bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Evaluation of a Physician-Targeted Video to Promote HIV Screening
Authors: Arya Monisha , Marek Haley G. , Marren Rachel E. , Hemmige Vagish , Street Richard L. , Giordano Thomas P.
Published: June 2018

Introduction. Despite national recommendations, routine opt-out HIV testing has not been widely adopted by physicians. Guided by previous research on physician barriers to HIV testing, we developed a physician-targeted video to promote routine opt-out HIV screening. The objective of this study was to evaluate this video intervention. Methods. From June to July 2016, physicians in two primary care clinics completed an online survey prior to and after watching the video. Survey items assessed acceptability of the video and HIV testing knowledge, attitudes, and intention to screen. Descriptive statistics were generated to analyze data. Results. Of the 53 participants, 90% liked or strongly liked the video. Pre- to postvideo, significant improvements were seen in the knowledge of national HIV screening recommendations (45.3% to 67.9%; p = .010) and of the proportion of unaware Houstonians living with HIV (22.6% to 75.5%; p < .001). Participant beliefs about the likelihood of patients accepting HIV testing increased from 47.2% to 84.9% pre- to postvideo ( p < .001). Intention to screen did not change; participants had high intentions pre- and postvideo. Conclusions. Our study found that a video is an acceptable HIV testing promotion medium for physicians. Our video improved physician HIV testing knowledge and attitudes, overcoming key barriers to HIV testing.
A Multifaceted Approach to Public Health Career and Professional Development Training
Authors: Sherrer Kristy J. , Prelip Michael L.
Published: June 2018

The purpose of this article is to describe how a multifaceted approach to career and professional development training, focused on core competencies, student-driven programming, inter and multidisciplinary collaboration, and cultivating a community of insight and support, is being implemented by a university Public Health Career Services office with limited staff and resources and to share these practices for other public health programs to scale this approach to their own students’ needs. The design of the career and professional development training program comprised five main approaches: (1) one-on-one career counseling, (2) peer-to-peer learning workshops, (3) community partnerships and experiential opportunities, (4) student-driven programming, and (5) accessible training and digital resources. All programs were tracked to gauge participation and to assess effectiveness. Noteworthy findings from program evaluations include (1) a large increase in student confidence levels in professionalism topics, from all of the school’s departments; (2) benefits of student-driven programming and peer-to-peer learning, and (3) importance of employer and alumni engagement. Rather than use an optional participation model, it is recommended that a cohort model or mandatory participation be implemented as the opportunity to build on curriculum is vital.
Diagnosing Pseudoaneurysm of the Extracranial Carotid Arteries Using Doppler Ultrasonography: A Case Report
Authors: Evans Katie , Birk Gurpreet K. , Antoniou George A.
Published: June 2018

Carotid artery pseudoaneurysms are a rare complication of carotid endarterectomy, with few recorded in the literature. We describe a case of a 56-year-old man who presented with symptoms of left hemispheric transient ischemic attack and subsequently underwent a carotid endarterectomy. The patient returned to Accident and Emergency department with an ipsilateral neck swelling found to be an extracranial pseudoaneurysm. Doppler ultrasound imaging was used throughout the management of this patient from preendarterectomy to postpseudoaneurysm bypass. This report discusses the importance of ultrasonography in the diagnosis and follow-up of carotid pseudoaneurysms.
Personal and Situational Antecedents of Workers’ Implicit Leadership Theories: A Within-Person, Between-Jobs Design
Authors: Shen Winny
Published: June 2018

Despite a flourishing literature demonstrating the consequences of implicit leadership theories (ILTs) for workplace phenomena, relatively little is known about the antecedents of ILTs, particularly those that are malleable or can be changed to shape ILTs. In two studies of dual-job holders, which allows for the modeling of between- and within-person predictors, I examined the extent to which workers’ ILTs were stable versus dynamic across work contexts. In line with connectionist perspectives, trait identities, a personal factor, promoted stability in ILTs across situations in both studies, whereas there was some limited evidence that organizational culture, a situational factor, only predicted ILTs within a given job context. Furthermore, the relationship between independent identity and ILTs differed when examining workers’ typical versus ideal leadership conceptualizations. Implications for future research on ILTs are also discussed.
Robotic Camera Assistance: The Future of Laparoscopic and Thoracoscopic Surgery?
Authors: Ali Jason M. , Lam Kyle , Coonar Aman S.
Published: June 2018

Introduction. Minimally invasive techniques have become the standard for a variety of procedures across all surgical specialties. There has been a recent move to integrate robotic technology into standard laparoscopic and thoracoscopic surgery with the aim of improving stability of the visual field with the use of robotic camera assistance. The aim of this study was to report on and examine the use of a headset-controlled robotic camera holder, FreeHand. Methods. Between May 2013 and Dec 2016, 105 procedures were observed where the FreeHand robotic camera assistant was used. Observations were made of 43 consultant surgeons in 30 hospitals performing 21 different surgical procedures. During the surgery, the number of scope cleans and collisions were quantified, and surgeons were asked to score from 0 to 5 the setup, ergonomics, usability, and overall experience in a questionnaire. Results. Overall surgeon satisfaction was rated as “good” for setup (4.29), ergonomics of the system (4.12), usability (4.39), and overall experience of the system (4.34). In 8 operations (7.6%), there was a conversion from robotic camera assistant to manual assistant. There were no reported adverse events attributable to the use of the system. Conclusion. This study demonstrates the breadth of surgical procedures that can be performed with a robotic camera assistant. The robotic camera assistant was found to be safe and simple to use and was positively perceived on assessment in multiple procedures spanning several surgical specialties. This work suggests that robotic camera assistants may offer significant benefits to laparoscopic and thoracoscopic surgeons.
An Urgent Need to Incorporate Evidence-Based Nutrition and Lifestyle Medicine Into Medical Training
Authors: Reddy Koushik R. , Freeman Andrew M. , Esselstyn Caldwell B.
Published: June 2018

It is well established that evidence based clinical nutrition and lifestyle practices play a pivotal role in the prevention, treatment and potential reversal of various common chronic diseases. However, this area of science is under appreciated at all levels of medical education and training. Most medical schools and residency programs do not offer any organized training in nutrition and lifestyle medicine. Given recent data on the rising cost and loss of quality of life secondary to preventable causes, there is an absolute need for a drastic reform of the US medical education system.
An improved cyber-physical systems architecture for Industry 4.0 smart factories
Authors: Jiang Jehn-Ruey
Published: June 2018

The cyber-physical system is the core concept of Industry 4.0 for building smart factories. We can rely on the ISA-95 architecture or the 5C architecture to build the cyber-physical system for smart factories. However, both architectures emphasize more on vertical integration and less on horizontal integration. This article proposes the 8C architecture by adding 3C facets into the 5C architecture. The 3C facets are coalition, customer, and content. The proposed 8C architecture is a helpful guideline to build the cyber-physical system for smart factories. We show an example of designing and developing, on the basis of the proposed 8C architecture, a smart factory cyber-physical system, including an Industrial Internet of Things gateway and a smart factory data center running in the cloud environment.
Grouping-based adaptive spatial formation of swarm robots in a dynamic environment
Authors: Wang Qiuzhen , Mao Xinjun , Yang Shuo , Chen Yin , Liu Xinwang
Published: June 2018

Spatial formations of swarm robots are increasingly applied in many domains in which the environments are dynamic and unpredictable. The autonomy of the individual robots and decentralization of the entire system increase the complexity of the response to environmental changes, which could prolong the formation convergence and significantly increase the communication cost. To address these issues, we propose an adaptive mechanism with three basic behaviours for each individual robot and design a grouping-based spatial formation algorithm for swarm robots to respond to changes and accomplish shape formation. Specifically, the robots are automatically partitioned into several groups based on their spatial neighbours. In this manner, the interactions and self-organization of robots are primarily performed at the intra-group rather than inter-group level, leading to decreased communication costs. Furthermore, this grouping mechanism naturally supports parallel formation and therefore improves the convergence speed. Our simulation and experimental results demonstrate that the proposed method significantly improves the convergence speed and decreases the communication cost, thus validating the effectiveness of the proposed adaptive mechanism.
Path planning for mobile robot based on modified rapidly exploring random tree method and neural network
Authors: Zhang Pengchao , Xiong Chao , Li Wenke , Du Xiaoxiong , Zhao Chuan
Published: June 2018

In the course of the task, the mobile robot should find the shortest and most smooth obstacle-free path to move from the current point to the target point efficiently, which is namely the path planning problem of the mobile robot. After analyzing a large number of planning algorithms, it is found that the combination of traditional planning algorithm and heuristic programming algorithm based on artificial intelligence have outstanding performance. Considering that the basic rapidly exploring random tree algorithm is widely used for some of its advantages, meanwhile there are still defects such as poor real-time performance and rough planned path. So, in order to overcome these shortcomings, this article proposes target bias search strategy and a new metric function taking both distance and angle into account to improve the basic rapidly exploring random tree algorithm, and the neural network is used for curve post-processing to obtain a smooth path. Through simulating in complex environment and comparison with the basic rapidly exploring random tree algorithm, it shows good real-time performance and relatively shorter and smoother planned path, proving that the improved algorithm has good performance in handling path planning problem.
Anaemia and transfusion triggers in critically ill patients – What we have learnt thus far
Authors: Jandu Amritpal Singh , Vidgeon Steven , Ahmed Nadeem
Published: June 2018

Anaemia is a common finding in critically ill patients, the cause of which is multi-factorial including: sepsis, haemolysis (and disseminated intravascular coagulation), iatrogenic blood loss secondary to laboratory sampling, post-operative anaemia, bone marrow suppression/failure, decreased production of erythropoietin, anaemia secondary to drugs/toxins, overt or occult blood loss, functional iron deficiency, poor nutrition and haemodilution. Anaemia is associated with deleterious outcomes including increased risk of cardiac-related morbidity and mortality and decrease in oxygen-carrying capacity in the face of increased metabolic demands. There is a growing body of evidence, which demonstrates that packed red blood cell transfusions are associated with poorer outcomes. Clinicians therefore need to weigh the potential benefit of treating anaemia against the desire to avoid unnecessary transfusions. We explored current literature regarding transfusion triggers and morbidity and mortality associated with packed red blood cell transfusions transfusion, concentrating on studies that have been conducted in critical care patients. In addition, we reflected on trials which considered the viability of iron transfusion and erythropoietin in critically unwell patients.
Expanding the Use of Educational Data for Social Justice: Lessons From the Texas Cap on Special Education and Implications for Practitioner–Scholar Preparation
Authors: Knight David S. , DeMatthews David E.
Published: June 2018

Educational data offer a powerful tool for supporting equity. In this article, the authors call for a shift toward greater use of data in educator preparation programs. The authors motivate their proposal by highlighting findings from the Department of Education report released January 2018, which found that the Texas Education Agency systematically denied students special education services. The article outlines three basic metrics that stakeholders can use to identify potential noncompliance with the Individuals With Disabilities Education Act. The authors describe other ways data can be used to promote equity and close with recommendations for educator preparation policy and practice.
Effects of Controlling Abnormal Joint Movement on Expression of MMP13 and TIMP-1 in Osteoarthritis
Authors: Onitsuka Katsuya , Murata Kenji , Kokubun Takanori , Fujiwara Shuhei , Nakajima Aya , Morishita Yuri , Kanemura Naohiko
Published: June 2018

Objective

Abnormal joint movement is associated with osteoarthritis (OA). Previous studies using the controlling abnormal joint movement (CAJM) model of OA reported delayed cartilage degeneration; however, none of them focused on gait performance and the localization of matrix metalloproteinase 13 (MMP13) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in chondrocytes. Therefore, we aimed to investigate the effect of controlling abnormal joint movement on gait performance and the localization of MMP13 and TIMP-1, using kinematic and histological analyses.

Design

Rats were assigned to 2 groups: anterior cruciate ligament transection (ACL-T) group and CAJM group ( n = 5/group); contralateral hind limbs of ACL-T rats were designated as intact. After 1, 2, and 4 weeks, step length was analyzed, and after 2, 4, and 8 weeks, Safranin O-Fast Green staining and immunohistochemical staining for MMP13 and TIMP-1 were performed.

Results

Step length did not differ significantly between the groups. However, degeneration of articular cartilage was higher in the ACL-T group than in the intact group ( P < 0.05). There was no significant difference in the CAJM group at all time points. Immunohistochemical analysis of the MMP13/TIMP-1 relationship revealed a significant increase in the expression ratio of MMP13 after 4 weeks in the ACL-T group compared to the CAJM group ( P < 0.05).

Conclusions

Controlling abnormal joint movement may reduce mechanical stress owing to kinematic elements of small articulation including joint instability and delayed cartilage degeneration, despite the lack of kinematic change in step length.
Anti-Inflammatory Effect of Carprofen Is Enhanced by Avocado/Soybean Unsaponifiables, Glucosamine and Chondroitin Sulfate Combination in Chondrocyte Microcarrier Spinner Culture
Authors: Grzanna Mark W. , Secor Erica J. , Fortuno Lowella V. , Au Angela Y. , Frondoza Carmelita G.
Published: June 2018

Objective

Osteoarthritis is a painful, chronic joint disease affecting man and animals with no known curative therapies. Palliative nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used but they cause adverse side effects prompting the search for safer alternatives. To address this need, we evaluated the anti-inflammatory activity of avocado/soybean unsaponifiables (ASU), glucosamine (GLU), and chondroitin sulfate (CS) with or without the NSAID carprofen.

Design

Canine chondrocytes were propagated in microcarrier spinner culture and incubated with (1) control medium, (2) ASU (8.3 µg/mL) + GLU (11 µg/mL) + CS (20 µg/mL) combination for 24 hours; and/or carprofen (40 ng/mL). Cultures were next incubated with control medium alone or IL-1β (10 ng/mL) for another 24 hours. Production of PGE2, IL-6, IL-8, and MCP-1 (also known as CCL-2) were measured by ELISA.

Results

Chondrocytes proliferated in microcarrier spinner culture and produced type II collagen and aggrecan. Stimulation with IL-1β induced significant increases in PGE2, IL-6, IL-8, and MCP-1 production. The increases in production were suppressed by carprofen as well as [ASU+GLU+CS]. The combination of carprofen and [ASU+GLU+CS] reduced PGE2 production significantly more than either preparation alone. The inhibitory effect of carprofen on IL-6, IL-8, and MCP-1 production was significantly less than that of [ASU+GLU+CS], whereas the combination did not reduce the production of these molecules significantly more than [ASU+GLU+CS] alone.

Conclusions

The potentiating effect of [ASU+GLU+CS] on low-dose carprofen was identified in chondrocyte microcarrier spinner cultures. Our results suggest that the combination of low-dose NSAIDs like carprofen with [ASU+GLU+CS] could offer a safe, effective management for joint pain.
A case series of Kimura’s disease: a diagnostic challenge
Authors: Kumar Vivek , Mittal Navneet , Huang Yiwu , Balderracchi Jasminka , Zheng Huo Xiang , Li Zujin , Xu Yiqing
Published: June 2018

Kimura’s disease (KD) is a rare, benign disorder characterized by subcutaneous masses with regional lymph-node enlargement. It is considered to be due to chronic inflammation of unclear etiology. Most cases have been reported in young, 20–30-year-old men of Asian descent. The diagnosis of KD is based on pathological features and elevated immunoglobulin E levels. Characteristic pathological features include intact lymph-node architecture, florid germinal center hyperplasia, extensive eosinophilic infiltrates, and proliferation of postcapillary venules. However, these features can also be seen in Hodgkin’s disease or T-cell lymphoma, therefore, cases presenting as KD pose a diagnostic challenge. We report a case series of two cases with suspected KD at initial presentation, with one patient eventually diagnosed with Hodgkin’s disease after clinical progression. The first case was a 45-year-old Asian man who presented with bilateral thigh masses and significantly enlarged inguinal lymph nodes. The histopathology was characteristic and the patient had stable disease on treatment with cetirizine for 20 months. The second case was a 29-year-old African-American man who had progressive enlargement of the right neck lymph nodes extending into the mediastinum, with the original biopsy suggestive of KD. An initial search for Reed–Sternberg cells using immunohistochemical staining for CD15 and CD30 was negative. However, the patient developed neurological symptoms corresponding to tumor extension to the cervical and thoracic neural foramina. A repeat biopsy showed a lack of nodal structure and atypical large cells that were positive for CD30 staining. The patient was treated with chemotherapy with good response. We emphasize the importance of following the clinical course to render an accurate diagnosis. Both cases showed extensive eosinophilic infiltration and other KD-like pathological features. However, KD is rare; not missing a malignant diagnosis lies in high clinical suspicion and repeated exhaustive work up.
The importance of factorial design in tissue engineering and biomaterials science: Optimisation of cell seeding efficiency on dermal scaffolds as a case study
Authors: Levin Alexandra , Sharma Vaibhav , Hook Lilian , García-Gareta Elena
Published: June 2018

This article presents a case study to show the usefulness and importance of using factorial design in tissue engineering and biomaterials science. We used a full factorial experimental design (2 × 2 × 2 × 3) to solve a routine query in every biomaterial research project: the optimisation of cell seeding efficiency for pre-clinical in vitro cell studies, the importance of which is often overlooked. In addition, tissue-engineered scaffolds can be cellularised with relevant cell type(s) to form implantable tissue constructs, where the cell seeding method must be reliable and robust. Our results show the complex relationship between cells and scaffolds and suggest that the optimum seeding conditions for each material may be different due to different material properties, and therefore, should be investigated for individual scaffolds. Our factorial experimental design can be easily translated to other cell types and three-dimensional biomaterials, where multiple interacting variables can be thoroughly investigated for better understanding of cell–biomaterial interactions.
Sequential treatment with riociguat and balloon pulmonary angioplasty for patients with inoperable chronic thromboembolic pulmonary hypertension
Authors: Wiedenroth Christoph B. , Ghofrani H. Ardeschir , Adameit Miriam S.D. , Breithecker Andreas , Haas Moritz , Kriechbaum Steffen , Rieth Andreas , Hamm Christian W. , Mayer Eckhard , Guth Stefan , Liebetrau Christoph
Published: June 2018

Riociguat is the treatment of choice for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). We addressed here whether additional balloon pulmonary angioplasty (BPA) provides further benefits. A prospective series of 36 consecutive patients with inoperable CTEPH were treated with riociguat at least three months before BPA. All patients underwent diagnostic workup at baseline, before BPA treatments, and six months after final intervention. The main outcome measures were pulmonary hemodynamic parameters and World Health Organization (WHO) functional class (FC). Significant improvements in pulmonary hemodynamics and physical capacity were observed for riociguat treatment, and subsequent BPA interventions yielded further benefits. With targeted medication, WHO FC improved by at least one class in 13 (36.1%) patients (P = 0.01). Hemodynamic assessment showed significant improvements in mean pulmonary arterial pressure (mPAP) (49 ± 12 mmHg vs. 43 ± 12 mmHg; P = 0.003) and PVR (956 ± 501 dyn·s·cm–5 vs. 517 ± 279 dyn·s·cm–5; P = 0.0001). Treatment with a combination of targeted medication and BPA resulted in WHO FC improvement in 34 (94.4%) patients. Hemodynamic assessment showed significant improvement in mPAP (43 ± 12 mmHg vs. 34 ± 14 mmHg; P = 0.0001) and PVR (517 ± 279 dyn·s·cm–5 vs. 360 ± 175 dyn·s·cm–5; P = 0.0001). These findings provide, for the first time, support for the therapeutic strategy recommended by current guidelines.
Non‐invasive right ventricular load adaptability indices in patients with scleroderma‐associated pulmonary arterial hypertension
Authors: French Sarah , Amsallem Myriam , Ouazani Nadia , Li Shufeng , Kudelko Kristina , Zamanian Roham T. , Haddad Francois , Chung Lorinda
Published: June 2018

Scleroderma‐associated pulmonary arterial hypertension (SSc‐PAH) is associated with worse outcome than idiopathic pulmonary arterial hypertension (IPAH), potentially due to worse right ventricular adaptation to load as suggested by pressure–volume loop analysis. The value of non‐invasive load‐adaptability metrics has not been fully explored in SSc‐PAH. This study sought to assess whether patients with incident SSc‐PAH have worse echocardiographic load‐adaptability metrics than patients with IPAH. Twenty‐two patients with incident SSc‐PAH were matched 1:1 with IPAH based on pulmonary vascular resistance. Echocardiographic load‐adaptability indices were divided into: surrogates of ventriculo‐arterial coupling (e.g. right ventricular area change/end‐systolic area), indices reflecting the proportionality of load adaptation (e.g. tricuspid regurgitation velocity‐time integral normalized for average right ventricular radius), and simple ratios (e.g. tricuspid annular plane systolic excursion/right ventricular systolic pressure). The prognostic value of these indices for clinical worsening (i.e. death, transplant, or hospitalization for heart failure) at one year was explored. The two groups were comprised of patients of similar age, with similar cardiac index, pulmonary resistance, capacitance and NT‐proBNP levels (p > 0.10). There was no difference in baseline right ventricular dimension, function or load‐adaptability indices. At one year, eight (36.4%) SSc‐PAH patients had experienced clinical worsening (eight hospitalizations and two deaths) versus one hospitalization in the IPAH group. Load adaptation at one year in survivors was not worse in SSc‐PAH (p > 0.33). Patients with IPAH responded better to therapy than SSc‐PAH in terms of reduction of right ventricular areas at one year (p < 0.05). Right ventricular load‐adaptability echocardiographic indices do not appear to capture the increased risk of negative outcomes at one year associated with SSc‐PAH.
Physical activity modifies the risk of atrial fibrillation in obese individuals: The HUNT3 study
Authors: Garnvik Lars E , Malmo Vegard , Janszky Imre , Wisløff Ulrik , Loennechen Jan P , Nes Bjarne M
Published: June 2018

Background

Atrial fibrillation is the most common heart rhythm disorder, and high body mass index is a well-established risk factor for atrial fibrillation. The objective of this study was to examine the associations of physical activity and body mass index and risk of atrial fibrillation, and the modifying role of physical activity on the association between body mass index and atrial fibrillation.

Design

The design was a prospective cohort study.

Methods

This study followed 43,602 men and women from the HUNT3 study in 2006–2008 until first atrial fibrillation diagnosis or end of follow-up in 2015. Atrial fibrillation diagnoses were collected from hospital registers and validated by medical doctors. Cox proportional hazard regression analysis was performed to assess the association between physical activity, body mass index and atrial fibrillation.

Results

During a mean follow-up of 8.1 years (352,770 person-years), 1459 cases of atrial fibrillation were detected (4.1 events per 1000 person-years). Increasing levels of physical activity were associated with gradually lower risk of atrial fibrillation ( p trend 0.069). Overweight and obesity were associated with an 18% (hazard ratio 1.18, 95% confidence interval 1.03–1.35) and 59% (hazard ratio 1.59, 95% confidence interval 1.37–1.84) increased risk of atrial fibrillation, respectively. High levels of physical activity attenuated some of the higher atrial fibrillation risk in obese individuals (hazard ratio 1.53, 95% confidence interval 1.03–2.28 in active and 1.96, 95% confidence interval 1.44–2.67 in inactive) compared to normal weight active individuals.

Conclusion

Overweight and obesity were associated with increased risk of atrial fibrillation. Physical activity offsets some, but not all, atrial fibrillation risk associated with obesity.
Use of autologous bone grafting from the calcaneus and interconnected porous hydroxyapatite ceramic for bone transplantation in rheumatoid foot surgery
Authors: Hirao Makoto , Ebina Kosuke , Etani Yuki , Tsuboi Hideki , Noguchi Takaaki , Tsuji Shigeyoshi , Hashimoto Jun , Yoshikawa Hideki
Published: June 2018

Cancellous bone grafts from the calcaneus have been used for the foot and ankle as well as iliac bone graft; however, there is a sparse report for calcaneal bone transplantation in the field of rheumatoid foot surgery. In this study, safety and usefulness of calcaneal bone grafts, and combination with interconnected porous hydroxyapatite ceramic, was evaluated in rheumatoid arthritis foot surgeries. Of six rheumatoid arthritis cases, three (talo-navicular joint fusion) used a calcaneal bone graft alone, and the remaining three cases (subtalar joint and talo-navicular joint fusion) used a combination of calcaneal bone graft and interconnected porous hydroxyapatite ceramic augmented with dense calcium hydroxyapatite for subtalar bony defect (1.5–2.0 cm) after the correction. Pre- and postoperative Japanese Society for Surgery of the Foot rheumatoid arthritis foot ankle scale scores were obtained for the clinical assessment. As radiographic assessment, tibio-calcaneal angle, calcaneal pitch, talo-1st metatarsal angle, and pronated foot index were also evaluated. After starting weight-bearing or walking, there was no pain and skin trouble at the fusion and harvesting sites. All cases achieved bony fusion within 6–10 weeks. Japanese Society for Surgery of the Foot rheumatoid arthritis foot ankle score was improved in all six cases. Furthermore, tibio-calcaneal angle, talo-1st metatarsal angle, and pronated foot index were also improved at latest follow-up in all cases. In conclusion, autologous bone grafting from the calcaneus was safe and convenient even in rheumatoid foot surgeries. For larger bony defects (1.5–2.0 cm), combination use with interconnected porous hydroxyapatite ceramic augmented with dense calcium hydroxyapatite was also useful.
Batons and ballots: The effectiveness of state violence in fighting against Catalan separatism
Authors: Barceló Joan
Published: June 2018

What are the consequences of police brutality in fighting against the Catalan secessionist movement? While Spanish authorities resorted to violence with the hope that forceful action would deter further support for separatism, recent studies of repression argue that state violence tends to backfire. I test these two plausible arguments in the context of non-lethal police brutality to prevent an illegal self-determination referendum. For this, I combine data of the local distribution of police violence during the referendum and the official results of the subsequent regional elections. Because police forces were not deployed randomly, I employ a difference-in-differences estimation with matching to evaluate the electoral consequences of violence. The results show no clear evidence that police brutality affected support for separatism or electoral mobilization in the areas that it was deployed. The lack of a clear effect sets an agenda for future research in the investigation of the conditions under which state violence affects dissenting movements.
An Oasis of Literacy in a Desert of Poverty: A Case Study of a Rural School for the Underprivileged in Southern Punjab
Authors: Kazi Asma Shahid , Aziz Fakhra , Quraishi Uzma
Published: June 2018

This study is an attempt to investigate the impact of educational facilities of a school on various aspects of self-efficacy, confidence, and character building of the underprivileged people in Dera Jutta, a village in Southern Punjab. Trust for Rural Uplift and Community Education (TRUCE) was initiated in the year 2000, and under its auspices, Nafisa Mai School was started. To gain insight into the project, data were collected from students of Grade 10 and teachers of all classes with the help of semistructured interviews and in-depth probes. Detailed classroom observations were also conducted to gain insight into the facilities and methodology. Data were analyzed by coding them into themes. The results reveal a high level of student satisfaction related to the academic and cocurricular facilities and activities. Findings also show that although many students drop out after primary and middle school, 100% success rate is witnessed in terms of pass percentage at the matriculation level. The teachers’ interviews portray immense satisfaction and dedication in terms of job satisfaction and facilities. The greatest impact revealed both by students and teachers however was not just in terms of academic achievement but in various aspects of self-efficacy, confidence, and character building. The entire village and its adjoining areas have benefited from the school initiative, along with other community ventures of TRUCE in empowering the community.
Benign endometriosis masquerading as intra-abdominal malignancy: One of the most extreme cases reported and a review of the literature
Authors: Walker Philippa J , Johnson Neil P
Published: June 2018

Introduction:

To elicit key clinical lessons from an extreme case of endometriosis associated with massive ascites and a review of the literature.

Methods:

We report one of the most extreme cases of massive ascites caused by endometriosis. For literature review, MEDLINE via OVID (from 1946 to 2016) database was searched. As a result, all the publications based on the keywords relating to the review topic were acquired.

Case:

A 32-year-old nulliparous woman, with stage 4 endometriosis and primary infertility, presented with massive ascites, complex pelvic mass, pleural effusion, weight loss, anaemia and elevated CA-125 suggesting ovarian malignancy. Six litres of ascites was drained. After extensive investigations to exclude malignancy, endometriosis-related ascites was diagnosed. Red-cell transfusion, nasogastric-tube-feeding and gonadotrophin-releasing-hormone analogue were initiated and long-term follow-up is planned. Ablation of ovarian function either by surgical oophorectomy or ovarian irradiation appears to cure the condition without recurrence. Endocrine therapy, in the form of gonadotrophin-releasing-hormone analogue or progestins, is useful if surgery is undesirable, as most women with this condition are young and wish to preserve fertility. Endocrine therapy alone resolves the problem in the majority, but ascites reappears after stopping treatment.

Conclusion:

Endometriosis associated with massive ascites and pleural effusion is rare. There are less than 30 similar case reports in the literature. In women of reproductive age who present with clinical and imaging features to suggest ovarian malignancy, a diagnosis of endometriosis should be considered. Although permanent cure is by oophorectomy, endocrine therapy is useful if surgery is undesirable.
Tubular surgery with the assistance of endoscopic surgery via a paramedian or midline approach for lumbar spinal canal stenosis at the L4/5 level
Authors: Komatsu Jun , Muta Tomoya , Nagura Nana , Iwabuchi Masumi , Fukuda Hironari , Kaneko Kazuo , Shirado Osamu
Published: June 2018

Background:

Lumbar spinal canal stenosis surgery has recently improved with the use of minimally invasive techniques. Less invasive procedures have emerged, and microendoscopic decompression through smaller incisions is frequently performed. Tubular surgery with the assistance of endoscopic surgery procedures has led to particularly remarkable changes in surgery, with reduced tissue trauma and morbidity.

Purpose:

The purpose of this study was to compare the clinical outcomes of two different minimally invasive decompressive surgical techniques (microendoscopic bilateral decompression surgery using the unilateral approach [microendoscopic laminectomy (MEL)] and microendoscopy-assisted muscle-preserving interlaminar decompression (MILD; ME-MILD)) using spinal endoscopy for lumbar spinal canal stenosis measured using a visual analog scale (VAS), the Japanese Orthopedic Association (JOA) score, and the JOA Back Pain Evaluation Questionnaire (JOABPEQ), which is based on a patient-oriented scoring system.

Study design:

This study was a retrospective review of prospectively collected surgical data.

Methods:

The study included 81 patients (MEL 39 patients, 20 men and 19 women, mean age 68.9 years; and ME-MILD 42 patients, 22 men and 20 women, mean age 73.1 years) with lumbar spinal stenosis (LSS). The indications for surgery were moderate-to-severe stenosis, persistent neurological symptoms, and failure of conservative treatment over 3 months, with a JOA score under 15 points or intermittent claudication at 100 m. This study included patients having LSS at a single vertebral level (L4/5).

Results:

Low back pain, buttock-leg pain, and numbness were significantly improved in terms of the VAS score from 3 months with both MEL and ME-MILD. In all periods, JOA scores over 3 years of follow-up were significantly higher than those obtained before surgery with both MEL and ME-MILD, and there were improvements of low back pain and walking function.

Conclusions:

These observations demonstrate that ME-MILD is a safe and very effective minimally invasive technique for degenerative LSS, similar to MEL.
Age- and Sex-Specific Morphologic Variations of Capital Femoral Epiphysis Growth in Children and Adolescents Without Hip Disorders
Authors: Novais Eduardo N. , Maranho Daniel A. , Kim Young-Jo , Kiapour Ata
Published: June 2018

Background:

Understanding the development of the capital femoral epiphysis is essential to identify pathologic variations that may lead to cam morphology.

Purpose/Hypothesis:

The purpose of this study was to investigate the development of the capital femoral epiphysis during childhood and adolescence, with specific morphologic analysis of the peripheral growth and the metaphyseal surface of the growth plate. We hypothesized that age- and sex-dependent morphologic variations of the peripheral growth (cupping) and surface anatomy (epiphyseal tubercle) of the epiphysis would be evident with increasing age.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Pelvic computed tomography scans of 80 children and adolescents (range, 8-15 years; n = 10 per age group; 50% male), imaged because of suspected appendicitis, were used to reformat the proximal femur. All patients had asymptomatic hips with no signs or history of hip disorder. We measured the peripheral cupping of the epiphysis and the epiphyseal tubercle dimensions from 3-dimensional models. All measurements were normalized to the epiphyseal diameter. The effect of age on these parameters was evaluated by use of linear regression analysis. A 2-way analysis of variance (ANOVA) was used to compare these parameters between males and females.

Results:

The mean epiphyseal cupping increased with increasing age ( R2 = 0.54; P < .001). The mean normalized epiphyseal cupping was consistently higher in the anterior and posterior directions compared with the inferior and superior locations. Male patients aged 10 and 11 years had lower ( P = .002) mean epiphyseal cupping compared with female patients of the same age. We observed no difference between male and female participants after 12 years of age ( P > .3). The normalized epiphyseal tubercle height ( R2 = 0.08; P = .009), width ( R2 = 0.13; P = .001), and length ( R2 = 0.45; P < .001) decreased with increasing age, with no differences between male and female patients. On average, a 2.6-fold increase was found in epiphyseal cupping from 8 to 15 years of age, whereas normalized tubercle height decreased by 0.4-fold.

Conclusion:

Peripheral cupping of the epiphysis over the metaphysis increases with age, while the relative epiphyseal tubercle dimensions decrease. Females have an earlier onset of rapid increase in the peripheral cupping compared with males; however, no differences in epiphyseal tubercle dimensions were found between male and female patients. These findings may guide future studies investigating the development of cam morphology, which should consider the surface morphologic characteristics of the capital femoral epiphysis, the growth plate, and the differences in morphologic characteristics according to age and sex.
Cybersecurity Breach and Crisis Response: An Analysis of Organizations’ Official Statements in the United States and South Korea
Authors: Kim Nahyun , Lee Suman
Published: June 2018

Cybersecurity breaches have rapidly become a high-impact crisis for many corporations. Thus, it is critically important for corporations to know how to protect their reputation through effective crisis communication. Considering the scarcity of empirical research on cybersecurity breaches in crisis communication, the current study attempts to fill this research gap. This study compared 108 official statements issued by organizations in the United States and South Korea when cybersecurity breaches threatened the reputations of various corporations. The characteristics of an apology (responsibility admittance, sympathetic expression, reassurance, compensation) and other features of crisis response (use of excuses, functions of apology, and organizational representation) were examined. This study found that the features of the official statements differed by cultural dimension (individualism vs. collectivism, small vs. large power distance) and by communication style (low-context vs. high-context communication).
Stereotype Threat and Educational Tracking: A Field Experiment in Chinese Vocational High Schools
Authors: Chu James , Loyalka Prashant , Li Guirong , Gao Liya , Song Yao
Published: June 2018

Educational tracks create differential expectations of student ability, raising concerns that the negative stereotypes associated with lower tracks might threaten student performance. The authors test this concern by drawing on a field experiment enrolling 11,624 Chinese vocational high school students, half of whom were randomly primed about their tracks before taking technical skill and math exams. As in almost all countries, Chinese students are sorted between vocational and academic tracks, and vocational students are stereotyped as having poor academic abilities. Priming had no effect on technical skills and, contrary to hypotheses, modestly improved math performance. In exploring multiple interpretations, the authors highlight how vocational tracking may crystallize stereotypes but simultaneously diminishes stereotype threat by removing academic performance as a central measure of merit. Taken together, the study implies that reminding students about their vocational or academic identities is unlikely to further contribute to achievement gaps by educational track.
Directed Consultation and Supported Professionalism: Promoting Adaptive Evidence-Based Practices in Rural Schools
Authors: Farmer Thomas W. , Hamm Jill V. , Lee David L. , Sterrett Brittany I. , Rizzo Karen , Hoffman Abigail S.
Published: June 2018

Although there have been several advances in the development of evidence-based practices (EBPs) to support students with disabilities, many rural schools struggle to use EBPs. Rural schools may experience challenges that constrain their potential to provide support for the implementation of EBPs. Furthermore, there may be a mismatch between EBPs and the circumstances, resources, and needs of many rural schools. Directed consultation is an intervention support framework designed to adapt the use of EBPs by using local data and stakeholders’ insights to align strategies to the unique features and needs of rural schools, teachers, and students. This article considers the use of directed consultation to support the individualization and intensification of intervention for students with disabilities in rural schools. The establishment of rural research-practitioner partnerships is also discussed with the goal of developing a broad range of directed consultation content and delivery approaches.
Platelet MEKK3 regulates arterial thrombosis and myocardial infarct expansion in mice
Authors: Fan Xuemei , Wang Conghui , Shi Panlai , Gao Wen , Gu Jianmin , Geng Yan , Yang Wenlong , Wu Ningbo , Wang Yang , Xu Yanyan , Chen Xue , Zhang Lin , Wang Kemin , Su Bing , Liu Junling
Published: June 2018

Key Points

MEKK3 regulates platelet activation through ERK1/2 and JNK2. MEKK3 −/− mice are protected from microthrombosis and myocardial infarct expansion post-MI.
Prevalence of antibiotic resistant Escherichia coli isolates from fecal samples of food handlers in Qatar
Authors: Eltai Nahla O. , Yassine Hadi M. , Al Thani Asmaa A. , Abu Madi Marwan A. , Ismail Ahmed , Ibrahim Emad , Alali Walid Q.
Published: June 2018

Background

It is well documented that food handlers harbor and shed enteric foodborne pathogens causing foodborne disease outbreaks. However, little known on enteric antibiotic resistant (AR) bacteria carriage in food handlers. The objective of this study was to establish a baseline prevalence of fecal AR E. coli among food handlers in Qatar.

Methods

Fecal samples were collected from 456 migrant food handlers of different nationalities arriving in Qatar on a work permit between January 2015 and December 2016. These samples (25 g each) were collected based on the availability and examination schedule at the Medical Commission facility from those consented to participate. Isolated E. coli bacteria were tested for antibiotic susceptibility against nine antibiotics using the E-test method and Double Disc Synergy Test (DDST) for extended-spectrum beta-lactamase (ESBL) production.

Results

From the 78 E. coli positive samples (17.1%, n = 456), 60% of the isolates were resistant to at least one antibiotic, whereas, 27% were multi-drug resistant (MDR). Seven isolates (9%, n = 78) were ESBL producers of which five were MDR. Individual AR E. coli frequencies to the nine antibiotics were not significantly (P > 0.05) different by nationality.

Conclusions

Based on our findings, we revealed that individual resistant E. coli and MDR resistant E. coli were common in fecal samples of food handlers in Qatar. This may indicate that food handlers can potentially contaminate foods with AR E. coli, a possible public health concern.
Age exerts a continuous effect in the outcomes of Asian breast cancer patients treated with breast‐conserving therapy
Authors: Wong Fuh Yong , Tham Wei Ying , Nei Wen Long , Lim Cindy , Miao Hui
Published: June 2018

Background

Asians are diagnosed with breast cancer at a younger age than Caucasians are. We studied the effect of age on locoregional recurrence and the survival of Asian breast cancer patients treated with breast‐conserving therapy.

Methods

Medical records of 2492 patients treated with breast‐conserving therapy between 1989 and 2012 were reviewed. The Kaplan–Meier method was used to estimate locoregional recurrence, breast cancer‐free survival, and breast cancer‐specific survival rates. These rates were then compared using log‐rank tests. Outcomes and age were modeled by Cox proportional hazards. Fractional polynomials were then used to test for non‐linear relationships between age and outcomes.

Results

Patients ≤ 40 years old were more likely to have locoregional recurrence than were older patients (Hazard ratio [HR] = 2.32, P < 0.001). Locoregional recurrence rates decreased year‐on‐year by 4% for patients with luminal‐type breast cancers, compared with 8% for those with triple‐negative cancers. Similarly, breast cancer‐free survival rates increased year‐on‐year by 4% versus 8% for luminal‐type and triple‐negative cancers, respectively. Breast cancer‐specific survival rates increased with age by 5% year‐on‐year. Both breast cancer‐free survival and breast cancer‐specific survival rates in patients with luminal cancers exhibited a non‐linear (“L‐shaped”) relationship—where decreasing age at presentation was associated with escalating risks of relapse and death. The influence of age on overall survival was confounded by competing non‐cancer deaths in older women, resulting in a “U‐shaped” relationship.

Conclusions

Young Asian breast cancer patients have a continuous year‐on‐year increase in rates of disease relapse and cancer deaths compared with older patients with no apparent threshold.