bluuebunny/crossref_metadata_2025 huggingface dataset:
Cylinder-specific model-based control of combustion phasing for multiple-cylinder diesel engines operating with high dilution and boost levels
Authors: Sui Wenbo , Hall Carrie M , Kapadia Gina
Published: October 2018

Accurate control of combustion phasing is indispensable for diesel engines due to the strong impact of combustion timing on efficiency. In this work, a non-linear combustion phasing model is developed and integrated with a cylinder-specific model of intake gas. The combustion phasing model uses a knock integral model, a burn duration model, and a Wiebe function to predict CA50 (the crank angle at which 50% of the mass of fuel has burned). Meanwhile, the intake gas property model predicts the exhaust gas recirculation fraction and the in-cylinder pressure and temperature at intake valve closing for different cylinders. As such, cylinder-to-cylinder variation of the pressure and temperature at intake valves closing is also considered in this model. This combined model is simplified for controller design and validated. Based on these models, two combustion phasing control strategies are explored. The first is an adaptive controller that is designed for closed-loop control and the second is a feedforward model–based control strategy for open-loop control. These two control approaches were tested in simulations for all six cylinders, and the results demonstrate that the CA50 can reach steady-state conditions within 10 cycles. In addition, the steady-state errors are less than ±0.1 crank angle degree with the adaptive control approach and less than ±1.3 crank angle degree with feedforward model–based control. The impact of errors on the control algorithms is also discussed in the article.
Qualitatively exploring the suitability of tablet computers to encourage participation with activities by people with moderate stage dementia
Authors: Smith Sarah Kate , Mountain Gail A , Hawkins Rebecca J
Published: October 2018

Introduction

Opportunities to participate with enjoyable activities is one of the most frequently reported unmet needs by the person living with dementia. Enabling and intuitive technologies may offer accessible ways to engage with such activities.

Objectives

To explore how tablet computers might encourage participation in enjoyable activities by people with moderate levels of dementia and to consider how such technologies might be incorporated into the repertoire of activities currently provided through day care settings.

Methods

A focused visual ethnographic approach was developed specifically to meet the research objectives. Twelve participants attending a community day care centre and nine supporters (both volunteers and paid staff) consented to take part in the research. Technology facilitated group activity sessions took place twice a week for a period of four weeks and all were video recorded. Findings: Video analysis demonstrated that the majority of people with dementia found the technology an effective means of participating in enjoyable activities. Analysis also revealed the extent to which participation relies on the existence of effective support. It showed how maintaining focus on retained strengths and abilities enabled the group overall to meet and often exceed their own and others perceived capacity to participate. Finally, analysis confirmed the importance of enjoyment of activities ‘in the moment’ and the need for those supporting people in the moderate stages of dementia to acknowledge and work with this.

Conclusion

The use of tablet computers to enhance participation in sociable and enjoyable activities in day care settings is realistic and achievable if supported appropriately.
Implementing e-learning and e-tools for care home staff supporting residents with dementia and challenging behaviour: A process evaluation of the ResCare study using normalisation process theory
Authors: Keenan Julia , Poland Fiona , Manthorpe Jill , Hart Cathryn , Moniz-Cook Esme
Published: October 2018

Dementia-related symptoms, sometimes termed challenging or distressing behaviour, can give rise to significant distress in care homes. Individualised formulation-led interventions show promise in reducing these behaviours. ResCare, a cluster randomised controlled trial in England, tested an online individualised intervention, comprising e-learning and decision support e-tools, designed to enable staff to better support residents with such symptoms. Normalisation process theory was used to understand the implementation processes. We analysed contextual process data for all 27 ‘intervention’ care homes and identified three implementation mechanisms. These were examined for four illustrative case study homes. Seven qualitative interviews with care home staff and one interview with two research therapists informed this understanding. The main barrier to implementation was difficulty in conveying a sustained understanding of the value of individually tailored interventions. Emphasis was placed on training rather than practice change. Implementation seemed easier in smaller homes and in those with flexible managerial styles where transfer of knowledge and skill might have been easier to achieve. Take up of e-learning and e-tools proved hard. There may be a need to continually promote ‘buy-in’ of the potential benefits of individualised formulation-led interventions, and this would have to be congruent with other priorities. Interventions within care homes need to consider organisational readiness, capacity for innovation and ongoing appraisal and adjustment to maintain changes in practice.
Reducing falls among people living with dementia: A systematic review
Authors: Peek Kerry , Bryant Jamie , Carey Mariko , Dodd Natalie , Freund Megan , Lawson Samuel , Meyer Claudia
Published: October 2018

Background

People diagnosed with dementia are at greater risk of falls. Given the increasing incidence of dementia globally, high quality and methodologically rigorous research is needed to inform evidence-based practice initiatives.

Aims

To describe the published literature related to describing, reducing or preventing fall incidences for people living with dementia including: (1) trends in the total number of intervention and non-intervention studies between 1997 and 2016; (2) the methodological quality of identified intervention studies; and (3) the effectiveness of interventions designed to reduce the incidence of falls among people living with dementia.

Methods

A systematic review of five databases was conducted to identify studies reporting any aspect of falls incidence for people with a diagnosis of dementia. Studies meeting the eligibility criteria were coded as intervention or non-intervention studies. Intervention studies were assessed using Cochrane’s Effective Practice and Organisation of Care tool. Data about the effectiveness of interventions meeting Effective Practice and Organisation of Care criteria were extracted.

Results

Seventy-two eligible studies were identified; 57 were non-intervention studies, and 15 were intervention studies. The number of published studies increased between 1997 and 2016, peaking in 2013 ( n = 10). Of the 15 intervention studies, seven studies met Effective Practice and Organisation of Care design criteria with one study rated low risk on all eight Effective Practice and Organisation of Care risk of bias domains. One high-risk exercise-based intervention study demonstrated a significant reduction in falls among people living with dementia.

Conclusions

There is currently insufficient evidence to endorse any intervention to reduce falls for people living with dementia in any setting. More high-quality intervention studies are needed.
A Work and Learning Dual System Model for Talent Development in South Korea: A Multiple Stakeholder View
Authors: Chai Dae Seok , Kim Sehoon , Kim Minjung
Published: October 2018

The Problem

Although a continual nationwide drive to develop human resources has enabled Korea to achieve rapid economic growth, Korean society has recently faced several emerging social and economic issues at the national, organizational, and individual levels including a higher unemployment rate, a competency mismatch between the skills new employees possess and what employers require, and the required additional cost of reeducation. To address these issues, the Korean government and private organizations have cooperated to create a new government-private sector collaboration model called a work and learning dual system (WLDS).

The Solution

Our study explored how WLDS functions in the workplace and its influence on learning and performance outcomes at various levels through interviews with multiple stakeholders and documents collected from the organizations responsible for the implementation of WLDS. Twelve employees in the organizations were interviewed, and internal and external documents were analyzed. The findings were presented within the key dimensions of talent development by Garavan, Carbery, and Rock, and the outcomes were specified from multiple stakeholders at various levels. WLDS provides important implications for research on not only talent development but also human resource development (HRD) practices through public–private partnerships.

The Stakeholders

The findings offer several important practical insights for multiple stakeholders. HRD practitioners and policy makers in emerging markets can learn from this type of combined talent development program with structured off- and on-the-job-training. In terms of national HRD, they can strategically and systematically improve their talent development programs and cooperate with relevant governmental agencies.
Talent Management and Development in the United Arab Emirates
Authors: Dirani Khalil , Bowman Eric , Guyer Thomas , Kasper Richard , Makarem Yasmeen , Ray Sarah , Wang Chih-Wei , Xie Lei
Published: October 2018

The Problem

Although there is a surge in research on Talent management and talent development (hence forward TMD) practices across different regions, most of what we know about these topics in the United Arab Emirates (UAE) is based on government and practitioners’ reports. Nowadays, UAE is going through unprecedented times of growth. Organizations are operating in a diverse environment created by a smart government vision and practical policies that allowed the UAE to be labeled as a talent magnet destination. Still, TMD activities seem to be influenced by a two-tier system, one for Emirati nationals and another for expatriates. The question is whether the UAE is able to continue its growth through current TMD practices or whether a more strategic approach is needed to address the current TMD challenges and to meet the needs of individuals and of organizations.

The Solution

The purpose of this article is to provide an overview of professionals’ perspectives in different sectors about (a) the government policies, (b) current activities, and (c) challenges and contextual factors that affect the current state of TMD in the country. Once we understand the different policies, activities, and challenges, practitioners and leaders can use TMD as a source of power, or a strategy, that can lead people and organizations into success.

The Stakeholders

Human resources and organization development experts working in international contexts, administrators in academic institutions, and leaders in government organizations interested in HRD in the context of the UAE, will find the information presented in this study useful.
The Effectiveness of Male-Targeted Sexual Assault Prevention Programs: A Meta-Analysis
Authors: Wright Lauren A. , Zounlome Nelson O. O. , Whiston Susan C.
Published: October 2018

According to Black et al., one in five women will be raped during their lifetimes. In one national survey, it was found that of 14,989 female college students from nine institutions, 34% reported experiencing a completed or attempted sexual assault in their lifetimes and 21% of them reported that they had experienced a completed or attempted sexual assault as a college student. Therefore, effective sexual assault prevention efforts targeted at men are needed, and several initiatives have been developed. The current study provides a meta-analytic investigation of male-targeted sexual assault prevention interventions. Eligible studies were located from the following databases: Psychological Information Database, Education Resources Information Center, Medical Literature Analysis and Retrieval System Online, Google Scholar, Dissertation Abstracts Online, Criminal Justice Abstracts, and reference sections of relevant articles. The weighted mean effect size for between-subjects studies of sexual assault attitudes showed improvement ( d = −0.24, k = 25), and the effect was statistically significant ( p < .001). The weighted mean effect size for between-subjects studies of future inclinations toward engaging in sexually aggressive behavior ( d = −0.20, k = 13, p = .02) and toward engaging in sexual assault prevention behavior ( d = 0.27, k = 10, p = .007) showed statistically significant improvements as well. However, the weighted mean effect sizes for between-subjects studies of rape empathy, sexual assault knowledge, sexual assault–related attitudes, and sexual assault perpetration were nonsignificant. Results show there is significant room for growth, both in terms of practical applications and further research.
Making Home through Cord-cutting: The Case of Korean Transient Migrants’ Postcable Culture in the United States
Authors: Lee Claire Shinhea
Published: October 2018

With the rapid development of new media technology, many people are “cutting the cords” and viewing television through Internet-based video services via streaming or downloading. This study aims to better understand and contextualize this phenomenon through investigating Korean transient migrants’ television-viewing practices. Through forty qualitative interviews and employing the framework of the domestication theory perspective, this article examines how these deterritorialized individuals who experience dislocation make home through cord-cutting practices. By making use of the Internet and delivery technologies/interfaces legally and illegally, Korean transient migrants go beyond territorial limitations and make home materially, feel home affectively, and connect home relationally in their diasporic space. Moreover, the study debunks some utopian ideas about online audiences and shows what remains fixed in terms of transnational postcable culture. I argue that the article provides many insights into investigating contemporary television audiences and suggest a novel approach to studying migrant media practices.
The effects of surface modification using O2 low temperature plasma on chrome tanning properties of natural leather
Authors: Jiang Yuanping , Li Jiaxun , Liu Fangming , Zhang Zongcai , Li Zhengjun , Yang Mingbo , Li Lixin
Published: October 2018

Low temperature plasma technology has the characteristics of economy, pollution-free and high efficiency. The pioneering works were carried out by applying low temperature plasma to surface modification of natural leather and chrome tanning process, to reduce water pollution. The effects of oxygen low temperature plasma treatment on the micro-structure, chemical compositions and active groups of leather fiber were studied in this paper. The optimal low temperature plasma treatment time was 10 min, which had the maximal chrome exhausting value. The SEM results showed that the leather surface was etched rougher with time increasing. The contact angle measurements showed that the hydrophilic property of leather surface increased after low temperature plasma process. The XPS data showed that the O1s area ratios increased from 19.49% to 26.45%, the content of COOH roughly tripled after O2 low temperature plasma treatment for 10 min, and the surface chrome content increased from 1.09% to 1.31% after chrome tanning. Based on the above results, low temperature plasma technology may provide a new exploring method for high-exhaustion chrome tanning technology.
Meeting the evolving demands of neurointervention: Implementation and utilization of nurse practitioners
Authors: Schwegel Claire , Rothman Nicole , Muller Kimberly , Loria Stephanie , Raunig Katherine , Rumsey Jamie , Fifi Johanna , Oxley Thomas , Mocco J
Published: October 2018

Growth in the neurointerventional field, as a result of the emergence of thrombectomy as the gold standard treatment for large vessel occlusions, has created complex challenges. In an effort to meet evolving demands and fill workflow gaps, nurse practitioners have taken on highly specialized roles. Neurointerventional care has rapidly evolved similarly to interventional cardiac care, in that nurse practitioners are successfully being incorporated as procedural assistants in catheterization laboratories. Similar utilization of nurse practitioners in interventional neuroradiology holds the capacity to decrease physician workload, mitigate stresses contributing to burn-out, and reallocate more physician time to procedures. Nurse practitioner practice faces procedural, clinical, legal and interpersonal barriers. Despite calls for expanded practice by the Institutes of Medicine, a paucity of nurse practitioner training opportunities exists. Fragmented privileging processes contribute to environments where nurse practitioners must navigate hurdles without established interventional neuroradiology-specific precedent. Increased nurse practitioner mentorship, fluoroscopy law standardization, physician support surrounding nurse practitioner autonomy, and role consistency is imperative for optimal nurse practitioner utilization. Nurse practitioners are uniquely equipped to bridge evolving gaps through the provision of safe, efficacious care, and generating revenue at lower costs. Discussion surrounding nurse practitioner use to bridge workflow gaps is an exciting opportunity for future practice development.
Dancing Days With Young People
Authors: Winther Helle
Published: October 2018

The film Dancing Days With Young People is inspired by art-based research and performative social science. Here artists and researchers examine important issues together. The film follows 1 teacher, 21 university students, and 200 high school pupils from various cultural backgrounds. It focuses especially on the young university students in a challenging course of teaching emphasizing creativity, embodied leadership, and dance. Here, they also teach the high school pupils various styles of dance. Research shows that it can be challenging for many young people to develop teaching competency and the embodied leadership they will need in their impending work as teachers. This is also an issue in many university educations and other educational fields. Therefore, the research questions examined how we can develop somatic awareness, creativity, and embodied leadership through innovative educational processes. And how close-to-practice, artistic elicitation methods may contribute to both researching and portraying this process. The film was created by collaboration between a researcher and teacher, a documentary film instructor, a musician, and a creative film editor. The film was both part of the research process and the result of the creative collaborative. It may be regarded as a coproduced research publication in itself, as it visualizes and documents the findings of the project. Therefore, the film may be seen as a contribution to the growing field within performative social science. Here, the film illustrates especially well the intense moments in sensual emotional situations, which cannot be captured solely in the world of words. The findings show that embodied leadership may be developed through real-world learning processes in which joyous, vulnerable, and subjectively experienced risk-filled situations become part of a common creative educational journey. The teaching methods and the theme of embodiment and leadership may be applicable in wider educational fields.
Direct costs of glaucoma: Relationship between cost and severity of the disease
Authors: Real JP , Lafuente MC , Palma SD , Tártara LI
Published: October 2018

Objectives

To estimate the direct medical costs associated with the management of patients with primary open-angle glaucoma and to compare the costs of patients according to the degree of severity.

Methods

A longitudinal retrospective study was carried out using all patients with primary open-angle glaucoma that recorded follow-up from May 2010 to June 2013 at the Hospital Privado de Córdoba. We estimated the cost of the disease from the perspectives of the institution, with a bottom-up approach.

Results

The three-year follow-up after treatment of 104 patients revealed that the average cost of care for a patient with primary open-angle glaucoma was US$2746 ± 1560. The first year of treatment was significantly more expensive than subsequent ones (US$1100–$810–$827). Cost was related to the degree of severity of glaucoma; patients in “Stage 0” had significantly lower costs than those in other groups (Kruskal–Wallis test, p < 0.01). This was a consequence of lower costs associated with medication and a lower percentage of patients undergoing surgery.

Discussion

The direct medical costs of a patient with primary open-angle glaucoma vary according to the severity of their disease and the year of treatment. We found that costs increased with disease severity, but decreased over time.
Age-related effects in compound production: Evidence from a double-object picture naming task
Authors: Lorenz Antje , Zwitserlood Pienie , Regel Stefanie , Abdel Rahman Rasha
Published: October 2018

This study investigated effects of healthy ageing and of non-verbal attentional control on speech production. Young and older speakers participated in a picture-word interference (PWI) task with compound targets. To increase the processing load, the two pictures of the compounds’ constituents were presented side-by-side for spoken naming (e.g., a picture of a sun + a picture of a flower to be named with sunflower). Written distractors either corresponded to the first or second constituent ( sun or flower → sunflower), or were semantically related either to the first constituent of the target ( moon → sunflower) or to the second constituent/whole word ( tulip → sunflower). Morpho-phonological facilitation was obtained for both constituents, whereas semantic interference was restricted to first-constituent-related semantic distractors. Furthermore, a trend towards facilitation was obtained for distractors that were semantically related to the whole word. Older speakers were slower and produced more errors than young speakers. While morphological effects of first-constituent distractors were stronger for the elderly, the semantic effects were not affected by age. Non-verbal attentional control processes, measured in the Simon task, significantly contributed to morpho-phonological priming in the elderly, but they did not affect semantic interference or semantic facilitation. With a picture naming task that increases the semantic and lexical processing load, we corroborate earlier evidence that word-finding difficulties in the elderly result from deficient phonological encoding, whereas lexical-semantic and morpho-phonological representations remain stable with age.
Statistical analysis plan (SAP) for the Very Early Rehabilitation in Speech (VERSE) after stroke trial: an international 3-arm clinical trial to determine the effectiveness of early, intensive, prescribed, direct aphasia therapy
Authors: Godecke Erin , Rai Tapan , Cadilhac Dominique A , Armstrong Elizabeth , Middleton Sandy , Ciccone Natalie , Whitworth Anne , Rose Miranda L , Holland Audrey , Ellery Fiona , Hankey Graeme J , Bernhardt Julie ,   for the VERSE Collaboration
Published: October 2018

Background

Limited evidence exists to support very early intensive aphasia rehabilitation after stroke. VERSE is a PROBE trial designed to determine whether two types of intensive aphasia therapy, beginning within 14 days of acute stroke, provide greater therapeutic and cost-effectiveness than usual care.

Objective

To publish the detailed statistical analysis plan for the VERSE trial prior to unblinding. This statistical analysis plan was based on the published and registered VERSE trial protocol and was developed by the blinded steering committee and management team, led by the trial statistician. This plan was developed using outcome measures and trial data collection forms.

Results

The VERSE statistical analysis plan is consistent with reporting standards for clinical trials and provides for clear and open reporting.

Conclusions

Publication of a statistical analysis plan serves to reduce potential trial reporting bias and outlines transparent pre-specified analyses. Australian New Zealand Clinical Trials Registry (ANZCTR) Registration number: ACTRN12613000776707; Universal Trial Number (UTN) is U1111-1145-4130.
Classification of congenital upper limb anomalies: towards improved communication, diagnosis, and discovery
Authors: Oberg Kerby C.
Published: October 2018

Recently the International Federation of Societies for Surgery of the Hand replaced the Swanson scheme for classifying congenital upper limb anomalies with the Oberg, Manske, Tonkin (OMT) classification. This review explores the reasons for this change after nearly 50 years of using the Swanson classification. In particular, it documents the state of our understanding regarding genetics and limb development at the time Swanson generated his classification. It also describes the continued progress in clinical genetics and developmental biology. Such progress drives the need to embrace and incorporate these changes within a new classification scheme; one that will improve communication, diagnosis, and support further discovery of the pathogenesis of congenital hand anomalies.
Bleeding in patients receiving non-vitamin K oral anticoagulants: clinical trial evidence
Authors: Bracey Arthur , Shatila Wassim , Wilson James
Published: October 2018

In optimizing anticoagulation therapy, it is essential to balance treatment efficacy with the major adverse effect of anticoagulant treatment, bleeding risk. This narrative review examines the efficacy and safety of the non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban compared with standard anticoagulation or placebo. NOAC therapies provide equivalent to superior protection versus standard therapy, with similar or superior safety, and potential benefits in convenience. We will review the phase III evidence for each of the available NOACs in different antithrombotic indications, including atrial fibrillation (in the absence of significant mitral stenosis or mechanical heart valves); prophylaxis of venous thromboembolism (VTE) in patients undergoing orthopedic surgery; and acute and long-term treatment of VTE. Further, we will illustrate scenarios in which the evidence is stronger for a particular agent in the context of the overall positive safety and efficacy profile of NOACs in general. Limitations of the factor Xa inhibitors include the lack of a specific antidote in case of a bleeding emergency (an approved agent is available for reversing the effect of the direct thrombin inhibitor). We discuss the options for mitigating bleeding and describe the ongoing developments towards specific reversal agents. In conclusion, the available data for efficacy and safety, together with reliable pharmacokinetics obviating the need for regular monitoring, indicate that NOACs may offer substantial benefits for patients with nonvalvular atrial fibrillation or VTE.
Normal changes of ageing
Authors: Grayston Fiona
Published: October 2018

Our population is ageing. People are living for longer and with more complex medical problems, and this is placing increasing pressure on health services. It has never been more important for clinicians to understand what constitutes normal ageing. An understanding of normal ageing can help us to anticipate future healthcare needs, promote health and independence, and differentiate age-appropriate physiology from pathology. This article aims to highlight how ageing affects different body systems. Special consideration is then given to how such changes affect the use of medications and the interpretation of laboratory tests in older adults.
Who do the women trust for maternity care: A knowledge network–based study in rural India
Authors: Amrita  , Roy Ram Babu
Published: October 2018

Background:

Knowledge about the causes of critical ailments and risks during a maternity episode is crucial for women’s health. Although maternity-care knowledge is present both in explicit and tacit forms, there is a lack of requisite knowledge among women. Rural women rely on their community for such knowledge.

Objective:

This article sought to analyse knowledge-sharing practices of rural women in India in relation to critical decisions during a maternity episode.

Method:

Primary data were gathered through interview of 306 married women, who had had at least one childbirth during the previous 5 years, and were collected using structured interviews conducted in 10 villages of two districts in West Bengal, India. Their knowledge level of risks and networks of communication was examined for four critical decisions: (i) general health, (ii) choice of delivery method, (iii) antenatal check-up visits and (iv) nutrition.

Results:

This empirical study using degree-centrality method demonstrated that the pattern of knowledge flow is not uniform for different types of decisions. Many women were not aware of critical danger signs during pregnancy episodes. Only 28% of participants could mention at least three danger signs during pregnancy episodes. For the purposes of this study, these women were considered “knowledgeable.”

Discussion:

Maternal health in the community could be improved by redesigning the knowledge network for sharing the maternity-care knowledge of risks and danger signs. This research highlights the influence of culture on maternity-related knowledge-sharing in rural India and uncovers structural holes in the knowledge network.

Implications:

Results of this research could be used to design policies and programs to create community-based knowledge networks for maternity care.
Transgender Students: Advocacy, Care, and Support Opportunities for School Nurses
Authors: Menkin Dane , Flores Dalmacio Dennis
Published: October 2018

Transgender individuals are disproportionately affected by negative mental and sexual health outcomes. School nurses have prime opportunities to combat these outcomes through affirming nursing care, especially when transgender students are socially transitioning. Examples of affirming practice include recognizing students’ gender-affirming names, using their pronouns, ensuring safe locker rooms, advocating for student’s clothing choices, stopping bullying and harassment, and refraining from making assumptions about their transgender students’ sexual orientation. Through inclusive care directly provided to transgender children, school nurses can also be instrumental in ushering an affirming environment for all.
What Does an Optimal District Standard For School Nursing Look Like?
Authors: Cross Ted , Maughan Erin D. , Mazyck Donna
Published: October 2018

As a district, Mansfield Independent School District wanted to validate that Health Services was performing at the highest level possible, implementing evidence-based practices, and achieving the highest outcomes with our students and staff. NASN (2016) had developed the Framework for 21st Century School Nursing Practice to illustrate the practice of school nurses; and sought ways to operationalize the Framework for local school nurses and district level use. This article will explain how the two groups partnered together to develop a tool and assessment program. The article will discuss the approach, challenges, and perspectives of both Mansfield Independent School District and NASN, lessons learned, outcome, and future/potential changes within health services.
An Eye on Vision: Seven Questions About Vision Screening and Eye Health—Part 4
Authors: Nottingham Chaplin P. Kay , Baldonado Kira , Cotter Susan , Moore Bruce , Bradford Geoffrey E.
Published: October 2018

Current evidence-based and best-practice vision screening and eye health approaches, tools, and procedures are the result of revised national guidelines in the past 3 years and advances in research during the past 18 years. To help the busy school nurse with little time to keep up with changes in children’s vision practices and a growing body of literature, the National Center for Children’s Vision and Eye Health at Prevent Blindness is providing answers to seven questions that are often received from the field. Topical areas are (1) instrument-based screening and stereopsis, (2) optotype-based screening if child is referred from instrument-based screening, (3) next steps if a student’s glasses are scratched or broken, (4) critical line screening with a threshold eye chart, (5) full threshold screening if student does not pass critical line screening, (6) holding a ruler beneath line of optotypes to identify, and (7) convergence insufficiency screening in the school setting.
The etiology of potential small‐bowel bleeding depending on patient's age and gender
Authors: Song Joo Hye , Hong Sung Noh , Kyung Chang Dong , Ran Jeon Seong , Kim Jin-Oh , Kim Jinsu , Lee Bo-In , Choi Myung-Gyu , Kim Kyeong Ok , Yang Dong-Hoon , Song Hyun Joo , Hyuk Do Jae , Jeong Lim Yun , Shim Ki-Nam , Park Soo Jung , Kim Ji Hyun , Moon Jeong Seop , Joo Jang Hyun , Jai Chun Hoon
Published: October 2018

Background

Whether the etiology of potential small‐bowel bleeding depends on the age and gender of the patient is not yet fully understood.

Methods

A total of 1953 patients who underwent video capsule endoscopy (VCE) to evaluate potential small‐bowel bleeding and were registered in the Capsule Endoscopy Nationwide Database Registry from 2003 to 2014 were eligible for this study. VCE findings and the etiology of small‐bowel bleeding were analyzed by age and gender.

Results

The diagnostic yield of VCE was 48.4% (95% CI: 46.2%–50.6%) and the diagnosis rate of etiology of potential small‐bowel bleeding was 61.4% (95% CI: 59.2%–63.6%). The etiology of potential small‐bowel bleeding depends on the age and gender of the patient. Crohn's disease and small‐bowel diverticular diseases were more prevalent etiology of potential small‐bowel bleeding in the young adults group (< 40 years) whereas angiodysplasia was revealed to be a most common etiology in elderly group (≥ 60 years), reaching statistical significance (p<0.00152) by Bonferroni correction.

Conclusions

The etiology of potential small‐bowel bleeding depends on the age of the patient. Thus, an individualized lesion‐specific diagnostic approach based on age might be needed for patients with potential small‐bowel bleeding.
Marina crystal minerals (MCM) activate human dendritic cells to induce CD4+ and CD8+ T cell responses in vitro
Authors: Ghoneum Mamdooh H , Ogura Takeshi , Gimzewski James K , Ghoneum Aya D , Henary Michael C , Agrawal Sudhanshu
Published: October 2018

Marina crystal minerals (MCM) are a mixture that contains crystallized minerals along with trace elements extracted from seawater. It is a nutritional supplement that is capable of enhancing natural killer (NK) cell activity and increasing T and B cell proliferation in humans post ingestion. However, its effect on dendritic cells (DCs), the cells that bridge innate and adaptive immunity, is not yet known. In this study, we examine the stimulatory effects of MCM on DCs’ maturation and function in vitro. Human monocyte–derived DCs were treated with MCM at two different concentrations (10 and 20 µg/mL) for 24 h. Results showed that MCM treatment activated DCs in a dose-dependent fashion. It caused the upregulation of costimulatory molecules CD80, CD86, and HLA-DR, and prompted the production of DC cytokines, including interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, and IL-1β, and chemokines (monocyte chemotactic protein-1 (MCP-1)) and interferon-gamma-inducible protein-10 (IP-10). In addition, activated DCs primed CD4+ T cells to secrete significant amounts of interferon gamma (IFN-γ), and they also stimulated CD8+ T cells to express higher amounts of CD107a. These results indicate that MCM is a potentially powerful adjuvant, from natural materials, that activates human DCs in vitro and therefore may suggest its possible use in immune-based therapies against cancer and viral infections.
Rhythm Workers
Authors: Bégel Valentin , Seilles Antoine , Dalla Bella Simone
Published: October 2018

Rhythm perception and production can be disrupted by neurological or neurodevelopmental disorders (e.g., Parkinson’s disease, dyslexia). Rhythm deficits are associated with poor performance in language, attention, and working memory tasks. Re-training rhythmic skills may thus provide a promising avenue for improving these associated cognitive functions. To this end, here we present a new protocol for selective training of rhythmic skills implemented in a tablet serious game called Rhythm Workers. Experiment 1 served to select 54 musical excerpts based on the tapping performance of 18 non-musicians who moved to the beat of music. The excerpts were sorted in terms of the difficulty of tracking their beat, and assigned to different difficulty levels in the game. In Experiment 2, the training protocol was devised and tested in a proof-of-concept study, including two versions of the game. One version (tapping version) required a synchronized motor response (via tapping), while the other (perception version) asked for a perceptual judgment. Ten participants were trained with one version and 10 with the other version of Rhythm Workers, for 2 weeks. A control group ( n = 10) did not receive any training. Participants in the experimental groups showed high compliance and motivation in playing the game. The effect of the training on rhythm skills yielded encouraging results with both versions of the game. Rhythm Workers thus appears to be a motivating and potentially efficient way to train rhythmic abilities in healthy young adults, with possible applications for (re)training these skills in individuals with rhythm disorders.
Lateral hemiepiphysiodesis of the first metatarsal for juvenile hallux valgus
Authors: Sabah Y , Rosello O , Clement J L , Solla F , Chau E , Oborocianu I , Rampalv V
Published: October 2018

Background:

Juvenile hallux valgus (JHV) frequently results in an impaired quality of life because of pain and deformity. We used a validated clinical score to investigate the efficacy of lateral hemiepiphysiodesis of the first metatarsal base as a treatment for JHV.

Methods:

We conducted a prospective, nonrandomized, single center cohort study of children who underwent lateral hemiepiphysiodesis for 31-IV, with a clinical and radiologic follow-up of at least 2 years. The efficiency of the procedure was assessed with the Hallux Metatarsophalangeal Interphalangeal Scale (HMIS), the metatarsophalangeal angle (MPA), and intermetatarsal angle (IMA).

Results:

Twelve patients (22 feet) with JHV were treated by lateral hemiepiphysiodesis between 2012 and 2015. Average age at surgery was 10 years, and average follow-up was 3.5 years. The average HMIS score increased from an average of 56 at baseline, to 92 at last follow-up ( p < 0.01). The average IMA decreased by 2°, from 13° preoperatively to 11° postoperatively. Average MPA decreased from 26° at baseline to 22° after surgery. No complications occurred in the immediate postoperative period, and no patient needed an additional procedure.

Conclusion:

The HMIS score was significantly improved after lateral hemiepiphyslodesis, with a clear improvement in pain and functional impairment at last follow-up. We noted a stabilization of the IMA and MPA, but the radiologic benefit did not reach statistical significance. Our data support the use of lateral hemiepiphysiodesis as an effective and safe treatment of JHV.
Higher body mass index is not a risk factor for in-hospital adverse outcomes following total knee arthroplasty
Authors: Gurunathan Usha , Pym Aaron , Anderson Cameron , Marshall Amanda , Whitehouse Sarah L , Crawford Ross W
Published: October 2018

Purpose:

To investigate the association between body mass index (BMI) and perioperative complications until hospital discharge, following primary total knee arthroplasty (TKA).

Methods:

This retrospective study reviewed 1665 cases of elective primary unilateral TKA performed between 2006 and 2010, from a prospective secure electronic database. Types of complications, length of operating time, and duration of hospital stay were analyzed in both adjusted (for known confounders) and unadjusted analyses. A further matched analysis was also performed.

Results:

In terms of overall complications, there was no statistically significant difference between the BMI categories. When individual obesity category was considered, obese 2 had the lowest odds of developing complications, both with unadjusted (odds ratio (OR): 0.61, 95% confidence interval (CI) 0.41–0.91, p < 0.015) and adjusted regression analysis (OR: 0.65, 95% CI: 0.43–0.99, p = 0.044). Compared to normal weight category, obese class 3 (≥40 kg/m2) individuals were at 66% (OR: 0.34, 95% CI: 0.21–0.55) lower (unadjusted) odds of developing cardiac complications (overall p < 0.001). With the matched analysis, compared to normal weight category, obese class 3 (≥40 kg/m2) individuals were at a 60% (OR: 0.40, 95% CI: 0.23–0.68) lower (unadjusted) odds of developing cardiac complications (overall p = 0.004). Obese 3 patients had significantly higher operating time compared with other groups ( p < 0.001).

Conclusion:

This study did not find a significant association between BMI and increased overall in-hospital medical or surgical complications following primary TKA. Obesity significantly increased the length of operating time.
Morphological and mechanical properties of plantar fascia and intrinsic foot muscles in individuals with and without flat foot
Authors: Taş Serkan , Ünlüer Nezehat Özgül , Korkusuz Feza
Published: October 2018

Purpose:

Many musculoskeletal disorders are associated with over-pronated foot and decreased medial longitudinal arch (MLA) height. Foot intrinsic muscles and plantar fascia (PF) are the primary structures that support MLA. An important reason for the over-pronated foot and the reduction in the MLA height may be the morphological characteristics of the foot intrinsic muscles and PF as well as changes in their mechanical properties. The aim of the present study is to investigate the morphologic structure and mechanical properties of PF, flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and abductor hallucis (AbH) muscles in individuals with flat foot and to compare the results with those of healthy individuals.

Methods:

The study included 80 participants, 40 with flat foot and 40 with normal foot posture. The foot posture of the participants was assessed using the Foot Posture Index. PF, FHB, FDB, and AbH thickness and stiffness were measured with an ultrasonography device using a linear ultrasonography probe.

Results:

Individuals with flat foot had higher AbH thickness compared to individuals with normal foot posture ( p < 0.001), whereas both groups were similar in terms of PF ( p = 0.188), FHB ( p = 0.627), and FDB ( p = 0.212) thickness. Stiffness values of the assessed tissues were similar in both groups ( p > 0.05).

Conclusion:

AbH thickness was higher in individuals with flat foot; however, PF, FHB, and FDB thickness were similar in both groups. In addition, our results suggest that foot posture is not related to the stiffness of the assessed tissues.
Modified SERI technique in the treatment of hallux valgus combined with arthritis
Authors: Ceccarelli Francesco , Carolla Antonio , Schiavi Paolo , Calderazzi Filippo
Published: October 2018

Introduction:

Few reports encompass the treatment of first metatarsophalangeal joint (MTPJ) arthritis complicating hallux valgus. Indeed, in the literature, there is a lack of guidance concerning the management of patients affected by mild to moderate first MTPJ arthritis complicating hallux valgus. The aim of this study is to present the mid-term results of an original joint-preserving surgical technique.

Materials and Methods:

A group of 50 patients (60 feet) affected by mild to moderate first MTPJ arthritis complicating hallux valgus who underwent modified Giannini’s SERI (simple, effective, rapid, inexpensive) surgical procedure were prospectively reviewed. They were clinically and radiographically evaluated preoperatively and after surgery and were also assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score and Coughlin and Shurnas classification. The average follow-up was 38 months. A multivariate analysis was performed to evaluate the existing relationship between postoperative AOFAS results and radiological preoperative measured angles and sesamoid grade of dislocation.

Results:

The average AOFAS score significantly improved at last follow-up to an average of 90.5 ± 14.5, while preoperatively it was 45.6 ± 15.3 ( p < 0.001). On multivariate analysis, a statistically significant correlation resulted among all the radiographic preoperative registered parameters and clinical postoperative results. However, it was shown that any radiological parameter alone could not predict a better clinical recovery.

Conclusions:

The surgical technique proposed here could extend the indications of the SERI procedure to those patients affected by mild to moderate hallux valgus combined with mild to moderate osteoarthritis.
Onlay vascularized fibular grafting as a salvage procedure for the management of nonunion after reconstruction of the femur following tumor resection
Authors: Lee Jae Hoon , Han Chung Soo , Baek Jong Hun
Published: October 2018

Purpose:

The femur is prone to nonunion after biologic reconstruction following tumor resection, due to high bending forces. Nonunion at the host–graft junction is difficult to treat since the graft is in an avascular state. We aimed to investigate the clinical and radiographic results of an onlay free vascularized fibular grafting (VFG) as a salvage procedure for nonunion management after biologic reconstruction of the femur following bone tumor resection.

Methods:

We retrospectively reviewed 10 patients (8 men and 2 women, median age: 15.5 years, range: 10–47) who underwent an onlay VFG for nonunion after intercalary reconstruction of the femur using an allograft ( n = 7) or pasteurized autograft ( n = 3), following tumor resection. The median follow-up period after VFG was 85.7 (24.6–163.5) months.

Results:

The median time to union between the host bone and the VFG osteotomy sites was 3.5 (2.8–4.5) months. The median time to union at the host–graft junctions was 10.6 (6.6–12.7) months. Two postoperative complications requiring revision surgery occurred in two patients: one graft fracture and one deep infection with synchronous graft fracture. Internal fixation was required in the patient with graft fracture. The patient with the infection and synchronous graft fracture was treated using debridement, antibiotics, and an external fixator. The median Musculoskeletal Tumor Society functional score was 88% (60–97%) at the final follow-up.

Conclusion:

Onlay VFG as a salvage procedure for nonunion of a biologic intercalary reconstruction of the femur after tumor resection is a useful treatment option.