bluuebunny/crossref_metadata_2025 huggingface dataset:
Deficits in Glenohumeral Passive Range of Motion Increase Risk of Elbow Injury in Professional Baseball Pitchers
Authors: Wilk Kevin E. , Macrina Leonard C. , Fleisig Glenn S. , Aune Kyle T. , Porterfield Ron A. , Harker Paul , Evans Timothy J. , Andrews James R.
Published: June 2014

Background:

Injuries to the elbow joint in baseball pitchers appear common. There appears to be a correlation between shoulder range of motion and elbow injuries.

Purpose:

To prospectively determine whether decreased ROM of the throwing shoulder is correlated with the onset of elbow injuries in professional baseball pitchers.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

For 8 consecutive years (2005-2012), passive range of motion of both the throwing and nonthrowing shoulders of all major and minor league pitchers within a single professional baseball organization were measured by using a bubble goniometer during spring training. In total, 505 examinations were conducted on 296 pitchers. Glenohumeral external rotation and internal rotation were assessed in the supine position with the arm at 90° of abduction and in the plane of the scapula. The scapula was stabilized per methods previously established. Total rotation was defined as the sum of external rotation and internal rotation. Passive shoulder flexion was assessed with the subject supine and the scapula stabilized per methods previously established. Elbow injuries and days missed because of elbow injuries were assessed and recorded by the medical staff of the team. Throwing and nonthrowing shoulder measurements were compared by using Student t tests; 1-tailed Fisher exact tests were performed to identify significant associations between shoulder motion and elbow injury. Nominal logistic regression was performed to determine the odds of elbow injury.

Results:

Significant differences were noted during side-to-side comparisons within subjects. There were 49 elbow injuries and 8 surgeries in 38 players, accounting for a total of 2551 days missed. Neither glenohumeral internal rotation deficit nor external rotation insufficiency was correlated with elbow injuries. Pitchers with deficits of >5° in total rotation in their throwing shoulders had a 2.6 times greater risk for injury. Pitchers with deficit of ≥5° in flexion of the throwing shoulder had a 2.8 times greater risk for injury.

Conclusion:

Bilateral differences in shoulder total rotation and flexion had a significant effect on the risk for elbow injuries in pitchers. Clinicians need to be aware of these findings and plan preventive programs that address these issues in hopes of reducing elbow injuries.
Design, quality, and quality assurance of solid recovered fuels for the substitution of fossil feedstock in the cement industry
Authors: Sarc R , Lorber KE , Pomberger R , Rogetzer M , Sipple EM
Published: June 2014

This paper describes the requirements for the production, quality, and quality assurance of solid recovered fuels (SRF) that are increasingly used in the cement industry. Different aspects have to be considered before using SRF as an alternative fuel. Here, a study on the quality of SRF used in the cement industry is presented. This overview is completed by an investigation of type and properties of input materials used at waste splitting and SRF production plants in Austria. As a simplified classification, SRF can be divided into two classes: a fine, high-calorific SRF for the main burner, or coarser SRF material with low calorific value for secondary firing systems, such as precombustion chambers or similar systems. In the present study, SRFs coming from various sources that fall under these two different waste fuel classes are discussed. Both SRFs are actually fired in the grey clinker kiln of the Holcim (Slovensko) plant in Rohožnik (Slovakia). The fine premium-quality material is used in the main burner and the coarse regular-quality material is fed to a FLS Hotdisc combustion device. In general, the alternative fuels are used instead of their substituted fossil fuels. For this, chemical compositions and other properties of SRF were compared to hard coal as one of the most common conventional fuels in Europe. This approach allows to compare the heavy metal input from traditional and alternative fuels and to comment on the legal requirements on SRF that, at the moment, are under development in Europe.
EU Democracy Promotion in Eastern ENP Countries
Authors: Buşcaneanu Sergiu
Published: June 2014

This study shows that the increased incentive structures from and the more intense socialization process with the European Union (EU) since the launch of European Neighbourhood Policy (ENP) have not translated into a higher level of democratic development in Eastern ENP countries. However, on the long run (1991–2010), the EU democracy promotion in the region under consideration appears to be largely consistent. In addition, a content analysis of Progress Reports released by the European Commission on the implementation process of European Neighbourhood Policy Action Plans (ENPAPs) reveals that some Eastern neighbours of the EU have attempted to consider in their reform agendas the democracy-related objectives of these documents and that some have also sought to adopt international democratic instruments as required by the ENPAPs. Though the record is far from satisfactory on norm internalization, content analysis of Commission’s Reports suggests that one should acknowledge a modest democratization role for the EU.
Correlates of Neighborhood Environment With Walking Among Older Asian Americans
Authors: Li Yawen , Kao Dennis , Dinh Tam Q.
Published: June 2014

Objective: There is a limited research and understanding regarding the physical activity (PA) of older Asian Americans. This study examined the associations between neighborhood factors and walking among older Asian Americans. Method: Drawing from the 2003 California Health Interview Survey, our sample included 1,045 older adults aged 55 and above representing five Asian groups: Chinese, Filipino, Japanese, Korean, and Vietnamese. Zero-inflated negative binomial regression models were used to test the association between neighborhood factors and walking. Results: The results showed that different from the less active health profile among Asian Americans when compared with White adults, Asian older adults overall walked considerably more than White seniors. Higher neighborhood cohesion was associated with more walking among some groups but not all. Association between other neighborhood factors and walking varied among the ethnic groups. Discussion: Health promotion policies and programs should be strategically tailored for specific ethnic groups to more effectively promote PA among older Asian Americans.
Thermolysis parameter and kinetic research in copolyamide 66 containing 2-carboxyethyl phenyl phosphinic acid
Authors: Sheng-Long Tan , Lian-Xin Ma , Xiao-Guang Sun , Xu-Dong Tang
Published: June 2014

Polyamide 66 (PA66) containing phosphorus with flame-retardant property (FR-PA66) was synthesized with adipic acid hexamethylene salt and 2-carboxyethyl phenyl phosphinic acid as raw materials. The thermal degradation kinetics of FR-PA66 and PA66 were measured using a thermogravimetric analyzer, and the data obtained were analyzed with Flynn–Wall–Ozawa and Coast–Redfern methods. The results show that the activation energy ( Ea) of PA66 fabricated under different conditions will be different, while the mechanism functions of thermal decomposition remain the same. Comparing the limit Ea value of PA66 with FR-PA66 at different stages of thermolysis, FR-PA66 keeps the initial thermolysis Ea almost unchanged, reduces the middle thermolysis Ea to 139.1 kJ mol−1, and increases the last thermolysis Ea to 454 kJ mol−1, that is 223 kJ mol−1 higher than that of PA66 with 231 kJ mol−1. This result may be explained by the first cleavage of P–C bond and the formation of the carbonized protective layer. In addition, the most probable kinetic mechanism functions ( F( α)) of thermolysis of FR-PA66 in three different stages were when the rate of decomposition ( α) is lower than 0.4, F( α) = −ln(1 − α); when α is between 0.4 and 0.65, F( α) = [−ln(1 − α)]; and when α is beyond 0.65, F( α) = [−ln(1 − α)].
Synthesis and characterization of a liquid oxygen-compatible epoxy resin
Authors: Wu Zhanjun , Li Shichao , Liu Minjing , Wang Zhi , Li Jialiang
Published: June 2014

The bromine element was introduced into an epoxy resin to improve the liquid oxygen compatibility of the epoxy resin. After curing using 4,4′-diamino diphenylmethane, the liquid oxygen compatibility of all specimens was measured by the liquid oxygen mechanical impact test (ASTM D2512-95). The results suggested that the bromine-modified epoxy resin (BEP) was compatible with liquid oxygen, whereas the bisphenol F epoxy resin (EP) had poor liquid oxygen compatibility. The results of thermogravimetric analysis indicated that the incorporation of tetrabromobisphenol A into EP could accelerate the second-stage thermal degradation of BEP, leading to improvement of the liquid oxygen compatibility. X-ray photoelectron spectroscopy analysis indicated that the C–C/H groups on the surface of specimens could be oxidized to C–O–H/C and C=O groups during the impact process. The mechanism of bromine enhancement on the liquid oxygen compatibility of epoxy resin is proposed.
Optimization study of weld geometry in the tandem submerged arc welding process
Authors: Lafdani MH Kakaei , Ghadiri Zahrani Esmaeil , Galloway Alexander M
Published: June 2014

For any welded component, the weld geometry is a determinative criterion that has a strong influence on the mechanical integrity of the joint. It is therefore important that the weld geometry is adequately considered when establishing the design of the component being welded. Based on the tandem submerged arc welding process, this study reports on an experimental and optimization investigation of the weld geometry characteristics such as bead width, reinforcement form factor and penetration shape factor. The selected process parameters were welding amperage and welding voltage, and these were initially investigated to determine their effect on weld geometry. From this, the results indicated that all developed models for these outputs predicted the behavior of the inputs with high precision. Thus, an optimal condition was established in which the penetration depth was maximized, and hence, a multi-response optimization was determined. Also, the conditions in which the weld reinforcement form factor (W/R) and penetration shape factor (W/P) were minimized are determined and validated.
Time-domain simulation and experimental verification of dynamic cutting forces and chatter stability for circular corner milling
Authors: Peng Chong , Wang Lun , Li Zhongqun , Yang Yiqing
Published: June 2014

Based on the modeling of circular corner milling process, the implicit three-step four-order ADAMS numerical analysis method is presented in this article to solve the differential equation of milling dynamics, which considers non-uniform variation of the radial depth of cut and nonlinear feature of tool–workpiece system. The dynamic cutting forces are predicted in time domain and experimentally verified. On this basis, with comprehensive application of time-domain stability criteria for predicted data, the chatter stability of the milling process is simulated. The predicted stability lobe diagrams are compared against experimental results to confirm the validity of the simulation algorithm, which provides an effective way to optimize cutting parameters for circular corner milling.
Effects of cutting parameters on chip morphology and tool wear in high-speed face milling of hardened steel
Authors: Cui Xiaobin , Zhao Jun
Published: June 2014

High-speed face milling of hardened steel was conducted to investigate the effects of cutting parameters on chip morphology and tool wear. It was found that the tool–chip contact length decreased substantially as the cutting speed increased over 2000 m/min. The adiabatic shear theory is more suitable for describing the formation of individual saw-tooth obtained in the present study. When the cutting speed was relatively low, relatively long tool life can be obtained at large radial depth of cut. On the contrary, when the cutting speed was relatively high, smaller radial depth of cut was beneficial for the acquisition of longer tool life. When the cutting speed was relatively low, due to relatively high mechanical load at relatively small radial depth of cut, large flaked region arose on the tool rake face and the main wear mechanisms of the tool flank face was fracture. However, when the radial depth of cut was relatively large, because of the relatively low mechanical load, there was no flaking on the tool rake face. There existed thermal crack perpendicular to the cutting edge due to the relatively high cutting temperature. When the cutting speed was relatively high, due to the drastically reduced tool–chip contact length, there was very small area of coating delamination near the cutting edge (at relatively small radial depth of cut) or no wear near the cutting edge (at relatively large radial depth of cut).
Degradation analysis of grinding machine spindle systems based on complexity
Authors: Dong Xinfeng , Zhang Weimin
Published: June 2014

In order to monitor the degradation statuses of the spindle systems of machine tool during use, a degradation analysis method based on the complexity is proposed. In this article, the workpiece spindle systems of the grinding machine tool are taken as research object. First, the vibration signals of the workpiece spindle systems in X2 direction are monthly measured from April to October. The complexity values per month of the filtered vibration signals in X2 direction are calculated by Lempel–Ziv algorithm and are used as the index to monitor the degradation statuses of the workpiece spindle systems during 6 months running. The results show that the complexity values of the measured vibration signals from April to October gradually increase, and the status of the workpiece spindle systems of the grinding machine tool has a slight degradation. Finally, in order to verify the validity of the proposed method, the degradation bearing data published by Case Western Reserve University are used to verify the feasibility, and the result shows that the complexity is effective to the degradation analysis of the spindle systems of machine tool.
A two-round design method for ultra-precision flycutting machine tools with stringent process requirements
Authors: Chen Wanqun , Liang Yingchun , Sun Yazhou , Huo Dehong , Su Hao , Zhang Feihu
Published: June 2014

In order to achieve the special functional surfaces machining, a two-round design method for the ultra-precision machine tool design is proposed in this article. This method starts from the engineering design experience; by alternately using the simulation and experiment, the “design-simulation-experiment-simulation-redesign experiment” strategy is employed to the machine tool design. The main influence factors for all of the specifications are determined by this alternating strategy. The analysis of the machine tool performance and the surface generation simulation are well integrated, and the test software is used early at the design stage to estimate the predicted surface. This design method is used for an ultra-precision flycutting machine tool design for potassium dihydrogen phosphate crystal machining, and the results show that by the two rounds of design and modification, the final machine tool meets the processing requirements well. It is believed that the proposed model can be successfully applied to an ultra-precision machine tool designed for achieving strict processing requirements.
Nonlinear dynamic characteristics of a three-dimensional rod-fastening rotor bearing system
Authors: Liu Yi , Liu Heng , Wang Xin , Jing Minqing
Published: June 2014

The nonlinear dynamic characteristics of three-dimensional rod-fastening rotor bearing system are investigated in this paper. The rod-fastening rotor includes discontinuous shaft, rotating disks, circumferentially distributed rods, and macrointerfaces between disks. The first three parts are discretized by three dimensional elements, and the macrointerfaces are connected by some springs whose stiffness is determined by a proposed linear partition method. For comparison, the three-dimensional dynamic model of a corresponding complete rotor bearing system is also built. After the rod-fastening and complete rotor bearing system are reduced by a component mode synthesis, periodic motions and stability margins are calculated by using the shooting method and path-following technique, and the local stability of system is obtained by using the Floquet theory. Comparative results show the both systems have a resemblance in the bifurcation features when mass eccentricity and rotating speed are changed. The vibration response has the identical frequency components when typical bifurcations occur. The dynamic stress is obtained by regarding the displacements of all nodes as load. Moreover, the unbalanced and insufficient of the pre-tightening forces lead to obvious disadvantageous influence on the stability and vibration of the both systems. Generally, this paper considers the interfacial effect of the rod-fastening rotor bearing system and the relative nonlinear dynamic features are obtained.
Improved adaptive neural network control for humanoid robot hand in workspace
Authors: Liu Xin-hua , Zheng Xian-hua , Li Sheng-peng , Chen Xiao-hu , Wang Zhong-bin
Published: June 2014

In order to improve the control performance of humanoid robot hand in workspace, an adaptive control method based on improved neural network was proposed. rival-penalized competitive learning and recursive orthogonal least-squares algorithms were applied to reinforce the learning capability of Gaussian radial basis function neural network and realize the real-time of neural network. Moreover, an improved neural network model for humanoid robot hand was established with Ge-Lee matrix and its operator, and a controller was designed. Finally, an example of humanoid robot hand finger was provided. The results showed that the proposed control method could effectively control the unknown nonlinear dynamic properties and load disturbances of the finger with a much smaller tracking errors.
Exploring the relationship between peatland net carbon balance and apparent carbon accumulation rate at century to millennial time scales
Authors: Frolking Steve , Talbot Julie , Subin Zack M
Published: June 2014

Each year, a peatland has an annual net carbon balance ( NCB), which can be positive (net uptake), zero or negative. Over centuries to millennia, this NCB accumulates as a peat profile. Contemporary peatlands can be sampled (cored), and the past apparent carbon accumulation rate ( aCAR) can be determined as the quantity of peat carbon in any particular dated interval down the core profile. We use a process-based peatland carbon and water cycle model to compare peatland annual NCB during millennia of peat accumulation to the contemporary estimate of aCAR, resulting from this accumulation. Integrating over the entire profile, the accumulated NCB must equal the aCAR, but for shorter time intervals, these two quantities can diverge. A climate variation/perturbation that leads to persistent, slow carbon loss or negligible carbon gain through enhanced decomposition will necessarily reduce the aCAR for time periods before the climate variation/perturbation occurred. This can compromise peatland climate–carbon balance relationships inferred from joint analysis of peat cores and paleoclimate reconstructions.
Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms?
Authors: Palagini L , Tani C , Bruno R M , Gemignani A , Mauri M , Bombardieri S , Riemann D , Mosca M
Published: June 2014

Objectives

Sleep disturbances are frequently observed in rheumatic diseases including systemic lupus erythematosus (SLE). This study aimed at evaluating the prevalence of insomnia, poor sleep quality and their determinants in a cohort of SLE patients.

Methods

Eighty-one consecutive SLE female patients were evaluated in a cross-sectional study. The Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Beck Depression Inventory (BDI) and the Self-rating Anxiety Scale (SAS) were administered. Patients with previous diagnosis of obstructive sleep apnea or restless legs syndrome were excluded. Fifty-three women with hypertension (without SLE) were enrolled as control group (H).

Results

In the SLE cohort poor sleep quality (65.4% vs 39.6%, p < 0.01) and difficulty in maintaining sleep and/or early morning awakening (65.4% vs 22.6%, p < 0.001), but not insomnia (33.3% vs 22.6%, p = ns), were more prevalent than in H. Depressive symptoms were present in 34.6% of SLE vs 13.2% H patients ( p < 0.001) while state anxiety was more common in H patients (H 35.8% vs SLE 17.3%, p < 0.005). SLE was associated with a 2.5-times higher probability of presenting poor sleep quality in comparison to H (OR 2.5 [CI 1.21–5.16]). After adjusting for confounders, both depressive symptoms (OR 4.4, [1.4–14.3]) and use of immunosuppressive drugs (OR 4.3 [CI 1.3–14.8]) were significantly associated with poor sleep quality in SLE patients. Furthermore, poor sleep quality was not associated either with disease duration or activity.

Conclusions

In a cohort of SLE women, insomnia and poor sleep quality, especially difficulties in maintaining sleep, were common. Depressive symptoms might be responsible for the higher prevalence of poor sleep quality in SLE.
The development of artificial organs and prostheses worldwide and in the Ottoman Empire
Authors: Birdane Leman , Cingi Cemal , Elçioğlu Ömür , Muluk Nuray Bayar
Published: June 2014

An artificial organ or prosthesis is a man-made device that is implanted or integrated into a human to replace a natural organ. There were many historical steps in the development of artificial organs and prostheses. New surgical techniques, the development of prosthetic materials and the creative ideas of engineers led to progress in this field.
A biography of William Tuke (1732–1822): Founder of the modern mental asylum
Authors: Kibria Ayisha A , Metcalfe Neil H
Published: June 2014

William Tuke was a 19th-century reformist and philanthropist notable for his work in mental health. He was known for his strict self-discipline and judicious manner. He was also a firm believer in the Quaker faith and actively supported the group and employed many of their principles in his work, especially in his chef d’oeuvre, The Retreat, established in 1792, a mental asylum in York. Possibly catalysed by the very public mismanagement of King George III's ‘madness’, he pioneered the use of moral treatment, a new humane method of treating mental illness. This focussed on allowing patients to live in a community, partake in daily activities and not be subjected to the brutality of the commonplace asylum, all of which were very rare in the treatment of lunatics at that time. Described as ‘The Period of Humane Reform’, his work coincided with the emergence of similar approaches in France, most famously by Philippe Pinel (1745–1826) and his pupil Jean Esquirol (1772–1840) in Paris. Tuke eventually went on to aid in the reform of the law with regards to asylums.
The practice of statutory auditing in France (1867–1935): The case of Pont-à-Mousson and Saint-Gobain companies
Authors: Dattin Christine Fournès
Published: June 2014

The Company Act of July 1867 introduced a new actor into the life of French limited companies: the statutory auditor. It defined the assignment of this new character but gave free rein with regard to auditor recruitment. The aim of this article is to show how this new legal obligation would be implemented. To this end, this article presents the 1867 Act and the French economic, social and political context. It describes the lowly position of professional accounting organisations, their lack of prestige, the predominance of secrecy in business, and an ethos of individualism. To illustrate the actual practice of statutory auditing, this article studies the archives of two major industrial companies of that period: Pont-à-Mousson and Saint-Gobain. These archives show that the auditors were closer to the directors than the proxies of shareholders. In turn, this led to the auditors remaining tied to business secrecy and their independence was challenged.
Quantitative robust linear parameter varying H∞ vibration control of flexible structures for saving the control energy
Authors: Zhang Kai , Scorletti Gérard , Ichchou Mohamed , Mieyeville Fabien
Published: June 2014

In this article, a general and systematical quantitative robust linear parameter varying control method is proposed for active vibration control of linear parameter varying flexible structures such that a complete set of control objectives can be considered, especially the reduction of necessarily required control energy and the control input. To achieve this goal, the phase and gain control policies are employed in linear parameter varying H∞ control designs for suitable selection of weighting functions. The designed parameter-dependent H∞ controller allows us to explicitly consider the time-varying parameters of the dynamical models for saving the control energy and achieving other control objectives such as the specification of vibration reduction and qualitative robustness properties to both parametric and dynamic uncertainties. Then, various reliable robustness analyses are conducted to quantitatively verify the robustness properties in both deterministic and probabilistic senses. The design processes and the effectiveness of the proposed control method are illustrated by active vibration control of a non-collocated piezoelectric cantilever beam excited by an external position-varying force which is the disturbance to be rejected. This plant has typical parameter (force position)-dependent dynamics and is modeled as a linear parameter varying system whose time-varying parameter is the actual position of the disturbance. The numerical simulations demonstrate that, compared to the classical H∞ control and the acceleration feedback control, the proposed control method allows us to compute a quantitatively robust force-position-dependent H∞ controller whose benefit is requiring less control energy and smaller control input, while satisfying the same control objectives in the frequency and time domains.
Synergistic smart morphing aileron: Experimental quasi-static performance characterization
Authors: Pankonien Alexander M , Faria Cassio T , Inman Daniel J
Published: June 2014

This article describes the development and characterization of the synergistic smart morphing aileron concept, which leverages the properties of two different smart material actuators to achieve performance that exceeds that of the constituent materials. Utilizing the relatively higher work density and phase transformation of shape memory alloys combined with the larger bandwidth and conformal bending of bonded piezoelectric macro-fiber composites, the resultant synergistic morphing design improves the range of static tip deflections, enabling the capability to hold more trim positions over long timescales while still quickly compensating for dynamic loading. By commanding an input of full-range square waves of 0.01–10 Hz to the actuators, first-order time responses were measured and characterized using a common methodology by tracking a relative time constant. Using this method, aeroelastic effects for each actuator and the combined system were characterized in a wind tunnel at 0° angle of attack with flow speeds ranging from 0 to 15 m/s. This novel approach characterized a large-deflection morphing actuation system with multiple smart materials operating over different timescales. The combined system achieved additive amplitude while tracking the faster actuation response of the macro-fiber composite between 0.1 and 1 Hz.
Topology optimization of shunted piezoelectric elements for structural vibration reduction
Authors: Pereira da Silva Luciano , Larbi Walid , Deü Jean-François
Published: June 2014

Passive structural vibration reduction by means of shunted piezoelectric patches is addressed in this article. The concept of topology optimization, based on the solid isotropic material with penalization method, is employed in this work to optimize, in terms of damping efficiency, the geometry of piezoelectric patches, as well as their placement on the host elastic structure. The proposed optimization procedure consists of distributing the piezoelectric material in such a way as to maximize the modal electromechanical coupling factor of the mechanical vibration mode to which the shunt is tuned. An original finite element formulation, suitable to any elastic structures with surface-mounted piezoelectric patches, is proposed to solve the electromechanical problem. Numerical examples validate and demonstrate the potential of the proposed approach for the design of piezoelectric shunt devices.
Passive-only damage detection by reciprocity of Green’s functions reconstructed from diffuse acoustic fields with application to wind turbine blades
Authors: Tippmann Jeffery Dwayne , Lanza di Scalea Francesco
Published: June 2014

The increasing demand for renewable and clean power generation has resulted in the increased size of rotor blades in wind turbine systems. The operational environments have introduced the need for structural health monitoring of the blades to help prevent unexpected failures. A new passive approach is here presented to detect damage in a wind turbine blade using the reciprocity of Green’s function. This is achieved using the derivative of an ensemble average of cross-correlation functions to reconstruct the forward and backward time-domain Green’s functions between any two detection points on the structure within a diffuse acoustic field. Damage is detected when the similarity between the forward and backward signals decreases due to the wave nonlinearities introduced by the discontinuity that break the field reciprocity condition. Proof-of-principle results are presented first for an aluminum plate and then for a 9-m-long composite wind turbine blade containing known, simulated damage.
Evaluation of Posterior Malleolar Fractures and the Posterior Pilon Variant in Operatively Treated Ankle Fractures
Authors: Switaj Paul J. , Weatherford Brian , Fuchs Daniel , Rosenthal Brett , Pang Eric , Kadakia Anish R.
Published: June 2014

Background:

Substantial attention has recently been placed on fractures of the posterior malleolus. Fracture extension to the posteromedial rim (“posterior pilon variant”) may result in articular incongruity and talar subluxation. Current classification systems fail to account for these fractures. The relative frequency of this fracture, its associated patient characteristics, and the reliability of its diagnosis have never been reported in such a large series.

Methods:

We retrospectively identified 270 patients who met our inclusion criteria. Basic demographic data were collected. The fractures were classified according to Lauge-Hansen and AO/OTA. Additional radiographic data included whether the fracture involved the posterior malleolus and whether the fracture represented a posterior pilon variant. Univariate statistical methods, chi-square analysis, and interobserver reliability were assessed.

Results:

The relative frequency of posterior malleolus fracture was 50%. The relative frequency of the posterior pilon variant was 20%. No significant difference was noted with respect to the frequency of posterior malleolar or posterior pilon variant between the subgroups of the AO/OTA and Lauge-Hansen classification systems when compared to the overall fracture distribution. Patients with posterior malleolar fractures and posterior pilon variants were significantly older. Females were significantly more likely than men to sustain posterior malleolar fractures and posterior pilon variants. Patients with diabetes trended toward a greater risk of both types of fractures. Interobserver reliability data revealed substantial agreement for posterior malleolar fractures and posterior pilon variants.

Conclusion:

These data represent the highest reported rate of posterior malleolar involvement in operatively treated ankle fractures and is the first to describe the percentage of the posterior pilon variant in such a large series. The interobserver reliability data demonstrate substantial agreement in identification of posterior malleolar fractures and the posterior pilon variant based on plain radiographs. Certain patient characteristics such as age, sex, and diabetes may be associated with these fractures.

Level of Evidence:

Level III, retrospective cohort study.
Difference in Postural Control Between Patients With Functional and Mechanical Ankle Instability
Authors: Chen Henry , Li Hong-Yun , Zhang Jian , Hua Ying-Hui , Chen Shi-Yi
Published: June 2014

Background:

Lateral ankle sprain is one of the most common injuries. Since the structural and pathological differences in mechanical ankle instability (MAI) and functional ankle instability (FAI) may not be the same, it may be better to treat these as separate groups. The purpose of this study was to compare the difference in postural sway between MAI and FAI in patients with chronic ankle instability (CAI).

Methods:

Twenty-six patients with CAI and 14 healthy control participants were included in the study. The CAI patients were subdivided into MAI (15 patients) and FAI (11 patients) groups. Patients who were diagnosed with lateral ankle ligaments rupture by magnetic resonance imaging and ultrasonography were assigned to the MAI group. All participants performed single-limb postural sway tests 3 times on each leg with eyes closed and open. The average distances from the mean center of pressure position in the mediolateral and anteroposterior directions were recorded and compared among the 3 groups.

Results:

The unstable ankles in the MAI group showed significantly greater postural sway in the anterior, posterior, and medial directions compared with those in the control group with eyes closed. With eyes open, significantly greater postural sway was found in the anterior direction. In the FAI group, no difference was found in postural sway compared with those in the control group. The MAI group showed significantly greater postural sway in the anterior direction compared with the FAI group with eyes closed and open. No significant difference in postural sway was found between the unstable and stable ankles in the MAI or FAI groups, with or without vision.

Conclusions:

Patients with MAI have deficits in postural control, especially in anterior-posterior directions. However, no difference was found in postural sway in patients with FAI compared with healthy people.

Clinical Relevance:

As MAI patients suffer from deficits in postural control, balance training should be applied in those patients. In addition, special training should also include the contralateral side after a unilateral ankle ligament injured.
The Influence of Concomitant Triceps Surae Lengthening at the Time of Total Ankle Arthroplasty on Postoperative Outcomes
Authors: Queen Robin M. , Grier A. Jordan , Butler Robert J. , Nunley James A. , Easley Mark E. , Adams Samuel B. , DeOrio James K.
Published: June 2014

Background:

Concomitant procedures are being performed with total ankle replacement (TAR) to improve alignment, function, and mobility. The purpose of this study was to examine the differences in outcomes between patients who had a concomitant triceps surae lengthening (gastrocnemius recession [GSR] or triple hemisection [TAL]) versus a group that underwent TAR alone preoperatively and 1 year after TAR.

Methods:

For this prospective, nonrandomized study, 229 patients (37 GSR, 22 TAL, and 170 TAR alone) were examined. Patient-reported outcomes, physical performance, and lower extremity gait mechanics were completed preoperatively and 1 year postoperatively. A series of repeated measures ANOVAs were used to determine significant differences ( P < .05), and Tukey’s post hoc testing was used to follow any significant ANOVA results.

Results:

No difference existed in BMI, age, gender, or dorsiflexion (DF) angle at heel strike between the triceps surae lengthening groups or between preoperative and 1 year following TAR. Walking speed, the physical performance measures, the AOFAS Hindfoot Score, SF-36, peak plantar flexion angle, and the peak plantar flexion moment were significantly improved ( P < .001) postoperatively with no differences between the triceps surae lengthening groups. The peak DF angle ( P = .006) and the ankle range of motion ( P = .014) demonstrated a greater improvement from preoperative to 1 year postoperatively in the triceps surae lengthening groups in comparison to the TAR alone group.

Conclusion:

Significant improvements existed between preoperative and 1 year postoperatively for most of the variables of interest independent of the triceps surae lengthening group. This study demonstrated that the use of a concomitant triceps surae lengthening procedure (GSR or TAL) resulted in equivalent outcomes when compared with a group undergoing TAR alone.

Level of Evidence:

Level II, prospective comparative study.
The nonlinear vibration and stability of a non-uniform continuous spindle system with nonlinear and nonsmooth boundaries
Authors: Gao Shang-Han , Nong Sheng-Long , Xu Wu-Bin , Meng Guang
Published: June 2014

In this paper, the vibrations of a non-uniform continuous Timoshenko beam model for spindle system with nonlinear and nonsmooth boundaries are analyzed. The Galerkin method is used to discretize the governing nonlinear partial differential equations. Then, the averaging technique is applied to obtain the modulation equations. The frequency response curves are presented and variations of the curves with respect to the bearing interference fit value are discussed. As the interference fit value increases, the nonlinearity of system decreases. All curves are found converge asymptotically to the same dimensionless frequency value as the vibration amplitudes increase. Fixed points are also observed near the natural frequencies in the response curves. These above results provide theoretical foundations for further nonlinear dynamic analysis and design of the spindle bearing systems.
Partial surface texturing: A mechanism for local flow reconditioning in lubricated contacts
Authors: Scaraggi Michele
Published: June 2014

The texture hydrodynamics occurring in optimized steady-state lubricated contacts is theoretically investigated recurring to the recent Bruggeman texture hydrodynamics model. In particular, an attempt is made to unravel the intimate relationship between the texture-induced local flow properties and the macroscopic characteristics of the contact such as friction and supported load. The existence of different mechanisms of fluid flow harvesting and channeling is discussed, highlighting their strict relationship to the particular texture physical and topological properties. Whilst their single-species optimization does not produce particularly interesting performances in comparison to classical geometries, their optimized synergistic interaction, instead, provides a remarkable load generation and friction reduction almost independently from the macroscopic geometrical characteristics of the contact. The provided discussion can be easily extended to other contact geometries, such as for journal bearings, wet clutches and dynamic sealings, as well as to bio-tribology and soft contact applications.
The aetiology of acute neurological decline in multiple sclerosis: Experience from an open-access clinic
Authors: Tallantyre Emma C , Causon Emmie G , Harding Katharine E , Pickersgill Trevor P , Robertson Neil P
Published: June 2014

Background:

Multiple sclerosis (MS) relapses contribute to disability and influence treatment decisions. Many centres now provide open access to specialist services for patients with new symptoms. However, there is scarce literature on the spectrum of presentations encountered in this setting.

Objective:

The objective of this paper is to characterise presentations to an open, rapid-access MS relapse clinic and the impact on disease management.

Methods:

A retrospective review of outpatient episodes over a three-year period was conducted. Demographic and service data, symptoms, disability, diagnosis and management were recorded according to a standardised proforma.

Results:

A total of 371 attendances were analysed. A new MS relapse was diagnosed in 216 (58%) episodes, of which 56 (26%) patients had an additional diagnosis which had also contributed to their presentation. Of 266 reports of non-relapse-related symptoms, 73 were unrelated to MS. Treatment interventions were made in almost all relapsing patients and in 70% of patients presenting with acute, non-relapse-related symptoms of MS. Changes to disease-modifying therapies were considered in 28% of consultations.

Conclusion:

Diagnosing MS relapses is crucial for disease management and yet remains challenging. Clinicians should be aware of differential diagnoses and confounding factors. The high incidence of therapeutic interventions observed suggests that rapid-access clinics represent an effective platform for responsive disease management.
‘Welcome to participate!’: Host activities and caller’s position in Swedish election campaign phone-ins in the 1970s and the 2000s
Authors: Ekström Mats , Moberg Ulla
Published: June 2014

This article presents a study of Swedish election campaign phone-ins from 1970 and from the last decade (2002–2010), with a focus on how different organizations of the interaction, and the activities of the journalist/host, influence the position and power of the caller. Based on Conversation Analysis, two distinct parts of the conversations are explored: the openings of the call and the third turns following a politician’s answer to a caller’s question. The study shows that the power of the caller has decreased in recent election campaigns and this is related to changes in the mediation work by the host. Although the idea of the programs is to support citizen participation, the journalist activities tend to make it hard for the caller to establish a direct dialogue with the politician. The study contributes to previous research on callers’ positions in phone-ins, as well as the general debate about the journalistic efforts to involve citizens in various forms of broadcast communication.
Child maltreatment in Japan
Authors: Kadonaga Tomoko , Fraser Mark W
Published: June 2014

Over the past 15 years, the number of child maltreatment incidents reported to Child Guidance Centers in Japan has increased more than three fold. Reviewing a wide range of policy white-papers and research reports in Japan, we discuss the prevalence of child maltreatment, its social construction over time, societal factors contributing to child maltreatment, and the development and design of the Japanese child welfare system. We conclude with a discussion of emerging issues and challenges.

Findings

A variety of risk factors exacerbate maltreatment in Japan. These include the decline of extended familial supports, low paternal involvement in childrearing, and demanding work routines for both men and women who seek professional careers. Throughout the paper, we discuss historically competing social constructions of the child, family, and work. In addition, we discuss the gendered roles of men and women in Japanese society. Japan's legacy of Shintoism and Confucianism, the institutionalization of patriarchy in the Tokugawa and Meiji Periods, and the modern constraints placed on families by Japanese corporations are explored as factors affecting child maltreatment and the services rendered by the child welfare system. Under the Child Welfare Act of 1948 and the Prevention of Child Abuse Act of 2000, approximately 90% of children in need, including maltreated children, receive care in large group home settings in Japan. Compared to other nations, Japan places great reliance on out-of-home care. Preventive systems to strengthen families and avert out of home placements have not be adequately developed.

Applications

Japanese scholars are re-examining the child welfare system in efforts to design family-based policies and services to both prevent maltreatment and provide alternatives to out-of-home care.
Applying RE-AIM to the Evaluation of FUEL Your Life
Authors: Brace Andrea M. , Padilla Heather M. , DeJoy David M. , Wilson Mark G. , Vandenberg Robert J. , Davis Marsha
Published: June 2014

Weight management programs are becoming increasingly common in workplace settings; however, few target middle-aged men. The purpose of this article is to describe the process evaluation of a worksite translation of the Diabetes Prevention Program in a predominantly middle-aged male population. The translated program, FUEL Your Life, was largely self-directed, with support from peer health coaches and occupational health nurses. The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework was used to examine the factors that influenced program implementation using data from an environmental assessment, participant surveys, peer health coach surveys, and occupational health nurse interviews. An overwhelming majority of the employees who enrolled in the study were overweight or obese (92%). Overall, the program was effective for weight maintenance; those with higher levels of participation and engagement had better weight loss outcomes. The peer health coach and family elements of the intervention were underused. The program was successful in reaching the intended population; however, the program had limited success in engaging this population. Not surprisingly, weight loss was a function of participant engagement and participation. Increasing participant engagement and participation is important to the success of weight management interventions translated to the worksite setting. Garnering buy-in and support from management can serve to increase the perceived importance of weight management in worksites. With management support, weight management protocols could be integrated as a component of the mandatory safety and health assessments already in place, fostering promotion of healthy weight in the workforce.
Evaluating School Obesity-Related Policies Using Surveillance Tools
Authors: Nanney Marilyn S. , Nelson Toben F. , Kubik Martha Y. , Coulter Sara , Davey Cynthia S. , MacLehose Richard , Rode Peter A.
Published: June 2014

The evidence evaluating the association between school obestiy prevention policies and student weight is mixed. The lack of consistent findings may result, in part, from limited evaluation approaches. The goal of this article is to demonstrate the use of surveillance data to address methodological gaps and opportunities in the school policy evaluation literature using lessons from the School Obesity-Related Policy Evaluation (ScOPE) study. The ScOPE study uses a repeated, cross-sectional study design to evaluate the association between school food and activity policies in Minnesota and behavioral and weight status of youth attending those schools. Three surveillance tools are used to accomplish study goals: Minnesota School Health Profiles (2002-2012), Minnesota Student Survey (2001-2013), and National Center for Educational Statistics. The ScOPE study takes two broad steps. First, we assemble policy data across multiple years and monitor changes over time in school characteristics and the survey instrument(s), establish external validity, and describe trends and patterns in the distribution of policies. Second, we link policy data to student data on health behaviors and weight status, assess nonresponse bias, and identify cohorts of schools. To illustrate the potential for program evaluators, the process, challenges encountered, and solutions used in the ScOPE study are presented.