bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of an immunoassay for anti-Müllerian hormone measurements and reference intervals in healthy Brazilian subjects
Authors: Woloszynek Renata Reis , Brito Luciana Pinto , Batista Marcelo Cidade , Valassi Helena Panteliou Lima , Mendonca Berenice Bilharinho , Brito Vinicius Nahime
Published: September 2014

Background

Anti-Müllerian hormone is marker of ovarian and testicular reserve. The clinical use of this hormone requires proper standardization of reference intervals. The aims of this study were to validate the Anti-Müllerian hormone Gen II immunoassay, to establish Anti-Müllerian hormone reference intervals in healthy subjects, and to evaluate the influence of hormonal contraceptives, smoking, and body mass index on Anti-Müllerian hormone.

Methods

The validation of the Anti-Müllerian hormone Gen II assay (Beckman Coulter Company, TX, USA) was performed using a simplified protocol recommended by Clinical Laboratory Standard Institute. One-hundred and thirty-three healthy females and 120 males were prospectively selected for this study.

Results

The analytical and functional sensitivities of the Anti-Müllerian hormone Gen II immunoassay were 0.02 and 0.2 ng/mL, respectively. Intra-assay coefficients ranged from 5.2 to 9.0%, whereas inter-assay precision ranged from 4.6 to 7.8% at different concentrations. In females, Anti-Müllerian hormone showed progressive decline with increasing age (r = −0.4, p < 0.001), whereas in males, age showed no influence on Anti-Müllerian hormone concentrations. In females, Anti-Müllerian hormone concentrations did not differ between users and non-users of hormonal contraceptives, smokers, and non-smokers and obese and lean individuals. However, there was a negative and significant correlation between Anti-Müllerian hormone and body mass index in males (r = −0.3, p = 0.008).

Conclusions

Anti-Müllerian hormone Gen II assay was reliable for determining serum Anti-Müllerian hormone concentrations. Anti-Müllerian hormone concentrations declined with aging and presented a wide inter-individual variability. The lack of influence of hormonal contraceptives, smoking, and obesity on Anti-Müllerian hormone in both sexes allowed us to refine the normative concentrations for the Brazilian population.
Specificity of elevated cerebrospinal fluid bilirubin in the investigation of subarachnoid haemorrhage
Authors: Falconer Helen L , Walker Susan A , Peter Ashby J
Published: September 2014

Background

The spectrophotometric examination of cerebrospinal fluid for bilirubin is an established investigation in patients with suspected subarachnoid haemorrhage. This study assesses the diagnostic specificity of an elevated cerebrospinal fluid bilirubin and how this may be influenced by the presence of oxyhaemoglobin and the concentration of cerebrospinal fluid total protein.

Methods

One thousand cerebrospinal fluid spectroscopy reports were reviewed. Electronic patient records were examined to determine the clinical outcome in patients with an elevated cerebrospinal fluid bilirubin.

Results

Forty-four out of 1000 cerebrospinal fluid scans showed an increase in cerebrospinal fluid bilirubin unrelated to elevated serum bilirubin concentrations. This was associated with subarachnoid haemorrhage in 16 (36%) cases. Subarachnoid haemorrhage was confirmed in 5/17 (29%) patients positive for cerebrospinal fluid bilirubin alone and in 11/27 (41%) patients positive for both cerebrospinal fluid bilirubin and oxyhaemoglobin. At cerebrospinal fluid total protein concentrations <1 g/L, the specificity for subarachnoid haemorrhage improved: 4/9 (44%) vs. 1/8 (13%) with an increase in cerebrospinal fluid bilirubin alone; 6/10 (60%) vs. 5/17 (29%) in patients with increases in both bilirubin and oxyhaemoglobin.

Conclusion

While an increase in cerebrospinal fluid bilirubin may be considered consistent with subarachnoid haemorrhage, the likelihood that a subarachnoid haemorrhage has occurred is influenced by the presence of oxyhaemoglobin and the concentration of total protein in the cerebrospinal fluid.
Transient elevation of serum 5-HIAA by dietary serotonin and distribution of 5-HIAA in serum protein fractions
Authors: Tohmola Niina , Johansson Anna , Sane Timo , Renkonen Risto , Hämäläinen Esa , Itkonen Outi
Published: September 2014

Introduction

Dietary serotonin increases urinary secretion of 5-HIAA. A falsely elevated 5-HIAA may lead to incorrect suspicion of a neuroendocrine tumour. Therefore, we determined the effect and duration of dietary serotonin on serum 5-HIAA concentration. We also studied the distribution of 5-HIAA in serum fractions.

Methods

We used serum samples from healthy volunteers (31 women and four men). All test subjects avoided serotonin-containing foods for three days before sample collection. They then ate either pineapple, banana, kiwi fruit, tomato or walnuts and additional blood samples were taken after 2, 4, 6, 24, 48 and 72 h. To study the distribution of 5-HIAA in serum, samples from a healthy individual, a test person who had ingested walnuts, and from a neuroendocrine tumour patient were fractionated by gel filtration chromatography. The fractions were analysed for 5-HIAA.

Results

Serum 5-HIAA concentration increased significantly ( P ≤ 0.001) within 2 h after ingestion of serotonin-containing food. After 2 h, 5-HIAA concentration started to decrease and reached the baseline concentration within 24 h. A calculated half-life of 5-HIAA in circulation was 1.3 h. In fractionated serum, 5-HIAA was found not only in free form but also in the albumin and α2-globulin fractions.

Conclusions

The increase of serum 5-HIAA caused by dietary serotonin is significant but transient. Therefore, serotonin-containing foods should be avoided for one day before blood sampling. In serum, 5-HIAA is free and apparently bound to albumin. Minor amounts were also found in the α2-globulin fraction. Our liquid chromatography tandem mass spectrometry assay measures free 5-HIAA in serum.
Construction of Monomer-free, Highly Crosslinked, Water-compatible Polymers
Authors: Dailing E.A. , Lewis S.H. , Barros M.D. , Stansbury J.W.
Published: September 2014

Polymeric dental adhesives require the formation of densely crosslinked network structures to best ensure mechanical strength and durability in clinical service. Monomeric precursors to these materials typically consist of mixtures of hydrophilic and hydrophobic components that potentially undergo phase separation in the presence of low concentrations of water, which is detrimental to material performance and has motivated significant investigation into formulations that reduce this effect. We have investigated an approach to network formation based on nanogels that are dispersed in inert solvent and directly polymerized into crosslinked polymers. Monomers of various hydrophilic or hydrophobic characteristics were copolymerized into particulate nanogels bearing internal and external polymerizable functionality. Nanogel dispersions were stable at high concentrations in acetone or, with some exceptions, in water and produced networks with a wide range of mechanical properties. Networks formed rapidly upon light activation and reached high conversion with extremely low volumetric shrinkage. Prepolymerizing monomers into reactive nanostructures significantly changes how hydrophobic materials respond to water compared with networks obtained from polymerizations involving free monomer. The modulus of fully hydrated networks formed solely from nanogels was shown to equal or exceed the modulus in the dry state for networks based on nanogels containing a hydrophobic dimethacrylate and hydrophilic monomethacrylate, a result that was not observed in a hydroxyethyl methacrylate (HEMA) homopolymer or in networks formed from nanogels copolymerized with HEMA. These results highlight the unique approach to network development from nanoscale precursors and properties that have direct implications in functional dental materials.
The Influence of Spelling Ability on Vocabulary Choices When Writing for Children With Dyslexia
Authors: Sumner Emma , Connelly Vincent , Barnett Anna L.
Published: September 2014

Spelling is a prerequisite to expressing vocabulary in writing. Research has shown that children with dyslexia are hesitant spellers when composing. This study aimed to determine whether the hesitant spelling of children with dyslexia, evidenced by frequent pausing, affects vocabulary choices when writing. A total of 31 children with dyslexia, mean age 9 years, were compared to typically developing groups of children: the first matched by age, the second by spelling ability. Oral vocabulary was measured and children completed a written and verbal compositional task. Lexical diversity comparisons were made across written and verbal compositions to highlight the constraint of having to select and spell words. A digital writing tablet recorded the writing. Children with dyslexia and the spelling-ability group made a high proportion of spelling errors and within-word pauses, and had a lower lexical diversity within their written compositions compared to their verbal compositions. The age-matched peers demonstrated the opposite pattern. Spelling ability and pausing predicted 53% of the variance in written lexical diversity of children with dyslexia, demonstrating the link between spelling and vocabulary when writing. Oral language skills had no effect. Lexical diversity correlated with written and verbal text quality for all groups. Practical implications are discussed and related to writing models.
Turning Labor into Capital
Authors: McCarthy Michael A.
Published: September 2014

This article explores union attempts to control pension fund investment for the debate on financial restructuring in the United States. It puts popular control of finance into comparative and historical perspective and argues that laws and politics help explain why the flow of finance is corporate controlled. First, changes in the legal regime—the Taft-Hartley Act of 1947 and the Employee Retirement Income Security Act (ERISA) of 1974—put constraints on labor’s ability to influence investment decisions. This is evident when comparing single- and multi-employer plans, where the laws had different consequences. Second, attempts to reform these laws failed. Had they been successful, Carter’s proposed economic revitalization plan in the run-up to his failed reelection in 1980 would have created new ways for unions to control and redirect retirement investment for social purposes. The reform failure is treated as a “suppressed historical alternative” through a comparison with a successful reform in Quebec, Canada, which gave unions broad controls over the Solidarity Fund in 1983. The findings suggest, somewhat counter-intuitively, that legal restrictions need to be loosened for democratic control of finance to be possible. For pension funds, more regulations led to more corporate control, not less.
Pain and Anxiety Experienced by Patients Following Placement of a Percutaneous Endoscopic Gastrostomy
Authors: Oppong Philip , Pitts Narrie , Chudleigh Vicky , Latchford Andrew , Roy Amy , Rocket Mark , Lewis Stephen
Published: September 2014

Background: Abdominal pain following percutaneous endoscopic gastrostomy (PEG) placement is a recognized complication. However, the prevalence and degree of severity of pain are poorly characterized. We assessed abdominal pain and anxiety levels associated with PEG placement in communicative and noncommunicative patients. Methods: A prospective questionnaire assessed patients' anxiety and abdominal pain 1 hour before, 1 hour after, and 24 hours after PEG placement using 11‐point Likert‐type scales. Patients were followed up until pain had resolved. Procedural data, analgesia requirements, and complications were recorded. For analysis, patients were divided into 2 groups: communicative (able to self‐assess) and noncommunicative (clinician assessed). Results: Seventy consecutive patients were assessed. Of the 49 self‐assessed patients, 11 (22%) reported immediate pain, 32 (65%) reported pain at 1 hour (24 mild, 5 moderate, 3 severe), and 40 (82%) reported pain at 24 hours. Pain most commonly lasted between 24 and 48 hours (25 patients). Of the 21 clinician‐assessed patients, only 1 was deemed to have pain, and this was at 24 hours. Four (6%) patients were admitted with pain. There was no relationship between preplacement anxiety scores and postplacement pain scores. Discussion: Abdominal pain after PEG placement pain is common but resolved by 48 hours in most patients. In patients able to communicate, clinicians scored pain lower compared with patients' scores. It is likely that pain is not identified in patients unable to communicate. Patients need to be better informed about the possibility of postprocedural pain and routinely offered access to appropriate analgesia.
Application of the Maximal Covering Location Problem to Habitat Reserve Site Selection
Authors: Snyder Stephanie A. , Haight Robert G.
Published: September 2014

The Maximal Covering Location Problem (MCLP) is a classic model from the location science literature which has found wide application. One important application is to a fundamental problem in conservation biology, the Maximum Covering Species Problem (MCSP), which identifies land parcels to protect to maximize the number of species represented in the selected sites. We trace the evolution of the MCSP from the MCLP, review extensions, and offer suggestions for new lines of research related to the MCSP.
Extracardiac Fontan in apicocaval juxtaposition
Authors: Gil-Jaurena Juan-Miguel , Pérez-Caballero Ramón , Pita Ana , González-López Mayte
Published: September 2014

Extracardiac total cavopulmonary connection between the inferior vena cava and right pulmonary artery has become the most popular Fontan modification nowadays, yielding good results. However, certain situs anomalies along with systemic venous drainage variations give rise to an issue about the best way for extracardiac conduit routing. Three cases of apicocaval juxtaposition are described. The situs was inversus with the apex and inferior vena cava on the same side (left), whereas the superior vena cava (Glenn) was located on the right in all cases. The literature is revisited and technical options are discussed. Surgery was carried out with excellent short- and midterm results.
Turning Defects to Advantages: The Discourse of Labour in the Autobiographies of Soviet Blinded Second World War Veterans
Authors: Cristina Galmarini Maria
Published: September 2014

This article explores how blinded Soviet Second World War veterans faced the problem of social reintegration and adjustment to peacetime civilian life. Their suddenly acquired blindness compelled these men to craft new subjectivities. To give legitimacy to their desires for inclusion and equality, many blind veterans advocated integration through labour. While these men chose to operate within the hegemonic discourses of labour and ability, their status as blind veterans also altered the Soviet idiom of productive work and exemplary subjectivity. Using the highly scripted genre of autobiography, disabled individuals engaged with the standards of fitness promoted by the socialist culture of labour, but also reconceived work as a source of happiness and proposed an alternative model of Soviet subjectivity.
Electronic commerce and online consumer behavior research
Authors: Hwang Yujong , Jeong Jaeseok
Published: September 2014

This paper aims to identify studies concerning online purchase behavior research published after 2000 in the main management information systems (MIS) and electronic commerce journals. These are categorized as studies of website use and online purchase behavior respectively. The review presents a holistic picture of the domain for online consumer behavior. The paper provides an insight into the field of electronic commerce and online consumer behavior with further discussions on theoretical and practical implication of these studies.
Breaking bad news about transitions to dying: A qualitative exploration of the role of the District Nurse
Authors: Griffiths Jane , Ewing Gail , Wilson Charlotte , Connolly Michael , Grande Gunn
Published: September 2014

Background:

UK District Nurses have an important role in enabling a good death. Patients and families need to know the patient is approaching the dying phase, yet evidence suggests breaking bad news about the patient’s transition to dying rarely happens. District Nurses spend a lot of time with patients and families during the dying phase and are ideally placed to recognise and discuss the transition to dying.

Aim:

To explore the role of District Nurses in breaking bad news of transition to dying.

Design:

Qualitative focus groups.

Setting:

Primary care (District Nurse service); Four National Health Service Trusts, North West England.

Participants:

A total of 40 District Nurses across the Trusts, all Registered General Nurse qualified. Median number of years as a District Nurse was 12.5. All had palliative cancer patients on their caseloads.

Results:

District Nurses’ role in breaking bad news of transition to dying was challenging, but the conversation was described as essential preparation for a good death. Four main challenges with the conversations were patients’ responses to the prognosis (unawareness, denial and anger), timing the conversation, complexities of the home environment and limited preparation in this aspect of their work.

Conclusions:

District Nurses are with patients during their last weeks of life. While other colleagues can avoid breaking bad news of transition to dying, District Nurses have no choice if they are to provide optimal end of life care. While ideally placed to carry out this work, it is complex and they are unprepared for it. They urgently need carefully tailored training in this aspect of their work, to enable them to provide optimal end of life care.
Palliative Care Phase: Inter-rater reliability and acceptability in a national study
Authors: Masso Malcolm , Allingham Samuel Frederic , Banfield Maree , Johnson Claire Elizabeth , Pidgeon Tanya , Yates Patsy , Eagar Kathy
Published: September 2014

Background:

The concept of palliative care consisting of five distinct, clinically meaningful, phases (stable, unstable, deteriorating, terminal and bereavement) was developed in Australia about 20 years ago and is used routinely for communicating clinical status, care planning, quality improvement and funding.

Aim:

To test the reliability and acceptability of revised definitions of Palliative Care Phase.

Design:

Multi-centre cross-sectional study involving pairs of clinicians independently rating patients according to revised definitions of Palliative Care Phase.

Setting/participants:

Clinicians from 10 Australian palliative care services, including 9 inpatient units and 1 mixed inpatient/community-based service.

Results:

A total of 102 nursing and medical clinicians participated, undertaking 595 paired assessments of 410 patients, of which 90.7% occurred within 2 h. Clinicians rated 54.8% of patients in the stable phase, 15.8% in the unstable phase, 20.8% in the deteriorating phase and 8.7% in the terminal phase. Overall agreement between clinicians’ rating of Palliative Care Phase was substantial (kappa = 0.67; 95% confidence interval = 0.61–0.70). A moderate level of inter-rater reliability was apparent across all participating sites. The results indicated that Palliative Care Phase was an acceptable measure, with no significant difficulties assigning patients to a Palliative Care Phase and a good fit between assessment of phase and the definition of that phase. The most difficult phase to distinguish from other phases was the deteriorating phase.

Conclusion:

Policy makers, funders and clinicians can be confident that Palliative Care Phase is a reliable and acceptable measure that can be used for care planning, quality improvement and funding purposes.
Encephalitozoonosis in 2 South American Fur Seal (Arctocephalus australis) Pups
Authors: Seguel M. , Howerth E. W. , Ritter J. , Paredes E. , Colegrove K. , Gottdenker N.
Published: September 2014

Cerebral and disseminated encephalitozoonosis was diagnosed by histopathology, electron microscopy, and immunohistochemistry in 2 free-ranging South American fur seal pups found dead at Guafo Island (43°33′S 74°49′W) in southern Chile. In the brain, lesions were characterized by random foci of necrosis with large numbers of macrophages containing numerous microsporidial organisms within parasitophorous vacuoles. In addition, occasional histiocytes loaded with numerous mature and immature microsporidia spores consistent with Encephalitozoon sp were observed in pulmonary alveolar septa, splenic red pulp, glomerular capillaries, and proximal renal tubules by Gram and immunohistochemical stains. To our knowledge, microsporidial infection in a marine mammal species has not been previously reported.
Automatic extruder for processing recycled polymers with ultrasound and temperature control system
Authors: Nguyen Bao Kha , McNally Gerard , Clarke Alan
Published: September 2014

Melt viscosity is one of the main factors affecting product quality in extrusion processes particularly with regard to recycled polymers. However, due to wide variability in the physical properties of recycled feedstock, it is difficult to maintain the melt viscosity during extrusion of polymer blends and obtain good quality product without generating scrap. This research investigates the application of ultrasound and temperature control in an automatic extruder controller, which has ability to maintain constant melt viscosity from variable recycled polymer feedstock during extrusion processing. An ultrasonic modulation system has been developed and fitted to the extruder prior to the die to convey ultrasonic energy from a high power ultrasonic generator to the polymer melt. Two separate control loops have been developed to run simultaneously in one controller: the first loop controls the ultrasonic energy or temperature to maintain constant die pressure, the second loop is used to control extruder screw speed to maintain constant throughput at the extruder die. Time response and energy consumption of the control methods in real-time experiments are also investigated and reported this paper.
Renal biopsy in the management of lupus nephritis during pregnancy
Authors: Chen T K , Gelber A C , Witter F R , Petri M , Fine D M
Published: September 2014

The differential diagnosis of proteinuria and hematuria in pregnancy is broad and includes active lupus nephritis. Identification of the correct diagnosis often has a profound therapeutic impact on not only the mother but also the fetus. To date, relatively few reports exist on the role of renal biopsy during pregnancy among women with systemic lupus erythematosus (SLE). We present a case series of 11 pregnant women with SLE who underwent a renal biopsy to evaluate a presumptive flare of lupus nephritis. The electronic medical record was retrospectively analyzed for pre-biopsy serum creatinine, proteinuria, hematuria, antinuclear antibodies (ANA), and antibodies to double-stranded DNA (anti-dsDNA); histologic findings on renal biopsy; and the clinical course of each mother and fetus. From 2001 to 2012, 11 pregnant women with SLE flares during pregnancy underwent a renal biopsy at an academic tertiary medical center. At the time of biopsy, median gestational age was 16 weeks (range 9 to 27), median serum creatinine was 0.6 mg/dl (interquartile range 0.5 to 0.9), six (55%) had hematuria, and all had proteinuria >500 mg/24 hours. Proliferative lupus nephritis was found in 10 (91%) of 11 biopsies (five with ISN/RPS Class III; five with ISN/RPS Class IV). All but one individual underwent a change in management guided by information gleaned from renal biopsy. No apparent biopsy-related complications occurred to mother or fetus. Three women elected to terminate their pregnancy; although many factors were involved, the findings on renal biopsy informed the decision-making process. Among the remaining cases, there were three pre-term deliveries, one fetus with complete heart block, one in utero demise, and one maternal death. Renal biopsy is helpful at informing the management of patients with lupus nephritis during pregnancy.
Analysis and compensation methods for time delays in an impact buffer system based on magnetorheological dampers
Authors: Zheng Jiajia , Li Zhaochun , Koo Jeong-Hoi , Wang Jiong
Published: September 2014

Magnetorheological dampers have been widely studied as versatile real-time actuators for solving vibration problems in various structures and systems. However, the inherent time delay problem of magnetorheological actuators may cause performance degradation of semi-active control systems. The primary purposes of this article are to provide a comprehensive analysis on the time delay of an impact buffer system based on a magnetorheological damper and to propose compensation methods to reduce the time delay. To this end, this study evaluated the electromagnetic circuit in the magnetorheological damper and designed an advanced correcting circuit to improve the response time. The simulation results show that the proposed circuit reduces the time delay by 5 ms. Using a magnetorheological buffer system setup, its force response times were tested. The experimental results show that the electromagnetic circuit plays a significant role in the time delay and it is highly dependent on the effectiveness of the electric parts of the control hardware. Furthermore, a proportional–integral–derivative controller is able to reduce the time delay and improve the dynamic performance of the magnetorheological impact buffer system.
Learning to do Better
Authors: Fritz Heather A.
Published: September 2014

In this article I examine the process by which low-income (mostly minority) women develop the skills to integrate diabetes self-management into daily life and the conditions that affect the process. I present and describe a multimethod approach, including semistructured interviews, photo elicitation, time geographic diaries, and a standardized assessment which were used to collect data from 10 low-income women with type 2 diabetes, ages 40 to 64 years, between July and December 2012. I describe the grounded theory approach to data analysis which facilitated the development of the Transactional Model of Diabetes Self-Management (DSM) Integration. The model depicts the theorized process whereby low-income women accept aspects of diabetes education and training as congruent with their circumstances, act on them, and practice with them until they become integrated into daily life. Inquiry and practice play key roles in assimilating DSM. I discuss the study’s implications for facilitating better health-management programs.
Radiographic and Functional Outcomes Following Bilateral Ankle Fusions
Authors: Houdek Matthew T. , Wilke Benjamin K. , Ryssman Daniel B. , Turner Norman S.
Published: September 2014

Background:

Ankle arthrodesis is considered to be a well-accepted technique for end-stage ankle arthritis. Our purpose was to evaluate outcomes of patients with bilateral ankle arthrodeses with attention to radiographic and functional outcomes.

Methods:

Medical records of 31 patients were reviewed from 1977 through 2007. All patients had 1 year of clinical follow-up after their contralateral ankle arthrodesis, with an average follow-up of 11.2 years following the initial arthrodesis. Pertinent patient demographics and information pertaining to the operative procedure, complications, and subsequent adjacent joint fusions was collected. Radiographs were reviewed for time to fusion and adjacent joint arthritis. Functional outcomes were measured using the Foot and Ankle Ability Measure (FAAM) and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot scale.

Results:

Ten females and 21 males underwent bilateral ankle fusions at an average age of 57 years at the time of the initial fusion. The contralateral fusion occurred on average 3.1 years following the initial fusion. Radiographic fusion occurred 12 weeks following the initial fusion and 14 weeks following the contralateral fusion. There was a significant increase ( P = .0001) in the average AOFAS score postoperatively in both ankles. The average FAAM score at last follow-up was 70. Adjacent joint arthritis developed in the majority of patients; however, most of the patients were free from adjacent fusions and reported their function as “normal” or “nearly normal” at last follow-up.

Conclusion:

Bilateral ankle arthrodesis was an acceptable treatment option for patients with bilateral, end-stage ankle arthritis.

Level of Evidence:

Level IV, retrospective case series.
Endoscopic Repair of Posterior Ankle Impingement Syndrome Due to Os Trigonum in Soccer Players
Authors: López Valerio Víctor , Seijas Roberto , Alvarez Pedro , Ares Oscar , Steinbacher Gilbert , Sallent Andrea , Cugat Ramón
Published: September 2014

Background:

An os trigonum may cause posterior ankle impingement syndrome (PAIS), which may lead to poor sports performance, especially in soccer players. The aim of the present study was to analyze the outcomes of endoscopic repaired posterior ankle impingement (PAI) secondary to os trigonum syndrome within a group of soccer players as well as their return to play time.

Methods:

A retrospective review of 20 soccer players with Tegner activity level 9 was performed. All players were diagnosed of PAIS due to os trigonum. Chief complaint was pain produced with forced plantarflexion when kicking the ball. Conservative treatment was first performed during a 6-week rehabilitation program. When conservative treatment failed, arthroscopic surgical resection of the os trigonum was proposed. Visual analogue scale (VAS) was used to measure pain before and after surgery as well as time until their return to previous sports level.

Results:

VAS showed a mean preoperative pain score of 7.5 (SD = 0.9), whereas postoperative VAS at 1 month after surgery decreased to 0.8 (SD = 1.36). Mean symptomatic period was 8.5 months (SD = 4.3), from the beginning of symptoms up to the surgery day. Once patients had undergone surgery, mean time until their return to previous level of sports was 46.9 days (SD = 25.96), reaching the same pre-lesion Tegner level.

Conclusions:

Endoscopic treatment of posterior ankle impingement syndrome due to os trigonum showed excellent results. Hindfoot endoscopy with a posterior approach was an effective treatment and allowed for a prompt return to play in soccer players with a high activity level.

Level of Evidence:

Level IV, therapeutic study.
Cadmium Inhibits Neurite Outgrowth in Differentiating Human SH-SY5Y Neuroblastoma Cells
Authors: Pak Eun Joo , Son Gi Dong , Yoo Byung Sun
Published: September 2014

Cadmium, a highly ubiquitous heavy metal, is well known to induce neurotoxicity. However, the underlying mechanism of cadmium-mediated neurotoxicity remains unclear. We have studied cadmium inhibition of neurite outgrowth using human SH-SY5Y neuroblastoma cells induced to differentiate by all- trans-retinoic acid (RA). Cadmium, at a concentration of 3 μmol/L, had no significant effect on the viability of differentiating SH-SY5Y cells. However, the neurite outgrowth of the differentiating SH-SY5Y cells 48 hours after cadmium treatment (1-3 μmol/L cadmium) was significantly inhibited in a dose-dependent manner. Treatment of RA-stimulated differentiating SH-SY5Y cells with 1 to 3 μmol/L cadmium resulted in decreased level of cross-reactivities with 43-kDa growth-associated protein (GAP-43) in a dose-dependent manner. The reactive oxygen species (ROS) scavenger, NAC (N-acetyl-l-cysteine), recovered the expression of GAP-43 in cadmium-treated cells. The results indicate that cadmium is able to inhibit neurite outgrowth of differentiating SH-SY5Y cells and that this effect might result from ROS generation by cadmium.
Candidate selection methods and policy cohesion in parties
Authors: Smith Daniel M , Tsutsumi Hidenori
Published: September 2014

The method of candidate selection used by parties can influence a number of outcomes related to party organization and representation. In the past decade, Japan’s political parties have increasingly experimented with an ‘open recruitment’ system for selecting new candidates for national elections, but the degree of centralization in the process varies by party. We use candidate and voter survey data to assess whether the new system of recruitment has resulted in intraparty differences in the policy positions of candidates, and their distance from party supporters and the median voter. We find evidence that the new candidate selection method has resulted in the nomination of more centrist and urban-inclined candidates, an indication of greater responsiveness to voters, and that they exhibit higher levels of policy cohesion than their counterparts selected through traditional methods. However, these differences depend on the degree of party centralization in the process.
Anonymising interview data: challenges and compromise in practice
Authors: Saunders Benjamin , Kitzinger Jenny , Kitzinger Celia
Published: September 2014

Anonymising qualitative research data can be challenging, especially in highly sensitive contexts such as catastrophic brain injury and end-of-life decision-making. Using examples from in-depth interviews with family members of people in vegetative and minimally conscious states, this article discusses the issues we faced in trying to maximise participant anonymity alongside maintaining the integrity of our data. We discuss how we developed elaborate, context-sensitive strategies to try to preserve the richness of the interview material wherever possible while also protecting participants. This discussion of the practical and ethical details of anonymising is designed to add to the largely theoretical literature on this topic and to be of illustrative use to other researchers confronting similar dilemmas.
Gendered notions of nation: Integration and the “failure” of inclusive citizenship
Authors: Foerster Amy
Published: September 2014

Inspired by the “gendered turn” in immigration studies, this paper traces the particular ways that Germany's immigration history has been marked with gendered concerns, from its earliest policy on guest workers to its more recent commitment to promoting integration among newcomers. Utilizing the National Integration Plan (2007) as a lens through which to examine this trajectory, this analysis suggests that the Plan's specific, gendered provisions not only mark immigrant women as “imperiled Others” but also ignore structural factors that influence, and sometimes hinder, integration. In so doing, the German state maintains notions of an egalitarian, emancipated, and progressive citizenry, while crafting an integration policy that is both coercive and non-inclusive—and that continues to mark immigrant women both as obstacles to integration, and as intrinsically “un-German.”
A Wald test for zero inflation and deflation for correlated count data from dental caries research
Authors: Hsu Wei-Wen , Todem David , Kim KyungMann , Sohn Woosung
Published: September 2014

Tests of homogeneity in zero-inflated models for count data have been well discussed in the literature, but the existing methodologies have relied primarily on score statistics. An often cited justification for the use of these statistics is that they do not require the model to be fitted under the alternative. But the advent of computer software with robust functions and procedures has made it easy for these alternative models to be fitted routinely in practice. In this article, we exploit this opportunity by using results generated from these analyses to develop a Wald test statistic to evaluate homogeneity in the class of zero-inflated models. We show how the proposed test can be performed with minimal programming effort for the practicing statistician. Technically, the test is based on a reparameterization of the mixing weights that naturally incorporates covariates under heterogeneity, a characteristic often ignored by existing testing procedures. A quasi-likelihood function derived from a working independence model coupled with the so-called sandwich estimator of the covariance matrix of the parameter estimates is used to accommodate correlation in the data. A simulation study is conducted to evaluate the empirical performance of the proposed Wald test and its real life applications are illustrated using correlated dental caries counts in young children.
‘Talking about my experiences … at times disturbing yet positive’: Producing narratives with people living with dementia
Authors: Benbow Susan M , Kingston Paul
Published: September 2014

Background

This research investigated narrative production and use with families living with dementia. We hypothesised that the process of narrative production would be beneficial to people with dementia and carers, and would elicit important learning for health and social care professionals.

Method

Through third sector partners, we recruited community-dwelling people with dementia and carers who consented to develop written, audiotaped or videotaped narratives. Audio-taped narratives were transcribed verbatim and handwritten narratives word-processed. After checking by participants, completed narratives were analysed thematically using qualitative data analysis computer software. A summary of the analysis was circulated to participants, inviting feedback: the analysis was then reviewed. A feedback questionnaire was subsequently circulated to participants, and responses were analysed thematically.

Results

Twenty-one carers and 20 people with dementia participated in the project. Four themes of support were identified: ‘relationships’, ‘services’, ‘prior experience of coping’ and having an ‘explanation for the dementia’. Three themes were identified as possible additional stresses: ‘emotions’, ‘physical health’ and ‘identity’. We suggest a model incorporating all these themes, which appeared to contribute to three further themes; ‘experience of dementia’, ‘approaches to coping’ and ‘looking to the future’. In participant feedback, the main themes identified were ‘emotions’, ‘putting things in perspective’, ‘sharing or not sharing the narrative’ and ‘actions resulting’.

Conclusions

Producing a narrative is a valuable and engaging experience for people with dementia and carers, and is likely to contribute to the quality of dementia care. Further research is needed to establish how narrative production could be incorporated into routine practice.
Creative making, large lectures, and social media: Breaking with tradition in art and design education
Authors: Filimowicz Michael A , Tzankova Veronika K
Published: September 2014

The purpose of this article is to challenge the notion of small studio format delivery expectations in art and design education. Our research reports on an introductory Digital Photography course design that produced equivalent learning outcomes in a large enrollment lecture format. The objective of the project was to introduce (1) a case-based approach to teaching and learning and (2) a multitiered feedback model. The positive learning outcomes produced by this course design call into question the prevailing regimes of teaching creative production within the limits of small studio pedagogy. In addition, the multitiered feedback model we propose can be extended much beyond a classroom setting to include ‘crowdsourcing’ as a feedback model in Massive Open Online Courses, also known as MOOCs. Our approach is also highly suggestive of further investigation into applying Kant’s notion of the sensus communis – the shared subjective but universal sense of the aesthetic – to common issues surrounding creativity, scale and evaluation.
The Social Identity Politics of Peer Networks
Authors: Parsons Bryan M.
Published: September 2014

Building on recent studies of social pressure and group conformity in peer groups, I apply a social identity framework from social psychology to the study of political networks. Using the American National Election Studies (ANES) 2008-2009 Panel Study, I test several hypotheses regarding the relationship between peer networks, the salience of partisan identity, and the consequences for intergroup attitudinal and affective polarization. The findings suggest that peer network homogeneity produces the strongest association with more salient partisan identities across several network characteristics, including cohesiveness, sophistication, and density. Both the salience of partisan identities and network homogeneity are also linked to significant intergroup polarization, that is, differences in in-group and out-group partisan affect. The current research contributes to the existing literature on political networks by highlighting the role of social identities and providing a theoretical framework worth considering for future research.
Acceptability of an e-Learning Program to Help Nursing Assistants Manage Relationship Conflict in Nursing Homes
Authors: Marziali Elsa , Mackenzie Corey Scott , Tchernikov Illia
Published: September 2014

Background:

Management of nursing assistants’ (NAs) emotional stress from relationship conflicts with residents, families, and coworkers is rarely the focus of educational programs. Our objective was to gather feedback from NAs and their nursing supervisors (NSs) about the utility of our e-learning program for managing relationship stress.

Methods:

A total of 147 NAs and their NSs from 17 long-term care homes viewed the educational modules (DVD slides with voice-over), either individually or in small groups, and provided feedback using conference call focus groups.

Results:

Qualitative analysis of NA feedback showed that workplace relationship conflict stress was associated with workload and the absence of a forum for discussing relationship conflicts that was not acknowledged by NSs.

Conclusion:

This accessible e-learning program provides NAs with strategies for managing stressful emotions arising from workplace relationship conflict situations and underscores the importance of supervisory support and team collaboration in coping with emotionally evoked workplace stress.
Becoming Other-wise
Authors: Bamber Philip M.
Published: September 2014

This article explores the potential of pedagogical approaches such as International Service-Learning (ISL) to cultivate a cosmopolitan orientation. Founded upon the premise that conceptualisations of transformative learning must be expanded upon to account for the interaction and balance between epistemological and ontological aspects of learning, it seeks to illuminate the barriers that inhibit the transformative nature of such experiences. A group of conditions, processes, and resultant dispositions for cosmopolitan learning are identified as being particularly useful for interpreting the ongoing experience of ISL for 27 students across a range of locations. This framework is exemplified here to develop an understanding of cosmopolitan learning as a transformative process of becoming other-wise: A form of engagement that is fundamentally holistic and relational with a distinct moral dimension. Although ISL has the potential to nurture cosmopolitanism, evidence is presented of a number of factors that tend to militate against this.
The similarities and differences among patients with abdominal aortic aneurysms referred to a tertiary hospital and found at necropsy
Authors: da Silva Erasmo S , Gornati Vitor C , Casella Ivan B , Aun Ricardo , Estenssoro Andre EV , Puech-Leão Pedro , De Luccia Nelson
Published: September 2014

Objective

To analyze the characteristics of patients with abdominal aortic aneurysms referred to a tertiary center and to compare with individuals with abdominal aortic aneurysm found at necropsy.

Methods

We have retrospectively analyzed the medical records of 556 patients with abdominal aortic aneurysm and 102 cases abdominal aortic aneurysm found at necropsy.

Results

At univariated analysis, hypertension, tobacco use and maximum diameter were significant risk factors for symptomatic aneurysm, while diabetes tended to be a protective factor for rupture. By logistic regression analysis, the largest transverse diameter was the only one significantly associated with abdominal aortic aneurysm rupture ( p < .0001, odds ratio 1.7, 95% confidence interval 1.481–1.951). Intact abdominal aortic aneurysm found at necropsy showed similarities with outpatients in relation to abdominal aortic aneurysm diameter and risk factors.

Conclusion

Intact abdominal aortic aneurysm at necropsy and at outpatients setting showed similarities that confirmed that abdominal aortic aneurysm repair is less offered to women, and they died more frequently with intact abdominal aortic aneurysm from other causes.
Diagnoses, labels and stereotypes
Authors: Aston Megan , Breau Lynn , MacLeod Emily
Published: September 2014

Children with intellectual disabilities (IDs) and their parents continue to experience stigma within health-care systems. Whilst some research studies have examined the stigma associated with children who have IDs, there continues to be a gap in understanding how the experiences of these children, their parents and nurses have been constructed personally, socially and institutionally. Face-to-face semi-structured interviews were conducted with 17 mothers, 12 nurses and 8 children. Feminist post-structuralism and discourse analysis were used to examine the experiences of children, parents and nurses with the intent of understanding the dominant taken-for-granted everyday practices as well as hidden or marginalized practices. Four main themes emerged, which included the theme of Diagnoses, Labels and Stereotypes, which will be discussed in this article. Participants provided rich detail about their experiences in the hospital and how they addressed and often attempted to challenge the stigma associated with children with IDs.
Down syndrome and dementia
Authors: Wark Stuart , Hussain Rafat , Parmenter Trevor
Published: September 2014

The past century has seen a dramatic improvement in the life expectancy of people with Down syndrome. However, research has shown that individuals with Down syndrome now have an increased likelihood of early onset dementia. They are more likely than their mainstream peers to experience other significant co-morbidities including mental health issues such as depression. This case study reports a phenomenon in which three individuals with Down syndrome and dementia are described as experiencing a rebound in their functioning after a clear and sustained period of decline. It is hypothesized that this phenomenon is not actually a reversal of the expected dementia trajectory but is an undiagnosed depression exaggerating the true level of functional decline associated with the dementia. The proactive identification and treatment of depressive symptoms may therefore increase the quality of life of some people with Down syndrome and dementia.
Clinical outcomes of early active mobilization following flexor tendon repair using the six-strand technique: short- and long-term evaluations
Authors: Moriya K. , Yoshizu T. , Maki Y. , Tsubokawa N. , Narisawa H. , Endo N.
Published: September 2014

We evaluated the factors influencing outcomes of flexor tendon repair in 112 fingers using a six-strand suture with the Yoshizu #1 technique and early postoperative active mobilization in 101 consecutive patients. A total of 32 fingers had injuries in Zone I, 78 in Zone II, and two in Zone III. The mean follow-up period was 6 months; 16 patients (19 fingers) participated in long-term follow-up of 2 to 16 years. The total active motion was 230° SD 29°; it correlated negatively with age. The total active motion was 231° SD 28° after repair of the lacerated flexor digitorum superficialis tendon, and was 205° SD 37° after excision of the flexor digitorum superficialis tendon ends ( p = 0.0093). A total of 19 fingers showed no significant increases in total active motion more than 2 years after surgery. The rupture rate was 5.4% in our patients and related to surgeons’ level of expertise. Five out of six ruptured tendons were repaired by inexperienced surgeons.

Level of Evidence IV