bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical and experimental research on engagement process of wet multi-plate friction clutches with groove consideration
Authors: Wu Peng-hui , Xu Jin , Zhou Xiao-Jun
Published: July 2019

A numerical model is established to investigate the effects of the influencing factors such as design parameters and operating conditions on the performance and behavior of the engagement process of the wet clutch based on the Navier–Stokes equations, contact mechanics, and heat transfer theory. A finite element contact model called KE contact model is used to analyze the rough contact during engagement process and thermal effect on the viscosity is considered based on heat transfer theory. The integration of the grooving into the simulation and the method of coupled finite element by domain decomposition of groove and ungrooved areas are put forward to facilitate the analysis. The experimental results agree well with the numerical model which takes the normal pressure, the temperature of ATF, relative revolution speed, the permeability and the groove geometry into account. The results of numerical simulation and the experiment indicate that the applied pressure not only affects the engagement time, but also has influence on the value of the engagement torque. Besides, the engagement time is roughly proportional to the relative revolution speed. The influencing factors such as the temperature of ATF, the permeability, grooves, the torque judders and effects of PID control parameters are also discussed in the paper. The performance and behavior of the engagement of the wet clutch were studied by two methods of numerical calculation and experimental research, which make the working process of the wet clutch more detailed.
Wear and failure of polyoxymethylene/calcium carbonate nanocomposite gears
Authors: Mohsenzadeh Rasool , Majidi Hojjat , Soltanzadeh Mohsen , Shelesh-Nezhad Karim
Published: July 2019

Nanocomposite gears and standard mechanical testing specimens based on polyoxymethylene containing different fractions (0, 3, 6, and 9 wt%) of nanosized precipitated calcium carbonate particles were produced by using twin-screw extruder and injection molding machine. The wear and temperature of gears teeth were measured by a gear test rig. The morphologies of fractured gears teeth were analyzed by using scanning electron microscopy. Results of experiments indicate that the incorporation of CaCO3 nanoparticles into polyoxymethylene increases the flexural and heat resistance and reduces the magnitudes of wear and temperature of gears noticeably. The maximum flexural resistance is achieved by employing 3 wt% of CaCO3 nanoparticles. Gears containing 3 wt% of CaCO3 nanoparticles present the lowest wear rate, which is 61% smaller than that of neat polyoxymethylene gear. The life time (durability till failure) of nanocomposite gear was twofold as compared to neat polyoxymethylene gear. The nanocomposite gear showed abrasive-wear and brittle-fracture, yet the neat polyoxymethylene gear demonstrated prevailing cohesive wear and ductile failure.
Video interpretation and diagnosis of pediatric amblyopia and eye disease
Authors: Sabri Kourosh , Moinul Prima , Tehrani Nasrin , Wiggins Rick , Fleming Natalie , Farrokhyar Forough
Published: July 2019

Aim

The aim of this study was to assess the potential of using video screening to interpret the results of paediatric eye examinations.

Design

Prospective multi-centred, blinded study.

Methods

Children aged 5 months to 11 years referred to a paediatric ophthalmology centre were enrolled in the study. Outcome measures included the degree of agreement between examiners for assessment of various aspects of paediatric eye examination. In Phase 1, children were individually assessed in the clinic by three different examiners to determine the level of agreement. In Phase 2 a video recording was made of the first ophthalmologist examining the children. The other two examiners viewed the video recordings to make their diagnoses. Areas of assessment included lid function, pupillary function, ocular motility, strabismus, nystagmus, torticollis and facial asymmetry. Agreement between examiners was measured using Gwet’s agreement coefficient (AC1).

Results

A total of 27 patients in Phase 1 (mean age 4.0 years) and 160 children in Phase 2 (mean age 4.8 years) underwent clinical and video-recorded screening. In Phase 1, all but one area of ocular examination (heterotropia) achieved ≥84% agreement between three examiners. In Phase 2, there was greater variation between direct clinical examination and interpretation of video findings, ranging from 55–100% agreement.

Conclusion

Using experienced clinicians and changing only one variable in Phase 2 (the method of assessment – direct examination versus video interpretation), the results show the possible usefulness of video-recorded screening as a means of assessing children. Further research is indicated to assess the accuracy of ophthalmologists interpreting video recordings of eye examinations performed by trained non-eye-care professionals.
Obesity, physical activity, and sedentary behaviors in adolescents with autism spectrum disorder compared with typically developing peers
Authors: McCoy Stephanie M , Morgan Kristen
Published: July 2019

Decreased engagement in beneficial physical activity and increased levels of sedentary behavior and unhealthy weight are a continued public health concern in adolescents. Adolescents with autism spectrum disorder may be at an increased risk compared with their typically developing peers. Weekly physical activity, sedentary behavior, and body mass index classification were compared among adolescents with and without autism spectrum disorder. Analyses included 33,865 adolescents (autism spectrum disorder, n = 1036) from the 2016–2017 National Survey of Children’s Health (United States). After adjustment for covariates, adolescents with autism spectrum disorder were found to engage in less physical activity and were more likely to be overweight and obese compared with their typically developing peers ( p’s < 0.05). As parent-reported autism spectrum disorder severity increased, the adjusted odds of being overweight and obese significantly increased and physical activity participation decreased ( p-for-trends < 0.001). The findings suggest there is a need for targeted programs to decrease unhealthy weight status and support physical activity opportunities for adolescents with autism spectrum disorder across the severity spectrum.
Interprofessional collaboration in school: Effects on teaching and learning
Authors: Borg Elin , Drange Ida
Published: July 2019

The main objective of this study is to identify and understand interprofessional collaboration practices in schools using a mixed-methods design. First, we conducted a literature review on interprofessional collaboration in schools to give insights into the ways teachers and other professions collaborate with each other, and what kind of interprofessional interventions show positive effects on teaching and learning. Second, we collected data from five Norwegian elementary schools to gain knowledge of factors that facilitate and hinder interprofessional collaboration. The results show that interprofessional collaboration was defined differently in the literature, and that research is lacking on interprofessional collaboration that involves multiple professions in school. Interventions in which social workers and school nurses were involved gave positive, though small-to-moderate, effects on a range of outcome measures. However, interventions that targeted the whole school were found to be the most promising for making changes that persist over time.
Vibration and stability analysis of functionally graded CNT-reinforced composite beams with variable thickness on elastic foundation
Authors: Mohseni Ali , Shakouri M
Published: July 2019

The free vibration and buckling of functionally graded carbon nanotube reinforced composite beams with variable thickness resting on elastic foundations are investigated in the present paper. To account rotary inertia and transverse shear deformation effects, the Timoshenko beam theory is employed and governing equations are derived using Hamilton's principle. The obtained equations are solved using generalized differential quadrature method. Different carbon nanotube distributions through the thickness are considered, and the rule of mixture is used to describe the effective material properties of the functionally graded reinforced beams. The results are validated with available investigations, and the effects of boundary conditions, nanotube volume fraction and distribution, foundation and thickness ratio on both natural frequency and buckling load are studied. Finally, due to the weight optimization in aerospace and turbomachinery applications, the optimum beam shape and nanotube distribution are suggested to achieve the most capacity of bearing axial loads with fixed weight.
The limits of conjecture: Political liberalism, counter-radicalisation and unreasonable religious views
Authors: Badano Gabriele , Nuti Alasia
Published: July 2019

Originally proposed by John Rawls, the idea of reasoning from conjecture is popular among the proponents of political liberalism in normative political theory. Reasoning from conjecture consists in discussing with fellow citizens who are attracted to illiberal and antidemocratic ideas by focusing on their religious or otherwise comprehensive doctrines, attempting to convince them that such doctrines actually call for loyalty to liberal democracy. Our goal is to criticise reasoning from conjecture as a tool aimed at persuasion and, in turn, at improving the stability of liberal democratic institutions. To pursue this goal, we use as case study real-world efforts to counter-radicalise at-risk Muslim citizens, which, at first glance, reasoning from conjecture seems well-placed to contribute to. This case study helps us to argue that the supporters of reasoning from conjecture over-intellectualise opposition to liberal democracy and what societies can do to counter it. Specifically, they (i) underestimate how few members of society can effectively perform reasoning from conjecture; (ii) overlook that the burdens of judgement, a key notion for political liberals, highlight how dim the prospects of reasoning from conjecture are and (iii) do not pay attention to the causes of religious persons’ opposition to liberal democracy. However, not everything is lost for political liberals, provided that they redirect attention to different and under-researched resources contained in Rawls’s theory. In closing, we briefly explain how such resources are much better placed than reasoning from conjecture to provide guidance relative to counter-radicalisation in societies (i) populated by persons who do not generally hold anything close to a fully worked out and internally consistent comprehensive doctrine and (ii) where political institutions should take responsibility for at least part of the existing alienation from liberal democratic values.
Quantification and confirmation of four aflatoxins using a LC–MS/MS QTRAP system in multiple reaction monitoring, enhanced product ion scan, and MS3 modes
Authors: Lv Shencong , Wang Henghui , Yan Yong , Ge Miaohua , Guan Jian
Published: July 2019

A simple, rapid, and efficient liquid chromatography tandem mass spectrometry (LC–MS/MS) method, operated in electrospray ionization and quadrupole linear ion trap modes, has been developed for the identification and structural characterization of aflatoxins in peanuts and its derivative products or bean sauce. Samples (5 g) were extracted with acetonitrile/water/formic acid (79:20:1, v/v). After centrifugation and dilution, the extracts were separated on a C18 analytical column by gradient elution (acetonitrile/0.2% formic acid) and analyzed by UPLC–MS/MS. External calibration was used for qualification. The developed multiple reaction monitoring–information-dependent acquisition–enhanced product ion method enabled quantification and confirmation of the analytes in a single run. Enhanced product ion mode was used for qualitative analysis, while multiple reaction monitoring mode was used for quantitative analysis. An in-house library was constructed for identification. Calibration curves showed good linearity with correlation coefficients (r) higher than 0.994. Limits of detection were determined to be below 0.26 µg kg−1 for most analytes. The recoveries for those substances were in the acceptable range of 80.2%–119.1%. A new LC–MS3 method was established for further confirmation. One pickled pepper peanut was found to contain aflatoxins B1, B2, and G1 with contents of 90.93, 26.64, and 1.92 µg kg−1, respectively.
Impact of the Bird-Beak Configuration on Postoperative Outcome After Thoracic Endovascular Aortic Repair: A Meta-analysis
Authors: Marrocco-Trischitta Massimiliano M. , Spampinato Benedetta , Mazzeo Girolomina , Mazzaccaro Daniela , Milani Valentina , Alaidroos Moad , Ambrogi Federico , Nano Giovanni
Published: July 2019

Purpose: To investigate the association between the bird-beak configuration (BBC), a wedge-shaped gap between the undersurface of a thoracic endograft and the lesser curvature of the arch after thoracic endovascular aortic repair (TEVAR), and postoperative outcome after TEVAR. Methods: The study was performed according to the PRISMA guidelines. The PubMed, EMBASE, and Cochrane databases were searched to identify all case series reporting BBC after TEVAR between 2006 and April 2018. Data analysis was performed considering the difference in the risk of complications for presence vs absence of BBC. After screening 1633 articles, 21 studies were identified that matched the selection criteria; 12 of these reported detailed information to investigate the postoperative outcome using proportion meta-analysis with a random effects model. The pooled risk difference is reported with the 95% confidence interval (CI). Heterogeneity of the included studies was assessed with the I2 statistic (low 25%, medium 50%, high 75%). Results: Complications occurred within a range of 0 to 72 months in 14.7% (95% CI 7.4% to 27.3%) of patients with BBC and in 6.3% (95% CI 2.5% to 15.4%) of patients without BBC. A cumulative incidence could not be assessed. The summary risk difference was 11.1% (95% CI −0.1% to 22.3%, p=0.052). There was significant heterogeneity ( I2=85.6%). The Egger test did not show evidence of publication bias (p=0.975). When specifically considering type Ia endoleak and endograft migration, the risk difference between BBC and non-BBC patients was 8.2% (95% CI 0.3% to 16.1%, p=0.042; I2=69.0%). The specific risk difference for endograft collapse/infolding and thrombosis was 3.7% (95% CI −3.5% to 11.1%, p=0.308; I2=10.2%). Conclusion: At present the literature does not provide statistical evidence to establish an overall prognostic value of the BBC. Nevertheless, the BBC appears to be associated with a high risk of type Ia endoleak and endograft migration, which warrants specific and long-term surveillance. Clinically relevant values for BBC grading should be established to perhaps define indications for preemptive treatment based on the presence of BBC only.
Oral administration of α-ketoglutarate enhances nitric oxide synthesis by endothelial cells and whole-body insulin sensitivity in diet-induced obese rats
Authors: Tekwe Carmen D , Yao Kang , Lei Jian , Li Xilong , Gupta Anand , Luan Yuanyuan , Meininger Cynthia J , Bazer Fuller W , Wu Guoyao
Published: July 2019

Obesity is a risk factor for many chronic diseases, including hypertension, type-2 diabetes, and cancer. Interestingly, concentrations of branched-chain amino acids (BCAAs) in plasma are commonly associated with endothelial dysfunction in humans and animals with obesity. Because L-leucine inhibits nitric oxide synthesis by endothelial cells (EC), we hypothesized that dietary supplementation with AKG (a substrate for BCAA transaminase) may stimulate BCAA catabolism in the small intestine and extra-intestinal tissues, thereby reducing the circulating concentrations of BCAAs and increasing nitric oxide synthesis by endothelial cells. Beginning at four weeks of age, male Sprague-Dawley rats were fed a low-fat or a high-fat diet for 15 weeks. At 19 weeks of age, lean or obese rats continued to be fed for 12 weeks their respective diets and received drinking water containing 0 or 1% AKG ( n =  8/group). At 31 weeks of age, the rats were euthanized to obtain tissues. Food intake did not differ ( P >  0.05) between rats supplemented with or without AKG. Oral administration of AKG (250 mg/kg BW per day) reduced ( P <  0.05) concentrations of BCAAs, glucose, ammonia, and triacylglycerols in plasma, adiposity, and glutamine:fructose-6-phosphate transaminase activity in endothelial cells, and enhanced ( P <  0.05) concentrations of the reduced form of glutathione in tissues, nitric oxide synthesis by endothelial cells, and whole-body insulin sensitivity (indicated by oral glucose tolerance test) in both low-fat and high-fat rats. AKG administration reduced ( P <  0.05) white adipose tissue weights of rats in the low-fat and high-fat groups. These novel results indicate that AKG can reduce adiposity and increase nitric oxide production by endothelial cells in diet-induced obese rats.

Impact statement

Obesity is associated with elevated concentrations of branched-chain amino acids, including L-leucine. L-Leucine inhibits the synthesis of nitric oxide from L-arginine by endothelial cells, contributing to impairments in angiogenesis, blood flow, and vascular dysfunction, as well as insulin resistance. Reduction in the circulating levels of branched-chain amino acids through dietary supplementation with α-ketoglutarate to promote their transamination in the small intestine and other tissues can restore nitric oxide synthesis in the vasculature and reduce the weights of white adipose tissues, thereby improving metabolic profiles and whole-body insulin sensitivity (indicated by oral glucose tolerance test) in diet-induced obese rats. Our findings provide a simple and effective nutritional means to alleviate metabolic syndrome in obese subjects. This is highly significant to combat the current obesity epidemic and associated health problems in humans worldwide.
A novel method to determine basic probability assignment in Dempster–Shafer theory and its application in multi-sensor information fusion
Authors: Fei Liguo , Xia Jun , Feng Yuqiang , Liu Luning
Published: July 2019

Multi-sensor information fusion occurs in a vast variety of applications, including medical diagnosis, automatic drive, speech recognition, and so on. Often these problems can be modeled by Dempster–Shafer theory. In Dempster–Shafer theory, the most primary processing unit is the basic probability assignment, which is a description of objective information in the real world. How to make this description more effective is a vital but open issue. A novel basic probability assignment generation model is proposed in this article whose objective is to provide perspective with respect to how basic probability assignment can be determined based on learning algorithms. First, the basic probability assignment generation model is constructed based on clustering idea using K-means method, which is employed to determine basic probability assignment with the proposed basic probability assignment generation method. Moreover, the proposed basic probability assignment generation method is extended by K–nearest neighbor (K-NN) algorithm. The detailed implementation of the proposed method is demonstrated by several numerical examples. As an extension, a classifier called KKC is constructed according to the developed approach, and its classification effect is compared with several famous classification algorithms. Experiments manifest desirable results with regard to classification accuracy, which illustrates the applicability of the proposed method to determine basic probability assignment.
Indoor localization system based on virtual access points with filtering schemes
Authors: Lee Dong Myung , Labinghisa Boney
Published: July 2019

In indoor positioning techniques, Wi-Fi is one of the most used technology because of its availability and cost-effectiveness. Access points are usually the main source of Wi-Fi signals in an indoor environment. If access points are optimized to cover the indoor area, this could improve Wi-Fi signal distribution. This article proposed an alternative to optimizing access point placement and distribution by introducing virtual access points that can be virtually placed in any part of the indoor environment without installation of actual access points. Virtual access points will be created heuristically by correlating received signal strength indicator of already existing access points and through linear regression. After introducing virtual access points in the indoor environment, next will be the addition of filters to improve signal fluctuation and reduce noise interference. Kalman filter has been previously used together with virtual access point and showed improvement by decreasing error distance of Wi-Fi fingerprinting results. This article also aims to include particle filter in the system to further improve localization and test its effectiveness when paired with Kalman filter. The performance testing of the algorithm in different indoor environments resulted in 3.18 and 3.59 m error distances. An improvement was added on the system by using relative distances instead of received signal strength indicator values in distance estimation and gave an error distance average of 1.85 m.
Multi-connection load compensation and load information calculation for an upper-limb exoskeleton based on a six-axis force/torque sensor
Authors: Wang Xin , Song Qiuzhi , Zhou Shitong , Tang Jing , Chen Kezhong , Cao Heng
Published: July 2019

In this article, a method of multi-connection load compensation and load information calculation for an upper-limb exoskeleton is proposed based on a six-axis force/torque sensor installed between the exoskeleton and the end effector. The proposed load compensation method uses a mounted sensor to measure the force and torque between the exoskeleton and load of different connections and adds a compensator to the controller to compensate the component caused by the load in the human–robot interaction force, so that the human–robot interaction force is only used to operate the exoskeleton. Therefore, the operator can manipulate the exoskeleton with the same interaction force to lift loads of different weights with a passive or fixed connection, and the human–robot interaction force is minimized. Moreover, the proposed load information calculation method can calculate the weight of the load and the position of its center of gravity relative to the exoskeleton and end effector accurately, which is necessary for acquiring the upper-limb exoskeleton center of gravity and stability control of whole-body exoskeleton. In order to verify the effectiveness of the proposed method, we performed load handling and operational stability experiments. The experimental results showed that the proposed method realized the expected function.
The Acute Effect of High-Intensity Exercise on Executive Function: A Meta-Analysis
Authors: Moreau David , Chou Edward
Published: July 2019

High-intensity exercise has recently emerged as a potent alternative to aerobic regimens, with ramifications for health and brain function. As part of this trend, single sessions of intense exercise have been proposed as powerful, noninvasive means for transiently enhancing cognition. However, findings in this field remain mixed, and a thorough synthesis of the evidence is lacking. Here, we synthesized the literature in a meta-analysis of the acute effect of high-intensity exercise on executive function. We included a total of 1,177 participants and 147 effect sizes across 28 studies and found a small facilitating effect ( d = 0.24) of high-intensity exercise on executive function. However, this effect was significant only compared with rest ( d = 0.34); it was not significant when high-intensity exercise was compared with low-to-moderate intensity exercise ( d = 0.07). This suggests that intense and moderate exercise affect executive function in a comparable manner. We tested a number of moderators that together explained a significant proportion of the between-studies variance. Overall, our findings indicate that high-intensity cardiovascular exercise might be a viable alternative for eliciting acute cognitive gains. We discuss the potential of this line of research, identify a number of challenges and limitations it faces, and propose applications to individuals, society, and policies.
Deconstructing and Reconstructing Resilience: A Dynamic Network Approach
Authors: Kalisch Raffael , Cramer Angélique O. J. , Binder Harald , Fritz Jessica , Leertouwer IJsbrand , Lunansky Gabriela , Meyer Benjamin , Timmer Jens , Veer Ilya M. , van Harmelen Anne-Laura
Published: July 2019

Resilience is still often viewed as a unitary personality construct that, as a kind of antinosological entity, protects individuals against stress-related mental problems. However, increasing evidence indicates that maintaining mental health in the face of adversity results from complex and dynamic processes of adaptation to stressors that involve the activation of several separable protective factors. Such resilience factors can reside at biological, psychological, and social levels and may include stable predispositions (such as genotype or personality traits) and malleable properties, skills, capacities, or external circumstances (such as gene-expression patterns, emotion-regulation abilities, appraisal styles, or social support). We abandon the notion of resilience as an entity here. Starting from a conceptualization of psychiatric disorders as dynamic networks of interacting symptoms that may be driven by stressors into stable maladaptive states of disease, we deconstruct the maintenance of mental health during stressor exposure into time-variant dampening influences of resilience factors onto these symptom networks. Resilience factors are separate additional network nodes that weaken symptom–symptom interconnections or symptom autoconnections, thereby preventing maladaptive system transitions. We argue that these hybrid symptom-and-resilience-factor networks provide a promising new way of unraveling the complex dynamics of mental health.
Researching cross-national policy mobilities in crime control
Authors: Jones Trevor , Blaustein Jarrett , Newburn Tim
Published: July 2019

The empirical study of ‘policy transfer’ and related topics remains a relatively rare enterprise in criminology. Comparative studies of crime control policy tend to focus on broader structural explanations on the one hand, or more specific socio-cultural analyses on the other. By contrast, scholars from other disciplinary traditions – including political science, public administration, comparative social policy and human geography – have developed a vibrant body of empirical research into the dynamics and impacts of cross-jurisdictional flows of policy ideas, programmes and practices. This research provides helpful methodological pointers to criminologists interested in carrying out such work within the field of crime control. This article argues that the relative lack of empirical research on cross-national crime policy movement arises from two main factors: first, a generalised sense that the topic is of rather minor importance and second, a lack of methodological clarity about how such research might proceed. Such methodological barriers have arguably been further strengthened by major critiques of the political science frameworks of ‘policy transfer’ that have been influential in the field. We view cross-national policy movement as an important subject for empirical criminological inquiry, and consider extant methodological approaches and potential future directions, drawing in particular on wider work within political science and human geography. There is significant potential for criminologists to learn from, and contribute to, the methodological approaches deployed by researchers from other disciplines and thus enhance knowledge about the concept of policy mobilities.
Influence of model-predicted rivaroxaban exposure and patient characteristics on efficacy and safety outcomes in patients with acute coronary syndrome
Authors: Zhang Liping , Yan Xiaoyu , Nandy Partha , Willmann Stefan , Fox Keith A. A. , Berkowitz Scott D. , Sharma Amarnath , Hermanowski-Vosatka Anne , Schmidt Stephan , Weitz Jeffrey I. , Garmann Dirk , Peters Gary
Published: July 2019

Background:

This analysis aimed to evaluate the impact of rivaroxaban exposure and patient characteristics on efficacy and safety outcomes in patients with acute coronary syndrome (ACS) and to determine whether therapeutic drug monitoring might provide additional information regarding rivaroxaban dose, beyond what patient characteristics provide.

Methods:

A post hoc exposure–response analysis was conducted using data from the phase III ATLAS ACS 2 Thrombolysis in Myocardial Infarction (TIMI) 51 study, in which 15,526 randomized ACS patients received rivaroxaban (2.5 mg or 5 mg twice daily) or placebo for a mean of 13 months (maximum follow up: 31 months). A multivariate Cox model was used to correlate individual predicted rivaroxaban exposures and patient characteristics with time-to-event clinical outcomes.

Results:

For the incidence of myocardial infarction (MI), ischemic stroke, or nonhemorrhagic cardiovascular death, hazard ratios (HRs) for steady-state maximum plasma concentration (Cmax) in the 5th and 95th percentiles versus the median were statistically significant but close to 1 for both rivaroxaban doses. For TIMI major bleeding events, a statistically significant association was observed with Cmax [HR, 1.08; 95% CI, 1.06–1.11 (95th percentile versus median, 2.5 mg twice daily)], sex [HR, 0.56; 95% CI, 0.38–0.84 (female versus male)], and previous revascularization [HR, 0.62; 95% CI, 0.44–0.87 (no versus yes)].

Conclusions:

The shallow slopes of the exposure–response relationships and the lack of a clear therapeutic window render it unlikely that therapeutic drug monitoring in patients with ACS would provide additional information regarding rivaroxaban dose beyond that provided by patient characteristics.
Distal biceps tendon repair via new knotless endobutton fixation: A biomechanical study
Authors: Rutka Victor , Weppe Florent , Duprey Sonia , Gras Laure-Lise
Published: July 2019

Background

Distal biceps tendon repair using endobutton fixation has shown the best biomechanical results in terms of pullout strength. Here, we compared Sethi’s enhanced tension adjustable endobutton technique known as the “tension slide technique” to a new knotless endobutton fixation technique without a post-fixation screw. Our new approach is as effective as the tension slide technique in terms of pullout strength and gapping after early mobilization.

Methods

A biomechanical cadaveric study with 16 paired arms was performed. With the radius held in place, the distal biceps tendon was loaded at 100 N for 500 cycles and the load was then increased until failure. Gapping after loading cycles and maximum load to failure were recorded and compared.

Results

Median bone-tendon gapping was 5.77 mm (interquartile range (IQR) 4.84–9.11) for tension slide technique and 4.72 mm (IQR 1.77–6.16) for the knotless fixation (p = 0.047). Median load to failure was 257.87 N (IQR 222.07–325.35) in the tension slide technique group and 407.78 N (IQR 358.54–485.20) in the knotless group (p = 0.047).

Discussion

The knotless endobutton provides better pullout strength and elongation results compared to the tension slide technique without the use of an interference screw, allowing early mobilization in order to faster return to daily living activities. Level of evidence: Basic science study.
Inter- and intra-rater reliability and clinical utility of the Brachial Plexus Outcome Measure: A pilot study
Authors: Brown Hazel , Bassett Paul , Quick Tom J
Published: July 2019

Introduction

Birth-related plexus injuries cause paralysis of the upper limb. The majority of patients spontaneously recover, but many suffer with long-term limitations in function. The Brachial Plexus Outcome Measure was developed to assess upper limb function in children with birth-related plexus injuries. This pilot study assessed the inter- and intrarater reliability in novice users. Information was also gained with regards to the perceived clinical utility of the tool.

Methods

Eleven therapists, experienced in the treatment of birth-related plexus injuries but naïve in the use of the Brachial Plexus Outcome Measure, were recruited as raters. Eight video-recorded assessments were independently scored. Four raters were randomly selected to repeat two of the analyses. The perceived clinical utility of the Brachial Plexus Outcome Measure was investigated via a questionnaire.

Results

Across the domains of the Brachial Plexus Outcome Measure, the majority of items scored ‘Fair’ for inter-rater reliability with kappa scores ranging from 0.13–0.46. Intra-rater agreement was better with the majority of items scoring 0.44–0.86 upon weighted kappa analysis. Participant scores for clinical utility were mixed. However, 7 of the 11 raters agreed that the Brachial Plexus Outcome Measure is useful as a pre- and post-intervention tool.

Conclusions

When compared to the inter-rater reliability of similar functional outcome measures, these results are less favourable. Future research and suggestions to improve the implementation, reliability and clinical utility of the Brachial Plexus Outcome Measure have been identified. These include better standardisation of equipment and improved instructional guidance. In addition, within the clinical setting, it is recommended that the same clinician assesses the same child over the course of their treatment.
You Win Some, You Lose Some: Pension Reform in Bachelet’s First and Second Administrations
Authors: Borzutzky Silvia
Published: July 2019

This article analyses and compares President Bachelet’s successful efforts to reform the Chilean pension system in 2008 and her failure to achieve the same objective in 2017. The article addresses the impact of electoral promises, policy legacies, policy ideology, presidential power, the role of the private sector, and the role that the government coalitions had in the process of pension reform during the Bachelet administrations. We argue that the 2008 reform was possible because of Bachelet’s personal commitment to reform and the presence of a stable governing coalition that had the will and capacity to legislate. In the second administration, although the policy legacies and ideology had remained the same, the reform did not materialise due to intense conflict within the administration and within the government coalition, as well as conflict between the administration and the coalition. These conflicts, in turn, generated a vicious cycle responsible for Bachelet’s declining popularity, limited political capital, and reduced support for reform. A stagnant economy further undermined these efforts. In brief, this article argues that when assessing success and failure in pension policy reform it is important to analyse not only policy legacies and political ideology but also the strength of the executive, the cohesion of the governing coalition, and the country’s economic performance.
Let’s Talk About This in Public: Consumer Expectations for Online Review Response
Authors: Zhang Lu , Gao Yixing (Lisa) , Zheng Xiaoyun
Published: July 2019

Online consumer reviews are becoming one of the key drivers of hospitality firm performance. Although research has investigated different aspects of online reviews such as their volume and length, issues regarding the effectiveness of review response demand for further investigation. Drawing on theories of expectancy value and communication, we develop and test a framework of consumer expectations regarding company responses. Results from two experiments show that consumer preferences for responses to their online reviews depend on the factors of valence (positive vs. negative), explanation type (explained action vs. explained reaction), and response channel (private vs. public). Perceived usefulness is found to be the underlying mechanism that explains these effects. The study’s theoretical contributions and managerial implications are discussed.
Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study
Authors: Mazidi Mahdi , Dehghani Mohsen , Sharpe Louise , Dolatshahi Behrooz , Ranjbar Seyran , Khatibi Ali
Published: July 2019

Introduction:

This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients.

Methods:

A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires.

Results:

In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control.

Conclusion:

This study supported the vigilance–avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.
Antimicrobial susceptibility patterns of organisms causing secondary abdominal infections in patients with perforated abdominal viscus
Authors: Kumar-M Praveen , Shafiq Nusrat , Kumar Pradeep , Gupta Ashish , Malhotra Samir , M. Naveen , Gautam Vikas , Ray Pallab , Gupta Rajesh , Gupta Vikas , Deen Yadav Thakur , Verma G. R. , Singh Rajinder , Singh Gurpreet
Published: July 2019

Background:

Secondary peritonitis, following intestinal perforation, constitutes a significant proportion of cases admitted as a surgical emergency and has a mortality rate of 6–21% worldwide. As a part of an antimicrobial stewardship program, we noted considerable variation among the choice of empirical regimens among such cases. Hence, we conducted a prospective study to generate the evidence for a rational empiric regimen for patients with secondary peritonitis following intestinal perforation.

Methods:

The study included a complete follow up of 77 cases of secondary peritonitis admitted during a 12 month period. The intraoperative fluid (peritoneal) sample of the patient was sent for culture and sensitivity pattern analysis.

Results:

The sites of perforation as seen in decreasing order were lower gastrointestinal (GI) (50.6%), upper GI (36.4%), and unclassified (13%). The most common organism found in the intraoperative fluid was Escherichia coli (47.9%) followed by Klebsiella pneumoniae (12.5%). amikacin, cefoperazone-sulbactam, piperacillin-tazobactam and imipenem were sensitive in 22 (out of 23 tested), 5 (out of 9), 13 (out of 13) and 22 (out of 22) isolates of E. coli and 3 (out of 6), 1 (out of 3), 4 (out of 6), 4 (out of 6) isolates of K. pneumoniae, respectively. The most common empirical antibiotic was cefoperazone-sulbactam (38.7%) followed by piperacillin-tazobactam (29.3%).

Conclusion:

Based on our prospective study, piperacillin-tazobactam or imipenem should be used empirically in patients presenting with complicated intra-abdominal infections secondary to perforated viscus, especially if they have sepsis or septic shock.
Fecal microbiota transplantation in irritable bowel syndrome: A systematic review and meta‐analysis
Authors: Myneedu Kanchana , Deoker Abhizith , Schmulson Max J , Bashashati Mohammad
Published: July 2019

Background

Modulating gut microbiota is a potential treatment for irritable bowel syndrome (IBS). This meta‐analysis explored whether fecal microbiota transplantation (FMT) is successful in treating IBS.

Methods

A systematic review was performed to find trials on FMT in IBS. Ratios and relative ratios (RR) of improvement for single‐arm trials (SATs) and randomized controlled trials (RCTs) were calculated, respectively. Changes in IBS Severity Scoring System (IBS‐SSS) and IBS Quality of Life (IBS‐QOL) instrument compared to baseline in FMT versus placebo groups were pooled.

Results

In SATs, 59.5% (95% confidence interval (CI) 49.1–69.3) of IBS patients showed significant improvement. In RCTs, there were no differences between FMT and control in improvement (RR=0.93 (95% CI 0.50–1.75)) or changes in the IBS‐SSS and IBS‐QOL.

Conclusions

FMT was not effective in IBS. Variations in FMT methods and patient factors may contribute to the heterogeneous results of the trials.
The Alphacrucis College clinical teaching model: An evaluation
Authors: Twelves Jim
Published: July 2019

Alphacrucis College, Australia, has developed a Clinical Teaching Model (CTM) as an option within the initial teacher-training awards. The Alphacrucis College model intentionally combines the pre-service teachers’ spiritual formation with their professional development. This article reports on an evaluation of the CTM students’ experience compared with that of students under the traditional approach. The key findings confirm an increased sense of self-discipline and confidence, and an overwhelming appreciation for the practical application without assessment. The students appreciated that in the CTM process, faith was being coupled with their calling to teach.
No Difference Between Posterolateral Corner Repair and Reconstruction With Concurrent ACL Surgery: Results From a Prospective Multicenter Cohort
Authors: Westermann Robert W. , Marx Robert G. , Spindler Kurt P. , Huston Laura J. ,   MOON Knee Group, Amendola Annunziato , Andrish Jack T. , Brophy Robert H. , Dunn Warren R. , Flanigan David C. , Jones Morgan H. , Kaeding Christopher C. , Matava Matthew J. , McCarty Eric C. , Parker Richard D. , Reinke Emily K. , Vidal Armando F. , Wolcott Michelle L. , Wolf Brian R.
Published: July 2019

Background:

Injuries to the posterolateral corner (PLC) may occur concurrently with anterior cruciate ligament (ACL) injury.

Purpose/Hypothesis:

This study evaluated the outcomes of patients who underwent operative management of PLC injuries concurrently with ACL reconstruction in a prospective multicenter cohort. We hypothesized that there would be no differences in outcomes between patients who were treated with PLC repair and PLC reconstruction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients undergoing ACL reconstruction were enrolled into a prospective longitudinal multicenter cohort between 2002 and 2008. Those with complete 6-year follow-up data (patient-reported outcomes and subsequent surgery information) were identified. Excluded from the study were patients with posterior cruciate ligament injuries. Patients who underwent PLC repair were compared with those who underwent PLC reconstruction with regard to interval from injury to surgery, need for revision surgery, and long-term outcomes at 6 years.

Results:

During the identified time frame, 3026 identified patients underwent primary ACL reconstruction; 34 (1.1%) also underwent concurrent PLC surgery (15 repairs, 19 reconstructions [18 allografts, 1 autograft]). With the numbers available, we did not detect significant differences between groups regarding the rate of meniscal or chondral injuries. Median time to PLC reconstruction was 121 days as compared with 19 days for concurrent ACL reconstruction and PLC repair ( P = .01). There were no between-group differences in Marx activity scores prior to surgery ( P = .4). At 6-year follow-up, there were no between-group differences in Knee injury and Osteoarthritis Outcome Score ( P = .36-.83) or International Knee Documentation Committee score ( P = .84); however, patients treated with PLC reconstructions had lower Marx activity scores (4.1 vs 9.4; P = .02). There was 1 ACL revision in the PLC reconstruction group, and 1 of the PLC repairs was revised to a reconstruction during the follow-up period.

Conclusion:

Good outcomes were achieved at 6-year follow-up with both repair and reconstruction of PLC injuries treated concurrently with ACL reconstruction. The PLC reconstruction group had lower activity levels 6 years after surgery. The present data suggest that, for appropriately selected patients undergoing acute surgical treatment of combined ACL and PLC injuries, PCL repair can achieve good long-term outcomes.
Online Activism, Social Movements and Mediated Politics in Contemporary Bangladesh
Authors: Roy Ratan Kumar
Published: July 2019

Politics online is a significant phenomenon today in Bangladesh given the reach of internet, resulting in the proliferation of the use of social media and online activism. The intertwined dynamic of digital drive and mediated politics can be traced in other parts of the region of South Asia as a burgeoning spectacle. In this context, the instance of Bangladesh with regard to online activism provides distinctive clues to fathom the nature of mediated politics. This paper examines a social media-driven youth protest, Shahbag Movement in 2013 to unravel the interactive dynamics between new media, traditional media and social movement. Bringing in the empirical cases, in the ultimate analysis, it delves deeper into the conceptual aspects of media practices, mediation and mediatisation.
Showcasing Environmental Justice Movements from the South: Comparing the Role of Media in Bangladesh
Authors: Luthfa Samina
Published: July 2019

When we think about the role of media in social movements, we identify media’s representation of the core grievance of the movement, traction of the movement in the media and its role in helping the movement. Using two examples from Bangladesh’s recent environmental justice movements, I show the changing role of media coverage on the movements, given the political opportunity structures available and discuss the differences between the cases. Using newspaper data and social media interactions, I compare the dynamics of media’s treatment of two movements, one against a proposed open cast coal mine in Phulbari, Dinajpur and another protesting against the establishment of a coal-fired power plant near Sundarbans. For the first case, I analyze the role of print media and for the second, both print and social media. I argue that both old and new media served as stages showcasing contested meanings of development, environmental injustice in both cases. However, I also show that the differences between the contribution in motivating the resistances by old and new media is different. However, both types of media, when appropriated by the capitalist interests can become weapons against the marginalized more often than it works as a space for upholding their voices.