bluuebunny/crossref_metadata_2025 huggingface dataset:
Searching for the “Active Ingredients” in Physical Rehabilitation Programs Across Europe, Necessary to Improve Mobility in People With Multiple Sclerosis: A Multicenter Study
Authors: Kalron Alon , Feys Peter , Dalgas Ulrik , Smedal Tori , Freeman Jennifer , Romberg Anders , Conyers Helen , Elorriaga Iratxe , Gebara Benoit , Merilainen Johanna , Heric-Mansrud Adnan , Jensen Ellen , Jones Kari , Knuts Kathy , Maertens de Noordhout Benoit , Martic Andrej , Normann Britt , O. Eijnde Bert , Rasova Kamila , Santoyo Medina Carme , Baert Ilse
Published: March 2019

Background. Physical rehabilitation programs can lead to improvements in mobility in people with multiple sclerosis (PwMS). Objective. To identify which rehabilitation program elements are employed in real life and how they might affect mobility improvement in PwMS. Methods. Participants were divided into improved and nonimproved mobility groups based on changes observed in the Multiple Sclerosis Walking Scale–12 following multimodal physical rehabilitation programs. Analyses were performed at group and subgroup (mild and moderate-severe disability) levels. Rehabilitation program elements included setting, number of weeks, number of sessions, total duration, therapy format (individual, group, autonomous), therapy goals, and therapeutic approaches. Results. The study comprised 279 PwMS from 17 European centers. PwMS in the improved group received more sessions of individual therapy in both subgroups. In the mildly disabled group, 60.9% of the improved received resistance training, whereas, 68.5% of the nonimproved received self-stretching. In the moderately-severely disabled group, 31.4% of the improved, received aerobic training, while 50.4% of the nonimproved received passive mobilization/stretching. Conclusions. We believe that our findings are an important step in opening the black-box of physical rehabilitation, imparting guidance, and assisting future research in defining characteristics of effective physical rehabilitation.
Help Wanted: Mental Health and Social Stressors Among Latino Day Laborers
Authors: Hill Clara M. , Williams Emily C. , Ornelas India J.
Published: March 2019

Latino day laborers may be especially vulnerable to poor mental health due to stressful life experiences, yet few studies have described patterns of mental health outcomes and their correlates in this population. Patterns of depression (PHQ-9) and anxiety (GAD-7), and associations with demographic characteristics, social stressors, and substance use in a recruited sample of male Latino day laborers ( n = 101) are described. High rates of depression and anxiety were identified. Specifically, 39% screened positive for moderate or severe depression and 25% for moderate or severe anxiety. Higher levels of depression and anxiety symptoms were associated with being single, being homeless or in temporary housing, experiencing discrimination, acculturation stress, and marijuana use. While tobacco and unhealthy alcohol use were common in this sample (39% and 66%, respectively), they were not associated with depression and anxiety. These findings suggest that depression and anxiety are common among Latino day laborers and associated with stressful life experiences. Future research should further assess ways to ameliorate social stressors and reduce risk for poor mental health.
Firework Injuries of the Hand: An Analysis of Treatment and Health Care Utilization
Authors: Amador Ricardo O. , Ozkan Sezai , Chen Neal C. , Eberlin Kyle R.
Published: March 2019

Background: Firework injuries to the hand can be devastating due to the explosive and ballistic nature of these devices. The aim of this study was to describe the injury and treatment characteristics of patients requiring surgery for firework-related hand injuries and to investigate which factors are associated with an increased utilization of health care resources. Methods: A retrospective chart review of patients undergoing surgery for firework-related hand injuries at two American College of Surgeons level I trauma centers between 2005 and 2016 was performed. Twenty cases were identified. These patients were evaluated for demographics, injury characteristics, number and types of surgical interventions, length of stay, and utilization of health care resources. Bivariate analyses were performed to investigate which factors were associated with increased consumption of health care resources. Results: Injuries ranged from digital nerve injuries to traumatic amputation. Patients underwent a median of 3 surgical operations. More than half the patients underwent flap or skin graft coverage of a soft tissue defect. The median length of hospital stay was 7 days. Factors found to be associated with an increased utilization of surgical and hospital resources included a first web space injury, thumb fracture, and traumatic amputation of any digit. Conclusions: The morbidity inflicted by firework injuries to individual patients is substantial. Patients with severe injuries undergo a median of three surgical operations and have a long duration of initial hospital stay. Knowing which factors are associated with an increased utilization of resources can help prognosticate these preventable injuries.
Clustering-based task coordination to search and rescue teamwork of multiple agents
Authors: Shi Haobin , Zhang Renyu , Sun Gang , Chen Jialin
Published: March 2019

It is important to have reasonable task coordination and path planning in rescue operations after a large-scale urban disaster. Whereas, there are many problems which can hamper rescue operations, such as communication obstacles, collapsed buildings, and secondary disaster. This article proposes a novel approach named ISODATA-K to achieve the task coordination and execution with heterogeneous ad hoc multi-agent. Inspired by the clustering analysis, ISODATA-K method, which does not require any input and threshold parameters, assigns the rescue agents to every area of the damaged city adaptively and efficiently. When the rescue agents get respective task, the path planning is done by A* algorithm which costs little time to find the relatively short route. The results of experiments demonstrate that the proposed method allows satisfactory rescue operations.
A new fuzzy time-delay control for cable-driven robot
Authors: Jiang Surong , Wang Yaoyao , Ju Feng , Chen Bai , Wu Hongtao
Published: March 2019

To overcome the problems of structural parametric uncertainty and cable transmission model complexity, a nonlinear controller based on time-delay estimation and fuzzy self-tuning is proposed. The unknown dynamics and disturbances are estimated by time delaying the state of motion immediately before. The control gains are self-tuned by a fuzzy controller, which can reduce the errors caused by system’s uncertainties and external disturbances. Compared with the conventional Proportional-derivative (PD) and time-delay control, the result shows that the proposed control scheme based on time-delay estimation can improve the joint trajectory tracking accuracy of cable-driven robot by significantly reducing the control gains. With the PD gains self-tuned by fuzzy strategy, the mean square errors of trajectory tracking are decreased approximately by 5–20% more than the conventional time-delay control with constant gains. In addition, the experimental result shows that the proposed method has an effective inhibitory effect on dead zone in cable-driven joints. Experiment performed on position tracking control of a 2-degree-of-freedom cable-driven robot is presented to illustrate that the controller has the advantages of simple and reliable structure, model-free, strong robustness, and high tracking accuracy.
An adaptive model combining a total variation filter and a fractional-order filter for image restoration
Authors: Yang Yafeng , Zhao Donghong
Published: March 2019

In this paper, we propose a model that combines a total variation filter with a fractional-order filter, which can unite the advantages of the two filters, and has a remarkable effect in the protection of image edges and texture details; simultaneously, the proposed model can eliminate the staircase effect. In addition, the model improves the PSNR compared with the total variation filter and the fractional-order filter when removing noise. Zhu and Chan presented the primal-dual hybrid gradient algorithm and proved that it is effective for the total variation filter. On the basis of their work, we employ the primal-dual hybrid gradient algorithm to solve the combined model in this article. The final experimental results show that the new model and algorithm are effective for image restoration.
High-Density Autologous Chondrocyte Implantation as Treatment for Ankle Osteochondral Defects
Authors: López-Alcorocho Juan Manuel , Guillén-Vicente Isabel , Rodríguez-Iñigo Elena , Navarro Ramón , Caballero-Santos Rosa , Guillén-Vicente Marta , Casqueiro Mercedes , Fernández-Jaén Tomás F. , Sanz Fernando , Arauz Santiago , Abelow Steve , Guillén-García Pedro
Published: March 2019

Purpose

Two-year follow-up to assess efficacy and safety of high-density autologous chondrocyte implantation (HD-ACI) in patients with cartilage lesions in the ankle.

Design

Twenty-four consecutive patients with International Cartilage repair Society (ICRS) grade 3-4 cartilage lesions of the ankle were included. Five million chondrocytes per cm2 of lesion were implanted using a type I/III collagen membrane as a carrier and treatment effectiveness was assessed by evaluating pain with the visual analogue scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at baseline, 12-month, and 24-month follow-up, together with dorsal and plantar flexion. Magnetic resonance observation for cartilage repair tissue (MOCART) score was used to evaluate cartilage healing. Histological study was possible in 5 cases.

Results

Patients’ median age was 31 years (range 18-55 years). Median VAS score was 8 (range 5-10) at baseline, 1.5 (range 0-8) at 12-month follow-up, and 2 (rang e0-5) at 24-month follow-up ( P < 0.001). Median AOFAS score was 39.5 (range 29-48) at baseline, 90 (range 38-100) at 12-month follow-up, and 90 (range 40-100) at 24-month follow-up ( P < 0.001). Complete dorsal flexion significantly increased at 12 months (16/24, 66.7%) and 24 months (17/24, 70.8%) with regard to baseline (13/24, 54.2%) ( P = 0.002). MOCART at 12- and 24-month follow-ups were 73.71 ± 15.99 and 72.33 ± 16.21. Histological study confirmed that neosynthetized tissue was cartilage with hyaline extracellular matrix and numerous viable chondrocytes.

Conclusion

HD-ACI is a safe and effective technique to treat osteochondral lesions in the talus, providing good clinical and histological results at short- and mid-term follow-ups.
Psycho-social impact of developmental dysplasia of the hip and of differential access to early diagnosis and treatment: A narrative study of young adults
Authors: Gambling Tina Samantha , Long Andrew
Published: March 2019

Objectives:

Symptomatic developmental dysplasia of the hip can present in the young, active adult patient and can lead to severe pain and disability at a young age. The overall aim of the study was to deepen the understanding of the impact of developmental dysplasia of the hip on young adults’ quality of life and psycho-social well-being, focusing on how differential access to early diagnosis impacted the trajectory of the disease and treatment options.

Methods:

We conducted semi-structured interviews and gathered online stories from 97 participants. A narrative and thematic analysis was used to integrate the dataset producing a multi-dimensional view.

Results:

A narrative plot showing how events unfolded over time was identified for each participant. Two common plots were identified: Plot 1 focused around those participants who received a prompt diagnosis and were treated within 12 months of diagnosis (n = 22) and Plot 2 focused around those who experienced a late/delayed diagnosis (mean = 8 years; range = 12–364 months) (n = 75) and thus delayed treatment. Participants in Plot 2 became more debilitated over time and experienced chronic hip pain for a prolonged period before an accurate diagnosis and/or intervention was made. It was clear from the narratives when pain persists over time, participants’ quality of life and psycho-social well-being were affected.

Conclusions:

Developmental dysplasia of the hip is an under-recognised condition; more research is needed to develop a clear clinical picture that can be used to alert frontline health professionals to the potential for developmental dysplasia of the hip so that they can promptly diagnose patients and refer them to specialist centres. Patients can also experience a profound impact on their quality of life and psycho-social well-being. Patients actively seek information from support groups about all aspects of their condition. Further research is required to determine the long-term impact of developmental dysplasia of the hip to develop evidence-based information for clinicians and patients.
Workflow efficiency pilot study of Surgery Viewer©: A secure hands-free intraoperative multimedia interface for Google Glass™
Authors: Ahmad Salman , Tann John , Gaddy John , McKenzie Aaron , Zentz Alan , Naumann Ben , Toy Sophia , Leighow Carla
Published: March 2019

Background:

The Google Glass™ heads-up-display system has been adopted by the medical field for applications such as image capture, live streaming and decision support.

Methods:

We designed a custom application for Google Glass™ called Surgery Viewer© to capture patient images and securely transfer them to the electronic medical record. Surgery Viewer© was compared to a standard digital camera and an Apple iOS© device using another image capture application. Comparative workflow metrics included timings of image capture and a usability survey.

Results:

Ten patients were studied in operating room and wound clinic settings. Average times to log in (Surgery Viewer©, Image Capture™) or turn on (digital camera) were 18.39 s, 9.91 s and 2.11 s for Surgery Viewer©, Image Capture™ and digital camera, respectively. In the operating room, the average times to select the correct patient were 3.06 s, 14.77 s and 4.45 s for Surgery Viewer©, Image Capture™ and digital camera, respectively. Average image capture times were 8.67 s, 7.77 s and 7.60 s for Surgery Viewer©, Image Capture™ and digital camera, respectively. Images captured by Surgery Viewer© and Image Capture™ were instantaneously uploaded to the electronic medical record, but digital camera images took on average 1522 s to be uploaded. In the wound clinic, the average times to select the correct patient were 16.29 s, 7.35 s and 4.63 s for Surgery Viewer©, Image Capture™ and digital camera, respectively. Image capture times were 9.55 s, 5.28 s and 3.47 s, respectively. Digital camera took on average 27,758 s to upload.

Conclusion:

Surgery Viewer© performed equivalently with Image Capture™ while digital camera took longer to upload. Users found the application easy to learn with Surgery Viewer© concerns, including log on procedure, ambient distraction from voice recognition, viewfinder perspective and battery life.
Mapping the political landscape of Persian Twitter: The case of 2013 presidential election
Authors: Khazraee Emad
Published: March 2019

The fallacy of premature designations such as “Iran's Twitter Revolution” can be attributed to the empirical gap in our knowledge about such sociotechnical phenomena in non-Western societies. To fill this gap, we need in-depth analyses of social media use in those contexts and to create detailed maps of online public environments in such societies. This paper aims to present such cartography of the political landscape of Persian Twitter by studying the case of Iran's 2013 presidential election. The objective of this study is twofold: first, to fill the empirical gap in our knowledge about Twitter use in Iran, and second, to develop computational methods for studying Persian Twitter (e.g., effective methods for analyzing Persian text) and identify the best methods for addressing different issues (e.g., topic detection and sentiment analysis). During Iran's 2013 presidential election, three million tweets were collected and analyzed using social network analysis and machine learning. The findings provide a more nuanced view of the political landscape of Persian Twitter and identify patterns in accordance with or in contrast to those identified in the English-speaking Twittersphere around the 2013 presidential election. Persian Twitter was dominated by micro-celebrities, whereas institutional elites dominated English discourse about Iran on Twitter. The results also illustrate that Persian Twitter in 2013 was predominantly in favor of reformists. Finally, this study demonstrates that sentiment analysis toward political name entities can be used efficiently for mapping the political landscape of conversation on Twitter.
Does attendance at the ECTRIMS congress impact on therapeutic decisions in multiple sclerosis care?
Authors: Saposnik Gustavo , Maurino Jorge , Sempere Angel P , Terzaghi Maria A , Amato Maria Pia , Montalban Xavier
Published: March 2019

Conferences traditionally play an important role in the ongoing medical education of healthcare professionals. We assessed the influence of attending the ECTRIMS congress on therapeutic decision-making in multiple sclerosis (MS) care. A non-interventional, cross-sectional study involving 96 neurologists was conducted. Treatment escalation when therapeutic goals were unmet and management errors related to tolerability and safety scenarios of MS therapies were tested using different case-scenarios. Attendance at ECTRIMS was associated with an increase likelihood of treatment escalation in the presence of clinical progression (cognitive decline) and radiological activity (OR 2.44; 95% CI 1.06–5.82) and lower number of management errors (OR 0.26; 95% CI 0.07–0.98). Attendance at ECTRIMS may facilitate therapeutic decisions and reduction in management errors in MS care.
What public and whose opinion? A study of Chinese online public opinion analysis
Authors: Jia Lianrui
Published: March 2019

As a recently emerged information service on the Chinese Internet, online public opinion analysis (网络舆情分析) is a type of service to monitor, assess, and synthesize online public communication through automated software and trained individuals. This article provides an industry overview of the rise of online public opinion in China and examines the political economy of the People’s Public Opinion Office. Second, this article looks at the marketing of the profession in news coverage, training materials, as well as published interviews with People’s Public Opinion Office’s managers and experts. Through a close reading of People’s Public Opinion Office’s published annual reports from 2007 to 2016 focusing on the issue of online rumor, this article delineates how the identification and prognostics of online rumor evolves with the State’s anti-rumor campaign that aims to forestall or pacify collective action. In sum, this article sets to examine the professionalization and industrialization of online public opinion analysis as a part of the co-evolutionary dynamics between the state and civil society in China. Using the government’s anti-rumor campaign as an example, this article critically investigates the mediating role online public opinion analysis plays in the “sausage factory” of public opinion gauging and monitoring, which sets the basis upon which policymaking process is guided and justified.
Revisiting the Althusser/E. P. Thompson-Controversy: Towards a Marxist theory of communication
Authors: Fuchs Christian
Published: March 2019

This essay revisits the controversy between Louis Althusser’s Marxist structuralism and Edward P. Thompson’s Marxist humanism. It draws conclusions from this controversy for the foundations of the Marxist theory of communication. The controversy’s key disagreements concern the questions of how the economic and the non-economic (the base/superstructure problem), as well as structures and agency are related. Whereas Althusser focuses on articulation and over-determination, Thompson stresses the role of experience in society in general, and class societies in particular. This essay reflects on how both these approaches relate to the role of communication in society and capitalism. Communication is a process in which humans produce and reproduce social relations in manners that mediate not just understanding the world and other humans, but also the dialectic of structure and agency and the dialectic of society’s realms. For a Marxist theory of society, also the forgotten meaning of communication as commoning is of crucial importance.
ISIS’s media strategy as image warfare: Strategic messaging over time and across platforms
Authors: Yarchi Moran
Published: March 2019

The media plays a crucial role in contemporary conflicts because an image war is occurring alongside the military confrontation. The Islamic state of Iraq and al-Sham (ISIS) sets a prime example for the usage of image as part of its fighting strategy, using various platforms to communicate its narrative. This study evaluates ISIS’s image front by analyzing its messages promoted through various online communication platforms: audio statements made by ISIS leaders, official videos, Dabiq and Rumiyah magazines, Islamic chants ( nasheeds), and Amaq news reports. The findings indicate that ISIS uses messages strategically in an attempt to create and maintain its image as a powerful organization. The three main themes are power projection, violence, and Islamic religious messages (while different emphases are placed on various platforms). Most messages target Muslims, while others (usually threats) target the organization’s various enemies. It appears that ISIS invests considerable resources and efforts into promoting its narrative as part of the image war—projecting its power, based on religious arguments, on one hand, and demonizing and threatening its enemies on the other, using repeated themes, descriptions, metaphors, and visual images (videos, pictures, and infographics). The study’s analysis indicates that ISIS puts a lot of emphasis on the media/image aspects of its battle, and uses all of the tools in its tool box in an attempt to succeed in the image war, a central front in contemporary conflicts.
A review of the current state of research on China’s international image management
Authors: Hartig Falk
Published: March 2019

Image Management is a crucial aspect of China’s engagement with the world, and the related scholarship has already produced high-quality learned analyses. This article, however, identifies a certain stagnation in knowledge production. This stagnation, I argue, is first due to a tendency to focus research on a few recurring themes and second due to three contested areas and related research gaps. These contestations concern (1) the question how to describe and conceptualize image management practices, (2) the question what instruments belong to image management practices, and (3) most importantly the question of audiences and how to measure the impact of these practices. By mapping out these areas, this article provides avenues for further research and argues in favor of interdisciplinary mixed-methods research in this field. Taking those contested areas and the existing research gaps more seriously into consideration is imperative to understand China’s communicative practices which increasingly become a major component of China’s overall behavior on the global stage.
Variation in Documenting Diagnosable Chronic Kidney Disease in General Medical Practice: Implications for Quality Improvement and Research
Authors: Kitsos Alex , Peterson Gregory M. , Jose Matthew D. , Khanam Masuma Akter , Castelino Ronald L. , Radford Jan C.
Published: March 2019

Background: National health surveys indicate that chronic kidney disease (CKD) is an increasingly prevalent condition in Australia, placing a significant burden on the health budget and on the affected individuals themselves. Yet, there are relatively limited data on the prevalence of CKD within Australian general practice patients. In part, this could be due to variation in the terminology used by general practitioners (GPs) to identify and document a diagnosis of CKD. This project sought to investigate the variation in terms used when recording a diagnosis of CKD in general practice. Methods: A search of routinely collected de-identified Australian general practice patient data (NPS MedicineWise MedicineInsight from January 1, 2013, to June 1, 2016; collected from 329 general practices) was conducted to determine the terms used. Manual searches were conducted on coded and on “free-text” or narrative information in the medical history, reason for encounter, and reason for prescription data fields. Results: From this data set, 61 102 patients were potentially diagnosable with CKD on the basis of pathology results, but only 14 172 (23.2%) of these had a term representing CKD in their electronic record. Younger patients with pathology evidence of CKD were more likely to have documented CKD compared with older patients. There were a total of 2090 unique recorded documentation terms used by the GPs for CKD. The most commonly used terms tended to be those included as “pick-list” options within the various general practice software packages’ standard “classifications,” accounting for 84% of use. Conclusions: A diagnosis of CKD was often not documented and, when recorded, it was in a variety of ways. While recording CKD with various terms and in free-text fields may allow GPs to flexibly document disease qualifiers and enter patient specific information, it might inadvertently decrease the quality of data collected from general practice records for clinical audit or research purposes.
Versifying History and National Trauma in Tanure Ojaide’s The Endless Song
Authors: Onwuka Edwin , Uba Emmanuel , Fortress Isaiah
Published: March 2019

The symbiotic relationship between literature and history is most visible in the writer’s deployment of his or her art to document experiences of the past and their impacts on the feelings and well-being of his or her people in the periods represented in the work(s). This article explores the historical content and significance of Tanure Ojaide’s The Endless Song from a new historical perspective. Most studies on Ojaide’s poetry often focus on his critique of bad leadership and his denunciation of exploitation and pillaging of Nigeria’s Niger Delta region with little attention paid to his poems as history in verse form. This article therefore contributes to criticism on the interface between literature and history. This study further highlights significant motifs in Nigeria’s history in the periods documented in The Endless Song and analyses the traumatic impacts of the events on the well-being of Nigeria and her people. These are aimed at showing that Ojaide’s The Endless Song is more than an outcry against the plundering of the Niger Delta region; it represents the spatiotemporal record of Nigeria’s turbulent history.
The Role of Relationships: An Exploratory Study of Early Childhood Educators Earning a Bachelor’s Degree
Authors: Douglass Anne L.
Published: March 2019

Professional standards increasingly call for early childhood educators to hold a bachelor’s degree as one measure of educator quality. This has prompted many educators to return to college, creating both a need and an opportunity to better understand the factors that support educators to complete their degree and apply what they learn to their teaching practice. This qualitative study examined the higher education experiences of early educators enrolled in a public urban university early childhood teacher education program. Using a theoretical lens grounded in relational theory, this study explored how relationships in the university and the workplace influenced educators’ progress toward degree completion and their application of learning into practice. Data included in-depth individual interviews with educators and their workplace supervisors. This study shows how positive relationships with university faculty, staff, peers, and workplace colleagues and supervisors can support educators as they work toward earning their bachelor’s degree. The results revealed four characteristics of these relationships that influenced educators, as well as key barriers and challenges. In particular, the findings show how several negative relational dynamics may act as a barrier to educators’ efforts to apply new learning in the workplace. The paper concludes with implications for research and practice, and calls for increased attention to the relational contexts in which educators pursue their degree and make improvements in their teaching practices.
Workplace Bullying and Newly Licensed Registered Nurses: An Evolutionary Concept Analysis
Authors: Anusiewicz Colleen V. , Shirey Maria R. , Patrician Patricia A.
Published: March 2019

Workplace bullying (WPB) among nurses, especially newly licensed registered nurses (NLRNs), negatively affects nurse, patient, and organizational outcomes. Despite empirical evidence addressing the prevalence and impact of WPB, the behavior continues to persist within nursing work environments. Increased conceptual clarity of WPB is needed for interventions to be developed, executed, and evaluated. The purposes of this concept analysis, in which we used Rodgers’ evolutionary method, were to obtain a clearer understanding of WPB, to differentiate the concept from other forms of workplace violence, and to describe a definition of WPB consistently used in the literature. Three attributes specific to WPB included negative behaviors directed toward an individual who perceives themselves to be a target, a time frame of experiencing these negative behaviors (e.g., daily or weekly) for a prolonged period (e.g., several weeks), and the inclusion of a power gradient or hierarchy between the bully and target. Antecedents identified for WPB included a scarcity of resources and poor leadership and management. Consequences associated with WPB included adverse nurse, patient, and health care organizational outcomes. WPB was conceptually defined as any negative behavior, exhibited by a nurse of either perceived or actual power, that was repeatedly (i.e., daily or weekly) and persistently directed toward NLRNs who have difficulty defending themselves against the behavior. Implications for researchers, health care organizations, nurse leaders, and nurses are included.
Toward a holistic networks approach to strategic third-party intervention: A literature review
Authors: Hannigan Colin
Published: March 2019

How do third parties decide to intervene in civil conflicts? The study of intervention has focused primarily on the conflict characteristics and dyadic linkages that make intervention more likely, or the conflict outcomes that interventions generate, while holding all else equal. To paint a more complete picture of what goes into the intervention decision, I advocate a shift in the way we conceive of interventions toward network analysis, which grants due agency to the multiple external actors and internal combatants that influence the decision to intervene. This review critically examines and synthesizes the recent literature on third-party interventions in civil conflict and, in so doing, identifies some areas for future research.
Computational simulation of sacral-alar-iliac (S2AI) screw fixation of pelvis and implications for fluoroscopic procedure: A cadaver study
Authors: Jeong Soon-Taek , Park Young-Seop , Jung Gu-Hee
Published: March 2019

Purpose:

To determine an easy and convenient method of sacral-alar-iliac (S2AI) screw fixation and introduce the surgical landmarks for fluoroscopic procedure by analyzing 3-D models of pelvis and virtual implantation in a 3-D model.

Materials and Methods:

Eighty-two cadavers underwent computed tomography scans and the images imported into Mimics® software to make the 3-D pelvis model. The pedicle screw (Ø 8.5 mm/length 115 mm) was processed into a 3-D model using a 3-D-sensor (Comet5®) at the actual size and virtually placed as the S2AI screw. The ideal screw position was defined as the maximal intraosseous length without cortical perforation along the entire path. The ideal entry point and screw trajectory were verified and assessed to introduce the surgical landmark for fluoroscopic procedure.

Results:

There was no cortical violation around nerve root canal and greater sciatic notch through the entry point between first and second dorsal sacral foramen. There was no impossible model of S2AI screws. The average screw length was 99.8 mm (range, 59.8–115 mm; standard deviation, 16.1) and just one model had shorter than 65 mm S2AI screw. The factors limiting the intra-iliac screw length were sex ( p = 0.000) and the iliac groove around the sacroiliac joint ( p = 0.000). A free 360° rotation with magnification revealed that the screw trajectory was consistently directed toward the anteroinferior iliac spine (AIIS) in any plane.

Conclusion:

The ideal entry point of S2AI screw showed a wide range of tolerance between the first and second dorsal sacral foramen; and thus, there was no need for deep dissection to identify the first dorsal sacral foramen. Considering the tendency to shift the pilot hole laterally and the ideal screw trajectory was consistently directed toward AIIS, the entry point is better to be located with a medial shift.
Characteristics of Bone-Conduction Devices Simulated in a Finite-Element Model of a Whole Human Head
Authors: Chang You , Stenfelt Stefan
Published: March 2019

Nowadays, many different kinds of bone-conduction devices (BCDs) are available for hearing rehabilitation. Most studies of these devices fail to compare the different types of BCDs under the same conditions. Moreover, most results are between two BCDs in the same subject, or two BCDs in different subjects failing to provide an overview of the results between several of the BCDs. Another issue is that some BCDs require surgical procedures that prevent comparison of the BCDs in the same persons. In this study, four types of skin-drive BCDs, three direct-drive BCDs, and one oral device were evaluated in a finite-element model of the human head that was able to simulate all BCDs under the same conditions. The evaluation was conducted using both a dynamic force as input and an electric voltage to a model of a BCD vibrator unit. The results showed that the direct-drive BCDs and the oral device gave vibration responses within 10 dB at the cochlea. The skin-drive BCDs had similar or even better cochlear vibration responses than the direct-drive BCDs at low frequencies, but the direct-drive BCDs gave up to 30 dB higher cochlear vibration responses at high frequencies. The study also investigated the mechanical point impedance at the interface between the BCD and the head, providing information that explains some of the differences seen in the results. For example, when the skin-drive BCD attachment area becomes too small, the transducer cannot provide an output force similar to the devices with larger attachment surfaces.
Prescribed analgesics in pregnancy and risk of childhood asthma
Authors: Shaheen Seif O. , Lundholm Cecilia , Brew Bronwyn K. , Almqvist Catarina
Published: March 2019

Many epidemiological studies have reported a positive association between prenatal exposure to paracetamol and childhood wheezing and asthma. We investigated whether the link between prenatal analgesic exposure and asthma/wheeze is specific to paracetamol, and whether it is causal or confounded.

Using linked Swedish health register data we investigated the relation between various prescribed analgesics in pregnancy and the risk of childhood asthma/wheeze in a population of 492 999, and used negative paternal control and sibling comparison approaches to explore unmeasured confounding.

After controlling for potential confounders, prescribed opioids, antimigraine drugs and paracetamol were all positively associated with childhood asthma/wheeze risk at all ages (e.g.for asthma/wheeze at age 4 years: adjusted OR 1.39 (95% CI 1.30–1.49), 1.19 (95% CI 1.01–1.40) and 1.47 (95% CI 1.36–1.59) for opioids, antimigraine drugs and paracetamol, respectively). The results of the paternal control analysis did not suggest the presence of unmeasured confounding by genetics or shared environment. However, the sibling control analysis broadly suggested that associations between prenatal exposure to the analgesics and asthma/wheeze were confounded by specific maternal factors (e.g.for asthma/wheeze at age 4 years: adjusted OR 0.91 (95% CI 0.62–1.31), 0.50 (95% CI 0.17–1.45) and 0.80 (95% CI 0.50–1.29) for opioids, antimigraine drugs and paracetamol, respectively).

We propose that analgesic use in pregnancy does not cause childhood asthma/wheeze and that the association is confounded by unmeasured factors that are intrinsic to the mother, such as chronic pain or anxiety.
Mycobacterium abscessuspulmonary disease: individual patient data meta-analysis
Authors: Kwak Nakwon , Dalcolmo Margareth Pretti , Daley Charles L. , Eather Geoffrey , Gayoso Regina , Hasegawa Naoki , Jhun Byung Woo , Koh Won-Jung , Namkoong Ho , Park Jimyung , Thomson Rachel , van Ingen Jakko , Zweijpfenning Sanne M.H. , Yim Jae-Joon
Published: March 2019

Treatment ofMycobacterium abscessuspulmonary disease (MAB-PD), caused byM. abscessussubsp.abscessus,M. abscessussubsp.massilienseorM. abscessussubsp.bolletii, is challenging.

We conducted an individual patient data meta-analysis based on studies reporting treatment outcomes for MAB-PD to clarify treatment outcomes for MAB-PD and the impact of each drug on treatment outcomes. Treatment success was defined as culture conversion for ≥12 months while on treatment or sustained culture conversion without relapse until the end of treatment.

Among 14 eligible studies, datasets from eight studies were provided and a total of 303 patients with MAB-PD were included in the analysis. The treatment success rate across all patients with MAB-PD was 45.6%. The specific treatment success rates were 33.0% forM. abscessussubsp.abscessusand 56.7% forM. abscessussubsp.massiliense. For MAB-PD overall, the use of imipenem was associated with treatment success (adjusted odds ratio (aOR) 2.65, 95% CI 1.36–5.10). For patients withM. abscessussubsp.abscessus, the use of azithromycin (aOR 3.29, 95% CI 1.26–8.62), parenteral amikacin (aOR 1.44, 95% CI 1.05–1.99) or imipenem (aOR 7.96, 95% CI 1.52–41.6) was related to treatment success. For patients with M. abscessussubsp.massiliense, the choice among these drugs was not associated with treatment outcomes.

Treatment outcomes for MAB-PD are unsatisfactory. The use of azithromycin, amikacin or imipenem was associated with better outcomes for patients withM. abscessussubsp.abscessus.
Incidence of autoimmune pulmonary alveolar proteinosis estimated using Poisson distribution
Authors: Kitamura Nobutaka , Ohkouchi Shinya , Tazawa Ryushi , Ishii Haruyuki , Takada Toshinori , Sakagami Takuro , Tanaka Takahiro , Nakata Koh
Published: March 2019

The incidence and prevalence of autoimmune pulmonary alveolar proteinosis in Japan were previously estimated to be 0.49 and 6.2 per million, respectively. Thereafter, an increase in serological diagnosis forced a re-estimation of the incidence based on more contemporaneous data using more robust methods.

Sera of 702 patients were positive for granulocyte-macrophage colony-stimulating factor autoantibody during the 2006–2016 period (group A). Of these patients, 43 were actively surveyed in Niigata prefecture (group B) for estimation of the incidence. To estimate the survival period, 103 patients (group C) were investigated retrospectively for the 1999–2017 period using restricted mean survival time.

In group A, the number of patients diagnosed in each prefecture was closely correlated with the corresponding population, indicating no regional integration of onset. In group B, a total of 43 patients were diagnosed, the annual number followed a Poisson distribution and the incidence was thus estimated to be 1.65 per million. In group C, the retrospective cohort study revealed the mean survival period to be 16.1 years. Taken together, the prevalence was estimated to be 26.6 per million, indicating that the previous data for incidence and prevalence was an underestimation.
Research highlights from the 2018 European Respiratory Society International Congress: airway disease
Authors: Schleich Florence , Bikov Andras , Mathioudakis Alexander G. , McDonnell Melissa , Andersson Cecilia , Bonini Matteo , Uller Lena , Idzko Marco , Singh Dave , Lopez-Campos Jose Luis , Bossios Apostolos , Adcock Ian M. , Usmani Omar , Spanevello Antonio , Bonvini Sara J.
Published: March 2019

The annual European Respiratory Society (ERS) International Congress (held in Paris in 2018) was once again a platform for discussion of the highest-quality scientific research, cutting-edge techniques and innovative new therapies within the respiratory field. This article discusses only some of the high-quality research studies presented at this year's Congress, with a particular focus on airway diseases including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cough, as presented through Assembly 5 of the ERS (Airway Diseases: Asthma and COPD). The authors establish the key take-home messages of these studies, compare their findings and place them in the context of current understanding.
Altered bioavailability of epoxyeicosatrienoic acids is associated with conduit artery endothelial dysfunction in type 2 diabetic patients
Authors: Duflot Thomas , Moreau-Grangé Lucile , Roche Clothilde , Iacob Michèle , Wils Julien , Rémy-Jouet Isabelle , Cailleux Anne-Françoise , Leuillier Matthieu , Renet Sylvanie , Li Dongyang , Morisseau Christophe , Lamoureux Fabien , Richard Vincent , Prévost Gaëtan , Joannidès Robinson , Bellien Jérémy
Published: March 2019

Background

This pathophysiological study addressed the hypothesis that soluble epoxide hydrolase (sEH), which metabolizes the vasodilator and anti-inflammatory epoxyeicosatrienoic acids (EETs) to dihydroxyeicosatrienoic acids (DHETs), contributes to conduit artery endothelial dysfunction in type 2 diabetes.

Methods and results

Radial artery endothelium-dependent flow-mediated dilatation in response to hand skin heating was reduced in essential hypertensive patients (n = 9) and type 2 diabetic subjects with (n = 19) or without hypertension (n = 10) compared to healthy subjects (n = 36), taking into consideration cardiovascular risk factors, flow stimulus and endothelium-independent dilatation to glyceryl trinitrate. Diabetic patients but not non-diabetic hypertensive subjects displayed elevated whole blood reactive oxygen species levels and loss of NO release during heating, assessed by measuring local plasma nitrite variation. Moreover, plasma levels of EET regioisomers increased during heating in healthy subjects, did not change in hypertensive patients and decreased in diabetic patients. Correlation analysis showed in the overall population that the less NO and EETs bioavailability increases during heating, the more flow-mediated dilatation is reduced. The expression and activity of sEH, measured in isolated peripheral blood mononuclear cells, was elevated in diabetic but not hypertensive patients, leading to increased EETs conversion to DHETs. Finally, hyperglycemic and hyperinsulinemic euglycemic clamps induced a decrease in flow-mediated dilatation in healthy subjects and this was associated with an altered EETs release during heating.

Conclusions

These results demonstrate that an increased EETs degradation by sEH and altered NO bioavailability are associated with conduit artery endothelial dysfunction in type 2 diabetic patients independently from their hypertensive status. The hyperinsulinemic and hyperglycemic state in these patients may contribute to these alterations.

Trial registrationNCT02311075. Registered December 8, 2014.
Where do we stand? The availability and efficacy of diabetes related foot health programs for Aboriginal and Torres Strait Islander Australians: a systematic review
Authors: Chuter Vivienne , West Matthew , Hawke Fiona , Searle Angela
Published: March 2019

Background

Aboriginal and Torres Islander Australians experience considerably higher rates of diabetes and diabetes related foot complications and amputations than non‐Indigenous Australians. Therefore there is a need to identify aspects of Aboriginal and Torres Islander focussed foot health programs that have had successful outcomes in reducing diabetes related foot complications. Wider knowledge and implementation of these programs may help reduce the high burden of diabetes related foot disease experienced by Aboriginal and Torres Islander Australians.

Methods

PubMeD, Informit Indigenous collection, CINAHL, SCOPUS, the Cochrane Library and grey literature sources were searched to 28th August 2018. We included any published reports or studies of stand‐alone diabetes related foot care interventions, programs, services, educational resources or assessment of these interventions, designed for Aboriginal and Torres Strait Islander Australians.

Results

Thirteen studies detailing interventions in the Northern Territory, New South Wales, Queensland and Western Australia met the inclusion criteria. Five reports described delivery of podiatry services while the other eight investigated educational and training programs. Half of the reports related to aspects of the Indigenous Diabetic Foot program which provides culturally appropriate foot education and training workshops for health care providers. One article reported quantitative data related to clinical patient outcome measures.

Conclusions

No state‐ or nation‐wide foot health programs for prevention of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians were identified. One program achieved high adherence to the national guidelines regarding timing of podiatry review treatments through use of an evidence based foot risk classification tool and provision of services in a culturally appropriate centre.
Changes in treatment status of patients with severe mental illness in rural China, 1994–2015
Authors: Ran Mao-Sheng , Weng Xue , Liu Yu-Jun , Zhang Tian-Ming , Yu Yue-Hui , Peng Man-Man , Luo Wei , Hu Shi-Hui , Yang Xin , Liu Bo , Zhang Tin , Thornicroft Graham , Chan Cecilia Lai-Wan , Xiang Meng-Ze
Published: March 2019

Background

Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.

Aims

To explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI.

Method

Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China.

Results

Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status.

Conclusions

Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.

Declaration of interest

None.