bluuebunny/crossref_metadata_2025 huggingface dataset:
Deliberative perfectionism
Authors: Bonotti Matteo
Published: February 2015

In contemporary political theory, perfectionists believe that the state should promote substantive conceptions of the good through its legislation. Supporters of neutrality, instead, claim that the state should refrain from doing so. In this article I analyse perfectionism in relation to Jürgen Habermas’ theory of discourse and deliberative politics (1996) and critique Habermas’ distinction between ‘ethical’ and ‘moral’ discourses (1984, 1990). By relating Habermas’ theory to George Sher’s account of perfectionism (1997), I argue that we can establish the meta-ethical grounds for a model of deliberation encompassing ethical matters (that is, questions concerning the good life) not confined to the limits of specific communities. I conclude by arguing that ethical deliberation is not only feasible but also desirable. Given the fact of ethical pluralism, and in order to show respect towards their fellow citizens, political perfectionists ought to be ready to show how their ethical claims (which they want to see translated into state policy) relate to deeper meta-ethical human goals on which we can ideally find a consensus through deliberation.
Towards a critical theory of the political
Authors: Volk Christian
Published: February 2015

The phrase ‘critique of power’ refers to that analytical program within social philosophy that concerns the discord between the individual and the social orders. From the perspective of many critical theorists, Hannah Arendt’s conception of power, however, is considered unsuitable for such a critical enterprise. In contrast to this assumption, the article argues for reading Hannah Arendt’s concept of power in the light of a critical theory of the political. The critical potential of her thoughts is embedded in her concept of power, which provides an as yet disregarded but highly relevant approach for the analysis of contemporary political orders. Despite the great number of writings concerned with Arendt’s concept of power, this critical potential has not yet been unfolded. This is primarily due to a constricted reading of her concept of power where it is seen as per se normatively positive and non-repressive. In order to overcome this misleading interpretation, the article reconstructs Arendt’s concept of power and argues that her political thinking should be literally read as a critique of power. To illustrate this critical potential, the article unfolds 5 dimensions of Arendt’s analysis of power: the political-parcipitative; the socio-economic; the political-institutional; the ideological-critical; and the ethical.
The manner of contention
Authors: Örs İlay Romain , Turan Ömer
Published: February 2015

This article is based on an ethnographic investigation of the Gezi Park events in 2013. Starting from the much acknowledged characteristics of Gezi as being its cultural and political pluralism and its commitment to non-violence, in this article we are engaging with two interlinked questions: How has the plurality of participants and orientations been possible to attain, and how could this pluralism be contained without any major conflict at Gezi? We propose to provide an answer by focusing on the manners of everyday life at Gezi Park during the time of dissidence, which we conceptualize as ‘manner of contention’. It was the manner of contention that characterized the specific ways in which contentious politics took place at Gezi and prevented the formation of clashes among the plurality of contenders. The ethnographic research delineates at least 4 components of manner of contention in the case of Gezi: an ethos of collective work; a spirit of exchange and gift-giving; politeness; and non-violence.
A Measure of Prejudice Against Accented English (MPAAE)
Authors: Ura Masako , Preston Kathleen S. J. , Mearns Jack
Published: February 2015

Though numerous experiments support the presence of linguistic prejudice toward English speakers with foreign accents, there is, to date, no self-report measure of such prejudice. To capture the multidimensional nature of linguistic prejudice, we created the Measure of Prejudice Against Accented English via using the nominal response model under the item response theory. The resulting 36-item scale, using an empirically derived response format, is informative about individuals across all levels of accented-English prejudice. The scale has good psychometric properties. In addition, it displayed concurrent validity through positive correlations with self-reported xenophobia and feelings of threat from immigrants; it showed discriminant validity by not correlating with social desirability. To evaluate predictive validity, we conducted an experiment in which high linguistic prejudice scores were associated with lower ratings of job applicants who spoke with foreign accents.
Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations
Authors: Sommers Juultje , Engelbert Raoul HH , Dettling-Ihnenfeldt Daniela , Gosselink Rik , Spronk Peter E , Nollet Frans , van der Schaaf Marike
Published: February 2015

Objective:

To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units.

Methods:

We used the EBRO method, as recommended by the ‘Dutch Evidence Based Guideline Development Platform’ to develop an ‘evidence statement for physiotherapy in the intensive care unit’. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts.

Results:

Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment.

Conclusions:

These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014.
Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials
Authors: Searle Angela , Spink Martin , Ho Alan , Chuter Vivienne
Published: February 2015

Objective:

To determine, for adults with chronic low back pain, which exercise interventions are the most effective at reducing pain compared to other treatments.

Data sources:

A search of MEDLINE, CINAHL, EMBASE, SPORTDiscus, PsycINFO and The Cochrane Library was conducted up to October 2014.

Review methods:

Databases were searched for published reports of randomised trials that investigated the treatment of chronic low back pain of non-specific origin with an exercise intervention. Two authors independently reviewed and selected relevant trials. Methodological quality was evaluated using the Downs and Black tool.

Results:

Forty-five trials met the inclusion criteria and thirty-nine were included in the meta-analysis. Combined meta-analysis revealed significantly lower chronic low back pain with intervention groups using exercise compared to a control group or other treatment group (Standard Mean Deviation (SMD) =-0.32, CI 95% -0.44 to -0.19, P<0.01). Separate exploratory subgroup analysis showed a significant effect for strength/resistance and coordination/stabilisation programs.

Conclusions:

Our results found a beneficial effect for strength/resistance and coordination/stabilisation exercise programs over other interventions in the treatment of chronic low back pain and that cardiorespiratory and combined exercise programs are ineffective.
Does cervical spine manipulation reduce pain in people with degenerative cervical radiculopathy? A systematic review of the evidence, and a meta-analysis
Authors: Zhu Liguo , Wei Xu , Wang Shangquan
Published: February 2015

Objective:

To access the effectiveness and safety of cervical spine manipulation for cervical radiculopathy.

Data sources:

PubMed, the Cochrane Central Registry of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Wanfang data, the website of Chinese clinical trial registry and international clinical trial registry by US National Institutes of Health.

Review methods:

Randomized controlled trials that investigated the effects of cervical manipulation compared with no treatment, placebo or conventional therapies on pain measurement in patients with degenerative cervical radiculopathy were searched. Two authors independently evaluated the quality of the trials according to the risk of bias assessment provided by the PEDro (physiotherapy evidence database) scale. RevMan V.5.2.0 software was employed for data analysis. The GRADE approach was used to evaluate the overall quality of the evidence.

Results:

Three trials with 502 participants were included. Meta-analysis suggested that cervical spine manipulation (mean difference 1.28, 95% confidence interval 0.80 to 1.75; P < 0.00001; heterogeneity: Chi2 = 8.57, P = 0.01, I2 = 77%) improving visual analogue scale for pain showed superior immediate effects compared with cervical computer traction. The overall strength of evidence was judged to be moderate quality. One out of three trials reported the adverse events and none with a small sample size.

Conclusion:

There was moderate level evidence to support the immediate effectiveness of cervical spine manipulation in treating people with cervical radiculopathy. The safety of cervical manipulation cannot be taken as an exact conclusion so far.
Patients’ preferences in palliative care: A systematic mixed studies review
Authors: Sandsdalen Tuva , Hov Reidun , Høye Sevald , Rystedt Ingrid , Wilde-Larsson Bodil
Published: February 2015

Background:

It is necessary to develop palliative care to meet existing and future needs of patients and their families. It is important to include knowledge of patient preferences when developing high-quality palliative care services. Previous reviews have focused on patient preferences with regard to specific components of palliative care. There is a need to review research on patient’s combined preferences for all elements that constitute palliative care.

Aim:

The aim of this study is to identify preferences for palliative care among patients in the palliative phase of their illness, by synthesizing existing research.

Data sources:

Studies were retrieved by searching databases – the Cochrane Library, Medline, CINAHL, PsycINFO, Scopus and Sociological Abstracts – from 1946 to 2014, and by hand searching references in the studies included.

Design:

A systematic mixed studies review was conducted. Two reviewers independently selected studies for inclusion and extracted data according to the eligibility criteria. Data were synthesized using integrative thematic analysis.

Results:

The 13 qualitative and 10 quantitative studies identified included participants with different illnesses in various settings. Four themes emerged representing patient preferences for care. The theme ‘Living a meaningful life’ illustrated what patients strived for. The opportunity to focus on living required the presence of ‘Responsive healthcare personnel’, a ‘Responsive care environment’ and ‘Responsiveness in the organization of palliative care’.

Conclusion:

The four themes may be useful for guiding clinical practice and measurements of quality, with the overall goal of meeting future needs and improving quality in palliative care services to suit patients’ preferences.
‘No matter what the cost’: A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context
Authors: Gott Merryn , Allen Ruth , Moeke-Maxwell Tess , Gardiner Clare , Robinson Jackie
Published: February 2015

Background:

There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life.

Aim:

To explore the nature and range of financial costs incurred by family caregiving within a palliative care context.

Design:

In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels.

Setting:

Auckland, New Zealand.

Findings:

Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited.

Conclusion:

Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings.
Pain management at the end of life: A comparative study of cancer, dementia, and chronic obstructive pulmonary disease patients
Authors: Romem Anat , Tom Sarah E , Beauchene Michelle , Babington Lynn , Scharf Steven M , Romem Ayal
Published: February 2015

Background:

Limited data exist concerning the unique pain characteristics of patients with non-cancer terminal diseases referred for inpatient hospice care.

Aims:

To define the unique pain characteristics of patients admitted to an acute inpatient hospice setting with end-stage dementia or chronic obstructive lung disease (or chronic obstructive pulmonary disease) and to compare them to patients with end-stage cancer.

Design:

Retrospective patient chart review. Demographic, physiological, pain parameters, and medication utilization data were extracted. Associations between pain characteristics, medication utilization, and admission diagnoses were assessed. Analyses included descriptive statistics.

Setting/participants:

In total, 146 patients admitted to an acute inpatient hospice between 1 April 2011 and 31 March 2012 with an underlying primary diagnosis of chronic obstructive pulmonary disease ( n = 51), dementia ( n = 48), or cancer ( n = 47).

Results:

Pain was highly prevalent in all diagnostic groups, with cancer patients experiencing more severe pain on admission. Cancer patients received a significantly higher cumulative opioid dose compared with dementia and chronic obstructive pulmonary disease patients. Pain control within 24 h of pain onset was achieved in less than half of all patient groups with chronic obstructive pulmonary disease patients the least likely to achieve pain control.

Conclusions:

Despite the fact that pain is the most common complaint at the end of life, pain management may be suboptimal for some primary diagnoses. Admission diagnosis is the strongest predictor of pain control. Patient with cancer achieve the best pain control, and chronic obstructive pulmonary disease patients are the least likely to have their pain adequately treated.
The Social Context of Urban Classrooms
Authors: Frazier Stacy L. , Mehta Tara G. , Atkins Marc S. , Glisson Charles , Green Philip D. , Gibbons Robert D. , Kim Jong Bae , Chapman Jason E. , Schoenwald Sonja K. , Cua Grace , Ogle Robert R. ,   the LINKS (Linking Neighborhoods, Kids, and Schools) Center
Published: February 2015

Classrooms are unique and complex work settings in which teachers and students both participate in and contribute to classroom processes. This article describes the measurement phase of a study that examined the social ecology of urban classrooms. Informed by the dimensions and items of an established measure of organizational climate, we designed the Student Climate Survey ( n = 53 items) to assess student psychological climate in third through eighth grades. We administered the survey to 621 students at three time points within one school year in 69 classrooms within eight urban schools. A multidimensional item response theory (IRT) analysis based on a full-information item bifactor model revealed 18 items that loaded on a primary factor and demonstrated good criterion and predictive validity. Opportunities for the Student Climate Survey to advance our contextual understanding of urban classrooms and inform intervention are discussed.
Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma
Authors: Littooij Annemieke S , Kwee Thomas C , Barber Ignasi , Granata Claudio , de Keizer Bart , Beek Frederik JA , Hobbelink Monique G , Fijnheer Rob , Stoker Jaap , Nievelstein Rutger AJ
Published: February 2015

Background

Accurate evaluation of the spleen is an important component of staging lymphoma, because this may have prognostic and therapeutic implications.

Purpose

To determine the diagnostic value of whole-body magnetic resonance imaging (MRI), including diffusion-weighted imaging (whole-body MRI-DWI) in the detection of splenic involvement in lymphoma.

Material and Methods

This IRB approved, prospective multicenter study included a total of 107 patients with newly diagnosed, histologically proven lymphoma who underwent 1.5 T whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI and FDG-PET/CT were independently evaluated by a radiologist and a nuclear medicine physician, in a blinded manner. Splenic involvement at MRI was defined as splenic index > 725 cm3 or discrete nodules. At FDG-PET/CT splenic involvement was defined as splenic uptake greater than liver uptake or hypodense nodules at contrast-enhanced CT. FDG-PET/CT augmented with follow-up imaging after treatment was used as reference standard.

Results

Splenic involvement was detected with FDG-PET/CT in 21 patients, all demonstrating response to treatment. The sensitivity, specificity, positive predictive value, and negative predictive value of whole-body MRI-DWI for the detection of splenic involvement were 85.7 %, 96.5 %, 85.7%, and 96.5%, respectively. Three out of six discrepancies were related to suboptimal criterion of splenic size used with whole-body MRI-DWI versus the size-independent FDG uptake.

Conclusion

Whole-body MRI-DWI is reasonably accurate in the detection of splenic lymphomatous involvement.
Primary sphenoid sinus meningioma resection via transnasal transsphenoid approach: A case report
Authors: Wang Zhen , Wang Yongjie , Zhao Xuequn , Zhang JianMin
Published: February 2015

Meningiomas are slow-growing benign lesions that constitute ∼ 25% of primary intracranial tumours. Extracranial meningioma of the sphenoid sinus is extremely rare and may arise from ectopic arachnoid nests left behind during embryonic development. We present the case of a 61-year-old woman with left oculomotor nerve paralysis. Magnetic resonance imaging (MRI) revealed a 43 × 31 × 33 mm mass in the sphenoid sinus invading anteriorly into the posterior ethmoid sinus and superiorly into the base of the anterior cranial fossa. Microscopic transnasal transsphenoidal surgery was performed with multilayer reconstruction to the cranial base. Postoperative MRI confirmed total resection and recovery was uneventful. The pathological diagnosis was grade I meningothelial meningioma. Meningioma should be included in the differential diagnosis of sphenoid sinus mass. Surgery is the first-choice treatment and a transnasal transphenoidal approach is recommended. Cranial base reconstruction is important to avoid postoperative cerebrospinal fluid leakage.
(Mis)matching perceptual learning styles and practicing behavior in tertiary level Western Classical instrumentalists
Authors: Odendaal Albi
Published: February 2015

Perceptual learning style theory argues that humans have differing perceptual strengths and that instruction and learning materials should be adapted to fit their visual, auditory and/or kinesthetic preferences. The claims of various theorists that perceptual learning style theory also applies to the learning of musical material when practicing were tested using a questionnaire that draws on the formulations of these theorists. In total, 131 Western Classical instrument students in higher music education were surveyed using a paper-based questionnaire regarding the frequency with which they engaged in particular learning strategies and behaviors while practicing a large scale composition from the Classical or Romantic era. No response patterns comparable to those suggested by perceptual learning style theory could be identified through either principal components or cluster analyses. The applicability of the theory to describe individual differences in learning is questioned.
Tibial and Femoral Tunnel Changes After ACL Reconstruction
Authors: Weber Alexander E. , Delos Demetris , Oltean Hanna N. , Vadasdi Katherine , Cavanaugh John , Potter Hollis G. , Rodeo Scott A.
Published: February 2015

Background:

Tunnel widening after anterior cruciate ligament reconstruction (ACL-R) is a well-accepted and frequent phenomenon, yet little is known regarding its origin or natural history.

Purpose:

To prospectively evaluate the cross-sectional area (CSA) changes in tibial and femoral bone tunnels after ACL-R with serial MRI.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients underwent arthroscopic ACL-R with the same surgeon, surgical technique, and rehabilitation protocol. Each patient underwent preoperative dual-energy x-ray absorptiometry and clinical evaluation, as well as postoperative time zero MRI followed by subsequent MRI and clinical examination, including functional and subjective outcome tests, at 6, 12, 24, 52, and 104 weeks. Tibial and femoral tunnel CSA was measured on each MRI at tunnel aperture (ttA and ftA), midsection (ttM and ftM), and exit (ttE and ftE). Logistic regression modeling was used to examine the predictive value of demographic data and preoperative bone quality (as measured by dual-energy x-ray absorptiometry) on functional outcome scores, manual and instrumented laxity measurements, and changes in tunnel area over time.

Results:

Eighteen patients (including 12 men), mean age 35.5 ± 8.7 years, underwent ACL-R. There was significant tunnel expansion at ttA and ftA sites 6 weeks postoperatively ( P = .024 and .0045, respectively). Expansion continued for 24 weeks, with progressive tunnel narrowing thereafter. Average ttA CSA was significantly larger than ftA CSA at all times. The ttM significantly expanded after 6 weeks ( P = .06); continued expansion to week 12 was followed by 21 months of reduction in tunnel diameter. The ftM and both ttE and ftE sites decreased in CSA over the 2 years. Median Lysholm and International Knee Documentation Committee scores significantly improved at final follow-up ( P = .0083 and <.0001, respectively), and patients returned to preoperative activity levels. Pivot shift significantly decreased ( P < .0001). Younger age (<30 years), male sex, and delayed ACL-R (>1 year from time of injury) predicted increased tunnel widening and accelerated expansion in CSA ( P < .005).

Conclusion:

Tunnel expansion after ACL-R occurs early and primarily at the tunnel apertures. Expansion may not affect clinical outcome. Younger age, male sex, and delay from injury to ACL-R may be potential risks for enlargement.
Research on permeability of satin fabrics based on fractal theory
Authors: Wang Gongdong , Chen Hao , Lv Sichao , Bikram Maharjan Raj , Zhao Xinkun
Published: February 2015

A new fractal model for predicting the permeability of satin fabrics is proposed mainly based on the fractal theory. The repetitive unit was selected first according to the structural characteristic of a fabric. Then, the tortuosity fractal dimension was figured out after the actual length of a pore channel calculated by the minimum potential energy method. The maximum equivalent diameter, on which the structure fractal dimension can be computed depends, was obtained later by the microscopic measurement technique. Subsequently, the permeability was expressed as the explicit equation of various structural parameters, such as the representative length, the tortuosity fractal dimension, and the structure fractal dimension, which makes the physical meanings of each parameter intuitive and clear. Finally, the permeability of a five-harness fabric and an eight-harness fabric was predicted according to the new fractal models. In order to validate the new model, contrast experiments were designed. The results show that the predicted values agree well with the experimental values, which illustrate that the new method is feasible and effective.
Coupling effect of concrete strength and bonding length on bond behaviors of fiber reinforced polymer–concrete interface
Authors: Li Weiwen , Li Jun , Ren Xiaoli , Leung Christopher KY , Xing Feng
Published: February 2015

Concrete structures retrofitted with externally bonded fiber reinforced polymer (EB-FRP) sheets have been widely introduced and applied for the last several decades. In order to study the coupling effect of concrete strength and bonding length on the bond properties of FRP–concrete system, a series of direct shear bond tests have been conducted. The test results show that not only the failure mode but also the bond capacity are affected significantly by the coupling effect between concrete strength and bonding length. Furthermore, a theoretical model is applied to demonstrate the two-way debonding failure for the specimens with bonding length less than the effective bonding length. Based on the existing bond strength model, an advanced model, which takes into account the coupling effect of concrete strength and bonding length, is then proposed. The advanced model can fairly satisfactorily predicate the bond strength of CFRP–concrete interface under different concrete strengths and bonding lengths.
Cytochrome P450 2E1 is responsible for the initiation of 1,2-dichloropropane-induced liver damage
Authors: Yanagiba Yukie , Suzuki Tetsuya , Suda Megumi , Hojo Rieko , Gonzalez Frank J , Nakajima Tamie , Wang Rui-Sheng
Published: February 2015

1,2-Dichloropropane (1,2-DCP), a solvent, which is the main component of the cleaner used in the offset printing companies in Japan, is suspected to be the causative agent of bile duct cancer, which has been recently reported at high incidence in those offset printing workplaces. While there are some reports about the acute toxicity of 1,2-DCP, no information about its metabolism related to toxicity in animals is available. As part of our efforts toward clarifying the role of 1,2-DCP in the development of cancer, we studied the metabolic pathways and the hepatotoxic effect of 1,2-DCP in mice with or without cytochrome P450 2E1 (CYP2E1) activity. In an in vitro reaction system containing liver homogenate, 1,2-DCP was only metabolized by liver tissue of wild-type mice but not by that of cyp2e1-null mice. Furthermore, the kinetics of the solvent in mice revealed a great difference between the two genotypes; 1,2-DCP administration resulted in dose-dependent hepatic damage, as shown biochemically and pathologically, but this effect was only observed in wild-type mice. The nuclear factor κB p52 pathway was involved in the liver response to 1,2-DCP. Our results clearly indicate that the oxidative metabolism of 1,2-DCP in mice is exclusively catalyzed by CYP2E1, and this step is indispensable for the manifestation of the hepatotoxic effect of the solvent.
Implications of Sarcopenia in Major Surgery
Authors: Friedman Jeffrey , Lussiez Alisha , Sullivan June , Wang Stewart , Englesbe Michael
Published: February 2015

Background: Sarcopenia, defined as a decrease in skeletal muscle mass and strength, is an important risk factor in clinical medicine associated with frailty, mortality, and worse surgical and nonsurgical outcomes. Conventional measures of sarcopenia rely on the subjective “eyeball test” and do not adequately describe risk. Computed tomography (CT) imaging studies may be used to objectively measure sarcopenia and may be used for surgical risk stratification and identification of patients for inclusion in a novel clinical remediation program. Methods: We describe results observed in the general, vascular, and liver transplant surgery populations determined by analytic morphomics—an analysis of CT scans in a semiautomated process using MATLAB v13.0. A perioperative optimization program has been implemented with the objective of remediating sarcopenia through improvement of patient mental and physical status prior to surgery. Results: Using analytic morphomics, we have noted significantly higher cost and increased rates of mortality and surgical complications among sarcopenic patients. The training program shows initial success, and among participating patients, we have observed reductions in payer and hospital costs and a decrease in length of hospital stay for patients following surgery. Conclusions: Through analytic morphomics, we are able to quantify markers of sarcopenia and identify patients at risk for increased mortality and poor surgical outcomes. Early identification of patients offers us the opportunity to remediate sarcopenia through perioperative training and support. Participating patients spend less time in the hospital and have lower healthcare costs. This program has the potential to improve the perioperative patient experience and ease financial burdens.
Functional Assessment of Nutrition Status
Authors: Russell Mary Krystofiak
Published: February 2015

Functional status assessment has been recommended as a part of a complete nutrition assessment for decades, but the specific components of this assessment have eluded a consensus definition. The recent Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus criteria for identification of malnutrition include functional assessment determined by handgrip dynamometry, with the understanding that this technique is not practical for use in some patient populations. Other techniques for functional assessment include physical performance measures such as timed gait and chair stands, as well as activities of daily living tools such as the Katz Index, Lawton Scale, and Karnofsky Scale Index. Manual muscle testing and computed tomography scan assessment of lean tissue are other tools that show promise in correlating functional and nutrition assessments. Functional assessment parameters may be least well correlated with nutrition status in older individuals. Despite a number of scientific studies of a variety of tools for functional assessment, there is to date no definitive tool for use in all individuals in all settings. Nutrition scientists and clinicians must continue to collaborate with colleagues in physical and occupational therapy, geriatrics, and nursing to refine current functional assessment tools to more effectively correlate with nutrition and malnutrition assessment parameters.
Zinc
Authors: Livingstone Callum
Published: February 2015

The essential trace element zinc (Zn) has a large number of physiologic roles, in particular being required for growth and functioning of the immune system. Adaptive mechanisms enable the body to maintain normal total body Zn status over a wide range of intakes, but deficiency can occur because of reduced absorption or increased gastrointestinal losses. Deficiency impairs physiologic processes, leading to clinical consequences that include failure to thrive, skin rash, and impaired wound healing. Mild deficiency that is not clinically overt may still cause nonspecific consequences, such as susceptibility to infection and poor growth. The plasma Zn concentration has poor sensitivity and specificity as a test of deficiency. Consequently, diagnosis of deficiency requires a combination of clinical assessment and biochemical tests. Patients receiving parenteral nutrition (PN) are susceptible to Zn deficiency and its consequences. Nutrition support teams should have a strategy for assessing Zn status and optimizing this by appropriate supplementation. Nutrition guidelines recommend generous Zn provision from the start of PN. This review covers the physiology of Zn, the consequences of its deficiency, and the assessment of its status, before discussing its role in PN.
A 46-Year-Old Woman With Dyspnea From an Inhalational Exposure, Triggering Thyroid Storm and Subsequent Multi-Organ System Failure
Authors: Moraco Andrew H. , Banauch Gisela , Kopec Scott
Published: February 2015

Background:

Thyroid storm is a rare, life-threatening condition which arises in patients with thyrotoxicosis, with an annual incidence of 2 patients per 1,000,000 and a mortality rate of 11%.

Case:

We present the case of a 46-year-old-female with a medical history of controlled mild intermittent asthma, who presented with a severe asthma exacerbation, that triggered thyroid storm after exposure to polyurethane fumes.

Conclusion:

This patient represents, to the best of our knowledge, the first patient in whom the stress related to a severe asthma attack triggered the development of thyroid storm. She also is the first patient with no indication of cardiac dysfunction who developed fatal cardiac arrest after initiation of b-blockade for treatment of thyroid storm.
Exploration of Withdrawal of Life-Sustaining Therapy in Canadian Intensive Care Units
Authors: van Beinum Amanda , Hornby Laura , Ramsay Tim , Ward Roxanne , Shemie Sam D. , Dhanani Sonny
Published: February 2015

Objective:

The process of controlled donation after circulatory death (cDCD) is strongly connected with the process of withdrawal of life-sustaining therapy. In addition to impacting cDCD success, actions comprising withdrawal of life-sustaining therapy have implications for quality of palliative care. We examined pilot study data from Canadian intensive care units to explore current practices of life-sustaining therapy withdrawal in nondonor patients and described variability in standard practice.

Design:

Secondary analysis of observational data collected for Determination of Death Practices in Intensive Care pilot study.

Setting:

Four Canadian adult intensive care units.

Patients:

Patients ≥18 years in whom a decision to withdraw life-sustaining therapy was made and substitute decision makers consented to study participation. Organ donors were excluded.

Interventions:

None.

Measurements and Main Results:

Prospective observational data on interventions withdrawn, drugs administered, and timing of life-sustaining therapy withdrawal was available for 36 patients who participated in the pilot study. Of the patients, 42% died in ≤1 hour; median length of time to death varied between intensive care units (39-390 minutes). Withdrawal of life-sustaining therapy processes appeared to follow a general pattern of vasoactive drug withdrawal followed by withdrawal of mechanical ventilation and extubation in most sites but specific steps varied. Approaches to extubation and weaning of vasoactive drugs were not consistent. Protocols detailing the process of life-sustaining therapy withdrawal were available for 3 of 4 sites and also exhibited differences across sites.

Conclusions:

Standard practice of life-sustaining therapy withdrawal appears to differ between selected Canadian sites. Variability in withdrawal of life-sustaining therapy may have a potential impact both on rates of cDCD success and quality of palliative care.
Potential use of gallium-doped phosphate-based glass material for periodontitis treatment
Authors: Sahdev Rohan , Ansari Tahera I , Higham Susan M , Valappil Sabeel P
Published: February 2015

This study aimed at evaluating the potential effect of gallium-incorporated phosphate-based glasses towards periodontitis-associated bacteria, Porphyromonas gingivalis, and matrix metalloproteinase-13. Periodontitis describes a group of inflammatory diseases of the gingiva and supporting structures of the periodontium. They are initiated by the accumulation of plaque bacteria, such as the putative periodontal pathogen Porphyromonas gingivalis, but the host immune response such as elevated matrix metalloproteinases are the major contributing factor for destruction of periodontal tissues. Antibacterial assays of gallium-incorporated phosphate-based glasses were conducted on Porphyromonas gingivalis ATCC 33277 using disc diffusion assay on fastidious anaerobe agar and liquid broth assay in a modified tryptic soy broth. In vitro study investigated the effect of gallium on purified recombinant human matrix metalloproteinase-13 activity using matrix metalloproteinase assay kit. In vivo biocompatibility of gallium-incorporated phosphate-based glass was evaluated in rats as subcutaneous implants. Antibacterial assay of gallium displayed activity against Porphyromonas gingivalis (inhibition zone of 22 ± 0.5 mm compared with 0 mm for control glass, c-PBG). Gallium in the glass contributed to growth inhibitory effect on Porphyromonas gingivalis (up to 1.30 reductions in log 10 values of the viable counts compared with control) in a modified tryptic soy broth. In vitro study showed gallium-incorporated phosphate-based glasses inhibited matrix metalloproteinase activity significantly ( p ≤ 0.01) compared with c-PBG. Evaluation of in vivo biocompatibility of gallium-incorporated phosphate-based glasses in rats showed a non-toxic and foreign body response after 2 weeks of implantation. The results indicate that gallium ions might act on multiple targets of biological mechanisms underlying periodontal disease. Moreover, gallium-incorporated phosphate-based glasses are biocompatible in a rat model. The findings warrant further investigation and will have important clinical implications in the future treatment and management of periodontitis.
Are Male Perpetrators of Intimate Partner Violence Different From Convicted Violent Offenders? Examination of Psychopathic Traits and Life Success in Males From a Community Survey
Authors: Theobald Delphine , Farrington David P. , Coid Jeremy W. , Piquero Alex R.
Published: February 2015

We used data from the Cambridge Study in Delinquent Development, a prospective longitudinal survey of more than 400 males in the United Kingdom followed from age 8 to age 48 to investigate intimate partner violence (IPV) and its association with psychopathy. We investigated the differences in psychopathy scores between those men who were convicted of violence, those who were involved in both extra- and intra-familial violence, and those who committed IPV only. We also considered whether these generally violent men had poorer life success overall with regard to their drinking and drug taking, depression, and other mental disorders. Our findings suggest that those men who are violent both within and outside the home (the generally violent men) are distinguished from those who commit violent crimes outside the home and those who are involved in IPV within the home only. The differences appear to be more in degree than in kind. These findings are discussed with a focus on whether specific interventions are required for those who commit IPV or whether early intervention should be focused on violent behavior in general.
The Relationship Between Emotion Dysregulation and Impulsive Aggression in Veterans With Posttraumatic Stress Disorder Symptoms
Authors: Miles Shannon R. , Menefee Deleene S. , Wanner Jill , Teten Tharp Andra , Kent Thomas A.
Published: February 2015

While Veterans in general are no more dangerous than the civilian population, Veterans with posttraumatic stress disorder (PTSD) have stronger associations with anger and hostility and certain forms of aggression, such as intimate partner violence, than civilians with PTSD. This is alarming because up to 21% of Veterans seeking Veterans Affairs (VA) health care are diagnosed with PTSD. Emotion regulation difficulties (emotion dysregulation) are also related to increased PTSD symptom severity and may play a role in aggressive behavior. Because the predominant form of aggression in PTSD appears to be the impulsive subtype, the authors sought to clarify the relationship between PTSD, emotion dysregulation, and impulsive aggression. We examined how emotion dysregulation influenced impulsive aggression in a Veteran sample ( N = 479) seeking treatment for trauma sequelae. All Veterans completed measures that assessed demographic information, emotion dysregulation, aggression frequency and subtype, and PTSD symptoms. Men generally reported more aggression than women. The emotion dysregulation, aggression, and PTSD measures were significantly correlated. Two cross-sectional mediation models showed emotion dysregulation fully accounted for the relationship between PTSD and impulsive aggression (indirect path for men: b = .07, SE = .026, bias-correct and accelerated confidence interval [BCa CI] = [0.02, 0.13]; indirect path for women: b = .08, SE = .022, BCa CI = [0.05, 0.13]). PTSD can increase negative emotions yet does not always lead to aggressive behaviors. The ability to regulate emotions may be pivotal to inhibiting aggression in those with PTSD. PTSD interventions may benefit from augmentation with emotion regulation skills training.
Lifetime Video Game Consumption, Interpersonal Aggression, Hostile Sexism, and Rape Myth Acceptance
Authors: Fox Jesse , Potocki Bridget
Published: February 2015

Although previous research has investigated relationships between media consumption, sexism, and rape myth acceptance (RMA), limited research has investigated video games despite their emergence as one of the most popular forms of media entertainment globally. Given that video games typically feature even less diverse and more objectified representations of women than traditional mainstream media, we predicted that there would be relationships between video game consumption and negative beliefs and attitudes about women. In this study, we conducted a survey ( N = 351) of male and female adults and used structural equation modeling to analyze relationships among video game consumption, trait interpersonal aggression, ambivalent sexism, and first-order (percentage of false rape accusations) and second-order cultivation effects (RMA). We found support for the hypothesized cultivation model, indicating a relationship between video game consumption and RMA via interpersonal aggression and hostile sexism. Although these findings cannot be interpreted causally, we discuss the implications of these associations and future directions for research.
There Is No Strength in Emotions
Authors: Huey Laura
Published: February 2015

This article is based on analysis of 76 in-depth qualitative interviews conducted with homeless women in Los Angeles. What is revealed are three patterns of street enculturation—“low-,” “medium-,” and “high street”— which are linked to attitudes women professed to hold about violence. In essence, the degree to which a woman had adopted a “street orientation” is seen to influence how she spoke of violence during earlier portions of the interview. However, several “medium-street” and “high-street” women subsequently acknowledged (directly or indirectly) that they were “fronting” for the interviewer to preserve a tough façade. When they opened up about their real feelings, the extent to which they had internalized the trauma of violence was revealed. Implications of these findings are explored.
Residency Program Directors’ View on the Value of Teaching
Authors: Korte Catherine , Smith Andrew , Pace Heather
Published: February 2015

Purpose:

There is no standardization for teaching activities or a requirement for residency programs to offer specific teaching programs to pharmacy residents. This study will determine the perceived value of providing teaching opportunities to postgraduate year 1 (PGY-1) pharmacy residents in the perspective of the residency program director. The study will also identify the features, depth, and breadth of the teaching experiences afforded to PGY-1 pharmacy residents.

Methods:

A 20-question survey was distributed electronically to 868 American Society of Health-System Pharmacists-accredited PGY-1 residency program directors.

Results:

The survey was completed by 322 program directors. Developing pharmacy educators was found to be highly valued by 57% of the program directors. Advertisement of teaching opportunities was found to be statistically significant when comparing program directors with a high perceived value for providing teaching opportunities to program demographics. Statistically significant differences were identified associating development of a teaching portfolio, evaluation of Advanced Pharmacy Practice Experiences students, and delivery of didactic lectures with program directors who highly value developing pharmacy educators.

Conclusions:

Future residency candidates interested in teaching or a career in academia may utilize these findings to identify programs that are more likely to value developing pharmacy educators. The implementation of a standardized teaching experience among all programs may be difficult.
Investigation into the role of cooling/lubrication effect of cryogenic minimum quantity lubrication in machining of AISI H13 steel by three-dimensional finite element method
Authors: Su Yu
Published: February 2015

This article developed a three-dimensional finite element model of cryogenic minimum quantity lubrication machining in order to investigate the role of cooling/lubrication effect of cryogenic minimum quantity lubrication in machining of AISI H13 steel. In this model, the cryogenic cooling effect provided by refrigerated compressed air is modeled with a convective heat transfer coefficient. A heat transfer window with the temperature and convective heat transfer coefficient of refrigerated compressed air was defined on tool face and workpiece, respectively, which could move at the same speed as cutting tool so as to simulate continuous cryogenic cooling process of cutting zone under cryogenic minimum quantity lubrication condition. The temperature of refrigerated compressed air was set at −10 °C, −30 °C, −50 °C, −100 °C, and −140 °C to study the influence of cryogenic cooling effect of cryogenic minimum quantity lubrication. Frictional contact between tool and chip was modeled with a simple constant shear stress model. Comparative simulations were conducted under different cooling/lubrication conditions, those are, dry cutting, refrigerated compressed air, and cryogenic minimum quantity lubrication. The simulation results show that both cryogenic cooling effect and lubrication effect resulted in reduction in cutting force and tool temperature when machining AISI H13 steel under cryogenic minimum quantity lubrication condition. With a decrease in temperature of refrigerated compressed air, cutting force and tool temperature did not decrease continuously. The reduction in cutting force, maximum tool temperature, and average temperature of rake face and flank face at low and high cutting speeds was strongly attributed to the cryogenic cooling effect and lubrication effect provided by cryogenic minimum quantity lubrication, respectively. A significant reduction in cutting force and tool temperature was caused by the improvement in lubrication effect provided by cryogenic minimum quantity lubrication irrespective of the cutting speed. The trends revealed by the simulations provide helpful information for the development of this technique.