.
Enhancing Medical Learners’ Knowledge of, Comfort and Confidence in Holding Serious Illness Conversations
Authors: Tam Vivian , You John J. , Bernacki Rachelle
Published: July 2019

Objectives:

Having early discussions with seriously ill patients about their priorities and values can improve their peace of mind and family outcomes during bereavement; however, physicians and medical students report feeling underprepared to hold serious illness conversations. We evaluated the impact of the Serious Illness Care Program clinician training workshop on medical learners’ knowledge of comfort and confidence in holding such conversations.

Methods:

Eligible learners were penultimate- or final-year medical students or first-year residents of generalist programs (Family Medicine, Internal Medicine). Learners participated in a 2.5-hour workshop involving reflection on serious illness discussions, didactic teaching and demonstration of the Serious Illness Conversation Guide (SICG), role play with standardized patients, direct observation, and feedback from experts. Participants completed pre- and post-intervention questionnaires with Likert-type scale and open-ended questions, which were analyzed using paired t tests and qualitative content analysis, respectively.

Results:

We enrolled 25 learners. The intervention was associated with an increase in knowledge ( P < .001) and self-efficacy ( P < .001). All learners reported gaining new skills, with a majority specifically identifying a framework for structuring serious illness conversations in the qualitative analysis (n = 14, 56%). Participants stated the workshops would improve their comfort in holding serious illness conversations (n = 24, 96%), and that it would be valuable to integrate the workshops into their formal curricula (n = 23, 92%).

Conclusions:

Training on the use of the SICG is novel for medical students and first-year residents and associated with the improvement in their knowledge of and perceived capacity to hold serious illness conversations. This study suggests that the integration of SICG training into medical curricula may have educational value.
We Are Wilderness Explorers: A Review of Outdoor Education in Canada
Authors: Purc-Stephenson R. J. , Rawleigh M. , Kemp H. , Asfeldt Morten
Published: July 2019

Background: Outdoor education (OE) should be understood in place, time, and culture because it is not a universal teaching approach. We currently know little about what constitutes the “Canadian ways” of doing OE or what students gain from the experience. Purpose: Our goal was to (a) identify the underlying factors guiding OE programs in Canada and (b) describe the learning outcomes and psychosocial benefits of engaging in OE from the students’ perspective. Methodology/Approach: We conducted a systematic review of qualitative studies that examined OE in Canada. We searched published studies from electronic databases (1980-2018). We used meta-ethnography to synthesize the findings. Findings/Conclusions: We reviewed 21 studies reporting on the experiences of 508 students. Using thematic analysis, we identified eight themes highlighting process, goals, and learning outcomes. We developed a model that describes the common teaching components, learning process, and short-term outcomes for OE in Canada. Implications: Our results represent the first study to synthesize OE published research in Canada, which help form a unified voice and a distinctive national identity for OE in Canada. Our results serve as a catalyst for educators to share ideas, practices, and learning goals.
Histiocytoid Ductal Carcinoma In Situ of the Breast: Not All Intraductal Foamy Cells Are Macrophages!
Authors: Dano Hélène , Galant Christine , Coyette Maude , Van Bockstal Mieke R.
Published: July 2019

With the advent of screening mammography, the incidence of ductal carcinoma in situ (DCIS) has increased. DCIS accounts for around 20% of breast cancers diagnosed at present. The histiocytoid variant of clear cell DCIS is a rare subtype of DCIS, characterized by epithelial cells with a clear and foamy cytoplasm. Histiocytoid DCIS serves as a potential diagnostic pitfall, since it can be easily mistaken for intraductal collections of foamy macrophages. In this article, we report a particular case of biphasic DCIS, characterized by an extensive histiocytoid-type clear cell component and a conventional “non-clear” cell component. Both components presented with HER2 protein overexpression. We discuss the diagnostic challenge and differential diagnosis of clear cell DCIS, as well as the role of HER2 overexpression in DCIS pathogenesis.
Intraoperative Assessment of the Axial Rotational Positioning of a Modern Ankle Arthroplasty Tibial Component Using Preoperative Patient-Specific Instrumentation Guidance
Authors: Gagne Oliver J. , Veljkovic Andrea , Townshend Dave , Younger Alastair , Wing Kevin J. , Penner Murray J.
Published: July 2019

Background:

The use of patient-specific instrumentation (PSI) in modern total ankle replacement (TAR) has augmented positioning of the tibial component, eliminating the need for complex jigs. Coronal and sagittal alignment are intuitive with this design and have been studied, but axial rotation has not. The purpose of this study was to assess the relationship between the planned preoperative axial rotation as set by the PSI guide and the rotation determined intraoperatively with non-PSI instrumentation.

Methods:

This was a prospective cohort study of 22 consecutive cases. The axial rotation angle between the medial gutter and the tibial implant position on the preoperative CT-scan based plan was extracted. At the time of surgery, the medial gutter alignment instrument from the non-PSI instrumentation was inserted and an intraoperative axial photograph obtained to record the angle between the medial gutter and the axial rotation guide pins set by the PSI instrumentation. The 2 measurements were compared and further statistical analysis included Pearson correlation and paired Student t test.

Results:

The average axial rotation angle between the medial gutter and the implant on the PSI preoperative plan was 5.4 ± 2.9 degrees, whereas the intraoperative photograph from the medial gutter alignment instrument to the pin was 5.9 ±3.8 degrees. This demonstrated a Pearson correlation of R = 0.54 and a P value of .53. The average difference between the two was −0.46 (95% CI: –2.04, 1.10), meaning that components were either slightly externally rotated or that the fork was aimed internally. Based on this group, 50% (11/22) were within 2 degrees of the target and 77% (17/22) were within 4 degrees of the target.

Conclusion:

Patient-specific guides allowed for reproducible rotational tibial component implantation in modern TAR. Further work is needed to better understand the biomechanical effects of the rotational profile and consequences on survivorship.

Level of Evidence:

Level IV, case series.
Assessing Appetitive Traits Among Chinese Young Adults Using the Adult Eating Behavior Questionnaire: Factor Structure, Gender Invariance and Latent Mean Differences, and Associations With BMI
Authors: He Jinbo , Sun Shengyan , Zickgraf Hana F. , Ellis Jordan M. , Fan Xitao
Published: July 2019

The current study examined the factor structure, measurement reliability, measurement invariance across genders, and latent gender mean differences, of a new Chinese translation of the Adult Eating Behavior Questionnaire (C-AEBQ) in a Chinese young adult sample ( n = 1,068, 52.57% women). The associations between the appetitive traits assessed by the AEBQ and body mass index were also explored. The previously established eight-factor model of the AEBQ was supported in the present sample. The C-AEBQ had strong measurement invariance between genders. Cronbach’s alpha estimates of the eight subscales of the C-AEBQ ranged from 0.76 to 0.97, and the test–retest reliability coefficients of the subscales ranged from 0.50 to 0.77. The C-AEBQ had adequate convergent and divergent validity, as supported by the theoretically expected correlations between C-AEBQ and the Three-Factor Eating Questionnaire. Furthermore, Satiety Responsiveness, Slowness in Eating, and Food Fussiness were inversely associated with body mass index. Overall, the C-AEBQ appears to be a psychometrically sound instrument as a comprehensive measure for appetitive traits for Chinese young adults.
The Value of Physical Symptoms in Screening For Posttraumatic Stress Disorder in the Military
Authors: Graham Kristin , Searle Amelia , Van Hooff Miranda , Lawrence-Wood Ellie , McFarlane Alexander
Published: July 2019

Physical symptoms are highly comorbid with posttraumatic stress disorder (PTSD). As PTSD is underdiagnosed, this study explored the value of self-reported physical symptoms in screening for 30-day PTSD in military personnel. Two physical symptom scales were constructed using items from a 67-item health symptom checklist, clinical interviews were used as the diagnostic reference standard, and diagnostic utility of physical symptoms was compared with the current gold standard screen, the PTSD checklist (PCL). Receiver operating characteristic analyses showed that both a 9-item and a 10-item physical symptom scale were of value in predicting PTSD (areas under the curve 0.81 and 0.85). Importantly, two thirds of PTSD positive personnel missed by the PCL were captured with physical symptoms scales, and when physical symptoms were added to the PCL, prediction was improved (areas under the curve 0.90 to 0.92). Our findings highlight the value of including assessing physical symptoms in PTSD screening.
Child Maltreatment and Polyvictimization as Predictors of Intimate Partner Violence in Women From the General Population of Quebec
Authors: Brassard Audrey , Tourigny Marc , Dugal Caroline , Lussier Yvan , Sabourin Stéphane , Godbout Natacha
Published: July 2019

This study aimed to (a) evaluate the prevalence of intimate partner violence (IPV) and revictimization among a representative sample of 1,001 women living in Quebec, Canada; (b) examine whether IPV was predicted by experiences of child maltreatment; and (c) explore the role of polyvictimization on IPV beyond the effect of any type of exposure. Results indicate the prevalence rates of lifetime IPV (10.5%), IPV over the last year (2.5%), and revictimization (7.2%). All forms of child maltreatment predicted an increased risk of IPV victimization, yet polyvictimization was related to IPV beyond the effects of specific forms of child maltreatment.
Refined dimensional reduction for isotropic elastic Cosserat shells with initial curvature
Authors: Bîrsan Mircea , Ghiba Ionel-Dumitrel , Martin Robert J , Neff Patrizio
Published: July 2019

Using a geometrically motivated 8-parameter ansatz through the thickness, we reduce a three-dimensional shell-like geometrically nonlinear Cosserat material to a fully two-dimensional shell model. Curvature effects are fully taken into account. For elastic isotropic Cosserat materials, the integration through the thickness can be performed analytically and a generalized plane stress condition allows for a closed-form expression of the thickness stretch and the nonsymmetric shift of the midsurface in bending. We obtain an explicit form of the elastic strain energy density for Cosserat shells, including terms up to order [Formula: see text] in the shell thickness h. This energy density is expressed as a quadratic function of the nonlinear elastic shell strain tensor and the bending–curvature tensor, with coefficients depending on the initial curvature of the shell.
Moore–Gibson–Thompson thermoelasticity
Authors: Quintanilla Ramón
Published: July 2019

We consider a thermoelastic theory where the heat conduction is described by the Moore–Gibson–Thompson equation. In fact, this equation can be obtained after the introduction of a relaxation parameter in the Green–Naghdi type III model. We analyse the one- and three-dimensional cases. In three dimensions, we obtain the well-posedness and the stability of solutions. In one dimension, we obtain the exponential decay and the instability of the solutions depending on the conditions over the system of constitutive parameters. We also propose possible extensions for these theories.
Bilingualism May Be Protective Against Executive Function and Visual Processing Deficits Among Children With Attention Problems
Authors: Hardy Lindsay M. , Tomb Meghan , Cha Yoochai , Banker Sarah , Muñoz Francisco , Paul Alexis , Margolis Amy E.
Published: July 2019

Objective: The current study examined how the opposing effects of bilingualism and attention problems operate on executive functioning, visual processing, and verbal fluency in children with clinically significant levels of attention problems. Method: We tested whether bilingualism moderated associations between attention problems and visual processing, executive functioning, and verbal fluency. Results: Bilingual children ( n = 331) showed visual processing advantages relative to their monolingual peers ( n = 165), but only at higher, and not lower, levels of attention problems. Bilingualism did not moderate the association between attention problems and interference control; however, across all children, those with higher levels of attention problems had more difficulty with interference control. Monolingual children demonstrated advantages in verbal fluency relative to bilingual children, but this did not vary with attention problems. Conclusion: Visual processing advantages in bilinguals are detected among children with heightened attention problems, but advantages in interference control are not; findings may have implications for classroom interventions.
Manual-Based Personalized Intervention for Mothers of Children With SLD/ADHD: Effects on Maternal and Family Resources and Children’s Internalizing/Externalizing Behaviors
Authors: Al-Yagon Michal , Lachmi Michal , Danino Maly
Published: July 2019

Objective: This study explored manual-based personalized intervention for mothers of children with SLD and/or ADHD, as possibly contributing to (a) mothers’ parenting-related emotional/coping resources, (b) family functioning, and (c) child adjustment, compared with a control group of mothers. Method: Participants were 73 mothers of a child formally diagnosed with SLD and/or ADHD ages 7-17. Mothers were assigned to an experimental (n=40) or control (n=33) group. Short-term intervention utilized a three-stage emotion–cognition–behavior model. Pre-post assessments included maternal affective resources (positive/negative affect, parenting stress), maternal coping resources (general coping strategies, coping specifically with diagnosed child’s negative emotions), family cohesion/adaptability, and diagnosed child’s externalizing/internalizing syndromes. Results: Significant interactions emerged between group (experimental/control) and time (pre/post) for most study variables. Conclusion: Findings clearly revealed the intervention’s significant impact. Only the trained mothers demonstrated significant gains over time for most of the maternal, family, and child indices, whereas the untrained mothers did not.
Circulating endothelial and progenitor cells in age-related macular degeneration
Authors: Mucciolo Dario Pasquale , Marcucci Rossella , Sodi Andrea , Cesari Francesca , Murro Vittoria , Rogolino Angela , Rizzo Stanislao , Giusti Betti , Virgili Gianni , Prisco Domenico , Gori Anna Maria
Published: July 2019

Purpose:

To evaluate circulating endothelial and circulating progenitor cells as biomarkers in age-related macular degeneration patients (both exudative and atrophic forms) in order to establish the possible clinical implication of their assessment.

Methods:

We have enrolled 44 age-related macular degeneration patients: 22 patients with a recently diagnosed exudative (neovascular) form (Group A) and 22 patients with an atrophic (dry) form (Group B). The control group consisted of 22 age and sex-matched healthy subjects (Group C). The number of circulating endothelial progenitor cells (CD34+/KDR+, CD133+/KDR+, and CD34+/KDR+/CD133+), circulating progenitor cells (CD34+, CD133+, and CD34+/CD133+), and circulating endothelial cells were determined in the peripheral venous blood samples by flow cytometry. Neovascular age-related macular degeneration patients were evaluated at baseline and 4 weeks after a loading phase of three consequent intravitreal injections of ranibizumab.

Results:

Comparing age-related macular degeneration patients with the control group, endothelial progenitor cell and circulating progenitor cell levels were not significantly different, while age-related macular degeneration patients showed significantly higher levels of circulating endothelial cells ( p = 0.001). Anti–vascular endothelial growth factor treatment with intravitreal ranibizumab was associated with a significant reduction of endothelial progenitor cell levels, with no significant influence on circulating progenitor cells and circulating endothelial cells.

Conclusion:

We reported higher levels of circulating endothelial cells in age-related macular degeneration patients in comparison with the control group, thereby supporting the hypothesis of an involvement of endothelial dysregulation in the age-related macular degeneration and a reduction of the endothelial progenitor cell level in neovascular age-related macular degeneration patients after three intravitreal injections of ranibizumab.
Effect of marital status on patient-reported outcomes following total hip arthroplasty: a matched analysis with minimum 2-year follow-up
Authors: Lall Ajay C , Schwarzman Garrett R , Battaglia Muriel R , Chen Sarah L , Maldonado David R , Domb Benjamin G
Published: July 2019

Introduction:

Mental health and patient expectation have been identified as key predictors of recovery following THA; however, there is limited literature examining the effects of social support and marital status on patient-reported outcomes (PROs).

Methods:

Data were prospectively collected and retrospectively reviewed for patients who underwent THA between July 2008 and January 2016. Patients were included if they underwent primary THA during this period and if they had documented preoperative marital status of married, divorced, or never married. Married patients were group matched to non-married patients (divorced or never married) with similar sex, age, body mass index (BMI), gender distribution, and frequency of surgical approach.

Results:

There were 414 married patients and 98 non-married patients who were eligible and had minimum 2-year follow-up. Mean PROs were significantly worse in the non-married group than the married group for the following measures: modified Harris Hip Score ( p = 0.002), Harris Hip Score ( p = 0.002), Forgotten Joint Score ( p = 0.04), and the physical portions of the Veterans RAND ( p = 0.025) and Short Form ( p = 0.02) surveys.

Conclusions:

Our study demonstrated inferior absolute PRO scores at latest follow-up for patients who were non-married compared to married following THA. These results show that while total hip replacement may still yield clinical benefit in all patients, non-married patients may ultimately achieve an inferior functional status, and expectations should be adjusted accordingly. Physicians should assess levels of psychosocial support in their patients prior to undergoing hip arthroplasty in order to optimise results.
Squeaking and other noises in patients with ceramic-on-ceramic total hip arthroplasty
Authors: Baruffaldi Fabio , Mecca Rosaria , Stea Susanna , Beraudi Alina , Bordini Barbara , Amabile Marilina , Sudanese Alessandra , Toni Aldo
Published: July 2019

Introduction:

Noise in ceramic-on-ceramic (CoC) total hip arthroplasty (THA) is a potential symptom of abnormal bearing wear. Squeaking and other prosthetic hip noises are multi-factorial phenomena that can be analysed and may provide prognostic information.

Methods:

46 patients with noisy CoC bearings were investigated using X-ray, computed tomography and joint fluid analysis, and classified into either high or low risk of ceramic liner fracture groups according to previously published guidelines. Noise events from the bearings of 16 high risk cases which were subsequently revised were compared with 30 patients in the low risk control group who did not undergo revision. Noise events were analysed for their physical characteristics using a standardised protocol and classified as either low frequency and short duration ‘clicking’ or long duration and high frequency ‘squeaking’.

Results:

The peak frequency of squeaking during forward walking was significantly higher for patients in the case group who were revised, compared with the control group. The patient-reported onset of squeaking (46 months postoperatively) was earlier than short-noise emissions (82 months). In the standardised sequence of movements, short-noise always occurred more frequently than squeaking. Small heads (28 mm) were more likely to develop short-noise, while large heads (⩾32 mm) were more likely to develop squeaking.

Discussion:

Noise evaluation may provide additional value for predicting failure of CoC bearings, though some questions should be better investigated in a dedicated prospective trial.
Two-stage total hip arthroplasty following skeletal traction after extensive soft tissue release for severe limb-length discrepancy
Authors: Lee Soong Joon , Yoon Kang Sup
Published: July 2019

Introduction:

To maximise limb-length discrepancy (LLD) resolution during total hip arthroplasty (THA) for untreated developmental hip dysplasia or septic hip sequelae, THA following limb lengthening was introduced using different methods. We aimed to evaluate 2-stage THA results following limb lengthening via skeletal traction after extensive soft tissue release.

Method:

In total, 24 hips with severe LLD in 10 men and 14 women (mean age, 49.6 ± 15.2 years) underwent 2-stage THA and were followed thereafter (mean 6.3 ± 3.7 years). The entire abductor muscle origin was subperiosteally released from the ilium, and the soft tissue around the hip joint, including the psoas tendon, short external rotator, joint capsule, and adductor tendon, was extensively released. 2-stage THA was performed after 2-week skeletal traction using proximal tibial pins. During the final THA, 7 hips necessitated subtrochanteric shortening osteotomy (STO) for hip joint reduction. We evaluated the clinical and radiological results and especially focused on LLD and neurological complications.

Results:

The Harris Hip Score improved from 57.1 ± 9.6 to 88.3 ± 6.3 points. No patients showed worse abductor power. LLD improved from 5.0 ± 2.0 to 1.4 ± 1.0 cm. No permanent neurological complications occurred except for 1 transient peroneal nerve palsy during traction, which resolved fully after cessation of traction. There were 2 hips with STO nonunion treated with osteosynthesis and stem revision.

Conclusion:

2-stage THA following skeletal traction after extensive soft tissue release showed favourable results in terms of neurologic complication prevention and LLD resolution. However, a large proportion of patients still necessitated shortening osteotomy with a risk for nonunion at the osteotomy site. Though surgical procedures might be complicated and necessitate longer hospital stays, 2-stage THA with extensive soft tissue release might be an alternative treatment option for patients with severe LLD willing to resolve their limb length discrepancy.
Surgical rejoining of small arm veins to enhance dialysis fistula maturation
Authors: Nauwelaers Sigi , Lansink Wouter , Schroë Herman , Lauwers Geert
Published: July 2019

Non-maturation of arteriovenous fistulas is a frequent problem after dialysis access creation, especially in the forearm. The presence of accessory veins may play an important role in the non-maturing fistula. Several surgical and endovascular techniques are described to deal with this problem. We describe a new surgical technique in which we perform a rejoining of the arm veins to create a single large run-off vessel with greater diameter and flow for haemodialysis.
Long-run labour flexibility in hospitality: A dynamic common correlated effects approach
Authors: Alemayehu Fikru Kefyalew , Tveteraas Sigbjørn Landazuri
Published: July 2019

Matching staff level to demand is a key lever for utilizing resources efficiently and raising productivity in hospitality. The aim of the current study is to measure the long-run labour flexibility – that is – how quickly labour adjust to demand changes. We estimate the short and long-run labour flexibility at the firm and department levels of hospitality organizations. To account for endogeneity, unobserved heterogeneity and unobserved common shocks, we used the dynamic common correlated effects model on daily performance data of 94 hotels and restaurants from Norway over 12 years, but with gaps. We found that these hotels and restaurants operated at suboptimal levels in the long run. The findings suggest that the organizations can enhance labour flexibility in each department and, in particular, in food and beverages.
Do parents perceive the abnormal eating attitudes of their adolescent children with anorexia nervosa?
Authors: Laporta-Herrero Isabel , Latorre Patricia
Published: July 2019

Parents are often the first to detect the initial signs of anorexia nervosa (AN) and take necessary measures to ensure that their children receive appropriate treatment. The evaluation of AN in adolescence is complicated by taking into account the tendency to minimize and deny the symptoms by adolescents, and the difficulty of parents in detecting the main symptoms. We compared the adolescent and parent scores on measures of disordered eating at initial presentation. The sample consisted of 62 adolescents diagnosed with AN, who attended an eating disorder children’s unit. Adolescents completed the Eating Attitudes Test (EAT-40) and their parents the Anorectic Behavior Observation Scale (ABOS). The questionnaire data were collected as part of the routine clinical practice and were obtained from clinical notes. The findings indicate no significant correlations between the EAT-40 and ABOS scores, or between AN subtypes according to parent observation of symptoms. There were significant differences between parents, with mothers reporting higher scores than fathers. This study highlights the importance of psychoeducation for parents on the early signs of AN, in order to improve recognition and diagnosis at initial assessment of their adolescent children in the early phases.
The effect of a stability and coordination training programme on balance in older adults with cardiovascular disease: a randomised exploratory study
Authors: Segev Daria , Hellerstein Devora , Carasso Rafi , Dunsky Ayelet
Published: July 2019

Background:

Cardiovascular diseases are considered a leading factor in mortality and morbidity. The older adult population with cardiovascular diseases has a higher risk of falls as compared to a matched age healthy population.

Objective:

To investigate the effect of stability and coordination training within a cardiac rehabilitation programme on fall risk in older adults with cardiovascular diseases enrolled in cardiac rehabilitation.

Methods:

Twenty-six people with cardiovascular diseases (age 74±8) were divided randomly into intervention and control groups. The intervention group received 20 min of stability and coordination exercises as part of their 80 min cardiac rehabilitation programme, while the control group performed the traditional cardiac rehabilitation programme, twice a week, for 12 weeks. Balance assessment was based on three tests: the Timed Up and Go, Functional Reach and Balance Error Scoring System, which were measured twice before the intervention, once following the intervention and once four weeks after the termination of the intervention. A two-way analysis of variance (group × time) with repeated measures was performed to examine differences between groups and between assessments.

Results:

Seventy per cent of participants in the intervention group adhered to the programme, with significant improvement post-intervention in the Timed Up and Go ( p < .01) and the Balance Error Scoring System ( p < .05) with no changes among the control group.

Discussion:

Stability and coordination training alongside a traditional cardiac rehabilitation programme may improve static and dynamic balance, and muscle strength, skills that are considered major components in postural control. Clinicians who work in cardiac rehabilitation centres should consider including this training alongside the routine cardiac rehabilitation programme.
Evaluating the convergent and discriminant validity of three versions of the frailty phenotype in heart failure: results from the FRAME-HF study
Authors: McDonagh Julee , Salamonson Yenna , Ferguson Caleb , Prichard Roslyn , Jha Sunita R , Macdonald Peter S , Davidson Patricia M , Newton Phillip J
Published: July 2019

Background:

Frailty is an important predictive measure of mortality and rehospitalisation in people with heart failure. To date, there are no frailty instruments validated for use in people with heart failure.

Aim:

The aim of this study was to evaluate the convergent and discriminant validity of three versions of the frailty phenotype in those with heart failure.

Methods:

A single site, prospective cohort study was undertaken among individuals with a confirmed diagnosis of heart failure. Frailty was assessed concurrently using three versions of the frailty phenotype: the original frailty phenotype and two modified versions; the Survey of Health, Ageing and Retirement in Europe frailty instrument (SHARE-FI) and the St Vincent’s frailty instrument. Convergent and discriminant validity were assessed by reporting the correlations between each version and related heart failure subconstructs, and by evaluating the ability of each version to discriminate between normal and abnormal scores of other physical and psychosocial scales specific to heart failure-related subconstructs.

Results:

The New York Heart Association classes were moderately correlated with the St Vincent’s frailty instrument ( r=0.47, P⩽0.001), SHARE-FI ( r=0.42, P⩽0.001) and the frailty phenotype ( r=0.42, P⩽0.001). The SHARE-FI and the St Vincent’s frailty instrument were both able to discriminate consistently between normal and abnormal scores in three out of five of the physical and psychosocial subconstructs that were assessed. The SHARE-FI was also able to discriminate between inpatients and outpatients who were classified as frail.

Conclusions:

Both the SHARE-FI and the St Vincent’s frailty instrument displayed good convergent and discriminant validity.
Considering temperature effect on robust principal component analysis orthogonal distance as a damage detector
Authors: Mujica Luis Eduardo , Gharibnezhad Fahit , Rodellar José , Todd Michael
Published: July 2019

In previous works, the authors have shown the feasibility of using classical and robust principal component analysis for damage detection on structures when ultrasonic guided waves are used. It has also been demonstrated that robust principal component analysis presents a higher probability of detection accuracy when data are corrupted. In the present work, a robust principal component analysis orthogonal distance is proposed as a new feature for damage detection strategy based on ultrasonic guided waves on structures subjected to uniform temperature changes. The effect of this temperature fluctuation on the signal propagation and also in the new feature is analyzed. Temperature compensation is applied to mitigate the effect of temperature changes on the reliability of the damage detection methodology. The proposed feature and damage detection strategy that considers these effects are tested on two structures: a laboratory scale composite plate and a large-scale complex composite that is representative of a component from an aerospace application. The promising result proves the ability of the new feature as a damage detection tool.