bluuebunny/crossref_metadata_2025 huggingface dataset:
Cycles of Accumulation, Cycles of Struggle: The Zapatista Revolt in World-Systemic Perspective
Authors: Gunderson Christopher
Published: February 2018

The 1994 Zapatista uprising was not the first indigenous revolt in the territory known today as Chiapas, Mexico. Adopting insights from Cox and Nilsen and examining the history of three indigenous revolts in Chiapas within the framework of Arrighi’s “Systemic Cycles of Accumulation” (SCAs), this study considers the effects of such cycles on the timing of indigenous revolts. It finds a correlation between the initiation of the “financial expansion phase” of SCAs and outbreaks of indigenous revolt in Chiapas. Specifying the linkages between each SCA and developments in Chiapas, the study attributes this correlation to the effects of these phase shifts on the political opportunity structures of the indigenous communities. The implications of these findings for a theory of the timing of episodes of collective action generally is discussed.
Performing doubt and negotiating uncertainty
Authors: Henckes Nicolas , Rzesnitzek Lara
Published: February 2018

In the 20th century, the boundaries of psychosis emerged as an area in which psychiatric judgement faced numerous and profound uncertainties. Between obvious neuroses and personality and reactive disorders on the one hand, and unquestionable psychoses on the other, psychiatrists faced a world of suspected cases of schizophrenia, doubtful personality disorder diagnoses or probable cases of psychosis constituting a garden of equivocal clinical presentations in which both individual psychiatrists and the discipline as a whole were confronted with the limits of their knowledge. This article examines how psychiatrists from two German university clinics managed the multiple uncertainties involved in diagnosing cases of early psychosis between 1950 and 1980. Based on the analysis of a sample of records, we propose a pragmatic interpretation of the ways in which these uncertainties were recorded by psychiatrists. How were uncertainties and doubts expressed in the records and managed by clinicians? What means were used to dispel doubt? What were the consequences for patients of these diagnostic uncertainties? The article defines an uncertainty diagnosis as a diagnosis expressed with reservations by its author and recorded as such in a medical file. Depending on the nature of the uncertainty, the types of evidence used by the professionals and how this evidence was dealt with, we have identified three types of uncertainty diagnoses: suspicion, plausibility and probability diagnoses. The article then reflects on the role of the patients themselves in shaping these uncertain situations.
A novel accuracy model for the intrinsic kinematic property of a prismatic pair
Authors: Wu Yu , Wang Zhi , Dong Huimin , Wang Delun
Published: February 2018

A novel accuracy model is proposed to analyze the intrinsic kinematic property of the prismatic pair. The geometric error of guide rails, the elastic constrained structure of moving joints, and fixed joints are considered synthetically. The geometric error is measured by the 5D laser interferometer system with slide blocks. The elastic moving joints are equivalent to the springs, while the fixed joints to contact layers. The equilibrium equations are then set up and the analytical solution for five degrees-of-freedom errors of the moving table is revealed. The global invariant errors, including the straightness error space and the spherical image error surface, are proposed to describe the global kinematic characteristic of the moving table. Along with the comparison between the measured and theoretical indicators, the verification experiment to prove the availability of the model is carried out. As the movement of the table can be forecast precisely and evaluated objectively, the new methodology provides a theoretical basis for machine tool manufacture.
Experimental and theoretical studies on the pressure fluctuation of an internal gear pump with a high pressure
Authors: Liu Ying-Yuan , Li Yi-Ran , Wang Le-Qin
Published: February 2018

In this paper, the flow ripple equation is derived to analyze the effect of working condition on pressure pulsations of an internal gear pump. Results indicate that working pressure has a significant effect on pressure fluctuation of the internal gear pump, while the rotating speed has a complex influence on the pressure pulsation behavior. Then, pressure pulsations of the internal gear pump under different working conditions are discussed by experimental investigations. Results show that the internal gear pump taken for analysis has a low-pressure pulsation at a high working pressure and a relatively high rotational speed. Regarding the frequency spectrum of the pressure pulsation, the dominant frequency is Z* fn, i.e. the product of the tooth number of the driving gear (gear shaft) and its rotational frequency for many working conditions, caused by the inevitable unsteady discharge process of gear pumps. It transforms to the rotational frequency of the gear shaft ( fn) for a high rotational speed or a high operating pressure, but to the rotating frequency of the internal gear ring (2/3 fn) only for a high operating pressure. The occurrence of the two frequencies (2/3 fn and fn) may result from the deformation of the gear ring and the gear shaft under the unbalanced radial forces caused by a high working pressure. Moreover, the frequency spectrum of the inlet pressure pulsation presents some differences from that of the outlet pressure pulsation. This is because the inlet pressure may be influenced by cavity generated at the suction side of the pump.
Assessment of electricity distribution business model and market design alternatives: Evidence for policy design
Authors: Pereira Guillermo Ivan , Pereira da Silva Patrícia , Soule Deborah
Published: February 2018

The transition toward smart electricity distribution grids is transforming the European electricity sector. This has contributed to increased attention by policy makers regarding the future role of electricity distribution system operators in a more flexible, digital, and renewables-based electricity system. A better understanding on how to support the adaptation of the electricity distribution industry can contribute to the introduction of an effective policy framework. Our research provides evidence for policy design by presenting the results of a Policy Delphi study focused on business model and market design adaptation alternatives. We highlight the importance of supporting innovation and a more proactive approach to adaptation from both distribution system operators and regulators. Our findings support the importance of electricity distribution for neutral market facilitation, contributing to market development and enabling new market players. The results obtained support policy makers working on electricity sector adaptation and can contribute to the ongoing market redesign efforts under the Energy Union.
Bayesian hierarchical methods for meta-analysis combining randomized-controlled and single-arm studies
Authors: Zhang Jing , Ko Chia-Wen , Nie Lei , Chen Yong , Tiwari Ram
Published: February 2018

Meta-analysis of interventions usually relies on randomized controlled trials. However, when the dominant source of information comes from single-arm studies, or when the results from randomized controlled trials lack generalization due to strict inclusion and exclusion criteria, it is vital to synthesize both sources of evidence. One challenge of synthesizing both sources is that single-arm studies are usually less reliable than randomized controlled trials due to selection bias and confounding factors. In this paper, we propose a Bayesian hierarchical framework for the purpose of bias reduction and efficiency gain. Under this framework, three methods are proposed: bivariate generalized linear mixed effects models, hierarchical power prior model and hierarchical commensurate prior model. Design difference and potential biases are considered in all models, within which the hierarchical power prior and hierarchical commensurate prior models further offer to downweight single-arm studies flexibly. The hierarchical commensurate prior model is recommended as the primary method for evidence synthesis because of its accuracy and robustness. We illustrate our methods by applying all models to two motivating datasets and evaluate their performance through simulation studies. We finish with a discussion of the advantages and limitations of our methods, as well as directions for future research in this area.
Training Needs Analysis in a Government Regulatory Firm (B)
Authors: Karve Shailaja , Aggarwal-Gupta Meenakshi
Published: February 2018

Western State Electricity Regulatory Commission (WSERC) a Government Regulatory Firm in India needed to enhance its human resource capabilities. It was grappling with employees who were either on contract or deputation, and were essentially temporary in nature. The younger staff was lacking in both technical and managerial skills and could not contribute to the organization’s functioning. The senior staff appeared unwilling to transfer their knowledge to the junior staff. In addition, there were various people-related challenges in terms of differences in working styles, hierarchical culture of the firm, conflict across levels and functions and preference to operate in silos. It was decided to address the people related challenges through training to create a climate of trust and sharing before initiating a mentoring intervention. It was decided to undertake customized training to address the unique context and challenges being faced by the firm; therefore, a training needs analysis (TNA) was carried out. Various tools such as the TNA questionnaire, visioning exercise, personal interviews and focused group discussions (FGD) were used to gather data to identify specific training needs of the firm. The case focuses on the process of initiating a TNA in a small firm and some of the associated challenges.
Hematologic and biochemical characteristics of stranded green sea turtles
Authors: March Duane T. , Vinette-Herrin Kimberly , Peters Andrew , Ariel Ellen , Blyde David , Hayward Doug , Christidis Les , Kelaher Brendan P.
Published: February 2018

To improve understanding of pathophysiologic processes occurring in green sea turtles ( Chelonia mydas) stranded along the east coast of Australia, we retrospectively examined the hematologic and biochemical blood parameters of 127 green turtles admitted to 2 rehabilitation facilities, Dolphin Marine Magic (DMM) and Taronga Zoo (TZ), between 2002 and 2016. The predominant size class presented was small immature animals (SIM), comprising 88% and 69% of admissions to DMM and TZ, respectively. Significant differences in blood profiles were noted between facility, size, and outcome. Elevated levels of aspartate aminotransferase (AST) and heterophils were poor prognostic indicators in animals from TZ, but not DMM. SIM animals at both institutions had lower protein levels than large older (LO) animals. SIM animals at DMM also had lower hematocrit and monocyte concentration; SIM animals at TZ had lower heterophil counts. Urea was measured for 27 SIM animals from TZ, but the urea-to-uric acid ratio was not prognostically useful. Strong correlations were seen between AST and glutamate dehydrogenase (GDH; r = 0.68) and uric acid and bile acids ( r = 0.72) in the 45 SIM animals from DMM in which additional analytes were measured. χ2 contingency tests showed that the most recently published reference intervals were not prognostically useful. A paired t-test showed that protein levels rose and heterophil numbers fell in the 15 SIM animals from TZ during the rehabilitation process. Our results indicate that further work is required to identify reliable prognostic biomarkers for green turtles.
Broadband sound transmission loss enhancement of an arbitrary-thick hybrid smart composite plate using multi-objective particle swarm optimization–based active control
Authors: Hasheminejad Seyyed M , Hakimi Arash , Keshavarzpour Hemad
Published: February 2018

The active damping control strategy upgraded by a multi-objective particle swarm optimization algorithm is utilized for improved broadband suppression of sound transmission through a simply supported piezo-laminated rectangular panel of arbitrary thickness featuring an orthotropic functionally graded viscoelastic material interlayer. The controller parameters are tuned optimally through multi-objective particle swarm optimization which yields the Pareto optimal frontiers of certain applicable conflicting objective functions. Extensive numerical simulations include the calculated sound transmission loss of the passive, active, and hybrid (active–passive) piezo-composite panels under normally or obliquely incident plane waves. It is found that the overall sound transmission loss levels substantially rise with increasing thickness of (carbon fiber–reinforced) viscoelastic interlayer, which can further be improved by augmenting the fiber volume fraction. Also, the purely active multi-objective particle swarm optimization–based control system performs well in the low-frequency region, while the good performance of the hybrid smart panel is achieved by balancing an optimal trade-off between the active and passive control configurations in a relatively wide frequency range. Accuracy of formulation is confirmed by comparisons with the existing data as well as with those of a finite element model software package. Furthermore, a frequency-domain subspace identification scheme is applied to estimate the state matrices of proposed control systems, and the closed-loop stability is established based on eigenvalue analysis of identified systems.
The Hidden Cost of Cancer: The Siblings’ Story, A Mother’s Narrative on How Three of Her Children Journeyed Through Their 14-Year-Old Sister’s 9-Month Journey From Ill Heath to Death and Beyond
Authors: Bara Davie E.
Published: February 2018

The siblings of children diagnosed with cancer can get lost in the cancer journey. Through a mother’s eyes, this article examines the issues faced by three siblings when their teenage sister is diagnosed with and dies of cancer. It focuses on the impact their sister’s illness has on their educational, social, emotional, and communication skills. Each sibling not only had their own unique set of needs, but this article argues that the term cancer survivor should also be extended to the siblings as they comprise an intrinsic part of the family’s cancer journey. The article calls on professionals to adopt a holistic approach to reduce the impact that childhood cancer has on the siblings, and it highlights the far-reaching consequences of not properly supporting the siblings during this time.
Timing of Furlow Palatoplasty for Patients With Submucous Cleft Palate
Authors: Ettinger Russell E. , Kung Theodore A. , Wombacher Natalie , Berger Mary , Newman M. Haskell , Buchman Steven R. , Kasten Steven J.
Published: February 2018

Background:

Submucous cleft palate (SMCP) is the most common form of cleft involving the posterior palate, resulting in variable degrees of velar dysfunction and speech disturbance. Although early surgical intervention is indicated for patients with true cleft palate, the indications for palatoplasty and timing of surgical intervention for patients with SMCP remain controversial.

Methods:

Twenty-nine patients with SMCP were retrospectively reviewed. Patients treated with Furlow palatoplasty were dichotomized based on patient age at the time of surgical correction into early speech development and late speech development. Primary outcome measures included standardized assessments of hypernasal resonance and quantitative pre- and postoperative nasometry scores. Patients managed nonoperatively were included for comparison of early and late speech outcomes.

Results:

Both early and late groups demonstrated improvement in qualitative assessment of hypernasal resonance following Furlow palatoplasty. Early and late groups also had significant improvement in pre- to postoperative nasometry scores from 7.4 to 2.3 SD from norm ( P = .01) and 6.0 to 3.6 SD from norm ( P = .02), respectively. There was no difference in postoperative nasometry scores between early and late groups, 2.3 and 3.6 SD ( P = .12).

Conclusion:

Furlow palatoplasty significantly improves the degree of hypernasality in patients with SMCP based on pre- and postoperative nasometry scores and on qualitative assessment of hypernasality. There were no differences in speech outcomes based on early compared with late operative intervention. Therefore, early palatal repair is not obligatory for optimal speech outcomes in children with SMCP and palatoplasty should be deferred until the emergence of overt velopharyngeal insufficiency.
Factors Predicting Hospital Length of Stay Following Pharyngeal Flap for Velopharyngeal Insufficiency
Authors: Chao Jerry W. , Boyajian Michael J. , Amdur Richard L. , Mitchell Benjamin J. , Rogers Gary F. , Oh Albert K.
Published: February 2018

Objective:

Routine hospital admission following pharyngeal flap (PF) to correct velopharyngeal insufficiency (VPI) is the standard at most hospitals. Nevertheless, there is increasing resistance from third-party providers to approve stays longer than a “short stay” (23-hour) observation period. The purpose of the current study was to evaluate length of stay (LOS) and document potential influencing factors following PF.

Design:

Retrospective chart review. Demographic and perioperative data were collected, and statistical analyses were performed to determine associations with hospital length of stay (LOS). Readiness for discharge was determined by oral intake, analgesic requirement, and respiratory status.

Setting:

Tertiary care children’s hospital

Participants:

All patients undergoing PF for VPI between 1990 and 2014.

Outcome measures:

(1) LOS, (2) % satisfying all discharge criteria within a 23-hour observational time frame.

Results:

Seventy-five patients were studied, with an average age of 6.8 years. Mean LOS was 65.4 hours. Only 11 patients (14.9%) met all discharge criteria by 23 hours. Multivariate predictors of shorter LOS were increasing patient age, male gender, lack of syndromic association, administration of an intraoperative antiemetic and steroids, and shorter anesthetic duration. Time to first oral intake correlated positively with LOS. Administration of intraoperative antiemetics increased the odds of meeting all discharge criteria within 23 hours by a factor of 12.

Conclusions:

Identification of factors associated with LOS after PF may allow providers to predict and potentially mitigate hospital stays. Nevertheless, most patients undergoing PF are not clinically ready for discharge within a short-stay (23-hour) observation period.
Surgery for Velopharyngeal Dysfunction
Authors: de Blacam Catherine , Smith Susan , Orr David
Published: February 2018

Objective:

This systematic review sought to evaluate the consensus in the literature regarding the surgical management of VPD and to determine whether a particular procedure results in superior speech outcome or less morbidity

Design:

A systematic review was carried out according to PRISMA-P guidelines. Systematic review software was used to facilitate 3-stage screening and data extraction by 2 reviewers.

Setting:

University teaching hospital.

Patients, Participants:

Studies that reported perceptual speech assessment or obstructive sleep apnea (OSA) in patients who had undergone surgery for VPD were included in the review.

Interventions:

Four categories of surgery for VPD were examined—pharyngeal flap, sphincter pharyngoplasty, palatoplasty, and posterior pharyngeal wall augmentation.

Main outcome measures:

Perceptual speech assessment, need for further surgery, and occurrence of OSA were the outcomes of interest.

Results:

Eighty-three relevant studies were identified, comprising data on 4011 patients. Pharyngeal flap was the most common procedure (64% of patients). Overall, 70.7% of patients attained normal resonance and 65.3% attained normal nasal emission. There was no notable difference in speech outcomes, need for further surgery, or occurrence of OSA across the 4 categories of surgery examined. Heterogeneous groups of patients were reported upon and a variety of perceptual speech assessment scales were used.

Conclusions:

There is a lack of consensus in the literature to guide procedure selection for patients with VPD. The development of a standardized minimum data set to record postoperative speech, OSA, and patient-reported outcomes is required.
Speech and Surgical Outcomes in Children With Veau Types III and IV Cleft Palate
Authors: Pet Mitchell A. , Dodge Ryan , Siebold Babette , Kinter Sara , Perkins Jonathan , Tse Raymond W.
Published: February 2018

Objective:

This study compares speech and surgical outcomes in internationally adopted and nonadopted patients undergoing cleft palate repair, and examines the influence of age at initial palatoplasty.

Design:

Retrospective cohort study setting: Tertiary Care Children’s Hospital.

Patients:

70 international adoptees and 211 nonadoptees with Veau type III and IV clefts (without associated syndrome) repaired at our institution.

Outcome Measures:

Outcomes included VPI, compensatory misarticulations, intelligibility, nasal air emission, oronasal fistula, and secondary speech surgery. Speech evaluations completed near 5 years of age were gathered from a prospectively collected database.

Results:

Adoptees underwent palatoplasty 5.2 months after arrival, a mean of 10.4 months later than nonadoptees. Adoptees were significantly more likely to develop moderate/severe VPI and trended toward more frequent need for secondary speech surgery. Oronasal fistula occurred at similar rates. Increased age at initial palatoplasty was a significant predictor of moderate to severe VPI, and need for secondary speech surgery.

Conclusions:

International adoptees undergo palatoplasty 10.4 months later than nonadoptees and are significantly more likely to develop moderate/severe VPI, with a trend toward increased secondary speech surgery. An association between treatment delay and moderate/severe VPI and secondary speech surgery has been demonstrated. While a causal relationship between delayed repair and inferior outcomes in international adoptees has not been proven, this data suggests that surgical intervention upon unrepaired cleft palates soon after adoption may be beneficial. The opportunity for a change in practice exists, as half of the 10.4-month relative delay in palate repair occurs postadoption.
Ideal Versus Late Secondary Alveolar Bone Graft Surgery
Authors: Garcia Michele Alves , Yatabe Marilia , Fuzer Thais Ustulin , Calvo Adriana Maria , Trindade-Suedam Ivy Kiemle
Published: February 2018

Objective:

To compare the bone morphology after secondary alveolar bone graft surgery (SABG) performed before and after permanent canine eruption.

Design:

Cross-sectional study.

Setting:

Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil.

Patients:

25 cone-beam computed tomography (CBCT) scans of complete unilateral cleft lip and palate (CLP) individuals who underwent SABG before or after eruption of the permanent canine taken 2 and 6 months (T1 and T2) after SAGB, resulting in 50 CBCT scans. Two groups were assessed, Ideal Group (IG; n = 10) and Late Group (LG; n = 15), according to the time of the SABG.

Interventions:

SABG buccal-palatal thicknesses were measured in 3 different root levels: cement-enamel junction (cervical slice), middle point of the root (intermediate slice), and apex of the central incisor (apical slice). Thickness measurements were assessed in the mesial, distal, and intermediate aspects of the alveolar bone graft. Clinical long-term follow-up was also done.

Results:

The IG showed significantly greater bone thickness, especially in the intermediate and apical slices, when compared to LG, in T1 and T2. Bone thickness was maintained over time. Clinically, all the IG individuals completed orthodontics, and no major complications were observed. In contrast, 27% of the LG individuals had failures, and rehabilitation was achieved through prosthesis.

Conclusion:

Ideal SABG presents with better results compared with late ABG. When it is not possible to perform SABG at the ideal time, acceptable outcomes still can be expected for late bone grafting.
Association Between CRISPLD2 Polymorphisms and the Risk of Nonsyndromic Clefts of the Lip and/or Palate
Authors: Ge Xing , Shi Qiao-Mei , Ding Zhen , Ju Qiang , Wang Hui , Wang Qi , Li Meng-Xue , Chen Gang , Wang Heng-Xue , Xu Li-Chun
Published: February 2018

Objective:

Nonsyndromic clefts of the lip and/or palate (NSCL/P) are one of the most common polygenic diseases. Recently, many studies focused on the association between CRISPLD2 polymorphisms and NSCL/P risk. However, some studies have shown opposite results. In this study, meta-analysis was used to confirm whether CRISPLD2 polymorphism was associated with NSCL/P, and the possible mechanism between CRISPLD2 and NSCL/P was explored.

Methods:

Relevant studies were conducted on PubMed, Ovid, EBSCO, CINAHL, FMRS, Web of Science, CNKI, and Wanfang databases from their inception up to June 31, 2016. Review Manager 5.0.24 was used to analyze whether CRISPLD2 polymorphism was involved in NSCL/P by pooling odds ratios (ORs) and 95% confidence intervals (CIs). Potential publication bias was evaluated by visual inspection of the funnel plot.

Results:

CRISPLD2 rs4783099 was associated with cleft lip and/or palate (CL/P) statistically (OR = 3.18, P < .01). Compared to genotype TT, genotypes CC and CT were correlated significantly (OR = 2.04, P = .04) with CL/P. No evidence showed an association between genetic variation at the CRISPLD2 locus and cleft palate only (CP).

Conclusion:

The polymorphism of CRISPLD2 rs4783099 is correlated with an increased risk of CL/P.
3D-Printed Models of Cleft Lip and Palate for Surgical Training and Patient Education
Authors: Chou Pang-Yun , Hallac Rami R. , Shih Ellen , Trieu Jenny , Penumatcha Anjani , Das Priyanka , Meyer Clark A. , Seaward James R. , Kane Alex A.
Published: February 2018

Background:

Sculpted physical models and castings of the anatomy of cleft lip and palate are used for parent, patient, and trainee education of cleft lip and palate conditions. In this study, we designed a suite of digital 3-dimensional (3D) models of cleft lip and palate anatomy with additive manufacturing techniques for patient education.

Methods:

CT scans of subjects with isolated cleft palate, unilateral and bilateral cleft lip and palate, and a control were obtained. Soft tissue and bony structures were segmented and reconstructed into digital 3D models. The oral soft tissues overlying the cleft palate were manually molded with silicone putty and scanned using CT to create digital 3D models. These were then combined with the original model to integrate with segmentable soft tissues. Bone and soft tissues were 3D printed in different materials to mimic the rigidity/softness of the relevant anatomy. These models were presented to the parents/patients at our craniofacial clinic. Visual analog scale (VAS) surveys were obtained pertaining to the particular use of the models, to ascertain their value in parental education.

Results:

A total of 30 parents of children with cleft conditions completed VAS evaluations. The models provided the parents with a better understanding of their child’s condition with an overall evaluation score of 9.35 ± 0.5.

Conclusions:

We introduce a suite of 3D-printed models of cleft conditions that has a useful role in patient, parental, and allied health education with highly positive feedback.
Eigen-transitions in cantilever cylindrical shells subjected to vertical edge loads
Authors: Coman Ciprian D , Bassom Andrew P
Published: February 2018

A thin cantilever cylindrical shell subjected to a transverse shear force at the free end can experience two distinct modes of buckling, depending on its relative thickness and length. If the former parameter is fixed, then a short cylinder buckles in a diffuse manner, while the eigenmodal deformation of a moderately long shell is localised, both axially and circumferentially, near its fixed end. Donnell-type buckling equations for cylindrical shells are here coupled with a non-symmetric membrane basic state to produce a linear boundary-value problem that is shown to capture the transition between the aforementioned instability modes. The main interest lies in exploring the approximate asymptotic separation of the independent variables in the corresponding stability equations, when the eigen-deformation is doubly localised. Comparisons with direct numerical simulations of the full buckling problem provide further insight into the accuracy and limitations of our approximations.
Psychometric properties of the Cognitive and Metacognitive Learning Strategies Scales among preservice physical education teachers: A bifactor analysis
Authors: Liu Jiling , Xiang Ping , McBride Ron , Chen Han
Published: February 2018

Although widely used to measure self-regulated learning strategies, the Motivated Strategies for Learning Questionnaire has not yielded satisfactory construct validity across empirical studies. This study examined its psychometric properties by focusing on one of its subscales, the Cognitive and Metacognitive Learning Strategies Scales, among 419 preservice physical education teachers ( M age = 23.05 years, SD = 4.28) from five physical education teacher preparation programmes in the southwestern United States of America. The participants responded to the 31-item Cognitive and Metacognitive Learning Strategies Scales, which assessed five categories of learning strategies: rehearsal, elaboration, organization, critical thinking, and metacognitive self-regulation. Each item was on a seven-point Likert scale. Initial confirmatory factor analysis did not support the original five-factor model. Following exploratory factor analysis identified three latent factors. Subsequent bifactor exploratory factor analysis revealed one general factor and two group factors, and following bifactor confirmatory factor analysis confirmed that this structure had an acceptable model fit, χ2 (353) = 731.327, p <.001; Root Mean Square Error of Approximation = .053; Comparative Fit Index = .907; Standardized Root Mean Square Residual = .047. A respecified bifactor model with 18 items resulted in a good fit, χ2 (120) = 161.384, p <.001; Root Mean Square Error of Approximation = .030; Comparative Fit Index = .980; Standardized Root Mean Square Residual = .034. Score reliability for the general factor Omega Hierarchical = .825; for the two group factors, Omega Scales = .211 and .238, respectively. Implications for future research and practice are discussed.
No girls allowed?: Fluctuating boundaries between gay men and straight women in gay public space
Authors: Baldor Tyler
Published: February 2018

How are boundaries between sexual identities constructed and maintained through interaction? I draw on ethnographic observation in Philadelphia gay bars popular among heterosexual patrons and supplemental interviews with young gay-identifying club-goers to illuminate how men make situational claims to gay space by drawing distinctions between who ‘belongs’ in gay bars and who does not through interaction. Conceptualizing gay space as a collectively accomplished ‘mesh’ of particular interaction rituals, I find that men activated membership boundaries when presumably straight women's nightlife rituals were perceived to threaten the continued production of gay space by ‘straightening’ it. Men did not enact boundaries when straight women energized men's rituals with positive emotional energy and contributed to a bar's collective ‘gay’ feeling. Broadly, these findings suggest that the generation of shared emotions across groups in spaces with contested meaning or function helps determine the salience of boundaries.
Diasporic homecomings to the Kurdistan region of Iraq: Pre- and post-return experiences shaping motivations to re-return
Authors: Baser Bahar , Toivanen Mari
Published: February 2018

This article examines the dynamics of voluntary return migration to the Kurdistan region of Iraq in the post-Saddam period and provides a contextualised analysis of the returnees’ experiences in a rapidly shifting geopolitical situation in Kurdistan. It specifically focuses on examining how diasporans’ motivations to return, as well as their plans to re-return, are shaped in relation to their experiences in host societies and in the ‘homeland’. Drawing from qualitative interviews, it shows that Kurdish diasporans’ return can be characterised as ‘diasporic homecoming’ as it is motivated by the desire to contribute to the economic and political development of the Kurdistan region of Iraq. However, the mismatch between expectations and ‘homeland’ realities combined with positive experiences and social capital accumulated in the host country makes plans for re-return more foreseeable and less risky.
Affection, Deception, and Evolution: Deceptive Affectionate Messages as Mate Retention Behaviors
Authors: Redlick Madeleine H. , Vangelisti Anita L.
Published: February 2018

This study explored how partner mate value (PMV) and factors indicative of the relational climate (i.e., commitment and satisfaction) might affect individuals’ tendency to use deceptive affectionate messages (DAMs). Participants ( N = 203) responded to a survey including measures regarding these variables. Contrary to predictions, PMV and the tendency to engage in DAMs were significantly and negatively associated with one another. Analyses further indicated that commitment significantly moderated the negative association between PMV and DAMs. The present study also provided evidence that when commitment to the relationship is low, satisfaction mediates the negative association between PMV and DAMs.
GIRRL power! Participatory Action Research for building girl-led community resilience in South Africa
Authors: Forbes-Genade Kylah , van Niekerk Dewald
Published: February 2018

This article aims to crystallize the contributions of the Girls in Risk Reduction Leadership (GIRRL) Program in building resilient communities through the integration of adolescent girls into local level decision-making and action for reducing disaster risk. Disadvantaged adolescent girls carry a double burden derived from vulnerability associated with gender and age within the context of disaster risk. Girls often face greater danger than boys or adults and are perceived as powerless. Their needs go unheard and capacities ignored because of their exclusion from decision-making and social participation. Efforts to reduce risk must be inclusive of the needs of vulnerable populations. Despite global calls for the inclusion of women, children, and youth in risk reduction policy and planning, its application has been insufficient. The GIRRL Program, utilizing Participatory Action Research, helped to catalyze the capacities of girls through personal empowerment to drive the agenda for inclusive involvement of vulnerable populations to build community resilience. The paper will document the contributions of the GIRRL Program to improving community resilience through engaging decision-making, facilitating multi-sectoral understanding of vulnerability and risk, validating the importance of girls in risk reduction, creating capacity to manage girl-led processes, and strengthening risk reduction through local girl-led activities.
Snorkel Technique for Inferior Mesenteric Artery During Endovascular Repair of Abdominal Aortic Aneurysm
Authors: Ertugay Serkan , Daylan Ahmet , Bozkaya Halil , Oğuz Emrah , Apaydın Anıl , Parıldar Mustafa , Posacıoğlu Hakan
Published: February 2018

Purpose:

The snorkel technique is commonly used to preserve renal arteries in juxta renal aneurysm during endovascular repair. Herein, we present a patient who underwent bifurcated endograft implantation with snorkel technique for inferior mesenteric artery (IMA) in order to preserve the major source of bowel circulation.

Case Report:

A 69-year-old male patient was diagnosed with abdominal aortic aneurysm. His history revealed that he had bowel resection due to a car accident 30 years ago. In addition, he was given relaparotomy 4 times due to intestinal complications. Computed tomography showed fusiform aneurysm with a maximal diameter of 60 mm and chronical occlusion of the superior mesenteric artery. Inferior mesenteric artery was found to be hypertrophic. During EVAR, 6 mm × 10 cm covered VIABAHN Endoprosthesis (Gore Medical) was implanted to the IMA over a 0.018 guidewire via puncture of the left axillary artery. Initially, the main body of the aortic stent-graft (Gore C3, size 23-14-16) was implanted to the infra renal segment of the aorta (below the renal arteries and the orifice using VIABAHN) via the right femoral artery. Next, the contralateral leg (Gore, 14-12-00) was implanted. Computed tomography was examined at 1- and 32-month postoperatively, and no endoleak or patency of IMA stent was detected.

Conclusion:

In this case of IMA-dependent circulation of the intestinal system, the protection of IMA via snorkel technique was successful.
Surgical management of superior petrosal sinus dural arteriovenous fistulae with dominant internal carotid artery supply
Authors: Stapleton Christopher J , Patel Anoop P , Walcott Brian P , Torok Collin M , Koch Matthew J , Leslie-Mazwi Thabele M , Rabinov James D , Butler William E , Patel Aman B
Published: February 2018

Background

While technological advances have improved the efficacy of endovascular techniques for tentorial dural arteriovenous fistulae (DAVF), superior petrosal sinus (SPS) DAVF with dominant internal carotid artery (ICA) supply frequently require surgical intervention to achieve a definitive cure.

Methods

To compare the angiographic and clinical outcomes of endovascular and surgical interventions in patients with SPS DAVF, the records of all patients with tentorial DAVF from August 2010 to November 2015 were reviewed.

Results

Within this cohort, eight patients with nine SPS DAVF were eligible for evaluation. Five DAVF were initially treated with endovascular embolization, while four underwent surgical occlusion without embolization. Of the SPS DAVF treated with embolization, two (40%) remained occluded on follow-up, while the remaining three (60%) persisted/recurred and required surgical intervention for definitive closure. Of the four SPS DAVF treated with primary surgical occlusion, all four (100%) remained closed on follow-up. In addition, of the three SPS DAVF that persisted/recurred following embolization and required subsequent surgical closure, all three (100%) remained occluded on follow-up. Two (100%) SPS DAVF that were successfully treated with embolization had major or minor external carotid artery supply, while the three (100%) persistent lesions had major ICA supply via the meningohypophyseal trunk (MHT). Three (75%) of the four SPS DAVF treated with primary surgical occlusion had dominant MHT supply.

Conclusion

Complete endovascular closure of SPS DAVF with dominant ICA supply via the MHT may be difficult to achieve, while upfront surgical intervention is associated with a high rate of complete occlusion.
Improved procedural safety following protocol changes for selective ophthalmic arterial infusion of chemotherapy for treatment of ocular retinoblastoma
Authors: Ammanuel Simon , Alexander Matthew D , Damato Bertil , Cooke Daniel L , Halbach Van V , Amans Matthew R , Dowd Christopher F , Higashida Randall T , Hetts Steven W
Published: February 2018

Purpose

The aim was to evaluate the impact of protocol changes in selective ophthalmic arterial infusion (SOAI) for treatment of retinoblastoma (Rb).

Methods

A retrospective review was completed of 35 patients with Rb who were treated with SOAI between March 2010 and January 2017. Treatment details were tabulated for each SOAI session. SOAI protocol was changed in June 2015, and differences before and after this change were evaluated using two-tail chi-square tests and independent sample t-tests to note any differences in technical complications, need for enucleation, and other outcome variables

Results

125 SOAI sessions occurred. No technical complications occurred during the study. Two complications (1.6%) occurred in the postoperative setting. Both complications occurred prior to the change in protocol. Comparing the complication rates between the two protocols showed no significant difference (2.2% versus 0.0%; p = 0.505); 29 of 43 (67.4%) eyes had their vision preserved overall.

Conclusions

SOAI is an effective treatment for Rb. The refined protocol described herein was associated with fewer complications.
Middle cerebral artery pressure changes following Pipeline flow diversion
Authors: Brunozzi Denise , Shakur Sophia F , Charbel Fady T , Alaraj Ali
Published: February 2018

Objective

Pipeline embolization devices (PED) are commonly used for endovascular treatment of cerebral aneurysms but changes in intracranial hemodynamics after PED deployment are poorly understood. Here, we assess middle cerebral artery (MCA) and systemic blood pressure before and after PED treatment.

Methods

Records of patients with cerebral aneurysms proximal to the internal carotid artery terminus treated with PED at our institution between 2015 and 2017 were retrospectively reviewed. Patients were included if ipsilateral MCA pressure measurements were available. Ipsilateral MCA pressure was transduced via the microcatheter before and after PED deployment. Systemic arterial blood pressure was also simultaneously recorded. MCA, systemic blood pressure, and ratios of MCA to systemic blood pressure values were compared before and after treatment among the study cohort using the two-sample paired Student t test.

Results

Fourteen patients were included. Mean age was 54 years. Among the entire cohort, the ratio of MCA to systemic systolic and mean blood pressure were significantly higher after treatment (respectively 0.76 vs. 0.69, p = 0.01, and 0.94 vs. 0.89, p = 0.03), and the ratio of MCA to systemic diastolic pressures showed an increasing trend (1.08 vs. 1.03, p = 0.09). The percentage of ratio increase was independent of aneurysm size ( r = –0.24, p = 0.42 for systolic ratio; r = –0.09, p = 0.74 for diastolic ratio; r = –0.09; p = 0.76 for mean ratio, respectively).

Conclusions

Following PED deployment, the ratio of ipsilateral MCA to systemic systolic and mean blood pressure increased. These pressure changes should be further evaluated in a larger sample size.
Collateral circulation between angiosomes in the feet of diabetic patients
Authors: Orhan Erkan , Özçağlayan Ömer
Published: February 2018

Objectives

The main factor in the healing of foot ulcers in diabetic patients is adequate perfusion. There is no consensus on whether direct or indirect revascularization is more effective in leg revascularization. At the centre of that debate, there is a disagreement about whether collateral circulation is sufficient or not. Our aim is to evaluate collateral circulation activity between angiosomes in the feet of diabetic patients by evaluating the level of occlusion in leg arteries and comparing the angiosome regions that have necrosis.

Methods

The study included 61 patients. All had undergone CT angiography to the lower extremity prior to any revascularization of the leg arteries between September 2014 and September 2016. Stenosis was evaluated on the anterior tibial artery, the posterior tibial artery and the peroneal artery up to the level of the ankle. The opening of the vessel wall at the narrowest part of the vessel was determined as a percentage. The areas with necrosis were determined according to the angiosomes of the posterior tibial artery, anterior tibial artery and peroneal artery vessels.

Results

Necrosis of the foot was most common in the posterior tibial artery angiosome. Necrosis in the posterior tibial artery angiosome was independent of the level of posterior tibial artery occlusion; however, it was associated with the occlusion of the anterior tibial artery ( p < 0.05). It was found that anterior tibial artery occlusion over 15% resulted in necrosis in the posterior tibial artery angiosome.

Conclusions

Collateral circulation between the anterior tibial artery and posterior tibial artery is active and there is almost always occlusion in the posterior tibial artery branches. The posterior tibial artery angiosome is fed by the collateral arteries of the anterior tibial artery even if there is no occlusion of posterior tibial artery at the level of the leg, so indirect revascularization on the anterior tibial artery is sufficient to provide foot circulation.
Investigating principals’ data use in school: The impact of evidence-oriented attitudes and epistemological beliefs
Authors: Buske Ramona , Zlatkin-Troitschanskaia Olga
Published: February 2018

In this study, we examine the relationships between principals’ evidence-oriented attitudes and their data use in school leadership practices. Based on theoretical assumptions and existing empirical research, we develop hypotheses on the correlation of evidence-oriented attitudes, epistemological beliefs and principals’ data use. We test these hypotheses based on data collected from a sample of N = 297 principals at 153 schools of different types using structural equation modelling. The findings show that the examined attitudes and epistemological beliefs have a slight, yet significant influence on principals’ data use. In particular, principals’ skepticism towards knowledge or academia influences data use. We conclude by addressing the limitations of our study and the challenges they pose for future research as well as implications for evidence-based school improvement.
Modified Littler flap for sensory reconstruction of large thumb pulp defects
Authors: Wang Hui , Yang Xiaoxi , Chen Chao , Wang Bin , Wang Wei , Jia Song
Published: February 2018

The Littler flap has been widely used to repair large pulp defects of the thumb; however, several complications have occurred frequently. In order to reduce these issues, the modified Littler flap innervated by the dorsal branch of the proper digital nerve and the proper digital nerve from the ulnar aspect of the middle finger or the radial aspect of the ring finger were devised in 16 consecutive cases. At the donor site, the defect of the proper digital nerve was repaired with a nerve graft from the proximal portion of the ipsilateral dorsal branch of the proper digital nerve. At the final follow-up, the scores for the static two-point discrimination test, Semmes–Weinstein monofilament test and total active motions in both recipient and donor fingers were nearly normal. This modified Littler flap provides a simple and reliable alternative for treatment of large defects of the thumb pulp with low donor-site morbidity.

Level of Evidence: IV
Spinal accessory nerve repair using a direct nerve transfer from the upper trunk: results with 2 years follow-up
Authors: Cambon-Binder Adeline , Preure Lynda , Dubert-Khalifa Heba , Marcheix Pierre-Sylvain , Belkheyar Zoubir
Published: February 2018

Spinal accessory nerve grafting requires identification of both nerve stumps in the scar tissue, which is sometimes difficult. We propose a direct nerve transfer using a fascicle from the posterior division of the upper trunk. We retrospectively reviewed 11 patients with trapezius palsy due to an iatrogenic injury of the spinal accessory nerve in nine cases. The mean age was 38 years (range 21–59). Preoperatively, patients showed shoulder weakness and limited range of motion. At a mean follow-up of 25 months, active shoulder abduction improvement averaged 57°. Trapezius muscle strength graded M4 or M5 in 10 cases and M3 in one case. No deltoid or triceps impairment was reported. Scapula kinematics was considered normal in seven patients. This technique gave satisfactory functional results and may be an alternative to spinal accessory nerve grafting for the management of trapezius palsies if direct repair is not feasible.

Level of evidence: IV