bluuebunny/crossref_metadata_2025 huggingface dataset:
The Reconfiguration of Guanxi in a Twentieth-Century Indigenous Chinese Protestant Group
Authors: Zimmerman-Liu Teresa
Published: May 2017

Guanxiis the Chinese system of ideas and practices constituting social relationships and can be considered the foundation of Chinese societies. Protestant Christianity spread overguanxinetworks from its first introduction to China, changing bothguanxiand Christianity in the process. This paper proposes a causal model ofguanxiand then analyzes how it was reconstituted in the indigenous Chinese Protestant group, the Local Churches. It is based on published writings by Local Church founders and members and on the author’s thirty years of experience with the group. This case contributes to the academic understanding ofguanxiand Chinese Christianity, finding that extension of family, supply of resources, and social interaction are the core aspects ofguanxi, but that specific practices change in the Christian context to preserve biblical commandments. Becauseguanxinetworks are bonding rather than bridging, Chinese Christian groups will tend to diverge more than they converge.

關係是中國人構成社會交往的思想和實踐體系，可以說是中國社會的基礎。基督新教在中国的发展依赖于关系网络，在其传播过程中二者都发生了变化。本文先提出一个关于關係的因果模型，再分析關係如何在一個中國本土的新教團體—地方教會—中被重新構造。本項研究是基於地方教會創辦人和成員的寫作，也基於作者與該團體三十年的接触。這項個案研究 有助于擴展對關係與中國基督教的學術理解。關係最重要方面是家庭关系的延展，供應資源，以及社會交流，不過，基督徒為了遵守聖經的教訓， 改变了關係的某些实践。地方教会的关系网络强调内部团结，而不是对外开放，所以与其他基督教团体关系疏离，而不是趨向匯合。 (This article is in English.)
Concentrated evolutionary novelties in the foot musculature of Odontophrynidae (Anura: Neobatrachia), with comments on adaptations for burrowing
Authors: BLOTTO BORIS L. , PEREYRA MARTIN O. , FAIVOVICH JULIÁN , DIAS PEDRO HENRIQUE DOS SANTOS , GRANT TARAN
Published: May 2017

We studied the foot musculature of the fossorial family Odontophrynidae (composed of the genera Macrogenioglottus, Odontophrynus, and Proceratophrys) plus several outgroup taxa from Hyloidea and other burrowing taxa from across Anura. We found novel character-states supporting the monophyly of Odontophrynus, Proceratophrys, and Odontophrynus + Macrogenioglottus. The character-states observed in O. cultripes support conflicting phylogenetic positions within Odontophrynus. A comparison of some novel character-states with a diverse sample of burrowing taxa suggests that some modifications of the foot musculature might be involved in digging.
Tenure structure and perceived social disorder in post-WWII suburban housing estates: A multi-level study with a representative sample of estates
Authors: Kemppainen Teemu , Kauppinen Timo M , Stjernberg Mats , Sund Reijo
Published: May 2017

Studies on post-World War II housing estates have largely focused on problematic neighbourhoods, and there is a scarcity of literature on housing estates across their entire social scale. Moreover, there is insufficient evidence on the extent to which tenure structure differentiates estates from each other in terms of social disorder. Using a large cluster sample of Finnish estates representing a wide variety of estate neighbourhoods, we examined the implications of tenure structure in terms of social disadvantage and perceived social disorder. We also studied how social interaction and normative regulation mediate the impact of structural estate characteristics. We found that rental domination is associated with social disadvantage, which exposes residents to social disorder, in line with social disorganisation theory. Differences in normative regulation partly explain this association. In contrast, social interaction in the neighbourhood is not associated with the level of perceived social disorder. The theoretical and practical implications of the results are discussed.
Mental disorders in Australian 4- to 17- year olds: Parent-reported need for help
Authors: Johnson Sarah E , Lawrence David , Sawyer Michael , Zubrick Stephen R
Published: May 2017

Objective:

To describe the extent to which parents report that 4- to 17-year-olds with symptoms meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders need help, the types of help needed, the extent to which this need is being met and factors associated with a need for help.

Method:

During 2013–2014, a national household survey of the mental health of Australia’s young people (Young Minds Matter) was conducted, involving 6310 parents (and carers) of 4- to 17-year-olds. The survey identified 12-month mental disorders using the Diagnostic Interview Schedule for Children – Version IV ( n = 870) and asked parents about the need for four types of help – information, medication, counselling and life skills.

Results:

Parents of 79% of 4- to 17-year-olds with mental disorders reported that their child needed help, and of these, only 35% had their needs fully met. The greatest need for help was for those with major depressive disorder (95%) and conduct disorder (93%). Among these, 39% of those with major depressive disorder but only 19% of those with conduct disorder had their needs fully met. Counselling was the type of help most commonly identified as being needed (68%). In multivariate models, need for counselling was higher when children had autism or an intellectual disability, in blended families, when parents were distressed, and in the most advantaged socioeconomic areas.

Conclusions:

Many children and adolescents meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders have a completely unmet need for help, especially those with conduct disorders. Even with mild disorders, lack of clinical assessment represents an important missed opportunity for early intervention and treatment.
Multi-level two-way cross-chain inventory coordination model that combines the same level with different levels in multi-supply chains
Authors: Yan Bo , Cai Cong-Yan , Shi Ping
Published: May 2017

A cross-chain inventory emergency replenishment model that comprises the enterprises of manufacturers, wholesalers, and retailers at the same level and at different levels based on a co-opetition relationship in cluster supply chains is constructed in this work. The model is built by studying two three-level supply chains that each comprises manufacturers, wholesalers, and retailers using the system dynamics method. Subsequently, the proposed cross-chain inventory collaboration model is compared with currently available models and then simulated using the system dynamics simulation software Vensim. Simulation results show that the proposed model further improves existing theoretical research achievements in the field both locally and abroad, thereby advancing theoretical research on cross-chain inventory collaboration. This study also provides decision-making references for the practice of inventory collaboration among enterprises in industrial clusters.
Systematic Review of Ossicular Chain Anatomy: Strategic Planning for Development of Novel Middle Ear Prostheses
Authors: Kamrava Brandon , Roehm Pamela C.
Published: May 2017

Objective

To systematically review the anatomy of the ossicular chain.

Data Sources

Google Scholar, PubMed, and otologic textbooks.

Review Methods

A systematic literature search was performed on January 26, 2015. Search terms used to discover articles consisted of combinations of 2 keywords. One keyword from both groups was used: [ossicular, ossicle, malleus, incus, stapes] and [morphology, morphometric, anatomy, variation, physiology], yielding more than 50,000 hits. Articles were then screened by title and abstract if they did not contain information relevant to human ossicular chain anatomy. In addition to this search, references of selected articles were studied as well as suggested relevant articles from publication databases. Standard otologic textbooks were screened using the search criteria.

Results

Thirty‐three sources were selected for use in this review. From these studies, data on the composition, physiology, morphology, and morphometrics were acquired. In addition, any correlations or lack of correlations between features of the ossicular chain and other features of the ossicular chain or patient were noted, with bilateral symmetry between ossicles being the only important correlation reported.

Conclusion

There was significant variation in all dimensions of each ossicle between individuals, given that degree of variation, custom fitting, or custom manufacturing of prostheses for each patient could optimize prosthesis fit. From published data, an accurate 3‐dimensional model of the malleus, incus, and stapes can be created, which can then be further modified for each patient’s individual anatomy.
The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate
Authors: Shaffer Amber D. , Ford Matthew D. , Choi Sukgi S. , Jabbour Noel
Published: May 2017

Objective

Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate.

Study Design

Case series with chart review.

Setting

Tertiary care children’s hospital.

Subjects and Methods

Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children’s hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12 months of age. Data from 152 patients with isolated cleft palate and 166 patients with cleft lip and palate were analyzed using Wilcoxon rank‐sum, χ2, and Fisher exact test and logistic regression.

Results

Most patients (242, 76.1%) received tubes before palatoplasty. Hearing loss after tubes, but not before, was associated with speech/language delays at 24 months (P =. 005) and language delays (P =. 048) and speech sound production disorders (SSPDs, P =. 040) at 5 years. Receiving tubes before palatoplasty was associated with failed newborn hearing screen (P =. 001) and younger age at first posttubes type B tympanogram with normal canal volume (P =. 015). Hearing loss after tubes (P =. 021), language delays (P =. 025), SSPDs (P =. 003), and velopharyngeal insufficiency (P =. 032) at 5 years and speech surgery (P =. 022) were associated with more tubes.

Conclusion

Continued middle ear disease, reflected by hearing loss and multiple tubes, may impair speech and language development. Inserting tubes before palatoplasty did not mitigate these impairments better than later tube placement.
Comparing 30‐Day Morbidity and Mortality in Pediatric and Adult Otologic Surgery
Authors: Schwam Zachary G. , Michaelides Elias , Schwam Jennifer R. , Kuo Phoebe , Hajek Michael A. , Judson Benjamin L. , Schutt Christopher
Published: May 2017

Objective

To determine differences in timing and rate of postoperative adverse events among pediatric and adult populations undergoing specific otologic procedures.

Study Design

Administrative database study.

Setting

Multi‐institutional database.

Subjects and Methods

The National Surgical Quality Improvement Program (NSQIP) and NSQIP‐Pediatric (NSQIP‐P) were used to extract data from 819 adults (years 2005‐2010) and 7020 children (years 2012‐2014) undergoing tympanoplasty and (tympano)mastoidectomy, respectively. Simple summary statistics, χ2, and multivariable logistic regression analyses were performed.

Results

There were no significant differences in overall adverse event rates between adults (2.9%) and children (2.3%) (P =. 233). Adults experienced infectious complications more frequently than did children (0.4% vs 0.0%, P =. 002). Postdischarge complications accounted for 83.7% of all complications. Children treated by pediatric otolaryngologists had higher readmission rates (odds ratio [OR], 2.80; 95% confidence interval [CI], 1.20‐3.60; P =. 002). Tympanomastoidectomy was associated with higher odds of reoperation (OR, 1.02; 95% CI, 1.01‐1.03; P <. 001), as was undergoing a concurrent procedure that did not include myringotomy (OR, 3.38; 95% CI, 1.47‐7.79; P =. 004).

Conclusion

Both adult and pediatric otologic surgery are safe, with patients experiencing similarly low complication rates. Most adverse events occur after discharge.
Long‐term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia
Authors: Sanuki Tetsuji , Yumoto Eiji
Published: May 2017

Objectives

Standard treatments of adductor spasmodic dysphonia (AdSD) provide temporary relief of symptoms. Type 2 thyroplasty offers a long‐term solution; however, long‐term voice outcome data are lacking. The objective of this study was to assess the long‐term voice outcomes of type 2 thyroplasty with titanium bridges through use of a validated voice questionnaire.

Study Design

Case series with chart review.

Setting

University hospital.

Subjects and Methods

Forty‐seven consecutively enrolled patients with AdSD underwent type 2 thyroplasty with titanium bridges between August 2006 and November 2014. Questionnaires were completed during regularly scheduled follow‐ups and, in some cases, were sent to patients who missed follow‐up appointments. In 2015, questionnaires were mailed to all 47 patients and included a Voice Handicap Index–10 evaluation, as well as questions on postoperative vocal symptoms, surgical site, and status of the implanted titanium bridges.

Results

Of 47 patients with AdSD, 31 (66%) completed the questionnaires. The average follow‐up interval was 41.3 months. No patient reported experiencing an adverse event around the surgical site, and almost all were satisfied with their voices postoperatively. The mean postoperative (>3 years) Voice Handicap Index–10 score improved significantly, from 26.3 to 9.4 (n = 17, P =. 0009).

Conclusions

Type 2 thyroplasty for AdSD significantly improved patient quality of life and voice symptoms and continued to do so long after the surgery. The results of this study suggest that type 2 thyroplasty provides relief from vocal symptoms in patients with AdSD for >3 years.
Educational Cadaveric Module for Teaching Percutaneous and Intranasal Osteotomies in Rhinoplasty
Authors: Chen Jenny X. , Kozin Elliott D. , Shaye David A. , Hadlock Theresa , Lindsay Robin , Lee Linda N.
Published: May 2017

Lateral osteotomies are essential to rhinoplasty and are performed through percutaneous or intranasal approaches. Both techniques are difficult to teach as they rely on tactile feedback. Thus, it is critical to understand trainee learning curves to minimize complications. Herein, we aim to (1) demonstrate an educational module for teaching lateral osteotomies and (2) examine potential differences in outcomes between the 2 surgical approaches when performed by trainees. After a hands‐on cadaveric laboratory, trainees (n = 24) reported increased confidence in performing both types of osteotomies (P <. 0001). Completion of the bony cut was similar between intranasal and percutaneous osteotomies (96% vs 75%, P =. 097), as was correct placement of the osteotomy (75% vs 67%, P =. 53). Intranasal osteotomies were more likely to cause periosteal disruption (P =. 02). This pilot study demonstrates that cadaveric laboratories are an effective way to teach lateral osteotomies and that percutaneous osteotomies may be less likely to cause periosteal disruption in trainees’ hands.
Psychoanalysis of Investor Irrationality and Dynamism in Stock Market
Authors: Tuyon Jasman , Ahmad Zamri
Published: May 2017

This article provides an alternative theoretical framework to explain investors’ irrational behaviours in finance theories (mainly asset pricing) based on psychoanalysis approach. This is an approach used by psychoanalysts and psychiatrists to investigate human minds. The investigation is facilitated by interdisciplinary theories, namely (a) bounded rationality theory which differentiates intuition and reasoning, (b) prospect theory which explains framing and valuation and (c) theory of mind which divides behavioural risks into cognitive heuristics and affective biases. These theories collectively explain the origin of irrational behaviours. Additionally, (d) the ABC (Activating–Beliefs–Consequences) model is also used to interpret the causes and effects of irrational behaviours on investors and market behaviour. Last theory, (e) the dual system model of preference is used to conceptualize the bounded human mind that contains both rational and irrational elements. The proposed theoretical framework provides the theoretical foundation of investors’ irrational origin, forces, causes as well as their systematic effects on investors, asset prices and stock market behaviours dynamism. The validity of the theoretical framework is supported by empirical test using a representative of emerging stock market data and behavioural risk proxies.
Past and Present Nationalist Political Rhetoric in Finland: Changes and Continuities
Authors: Sakki Inari , Hakoköngäs Eemeli , Pettersson Katarina
Published: May 2017

This article focuses on nationalist political rhetoric in two historical periods in Finland. We analysed the rhetorical changes and continuities in anticommunist newspaper articles from the past (1930s) and in anti-Islam blogs in the present (2010s). We identified two similar discourses in the political rhetoric of both eras, each discourse constructed around two different Others: the external Other, the stranger from the outside world, and the internal Others, those within our own society. Our analysis identified some significant differences pertaining to the form of the rhetoric in the two studied time periods. The writers in the past used unproblematic and blatant rhetoric that often relied on metaphorical and hyperbolic expressions. The present-day bloggers painted a negative picture of the Other more often than did their counterparts of the 1930s by using factuality-enhancing strategies such as giving details, citing statistics, and drawing on expert knowledge. Importantly, moreover, the present-day discourse was characterised by defensive and counterattacking rhetorical formulations, as illustrated by the extensive denials and reversals of racism. Our analysis suggests that the discourse of Otherness seems to require much more rhetorical work and justifying proclamations in the present than in the past nationalist political rhetoric.
Does It Matter if the Consensus on Anthropogenic Global Warming Is 97% or 99.99%?
Authors: Skuce Andrew G. , Cook John , Richardson Mark , Winkler Bärbel , Rice Ken , Green Sarah A. , Jacobs Peter , Nuccitelli Dana
Published: May 2017

Cook et al. reported a 97% scientific consensus on anthropogenic global warming (AGW), based on a study of 11,944 abstracts in peer-reviewed science journals. Powell claims that the Cook et al. methodology was flawed and that the true consensus is virtually unanimous at 99.99%. Powell’s method underestimates the level of disagreement because it relies on finding explicit rejection statements as well as the assumption that abstracts without a stated position endorse the consensus. Cook et al.’s survey of the papers’ authors revealed that papers may express disagreement with AGW despite the absence of a rejection statement in the abstract. Surveys reveal a large gap between the public perception of the degree of scientific consensus on AGW and reality. We argue that it is the size of this gap, rather than the small difference between 97% and 99.99%, that matters in communicating the true state of scientific opinion to the public.
Mortality in Pediatric Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Authors: Wong Judith Ju-Ming , Jit Mark , Sultana Rehena , Mok Yee Hui , Yeo Joo Guan , Koh Jia Wen Janine Cynthia , Loh Tsee Foong , Lee Jan Hau
Published: May 2017

Objective:

Sparse and conflicting evidence exists regarding mortality risk from pediatric acute respiratory distress syndrome (ARDS). We aimed to determine the pooled mortality in pediatric ARDS and to describe its trend over time.

Data Sources and Study Selection:

MEDLINE, EMBASE, and Web of Science were searched from 1960 to August 2015. Keywords or medical subject headings (MESH) terms used included “respiratory distress syndrome, adult,” “acute lung injury,” “acute respiratory insufficiency,” “acute hypoxemic respiratory failure,” “pediatrics,” and “child.” Study inclusion criteria were (1) pediatric patients aged 0 days to 18 years, (2) sufficient baseline data described in the pediatric ARDS group, and (3) mortality data. Randomized controlled trials (RCTs) and prospective observational studies were eligible.

Data Extraction and Synthesis:

Data on study characteristics, patient demographics, measures of oxygenation, and mortality were extracted using a standard data extraction form. Independent authors conducted the search, applied the selection criteria, and extracted the data. Methodological quality of studies was assessed. Meta-analysis using a random-effects model was performed to obtain pooled estimates of mortality. Meta-regression was performed to analyze variables contributing to change in mortality over time. Eight RCTs and 21 observational studies (n = 2274 patients) were included. Pooled mortality rate was 24% (95% confidence interval [CI]: 19-31). There was a decrease in mortality rates over 3 epochs (≤2000, 2001-2009, and ≥2010: 40% [95% CI: 24-59], 35% [95% CI: 21-51], and 18% [95% CI: 12-26], respectively, P < .001). Observational studies reported a higher mortality rate than RCTs (27% [95% CI: 24-29] versus 16% [95% CI: 12-20], P < .001). Earlier year of publication was an independent factor associated with mortality.

Conclusion:

Overall mortality rate in pediatric ARDS is approximately 24%. Studies conducted and published later were associated with better survival.
From duping clients to institutional entrepreneurship in Mauritius: the account of a former BPO worker who became an activist
Authors: Emilien Blandine , Veerta Shankar
Published: May 2017

This ‘on the front line’ account allows Shankar Veerta to voice out his concerns as an activist in Mauritius. Shankar’s account provides insights into the recent work of collective actors who, as institutional entrepreneurs, aim to bring social change in Mauritius and support vulnerable workers. Mauritius has achieved its heralded economic success by adjusting consistently to liberalized regimes of the global economy. As a former business process outsourcing (BPO) worker, however, Shankar casts a critical lens on challenges facing workers operating in the new BPO sector of Mauritius. He then explains how and why he joined a local political movement that supported non-unionized workers during major industrial disputes in the BPO sector in 2011. Finally, Shankar describes the movement’s attempts to initiate divergent change through enabling conditions that have allowed it to start raising awareness among Mauritian workers and citizens.
Cost-effective propagation paths for multiple change requirements in the product design
Authors: Ullah Inayat , Tang Dunbing , Yin Leilei , Hussain Ishfaq , Wang Qi
Published: May 2017

Design projects have been surrounded by tight schedule and cost overruns. Therefore, it is indispensable to resolve the design changes in an economical way. This work introduces an advanced technique to assess and optimize change propagation paths for multiple change requirements occurring simultaneously during the product development process. A novel multiple change requirement algorithm and a mathematical model considering the overall propagated risk are developed, to explore cost-effective change propagation paths in terms of lead time. The risk is quantified with regard to propagation likelihood and change impact, which results in re-work. Design structure matrix framework is used to capture the dependencies between components. It is revealed that the change requirements execution sequence has a significant effect on the total number of change propagation paths, change steps, distinct change components, and completion time. This approach is illustrated by a case study, which indicates that the proposed methodology can assist the designer in exploring and selecting optimal change propagation paths.
Effect of the presence of moisture at the wheel–rail interface during dew and damp conditions
Authors: White BT , Nilsson R , Olofsson U , Arnall AD , Evans MD , Armitage T , Fisk J , Fletcher DI , Lewis R
Published: May 2017

Incidents involving low levels of adhesion between the wheel and rail are a recurrent issue in the rail industry. The problem has been mitigated using friction modifiers and traction enhancers, but a significant number of incidents still occur throughout the year. This study looks at the environmental conditions that surround periods of low adhesion in order to provide an insight into why low adhesion events occur. Network Rail Autumn data, which provided details on the time and location of low adhesion incidents, were compared against weather data on a national and then local scale. Low adhesion incidents have often been attributed to contamination on the rails, such as organic leaf matter, but these incidents also occur when no contamination is visible. The time, date and location of incidents were linked to local weather data to establish any specific weather conditions that could lead to these events. The effects of precipitation, temperature and humidity on rails were analysed in order to further the understanding of low adhesion in the wheel–rail contact, which will lead to adopting better methods of mitigating this problem.
Midterm Outcome of the Agility Total Ankle Arthroplasty
Authors: Raikin Steven M. , Sandrowski Kristin , Kane Justin M. , Beck David , Winters Brian S.
Published: May 2017

Background:

Ankle arthritis is a debilitating condition that causes severe functional impairment. While arthrodesis has been the gold standard of surgical treatment for this condition, significant improvements in total ankle arthroplasty have made it a viable alternative. The purpose of this study was to look at the midterm follow-up of the Agility total ankle.

Methods:

A retrospective review of prospectively collected data was conducted on 127 consecutive Agility total ankles implanted between 2002 and 2009. Charts were reviewed to collect patient demographics. In addition, coronal alignment, overall arc of motion, tibiotalar component motion, syndesmotic fusion, zones of osteolysis, and subsidence were determined. A Kaplan-Meier survival and linear regression analysis were used to predict implant failure. A multivariate regression analysis was used to assess whether radiographic measures were predictive of patient satisfaction.

Results:

Ninety (78.2%) of 115 patients retained their primary implant, of which 105 were available for evaluation, with an average follow-up of 9.1 years. Twenty-five had their implant removed. The average score for the Foot and Ankle Ability Measure (FAAM) activities of daily living subscale was 82.4, FAAM sport subscale 55.3, postoperative visual analog scale (VAS) for pain 12.7, and Short Form-12 (SF-12) Health Survey physical component 45.8 and SF-12 mental component 56.1. Average arc of motion across the implant was 22.3 and 6.3 degrees in adjacent joints. Osteolysis most commonly occurred in zones 1 and 6. No statistical differences were found in the rate or location of subsidence. Linear regression analysis demonstrated that age at the time of surgery was predictive of failure ( P = .036). Inflammatory and atraumatic arthritis demonstrated higher likelihoods of revision. No correlation was detected between radiographic parameters and outcomes scores ( P > .05; rho >0.2). A significant reduction in mean VAS pain scores by 67.6% was maintained at an average of 8 years.

Discussion:

Our results were improved over the nondesigner outcomes published in the current literature. Survivorship approached 80% at 9 years, with Kaplan-Meier 14-year survival calculated at 70.4%. Patients with their original implant were functioning with a high level of satisfaction based on statistically validated outcome scores, which was independent of the radiographic appearance of their implant. Age at the time of surgery and inflammatory/atraumatic arthritis were predictive of failure.

Level of Evidence:

Level IV, case series.
Navigating Undiagnosed Dissociative Identity Disorder in the Inpatient Setting: A Case Report
Authors: Urbina Theresa M. , May Tania , Hastings Michelle
Published: May 2017

BACKGROUND: This case illustrates previously undiagnosed dissociative identity disorder (DID) in a middle-aged female with extensive childhood trauma, who was high functioning prior to a trigger that caused a reemergence of her symptoms. The trigger sparked a dissociative state, attempted suicide, and subsequent inpatient psychiatric hospitalization. OBJECTIVE: Practitioners should include in their differential and screen for undiagnosed DID in patients with episodic psychiatric hospitalizations refractory to the standard treatments for previously diagnosed mental illnesses. DESIGN: Case study. RESULTS: During hospitalization, the diagnosis of DID became apparent and treatment included low-dose risperidone, mirtazapine, sertraline, unconditional positive regard, normalization of her dissociative states in an attempt to decrease her anxiety during treatment, and documentation for the patient via written notes following interviews. CONCLUSION: These methods helped her come to terms with the diagnosis and allowed the treatment team to teach her coping skills to lessen the impact of dissociative states following discharge.
Hold Your Traditional Discourses! A Study Exploring Newspaper and Web News Reporting of New York’s Inaugural Disability Pride Parade
Authors: Mellifont Damian
Published: May 2017

In 2015, New York held its inaugural disability pride parade to celebrate the 25th year anniversary of the Americans with Disabilities Act. To date, no study has explored the media models of disability as promoted in newspaper and web news reporting of this event. Applying critical discourse analysis to a sample of 31 news texts covering the parade obtained through a CrossSearch database query and supplementary internet search, this exploratory study reveals themes that call for improvements in areas of (1) social inclusion, (2) solidarity in the disability community and (3) treatment of people with disabilities. Also revealed by this research are progressive discourses which reflect cultural pluralism, civil rights, consumer and legal media models of disability. As the solidarity theme exists outside of prevailing progressive discourses, opportunities therefore exist for journalists to ethically report on disability in ways which reinforce and extend upon non-traditional discourses.
Thumb boutonnière deformity without rheumatoid arthritis or trauma
Authors: Hara T. , Yoneda H. , Kurimoto S. , Yamamoto M. , Iwatsuki K. , Hirata H.
Published: May 2017

Boutonnière deformity of the thumb without rheumatoid arthritis or trauma is not widely recognised. This study aimed to investigate its prevalence, relation to sex and age, and identifying factors associated with the extensor mechanism using ultrasonography. We examined 248 thumbs from 127 participants who were asymptomatic for hand disorders and had no history of hand injury. Boutonnière deformity was identified in 20 thumbs of 17 participants and was significantly more prevalent among elderly participants than among young participants. No significant differences in sex or hand dominance were noted. The deformity had a significant effect on range of motion and grip and pinch strengths. The extensor pollicis brevis (EPB) tendon was significantly narrower in affected thumbs than in non-affected thumbs. The prevalence of boutonnière deformity without rheumatoid arthritis or trauma was 13%, and the deformity was associated with advanced age and a narrow EPB tendon.

Level of evidence: III
A prospective cohort study of thoracic ultrasound in acute respiratory failure: the C3PO protocol
Authors: Wallbridge Peter D , Joosten Simon A , Hannan Liam M , Steinfort Daniel P , Irving L , Goldin J , Hew Mark
Published: May 2017

Objectives

This study was performed to assess the clinical utility of a standardised thoracic ultrasound examination when added to standard care in patients with acute respiratory failure admitted to an intermediate care unit. This study aimed to assess the impact on clinical diagnosis, clinician confidence and management. Ultrasound has been shown to have utility in patients admitted to intensive care and emergency; however, utility in a ward setting is unknown.

Design

Prospective cohort study.

Setting

Tertiary hospital in Melbourne, Australia.

Participants

50 patients with acute respiratory failure requiring admission to an intermediate care unit.

Main outcome measures

(1) Change in clinical diagnosis or additional clinical diagnosis following thoracic ultrasound. (2) Change in diagnostic confidence following thoracic ultrasound. (3) Change to management following thoracic ultrasound.

Results

In 34% of patients, ultrasound detected unexpected findings that changed or added to the clinical diagnosis. Diagnostic confidence was increased in 44%, and the treating clinician altered the management plan in 30% as a result of the ultrasound. Ultrasound was particularly useful in clarifying the diagnosis in patients with multiple initial diagnoses, reducing to a single diagnosis in 69%.

Conclusions

Thoracic ultrasound has clinical utility in non-intubated adults with acute respiratory failure managed outside intensive care settings. It changed aetiological diagnosis, increases diagnostic confidence and altered clinical management in one out of three patients scanned. Our results suggest extended utility of thoracic ultrasound in acute respiratory failure to a broader context outside the intensive care unit population.
Title, Rituals, and Land Use: The Heritage of a Nigerian Society
Authors: Opata Christian Chukwuma , Asogwa Odoja
Published: May 2017

Among the Igbo of Southeastern Nigeria, land is regarded as the source of human sustenance and the eternal sacred pot from where all plants and humans draw their powers of fertility and reproduction. The Igbo venerate land as an earth goddess. As a predominantly agrarian society, they not only deify land by instituting shrines in its honor, they also take titles that regulate ownership and use of land. This study examines the interface between title-taking, African indigenous religious rituals, and land use practices among the Nsukka Igbo of Southeastern Nigeria. In the study area, there is no taxonomical distinction between land and the earth goddess, and titles relating to land are laden with rituals whose meaning needs to be investigated. As a study in the axiology of the people, the study adopted participant observations and field investigations. It combines its findings with views in extant literature on Igbo worldview on land and land ownership and sifts the difference between the Nsukka Igbo and other Igbo people. The research is anchored on the theory of cultural peculiarity. This line of thought, it is hoped, would clarify some of the gray and contentious issues about rituals and inheritance in the study area. Such clarification would help reduce the tension between those who take such titles and those, for reasons of cultural barriers, do not have the right to do so.
Transformative city branding for policy change: The case of Seoul’s participatory branding
Authors: Joo Yu-Min , Seo Bokyong
Published: May 2017

City branding has been widely adopted by entrepreneurial local governments to strengthen city identities and to attract global attention amid intensified intercity competition. Asian global cities, in particular, have competitively branded themselves to signal that they belong to the group of advanced global cities. This paper illustrates the transformative role of city branding in the making of a global city’s local identity, which has been hitherto underexplored in the literature. Specifically, it examines Seoul’s branding exercises, focusing on its unconventional projects that reflect the city’s recent efforts to become a “human-centered,” progressive city. We suggest adding a “transformative-enhancing” dimension to the existing “external–internal” city-branding framework, and argue that Seoul’s transformative city branding is, in fact, communicating the mayor’s new signature policies with citizens. When combined with a strong mayor’s efforts to cater to changing societal pressures, city branding is no longer solely a neoliberal marketing exercise, but a political project of policy change.
A meta-analysis of genome-wide association studies of asthma in Puerto Ricans
Authors: Yan Qi , Brehm John , Pino-Yanes Maria , Forno Erick , Lin Jerome , Oh Sam S. , Acosta-Perez Edna , Laurie Cathy C. , Cloutier Michelle M. , Raby Benjamin A. , Stilp Adrienne M. , Sofer Tamar , Hu Donglei , Huntsman Scott , Eng Celeste S. , Conomos Matthew P. , Rastogi Deepa , Rice Kenneth , Canino Glorisa , Chen Wei , Barr R. Graham , Burchard Esteban G. , Celedón Juan C.
Published: May 2017

Puerto Ricans are disproportionately affected with asthma in the USA. In this study, we aim to identify genetic variants that confer susceptibility to asthma in Puerto Ricans.

We conducted a meta-analysis of genome-wide association studies (GWAS) of asthma in Puerto Ricans, including participants from: the Genetics of Asthma in Latino Americans (GALA) I-II, the Hartford–Puerto Rico Study and the Hispanic Community Health Study. Moreover, we examined whether susceptibility loci identified in previous meta-analyses of GWAS are associated with asthma in Puerto Ricans.

The only locus to achieve genome-wide significance was chromosome 17q21, as evidenced by our top single nucleotide polymorphism (SNP), rs907092 (OR 0.71, p=1.2×10−12) atIKZF3. Similar to results in non-Puerto Ricans, SNPs in genes in the same linkage disequilibrium block asIKZF3(e.g. ZPBP2,ORMDL3andGSDMB) were significantly associated with asthma in Puerto Ricans. With regard to results from a meta-analysis in Europeans, we replicated findings for rs2305480 atGSDMB, but not for SNPs in any other genes. On the other hand, we replicated results from a meta-analysis of North American populations for SNPs atIL1RL1,TSLPandGSDMBbut not forIL33.

Our findings suggest that common variants on chromosome 17q21 have the greatest effects on asthma in Puerto Ricans.
Defining asthma–COPD overlap syndrome: a population-based study
Authors: Bonten Tobias N. , Kasteleyn Marise J. , de Mutsert Renee , Hiemstra Pieter S. , Rosendaal Frits R. , Chavannes Niels H. , Slats Annelies M. , Taube Christian
Published: May 2017

Asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) seems an important clinical phenotype, but multiple definitions have been proposed. This study's objectives were to assess the effect of different ACOS definitions on prevalence, patient characteristics and exacerbations.

5675 individuals aged 45–65 years, with 846 asthma/COPD patients, were included in the Netherlands Epidemiology of Obesity study between 2008 and 2012, and followed-up for a median of 1.8 years. ACOS was defined by recent consensus criteria and five other definitions, based on registry, questionnaires and lung function.

Prevalence of ACOS in the asthma/COPD population ranged between 4.4% and 38.3%, depending on the definition used. Agreement between registry-based and self-reported ACOS was 0.04 and 0.41 when lung function (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7) was added. With registry or self-report defined ACOS, only 51% and 33% had FEV1/FVC <0.7. Patient characteristics were similar, but asthma duration was longer with self-reported compared with registry-based ACOS (mean difference 22 years (95% CI 12–33)). Exacerbation risk was highest with registry-based ACOS compared with asthma (adjusted incidence rate ratio 1.6 (95% CI 1.2–2.1)).

This study adds important knowledge about agreement between ACOS definitions and their relation with exacerbations. Given the low agreement, differences in prevalence, patient characteristics and risk of exacerbations, consensus about ACOS definition in different care settings is urgently needed.
Differences between asthma–COPD overlap syndrome and adult-onset asthma
Authors: Tommola Minna , Ilmarinen Pinja , Tuomisto Leena E. , Lehtimäki Lauri , Haanpää Jussi , Niemelä Onni , Kankaanranta Hannu
Published: May 2017

Differences between asthma–COPD overlap syndrome (ACOS) and adult-onset asthma are poorly understood. This study aimed to evaluate these differences in a clinical cohort of patients with adult-onset asthma, as a part of the Seinäjoki Adult Asthma Study (SAAS).

188 patients were diagnosed with adult-onset asthma and re-evaluated 12 years after diagnosis. They were divided into three groups based on smoking history and post bronchodilator spirometry values: 1) never- and ex-smokers with <10 smoked pack-years; 2) non-obstructive (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7) patients with ≥10 pack-years; and 3) ACOS patients with ≥10 pack-years and FEV1/FVC <0.7.

ACOS patients had lower diffusing capacity (DLCO/VA86% predictedversus98 or 96% predicted; p<0.001), higher blood neutrophil levels (4.50versus3.60 or 3.85×109L−1; p=0.008), and higher IL-6 levels (2.88versus1.52 or 2.10 pg·mL−1, p<0.001) as compared to never- and ex-smokers with <10 pack-years, or non-obstructive patients with ≥10 pack-years smoking history, respectively. ACOS patients also showed reduced lung function, higher remaining bronchial reversibility and a higher number of comorbidities.

This study shows distinct differences in diffusing capacity, blood neutrophil and IL-6 levels, bronchial reversibility, lung function and comorbidities between ACOS and adult-onset asthma. The present findings should be considered in the comprehensive assessment of adult asthma patients.
Th-2 signature in chronic airway diseases: towards the extinction of asthma−COPD overlap syndrome?
Authors: Cosío Borja G. , Pérez de Llano Luis , Lopez Viña Antolin , Torrego Alfons , Lopez-Campos Jose Luis , Soriano Joan B. , Martinez Moragon Eva , Izquierdo Jose Luis , Bobolea Irina , Callejas Javier , Plaza Vicente , Miravitlles Marc , Soler-Catalunya Juan Jose
Published: May 2017

We aimed to describe the differences and similarities between patients with chronic obstructive airway disease classified on the basis of classical diagnostic labels (asthma, chronic obstructive pulmonary disease (COPD), or asthma–COPD overlap (ACOS)) or according to the underlying inflammatory pattern (Th-2 signature, either Th-2-high or Th-2-low).

We performed a cross-sectional study of patients aged ≥40 years and with a post-bronchodilator forced expiratory volume in 1 s to forced vital capacity ratio ≤0.7 with a previous diagnosis of asthma (non-smoking asthmatics (NSA)), COPD or ACOS, the latter including both smoking asthmatics (SA) and patients with eosinophilic COPD (COPD-e). Clinical, functional and inflammatory parameters (blood eosinophil count, IgE and exhaled nitric oxide fraction (FeNO)) were compared between groups. Th-2 signature was defined by a blood eosinophil count ≥300 cells·μL−1and/or a sputum eosinophil count ≥3%.

Overall, 292 patients were included in the study: 89 with COPD, 94 NSA and 109 with ACOS (44 SA and 65 with COPD-e). No differences in symptoms or exacerbation rate were found between the three groups. With regards the underlying inflammatory pattern, 94 patients (32.2%) were characterised as Th-2-high and 198 (67.8%) as Th-2-low. The Th-2 signature was found in 49% of NSA, 3.3% of patients with COPD, 30% of SA and 49.3% of patients with COPD-e. This classification yielded significant differences in demographic, functional and inflammatory characteristics.

We conclude that a classification based upon the inflammatory profile, irrespective of the taxonomy, provides a more clear distinction of patients with chronic obstructive airway disease.
RETRACTED ARTICLE: Effect of catalpol on remyelination through experimental autoimmune encephalomyelitis acting to promote Olig1 and Olig2 expressions in mice
Authors: Yang Tao , Zheng Qi , Wang Su , Fang Ling , Liu Lei , Zhao Hui , Wang Lei , Fan Yongping
Published: May 2017

Background

Multiple sclerosis (MS) as an autoimmune disorder is a common disease occurring in central nervous system (CNS) and the remyelination plays a pivotal role in the alleviating neurological impairment in the MS. Catalpol, an effective component extracted from the Chinese herb Radix Rehmanniae, which has been proved protective in cerebral diseases.

Methods

To determine the protective effects and mechanisms of Catalpol on MS, the mice with experimental autoimmune encephalomyelitis (EAE) were induced by myelin oligodendrocyte glycoprotein (MOG) 35–55, as a model for human MS. Th17 cells were counted by flow cytometric (FCM). The expressions of nerve-glial antigen (NG) 2 and myelin basic protein (MBP) were measured by immunohistochemical staining. Olig1+ and Olig2+/BrdU+ cells were counted by immunofluorescence. Olig1 and Olig2 gene expressions were detected by real-time fluorescent quantitative reverse transcription (qRT) -PCR.

Results

The results showed that Catalpol improved neurological function, reduced inflammatory cell infiltration and demyelination. It could decrease Th17 cells in the peripheral blood. It increased the protein expressions of NG2 and MBP in mice brains, up-regulated markedly protein and gene expressions of Olig1 and Olig2 in terms of timing, site and targets.

Conclusions

These data demonstrated that Catalpol had a strong neuroprotective effect on EAE mice. Catalpol also plays a role in remyelination by promoting the expressions of Olig1 and Olig2 transcription factors.
A qualitative evaluation of scalpel skill teaching of podiatry students
Authors: Causby Ryan S , McDonnell Michelle N , Reed Lloyd , Fryer Caroline E , Hillier Susan L
Published: May 2017

Background

Degrees in health disciplines need a balance of theoretical knowledge and sufficient clinical practice to meet registration requirements, in particular those requiring specialist skills such as the use of scalpels and other small instruments, such as podiatry. However, despite this requirement there is a scarcity of literature and research to inform teaching of these particular manual clinical skills. Therefore, the aims of this study were to determine the current approaches being used to teach manual skills, in particular scalpel skills, in university podiatry programs in Australia and New Zealand, and to explore what issues, challenges and innovations exist.

Methods

A qualitative study, consisting of semi‐structured interviews with staff at eight university podiatry programs in Australia and New Zealand was undertaken to determine how these skills are taught and evaluated, and how poor performers are managed. A conventional content analysis technique was used to analyse and code interview data, with the resultant categories reported.

Results

Approaches to teaching manual clinical skills, in particular scalpel skills, appear to be consistent between university programs in Australia and New Zealand in utilising didactic‐style content, demonstration, physical practice on inanimate objects and real skin, and often the use of supplementary audio‐visual material. The main reported differences between programs were in methods and processes of practice, with controversy regarding the use of inanimate objects versus real skin for practice.

Conclusions

Despite a lack of research and literature surrounding this topic, the approach to teaching is relatively consistent between programs with greatest disparity being the structure and duration of practice. Key issues for teaching staff in teaching manual skills were students' clinical exposure, motivation, levels of anxiety and dexterity.