bluuebunny/crossref_metadata_2025 huggingface dataset:
Benefit and customer demand approach for maintenance optimization of complex systems using Bayesian networks
Authors: Ait Mokhtar El Hassene , Laggoune Radouane , Chateauneuf Alaa
Published: July 2017

The satisfaction of client needs is the goal of most of the industrial systems, which can be achieved by appropriate life-cycle management. When it concerns complex real-world systems, the difficulty of managing their life-cycle increases with increasing of the links and interactions between the system components and between the system and its environment. Therefore, the need of addressing a complete and realistic maintenance planning approach to face these difficulties is crucial. This article presents a methodology for maintenance optimization of complex systems using Bayesian networks. In this methodology, the objective function, which aims at maximizing the system benefit, allows conciliating between two contradictory objectives: reducing the maintenance costs and reaching an availability target fixed according to the customer demand. The Bayesian networks are used to take into account the system interactions, while the maintenance policy, which is based on the imperfect preventive maintenance and considers several efficiency levels, is used to build a realistic maintenance planning model. An application to a water supply system is included to illustrate the benefit and the effectiveness of the proposed approach.
Clinical determinants of clopidogrel responsiveness in a heterogeneous cohort of Puerto Rican Hispanics
Authors: Hernandez-Suarez Dagmar F. , Scott Stuart A. , Tomey Matthew I. , Melin Kyle , Lopez-Candales Angel , Buckley Charlotte E. , Duconge Jorge
Published: July 2017

Background:

Clopidogrel is by far the most prescribed platelet adenosine diphosphate (ADP) antagonist in Puerto Rico despite the advent of newer agents (prasugrel and ticagrelor). Given the paucity of data on clopidogrel responsiveness in Hispanics, we sought to determine the association between clinical characteristics and platelet reactivity in Puerto Rican patients on clopidogrel therapy.

Study population:

A total of 100 Puerto Rican patients on clopidogrel therapy were enrolled and allocated into two groups: Group I, without high on-treatment platelet reactivity (HTPR); and Group II, with HTPR. Platelet function was measured ex vivo using the VerifyNow® P2Y12 assay.

Results:

The cohort was comprised of Hispanic patients with coronary artery disease (57%), peripheral artery disease (32%), carotid artery stenosis (7%), cerebral artery aneurysm (2%), and stroke (2%). Mean platelet reactivity was 200 ± 61 P2Y12 reaction units (PRUs) (range: 8–324), and 35% of patients had HTPR (PRUs ⩾ 230). Multivariable logistic regression analysis determined that diabetes mellitus (DM) [odds ratio (OR) = 3.27; 95% confidence interval (CI): 1.20–8.96], use of proton-pump inhibitors (PPIs) (OR = 3.60; 95% CI: 1.09–11.82), and calcium channel blockers (CCBs) (OR = 3.10; 95% CI: 1.09–8.83) were independent predictors of HTPR ( p < 0.05) after adjusting for other clinical variables.

Conclusions:

In a sample of 100 Puerto Rican Hispanic patients on clopidogrel, 35% had HTPR. Furthermore, DM, PPIs and CCBs predicted HTPR. Clinical outcome data are needed to identify appropriate PRU thresholds for risk prediction in the Puerto Rican population.
Performance management in SME high-growth sectors and high-impact sectors in Thailand
Authors: Na-Nan Khahan , Chaiprasit Kanokporn , Pukkeeree Peerapong
Published: July 2017

Performance management (PM) plays a vital role in the successful operation of an organization. It is essential for organizations to understand the correlations between factors, problems and solutions to enhance the efficiency of PM. Mixed method research is applied, including explanatory sequential design (Quan → Qual). By analysing findings and interviews from a cluster of small and medium enterprise (SME) high-growth sectors and high-impact sectors based on descriptive and inferential statistics, the PM finding is that these two SMEs are not different. Moreover, the factors that influence PM are recruitment, retention and retirement. Regarding PM problems, the key factors are a lack of employee participation, unclear goals, unfair evaluations, ineffectual communication and ineffective application of evaluations to improve PM. Therefore, related private and government organizations should enhance their knowledge and understanding of problem-solving procedures by attending trainings or discussing these topics with experts to raise their awareness of PM and to learn how to resolve related issues, particularly factors that directly influence PM, to ensure progress in their performance.
Self-Reported Compensation Techniques for Carbohydrate, Exercise, and Alcohol Behaviors in Patients With Type 1 Diabetes on Insulin Pump Therapy
Authors: Groat Danielle , Soni Hiral , Grando Maria Adela , Thompson Bithika , Cook Curtiss B.
Published: July 2017

Studies have found variability in self-care behaviors in patients with type 1 diabetes, particularly when incorporating exercise and alcohol consumption. The objective of this study was to provide results from a survey to understand (1) insulin pump behaviors, (2) reported self-management behaviors for exercise and alcohol, and (3) perceptions of the effects of exercise and alcohol on blood glucose (BG) control. Fourteen participants from an outpatient endocrinology practice were recruited and administered an electronic survey. Compensation techniques for exercise and alcohol, along with reasons for employing the techniques were identified. Also identified were factors that participants said affected BG control with regard to exercise and alcohol. These results confirm the considerable inconsistency patients have about incorporating exercise and alcohol into decisions about self-management behaviors.
Reference Price and Its Asymmetric Effects on Price Evaluations: The Moderating Role of Gender
Authors: Choi Choongbeom , Joe Sung Jun , Mattila Anna S.
Published: July 2017

Empirical research shows that customers form price evaluations by comparing the actual price with a reference price. The relative use of an internal reference price (IRP) versus an external reference price (ERP) is an important issue in the lodging industry due to the popularity of price-comparison–based advertising. Although prior literature shows that demographic factors influence the relative use of IRP and ERP, the impact of gender on the relationship between reference prices and price evaluations has received scant attention in both hospitality and marketing contexts. Drawing on the agency-communal theory, the current research examines the effect of gender on the use of IRP and ERP in price evaluations. The findings indicate that males are more susceptible to IRP than to ERP, whereas females are only influenced by ERP. Relevant managerial implications are drawn in terms of pricing and promotional strategies.
Complications associated with the use of oral anticoagulation in patients with pulmonary arterial hypertension from two referral centers
Authors: Roldan Tamara , Rios Juan J , Villamañan Elena , Waxman Aaron B.
Published: July 2017

Anticoagulants are widely used in patients with pulmonary arterial hypertension (PAH) to prolong survival. However, there is a lack of robust evidence demonstrating the benefits of anticoagulants in PAH patients and very little is known about the complications of their use in this population. The objective of this study is to compare the safety of routine administration of oral anticoagulants between PAH patients who were and were not treated with oral anticoagulants. This observational, retrospective cohort study included consecutive patients with confirmed PAH from two centers: Brigham and Women’s Hospital in Boston and Hospital Universitario La Paz in Madrid from January 2009 to August 2015. The study group comprised patients who received therapeutic anticoagulation; patients who had never received anticoagulants were placed in the control group. Of the 201 included patients, 60.2% were treated with oral anticoagulants and 39.8% were not treated. The hazard ratio for major bleeding was 2.7 (95% confidence interval [CI] = 1.1–6.8; P = 0.036). The incidence rate for the anticoagulation group was 4.7 per 100 patient‐years (95% CI = 2.5–8.0). The most frequent major hemorrhage was gastrointestinal bleeding with 24 cases (72.7%). Prior bleeding, poor anticoagulation, HAS‐BLED score ≥3, diabetes, and number of medications were factors that increased the risk of major bleeding in patients using anticoagulants. The harmful effects of anticoagulants could outweigh the benefits in PAH patients. Therefore, anticoagulants should be prescribed on a case‐by‐case basis and should not be systematically recommended.
Unemployment and HIV mortality in the countries of the Organisation for Economic Co-operation and Development: 1981–2009
Authors: Maruthappu Mahiben , Zhou Charlie , Williams Callum , Zeltner Thomas , Atun Rifat
Published: July 2017

Objectives

To determine an association between unemployment rates and human immunodeficiency virus (HIV) mortality in the Organisation for Economic Co-operation and Development (OECD).

Design

Multivariate regression analysis.

Participants

OECD member states.

Setting

OECD.

Main outcome measures

World Health Organization HIV mortality.

Results

Between 1981 and 2009, a 1% increase in unemployment was associated with an increase in HIV mortality in the OECD (coefficient for men 0.711, 0.334–1.089, p = 0.0003; coefficient for women 0.166, 0.071–0.260, p = 0.0007). Time lag analysis showed a significant increase in HIV mortality for up to two years after rises in unemployment: p = 0.0008 for men and p = 0.0030 for women in year 1, p = 0.0067 for men and p = 0.0403 for women in year 2.

Conclusions

Rises in unemployment are associated with increased HIV mortality. Economic fiscal policy may impact upon population health. Policy discussions should take into consideration potential health outcomes.
A case of hypercalcaemia in an immunocompetent patient with Mycobacterium avium intracellulare
Authors: Parsons Christine E , Singh Sujata , Geyer Holly L
Published: July 2017

Mycobacterium avium intracellulare infection or colonization should be considered in the differential diagnosis of hypercalcemia, especially in immunocompromised individuals, in the appropriate clinical context.
How journalists verify user-generated content during terrorist crises. Analyzing Twitter communication during the Brussels attacks
Authors: Rauchfleisch Adrian , Artho Xenia , Metag Julia , Post Senja , Schäfer Mike S.
Published: July 2017

Social media, and Twitter in particular, have become important sources for journalists in times of crises. User-generated content (UGC) can provide journalists with on-site information and material they otherwise would not have access to. But how they source and verify UGC has not yet been systematically analyzed. This study analyzes sourcing and verification practices on Twitter during the Brussels attacks in March 2016. Based on quantitative content analysis, we identified (1) the journalists and news organizations sourcing during the attacks, (2) classified different forms of sourcing and verification requests, and (3) analyzed the sourced UGC. Results show that sourcing on Twitter has become a global phenomenon. During the first hours of the attack, journalists rely on UGC. Their sourcing and verification practices vary widely and often lack basic verification procedures, which leads to a discussion about the ethical implications of sourcing practices.
Multifaceted competence requirements in care homes: Ethical and interactional competence emphasized
Authors: Kiljunen Outi , Välimäki Tarja , Partanen Pirjo , Kankkunen Päivi
Published: July 2017

Nurses need versatile competence to care for older people in care home settings. A modified Delphi study was conducted to identify competencies registered nurses and licensed practical nurses need to care for older people in care homes. A total of 38 panelists consisting of experienced professionals in clinical and managerial roles were recruited to identify types of competencies these nurses require. In total, 80 competencies for licensed practical nurses and 81 competencies for registered nurses were identified as necessary. This study has shown that licensed practical nurses are required to have similar competencies to registered nurses in care homes. Nurse managers, nurse educators, and policy makers should pay more attention, to nurses’ work requirements, especially for licensed practical nurses, and support nurses to meet the needs of older people living in care homes.
Information about sexual activity after hip replacement: A literature review
Authors: Pennbrant Sandra , Gustafsson Törn Jeanette , Munthe Helena
Published: July 2017

Sexual activity is an important aspect of quality of life and contributes to healing and recovery. Adequate information may minimize post-operative risks and improve wellbeing. The aim of this literature review was to identify and review articles regarding the information on sexual activity after hip replacement provided to or obtained by patients and partners prior to their hip replacement surgery. The literature search was performed in the following databases: CINAHL, PubMed/Medline, MEDLINE (via Ebscoost) and Scopus. The results underline the importance of providing hip replacement patients and partners with relevant information, to reduce their concerns and improve their satisfaction and quality of life. Such information could promote person-centered care for patient and partner, and increase long-term cost-effectiveness for the healthcare organization. Information to patients and partners on post-hip-replacement sexual limitations has not been closely studied. Further research is needed to help healthcare providers promote patients’ and partners’ sexual health and quality of life and improve wellbeing.
Health-related stigma related to leprosy: What can be learned from nurses in Ghana?
Authors: Bergman Love , Britton Asabea , Kneck Åsa
Published: July 2017

The aim of the study was to describe nurses’ experiences of how stigma affected the care and health of patients with leprosy. Health-related stigma exists worldwide and affects patients, relatives and caregivers. Mere word ‘leprosy’ is often met with disgust, shame and fear. Knowledge of health-related stigma is important for developing care in different parts of the world. The study has a qualitative, descriptive design. Seven semi-structured individual interviews were conducted with nurses working at a hospital specializing in leprosy care. The study was carried out in the central region of Ghana. Data were analysed using qualitative content analysis. The findings are presented as one theme, ‘Increased knowledge and holistic interventions are important in care for patients with leprosy’, and three sub-themes: ‘knowledge and beliefs are intimately interlaced with leprosy-related stigma’, ‘information is important but not enough to change behaviours and attitudes’ and ‘long-term interventions in a social context’. We conclude that caring for patients with leprosy involved long-term interventions, not at least in relation to education on a society level as well as concerning patients’ abilities to learn a skill to make an income in order to be less dependent on healthcare facilities.
Preoperative Venovenous ECMO in an Infant With Late Diagnosis of Hypoplastic Left Heart Syndrome
Authors: Eschenbach Lena K. , Kasnar-Samprec Jelena , Ackermann Kilian , Schreiber Christian , Lange Rudiger , Cleuziou Julie
Published: July 2017

Late diagnosis and late referral for the Norwood stage 1 procedure in patients with hypoplastic left heart syndrome is rare and associated with a higher mortality. We present a case of a cyanotic almost five-week-old infant with hypoplastic left heart syndrome, highly restrictive foramen ovale, and patent ductus arteriosus, who was bridged with venovenous extracorporeal membrane oxygenation to the Norwood stage 1 procedure.
“We Can Remember It for You”: Location, Memory, and Commodification in Social Networking Sites
Authors: Drakopoulou Sophia
Published: July 2017

This article explores the spatial self through the performative aspects of location sharing and geotagging in the process of self-representation on social networking sites (SNSs). Based on the legacy of early experimentations with location-based technologies for social interaction, the article asserts that the representation of location in SNSs has more temporal than spatial attributes. The article explores the immediacy of networks and the different kinds of temporality encountered in SNSs to address the commodification of geotagged content uploaded on SNSs. Location-based data are valuable commodities bought and sold in the market. Therefore, the act of archiving memories on SNSs is commodified and performed within the predetermined functions and actions set within the SNSs’ interfaces. SNSs devise ways to keep users constantly interacting with the present moment in time and simultaneously create memories of the recent past while disclosing personal data that companies use for profit.
Does Role Balance Influence the Effect of Personality on College Success? A Mediation Model
Authors: Bishop Jennifer L. , Roberson Patricia N. E. , Norona Jerika C. , Welsh Deborah P.
Published: July 2017

While the relationship between individual factors, including personality dimensions, and tertiary academic outcomes is well established, the mechanisms by which these factors influence academic success have been less fully explored. This study tested one potential mechanism, the developmental task of role balance, by which personality may influence college success. During emerging adulthood, young people simultaneously explore and establish both individual and relational role identities. As part of this process, these emerging adults work to balance their individual roles with their relational roles in order to maximize success and satisfaction across domains. Using a college student sample ( N = 299), this study used Structural Equation Modeling (SEM) to test role balance as a mediator between personality dimensions and multiple indicators of college success. Tests indicated that role balance partially mediates the relationship between conscientiousness and neuroticism and college satisfaction but is not associated with other traditional measures of college achievement (grade point average, intention to withdraw).
Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus
Authors: Xie Jing-Ming , Chen Zhong-Qiang , Shen Jian-Xiong , Zhang Xue-Song , Yang Cao , Zheng Zhao-Min , Qian Bang-Ping , Tzeng Shiau-Tzu , Tian Hui-Zhong , Li Chao , Wu Ji , Wu Zeng-Hui , Ding Wen-Yuan , Ma Yuan , Du Shi-Xin , Bai Yu-Shu , Wang Ying-Song , Liu Li-Min , Yang Hua , Zhou Zhuo-Jia , Xie Shi-Ming , Cao Qi , Yang Zhao
Published: July 2017

In the past decades, an increasing number of surgeons started using posterior vertebral column resection (PVCR) to treat severe, rigid and angular spinal deformities. Little high-level evidence is available to guide surgical treatment. The aims of our study were to identify important surgical strategies and key technical points of Chinese experts who have extensive experience in the management of severe, rigid and angular spinal deformities using PVCR, and to standardize and unify the current core concepts. Workgroups of consensus were formed by selecting nationwide representing experts and comprehensive consultations. Eight task forces for major issues were established, then retrieval of literature, collection of expert opinions and writing of review articles were carried out. A modified Delphi process was chosen in round-table forum with three face-to-face meetings. Consensus was reached with items graded more than seven points including: indications and contraindications of PVCR; review PVCR in the evolution of spinal osteotomies; The corrective mechanism and safety of spinal cord; monitoring and responses of spinal cord crisis; characteristics and therapeutic outcome of pulmonary function; management of bleeding during PVCR; relationship of pedicle screw insertion and spinal cord safety; and analysis of non-neurologic complications and prevention strategies. In conclusion, The essential properties regarding PVCR procedure are tightly linked with various factors such as medical and surgical indication, range and level of vertebral column resection, strategies of correction, corrective efficiency and control of neurological risk. PVCR is used mainly for severe, rigid spinal deformity that is not manageable by other osteotomy techniques.
Current practice in the management of Rockwood type III acromioclavicular joint dislocations—National survey
Authors: Domos Peter , Sim Frank , Dunne Mike , White Andrew
Published: July 2017

Purpose:

Our aim was to conduct this survey among consultant shoulder surgeons in the United Kingdom to document the current management of Rockwood type III acromioclavicular joint (ACJ) injuries.

Methods:

British Elbow and Shoulder Society Research Committee-approved online survey was used and 137 responses were collected within 3 months.

Results:

One hundred percent of responders would treat type III injuries conservatively initially. Routine physiotherapy would be offered by 86% of surgeons. The patient’s factors that influence the decision to consider surgery are pre-injury functional demand, current functional deficit, pain and patient request for surgery. Across all groups the mean time to surgical intervention from injury was 3.8 months. About 45% of all consultants would use the same technique for all cases and there were differences between the varieties of techniques used by surgeons, depending on their degree of experience. LockDown was the most widely used technique in all groups of patients. This was followed by Ligament Augmentation & Reconstruction System (LARS), hook plate and Arthroscopic TightRope/DogBone technique for acute injuries. LARS, modified Weaver–Dunn and ACJ resection were used most commonly after LockDown for delayed cases.

Conclusion:

Our survey revealed the current trends in clinical practice to treat symptomatic Rockwood type III ACJ injuries, but it also confirmed the controversial and complex management differences, which vary among shoulder surgeons in the United Kingdom.
Total hip arthroplasty after failed osteosynthesis of proximal femoral fractures: Revision and mortality of 80 patients
Authors: Müller Franz , Galler Michael , Zellner Michael , Bäuml Christian , Füchtmeier Bernd
Published: July 2017

Purpose:

Total hip arthroplasty (THA) after failed osteosynthesis for proximal femoral fractures is associated with higher revision rates, particularly for dislocation. The purpose of this study was to report our results with THA after failed osteosynthesis within a treatment period of 10 years.

Methods:

A retrospective cohort study including 80 consecutive patients was conducted. After a minimum follow-up of 1 year, we evaluated revision for any cause including dislocation, outcome, and mortality.

Results:

We performed 48 THAs with standard components only and 32 THAs with revision implants. Routinely, a 36-mm femoral head was used, and trochanteric fixation was performed in one-third of the cases. Total revision rate for any cause was 21%, which included six infections, six periprosthetic fractures, and five hematomas. One hip dislocation was also treated. Treatment with uncemented revision stem revealed significantly higher number of revisions—compared to standard cemented or uncemented stem. The mortality rate after 1 year was 9%, and the mean Parker score at follow-up was 6.6 (range: 0−9).

Conclusions:

THA was associated with an increased surgical revision rate, but hip dislocation was documented only once. In most cases, a standard implant with a large 36-mm femoral head size was sufficient. Uncemented revision stem revealed significantly higher number of revisions—compared to standard cemented or uncemented stem. One-year mortality was lower than expected.
Concomitant SLAP repair does not influence the surgical outcome for arthroscopic Bankart repair of traumatic shoulder dislocations
Authors: Aydin Nuri , Unal Mehmet Bekir , Asansu Mustafa , Tok Okan
Published: July 2017

Background:

Prior studies revealed the presence of superior labrum anterior-to-posterior (SLAP) injury together with Bankart lesions in some patients. The purpose of the study is to compare the clinical results of isolated Bankart repairs with the clinical results of Bankart repairs when performed with concomitant SLAP repairs.

Methods:

The patients who underwent arthroscopic surgery for treatment of anterior glenohumeral instability were evaluated retrospectively. Group 1 consisted of 19 patients who had arthroscopic SLAP repair together with Bankart repair. The mean age of the patients was 23. Group 2 consisted of 38 patients who underwent isolated Bankart repair. The mean age was 24. Knotless anchors were used in both groups.

Results:

The mean follow-up was 34 months (range: 26–72). In group 1, the mean preoperative Constant score was 84 (range: 74–90, standard deviation (SD): 5.91) and Rowe score was 64.1 (range: 40–70, SD: 8.14). In group 2, the preoperative Constant score was 84.4 (range: 70–96, SD: 5.88) and Rowe score was 60 (range: 45–70, SD: 7.95). In group 1, the postoperative mean Constant score raised to 96.8 (range: 88–100, SD: 2.91) and the mean Rowe score raised to 92.3 (range: 85–100, SD: 5.17). In group 2, the postoperative mean Constant score was 94.9 (range: 88–100, SD: 3.70) and the mean Rowe score was 94.2 (range: 80–100, SD: 4.71). The difference between the scores of two groups was insignificant ( p > 0.05). When the numbers of redislocations and range of motion were compared, no significant difference was found ( p > 0.05).

Conclusion:

Accompanying SLAP repair in surgical treatment with Bankart repair for shoulder instability does not affect the results negatively. Properly repaired labral tears extending from anterior inferior to the posterior superior of the glenoid in instability treatment have the same outcome in overall results as repaired isolated Bankart lesions.
The reliability of measuring acetabular component position on radiographs using everyday diagnostic imaging software
Authors: Lahy Jack , Stevens Jarrad , McKenzie Dean , de Steiger Richard
Published: July 2017

Background:

It is standard practice for total hip arthroplasty (THA) patients to have post-operative imaging, and one of the reasons is to assess the adequacy of acetabular component position. Correct positioning of the acetabular component is important for successful outcome in THA. Acetabular component position can be measured from either computed tomography (CT) or plain radiographs. While CT is the gold standard for accurately measuring acetabular component position, radiographs are routinely used for post-operative evaluation. However, measurement of acetabular component position from plain radiographs is not straightforward and numerous methods have been proposed. As most imaging is now digital, the aim of this study was to investigate the reliability of one method to measure acetabular component position using a basic diagnostic imaging software program that is readily available to orthopaedic surgeons.

Methods:

We investigated the reliability Lewinnek’s method using a basic Picture Archiving and Communication System program, InteleViewer ™ . We measured 69 post-operative anteroposterior (AP) radiographs of patients who underwent primary THA. Intra-observer and inter-observer reliability for Lewinnek’s method was calculated using the intraclass correlation coefficient.

Results:

Our results showed excellent intra- and inter-observer reliability for both inclination (0.99, 95% confidence interval (CI): 0.99–1.0; and 0.97, 95% CI: 0.95–0.99) and anteversion (0.99, 95% CI: 0.98–0.99; and 0.93, 95% CI: 0.89–0.96) measurements.

Conclusion:

This study has shown that using Lewinnek’s method, acetabular component position can be reliably measured on post-operative AP digital radiographs using readily available software tools.
Functional Brace in ACL Surgery: Force Quantification in an In Vivo Study
Authors: LaPrade Robert F. , Venderley Melanie B. , Dahl Kimi D. , Dornan Grant J. , Turnbull Travis Lee
Published: July 2017

Background:

A need exists for a functional anterior cruciate ligament (ACL) brace that dynamically supports the knee joint to match the angle-dependent forces of a native ACL, especially in the early postoperative period.

Purpose/Hypothesis:

The purpose of this study was to quantify the posteriorly directed external forces applied to the anterior proximal tibia by both a static and a dynamic force ACL brace. The proximal strap forces applied by the static force brace were hypothesized to remain relatively constant regardless of knee flexion angle compared with those of the dynamic force brace.

Study Design:

Controlled laboratory study.

Methods:

Seven healthy adult males (mean age, 27.4 ± 3.4 years; mean height, 1.8 ± 0.1 m; mean body mass, 84.1 ± 11.3 kg) were fitted with both a static and a dynamic force ACL brace. Participants completed 3 functional activities: unloaded extension, sit-to-stand, and stair ascent. Kinematic data were collected using traditional motion-capture techniques while posteriorly directed forces applied to the anterior aspect of both the proximal and distal tibia were simultaneously collected using a customized pressure-mapping technique.

Results:

The mean posteriorly directed forces applied to the proximal tibia at 30° of flexion by the dynamic force brace during unloaded extension (80.2 N), sit-to-stand (57.5 N), and stair ascent (56.3 N) activities were significantly larger, regardless of force setting, than those applied by the static force brace (10.1 N, 9.5 N, and 11.9 N, respectively; P < .001).

Conclusion:

The dynamic force ACL brace, compared with the static force brace, applied significantly larger posteriorly directed forces to the anterior proximal tibia in extension, where the ACL is known to experience larger in vivo forces. Further studies are required to determine whether the physiological behavior of the brace will reduce anterior knee laxity and improve long-term patient outcomes.

Clinical Relevance:

ACL braces that dynamically restrain the proximal tibia in a manner similar to physiological ACL function may improve pre- and postoperative treatment.
The Relationship Between Method of Viewing Lectures, Course Ratings, and Course Timing
Authors: Burton William B , Ma Terence P , Grayson Martha S
Published: July 2017

Background:

In recent years, medical schools have provided students access to video recordings of course lectures, but few studies have investigated the impact of this on ratings of courses and teachers. This study investigated whether the method of viewing lectures was related to student ratings of the course and its components and whether the method used changed over time.

Methods:

Preclinical medical students indicated whether ratings of course lectures were based primarily on lecture attendance, video capture, or both. Students were categorized into Lecture, Video, or Both groups based on their responses to this question. The data consisted of 7584 student evaluations collected over 2 years.

Results:

Students who attended live lectures rated the course and its components higher than students who only viewed the video or used both methods, although these differences were very small. Students increasingly watched lectures exclusively by video over time: in comparison with first-year students, second-year students were more likely to watch lectures exclusively by video; in comparison with students in the first half of the academic year, students in the second half of the academic year were more likely to watch lectures exclusively by video.

Conclusions:

With the increase in use of lecture video recordings across medical schools, attention must be paid to student attitudes regarding these methods.
Postoperative atrial fibrillation: Target for stroke prevention?
Authors: Thijs Vincent , Lemmens Robin , Farouque Omar , Donnan Geoffrey , Heidbuchel Hein
Published: July 2017

Purpose

A substantial number of patients without a history of atrial fibrillation who undergo surgery develop one or more episodes of atrial fibrillation in the first few days after the operation. We studied whether postoperative transient atrial fibrillation is a risk factor for future atrial fibrillation, stroke and death.

Method

We performed a narrative review of the literature on epidemiology, mechanisms, risk of atrial fibrillation, stroke and death after postoperative atrial fibrillation. We reviewed antithrombotic guidelines on this topic and identified gaps in current management.

Findings

Patients with postoperative atrial fibrillation are at high risk of developing atrial fibrillation in the long term. Mortality is also increased. Most, but not all observational studies report a higher risk of stroke. The optimal antithrombotic regimen for patients with postoperative atrial fibrillation has not been defined. The role of lifestyle changes and of surgical occlusion of the left atrial appendage in preventing adverse outcomes after postoperative atrial fibrillation is not established.

Conclusion

Further studies are warranted to establish the optimal strategy to prevent adverse long-term outcomes after transient, postoperative atrial fibrillation.
Fracture Behavior of Magnetic Media Films
Authors: Wu S. , Bubeck R. A. , Carriere C. J.
Published: July 2017

The fracture behavior was determined for three polymeric films which are used for magnetic media and other applications. Both fracture initiation and propagation were characterized by a specialized video-based real-time film fracture technique. The toughness of each of these films was evaluated from the fracture mechanism and material properties of the films. The results showed that a material's resistance to crack propagation is not proportional to its resistance to crack initiation; and the stress associated with the crack initiation is usually smaller than the maximum stress.
The role of family and school-level factors in bullying and cyberbullying: a cross-sectional study
Authors: Bevilacqua Leonardo , Shackleton Nichola , Hale Daniel , Allen Elizabeth , Bond Lyndal , Christie Deborah , Elbourne Diana , Fitzgerald-Yau Natasha , Fletcher Adam , Jones Rebecca , Miners Alec , Scott Stephen , Wiggins Meg , Bonell Chris , Viner Russell M.
Published: July 2017

Background

Bullying and cyberbullying are common phenomena in schools. These negative behaviours can have a significant impact on the health and particularly mental health of those involved in such behaviours, both as victims and as bullies. This UK study aims to investigate student-level and school-level characteristics of those who become involved in bullying and cyberbullying behaviours as victims or perpetrators.

Methods

We used data from 6667 Year 7 students from the baseline survey of a cluster randomized trial in 40 English schools to investigate the associations between individual-level and school-level variables with bullying victimization, cyberbullying perpetration, and cyberbullying victimization. We ran multilevel models to examine associations of bullying outcomes with individual-level variables and school-level variables.

Results

In multilevel models, at the school level, school type and school quality measures were associated with bullying risk: students in voluntary-aided schools were less likely to report bullying victimization (0.6 (0.4, 0.9) p = 0.008), and those in community (3.9 (1.5, 10.5) p = 0.007) and foundation (4.0 (1.6, 9.9) p = 0.003) schools were more likely to report being perpetrators of cyberbullying than students in mainstream academies. A school quality rating of “Good” was associated with greater reported bullying victimization (1.3 (1.02, 1.5) p = 0.03) compared to ratings of “Outstanding.”

Conclusions

Bullying victimization and cyberbullying prevalence vary across school type and school quality, supporting the hypothesis that organisational/management factors within the school may have an impact on students’ behaviour. These findings will inform future longitudinal research investigating which school factors and processes promote or prevent bullying and cyberbullying behaviours.

Trial registration

Trial ID: ISRCTN10751359 Registered: 11/03/2014 (retrospectively registered).
Clay barriers for protecting historic buildings from ground moisture intrusion
Authors: Michette Martin , Lorenz Rüdiger , Ziegert Christof
Published: July 2017

Background

Conservators and architects working with built heritage at risk from ground moisture intrusion face a difficult choice. Leaving the building unprotected can lead to moisture related deterioration; installing vertical and/or horizontal barriers using standard materials requires chemical or mechanical intervention with the historic fabric. The use of compacted clay to form a barrier is commonplace in some areas of environmental engineering, and can be applied to built heritage conservation. Naturally occurring or slightly modified soils were traditionally used for protecting buildings in a number of vernacular techniques. Knowledge of what types of soils are suitable for use could provide certain regions with a low-cost, low-impact alternative for protecting historic buildings. Three commercially available products previously shown to have low hydraulic conductivity were analysed in order to identify waterproofing mechanisms; these included two specialised bentonite–sand mixtures and a Saxonian glacial till.

Results

The till relies on a high proportion of densely agglomerated fine grains to achieve a low permeability when consolidated, possibly assisted by the presence of calcite. The specialised mixtures rely on an engineered grain size distribution, with practically no silt sized grains, and a fraction of sodium bentonites capable of forming colloidal suspension when compacted. All materials showed a low risk of shrinkage when compacted at optimum moisture content.

Conclusion

Different mechanisms appear to account for the low hydraulic conductivities found in clay barrier material. The implication is that a range of soil material may be suitable for protecting built heritage from ground moisture intrusion and its associated decay mechanisms. The suitability of glacial till may present large areas of Northern Europe with locally available barrier material.
Modification and optimization of electrospun gelatin sheets by electron beam irradiation for soft tissue engineering
Authors: Lee Jae Baek , Ko Young-Gwang , Cho Donghwan , Park Won Ho , Kwon Oh Hyeong
Published: July 2017

Background

Crosslinked gelatin nanofibers are one of the widely used scaffolds for soft tissue engineering. However, modifying the biodegradation rate of chemically crosslinked gelatin is necessary to facilitate cell migration and tissue regeneration. Here, we investigated the optimal electron beam (e-beam) irradiation doses with biodegradation behavior on changes in the molecular weight, morphology, pore structure, and cell proliferation profiles of electrospun nanofibrous gelatin sheets.

Methods

The molecular weights of uncrosslinked gelatin nanofibers were measured using gel permeation chromatography. The morphology and pore structure of the gelatin scaffolds were analyzed by scanning electron microscopy and a porosimeter. Biodegradation tests were performed in phosphate-buffered saline solutions for 4 weeks. Cell proliferation and tissue regeneration profiles were examined in fibroblasts using WST-1 assays and hematoxylin and eosin staining.

Results

Crosslinked gelatin nanofiber sheets exposed to e-beam irradiation over 300 kGy showed approximately 50% weight loss in 2 weeks. Gelatin scaffolds exposed to e-beam irradiation at 100–200 kGy showed significantly increased cell proliferation after 7 days of incubation.

Conclusions

These findings suggested that the biodegradation and cell proliferation rates of gelatin nanofiber scaffolds could be optimized by varying e-beam irradiation doses for soft tissue engineering.
Renal Medullary Carcinoma: Establishing Standards in Practice
Authors: Beckermann Kathryn E. , Sharma Deva , Chaturvedi Shruti , Msaouel Pavlos , Abboud Miguel R. , Allory Yves , Bourdeaut Franck , Calderaro Julien , de Cubas Aguirre A. , Derebail Vimal K. , Hong Andrew L. , Naik Rakhi P. , Malouf Gabriel G. , Mullen Elizabeth A. , Reuter Victor E. , Roberts Charles W.M. , Walker Cheryl L. , Wood Christopher G. , DeBaun Michael R. , Van Poppel Hendrik , Tannir Nizar M. , Rathmell W. Kimryn
Published: July 2017

Although renal medullary carcinoma (RMC) is a rare subtype of kidney cancer, it is particularly devastating in that it is nearly uniformly lethal. No established guidelines exist for the diagnosis and management of RMC. In April 2016, a panel of experts developed clinical guidelines on the basis of a literature review and consensus statements. The goal was to propose recommendations for standardized diagnostic and management approaches and to establish an international clinical registry and biorepository for RMC. Published data are limited to case reports and small retrospective reviews. The RMC Working Group prepared recommendations to inform providers and patients faced with a low level of medical evidence. The diagnosis of RMC should be considered in all patients younger than 50 years with poorly differentiated carcinoma that arises from the renal medulla. These patients should be tested for sickle cell hemoglobinopathies, and if positive, SMARCB1/INI1 loss should be confirmed by immunohistochemistry. The majority of patients with RMC are diagnosed with metastatic disease. Upfront radical nephrectomy should be considered in patients with good performance status and low metastatic burden or after response to systemic therapy. Currently, cytotoxic, platinum-based chemotherapy provides the best, albeit brief, palliative clinical benefit. Vascular endothelial growth factor–directed therapies and mammalian target of rapamycin inhibitors are ineffective in RMC as monotherapy. Therapeutic trials of novel agents are now available for RMC, and every effort should be made to enroll patients in clinical studies.
Multiple modes of Lrp4 function in modulation of Wnt/β-catenin signaling during tooth development
Authors: Ahn Youngwook , Sims Carrie , Murray Megan J. , Kuhlmann Paige K. , Fuentes-Antrás Jesús , Weatherbee Scott D. , Krumlauf Robb
Published: July 2017

During development and homeostasis, precise control of Wnt/β-catenin signaling is in part achieved by secreted and membrane proteins that negatively control activity of the Wnt co-receptors Lrp5 and Lrp6. Lrp4 is related to Lrp5/6 and is implicated in modulation of Wnt/β-catenin signaling, presumably through its ability to bind to the Wise (Sostdc1)/sclerostin (Sost) family of Wnt antagonists. To gain insights into the molecular mechanisms of Lrp4 function in modulating Wnt signaling, we performed an array of genetic analyses in murine tooth development, where Lrp4 and Wise play important roles. We provide genetic evidence that Lrp4 mediates the Wnt inhibitory function of Wise and also modulates Wnt/β-catenin signaling independently of Wise. Chimeric receptor analyses raise the possibility that the Lrp4 extracellular domain interacts with Wnt ligands, as well as the Wnt antagonists. Diverse modes of Lrp4 function are supported by severe tooth phenotypes of mice carrying a human mutation known to abolish Lrp4 binding to Sost. Our data suggest a model whereby Lrp4 modulates Wnt/β-catenin signaling via interaction with Wnt ligands and antagonists in a context-dependent manner.
Contest of decisions on refuse admission to the russian federation
Authors: Иванов Дмитрий , Ivanov Dmitriy
Published: July 2017

In this article will be considered pre-judicial and judicial ways of protection of the rights of foreign citizens and persons without citizenship on which authorized bodies of executive power have made decisions on refuse admission to the Russian Federation, except for cases of application by courts of additional administrative punishment in the form of exclusion out of borders of the Russian Federation, and also a way of obtaining information on adoption of such decisions.
Aproximación a la orientación al mercado y sus consecuencias en unidades básicas de actuación pública: El caso del servicio de fomento de la economía social vasca
Authors: Morandeira Arca Jon , De Elizagarate Gutiérrez Victoria , Bakaikoa Azurmendi Baleren
Published: July 2017

La mayor parte de los estudios realizados, sino todos, en materia de orientación al servicio del público se han centrado en el ámbito institucional o nivel jerárquico de decisión estratégica. Por ello y teniendo en cuenta que  la orientación al mercado puede variar entre distintos niveles de una misma organización, este trabajo tiene como objetivo el análisis de la orientación al servicio del público en una unidad básica de actuación pública dentro de un Gobierno, es decir, en un nivel jerárquico de la esfera táctica y operativa de la actuación pública. El análisis de la orientación al servicio del público y sus consecuencias en el rendimiento, se ha realizado sobre la unidad básica de actuación pública de fomento de la Economía Social del País Vasco.
Análisis del proceso de adopción de sistemas de gestión de ecodiseño en cooperativas del sector de bienes de equipo
Authors: Landeta-Manzano Beñat , Arana-Landín Germán , Ruíz de Arbulo Patxi , Díaz de Basurto Pablo
Published: July 2017

La norma ISO 14006 de diseño ecológico o ecodiseño se creó en 2011 con el fin de complementar el estándar ISO 14001 de gestión medioambiental. Aunque hay una gran cantidad de referencias en la literatura que analizan el proceso de adopción de la ISO 14001, el estándar de ecodiseño no ha recibido tanta atención dado que no ha tenido la difusión esperada. A este respecto, con el fin de contribuir de paliar esta carencia, el objetivo de este artículo es realizar un análisis exploratorio sobre el proceso de adopción e integración de la ISO 14006 en la gestión ambiental de dos cooperativas vascas que han sido pioneras en hacerlo a nivel estatal. Tras el análisis de los principales motivos que han llevado a las empresas a adoptar la estándar ISO 14006, la investigación se ha centrado en el análisis del impacto de dicha adopción, tanto a nivel operativo como en términos de resultados, en las empresas. Con todo ello, sean extraído una serie de conclusiones que se esperan pueda ser de interés tanto para las empresas y para y a otros grupos de interés, tales como los decisores públicos que tienen como fin establecer políticas orientadas a la mejora de la eficiencia en la gestión medioambiental y de los recursos.