bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic research and analyses of a novel exoskeleton walking with humanoid gaits
Authors: Pan Dalei , Gao Feng , Miao Yunjie
Published: October 2013

This article proposes a novel type of series-parallel lower extremity exoskeleton driven by hydraulic actuators. Each leg of the exoskeleton has six DOFs, which can walk like human and carry heavy loads. A mapping from the positions of human lower extremity joints to the exoskeleton joints was established. Based on Kane's method, the inverse dynamic model of the exoskeleton was conducted. Finally, the exoskeleton humanoid gaits of level walking, ascent, descent, level walking with different loads and speed were simulated, and the required driving torques and power were obtained. These performance analyses provide a basis to the design of the control law and the estimation of the hydraulic actuator parameters for the exoskeleton.
Investigation on turning of AISI 1040 steel with the application of nano-crystalline graphite powder as lubricant
Authors: Srikiran S , Ramji K , Satyanarayana B , Ramana SV
Published: October 2013

The past few decades have witnessed significant advancements in turning processes, cutting tools and coolant/lubricant chemistry. These developments have enhanced the machining capabilities of hard materials when machining at higher cutting conditions. Turning, being characterized by the development of high temperatures at the cutting zone, is critical with respect to the tool life and surface finish apart from other machining results like the forces generated. This phenomenon of heat generation at the cutting zone plays a negative role during turning operations due to their peculiar characteristics such as poor thermal conductivity, high strength at elevated temperature, resistance to wear and chemical degradation. Cutting fluids and solid lubricants are generally used to overcome the problem of heat generation at the cutting zone. The use of cutting fluids in the conventional way may not effectively control the heat generated in turning operation. Moreover, cutting fluids are a major source of pollution. With the advancement in technology, nano-level particulate solid lubricants are being used nowadays in machining operations, especially grinding and turning. The present work deals with the investigation of using nano-level particulate graphite powder as a solid lubricant and various tests were conducted by machining AISI 1040 steel using tungsten carbide inserts. The experiments were conducted by taking into account the parameters like feed rate ranging from 0.05 mm/rev to 0.125 mm/rev, cutting speed ranging from 51 m/min to 192.6 m/min and depth of cut from 0.25 mm to 1 mm. Four levels of each parameter are considered for experimentation. The results indicate that with the decrease in the nano-sized graphite powder, there is an increase of cutting forces – feed force, cutting force and thrust force. The temperatures at the tool–chip interface also increases with the decrease in the lubricant size. It is found that the surface roughness of the workpiece after machining deteriorated due to the size of the lubricant particle.
Hierarchical Encoding Makes Individuals in a Group Seem More Attractive
Authors: Walker Drew , Vul Edward
Published: October 2013

In the research reported here, we found evidence of the cheerleader effect—people seem more attractive in a group than in isolation. We propose that this effect arises via an interplay of three cognitive phenomena: (a) The visual system automatically computes ensemble representations of faces presented in a group, (b) individual members of the group are biased toward this ensemble average, and (c) average faces are attractive. Taken together, these phenomena suggest that individual faces will seem more attractive when presented in a group because they will appear more similar to the average group face, which is more attractive than group members’ individual faces. We tested this hypothesis in five experiments in which subjects rated the attractiveness of faces presented either alone or in a group with the same gender. Our results were consistent with the cheerleader effect.
Numerical modelling of pseudoelastic behaviour of NiTi porous plates
Authors: Shariat Bashir S , Liu Yinong , Rio Gerard
Published: October 2013

This study presents a computational model for deformation behaviour of near-equiatomic NiTi holey plates using finite element method. Near-equiatomic NiTi alloy deforms via stress-induced A↔M martensitic transformation, which exhibits a typical hystoelastic mechanical behaviour over a stress plateau, known as the pseudoelasticity. In this model, the transformation stress is decomposed into two components: the hyperelastic stress, which describes the main reversible aspect of the deformation process, and the hysteretic stress, which describes the irreversible aspect of the process. It is found that with increasing the level of porosity (area fraction of holes), the apparent elastic modulus before and after the stress plateau decrease, the nominal stresses for the A↔M transformation decrease and the strain increases, and the pseudoelastic stress hysteresis decreases. In particular, the transformation strain increases by about 25% by introducing 32% porosity. Upon loading, the strain in a holey plate made of NiTi is more uniformly distributed than in a steel plate of the same geometry. The majority of steel plate remains in a low strain range, with a small portion highly strained. In NiTi, a large volume fraction of the plate undergoes moderate strains.
Nonlinear multiclass support vector machine–based health monitoring system for buildings employing magnetorheological dampers
Authors: Chong Jo Woon , Kim Yeesock , Chon Ki H
Published: October 2013

In this article, a nonlinear multiclass support vector machine–based structural health monitoring system for smart structures is proposed. It is developed through the integration of a nonlinear multiclass support vector machine, discrete wavelet transforms, autoregressive models, and damage-sensitive features. The discrete wavelet transform is first applied to signals obtained from both healthy and damaged smart structures under random excitations, and it generates wavelet-filtered signal. It not only compresses lengthy data but also filters noise from the original data. Based on the wavelet-filtered signals, several wavelet-based autoregressive models are then constructed. Next, damage-sensitive features are extracted from the wavelet-based autoregressive coefficients and then the nonlinear multiclass support vector machine is trained by a variety of damage levels of wavelet-based autoregressive coefficient sets in an optimal method. The trained nonlinear multiclass support vector machine takes new test wavelet-based autoregressive coefficients that are not used in the training process and quantitatively estimates the damage levels. To demonstrate the effectiveness of the proposed nonlinear multiclass support vector machine, a three-story smart building equipped with a magnetorheological damper is studied. As a baseline, naive Bayes classifier–based structural health monitoring system is presented. It is shown from the simulation that the proposed nonlinear multiclass support vector machine–based approach is efficient and precise in quantitatively estimating damage statuses of the smart structures.
Bistable electromagnetic generator based on buckled beams for vibration energy harvesting
Authors: Cottone Francesco , Basset Philippe , Vocca Helios , Gammaitoni Luca , Bourouina Tarik
Published: October 2013

Bistable piezoelectric generators have been demonstrated to outperform linear spring–mass–damper systems in terms of frequency bandwidth and harvested power from wideband vibrations. In this work, a nonlinear vibration energy harvester consisting of clamped–clamped buckled beams combined with a four-pole magnet across coil generator is investigated. By buckling the support beams, an elastic Duffing potential is provided so that the seismic mass can pass from being dynamically monostable to bistable. A theoretical model of the system is presented, and experimental tests are performed on a prototype. In the unbuckled state, the device exhibits higher maximum power at resonance than in the buckled, but, in general, no significant difference is noted in terms of average harvested power between monostable and bistable regimes under harmonic and band-limited stochastic vibrations. However, for an optimal acceleration level, the bistable configuration shows a factor of 2.5 times wider bandwidth and higher power outside from the natural resonance as compared with the monostable regime. It is also observed that the benefits of bistable dynamics mostly depend on the ratio between the characteristic cutoff frequency of the electrical circuit and the mechanical resonance.
Energy harvesting from fluid-induced buckling of ionic polymer metal composites
Authors: Cellini Filippo , Cha Youngsu , Porfiri Maurizio
Published: October 2013

In this article, we assess the feasibility of energy harvesting from mechanical buckling of ionic polymer metal composites induced by a steady fluid flow. Specifically, we consider an underwater energy harvester composed of a paddle wheel, a slider-crank mechanism, and two ionic polymer metal composites clamped at both their ends. To enhance electromechanical transduction, the electrodes of the ionic polymer metal composites are split into three parts via a selective platinum deposition process. The system is installed in a water tunnel and experiments are performed to elucidate the influence of both the flow speed and the shunting resistance on energy harvesting. To provide a theoretical interpretation of the experimental results, the classical post-buckling theory of inextensible elastic beams is adapted to predict mechanical deformations and a lumped-circuit model is utilized to estimate the harvested power.
Quality of Care in Psychosis and Bipolar Disorder From the Service User Perspective
Authors: Skelly Niamh , Schnittger Rebecca I. , Butterly Lisa , Frorath Charlotte , Morgan Craig , McLoughlin Declan M. , Fearon Paul
Published: October 2013

According to the recovery model of mental health care, service development should incorporate the expert knowledge of service users. To date, there has been limited research into conceptualizations of mental health care quality among services users diagnosed with bipolar disorder or psychosis. To investigate service user perspectives on quality of care, we conducted six focus groups ( N = 29) with inpatients and outpatients of an independent Irish mental health service. We undertook an inductive thematic analysis of the data. Participants identified proactive staff, meaningful and warm staff–patient interactions, and safety and sociability in the inpatient environment as components of good quality mental health care. Participants also discussed how the implementation of best practice guidelines does not necessarily improve quality of care from the service user perspective. This and similar qualitative research should be used to inform service development and the creation of evaluation instruments compatible with the recovery model.
Ultrasound Morphology of the Achilles in Asymptomatic Patients With and Without Diabetes
Authors: Abate Michele , Salini Vincenzo , Antinolfi Pierluigi , Schiavone Cosima
Published: October 2013

Background:

The prevalence of tendinopathies is increased in subjects with diabetes mellitus. However, there are few data on the structural abnormalities of Achilles tendons in asymptomatic diabetic patients. The aim of the study was to assess the morphologic characteristics of the Achilles tendon in subjects with diabetes in comparison with controls without diabetes.

Methods:

Participants were consecutively recruited from an outpatient population. Ultrasound longitudinal and transverse scans were performed bilaterally along the full length of Achilles tendon from the musculotendinous junction to the insertion. Degenerative features (abnormal fibrillar pattern, hypo-hyperechoic areas), signs of enthesopathy (bony erosion, enthesophytes, and bursitis), and intratendinous neovessel formation were recorded.

Results:

Asymptomatic sonographic abnormalities (ASA) were significantly increased in subjects with diabetes (35/136 [25.7%] vs 32/273 [11.7%], P = .0003). Sixty tendons with ASA were observed in the first group and 45 in the latter because ASA were bilateral in 25 and in 13 subjects, respectively. ASA were more frequently localized at the enthesis (32/60 [53.3%] vs 9/45 [20%], P = .0005) in the diabetes group, whereas, on the contrary, they were more prevalent at the midportion in controls (38/45 [84.4%] vs 36/60 [60%], P < .006).

Conclusion:

Diabetes may predispose to Achilles tendinopathy and particularly to Achilles enthesopathy. Longitudinal studies, evaluating the progression of the lesions not only in the midportion of the tendon but also at the insertion are needed to support this conclusion.

Level of Evidence:

Level III, comparative series.
Silfverskiöld’s Test in Total Ankle Replacement With Gastrocnemius Recession
Authors: DeOrio James K. , Lewis John S.
Published: October 2013

Background:

For patients undergoing primary total ankle replacement (TAR) with an equinus contracture, gastrocnemius recession may be performed to increase dorsiflexion. We examined whether gastrocnemius recession would significantly increase dorsiflexion even with a negative Silfverskiöld test.

Methods:

Data were prospectively collected on a consecutive series of 29 patients who underwent TAR. All were deemed to require lengthening of the posterior soft tissue structures for unacceptable equinus contracture. Once each patient was under anesthesia, Silfverskiöld’s test was performed. A digital photograph was taken with the ankle at maximum passive dorsiflexion with the knee at 0 degrees of flexion and again with the knee at 30 degrees of flexion. Strayer gastrocnemius recession was then performed in standard fashion in every patient. After recession, Silfverskiöld’s test was again performed with photographs obtained in the same manner. The digital photographs demonstrating the results of the preoperative and postoperative Silfverskiöld’s tests in both knee positions were analyzed and the degree of ankle dorsiflexion measured.

Results:

Regardless of the results of Silfverskiöld’s test, after gastrocnemius recession, patients had an average increase of 12.6 ± 1.6 degrees of dorsiflexion with the knee extended compared to the same position preoperatively ( P < .0001) and an increase of 10.1 ± 2.0 degrees with the knee flexed ( P < .001). In 6 patients Silfverskiöld’s test was markedly positive preoperatively; in this group, recession resulted in an average increase of dorsiflexion of 17.8 ± 3.6 degrees with the knee extended ( P = .004) and 13.4 ± 5.4 degrees with the knee flexed ( P = .055). For the remaining 23 patients with a negative preoperative Silfverskiöld’s test, dorsiflexion increased by 11.3 ± 1.6 ( P < .0001) and 9.3 ± 2.2 degrees ( P = .0003) with the knee extended and flexed, respectively.

Conclusion:

Our data show that a gastrocnemius recession resulted in a significant, reproducible increase in dorsiflexion regardless of the results of the Silfverskiöld test while avoiding potential push-off and plantarflexion weakness associated with an Achilles lengthening.

Level of Evidence:

Level IV, case series.
Accessing Science Through Media
Authors: Gelmez Burakgazi Sevinc , Yildirim Ali
Published: October 2013

This qualitative phenomenological study aims to investigate fourth and fifth graders’ uses of mass media (TV, newspapers, Internet, magazines) and to assess their various features as sources for science learning. The data were collected from 47 purposefully selected students through focus groups and were analyzed through qualitative analysis using uses and gratifications theory as a conceptual framework. The results indicated that students were active in choosing and utilizing media to meet their cognitive, affective, personal integrative, and social integrative needs. Furthermore accessibility, content, and presentation were the key factors in influencing students’ motivation of use of the media.
Control of a class of nonsmooth dynamical systems
Authors: Erfanian Hamid Reza , Skandari Mohammad Hadi Noori , Kamyad Ali Vahidian
Published: October 2013

In this paper, the authors propose an approach to control a class of nonsmooth continuous and discontinuous dynamical systems which is based on a generalization of derivative and Chebyshev pseudospectral (PS) methods. First a generalized derivative for nonsmooth functions, which is proposed by Kamyad et al. is considered. Therefore the obtained generalized derivative of a nonsmooth function is approximated with the Fourier series. So, the nonsmooth control problem is approximated by a smooth optimal control problem and in what follows, it is solved by Chebyshev PS method and the approximate solution for the state and control of the main problem is achieved. Finally, some numerical examples of the control of nonsmooth dynamical systems are solved to illustrate the efficiency of the authors’ approach.
Across the High Seas
Authors: Bajpai Asha
Published: October 2013

This article examines the issues and concerns faced by Indian women in transnational marriages or what are popularly known as NRI marriages in India. It discusses how the Indian laws, the courts, and women try to deal with the difficulties and problems relating to issues of abuse, abandonment, and violence. It also highlights the inadequacies in laws and policies relating to such marriages in India. This article is complimentary to the article by Ann Stewart that concentrates on the “receiving” end of transnational marriages in the United Kingdom, and focuses on the ways in which the socio-legal context of the receiving State (in this case, the United Kingdom) presents difficulties for South Asian women. This article, conversely, takes a “sending” perspective, that is, the response of the home state, India, to the difficulties faced by Indian women involved in transnational marriages.
Multiscale simulation of sliding contacts between two rough sealing surfaces
Authors: Gong Ran , Chen Yongliang , Che Huajun , Zhu Maotao
Published: October 2013

A multiscale method based on numerical computation of finite element method (FEM) and movable cellular automata (MCA) is proposed. The proposed method aims to investigate the sliding contact of sealing rings in macroscale and microscale within a unified framework. The multiscale FEM–MCA coupling method based on mechanical and dynamic parameter transition has superior features such as multiscale time and multiscale space, which improve the efficiency of simulation significantly. Several certain positions of the sealing ring under different operating conditions were selected based on the thermal and structural responses obtained through FEM. Using the proposed multiscale method, we visualized and investigated several types of frictional information in microscale. Coefficients of friction (CoF) of all the cases were calculated and compared. The results indicate that the formation of a mechanically mixed layer (MML) has a significant function in reducing friction force. The thickness of the MML depends on the relative sliding velocity and external pressure. The CoF variations in the microscale model caused by the effects of MML differ from their macroscopic behaviors, but are in accordance with conventional friction theories.
A new tool for hazard analysis and force-field analysis: The Lovebug diagram
Authors: Card Alan J
Published: October 2013

Background

Fishbone diagrams have been widely promoted as a systems-focused hazard analysis tool for use in root cause analysis, but they suffer from a number of structural weaknesses, including a unidirectional structure that only takes into account forces that promote an accident (ignoring those that make the accident less likely or less severe) and a means of displaying these forces that does not convey any difference in strength of influence. In a separate but related issue, many healthcare organizations suffer from a lack of change management expertise.

Proposed solution

To address these concerns, I present a novel technique, the Lovebug diagram, which draws from both Fishbone diagrams and force-field analysis (an approach to analyzing planned change). This new technique adds value to both its progenitor methods, while retaining their key strengths and ease of use. It can be used both prospectively, to assess planned changes, and retrospectively to assess unplanned (accidental) departures from the status quo.

Discussion

The Lovebug diagram is a more powerful analytical tool than its progenitor methods; however, overall adoption of systems-focused tools for root cause analysis remains suboptimal. Additional research is needed to determine how best to promote a truly systems-focused approach to healthcare root cause analysis. Beyond this retrospective use of the technique, it represents a simple tool to assist healthcare organizations with prospective change management.
Applying Process Mapping and Analysis as a Quality Improvement Strategy to Increase the Adoption of Fruit, Vegetable, and Water Breaks in Australian Primary Schools
Authors: Biggs Janice S. , Farrell Louise , Lawrence Glenda , Johnson Julie K.
Published: October 2013

Over the past decade, public health policy in Australia has prioritized the prevention and control of obesity and invested in programs that promote healthy eating–related behaviors, which includes increasing fruit and vegetable consumption in children. This article reports on a study that used process mapping and analysis as a quality improvement strategy to improve the delivery of a nutrition primary prevention program delivered in primary schools in New South Wales, Australia. Crunch&Sip® has been delivered since 2008. To date, adoption is low with only 25% of schools implementing the program. We investigated the cause of low adoption and propose actions to increase school participation. We conducted semistructured interviews with key stakeholders and analyzed the process of delivering Crunch&Sip to schools. Interviews and process mapping and analysis identified a number of barriers to schools adopting the program. The analyses identified the need to simplify and streamline the process of delivering the program to schools and introduce monitoring and feedback loops to track ongoing participation. The combination of stakeholder interviews and process mapping and analysis provided important practical solutions to improving program delivery and also contributed to building an understanding of factors that help and hinder program adoption. The insight provided by this analysis helped identify usable routine measures of adoption, which were an improvement over those used in the existing program plan. This study contributed toward improving the quality and efficiency of delivering a health promoting program to work toward achieving healthy eating behaviors in children.
Gender Differences in the Use of Drug Resistance Strategies
Authors: Okamoto Scott K. , Pel Suzanne , Helm Susana , Valdez Jessica K.
Published: October 2013

This study examines gender differences in the use of drug resistance strategies for rural Asian/Pacific Islander youth. Multiethnic Asian/Pacific Islander youth ( N = 213) from six middle/intermediate schools on the Island of Hawai‘i participated in the study, and gender differences in their real-world use of specific strategies (e.g., refuse, explain, avoid, leave) were examined. Despite similar levels of exposure to situations where drugs and/or alcohol were offered, girls indicated significantly lower usage of most of the resistance strategies compared to boys, suggesting girls’ increased risk in dealing with drug-related problem situations. Implications for gender-and culture-specific health promotion and drug prevention curricula are discussed.
Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder Complicated by Stigma
Authors: Babinski Dara E. , Pelham William E. , Waxmonsky James G.
Published: October 2013

Nearly 50% of children continue to experience obsessive-compulsive disorder (OCD) symptoms and impairment at the end of traditional Cognitive-Behavioral Therapy (CBT), and some studies suggest that stigma may complicate the course of CBT for OCD. This case study describes the use of CBT for a 9-year-old boy, “Isaac,” who was diagnosed with OCD and was experiencing stigma related to a visible physical handicap. Manualized CBT was conducted, and substantial improvement in OCD symptoms and functioning emerged. However, given the persistence of obsessions, which we believed to be particularly difficult to resist given the visibility of his handicap and associated stigma, additional booster sessions were included, from which more improvements emerged, and they were maintained over a year. Thus, this case study illustrates the benefit of addressing OCD symptoms and impairment as well as other complicating factors, such as stigma, in the course of treatment.
Preference-Enhanced Communication Intervention and Development of Social Communicative Functions in a Child With Autism Spectrum Disorder
Authors: van der Meer Larah , Sigafoos Jeff , Sutherland Dean , McLay Laurie , Lang Russell , Lancioni Giulio E. , O’Reilly Mark F. , Marschik Peter B.
Published: October 2013

Individuals with autism spectrum disorder (ASD) who exhibit limited speech can learn to communicate using augmentative and alternative communication (AAC) systems. We describe the case of Ian, a 10-year-old boy with ASD who had learned to use an Apple iPod®- and iPad®-based speech-generating device (SGD)Note 1, picture exchange (PE), and manual signing (MS) for functional communication (e.g., requesting), but had difficulty in using these AAC systems for spontaneous and socially oriented functions of communication. His difficulties were originally conceptualized as reflecting the social interaction and communication deficits characteristic of ASD. Alternatively, we suggest that the intervention did not allow for the development of more advanced communication. A preference-enhanced intervention was introduced with Ian’s chosen AAC system only, that is the iPad®-based SGD. Opportunities for communication were created using highly motivating activities and behavioral strategies. Results suggest that the approach facilitated development of spontaneous and socially oriented communication.
Effective Diet and Exercise Interventions to Improve Body Composition in Obese Individuals
Authors: Rankin Janet Walberg
Published: October 2013

Because higher body fat and lower lean mass is associated with excess morbidity and mortality, health care teams need specific science-based recommendations to advise clients on lifestyle approaches to alter body composition. Combining exercise with modest energy restriction is recommended to cause up to 20% more weight and fat loss, improved function, and reduced lean mass loss than modification of diet alone. The optimal diet for developing a leaner body composition is one that is modestly reduced in energy and contains lower fat and higher protein than average. Aerobic exercise alone may cause minimal change in body weight (1%-3%) and fat if greater than 250 min/wk. Higher intensity or duration of exercise can cause more substantial fat loss but may have poor long-term compliance. Resistance exercise boosts lean body mass and improves some health indicators but generally does not cause fat loss. In summary, consumption of a low-fat (20%-25% of energy), moderately high-protein (>1.2 g/kg and up to 20%-25% of energy) diet with modestly reduced energy (500-1000 kcal/d) combined with aerobic (3-5 d/wk, at least 250 min/wk) and resistance exercise (2 d/wk) can improve body composition to reduce clinically relevant risks associated with obesity.
Single minimal path based backup path for multi-state network
Authors: Zhang Yun , Xu Zhengguo , Wang Xinli , Lu Jiangang , Sun Youxian
Published: October 2013

Backup path is an important mechanism to sustain the reliability of a multi-state network. As a popular backup path method, the double minimal path based backup path algorithm can improve the multi-state network’s reliability when the main paths fail. However, this algorithm cannot work efficiently when a single main minimal path fails. To improve the reliability in the first main minimal path failure case, we propose a single minimal path based backup path algorithm. In the single minimal path based backup path algorithm, two disjoint minimal paths are used as the main routing pair to transmit the data, and one single minimal path, which is disjoint with the main minimal paths, acts as the backup path. In the second main minimal path failure case, we propose a double–single minimal path based backup path algorithm to improve the multi-state network reliability. To develop the single minimal path based backup path and the double–single minimal path based backup path algorithms, this article first formulates the multi-state network reliability analysis problem. Then, a solution procedure is proposed to calculate the multi-state network reliability. Furthermore, numerical examples are given to validate the effectiveness of the algorithms. Finally, some comparisons are made between the single minimal path based backup path/double–single minimal path based backup path and the double minimal path based backup path/double minimal path based backup path algorithms. The comparison results indicate that the single minimal path based backup path and the double–single minimal path based backup path algorithms lead to considerable improvement in terms of the multi-state network reliability in the first and the second main minimal path failure cases, respectively, which are verified by both the mathematical analysis and numerical experiments.
Bayesian nonparametric models for combining heterogeneous reliability data
Authors: Warr Richard L , Collins David H
Published: October 2013

Modern complex engineering systems often present the analyst with a mix of data types that can be used for reliability prediction: system test results, lifetime data from unit tests of components, and subsystem data, all of which may have predictive value for the system lifetime. We present a hierarchical nonparametric framework, using Dirichlet processes, in which time-to-event distributions may be estimated from sample data or derived based on physical failure mechanisms. By applying a Bayesian methodology, the framework can incorporate prior information, including expert opinion.
A reliable surgical treatment for digital mucous cysts
Authors: Johnson S. M. , Treon K. , Thomas S. , Cox Q. G. N.
Published: October 2013

There is no clear consensus about the best operative technique for the treatment of digital mucous cysts. We carried out a retrospective review of all patients who underwent excision of a digital mucous cyst using a local advancement skin flap over a 10-year period. A total of 69 patients were included and were reviewed at an average of 38 months (minimum 6 months) post-operatively. No patients were lost to follow-up. There was only one case of cyst recurrence. Of these 67 patients were happy with the scar and 63 patients said they would have the procedure again; 36 patients had a pre-operative nail deformity and 21 reported that the deformity grew out after the procedure.
The search for the ideal tendon repair in zone 2: strand number, anchor points and suture thickness
Authors: Savage R.
Published: October 2013

This review article examines the mechanical factors involved in tendon repair by sutures. The repair strength, repair stiffness and gap resistance can be increased by increasing the number of core strands and anchor points, by increased anchor point efficiency and the use of peripheral sutures, and by using thicker sutures. In the future, laboratory tests could be standardized to a specific animal model and to a defined cyclic motion programme. Clinical studies support the use of multi-strand core and peripheral sutures, but two-strand core sutures are not adequate to ensure consistently good clinical results. Training surgeons in complex tendon repair techniques is essential.
Dynamic motion analysis of dart throwers motion visualized through computerized tomography and calculation of the axis of rotation
Authors: Edirisinghe Y. , Troupis J. M. , Patel M. , Smith J. , Crossett M.
Published: October 2013

We used a dynamic three-dimensional (3D) mapping method to model the wrist in dynamic unrestricted dart throwers motion in three men and four women. With the aid of precision landmark identification, a 3D coordinate system was applied to the distal radius and the movement of the carpus was described. Subsequently, with dynamic 3D reconstructions and freedom to position the camera viewpoint anywhere in space, we observed the motion pathways of all carpal bones in dart throwers motion and calculated its axis of rotation. This was calculated to lie in 27° of anteversion from the coronal plane and 44° of varus angulation relative to the transverse plane. This technique is a safe and a feasible carpal imaging method to gain key information for decision making in future hand surgical and rehabilitative practices.
The growth factors involved in flexor tendon repair and adhesion formation
Authors: Branford O. A. , Klass B. R. , Grobbelaar A. O. , Rolfe K. J.
Published: October 2013

Flexor tendon injuries remain a significant clinical problem, owing to the formation of adhesions or tendon rupture. A number of strategies have been tried to improve outcomes, but as yet none are routinely used in clinical practice. Understanding the role that growth factors play in tendon repair should enable a more targeted approach to be developed to improve the results of flexor tendon repair. This review describes the main growth factors in tendon wound healing, and the role they play in both repair and adhesion formation.
Clinical experience with duloxetine in the management of chronic musculoskeletal pain. A focus on osteoarthritis of the knee
Authors: Brown Jacques P. , Boulay Luc J.
Published: October 2013

Duloxetine is a serotonin and norepinephrine reuptake inhibitor (SNRI) with central nervous system activity. Its analgesic efficacy in central pain is putatively related to its influence on descending inhibitory pain pathways. The analgesic efficacy of duloxetine has been demonstrated in four distinct chronic pain conditions. These include neuropathic pain associated with diabetic peripheral neuropathy, fibromyalgia, chronic low back pain, and osteoarthritis knee pain (OAKP). The purpose of this review is to examine the clinical efficacy and safety of duloxetine in the management of chronic OAKP. Three separate randomized, double-blind placebo-controlled trials have demonstrated that (1) a clinically meaningful decrease in pain severity occurs at about 4 weeks relative to placebo, (2) patients receiving duloxetine report better improvements in physical functioning relative to placebo, (3) duloxetine is safe and effective when used adjunctively with nonsteroidal anti-inflammatory drugs, and (4) that there are no new safety signals beyond what has been observed in other indications.
Translating Research Into a Seamless Transition Model
Authors: Luecking Debra Martin , Luecking Richard G.
Published: October 2013

Recently, consensus among researchers and professionals has emerged about factors that contribute to postschool success of youth with disabilities. Prominent among these factors are targeted academic preparation, family involvement, youth empowerment, and service collaboration and linkages. Work experience and paid employment have been identified as being highly associated with positive postschool employment outcomes. These components are reflected in the Guideposts for Success, produced by the National Collaborative on Workforce and Disability/Youth (NCWD/Y), which represents professional consensus and extant research about what constitutes optimal transition service. The authors present a descriptive report on the implementation of a model for systematically delivering seamless transition services based on components of the NCWD/Y Guideposts. They report on how this model has been applied in 11 of the 24 county-wide school districts in Maryland for diverse special education populations, and provide preliminary data on its early impact on the students’ transition to careers.
A Quantitative Analysis of Photographs and Articles on espnW
Authors: Wolter Sarah
Published: October 2013

espnW is ESPN, Inc.’s first initiative developed specifically for female fans and female athletes. To date, no comprehensive analysis of photographs or articles on the espnW website has been published. This study is a quantitative analysis of the first 6 months of photographs and feature articles of espnW to ascertain how the site covers athletes and sports. Results reveal that female athletes are covered photographically in unprecedented ways from mainstream media on espnW, both in frequency and in seriousness of coverage as measured by athletes in uniform, on the playing surface, and in action. Additionally, feature articles portray female athletes as serious competitors by highlighting athletic performance and psychological/emotional strengths instead of focusing on athletes’ physical appearance, family roles, or personal relationships. Although some depictions mirror past representations, where female athletes are represented more than male athletes in individual sports and more at the recreational level of sport, these factors pale in comparison to the number of factors that showcase female athletes as serious competitors.
HIV-Associated Thromboembolic Phenomenon due to Protein C Deficiency
Authors: Goyal Anmol , Shah Ira
Published: October 2013

HIV-infected individuals are at a high risk of developing arterial and venous thromboembolism. Opportunistic infections, protease inhibitors, low CD4 count, antiphospholipid antibodies, protein S, and protein C deficiencies are some important risk factors associated with it. However, thromboembolic phenomenon due to protein C deficiency has been rarely reported. We report a case of a 12-year-old girl with facial palsy due to middle cerebral artery infarct because of HIV infection and associated protein C deficiency.
Perceptions of Male Circumcision among Married Couples in Rural Malawi
Authors: Shacham Enbal , Godlonton Susan , Thornton Rebecca L.
Published: October 2013

Voluntary medical male circumcision (VMMC) is being suggested as an essential HIV prevention strategy in high-prevalence areas. These analyses reflect data collected from 360 married couples, 50% of which included a circumcised husband and the other 50% uncircumcised, in rural Malawi. Regardless of their circumcision status, men were more likely to perceive that being circumcised was less painful than having a tooth pulled, giving birth, and having malaria. Men reported having the same sexual pleasure regardless of the circumcision status, while women were 2.0 times more likely to report greater sexual pleasure with a circumcised partner. Participants identified the medical benefits of VMMC and highlighted the potential personal benefits of VMMC. As VMMC has become a promising method of HIV prevention, this study revealed opportunities for intervention development to increase rates of VMMC among men.
Outcomes of a Postexposure Prophylaxis Program at the Korle-Bu Teaching Hospital in Ghana
Authors: Tetteh Raymond A. , Nartey Edmund T. , Lartey Margaret , Mantel-Teeuwisse Aukje K. , Leufkens Hubert G. M. , Nortey Priscilla A. , Dodoo Alexander N. O.
Published: October 2013

The risk for occupational exposure to HIV is a serious public health problem that is well characterized in the developed world, but less so in the developing countries such as Ghana. This study was undertaken to examine the characteristics of occupational exposure to HIV and the utilization of a risk assessment system (RAS)–based postexposure prophylaxis (PEP) among health care workers (HCWs) and health care students (HCSs) in the Korle-Bu Teaching Hospital (KBTH). During the study period (January 2005–December 2010), a total of 260 and 35 exposures were reported by HCWs and HCSs, respectively. Ward attendants reported the highest incidence rate of 6.46 of 100 person-years (P-Y). The incidence of high-risk exposures was 0.33 of 100 P-Y (n = 65); 60.0% occurred during a procedure of disposing of a needle and 24.6% during a cannula insertion. A total of 289 of the 295 individuals were administered PEP, of which 181 (62.6%) completed the 6-month follow-up testing schedule and none sero-converted. This shows that with a good RAS in place, it is possible to deploy an effective PEP program in a typical African teaching hospital like the KBTH in Accra, Ghana.
Welfare Homes for Patients Living with HIV/AIDS in Andalusia
Authors: Ivanova Radka , Vergara Salvador , Milla Manuel , Lozano Fernando , Santos Jesús
Published: October 2013

Aims:

To study the AIDS welfare homes (AWHs) in Andalusia, assess their resources and the services provided, and describe the characteristics of their residents.

Patients and Methods:

Cross-sectional, observational study; an interview questionnaire technique was used with the managers and the residents of the AWHs.

Results:

A total of 7 AWHs and 96 residents were included; 32% of the staff were health care workers and 45.5% volunteers. The occupancy rate was 86% (2007) and 96% (2008). Residents’ characteristics: mean age 45.6 years, 73% male, 92% with at least 1 AIDS-defining disease, median Karnofsky index 60 (50-80), and median Barthel index 80 (40-100). Half the residents had physical sequelae and 31% mental sequelae.

Conclusion:

The AWHs perform an important role in the care of certain types of patients with HIV infection. They require human and material resources to be able to tackle the immense difficulties associated with this group of patients.
Forfeited hepatogenesis program and increased embryonic stem cell traits in young hepatocellular carcinoma (HCC) comparing to elderly HCC
Authors: Wang Hsei-Wei , Hsieh Tsung-Han , Huang SSu-Yi , Chau Gar-Yang , Tung Chien-Yi , Su Chien-Wei , Wu Jaw-Ching
Published: October 2013

Background

Hepatocellular carcinoma (HCC) in young subjects is rare but more devastating. We hypothesize that genes and etiological pathways are unique to young HCC (yHCC; ≤40 years old at diagnosis) patients. We therefore compared the gene expression profiles between yHCCs and HCCs from elderly patients.

Results

All 44 young HCCs (≤40 years old at the diagnosis; 23 cases in the training set while another 21 in the validation cohort) were positive for serum hepatitis B surface antigen (HBsAg), but negative for antibodies to hepatitis C virus (anti-HCV). All 48 elderly (>40 years old; 38 in the training set while another 10 in the validation cohort) HCC patients enrolled were also serum HBsAg positive and anti-HCV negative. Comparative genomics analysis was further performed for elucidating enriched or suppressed biological activities in different HCC subtypes.

The yHCC group showed more macroscopic venous invasions (60.9% vs. 10.5%, p < 0.001), fewer associated cirrhosis (17.4% vs. 63.2%, p < 0.001), and distinct profiles of expressed genes, especially those related to DNA replication and repair. yHCCs possessed increased embryonic stem cell (ESC) traits and were more dedifferentiated. A 309-gene signature was obtained from two training cohorts and validated in another independent data set. The ILF3 ESC gene, which was previously reported in poorly differentiated breast cancers and bladder carcinomas, was also present in yHCCs. Genes associated with HCC suppression, including AR and ADRA1A, were less abundant in yHCCs. ESC genes were also more enriched in advanced HCCs from elderly patients.

Conclusion

This study revealed the molecular makeup of yHCC and the link between ESC traits and HCC subtypes. Findings in elderly tumors, therefore, cannot be simply extrapolated to young patients, and yHCC should be treated differently.
Optimised laser microdissection of the human ocular surface epithelial regions for microarray studies
Authors: Kulkarni Bina B , Powe Desmond G , Hopkinson Andrew , Dua Harminder S
Published: October 2013

Background

The most important challenge of performing insitu transcriptional profiling of the human ocular surface epithelial regions is obtaining samples in sufficient amounts, without contamination from adjacent tissue, as the region of interest is microscopic and closely apposed to other tissues regions. We have effectively collected ocular surface (OS) epithelial tissue samples from the Limbal Epithelial Crypt (LEC), limbus, cornea and conjunctiva of post-mortem cadaver eyes with laser microdissection (LMD) technique for gene expression studies with spotted oligonucleotide microarrays and Gene 1.0 ST arrays.

Methods

Human donor eyes (4 pairs for spotted oligonucleotide microarrays, 3 pairs for Gene 1.0 ST arrays) consented for research were included in this study with due ethical approval of the Nottingham Research Ethics Committee. Eye retrieval was performed within 36 hours of post-mortem period. The dissected corneoscleral buttons were immersed in OCT media and frozen in liquid nitrogen and stored at −80°C till further use. Microscopic tissue sections of interest were taken on PALM slides and stained with Toluidine Blue for laser microdissection with PALM microbeam systems. Optimisation of the laser microdissection technique was crucial for efficient and cost effective sample collection.

Results

The starting concentration of RNA as stipulated by the protocol of microarray platforms was taken as the cut-off concentration of RNA samples in our studies. The area of LMD tissue processed for spotted oligonucleotide microarray study ranged from 86,253 μm2 in LEC to 392,887 μm2 in LEC stroma. The RNA concentration of the LMD samples ranged from 22 to 92 pg/μl. The recommended starting concentration of the RNA samples used for Gene 1.0 ST arrays was 6 ng/5 μl. To achieve the desired RNA concentration the area of ocular surface epithelial tissue sample processed for the Gene 1.0 ST array experiments was approximately 100,0000 μm2 to 130,0000 μm2. RNA concentration of these samples ranged from 10.88 ng/12 μl to 25.8 ng/12 μl, with the RNA integrity numbers (RIN) for these samples from 3.3 to 7.9. RNA samples with RIN values below 2, that had failed to amplify satisfactorily were discarded.

Conclusions

The optimised protocol for sample collection and laser microdissection improved the RNA yield of the insitu ocular surface epithelial regions for effective microarray studies on spotted oligonucleotide and affymetrix platforms.