bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired Podocyte Autophagy Exacerbates Proteinuria in Diabetic Nephropathy
Authors: Tagawa Atsuko , Yasuda Mako , Kume Shinji , Yamahara Kosuke , Nakazawa Jun , Chin-Kanasaki Masami , Araki Hisazumi , Araki Shin-ichi , Koya Daisuke , Asanuma Katsuhiko , Kim Eun-Hee , Haneda Masakazu , Kajiwara Nobuyuki , Hayashi Kazuyuki , Ohashi Hiroshi , Ugi Satoshi , Maegawa Hiroshi , Uzu Takashi
Published: September 2015

Overcoming refractory massive proteinuria remains a clinical and research issue in diabetic nephropathy. This study was designed to investigate the pathogenesis of massive proteinuria in diabetic nephropathy, with a special focus on podocyte autophagy, a system of intracellular degradation that maintains cell and organelle homeostasis, using human tissue samples and animal models. Insufficient podocyte autophagy was observed histologically in patients and rats with diabetes and massive proteinuria accompanied by podocyte loss, but not in those with no or minimal proteinuria. Podocyte-specific autophagy-deficient mice developed podocyte loss and massive proteinuria in a high-fat diet (HFD)–induced diabetic model for inducing minimal proteinuria. Interestingly, huge damaged lysosomes were found in the podocytes of diabetic rats with massive proteinuria and HFD-fed, podocyte-specific autophagy-deficient mice. Furthermore, stimulation of cultured podocytes with sera from patients and rats with diabetes and massive proteinuria impaired autophagy, resulting in lysosome dysfunction and apoptosis. These results suggest that autophagy plays a pivotal role in maintaining lysosome homeostasis in podocytes under diabetic conditions, and that its impairment is involved in the pathogenesis of podocyte loss, leading to massive proteinuria in diabetic nephropathy. These results may contribute to the development of a new therapeutic strategy for advanced diabetic nephropathy.
Mesenteric Fat Lipolysis Mediates Obesity-Associated Hepatic Steatosis and Insulin Resistance
Authors: Wueest Stephan , Item Flurin , Lucchini Fabrizio C. , Challa Tenagne D. , Müller Werner , Blüher Matthias , Konrad Daniel
Published: September 2015

Hepatic steatosis and insulin resistance are among the most prevalent metabolic disorders and are tightly associated with obesity and type 2 diabetes. However, the underlying mechanisms linking obesity to hepatic lipid accumulation and insulin resistance are incompletely understood. Glycoprotein 130 (gp130) is the common signal transducer of all interleukin 6 (IL-6) cytokines. We provide evidence that gp130-mediated adipose tissue lipolysis promotes hepatic steatosis and insulin resistance. In obese mice, adipocyte-specific gp130 deletion reduced basal lipolysis and enhanced insulin’s ability to suppress lipolysis from mesenteric but not epididymal adipocytes. Consistently, free fatty acid levels were reduced in portal but not in systemic circulation of obese knockout mice. Of note, adipocyte-specific gp130 knockout mice were protected from high-fat diet–induced hepatic steatosis as well as from insulin resistance. In humans, omental but not subcutaneous IL-6 mRNA expression correlated positively with liver lipid accumulation (r = 0.31, P < 0.05) and negatively with hyperinsulinemic-euglycemic clamp glucose infusion rate (r = −0.28, P < 0.05). The results show that IL-6 cytokine-induced lipolysis may be restricted to mesenteric white adipose tissue and that it contributes to hepatic insulin resistance and steatosis. Therefore, blocking IL-6 cytokine signaling in (mesenteric) adipocytes may be a novel approach to blunting detrimental fat-liver crosstalk in obesity.
Lesion Activity Assessment (LAA) in Conjunction With International Caries Detection and Assessment System (ICDAS) for Occlusal Caries Diagnosis in Permanent Teeth
Authors: Cotta FVMD , de Castilho LS , Moreira AN , Paiva SM , Ferreira EF , Ferreira LCN , Magalhães CS
Published: September 2015

Objective

The aim of this study was to investigate the clinical performance and to validate the Lesion Activity Assessment (LAA) in conjunction with the International Caries Detection and Assessment System (ICDAS) for occlusal caries diagnosis in permanent teeth.

Methods

Patients with erupted or partially erupted third molars were recruited from the surgery clinic of the School of Dentistry of the Universidade Federal de Minas Gerais, Brazil. A calibrated examiner evaluated 49 teeth using the ICDAS-LAA criteria. The histologic criterion proposed by Ekstrand and others was used to validate severity at the thresholds D1 (outer half of the enamel), D2 (inner half of the enamel and outer third of the dentin), and D3 (inner or middle third of the dentin). Lesion activity was validated using 0.1% methyl red solution.

Results

The method demonstrated good reliability (weighted kappa for severity=0.60; unweighted kappa for activity=0.61). The ICDAS presented a higher performance for lesion detection (area under the receiver operating characteristic curve [Az]=0.79) using the threshold D3. At the thresholds D1 and D2, the results for Az were 0.57 and 0.74, respectively. Regarding the ICDAS-LAA, Az = 0.59.

Conclusions

Clinical protocols can use ICDAS for the severity diagnosis of occlusal caries, but the LAA performance was poor.
Effect of prewarming on the body temperature of small dogs undergoing inhalation anesthesia
Authors: Rigotti Clara F. , Jolliffe Colette T. , Leece Elizabeth A.
Published: September 2015

Objective—To investigate whether prewarming affects body temperature of small dogs (weighing < 10 kg [22 lb]) undergoing inhalation anesthesia.

Design—Prospective, randomized, blinded clinical trial.

Animals—20 dogs weighing < 10 kg with American Society of Anesthesiologists physical status I or II.

Procedures—Baseline rectal temperature was recorded. Before IM administration of buprenorphine hydrochloride and acepromazine maleate, dogs were randomly assigned to be placed in a pediatric incubator at 33°C (91.4°F) for approximately 30 to 60 minutes (prewarming group) or to receive no prewarming (control group); subsequently, dogs underwent inhalation anesthesia with isoflurane in oxygen. Rectal, esophageal, and ambient temperatures were measured every 5 minutes from induction of anesthesia (IOA) for > 1 hour by an observer who was unaware of treatment. If a dog became hypothermic (esophageal temperature < 36°C [96.8°F]), it was withdrawn from the study. Variables of interest relating to dogs, anesthesia, temperatures, hypothermia, and study withdrawal were compared between groups.

Results—1 dog was excluded from the prewarming group after becoming excessively excited in the incubator. Between groups, age, weight, body condition score, degree of preanesthesia sedation, interval from sedation to IOA, duration of anesthesia, baseline rectal temperature, rectal temperatures immediately prior to IOA, esophageal temperature following IOA, ambient temperature during the first 70 minutes of anesthesia, esophageal or rectal temperature during the first 90 minutes of anesthesia, and incidence of hypothermia and study withdrawal (5 dogs/group) did not differ significantly.

Conclusions and Clinical Relevance—Prewarming in an incubator prior to IOA failed to improve or maintain body temperature of dogs weighing < 10 kg during inhalation anesthesia. (J Am Vet Med Assoc 2015;247:765–770)
Outcomes of dogs undergoing limb amputation, owner satisfaction with limb amputation procedures, and owner perceptions regarding postsurgical adaptation: 64 cases (2005–2012)
Authors: Dickerson Vanna M. , Coleman Kevin D. , Ogawa Morika , Saba Corey F. , Cornell Karen K. , Radlinsky MaryAnn G. , Schmiedt Chad W.
Published: September 2015

Objective—To evaluate outcomes of dogs and owner satisfaction and perception of their dogs’ adaptation following amputation of a thoracic or pelvic limb.

Design—Retrospective case series.

Animals—64 client-owned dogs.

Procedures—Medical records of dogs that underwent limb amputation at a veterinary teaching hospital between 2005 and 2012 were reviewed. Signalment, body weight, and body condition scores at the time of amputation, dates of amputation and discharge from the hospital, whether a thoracic or pelvic limb was amputated, and reason for amputation were recorded. Histologic diagnosis and date of death were recorded if applicable. Owners were interviewed by telephone about their experience and interpretation of the dog's adaptation after surgery. Associations between perioperative variables and postoperative quality of life scores were investigated.

Results—58 of 64 (91%) owners perceived no change in their dog's attitude after amputation; 56 (88%) reported complete or nearly complete return to preamputation quality of life, 50 (78%) indicated the dog's recovery and adaptation were better than expected, and 47 (73%) reported no change in the dog's recreational activities. Body condition scores and body weight at the time of amputation were negatively correlated with quality of life scores after surgery. Taking all factors into account, most (55/64 [86%]) respondents reported they would make the same decision regarding amputation again, and 4 (6%) indicated they would not; 5 (8%) were unsure.

Conclusions and Clinical Relevance—This information may aid veterinarians in educating clients about adaptation potential of dogs following limb amputation and the need for postoperative weight control in such patients. (J Am Vet Med Assoc 2015;247:786–792)
Radiographic characterization of ossification of the ungular cartilages in horses: 271 cases (2005–2012)
Authors: Jones Laura E. , Dyson Sue J.
Published: September 2015

Objective—To describe in detail the radiographic appearance of ossified ungular cartilages in horses and to evaluate the usefulness of a flexed dorsolateral-palmaromedial oblique (flexed oblique) radiographic view in evaluating the ungular cartilages.

Design—Retrospective case series.

Sample—Radiographs of 1,255 front feet of horses.

Procedures—Ossification of the ungular cartilages was graded during evaluation of radiographs on a scale from 0 to 5; feet with cartilages with an ossification grade ≥ 2 were included (386 feet [271 horses]). The shape (straight, curved outward or inward, and dorsopalmar extension of ossification) was determined. The view on which abnormalities were best identified was documented. Abnormalities of the compact bone, radiopacity, trabecular architecture, compactospongious demarcation, and presence of radiolucent lines were recorded; grouped as modeling, adaptive changes, or both; compared with ossification grade, separate centers of ossification, mediolateral symmetry of ossification, shape, cartilage (medial or lateral), and foot (left or right); and tested for significant associations.

Results—Fractures (n = 35) were most common in feet with cartilages with an ossification grade of 4 (18) or 5 (17) and were best identified in flexed oblique images, compared with more commonly recommended images. Multivariable logistic regression showed a significant positive association of ossification grade with modeling or adaptive changes; feet with cartilages with an ossification grade of 4 (OR, 11.59; 95% CI, 6.52 to 20.60) or 5 (OR, 72.90; 95% CI, 25.32 to 209.90) were more likely than those with an ossification grade of 2 or 3 to have modeling or adaptive changes. Abnormally shaped cartilages were more likely to have modeling or adaptive changes, compared with normally shaped cartilages (OR, 4.90; 95% CI, 1.94 to 12.42).

Conclusions and Clinical Relevance—Extensive ossification and the presence of inward or outward curvature as well as palmar curvature or a bulbous shape were significant risk factors for modelling and adaptive changes. Flexed oblique images provided clinically useful information, including detection of abnormal shape and fractures, that may not be evident on other currently recommended images. Such images are recommended for complete radiographic appraisal of ossified ungular cartilages of the foot in horses. (J Am Vet Med Assoc 2015;247:801–811)
Association Between Anatomical Characteristics, Knee Laxity, Muscle Strength, and Peak Knee Valgus During Vertical Drop-Jump Landings
Authors: Nilstad Agnethe , Krosshaug Tron , Mok Kam-Ming , Bahr Roald , Andersen Thor Einar
Published: September 2015

Study Design

Controlled laboratory study; cross-sectional.

Objectives

To investigate the relationship among anatomical variables, knee laxity, muscle strength, and peak knee valgus angles during a vertical drop-jump landing task.

Background

Excessive knee valgus has been associated with anterior cruciate ligament injury in females; however, the influence of anatomical characteristics, knee laxity, and muscle strength on frontal plane knee motion is not completely understood.

Methods

Norwegian elite female soccer players (n = 279; mean ± SD age, 21 ± 4 years; height, 167 ± 6 cm; body mass, 63 ± 7 kg) were evaluated from 2009 through 2012. The evaluation included 3-D motion analysis of a vertical drop jump, anatomical measures (height, static knee valgus, leg length, and static foot posture), knee laxity, and muscle strength (quadriceps, hamstrings, and hip abductors). Multiple linear regression analyses were used to investigate the relationships among anatomical characteristics, knee laxity, muscle strength, and peak knee valgus angles.

Results

Anatomical characteristics explained 11% of the variance in peak knee valgus angles (P<.001), with height and static knee valgus being significant predictors.

Conclusion

Greater body height and static knee valgus were associated with greater peak knee valgus angles during a vertical drop-jump landing task. However, these variables only explained 11% of the variance in peak knee valgus. J Orthop Sports Phys Ther 2015;45(12):998–1005. Epub 17 Sep 2015. doi:10.2519/jospt.2015.5612
Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All
Authors: Coombes Brooke K. , Bisset Leanne , Vicenzino Bill
Published: September 2015

Synopsis

Clear guidelines for the clinical management of individuals with lateral elbow tendinopathy (LET) are hampered by many proposed interventions and the condition's prognosis, ranging from immediate resolution of symptoms following simple advice in some patients to long-lasting problems, regardless of treatment, in others. This is compounded by our lack of understanding of the complexity of the underlying pathophysiology of LET. In this article, we collate evidence and expert opinion on the pathophysiology, clinical presentation, and differential diagnosis of LET. Factors that might provide prognostic value or direction for physical rehabilitation, such as the presence of neck pain, tendon tears, or central sensitization, are canvassed. Clinical recommendations for physical rehabilitation are provided, including the prescription of exercise and adjunctive physical therapy and pharmacotherapy. A preliminary algorithm, including targeted interventions, for the management of subgroups of patients with LET based on identified prognostic factors is proposed. Further research is needed to evaluate whether such an approach may lead to improved outcomes and more efficient resource allocation. J Orthop Sports Phys Ther 2015;45(11):938–949. Epub 17 Sep 2015. doi:10.2519/jospt.2015.5841
Cognitive Contributions to Freezing of Gait in Parkinson Disease: Implications for Physical Rehabilitation
Authors: Peterson Daniel S. , King Laurie A. , Cohen Rajal G. , Horak Fay B.
Published: September 2015

People with Parkinson disease (PD) who show freezing of gait also have dysfunction in cognitive domains that interact with mobility. Specifically, freezing of gait is associated with executive dysfunction involving response inhibition, divided attention or switching attention, and visuospatial function. The neural control impairments leading to freezing of gait have recently been attributed to higher-level, executive and attentional cortical processes involved in coordinating posture and gait rather than to lower-level, sensorimotor impairments. To date, rehabilitation for freezing of gait primarily has focused on compensatory mobility training to overcome freezing events, such as sensory cueing and voluntary step planning. Recently, a few interventions have focused on restitutive, rather than compensatory, therapy. Given the documented impairments in executive function specific to patients with PD who freeze and increasing evidence of overlap between cognitive and motor function, incorporating cognitive challenges with mobility training may have important benefits for patients with freezing of gait. Thus, a novel theoretical framework is proposed for exercise interventions that jointly address both the specific cognitive and mobility challenges of people with PD who freeze.
Implementation of a Quality Improvement Process Aimed to Deliver Higher-Value Physical Therapy for Patients With Low Back Pain: Case Report
Authors: Karlen Emily , McCathie Becky
Published: September 2015

Background and Purpose

The current state of health care demands higher-value care. Due to many barriers, clinicians routinely do not implement evidence-based care even though it is known to improve quality and reduce cost of care. The purpose of this case report is to describe a theory-based, multitactic implementation of a quality improvement process aimed to deliver higher-value physical therapy for patients with low back pain.

Case Description

Patients were treated from January 2010 through December 2014 in 1 of 32 outpatient physical therapy clinics within an academic health care system. Data were examined from 47,755 patients (mean age=50.3 years) entering outpatient physical therapy for management of nonspecific low back pain, with or without radicular pain. Development and implementation tactics were constructed from adult learning and change management theory to enhance adherence to best practice care among 130 physical therapists. A quality improvement team implemented 4 tactics: establish care delivery expectations, facilitate peer-led clinical and operational teams, foster a learning environment focused on meeting a population's needs, and continuously collect and analyze outcomes data. Physical therapy utilization and change in functional disability were measured to assess relative cost and quality of care. Secondarily, charge data assessed change in physical therapists' application of evidence-based care.

Outcomes

Implementation of a quality improvement process was measured by year-over-year improved clinical outcomes, decreased utilization, and increased adherence to evidence-based physical therapy, which was associated with higher-value care.

Discussion

When adult learning and change management theory are combined in quality improvement efforts, common barriers to implementing evidence-based care can be overcome, creating an environment supportive of delivering higher-value physical therapy for patients with low back pain.
Dermatopathia Pigmentosa Reticularis with Salzmann’s nodular degeneration of cornea: A rare association
Authors: Goel R , Bodh S A , Sardana K , Goel A
Published: September 2015

Background: Dermatopathia pigmentosa reticularis (DPR) is a very rare autosomal dominant disorder with the diagnostic triad of generalized reticulate hyperpigmentation, noncicatricial alopecia and onychodystrophy. Objective: To describe the occurrence of Salzmann’s nodular degeneration of cornea with moderate dry eye in a patient with Dermatopathia pigmentosa reticularis.Case: We present an 11 year old young Indian girl with DPR who had Salzmann’s nodular degeneration of cornea with moderate dry eye. She was put on symptomatic treatment and counseled regarding the course of disease, familial nature and avoidance of exposure to sun. Conclusion: In a patient of Salzmann`s nodular degeneration with generalized reticulate hyperpigmentation, noncicatricial alopecia and onychodystrophy the diagnosis of DPR must be kept in mind. A multidisciplinary approach is required for the management of such cases.
Field Aging and Development of Aging Model for Hot-Poured Crack Sealants
Authors: Ozer Hasan , Yousefi Seyed Saleh , Al-Qadi Imad L. , Elizalde-Castro Guillermo
Published: September 2015

An investigation was conducted to evaluate the long-term field aging effects of hot-poured crack sealants by differential aging testing. An analysis of rheological and mechanical properties to implement two performance-based tests was used to characterize aging of sealants. A set of eight types of crack sealants was exposed to approximately 2 years of weathering conditions. Aging mechanisms were investigated by a comparison of the critical properties with those obtained at the time of installation inside a small kettle. Samples were collected every 6 months after installation for laboratory characterization. Laboratory characterization included low-temperature stiffness, cohesion, adhesion, and viscosity. According to the results of the experimental program, a consistent increase was observed in the low-temperature stiffness of crack sealants as a result of weathering. The study showed that the low- and high-temperature properties of the surface portion were significantly influenced by weathering effects even within a short period of time. A superposition rule analogous to time–temperature superposition for viscoelastic materials was applied to develop master curves. A phenomenological aging model was developed as a function of aging time and represented shift factors used in the master curve development. Sealants were categorized as Type A, B, or C on the basis of increasing aging potential.
Damage Characterization and Rehabilitation of the Teil Bridge, Ardèche, France
Authors: Cremona Christian F. , Germain Didier , Houel Adrien
Published: September 2015

This paper describes the experimental investigations and the planned rehabilitation program for the Teil Bridge, which connects the cities of Le Teil and Montέlimar in the Rhône–Alpes region of the Ardèche Department of France. Soon after the sudden rupture of a strand near the anchorage, the bridge was closed to traffic. Inspections were conducted to understand the causes of this event and to assess the strength of cables and strand sockets. Before the bridge was rehabilitated, its safety was improved through the strengthening of each socket. The bridge was then reopened to pedestrians and cyclists only. An acoustic emission system was installed over the course of a year. Events related to cable ruptures were monitored accordingly. Meanwhile, several other experimental investigations were conducted on steel and concrete materials (i.e., resilience, tensile steel strength, carbonation, chloride ingress) to estimate the residual structural service life of the bridge and to plan repair actions. A major rehabilitation program was then scheduled to change all of the cables and sockets. This paper presents stages of the investigation and the rehabilitation process.
Complications associated with bacitracin powder in surgical wounds
Authors: Beckman Joshua M. , Amankwah Ernest K. , Tetreault Lisa L. , Perlman Sharon A. , Tuite Gerald F.
Published: September 2015

OBJECT

There has been renewed interest in the application of concentrated antibiotic powder to surgical wounds as a method to decrease infection rates. While there is substantial medical literature describing the effectiveness and complications associated with vancomycin and gentamycin powders, very little has been reported regarding the safety and effectiveness of bacitracin powder in surgical wounds. In this paper the authors report their detailed analysis of potential bacitracin powder-related complications in a population of pediatric patients who underwent shunt surgery.

METHODS

A detailed retrospective analysis was completed of all CSF shunt surgeries performed by the corresponding author at a large children’s hospital between 2001 and 2013. This cohort consisted of many patients who were the subject of a previous report that showed the use of bacitracin powder in shunt wounds potentially decreased infection rates. Data were collected regarding the most common known complications of bacitracin, i.e., anaphylaxis, wound healing difficulties, and renal dysfunction. Data were stratified by typical demographic, medical, and surgical variables, including whether bacitracin powder was applied to wounds prior to closure.

RESULTS

A total of 597 patients were reviewed in the analysis: 389 underwent surgery without bacitracin powder and 208 had concentrated bacitracin powder applied to the wounds prior to closure. The application of bacitracin powder was not associated with anaphylaxis (n = 0 both groups) or with an increase in wound breakdown (n = 5 in the control group, n = 0 in the bacitracin powder group) or renal dysfunction (creatinine/estimated glomerular filtration rate) using both comparative and multivariate analyses between the 2 groups. The sample size evaluating renal function was significantly lower (range 6–320) than that of anaphylaxis and wound breakdown analysis because only clinical values acquired during the routine care of these patients were available for analysis. The only significant difference in demographics was the more frequent use of intrathecal vancomycin and gentamycin in patients who received bacitracin powder (n = 1 for controls, n = 21 for bacitracin powder). In the multivariate analysis, only 1 factor, surgery performed on a premature infant within the first 3 months of life, was independently associated with a change in creatinine at 3 months (creatinine decreased by 0.18) compared with the level before surgery (p < 0.0001). Bacitracin powder was not a significant factor.

CONCLUSIONS

To the authors’ knowledge, this is the first study to systematically analyze the potential complications of concentrated bacitracin powder applied to surgical wounds. The use of topical bacitracin powder in CSF shunt wounds was not associated with anaphylaxis, wound breakdown, or renal dysfunction. Further study using standardized protocols is necessary before widespread use can be recommended.
Surgical treatment of low lumbar osteoporotic vertebral collapse: a single-institution experience
Authors: Nakajima Hideaki , Uchida Kenzo , Honjoh Kazuya , Sakamoto Takumi , Kitade Makoto , Baba Hisatoshi
Published: September 2015

OBJECT

Low lumbar osteoporotic vertebral collapse (OVC) has not been well documented compared with OVC of the thoracolumbar spine. The differences between low lumbar and thoracolumbar lesions should be studied to provide better treatment. The aim of this study was to clarify the clinical and imaging features as well as outcomes of low lumbar OVC and to discuss the appropriate surgical treatment.

METHODS

Thirty patients (10 men; 20 women; mean age 79.3 ± 4.7 years [range 70–88 years]) with low lumbar OVC affecting levels below L-3 underwent surgical treatment. The clinical symptoms, morphological features of affected vertebra, sagittal spinopelvic alignment, neurological status before and after surgery, and surgical procedures were reviewed at a mean follow-up period of 2.4 years.

RESULTS

The main clinical symptom was radicular leg pain. Most patients had old compression fractures at the thoracolumbar level. The affected vertebra was flat-type and concave or H-shaped type, not wedge type as often found in thoracolumbar OVC. There were mismatches between pelvic incidence and lumbar lordosis on plain radiographs. On CT and MR images, foraminal stenosis was seen in 18 patients (60%) and canal stenosis in 24 patients (80%). Decompression with short fusion using a posterior approach was performed. Augmentations of vertebroplasty, posterolateral fusion, and posterior lumbar interbody fusion were performed based on the presence/absence of local kyphosis of lumbar spine, cleft formation, and/or intervertebral instability. Although the neurological and visual analog scale scores improved postoperatively, 8 patients (26.7%) developed postoperative complications mainly related to instrumentation failure. In patients with postoperative complications, lumbar spine bone mineral density was significantly low, but the spinopelvic alignment showed no correlation when compared with those without complications.

CONCLUSIONS

The main types of low lumbar OVC were flat-type and concave type, which resulted in neurological symptoms by retropulsed bony fragments generating foraminal stenosis and/or canal stenosis. For patients with low lumbar OVC, decompression of the foraminal and canal stenosis with short fusion surgery via posterior approach can improve neurological symptoms. Since these patients are elderly with poor bone quality and other complications, treatments for both OVC and osteoporosis should be provided to achieve good clinical outcome.
Fecal incontinence as a predominant symptom in a case of multiply recurrent tethered cord: diagnosis and operative strategies
Authors: Behaine Jose , Abdel Latif Assem M. , Greenfield Jeffrey P.
Published: September 2015

Recurrent manifestations of tethered spinal cord after an initial operative intervention for a simple fatty filum terminale is fairly uncommon. The authors present the case of an unusual clinical course in which there were 3 distinct episodes of recurrence, each time presenting predominantly as fecal incontinence and resolving with operative intervention. Typical signs of tethering were absent on radiological evaluation, and operative intervention was based on clinical grounds. Intraoperatively, sacral nerve roots to the anal sphincter were found tethered to the filar stump with electrophysiological evidence of regained activity on disentanglement. To the best of the authors’ knowledge, a similar clinical course or operative findings have not been reported.
Incidence of hemorrhage in the pediatric population with placement and removal of external ventricular drains
Authors: Miller Catherine , Guillaume Daniel
Published: September 2015

OBJECT

External ventricular drains (EVDs) are regularly used in pediatric neurosurgery for diagnostic and therapeutic purposes. Hemorrhage caused by placing an EVD is a common complication noted in the adult literature. In the pediatric literature, on the other hand, only a few articles have assessed the risk of hemorrhage with placement, and none have reported the occurrence of hemorrhage with removal of an EVD. The authors investigated the incidence of hemorrhage with both placement and removal of the EVD in a pediatric population.

METHODS

After obtaining institutional review board approval, a comprehensive database was created to include all pediatric patients who required EVD placement between March 2008 and June 2014 at the authors’ institution. A retrospective chart review was completed, and all imaging was reviewed for evidence of hemorrhage with placement and removal of the EVD.

RESULTS

During the designated time period, 73 EVDs were placed in 63 patients (ages 2 weeks–17 years). Indications for EVD placement were as follows: shunt infection/malfunction (21), tumor (12), hydrocephalus (18), hemorrhage (12), edema (4), trauma (1), and other (5). Hemorrhage with placement was noted in 5 of the 50 patients who underwent imaging, with a volume ranging from 0.48 cm3 to 7.7 cm3. Thirty-two patients had imaging after EVD removal, and 7 of these patients were noted to have hemorrhage (volume range 0.012 cm3 to 81.5 cm3).

CONCLUSIONS

The authors found the incidence of hemorrhage at EVD placement to be 10%, and the incidence of hemorrhage on EVD removal to be 21.9% in those patients who underwent imaging after each event. Although none of the hemorrhages were of obvious clinical significance, these data can be useful in decision making, and in discussing the risks of EVDs with the patient’s family.
PROJECT NETWORK MANAGEMENT: RISKS AND CONTRIBUTORS FROM THE VIEWPOINT OF CONTRACTORS AND SUB-CONTRACTORS
Authors: HWANG Bon Gang , NG Han Boey
Published: September 2015

Over the years, the network of construction project participants has expanded immensely. Clients have more stringent requirements due to increasing project complexity, difficulties with interaction and coordination, and uncertainties among various stakeholders. Emergent issues can bring many uncertain risks to the project execution process and yet the body of knowledge in this area, as applied to the Singapore construction environment, is insufficient. Therefore, the main objective of this study is to identify critical network risks extant in the industry in order to attain a better understanding of the attitudes of stakeholders towards network risk management. Thirtythree construction companies participated in a survey developed for this study and the analysis of the responses identified ten top critical network risks and the stakeholders who most contribute to these risks. The findings from this study will help the industry to promote a healthy working relationship among stakeholders, and will further facilitate collaboration within the project network.
ASSESSMENT OF ABNORMALLY LOW TENDERS: A MULTINOMIAL LOGISTIC REGRESSION APPROACH
Authors: GUNDUZ Murat , KARACAN H. Volkan
Published: September 2015

This study was performed in order to reveal factors affecting abnormally low tenders (ALTs) and to minimize negative effects of them. A thorough literature review was carried out to observe past research about the reasons of and possible solutions to ALTs. A questionnaire was prepared and submitted to construction professionals to capture negative impacts of ALTs based on the interviews with experts and past literature. 430 companies responded to the questionnaire. The data analysis was carried out by the multinomial logistic regression statistical tool. Having quality control systems and restricted procedure with prequalification procurement systems were main significant factors to reduce ALTs. Based on all significant factors, recommendations were made to construction professionals and companies to reduce adverse effects of ALTs.
Interior-Induced Fracture Mechanism of High Cleanliness Spring Steel (JIS SWOSC-V) in Very High Cycle Regime
Authors: Miura Taku , Sakakibara Takayuki , Kuno Takanori , Ueno Akira , Kikuchi Shoichi , Sakai Tatsuo
Published: September 2015

In order to investigate the interior-induced fatigue crack propagation behavior of high cleanliness valve spring steel (JIS SWOSC-V), rotating bending fatigue tests were performed for various kinds of specimens with different hardness or surface finishings. The harder specimen with higher compressive residual stress showed longer fatigue life. The electrochemical polished specimen pre-treated with shot peening showed almost same fatigue life as the shot-peened specimen in spite of the difference in surface roughness. After fatigue tests, fracture surfaces were observed using a scanning electron microscope (SEM) to evaluate the fatigue fracture mechanism. Most specimens failed in surface-induced fracture mode due to high cleanliness; however, some specimens failed in interior-induced fracture mode in the very high cycle regime. Although non-metallic inclusions were not observed at interior fatigue crack initiation sites, 2 types of significant microstructures (with smooth surface or granular surface) were observed. EBSD analysis, profile analysis and computational simulation using a fracture surface topographic analysis (FRASTA) method were performed to investigate the mechanism of the interior-induced fatigue fracture caused by the microstructure at defect without any inclusion.
The Top 10 Influential Articles in Very High Cycle Fatigue
Authors: Liu Yong Jie , Kashif Khan Muhammad , Wang Qing Yuan
Published: September 2015

The top 10 most influential articles in Very high cycle fatigue (VHCF) have been indentified from web of science data. The attributes of the top 10 papers have been discussed. It was found that specialty area of fatigue called as “VHCF” is an emerging field. The most cited papers discussed the two the fatigue crack mechanism in fatigue. It was found that crack initiation shifts from surface to subsurface if the material beyond 107 cycles. There are some models which can predict the fatigue life of the material however the exact estimation is still challenging. Hence, it was found that still further efforts are required in the field to accurately understand the VHCF behavior.
VHCF Behavior and Word Hardening of a Ferritic-Martensitic Steel at High Mean Stresses
Authors: Beck Tilmann , Kovacs Stephan A. , Ritz Fabian
Published: September 2015

Low-pressure steam turbine blades undergo VHCF-loadings induced by inhomogenous flow behind the vanes resulting in excitation frequencies of ≈ 2 kHz for rotational speeds of 50 Hz and a typical number of stator vanes of ≈ 60. The VHCF loading is superimposed by considerable mean stresses caused by centrifugal forces. In the present study, the VHCF-behavior of the ferritic-martensitic turbine blade steel X10CrNiMoV12-2-2 is investigated using an ultrasonic fatigue testing system up to cycle numbers of 5∙109 at stress ratios from R = -1 up to 0.7, i.e. up to very high mean stresses. Generally, crack initiation changes from the surface to internal inclusions at fatigue lives around 4∙107. The transition between fatigue failure and run-outs is shifted to higher lifetime with increasing R, and fine grained areas (FGAs) at the crack initiation sites only occur at R < -0.1. However, the fracture mechanics approach proposed by Murakami consistently describes the lifetime behavior for all load ratios over 4 decades of lifetime. At R up from 0.5 considerable cyclic creep occurs, even for lifetimes above 108 cycles, resulting in cyclic hardening which was proved by microhardness measurements at longitudinal sections. This effect at least partially explains the high maximum stresses close to the tensile strength of the material occurring in the VHCF regime at load ratios ≥ 0.5.
Experimental Investigation and Simulation of the Fatigue Mechanisms of a Duplex Stainless Steel under HCF and VHCF Loading Conditions
Authors: Dönges Benjamin , Fritzen Claus Peter , Christ Hans Jürgen
Published: September 2015

High frequency push-pull fatigue experiments on the austenitic-ferritic duplex stainless steel X2CrNiMoN22-5-3 (318LN) revealed that crack nucleation and crack propagation through the first grain determine significantly the lifetime of the material. Only in very few cases it was observed that fatigue samples which endured one billion load cycles without failure (run-out samples) contain microcracks which reached or overcame the first microstructural barrier (phase or grain boundary). This leads to the conclusion that in most cases the highest macroscopic stress or strain amplitude which does not lead to fatigue crack propagation through the entire first grain can be considered as the fatigue limit of the material. The present study documents that the experimentally identified fatigue mechanisms can be represented in mesoscopic finite element simulations by taking into account the effects of anisotropic elasticity, crystal plasticity, macro and micro residual stresses, plastic strain concentration in form of slip bands, crack nucleation and short crack propagation through the first grain. The current investigation shows that such simulations enable the determination of the fatigue limit of both real and synthetic microstructures. By means of real microstructures, containing slip traces and microcracks, the calculations can be verified and the required microstructural parameters can be determined.
The most Influential Articles in Very High Cycle Fatigue
Authors: Wang Q.Y. , Khan Muhammad Kashif
Published: September 2015

The most influential articles in Very high cycle fatigue (VHCF) during last 20 years have been identified from web of science data. It has been found that VHCF is an important category of fatigue damage and has produced the highest impact in the field. The number of articles and their citations is continuously increasing in the overall published papers in the field of fatigue. In VHCF field, it was found that the participants of VHCF conferences from VHCF 1 to 5 are the main contributors in all the VHCF papers and in its top 100 influential papers. Majority of the articles were experimental studies. The fatigue crack initiation in the VHCF domain is considered the most important area in the field. In VHCF, the most influential papers till date have been identified. This may prove helpful to trainees mastering the most influential literature of the field as well as more established professionals searching for starting points for new investigations
Three Point Bending Fatigue of Carbon Fiber Fabric Reinforced Polyphenylensulfide in the Very High Cycle Fatigue Regime
Authors: Backe Daniel , Balle Frank , Eifler Dietmar
Published: September 2015

Carbon fiber reinforced polymers (CFRP) are getting more and more important for structural components for automotive and aerospace applications. These components are subjected to 1011and more loading cycles during their time in service. Therefore the VHCF behavior and the corresponding failure mechanisms have to be well understood. To obtain a comprehensive knowledge about the fatigue behavior and failure mechanisms of CFRP in the VHCF regime, a new Ultrasonic Testing Facility (UTF) for cyclic 3-point bending at 20 kHz has been developed at WKK. This UTF with combined online nondestructive testing via laser vibrometry and IRthermography enables VHCF experiments up to 109cycles in twelve days without overcritical heating up to the glass transition temperature of the polymer. The chosen material in this research project is the commercially available and aircraft qualified carbon fiber fabric reinforced polyphenylensulfide (CF-PPS). To determine the fatigue characteristics of CF-PPS load increase tests and based on these results constant amplitude tests up to 109cycles have been carried out. Light optical and SEM microscopy have been performed in defined fatigue states or finally after reaching 109cycles with shear stress amplitudes of at least 44% of the monotonic ultimate shear strength. The induced fatigue damage of CF-PPS in the VHCF regime was studied in detail.
Identity, construction and memory in Joanne Leonard’s Being in pictures: An intimate photo memoir (2008)
Authors: Du Plooy Heilna
Published: September 2015

When Joanne Leonard’s photo collage Romanticism is ultimately fatal (1972) appeared in H.W. Janson’s History of art, the image brought her recognition as an artist. It gave her the confidence to further develop her technique of making photo collages, and the collages became a means of giving expression to her personal emotions as well as her reactions to historical events and public debates. In 2008, Leonard published an autobiographical text, ‘an intimate memoir’, in which she presents a selection of photographs and photo collages narrating her development as an artist and as a person. Written text is added to the visual images, providing information about the content and technical aspects of the photographs and collages as well as about the stages of her life as a person and an artist. This article discusses Joanne Leonard’s photo memoir by focussing on the relationship between identity and narrativity, on the constructed nature of all representions and especially represented autobiographical narratives and, finally, on the understanding and functioning of memory. The theoretical and philosophical aspects of identity, narrative identity, construction and memory are explored, and selected art works are analysed and discussed. The conclusion of the article suggests that autobiography, in all its variety, remains one of the most fascinating genres to study and that this photo memoir is an exceptional example.
The relationship between self-efficacy and reading proficiency of first-year students: An exploratory study
Authors: Boakye Naomi A.N.Y.
Published: September 2015

Self-efficacy, which is the belief about one’s ability to perform a task successfully, has been widely acknowledged as important in learning. This affective factor, though not explicitly evident, has been said to play an important role in academic performance. However, its role in reading development has not been widely investigated. To determine the relationship between self-efficacy and reading proficiency, a study was conducted with first-year students in a South African tertiary institution. Students’ self-efficacy levels were elicited through a questionnaire and their reading proficiency was obtained through the Test of Academic Literacy levels (TALL), which essentially assesses reading proficiency. An analysis of variance showed a robust relationship between reading self-efficacy and reading proficiency for this cohort of students. Regression analysis conducted with other affective factors showed self-efficacy as the best predictor of students’ reading proficiency. Results are discussed as they relate to previous research and recommendations are made to include the development of self-efficacy in reading instruction.
Identity theory and research in the South African organisational context
Authors: Coetzee Melinde
Published: September 2015

No abstract available.
Role of endoscopy in gastroesophageal reflux disease
Authors: Rai Tarun , Vennalaganti Prashanth , Sharma Prateek
Published: September 2015

Gastroesophageal reflux disease is a condition due to reflux of stomach content in the esophagus causing trouble symptoms or complications or both. GERD is a clinical diagnosis and typically presents with a heartburn and/or regurgitation and a positive response to antacid secretory medications. GERD is the leading outpatient diagnosis among all gastrointestinal disorders in the United States. Approximately 40% of population report occasional symptoms of GERD whereas 10-20% of patients will have symptoms at least once in a week. Recent guidelines from gastrointestinal societies such as American College of Gastroenterology, American Society for Gastrointestinal Endoscopy and American College of Physicians have laid out specific indications regarding role of esophagogastroduodenoscopy in GERD. Despite these recommendations, studies have revealed that one-fifth to two-fifth EGDs may not be clinically indicated, especially where open access endoscopy referral system is used. Traditionally, GERD has been thought to be a disease of the western world. Prevalence rates had been estimated to be lower in Asia when compared to that of the Western Countries. Few recent epidemiological studies in India showed the prevalence of reflux disease in India to be between 8-24%, which is comparable to the western world. The use of EGDs becomes more critical for developing countries such as India where prevalence of GERD and BE is comparable to the western countries but have limited resources. In addition to direct cost for an EGD, it burdens economy with indirect costs such as time off from the work, transportation and any procedural complications. Risk stratifying patients with GERD may therefore prevent unnecessary procedures, harms and costs. The aim of this paper is to review the existing evidence on the role of endoscopy in GERD.