bluuebunny/crossref_metadata_2025 huggingface dataset:
No gold medals: Assessing Australia’s international mental health performance
Authors: Rosenberg Sebastian , Hickie Ian
Published: October 2018

Objective:

The objective of this study was to present an assessment of Australia’s mental health system performance, within its social context, by comparison with other countries.

Method:

A review of existing literature and databases from both Australia and overseas was undertaken. Systems permitting international comparison of mental health and its social context are few. The review is limited in scope.

Results:

Although Australia was one of the first nations to develop and adopt a national mental health policy (in 1992), the data that are available suggest that we are not World leaders across the identified domains.

Conclusions:

While international benchmarking can play an important role in fostering quality improvement, there are only limited mental health or social system performance data sources to utilise. It would be desirable for a more systematic international process to be established to review existing approaches and design a new multilateral strategy. It would be important that this new strategy reflected the full experience of mental health and its broader social context.
Psychiatry trainee welfare – from words to action
Authors: Kim Hannah , Suetani Shuichi , Forbes Malcolm , Nguyen David
Published: October 2018

Objective:

To review selected literature available on trainee welfare and reflect on our own experiences to provide practical advice to our colleagues and suggest strategies to enhance trainee welfare.

Conclusions:

Promoting the welfare of psychiatry trainees requires a three-pronged approach. We must care for ourselves through individual strategies; we must advocate for optimization of the systems we work in to minimize modifiable factors associated with burnout; and we must continue on the perennial challenge of culture change to reduce stigma around stress and mental illness and promote a healthier workplace.
Effects of electrodes and electrical connections of piezoelectric layers on dynamic characteristics of radially polarized multilayer piezoelectric cylindrical transducers
Authors: Wang Jianjun , Liu Donghuan , Li Weijie , Wei Peijun , Tang Lihua
Published: October 2018

Piezoelectric cylindrical transducer is a type of excellent smart devices that can generate radial sound radiation due to its unique structural characteristics and has been widely used for ultrasonic and underwater sound applications. In the design of a piezoelectric cylindrical transducer, especially with the multilayer structure, the electrodes and electrical connections of piezoelectric layers are two key factors affecting the device performance but have not been well evaluated, which result in the inaccurate prediction of dynamic characteristics. This work establishes the exact theoretical models for radially polarized multilayer piezoelectric cylindrical transducers by taking into account the electrodes and electrical connections of piezoelectric layers. Based on the plane stress assumption, the dynamic solutions of the models are derived. Analytical expressions of electric impedances are also derived to obtain the resonance frequencies. In addition, the analytical solutions are validated using the special example in the earlier work and comparing them with the finite element analysis results. Subsequently, the effects of the electrodes and electrical connections of piezoelectric layers on the dynamic characteristics of the transducer are analyzed and discussed. The results show that the electrode thickness, the electrode type, and the parallel and series connections significantly affect the transducer’s performance, thus providing useful guidelines in the design of piezoelectric cylindrical transducers. This work contributes to an overall analysis on the dynamic characteristics of the radially polarized multilayer piezoelectric cylindrical transducers, which is very helpful to improve the performance of two-dimensional emitter and receiver in underwater sound and ultrasonic applications.
An experimental–numerical study on shape memory behavior of PU/PCL/ZnO ternary blend
Authors: Abbasi-Shirsavar M , Baghani M , Taghavimehr M , Golzar M , Nikzad M , Ansari M , George D
Published: October 2018

Shape memory polymer composites have attracted significant attention due to novel properties and great applications. In this article, we focus on the fabrication and simulation of polyurethane/polycaprolactone nanocomposites. The polyurethane/polycaprolactone blends containing ZnO nanoparticles (5 to 30 wt%) are fabricated using a solution mixing and casting method. It is found that significant improvement of polyurethane/polycaprolactone composites in Young’s modulus is achieved by incorporating 20 wt% of ZnO nanoparticles; also, the results of the shape recovery ratio reveal that adding an optimum amount of ZnO (the reinforcement) can increase the shape recovery ratio (for 20 wt% of ZnO). These results could most likely be explained by the fact that some particles restrict the hard segment–soft segment interactions and provide more mobility to polycaprolactone components, while the other nanoparticles can act as the nucleating agent for polycaprolactone chains. A generalized Maxwell model is then used to examine the shape memory behavior of shape memory polymer composites. The dynamic mechanical thermal analysis results are utilized to define the model coefficients and the simulation is carried out to determine the shape recovery ratio. Simulation of this shape recovery ratio for shape memory polymer composites reveals that the numerical results are in good agreement with those of the experimental data.
Young Muslim Pakistani Women’s Lived Experiences of Izzat, Mental Health, and Well-Being
Authors: Gunasinghe Cerisse , Hatch Stephani L. , Lawrence Jane
Published: October 2018

This article explores how six Pakistani Muslim women interpret cultural concepts of izzat (honor and self-respect); what role, if any, it has in their lives; and whether there is interplay between upholding izzat and the participants’ help-seeking strategies for mental health and well-being. Semistructured interviews were conducted and analyzed with an interpretative phenomenological analytic framework. Three themes were identified: (a) “the rules of izzat,” (b) “negotiating tensions,” and (c) “speaking out/breaking the ‘rules.’” Findings highlighted new insights into the understanding of izzat and the implications these cultural concepts have for strategies in managing or silencing of psychological distress. Interviews illustrated tensions the participants experience when considering izzat, how these are negotiated to enable them to self-manage or seek help, and possible life experiences that might lead to self-harm and attempted suicide. Notably, cultural codes, in particular izzat, appear to vary over the life course and are influenced by migration.
Child, Family, and Early Intervention Characteristics Related to Family Quality of Life in Spain
Authors: García-Grau Pau , McWilliam R. A. , Martínez-Rico Gabriel , Morales-Murillo Catalina P.
Published: October 2018

Family quality of life (FQoL) is considered one of the aims of early intervention (EI) services and a good indicator of service quality. Families were recruited from EI centers in 12 of 17 communities (states) in Spain. This study describes the FQoL of 250 Spanish families with children aged 0 to 6 years in EI services during a family-centered implementation process. We used an EI-specific FQoL scale that includes families’ perception of their child’s functioning as one factor. We also describe the relationships among individual, family, and service variables as well as FQoL. Type of disability, socioeconomic status, and family-centered practices impacted Child Functioning, Overall Life Situation, and Access to Information and Services factors, respectively. Fewer number of professionals involved was related with greater perception of child’s functionality. Family-centeredness, type of family, and type of disability were the most influencing variables for the Total score. Implications for practice are discussed.
Correlated Trait–Correlated Method Minus One Analysis of the Convergent and Discriminant Validity of the Conners 3 Short Forms
Authors: Gomez Rapson , Vance Alasdair , Stavropoulos Vasileios
Published: October 2018

This study used the correlated trait–correlated method minus one model to examine the convergent and discriminant validity of the scales of the Conners 3 Short [C 3 (S)]. The C 3 (S) scales in the analysis were inattention (IN), hyperactivity/impulsivity (HY), learning problems (LP; learning problems/executive functioning from the teacher version), aggression (AG), and peer relations (PR, only for parent and teacher versions). A total of 529 adolescents and children (75% males, mean age = 11.75 years, SD = 2.97 years) provided self-ratings, and were also rated by their mothers and teachers. The findings indicated no support for the convergence of IN and HY across the three respondents. In contrast, there was convergence for LP, AG, and PR. There was support for the discriminant validity of the traits, except between IN and HY. The findings are discussed in relation to the convergent and discriminant validity of the C 3 (S) measures, and the clinical use of the C 3 (S).
Psychometric Properties of the Dutch Strengths and Difficulties Questionnaire (SDQ) in Adolescent Community and Clinical Populations
Authors: Vugteveen Jorien , de Bildt Annelies , Serra Marike , de Wolff Marianne S. , Timmerman Marieke E.
Published: October 2018

This study assessed the factor structures of the Strengths and Difficulties Questionnaire (SDQ) adolescent and parent versions and their measurement invariance across settings in clinical ( n = 4,053) and community ( n = 962) samples of Dutch adolescents aged 12 to 17 years. Per SDQ version, confirmatory factor analyses were performed to assess its factor structure in clinical and community settings and to test for measurement invariance across these settings. The results suggest measurement invariance of the presumed five-factor structure for the parent version and a six-factor structure for the adolescent version. Furthermore, evaluation of the SDQ scale sum scores as used in practice, indicated that working with sum scores yields a fairly reasonable approximation of working with the favorable but less easily computed factor scores. These findings suggest that adolescent- and parent-reported SDQ scores can be interpreted using community-based norm scores, regardless of whether the adolescent has been referred for mental health problems.
A Reformulated Architecture of Cognitive Risks for Psychopathology: Common and Specific Dimensions and Links to Internalizing Outcomes in Adolescence
Authors: Schweizer Tina H. , Snyder Hannah R. , Hankin Benjamin L.
Published: October 2018

Multiple cognitive risk products (dysfunctional attitudes [DA], negative inferential style [NIS], self-criticism, dependency, rumination) predict internalizing disorders; however, an optimal structure to assess these risks is unknown. We evaluated the fit, construct validity, and utility of a bifactor, single, and correlated factor model in a community sample of 382 adolescents (age 11-15 years; 59% female). The bifactor, hierarchical single, and correlated factor models all fit well. The bifactor model included a common factor ( c), capturing covariance across all cognitive risk measures, and specific latent factors for DA, NIS, dependency and rumination. Construct validity of these factor structures was evaluated with external validators, including depression and anxious arousal (AA) symptoms, positive affect (PA) and negative affect (NA), and onset of depression diagnostic onset over 2 years. C was associated with higher depression, NA, and AA; lower PA; and predicted depressive episodes. Hierarchical single and correlated factor models also related to external validators.
Two Different Buprenorphine Treatment Settings With Similar Retention Rates: Implications for Expanding Access to Treatment for Opioid Use Disorder
Authors: Tierney Matthew , Melino Katerina , Adeniji Adebowale , Shumway Martha , Allen Isabel E. , Waters Catherine M.
Published: October 2018

INTRODUCTION: There is considerable need for effective and accessible treatment for opioid use disorder. AIMS: Our study explored differences in buprenorphine treatment retention and duration, with a focus on selected sociodemographic factors and treatment indicators, in two different settings: an office-based buprenorphine induction and stabilization clinic (OBIC) and a community-based primary care clinic (CPC). METHOD: This nonexperimental retrospective chart review compared demographic information and buprenorphine treatment details, including treatment retention and duration. RESULTS: There were no statistically significant differences in buprenorphine treatment indicators between the OBIC and CPC groups, with two exceptions: the number of written buprenorphine prescriptions was significantly greater for the OBIC group, as was the number of filled buprenorphine prescriptions. CONCLUSIONS: Given similar treatment retention and duration in two different buprenorphine treatment settings, our findings suggest that access to buprenorphine treatment in standard integrated care settings can be supplemented by novel treatment structures such as the OBIC in order to increase access to care during the current opioid epidemic.
Bringing the Bridge to Veterans in Home Health Care
Authors: Cook Jan
Published: October 2018

This commentary familiarizes the reader with the Project NAGA Bridge Model as a way to honor veterans in the home health care setting. Family members can share the legacies of veterans in a partnership of the two cultures, civilian and military, and in so doing, enrich the communities where they live. The writing promotes the implementation of the military Form DD 214 as a comprehensive record of veterans’ military service and asks for the improvement of the situation of veterans needing health care.
Immune keratitis: An unusual primary presentation of neuro-Behçet’s disease
Authors: Jinagal Jitender , Agarwal Aniruddha , Negi Avinash , Gupta Gaurav , Sharma Vikas , Gupta Parul Chawla , Ram Jagat
Published: October 2018

A 19-year-old Nepalese male presented with complaints of bilateral ocular discomfort, photophobia, watering, and redness for 1 week. Visual acuity was 6/12 and 6/60 in the right and left eye, respectively. On biomicroscopic examination, presence of peripheral stromal infiltrates with conjunctival follicles was noted; infiltrates progressed to involve central cornea with further decrease in vision over next few days. After ruling out infectious keratitis, detailed systemic examination and laboratory investigations were diagnostic of neuro-Behçet’s disease. Patient responded to systemic steroidal and immunosuppressive therapy characterized by corneal healing and visual acuity improvement to 6/6 and 6/9. Although rare, but neuro-Behçet’s disease can primarily present as bilateral immune keratitis and every case of bilateral keratitis needs early systemic evaluation after ruling out infective etiologies.
Impact of Video Aid on Quality of Bowel Preparation Among Patients Undergoing Outpatient Screening Colonoscopy
Authors: Fatima Sanna , Jain Deepanshu , Hibbard Christopher
Published: October 2018

Aim:

To investigate the effect of video aid on quality of bowel preparation.

Study:

A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II <50%, Group III >50% to <75%, and Group IV watched ⩾75% of the video.

Results:

A total of 338 patients with an average age of 59.1 years and 60.3% females were included in the final study cohort. Of the patients in Groups I, II, III, and IV, 94.3%, 90.9%, 100%, and 91.7%, respectively, had adequate preparation ( P value = .827). Adenoma detection rate (ADR) for Groups I, II, III, and IV was 28.8%, 50%, 50%, and 22.6%, respectively ( P value = .305). The mean cecal intubation time was 20.7, 16.4, 16.57, and 17 minutes for Groups I, II, III, and IV, respectively ( P value = .041).

Conclusions:

Video aid use for patients undergoing screening colonoscopy lacked a statistically significant impact on the quality of bowel preparation, ADR, and advanced adenoma detection rate when compared with standard practice.
Structure and agency in novice music teaching
Authors: Powell Sean Robert
Published: October 2018

Using multiple interviews and observations, I chronicled the experiences of three novice music teachers in the United States over a 2-year period, including their student teaching internships and first years of in-service teaching. I analyzed these experiences through the lens of strong structuration theory, Stones’s (2005) extension and elaboration of Giddens’s (1984) original structuration theory. My guiding research questions were: a) How do the structures of music teaching within public schools in the U.S. enable and inhibit the agency of novice music teachers? and, b) How do the practices of novice music teachers reproduce, sustain, and change the structures of music education? I discuss how teacher educators, preservice teachers, and in-service teachers can work together in dialogue to assist novice music teachers in cultivating agential resistance by developing perceptions of power/capability, adequate knowledge, and requisite reflective distance.
Adapting work to the worker
Authors: Bell Mark
Published: October 2018

The changing profile of the European workforce creates pressure to adapt the working environment in order to accommodate worker diversity, such as that related to disability, religious practice or caring responsibilities. There is an ongoing debate within equality law on the extent to which law should require employers to provide such accommodation. This article examines the rationales that justify legal intervention and maps out various ways in which European Union legislation already requires employers to accommodate worker diversity. It identifies three types of accommodation duty: protective, substantive and procedural. The article argues that the debate can be enhanced by looking beyond the confines of equality law and drawing connections with a wider agenda for labour market reform. A better understanding of the different types of accommodation duty helps to expand the debate beyond a narrow focus on whether the duty of reasonable accommodation for workers with disabilities should be extended to other discrimination grounds.
Adverse childhood experiences as a predictor of attendance at a health-promotion program
Authors: Karatekin Canan , Hill Maria
Published: October 2018

This short-term longitudinal study examined whether adverse childhood experiences predicted attendance at a fitness program. We asked undergraduates participating in a group fitness program at a university to complete measures of mental health and adverse childhood experiences at the start of the semester. Attendance data were obtained from the recreational center at the end of the semester. Adverse childhood experiences predicted attendance after parental education and mental health were taken into account. To our knowledge, this is the first study to demonstrate that more adverse childhood experiences predict lower attendance at a health-promotion program. Findings suggest a need for adverse childhood experiences screening to prevent drop-out.
The Organisation for Economic Co-operation and Development’s International Early Learning Study: What’s going on
Authors: Moss Peter , Urban Mathias
Published: October 2018

In this colloquium, the authors provide an update on the Organisation for Economic Co-operation and Development’s proposal for an International Early Learning and Child Well-being Study, the ‘first wave’ of which is now being implemented in three countries: England, Estonia and the USA. The authors argue that as the International Early Learning and Child Well-being Study progresses, its superficiality and pointlessness become more apparent. They also locate the International Early Learning and Child Well-being Study in a ‘global web of measurement’ centred on the Organisation for Economic Co-operation and Development, whose aim appears to be the reduction of education to a purely technical exercise of producing common outcomes measured by common indicators, with the Organisation for Economic Co-operation and Development acting as the global arbiter, assessor and governor of education. They call on the Organisation for Economic Co-operation and Development and its partners to start engaging with legitimate concerns and criticisms.
Interviews with women in India
Authors: Turnbull Brian
Published: October 2018

Significant social science research has been dedicated to determining and describing effective means of gathering data via the interview, while minimizing bias and accounting for the methodological and ethical problems created by gender power imbalance and racial privilege. This research note contributes to this discussion by providing insight from fieldwork conducted in the highly patriarchal environment of Rajasthan, India, with a focus on experiences often unique to conducting research in the developing world. I discuss the unique theoretical and methodological challenges created by a white male using semi-structured interviews with women to determine the degree of independence among representatives brought in through the gender quota system.
The effect of polyester recycled tire fibers mixed with ground tire rubber on polyethylene composites. Part II
Authors: Moghaddamzadeh Siavosh , Rodrigue Denis
Published: October 2018

This work reports on the mechanical (tension, flexion, and impact) and physical (density and hardness) properties of polyester recycled tire fibers (RTFs) mixed with ground tire rubber and linear low-density polyethylene with and without styrene–ethylene–butylene–styrene grafted maleic anhydride as a compatibilizer. In particular, the effect of RTF content (10, 25, and 50 wt%), extruder screw speed (110, 180, and 250 r/min), and temperature profiles (extrusion and injection molding) was studied. The results showed that the best properties were obtained at the highest RTF content (50%) and extruder screw speed (250 r/min) combined with the lowest temperature profile in both extrusion and injection molding when the compatibilizer was added.
Compatibilization and mechanical properties of compression-molded polypropylene/high-impact polystyrene blends
Authors: de Mello Felipe Bier , Nachtigall Sonia Marli Bohrz , Salles Cleia de Andrade , Amico Sandro Campos
Published: October 2018

This research work focused on polypropylene/high-impact polystyrene polymer blends. Since this blend (80/20 in weight) was incompatible, styrene–ethylene–butylene–styrene (SEBS) block copolymer, styrene–butadiene–styrene (SBS), and ethylene vinyl acetate were tested as compatibilizers (2.5 or 7.5 wt% in relation to blend). After blending via extrusion, the compositions were compression molded and their mechanical (tensile and impact), morphological (scanning electron microscopy), and rheological (melt flow index and viscosity) properties were evaluated. Blends containing SBS and 7.5 wt% of SEBS showed a positive effect regarding impact strength, although with a decrease in Young’s modulus and tensile strength. Rheological characteristics were also affected by the compatibilizers.
Characterization of waste tire rubber devulcanized in twin-screw extruder with thermoplastics
Authors: Nunes Anderson Thadeu , Santos Rubens Eduardo dos , Pereira Juliene Sátiro , Barbosa Rafael , Ambrósio José Donato
Published: October 2018

Waste tire rubber (WTR) supplied by a truck tire retreader were processed in an intermeshing co-rotating twin-screw extruder (ICTSE). The extrusion process evaluated the efficiency of the thermomechanical recycling in the devulcanization of WTR rubbers. Samples were prepared by varying the process parameters, the particles sizes and thermoplastics, and the latter was used as devulcanization auxiliary agents. After extrusion, samples were subjected to solvent extraction to determine the soluble fraction (SF). Subsequently, these SF were characterized by Fourier transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The highest SF (29 wt%) was obtained with higher screw rotating speed and with smaller particle size. Higher SF indicated a higher degree of devulcanization. The FTIR and DSC analyses showed that natural rubber was the main rubber extracted from extruded samples. In addition, polypropylene was more effective than low-density polyethylene in the devulcanization process, promoting higher SF.
Using Consumer Data to Inform Marketing Strategies for Chlorhexidine for Umbilical Cord Care Programming in Kenya and Nigeria
Authors: Metzler Mutsumi , Coffey Patricia S.
Published: October 2018

Introduction:

To date, distribution and communication channels being used at the country level for the introduction of 7.1% chlorhexidine digluconate (CHX) for umbilical cord care have been selected based on experience and knowledge gained through other public health programs rather than using results from targeted consumer research related to the 4Ps of social marketing (product, place, price, and promotion).

Objective:

To identify effective place and pricing strategies for the introduction of CHX in Nigeria and Kenya.

Study Design:

Observational cross-sectional study of potential consumers in two countries.

Method:

Data were collected from women who (i) were currently pregnant and had birthed a child previously or (ii) had delivered an infant within the past 3 months through face-to-face household interviews using structured questionnaires in four states in Nigeria ( n = 319) and four regions in Kenya ( n = 604).

Results:

The use of cord care substances, timing of use, product channels and prices that women pay for them, and preferences related to CHX are highlighted.

Conclusions:

Country-specific and audience data related to the 4Ps should be used to develop context-specific strategies that address the preferences of women. For example, in Nigeria, using retailers to distribute CHX would be a reasonable strategy, whereas in Kenya, use of retailers would be better as an augmentative strategy. Differentiating CHX from existing cord care substances, especially methylated spirits, is important for both countries. In Kenya, the strategy should articulate the benefits of CHX compared to dry cord care in areas of suboptimal hygienic conditions. In both countries, pricing CHX slightly lower than methylated spirits may be the optimal pricing strategy, given that the perceived value/benefits of the two products are similar.
Interpretation of Optical Coherence Tomography Images for Breast Tissue Assessment
Authors: Yemul Kiran S. , Zysk Adam M. , Richardson Andrea L. , Tangella Krishnarao V. , Jacobs Lisa K.
Published: October 2018

Purpose. Initial studies have shown that optical coherence tomography (OCT) is an effective margin-evaluation tool for breast-conserving surgery, but methods for the interpretation of breast OCT images have not been directly studied. In this work, breast pathologies were assessed with a handheld OCT probe. OCT images and corresponding histology were used to develop guidelines for the identification of breast tissue features in OCT images. Methods. Mastectomy and breast-conserving surgery specimens from 26 women were imaged with a handheld OCT probe. During standard pathology specimen dissection, representative 1-cm × 1-cm tissue regions were grossly identified, assessed with OCT, inked for orientation and image-matching purposes, and processed. Histology slides corresponding to the OCT image region were digitally photographed. OCT and histology images from the same region were paired by selecting the best structural matches. Results. In total, 2880 OCT images were acquired from 26 breast specimens (from 26 patients) and 48 matching OCT-histology image pairs were identified. These matched image pairs illustrate tissue types including adipose tissue, dense fibrosis, fibroadipose tissue, blood vessels, regular and hyperplastic ducts and lobules, cysts, cyst, fibroadenoma, invasive ductal carcinoma, invasive lobular carcinoma, ductal carcinoma in situ, calcifications, and biopsy cavities. Differentiation between pathologies was achieved by considering feature boundaries, interior appearance, posterior shadowing or enhancement, and overall morphologic patterns. Conclusions. This is the first work to systematically catalog the critical features of breast OCT images. The results indicate that OCT can be used to identify and distinguish between benign and malignant features in human breast tissue.
Surgical Technique and Anatomical Considerations for the Modified L’Episcopo Tendon Transfer
Authors: Brogan David M. , Leversedge Fraser J.
Published: October 2018

Background: Birth brachial plexus injury usually affects the upper trunks of the brachial plexus and can cause substantial loss of active shoulder external rotation and abduction. Due to the unbalanced rotational forces acting at the glenohumeral joint, the natural history of the condition involves progressive glenohumeral joint dysplasia with associated upper limb dysfunction. Surgical reconstruction methods have been described previously by Sever and L’Episcopo, and modified by Hoffer and Roper to release the adduction contracture and to restore external rotation and shoulder abduction. Methods: The authors describe their preferred technique for contracture release and tendon transfer to improve external rotation and shoulder abduction. Pertinent anatomy and highlights of surgical exposure are reviewed. Results: The senior author has utilized this technique with consistent clinical outcomes to improve shoulder function for patients with persisting nerve palsy associated with birth brachial plexus injury. A review of the literature supports utilization of this technique. Conclusions: Transfer of the latissimus dorsi and teres major to the posterior rotator cuff for reanimation of shoulder abduction and external rotation deficits associated with birth brachial plexus injury is a safe and reliable technique. Careful patient selection and attention to surgical detail are critical for optimal outcomes.
Acute Effects of Whole-Body Vibration on the Pain Level, Flexibility, and Cardiovascular Responses in Individuals With Metabolic Syndrome
Authors: Sá-Caputo D.C. , Paineiras-Domingos L.L. , Oliveira Ricardo , Neves Mario F.T. , Brandão Andrea , Marin Pedro J. , Sañudo Borja , Furness Trentham , Taiar Redha , Bernardo-Filho M.
Published: October 2018

The aim of the study was to assess the acute effect of whole-body vibration (WBV) exercise, with low frequency (5 Hz), on the pain level (PL), trunk flexibility, and cardiovascular responses (blood pressure [BP] and heart rate [HR]) in individuals with metabolic syndrome (MetS). Forty-four individuals were included in the study (control: 15) or in (WBV exercise: 29) groups. They were submitted to 3 bouts (1 minute each) of WBV exercise (5 Hz and peak-to-peak displacements of 2.5, 5.0, and 7.5 mm, corresponding to peak accelerations of 0.12, 0.25, and 0.35 g, respectively, sitting in a chair with the feet on the platform with knees flexed, followed by 1 minute of interset rest. The Control Group performed the same protocol, but the platform was turned off. The PL was measured through the visual analog pain scale, and the flexibility was measured through the anterior trunk flexion test. Significant improvements on PL ( P = .031) and flexibility ( P = .004) were found only in the WBV exercise group. The BP and HR remained at physiological levels. In conclusion, the WBV exercise would lead to physiological response decreasing PL and increasing flexibility as well as maintaining the cardiovascular responses in individuals with MetS.
Impact of ascending aortic, hemiarch and arch repair on early and long-term outcomes in patients with Stanford A acute aortic dissection
Authors: Merkle Julia , Sabashnikov Anton , Deppe Antje-Christin , Zeriouh Mohamed , Maier Johanna , Weber Carolyn , Eghbalzadeh Kaveh , Schlachtenberger Georg , Shostak Olga , Djordjevic Ilija , Kuhn Elmar , Rahmanian Parwis B. , Madershahian Navid , Rustenbach Christian , Liakopoulos Oliver , Choi Yeong-Hoon , Kuhn-Régnier Ferdinand , Wahlers Thorsten
Published: October 2018

Background:

Stanford A acute aortic dissection (AAD) is a life-threatening emergency associated with major morbidity and mortality. The aim of this study was to compare outcomes of three different surgical approaches in patients with Stanford A AAD.

Methods:

From January 2006 to March 2015 a total of 240 consecutive patients with diagnosed Stanford A AAD underwent elective, isolated surgical aortic repair in our centre. Patients were divided into three groups according to the extent of surgical repair: isolated replacement of the ascending aorta, hemiarch replacement and total arch replacement. Patients were followed up for up to 9 years. After univariate analysis multinomial logistic regression was performed for subgroup analysis. Baseline characteristics and endpoints as well as long-term survival were analysed.

Results:

There were no statistically significant differences among the three groups in terms of demographics and preoperative baseline and clinical characteristics. Incidence of in-hospital stroke ( p = 0.034), need for reopening due to bleeding ( p = 0.031) and in-hospital mortality ( p = 0.017) increased significantly with the extent of the surgical approach. There was no statistical difference in terms of long-term survival ( p = 0.166) among the three groups. Applying multinomial logistic regression for subgroup analysis significantly higher odds for stroke ( p = 0.023), reopening for bleeding ( p = 0.010) and in-hospital mortality ( p = 0.009) for the arch surgery group in comparison to the ascending aorta surgery group as well as significantly higher odds for stroke ( p = 0.029) for the total arch surgery group in comparison to the hemiarch surgery group were identified.

Conclusions:

With Stanford A AAD the incidence of perioperative complications increased significantly with the extent of the surgical approach. Subgroup analysis and long-term follow up in patients undergoing isolated ascending or hemiarch surgery showed a lower incidence of cerebrovascular events compared with surgery for total arch replacement.
Assessment of renal function in patients with myositis and treated with subcutaneous immunoglobulin: a series of 24 cases
Authors: Cherin Patrick , Tadmouri Abir , de Jaeger Christophe , Pindi Sala Taylor , Crave Jean-Charles
Published: October 2018

Immunoglobulin (Ig) therapy is used to treat a wide range of immunodeficiencies and autoimmune diseases; While, its clinical benefit has been demonstrated in several studies, Ig therapy is associated with a risk of systemic adverse effects. As such, Onset of renal impairment, including acute renal failure, osmotic nephrosis and renal insufficiency, after immunoglobulin administration is rare, but is one of the most significant concerns related to intravenous Ig use at immunomodulatory doses. However, only few studies have investigated the safety of subcutaneous Ig (SCIg) in relation to these rare conditions. The aim of this prospective study is to describe the safety of SCIg (Gammanorm), specifically with regards to renal function, in inflammatory myopathies including mainly polymyositis (PM), dermatomyositis (DM) and inclusion body myositis (IBM). Twenty-four cases were included: 10 patients with PM, 6 with IBM, 5 with DM, 2 with mixed connective-tissue disease (MCTD) and 1 patient with scleromyositis. SCIg was given two to three times per week at 2 g/kg/month in all patients. Patients were treated for a mean duration of 24.6 ± 11.4 months (range 8–37 months) and received a median of 78 SCIg infusions. Renal function was stable over the study period in all patients. High-dose SCIg was well tolerated; the treatment was not withdrawn during the first year in any patient for safety issues. These results suggest that the use of high-dose SCIg is generally feasible and safe in patients with inflammatory myopathies.
Efficacy of collagen and alginate hydrogels for the prevention of rat chondrocyte dedifferentiation
Authors: Jin Guang-Zhen , Kim Hae-Won
Published: October 2018

Dedifferentiation of chondrocytes remains a major problem in cartilage tissue engineering. The development of hydrogels that can preserve chondrogenic phenotype and prevent chondrocyte dedifferentiation is a meaningful strategy to solve dedifferentiation problem of chondrocytes. In the present study, three gels were prepared (alginate gel (Alg gel), type I collagen gel (Col gel), and their combination gel (Alg/Col gel)), and the in vitro efficacy of chondrocytes culture while preserving their phenotypes was investigated. While Col gel became substantially contracted with time, the cells encapsulated in Alg gel preserved the shape over the culture period of 14 days. The mechanical and cell-associated contraction behaviors of Alg/Col gel were similar to those of Alg. The cells in Alg and Alg/Col gels exhibited round morphology, whereas those in Col gel became elongated (i.e. fibroblast-like) during cultures. The cells proliferated with time in all gels with the highest proliferation being attained in Col gel. The expression of chondrogenic genes, including SOX9, type II collagen, and aggrecan, was significantly up-regulated in Alg/Col gel and Col gel, particularly in Col gel. However, the chondrocyte dedifferentiation markers, type I collagen and alkaline phosphatase ( ALP), were also expressed at significant levels in Col gel, which being contrasted with the events in Alg and Alg/Col gels. The current results suggest the cells cultured in hydrogels can express chondrocyte dedifferentiation markers as well as chondrocyte markers, which draws attention to choose proper hydrogels for chondrocyte-based cartilage tissue engineering.
Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review
Authors: Vink Mark , Vink-Niese Alexandra
Published: October 2018

The analysis of the 2017 Cochrane review reveals flaws, which means that contrary to its findings, there is no evidence that graded exercise therapy is effective. Because of the failure to report harms adequately in the trials covered by the review, it cannot be said that graded exercise therapy is safe. The analysis of the objective outcomes in the trials provides sufficient evidence to conclude that graded exercise therapy is an ineffective treatment for myalgic encephalomyelitis/chronic fatigue syndrome.
Correlates of Patients’ Preference for Therapeutic Injections in a Major Regional Referral Hospital in Ghana: Implications for Policy and Clinical Practice
Authors: Alhassan Robert Kaba , Adu-Gyamfi Bismark Appiah , Oliver Agbolosu , Ayensu Bright , Awoenam Gbekor , Angela Owusu , Nketiah-Amponsah Edward , Mwini-Nyaledzigbor Prudence P.
Published: October 2018

Abuse of injections, particularly in resource poor countries, remains a challenge evident in the increasing preference for therapeutic injections over oral medication. Objective of this study is to explore factors associated with patients’ preference for therapeutic injection over oral medication in the Volta Regional Hospital, Ho in Ghana. The study is a cross-sectional survey conducted among 200 patients accessing care in Volta Regional Hospital. Data were analyzed using STATA statistical software for data analysis. Univariate probit regression was used to ascertain factors associated with patients’ preference for therapeutic injections over oral medication (main outcome variable of interest). It was found that 74% of the 200 respondents preferred injection to oral medication. More outpatients preferred injectable medication over oral ( p = .041); 86% of the respondents said they never experienced complication related to injectable medication. Patients who perceived injection as more efficacious were more likely to opt for it over oral medication (coefficient = 2.22; SE = 0.33; p < .05). It is concluded that patients’ preference for injectable medication over oral remains high in Ghana, and this preference is significantly associated with patients’ perceptions on superiority of injections over oral medication. There is the need to intensify health education for clients and in-service trainings for health providers to control abuse of therapeutic injections and promote patient safety.
Triadimefon Disrupts Working Memory in the Matching-to-Position Task
Authors: Holden John M. , Hemmelman Ethan , McGlasson Rowan , Smith Zaria , Ruhland Ashley , Hoover Erin
Published: October 2018

Triadimefon (TDF) is a fungicide which has psychostimulant properties similar to cocaine and amphetamine. Past studies with psychostimulants suggests that acute exposure leads to disruptions in working memory. In this study, we examined the effects of TDF exposure (relative to corn oil control) on performance in the delayed matching-to-position task in two separate studies using Sprague-Dawley male rats. In both studies, TDF exposure led to significantly poorer performance across delays. TDF shows similar properties to cocaine and amphetamine in terms of disrupting working memory.
Risk of patella baja after opening-wedge high tibial osteotomy
Authors: Otsuki Shuhei , Murakami Tomohiko , Okamoto Yoshinori , Nakagawa Kosuke , Okuno Nobuhiro , Wakama Hitoshi , Neo Masashi
Published: October 2018

Purpose:

Medial opening-wedge high tibial osteotomy (OWHTO) induces a lower patellar position, and the subsequent degree of patellar movement may not be predicted preoperatively. The purpose of this study was to clarify the relationship between preoperative and postoperative patellar height based on the correction angle of OWHTO and to create a formula to predict the appearance of patella baja following OWHTO.

Materials and Methods:

Seventy-five knees with varus knee osteoarthritis treated with OWHTO were included in this study. The Caton–Deschamps index was used to evaluate patellar height preoperatively and postoperatively, and the cut-off value for preoperative parameters was determined by a receiver operating characteristic curve to determine the risk ratio for postoperative patella baja.

Results:

The Caton–Deschamps index significantly decreased from 0.93 to 0.77 after OWHTO ( p < 0.01). The OWHTO correction angle negatively correlated with the delta Caton–Deschamps index ( r = −0.44, p < 0.01), and a 1.7% decrease in the Caton–Deschamps index was shown with a 1° correction angle. Receiver operating characteristic curve analysis revealed that a Caton–Deschamps index of 0.8 was the cutoff for OWHTO; knees with a preoperative Caton–Deschamps index of < 0.8 tended to develop patella baja after OWHTO, with a risk ratio of 9.5 (95% confidence interval [4.3–20.7]).

Conclusions:

OWHTO can induce patella baja, and a 1.7% decrease in the Caton–Deschamps index was shown with a 1°-correction angle. A preoperative Caton–Deschamps index < 0.8 should be considered a risk factor for postoperative patella baja.

Level of Evidence:

Retrospective study, Level IV
Total contact casting versus traditional dressing in diabetic foot ulcers
Authors: Sahu Biswajit , Prusty Alok , Tudu Barsha
Published: October 2018

This study compared the treatment of total contact casting (TCC) with traditional dressing treatment (TD) in the management of neuropathic diabetic plantar ulcers. Thirty-one patients with plantar ulcers without any gross infection, osteomyelitis or gangrene were randomly assigned to the TCC group (n = 15) or TD group (n = 16). In the experimental group, TCC was applied on the initial visit and subjects were instructed to limit ambulation to one-third of their usual activity. Subjects in the control group (TD) were prescribed dressing changes and were advised against bearing weight on the involved extremity. Ulcers were considered healed if they showed complete skin closure with no drainage. Ulcers were considered not healed if they showed no decrease in size by 6 weeks or if infection developed requiring hospitalization. In the TCC group, 12 of 15 ulcers healed in 48 ± 7 days; in the TD group, 10 of 16 ulcers healed in 58 ± 9 days. Comparatively higher rate of ulcer healing with fewer infections was seen in the TCC group. We conclude TCC is a more effective method than dressing for treating diabetic plantar ulcers reducing the risks of amputation.
Changes of mediolateral soft tissue gaps in total knee arthroplasty after suturing medial extensor in navigation
Authors: Chae Seung Bum , Cho Myung Rae , Kwon Jae Bum , Lee Jae Hyuk , Choi Won Kee
Published: October 2018

Purpose:

Aim is to investigate the changes of mediolateral soft tissue gaps in total knee arthroplasty (TKA) after suturing medial extensor.

Methods and materials:

We compared the differences of medial and lateral gap values that were shown by the computer navigation at 0°, 45°, 90°, and 120° knee flexion during patella in situ and during patella repaired by a towel clip on two constant sites. Fifty consecutive knees (43 patients) scheduled for TKA due to varus knee osteoarthritis, from February 2017 to May 2017, were enrolled in this prospective study.

Results:

The medial gaps with patella repaired were significantly lower ( p < 0.05) than the medial gaps with patella in situ at 45°, 90°, and 120° knee flexion. Differences in the medial gap were largest at 90, with the difference of 0.87 mm. Twenty-four of 50 cases (48%) showed medial gap differences of 1 mm or over, and 13 of 50 cases (26%) showed medial gap differences of 2 mm or over. The variation in the medial gap at 90° following patellar repair showed significant association (correlation coefficient = 0.78, p = 0.001) with the difference between medial and lateral gaps (medial gap − lateral gap) at 90° of patella in situ. At 90° knee flexion, when the medial and lateral gap difference in patella in situ was 1 mm or less, 73.5% (25/34) of the cases showed variation in the medial gap of less than 1 mm after patellar repair.

Conclusion:

During TKA, while measuring the medial gap with patella in situ, overestimation might occur, especially in the position of knee flexion. Thus, reevaluation using towel clips should be considered when the medial and lateral gap difference is 1 mm or larger when patella in situ during evaluation of the medial and lateral gaps at 90° knee flexion.
Human Botfly: A Case Report and Overview of Differential Diagnosis
Authors: Shenouda Mina , Enten Garrett , Nguyen Thanh , Mangar Devanand , Camporesi Enrico
Published: October 2018

Dermatobia hominis, commonly known as the human botfly, is native to Tropical America. As such, cutaneous infestation by its developing larvae, or myiasis, is quite common in this region. The distinct dermatological presentation of D hominis myiasis allows for its early recognition and noninvasive treatment by locals. However, it can prove quite perplexing for those unfamiliar with the lesion’s unique appearance. Common erroneous diagnoses include the following: folliculitis, benign dermatocyst, and embedded foreign body with localized infection. We present a patient who acquired D hominis while she was in Belize. In this report, we discuss the presentation, differential diagnosis, diagnostic tests, and therapeutic approaches of human botfly lesion to raise the awareness about human botfly.