bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors of perioperative complications and transfusion following total hip arthroplasty in systemic lupus erythematosus patients
Authors: Li Z , Du Y , Xiang S , Feng B , Bian Y , Qian W , Jin J , Lin J , Weng X
Published: July 2019

Background

In recent years, hip arthroplasty rates in systemic lupus erythematosus (SLE) patients have been increasing rapidly. Although patients with SLE generally show beneficial or desirable functional outcomes following total hip arthroplasty (THA), it has been reported that SLE patients after THA have increased risk of postoperative complications, especially during the period of hospitalization.

Objectives

In the present study, we aimed to identify possible factors associated with complications or transfusion of THA in SLE patients during hospitalization.

Methods

The present study was a retrospective study conducted in Peking Union Medical College Hospital. Data were collected from medical records of patients who underwent THA from January 2012 to June 2018. The primary outcome variable was perioperative complications, which was defined as having one or more of the following conditions: high fever, infection, impaired wound healing, venous thrombosis of the lower extremities, hematoma, arrhythmia, implant complications. The secondary outcome was perioperative transfusion.

Results

During January 2012 to June 2018, 100 patients had taken the surgery of THA. After multivariate analysis, independent risk factors for perioperative complications were: age ≥ 45 years ( p = 0.001), SLE with other connective tissue diseases ( p = 0.029), high temperature ( p = 0.030), positive anti-dsDNA antibody ( p = 0.043), and Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index ≥ 3 ( p = 0.008). Independent risk factors for perioperative transfusion were bilateral THA ( p = 0.029), low hemoglobin ( p = 0.021) and abnormal renal function ( p = 0.021).

Conclusion

For SLE patients following THA, age > 45 years, SLE with other connective tissue disease, high temperature, positive anti-dsDNA antibody and SLICC/ACR Damage Index ≥ 3 were the risk factors of complications during hospitalization and bilateral THA, low hemoglobin and abnormal renal function were the risk factors of transfusion.
A Bayesian analysis for pseudo-compositional data with spatial structure
Authors: Martinez Edson Z , Achcar Jorge A , Aragon Davi C , Brunherotti Marisa AA
Published: July 2019

We proposed a Bayesian analysis of pseudo-compositional data in presence of a latent factor, assuming a spatial structure. This development was motivated by a dataset containing information on the number of newborns of primiparous mothers living in each of the microregions of the state of Sao Paulo, Brazil, in the year of 2015, stratified by the age of the mothers (15–18, 19–29 and 30 years or more). Considering that data on newborns are not stochastically distributed among the three age groups, but they are explained in relation to women's population structure, we adopted the expression “pseudo-compositional data” to refer to this data structure. The hypothesis of interest establishes that the age of the first pregnancy is associated with the economic conditions of the geographic area where the mother lives. The incidence of poverty was included as an independent variable. Additive log-ratio ( alr) and isometric log-ratio ( ilr) transformations were considered, as is usually done in the analysis of compositional data. The model included a random effect related to the spatial effect assumed to have a conditional autoregressive structure. A Bayesian Markov Chain Monte Carlo (MCMC) simulation procedure was used to get the posterior summaries of interest. The model based on the ( ilr) transformation was well fitted to the data, showing that in the microregions with the highest incidence of poverty, there are higher proportions of women who have their first child in adolescence, while in the microregions with the lowest incidence of poverty, there are higher proportions of women who have their first child after the age of 30 years. From these results it is possible to conclude that this Bayesian approach was very useful in the estimation of the parameters of the proposed model. The proposed method should have a broad application to other problems involving pseudo-compositional data.
The independent prognostic impact of the GATA2 pioneering factor is restricted to ERG-negative prostate cancer
Authors: Büscheck Franziska , Zub Maciej , Heumann Asmus , Hube-Magg Claudia , Simon Ronald , Lang Dagmar S , Höflmayer Doris , Neubauer Emily , Jacobsen Frank , Hinsch Andrea , Luebke Andreas M , Tsourlakis Maria Christina , Sauter Guido , Huland Hartwig , Graefen Markus , Haese Alexander , Heinzer Hans , Schlomm Torsten , Clauditz Till S , Burandt Eike , Wilczak Waldemar , Steurer Stefan , Minner Sarah
Published: July 2019

GATA2 is a pioneering transcription factor governing androgen receptor expression and signaling in prostate cells. To understand the prognostic potential of GATA2 assessment in prostate cancer, we analyzed nuclear GATA2 expression on an annotated tissue microarray with 12,427 prostate cancer samples. Normal prostate glands were negative to weakly positive. GATA2 staining was found in almost all prostate cancers (95%). Strong GATA2 staining was linked to advanced tumor stage, high classical and quantitative Gleason grade (p < 0.0001 each), positive nodal stage (p = 0.0116), and early biochemical recurrence (p < 0.0001). GATA2 was linked to ERG-fusion-type cancers, with strong GATA2 staining in 29% of ERG-negative and 53% of ERG-positive cancers (p < 0.0001). Separate calculations in 3854 cancers with and 4768 cancers without TMPRSS2:ERG fusion revealed that these associations with tumor phenotype and patient outcome were largely driven by the subset of ERG-negative tumors. GATA2 expression was further linked to androgen receptor expression: Only 8% of androgen receptor-negative, but 56% of strongly androgen receptor expressing cancers had strong GATA2 expression (p < 0.0001). In conclusion, the results of our study demonstrate that increasing GATA2 levels are linked to prostate cancer progression and aggressiveness. The prognostic value of GATA2 is remarkable in ERG-negative cancers. However, the upregulation of GATA2 in ERG-positive cancers makes it unsuitable as a prognostic marker in this patient subset.
No evidence for hedonic shifts to bring about more moral hypocrisy: A comment on Lindenberg et al. (2018)
Authors: Przepiorka Wojtek
Published: July 2019

Lindenberg et al. report experimental evidence for the effect of hedonic shifts on subjects’ propensity to engage in moral hypocrisy. Hedonic shifts are changes in individuals’ cognitive states that can be triggered by cues in these individuals’ environments such as ambient smells. Individuals in a hedonic cognitive state aim at doing what makes them feel good. Hence, the authors hypothesize that (1) individuals who are in a bad mood and are put in a hedonic cognitive state will more often take a moral stance and (2) when asked to act morally refuse to do so, (3) especially when the costs for acting morally are high, and (4) even if the moral issue upon which they are asked to act is unrelated to the issue pertaining to the moral stance they took. The authors test these four hypotheses in two laboratory experiments and conclude that their results support these hypotheses. In this comment, I highlight design, measurement, and data analysis issues arising with the two studies that challenge this conclusion. Throughout my comment, I give some indications as to how a laboratory experiment testing these four hypotheses could be designed and conducted.
Topological optimization of variable area plate capacitors for coupled electromechanical energy harvesters
Authors: Sequeira Dane , Coonley Kip , Mann Brian
Published: July 2019

This article examines how topological optimization can be applied to identify nonintuitive capacitor plate patterning that maximizes average power dissipated through an electrical circuit during energy harvesting. Coupled electromechanical equations of motion are derived that include both the instantaneous and change in overlapping conductive area as functions of plate rotation. A genetic algorithm is used to optimize these terms and then map them to physical plate configurations. The results obtained apply specifically to the case presented; however, the methods are general and can be used to solve a broad range of electrostatic energy harvesting problems.
Nondestructive and electromagnetic evaluations of stealth structures damaged by lightning strike
Authors: Jang Jae-Kyeong , Hyun Jong-Min , Son Dae-Sung , Lee Jung-Ryul
Published: July 2019

Stealth technology is very important for the survival of military aircraft. A stealth aircraft structure has both electromagnetic and mechanical functions. Lightning can cause failure on both the points. In this study, we claim that the stealth structure should be evaluated nondestructively and electromagnetically, and we propose a method for full-field evaluations of both the functions. First, a radar absorbing structure was designed and fabricated with stealth capability in the X-band. The radar absorbing structure consisted of a carbon nanotube layer (glass/epoxy dispersed with multiwalled carbon nanotubes), a spacer layer (glass/epoxy) and a perfect electrical conductor layer. A lightning test was performed using an impulse current generator according to standard regulations. Then, nondestructive damage and electromagnetic performance evaluations were performed using a pulse-echo laser ultrasonic propagation imager and a scanning free-space measurement system, respectively. The results showed that neither structural damage nor changes in the electromagnetic properties were observed during the two evaluations. In general, the composites were severely damaged by lightning. However, it turned out that the radar absorbing structure with the carbon nanotube layer could prevent serious damage to stealth function as well as material damage owing to the high conductivity of the carbon nanotubes dispersed in its surface layer.
A Tablet-Based Volunteer-Mediated Intervention for Cognitively Impaired Older People: A Pretest–Posttest
Authors: Chen Ke , Lou Vivian Wei Qun , Lo Selina Siu Ching
Published: July 2019

Purpose:

This study evaluated the potential effectiveness of a tablet-based, volunteer-led intervention (Lok Chi In-home Training) for cognitively impaired older people in improving cognitive and emotional health.

Method:

A one-group pretest and posttest design was adopted, involving 57 community-dwelling older people with cognitive impairments (Montreal Cognitive Score between 13 and 22, without neuropsychiatric behavioral problem). Trained volunteers performed eight in-home training sessions using a tablet to facilitate. Outcome measures include cognitive function, depression, activity of daily living, and instrumental activity of daily living.

Results:

A paired sample t test indicated that after receiving Lok Chi In-home Training, participants showed significantly large improvements on cognitive ability, moderate improvements on depression, and small improvements on instrumental activity of daily living.

Conclusions:

This study demonstrated the feasibility and potential benefits of Lok Chi intervention for improving cognition and emotion.
Depression Reduction Among Acupuncture Patients in an Interprofessional Study
Authors: Leung Patrick , Cheung Monit , Hou Liwen , Webb Ann E. , Chen Xin , Hune Nikki
Published: July 2019

Purpose:

Acupuncture as a sole treatment was tested for patients with depressive symptoms when seeking treatment in an interprofessional project. This study aims to test the relative effects of depression-specific acupuncture treatment (DSAT) versus nondepression-specific acupuncture treatment (Non-DSAT) on depression scores of patients seeking acupuncture care.

Method:

In this chart-review quasi-experimental study, former patient charts were randomly selected from a 3-year record at two college-operated acupuncture clinics in Houston. Among them, 62 charts contained depression data measured by the Hopkins Symptoms Checklist-25 (HSCL-25).

Results:

Data show that 39 patients received DSAT and 23 patients received Non-DSAT, but none of them indicated depression as a reason for treatment. After treatment, although the prevalence rate was lower, the average depression score was higher in both groups. Further analysis with the mixed between-within-subjects analysis of variance showed insignificant group interactive effects on the depression score change.

Discussion:

Depression outcomes between the two groups were not conclusive. Acupuncture as a depression treatment method should be further tested with a longitudinal research design focusing on patients with depressive symptoms. The role of social workers is essential so that depression screening can be accurately conducted.
Cone-Beam Computed Tomography Evaluation of Skeletal Deformities and Pharyngeal Airway in Chinese Han Individuals With Nonsyndromic Unilateral Cleft Lip and Palate
Authors: Zhang Yuan , Wang Yuhua , Zhang Yaoyuan , Li Sheng , Wang Lin , Qian Yajing
Published: July 2019

Objective:

This study examined the relationships between skeletal deformities and the pharyngeal airway of patients with nonsyndromic unilateral cleft lip and palate (UCLP).

Design:

Retrospective study.

Setting:

Orthodontics and Oral and Maxillofacial Surgery Departments in the Affiliated Hospital of Stomatology, Nanjing Medical University, China.

Patients, Participants:

The sample comprised 30 nonsyndromic UCLP patients and 30 healthy controls. Each group has 23 males and 7 females.

Interventions:

All cone-beam computed tomography images were obtained with the participant in the standard supine position and asked to bite with intercuspal position without swallowing or moving their heads and tongues during scanning.

Main Outcome Measure(s):

SNA, SNB, ANB, anterior cranial base, Wits appraisal, maxillary length (PTM-ANS || FH), maxillary position (S-PTM || FH), mandibular length (Go-Pog || MP), FMA, posterior face height, anterior face height, Posterior-Anterior face height, lower face height, pharyngeal airway volumes, and areas were evaluated by Dolphin imaging software.

Results:

The UCLP group showed significantly decreased SNA, SNB, ANB, PTM-ANS || FH, S-PTM || FH, P-A Face Height compared with the controls. However, the airway volumes and areas showed no significant difference between 2 groups. The total airway volume and minimum cross-sectional area in UCLP patients were related to the Go-Pog || MP and FMA.

Conclusions:

Patients with UCLP have both the maxillary and mandibular deficiencies in the sagittal dimension. Both the sagittal and vertical relationships of the jaw might affect the airway volume and area. However, no significant difference was detected in airway volume and area in UCLP patients when compared with the controls.
Considering Quality of Life while Repudiating Disability Injustice: A Pathways Approach to Setting Priorities
Authors: Persad Govind
Published: July 2019

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where (1) quality of life suffers because of disability-focused exclusion or injustice differently from cases where (2) lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life.
Learning from the Flint Water Crisis: Restoring and Improving Public Health Practice, Accountability, and Trust
Authors: Boufides Colleen Healy , Gable Lance , Jacobson Peter D.
Published: July 2019

The Flint water crisis demonstrates the importance of adequate legal preparedness in dealing with complicated legal arrangements and multiple statutory responsibilities. It also demonstrates the need for alternative accountability measures when public officials fail to protect the public's health and explores mechanisms for restoring community trust in governmental public health.
Public Health Law Strategies for Suicide Prevention Using the Socioecological Model
Authors: Cerulli Catherine , Winterfeld Amy , Younger Monica , Krueger Jill
Published: July 2019

Suicide is a public health problem which will require an integrated cross-sector approach to help reduce prevalence rates. One strategy is to include the legal system in a more integrated way with suicide prevention efforts. Caine (2013) explored a public health approach to suicide prevention, depicting risk factors across the socio-ecological model. The purpose of this paper is to examine laws that impact suicide prevention at the individual, relational, community, and societal levels. These levels are fluid, and some interventions will fall between two, such as a community-level approach to training that enhances provider-patient relationships. At the individual level, we will review laws to improve screening requirements across systems. At the relational level, we note interventions with couples having conflict, such as protection orders and access to attorney consultations, which have been known to be injury prevention mechanisms. At the community level, we discuss legislation that recommends suicide prevention efforts for key individuals working as frontline providers in the medical and educational systems. At the societal level, we explore public awareness campaigns that target stigma reduction for those suffering from mental health burden and enhance linkage to care. The article closes with the discussion that laws are good, but their implementation is essential.
Opioid-Related Legislation in Kentucky and West Virginia: Assessing Policy Impact
Authors: Costich Julia F. , Quesinberry Dana
Published: July 2019

Kentucky and West Virginia are among the states most severely affected by opioid poisonings and deaths. The legislatures of both states have enacted a broad range of bills intended to address related issues. We present an overview of legislation enacted in 2017 and 2018, along with an approach to analysis of practitioner response to one type of legislation.
Collaborating with Sovereign Tribal Nations to Legally Prepare for Public Health Emergencies
Authors: Hershey Tina Batra
Published: July 2019

Public health emergencies, including infectious disease outbreaks and natural disasters, are issues faced by every community. To address these threats, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness, as well as improve coordination and collaboration across jurisdictions. As sovereign entities, Tribal governments have the authority to create their own laws and take the necessary steps to prepare for, respond to, and recover from disasters and emergencies. Legal preparedness is a key component of public health preparedness. This article first explains legal preparedness and Tribal sovereignty and then describes the relationship between Tribal Nations, the US government, and states. Specific Tribal concerns with respect to emergency preparedness and the importance of coordination and collaboration across jurisdictions for emergency preparedness are discussed. Examples of collaborative efforts between Tribal and other governments to enhance legal preparedness are described.
Becoming a Hybrid Entity: A Policy Option for Public Health
Authors: Milam Sallie , Moorehead Melissa
Published: July 2019

When Congress passed HIPAA, it did not intend to constrain public health's data sharing in the same way as clinical or payers. In fact, HIPAA recognizes data sharing with public health as a matter of national priority and shields this function from its reach. However, a health department may offer services that bring it within HIPAA's purview, such as running a Children's Health Insurance Program or a laboratory that bills electronically. When this is the case, HIPAA requires all information and departments be subject to HIPAA unless the public health authority chooses to hybridize. Health departments might re-assess their coverage and elect to become a hybrid entity, thereby restricting HIPAA to only where required and removing barriers to information sharing with communities.
Building the Legal Capacity of the Public Health Workforce: Introducing the Public Health Law Academy
Authors: Ransom Montrece McNeill , Johnson Rebecca , Ashe Marice , Penn Matthew , Ferrell F. Abigail , Baffour Kelsey
Published: July 2019

Knowledge of the law and its impact on health outcomes is increasingly important in public health practice. The CDC's Public Health Law Academy helps satisfy this need by providing online trainings, facilitator toolkits, and legal epidemiology tools to aid practitioners in learning about the law's role in promoting public health.
The Ethical and Public Health Implications of Family Separation
Authors: Stange Mia , Stark Brett
Published: July 2019

When immigrant children are separated from their parents, inexorable medical and legal harms result. Family separation violates a fundamental right of parents to participate in medical decisions involving their children. This paper reviews and contributes to evolving analyses of the public health, legal, and ethical consequences of immigration policy.
Food Waste: Addressing our 160 Billion Pound Public Health Challenge with Policy and Business Interventions
Authors: Swinburne Mathew , Sandson Katie
Published: July 2019

The United States wastes approximately 40% of its food supply. This article will examine the implications of this waste for food insecurity and climate change. It will also explore how the law and social entrepreneurship can be used to confront this public health challenge.
Striving for Health Equity through Medical, Public Health, and Legal Collaboration
Authors: Teitelbaum Joel B. , Theiss Joanna , Boufides Colleen Healy
Published: July 2019

This article discusses (1) the ways in which law functions as a determinant of health, (2) historical collaborations between the health and legal professions, (3) the benefits of creating medical-public health-legal collaborations, and (4) how viewing law through a collaborative, population health lens can lead to health equity.
A Public Health Approach to Gun Violence, Legally Speaking
Authors: Ulrich Michael R.
Published: July 2019

The call for a public health approach to gun violence has largely ignored what role the nascent Second Amendment jurisprudence will play in hindering change. Given the state interest for infringing on Second Amendment rights is nearly always public safety, public health law doctrine provides an apt framework for analysis.
Equity in Action: Operationalizing Processes in State Governance
Authors: Weisman Susan , Ben-Moshe Karen , Moua Vayong , Hernandez Sarah
Published: July 2019

This article takes a birds-eye view of equity in action, showcasing efforts to embed an equity lens in legislated and non-legislated policies and practices in three states. Authors from California, Colorado, and Minnesota provide state-specific examples of how equity has been advanced and operationalized in state-level governance. The article describes progress and lessons learned and offers guidance to others.
D-Dimer Predicts Disease Severity but Not Long-Term Prognosis in Acute Pulmonary Embolism
Authors: Geissenberger Fabian , Schwarz Florian , Probst Michael , Haberl Sabine , Gruetzner Stefanie , Kroencke Thomas , von Scheidt Wolfgang , Berghaus Thomas M.
Published: July 2019

D-dimer might be correlated with prognosis in pulmonary embolism (PE). The predictive value of plasma D-dimer for disease severity and survival was investigated in the lowest and highest D-dimer quartile among 200 patients with PE. Patients with high D-dimers were significantly more often hypotensive ( P = .001), tachycardic ( P = .016), or hypoxemic ( P = .001). Pulmonary arterial obstruction index (PAOI) values were significantly higher in the high D-dimer quartile ( P < .001). Elevated troponin I (TNI) levels ( P < .001), simplified PE severity indices ≥1 ( P < .001), right-to-left ventricular (RV/LV) diameter ratios ≥1 ( P < .001), and thrombolysis ( P = .001) were more frequent in the high D-dimer quartile. D-dimer was associated with RV/LV ratios ≥1 ( P = .021), elevated PAOI ( P < .001) or TNI levels ( P < .001), hypotension ( P < .001), tachycardia ( P = .003), and hypoxemia ( P < .001), but not with long-term all-cause mortality. D-dimer predicts disease severity but not long-term prognosis in acute PE, possibly due to a more aggressive treatment strategy in severely affected patients.
The Mortgage Interest Deduction: Causes of Fluctuations in a Procyclical Tax Expenditure
Authors: Splinter David
Published: July 2019

The mortgage interest deduction (MID) is the largest source of US federal homeowner support. I estimate that this tax expenditure fluctuated between 0.2 and 0.9 percent of gross domestic product (GDP) over the past five decades. About half of these fluctuations were caused by changes in tax policy, rather than changes in the housing market. Fluctuations in the MID tax expenditure do not tend to move with homeownership rates; instead, they are procyclical, meaning the MID may exacerbate business cycles.
Controlling Nutritional Status (CONUT) Score as a Predictor of All-Cause Mortality at 3 Months in Stroke Patients
Authors: López Espuela Fidel , Roncero-Martín Raúl , Zamorano Juan Diego Pedrera , Rey-Sanchez Purificación , Aliaga-Vera Ignacio , Portilla Cuenca Juan Carlos , Naranjo Ignacio Casado , Morán-García José María , Lavado-García Jesús María
Published: July 2019

Malnutrition is frequently observed in patients after stroke and is associated with poor outcomes. Patients at risk of malnutrition may be identified with several nutrition screening tools, but no nutritional screening tool has been validated for use with stroke patients. The aim of this study was to explore the ability of the Controlling Nutritional Status (CONUT) score to predict 3-month mortality in stroke patients.

Method:

Patients were recruited from consecutive admissions at a hyperacute stroke unit and were screened for risk of malnutrition (light, moderate, or severe) using CONUT scores. At the next visit, 3-month outcomes were obtained.

Results:

Of the 164 recruited patients, 51.2% were male. Mean patient age was 77.7 ( SD = 7.0) years, and 85.8% of patients had an ischemic stroke. There was a significant difference in the survival rate ( p < .001) at 3 months between patients with moderate risk for malnourishment compared to the other patients. The multivariate regression Cox model showed that moderate risk of malnourishment, according to the CONUT score, increased the risk for death at 3 months (hazard ratio = 1.086; 95% CI [1.057, 8.305]; p < .039).

Conclusion:

The CONUT score has predictive validity for all-cause mortality in stroke patients after 3 months, both in hospital and after discharge. Further prospective multicenter studies with larger samples are needed to clarify the usefulness of the CONUT score in the prognosis of all-cause mortality in stroke patients.
Effects of Nocturnal Sleep Quality on Diurnal Cortisol Profiles and Attention in Nurses: A Cross-Sectional Study
Authors: Tsai Jui-Chen , Chou Kuei-Ru , Tsai Hsiu-Ting , Yen Yu-Chun , Niu Shu-Fen
Published: July 2019

Objective:

Low sleep quality (LSQ) activates the hypothalamic–pituitary–adrenal (HPA) axis and is related to arousal. Nursing staff, who work in shifts, tend to exhibit LSQ, which affects the level of vigor after awakening. This study investigated the effects of nocturnal sleep quality on diurnal cortisol profiles and sustained attention in day-shift nurses.

Method:

This study adopted a prospective cross-sectional design. Participants were recruited from a university-affiliated hospital in northern Taiwan. In the initial stage of this study, the Chinese Pittsburgh Sleep Quality Index (PSQI) Questionnaire was administered to 199 participants to categorize them as either LSQ (PSQI > 5) or high sleep quality (HSQ; PSQI ≤ 5). Participants were then randomly sampled from the two groups. Nocturnal sleep data and four diurnal saliva samples were collected for each participant. Sustained attention was measured before they started work. A total of 32 and 29 participants in the HSQ and LSQ groups, respectively, completed the data collection process.

Results:

Compared with the HSQ group, the LSQ group exhibited earlier wake-up times ( p = .02), a flatter cortisol awakening response (CAR) slope ( p < .01), a flatter morning-to-evening slope ( p < .01), and prolonged reaction speed and mean reaction time before starting work ( p < .01).

Conclusion:

Compared with the HSQ group, the LSQ group exhibited impaired HPA-axis regulation, with a flatter CAR and diurnal cortisol slope and poor sustained attention in the morning. Nursing staff are advised to achieve HSQ to improve attention and performance levels and maintain optimum work safety.
Large head ceramic-on-ceramic bearing in primary total hip arthroplasty: average 3-year follow-up of a multicentre study
Authors: Lavigne Martin , Vendittoli Pascal-André , Virolainen Petri , Corten Kristoff , Martinez Mariano , Zicat Bernard , Peter Viju , Bloem Rolf , Miazzolo Nicolas , Remes Ville
Published: July 2019

Background:

Surgeons are increasingly using larger femoral head sizes in total hip arthroplasty (THA) to improve stability and reduce the rate of dislocation, 1 of the leading causes of revision surgery. Large ceramic head sizes up to 48 mm can now be used with monoblock acetabular components. National registries have shown promising results at short-term with large diameter ceramic-on-ceramic THA, with very low revision rates. This study reports on the average 3-year follow up of a press-fit monoblock large diameter acetabular shell with a pre-assembled ceramic liner, with emphasis on the radiographic outcome, complications related to the implantation of the cup, and the patient’s clinical outcome.

Methods:

170 hips in 169 patients were reviewed at an average 38 ± 5.8 months following surgery.

Results:

The radiographic review revealed no acetabular cup loosening, no osteolysis and no cup migration. 1 acetabular cup was revised for malposition. The patient clinical outcome and the satisfaction rate were excellent. At 3 years, 7.1% of patients complained of groin pain and 3.5% spontaneously reported hip joint generated noise. 1 patient sustained a non-recurrent traumatic hip dislocation 2 years post surgery.

Conclusions:

New technology should be introduced cautiously on the market. This is especially true for the large diameter ceramic monoblock acetabular component used in this study since it involves a new acetabular component design. At short term, we have not identified new modes of failure with this implant. Longer follow-up is still needed to assess the safety of large ceramic bearing in THA.
The short external rotators dissection during the posterior approach in total hip arthroplasty did not change the blood flow
Authors: Setoguchi Daisuke , Kinoshita Koichi , Ishimatsu Tetsuro , Ishii Satohiro , Yamamoto Takuaki
Published: July 2019

Objectives:

The posterior approach in total hip arthroplasty (THA) often requires dissection of the short external rotators (SERs), which could increase the postoperative dislocation rate. The reattachment of the dissected SERs has been reported to reduce the dislocation rate, while such repair generally causes progression of muscle atrophy. 1 of the suggested causes of atrophy is reduced blood flow to the repaired SERs. The present study aimed to measure the blood flow of the SERs before dissection (pre-tenotomy) and after reattachment (post-reattachment) during the posterior approach in THA.

Methods:

This prospective study included 26 patients who underwent THA via the posterior approach. A laser-Doppler rheometer was used to measure the blood flow in the following SERs at the time of pre-tenotomy and post-reattachment: the piriformis muscle (PM), superior gemellus (SG), inferior gemellus (IG), obturator internus (OI), and subcutaneous tissue as a control.

Results:

The average pre-tenotomy and post-reattachment blood flows (mL/minutes/100 g) were: 1.90 ± 0.28 and 1.92 ± 0.40 in the PM, 1.94 ± 0.20 and 1.99 ± 0.39 in the SG, 1.91 ± 0.21 and 1.94 ± 0.30 in the IG, 1.93 ± 0.22 and 1.98 ± 0.36 in the OI, and 1.94 ± 0.24 and 1.87 ± 0.38 in the subcutaneous tissue. The pre-tenotomy and post-reattachment blood flows did not show significant difference in any muscle.

Conclusions:

Laser-Doppler blood flow measurements showed that the blood flow is preserved, even when the SERs are dissected and reattached in THA via the posterior approach.
Modern trunnion designs do not affect clinically significant patient-reported outcomes
Authors: Ihekweazu Ugonna N , Lyman Stephen , Chiu Yu-fen , Vaynberg Idelle , Westrich Geoffrey
Published: July 2019

Introduction:

Trunnion geometry is known to vary between hip systems. Trunnionosis and the impact of trunnion design on total hip arthroplasty (THA) survival, has gained attention as a failure mechanism. We sought to report the differences in patient-reported outcome measures (PROMs) between the most commonly utilised modern THA trunnions.

Methods:

We reviewed primary unilateral THA patients from May 2007 to October 2011. The most frequently used stems were included. LEAS, HOOS subdomains, and SF-12 were obtained pre and post operatively while satisfaction was measured at 2 years after THA. Trunnions were grouped by taper geometry and manufacturer. The 2-year change in PROMs for each trunnion was compared to the pooled 2-year change in HOOS for all other trunnions.

Results:

3950 THA patients were studied. 6 trunnion designs were evaluated from 5 manufacturers. The range in differences between the 2-year change in individual PROMs were as follows: HOOS pain (0.6–2.4), HOOS symptoms (0–3.8), HOOS ADL (0.4–4), and HOOS QOL (0.5–3.6). None of the differences in the 2-year change in PROMs reached a minimal clinically important change (MCIC), which we previously determined to be a minimum of 9 points for all HOOS domains.

Conclusion:

All of the trunnions designs utilised in our study cohort demonstrated excellent clinical results. Small differences were well below the known MCIC; and were not clinically relevant. The findings of this study should prompt further investigations into the long-term impact of trunnion design on clinical patient-reported outcomes.
Lessons Learned From the Creating Active Communities and Healthy Environments Toolkit Pilot: A Qualitative Study
Authors: Shams-White Marissa M , Cuccia Alison , Ona Fernando , Bullock Steven , Chui Kenneth , McKeown Nicola , Must Aviva
Published: July 2019

The US Army Public Health Center developed the Creating Active Communities and Healthy Environments (CACHE) Toolkit to help military installations evaluate the quality of their built environments relative to healthy eating, physical activity, and tobacco-free living. This study sought to improve its implementation process and assess subsequent Action Plan Guides’ utility at 5 military installations. Baseline data included a knowledge, attitudes, and beliefs survey (N = 34); post-Toolkit implementation data included focus groups (N = 2) and interviews (N = 10). Although >80% of participants agreed the built environment affects healthy living, only 44%, 53%, and 35% agreed their installations’ built environments promoted healthy eating, physical activity, and tobacco-free living, respectively. Emerging themes comprised “Opportunities to Improve Toolkit and Action Plan Guide Functionality,” the “Sociopolitical Landscape Affects Toolkit Implementation,” and the “Sociopolitical and Physical Landscapes Affect the Toolkit’s Value and Utility.” This study provides concrete lessons for the CACHE Toolkit and other public health-based military initiatives.
Are Increasing Trends in Opioid-Related Hospitalizations Attributable to Increases in Diagnosis Recordability? Evidence from 2 Large States
Authors: Denham Alina , Mullaney Teraisa , Hill Elaine L , Veazie Peter J
Published: July 2019

Based on calculations using all-listed diagnoses, the Agency for Healthcare Research and Quality (AHRQ) reports increasing national trends in opioid-related hospitalizations. It is unclear whether the reported increases are attributable to increases in available diagnosis fields. We leveraged increases in available diagnosis fields, ie, diagnosis recordability, in 2 states to examine their effects on opioid-related hospitalizations, graphically and with nonlinear least squares. Hospitalization data from Texas (1999-2011, N = 36 593 049) and New York (2005-2015Q3, N = 27 582 208) were aggregated to quarter-year in each state. Opioid-related hospitalizations were identified using the same International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Diagnosis Codes as AHRQ. In Texas, the increase in diagnosis recordability resulted in a 29.9% discrete shift in the number of recorded opioid diagnoses and a 3-fold increase in the slope. In New York, a smaller discrete shift (3.1%) and a 3-fold increase in the slope were identified, although a more pronounced change in the trend occurred 5 years earlier (slope change from flat to increasing). Increases in recordability lead to a broader definition of opioid-related hospitalizations, if all-listed diagnoses are used; we found that more hospitalizations are identified using the postchange definition than with the prechange definition (9.7% more in Texas and 4.9% more in New York after 4 years). We conclude that reported increases in opioid-related hospitalizations are partially attributable to increases in diagnosis recordability. Cross-state and temporal comparisons of opioid-related hospitalization rates based on all-listed diagnoses can misrepresent the true relative extent of opioid-related hospital use and therefore of the opioid epidemic.
A comprehensive mathematical model for an accurate calculation of the oil film thickness of strip cold rolling
Authors: Bian Xinxiao , Wang Quan
Published: July 2019

The surface quality of cold rolled strip is related to a greater extent on the rolling oil film thickness, and there are many factors that affect the oil film thickness. Considering the various factors comprehensively, an integrated mathematical model is established, such as roughness of rolls and strips, elastohydrodynamic lubrication, friction heat and plastic deformation heat in the rolling zone, viscosity varying with temperature and pressure, etc. A series of equations are developed, such as the Reynolds equation of partial membrane hydrodynamic lubrication based on average flow theory, equation of oil film thickness on rough elastic surface, the thermal interface equations between strip, oil film and roller surface, surface asperity contact pressure equation, lubricant viscosity and density equations, motion equation of the oil film, etc. This model is solved by finite difference method to get the film pressure, oil film thickness, and temperature distribution in the rolling zone. The average rolling pressure, the roll, and strip temperature calculated by the model are very close to the field test results. Comparing the minimum film thickness calculated by the model with the regression formula of other literature test, the error is less than 10%. The minimum oil film thickness is analyzed. It increases with the decrease of the rolling force and is approximately proportional to the rolling speed and lubricant viscosity.
Party nomination strategies in flexible-list systems: Do preference votes matter for realistic list positions?
Authors: Put Gert-Jan , Smulders Jef , Maddens Bart
Published: July 2019

Previous studies on flexible-list systems demonstrate that party selectorates promote candidates with a high number of preference votes to better list positions in the next election. This research note asks whether these rank promotions are limited to candidates in unrealistic list positions at the lower end of the ballot or also include candidates moving into realistic list positions (i.e. electorally safer highest ranks). Using a longitudinal data set of candidates for 18 parliamentary elections in Flanders (Belgium), we first successfully replicate the earlier established preference vote-effect on future list positions, but subsequently show that promotions from unrealistic to realistic positions are relatively rare. Moreover, preference votes do not seem to affect the ability to move upwards on the list or to receive a realistic position at the next election when controlling for incumbency and list position at the previous election. Robustness tests using different operationalizations for realistic position lead to similar empirical results. Preference votes do not seem to matter for realistic list positions.
The collective memory of dominant parties in parliamentary discourse
Authors: Malka Reut Itzkovitch , Shenhav Shaul R , Rahat Gideon , Hazan Reuven Y
Published: July 2019

When the past is contested by political actors, it can play a notable role both in present and in future politics. This is especially true when it comes to the memory of dominant parties, which are part and parcel of political and national history. Focusing on dominant parties in parliamentary democracies, this article examines the memory dynamics of a dominant party after its demise and highlights the importance of memory modes in understanding these dynamics. Using theories of collective memory, it identifies four possible modes of memory in a post-dominance era, suggesting discursive and power-related indications for each mode. The article then utilizes this framework to examine the memory of Mapai, the once-dominant party in Israel. On the basis of this analysis, the authors propose hypotheses concerning the comparative cases of Sweden, Italy, and Japan.
Modal identification for superstructure using virtual impulse response
Authors: Qu Chun-Xu , Yi Ting-Hua , Li Hong-Nan
Published: July 2019

In civil engineering, structural modes are identified with the assumption of stationary white noise, which cannot be satisfied in practical engineering. This article proposes a new method, which contains the virtual impulse response and eigensystem realization algorithm. The formulation of virtual impulse response is derived from the inverse Fourier transform of the ratio of the cross-power to auto-power spectral density functions of the measurement responses, which is based on the concept of frequency response function. During the formulation derivation, a single point excitation is only considered. Frequency response function would not change with different excitations and responses, which means that the excitation cannot influence frequency response function. The impulse response is pointed out to only represent the behavior of superstructure. After obtaining impulse responses, eigensystem realization algorithm is then performed to identify the modes of superstructure. The proposed method is validated by a numerical example. The results show that virtual impulse response can have much better free decayed behavior than natural excitation technique and identify very precise modal parameters for superstructure.
A new finite element model for vibration analysis of a coated blisk with variable coating thickness
Authors: Yan Xianfei , Gao Junnan , Sun Wei , Xu Kunpeng
Published: July 2019

In the damping design of blisks with hard coating, changing coating thickness is one of the frequently used ways for achieving better damping performance. Nevertheless, for the vibration analysis with variable coating thickness by using commercial finite element software, it is necessary to regenerate the finite element mesh, which results in inconvenience in computation. In this paper, a new laminated element is developed to solve this problem, which needs solely the node coordinates corresponding to the maximum coating thickness. The additional virtual layers to simulate the variations of coating thickness are introduced for the presented element to avoid regenerating new node coordinates. By comparing the analysis results obtained by SOLID185 in ANSYS software, experiment and the developed element, this new element is verified that it remains effective for variable coating thickness parameter input. Furthermore, the effects of the coating thickness on the natural frequency and the forced response of an actual blisk are analysed and due to using the same node coordinates, the computational efficiency is improved significantly. The analysis results indicate that with the increase of coating thickness, the resonance response is reduced significantly and even the thinner coating could also achieve better damping performance.
Government coalitions and Eurosceptic voting in the 2014 European Parliament elections
Authors: Camatarri Stefano , Zucchini Francesco
Published: July 2019

The 2014 European elections were characterized in many countries by growing support for Eurosceptic parties. This growth was not uniform and not clearly associated with the economic performance of these member states. In this article, we investigate the role played in the 2014 European Parliament elections by a country-specific factor – the composition of government coalitions – different from economic performance. In particular, we argue that in those countries where moderately Eurosceptic parties were more involved in the government, citizens with negative attitudes toward the European Union were more likely to vote for highly Eurosceptic parties. This was especially the case when the governments also included strongly pro-EU parties. The empirical analysis, which is based upon the 2014 European Election Voter Study, the Chapel Hill Expert Survey, and the Parliaments and Governments database, confirms our hypotheses.
Protecting the entrepreneurial poor: A human rights approach
Authors: Queralt Jahel
Published: July 2019

Half of the working poor in developing countries are informal entrepreneurs – they make a living by engaging in commercial activities in the shadow economy. A series of government and market failures – for example, corruption, policy uncertainty, and barriers in access to financial services – limit the productivity of informal businesses and condemn their owners to remain poor. This article offers a normative analysis of this problem and makes a twofold contribution. First, it argues that some institutional obstacles that push the entrepreneurial poor toward informality are a violation of a bundle of rights that we can refer as entrepreneurial rights. Second, it claims that these rights ought to be recognized as legal human rights because of their value to realize individual autonomy and to satisfy the basic need to engage in production.