bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine in a Dutch intensive care unit: A descriptive study of the first results
Authors: van der Voort Peter HJ , de Metz Jesse , Wester Jos PJ , van Stijn Ilse , Feijen Hilde Marieken , Balzereit Anja , Rijkenberg Saskia , Obster Renate , Bosman Rob J
Published: July 2015

Introduction

Tele-intensive care (teleIC) can be used to increase the level of care in the intensive care unit (ICU) with the tele-intensivist being at a remote site. In this study we describe the implementation and outcomes, including patient and family satisfaction, of the first Dutch teleIC.

Methods

In a retrospective analysis the patient characteristics are described with a focus on patient outcomes and patient and family satisfaction. The teleIC started on 6 December 2010 in an ICU with three beds. Data for all admitted patients were collected from 1 January 2011 through 31 December 2013 from available systems. Severity of disease (APACHE IV) and standardized mortality ratios (SMR) were available over the complete calendar years 2012 and 2013. A prospective self-made survey of patient and family satisfaction was performed over a 14-month period after the implementation of teleIC.

Results

In 2012 and 2013, 556 patients were admitted. The number of operating room recovery patients in the ICU declined over time. One hundred and seven patients were transferred to a higher-level ICU (19%). The SMR for non-transferred patients was 0.73 (95% CI (confidence interval) 0.54–0.98) and 0.66 (95% CI (confidence interval) 0.40–1.02) for transferred patients. These numbers are in line with national data. Thirty-six percent of family and 38% of the patients responded to the survey and showed a positive response concerning communication within the tele IC setting.

Conclusion

Implementation of teleIC in a Dutch situation was successful and showed favourable results in patient outcomes and the satisfaction of patients and family members.
Global health education in Swedish medical schools
Authors: Ehn S. , Agardh A. , Holmer H. , Krantz G. , Hagander L.
Published: July 2015

Aims: Global health education is increasingly acknowledged as an opportunity for medical schools to prepare future practitioners for the broad health challenges of our time. The purpose of this study was to describe the evolution of global health education in Swedish medical schools and to assess students’ perceived needs for such education. Methods:Data on global health education were collected from all medical faculties in Sweden for the years 2000–2013. In addition, 76% (439/577) of all Swedish medical students in their final semester answered a structured questionnaire. Results: Global health education is offered at four of Sweden’s seven medical schools, and most medical students have had no global health education. Medical students in their final semester consider themselves to lack knowledge and skills in areas such as the global burden of disease (51%), social determinants of health (52%), culture and health (60%), climate and health (62%), health promotion and disease prevention (66%), strategies for equal access to health care (69%) and global health care systems (72%). A significant association was found between self-assessed competence and the amount of global health education received ( p<0.001). A majority of Swedish medical students (83%) wished to have more global health education added to the curriculum. Conclusions : Most Swedish medical students have had no global health education as part of their medical school curriculum. Expanded education in global health is sought after by medical students and could strengthen the professional development of future medical doctors in a wide range of topics important for practitioners in the global world of the twenty-first century.
Gender patterns in domestic labour among young adults in different living arrangements in Australia
Authors: Craig Lyn , Powell Abigail , Brown Judith E.
Published: July 2015

Most research on gender divisions of housework focuses on couple and family households. This article extends this literature to examine gender differences in domestic labour across living arrangements, with particular focus on young adults. Using time-diary data from the nationally representative Australian Bureau of Statistics (ABS) Time Use Survey (2006) it examines the amount and composition of domestic work performed by 20–34-year-olds ( n = 889) living with parents, in a share household, alone, or in a couple, differentiating between routine and non-routine housework tasks, and between housework done for oneself only or for the household. It finds gender differences are strongest in couple households, but pertain across living arrangements, including share houses. Also, women’s domestic labour varies more by household characteristics than men’s. However, there is some evidence of non-conformity to gender stereotypes, with young men living in couple relationships contributing more time on activities for the household than young men in other households.
Designing and implementing maturity models in hospitals: An experience report from 5 years of research
Authors: Blondiau André , Mettler Tobias , Winter Robert
Published: July 2015

In recent years, a wide range of generic and domain-specific maturity models have been developed in order to improve organizational design and learning of healthcare organizations. While many of these studies describe methods on how to measure dedicated aspects of a healthcare organization’s “maturity,” little evidence exists on how to effectively implement and deploy them into practice. This article therefore delineates the encountered challenges during the design and implementation of three maturity models for distinct improvement areas in hospitals. On the one hand, this study’s findings may serve as basis for refining existing maturity model design approaches. On the other hand, it may facilitate further research in domain-specific organizational design with maturity models.
Feasibility of utilizing a commercial eye tracker to assess electronic health record use during patient simulation
Authors: Gold Jeffrey Allen , Stephenson Laurel E , Gorsuch Adriel , Parthasarathy Keshav , Mohan Vishnu
Published: July 2015

Numerous reports describe unintended consequences of electronic health record implementation. Having previously described physicians’ failures to recognize patient safety issues within our electronic health record simulation environment, we now report on our use of eye and screen-tracking technology to understand factors associated with poor error recognition during an intensive care unit–based electronic health record simulation. We linked performance on the simulation to standard eye and screen-tracking readouts including number of fixations, saccades, mouse clicks and screens visited. In addition, we developed an overall Composite Eye Tracking score which measured when, where and how often each safety item was viewed. For 39 participants, the Composite Eye Tracking score correlated with performance on the simulation (p = 0.004). Overall, the improved performance was associated with a pattern of rapid scanning of data manifested by increased number of screens visited (p = 0.001), mouse clicks (p = 0.03) and saccades (p = 0.004). Eye tracking can be successfully integrated into electronic health record–based simulation and provides a surrogate measure of cognitive decision making and electronic health record usability.
Syrian refugees and information precarity
Authors: Wall Melissa , Otis Campbell Madeline , Janbek Dana
Published: July 2015

This study employed focus groups to examine the ways Syrian refugees living in a large refugee camp in Jordan are using cell phones to cope with information precarity, a condition of information instability and insecurity that may result in heightened exposure to violence. These refugees are found to experience information precarity in terms of technological and social access to relevant information; the prevalence of irrelevant, sometimes dangerous information; inability to control their own images; surveillance by the Syrian state; and disrupted social support.
Microstructure and static immersion corrosion behavior of AA7020-O Al plates joined by friction stir welding
Authors: Mosleh AO , Mahmoud FH , Mahmoud TS , Khalifa TA
Published: July 2015

In the present investigation, the influence of tool pin profile and postweld heat treatment on microstructure, hardness, and static immersion corrosion behavior of AA7020-O Al plates joined by friction stir welding was investigated. Friction stir welding was conducted using two tools having different pin profiles, typically, a tool with tapered cylindrical pin and a tool with two flat-sided cylindrical pin. Postweld heat treatment was carried out using a solution heat treatment temperature of 540 ± 1℃ for 12 h followed by aging at 155 ± 1℃ for 6 h. Corrosion tests were carried out by immersing the welds in an aqueous solution containing NaCl and H2O2 for 6 h according to ASTM-G110. The results revealed that the two flat-sided cylindrical pin tool produces finer α-Al grains, at the center of dynamically recrystallized zones, than the tapered cylindrical pin tool. The postweld heat treatment slightly increases the size of the α-Al grains at the center of dynamically recrystallized zones. In the as-welded conditions, the friction stir welded regions exhibited lower hardness values than the base alloy. However, the regions friction stir welded using two flat-sided cylindrical pin tool showed relatively higher hardness values than those regions friction stir welded using the tapered cylindrical pin tool. The postweld heat treatment slightly increases the hardness of the welded regions to values that are still lower than the base alloy. Generally, the dynamically recrystallized zones are more susceptible to corrosion than the base alloy. In both AW and postweld heat treatment conditions, the thermomechanically affected zones showed the lowest corrosion resistance when compared with dynamically recrystallized zones and heat affected zone regions. In the as-welded conditions, regions friction stir welded using tapered cylindrical pin tool exhibited better corrosion resistance than those friction stir welded using two flat-sided cylindrical pin. The postweld heat treatment improves the corrosion resistance of the dynamically recrystallized zones friction stir welded using two flat-sided cylindrical pin tool.
Between theory and social reality: Ethnography and Interpretation and Social Knowledge: Introduction to the special issue
Authors: Voyer Andrea , Trondman Mats
Published: July 2015

Difficulties distinguishing the ethnographic object and the ethnographer's analysis can pose a challenge to the conduct and dissemination of ethnographic work. The close distance between ethnographic observation and the ethnographer's interpretation elides the boundary between considerations of theory and method. In his book, Interpretation and Social Knowledge, Reed describes interpretivism as an epistemological approach aimed at harnessing the potential of social explanations developed in ethnography's interstitial position – the space between theory and social reality. This issue of Ethnographyc provides a forum for ethnographers coming from different theoretical positions and working in different empirical areas to reflect upon on the value and limitations of interpretivism in ethnography.
Interpretive reflexivity in ethnography
Authors: Lichterman Paul
Published: July 2015

Many would argue that ethnographic knowledge claims are partial. Many say this predicament demands the researcher’s self-reflexivity about ethnographic claims. Commonly, ethnographers perform reflexivity by discussing how their research may reflect interests or biases that accompany their positions in hierarchies of domination. Positional reflexivity uneasily straddles a realism that claims to know which position(s) affected the research, and a normativism that aims to demystify what we claim to know. Both stances suppress the interpretive work that researchers and researched constantly are doing. In a more interpretive practice of reflexivity, ethnographers explore how they figured out other people’s meanings in the field, instead of focusing on correlations between their claims and their social position. Interpretive reflexivity considers social positions within ongoing circuits of communication between researcher and researched. Since interpretations are part of explanation in much ethnography, interpretive reflexivity widens our ability to assess causal as well as interpretive claims.
Fragments from an ethnographer’s field guide: Skepticism, thick minimalism, and big theory
Authors: Wherry Frederick F.
Published: July 2015

This article challenges Isaac Reed’s discussion of interpretation in the social sciences by honing in on the unique properties of ethnographic research and the relationship between ethnography and theory. What are the practicalities of using theory to structure ethnographic engagement and of developing maximal theoretical explanations from participant observation? This article first advocates establishing skepticism by searching out evidence to counteract our claims and identifying how our conclusions could have turned out otherwise. Second, ethnographers should specify thick minimal matches between what our concepts are and how they manifest themselves in thick description (often in a reformulated forms) in our field sites; and third, thick minimal matches can be made to facilitate big theory by re-signifying the evidence within a body of existing significations and within a community of scholars.
‘He’s still the winner in my mind’: Maintaining the collective identity in sport through social creativity and group affirmation
Authors: Jones Ian
Published: July 2015

Social Creativity and Group Affirmation are two strategies by which individuals who identify with a sporting activity, team, group or individual may protect that sense of identification in light of negative events. This article explores the use of such strategies through examining reactions to doping allegations surrounding Lance Armstrong to explain how members of two brand communities (one based on the brand of Armstrong as a cyclist and the other on the brand of Armstrong as a cancer survivor) maintain a sense of allegiance. Through undertaking a netnographic approach, six strategies were identified by members of these communities, three of which could be identified as Social Creativity Strategies (Lance Armstrong as ‘superhuman’, the notion of cycling as a ‘level playing field’, Armstrong as scapegoat) and three as Group Affirmation (Armstrong as a continuing inspiration, the Armstrong legacy and denial). The two brand communities demonstrated differing patterns of maintenance, with those within the cycling community focusing more upon Social Creativity strategies, whereas those members of the Armstrong as cancer survivor brand tended to focus upon Group Affirmation strategies.
A shape which represents an eternity of riddles: fractals and scale in the work of Wilson Harris
Authors: Noxolo Pat
Published: July 2015

This article undertakes a geographical investigation of the potential application of the concept of fractals to Wilson Harris’ understanding of the relationships between language and landscape. Alan Riach, briefly describing a fractal as ‘an irregular action or shape, such as a cloud or a coastline . . .’, has famously argued that Harris’ poetry and prose (his work notoriously blurs this boundary) ‘. . . is caught up by the shifting fractals of political energy on a global stage . . .’ Retracing this essentially metaphorical use of the term fractal back through its physical geography routes, the article begins by briefly exploring the complex meanings of the term as it is used to describe dynamic geomorphological processes, particularly the changing shapes of coastlines and rivers. Bringing this into relationship with Wilson Harris’ most recent work The Ghost of Memory, as well as his own commentaries on his work as a whole, the article argues that the application of the adjective ‘fractal’ specifically to landscape as it is described in Harris’ work is not purely metaphorical, but usefully describes the conditions for the relationships between language and landscape that Harris has spent a lifetime expressing. This tentative and contested geographical understanding of natural features of the environment as in this way not static but ‘in constant motion and unfinished’ can therefore form the beginning of an understanding of Harris’ critique of environmental degradation as disconnection. The article will end by briefly exploring the potential value of Harris’ work in relation to literature and spatiality.
The importance of procedural justice and police performance in shaping intentions to cooperate with the police: Does social identity matter?
Authors: Murphy Kristina , Sargeant Elise , Cherney Adrian
Published: July 2015

Research consistently reveals that public perceptions of procedural justice and police performance are important for fostering citizens’ willingness to cooperate with police, with procedural justice being more important than police performance. Identifying factors that motivate people’s intentions to cooperate with police is the focus of the present study. Of particular interest will be how people’s affiliations with different groups in society moderate their responses to questions about their willingness to cooperate with police. The study utilizes survey data from 10,148 Australian residents and demonstrates that procedural justice, police performance, and identity each predict people’s intentions to cooperate with police. The findings also reveal that identity can moderate citizens’ concerns about procedural justice and police performance when predicting cooperation.
The associations between increasing degrees of homeostatic model assessment for insulin resistance and muscular strengthening activities among euglycaemic US adults
Authors: Boyer William R , Johnson Tammie M , Fitzhugh Eugene C , Richardson Michael R , Churilla James R
Published: July 2015

Purpose:

To examine the associations between the homeostatic model assessment for insulin resistance and self-reported muscular strengthening activity in a nationally representative sample of euglycaemic US adults.

Methods:

Sample included euglycaemic adults (⩾20 years of age ( n = 2009)) from the 1999 to 2004 National Health and Nutrition Examination Survey. Homeostatic model assessment for insulin resistance was categorized into quartiles and was the primary independent variable of interest. No reported muscular strengthening activity was the dependent variable.

Results:

Following adjustment for covariates, those with homeostatic model assessment for insulin resistance values in fourth (odds ratio: 2.04, 95% confidence interval: 1.35−3.06, p < 0.001) quartile were found to have significantly greater odds of reporting no muscular strengthening activity. Following further adjustment for non-muscular strengthening activity specific aerobic leisure-time physical activity, results remained significant for the fourth (odds ratio: 2.30, 95% confidence interval: 1.50−3.52, p < 0.001) quartile. A significant trend was seen across quartiles of homeostatic model assessment for insulin resistance for increasing prevalence of no muscular strengthening activity ( p < 0.001).

Conclusion:

Having a higher homeostatic model assessment for insulin resistance value is associated with greater odds of reporting no muscular strengthening activity among euglycaemic US adults. This implies that subjects with an increasing degree of insulin resistance are more likely to not engage in muscular strengthening activity, an exercise modality that has been shown to reduce the risk of several cardiometabolic diseases and improve glycaemic status.
From Subjective Cognitive Complaints to Dementia
Authors: Mendonça Marcelo D. , Alves Luísa , Bugalho Paulo
Published: July 2015

Subjective cognitive complaints (SCCs) are frequent in the elderly population. The majority of individuals with subjective complaints never progress to significant cognitive decline, but some of them have a higher risk of progression to objective cognitive impairment than persons with no cognitive concerns. We performed a systematic review of community-based studies that focused on the progression risk associated with SCC and on the complainers’ characteristics associated with progression. Seventeen studies were included. As a group, SCCs are associated with a significantly higher risk of progression to dementia. Worried complainers, persons who refer an impact of their complaints on activities of daily living, and those whose complaints are also noticed by an informant have the highest risk of progression. Taking into account the fluctuating course of SCC and their frequent reversion, care should be taken to not overvaluate them. Further studies are necessary to better define risk features.
Galectin-3 in autoimmunity and autoimmune diseases
Authors: de Oliveira Felipe L , Gatto Mariele , Bassi Nicola , Luisetto Roberto , Ghirardello Anna , Punzi Leonardo , Doria Andrea
Published: July 2015

Galectin-3 (gal-3) is a β-galactoside-binding lectin, which regulates cell–cell and extracellular interactions during self/non-self-antigen recognition and cellular activation, proliferation, differentiation, migration and apoptosis. It plays a significant role in cellular and tissue pathophysiology by organizing niches that drive inflammation and immune responses. Gal-3 has some therapeutic potential in several diseases, including chronic inflammatory disorders, cancer and autoimmune diseases. Gal-3 exerts a broad spectrum of functions which differs according to its intra- or extracellular localization. Recombinant gal-3 strategy has been used to identify potential mode of action of gal-3; however, exogenous gal-3 may not reproduce the functions of the endogenous gal-3. Notably, gal-3 induces monocyte–macrophage differentiation, interferes with dendritic cell fate decision, regulates apoptosis on T lymphocytes and inhibits B-lymphocyte differentiation into immunoglobulin secreting plasma cells. Considering the influence of these cell populations in the pathogenesis of several autoimmune diseases, gal-3 seems to play a role in development of autoimmunity. Gal-3 has been suggested as a potential therapeutic agent in patients affected with some autoimmune disorders. However, the precise role of gal-3 in driving the inflammatory process in autoimmune or immune-mediated disorders remains elusive. Here, we reviewed the involvement of gal-3 in cellular and tissue events during autoimmune and immune-mediated inflammatory diseases.
Patellar Fractures
Authors: Buezo Oscar , Cuscó Xavier , Seijas Roberto , Sallent Andrea , Ares Oscar , Álvarez-Díaz Pedro , Cugat Ramón
Published: July 2015

Purpose. To describe a new surgical procedure and its outcomes: osteosynthesis with high-resistance sutures, avoiding metallic implants. Open sky osteosynthesis with Kirschner and cerclage wiring is the current gold standard for patella fractures. Favorable functional outcomes have been observed, although implant removal is required in many cases due to the prominent wires under the skin. New implants have been sought after to minimize the need for second surgeries. Methods. Eight patients, aged between 25 and 61 years, with a minimum follow-up of 24 months, were included in the present study. The surgical procedure consists of open reduction followed by internal fixation performing 3 longitudinal tunnels crossing double high-resistance sutures within these tunnels and suturing among them. Next, an anterior cerclage with parenchymal suture was performed. Results. During follow-up, no secondary fracture displacement was observed. No patient required or requested implant removal. Functional outcomes were equitable to other surgical techniques. Conclusion. Despite the relatively small number of patients, osteosynthesis with high-resistance suture presents as an acceptable alternative within patella fracture treatment, being safe and with similar functional outcomes when compared with other techniques. Furthermore, no second surgeries for implant removal were required during the present study.
Assessment of handgrip strength in preschool children aged 3 to 5 years
Authors: Sanchez-Delgado G. , Cadenas-Sanchez C. , Mora-Gonzalez J. , Martinez-Tellez B. , Chillón P. , Löf M. , Ortega F. B. , Ruiz J. R.
Published: July 2015

We investigated whether there is an optimal grip span for determining the maximum handgrip strength in preschool children and if it is influenced by gender, age, or hand size. A total of 292 preschool children (3–5 years; 59.2% boys) carried out the handgrip strength test with different grip spans (4.0, 4.5, 5.0, 5.5, and 6.0 cm). The hand size was also measured. We also determined the reliability of the optimal grip span in another group of children ( n = 56, 57% boys) who did the test twice, with a 3-hour difference between tests. The results showed that 4.0 cm is the optimal grip span to determine the maximum handgrip strength in preschool children. This result applied to both genders, all age groups, and hand sizes. Paired t-tests showed no significant differences between test and retest. These findings may guide clinicians and researchers in selecting the optimal grip span when measuring handgrip strength in preschool children.

Level IV
Isolated C5–C6 avulsion in obstetric brachial plexus palsy treated by ipsilateral C7 neurotization to the upper trunk: outcomes at a mean follow-up of 9 years
Authors: Gibon E. , Romana C. , Vialle R. , Fitoussi F.
Published: July 2015

Cervical root avulsions are the worst pattern of injury in obstetrical brachial plexus injury (OBPI). The prognosis is poor and the treatment is mainly surgical with extraplexual neurotizations or muscle transfers. We present the outcomes of a technique performed in our institution to treat C5–C6 avulsion in obstetrical brachial plexus injury. This technique consists of a total ipsilateral C7 neurotization to the upper trunk. Ten babies with isolated C5–C6 root avulsion were operated on; we were able to review nine of them at over 12 months follow-up. The shoulder and the elbow function were assessed, as well as the Mallet Score. The mean follow-up was 9.2 years (SD 5.7). After a follow-up of 6 years, elbow flexion was restored with a range of motion ⩾130° and a motor function ⩾M3 in all patients. The average Mallet score was 18.1 (SD 1.2). This approach appears to be a viable alternative to extraplexual neurotizations for the treatment of C5–C6 nerve root avulsion.
Landing impact analysis of sport surfaces using three-dimensional finite element model
Authors: Farhang Behzad , Araghi Fargol R , Bahmani Aram , Moztarzadeh Fathollah , Shafieian Mehdi
Published: July 2015

Shock absorbance, or force reduction, is the most significant parameter in sport surfaces which has been used as an injury prevention criterion. Many sport federations like the International Association of Athletics Federations, the International Federation of Association Football and the International Hockey Federation have arranged force reduction tests for sport surfaces which are performed by an apparatus called the Artificial Athlete Berlin. As this apparatus has been designed for simulating a normal subject at usual conditions, some major details are neglected. In this article, a finite element model, which included the human lower limb and a standard sport surface, was developed and is capable of extracting force reduction parameters in various sport conditions. The viscoelastic behavior of the sport surface was extracted by compression stress-relaxation tests with various strain rates to import into the finite element model. To calculate the shock absorbance of the sport surface, the contact pressure versus time curves were plotted for the top and bottom layers of the sport surface. The difference between peak values of curves was extracted as the sport surface shock absorbance ability. To validate the proposed model, a finite element model which included the Artificial Athlete Berlin apparatus was simulated. The results present an excellent correlation between the proposed and the Artificial Athlete Berlin apparatus models. Also, the shock absorption value obtained by the proposed model was close to the average value reported by the ASTM F2772 standard which the sport surface meets.
Physiotherapy treatment for atraumatic recurrent shoulder instability: early results of a specific exercise protocol using pathology-specific outcome measures
Authors: Bateman Marcus , Smith Benjamin E , Osborne Sally E , Wilkes Sally R
Published: July 2015

Background

Recurrent shoulder instability is usually caused by a traumatic event resulting in structural pathology, although a small subgroup of patients experience symptomatic recurrent shoulder instability without trauma. These patients are usually treated non-operatively but limited evidence exists regarding effective conservative management. In particular, there is a lack of reproducible exercise regimes and none that have been tested with condition-specific outcome measures.

Methods

A service evaluation was conducted over a 15-month period to assess our current treatment protocol used in the management of patients with atraumatic recurrent shoulder instability. The regime is reproducible with target-led progression milestones. Oxford Instability Shoulder Scores (OISS) and Western Ontario Shoulder Index (WOSI) scores were compared between baseline and final follow-up.

Results

Eighteen consecutive patients were included with mean follow-up of 4.5 months (range 1.35 months to 11.77 months). A statistically significant improvement was seen in both outcome measures. Mean OISS improved by 16.67 points (confidence interval: 12.34 to 20.99; p < 0.001). Mean WOSI improved by 36.76% (confidence interval: 28.46 to 45.06; p < 0.001).

Conclusions

For this small group of patients with recurrent atraumatic shoulder instability, the Derby Shoulder Instability Programme produced significant improvements over the short term, with a high level of patient compliance. This is the first study to include pathology-specific patient-reported outcome measures to assess outcomes from a specific and reproducible exercise regime in this group of patients. The findings support further research to evaluate the exercise protocol in a larger group of patients over the longer term.
Lipoma in the subscapularis muscle causing scapular malposition
Authors: Kawano Yusuke , Nakamichi Noriaki , Matsumura Noboru
Published: July 2015

A 70-year-old woman had pain and fatigability of her left shoulder with asymmetric scapular position. The medial border of the scapula was more prominent in the left side compared to the right scapula, and scapular motion was different between sides. Magnetic resonance imaging showed a mass on the ventral surface of the scapula. Tumour resection was performed through the medial approach, and the tissue samples were found to be a lipoma with a pathological examination. Post-operatively, her pain immediately disappeared. Two years after surgery, no recurrence of the tumour had been found.

Soft tissue tumours have never been reported as a cause of scapular malposition or winging. We reported a case with scapular malposition and dyskinesis caused by lipoma in the subscapularis muscle. Surgical resection successfully relieved her symptoms and improved the scapular motion. Soft tissue tumour occurring in the subscapularis muscle could possibly cause abnormal scapular position and motion.
Decision Making and the Limits of Evidence
Authors: Boyko Matthew , Iancu Daniela , Lesiuk Howard , Dowlatshahi Dar , Shamy Michel C. F.
Published: July 2015

We report the case of a pregnant woman treated for acute ischemic stroke and review the literature on acute stroke treatment in pregnancy. To our knowledge, this is the first case reporting the successful use of intravenous tissue plasminogen activator and a stent retriever for acute stroke in pregnancy. We then use this case to consider the way medical knowledge is used in therapeutic decision making and argue that decision making necessarily extends beyond the limits of clinical trial evidence.
Alicaforsen, an antisense inhibitor of ICAM‐1, as treatment for chronic refractory pouchitis after proctocolectomy: A case series
Authors: Greuter Thomas , Biedermann Luc , Rogler Gerhard , Sauter Bernhard , Seibold Frank
Published: July 2015

Background and aims

The published data about the efficacy of the intercellular adhesion molecule‐1 (ICAM‐1) antisense oligonucleotide termed alicaforsen in inflammatory bowel disease (IBD) is rather inconsistent. This case series analyzes its efficacy in chronic refractory pouchitis, after proctocolectomy.

Methods

We performed a retrospective analysis on all patients who had received at least one dose of alicaforsen for IBD at three referral centers in Switzerland. We assessed the drug’s efficacy in patients treated for chronic refractory pouchitis, by comparing the clinical and/or endoscopic disease activity at baseline with a 2–3‐month follow‐up visit.

Results

We identified 22 patients who had received at least one dose. Among them, 13 patients were being treated for chronic refractory pouchitis. These patients had a median age of 38.0 years (95% CI 21.0–69.0) and five were female (38.5%). The median time since pouch surgery was 102.5 months (95% CI 16.0–288.0), with a median pouchitis duration of 16.0 months (95% CI 4.0–216.0). At 2–3 months after therapy, clinical and endoscopic disease activity was significantly reduced (stool frequency 9.0 versus 6.0, the Pouchitis Disease Activity Index (PDAI) clinical subscore was 4.0 versus 1.0, and the endoscopic disease activity was 4.0 versus 2.0). Clinical improvement was achieved in 11 out of 13 pouchitis patients (84.6%); however, a relapse was observed in nine of these patients (81.8%). The median time from clinical improvement to relapse was 16 weeks (95% CI 9.0–23.0).

Conclusions

Alicaforsen seemed to be efficacious in inducing clinical and/or endoscopic improvement in chronic refractory pouchitis and may be a promising treatment alternative in those patients; however, given the high proportion of relapse, one 6‐week course of alicaforsen may not be sufficient.
Effectiveness of focal vs. balloon radiofrequency ablation devices in the treatment of Barrett’s esophagus
Authors: Brown Jesica , Alsop Benjamin , Gupta Neil , Buckles Daniel C , Olyaee Mojtaba S , Vennalaganti Prashanth , Kanakadandi Vijay Naag , Saligram Shreyas , Sharma Prateek
Published: July 2015

Background and aims

The safety and efficacy of radiofrequency ablation (RFA) in treatment of Barrett’s esophagus (BE)‐associated dysplasia has been well established. The effectiveness of focal and balloon RFA devices has not been compared. Therefore, the aim of our study was to assess the effectiveness of focal and balloon RFA devices in the treatment of BE by calculating absolute and percentage change in BE length with RFA therapy by comparing pre‐ and post‐treatment BE length.

Patients and methods

This is a retrospective cross‐sectional study of patients who underwent at least one treatment with either focal and/or balloon RFA devices who were identified from two tertiary centers. Patients’ demographics, hiatal hernia, pre‐ and post‐treatment BE length, prior use of endoscopic therapies and number of sessions were recorded.

Results

Sixty‐one patients who had undergone 161 RFA treatment sessions met inclusion criteria. There was no significant difference in percentage change in BE length with greater number of RFA sessions. RFA with a focal device resulted in greater percentage reduction in BE length compared to the balloon system (73% vs. 39%, p  < 0.01). After adjusting for initial BE length, pre‐treatment BE length, hernia status, prior endoscopic mucosal resection (EMR), prior RFA, and prior EMR/RFA sessions, RFA with a focal device at each session remained an independent predictor for a significant reduction in BE extent as compared to the balloon system.

Conclusion

The focal RFA device alone was more effective in treatment of BE compared to the balloon system, with a greater reduction in extent of BE. The focal RFA device for endoscopic eradication therapy of BE should be considered the preferred technique.
The burden of bowel preparations in patients undergoing elective colonoscopy
Authors: Sharara Ala I , El Reda Zeinab D , Harb Ali H , Abou Fadel Carla G , Sarkis Fayez S , Chalhoub Jean M , Abou Mrad Rachel
Published: July 2015

Background

An adequate bowel preparation is an important quality measure for optimal colonoscopy.

Aims

The aim of this article is to study the burden of bowel preparations by examining seven specific variables (hunger, taste, volume, sleep, social, work, and adverse events (AEs)).

Methods

Ambulatory patients undergoing elective colonoscopy completed a questionnaire regarding their experience with the prescribed preparation. The seven study variables were graded using a numerical scale of 0–10 (best to worst). A score >6 was considered to indicate a significant impact and used as primary outcome. Patients were also asked to grade in descending order what they perceived as the worst aspect of the preparation.

Results

A total of 216 patients completed the survey. Preparations consisted of split‐dose sodium picosulfate (SPS) (n  = 49), split‐dose 4 l PEG ± menthol (n  = 49), full‐dose PEG (n  = 68), and 2 l split‐dose PEG + ascorbic acid (n  = 50). Except for work and AEs, all variables were considered to have a negative impact by >20% of patients (range 20.4–34.2). SPS was superior to PEG regimens in taste (4.1% vs. 35.9%) and volume (0% vs. 44.9%) (p  < 0.05 for both) but inferior for hunger (30.6% vs. 19.2%; p  = 0.09). The addition of menthol to PEG significantly improved taste (22.4% vs. 41.5%; p  = 0.02). Sleep disturbances were most common with SPS and least with split‐dose PEG (30.6% vs. 17.4%; p  < 0.05). Overall, patients ranked volume, taste, and hunger as most burdensome.

Conclusions

The burden of bowel preparation is substantial. An informed personalized choice of preparation may improve adherence, tolerability and colon cleansing.
Short‐term prognosis of potential celiac disease in Indian patients
Authors: Kondala Raghuram , Puri Amarender S , Banka Ameet K , Sachdeva Sanjeev , Sakhuja Puja
Published: July 2015

Background

Progression of potential celiac disease (PCD) to overt celiac disease (CD) has been described in some studies from the Western Hemisphere. There are no Asian data on this aspect of CD.

Objective

We aimed to study the short‐term histological course of PCD in Indian patients.

Methods

Patients with PCD were prospectively identified by screening relatives of patients with CD, the diarrheal subtype of irritable bowel syndrome (IBS‐D) and patients with iron deficiency anemia (IDA). Patients with serology that was positive for immunoglobulin A antibodies against tissue transglutaminase (IgA anti‐tTG) were subjected to endoscopy with duodenal biopsy. PCD was defined as a Marsh‐0 to Marsh‐II lesion on duodenal biopsy, along with positive IgA tTG serology. Retesting for serology and histology was done at 6‐month intervals, for 12 months.

Results : We diagnosed 57 patients (23 male) of mean age 28.7 years (range: 4–73 yrs) as having PCD. Of these 57 patients, 28 were identified by screening 192 first‐degree relatives of 55 index cases of CD, while the remaining 29 had either IBS‐D or IDA. Duodenal biopsy showed Marsh‐0, Marsh‐I and Marsh‐II changes in 28, 27 and 2 patients, respectively. At 6 months, 12 patients became seronegative. The remaining 45 patients continued to be seropositive at the 12‐month time point. Histological progression to Marsh‐III occurred in only four patients, while progression from Marsh‐0 to either Marsh‐I or Marsh‐II occurred in six patients and one patient, respectively; but 14 patients with Marsh‐I did show regression to Marsh‐0. Of the two patients who were initially Marsh‐II, one remained so upon follow up and one showed regression to Marsh‐0.

Conclusions

Our data suggested that despite the fact that nearly 80% of the patients diagnosed to have PCD continue to remain seropositive for tTG 12 months later, histological progression to Marsh‐III occurred in only 7% of patients over the same time period. These observations do not justify starting a gluten‐free diet in all patients with PCD, in India.
Mining texts to efficiently generate global data on political regime types
Authors: Minhas Shahryar , Ulfelder Jay , Ward Michael D
Published: July 2015

We describe the design and results of an experiment in using text-mining and machine-learning techniques to generate annual measures of national political regime types. Valid and reliable measures of countries’ forms of national government are essential to cross-national and dynamic analysis of many phenomena of great interest to political scientists, including civil war, interstate war, democratization, and coups d’état. Unfortunately, traditional measures of regime type are very expensive to produce, and observations for ambiguous cases are often sharply contested. In this project, we train a series of support vector machine (SVM) classifiers to infer regime type from textual data sources. To train the classifiers, we used vectorized textual reports from Freedom House and the State Department as features for a training set of prelabeled regime type data. To validate our SVM classifiers, we compare their predictions in an out-of-sample context, and the performance results across a variety of metrics (accuracy, precision, recall) are very high. The results of this project highlight the ability of these techniques to contribute to producing real-time data sources for use in political science that can also be routinely updated at much lower cost than human-coded data. To this end, we set up a text-processing pipeline that pulls updated textual data from selected sources, conducts feature extraction, and applies supervised machine learning methods to produce measures of regime type. This pipeline, written in Python, can be pulled from the Github repository associated with this project and easily extended as more data becomes available.
Ties that bind: revisiting context, identity, and attitudes
Authors: Krueger James S. , Pedraza Francisco I.
Published: July 2015

The article focuses on group-based features of issue publics and advances the concept of residual group saliency as a way to organize members of issue publics. We accord veterans exemplar or prototype status, and civilians as periphery members of this issue public. As issue public exemplars, veterans anchor the “right” attitudes and behaviors for the veteran issue public, and civilians, especially those with family ties to veterans, gravitate toward those exemplar attitudes. We argue that pressure to conform to these “right” attitudes among civilians who are connected to a veteran is greater when there are more veterans in their environment. However, veterans and civilians who are not connected to a veteran are not responsive to such contextual effects, the former because they are already exemplars, and the latter because there is no motivation to evaluate the self in relation to veterans. We test and find support for these claims using data from the 2010 Cooperative Congressional Election Study. We conclude with an evaluative discussion and suggestions for future research.
When all is said and done: updating “Elections, special interests, and financial crisis”
Authors: Gandrud Christopher , Hallerberg Mark
Published: July 2015

How do elections affect the costliness of financial crises to taxpayers? Previous research contends that more electorally competitive countries choose policies that are less costly to taxpayers. In this paper, we update Keefer’s seminal 2007 article published in International Organization with revised data. The original article found that more electorally competitive countries had lower fiscal costs from responding to crises. The commonly used IMF/World Bank data set Keefer employed has since been extensively corrected and expanded. We update the original analysis with the newest version of this data set. After doing so, we find no evidence for an association between electoral competitiveness and the fiscal costs of responding to financial crises both within the original sample and outside of it. Our update highlights a broader methodological lesson: that the costs of responding to financial crises can take many years to be settled. Future research should explicitly address and model this delayed cost resolution.
Politics is local: State legislator voting on restrictive voter identification legislation
Authors: McKee Seth C
Published: July 2015

The marked increase in restrictive voter identification (ID) laws since the 2010 elections reveals the extreme partisan polarization in those state legislatures advancing this reform. Unlike previous studies that examine state-level factors expected to influence passage of restrictive voter ID bills, this study is the first to investigate the question using the state legislator as the unit of analysis. Multivariate analysis of the voting behavior of state legislators shows which kinds of district-level factors increase or decrease their likelihood of supporting stricter voter ID laws. Given the differentiable coalitions favoring Democratic and Republican candidates, certain partisan-aligned district demographics influence state lawmaker support for restrictive voter ID legislation. Race in particular is a major cleavage conditioning support for restrictive voter ID laws. Unlike the mixed findings generated by macro-level studies, this article provides convincing evidence that the size of the black district population negatively influences the likelihood that a Democratic legislator votes in favor of a restrictive voter ID bill, but positively affects the probability that a Republican lawmaker votes yes. The findings in this study illuminate the contextual factors that influence legislator voting on this salient election reform.
Measurements of cognitive skill by survey mode: Marginal differences and scaling similarities
Authors: Gooch Andrew
Published: July 2015

This paper addresses how measurements of cognitive skill differ based on survey mode, from a face-to-face interview to a self-completed survey, using the Wordsum vocabulary test found in the General Social Survey. The Wordsum acts as a proxy for general cognitive skill, and it has been used to predict a variety of political variables. Therefore, knowing differences in cognitive skill by mode are important for political science research because of the proliferation of self-completed Internet surveys. I leverage a large-scale mode experiment that randomizes a general population sample into a face-to-face or self-completed interview. Results show that historically easy questions are more likely to yield correct answers in the face-to-face treatment, but modest-to-difficult test questions have a higher rate of correct answers in the self-completed treatment (marginal distributions). A cognitive skill scale using item response theory, however, does not differ by mode because the ordering of ideal points does not change from a face-to-face interview to a self-completed survey. When applying the scale to a well-established model of party identification, I show no difference by mode, suggesting that a transition from face-to-face interviews to self-completed surveys may not alter conclusion drawn from models that use the Wordsum test.