bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV control in postpartum mothers: a turbulent time
Authors: Loftus Hannah , Burnett Alexander , Naylor Simone , Bates Sylvia , Greig Julia
Published: September 2015

We conducted an audit looking at the management of HIV-positive women in the postpartum period. We found that of the women with a previous AIDS-defining condition or a CD4 count <350 cells/µL, 83% were correctly continued on antiretroviral therapy (ART) and 84.1% of these had good virological control. ART was correctly stopped in 100% of women who had always had a CD4 count >500 cells/µL. A significant finding from our audit was that all of the women who had poor virological control or stopped ART against medical advice had social issues or self-reported depression. The main recommendation was to extend the pregnancy multidisciplinary team (MDT) meeting to include the 12-month postpartum period to offer support to women to try to improve treatment outcomes.
Occult hepatitis B virus infection and S gene escape mutants in HIV-infected patients after hepatitis B virus vaccination
Authors: Aghakhani Arezoo , Mohraz Minoo , Aghasadeghi Mohammad Reza , Banifazl Mohammad , Vahabpour Rouhollah , Karami Afsaneh , Foroughi Maryam , Ramezani Amitis
Published: September 2015

Hepatitis B virus (HBV) vaccination is recommended for HIV patients. Despite the relative success of HBV vaccination, breakthrough infections can occur infrequently in patients, and it can be due to occult HBV infection, vaccine unresponsiveness and/or emergence of escape mutants. This study assessed the presence of occult HBV infection and S gene escape mutants in HIV-positive patients after HBV vaccination. Ninety-two HIV-positive patients were enrolled in this study, including 52 responders to HBV vaccine and 40 non-responders. All of the cases received HBV vaccine according to routine HBV vaccination protocols. The presence of HBV-DNA was determined by real-time polymerase chain reaction (PCR). In HBV-DNA positive samples, the most conserved regions of S gene sequences were amplified by nested PCR and PCR products were sequenced. Occult HBV infection was detected in two cases. Glycine to arginine mutation at residue 145 (G145R) within the ‘a’ region of the S gene was detected in one of the occult HBV infection cases who was in the non-responder group. This study showed that the prevalence of occult HBV infection and vaccine escape mutants was low in our HBV-vaccinated HIV-positive patients in both responder and non-responder groups, so there was no alarming evidence indicating breakthrough HBV infection in our vaccinated HIV-positive cases.
Numerical study on thermal performance characteristics of a cascaded latent heat storage unit
Authors: Wang Yifei , Wang Liang , Chen Haisheng , Xie Ningning , Yang Zheng , Chai Lei
Published: September 2015

This study presents a numerical investigation on a cascaded shell-and-tube 3PCMs latent heat thermal storage unit filled with three types of phase-change materials namely, C24H50, C21H44, and C18H38. The mathematical model is based on the enthalpy method and considers the effect of the natural convection of liquid phase-change material during melting. The transient heat transfer and thermal storage characteristic of the 3PCMs unit are analyzed and compared with those of a 1PCM unit that utilizes C24H50. The influences of heat transfer fluid flow rate and inlet temperature on the efficiency, accumulated energy, and exergy of the latent heat thermal storage unit are studied. Results show that the 3PCMs unit can improve the heat transfer rate greatly and shorten the heat storage time effectively, as much as 58% more energy can be stored than the 1PCM unit at the same charging time. The increase of both inlet temperature and flow rate of the heat transfer fluid will lead to a shorter charging time, whereas the advantage of the 3PCMs unit on storage performance over the 1PCM unit becomes more insignificant.
An Lck–cre transgene accelerates autoantibody production and lupus development in (NZB × NZW)F1 mice
Authors: Nelson R K , Gould K A
Published: September 2015

Lupus is an autoimmune disease characterized by the development of antinuclear autoantibodies and immune complex-mediated tissue damage. T cells in lupus patients appear to undergo apoptosis at an increased rate, and this enhanced T cell apoptosis has been postulated to contribute to lupus pathogenesis by increasing autoantigen load. However, there is no direct evidence to support this hypothesis. In this study, we show that an Lck–cre transgene, which increases T cell apoptosis as a result of T cell-specific expression of cre recombinase, accelerates the development of autoantibodies and nephritis in lupus-prone (NZB × NZW)F1 mice. Although the enhanced T cell apoptosis in Lck–cre transgenic mice resulted in an overall decrease in the relative abundance of splenic CD4+ and CD8+ T cells, the proportion of activated CD4+ T cells was increased and no significant change was observed in the relative abundance of suppressive T cells. We postulate that the Lck–cre transgene promoted lupus by enhancing T cell apoptosis, which, in conjunction with the impaired clearance of apoptotic cells in lupus-prone mice, increased the nuclear antigen load and accelerated the development of anti-nuclear autoantibodies. Furthermore, our results also underscore the importance of including cre-only controls in studies using the cre-lox system.
Elevated BLyS levels in patients with systemic lupus erythematosus: Associated factors and responses to belimumab
Authors: Roth D A , Thompson A , Tang Y , Hammer A E , Molta C T , Gordon D
Published: September 2015

Introduction

Patients with systemic lupus erythematosus (SLE) with B-lymphocyte stimulator (BLyS) levels ≥ 2 ng/mL are at increased risk of flare. A regression analysis was undertaken to identify routine clinical measures that correlate with BLyS ≥ 2 ng/mL. Efficacy and safety of belimumab 10 mg/kg were examined in patients with BLyS ≥ 2 ng/mL and < 2 ng/mL.

Methods

Data from BLISS-52 and -76 ( N = 1684) were pooled post hoc. A univariate logistic regression was employed to identify factors predictive of baseline BLyS ≥ 2 ng/mL. Factors significant at the 0.05 level then entered a stepwise logistic regression as covariates. Efficacy endpoints included SLE responder index (SRI), ≥ 4-point reduction in Safety of Estrogens in Lupus National Assessment–Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) and risk of severe flare over 52 weeks. Adverse events (AEs) were analyzed for each treatment arm and BLyS subgroup.

Results

Baseline predictors of BLyS ≥ 2 ng/mL included positive anti-Smith (≥ 15 U/mL), low complement (C) 3 (< 900 mg/L), anti-double-stranded DNA (anti-dsDNA) 80–200 and ≥ 200 IU/mL, immunosuppressant usage, proteinuria, elevated C-reactive protein (CRP), and low total lymphocyte count for all patients. Belimumab 10 mg/kg led to significantly greater SRI responses over 52 weeks versus placebo in both BLyS subgroups, though treatment differences were numerically greater at Week 52 in the BLyS ≥ 2 ng/mL group (24.1%, p < 0.0001) compared with BLyS < 2 ng/mL (8.2%, p = 0.0158). Results were similar for ≥ 4-point reduction in SELENA-SLEDAI. Risk of severe flare over 52 weeks was significantly reduced with belimumab 10 mg/kg versus placebo in the BLyS ≥ 2 ng/mL group ( p = 0.0002). AEs were similar across treatment arms and BLyS subgroups.

Conclusions

Positive anti-Smith, low C3, anti-dsDNA ≥ 80 IU/mL, immunosuppressant usage, proteinuria, elevated CRP, and low total lymphocyte count were predictors of BLyS ≥ 2 ng/mL. Monitoring these factors could identify patients with BLyS ≥ 2 ng/mL who are at risk of flare.
Alveolar hemorrhage in systemic lupus erythematosus: a cohort review
Authors: Andrade C , Mendonça T , Farinha F , Correia J , Marinho A , Almeida I , Vasconcelos C
Published: September 2015

Diffuse alveolar hemorrhage (DAH) is a rare but potentially catastrophic manifestation with a high mortality. Among rheumatologic diseases, it occurs most frequently in patients with systemic lupus erythematosus (SLE) and systemic vasculitis. Despite new diagnostic tools and therapies, it remains a diagnostic and therapeutic challenge. The aim of this work was to characterize the SLE patients with an episode of alveolar hemorrhage followed in our Clinical Immunology Unit (CIU). A retrospective chart review was carried out for all patients with SLE followed in CIU between 1984 and the end of 2013. We reviewed the following data: demographic characteristics, clinical and laboratory data, radiologic investigations, histologic studies, treatment, and outcome. We identified 10 episodes of DAH, corresponding to seven patients, all female. These represent 1.6% of SLE patients followed in our Unit. The age at DAH attack was 42.75 ± 18.9 years. The average time between diagnosis of SLE and the onset of DAH was 7.1 years. Three patients had the diagnosis of SLE and the DAH attack at the same time. Disease activity according to SLEDAI was high, ranging from 15 to 41. All patients were treated with methylprednisolone, 37.5% cyclophosphamide and 28.6% plasmapheresis. The overall mortality rate was 28.6%.
A new approach to categorising continuous variables in prediction models: Proposal and validation
Authors: Barrio Irantzu , Arostegui Inmaculada , Rodríguez-Álvarez María-Xosé , Quintana José-María
Published: September 2015

When developing prediction models for application in clinical practice, health practitioners usually categorise clinical variables that are continuous in nature. Although categorisation is not regarded as advisable from a statistical point of view, due to loss of information and power, it is a common practice in medical research. Consequently, providing researchers with a useful and valid categorisation method could be a relevant issue when developing prediction models. Without recommending categorisation of continuous predictors, our aim is to propose a valid way to do it whenever it is considered necessary by clinical researchers. This paper focuses on categorising a continuous predictor within a logistic regression model, in such a way that the best discriminative ability is obtained in terms of the highest area under the receiver operating characteristic curve (AUC). The proposed methodology is validated when the optimal cut points’ location is known in theory or in practice. In addition, the proposed method is applied to a real data-set of patients with an exacerbation of chronic obstructive pulmonary disease, in the context of the IRYSS-COPD study where a clinical prediction rule for severe evolution was being developed. The clinical variable PCO2 was categorised in a univariable and a multivariable setting.
A joint frailty-copula model between tumour progression and death for meta-analysis
Authors: Emura Takeshi , Nakatochi Masahiro , Murotani Kenta , Rondeau Virginie
Published: September 2015

Dependent censoring often arises in biomedical studies when time to tumour progression (e.g., relapse of cancer) is censored by an informative terminal event (e.g., death). For meta-analysis combining existing studies, a joint survival model between tumour progression and death has been considered under semicompeting risks, which induces dependence through the study-specific frailty. Our paper here utilizes copulas to generalize the joint frailty model by introducing additional source of dependence arising from intra-subject association between tumour progression and death. The practical value of the new model is particularly evident for meta-analyses in which only a few covariates are consistently measured across studies and hence there exist residual dependence. The covariate effects are formulated through the Cox proportional hazards model, and the baseline hazards are nonparametrically modeled on a basis of splines. The estimator is then obtained by maximizing a penalized log-likelihood function. We also show that the present methodologies are easily modified for the competing risks or recurrent event data, and are generalized to accommodate left-truncation. Simulations are performed to examine the performance of the proposed estimator. The method is applied to a meta-analysis for assessing a recently suggested biomarker CXCL12 for survival in ovarian cancer patients. We implement our proposed methods in R joint.Cox package.
A regression method for modelling geometric rates
Authors: Bottai Matteo
Published: September 2015

The occurrence of an event of interest over time is often summarized by the incidence rate, defined as the average number of events per person-time. This type of rate applies to events that may occur repeatedly over time on any given subject, such as infections, and Poisson regression represents a natural regression method for modelling the effect of covariates on it. However, for events that can occur only once, such as death, the geometric rate may be a better summary measure. The geometric rate has long been utilized in demography for studying the growth of populations and in finance to compute compound interest on capital. This type of rate, however, is virtually unknown to medical research. This may be partly a consequence of the lack of a regression method for it. This paper describes a regression method for modelling the effect of covariates on the geometric rate. The described method is based on applying quantile regression to a transform of the time-to-event variable. The proposed method is used to analyze mortality in a randomized clinical trial and in an observational epidemiological study.
From the preserves of the educated elite to virtually everywhere: A content analysis of Danish science news in 1999 and 2012
Authors: Vestergård Gunver Lystbæk , Nielsen Kristian H.
Published: September 2015

In an attempt to qualify changes to science news reporting due to the impact of the Internet, we studied all science news articles published in Danish national newspapers in a November week in 1999 and 2012, respectively. We find the same amount of science coverage, about 4% of the total news production, in both years, although the tabloids produce more science news in 2012. Online science news also received high priority. Journalists in 2012 more often than in 1999 make reference to scientific journals and cite a wider range of journals. Science news in 2012 is more international and politically oriented than in 1999. Based on these findings, we suggest that science news, due partly to the emergence of online resources, is becoming more diverse and available to a wider audience. Science news is no longer for the elite but has spread to virtually everywhere in the national news system.
Making sense of research on the neuroimage bias
Authors: Baker D. A. , Ware Jillian M. , Schweitzer N. J. , Risko Evan F.
Published: September 2015

Both academic and legal communities have cautioned that laypersons may be unduly persuaded by images of the brain and may fail to interpret them appropriately. While early studies confirmed this concern, a second wave of research was repeatedly unable to find evidence of such a bias. The newest wave of studies paints a more nuanced picture in which, under certain circumstances, a neuroimage bias reemerges. To help make sense of this discordant body of research, we highlight the contextual significance of understanding how laypersons’ decision making is or is not impacted by neuroimages, provide an overview of findings from all sides of the neuroimage bias question, and discuss what these findings mean to public use and understanding of neuroimages.
Sir William Brooke O’Shaughnessy (1808–1889), MD, FRS, LRCS Ed: Chemical pathologist, pharmacologist and pioneer in electric telegraphy
Authors: MacGillivray Neil
Published: September 2015

This article reviews the life and work of Sir William O’Shaughnessy Brooke (formerly Sir William Brooke O'Shaughnessy), an Edinburgh doctor of medicine and Fellow of the Royal Society who as a young doctor in London analysed the blood and excreta of cholera victims, an action which led to the first successful use of intravenous replacement therapy. His career in India was distinguished in several spheres: chemistry, pharmacology in which he introduced cannabis indica to Europe, and in the field of electric telegraphy where he became the superintendent of telegraphs for India.
James Bell Pettigrew (1832–1908) MD, LLD, FRS, comparative anatomist, physiologist and aerobiologist
Authors: Gardner Dugald
Published: September 2015

After leaving Glasgow University, Pettigrew joined the Edinburgh Medical School in 1856. Professor Goodsir determined Pettigrew’s entire future by awarding him the Anatomy Gold Medal for an essay on cardiac muscle. The essay was accompanied by dissections of such high quality that they led to the Croonian Lecture of the Royal Society of London in 1860. After graduating, Pettigrew’s time as House Surgeon to James Syme was followed by a position in the Hunterian Museum, London. Intensive studies of urinary and alimentary muscle, and observations of insects and animals, with lectures on flight to distinguished societies, contributed to disabling illness and a long convalescence but in 1869 Pettigrew became Conservator of the Royal College of Surgeons of Edinburgh and then Pathologist to the Royal Infirmary of Edinburgh. The publication of Physiology of the Circulation and of Animal Locomotion, with its emphasis on aeronautics, ensured international fame. Fellowship of both London and Edinburgh Royal Societies was another factor contributing to Pettigrew’s election to the Chandos Chair at St Andrews University in 1875. The construction and abortive flying of a motor-driven aeroplane came near the end of his life and Pettigrew gave his remaining years to completing his monumental Design in Nature.
A good death
Authors: Hold Judith L
Published: September 2015

Background:

On a day to day basis, nurses are facing more ethical dilemmas during end-of-life care resulting in not being able to actualize a good death for patients.

Research objective:

The purpose of this study was to explore how experienced hospice nurses resolve day to day ethical dilemmas during end-of-life care.

Research design:

The study used a qualitative narrative approach.

Participants:

Through purposeful sampling, a total of six experienced hospice nurse participated.

Ethical considerations:

Approval from the researcher’s university Institutional Review Board for ethical review was obtained.

Findings:

Using core story creation, several different ethical dilemmas were identified divulging struggles with key stakeholders including family members and providers. Thematic analysis generated three main themes: Ethics within Practice, Ethical Knowledge, and Ethical Solutions.

Discussion:

The participants told their stories depicting a keen awareness of ethical conflicts situated by contextual factors including social, political, and personal issues. The nurses’ deliberations were informed through formal, experiential, and intuitive knowledge. Ethical predicaments were resolved by either following rules or choosing acts of resistance.

Conclusion:

A better understanding was obtained on how experienced hospice nurses successfully resolve ethical dilemmas culminating in better deaths for patients.
Access to services for young adults with medical complexity
Authors: Joly Elizabeth
Published: September 2015

Background:

With the number of young people with medical complexity increasing, an increasing number must navigate the transition to adulthood. This transition, in part, involves a situational transition in which young people and their families must access new services in the adult system.

Objectives:

To explore how societal ideologies, communities, and organizations represent the foundation of barriers to access to services.

Research Design:

The discussion in this paper, framed within a social justice perspective, outlines barriers to access to services at the societal and community levels including societal ideologies, differences in philosophies of care in pediatric and adult care, physical environments, and availability of services.

Ethical Considerations:

Since this is an exploratory discussion paper, no ethical approval was required.

Findings and Conclusion:

Based on analysis of the literature from a social justice perspective, it is suggested that the adult health care and social service systems do not provide the supports and services necessary to empower young people and their families to achieve their goals and maintain their health and quality of life. It is, thus, an ethical issue that the transfer from pediatric to adult services is occurring in the absence of appropriate services. Recommendations at the individual, community and policy levels highlight how nurses can address this ethical issue to promote more equitable access to services.
Clear conscience grounded in relations: Expressions of Persian-speaking nurses in Sweden
Authors: Mazaheri Monir , Ericson-Lidman Eva , Zargham-Boroujeni Ali , Öhlén Joakim , Norberg Astrid
Published: September 2015

Background:

Conscience is an important concept in ethics, having various meanings in different cultures. Because a growing number of healthcare professionals are of immigrant background, particularly within the care of older people, demanding multiple ethical positions, it is important to explore the meaning of conscience among care providers within different cultural contexts.

Research objective:

The study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia.

Research design:

A phenomenological hermeneutical method guided the study.

Participants and research context:

A total of 10 enrolled nurses with Iranian background, aged 33–46 years, participated in the study. All worked full time in residential care settings for Persian-speaking people with dementia in a large city, in Sweden.

Ethical considerations:

The study was approved by the Regional Ethical Review Board for ethical vetting of research involving humans. Participants were given verbal and written study information and assured that their participation was voluntary and confidential.

Findings:

Three themes were constructed including perception of conscience, clear conscience grounded in relations and striving to keep a clear conscience. The conscience was perceived as an inner guide grounded in feelings, which is dynamic and subject to changes throughout life. Having a clear conscience meant being able to form a bond with others, to respect them and to get their confirmation that one does well. To have a clear conscience demanded listening to the voice of the conscience. The enrolled nurses strived to keep their conscience clear by being generous in helping others, accomplishing daily tasks well and behaving nicely in the hope of being treated the same way one day.

Conclusion:

Cultural frameworks and the context of practice needed to be considered in interpreting the meaning of conscience and clear conscience.
Development of a synergistic damage mechanics model to predict evolution of ply cracking and stiffness changes in multidirectional composite laminates under creep
Authors: Berton Thomas , Montesano John , Singh Chandra Veer
Published: September 2015

A physics-based multi-scale model that couples viscoelasticity and time-dependent damage evolution for general multidirectional laminates subjected to long-term creep loading is developed. The viscoelastic ply behavior is evaluated using a nonlinear Schapery-type viscoelastic model, while a methodology employed within the framework of classical laminate theory is used to predict the corresponding laminate time-dependent response. The evolution of microscopic ply cracks in multiple plies with different orientations during creep loading is predicted using an energy-based approach, and the corresponding laminate stiffness degradation is evaluated using a synergistic damage mechanics-based model that relies on computational micromechanics in lieu of costly experimental data. The developed model is used to predict the evolution of ply cracks and the viscoelastic stress–strain response of various cross-ply and multidirectional laminates under quasi-static and creep loading. Predicted strains, compliance changes and crack density evolutions show excellent agreement with available experimental creep data for different laminate stacking sequences, providing validation for the model. Predictions are also made for two additional multidirectional laminates in order to investigate the effect of off-axis ply angle on the creep response, which demonstrates the versatility of the model and its usefulness in assessing the long-term durability of general multidirectional composite laminates.
Optimizing Anticoagulation Management Through the Use of a Hospital Engagement Network Metric for Inpatient Anticoagulant-Associated Hemorrhage
Authors: Hoffman Janet L. , Aneese Nadia J. , Schmidt Kyle J. , Chaben Alex C. , Smythe Maureen A.
Published: September 2015

Background: The University HealthSystem Consortium (UHC), a national hospital engagement network (HEN), establishes health-system metrics to assess and improve quality of care. In 2012, a metric for inpatient anticoagulant hemorrhage was developed. The utility of this metric to improve anticoagulation care has not been assessed. Objective: To identify opportunities to improve anticoagulation safety through the use of a HEN metric for inpatient anticoagulant-associated hemorrhage. Methods: This was a single-center, retrospective, observational study of metric identified patients with presumed inpatient anticoagulant hemorrhage. Records were reviewed to confirm anticoagulant hemorrhage and identify bleed site and severity. A structured process was used to assess bleed preventability and subsequently identify opportunities for improving care. Each bleed was reviewed by 2 investigators. Results: Anticoagulant hemorrhage was confirmed in 85.9% (61/71) with heparin infusion the most common anticoagulant. Patients were primarily medical, with a mean age of 72.7 ± 15 years. The most common bleed sites were gastrointestinal (24.6%) and retroperitoneal (21.3%). Major bleeding occurred in 60.7% (37/61). Anticoagulant hemorrhage was preventable in 18% (11/61) of cases with heparin protocol noncompliance the most common cause of a preventable bleed. Several opportunities for improving heparin infusion therapy were recognized and protocol changes were implemented. Conclusions: The UHC metric accurately captures inpatient anticoagulant-associated hemorrhage the majority of time. The UHC metric on anticoagulant-associated hemorrhage can be a useful part of a health system’s overall plan for the safe use of anticoagulants in the hospital setting.
Moberg Osteotomy Shifts Contact Pressure Plantarly in the First Metatarsophalangeal Joint in a Biomechanical Model
Authors: Kim Paul Hyon-Uk , Chen Xiang , Hillstrom Howard , Ellis Scott J. , Baxter Josh R. , Deland Jonathan T.
Published: September 2015

Background:

A proximal phalangeal dorsiflexion osteotomy (Moberg osteotomy) is commonly used to treat hallux rigidus, but the mechanical explanation for its effectiveness is unclear. The purpose of our study was to test the effect of a Moberg osteotomy on first metatarsophalangeal joint contact mechanics.

Methods:

Ten cadaveric first ray specimens were dissected, with the medial band of the plantar aponeurosis preserved at its origin, and placed in a custom testing apparatus. Forefoot loads during mid-stance with the first metatarsal positioned at 10 degrees were simulated using a custom-made loading jig while contact mechanics were acquired with a thin pressure-sensitive sensor. A Moberg osteotomy was performed starting 9 mm distal to the proximal phalanx with excision of a 3-mm wedge of bone and fixated with a 2-mm Kirschner wire. The effect of the Moberg osteotomy was tested by reapplying the forefoot loads and acquiring the joint pressures. The center of pressure, peak pressure, and contact area were calculated. Paired t tests were performed to determine if the Moberg osteotomy affected joint contact mechanics.

Results:

The Moberg osteotomy shifted the center of contact pressure on the proximal phalanx surface more plantarly ( P < .01). However, the Moberg osteotomy did not affect the peak pressure ( P = .62) or the joint contact area ( P = .96).

Conclusions:

There were no differences in peak pressure or first MTPJ contact area, but a plantar shift in the center of pressure occurred after the Moberg osteotomy.

Clinical Relevance:

The plantar cartilage, which is often spared from arthritic changes, may be preferentially loaded and the potential edge loading following cheilectomy may be avoided with the Moberg osteotomy secondary to the plantar shift of center of pressure.
Outcomes and Return to Activity After Operative Repair of Chronic Latent Syndesmotic Instability
Authors: Ryan Paul M. , Rodriguez Ryan M.
Published: September 2015

Background:

This study is a retrospective review of prospectively gathered data determining the postoperative outcomes of patients who underwent operative treatment to address chronic syndesmotic instability.

Methods:

The cohort is composed of 19 individuals who elected to undergo operative treatment of chronic syndesmotic instability. The operative repair consisted of arthroscopic debridement in all cases with reduction and suture button fixation of those patients who had greater than 4 mm of syndesmotic diastasis on arthroscopic evaluation. All patients had a minimum of 24 months follow-up. This study retrospectively examined the prospectively gathered preoperative and postoperative outcome scores to include a Visual Analog Scale (VAS) pain score and an American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. In addition, patients were questioned on their ability to return to their preinjury level of activity and their ability to continue running sports. Fourteen patients returned their postoperative surveys.

Results:

Mean AOFAS scores improved significantly from 48 to 82.7 ( P = .014). Mean VAS scores improved from 6.1 to 1.0 ( P = .002). Overall, 86% (12/14) of patients were able to return to running and 79% (11/14) of patients were able to return to their preinjury level of sport. Preoperative and postoperative weight-bearing ankle radiographs were reviewed to evaluate the tibiofibular clear space and overlap. The clear space measured on anteroposterior (AP) radiographs decreased from 5.4 mm to 4.6 mm ( P = .005), the clear space evaluated on the mortise radiograph decreased from 4.5 mm to 3.6 mm ( P = .006), and the overlap measured on the AP radiograph increased from 5.7 mm to 6.9 mm ( P = .019). All radiographs were measured by a board-certified musculoskeletal radiologist.

Conclusion:

This study presents a treatment method that can be instituted at the time of diagnosis for syndesmotic injuries with greater than 4 mm of diastasis that were treated with debridement and stabilization. The results of this treatment technique are promising, with significant improvements in subjective outcome scores and a high rate of return to running sports.

Level of Evidence:

Level IV, retrospective case series.
Feigned Adjudicative Incompetence
Authors: Rogers Richard , Robinson Emily V. , Henry Sarah A.
Published: September 2015

Psychological assessments are highly dependent on the forthrightness and sincere efforts of examinees. In particular, evaluations in forensic settings must consider whether feigning or other response styles are utilized to intentionally distort the clinical presentation. The current study examines the effectiveness of the Inventory of Legal Knowledge (ILK) at detecting feigned incompetency within a sample of jail detainees. As an ancillary goal, several scales of the Standardized Assessment of Miranda Abilities were included in the same within-subjects simulation design. Results of the total ILK score raised concerns regarding the mischaracterization of genuine offenders as “suggestive of feigning.” Pending cross-validation, however, a Revised ILK proved highly effective, using a floor effect detection strategy. Although intended for Miranda-specific abilities, several detection strategies on the Standardized Assessment of Miranda Abilities appeared to be very promising within a broadened context of feigned incompetency.
Vibration control of uncertain structures with actuator saturation using hedge-algebras-based fuzzy controller
Authors: Bui Hai-Le , Nguyen Cong-Hung , Bui Van-Binh , Le Kim-Ngoc , Tran Huu-Quoc
Published: September 2015

In this study, the problem of vibration control of structures involving parameter uncertainties and actuator saturation using hedge-algebras-based fuzzy controller (HAC) is presented. When structural damping and stiffness cannot always be measured easily and precisely, their uncertainties are assumed to be norm-bounded. The proposed controller is designed based on hedge algebras theory, where inherent order relationships between linguistic values of each linguistic variable, determined by isomorphisms mapping called semantically quantifying mapping based on few fuzziness parameters of each linguistic variable instead of using any fuzzy sets, are always ensured. The performance of the proposed controller is investigated by numerical simulations on active control of a benchmark three-storey building structure with active bracing system subjected to excitation of typical earthquakes. A conventional fuzzy controller, designed based on parameters similar to those of HAC, is also considered for the purpose of comparing effectiveness between controllers in order to shown advantages of the proposed method.
The edge waves on a Kirchhoff plate bilaterally supported by a two-parameter elastic foundation
Authors: Kaplunov J , Nobili A
Published: September 2015

In this paper, the bending waves propagating along the edge of a semi-infinite Kirchhoff plate resting on a two-parameter Pasternak elastic foundation are studied. Two geometries of the foundation are considered: either it is infinite or it is semi-infinite with the edges of the plate and of the foundation coinciding. Dispersion relations along with phase and group velocity expressions are obtained. It is shown that the semi-infinite foundation setup exhibits a cut-off frequency which is the same as for a Winkler foundation. The phase velocity possesses a minimum which corresponds to the critical velocity of a moving load. The infinite foundation exhibits a cut-off frequency which depends on its relative stiffness and occurs at a nonzero wavenumber, which is in fact hardly observed in elastodynamics. As a result, the associated phase velocity minimum is admissible only up to a limiting value of the stiffness. In the case of a foundation with small stiffness, asymptotic expansions are derived and beam-like one-dimensional equivalent models are deduced accordingly. It is demonstrated that for the infinite foundation the related nonclassical beam-like model comprises a pseudo-differential operator.
Strange Fruit
Authors: Tillmann Lisa M.
Published: September 2015

This poem examines drone warfare as a form of lynching. “Strange Fruit” links the deaths of Pakistani children Zeerak and Maria Khan to the murders of Thomas Shipp and Abram Smith, documented in the most infamous lynching photograph in U.S. history.
Effects of Socialization on Gender Discrimination and Violence Against Women in Lebanon
Authors: Usta Jinan , Farver JoAnn M. , Hamieh Christine Sylva
Published: September 2015

This study explored the socialization of Lebanese men’s attitudes toward gender equality to understand violence against women in Middle Eastern countries. Two hundred seventy-three men completed a survey, and 73 participated in seven focus groups. Survey results showed that participants’ education, parents’ expectations for gender-typed behavior, school discipline, and exposure to community violence predicted the men’s attitudes toward gender inequality. In focus group discussions, participants expressed that masculinity imposed a taxing role wherein they perceived themselves as “victims” of a traditional culture where norms grant men control and power over women.
Inactivation of spoiling microorganisms in apple juice by a combination of essential oils’ constituents and physical treatments
Authors: Chueca Beatriz , Ramírez Nayeli , Arvizu-Medrano Sofía M , García-Gonzalo Diego , Pagán Rafael
Published: September 2015

A combination of different hurdles, such as mild heat (54 ℃ for 10 min) or pulsed electric field (25 pulses; 25 kV/cm; 3.35 kJ/cm per pulse) treatments and essential oils constituents (carvacrol, citral, and (+)-limonene), to reduce spoiling bacteria and yeasts in apple juice was evaluated. For this purpose, the heat and pulsed electric field resistances of five strains of Leuconostoc spp. and five Saccharomyces spp. strains were assayed, achieving different inactivation levels for each treatment and strain. For instance, Leuconostoc fallax 74, the most heat-resistant strain, was the second-most sensitive strain to pulsed electric field. The most resistant strains were exposed to combined processes of heat or pulsed electric field and 0.2 µl/ml essential oils constituents. The combination of heat and essential oils constituents proved to be synergistic against both microorganisms in apple juice. The most effective was the combination of mild heat and carvacrol, which caused the inactivation of 99% of L. fallax 74 and 99.99% of Saccharomyces cerevisiae CECT 1172 cells. Therefore, this study shows the great potential of carvacrol, citral, and (+)-limonene in combined treatments with mild heat to achieve a higher degree of inactivation of spoiling microorganisms in apple juice, and thus, to extend its shelf life.
Self-Management Techniques to Improve Chronic Diseases
Authors: Alpert Patricia T.
Published: September 2015

With the advances made in modern medical treatments older adults are living longer. Approximately 80% have at least one chronic disease condition, which can affect their independence and quality of life if not managed appropriately. Much of chronic disease care centers on patients attending to lifestyle modifications and sustaining non-medical care routines. Consistent self-management is difficult to sustain. This article discusses some of the most frequently used integrative approaches to help patients manage their own disease condition.
Service Recovery via Social Media
Authors: Schaefers Tobias , Schamari Julia
Published: September 2015

Social media channels are increasingly used by consumers to post complaints to companies. In contrast to traditional channels, the complaint and a firm’s recovery efforts are visible to passive observers who are virtually present. Additionally, these unaffected users may become involved by supporting a complainant with negative comments or by supporting the firm with positive comments, leading to interactive virtual presence (VP). We reveal that such VP affects how a complainant reacts to successful and unsuccessful service recovery. Based on social influence theory (SIT), we investigate the influence of a mere VP as well as interactive VP of positive and negative valence on the complainant’s satisfaction and purchase intentions and analyze the role of expertise of those who are virtually present. The results indicate that SIT is applicable to virtual environments but that restrictions apply. Specifically, mere VP enhances the effects of recovery success, but—in contrast to SIT—not the negative results of unsuccessful recovery, and interactive VP leads to attitude polarization. Moreover, high-expertise individuals who engage in positive (negative) interactions after unsuccessful (successful) recovery are deleterious. When experts disconfirm successful recovery, they have higher credibility and reduce confidence in the firm. However, in contrast to SIT, experts trying to mitigate unsuccessful recovery are perceived as less credible, which also reduces confidence. Overall, if service recovery via social media is successful, firms will benefit from VP. However, caution is advised when using expert users who may interfere with service recovery processes.
Tailoring of the bearing stiffness to enhance the performance of gas-lubricated bump-type foil thrust bearing
Authors: Gad Abdelrasoul M , Kaneko Shigehiko
Published: September 2015

This study aims to tailor the bearing stiffness for enhancing the load-carrying capacity of foil thrust bearings. New architectures for the bump foil are introduced with structural stiffness tailored in the radial and circumferential directions to ensure a converging gas film under high axial loads while maintaining a reasonable bearing compliance to accommodate thermal as well as mechanical distortions. The structural stiffness of the bearing is calculated with an analytical method previously introduced by the authors, and the flow in the gas film is modeled with 2-D compressible Reynolds equation. The Couette Approximation technique is used to calculate the temperature distribution in the gas film and the small perturbations method is used to calculate its dynamic force coefficients. Enhanced load capacity could be obtained with the introduced bump foil designs.
Effects of axial misalignment of rings on the dynamic characteristics of cylindrical roller bearings
Authors: Zhenhuan Ye , Liqin Wang
Published: September 2015

Axial misalignment of bearing rings has an effect on the loading characteristics and stability of cylindrical roller bearings. Based on the kinematic relationship between bearing elements, a dynamic model of cylindrical roller bearings was developed. The effect of axial misalignment of rings on the contact pressure distribution of cylindrical roller bearings with a Lundberg logarithm modified profile roller was analysed. The vibration of the contact pressure and the cage stability during bearing operation were also analysed. The results show that a tilt between the inner ring and outer ring leads to stress concentration along the roller generatrix of the roller in the loaded zone. At the same time, when the bearing in operation, the cage sliding ratio and swing amplitude of the rollers in the loaded zone increase with the increasing tilt angle of the inner ring. The stress concentration of the rollers in the loaded zone that results from the tilt between the inner ring and outer ring could be improved by increasing the Lundberg logarithm modified coefficient.
Older adults’ self-reported barriers to adherence to dietary guidelines and strategies to overcome them
Authors: McLaughlin Anne Collins , Whitlock Laura A , Lester Kate L , McGraw Anne E
Published: September 2015

Once an older adult develops type 2 diabetes, they often need to change their diet as part of the treatment. We report differences in dietary barriers and strategies to overcome them in 17 older adults without type 2. Data were gathered through 24-hour diet recalls, collected barriers and strategies in changing diet, and the health locus of control scales. Differences in barriers and strategies were partially explained by health locus of control subscales. People who believed that others (e.g. doctors) controlled their health were less likely to identify barriers or strategies to overcome them. The results contribute to training materials and decision aids.
Binge-watching: Video-on-demand, quality TV and mainstreaming fandom
Authors: Jenner Mareike
Published: September 2015

This article explores the concept of the binge as viewing protocol associated with fan practices, industry practice and linked to ‘cult’ and ‘quality’ serialised content. Viewing binge-watching as an intersection of discourses of industry, audience and text, the concept is analysed here as shaped by a range of issues that dominate the contemporary media landscape. In this, factors like technological developments, fan discourses and practices being adopted as ‘mainstream’ media practice, changes in the discursive construction of ‘television’ and an emerging video-on-demand industry contribute to the construction of binge-watching as deliberate, self-scheduled alternative to ‘watching TV’.
Assessment of radiation hazards due to exposure to radionuclides in marble and ceramic commonly used as decorative building materials in Egypt
Authors: Hassan Nabil M. , Mansour N. A. , Fayez-Hassan M. , Fares Samar
Published: September 2015

The concentrations of 238 U (226Ra), 232Th, and 40K for the commonly used decorative building materials (15 marble and 15 ceramic) in Egypt were measured using gamma spectroscopy system. Radionuclides concentrations in marble samples were ranged from: ND to 49.92 ± 7.74 Bq kg−1 for 226Ra, 8.30 ± 1.70 to 119.52 ± 16.00 Bq kg−1 for 232Th, and 32.60 ± 4.25 to 2238.33 ± 242.66 Bq kg−1 for 40K while in ceramic samples the concentration ranged from: 28.42 ± 5.41 to 118.70 ± 20.34 Bq kg−1 for 226Ra, 30.65 ± 5.49 to 114.15 ± 18.78 Bq kg−1 for 232Th, and 389.54 ± 49.57 to 1069.83 ± 124.50 Bq kg−1 for 40K, respectively. These results imply that radium and thorium concentrations were below the worldwide recommended values but potassium was above the standard guideline. Radiological hazards indices of radium equivalent activity (Raeq), external and internal hazard indices: Hex and Hin, respectively, and annual effective doses of the investigated materials due to the presence of those radionuclides were calculated and had values less than the worldwide recommended values of 370 Bq kg−1, unity and 1 mSv y−1, respectively. Therefore, the studied types of marble and ceramic can be safely used as decorative building materials.
Transocular ultrasound measurement of the optic nerve sheath diameter can identify elevated intracranial pressure in trauma patients
Authors: Nash Joshua E , O’Rourke Colin , Moorman Matthew L
Published: September 2015

Background

Prompt identification of elevated intracranial pressure (eICP) is life-saving. Physical exam alone often fails to identify this problem and invasive monitoring is not always utilized appropriately. A non-invasive, rapid, reliable technique to detect eICP is needed and optic nerve sheath diameter (ONSD) is known to be a valid surrogate. Historically, ONSD in patients with eICP above 20 mmHg varied from 0.5 to 0.7 cm. Receiver operator curves predict that diameters below 0.5 to 0.58 cm correspond to normal pressures. Interobserver variability is low (0.01--0.03 cm). The learning curve was 25 and 10 procedures for novice and experienced sonographers, respectively. We report our initial experience using ultrasound to measure ONSD during initial trauma evaluation.

Study design

Transocular ultrasound was used to determine ONSD after traumatic brain injury. Data were correlated with CT and exam findings or measured ICP. Measurements were performed by a single trauma surgeon. Time to perform the measurement was recorded. Relevant literature from the past 15 years was reviewed.

Results

Physical exam was not a reliable indicator of eICP. In patients with eICP requiring surgery, ONSD averaged 0.62 cm. Normal pressures were ensured if the ONDS was <0.50 cm (95% CI 0.469–0.540 cm, p < 0.001). Intraobserver variability was low (0.01--0.02 cm). Average time to perform the exam was less than 2 min.

Conclusions

Determining ONSD with ultrasound is easy to learn, precise, and inexpensive. An ONSD of less than 5 mm ensures no eICP. This procedure can be added to the evaluation of trauma patients with no delay in care. Future prospective studies may validate and incorporate this technique into the trauma surgeon's armamentarium.