bluuebunny/crossref_metadata_2025 huggingface dataset:
Heel-Rise Height Deficit 1 Year After Achilles Tendon Rupture Relates to Changes in Ankle Biomechanics 6 Years After Injury
Authors: Brorsson Annelie , Willy Richard W. , Tranberg Roy , Grävare Silbernagel Karin
Published: August 2017

Background:

It is unknown whether the height of a heel-rise performed in the single-leg standing heel-rise test 1 year after an Achilles tendon rupture (ATR) correlates with ankle biomechanics during walking, jogging, and jumping in the long-term.

Purpose:

To explore the differences in ankle biomechanics, tendon length, calf muscle recovery, and patient-reported outcomes at a mean of 6 years after ATR between 2 groups that, at 1-year follow-up, had less than 15% versus greater than 30% differences in heel-rise height.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Seventeen patients with less than 15% (<15% group) and 17 patients with greater than 30% (>30% group) side-to-side difference in heel-rise height at 1 year after ATR were evaluated at a mean (SD) 6.1 (2.0) years after their ATR. Ankle kinematics and kinetics were sampled via standard motion capture procedures during walking, jogging, and jumping. Patient-reported outcome was evaluated with Achilles tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and Foot and Ankle Outcome Score (FAOS). Tendon length was evaluated by ultrasonography. The Limb Symmetry Index (LSI = [Injured Side ÷ Healthy Side] × 100) was calculated for side differences.

Results:

The >30% group had significantly more deficits in ankle kinetics during all activities compared with patients in the <15% group at a mean of 6 years after ATR (LSI, 70%-149% and 84%-106%, respectively; P = .010-.024). The >30% group, compared with the <15% group, also had significantly lower values in heel-rise height (LSI, 72% and 95%, respectively; P < .001) and heel-rise work (LSI, 58% and 91%, respectively; P < .001) and significantly larger side-to-side difference in tendon length (114% and 106%, respectively; P = .012). Achilles tendon length correlated with ankle kinematic variables ( r = 0.38-0.44; P = .015-.027) whereas heel-rise work correlated with kinetic variables ( r = −0.57 to 0.56; P = .001-.047). LSI tendon length correlated negatively with LSI heel-rise height ( r = −0.41; P = .018). No differences were found between groups in patient-reported outcome ( P = .143-.852).

Conclusion:

Height obtained during the single-leg standing heel-rise test performed 1 year after ATR related to the long-term ability to regain normal ankle biomechanics. Minimizing tendon elongation and regaining heel-rise height may be important for the long-term recovery of ankle biomechanics, particularly during more demanding activities such as jumping.
Fish, politics and protectionism since c.1750: Introduction
Authors: Wilcox Martin
Published: August 2017

Fishing is a uniquely difficult industry for policymakers to deal with, throwing up complex and inherently international issues of access to, and conservation of, its resource base. It also generates more familiar problems of economic development support, especially in times of depression. This short introduction sketches out some of these issues, providing context for the Forum contributions which follow.
The Herring Enlightenment: Adam Smith and the reform of British fishing subsidies, 1783–1799
Authors: Rieser Alison
Published: August 2017

In late eighteenth-century Britain, Adam Smith was the most influential thinker to offer advice on fisheries policy. In The Wealth of Nations, Smith argued that subsidized, offshore fishing vessels were being built to catch subsidies, not fish. He argued that the tonnage bounties, intended to promote an export trade in herring, had instead raised local food prices and destroyed the Scottish small-boat fishery. This article describes the parliamentary inquiries this criticism joined, including whether public subsidies could help to build a British fishery at an appropriate scale. Speculating on the relative role of politics, geography and Enlightenment thinking in the parliamentary debate, it concludes that the herring itself made the public subsidies system succeed. The ‘Grand Shoal’ known in earlier decades reassembled along the Scottish coasts, and catches by vessels of all sizes increased dramatically. When, by 1799, British herring catches equalled the Dutch fishery at its peak, the ‘fickle’ herring made Adam Smith’s experiment in fish policy and politics a success.
Galleys in the Caribbean according to English travel accounts and images
Authors: Nakashima Roxana
Published: August 2017

The Spanish monarchy deployed Mediterranean galleys to protect its interests in the Caribbean in the final quarter of the sixteenth century. This article examines English travel accounts and various eyewitnesses’ visual representations of these oared vessels to provide, for the first time, the perspective of the aggressors who were challenging the experimental Spanish defence system. English accounts of struggles with galleys show how gunpowder weapons were changing the pattern of naval fighting, and highlight the inadequacies of Mediterranean oared vessels in their efforts to defend Caribbean coasts. The circulation of information in different publications of the time is analysed, while further lines of enquiry into images depicting these galleys are also identified.
Food justice, common heritage and the oceans: Resource narratives in the context of the Third United Nations Conference on the Law of the Sea
Authors: Sackel Johanna
Published: August 2017

The United Nations Conference on the Law of the Sea was an arena in which global resource equity was negotiated in a process that extended beyond the governmental actors who took centre stage. But our perceptions of the role of an increasingly civil society in framing national decision-making processes during the 1970s – for instance, through trade associations or nongovernmental organizations – is blurred. Both civil society and economic actors crafted similar policies, though for different purposes: some – with regard to the north–south divide – focused on the conservation of the ocean’s resources over the long term, whereas others were more concerned with short-term economic benefits. This article asks which arguments legitimized property and usage rights, and which resource narratives were used. By taking into account the charged relationship of local–national–global reaches, it also examines perceptions and management of resources in the context of resource equity on a global scale.
Brazilian manatees (re)discovered: Early modern accounts reflecting the overexploitation of aquatic resources and the emergence of conservation concerns
Authors: Vieira Nina , Brito Cristina
Published: August 2017

The relationship between indigenous people and manatees in Brazil dates back to prehistoric times. It has been the subject of interdisciplinary research by specialists in marine environmental history, ethnozoology and anthropology. Manatee species, Thrichechus inunguis and Thrichechus manatus, form part of the local culture and traditions of their distribution regions: subtropical and tropical regions, as well as the entire Amazon basin and its Atlantic range. The estimated number of manatees in Brazil when the Europeans first arrived was in the tens of thousands. But the several uses of this exotic, large and strange New World creature not only meant that it featured from early times in literature, folklore and mythology, but also led to hunting and therefore falling populations. We have collected information from documentary sources that referred to manatees. These derived mainly from the early modern era, and included travel books, letters from Portuguese and Spanish missionaries and explorers, chronicles, scientific treatises, illustrated broadsheets, leaflets and images in naturalists’ records, sailors’ reports, folklore sources, poetry and literature. Our main goal was to frame and discuss the first historical accounts of the human exploitation, uses and perceptions of manatees in the Americas. This facilitated analysis of the abundance and uses of manatees from the sixteenth century to this day, as well as discussion of conservation issues, which started to emerge during the mid-eighteenth century, around overexploited resources in colonial Brazil. In focusing on manatees, and other aquatic animals, we offer paradigmatic case studies of past ecosystems and the historical relationships between people and nature.
Dangers from the sea: Considerations of the 1900 Galveston hurricane
Authors: McElreath David H. , Doss Daniel Adrian , Jensen Carl , Lackey Hilliard , Jones Don W. , Wigginton Mike , Goza Rebecca
Published: August 2017

Within the context of homeland security, all organizations must acknowledge the potential of disasters when crafting strategy and pondering contingencies because any number of threats has the potential to disrupt business operations and continuity. Although numerous incidents have affected modern society, the 1900 Galveston hurricane remains the deadliest natural disaster in American history, even surpassing the death tolls of hurricanes Katrina and Sandy. This article examines the Galveston incident from the perspective of communications and the emergency management cycle. Insight is provided regarding the efforts of modern organizations to address possible threats and maintain continuity of operations.
Governor Nelson Dingley lives on: Maine, California, Norway and protectionism
Authors: Crocker Piers
Published: August 2017

This article examines, from Norwegian sources, the stormy relationship between the local American canned fish industry and the Norwegian producers – and American importers – of Norwegian canned fish, principally ‘sardines’ (sprats) and herring. American opposition took the form of protectionism, either as direct import duty, or by implied criticism of the Norwegian industry (use of child labour or ‘inexperienced’ producers, or claims of ‘dumping’ sub-standard goods on the US market). Opposition varied with the national and international politics and economics of the day, with Republicans and Democrats raising and reducing tariffs depending on the state (and complaints) of the local canning industries in Monterey and Maine. The Great Crash and resulting devaluation of foreign currencies against the dollar, and thereafter abandoning the gold standard, also played their part. The Dingley Tariff, the Payne–Aldrich Tariff Act, the Underwood Tariff, the Fordney–McCumber Tariff and GATT are treated in more detail. In the end, it was acknowledged that it was not a matter of competition, but of preferences for Norwegian sprat canned in olive oil, as opposed to American herring packed in cottonseed oil, and primarily marketed to Norwegian immigrants. In all, the issue lasted for over 70 years, ending in the words – to the Norwegian National Canneries Association – ‘ Congratulations unanimous win in tariff commission’.
Donor Milk or Formula: A Qualitative Study of Postpartum Mothers of Healthy Newborns
Authors: Kair Laura R. , Flaherman Valerie J.
Published: August 2017

Background:

Many breastfed infants receive supplemental feeds during the birth hospitalization, either by maternal request or due to medical indications. Donor milk from a certified milk bank has become increasingly available and is now used in some settings for term and late preterm infants. No studies have explored maternal opinions about donor milk and formula as options for supplementary feedings.

Research aim:

This study aimed to explore maternal perceptions about donor milk and formula supplementation and implications for continued breastfeeding.

Methods:

The authors conducted semistructured interviews with 30 postpartum mothers of healthy newborns who breastfed and gave supplementary feedings with pasteurized donor milk and/or formula during the birth hospitalization. They analyzed transcripts using the constant comparative method and identified four major themes.

Results:

Identified themes included the following: (a) Donor milk is seen as temporary whereas formula is seen as an ongoing plan, (b) formula is viewed as familiar whereas donor milk is viewed as unfamiliar, (c) donor milk is costly and challenging logistically, and (d) donor milk is “healthier.”

Conclusion:

For mothers who view donor milk as temporary and formula as permanent, the provision of donor milk rather than formula when supplementation is medically indicated may have the potential to promote the return to exclusive maternal breastfeeding. Barriers to the use of donor milk include cost and lack of familiarity and access.
Implementing Sustainability in Organizations: How Practitioners Discursively Position Work
Authors: Mitra Rahul , Buzzanell Patrice M.
Published: August 2017

Although largely espoused by contemporary organizations, implementing sustainability is often vague and ineffective. In contrast to most studies that employ resource-based or institutional perspectives to study sustainable organizing, we draw on discursive positioning theory to examine how sustainability practitioners make sense of and enact their work on the ground. Interviewing 45 practitioners and analyzing 35 curriculum vitae (CVs), we traced four subject positions – discovery, enlightenment, legitimacy, and consumption – constructed via 12 discursive resources. These positions emphasized 12 strategic messages, depending on participants’ work contexts. Findings also indicated four ways that politics shaped participants’ subject positions through government collaborations, regulatory environments, vested political agendas, and dominant sociopolitical discourses. We close by discussing some key theoretical and practical implications related to discursive positioning, the political implications of work practices, and sustainability policy making.
Spillover improved survival in non-invited patients of the colorectal cancer screening programme
Authors: Miettinen Joonas , Malila Nea , Hakama Matti , Pitkäniemi Janne
Published: August 2017

Objectives

In colorectal cancer screening, randomized clinical trials have shown a 16% mean reduction in colorectal cancer mortality, but the Finnish randomized health services study showed no effect. We quantified spillover (the total indirect effect caused by the programme on the non-invited) and corrected the effectiveness estimate of the Finnish programme.

Methods

We retrieved from the Finnish Cancer Registry data on all non-invited colorectal cancer patients diagnosed in 1999–2013 in municipalities that adopted screening ( n = 18,948). Patients were stratified by three 5-year diagnostic periods and two calendar periods of programme adoption in the municipality of residence. Follow-up ended on 31 December 2013. We measured the spillover effect in patient survival, based on differences of adjusted estimates of the colorectal cancer-related hazard of death between pairs of consecutive diagnostic periods.

Results

The spillover effect was estimated as 9 percentage points (95% confidence interval: −1 to 19 percentage points). It was 13 percentage points in men (−1 to 26 percentage points) and 5 percentage points in women (−9 to 20 percentage points). The corrected effect estimate of implementing screening in Finland was 5 percentage points.

Conclusions

The corrected Finnish effectiveness estimate was consistent with estimates from randomized trials. Indirect effects (spillover) bias the invitee–control contrast. In this case, spillover was an inherent benefit of the Finnish programme.
Regulating work in the gig economy: What are the options?
Authors: Stewart Andrew , Stanford Jim
Published: August 2017

Paid work associated with digital platform businesses (in taxi, delivery, maintenance and other functions) embodies features which complicate the application of traditional labour regulations and employment standards. This article reviews the extent of this type of work in Australia, and its main characteristics. It then considers the applicability of existing employment regulations to these ‘gig’ jobs, citing both Australian and international legislation and case law. There is considerable uncertainty regarding the scope of traditional regulations, minimum standards and remedies in the realm of irregular digitally mediated work. Regulators and policymakers should consider how to strengthen and expand the regulatory framework governing gig work. The article notes five major options in this regard: enforcement of existing laws; clarifying or expanding definitions of ‘employment’; creating a new category of ‘independent worker’; creating rights for ‘workers’, not employees; and reconsidering the concept of an ‘employer’. We review the pros and cons of these approaches and urge regulators to be creative and ambitious in better protecting the minimum standards and conditions of workers in these situations.
Evaluation of a PCR assay on overgrown individual fecal samples cultured for Mycobacterium avium subsp. paratuberculosis
Authors: Rangel Saray , Arango-Sabogal Juan C. , Labrecque Olivia , Paré Julie , Fairbrother Julie-Hélène , Buczinski Sébastien , Roy Jean-Philippe , Côté Geneviève , Wellemans Vincent , Fecteau Gilles
Published: August 2017

Microbial overgrowth can interfere with Mycobacterium avium subsp. paratuberculosis (MAP) growth and detection. We estimated the percentage of positive samples by PCR performed on the incubated media of individual fecal samples classified as non-interpretable (NI) by bacteriologic culture of liquid media. A total of 262 liquid cultures declared NI and 88 samples declared negative were included in the study. MAP DNA was detected in 7 NI samples (2.7%; 95% CI: 1.1–5.4%) and in 1 negative sample (1.1%; 95% CI: 0.3–6.2%). The PCR allowed the detection of MAP-positive samples that had been missed in the initial bacteriologic culture. However, the benefit of these few additional positive results must be weighed against the additional costs incurred. Using PCR to classify overgrown cultures optimizes the detection process and eliminates the NI outcome.
High Leptospira seroprevalence in captive and wild-caught vervet monkeys (Chlorocebus sabeus) on the Caribbean island of Saint Kitts
Authors: Rajeev Sreekumari , Conan Anne , Pratt Nicola , Beierschmitt Amy , Palmour Roberta
Published: August 2017

Leptospirosis is a zoonotic disease of global importance. Very little information is available on Leptospira infection in nonhuman primates. We report herein a high seroprevalence (49.4%; 95% confidence interval: 41.6–57.2%) to Leptospira serovars in vervet monkeys ( Chlorocebus sabeus) on the Caribbean island of Saint Kitts. Monkeys bred in captivity ( n = 81) had a significantly higher seroprevalence compared to wild-caught monkeys ( n = 81; p < 0.05). Seroprevalence to serovar Bataviae was significantly higher in monkeys bred in captivity and was higher to serovar Bratislava in wild-caught monkeys ( p < 0.05). Our data confirm that exposure to various Leptospira serovars and seroconversion occurs in wild and captive vervet monkeys on the Caribbean island of Saint Kitts. Further studies are warranted to better understand epidemiology, transmission, pathology, and possible reservoir status in this species.
Experimental study on the aeroelastic behavior of a typical airfoil section with superelastic shape memory alloy springs
Authors: Candido de Sousa Vagner , De Marqui Carlos
Published: August 2017

An experimental study on the aeroelastic behavior of a 2-degree-of-freedom typical airfoil section with superelastic shape memory alloy springs is reported. Shape memory alloy helical springs are included in the pitch degree-of-freedom of the typical section so that the effects of pseudoelastic hysteresis on the aeroelastic behavior of the system can be investigated. The experimental identification of the aeroelastic parameters is described. Wind tunnel tests are conducted for different shape memory alloy springs’ preload levels, airflow speeds, and initial conditions. It is shown that the linear unstable post-flutter behavior is transformed into stable limit cycle oscillations of acceptable amplitudes over a range of airflow speeds due to pseudoelastic hysteresis. Therefore, shape memory alloy springs can be effectively exploited to passively enhance the aeroelastic behavior of a typical section.
Stress and active control analysis of functionally graded piezoelectric material cylinder and disk under electro-thermo-mechanical loading
Authors: Parhizkar Yaghoobi Mohammad , Ghaffari Iman , Ghannad Mehdi
Published: August 2017

The purpose of this article is to investigate the active control behavior and stress analysis of functionally graded piezoelectric material circular hollow cylinder and disk under electro-thermo-mechanical loading. Also, this research presents a new compact formula for analysis of cylinder and disk that could be useful for engineers and designers to get insight into behavioral change of structures by geometry. The exact solutions of the functionally graded piezoelectric material structures could be found based on Lame’s solution. For a radially polarized cylinder and disk with continuously graded properties, it is assumed that material properties are varied by a power-law function, and inner surface and outer surface of these structures are considered to be sensor and actuator, respectively. Based on the exact solution, extensive numerical analyses are carried out to provide an insight into the effect of non-homogeneity constant and control factor on electro-thermo-mechanical behaviors and active control analysis of structures. The results show how the electro-thermo-mechanical behaviors change by non-homogeneity and control factor.
Association Between Body Mass Index and Cardiometabolic Risks Among Malay Obese Adults
Authors: Daud Azlina , Shahadan Siti Zuhaidah
Published: August 2017

Cardiometabolic risk (CMR) is a cluster of risk factors that may predict the occurrence of cardiovascular diseases and diabetes mellitus. This study investigated the association between CMR with body mass index (BMI) among obese adults. The CMRs, including waist circumference, systolic and diastolic blood pressure, blood glucose, total cholesterol, low-density and high-density lipoprotein, triglyceride, and high-sensitivity C-reactive protein (hs-CRP) level, were quantified in 82 obese adults. The findings indicate the highest correlation coefficient value ( r) was .618 between BMI and waist circumference; a weak correlation between mass index and systolic ( r = .276) and diastolic ( r = .311) blood pressure and hs-CRP ( r = .384); and a very weak correlation between BMI level and fasting blood glucose ( r = .069), total cholesterol ( r = .014), low-density lipoprotein (.013), high-density lipoprotein (−.154), and triglyceride (.173). Future strategies for CMR reduction among obese adults should focus on waist circumference and hs-CRP level.
Examining the Structure of the Career Adapt-Abilities Scale
Authors: Nye Christopher D. , Leong Frederick , Prasad Joshua , Gardner Danielle , Tien Hsiu-Lan Shelley
Published: August 2017

The Career Adapt-Abilities Scale (CAAS), a measure developed to evaluate an individual’s level of career adaptability, was initially validated as consisting of four factors (concern, control, curiosity, and confidence). The following study explores the structural validity of the CAAS when a fifth factor, cooperation, is included. Beyond examining the structural validity, we additionally conducted a cross-cultural validation of the five-factor model across American, Chinese, and Taiwanese samples. Our cross-cultural comparisons provided some support for the factorial equivalence of the five-factor Career Adapt-Abilities Scale (CAAS-5) in terms of the configural model. However, the results for the scalar model gave some indication of nonequivalence. Follow-up analyses showed that all items functioned similarly across groups, suggesting that small deviations in item functioning may have resulted in nonequivalence when aggregated to the scale level. Given the conceptual importance of cooperation’s inclusion, we contend that future research on career adaptability should explore the CAAS-5 further.
Analytical and experimental study of an ultrasonic horn with a bend angle
Authors: Xiping He , Haidao Zhang
Published: August 2017

An ultrasonic horn is a key component in power ultrasonic longitudinal vibration systems, and the most common horns are designed to allow vibration to travel along a single straight axis. However, change of the propagation direction is required in such applications as ultrasonic cleaning of the inner surface of a bent pipe, ultrasonic-assisted turning for a deep concave workpiece, and ultrasonic bone cutting devices. To address this requirement, this work proposes an angled horn comprising two uniform rods of finite length, which can be excited to resonate in longitudinal mode to change the propagation direction of a longitudinal vibration. Experimental comparison of the working frequencies of the designed and fabricated angled horns validated the effectiveness of the proposed design method. Experimental tests also showed that longitudinal vibration excited by a transducer along the axial direction was successfully transferred from the input end to the output end via the angled horn. Furthermore, the linear vibration characteristics of nine prototype vibration systems (composed of one transducer and nine angled horns) were obtained by measuring the vibration amplitudes induced by various excited voltages applied to the transducer.
Making moves: Transitioning R-EPOCH to the ambulatory setting
Authors: Martin Allison L , Frank Joel P , Waggoner Mindy L
Published: August 2017

Purpose

Ambulatory administration of chemotherapy provides benefit to patients and institutions alike. We hypothesized that transitioning rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (R-EPOCH) from an inpatient to ambulatory setting would reduce inpatient bed days and overall healthcare costs. The purpose of this effort was to create a guideline that would transition R-EPOCH to the ambulatory setting. To assess institutional benefit, we assessed inpatient bed days saved and financial impact.

Methods

A single center, retrospective analysis of inpatient R-EPOCH administration from January 2013 to December 2015 defined the need for medication use guidelines for ambulatory R-EPOCH administration. While this guideline targeted a reduction in inpatient bed days, it also created desired staff-and-patient education on R-EPOCH. Multidisciplinary collaboration enabled this comprehensive approach to outpatient chemotherapy administration.

Results

The 42 patients included received 147 cycles of R-EPOCH. Administration was primarily inpatient, amounting to 107 cycles and 799 inpatient days. Concurrently, 40 cycles of R-EPOCH were administered to 11 patients in the ambulatory setting. Only two patients received all cycles as outpatient; the other nine patients received chemotherapy in both settings. Financial analysis showed a 53% reduction in drug acquisition cost and 30% reduction in direct costs with ambulatory R-EPOCH administration. Based on our projection, after guideline implementation, 12 patients will be eligible for ambulatory R-EPOCH annually, resulting in a savings of 360 bed days and approximately $650,000 per year.

Conclusion

Transitioning R-EPOCH is a viable option to significantly decrease inpatient bed days and overall healthcare costs. Multidisciplinary collaboration is vital to successfully transitioning regimens to the ambulatory setting and to establishing consistent support for ambulatory administration.
Severe sunitinib-induced myelosuppression in a patient with a CYP 3A4 polymorphism
Authors: Patel Nirav D , Chakrabory Kanishka , Messmer Garrett , Krishnan Koyamangalath , Bossaer John B
Published: August 2017

Sunitinib, an oral vascular endothelial growth factor receptor, is a first-line option for metastatic renal cell carcinoma and widely used in clinical practice. Despite the proven benefit of sunitnib in metastatic renal cell carcinoma, patients may suffer from a variety of adverse events including hypertension, fatigue, hypothyroidism, hand–foot skin reactions, rash, depigmentation, and myelosuppression. Myelosuppression is usually mild, transient and resolves during the two weeks at the end of each cycle where no drug is taken. We present a case of severe and early grade 3 neutropenia and thrombocytopenia occurring two weeks into a six-week cycle. Because of the extreme nature of the toxicity, CYP 3A4 polymorphisms were explored. The patient was found to be heterozygous for CYP 3A4*22, at least partially explaining the early-onset and severity of myelosuppression. This pharmacogenetics information resulted in a rechallenge of dose-reduced sunitinib, which was well tolerated by the patient. The current state of pharmacogenomics concerning sunitinb is also presented, and the need for greater research in this area is highlighted.
The impact of adverse childhood experiences on health service use across the life course using a retrospective cohort study
Authors: Bellis Mark , Hughes Karen , Hardcastle Katie , Ashton Kathryn , Ford Kat , Quigg Zara , Davies Alisha
Published: August 2017

Objectives

The lifelong health impacts of adverse childhood experiences are increasingly being identified, including earlier and more frequent development of non-communicable disease. Our aim was to examine whether adverse childhood experiences are related to increased use of primary, emergency and in-patient care and at what ages such impact is apparent.

Methods

Household surveys were undertaken in 2015 with 7414 adults resident in Wales and England using random probability stratified sampling (age range 18–69 years). Nine adverse childhood experiences (covering childhood abuse and household stressors) and three types of health care use in the last 12 months were assessed: number of general practice (GP) visits, emergency department (ED) attendances and nights spent in hospital.

Results

Levels of use increased with increasing numbers of adverse childhood experiences experienced. Compared to those with no adverse childhood experiences, odds (±95% CIs) of frequent GP use (≥6 visits), any ED attendance or any overnight hospital stay were 2.34 (1.88–2.92), 2.32 (1.90–2.83) and 2.67 (2.06–3.47) in those with ≥ 4 adverse childhood experiences. Differences were independent of socio-economic measures of deprivation and other demographics. Higher health care use in those with ≥ 4 adverse childhood experiences (compared with no adverse childhood experiences) was evident at 18–29 years of age and continued through to 50–59 years. Demographically adjusted means for ED attendance rose from 12.2% of 18-29 year olds with no adverse childhood experiences to 28.8% of those with ≥ 4 adverse childhood experiences. At 60–69 years, only overnight hospital stay was significant (9.8% vs. 25.0%).

Conclusions

Along with the acute impacts of adverse childhood experiences on child health, a life course perspective provides a compelling case for investing in safe and nurturing childhoods. Disproportionate health expenditure in later life might be reduced through childhood interventions to prevent adverse childhood experiences.
Governing policy evaluation? Towards a new typology
Authors: Schoenefeld Jonas , Jordan Andrew
Published: August 2017

As policy evaluation matures, thoughts are turning to its governance. However, few scholars have combined insights from the evaluation and governance literatures to shed new light on this matter. In order to address this important gap, this article develops a new typology of ways to comprehend and perhaps ultimately govern ex-post policy evaluation activities. The article then explores its validity in the context of climate policy evaluation activities, a vibrant policy area in which the demand for and practices of evaluation have grown fast, particularly in Europe. The analysis reveals that the typology usefully guides new thinking, but also highlights important gaps in our empirical knowledge of the various modes of governing policy evaluation. The article identifies a need for a new research agenda that simultaneously develops a fuller understanding of these evaluation practices and the options for governing them.
Intersecting social-capital and perceived-efficacy perspectives to explain underperformance in community-based monitoring
Authors: Dewachter Sara , Holvoet Nathalie
Published: August 2017

While community-based monitoring is becoming increasingly commonplace, evidence as to its functioning remains inconsistent. Based on Ugandan village network and survey data, this article studies community-based monitoring from a social-capital and perceived-efficacy perspective. From a social-capital perspective, the prospects for community-based monitoring look promising as there is a high social-capital stock and an efficient information-sharing network galvanizing information for a few key individuals. The dominant efficacy profiles are also encouraging as there is an abundance of ‘followers’ (with high belief in collective capabilities) and some ‘leaders’ for collective action (with high belief in individual and collective capabilities). And yet, few community-based monitoring activities are undertaken. Our article shows that only the intersection of both theoretical lenses explains the underperformance in community-based monitoring, as those actors who are central in the information-sharing network do not have a ‘leadership’ efficacy profile while those who are ‘leaders’ are not central in the village information network.
Patterns of fixation during face recognition: Differences in autism across age
Authors: Fedor Jennifer , Lynn Andrew , Foran William , DiCicco-Bloom Jared , Luna Beatriz , O’Hearn Kirsten
Published: August 2017

Difficulties with face recognition increase from adolescence to adulthood in autism, reflecting a lack of typical late development. We examined whether this reflects differences in the development of patterns of fixation to eyes and mouths during face recognition. Children, adolescents, and adults (aged 7–30) with and without autism completed the Cambridge Face Memory Test while gaze was recorded. Average duration and number of fixations were calculated for eyes and mouth regions of interest, defined individually for each face image in the task. All groups and age groups made more and longer fixations to eyes than mouths. However, during face memorization, typically developing children and adults, but not adolescents, made more fixations to eyes than did their peers with autism. During face recognition, typically developing children and adults made shorter fixations on mouths than did their peers with autism; this pattern was reversed in adolescence, with adolescents with autism making more fixations to mouths than typically developing adolescents. Results suggest that group differences in patterns of fixations to faces change with age. Furthermore, different relationships between patterns of fixations and face recognition performance in typical development and autism suggest that these differences contribute, at least in part, to difficulties in autism.
Chinese speech intelligibility of children in noisy and reverberant environments
Authors: Peng Jianxin , Wu Shengju
Published: August 2017

Reverberation time and signal-to-noise ratio in classrooms are critical factors to speech intelligibility. In this study, the combined effect of reverberation time and signal-to-noise ratio on Chinese speech intelligibility of children was investigated in 28 elementary school classrooms in China. The results show that Chinese speech intelligibility scores increase with an increase of signal-to-noise ratio and the age of children, and decrease with an increase of reverberation time in classrooms. Younger children require higher signal-to-noise ratio and shorter reverberation time than older children to understand the speech. The A-weighted signal-to-noise ratio combined with a wide range of reverberation time can be used to predict speech intelligibility score and serve as a criterion for classroom design for elementary schools.
Identifying potential predictive indicators of massive transfusion in pediatric trauma
Authors: Hwu Ruth S , Keller Martin S , Spinella Philip C , Baker David , Shi Junxin , Leonard Julie C
Published: August 2017

Objective

Predictive scores were developed in adults to identify patients at risk for traumatic hemorrhage but have not been studied in children. Our objective was to identify clinical predictors of massive transfusion (≥40 ml/kg red blood cells or ≥80 ml/kg total blood product at 24 h) in injured children.

Methods

We conducted a retrospective case–control study of children <18 years old who presented from 2005 to 2014 for trauma care. Cases were children who received massive transfusion. Two control groups were identified: (1) ‘random’ and (2) matched for age and injury severity score (matched). Variables included vital signs, injury mechanism, active bleeding, and laboratory values. Multivariate logistic regression models to predict massive transfusion were developed using only clinical findings (‘pre-arrival’ model) and then also including laboratory values (emergency department model).

Results

Of 11,995 injured children, 44 received massive transfusion. We selected 132 random and 127 matched controls. Using random controls, the pre-arrival model included heart rate, Glasgow Coma Scale, temperature, and penetrating injury mechanism (AUC = 0.965). With matched controls, the pre-arrival model included Glasgow Coma Scale, penetrating injury, and active bleeding resulted (AUC = 0.812). The ED model using random controls included Glasgow Coma Scale, hemoglobin, and penetrating injury (AUC = 0.987). The emergency department model using matched controls included hemoglobin, temperature, prolonged partial thromboplastin time, and active bleeding on arrival (AUC = 0.734).

Conclusions

We identified predictive models for children who receive massive transfusion that rely on only clinical findings pre-arrival to the emergency department and then incorporate laboratory tests for those in the emergency department.
Radar-based structural health monitoring of wind turbine blades: The case of damage detection
Authors: Moll Jochen , Arnold Philip , Mälzer Moritz , Krozer Viktor , Pozdniakov Dimitry , Salman Rahmi , Rediske Stephan , Scholz Markus , Friedmann Herbert , Nuber Andreas
Published: August 2017

Structural health monitoring of wind turbine blades is challenging due to its large dimensions, as well as the complex and heterogeneous material system. In this article, we will introduce a radically new structural health monitoring approach that uses permanently installed radar sensors in the microwave and millimetre-wave frequency range for remote and in-service inspection of wind turbine blades. The radar sensor is placed at the tower of the wind turbine and irradiates the electromagnetic waves in the direction of the rotating blades. Experimental results for damage detection of complex structures will be presented in a laboratory environment for the case of a 10-mm-thick glass-fibre-reinforced plastic plate, as well as a real blade-tip sample.
Improving Patient Compliance With Post-EVAR Surveillance May Prevent Late Rupture
Authors: Skervin Alicia L. , Lim Chung S. , Sritharan Kaji
Published: August 2017

Endovascular aneurysm repair (EVAR) has gained increasing popularity in the treatment of infrarenal abdominal aortic aneurysm. Despite its favorable early outcomes, the long-term efficacy of EVAR remains a concern. Late rupture is the ultimate treatment failure and continues to complicate EVAR. Univariate and multivariate analyses have identified factors predictive of late rupture. The importance of EVAR surveillance to prevent late complications is equally widely acknowledged. This article aims to present our current understanding of the precipitating factors of late rupture after EVAR and explores whether the key to its prevention lies within improving patient factors, particularly compliance to follow-up appointments or whether physicians hold the solution.
Transcatheter Embolization of Cystic Artery Pseudoaneurysms Secondary to Acute Cholecystitis
Authors: Tapnio Richard H. , Kolber Marcin K. , Shukla Pratik A. , Berkowitz Eric
Published: August 2017

Cystic artery pseudoaneurysm is a rare entity most closely associated with trauma to the biliary vasculature (usually iatrogenic) or inflammation from adjacent cholecystitis. Most cases are treated intraoperatively during cholecystectomy. We describe 3 cases of cystic artery pseudoaneurysms secondary to acute cholecystitis, 2 with active hemobilia, treated with transcatheter embolization at our institution.
Malware modeling and experimentation through parameterized behavior
Authors: Celik Z. Berkay , McDaniel Patrick , Bowen Thomas
Published: August 2017

Experimentation is critical to understanding the malware operation and to evaluating potential defenses. However, constructing the controlled environments needed for this experimentation is both time-consuming and error-prone. In this study, we highlight several common mistakes made by researchers and conclude that existing evaluations of malware detection techniques often lack in both flexibility and transparency. For instance, we show that small variations in the malware’s behavioral parameters can have a significant impact on the evaluation results. These variations, if unexplored, may lead to overly optimistic conclusions and detection systems that are ineffective in practice. To overcome these issues, we propose a framework to model malware behavior and guide systematic parameter selection. We evaluate our framework using a synthetic botnet executed within the CyberVAN testbed. Our study is intended to foster critical evaluation of proposed detection techniques and stymie unintentionally erroneous experimentation.
Beyond equality: Providing equitable care for persons with disabilities
Authors: Wakeham Scott , Heung Sally , Lee Janet , Sadowski Cheryl A.
Published: August 2017

Background:

Almost 14% of Canadians have a disability, and older adults are most commonly affected. People living with disabilities have challenges accessing health care services, including medications and other services provided in pharmacies.

Methods:

A literature review was conducted regarding disability and pharmacy services. Resources regarding accessibility were also incorporated.

Results:

A number of organizations provide guidance on caring for those with disabilities. A primary concern for these vulnerable individuals relates to being invisible or overlooked by the health care system. There are also the stresses of physical, communication and attitudinal barriers. Pharmacists may be unaware of these barriers and may actually be contributing to them. To understand their patients’ accessibility needs, pharmacists can consider physical and nonphysical barriers and engage in education, advocacy and communications training to improve their patient-centred care for individuals with disabilities.

Discussion and Conclusion:

Pharmacists can improve the care of individuals with disabilities by learning more about accessibility. Within the community pharmacy environment, there are physical and nonphysical interventions that pharmacists can implement to ensure that patient-centred care is prioritized.
Activation of NLRP3 inflammasome in peripheral nerve contributes to paclitaxel-induced neuropathic pain
Authors: Jia Min , Wu Caihua , Gao Fang , Xiang Hongchun , Sun Ning , Peng Ping , Li Jingjing , Yuan Xiaocui , Li Hongping , Meng Xianfang , Tian Bo , Shi Jing , Li Man
Published: August 2017

Background

Paclitaxel is commonly used as a cancer chemotherapy drug that frequently causes peripheral neuropathic pain. Inflammasome is a multiprotein complex consisting of Nod-like receptor proteins (NLRPs), apoptosis-associated speck-like protein, and caspase-1, which functions to switch on the inflammatory process and the release of interleukin-1β. Growing evidences have supported that peripheral interleukin-1β is critical in enhancing paclitaxel-induced neuropathic pain. However, whether activation of NLRP3 inflammasome in peripheral nerve contributes to paclitaxel-induced neuropathic pain is still unclear.

Results

Paclitaxel induced mechanical allodynia of rats from day 3 and worsened gradually till 3 weeks after injection. Paclitaxel resulted in expression of NLRP3 and activated fragments of caspase-1 and interleukin-1β in L4-6 dorsal root ganglia and sciatic nerve three weeks after injection, indicating activation of NLRP3 inflammasome. The expression of NLRP3 was located in CD68-labeled macrophages infiltrating in L4-6 dorsal root ganglia and sciatic nerve, and paclitaxel increased the expression of NLRP3 in macrophage. Moreover, the paclitaxel elicited mitochondria damage, which became swollen and enlarged in macrophages and axons of sciatic nerve three weeks after injection. In vitro, paclitaxel increased the number of damaged mitochondria and mitochondrial reactive oxygen species production in the rat alveolar macrophage cell line NR8383. The administration of a non-specific reactive oxygen species scavenger, phenyl-N-tert-butylnitrone, markedly alleviated mechanical allodynia and inhibited the activation of NLRP3 inflammasome in L4-6 dorsal root ganglia and sciatic nerve of the paclitaxel-induced neuropathic pain model.

Conclusions

Paclitaxel induced mechanical allodynia and activation of NLRP3 inflammasome in infiltrated macrophages of L4-6 dorsal root ganglia and sciatic nerve. Paclitaxel elicited mitochondria damage and reactive oxygen species production may result in activation of NLRP3 inflammasome in peripheral nerve, which contributes to paclitaxel-induced neuropathic pain.