bluuebunny/crossref_metadata_2025 huggingface dataset:
Extra-African powers and the crisis of regionalism in Africa: background to and reflections on France’s engagement with Africa
Authors: Basiru Adeniyi S.
Published: July 2016

In the 1960s, African leaders, irrespective of their ideological orientations, size of their nations and indeed, level of national development, did believe that the futures of their countries lie in collective self-reliance efforts. To achieve this lofty objective, various regionalist frameworks were designed and instrumentalized, albeit, to transform the continent but the material and spiritual conditions of the majority of the inhabitants have not improved. Whatever aspect one considers – security, foreign investment, trade, information technology and skilled labour force – the continent outlook gives little or no cause for celebration. What could be responsible for this state of affairs or put differently, what accounts for the crisis of regionalism in Africa? This paper sought answer(s) to these questions in the light of West and Central African experience under French colonialism. Drawing on secondary historical data and leaning on structural dependency platform spiced with colonialism thesis, it argued that la Francophonie, the assimilatory base of French imperialism, and its legacy, has to a reasonable extent, thwarted efforts at institutionalizing regional integration in the sub-region. The paper concluded that given the prevailing realities on ground, the structure may persist unless the forces that incubated it are confronted frontally.
Fatigue properties of friction stir welded joint of ultrafine-grained 2024 aluminium alloy
Authors: Wang W. , Qiao K. , Wu J.L. , Li T.Q. , Cai J. , Wang K.S.
Published: July 2016

Ultrafine-grained (UFG) 2024 aluminium alloy prepared by the equal channel angular pressing was friction stir welded (FSW). The high cycle fatigue and crack growth behaviour of the FSW joint were investigated in air and NaCl solution, respectively. This study demonstrated that FSW was a viable technique for joining UFG materials. The UFG microstructure was retained in the nugget zone (NZ). Compared with the UFG base metal (BM), FSW joint exhibited lower ultimate tensile strength and hardness, and the minimum hardness value was located in the heat affected zone (HAZ). NaCl solution significantly reduced the fatigue strength of FSW joint. Fatigue crack propagation rates in the NZ and HAZ were slower than that in the BM in the whole fatigue life.
Let me Take the Wheel: Illusory Control and Sense of Agency
Authors: Tobias-Webb Juliette , Limbrick-Oldfield Eve H. , Gillan Claire M. , Moore James W. , Aitken Michael R. F. , Clark Luke
Published: July 2016

Illusory control refers to an effect in games of chance where features associated with skilful situations increase expectancies of success. Past work has operationalized illusory control in terms of subjective ratings or behaviour, with limited consideration of the relationship between these definitions, or the broader construct of agency. This study used a novel card-guessing task in 78 participants to investigate the relationship between subjective and behavioural illusory control. We compared trials in which participants (a) had no opportunity to exercise illusory control, (b) could exercise illusory control for free, or (c) could pay to exercise illusory control. Contingency Judgment and Intentional Binding tasks assessed explicit and implicit sense of agency, respectively. On the card-guessing task, confidence was higher when participants exerted control than in the baseline condition. In a complementary model, participants were more likely to exercise control when their confidence was high, and this effect was accentuated in the pay condition relative to the free condition. Decisions to pay were positively correlated with control ratings on the Contingency Judgment task, but were not significantly related to Intentional Binding. These results establish an association between subjective and behavioural illusory control and locate the construct within the cognitive literature on agency.
Megan King: A force to be reckoned with
Authors: Jordan Shawn
Published: July 2016

King’s work focuses on the intimate biomechanical link between the nucleus and the cytoskeleton.
HIV-related stigma and universal testing and treatment for HIV prevention and care: design of an implementation science evaluation nested in the HPTN 071 (PopART) cluster-randomized trial in Zambia and South Africa
Authors: Hargreaves James R , Stangl Anne , Bond Virginia , Hoddinott Graeme , Krishnaratne Shari , Mathema Hlengani , Moyo Maureen , Viljoen Lario , Brady Laura , Sievwright Kirsty , Horn Lyn , Sabapathy Kalpana , Ayles Helen , Beyers Nulda , Bock Peter , Fidler Sarah , Griffith Sam , Seeley Janet , Hayes Richard ,   on Behalf of the HPTN 071 (PopART) study team
Published: July 2016

Background : Stigma and discrimination related to HIV and key populations at high risk of HIV have the potential to impede the implementation of effective HIV prevention and treatment programmes at scale. Studies measuring the impact of stigma on these programmes are rare. We are conducting an implementation science study of HIV-related stigma in communities and health settings within a large, pragmatic cluster-randomized trial of a universal testing and treatment intervention for HIV prevention in Zambia and South Africa and will assess how stigma affects, and is affected by, implementation of this intervention.

Methods/Design : A mixed-method evaluation will be nested within HIV prevention trials network (HPTN) 071/PopART (Clinical Trials registration number NCT01900977), a three-arm trial comparing universal door-to-door delivery of HIV testing and referral to prevention and treatment services, accompanied by either an immediate offer of anti-retroviral treatment to people living with HIV regardless of clinical status, or an offer of treatment in-line with national guidelines, with a standard-of-care control arm. The primary outcome of HPTN 071/PopART is HIV incidence measured among a cohort of 52 500 individuals in 21 study clusters. Our evaluation will include integrated quantitative and qualitative data collection and analysis in all trial sites. We will collect quantitative data on indicators of HIV-related stigma over 3 years from large probability samples of community members, health workers and people living with HIV. We will collect qualitative data, including in-depth interviews and observations from members of these same groups sampled purposively. In analysis, we will: (1) compare HIV-related stigma measures between study arms, (2) link data on stigma to measures of the success of implementation of the PopART intervention and (3) explore changes in the dominant drivers and manifestations of stigma in study communities and the health system.

Discussion : HIV-related stigma may impede the successful implementation of HIV prevention and treatment programmes. Using a novel study-design nested within a large, community randomized trial we will evaluate the extent to which HIV-related stigma affects and is affected by the implementation of a comprehensive combination HIV prevention intervention including a universal test and treatment approach.
The electronic health record audit file: the patient is waiting
Authors: Hirsch Annemarie G , Jones J B , Lerch Virginia R , Tang Xiaoqin , Berger Andrea , Clark Deserae N , Stewart Walter F
Published: July 2016

Objective: We describe how electronic health record (EHR) audit files can be used to understand how time is spent in primary care (PC).

Materials/methods: We used audit file data from the Geisinger Clinic to quantify elements of the clinical workflow and to determine how these times vary by patient and encounter factors. We randomly selected audit file records representing 36 437 PC encounters across 26 clinic locations. Audit file data were used to estimate duration and variance of: (1) time in the waiting room, (2) nurse time with the patient, (3) time in the exam room without a nurse or physician, and (4) physician time with the patient. Multivariate modeling was used to test for differences by patient and by encounter features.

Results: On average, a PC encounter took 54.6 minutes, with 5 minutes of nurse time, 15.5 minutes of physician time, and the remaining 62% of the time spent waiting to see a clinician or check out. Older age, female sex, and chronic disease were associated with longer wait times and longer time with clinicians. Level of service and numbers of medications, procedures, and lab orders were associated with longer time with clinicians. Late check-in and same-day visits were associated with shorter wait time and clinician time.

Conclusions: This study provides insights on uses of audit file data for workflow analysis during PC encounters.

Discussion: Scalable ways to quantify clinical encounter workflow elements may provide the means to develop more efficient approaches to care and improve the patient experience.
THE 3rd INTERNATIONAL CONGRESS ON PRE‐ AND PROBIOTICS
Authors: Vandenplas Yvan
Published: July 2016

It has become tradition to organize every two years an international meeting on pre‐ and probiotics, dedicated to paediatrics. The first and second meetings were held in Turkey. During recent years interest has focused on the composition of the gastro‐intestinal microbiome. Today, it is obvious that the microbiome composition differs between healthy children and with sick children as is the case in immune mediated diseases: inflammatory bowel disease, allergy, diabetes, ….However, manipulation of the microbiome is most of the time disappointing as it does often not result in improvement of the condition. The interest of industry in the microbiome is obvious, since we will have nine satellite symposia.
PROBIOTICS AND HEAVY METALS
Authors: Foligné B.
Published: July 2016

Heavy metal (HM) bioremediation is based on specific capacities of microorganisms to immobilize and/or inactivate pollutants by various passive (biosorption, complexation) or active transport (internalization, efflux/uptake ratio) mechanisms to lower HM biodisponibility. This concept can also be applied in vivo ‘inside the digestive tract’. Likely, commensal intestinal microorganisms play a clear positive role in interactions with HMs. Providing that microbial species meet safe criteria for dietary use, transitory bugs may at least do as well and even better than resident ones. Various food microbes can indeed prevent the absorption of HMs into the body and remove such xenobiotics during defecation. Efforts have mostly focused on lactic acid bacteria and related species, showing a suitable capacity for selected lactobacilli and bifidobacteria to sequester lead and cadmium divalent cations and mercury salts. A Promising proof of concept of efficiency was recently demonstrated in preclinical models of acute and chronic HM toxicity in mice. Likewise, a first clinical study showed reduced circulating levels of toxic HMs in pregnant women and children living in a contaminated area by using a designed fermented milk. Further research is thus actively needed to examine the best biosorption ability of various other food grade bacteria and to decipher the specific related mechanisms regarding the type of metal element. We have already identified that several strains from cheese ecosystems and fermented meats are to date little explored but have much greater bioremediation capacities when compared to lactobacilli spp. These promising microbes derived illustrate the concept of Probiotics versus Xenobiotics.
QUALITY CONTROL OF PROBIOTICS
Authors: Warzée J.P.
Published: July 2016

Numerous proprietary medicinal products and food supplements, containing probiotics such as Lactobacilli, Bifidobacteria have been introduced in Europe over the last 10 years. Today all parties involved agree on the need for a “Quality Label” to differentiate quality products from “non‐controlled“ products.

The “European Scientific League for Probiotics” (ESLP) label is a “Quality Label” created by the non‐profit association “European Scientific League for Probiotics” founded in 2011. The ESLP quality label is exclusively granted to specialities based on documented specific strains and associations (specific for adults, children or women) sold through the pharmacy channel. The ESLP quality label is assigned at spontaneous application by the manufacturer. The ESLP quality label is granted after qualitative and quantitative microbiological analysis have been carried out by an independent laboratory and this based on the specifications defined by the ESLP Scientific Committee consisting of key opinion leaders in Microbiology. The purpose is to verify if probiotic bacteria announced by the business operators are present in sufficient quantities in the products sold to consumers.
MICROBIOTA AND DEVELOPMENT OF GASTRO‐INTESTINAL FUNCTION AND INFLAMMATION
Authors: Indrio F.
Published: July 2016

During the third trimester of pregnancy and in the first days after birth, important processes of intestinal maturation take place. Although anatomical differentiation of the human gut is usually achieved within 20 weeks of gestation, the functional maturation of the gastrointestinal tract is occurs later and requires organized peristalsis and coordinated sucking and swallowing reflexes that are not established until 29–30 weeks and 32–34 weeks of gestations, respectively

Sensory‐motor gastrointestinal functions are strictly related to the infant's immune system which plays a crucial role in modulating appropriate and non‐exaggerated responses to luminal antigens. This fundamental enteric function, known as “oral tolerance,” is based on the interaction between the luminal content (microbiota, food antigens and other molecules), the intestinal epithelium and the tolerogenic dendritic cells (DCs) from mesenteric lymph nodes of the gut associated lymphoid tissue (GALT), and is associated with specific cytokine patterns.

It has been suggested that the early composition of the intestinal microbiota at birth can influence the correct ontogenesis of the gut barrier and motor and immune function through a complex neuroendocrine cross‐talk.

Consequences of prematurity like antibiotic usage, feeding type and being located in neonatal intensive care unit (NICU) may cause an intestinal dysbiosis that affects the intestinal integrity and disrupts the delicate balance between intestinal microbiota and the immune system of premature infants. An aberrant microbial colonization pattern might contribute to the development of an early traumatic inflammatory insult on the gut‐brain axis with short and long term consequences on gastrointestinal well‐being.
THE EFFECT OF PROBIOTICS IN ABDOMINAL PAIN‐RELATED FUNCTIONAL GASTROINTESTINAL DISORDERS IN CHILDHOOD.
Authors: Weizman Z.
Published: July 2016

Functional gastrointestinal disorders, associated with abdominal pain, are one of the most common complaints in childhood. Although benign in nature, these conditions are commonly associated with an excessive anxiety, unnecessary laboratory tests and a significant economic burden.

According to the Rome III criteria these disorders may be classified into: functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain (FAP) and abdominal migraine. Several studies in adults have demonstrated some clinical benefit of particular probiotic agents, mostly in IBS.

Pediatric literature data are scarce and controversial, as they present a wide variability of study design and type of microorganisms.

The present lecture will outline our own data along a systematic literature review, demonstrating the evidence‐based data regarding the efficacy of probiotic agents in these conditions. Results are presented in the table below. Potential mechanisms, useful guidelines and future directions will be delineated as well.

In conclusion, probiotic microorganisms may serve, to some extent, as a therapeutic aid in selected abdominal pain‐related functional gastrointestinal disorders in childhood, mainly FAP and IBS. These preliminary promising results should be validated in future well‐designed large‐scale trials.
FERMENTABLE OLIGOSACCHARIDES, DISACCHARIDES, MONOSACCHARIDES AND POLYOLS (FODMAP) AS A PREBIOTIC AND INTERACTION WITH MICROBIOME
Authors: Biesiekierski J.
Published: July 2016

Reducing intake of a group of poorly absorbed, short‐chain carbohydrates, termed FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) has demonstrated symptom improvement in 75% of adult patients with irritable bowel syndrome (IBS). There are limited good quality randomised controlled trials of FODMAPs in children and current evidence is largely based on studies in adults.

FODMAPs are found naturally in a range of foods and include fructose (in excess of glucose), lactose, polyols, fructans and galacto‐oligosaccharides. FODMAPs increase delivery of liquid and gas to the lumen, by virtue of their small molecular size, osmotic effect and rapid fermentability. This can lead to intestinal distension, which together with peripheral and central predisposing factors (e.g., visceral hypersensitivity) can generate gastrointestinal symptoms such as wind, bloating, abdominal pain and affect motility.

FODMAPs, especially oligosaccharides, have shown positive effects on the colonic microenvironment and microbiota in healthy populations. Recent findings of changes in gut microbiota composition of IBS and healthy subjects with differing FODMAP intakes including changes in total bacteria abundance and altering the relative abundance of Bifidobacteria, raise caution to recommending the low FODMAP diet long‐term, and reinforce that the low FODMAP diet should not be recommended for asymptomatic populations.

The use of the FODMAP diet in gastrointestinal disorders, including mechanisms of action, overview of the diet's structure and efficacy and further studies needed will be discussed, including limitations and what data exists within the paediatric population.
GUT MICROBIOTA AS A TARGET FOR FOOD ALLERGY
Authors: Canani Roberto Berni
Published: July 2016

Evidence suggests a key pathogenetic role for gut microbiota modifications (dysbiosis) in food allergy development. Several factors responsible for dysbiosis have been associated with the occurrence of food allergy, such as caesarean delivery, lack of breast milk, drugs use (mainly antibiotics and gastric acidity inhibitors), antiseptic agents use, and low fibers/hight fat diet.

No specific bacterial taxa have been consistently associated with food allergy, but evidence suggests that gut dysbiosis occurs even before food allergy signs and symptoms presentation.

Data from animal and human studies highlight the ability of particular bacterial taxa to ferment dietary fibers for the production of short chain fatty acids (SCFAs) that affect host immunity and help to explain their health‐promoting role. Among SCFAs butyrate has a pivotal role in tolerance induction.

Modulation of gut microbiota composition and/or function using selected probiotics strains represents a promising strategy for treatment and prevention of food allergy in childhood.
MICROBIOTA MANAGEMENT FOR THE PREVENTION OF RECURRENT EAR AND THORAT INFECTIONS
Authors: Gerritsen C. , Grahn‐Håkansson E. , Roos K.
Published: July 2016

Upper respiratory tract infections (URTIs) are caused by an (acute) infection of a region in the upper respiratory tract. This commonly includes diseases like tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media and the common cold. URTIs can be caused by a variety of microorganisms including viruses and bacteria. Due to the combination of high colonization rates of potential pathogens and an immature immune system especially children are prone to the development of URTIs. Recurrent infections can have even more serious consequences, like hearing loss, and speaking‐ and learning disability. Treatments vary between countries and include to wait until the infections over, antibiotic prescription or in more severe cases surgery. A main disadvantage of traditional treatment options is that they only relieve the symptoms but do not address the underlying cause. The extensive use of antibiotic for acute otitis media (AOM) has obvious public health and economic consequences.

Only very recently studies are being published researching the microbial communities that inhabit the (upper) respiratory tract. These studies show that the bacterial players in the respiratory tract are quite different to the key players in the gastro‐intestinal tract. Data indicate that just like the gastro‐intestinal tract, diversity in the microbiota seems to play an important role in the susceptibility to infections. Alternative therapies that support the commensal microbiota in the upper respiratory tract are highly desired. Recent studies have suggested that probiotics may reduce the risk of various symptoms of URTIs. The mechanisms behind the possible beneficial effect of probiotics on URTIs are not completely clear but may be related to colonization of the probiotic bacteria in the upper respiratory tract. At the moment we are looking into the possibilities to develop a probiotic formulation under the Ecologic®brand for upper respiratory tract infections. We have acquired a small collection of bacterial strains that already have shown their efficacy to be able to prevent the recurrence of ear and throat infection in several clinical trials (1–6). With these bacterial strains as a basis we are developing a probiotic formulation that stimulates the commensal upper respiratory tract microbiota and inhibits the specific pathogens involved in recurrent ear and throat infections.
Maternal Gut Microbiota Composition and Inflammatory Cytokines Before and After Delivery
Authors: Hermansson Henriina , Rautava Samuli , Isolauri Erika
Published: July 2016

Introduction:

The metabolic and immunologic changes during pregnancy endorse the growth and development of the foetus (1). The composition of the gut microbiota changes in parallel (2) but little is known about the significance of the gut microbiota in pregnancy and the pace of recovery after delivery.

Methods:

A nested case‐control study based on a prospective intervention trial (3) was conducted. Altogether 10 women who had delivered by elective caesarean section (CS) and 13 women with non‐elective CS were selected for this study. Women who had delivered vaginally (n = 23) were chosen as controls and matched for pre‐pregnancy BMI, probiotic intervention during pregnancy as well as antibiotic exposure during pregnancy and labour. Blood and faecal samples were collected at the third trimester of pregnancy and one month postpartum. The composition of the gut microbiota was assessed by qPCR. The concentrations of the cytokines IL‐1, IL‐6, IL‐8, IL‐10, MCP‐1, TNF‐α were measured from serum.

Results:

One month after delivery the gut microbiota composition had not changed from the situation at the third trimester. Against this trend, faecal Clostridium coccoides numbers were higher in mothers after vaginal delivery as compared to those who had delivered by CS (p = 0.0001). The serum concentrations pro‐inflammatory cytokines were higher one month postpartum than in the third trimester of pregnancy (Table 1).

Discussion:

Pregnancy alters the gut microbiota composition (1) and these pro‐inflammatory changes seen at the third trimester of pregnancy have not yet normalized one month after delivery. A parallel pro‐inflammatory tone was manifested in the serum cytokine profile indicating that the inflammatory state continues after pregnancy. The mode of delivery plays little role in these phenomena. Therefore probiotic intervention in attempt to reduce the risk of inflammatory conditions may need extension beyond the perinatal period.
Effects of Probiotics on Performance, Carcass Yield and Internal Organs in Broilers
Authors: Yalçin Suzan , Eser Handan , Yalçin Sakine
Published: July 2016

Introduction:

Probiotics have been used increasingly in poultry diets after the ban on the use of antibiotic growth promoters in the EU. Probiotics include beneficial microorganisms that may have positive effects on the intestinal tract of poultry. This study was aimed to determine the effects of dietary probiotics on performance, carcass yield and internal organs in broilers.

Methods:

A total of 300 Ross 308 broiler male chicks aged one day were divided into one control group and two treatment groups each group containing 100 chicks. Each group was divided into 5 replicates, as subgroups, each comprising 20 chicks. Feed and water were provided for ad libitum consumption and the diets were presented in mash form. The experimental period lasted 39 days. Basal diet was supplemented with the probiotics (Nafoil forte, Bacillus subtilis, Lactobacillus plantarum, Saccharomyces cerevisiae, Biotem Ltd Company). Probiotics were added at 0.1 and 0.2% to the first and second treatment groups, respectively. Body weight and feed intake were recorded. Body weight gain and feed conversion ratio were calculated. At the end of the experiment (d 39) 10 broilers from each group were weighed and slaughtered by severing the jugular vein. Hot carcass weights were determined and carcass yield was calculated. Absolute and proportional weights of abdominal fat, liver, heart, spleen, gizzard and Bursa of Fabricius were also determined.

Results:

Dietary supplementation of probiotics containing Bacillus subtilis, Lactobacillus plantarum, Saccharomyces cerevisiae didn't affect the final body weight, body weight gain, feed intake and feed efficiency during the 39 days of experimental period. Probiotics supplementation increased carcass yield (P < 0.05) and decreased abdominal fat percentages (P < 0.05). Relative weights of liver, heart, gizzard, spleen and Bursa of Fabricius were not affected from the usage of probiotics.

Discussion:

Dietary probiotics supplementation improved carcass yield and decreased the abdominal fat significantly without changing other performance parameters in broilers. As a conclusion dietary probiotics supplementation might be beneficial additives for broilers.
A Taxonomy of Fatigue Concepts and Their Relation to Hearing Loss
Authors: Hornsby Benjamin W. Y. , Naylor Graham , Bess Fred H.
Published: July 2016

Fatigue is common in individuals with a variety of chronic health conditions and can have significant negative effects on quality of life. Although limited in scope, recent work suggests persons with hearing loss may be at increased risk for fatigue, in part due to effortful listening that is exacerbated by their hearing impairment. However, the mechanisms responsible for hearing loss-related fatigue, and the efficacy of audiologic interventions for reducing fatigue, remain unclear. To improve our understanding of hearing loss-related fatigue, as a field it is important to develop a common conceptual understanding of this construct. In this article, the broader fatigue literature is reviewed to identify and describe core constructs, consequences, and methods for assessing fatigue and related constructs. Finally, the current knowledge linking hearing loss and fatigue is described and may be summarized as follows: Hearing impairment may increase the risk of subjective fatigue and vigor deficits; adults with hearing loss require more time to recover from fatigue after work and have more work absences; sustained, effortful, listening can be fatiguing; optimal methods for eliciting and measuring fatigue in persons with hearing loss remain unclear and may vary with listening condition; and amplification may minimize decrements in cognitive processing speed during sustained effortful listening. Future research is needed to develop reliable measurement methods to quantify hearing loss-related fatigue, explore factors responsible for modulating fatigue in people with hearing loss, and identify and evaluate potential interventions for reducing hearing loss-related fatigue.
Using Speech Recall in Hearing Aid Fitting and Outcome Evaluation Under Ecological Test Conditions
Authors: Lunner Thomas , Rudner Mary , Rosenbom Tove , Ågren Jessica , Ng Elaine Hoi Ning
Published: July 2016

In adaptive Speech Reception Threshold (SRT) tests used in the audiological clinic, speech is presented at signal to noise ratios (SNRs) that are lower than those generally encountered in real-life communication situations. At higher, ecologically valid SNRs, however, SRTs are insensitive to changes in hearing aid signal processing that may be of benefit to listeners who are hard of hearing. Previous studies conducted in Swedish using the Sentence-final Word Identification and Recall test (SWIR) have indicated that at such SNRs, the ability to recall spoken words may be a more informative measure. In the present study, a Danish version of SWIR, known as the Sentence-final Word Identification and Recall Test in a New Language (SWIRL) was introduced and evaluated in two experiments. The objective of experiment 1 was to determine if the Swedish results demonstrating benefit from noise reduction signal processing for hearing aid wearers could be replicated in 25 Danish participants with mild to moderate symmetrical sensorineural hearing loss. The objective of experiment 2 was to compare direct-drive and skin-drive transmission in 16 Danish users of bone-anchored hearing aids with conductive hearing loss or mixed sensorineural and conductive hearing loss. In experiment 1, performance on SWIRL improved when hearing aid noise reduction was used, replicating the Swedish results and generalizing them across languages. In experiment 2, performance on SWIRL was better for direct-drive compared with skin-drive transmission conditions. These findings indicate that spoken word recall can be used to identify benefits from hearing aid signal processing at ecologically valid, positive SNRs where SRTs are insensitive.
The Moderating Effect of Success Importance on the Relationship Between Listening Demand and Listening Effort
Authors: Richter Michael
Published: July 2016

A common element of the psychophysiological research on listening effort is the focus on listening demand as determinant of effort. The article discusses preceding studies and theorizing on effort to show that the link between listening demand and listening effort is moderated by various variables. Moreover, I will present a recent study that examined the joint effect of listening demand and success importance on effort-related cardiovascular reactivity in an auditory discrimination task. Results for pre-ejection period reactivity—an indicator of sympathetic activity—supported the hypothesis that the relationship between listening demand and listening effort is moderated by other variables: Pre-ejection period reactivity was higher in the high-demand-high-success-importance condition than in the other three conditions. This new finding as well as the findings of previous research on effort suggest that a broader perspective on the determinants of listening effort is warranted.
Evolution of Models of Working Memory and Cognitive Resources
Authors: Wingfield Arthur
Published: July 2016

The goal of this article is to trace the evolution of models of working memory and cognitive resources from the early 20th century to today. Linear flow models of information processing common in the 1960s and 1970s centered on the transfer of verbal information from a limited-capacity short-term memory store to long-term memory through rehearsal. Current conceptions see working memory as a dynamic system that includes both maintaining and manipulating information through a series of interactive components that include executive control and attentional resources. These models also reflect the evolution from an almost exclusive concentration on working memory for verbal materials to inclusion of a visual working memory component. Although differing in postulated mechanisms and emphasis, these evolving viewpoints all share the recognition that human information processing is a limited-capacity system with limits on the amount of information that can be attended to, remain activated in memory, and utilized at one time. These limitations take on special importance in spoken language comprehension, especially when the stimuli have complex linguistic structures or listening effort is increased by poor acoustic quality or reduced hearing acuity.
Cortisol, Chromogranin A, and Pupillary Responses Evoked by Speech Recognition Tasks in Normally Hearing and Hard-of-Hearing Listeners: A Pilot Study
Authors: Kramer Sophia E. , Teunissen Charlotte E. , Zekveld Adriana A.
Published: July 2016

Pupillometry is one method that has been used to measure processing load expended during speech understanding. Notably, speech perception (in noise) tasks can evoke a pupil response. It is not known if there is concurrent activation of the sympathetic nervous system as indexed by salivary cortisol and chromogranin A (CgA) and whether such activation differs between normally hearing (NH) and hard-of-hearing (HH) adults. Ten NH and 10 adults with mild-to-moderate hearing loss (mean age 52 years) participated. Two speech perception tests were administered in random order: one in quiet targeting 100% correct performance and one in noise targeting 50% correct performance. Pupil responses and salivary samples for cortisol and CgA analyses were collected four times: before testing, after the two speech perception tests, and at the end of the session. Participants rated their perceived accuracy, effort, and motivation. Effects were examined using repeated-measures analyses of variance. Correlations between outcomes were calculated. HH listeners had smaller peak pupil dilations (PPDs) than NH listeners in the speech in noise condition only. No group or condition effects were observed for the cortisol data, but HH listeners tended to have higher cortisol levels across conditions. CgA levels were larger at the pretesting time than at the three other test times. Hearing impairment did not affect CgA. Self-rated motivation correlated most often with cortisol or PPD values. The three physiological indicators of cognitive load and stress (PPD, cortisol, and CgA) are not equally affected by speech testing or hearing impairment. Each of them seem to capture a different dimension of sympathetic nervous system activity.
Shelf acetabuloplasty for reconstructive or salvage surgical treatment in Legg-Calvé-Perthes disease
Authors: Paulson Andrea , Mielke Cary
Published: July 2016

Background:

Treatment for Legg-Calvé-Perthes (LCP) disease remains controversial. When containment is not possible, salvage procedures have been used to treat symptomatic LCP disease.

Methods:

The purpose of this study was to assess the effectiveness of shelf acetabuloplasty (SA) for treatment of patients with symptomatic Legg-Calvé-Perthes (LCP) disease. A retrospective review of 17 patients with LCP disease treated by SA was conducted. The mean age at diagnosis was 7 yr, the mean age at SA was 9 yr, and the mean age at final follow-up was 14 yr. Surgery was offered to provide femoral head coverage and pain relief. Preoperative range of motion (ROM) and radiographs were evaluated. Radiographs, ROM, and Adolescent (parent report) Outcomes Data Collection Instrument (PODCI) outcomes were done at final follow-up. The lateral pillar classification of Herring was assessed preoperatively. The Stulberg classification was determined at final follow-up.

Results:

Preoperatively, 10 patients were Herring B, two were Herring B/C, and five were Herring C. Significant improvement was seen at final follow-up in all radiographic parameters that document improved femoral head coverage. No change was seen in the lateral acetabular shape (LAS) or the articulotrochanteric distance (ATD). Six hips at final visit were Stulberg 1 or 2 (35%), six hips were Stulberg 3 (35%), and five hips were Stulberg 4 or 5 (30%). All PODCI outcomes were slightly below normal, except happiness rated slightly above normal. Sixteen of 17 patients would recommend SA to others.

Conclusions:

SA remains a viable option for successful treatment during any stage of symptomatic LCP disease.
Analysis of surgeon experience and impact of comorbidities on early discharge after mini-open transforaminal lumbar interbody fusion
Authors: Chan Ferdinand J. , Stelma Sarah , Cho Woojin , Krystal Jonathan , Sharan Alok D.
Published: July 2016

Background:

Mini-open transforaminal lumbar interbody fusion (TLIF) has emerged as an alternative to open lumbar fusion. Currently, there is a limited amount of literature concerning the learning curve and perioperative variables of mini-open TLIF despite literature suggesting its overall advantage over open procedures. The objectives of this study were to evaluate the learning curve associated with mini-open TLIF and to identify factors affecting length of stay (LOS).

Methods:

Retrospective review of one surgeon’s first 100 mini-open TLIF cases was performed to evaluate operative time, LOS, estimated blood loss (EBL), Oswestry Disability Index (ODI), visual analog pain scores (VAS), and fusion status. Operative time and LOS data were used to determine a proficiency point. Additional patient factors were collected and their impact on LOS was determined.

Results:

Operative time was found to be significantly less after 21 patients and LOS shorter after 22 patients. No significant differences were found when the first 22 patients were compared to the last 78 patients for ODI, VAS, and fusion status. Factors associated with decreased LOS include shorter operative time, lower EBL, later point on the learning curve of the surgeon, and patient factors including lower body mass index, being married or living with a significant other, and having a prior lumbar surgery.

Conclusions:

A significant learning curve is associated with mini-open TLIF. Similar follow-up outcomes suggest satisfactory outcomes even during the learning curve period.
Autologous platelet-rich plasma injection in tennis elbow and plantar fasciitis
Authors: Gupta S.K.Venkatesh , Bandari Divya
Published: July 2016

Background:

The introduction of platelet rich plasma (PRP) as a possible adjunct to conservative and operative treatment has motivated significant research into this topic. PRP is a set of autologous platelet products used to accelerate recovery from injury by bringing to the site of injury a set of molecules that will accelerate the functional recovery of the tissue by trying to regenerate it rather than merely repair with scar tissue. In this prospective study, we evaluate the results of PRP in tennis elbow and plantar fasciitis.

Methods:

During October 2013 to March 2015, 100 patients, 60 with tennis elbow and 40 plantar fasciitis, who visited our center with failed conservative treatment were treated with PRP, and results were evaluated with VAS, DASH and FHSQ scores.

Results:

Among 60 patients with tennis elbow (24 males and 36 females) post-PRP injection significant differences were observed between VAS and DASH score at baseline and after 4 wk and 8 wk (P<0.001). Among 40 patients with plantar fasciitis (16 males and 24 females) post-PRP injection significant results were observed between VAS and FHSQ scores at baseline and after 4 wk and 8 wk (P<0.001).

Conclusions:

PRP when given with proper care appears to be helpful in tennis elbow and plantar fasciitis. It is safe and a significant improvement has been observed in VAS and DASH scores for tennis elbow and VAS and FHSQ for plantar fasciitis.
First Place Award Multidisciplinary care of the hip fracture patient: a case control analysis of differing treatment protocols
Authors: Noticewala Manish S. , Swart Eric , Shah Roshan P. , Macaulay William , Geller Jeffrey A.
Published: July 2016

Background:

Recent evidence has suggested that geriatric patients with osteoporotic hip fractures may benefit from comanagement with a multidisciplinary care team. We evaluated the effect that establishment of a comprehensive multidisciplinary care team had on time to surgery, length of hospital stay, postoperative complications, and morbidity on geriatric hip fracture patients.

Methods:

This study was a retrospective comparative cohort study of 267 patients admitted for geriatric hip fractures at an academic trauma center and a community hospital. Patients at the academic hospital were treated by a unilateral orthopaedic team, while patients at the community hospital were treated by a comprehensive multidisciplinary team (MDT), with both hospitals served by the same group of rotating physicians and ancillary staff. Outcomes included time to surgery (TTS), length of stay (LOS), postoperative complications, and mortality rates.

Results:

One hundred and twenty-nine hip fractures were treated by the MDT and 138 by the non-MDT. The MDT cohort was older (84.5 vs. 79.9 yr, P<0.001) and had a larger percentage of women (79.8% vs. 67.4%, P=0.03) than the non-MDT cohort. Patients in the MDT cohort experienced a shorter TTS (1.7 vs. 2.4 days, P<0.001) and LOS (8.2 vs. 10.7 days, P=0.024) than those in the non-MDT cohort. There were no differences in complication or mortality rates between the two cohorts.

Conclusions:

Treatment of patients with hip fractures by a comprehensive multidisciplinary team may lead to improved clinical processes shown by decreased time to surgery and shorter LOS but did not significantly decrease individual complication or mortality rates.
Third Place Award Off-label versus on-label outcomes of total joint arthroplasty
Authors: Liu Jane , Small Travis , Masch Jessica , Goldblum Andrew , Klika Alison , Barsoum Wael
Published: July 2016

Background:

Original indications for knee and hip arthroplasty implants were developed decades ago and categorized conditions, such as obesity and developmental dysplasia, as contraindications, rendering their use in these patients “off-label”. The objective of this pilot study was to determine the prevalence of off-label use at our institution and test for differences in clinical and functional outcomes between patients with implants used on- and off-label.

Methods:

Primary knee or hip arthroplasty patients treated between January 2010 and June 2010 were studied. Revision rate, University of California Los Angeles (UCLA) activity level, functional (i.e., Hip Disability and Osteoarthritis Outcome Score or Knee Disability and Osteoarthritis Outcome Score) and Short Form-12 General Health Status were compared.

Results:

Two hundred and twenty five (81.5%) patients responded to the survey (92 hips and 133 knees), 154 (68.4%) of which had off-label use of an implant. There were no differences detected between groups.

Conclusions:

This study suggests that on-label and off-label patients have similar short-term outcomes.
Emerging biomarkers in systemic sclerosis
Authors: Manetti Mirko
Published: July 2016

Purpose of review

The severity of each organ involvement, natural course, and response to therapies are extremely heterogeneous among patients with systemic sclerosis (SSc). The discovery and validation of biomarkers can help identify disease risk, improve early diagnosis and prognosis, better design clinical trials and assess response to treatment, and further elucidate the underlying pathogenic mechanisms of this disease. The goal of this review is to summarize recent advances into the field of SSc biomarker development.

Recent findings

The use of both traditional and next-generation techniques, including large-scale transcriptomic, epigenomic, and proteomic technologies, has yielded a slew of new candidate biomarkers that correlate with different SSc clinical phenotypes. Recent evidence indicates that skin gene expression-based pharmacodynamic biomarkers have the potential to be employed as surrogate measures of clinical endpoints (i.e. modified Rodnan skin thickness score) providing objective assessment of response in clinical trials.

Several promising biomarkers addressing key unmet needs related to the evaluation and management of SSc patients have been recently proposed. Nevertheless, these biomarkers still require rigorous validation in prospective studies and have yet to make their way into clinical practice and therapeutic development. Robust biomarkers, ideally mechanistic ones, are needed to enable precision medicine in SSc.
Risk Factors for Early ACL Reconstruction Failure in Pediatric and Adolescent Patients: A Review of 561 Cases
Authors: Ho Brian , Edmonds Eric W. , Chambers Henry G. , Bastrom Tracey P. , Pennock Andrew T.
Published: July 2016

Background:

Anterior cruciate ligament (ACL) reconstruction failure is relatively common in young high-risk athletes. The purpose of this study was to examine a single center’s 10-year experience with ACL reconstructions in pediatric and adolescent patients to better define short-term failure rates and risk factors for revision ACL surgery.

Methods:

This institutional review board-approved retrospective study included all patients who underwent a primary ACL reconstruction between 2002 and 2013. Chart and radiographic review was performed to assess patient demographic, injury, and surgical data including growth plate status, concomitant ligament/meniscus/cartilage injury, surgical procedures, femoral drilling technique, graft source and type, femoral and tibial fixation devices, and graft size. Graft failures had to be confirmed both with clinical examination and magnetic resonance imaging or the patient had to undergo a revision ACL reconstruction. Potential factors associated with failure were evaluated using either parametric or nonparametric analysis as appropriate.

Results:

A total of 561 ACL reconstructions were performed that met our inclusion criteria. The average patient age was 15.4 years (range, 5 to 19 y) and 53% of the patients were male. In all, 54 failures were identified for a 9.6% failure rate. Soft tissue grafts were twice as likely to fail compared with patellar tendon grafts (13% vs. 6%; P<0.001). Multivariate analysis revealed that graft choice (soft tissue vs. patellar tendon) was the primary variable predictive of failure (P<0.05), with interactions/mediating effects contributed by maturity (growth plate status) and ACL technique (P<0.05). The average time to failure was 13.6 months and hamstring grafts and anatomic femoral tunnels were both found to fail earlier (P<0.05). During the study period, approximately 8% of patients sustained a contralateral ACL injury.

Conclusions:

ACL failure rates in adolescent and pediatric patients vary based on patient age, graft selection, and surgical technique. Bone patellar tendon bone autografts had the lowest failure rate in this high-risk population.

Level of Evidence:

Level IV—retrospective case series.
Childhood leukaemia near nuclear sites in Belgium, 2002–2008
Authors: Bollaerts Kaatje , Simons Koen , Van Bladel Lodewijk , De Smedt Tom , Sonck Michel , Fierens Sébastien , Poffijn André , Geraets David , Gosselin Pol , Van Oyen Herman , Francart Julie , Van Nieuwenhuyse An
Published: July 2016

This paper describes an ecological study investigating whether there is an excess incidence of acute leukaemia among children aged 0–14 years living in the vicinity of the nuclear sites in Belgium. Poisson regression modelling was carried out for proximity areas of varying sizes. In addition, the hypothesis of a gradient in leukaemia incidence with increasing levels of surrogate exposures was explored by means of focused hypothesis tests and generalized additive models. For the surrogate exposures, three proxies were used, that is, residential proximity to the nuclear site, prevailing winds and simulated radioactive discharges, on the basis of mathematical dispersion modelling. No excess incidence of acute leukaemia was observed around the nuclear power plants of Doel or Tihange nor around the nuclear site of Fleurus, which is a major manufacturer of radioactive isotopes in Europe. Around the site of Mol-Dessel, however, two- to three-fold increased leukaemia incidence rates were found in children aged 0–14 years living in the 0–5, 0–10 and the 0–15 km proximity areas. For this site, there was evidence for a gradient in leukaemia incidence with increased proximity, prevailing winds and simulated radioactive discharges, suggesting a potential link with the site that needs further investigation. An increased incidence of acute leukaemia in children aged 0–14 years was observed around one nuclear site that hosted reprocessing activities in the past and where nuclear research activities and radioactive waste treatment are ongoing.