bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of Manipulation Under Anesthesia or Lysis of Adhesions After Arthroscopic Knee Surgery
Authors: Werner Brian C. , Cancienne Jourdan M. , Miller Mark D. , Gwathmey F. Winston
Published: April 2015

Background:

Arthrofibrosis after knee arthroscopy is a challenging complication. Previous studies reporting incidences of manipulation under anesthesia (MUA) or lysis of adhesions (LOA) after knee arthroscopy are limited by confounders such as small sample size and regional sampling bias.

Purpose:

To investigate the incidence of MUA or LOA after common arthroscopic knee procedures.

Study Design:

Descriptive epidemiology study.

Methods:

A national insurance database was retrospectively queried for arthroscopic knee procedures from 2007 to 2011. The incidence of postoperative MUA and LOA within 3 and 6 months postoperatively was determined for each of 13 common arthroscopic knee surgeries, including ligamentous reconstructive procedures, cartilage restoration procedures, and meniscal procedures.

Results:

A total of 330,714 unique patients who underwent knee arthroscopy were included in the study. The overall incidence of MUA was 0.06% to 6.00% by 3 months and 0.11% to 8.00% by 6 months postoperatively. The incidence of LOA was somewhat less, ranging from 0.04% to 4.00% by 3 months and 0.06% to 6.00% by 6 months postoperatively. Isolated arthroscopic partial meniscectomy had the lowest incidence of postoperative MUA and LOA, while multiligament reconstructions and meniscal transplants had the highest incidences.

Conclusion:

The overall incidence of MUA and LOA after arthroscopic knee procedures is low but rises significantly as the number of concomitant procedures or complexity of the procedures increases. This information may be useful in counseling patients on the likelihood of MUA or LOA based on the type of arthroscopic knee procedure that is planned.
The protective effects of prostaglandin E1 on lung injury following renal ischemia–reperfusion in rats
Authors: Oztay Fusun , Kara-Kisla Beyhan , Orhan Nurcan , Yanardag Refiye , Bolkent Sehnaz
Published: April 2015

For the purposes of the present study, the protective effect of prostaglandin E1 (PGE1) on lung injury following renal ischemia–reperfusion (RIR) was investigated. Adult male rats were divided into four groups, namely, (I) control rats given physiological saline; (II) rats given PGE1 (20 μg/kg, intravenously); (III) rats subjected to RIR; and (IV) rats subjected to RIR given PGE1 30 min prior to ischemia and just before reperfusion. The right nephrectomy was performed in the RIR model. The left renal pedicle was occluded for 60 min to induce ischemia and then the left kidney was subjected to reperfusion for 60 min. The lungs of rats were used for microscopic and biochemical analyses. Although rats subjected to RIR did not exhibit heavy degenerative alterations in the lung structure, they possessed pulmonary interstitial edema. Lung glutathione levels and catalase, superoxide dismutase, glutathione peroxidase, and tissue factor (TF) activities were decreased in rats subjected to RIR, while lung lipid peroxidation, myeloperoxidase (MPO), xanthine oxidase and serum lactate dehydrogenase (LDH) activities, and blood urea and serum creatinine levels were increased in these rats when compared with the control group. PGE1 treatments resulted in the regression of oxidative stress via induction of antioxidant system, the decreased MPO and LDH activities, the reduced urea and creatinine levels, and the induced TF activity in rats subjected to RIR, while edema still remained permanent. We conclude that PGE1 may be useful in preventing lung injury with the exception of edema that occurred as a result of RIR in rats.
Blood pressure and occupational exposure to noise and lead (Pb)
Authors: Rapisarda Venerando , Ledda Caterina , Ferrante Margherita , Fiore Maria , Cocuzza Salvatore , Bracci Massimo , Fenga Concettina
Published: April 2015

Several studies have explored the hypothesis that low blood lead (PbB) and high noise levels may be associated with an increased risk of hypertension. To assess the possible relationship between occupational exposure to lead (Pb) and noise and elevated blood pressure, we studied 105 workers (age: 41.27 ± 6.25 years and length of employment: 4.12 ± 5.33 years) employed in a Pb battery recycling plant by measuring A-weighted equivalent sound level, PbB, δ-aminolevulinic acid dehydratase (ALAD) activity and zinc protoporphyrin (ZPP) levels and systolic and diastolic blood pressure (SBP and DBP). Results showed that occupational exposure to higher ambient Pb and noise levels was related to slightly increased SBP and DBP. PbB values correlated significantly with SBP and DBP, whereas noise levels correlated neither with SBP nor with DBP. Furthermore, workers exposed to higher ambient Pb had higher PbB and ZPP and showed more decreased ALAD activity. Blood pressure does not correlate with noise exposure but only with PbB concentration.
Managing Salesforce Performance
Authors: Madhani Pankaj M.
Published: April 2015

Effective management and motivation of salesforce is crucial to the success of sales organization as it ensures proper salesforce focus on market needs and successful achievement of organization goals. Sales organizations have two main approaches for managing the behavior of their salesforce, namely, behavior-based (monitoring) and outcome-based (incentives). A behavior system evaluates the salesforce in light of the selling process, while an outcome system evaluates the salesforce in light of results. This research identifies key characteristics of behavior- and outcome-based systems along with its benefits and drawbacks and suggests selection criteria for appropriate choice of behavior versus outcome measures. The study explains agency theory and highlights the underlying logic of short-term behavior of salespeople when compensated with incentives. Research also provides performance matrices for measurement and evaluation of financial impact of behavior and outcome control. The behavior-based and outcome-based control systems are at the extremes, and many sales organizations function in the middle, balancing the two. Finally, the study provides a numerical illustration to design an optimal performance measurement scenario based on behavior- and outcome-based measures.
Creativity and Sustainable Fashion Apparel Consumption
Authors: Ruppert-Stroescu Mary , LeHew Melody L. A. , Connell Kim Y. Hiller , Armstrong Cosette M.
Published: April 2015

Because promoting sustainable fashion apparel consumption is a pressing contemporary problem, Generation Y participants in the Midwestern United States were challenged to a Fashion Detox, where they refrained from acquiring fashion apparel for ten weeks and blogged about the experience. Content analysis of blog entries for this exploratory study revealed expressions of creativity that were examined through the lens of the propulsion model of kinds of creative contributions. Findings revealed kinds of creative contributions stimulated by voluntary simplicity that satisfy the fashion apparel consumer’s need for novelty and change: expressions of creativity that follow a fashion-driven direction already established, called redefinition and forward incrementation, and those that take a completely different path but within the context of seeking novelty and change, or redirection. Examples of creative activities within these three kinds of creative contributions are, respectively, re-designing old clothes, shifting their focus to home décor instead of apparel, and turning away from fashion apparel altogether. Fourty-six percent of the participants left the 10-week activity feeling that their creativity had been enhanced and 54% expressed the intention to carry on the sustainable consumption lessons they learned. By cultivating expressions of creativity that lead to sustainable consumption through education and innovative business models, stakeholders may initiate a paradigm shift that fulfills the fashion apparel consumer’s need for novelty and change without sacrificing the planet s resources.
The Effects of Political Rhetoric on the Rise of Legitimized Racism in France: The Case of the 2005 French Riots
Authors: Léonard Marie des Neiges
Published: April 2015

Through a review of public speeches, media declarations and interviews by French government officials and influential intellectuals, this paper examines the language used and the measures taken by the French government during the 2005 ethnic riots. Particularly, this essay argues that the government’s response to the riots shows that (1) by applying a white racial frame on the riots and the rioters, the state was able to denigrate the rioters and deny any legitimacy to the riots themselves; and that (2) by applying color-blind racist labels to the rioters, the state was able to discredit the revolt so as to rationalize and justify a set of repressive tactics and racist measures without ‘sounding racist’. Furthermore, this study reveals that the French government ultimately normalized a racial frame about the riots through color-blind rhetoric and practices. This essay concludes that the rhetoric used by the French government signals the rise of a legitimized racism, becoming a dominantly accepted and supported view in the political arena and society in France.
Experimental investigation on forced response of mistuned bladed disc rotor in an aero-engine
Authors: Madhavan S , Jain Rajeev , Sujatha C , Sekhar AS
Published: April 2015

An experimental investigation on forced response of a first stage compressor mistuned bladed disc rotor is performed in an operational aero-engine. It is desired to evaluate the maximum blade amplitude response of the bladed disc for the existing blade mistuning pattern depending on blade mode, exciting engine order, and aerodynamic influences. Finite element analysis on a single cantilever blade is performed and the possible resonances are estimated. Bench tests on a stand-alone blade are conducted to verify the finite element predictions. Experiments are conducted on a full-scale core engine using blade tip timing system. Blade tip timing system utilizes noncontacting sensors installed on the engine casing which provides vibration responses of all the blades in a rotor. The vibration responses obtained from blade tip timing system is validated using simultaneously measured strains from a few blade-mounted strain gages. A good correlation is observed between the predicted and measured blade responses. The effect of blade mistuning on the amplitude resonant response of the bladed disc is explored experimentally. It is observed that the maximum amplitude response of the blades due to forced resonant excitation is far below the fatigue limits for the prevailing blade mistuning pattern. The present exercise of quantifying the blade resonant responses through efficient implementation of the blade tip timing system is crucial to understand and thus avoid high-cycle fatigue, which is one of the most serious problems in aero-engine development.
Quercetin attenuates di-(2-ethylhexyl) phthalate-induced testicular toxicity in adult rats
Authors: Abd-Ellah MF , Aly HAA , Mokhlis HAM , Abdel-Aziz AH
Published: April 2015

The aim of the present study was to investigate the potential oxidative damage of di-(2-ethylhexyl) phthalate (DEHP) in the rat testis and to further elucidate the potential modulatory effect of quercetin. DEHP was diluted in corn oil and given to rats by oral gavage at doses 0, 300, 600, and 900 mg/kg/day (groups I, III, IV, or V, respectively) for 15 consecutive days. Group VI was pretreated with quercetin (90 mg/kg), 24 h before starting the experiment and then treated with DEHP (900 mg/kg/day) for 15 consecutive days. Group II was treated with quercetin (90 mg/kg/day). The relative testes weight and sperm motility were significantly decreased by treatment with 900 mg/kg of DEHP. Both sperm count and daily sperm production were significantly decreased by DEHP treatment at doses of 600 and 900 mg/kg. Serum testosterone level and prostatic acid phosphatase (ACP) activity and testicular lactate dehydrogenase-X (LDH-X) activity were significantly decreased in animals treated with 900 mg/kg. Serum total ACP activity was significantly increased in animals treated with 600 and 900 mg/kg of DEHP. DEHP treatment induced oxidative stress and histopathological abnormality. These abnormalities were effectively normalized by pretreatment with quercetin except for LDH-X near normalcy. In conclusion, the findings of this study demonstrate that DEHP impairs testicular function at least, in part, by inducing oxidative stress and quercetin has a potent protective effect against DEHP-induced testicular toxicity in rats.
The saved and the drowned: Governing indifference in the name of security
Authors: Basaran Tugba
Published: April 2015

The duty to render assistance at sea appears to be a well-established humanitarian norm; nonetheless, in 2011 alone more than 1500 people drowned in the Mediterranean. Witnesses recount that many could have been rescued if fellow seafarers had not ignored their pleas for help. Struggling to understand failures to rescue, many seek to portray indifference as individual failure from the norm. In contrast hereto, this article provides an insight into the governing of indifference in contemporary liberal societies - that is, how people are guided towards becoming indifferent to the lives and sufferings of particular populations. Thus, my focus will be on the workings of law and its potential to produce collective indifference. The drowned, I argue, are not casualties of individual immoral behaviour; through a system of sanctions, fellow human beings are encouraged to look away and even to let people die at borders in the name of security. This not only dilutes the legal duty to rescue but has also had a detrimental impact upon the normative landscape, leading to a distinction between worthy lives that fall within the duty to rescue and charitable lives becoming a question of benevolence.
A harmonic analysis network
Authors: Alpaydin Ruhan , Mazzola Guerino
Published: April 2015

Harmonic analysis of symbolic music provides useful insights into music composition and performance. Automation of harmonic analysis could provide further help in making the analysis process explicit, precise, and user-configurable. The HarmoRubette component in the RUBATO music software environment was developed for such purposes. We decomposed, redesigned and extended HarmoRubette into a Harmonic Analysis Network. We describe our tonality/Harmonic Analysis Network in detail and discuss two sample analyses with the network.
The impact of the Global Financial Crisis on youth unemployment
Authors: Junankar PN (Raja)
Published: April 2015

Australia was one of the few OECD countries to emerge from the Global Financial Crisis (GFC) without facing a recession, usually defined as negative GDP growth for two consecutive quarters. However, the (overall) unemployment rate did increase following the GFC and has still not returned to pre–GFC levels. Unemployment rates for young people went up much more dramatically and remain high. This article investigates the impact of the GFC on youth unemployment and long-term unemployment. To anticipate our results, we find that the youth unemployment rates increased significantly owing to a fall in aggregate demand, although youth wages had been falling relative to adult wages. These findings do not support the commonly heard claim that youth wages are pricing young people out of the market.
Development of a Tier 3 Curriculum to Teach Early Literacy Skills
Authors: Kaminski Ruth A. , Powell-Smith Kelly A. , Hommel Annie , McMahon Rose , Aguayo Katherine Bravo
Published: April 2015

Children with the lowest oral language and early literacy skills at entry to kindergarten are the most vulnerable to poor literacy outcomes. This article describes the programmatic development of a Tier 3 early literacy intervention for preschool children who are most in need of intensive support to achieve early literacy outcomes. The intervention consists of carefully sequenced activities and games to promote early literacy development and is designed to be implemented by an early childhood educator with small groups of one to two children during center time or small-group instruction time in the classroom. Development of, and research on, the intervention followed an iterative process leading to a sequence of studies demonstrating moderate to strong effect sizes for children who qualified for Tier 3 support. Children who received intervention were a diverse group who presented an array of challenging characteristics that required individualization of the intervention. Children progressed at different rates, and some children clearly needed more opportunities to receive the intervention. Further research is needed to investigate factors related to effectiveness of Tier 3 interventions, including characteristics of the intervention, such as duration, time, and group size, as well as the characteristics of children who respond/do not respond.
Disturbance observer and finite-time tracker design of disturbed third-order nonholonomic systems using terminal sliding mode
Authors: Mobayen Saleh , Javadi Shamsi
Published: April 2015

This paper proposes a novel recursive terminal sliding mode structure for tracking control of third-order chained–form nonholonomic systems in the presence of the unknown external disturbances. Finite-time convergence of the disturbance approximation error is guaranteed using the designed disturbance observer. Under the proposed terminal sliding model tracking control technique, the finite-time convergence of the states of the closed-loop system is guaranteed via Lyapunov analysis. A new reaching control law is proposed to guarantee the existence of the sliding mode around the recursive TSM surface in a finite-time. Simulation results are illustrated on a benchmark example of third-order chained-form nonholonomic systems: a wheeled mobile robot. The results demonstrate that the proposed control technique achieves promising tracking performance for nonholonomic systems.
The Effects of Inattentiveness and Hyperactivity on Posttraumatic Stress Symptoms: Does a Diagnosis of Posttraumatic Stress Disorder Matter?
Authors: Adams Zachary , Adams Thomas , Stauffacher Kirstin , Mandel Howard , Wang Zhewu
Published: April 2015

Objective: To address the nature of associations between ADHD symptoms and posttraumatic stress disorder (PTSD) psychopathology in adult military veterans. Method: Ninety-five combat veterans, with PTSD ( n = 63) and without PTSD ( n = 32), were recruited for this study. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS) and ADHD was assessed with Connors’ Adult ADHD Rating Scale−Self-Report: Short Version (CAARS-S:S). Results: PTSD participants endorsed greater hyperactivity or restlessness, inattention or memory problems, and impulsivity or emotional lability scores than participants without PTSD. Among PTSD participants, inattention or memory problems and impulsivity or emotional lability were significant predictors of total PTSD symptoms, but only inattention or memory problems significantly predicted PTSD symptoms when other ADHD symptom clusters were considered simultaneously. Conclusion: Our data suggest that inattention may serve as a risk factor for posttraumatic stress symptoms following combat exposure.
Modeling and Estimating the Effects of Institutional Variables on a Pay-as-you-go Social Security System and on Household Saving
Authors: Hatzinikolaou Dimitris , Tsoka Agathi
Published: April 2015

Using a two-period overlapping generations model and three panel data sets of annual aggregate data from twenty-five countries, we estimate a fixed-effects Euler equation for household saving. We focus on the effects of several institutional and other variables, such as corruption and the debt to gross domestic product (GDP) ratio, on household saving and on the probability that a pay-as-you-go social security system will grant pensions. We find that social security contributions reduce saving in a less than one-for-one manner. Also, as corruption or the debt to GDP ratio increases, the probability that the system will grant pensions falls, and so does the effect of social security contributions on saving. Finally, the marginal effect of an improvement in the quality of institutions on the credibility of the social security system is greater in countries where the quality of institutions is low than in countries where it is high, a result that stresses the role of institutions in reducing uncertainty about pensions.
Sensitivity of the modified Children’s Yale–Brown Obsessive Compulsive Scale to detect change: Results from two multi-site trials
Authors: Scahill Lawrence , Sukhodolsky Denis G , Anderberg Emily , Dimitropoulos Anastasia , Dziura James , Aman Michael G , McCracken James , Tierney Elaine , Hallett Victoria , Katz Karol , Vitiello Benedetto , McDougle Christopher
Published: April 2015

Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children’s Yale–Brown Obsessive Compulsive Scale modified for autism spectrum disorder to detect change with treatment. Study 1 included 52 subjects assigned to placebo and 49 subjects to risperidone under double-blind conditions. In Study 2, 49 subjects received risperidone only and 75 subjects received risperidone plus parent training. The combined sample consisted of 187 boys and 38 girls (aged 4–17 years). At the medication-free baseline, the internal consistency on the Children’s Yale–Brown Obsessive Compulsive Scale modified for autism spectrum disorder total score was excellent (Cronbach’s alpha = 0.84) and the mean scores were similar across the four groups. Compared to placebo in Study 1, all three active treatment groups showed significant improvement (effect sizes: 0.74–0.88). There were no differences between active treatment groups. These results indicate that the Children’s Yale–Brown Obsessive Compulsive Scale modified for autism spectrum disorder has acceptable test–retest as evidenced by the medium to high correlations in the placebo group and demonstrated sensitivity to change with treatment.
“Respect the way I need to communicate with you”: Healthcare experiences of adults on the autism spectrum
Authors: Nicolaidis Christina , Raymaker Dora M , Ashkenazy Elesia , McDonald Katherine E , Dern Sebastian , Baggs Amelia EV , Kapp Steven K , Weiner Michael , Boisclair W Cody
Published: April 2015

Our objective was to obtain an in-depth understanding of autistic adults’ experiences with healthcare and their recommendations for improving care. Our academic–community partnership used a community-based participatory research approach to conduct semi-structured, open-ended interviews with 39 autistic adults and 16 people who had experience supporting autistic adults in healthcare settings. Participants identified patient-level, autism-related factors that impact healthcare interactions, including verbal communication skills, sensory sensitivities, challenges with body awareness, slow processing speed, atypical non-verbal communication, and challenges with organization. However, the success of healthcare interactions largely depended on the interplay between patient- and provider-level factors, as well as the larger context in which patients were receiving care. Provider-level factors included providers’ knowledge about autism in adults, incorrect assumptions about individual patients, willingness to allow written communication, use of accessible language, openness to providing other accommodations, and skill in appropriately incorporating supporters. System-level factors included the availability of supporters, complexity of the healthcare system, accessibility of healthcare facilities, and stigma about autism. Further efforts are needed to empower patients, adequately train providers, increase the accessibility of the healthcare system, and decrease discrimination.
Measuring citizens’ implicit and explicit attitudes towards the European Union
Authors: Maier Michaela , Maier Jürgen , Baumert Anna , Jahn Nico , Krause Stefan , Adam Silke
Published: April 2015

Studies assessing citizens’ attitudes towards Europe have mostly used explicit concepts and measures. However, psychologists have shown that human behaviour is not only determined by explicit attitudes which can be assessed via self-report, but also by implicit attitudes which require indirect measurement. We combine a self-report questionnaire with an implicit Affective Misattribution Procedure for the first time in an online environment to estimate the reliability, validity and predictive power of this implicit measure for the explanation of European Union-skeptical behaviour. Based on a survey with a sample representative for Germany, we found evidence for good reliability and validity of the implicit measure. In addition, the implicit attitude had a significant incremental impact beyond explicit attitudes on citizens’ proneness to engage in EU-skeptical information and voting behaviour.
Prognostic algorithms for L70 life prediction of solid state lighting
Authors: Padmasali AN , Kini SG
Published: April 2015

The life of light-emitting diodes (LEDs) is difficult to measure by traditional testing methods as they are not likely to fail completely. The Illuminating Engineering Society of North America (IESNA) uses a standard regression approach based on short-term collected lumen data to predict the L70 lifetime of LEDs. In this paper, a model-based prognostics method is employed to determine the life of luminaires using LEDs. Unscented Kalman filter and particle filter algorithms are used for degradation model parameter estimation. An analytical approach based on three statistical models (Weibull, normal, lognormal) is employed and a best fit is determined by the Akaike information criterion. The resulting L70 is compared with L70 derived from the IESNA approach to accurately determine the best prognostic method.
Pulmonary function abnormalities in adult patients with acute exacerbation of bronchiectasis
Authors: Ma Yanliang , Niu Yuqian , Tian Guizhen , Wei Jingan , Gao Zhancheng
Published: April 2015

Lung function impairments, especially airflow obstruction, are important features during acute exacerbation in patients with bronchiectasis. Recognition of the risk factors associated with airflow obstruction is important in the management of these exacerbations. The medical records of adult patients admitted to the Peking University People’s Hospital, Beijing, China, from 2004 to 2011 with a diagnosis of bronchiectasis were reviewed retrospectively. Univariate and multivariate analyses were used to evaluate the risk factors associated with airflow obstruction. Airflow obstruction was found in 55.6% of 156 patients hospitalized with acute exacerbation of bronchiectasis, and the risk factors associated with airflow obstruction included young age (≤14 years old) at diagnosis (odds ratio (OR) = 3.454, 95% confidence interval (CI) 1.709–6.982, p = 0.001) as well as the presence of chronic obstructive pulmonary disease (COPD; OR = 14.677, 95% CI 5.696–37.819, p = 0.001), asthma (OR = 3.063, 95% CI 1.403–6.690, p = 0.005), and wheezing on auscultation (OR = 3.279, 95% CI 1.495–7.194, p = 0.003). The C-reactive protein (13.9 mg/dl vs. 6.89 mg/dl, p = 0.005), partial pressure of arterial oxygen (66.7 ± 8.57 mmHg vs. 89.56 ± 12.80 mmHg, p < 0.001), and partial pressure of arterial carbon dioxide (40.52 ± 2.77 mmHg vs. 42.87 ± 5.39 mmHg, p = 0.02) profiles were different between patients with or without airflow obstruction. In addition, patients colonized with potential pathogenic microorganisms had a decreased diffusing capacity (56.0% vs. 64.7%, p = 0.04). Abnormal pulmonary function was common in hospitalized patients with bronchiectasis exacerbations. Airflow obstruction was correlated with the patient’s age at diagnosis, as well as the presence of combined COPD and asthma, and wheezing on auscultation, which also resulted in more severe systemic inflammation and hypoxemia.
Restarting Static
Authors: Oswald Kathleen F. , Bailey Wm. Ruffin
Published: April 2015

This article examines the digital television (DTV) transition with particular focus on technical protocols, political and legal decisions, and home hardware. Considering the great potential for redefining television in the digital medium, we highlight ways in which television was “rebooted” rather than reinvented. Without the technical constraints that shaped analog television, many carryovers to DTV can be ascribed to social rather than conventionally technical influences and stakeholders. Three themes emerge from our analysis: (1) a technocratic discourse that favored resolution over reception as central to broadcasting as public service, (2) an inadequate public information campaign and failure to explore the range of opportunities presented by the digital format, and (3) a rearticulation of the home theater assemblage to cope with DTV through replacement-driven obsolescence. We argue that approaching DTV as a “reboot” serves as a model for investigating digital transitions more broadly in a new model of public service.
Clinical comparison of hook plate fixation versus extension block pinning for bony mallet finger: a retrospective comparison study
Authors: Acar M. A. , Güzel Y. , Güleç A. , Uzer G. , Elmadağ M.
Published: April 2015

The aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford’s criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy.

Level of evidence: Level III
An unusual case of nonsustained ventricular tachycardia
Authors: Brandt John C. , Harman Eloise , Winchester David
Published: April 2015

A 54-year-old woman with advanced cirrhosis secondary to hepatitis C, end-stage kidney failure on hemodialysis, and nonischemic cardiomyopathy was admitted to the medical intensive care unit for treatment of a superior vena cava (SVC) thrombus involving a recently implanted cardioverter–defibrillator (ICD). During her hospitalization, the patient abruptly developed frequent ventricular ectopy with up to 20 beat runs of hemodynamically significant nonsustained ventricular tachycardia. Because ventricular ectopy was not previously seen in the patient, the sudden onset prompted a thorough evaluation. After other causes were excluded, a recently placed scopolamine patch was removed; the ventricular ectopy completely resolved within 24 hours and did not recur for the remainder of the patient’s extended hospitalization. While anticholinergic syndrome is associated with a vagally mediated sinus tachycardia, ventricular arrhythmias have not previously been reported with scopolamine, to the best of the authors’ knowledge. The observed cardiac side effects of scopolamine rarely occur at therapeutic doses. Scopolamine is metabolized primarily in the liver and excreted by the kidneys, so renal and hepatic impairment should be considered when initiating and dosing this medication. Because anticholinergic medications including scopolamine are commonly used in various clinical settings, we believe that clinicians should be aware of this significant but completely reversible adverse effect.
Critically appraising the evidence
Authors: Merriel Samuel
Published: April 2015

The ability to understand and analyse a research paper and decide whether it should change your clinical practice is a key skill in providing evidence-based medicine. As GPs, we need to stay abreast of the latest developments in medical research across all disciplines by appraising evidence that is presented to us in a critical and efficient manner. This article aims to refresh your knowledge of statistics and study design, explain the process of critical appraisal, and present resources that can assist you in analysing research articles.
Exploring the approaches used to teach concepts of hand hygiene to Australian medical students
Authors: Kaur Rajneesh , Razee Husna , Seale Holly
Published: April 2015

Background:

Recent audit data has revealed that the hand hygiene (HH) rates of Australian medical students is suboptimal. It has been suggested that new approaches are needed to teach students about infection control. As a first step, we undertook a study to determine the current educational approaches used to teach Australian medical students about HH. Secondly, this study aimed to explore the perceived barriers and to explore what other teaching approaches could be used to improve the levels of knowledge and compliance.

Methods:

A self-administered questionnaire was sent to the Dean of Medical Education at each of the medical schools in late 2012.

Results:

Of the 19 medical schools in Australia, 17 agreed to participate. The most commonly reported approaches currently used to teach students about HH are skills stations (17/17) and case scenarios/lectures (15/17). Clinical practical exams (15/17) and competency checks (11/17) are mostly used to assess the HH practices of medical students. Participants nominated the following as barriers to improving HH compliance: negative role modelling by senior doctors, and negative attitudes of students. Practical exercises (15/17), online teaching (12/17) and reflection (12/17) were suggested as other useful approaches that could be used to teach these concepts.

Conclusion:

Practical laboratory-based approaches were suggested as the most useful teaching and learning approach. Given the trend towards blended learning, universities may want to consider new HH teaching approaches that combine campus-based learning with online components and reflection. Early exposure and the continued reinforcement of HH concepts through the student’s medical degree are essential.
Evaluation of functional outcomes and complications following modified Latarjet reconstruction in athletes with anterior shoulder instability
Authors: Colegate-Stone Toby J , van der Watt Christelle , de Beer Joe F
Published: April 2015

Background

The optimal management of anterior shoulder instability in athletes continues to be a challenge. The present study aimed to evaluate the functional outcomes of athletes with anterior shoulder instability following modified Latarjet reconstruction through assessing the timing of return to sport and complications.

Methods

Retrospective assessment was performed of athletes ( n = 56) who presented with recurrent anterior shoulder instability and were treated with modified congruent arc Latarjet reconstruction over a 1-year period. Rugby union was the predominant sport performed. Pre-operative instability severity index scores were assessed. Postoperative complications were recorded as was the time taken for the athlete to return to sport.

Results

Arthroscopic evaluation revealed that 86% of patients had associated bony lesions affecting the glenohumeral joint. The overall complication rate relating to the Latarjet reconstruction was 7%. No episodes of recurrent shoulder instability were noted. Of the patients, 89% returned to competitive sport at the same level as that prior to surgery. The mean time post surgery to returning to full training was 3.2 months.

Conclusions

The modified congruent arc Latarjet procedure facilitates early rehabilitation and return to sport. These results support our systematic management protocol of performing modified Latarjet surgery in contact sport athletes with recurrent anterior instability.
Technology to Reduce Hypoglycemia
Authors: Yeoh Ester , Choudhary Pratik
Published: April 2015

Hypoglycemia is a major barrier toward achieving glycemic targets and is associated with significant morbidity (both psychological and physical) and mortality. This article reviews technological strategies, from simple to more advanced technologies, which may help prevent or mitigate exposure to hypoglycemia. More efficient insulin delivery systems, bolus advisor calculators, data downloads providing information on glucose trends, continuous glucose monitoring with alarms warning of hypoglycemia, predictive algorithms, and finally closed loop insulin delivery systems are reviewed. The building blocks to correct use and interpretation of this range of available technology require patient education and appropriate patient selection.
Improved Postprandial Glucose Control Using the InsuPad Device in Insulin-Treated Type 2 Diabetes
Authors: Raz Itamar , Bitton Gabriel , Feldman Dmitry , Alon Tal , Pfutzner Andreas , Tamborlane William V.
Published: April 2015

Background: Delays in the time-action profiles of premeal boluses of rapid-acting insulin analogs contribute to early postmeal hyperglycemia in patients with diabetes. We tested whether applying local heat to skin around the injection site to increase the rate of insulin absorption reduces postprandial hyperglycemia in patients with type 2 diabetes. Methods: Fourteen patients with type 2 diabetes (4 females; age 61.6 ± 8.4 years, HbA1c 8.42 ± 1.13%; BMI 29.10 ± 5.61 kg/m2) on intensified insulin therapy underwent 5-hour meal tolerance tests (MTTs) with a standardized liquid meal after an overnight fast on 2 study days. Subjects injected 0.2 U/kg of insulin aspart or lispro subcutaneously into the abdominal skin on both days with and without the use of the InsuPad device. Results: Following the premeal bolus injection of rapid-acting insulin analog, infusion site warming led to a rise in plasma insulin levels to peak concentrations that were significantly earlier than without skin warming (mean ± SD 52 ± 26.7 vs 80 ± 51.3 minutes, P < .005) as well as increase in plasma insulin levels during the first hour after injection (mean ± SD 63.5 ± 32.7 IU vs 48.0 ± 25.0 uU.min/ml, P = .019). As a result, the area under the curve of the postprandial glucose excursion during the first 2 hours (the primary study outcome) and the entire 5 hours after the meal were significantly reduced ( P = .007 and P = .03, respectively) with skin warming around the injection site. Discussion and Conclusions: Use of the InsuPad to increase the rate of insulin absorption provides an effective means to achieve better control of postmeal glucose excursions in type 2 diabetic patients receiving premeal injections of rapid-acting insulin analogs.
Computer Vision-Based Carbohydrate Estimation for Type 1 Patients With Diabetes Using Smartphones
Authors: Anthimopoulos Marios , Dehais Joachim , Shevchik Sergey , Ransford Botwey H. , Duke David , Diem Peter , Mougiakakou Stavroula
Published: April 2015

Background: Individuals with type 1 diabetes (T1D) have to count the carbohydrates (CHOs) of their meal to estimate the prandial insulin dose needed to compensate for the meal’s effect on blood glucose levels. CHO counting is very challenging but also crucial, since an error of 20 grams can substantially impair postprandial control. Method: The GoCARB system is a smartphone application designed to support T1D patients with CHO counting of nonpacked foods. In a typical scenario, the user places a reference card next to the dish and acquires 2 images with his/her smartphone. From these images, the plate is detected and the different food items on the plate are automatically segmented and recognized, while their 3D shape is reconstructed. Finally, the food volumes are calculated and the CHO content is estimated by combining the previous results and using the USDA nutritional database. Results: To evaluate the proposed system, a set of 24 multi-food dishes was used. For each dish, 3 pairs of images were taken and for each pair, the system was applied 4 times. The mean absolute percentage error in CHO estimation was 10 ± 12%, which led to a mean absolute error of 6 ± 8 CHO grams for normal-sized dishes. Conclusion: The laboratory experiments demonstrated the feasibility of the GoCARB prototype system since the error was below the initial goal of 20 grams. However, further improvements and evaluation are needed prior launching a system able to meet the inter- and intracultural eating habits.
The Media’s Role in Lawmaking
Authors: Melenhorst Lotte
Published: April 2015

Despite the ongoing debate about the role the media play in democracies, there is little empirical research on its role in lawmaking. Yet studies conducted at the micro-level can provide insight into the influence journalists exert on this fundamental aspect of politics. This case study analyzes the role of media attention in the legislative process that resulted in the legal regulation of (semi)public officials’ remuneration in the Netherlands. The chronological in-depth analysis of claims made in the media and in parliament shows that during the legislative process, political actors responded to media attention directly and indirectly. Incident-driven coverage served as a source for questions and was strategically used by members of parliament (MPs) in legislative debates to substantiate and illustrate their position. More indirectly, long-term trends in media coverage for specific topics contributed to the introduction of and support for amendments to the bill.
Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial
Authors: Berg Astrid T , Stafne Signe N , Hiller Aud , Slørdahl Stig A , Aamot Inger-Lise
Published: April 2015

Objectives:

To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain.

Methods:

A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life.

Results:

Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (–17.6, 95% confidence interval: –30.5, –4.7; p < 0.01), and the reduction was persistent at 3 months’ follow-up (–15.2, 95% confidence interval: –28.5, –1.8; p = 0.03). Health-related quality of life improved in all three domains in patients with no significant difference between groups.

Conclusion:

Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.
Implicit attitudes and their measurement: Theoretical foundations and use in consumer behavior research
Authors: Ackermann Claire-Lise , Mathieu Jean-Pierre
Published: April 2015

Implicit attitude automatically influences our judgments without our being aware of it. This article aims to introduce the concept of implicit attitude and its main measurement tool, the Implicit Association Test, and their significance in the study of consumer behavior.
Bien-être and well-being in consumer research: A comparative analysis
Authors: Gorge Hélène , Özçağlar-Toulouse Nil , Toussaint Stéphanie
Published: April 2015

This article provides a critical overview in which French-language research on consumer bien-être (BEC) is compared to English-language studies of well-being as part of Transformative Consumer Research (TCR). We begin by identifying the specific positions adopted and themes addressed by the researchers, before exploring the cultural roots of each approach. We conclude with a discussion of our findings and suggested research perspectives and avenues for the future.
Putting Technology Into Youth Mental Health Practice
Authors: Montague Alice E. , Varcin Kandice J. , Simmons Magenta B. , Parker Alexandra G.
Published: April 2015

Although young people aged 16 to 25 are particularly susceptible to mental ill-health, they are difficult to engage in ongoing treatment. Meanwhile, young people are more engaged with digital technologies than ever before, with the Internet and mobile technologies reaching ubiquity in young lives. Despite this, it is unclear from the literature how young people’s high technology use may be harnessed for the better management of youth mental health problems in face-to-face treatment. To explore young people’s opinions on how technology can be used for treatment engagement and as a complement to mental health treatment, a total of 21 participants aged 16 to 25 years were consulted in two focus groups. Transcripts were analyzed using thematic analysis, with consensus coding by two independent raters. Participants were positive about the integration of technology into youth mental health practice, but indicated that identifying the client’s preferred technology was the most reliable means of engagement. They reported already using technology as an informal complement to treatment, and asserted that formal technology integration must have a clear benefit to treatment while not replacing face-to-face time. Technology use to provide support beyond discharge and between sessions was suggested as a useful means for continuity of care and to prevent relapse. While various technologies were described as engaging, easy-to-access, informative, and empowering, their benefits are not yet being harnessed in youth health services to their full potential. More research is required to better understand how to best put technology into youth mental health practice.
Self-Esteem Deficits Among Psychiatric Patients
Authors: Rizwan Muhammad , Ahmad Riaz
Published: April 2015

The objective of the present study was to investigate the difference in the level of self-esteem among patients with psychiatric disorders and normal controls. After a detailed literature review, it was hypothesized that there would be a significant difference in the level of self-esteem among patients with psychiatric disorders and normal controls. The sample of the present study consisted of 260 participants, who were further divided into two groups: clinical group ( n = 140) and normal controls ( n = 120). The age range of the participants in both the samples were 18 to 25 years (with the mean age of 22.14 years for psychiatric patients and 21.18 years for normal controls), and they belonged to middle socioeconomic status. The clinical group consisted of diagnosed psychiatric patients according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria and further divided into four subgroups, including patients of (a) schizophrenia ( n = 40), (b) major depressive disorder ( n = 40), (c) obsessive-compulsive disorder ( n = 40), and (d) opioid dependence disorder ( n = 20). The semi-structured interview form of Institute of Clinical Psychology, University of Karachi, and Rosenberg Self-Esteem Scale were used. Descriptive Statistics and one-way ANOVA were applied to analyze and interpret the data in statistical terminology. Results indicate significant differences among patients with psychiatric disorders and normal controls on the variable of self-esteem ( F = 30.513, df = 4, 255, p< .05). The finding has implications for clinical interventions and also suggests avenues for future research.