bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer risk from paediatric computed tomography scanning: implications for radiation protection in medicine
Authors: Kesminiene A. , Cardis E.
Published: April 2018

The use of computed tomography (CT) imaging is clearly beneficial for millions of patients. However, the potential adverse health effects, particularly cancer, of ionising radiation exposure from CT early in life are an issue of growing concern in the radiological protection, medical, and public health communities. Although efforts to quantify these effects have been conducted, the precision and accuracy of reported risks needs confirmation. EPI-CT, a European collaborative epidemiological study, was set up to quantify risks from paediatric CT to optimise paediatric diagnostic protocol. The study, coordinated by the International Agency for Research on Cancer, was designed as a multi-national cohort study of children and young adults who underwent CT scanning for long-term follow-up. It combined data from existing and extended cohorts in France, the UK, and Germany, and from new cohorts assembled in Belgium, Denmark, the Netherlands, Norway, Spain, and Sweden using a common protocol. A flexible dose reconstruction approach that can accommodate collection of data from historical sources (prior to 2000) and automatically extract data from the Digital Imaging and Communications in Medicine headers of recorded images available in the Picture Archiving Communication System was developed. Individual organ dose estimates for each child were derived from Monte-Carlo-based radiation transport calculations using hybrid phantoms of different sexes and ages. To account for uncertainties due to missing input data, a simulation method that maintains correlations of doses for persons within subgroups with similar exposure attributes and simulates uncertain dose-model parameter values was used. Simulation studies to evaluate the potential impact of a range of potential confounders (e.g. underlying medical conditions, socio-economic status, missing medical procedures performed outside of participating hospitals) on risk estimates were conducted based on data from some EPI-CT countries and/or reasonable scenarios. In total, 1,170,186 patients (before censorship) were enrolled in the national cohorts. Most patients (75%) had only undergone one CT scan and 29% of all patients were aged <5 years at the time of their first CT examination. The median duration of follow-up was 8 years for the entire cohort, although this varied between countries. Overall, the follow-up accounted for nearly 10 million person-years. This study received partial funding from the European Commission 7th Framework Programme under Grant Agreement No. 269912.
Compassion in a heartbeat: Physiology during couples’ loss discussions
Authors: Corner Geoffrey W. , Saxbe Darby E. , Chaspari Theodora , Rasmussen Hannah F. , Perrone Laura , Pettit Corey , Friendly Madeleine , Timmons Adela C. , Margolin Gayla
Published: April 2018

The physiology of compassion, typically studied in individuals, has not yet been studied dyadically and in the context of close relationships. The current study used dating partners’ discussions of personal losses to simultaneously investigate the physiological profile of compassion in an individual sharing an emotionally salient loss, the “narrator,” and his or her partner, the “listener.” In a given moment, listeners who perceived themselves as being more compassionate had a lower heart rate. This association was stronger for listeners whose partners were less anxiously attached. Narrators and listeners who were more avoidantly attached showed stronger positive associations between their average heart rate and overall compassion. Additionally, narrators’ compassion moderated linkage between partners’ heart rates such that heart rates were more strongly linked in moments with lower levels of compassion. These results support studying compassion dyadically and illustrate the importance of attachment style in the physiology of compassion.
Flexible mindset in the family: Filial piety, cognitive flexibility, and general mental health
Authors: Jen Chun-Hui , Chen Wei-Wen , Wu Chih-Wen
Published: April 2018

Reciprocal and authoritarian filial piety beliefs have been shown to have distinct relationships with psychological development and well-being. Such beliefs provide an important foundation for parent–child relationships in Chinese families. However, the literature remains unclear about the mechanism through which filial piety contributes to individuals’ well-being. Because researchers have identified cognitive flexibility as a crucial factor in family contexts and demonstrated that it is associated with individuals’ well-being, the present study aimed to examine the mediating role of cognitive flexibility in the relationship between filial piety and Chinese young adults’general mental health (i.e., self-esteem, life satisfaction, and mental wellness). A total of 455 college students from Taiwan participated in the survey. Structural equation modeling yielded the following findings: (a) Reciprocal filial piety was positively associated with cognitive flexibility and authoritarian filial piety was negatively associated with cognitive flexibility; (b) cognitive flexibility contributed positively to life satisfaction, self-esteem, and mental wellness; and (c) cognitive flexibility mediated the relationship of the two filial piety beliefs with life satisfaction, self-esteem, and mental wellness. These findings indicate that the two filial piety beliefs, which reflect different parent–child relationship quality nurtured in family contexts, could relate to individuals’ flexible mindsets.
Decision-making in the management of property investment by Australian superannuation funds
Authors: Hutcheson Tiffany , Newell Graeme
Published: April 2018

Decision-making in property investment by superannuation funds is an important investment decision, but it is different to their decision-making on other asset classes included in their asset portfolios. The large value and heterogeneous nature of individual pieces of real estate make the market for real estate relatively illiquid and subject to larger transaction costs than other asset classes. Based on interview surveys of Australian superannuation funds, using the analytical hierarchical process (AHP), we identified strategic decision-making as being the most important factor used by the superannuation funds when making decisions on the management of their property investment portfolio. Comments during the interviews indicated that their decisions were influenced by restrictions in their fund’s investment mandate and the level of funds that they had to invest. The AHP technique has allowed this research to provide a more in-depth understanding of the management of decision-making factors than previous surveys.
Impact of Curbside Parking on Bicycle Lane Capacity in Nanjing, China
Authors: Ye Xiaofei , Yan Xingchen , Chen Jun , Wang Tao , Yang Zhao
Published: April 2018

As roadway resources are being occupied by curbside parking and because of the operational characteristics of parking maneuvers, the capacity of the adjacent travel lane can be significantly reduced. To analyze the influence of curbside parking on the capacity of the bicycle lane, a conflict technique based on additive conflict flow was applied to establish the base capacity model. The actual capacity of the bicycle lane with curb parking was then established by adjusting the base capacity to reflect the influence: lane width, the time influence of parking maneuvers, and proportion of e-bikes. Eight datasets from the exclusive bicycle lanes with different widths and parking maneuvers were collected in Nanjing, China for calibration and evaluation purposes. As a result of a higher number of parking maneuvers, the Emeiling Road was taken as the main case study. The capacity of the bicycle lane was calculated, and the effectiveness of the proposed method was validated by the speed-density-volume relationship model. The proposed model was applied to analyze the effect of different positions of parking berths on the capacity. The results indicate that, with around 65% share of e-bikes, the estimated capacity of Emeiling Road is 2622 bicycles/h, decreasing by 47.10% under the influence of curbside parking. The results also imply that the berths near the openings of the isolation belt have less influence than those in the middle position. These findings could be helpful and useful for practitioners to improve the capacity of bicycle lanes under the influence of curbside parking.
Settler Feminism, Race Making, and Early Social Work in Canada
Authors: Johnstone Marjorie
Published: April 2018

Canada was one of the civilizing outposts that formed part of the British plan of imperial hegemony. This liberal democratic white settler society is the context where the new female-dominated social work profession developed. Using various historical archives of the mission statements and practice of early Canadian social work, I critically examine how first-wave feminisms, hegemonic imperial discourses, and settler colonial structures of governance worked as formative factors in the birth of Canadian social work and illustrate this with the life of an early Toronto social worker, Joan Arnoldi (D.O.B. 1882).
Disjunctures in Experiences of Support During the Transition to Fatherhood of Men Who Have Used Intimate Partner Violence
Authors: Carlson Juliana , Casey Erin
Published: April 2018

The transition to fatherhood has been shown to be a stressful time for men, and their experiences of identifying and accessing formal and informal support are mixed. However, research on the experience of men who use intimate partner violence (IPV) during the transition to fatherhood is limited. The evidence documenting the prevalence and short- and long-term impact of violence perpetrated by men against women during pregnancy and postpartum demonstrates the seriousness of this public health issue. To understand the mechanisms of interrupting IPV by engaging men, the gap between what is known about experiences of identifying the need for and access to support during the transition to fatherhood of men with past and current histories of using IPV must be bridged. The study described explores experiences of support during the transition to fatherhood of men who have used IPV. Descriptive findings revealed that men had a range of types of supports from multiple sources; however, most also identified crucial unmet instrumental and socioemotional needs. Four themes surfaced disjunctures in how participants described resources they needed, accessed, and desired. Specifically, these disjunctures were related to men’s adherence to a self-reliant identity, a lack of male-specific peer or role model support, the tendency for childbirth classes to be geared toward mothers and not seen by fathers as sources of support, and a gap between men’s goals for themselves as fathers, and the actual tools, resources, and modeling that were accessible and “acceptable.” The implications include suggestions for group-based programmatic efforts, and three initial steps for organizations to assess and build current capacity to engage—with safety and accountability at the forefront—fathers who use IPV.
Development and Comfort Characterization of 2D-Woven Auxetic Fabric for Wearable and Medical Textile Applications
Authors: Ali Mumtaz , Zeeshan Muhammad , Ahmed Sheraz , Qadir Bilal , Nawab Yasir , Anjum Aima Sameen , Riaz Rabia
Published: April 2018

Knitted auxetic fabrics (AF) are in common practice but their stability and thickness are major problems in commercial applications. Therefore, a simple method of developing woven AF is proposed here. Differential shrinking property of different weaves is utilized to visualize auxetic honey comb geometry in fabric structure. Based on this fabric structure, auxeticity is induced in 2-D-woven fabric. AF is developed using conventional nonauxetic materials (i.e., cotton in warp and elastane [Lycra] yarn in the weft). Auxetic nature and auxetic structure in the fabric were characterized by microscope. Comfort properties (air permeability, thermal resistance, stiffness, and wicking) of AF were compared with conventional nonauxetic fabrics (NAF). Piezoresistive nature of conductive AF and NAF is also compared. AF showed superior comfort properties and higher sensitivity as compared to conventional NAF. Based on results, AF can be considered better replacement of conventional NAF in wearable and medical applications.
Capitalism, Neoliberalism, and Unfree Labour
Authors: Gordon Todd
Published: April 2018

The literature on the unfree character of temporary migrant labour has drawn much needed attention to the poor working conditions faced by migrant workers and opened up an important space to challenge those ubiquitous claims by defenders of the current political-economic status quo of the freedom expressed at the core of neoliberalism. However, there is a risk to focusing on legal unfreedom to the exclusion of a broader critique of the logic of capitalist reproduction, the very premise of which is the private ownership of society’s productive wealth and the alienation of the majority of people from that wealth. Unfreedom and coercion are systematic to capitalist market relations, and all wage labour, including that of formally ‘free’, is unfree. This article examines different conceptions of labour unfreedom and concludes with a discussion of unfree labour in the neoliberal context.
Adaptive neural finite-time trajectory tracking control of hydraulic excavators
Authors: Li Yong , Wang Qingfeng
Published: April 2018

This article is focused on the high-performance trajectory tracking control of single actuator of a hydraulic excavator. A novel adaptive neural finite-time controller without tedious offline parameter identification and the complex backstepping scheme is put forward. By employing a coordinate transform, the original system can be represented in a canonical form. Consequently, the control objective is retained by controlling the transformed system, which allows a simple controller design without using backstepping. To estimate the immeasurable states of the transformed system, a high-order sliding mode observer is employed, of which observation error is guaranteed to be bounded in finite time. To guarantee finite-time trajectory tracking performance, an adaptive neural finite-time controller based on neural network approximation and terminal sliding mode theory is synthesized. During its synthesis, an echo state network is used to approximate the lumped uncertain system functions, and it guarantees an improved approximation with online-updated output weights. Besides, to handle the lumped uncertain nonlinearities resulting from observation error and neural approximation error, a robust term is employed. The influences of the uncertain nonlinearities are restrained with a novel parameter adaption law, which estimates and updates the upper bound of the lumped uncertain nonlinearities online. With this novel controller, the finite-time trajectory tracking error convergence is proved theoretically. The superior performance and the practical applicability of the proposed method are verified by comparative simulations and experiments.
Pussies Rioting and Indecent Praying: Transforming Orthodoxy in the Company of Marcella Althaus-Reid
Authors: McGeoch Graham
Published: April 2018

This article proposes to engage Pussy Riot’s Punk Prayer in light of Marcella Althaus-Reid’s Indecent Theology and in dialogue with Orthodox theology and the prison letters exchanged by Nadhezhda Tolokonnikova, and Slavoj Zizek. First, there is a discussion of aspects of Althaus-Reid’s theology: caminata, libertinaje, and la vida loca. Second, the Punk Prayer – what I will call an Indecent Prayer – is presented in dialogue with Althaus-Reid’s theology and Orthodox theology. Third, the prison letters between Nadya and Slavoj are discussed in light of Althaus-Reid’s Indecent theology and Nadya Tolokonnikova’s Sly Christianity.
Determinants of Competitiveness of Garment Industry in Ethiopia—An Empirical Study
Authors: Hagos Fitsum , Singh Ajit Pal , Singh Rajwinder
Published: April 2018

The objective of this study is to identify the factors that determine the competitiveness of garment industry in Ethiopia. To achieve this, Porter's diamond model of national competitiveness was detected as a model to assess the competitiveness of the garment industry in Ethiopia. Based on conceptual framework, the study's six hypotheses were developed and tested. Six independent variables considered are: factor conditions; demand conditions; related and supporting industries; industry's strategy, structure and rivalry; role of government; and chance factors and dependent variable is competiveness. Primary data are collected by self-administered structured questionnaire from owners/general managers of industry. Totally 37 out of the targeted 38 respondents duly filled and returned the questionnaires for analysis giving response rate of 97.36 per cent. The results were presented in forms of mean, standard deviation, Pearson correlation, ANOVA and regression analysis. This study finds that the composite the five independent variables accounted for 73 per cent variance for the competitiveness of garment industry in Ethiopia. The independent variables show the positive effect on predicting the dependent variable (except the demand conditions). Two factors --factor conditions and chance factors --were found to be statically significant determinants for the competitiveness of the garment industry in Ethiopia.
A thermomechanical fatigue hysteresis-based damage evolution model for fiber-reinforced ceramic–matrix composites
Authors: Longbiao Li
Published: April 2018

In this paper, a thermomechanical fatigue hysteresis-based damage evolution model for fiber-reinforced ceramic–matrix composites has been developed. Upon unloading and reloading, the fiber/matrix interface debonded length, interface counter-slip length, and interface new-slip length change with increasing or decreasing applied stress, which affects the stress–strain fatigue hysteresis loops and fatigue hysteresis-based damage parameters. The reloading/unloading stress–strain relationships when fiber/matrix interface partially or completely debonding are determined as a function of interface debonding/sliding, peak stress, applied cycle number, and thermal cycle temperature. The relationships between thermomechanical fatigue loading parameters (i.e. peak stress, applied cycle number, and thermal cyclic temperature), fiber/matrix interface debonding/sliding lengths, and fatigue hysteresis-based damage parameters (i.e. fatigue hysteresis dissipated energy, fatigue hysteresis modulus, and fatigue peak strain) have been established. The effects of fiber volume fraction, peak stress, matrix cracking space, and thermal cyclic temperature range on damage evolution under the out-of-phase thermomechanical cyclic loading have been discussed. The differences in damage evolution between in-phase/out-of-phase thermomechanical fatigue and isothermal fatigue loading at the same peak stress have been analyzed. The damage evolution of cross-ply SiC/magnesium aluminosilicate composite under the out-of-phase thermomechanical and isothermal fatigue loading has been predicted.
Reducing Muslim Mammography Disparities: Outcomes From a Religiously Tailored Mosque-Based Intervention
Authors: Padela Aasim I. , Malik Sana , Ally Syeda Akila , Quinn Michael , Hall Stephen , Peek Monica
Published: April 2018

Objective. To describe the design of, and participant-level outcomes related to, a religiously tailored, peer-led group education program aimed at enhancing Muslim women’s mammography intention. Method. Using a community-engaged approach and mixed methods, we identified and addressed barrier beliefs impeding mammography screening among Muslim American women. Our religiously tailored, mosque-based, peer-led intervention involved facilitated discussions and expert-led didactics conveying health-related religious teachings, and information about the benefits and process of mammography. Barrier beliefs were addressed through reframing, reprioritizing, or reforming such beliefs. Participant surveys were collected preintervention, postintervention, 6 months postintervention, and 1 year postintervention. These measured changes in mammography intention, likelihood, confidence, and resonance with barrier and facilitator beliefs. Results. A total of 58 Muslim women (mean age = 50 years) that had not had a mammogram in the past 2 years participated in the two-session program. Self-reported likelihood of obtaining a mammogram increased significantly ( p = .01) and coincided with a positive trend in confidence ( p = .08). Individuals with higher agreement with barrier beliefs preintervention had lower odds for positive change in likelihood (odds ratio = 0.80, p = .03), while those who were married had higher odds for positive change in likelihood (odds ratio = 37.69, p = .02). At 1-year follow-up, 22 participants had obtained a mammogram. Conclusion. Our pilot mosque-based intervention demonstrated efficacy in improving Muslim women’s self-reported likelihood of obtaining mammograms, and increased their mammography utilization, with nearly 40% obtaining a mammogram within 12 months of the intervention. Impact. Our conceptual model for religiously tailoring messages, along with its implementation curriculum, proved effective in enhancing the likelihood and receipt of mammograms among Muslim American women. Accordingly, our work advances both the theory and practice of faith-based interventions and provides a model for addressing Muslim women’s cancer screening disparities.
Neuromyelitis optica spectrum disorder mimicking extensive leukodystrophy
Authors: Ciron Jonathan , Colin Olivier , Rosier Marie-Pierre , Lapeyrie Soline , Biotti Damien , Brassat David , Neau Jean-Philippe
Published: April 2018

Brain MRI was originally considered to appear normal in neuromyelitis optica spectrum disorders (NMO-SD). Typical brain lesions are now well described and have been integrated in the latest revision of NMO-SD criteria, but the NMO-SD MRI pattern remains not yet comprehensive. We report here extensive white matter lesions (EWML) mimicking leukodystrophy in a 50-year-old woman with long-lasting anti-AQP4+ NMO-SD. We suggest that EWML could be a possible brain MRI presentation of NMO-SD patients.
Cafébabel and ‘Génération Bataclan’: Cosmopolitan identities and/as constructive European news
Authors: Bødker Henrik
Published: April 2018

The attack on the Bataclan Theatre in Paris in November 2015 arguably targeted a transnational community of youths able to move and convene freely; as such, it was an attack on the liberal and cosmopolitan core of the European project. Cafébabel (cafebabel.com), a multilingual current affairs online magazine co-funded by the European Union, is intricately linked to this project. This article consequently investigates how Cafébabel, in the aftermath of the attack, appropriated the notion of ‘Génération Bataclan’ from a front page of Libération and how this may be seen as a constructive intervention in the relations between terrorism and journalism in Europe. Cafëbabel’s coverage was, it will be argued, linked to efforts to reflect and/or construct a generational and transnational ‘cosmopolitan identity’ within journalistic practices that largely can be called participatory. Following this, the article consequently argues for seeing Cafébabel’s coverage as instances of constructive news as participation in the European project, which is related to how the outlet perceives the news by national legacy media as un-constructive (conflict, scepticism, nationalism, sensationalism, etc.). In analysing a sample of articles from Cafébabel following the Paris attacks, the article consequently employs a theoretical foundation that merges elements from writings applying three distinct concepts, namely, constructive journalism, journalism as practice and cosmopolitanism.
Expanding the International Baccalaureate Diploma Programme in Japan: The Role of University Admissions Reforms
Authors: Sanders Justin , Ishikura Yukiko
Published: April 2018

In 2011, the Japanese government, in partnership with the International Baccalaureate (IB) Organization, embarked on an ambitious agenda of increasing the number of schools offering the IB Diploma Programme (DP) in Japan. One of the biggest challenges in this initiative is improving the recognition of the IB Diploma as an acceptable and sought after qualification for entry into the nation’s higher education institutions. By examining data on DP student matriculation and a survey of Japanese university admissions offices, this paper explores the relationship between the government project, growth of the DP and admissions reform in Japan. Analysis suggests that while the DP recognition situation in Japan is changing, the pace is fairly gradual compared to the timeline set by the government, and there is still some way to go to meet the project targets. Additionally, it appears to be the private universities rather than the national universities that are leading in the reforms and accepting the most DP students.
Is diabetes a marker of higher risk after carotid revascularization? Experience from a single centre
Authors: Casana Renato , Malloggi Chiara , Odero Andrea , Tolva Valerio , Bulbulia Richard , Halliday Alison , Silani Vincenzo
Published: April 2018

Purpose:

This single centre study investigates the influence of diabetes mellitus on outcomes following carotid artery endarterectomy or stenting.

Methods:

In total, 752 carotid revascularizations (58.2% carotid artery stenting and 41.8% carotid endarterectomy) were performed in 221 (29.4%) patients with diabetes and 532 (70.6%) patients without diabetes. The study outcomes were death, disabling and non-disabling stroke, transient ischaemic attack and restenosis within 36 months after the procedure.

Results:

Patients with diabetes had higher periprocedural risk of any stroke or death (3.6% diabetes vs 0.6% no diabetes; p < 0.05), transient ischaemic attack (1.8% diabetes vs 0.2% no diabetes; p > 0.05) and restenosis (2.7% diabetes vs 0.6% no diabetes; p < 0.05). During long-term follow-up, there were no significant differences in Kaplan–Meier estimates of freedom from death, any stroke and transient ischaemic attack, between people with and without diabetes for each carotid artery stenting and carotid endarterectomy subgroup. Patients with diabetes showed higher rates of restenosis during follow-up than patients without diabetes (36-months estimate risk of restenosis: 21.2% diabetes vs 12.5% no diabetes; p < 0.05).

Conclusion:

The presence of diabetes was associated with increased periprocedural risk, but no further additional risk emerged during longer term follow-up. Restenosis rates were higher among patients with diabetes.
High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity
Authors: Crozier Jennifer , Roig Marc , Eng Janice J. , MacKay-Lyons Marilyn , Fung Joyce , Ploughman Michelle , Bailey Damian M. , Sweet Shane N. , Giacomantonio Nicholas , Thiel Alexander , Trivino Michael , Tang Ada
Published: April 2018

Introduction. Stroke is the leading cause of adult disability. Individuals poststroke possess less than half of the cardiorespiratory fitness (CRF) as their nonstroke counterparts, leading to inactivity, deconditioning, and an increased risk of cardiovascular events. Preserving cardiovascular health is critical to lower stroke risk; however, stroke rehabilitation typically provides limited opportunity for cardiovascular exercise. Optimal cardiovascular training parameters to maximize recovery in stroke survivors also remains unknown. While stroke rehabilitation recommendations suggest the use of moderate-intensity continuous exercise (MICE) to improve CRF, neither is it routinely implemented in clinical practice, nor is the intensity always sufficient to elicit a training effect. High-intensity interval training (HIIT) has emerged as a potentially effective alternative that encompasses brief high-intensity bursts of exercise interspersed with bouts of recovery, aiming to maximize cardiovascular exercise intensity in a time-efficient manner. HIIT may provide an alternative exercise intervention and invoke more pronounced benefits poststroke. Objectives. To provide an updated review of HIIT poststroke through ( a) synthesizing current evidence; ( b) proposing preliminary considerations of HIIT parameters to optimize benefit; ( c) discussing potential mechanisms underlying changes in function, cardiovascular health, and neuroplasticity following HIIT; and ( d) discussing clinical implications and directions for future research. Results. Preliminary evidence from 10 studies report HIIT-associated improvements in functional, cardiovascular, and neuroplastic outcomes poststroke; however, optimal HIIT parameters remain unknown. Conclusion. Larger randomized controlled trials are necessary to establish ( a) effectiveness, safety, and optimal training parameters within more heterogeneous poststroke populations; (b) potential mechanisms of HIIT-associated improvements; and ( c) adherence and psychosocial outcomes.
Real-time predication and navigation on traffic congestion model with equilibrium Markov chain
Authors: Zheng Yan , Li Yanran , Own Chung-Ming , Meng Zhaopeng , Gao Mengya
Published: April 2018

With the explosive growth of vehicles on the road, traffic congestion has become an inevitable problem when applying guidance algorithms to transportation networks in a busy and crowded city. In our study, the authors proposed an advanced prediction and navigation models on a dynamic traffic network. In contrast to the traditional shortest path algorithms, focused on the static network, the first part of our guiding method considered the potential traffic jams and was developed to provide the optimal driving advice for the distinct periods of a day. Accordingly, by dividing the real-time Global Positioning System data of taxis in Shenzhen city into 50 regions, the equilibrium Markov chain model was designed for dispatching vehicles and applied to ease the city congestion. With the reveals of our field experiments, the traffic congestion of city traffic networks can be alleviated effectively and efficiently, the system performance also can be retained.
Immunotherapy of experimental and human stroke with agents approved for multiple sclerosis: a systematic review
Authors: Dreikorn Mirjam , Milacic Zeljko , Pavlovic Vladimir , Meuth Sven G. , Kleinschnitz Christoph , Kraft Peter
Published: April 2018

Background:

‘Thromboinflammation’ describes a novel concept in stroke pathophysiology that has opened up the possibility of immunotherapeutic approaches which could become promising strategies for targeted stroke therapies in the future.

Methods:

We reviewed current evidence for agents approved for multiple sclerosis in preclinical and clinical stroke studies. A systematic review was performed in accordance with the PRISMA statement, searching MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 16 October 2017.

Results:

The review included 52 of 629 identified studies, consisting of 5 clinical and 47 preclinical trials. Most of the studies showed beneficial effects of the evaluated immunotherapeutic drugs in terms of reduction in morphological lesion size and improvement in functional outcome. Nevertheless, the significance of these findings is limited due to the high degree of heterogeneity.

Conclusions:

Immunotherapy of stroke might be effective and could become a promising treatment strategy, but larger clinical trials with standardized interventions and outcome measures are needed.
Severe oesophageal constriction due to an aberrant right subclavian artery with Kommerell’s diverticulum in a cat
Authors: Suzuki Ryohei , Mochizuki Yohei , Yoshimatsu Hiroki , Niina Ayaka , Teshima Takahiro , Matsumoto Hirotaka , Koyama Hidekazu
Published: April 2018

Case summary

A 6-month-old female cat with a history of chronic regurgitation presented with weight loss. CT angiography (CTA) showed severe constriction of the oesophagus due to an aberrant right subclavian artery and Kommerell’s diverticulum. The cat was surgically treated and remained clinically normal. More than 1 year after surgery, the general condition of the cat was stable and body weight had increased.

Relevance and novel information

This case report describes the clinical findings and surgical management of a cat diagnosed with severe oesophageal constriction caused by an aberrant right subclavian artery with Kommerell’s diverticulum (markedly dilated origin of the aberrant right subclavian artery), which are rare vascular anomalies in veterinary medicine and specifically in cats. The Kommerell’s diverticulum compressed the oesophagus and contributed to the severe oesophageal constriction in this case. Preoperative CTA was useful in the diagnosis and treatment planning.
“No Prejudice Here”: Examining Social Identity Work in Starter Pack Memes
Authors: Eschler Jordan , Menking Amanda
Published: April 2018

As a performance venue, online social spaces afford users a variety of ways to express themselves. Many of these expressions include social identity work, such as the articulation, affirmation, or policing of a shared identity. In this study, we examine one online space in which users engage in social identity work: a Reddit forum (r/starterpacks) that primarily generates and discusses image memes of a very specific format: the “starter pack.” Users leverage these image memes to convey what we refer to in this article as prototypes of social identities. Many of these prototypical depictions are necessarily influenced by offline social groups and/or consumer culture, and are furthermore constructed around gendered, racial, or ethnic stereotypes. To understand how these image memes are used to form and perpetuate prototypes of social identities, we employed content analysis to evaluate a sample of 500 image meme artifacts created, shared, and upvoted by the subreddit’s users. We discuss the process of applying visual analysis techniques to articulate themes identified in the image meme expressions, in particular: (1) the default of the White, male identity in starter pack characterizations; (2) the production of oppressive social identities through the use of visual and textual content; and (3) the dedication to a stance of “consumption” in assembling starter pack memes, both through body politics expressed therein and use of consumer goods in images. Finally, we draw on reader response theory to frame the challenges of researchers “reading” starter pack memes, despite employing systematic methods of analysis.
Causal attribution in block-recursive social systems: A structural modeling perspective
Authors: Wunsch Guillaume , Mouchart Michel , Russo Federica
Published: April 2018

One method for causal analysis in the social sciences is structural modeling. Structural models, as used in this article, model the (causal) mechanism for a social phenomenon by recursively decomposing the multivariate distribution of the variables of interest. Often, however, one does not achieve a complete decomposition in terms of single variables but in terms of “blocks” of variables only. Papers giving an overview of this issue are nevertheless rare. The purpose of this article is to categorize distinct types of block-recursivity and to examine, in a multidisciplinary perspective, the implications of block-recursivity for causal attribution. A probabilistic approach to causality is first developed in the framework of a structural model. The article then examines block-recursivity due to the presence of contingent conditions, of interaction, and of conjunctive causes. It also discusses causal attribution when information on the ordering of the variables is incomplete. The article concludes by emphasizing, in particular, the importance of properly specifying the population of reference.
Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review
Authors: Salathé Cornelia Rolli , Melloh Markus , Crawford Rebecca , Scherrer Stephanie , Boos Norbert , Elfering Achim
Published: April 2018

Study Design:

Systematic review.

Objectives:

To review the current literature on the treatment efficacy, clinical utility, and cost-effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) for patients suffering from persistent (nonspecific) lower back pain (LBP) in relation to pain intensity, disability, health-related quality of life, and work ability/sick leave.

Methods:

We carried out a systematic search of Web of Science, Cochrane Library, PubMed Central, EMBASE, and PsycINFO for English- and German-language literature published between January 2010 and July 2017. Study selection consisted of exclusion and inclusion phases. After screening for duplication, studies were excluded on the basis of criteria covering study design, number of participants, language of publication, and provision of information about the intervention. All the remaining articles dealing with the efficacy, utility, or cost-effectiveness of intensive (more than 25 hours per week) MBR encompassing at least 3 health domains and cognitive behavioral therapy–based psychological education were included.

Results:

The search retrieved 1199 publications of which 1116 were duplicates or met the exclusion criteria. Seventy of the remaining 83 articles did not meet the inclusion criteria; thus 13 studies were reviewed. All studies reporting changes in pain intensity or disability over 12 months after MBR reported moderate effect sizes and/or p-values for both outcomes. The effects on health-related quality of life were mixed, but MBR substantially reduced costs. Overall MBR produced an enduring improvement in work ability despite controversy and variable results.

Conclusions:

MBR is an effective treatment for nonspecific LBP, but there is room for improvement in cost-effectiveness and impact on sick leave, where the evidence was less compelling.
Spinal Reconstruction Techniques for Traumatic Spinal Injuries: A Systematic Review of Biomechanical Studies
Authors: Joaquim Andrei F. , Maslak Joseph P. , Patel Alpesh A.
Published: April 2018

Study Design:

Systematic literature review.

Objectives:

Many studies have provided evidence that short-segment posterior fixation (SSPF—1 level above and 1 below) with screws at the fracture level (SFL) are enough to achieve stability in some injury patterns, such as burst fractures, avoiding the need for circumferential reconstruction and long-segment instrumented fusion (LSIF—at least 2 levels above and 2 below). Given the potential benefits of avoiding unnecessary fusion in mobile healthy spinal segments, we performed a systematic review of biomechanical studies comparing different spinal reconstruction techniques for fractures of the thoracolumbar spine.

Methods:

A systematic literature review was performed in the PubMed and OVID databases of biomechanical studies comparing biomechanical differences between techniques of spine reconstructions.

Results:

Eight studies were included and evaluated. Five of 6 studies reported stiffness improvement with SSPF and SFL, even comparable to circumferential fusion for a burst fracture. Two studies reported that LSPF has higher stiffness and restricts range of motion better than SSPF, but inclusion of screws in the fracture level is similar to LSPF (1 study). Finally, although SSPF is less stiff than anterior reconstruction, adding a SFL in SSPF results in similar stiffness than circumferential fusion for unstable burst fractures.

Conclusions:

Biomechanical studies analyzed generally suggested that SFL in SSPF may improve construction stiffness, and can even be compared with long-segment fixation or circumferential reconstruction in some scenarios. This construct option may be used to enhance stiffness in selected injury patterns, avoiding the needs of an additional anterior approach.
A Review of Perforator Flaps for Burn Scar Contractures of Joints
Authors: Lewinson Ryan T. , Capozzi Lauren C. , Johnson Kody , Harrop Alan Robertson , Fraulin Frankie O. G. , Nickerson Duncan
Published: April 2018

Objective:

Perforator flaps are one possible surgical treatment for burn scar contractures; however, a review of evidence on this topic is lacking.

Methods:

MEDLINE was searched for articles related to perforator flaps for burn contractures. Following title and abstract screen, full texts were searched to identify articles describing perforator flaps for burn scar joint contractures. Data were extracted and summarized descriptively. Only articles that contained ≥10 patients with burn scar contracture were considered.

Results:

Two hundred forty-eight articles were identified, of which 17 met criteria for review. Of these, 16 were low-quality case series, while 1 was an open randomized controlled trial. In total, perforator flaps were performed on 339 patients (age range: 3-75 years), with the most common contracture locations being cervical (n = 218) and knee (n = 41). Nine of the 17 articles described a rehabilitation strategy. In general, functional outcomes were excellent, with the majority of patients experiencing return of normal joint range of motion and no recontracture. Compared to full-thickness skin grafts, perforator flaps showed greater improvements in joint range of motion. Cosmetically, perforator flaps were shown to have good color match with surrounding tissue, good contour around anatomical landmarks, and improved overall patient appearance. The most common complications were marginal flap necrosis (n = 26 patients) and venous congestion (n = 17 patients).

Conclusions:

Preliminary evidence from low-quality case series and 1 high-quality trial suggests perforator flaps may be successful for resurfacing released burn scar contractures; however, there is a need for additional trials comparing perforator flaps to other approaches.
Defining Platelet-Rich Plasma Usage by Team Physicians in Elite Athletes
Authors: Kantrowitz David E. , Padaki Ajay S. , Ahmad Christopher S. , Lynch T. Sean
Published: April 2018

Background:

The indications for the use of platelet-rich plasma (PRP) are vaguely defined despite the frequency of its use as a treatment for athletes. While select studies have advocated for its efficacy, the majority of orthopaedic research conducted on the topic has been equivocal.

Purpose:

To define the use of PRP in elite athletes by team physicians from professional sports leagues.

Study Design:

Cross-sectional study.

Methods:

A survey assessing treatment timing, usage patterns, indications, and complications was generated by fellowship-trained sports medicine orthopaedic surgeons. The survey was distributed to team physicians from the National Football League, National Basketball Association, Major League Baseball, National Hockey League, Major League Soccer, and the “Power 5” Division I conferences of the National Collegiate Athletic Association. From a compilation of publicly available email addresses and those available from professional team physician associations, 149 team physicians were sent this PRP assessment tool.

Results:

Of the 149 professional and collegiate team physicians contacted, 59 started the survey and 46 completed it, resulting in a 39.6% participation rate and a 30.9% completion rate. Approximately 93% of physicians stated that they use PRP in their practices, and 72% use ultrasonography for injection guidance. On average, collegiate team physicians and National Football League physicians treated the most players per season with PRP (69.4 and 60.4 players, respectively), while National Hockey League physicians treated the fewest (18.0 players). The majority of respondents reported no complications from PRP injections (70%), with pain being the most common complication reported (26%). There was no consensus on the most important aspect of PRP formulation, with the top 2 responses being platelet concentration (48%) and white blood cell concentration (39%). When grading the importance of indications to use PRP, physicians found athlete desire on average (7.5 ± 2.2 [SD]; out of 10) to be more important than reimbursement (2.2 ± 2.2) ( P < .001). Importantly, physicians stated that they moderately (5.4 ± 2.3) believed in the evidence behind PRP. Physicians listed hamstring injuries as the most common injury treated with PRP. Hamstring injuries were treated with a mean 3.14 PRP injections, as opposed to 2.19 injections for nonhamstring injuries.

Conclusion:

Professional and collegiate team physicians frequently use PRP despite a lack of consensus regarding the importance of the formulation of the product, the timing of treatment, and the conditions that would most benefit from PRP treatment.
ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update
Authors: Migliori Giovanni Battista , Sotgiu Giovanni , Rosales-Klintz Senia , Centis Rosella , D'Ambrosio Lia , Abubakar Ibrahim , Bothamley Graham , Caminero Jose Antonio , Cirillo Daniela Maria , Dara Masoud , de Vries Gerard , Aliberti Stefano , Dinh-Xuan Anh Tuan , Duarte Raquel , Midulla Fabio , Solovic Ivan , Subotic Dragan R. , Amicosante Massimo , Correia Ana Maria , Cirule Andra , Gualano Gina , Kunst Heinke , Palmieri Fabrizio , Riekstina Vija , Tiberi Simon , Verduin Remi , van der Werf Marieke J.
Published: April 2018

The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, therefore, the standards were reviewed and updated.

A panel of international experts, led by a writing group from the European Respiratory Society (ERS) and the European Centre for Disease Prevention and Control (ECDC), updated the ESTC on the basis of new published evidence. The underlying principles of these patient-centred standards remain unchanged. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and comorbidities, and public health and prevention.

The ESTC target clinicians and public health workers, provide an easy-to-use resource and act as a guide through all the required activities to ensure optimal diagnosis, treatment and prevention of TB.
Early diagnosis from newborn screening maximises survival in severe cystic fibrosis
Authors: Tridello Gloria , Castellani Carlo , Meneghelli Ilaria , Tamanini Anna , Assael Baroukh M.
Published: April 2018

Newborn screening (NBS) for cystic fibrosis (CF) has been gradually established in several countries, but scant data are available on its long-term effects on survival. Our objective was to evaluate the long-term effects of CF NBS on survival.

586 patients, diagnosed and followed between 1971 and 2014 at the Verona CF Centre were analysed. Eligibility was confirmed in 342 cases diagnosed by NBS, 101 with meconium ileus and 143 through symptoms (44 out of 143 were NBS false negatives). The primary end-point was the 30-year overall survival in patients diagnosed by NBS. Patients were grouped according to the number of hospitalisations for respiratory or nutritional symptoms in the first 3 years of life: 0 (mild), 1–2 (moderate) and ≥3 (severe). Survival in NBS and symptoms groups was compared.

The 30-year survival probability of the NBS group was 80.1% (95% CI 71.4–86.4%); in the symptoms group it was 71.0% (95% CI 62.2–78.2%). The 20-year survival was significantly higher in the NBSversussymptoms group in the severe (85%versus64%, p=0.007) and moderate (94%versus86%, p=0.016) groups. An adjusted Cox-model estimation confirmed differences in both the groups.

Poor outcome associated with early severe presentation of CF is tempered by NBS.