bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Device for the Evacuation of Cerumen
Authors: Katzenell Udi , Halperin Doron , Dahan Tzofit , Bartov Noam
Published: March 2019

Objectives:

The aim of this study was to assess a new device designed to safely remove cerumen from the external auditory canal in an office setting with minimal training.

Methods:

The research was conducted in the Department of Otolaryngology at Kaplan Medical Center in Israel. Patients with cerumen were treated with the device. Efficacy, safety, and pain were evaluated using scales developed for this experiment. The cerumen obstruction scale (0-5) was assessed before and after the procedure. Improvement by 2 or more grades was considered to indicate at successful procedure.

Results:

Fifty-nine ears in 46 patients were treated. Seventeen patients (37%) had recurrent cerumen impaction, and 14 (30.4%) used cotton swabs frequently. Fifty-two ears (88%) had hard cerumen. The procedure was successful in 51 ears (86.4%). In 48 ears (81%) there was no pain or mild pain, and in 11 ears (19%), the patient reported the procedure to be uncomfortable. Seven patients (15.2%) asked to abort the procedure because of discomfort or pain. In 39 ears (66%), the cerumen was evacuated easily. Inspection after the procedure revealed no injury in 56 ears (95%). Three ears (5%) had mild irritation of the ear canal, and none had injury to the tympanic membrane. Median length of the procedure was 30 ± 42.1 seconds (range, 2-240 seconds). The median number of insertions of the device in 1 procedure was 2 (range 1-7; SD, 1.3).

Conclusions:

The tested device is an effective and safe device for the evacuation of cerumen. It can be used by general practitioners, pediatricians, and audiologists.
Airway Biopsy Results From Patients With Suspected Granulomatosis With Polyangiitis (2005-2015): Clinicopathological Correlation and Proposal of an Algorithm to Improve Diagnosis
Authors: Echeagaray Héctor , Tona Gabriel , Rivera-Rosales Rosa María , Ruiz Natllely , Castorena-Maldonado Armando , Flores-Suárez Luis Felipe
Published: March 2019

Objectives:

The aim of this study was to review the histologic diagnostic yield of airway biopsies with a suspected granulomatosis with polyangiitis (GPA) diagnosis at a single center devoted to respiratory diseases using previously published criteria. A secondary aim was to apply the algorithm proposed by the European Medicines Agency to determine whether more biopsies were confidently identified as having GPA diagnoses.

Methods:

From a total of 132 airway biopsies (2005-2015), 50 were randomly selected for second review by an expert pathologist, and previously published criteria were applied. Thereafter, antineutrophil cytoplasm autoantibody testing results and the European Medicines Agency algorithm were applied.

Results:

Repeat review and application of the published criteria resulted in an increase from 16 to 25 diagnoses of GPA. This increased to 35 of 50 when antineutrophil cytoplasm autoantibody results and the European Medicines Agency algorithm were applied. Interobserver correlation was 57.5% among pathologists (κ = 0.19), which was likely due to missing clinical information and inadequate tissue samples. Patients with generalized disease were 2.6 times more likely to obtain diagnostic GPA airway biopsy results than those with limited disease (airway only).

Conclusions:

An increase in the diagnostic yield of this malady could be attained by following an algorithm that incorporates carefully retrieved clinical, endoscopic, and serologic data, coupled with systematic histopathologic sample review.
Sentencing Departures and Female Defendants: Assessing the Effects of Racial and Ethnic Threat
Authors: Warren Patricia Y. , Cochran Joshua , Shields Ryan T. , Feldmeyer Ben , Bailey Caroline , Stewart Eric A.
Published: March 2019

Prior research exploring the effects of racial and ethnic threat has largely focused on the threat posed by minority males, with little attention devoted to understanding how threat accounts for variations in punishment among racial and ethnic female defendants. Using 2003-2012 data from Florida sentencing guidelines, we examine the odds of receiving an upward and downward departure among racial and ethnic females. The results suggest that Black and Latino females sentenced in counties with larger Black populations are more likely to receive an upward departure. However, in counties with larger Latino populations, the likelihood of an upward departure decreases for Blacks and Latinos. In addition, racial and ethnic population sizes do not significantly influence the odds of a downward departure.
In-situ damage assessment of a novel carbon/flax/epoxy hybrid composite under tensile and compressive loading
Authors: Al-Hajaj Zainab , Sarwar Ahmed , Zdero Radovan , Bougherara Habiba
Published: March 2019

Damage under progressive load–unload until failure was assessed for a new woven carbon fibre/flax fibre/epoxy hybrid composite via stiffness degradation D, permanent strain [Formula: see text], and crack density [Formula: see text]. Type A configuration had woven carbon fibres and unidirectional flax fibres (i.e. [0–90C2/0F12/0–90C2]), while Type B configuration had woven carbon fibres and ±45 ° obliquely angled flax fibres (i.e. [0–90C2/(±45)F6S/0–90C2]. Results were obtained for D in tension (Type A, 0.080; Type B, 0.089) and compression (Type A, 0.178; Type B, 0.207), [Formula: see text] in tension (Type A, 0.085%; Type B, 0.075%) and compression (Type A, 0.086%; Type B, 0.086%), and [Formula: see text] in tension (Type A, range = 0.12–1.06%; Type B, range = 0.6–1.43%) and compression (Type A, range = 0.65–1.20%; Type B, range = 1.05–2.20%). Failure involved flax fibre bundle cracks and interfacial cracks in the flax fibre/epoxy region.
Analysis of the Effect of the Elderly’s Labor Status on Care Cost at the End of Life
Authors: Kim Eun-Jung , Yoon Seok-Jun , Kim Young-Eun , Go Dunsol , Jung Yunsun , Radnaabaatar Munkhzul
Published: March 2019

This study quantitatively analyzes the effects of employment patterns at the time of death of the elderly on the utilization of medical care before death using the cohort data from the National Health Insurance Corporation, controlling mortality to obtain more accurate results. Gender was coded as 0 for males and 1 for females, and average monthly household income was taken as a logarithm to approximate a normal distribution. Care cost at the end of life was defined as the sum of the national health insurance contributions and statutory self-contributions. To measure proximity to death, deceased elderly were divided by the period from last hospital visit to death (except any hospital visit at time of death). We distinguished regular workers, irregular workers, self-employed and employers, unpaid family workers, and unemployed. The data used in this study are sample cohort data from the National Health Insurance Corporation. We examined the relationships between variables through 4 models using negative binomial regression. The effects of employment status on health status were analyzed and adjusted for demographic characteristics, socioeconomic status, and proximity to death. As the dependent variable, medical expenses were taken for 1 year before death. In this study, care costs at end of life were higher when children were economically independent and when the respondent was more educated, had high economic level, and had high average monthly household income. In addition, employment security also had a significant impact on care cost at end of life: Irregular workers spent significantly less than regular workers. The fact that care cost at end of life is differentiated according to employment status suggests that individuals’ health exists within a social context, which may also constrain it: There is a risk that people’s health status will become determined by socioeconomic status.
Depression, anxiety, and attachment among women hospitalized on an antepartum unit
Authors: Nagle-Yang Sarah , Phillips MacKenzie , Albaugh Avril , Zhao Lulu , Amin Jaina , Ahmad Erum , Hatters Friedman Susan
Published: March 2019

Objective

To examine the prevalence of depression, anxiety, attachment issues, and associated factors among pregnant women hospitalized on an antepartum unit.

Method

Ninety-eight women hospitalized on an antepartum unit reported demographic and social information and were evaluated with screening tools for depression, anxiety, and maternal–fetal attachment. Data were analyzed using descriptive statistics and logistical regression analysis.

Results

Over one third (36%) of participants screened at risk for depression. Almost half (47%) reported elevated state anxiety and over one third (37%) reported elevated trait anxiety. Depression and anxiety were frequently comorbid. Positive screens for depression and anxiety were associated with decreased maternal-fetal attachment. Those who screened at risk for depression and anxiety in this sample often had a personal or family history of depression or anxiety or a history of intimate partner victimization. Substance use was common among those with elevated anxiety. Only a minority (15%) of at-risk participants had been referred to mental health treatment.

Conclusions

Women hospitalized on antepartum units had an elevated risk of depression and anxiety. Depression and anxiety were strongly comorbid in this population. Screening efforts to increase detection of perinatal depression and anxiety are recommended on obstetrical antepartum units.
Agreement Between Courts and SVP Evaluators in the State of Wisconsin
Authors: Elwood Richard W.
Published: March 2019

The study compares agreement between Department of Health Services (DHS) evaluator’s opinions and court decisions in all 132 sexually violent person (SVP) trials in Wisconsin from 2012 through 2016. Previous research on mock jurors in simulated SVP cases may not extend to real-world SVP legal proceedings. This is the first study to directly compare evaluator opinions with court decisions in actual SVP commitment cases. Trial courts found 81% of participants to be an SVP (SVP+). Courts agreed with the DHS evaluator’s opinion in 67% of the cases, which represents slight to fair agreement beyond chance. Trial courts agreed with evaluators’ SVP+ opinions far more than they did with evaluators’ SVP– (not SVP) opinions. The rates of SVP+ opinions differed widely among DHS evaluators. The implications for public policy and forensic practice are discussed.
Systematic Review of Human Trafficking Educational Interventions for Health Care Providers
Authors: Fraley Hannah E. , Aronowitz Teri , Stoklosa Hanni M.
Published: March 2019

Human trafficking is a global population health threat. Trafficking minors threatens the safety and well-being of youth. Limited studies measure health care providers’ awareness and attitudes toward trafficking. This systematic review synthesized retrospective and current knowledge and identified gaps in educational interventions aimed at increasing providers’ awareness and attitudes toward trafficking. A systematic search of four databases identified peer-reviewed published papers between January 1, 2000 and September 1, 2018. The Cochrane Collaboration’s Preferred Reporting Items for Systematic Reviews was followed. Study quality was assessed using the Downs and Black checklist. The Psychometric Grading Framework was used to assess the validity of instruments. Findings across studies ( N = 7) reveal providers (mostly social workers and physicians) have low awareness of trafficking and can have negative attitudes toward victims. Multiphase educational approaches and use of content experts, including survivors, in developing interventions enhanced sustainability of outcomes. Targeting multidisciplinary health care teams, including nurses, enhanced interventions.
Participatory water conservation education on social media in Amathole District local municipalities, Eastern Cape, South Africa
Authors: Hove Charity , Osunkunle Oluyinka Oludolapo
Published: March 2019

Social media has been attributed as beneficial by aiding fast and reliable communication which cuts across time and geographical boundaries. In South Africa, reports indicate that most people have access to social media. Such attributes can be harnessed by municipalities to educate about water conservation, especially considering the drought and water crisis that was experienced in Eastern Cape, South Africa. This paper focused on local municipalities in Amathole District in the Eastern Cape Province, which was declared a high risk zone due to the drought that prevailed in 2016 till 2017. The Government to Citizen Model (G2C) was used as a theoretical framework which supports participation. Purposive sampling was used, with water messages being prioritised. Qualitative content analysis was used to analyse content on the local municipalities’ social media platforms. The researchers found that local municipalities in Amathole District, excluding the district municipality, were not using social media platforms for participatory water conservation education.
Morphologically induced stability on an underwater legged robot with a deformable body
Authors: Picardi Giacomo , Hauser Helmut , Laschi Cecilia , Calisti Marcello
Published: March 2019

For robots to navigate successfully in the real world, unstructured environment adaptability is a prerequisite. Although this is typically implemented within the control layer, there have been recent proposals of adaptation through a morphing of the body. However, the successful demonstration of this approach has mostly been theoretical and in simulations thus far. In this work we present an underwater hopping robot that features a deformable body implemented as a deployable structure that is covered by a soft skin for which it is possible to manually change the body size without altering any other property (e.g. buoyancy or weight). For such a system, we show that it is possible to induce a stable hopping behavior instead of a fall, by just increasing the body size. We provide a mathematical model that describes the hopping behavior of the robot under the influence of shape-dependent underwater contributions (drag, buoyancy, and added mass) in order to analyze and compare the results obtained. Moreover, we show that for certain conditions, a stable hopping behavior can only be obtained through changing the morphology of the robot as the controller (i.e. actuator) would already be working at maximum capacity. The presented work demonstrates that, through the exploitation of shape-dependent forces, the dynamics of a system can be modified through altering the morphology of the body to induce a desirable behavior and, thus, a morphological change can be an effective alternative to the classic control.
Characterization and predictive mechanisms of experimentally induced tension-type headache
Authors: Exposto Fernando Gustavo , Bendixen Karina H , Ernberg Malin , Bach Flemming Winther , Svensson Peter
Published: March 2019

Objective

Studies have shown it is possible to elicit a tension-type headache episode in 15 to 30% of healthy individuals following a tooth-clenching or stress-inducing task. Despite this, no studies have attempted to understand why some healthy individuals develop a headache episode while others do not.

Methods

The present randomized, single-blind, controlled study recruited 60 healthy participants who participated in a 30-minute tooth-clenching task and 10 participants who participated in a control task. Before the tasks, participants had their pericranial tenderness and pain modulation profiles (wind-up ratio and conditioned pain modulation) assessed. Two hours later, pericranial tenderness and pressure pain thresholds were assessed as well as any developing temporomandibular disorders. Pain diaries were kept for 24 hours to register any developing pain or headache.

Results

Participants with a decrease in pericranial tenderness after the tooth-clenching task were less likely to develop headache when compared to participants without. Pain modulation profiles could not predict who developed headache and who did not. Finally, no difference was found between groups for developing temporomandibular disorders. No difference in frequency of participants who developed headache was found between the tooth-clenching and the control task.

Conclusions

In conclusion, it was shown that increased pericranial tenderness was not required to trigger an episode of tension-type headache in healthy participants. Furthermore, pain modulation profiles could not predict who developed headache and who did not. Finally, activation of descending inhibitory pathways, as assessed by decreases in pericranial tenderness, was protective against the development of headache. These findings provide new insights into the pathophysiology of experimentally-induced tension-type headache.
Educational approaches for improving physicians’ use of health information technology
Authors: Shachak Aviv , Randhawa Gurprit K. , Crampton Noah H.
Published: March 2019

The benefits of Health Information Technology (HIT) depend on the way they are being used. Education and training are often needed to move from basic to advanced, value-adding, use. In this article, we describe three educational approaches that can help in achieving this goal: “productive failure,” video tutorials, and simulation. We describe the rationale behind these approaches, their strengths, and limitations and illustrate their application, respectively, to three problems associated with the use of HIT in clinical practice: improving data quality within Electronic Medical Records (EMRs) at the point of data entry, use of advanced EMR features for chronic disease management, and impact of the EMR on patient-clinician communication. We conclude that, while these approaches are promising, there is a need for innovation and diversity of educational approaches to address use of advanced HIT features, identified challenges with HIT, and usage in context—as well as for rigorous evaluation.
Variations in Emotional, Sexual, and Physical Intimate Partner Violence Among Women in Uganda: A Multilevel Analysis
Authors: Amegbor Prince M. , Pascoe Laura
Published: March 2019

Evidence shows that a significant proportion of ever-partnered women suffer some form of intimate partner violence (IPV) perpetuated by male partners. The prevalence of IPV in sub-Saharan African countries is considerably higher than global estimates. Although existing studies show the effect of women’s and intimate male partner’s characteristics on IPV, knowledge on how these factors increase or reduce women’s risk to specific types of IPV is limited. Using the 2016 Ugandan Demographic and Health Survey (UDHS), we examine regional variations in women’s and intimate male partner’s characteristics and their effect on emotional, sexual, and physical violence perpetuated by men and experienced by women in Uganda. The result shows that women’s educational status is a significant predictor of all forms of IPV, whereas other characteristics, such as employment and housing ownership, have differential effects on specific types of IPV. Less educated women were more likely to experience emotional, sexual, and physical violence. Alcohol abuse was a significant determinant of men perpetuating all types of IPV; other male characteristics had differential effects on specific types of IPV. Male partners who abuse alcohol “often” and “sometimes” were more likely to commit acts of emotional, sexual, and physical violence against their female intimate partners. The findings also show that ~5%, ~8%, and ~2% of the variance in emotional, sexual, and physical violence (respectively; in the final models) are attributable to regional differences. The findings suggest the need for interventions aimed at increasing women’s access to higher education, working with men and boys to reduce the occurrence of alcohol abuse and address harmful constructions of masculinity, and promoting gender equality among men as well as women.
Registered Apprenticeship and Career Advancement for Low-Wage Service Workers
Authors: Kuehn Daniel
Published: March 2019

Registered apprenticeship is a time-tested approach to building technical skills through a combination of classroom and closely supervised on-the-job training. This study explores the growth of registered apprenticeship in service occupations over the past two decades and uses administrative data on registered apprentices to identify the factors associated with successful program completion and exit wage growth. Key program characteristics vary across different service occupations, but shorter apprenticeship programs operated by single employers working jointly with a union seem to be consistently associated with higher completion rates. Partnerships with community colleges fail to generate higher completion rates, although for many service occupations these partnerships are associated with higher exit wages.
A new strategy to estimate static loads for the dynamic weighing in motion of railway vehicles
Authors: Mosleh Araliya , Costa Pedro Alves , Calçada Rui
Published: March 2019

The present paper focuses on the numerical modeling of a weigh-in-motion system developed with the purpose of assessing the static loads imposed by the train onto the track infrastructure. Weigh-in-motion systems would be useful in overcoming the disadvantages typical of the conventional static weighing such as costs and traffic management. However, contrary to the conventional static weighing, weigh-in-motion systems do not allow a direct measurement of the static load since the train–track dynamic interaction gives rise to dynamic loads that are added to the static ones. This study investigates how train speed and track unevenness affect the loads assessed by the weigh-in-motion system. In order to achieve that goal, a comprehensive statistical study was performed based on an extensive amount of calculations. Finally, based on the conclusions and trend identified through the comprehensive parametric study, an approach is proposed to correct the direct result given by the weigh-in-motion system in order to obtain an estimation of the static load.
Mechanical and thermal damage in cortical bone drilling in vivo
Authors: Zhang Yue , Xu Linlin , Wang Chengyong , Chen Zhihua , Han Shuai , Chen Bin , Chen Jacky
Published: March 2019

Recently, the failure rate of fracture fixation to fractured bone has increased. Mechanical and thermal damage to the bone, which influences the contact area and cell growth between the bone and the screw, is the primary reason for fixation failure. However, research has mainly focused on force and temperature in bone drilling. In this study, the characteristics of hole edges, microcracks, empty lacunae, and osteon necrosis were investigated as viewed in the transverse and longitudinal sections after drilling. Drilling force and temperature were also recorded for comparing the relationship with mechanical and thermal damage. Experiments were conducted in vivo using five different drill geometries under the same drilling parameters. Characteristics of the hole wall were detected using computed tomography. Microcracks and necrosis were analyzed using the pathological sectioning method. The maximum microcrack was approximately 3000 and 1400 μm in the transverse section and longitudinal section, respectively, which were much larger than those observed in previous studies. Empty lacuna and osteon necrosis, starting from the Haversian canal, were also found. The drill bit geometry, chisel edge, flute number, edges, and steps had a strong effect on bone damage, particularly the chisel edge. The standard and classic surgical drill caused the greatest surface damage and necrosis of the five drill bit geometries studied. The microstructural features including osteons and matrix played an important role in numbers and length of microcracks and necrosis. More microcracks were generated in the transverse direction, while a greater length of the empty lacuna was generated in the longitudinal direction under the same drilling parameters. Microcracks mainly propagated in a straight manner in and parallel to the interstitial bone matrix and cement line. Drilling forces were not directly correlated with bone damage; thus, hole performance should be considered to evaluate the superiority and inferiority of drill bits rather than the drill force alone.
Analytic Versus Computational Cognitive Models: Agent-Based Modeling as a Tool in Cognitive Sciences
Authors: Madsen Jens Koed , Bailey Richard , Carrella Ernesto , Koralus Philipp
Published: March 2019

Computational cognitive models typically focus on individual behavior in isolation. Models frequently employ closed-form solutions in which a state of the system can be computed if all parameters and functions are known. However, closed-form models are challenged when used to predict behaviors for dynamic, adaptive, and heterogeneous agents. Such systems are complex and typically cannot be predicted or explained by analytical solutions without application of significant simplifications. In addressing this problem, cognitive and social psychological sciences may profitably use agent-based models, which are widely employed to simulate complex systems. We show that these models can be used to explore how cognitive models scale in social networks to calibrate model parameters, to validate model predictions, and to engender model development. Agent-based models allow for controlled experiments of complex systems and can explore how changes in low-level parameters impact the behavior at a whole-system level. They can test predictions of cognitive models and may function as a bridge between individually and socially oriented models.
Sense and Nonsense: Teaching Journalism and Science Students to Be Advocates for Science and Information Literacy
Authors: Reed Katherine , Hiles Sara Shipley , Tipton Peter
Published: March 2019

Long before “fake news” became a catchphrase, misguided beliefs about scientific truths undermined the free exercise of democracy and personal decision-making. Journalistic norms such as providing false balance in the name of “objectivity,” deliberate manipulation by vested interests, and the human tendency toward confirmation bias combined to enable the dissemination of damaging misinformation about tobacco, climate change, vaccines, nuclear power, genetically modified foods, and other topics critical to the health and welfare of the modern world. This article examines an innovative new course designed to teach a mixed group of journalism and science, technology, engineering and mathematics (STEM) majors to evaluate expertise and bias, examine data and misrepresentation, and develop evidence-based communication on complex scientific topics. The course covered concepts such as fact-checking, validation, fraud, the “backfire effect,” confirmation bias, limitations of the scientific method, conspiracy theories, misuse of statistics, and the role of journalists and scientists as truth-tellers in society. Journalism and science students learned to communicate with each other and with their respective audiences. A series of critical thinking assignments culminated in a final project where students, working in mixed teams, developed an interactive multimedia project communicating a controversial science topic to the public. This interdisciplinary course is offered as one model for teaching science literacy and information literacy to journalism and STEM students.
Psychosocial Burden of Undiagnosed Persistent ADHD Symptoms in 12-Year-Old Children: A Population-Based Birth Cohort Study
Authors: Okumura Yasuyuki , Yamasaki Syudo , Ando Shuntaro , Usami Masahide , Endo Kaori , Hiraiwa-Hasegawa Mariko , Kasai Kiyoto , Nishida Atsushi
Published: March 2019

Objective: To describe the psychosocial functioning in children with undiagnosed persistent ADHD symptoms. Method: A prospective, population-based birth cohort study was conducted among 2,945 children and their primary caregivers who lived in Tokyo, Japan, and were followed up at the age of 10 years and 12 years. Parents reported a history of ADHD diagnosis and completed the Strengths and Difficulties Questionnaire. Results: Overall, 91 participants had persistent ADHD symptoms; however, 76 (83.5%) had no history of an ADHD diagnosis. The presence of undiagnosed ADHD symptoms was significantly associated with worse psychosocial functioning for most continuous outcomes when compared with the absence of ADHD symptoms and diagnosis, including lower self-esteem (standardized mean difference [SMD] = −0.31) and higher depression (SMD = 0.36), emotional symptoms (SMD = 0.69), conduct problems (SMD = 1.26), and peer relationship problems (SMD = 0.98). Conclusion: Our findings suggest the importance of paying more attention to the possible underdiagnosis of ADHD in children.
Absence of Distinct Immunohistochemical Distribution of Annexin A5, C3b, C4d, and C5b-9 in Placentas From Patients With Antiphospholipid Antibodies, Preeclampsia, and Systemic Lupus Erythematosus
Authors: Matrai Cathleen E , Rand Jacob H , Baergen Rebecca N
Published: March 2019

Introduction

In pregnancy, the presence of preeclampsia (PEC), systemic lupus erythematosus (SLE), and/or antiphospholipid antibody syndrome (APLS) is characterized by poor obstetric outcomes, with potential adverse effects for both mother and fetus. Although the histopathologic changes observed in these entities have been well established, the pathogenic mediators associated with tissue injury are poorly understood.

Methods

Forty placentas were evaluated, including 10 patients with preeclampsia, 9 with SLE, 11 with APLS, and 10 disease-free controls. Each case was subjected to a panel of immunohistochemical markers including C3b, C4d, Annexin A5, and C5b-9. Staining was graded on intensity and distribution.

Results

C4d staining was distinctly different among disease groups and controls. Moreover, 6/10 PEC cases, 3/9 SLE cases, and 4/11 APLS cases showed at least focal staining for C4d. All controls were negative. Annexin A5 (AnxA5) staining showed intrinsic variability in all disease groups, while 10/10 controls showed diffuse, strong staining (2+ or 3+). C3b staining was heterogeneous among groups.

Discussion

Previously, antiphospholipid antibody (aPLA)-associated pregnancy complications have been thought to be a consequence of a unique aPLA-mediated pathogenic mechanism. However, the immunohistochemical similarity (increased complement and decreased AnxA5 staining) observed in placentas from patients with APLS, PEC, and SLE suggests that aPLA-associated pregnancy complications may reflect a more general autoimmune mechanism.
Development and validation of the Child Welfare Provider Stigma Inventory
Authors: Kennedy Stephanie C , Miller Carmella , Wilke Dina
Published: March 2019

An initial validation of the Child Welfare Provider Stigma Inventory is reported. The Child Welfare Provider Stigma Inventory assesses stigmas held by child welfare professionals toward clients on three domains: Attitudes, Behavior, and Coworker Influence.

Methods

Initial validation of the Child Welfare Provider Stigma Inventory was conducted with a sample of 360 child welfare professionals in Florida. Scale conceptualization and development, content validation, and construct validation measures are discussed.

Findings

Preliminary psychometrics indicated good model fit for a three factor multidimensional scale. Racial differences emerged and subgroup models were also validated. Reliabilities were moderate to strong; the global stratified α was .89. Evidence of construct validity supported hypotheses about the accuracy of underlying constructs.

Conclusions

The Child Welfare Provider Stigma Inventory appears to be a reliable and valid measure of provider stigma.

Applications

The Child Welfare Provider Stigma Inventory may be useful for agency climate assessment and quality improvement initiatives, as well as for in-service training and social work education.
Numerical study on combustion characteristics of six-stroke-cycle gasoline compression ignition engine with continuously variable valve duration valve technology
Authors: Rajput Oudumbar , Ra Youngchul , Ha Kyoung-Pyo , Son You-Sang
Published: March 2019

Engine performance and emissions of a six-stroke gasoline compression ignition engine with a wide range of continuously variable valve duration control were numerically investigated at low engine load conditions. For the simulations, an in-house three-dimensional computational fluid dynamics code with high-fidelity physical sub-models was used, and the combustion and emission kinetics were computed using a reduced kinetics mechanism for a 14-component gasoline surrogate fuel. Variation of valve timing and duration was considered under both positive valve overlap and negative valve overlap including the rebreathing of intake valves via continuously variable valve duration control. Close attention was paid to understand the effects of two additional strokes of the engine cycle on the thermal and chemical conditions of charge mixtures that alter ignition, combustion and energy recovery processes. Double injections were found to be necessary to effectively utilize the additional two strokes for the combustion of overly mixed lean charge mixtures during the second power stroke. It was found that combustion phasing in both power strokes is effectively controlled by the intake valve closure timing. Engine operation under negative valve overlap condition tends to advance the ignition timing of the first power stroke but has minimal effect on the ignition timing of second power stroke. Re-breathing was found to be an effective way to control the ignition timing in second power stroke at a slight expense of the combustion efficiency. The operation of a six-stroke gasoline compression ignition engine could be successfully simulated. In addition, the operability range of the six-stroke gasoline compression ignition engine could be substantially extended by employing the continuously variable valve duration technique.
Fine-grained access control method for private data in android system
Authors: Liu Gang , Zhang Guofang , Wang Quan , Ji Shaomin , Zhang Lizhi
Published: March 2019

In Android systems, sensitive information associated with system permission is exposed to the application completely once it gains the permission. To solve this problem, this article presents a fine-grained access control framework for sensitive information based on eXtensible Access Control Markup Language data flow model. In this framework, a user can define access policies for each application and resource and the application’s access request to sensitive information is evaluated by these policies. Therefore, all access requests must comply with the security policy irrespective of whether they have gained the permission associated with the information. This helps to protect sensitive data outside the Android permission mechanism. In order to facilitate users to manage policies, the proposed framework implements automatic policy generation and policy conflict detection functions. The framework is implemented in TaintDroid and experiments indicate that the improvement is effective in achieving fine-grained access control to sensitive information and does not adversely affect the system overhead costs.
Supercharge End-to-Side Nerve Transfer: Systematic Review
Authors: Dunn John C. , Gonzalez Gilberto A. , Fernandez Isaac , Orr Justin D. , Polfer Elizabeth M. , Nesti Leon J.
Published: March 2019

Background: To decrease the time to reinnervation of the intrinsic motor end plates after high ulnar nerve injuries, a supercharged end-to-side (SETS) anterior interosseous to ulnar motor nerve transfer has been proposed. The purpose of this study was to compile and review the indications, outcomes, and complications of SETS anterior interosseous to ulnar motor nerve transfer. Methods: A literature search was performed, identifying 73 papers; 4 of which met inclusion and exclusion criteria, including 78 patients. Papers included were those that contained the results of SETS between the years 2000 and 2018. Data were pooled and analyzed focusing on the primary outcomes: intrinsic muscle recovery and complications. Results: Four studies with 78 patients met inclusion and exclusion criteria. Most patients (33.3%) underwent SETS for an ulnar nerve lesion in continuity, the average age was 46.5 years, and the average follow-up was 10 months. The average duration of symptoms before surgery was 99 weeks, all patients had weakness and numbness, nearly all (96%) had atrophy, and half (53%) had pain. Grip and key pinch strength improved 202% and 179%, respectively, from the preoperative assessment. The vast majority (91.9%) recovered intrinsic function at an average of 3.7 months. Other than 8% of patients who did not recover intrinsic strength, no other complications were reported in any of the 78 patients. Conclusions: The SETS is a successful procedure with low morbidity, which may restore intrinsic function in patients with proximal nerve injuries.
A free gait controller designed for a heavy load hexapod robot
Authors: Zha Fusheng , Chen Chen , Guo Wei , Zheng Penglong , Shi Junyi
Published: March 2019

As macroscopic rough terrains are time varying and full of local topographic mutations, stable locomotions of legged robots moving through such terrains in a fixed gait form can be hardly obtained. This problem becomes more severe as the size and weight of the robot increase. An ideal pre-planned gait changing method can also be hardly designed due to the same limitations. Aiming to solve the problem, a new kind of free gait controller applied to a large-scale hexapod robot with heavy load is developed. The controller consists of two parts, a free gait planner and a gait regulator. Based on the observed macro terrain changes, the free gait planner adopts the macro terrain recognition method and the status searching method for selecting the best leg support status automatically. The gait regulator is adopted for the correction of the selected status to cope with local topographic mutations. Detailed simulation experiments are presented to demonstrate that, with the designed controller, the adopted hexapod robot can change moving gaits automatically in terms of the terrain conditions and obtain stable locomotions through rough terrains.
Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction
Authors: Campbell Jeffrey D. , Trock Bruce J. , Oppenheim Adam R. , Anusionwu Ifeanyichukwu , Gor Ronak A. , Burnett Arthur L.
Published: March 2019

Background:

The aim of this study was to perform a meta-analysis of randomized controlled trials (RCTs) that evaluate the efficacy of low-intensity extracorporeal shock wave therapy (LiESWT) for the treatment of erectile dysfunction (ED).

Materials and methods:

A comprehensive search of PubMed, Medline, and Cochrane databases was performed from November 2005 to July 2018. RCTs evaluating efficacy of LiESWT in the treatment of ED were selected. The primary outcomes were the mean difference between treatment and sham patients in the International Index of Erectile Function-Erectile Function (IIEF-EF) domain score 1 month after treatment, and the mean change in IIEF-EF from baseline to 1 month post-treatment. The secondary analysis considered the percentage of men whose erectile hardness score (EHS) changed from <2 at baseline to >3 after treatment. All analyses used a random effects method to pool study-specific results.

Results:

A total of seven RCTs provided data for 607 patients. The mean IIEF-EF 1 month post-treatment ranged from 12.8 to 22.0 in the treatment group versus 8.17–16.43 in the sham group. The mean difference between the treatment and sham groups at the 1 month follow up was a statistically significant increase in IIEF-EF of 4.23 ( p = 0.012). Overall, five of the seven trials provided data on the proportion of patients with baseline EHS <2 who improved to EHS >3 at 1 month post-treatment. The proportions ranged from 3.5 to 90% in the treatment group versus 0–9% in the sham group and the pooled relative risk of EHS improvement for the treated versus sham group was 6.63 ( p = 0.0095). No significant adverse events were reported.

Conclusions:

This is the first meta-analysis that evaluates RCTs exploring LiESWT as a treatment modality strictly for ED. This therapeutic strategy appears to be well tolerated with short-term benefits. However further studies exploring specific treatment regimens and long-term outcomes are needed.
Profiling mental health professionals in relation to perceived interprofessional collaboration on teams
Authors: Ndibu Muntu Keba Kebe Nicolas , Chiocchio François , Bamvita Jean-Marie , Fleury Marie-Josée
Published: March 2019

Objectives:

This study aims at identifying profiles of mental health professionals based on individual, interactional, structural and professional role characteristics related to interprofessional collaboration.

Methods:

Mental health professionals ( N = 315) working in primary health care and specialized mental health teams in four Quebec local service networks completed a self-administered questionnaire eliciting information on individual, interactional, structural and professional role characteristics.

Results:

Cluster analysis identified four profiles of mental health professionals. Those with the highest interprofessional collaboration scores comprised two profiles labeled “highly collaborative female professionals with fewer conflicts and more knowledge sharing and integration” and “highly collaborative male professionals with fewer conflicts, more participation in decision-making and mutual trust.” By contrast, the profile labeled “slightly collaborative professionals with high seniority, many conflicts and less knowledge integration and mutual trust” had the lowest interprofessional collaboration score. Another profile positioned between these groups was identified as “moderately collaborative female psychosocial professionals with less participation in decision-making.”

Discussion and conclusion:

Organizational support, participation in decision-making, knowledge sharing, knowledge integration, mutual trust, affective commitment toward the team, professional diversity and belief in the benefits of interdisciplinary collaboration were features associated with profiles where perceived interprofessional collaboration was higher. These team qualities should be strongly encouraged by mental health managers for improving interprofessional collaboration. Training is also needed to promote improvement in interprofessional collaboration competencies.
An unusual case of feline otitis externa due to sporotrichosis
Authors: Mascarenhas Mariana Bezerra , Botelho Cristiane Bazaga , Manier Bruna Sampaio Martins Land , Costa Thiago Souza , Fernandes Julio Israel
Published: March 2019

Case summary

It is described a case of a 10-month-old female mixed-breed cat with left ear discharge of approximately 6 days’ duration prior to the admission. Secretions were collected from both ears using a sterile swab for cytological and mycological analysis. A pyogranulomatous inflammatory infiltrate (predominantly characterized by the presence of neutrophils and macrophages) with the presence of cocci, rods and many yeast-like structures were seen on cytological analysis; the fungal culture confirmed the presence of the Sporothrix schenckii complex. Upon diagnosis of fungal otitis due to the S schenckii complex, treatment with oral itraconazole was administered. After 4 weeks of treatment, no S schenckii complex colonies were isolated, and clinical recovery had occurred.

Relevance and novel information

Although rare, clinicians must be aware of atypical presentations of sporotrichosis, as in this case of external otitis. This is of clinical relevance because this infection has been reported in several countries and is defined as a zoonotic disease.
Health Equity in Community Assessments: A Participatory Approach in Rural Virginia
Authors: deValpine Maria Gilson , Trull Laura Hunt
Published: March 2019

A coalition of community members and human service professionals in the rural central Shenandoah Valley of Virginia has performed a community assessment every 5 years. Overreliance on quantitative surveys and hospital-based Community Health Needs Assessments resulted in earlier assessments failing to identify the needs of vulnerable populations. As the coalition approached the time for a new assessment, their priority was to develop a deeper understanding of community health needs and solutions. An extended co-learning process between coalition, community, and local academic representatives resulted in a plan to develop assessment methods and community health improvement resources suited to this goal. The coalition identified methods rooted in the social determinants of health and utilized a community-based participatory research approach to provide underserved residents the opportunity to contribute to health research and decision making and produce an assessment more reflective of their community. Resources including local interpretation and implications of the World Health Organization’s 10 Social Determinants of Health, a Healthy People 2020 community health services profile, and user-friendly access to community-based secondary data sets were developed for intervention planning. All information, resources, and implications were shared at meetings, in public announcements, and at a public forum. All data remain publicly available on the coalition’s website. Previously held beliefs regarding access to care and quality of life were substantiated through this process, enabling the coalition to better align itself with local political entities and to move forward immediately with community health improvement planning.