bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishing thresholds for metal ion levels in patients with bilateral Articular Surface Replacement hip arthroplasty
Authors: Donahue Gabrielle S , Galea Vincent P , Laaksonen Inari , Connelly James W. , Muratoglu Orhun , Malchau Henrik
Published: July 2018

Introduction:

The primary aim of the current study was to determine whether metal ion levels could identify well- from poorly-functioning implants in patients after undergoing bilateral Articular Surface Replacement (ASR) Hip System. The secondary aim was to establish threshold values for Co and Cr that could be used to predict clinical problems in these patients.

Materials and methods:

The study included 125 patients treated with bilateral ASR hip resurfacing (HRA) and 93 patients treated with bilateral ASR XL total hip arthroplasty (THA) at a mean follow-up of 7.1 years post-surgery. Patients were labelled as well- or poorly-functioning based on strict criteria. We calculated the Co and Cr safe upper ion limits (SUL) for ASR HRA and ASR XL THA separately and assessed these cutoffs ability to predict clinical problems.

Results:

In patients with bilateral ASR HRA, the well-functioning group had lower ions than the poorly-functioning. In ASR THA patients, there was no difference in blood Co or Cr levels between well- and poorly-functioning implant groups ( p = 0.118 and p = 0.379, respectively). Both Co and Cr could effectively discriminate between well-functioning and poorly-functioning ASR HRA implants ( p < 0.001 and p < 0.001, respectively), but not for ASR THA implants ( p = 0.118 and p = 0.564, respectively). SULs of 4.0 ppb for Co and 4.0 ppb for Cr could differentiate between well- and poorly-functioning implants with high specificity.

Conclusions:

Metal ion levels are a more reliable tool in MoM HRA than THA when discriminating well- from poorly-functioning implants in bilateral patients. For patients treated with bilateral ASR HRA, ion levels above 4.0 ppb are highly specific for the detection of clinical problems.
A Supervised Learning Tool for Prostate Cancer Foci Detection and Aggressiveness Identification using Multiparametric magnetic resonance imaging/magnetic resonance spectroscopy imaging
Authors: Kirlik Gokhan , Gullapalli Rao , D’Souza Warren , Md Daud Iqbal Gazi , Naslund Michael , Wong Jade , Papadimitrou John , Roys Steve , Mistry Nilesh , Zhang Hao
Published: July 2018

Prostate cancer is the most frequently diagnosed cancer in men in the United States. The current main methods for diagnosing prostate cancer include prostate-specific antigen test and transrectal biopsy. Prostate-specific antigen screening has been criticized for overdiagnosis and unnecessary treatment, and transrectal biopsy is an invasive procedure with low sensitivity for diagnosis. We provided a quantitative tool using supervised learning with multiparametric imaging to be able to accurately detect cancer foci and its aggressiveness. A total of 223 specimens from patients who received magnetic resonance imaging (MRI) and magnetic resonance spectroscopy imaging prior to the surgery were studied. Multiparametric imaging included extracting T2-map, apparent diffusion coefficient (ADC) using diffusion-weighted MRI, [Formula: see text] using dynamic contrast-enhanced MRI, and 3-dimensional-MR spectroscopy. A pathologist reviewed all 223 specimens and marked cancerous regions on each and graded them with Gleason scores, which served as the ground truth to validate our prediction model. In cancer aggressiveness prediction, the average area under the receiver operating characteristic curve (AUC) value was 0.73 with 95% confidence interval (0.72-0.74) and the average sensitivity and specificity were 0.72 (0.71-0.73) and 0.73 (0.71-0.75), respectively. For the cancer detection model, the average AUC value was 0.68 (0.66-0.70) and the average sensitivity and specificity were 0.73 (0.70-0.77) and 0.62 (0.60-0.68), respectively. Our method included capability to handle class imbalance using adaptive boosting with random undersampling. In addition, our method was noninvasive and allowed for nonsubjective disease characterization, which provided physician information to make personalized treatment decision.
An ultrasonic measurement method for full range of oil film thickness
Authors: Zhang Kai , Dou Pan , Wu Tonghai , Feng Kai , Zhu Youquan
Published: July 2018

Ultrasonic method is quite promising for oil film thickness measurement in industry, while there is normally a dead zone for one ultrasonic sensor with a special center frequency when measuring the oil film thickness by the traditional reflection coefficient amplitude. In this paper, an ultrasonic measurement method for full range of oil film thickness was investigated. The theoretical relationship between the oil film thickness and the reflection coefficient phase was firstly built up and the reflection coefficient phase was found to be able to measure the oil film thickness in the dead zone. Then the reflection coefficient amplitude and phase were combined to measure the oil film thickness in the full range. A high-precision calibrated rig, which could form a series of known film thicknesses oil layers, was set up and the performance of this method was shown to work well. This method is significant for online oil film thickness monitoring in industry.
Anxiety and depressive symptoms during pregnancy, perceived control and posttraumatic stress symptoms after childbirth: A longitudinal mediation analysis
Authors: Brandão Tânia , Brites Rute , Nunes Odete , Pires Mónica , Hipólito João
Published: July 2018

This longitudinal study evaluated the mediating role of sense of control during labour in the association between anxiety and depression levels during pregnancy and postpartum posttraumatic stress disorder symptoms. Participants were 57 women. Anxiety and depression were assessed during pregnancy; sense of control and childbirth-related posttraumatic stress disorder symptoms were collected 6–8 weeks after childbirth. Higher levels of anxiety and depression were associated with more postpartum posttraumatic stress disorder symptoms through lack of perceived control. For depression, this happened only for primiparous. Interventions targeting mechanisms enhancing perceptions/feelings of control should be offered to these women to prevent/minimize childbirth-related posttraumatic stress disorder.
Cardiac Injuries at Estonian Major Trauma Facilities: A 23-year Perspective
Authors: Einberg M. , Saar S. , Seljanko A. , Lomp A. , Lepner U. , Talving P.
Published: July 2018

Background and Aims:

Cardiac injuries are highly lethal lesions following trauma and most of the patients decease in pre-hospital settings. However, studies on cardiac trauma in Estonia are scarce. Thus, we set out to study cardiac injuries admitted to Estonian major trauma facilities during 23 years of Estonian independence.

Materials and Methods:

After the ethics review board approval, all consecutive patients with cardiac injuries per ICD-9 (861.0 and 861.1) and ICD-10 codes (S.26) admitted to the major trauma facilities between 1 January 1993 and 31 July 2016 were retrospectively reviewed. Cardiac contusions were excluded. Data collected included demographics, injury profile, and in-hospital outcomes. Primary outcome was mortality. Secondary outcomes were cardiac injury profile and hospital length of stay.

Results:

During the study period, 37 patients were included. Mean age was 33.1 ± 12.0 years and 92% were male. Penetrating and blunt trauma accounted for 89% and 11% of the cases, respectively. Thoracotomy and sternotomy rates for cardiac repair were 80% and 20%, respectively. Most frequently injured cardiac chamber was left ventricle at 49% followed by right ventricle, right atrium, and left atrium at 34%, 17%, and 3% of the patients, respectively. Multi-chamber injury was observed at 5% of the cases. Overall hospital length of stay was 13.5 ± 16.7 days. Overall mortality was 22% (n = 8) with uniformly fatal outcomes following left atrial and multi-chamber injuries.

Conclusion:

Overall, 37 patients with cardiac injuries were hospitalized to national major trauma facilities during the 23-year study period. The overall in-hospital mortality was 22% comparing favorably with previous reports. Risk factors for mortality were initial Glasgow Coma Scale < 9, pre-hospital cardiopulmonary resuscitation, and alcohol intoxication.
Do you really know your reporters? Evaluation methods of editors-in-chief
Authors: Lahav Hagar , Reich Zvi
Published: July 2018

This article explores how leading Israeli news organizations evaluate the performance of their reporters in an era when evaluations are becoming more intensive and challenging, addressing new measures, pressures, and narrower margins of error concerning editorial employment. Data are based on in-depth interviews with 13 current and former editors-in-chief – the ultimate decision-makers on these matters. Findings indicate that evaluation is mostly impressionistic, informal, and aversive toward the uses of quantitative indicators. These tendencies are anchored in a deep belief that evaluating reporters is an ‘art’ more than a ‘science’. Editors’ evaluations are prone to huge blind spots, ignoring most reporters, who neither excel nor fail on a daily basis, overlooking audiences’ input, and reveal lack of awareness of the need to use evaluations as a public signaling system of quality in journalism.
The Bristol school of multiculturalism
Authors: Brahm Levey Geoffrey
Published: July 2018

Tariq Modood, Bhikhu Parekh, Nasar Meer and Varun Uberoi are well known for their defence of multiculturalism in Britain and beyond. The article contends that the collective oeuvre of these and other scholars associated with the University of Bristol’s Centre for the Study of Ethnicity and Citizenship represents a distinctive and important school of multicultural political thought, a ‘Bristol school of multiculturalism’. The school challenges the liberal biases of much of the corpus of multicultural political thinking and the nostrums of British and other western democracies regarding the status of the majority culture as well as of cultural minorities. It is an identarian and assertive multiculturalism that, above all, seeks inclusion and a sense of belonging in the national community. The article situates the Bristol school in the British context in which it arose, outlines its distinctive approach and principles and critically assesses its positions on liberalism and national identity. It also raises the question of the political acceptability of the Bristol school’s ‘muscular multiculturalism’.
Individual risk factors for possible undetected dementia amongst community-dwelling older people in New Zealand
Authors: Martinez-Ruiz Adrian , Huang Ying , Gee Susan , Jamieson Hamish , Cheung Gary
Published: July 2018

There is general acknowledgement of the importance of early diagnosis of dementia, yet there are still high rates of undetected dementia internationally. The aim of this cross-sectional study was to determine the sociodemographic characteristics associated with possible undetected dementia in a large sample of community-dwelling older New Zealanders. The sample consisted of older people (age ≥ 65) who had received the homecare version of the international Residential Home Care Assessment version 9.1 over a two-year period and who were screened positive for possible dementia on the international Residential Assessment’s Cognitive Performance Scale. People with possible alternative explanations for impaired cognitive performance such as depression and other neurological conditions were excluded from analysis. The 5202 eligible individuals were categorized into two groups: (1) those with a recorded diagnosis of dementia (64%) and (2) those without a recorded diagnosis of dementia (i.e. possible undetected dementia group) (36%). Logistic regression was used to evaluate the association between individual characteristics and possible undetected dementia. Significant risk factors for being in the possible undetected dementia group included Asian ethnicity, living alone, not having participated in long-standing social activities recently, major life stressors, and limited accessibility of their house. The knowledge gained from this study could enable targeting of services and resources for the groups at risk of undetected dementia to have a more equitable access to early diagnosis.
Exploring the Validity of Behavior Coding
Authors: Park Hyunjoo , Lee Jaehwan
Published: July 2018

Behavior coding is used to detect issues in questionnaires by flagging interactions between survey respondents and interviewers when their interactions deviate from standardized interviewing. It has become a popular method for evaluating survey questionnaire quality and has been used mostly in Western countries, with little research being done in Asia. However, because of its dependence on overt behaviors observed during the coding, it was hypothesized that it might not be as effective in a country where different communicative norms are present. We conducted an experiment in Korea using two sets of survey questionnaires with embedded problematic questions in the experimental group to investigate the validity of behavior coding as reference to the control group. Using 200 audio recordings from a telephone survey, we investigated whether behavior-coded data were helpful in identifying embedded flaws. The results indicated behavior coding in Korean surveys may not be as effective as in Western countries.
An Exploratory Study of a Nurse-Led HIV Postexposure Prophylaxis Program
Authors: O’Byrne Patrick , Jacob Jean Daniel , Orser Lauren
Published: July 2018

The provision of HIV medications to HIV-negative persons after exposure to HIV is known as postexposure prophylaxis (PEP). Because this prevention strategy is primarily only available in emergency rooms, we piloted a nurse-led community-based PEP program in Ottawa from September 2013 through August 2015. As part of evaluating this program, we conducted qualitative interviews with persons who initiated PEP. Twelve men who had engaged in condomless anal sex with other males participated. Thematic analysis of the interview transcripts highlighted that PEP was considered unmentionable because the participants’ saw it as proof of past behavior that was perceived negatively. Our results thus revealed that PEP was stigmatized, which made our participants reluctant to answer health care professionals’ “questions” about why they needed PEP. To do so was to be exposed to stigma. The use of PEP for our participants was a balance between wanting to minimize the risks of HIV acquisition against the risks of disclosing the unmentionable. We take these findings to mean that clinicians and health service policy workers should move PEP into community clinics (decentralizing it from hospitals, and increase the involvement of nurses); aim to provide all required PEP services in community settings (consolidate PEP provision in these clinics); and ensure PEP services are streamlined to remove extraneous data collection (meaning history and exam tools should be standardized to minimize needless questions that may impede PEP access). Together, these recommendations may increase patients’ access to PEP, and maximize its HIV prevention effects.
Low-velocity impact behavior of composites reinforced with weft-knitted spacer glass fabrics
Authors: Dabiryan Hadi , Hasanalizade Fatemeh , Sadighi Mojtaba
Published: July 2018

Structural parameters of fabrics influence the mechanical behaviour of fabric-reinforced composites. Weft-knitted spacer fabrics have high energy absorption capacity. In this paper, low-velocity impact behavior of composites reinforced with weft-knitted spacer fabrics has been studied using energy-balance method. The effect of fabric geometry on the impact behavior of composites was investigated. A theoretical model was generated to predict the energy dissipated through the impact, considering the structural parameters of fabrics as reinforcement of composites. For this purpose, dissipated energies due to contact, membrane and bending deformation of fabrics, and buckling deformation of spacer yarns were considered. In order to evaluate the proposed model, weft-knitted spacer fabrics with two types of spacer yarn's orientation were used as reinforcement of composites. Low-velocity impact examinations were performed using the drop hammer testing machine. The results showed that the model has about 12 and 13% error in prediction of dissipated energies of different samples. Comparison between theoretical and experimental results confirms that the proposed model is capable to predict the impact behavior of weft-knitted spacer fabric-reinforced composites.
Silencing of ENO1 by shRNA Inhibits the Proliferation of Gastric Cancer Cells
Authors: Qiao Hui , Wang Yu-Feng , Yuan Wen-Zhen , Zhu Bing-Dong , Jiang Lei , Guan Quan-Lin
Published: July 2018

α-Enolase is a significant subunit of enolase and acts as a glycolytic enzyme responsible for catalyzing the conversion of 2-phosphoglycerate to phosphoenolpyruvate in the anaerobic glycolysis pathway. The research about their role is known little in tumor invasion and metastasis. This research analyzed the effect of α-enolase in proliferation and progression of human gastric cancer. The constructed PLKO.1-ENO1 shRNA vector was transfected into 293 T cells and used to infect gastric cancer cells, MKN45, by using lentivirus method. Negative controls were generated by infection with viruses containing empty vector PLKO.1-scramble-shRNA by the same protocol and using wild-type MKN45 cells as blank control. The silencing effect was confirmed by reverse transcription polymerase chain reaction and Western blotting at messenger RNA and protein levels, respectively. Cell proliferation and chemosensitivity were tested by methyl-thiazolyl-tetrazolium assay. Cell apoptosis was tested by flow cytometry. The cell line α-enolase short hairpin RNA stabling silence α-enolase was successfully constructed. In the α-enolase short hairpin RNA cell lines, messenger RNA and protein expression of α-enolase were significantly lower than those in negative control and blank control groups. The proliferation and clone formation ability were significantly inhibited, cell apoptosis was increased significantly, and the inhibition rate of chemotherapy drugs was increased ( P < .05). Our data provide strong evidence that α-enolase short hairpin RNA interference vector can effectively suppress the proliferation and increase chemosensitivity of MKN45 cells, which may provide a novel gene therapy for gastric cancer.
Converting Treatment Plans From Helical Tomotherapy to L-Shape Linac: Clinical Workflow and Dosimetric Evaluation
Authors: Yuan Zilong , Nair Chithra Kumaran , Benedict Stanley H. , Valicenti Richard K. , Rao Shyam , Fragoso Ruben C. , Wright Cari , Qiu Jianfeng , Rong Yi
Published: July 2018

This work evaluated a commercial fallback planning workflow designed to provide cross-platform treatment planning and delivery. A total of 27 helical tomotherapy intensity-modulated radiotherapy plans covering 4 anatomical sites were selected, including 7 brain, 5 unilateral head and neck, 5 bilateral head and neck, 5 pelvis, and 5 prostate cases. All helical tomotherapy plans were converted to 7-field/9-field intensity-modulated radiotherapy and volumetric-modulated radiotherapy plans through fallback dose-mimicking algorithm using a 6-MV beam model. The planning target volume (PTV) coverage ( D1, D99, and homogeneity index) and organs at risk dose constraints were evaluated and compared. Overall, all 3 techniques resulted in relatively inferior target dose coverage compared to helical tomotherapy plans, with higher homogeneity index and maximum dose. The organs at risk dose ratio of fallback to helical tomotherapy plans covered a wide spectrum, from 0.87 to 1.11 on average for all sites, with fallback plans being superior for brain, pelvis, and prostate sites. The quality of fallback plans depends on the delivery technique, field numbers, and angles, as well as user selection of structures for organs at risk. In actual clinical scenario, fallback plans would typically be needed for 1 to 5 fractions of a treatment course in the event of machine breakdown. Our results suggested that <1% dose variance can be introduced in target coverage and/or organs at risk from fallback plans. The presented clinical workflow showed that the fallback plan generation typically takes 10 to 20 minutes per case. Fallback planning provides an expeditious and effective strategy for transferring patients cross platforms, and minimizing the untold risk of a patient missing treatment(s).
Union Rates and Complications After Thumb Metacarpophalangeal Fusion
Authors: Lutsky Kevin F. , Edelman David , Lebowitz Cory , Matzon Jonas L. , Beredjiklian Pedro K.
Published: July 2018

Background: Fusion of the thumb metacarpophalangeal joint (MPJ) can be performed using tension band wiring (TBW) or plate and screw (PS) fixation. This study evaluated results and complications using these techniques. Methods: A retrospective review of patients who underwent thumb MPJ fusion at our institution from 2010 to 2016 was performed. Patients with >1 year follow-up were included. Demographic information, indication for fusion, time to fusion, and complications were collected. Final radiographs were examined and alignment measured. Results: There were 56 thumbs in 53 patients (42 women and 11 men) including 12 TBW and 44 PS. The mean age was 60.9 years, and follow-up was 32.4 months. Twenty-eight of 44 plates were nonlocking, and 16 were locking. Of the locking plates, 7 of 26 used all locking screws, and 9 of 26 had a combination of locked and nonlocked screws. The mean flexion angle for TBW was 16.5° and PS was 12.8°. The mean coronal angle for TBW patients was 4.0° ulnar and PS was 2.5° ulnar. The overall union rate was 95%. There were 12 complications, 9 in the PS group. The TBW complications were painful hardware requiring removal. Eight complications in the PS group occurred in patients with locked plates. Five of the delayed or nonunions occurred in patients with locked plates and 4 of these were in plates with all screws locked. Conclusion: Complications using PS or TBW are not infrequent. Alignment with both techniques is similar, but use of locked plates specifically increases the rate of delayed or nonunions. We do not recommend routine use of locked plates for fusion of the thumb MPJ.
The surgical care practitioner seeking consent: An appropriate delegate?
Authors: Nicholas Michael
Published: July 2018

Surgical care practitioners (SCPs) have become recognised as integral members of the surgical team in many healthcare establishments. Seeking informed consent either as the operating practitioner or on behalf of the surgeon, as their delegate, has becoming routine for many SCPs. Informed consent is a critical step in the patient’s care pathway and fundamental in fostering shared decision making and safer surgical practice. The relatively recent case of Montgomery v Lanarkshire Health Board has highlighted a need for those practitioners seeking informed consent to critically examine their practice and revisit the founding principles of the process.
Belongingness: Student ODPs’ learning experiences in clinical placements
Authors: McAvoy Valerie , Waite Marion
Published: July 2018

The aim of this qualitative study is to explore student operating department practitioners’ (ODPs’) experiences of belongingness in clinical placements. Belongingness has been shown to be significant for learning in clinical placements for student nurses and midwives. This study was designed to look specifically at student ODPs’ experiences. Semi-structured interviews were conducted with eight student ODPs. The interviews were transcribed and coded. All student ODPs could describe clinical placement experiences where they felt they belonged and those where they felt they did not belong. Both had a significant impact on students’ learning experience. Students also described their own sense of responsibility for belonging while in placement. This study provides qualitative data to help understand how belongingness can positively or negatively affect the learning experiences of student ODPs in clinical placements.
Nurses’ knowledge about perioperative care of patients with neurological diseases
Authors: Laopoulou Evagelia , Papagiorgis Petros , Chrysovitsanou Chrysa , Tsiou Chrysoula , Plakas Sotirios , Fouka Georgia
Published: July 2018

This study investigated the level of nurses’ knowledge regarding the perioperative care of neurological patients. An author-developed questionnaire of 20 items was used in a sample of 94 hospital nurses serving in the neurology, surgery and anesthesiology departments and the intensive care unit. The average percentage of participants with correct answers was 49.2%. The mean value of participants' score was 9.8 ±3.4. Preexisting experience in the care of cases with multiple sclerosis and Parkinson’s disease was positively related to the level of knowledge (p = 0.001 and 0.014 respectively). The ascertained level of nurses' knowledge regarding the perioperative care of neurological patients was moderate, questioning their adequacy to handle such cases. Previous experience in the care of particular diseases had significantly positive impact on knowledge, suggesting potential improvement strategies through targeted education and specialization of nurses. In conclusion, nurse's knowledge regarding perioperative care of neurological patients was insufficient, requiring appropriate improvement interventions.
Renal trauma: the current best practice
Authors: Erlich Tomer , Kitrey Noam D.
Published: July 2018

The kidneys are the most vulnerable genitourinary organ in trauma, as they are involved in up to 3.25% of trauma patients. The most common mechanism for renal injury is blunt trauma (predominantly by motor vehicle accidents and falls), while penetrating trauma (mainly caused by firearms and stab wound) comprise the rest. High-velocity weapons impose specifically problematic damage because of the high energy and collateral effect. The mainstay of renal trauma diagnosis is based on contrast-enhanced computed tomography (CT), which is indicated in all stable patients with gross hematuria and in patients presenting with microscopic hematuria and hypotension. Additionally, CT should be performed when the mechanism of injury or physical examination findings are suggestive of renal injury (e.g. rapid deceleration, rib fractures, flank ecchymosis, and every penetrating injury of the abdomen, flank or lower chest). Renal trauma management has evolved during the last decades, with a distinct evolution toward a nonoperative approach. The lion’s share of renal trauma patients are managed nonoperatively with careful monitoring, reimaging when there is any deterioration, and the use of minimally invasive procedures. These procedures include angioembolization in cases of active bleeding and endourological stenting in cases of urine extravasation.
An Empirical Examination of Nursing Units in China Based on Nurse Experience
Authors: Xuan Xiaodong , Li Zongfei , Chen Xixi
Published: July 2018

Objectives:

To create opportunities to increase nursing staff’s satisfaction and operational efficiency and eventually improve nurses’ experiences through better design in unit layout.

Background:

The majority of research performed on nursing units in China only focused on the spatial design itself, and few studies examined the nursing unit empirically based on nurses’ experience. Nursing units need to be designed with understanding nurses’ behavior and experience in China.

Method:

A mixed-method approach was conducted in four double-corridor nursing units in China. Observation and interview data were collected to explore how physical environments for managing administrative duties, medications, and caring patient were used in nursing units.

Results:

The most frequent activities were communication, medication, and patient-care activities. The places in which nurses spent the most of theirs working times were the nurse station (NS), patient room, workstation on wheels (WoW), and medication room. The important clinical work spaces were the patient room, NS, WoW, medication room, doctor’s office, disposal room, examining room, and back corridor. The important traffic linkages were between NS and medication room, patient room and WoW, and medication room and patient room.

Conclusions:

This article revealed the frequency of nurse activities; how they spent their time; how they use the clinical spaces; identified important clinical spaces, linkages, and driver of inefficiency in nursing work and nursing unit design; and finally generated recommendations for double-corridor nursing unit design in China which can be used by medical planner, hospital administrator.
Spillover Impact of Non-Gaming Amenities on Gaming Volumes
Authors: Min Ji Hye , Lee Harold , Blum Shane C.
Published: July 2018

Considering the popularity of integrated resorts, this study aimed to investigate different types of non-gaming amenities as indirect casino revenue-generating centers. With fierce competition in the casino industry, non-gaming amenities, such as casino-operated restaurants, showrooms, hotel rooms, and retail outlets, are used as a tool to attract customers and generate more casino sales. In this regard, non-gaming amenities need to be evaluated not only by the revenue they generate but also by the indirect revenue they contribute to other amenities such as gaming. By examining casino performance data over a 365-day period, the finding suggested little effect of non-gaming amenities on table gaming volume. However, restaurant and showroom amenities were found to have positive and significant relationships with slot gaming volume. The findings of the study advance the literature as non-gaming and gaming relationships have not been addressed deeply in the literature due to the difficulty of data collection. The study also provides practical insights for operators to increase earnings with the optimal use of non-gaming amenities.
Timing of Intra-Articular Injection of Synovial Mesenchymal Stem Cells Affects Cartilage Restoration in a Partial Thickness Cartilage Defect Model in Rats
Authors: Enomoto Takahiro , Akagi Ryuichiro , Ogawa Yuya , Yamaguchi Satoshi , Hoshi Hiroko , Sasaki Toshihide , Sato Yusuke , Nakagawa Ryosuke , Kimura Seiji , Ohtori Seiji , Sasho Takahisa
Published: July 2018

Objective

We investigated the effect of administration of intra-articular mesenchymal stem cells (MSCs) on cartilage repair at different timings, and the distribution of MSCs in the knee.

Design

A partial thickness cartilage defect (PTCD) was created on the medial femoral condyle in 14-week-old Sprague-Dawley rats. Intra-articular injection of 1 × 106 MSCs was performed at 3 time points, namely at the time of surgery (0w group), at 1 week after surgery (1w group), and at 2 weeks after surgery (2w group). For the control, 50 μL phosphate-buffered saline was injected at the time of surgery. The femoral condyles were collected at 6 weeks after creation of PTCD and assessed histologically. To investigate the distribution of MSCs, fluorescent-labeled MSCs were injected into the knee joint.

Results

In the control group, the cartilage lesion was distinguishable from surrounding cartilage. In the 0w group, hypocellularity and a slight decrease in safranin O stainability were observed around the injured area, but cartilage was restored to a nearly normal condition. In contrast, in the 1w and 2w groups, the cartilage surface was irregular and safranin O stainability in the injured and surrounding areas was poor. Histological score in the 0w group was significantly better than in the control, 1w, and 2w groups. At 1 day postinjection, fluorescent-labeled MSCs were mostly distributed in synovium. However, no migration into the PTCD was observed.

Conclusions

Early intra-articular injection of MSCs was effective in enhancing cartilage healing in a rat PTCD model. Injected MSCs were distributed in synovium, not in cartilage surrounding the PTCD.
Fanconi syndrome due to tenofovir disoproxil fumarate reversed by switching to tenofovir alafenamide fumarate in an HIV-infected patient
Authors: Mothobi Nomvuyo Z. , Masters Jeffrey , Marriott Deborah J.
Published: July 2018

A case of tenofovir-induced Fanconi syndrome in a patient receiving antiretroviral therapy for HIV infection, with resolution of the related electrolyte abnormalities upon switch from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate, is reported. Tenofovir alafenamide fumarate, a novel prodrug of tenofovir containing significantly lower doses of tenofovir than tenofovir disoproxil fumarate, has been associated with a favourable renal profile compared to tenofovir disoproxil fumarate. Generally, the rare complication of tenofovir disoproxil fumarate–induced Fanconi syndrome is managed by cessation of tenofovir. There are limited reports of the impact of a switch strategy from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate, which may be necessary in patients unable to discontinue tenofovir.
Effect of a multifaceted stewardship intervention on antibiotic prescribing and outcomes for acute bacterial skin and skin structure infections
Authors: Roshdy Danya , Jaffa Rupal , Pillinger Kelly E. , Guffey Josh , Rozario Nigel , Davidson Lisa , McCurdy Lewis
Published: July 2018

Background:

Acute bacterial skin and skin structure infections (ABSSSI) are a leading cause of hospitalization, but are often treated inappropriately in the inpatient setting. A multifaceted stewardship intervention was implemented to encourage prescribing of guideline-concordant therapy (GCT).

Objective:

To examine the impact of this initiative on antimicrobial prescribing practices and patient outcomes.

Methods:

This was a single-center, retrospective study of adult inpatients admitted with a primary or secondary diagnosis of ABSSSI, classified by type and severity based on signs of systemic infection. Patients treated during the pre-intervention period (pre-IP) were compared with patients treated during the post-intervention period (post-IP). The primary endpoint was receipt of GCT. Secondary endpoints included receipt of anti-anaerobic antibiotic (AAA) or broad-spectrum antibiotics (BSA).

Results:

A total of 125 patients were included, 64 in the pre-IP and 61 in the post-IP. There was a statistically significant increase in prescribing of GCT during the post-IP compared with the pre-IP (14% versus 56%, p < 0.0001) and a decrease in use of AAA (56% versus 34%, p = 0.01). No difference was observed with use of BSA (16% versus 15%, p = 0.89). Use of the computerized order set during the post-IP was low (18%). There was a numerical, but non-significant reduction in 30-day readmission (14.1% versus 6.6%, p = 0.17).

Conclusion:

The multifaceted intervention was effective for improving prescribing of GCT for ABSSSI. Given low use of the computerized order set, improved prescribing seemed to be driven by provider education. Strategies around ongoing education may be key to sustain positive results of stewardship interventions.
Revisiting the labor market competition hypothesis in a comparative perspective: Does retirement affect opinion about immigration?
Authors: Jeannet Anne-Marie
Published: July 2018

Labor market competition is a leading explanation for defensive attitudes towards immigration but empirical support for this hypothesis is widely debated. This paper re-evaluates its explanatory power by investigating the relationship between labor market retirement and attitudes towards immigration in 14 European countries. The empirical results, based on an instrumental variable strategy to deal with potential endogeneity, find that although retirement is an important change in a person’s labor market participation, it does not generally shift opinions. As a plausible explanation for this, I use a cross-national survey experiment to demonstrate that individuals who are retired retain socio-tropic orientations towards immigration, which, I argue, likely override their ego-tropic orientations. The combined evidence indicates that the labor market competition hypothesis may not be suitable as a comprehensive explanation for public opinion about immigration.
Taking the time? Explaining effortful participation among low-cost online survey participants
Authors: Anson Ian G.
Published: July 2018

Recent research has shown that Amazon MTurk workers exhibit substantially more effort and attention than respondents in student samples when participating in survey experiments. In this paper, I examine when and why low-cost online survey participants provide effortful responses to survey experiments in political science. I compare novice and veteran MTurk workers to participants in Qualtrics’s qBus, a comparable online omnibus program. The results show that MTurk platform participation is associated with substantially greater effort across a variety of indicators of effort relative to demographically-matched peers. This effect endures even when compensating for the amount of survey experience accumulated by respondents, suggesting that MTurk workers may be especially motivated due to an understudied self-selection mechanism. Together, the findings suggest that novice and veteran MTurk workers alike are preferable to comparable convenience sample participants when performing complex tasks.
Behavior change techniques in mobile applications for sedentary behavior
Authors: Dunn Emily E , Gainforth Heather L , Robertson-Wilson Jennifer E
Published: July 2018

Objective

Mobile applications (apps) are increasingly being utilized in health behavior change interventions. To determine the presence of underlying behavior change mechanisms, apps for physical activity have been coded for behavior change techniques (BCTs). However, apps for sedentary behavior have yet to be assessed for BCTs. Thus, the purpose of the present study was to review apps designed to decrease sedentary time and determine the presence of BCTs.

Methods

Systematic searches of the iTunes App and Google Play stores were completed using keyword searches. Two reviewers independently coded free ( n = 36) and paid ( n = 14) app descriptions using a taxonomy of 93 BCTs (December 2016–January 2017). A subsample ( n = 4) of free apps were trialed for one week by the reviewers and coded for the presence of BCTs (February 2017).

Results

In the free and paid app descriptions, only 10 of 93 BCTs were present with a mean of 2.42 BCTs (range 0–6) per app. The BCTs coded most frequently were “prompts/cues” ( n = 43), “information about health consequences” ( n = 31), and “self-monitoring of behavior” ( n = 17). For the four free apps that were trialed, three additional BCTs were coded that were not coded in the descriptions: “graded tasks,” “focus on past successes,” and “behavior substitution.”

Conclusions

These sedentary behavior apps have fewer BCTs compared with physical activity apps and traditional (i.e., non-app) physical activity and healthy eating interventions. The present study sheds light on the behavior change potential of sedentary behavior apps and provides practical insight about coding for BCTs in apps.
China-Africa media relations: What we know so far
Authors: Wasserman Herman
Published: July 2018

The increased presence of Chinese media in Africa has been a topic of much debate in recent years, and has given rise to a burgeoning research area. Seen as a platform upon which China can exert its ‘soft power’ in Africa as part of its outward-looking international relations policy, Chinese media has been considered instrumental in portraying a more positive picture of China among African audiences, partly in an attempt to support the expansion of Chinese economic activities on the continent. Critics have however questioned the influence that Chinese media practices may have on journalistic value systems and press freedom on the continent. These criticisms assume that Chinese media may have a big impact on African media, although the empirical basis for such claims have often been lacking.
Cournot-like Interaction with Cournot Outcomes
Authors: Soldatos Gerasimos T.
Published: July 2018

This article works out a Cournot duopoly where firms take price as given, but it is not the same price that is taken for given by each firm; it depends on individual expectations about opponent’s behaviour as are shaped by the business cycle. Yet, the result of this interaction is a Cournot equilibrium as if the calculations were based on the same price. It is not the price that would be assumed in the absence of expectations. Expectations make inverse-U-shaped reaction curves peak at higher output levels relative to peaks in their absence, implying a lower price vis-à-vis that which is taken for granted in the traditional analysis. And, output levels are higher because they reflect optimism for the course of the economy. In the static context of the analysis, a Cournot equilibrium comes about as if the business cycle is at each peak. Policy-wise, the message is that observed price variations in an oligopoly do not necessarily indicate Bertrand competition despite the possibility that dynamic interaction may lead to outcomes other than the Cournot one; but it will be about disequilibrium and unstable outcomes.

JEL Classifications: D43, L13, E32
Acute Fixation of Type IV and V Acromioclavicular Separations: An Internal Splint Technique
Authors: LaMartina Joey A. , Lau Brian C. , Miller Liane , Salesky Madeleine A. , Feeley Brian T. , Ma C. Benjamin , Zhang Alan L.
Published: July 2018

Background:

There is no standard method for the surgical treatment of acromioclavicular (AC) joint separations. Current techniques have associated complications, including need for device removal, coracoid fracture, and inadequate reduction.

Purpose:

To evaluate the clinical outcomes of an internal splint technique without graft augmentation or rigid fixation to treat acute Rockwood type IV and V AC joint injuries.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective analysis was performed of 26 patients who underwent a novel internal splint fixation technique between 2011 and 2016. Patients had type IV (n = 2) and type V (n = 24) acute AC separations. The mean time to surgery was 13.7 days (range, 1-28 days). The surgical technique included an open approach with coracoclavicular suture and tape fixation and AC suture fixation. Range of motion, strength, and radiographs were evaluated after surgery. Patient follow-up included the DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire at a mean 3.3 years postoperatively (range, 6 months–8.6 years). DASH questionnaires were obtained for all patients via email. Patients were also surveyed on cosmetic appearance and willingness to undergo the operation again.

Results:

All patients regained full strength and range of motion following surgery. All postoperative radiographs demonstrated well-maintained reduction of the AC joint. The mean DASH score was 3.4 at final follow-up, and 23 of 26 respondents were satisfied with their postoperative shoulder appearance. There were no reoperations, and all patients stated that they would have the operation again given the same circumstances.

Conclusion:

The results of this study demonstrate a reliable new technique for acute fixation of type IV or V AC joint injuries via an internal splint construct. This technique enables reduction in the coronal and sagittal planes without the need for graft augmentation or a rigid implant, allowing healing of the coracoclavicular and AC ligaments.
Recurrent Encephalopathy During Febrile Illnesses in a 6-Year-Old Boy
Authors: Szuch Eliza , Auriemma Jeanna
Published: July 2018

Acute onset of encephalopathy is often due to infections or intoxications, but a high index of suspicion should exist for metabolic or autoimmune causes particularly in recurrent cases. A 6-year-old previously healthy Caucasian male presented with confusion and somnolence. He had several days of fever, myalgia, headaches, and rhinorrhea and was influenza-A positive. He was noted to have new urinary incontinence, inability to follow commands, and was responsive only to noxious stimuli. His neurological examination revealed bilateral ankle clonus. Laboratory results were significant for hypoglycemia and high anion gap metabolic acidosis. Cerebrospinal fluid was unremarkable and cultures remained negative. A magnetic resonance imaging (MRI) of the brain showed diffuse gray matter restricted diffusion. His presentation was attributed to acute influenza-A encephalitis. Four months later, he presented with emesis, abdominal pain, dehydration, and hypoglycemia. He subsequently developed dysarthria and confusion. A brain MRI was similar to his previous presentation. A repeat lumbar puncture was normal. A urine organic acid profile showed elevations of ketones and branched chain ketoacids, with mild elevations of N-acetylleucine and N-acetyl isoleucine. This pattern is consistent with maple syrup urine disease (MSUD). Genetic testing revealed that he is a heterozygote for 2 pathogenic variants in the BCKDHB gene (P200X and G278S), confirming MSUD. This case highlights the importance of broadening workup to include inborn errors of metabolism in cases of unexplained encephalopathy. Providers should be aware that diseases such as MSUD can occur in intermittent forms that may not be detected until early childhood.
A Single-Center Study of Viral Respiratory Tract Infections in Hospitalized Children From the Kurdistan Region of Iraq
Authors: Hassan Dlshad A. , Rachid Shwan K. , Ziebuhr John
Published: July 2018

Viral respiratory infections are among the most common causes of disease in humans, particularly in young children, and remain a major public health problem worldwide. For many geographic regions, there is limited epidemiological information on the main causative agents of these diseases. In this article, we investigated, in a prospective study, the viral agents leading to acute respiratory disease in children younger than 15 years of age who were admitted to the pediatric emergency unit of a major teaching hospital in Erbil City, capital of the Kurdistan region, Iraq. Nasopharyngeal samples obtained from 269 hospitalized children were analyzed for viral respiratory pathogens using the xTAG Respiratory Virus Panel Fast assay, and the data were correlated with the clinical and demographic information available for these patients. One or more respiratory virus(es) were detected in 203 out of 269 (75.5%) samples. The most frequent viruses were enterovirus/rhinovirus (n = 88; 32.7%), respiratory syncytial virus (n = 55; 20.4%), and human metapneumovirus (n = 36; 13.4%). In 42 samples (15.6%), coinfections with 2 or more respiratory viruses were detected, with enterovirus/rhinovirus, respiratory syncytial virus, human metapneumovirus, and adenovirus being identified as the most common agents in viral coinfections in these patients.
Japan and the Revolution in Military Affairs
Authors: Le Tom
Published: July 2018

The Revolution in Military Affairs (RMA) has not only changed how the USA engages in warfare but also how it maintains its military supremacy and how other nations budget and strategize. The very idea of the RMA has impacted how nations manage their technological advantages and raises the questions of can the RMA be monopolized and if not, which nations can adopt their own RMA? In September 2000, the Japan Defence Agency (now the Ministry of Defence [MOD]) produced a report titled ‘“Info-RMA”: Study on Info-RMA and the Future of the Self-Defence Forces’ to explore the prospects of implementing RMA principles in the Japan Self-Defence Forces. In this article, I explore to what extent can RMA principles be implemented in the Self-Defence Forces? I argue that although several significant changes have been implemented in technology, doctrine, operations and organization, various normative and technical constraints have directed the MOD to craft an RMA with Japanese characteristics, emphasizing defence and interconnectedness with the US armed forces. These findings suggest that current efforts to ‘normalize’ the Self-Defence Forces can succeed if crafted to appeal to the sensibilities of the Japanese public.