bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood Pressure after Surgery among Obese and Nonobese Children with Obstructive Sleep Apnea
Authors: Kuo Yen‐Lin , Kang Kun‐Tai , Chiu Shuenn‐Nan , Weng Wen‐Chin , Lee Pei‐Lin , Hsu Wei‐Chung
Published: May 2015

Objectives

Treating obstructive sleep apnea in children is found to be associated with blood pressure decreases. However, exactly how adenotonsillectomy (T&A) affects blood pressure in obese and nonobese children remains unclear. This study assesses how obesity affects blood pressure in children with sleep apnea after T&A.

Study Design

Case series with chart review.

Setting

A tertiary referral center.

Subjects and Methods

From 2010 to 2012, a total of 78 children were included. Based on propensity score methods (age, sex, and preoperative apnea‐hypopnea index matched), children were assigned to either the obese group (n = 39) or the nonobese group (n = 39). All children received adenotonsillectomy. We recorded clinical symptoms, preoperative overnight polysomnography (PSG), and subsequent PSG within 3 months after T&A. We measured blood pressure 3 times before PSG (nocturnal blood pressure) and after PSG (morning blood pressure) in a sleep laboratory.

Results

Following surgery, the nonobese group had a significantly decreased nocturnal diastolic blood pressure (DBP) index (–12.0 to −18.8, P =. 018), morning systolic blood pressure (SBP; 111.1 to 105.8 mm Hg, P =. 014), SBP index (–5.4 to −10.9, P =. 008), and DBP (–12.0 to −18.7, P =. 023). Nevertheless, all blood pressure parameters in the obese group were not significantly changed postoperatively. The nonobese group improved more than obese group in nocturnal and morning DBP and DBP index by 2‐way analysis of variance.

Conclusion

Among the children receiving T&A as treatment for OSA, nonobese children improved more than obese children did in terms of blood pressure, allowing us to infer that obese children with OSA may benefit less from T&A in cardiovascular morbidities.
Laryngectomy Complications Are Associated with Perioperative Antibiotic Choice
Authors: Langerman Alexander , Ham Sandra A. , Pisano Jennifer , Pariser Joseph , Hohmann Samuel F. , Meltzer David O.
Published: May 2015

Objective

To assess hospital‐ and physician‐level variation in pattern of perioperative antibiotic use for laryngectomy and the relationship between pattern of antibiotic use and surgical site infection (SSI), wound dehiscence, and antibiotic‐induced complications.

Study Design

Retrospective analysis of University HealthSystem Consortium data.

Setting

Academic medical centers and affiliated hospitals.

Subjects and Methods

Elective admissions for laryngectomy from 2008 to 2011 and associated 30‐day readmissions were analyzed with multivariate logistic regression models.

Results

There were 439 unique antibiotic regimens (agents and duration) identified over the first 4 days of the 1865 admissions included in this study. Ampicillin/sulbactam, cefazolin + metronidazole, and clindamycin were the most common agents given on the day of surgery. Clindamycin was independently associated with higher odds of SSI (odds ratio [OR] = 3.87, 95% confidence interval [CI] = 2.31‐6.49]), wound dehiscence (OR = 3.42, 95% CI = 2.07‐5.64), and antibiotic‐induced complications (OR = 3.01, 95% CI = 1.59‐5.67) when given alone; it was also associated with higher odds of SSI (OR = 2.69, 95% CI = 1.43‐5.05) and antibiotic‐induced complications (OR = 2.20, 95% CI = 1.04‐4.64) when given with other agents. These effects were stronger in a subsample of high‐volume physicians and hospitals.

Conclusion

There is substantial variability in perioperative antibiotic strategies for laryngectomy. Clindamycin was associated with much higher odds of short‐term complications as compared to other common regimens. Based on these data, clinical trials should be planned to firmly establish the most effective and cost‐effective antibiotic management for laryngectomy and determine potential alternatives to clindamycin for penicillin‐allergic patients.
Conceptualizing value co-creation for service innovation in academic libraries
Authors: Islam Md Anwarul , Agarwal Naresh Kumar , Ikeda Mitsuru
Published: May 2015

For the academic library to remain relevant to its users, it must redefine its role in the digital environment and innovate to create responsive and convenient services. It must work actively not just to create value for the user but to involve the user in value co-creating value for service innovation. In this theoretical work, we conceptualize the business concept of value co-creation in the context of libraries and propose a framework of value co-creation for service innovation in academic libraries. With guidance on value co-creation in an academic library environment, and library actors mapped to the co-creation cycle, libraries can use the framework to offer new library services to user communities. The framework also provides a basis for further research in this area.
Prospects and challenges of simulating river channel response to future climate change
Authors: Lotsari Eliisa , Thorndycraft Varyl , Alho Petteri
Published: May 2015

Due to the predicted impacts of future climate on hydrology, morphological changes to river channels are expected. Quantifying the magnitudes and rates of future channel change is important for sustainable river channel management. To date, reviews of simulation approaches for investigating river channels and the modelling of environmental change impacts on channel form and process have focused on contemporary process or palaeo perspectives. Hence, herein we review numerical modelling approaches available for reach-scale simulation of future river channels and the predicted in-channel hydro- and morphodynamic changes modelled. We found that despite their widespread availability, hydrodynamic, morphodynamic and cellular models have yet to be used routinely in future in-channel simulations, with cellular models in particular under-represented. Our review shows that predictions of within-channel changes vary greatly between hydro-climatic regions and under contrasting climate change scenarios, mainly due to varying input discharge scenarios; however, increased sediment transport and flood risk are usually predicted. Key challenges in simulating future channel change include representations of external forcing conditions, adequate temporal and spatial scales, transport equations, changing channel materials and lateral erosion; calibration and validation; simulation chains with multiple models; and identification of feedback systems and non-linearity. Nevertheless, despite these challenges, models with increasing complexity have recently been developed and so there is increasing potential in their application. One-dimensional hydro- and morphodynamic simulations, and cellular models, can be modified to reflect the requirements of future representations, such as grain size properties, whilst there is also now an increasing capability to include a greater quantity of external forcing conditions. Some studies, however, have demonstrated the need to develop two-dimensional models for application in centennial-scale studies. We recommend that a wider range of scenarios and the combined effects of multiple external forcing factors should be included, whilst studies are also needed from more hydrologically diverse reaches.
Financial constraints and dividend policy
Authors: Pathan Shams , Faff Robert , Méndez Carlos Fernández , Masters Nicholas
Published: May 2015

Using a sample of US listed firms over the 1989–2012 period, we find that financially constrained dividend-increasing firms experience superior short-run abnormal stock returns, but suffer worse operating performance compared to similar unconstrained firms. More specifically, constrained firms in more competitive industries realize poorer long-run and operating performance. Likewise, constrained firms that increase dividends during the financial crisis also deliver inferior post-dividend-increase long-run return than do unconstrained firms. We also find evidence that constrained firms show worse stock market reaction to new equity issue announcements following dividend increase, but display a positive market response if they potentially have high investment growth opportunities. Our results are robust to alternative financial constraint proxies and abnormal return measures.
Reversible cerebral vasoconstriction syndrome in the context of recent cerebral venous thrombosis: Report of a case
Authors: Bourvis Nadège , Franc Julie , Szatmary Zoltan , Chabriat Hugues , Crassard Isabelle , Ducros Anne
Published: May 2015

Introduction

Reversible cerebral constriction syndrome and cerebral venous thrombosis are two rare conditions. Reversible cerebral constriction syndrome affects the cerebral arteries and the pathology is still largely unknown. To date, no physiological link with cerebral venous thrombosis has been reported.

Case results

We report here the case of a 24-year-old woman who presented a reversible cerebral constriction syndrome in the setting of a cerebral venous thrombosis. Cerebral venous thrombosis had developed in her left lateral venous sinus, within the stent placed one year before, in order to treat an idiopathic intracranial hypertension.

Discussion

The co-occurrence of cerebral venous thrombosis and reversible cerebral constriction syndrome in the same patient raises the issue of a potential link between them. We discuss the potential common trigger factors in this case: recent hormonal therapy; intracranial hypotension iatrogenically induced by lumbar puncture.
Treatment and prognosis of subdural hematoma in patients with spontaneous intracranial hypotension
Authors: Chen Ying-Chu , Wang Yen-Feng , Li Jie-Yuan , Chen Shih-Pin , Lirng Jiing-Feng , Hseu Shu-Shya , Tung Hsin , Chen Po-Lin , Wang Shuu-Jiun , Fuh Jong-Ling
Published: May 2015

Objective

The objective of this article is to elucidate the outcome, prognostic predictors and timing of surgical intervention for subdural hematoma (SDH) in patients with spontaneous intracranial hypotension (SIH).

Methods

Patients with SDH were identified retrospectively from 227 consecutive SIH patients. Data were collected on demographics, clinical courses, neuroimaging findings, and treatment of SDH, which was later divided into conservative treatment, epidural blood patches (EBP), and surgical intervention. Poor outcome was defined as severe neurological sequelae or death.

Results

Forty-five patients (20%) with SDH (mean maximal thickness 11.9 ± 6.2 mm) were recruited. All 15 patients with SDH <10 mm achieved good outcomes by either conservative treatment or EBP. Of 30 patients with SDH ≥10 mm, patients with uncal herniation ( n = 3) had poor outcomes, even after emergent surgical evacuation ( n = 2), compared to those without ( n = 27) (100% vs. 0%, p < 0.001). Fourteen patients underwent surgical evacuation, resulting in good outcomes in all 12 who received early intervention and poor outcomes in the remaining two who received delayed intervention after Glasgow Coma Scale (GCS) score ≤8 (100% vs. 0%, p = 0.01).

Conclusions

Uncal herniation results in poor outcomes in patients with SIH complicated with SDH. In individuals with SDH ≥10 mm and decreased GCS scores, early surgical evacuation might prevent uncal herniation.
Does Early Versus Delayed Active Range of Motion Affect Rotator Cuff Healing After Surgical Repair?
Authors: Kluczynski Melissa A. , Isenburg Maureen M. , Marzo John M. , Bisson Leslie J.
Published: May 2015

Background:

The timing of passive range of motion (ROM) after surgical repair of the rotator cuff (RC) has been shown to affect healing. However, it is unknown if early or delayed active ROM affects healing.

Purpose:

To determine whether early versus delayed active ROM affects structural results of RC repair surgery.

Study Design:

Systematic review and meta-analysis.

Methods:

A systematic review of articles published between January 2004 and April 2014 was conducted. Structural results were compared for early (<6 weeks after surgery) versus delayed (≥6 weeks after surgery) active ROM using chi-square and Fisher exact tests, as well as relative risks (RRs) and 95% CIs. The analyses were stratified by tear size and repair method.

Results:

A total of 37 studies (2251 repairs) were included in the analysis, with 10 (649 repairs) in the early group and 27 (1602 repairs) in the delayed group. For tears ≤3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for transosseous plus single-row suture anchor repairs (39.7% vs 24.3%; RR, 1.63 [95% CI, 1.28-2.08]). For tears >3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for suture bridge repairs (48% vs 17.5%; RR, 2.74 [95% CI, 1.59-4.73]) and all repair methods combined (40.5% vs 26.7%; RR, 1.52 [95% CI, 1.17-1.97]). For tears >5 cm, the risk of structural tendon defect was higher in the early versus delayed group for suture bridge repairs (100% vs 16.7%; RR, 6.00 [95% CI, 1.69-21.26]). There were no statistically significant associations for tears measuring ≤1, 1-3, or 3-5 cm.

Conclusion:

Early active ROM was associated with increased risk of a structural defect for small and large RC tears, and thus might not be advisable after RC repair.
Mismatched Educational Expectations and Achievement and Adolescent Women’s Risk of Unprotected First Sex
Authors: Beattie Irenee R.
Published: May 2015

Many scholars highlight the benefits of high educational expectations. The study of adolescent women’s sexual risk-taking focuses on college expectations and high achievement for buffering young women from negative outcomes. But one’s expectations and level of college preparation could be mismatched, which may have negative effects. Congruent expectations and achievement are likely to be most beneficial, while inflated expectations (high expectations and low test scores) and deflated expectations (low expectations and high test scores) are expected to be associated with higher risks. College preparatory versus lower coursework in high school may also moderate or mediate these effects. This study used National Educational Longitudinal Study (NELS:88) data with event history and logistic regression analyses to examine how expectations, achievement, and college-preparatory math coursework interact to affect adolescent women’s risk of unprotected first sex. Results show that the effects of expectations are conditional on achievement and coursework: Inflated or deflated expectations (relative to test scores) are associated with the highest risks of unprotected sex, as are low expectations among women in non-college-preparatory math. Theoretically, this has implications for understanding “rationality” in the relationship between educational factors and adolescent women’s sexual risk-taking, as well as for reconsidering the notion that high educational expectations always benefit youth.
The Roles of Attitudinal Perceptions and Cognitive Achievements in a Serious Game
Authors: Cheon Jongpil , Chung Sungwon , Lee Sangno
Published: May 2015

This study investigated a conceptual model that connects game expertise, attitudinal perceptions, and cognitive achievements, and behavioral intention in digital game-based learning. In the study, attitudinal perceptions consisted of three constructs: perceived enjoyment, perceived usefulness, and satisfaction, and cognitive achievements consisted of two constructs: game scores and recall of content. A total of 298 college students played a serious game about transistor recycling, and structural equation modeling was used to analyze data. Our findings showed that two attitudinal constructs (i.e., perceived enjoyment and perceived usefulness) and one cognitive achievement (i.e., game scores) positively influenced satisfaction, and then their satisfaction positively influenced both their recall of content and behavioral intention while game expertise significantly affected on perceived usefulness. This complementary relationship between attitudinal perceptions and cognitive achievements found in this study suggests that when designing a serious game, game designers need to consider the interplay between entertaining factors and instructional strategies.
Ubiquitous Geometry
Authors: Hwang Wu-Yuin , Lin Li-Kai , Ochirbat Ankhtuya , Shih Timothy K. , Kumara W. G. C. W.
Published: May 2015

Ubiquitous geometry (UG) system that was designed and developed for the sixth-grade school students to learn geometry through measuring geometric objects surrounding them is presented. Real geometric objects could facilitate and consolidate students' geometric learning if students were given an opportunity to apply and practice geometric concept-related theories with their daily life objects. Therefore, the main purpose of this study was an attempt to improve students' interest and learning in geometry by providing the proposed UG system in tablet computers to measure daily life objects. Furthermore, two activities, namely, peer assessment and competition, were also designed to facilitate students' interaction and learning. Based on the results of one of the experiments, it is found that students' learning motivation and achievement have been improved significantly. Further, results of the pair t-test applied for pretest and posttest data show that students' geometry learning performances have been improved significantly by using the UG system. Regarding the involvement of students in the proposed activities, it was found that the amounts of competition records, reviewing own competition records, and the highest score of competition were significantly correlated with students' learning gains. The reasons behind were further investigated and found that it can help students to find their own mistakes and clarify misconceptions by doing and reviewing their own competition records. Therefore, it is clear that the proposed UG system and competition activities in this study can help the students to learn geometry better in comparison to traditional learning.
Electroencephalographic (EEG) Photoparoxysmal Responses Under 5 Years of Age
Authors: Binelli Simona , Ragona Francesca , Canafoglia Laura , Freri Elena , Saletti Veronica , Casazza Marina , Gilioli Isabella , D’Arrigo Stefano , Visani Elisa , Panzica Ferruccio , Granata Tiziana , Riva Daria , Franceschetti Silvana
Published: May 2015

Electroencephalographic (EEG) photoparoxysmal response has been little investigated in very young patients. We studied 5055 patients aged less than 5 years with no acquired brain damage, who underwent EEG recording. We determined the prevalence and significance of photoparoxysmal response induced by 1 to 20 Hz photic stimulation. Fifty-three showed photoparoxysmal response and were diagnosed as having Dravet syndrome (11), epileptic encephalopathy with myoclonic seizures (8), neurodegenerative disorders (8), benign idiopathic epilepsies (9), and static disorders with a known or suspected genetic origin (17). Photoparoxysmal response occurred in response to 1 to 5 Hz trains in 41.5% subjects. In most patients with epileptic encephalopathies, photoparoxysmal response was a transient finding: in 53.2%, it failed to be replicated in the recordings performed more than 6 months after initial evaluation. Photoparoxysmal response is rare in patients aged less than 5 years and has some peculiarities such as occurrence with low-frequency stimuli. Its distribution in specific conditions indicates that photoparoxysmal response may be useful in diagnostic workup.
Why Do Women Justify Violence Against Wives More Often Than Do Men in Vietnam?
Authors: Krause Kathleen H. , Gordon-Roberts Rachel , VanderEnde Kristin , Schuler Sidney Ruth , Yount Kathryn M.
Published: May 2015

Intimate partner violence (IPV) harms the health of women and their children. In Vietnam, 31% of women report lifetime exposure to physical IPV, and surprisingly, women justify physical IPV against wives more often than do men. We compare men’s and women’s rates of finding good reason for wife hitting and assess whether differences in childhood experiences and resources and constraints in adulthood account for observed differences. Probability samples of married men ( n = 522) and women ( n = 533) were surveyed in Vietnam. Ordered logit models assessed the proportional odds for women versus men of finding more “good reasons” to hit a wife (never, 1-3 situations, 4-6 situations). In all situations, women found good reason to hit a wife more often than did men. The unadjusted odds for women versus men of reporting more good reasons to hit a wife were 6.55 (95% confidence interval [CI] = [4.82, 8.91]). This gap disappeared in adjusted models that included significant interactions of gender with age, number of children ever born, and experience of physical IPV as an adult. Having children was associated with justifying wife hitting among women but not men. Exposure to IPV in adulthood was associated with justifying wife hitting among men, but was negatively associated with justification of IPV among women. Further study of the gendered effects of resources and constraints in adulthood on attitudes about IPV against women will clarify women’s more frequent reporting than men’s that IPV against women is justified.
How to see failure: Attempts by the Inspectorate of Education to detect and disarm failure in Dutch education policy
Authors: van der Steen Martijn , Scherpenisse Jorren , van Twist Mark , ’t Hart Paul
Published: May 2015

This article looks at policy failure in systems that rely on highly autonomous organizations to deliver the services promised in the policy programs. We argue that in order to better understand success and failure in such systems, the existing categories of policy failure and organizational failure do not suffice. Therefore, we look at the ability of agents assigned to that task to effectively act in the relation in-between the system level and the level of individual organizations. This brings to the fore another type of failure – governance failure – the inability of a policy system to timely detect and asses looming failure in individual parts. It is helpful to apply a lens of interactive complexity to these systems and to look at causal loops rather than causal lines. We apply this perspective to a case of the Inspectorate of Education, to study how it dealt with three cases of looming failure in schools. The perspective of causal loops helped the Inspectorate to understand in hindsight how two schools collapsed, and it was then used proactively to intervene in a third school. The paper helps practitioners to better deal with failure in layered policy and sets an agenda for further research into the use of circular dynamics for policy analysis and intervention.
Nigerian oil and gas industry local content development: A stakeholder analysis
Authors: De Vita Glauco , Lagoke Oluwatosin , Adesola Sola
Published: May 2015

This paper undertakes the first stakeholder analysis of the Nigerian oil and gas industry local content development (LCD) policy to gain a better understanding of the extent of stakeholders’ interactions and how such interactions align to conditions conducive to local content development. Drawing from policy documents and semi-structured interviews, 15 stakeholder groups are identified, and seven of them categorized as key “players.” A social network analysis then reveals that (i) a significant proportion of relationships between key players are unidirectional; (ii) a marginal role is played by higher education institutions within the network; (iii) it is international oil companies rather than indigenous operators that exhibit “global centrality” within the industry network, with the former stakeholder group pivotally determining industry activities. Our findings provide a valuable first step toward the development of a polycentric framework for the appraisal of the Nigerian local content development policy.
High dynamic feedback linearization control of hydraulic actuators with backstepping
Authors: Yao Jianyong , Yang Guichao , Jiao Zongxia
Published: May 2015

This article concerns the high dynamic tracking control of hydraulic servo systems. Unlike previous works usually dealing with high-accuracy tracking control, the proposed feedback linearization controller in this article guarantees excellent tracking performance even with high-frequency tracking demand. To handle unmatched disturbances in hydraulic systems, backstepping method is synthesized in the proposed controller. Typically, in the hydraulic systems, there also exist direct-current unmodeled disturbances which may lead to steady-state errors. An integral-like feedback term is added in the controller to cancel this unexpected effect. The stability of the closed-loop system is guaranteed via frequency-domain analysis. Three controllers, that is, the proportional–integral controller, the proportional–integral controller with velocity feed-forward scheme and the proposed feedback linearization controller, are compared. Extensive comparative experimental results demonstrate the high dynamic tracking performance of the proposed control strategy.
In Their Own Eyes and Voices
Authors: Han Jian , Liang Neng
Published: May 2015

The purpose of this study was to more effectively understand the learning experiences of Executive Master of Business Administration (EMBA) students. We asked 330 EMBA students to draw a graphic representation of their life and reflect on their EMBA experiences. We then applied the Zaltman metaphor elicitation technique to conduct in-depth interviews with 13 EMBA students. By analyzing the visual and narrative data, we documented that the students tended to enter EMBA programs during transitional periods when facing major personal, professional, and self-conceptual challenges. The four most valued outcomes of their EMBA experiences were an analytical framework, a well-connected network, a community to belong to, and a journey of self-discovery and renewal.
Impact of Diabetes on Outcome of Total Ankle Replacement
Authors: Gross Christopher E. , Green Cynthia L. , DeOrio James K. , Easley Mark , Adams Samuel , Nunley James A.
Published: May 2015

Background:

As the incidence of diabetes mellitus (DM) grows, managing patients with diabetes and concomitant ankle arthritis poses a challenging clinical dilemma. While diabetes is known to be a risk factor for complications relating to open reduction and internal fixation of ankle fractures, it is unclear if DM is a risk factor for negative outcomes after total ankle replacement (TAR).

Methods:

We retrospectively identified a consecutive series of 813 primary TARs performed between 2002 and November 2013 that had a minimum follow-up of 1 year. Within that larger group, we identified 50 patients with DM and used a control group without DM for comparison (n = 55). Clinical outcomes including wound issues, infection rates, complications, and failure rates were then compared. Functional outcomes, including American Orthopaedic Foot & Ankle Society hindfoot score, Short Form–36 (SF-36), Short Musculoskeletal Function Assessment, Foot and Ankle Disability Index, and visual analog scale, were also compared. Median patient follow-up was 2.3 years in the DM group and 3.1 years in the control group ( P = .239).

Results:

The body mass index, age, preoperative American Society of Anesthesiologists (ASA) grading, and smoking history in the DM were significantly higher than in the control group. While 5 patients (10%) in the DM group had secondary operations related to the TAR, no patients had a superficial or deep infection. Eight patients (14.5%) in the control group had secondary operations, including 1 patient who needed a flap. There was no statistical differences in secondary operations ( P = .562), revisions ( P = .604), or failure rates ( P = .345). For both the diabetes and control groups, all functional outcome scores except SF-36 General Health significantly improved at 1 year postoperatively; these improvements were maintained at most recent follow-up. There was no statistically significant difference between the groups regarding functional outcomes except that at 1 year, the magnitude of improvement in SF-36 General Heath was significantly better in the control group.

Conclusions:

Total ankle arthroplasty appears to be an effective and safe means for providing pain relief and improving function in patients with diabetes and ankle arthritis. While patients with DM were heavier and had worse ASA preoperative grades, they did not have a significantly different complication or infection rate.

Level of Evidence:

Level III, retrospective comparative study.
Virtual and Hybrid Meetings: A Mixed Research Synthesis of 2002-2012 Research
Authors: Sox Carole B. , Kline Sheryl F. , Crews Tena B. , Strick Sandra K. , Campbell Jeffrey M.
Published: May 2015

This research presents an examination of literature written within hospitality and tourism studies and within other disciplines pertaining to virtual and hybrid meeting genres over a 10-year period (2002-2012). While 15 articles were found within hospitality and tourism journals, 67 articles were included within this review, with the majority published within refereed journals outside of hospitality and tourism. Articles were categorized by journal, year, methodology, and theme. Using the diffusion of innovation theory, five themes emerged: comparison of virtual and/or hybrid meetings with face-to-face meetings, perceptions and attitudes toward virtual and hybrid meetings, management and design of virtual and/or hybrid meetings, specific audiences for virtual and hybrid meetings, and uses of technology within virtual and hybrid meetings. These articles have been accumulated to identify gaps in the literature and provide future research recommendations within hospitality and tourism to be addressed.
Highly pathogenic beta-hemolytic streptococcal infections in cats from an institutionalized hoarding facility and a multi-species comparison
Authors: Morrow Becky L , McNatt Rachel , Joyce Lindsay , McBride Shelley , Morgan Daniel , Tressler Chelsey , Mellits Cara
Published: May 2015

Objectives

Two hundred and thirty-four cats removed from an institutionalized hoarding facility (IHF) demonstrated severe, atypical pyogenic infections. The objective of this study was to document the various syndromes and determine the etiology of the infections.

Methods

All cats were evaluated initially after removal from the IHF and on a daily basis for at least 15 months. Samples were collected and sent for culture/susceptibility and histopathology to commercial laboratories or stored at −20oC. PCR was performed using universal bacterial primers to amplify the 16S–23S rRNA intergenic spacer region. PCR products were sequenced to determine the identity of the bacteria.

Results

Multiple pyogenic syndromes were documented, including abscesses of the paws and carpal/tarsal regions in 82 cats, acute rhinitis with profuse purulent nasal discharge in 68 cats and cervical lymphadenitis with abscessation unassociated with any wounding in 51 cats. Many cats exhibited septic arthritis with total joint destruction, necrotizing fasciitis, meningitis, otitis and septic shock, often leading to death. These infections appeared to be caused by beta-hemolytic streptococci (BHS) based on initial culture results (n = 10), though speciation was unclear and some samples (n = 6) produced no growth. Based on PCR results (n = 26), Streptococcus canis was the only bacterial species or the dominant species identified in each sample, and was the only species present in all the regions associated with the pyogenic infections.

Conclusions and relevance

Horizontal gene transfer and loss of the cell wall may account for the discrepancy between the culture and PCR results and the highly pathogenic nature of S canis in this particular population of cats. A large-scale hoarding situation with multiple animal species, overcrowding, stress and mixing of animals from many geographical regions created ideal conditions for these events to occur. The specific virulence factors present may be more useful in predicting the pathophysiology of BHS infections than the species of Streptococcus found in the host per se.
Non-invasive evaluation of the haemodynamic effects of high-dose medetomidine in healthy cats for semen collection
Authors: Romagnoli Noemi , Zambelli Daniele , Cunto Marco , Lambertini Carlotta , Ventrella Domenico , Baron Toaldo Marco
Published: May 2015

Objectives

This study aimed to assess non-invasively the cardiovascular effects of high-dose medetomidine on healthy male cats undergoing semen collection.

Methods

Haemodynamic evaluations were assessed on the basis of clinical examination, systolic arterial pressure (SAP) and transthoracic echocardiographic examination. Eight client owned, male domestic shorthair cats were sedated with a bolus of medetomidine intramuscularly (IM; 0.13 mg/kg), and semen collection was performed. A second transthoracic echocardiographic examination and SAP measurement were carried out 15 mins after sedation. At the end of the examination, the patients received a bolus of atipamezole (0.3 mg/kg) IM.

Results

The cats were deeply sedated, relaxed and laterally recumbent during the entire procedure. No rhythm abnormalities were observed during the examinations and no significant increase in SAP was recorded. Heart rate dropped from 200 ± 33 to 92 ± 13.1 beats per min after sedation. There was a significant increase in left ventricular dimensions and the left atrial area. The parameters of left ventricular systolic function were reduced, as were systemic and pulmonary cardiac outputs. Peak diastolic wave velocities were significantly reduced, while isovolumic contraction and relaxation time of the left ventricle were prolonged. Aortic valve insufficiency was recorded for all cats, while mitral valve insufficiency was noted in five cats. None of the subjects developed systolic anterior motion of the mitral valve.

Conclusions and relevance

The protocol allowed us to collect good semen samples in healthy cats. However, high-dose medetomidine induces significant haemodynamic effects on the feline heart, mainly due to a reduced heart rate, an increased cardiac preload and impaired systolic function. The animals recovered from the anaesthesia, after antagonist administration, without showing any clinically relevant consequences.
A novel non-Hertzian contact model of spherical roller bearings
Authors: Xing Yu , Xu Hua , Pei Shiyuan , Chen Xiaolei , Liu Xuejing
Published: May 2015

Aiming at describing the indeterminate contact status and acquiring the mechanical behavior of the spherical roller bearing, a novel method is proposed to establish the non-Hertzian contact model. The importance of the indeterminate contact status is illustrated by the comparisons with the computing results of the Hertzian contact model. In view of the computing accuracy and rate, the computing efficiency of the finite element model is lower than that of the non-Hertzian contact model for the mechanical analysis of the spherical roller bearing. The effects of the design parameters in spherical roller bearings are analyzed by the non-Hertzian contact model. An agreement is shown from the analysis results of the typical ball bearing and roller bearing whereby the correctness and versatility of the non-Hertzian model are verified.
Assessment literacy in primary physical education
Authors: DinanThompson Maree , Penney Dawn
Published: May 2015

Internationally, assessment is acknowledged as a critical aspect of pedagogical practice and accountability systems, and as having a fundamental bearing upon what knowledge and ways of articulating knowledge come to be valued in schools. Teachers’ assessment literacy is arguably fundamental to their ability to successfully engage with multiple expectations of assessment and to facilitate assessment as a process that continually supports learning. Informed by Hay and Penney’s ((2013) Assessment in Physical Education: A Sociocultural Perspective. London: Routledge) assessment literacy framework, a qualitative case study investigation was undertaken with 18 primary physical education teachers in a regional area in Australia to gain insight into their assessment practices. The study utilised informal interviews, survey and document analysis. Primary physical education teachers were shown to be engaging with the comprehension, application, interpretation and critical engagement elements of the assessment literacy framework, albeit with limitations. Assessment practices appear to be embedded in teaching practices but were, in the main, superficial. Data analysis highlighted gaps in knowledge about assessment, a focus on accountability and performance, and a lack of moderation and student engagement in assessment. This study directs attention to the tensions, uncertainties and complexities associated with developing assessment of physical education and the challenges associated with extending quality and efficacy in assessment practices.
Non-condom related strategies to reduce the risk of HIV transmission: Perspectives and experiences of gay men with diagnosed HIV
Authors: Bourne Adam , Dodds Catherine , Keogh Peter , Weatherburn Peter
Published: May 2015

Gay men with diagnosed HIV can adopt a number of strategies to reduce the risk of transmitting HIV to others, although research has typically focussed on condom use. Interviews with 42 HIV-positive gay men who reported recent engagement in anal intercourse without condoms explored their awareness of sexual risk and their perceptions of non-condom-related strategies to reduce it. In articulating men’s ambivalence for strategies that can only reduce the risk of transmission, rather than eliminating, the findings have implications for the consideration and integration of new biomedical interventions to reduce the likelihood of HIV transmission.
‘A necessary evil that does not “really” cure disease’: The domestication of biomedicine by Dutch holistic general practitioners
Authors: Raaphorst Nadine , Houtman Dick
Published: May 2015

Against the background of studies about the domestication of complementary and alternative medicine into biomedical settings, this article studies how biomedicine is integrated into holistic settings. Data from 19 in-depth interviews with Dutch holistic general practitioners who combine complementary and alternative medicine with conventional treatments demonstrate that they do not believe that conventional biomedicine ‘really’ cures patients. They feel that it merely suppresses the physical symptoms of a disease, leaving the more fundamental and non-physical causes intact. As a consequence, they use conventional biomedicine for strictly practical and instrumental reasons. This is the case in life-threatening or acute situations, understood as non-physical causes of disease having been left untreated with complementary and alternative medicine for too long. More mundane reasons for its use are the need to take patients’ demands for biomedical treatment seriously or to obey authoritative rules, regulations and protocols. The integration of biomedicine into complementary and alternative medicine, then, follows the same logic of domestication of complementary and alternative medicine into biomedicine: it is made subordinate to the prevailing model of health and illness and treated as a practical add-on that does not ‘really’ cure people.
‘Who’s coming up next to do this work?’ Generational tensions in accounts of providing HIV care in the community
Authors: Newman Christy E , de Wit John BF , Reynolds Robert H , Canavan Peter G , Kidd Michael R
Published: May 2015

Generational change is believed to be transforming the educational and employment preferences of medical trainees. In this article, we examine generational tensions in interviews with policy leaders and clinicians on workforce issues within one subset of the Australian medical profession: general practitioners who provide care to people with HIV in community settings. Integrating the accounts of policy leaders (n = 24) and clinicians representing the ‘first generation’ (n = 21) and ‘next generation’ (n = 23) of clinicians to do this work, shared and divergent perspectives on the role of generational change in shaping professional engagement were revealed. While those engaged in the early response to HIV believed younger clinicians to be less interested in the scientific and political dimensions of HIV care and more concerned about financial security and life balance, the next generation both countered and integrated these beliefs into new ways of conceptualising the value and appeal of this field of medicine. Critical appraisal of the assumptions that underpin generational discourse is essential in appreciating the changing views of providers over time, particularly in fields of medicine which have featured significant historical turning points.
Tipping Point
Authors: Haynes Katalin Takacs , Josefy Matthew , Hitt Michael A.
Published: May 2015

We explore the potential effects of managers’ greed and altruism on their behaviors and firm outcomes. Greed represents extreme self-interest whereas altruism reflects concern for others. We argue that managerial greed leads to a focus on short-term decisions and short-term firm performance. Alternatively, managerial altruism normally produces a focus on longer term decisions and long-term firm performance. Managerial greed is also more likely to produce wrongdoing, whereas managerial altruism produces greater corporate citizenship behaviors. Managerial greed is likely to lead to turnover for non-performance–related reasons whereas managerial altruism is more likely to produce managerial turnover for performance reasons. Overall, we conclude that measured self-interest keeps managers focused on the firm’s goals and measured altruism helps the firm to build and maintain strong human and social capital. The extremes of either greed or altruism likely will harm firm performance. Thus, balance between managerial self-interest and managerial altruism leads to the greatest success.
Organizing in the Age of Competition, Cooperation, and Collaboration
Authors: Snow Charles C.
Published: May 2015

The purpose of this article is to describe how organizations have evolved across three periods of modern economic history. These periods can be called the age of competition, age of cooperation, and age of collaboration. The major organizational forms that appeared in each of the three eras, including their capabilities and limitations, are discussed.
Men’s Health Is Not Affected by Their Mothers’ Intrahepatic Cholestasis of Pregnancy
Authors: Hämäläinen Suvi-Tuulia , Turunen Kaisa , Kosunen Elise , Mattila Kari J. , Sumanen Markku
Published: May 2015

Little is known about the effects of mother’s intrahepatic cholestasis of pregnancy (ICP) on the health of sons born to these mothers. The purpose of the present study was to explore the health of sons born to mothers with ICP. The study design was a retrospective study of ICP mothers’ sons. In the region of Tampere University Hospital in Finland, 365 sons of mothers with ICP during 1969 to 1988 and 617 sons of mothers without ICP were sent a questionnaire in 2010. The response rates were 37.8% ( n = 138) and 36.6% ( n = 226), respectively. Only minor differences were reported between the two groups. Self-evaluated health was similar. There were no significant differences between the groups regarding symptoms and complaints, diagnosed diseases, mental health, and use of medicines. Cough was 10.8 percentage points less common among ICP mothers’ sons than among controls ( p = .034). Urticaria was more common among ICP mothers’ sons, the difference in percentage points being 2.2 ( p = .026). In general, a mother’s ICP does not affect her son’s health.
Dietary Protocols to Maximize Disease Reversal and Long-Term Safety
Authors: Fuhrman Joel
Published: May 2015

This article covers some important concepts and controversies in modern nutritional science. It describes a diet style designed to maximize health, longevity, and disease reversal—foundationally structured on the quality and comprehensive adequacy of nutrients rather than the balance of macronutrients, as is more popular today. I call such a diet, which attempts to optimize micronutrients, a nutritarian diet. I will review a small case series demonstrating typical results in diabetics and some of my clinical observations over the last 25 years treating people with a nutritarian diet, which could be either vegan or flexitarian. I will also discuss health concerns observed from an unsupplemented vegan diet, specifically the risk of depression and later life dementia in individuals with enhanced need for long-chain omega-3 fatty acids.
Neurological recovery after coma related to diffuse cerebral venous sinus thrombosis. Interest in thrombi-aspiration with Penumbra system
Authors: Gariel Florent , Berge Jerome , Dousset Vincent
Published: May 2015

We report a young man with a history of deep coma secondary to an extensive superior sagittal sinus thrombosis despite full systemic anticoagulation. Endovascular treatment combining a 5 Max ACE reperfusion catheter (Penumbra) and Solitaire (Covidien) retrieval device permitted revascularization of the superior sagittal sinus with restoration of anterograde venous flow. This treatment led to the disappearance of cytotoxic edema on MRI and to a neurological improvement with a modified Rankin scale score of 2 after two months. Our experience shows that this technique provides a useful and safe tool after failure of anticoagulation in cerebral venous sinus thrombosis.
Treatment of Popliteal (Baker) Cysts With Ultrasound-Guided Aspiration, Fenestration, and Injection
Authors: Smith Marvin K. , Lesniak Bryson , Baraga Michael G. , Kaplan Lee , Jose Jean
Published: May 2015

Background:

The purpose of this study was to determine the efficacy of ultrasound-guided aspiration, fenestration, and injection as a treatment in patients with symptomatic popliteal cysts.

Hypothesis:

Ultrasound-guided aspiration, fenestration, and injection (UGAFI) is an effective and safe treatment option for symptomatic popliteal cysts.

Study Design:

Retrospective cohort study.

Level of Evidence:

Level 3.

Methods:

Patients who received a UGAFI of popliteal cysts from 2008 to 2011 were identified. Preaspiration (PA) and follow-up Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, cyst recurrence, complications, cyst complexity, and size were obtained and compared for statistical significance. UGAFI involved aspiration of fluid through a spinal needle, fenestration of the cyst walls and septations, and injection of 1 mL (40 mg) triamcinolone (Kenalog) and 2 mL 0.5% bupivacaine (Sensorcaine) into the decompressed remnant.

Results:

The mean PA WOMAC score (48.55) improved significantly at final follow-up (FFU) to 17.15 ( P < 0.0001) for 47 patients. Within the WOMAC subcategories, there was also a significant difference in pain (PA, 10.68; FFU, 3.94; P < 0.0001), stiffness (PA, 4.51; FFU, 1.77; P < 0.0001), and physical function (PA, 31.34; FFU, 12.17; P < 0.0001). There were 6 reaspirations for recurrence (12.7%), and 1 patient underwent unicompartmental knee arthroplasty. There were no infections or other complications.

Conclusion:

Significant clinical improvement in patients with symptomatic popliteal cysts can be achieved via UGAFI as the sole treatment.

Clinical Relevance:

UGAFI is a safe and effective option as the sole treatment modality for symptomatic popliteal cysts.