bluuebunny/crossref_metadata_2025 huggingface dataset:
Internationalization of Ethiopian Higher Education Institutions: Manifestations of a Nascent System
Authors: Tamrat Wondwosen , Teferra Damtew
Published: July 2018

The changing landscape of higher education over the past few decades has increasingly brought internationalization to the fore as one major manifestation of the educational systems of both developed and developing countries alike. As part of this global trend, the Ethiopian higher education sector has, in the past decade, begun to exhibit some of the emerging trends of internationalization despite the paucity of data that portray the phenomenon in an organized manner. This study was conducted to address the prevailing deficiencies with particular focus on identifying the dominant manifestations of internationalization in Ethiopia’s public and private higher education institutions. Data were drawn from nine public and six private institutions using questionnaire and focus group discussion. The major findings of the study revealed that institutions consider internationalization as an important activity for the purposes of promoting teaching and resource mobilization, international research projects, and academic quality and standards. However, in most of the surveyed universities, internationalization was found to be more of an ad hoc and reactive process than a systematically administered proactive undertaking. On the basis of the findings that portray the features of a nascent system, the need for cohesive policies, strategic directions, and operational efficiencies both at national and institutional levels has been projected.
Mothers of Incest Victims: Villains, Victims, or Protectors?
Authors: Elbow Margaret , Mayfield Judy
Published: July 2018

Traditional theoretical explanations of father–daughter incest overlook the fact that some mothers take protective action on behalf of their daughters, influenced by evidence that many do not take such action. Drawing from life-events theory, the authors offer alternative explanations for what appears to be nonprotective behavior. Suggestions for reducing the need for family disruption are offered.
Anticipatory Mourning of Middle-Aged Parents of Adult Children with AIDS
Authors: Dane Barbara Oberhofer
Published: July 2018

There is little literature concerning the response of middle-aged parents to the dying of an adult child from complications due to AIDS. The author proposes a conceptual framework of anticipatory mourning for counseling these parents. Intervention strategies are discussed.
Clinical Considerations for Adults Abused as Children
Authors: Wartel Stephen G.
Published: July 2018

Each year a great many children are physically, sexually, or emotionally abused. This early trauma often overwhelms coping mechanisms and derails personality development, resulting in childhood and adult psychopathology. Until recently, the connection between childhood abuse and adult psychopathology eluded most clinicians, with negative consequences for survivors. The author examines these phenomena and discusses a biopsychosocial and integrative clinical approach to this population.
Holocaust Survivors and the Crisis of Aging
Authors: Cohen Betty Brodsky
Published: July 2018

The author discusses aging as an especially traumatic crisis for survivors of the Nazi Holocaust. Survivor guilt, unresolved mourning, and strained relations with the next generation are prominent among this group. Treatment difficulties are examined. Although this article focuses on Holocaust survivors, some of the suggestions offered are relevant to other groups that have survived massive psychic trauma.
A Structural Analysis of Families Adopting Special-Needs Children
Authors: Groze Victor , Rosenthal James A.
Published: July 2018

The authors analyzed the responses of 799 families who had finalized their adoption of a special-needs child. The Family Adaptability and Cohesion Evaluation Scales instrument was used to describe family process and structure in families who had successfully adopted a child with special needs. These families are much more adaptable and cohesive when compared with normative families. The cohesion subscales clearly indicated that close emotional bonding and recreation focused around the family were highly valued. Implications for practice are discussed.
Intervention with Male Toddlers who have Witnessed Parental Violence
Authors: Davies Douglas
Published: July 2018

Research evidence indicates that witnessing parental violence has serious negative effects on children and may predispose male children, in particular, to become violent in future relationships. This study utilizes attach' ment theory as a framework for understanding and intervening with male toddlers and their mothers in the aftermath of domestic violence. A detailed case study is used to illustrate this intervention approach.
Assessing Violent Couples
Authors: Douglas Harriet
Published: July 2018

In clinical assessment of violence between members of a couple, the practitioner's focus is expanded from the abusive incident and crisis stage to a view of couple dynamics during nonviolent periods. Often, couples view the noncrisis period as the norm and true state of the marriage, and violence is seen as an aberration. Issues such as emotional dependency, fear of rejection and abandonment, and shifting power balance between partners need to be addressed. The complexities of interaction and meaning surrounding the violence as well as the role of violence in the couple system allow for selective, differential use of an array of interventions.
Economic, Situational, and Psychological Correlates of the Decision-Making Process of Battered Women
Authors: Johnson Ida M.
Published: July 2018

The author presents the findings of a descriptive, exploratory study designed to measure the correlates of battered women's decisions to return home to the abuser after termination by a shelter. Data were collected from 426 battered women who sought help from a spouse-abuse shelter located in central Florida. Using exchange theory as a theoretical model, analysis revealed that battered women are likely to return home to the abuser when (1) the annual family income is high, (2) they are unemployed, (3) they have been victims of severe abuse, and (4) they have negative perceptions of themselves. Based on these findings, it was concluded that a woman's decision-making process varies with her perceived level of rewards and costs.
Group Treatment for Sexually Abused Girls: Evaluating Outcome
Authors: Hiebert-Murphy Diane , De Luca Rayleen V. , Runtz Marsha
Published: July 2018

Although many articles advocate treatment for child victims of sexual abuse, few studies have examined the effects of such treatment. The authors evaluated the effectiveness of group treatment for seven- to nine-year-old girls who had been sexually abused. The usefulness of parent-report and self-report measures in assessing therapeutic change was also examined. Findings support the hypothesis that group treatment decreases problem behaviors as reported by parents. The findings of the self-report data, however, were inconsistent. Implications for the measurement of therapeutic change in young sexually abused children are discussed.
Intergenerational Relationships across Cultures
Authors: Hines Paulette Moore , Garcia-Preto Nydia , McGoldrick Monica , Almeida Rhea , Weltman Susan
Published: July 2018

Ethnic background and cultural roots affect how individuals think, feel, and behave. These factors have only recently begun to be considered in family therapy training and practice. Differences among groups need to be valued and integrated into family therapy practice. The authors provide an overview of ethnic and cultural issues in clinical work with African American, Hispanic, Irish, Asian Indian, and Jewish clients.
The Cultural Story in Multicultural Family Therapy
Authors: McGill David W.
Published: July 2018

Cultural story assumes that a family brings to therapy not only a story of their idiosyncratic family problems, but that this story has been developed within the context of society's stories about gender, life cycle, ethnicity, class, and race. To utilize cultural story in therapy, therapists need to know something about various cultures. This approach allows the therapist to hold more than two “stories” at a time and thereby gain multiple perspectives on the family's concerns. The use of the genogram to develop the family's cultural story in therapy is discussed. Three case studies illustrate how the concept is applied to resolve presenting problems of families.
Working with Asian American Clients: One Person at a Time
Authors: Berg Insoo Kim , Miller Scott D.
Published: July 2018

The authors contend that not all clients from the same ethnic group experience life in similar ways. A treatment model is presented that incorporates both macro and micro views of ethnic differences and similarities. Therapists need to maintain both an ecosystemic view of how the ethnic and cultural experiences of the client affect treatment while not losing sight of the micro view of how these cultural traits are experienced at the individual level. Based on a solution-focused treatment model, the authors present an approach to working with clients from different ethnic or cultural groups. Case vignettes are used throughout to illustrate helpful techniques in working with Asian American clients.
Bulimia: A Systemic Family History Perspective
Authors: Kuntz Becky , Groze Victor , Yates William R.
Published: July 2018

Explanations of the origin of eating disorders range from biological theory, which studies metabolic, hormonal, and genetic influences, to cognitive theory, which emphasizes illogical thought processes. Although these theories have components that help explain the etiology of eating disorders, systems theory takes into consideration the significance of family in the development of eating disorders. The authors propose that systems theory coupled with family therapy can be successful in the treatment of bulimia.
The Father–Son Project
Authors: Bowman Ted
Published: July 2018

Family-centered therapeutic and educational approaches generally include men. However, fewer men than women utilize the services of most family agencies. The author describes a three-generational men's retreat for grandfathers, fathers, and sons. The program allowed participants to observe the affirmative and painful interactions of other participants as well as provide valuable contributions of their own.
Adult Family Life of Men who Fathered as Adolescents
Authors: Heath D. Terri , McKenry Patrick C.
Published: July 2018

Using data from a national survey, the authors investigated the family life of men who fathered their first child during adolescence (N = 227) from a quality-of-life perspective. Findings suggest that men who first fathered during their adolescent years experience levels of marital satisfaction and instability in intimate relationships similar to those of men who first fathered during their twenties. However, men who were fathers as adolescents actually reported greater parental satisfaction than did men who first fathered during their twenties. Implications for policy and practice are discussed.
School-to-Home Transfer of Conflict Management Skills among School-Age Children
Authors: Gentry Deborah B. , Benenson Wayne A.
Published: July 2018

This study determined the degree to and manner in which elementary students in a school-based peer-mediation program transferred conflict-management information and skills learned and practiced at school to the home setting for use in resolving sibling conflicts. Twenty-seven student “conflict managers” from grades four to six and at least one of their parents were interviewed before and after intervention. Data were collected on (1) demographic information; (2) perceptions of the frequency, intensity, and duration of sibling conflicts; (3) the necessity and kind of parent intervention; and (4) the level of positive conflict-management skills demonstrated by the children. Findings indicated that children perceived a significant decline in the frequency and intensity of conflicts with siblings. Parents perceived a similar decline in the frequency of such conflicts and in their need to intervene. Parents additionally perceived a significant improvement in their child's use of productive talk during conflicts.
The Role of Social Workers' Religious Beliefs in Helping Family Members Forgive
Authors: DiBlasio Frederick A.
Published: July 2018

Practice experience suggests that forgiveness can strengthen family relationships and bring about social, psychological, and, for some, spiritual healing. This article presents a study from the first known quantitative investigation of social workers' attitude toward, theory of, and use of forgiveness in the clinical setting. Data were gathered from a sample of social workers, primarily testing the differences between a group of strongly religious practitioners and those with less religious conviction on five theoretical constructs: forgiveness attitude, forgiveness techniques, forgiveness and depression, forgiveness and anger, and religious openness. Although it was hypothesized that religious social workers would show favorable differences on all theoretical variables tested, they differed from less religious social workers only on attitude toward forgiveness. Several possible explanations for the findings are offered.
Abortion and Pregnant Adolescents
Authors: Trad Paul V.
Published: July 2018

Statistics indicate that the incidence of pregnancy termination through abortion is on the rise among adolescents. This trend is particularly disturbing because many teenagers opting for an abortion disclose that they engaged in unprotected sexual activities. Despite the ostensible willingness of teenagers to rely upon abortion as a method of birth control, evidence suggests that the procedure may have enduring negative repercussions. Previewing, which focuses the adolescent on predicting the likely consequences of her behavior, may be a beneficial therapeutic intervention in these cases. During short-term psychotherapy, previewing may help teenagers anticipate the likely outcome of abortion and thus modify behavior patterns so that pregnancy and abortion may be avoided.
Making Videotapes of HIV-infected Women for Their Children
Authors: Taylor-Brown Susan , Wiener Lori
Published: July 2018

In the United States, the majority of HIV-infected women are of childbearing age and have dependent childen. Seropositivity for HIV threatens a woman's ability to care for her children into adulthood. In on effort to address the pain these women feel regarding their parental role, the authors helped HIV-infected women develop videotapes for their children. This article describes the therapeutic application of videotapes for HIV-infected women with dependent children. Case studies illustrate how women are prepared to make a tape for their children and the (aping process as well as examine issues practitioners confront before, during, and after the taping session.
Rural Mental Health Practice: Voices from the Field
Authors: Sullivan William Patrick , Hosier M. Diane , Otis Alisha G.
Published: July 2018

A commonly reported feature of rural mental health services is the ongoing difficulty agencies experience in the recruitment and retention of professional staff. The problem is compounded by negative portrayals of rural service by practitioners gleaned from the literature. The authors describe an exploratory study of the perceptions of 84 rural mental health professionals about their jobs. The professionals surveyed reported generally high levels of satisfaction with their jobs and rural life. Implications for rural mental health administrators and professional educators are offered.
Always Running: Candidate Emergence among Women of Color over Time
Authors: Silva Andrea , Skulley Carrie
Published: July 2018

The number of women seeking congressional office in the United States has dramatically increased since 1980. Previous research on women candidates explores why women run, but new research on candidate emergence shows that women face different challenges and advantages based on their race and ethnicity. We investigate these differences by disaggregating data on women’s candidate emergence by race and ethnicity to examine how these theories work when explicitly considering race and ethnicity. We focus our examination on women running in House primaries between 1980 and 2012. We argue that theories of candidate emergence are conditional to the racial and/or ethnic identification of the candidate. We employ a cross-sectional time series analysis with the intuition that examining congressional elections over time will allow us to make general comments about the participation of women in congressional elections. We find that many of the conditions thought necessary for women’s emergence as candidates are contextual and temporally specific. Moreover, conditions that encourage women to run do not necessarily apply to women of color.
Losing in the Funhouse? Winning in the Playhouse?
Authors: Badley Graham Francis
Published: July 2018

This article, autoethnography, my story or, preferably, reflective essay, relies on two metaphors. The first focuses on the university as an academic funhouse, a place of dialogue and ideas, espousing freedoms to learn, play, read, research, speak, teach, and even to offend. However, the notion of an academic funhouse in age of managerialism and neoliberalism is now difficult to sustain. The second metaphor is that of a global playhouse where post-academics may continue to pursue old interests and develop new ones. However, as all performers and writers and others contributing to the work and pleasures of the playhouse are fully aware, an end-stage is inevitable.
Renga, Research, Reflexivity: Poetic Representation
Authors: Lahman Maria K. E. , Hancock Emilie , Alhudithi Ahlam , Kincaid Tyler , Lafferty Mel , Patchett Erin , Loften Larry , Couch Connie
Published: July 2018

In a graduate course dedicated to writing and representing qualitative research in varied ways members challenged themselves to create a renga, a Japanese form of cooperative linked poetry, around the topic of doctoral students’ graduate school experiences, employing imagery from natural elements. Along with creating a stanza of the poem each poet wrote a reflection as a way of engaging reflexively with the process. Areas of note included thinking in a new way, finding the way back to a way of thinking, the challenge in creating a poem, and power in the process and ensuing results.
Incidence and management of adverse events associated with panobinostat in the treatment of relapsed/refractory multiple myeloma
Authors: Moore Donald C , Arnall Justin R , Harvey R Donald
Published: July 2018

Multiple myeloma is a plasma cell neoplasm that has seen impressive improvements in outcomes in recent years with combination therapies, such as proteasome inhibitors and immunomodulatory drugs. Histone deacetylase inhibition is an additional unique mechanism of action with established biological relevance in multiple myeloma. Panobinostat is the first histone deacetylase inhibitor indicated for the treatment of relapsed/refractory multiple myeloma in patients who have received at least two prior regimens, including bortezomib and an immunomodulatory agent. While the addition of panobinostat to bortezomib and dexamethasone has demonstrated response and progression-free survival benefits, the incidence and severity of adverse events associated with it can create a challenge for clinicians and patients. Specifically, diarrhea, myelosuppression, an increased risk for infectious complications, cardiotoxicity, and nausea/vomiting may be seen with use. The frequency and grade of adverse event occurrence may differ between doses and schedule of panobinostat as well as with different companion therapies and routes. Herein we discuss the incidence, severity, and practical management of adverse events associated with panobinostat in the treatment of relapsed/refractory multiple myeloma.
The Implementation of Extended Examination Duration for Students With ADHD in Higher Education
Authors: Jansen Dorien , Petry Katja , Evans Steven W. , Noens Ilse , Baeyens Dieter
Published: July 2018

Objective:

Recently, research indicated that extended examination duration was perceived as effective by students with ADHD. However, the objective effectiveness of this accommodation has not been researched extensively. This study addresses this gap in literature.

Method:

A total of 30 students with ADHD and 30 matched typically developing controls (TDC) participated in a simulation of a real-life examination. They filled in three parallel versions of a paper-and-pencil test in three time conditions: 1 hr (+0%), 1 hr 20 min (+33%), and 1 hr 30 min (+50%).

Results:

When granted extended examination duration, students with ADHD and TDC use extra time but their performance does not increase. In addition, test-taking strategies were altered to a limited extent, and strategies that are perceived as effective (e.g., marking key words) were rarely used by the students.

Conclusion:

It is concluded that extended examination duration is not objectively effective in an experimental design. Limitations and guidelines for future research are formulated.
Sworn Volunteers in American Policing, 1999 to 2013
Authors: Malega Ron , Garner Joel H.
Published: July 2018

This study describes changes in the use of sworn volunteers among the nation’s local law enforcement agencies and identifies those state-level certification, community, and agency characteristics associated with agencies using such volunteers in 2013. Law Enforcement Management and Administrative Statistics data from 1999 through 2013 were analyzed to document trends in both the number of sworn volunteers and the prevalence of agencies using sworn volunteers. While there has been a modest decline in the use of sworn volunteers since 1999, in 2013, about 36% of all local law enforcement agencies used sworn volunteers; furthermore, these volunteers comprised 7% of all local sworn personnel having arrest authority nationwide in 2013. A survey of peace officer standards and training agencies found that approximately two thirds of states required state-level certification of sworn volunteers. Multivariate analyses of state-level certification standards, census data, and agency characteristics found that agencies were more likely to use sworn volunteers if they (a) are a sheriff's office, (b) serve jurisdictions with larger populations, (c) have greater levels of social disadvantage, (d) do not require recruits to have more than a high school education, or (e) are located within states offering graduated levels of sworn volunteer certifications. Agencies were less likely to use volunteer officers if they (a) hire part-time sworn officers, (b) have a greater entry-level salary, or (c) are accredited.
Intraocular lens implantation in children with unilateral congenital cataract in the first 4 years of life
Authors: Yangzes Sonam , Kaur Savleen , Gupta Parul Chawla , Sharma Manu , Jinagal Jitender , Singh Jaspreet , Ram Jagat
Published: July 2018

Purpose:

To describe the outcome of phacoaspiration with intraocular lens implantation in children with unilateral congenital cataract in the first 4 years of life.

Methods:

A retrospective chart review of children with visually significant unilateral congenital cataract presenting in the first 4 years of life was done. Children with a minimum postsurgical follow-up of 1 year were included. Outcome measures were mean spherical equivalent, visual axis clarity, visual acuity and complications till the last follow-up.

Results:

Ninety-three children met the inclusion criteria. The mean age of surgery was 13.23 ± 11.89 months and the mean follow-up period was 24.37 ± 17.35 months. Nearly 40% of children presented during their first year of life. No difference was noted between the subgroups in terms of age ( p = 0.310), sex ( p = 0.475) or laterality ( p = 0.349). Surgical membranectomy was performed in 22 eyes (23.6%) after an average period of 4.85 ± 2.58 months after surgery. One eye underwent piggy back intraocular lens and four eyes underwent intraocular lens exchange after a mean duration of 50 months (range 40–60 months). The mean visual acuity was 0.79 ± 0.11 (log MAR chart). A total of 60.7% of these children ( n = 31) achieved best corrected visual acuity or 20/80 or better.

Conclusion:

The results of our study suggest that primary intraocular lens implantation in children with unilateral congenital cataract gives good structural and functional results. Besides a meticulous surgery, visual outcome is affected by the time of presentation and postoperative compliance to amblyopia therapy.
Dark adaptation changes in highly myopic patients
Authors: Messerlin Arnaud , Greth Mathieu , Bourcier Tristan , Sauer Arnaud , Speeg-Schatz Claude , Gaucher David
Published: July 2018

Purpose:

The objective of this study was to determine whether the dark adaptation time was longer in highly myopic patients than in emmetropic patients and whether there was a correlation between dark adaptation results and axial length.

Patients and methods:

We conducted a retrospective study that included highly myopic patients with −6.00 dioptres or more, matched to emmetropic control patients of the same age. All patients underwent an automated adaptometry protocol that calculates the rod intercept that reflects rod-mediated dark adaptation. Axial length was measured. Colour photographs were taken to look for retinal atrophic lesions.

Results:

A total of 25 highly myopic patients and 25 control patients were included. The mean rod intercept was 4.38 (±1.60) min in the myopic patients and 4.27 (±1.41) min in the control patients. This difference was not statistically significant ( p = 0.79). However, in myopic patients, the longer the axial length was, the longer the dark adaptation time was ( p = 0.0003). In addition, dark adaptation was significantly longer in myopic patients with retinal pigment epithelium atrophy than in patients without lesions ( p = 0.0398).

Conclusion:

In this study, dark adaptation time did not significantly differ between myopic patients and controls but was correlated with axial length in patients with severe myopia and was significantly longer in the presence of retinal pigment epithelium atrophic lesions.
Impingement of a propeller-slipstream on a leading edge with a flow-permeable insert: A computational aeroacoustic study
Authors: Avallone Francesco , Casalino Damiano , Ragni Daniele
Published: July 2018

This manuscript describes an aeroacoustic computational study on the impingement of a tractor-propeller slipstream on the leading edge of a pylon. Both the flow and acoustic fields are studied for two pylon leading edges: a solid and a flow-permeable one. The computational set-up replicates experiments performed at Delft University of Technology. Computational results are validated against measurements. It is found that the installation of the flow-permeable leading-edge insert generates a thicker boundary layer on the retreating blade side of the pylon. This is caused by an aerodynamic asymmetry induced by the helicoidal motion of the propeller wake, which promotes a flow motion through the cavity from the advancing to the retreating blade side of the pylon. The flow-permeable leading-edge insert mitigates the amplitude of the surface pressure fluctuations only on the pylon-retreating blade side towards the trailing edge, thus reducing structure-borne noise. Furthermore, it causes a reduction of the near-field noise only for receiver angles oriented in the upstream direction at the pylon-retreating blade side. In this range of receiver angles, it is found that the flow-permeable leading-edge insert reduces the amplitude of the tonal peaks for the third and fourth blade passage frequency, but strongly increases the broadband noise for frequencies higher that the seventh blade passage frequency.
Multi-disciplinary optimization of a contra-rotating fan
Authors: Grasso Gabriele , Moreau Stéphane , Christophe Julien , Schram Christophe
Published: July 2018

This paper presents the shape optimization of the blades of a contra-rotating fan according to aerodynamic, structural and aeroacoustic criteria. The prediction of wake-interaction and trailing-edge noise emission is integrated into the optimization process by means of RANS-based hybrid methods. These methods split the description of the flow field, which is made by computational fluid dynamics, from the quantification of the source of noise and of its propagation, obtained using analytic formulations. The optimization is performed by an evolutionary algorithm assisted by an artificial neural network. The sensitivity analysis of the design parameters and of the constraints used in the optimization process provides a new perspective on the multi-objective efficiency-noise optimization approach, which will be increasingly used in turbomachinery design in the future.
A parametric study of airframe effects on the noise emission from installed contra-rotating open rotors
Authors: Kennedy J , Eret P , Bennett GJ
Published: July 2018

This work reports on the results of the Clean Sky WENEMOR project which has conducted an extensive experimental investigation of installed contra-rotating open rotors on a scale model of an advanced regional aircraft configuration. The tests were conducted in the Pininfarina Wind Tunnel, Italy and the data used for this analysis were taken from a linear far-field array of microphones. The contra-rotating open rotors were operated in pusher and tractor modes with approach and takeoff settings for revolutions per minute and thrust. Realistic modern blade profiles were supplied and utilized through the Clean Sky Green Regional Aircraft program. A range of airframe geometries was tested which included interchangeable tails, engine pylon elongation, engine pylon rotation, and variable wing to engine distance. Changes in the contra-rotating open rotor noise emission to the far field as a function of flow speed, angle of attack, and airframe geometry were clearly identified. The influence of airframe geometry on contra-rotating open rotor tonal content, directivity, and broadband levels is reported for emission angles from [Formula: see text] to [Formula: see text]. Both significant noise increases and decreases with respect to the baseline airframe configurations were detected in both the tonal and broadband levels as a function of emission angle (ranging from 10 to 25 dB at the blade passing frequency tones). While the changes to the tonal level were generally greater than those of the broadband level, the broadband levels are shown to be significant when considering the influence of airframe geometries on contra-rotating open rotor noise emission.
Open Reduction Internal Fixation With Transverse Volar Plating for Unstable Proximal Interphalangeal Fracture-Dislocation: The Seatbelt Procedure
Authors: Federer Andrew E. , Guerrero Evan M. , Dekker Travis J. , Mithani Suhail K. , Aldridge J. Mack , Ruch David S. , Richard Marc J.
Published: July 2018

Background: Unstable intra-articular proximal interphalangeal (PIP) joint fracture-dislocations present a difficult problem that requires congruous joint reduction and stable internal fixation or distraction. Though fractures with limited articular involvement may be treated successfully with less invasive procedures, fracture-dislocations with a volar shear component may benefit from joint reduction with subchondral support for maintenance of stability. The purpose of this article is to describe a volar transverse plate and screw technique and report the short-term postoperative results. Methods: Seventeen patients with volar shear PIP dorsal fracture-dislocations were treated with transverse plate and screw constructs at an average of 21 days (range, 2-52) after injury. Information on postoperative stability, range of motion at PIP and distal interphalangeal (DIP) joints, and radiographic outcomes and complications were retrospectively collected. Results: At a mean of 7.3 months post-operation (range, 1.5-24), there were no recurrent dislocations and an average PIP arc of 77.4° and DIP arc of 61.5°. Sixteen of 17 patients had radiographically concentric joints, with 1 patient showing slight radiographic dorsal subluxation not apparent clinically. Two of 17 patients (11.8%) had revision surgery for tenolysis and removal of hardware to improve range of motion at 4 and 9 months post-operation. Conclusions: In the setting of PIP dorsal fracture-dislocations with volar shear component >40% of the articular surface, the Seatbelt procedure allows for concentric joint and articular surface reduction with subchondral support for maintenance of stability. This volar transverse plating technique allows for highly functional range of motion without PIP dorsal subluxation clinically in the setting of comminution and delayed presentation.
Factors that affect scrub practitioner non-technical skills: a qualitative analysis
Authors: McClelland Guy
Published: July 2018

Context

Non-technical skills are the cognitive and affective behaviours that underpin clinical practice in surgery. The purpose of this study was to explore the factors that affect how scrub practitioners use non-technical skills during surgery and their behavioural responses to those factors.

Methods

Eight scrub practitioners participated in a qualitative semi-structured interview study.

Results

Five major categories were found to affect scrub practitioner non-technical skills. These categories were democratises surgery, learns from experiences, comprehends situations, comprehends behaviours and insidious threats.

Key findings and implications:

A scrub practitioner’s ability to use non-technical skills results from the interdependent relationship of intrinsic and extrinsic motivators that affect their own behaviours, and those of their colleagues, during surgery.
Assessing the perioperative communication needs of a patient with learning disabilities: An holistic case study approach
Authors: Wilkinson Sue
Published: July 2018

Patients should be at the heart of everything we do. The aim should always be to achieve healthcare outcomes by involving patients fully in their own care, with decisions made in partnership with clinicians, rather than by clinicians alone: ‘no decision about me, without me’ (DH 2012). This article details a plan of care for an 18 year old male patient with a moderate level of learning disability who was scheduled for a tonsillectomy at a local NHS trust hospital. It focuses on the management of the patient’s anxiety, nausea and pain. In accordance with the Health and Care Professions Council’s code of confidentiality (HCPC 2014) the location and individual names of places and people concerned will not be disclosed. The patient presented at the pre-assessment appointment as having a learning disability consistent with a diagnosis of being on the autistic spectrum. More specifically, he had cognitive impairment which affected his ability to understand complex information. This, combined with a reduced ability to cope independently, formed the rationale for the attendance of a carer throughout his perioperative journey. According to the National Autistic Society (NAS) there are approximately 700,000 people with autism spectrum disorder (ASD) in the UK ie more than 1 in 100. Autism is a part of daily life for 2.8 million people (NAS nd).
Outcomes of radialization for radial longitudinal deficiency: 20 limbs with minimum 5-year follow-up
Authors: Bhat Anil K. , Narayanakurup Jayakrishnan K. , Acharya Ashwath M. , Kumar Bhaskaranand
Published: July 2018

We report functional and cosmetic outcomes in 14 patients (six bilateral and eight unilateral) with type IV radial longitudinal deficiency who underwent radialization. Follow-up ranged from 5 to 19 years. Outcome measures were grip and pinch strengths, Percival and Sykes score, Vilkki score, Cattaneo grading, and a questionnaire to patients. Radiological assessment included the hand-forearm angle, the hand-forearm position, and ulna length and width. At final follow-up, the length of the affected ulna was 56% of the length of the normal ulna. The distal ulna hypertrophied to 97% of the opposite distal radius and a median loss of correction of hand-forearm angle was 9°. All hands improved on Vilkki severity grade and on the Cattaneo functional and aesthetic grading. We conclude that radialization is an effective procedure in these cases, but secondary procedures may be required for the long-term maintenance of wrist alignment and hand function.

Level of evidence: IV
Incorporating Unannounced Meals and Exercise in Adaptive Learning of Personalized Models for Multivariable Artificial Pancreas Systems
Authors: Hajizadeh Iman , Rashid Mudassir , Turksoy Kamuran , Samadi Sediqeh , Feng Jianyuan , Sevil Mert , Hobbs Nicole , Lazaro Caterina , Maloney Zacharie , Littlejohn Elizabeth , Cinar Ali
Published: July 2018

Background:

Despite the recent advancements in the modeling of glycemic dynamics for type 1 diabetes mellitus, automatically considering unannounced meals and exercise without manual user inputs remains challenging.

Method:

An adaptive model identification technique that incorporates exercise information and estimates of the effects of unannounced meals obtained automatically without user input is proposed in this work. The effects of the unknown consumed carbohydrates are estimated using an individualized unscented Kalman filtering algorithm employing an augmented glucose-insulin dynamic model, and exercise information is acquired from noninvasive physiological measurements. The additional information on meals and exercise is incorporated with personalized estimates of plasma insulin concentration and glucose measurement data in an adaptive model identification algorithm.

Results:

The efficacy of the proposed personalized and adaptive modeling algorithm is demonstrated using clinical data involving closed-loop experiments of the artificial pancreas system, and the results demonstrate accurate glycemic modeling with the average root-mean-square error (mean absolute error) of 25.50 mg/dL (18.18 mg/dL) for six-step (30 minutes ahead) predictions.

Conclusions:

The approach presented is able to identify reliable time-varying individualized glucose-insulin models.
A Room of One’s Own: Need for Uniqueness Counters Online WoM
Authors: Chark Robin , Fong Lawrence Hoc Nang , Tang Candy Mei Fung
Published: July 2018

We examine how consumers’ desire to be different reduces their reliance on others’ suggestions and thus increases their tendency to diverge from the average opinion. While the extant literature focuses on the role of need for uniqueness in attitude formation and choice behavior, not much has been done to test the effect of uniqueness seeking on reactions to persuasive, word of mouth (WoM) messages. In four studies, we find converging evidence for a uniqueness effect. Specifically, the uniqueness motivation interacts with the valence of the average opinion such that when uniqueness motivation is low, consumers follow others’ advice and thus their attitudes depend primarily on the valence of the average opinion; meanwhile, the uniqueness seekers rely less on the valence and are more likely to form less favorable attitudes after reading positive reviews and to hold less unfavorable ones when the reviews are negative. These effects are found when trait need for uniqueness is measured as well as when situational need for uniqueness is manipulated. We further examine the process through which uniqueness motivation results in nonconformist attitudes. Uniqueness seekers perceive minority opinions as more diagnostic. Thus, these minority opinions are disproportionately represented in uniqueness seekers’ nonconformist views. These findings are important to the hospitality industry as consumers often rely on others’ experiences by reading online reviews to help make decisions concerning their own hospitality needs, which are highly experiential in nature.
Culture Conditions that Support Expansion and Chondrogenesis of Middle-Aged Rat Mesenchymal Stem Cells
Authors: Kisiday John D. , Schwartz John A. , Tangtrongsup Suwimol , Goodrich Laurie R. , Grande Daniel A.
Published: July 2018

Objective

Rats are an early preclinical model for cartilage tissue engineering, and a practical species for investigating the effects of aging. However, rats may be a poor aging model for mesenchymal stem cells (MSCs) based on laboratory reports of a severe decline in chondrogenesis beyond young adulthood. Such testing has not been conducted with MSCs seeded in a scaffold, which can improve the propensity of MSCs to undergo chondrogenesis. Therefore, the objective of this study was to evaluate chondrogenesis of middle-aged rat MSCs encapsulated in agarose.

Design

MSCs from 14- to 15-month-old rats were expanded, seeded into agarose, and cultured in chondrogenic medium with or without 5% serum for 15 days. Samples were evaluated for cell viability and cartilaginous extracellular matrix (ECM) accumulation. Experiments were repeated using MSCs from 6-week-old rats.

Results

During expansion, middle-aged rat MSCs demonstrated a diminishing proliferation rate that was improved ~2-fold in part by transient exposure to chondrogenic medium. In agarose culture in defined medium, middle-aged rat MSCs accumulated ECM to a much greater extent than negative controls. Serum supplementation improved cell survival ~2-fold, and increased ECM accumulation ~3-fold. Histological analysis indicated that defined medium supported chondrogenesis in a subset of cells, while serum-supplementation increased the frequency of chondrogenic cells. In contrast, young rat MSCs experienced robust chondrogenesis in defined medium that was not improved with serum-supplementation.

Conclusions

These data demonstrate a previously-unreported propensity of middle-aged rat MSCs to undergo chondrogenesis, and the potential of serum to enhance chondrogenesis of aging MSCs.
The Importance of Amodal Completion in Everyday Perception
Authors: Nanay Bence
Published: July 2018

Amodal completion is the representation of those parts of the perceived object that we get no sensory stimulation from. In the case of vision, it is the representation of occluded parts of objects we see: When we see a cat behind a picket fence, our perceptual system represents those parts of the cat that are occluded by the picket fence. The aim of this piece is to argue that amodal completion plays a constitutive role in our everyday perception and trace the theoretical consequences of this claim.
Long-Term Training-Induced Gains of an Auditory Skill in School-Age Children As Compared With Adults
Authors: Zaltz Y. , Ari-Even Roth D. , Karni A. , Kishon-Rabin L.
Published: July 2018

The few studies that compared auditory skill learning between children and adults found variable results, with only some children reaching adult-like thresholds following training. The present study aimed to assess auditory skill learning in children as compared with adults during single- and multisession training. It was of interest to ascertain whether children who do not reach adult-like performance following a single training session simply require additional training, or whether different mechanisms underlying skill learning need to reach maturity in order to become adult-like performers. Forty children (7–9 years) and 45 young adults (18–35 years) trained in a single session. Of them, 20 children and 24 adults continued training for eight additional sessions. Each session included six frequency discrimination thresholds at 1000 Hz using adaptive forced-choice procedure. Retention of the learning-gains was tested 6 to 8 months posttraining. Results showed that (a) over half of the children presented similar performance and time course of learning as the adults. These children had better nonverbal reasoning and working memory abilities than their non-adult-like peers. (b) The best predicting factor for the outcomes of multisession training was a child’s performance following one training session. (c) Performance gains were retained for all children with the non-adult-like children further improving, 6 to 8 months posttraining. Results suggest that mature auditory skill learning can emerge before puberty, provided that task-related cognitive mechanisms and task-specific sensory processing are already mature. Short-term training is sufficient, however, to reflect the maturity of these mechanisms, allowing the prediction of the efficiency of a prolonged training for a given child.
Crbn
I391V is sufficient to confer in vivo sensitivity to thalidomide and its derivatives in mice
Authors: Fink Emma C. , McConkey Marie , Adams Dylan N. , Haldar Saurav D. , Kennedy James A. , Guirguis Andrew A. , Udeshi Namrata D. , Mani D. R. , Chen Michelle , Liddicoat Brian , Svinkina Tanya , Nguyen Andrew T. , Carr Steven A. , Ebert Benjamin L.
Published: July 2018

Key Points

Crbn I391V mice degrade known thalidomide derivative targets and recapitulate thalidomide-induced cytopenias and teratogenicity. Degradation of Ck1α is sufficient to explain the in vivo therapeutic window of lenalidomide in del(5q) myelodysplastic syndrome.
Regulation of the adaptation to ER stress by KLF4 facilitates melanoma cell metastasis via upregulating NUCB2 expression
Authors: Zhang Dongmei , Lin Jingrong , Chao Yulin , Zhang Lu , Jin Lei , Li Na , He Ruiping , Ma Binbin , Zhao Wenzhi , Han Chuanchun
Published: July 2018

Background

Adaptation to ER stress has been indicated to play an important role in resistance to therapy in human melanoma. However, the relationship between adaptation to ER stress and cell metastasis in human melanoma remains unclear.

Methods

The relationship of adaptation to ER stress and cell metastasis was investigated using transwell and mouse metastasis assays. The potential molecular mechanism of KLF4 in regulating the adaptation to ER stress and cell metastasis was investigated using RNA sequencing analysis, q-RT-PCR and western blot assays. The transcriptional regulation of nucleobindin 2 (NUCB2) by KLF4 was identified using bioinformatic analysis, luciferase assay, and chromatin immunoprecipitation (ChIP). The clinical significance of KLF4 and NUCB2 was based on human tissue microarray (TMA) analysis.

Results

Here, we demonstrated that KLF4 was induced by ER stress in melanoma cells, and increased KLF4 inhibited cell apoptosis and promoted cell metastasis. Further mechanistic studies revealed that KLF4 directly bound to the promoter of NUCB2, facilitating its transcription. Additionally, an increase in KLF4 promoted melanoma ER stress resistance, tumour growth and cell metastasis by regulating NCUB2 expression in vitro and in vivo. Elevated KLF4 was found in human melanoma tissues, which was associated with NUCB2 expression.

Conclusion

Our data revealed that the promotion of ER stress resistance via the KLF4-NUCB2 axis is essential for melanoma cell metastasis, and KLF4 may be a promising specific target for melanoma therapy.