bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Relevance of Classifying Massive Rotator Cuff Tears: Results Based on Functional and Radiological Findings After Arthroscopic Repair
Authors: Ok Hyun Soo , Kim Byung Guk , Choi Won Chul , Hong Chul Gie , Kim Jee Woong , Kim Jae Hwa
Published: October 2016

Background:

Studies on the results of arthroscopic repair of massive rotator cuff tears have reported widely varied prognoses. Among other factors, the sizable discrepancy can be attributable to the fact that the current definition of massive rotator cuff tears covers an extensive area of tendons.

Hypothesis:

Functional and radiological results according to subgroups would show significant inter-subgroup differences preoperatively and postoperatively.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 104 patients who required arthroscopic repair for massive rotator cuff tears were prospectively evaluated. The patients were allocated into 3 groups according to tendon involvement as diagnosed by preoperative magnetic resonance imaging: group 1 (anterosuperior type involving the subscapularis and supraspinatus), group 2 (posterosuperior type involving the infraspinatus and supraspinatus), and group 3 (anteroposterior type involving the subscapularis, supraspinatus, and infraspinatus). We compared functional results (at 2 years postoperatively) and radiological findings (at 1 year postoperatively) for each group.

Results:

There were 34 patients in group 1, 54 in group 2, and 16 in group 3. In all 3 groups, functional results significantly improved after surgery. There were no statistically significant intergroup differences in functional results among the 3 groups. On the radiological evaluations, each group (groups 1, 2, and 3) showed a significantly different result in the preoperative acromiohumeral distance (AHD) (7.19, 5.44, and 5.22 mm, respectively), tear size (38.8, 39.3, and 46.4 mm, respectively), extent of retraction (33.9, 40.0, and 41.4 mm, respectively), postoperative AHD (8.92, 7.37, and 6.71 mm, respectively), and retear rate (23.5%, 51.9%, and 56.2%, respectively) ( P < .001 for all).

Conclusion:

Massive rotator cuff tears can be divided into 3 types: anterosuperior (group 1), posterosuperior (group 2), and anteroposterior (group 3). Each group has distinctive characteristics and shows different results in the preoperative AHD, tear size, extent of retraction, postoperative AHD, and retear rate, which provide a reasonable basis for categorization. So far, massive rotator cuff tears have only been broadly defined, consequently being understood as a single category by many. However, to clearly understand and evaluate this injury, we suggest identifying differences within the category through proper subclassification.
A Prospective Randomized Study Comparing the Interference Screw and Suture Anchor Techniques for Biceps Tenodesis
Authors: Park Ji Soon , Kim Sae Hoon , Jung Ho Jin , Lee Ye Hyun , Oh Joo Han
Published: October 2016

Background:

Several methods are used to perform biceps tenodesis in patients with superior labrum-biceps complex (SLBC) lesions accompanied by a rotator cuff tear. However, limited clinical data are available regarding the best technique in terms of clinical and anatomic outcomes.

Purpose:

To compare the clinical and anatomic outcomes of the interference screw (IS) and suture anchor (SA) fixation techniques for biceps tenodesis performed along with arthroscopic rotator cuff repair.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

A total of 80 patients who underwent arthroscopic rotator cuff repair with SLBC lesions were prospectively enrolled and randomly divided according to the tenodesis method: the IS and SA groups. Functional outcomes were evaluated with the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), Constant score, Korean Shoulder Score (KSS), and long head of the biceps (LHB) score at least 2 years after surgery. The anatomic status of tenodesis was estimated using magnetic resonance imaging or ultrasonography, and the anatomic failure of tenodesis was determined when the biceps tendon was not traced in the intertubercular groove directly from the insertion site of the IS or SA.

Results:

Thirty-three patients in the IS group and 34 in the SA group were monitored for more than 2 years. All postoperative functional scores improved significantly compared with the preoperative scores (all P < .001) and were not significantly different between the groups, including the LHB score (all P > .05). Nine anatomic failures of tenodesis were observed: 7 in the IS group and 2 in the SA group ( P = .083). In a multivariate analysis using logistic regression, IS fixation ( P = .003) and a higher (ie, more physically demanding) work level ( P = .022) were factors associated with the anatomic failure of tenodesis significantly. In patients with tenodesis failure, the LHB score ( P = .049) and the degree of Popeye deformity by the patient and examiner ( P = .004 and .018, respectively) were statistically different compared with patients with intact tenodeses.

Conclusion:

Care must be taken while performing biceps tenodesis in patients with a higher work level; IS fixation appears to pose a higher risk in terms of the anatomic failure of tenodesis than SA fixation, although functional outcomes were not different.
Performance of PROMIS Instruments in Patients With Shoulder Instability
Authors: Anthony Chris A. , Glass Natalie A. , Hancock Kyle , Bollier Matt , Wolf Brian R. , Hettrich Carolyn M.
Published: October 2016

Background:

Shoulder instability is a relatively common condition occurring in 2% of the population. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains.

Purpose:

To compare PROMIS instruments to current PRO instruments in patients who would be undergoing operative intervention for recurrent shoulder instability.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

A total of 74 patients with a primary diagnosis of shoulder instability who would be undergoing surgery were asked to fill out the American Shoulder and Elbow Surgeons shoulder assessment form (ASES), Marx shoulder activity scale (Marx), Short Form–36 Health Survey Physical Function subscale (SF-36 PF), Western Ontario Shoulder Instability Index (WOSI), PROMIS physical function computer adaptive test (PF CAT), and PROMIS upper extremity item bank (UE). Correlation between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3).

Results:

Utilization of the PROMIS UE demonstrated excellent correlation with the SF-36 PF ( r = 0.78, P < .01) and ASES ( r = 0.71, P < .01); there was excellent-good correlation with the EQ-5D ( r = 0.66, P < .01), WOSI ( r = 0.63, P < .01), and PROMIS PF CAT ( r = 0.63, P < .01). Utilization of the PROMIS PF CAT demonstrated excellent correlation with the SF-36 PF ( r = 0.72, P < .01); there was excellent-good correlation with the ASES ( r = 0.67, P < .01) and PROMIS UE ( r = 0.63, P < .01). When utilizing the PROMIS UE, ceiling effects were present in 28.6% of patients aged 18 to 21 years. Patients, on average, answered 4.6 ± 1.8 questions utilizing the PROMIS PF CAT.

Conclusion:

The PROMIS UE and PROMIS PF CAT demonstrated good to excellent correlation with common shoulder and upper extremity PRO instruments as well as the SF-36 PF in patients with shoulder instability. In patients aged ≤21 years, there were significant ceiling effects utilizing the PROMIS UE. While the PROMIS PF CAT appears appropriate for use in adults of any age, our findings demonstrate that the PROMIS UE has significant ceiling effects in patients with shoulder instability who are ≤21 years old, and we do not recommend use of the PROMIS UE in this population.
Falls Risks and Prevention Behaviors Among Community-Dwelling Homebound and Non-Homebound Older Adults
Authors: Casteel Carri , Jones Jennifer , Gildner Paula , Bowling James M. , Blalock Susan J.
Published: October 2016

The objectives were to examine falls risk factors to determine how the magnitude of risk may differ between homebound and non-homebound older adults, and to describe falls prevention behaviors and participation in falls prevention education. A cross-sectional survey was conducted with convenience samples of community-dwelling older adults recruited through Meals on Wheels programs (homebound, n = 80) and senior centers (non-homebound, n = 84) in North Carolina. Data were collected during home visits and included an interview and medication inventory. Multivariate negative binomial regression with robust variance estimation modeled risk factors for falls. Risk factors for falls observed in both the homebound and non-homebound populations are consistent with what is known in the literature. However, the magnitude of the risk was higher in the homebound than in the non-homebound population with respect to vision impairments, number of high-risk and over-the-counter medications, and use of walking aids .Few participants reported participating in a falls prevention program.
Developing the Theory of Perspective Transformation
Authors: Hoggan Chad , Mälkki Kaisu , Finnegan Fergal
Published: October 2016

Mezirow’s theory of perspective transformation has proved to be a great asset to the scholarship of adult education and has provided a solid theoretical base for understanding complex learning phenomena. However, in the discussions surrounding Mezirow’s work, a certain “stuckness” appears which we think is unproductive. Critiques of Mezirow are often repeated, secondhand or thirdhand, causing important issues and tensions to become simplified and dichotomized, which causes complex aspects of the theory to lose the nuance that a good theory provides. This article draws on recent contributions to the literature in order to elaborate on the theory of perspective transformation in light of these recurring critiques. In so doing, we introduce three key concepts to the lexicon of perspective transformation: continuity, intersubjectivity, and emancipatory praxis. For each, we address the underlying omission or weakness in Mezirow’s theory and offer revised conceptualizations of the theory.
Entrainment Maps
Authors: Diekman Casey O. , Bose Amitabha
Published: October 2016

Circadian oscillators found across a variety of species are subject to periodic external light-dark forcing. Entrainment to light-dark cycles enables the circadian system to align biological functions with appropriate times of day or night. Phase response curves (PRCs) have been used for decades to gain valuable insights into entrainment; however, PRCs may not accurately describe entrainment to photoperiods with substantial amounts of both light and dark due to their reliance on a single limit cycle attractor. We have developed a new tool, called an entrainment map, that overcomes this limitation of PRCs and can assess whether, and at what phase, a circadian oscillator entrains to external forcing with any photoperiod. This is a 1-dimensional map that we construct for 3 different mathematical models of circadian clocks. Using the map, we are able to determine conditions for existence and stability of phase-locked solutions. In addition, we consider the dependence on various parameters such as the photoperiod and intensity of the external light as well as the mismatch in intrinsic oscillator frequency with the light-dark cycle. We show that the entrainment map yields more accurate predictions for phase locking than methods based on the PRC. The map is also ideally suited to calculate the amount of time required to achieve entrainment as a function of initial conditions and the bifurcations of stable and unstable periodic solutions that lead to loss of entrainment.
Victim, Allegation, and Investigation Characteristics Associated With Substantiated Reports of Sexual Abuse of Adults in Residential Care Settings
Authors: Abner Erin L. , Teaster Pamela B. , Mendiondo Marta S. , Ramsey-Klawsnik Holly , Marcum Jennifer L. , Crawford Tim N. , Wangmo Tenzin
Published: October 2016

The purpose of this study was to identify characteristics of investigations of sexual abuse concerning vulnerable adults residing in facility settings that were associated with case substantiation. Data on 410 reports of sexual abuse were collected prospectively from Adult Protective Services (APS) and state licensure agency staff in New Hampshire, Oregon, Tennessee, Texas, and Wisconsin over a six-month period. Specifically, we examined differences between reports that were substantiated and those that were not by comparing characteristics of alleged victims, alleged perpetrators, and aspects of investigation using logistic regression. We found that a relatively low proportion of cases (18%) were substantiated overall. Compared to cases that were not substantiated, cases that were substantiated were more likely to feature nursing home residents, older victims, female victims, and allegations of physical contact between the alleged perpetrator and victim. Despite the high proportion of alleged perpetrators who were facility staff (51%) compared to resident perpetrators (25%), cases with resident-to-resident allegations of abuse were much more likely to be substantiated, accounting for 63% of substantiated cases. In light of these findings, we believe it is important that investigators are trained to handle sexual abuse cases appropriately and that they are able to investigate the case thoroughly, promptly, and with as much information as possible. It is also critical that investigators make substantiation decisions using the appropriate standard for confirmation (e.g., preponderance of the evidence, beyond a reasonable doubt, clear and convincing evidence) as state law dictates.
Associations Between Sexual Assault Severity and Psychological and Physical Health Outcomes: Similarities and Differences Among African American and Caucasian Survivors
Authors: Pegram Sheri E. , Abbey Antonia
Published: October 2016

There are well-established associations between sexual assault victimization and deleterious psychological and physical health outcomes. The present study contributes to the emerging health disparities literature by examining similarities and differences in relationships between the severity of the sexual assault and health in a community sample of African American and Caucasian survivors. Although the overall pattern of relationships was expected to be comparable for all survivors, some associations were hypothesized to be stronger for African American survivors as compared with Caucasian survivors based on theories of chronic stress. Single, African American, and Caucasian women were recruited for a study of dating experiences through random digit dialing in one large metropolitan area. Participants who experienced a sexual assault since age 14 were included in this study (121 African American and 100 Caucasian women). Multigroup path analyses indicated that for both African American and Caucasian survivors, sexual assault severity was significantly positively associated with posttraumatic stress disorder (PTSD) symptoms, and depressive symptoms were significantly positively associated with physical health symptoms. Among African American survivors, sexual assault severity affected physical health symptoms indirectly through its impact on depressive symptoms, and assault severity indirectly affected drinking problems through its impact on PTSD symptoms; these relationships were not found for Caucasian survivors. These findings highlight the need for additional research that focuses on health disparities in sexual assault survivors’ recovery process, so that treatment programs address culturally relevant issues.
Have Post-Kelo Restrictions on Eminent Domain Influenced State Economic Development?
Authors: Byrne Paul F.
Published: October 2016

In 2005, the Supreme Court’s Kelo v. New London ruling reaffirmed governments’ right to use eminent domain for economic development purposes. Widespread public backlash over the ruling resulted in numerous states quickly passing laws restricting the use of eminent domain for such purposes. This study uses the swift and uneven response of state legislatures to the public outcry that followed Kelo to test the empirical question of whether restrictions on eminent domain affect states’ ability to fulfill their economic development goals. Results indicate that states that restricted the use of eminent domain following the Kelo ruling experienced no adverse effects in terms of state employment and gross state product or county employment and county income in the states’ most dense counties.
Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases
Authors: Zhang Dong-Mei , Ye Jian-Xin , Mu Jun-Shan , Cui Xiao-Ping
Published: October 2016

Increase in serum homocysteine is shown to be a potential risk factor for cognitive impairment. Evidence suggests that vitamin B supplementation may reduce cognitive decline by lowering the homocysteine levels. The current meta-analysis evaluated the efficacy of folic acid along with vitamin B12 and/or B6 in lowering homocysteine, thereby attenuating cognitive decline in elderly patients with Alzheimer disease or dementia. Randomized controlled trials (RCTs) comparing the efficacy of folate and B vitamin supplementation in patients with cognitive decline secondary to Alzheimer disease or dementia were identified using the keywords, “homocysteine, hyper-homocysteinemia, B vitamin, vitamin B6, B12, folic acid, cognitive, Alzheimer’s disease, and dementia.” The outcome measures analyzed were the Mini-Mental State Examination (MMSE) score and serum homocysteine. Of the 77 studies identified, 4 RCTs were included in the current meta-analysis. The baseline characteristics, age, and gender distribution of patients among the 2 groups (supplement vs placebo) were comparable. The results reveal that the intervention group achieved significantly greater reduction in homocysteine levels than the control (pooled difference in means = −3.625, 95% confidence interval [CI] = −5.642 to −1.608, P < .001). However, no significant difference in MMSE (pooled difference in means = 0.027, 95% CI = −0.518 to 0.573, P = 0.921) was observed between the groups. Taken together, vitamin B supplementation was effective in reducing serum homocysteine levels. However, it did not translate into cognitive improvement, indicating that the existing data on vitamin B-induced improvement in cognition by lowering homocysteine levels are conflicting.
The Parkinson’s Active Living (PAL) Program
Authors: Butterfield London C. , Cimino Cynthia R. , Salazar Robert , Sanchez-Ramos Juan , Bowers Dawn , Okun Michael S.
Published: October 2016

Background:

Apathy, one of the most common neuropsychiatric symptoms in Parkinson’s disease (PD), has been associated with reduced daily functioning, cognition, treatment compliance, quality of life, and increased caregiver burden and distress, among other outcomes.

Objectives:

The purpose of the present study was to develop and gather pilot data on the feasibility, acceptability, and efficacy of the Parkinson’s Active Living (PAL) program, to our knowledge, the first behavioral treatment specifically designed to target apathy in patients with PD. The Parkinson’s Active Living is a primarily telephone-based, 6-week activity scheduling and monitoring intervention that incorporates external cueing to target disease-related self-generational deficits to reduce levels of apathy in nondemented, highly apathetic patients with PD.

Methods:

Participants aged 44 to 86 years (mean = 66, SD [standard deviation] = 10.7) ranging in disease duration from <1 to 23 years with elevated apathy (Apathy Evaluation Scale >35) were enrolled in a 1-arm trial and tested at 3 time points (baseline, posttest, and 1-month follow-up).

Results:

Feasibility aspects (ie, acceptability, demand, implementation, practicality, adaptation, integration, and expansion) and efficacy of PAL program are reported. Matched pairs t tests showed a medium to large effect of treatment on patient apathy (52% showing ≥1 SD improvement), depression (33% showing ≥1 SD improvement), and quality of life at posttest, with improvements in apathy and depression maintained at follow-up.

Conclusions:

The program may hold promise as an effective nonpharmacological intervention for apathy in PD. Implications and future directions are discussed. Randomized controlled trials are needed.
Re-interpreting: Narratives of childhood language brokering over time
Authors: Orellana Marjorie Faulstich , Phoenix Ann
Published: October 2016

This article probes how childhood experiences are actively taken into adult lives and thus challenges the unwitting and unintentional reproduction of an adult–child binary in childhood studies. We do this by analyzing interviews with one adult daughter of immigrants from Mexico to the United States at four points in time (ages 19, 26, 27, and 33). Using narrative analysis to examine the mutability of memory, we consider how Eva oriented herself to her childhood story, what was salient and invisible in each recount, the values she associated with the practice, and the meanings she took from her experiences. We show how Eva re-interpreted her experiences as an immigrant child language broker in relation to unfolding life events, showing her childhood to be very much alive in her adult life. Language brokering serves as one way in which to examine the interpenetration of childhood into adulthood, rather than being the focus per se.
An intelligent method to generate liaison graphs for truss structures
Authors: Cao Hao , Mo Rong , Wan Neng , Deng Qi
Published: October 2016

Liaison graph is a necessary prerequisite of assembly sequence planning for mechanical products. Traditionally, it is generated via shape matching of joints among parts, but this strategy is invalid to truss structures because they lack patterns for shape matching. In this context, this article presents an intelligent method based on support vector machine to obtain liaison graphs of truss products automatically. This method defined three kinds of oriented bounding boxes to embody the relationships of the joints in truss structures. Based on them, a series of factors are deduced as training data for support vector machine. Furthermore, two algorithms are introduced to calculate oriented bounding boxes to facilitate the data extraction. By these processes, this method established the knowledge of joints and realized the intelligent construction of liaison graph without shape matching reasoning. To verify the effect of the method, an experimental implementation is presented. The results suggest that the proposed method could recognize most joint types and construct liaison graph automatically with sufficient sample training. The correct recognition rate is more than 85%. Comparing with back-propagation neural network, support vector machine is more accurate and stable in this case. As an alternative method, it could help the engineers to arrange the assembly plan for truss structures and other similar assemblies.
An energy mapping methodology to reduce energy consumption in manufacturing operations
Authors: Cosgrove John , Rivas Duarte Maria-Jose , Littlewood John , Wilgeroth Paul
Published: October 2016

The manufacturing industry is increasingly accountable for the environmental impact resulting from its activities. Research indicates that specific production processes within manufacturing plants generate significant environmental impact through energy consumption. To understand the consumption of energy in a production environment, it is necessary to outline the energy flow within the facility, along with the classification of energy usage and its relationship to processes and production outputs. It is also important to identify auxiliary (non-value added) energy within production as the area with the greatest potential for savings through changes in operational behaviour. This article introduces a practical process mapping methodology that combines energy management with value stream mapping. The methodology is based on ‘Lean’ manufacturing principles and on application to a couple of industry use cases has been shown to successfully illustrate the relationship between the energy usage and production activities for a particular value stream. Furthermore, the significant energy users in relation to the actual production process steps have been identified, and energy reduction opportunities of 42% and 50% have been quantified.
Size-dependent thermally affected wave propagation analysis in nonlocal strain gradient functionally graded nanoplates via a quasi-3D plate theory
Authors: Ebrahimi Farzad , Barati Mohammad Reza
Published: October 2016

This article examines the application of nonlocal strain gradient elasticity theory to wave dispersion behavior of a size-dependent functionally graded nanoplate in thermal environments. The theory contains two scale parameters corresponding to nonlocal and strain gradient effects. A quasi-3D plate theory considering shear and normal deformations is employed to present the formulation. Mori–Tanaka micromechanical model is used to describe functionally graded material properties. Hamilton’s principle is employed to obtain the governing equations of nanoplate accounting for thickness stretching effect. These equations are solved analytically to find wave frequencies and phase velocities of functionally graded nanoplate. It is indicated that wave dispersion behavior of functionally graded nanoplates is significantly affected by temperature rise, nonlocality, length scale parameter, and material composition.
Structural ultimate strength analysis of a first stage fan blade in a turbine jet engine RD-33
Authors: Kozakiewicz Adam , Kachel Stanisław , Jóźwiak Stanisław , Jóźwiak Przemysław
Published: October 2016

Statistical data clearly points out compressor train outage as one of the main reasons for the breakdown of aircraft power units. Outages are caused by various factors, including material conditions as the main one. Therefore, structural ultimate strength analysis of constructional raw material properties used in the production process of such an important part of an engine is not only of tremendous significance during the designing phase but also in a research phase and expertise associated with emergency situations. Considering the above-mentioned factors the article presents the outcomes of chemical composition, morphology, and phase structure of metallic material used to produce first row fan blades of RD-33 turbine jet engine, which is (currently) used by the Polish Air Force. Apart from typical material structure analysis, also the basic mechanical strength properties of materials have been determined including hardness, tensile, and impact tests. These may now constitute the basis for the analysis of substitute materials selection allowing the production of analyzed engine part.
Do You See the Forest or the Tree? Neural Gain and Breadth Versus Focus in Perceptual Processing
Authors: Eldar Eran , Niv Yael , Cohen Jonathan D.
Published: October 2016

When perceiving rich sensory information, some people may integrate its various aspects, whereas other people may selectively focus on its most salient aspects. We propose that neural gain modulates the trade-off between breadth and selectivity, such that high gain focuses perception on those aspects of the information that have the strongest, most immediate influence, whereas low gain allows broader integration of different aspects. We illustrate our hypothesis using a neural-network model of ambiguous-letter perception. We then report an experiment demonstrating that, as predicted by the model, pupil-diameter indices of higher gain are associated with letter perception that is more selectively focused on the letter’s shape or, if primed, its semantic content. Finally, we report a recognition-memory experiment showing that the relationship between gain and selective processing also applies when the influence of different stimulus features is voluntarily modulated by task demands.
Rapid review of evaluation of interventions to improve participation in cancer screening services
Authors: Duffy Stephen W , Myles Jonathan P , Maroni Roberta , Mohammad Abeera
Published: October 2016

Objective

Screening participation is spread differently across populations, according to factors such as ethnicity or socioeconomic status. We here review the current evidence on effects of interventions to improve cancer screening participation, focussing in particular on effects in underserved populations.

Methods

We selected studies to review based on their characteristics: focussing on population screening programmes, showing a quantitative estimate of the effect of the intervention, and published since 1990. To determine eligibility for our purposes, we first reviewed titles, then abstracts, and finally the full paper. We started with a narrow search and expanded this until the search yielded eligible papers on title review which were less than 1% of the total. We classified the eligible studies by intervention type and by the cancer for which they screened, while looking to identify effects in any inequality dimension.

Results

The 68 papers included in our review reported on 71 intervention studies. Of the interventions, 58 had significant positive effects on increasing participation, with increase rates of the order of 2%–20% (in absolute terms).

Conclusions

Across different countries and health systems, a number of interventions were found more consistently to improve participation in cancer screening, including in underserved populations: pre-screening reminders, general practitioner endorsement, more personalized reminders for non-participants, and more acceptable screening tests in bowel and cervical screening.
Breast cancer incidence trends in Norway and estimates of overdiagnosis
Authors: van Luijt Paula A , Heijnsdijk Eveline AM , van Ravesteyn Nicolien T , Hofvind Solveig , de Koning Harry J
Published: October 2016

Objective

Fluctuations in the incidence of breast cancer in Norway in the last three decades are partly explained by the use of hormone replacement therapy and mammography screening, but overdiagnosis has also been suggested as a cause. We assessed the trends in breast cancer incidence and overdiagnosis in Norway.

Methods

We calibrated our microsimulation model to Norwegian Cancer Registration data. The model takes into account the use of mammography (both within and outside the Norwegian Breast Cancer Screening Programme) and of hormone replacement therapy. We obtained a proper fit of breast cancer incidence in recent years, when assuming an increase in the background risk for breast cancer, and estimated overdiagnosis.

Results

We estimated a 2% overdiagnosis rate as a fraction of all cancers diagnosed in women aged 50–100, and a 3% overdiagnosis rate as a fraction of all cancers diagnosed in women aged 50–70 (i.e. screening age). If all of the increased incidence would be the result of the detection of slow growing tumours, these estimates were 7% and 11%, respectively.

Conclusion

Besides mammography and hormone replacement therapy use, additional risk factors contributed to the sudden increase in breast cancer incidence in Norway. Overdiagnosis estimates due to screening were within the range of international plausible estimates.
Meso-scale fracture simulation using an augmented Lagrangian approach
Authors: Labanda Nicolás A , Giusti Sebastián M , Luccioni Bibiana M
Published: October 2016

A cohesive zone model implemented in an augmented Lagrangian functional is used for simulation of meso-scale fracture problems in this paper. The method originally developed by Lorentz is first presented in a rigorous variational framework. The equivalence between the stationary point of the one-field problem and the saddle point of the mixed formulation is proved by solving the double inequality of the mixed functional. An adaptation to simulate fracture phenomena in the meso-scale via mesh modification is also presented as an algorithm to insert zero-thickness interface elements based on Lagrange multipliers, boarding the non-trivial task of the field interpolation for different crack paths (plain and tortuous). A suitable tool to study the matrix fracture and debonding phenomena in composites with strongly different component stiffnesses that avoids ill-conditioning matrices associated with intrinsic cohesive zone models is obtained. The method stability is discussed using a simple patch test. Some numerical applications to fracture problems taking into account the mesostructure and, particularly, the study of transverse failure of longitudinal fiber reinforced epoxy and the fracture in concrete specimens are included in the paper. Comparing the numerical results with the experimental results obtained by other researchers, the paper introduces a discussion about the influence of coarse aggregate volume in meso-scale fracture mechanisms in concrete L-shaped specimens.
The Effects of the Hypothetical Putative Confession and Negatively Valenced Yes/No Questions on Maltreated and Nonmaltreated Children’s Disclosure of a Minor Transgression
Authors: Stolzenberg Stacia N. , McWilliams Kelly , Lyon Thomas D.
Published: October 2016

This study examined the effects of the hypothetical putative confession (telling children “What if I said that [the suspect] told me everything that happened and he said he wants you to tell the truth?”) and negatively valenced yes/no questions varying in their explicitness (“Did the [toy] break?” vs. “Did something bad happen to the [toy]?”) on two hundred and six 4- to 9-year-old maltreated and nonmaltreated children’s reports, half of whom had experienced toy breakage and had been admonished to keep the breakage a secret. The hypothetical putative confession increased the likelihood that children disclosed breakage without increasing false reports. The yes/no questions elicited additional disclosures of breakage but also some false reports. The less explicit questions (referencing “something bad”) were as effective in eliciting true reports as the questions explicitly referencing breakage. Pairing affirmative answers to the yes/no questions with recall questions asking for elaboration allowed for better discrimination between true and false reports. The results suggest promising avenues for interviewers seeking to increase true disclosures without increasing false reports.
A note on the wave equation for a class of constitutive relations for nonlinear elastic bodies that are not Green elastic
Authors: Meneses R , Orellana O , Bustamante R
Published: October 2016

A class of constitutive relations for elastic bodies has been proposed recently, where the linearized strain tensor is expressed as a nonlinear function of the stress tensor. Considering this new type of constitutive equation, the initial boundary value problem for such elastic bodies has been expressed only in terms of the stress tensor. In this communication, this new type of nonlinear wave equation is studied for the case of a one-dimensional straight bar. Conditions for the existence of the travelling wave solutions are given and some self-similar solutions are obtained.
Adult ADHD Symptomatology in Active Duty Army Personnel: Results From the Army Study to Assess Risk and Resilience in Servicemembers
Authors: Kok Brian C. , Reed David E. , Wickham Robert E. , Brown Lisa M.
Published: October 2016

Objective: Although the prevalence of adult ADHD has been well established in the general population, few studies have examined the prevalence of ADHD symptoms in the military. Method: The present study used data from 21,449 active duty soldiers, whose responses were collected as part of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Positive ADHD screens were identified using two alternative scoring methods of the Adult Self-Report ADHD Scale Screener. Results: The estimated prevalence of ADHD in this sample was 7.6% and 9.0% depending on diagnostic method. Contrary to initial hypotheses that ADHD would be highest in the 18- to 19-year-old age-group, the age distribution of ADHD in this study was centered around the 25- to 29-year-old age-group. Conclusions: The findings of this study indicate that adult ADHD symptoms are common in Army personnel, and are not limited to the youngest cohorts. Implications on screening, administrative policy, and future research directions are also discussed.
An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease
Authors: Caney Sarah MA
Published: October 2016

Objectives

The objective of this study was to learn about owner experiences of chronic kidney disease (CKD), focusing on use of therapeutic renal diets (TRDs) and intestinal phosphate binders (IPBs).

Methods

An online survey was promoted to UK-based cat owners.

Results

In total, 859 owners participated. Most cats (n = 620; 72.18%) had two or more clinical signs at the time of their CKD diagnosis. Most common were polydipsia (n = 462; 53.78%) and weight loss (n = 426; 49.59%). In 94 cats (10.94%) CKD was only diagnosed as a result of wellness screening. In total, 371 participants (43.19%) reported that their cat’s blood pressure had been measured; 100 of these (26.95% of those where blood pressure had been measured) subsequently received anti-hypertensive medication. In total, 90.80% of all participating owners had received a recommendation to feed a TRD. Five hundred and seventy-one owners (66.47%) reported that they were feeding a TRD as a component of their cat’s diet. The most common reason for not feeding a TRD was that the cat did not like it (n = 123; 59.13%). Where a veterinary recommendation to feed a TRD had been received, 564 owners (72.31%) reported feeding a TRD as a component of their cat’s diet vs seven owners (7.04%) who had not received a veterinary recommendation to feed a TRD. IPBs had been recommended to 321 owners (37.81%) and for 72 owners (8.38%) the recommendation came from a source other than a veterinary professional. Where used, IPBs were commonly added to a TRD (n = 136; 49.28%) and were generally accepted within 4 weeks (n = 178; 73.86%).

Conclusions and relevance

Awareness of TRDs was high but much lower for IPBs. A veterinary recommendation to feed a TRD was associated with higher compliance.
Professionalization and evaluation: A European analysis in the digital era
Authors: Castro Maria Pia , Fragapane Stefania , Rinaldi Francesco Mazzeo
Published: October 2016

It is expected that the number of evaluators will continue to grow in the near future. However, the heterogeneity of different national contexts makes the consolidation of a consistent ‘jurisdiction’ for the professional evaluator rather problematic. This article contributes to the debate on the professionalization of evaluators by looking at practices attributed, competences and skills required by employers, and the main topics addressed by the community of evaluators. The authors draw on various sources – ISCO08 (International Standard Classification of Occupation); ESCO (European Skills, Competences, Qualifications and Occupations); job offers posted on the EES (European Evaluation Society) website; EES LinkedIn group – to argue that the practice of evaluation has achieved a supranational dimension, with potential consequences both on evaluators’ educational profile and on the ways in which evaluations are commissioned and conducted.
Expert views on applying complexity theory in evaluation: Opportunities and barriers
Authors: Walton Mat
Published: October 2016

Interest in evaluating complexity appears to be on the rise. Increasing application of systems thinking and complex systems methodologies to evaluation can be seen in contents of journals and evaluation conferences. To date there has been little systematic examination of experiences of this application. This research considers the experience of 41 key informant participants with experience of complexity and systems approaches in evaluation. The results highlight institutional, political and social science factors that provide opportunities for further application. The following are identified as barriers to application: multiple definitions of complexity, the dominance of existing approaches, the purpose of evaluation and perception of resources required to apply complexity and systems approaches in evaluation. Where increasing the use of complexity and systems methodologies is a desired goal, this research suggests action regarding: how these methodologies are communicated; and evaluation training.
How to formulate research questions and design studies for telehealth assessment and evaluation
Authors: Fatehi Farhad , Smith Anthony C , Maeder Anthony , Wade Victoria , Gray Leonard C
Published: October 2016

Planning a research strategy and formulating the right research questions at various stages of developing a telehealth intervention are essential for producing scientific evidence. The aim of research at each stage should correspond to the maturity of the intervention and will require a variety of study designs. Although there are several published evaluation frameworks for telemedicine or telehealth as a subset of broader eHealth domain, there is currently no simple model to guide research planning. In this paper we propose a five-stage model as a framework for planning a comprehensive telehealth research program for a new intervention or service system. The stages are: (1) Concept development, (2) Service design, (3) Pre-implementation, (4) Implementation, (5) Post-implementation, and at each stage a number of studies are considered. Robust evaluation is important for the widespread acceptance and implementation of telehealth. We hope this framework enables researchers, service administrators and clinicians to conceptualise, undertake and appraise telehealth research from the point of view of being able to assess how applicable and valid the research is for their particular circumstances.
Evaluating barriers to adopting telemedicine worldwide: A systematic review
Authors: Scott Kruse Clemens , Karem Priyanka , Shifflett Kelli , Vegi Lokesh , Ravi Karuna , Brooks Matthew
Published: October 2016

Introduction and objective

Studies on telemedicine have shown success in reducing the geographical and time obstacles incurred in the receipt of care in traditional modalities with the same or greater effectiveness; however, there are several barriers that need to be addressed in order for telemedicine technology to spread. The aim of this review is to evaluate barriers to adopting telemedicine worldwide through the analysis of published work.

Methods

The authors conducted a systematic literature review by extracting the data from the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PubMed (MEDLINE) research databases. The reviewers in this study analysed 30 articles (nine from CINAHL and 21 from Medline) and identified barriers found in the literature. This review followed the checklist from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009. The reviewers organized the results into one table and five figures that depict the data in different ways, organized by: barrier, country-specific barriers, organization-specific barriers, patient-specific barriers, and medical-staff and programmer-specific barriers.

Results

The reviewers identified 33 barriers with a frequency of 100 occurrences through the 30 articles. The study identified the issues with technically challenged staff (11%), followed by resistance to change (8%), cost (8%), reimbursement (5%), age of patient (5%), and level of education of patient (5%). All other barriers occurred at or less than 4% of the time.

Discussion and conclusions

Telemedicine is not yet ubiquitous, and barriers vary widely. The top barriers are technology-specific and could be overcome through training, change-management techniques, and alternating delivery by telemedicine and personal patient-to-provider interaction. The results of this study identify several barriers that could be eliminated by focused policy. Future work should evaluate policy to identify which one to lever to maximize the results.
The role of motivation in predicting antiretroviral therapy adherence in China
Authors: Vian Taryn , Bachman DeSilva Mary , Cabral Howard J , Williams Geoffrey C , Gifford Allen L , Zhong Li , Xie Wubin , Gill Christopher J , Sabin Lora L
Published: October 2016

Patient motivation is important in managing medication regimens such as antiretroviral treatment for HIV/AIDS. We tested whether self-determination theory could predict adherence behavior among 115 HIV-positive patients in the China Adherence through Technology Study, a randomized controlled trial of an intervention using text reminders and supportive counseling to increase adherence. Being in the treatment group had a significant effect on improving adherence; however, we did not find evidence that self-determination theory predicts adherence in this population of HIV-positive patients. Autonomous motivation was strongly associated with perceived competence; among low adherers, external regulation was negatively correlated with adherence.
Human papillomavirus vaccine information, motivation, and behavioral skills among young adult US women
Authors: Thompson Erika L , Vamos Cheryl A , Straub Diane M , Sappenfield William M , Daley Ellen M
Published: October 2016

This study elicited the information needs, motivations, and behavioral skills related to human papillomavirus vaccine decision-making among young adult women. Interviews were conducted with college women, aged 18–26 years, and stratified by recently vaccinated ( N = 25) and unvaccinated ( N = 25). Comparative thematic analysis using the Information, Motivation, and Behavioral Skills Model was conducted. Healthcare providers were identified as the most trusted sources for information. While unvaccinated women did not have experience receiving the vaccine, they reported the same procedural knowledge for vaccination. These findings suggest that young adult women have the information and procedural knowledge for human papillomavirus vaccination, but motivations may influence their decision-making.
Performance comparison of conventional and local computer room air-conditioning systems in data centres by CFD analysis
Authors: Takeuchi Jinya , Kurabuchi Takashi , Yoshino Hajime , Lee Sihwan
Published: October 2016

The maximum inlet air temperature and air recirculation ratio of information technology machines are important in evaluating the air-conditioning efficiency of data centres. In this study, evaluation models for estimating air and heat distributions were developed based on the thermal equilibrium in data centres, assuming conventional computer room air-conditioning and local computer room air-conditioning systems. The computer room air-conditioning cooling efficiency ( η-index) was defined as the ratio of the effective cooling air volume of an information technology machine to the air volume of the computer room air-conditioning system. The recirculation ratio for an information technology machine ( γ-index) was defined based on the air volume and thermal equilibrium. Several factors affecting air-conditioning efficiency, such as the mounting positions and heat load of the information technology machines and the ratio of the computer room air-conditioning system air volume to that of the information technology machine ( V/Vm-index), were analysed using computational fluid dynamics. A mismatch was confirmed between the heat recirculation ratio ( γm-index) and air recirculation ratio ( γq-index), and the effect of heat transmission by the wall could be ignored in data centres. The mean γ values and inlet air temperatures ( θ0 m-index) could be reduced effectively by increasing the value of V/Vm and mounting the information technology machines at the bottom of each rack.