bluuebunny/crossref_metadata_2025 huggingface dataset:
Gait Patterns Differ Between ACL-Reconstructed Athletes Who Pass Return-to-Sport Criteria and Those Who Fail
Authors: Di Stasi Stephanie L. , Logerstedt David , Gardinier Emily S. , Snyder-Mackler Lynn
Published: April 2013

Background:

The current standard of practice for an athlete to return to sport after anterior cruciate ligament (ACL) reconstruction is varied. Attempt to return to activity is typically advised 6 months after surgery, but functional performance deficits and gait abnormalities are often still evident and may have important implications on future function.

Hypothesis:

When comparing the involved and uninvolved limbs, patients who failed return-to-sport (RTS) criteria would demonstrate (1) smaller peak knee angles, extensor moments, and peak power absorption at the knee of the involved limb and (2) larger peak hip angles, extensor moments, and peak power generation of the involved limb.

Study Design:

Controlled laboratory study.

Methods:

A total of 42 patients completed functional and biomechanical gait assessment 6 months after ACL reconstruction. Functional testing involved an isometric quadriceps strength test, 4 single-legged hop tests, and 2 self-report questionnaires. Three-dimensional motion analysis was used to measure sagittal plane kinematics and kinetics of the hip and knee. A mixed-model analysis of variance and post hoc t tests were used to compare the limb symmetry of those who passed and those who did not pass RTS criteria. Minimal clinically important differences were calculated from healthy gait data and used to further define meaningful limb asymmetries.

Results:

Twenty of the 42 (48%) patients passed RTS criteria 6 months after ACL reconstruction. Patients who did not pass the criteria demonstrated statistically significant differences between limbs on all kinematic and kinetic variables at the knee ( P ≤ .027). Clinically meaningful asymmetries at the hip were also identified in this group. Only kinetic asymmetries at the knee were identified in the patients who passed RTS criteria.

Conclusion:

Athletes who demonstrate superior functional performance 6 months after ACL reconstruction may have fewer abnormal and asymmetrical gait behaviors than their poorer performing counterparts. Patients who did not pass RTS criteria not only demonstrated larger kinematic and kinetic asymmetries between limbs but also appeared to use a gait strategy more closely aligned with athletes early after ACL rupture.

Clinical Relevance:

Poor performance on a battery of functional performance measures may be related to the presence of movement asymmetries in athletes after ACL reconstruction. Objective RTS criteria have the potential to provide information to clinicians who determine when these athletes return to activity, and may aid in the prescription of targeted rehabilitation to address underlying movement asymmetry.
Language Regression Associated With Autistic Regression and Electroencephalographic (EEG) Abnormalities
Authors: Chilosi Anna Maria , Brovedani Paola , Ferrari Anna Rita , Ziegler Anne-Lise , Guerrini Renzo , Deonna Thierry
Published: April 2013

We report a boy, referred at 25 months following a dramatic isolated language regression antedating autistic–like symptomatology. His sleep electroencephalogram (EEG) showed persistent focal epileptiform activity over the left parietal and vertex areas never associated with clinical seizures. He was started on adrenocorticotropic hormone (ACTH) with a significant improvement in language, behavior, and in EEG discharges in rapid eye movement (REM) sleep. Later course was characterized by fluctuations/regressions in language and behavior abilities, in phase with recrudescence of EEG abnormalities prompting additional ACTH courses that led to remarkable decrease in EEG abnormalities, improvement in language, and to a lesser degree, in autistic behavior. The timely documentation of regression episodes suggesting an “atypical” autistic regression, striking therapy-induced improvement, fluctuation of symptomatology over time could be ascribed to recurrent and persisting EEG abnormalities.
Breastfeeding Peer Counselors as Direct Lactation Care Providers in the Neonatal Intensive Care Unit
Authors: Meier Paula P. , Engstrom Janet L. , Rossman Beverly
Published: April 2013

In 2005, the Level III neonatal intensive care unit (NICU) at Rush University Medical Center initiated a demonstration project employing breastfeeding peer counselors, former parents of NICU infants, as direct lactation care providers who worked collaboratively with the NICU nurses. This article describes the conceptualization, implementation, and evaluation of this program and provides templates for other NICUs that wish to incorporate breastfeeding peer counselors with the goal of providing quality, evidence-based lactation care.
Lying aversion, lobbying, and context in a strategic communication experiment
Authors: Minozzi William , Woon Jonathan
Published: April 2013

Almost all institutions within modern democracies depend on a mix of communication and competition. However, most formal theory and experimental evidence ignores one of these two features. We present a formal theory of communicative competition in which senders vary in their aversion to lying, and test hypotheses from this theory using a strategic communication experiment. To influence lying aversion, we compare a Context Condition, in which pre-play instructions are cast in political language, with a Baseline Condition, in which all language is abstract. We find that in early rounds of play, subjects in the Context Condition exaggerated more as a function of their biases than those in the Baseline Condition when we control for the past history of play. However, by the last round of play, subjects in both conditions converged on persistent exaggeration. This finding indicates that competition crowds outlying aversion in settings of strategic communication.
Nonlinear adaptive filter backstepping flight control for reentry vehicle with input constraint and external disturbances
Authors: Zong Q , Wang F , Tian B-L
Published: April 2013

This article presents an adaptive filter backstepping control strategy for reusable launch vehicles attitude tracking during reentry phase in the presence of input constraints, model uncertainties and external disturbances. The control-oriented model with uncertainties is constructed, where the uncertainties do not satisfy the linear parameterization assumption. To cope with input constraints, an auxiliary system is introduced, and the states of which are applied to the procedure of control design and stability analysis. Second-order filters are employed to overcome the ‘explosion of terms’ problem inherent in traditional backstepping control. Moreover, the stability of the closed-loop system is proven via Lyapunov technique, and the tracking error can be forced into an arbitrarily small neighborhood around zero (i.e. semi-globally uniformly ultimate bounded tracking). Finally, the 6-degree-of-freedom nonlinear reusable launch vehicle simulation results are presented to verify the effectiveness of the control strategy.
Experimental and numerical investigations on flow fields and performance of dual combustion ramjet
Authors: Tan Jianguo , Wu Jiping , Wang Zhenguo
Published: April 2013

Dual combustion ramjet (DCR) is one of the most promising and realistic propulsion systems to realize hypersonic flight. The flow fields and the performance of the full-size DCR in Ma4/17 km and Ma6/25 km flight conditions are investigated through direct-connected experiments and numerical simulations. The pressure distributions from simulations are in agreement with that from experiments under both cold flow and hot flow conditions. Different combustion modes are revealed according to numerical results: purely subsonic flow field is established in the front part of the combustor in Mach 4 condition, and there is a thermal choked throat; only central flow is subsonic in Mach 6 condition, and the peripheral supersonic air results in a lower static temperature (less than 2000 K), which is beneficial to thermal protection of the combustor wall. The thrust increment increases with the increasing of the equivalence ratio (Φ). The thrust increment is 8.1 kN for Mach 4 when Φ = 0.9; however, further increasing the equivalence ratio causes unstart of the supersonic intake. The thrust increment is 3.15 kN for Mach 6 when Φ = 1.0. The equivalence ratio affects the combustion efficiency and the specific impulse with the same trend. The maximum combustion efficiency is 0.91 for Mach 4 and 0.89 for Mach 6. The maximum specific impulse is 13.3 kN·s/kg for Mach 4 and 7.96 kN·s/kg for Mach 6. In general, the performance is good and the DCR is worth further investigating.
Extended physics-based wing mass estimation in early design stages applying automated model generation
Authors: Dorbath F , Nagel B , Gollnick V
Published: April 2013

This article introduces a tool chain for extended physics-based wing mass estimation. Compared to state-of-the-art tool chains, the physics-based structural modelling is extended beyond the wing primary structure. The structural model also includes the movable trailing edge devices including tracks, the spoilers, the engine pylons and the landing gear. The chain consists of the structural analysis model, models for aerodynamic, fuel, landing gear and engine loads as well as a sizing algorithm. To make the complexity of the model generation process feasible for preliminary aircraft design, a knowledge-based approach is chosen. This means that the analysis models are created partly automatically, which leads to a minimum set of required input parameters for the central model generator. The DLR aircraft parametrisation format Common Parametric Aircraft Configuration Scheme is used as central data model for input and output. Therefore, the chain can be easily included in a wider multidisciplinary aircraft design environment.
Research on spacecraft design for ORS based on the systems theory
Authors: Huang Wen-bo , Zhang Wei-hua , Chen Li-li , Shi Shuai , Cai Ye-quan
Published: April 2013

The unpredictability and uncertainty of Operationally Responsive Space (ORS) missions have brought new challenges to traditional spacecraft design methods, in which the satellite and the launch vehicle are designed independently. In this article, a novel integrated design method for ORS spacecraft design has been proposed by analyzing the characteristics of the ORS missions according to the system theory. Firstly, the feasibility of the integrated design method is analyzed. Then, qualitative analyses of integrated design method for the subsystems of the traditional satellite and the launch vehicle are carried out. Finally, the advantages of the integrated design method are demonstrated through quantitative research, especially for the uncertain space missions. Simulation results show that the integrated design method is an effective technology to realize unpredictable ORS missions.
Automatic model bank selection in multiple model identification of gas turbine dynamics
Authors: Hosseini SeyedM , Fatehi Alireza , Sedigh Ali K , Johansen Tor A
Published: April 2013

A multiple model structure of a prototype industrial gas turbine system is constructed under normal operation using a systematic method that incorporates non-linearity measure and H-gap metric tools with the multiple models technique. First, two new non-linearity indices for multiple input–multiple output systems are introduced and employed for decomposing the operating space of a gas turbine into some linear and non-linear modes. The non-linear modes may be further partitioned into some linear modes. The input and output data in each of the linear modes are used to construct an initial multiple model structure. In order to avoid the increase of the number of linear local models, the H-gap metric is extended to multiple input–multiple output systems and used to measure the similarity between linear local models and to merge the similar models. As a result, an algorithm is proposed for construction of multiple linear local models. The algorithm is employed for the identification of a single-shaft prototype industrial gas turbine.
Superlattice multinanolayered thin films of SiO2/SiO2 + Ge for thermoelectric device applications
Authors: Budak Satilmis , Parker Robert , Smith Cydale , Muntele Claudiu , Heidary Kaveh , Johnson Ralph B , Ila Daryush
Published: April 2013

Thermoelectric generators convert heat to electricity. Effective thermoelectric materials and devices have a low thermal conductivity and a high electrical conductivity. The performance of thermoelectric materials and devices is shown by a dimensionless figure of merit, ZT = S2 σT/ K, where S is the Seebeck coefficient, σ is the electrical conductivity, T is the absolute temperature, and K is the thermal conductivity. We have prepared 100 alternating layers of SiO2/SiO2+ Ge superlattice thin films using ion beam–assisted deposition for the thermoelectric generator device application. The 5 MeV Si ion bombardments were performed using the Center for Irradiation Materials’ Pelletron ion beam accelerator to form quantum dots and/or quantum clusters in the multinanolayer superlattice thin films to decrease the cross-plane thermal conductivity and increase the cross-plane Seebeck coefficient and cross-plane electrical conductivity. The thermoelectric and transport properties have been characterized for SiO2/SiO2+ Ge superlattice thin films.
Failure analysis of a dielectric elastomer plate actuator considering boundary constraints
Authors: Zhou Jianyou , Jiang Liying , Khayat Roger E
Published: April 2013

Dielectric elastomer actuators, a promising transducer technology, have received much attention due to their high efficiency and large deformation. However, in addition to electrical breakdown, dielectric elastomer actuators may also be easily affected by electromechanical instability. These failure modes inhibit the full potential actuation of dielectric elastomers. This study examines the parametric range for which electromechanical instability can be avoided for a dielectric elastomer plate actuator while achieving large actuation. It is found that the electromechanical instability can altogether be eliminated by boundary constraints. With control of the boundary conditions, consideration should also be given to the possible mechanical buckling failure that may occur. Simulation results based on Gent constitutive model are presented to show how these failure modes can be controlled and to what extent the performance of the dielectric elastomer actuator can be improved. This work should provide a better understanding on how to achieve the desired actuation performance of dielectric elastomers, thus leading to a better and controlled design for the applications of these smart materials in transduction technologies.
An algorithm for damage localization in steel truss structures: Numerical simulation and experimental validation
Authors: An Yonghui , Li Binbin , Ou Jinping
Published: April 2013

It is imperative to study the damage detection methods of steel truss structures that are always employed in extreme environment. Accurate structural damage localization is still a challenge due to high noise and low accuracy of the structural finite element model. To develop a dependable damage localization technique for truss structural health monitoring, a novel idea of damage localization is proposed: the curvature difference method of strain waveform fractal dimension, based on fractal theory and curvature method. To validate the approach, a simply supported bailey steel truss benchmark model has been designed and constructed in the laboratory. Based on the model, both experimental and numerical simulation results using the procedure under pulse excitation indicate that it is feasible and effective to detect the change of boundary conditions and the stiffness reduction of a truss member. In addition, the proposed technique exhibits high-noise insusceptibility (e.g. it works for noise levels up to 20% for a 10% truss member stiffness reduction). Moreover, the proposed technology is robust against the accuracy of the finite element model of measured structures, which decrease the workload of model updating dramatically. All these lay a good foundation for its engineering application.
Novel real-time acousto-ultrasonic sensors using two phase-shifted fiber Bragg gratings
Authors: Wu Qi , Okabe Yoji
Published: April 2013

A novel real-time acousto-ultrasonic sensor system using a phase-shifted fiber Bragg grating rather than a normal fiber Bragg grating was investigated. The spectrum of the phase-shifted fiber Bragg grating was simulated and analyzed, which indicates that a phase-shifted fiber Bragg grating has superior properties when compared to a normal fiber Bragg grating. Based on theoretical considerations, a novel real-time acousto-ultrasonic sensor system was proposed. Two identical 5-mm phase-shifted fiber Bragg gratings, with slightly different Bragg wavelengths, were used as the filter and the sensor. An amplified spontaneous emission light source and an apodized fiber Bragg grating were connected to illuminate the phase-shifted fiber Bragg gratings. The design allows the strain resulting from the ultrasonic wave to be precisely received and converted to the fluctuation of the output voltage. An ultrasonic wave generated in a carbon fiber–reinforced plastic plate using a macrofiber composite actuator was detected by both the phase-shifted fiber Bragg grating sensor system and a sensor system based on a normal fiber Bragg grating and arrayed waveguide grating. Comparison of the temporal and spectral responses of these two systems indicates that the phase-shifted fiber Bragg grating sensor system has a higher sensitivity than the fiber Bragg grating system. The results show that the phase-shifted fiber Bragg grating system does not require data averaging for noise reduction to measure the Lamb wave modes in a carbon fiber–reinforced plastic plate.
Linear magnetorheological brake with serpentine flux path as a high force and low off-state friction actuator for haptics
Authors: Alkan Mustafa S , Gurocak Hakan , Gonenc Berk
Published: April 2013

In robotics and haptics, actuators that are capable of high force output with compact size are desired for stable and stiff interfaces. Magnetorheological brakes are viable options for such implementations since they have large force-to-volume ratios. Existing linear magnetorheological brakes have limited strokes, are relatively large, and have high off-state friction forces mainly due to the piston-cylinder internal design. The main contribution of this research is a new alternative internal design for linear magnetorheological brakes. The proposed approach uses the serpentine flux path concept to eliminate the piston-cylinder arrangement. It leads to significantly less off-state friction and infinite stroke. To the best of our knowledge, this is the first such linear magnetorheological brake. Our new brake can produce 173-N force. In comparison, a conventional linear magnetorheological brake with the same size can only produce about 27-N force. Our results showed that the ratio of the off-state friction force to the maximum force output in the prototype linear brake is about 3% compared with more than 10% for most similar devices in the literature and 27% for a commercial brake. At the same time, the compactness was improved as our prototype is about half the size of a commercially available product.
Her2 Amplification in Gastric Cancer Is a Rare Event Restricted to the Intestinal Phenotype
Authors: Cruz-Reyes Carolina , Gamboa-Dominguez Armando
Published: April 2013

The objectives of this study were to identify HER2 prevalence in gastric cancer and correlate it with location, phenotype, and follow-up. Consecutive gastric cancer patients with tissue blocks, gross data, and follow-up data, were submitted to immunohistochemistry (IHC) with HercepTest. Chromogenic and fluorescence in situ hybridization was performed in IHC-positive tumors. A total of 269 patients were included with a median age of 61 years. In 172 gastrectomized patients, histotypes were diffuse (72, 41.8%), intestinal (63, 36.6%), and mixed (37, 21.5%). HER2 IHC expression was 0 in 167, 2+ in 2, and 3+ in 3 tumors. Only endoscopic biopsies were available in 97 patients and HER2 IHC expression was 0 in 88, 1+ in 3, 2+ in 4, and 3+ in 2 patients. In all, 10/269 (3.7%) had HER2 amplification. Amplified tumors were intestinal adenocarcinomas located throughout the different regions of the stomach. Heterogeneity was documented in 4 widely sampled tumors. HER2 amplification was restricted to the intestinal phenotype. It is a rare event and its screening should be driven by gastric cancer histotype.
Phylloides Tumor With Numerous Thanatosomes (“Death Bodies”)
Authors: D’Alfonso Timothy M. , Ginter Paula S. , Salvatore Steven P. , Antonio Lilian B. , Hoda Syed A.
Published: April 2013

Thanatosomes, a form of degenerative intracellular hyaline globules, have been described in various neoplastic and nonneoplastic disease processes in several organs. These structures are indicative of apoptotic cell death. Herein, we report 2 cases of malignant phylloides tumor, both of which showed numerous thanatosomes—to the point of dominating the histological appearance and masking the stromal element. Our subsequently conducted study showed that thanatosomes were present in 14 of 86 (16.3%) high-grade malignant breast tumors. The structures were identified in 5/25 (20%) malignant phylloides tumors, 4/19 (21.1%) metaplastic spindle cell carcinomas, 3/21 (14.3%) invasive carcinomas s/p neoadjuvant chemotherapy, and 2/21 (9.5%) poorly differentiated invasive ductal carcinomas. When present, thanatosomes were typically a rare and focal finding in most types of cases. In malignant phylloides tumors, the structures were relatively more numerous when present. Our study shows that although thanatosomes can be present in several types of malignant breast tumors, they are more common in malignant phylloides tumor. Only rarely, as evident from our 2 index cases, do thanatosomes cause diagnostic difficulty.
Primary Acinic Cell Carcinoma of the Breast
Authors: Zhao Yang , Li Weidong , Lang Ronggang , Yang Yiling , Gao Xia , Zheng Yi , Zhang Chao , Fu Xilin , Fu Li
Published: April 2013

Acinic cell carcinoma (ACC) of the breast is a rare tumor that is listed in the 2003 World Health Organization (WHO) classification of tumors of the breast. Pure form ACC of the breast is even rarer. To date, only 12 cases have been reported in the English-language literature. A case of primary ACC of the breast in a 38-year-old woman is presented in this report. Histologically, the neoplastic cells are characterized by widespread acinci cell-like differentiation with a eosinophilic granular or clear cytoplasm, resembling acinic cells of the parotid gland. In addition, the neoplastic cells are positive for lysozyme, EMA, S-100, CD68 and GCDFP-15 and negative for α-anti-chymotrypsin, synaptophysin, ER, PR and Her-2/neu. This primary breast tumor was confirmed by clinical, morphological, and immunohistochemical studies. Characteristic features and differential diagnosis of this tumor were discussed in the light of pertinent literature.
Incidental Placental Site Nodule in a Fallopian Tube
Authors: Choi Jacqueline J. , Emmadi Rajyasree
Published: April 2013

A placental site nodule is a benign proliferation of intermediate trophoblasts from a previous gestation that failed to completely involute. It is a rare entity that is often asymptomatic and is usually found incidentally weeks or even years after the pregnancy. The most common location for placental site nodules is in the uterus within the endometrium and occasionally in the cervix, diagnosed by uterine curettings or hysterectomy. However, rare extrauterine cases have been documented and should be considered as a differential diagnosis when encountered in locations such as the fallopian tube. Here, we present a case of a 28-year-old woman with a history of spontaneous abortions who was found to have a placental site nodule of the fallopian tube after postpartum tubal ligation.
Isolated Spring Ligament Failure as a Cause of Adult-Acquired Flatfoot Deformity
Authors: Orr Justin D. , Nunley James A.
Published: April 2013

Background:

Adult-acquired flatfoot deformity is usually secondary to failure of the tibialis posterior tendon, with secondary injury to the surrounding osseous-ligamentous complex. Rarely, patients may present with a normal tibialis posterior tendon and an isolated injury of the plantar calcaneonavicular, or spring, ligament. The current study describes the clinical presentation and operative management of 6 patients with isolated spring ligament ruptures who presented with symptomatic flexible flatfoot deformities.

Methods:

Six consecutive patients with unilateral flatfoot deformities secondary to spring ligament failure were operatively treated at one institution between 2003 and 2010. All patients presented with symptomatic flatfoot deformities recalcitrant to conservative management. No patients had previous flatfoot reconstructive surgery, but all had undergone some combination of orthotic use, immobilization, or activity modifications prior to operative treatment. In each case, intraoperative findings demonstrated a tear of the spring ligament complex with a normal tibialis posterior tendon. To address the deformities, spring ligament repairs and adjunctive flatfoot reconstructions were performed. A retrospective chart study was performed to document patient presentation, demographics, and outcomes.

Results:

Average patient age was 42 years. All 6 patients were female. All patients presented with medial foot pain for a mean of 27 months prior to presentation. Spring ligament abnormality was demonstrated in all 5 patients who received preoperative magnetic resonance imaging. Intraoperatively, all 6 patients demonstrated spring ligament tears and no significant tibialis posterior tendon abnormality. All 6 patients underwent spring ligament repairs with or without adjunctive flatfoot reconstructions. At mean follow-up of 13 months, all but 1 patient were pain-free without orthotics, and all patients were without residual deformity. There was a single patient with delayed bone graft healing and no other minor or major complications in this series.

Conclusions:

Adult-acquired flatfoot deformity is usually secondary to tibialis posterior tendon failure but in rare cases may be secondary to isolated spring ligament injury without tibialis posterior tendon abnormality. This unique clinical entity should be considered in patients who present with flatfoot deformities. In this study, although preoperative magnetic resonance imaging was not required, it identified a suspected spring ligament tear in all cases in which it was used. Thorough intraoperative exploration can identify an injury to the spring ligament and a normal tibialis posterior tendon. Failure to recognize an isolated spring ligament injury as the primary cause of a flatfoot deformity could lead to inappropriate operative management.

Level of Evidence:

Level IV, retrospective study.
Isolated Subtalar Arthrodesis Through Minimal Incision Surgery
Authors: Carranza-Bencano A. , Tejero-García S. , Del Castillo-Blanco G. , Fernández-Torres J. J. , Alegrete-Parra A.
Published: April 2013

Background:

In recent years there has been an increase in the use of minimally invasive techniques, such as arthroscopy, percutaneous, and minimally invasive incisions, for foot and ankle surgery. The purpose of this study was to analyze the fusion rate and clinical results of isolated subtalar arthrodesis (ISA) using the novel and original technique of minimal incision surgery (MIS).

Methods:

There were a total of 77 feet in 76 patients who underwent ISA and were followed for 50 months on average (range, 15-108). The first 30 cases were evaluated retrospectively, and 47 cases were evaluated prospectively. MIS without tourniquet was used in all cases and fusion was assessed radiographically and clinically. Clinical outcome measures used were the Angus and Cowell Scoring System, AOFAS Ankle-Hindfoot, the SF-36, and a patient satisfaction questionnaire 12 months after the intervention.

Results:

Radiographic and clinical consolidation was achieved in 92% of cases. Main outcomes were “good” in 57 patients as determined by the Angus and Cowell criteria, with 13 “fair” and 7 “poor” results. In the prospective group, AOFAS scores improved by 47.6 points (95% CI: 50.7-42.5) 12 months after surgical intervention. SF-36 outcomes improved by 14.5 points (95% CI: 11.58-17.31) in the mental summary component and 4.2 points (95% CI: 2.2-6.1) in the physical summary component. We recorded no cases of early complications such as wound infections, neurovascular damage, or delayed wound healing.

Conclusions:

To our knowledge, the present series represents the largest study on subtalar arthrodesis using minimally invasive surgery. The data obtained showed a similar rate of bony union and clinical outcomes compared with the literature, but without early wound complications. ISA using the MIS technique was a good option for patients at greater risk of wound healing complications.

Level of Evidence:

Level IV, case series.
Functional Rehabilitation With a Foot Plate Modification for Circular External Fixation
Authors: Blair James A. , Owens Johnny G. , Saucedo Joey , Hsu Joseph R. ,   Skeletal Trauma Research Consortium (STReC)
Published: April 2013

Background:

Customized foot plates attached to the foot ring of an ankle-spanning circular external fixator present a unique opportunity for patients undergoing complex lower-extremity limb salvage to participate in highly advanced weight-bearing physical therapy. The purpose of this study was to identify the rehabilitation capabilities afforded by this external fixator modification.

Methods:

Surgical logs and radiographs were reviewed to identify all lower-extremity limb salvage patients from February 2008 to December 2010 treated with an ankle-spanning circular external fixator and a customized foot plate treated by the same orthopedic surgeon and enrolled in our institution’s Return To Run clinical pathway. Medical records were reviewed to identify a series of exercises that each patient was able to perform.

Results:

Eleven patients were identified. All patients were treated by the same physical therapist. All 11 patients were able to bear full weight on their foot plates and perform regular and split squats. Six of 11 patients were able to ambulate unassisted, and 5 patients required a cane. All 11 patients could navigate stairs and use an elliptical and stair-stepping machine. Six of 11 patients could perform single-leg hack squats. Eight of 11 patients were able to perform double-leg shuttle jumps, although only 5 of 11 patients could perform single-leg shuttle jumps. Five of 11 patients were able to perform a single-leg balance. Only 1 patient was able to run on the foot plate.

Conclusions:

Patients undergoing lower-extremity limb salvage with an ankle-spanning circular external fixator and a customized foot plate were able to participate in highly advanced weight-bearing physical therapy exercises during the osseous and soft-tissue healing process.

Level of Evidence:

Level IV, retrospective case series.
Risk Factors for Postoperative Wound Complications of Calcaneal Fractures Following Plate Fixation
Authors: Ding Liang , He Zhimin , Xiao Haijun , Chai Leizi , Xue Feng
Published: April 2013

Background:

A fairly high prevalence of wound complications after open reduction and internal plate fixation (ORIF) of closed calcaneal fractures via the extensile lateral approach has been reported. The goal of this study was to analyze and identify independent risk factors for wound complications among closed calcaneal fractures undergoing ORIF.

Methods:

The medical records of all closed calcaneal fracture patients who underwent ORIF from July 2005 to July 2012 were reviewed to identify those who developed a wound complication. Then we constructed a univariate and multivariate logistic regression to evaluate the independent associations of potential risk factors for surgical wound complication. Records showed 479 patients who underwent ORIF of a closed calcaneal fracture from July 2005 to July 2012. The patients were followed for 3 to 28 months, with an average follow-up period of 14.2 months. Eleven patients had bilateral fractures, for a total of 490 fractured calcanei.

Results:

The overall rate of postoperative wound complications following ORIF of closed calcaneus fractures was 17.8% (87 wound complications in 490 operations). With the regression model, smoking history (odds ratio, 5.79; 95% CI: 1.55 to 21.70; P = .009), diabetes mellitus (odds ratio, 6.23; 95% CI: 1.37 to 28.31; P = .018), Sanders type (odds ratio, 5.44; 95% CI: 2.02 to 14.64; P = .001), number of residents and/or fellows present during the case (odds ratio, 1.63; 95% CI: 1.06 to 2.52; P = .028), duration of surgery (odds ratio, 4.54; 95% CI: 1.46 to 14.12; P < .001), estimated blood loss (odds ratio, 1.02; 95% CI: 1.01 to 1.04%; P < .001), and 10 or more people present in the operating room during the entire case (odds ratio, 2.30; 95% CI: 1.79 to 2.94; P < .001) were risk factors for wound complication. Tourniquet use (odds ratio, 0.02; 95% CI: 0.00 to 0.08; P < .001), which was associated with a decreased risk for the development of a wound complication, was observed as a protective factor. Diabetes mellitus, Sanders type, and smoking were the strongest risk factors for postoperative wound complication after adjusting for all other variables.

Conclusions:

Smoking, diabetes mellitus, Sanders type, number of residents and/or fellows present during the case, duration of surgery, estimated blood loss, and high number of persons present in the operating room during the entire case were related to an increased risk for postoperative wound complication of closed calcaneal fractures following ORIF. Tourniquet use was associated with a decreased risk for the development of a wound complication.

Level of Evidence:

Level III, retrospective comparative series.
Perinatal Dyadic Psychotherapy
Authors: Goodman Janice H. , Guarino Antony J. , Prager Joanna E.
Published: April 2013

Maternal postpartum depression (PPD) and mother–infant relationship dysfunction have reciprocal effects on each other and thus an integrated approach that addresses both problems simultaneously may lead to improved outcomes. This study aimed to determine the feasibility, acceptability, and preliminary efficacy of a new intervention, Perinatal Dyadic Psychotherapy (PDP), for the early treatment of maternal PPD. PDP is designed to promote maternal mental health and facilitate optimal mother–infant relationships via (a) a supportive, relationship-based, mother–infant psychotherapeutic component, and (b) a developmentally based infant-oriented component focused on promoting positive mother–infant interactions. This paper describes the pilot use of PDP with six acutely depressed postpartum women. Nurses delivered the intervention over eight home visits. Results indicate that PDP is a feasible, acceptable, and safe intervention with this population. All participants achieved remission of depression with significant reduction of depression and anxiety symptoms, suggesting that PDP is a promising treatment for PPD.
Vibration analysis of an influence of groove in the bottom land of a spur gear
Authors: Subramanian Ramesh Babu , Srinivasan K
Published: April 2013

Modern machinery and manufacturing systems are committed to be more accurate and punctual in delivery, which in turn requires a perfect machining and maintenance system. Maintenance has many indispensable tasks, of which vibration control is one of the most challenging for maintenance engineers. Majorly in rotating machinery like gears and turbines, vibration is the predominant factor to be controlled. Hence this paper deals with a novel way of controlling the vibration in spur gears. Generally gear vibrations can be reduced by profile modification or by decreasing the pressure angle or dynamic load and also by means of increasing the contact ratio. In this work, a profile modification is considered. A groove has been generated at the bottom land of the gear in order to increase the thickness and height of the gear tooth at the root. Due to this, the stiffness of the gear tooth at the bottom land of the gear increases which in turn reduces the radial load deflection and the vibration amplitude in the vertical direction (shaft bending direction). Two spur gears (gear A and gear B) having the same gear parameters are selected. In gear B, a groove has been generated at the bottom land. Both the gears are discretized and analyzed by FEA software. The analysis is made under frequency response to identify the amplitude of vibration of the gears due to transmitted (tangential) load and radial load for the existing gear (gear A) and the modified one (gear B). The result shows that the modified gear has a better control in the radial load direction. Hence an increase in the tooth depth within a limit ensures that the control of magnitude of the vibration is effective. Finally, experimental analysis has been done to validate the computational data and the results are in good agreement.
Little-Known Truths, Quirky Anecdotes, Seething Scandals, and Even Some Science in the History of (Primarily Achievement) Motivation
Authors: Weiner Bernard
Published: April 2013

This article presents a history of the study of motivation from approximately 1900-1975, focusing on achievement strivings and containing little-known and often surprising facts about the main contributors to this field. Four theorists are highlighted: David McClelland, Kurt Lewin, John Atkinson, and Fritz Heider, each associated with a different theoretical approach (respectively and in order of historical emergence: trait, Gestalt, expectancy/value, and attribution theory). A fifth conception, drive theory, is also represented. In addition, a number of individuals who influenced these theorists and others who followed them are discussed. The article emphasizes the interrelations between the theorists and the interaction between personal and scientific life.
Decreasing Supermarket Tantrums by Increasing Shopping Tasks
Authors: Greenwald Ashley E. , Williams W. Larry , Seniuk Holly A.
Published: April 2013

A brief training package consisting of pre-teaching of appropriate grocery item–gathering skills and reinforcement for appropriate behavior was used to teach a child diagnosed with autism to remain in a store and participate in shopping without exhibiting tantrums. The training package began with teaching the necessary component skills and expectations in the participant’s home, and these skills were then established at a local supermarket.
Utilization of child health services, stress, social support and child characteristics in primiparous and multiparous mothers of 18-month-old children
Authors: Lagerberg Dagmar , Magnusson Margaretha
Published: April 2013

Aim: Traditionally, the child health services have laid emphasis on first-time mothers. Some researchers have argued that the needs of multiparous mothers must be considered equally important. The aim of this paper was to analyse parity-related characteristics in pairs of mothers and 18-month-old children. Methods: The study was population-based and cross-sectional. 586 primiparous mothers and 821 mothers with at least one previous child completed a questionnaire. Additional information was extracted from the child health records by the nurses. Data were collected in 2002–2003 and 2004–2005. Results: Compared to multiparous mothers, primiparous mothers had a higher utilization of child health services. Multiparous mothers scored higher on parental incompetence stress and felt that their work load was more demanding. Multiparous mothers reported less social support, particularly in practical respects such as baby-sitting. They considered their interaction with the child as less satisfactory than did primiparous mothers; their children participated less in shared reading and had a more restricted vocabulary. Fewer multiparous mothers assessed their own and their child’s total situation as very good. Conclusions: The child health services should develop competence and methods to support multiparous mothers and alleviate their workload when caring for several children.
The twilight of fields: Limitations of a concept or disappearance of a historical reality?
Authors: Lemieux Cyril
Published: April 2013

The concept of field forged by Pierre Bourdieu is often regarded as if it could be applied universally (as the concept of ‘habitus’, for example, can be). This article shows that such an extensive use comes from a misunderstanding of the real nature of this concept. From Bourdieu’s own viewpoint, clearly developed in The Rules of Art, fields have emerged in a highly specific type of society: that is, the so-called ‘differentiated’ or ‘capitalist’ societies. Therefore, they must be considered one and only one of the many possible modes of organizing productive activities, a mode that at the scale of human history is remarkable for its rarity. From this perspective, taking seriously the concept of field requires to renounce applying it at all costs to any concrete action system or sociohistorical configuration characterized by interdependences. Nor can one postulate that fields are in any way the human species’ ultimate, perfect way of organizing its productive activities, though this normative tendency can be felt in Bourdieu’s own writing when he discusses science or art. Provided we are careful to use it restrictively, the field concept will hold up quite well against the many objections it has elicited. Moreover, one can only maximize the concept’s heuristic returns if one keeps in mind that it refers to a determined socio-historical reality: that is, if one is willing to envisage the possible disappearance of the reality it accounts for.
Emergent literacy: Preschool teachers’ beliefs and practices
Authors: Sandvik Jenny Miglis , van Daal Victor HP , Adèr Herman J
Published: April 2013

The present study reports on the construction of a research instrument developed to examine preschool teachers’ beliefs and practices in relation to emergent literacy. A 130-item survey (Preschool Literacy Survey, PLS) was completed by a total of 90 preschool teachers in Norway. Items were grouped into homogenous scales, and the relationship between beliefs and practices was examined using structural equation modelling. The structural model for all preschool teachers was compared in a qualitative way with the structural model for a random group of preschool teachers ( n = 54), who had not participated in literacy-awareness training to look at whether the effects of literacy-awareness training could be assessed with the PLS. The main results show that teachers who took part in the literacy-awareness training were more homogeneous in respect of their beliefs and practices, that their beliefs were strongly underpinned by their beliefs about the specific role of the preschool teacher and by their beliefs about practices consistent with current research. Finally, it seems that the literacy-awareness programme affected the beliefs rather than the practices of preschool teachers. How a PLS can further contribute to research on early literacy in preschools and preschool teacher training is discussed.
The effect of thematically related play on engagement in storybook reading in children with hearing loss
Authors: Pataki Kristen W , Metz Alexia E , Pakulski Lori
Published: April 2013

Purpose:

This study examined whether theme-related play increased subsequent engagement in storybook reading in preschool children with typical hearing and with hearing loss.

Method:

This study employed a counterbalanced experimental design. In all sessions, participants engaged in free play first and then were read a storybook. In the experimental condition, the play materials matched the theme of the book, and in the control condition it did not. Conditions were presented in random order. Storybooks had language at the early preschool level and had characters, plots, and illustrations. Twenty-three preschool-aged children participated, 12 with typical hearing and 11 with hearing loss. Engagement during storybook reading was measured using a modified Child Behaviour Rating Scale (CBRS; Mahoney, 1998), consisting of five Items: Attention to Activity, Involvement, Cooperation (Attention subscale), and Affect and Joint Attention (Socio-emotional subscale).

Results:

Play that matched the theme of the storybook selectively enhanced engagement, particularly the Affect Item and the Socio-emotional Subscale of the CBRS, in participants with hearing loss.

Conclusions:

Thematically related play prior to reading leads to increased interaction with the reader and more positive emotion during reading for children with hearing loss. Implementing this approach is simple and fun for school and home settings.
Living with the deceased: absence, presence and absence-presence
Authors: Maddrell Avril
Published: April 2013

In this paper I build on my previous case-study focused research on memorialization to develop a thesis for absence-presence evidenced in vernacular memorial artefacts, spaces and performances at a variety of scales and locations across the British Isles. I make three key arguments: i) for bringing the universally significant experience of absence through bereavement to the fore in cultural geographies of absence; ii) for moving beyond representational and phenomenological analysis of memorial artefacts and spaces to focus critical attention on the contextualized interface between the representational and more-than-representational, embodied and affective practices that surround them, for a more nuanced understanding of the relationship between the living and the absent deceased; and iii) that this interface of form and practice at a variety of vernacular memorials and locations evidences dynamic negotiations of absence-presence. I explore the ways in which the emotions, memory and materiality of absence through death is expressed and negotiated in different memorial forms and landscape settings in the British Isles. Analysis is based on a range of empirical examples drawn from contemporary practices of memorialization and remembrance, and explores how living with absence as a result of bereavement is mediated through different material forms and practices including expressions of ‘continuing bonds’. The discussion is contextualized in relation to wider dialogue on absent presence, but argues that expressions of continuing bonds with the deceased evidence a relational and dynamic absence-presence. Practices associated with absence-presence intersect with growing trends to mark private grief and remembrance of individuals in public space, through the creation of a range of informal memorials that frame a ‘Third Emotional Space’ for the bereaved. The material memorialscape is indicative of the interwoven narrative journeys in and through particular place-temporalities for the living, for whom bereavement is a confluence of emotional-spiritual-practical way-finding.
Instructional Leadership in Turkish Primary Schools
Authors: Gumus Sedat , Akcaoglu Mete
Published: April 2013

School leadership, one of the most important aspects of school improvement, has not received much attention from either policymakers or researchers in Turkey despite many countries embrace creating and developing effective leaders as one of the important first steps to improve their education. This research looked at the instructional leadership skills of Turkish principals from the teacher's perspective measured through a survey collected from primary school teachers in five different cities in Turkey, first, to describe the current situation and, second, to find out if teachers’ experience and gender affect their views. The results show that Turkish principals practice their instructional leadership roles only occasionally and teachers’ gender significantly affects their perception.