bluuebunny/crossref_metadata_2025 huggingface dataset:
Right Forearm Eruption Associated With Playing Minecraft: A Case of Contact Dermatitis Related to Computer Gaming
Authors: Abbas Mariam , Fiorillo Loretta , Elliott John F.
Published: March 2018

This submission highlights the importance of careful history taking along with a strong index of suspicion for an exogenous cause of dermatitis. In particular, it highlights the importance of being aware of the latest trends and exposure risks for contact dermatitis.
Sheltering the president from blame: Drone strikes, media assessments and heterogeneous responsibility 2002–2014
Authors: Davies Graeme AM , Schulzke Marcus , Almond Thomas
Published: March 2018

This article presents the first systematic analysis of how location of drone strikes and the identification of civilian or terrorist casualties in newspaper reporting affect media assessments of operational outcomes and elite responsibility. Conducting a content analysis of several hundred newspaper articles, we evaluate the likelihood of these newspapers identifying the civilian casualties, the role those casualties play in media assessments of operational outcomes, and who they blame for failure. We found that there were significant differences in the likelihood of the two newspapers reporting civilian casualties. We demonstrate that political elites including the US President tended to avoid blame for failure, with much of the focus of newspaper dissatisfaction being directed at the intelligence agencies. We believe these findings have serious ramifications for the democratic oversight for future warfare and have the potential to undermine the ability of public to constrain elites from launching military operations using drones.
Journalism’s institutional discourses in the pre-Internet era: Industry threats and persistent nostalgia at the American Society of Newspaper Editors
Authors: Buozis Michael , Rooney Shannon , Creech Brian
Published: March 2018

The institutional discourses of US journalism display both an ever-present sense of crisis and a persistent nostalgia for a mythic golden age when the news was better made and better respected by the public. This article examines discussions hosted by the American Society of Newspaper Editors between 1986 and 2000, what we call ‘the pre-Internet era’, as a site of discursive constitution and relative stability in the news industry. As various actors inside the news industry utilize both nostalgia and crisis as common representational strategies, these discourses circulate and propagate a sense-making regime that is both precise and flexible in its deployment, and thus, helps journalism cohere as a field. Specific discussions around the First Amendment, journalistic identities, and business issues all provide fertile ground for challenging and reaffirming journalism’s binding values, and reveal larger structures of power around who has the authority to both describe threats to journalism and prescribe possible solutions.
Stability of ultraviolet-cured chitosan coating on cotton gauze for water filtration
Authors: Truffa Giachet Francesca , Periolatto Monica , Sanchez Ramirez Diego Omar , Carletto Riccardo Andrea , Varesano Alessio , Vineis Claudia , Bongiovanni Roberta
Published: March 2018

Cotton gauzes coated with chitosan have been tested as water filter for biological disinfection against Gram-positive bacteria. The present study develops the previous ones, aiming to the stability evaluation of ultraviolet-cured chitosan coating of cotton gauzes in order to optimize the chitosan amount applied to the substrate, lowering the add-on percentage as much as possible: 10%, 5% and 2% wt were here considered. Antibacterial activity and permanence of this property after water flow were tested, showing good results, in particular as regards 10% wt and 5% wt chitosan coated cotton gauze. Moreover, chitosan release was studied in both static and dynamic conditions, with the result that water flux causes a reduction of the amount of chitosan, which remains bounded to the fibres. This reduction depends on the duration of the flux and on the original amount of chitosan on the filter.
A Meta-analysis of Preoperative Duplex Ultrasound Vessel Diameters for Successful Radiocephalic Fistula Placement
Authors: Glass Carolyn , Johansson Marcia , DiGragio William , Illig Karl A.
Published: March 2018

Background

The Kidney Dialysis Outcomes Quality Initiative (K/DOQI) guidelines for vascular access recommend the use of radiocephalic wrist arteriovenous fistulas (RCAVFs) as the initial option for dialysis access. The survival rate of a successfully placed fistula is excellent. However, 10–24% of RCAVFs fail to reach functional status as the result of early thrombosis or maturation failure. Many authors have investigated the utility of preoperative vascular mapping by Duplex ultrasound to predict adequate vessel size for successful fistula placement. This meta-analysis is the first in which preoperative radial arterial (RAD) and cephalic venous diameters (CVD) required for favorable fistula outcomes are reviewed.

Methods

A literature search was performed by use of the MEDLINE electronic base for “arteriovenous, fistula, ultrasound, and hemodialysis.” The analysis yielded 166 studies, of which 20 studies included preoperative duplex data. Meta-analysis was performed by applying the statistical test of comparing two proportions, assuming equal variances.

Results

A total of 433 patients were duplexed for preoperative evaluation of the RAD and 386 for CVD. The total number of subjects ranged from 21 to 91, mean age 58.7 years. The subjects were 55.5% male, 39.0% with diabetes mellitus. Meta-analysis yielded 2.0 mm for RAD and 2.0 mm for CVD as designated cutoff vessel diameters. Our study showed the mean fistula success rate was significantly different between RAD >2.0 mm (59%) and RAD >2.0 mm (40%). The mean fistula success rate was also significantly different between CVD > 2.0 mm (71%) and >2.0 mm (29%). Successful fistula placement was defined as a functional fistula at least 4–6 weeks after creation.

Conclusion

On the basis of our study, the use of Duplex ultrasound is important in determining preoperative vessel diameter size, and subsequent functional success rate of fistula placement.
Hybrid Endovascular Surgical Repair in Takayasu's Arteritis: Duplex Ultrasound Follow-up
Authors: Broadbent Karen , Garami Zsolt , Peden Eric K. , Lumsden Alan
Published: March 2018

Introduction

Takayasu's arteritis (TA), a rare condition occurring primarily in young women, is a granulomatous vasculitis usually affecting the aorta and its branches. Our case report describes the duplex ultrasound findings in a 16-year-old Hispanic woman after a hybrid endovascular procedure.

Patient Description

TA in this patient was diagnosed in 2005 after a pulsatile neck mass developed on the right side of her neck. To date, she has required four vascular interventions in less than 3 years. The first procedure was an aortic root, ascending aorta and aortic arch replacement with Dacron graft replacement of the left common carotid and innominate arteries. She then developed a pseudoaneurysm in the distal left common carotid artery replacement graft, which was excluded with a stent-graft. The third procedure was a balloon angioplasty of an anastomotic stenosis of the aorto-innominate artery graft. This, however, recurred and there was also a small anastomotic pseudoaneurysm at this site. Revascularization was complicated by the fact that the left subclavian artery was occluded, with reversed flow in the left vertebral artery. Consequently, preservation of antegrade flow in the right vertebral artery was a priority. Transposition of the right common carotid artery to the subclavian artery with placement of a balloon expandable stent graft from the aortoinnominate artery graft into the subclavian artery (proximal to the vertebral artery) was performed.

Methods

All available imaging exams and operative reports were reviewed. Bilateral carotid duplex evaluation in addition to duplex examination of all bypasses and the distal native arteries were performed using high resolution ultrasound equipment and probes of varying frequency.

Results

Normal caliber wall thickness was identified in bilateral common carotid arteries. No evidence of intimal hyperplasia could be detected in stented areas. All open surgical or endovascular repair sites were well visualized, with the exception of only the proximal most innominate artery bypass graft and the aortic arch. Primarily retrograde left vertebral artery flow feeds the left subclavian artery. There was no evidence of restenosis or pseudoaneurysm formation.

Discussion

Long-term follow-up of the patient with TA after open surgical or endovascular procedures is extremely important because of the chronic nature of the disease process. Duplex ultrasound is a safe, effective adjunct to the standard radiologic arsenal usually used to follow these high-risk patients.
Vascular Ultrasound Imaging of Axillary Artery Thrombosis in a Neonate
Authors: Pollard Bree , Johnson Bonnie , Van Meurs Krisa
Published: March 2018

This case report presents a 4-day-old neonate with axillary artery thrombosis born to a diabetic mother. After receiving an angiogram and blood workup, the neonate then received an ultrasound. The angiogram, as well as the ultrasound, revealed left axillary artery thrombus. The neonate received low molecular weight heparin treatment and was closely monitored over the course of the hospitalization. Because of the rarity of neonatal axillary arterial thrombosis, the condition is sporadically reported in literature. Causes of this condition have been attributed to sepsis, congestive heart failure, trauma, coagulation disorders, polycythemia, and dehydration. It is documented that a clot can form in the renal vein, inferior vena cava, ductus arteriosus, or umbilical vessels and travel to an upper extremity artery. Treatments include clinical observation, systemic anticoagulation, surgical thrombectomy, or intraoperative balloon angioplasty. This case demonstrates the ability of ultrasound to diagnose and follow upper extremity arterial thrombus in neonates.
Unusual Presentation and Identification of a Post-traumatic Arteriovenous Fistula Identified with the Use of Duplex Ultrasonography
Authors: Umphrey Susan , Levesque Sally , Gupta Vishal , Shea Lori D. , Root Drena , Cambria Richard P. , Jaff Michael R.
Published: March 2018

Case Report

A 49-year-old athletic male presented with a 3-year history of unrelenting left lower-extremity edema after a motor vehicle accident. He underwent a venous duplex ultrasound, which revealed distal left superficial femoral and popliteal deep venous thrombosis and multiple venous collaterals with arterial Doppler signals within the thrombus and vein wall at the level of the popliteal fossa. Doppler waveforms were highly suspicious for an arteriovenous fistula (AVF). Direct auscultation of the popliteal fossa revealed a continuous bruit. Magnetic resonance arteriography revealed early venous filling of the left femoral vein with multiple dilated veins in the region of the popliteal artery, consistent with AVF. The patient underwent surgical interruption of the AVF with significant resolution of the lower extremity edema.

Conclusion

In our experience, unusual Doppler waveform characteristics and multiple collateral vessels should alert the sonographer to the possibility of an AVF. This report exemplifies the role of Doppler ultrasound in the diagnosis of unrelenting and unexplained lower extremity edema.
The effect of time-periodic base angular motions upon dynamic response of asymmetric rotor systems
Authors: Yi Yiwu , Qiu Zhenyu , Han Qinkai
Published: March 2018

The effect of time-periodic base angular motions upon dynamic response of asymmetric rotor systems is investigated in this article. Both the disk and rotating shaft with asymmetric cross sections are considered. The rigid rotor base rotates around the three axis with time-varying angular speeds. Equations of motion for every components (asymmetric disk and shaft elements) are derived to assembe the finite element model of the whole rotor-bearing system. Due to the rotor asymmetries and angular motions of the rigid base, the finite element model has time-variable mass, gyroscopic, and stiffness coefficients. Parametric instability regions and rotor center orbits are compared with references’ results for model verifications. Then, forced responses of the system under unbalanced excitations, shaft asymmetry, and base angular motions are obtained. Effects of various types of angular motions, amplitudes, and frequency of base motions upon the response spectra and external resonances are discussed. As long as the periodic base angular motion is considered, both the response spectra and external resonances change significantly. Additional frequencies, including base frequency and combined frequencies, are found in the response spectra. Besides the critical and half-critical resonances (for the asymmetric rotor system), there are multiple resonances after considering the periodic base motions.
Epipolar geometry and stereo matching algorithm for underwater fish-eye images
Authors: Li Yaqian , Zhang Yakun , Li Haibin , Zhang Wenming , Zhang Qiang
Published: March 2018

A fish-eye lens achieves a large field of view at the cost of image distortion, and underwater imaging by a fish-eye lens introduces refraction when light passes through the different medium. To obtain three-dimensional information, under these circumstances, a stereo matching algorithm is proposed that analyzes the geometric characteristics of an underwater fish-eye image, taking into account distortion and refraction. First, the underwater imaging model of a stereo fish-eye camera is established, and the epipolar curve of the underwater fish-eye image is calculated. Then, in the matching step, an adaptive window based on mean-shift segmentation is proposed to further alleviate the impact of distortion. Experiments are performed on synthetic images and natural scene images. The results show that the proposed model and the calculated epipolar curve are effective and that the adaptive window method could improve the precision of stereo matching on underwater fish-eye images.
Belonging and exclusion in the lives of young people with intellectual disability in small town communities
Authors: Robinson Sally , Hill Malcolm , Fisher Karen R , Graham Anne
Published: March 2018

In recent policies, it is assumed that communities welcome the inclusion of young people with intellectual disability. However, little is known about perspectives of young people themselves. This article reports on research that sought to address this gap. Young people with intellectual disability living in three Australian small town communities participated in pictorial mapping and photo-rich methods to explore belonging and exclusion and links between these. Young people’s feelings of comfort and safety with local spaces and people were important for their sense of belonging. Emplaced relationships with family and some friends were key to strong belonging, as were positive attachments to disability support workers and spaces. Social exclusion, either from particular places or more generally, was keenly felt. Young people’s confidence, willingness to enter social spaces and relationships were magnified by ways that systems responded to their impairment, at worst fracturing their sense of feeling welcome and included.
Institutional educational technology policy and strategy documents: An inequality gaze
Authors: Czerniewicz Laura , Rother Kyle
Published: March 2018

Issues of inequality in higher education have received considerable attention in recent decades, but the intersection of inequality and educational technology at an institutional level has received little attention. This study aims to provide a perspective on institutional educational technology policy informed by current understandings of inequality. The study takes the form of a content analysis of institutional educational technology policy and strategy documents of universities in the United Kingdom and South Africa. A preliminary review of the educational technology policy literature reveals low levels of engagement with issues of inequality in policy documents at an institutional level. Therborn’s typology of inequality provides the basis of a structured framework for the analysis, with Bourdieu’s concepts of capital being incorporated as markers of the various types of inequality. The study reveals regional differences in the approach to inequality as a policy matter, as well as a varied engagement with the issues of inequality related to educational technology at a policy level.
A project management issue of new technology developments: A case study on lack of human factors’ attention in human–robot interaction
Authors: Fossum Knut R , Danielsen Brit-Eli , Aarseth Wenche , Johnsen Stig Ole
Published: March 2018

The complexity of today’s sociotechnical systems has prompted researchers and practitioners to advocate new holistic approaches to safety. However, many engineering standards, methods and processes for addressing technical, human and organizational factors do not fully reflect this. This article investigates known project management challenges and how they can explain the lack of attention to human factors issues in the design and development of new technology. As such, the work contributes to a research stream investigating why the human factors discipline is repeatedly marginalized in engineering projects. This article reports on findings from a case study – a research and innovation project developing technology and concepts for human–robot collaboration. We conclude that a narrow focus on early project phases and insufficient information coordination contribute to marginalizing the role of human factors in the design and development of new technology.
Graphs models and algorithms for reliability assessment of coherent and non-coherent systems
Authors: Brînzei Nicolae , Aubry Jean-François
Published: March 2018

In this article, we propose new models and algorithms for the reliability assessment of systems relying on concepts of graphs theory. These developments exploit the order relation on the set of system components’ states which is graphically represented by the Hasse diagram. The monotony property of the reliability structure function of coherent systems allows us to obtain an ordered graph from the Hasse diagram. This ordered graph represents all the system states and it can be obtained from only the knowledge of the system tie-sets. First of all, this model gives a new way for the research of a minimal disjoint Boolean polynomial, and, second, it is able to directly find the system reliability without resorting to an intermediate Boolean polynomial. Browsing the paths from the minimal tie-sets to the maxima of the ordered graph and using a weight associated with each node, we are able to propose a new algorithm to directly obtain the reliability polynomial by the research of sub-graphs representing eligible monomials. This approach is then extended to non-coherent systems thanks to the introduction of a new concept of terminal tie-sets. These algorithms are applied to some case studies, for both coherent and non-coherent real systems, and the results compared with those computed using standard reliability block diagram or fault tree models validate the proposed approach. Formal definitions of used graphs and of developed algorithms are also given, making their software implementation easy and efficient.
Safety and feasibility of above cuff vocalisation for ventilator-dependant patients with tracheostomies
Authors: McGrath Brendan A , Wallace Sarah , Wilson Mark , Nicholson Leanne , Felton Tim , Bowyer Christine , Bentley Andrew M
Published: March 2018

Introduction

Temporary tracheostomy is commonly used in patients admitted to intensive care units. Cuffed tubes prevent laryngeal airflow, preventing vocalisation. Sub-glottic suction tubes such as the ‘Blue Line Ultra Suctionaid™’ are used primarily to remove sub-glottic secretions, but retrograde gas flows via the suction port can facilitate above cuff vocalisation. The aims were to assess whether patients could achieve an audible voice using above cuff vocalisation, to demonstrate the safe use of the Blue Line Ultra Suctionaid™ tracheostomy tube for above cuff vocalisation, and to assess potential benefits of above cuff vocalisation for communication, secretion management and swallowing.

Methods

Our study (Reference 15/NW/0464, IRAS 178997) recruited adult intensive care unit patients who were alert, able to participate in an above cuff vocalisation trial and dependent on an inflated Blue Line Ultra Suctionaid™ cuff for ventilatory support. Consenting participants underwent fibreoptic endoscopic assessment of swallow by experienced Speech & Language Therapy staff with and without above cuff vocalisation. Clinical and fibreoptic endoscopic assessment of swallow, assessment of voice quality, swallowing and secretion management were recorded and scored. Median differences between paired observations and scores were analysed with and without above cuff vocalisation. Adverse events were identified by follow up fibreoptic endoscopic assessment of swallow and patient accounts.

Results

Ten patients completed the study. Above cuff vocalisation was used for a median of 15 min, during a median of nine episodes, over a median of three days. Above cuff vocalisation resulted in an audible voice in eight of the 10 patients, during 66 out of 91 above cuff vocalisation attempts. There improvements in unstimulated dry cough and swallow frequency and aspiration ratings measured by fibreoptic endoscopic assessment of swallow. No complications were reported or observed in 66 attempts with only one episode terminated prematurely.

Conclusions

Above cuff vocalisation can achieve effective, safe, well-tolerated vocalisation in ventilator-dependant intensive care unit patients. Above cuff vocalisation has the potential to aid earlier, more effective communication and may improve laryngeal function and rehabilitation.
Effect of immobilization of the distal interphalangeal joint of fingers on grip strength
Authors: Wu Feiran , Mehta Saurabh Sagar , Dickson David , Catchpole Dee , Ng Chye Yew
Published: March 2018

Arthrodesis of the distal interphalangeal joint of the finger is an effective salvage treatment for end-stage arthropathy of the joint. This study aimed to evaluate the effect of simulated fusion of individual distal interphalangeal joints on the overall grip strength of the hand. Custom moulded thermoplastic splints were used to simulate fusion by immobilizing the index, middle, ring and little fingers’ distal interphalangeal joints in turn in both hands of 56 healthy participants. Testing was performed with no immobilization and after immobilization of each of the individual digits. Grip strengths reduced significantly following immobilization of the distal interphalangeal joint. The degree of reduction became progressively more pronounced from the index to the little fingers (12%, 18%, 24% and 25%, respectively) and was similar for the dominant and non-dominant hands. This information may have clinical application when counselling patients regarding fusion of the distal interphalangeal joint of the fingers.
Fractures at the junction of diaphysis and metaphysis of the proximal phalanges in adults
Authors: Shewring David J. , Trickett Ryan W. , Smith Adam
Published: March 2018

We describe the treatment of 101 patients with 113 fractures of the proximal phalanx at the junction of the diaphysis with the proximal metaphysis. Fractures were stabilized using a single extra-articular percutaneous Kirschner wire passed lateral to the metacarpal head into the base of the phalanx base and across the fracture to engage the lateral cortex. Patients were treated semi-electively on a day surgery unit. The metacarpophalangeal joint was splinted in flexion with mobilization of the proximal inter-phalangeal joints, until the wire was removed at 24 days and the hand then freely mobilized. The mean total active movement was 230° and no patients experienced problems with significant pain. There were two pin site infections. There were no cases of angular or rotational malunion. These injuries can be successfully and safely treated using this simple technique, negating the need for close monitoring for angular displacement of the fracture, which is frequently seen with non-surgical management.

Level of evidence: IV
Rheolytic effects of left main mid-shaft/distal stenting: a computational flow dynamic analysis
Authors: Rigatelli Gianluca , Zuin Marco , Dell’Avvocata Fabio , Nguyen Thach
Published: March 2018

Background

The aim of this study was to evaluate the rheolytic effects of stenting a mid-shaft/distal left main coronary artery (LMCA) lesion with and without ostial coverage. Stenting of the LMCA has emerged as a valid alternative in place of traditional coronary bypass graft surgery. However, in case of mid-shaft/distal lesion, there is no consensus regarding the extension of the strut coverage up to the ostium or to stent only the culprit lesion.

Methods

We reconstructed a left main-left descending coronary artery (LM-LCA)-left circumflex (LCX) bifurcation after analysing 100 consecutive patients (mean age 71.4 ± 9.3, 49 males) with LM mid-shaft/distal disease. The mean diameter of proximal LM, left anterior descending (LAD) and LCX, evaluated with quantitative coronary angiography (QCA) was 4.62 ± 0.86 mm, 3.31 ± 0.92 mm, and 2.74 ± 0.93 mm, respectively. For the stent simulation, a third-generation, everolimus-eluting stent was virtually reconstructed.

Results

After virtual stenting, the net area averaged wall shear stress (WSS) of the model and the WSS at the LCA-LCX bifurcation resulted higher when the stent covered the culprit mid-shaft lesion only compared with the extension of the stent covering the ostium (3.68 versus 2.06 Pa, p = 0.01 and 3.97 versus 1.98 Pa, p < 0.001, respectively. Similarly, the static pressure and the Reynolds number were significantly higher after stent implantation covering up the ostium. At the ostium, the flow resulted more laminar when stenting only the mid-shaft lesion than including the ostium.

Conclusions

Although these findings cannot be translated directly into real practice our brief study suggests that stenting lesion 1:1 or extending the stent to cover the LM ostium impacts differently the rheolytic properties of LMCA bifurcation with potential insights for restenosis or thrombosis.
Numerical methods study of solving transient flow of impeller machinery under mutational working conditions
Authors: Zhang Yu-Liang , Zhu Zu-Chao , Zhou Zhao-Zhong , Sheng Yi-Ni , Zhao Yan-Juan
Published: March 2018

The transient performances of impeller machinery under typical mutational working conditions play an important role in the area of engineering and have attracted extensive attention. In order to fully understand transient behaviors of impeller machinery under mutational working conditions, it is very necessary to confirm an efficient and reliable solving method. In this paper, the dynamic mesh method and the sliding mesh method are respectively used to be solved the inner transient flow of a 2D centrifugal pump model during abrupt start-up period. The  Renormalization-group (RNG) k– ε turbulence model in eddy viscosity models is chosen to close the Reynolds-average equation and to complete the turbulence calculation. Moreover, the SIMPLE algorithm is also adapted to accomplish the coupling calculation between velocity and pressure. The study shows that in theory, the most appropriate method to solve transient flow is the dynamic mesh method, but it has the shortage of low mesh quality during mesh reconstruction. The sliding mesh method with high mesh quality is an ideal solving method under mutational working conditions. In general, both of the methods would reflect the basic characteristics of inner flow, while the sliding mesh method has higher solution precision.
Cerebral venous thrombosis revealing Behçet’s disease in a Moroccan patient: A case report and literature review
Authors: Krumb Evelien , Lefebvre Chantal , Peeters André , Hermans Cédric
Published: March 2018

Behçet’s disease is an inflammatory disease, the origin of which still remains unclear, and it has multiple manifestations, one of them being thrombosis. In this report, we describe the case of a 24-year-old Moroccan patient who presented with headache persisting for more than 2 weeks, which was found to be caused by cerebral venous sinus thrombosis. His medical history of recurrent oral and genital ulcerations, epididymitis and one episode of pericarditis led to the diagnosis of Behçet’s disease. We could observe an almost complete relief of symptoms with colchicine therapy, and anticoagulation with warfarin was started for secondary prevention of thrombosis.
Near-fatal kinking of mammary graft due to emphysematous lung disease
Authors: Denny John T , Mungekar Sagar , Landgraf Benjamin R , McRae Valerie A , Ibrar Sajjad , Kiss Geza K , Bonitz Joyce , Cohen Shaul , Tse James T
Published: March 2018

Left internal mammary artery grafting is commonly used in elective coronary artery bypass graft surgery. We report a near-fatal case with graft kinking upon sternal closure due to distended, emphysematous lungs impinging on the mammary graft. After the sternum was closed, the patient suffered a severe hemodynamic deterioration. Surgical examination revealed kinking of his left internal mammary artery upon sternal closure due to distended, emphysematous lungs impinging on the mammary graft. Using an off-bypass technique, the kink in the mammary graft to the left anterior descending artery was removed by moving the origin of the left internal mammary artery to a hooded graft of a saphenous vein graft instead. In this position, the graft no longer was impinged upon by the distended emphysematous lungs. Subsequently, the patient’s sternum was closed without hemodynamic impingement. Although chronic obstructive pulmonary disease is well described to increase complications in coronary artery bypass graft surgery, it has not been previously associated with the kinking of a left internal mammary artery. This report highlights another contribution that chronic obstructive pulmonary disease can make to increased morbidity following coronary artery bypass graft surgery and alerts readers to watch for this complication in susceptible patients.
Non-primary nail-plate syphilis in an HIV-infected patient
Authors: Gabrielli Chiara , Cardaci Salvatore , Malincarne Lisa , Pasticci Maria Bruna
Published: March 2018

A 37-year-old Caucasian male, HIV-infected (CDC A2) in 2012 and on antiretroviral therapy, presented for a follow-up visit. On physical examination, a barely discernible light-colored macular rash was observed on the trunk, not involving the palms and soles. However, clear maculo-papular lesions were present over the proximal volar aspect of both forearms. Furthermore, well-demarked purplish, opaque, rough, vertically ridged plaque-like lesions were observed over the proximal portions of fingernails. The patient reported that cutaneous and nail lesions had appeared about 2 months prior and that he had engaged in unprotected sex 5 months before. Serologic tests for syphilis resulted reactive. Intramuscular injection of benzathine penicillin G, 2.4 million units, was administered once a week for 3 weeks. One month after therapy, the rash was no longer present, and at 5 months, nail abnormalities had disappeared. The clinical findings, the serologic results, and the disappearance of skin and nail lesions after the administration of penicillin strongly suggest that this HIV-infected patient had secondary or early late syphilis with skin and nail-plate involvement. We are experiencing a resurgence of syphilis as well as an increase in unusual and/or forgotten clinical manifestations. Syphilis remains a diagnostically challenging disease
“Just the Type with whom I Like to Work”: Two Correspondence Field Experiments in an Online Mental Health Care Market
Authors: Kugelmass Heather
Published: March 2018

Two field experiments investigated discrimination in an online mental health care market. The subjects were 908 mental health care providers (MHPs) who advertise for clients on a website through which help-seekers email providers. Both studies measured MHPs’ receptiveness to an ostensibly black or white help-seeker requesting an appointment. In the first study, no racial or gender disparities were observed. However, help-seekers in the second study, who signaled lower education than those in the first, were confronted with significantly lower accessibility overall. Moreover, black help-seekers with low education and high social need (i.e., a caseworker) received significantly fewer positive responses than any other group. Although the two studies are not directly comparable, their results suggest a hierarchy of accessibility: MHPs prefer more educated help-seekers over less educated ones and among those less educated prefer black help-seekers with a caseworker the least. These disparities persist after controlling for MHPs’ sociodemographic and financial characteristics.
Private Urban Garden Satisfaction and Its Determinants in Quito, Ecuador
Authors: Cruz-Cárdenas Jorge , Oleas Nora H.
Published: March 2018

Because of their importance to people, nature, and societies, domestic gardens have attracted increasing research interest. However, significant areas of interest remain unexplored, such as the variables that determine individuals’ satisfaction with their gardens. Our main goal was to address this gap. We surveyed 1,005 individuals with home gardens in Quito, Ecuador, to collect information on three groups of variables: (a) psychological and individual factors, (b) social and family aspects, and (c) garden characteristics. We used these groups of variables as predictors of satisfaction in a regression model ( R2 = 0.242), with the first and third contributing the most to our understanding of satisfaction. In particular, people tended to be more satisfied with gardens composed of mostly native plants. In addition, individuals tended to be more satisfied if their motives for garden use were related to nature. In contrast, a high level of consumed resources negatively affected satisfaction.
Medical Marijuana Update
Authors: Phillips Jennan A.
Published: March 2018

The majority of states now allow medical marijuana, and recent court decisions could influence workplace practice concerning its use.
Risk Factors for Postoperative Coronal Balance in Adult Spinal Deformity Surgery
Authors: Lewis Stephen J. , Keshen Sam G. , Kato So , Dear Taylor E. , Gazendam Aaron M.
Published: March 2018

Study Design:

A retrospective case-control study.

Objectives:

To determine factors influencing the ability to achieve coronal balance following spinal deformity surgery.

Methods:

Following institutional ethics approval, the radiographs of 47 patients treated for spinal deformity surgery with long fusions to the pelvis, were retrospectively reviewed. The postoperative measurements included coronal balance, L4 tilt, and L5 tilt, levels fused, apical vertebral translation and maximum Cobb angle. L4 and L5 tilt angles were measured between the superior endplate and the horizontal. Sagittal parameters including thoracic kyphosis, lumbar lordosis, pelvic incidence, and sagittal vertical axis were recorded. Coronal balance was defined as the distance between the central sacral line and the mid body of C7 being ≤40 mm. Surgical factors, including levels fused, use of iliac fixation with and without connectors, use of S2A1 screws, interbody devices, and osteotomies. Statistical tests were performed to determine factors that contribute to postoperative coronal imbalance.

Results:

Of the 47 patients reviewed, 32 were balanced after surgery and 14 were imbalanced. Coronal balance was 1.30 cm from center in the balanced group compared to 4.83 cm in the imbalanced group ( P < .01). Both L4 and L5 tilt were statistically different between the groups. Gender and the use of transverse connectors differed between the groups but not statistically.

Conclusions:

In adult spinal deformity patients undergoing primary fusions to the pelvis, the ability to level the coronal tilt of L4 and L5 had the greatest impact on the ability to achieve coronal balance in this small series. A larger prospective series can help validate this important finding.
Does Obesity Explain the Effect of the Metabolic Syndrome on Complications Following Elective Lumbar Fusion? A Propensity Score Matched Analysis
Authors: Lovecchio Francis , Fu Michael C. , Iyer Sravisht , Steinhaus Michael , Albert Todd
Published: March 2018

Study Design:

Propensity score matched retrospective cohort study.

Objectives:

Obesity is a major confounder in determining the independent effect of metabolic syndrome (MetS) on complications after spinal surgery. The purpose of this study is to differentiate MetS from obesity as an independent influence on perioperative outcomes after elective lumbar spine fusion.

Methods:

One- to 3-level posterior spinal fusion cases were identified from the 2011-2014 American College of Surgeons’ National Surgical Quality Improvement Program. To determine the effects of MetS outside of obesity itself, patients with MetS were first compared to a no-MetS cohort and then to an obese-only no-MetS cohort. Two propensity score matches based on demographics, comorbidities, surgical complexity, and diagnosis were used to match patients in 1:1 ratios and compare outcomes. Logistic regression with propensity score adjustment was further utilized as a secondary method of reducing selection bias.

Results:

Out of 18 605 patients that met criteria for inclusion, 1903 (10.2%) met our definition of MetS. Patients with MetS had a higher rate of wound complications (3.8% vs 2.7% obese no MetS, P = .045; vs 2.6% no MetS, P = .035), readmissions (7.4% vs 2.2% obese no MetS, P < .001; vs 4.6% no MetS, P < .001), and extended length of stay (29.1% vs 23.9% obese no MetS, P < .001; vs 23.5% no MetS, P < .001). Patients with MetS were more likely to experience a wound complication (odds ratio = 1.47, 95% confidence interval = 1.02-2.12) or readmission (odds ratio = 1.48, 95% confidence interval = 1.22-1.80).

Conclusions:

Even after controlling for obesity, MetS is an independent risk factor for adverse short-term outcomes. These findings have various implications for preoperative risk stratification and reduction strategies.
Social Skill Dimensions and Career Dynamics
Authors: Wyant Amanda , Manzoni Anna , McDonald Steve
Published: March 2018

All work is social, yet little is known about social skill dimensions or how social skill experiences accumulate across careers. Using occupational data (O*NET) on social tasks, the authors identify social skills’ latent dimensions. They find four main types: emotion, communication, coordination, and sales. O*NET provides skill importance scores for each occupation, which the authors link to individual careers (Panel Study of Income Dynamics). The authors then analyze cumulative skill exposure among three cohorts of workers using multitrajectory modeling. They find substantial variability in social skill experience across early-, middle-, and late-career workers. White, female, and highly educated workers are the most likely to accumulate social skill experience, net of total years of experience. Group differences in cumulative exposure to social skill are rooted in early-career experiences. This study enhances the understanding of social skill exposure across careers and has important implications for future research on social stratification and economic inequality.
Sonographic Presentation of Endometrial Carcinoma Stage I: A Case Study
Authors: Castaneda Nathalie
Published: March 2018

Endometrial carcinoma is the most commonly diagnosed malignancy in the female reproductive tract, mainly affecting women in their postmenopausal years. Although rare, it can also present in premenopausal women. The most common clinical presentation is episodes of abnormal uterine bleeding. Magnetic resonance imaging (MRI), computed tomography (CT), and sonography are imaging modalities used to detect endometrial carcinoma. However, a conclusive diagnosis is made through endometrial biopsy. A case is reported of endometrial distension with endometrial carcinoma and cervical stenosis listed as differentials and originally detected through CT. Sonographic assessment showed an irregular thickened endometrium and an endometrial cavity containing fluid with low-level echoes and areas of polypoid mass-like tissue. Based on these findings, the patient underwent an endometrial biopsy that provided confirmation of endometrioid adenocarcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage 1).
Warfarin alters vitamin K metabolism: a surprising mechanism of VKORC1 uncoupling necessitates an additional reductase
Authors: Rishavy Mark A. , Hallgren Kevin W. , Wilson Lee , Singh Savita , Runge Kurt W. , Berkner Kathleen L.
Published: March 2018

Key Points

Analysis of full VKORC1 reduction of vitamin K epoxide vs the individual reactions shows that warfarin uncouples the 2 reactions. A mutant becomes more active than wild-type VKORC1 only in the presence of warfarin, revealing a novel mechanism for warfarin resistance.
Selectins and chemokines use shared and distinct signals to activate β2 integrins in neutrophils
Authors: Yago Tadayuki , Zhang Nan , Zhao Liang , Abrams Charles S. , McEver Rodger P.
Published: March 2018

Key Points

Selectin and chemokine signals use both Rap1a and PIP5Kγ90 to activate β2 integrins in neutrophils. Suboptimal chemokine signals synergize with selectin signals to activate β2 integrins in neutrophils.
Personalised pulmonary rehabilitation in COPD
Authors: Wouters Emiel F.M. , Wouters Birgit B.R.E.F. , Augustin Ingrid M.L. , Houben-Wilke Sarah , Vanfleteren Lowie E.G.W. , Franssen Frits M.E.
Published: March 2018

This review summarises ongoing developments in personalised medicine and individualised medicine in chronic obstructive pulmonary disease (COPD). Currently applied classification systems largely ignore the complexity and heterogeneity of the COPD syndrome. Personalised medicine has to consider the influence of unique circumstances of the person, which contribute to this heterogeneity and complexity. Pulmonary rehabilitation is described as a comprehensive, individualised intervention based on thorough assessment of identifiable treatable traits. Partnership in care will become a crucial factor to improve and maintain health. Tolerating uncertainty and unpredictability will enrich future doctor–patient relationships.
Estimates of Cancer Incidence in Ethiopia in 2015 Using Population-Based Registry Data
Authors: Memirie Solomon Tessema , Habtemariam Mahlet Kifle , Asefa Mathewos , Deressa Biniyam Tefera , Abayneh Getamesay , Tsegaye Biniam , Abraha Mihiret Woldetinsae , Ababi Girma , Jemal Ahmedin , Rebbeck Timothy R. , Verguet Stéphane
Published: March 2018

Purpose

Noncommunicable diseases, prominently cancer, have become the second leading cause of death in the adult population of Ethiopia. A population-based cancer registry has been used in Addis Ababa (the capital city) since 2011. Availability of up-to-date estimates on cancer incidence is important in guiding the national cancer control program in Ethiopia.

Methods

We obtained primary data on 8,539 patients from the Addis Ababa population-based cancer registry and supplemented by data on 1,648 cancer cases collected from six Ethiopian regions. We estimated the number of the commonest forms of cancer diagnosed among males and females in Ethiopia and computed crude and age-standardized incidence rates.

Results

For 2015 in Ethiopia, we estimated that 21,563 (95% CI, 17,416 to 25,660) and 42,722 (95% CI, 37,412 to 48,040) incident cancer cases were diagnosed in males and females, respectively. The most common adult cancers were: cancers of the breast and cervix, colorectal cancer, non-Hodgkin lymphoma, leukemia, and cancers of the prostate, thyroid, lung, stomach, and liver. Leukemia was the leading cancer diagnosis in the pediatric age group (age 0 to 14 years). Breast cancer was by far the commonest cancer, constituting 33% of the cancers in women and 23% of all cancers identified from the Addis Ababa cancer registry. It was also the commonest cancer in four of the six Ethiopian regions included in the analysis. Colorectal cancer and non-Hodgkin lymphoma were the commonest malignancies in men.

Conclusion

Cancer, and more prominently breast cancer, poses a substantial public health threat in Ethiopia. The fight against cancer calls for expansion of population-based registry sites to improve quantifying the cancer burden in Ethiopia and requires both increased investment and application of existing cancer control knowledge across all segments of the Ethiopian population.
“Everything Is Alive”: Moving and Reading in Excess of American Freedom
Authors: Curseen Allison S.
Published: March 2018

Focusing on the minor details of suffering cats, I read The Adventures of Tom Sawyer as an exemplary illustration of the way in which American novels of individual development destabilize around the movement of minor bodies and minor characters. This destabilization allows not only an interrogation of the limits of US citizenship but also an exploration of how narratives may register something in excess of the citizen and the subject. Distinguishing between the antebellum (boy) characters’ violent play with cats and the postbellum narrator’s ludic play as cat, I argue that cats emerge in Tom Sawyer as captive bodies (among many hard-to-see captives). In the constrained but spectacular movements of these captive bodies, the novel troubles the particularly American freedom actualized in Tom’s play and gestures to a fugitive or feral movement that, though necessary to Tom’s development, always leaps beyond and in the way of efforts to produce a free, individual subject.
The Biopolitics of Feeling
Authors: Schuller Kyla
Published: March 2018

In The Biopolitics of Feeling Kyla Schuller unearths the forgotten, multiethnic sciences of impressibility—the capacity to be transformed by one's environment and experiences—to uncover how biopower developed in the United States. Schuller challenges prevalent interpretations of biopower and literary cultures to reveal how biopower emerged within the discourses and practices of sentimentalism. Through analyses of evolutionary theories, gynecological sciences, abolitionist poetry and other literary texts, feminist tracts, child welfare reforms, and black uplift movements, Schuller excavates a vast apparatus that regulated the capacity of sensory and emotional feeling in an attempt to shape the evolution of the national population. Her historical and theoretical work exposes the overlooked role of sex difference in population management and the optimization of life, illuminating how models of binary sex function as one of the key mechanisms of racializing power. Schuller thereby overturns long-accepted frameworks of the nature of race and sex difference, offers key corrective insights to modern debates surrounding the equation of racism with determinism and the liberatory potential of ideas about the plasticity of the body, and reframes contemporary notions of sentiment, affect, sexuality, evolution, and heredity.