bluuebunny/crossref_metadata_2025 huggingface dataset:
Conjunctival bleb compression sutures: An effective method of addressing hypotony after trabeculectomy or trabeculectomy-related procedures
Authors: Yu Jonathan TS , Mercieca Karl , Au Leon
Published: June 2018

Purpose:

Over-filtration is a well-known complication of trabeculectomy and related procedures, especially with adjunctive antimetabolites. Secondary hypotony can result in reduced visual acuity and compromise long-term surgical success. Persistent hypotony requires intervention and we describe an effective adaptation of placing conjunctival compression sutures directly over the scleral flap.

Methods:

A retrospective consecutive case series of all patients who underwent conjunctival compression suturing from 2012 to 2014 at Manchester Royal Eye Hospital, UK. Under sub-tenon’s anaesthesia, two 9/0 nylon figure-of-eight transconjunctival sutures were placed horizontally across the bleb: the first over the anterior flap/ostium and the second over the posterior flap edge to reduce flow through the trabeculectomy flap.

Results:

A total of 10 patients underwent conjunctival compression suturing, and all patients had successful reversal of hypotony and symptom resolution within 1 week with corresponding clinical improvement. Intraocular pressure control was maintained without topical pressure-lowering agents in seven patients (median = 10 mmHg, range = 7–12 mmHg) with a median follow-up of 35.9 months (range = 11–61 months). Two patients required topical therapy to maintain intraocular pressure ≤ 14 mmHg and one patient’s hypotony returned after 10 months but remained untreated due to pre-existing poor vision. No patients required a return to theatre.

Conclusion:

This series demonstrates that conjunctival compression sutures can successfully provide long-term control of trabeculectomy-bleb-related hypotony. This technique offers an effective alternative for glaucoma surgeons in addressing post-trabeculectomy hypotony.
Is there an overlooked “window of opportunity” in MS exercise therapy? Perspectives for early MS rehabilitation
Authors: Riemenschneider Morten , Hvid Lars G , Stenager Egon , Dalgas Ulrik
Published: June 2018

While early medical treatment has proven effective in MS, early-phase MS rehabilitation has not gained much attention in MS research and clinical practice. Exercise therapy is one of the most promising treatment strategies in MS rehabilitation. Here, we provide a topical review investigating when exercise therapy is initiated in existing MS studies, showing that exercise is initiated at a rather late disease stage, where it predominantly serves as a symptomatic treatment. Recent findings in MS suggest that exercise may have neuroprotective and disease-modifying effects. Such findings along with the findings from medical trials that an early-stage “window of opportunity” exists leads to the proposal that early exercise therapy should be an increased focus in research and clinical practice for persons with MS. A further perspective relates to other rehabilitation interventions that are also initiated at a later disease stage, as these may also take advantage of an early-phase approach.
Influencing factors of residual drifts of precast segmental bridge columns with energy dissipation bars
Authors: Cai Zhong-Kui , Zhou Zheng , Wang Zhenyu
Published: June 2018

The energy dissipation bar has been proven to be an effective way to improve the lateral strength and the seismic capacity of the precast segmental bridge column. To date, however, investigations on how the main design parameters affect the residual drift of such bridge columns are quite limited. Focusing on this research gap, a novel numerical simulation method was proposed in this article to investigate the influencing factors of residual drift of precast segmental bridge columns with energy dissipation bars. First, the refined fiber element model was developed based on the OpenSees software package, considering the bond slip phenomenon at the column end and the boundary condition at the interface between the two adjacent segments. Then, the proposed numerical model was validated by comparing the simulated hysteretic behavior of the precast segmental bridge columns with available experimental data. After that, cyclic analyses were performed on 288 precast segmental bridge column models with different design parameters. Four important influencing factors were investigated, including the post-tensioning force, gravity load, energy dissipation bar ratio, and shear span ratio. According to the analysis results, some suggestions were provided for the practical design procedure of the energy dissipation bar reinforced precast segmental bridge columns.
Mortality, morbidity and follow-up after acute poisoning by substances of abuse: A prospective observational cohort study
Authors: Vallersnes Odd Martin , Jacobsen Dag , Ekeberg Øivind , Brekke Mette
Published: June 2018

Aims: Despite the excess mortality and morbidity associated with acute poisoning by substances of abuse, follow-up is frequently not organised. We assessed morbidity, including repeated poisoning, and follow-up after acute poisoning by substances of abuse through charting contacts with health services. We also charted short-term mortality. Methods: Patients 12 years and older treated for acute poisoning by substances of abuse at a primary care emergency outpatient clinic in Oslo, Norway, were included consecutively from October 2011 through September 2012. We retrieved information from national registers on fatalities, hospital admissions, and contacts at outpatient specialist health services and with general practitioners (GPs), during the 90 days following a poisoning episode. Results: We included 1731 patients treated for 2343 poisoning episodes. During the 90 days following the poisoning, 31% of the patients were treated at somatic hospitals, 9% admitted to psychiatric hospitals, 37% in treatment at outpatient psychiatric/addiction specialist health services, 55% saw their GP, while 34% had no follow-up. The short-term mortality rate was 2.0%, eight times higher than expected. Increasing age, suicidal intention, opioid poisoning, and severe mental illness were associated with increased risk of death. Increasing age, male gender, opioid poisoning, and severe mental illness were associated with repeated poisoning. Patients with increased risk of repeated poisoning were more likely to be in follow-up at outpatient specialist psychiatric/addiction services and in contact with their GP. Conclusions: Follow-up measures seem targeted to those most in need, though one out of three had none. The mortality rate calls for concern.
Ageing populations in the Nordic countries: Mortality and longevity from 1990 to 2014
Authors: Jørgensen Terese Sara Høj , Fors Stefan , Nilsson Charlotte Juul , Enroth Linda , Aaltonen Mari , Sundberg Louise , Brønnum-Hansen Henrik , Strand Bjørn Heine , Chang Milan , Jylhä Marja
Published: June 2018

Aims: Cross-country comparisons of mortality and longevity patterns of Nordic populations could contribute with novel insights into the compositional changes of these populations. We investigated three metrics of population ageing: the proportion of the population aged 75+ and 90+ years, the proportion of birth cohorts reaching 75 and 90 years, and life expectancy (LE) at age 75 and 90 years in Sweden, Norway, Iceland, Denmark and Finland, in the period 1990–2014. Methods: Demographic information was collected from national statistical databases and the Human Mortality Database. Results: All metrics on population ageing increased during the study period, but there were some cross-country variations. Finland experienced a notably steep increase in the proportion of 75+ and 90+ year olds compared to the other countries. Regarding the proportion reaching old ages, the Finnish lagged behind from the beginning, but females decreased this difference. The Danes were more similar to the other countries at the beginning, but did not experience the same increase over time. Gender-specific LE at age 75 and 90 years was similar overall in the five countries. Conclusions: Developments in cross-country variation suggest that survival until old age has become more similar for Finnish females and more different for Danish males and females compared with the other countries in recent decades. This provides perspectives on the potential to improve longevity in Denmark and Finland. Similarities in LE in old age suggest that expected mortality in old age has been more similar throughout the study period.
‘Good Morning Fitfam’: Top posts, hashtags and gender display on Instagram
Authors: Baker Stephanie Alice , Walsh Michael James
Published: June 2018

Social networking sites are important platforms for visual self-presentation online. This article investigates how content producers present their gender identities on the social networking site, Instagram. We draw upon and develop Goffman’s analytic framework to understand the self-presentation techniques and styles users employ online. Conducting a visual content analysis of clean eating–related top posts, we examine how users deploy clean eating hashtags and how the architecture of Instagram constrains and enables certain identities around shared lifestyles and commercial interests. Our findings reveal the symbolic significance of hashtags for group membership and the degree to which gender identities on Instagram are configured around platform interfaces.
Locked down apps versus the social media ecology: Why do young people and educators disagree on the best delivery platform for digital sexual health entertainment education?
Authors: McKee Alan , Albury Kath , Burgess Jean , Light Ben , Osman Kim , Walsh Anthony
Published: June 2018

This article reports on focus groups exploring the best way to reach young men with vulgar comedy videos that provide sexual health information. Young people reported that they found the means by which the material was presented – as a locked down app – to be problematic, and that it would better be delivered through social media platforms such as YouTube. This would make it more ‘spreadable’. By contrast, adult sex education stakeholders thought the material should be contained within a locked down, stand-alone app – otherwise it might be seen by children who are too young, and/or young people might misunderstand the messages. We argue that the difference in approach represented by these two sets of opinions represents a fundamental stumbling block for attempts to reach young people with digital sexual health materials, which can be understood through the prism of different cultural forms – education versus entertainment.
Questioning democratic notions of governance: A case study examining how a kindergarten teacher and her students give voice to and enact a neoliberal framing of schooling
Authors: Brown Christopher P , Englehardt Joanna , Barry David P , Ku Da Hei
Published: June 2018

An important factor that may be missing from recent attempts to counter, resist, and/or reconceptualize the neoliberal framing of the early education process is the actions of children, particularly those that reinforce the neoliberal assemblage of schooling they learn through their interactions with their teacher in school. This article begins to address this issue by employing Foucault’s conceptions of governmentality to examine how a teacher and students in a kindergarten classroom located in the USA give voice to and make choices that reflect the dominant neoliberal discourses of schooling. Such an analysis creates the opportunity to consider what needs to be done to assist both early educators and the children themselves so that they can live in the presence of each other within their neoliberal classrooms otherwise.
Providing quality early childhood professional development at the intersections of power, race, gender, and dis/ability
Authors: Black Felicia V
Published: June 2018

Quality professional development for a diverse early education and care workforce has been a priority in policy reform agendas. This issue points to the need to address quality professional development for this particular workforce, across varied childcare settings, which takes into consideration the complex experiences and intersecting social positions of these individuals. This colloquium reports on a case study of part-time childcare staff’s experiences as the researcher implemented an on-site professional development program at an area childcare center. Post-structural perspectives and Black feminist thought were utilized as epistemological and analytical tools to highlight how power discourse and the intersecting subject positions (gender, race, and dis/ability) of particular participants influenced both the implementation of and access to quality professional development within the given context.
Application of a zero-dimensional model to assess the effect of swirl on indicated efficiency
Authors: Broatch Alberto , Martín Jaime , García Antonio , Blanco-Cavero Diego , Warey Alok , Domenech Vicent
Published: June 2018

Increasing internal combustion engine efficiency continues being one of the main goals of engine research. To achieve this objective, different engine strategies are being developed continuously. However, the assessment of these techniques is not straightforward due to their influence on various intermediate phenomena inherent to the combustion process, which finally result in indicated efficiency trade-offs. During this work, a new methodology to assess these intermediate imperfections on gross indicated efficiency using a zero-dimensional model is developed. This methodology is applied to a swirl parametric study, where it has been concluded that the heat transfer and the rate of heat release are the single relevant changing phenomena. Results show that heat transfer always increases with swirl affecting negatively gross indicated efficiency (around −0.5%), while the impact of combustion velocity is not monotonous. It is enhanced up to a certain swirl ratio (it changes with engine speed) at low engine speed (resulting in an increment of +1.7% in gross indicated efficiency), but it is slowed down at high engine speed with the consequent worsening of gross indicated efficiency (−0.8%).
Dynamic degree-corrected blockmodels for social networks: A nonparametric approach
Authors: Tan Linda SL , Iorio Maria De
Published: June 2018

A nonparametric approach to the modelling of social networks using degree-corrected stochastic blockmodels is proposed. The model for static network consists of a stochastic blockmodel using a probit regression formulation, and popularity parameters are incorporated to account for degree heterogeneity. We specify a Dirichlet process prior to detect community structure as well as to induce clustering in the popularity parameters. This approach is flexible yet parsimonious as it allows the appropriate number of communities and popularity clusters to be determined automatically by the data. We further discuss and implement extensions of the static model to dynamic networks. In a Bayesian framework, we perform posterior inference through MCMC algorithms. The models are illustrated using several real-world benchmark social networks.
Repeated responses in misclassification binary regression: A Bayesian approach
Authors: Pires Magda Carvalho , Quinino Roberto da Costa
Published: June 2018

Binary regression models generally assume that the response variable is measured perfectly. However, in some situations, the outcome is subject to misclassification: a success may be erroneously classified as a failure or vice versa. Many methods, described in existing literature, have been developed to deal with misclassification, but we demonstrate that these methods may lead to serious inferential problems when only a single evaluation of the individual is taken. Thus, this study proposes to incorporate repeated and independent responses in misclassification binary regression models, considering the total number of successes obtained or even the simple majority classification. We use subjective prior distributions, as our conditional means prior, to evaluate and compare models. A data augmentation approach, Gibbs sampling, and Adaptive Rejection Metropolis Sampling are used for posterior inferences. Simulation studies suggested that repeated measures significantly improve the posterior estimates, in that these estimates are closer to those obtained in a case with no misclassifications with a lower standard deviation. Finally, we illustrate the usefulness of the new methodology with the analysis about defects in eyeglass lenses.
Nuclear penalized multinomial regression with an application to predicting at bat outcomes in baseball
Authors: Powers Scott , Hastie Trevor , Tibshirani Robert
Published: June 2018

We propose the nuclear norm penalty as an alternative to the ridge penalty for regularized multinomial regression. This convex relaxation of reduced-rank multinomial regression has the advantage of leveraging underlying structure among the response categories to make better predictions. We apply our method, nuclear penalized multinomial regression (NPMR), to Major League Baseball play-by-play data to predict outcome probabilities based on batter–pitcher matchups. The interpretation of the results meshes well with subject-area expertise and also suggests a novel understanding of what differentiates players.
Influence of segregation versus mixing: Intergroup contact and attitudes among White-British and Asian-British students in high schools in Oldham, England
Authors: Hewstone Miles , Ramiah Ananthi Al , Schmid Katharina , Floe Christina , Zalk Maarten van , Wölfer Ralf , New Rachel
Published: June 2018

We report findings from three longitudinal studies investigating the extent, quality and consequences of intergroup contact in schools between young Asian-British and White-British secondary (high-school) students. Results provide robust support for Allport’s ‘contact hypothesis’ in this setting. Specifically, mixing (vs segregation) in high schools does actually promote intergroup contact (although there is still resegregation), and contact improves attitudes and trust towards the outgroup. We conclude that faith schools, to the extent that they are segregated, deprive young people of the opportunity to mix across ethnic and religious lines during the school day; in the absence of positive contact in a safe setting, intergroup contact and especially cross-group friendships are restricted, and positive outgroup attitudes are thwarted.
Violence Against Women in Turkey: A Social Ecological Framework of Determinants and Prevention Strategies
Authors: Tekkas Kerman Kader , Betrus Patricia
Published: June 2018

Violence against women (VAW) in Turkey is concerning, and to develop and implement effective prevention strategies for addressing it, careful consideration must be given to the factors that influence it. In this review, we synthesized the body of literature on VAW in Turkey according to a social ecological framework, which is a theoretical model considering the complex interplay between individual, relationship, community, and societal factors. Consistent with this framework, we obtained research articles and commentaries in Turkish and English from a variety of national and international databases and websites regarding risk factors, cultural practices violating women’s rights, and trends and current practices, including prevention efforts. Our review revealed that factors influencing VAW are marriage at young age, lower education level, alcohol abuse, and childhood trauma or abuse history for individual level; having multiple partners, low relationship satisfaction, and forced marriage for relationship level; poverty, lack of social support, and lack of employment opportunities for community level; cultural acceptance of men’s superiority and dominance over women, acceptance of violence, cultural practices, and weak legal sanctions for societal level. Additionally, we reviewed multilevel prevention strategies in the extant literature on effective prevention and intervention efforts according to social ecological framework and proposed research, practice, and policy implications derived from this framework.
Feasibility and Preliminary Efficacy of a 10-Week Resistance and Aerobic Exercise Intervention During Neoadjuvant Chemoradiation Treatment in Rectal Cancer Patients
Authors: Singh Favil , Galvão Daniel A. , Newton Robert U. , Spry Nigel A. , Baker Michael K. , Taaffe Dennis R.
Published: June 2018

Background: Neoadjuvant chemoradiation treatment (CRT) in rectal cancer patients is associated with a reduction in physical capacity, lean mass and increased fatigue. As a countermeasure to these treatment-related adverse effects, we examined the feasibility and preliminary efficacy of a 10-week exercise program during CRT. Methods: Ten rectal cancer patients (7 men, aged 27-70 years, body mass index = 26.4 ± 3.8 kg/m2) receiving CRT undertook supervised resistance and aerobic exercise twice weekly. Assessments were undertaken pre- and post-intervention for upper and lower body muscle strength by 1-RM, muscle endurance, physical performance tests, body composition by dual X-ray absorptiometry, quality of life, and fatigue. Results: There was a significant loss in appendicular skeletal muscle (−1.1 kg, P = .012), and fat mass (−0.8 kg, P = .029) following CRT. Despite the loss in skeletal muscle, leg press ( P = .030) and leg extension ( P = .046) strength improved by 27.2% and 22.7%, respectively, and leg press endurance by 76.7% ( P = .007). Changes in strength were accompanied by improved performance ( P < .05) in 6-m fast walking speed (6.9%) and dynamic balance as determined by the 6-m backwards walk (15.5%). There was minimal change in quality of life and fatigue, and no adverse events related to training. Conclusions: Exercise during neoadjuvant CRT appears to be feasible and well tolerated in rectal cancer patients and may enhance physical function while minimizing adverse changes in body composition and cancer-related fatigue. These initial findings need to be confirmed in randomized controlled trials.
Perspective: Why Exercise Is Good and Its Lack Bad for Everything
Authors: Bortz Walter M.
Published: June 2018

Evidence of the central value of physical exercise in human health is rampant, yet the fundamental underlying explanation of this universal benefit evades comprehension. The first principles of this underlying effect are found within the laws of thermodynamics and are explicitly outlined within the metabolic field (Schrodinger) as presented herein. To understand the basic mechanism responsible for the universal positive benefits of exercise mandates that the first principle of energy flow be enunciated. “On the dry bones of atoms and the distribution of energy in the universe are assembled the flesh and blood of life” (Prigogine, 1984). The engine of metabolism requires the ready provision of the primal energy first evidenced at the Big Bang as described in The Big Picture.
A method of calculating the degree of freedom of foldable plate rigid origami with adjacency matrix
Authors: Yu Hongying , Guo Zhen , Wang Junru
Published: June 2018

The mechanism with good fold performance derived from rigid origami is widely used in the field of engineering. In this article, the adjacency matrix method was proposed to analyze the degree of freedom of foldable plate rigid origami. This method can also judge the number of redundant constraints while calculating the degree of freedom of the rigid origami. First, the adjacency matrix between vertices of origami structure was established. Then the elimination matrix was introduced, and the process of determining the motion state of vertices was described by matrix product. The degree of freedom of rigid origami was determined by calculating the number of constraints introduced. A method for judging redundant constraints of rigid origami was proposed, and the number of redundant constraints was determined by computing the sum of the row elements corresponding to the vertices. The motion state of the cross-crease vertex was analyzed, and the computational error of the degree of freedom at the cross-crease vertex was avoided by the method of classification and simplification. The degree of freedom of the ring pattern was discussed, and the calculation method of the degree of freedom of whole pattern with many ring patterns was summarized. Finally, the degree of freedom of typical rigid origami was analyzed.
Reference intervals for serum progastrin-releasing peptide in healthy Chinese adults with electrochemiluminescence immunoassay
Authors: Yang Yuanqing , Zheng Taiqing , Jiang Hongmin , Tang Aiguo , Xiang Zhongyuan
Published: June 2018

Background:

Reliable reference intervals for serum progastrin-releasing peptide (ProGRP) in healthy Chinese adults with electrochemiluminescence immunoassay (ECLIA) are still lacking in the Chinese population.

Objectives:

The study aims to establish reference intervals for ProGRP with ECLIA in apparently healthy Chinese adults.

Methods:

A total of 384 apparently healthy individuals from six representative geographical regions in China were enrolled: 200 males and 184 females with a mean age of 43.4±12.2 years, and an age range from 21 to 85 years. Serum ProGRP levels were analyzed on Cobas e601 automatic immunoassay analyzer with ECLIA. Reference intervals for serum ProGRP with ECLIA were determined following CLSI C28-A3 guidelines using a nonparametric method.

Results:

In an apparently healthy Chinese population, the reference intervals for serum ProGRP with ECLIA were ⩽53.92 ng/L for adults aged 21–70 years and ⩽75.69 ng/L for adults aged >70 years, respectively.

Conclusions:

The reference values for serum ProGRP with ECLIA in an apparently healthy Chinese population were established according to the CLSI C28-A3 document, providing a reference for the clinical work.
Long non-coding RNA PVT1 as a novel potential biomarker for predicting the prognosis of colorectal cancer
Authors: Fan Heng , Zhu Jian-hua , Yao Xue-qing
Published: June 2018

Background:

Long non-coding RNA (lncRNA) plays a very important role in the occurrence and development of various tumors, and is a potential biomarker for cancer diagnosis and prognosis. The purpose of this study was to investigate the relationship between the expression of lncRNA plasmacytoma variant translocation 1 (PVT1) and the prognostic significance in patients with colorectal cancer.

Methods:

The expression of PVT1 was measured by real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) in cancerous and adjacent tissues of 210 colorectal cancer patients. The disease-free survival and overall survival of colorectal cancer patients were evaluated by Kaplan–Meier analysis, and univariate and multivariate analysis were performed by Cox proportional-hazards model.

Results:

Our results revealed that PVT1 expression in cancer tissues of colorectal cancer was significantly higher than that of adjacent tissues ( P<0.001). High PVT1 expression was increased by 51.4% (108/210), which was significantly correlated with the tumor differentiation, the depth of invasion, the stage of tumor, node, metastasis (TNM), and lymphatic metastasis. The Kaplan–Meier analysis showed that high PVT1 expression resulted in a shorter disease-free survival (Log-rank test P<0.001) and overall survival (Log-rank test P<0.001) compared with the low PVT1 expression group in colorectal cancer patients, whether at TNM I/II stage or at TNM III/IV stage. A multivariate Cox regression analysis demonstrated that high PVT1 expression was an independent predictor of poor prognosis in colorectal cancer patients.

Conclusions:

Our results suggest that high PVT1 expression might be a potential biomarker for assessing tumor recurrence and prognosis in colorectal cancer patients.
Media, communication and the struggle for social progress
Authors: Couldry Nick , Rodriguez Clemencia , Bolin Göran , Cohen Julie , Volkmer Ingrid , Goggin Gerard , Kraidy Marwan , Iwabuchi Koichi , Qiu Jack Linchuan , Wasserman Herman , Zhao Yuezhi , Rincón Omar , Magallanes-Blanco Claudia , Thomas Pradip Ninan , Koltsova Olessia , Rakhmani Inaya , Lee Kwang-Suk
Published: June 2018

This article discusses the role of media and communications in contributing to social progress, as elaborated in a landmark international project – the International Panel on Social Progress. First, it analyses how media and digital platforms have contributed to global inequality by examining media access and infrastructure across world regions. Second, it looks at media governance and the different mechanisms of corporatized control over media platforms, algorithms and content. Third, the article examines how the democratization of media is a key element in the struggle for social justice. It argues that effective media access – in terms of distribution of media resources, even relations between spaces of connection and the design and operation of spaces that foster dialogue, free speech and respectful cultural exchange – is a core component of social progress.
How to change your memory of an object with a posture and a verb
Authors: Dutriaux Léo , Dahiez Xavière , Gyselinck Valérie
Published: June 2018

According to grounded cognition, the format of representation of knowledge is sensorimotor. This means that long-term memory shares processing resources with the sensorimotor system. The main objective of this work is to provide new evidence in favour of two claims from the embodied cognition framework: (1) memory is grounded on the sensorimotor system, that is, memory shares processing resources with the sensorimotor system, and (2) memory serves at least in part to support action. For this purpose, the present experiment aimed to show that the action context modulates the motor simulation and, consequently, the memory of manipulable objects. Participants were presented with short phrases comprising the name of a manipulable object, and an action verb (“To take a cup”) or an attentional verb (“To see a cup”). During this phase, they had to put their hands in front of them in the control condition, whereas they had to keep them behind their back in the interfering condition. A cued recall test followed after a short distractive letter-matching task, with the verbs serving as cues. Results showed that memory of the words denoting manipulable objects was impaired by the interfering posture when associated with an action verb, but not when associated with an attentional verb. This suggests that a context which does not favour action interferes with motor simulation and thus decreases the memory of manipulable objects. These results provide strong evidence for a grounded account of memory and language.
What interventions are performed in daily practice to prevent surgical site infections in neurosurgical patients? Findings from an explorative survey
Authors: Moreale Renzo , Doretto Mara , Maccherozzi Milena , Marangone Rosj , Noacco Massimo , Paiani Alex , Razzini Cristina , Rizzi Giulia , Romano Alessia , Sbrizzai Quinto , Simeoni Irene , Palese Alvisa
Published: June 2018

Aim

The primary aim of the study was to describe the perioperative care ensured on a daily basis to prevent surgical site infection in Italian neurosurgeries; the secondary aim was to explore surgical site infections 30 days after the surgical procedures.

Methods

Patients cared for in 16 neurosurgical units who (a) were ≥18 years of age, (b) underwent neurosurgical procedures, and (c) were willing to participate in the study were taken into account.

Results

A total of 383 patients were included. A preoperative shower was performed in 332 cases (86.7%), shaving in 318 (83%) cases, and antibiotic prophylaxis was administered in 293 (76.5%) cases. Surgical site disinfection was performed mainly with povidone–iodine (344; 89.8%). A surgical site dressing was applied in 376 (98.2%) cases and was changed on average after 37.8h for shaved and 39h for non-shaved patients. Postoperative shampooing was performed only in 74 (19.3%) cases. Surgical site infection at 30 days occurred in three (0.8%) patients. Discussion and conclusions: Perioperative care aimed at preventing surgical site infections is variable across Italian neurosurgical units. More studies aimed at developing evidence capable of supporting decision-making processes in neurosurgery care are strongly recommended.
Severe postoperative hemorrhage in a patient on dietary and herbal supplements
Authors: Wang Ling , Lanka Lavanya , Chen Dong , Pruthi Rajiv K.
Published: June 2018

We report a case of a patient with severe postoperative bleeding complication, secondary to dietary and herbal supplements induced platelet dysfunction. This case demonstrates the importance of preoperative assessment which includes questioning the patient with regards to their dietary and herbal supplements and of stressing the importance of discontinuing them prior to surgery.
Combined walking outcome measures identify clinically meaningful response to prolonged-release fampridine
Authors: Sola-Valls Núria , Blanco Yolanda , Sepúlveda María , Llufriu Sara , Martínez-Lapiscina Elena H. , Zubizarreta Irati , Pulido-Valdeolivas Irene , Montejo Carmen , Villoslada Pablo , Saiz Albert
Published: June 2018

Background:

Gait impairment is common in multiple sclerosis (MS) and negatively impacts patients’ health-related quality of life (HRQoL). Prolonged-release fampridine (PR-fam) improves walking speed, but it is unclear which walking measures are the most suitable for identifying treatment response. Our aim was to assess the effect of PR-fam and the outcome measures that best identify short- and long-term clinically meaningful response.

Methods:

We conducted a prospective study in 32 MS patients treated with PR-fam for a year. The assessments at 2 weeks, 3, 6 and 12 months included: timed 25-foot walk (T25FW), 6-minute walk test (6MWT), MS Walking Scale-12 (MSWS-12), a five-level version of the EuroQoL-5 dimensions, and accelerometry. PR-fam response was defined as an improvement in T25FW ⩾20%.

Results:

Twenty-five (78%) patients were considered responders after 2 weeks of PR-fam and improved significantly in all measures. Responders to T25FW and MSWS-12 ( n = 19) showed a significant improvement in HRQoL and accelerometer data compared with responders only to T25FW ( n = 6). At 1 year, 15/20 (75%) patients remained responders, but only those with permanent response to T25FW and MSWS-12 ( n = 8; 53%) showed a significant improvement in 6MWT and HRQoL.

Conclusion:

The combination of T25FW and MSWS-12 identify better those patients with a clinically significant benefit of PR-fam.
Successful use of extracorporeal cardiopulmonary membrane oxygenation in acute severe aortic regurgitation with cardiovascular collapse
Authors: Lu Anqi , Chew Sophia Tsong Huey
Published: June 2018

We report the case of a 55-year-old man who was transferred from an overseas institution with an initial impression of non-ST-elevation myocardial infarction (NSTEMI). Subsequent investigation found a severe aortic regurgitation (AR) complicated by acute ischemic hepatitis and acute renal injury, and the patient developed cardiopulmonary collapse with pulseless electrical activity perioperatively. Cardiopulmonary resuscitation was commenced immediately, venoarterial extracorporeal membrane oxygenation (ECMO) was immediately set up to bridge for emergency aortic-valve replacement surgery. The patient was subsequently weaned off ECMO and made a complete recovery. We demonstrate the successful use of ECMO for resuscitation in a patient with AR complicated by cardiovascular collapse.
Muscle-sparing pedicled transverse rectus abdominis myocutaneous flaps for breast reconstruction: Combining benefits of both worlds
Authors: Wu Yijun , Ho Samuel Yew Ming
Published: June 2018

Background:

Breast reconstruction plays a vital role in the restoration of form post-mastectomy. Autologous breast reconstructions using both free as well as pedicled flaps form the bulk of the breast reconstruction in our centre.

Objective:

This study seeks to evaluate the muscle-sparing modification of the pedicled transverse rectus abdominis myocutaneous (MS-TRAM) flaps against conventional transverse rectus abdominis myocutaneous (TRAM) flaps, in an attempt to marry the benefits of both and minimise the drawbacks of each technique.

Patients and methods:

A retrospective analysis of 20 women, 10 of whom had undergone unilateral immediate breast reconstruction with pedicled MS-TRAM flaps after skin-sparing mastectomy (MS group), and 10 who had undergone the conventional pedicled TRAM flap (control group) by the same surgeon (S. Ho) over a two-year period from 2013 to 2015 was performed. Patients’ records were reviewed, assessing patient demographics including age, smoking status and evaluating the operative time, time to ambulation, length of hospital stay, pain scores and abdominal bulge rates.

Results:

Mean operative time was not significantly longer in the MS group. Pain scores were lower in the MS group. The length of hospital stay was not significantly different between the two groups. Abdominal bulge rates at 24 months postoperatively were 0% in the MS group patients and 10% in the control group.

Conclusion

The pedicled MS-TRAM flap is an excellent breast reconstruction option that is comparable to the conventional TRAM flap. It preserves innervated muscle in the donor site that reduces time to ambulation and postoperative pain. It does not add significantly to surgical time and does not require microvascular anastomosis.
Relationship between body mass index, body image, and fear of negative evaluation: Moderating role of self-esteem
Authors: Ahadzadeh Ashraf Sadat , Rafik-Galea Shameem , Alavi Masoumeh , Amini Mansour
Published: June 2018

This study examined the correlation between body mass index as independent variable, and body image and fear of negative evaluation as dependent variables, as well as the moderating role of self-esteem in these correlations. A total of 318 Malaysian young adults were conveniently recruited to do the self-administered survey on the demographic characteristics body image, fear of negative evaluation, and self-esteem. Partial least squares structural equation modeling was used to test the research hypotheses. The results revealed that body mass index was negatively associated with body image, while no such correlation was found with fear of negative evaluation. Meanwhile, the negative correlation of body mass index with body image was stronger among those with lower self-esteem, while a positive association of body mass index with fear of negative evaluation was significant only among individuals with low self-esteem.
Immunizing Inefficient Field Frames for Mitigating Social Problems: The Institutional Work Behind the Technocratic Antidoping System
Authors: Meier Henk E. , Reinold Marcel
Published: June 2018

Although the heavily expanded technocratic doping test system has failed to detect the most spectacular cases of performance enhancement and to eradicate doping as social problem, it enjoys social fact quality. Research presented here argues that the taken-for-granted character of the technocratic test system represents a prime example of institutional work. The technocratic test system became institutionalized and maintained because the agendas of field actors converged around a field frame, enjoying cultural resonance and, at first, strong pragmatic viability. The specific methods of frame stabilization employed by actors interested in institutional maintenance served to stabilize unrealistic policy expectations. The article aims to support these ideas by analyzing the trajectory of antidoping in the International Olympic Committee (IOC) based on rich archival sources.
Epidemiological Dimensions of Social Anhedonia
Authors: Dodell-Feder David , Germine Laura
Published: June 2018

Social anhedonia (SA)—reduced drive for and pleasure from social interaction—is associated with social/emotional dysfunction and risk for psychopathology. However, our understanding of the factors that contribute to variation in SA remains limited. Here, we investigate the epidemiology of SA in an international population-based sample of more than 19,000 individuals who completed the Revised Social Anhedonia Scale through TestMyBrain.org . We find that SA exhibits considerable variation over the life span and is higher in males versus females, people of lower socioeconomic status, those of African ethnicity, nonmigrants, and people living in ethnically dense locations and less urban environments. Gender, socioeconomic status, and urbanicity were the only factors that captured unique variance in SA. These findings provide a framework for understanding how variation in epidemiological factors contribute to variation in elemental building blocks of psychopathology, and demonstrate the utility of using big data approaches toward the study of risk and Research Domain Criteria dimensions.
Surgical Correction of Spinopelvic Instability in Children With Caudal Regression Syndrome
Authors: Vissarionov Sergei , Schroder Josh E. , Kokushin Dmitrii , Murashko Vladislav , Belianchikov Sergei , Kaplan Leon
Published: June 2018

Study Design:

Retrospective cohort.

Objective:

To analyze the outcome of surgical correction of children with caudal regression syndrome.

Methods:

The study included 12 patients aged 1.5 to 9 years with caudal regression syndrome. In order determine the type of caudal regression, the Renshaw Classification was used. The surgery included correction and stabilization of the kyphotic deformity at the unstable lumbosacral region, with reconstruction of the sagittal balance using a bony block constructed from allograft. Short- and long-term outcomes were evaluated. The study was approved by the local institutional review board.

Results:

Children with types III and IV caudal regression syndrome underwent spinal-pelvic fusion, with 100% fusion rate, which allows sufficient stabilization of the lumbopelvic segment permitting patient mobilization and standing in type III patients. There were 5 complications needing additional care.

Conclusion:

Multilevel pedicular screw fixation in combination with spinopelvic fusion with cortical allografts allows reconstruction of the sagittal alignment with solid bony fusion improving the quality of life for these patients.
A Comparison of Two Ovine Lumbar Intervertebral Disc Injury Models for the Evaluation and Development of Novel Regenerative Therapies
Authors: Daly Chris D. , Ghosh Peter , Badal Tanya , Shimmon Ronald , Jenkin Graham , Oehme David , Cooper-White Justin , Sher Idrees , Chandra Ronil V. , Goldschlager Tony
Published: June 2018

Study Design:

Large animal research.

Objective:

Lumbar discectomy is the most commonly performed spinal surgical procedure. We investigated 2 large animal models of lumbar discectomy in order to study the regenerative capacity of mesenchymal stem cells following disc injury.

Methods:

Twelve adult ewes underwent baseline 3-T magnetic resonance imaging (MRI) followed by lumbar intervertebral disc injury by either drill bit (n = 6) or annulotomy and partial nucleotomy (APN) (n = 6). Necropsies were performed 6 months later. Lumbar spines underwent 3-T and 9.4-T MRI prior to histological, morphological and biochemical analysis.

Results:

Drill bit-injured (DBI) and APN-injured discs demonstrated increased Pfirrmann grades relative to uninjured controls ( P < .005), with no difference between the 2 models. Disc height index loss was greater in the APN group compared with the DBI group ( P < .005). Gross morphology injury scores were higher in APN than DBI discs ( P < .05) and both were higher than controls ( P < .005). Proteoglycan was reduced in the discs of both injury models relative to controls ( P < .005), but lower in the APN group ( P < .05). Total collagen of the APN group disc regions was higher than DBI and control discs ( P < .05). Histology revealed more matrix degeneration, vascular infiltration, and granulation in the APN model.

Conclusion:

Although both models produced disc degeneration, the APN model better replicated the pathobiology of human discs postdiscectomy. We therefore concluded that the APN model was a more appropriate model for the investigation of the regenerative capacity of mesenchymal stem cells administered postdiscectomy.
Clinical Outcomes After the Nonoperative Management of Lateral Patellar Dislocations: A Systematic Review
Authors: Moiz Munim , Smith Nick , Smith Toby O. , Chawla Amit , Thompson Peter , Metcalfe Andrew
Published: June 2018

Background:

The first-line treatment for patellar dislocations is often nonoperative and consists of physical therapy and immobilization techniques, with various adjuncts employed. However, the outcomes of nonoperative therapy are poorly described, and there is a lack of quality evidence to define the optimal intervention.

Purpose:

To perform a comprehensive review of the literature and assess the quality of studies presenting patient outcomes from nonoperative interventions for patellar dislocations.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

The MEDLINE, AMED, Embase, CINAHL, Cochrane Library, PEDro, and SPORTDiscus electronic databases were searched through July 2017 by 3 independent reviewers. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Study quality was assessed using the CONSORT (Consolidated Standards for Reporting Trials) criteria for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies and case series.

Results:

A total of 25 studies met our inclusion criteria, including 12 randomized controlled trials, 7 cohort studies, and 6 case series, consisting of 1066 patients. Studies were grouped according to 4 broad categories of nonoperative interventions based on immobilization, weightbearing status, quadriceps exercise type, and alternative therapies. The most commonly used outcome measure was the Kujala score, and the pooled redislocation rate was 31%.

Conclusion:

This systematic review found that patient-reported outcomes consistently improved after all methods of treatment but did not return to normal. Redislocation rates were high and close to the redislocation rates reported in natural history studies. There is a lack of quality evidence to advocate the use of any particular nonoperative technique for the treatment of patellar dislocations.