bluuebunny/crossref_metadata_2025 huggingface dataset:
The GraftLink Ulnar Collateral Ligament Reconstruction
Authors: Lynch Jamie L. , Pifer Matthew A. , Maerz Tristan , Kurdziel Michael D. , Davidson Abigail A. , Baker Kevin C. , Anderson Kyle
Published: August 2013

Background:

Ulnar collateral ligament (UCL) reconstruction aims to restore valgus stability, and numerous techniques have been described in the literature.

Hypothesis/Purpose:

To biomechanically compare the GraftLink (GL) technique with traditional bone tunnels used in the docking (DO) technique. It is hypothesized that the GL method will offer a stiffer, less lax construct compared with the DO.

Study Design:

Controlled laboratory study.

Methods:

Native and reconstructed states were tested in 7 matched pairs of cadaveric arms. To test kinematics, a 1.5-N·m valgus torque was applied and the resultant displacement at 15° to 90° of flexion was measured. Dissipated energy and the torque at the peak of the 10th cycle of preconditioning were analyzed during kinematic tests. Failure testing was performed by internal rotation of the humerus at 4.5 deg/s in 70° of flexion. Ulnotrochlear joint (UTJ) gapping was quantified during failure tests by use of video tracking.

Results:

Kinematics testing revealed no differences between the native state and the reconstructed state in either the DO or the GL group at any flexion angle. Stiffness was lower in the reconstructed specimens in both the DO (39.92 N·m/rad) and GL (50.74 N·m/rad) groups compared with their matched native states (DO Native, 71.41 N·m/rad, P = .005; GL Native, 86.36 N·m/rad, P = .002). There was no difference in stiffness between DO and GL. Reconstructed specimens in the GL group had lower torque at failure compared with native specimens (17.404 N·m vs 24.63 N·m, P = .038), but there was no difference in the DO group at failure. There was no difference in torque at failure between DO and GL. The DO exhibited higher angular displacement at failure compared with the native state (34.21° vs 21.79°, P = .010) and compared with the GL when normalized (1.58-fold vs 1.19-fold, P = .039). Compared with their native states, both DO and GL had significantly higher UTJ gapping at 3 N·m and at failure. The DO had significantly higher normalized UTJ gapping than the GL at 3 N·m ( P = .037 ) and at failure ( P = .043).

Conclusion:

The DO and GL both restored joint kinematics under low loading conditions. Although less stiff, the GL exhibited lower joint gapping and laxity than did the DO.

Clinical Relevance:

Understanding the biomechanics of UCL reconstruction has significant implications for postoperative management as it relates to early rehabilitation. Biomechanically inferior constructs could risk graft failure or early loosening during rehabilitation, and comparing the biomechanics of new techniques to established, widely used procedures such as the docking technique can provide important information about the immediate postoperative performance.
Composite hull structures subjected to wave-induced slamming impact
Authors: Kim Yail J , Yoshitake Isamu , Liu Rui
Published: August 2013

This paper presents a review of the state-of-the-art concerning composite hull structures subjected to wave-induced slamming load. Slamming is one of the critical load components that can influence the behavior of marine structures and can result in micro- or macro-level damage. Emphasis of the review is placed on fundamental issues with regard to the interaction between composite hulls and slamming events, including material characteristics, structural configurations, hydroelasticity, and the nature of wave-generated impact load. Practical aspects such as design implementation are also discussed. Recent developments in predictive approaches (e.g. multi-scale modeling) and hybrid testing methodologies are elaborated. Current research needs are identified and technical topics requiring further study are suggested.
Influence of fiber grid on interlayer bond property of airport double-layer pavement
Authors: Yan Xiangcheng , Weng Xingzhong , Kou Yanan
Published: August 2013

In order to study the interlayer bond property of airport double-layer pavement, the cement concrete cube splitting tensile test and double-layer beam test were conducted. The bond mechanism of fiber grid and airport double-layer pavement was analyzed. The deflection and strain of upper and lower beams of double-layer beam were measured. The splitting tensile strength of new and old cement concrete cubes, the strain ratio, deflection difference and coupling coefficient of the double-layer beam were taken as criteria for the interlayer bond property of airport double-layer pavement. The result demonstrates that the splitting tensile strength is maximal when the basalt fiber grid with dimension of 5 mm was adopted, the old cement concrete and fiber grid surface treatment have great influence on splitting tensile strength, but the maximum grain size of coarse aggregate have few influence on it. The friction between double-layer beam reduces the strains of the bottom of the lower and upper beams by 44.44–98.46%. The fiber grid and old cement concrete surface treatment not only increase the coupling coefficient with the range of 4.60–15.73% but also decrease the deflection difference, the number of which ranges from 0.004 mm to 0.016 mm, thus improve the integral force performance and deformation ability of double-layer beams.
Non-linear idealisation error analysis of an aerospace stiffened panel loaded in compression
Authors: Hetey Laszlo , Campbell James , Vignjevic Rade
Published: August 2013

The SAFE Structural Analysis procedure is an idealisation error control methodology devised for linear static finite element analysis. This study examines the applicability of this process to non-linear problems. The studied case is the collapse analysis of an aircraft stiffened panel loaded in compression. This article presents the critical investigation of important modelling assumptions, including the joint modelling, boundary conditions, geometrical imperfections and scattering in material parameters. Potential error sources are identified and then analysed using the non-linear finite element solver ABAQUS. The analysis derived an improved finite element model and concrete idealisation error estimates. The finally simulated failure behaviour corresponds well to the data measured in the test.
A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia
Authors: Peitzmeier Sarah , Mason Krystal , Ceesay Nuha , Diouf Daouda , Drame Fatou , Loum Jaegan , Baral Stefan
Published: August 2013

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants ( n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% ( n = 5/40) knew their status. Condom usage at last sex was 97.1% ( n = 170/175) with new clients and 44.2% ( n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs.
Lung cancer in HIV-infected patients
Authors: Palacios Rosario , Pascual Javier , Cabrera Eva , Lebrón Jose M , Guerrero-León Miguel A , del Arco Alfonso , Colmenero Juan D , Santos Jesús
Published: August 2013

Our objective was to determine the prevalence and characteristics of lung cancer (LC) in HIV patients and compare them with LC patients from the general population. All HIV patients diagnosed at three hospitals in Malaga (southern Spain) who developed LC during January 1989-June 2012 were reviewed. They were compared with a sample of patients with LC taken from the Pneumology and Oncology Department of the Hospital Virgen de le Victoria (Malaga) during the same period. Of the 4721 HIV patients (83% men) followed-up during the study period, 61 (1.29%) developed LC: 82% were men, mean age 48 years, all except two were smokers, 47.5% had a prior lung infection, and the median CD4 count was 237 cells/mm3. Forty (65.5%) patients were on antiretroviral therapy at LC diagnosis (70% had an undetectable viral load). The HIV-negative group was older at diagnosis, contained fewer active smokers, had a greater frequency of the squamous cell carcinoma histological subtype and fewer cases of adenocarcinoma. Presentation was advanced in both groups and the median survival of HIV patients was three months. LC is a common tumour in HIV patients. It affects men and women equally, with a history of smoking and often a prior opportunistic lung disease. Affected patients are often immunosuppressed and have had an AIDS-related diagnosis.
The Illusion of Saving Face
Authors: Dong Ping , Huang Xun (Irene) , Wyer Robert S.
Published: August 2013

People who feel embarrassed are often motivated to avoid social contact—that is, to hide their face. At the same time, they may be motivated to restore the positive image that has been tarnished by the embarrassing event (or, in other words, to restore the face lost in the event). Individuals can symbolically employ these coping strategies by choosing commercial products that literally either hide their face (e.g., sunglasses) or repair it (e.g., restorative cosmetics). However, the two coping strategies have different consequences. Although symbolically repairing one’s face eliminates aversive feelings of embarrassment and restores one’s willingness to engage in social activities, symbolically hiding one’s face has little impact.
Delta neutrophil index as a marker for differential diagnosis between flare and infection in febrile systemic lupus erythematosus patients
Authors: Pyo JY , Park JS , Park Y-B , Lee S-K , Ha Y-J , Lee S-W
Published: August 2013

* These authors contributed equally to this work. Fever is a common symptom of systemic lupus erythematosus (SLE), and because of this it is difficult to discriminate between SLE flare and infection. The delta neutrophil index (DNI), automatically determined by the ADVIA 2120 electronic cell analyzer, has been reported to reflect the fraction of circulating immature granulocytes and to be associated with the presence of infection. In this study, we investigated the utility of DNI in discriminating infections from SLE flares in febrile SLE patients. In total, 111 episodes in 92 febrile SLE patients were reviewed. The infection group showed significantly higher white blood cell counts, neutrophil counts, C-reactive protein and procalcitonin than the SLE flare group. Complement (C)3 and C4 levels were decreased significantly in the SLE flare group. Patients in the SLE flare group had significantly lower DNI than those in both infection groups, with or without bacteremia. In a multivariate logistic regression analysis, only DNI was a significant independent factor for the presence of infection (odds ratio (OR): 18.9). When we selected a DNI value of 2.8% as the cutoff for infection, SLE patients with DNI ≥ 2.8% were found to be at higher risk for infection than those with DNI < 2.8% (relative risk 8.48-fold). Our data suggest that DNI may be a marker to differentiate infections from SLE flares in febrile SLE patients.
Quality of the Literacy Environment in Inclusive Early Childhood Special Education Classrooms
Authors: Guo Ying , Sawyer Brook E. , Justice Laura M. , Kaderavek Joan N.
Published: August 2013

The purpose of this study was to examine the quality of the literacy environment in inclusive early childhood special education (ECSE) classrooms ( N = 54). The first aim was to describe the quality of the literacy environment in terms of structure (i.e., book materials and print/writing materials) and instruction (i.e., instructional support). The second aim was to examine the interrelationships among teacher and classroom factors and the quality of the literacy environment. Results showed that, on average, the quality of the structural literacy environment was low to moderate, and the quality of the instructional literacy environment was generally low. Only one factor, the number of children who were dual-language learners, related to the quality of the structural literacy environment, whereas the quality of the instructional literacy environment was positively associated with two teacher-level factors (teacher education and self-efficacy) and negatively associated with one teacher-level factor (the number of language and literacy workshops attended). Study findings suggest the need to examine ways to improve the literacy environment of ECSE classrooms and to better understand sources of variance with respect to the literacy environment.
CT Density Analysis of the Medial Cuneiform
Authors: Panchbhavi Vinod K. , Boutris Nickolas , Patel Karan , Molina Domingo , Andersen Clark R.
Published: August 2013

Background:

A cannulated lag screw inserted through the medial cuneiform into the base of the second metatarsal is often utilized to reduce the diastasis and aid healing of Lisfranc injuries. Also procedures such as a midfoot or a Lapidus arthrodesis require adequate implant-bone purchase in the medial cuneiform. The medial cuneiform contains cancellous bone of varying density. Knowledge of density variation may be helpful for implant usage and manufacturing of area specific implants.

Methods:

In 60 randomly selected patients, mean computed tomography (CT) intensity in Hounsfield units was measured at 12 sampled locations within the medial cuneiform and served as a proxy for bone density. The patients’ age, gender, and race were recorded. An analysis of variance (ANOVA) assessed the effect of age, gender, race, and sample site on bone density. Statistical testing assumed 95% level of confidence.

Results:

ANOVA showed age, gender, and sample site had significant effects ( P < .001) on bone density, though race had no significant effect ( P = .28). The distal-dorsal-lateral (DDL) site was significantly denser than all other sites ( P < .001) except the middle-dorsal-lateral (MDL) ( P = .53). The proximal-plantar-lateral (PPL) site was significantly less dense than all other sites ( P < .001) except the middle-plantar-lateral/medial and the proximal-plantar-medial sites ( P < .14). A general trend of density increasing in the distal and dorsal directions was evident, and within the dorsal sites there was a trend of increasing density in the lateral direction.

Conclusion:

This is the first study to date to measure density of the medial cuneiform using living subjects. The sample size of 60 patients was also the largest of any study measuring density of this bone. We conclude that the densest area of the medial cuneiform is the most anterior, dorsal, and lateral portion.

Clinical Relevance:

The findings of this study may indicate the most optimal area for implant purchase in the medial cuneiform when reducing the diastasis between the base of the second metatarsal and medial cuneiform and for stabilization of the medial column.
Stability analysis of a two-degree-of-freedom mechanical system subject to proportional–derivative digital position control
Authors: Habib Giuseppe , Rega Giuseppe , Stepan Gabor
Published: August 2013

In this paper we present an analysis of the stability of a two-degree-of-freedom system, modeling a robotic arm connected to the actuator through an elastic joint and subject to digital position control. The system consists of two lumped masses connected to each other through a spring and a damper. In the model there is only one actuator, so the system is underactuated in a certain sense; two cases are considered, referring to a collocated and a noncollocated configuration. Stability analysis is presented using both a continuous and a discrete time approach. The discrete time approach is related to the case of a digital controller, typical in real applications. This samples the position and the velocity signals at discrete time intervals and, therefore, it generates a piecewise constant control force, introducing a delay in the control system as well. The stability charts are presented in the parameter space of the sampling time and the control gains. Their differences highlight the role played by the resonances between the finite sampling frequency and the natural frequency of the system in achieving robust stability with respect to parameter variations.
Fuzzy control of a semi-active multiple degree-of-freedom vibration isolation system
Authors: Song Chunsheng , Zhou Zude , Xie Shengquan , Hu Yefa , Zhang Jinguang , Wu Huachun
Published: August 2013

Semi-active isolation systems fill the gap between passive and active systems, delivering the versatility and adaptability of fully active systems, by expending a small amount of energy to change system parameters such as stiffness and damping. Magnetic suspension vibration isolation provides an excellent active isolation technology, and has shown useful characteristics including noncontact isolation, fast response, high reliability and long lifespan. However, because it is highly nonlinear and time variant, the control of magnetic suspension vibration isolation is an area that still requires further exploration. This paper presents a fuzzy control algorithm for a semi-active multi-degree-of-freedom vibration system. The fuzzy control is based on the minimization of the weighted sum of squared output forces. The output force response of the fuzzy, PID control semi-active vibration isolation system and passive system under the same excitation are simulated. The simulation results show that the fuzzy control system has much better performance in vibration isolation. An experimental platform is developed to test the performance of the magnetic suspension vibration isolation system and the proposed fuzzy control algorithm. The experimental results are found to be in good agreement with simulation.
Implementation and verification of real-time hybrid simulation (RTHS) using a shake table for research and education
Authors: Ashasi-Sorkhabi Ali , Malekghasemi Hadi , Mercan Oya
Published: August 2013

In this study, as a state of the art testing method, real-time hybrid simulation (RTHS) is implemented and verified with a shake table for education and research. As an application example, the dynamic behavior of a tuned liquid damper (TLD)-structure system is investigated. RTHS is a practical and economical experimental technique which complements the strengths of computer simulation with physical testing. It separates the test structure into two substructures where part of the structure for which a reliable analytical model is not available is tested physically (experimental substructure) and coupled together with the analytical model of the remaining structure (analytical substructure). The implementation of RTHS involves challenges in accurate control of the experimental substructure as well as the synchronization of the signals. The details of the hardware and the software developed and the steps taken to improve the controller are discussed in this paper so that the implementation of RTHS is properly introduced. The accuracy has been verified using tracking indicators as well as using the response obtained from a spring-mass oscillator and TLD system. The shake table used in this study is available in over 100 universities around the world. In this paper, the implementation of RTHS is provided with sufficient details to enable easy introduction of this testing method wherever a similar shake table is available. This additional functionality will not only provide a new research tool, but it will also facilitate classroom demonstrations to improve how students understand new concepts in structural dynamics and earthquake engineering.
Bifurcation and chaotic vibration in electromechanical integrated toroidal drive
Authors: Xu Lizhong , Gao Yanxia
Published: August 2013

In this paper, we analyze the nonlinear magnetic-interaction forces in an electromechanical integrated toroidal drive and deduce the nonlinear electromechanically coupled dynamics equations of the drive system. Based on these equations, the bifurcation and chaotic vibrations of the drive system are investigated. The results show that chaotic vibrations occur in the drive system when the current in worm coils is relatively large. The current in worm coils, the ratio of the center distance to planet radius, the worm-coil inductance, and the support stiffness of the planet all have significant influence on the nonlinear vibrations of the drive system. We show the ranges for the system parameters that lead to a drive system with good dynamics. These results can be used to predict the dynamic load in a drive system and are useful for maximizing the power density of a drive system.
A novel method of fault diagnosis for rolling element bearings based on the accumulated envelope spectrum of the wavelet packet
Authors: Jiang Ruihong , Liu Shulin , Tang Youfu , Liu Yinghui
Published: August 2013

Envelope analysis is an effective technique of fault diagnosis for rolling element bearings (REBs). However, envelope analysis needs to select an appropriate frequency band of the signal. Numerous selection methods have been investigated, such as spectral kurtosis (SK) and wavelet packet kurtogram (WPK), which are based on kurtosis. Nevertheless, existing approaches are sometimes unable to identify bearing faults due to the contamination of discrete and random noises. In this paper, a novel method of fault diagnosis for bearings is proposed, which accumulates all or part of sub-band signals’ envelope spectrums at a given level in wavelet packet rather than demodulates one selected frequency sub-band signal. Two simulated signals and a real signal are analyzed to test the performance of the novel method. In the first case, stochastic impulses are added into the simulated outer race fault signal. The analysis shows that the novel approach is more robust to stochastic impulses than the other two methods such as SK and WPK. In the second case, the simulated signal containing two outer race faults from different REBs is analyzed using the three methods, respectively. The results show that the novel approach captures more useful information and detects the two different REBs’ faults contained in the same signal more effectively. Furthermore, the effectiveness of the novel method is validated by identifying the characteristic fault frequency of the real REB.
Vibrations supervision in gas turbine based on parity space approach to increasing efficiency
Authors: Hafaifa Ahmed , Guemana Mouloud , Daoudi Attia
Published: August 2013

The purpose of this work is to increase the online availability of industrial gas compression installations. By prevention against the failures in gas turbines, used in this gas compression installation. In this work a new vibrations supervision approach based on parity space is used, this will guarantee us the optimal availability of this system. The obtained results show clearly how to ensure a reliable and safe operation in gas compression plants to economically recover the transported gas.
Active control of power flow transmission in complex space truss structures based on the advanced Timoshenko theory
Authors: Zhao Yang , Wang You-Yi , Ma Wen-Lai
Published: August 2013

The disturbance propagation and active vibration control in complex space truss structures are investigated. Firstly, based on the advanced Timoshenko theory, the accurate dynamic responses of the space truss are obtained by the traveling wave method. Each structural member is treated as a waveguide, which transmits longitudinal, bending and torsional waves, and is connected by the junction. Secondly, the active power flow transmission of the space truss is suppressed by the feedforward active vibration control. Finally, the numerical simulation is implemented. The simulation results indicate that the dynamic responses of a space truss structure calculated by the traveling wave method are accurate and reliable in comparison with the results obtained by the finite element method. The dynamic responses are more accurate when using the Timoshenko beam model due to considering the effects of rotary inertia and shear distortion, especially in medium and high frequency ranges. Active control effects, attained by minimizing the active power flow, are compared with those achieved by minimizing the acceleration for suppressing the active power flow or the acceleration. It shows that active control effects achieved by minimizing the active power flow are much more effective than those reached by minimizing the acceleration, whether the error sensor is located in the far field or near field of the control source. In addition, the small error of the optimal control force has slight effects on the control results.
Now for the Hard Stuff
Authors: Preskill Hallie
Published: August 2013

Though several excellent literature reviews and research syntheses have been conducted, and thoughtful frameworks and models have been proposed, I believe it is time for the evaluation field to tackle the “hard stuff” of evaluation capacity building (ECB). This entails engaging staff in ECB activities, building the evaluation capacity of leaders, focusing on learning transfer, and evaluating ECB efforts. In this brief article, I describe these four challenges and pose questions for both practitioners and researchers to consider and act upon.
Predictions of the average surface separation and stiffness between contacting elastic and elastic–plastic sinusoidal surfaces
Authors: Rostami Amir , Jackson Robert L
Published: August 2013

The behavior of regular wavy surfaces in contact is important for the study of rough surface contact, and therefore has applications to the prediction of friction, wear, surface fatigue, and electrical and thermal contact resistance. This work characterizes the average surface separation between a sinusoidal surface and a flat rigid surface as a function of the average contact pressure or load using the finite element method (FEM). The FEM results also agree well with the limiting spherical based solutions at low contact pressures and the other asymptotic solution at high contact pressures. Empirical fits are provided that can approximately predict the average surface separation for both elastic and elastic–plastic sinusoidal contacts over a wide range of material properties. Contact stiffness can also be predicted from surface separation results.
Micro-slippage effects in pre-rolling induced by a disturbed and undisturbed pendulum with spherical supports
Authors: Gilavdary Igor , Mekid Samir , Riznookaya Natalia
Published: August 2013

Dynamics of small free swings of a pendulum supported by two spherical balls pre-rolling on a flat basis are considered to investigate the occurrence of micro-slippage at the contact interface between the balls and the flat surface. The basic mechanisms of this micro-slippage are investigated, showing how geometric conditions could initiate and magnify micro-slippage rather than assuming that these effects are core characteristics in any rolling system. This article also discusses the energy dissipation of a ball slipping on a flat surface at pre-rolling caused by three mechanisms and the conditions enabling the decrease of energy dissipation of the pendulum and the influence of the basis vibrations.
Effect of laser quenching on wear and damage of heavy-haul wheel/rail materials
Authors: Wang WJ , Guo J , Liu QY , Zhu MH
Published: August 2013

In order to alleviate the wear of heavy-haul wheel/rail materials, the wear experiments of wheel/rail rollers undergoing laser quenching were carried out using rolling-sliding testing apparatus. The results indicate that laser quenching produces a hard martensite layer with a certain depth. The improvement of wear resistance of materials resulting from laser quenching markedly decreases the wear volume of wheel/rail rollers. The maximal decrease rate of wear volume of wheel and rail materials is about 92.9% and 89.5%, respectively. Furthermore, the worn surfaces of wheel/rail rollers present different surface morphology and damage mechanisms due to difference of hardness matching. When the surface hardness of wheel/rail rollers undergoing laser quenching is high, the spalling damage and adhesion wear are dominating. When a single wheel or rail roller undergoes laser quenching, the damage mechanism of wheel and rail rollers are significantly different. According to the severe wear region of the heavy-haul wheel/rail, it is proposed that the rail side and wheel flange may undergo laser quenching treatment for alleviating wear of heavy-haul wheel/rail materials. However, further work should be carried out for clarifying the fatigue characteristic of wheel/rail with laser quenching.
An exploration of the perceptions and experiences of living with chronic anorexia nervosa while an inpatient on an Eating Disorders Unit: An Interpretative Phenomenological Analysis (IPA) study
Authors: Fox John RE , Diab Pascal
Published: August 2013

Chronic anorexia nervosa (cAN) is a challenging presentation for the clinician. Motivation to recover is low, and outcomes are often poor. Within this study. six participants, currently in treatment, were interviewed. These interview transcripts were analysed using Interpretative Phenomenological Analysis. The results highlighted five superordinate themes resulted from the analysis and these referred to the following points: (1) ‘making sense of AN’, (2) ‘experience of treatment/treatment’, (3) ‘interpersonal relationships’, (4) ‘battling with anorexia’ and (5) ‘staff pessimism in the treatment of cAN’. These results highlighted how the self is entwined with anorexia nervosa and thus making it incredibly difficult to perceive a life without cAN.
Developing indicators of service integration for child health
Authors: Pullon Susan , McKinlay Brodie , Yager Jess , Duncan Bruce , McHugh Patrick , Dowell Anthony
Published: August 2013

Children in many areas of New Zealand have poor health indices; statistics indicate health inequalities. Existing international indicators of child health currently take little account of local context. There are few composite indicators of how child health services are integrated at a community level. This study aimed to explore what local people consider would be useful indicators of better child health. Data for this qualitative study were collected via 24 individual interviews and two focus groups in a rural area of New Zealand. A total of 13 in-depth interviews were conducted with parents/families of small children. Participants were asked about wide-ranging aspects of child health. Also, 11 interviews and two focus groups were conducted with front line health professionals/stakeholders. Key themes from the content thematic analysis: include child health should be measured in multidimensional ways; essential interdependence of family–child health; universal access to culturally appropriate care, free primary care services and parenting education and support is needed; and there is a lack of integration and communication between health, education and social services. There is an important need to measure and monitor communication/integration across existing health, education and social services, provide better parenting support and health education and improve access to culturally appropriate primary care.
Pain reports in children and adolescents with type 1 diabetes mellitus
Authors: Tran Susan T , Salamon Katherine S , Hainsworth Keri R , Kichler Jessica C , Davies W Hobart , Alemzadeh Ramin , Weisman Steven J
Published: August 2013

The purpose of this study is to examine prevalence rates of pain reports in youth with type 1 diabetes mellitus (T1DM) and potential predictors of pain. Pain is a common and debilitating symptom of diabetic polyneuropathies. There is currently little research regarding pain in youth with T1DM. It was predicted that self-care and general health factors would predict pain as suggested by the general pain literature. Participants ( N = 269) ranged in age from 13 to 17 years; youth had a mean time since diagnosis of 5.8 years. Data collected included diabetes self-management variables, ratings of the patient’s current functioning and pain intensity (‘current’), and information collected about experiences that occurred in the time preceding each appointment (‘interim’). About half of the youth ( n = 121, 49.0%) reported any interim pain across both appointments. Female adolescents and those individuals who were physically active and/or utilized health-care system more acutely were more likely to report interim central nervous system pain. Improved diabetes self-management and increased level of physical activity may reduce experiences of pain and increase the quality of life of youth with T1DM. Regular monitoring of both current and interim pain experiences of youth with T1DM is recommended.
Comparison of utility scores from the Visual Analog Scale and Health Utilities Index 3 in children following pediatric intensive care unit admission
Authors: Ebrahim Shanil , Parshuram Christopher
Published: August 2013

Indirect and direct health-related quality of life (HRQoL) measures are intended to assess the same underlying constructs. There is evidence that the two types of assessments can show important differences. We assessed the agreement between the utilities of direct and indirect HRQoL measurements in children following pediatric intensive care unit (PICU) admission. We collected Health Utilities Index 3 (HUI-3) and Visual Analog Scale (VAS) ratings of children who were urgently admitted to the PICU of a university-affiliated pediatric hospital at ICU admission (baseline) and one month post-ICU admission. The mean (SD) VAS converted standard gamble and HUI-3 utilities were 0.82 (±0.19) and 0.70 (±0.39), respectively, at baseline ( n = 51), and 0.81 (±0.15) and 0.58 (±0.39) at one month ( n = 36). The VAS utilities were significantly greater than the HUI-3 utilities ( p = 0.009). At baseline, the intraclass coefficient (95% confidence interval) was 0.49 (0.25–0.68), representing moderate agreement, and at one month, was 0.18 (−0.87 to 0.45), representing negligible agreement. There were significant differences between indirect and direct measures, and inconsistent agreement between utilities derived from the two measures. These data illustrate the potential impact of HRQoL assessment techniques on economic analyses used to inform health policy decision-making for pediatric critical care.
When “mom’s the boss”: Control over domestic decision making reduces women’s interest in workplace power
Authors: Williams Melissa J. , Chen Serena
Published: August 2013

Although men are typically considered to have more power than women, women are more likely than men to be primary decision makers in the household domain. We argue that the portrayal of women’s traditional role as representing a form of power, albeit limited in scope, is widespread in popular culture, and that this power is perceived as desirable and providing a subjective sense of control (Study 1). Yet power over household decision making may also function to reduce women’s objections to a status quo in which they have less power overall, outside their traditional role. Two experiments (Studies 2 and 3) showed that power over household decisions (but not mere domestic tasks) reduced women’s interest in achieving power in the workplace. Men’s interest in workplace power, on the other hand, was unaffected by the degree to which they wielded power at home.
Does helicopter transport impact outcome following trauma?
Authors: Brown Joshua B , Gestring Mark L
Published: August 2013

Helicopter transport (HT) has evolved from military roots into a critical component of trauma systems throughout the world. Concerns over cost and safety continue to challenge the role of HT in the civilian setting. Despite this, recent evidence has demonstrated a survival advantage for trauma patients undergoing HT. For patients transported from the scene of injury, improved survival has been shown in several multicenter studies as well as evaluation of large national databases. Issues of overtriage, however, remain problematic for scene HT and represent a prime area for future research in helicopter emergency medical systems (EMS). Patients undergoing inter-facility transfer have also been shown to have improved outcomes over ground transport in terms of shorter transfer times and increased survival particularly in more severely injured patients. The benefits seen are likely a result of a combination of rapid transport, advanced medical capabilities, and accessibility to remote terrain. Several subgroups of patients undergoing HT have been the subject of study as well. Patients with severe head injury have consistently been shown to have superior outcomes over ground ambulance, attributable to improvements in airway management early in the course of their injury. Conversely, HT for urban and penetrating injury has not seen similar benefits, likely due to proximity of trauma centers and recent advancements in urban EMS systems. The benefits of including physicians in helicopter crews are less clear and vary by region and system. Helicopter transport for trauma does appear to improve outcomes for trauma patients, and optimizing utilization of this valuable resource will be key as the role of helicopter EMS continues to develop within trauma systems.
Prospective study of injury severity scores during a season of British Superbike racing
Authors: O’Dowd DP , Robertshaw S , Walker A , Roberts DG , Romer H
Published: August 2013

Background:

Motorbike racing is considered by many to be a dangerous sport, but there are little data within the literature to support this view. The purpose of this study was to determine the injury severity scores of injured riders in order to assess injury severity in elite level motorbike racing.

Methods:

Injury data were prospectively collected from all riders who attended the circuit medical centres at all rounds of the 2011 British Superbike Season. Abbreviated injury score and injury severity score were calculated for each rider and recorded along with other rider demographics.

Results:

A total of 259 riders presented to the circuit medical centres with injuries during the 2011 season. They suffered 382 injuries between them, with one fatality. The median injury severity score was 1 (mean 3.28, range 1–48, SD 5.08). Of the 1010 fallers during the season, only 33 (3.3%) required acute hospital admission.

Conclusion:

Greater than 93% of injured riders had injuries with an injury severity score ≤ 8 which is likely related to the high degree of protective clothing worn and safety measures at circuits including air fencing. The injury severity scores presented here for motorbike racing are less than or comparable to those seen in other physical sports such as elite level horse riding.
The renin-angiotensin system meets the hallmarks of cancer
Authors: Wegman-Ostrosky Talia , Soto-Reyes Ernesto , Vidal-Millán Silvia , Sánchez-Corona José
Published: August 2013

The hallmarks of cancer are described as the distinctive and complementary capacities that cells must acquire during the multistep development of becoming a cancer cell that allow them to survive, proliferate and disseminate. The renin-angiotensin system (RAS) was first discovered and extensively studied in the physiological regulation of systemic arterial pressure. RAS signalling increases cell proliferation in malignancy by directly affecting tumour and stromal cells and by indirectly modulating the growth of vascular cells during angiogenesis. We aim to describe and give a general view of how the RAS is involved in several hallmarks of cancer and how this could open a window to several interesting treatments.
Religious gift giving
Authors: Moufahim Mona
Published: August 2013

This article enhances the understanding of consumption practices, particularly gift giving, within the context of an Islamic pilgrimage called the ziyara. Pilgrimages are rich sites of analysis of entangled secular and sacred consumption. The findings of ethnographic research undertaken in this area have made a significant contribution to the literature on gift giving. Three particular types of gifts have been identified (1) ordinary liturgical gifts, (2) supplication gifts that invite ‘prayer’ counter-gifts and (3) soteriological gifts in the form of hassanat that are given to ensure other-worldly salvation. Pilgrims see the purchasing and consumption of gifts as activities intrinsic to their pilgrimage, even as sine qua non in the case of gifts distributed in the shrines. The consumption of material objects appears to be integral to pilgrimage rituals and transforms the intangible spiritual experience of the pilgrims into something ‘palpable’. The gifts are intended to embody the sacredness of the sites visited by the pilgrims and allow family and friends to partake in their sacred experience.
Back to the future
Authors: Hirschman Elizabeth C.
Published: August 2013

Spain during the time period 711 to 1492 was one of the most brilliantly creative and affluent nations in the Western Europe. During this epoch, Spain was populated by Muslims, Christians, and Jews who served as rulers, military leaders, scientists, philosophers, mathematicians, astronomers, and merchants, as well as consumers. The highest levels of cultural creativity and affluence are traceable to those rulers who encouraged religious tolerance, regardless of their own religious affiliation. I propose that this historical pattern is a valid one for marketing systems in contemporary Muslim–Christian–Jewish societies. Enforcement of religious orthodoxy by the government appears to discourage cooperative entrepreneurial activities and to reduce affluence, whereas government support of interfaith endeavors is linked to advances in science, business, and the arts.
A “Blush Sign”
Authors: Hollingsworth Andrew , Duddy Martin , Tiwari Alok
Published: August 2013

Vein graft stenosis is a well-recognized complication of infrainguinal bypass surgery. Balloon angioplasty is an accepted method for managing vein graft stenosis in selected patients. This intervention is not without complication. We present 2 cases of delayed pseudoaneurysm formation after balloon angioplasty of vein graft stenoses. Both cases showed a persistent contrast stain or blush as an indication of vein wall damage and propose that this is a radiological harbinger of delayed rupture and pseudoaneurysm formation.
Intercostal and pectoral nerve transfers to re-innervate the biceps muscle in obstetric brachial plexus lesions
Authors: Pondaag W. , Malessy M. J. A.
Published: August 2013

In obstetric brachial plexus lesions with avulsion injury, nerve grafting for biceps muscle re-innervation may not be possible owing to the unavailability of a proximal stump. In such cases, the intercostal nerves or medial pectoral nerve can serve as donor nerves in an end-to-end transfer to the musculocutaneous nerve. The present study reports the results of both techniques from a single institution in a consecutive series of 42 patients between 1995 and 2008. From 1995 to 2000 we always used the intercostal nerve transfer, and from 2001 to 2008 both techniques were used. Biceps muscle force ≥Medical Research Council Grade 3 was achieved in 37 of 42 patients after a mean follow-up of 44 months. There was no statistical difference in the results in the medial pectoral nerve transfer group ( n = 25) and the intercostal nerve transfer group ( n = 17).
The Liebenberg syndrome: in depth analysis of the original family
Authors: Mennen U. , Mundlos S. , Spielmann M.
Published: August 2013

The Liebenberg syndrome was first described in 1973 in a five- generation family. A sixth generation was added in 2001, and in 2009 a hitherto unknown branch of the same family with similar anomalies extended the family tree significantly. This article describes the clinical findings and illustrates the abnormalities with radiographs and three-dimensional computed tomography scans. We discuss the genetic abnormality that causes Liebenberg syndrome, the genomic rearrangement at the PITX1 locus on chromosome 5.The structural variations seem to result in an ectopic expression of paired-like homeodomain transcription factor 1 (PITX1) in the forelimb causing a partial arm-to-leg transformation in these patients.
Efficacy and safety of laquinimod in multiple sclerosis: current status
Authors: Haggiag Shalom , Ruggieri Serena , Gasperini Claudio
Published: August 2013

Laquinimod is a novel immunomodulatory agent, in development as a potential disease-modifying treatment for multiple sclerosis (MS). Structurally related to linomide, its pharmacological predecessor, laquinimod combines anti-inflammatory and possibly clinically relevant neuroprotective effects with the convenience of oral administration. In this review we aim to highlight the immunomodulatory and neuroprotective effects of laquinimod, and to describe its effects in animal models of MS. Furthermore, we focus on current results of clinical studies in MS. Randomized, controlled clinical trials in relapsing MS demonstrate a dose–response effect on disease activity, measured by reduced clinical relapse rate, reduced number of brain MRI active lesions, as well as on sustained disability and brain atrophy. Laquinimod has a favourable tolerability and safety profile. A new phase III study, recently completed, will soon provide further details on the therapeutic potential of this drug. Laquinimod is a promising emerging treatment for relapsing–remitting MS that may provide a new therapeutic option in the near future.
Spontaneous recovery of long-term severe complex regional pain syndrome of the upper limb: A case report
Authors: Glassey Nicole , Gunawardane Pradeepa , Starley Ian F
Published: August 2013

A case report is presented detailing the development, medical and therapeutic treatment of a patient with severe complex regional pain syndrome of the upper limb. The sudden spontaneous recovery of this patient’s symptoms is discussed and the evidence for diagnosis of complex regional pain syndrome is reflected upon with reference to the adapted Budapest diagnostic criteria.
More of the Same or Marketplace of Opinions? A Cross-National Comparison of Diversity in Online News Reporting
Authors: Humprecht Edda , Büchel Florin
Published: August 2013

This paper examines diversity in online news reporting and explanatory factors that shape news production. The analysis is based on online news from six countries (the United States, Germany, the United Kingdom, Switzerland, France, and Italy), comparing online-only news sites and legacy media. The analysis shows that most online media reported in a diverse way, comprising multiple topics and actors. Furthermore, event-driven news journalism explains the occurrence of high diversity in news reporting. Available resources and the intensiveness of online reporting (the extent as well as the editing style) also account for diversity. We draw from these findings to make a contribution to research on diversity in online news and to comparative communication studies. Qualitative comparative analysis is used to reflect on the direction and meaning of changes in journalistic practices in the current media environment.