bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Force Direction on the Fracture Pattern and Fracture Resistance of Canine Teeth in Dogs
Authors: Goldschmidt Stephanie , Zimmerman Catherine , Collins Caitlyn , Hetzel Scott , Ploeg Heidi-Lynn , Soukup Jason W.
Published: April 2017

Biomechanical studies of the elongated canine tooth of animals are few, and thus our understanding of mechanical and physical properties of animal teeth is limited. The objective of the present study was to evaluate the influence of force direction on fracture resistance and fracture pattern of canine teeth in an ex vivo dog cadaver model. Forty-five extracted canine teeth from laboratory beagle dogs were standardized by hard tissue volume and randomly distributed among 3 force direction groups. The teeth were secured within a universal testing machine and a load was applied at different directions based on testing group. The maximum force to fracture and the fracture pattern classification were recorded for each tooth. After correcting for hard tissue cross-sectional area in a multivariate analysis, no significant difference in the amount of force required for fracture was apparent between the different force direction groups. However, the influence of force direction on fracture pattern was significant. The results of this study may allow the clinician to educate clients on possible causal force directions in clinically fractured teeth and, thus, help prevent any contributing behavior in the future.
Lean Six Sigma in Health Operations
Authors: Yaduvanshi Deepak , Sharma Ashu
Published: April 2017

The hospitals over the last few years have been facing major issues and challenges; the patients aspire world-class health care quality delivery while state and health insurance companies demand the delivery at the lowest price. Lean which eliminates the waste and Six Sigma which decreases the variation in hospital processes are complementary quality improvement tools that can help to achieve these goals. The lean principles have been now successfully applied to the delivery of health care over the last few years. Lean management primary begins with underlying principle of eliminating waste. In order for lean methodology to be successful and able to enhance the operations the hospital must first work to create an organizational culture that is receptive to lean thinking. The commitment to start lean must start from the top management, and the junior staff must be involved. Whether manufacturing a car or delivering health care to a patient, the industry worker or health personal relies on multiple, disorganized, chaotic and complex in-built system and processes to accomplish the goal to deliver value to the customer or patient. It is a widely held dictum that once the lean principles are applied rigorously and throughout an entire organization, it can have a positive impact on productivity, cost, quality and timely delivery in a resource limited settings of Indian subcontinent. In hospital industry, the operational efficiency means rapid access to care, minimum waiting time while at the same time delivering defect free quality care at the minimum cost. We believe the Lean Six Sigma (LSS) is a panacea management philosophy to overcome the burgeoning health and hospital industry challenges.
The Native Symbols Engaging Turkish Players to Digital Games in a Playability Perspective
Authors: Aslan Alper , Coban Murat , Karakus Yilmaz Turkan , Goktas Yuksel
Published: April 2017

Background. The satisfaction of a player’s gaming experience has a great impact on their game preferences. The goal of this study was to investigate the opinions and experiences of Turkish players of computer games in order to examine the effects of native symbols on their game preferences.

Method. The data collection tools were games developed in Turkey, websites for these games, user comments made on the video records of the games, online forums, and an open-ended questionnaire.

Results. The results indicate that although native symbols from the players’ home society play a role in shaping the users’ playability perception, it cannot be argued that they change the game preferences. These results may be applied to computer games’ designs, development strategies, and advertising methods to attract all players.
Procedures of Commodification: Case Livestock Welfare
Authors: Torssonen Sami
Published: April 2017

Background. No scholarship exists on videogames that commodify, or contribute to the emergence of objects of trade. Such games are prone to become increasingly common, however, since the popularity of commodification as a policy tool is on the rise.

Purpose. A procedures of commodification approach is proposed in this article for studying how videogames commodify.

Approach. The approach is based on a combination of classical economics and Ian Bogost’s established framework for studying videogame rhetoric. The resultant framework is suitable for analyzing whether, and how, a game participates in commodity circulation and production.

Results. The approach is applied comparatively to two games on livestock welfare production and consumption.

Conclusion. The results suggest that rhetorical analysis can be fruitfully combined with systemic social theory.
Pressure Ulcers Prevalence in the Acute Care Setting: A Systematic Review, 2000-2015
Authors: Tubaishat Ahmad , Papanikolaou Panos , Anthony Denis , Habiballah Laila
Published: April 2017

Little is known about the prevalence of pressure ulcer (PrU) in acute care settings. The aim of this study is to determine the prevalence rate of PrU in acute care settings and to assess the methodological quality of the reviewed publications. The Cumulative Index to Nursing and Allied Health Literature, British Nursing Index, MEDLINE, and Cochrane Database of Systematic Reviews were searched using the keywords pressure ulcer or decubitus ulcer or bed sore or pressure sore or pressure injury, with prevalence and acute care, for studies published between January 2000 and December 2015. Nineteen publications met our criteria. These reported a prevalence range of between 7.8% and 54% for those using European Pressure Ulcer Advisory Panel methodology, 6% and 22% for those using National Pressure Ulcer Advisory Panel methodology, and 4.94% for the study that employed the Torrance system. The likely worldwide PrU prevalence rate range in acute care settings is between 6% and 18.5%. Prevalence rate varies between studies depending on the methodology of data collection. Moreover, the methodological quality of the included studies in the review was variable; therefore, it was difficult to compare the prevalence rate between the studies, settings, and countries.
A Story of Becoming: Trans* Equity as Ethnodrama
Authors: Sweet Joseph D. , Carlson David Lee
Published: April 2017

Amid today’s political climate, it becomes increasingly critical to encourage and maintain trans*1 equity practices of affirmation and recognition. While providing opportunities for hope and empathy, this article situates ethnodrama within gender theory to stage the lived experience of one female-to-male (FTM) trans* high school student. Distilled from a corpus of ethnographic interviews, this performance captures the student’s school experiences, and exchanges with his parents. Given theater possesses the potential to create empathy and affect social change, this ethnodrama attempts a novel embodiment of the layered complexities of trans* inclusion to foster pedagogies of recognition and gender equity. In this way, this performative text contributes to the burgeoning and important field of gender studies in education.
Antimethodology: Postqualitative Generative Conventions
Authors: Nordstrom Susan Naomi
Published: April 2017

In this article, I explain antimethodology—a creative and generative methodology—and its resulting research conventions that were put to work in a study about an assemblage of humans, nonhumans, living, and nonliving in family history genealogy. Antimethodology is a middle space that is created between reterritorializing forces (e.g., conventional qualitative inquiry) and deterritorializing forces (e.g., poststructural and posthuman theories that throw positivist and interpretivist theories that ground conventional qualitative inquiry into radical doubt). Antimethodology, then, cannot be replicated or transferred to other studies. Rather, each iteration of antimethodology materializes from the forces at work in a research context. I offer research conventions, or contingent meetings between these forces, as a way to rethink methods, data, and other practices within qualitative inquiry/research.
Mosaic Neurofibromatosis Type 1 in Children: A Single-Institution Experience
Authors: Lara-Corrales Irene , Moazzami Mitra , García-Romero Maria Teresa , Pope Elena , Parkin Patricia , Shugar Andrea , Kannu Peter
Published: April 2017

Background:

Neurofibromatosis type 1 (NF1) is a neurocutaneous disorder caused by loss-of-function mutation in the NF1 gene. Segmental or mosaic NF1 (MNF) is an uncommon presentation of the NF1 result of postzygotic mutations that present with subtle localised clinical findings.

Objectives:

Our study’s objectives were to describe the clinical characteristics of children with MNF.

Methods:

We conducted a cross-sectional study of children diagnosed with MNF at the Hospital for Sick Children in Toronto, Canada, from January 1992 to September 2012. Data were abstracted from health records and analysed using a standardised data collection form approved by our hospital Research Ethics Board.

Results:

We identified 60 patients with MNF; 32 of 60 (53.3%) were female. Mean ± SD age at first assessment was 10.6 ± 4.6 years. The most common initial physical manifestation in 39 of 60 (65.0%) patients was localised pigmentary changes only, followed by plexiform neurofibromas only in 10 of 60 (16.7%) and neurofibromas only in 9 of 60 (15.0%). Unilateral findings were seen in 46 of 60 (76.7%) patients. Most common associations identified included learning disabilities (7/60; 12%) and bony abnormalities (6/60; 10.0%).

Conclusions:

MNF is an underrecognised condition with potential implications for patients. Children mostly present with pigmentary anomalies only. Most patients do not develop associated findings or complications before adulthood, but long-term follow-up will help determine outcomes and possible associations. Recognition and confirmation of the diagnosis is important to provide follow-up and genetic counselling to patients.
How does video interaction guidance contribute to infant and parental mental health and well-being?
Authors: Kennedy Hilary , Ball Kevin , Barlow Jane
Published: April 2017

This article describes the contribution of video interaction guidance (VIG) to the development of infant and parental and VIG practitioners’ mental health and well-being. The theoretical core of VIG was depicted in terms of concepts such as intersubjectivity, attunement and mediated learning. The way the VIG principles alongside the underpinning values and beliefs promote a process of attunement between parent and infant, the VIG practitioner and parent, and the VIG practitioner and supervisor is described. This article also describes some of the evidence about the effectiveness of video feedback techniques more generally and the way in which the underpinning theory of change enables VIG to target key ports of entry in terms of areas that have been highlighted by numerous epidemiological studies as being important in terms of supporting or derailing infant attachment security. A case study is used to demonstrate the way in which VIG can be integrated within broader therapeutic approaches such as parent–infant psychotherapy to support the interaction of parents who have been deeply traumatised in childhood. It also demonstrates how the parallel process of practitioner ‘attunement’ to mother is key to the mother’s recovery and her new ability to form attuned relationships herself with her children and other adults.
Emerging film cultures: Spotlight on post-disaster Haiti
Authors: Posch Doris
Published: April 2017

In the past decade, a new generation of filmmakers has committed to establishing a local film market via the film school, Ciné Institute, in Jacmèl, Haiti. Film production in Haiti today, grounded in a virtually non-existent cinema historiography, is particularly challenged by the neocolonial politics following the earthquake in Haiti in 2010 and Hurricane Matthew in 2016. Via lowest-budget productions, Haiti’s filmmakers are not only contributing to new modes of translocal media production but are also attempting to create economically viable exhibition networks and subsequent distribution infrastructures on a transglobal scale. This analysis draws on the local prolificacy and global orientation of Haiti’s emerging film cultures, and demonstrates that both aspects are influenced by and intervene in the broader contexts of geo-political debates in global cinema. Finally, this study considers the extent to which Haiti contributes to new configurations of film and media cultures in the Caribbean.
Perspective on Research and Teaching in Psychology: Enrichment or Burden?
Authors: Jucks Regina , Hillbrink Alessa
Published: April 2017

In Germany, most PhD psychology students are engaged in research and teach as well. As a result, they may experience both synergy and competition between these two activities. How do PhD psychology students themselves perceive the relationship between research and teaching? And how does this perception depend on their conceptions of research and teaching? The present study assessed conceptions of teaching (student vs teacher-focused, ATI-R), conceptions of research (CoRI) and the perceived relationship between research and teaching (open-ended question) as far as 63 PhD students in psychology were concerned. The perceived relationship was represented in terms of Compatibility (Commonality vs Dissimilarity) and Valence (Enrichment vs Burden). Results showed that conceptions of teaching were decisive for the research–teaching relationship. A teacher-focused conception of teaching was associated positively with the perceived Commonality of research and teaching, but negatively with perceived Enrichment. It is concluded that conceptions of teaching provide a promising approach for studying the research–teaching relationship. Theoretical and practical implications are discussed.
Close Campus Friendships and College Student Success
Authors: Bronkema Ryan H. , Bowman Nicholas A.
Published: April 2017

Friendships are widely considered to be an essential part of life in college and beyond. The existing literature on college friendships, academic achievement, and student attrition is mixed, which may occur as a result of varying ways of defining friendship. This study adds to an understanding of these dynamics by examining both the number of close campus friends as well as the emotional connection students have with these friends within a large, multi-institutional sample. Multilevel analyses found that both of these attributes of campus friendships are positively and significantly related to six-year graduation rate, whereas only the number of close campus friends significantly predicts college grade point average.
Still Here, Writing, Trying to Be a Part of the Conversation
Authors: Pelias Ronald J.
Published: April 2017

Feeling the pervasive power of Neoliberalism with each sentence, I trace its damage to our political landscape, to our university environment, and to my sense of personal worth. The essay, cast in the negative, offers hope with its final gesture toward the dialogic.
Wireless vision-based fuzzy controllers for moving object tracking using a quadcopter
Authors: Algabri Mohammed , Mathkour Hassan , Mekhtiche Mohamed Amine , Bencherif Mohamed Abdelkader , Alsulaiman Mansour , Arafah Mohammed Amer , Ghaleb Hamid
Published: April 2017

During the last few decades, the utilization of unmanned aerial vehicles has grown in military and has seen new civil applications because of their reduced cost and hovering capabilities. This article presents a visual servoing system for detecting and tracking a moving object using an unmanned aerial vehicle. The system consists of two sequential components. The first component addresses the detection of a moving object, using the unmanned aerial vehicle based on color features. The second component addresses the visual servoing control that is designed to guide the unmanned aerial vehicle according to the target position and inclination. Three fuzzy logic modules are implemented in order to control the unmanned aerial vehicle in tracking a moving object. The proposed method is validated on a real flight using an AR.Drone 2.0 quadcopter. The obtained results show that the performance of the proposed method is suitable for object-following tasks in surveillance applications. This research investigates the use of unmanned aerial vehicle technology for crowd monitoring during Hajj and it could also be used for border surveillance to monitor Saudi Arabia’s borders.
Assessment of exposure risk from hidden fungal growth by measurements of air change rates in construction cavities and living areas
Authors: Knudsen Sofie M , Møller Eva B , Gunnarsen Lars
Published: April 2017

The transfer of particulate and gaseous pollution from hidden fungi growing on non-visible surfaces within the building envelope to occupied rooms is limited by the separating structure. Yet, growth, even in sealed construction cavities, is known to cause annoying smells and other more adverse health symptoms among the building occupants. This study analyses limitations of air change rate measurements in inaccessible construction cavities as well as analyses of the air exchange between living areas and accessible cavities such as crawl spaces and attics. It was necessary to invent a field study technique to use the tracer gas decay method in small and inaccessible cavities. This technique allowed further investigation on the exposure risk from hidden fungal growth. Assessment of the air transfer between crawl spaces and living areas indicate that the tightness of separating structure has an influence on the exposure risk.
A phase-field microscale enhancement for macro models of capillary-driven contact point dynamics
Authors: Kronbichler Martin , Kreiss Gunilla
Published: April 2017

We present a method to determine the relation between contact point velocity and contact angle, which can be used as a boundary condition for simulating immiscible and incompressible fluids in contact with solids. The relation is determined from a micro model based on the phase field method. The micro model performs a steady-state computation in a box around the contact point, with far field data given by the macroscale wall contact angle. The size of the micro box is chosen such that physical diffusive processes around the contact point are fully represented. The contact point velocity is shown to converge with respect to the size of the micro box. The angle–velocity relation determined by the micro model is verified on a parameter setting that can be represented by a full phase field simulation.
Seeing and Feeling Your Way to Accurate Personality Judgments
Authors: Colman Douglas E. , Letzring Tera D. , Biesanz Jeremy C.
Published: April 2017

Empathy, the practice of taking and emotionally identifying with another’s point of view, is a skill that likely provides context to another’s behavior. Yet systematic research on its relation with accurate personality trait judgment is sparse. This study investigated this relation between one’s empathic response tendencies (perspective taking, empathic concern, fantasy, and personal distress) and the accuracy with which she or he makes judgments of others. Using four different samples ( N = 1,153), the tendency to perspective take ( ds = .23–.27) and show empathic concern ( ds = .28–.42) were all positively related meta-analytically to distinctive accuracy, normative accuracy, and the assumed similarity of trait judgments. However, the empathic tendencies for fantasy and personal distress showed more complex patterns of relation. These findings are discussed in relation to previous literature, and in particular, why it is reasonable for empathy to be related to the accuracy of trait judgments.
Does dysfunction of the autonomic nervous system affect success of renal denervation in reducing blood pressure?
Authors: Fricke Lisa , Petroff David , Desch Steffen , Lurz Philipp , Reinhardt Sebastian , Sonnabend Melanie , Classen Joseph , Baum Petra
Published: April 2017

Objectives:

Renal denervation is an interventional approach aiming to reduce high blood pressure. Its efficacy is subject of controversial debate. We analyzed autonomic function in patients undergoing renal denervation to identify responders.

Methods:

A total of 21 patients with treatment-resistant hypertension scheduled for renal denervation were included. Heart rate variability, pupillary function and sympathetic skin response were examined prior to intervention. Before and 1 or 3 months after intervention, 24-h ambulatory blood pressure readings were taken.

Results:

Patients were stratified according to sympathetic nervous system function. Sympathetic activity was reduced in 12 participants (group 1) and normal or enhanced in nine patients (group 2). The mean of daytime systolic blood pressure decreased in groups 1 and 2 from 168 to 157 mmHg (95% confidence interval for difference, 1–21 mmHg, p = 0.035) and from 166 to 145 mmHg (8–34 mmHg, p = 0.005), respectively. In a linear model, blood pressure reduction was 11.3 mmHg (0.3–22 mmHg) greater in group 2 than in group 1 (p = 0.045).

Conclusion:

Patients with preexisting reduced activity of the sympathetic nervous system benefited less from renal denervation.
Rhetoric of civil conflict management: United Nations Security Council debates over the Syrian civil war
Authors: Medzihorsky Juraj , Popovic Milos , Jenne Erin K.
Published: April 2017

This paper introduces a spatial model of civil conflict management rhetoric to explore how the emerging norm of responsibility to protect shapes major power rhetorical responses to civil war. Using framing theory, we argue that responsibility to protect functions like a prescriptive norm, such that representing a conflict as one of (1) human rights violations (problem definition), implies rhetorical support for (2) coercive outside intervention (solution identification). These dimensions reflect the problem-solution form of a prescriptive norm. Using dictionary scaling with a dynamic model, we analyze the positions of UN Security Council members in debates over the Syrian Civil War separately for each dimension. We find that the permanent members who emphasized human rights violations also used intervention rhetoric (UK, France, and the US), and those who did not used non-intervention rhetoric (Russia and China). We conclude that, while not a fully consolidated norm, responsibility to protect appears to have structured major power rhetorical responses to the Syrian Civil War.
Work, Family, and Masculine Identity: An Intersectional Approach to Understanding Young, Black Men’s Experiences of Reentry
Authors: Panuccio Elizabeth , Christian Johnna
Published: April 2017

Through a qualitative study of the reintegration experiences of African American men, aged 18–25, we heed Fader and Traylor’s call for intersectional analyses of desistance and reentry. The current study draws from prior works to analyze the processes of “adultification” among economically disadvantaged African American young men and the impact of postincarceration employment challenges on masculine identity during young adulthood. We extend earlier research by incorporating the perspectives of family members, allowing for an in-depth examination of the processes that occur during the postrelease transition to adulthood and the complications that may emanate from families. Our findings allow us to explicate an intersectional reintegration process in light of early adultification processes, particularly relating to employment and family relationships. We highlight the overlay of adultification processes for disadvantaged youth, their subsequent offending, the multilayered and intersectional challenges of reintegration, and how they overcome these challenges. The implications for an intersectional approach to reentry are discussed.
Race, Ethnicity, and the American Criminal Justice System: The Perceptions and Experiences of West Indian Men
Authors: Robertson O. Nicholas , Adelman Robert M.
Published: April 2017

Using in-depth interview data from 30 young Black men of West Indian background, we examine their experiences with and perceptions of the American criminal justice system. Their experiences lead these men to contend that the system, especially police authorities, do not differentiate between Blacks based on ethnicity and subsequently treat West Indians and African Americans in a similar manner, that is, race trumps ethnicity. These men discuss their concerns about stereotypes of minorities, especially as they are reflected in the media, as the primary reasons for their treatment. However, these men also provide nuanced accounts in which not all system actors engage in discriminatory behavior. These accounts rest on an immigrant lens regarding criminal justice, which may indicate a more favorable outlook compared to their native-born Black counterparts. Overall, though, the interview data suggest that a Black–White divide regarding such perceptions will persist in an era of substantial sociodemographic change.
Financialization, Income Inequality, and Redistribution in 18 Affluent Democracies, 1981–2011
Authors: Hyde Allen , Vachon Todd , Wallace Michael
Published: April 2017

In recent decades, the growth of finance and rising income inequality has become a pervasive feature of the political economies in affluent capitalist democracies. This study investigates the long-run effects of financialization on three measures of income inequality—market-generated income inequality, redistribution, and state-mediated income inequality—in 18 affluent capitalist democracies from 1981 to 2011. We focus on three aspects of financialization (finance, insurance, and real estate employment; credit expansion; and financial crises). We find support for our claims that all three measures of financialization increase market-generated and state-mediated income inequality. The results for redistribution are mixed: credit expansion decreases redistribution as expected, but financial crises increase redistribution—a finding that supports the welfare state stabilization hypothesis.
A workflow to skeletonize faults and stratigraphic features
Authors: Qi Jie , Machado Gabriel , Marfurt Kurt
Published: April 2017

Improving the accuracy and completeness of subtle discontinuities in noisy seismic data is useful for mapping faults, fractures, unconformities, and stratigraphic edges. We have developed a workflow to improve the quality of coherence attributes. First, we apply principal component structure-oriented filtering to reject random noise and sharpen the lateral edges of seismic amplitude data. Next, we compute eigenstructure coherence, which highlights the stratigraphic and structural discontinuities. We apply a Laplacian of a Gaussian filter to the coherence attribute that sharpens the steeply dipping faults, attenuates the stratigraphic features parallel to the seismic reflectors, and skeletonizes the unconformity features subparallel to the reflectors. Finally, we skeletonize the filtered coherence attribute along with the fault plane. The filtered and skeletonized seismic coherence attribute highlights the geologic discontinuities more clearly and precisely. These discontinuous features can be color coded by their dipping orientation or as a suite of independent, azimuthally limited volumes, providing the interpreter a means of isolating fault sets that are either problematic or especially productive. We validate the effectiveness of our workflow by applying it to seismic surveys acquired from the Gulf of Mexico, USA, and the Great South Basin, New Zealand. The skeletonized result rejects noise and enhances discontinuities seen in the vertical and lateral directions. The corendering of the “fault” azimuth and the fault-dip magnitude exhibits the strengths of the discontinuities and their orientation. Finally, we compared our workflow with the results generated from the swarm intelligence and found our method to be better at tracking short faults and stratigraphic discontinuities.
Extranodal Marginal Zone Lymphoma: No Longer Just a Sidekick
Authors: Kamdar Manali K. , Smith Sonali M.
Published: April 2017

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A 51-year-old healthy female with good performance status presented for gynecologic surgery for a benign condition. A preprocedure chest x-ray showed a right lower lobe infiltrate. A subsequent computed tomography (CT) scan of the chest with contrast revealed a large consolidative right lower lobe mass with surrounding inflammation ( Fig 1A ). Bronchoscopy with biopsy revealed a low-grade lymphoma with the following immunophenotype: CD45+, CD20+, BCL2+, CD10 negative, CD5 negative, cyclin D1 negative, and Ki-67 index of less than 5%. Morphology and immunohistochemistry were most consistent with pulmonary extranodal marginal zone lymphoma (ENMZL; Fig 2 ). The patient was asymptomatic and denied fevers, sweats, weight loss, shortness of breath or dyspnea on exertion, or cough. Her history was notable for exposure to parrots over several months before presentation. Complete staging with a CT of the chest, abdomen, and pelvis with contrast redemonstrated disease that was localized to the chest with mild compression of the pulmonary vasculature but no other evidence of lymphoma. She was referred to discuss management of stage IAE pulmonary ENMZL lymphoma.
A Retrospective Study to Evaluate the Effect of Concentration of Hypertonic Saline on Efficacy and Safety of Epidural Adhesiolysis
Authors: Choi Eun Joo , Yoo Yong Jae , Lee Pyung Bok , Kim Yong-Chul , Lee Sang Chul , Moon Jee Youn
Published: April 2017

BACKGROUND:

Percutaneous epidural adhesiolysis (PEA) is a minimally invasive procedure that is performed to relieve low back and/or lower limb pain secondary to adhesions or scarring in the epidural space that is refractory to conservative treatment. The optimal concentration of hypertonic saline might be an important factor in the safety and efficacy of PEA. We evaluated differences in the efficacy and safety of 2 concentrations of hypertonic saline (5% and 10%) used in lumbar PEA at our institutions in a retrospective study.

METHODS:

Patients who received lumbar PEA between January 2009 and June 2014 at either of 2 large civilian teaching institutions in South Korea were assigned to the 5% or 10% groups according to the osmolality of saline. The primary outcome of this study was the difference in change in the 11-point numerical rating scale (NRS) scores of low back and leg pain from baseline to 6 months after PEA between patients in the 2 groups. The number of additional epidural injections, patients’ satisfaction with PEA, and any complications that occurred within 6 months after PEA were reviewed.

RESULTS:

This study included 543 patients (5% group, 333; 10% group, 210). Post-PEA NRS pain scores were significantly lower compared with those at baseline in both groups; however, there were no significant differences between the 2 groups at 6 months or any time point after PEA with regard to any of the clinical characteristics, except infusion-related pain, which exhibited borderline significance for greater scores in the 10% group compared with those in the 5% group (P = .041). Multivariable linear regression analysis with adjustments for covariates, including the number of additional epidural injections, revealed no significant association between patient group and the decrease in NRS pain scores at 6 months of follow-up. Transient adverse events related to PEA were recorded in 3 patients (10% group, 2; 5% group, 1).

CONCLUSIONS:

In PEA, 5% hypertonic saline exhibited similar positive outcomes after 6 months of follow-up as 10% hypertonic saline, with less infusion-related pain. This result suggests that infusion of 5% hypertonic saline may be considered as an alternative to 10% hypertonic saline in lumbar PEA. Further prospective randomized studies are required to better appreciate the outcome with regard to the use of different concentrations of hypertonic saline for PEA.
Prophylactic Pentazocine Reduces the Incidence of Pruritus After Cesarean Delivery Under Spinal Anesthesia With Opioids: A Prospective Randomized Clinical Trial
Authors: Hirabayashi Masato , Doi Katsushi , Imamachi Noritaka , Kishimoto Tomomune , Saito Yoji
Published: April 2017

BACKGROUND:

The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids.

METHODS:

We obtained institutional review board approval and written informed consent from the 122 patients (American Society of Anesthesiologists [ASA] physical status II; aged 20–40 years) scheduled for elective cesarean delivery who were included in this study. Spinal anesthesia was performed with 10 mg of 0.5% hyperbaric bupivacaine, 10 μg of fentanyl, and 100 μg of morphine. After delivery of the baby and placenta, the parturient women were randomized to intravenously receive 15 mg (1 mL) of pentazocine or 1 mL of saline. All women received postoperative analgesia with the epidural infusion of 0.15% levobupivacaine. The presence of pruritus within the first 24 hours after intrathecal administration of opioids was recorded, and severity of itch, numerical rating scale (NRS) for pain, and adverse effects were also recorded at the time of the arrival on the ward, as well as 3, 6, 12, and 24 hours after the intrathecal administration of opioids.

RESULTS:

A total of 119 women completed the study. IV pentazocine reduced the overall incidence of pruritus within the first 24 hours compared to IV saline, with an estimated relative risk of 69% (95% confidence interval [CI], 52%, 90%; P = .007). IV pentazocine also reduced the severity of pruritus. The incidence of nausea and vomiting was not significantly different. There were no significant differences in postoperative NRS scores.

CONCLUSIONS:

A single 15-mg dose of IV pentazocine after delivery can reduce both the incidence and severity of pruritus in women who have received subarachnoid opioids during cesarean delivery.
Quality Assessment of Meta-analyses Published in Leading Anesthesiology Journals From 2005 to 2014
Authors: Hall Amber M. , Lee Sandra , Zurakowski David
Published: April 2017

Meta-analysis, when preceded by a systematic review, is considered the “gold standard” in data aggregation; however, the quality of meta-analyses is often questionable, leading to uncertainty about the accuracy of results. In this study, we evaluate the quality of meta-analyses published in 5 leading anesthesiology journals from 2005 to 2014. A total of 220 meta-analyses published in Anesthesiology, Pain, British Journal of Anaesthesia, Anaesthesia, or Anesthesia & Analgesia were identified for inclusion. The quality of each meta-analysis was determined using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR). R-AMSTAR rated 11 questions related to systematic reviews and meta-analyses on a scale of 1–4, with 4 representing the highest quality. Overall meta-analyses quality was evaluated using a Spearmen regression analysis and found to positively correlate with time (rs = 0.24, P < .001). Similarly, a temporal association was found for conflict of interest (rs = 0.51, P < .001) and comprised a list of included and excluded studies (rs = 0.32, P < .001). In conclusion, the quality of meta-analyses published in leading anesthesiology journals has increased over the last decade. Furthermore, assessing the scientific quality of included studies in meta-analyses (P = .60) and using this assessment to formulate conclusions and/or recommendations (P = .67) remains relatively low (median R-AMSTAR: 2, interquartile range [IQR]: 2–3]; median R-AMSTAR: 2, IQR: 1–2, respectively).
Southern Osmanthus and Northern Pear: The Garden of Xiang Ziyin as a Site of Memory in the Writings of Southern Song Literati
Authors: Ridgway Benjamin
Published: April 2017

Taking an interdisciplinary perspective from cultural memory studies, this article examines how the garden of the northern refugee Xiang Ziyin 向子諲 (1085–1152), Aromal Arbor 薌林, became a site of memory for two generations of Southern Song literati following the collapse of the Northern Song dynasty in 1126–27. Investigating the dialogue of major figures such as Li Gang (1083–1140), Hu Hong (1105–61), Zhou Bida (1126–1204), Fan Chengda (1126–93), Lou Yue (1137–1213), and Zhu Xi (1130–1200) writing in a range of genres (shi poetry, song lyrics, personal letters, travel diaries, and the preface and postface to Xiang's collected works) on Aromal Arbor, the article concludes that the reason the space of his garden became a site of memory was due to the way it captured the tension between setting down roots and a nostalgic desire for return that defined the literati ethos of twelfth-century China during the “migration south.”
Lust as Prerequisite: Eroticism in The Story of the Stone
Authors: Wu I-Hsien
Published: April 2017

In chapter 1 of The Story of the Stone, the internal narrator notably censures erotic fiction and draws a line between his own narrative and the filthy obscenities. Yet the novel does the exact opposite. In the Stone, eroticism is not only part of a physiological act, but it is also highlighted as a narrative act, in which a network of textual and intertextual references is made to emphasize the significance of physical desire. Focusing on this network, this article examines the importance of eroticism in the making of the novel and explores how the Stone reinterprets and positions itself in the genealogy of lust.
Toward an Innovative Poetics: Wang Changling on Yi 意 And Literary Creation
Authors: Cai Zong-qi
Published: April 2017

This article reveals the coherent theory of literary creation hidden within the multivalence of the term yi in Wang Changling's (ca. 698–ca. 756) writings on poetry. A close and intertextual reading demonstrates how Wang deftly appropriates various Daoist and Daoist-inspired notions of yi 意 to illuminate different phases of literary creation. Comparisons with the term's adaptations by earlier literary and calligraphy critics further accentuate Wang's unique and innovative approach. Looking into a hitherto neglected Buddhist source, the author uncovers a Buddhicized yi-xiang-yan 意-象-言 (conception-image-word) paradigm, one that allows Wang to move beyond the theories of Lu Ji (261–303) and Liu Xie (ca. 465–ca. 522). Borrowing the Buddhist sense of yi and yishi 意識, Wang demonstrates the creative mind's receptivity to the richness and nuances of the world, followed by its dynamic transformation of what it has absorbed in quietude. The result is a much more detailed view of the different phases of the creative process—one that leads to a new appreciation of its poetic results.
Blockchain protocols in clinical trials: Transparency and traceability of consent
Authors: Benchoufi Mehdi , Porcher Raphael , Ravaud Philippe
Published: April 2017

Clinical trial consent for protocols and their revisions should be transparent for patients and traceable for stakeholders. Our goal is to implement a process allowing the collection of patients’ informed consent, which is bound to protocol revisions, storing and tracking the consent in a secure, unfalsifiable and publicly verifiable way, and enabling the sharing of this information in real time. For that, we will built a consent workflow using a rising technology called Blockchain. This is a distributed technology that brings a built-in layer of transparency and traceability. Additionally, it removes the need for third parties, and gives participative control to the peer-to-peer users. From a more general and prospective point of view, we believe Blockchain technology brings a paradigmatical shift to the entire clinical research field. We designed a Proof-of-Concept protocol consisting of time-stamping each step of the patient’s consent collection using Blockchain; thus archiving and historicising the consent through cryptographic validation in a securely unfalsifiable and transparent way. For each revision of the protocol, consent was sought again. We obtained a single document, in a standard open format, that accounted for the whole consent collection process: timestamped consent status with regards to each version of the protocol. This document cannot be corrupted, and can be checked on any dedicated public website. It should be considered as a robust proof of data. In the future, we think that the complex data flow of a clinical trial can be tracked using Blockchain. Moreover, a blockchain core functionality, named Smart Contract, can help prevent clinical trial events not to happen in the right chronological order: including patients before they consented or analysing case report forms data before freezing the database. This will help reaching reliability, security, and transparency, and could be a consistent step towards reproducibility.
Inducing death in tumor cells: roles of the inhibitor of apoptosis proteins
Authors: Finlay Darren , Teriete Peter , Vamos Mitchell , Cosford Nicholas D. P. , Vuori Kristiina
Published: April 2017

The heterogeneous group of diseases collectively termed cancer results not just from aberrant cellular proliferation but also from a lack of accompanying homeostatic cell death. Indeed, cancer cells regularly acquire resistance to programmed cell death, or apoptosis, which not only supports cancer progression but also leads to resistance to therapeutic agents. Thus, various approaches have been undertaken in order to induce apoptosis in tumor cells for therapeutic purposes. Here, we will focus our discussion on agents that directly affect the apoptotic machinery itself rather than on drugs that induce apoptosis in tumor cells indirectly, such as by DNA damage or kinase dependency inhibition. As the roles of the Bcl-2 family have been extensively studied and reviewed recently, we will focus in this review specifically on the inhibitor of apoptosis protein (IAP) family. IAPs are a disparate group of proteins that all contain a baculovirus IAP repeat domain, which is important for the inhibition of apoptosis in some, but not all, family members. We describe each of the family members with respect to their structural and functional similarities and differences and their respective roles in cancer. Finally, we also review the current state of IAPs as targets for anti-cancer therapeutics and discuss the current clinical state of IAP antagonists.
Epidemiology of adulthood drowning deaths in Bangladesh: Findings from a nationwide health and injury survey
Authors: Hossain Mohammad Jahangir , Biswas Animesh , Mashreky Saidur Rahman , Rahman Fazlur , Rahman Aminur
Published: April 2017

Background: Annual global death due to drowning accounts for 372,000 lives, 90% of which occur in low and middle income countries. Life in Bangladesh exposes adults and children to may water bodies for daily household needs, and as a result drowning is common. In Bangladesh, due to lack of systemic data collection, drowning among adults is unknown; most research is focused on childhood drowning. The aim of the present study was to explore the epidemiology of adulthood drowning deaths in Bangladesh.

Methodology: A nationwide cross-sectional survey was conducted from January to December in 2003 among 171,366 rural and urban households, with a sample of 819,429 individuals to determine the epidemiology of adulthood drowning in Bangladesh.  

Results:  Annual fatal drowning incidence among adults was 5.85/100,000 individuals. Of these, 71.4% were male and 28.6% were female (RR 2.39). In total, 90% of the fatalities were from rural areas. Rural populations were also found to have a 8.58 times higher risk of drowning than those in urban areas. About 95% of drowning occurred in natural water bodies. About 61.6% of the deaths occurred at the scene followed by 33.5% at the home. Of the drowning fatalities, 67% took place in water bodies within 100 meters of the household. Among the drowning fatalities 78.4% occurred in daylight between 7.00 and 18.00. Over 97% of the victims were from poor socio economic conditions with a monthly income tk. 6,000 ($94) or less. Only 25.5% of incidences were reported to the police station.

Conclusions: Every year a significant number of adults die due to drowning in Bangladesh.  Populations living in rural areas, especially men, were the main victims of drowning. This survey finding might help policy makers and scientists to understand the drowning scenario among adults in Bangladesh.
Arkas: Rapid reproducible RNAseq analysis
Authors: Colombo Anthony R. , J. Triche Jr Timothy , Ramsingh Giridharan
Published: April 2017

The recently introduced Kallisto pseudoaligner has radically simplified the quantification of transcripts in RNA-sequencing experiments.  We offer cloud-scale RNAseq pipelines Arkas-Quantification, which deploys Kallisto for parallel cloud computations, and Arkas-Analysis, which annotates the Kallisto results by extracting structured information directly from source FASTA files with per-contig metadata and calculates the differential expression and gene-set enrichment analysis on both coding genes and transcripts. The biologically informative downstream gene-set analysis maintains special focus on Reactome annotations while supporting ENSEMBL transcriptomes. The Arkas cloud quantification pipeline includes support for custom user-uploaded FASTA files, selection for bias correction and pseudoBAM output. The option to retain pseudoBAM output for structural variant detection and annotation provides a middle ground between de novo transcriptome assembly and routine quantification, while consuming a fraction of the resources used by popular fusion detection pipelines.  Illumina's BaseSpace cloud computing environment, where these two applications are hosted, offers a massively parallel distributive quantification step for users where investigators are better served by cloud-based computing platforms due to inherent efficiencies of scale.