bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-probabilistic parameter sensitivity analysis for structures based on ellipsoidal model
Authors: Zhang Feng , Luo Kailiang , Zhai Weihao , Tan Shiwang , Wang Yameng
Published: August 2018

Sensitivity analysis plays a crucial role in identifying the structure important parameters. In this article, a new non-probabilistic parameter sensitivity analysis method is proposed according to the ellipsoidal model. Meanwhile, an analytical solution of non-probabilistic parameter sensitivity analysis method based on the ellipsoidal model is derived for linear performance function, as well as an approximately analytical solution is obtained for nonlinear performance function using the first-order Taylor expansion to linearize the functions in design point. Finally, the proposed method is illustrated by three examples, which shows that it is reasonable and applicable.
Fuzzy extended VIKOR-based mobile robot selection model for hospital pharmacy
Authors: Zhou Fuli , Wang Xu , Goh Mark
Published: August 2018

To stimulate the development of the Internet of Health Things and the construction of a robotic automation system in the healthcare industry, the mobile robot selection problem for a hospital pharmacy is studied. We target the mobile robot selection as a multi-criteria decision-making problem. The VIKOR-based implementation steps integrating fuzzy extended analytic hierarchy process technique are developed. To avoid any loss of information and ensure the veracity of the VIKOR-based calculations, we employ the fuzzy ranking technique based on the degree of possibility to select the best mobile robot alternative by deriving the minimum fuzzy comprehensive utility value. The results of a case study and the accompanying sensitivity analysis show the effectiveness and robustness of the fuzzy extended VIKOR approach for the mobile robot selection problem.
A new kind of research
Authors: Mercer Stewart , Gillies John , Calderwood Catherine , Smith Gregor
Published: August 2018

General practice is entering a period of rapid change and requires research evidence to guide it. The ‘gold standard’ model of research, based on randomised controlled trials that are expensive, take several years to complete, and even more years to be implemented, is insufficient to inform the rapidly changing primary care landscape. This article will discuss a new kind of research, co-produced by academics, patients, and NHS staff, which offers a more realistic approach to informing policy and service development in a timely manner. We use the example of multimorbidity to discuss the need for such research. Multimorbidity is not the only population challenge that general practice faces, but it is a key one. Given the very limited evidence-base for how best to manage patients with multimorbidity, discussed in more detail below, it is a prime target for a new kind of research.
A new kind of hope
Authors: Manek Nishma , Harding Nick
Published: August 2018

Think back to when you were applying for medical school, full of hope for the years to come. Think back to all that followed: the late-night studying, the long weekends, the scrubs smattered with bodily fluids. For most of us, it was a sense of hope that kept us going. However, we all have days when that hope feels stifled. Days when we are acutely aware of the increasing demand, days when we feel we have short-changed our patients due to factors outside our control, and days when we look at the senior GPs around us, and know deep down that we are not willing to consecrate ourselves to our work in quite the same way.
Inflammatory molecules might become both biomarkers and therapeutic targets for stroke management
Authors: Ramiro Laura , Simats Alba , García-Berrocoso Teresa , Montaner Joan
Published: August 2018

Stroke is the fifth leading cause of death and the most frequent cause of disability worldwide. Currently, stroke diagnosis is based on neuroimaging; therefore, the lack of a rapid tool to diagnose stroke is still a major concern. In addition, therapeutic approaches to combat ischemic stroke are still scarce, since the only approved therapies are directed toward restoring blood flow to the affected brain area. However, due to the reduced time window during which these therapies are effective, few patients benefit from them; therefore, alternative treatments are urgently needed to reduce stroke brain damage in order to improve patients’ outcome. The inflammatory response triggered after the ischemic event plays an important role in the progression of stroke; consequently, the study of inflammatory molecules in the acute phase of stroke has attracted increasing interest in recent decades. Here, we provide an overview of the inflammatory processes occurring during ischemic stroke, as well as the potential for these inflammatory molecules to become stroke biomarkers and the possibility that these candidates will become interesting neuroprotective therapeutic targets to be blocked or stimulated in order to modulate inflammation after stroke.
Short-term rates of radiolucency after primary total shoulder arthroplasty using a cementless metal-backed pegged polyethylene glenoid
Authors: Al-Hourani Khalid , Smith James R , Crowther Mark A , Sarangi Partha , McCann Philip A
Published: August 2018

Background

Total shoulder arthroplasty has shown good clinical efficacy in treating primary and secondary degenerative conditions of the glenohumeral joint. Glenoid loosening, however, remains the commonest cause of failure. The purpose of this study was to investigate the rate of radiographic periprosthetic lucency associated with the use of an uncemented, pegged, metal-backed polyethylene glenoid component.

Materials and methods

A retrospective, single-centre study using the Epoca (Synthes, Paoli, Pennsylvania) metal-backed glenoid component. Operations were performed by two experienced consultant upper limb surgeons. Radiographs were analysed for immediate post-operative component seating and periprosthetic radiolucent lines at predefined regular post-operative intervals. Intra- and inter-observer reliability was assessed to improve validity of results.

Results

Mean age and follow-up was 72 (48–91) years and 2.5 years (2–5), respectively. Main indications for total shoulder arthroplasty were primary osteoarthritis, rheumatoid arthritis, revision for failed hemi-arthroplasty and acute fracture. Ninety-six per cent of components were completely seated post-operatively. Fifty-four (95%) of the 57 shoulders had no periprosthetic radiolucent lines at most recent follow-up. Complete post-operative glenoid seating was significantly associated with the absence of later periprosthetic radiolucency (p < 0.01).

Conclusion

This study reports low early radiolucency rates with the pegged, uncemented, metal-backed polyethylene glenoid prosthesis used. Excellent post-operative glenoid seating is associated with a significantly lower rate of radiolucency. Longer follow-up data are required to confirm these early promising results. Level of evidence: Therapeutic, level IV.
Open Source Closed-Loop Insulin Delivery Systems: A Clash of Cultures or Merging of Diverse Approaches?
Authors: Barnard Katharine D. , Ziegler Ralph , Klonoff David C. , Braune Katarina , Petersen Bettina , Rendschmidt Til , Finan Daniel , Kowalski Aaron , Heinemann Lutz
Published: August 2018

Biomedical outcomes for people with diabetes remain suboptimal for many. Psychosocial care in diabetes does not fare any better. “Artificial pancreas” (also known as “closed-loop” and “automated insulin delivery”) systems present a promising therapeutic option for people with diabetes (PWD)—simultaneously improving glycemic outcomes, reducing the burden of self-management, and improving health-related quality of life. In recent years there has emerged a growing movement of PWD innovators rallying behind the mantra #WeAreNotWaiting, developing “do-it-yourself artificial pancreas systems (DIY APS).” Self-reported results by DIY APS users show improved metabolic outcomes such as impressive stability of glucose profiles, significant reduction of A1c, and more time within their glycemic target range. However, the benefits remain unclear for the broader population of PWD beyond these highly engaged, highly tech-savvy users willing and able to engage in the demands of building and maintaining their DIY APS. We discuss the challenges faced by key stakeholder groups in terms of potential collaboration and open debate of these challenges.
Boots Are Not Made for Driving: A Cautionary Case Report About the Dangers of Driving in a CAM Walker Boot and Literature Review
Authors: Symes Michael J. , Escudero Mario , Abdulla Irfan , Veljkovic Andrea , Paquette Scott , Younger Alastair S. E.
Published: August 2018

This case report is the first documented case of a serious motor vehicle accident caused by a patient driving in a controlled ankle motion (CAM) walker boot. The real-life nature and severity of injury in this case supplements the existing experimental studies on the dangers of driving while immobilized in a CAM boot and is likely to resonate strongly with both patients and surgeons. With CAM boots used so commonly after lower limb surgery, this case not only has the potential to change practice as an educational tool for patients but also raises important medicolegal implications for orthopaedic surgeons.

Levels of Evidence: Level V
A Network Perspective on Attitude Strength: Testing the Connectivity Hypothesis
Authors: Dalege Jonas , Borsboom Denny , van Harreveld Frenk , van der Maas Han L. J.
Published: August 2018

Attitude strength is a key characteristic of attitudes. Strong attitudes are durable and impactful, while weak attitudes are fluctuating and inconsequential. Recently, the causal attitude network (CAN) model was proposed as a comprehensive measurement model of attitudes, which conceptualizes attitudes as networks of causally connected evaluative reactions (i.e., beliefs, feelings, and behavior toward an attitude object). Here, we test the central postulate of the CAN model that highly connected attitude networks correspond to strong attitudes. We use data from the American National Election Studies 1980–2012 on attitudes toward presidential candidates ( N = 18,795). We first show that political interest predicts connectivity of attitude networks toward presidential candidates. Second, we show that connectivity is strongly related to two defining features of strong attitudes—stability of the attitude and the attitude’s impact on behavior. We conclude that network theory provides a promising framework to advance the understanding of attitude strength.
Method to evaluate the effect of inclination angle of steel open-type check dam on debris flow impact load
Authors: Horiguchi Toshiyuki , Komatsu Yoshiharu
Published: August 2018

Although the latest statistics indicate a decrease in the number of victims of natural disasters in Japan, the number of sediment disasters has increased. A countermeasure against natural disasters is provided by the installation of a steel open-type check dam (hereafter, open Sabo dam). The open Sabo dam is expected to capture boulders (more than 1.0 m in diameter) contained in debris flow of which boulders concentrate in front part. When a debris flow impacts an open Sabo dam, the large impact load on the steel pipes are caused by the impact of boulders under debris flow. Therefore, it is important to evaluate the impact of both boulders and the following soil and small gravels including fluid force of the open Sabo dam from the design point of view. Although an open Sabo dam has various shapes especially, the every open Sabo dams is evaluated by the same design method in Japan. It is necessary to propose the load evaluation method in the experiment scale in contrast with different shape of open Sabo dam. This article presents an experimental approach to determine the effect of the front inclination angle of steel open Sabo dams on the impact load. The debris flow impacts 1/40 scale models of steel open Sabo dams which are set in a flow channel flume, and the debris flow load is measured by using three load cells placed horizontally at the back of the Sabo dam model. Different front inclination angles are set for each Sabo dam models. The time history of the impact load is examined by comparing the loads corresponding to four kinds of dams, which are different from the front inclination angles, and decrease of impact load considering the buffering effect of driftwoods in debris flow.
The British Association of Urological Surgeons radical cystectomy audit 2014/2015: An update on current practice, and an analysis of the effect of centre and surgeon case volume
Authors: Khadhouri Sinan , Miller Catherine , Cresswell Joanne , Rowe Edward , Fowler Sarah , Housome Luke , McGrath John S.
Published: August 2018

Objective:

The Consultant Outcomes Publication has made it mandatory to submit surgeon-level data on radical cystectomy (RC) practice in England. The current analysis describes contemporary surgical practice and compares this by surgeon and centre case volume.

Materials and methods:

Between 1 January 2014 and 31 December 2015, data on 3742 RCs performed by 161 surgeons over 84 centres were recorded on the British Association of Urological Surgeons audit and data platform. Centre case volumes were grouped as high (> 60), medium (30–60) and low (< 30), while surgeon case volumes were grouped as high (> 30), medium (8–30) and low (< 8). All data averages were for the combined 2-year period.

Results:

The median number of RCs performed was 16/surgeon and 31/centre; 45.4% of cases were performed for muscle-invasive transitional cell carcinoma (TCC). The commonest performed urinary diversion was ileal conduit (85.2%), followed by orthotopic bladder substitution (5.7%). Open radical cystectomy (ORC) was performed in 67.8%, robotically-assisted cystectomy (RARC) in 20.6% and laparoscopic cystectomy (LRC) in 9.1% of cases. RARC was more likely to be performed by high-volume surgeons and centres. The majority of patients underwent a lymph node dissection (LND), with rates varying from 79.5% to 90.3%. Reported rates of high-grade complication were generally low across all groups, suggesting under-reporting. There was a trend towards higher reported transfusion rates as centre volumes decreased. The median length of stay (LOS) was 7–9 days for minimally invasive approaches compared to open surgery, which was 11–12 days. Mortality rates were low across all groups.

Conclusions:

Compliance with the data registry is high. ORC remains the most common approach. High-case volume surgeons and centres more commonly offer RARC. The majority of patients undergo LND. There is a trend towards higher reported rates of transfusion as centre volume decreases. LOS is shorter in RARC and LRC in comparison to ORC, but is otherwise similar across centres and surgeons.

Level of evidence:

2b
A Case Study for Study Bibles: The Book of Haggai
Authors: Ogden Graham
Published: August 2018

This article makes a case for properly defining “Bible translation” as nothing less than the preparation of a study Bible. Rendering the text of a biblical book into another language without providing the reader with adequate tools for understanding that text within its ancient culture is providing only half the material necessary for the work to be called a “translation.” The article seeks to illustrate the thesis by example from the book of Haggai and the several difficult issues it raises, issues that inevitably cause deep concern for serious readers of the Bible—the nature of God, the relationship between natural crises and human behaviour, the writer’s use of hyperbole while attributing everything written as coming from the godhead.
Metaphors at Cultural Crossroads: Examples from CIS Countries
Authors: Desnitsky Andrei S.
Published: August 2018

Translating metaphors is one of the most prominent areas where the importance of respect for the receptor languages and cultures can be demonstrated and in this article I present a few examples from my own experience with CIS (former USSR) languages. Among other treatments of metaphor, I draw on the work of K. McElhanon, who suggests translating scenarios rather than words and expressions, even though scenarios are not identical in different cultures.
Translation to the Third and Fourth Generations: The Gbaya Bible and Gbaya Language Enrichment
Authors: Noss Philip A.
Published: August 2018

The story of the Gbaya Bible begins with the first translation efforts of the early missionaries and the first Gbaya Christians. As the language was being standardized, the New Testament was translated and the Christian church was being planted. The second generation of translation was carried out by an interconfessional team of mother-tongue speakers who followed the principles of dynamic equivalence and Gbaya oral literary style. Shifting toward functional equivalence as they developed the language, their effort culminated in the publication of the Bible with the Deuterocanon. The third generation is represented by today’s community of Gbaya theologians and scholars who build on their predecessors’ use of the Gbaya language, employing it for the creation of written literature, for theological discourse, and for academic commentary. As they exploit the resourceful features of Gbaya expression, they continue to press the communicative world of the Gbaya ancestors into a future without bounds.
Newton Goes East: Natural Philosophy in the First Malay Grammar (1736) and the First Malay Bible (1733)
Authors: de Vries Lourens
Published: August 2018

George Henrik Werndly’s work in Malay grammar, literature, and Bible translation can be understood and explained in the context of late seventeenth- and early eighteenth-century natural philosophy, especially natural philosophy in the spirit of Newton. The Dutch natural philosopher Lambert ten Kate, who was deeply influenced by Isaac Newton, is one of the main channels through which the ideas of the natural philosophy tradition reached Werndly. Ten Kate had applied the methodologies of natural philosophy to linguistics in ways that inspired Werndly to follow the same approach in his grammar of Malay.
Whom Do We Trust to Translate? An Early Eighteenth-Century Muslim Translation of the Gospels into Persian
Authors: Thomas Kenneth J.
Published: August 2018

Seventeenth-century Muslim scholar Khatun Abadi, commissioned by his shah, was the first native speaker to translate the Gospels into Persian. The goal was an accurate rendition, accompanied by notes intended to address contradictions and false claims of Christians. The translation was completed in 1703 but first published in 1995, in Iran. Understanding translation to be an act of interpretation, this study asks if we can trust a translation made by someone who does not accept the interpretation of the community that calls the text scripture. Based on analysis of translator notes, translation deviations from its Arabic base text, and the choice of key terms, the study concludes that the translator maintained the text’s integrity with few exceptions but that his notes are problematic from the perspective of the Christian community. Lessons are suggested for Christian translators who work with persons of other faiths or prepare renditions to be used by them.
Should Translation Consultants Keep and Share a List of Key Texts and Passages to Check? If So, What Might Such a List Look Like?
Authors: Liriano Fausto , Bascom Bob
Published: August 2018

Translation consultants find that they keep coming back to some of the same texts and passages time and again in their translation checking. These are texts that present particular challenges across many different projects, and so become places that consultants always make sure they have looked at carefully. This article explores the risks and benefits of using lists of such texts as a guide for checking.
Translation from the Other Side: Process before Product or “In Defense of Lost Causes”
Authors: Towner Philip H.
Published: August 2018

In Western scholarship, descriptions of translation have emphasized instrumentality and outcome, leaving one to wonder where the translator as human being is in this product-oriented field. Bible translation is equally affected by this tendency. In fact, recent developments affecting the Bible translation mission, including an infusion of funding which comes with a focus on technology and the expectation of increased speed to product, make questions about the translator and translation as process all the more acute. This essay suggests that a perspective on translation has been lost or obscured, and seeks to look at translation “from the other side”—the side of anthropology, which allows translation to be (re)considered as a serious human endeavor, a feature of human life-in-movement, a meaningful and meaning-making process.
The Origins of Interpreting in the Old Testament and the Meturgeman in the Synagogue
Authors: Salevsky Heidemarie
Published: August 2018

Interpreting as a form of mediated interlingual communication can be traced back to the third millennium B.C. in the secular sphere. In the Bible Nehemiah 8 shows how Hebrew passages were rendered into Aramaic. Luther’s translation (1984) of Neh 8.8 is compared in the article with RSV (1952), NRSV (1989), and the Russian Tolkovaja Biblija (1904–1907/1987). The emergence of targumim can be attributed to the need to render Hebrew texts into Aramaic, especially in the synagogue service. The Babylonian Talmud acknowledges this as established practice and gives elaborate instructions as to the correct way of delivering the targumim. They are often interpretive to an extent that far exceeds the bounds of translation or even paraphrase because the interpreter ( meturgeman) had to transmit the teachings of the rabbi to the common people by placing the original text into a wider context or by amplifying and explaining it.
Women’s experiences of managing digitation: do we ask enough in primary care?
Authors: Eustice Sharon , Endacott Ruth , Morris Jenny , Shankar Rohit , Kent Bridie
Published: August 2018

The aim of this paper was to consider the available evidence for the current management of pelvic organ prolapse, which is a common presentation in primary care. However, not all women will present, only presenting when symptoms become bothersome. Particular attention was paid to understanding the problem of rectocele and its influence on obstructive defaecation symptoms. The burden of rectocele and its consequences are not truly known. Furthermore, healthcare professionals may not always enquire about bowel symptoms and patients may not disclose them. Complex emotions around coping and managing stress add to the challenges with seeking healthcare. Therefore, the impact on the lived experience of women who have difficulty with rectal emptying can be significant. The review identified a dearth of knowledge about women living with the problem of obstructive defaecation resulting in the use of digitation. Improving the management of digitation, an under-reported problem, is necessary to improve the quality of life for women. Primary care needs to increase access to conservative measures for women struggling with bothersome symptoms, such as constipation, the need to digitate or anxiety.
Multidisciplinary rehabilitation treatment is not effective for myalgic encephalomyelitis/chronic fatigue syndrome: A review of the FatiGo trial
Authors: Vink Mark , Vink-Niese Alexandra
Published: August 2018

The FatiGo trial concluded that multidisciplinary rehabilitation treatment is more effective for chronic fatigue syndrome/myalgic encephalomyelitis in the long term than cognitive behaviour therapy and that multidisciplinary rehabilitation treatment is more cost-effective for fatigue and cognitive behaviour therapy for quality of life. However, FatiGo suffered from a number of serious methodological flaws. Moreover, it ignored the results of the activity metre, its only objective outcome. This jeopardizes the validity of FatiGo. Its analysis shows that there was no statistically significant difference between multidisciplinary rehabilitation treatment and cognitive behaviour therapy and neither are (cost-)effective. FatiGo’s claims of efficacy of multidisciplinary rehabilitation treatment and cognitive behaviour therapy for chronic fatigue syndrome/myalgic encephalomyelitis are misleading and not justified by their results.
‘It’s been a long haul, a big haul, but we’ve made it’: hepatitis C virus treatment in post-transplant patients with virus recurrence: An interpretative phenomenological analysis
Authors: Krzeczkowska Anna , Flowers Paul , Chouliara Zoe , Hayes Peter , Dickson Adele
Published: August 2018

The lived experience of both interferon-based and new interferon-free treatments in patients with hepatitis C virus remains understudied. To explore their journey through hepatitis C virus treatment, we interviewed seven post-transplant patients with recurrent hepatitis C virus. Three themes were identified using interpretative phenomenological analysis. Participants reported an ongoing sense of ontological uncertainty characterized by lack of control over their condition and treatment. Furthermore, an apposition of scepticism and hope accompanying each stage of hepatitis C virus treatment was described. A staged approach to psychological intervention tailored to the needs of the patient and their associated ‘stage’ of hepatitis C virus treatment was recommended.
Introducing Primary Care Telephone Visits: An Urban Safety-Net Community Clinic Experience
Authors: Kyanko Kelly , Hanley Kathleen , Zabar Sondra , Joseph Jennifer , Bateman William , Schoenthaler Antoinette
Published: August 2018

Background: Telephone consultation is widely used in primary care and can provide an effective and efficient alternative for the in-person visit. Gouverneur Health, a safety-net primary care practice in New York City serving a predominately immigrant population, evaluated the feasibility and physician and patient acceptability of a telephone visit initiative in 2015. Measures: Patient and physician surveys, and physician focus groups. Results: Though only 85 of 270 scheduled telephone visits (31%) were completed, 84% of patients reported being highly satisfied with their telephone visit. Half of physicians opted to participate in the pilot. Among participating physicians, all reported they were able to communicate adequately and safely care for patients over the telephone. Conclusions: Participating patients and physicians in a linguistically and culturally diverse urban safety-net primary care clinic were highly satisfied with the use of telephone visits, though completion of the visits was low. Lessons learned from this implementation can be used to expand access and provision of high-quality primary care to other vulnerable populations.
“Diversity Is Important to Me”: White Parents and Exposure-to-Diversity Parenting Practices
Authors: Underhill Megan R.
Published: August 2018

Drawing upon interviews with 40 parents in Cincinnati, Ohio, the author explores how “exposure to diversity,” an implicit racial socialization practice, has become a defining feature of how some middle-class white parents teach their children about race and reflect on what it means to be a good white parent. Exposure to diversity involves white parents’ active efforts to expose their children to people of color via trips to multiracial parks, enrollment in multiracial schools, or residence in multiracial neighborhoods. The author argues that white parents’ efforts are informed by their adherence to both a “diversity ideology” wherein racial diversity is frequently, but not always, framed as a positive social dynamic that enriches their family’s white life, and a middle-class desire to craft a high-status white child via distinction-oriented parenting practices. Taken together, white middle-class parents pursue an exposure-to-diversity strategy because they believe, whether consciously or not, that diversity provides them and their children with the means to facilitate small-scale social change and to craft a comfortable, open-minded white child who possesses racial and class distinction.
Non-linear asymmetric gap models of residential satisfaction: Formulation and empirical evidence
Authors: Jiang Wen , Feng Tao , Timmermans Harry JP
Published: August 2018

This paper proposes non-linear asymmetric gap–satisfaction models to assess the influence of the gap between aspirations and perceived residential attributes on residential satisfaction. Two variants of the residential gap are specified based on the difference and ratio between aspiration and reality. Besides the influence of residential gap, the interactions with social-demographics are incorporated in three specifications of gap–satisfaction relationship. Using empirical data collected from eight renovated historical blocks in two Chinese cities, the relative performances of the proposed gap models are compared with truncated linear symmetric gap models and traditional linear (absolute) difference models for housing, living environmental and neighbourhood attributes. The estimation results indicate that overall the non-linear asymmetric gap models outperform the linear gap models. The model fit for housing and living environmental attributes are very good. Satisfaction for housing attributes is predicted best with non-linear asymmetric gap ratio models, while the environmental attributes are best represented by non-linear asymmetric difference models. In case of the neighbourhood dimension, non-linear asymmetric gap ratio models show the best performance, while these models yield a good fit only for two attributes. The interaction effect of social-demographics is found to vary between residential attributes.
How Will the Foot and Ankle Orthopedic Community Respond to the Growing Opioid Epidemic?
Authors: Donahue Gabrielle S. , Hagemeijer Noortje Catherine , Johnson Anne Holly
Published: August 2018

In the midst of the current opioid crisis, it has become critically important to properly manage opioid-prescribing patterns for the treatment of postoperative pain. There is currently a scarcity of literature specifying prescription and consumption patterns following orthopedic surgery and specifically foot and ankle surgery. Clinical guidelines for postoperative pain management are deficient.
Uses of Braces and Orthotics for Conservative Management of Foot and Ankle Disorders
Authors: Elattar Osama , Smith Tyler , Ferguson Adam , Farber Daniel , Wapner Keith
Published: August 2018

Nonsurgical management is almost always considered the first-line treatment for the vast majority of foot and ankle pathologies. Foot orthoses, shoe modifications, and therapeutic footwear are considered essential tools for successful conservative management of different foot and ankle disorders. Orthopedic foot and ankle surgeons should have a meticulous understanding of the lower extremity biomechanics as well as the pathoanatomy and the sequelae of diseases affecting the foot and/or ankle. This is essential to the understanding of the desired effects of the different inserts, orthotics, shoe modifications, or braces that may be prescribed for these conditions. In this article, we will summarize the orthoses used for treatment of the most commonly encountered foot and ankle pathologies, with the exclusion of treatment for the diabetic foot because of the unique requirements of that disease process.
Scleral Fixation of Posterior Chamber Intraocular Lenses Using Gore-Tex Suture: Clinical Outcomes From a Single Institution
Authors: Botsford Benjamin , Williams Andrew M. , Conner Ian P. , Eller Andrew W. , Martel Joseph N.
Published: August 2018

Purpose:

The purpose of this article is to examine the clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture at our institution.

Methods:

A retrospective chart review was conducted of patients who underwent scleral fixation of an IOL with Gore-Tex suture with concurrent pars plana vitrectomy. Intraoperative and postoperative complications were assessed.

Results:

Seventy-four eyes of 74 patients were included with a mean follow-up interval of 210 days (range, 33–720 days). The mean best-corrected visual acuity improved from 20/480 (1.38 logarithm of the minimum angle of resolution [logMAR]) preoperatively to 20/78 (0.59 logMAR) postoperatively ( P < .001). Indications included dislocated lens implant (42), aphakia without capsular support (18), and subluxation of crystalline lens (14). Bausch and Lomb Akreos AO60 IOL was implanted in 52 eyes, Alcon CZ70BD in 15, and Bausch and Lomb enVista MX60 in 6. Postoperative complications included temporary ocular hypertension in 9 eyes (12%), temporary hypotony in 7 (9%), cystoid macular edema in 3 eyes (4%), corneal decompensation in 2 eyes (3%), IOL dislocation requiring exchange in 1 case (1.4%), vitreous hemorrhage in 2 cases (3%), and retinal detachment in 2 cases (3%). There were no cases of postoperative suture breakage or erosion, endophthalmitis, or hyphema.

Conclusions:

The use of Gore-Tex suture in scleral fixation of posterior chamber IOLs was well tolerated at a mean follow-up interval of 210 days. There were no suture-related complications.
Music Listening Habits and Music Behaviors of Middle and High School Musicians
Authors: Williams Matthew L. , Geringer John M. , Brittin Ruth V.
Published: August 2018

The purpose of this study was to explore music listening and performance characteristics of middle and high school students. The questions under investigation addressed reasons for liking a favorite piece, time spent listening, media used to listen, ways in which students discovered new music, and the types of music performed as well as the types that students would like to perform. Results indicated that students liked their favorite pieces for musical reasons and reported listening to music roughly 4 hours each day outside of school. Students listened largely through portable devices and streaming technology, and just over half indicated they found new music through the Internet or dedicated apps. Classical, jazz, and rock were the most frequently performed genres, although students indicated greater interest in playing all 11 genres. Overall, the results portray middle and high school students as active consumers and performers of music.
Bacterial contamination of frequently touched objects in a tertiary care hospital of Pokhara, Nepal: how safe are our hands?
Authors: Bhatta Dharm Raj , Hamal Deependra , Shrestha Rajani , Hosuru Subramanya Supram , Baral Nisha , Singh Rajesh Kumar , Nayak Niranjan , Gokhale Shishir
Published: August 2018

Background

Objects frequently touched by patients and healthcare workers in hospitals harbor potential pathogens and may act as source of infectious agents. This study aimed to determine the bacterial contamination of common hospital objects frequently touched by patients, visitors and healthcare workers.

Methods

A total of 232 samples were collected from various sites like surface of biometric attendance devices, elevator buttons, door handles, staircase railings, telephone sets and water taps. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Biofilm forming ability of the S. aureus isolates was tested by a microtitre plate method.

Results

A total of 232 samples were collected and 219 bacterial isolates were recovered from 181 samples. Staphylococcus aureus was the most common bacterial isolate (44/219). Majority of S. aureus isolates were recovered from elevator buttons, biometric attendance devices and door handles. Among the S. aureus isolates, 36.3% (16/44) were methicillin resistant Staphylococcus aureus (MRSA) while remaining were methicillin sensitive Staphylococcus aureus (MSSA). Out of 44 S. aureus isolates, 12 (29.5%) were multidrug resistant and 14 (31.8%) were biofilm producers. The majority of MRSA isolates 62.5% (10/16) were biofilm producers. Acinetobacter was the most common Gram negative isolate followed by E coli and Pseudomonas species.

Conclusions

High bacterial contamination of frequently touched objects with variety of potential pathogens and normal flora was detected. S. aureus was the most common bacterial isolate. Biofilm forming ability offers additional survival advantage to the organisms on these objects. Present study highlights the need of improved hand hygiene among healthcare workers and regular cleaning/disinfection of sites of frequent public contact.
The outcomes of home treatment for schizophrenia
Authors: Huang Hannah Chu Han , Taylor Mark , Carmichael Alasdair
Published: August 2018

Aims and method

We examined whether intensive home treatment (IHTT) was beneficial for acute schizophrenia, using the Clinical Global Impression (CGI) scale as a measure of severity and change, between 2011–2015. Demographic and clinical details were collected.

Results

309 cases were referred to IHTT, comprising 245 separate individuals. This represented all severe acute psychotic episodes in Edinburgh during the study period. Three quarters of individuals had an improvement in CGI following IHTT and were safely managed at home. Thirty-nine per cent of all people received three or more regular medications. Comorbid drug and alcohol misuse was also frequently seen.

Clinical implications

IHTT can be beneficial to those suffering an acute episode of psychosis and has been shown to improve overall clinical outcome based on the CGI. Medication polypharmacy, as well as drug and alcohol use, are commonly seen in this population.

Declaration of interest

M.T. worked in IHTT at the time of the study, and has received fees and/or hospitality from Janssen, Lundbeck and Otsuka in the past 3 years.
Central Serotonin and Impulsive Aggression
Authors: Coccaro Emil F.
Published: August 2018

The role of central serotonergic (5-HT) system dysfunction in the regulation of aggression in both animals and man has been investigated for more than the past two decades. Evidence for reduced central 5-HT in the mediation of aggression comes from both behavioural and correlative studies. Functional reduction and augmentation of 5-HT activity is respectively associated with increased and decreased aggression in various animal models of aggression. While similar studies in man have not been performed, strong and consistent associations between indices reflecting reduced pre-synaptic 5-HT activity and aggression have been reported. Evidence of post-synaptic receptor upregulation in the brains of suicide victims has also been reported leaving the functional status 5-HT activity in such patients an open question. However, reduced neuroendocrine (i.e. prolactin) responses to fenfluramine, a 5-HT uptake inhibitor/releaser, which activates both pre- and post-synaptic sides of the 5-HT synapse, strongly suggest that overall central 5-HT activity is reduced in mood and/or personality disorder patients with history of suicidal and/or impulsive aggressive behaviour. Preliminary data with the 5-HT receptor agonist m-chlorophenylpiperazine further suggest that reduced activity of post-synaptic 5-HT receptors may be an important correlate of impulsive aggressive behaviour. Pharmacological agents with potent 5-HT pre- and/or post-synaptic augmenting effects should be tested clinically to determine their efficacy in the treatment of impulsive aggressive behaviour in psychiatric patients.
Gender Differences in Carers of Dementia Sufferers
Authors: Morris Robin G. , Woods Robert T. , Davies Kath S. , Morris Lorna W.
Published: August 2018

Recent research shows that the demands of the caregiving role are experienced differently by men and women. Both the subjective and the objective strain and burden appear to be greater in female carers of dementia sufferers, and factors that influence this include differences in role expectations and coping strategies. These findings have implications for the provision of services for dementia sufferers and their carers.
The TAPS Project. 9: The Reliability of the Patient Attitude Questionnaire
Authors: Thornicroft Graham , Gooch Christopher , O'Driscoll Catherine , Reda Sawsan
Published: August 2018

The development of the hospital and community versions of the Patient Attitude Questionnaire is described. The instrument rates the attitudes of psychiatric patients towards their treatment settings and staff, and is framed specifically to assess attitudinal change during the transfer of patients from hospital. For the items rated using the kappa coefficient of agreement, the mean test-retest reliability value was 0.51, and the average inter-rater value was 0.82. This study shows that long-term psychiatric patients are able to give clear and consistent views about their living arrangements - views that should be sought and respected by staff.
The TAPS Project. 10: The Long-Stay Populations of Friern and Claybury Hospitals: The Baseline Survey
Authors: O'Driscoll Catherine , Wills Walter , Leff Julian , Margolius Olga
Published: August 2018

As part of the TAPS project, the baseline long-stay populations of Friern and Claybury Hospitals were compared using the TAPS assessment schedules. Each hospital has reduced bed numbers by two-thirds, and although the two have been subjected to different influences, their remaining long-stay patients were similar, and characterised by severe problems with hygiene, florid psychotic symptoms, a high prevalence of negative symptoms, and impoverished social networks.
Suicide in Depressed Patients: Medico-legal Issues
Authors: Daly R. J.
Published: August 2018

In psychiatry, the law, and economics, there are many areas of overlap where our knowledge and appreciation are growing and developing. Many doctors ‘understand the words but not the music’, and the same is true for the other professions involved. This is exemplified in relation to suicide.
Who Responds to Prophylactic Lithium Therapy?
Authors: Abou-Saleh M. T.
Published: August 2018

The search for predictors of outcome has not been particularly rewarding, and the use of lithium remains empirical: a trial of lithium is the most powerful predictor of outcome. However, lithium is a highly specific treatment for bipolar disorder. In non-bipolar affective disorder, factors of interest are correlates of bipolar disorder: mood-congruent psychotic features, retarded-endogenous profile, cyclothymic personality, positive family history of bipolar illness, periodicity, and normality between episodes of illness.
Assessing Depression in Schizophrenia: The Calgary Depression Scale
Authors: Addington Donald , Addington Jean , Maticka-tyndale Eleanor
Published: August 2018

Since existing depression scales were designed for assessment of depression in non-psychotic populations, such scales have items which do not distinguish depressed from non-depressed psychotic subjects. The authors describe a new scale, the Calgary Depression Scale, which was designed for the assessment of depression in schizophrenia. The scale was derived from two existing scales by factor analysis and reliability analysis. It has been further tested in two new samples. In the first it has been shown to be reliable, congruent with a self-report scale and valid. In the second sample it has been shown that there is no overlap with negative or extrapyramidal symptoms.
Patients' Own Contributions to Long-Term Supportive Psychotherapy in Schizophrenic Disorders
Authors: Gilbert Sidsel , Ugelstad Endre
Published: August 2018

The paper describes a study based on the Nordic multi-centre research project NIPS. In the Norwegian part, based on one-year screening and sampling of all new schizophrenic cases in a catchment area in Oslo, patients and therapists were interviewed after 2–3 years. Some patients seemed to have played a much more active part in establishing and breaking therapeutic contacts and in setting the terms for the relationship than is usually acknowledged. In the interviews at five-year follow-up, many patients produced viewpoints on their psychotherapeutic experiences that seem to be very important in relation to therapy.
An Integrated System of Community Services for the Rehabilitation of Chronic Psychiatric Patients in Shenyang, China
Authors: Wang Xishi
Published: August 2018

The evolution of the Zhengyang Community Mental Health Rehabilitation Centre described in this paper proves that community-based mental health services initiated and developed by enthusiastic and committed community members can be successful in the Chinese setting. The most important step is to utilise community resources to secure a stable source of income, preferably by establishing a profitable welfare enterprise that can both finance the provision of other services and provide work for mentally ill clients who cannot obtain regular employment. The ultimate goal is to reintroduce as many clients back into the community as possible, so a range of services is needed: supervision of medication, social skills training, occupational rehabilitation, and, most importantly, work placement. The vitality of the organisation depends on its flexibility and responsiveness to the changing needs of patients; it must use its experience to guide policy decisions about the development of new services and the alteration or termination of existing services.
Enterprise-Based Sheltered Workshops in Nanjing
Authors: Luo Kailin , Yu Dongshan
Published: August 2018

This paper describes the development of community mental health services in Nanjing and reports on a retrospective study that compared the two-year outcome for 78 schizophrenic patients who attended four enterprise-based sheltered workshops (experimental group) with that of 78 schizophrenic patients who attended an out-patient clinic (control group). Despite having a longer course of illness and more prior hospital admissions than patients in the control group, at the end of the two years patients treated in enterprise-based sheltered workshops had significantly less psychosocial dysfunction (mean Social Dysfunction Screening Schedule score 3.4 (s.d. 0.2) v. 7.4 (s.d. 0.7), t = 49.2, d.f. 154, P<0.001) and less severe psychiatric symptomatology (mean Brief Psychiatric Rating Scale score 33.1 (s.d. 2.7) v. 54.1 (s.d. 2.9), t = 47.0, d.f. 1 54, P<0.001). Moreover, compared with the control group, over the two year period a smaller proportion of the experimental group experienced a clinical relapse (14.1% v. 38.5%, χ2 = 5.10, d.f. 1, P<0.05) or hospital readmission (7.7% v. 21.8%, χ2= 10.7, d.f. 1, P<0.01). We conclude that the organisation of on-site sheltered workshops for mentally ill factory workers is an effective model for promoting community mental health that merits widespread application in China.
Historical Overview of Outcome of Depression
Authors: Paykel Eugene S.
Published: August 2018

Kraepelin established manic–depressive disorder on the psychiatric map as a remitting but recurrent disorder. As the concept of affective disorder became broader, its potentially chronic nature was also recognised in long-term follow-up studies. However, the advent of antidepressants in the late 1950s gave rise to more therapeutic optimism, and a tendency to regard unremitting and chronic features as reflecting characterological rather than affective disorders. In the late 1970s, an era of reappraisal started, and it is now clear from long-term follow-up studies that recurrence is common and chronicity occurs, although probably in a smaller proportion than previously. The wheel has come full circle recently in Britain, as the Department of Health and the Medical Research Council have established relapse and chronicity in depression as major health service research priorities.