bluuebunny/crossref_metadata_2025 huggingface dataset:
A transactional approach to predicting stress experienced when writing dissertations
Authors: Silinda Fortunate Tintswalo
Published: October 2018

Although substantial attention has been given to doctoral students, the attention given to master’s students writing dissertations is limited. This article outlines a transactional model of stress that conceptualises dissertation writing as a stressor consisting of a series of phases that tend to increase the risk of negative outcomes. A mixed-method design was used to address the aim of the study. An adapted version of the Stress and Support Questionnaire for University Students was used to measure the stress that master’s students experienced. Open-ended questions were employed to measure students’ evaluations of the stress experienced when writing a dissertation. The model proposed that the phases of dissertation writing moderate the relationship between stressor factors and the stress experienced. In an empirical study making use of the model, the moderation analyses revealed that Phase 1 of dissertation writing significantly moderated the relationship between the stress experienced, stressor factors of relationships, financial and transport problems and health related problems. The qualitative data suggested that stress is evaluated either positively or negatively depending on time-management styles and support systems. The results obtained underscore the importance of support structures in alleviating the stress experienced when writing dissertations in order to improve students’ retention and graduation rates.
Treatment of Tonsillar Carcinoma following Nononcologic Tonsillectomy: Efficacy of Transoral Robotic Revision Tonsillectomy
Authors: Gobillot Theodore A. , Kaka Azeem S. , Patel Sapna A. , Rodriguez Cristina , Cannon Richard B. , Futran Neal D. , Houlton Jeffrey J.
Published: October 2018

Objective

To evaluate whether transoral robotic surgery (TORS) is a suitable treatment approach for patients diagnosed with tonsillar carcinoma after a standard palatine tonsillectomy.

Study Design

Retrospective cohort study.

Setting

Tertiary care medical center.

Subjects and Methods

Patients who underwent TORS at the University of Washington from 2010 to 2017 (n = 150) were identified. All patients who were diagnosed with tonsillar carcinoma following a nononcologic tonsillectomy and subsequently underwent TORS radical tonsillectomy were included (n = 14). Tumor stage–matched subjects (n = 44) were included who did not undergo standard tonsillectomy prior to TORS. Our primary outcome was final margin status. Secondary outcomes were presence of residual tumor, receipt and dose of postoperative adjuvant therapy, disease‐free survival (DFS), and disease‐specific survival. Patients with <6 months of follow‐up following definitive treatment were excluded from survival analyses.

Results

Final margin status was clear in all subjects. Residual tumor was not identified in 13 of 14 (92.9%) prior‐tonsillectomy subjects following TORS radical tonsillectomy. Seven of 14 (50%) prior‐tonsillectomy subjects and 12 of 44 (27.3%) TORS‐matched subjects did not require adjuvant therapy due to favorable pathology. Among subjects who received post‐TORS radiation therapy (RT) at our institution, RT dose reduction was achieved in 3 of 4 (75%) prior‐tonsillectomy subjects and 21 of 24 (87.5%) TORS‐matched subjects. Ten of 14 (71.4%) prior‐tonsillectomy subjects and 31 of 44 (70.5%) TORS‐matched subjects avoided post‐TORS chemotherapy. DFS was not significantly different (P =. 87) between prior‐tonsillectomy and TORS‐matched groups, and no subjects died of related disease.

Conclusions

Patients diagnosed with tonsillar carcinoma following a prior nononcologic standard palatine tonsillectomy are suitable candidates for revision surgery with TORS radical tonsillectomy.
Effect of Postoperative Xylitol Nasal Irrigation on Patients with Sinonasal Diseases
Authors: Kim Do Hyun , Kim Yeonji , Lim Il Gye , Cho Jin Hee , Park Yong Jin , Kim Sung Won , Kim Soo Whan
Published: October 2018

Objective

To examine the effect of xylitol nasal irrigation in a large sample size of patients who had undergone nasal surgery.

Study Design

Double‐blinded randomized controlled crossover study.

Setting

Tertiary referral center.

Methods

The study included 100 patients with sinonasal disease who underwent endoscopic sinus surgery (ESS), septoplasty, or both concurrently. To identify patients with allergic sensitization, serum‐specific immunoglobulin E levels were measured. Nasal symptoms were evaluated with the NOSE (Nasal Obstruction Symptoms Evaluation) and SNOT‐20 (Sino‐Nasal Outcome Test–20) and via visual analog scale (VAS) scores.

Results

In the ESS group (n = 34), the general nasal symptom score evaluated by the SNOT‐20 showed significantly greater improvement in the xylitol group versus the saline group (P =. 022). VAS symptom scores for sneezing (P =. 003), headache (P =. 02), and facial pain (P =. 037) were also more improved in the xylitol group. In the septoplasty group (n = 39), the VAS score for nasal stuffiness showed a significantly greater improvement in the xylitol group when compared with the saline irrigation group (P =. 001). Among the patients with allergic sensitization (n = 31), rhinorrhea symptoms improved significantly more in the xylitol group than in the saline group (P =. 024). The preference survey showed that more than half of the patients in each surgical group preferred xylitol irrigation.

Conclusion

We found that xylitol nasal irrigation was useful in postoperative ESS and septoplasty care. For patients with allergic sensitization, rhinorrhea showed greater improvement in the xylitol group than in the saline group.
Effects of a self-management programme on patient participation in patients with chronic heart failure or chronic obstructive pulmonary disease: A randomized controlled trial
Authors: Luhr Kristina , Eldh Ann C , Theander Kersti , Holmefur Marie
Published: October 2018

Background:

Self-management strategies are crucial to patients with long-term conditions and can presumably promote patient participation, given that to patients, patient participation connotes opportunities for self-care (along with being engaged in an exchange of knowledge, a phrasing of joint goals and planning of care). So far, limited attention has been given to what components support self-management and what outcomes can be achieved. An exclusive self-management programme in primary healthcare entailed assessing its influence on patient participation.

Aim:

To describe the effects of a self-management programme on preferences for, and experiences of, patient participation in patients with chronic obstructive pulmonary disease or chronic heart failure.

Methods:

A randomized controlled trial with a six session intervention programme, including phrasing of individual action plans and group discussions on the patients’ issues. The intervention group ( n=59) received standard care and the self-management programme, and the control group ( n=59) received standard care only. Data was collected at baseline and at three months and 12 months after the intervention started, using the Patient Preferences for Patient Participation (the 4Ps) measure.

Results:

No significant differences were found within the groups, or between the groups, in preferences and experiences of patient participation, either in summary score or at an item level.

Conclusion:

A self-management group programme led by trained primary healthcare staff in primary care did not serve as means to influence patients’ experience of patient participation in the care of their long-term condition. Further studies are needed in regard to what facilitates patient participation in this setting and beyond.
The case for early post-vasectomy semen analysis combining small non-motile sperm and azoospermia
Authors: Hendry Jane , Small Robert , Zreik Abdullah , Smyth Niamh , Taylor Joby
Published: October 2018

Background:

Post-vasectomy semen analysis timing and criteria guidelines have evolved over time. Through analysis of our unit’s practice of post-vasectomy semen analysis from earlier sampling protocols at 8 weeks to single sampling at 12 weeks then 16 weeks, the impact on success rates and patient compliance were assessed. In addition, the use of small numbers of non-motile sperm and azoospermia combined rates as a marker of sterility were examined.

Methods:

All patients who underwent vasectomy in 2011 (8 and 12-week samples), 2013 (12-week samples) and 2016 (16-week samples) were included. Patients were given written and verbal instructions explaining the sample delivery protocol and samples. χ2 Testing was used to compare patient compliance and the results of post-vasectomy semen analysis with significance set at P<0.05.

Results:

In total 1124 vasectomies were performed, with 21% ( N=232) of patients non-compliant with submitting samples at the requested time period. Azoospermia rates increased with a longer time to post-vasectomy semen analysis from 82% to 95%, P<0.001; however, declining compliance meant the proportion of patients given clearance remained the same (70% vs. 68%, P=0.32). Rates of small non-motile sperm declined over an increasing time to post-vasectomy semen analysis. Therefore combined azoospermia and small non-motile sperm rates remained stable over an increasing sampling time (95% vs. 99%, P=0.39).

Conclusion:

The use of earlier post-vasectomy semen analysis is recommended as patient compliance decreases with the time from vasectomy. When azoospermia and small non-motile sperm rates are combined the rates of success of the procedure remain the same over time therefore earlier testing at 8 weeks is feasible without compromising clearance rates.

Level of evidence:

Not applicable for this single centre audit.
Operative Treatment of Proximal Rectus Femoris Injuries in Professional Soccer Players: A Series of 19 Cases
Authors: Lempainen Lasse , Kosola Jussi , Pruna Ricard , Puigdellivol Jordi , Ranne Juha , Orava Sakari
Published: October 2018

Background:

Proximal rectus femoris (PRF) tears are relatively rare injuries among top-level athletes. PRF injuries can be avulsions of both tendon heads (direct and reflected heads) or of a single head, and some have a tendency to progress to recurrent injuries.

Purpose:

To describe a series of operatively treated PRF ruptures in professional soccer players.

Study Design:

Case series; Level of evidence, 4.

Methods:

Nineteen cases of PRF injuries (18 patients, 1 bilateral) in professional soccer players who were treated surgically were retrospectively reviewed. Perioperative findings with return-to-play data were recorded.

Results:

Of the PRF injuries, 10 total avulsions (both heads) and 9 single-head tears were seen on magnetic resonance imaging and were later confirmed during surgery. All 18 patients returned to their preinjury level of play (mean follow-up, 2.8 years [range, 1-11 years]).

Conclusion:

The repair of PRF tears in professional soccer players yielded good results and allowed all patients to return to their preinjury level of play.
Receiving Bad News: A Thematic Analysis of Stroke Survivor Experiences
Authors: Maddern Robyn , Kneebone Ian I
Published: October 2018

Background:

Breaking bad news to patients may be required in service provision to stroke survivors. While challenging, it may be critical to the retention of optimism and participation in rehabilitation.

Objectives:

To explore the experience of stroke survivors when receiving bad news (RBN) from medical practitioners.

Methods:

Data were obtained via 1:1 interviews conducted at stroke support groups with survivors at least 12 months into recovery and subsequently transcribed for thematic analysis and coded using NVivo.

Results:

Eight of 10 participants experienced RBN, and 2 participants did not. The themes of being “lucky to be alive” and waiting for “delayed information” were expressed by all participants early in the interviews. Three sub-themes emerged and were labelled alliance, dissent, and dissatisfaction, each with a further 3 contextual themes. The perception of RBN was marked amongst the dissent and dissatisfaction groups, with the latter reporting negative implications for their rehabilitation as well as negative emotions, such as anger and anxiety. The perception of a poor-quality relationship with medical practitioners was said to impede rehabilitation and recovery processes. The dissent group was characterized by initial disbelief after RBN and consequently poorer long-term outcomes, whilst the Alliance group experienced very good quality of care due to existing personal knowledge and therefore did not perceive RBN during their early medical meetings.

Conclusions:

In the period soon after their stroke, survivors required their medical practitioners to not only communicate knowledge and information, but also needed validation of their hopes and fears for the future from an empathically attuned clinician.
The geochemical evolution of Nb–Ta–Sn oxides from pegmatites of the Cape Cross–Uis pegmatite belt, Namibia
Authors: Fuchsloch Warrick C. , Nex Paul A. M. , Kinnaird Judith A.
Published: October 2018

The Cape Cross–Uis pegmatite belt, Damara Orogen, north-central Namibia hosts multiple Ta–Nb- and Sn-oxide-bearing pegmatites. Columbite-group minerals, tapiolite, cassiterite and minor ixiolite and wodginite occur in abundance within pegmatites and display various compositional and internal structural mineralogical variations. Ta–Nb oxides display various zonation patterns indicative of multiple crystallisation phases, whereas cassiterite is dominantly homogeneous with minor euhedral columbite-group mineral inclusions. Ta–Nb oxides are mostly rich in Fe, with fractionation patterns in the columbite quadrilateral being sub parallel to the Ta/(Ta + Nb) axis; increasing Ta/(Ta + Nb) with little change in Mn/(Mn + Fe), which is consistent with classical trends in beryl-to-spodumene rare-element pegmatites. In addition, these trends suggest that co-crystallising minerals compete with Ta–Nb oxides for elements such as Mn, preventing Ta–Nb oxides from attaining Mn-rich compositions during the fractionation process. Cassiterite shows similar fractionation patterns with Fe > Mn and notable increases in the Ta content. Minor-element substitution in Ta–Nb oxides shows sharp decreases with increasing fractionation supporting the hypothesis that newly stabilised co-occurring minerals compete with columbite-group minerals for certain elements. Tapiolite shows the same minor-element trend, however, only for Sn and Ti suggesting cassiterite was a dominant competing mineral. Although crystallisation of Ta–Nb oxides from an aqueous fluid at the late-stages of pegmatite genesis is highly debated, significantly elevated Ta contents in metasomatised country rock, compared to unaltered country rock, may give new insight, suggesting that Ta may indeed partition into, and be transported by, an exsolved aqueous fluid. However, further studies of the country rock metasomatic contacts are required as currently the dataset is limited. The degree of fractionation as depicted by Ta–Nb and Sn oxides within pegmatites, indicate that a zonation from primitive to evolved pegmatites surrounding granites is not present and that pegmatites are probably not related to granites in the typical parent–daughter relationship.
Small-molecule BCL6 inhibitor effectively treats mice with nonsclerodermatous chronic graft-versus-host disease
Authors: Paz Katelyn , Flynn Ryan , Du Jing , Qi Jun , Luznik Leo , Maillard Ivan , MacDonald Kelli P. , Hill Geoffrey R. , Serody Jonathan S. , Murphy William J. , Sage Peter T. , Sharpe Arlene H. , Miklos David , Cutler Corey S. , Koreth John , Antin Joseph H. , Soiffer Robert J. , Ritz Jerome , Bradner James E. , Melnick Ari M. , Blazar Bruce R.
Published: October 2018

Patient outcomes for steroid-dependent or -refractory chronic graft-versus-host diesease (cGVHD) are poor, and only ibrutinib has been US Food and Drug Administration (FDA) approved for this indication. cGVHD is often driven by the germinal center (GC) reaction, in which T follicular helper cells interact with GC B cells to produce antibodies that are associated with disease pathogenesis. The transcriptional corepressor B-cell lymphoma 6 (BCL6) is a member of the Broad-complex, Tramtrack, and Bric-abrac/poxvirus and zinc finger (BTB/POZ) transcription factor family and master regulator of the immune cells in the GC reaction. We demonstrate that BCL6 expression in both donor T cells and B cells is necessary for cGVHD development, pointing to BCL6 as a therapeutic cGVHD target. A small-molecule BCL6 inhibitor reversed active cGVHD in a mouse model of multiorgan system injury with bronchiolitis obliterans associated with a robust GC reaction, but not in cGVHD mice with scleroderma as the prominent manifestation. For cGVHD patients with antibody-driven cGVHD, targeting of BCL6 represents a new approach with specificity for a master GC regulator that would extend the currently available second-line agents.
Active Faulting in Source Region of 2016–2017 Central Italy Event Sequence
Authors: Galadini Fabrizio , Falcucci Emanuela , Gori Stefano , Zimmaro Paolo , Cheloni Daniele , Stewart Jonathan P.
Published: October 2018

The Central Italy earthquake sequence produced three main shocks: M6.1 24 August, M5.9 26 October, and M6.5 30 October 2016. Additional M5–5.5 events struck this territory on 18 January 2017 in the Campotosto area. Fault plane solutions for the main shocks exhibit normal faulting (characteristic of crustal extension occurring in the inner central Apennines). Significant evidence, including hypocenter locations, strike and dip angles of the moment tensors, inverted finite fault models (using GPS, interferometric aperture radar, and ground motion data), and surface rupture patterns, all point to the earthquakes having been generated on the Mt. Vettore–Mt. Bove fault system (all three main shocks) and on the Amatrice fault, in the northern sector of the Laga Mountains (portion of 24 August event). The earthquake sequence provides examples of both synthetic and antithetic ruptures on a single fault system (30 October event) and rupture between two faults (24 August event). We describe active faults in the region and their segmentation and present understanding of the potential for linkages between segments (or faults) in the generation of large earthquakes.
Neuroborreliosis and Neurosyphilis
Authors: Halperin John J.
Published: October 2018

PURPOSE OF REVIEW

This article presents an overview of the current diagnosis and management of two spirochetal infections of the nervous system, neuroborreliosis (Lyme disease) and neurosyphilis, focusing on similarities and differences. Although neuroborreliosis was first identified almost a century ago, much confusion remains about how to accurately diagnose this quite treatable nervous system infection. Well-established diagnostic tools and therapeutic regimens exist for neurosyphilis, which has been well-known for centuries.

RECENT FINDINGS

Serologic testing targeting the C6 antigen may simplify diagnostic testing in neuroborreliosis while improving accuracy. Historically, screening for syphilis has used a reaginic test followed by a treponeme-specific assay; alternative approaches, including use of well-defined recombinant antigens, may improve sensitivity without sacrificing specificity. In neuroborreliosis, measurement of the chemokine CXCL13 in CSF may provide a useful marker of disease activity in the central nervous system.

Lyme disease causes meningitis, cranial neuritis, radiculitis, and mononeuropathy multiplex. Cognitive symptoms, occurring either during (encephalopathy) or after infection (posttreatment Lyme disease syndrome) are rarely, if ever, due to central nervous system infection. Posttreatment Lyme disease syndrome is not antibiotic responsive. Syphilis causes meningitis, cranial neuritis, chronic meningovascular syphilis, tabes dorsalis, and parenchymal neurosyphilis. The organism remains highly sensitive to penicillin, but residua of chronic infection may be irreversible.
Helminthic Infections of the Central Nervous System
Authors: Cho Tracey A.
Published: October 2018

PURPOSE OF REVIEW

This article discusses select helminthic parasitic infections that may affect the central nervous system and reviews the epidemiology, neurologic presentation, recommended diagnostic testing, and treatment approach to these infections.

RECENT FINDINGS

Emigration from and travel to areas endemic for helminthic infections that affect the nervous system has led to increased incidence of parasitic neurologic disease in developed countries, necessitating that neurologists be familiar with the diagnostic and therapeutic approach to these diseases. Evidence is emerging on the optimal treatment for neurocysticercosis, which varies based on the form of the disease in the nervous system.

Parenchymal neurocysticercosis is a leading cause of acquired epilepsy worldwide, and extraparenchymal neurocysticercosis is responsible for many cases of hydrocephalus. Recognition of the different stages and locations of neurocysticercosis is essential for proper management. Similarly, schistosomiasis constitutes a major cause of myelopathy in endemic areas and requires prompt diagnosis and treatment to avoid permanent deficits.
Tuberculosis of the Central Nervous System
Authors: Zunt Joseph R.
Published: October 2018

PURPOSE OF REVIEW

This article details the epidemiology and clinical manifestations of central nervous system (CNS) tuberculosis (TB), provides guidance for diagnostic imaging and CSF testing, and recommends treatment strategies for tuberculous meningitis and other forms of CNS TB, illustrating key aspects of diagnosis and management with case presentations.

RECENT FINDINGS

Although improvements in our understanding of the pathogenesis and management of CNS TB have occurred over the past 50 years, the emergence of multidrug-resistant and extensively drug-resistant TB, the advent of acquired immunodeficiency syndrome (AIDS), and the subsequent availability of highly active antiretroviral therapy that can produce the immune reconstitution inflammatory syndrome have complicated the diagnosis and treatment of CNS TB. Advances in diagnostic assays promise to increase the speed of diagnosis as well as the percentage of people with a confirmed rather than a presumptive diagnosis. Advances in precision medicine have identified polymorphisms in the LTA4H gene that influence the risk for inflammation in patients with tuberculous meningitis.

CNS TB continues to be a major cause of morbidity and mortality, with the majority of people affected living in low-income and middle-income countries. Newer diagnostic assays promise to increase the speed of diagnosis and improve appropriate selection of antituberculous therapy and anti-inflammatory medications. Despite these advances, CNS TB remains difficult to diagnose, and clinicians should have a low threshold for initiating empiric therapy in patients with presumptive infection.
Acute Bacterial Meningitis
Authors: Davis Larry E.
Published: October 2018

PURPOSE OF REVIEW

While acute bacterial meningitis is becoming less common in developed countries because of the widespread use of vaccines against Streptococcus pneumoniae, Neisseria meningitides, and Haemophilus influenzae, bacterial meningitis still occurs worldwide, with peak incidence in young children and the elderly. Bacterial meningitis is usually lethal unless appropriate antibiotics that cross the blood-brain barrier are given. Clinical suspicion of bacterial meningitis begins when patients present with the abrupt onset of fever, headache, and meningismus.

RECENT FINDINGS

New technologies are being developed for more rapid identification of the bacterial species causing meningitis. When appropriate, administration of adjunctive dexamethasone with the antibiotics often lessens neurologic sequelae in survivors, which may include aphasia, ataxia, paresis, hearing loss, and cognitive impairment.

Confirmation of the diagnosis of bacterial meningitis comes mainly from examination and culture of CSF obtained from a lumbar puncture. Typically, the CSF shows an elevated neutrophil count, elevated protein, depressed glucose, positive Gram stain, and growth of the bacteria on appropriate culture media. Antibiotic sensitivities of the bacteria determine the appropriate antibiotics, although an educated guess of the best antibiotics to be given promptly must be made until the antibiotic sensitivities return, usually in a few days.
Preexercise Carbohydrate Ingestion and Transient Hypoglycemia: Fasting versus Feeding
Authors: KONDO SAKI , TANISAWA KUMPEI , SUZUKI KATSUHIKO , TERADA SHIN , HIGUCHI MITSURU
Published: October 2018

Purpose

Carbohydrate (CHO) ingestion 30 to 45 min before exercise results in transient hypoglycemia after starting the exercise in some, but not all, subjects. However, whether transient hypoglycemia is more likely to occur under fed or fasted condition remains unknown. This study aimed to directly compare the effects of fasting versus feeding on plasma glucose responses after preexercise CHO intake and to examine the relationship between insulin responses and onset of transient hypoglycemia.

Methods

Sixteen subjects performed 60-min cycle ergometer exercises at 75% maximal oxygen uptake (V˙O2max) under overnight fasted and fed (4 h after breakfast) conditions. In both conditions, they consumed 500 mL of beverage (150 g of glucose) 30 min before beginning exercise.

Results

The mean plasma glucose concentrations 15 min after starting the exercise did not fall below 4.0 mmol·L−1 (criteria for hypoglycemia) in both states; however, individual differences in the occurrence of transient hypoglycemia were noted. In the fasted state, plasma glucose levels transiently dropped below 4.0 mmol·L−1 in five subjects, who had substantially higher serum insulin levels at the start of exercise, compared with those who did not develop hypoglycemia. Although seven subjects developed transient hypoglycemia in the fed state, no relationship was observed between insulin responses and hypoglycemia. Three subjects developed hypoglycemia in both fasted and fed states.

Conclusions

These results suggest that transient hypoglycemia after preexercise CHO ingestion occurs in some, but not all, subjects, under both conditions. Furthermore, subjects with enhanced insulin responses seem to be more prone to transient hypoglycemia in the fasted condition.
Physical Activity Associates with Muscle Insulin Sensitivity Postbariatric Surgery
Authors: SAVOLAINEN ANNA M. , KARMI ANNA , IMMONEN HEIDI , SOINIO MINNA , SAUNAVAARA VIRVA , PHAM TAM , SALMINEN PAULINA , HELMIÖ MIKA , OVASKA JARI , LÖYTTYNIEMI ELIISA , HEISKANEN MARJA A. , LEHTIMÄKI TERHO , MARI ANDREA , NUUTILA PIRJO , HANNUKAINEN JARNA C.
Published: October 2018

Purpose

Bariatric surgery is considered as an effective therapeutic strategy for weight loss in severe obesity. Remission of type 2 diabetes is often achieved after the surgery. We investigated whether increase in self-reported habitual physical activity associates with improved skeletal muscle insulin sensitivity and reduction of fat depots after bariatric surgery.

Methods

We assessed self-reported habitual physical activity using Baecke questionnaire in 18 diabetic and 28 nondiabetic patients with morbid obesity (median age, 46 yr; body mass index, 42.0 kg·m−2) before and 6 months after bariatric surgery operation. Insulin-stimulated femoral muscle glucose uptake was measured using fluorodeoxyglucose positron emission tomography method during hyperinsulinemia. In addition, abdominal subcutaneous and visceral fat masses were quantified using magnetic resonance imaging and liver fat content using magnetic resonance spectroscopy. Also, serum proinflammatory cytokines were measured.

Results

Patients lost on average 22.9% of weight during the follow-up period of 6 months (P< 0.001). Self-reported habitual physical activity level increased (P= 0.017). Improvement in skeletal muscle insulin sensitivity was observed only in those patients who reported increase in their physical activity postoperatively (P= 0.018). The increase in self-reported physical activity associated with the loss of visceral fat mass (P= 0.029). Postoperative self-reported physical activity correlated also positively with postoperative hepatic insulin clearance (P= 0.02) and tended to correlate negatively with liver fat content (P= 0.076). Postoperative self-reported physical activity also correlated negatively with serum TNFα, methyl-accepting chemotaxis protein and interleukin 6 levels.

Conclusions

Self-reported physical activity is associated with reversal of skeletal muscle insulin resistance after bariatric surgery as well as with the loss of visceral fat content and improved postoperative metabolism in bariatric surgery patients.

Trial registration:Clinicaltrials.gov, NCT00793143 (SLEEVEPASS), NCT01373892 (SLEEVEPET2).
Metabolic Costs of Standing and Walking in Healthy Military-Age Adults: A Meta-regression
Authors: LOONEY DAVID P. , POTTER ADAM W. , PRYOR J. LUKE , BREMNER PATRICIA E. , CHALMERS CHRISTOPHER R. , MCCLUNG HOLLY L. , WELLES ALEXANDER P. , SANTEE WILLIAM R.
Published: October 2018

Introduction

The Load Carriage Decision Aid (LCDA) is a U.S. Army planning tool that predicts physiological responses of soldiers during different dismounted troop scenarios. We aimed to develop an equation that calculates standing and walking metabolic rates in healthy military-age adults for the LCDA using a meta-regression.

Methods

We searched for studies that measured the energetic cost of standing and treadmill walking in healthy men and women via indirect calorimetry. We used mixed effects meta-regression to determine an optimal equation to calculate standing and walking metabolic rates as a function of walking speed (S, m·s−1). The optimal equation was used to determine the economical speed at which the metabolic cost per distance walked is minimized. The estimation precision of the new LCDA walking equation was compared with that of seven reference predictive equations.

Results

The meta-regression included 48 studies. The optimal equation for calculating normal standing and walking metabolic rates (W·kg−1) was 1.44 + 1.94S
0.43 + 0.24S
4. The economical speed for level walking was 1.39 m·s−1 (~ 3.1 mph). The LCDA walking equation was more precise across all walking speeds (bias ± SD, 0.01 ± 0.33 W·kg−1) than the reference predictive equations.

Conclusion

Practitioners can use the new LCDA walking equation to calculate energy expenditure during standing and walking at speeds <2 m·s−1 in healthy, military-age adults. The LCDA walking equation avoids the errors estimated by other equations at lower and higher walking speeds.
Individual Variability in Waist Circumference and Body Weight in Response to Exercise
Authors: HAMMOND BRITTANY P. , STOTZ PAULA J. , BRENNAN ANDREA M. , LAMARCHE BENOÎT , DAY ANDREW G. , ROSS ROBERT
Published: October 2018

Purpose

This study aimed to determine the magnitude of exercise-induced individual variability for waist circumference (WC) and body weight change after accounting for biological variability and measurement error. Determinants of response variability were also considered.

Methods

Participants (53 ± 7.5 yr) were 181 adults (61% women) with abdominal obesity randomized to the following: control; low-amount, low-intensity exercise (LALI); high-amount, low-intensity exercise (HALI); or high-amount, high-intensity exercise (HAHI) for 24 wk. Unstructured physical activity was measured by accelerometer. The variability in response to exercise for WC and body weight (SDR) was isolated by subtracting the SD values for the change scores in the exercise group from that of the control group.

Results

The variability of response due to exercise (SDR) for change in WC was 3.1, −0.3, and 3.1 cm for LALI, HALI, and HAHI groups, respectively. Corresponding values for body weight were 3.8, 2.0, and 3.5 kg for LALI, HALI, and HAHI, respectively. The high-amount exercise groups yielded the highest proportion of individuals with a clinically meaningful response. No variables predicted the response to exercise (P > 0.05).

Conclusions

Substantial variability in response to standardized exercise was observed for change in both WC and body weight after accounting for the variability not attributed to exercise. Potential determinants of the interindividual variability in response to exercise remain unclear.
The coastal zone of Russia on the Baltic: factors, peculiarities, perspectives and strategies for cross-border clustering
Authors: Клемешев Андрей , Klemeshev Andrey , Федоров Геннадий , Fedorov Gennady , Кузнецова Татьяна , Kuznecova Tat'yana , Михайлов Андрей , Mihaylov Andrey , Михайлова Анна , Mihaylova Anna , Дружинин Александр , Druzhinin Aleksandr , Пальмовски Тадеуш , Pal'movski Tadeush , Студжиницки Томаш , Studzhinicki Tomash , Горочная Василиса , Gorochnaya Vasilisa , Лачининский Станислав , Lachininskiy Stanislav , Дец Игорь , Dec Igor' , Гонтарь Николай , Gontar' Nikolay
Published: October 2018

The study attempts to understand the phenomenon of cross-border cluster formation in the specific context of the coastal zones of Russia in the Baltic sea, to assess the impact of modern global geopolitical and geo-economic trends, including the processes of European and Eurasian integration. The priority characterizes the formation of cross-border clusters in the Russian coastal regions in the Baltic sea, analyzes the tools, problems and promising algorithms for the implementation of the cluster policy of the state, taking into account the specifics of the coastal zones.
Modern theory of fracture of deformable materials
Authors: Басовский Леонид , Basovskiy Leonid
Published: October 2018

Researches and developments on creation of the theory of damage and destruction of deformable isotropic and anisotropic materials are stated. The proposed model and criteria to predict the destruction of the monotonic, non-monotonic, including the alternating cyclic loading. From the proposed criteria in the limiting special cases follow the known criteria used in predicting failure under monotonic loading, as well as cyclic loading, leading to fatigue failure. Possibility of application of the offered models and criteria for design and optimization of processes of processing of materials is shown.
Patient’s failures and psychotherapist’s successes, or failure in psychotherapy in the eyes of a psychotherapist
Authors: Małus Aleksandra , Konarzewska Beata , Galińska-Skok Beata
Published: October 2018

Aim of the study

To answer the question of what significance psychotherapists attach to failure.

Subject or material and methods

The study group included 100 psychotherapists. A qualitative method (open questions) and a quantitative method (Self Confrontation Method by Hubert Hermans) were used. An analysis of psychotherapists' comprehension and experience of failure, and an analysis of emotions felt when succeeding or failing in psychotherapy were performed.

Results

94% of psychotherapists declared that they experienced failures in the course of their professional work. The failures were accompanied by particularly negative emotions and were quantitatively and qualitatively different from the emotions felt when a patient's therapy was completed successfully. A failure was most frequently (76 out of 100 psychotherapists) perceived as premature termination of treatment by the patient where therapy cessation was attributed in 70% of cases to factors within the patient's control. Psychotherapists evaluated their competences highly - they claimed to possess qualities predisposing them to an average success rate of 73%. They rated their job satisfaction at the level of 80%. 61% of psychotherapists discussed their failures at counselling supervision meetings.

Discussion

A tendency to preserve one's self-esteem and to strengthen one's self displayed by psychotherapists is evident in the process of analysing previously committed mistakes.

Conclusions

Psychotherapists experience failures and they are most frequently inclined to attribute them to factors within patients' control.
Editorial
Authors: Cyranka Katarzyna
Published: October 2018

Despite the established position of psychotherapy among treatment methods in psychiatry, there are many questions related to various issues related to its application. The number of therapeutic approaches, which try to justify their accuracy and effectiveness according to the various crises that make people seek for help, is also quite impressive and still increasing. Therefore, we are pleased that some interesting articles in this issue of Archives take up this subject. A. Małus et al. examined the beliefs of psychotherapists regarding their perception of their own competence and on this background the way of dealing with the occurring failures. It is worth consideration that therapists mostly assessed their work well, and the reasons for failure were likely to be placed on the side of patients. As a kind of approximation of this problem, we can treat the case of difficult therapy of a patient with anorexia nervosa and co-occurring borderline personality disorder, whose authors [K. Kordyńska, et al.] managed to achieve only a partial improvement. They conclude that in such conditions the complexity of the patient's needs dictated the necessity of using a pragmatic combination of several modalities of help - integrative psychotherapy, dietary intervention, and also pharmacotherapy. .
INFLUENCE OF TEMPERATURE AND STRAIN RATE ON SUPERPLASTICITY KINETICS OF COMPOSITE AZ61-F MAGNESIUM MATERIALS
Authors: Besterci Michal , Huang Song-Jeng , Sülleiová Katarína , Ballóková Beáta
Published: October 2018

Micromechanisms of fracture of AZ61-F composites in the zone of quasi-superplastic deformation were analyzed and quantified in this work. Deformation of AZ61-F magnesium alloys with 1 wt.% of Al2O3 phase was tested at a temperature of 473 K and different strain rates. It was shown that at the temperature of 473 K and the highest strain rate applied from 1× 10−2 to 1 × 10−4 s−1, a significant growth of ductility was observed. The mean dimples diameter of the ductile fracture decreased with the decreasing strain rate. The grain size of 0.7 μm was reached by severe plastic deformation using equal channel angular pressing (ECAP). Secondary Mg17Al12 and Al2O3 phases were identified. The maximum strain was reached at the temperature of 473 K and strain rate of 1 × 10−4 s−1.
EFFECT OF NITROGEN HYDROGEN RATIO ON PLASMA NITRIDING FOR 38CrMoAl
Authors: Song Lu , Peng Tiantian , Zhao Xiaobin , Hu Jing
Published: October 2018

Critical nitrogen hydrogen ratio in plasma nitriding was primarily investigated to get enhanced performance for 38CrMoAl steel. The modified surface layer was characterized by optical microscopy (OM), X-ray diffraction (XRD) and micro-hardness tester. The results showed that the critical nitrogen hydrogen ratio was 1: 5 while plasma nitriding at 540℃ for 6 h. Under this condition, no compound layer was formed, and accompanied with high surface hardness, while the compound layer was formed accompanied with lower surface hardness with nitrogen hydrogen ratio higher than the critical value.
DEVELOPMENT OF THE TUBE QUENCHING PROTOTYPE UNIT
Authors: Turoň Rostislav , Squerzi Michael , Hnízdil Milan , Chabičovský Martin , Simeček Pavel , Kreisinger Miroslav
Published: October 2018

This paper describes the stages of applied research and development leading to a functional prototype of a quenching unit. It became a part of a closed facility of process equipment for thermal treatment by refining and other methods of annealing of seamless steel tubes for the OCTG industry (Oil Country Tubular Goods), power engineering and mechanical engineering in Třinecké Železárny. The development of the prototype has been divided into several stages: mapping of the current state and critical assessment of the technical and technological level of the existing equipment in the Tube Mill, laboratory testing of tube samples cooling, including numerical simulations with the prediction of the initial settings of the process parameters for the recommendation of the technological configuration of the quenching unit prototype and finally a comprehensive technical design of the prototype quenching unit. The design of the prototype technical solution served as the basis for the creation of the detailed engineering documentation with the subsequent construction of the prototype quenching unit. The paper summarizes the procedures and results of individual development stages, including the results of measured temperatures of tubes during actual operation of the prototype and the results of additional numerical simulations of its actual cooling capacity.
Los crímenes de violencia sexual cometidos al interior de un grupo armado: El caso de los niños soldados en The Prosecutor vs. Bosco Ntaganda
Authors: Fernández Carter Catalina
Published: October 2018

Recientemente, la Corte Penal Internacional confirmó su jurisdicción en el casoseguido contra Bosco Ntaganda, sobre presuntos crímenes de guerra de violacióny esclavitud sexual cometidos contra niños soldados que pertenecían al mismogrupo armado que su agresor. En el presente artículo se examinarán críticamentelas razones y justificaciones otorgadas por la Corte para establecer su jurisdicción y en particular, la interpretación realizada por la Corte respecto a la necesidad de incorporar requisitos adicionales a la descripción típica de los crímenes de guerra de violación y esclavitud sexual bajo el marco establecido del Derecho Internacional. Para estos efectos, se comenzará analizando el concepto tradicional de persona protegida en el Derecho Humanitario, para luego destacar los aspectos esenciales de la decisión de la Corte. A continuación, se examinarán las diferencias fundamentales que existen entre los apartados (a) y (c), por una parte, y (b) y (e), por otra, ambos del artículo 8.2 del Estatuto de Roma, de manera de determinar si el Derecho Internacional Humanitario amparaba la conclusión de la Corte en relación con los crímenes cometidos al interior de grupos armados. Finalmente, se exponen algunas conclusiones y alternativas que podrían permitir a la Corte ejercer jurisdicción sobre ese tipo de crímenes, incluso si las víctimas fueran miembros adultos del mismo grupo armado.
Paci cação na favela não para a favela Uma análise sobre o projeto de paci cação e programas governamentais, como justiça comunitária, implementados na favela, perquirindo quem são os reais bene ciários do projeto e ressaltando a potência política favelada neste contexto
Authors: Ferreira de Andrade Nathalie
Published: October 2018

O conceito de Justiça vem sendo discutido há séculos, por diversas áreas de conheci- mento, não se concluindo pela unicidade de signi cação. Ocorre que, em nome da jus- tiça social, implementou-se um processo de paci cação no Complexo do Alemão e em outras favelas da cidade do Rio de Janeiro, tendo como instrumento as Unidades de Polícia Paci cadora (“UPPs”), em que são registradas uma série de atentados à dignida- de humana. O presente trabalho é baseado em dados produzidos em pesquisa realizada no Complexo do Alemão, com destaque para o objeto empírico, qual seja, a cohabita- ção de uma unidade de educação e o aparelho de segurança UPP. Analisa-se o objeto e argumenta-se a quem atende o discurso de justiça que legitima ações governamentais desta natureza.
Confirmatory Factor Analysis of Ordinal Variables: A Simulation Study Comparing the Main Estimation Methods
Authors: Holgado-Tello Francisco Pablo , Morata-Ramirez Mª Ángeles , Barbero García Maria Isabel
Published: October 2018

In order to obtain evidences about construct validity through Confirmatory Factor Analysis, it has been usual treating Likert-type scales as if they were continuous variables measured on an interval scale. Therefore, Maximum Likelihood estimation method has been broadly applied, but in turn it implies problems concerning both Pearson correlations and skewness in the distribution of responses to items. In this simulation study we analyse —through χ2, Type I error, and power— correctly specified and misspecified models comparing five estimation methods (Maximum Likelihood —ml—, Robust Maximum Likelihood —rml—, Weighted Least Squares —wls—, nweighted Least Squares —uls— and Robust Unweighted Least Squares —ruls—) in relation to the models features: number of factors, number of response categories, items’ skewness, and sample size. We advise using ruls estimation method, in which polychoric correlations are implied.Keywords: Confirmatory Factor Analysis, Likert-type scales, estimation methods, Type I error, power.
Validação psicométrica da Escala da Relação Coparental em mães portuguesas
Authors: Lamela Diogo , Morais Ana , Jongenelen Inês
Published: October 2018

O presente estudo teve como objetivo a adaptação e a validação da Escala de Relação Coparental —erc— em mães portuguesas. A versão original da medida avalia as quatro dimensões da coparentalidade do modelo ecológico da coparentalidade, através de 7 subescalas. O estudo foi composto por uma amostra de 548 mães numa relação íntima heterossexual, e pelo menos um filho com o atual parceiro conjugal com uma idade inferior a 18 anos. Testada através de análise fatorial confirmatória, a solução fatorial final investigada apresentou um ajustamento satisfatório, o que sugere a validade de construto da erc, χ2 (372) = 828.5, ns, cfi = 0.95, nfi = 0.91 e rmsea = 0.04 (90  ic = 0.04-0.05). A escala também apresentou coeficientes de consistência interna entre o satisfatório e o elevado em todas as subescalas (α de Cronbach entre 0.70 e 0.94) e valores muito satisfatórios de validade convergente e divergente, obtidos através de análises correlacionais da erc com outros construtos teoricamente selecionados. Os resultados dão suporte inicial à qualidade psicométrica da versão portuguesa da erc.Palavras-chave: coparentalidade, mães, validação, avaliação.
Yo soy lo que tú no eres: la alteridad en la definición de la identidad andaluza
Authors: Macías-Gómez-Stern Beatriz , Arias-Sánchez Samuel
Published: October 2018

En este artículo presentamos los resultados de una investigación empírica donde exploramos el impacto de la emigración, como experiencia de contraste con un “otro cultural” en la construcción de la identidad andaluza (Sur de España). Para ello hemos analizado el uso de comparaciones en narrativas identitarias (Bruner, 1991) de personas con distintas experiencias migratorias en grupos de discusión sobre la identidad andaluza. Nuestra hipótesis de trabajo era que los participantes con experiencia directa de migración usarían la comparación como recurso discursivo en mayor medida que aquellos que no habían vivido dicha experiencia. Se analizaron los datos discursivos usando un sistema de categorías de elaboración propia. Nuestra unidad de análisis para la codificación fue la “narrativa de identificación”, objetivada como cada enunciado o turno de palabra en el debate. Los resultados mostraron que el uso de las comparaciones como estrategia de construcción de la identidad en el debate era diferencialmente usada por los tres grupos (emigrantes, no emigrantes y emigrantes retornados), siendo los emigrantes los que más recurrían a dicho recurso. También variaban la naturaleza y el grado de explicitud de los objetos y referentes de la comparación. Como conclusión esgrimimos que la experiencia de emigración, como vivencia de contraste con un alter cultural, afecta en el modo en el que las personas construimos nuestras identidades, siendo la comparación con este alter uno de los recursos más empleados para dicho proceso.