bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Patient Sex Influence Cartilage Surgery Outcome?
Authors: Filardo Giuseppe , Kon Elizaveta , Andriolo Luca , Vannini Francesca , Buda Roberto , Ferruzzi Alberto , Giannini Sandro , Marcacci Maurilio
Published: July 2013

Background:

Sexual dimorphism in humans has already been documented at different levels, and preliminary findings also suggest the importance of patient sex on clinical outcome in the treatment of cartilage lesions.

Purpose:

To document and analyze the influence of sex on clinical outcome in a large cohort of patients treated with a cartilage regenerative procedure for knee chondral lesions and prospectively followed at midterm follow-up.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 250 knees were treated with matrix-assisted autologous chondrocyte transplantation (MACT) and prospectively evaluated with International Knee Documentation Committee (IKDC), EuroQol visual analog scale (EQ-VAS), and Tegner scores at 1-, 2-, and minimum 5-year follow-ups to compare results obtained in men and women. The lesions were focal International Cartilage Repair Society grade III-IV chondral knee defects involving femoral condyles, trochleae, and patellae. Two homogeneous groups of 56 male patients and 56 female patients were then selected by a blinded statistician for a matched-pair analysis.

Results:

A statistically significant improvement in all the scores in both men and women was observed in the general population. The IKDC subjective score showed better results for men at all follow-up times: at 5 years, the mean IKDC subjective score was 79.5 ± 18.6 versus 64.3 ± 20.2 for men and women, respectively ( P < .0005), and the same trend was confirmed with the EQ-VAS and Tegner scores. The matched-pair analysis confirmed the difference of final results achieved (74.1 ± 19.8 vs 63.7 ± 20.2, respectively; P = .006). However, men and women started with different preoperative levels, and the analysis of the improvement obtained was not significantly different. Finally, when scores were standardized for each patient, according to the mean score typical for the corresponding age and sex category in a healthy population, a sex-related difference was not confirmed at any of the follow-ups. Etiological factors, lesion site, and preinjury activity level differed in women and men of the general population and were the confounding factors responsible for the different outcome not confirmed by the analysis of homogeneous cohorts of patients.

Conclusion:

Women have a different knee chondral lesion pattern and more often have unfavorable conditions related to the cause of injury, site, and activity level, and they also have lower raw, not standardized, scores. However, a matched-pair analysis with data standardized for the specific patient categories showed that, on equal terms, women have the same possibilities for successful outcome as men after surgical treatment for knee cartilage regeneration.
Use of a Bioactive Scaffold to Stimulate Anterior Cruciate Ligament Healing Also Minimizes Posttraumatic Osteoarthritis After Surgery
Authors: Murray Martha M. , Fleming Braden C.
Published: July 2013

Background:

Although anterior cruciate ligament (ACL) reconstruction is the treatment gold standard for ACL injury, it does not reduce the risk of posttraumatic osteoarthritis. Therefore, new treatments that minimize this postoperative complication are of interest. Bioenhanced ACL repair, in which a bioactive scaffold is used to stimulate healing of an ACL transection, has shown considerable promise in short-term studies. The long-term results of this technique and the effects of the bioenhancement on the articular cartilage have not been previously evaluated in a large animal model.

Hypotheses:

(1) The structural (tensile) properties of the porcine ACL at 6 and 12 months after injury are similar when treated with bioenhanced ACL repair, bioenhanced ACL reconstruction, or conventional ACL reconstruction, and all treatments yield results superior to untreated ACL transection. (2) After 1 year, macroscopic cartilage damage following bioenhanced ACL repair is similar to that in bioenhanced ACL reconstruction and less than in conventional ACL reconstruction and untreated ACL transection.

Study Design:

Controlled laboratory study.

Methods:

A total of 64 Yucatan mini-pigs underwent ACL transection and randomization to 4 experimental groups: no treatment, conventional ACL reconstruction, bioenhanced ACL reconstruction using a bioactive scaffold, and bioenhanced ACL repair using a bioactive scaffold. The biomechanical properties of the ligament or graft were examined and macroscopic assessments of the cartilage surfaces were performed after 6 and 12 months of healing.

Results:

The structural properties (ie, linear stiffness, yield, and maximum loads) of the ligament after bioenhanced ACL repair were not significantly different from those in bioenhanced ACL reconstruction or conventional ACL reconstruction but were significantly greater than those in untreated ACL transection after 12 months of healing. Macroscopic cartilage damage after bioenhanced ACL repair was significantly less than that in untreated ACL transection and bioenhanced ACL reconstruction, and there was a strong trend ( P = .068) for less macroscopic cartilage damage than in conventional ACL reconstruction in the porcine model at 12 months.

Conclusion:

Bioenhanced ACL repair produces a ligament that is biomechanically similar to an ACL graft and provides chondroprotection to the joint after ACL surgery.

Clinical Relevance:

Bioenhanced ACL repair may provide a new, less invasive treatment option that reduces cartilage damage following joint injury.
Topographic Analysis of the Glenoid and Proximal Medial Tibial Articular Surfaces
Authors: Gupta Anil K. , Forsythe Brian , Lee Andrew S. , Harris Joshua D. , McCormick Frank , Abrams Geoffrey D. , Verma Nikhil N. , Romeo Anthony A. , Inoue Nozomu , Cole Brian J.
Published: July 2013

Background:

Current knowledge is lacking concerning the appropriate site of osteochondral allograft harvest to match glenoid shape for the purposes of glenoid resurfacing. This has led to difficulty with adequate restoration of the geometry of the glenoid with currently available techniques.

Hypothesis:

The medial tibial plateau will provide a suitable osteochondral harvest site because of its concavity and anatomic similarity to the glenoid.

Study Design:

Descriptive laboratory study.

Methods:

Computed tomography (CT) was performed on 4 cadaveric proximal tibias and 4 scapulae, allowing for 16 glenoid-tibial comparative combinations. Three-dimensional CT models were created and exported into point-cloud models. A local coordinate map of the glenoid and medial tibial plateau articular surfaces was created. Two zones of the medial tibial articular surface (anterior and posterior) were quantified. The glenoid articular surface was defined as a best-fit circle of the glenoid articular surface maintaining a 2-mm bony rim. This surface was virtually placed on a point on the tibial articular surface in 3D space. The tibial surface was segmented, and its 3D surface orientation was determined with respect to its surface. The 3D orientation of the glenoid surface was reoriented so that the direction of the glenoid surface matched that of the tibial surface. The least distances between the point-clouds on the glenoid and tibial surfaces were calculated. The glenoid surface was rotated 360° in 1° increments, and the mean least distance was determined at each rotating angle.

Results:

When the centroid of the glenoid surface was placed on the medial tibial articular surface, it covered approximately two-thirds of the anterior or posterior tibial surfaces. Overall, the mean least distance difference in articular congruity of all 16 glenoid–medial tibial surface combinations was 0.74 mm (standard deviation, ±0.13 mm). The mean least distance difference of the anterior and posterior two-thirds of the medial tibial articular surface was 0.72 mm (±0.13 mm) and 0.76 mm (±0.16 mm), respectively. There was no significant difference between the anterior and posterior two-thirds of the tibia with regard to topographic match of the glenoid ( P = .187).

Conclusion:

The findings suggest that the medial tibial articular surface provides an appropriate anatomic match to the glenoid articular surface. Both the anterior and posterior two-thirds of the medial tibial articular surface are potential sites for osteochondral graft harvest.

Clinical Relevance:

This method can be applied to future studies evaluating the ideal sites of graft harvest to treat zonal glenoid bone wear and/or loss.
Risk Factors for Recurrent Anterior Cruciate Ligament Reconstruction
Authors: Wasserstein David , Khoshbin Amir , Dwyer Tim , Chahal Jaskarndip , Gandhi Rajiv , Mahomed Nizar , Ogilvie-Harris Darrell
Published: July 2013

Background:

Anterior cruciate ligament reconstruction (ACLR) is routinely performed for symptomatic instability. Although it is a common procedure, there remain differences in surgical technique. Hospital administrative records in a public health care system were used to investigate the effect of patient, provider, and surgical factors on the risk of revision ACLR.

Purpose:

To define the rate and risk factors for ACL reoperation in Ontario, Canada, including both ipsilateral revision and contralateral primary procedures.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All primary elective ACLR procedures performed in Ontario (July 2003 to March 2008) in patients aged 15 to 60 years were identified via physician billing and hospital databases. Revision and contralateral ACLR were sought until January 2012. Patient factors (age, sex, comorbidity, income quintile, length of index hospital admission), provider factors (surgeon volume, academic hospital status), and surgical factors (allograft vs autograft; fixation type [screw, button, staple]; concomitant operative procedures) were used as covariates in a Cox proportional hazards survivorship model to generate hazard ratios (HRs) with confidence intervals (CIs) (α = .05). Kaplan-Meier survivorship curves with ACL revision as the end point were generated.

Results:

A total of 12,967 ACLR procedures with a mean follow-up of 5.2 years were eligible for study using preset criteria. The revision rate was 2.6% (mean ± SD, 2.91 ± 1.71 years to revision). The rate of primary contralateral ACLR was 4.6% (mean, 2.95 ± 1.81 years). In the Cox model, younger age (15-19 years) (HR, 2.1; 95% CI, 1.5-2.9; P < .001), ACLR performed at an academic hospital (HR, 1.6; 95% CI, 1.2-2.1; P < .001), and the use of allograft (HR, 1.7; 95% CI, 1.1-2.6; P = .02) significantly increased the risk of revision ACLR. Only younger age (HR, 2.1; 95% CI, 1.6-2.7; P < .001) was associated with an increased risk of contralateral ACLR.

Conclusion:

Contralateral ACLR was more frequent than revision ACLR in this population, while both surgical procedures were most common in patients younger than 20 years. Academic hospital status, but not surgeon volume, as well as the use of allograft also increased the risk for revision ACLR.
Group Processes in the Movie, ‘As it is in Heaven’: Leadership that Enhances; Leadership that Stifles
Authors: Ofer Gila
Published: July 2013

The movie tells the story of Daniel, who, after suffering a heart attack, retires from his glamorous life as a world famous orchestra conductor and returns to the peaceful village in northern Sweden in which he grew up as a child. The film presents a portrait of a society existing under the tutelage of the community pastor, under whose influence, community members keep their emotions and instincts locked up, blind themselves to what is going on around them and imprison themselves in stereotyped roles that prevent freedom and personal development. Daniel’s arrival brings a change to this. The aim of the article is to demonstrate through this movie the power of transformative leadership and the importance of going into the unknown, of transformation of the leader himself, and of enhancing individual members of the group by listening and looking.
The 37th S.H. Foulkes Annual Lecture: One Person is No Person
Authors: Ormay Tom
Published: July 2013

Our social nature had been an intelligent assumption for a long time, until biology demonstrated it in the 1960s. Psychoanalysis, the science of human nature has been based on selfish foundations, and its structural theory presents us with a single, lonely person of id, ego and superego. Even Foulkes, who based his group theories on psychoanalysis, could only speculate about our social nature, but gave us the fundamental notion of the social unconscious. In the 1960s biology scientifically demonstrated the social instinct. Yet, the various thinkers, who tried to enlarge group analytic thinking, continued speculating, and did not make use of the social instinct, although it was there. As if the body, the material part of us was not important, as if we existed all up there, in some higher regions. We need our body for love, and a theory good enough to understand it. What I have to offer is a personality theory based on instincts, or with other words, on the psychological affects of our genes. Our ego develops out of the older selfish instinct, as elaborated by psychoanalysis. But the new social instinct provides the foundations of our genuinely social nature, I call ‘nos’, Latin for ‘we’. Accordingly the new structural theory is made up of the id, ego and nos. On such a foundation we can build a consistent social group analytic theory.
Multi-stakeholder decision analysis and comparative risk assessment for reuse–recycle oriented e-waste management strategies: a game theoretic approach
Authors: Kaushal Rajendra Kumar , Nema Arvind K
Published: July 2013

This article deals with assessment of the potential health risk posed by carcinogenic and non-carcinogenic substances, namely lead (Pb), cadmium (Cd), copper, chromium (CrVI), zinc, nickel and mercury, present in e-waste. A multi-objective, multi-stakeholder approach based on strategic game theory model has been developed considering cost, as well as human health risk. The trade-off due to cost difference between a hazardous substances-free (HSF) and a hazardous substance (HS)-containing desktop computer, and the risk posed by them at the time of disposal, has been analyzed. The cancer risk due to dust inhalation for workers at a recycling site in Bangalore for Pb, Cr(VI) and Cd was found to be 4, 33 and 101 in 1 million respectively. Pb and Cr(VI) result in a very high risk owing to dust ingestion at slums near the recycling site—175 and 81 in 1 million for children, and 24 and 11 in 1 million for adults respectively. The concentration of Pb at a battery workshop in Mayapuri, Delhi (hazard quotient = 3.178) was found to pose adverse health hazards. The government may impose an appropriate penalty on the land disposal of computer waste and/or may give an incentive to manufacturer for producing HSF computers through, for example, relaxing taxes, but there should be no such incentive for manufacturing HS-containing computers.
The effect of increased private sector involvement in solid waste collection in five cities in Ghana
Authors: Oduro-Kwarteng Sampson , van Dijk Meine Pieter
Published: July 2013

Private sector involvement in solid waste management in developing countries has increased, but the effect is not always clear. This study assesses how it has been organized in five cities in Ghana, what has been its effect and what lessons for private sector development in developing countries can be drawn. Data were collected from 25 private companies and a sample of 1200 households. More than 60% of solid waste in Ghanaian cities is now collected by private enterprises. Sometimes, and increasingly, competitive bidding takes place, although sometimes no bidding is organized leading to rendering of this service and no contract being signed. Local governments and local solid waste companies have not changed to more customer-oriented delivery because of the slow pace of charging users and the resulting low rate of cost recovery. The participation of the population has been limited, which contributes to low cost recovery. However, a gradual better functioning of the system put in place is shown. We observed an increasing use of competitive bidding, signing of contracts and city-wide user charging.
Hollow-fiber membrane bioreactor for the treatment of high-strength landfill leachate
Authors: Rizkallah Marwan , El-Fadel Mutasem , Saikaly Pascal E , Ayoub George M , Darwiche Nadine , Hashisho Jihan
Published: July 2013

Performance assessment of membrane bioreactor (MBR) technology for the treatability of high-strength landfill leachate is relatively limited or lacking. This study examines the feasibility of treating high-strength landfill leachate using a hollow-fiber MBR. For this purpose, a laboratory-scale MBR was constructed and operated to treat leachate with a chemical oxygen demand (COD) of 9000–11,000 mg/l, a 5-day biochemical oxygen demand (BOD5) of 4000–6,000 mg/l, volatile suspended solids (VSS) of 300–500 mg/l, total nitrogen (TN) of 2000–6000 mg/l, and an ammonia-nitrogen (NH3-N) of 1800–4000 mg/l. VSS was used with the BOD and COD data to simulate the biological activity in the activated sludge. Removal efficiencies > 95–99% for BOD5, VSS, TN and NH3-N were attained. The coupled experimental and simulation results contribute in filling a gap in managing high-strength landfill leachate and providing guidelines for corresponding MBR application.
A Novel c.776_777insA Mutation in CLN1 Leads to Infantile Neuronal Ceroid Lipofuscinosis
Authors: Miller Jake N. , Pearce David A.
Published: July 2013

The neuronal ceroid lipofuscinoses are the most common autosomal recessive neurodegenerative disorders in children, with a worldwide incidence of 1 in 100 000 live births. Multiple clinical variants are caused by more than 400 mutations in at least 14 different genes. These progressive genetic disorders primarily manifest in the central nervous system because of an extensive loss of neurons, specifically in the cerebral and cerebellar cortices. Patients with mutations in CLN1, which encodes palmitoyl-protein thioesterase 1 (PPT1), primarily manifest with infantile neuronal ceroid lipofuscinosis (Haltia-Santavuori disease). Affected children usually present between 1 and 2 years of age and typically die by 8 to 13 years of age. We describe a patient with infantile neuronal ceroid lipofuscinosis with a novel c.776_777insA mutation in CLN1. This insertion induces a frameshift and a premature stop codon late within the CLN1 messenger RNA (mRNA) transcript which is likely recognized by nonsense-mediated translation repression, decreasing PPT1 abundance.
Employment Hardships and Health Insurance Coverage in Single-Mother Families During and After the Great Recession
Authors: Wu Chi-Fang , Eamon Mary Keegan
Published: July 2013

The study reported here determined that a national sample of single mothers had no health care coverage for an average of 9.35 months during a 32-month period during and after the Great Recession that began in December 2007 and ended in June 2009. Using comprehensively defined employment problems, it also found that adequately employed single mothers had the fewest months without health care coverage ( M = 4.36), which more than doubled for those who experienced unemployment or involuntary gaps in employment, and tripled for those who experienced underemployment. The multivariate results confirm that employment problems place single mothers at a high risk of lacking health insurance. Implications for health care policy are discussed.
Social Interests, Policy Networks, and Legislative Outcomes
Authors: Vuković Danilo , Babović Marija
Published: July 2013

The article analyzes how various societal interests and groups influenced employment and social policies in contemporary Serbia. These policies were shaped under the influence of international actors and current mainstream ideas. However, various societal interests and interest groups have affected them. Using policy network analysis, we identified key actors, their interests and ideological preferences, and the influence they exerted on the employment and welfare policies. The research indicates that the potential for the redistribution of power and resources is a trigger for establishing policy networks. In the field of social welfare we identify a stable policy network connecting various professional groups (from the public sector, academia, and the nongovernmental sector). There was a lack of other social interests in the debate, that is, welfare beneficiaries or civil society pressures that would influence policy process. The policy network was thereby primarily based on clearly identified interests of professional groups, and new welfare policies redefined and improved their professional and social status. In the field of employment policies, there was a lack of societal interests and organized interests groups that would influence policy process and outcomes. No policy network was identified, and obviously key actors in shaping of employment and labor policies (i.e., economic elites) were not even among the direct participants in the process. During the course of the policy reforms, direct and specific redistributive interests of groups that could have benefited from the new policies had mediated various policy inputs and at the end prevailed over the broader ideological frameworks.
Uncatalyzed synthesis of polyphenylacetylene cross-linked by viologen groups and their chemical properties
Authors: Yamaguchi Isao , Yamamoto Makoto
Published: July 2013

Polyphenylacetylenes cross-linked with viologen groups (polymers 1a and 1b) were obtained from the reaction of 4-ethynylaniline with 1,1′-bis(2,4-dinitrophenyl)-4,4′-bipyridinium dichloride (salt 1) and the reaction of 4-(1-trimethylsilylethynyl)aniline with salt 1, followed by the deprotection of the trimethylsilyl group. Model compound (model 1) was synthesized by the reaction of 4-ethynylaniline with 1-(2,4-dinitrophenyl)-4,4′-bipyridinium chloride (salt 2). Ultraviolet–visible spectra revealed that the polymers 1a and 1b had an expanded π-conjugation system along the polymer chain: the polymer showed an onset position of absorption at a wavelength approximately 100 nm longer than the corresponding wavelengths of the model compound. Polymers 1a and 1b received a two-step electrochemical reduction in the viologen group within the polymer and an electrochemical oxidation of the polymer backbone.
Syntheses and characterization of two novel 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide-based flame retardants for epoxy resin
Authors: Xiao Ling , Sun Dechao , Niu Tianli , Yao Youwei
Published: July 2013

Two novel phosphrous–nitrogen-containing flame retardants (3) and (4) were successfully synthesized from two steps: condensation reaction between 4-aminopenol and 1,4-phthaladehyde (or 4,4′-biphenyldicarboxaldehyde) and addition reaction between the above condensation compounds and 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide. The structures of (3) and (4) were characterized by Fourier transform infrared, nuclear magnetic resonance, and mass spectroscopy methods. The results show that (3) and (4) can serve as co-curing agents of diaminodiphenylmethane (DDM) for the curing reaction of epoxy resin. The epoxy thermosets-containing DDM and (3) or (4) exhibit moderate changes in glass transition temperature, thermal stability, and show improvement in flame retardancy: UL94 V-0 grade can be obtained when phosphorus content of the epoxy thermoset is only 1.0%; the limiting oxygen index of epoxy resin system containing (4) reaches 40.9 when phosphorus content is up to 1.5%.
Studies on synthesis and characterization of multi-walled carbon nanotube-reinforced polyimide nanocomposites based on a siloxane-modified anhydride
Authors: Gunasekaran S. G. , Devaraju S. , Alagar M. , Dharmendirakumar M.
Published: July 2013

A novel series of multi-walled carbon nanotube (MWCNT) reinforced siloxane dianhydride based polyimide (PI) nanocomposites were designed and developed using in situ polymerization approach via thermal imidization. The polyamic acid obtained from the reaction of siloxane dianhydride and pyridine diamine/ p-phenylenediamine was then incorporated with varying percentages of MWCNTs, which then undergoes thermal imidization to form MWCNT-PI nanocomposites. The synthesized PIs were then characterized using analytical methods. From thermal analysis, it can be seen that the glass transition temperature increased significantly by incorporating acid functionalized MWCNTs into the PI matrix than that of neat PI. This is due to the constraint effect of MWCNTs as well as the reduction in the movement of polymer chains. It exhibits an increased dielectric constant with the increase in weight percentage of MWCNTs to PI matrix. No aggregation and homogeneous dispersion of MWCNTs throughout the PI matrix have been achieved as evidenced by scanning electron microscopy and transmission electron microscopy. The newly designed PI system is responsible for the significant improvement of dispersion, thus enhancing attractive flame retardancy and dielectric properties.
Synthesis and properties of polybenzoxazines containing pyridyl group
Authors: Shibayama Yuji , Kawauchi Takehiro , Takeichi Tsutomu
Published: July 2013

A novel benzoxazine containing pyridyl group (B-3py) was prepared from 3-aminopyridine, bisphenol A, and paraformaldehyde. Polymerization behavior of B-3py was investigated by differential scanning calorimetry (DSC). The DSC thermograms revealed that the exothermic peak due to the ring-opening polymerization of benzoxazine were shifted to lower temperature range by introducing pyridyl group because the pyridyl group served as a catalyst for the polymerization. B-3py was thermally treated up to 240°C on a glass plate, affording a brown colored transparent polybenzoxazine (PB-3py) film. The dynamic mechanical analysis of the film showed that the glass transition temperature of PB-3py was higher than that of a typical polybenzoxazine without pyridyl group (PB-a). This result is probably due to the further formation of hydrogen bonding through the pyridyl group as suggested by infrared analysis of the film. Moreover, thermogravimetric analysis revealed that 5 and 10% weight loss temperatures and char yield at 850°C of PB-3py were higher than those of PB-a. These results clearly indicate that the thermal properties of polybenzoxazine can be improved by introducing the pyridyl group in the network structure.
Laser–material interaction and grooving performance in ultrafast laser ablation of crystalline germanium under ambient conditions
Authors: Manickam Sivakumar , Wang Jun , Huang Chuanzhen
Published: July 2013

Microgrooving on crystalline germanium (Ge) <100> surface using 1064 nm wavelength ultrafast laser pulses under ambient condition is investigated. The interaction of laser and target material and the influence of processing parameters such as laser power, pulse repetition rate and scan speed on the groove dimensions and surface roughness are studied. For the laser radiation fluence range used (0.4–0.8 J/cm2), material removal is primarily controlled by optical penetration depth. The depth and width of grooves increase with laser power. In multipulse irradiation, heat accumulation due to residual thermal energy from successive laser pulses results in a greater material removal. Furthermore, groove depth and width decrease as the pulse repetition rate increases from 0.5 to 2 MHz, due to the decrease in pulse energy with an increase in repetition rate causing ablation threshold fluence to move towards the central portion of the Gaussian pulse. Surface roughness has not shown significant changes for the parameters used in this study. A micro-Raman analysis of groove surfaces reveals a change in the crystallinity of the Ge due to laser irradiation.
Micro electrochemical sinking and milling method for generation of micro features
Authors: Ghoshal B , Bhattacharyya B
Published: July 2013

Micro features are generated on SS-304 stainless steel by electrochemical micromachining. This research aims at the development of best method of micro profile generation for micro components based on electrochemical micromachining in terms of reduced taper angle, overcut, edge deviation and time of machining using cylindrical micro tool. Sinking and milling method is a new approach to microchannel generation, where a micro tool moves vertically to final depth or required depth of machined feature followed by milling along the path of the micro features. The experimental study of process parameters such as pulse frequency of applied voltage, electrolyte concentration, pulse width, micro tool feed rate, machining time and depth of sinking by micro tool is conducted for the investigation and comparative analysis of their effects on material dissolution during micro profile generation utilizing scanning layer-by-layer method as well as sinking and milling method. Machining zone has been simulated in two positions of micro tool, and it has been established that taper less through microchannels can be generated by the scanning method and the sinking and milling method. Complex taper less micro features such as channel net, “U” shape and “S” shape were machined. Micro profile of narrow entry width of 32 µm was machined on 50-µm-thick SS-304 sheet. Very narrow micro profile of 23 µm was also machined on 35-µm-thick SS-304 sheet by the fabricated micro tool of ϕ = 8 µm utilizing the new approach of sinking and milling in electrochemical micromachining.
Contour-parallel tool path generation for three-axis mesh surface machining based on one-step inverse forming
Authors: Xu Jinting , Wang Yujin , Zhang Xiangkui , Chang Shuyu
Published: July 2013

Recently, mesh surfaces have become the focus of considerable interest due to its simplicity for data exchange and geometric computation. However, for mesh surface machining, there are few tool path planning strategies but iso-planar method. In this article, a contour-parallel tool path method is presented for machining complicated mesh surfaces with holes or islands by introducing a so-called one-step inverse approach based on physical plastic deformation of metal materials. By rapidly simulating for the inverse forming process of sheet metal of auto-body panels, the machined surfaces are flattened into its initial flat blank on which the cutter contact points are calculated by iteratively offsetting the inner and outer contours of the blank. Then, using the mapping from the machined surfaces to the blank as a guide, the planar offset curves without self-intersection are inversely mapped onto the original mesh surfaces, forming the final contour-parallel tool paths. Benefiting the flattening method based on one-step inverse approach, the task of generating tool paths is reduced from a physical surface to a plane so that geometric computation of tool path generation is greatly simplified, especially for self-intersection elimination in offset curves. Moreover, a new data structure of offset curve is also introduced, which is used to effectively compute the self-intersections. The proposed method has been tested on several sample surfaces, and the experimental results show that the proposed method can deal with complicated mesh surfaces with holes or islands and is also more efficient compared with the traditional methods.
Raltegravir-induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome – Implications for clinical practice and patient safety
Authors: Perry Melissa E O , Almaani Noor , Desai Nemesha , Larbalestier Nick , Fox Julie , Chilton Daniella
Published: July 2013

This case report describes two severe antiretroviral drug adverse reactions that occurred in the same patient. A 55-year-old HIV-positive African woman received a single epidural triamcinolone injection for pain relief of postherpetic neuralgia. Forty-one days later, she developed severe iatrogenic Cushing’s syndrome due to the drug–drug interaction between triamcinolone and her boosted protease inhibitor therapy. The patient’s antiretroviral regimen was thus changed to replace her protease inhibitor with the integrase inhibitor raltegravir. Shortly after commencing the drug, the patient developed a severe adverse drug reaction manifesting as Drug Reaction (or Rash) with Eosinophilia and Systemic Symptoms (DRESS) syndrome. First described in 1996, this hypersensitivity syndrome presents with severe skin reaction as well as fever, rash, lymphadenopathy and internal organ involvement with marked eosinophilia. Clinicians should be aware of raltegravir-induced DRESS syndrome as well as the potential for drug–drug interactions due to protease inhibitor-based therapy.
Comparison of two interferon-gamma release assays (QuantiFERON-TB Gold In-Tube and T-SPOT.TB) in testing for latent tuberculosis infection among HIV-infected adults
Authors: Sultan B , Benn P , Mahungu T , Young M , Mercey D , Morris-Jones S , Miller RF
Published: July 2013

There is currently no ‘gold standard’ for diagnosis of latent tuberculosis infection (LTBI), and both the tuberculin skin test and interferon-gamma release assays (IGRAs) are used for diagnosis; the latter have a higher sensitivity than tuberculin skin tests for diagnosis of LTBI in HIV-infected individuals with lower CD4 counts. No evidence base exists for selection of IGRA methodology to identify LTBI among human immunodeficiency virus-infected patients in the UK. We prospectively evaluated two commercially available IGRA methods (QuantiFERON-TB Gold In Tube [QFG] and T-SPOT.TB) for testing LTBI among HIV-infected patients potentially nosocomially exposed to an HIV-infected patient with ‘smear-positive’ pulmonary tuberculosis. Among the exposed patients median CD4 count was 550 cells/µL; 105 (90%) of 117 were receiving antiretroviral therapy, of who 104 (99%) had an undetectable plasma HIV load. IGRAs were positive in 12 patients (10.3%); QFG positive in 11 (9.4%) and T-SPOT.TB positive in six (5.1%); both IGRAs were positive in five patients (4.3%). There was one indeterminate QFG and one borderline T-SPOT.TB result. Concordance between the two IGRAs was moderate ( κ = 0.56, 95% confidence interval = 0.27–0.85). IGRAs were positive in only 4 (29%) of 14 patients with previous culture-proven tuberculosis. No patient developed tuberculosis during 20 months of follow-up.
Size of anal squamous cell carcinomas at diagnosis: a retrospective case series
Authors: Read TRH , Huson KL , Millar JL , Haydon A , Porter IWT , Grulich AE , Hocking JS , Chen MY , Bradshaw CS , Fairley CK
Published: July 2013

Anal squamous cell carcinoma is more common in HIV-positive homosexual men than in the general population and prognosis worsens with increasing tumour size. To identify opportunities for earlier diagnosis, we aimed to determine size and visibility of anal squamous cell carcinoma at diagnosis. We conducted a retrospective review of medical records between 1992 and 2010 from one hospital radiotherapy centre, a major centre for HIV care, in Melbourne, Australia. Of 128 cases of anal squamous cell carcinoma, 24 (19%) were in HIV-positive men. At diagnosis, half (52%) of the tumours were externally visible and mean estimated tumour size was 36 mm (29 mm in HIV-positive and 38 mm in HIV-negative patients; p = 0.04) and 114/121 (94%) tumours were 1 cm or larger. The most frequent symptoms were bleeding (43%) and pain (36%) and mean duration of symptoms was 22 weeks. This suggests most anal squamous cell carcinoma were visible or palpable for some time before diagnosis, meaning that screening high-risk groups by anal inspection and palpation is plausible.
Asymptomatic syphilitic massive necrosis of the spleen in late syphilis
Authors: Radojevic Nemanja , Vukmirovic Filip , Curovic Ivana , Soc Miodrag
Published: July 2013

The varieties of luetic clinical variants are countless in nature. In this regard, an autopsy case of a 72-year-old homeless man who accidentally succumbed to carbon-monoxide poisoning is here presented and reviewed. The autopsy revealed the highly unusual finding of asymptomatic syphilitic necrosis of spleen followed by luetic mesaortitis, a solitary skin gumma, and syphilitic arthritis. The spleen was 8 × 4 × 3 cm in size; the capsule was completely calcified and firm, 3 to 5 mm thick. Only in the region of the hilus was a small part of preserved tissue found. After puncturing the capsule, a brown-yellowish pus-like mass was found which filled the entire space inside. When reviewing the relevant literature, this case and its finding of pan splenic necrosis accompanied by a calcified capsule seem to be unique in nature. In terms of the final diagnosis, a Treponema pallidum haemagglutination assay confirmed it to be syphilis. Since it was a late stage of the disease, it is estimated that it may have been present for more than 20 or 30 years in the deceased.
Mechanisms of steam turbine blade particle erosion and crucial parameters for minimizing blade erosion
Authors: Wang Shun-sen , Cai Liu-xi , Mao Jing-ru , Zhang Jun-jie , Xu Ya-tao
Published: July 2013

Reducing the solid particle erosion of blades is crucial to increasing the service life, reliability and cost of steam turbines. In this article, we performed many three-dimensional numerical simulations on the trajectory and erosion of solid particles in turbine cascades, and the relationship between the structural parameters of cascades and erosion characteristics was systematically studied. The results indicated that the erosion damage to the blade depends mainly on the first impingement of every solid particle on the wall after entering into the cascades, and the erosion rate of the first impingement is much larger than that caused by additional impingements on the wall after rebounding of the particle. Furthermore, it was also found that the structure parameter G = ( by− t)/ bx of the cascade and the attack angle ( α) of the steam admission are the most important parameters of blade erosion resistance. Increasing G or α would shift the position of the particle’s first impingement toward the leading edge of the blade. The most effective way of increasing the erosion resistance of the blade is to select an appropriate G while considering the particle size and attack angle ( α) required to prevent ferric oxide particles from causing serious erosion on the trailing edge. All of these achievements are important in the blade selection and anti-solid particle erosion optimization processes when designing a new turbine or upgrading an old turbine.
Exposure to priority organochlorine contaminants in the Italian general population. Part 1. Eight priority organochlorinated pesticides in blood serum
Authors: Mrema EJ , Rubino FM , Mandic-Rajcevic S , Sturchio E , Turci R , Osculati A , Brambilla G , Minoia C , Colosio C
Published: July 2013

Despite extensive use of organochlorinated pesticides (OCPs) such as dichlorodiphenyltrichloroethane (DDT) in Italy in the 1940s to 1970s, especially for public health control of malaria mosquitoes, information on their exposure levels among the general population is limited. These OCPs can be a source of health risk to human. A total of 137 blood samples were collected from residents of the general population of three Italian towns, Novafeltria, Pavia and Milan, to determine the levels of eight OCPs in blood serum. The concentrations of beta-hexachlorocyclohexane, hexachlorobenzene (HCB), 1,1-dichloro-2-( o-chlorophenyl)-2-( p-chlorophenyl)ethylene, 1,1-dichloro-2,2-bis( p-chlorophenyl)-ethylene ( p, p' -DDE), 1,1-dichloro-2-( o-chlorophenyl)-2-( p-chlorophenyl)ethane, 1,1-dichloro-2,2-bis (4-chlorophenyl)ethane, 1,1,1-trichloro-2-( o-chlorophenyl)-2-( p-chlorophenyl)-ethane and 1,1,1-trichloro-2,2-bis( p-chlorophenyl) ethane were measured by gas chromatography–mass spectrometry. Variations in serum concentrations of OCPs with respect to place of residence, gender, age and body mass index (BMI) were evaluated by non-parametric tests. p, p' -DDE and HCB were the most abundant and major contributors of total OCP concentration. Their levels differed significantly between the three towns with a trend Milan > Novafeltria > Pavia (  p < 0.0001). Females had significantly higher concentrations of HCB and p, p'-DDE than males in the overall population sample. HCB concentrations were significantly higher in females than in males of Milan ( p = 0.029). We observed positive correlations of p, p'-DDE and HCB with age in Novafeltria subjects ( r = 0.468, p = 0.004). Total OCP concentrations differed significantly across BMI categories ( p = 0.018) in overall population. We have demonstrated a clear pattern of the main OCPs in a fairly large population. Generally, our study provides information on OCPs exposure among the Italian general population and provides indications for further investigations.
Arnault Tzanck (1886–1954), founder of the first blood centre worldwide
Authors: Lefrère Jean-Jacques , Berche Patrick
Published: July 2013

Arnault Tzanck was at the origins of French transfusion and the founder of the first blood centre worldwide. This article retraces his career and personal itinerary and that path which led him to give his build the country's first organized and modern blood transfusion structure.
The other Founding Physicks: the lives and times of the physician signers of the Articles of Confederation and Perpetual Union
Authors: Bengtsson Bengt-Ola S
Published: July 2013

The Articles of Confederation and Perpetual Union was the interim constitution of the United States of America between 1777 and 1789. The name the United States of America is encountered here for the first time. Three physicians were among the 48 signers – Josiah Bartlett, Samuel Holten and Nathaniel Scudder. All three men started out studying and practising medicine but their lives took very different turns as the new nation emerged.
Dr Adolf Lukas Vischer (1884–1974) and ‘barbed-wire disease’
Authors: Ohry Avi , Solomon Zahava
Published: July 2013

The Swiss physician Adolf Lukas Vischer described a psychiatric syndrome among prisoners of war, the ‘barbed-wire disease’ that follows a long-term incarceration and which involved boredom, confusion, clouding of consciousness and amnesia. Vischer first identified this as an important clinical issue. Later in life, he became one of the first geriatricians and gerontologists.
Factors Associated With Traditional Chinese Medicine Utilization Among Urban Community Health Centers in Hubei Province of China
Authors: Cai Yi , Mao Zongfu , Xu Bruce , Wu Bei
Published: July 2013

This study aims to examine resources and utilization of traditional Chinese medicine (TCM) and factors influencing TCM utilization in urban community health centers (CHCs) in Hubei Province of China. A cross-sectional survey including 234 government-owned CHCs was conducted in 2009. One-way analysis of variance analysis and a Poisson regression model were used to examine distribution of TCM resources and factors influencing TCM utilization. This study found unequal distribution of TCM resources among districts. TCM outpatient visits were positively associated with higher economic development districts, lower initial capital investment of the CHCs, health services covered by health insurance, higher qualification of TCM physicians, provision of TCM health records and rehabilitation, and greater availability of herbal medicine. To achieve equal access to TCM services, policy makers should consider the socioeconomic differences and income groups, provide training for TCM physicians, build pathway to recruit senior TCM physicians, and cover more TCM therapies by health insurance.
Effects of Acculturation on Lifestyle and Health Status Among Older Vietnam-Born Australians
Authors: Tran Duong Thuy , Jorm Louisa , Johnson Maree , Bambrick Hilary , Lujic Sanja
Published: July 2013

Vietnamese immigrants represent a substantial culturally and linguistically diverse population of Australia, but little is known about the health-related effects of acculturation in this population. This study investigated the relationship between measures of acculturation and lifestyle behaviors and health status among 797 older Vietnam-born Australians who participated in the 45 and Up Study ( www.45andup.org.au ). The findings suggested that higher degrees of acculturation were associated with increased consumption of red meat, white meat, and seafood; higher levels of physical activities; and lower prevalence of overweight and obesity, type 2 diabetes, and smoking (in men). Targeted health messages could emphasize eating more vegetables, avoiding smoking and alcohol drinking, and increasing levels of physical activity.
Gender-Based Seasonality of Suicide in Japan, 2005-2012
Authors: Liu Yan , Zhang Ying , Arai Asuna , Obayashi Yoshihide , Tamashiro Hiko
Published: July 2013

This study aimed to explore the gender-based seasonal patterns of suicide in Japan between 2005 and 2012. With data from Japanese official reports, we carried out Prais–Winsten regression and Wilcoxon signed-rank test analysis with Stata 12.0 and SPSS 14.0. The suicide number was significantly higher in March, April, May, June, July, and October for both genders. The suicide number in men was markedly higher than that in women in every month. The suicide number in 2010 was lower than that in 2009 for men, while that in 2011 was higher than that in 2010 for women. The findings displayed that the nationwide television and publicity intervention campaigns might have positive effects on decreasing suicide of men while women suffered a post-earthquake increase. In terms of interventions, we should not only square up the seasonal patterns but also the gender differences in vulnerability.
Fish Intake by Adolescents Is Related to Nutrient Intake but Not Lifestyle Factors
Authors: Rahman Laila , Nigg Claudio R. , Rosner Lee S. , Iversen Cara S. , Chung Hai V. , Lai Morris , Saka Susan , Sayessian Maria L. , Watters Corilee A.
Published: July 2013

Nutrition during adolescence influences long-term health outcomes. Consumption of fish has many health benefits, yet few studies have investigated associations between fish intake and nutrient intake and lifestyle factors in adolescents. A cross-sectional study utilizing 24-hour dietary recalls obtained by in-person interviews investigated relationships between fish intake and demographic characteristics, nutrient intake, and lifestyle factors among adolescents (mean age = 15.5 years). Height, weight, and self-administered survey data were collected from 839 high school students who took part in the 2000-2004 Hawaii Nutrition Education Needs Assessment survey. About 8.5% of the students consumed fish, based on estimated EPA (eicosapentaenoic acid) + DHA (docosahexaenoic acid) intakes. Adolescents who consumed fish had higher intake of protein, water, B vitamins, magnesium, selenium, and zinc but consumed more calories, fat, saturated fat, and sodium. Considering the school health program’s potential to reach adolescents, more intensive school-based interventions can be directed to promote safe fish consumption and to encourage other positive lifestyle behaviors.
Determinants of Health-Related Quality of Life in Psoriasis Patients in Malaysia
Authors: Nyunt Wint Wint Thu , Low Wah Yun , Ismail Rokiah , Sockalingam Sargunan , Min Aung Ko Ko
Published: July 2013

Psoriasis is a chronic dermatological disorder that has a negative impact on quality of life (QoL). This hospital-based cross-sectional study determined factors associated with health-related QoL (HRQoL) impairment in adult psoriasis patients. HRQoL was assessed using the Dermatology Life Quality Index (DLQI). Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). A total of 223 patients, aged 18 to 83 years, were recruited. For 67 (30%) patients, psoriasis had very large to extremely large effect on their life (DLQI score = 11-30). The median DLQI score was 7 (interquartile range = 7). Factors significantly associated with severe impact on HRQoL (DLQI ≥ 10) were disease severity, single status, working status, sports activities, nail dystrophy, exposed area involvement, itch, disturbed sleep, stress, and infection. The factor predictive of severe impact of psoriasis on HRQoL was disease severity. A holistic approach in the management, including psychosocial issues, is absolutely crucial for the optimal care of psoriasis patients.