bluuebunny/crossref_metadata_2025 huggingface dataset:
Detecting Endometriosis in Adolescents: Why Not Start from Self-Report Screening Questionnaires for Adult Women?
Authors: Geysenbergh Brecht , Dancet Eline A.F. , D'Hooghe Thomas
Published: November 2016

Background: Endometriosis in adolescent girls is often diagnosed after a long delay. This diagnostic delay can be associated with more advanced stages of endometriosis and with a higher likelihood of fertility problems at a later age. Material and Methods: A systematic review of literature and quality assessment was performed in order to identify questionnaires that were developed to identify adult women with endometriosis. Based on these questionnaires, specific questions that had been reported to be predictive for endometriosis were selected and included in a newly composed questionnaire with the aim to identify adolescents at risk of developing endometriosis. Results: Based on the literature, we identified 5 questionnaires developed to identify adult women with endometriosis; this questionnaire contained 6 questions that had been reported to be predictive for adult endometriosis. These questions query age of menarche, cycle duration, dysmenorrhea, pain descriptors, dyschezia and urinary symptoms and were combined into a new self-report questionnaire aimed to identify adolescents at risk to develop endometriosis. Conclusion: We developed a self-report questionnaire aimed to identify adolescents at risk to develop endometriosis based on questions from self-report questionnaires that have been reported to identify adult women with endometriosis.
Postnatal Deletion of Podoplanin in Lymphatic Endothelium Results in Blood Filling of the Lymphatic System and Impairs Dendritic Cell Migration to Lymph Nodes
Authors: Bianchi Roberta , Russo Erica , Bachmann Samia B. , Proulx Steven T. , Sesartic Marko , Smaadahl Nora , Watson Steve P. , Buckley Christopher D. , Halin Cornelia , Detmar Michael
Published: November 2016

Objective—

The lymphatic vascular system exerts major physiological functions in the transport of interstitial fluid from peripheral tissues back to the blood circulation and in the trafficking of immune cells to lymph nodes. Previous studies in global constitutive knockout mice for the lymphatic transmembrane molecule podoplanin reported perinatal lethality and a complex phenotype with lung abnormalities, cardiac defects, lymphedema, blood-filled lymphatic vessels, and lack of lymph node organization, reflecting the importance of podoplanin expression not only by the lymphatic endothelium but also by a variety of nonendothelial cell types. Therefore, we aimed to dissect the specific role of podoplanin expressed by adult lymphatic vessels.

Approach and Results—

We generated an inducible, lymphatic-specific podoplanin knockout mouse model (Pdpn
ΔLEC
) and induced gene deletion postnatally. Pdpn
ΔLEC
mice were viable, and their lymphatic vessels appeared morphologically normal with unaltered fluid drainage function. Intriguingly, Pdpn
ΔLEC
mice had blood-filled lymph nodes and vessels, most frequently in the neck and axillary region, and displayed a blood-filled thoracic duct, suggestive of retrograde filling of blood from the blood circulation into the lymphatic system. Histological and fluorescence-activated cell sorter analyses revealed normal lymph node organization with the presence of erythrocytes within lymph node lymphatic vessels but not surrounding high endothelial venules. Moreover, fluorescein isothiocyanate painting experiments revealed reduced dendritic cell migration to lymph nodes in Pdpn
ΔLEC
mice.

Conclusions—

These results reveal an important role of podoplanin expressed by lymphatic vessels in preventing postnatal blood filling of the lymphatic vascular system and in contributing to efficient dendritic cell migration to the lymph nodes.
Body growth pattern of an isolated land crab species (Johngarthia planata) (Decapoda, Gercarcinidae) from the eastern tropical Pacific: an ecological approach
Authors: Sanvicente-Añorve Laura , Lemus-Santana Elia , Solís-Weiss Vivianne
Published: November 2016

This study examines the sexual differences in relative growth and morphometrical traits of the land crabJohngarthia planata(Stimpson, 1860). Individuals came from Clipperton, where an expedition was conducted in April 2015. A total of 275 individuals were captured manually, sexed and measured in seven dimensions from the carapace and chelae. Measurements were fitted to a power function to analyse the degree of allometry in growth. Results indicated that males had larger body and chelae sizes than females. For both sexes growth was negatively allometric for the carapace and positively allometric for the chelae. We hypothesize that stronger bodies in males confer advantages during intraspecific combats and their enlarged chelae are associated to their sexual behaviour. For each sex, measurements of both right and left chelae showed a homochelic condition. We suggest that these symmetrical features provide stability and balance to their body when feeding, fighting or excavating their burrows.
Sexism on the Silver Screen: Misogyny and Cultural Continuity in Soviet Glasnost Cinema, 1987–1991
Authors: Ter-Grigoryan Svetlana Y.
Published: October 2016

In the early 1990s, scholars largely viewed the height of the glasnost years, 1987 to 1991, to be a culturally and socially distinct period in comparison to the rest of the Soviet epoch. One of the main pieces of evidence employed in this argument was glasnost filmmakers’ novel use of sexuality and nudity. The debate about the cultural significance of the glasnost period, however, has been muted in recent decades. In this reevaluation, I suggest that the misogynistic nature of glasnost filmmakers’ sexuality and nudity depictions actually reflected cultural continuity with previous Soviet eras. This study ultimately challenges the idea of a culturally liberal glasnost period, and supports the case for conservatism throughout the Soviet period.
Statistical Seasonal Prediction Based on Regularized Regression
Authors: DelSole Timothy , Banerjee Arindam
Published: November 2016

This paper proposes a regularized regression procedure for finding a predictive relation between one variable and a field of other variables. The procedure estimates a linear prediction model under the constraint that the regression coefficients have smooth spatial structure. The smoothness constraint is imposed using a novel approach based on the eigenvectors of the Laplace operator over the domain, which results in a constrained optimization problem equivalent to either ridge regression or least absolute shrinkage and selection operator (LASSO) regression, which can be solved by standard numerical software. In addition, this paper explores an unconventional procedure whereby regression models are estimated from dynamical model output and then verified against observations—the reverse of the traditional order. The methodology is illustrated by constructing statistical prediction models of summer Texas-area temperature based on concurrent Pacific sea surface temperature (SST). None of the regularized regression models have statistically significant skill when estimated from observations. In contrast, when estimated from dynamical model output, the regression models have skill with respect to dynamical model data because of the substantially larger sample size available from dynamical model output. In addition, the regression models estimated from dynamical model data can predict observed anomalies with significant skill, even though no observations were used directly to estimate the regression models. The results indicate that dynamical models had no significant skill because they could not accurately predict the SST itself, not because they could not capture realistic SST teleconnections.
Clinical significance of GCF sIL-6R and calprotectin to evaluate the periodontal inflammation
Authors: Kajiura Yukari , Lew Jung-Hwan , Ikuta Takahisa , Nishikawa Yasufumi , Kido Jun-ichi , Nagata Toshihiko , Naruishi Koji
Published: November 2016

Background

Periodontitis is an inflammatory disease. The aim of this study was to investigate whether the soluble form of interleukin-6 receptor (sIL-6R) and calprotectin concentrations in gingival crevicular fluid are useful biomarkers in the evaluation of periodontitis.

Methods

First, a cross-sectional study was performed. A total of 34 periodontitis patients were enrolled and the gingival crevicular fluid samples were collected from the healthy and inflamed sites of periodontal pockets in each patient. The relationship between periodontal condition and gingival crevicular fluid sIL-6R and calprotectin concentrations was analysed statistically. The cut-off values of gingival crevicular fluid sIL-6R and calprotectin concentrations for the evaluation of periodontitis were determined using a receiver operating characteristic curve. Next, by using enzyme-linked immunosorbent assay, it was examined whether calprotectin induces sIL-6R production in THP-1 macrophages.

Results

Both gingival crevicular fluid sIL-6R and calprotectin concentrations were significantly higher in the inflamed sites than in the healthy sites ( P < 0.0001). The cut-off values of gingival crevicular fluid sIL-6R and calprotectin concentrations for the evaluation of periodontal inflammation were as follows: sIL-6R: 43.5 pg/site; calprotectin: 134.3 ng/site. In the in vitro study, calprotectin significantly induced sIL-6R production in THP-1 macrophages ( P < 0.01).

Conclusions

Both gingival crevicular fluid sIL-6R and calprotectin concentrations are significant biomarkers in the evaluation of periodontal inflammation.
Is Allison More Likely Than Lakisha to Receive a Callback From Counseling Professionals? A Racism Audit Study
Authors: Shin Richard Q. , Smith Lance C. , Welch Jamie C. , Ezeofor Ijeoma
Published: November 2016

Using an audit study, we examined racially biased callback responses in the mental health field by leaving voicemails soliciting services with practicing counselors and psychologists ( N = 371). To manipulate perceived race, an actor identified herself with either a stereotypically Black- or non–Latino White-sounding name. Although the difference in callback rate between the two names was not significant, the difference in voice messages from therapists that either promoted potential services or impeded services was significant. The caller with the stereotypically White-sounding name received voice messages that promoted the potential for services at a 12% higher rate than the caller with the stereotypically Black-sounding name. Limitations, future directions for research, and counseling implications are discussed.
Wuhua Therapy: A Way to ZhiMian Unallowable Experience in the Context of Chinese Culture
Authors: Chen Kan
Published: November 2016

Wuhua philosophy is rooted in Taoism. Zhuangzi described the practice of Wuhua as the “fasting of the heart mind” (心斋). Humanistic psychology and analytical psychology describe the “fasting of the heart mind” as a path leading to ZhiMian. The resolution of the boundary between conflicts is built on a dialogue between differences that is characterized by effort and an open attitude. The key to the Wuhua experience is Qi. In the experience of Qi, mankind humbly aims to understand the world from the heart mind position to explore how the self is related to the world and to define the self and the other interdependently and relatively. Wuhua therapy fosters experience in all dimensions, concentrating on the natural emergence and movement of Qi, and waits for it to lead to the dissolution of boundaries and to generate its creative healing nature. The method of Wuhua therapy involves noninterpretation, careful observation, and faithful reflection. This article describes a case that illustrates the method and discusses the resonance between Wuhua philosophy and humanistic psychology.
Finding solutions for periodic discrete-time generalized coupled Sylvester matrix equations via the generalized BCR method
Authors: Hajarian Masoud
Published: November 2016

The periodic discrete-time matrix equations have wide applications in stability theory, control theory and perturbation analysis. In this work, the biconjugate residual algorithm is generalized to construct a matrix iterative method to solve the periodic discrete-time generalized coupled Sylvester matrix equations

[Formula: see text]

The constructed method is shown to be convergent in a finite number of iterations in the absence of round-off errors. By comparing with other similar methods in practical computation, we give numerical results to demonstrate the accuracy and the numerical superiority of the constructed method.
ASPEN Safe Practices for Enteral Nutrition Therapy
Authors: Boullata Joseph I. , Carrera Amy Long , Harvey Lillian , Escuro Arlene A. , Hudson Lauren , Mays Andrew , McGinnis Carol , Wessel Jacqueline J. , Bajpai Sarita , Beebe Mara Lee , Kinn Tamara J. , Klang Mark G. , Lord Linda , Martin Karen , Pompeii‐Wolfe Cecelia , Sullivan Jackie , Wood Abby , Malone Ainsley , Guenter Peggi ,   ASPEN Safe Practices for Enteral Nutrition Therapy Task Force, American Society for Parenteral and Enteral Nutrition
Published: November 2016

Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process‐related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.
Impact of UK NICE Clinical Guidelines 168 and social deprivation on access to interventional treatment for symptomatic varicose vein and specialist referral for leg ulceration
Authors: Davies Huw OB , Popplewell Matthew , Bate Gareth , Kelly Lisa , Koutsoumpelis Andreas , Bradbury Andrew W
Published: November 2016

Background

UK National Institute for Health and Care Excellence (NICE) clinical guidelines (CG) 168, published in July 2013, aimed to improve the management of lower limb venous disease by newly recommending interventional treatment for all people affected by symptomatic varicose veins (VV) and specialist vascular referral for all people suffering from a leg ulcer (LU) that had been present for ≥2 weeks. This study aims to determine if CG168 has increased access to vascular services, particularly for the socially deprived, who might be expected to have greater need for such services.

Methods

The study was performed in a highly multi-cultural, socio-economically diverse, mixed urban/suburban population of approximately 1.2 million people living in and around East Birmingham, UK. Index of multiple deprivation quintile (IMD-Q) was used as a measure of social deprivation to compare levels of social deprivation of people undergoing interventions for symptomatic VV or referred with an LU during 18-month periods before and after the publication of CG168. The referring general practitioner practices (GPPs) were also recorded.

Results

There was no change in overall IMD-Q distribution before and after CG168 in terms of VV interventions. However, there was a non-significant increase in proportions of people classified as IMD-Q5 (the most deprived quintile). After CG168, fewer IMD-Q5 people with LU were referred, with a shift in referrals towards those from less socially deprived areas. More GPP referred people with both VV and LU after CG168, and those that referred patients before and after CG168 tended to refer more after CG168.

Conclusions

CG168 has increased VV interventions as well as the number referred with LU. However, this improvement in access to treatment and referral may have disproportionately favoured the more socio-economic privileged. Professional and public education is required to ensure that the beneficial impact of the CG168 recommendations are maximised and that those with the greatest health needs have equal access to evidence-based management of their venous disease.
Comparison of posterior lumbar interbody fusion with transforaminal lumbar interbody fusion for treatment of recurrent lumbar disc herniation: A retrospective study
Authors: Li Liqiang , Liu Yueju , Zhang Peng , Lei Tao , Li Jie , Shen Yong
Published: November 2016

Objective

To compare posterior lumbar interbody fusion (PLIF) with transforaminal lumbar interbody fusion (TLIF) for spinal fusion in patients previously treated by discectomy.

Methods

This retrospective study evaluated pre- and postoperative neurological status via Japan Orthopaedic Association (JOA) score. Surgical outcome was based on recovery rate percentage (RR%). Adverse event data were reviewed.

Results

Both PLIF ( n = 26) and TLIF ( n = 25) significantly improved neurological status. There were no significant between-group differences in postoperative JOA score, RR% or surgical outcome. Overall, 92.3% patients in the PLIF group and 84% in the TLIF group had an excellent or good outcome (RR ≥ 65%). No patient had a poor outcome (RR < 50%). There were six cases of dural tear in the PLIF group and two in the TLIF group.

Conclusions

PLIF and TLIF provided good outcomes for recurrent lumbar disc herniation. TLIF may be preferred because of its shorter operative time and fewer procedure-related complications than PLIF.
In vitro cytotoxicity and genotoxicity of composite mixtures of natural rubber and leather residues used for textile applications
Authors: Cavalcante Dalita GSM , Gomes Andressa S , dos Reis Elton AP , Danna Caroline S , Kerche - Silva Leandra E , Yoshihara Eidi , Job Aldo E
Published: November 2016

A novel composite material has been developed from natural rubber and leather waste, and a corresponding patent has been filed. This new material may be incorporated into textile and footwear products. However, as leather waste contains chromium, the biocompatibility of this new material and its safety for use in humans must be investigated. The aim of the present study was to investigate the presence of chromium in this new material, determine the amount of each form of chromium present (trivalent or hexavalent), and evaluate the potential cytotoxic and genotoxic effects of the novel composite in two cell lines. The cellular viability was quantified using the MTT3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide reduction method and neutral red uptake assay, and genotoxic damage was analyzed using the comet assay. Our findings indicated that the extracts obtained from the composite were severely cytotoxic to both cell lines tested, and additionally highly genotoxic to MRC-5 cells. These biological responses do not appear to be attributable to the presence of chromium, as the trivalent form was predominantly found to be present in the extracts, indicating that hexavalent chromium is not formed during the production of the novel composite. The incorporation of this new material in applications that do not involve direct contact with the human skin is thus indicated, and it is suggested that the chain of production of this material be studied in order to improve its biocompatibility so that it may safely be used in the textile and footwear industries.
Investigating Single- Versus Multiple-Source Approaches to Communicating Health Messages Via an Online Simulation
Authors: Jongenelis Michelle I. , Pettigrew Simone , Wakefield Melanie , Slevin Terry , Pratt Iain S , Chikritzhs Tanya , Liang Wenbin
Published: November 2016

Purpose:

To assess whether exposing drinkers to information about the alcohol–cancer link via multiple and diverse sources in an online simulation produces larger improvements in attitudes and intentions relative to exposure to a single source of information.

Design:

Experimental; unequal randomization with respondents allocated to either the single-source (20%) or multiple-source condition (80%). Alcohol-related behavioral intentions were assessed preexposure and postexposure.

Setting:

Australia.

Participants:

A total of 2087 drinkers consuming alcohol at least twice per month.

Measures:

Scales were used to assess attitudes toward the messages (believability, convincingness, and personal relevance) and behavioral intentions (extent to which participants believed that they should and would reduce their alcohol consumption and their intention to consume 5 or more drinks in a single session).

Analysis:

Hierarchical linear regression.

Results:

Source condition was significantly associated with all 3 attitudinal variables ( P < .001). Those exposed to an alcohol warning statement from multiple sources found the message more believable, convincing, and personally relevant compared to those exposed to a warning statement via a single source. They also reported significantly greater change preexposure to postexposure on the 2 behavioral beliefs that they should (Δ M = 0.25 vs Δ M = 0.09) and would (Δ M = 0.23 vs Δ M = 0.00) reduce their current alcohol consumption ( P < .001). Further, those in the multiple-source condition reported reduced intentions to consume 5 or more standard drinks in a single sitting (Δ M = 0.21 vs Δ M = 0.14; P < .001).

Conclusion:

Findings from the online simulation provide support for the suggestion that integrated approaches involving the combination of multiple sources to deliver a message produce superior outcomes compared to relying on a single source (eg, warning labels on alcoholic beverages).
Impact of a Temporary NRT Enhancement in a State Quitline and Web-Based Program
Authors: Cole Sam , Suter Casey , Nash Chelsea , Pollard Joseph
Published: November 2016

Purpose:

To examine the impact of a nicotine replacement therapy (NRT) enhancement on quit outcomes.

Design:

Observational study using an intent to treat as treated analysis.

Setting:

Not available.

Participants:

A total of 4022 Idaho tobacco users aged ≥18 years who received services from the Idaho Tobacco Quitline or Idaho’s web-based program.

Intervention:

One-call phone or web-based participants were sent a single 4- or 8-week NRT shipment. Multiple-call participants were sent NRT in a single 4-week shipment or two 4-week shipments (second shipment sent only to those completing a second coaching call).

Measures:

North American Quitline Consortium recommended Minimal Data Set items collected at registration and follow-up. Thirty-day point prevalence quit rates were assessed at 7-month follow-up.

Analysis:

Multiple logistic regression models were used to examine the effects of program type and amount of NRT sent to participants while controlling for demographic and tobacco use characteristics.

Results:

Abstinence rates were significantly higher among 8-week versus 4-week NRT recipients (42.5% vs 33.3%). The effect was only significant between multiple-call program participants who received both 4-week NRT shipments versus only the first of 2 possible 4-week shipments (51.1% vs 31.1%). Costs per quit were lowest among web-based participants who received 4 weeks of NRT (US$183 per quit) and highest among multiple-call participants who received only 1 of 2 possible NRT shipments (US$557 per quit).

Conclusion:

To better balance cost with clinical effectiveness, funders of state-based tobacco cessation services may want to consider (1) allowing tobacco users to choose between phone- and web-based programs while (2) limiting longer NRT benefits only to multiple-call program participants.
On the Subject of Far-Right-Wing Politics
Authors: Short Nicola
Published: November 2016

This paper explores how to consider the far right in historical-material and psychoanalytic perspective in the current conjuncture. Since the early post-Second World War interventions in this register, both the social relations of capitalism and psychoanalytic theory have evolved, while the problematic of the far-right had been somewhat marginalized as an object of research. This discussion revisits these broad concerns with attention to developments in the characterization of contemporary character structures and social relations. It examines two psychoanalytic approaches – drawn from Kohut and Lacan – that have been mobilized to examine the dominant character structures of late capitalism to consider their complementarity (and differences) with respect to certain psychological functions – defenses, affect and identification – that may offer insight into the far-right in the contemporary moment.
Multibody approach for the dynamic analysis of gears transmission for an electric vehicle
Authors: Belingardi G , Cuffaro V , Curà F
Published: November 2016

The dynamic analysis of a gear transmission system for electric vehicle is analyzed by means of a multibody approach. The architecture of the transmission is constituted of one gear ratio, with the differential integrated in the same gear box. The multibody model of the complete transmission has been created and optimized in order to get the dynamic response of the system. In particular, the frequency response function of the system in terms of rotational speed and loading forces has been determined. Furthermore, the dynamic transmission error has also been determined.
A numerical analysis of projectile nose geometry including sliding friction for penetration into geological targets
Authors: Ölçmen Semih M , Jones Stanley E , Weiner Ryan H
Published: November 2016

Optimal axisymmetric penetrator nose shapes that result in most penetration under the effect of pressure-dependent Coulomb Friction are presented. The nose shapes were determined by dividing a circular cylinder into line segments and iteratively updating the combination of line segment slopes to generate the nose geometries that result in the most penetration. Analysis was conducted for five different penetrator velocities, [Formula: see text], 11 different friction coefficient values, μ, and 10 different nose shape factors, α. Calculations were also made on common nose shapes including a 3/4 power nose, AMNG model, a tangent-ogive nose, and a standard cone to show that the new nose shapes result in the highest penetration. Results show that while most of the optimal nose shapes are convex shapes, the nose shapes become concave at μ = 0.4 for [Formula: see text], μ ≥ 0.6 for [Formula: see text], μ ≥ 0.8 for [Formula: see text] at different α values. The nose shapes are also blunt in general except for [Formula: see text], while μ = 0.1, α = 0.3; μ = 0.2, α = 0.4; μ = 0.5, α = 0.6; for [Formula: see text], while μ = 0.2, α = 0.3; μ = 0.4, α = 0.4; for [Formula: see text], while μ = 0.1, α = 0.2; μ = 0.3, α = 0.3; μ = 0.7, α = 0.4; for [Formula: see text], while μ = 0.1, α = 0.2; μ = 0.4, α = 0.3; μ = 0.5, α = 0.3, where the nose shapes are more close to a cone. Results can be used to select a nose shape that can achieve the desired penetration depth.
Real-time estimation of the pressure in the wheel cylinder with a hydraulic control unit in the vehicle braking control system based on the extended Kalman filter
Authors: Jiang Guirong , Miao Xiaolu , Wang Yuehui , Chen Jie , Li Dalong , Liu Lifu , Muhammad Fahad
Published: November 2016

The pressure in the wheel cylinder plays an important role in the anti-lock braking system, but direct measurement usually needs expensive sensors. Therefore, estimation of the pressure in the wheel cylinder is of great significance to optimize the algorithm of the anti-lock braking system. There are two commonly used estimation methods: one is based on the hydraulic model, and the other is based on the equation for the tyre dynamics. Both of these, however, suffer from inadequacies. The former method is sensitive to the accuracy of the model in practical applications, and an accumulated error appears if some parameters of the process are not sufficiently accurate. In the latter method the pressure in the wheel cylinder is calculated for each cycle but, when the vehicle is running, the fluctuations in the deceleration are relatively large. To estimate the pressure more accurately, a novel method is proposed in this paper, which combines these two methods on the basis of the extended Kalman filter. The method can compensate for the inadequacies of the two methods mentioned above by using the variation in the wheel speed as the observation variable to modify the hydraulic model. It can decrease its sensitivity to the accuracy of the hydraulic model and improve the accuracy of the estimated magnitude of the pressure. The estimated results are compared with the real values which are obtained by using a pressure sensor on a typical low-friction road and on an asphalt road; in addition, the effectiveness of the novel method is validated by hardware-in-the-loop tests and vehicle tests. The results show that the proposed method can provide an accurate estimation of the pressure in the wheel cylinder during hydraulic control of the anti-lock braking system or any other brake control system.
Improving signal passed at danger management in New Zealand rail operations: Combining stabilised approach procedures with risk-triggered commentary driving
Authors: O’Connell Phillip J , Lawton Fiona , Mills Ann M , Klockner Karen
Published: November 2016

The critical examination of driver cognition and information processing is vital to ensuring an effective signal passed at danger (SPAD) prevention strategy. Although this need was identified in KiwiRail’s organisational strategy to reduce signal passed at danger risk, the why and how factors were not clearly described and robustly linked to deliver the necessary effects. With risk-triggered commentary driving programmes gaining recognition as valuable components and activities within the driver competency model, an opportunity to couple risk-triggered commentary driving with stabilised approach methodologies and procedures, adopted from aviation and modified for use on New Zealand’s railway network was subsequently identified. A driver subject matter expert group was formed, a literature review completed, guidance developed and new procedures trialled. This activity provided new opportunities to introduce error-tolerant system design, increase accuracy of driver signal action response and reduce signal passed at danger risk on New Zealand’s National Rail System by adopting and designing bespoke methodologies that support enhanced driver cognition and safe system design.
Multifocal neuropathic arthropathy in patient with undiagnosed neurosyphilis: A case report
Authors: Kim Chang-Wan , Lee Chang-Rack
Published: November 2016

Although the prevalence of syphilis has decreased significantly, syphilis is still a common cause of neuropathic arthropathy. Tabetic arthropathy means progressive painless joint destruction that is related to neurosensory deficits caused by syphilis. In general, lower limb joints are involved and gradual swelling and instability of the involved joints are observed. Diagnosis of tabetic arthropathy is difficult as its clinical presentation is not specific and differential diagnosis is wide ranging. Hence, diagnosis of tabetic arthropathy requires clinical suspicion and an appropriate serological test. Laboratory tests for the diagnosis of syphilis include nontreponemal tests and treponemal tests. Conventionally, a nontreponemal test such as the Venereal Disease Research Laboratory test or the Rapid Plasma Reagin test is performed first as a screening test for syphilis, followed by a treponemal test to confirm the positive response found in the screening test. However, the sensitivity and specificity of the serum nontreponemal and treponemal tests for the diagnosis of syphilis are different based on the test type and the syphilis stages. We herein report a case of multifocal neuropathic arthropathy found in a patient whose syphilis was not diagnosed due to a nonreactive screening test result.
Challenges in Engaging Parents in the Drug and Alcohol Treatment: The Professionals’ Perspective
Authors: Misouridou Evdokia , Papadatou Danai
Published: November 2016

Addiction treatment centers often fail to involve families in treatment. The aim of the present study was to explore the challenges that Greek mental health professionals encounter in their work with parents of drug and alcohol abusers. A qualitative study design was adopted, and five focus group discussions were conducted with 27 drug and alcohol professionals. The thematic analysis of their accounts revealed the key difficulties that professionals encounter in their collaboration with parents that included parental lack of involvement or over-engagement in treatment, unrealistic expectations, ambivalence or opposition to change, ethical dilemmas, and alliance issues, as well as collaboration challenges among therapists. Findings highlight the challenges of a family approach in the treatment of addiction, and underscore the value of clinical supervision in addition to specialized training, to help professionals work on their anxiety, anger, guilt, prejudices, and deception, when engaging parents in the treatment of their addicted child.
Does Identifying Whether Pseudoangiomatous Stromal Hyperplasia (PASH) Is Focal or Diffuse on Core Biopsy Correlate With a PASH Nodule on Excision?
Authors: Rosa Gabriela , Dawson Andrea , Rowe J. Jordi
Published: November 2016

Aims. Pseudoangiomatous stromal hyperplasia (PASH) diagnosed on core needle biopsy is generally excised. As a consequence, PASH as an incidental finding, may lead to unnecessary excisions. This study categorized PASH in biopsies as diffuse versus focal to determine if this correlates with the presence of a mass. Methods. In a 10-year period, 253 biopsies were identified and 159 met inclusion criteria. Of these, 47 biopsies had excisions. Biopsies and excisions were classified as diffuse, involving 2 adjacent lobules, or focal PASH in a single lobule or noncontiguous lobules. The diffuse or focal category on biopsy was correlated to the category on excision. Fibroadenomas with PASH were defined as concordant with diffuse PASH on biopsy. The category was correlated to the presence/absence of a mass determined from radiographic/clinical data for the 159 biopsies. Results. The biopsies were classified as diffuse (105, 66%) and focal (54, 34%). A total of 67% of biopsies with focal PASH showed either focal or no PASH on excision. Diffuse PASH on biopsy, had diffuse PASH in 93% of excisions. Concordance of this classification between biopsy and excision, using a Fisher’s exact test (2-tailed P value is <.0001), is statistically significant. A mass was present in 102/105 (97%) of biopsies with diffuse PASH. In biopsies with focal PASH, 78% had a mass lesion. Conclusions. Classification of diffuse versus focal PASH on biopsy was concordant with findings on excision. We found that diffuse PASH on biopsy showed strong correlation with a mass lesion. Quantifying PASH may assist with clinical-pathologic correlation and reduce unnecessary excisions.
The Efficacy and Safety of Edoxaban for VTE Prophylaxis Post-Orthopedic Surgery: A Systematic Review
Authors: AlHajri Lamia , Jabbari Sima , AlEmad Hind , AlMahri Khawla , AlMahri Maryam , AlKitbi Noora
Published: November 2016

Background:

Venous thromboembolism (VTE) is a common complication that manifests during and/or after hospitalization, as well as postsurgeries including orthopedic surgeries. Edoxaban is a new oral direct factor Xa inhibitor that has been recently approved for treating VTE in patients who have already been treated with a parenteral anticoagulant and for the prevention of stroke and non-central nervous system systemic embolism in patients with nonvalvular atrial fibrillation.

Objectives:

The purpose of this systematic review was to evaluate the safety and efficacy of edoxaban for VTE prophylaxis after lower limb orthopedic surgery.

Materials and

A comprehensive search was conducted in Google Scholar, PubMed, MEDLINE, and ScienceDirect to identify potential records, then titles, abstracts, and full texts were screened using the inclusion criteria to filter out irrelevant studies. Moreover, the data extraction and quality assessment were undertaken using standardized tools, and the results were narratively synthesized and presented in tables.

Results:

Six studies were included in this systematic review after screening 2989 records. The majority of studies demonstrated a statistically significant reduction in VTE events in the edoxaban group(s) compared to the dalteparin, placebo, or enoxaparin groups (P < .05). The differences in VTE cases in some studies reached to approximately 50% favoring edoxaban 30 mg over the comparator (P < .05). However, other studies uncovered a statistically insignificant difference between edoxaban and the comparator “enoxaparin” when used for VTE prophylaxis (P > .05). On the other hand, although edoxaban found to cause more bleeding, the differences between edoxaban and the comparator are statistically insignificant (P > .05).

Conclusion:

This study helped to amalgamate evidence with regard to the use of edoxaban for VTE prophylaxis post-lower limb orthopedic surgery. In line with the results of the reviewed studies, edoxaban seems to be highly effective in reducing VTE post-lower limb orthopedic surgery.
Hospital Ownership of Physicians: Hospital Versus Physician Perspectives
Authors: Baker Laurence C. , Bundorf M. Kate , Devlin Aileen M. , Kessler Daniel P.
Published: November 2016

Although there has been significant interest from health services researchers and policy makers about recent trends in hospitals’ ownership of physician practices, few studies have investigated the strengths and weaknesses of available data sources. In this article, we compare results from two national surveys that have been used to assess ownership patterns, one of hospitals (the American Hospital Association survey) and one of physicians (the SK&A survey). We find some areas of agreement, but also some disagreement, between the two surveys. We conclude that full understanding of the causes and consequences of hospital ownership of physicians requires data collected at the both the hospital and the physician level. The appropriate measure of integration depends on the research question being investigated.
The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests
Authors: Saccà Francesco , Costabile Teresa , Carotenuto Antonio , Lanzillo Roberta , Moccia Marcello , Pane Chiara , Russo Cinzia Valeria , Barbarulo Anna Maria , Casertano Sara , Rossi Fabiana , Signoriello Elisabetta , Lus Giacomo , Brescia Morra Vincenzo
Published: November 2016

Objective:

Despite cognitive tests have been validated in multiple sclerosis (MS), a neuropsychological evaluation is not implemented in the Expanded Disability Status Scale (EDSS) scoring.

Methods:

We used the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and orientation tests (OTs) to measure the cerebral functional system (CFS) score and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS).

Results:

We tested 604 MS patients with BICAMS, OTs, and EDSS. In all, 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher Native-EDSS, and male gender were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (−0.112; p < 0.001) in 99 patients (16%). When considering patients with a Native-EDSS ⩽ 4.0, the proportion of miscalculated EDSS was 25%.

Conclusion:

The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ⩽4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.
Leptomeningeal contrast enhancement is associated with progression of cortical atrophy in MS: A retrospective, pilot, observational longitudinal study
Authors: Zivadinov Robert , Ramasamy Deepa P , Vaneckova Manuela , Gandhi Sirin , Chandra Avinash , Hagemeier Jesper , Bergsland Niels , Polak Paul , Benedict Ralph HB , Hojnacki David , Weinstock-Guttman Bianca
Published: November 2016

Background:

Leptomeningeal contrast enhancement (LM CE) has been recently described in multiple sclerosis (MS) patients as a potential in vivo marker of cortical pathology.

Objectives:

To investigate the association of LM CE and development of cortical atrophy in 50 MS patients (27 relapsing-remitting (RR) and 23 secondary-progressive (SP)) followed for 5 years.

Methods:

The presence and number of LM CE foci were assessed only at the 5-year follow-up using three-dimensional (3D) fluid-attenuated inversion recovery magnetic resonance imaging (MRI) sequence obtained 10 minutes after single dose of gadolinium injection on 3T scanner. The percentage change in whole brain, cortical and deep gray matter (GM) volumes, and lesion volume (LV) was measured between baseline and the 5-year follow-up.

Results:

In total, 25 (50%) of MS patients had LM CE at the 5-year follow-up. Significantly more SPMS patients (12, 85.7%) had multiple LM CE foci, compared to those with RRMS (2, 18.2%) ( p = 0.001). MS patients with LM CE showed significantly greater percentage decrease in total GM (−3.6% vs −2%, d = 0.80, p = 0.006) and cortical (−3.4% vs −1.8%, d = 0.84, p = 0.007) volumes and greater percentage increase in ventricular cerebrospinal fluid (vCSF) volume (22.8% vs 9.9%, d = 0.90, p = 0.003) over the follow-up, compared to those without.

Conclusion:

In this retrospective, pilot, observational longitudinal study, the presence of LM CE was associated with progression of cortical atrophy over 5 years.
The imperfect agenda-setter: Why do legislative proposals fail in the EU decision-making process?
Authors: Boranbay-Akan Serra , König Thomas , Osnabrügge Moritz
Published: November 2016

This article analyzes how uncertainty about the location of the pivotal actor influences the outcome of Commission proposals. We argue that the Commission is an imperfect agenda-setter and expect that Commission proposals are more likely to fail when uncertainty increases in the bicameral legislature of the Council and the European Parliament. Considering all legislative acts decided under the co-decision procedure proposed in the period from November 1993 until December 2009, we focus on withdrawal of Commission proposals as failures. In the empirical analysis we distinguish between electoral and procedural uncertainty and provide evidence that both types of uncertainty explain withdrawal of Commission proposals.
Effects of injection parameters, boost, and swirl ratio on gasoline compression ignition operation at idle and low-load conditions
Authors: Kodavasal Janardhan , Kolodziej Christopher P , Ciatti Stephen A , Som Sibendu
Published: November 2016

In this work, we study the effects of injector nozzle inclusion angle, injection pressure, boost, and swirl ratio on gasoline compression ignition combustion. Closed-cycle computational fluid dynamics simulations using a 1/7th sector mesh representing a single cylinder of a four-cylinder 1.9 L diesel engine, operated in gasoline compression ignition mode with 87 anti-knock index (AKI) gasoline, were performed. Two different operating conditions were studied—the first is representative of idle operation (4 mg fuel/cylinder/cycle, 850 r/min), and the second is representative of a low-load condition (10 mg fuel/cylinder/cycle, 1500 r/min). The mixture preparation and reaction space from the simulations were analyzed to gain insights into the effects of injection pressure, nozzle inclusion angle, boost, and swirl ratio on achieving stable low-load to idle gasoline compression ignition operation. It was found that narrower nozzle inclusion angles allow for more reactivity or propensity to ignition (determined qualitatively by computing constant volume ignition delays) and are suitable over a wider range of injection timings. Under idle conditions, it was found that lower injection pressures helped to reduce overmixing of the fuel, resulting in greater reactivity and ignitability (ease with which ignition can be achieved) of the gasoline. However, under the low-load condition, lower injection pressures did not increase ignitability, and it is hypothesized that this is because of reduced chemical residence time resulting from longer injection durations. Reduced swirl was found to maintain higher in-cylinder temperatures through compression, resulting in better ignitability. It was found that boosting the charge also helped to increase reactivity and advanced ignition timing.
Analysis of comfort and moisture management properties of polyester/milkweed blended plated knitted fabrics for active wear applications
Authors: Karthik T , Senthilkumar P , Murugan R
Published: November 2016

The search for sustainable renewable source of fibre is the need of the hour for the textile industry. In this aspect, milkweed fibres are considered to be one of the potential fibre crops. Plated knit fabrics are designed and engineered with correct selection of fibre and yarn constituents in the distinct bottom and top layer (next to sin) can serve well for next-to-skin applications. In this research work, the potential application of milkweed/polyester plated knitted fabrics for next-to-skin end uses were analysed by changing the inner and outer layers of plated fabrics and with different polyester/milkweed blend proportion. From the results of various moisture management indices of plated knitted fabrics, it is observed that except polyester/polyester and polyester/60% milkweed samples, which are exhibited as water penetration fabric, all other samples are showed as moisture management fabric. The hydrophobic fibre (polyester) in the top layer and hydrophilic fibres (milkweed) in the bottom layer exhibits higher bottom absorption rate, bottom spreading speed and one-way liquid transport leading to higher overall moisture management index. By considering the moisture management indices and grades of various samples, it could be observed that the plated fabric made from 40% milkweed/polyester could be an efficient moisture management fabric when used in either-way compared with other fabrics. One-way analysis of variance carried out at 95% confidence level showed that the results are statistically significant. The pair wise strength and association between various moisture management indices was analysed using Pearson correlation coefficient and observed that one-way transport capacity and overall moisture management capacity was found to be positively and linearly related to each other.