bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-Objective Pricing Optimization for a High-Speed Rail Network Under Competition
Authors: Cao Huizhuo , Li Xuemei , Vaze Vikrant , Li Xueyan
Published: April 2019

Multi-objective pricing of high-speed rail (HSR) passenger fares becomes a challenge when the HSR operator needs to deal with multiple conflicting objectives. Although many studies have tackled the challenge of calculating the optimal fares over railway networks, none of them focused on characterizing the trade-offs between multiple objectives under multi-modal competition. We formulate the multi-objective HSR fare optimization problem over a linear network by introducing the epsilon-constraint method within a bi-level programming model and develop an iterative algorithm to solve this model. This is the first HSR pricing study to use an epsilon-constraint methodology. We obtain two single-objective solutions and four multi-objective solutions and compare them on a variety of metrics. We also derive the Pareto frontier between the objectives of profit and passenger welfare to enable the operator to choose the best trade-off. Our results based on computational experiments with Beijing–Shanghai regional network provide several new insights. First, we find that small changes in fares can lead to a significant improvement in passenger welfare with no reduction in profitability under multi-objective optimization. Second, multi-objective optimization solutions show considerable improvements over the single-objective optimization solutions. Third, Pareto frontier enables decision-makers to make more informed decisions about choosing the best trade-offs. Overall, the explicit modeling of multiple objectives leads to better pricing solutions, which have the potential to guide pricing decisions for the HSR operators.
Anterior Cruciate Ligament Tear Promotes Skeletal Muscle Myostatin Expression, Fibrogenic Cell Expansion, and a Decline in Muscle Quality
Authors: Peck Bailey D. , Brightwell Camille R. , Johnson Darren L. , Ireland Mary Lloyd , Noehren Brian , Fry Christopher S.
Published: April 2019

Background:

Anterior cruciate ligament (ACL) tears result in significant quadriceps muscle atrophy that is resistant to recovery despite extensive rehabilitation. Recent work suggests an elevated fibrotic burden in the quadriceps muscle after the injury, which may limit recovery. Elucidating the mechanisms and cell types involved in the progression of fibrosis is critical for developing new treatment strategies.

Purpose:

To identify factors contributing to the elevated fibrotic burden found after the injury.

Study Design:

Descriptive laboratory study.

Methods:

After an ACL injury, muscle biopsy specimens were obtained from the injured and noninjured vastus lateralis of young adults (n = 14, mean ± SD: 23 ± 4 years). The expression of myostatin, transforming growth factor β, and other regulatory factors was measured, and immunohistochemical analyses were performed to assess turnover of extracellular matrix components.

Results:

Injured limb skeletal muscle demonstrated elevated myostatin gene ( P < .005) and protein ( P < .0005) expression, which correlated ( R2 = 0.38, P < .05) with fibroblast cell abundance. Immunohistochemical analysis showed that human fibroblasts express the activin type IIB receptor and that isolated primary human muscle-derived fibroblasts increased proliferation after myostatin treatment in vitro ( P < .05). Collagen 1 and fibronectin, primary components of the muscle extracellular matrix, were significantly higher in the injured limb ( P < .05). The abundance of procollagen 1–expressing cells as well as a novel index of collagen remodeling was also elevated in the injured limb ( P < .05).

Conclusion:

These findings support a role for myostatin in promoting fibrogenic alterations within skeletal muscle after an ACL injury.

Clinical Relevance:

The current work shows that the cause of muscle quality decline after ACL injury likely involves elevated myostatin expression, and future studies should explore therapeutic inhibition of myostatin to facilitate improvements in muscle recovery and return to sport.
Partial Transphyseal Anterior Cruciate Ligament Reconstruction: Clinical, Functional, and Radiographic Outcomes
Authors: Chambers Caitlin C. , Monroe Emily J. , Allen Christina R. , Pandya Nirav K.
Published: April 2019

Background:

With a steadily increasing rate of anterior cruciate ligament (ACL) injury and reconstruction in the pediatric population, disagreement remains regarding the optimal reconstruction technique for patients with ACL injury and ≥2 years of growth remaining.

Purpose:

This study aims to quantify the incidence of linear and angular growth disturbance of adolescents undergoing partial transphyseal ACL reconstruction (ACLR) while assessing graft failure rates, reoperation rates, and functional outcomes in the population.

Study Design:

Case series; Level of evidence, 4.

Methods:

Consecutive patients undergoing partial transphyseal ACLR by 2 surgeons were retrospectively reviewed. Radiographic outcomes, including bilateral limb length, mechanical axis deviation (MAD), mechanical lateral distal femoral angle (MLDFA), and medial proximal tibial angle (MPTA), were measured on long standing anterior-posterior view radiographs postoperatively. Growth disturbance was defined as ≥1-cm leg length discrepancy, ≥1-cm difference in MAD, or 5° difference in MLDFA or MPTA as compared with the nonoperative side and as MAD, MLDFA, or MPTA outside the established range of reference values. Clinical outcomes, including graft failure and reoperation, were recorded at each follow-up visit. Pediatric International Knee Documentation Committee (Pedi-IKDC) scores were collected electronically after last follow-up.

Results:

Twenty-four patients (mean ± SD age, 12.3 ± 0.9 years; 79.2% male) with a mean follow-up of 31.5 ± 17.1 months met inclusion criteria for the study. Overall postoperative growth disturbance incidence was 16.7% (4 of 24), but the incidence of growth disturbance was 66.7% (2 of 3) for those patients with >5 years of growth remaining. Seven patients (29.2%) required reoperation, most frequently for hardware removal. Two patients (8.3%) had graft failure with subsequent revision ACL reconstruction. One patient underwent bilateral medial distal femur hemiepiphysiodesis for genu valgum that was present before ACLR, but no other patients required guided growth procedures. In the subset of patients who completed a Pedi-IKDC questionnaire, the mean score was 94.8 ± 5.3.

Conclusion:

Overall, partial transphyseal ACLR has good functional outcomes and graft failure and reoperation rates, comparable with those seen with transphyseal and all-epiphyseal techniques. While postoperative growth disturbance occurred in 16.7% of the cohort, the severity was mild and well tolerated without necessitating secondary procedures. There is a high rate of growth disturbance of patients with >5 years of growth remaining (66.7%). Partial transphyseal ACLR represents a valid recommendation for adolescent patients with ACL injury and ≤5 years of growth remaining.
Radiographic Prevalence of Symphysis Pubis Abnormalities and Clinical Outcomes in Patients With Femoroacetabular Impingement Syndrome
Authors: Krishnamoorthy Vignesh P. , Kunze Kyle N. , Beck Edward C. , Cancienne Jourdan M. , O’Keefe Lauren S. , Ayeni Olufemi R. , Nho Shane J.
Published: April 2019

Background:

The decreased hip range of motion seen in femoroacetabular impingement syndrome (FAIS) may lead to compensatory increased motion at the symphysis pubis (SP) with resultant increased stress on the joint, which can subsequently lead to osteitis pubis.

Purpose:

To quantify the prevalence of SP abnormalities in patients with FAIS through the use of imaging modalities and to compare outcomes based on the presence of SP abnormalities.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Radiographs and magnetic resonance imaging (MRI) scans of 1009 consecutive patients who underwent primary hip arthroscopy for FAIS from January 2012 to January 2016 were identified. Exclusion criteria were patients undergoing revision or bilateral surgery, patients with dysplasia, and patients with less than 2-year follow-up. On radiographs, SP joints were reviewed for joint surface erosions, subchondral sclerosis and cysts, and ankylosis. MRI scans were reviewed for marrow edema in the subarticular pubic bone, subchondral sclerosis and cysts, joint surface erosions, and ankylosis. Patients with SP abnormalities were matched 1:2 to patients without SP abnormalities by age and body mass index. Outcomes included the Hip Outcome Score–Activities of Daily Living (HOS-ADL), HOS–Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), International Hip Outcome Tool–12 (iHOT-12), and visual analog scales (VAS) for pain and satisfaction.

Results:

830 patients were included; 23 (2.8%) demonstrated SP abnormalities. Of the 726 (72%) MRI scans reviewed, 15 (1.8%) showed bone marrow edema, subchondral sclerosis, erosions, or ankylosis. After matching, patients without SP abnormalities had significantly greater HOS-ADL (95.7 vs 83.0; P = .008), HOS-SS (91.6 vs 61.9; P = .003), iHOT-12 (89.5 vs 74.6; P = .046), and VAS satisfaction (91.3 vs 58.8; P = .004) scores, in addition to less postoperative pain (6.3 vs 23.5; P < .001). No significant differences were found in the mHHS (92.5 vs 82.2; P = .08). Patients without SP abnormalities had higher odds of achieving the minimal clinically important difference for the HOS-ADL (odds ratio [OR], 4.5; 95% CI, 1.3-14.1; P = .010), the HOS-SS (OR, 7.2; 95% CI, 1.8-18.5; P = .006), and the mHHS (OR, 14.5; 95% CI, 1.8-24.7; P = .013).

Conclusion:

A low prevalence (1.8%-2.6%) of SP joint abnormality is seen on imaging in patients with FAIS. These patients may demonstrate significantly inferior clinical outcomes and persistent postoperative pain after FAIS treatment.
Significance of spermatic cord invasion in radical inguinal orchidectomy: Will a modified subinguinal orchidectomy suffice?
Authors: Haroon Usman M , Bhatt Nikita R , Akram Ch Muhammad , Flood Hugh D , Giri Sibhasis K
Published: April 2019

Introduction and objectives:

Radical inguinal orchidectomy with ligation and division of the spermatic cord at the deep inguinal ring is the treatment of choice for testicular mass suspicious of cancer. In the era of organ preserving and minimally invasive surgery, it may be possible to propose a less radical sub-inguinal orchidectomy that may avoid the morbidity associated with opening the inguinal canal. The effect of this approach on oncological margins is not known. The aim of this article was to investigate the presence of spermatic cord involvement after a radical inguinal orchidectomy with a view to test feasibility of a modified sub-inguinal approach for testicular tumour excision.

Materials and methods:

A retrospective study on all orchidectomies performed for suspected testicular cancer was performed at a single hospital from over an 8-year period from January 2005 to December 2013. Non-cancerous lesions were excluded after histopathological review. All testicular malignancies were included and detailed histopathological review was performed.

Results:

A total of 121 orchidectomies were performed over the 8-year period. Three patients had spermatic cord involvement. Spermatic cord involvement did not adversely affect the outcome in these patients after a median follow-up of 5 years irrespective of tumour histology. The proximal spermatic cord was not involved in any testicular germ cell tumours on further cord sectioning, the only patient with proximal cord involvement had a B-cell lymphoma.

Conclusion:

We postulate that a sub-inguinal modified orchidectomy may be a less invasive alternative to radical inguinal orchidectomy, with comparable oncological outcomes based on low risk of spermatic cord involvement, which in itself is not a prognostic factor. We require further long-term follow-up studies on patients who have undergone this approach to validate the oncological outcomes and report the possible advantage of lower post-operative complications with this technique.
Abriendo Puertas: Evaluation of a Parent Education Program for Latinos
Authors: Caal Selma , Moore Kristin , Murphy Kelly , Lawner Elizabeth , Rojas Angela , DeMand Alex
Published: April 2019

This study examined the impact of the Abriendo Puertas parent education program among a large sample of low-income, Latino parents and caregivers of preschool children. In all, 922 parents were randomly assigned to the program ( n = 468) or a waitlist control group ( n = 454). Pretest data and posttest data (5-6 weeks postintervention) from parents (86.4% response rate) were collected from both the treatment and control groups. At each time point, parents reported on their knowledge, attitudes, and behaviors related to enhancing their children’s school readiness. Confirmatory factor analyses were conducted to assess the factorial validity of each survey scale, and path analyses were conducted to compare the outcomes of the treatment and control groups. In addition, to assess fade-out of program affects among treatment parents, follow-up data were collected 3 months postintervention. Intent-to-treat analyses found that, compared with the control group, the treatment group adopted parenting practices that enhanced preschool children’s preparation for school, gained knowledge about high-quality early child care and education settings, improved their ability to set goals for their children, and gained an appreciation for their role as models for their children. No differences were found between the control and treatment groups on parenting practices related to emotional expression, parental advocacy, or healthy behaviors. Results indicate that the Abriendo Puertas program improved parents’ and caregivers’ knowledge, attitudes, and behaviors. Results of this evaluation help build the evidence base on culturally relevant parenting programs for Latino parents of preschoolers.
Examining the 8-Year Trajectory of Posttraumatic Stress Symptoms in Children Exposed to Intimate Partner Violence
Authors: Galano Maria M. , Grogan-Kaylor Andrew , Clark Hannah M. , Stein Sara F. , Graham-Bermann Sandra A.
Published: April 2019

Millions of children witness intimate partner violence (IPV) each year, and the effects of these experiences are substantial. One of the more common sequelae of exposure to IPV is the development of posttraumatic stress symptoms (PTSS). Given the chronic nature of both IPV and PTSS, there is a need for prospective research on long-term mental health outcomes following IPV exposure in childhood. This study prospectively examines trajectories of PTSS over an 8-year period, beginning from the preschool period. This study also investigates factors that may be associated with these trajectories, including intervention participation, continued IPV exposure, and the caregiving environment. A total of 120 mother–child dyads participated in four study waves over an 8-year period, beginning when children were between the ages of 4 and 6. Mothers and children participated in an intervention between baseline and Time 2. At the onset of the study, all mothers reported experiencing IPV over the previous year. Findings demonstrate that, in general, children experienced worsening of their PTSS over the 8-year trajectory, and few factors were significantly associated with this trajectory. There were no associations between intervention participation, parenting behaviors, and long-term child PTSS outcomes; however, there were significant associations between amount of IPV exposure, mother’s level of PTSS, and children’s PTSS outcomes. These results underscore the need to better understand the impact of early-life exposure to IPV, as well as the need for interventions tailored to this developmental period. Furthermore, these findings highlight the long-term negative associations between chronic exposure to IPV and child well-being, as well as the significant connections between caregiver and child mental health.
Exploring the Evolution of Educational Technology Policy in Ireland: From Catching-Up to Pedagogical Maturity
Authors: McGarr Oliver , Johnston Keith
Published: April 2019

Many countries have launched national educational technology policies in the past number of decades aimed at increasing technology integration in schools. This article analyses educational technology policy in Ireland from 1997 to 2017 and draws attention to an underlying economic agenda for technology integration in schools, set against a backdrop of neoliberal discourses. The study found that the challenge of integrating technology is no longer understood as simply a challenge of “integration” but rather as a realignment of the existing education system toward a more student-centered experience. Most recent policy also recognizes the complex and contextually bound nature of the associated change process suggesting a maturation of understanding in respect of the intersection between technology and education. The article also highlights the symbolic function of policy and the role it plays in representing the educational system in a particular light to national and international audiences. Recognizing the symbolic function of educational technology policy and the neoliberal ideology underpinning it can help identify the reasons for the apparent failures of past attempts to integrate technology in schools as well as informing future policy iterations.
Impact of Reported β-Lactam Allergy on Management of Methicillin-Sensitive Staphylococcus aureus Bloodstream Infections
Authors: Veve Michael P. , January Spenser E. , Kenney Rachel M. , Zoratti Edward M. , Zervos Marcus J. , Davis Susan L.
Published: April 2019

Background:

Antistaphylococcal β-lactams antibiotics are the preferred treatment for methicillin-sensitive Staphylococcus aureus (MSSA) infections. Patient-reported β-lactam allergies may complicate antibiotic decision-making and delay optimal therapy, with potential implications on patient outcomes.

Objective:

To determine the impact of reported β-lactam allergies on the receipt of optimal therapy and outcomes for MSSA bloodstream infections (BSI).

Methods:

Retrospective, matched cohort of MSSA BSI patients with and without a reported β-lactam allergy. The primary end point was receipt of optimal therapy, defined as an antistaphylococcal β-lactam.

Results:

Two hundred twelve patients were included: 53 with reported β-lactam allergy and 159 without β-lactam allergy. Commonly reported β-lactam allergies were 26 (49%) immune-mediated reaction and 8 (15%) intolerance, with 19 (36%) having no documented reaction. Optimal antibiotics were given to 135 patients without a β-lactam allergy and 37 patients with a reported β-lactam allergy (85% vs 70%, P = .015). Among reported β-lactam allergy patients, those without a documented reaction were less likely to receive optimal therapy (47% vs 79 %, P = .042). Reported β-lactam allergy was not associated with clinical response ( P = .61) or MSSA-related mortality ( P = .83). When adjusting for immunosuppression, variables independently associated with optimal therapy were β-lactam allergy (adjusted odds ratio [adjOR], 0.3; 95% confidence interval [CI], 0.1-0.6) and infectious diseases consultation (adjOR, 6.1; 95%CI, 2.7-13.9). Optimal antibiotic use was associated with decreased all-cause 90-day mortality (adjOR, 0.23; 95%CI, 0.09-0.54).

Conclusions:

Patients with reported β-lactam allergies, particularly those without a documented reaction, were less likely to receive optimal antibiotics for MSSA BSI. Patient outcomes may be improved with enhanced quality of allergy history and routine infectious disease consultation.
Psychiatric Manifestations With Sacubitril/Valsartan: A Case Report
Authors: Wooster Jessica , Cook Elizabeth A. , Shipman Denver
Published: April 2019

Sacubitril/valsartan is an angiotensin receptor-neprilysin inhibitor approved for the treatment of heart failure with reduced ejection fraction (HFrEF). Valsartan is well studied, but sacubitril has much left to understand. This report describes a 31-year-old African American female diagnosed with HFrEF who presented with a 7-day history of psychiatric symptoms following a dose increase in sacubitril/valsartan. Prior to the dose increase, the patient had no history of psychiatric diagnoses, but upon hospital presentation, family described instances of confabulation, paranoia, delusions, hallucinations, and sleep disturbances. Laboratory tests were unremarkable, ruling out infectious processes and illicit substance use. However, cranial computed tomography scans depicted intracranial volume loss abnormal for age with commensurate mild ventricular enlargement. Sacubitril/valsartan was discontinued inpatient, symptoms resolved, and the medication intolerance was documented. Clinical trials involving sacubitril/valsartan lack systematic documentation of cognitive symptoms, but active studies exploring the role of neprilysin inhibition may expand knowledge of possible psychiatric adverse effects.
Analytical solution of capsizing moments in ship chamber under pitching excitation
Authors: Zhang Yang , Shi Duanwei , Shi Lang , Xia Re , Cheng Xionghao , Zhou Ji
Published: April 2019

As the core structure of the shiplift, the ship chamber is a typical rectangular container with filling water depth less than 0.1. Even small pitching excitation could produce large liquid sloshing and significant capsizing moment, and lead to a catastrophic overturning accident. As a basis of dynamical modeling and simulation of the shiplift, a fluid dynamic model is presented to predict the capsizing moments based on the Housner theory. Assuming a time-harmonic pitching excitation, the potential solution reflecting dynamic characteristics between pitching excitation and the fluid free surface oscillation angle is expanded analytically. A series of engineering formulas for the capsizing moments, including impulsive and convective parts, are then imposed. Comprehensive numerical analysis further extends the applicability of formulations to the cases for most of ship chambers or other rectangular tanks with similar filling water depth. The validation of proposed scheme is extensively demonstrated through comparison with other theoretical method and experimental results, and the interaction between the forcing frequency, the capsizing moments and fluid natural frequency has been qualitatively descripted. The results exhibited that the present model has accurate description under the conditions of small pitching angles and only considering the capsizing moments coming from the convective pressures can ensure high accuracy in engineering design.
Design of pure rolling line gear mechanisms for arbitrary intersecting shafts
Authors: Chen Zhen , Zeng Ming
Published: April 2019

Design of pure rolling line gear mechanisms for an arbitrary angle intersecting shafts was presented in this article. Based on the active design method of meshing line function for orthogonal shafts, three meshing types of conjugated tooth surfaces for an arbitrary angle intersecting shafts were discussed, including the parametric equations of different generatrix circles, the mathematical models of tooth surfaces, and central curves to be constructed, respectively. The validity of the active designed meshing line function was verified according to meshing equations, and the theoretical sliding rations were analyzed to prove pure rolling meshing. Then basic design parameters of pure rolling line gear mechanisms for the geometry design were determined, and the main structural parameters were obtained therefrom. Lastly, three groups of numerical examples were proposed according to mathematical models. Resin samples of line gears were processed by rapid prototyping technology and the kinematic performance of the pure rolling line gear mechanisms were validated. This paper laid the foundation of geometry and parameter design for pure rolling line gear mechanisms for an arbitrary angle intersecting shafts.
Improvement in the performance with less stiff air layer formation around the rubber tube-pasted grinding wheel
Authors: Guha Spandan , Das Partha Protim , Chakraborty Shankar
Published: April 2019

In the grinding operation, a stiff layer of air gets formed around the periphery of the grinding wheel that causes deterioration of its performance. In the present work, in order to restrict the generation of stiff air layer around the periphery of the grinding wheel, a rubber tube is pasted on its surface to improve the grinding performance. An experimental investigation is carried out with low alloy steel as the work material. Taguchi's L9 orthogonal array is considered for the design of experiments while taking cutting speed, depth of cut, and type of the cutting fluid as the input grinding parameters. A comparative analysis using rubber tube-pasted grinding wheel and normal grinding wheel reveals that the developed wheel significantly improves the grinding performance with respect to surface roughness, amplitude of vibration and grinding ratio, as compared to the normal wheel. Moreover, grey relational analysis aided with fuzzy logic is applied in the experimental results to derive the optimal combination of process parameters for further enhancement of the grinding performance. Finally, analysis of variance results identify cutting speed as the most significant parameter while grinding with normal wheel, whereas depth of cut appears to be the most important parameter while machining with rubber tube-pasted grinding wheel.
The Kirkbride buildings in contemporary culture (1850–2015): from ‘moral management’ to horror films
Authors: Pérez-Fernández Francisco , López-Muñoz Francisco
Published: April 2019

The so-called ‘Kirkbride Plan’ is a type of mental institution designed by the American psychiatrist Thomas Story Kirkbride. The Kirkbride-design asylums were built from 1848 to the end of the nineteenth century. Their structural characteristics were subordinated to a certain approach to moral management: exposure to natural light, beautiful views and good air circulation. These hospitals used several architectural styles, but they all had a similar general plan. The popularity of the model decreased for theoretical and economic reasons, so many were demolished or reused, but at least 25 of the original buildings became protected places. Over the years, surrounded by a legendary aura, these buildings have become a leitmotif of contemporary popular culture: ‘the asylum of terror’.
Reduction of aerodynamic forces on turbine blading by asymmetric layout of struts based on flow interaction between rotor-strut-volute
Authors: Gao Jie , Meng Fusheng , Jia Xiaoquan , Fu Weiliang , Yue Guoqiang
Published: April 2019

The flows in the power turbine and nonaxisymmetric exhaust volute with struts are closely coupled and inherently unsteady for marine gas turbines, and the flow interactions between them have a significant influence on the rotor and strut blade aerodynamic force characteristics; however, the asymmetric flow interactions have not been taken into account properly in current turbine design approaches. This paper is a continuation of the previous work and aims to clarify effects of different symmetrical and asymmetric layouts of struts on the flow interactions between power turbine and exhaust volute, in an attempt to seek an optimal layout of struts with the objective of making use of the mentioned asymmetric flow interactions to reduce the rotor and strut blade aerodynamic forces. This work was carried out using coupled unsteady simulations with the full annulus computational domain including 76 rotor blades, 9 strut blades, and an exhaust volute. Results show that the level of aerodynamic force at specific frequencies on the power turbine blade surface can be reduced by applying a proper distribution of asymmetric layout of struts; using the asymmetric strut design, although the reduction of the rotor blade aerodynamic force is weak, the strut blade aerodynamic force has been reduced significantly; the asymmetric layout of struts does not improve the overall flow characteristics of turbines very much. The present results indicate that it is possible to reduce vibration and increase blade fatigue life by asymmetric strut designs.
Higher education student pathways to ebook usage and engagement, and understanding: Highways and cul de sacs
Authors: Casselden Biddy , Pears Richard
Published: April 2019

Ebooks have enthusiastically been adopted by academic libraries, viewed as a golden bullet by library professionals, resulting in efficient resource use, space saving, student satisfaction and accommodating millennial generation study habits. A small-scale online survey undertaken at Northumbria and Durham Universities investigated students’ ebook use, examining aspects of learning ebooks support, searching strategies, devices used for ebook access, and reading and use strategies. Ninety-two responses were analysed using a mixed methods approach. Despite many advantages of ebooks including portability, availability, functionality and searching, results, demonstrated sentiment regarding ebooks was not wholly positive. There were frustrations regarding the complexity of ebook provision, publisher’s restrictions and the lack of compatibility with reading devices. A key finding related to ebook interrogation which involved greater targeted searching of content and a ‘bite-size’ approach to reading. Caution must be observed to ensure that library collections facilitate a complexity of learning styles, and provide opportunities for students to better digest content.
Information as a construction
Authors: Bosancic Boris , Matijevic Marta
Published: April 2019

The purpose of this review paper is to outline the constructivist approach to the notion of information from two perspectives. The first perspective explores the role of ‘constructed’ information in the ‘constructivist niche’ – a common name for the appropriate viewpoints in different science fields, such as cognitive and neuroscience, psychology, cybernetics and biology of cognition. The second perspective considers library and information science (LIS) papers in which information is treated as a constructed entity. This paper assumed the origin of the notion of information to be a construction as defined in the ‘constructivist niche’ that is based upon communication theory and cybernetics. Conversely, the origin of the notion of information as a construction as per LIS can be found in Bateson’s definition of information as a ‘difference which makes the difference,‘ as well as in the 1970s LIS definition wherein information is associated with the direction of a cognitive viewpoint, as in a ‘cognitive turn’. The study showed that ‘information as a construction‘, except in a few cases, did not play a significant role in the constructivist theories nor in LIS. LIS researchers reduce the concept of information to a subjective, socially-constructed entity which inherently results in different interpretations.
Extending understandings of risk in organised sport
Authors: Liu Lucen , Bruce Toni
Published: April 2019

Risk has been particularly associated with pain, injury, illness and even death in the studies of organised high-performance sport: in short, physical risk has been the primary focus. In contrast, this article explores the cultural dimensions of risk alongside the physical risk, which are revealed in an in-depth ethnographic study of waka ama (outrigger canoeing),1 an organised sport that is profoundly influenced by indigenous Māori culture. Waka ama participants’ discursive, embodied and agential responses to risk are presented as factionalised stories, a blend of fact and fiction that respects Māori oral traditions as a form of knowledge. The findings related to the influences of cultural concepts on shaping participants’ perceptions and responses to risk emerge as important new understandings of risk in organised sport.
Development of a multiaxis active seat mount to mitigate helicopter aircrew whole-body vibration exposure
Authors: Chen Yong , Zhang Shao , Chang Jiaxin , Fereidooni Amin , Wickramasinghe Viresh
Published: April 2019

This article presents the development and evaluation of a proof-of-concept multiaxis and actively controlled helicopter seat mount for aircrew whole-body vibration reduction. The multiaxis seat mount is designed to be installed between the helicopter seat floor and the seat supporting structure to minimize the impact on crashworthiness requirements of the helicopter seat. The design involves multiple miniature force actuators to counteract the vibrations of the seat frame and occupant transmitted from the helicopter floor in three orthogonal directions. The actuators are controlled by an adaptive feedforward filtered-x least mean square algorithm to cancel the helicopter floor vibration input. The prototype active seat mount design was tested in various configurations with a shaker table providing representative Bell-412 helicopter vibration inputs. Test results demonstrated that the vibrations of the seat frame and mannequin occupant body were suppressed simultaneously, and the major N/rev harmonic peaks of the occupant’s whole-body vibration were reduced by more than 20 dB. This demonstrated that the multiaxis active seat mount design can mitigate the whole-body vibration exposure of the helicopter aircrew to improve their ride quality and reduce adverse health effect.
Prelude to Death or Practice Failure? Trombley-Brennan Terminal Tissue Injury Update
Authors: Brennan Mary R. , Thomas Lily , Kline Myriam
Published: April 2019

In 2012, we published a study in this journal exploring the emergence of unique skin changes in end-of-life patients admitted to a palliative care unit. The purpose of the study was to describe the skin changes and identify the relationship between these changes and time of death. In the above study of 80 patients, the skin changes were found to be unique and different from Kennedy terminal ulcers and deep tissue injuries. Median time from identification of skin changes and death was 36 hours. The phenomenon was named as Trombley-Brennan terminal tissue injury. The current article presents findings that include the study of additional 86 patients. The results further validate the phenomenon and its relationship with time of death.
Outcomes and Cost of Patients With Terminal Cancer Admitted to Acute Care in the Final 2 Weeks of Life: A Retrospective Chart Review
Authors: Kyeremanteng Kwadwo , Ismail Abid , Wan Cynthia , Thavorn Kednapa , D’Egidio Gianni
Published: April 2019

Background:

Patients with terminal conditions are often admitted to the emergency department (ED) for acute medical services, but studies have suggested that multiple ED admissions may negatively impact end-of-life (EOL) care. Research have shown that incorporating palliative care (PC) is integral to optimal EOL care, but it is an aspect of medical practice that is often neglected. The current study sought to provide an overview of health outcomes and hospital costs of patients with cancer admitted to The Ottawa Hospital and/or received acute medical services during their final 2 weeks of life. Cost comparisons and estimates were made between hospital and hospice expenditures.

Methods:

We conducted a retrospective chart review of palliative patients who died at The Ottawa Hospital in 2012. A total of 130 patients who visited the ED within 2 weeks of death were included in the analyses.

Results:

In this cohort of patients, 71% of admitted patients did not have advanced care directives and 85% experienced a metastasis, but only 18% had a PC medical doctor. Patients were hospitalized, on average, for 7 days and hospitalization costs exceeded the estimated hospice cost by approximately 2.5 times (Can$1 041 170.00 at Can$8009.00/patient vs Can$401 570.00 at Can$3089.00/patient, respectively).

Conclusion:

Our study highlighted the importance of PC integration in high-risk patients, such as those in oncology. Patients in our sample had minimal PC involvement, low advanced care directives, and accrued high costs. Based on our analyses, we concluded that these patients would have likely benefited more from hospice care rather than hospitalization.
Factor Structure and Psychometric Properties of the Child Oral and Motor Proficiency Scale
Authors: Park Jinhee , Pados Britt Frisk , Thoyre Suzanne M. , Estrem Hayley H. , McComish Cara
Published: April 2019

The purpose of this study was to identify the factor structure of the Child Oral and Motor Proficiency Scale (ChOMPS) and to evaluate the psychometric properties, including internal consistency reliability, test–retest reliability, and construct validity as measured by convergent and known-groups validity. Principal component analysis with varimax rotation conducted on responses from 364 parents of children between 6 months and 7 years of age identified four subscales: complex movement patterns, basic movement patterns, oral-motor coordination, and fundamental oral-motor skills. Acceptable internal consistency reliability (Cronbach’s α = .97) and test–retest reliability ( r = .98) were found. Convergent and known-groups validity were supported by significant associations between the ChOMPS and validation measures, as well as significant differences in the ChOMPS scores between children with and without feeding problems. The ChOMPS is a 63-item parent-report measure of eating, drinking, and related motor skills in children aged 6 months to 7 years with evidence of reliability and validity.
Reflections in relation to the article of Villalobos and Razeto
Authors: Maturana Romesín Humberto
Published: April 2019

This is a very interesting article, and I would like to make a few epistemological and operational reflective commentaries that it evokes in me.
Group Threat at the Ground Level: Support for Ethnically Radical Parties in the Northern Ireland Assembly
Authors: Beaudette Donald M. , Kirkpatrick Andrew B.
Published: April 2019

Ethnic settlement patterns and other forms of everyday interethnic social contact have the potential to influence voter preferences for ethnic tribune parties who position themselves as the most strident protectors of, and flagbearers for, their respective ethnic groups. Previous studies on this topic have come to rival conclusions, with some finding that increased intergroup contact and residential mixing produce a corresponding increase in support for tribune parties and others finding the opposite. This study uses a combination of data from elections to the Northern Ireland Assembly from 1998 to 2017 and survey data from 2016 to evaluate these rival arguments and assess the extent to which the broader institutional and demographic context in which political competition takes place condition responses to intergroup contact. Our findings indicate that voters in both declining and ascending demographic groups respond similarly to intergroup contact, expressing less support for tribune parties in contexts where residential patterns and social networks provide more opportunities for intergroup contact. These results highlight the conditional nature of the effectiveness of consensus-based institutions in divided societies: they can create incentives for moderation, but those incentives are most likely to be realized in contexts where rival groups experience a high level of integration.
Leiomyomatous Hamartomas of the Oral Cavity: Clinicopathological and Immunohistochemical Features of 4 Cases and Literature Review
Authors: Sánchez-Romero Celeste , Bonan Paulo Rogério Ferreti , Pires Fábio Ramôa , Oliveira Silva-Junior Geraldo , Delgado Azañero Wilson , Almeida Oslei Paes de , Perez Danyel Elias da Cruz
Published: April 2019

Objective. To present 4 new cases of oral leiomyomatous hamartomas (OLH), describing its clinical, microscopical, and immunohistochemical features, and a literature review. Methods. The OLH cases were retrieved from the files of 2 Brazilian and 1 Peruvian oral pathology services. Clinical data were obtained from the pathology reports. Microscopical features were reviewed, and immunohistochemical reactions were performed. A review of the English-language literature about OLH was done. Results. The sample was composed of 3 females (4-, 10-, and 15-year-old) and 1 male (3-year-old). Three cases affected the dorsum of the tongue and one the incisive papilla, and all presented sessile or pedunculated smooth nodules. Microscopically, the lesions were composed of varying-size fascicles of smooth muscle fibers in a fibrous connective tissue background. Immunohistochemistry revealed positivity of the smooth muscle bundles for myogenic markers. The English-language literature review revealed 38 OLH cases reported, most were congenital or diagnosed up to 5 years old. The main locations were tongue and anterior maxilla. Conclusions. Although OLH is a rare lesion, it must be considered in the differential diagnosis of midline tongue or maxillary masses in newborns, infants, and youngsters.
Rigid Internal Fixation of Proximal Crescentic Metatarsal Osteotomy in Hallux Valgus Correction
Authors: Stith Andrew , Dang Debbie , Griffin Matthew , Flint Wesley , Hirose Christopher , Coughlin Michael
Published: April 2019

Background:

The purpose of this study was to evaluate outcomes utilizing a low-profile titanium plate and screw construct for rigid fixation of first ray proximal crescentic osteotomies in the treatment of hallux valgus.

Methods:

Forty-eight patients (53 feet) with mild to severe hallux valgus were prospectively enrolled and completed 12-month follow-up. All were treated with a proximal crescentic osteotomy, fixed with a low-profile titanium plate, distal soft tissue correction, with or without an Akin osteotomy. Recorded outcomes included change in first ray dorsiflexion angles, need for hardware removal, radiographic and clinical evaluation, pain, and American Orthopaedic Foot & Ankle Society (AOFAS) scores.

Results:

All patients achieved radiographic union of their osteotomy. An Akin osteotomy was performed in 83% of patients. Seventeen feet (32%) had hardware removed. First ray dorsiflexion angles increased from a mean of 1.6 degrees preoperatively to 5.0 degrees postoperatively ( P < .001). Dorsal malunion, defined as change in dorsiflexion angle greater than 1 standard deviation above the mean, occurred in 7 feet. The mean hallux valgus angle improved from 29 to 9 degrees ( P < .001). The mean 1-2 intermetatarsal angle decreased from 14 to 6 degrees ( P < .001). The first metatarsophalangeal joint range of motion decreased from 77 to 59 degrees ( P < .001). The mean visual analog scale score improved from 4 to 0.7 ( P < .0001). The mean AOFAS score improved from 55 to 89 points ( P < .001).

Conclusion:

Proximal crescentic metatarsal osteotomy, fixed with a low-profile titanium plate and screw construct, with distal soft tissue repair, and Akin osteotomy as indicated, was a safe and reliable method for operative treatment of hallux valgus.

Level of Evidence:

Level IV, retrospective case series.
Characterizing the Biomedical Data-Sharing Landscape
Authors: Villanueva Angela G. , Cook-Deegan Robert , Koenig Barbara A. , Deverka Patricia A. , Versalovic Erika , McGuire Amy L. , Majumder Mary A.
Published: April 2019

Advances in technologies and biomedical informatics have expanded capacity to generate and share biomedical data. With a lens on genomic data, we present a typology characterizing the data-sharing landscape in biomedical research to advance understanding of the key stakeholders and existing data-sharing practices. The typology highlights the diversity of data-sharing efforts and facilitators and reveals how novel data-sharing efforts are challenging existing norms regarding the role of individuals whom the data describe.
Genomic Data-Sharing Practices
Authors: Villanueva Angela G. , Cook-Deegan Robert , Robinson Jill O. , McGuire Amy L. , Majumder Mary A.
Published: April 2019

Making data broadly accessible is essential to creating a medical information commons (MIC). Transparency about data-sharing practices can cultivate trust among prospective and existing MIC participants. We present an analysis of 34 initiatives sharing DNA-derived data based on public information. We describe data-sharing practices captured, including practices related to consent, privacy and security, data access, oversight, and participant engagement. Our results reveal that data-sharing initiatives have some distance to go in achieving transparency.
Do Community Treatment Orders in Psychiatry Stand Up to Principalism: Considerations Reflected through the Prism of the Convention on the Rights of Persons with Disabilities
Authors: Newton-Howes Giles
Published: April 2019

Compulsory psychiatric treatment is the norm in many Western countries, despite the increasingly individualistic and autonomous approach to medical interventions. Community Treatment Orders (CTOs) are the singular best example of this, requiring community patients to accept a variety of interventions, both pharmacological and social, despite their explicit wish not to do so. The epidemiological, medical/treatment and legal intricacies of CTOs have been examined in detail, however the ethical considerations are less commonly considered. Principlism, the normative ethical code based on the principles of autonomy, beneficence, non-maleficence and justice, underpins modern medical ethics. Conflict exists between patient centred commentary that reflects individual autonomy in decision making and the need for supported decision making, as described in the Convention on the Rights of Persons with Disabilities (CRPD) and the increasing use of such coercive measures, which undermines this principle. What appears to have been lost is the analysis of whether CTOs, or any coercive measure in psychiatric practice measures up against these ethical principles. We consider whether CTOs, as an exemplar of coercive psychiatric practice, measures up against the tenets of principalism in the modern context in order to further this debate.
Thought Leader Perspectives on Participant Protections in Precision Medicine Research
Authors: Hammack Catherine M. , Brelsford Kathleen M. , Beskow Laura M.
Published: April 2019

Precision medicine research is rapidly taking a lead role in the pursuit of new ways to improve health and prevent disease, but also presents new challenges for protecting human subjects. The extent to which the current “web” of legal protections, including technical data security measures, as well as measures to restrict access or prevent misuse of research data, will protect participants in this context remains largely unknown. Understanding the strength, usefulness, and limitations of this constellation of laws, regulations, and procedures is critical to ensuring not only that participants are protected, but also that their participation decisions are accurately informed. To address these gaps, we conducted in-depth interviews with a diverse group of 60 thought-leaders to explore their perspectives on the protections associated with precision medicine research.
The Validity of the SNAP-IV in Children Displaying ADHD Symptoms
Authors: Hall Charlotte L. , Guo Boliang , Valentine Althea Z. , Groom Madeline J. , Daley David , Sayal Kapil , Hollis Chris
Published: April 2019

The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) is a widely used scale that measures the core symptoms of attention deficit hyperactivity disorder (ADHD). However, there are contradictory findings regarding factor structure. Factor structure and measurement equivalence/invariance analysis on parent and teacher SNAP-IV for children referred for an ADHD assessment ( N = 250; 6-17 years), revealed a two-factor structure provided the best fit. SNAP-IV scores were also compared with clinician diagnosis of ADHD and research diagnoses of ADHD and hyperkinetic disorder. Parent ratings of inattention and hyperactivity/impulsivity were good predictors of research but not clinician diagnosis. For teacher ratings, only hyperactivity/impulsivity scores were associated with research and clinician diagnosis. SNAP-IV scores showed high sensitivity but low specificity to clinician diagnosis. The SNAP-IV is a valid outcome measure for use in randomized controlled trials and clinical settings, and is best used as a screening rather than a diagnostic tool for ADHD.