bluuebunny/crossref_metadata_2025 huggingface dataset:
Family Business Succession and Its Impact on Financial Structure and Performance
Authors: Molly Vincent , Laveren Eddy , Deloof Marc
Published: September 2017

In this article the authors study the impact of a family business transfer on the financial structure and performance based on a sample of 152 small- to medium-sized businesses. The aim is to identify the effects of a succession by relying on panel data gathered over the period 1991 to 2006 resulting in more than 2,000 firm–year observations. The main findings are that a transfer from the first to the second generation negatively influences the debt rate of the company, whereas in successions between later generations this effect is reversed. With respect to firm growth, analyses indicate that in first-generation companies the growth rate decreases after the transition, whereas in next-generation firms no effect on the growth level can be identified. Finally, no evidence is found that a family firm's profitability is affected by succession, which shows that a transfer should not necessarily be seen as a negative event in the life cycle of a family business.
Sensor faults tolerance control for a novel multi-rotor aircraft based on sliding mode control
Authors: Fu Chunyang , Tian Yantao , Peng Cheng , Gong Xun , Zhang Lei , Guo Xiaojun
Published: September 2017

This paper deals with the controllers design using a novel siding mode control and proportional–derivative control for the trajectory tracking problem of a new multi-rotor aircraft, which experiences angular velocity sensor faults and external disturbances. The control system is divided into two parts: the inner loop for attitude subsystem and outer loop for position subsystem. For the inner loop, the angular velocity sensor faults, including bias, drift, loss of accuracy, and loss of effectiveness are considered as equivalent mismatched disturbances, while the system internal coupling, nonlinearity, and external disturbances are considered as equivalent matched disturbances. A novel sliding mode control approach is proposed for inner loop controller design, which includes a nonlinear disturbance observer to estimate both mismatched and matched disturbances, a novel switching surface based on the estimation of the mismatched disturbance to counteract its impact, a double power reaching law to attenuate the chattering problem, and a compensation for the matched disturbance to reduce the controller gains. The sensor faults are handled without fault detection and controller reconfiguration, making the method require less computation and easy implementation. The proposed method enhances the robustness without sacrificing the nominal properties. For outer loop, the proportional–derivative approach is used to design the virtual controller. The closed-loop system stability is proved by the Lyapunov theory. Finally, various simulation experiments are shown to validate the effectiveness, robustness, and the superiority of the proposed flight control scheme.
Acceptability and feasibility of self-sampling for the screening of sexually transmitted infections in cabana privacy shelters
Authors: Pittman Ellen , Purcell Hillary , Dize Laura , Gaydos Charlotte , Patterson-Rose Sherine , Biro Frank , Owens DeAnna , Widdice Lea E
Published: September 2017

Screening for sexually transmitted infections (STIs) outside of traditional health-care facilities is limited by the privacy needed for sample collection. We explored the acceptability of privacy shelters for the self-collection of genital swabs and tested the use of privacy shelters during mobile STI screening. Attendees ≥14 years old at two outdoor community events completed a questionnaire that assessed participant characteristics, health-care access, and rating of acceptability of self-collecting penile or vaginal swabs in a privacy shelter and four other private spaces: portable restroom, health van, home, and doctor’s office. A privacy shelter was used during mobile STI screening. The majority (65%) of the 95 participants reported that using a privacy shelter was somewhat or very acceptable. No participant characteristics or health-care access factors were associated with the acceptability of privacy shelters. Women rated a privacy shelter more acceptable than a portable restroom or health van. Men rated a privacy shelter more acceptable than a portable restroom. During mobile STI screening, all 13 men and women who requested STI testing used the privacy shelter for self-sampling. Rating of acceptability before and after privacy shelter use was the same. Privacy shelters may enable STI screening without using a building or vehicle for sample collection.
Abnormal lipids and the acquired immunodeficiency syndrome: is there a problem and what should we do about it?
Authors: Crook M A , Mir N
Published: September 2017

Recent research has shown abnormal lipids in acquired immunodeficiency syndrome (AIDS). In human immunodeficiency virus (HIV) infection hypocholesterolaemia, hypertriglyceridaemia and also low high density lipoprotein (HDL)-cholesterol have all been described. In addition, increased dense low density lipoprotein (LDL) particles and also lipoprotein (a) have been observed in some patients.

The use of the protease inhibitors has been associated with diabetes mellitus and also features of insulin resistance. This article looks at these lipid abnormalities in detail and discusses possible therapeutic options that may be available, in order to address them.
Declining syphilis prevalence in pregnant women in Nairobi since 1995: another success story in the STD field?
Authors: Temmerman M , Fonck K , Bashir F , Inion I , Ndinya-Achola J O , Bwayo J , Kirui P , Claeys P , Fransen L
Published: September 2017

Untreated maternal syphilis during pregnancy will cause adverse pregnancy outcomes in more than 60% of the infected women. In Nairobi, Kenya, the prevalence of syphilis in pregnant women of 2.9% in 1989, showed a rise to 6.5% in 1993, parallel to an increase of HIV-1 prevalence rates. Since the early 1990s, decentralized STD/HIV prevention and control programmes, including a specific syphilis control programme, were developed in the public health facilities of Nairobi. Since 1992 the prevalence of syphilis in pregnant women has been monitored. This paper reports the findings of 81,311 pregnant women between 1994 and 1997. A total of 4244 women (5.3%) tested positive with prevalence rates of 7.2% (95% CI: 6.7–7.7) in 1994, 7.3% (95% CI: 6.9–7.7) in 1995, 4.5% (95% CI: 4.3–4.8) in 1996 and 3.8% (95% CI: 3.6–4.0) in 1997. In conclusion, a marked decline in syphilis seroprevalence in pregnant women in Nairobi was observed since 1995–96 (P < 0.0001, Chi-square test for trend) in contrast to upward trends reported between 1990 and 1994–95 in the same population.
Low yield of chest radiography in screening for active pulmonary tuberculosis in HIV-infected patients in Hong Kong
Authors: Ho T T Y , Wong K H , Lee S S
Published: September 2017

This study assessed the usefulness of routine chest radiography for detecting active pulmonary tuberculosis in persons infected with human immunodeficiency virus (HIV) without suggestive symptoms in Hong Kong. Tuberculosis is common in this locality and tuberculosis/HIV co-infection has been a frequent and significant problem. Records of patients attending the largest HIV clinic were reviewed. Three hundred and eleven routine chest radiographs were performed among 191 HIV-infected patients with a total follow-up period of 792 person years. Of the 22 routine chest radiographs that had abnormalities in the lungs or hilar region, only one had led to the diagnosis of pulmonary tuberculosis. No patient with a normal chest radiograph was diagnosed to have tuberculosis within the following 2 months. The low yield (0.32%) suggests that routine chest radiography is not useful in screening for active pulmonary tuberculosis in asymptomatic HIV-infected patients even in a locality where the tuberculosis rate is high.
Long-term immunotherapy in HIV infection, combined with short-term antiretroviral treatment
Authors: Bratt Göran , Eriksson Lars E , Sandström Eric , Gilljam Gustav , Hinkula Jorma , Albert Jan , Redfield Robert , Wahren Britta
Published: September 2017

Forty asymptomatic HIV-infected individuals with CD4+ lymphocyte levels above 400 × 106/1 were immunized over 5 years with recombinant envelope glycoprotein gp160 (rgp160). After 5 years there was a trend towards more nonprogressors in the immunized group as compared to the matched controls. Since immunizations could activate HIV, the first 6 immunizations were followed by 2 weeks of zidovudine or placebo, double-blind. The viral load did not change during the first 6 months and was not different from that of the matched controls after 5 years. The best effect on CD4+ lymphocyte development was seen in individuals with a high viral load randomized to rgp160+zidovudine and in individuals with a low viral load randomized to rgp160+placebo. We conclude that rgp160 is safe and results in temporarily improved CD4+ development. Concomitant antiviral treatment might be of benefit, especially in patients with a more advanced disease and can today be given with more effective combinations.
Nursing in genitourinary medicine: 10 years on from the Monks Report
Authors: Sutton A , Kingsland T , Ross S , Burke M , Gray T , Jenkins J
Published: September 2017

Various reports and surveys since 1988 have highlighted differences in gradings and diversity of roles and responsibilities of nurses in genitourinary medicine (GUM). In addition there was no method of defining how many nurses work in the speciality. Therefore the Genito-Urinary Nurses Association (GUNA) undertook a survey last year to establish how many nurses, of what grade, undertaking what roles are working in GUM clinics. Over half the clinics in the UK responded, from full-time busy London clinics to small part-time rural clinics. The results suggest approximately 2000 nurses working in GUM nationally, with a wide diversity of grades, roles and responsibilities still apparent 10 years after the Monks Report. Further analysis of the data obtained by the survey is given in the report.
Dynamic Norms Promote Sustainable Behavior, Even if It Is Counternormative
Authors: Sparkman Gregg , Walton Gregory M.
Published: September 2017

It is well known that people conform to normative information about other people’s current attitudes and behaviors. Do they also conform to dynamic norms—information about how other people’s behavior is changing over time? We investigated this question in three online and two field experiments. Experiments 1 through 4 examined high levels of meat consumption, a normative and salient behavior that is decreasing in the United States. Dynamic norms motivated change despite prevailing static norms, increasing interest in eating less meat (Experiments 1–3) and doubling meatless orders at a café (Experiment 4). Mediators included the anticipation of less meat eating in the future ( preconformity) and the inference that reducing meat consumption mattered to other people (Experiments 2 and 3). In Experiment 5, we took advantage of a natural comparison to provide evidence that dynamic norms can also strengthen social-norm interventions when the static norm is positive; a positive dynamic norm resulted in reduced laundry loads and water use over 3 weeks during a drought.
Rural Poverty and Artisanal Mining in Sub-Saharan Africa
Authors: Justice Issah Musah-Surugu , Ahenkan Albert , Bawole Justice Nyigmah , Yeboah-Assiamah Emmanuel
Published: September 2017

Attempts to discuss small-scale artisanal mining (ASM) within the lenses of environment–poverty paradox have had two contending schools of thought. The first lens is the most dominant and holds that a single factor, ‘poverty’, drives people into ASM. The second lens contends that multiples of complex factors better explain who and why rural populations elect to enter employment in ASM. The literature appears to have largely focused on the single perspective, while the multi-complex web of factors has been largely ignored or at best just mentioned in passing. Employing the multi-complex perspective, this article provides a novel framework for unpacking the multiple factors that drive rural people into ASM in sub-Saharan Africa (SSA). We argue that a single factor (‘poverty’) is inadequate to explain why rural people choose ASM as an alternative livelihood source and any policy intervention based on such perspective may rarely succeed. Our discussion highlights that institutional failure, including foreign/external takeover, poor politico-regulatory environment and unfavourable climate have sanctioned rural people to engage in such arduous and unsafe livelihood support activity which degrades the environment. Both theoretical and empirical studies from SSA have been used to support the argument.
Developing and Evaluating a Psychoeducation Program for Caregivers of Bipolar Affective Disorder Patients: Report of a Pilot Project
Authors: Bland Robert , Harrison Christine
Published: September 2017

Family caregivers of people with bipolar disorder experience a range of difficulties in understanding and coping with the impact of the disorder. The Family Support Team at the Princess Alexandra Hospital in Brisbane, Queensland, developed an educational supportive program for families of people with bipolar disorder that sought to improve caregiver knowledge of the illness, reduce caregiver distress, and enhance caregiver coping. The program also sought to moderate caregiver attributions of patient behavior in order to build an illness perspective of behavior. The bipolar program was developed trialed, and evaluated Analysis of results shows encouraging improvements for some families in knowledge, distress, attributions, and ways of coping. Practice and research implications include identifying differences with the schizophrenia program, the importance of a problem-solving focus, maintaining a balance between information giving and support, and timing of the intervention.
Effects of Interactive Multimedia Training on Knowledge, Attitudes, and Self-Efficacy of Social Work Students
Authors: Cauble A. Elizabeth , Thurston Linda P.
Published: September 2017

Objective

Building Family Foundations (BFF), an interactive multimedia (1M) training curriculum for child welfare workers, and its use with baccalaureate social work students is described. Students’ attitudes toward technology and multimedia, instructional efficacy, and knowledge acquisition were examined.

Method

Social work students viewed selected units from BFF and completed pretests and posttests using the BFF Competency Rating Scale (CRS), the Child Welfare Knowledge Assessment (CWKA), and the Technology Rating Scale, adapted for use with multimedia. To provide a control group, items from a unit the students did not view were included in the BFF CRS and the CWKA.

Results

Significant differences between the pretest and posttest means were found. Users increased knowledge, developed a sense of competence in the subject area, and became more comfortable with the use of technology.

Conclusion

The results indicate that IM is an effective means of providing baccalaureate social work education.
Treatment of Attention-Deficit/Hyperactivity Disorder: Expert Consensus Guidelines
Authors: Conners C.K. , March J.S. , Frances A. , Wells K.C. , Ross R.
Published: September 2017

Objective

To develop treatment guidelines for attention-deficit/hyperactivity disorder (ADHD) based upon consensus among physicians and psychologists, particularly concerning aspects of management not yet well established by controlled research.

Method

Eighty questions regarding preferred modes of therapy, sequencing of treatments, developmental considerations, management of comorbid conditions, and partial response to treatment were developed by the authors. The survey was modified by expert consultants in psychology, psychiatry, neurology, pediatrics, and family practice. The survey was mailed to 50 psychologists and 51 physicians, with a 94% and 86% return rate, respectively. The survey used a modified version of the Rand Corporation Delphi method, and results were expressed statistically in terms of averages and confidence intervals.

Results

A high level of agreement between psychologists and psychiatrists was usually reached. First-line treatments were identified for most areas surveyed. Results were similar in most instances to practices recommended in guidelines developed by more qualitative methods.

Conclusions

Pharmacological and behavioral treatments for ADHD under a wide variety of conditions are well agreed upon by expert clinician-researchers. The resulting guidelines will provide reasonable guidance for most practice issues in ADHD until more controlled evidence is available.
Mobile media, domestic play and haptic ethnography
Authors: Richardson Ingrid , Hjorth Larissa
Published: September 2017

In this article, we explore the material, sensory and corporeal aspects of digital ethnography, primarily in the context of mobile media use in the domestic environment. We align our methodological approach to the ‘sensory turn’ in theory, situated loosely under the rubric of new materialism, and outline the insights that a post-phenomenological method can offer. Drawing from our current research into everyday media use conducted within Australian households, which involved a range of data collection methods aimed at capturing the embodiment of mobile media, we explore the significance of play in and around haptic interfaces. Mobile games are evidently integral to our embodied ways of knowing, and there are a number of challenges faced by the mobile media researcher who seeks to document, understand and interpret this contemporary cultural and everyday practice.
Process of transfer and reception of Bologna Process ideas in the Cameroon higher education system
Authors: Eta Elizabeth Agbor , Kallo Johanna , Rinne Risto
Published: September 2017

The Bologna Process (BP), which created the European Higher Education Area, has had a profound impact on educational systems in Europe and beyond, as far as Cameroon. Through thematic analysis of interviews and text documents, this article examines the adoption of BP ideas in Cameroon with a focus on the transfer and local reception to the adoption. This article shows that the adoption in Cameroon is found to continue a process that began with the adoption of the BP at the Central African Economic and Monetary Community (CEMAC) by the CEMAC heads of state, leading to its subsequent imposition on universities in Cameroon. The present findings show that, although imposed on the universities, the adoption of the BP found some support in Cameroon because of its potential to resolve the country’s higher education challenges. However, because of Cameroon’s dual French and Anglo-Saxon education system, some interviewees expressed scepticism about the adopted approaches, primarily because they appeared French driven. The article highlights some of the complexities and tensions associated with introducing a borrowed model to a dual system of education such as that in Cameroon.
The associations of body composition and anthropometric measures with carotid intima-media thickness in obese and non-obese schoolchildren: A possible predictor for cardiovascular diseases
Authors: Al-Shorman Alaa , Al-Domi Hayder , Al-Atoum Muatasem
Published: September 2017

Background

Increased carotid intima-media thickness is one of the predictors of future cardiovascular diseases. However, it is still unknown which body composition parameter or anthropometric measure is the best predictor for carotid intima-media thickness change among children and young adolescents.

Objective

To investigate the associations of body composition and anthropometric measures with carotid intima-media thickness among a group of obese and normal bodyweight schoolchildren.

Methods

A total of 125 schoolchildren (10–15 years) were recruited from four public schools in Amman, Jordan. Of them, 60 (29 boys and 31 girls) were normal bodyweight students and 65 (35 boys and 30 girls) were obese students. Anthropometric measures, fat mass and fat-free mass were determined. Carotid intima-media thickness of the common artery was measured using high-resolution B-mode ultrasound.

Results

Compared to normal bodyweight students, obese participants exhibited greater carotid intima-media thickness (mm) (0.45 ± 0.10 vs. 0.38 ± 0.08, p = 0.002) and fat-free mass (kg) (48.01 ± 11.39 vs. 32.65 ±7.65, p < 0.001). Pearson’s correlation coefficient and linear regression analysis revealed significant associations ( p≤0.05) between mean carotid intima-media thickness and body mass index, waist circumference, hip circumference, waist-to-hip ratio, fat mass and fat-free mass. Stepwise linear regression analysis revealed that waist circumference was the only measure that was statistically significant ( p ≤ 0.05) with mean carotid intima-media thickness (r2 = 0.129, p = 0.002).

Conclusions

Obesity is related to greater carotid intima-media thickness and other cardiovascular risk factors among schoolchildren. Waist circumference is more sensitive in predicting increased carotid intima-media thickness than other body composition or anthropometric measures. Waist circumference measurement in the analysis of future studies assessing the cardiovascular risk among obese children is warranted.
Automated quality control of ultrasound based on in-air reverberation patterns
Authors: van Horssen Pepijn , Schilham Arnold , Dickerscheid Dennis , van der Werf Niels , Keijzers Han , van Almere Ronald , Kuijer Joost , Peters Rob , Hofman Mark
Published: September 2017

Ultrasound image degradation originates primarily from transducer defects and potentially undermines reliable image interpretation. Systematic quantitative quality control is often neglected due to the limited resources available for this task. We propose a quantitative quality control based on in-air reverberation images. These images serve as an initial indication of image degradation. They are easily generated for any (curvi-)linear transducer independent of the level of expertise of the operator. Automated analysis is presented to extract quality parameters based on the in-air reverberation pattern. Static images acquired by the clinical user are transferred to a server where analysis is performed. The results are available to the sonographer prior to clinical use and transducer status can be remotely monitored with trend analysis over time. The method was evaluated for normal functioning and defect transducers. A pilot study was performed over a period of three weeks to assess reproducibility and practical feasibility. All reverberation images were successfully analysed for different transducer types and vendor-specific image presentation. The proposed quality parameters are sensitive to signal loss and allow differentiation of type and severity of image degradation. The pilot study was well received by the sonographers for the simplicity of the method and the measurements were consistent over time. The proposed automated analysis method of ultrasound quality control can monitor (curvi-)linear transducer status in the entire hospital, overcoming previous limitations for periodic quality control. Implementation of the method can reduce the number of defective transducers routinely used in clinical practice.
Smartphone apps as cosituated closets: A lesbian app, public/private spaces, mobile intimacy, and collapsing contexts
Authors: Choy Christine Hiu Ying
Published: September 2017

How does mobile media redefine public/private spaces, intimate relationships, communicative possibilities, and collapsing contexts (Boyd, 2010; Fortunati, 2002; Hjorth & Khoo, 2015; Lasén & Casado, 2012)? Using a case study of Hong Kong lesbian app Butterfly, I explicate how and why users cosituate on and off the app within their context. By analyzing digital ethnography and offline interviews data, I argue that Butterfly provides a mobile communication infrastructure for users to meet their lesbian needs and desires of (in)visible self, relationships, and community. The spatiality and mobility of the app enable users to cosituate in (a) the online and offline public and private spaces, (b) the disclosure and concealment of lesbian identities, and (c) the individual lesbian fantasies and sociocultural, political, and religious contexts. However, users’ cosituation as tactical resistance to the heteronormative context does not come without a cost.
Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice
Authors: Moayyedi Paul , Mearin Fermín , Azpiroz Fernando , Andresen Viola , Barbara Giovanni , Corsetti Maura , Emmanuel Anton , Hungin A Pali S , Layer Peter , Stanghellini Vincenzo , Whorwell Peter , Zerbib Frank , Tack Jan
Published: September 2017

Background

Effective management of irritable bowel syndrome (IBS), a common functional gastrointestinal disorder, can be challenging for physicians because of the lack of simple diagnostic tests and the wide variety of treatment approaches available.

Objective

The objective of this article is to outline a simple algorithm for day‐to‐day clinical practice to help physicians navigate key stages to reaching a positive IBS diagnosis and guidance on how to prioritise the use of specific management strategies.

Methods

This algorithm was based on the opinion of an expert panel evaluating current evidence.

Results

The key principles forming the foundation of this evidence‐supported algorithm are: confidently naming and explaining an IBS diagnosis for the patient, followed by assessment of key patient characteristics likely to influence the choice of therapy, such as predominant symptoms, and exploring the patient agenda and preferences. Consultation should always include education and reassurance with an explanatory model of IBS tailored to the patient. Individualised lifestyle changes, dietary modifications, pharmacological therapies, psychological strategies or a combination of interventions may be used to optimise treatment for each patient.

Conclusion

The simple visual tools developed here navigate the key stages to reaching a positive diagnosis of IBS, and provide a stepwise approach to patient‐centred management targeted towards the most bothersome symptoms. Establishing a strong patient‐physician relationship is central to all stages of the patient journey from diagnosis to effective management.
Clash of National Narratives and the Marginalization of Kurdish-Iranian History
Authors: Cabi Marouf
Published: September 2017

This article examines in a Kurdish-Iranian context the origins of Iranian and Kurdish national narratives that go back to the process of the transformation of historical consciousness in the nineteenth century. At the same time, it aims at making central to Iranian history a perception of Kurdish-Iranian history, which has largely remained both a marginalized and an understudied subject. In contrast to these national narratives’ construction of the past and their definitions of people, “Kurdish-Iranian” refers to an approach that simultaneously attempts to demarginalize Kurdish (social) history and highlight the impact of almost a century of socioeconomic transformation of Iran on the Kurdish society. An analysis of these narratives’ origins is required to understand the way they interpret history and define concepts. This approach and the absence of such an analysis in both Kurdish and Iranian studies provide for the originality of this article and, inspired by what I hold to be the ascendancy of national narratives due to recent regional and political developments, its immediacy. Methodologically, it is based on theories of nation and nationalism, in general, and the accompanying literature on the formation of modern Iranian national identity, in particular.
Role of Granulocyte-Macrophage Colony-Stimulating Factor in Acute Myeloid Leukemia/Myelodysplastic Syndromes
Authors: Kassem Neemat M. , Ayad Alya M. , El Husseiny Noha M. , El-Demerdash Doaa M. , Kassem Hebatallah A. , Mattar Mervat M.
Published: September 2017

Purpose

Granulocyte-macrophage colony-stimulating factor (GM-CSF) cytokine stimulates growth, differentiation, and function of myeloid progenitors. We aimed to study the role of GM-CSF gene expression, its protein, and antibodies in patients with acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) and their correlation to disease behavior and treatment outcome. The study included 50 Egyptian patients with AML/MDS in addition to 20 healthy volunteers as control subjects.

Patients and Methods

Assessment of GM-CSF gene expression was performed by quantitative real-time polymerase chain reaction. GM-CSF proteins and antibodies were assessed by enzyme-linked immunosorbent assay.

Results

There was significant decrease in GM-CSF gene expression ( P = .008), increase in serum level of GM-CSF protein ( P = .0001), and increase in anti–GM-CSF antibodies ( P = .001) in patients with AML/MDS compared with healthy control subjects. In addition, there was a significant negative correlation between serum levels of GM-CSF protein and initial peripheral blood blasts, percentage as well as response to therapy.

Conclusion

Any alteration in GM-CSF gene expression could have implications in leukemogenesis. In addition, GM-CSF protein serum levels could be used to predict outcome of therapy. GM-CSF antibodies may also play a role in the pathogenesis of AML/MDS. The use of these GM-CSF parameters for disease monitoring and as markers of disease activity needs further research.
Peripheral Nerve Hyperexcitability Syndromes
Authors: Sawlani Komal , Katirji Bashar
Published: September 2017

Purpose of Review: This article provides a review of the clinical phenotypes and evaluation of peripheral nerve hyperexcitability syndromes. These rare diagnoses include cramp-fasciculation syndrome, Isaacs syndrome, and Morvan syndrome. Recent investigations have led to an understanding of the autoimmune underpinnings of these conditions and their specific associated antibodies. As the presentation of peripheral nerve hyperexcitability syndromes includes muscle stiffness, twitches, and spasms, which are also shared with certain central nervous system and myopathic conditions, the differential diagnosis of peripheral nerve hyperexcitability syndromes is reviewed.

Recent Findings: Peripheral nerve hyperexcitability syndromes share clinical and electrodiagnostic evidence of motor nerve instability; however, their clinical presentations are varied. Case reviews have helped us understand the spectrum of symptoms associated with the three peripheral nerve hyperexcitability syndromes reviewed here: cramp-fasciculation syndrome, Isaacs syndrome, and Morvan syndrome. More recently, research has focused on understanding the voltage-gated potassium channel complex antibodies as well as neoplasms associated with these conditions.

Summary: The diagnosis of peripheral nerve hyperexcitability syndromes requires a high index of suspicion, support from the physical examination, familiarity with the spectrum of symptoms associated with peripheral nerve hyperexcitability syndromes, and recognition of diagnostic EMG features. Voltage-gated potassium channel complex antibodies are associated with these conditions. Optimum treatment and autoimmune pathogenesis remain areas of active research.
Financial Intermediation, International Risk Sharing, and Reserve Currencies
Authors: Maggiori Matteo
Published: September 2017

I model the equilibrium risk sharing between countries with varying financial development. The most financially developed country takes greater risks because its financial intermediaries deal with funding problems better. In good times, the more financially developed country consumes more and runs a trade deficit financed by the higher financial income that it earns as compensation for taking greater risk. During global crises, it suffers heavier losses. Its currency emerges as the reserve currency because it appreciates during crises, thus providing a good hedge. I provide evidence that financial net worth plays a crucial role in understanding this asymmetric risk sharing. (JEL E44, F14, F32, G01, G15, G21)
How Local Are Labor Markets? Evidence from a Spatial Job Search Model
Authors: Manning Alan , Petrongolo Barbara
Published: September 2017

This paper models the optimal search strategies of the unemployed across space to characterize local labor markets. Our methodology allows for linkages between numerous areas, while preserving tractability. We estimate that labor markets are quite local, as the attractiveness of jobs to applicants sharply decays with distance. Also, workers are discouraged from searching in areas with strong competition from other job-seekers. However, as labor markets overlap, a local stimulus or transport improvements have modest effects on local outcomes, because ripple effects in job applications dilute their impact across a series of overlapping markets. (JEL J61, J64, R23, R58)
The Growth Potential of Startups over the Business Cycle
Authors: Sedláček Petr , Sterk Vincent
Published: September 2017

This paper shows that employment in cohorts of US firms is strongly influenced by aggregate conditions at the time of their entry. Employment fluctuations of startups are procyclical, they persist into later years, and cohort-level employment variations are largely driven by differences in firm size, rather than the number of firms. An estimated general equilibrium firm dynamics model reveals that aggregate conditions at birth, rather than post-entry choices, drive the majority of cohort-level employment variation by affecting the share of startups with high growth potential. In the aggregate, changes in startup conditions result in large, slow-moving fluctuations in employment. (JEL D25, E24, E32, J23, L25, M13)
Long-term outcome of carpal tunnel release surgery in patients with severe carpal tunnel syndrome
Authors: Tang C. Q. Y. , Lai S. W. H. , Tay S. C.
Published: September 2017

Aims

Few studies have examined the long-term outcome of carpal tunnel release (CTR). The aim of this study was to evaluate the patient-reported long-term outcome of CTR for electrophysiologically severe carpal tunnel syndrome (CTS).

Patients and Methods

We reviewed the long-term outcome of 40 patients with bilateral severe CTS who underwent 80 CTRs (46 open, 34 endoscopic) between 2002 and 2012. The outcomes studied were patient-reported outcomes of numbness resolution, the Boston Carpal Tunnel Questionnaire (BCTQ) score, and patient satisfaction.

Results

The mean follow-up was 9.3 years. Complete resolution of numbness was reported by 93.8% of patients, persistent numbness by 3.8%, and recurrent numbness by 2.5%. The mean BCTQ symptom score was 1.1 (sd 0.3; 1.0 to 2.55) and the mean Boston function score was 1.15 (sd 0.46; 1.0 to 3.5). 72.5% of patients were asymptomatic and had no functional impairment. Men had poorer outcomes than women and patients < 55 years had poorer outcomes than patients ≥ 55 years. All patients who had undergone endoscopic CTR reported complete resolution of numbness compared with 89.1% of those who had undergone open release (p = 0.047). There was no significant difference in outcome between dominant and non-dominant hands. Patient satisfaction rates were good. There were no adverse events.

Conclusion

CTR has a favourable outcome and good rates of satisfaction, even in patients with bilateral severe CTS at a mean of nine years after surgery. Endoscopic CTR has a higher rate of numbness resolution than open surgery. There were no significant differences in outcome between the dominant and non-dominant hand. Cite this article: Bone Joint J 2017;99-B:1348–53.
A comparison study of stem taper material loss at similar and mixed metal head-neck taper junctions
Authors: Langton D. J. , Sidaginamale R. P. , Joyce T. J. , Meek R. D. , Bowsher J. G. , Deehan D. , Nargol A. V. F. , Holland J. P.
Published: September 2017

Aims

We sought to determine whether cobalt-chromium alloy (CoCr) femoral stem tapers (trunnions) wear more than titanium (Ti) alloy stem tapers (trunnions) when used in a large diameter (LD) metal-on-metal (MoM) hip arthroplasty system.

Patients and Methods

We performed explant analysis using validated methodology to determine the volumetric material loss at the taper surfaces of explanted LD CoCr MoM hip arthroplasties used with either a Ti alloy (n = 28) or CoCr femoral stem (n = 21). Only 12/14 taper constructs with a rough male taper surface and a nominal included angle close to 5.666° were included. Multiple regression modelling was undertaken using taper angle, taper roughness, bearing diameter (horizontal lever arm) as independent variables. Material loss was mapped using a coordinate measuring machine, profilometry and scanning electron microscopy.

Results

After adjustment for other factors, CoCr stem tapers were found to have significantly greater volumetric material loss than the equivalent Ti stem tapers.

Conclusion

When taper junction damage is identified during revision of a LD MoM hip, it should be suspected that a male taper composed of a standard CoCr alloy has sustained significant changes to the taper cone geometry which are likely to be more extensive than those affecting a Ti alloy stem. Cite this article: Bone Joint J 2017;99-B:1304–12.
Transforaminal lumbar interbody fusion using polyetheretherketone oblique cages with and without a titanium coating
Authors: Rickert M. , Fleege C. , Tarhan T. , Schreiner S. , Makowski M. R. , Rauschmann M. , Arabmotlagh M.
Published: September 2017

Aims

We compared the clinical and radiological outcomes of using a polyetheretherketone cage with (TiPEEK) and without a titanium coating (PEEK) for instrumented transforaminal lumbar interbody fusion (TLIF).

Materials and Methods

We conducted a randomised clinical pilot trial of 40 patients who were scheduled to undergo a TLIF procedure at one or two levels between L2 and L5. The Oswestry disability index (ODI), EuroQoL-5D, and back and leg pain were determined pre-operatively, and at three, six, and 12 months post-operatively. Fusion rates were assessed by thin slice CT at three months and by functional radiography at 12 months.

Results

At final follow-up, one patient in each group had been lost to follow-up. Two patients in each of the PEEK and TiPEEK groups were revised for pseudarthrosis (p = 1.00). The rate of complete or partial fusion at three months was 91.7% in both groups. Overall, there were no significant differences in ODI or in radiological outcomes between the groups.

Conclusion

Favourable results with identical clinical outcomes and a high rate of fusion was seen in both groups. The titanium coating appears to have no negative effects on outcome or safety in the short term. A future study to determine the effect of titanium coating is warranted. Cite this article: Bone Joint J 2017;99-B:1366–72.
Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy
Authors: Nakamura R. , Komatsu N. , Fujita K. , Kuroda K. , Takahashi M. , Omi R. , Katsuki Y. , Tsuchiya H.
Published: September 2017

Aims

Open wedge high tibial osteotomy (OWHTO) for medial-compartment osteoarthritis of the knee can be complicated by intra-operative lateral hinge fracture (LHF). We aimed to establish the relationship between hinge position and fracture types, and suggest an appropriate hinge position to reduce the risk of this complication.

Patients and Methods

Consecutive patients undergoing OWHTO were evaluated on coronal multiplanar reconstruction CT images. Hinge positions were divided into five zones in our new classification, by their relationship to the proximal tibiofibular joint (PTFJ). Fractures were classified into types I, II, and III according to the Takeuchi classification.

Results

Among 111 patients undergoing OWHTOs, 22 sustained lateral hinge fractures. Of the 89 patients without fractures, 70 had hinges in the zone within the PTFJ and lateral to the medial margin of the PTFJ (zone WL), just above the PTFJ. Among the five zones, the relative risk of unstable fracture was significantly lower in zone WL (relative risk 0.24, confidence interval 0.17 to 0.34).

Conclusion

Zone WL appears to offer the safest position for the placement of the osteotomy hinge when trying to avoid a fracture at the osteotomy site. Cite this article: Bone Joint J 2017;99B10:1313–18
Antisepsis of the skin before spinal surgery with povidone iodine-alcohol followed by chlorhexidine gluconate-alcohol versus povidone iodine-alcohol applied twice for the prevention of contamination of the wound by bacteria
Authors: Patrick S. , McDowell A. , Lee A. , Frau A. , Martin U. , Gardner E. , McLorinan G. , Eames N.
Published: September 2017

Aims

The aim of this study was to determine whether the sequential application of povidone iodine-alcohol (PVI) followed by chlorhexidine gluconate-alcohol (CHG) would reduce surgical wound contamination to a greater extent than PVI applied twice in patients undergoing spinal surgery.

Patients and Methods

A single-centre, interventional, two arm, parallel group randomised controlled trial was undertaken, involving 407 patients who underwent elective spinal surgery. For 203 patients, the skin was disinfected before surgery using PVI (10% [w/w (1% w/w available iodine)] in 95% industrial denatured alcohol, povidone iodine; Videne Alcoholic Tincture) twice, and for 204 patients using PVI once followed by CHG (2% [w/v] chlorhexidine gluconate in 70% [v/v] isopropyl alcohol; Chloraprep with tint). The primary outcome measure was contamination of the wound determined by aerobic and anaerobic bacterial growth from samples taken after disinfection.

Results

The detection of viable bacteria in any one of the samples taken after disinfection (culture-positive) was significantly lower in the group treated with both PVI and CHG than in the group treated with PVI alone (59 (29.1%) versus 85 (41.7%), p = 0.009; odds ratio 0.574; 95% confidence interval, 0.380 to 0.866).

Conclusions

Antisepsis of the skin with the sequential application of PVI and CHG more effectively reduces the contamination of a surgical wound than PVI alone. Cite this article: Bone Joint J 2017;99-B:1354–65.
Episodic payments (bundling)
Authors: Jacofsky D. J.
Published: September 2017

Episodic, or bundled payments, is a concept now familiar to most in the healthcare arena, but the models are often misunderstood. Under a traditional fee-for-service model, each provider bills separately for their services which creates financial incentives to maximise volumes. Under a bundled payment, a single entity, often referred to as a convener (maybe the hospital, the physician group, or a third party) assumes the risk through a payer contract for all services provided within a defined episode of care, and receives a single (bundled) payment for all services provided for that episode. The time frame around the intervention is variable, but defined in advance, as are included and excluded costs. Timing of the actual payment in a bundle may either be before the episode occurs (prospective payment model), or after the end of the episode through a reconciliation (retrospective payment model). In either case, the defined costs over the defined time frame are borne by the convener.

Cite this article: Bone Joint J 2017;99-B:1280–5.
TMJ dimensions in three-dimensional virtual models acquired through computed tomography of cone beam as sexual dimorphism
Authors: De França Critiano , Cunha Helena Midori , Barbieri Ana Amélia , Assis Afonso Celso Souza de , Manhães-Junior Luiz Roberto Coutinho , Lopes Sergio Lucio Pereira de Castro
Published: September 2017

Objective: The objective of this study was to relate the dimensions of the mandibular condyle with sex and age by means of three-dimensional models obtained by cone-beam computed tomography images (CBCT). Material and Methods: 120 CBCT examinations were selected belonging to the archives of the ICT-UNESP Clinic of Radiology. They were divided into five age groups, each containing 12 individuals of each sex. Virtual three-dimensional models were then created and two measurements from each mandibular condyle were taken: anteroposterior (AP) and mediolateral (ML). The t-test was used for independent samples to compare the measurements. Results: The AP measurements only of the left side showed a statistical difference between the sexes between 31 to 40 years of age; in the ML measurements, there were statistical differences between the sexes in all age groups on both sides, except in the age group above 60 years. Conclusion: The ML measurements of the mandibular condyles, regardless of side, showed significant statistical differences between sexes and age groups, with a tendency to greater values in males, and may be a determinant factor of sexual dimorphism.KeywordsX-Ray computed Tomography; Radiology; Sexual characteristics; Forensic anthropology; Forensic dentistry.
Assessment of knowledge related to diabetes mellitus among patients attending a dental college in Salem city-A cross sectional study
Authors: C Bharath , N Saravanan , S Venkatalakshmi
Published: September 2017

Objective: Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with a global prevalence rate of 8.3%. Diabetes not only affect general health but also oral health leading to periodontitis. Low level of knowledge about diabetes and lack of awareness regarding preventive options will ultimately impact self-care behavior. To assess diabetes related knowledge among patients attending Vinayaka Mission’s Sankarachariyar (VMS) Dental College outpatient department in Salem city, Tamilnadu. Materials And Methods: A cross sectional study was carried out for about two weeks which encompassed a convenient sample of 400 subjects aged 18-80 years. Knowledge of respondents regarding diabetes was measured using 15 item self-administered modified Diabetes Knowledge Questionnaire (DKQ). Results: When knowledge regarding cause of diabetes was considered, only 40% of subjects were aware that diabetes is not a communicable disease. Almost half (57.5%) of the participants believed that sweet consumption causes diabetes. Furthermore, 55% participants knew that diabetes can damage kidney and around 54.5% agreed that diabetes can also affect dental health. The higher mean knowledge scores was observed among males compared to females and the difference was statistically insignicant (p=0.37). Significantly higher mean knowledge scores were dissipated by subjects with graduation education (p=0.01), those with professional occupation (p=0.02) and participant from urban location (p=0.00). Conclusion: The study showed significantly lower level of awareness regarding diabetes among rural respondents compared to urban residents. Gap related to diabetes mellitus knowledge should be abridged between rural and urban province in order to reduce disease burden and to yield positive health outcomes in the society.KeywordsDiabetes mellitus; Diabetes management; Knowledge; Oral self-care.