bluuebunny/crossref_metadata_2025 huggingface dataset:
SVM predictive control for calcination zone temperature in lime rotary kiln with improved PSO algorithm
Authors: Zhongda Tian , Shujiang Li , Yanhong Wang , Xiangdong Wang
Published: September 2017

To improve the control performance of calcination zone temperature in a lime rotary kiln, a predictive control method based on a support vector machine (SVM) and improved particle swarm optimization (PSO) algorithm is proposed. As high-temperature thermal equipment, the lime rotary kiln requires accurate modelling because of its complex non-linearity and long delay characteristics. SVM has strong normalization and good learning ability compared with other modelling models such as neural network, partial least squares model and other non-linear regression models, which can avoid overfitting and local minimization problems. At the same time, it is sometimes difficult to obtain a large number of production sample data of lime rotary kiln. The modelling process based on SVM requires only a small amount of sample data. SVM is appropriate for the modelling of calcination zone temperature of the lime rotary kiln. The predictive control method in this paper utilizes SVM to establish a non-linear prediction model of calcination zone temperature of the lime rotary kiln. The calcination zone temperature can be achieved by output feedback of input control variables, the error and the error correction. The performance index function is established by the control deviations and control variables. An improved PSO algorithm with better convergence speed and accuracy is employed to obtain optimal control laws by rolling optimization. The stability of the control method has also been demonstrated. The proof process shows that the control method of this paper is asymptotically stable. The simulation results show that the prediction error of calcination zone temperature based on SVM is within ±20°C and the prediction accuracy is better. The model of calcination zone temperature in the lime rotary kiln based on SVM has good performance. The proposed predictive control method can make the output value of the calcination zone temperature of the lime rotary kiln fast and stable to track the change of the reference value. At the same time, in the presence of interference, the system can also track the reference value. The average single step rolling optimization time of the control variables needs to be 0.29 s, which can be used for the practical applications. The simulation results show that the proposed control method is effective.
H∞ control of anti-rollover strategy based on predictive vertical tire force
Authors: Zhao Wanzhong , Ji Lin , Wang Chunyan
Published: September 2017

The mainstream rollover evaluation index, lateral load transfer rate (LTR), is commonly used in the rollover control field. However, it is not instant enough to reflect the rollover tendency since it can only reflect the load transfer rate of one side wheels while single rear wheel leaves the ground first during rollover happens. In order to monitor the rollover tendency more instantly and improve the reliability of anti-rollover control system, a new evaluation index called predictive vertical tire force (PVTF) is proposed, which is based on the single vertical tire force and merges both iterative prediction and derivative prediction methods. Meanwhile, an optimization is taken to solve the contradiction between prediction time and deviation. Secondly, using the PVTF as the measurement output, an anti-rollover control system based on active steering is established in this paper. In order to achieve the desired tracking effect and anti-jamming capability, a two-way H∞ controller is adopted in the anti-rollover control system. Lastly, the simulation results of J-turn condition and NHTSA (national highway traffic safety administration) condition are conducted and the results indicate that the anti-rollover control system has strong stability and robustness. Meanwhile, benefit from the pre-warning function of PVTF, the controller is triggered earlier and the vertical tire forces of four wheels are controlled to be positive all the time, which is beneficial for handling stability.
Brain event-related potentials to phoneme contrasts and their correlation to reading skills in school-age children
Authors: Hämäläinen Jarmo , Landi Nicole , Loberg Otto , Lohvansuu Kaisa , Pugh Kenneth , Leppänen Paavo H. T.
Published: September 2017

Development of reading skills has been shown to be tightly linked to phonological processing skills and to some extent to speech perception abilities. Although speech perception is also known to play a role in reading development, it is not clear which processes underlie this connection. Using event-related potentials (ERPs) we investigated the speech processing mechanisms for common and uncommon sound contrasts (/ba/-/da/-/ga/ and /ata/-/at: a/) with respect to the native language of school-age children in Finland and the US. In addition, a comprehensive behavioral test battery of reading and phonological processing was administered. ERPs revealed that the children could discriminate between the speech sound contrasts (place of articulation and phoneme length) regardless of their native language. No differences emerged between the Finnish and US children in their change detection responses. The brain responses to the phoneme length contrast, however, correlated robustly with reading scores in the US children, with larger responses being linked to poorer reading skills. Finnish children also showed correlations between the reading and phonological measures and ERP responses, but the pattern of results was not as clear as for the US children. The results indicate that speech perception is linked to reading skills and this link is more robust for uncommon speech sound contrasts.
Organizational and Individual Level Antecedents of Psychological Capital and its Associated Outcomes: Development of a Conceptual Framework
Authors: Srivastava Urmila Rani , Maurya Vandana
Published: September 2017

The importance of positivity in life has been recognized long time back with the pioneering works of Seligman. Positive psychology as a field was founded on the belief that people want to lead meaningful and fulfilling lives, to cultivate what is best within them, and enhance their experiences of love, work and play. However, the potential need to incorporate the principles of positive psychology to enhance the lives of employees at workplace has been identified very lately. This review article starts with the journey from positive psychology to positive organizational behaviour (POB) followed by the elaborated conceptual development of psychological capital (PsyCap) and its uniqueness in relation to other positive constructs. Next section of the article presents evidence of major theoretical contributions in developing the field of POB and PsyCap along with distinction between states versus trait paradigm in Psychology. The purpose of this article is to provide an overview of recently introduced concept of PsyCap and reveal its antecedents and consequences. We have synthesized and integrated recent empirical research examining the nature of the construct of PsyCap and develop a conceptual framework regarding its individual and organizational antecedents and consequences for further understanding of the relevant issues in the area of PsyCap and POB. The organizational level antecedents of PsyCap included in this article are work engagement, organizational justice, workplace social support and authentic leadership. Likewise, individual level antecedents of PsyCap covered in this article are sense of humour and positive emotions. The major potential outcomes of PsyCap in the present article included both desirable (mental health, organizational citizenship behaviour (OCB), creative performance and ethical performance) and undesirable (incivility) work-related organizational outcomes. Several preliminary propositions have been offered to guide future research and the role of PsyCap within a broad theoretical and empirical context is discussed.

Finally, we have discussed the gaps in the relevant literature, major issues for future research on PsyCap along with implications and interventions about how management can enhance each within their employees for performance management, leadership development and HR development.
Iterated extended Kalman filter based visual-inertial odometry using direct photometric feedback
Authors: Bloesch Michael , Burri Michael , Omari Sammy , Hutter Marco , Siegwart Roland
Published: September 2017

This paper presents a visual-inertial odometry framework that tightly fuses inertial measurements with visual data from one or more cameras, by means of an iterated extended Kalman filter. By employing image patches as landmark descriptors, a photometric error is derived, which is directly integrated as an innovation term in the filter update step. Consequently, the data association is an inherent part of the estimation process and no additional feature extraction or matching processes are required. Furthermore, it enables the tracking of noncorner-shaped features, such as lines, and thereby increases the set of possible landmarks. The filter state is formulated in a fully robocentric fashion, which reduces errors related to nonlinearities. This also includes partitioning of a landmark’s location estimate into a bearing vector and distance and thereby allows an undelayed initialization of landmarks. Overall, this results in a compact approach, which exhibits a high level of robustness with respect to low scene texture and motion blur. Furthermore, there is no time-consuming initialization procedure and pose estimates are available starting at the second image frame. We test the filter on different real datasets and compare it with other state-of-the-art visual-inertial frameworks. Experimental results show that robust localization with high accuracy can be achieved with this filter-based framework.
‘It’s a big deal, being given a person’: why people who experience infertility may choose not to adopt
Authors: Smeeton Joe , Ward Jo
Published: September 2017

This article explores why individuals and couples who experience infertility and undergo treatment through new technologies do not subsequently go on to become parents via adoption. It does this in three ways: a review of the literature; interviews with those affected; and an online survey of views on adoption among people who have experienced infertility. It was found that couples do consider adoption alongside infertility treatment but it is usually a fallback choice. If adoption is to be perceived as an equal option, agencies need to offer support and advice at an earlier stage than is usual. Couples who are emotionally exhausted by medical interventions for their childlessness can then be helped off the infertility treadmill in order to become parents.
Social Isolation and Medicare Spending: Among Older Adults, Objective Isolation Increases Expenditures While Loneliness Does Not
Authors: Shaw Jonathan G. , Farid Monica , Noel-Miller Claire , Joseph Neesha , Houser Ari , Asch Steven M. , Bhattacharya Jay , Flowers Lynda
Published: September 2017

Objective: The purpose of this study was to evaluate the impact of objective isolation and loneliness on Medicare spending and outcomes. Method: We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to three-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality. Results: Objective isolation predicts greater spending, US$1,644 ( p < .001) per beneficiary annually, whereas loneliness predicts reduced spending, −US$768 ( p < .001). Increased spending concentrated in inpatient and nursing home (skilled nursing facilities [SNFs]) care; despite more health care, objectively isolated beneficiaries had 31% ( p < .001) greater risk of death. Loneliness did not predict SNF use or mortality, but predicted slightly less inpatient and outpatient care. Discussion: Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings.
Evaluation of genotoxicity and subchronic toxicity of standardized rose hip extract
Authors: Nagatomo A , Oguri M , Nishida N , Ogawa M , Ichikawa A , Tanaka-Azuma Y
Published: September 2017

Rose hip is the fruit of the rose plant, which is widely used in food, cosmetics and as a traditional medicine. Therefore, rose hip is considered safe and has a sufficient history of consumption as food. However, few studies have reported on the safety of rose hip extracts in toxicological analyses. Thus, to evaluate the safety of rosehip polyphenol MJ (RHPMJ), an aqueous ethanol extract standardized with the trans-tiliroside content, we performed genotoxicity and 90-day repeated oral dose toxicity studies in compliance with the Organisation for Economic Co-operation and Development-Good Laboratory Practice. RHPMJ did not induce gene mutations in reverse mutation tests of Salmonella typhimurium TA98, TA100, TA1535, TA1537 and Escherichia coli WP2 uvrA strains and did not induce chromosomal aberrations in cultured Chinese hamster lung (CHL/IU) cells. Moreover, micronucleus tests using rat bone marrow showed RHPMJ had no micronucleus-inducing potential. Finally, 90-day repeated oral dose toxicity studies (100–1000 mg/kg) in male and female rats showed no treatment-related toxicity in rats. These data indicate that the RHPMJ had no genotoxicity and a no-observed-adverse-effect level greater than 1000 mg/kg in rats.
Why do long distance truck drivers work extremely long hours?
Authors: Belzer Michael H , Sedo Stanley A
Published: September 2017

While other research has shown that higher paid truck and bus drivers are safer, this is the first study showingwhyhigher paid drivers are safer. We estimate the labour supply curve for long-haul truck drivers in the United States, applying two-stage least squares regression to a national survey of truck drivers. We start with the standard model of the labour supply curve and then develop two novel extensions of it, incorporating pay level and pay method, and testing the target earnings hypothesis. We distinguish between long-haul and short-haul jobs driving commercial motor vehicles. Truck and bus drivers choose between long-distance jobs requiring very long hours of work away from home and short-distance jobs generally requiring fewer hours. The labour supply curve exhibits a classic backward bending shape, reflecting drivers’ preference to work until they reach target earnings. Above target earnings, at a ‘safe rate’ for truck drivers, they trade labour for leisure, working fewer hours, leading to greater highway safety. Drivers work fewer hours at a higher pay rate and likely have less fatigue. Pay rates also have implications for driver health because worker health deteriorates as working time exceeds 40 hours.
Disability discrimination in children’s sport
Authors: Pearce Simone
Published: September 2017

This article examines how the Disability Discrimination Act 1992 (Cth) relates to children’s sport. More specifically, this article asks: how does the Disability Discrimination Act 1992 (Cth) address the treatment of children with disabilities participating in competitive sport? This article asserts that the ‘attitude’ in and around the construction of sport is framed in the ableism perspective that assumes ability. While there are specific disability sports, with rules designed to accommodate the different attributes people may possess, this article focuses on the nature and quality of access to, and experience in, sport that is not disability specific (mainstream sport), and argues that the law fails to protect children with disability being treated in a way that places them at a disadvantage. The primary concern raised by this article is that children with disability are not provided with fairness in competitive sport. This may be discriminatory.
Working animals’ rights: A disruption to the status quo
Authors: Shaw Rosemary
Published: September 2017

This article presents a thought project on how the law ought to treat working animals. The author argues that work health and safety legislation needs to take a fresh, contemporary and inclusive approach which challenges our anthropocentric mentality and recognises those animals that contribute to our economy through work. A critical reading of key sections of Australia’s model work health and safety legislation, as a representative example of contemporary work health and safety law, supports the contention working animals should be included as ‘workers’ under such laws.
Rethinking legal regulation of animal hoarding
Authors: Wootten Meg
Published: September 2017

Animal hoarding is a poorly understood phenomenon with potentially disastrous consequences for both the people and animals involved, but there has been little critique of the current legal regulation in Australia. The author examines the current regulation of animal hoarding in Australia, argues it is deficient because it does not address the psychological disorder underpinning the hoarding behaviour, and suggests a new model for regulating and addressing animal hoarding, including changes to animal welfare statutes and a multidisciplinary regulatory ‘court’ with a long-term focus.
Pleural lymphocyte-rich transudates in cats
Authors: Probo Monica , Valenti Valentina , Venco Luigi , Paltrinieri Saverio , Lavergne Emme , Trumel Catherine , Bertazzolo Walter
Published: September 2017

Objectives

Non-chylous lymphorrhagic pleural effusions are transudative effusions with a predominance of lymphocytes; however, they do not contain chylomicrons and therefore do not have the classical milky aspect of true chylous effusion. This type of effusion has been anecdotally associated with cardiac diseases in cats, but studies are lacking. The aim of this study was to investigate the association between this type of effusion and the primary disease.

Methods

In this study, feline non-chylous lymphorrhagic pleural effusions were retrospectively selected from the database of the authors’ institutions over a 3 year period. All cases underwent thoracic imaging, including echocardiography. Effusions classified as transudates with a predominance of lymphocytes on cytology were included.

Results

Thirty-three cases fulfilled the inclusion criteria: 23 (69.7%) had a concurrent cardiac disease, eight (24.2%) cases were associated with the presence of a mediastinal lymphoma or carcinoma or a thoracic mass, one case (3.0%) was a thymoma and one case (3.0%) was a sequela of a pyothorax.

Conclusions and relevance

Since a clear lymphatic origin of the fluid could not be demonstrated, lymphocyte-rich transudate might be considered a better designation for these kinds of effusions rather than non-chylous lymphorrhagic effusions. Although the number of cases in this preliminary study is low, the presence of a pleural lymphocyte-rich transudate in a cat should prompt the search for cardiac disease or intrathoracic neoplasia.
Recurrence of disease activity during pregnancy after cessation of fingolimod in multiple sclerosis
Authors: Meinl Ingrid , Havla Joachim , Hohlfeld Reinhard , Kümpfel Tania
Published: September 2017

Background:

Fingolimod is an effective treatment for active relapsing–remitting multiple sclerosis (MS). Discontinuation of therapy may be followed by recurrence of disease activity. Thus, female MS patients may be at risk of relapse during pregnancy after stopping fingolimod.

Objectives and methods:

To report the disease course during pregnancy of five women who interrupted therapy with fingolimod for pregnancy.

Results:

All patients experienced relapses during pregnancy and/or postpartum after stopping fingolimod.

Conclusion:

The risk of recurrence of disease activity during pregnancy after stopping fingolimod may be substantial. This should be considered and discussed with MS patients who are planning to become pregnant.
A pulmonary embolism response team’s initial 20 month experience treating 87 patients with submassive and massive pulmonary embolism
Authors: Sista Akhilesh K , Friedman Oren A , Dou Eda , Denvir Brendan , Askin Gulce , Stern Jamie , Estes Jaclyn , Salemi Arash , Winokur Ronald S , Horowitz James M
Published: September 2017

Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded. A total of 124 PERT activations occurred over 20 months: 43 in the first 10 months and 81 in the next 10. A total of 87 submassive (90.8%) and massive (9.2%) PE patients were included. The median age was 65 (51–75 IQR) years. Catheter-directed thrombolysis (CDT) was administered to 25 patients, systemic thrombolysis (ST) to six, and anticoagulation alone (AC) to 54. The median ICU stay and overall LOS were 6 (3–10 IQR) and 7 (4–14 IQR) days, respectively, with no association with any variables except a brain natriuretic peptide (BNP) >100 pg/mL ( p=0.008 ICU LOS; p=0.047 overall LOS). Twelve patients (13.7%) died in the hospital, nine of whom had metastatic or brain cancer, with a median overall LOS of 13 (11–17 IQR) days. There were five major bleeds: one in the CDT group, one in the ST group, and three in the AC group. Overall, (1) PERT activations increased after the first 10 months; (2) BNP >100 pg/mL was associated with a longer LOS; (3) rates of mortality and bleeding did not correlate with treatment; and (4) the majority of in-hospital deaths occurred in patients with advanced cancer.
Victims’ role in the criminal justice system
Authors: Boateng Francis D , Abess Gassan
Published: September 2017

In theory, crime victims have several rights and privileges—ranging from the rights to be heard to the right to confer with the prosecution. However, they are still considered as the forgotten individuals in the system because of underlying issues associated with the implementation of victims’ rights laws. Today, most states do not have any effective mechanisms of implementing legislation guaranteeing the rights of victims. The primary purpose of this article is to offer a comparative assessment of victims’ rights legislation in USA and to discuss some of the issues inherent in the implementation of these laws. Issues such as the lack of professional knowledge, the lack of enforcement mechanisms, strict eligibility criteria for compensation, varying definitions of victim across jurisdictions, and the limited scope of most crime victim legislation are discussed. The article also discusses ways to address the issues identified.
Settlement, expulsion, and return
Authors: Stilz Anna
Published: September 2017

This article discusses two normative questions raised by cases of colonial settlement. First, is it sometimes wrong to migrate and settle in a previously inhabited land? If so, under what conditions? Second, should settler countries ever take steps to undo wrongful settlement, by enforcing repatriation and return? The article argues that it is wrong to settle in another country in cases where (1) one comes with intent to colonize the population against their will, or (2) one possesses an adequate territorial base somewhere else, lacks an urgent interest in moving, and seeks to settle in a new place under conditions where settlement would severely harm the practices of prior occupants. It also argues for a presumption of repatriation and return in the first generation of wrongful settlement and holds that these remedies may be extended to second and higher generations in some – but not all – cases.
The power of “wealth, nobility and men:” Inequality and corruption in Machiavelli’s Florentine Histories
Authors: Maher Amanda
Published: September 2017

This article draws a connection between socio-economic inequality and political corruption based on a reading of Machiavelli’s Florentine Histories. Prevailing interpretations of the Histories attribute the moral corruption and civil conflict Machiavelli condemns as the source of Florence’s republican failure to the unique historical conditions of early-modern Florence. In this article, I trace Florentine corruption and factionalism to the perennial problem of inequality. Through his narration of the two centuries of Florentine history leading up to Cosimo de Medici’s ascent to first citizen, I contend, Machiavelli demonstrates the deleterious effect of inequality on the social relations, organizational forms, and modes of collective action in Florence. At the same time, his depiction of Florence’s transformation from a quasi-feudal commune dominated by a nobility with private armies to a modern commercial city ruled through patronage illustrates the contingent modality of inequality and the particularly subversive way it can manifest in the more civil republics of the modern era.
Desistance in drug-using offenders: A narrative review
Authors: Van Roeyen Sofie , Anderson Sarah , Vanderplasschen Wouter , Colman Charlotte , Vander Laenen Freya
Published: September 2017

The majority of available desistance research has examined desistance in the general offender population. However, applying the desistance approach to specific groups of offenders has potential to enrich our knowledge since their change processes show differences compared with those of the general offender population. Drug-using offenders is the group of offenders that has received most attention from desistance researchers. This article presents a narrative review of 15 studies that focus on desistance in this population. This review opted for a strict interpretation of ‘drug-using offenders’ in which two constitutive elements had to be present for inclusion, namely drug use and offending. Results indicate that only a limited amount of research applies the language of desistance to drug-using offenders. Also, it was apparent from the review that drug-using offenders are approached interchangeably with ‘desistance’ language and ‘recovery’ language. This review thus identifies gaps within the existing desistance literature, and it is expected that the further application of desistance language to drug-using offenders can build a better understanding of why and how drug-using offenders desist from drug use and offending. Further interdisciplinary research should be conducted on specific offender populations to improve understanding of the change process(es), which seems to be dual in nature but with a dynamic interplay between desistance and recovery.
The Bathroom Case: Creating a Supportive School Environment for Transgender and Gender Nonconforming Students
Authors: Beese Jane A. , Martin Jennifer L.
Published: September 2017

The recent federal guidance and litigation on transgender students have increased public awareness of the legal rights of transgender students. Title IX regulations have long permitted school districts to segregate male and female students in separate but comparable toilet, shower, and locker room facilities, but the legal issue presented by transgender students is how to gain access to facilities that match their gender identity. This case examines the nuances of accommodating transgender student needs, while examining the legal requirements for schools, and the practical implications of these requirements.
Prognostic usefulness of an age-adapted equation for renal function assessment in older patients with acute coronary syndrome
Authors: Rioboo Lestón Lucía , Abu-Assi Emad , Raposeiras-Roubin Sergio , Cobas-Paz Rafael , Caneiro-Queija Berenice , Rodríguez-Rodríguez Jose Manuel , Íñiguez-Romo Andres
Published: September 2017

Background:

Renal dysfunction negatively impacts survival in acute coronary syndrome patients. The Berlin Initiative Study creatinine-based (BIScrea) equation has recently been proposed for renal function assessment in older persons. However, up to now it is unknown if the superiority of the new BIScrea equation, with respect to the most recommended chronic kidney disease epidemiology collaboration creatinine-based (CKD-EPIcrea) formula, would translate into better risk prediction of adverse events in older patients with acute coronary syndrome.

Objectives:

To study the impact of using estimated glomerular filtration rate calculated according to the BIScrea and CKD-EPIcrea equations on mortality in acute coronary syndrome patients aged 70 years and over.

Methods:

Retrospectively, between 2011 and 2016, a total of 2008 patients with acute coronary syndrome (64% men; age 79±7 years) were studied. Follow-up was 18±10 months. Measures of performance were evaluated using continuous data and stratifying patients into three estimated glomerular filtration rate subgroups: ≥60, 59.9–30 and <30 mL/min/1.73 m2.

Results:

The two formulas afforded independent prognostic information over follow-up. However, risk prediction was most accurate using the BIScrea formula as evaluated by Cox proportional hazards models (hazard ratio (for each 10 mL/min/1.73 m2 decrease) 1.47 vs. 1.27 with the CKD-EPI equation; P<0.001 for comparison), c-statistic values (0.69 vs. 0.65, respectively; P=0.04 for comparison) and Bayesian information criterion. Net reclassification improvement based on the estimated glomerular filtration rate categories significantly favoured BIScrea +9 (95% confidence interval 2–16%; P=0.02).

Conclusions:

Our findings suggest that the BIScrea formula may improve death risk prediction more than the CKD-EPIcrea formula in older patients with acute coronary syndrome.
Effect of Topical Opioid Antagonist on Diabetic Wound Healing in Rat Model
Authors: Cain Jarrett , Titunick Michelle
Published: September 2017

Category:

Basic Sciences/Biologics, Diabetes

Introduction/Purpose:

Approximately 50% of the 170 million people worldwide with diabetes experience complications associated with delayed cutaneous wound healing. The current widely used treatment for DFU is topical platelet-derived growth factor (PDGF); however, it has significant side-effects. Preclinical studies have shown that a small molecular weight opioid receptor antagonist, blocks the interactions between the growth inhibitory peptide Opioid Growth Factor (OGF) and its receptor OGFr and accelerates cell proliferation and enhances angiogenesis and wound closure. The hypothesis of this research is that the topical formulation of opioid receptor antagonist is an effective therapy for healing of cutaneous wounds in diabetic rats, with healing times comparable to the standard care and will promote enhanced cell replication and accelerated angiogenesis.

Methods:

Fourteen diabetic rats per group with four excisional cutaneous wounds were positioned dorsally on type 1 diabetic rats and randomly treated topically with an opioid receptor antagonist (0.03% Naltrexone), topical platelet derived growth factor (Regranex®), or placebo moisturizing cream alone. Wound closure, DNA synthesis (bromodeoxyuridine incorporation-BrdU labeling), and production of the cytokines PDGF and vascular endothelial growth factor (VEGF) were monitored.

Results:

Naltrexone and Regranex® treatment resulted in more than 65% closure on days 8 and 10 respectively. On day 12, only one Naltrexone- and two Regranex-treated wounds remained (~1%), whereas the control group had 50% visible wounds. DNA synthesis in Regranex® treated wounds was 21% in comparison to vehicle-treated wounds at 28%; Naltrexone-treated diabetic wounds had 42% BrdU labeling comparable to the normal vehicle treated wounds. Naltrexone treatment significantly increased cell replication in comparison to Regranex treatment and to vehicle-only treated wounds (p<0.001). Tissue immunostained at 1, 2, and 4 days after surgery with anti-PDGF antibodies indicated that both Regranex® and Naltrexone increase PDGF+ labeling at 1 day, with Naltrexone treatment (but not Regranex®) continuing to enhance PDGF production at 4 days

Conclusion:

Topical opioid receptor antagonist has been shown to enhance wound healing by increasing cell replication, accelerating angiogenesis, and matrix formation and targets an underlying pathophysiology of diabetes and enhances cell replication at all stages of wound remodeling. Topical opioid receptor antagonist is safe and effectively targets the disease-modifying pathways in this comparison study of topical platelet derived growth factor for wound closure in Type 1 diabetic rats.These data suggest that blockade of the OGF-OGFr axis, utilizing 0.03% Naltrexone is a safe and effective alternative for treatment for diabetic wounds by targeting several phases of wound repair.
HV Patients Show Greater Pronation of the First Metatarsal than Normals
Authors: Campbell Bradley , Conti Stephen
Published: September 2017

Category:

Basic Sciences/Biologics, Bunion, Midfoot/Forefoot

Introduction/Purpose:

The progression of the hallux valgus (HV) deformity demonstrates dorsiflexion and abduction; concomitant pronation has not received adequate documentation and the extent of pronation in the pathology is unknown even though correction of the deformity may need to address all three angles. To overcome the inability of standard radiographs to capture pronation, we have developed a means to assess the three dimensional deformity using CT scans. Our goal was to document the extent of pronation/supination both of the first phalanx with respect to the first metatarsal and of the first metatarsal with respect to the second metatarsal. Furthermore, we wanted to regress pronation against the intermetatarsal (IMA) angle of hallux valgus patients.

Methods:

Three-dimensional models were reconstructed from loaded and unloaded CT files of patients (10 HV, 10 normal). The orientations of specific bones, in anatomic directions, were determined by selecting landmarks on the surface of the phalanx and of the first and second metatarsals. The resulting calculations output a set of angles to determine the pronation/supination of the first metatarsal relative to the second and of the first phalanx relative to the first metatarsal. A regression analysis was conducted to extrapolate any relationship between adduction and pronation (known intermetatarsal and pronation).

Results:

The average pronation of the first metatarsal relative to the second metatarsal was 19.8 ± 7.1 and 28.3 ± 10.8 in the normal and HV groups respectively (p < 0.05). The influence of weightbearing demonstrated pronation angle differences that were greater in the normal group than in the HV group for both the IM pronation and the HV pronation (p < 0.05) (Figure 1). The differences in HV angles and IM angles between normal and HV patients were 22° and 7° respectively. The regression analysis of the pronation and intermetatarsal angle was not found to be significant, with a weak correlation (r2 = 0.26).

Conclusion:

The pronation of the first metatarsal relative to the second metatarsal between normal and HV patients is significantly different. While the first metatarsal had measurable pronation in patients with hallux valgus but that value was not predicted by the IMA. The findings of this study indicate pronation should be considered in any surgical technique that seeks to restore native configurations.
Comparative Outcomes for Treatment of Articular Cartilage Lesions in the Ankle with Particulated Juvenile Cartilage Allograft
Authors: Deal James , Turner Robert , Ryan Paul , Anderson Claude , Groth Adam
Published: September 2017

Category:

Ankle

Introduction/Purpose:

Treatment of osteochondral defects of the talus with particulated juvenile cartilage allograft is a relatively new procedure. Although other treatment options exist for large osteochondral defects of the talus, the potential advantage of particulated juvenile allograft is the ability to perform the procedure arthroscopically or through a minimal approach. No previous studies have looked at the results of an arthroscopic approach and no previous studies have compared an arthroscopic technique to an open approach. The purpose of this study was to compare the outcomes of an arthroscopic transfer technique to the previously published open technique.

Methods:

A total of 34 patients underwent treatment of talar cartilage lesions with juvenile particulated cartilage allograft. Twenty of these were done arthroscopically and 14 were done with an open arthrotomy. There was no statistically significant difference between the groups with respect to age, lesion width, lesion depth, lesion length, or operative time. Scores for 6 different validated outcome measures were recorded for patients in each group pre-operatively and subsequently at 6 months, 1 year, 18 months, and 2 years.

Results:

Comparing outcome measurements at each data point to baseline, there were no statistically significant post-operative differences found between open and arthroscopic approaches with regards to VAS Pain Scale, AOFAS Ankle-Hindfoot Scale, Foot and Ankle Ability Measure - Sport Scale, or SF12 Physical Health Scale.

Conclusion:

Treatment of talar articular cartilage lesions with particulated juvenile cartilage allograft is associated with improved outcomes at 2 years with regards to several validated outcome measures regardless of technique utilized. At 2 years follow up, there were no statistically significant differences in outcomes utilizing an arthroscopic technique versus open technique with the numbers given. This data supports the use of particulated juvenile cartilage allograft utilizing either arthroscopic or open techniques.
Primary vs Secondary Osteochondral Autograft Transplantation in Patients with Large Sized OLT
Authors: Park Kwang Hwan , Hwang Yeokgu , Park Yoo Jung , Shim Dong-Woo , Lee Jin Woo
Published: September 2017

Category:

Ankle, Arthroscopy, Sports

Introduction/Purpose:

Osteochondral autograft transplantation (OAT) for large sized osteochondral lesions of the talus (OLT) has presented promising clinical results in recent studies. However, there was no study which has compared clinical outcomes between primary OAT and secondary OAT in the large sized OLT. The purpose of this study is to compare clinical outcomes between patients receiving primary transplantation and patients receiving secondary transplantation after failure of previous marrow stimulation for large sized OLT and investigate prognostic factor affecting clinical failures.

Methods:

Between 2005 and 2014, 18 patients with large sized OLT (=150 mm2) underwent primary OAT as a primary surgery (primary group) and 28 patients with large sized OLT underwent secondary OAT after a failure of arthroscopic marrow stimulation (secondary group). After arthroscopic inspection and debridement for concomitant soft tissue pathologies, conventional OAT procedures were performed. Clinical outcomes were assessed using visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS) and re-operation rate. Factors associated with clinical failure were evaluated using bivariate analysis and logistic regression analysis. Survival outcomes were compared using Kaplan-Meier analysis.

Results:

The mean follow-up time was 6.0 years (range 2.0-10.8) and the mean size of the lesion was 194.9 mm2 (range 151.7- 296.3). There was no significant difference in patients` demographics, and preoperative findings between primary and secondary groups. Postoperative VAS, AOFAS score, FAOS, and re-operation rate had no significant difference between primary and secondary groups at the last follow-up. According to bivariate analysis, significant factor associated with clinical failure was not prior marrow stimulation but more than 225 mm2 of lesion size in preoperative MRI. Logistic regression analysis revealed that preoperative AOFAS score was significant predictor of clinical failure after the OAT in this study. The survival probabilities were not significantly different between primary and secondary groups in Kaplan-Meier plots (P = .947).

Conclusion:

Outcomes of secondary OAT were comparable to those of primary OAT in the large sized OLT. Therefore, we suggested that symptomatic patients with large sized OLT could be initially treated by either arthroscopic marrow stimulation or OAT and if failed with marrow stimulation, secondary OAT could be considered.
Histological Analysis of Early Osteolysis in Total Ankle Arthroplasty
Authors: Schipper Oliver , Haddad Steven
Published: September 2017

Category:

Ankle Arthritis

Introduction/Purpose:

The purpose of this study was to perform a histological comparative analysis of tibiotalar joint samples taken from areas of osteolysis adjacent to total ankle arthroplasties vs control synovial specimens to determine the reaction to and presence of polyethylene (PE) particles.

Methods:

A total of 57 pathology samples were identified in the osteolysis group, while 11 were identified in the control group. For each sample, hematoxylin and eosin, Oil Red O (ORO), and macrophage marker CD163-stained slides were created. Polarized light and ORO stain were used to identify PE particles. The presence of metal particles and giant cell reaction to PE particles were also scored.

Results:

Macrophages, PE particles, metallosis, and foreign body giant cell reaction scores were significantly higher in the osteolysis group compared with the control group. In the osteolysis group, ORO staining was positive in 93% (53/57), birefringent material was present in 96.5% (55/57), and macrophage infiltrates were present in 96.5% (55/57). Foreign body giant cell reaction with giant cells surrounding PE particles was present in 49.1% (28/57) of osteolytic specimens. The presence of foreign body giant cell reaction was associated with significantly higher macrophage, ORO, and polarizable material scores. The average time to surgery for osteolysis from the index ankle replacement was 6.0 (range, 0-15) years for the 57 patients in the osteolysis group.

Conclusion:

This study is the largest ankle arthroplasty histological analysis to show that areas of osteolysis consist of abundant polyethylene wear particles, present both intracellularly and extracellularly. Furthermore, these areas were associated with a CD163+ macrophage infiltrate and frequently a foreign body reaction with giant cells engulfing PE particles. It is likely that implant wear particles play a significant role in osteolysis based on the histopathology.
Rates of Acute and Delayed Achilles Repair
Authors: Younger Alastair , Park Sam Si-Hyeong , Veljkovic Andrea , Penner Murray , Wing Kevin
Published: September 2017

Category:

Sports, Trauma

Introduction/Purpose:

The need for repair of the ruptured achilles tendon has been discussed extensively in recent literature. A landmark paper in 2010 (Willits JBJS) outlined that the re-rupture rates were similar in surgical and non surgically treated Achilles tendon ruptures. However concern has to be raised as to the strength of the muscle tendon complex if the tendon is too long, potentially increasing the rate of late repair. This paper analyses the rate of acute achilles tendon repair and delayed repair before and after the 2010 publication of the Willits paper.

Methods:

Using the published billings from the Province of British Columbia, the rates per year of surgical repair of achilles tendon and delayed repair were determined. The population of British Columbia has increased over the years from 3.9 million in 1997 to 4.7 million in 2016. The rates of acute and chronic surgery were plotted prior to 2010, and since 2010. The rates were fitted against time using a linear and binomial plot. The rates in the years before and after 2010 were compared with ANOVA and the change of rate in time compared with Pearson’s correlation.

Results:

The rate of acute repair increased from 271 repairs in 1997 to over 400 repairs per year in 2009. The rate of acute repair has since dropped to just over 300 repairs per year. This is reflected in the enclosed binomial plot. There was a significant increase until 2010 (p<0.001), and a significant decrease since 2010 p<0.05). An average of 374 repairs per year (95% CI 349 to 398) were performed before 2010, decreasing to 328 since (95% CI 294 to 360), p<0.05. The rate of late repair has increased from 48 per year (CI 40 to 56) to 80 (CI 70 to 91) since 2010. The rate of late repair increased both prior to (r2 prior to 2010 .5, p<0.01) and since 2010.

Conclusion:

The landmark 2010 paper has resulted in a reduction of acute repair. However the increase in late repair is concerning and indicates that the muscle tendon weakness observed in the 2010 paper on strength testing at 1 year review in the non surgical group may be causing an increased rate of late repair. Further evaluation and development of both surgical and non surgical technique is required if the need for late repair is going to be avoided that likely reflects poor patient outcomes.
Clinical outcomes of full thickness skin graft combined with negative pressure wound therapy in diabetes mellitus foot amputee after infection
Authors: Ahn Ji-Yong
Published: September 2017

Category:

Diabetes

Introduction/Purpose:

Infected diabetes mellitus (DM) foot has been controlled with amputation. After performing the amputation with preserving enough length of the foot due to functional and cosmetic advantages, remaining wounds have been covered with split thickness skin graft (STSG) despite of sacrifice of donor site with pain and scar. We hypothesized outcomes of full thickness skin graft (FTSG) combined with negative pressure wound therapy (NPWT) can be an alternative STSG. The aim of this study was to investigate clinical outcomes of FTSG combined with negative pressure wound therapy in DM foot infection.

Methods:

This study included 21 patients of infected DM foot (21 feet). There were 20 cases of midfoot and 1 case of hindfoot. We performed the amputation and combined NPWT at a mean age of 51.7 years (37 to 81) with the mean 12 months follow-up between June, 2014, and January, 2016. FTSG was performed after sufficient granulation healing of DM foot amputee. We measured multiple risk factors preoperatively and postoperatively. The wound healing after FTSG was evaluated during the followup. The relationship between outcomes of FTSG and multiple risk factors were evaluated.

Results:

20 feet showed complete healing of wound. One foot showed failed wound healing. Mean NPWT number of times before the FTSG were 11. Mean C-reactive protein (CRP) values and Hemoglobin A1C (HbA1C) were 1.24 and 9.21 just before FTSG, respectively. There were no significant correlations between wound healing and risk factors (CRP, HbA1C) (p=0.223, p=0.175).

Conclusion:

Full thickness skin graft combined with negative pressure wound therapy (NPWT) can be the treatment of choice for the diabetes mellitus foot amputee as an alternative STSG.