bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholecystocutaneous Fistula after Percutaneous Gallbladder Drainage
Authors: Pripotnev Stahs , Petrakos Andrew
Published: April 2014

Cases of cholecystocutaneous fistulas are now a rare occurrence as a result of rapid diagnosis and treatment. We present a case of cholecystocutaneous fistula developing after the removal of a percutaneous drain for the treatment of acute cholecystitis. Re-occurring infection and presence of gallstones led to fistulization of the gallbladder fundus and the development of a tract along the path created by the drain. The patient presented with re-occurring right upper quadrant abdominal pain, purulent discharge from the fistulous opening and expulsion of multiple gallstones. She underwent laparoscopic cholecystectomy and fistula excision.
Hacking Choreography: Dance and Live Coding
Authors: Sicchio Kate
Published: April 2014

This article explores the intersection of live coding and choreography, discussing the “practice as research” project Hacking Choreography. It examines the use of computer programming languages within dance scores, the creation of scores in real time, and the transparency of these scores to the audience during performance. Four pieces created by the author are discussed in terms of these elements and compared to live-coding practices for computer music. Through this, not only does live coding emerge as a performance practice related to sound or visuals, but it also continues its trajectory as a transdisciplinary approach to live performance events.
Human-Interpretable Feature Pattern Classification System Using Learning Classifier Systems
Authors: Ebadi Toktam , Kukenys Ignas , Browne Will N. , Zhang Mengjie
Published: April 2014

Image pattern classification is a challenging task due to the large search space of pixel data. Supervised and subsymbolic approaches have proven accurate in learning a problem’s classes. However, in the complex image recognition domain, there is a need for investigation of learning techniques that allow humans to interpret the learned rules in order to gain an insight about the problem. Learning classifier systems (LCSs) are a machine learning technique that have been minimally explored for image classification. This work has developed the feature pattern classification system (FPCS) framework by adopting Haar-like features from the image recognition domain for feature extraction. The FPCS integrates Haar-like features with XCS, which is an accuracy-based LCS. A major contribution of this work is that the developed framework is capable of producing human-interpretable rules. The FPCS system achieved 91 [Formula: see text] 1% accuracy on the unseen test set of the MNIST dataset. In addition, the FPCS is capable of autonomously adjusting the rotation angle in unaligned images. This rotation adjustment raised the accuracy of FPCS to 95%. Although the performance is competitive with equivalent approaches, this was not as accurate as subsymbolic approaches on this dataset. However, the benefit of the interpretability of rules produced by FPCS enabled us to identify the distribution of the learned angles—a normal distribution around [Formula: see text]—which would have been very difficult in subsymbolic approaches. The analyzable nature of FPCS is anticipated to be beneficial in domains such as speed sign recognition, where underlying reasoning and confidence of recognition needs to be human interpretable.
Review of the genera Hishimonus Ishihara and Litura Knight
(Hemiptera: Cicadellidae) from the Indian subcontinent
with description of new species
Authors: VIRAKTAMATH C. A. , MURTHY H. V. ANANTHA
Published: April 2014

This paper deals with 21 species of Hishimonus Ishihara and two species of Litura Knight from the Indian subcontinent. The following new species are described: Hishimonus acuminatus sp. nov. (India: Mizoram), H. distinctus sp. nov. (India: Karnataka, Kerala, Tamil Nadu. Sri Lanka), H. dwipae sp. nov. (Sri Lanka), H. longisetosus sp. nov. (India: Karnataka), H. spicans sp. nov. (India: Karnataka), H. thapai sp. nov. (Nepal), H. zeylanicus sp. nov. (Sri Lanka), and Litura triangula sp. nov. (India: Karnataka). Hishimonus versicolor Subba Rao & Ramakrishnan is removed from the genus Hishimonus and two new combinations namely, Hishimonus apricus (Melichar) comb. nov. (formerly in the genus Eutettix) and Litura tripunctatus (Li) comb. nov. (formerly in the genus Hishimonus) and a new name Hishimonus knightiella nom. nov. for Hishimonus apricus Knight 1970a, not Distant 1908 is proposed. H. gillespiei Dai, Fletcher & Zhang, H. pallidus Dai, Fletcher & Zhang, H. dividens Knight, H. aberrans Knight, H. concavus Knight, H. arcuatus Knight and Litura unda Knight are new records for India. All the taxa are described and new taxa are illustrated. Keys to identification of the species of Hishimonus and Litura found in the Indian subcontinent are also provided along with list of known host plants.
A new green anole lizard of the "Dactyloa" clade (Squamata: Dactyloidae) from the Magdalena river valley of Colombia
Authors: VELASCO JULIÁN A. , HURTADO-GÓMEZ JUAN PABLO
Published: April 2014

We describe a new species of Anolis from the Magdalena river valley in Colombia. The new species is morphologically similar to Anolis ibanezi and A. chocorum, but differs in body and dewlap color, and head scalation. We performed an exploratory multivariate analysis based on 15 morphological characteristics of the new species and A chocorum and found that differences between both species are mainly associated with head dimensions. A phylogenetic analysis based on morphological characters suggests that the new species is nested within the "Dactyloa" clade of Anolis. Finally, we discuss phylogenetic relationships and biogeographical affinities based in its distribution.
Impact of the Middle and Upper Tropospheric Cooling over Central Asia on the Summer Rainfall in the Tarim Basin, China
Authors: Zhao Yong , Huang Anning , Zhou Yang , Huang Danqing , Yang Qing , Ma Yufen , Li Man , Wei Gang
Published: April 2014

The changes in summer rainfall over the Tarim Basin, China, and the underlying mechanisms have been investigated using the observed rainfall data at 34 stations and the NCEP–NCAR reanalysis data during the period of 1961–2007. Results show that the summer rainfall over the Tarim Basin, which exhibits a significant increasing trend during the last half century, is closely related to the summer middle and upper tropospheric cooling over central Asia. Mechanism analysis indicates that the middle and upper tropospheric cooling over central Asia results in a location farther south of the subtropical westerly jet over western and central Asia with anomalous southerly wind at lower levels and ascending motion prevailing over the Tarim Basin. Such anomalies in the atmospheric circulations provide favorable conditions for the enhanced summer rainfall over the Tarim Basin. Further analysis suggests that the weakened South Asian summer monsoon (SASM) could be potentially responsible for the middle and upper tropospheric cooling over central Asia. This is largely through the atmospheric responses to the diabatic heating effect of the SASM. A weakened SASM can result in an anomalous cyclone in the middle and upper troposphere over central Asia. The western part of the anomalous cyclone produces more cold air advection, which leads to the cooling. This study suggests indirect but important effects of the SASM on the summer rainfall over the Tarim Basin.
Near-Inertial Mixing in the Central Arctic Ocean
Authors: Fer Ilker
Published: April 2014

Observations were made in April 2007 of horizontal currents, hydrography, and shear microstructure in the upper 500 m from a drifting ice camp in the central Arctic Ocean. An approximately 4-day-long time series, collected about 10 days after a storm event, shows enhanced near-inertial oscillations in the first half of the measurement period with comparable upward- and downward-propagating energy. Rough estimates of wind work and near-inertial flux imply that the waves were likely generated by the previous storm. The near-inertial frequency band is associated with dominant clockwise rotation in time of the horizontal currents and enhanced dissipation rates of turbulent kinetic energy. The vertical profile of dissipation rate shows elevated values in the pycnocline between the relatively turbulent underice boundary layer and the deeper quiescent water column. Dissipation averaged in the pycnocline is near-inertially modulated, and its magnitude decays approximately at a rate implied by the reduction of energy over time. Observations suggest that near-inertial energy and internal wave–induced mixing play a significant role in vertical mixing in the Arctic Ocean.
A Direct Latent Variable Modeling Based Method for Point and Interval Estimation of Coefficient Alpha
Authors: Raykov Tenko , Marcoulides George A.
Published: April 2014

A direct approach to point and interval estimation of Cronbach’s coefficient alpha for multiple component measuring instruments is outlined. The procedure is based on a latent variable modeling application with widely circulated software. As a by-product, using sample data the method permits ascertaining whether the population discrepancy between alpha and the composite reliability coefficient may be practically negligible for a given empirical setting. The outlined approach is illustrated with numerical data.
Diffusion Reflection
Authors: Fixler D. , Ankri R. , Kaplan I. , Novikov I. , Hirshberg A.
Published: April 2014

Intraoperative detection of residual disease in oral cancer may reduce the high rate of recurrences. The aim of the present study was to evaluate the detection sensitivity of diffusion reflection (DR) measurements of bioconjugated gold nanorods (GNRs) to cancerous sites in a rat model of oral squamous cell carcinoma. We used hyperspectral spectroscopy and DR measurements of GNRs bioconjugated to slide specimens of rat tongues where squamous carcinoma was induced by 4NQO (4-nitroquinoline-N-oxide). Wistar-derived male rats were used: 6 were sacrificed at wk 32 to 37 following 4NQO administration (experimental rats), as were 2 control rats at wk 32 and 36. The detection results were compared with histopathology: 19 sites of cancerous changes were identified microscopically (11 invasive cancer and 8 carcinoma in situ [CIS]). The GNRs attached selectively to areas of carcinomatous changes with an intensity exceeding 17 intensity units at 780 nm (overall specificity, 97%; overall sensitivity, 87%) when the hyperspectral spectroscopy system was used. The resulting DR slopes of the reflected intensity showed an increase of >80% in areas of invasive cancer and an increase of >30% in the CIS sites. The resulting intensity units of the hyperspectral spectroscopy system in the invasive cancer significantly exceed those of the CIS ( t test, p = .0002; Mann-Whitney, p = .0024). The results demonstrate a great potential of the direct DR scanning as a new and simple tool for detecting residual disease intraoperatively.
The Impact of Nocturnal Hypoglycemia on Clinical and Cost-Related Issues in Patients With Type 1 and Type 2 Diabetes
Authors: Edelman Steven V. , Blose Jamie S.
Published: April 2014

Purpose

This article provides an overview of the clinical and economic issues associated with hypoglycemia in patients with type 1 and type 2 diabetes mellitus. Current research regarding hypoglycemia is comprehensively reviewed, with special emphasis on nocturnal hypoglycemia, as almost 50% of all severe hypoglycemic episodes occur at nighttime during sleep. Current findings on the economic and human burden of hypoglycemia are presented.

Conclusions

Poor diabetes self-management leads to an increased risk for hypoglycemia and the development of long-term complications associated with poor glycemic control. Hypoglycemia is also associated with increased health care costs and resources required to treat hypoglycemic events, as well as personal financial costs and loss of productivity at school or work. In addition, fear, anxiety, and worry about hypoglycemic episodes are shown to interfere with patients’ quality of life. Nocturnal hypoglycemia can cause a number of immediate clinical consequences, including convulsions, coma, and even death. Repeated long-term exposure to nocturnal hypoglycemia can blunt counterregulatory mechanisms that maintain glucose levels, leading to reduced cognitive function, impaired awareness of hypoglycemia, and hypoglycemia-associated autonomic failure. Clinicians must be aware of the impact of hypoglycemia, particularly nocturnal hypoglycemia, so that they can prescribe appropriate glucose-lowering therapy and educate patients about the prevention and management of hypoglycemic events to reduce anxiety and improve quality of life.
Numerical and policy representation on the international stage: Women foreign policy leaders in Western industrialised systems
Authors: Bashevkin Sylvia
Published: April 2014

This article presents initial findings from one of the first comparative studies of women as foreign policy decision-makers in Western industrial systems. It begins with an overview of why political leaders matter to the conduct of contemporary international relations and what the existing literature tells us about women’s engagement in that domain. Next, we develop five propositions based on previous research, and evaluate them using longitudinal data from 10 established democratic systems. Analysing the public statements of appointees in the three countries with the most female elites, we report that women decision-makers were more likely to express pro-feminist rhetoric than the men who preceded or succeeded them; moreover, the most vocal pro-equality elites came from left-of-centre political backgrounds, and often had pre-recruitment experience in progressive parties or social movements. The discussion concludes with a brief look at promising directions for future research.
Lazzarato and the Micro-Politics of Invention
Authors: Muldoon James
Published: April 2014

Drawing from the writings of Deleuze and Foucault, various forms of political vitalism have emerged as one of the most dominant approaches to radical politics today. However, there has been considerable disagreement over the terms on which a debate over vitalism’s perceived utility should be carried out. This has allowed for a great confusion over what is at stake in the vitalist controversy. This article argues that an analysis of the most recent works of Maurizio Lazzarato, one of the most prominent contemporary political vitalists, assists in clarifying the terms of the debate and provides a rebuttal of several of the most common criticisms of political vitalist thought. Through his engagement with the work of French sociologist Gabriel Tarde, Lazzarato has developed a distinct variety of neo-monadology that analyses the world in terms of micro-psychic forces. On the basis of this ontology, Lazzarato constructs a politics of multiplicity consisting of open strategies of experimentation and creation, which he argues offers the best form of resistance to neo-liberal capitalism. It is argued that Lazzarato is able to provide an answer to the three common charges that vitalism is a mysticism, suffers from a lack of normative foundations, and has an incoherent political programme. The article concludes with a reflection on the extent to which political vitalism is still haunted by a failure to give an account of and come to terms with the role of negativity in politics.
Anti-Semitism and Islamophobia: Spectropolitics and Immigration
Authors: Romeyn Esther
Published: April 2014

In the context of the Dutch immigration debate, tributes to the Holocaust and the memory of Europe’s dead Jews increasingly serve to dismantle multiculturalism as a failed paradigm and to drive a wedge between a revitalized, redeemed, color-blind, post-racial Europe and disenfranchized immigrant, minority and Muslim populations. Embedded in these invocations of the Holocaust and its moral imperatives is a ‘spectropolitics’ of tolerance, in which tolerance, staged as an essential touchstone of Dutch identity, supplies a differential norm that measures the civilizational and racial disjuncture between Europeans, minorities, and Muslims, and validates the new dual paradigm of Dutch citizenship and immigration policy: securitization and disciplinary integration. The centrality of the Holocaust as paradigmatic of Dutch and European racial history meanwhile sidelines the colonial past as constitutive of European identity; displaces an alternative understanding of race as (bio- and necro-political) instruments of colonial rule; and disavows the continued application of these instruments of racial rule in Dutch and European post-colonial societies.
Sample Size and Power When Designing a Randomized Trial for the Estimation of Treatment, Selection, and Preference Effects
Authors: Turner Robin M. , Walter Stephen D. , Macaskill Petra , McCaffery Kirsten J. , Irwig Les
Published: April 2014

Background. A 2-stage randomized trial design, incorporating participant choice, provides unbiased estimates of the effects of the treatment or intervention (treatment effect), the difference between outcomes for participants who prefer one treatment compared with another (selection effect), and the interaction between participants’ preferences for treatment and the treatment actually received (preference effect). It is important to ensure that such trials are adequately powered to estimate these effects. Sample Size Formulas. This paper presents methods for determining the required sample sizes for estimating treatment, selection, and preference effects. We demonstrate the changes in sample size as various key parameters are changed. In general, approximately twice as many participants (in total) are needed to have equivalent power for detecting both treatment and selection/preference effects compared with a trial of the treatment effect alone. Primary Screening Example. We illustrate their application for the design of a primary screening trial comparing human papillomavirus DNA testing versus cervical screening (by Pap smear). Our example would require 520 participants to have 80% power to detect moderate-sized preference and selection effects and a small to moderate treatment effect. Conclusions. With the growing interest in understanding treatment choices and with the use of decision aids, well-designed and adequately powered 2-stage randomized trial designs offer the opportunity to determine the effects of participants’ preferences. Our sample size formulas will help future studies ensure that they have adequate power to detect selection and preference effects.
Selective inhibition of meningeal nociceptors by botulinum neurotoxin type A: Therapeutic implications for migraine and other pains
Authors: Burstein Rami , Zhang XiChun , Levy Dan , Aoki K Roger , Brin Mitchell F
Published: April 2014

Background

Meningeal and other trigeminal nociceptors are thought to play important roles in the initiation of migraine headache. Currently, the only approved peripherally administered chronic migraine prophylactic drug is onabotulinumtoxinA. The purpose of this study was to determine how botulinum neurotoxin type A (BoNT-A) affects naïve and sensitized meningeal nociceptors.

Material and methods

Using electrophysiological techniques, we identified 43 C- and 36 Aδ-meningeal nociceptors, and measured their spontaneous and evoked firing before and after BoNT-A administration to intracranial dura and extracranial suture-receptive fields.

Results

As a rule, BoNT-A inhibited C- but not Aδ-meningeal nociceptors. When applied to nonsensitized C-units, BoNT-A inhibited responses to mechanical stimulation of the dura with suprathreshold forces. When applied to sensitized units, BoNT-A reversed mechanical hypersensitivity. When applied before sensitization, BoNT-A prevented development of mechanical hypersensitivity. When applied extracranially to suture branches of intracranial meningeal nociceptors, BoNT-A inhibited the mechanical responsiveness of the suture branch but not dural axon. In contrast, BoNT-A did not inhibit C-unit responses to mechanical stimulation of the dura with threshold forces, or their spontaneous activity.

Discussion

The study provides evidence for the ability of BoNT-A to inhibit mechanical nociception in peripheral trigeminovascular neurons. These findings suggest that BoNT-A interferes with neuronal surface expression of high-threshold mechanosensitive ion channels linked preferentially to mechanical pain by preventing their fusion into the nerve terminal membrane.
“Do you think your main partner has other sex partners?” A simple question provides insight into sexual risk in Jamaica
Authors: Weir Sharon S , Figueroa J Peter , Byfield Lovette L , Scott Marion A , Hobbs Marcia M , Edwards Jessie E , Duncan Jacqueline P
Published: April 2014

To estimate the association between a simple measure of sexual partner concurrency and sexually transmitted infection (STI) we conducted a cross-sectional population-based household survey ( n = 1795) and targeted surveys of people at venues where people meet sexual partners ( n = 1580) to ask about sexual behaviour. Persons interviewed at venues were tested for HIV, gonorrhoea, chlamydia, and trichomoniasis. We compared the association between STI and reporting a partner had other partners. More women than men reported their main partner had other partners. Thirteen percent of all women in the population-based survey and 14.4% in the targeted survey reported having one partner in the past 12 months and that partner had additional partners. STI prevalence was significantly associated with reporting a partner had other partners (36.8% vs. 30.2%; prevalence ratio [PR] 1.2; 95% confidence interval [CI] 1.1, 1.4). Construction of complete sexual networks is costly and not routinely feasible. We recommend adding a question to cross-sectional surveys used to monitor sexual behaviour about whether the respondent believes his or her partner has other sexual partners. Although subject to bias, the question was useful in Jamaica to identify a group of women with only one sexual partner at increased risk of infection.
Supporting Child Victims of Sexual Abuse
Authors: Foster Jennifer M.
Published: April 2014

Families who present for counseling to address child sexual abuse (CSA) benefit from interventions that are evidence-based and meet children’s developmental needs. Trauma-focused cognitive behavioral therapy (TF-CBT) is an empirically supported approach that is structured to include parents or caregivers in parent-only sessions and a family component. This article reviews the CSA literature as it relates to families, provides an overview of TF-CBT and the trauma narrative intervention, and discusses preparation for and implementation of the narrative family session which is illustrated by a case study.
Intimate Partner Violence Typology and Treatment
Authors: Stare Bryan G. , Fernando Delini M.
Published: April 2014

Intimate partner violence (IPV) is a significant problem in society today. Many approaches have been taken to address the issue and treat the individual or couple. Gottman et al. published groundbreaking research aimed at classifying batterers based on heart rate reactivity. Their finding, that batterers may differ in type, is part of a wealth of recent research leading toward more effective treatment of IPV. Researchers have recently brought about many considerations to the way IPV can be classified and effectively treated by mental health professionals. The purpose of this article is to follow the developments of Gottman and others, as IPV research and treatment has grown over the past 17 years.
Post-Error Slowing in Patients With ADHD
Authors: Balogh Lívia , Czobor Pál
Published: April 2014

Objective: Post-error slowing (PES) is a cognitive mechanism for adaptive responses to reduce the probability of error in subsequent trials after error. To date, no meta-analytic summary of individual studies has been conducted to assess whether ADHD patients differ from controls in PES. Method: We identified 15 relevant publications, reporting 26 pairs of comparisons (ADHD, n = 1,053; healthy control, n = 614). Random-effect meta-analysis was used to determine the statistical effect size (ES) for PES. Results: PES was diminished in the ADHD group as compared with controls, with an ES in the medium range (Cohen’s d = 0.42). Significant group difference was observed in relation to the inter-stimulus interval (ISI): While healthy participants slowed down after an error during long (3,500 ms) compared with short ISIs (1,500 ms), ADHD participants sustained or even increased their speed. Conclusion: The pronounced group difference suggests that PES may be considered as a behavioral indicator for differentiating ADHD patients from healthy participants.
Tribological properties of phenolic resin bonded abrasive tools filled with two inclusion complexes of β-cyclodextrin and sulfur-containing additives
Authors: Guan JJ , Xu XF , Peng W
Published: April 2014

In this work, three kinds of phenolic resin bonded abrasive tool specimens containing β-cyclodextrin or its two complexes with dialkyl pentasulfide and sulfurized isobutylene at different contents were prepared by a cold compression method, respectively. The tribological properties of these abrasive tool specimens at different speeds and loads were investigated under water lubrication. The results indicated that filling of the complexes could improve the friction and wear performance of the abrasive tools. The minimum friction coefficient and wear rate were obtained when the content of the filler was about 15–20 wt.%. The friction coefficient of the abrasive tool decreased with the increase of speed and load, while the wear rate showed a reverse trend. X-ray photoelectron spectroscopy (XPS) analysis was employed to investigate the self-lubricating mechanism of the abrasive tool. It was found that the additives were released along with the decomposition of the complexes. The enhanced tribological properties of these abrasive tools were believed to stem from the formation of a self-lubricating layer that constituted by sulfide film and carbon deposited film, which had significant influence on the phenolic resin transfer process from substrate to the counter steel surface, and also had functions of anti-friction, anti-wear, and an improvement of surface quality.
Ecotourism
Authors: Litvin Stephen W , Chiam Michael KM
Published: April 2014

This research revisits an ecotourism-related article published in the early days of the Journal of Vacation Marketing. That study found its test population, Singaporean youth, to be generally disinterested ecotourism consumers. This replication, done a generation later, had findings consistent with the earlier work. However, by adding a second sample of Singaporean adults to the current study, the conclusion was reached that the purchase of ecotourism vacation products is likely more related to consumer life cycle than cohort. The findings apply to Singapore but can be considered for ecotourism providers and marketers wherever the product is promoted.
Occupied bed days a redundant currency? An evaluation of the first 10 years of an integrated model of care for mentally ill adolescents
Authors: Adrian Nicolette , Smith Jared G
Published: April 2014

Background:

We report on clinical outcomes from the first 10 years of operation of an Adolescent Assertive Outreach Team (AAOT) which forms part of an integrated Tier 4 service offering inpatient, day-patient and intensive community treatment.

Method:

Prospective data were recorded at pre- and post-treatment for patients accepted for treatment by the AAOT over a 10-year period.

Results:

A total of 393 adolescents were treated by the AAOT, and 135 received some hospital care as part of their treatment. Contact periods with the team were significantly shorter for those treated wholly in the community. Outcome measures indicated severe pathology at onset with substantial improvement in function regardless of whether treatment involved hospital care or community support only.

Conclusions:

Adolescent Outreach is a viable and sustainable alternative to inpatient care for some young people referred for admission, reducing but not eliminating the need for acute beds.
The context of empowerment and self-care within the field of diabetes
Authors: Scambler Sasha , Newton Paul , Asimakopoulou Koula
Published: April 2014

There is a growing emphasis within the diabetes literature on the importance of empowerment as a way of encouraging people to take control of and responsibility for the successful management of their disease. Patients are actively encouraged to become active participants in their care, and there is an expectation that health-care professionals will facilitate this process. This article uses Bourdieu’s concept of field, as a bounded social space in which actors conduct their lives day-to-day, to explore the context within which issues of empowerment are addressed and negotiated. The practice of empowerment within the biologically defined and biomedically ‘policed’ field of diabetes is explored using empirical data from a study of diabetes health-care professionals’ understanding and practices around empowerment. It is concluded that rather than promoting active self-management and empowerment, the nature of the field of diabetes, and in particular its privileging of the biomedical, can mitigate against people with diabetes negotiating the field effectively and taking control of the disease and its management.
Postoperative stiff shoulder after open rotator cuff repair: a 3- to 20-year follow-up study
Authors: Vastamäki H. , Vastamäki M.
Published: April 2014

Background and Aims:

Stiffness after a rotator cuff tear is common. So is stiffness after an arthroscopic rotator cuff repair. In the literature, however, postoperative restriction of passive range of motion after open rotator cuff repair in shoulders with free passive range of motion at surgery has seldom been recognized. We hypothesize that this postoperative stiffness is more frequent than recognized and slows the primary postoperative healing after a rotator cuff reconstruction. We wondered how common is postoperative restriction of both active and passive range of motion after open rotator cuff repair in shoulders with free passive preoperative range of motion, how it recovers, and whether this condition influences short- and long-term results of surgery. We also explored factors predicting postoperative shoulder stiffness.

Material and Methods:

We retrospectively identified 103 postoperative stiff shoulders among 416 consecutive open rotator cuff repairs, evaluating incidence and duration of stiffness, short-term clinical results and long-term range of motion, pain relief, shoulder strength, and functional results 3–20 (mean 8.7) years after surgery in 56 patients.

Results:

The incidence of postoperative shoulder stiffness was 20%. It delayed primary postoperative healing by 3–6 months and resolved during a mean 6.3 months postoperatively. External rotation resolved first, corresponding to that of the controls at 3 months; flexion and abduction took less than 1 year after surgery. The mean summarized range of motion (flexion + abduction + external rotation) increased as high as 93% of the controls’ range of motion by 6 months and 100% by 1 year. Flexion, abduction, and internal rotation improved to the level of the contralateral shoulders as did pain, strength, and function. Age at surgery and condition of the biceps tendon were related to postoperative stiffness.

Conclusions:

Postoperative stiff shoulder after open rotator cuff repair is a common complication resolving in 6–12 months with good long-term results.
Australian Chinese parents’ language attitudes and practices relating to their children’s bilingual development prior to school
Authors: Hu Jiangbo , Torr Jane , Whiteman Peter
Published: April 2014

This article reports on a deep investigation of five Australian Chinese families regarding their preschool-aged children’s bilingual experiences and development. Each family was visited 3 to 5 times by the first author. The mothers were interviewed about their attitudes toward their child’s bilingualism and their practices to promote it. A detailed observation lasting 4 to 5 hours was undertaken of each family to record the interaction between parents and children. The findings suggest that Chinese parents have positive attitudes toward bilingualism for pragmatic reasons, such as future career success and ease of communication with family members. Yet they also expressed concern that their child’s development of the home language would have a negative effect on their child’s English language development. Observations demonstrated that parents’ interactions with their children were frequently playful and informal, and English language was frequently used. Many of the materials parents provided to support their child’s home language, such as picture books and DVDs, were actually rooted in English culture. These findings suggest there is room for Chinese parents to increase their awareness of bilingual development in children, including the relationship between first and second language development and strategies for facilitating their children’s learning.
Endovascular first strategy for de novo TransAtlantic Inter-Society Consensus C and D femoro-popliteal disease: Mid-term outcomes from a single tertiary referral center
Authors: Grenville Jeffrey Lorne , Tan Kong Teng , Moshonov Hadas , Rajan Dheeraj Kumar
Published: April 2014

Purpose:

Describe outcomes after endovascular intervention of TransAtlantic Inter-Society Consensus C and D femoro-popliteal disease.

Materials and methods:

Retrospective cohort study. Patient demographics, ankle-brachial indices, and lesion details were analyzed from a prospectively maintained database. In all, 980 limbs treated with percutaneous transluminal angioplasty ± stenting of the femoro-popliteal segment between 2005 and 2012 were reviewed. Seventy-six patients representing 83 limbs with de novo TransAtlantic Inter-Society Consensus C and D lesions measuring ≥15 cm continuously were identified (mean age 71.3 ± 12.1 years, 62% male).

Results:

Twenty-five (30.1%) limbs were treated for severe claudication and 58 (69.9%) for critical limb ischemia. The mean pre-procedural ankle-brachial index was 0.47 ± 0.19. The mean lesion length was 22.9 ± 4.82 cm. Seventy patients representing 77 limbs were available for a mean follow-up length of 19.5 months (range 0–79). The mean post-procedural ankle-brachial index was 0.71 ± 0.28. Primary, assisted-primary, and secondary patency rates were 68.1%, 72.7%, and 83.3% at 6 months, 55.3%, 63.6%, and 58.3% at 12 months, and 38.2%, unavailable, and 10.4% at 24 months, respectively.

Conclusions:

Angioplasty-first strategy for TransAtlantic Inter-Society Consensus C and D lesions of the femoro-popliteal artery can be safely performed. However, patency drastically decreases after 12 months suggesting further improvements are required to achieve longer-term clinical benefit.
Preparation and characterization of bacterial cellulose/hyaluronic acid composites
Authors: Jia Yuanyuan , Huo Mingming , Huang Huijian , Fu Wei , Wang Yan , Zhang Jiamin , Jia Shiru
Published: April 2014

Bacterial cellulose/hyaluronic acid composites have been prepared by the nontoxic cross-linking agent 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide. The effects of hyaluronic acid concentration, temperature, and the 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide addition way on the performance of the composites have been discussed. Field emission scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, and thermogravimetric analyzer have been used to characterize the composite materials. The hyaluronic acid contents in the composites have been assayed by a colorimetric method. Hyaluronic acid concentration, the 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide addition way, and temperature have impacts on the hyaluronic acid content in composites. Fourier transform infrared spectra confirm the amide groups on the composites, which is attributed to hyaluronic acid molecules. The crystallinity indexes of composites decrease, in comparison with pristine bacterial cellulose, known from X-ray diffraction tests, possibly due to the integration of hyaluronic acid. The thermal decomposition temperatures of Composites A and B from Process 1 are lower than those of bacterial cellulose, which is ascribed to lower pyrolysis temperatures of hyaluronic acid compound in composite materials. However, Composites C and D from Process 2 do not undergo descent thermal stability. The novel nanocomposites have the potential to be used for biomedical and tissue engineering scaffold materials.
Sideline Coverage
Authors: Gould Sara J. , Cardone Dennis A. , Munyak John , Underwood Philipp J. , Gould Stephen A.
Published: April 2014

Context:

Sidelines coverage presents unique challenges in the evaluation of injured athletes. Health care providers may be confronted with the question of when to obtain radiographs following an injury. Given that most sidelines coverage occurs outside the elite level, radiographs are not readily available at the time of injury, and the decision of when to send a player for radiographs must be made based on physical examination. Clinical tools have been developed to aid in identifying injuries that are likely to result in radiographically important fractures or dislocations.

Evidence Acquisition:

A search for the keywords x-ray and decision rule along with the anatomic locations shoulder, elbow, wrist, knee, and ankle was performed using the PubMed database. No limits were set regarding year of publication. We selected meta-analyses, randomized controlled trials, and survey results. Our selection focused on the largest, most well-studied published reports. We also attempted to include studies that reported the application of the rules to the field of sports medicine.

Study Design:

Retrospective literature review.

Level of Evidence:

Level 4.

Results:

The Ottawa Foot and Ankle Rules have been validated and implemented and are appropriate for use in both pediatric and adult populations. The Ottawa Knee Rules have been widely studied, validated, and accepted for evaluation of knee injuries. There are promising studies of decision rules for clinically important fractures of the wrist, but these studies have not been validated. The elbow has been evaluated with good outcomes via the elbow extension test, which has been validated in both single and multicenter studies. Currently, there are no reliable clinical decision tools for traumatic sports injuries to the shoulder to aid in the decision of when to obtain radiographs.

Conclusion:

Clinical decision tools have been developed to aid in the diagnosis and management of injuries commonly sustained during sporting events. Tools that have been appropriately validated in populations outside the initial study population can assist sports medicine physicians in the decision of when to get radiographs from the sidelines.
Past and present in abdominal surgery management for Cushing’s syndrome
Authors: Vilallonga Ramon , Zafon Carles , Fort José Manuel , Mesa Jordi , Armengol Manel
Published: April 2014

Introduction:

Data on specific abdominal surgery and Cushing’s syndrome are infrequent and are usually included in the adrenalectomy reports. Current literature suggests the feasibility and reproducibility of the surgical adrenalectomies for patients diagnosed with non-functioning tumours and functioning adrenal tumours including pheochromocytoma, Conn’s syndrome and Cushing’s syndrome.

Discussion:

Medical treatment for Cushing’s syndrome is feasible but follow-up or clinical situations force the patient to undergo a surgical procedure. Laparoscopic surgery has become a gold standard nowadays in a broad spectrum of pathologies. Laparoscopic adrenalectomies are also standard procedures nowadays. However, despite the different characteristics and clinical disorders related to the laparoscopically removed adrenal tumours, the intraoperative and postoperative outcomes do not significantly differ in most cases between the different groups of patients, techniques and types of tumours. Tumour size, hormonal type and surgeon’s experience could be different factors that predict intraoperative and postoperative complications. Transabdominal and retroperitoneal approaches can be considered. Outcomes for Cushing’s syndrome do not differ depending on the surgical approach. Novel technologies and approaches such as single-port surgery or robotic surgery have proven to be safe and feasible.

Conclusion:

Laparoscopic adrenalectomy is a safe and feasible approach to adrenal pathology, providing the patients with all the benefits of minimally invasive surgery. Single-port access and robotic surgery can be performed but more data are required to identify their correct role between the different surgical approaches. Factors such as surgeon’s experience, tumour size and optimal technique can affect the outcomes of this surgery.
Nutrition Education for Postpartum Women
Authors: Falciglia Grace , Piazza Julia , Ritcher Erika , Reinerman Christina , Lee Seung Yeon
Published: April 2014

This pilot study examined the effectiveness of a 4-month clinic-based dietary intervention emphasizing the intake of deep yellow and dark green vegetables versus usual care on improving diet quality in postpartum women. The intervention group (n = 31) received 1 face-to-face nutrition education session with a registered dietitian, 2 follow-up phone calls, and 3 pamphlets distributed by mail. The usual care group (n = 25) received handouts with guidelines on healthy eating. Dietary outcomes were assessed from 3-day food recalls and evaluated using paired and independent t tests. Intervention women exhibited a significant increase in total vegetable intake ( P < .001) and in dark green and deep yellow vegetables ( P < .001). In comparison, the control group increased the intake of total vegetables ( P < .001), but did not increase the consumption of dark green and deep yellow vegetables. When comparing the change in intake between study groups for both types of vegetables, the difference was not significant. Furthermore, 61% of the intervention women met the goals for total vegetable intake compared with 12% for the usual care group ( P < .001). The intervention group also had a greater percentage of women (25.8%) that met the goal for deep yellow and dark green vegetable intake when compared with the usual care group (8%; P < .08). These results suggest that postpartum women are receptive to nutrition education and that nutrition education can influence vegetable intake.
The Influence of Family Socioeconomic Status on the Post–High School Outcomes of Youth With Disabilities
Authors: Wagner Mary M. , Newman Lynn A. , Javitz Harold S.
Published: April 2014

Using data from the National Longitudinal Transition Study–2, this study considers (a) the extent to which the socioeconomic status (SES) of youth with disabilities predicted their likelihood of high school graduation, postsecondary education enrollment, and employment; (b) the extent to which other individual and family factors mediated the SES–outcome relationships; and (c) other factors that significantly explained outcome variations for youth with disabilities. Results show that SES had a statistically significant but relatively small effect on outcomes, to a sizable extent the effect of SES was mediated by other factors, and many of the covariates in the analyses (e.g., disability type and severity, gender, race/ethnicity) had their own significant relationships with outcomes that contribute to our understanding of variations in them.
Learning and Memory Consolidation Processes of Attention-Bias Modification in Anxious and Nonanxious Individuals
Authors: Abend Rany , Pine Daniel S. , Fox Nathan A. , Bar-Haim Yair
Published: April 2014

Recent evidence suggests that attention-bias-modification (ABM) procedures may reduce anxiety via computerized attention-training tasks. However, the mechanisms underlying the modification of attention patterns in anxiety remain largely unexplored. Here, we compared anxious and nonanxious participants in terms of learning and memory consolidation effects associated with training to attend either toward or away from threat. When trained to attend away from threat, the primary training condition in ABM treatment, anxious participants demonstrated impaired within-session learning. In contrast, consolidation of threat-related learning did not vary as a function of anxiety. These findings suggest that anxious participants have a selective difficulty in altering their threat-related attention patterns during ABM. This specific deficit could explain inconsistent findings in the ABM research base, as well as elucidate potential targets for optimizing ABM protocols in the treatment of anxiety.
Long-term Course in Adolescents after Anterior Cruciate Ligament Reconstruction (ACL)
Authors: Mansson Olle , Sernert Ninni , Kartus Juri T.
Published: April 2014

Objectives:

The risk for further intra-articular damage associated with conservative treatment or delayed ACL reconstruction must be considered against the risk for growth disturbance with early reconstruction and trans-physeal drilling. Long-term follow-ups after surgical treatment of ACL injuries in children are rare. The aims of the present study were to evaluate the results 10-20 years after ACL reconstruction in terms of the presence of osteoarthritis, clinical assessments and health-related quality of life in patients who were adolescents at the time of surgery.

Methods:

32 children, aged 12-16 years (11 boys; 21 girls), with symtomatic unilateral ACL rupture, underwent reconstruction using bone-patellar bone-tendon (n=10) or hamstring tendon (n=22) autograft. Twenty-nine patients (91%) underwent clinical, radiographical and health-related quality of life assessments after 10-20 years (mean 175 months).

Results:

The reconstructed knee had significantly more osteoarthritic changes compared to the non-involved contra lateral knee. Preoperatively the Tegner activity level was 4 (2-8) and the Lysholm knee score was 75 (50-90) points. At follow-up the corresponding values were 4 (1-7) and 84 (34-100) points, (p=n.s; preop v follow-up). The one-leg-hop test was 84% (0-105) preoperatively and 93% (53-126) at follow-up (p=0.003). At follow-up muscle strength measurements diplayed more than 90 % of the non-involved leg in both extension and flexion. The knee laxity measurement was significantly less at follow-up than preoperatively (p=0.001). The SF-36 revealed scores compareable to healthy controls (fig. 1).The EQ 5D was 0.9. The KOOS values were lower in all dimensions compared to an aged matched healthy controls.

Conclusion:

In the long term, patients who were adolescents at the time of ACL reconstruction reveal significantly more radiographically visible osteoarthritic changes in their operated knee than in their non-involved contralateral knee Clinical outcomes and health-related quality of life are comparable to healthy controls.