bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of couple stress parameter on steady-state and dynamic characteristics of three-lobe journal bearing operating on TiO2 nanolubricant
Authors: Kumar Ashutosh , Kakoty SK
Published: July 2019

Steady-state and dynamic performance parameters of three-lobe fluid film bearing, operating on TiO2 nanolubricant have been obtained. The effective viscosity for a given volume fraction of TiO2 nanoparticle in base fluid is obtained by using Krieger–Dougherty viscosity model. Various bearing performance parameters are obtained by solving remodeled Reynolds equation, which includes couple stress parameter. The stiffness and damping coefficients are also obtained for different values of the couple stress parameter. Results show a significant rise in the nondimensional load-carrying capacity and flow coefficient while there is a decrease in friction variable. It also reveals a significant improvement in the dynamic coefficient of bearing.
Impact of journal bending on the failure of axle bearings in railroad passenger cars
Authors: Chang Wei , Xu Hua , Zhang Xi , Xing Yu , Meng Wei , Li Huawei , Li Xinhui
Published: July 2019

This research presents a systematic methodology to analyze the failure mechanism of cylindrical roller bearings of railroad passenger cars. Initially, a finite element model is developed to calculate the journal bending and internal contact load distribution, considering multi-interfacial contact parameters. Then, non-Hertzian contact theory is applied to prove the rollers’ abnormal contact behaviors, including load-distribution and displacement. Subsequently, a grease lubrication model is developed to study bearings lubrication under different operating conditions. Additionally, an exact service life model from ISO standards is used to evaluate the effect of journal bending. Finally, a system failure mechanism can be summarized and validated in the experiments, also helpful for axle box system bearings design and assembly.
Relationships between the use of pharmacomechanical catheter-directed thrombolysis, sonographic findings, and clinical outcomes in patients with acute proximal DVT: Results from the ATTRACT Multicenter Randomized Trial
Authors: Weinberg Ido , Vedantham Suresh , Salter Amber , Hadley Gail , Al-Hammadi Noor , Kearon Clive , Julian Jim A , Razavi Mahmood K , Gornik Heather L , Goldhaber Samuel Z , Comerota Anthony J , Kindzelski Andrei L , Schainfeld Robert M , Angle John F , Misra Sanjay , Schor Jonathan A , Hurst Darren , Jaff Michael R ,   for the ATTRACT Trial Investigators
Published: July 2019

Few studies have documented relationships between endovascular therapy, duplex ultrasonography (DUS), post-thrombotic syndrome (PTS), and quality of life (QOL). The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial randomized 692 patients with acute proximal deep vein thrombosis (DVT) to receive anticoagulation or anticoagulation plus pharmacomechanical catheter-directed thrombolysis (PCDT). Compression DUS was obtained at baseline, 1 month and 12 months. Reflux DUS was obtained at 12 months in a subset of 126 patients. Clinical outcomes were collected over 24 months. At 1 month, patients who received PCDT had less residual thrombus compared to Control patients, evidenced by non-compressible common femoral vein (CFV) (21% vs 35%, p < 0.0001), femoral vein (51% vs 70%, p < 0.0001), and popliteal vein (61% vs 74%, p < 0.0001). At 12 months, in the ultrasound substudy, valvular reflux prevalence was similar between groups (85% vs 91%, p = 0.35). CFV non-compressibility at 1 month was associated with higher rates of any PTS (61% vs 46%, p < 0.001), a higher incidence of moderate-or-severe PTS (30% vs 19%, p = 0.003), and worse QOL (difference 8.2 VEINES-QOL (VEnous INsufficiency Epidemiological and Economic Study on Quality of Life) points; p = 0.004) at 24 months. Valvular reflux at 12 months was associated with moderate-or-severe PTS at 24 months (30% vs 0%, p = 0.01). In summary, PCDT results in less residual thrombus but does not reduce venous valvular reflux. CFV non-compressibility at 1 month is associated with more PTS, more severe PTS, and worse QOL at 24 months. Valvular reflux may predispose to moderate-or-severe PTS. ClinicalTrials.gov Identifier NCT00790335.
Agency and life satisfaction in Bedouin children exposed to conditions of chronic stress and military violence: A two-wave longitudinal study in Palestine
Authors: Veronese Guido , Pepe Alessandro , Obaid Hania , Cavazzoni Federica , Perez Jesus
Published: July 2019

Bedouin children in Palestine are at risk of developing trauma-related pathologies as a result of chronic exposure to severe political and military violence. Little is known about their coping abilities and survival skills. The aim of our study was to longitudinally test the contribution of agency to predicting life satisfaction and the power of life satisfaction to mitigate traumatic stress in a group of Bedouin children exposed to prolonged military violence in West Bank, occupied Palestinian territories. We expected that children who maintained good levels of satisfaction over the time would be less at risk of developing stress- and trauma-related syndromes and that agency would act as a predeterminant of mitigated traumatic reactions. A quantitative cross-lagged path model (CLPM) research design was implemented. One hundred forty-three Palestinian children were administered with Children’s Hope Scale, Multidimensional Student Life Satisfaction Scale, Children’s Impact of Event Scale, and a built ad hoc traumatic checklist. The results provided support for all the study hypotheses, suggesting that in general Bedouin children draw on a considerable range of resources in adjusting to their chronically traumatic life context. Implications for clinical work and future research are discussed.
Scanpath similarity measure reveals not only a decreased social preference, but also an increased nonsocial preference in individuals with autism
Authors: Król Magdalena Ewa , Król Michał
Published: July 2019

We compared scanpath similarity in response to repeated presentations of social and nonsocial images representing natural scenes in a sample of 30 participants with autism spectrum disorder and 32 matched typically developing individuals. We used scanpath similarity (calculated using ScanMatch) as a novel measure of attentional bias or preference, which constrains eye-movement patterns by directing attention to specific visual or semantic features of the image. We found that, compared with the control group, scanpath similarity of participants with autism was significantly higher in response to nonsocial images, and significantly lower in response to social images. Moreover, scanpaths of participants with autism were more similar to scanpaths of other participants with autism in response to nonsocial images, and less similar in response to social images. Finally, we also found that in response to nonsocial images, scanpath similarity of participants with autism did not decline with stimulus repetition to the same extent as in the control group, which suggests more perseverative attention in the autism spectrum disorder group. These results show a preferential fixation on certain elements of social stimuli in typically developing individuals compared with individuals with autism, and on certain elements of nonsocial stimuli in the autism spectrum disorder group, compared with the typically developing group.
Pediatric complex care and surgery comanagement: Preparation for spinal fusion
Authors: Berry Jay G , Glaspy Tyler , Eagan Brian , Singer Sara , Glader Laurie , Emara Norah , Cox Joanne , Glotzbecker Michael , Crofton Charis , Ward Erin , Leahy Izabela , Salem Joseph , Troy Michael , O’Neill Margaret , Johnson Connor , Ferrari Lynne
Published: July 2019

The aim of this study is to assess the impact of preoperative comanagement with complex care pediatricians (CCP) on children with neuromuscular scoliosis undergoing spinal fusion. We performed chart review of 79 children aged 5–21 years undergoing spinal fusion 1/2014–6/2016 at a children’s hospital, with abstraction of clinical documentation from preoperative health evaluations performed regularly by anesthesiologists and irregularly by a CCP. Preoperative referrals to specialists, labs, tests, and care plans needed last minute for surgical clearance were measured. The mean age at surgery was 14 (SD 3) years; cerebral palsy (64%) was the most common neuromuscular condition. Thirty-nine children (49%) had a preoperative CCP evaluation a median 63 days (interquartile range (IQR) 33–156) before the preanesthesia visit. Children with CCP evaluation had more organ systems affected by coexisting conditions than children without an evaluation (median 11 (IQR 9–12) vs. 8 (IQR 5–11); p < .001). The rate of last-minute care coordination activities required for surgical clearance was lower for children with versus without CCP evaluation (1.8 vs. 3.6). A lower percentage of children with CCP evaluation required last-minute development of new preoperative plans (26% vs. 50%, p = .002). Children with CCP involvement were better prepared for surgery, requiring fewer last-minute care coordination activities for surgical clearance.
The celebritization of self-care: The celebrity health narrative of Demi Lovato and the sickscape of mental illness
Authors: Franssen Gaston
Published: July 2019

Using the threatened yet ultimately reconfirmed celebrity status of pop singer and mental health advocate Demi Lovato as a case study, this article analyzes how celebrity health narratives reflect and produce a neoliberal ideology of individuality in the context of mental health care. It is argued that Lovato has successfully rebranded herself as the embodiment of achievement, self-improvement and confidence by embracing her diagnosis with bipolar disorder and other mental health struggles. Furthermore, the article demonstrates how her celebrity health narrative has been repackaged and reproduced by the merchandizing industry, providing general lifestyle advice about the value of ongoing self-improvement. This convergence between the ‘sickscape’ of mental illness and celebrity culture can be understood as a ‘celebritization of self-care’, which reproduces a hyper-individualized, neoliberal and distinctly gendered ideology of meritocracy, and presents all forms of achievement, including recovery from mental illness, as the result of competitive individualism.
The making of authentic tortellini: Aestheticization of artisanal labor and elite univorism in the case of local food
Authors: Arfini Elisa A.G.
Published: July 2019

In this article, I will look at two distinct Bolognese practices within the tortellini commodity circuit as a case in the cultural production of traditional local food. The article is based on ethnographic observation of laboratories in the city of Bologna, interviews with ‘sfogline’ [skilled workers] and with the ‘Dotta Confraternita del Tortellino’, a local association of amateurs responsible for the filing of the traditional recipe in 1974. By analyzing two practices of valorization of one product, I will point out two different simultaneous enactments of aesthetic and moral values. Two contrasting aesthetic framings – the artisanal craftsmanship of skilled workers (sfogline) and the exclusive practices of elite gourmand (Confraternita) – revolve around tortellini. They will allow us to address two main theoretical issues: the construction of elite consumption practices based on aesthetics and the orchestration of aesthetics and moralities at different stages of the social life of a traditional food product.
A scenario-based methodology for determining fire resistance ratings of irregular steel structures
Authors: Behnam Behrouz
Published: July 2019

This article investigates the response of irregular steel structures under natural fires. As the severity and duration of natural fires depend on many factors, a probabilistic-based approach known as two-level factorial design is used, whereby possible fire scenarios are considered based on the minimum and maximum values of the involved factors. Two seven-story regular steel structures with three span lengths of 5500 and 7000 mm are designed to meet a 2.0-hr fire resistance rating based on the ISO834 fire. Two types of irregularities, setback and soft story, are then imposed on the regular structures to make them irregular. The regular and irregular structures are then exposed to the fire scenarios (32 in total) to evaluate their fire resistance ratings. The results show that while the regular structures are able to meet the required fire resistance rating under all of the fire scenarios, this is not the case for the irregular structures. It is shown that the reduction in the fire resistance ratings of the setback and the soft-story structures can be as low as 45% and 33% that of the required fire resistance ratings, respectively. Also, the setback irregular structures tend to collapse laterally, hence endangering the safety of adjacent buildings. To address the above deficiencies, it is proposed here that the maximum surface temperature on the structural members should be limited to 415°C–460°C. Alternatively, providing a 20%–25% increase in the insulation thickness can provide the required safety margin as dictated by fire codes.
How youth become workers: Identity, inequality and the post-Fordist self
Authors: Farrugia David
Published: July 2019

Post-Fordism describes a situation in which precarity and un/underemployment becomes normalised while the requirement for young people to seek subjectivity through work is intensified. In this context, this article draws on interviews with youth living in regions of high youth unemployment to examine how young people create identities as workers. The article shows that young people approach the cultivation of a working self in terms of how the capacity for productive labour contributes to projects of ‘self-realisation’. Classed subjectivities are formed through the different ethics through which young people approach the formation of the self as a worker. This demonstrates how the disciplinary requirements of work contribute to the contemporary experience of class among youth. The article concludes by suggesting that generational shifts in the experience of youth currently associated with employment insecurity can be usefully understood in terms of the dynamics of post-Fordist labouring subjectivities.
Does really no one care? Analyzing the public engagement of communication scientists on Twitter
Authors: Jünger Jakob , Fähnrich Birte
Published: July 2019

Recent publications question the public visibility of communication science as a discipline and its relevance for the broader society. To address this issue, we analyze the public engagement of communication scientists by using the example of their Twitter activity. We theoretically distinguish eight types of engagement and explore their empirical prevalence. The results show that a large share of communication is between peers, fulfilling social networking functions. Nevertheless, more than a quarter of the tweets are on political and social topics. In this way, communication scientists bring society into their scholarly community and thus act as bridge builders. They also reach diverse publics outside of science, such as followers from the field of economics. Our study thus highlights the diversity of connections between science and society and can offer a starting point to further research other fields of public engagement and the impact of the discipline on the public discourse.
Multimodal content analysis: expanding analytical approaches to content analysis
Authors: Serafini Frank , Reid Stephanie F
Published: July 2019

Research methods and analytical approaches that support inquiry in the social sciences need to respond to continual changes in the theoretical frameworks, research methods, and technologies used to support data collection and analysis in contemporary research frameworks. This article describes a variation of qualitative content analysis, termed ‘multimodal content analysis’, that draws upon previous iterations of qualitative content analysis, interpretivist research designs, deductive and inductive reasoning, qualitative data collection and analysis methods, and theories of multimodality for conceptualizing and analyzing a selected corpus of multimodal phenomena. In addition, the analysis of selected commercial wine labels is presented to offer researchers an example of multimodal content analysis to guide future research and open up a dialogue focusing on the potential advantages and challenges to researching multimodal phenomena.
Professionals’ views and experiences in supporting decision-making involvement for people living with dementia
Authors: Sinclair Craig , Bajic-Smith Julie , Gresham Meredith , Blake Meredith , Bucks Romola S , Field Sue , Clayton Josephine M , Radoslovich Helen , Agar Meera , Kurrle Susan
Published: July 2019

Background

The provision of supported decision-making for people living with disabilities is an emerging area of practice and rights-based law reform, and is required under international law.

Objectives

This qualitative study aimed to understand how Australian health and legal professionals conceptualised their professional roles in the practice of providing decision-making support for people living with dementia.

Methods

The methods were informed by grounded theory principles. In-depth, semi-structured interviews were conducted with 28 health and legal professionals involved in providing care or services for people with dementia. Interviews explored how professionals described their practice of providing support for decision-making and how they conceptualised their roles. The analysis was underpinned by the theoretical perspective of symbolic interactionism.

Results

Participants described providing support across a range of decision domains, some of which were specific to their professional role. Four key themes were identified: ‘establishing a basis for decision-making’, ‘the supportive toolbox’, ‘managing professional boundaries’ and ‘individualist advocacy versus relational practice’. Participants identified a range of generic and specialised techniques they used to provide support for people with dementia. These techniques were applied subject to resource limitations and perceived professional obligations and boundaries. A continuum of professional practice, ranging from ‘individualist advocacy’ to ‘relational practice’ describes the approaches adopted by different professionals.

Discussion

Professionals conceptualised their role in providing support for decision-making through the lens of their own profession. Differences in positioning on the continuum of ‘individualist advocacy’ through to ‘relational practice’ had practical implications for capacity assessment, engaging with persons with impaired decision-making capacity, and the inclusion of supporters and family members in decision-making processes. Further progress in implementing supported decision-making (including through law and policy reform) will require an understanding of these inter-professional differences in perceived roles relating to the practice of providing decision-making support.
We are not third parties: Exploring conflict between action researchers and stakeholders as the engine of transformation
Authors: Larrea Miren
Published: July 2019

Action research has approached conflict mainly through the concept of conflict resolution, where action researchers play a role as third parties acting as organizers, conveners, and facilitators. This paper proposes a complementary role as stakeholders in the conflicts of territorial development and thus, as one more part in conflict. This is done in the context of one specific approach to action research, namely, action research for territorial development and one specific project, the Territorial Development Laboratory initiated in 2009 in Gipuzkoa, Basque Country, Spain. The paper argues that the ideological and political positions of action researchers, legitimated by the other stakeholders through the action research process, give them a stake in territorial development conflicts. It also revisits the interpretation of participation in action research in order to conceptualize action researchers’ role as stakeholders in the conflicts of territorial development. These discussions are of interest for any action researcher wanting to explore her or his role as a part in conflict in action research processes and not exclusively as a third party facilitating the process.
Experiences of adult learners on using the Sakai Learning Management System for learning in Ghana
Authors: Biney Isaac Kofi
Published: July 2019

The advancement in information and communication technology and its application in teaching and learning tools have taken learning to a higher level. Innovations in information and communication technology and its deployment in teaching and learning aid adult learning through the distance education mode. Accra Learning Centre hosts the biggest student population pursuing degree programmes through the distance education mode in Ghana. Simple descriptive statistics were adopted to help build a case for using the qualitative data. A descriptive narrative design was employed for conducting the study which tilts towards the qualitative case study approach to investigate the meanings and experiences adult learners have had when using the Sakai Learning Management System platform. In-depth interviews and focus group discussions were used to collect data from 50 adult learners who participated in the study. Most (80%) of the learners indicated that they faced difficulties, including accessing computers, course materials online, weak link, poor network interface and connectivity, as well as power fluctuations when they started learning with the Sakai Learning Management System, which changed with time. The information and communication technology platform created greater access to self-learning. The study concludes that the information and communication technology laboratories should be refurbished – and equipped with new computer accessories – for an increased access to the Sakai Learning Management System.
Older Adults’ Experience With Fall Prevention Recommendations Derived From the STEADI
Authors: Vincenzo Jennifer L. , Patton Susan Kane
Published: July 2019

The Centers for Disease Control and Prevention (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit is a national effort to prevent falls among older adults. Studies have been conducted on implementation of the STEADI, but no studies have investigated older adults’ adherence to or perceptions of fall prevention recommendations delineated within the STEADI algorithm. Semistructured interviews were conducted with a purposive sample of older adults 6 months after attending a falls risk assessment. Seventy-nine percent accurately recalled their fall risk, 57% followed one or more recommendations, and 32% did not recall at least one recommendation correctly. The most common recommendation recalled and adhered to was exercise. No participants recalled or adhered to recommendations including medication review, taking time changing positions, vision check, podiatrist visit, or physical therapy. Thirty-two percent fell. Of these, 55.6% did not follow any recommendations. Interview transcripts were analyzed using comparative methodology following the tenets of thematic analysis. Three themes emerged: participating in fall prevention, barriers to following recommendations, and providers can encourage people to prevent falls. An unexpected facilitator to participation in fall prevention efforts emerged—older adults’ perception that they were positively influencing society by participating in research and working with students and the university. This finding provides an opportunity for providers of health education to address the growing public health issue of falls among older adults while also creating opportunities for students to engage in community service and interdisciplinary service learning.
New Media Goes to the Movies: Digitizing the Theatrical Audience
Authors: Hallinan Blake , Reynolds C. J.
Published: July 2019

Movie theaters typically appear adjacent to discussions of new media. Although there has been work on digital cinema, we shift the focus from the digitization of the medium to the digitization of the theatrical audience and analyze the movie theater as new media. To do so, we look at the historical and contemporary strategies for digitizing the theatrical audience of a prominent theater chain. We identify common media of digitization, including credit cards, computerized point-of-sale systems, and loyalty programs. The origins of these techniques and imperatives trace back to the 1970s and 1980s, even as they take on new forms today. We then analyze the industrial logics of audience digitization and emergent communication and data collection methods. Finally, we analyze the movie theater as a platform, showing both the relevance of movie theaters and the challenges their inclusion as an object of study poses for contemporary platform studies.
On the adaptability of ensemble methods for distributed classification systems: A comparative analysis
Authors: Villaverde Mónica , Aledo David , Pérez David , Moreno Félix
Published: July 2019

In this work, a two-stage architecture is used to analyze the information collected from several sensors. The first stage makes classifications from partial information of the entire target (i.e. from different points of view or from different kind of measures) using a simple artificial neural network as a classifier. In addition, the second stage aggregates all the estimations given by the ensemble in order to obtain the final classification. Four different ensembles methods are compared in the second stage: artificial neural network, plurality majority, basic weighted majority, and stochastic weighted majority. However, not only reliability is an important factor but also adaptation is critical when the ensemble is working in changing environments. Therefore, the artificial neural network and the plurality majority algorithm are compared against our two proposed adaptive algorithms. Unlike artificial neural network, majority methods do not require previous training. The effects of improving the first stage and how the system behaves when different perturbations are presented have been measured. Results have been obtained from two applications: a realistic one and another simpler one, with more training examples for a more accurate comparison. These results show that artificial neural network is the most accurate proposal, whereas the most innovative proposed stochastic weighted voting is the most adaptive one.
Development of novel patient selection criteria for a short stay endovascular aneurysm repair pathway: Improving patient selection for short stay endovascular aneurysm repair
Authors: Preece Ryan , Shaw Sarah , Wiltshire Joseph , Stenson Katherine , Budge James , De Bruin Jorg , Loftus Ian , Holt Peter , Patterson Benjamin
Published: July 2019

Objectives

A short-stay endovascular aneurysm repair (SS-EVAR) pathway for infrarenal abdominal aortic aneurysms offers the potential to improve service efficiency and patient satisfaction by reducing the hospital length of stay. This study aimed to determine whether the implementation of a novel set of patient selection criteria for a theoretical SS-EVAR pathway could facilitate an expansion of the proportion of suitable patients, whilst maintaining patient safety and limiting unplanned emergency readmissions.

Methods

Two SS-EVAR selection criteria (low and high risk) were generated based upon patient pre-operative comorbidities. The low risk criteria essentially selected fit and healthy individuals, whereas the high risk criteria included patients with a range of comorbidities that could still theoretically enable enrolment onto a SS-EVAR pathway. A retrospective analysis, whereby both criteria were applied to all elective EVARs recorded in the National Vascular Registry between 2013 and 2016 at a single tertiary vascular unit was performed. Rates and timings of postoperative complications, reinterventions and unplanned readmissions for patients meeting each criteria were assessed.

Results

In total, 188 patients were included (92% male, mean age 75.4 ± 7.2 years). Twenty-nine patients (15%) met the low risk criteria. Two (7%) of these experienced an inpatient complication which were both detected within 24 h of operation (including one who required reintervention), and no patients in this group had an unplanned readmission within 30 days. One-hundred and ten patients (59%) met our high risk criteria and 19 (17%) experienced an inpatient complication, with 4 (4%) of these occurring beyond 24 h post-EVAR (three urinary problems and one acute on chronic kidney injury). Six (6%) of these patients required a reintervention; however, all of these complications were detected within 24 h. Two (2%) high risk cohort patients required unplanned readmission within 30 days for a femoral pseudoaneurysm and musculoskeletal back pain.

Conclusions

With high risk patient selection criteria and appropriate post-operative safeguards, up to 60% of infrarenal abdominal aortic aneurysms patients could be safely enrolled onto a next-day discharge SS-EVAR pathway with minimal readmissions, thus allowing more effective resource utilisation.
Non-invasive sensor technology for prehospital stroke diagnosis: Current status and future directions
Authors: Walsh Kyle B
Published: July 2019

Background

The diagnosis of stroke in the prehospital environment is the subject of intense interest and research. There are a number of non-invasive external brain monitoring devices in development that utilize various technologies to function as sensors for stroke and other neurological conditions. Future increased use of one or more of these devices could result in substantial changes in the current processes for stroke diagnosis and treatment, including transportation of stroke patients by emergency medical services.

Aims

The present review will summarize information about 10 stroke sensor devices currently in development, utilizing various forms of technology, and all of which are external, non-invasive brain monitoring devices.

Summary of review

Ten devices are discussed including the technology utilized, the indications for use (stroke and, when relevant, other neurological conditions), the environment(s) indicated for use (with a focus on the prehospital setting), a description of the physical structure of each instrument, and, when available, findings that have been published in peer-reviewed journals or otherwise reported. The review is organized based on the technology utilized by each device, and seven distinct forms were identified: accelerometers, electroencephalography (EEG), microwaves, near-infrared, radiofrequency, transcranial doppler ultrasound, and volumetric impedance phase shift spectroscopy.

Conclusions

Non-invasive external brain monitoring devices are in various stages of development and have promise as stroke sensors in the prehospital setting. Some of the potential applications include to differentiate stroke from non-stroke, ischemic from hemorrhage stroke, and large vessel occlusion (LVO) from non-LVO ischemic stroke. Successful stroke diagnosis prior to hospital arrival could transform the current diagnostic and treatment paradigm for this disease.
Representing torture in Zero Dark Thirty (2012): Popular culture as a site of norm contestation
Authors: Schlag Gabi
Published: July 2019

The global war on terror (GWOT) is undoubtedly the most recent case where a government authorized ‘enhanced interrogation techniques’, a euphemism for torture. In addition to shocking stories and photographs from Guantánamo, Abu Ghraib and CIA black site prisons, popular culture assists in the production of torture’s public image and indicates a site of norm contestation. Therefore, the aim of this article is threefold. First, the author shows that Zero Dark Thirty (2012, dir. Kathryn Bigelow) is constitutive for the public image of torture and its meaning-in-use. Second, she argues that the film’s representation of torture works as a popular site of contesting the anti-torture norm. Finally, she reflects on the continuum between popular culture and the politics of torture.
Risk factors for instability after reverse shoulder arthroplasty
Authors: Guarrella Vincenzo , Chelli Mikael , Domos Peter , Ascione Francesco , Boileau Pascal , Walch Gilles
Published: July 2019

Background

This study aims to identify risk factors related to postoperative instability after reverse shoulder arthroplasty and evaluate the modalities and results of treatments in a large series of patients, with medium to long-term follow-up.

Methods

Retrospective multicenter series of 1035 consecutive Grammont type reverse shoulder arthroplasties implanted between 1992 and 2010. 19.9% had a reverse shoulder arthroplasty with bony lateralization on the glenoid side. Patients were reviewed and radiographed with minimum five years’ follow-up.

Results

At a mean follow-up of eight years, the overall rate of postoperative instability was 3.0%. Instability was more frequent in case of reverse shoulder arthroplasty for revision surgery, in younger patients, in case of scapular notching, and tuberosity resorption. Lateralized reverse shoulder arthroplasties were associated with a lower instability rate. A reoperation to restore stability was needed in 70% of cases. The improvement in Constant Score was lower in patients with unstable reverse shoulder arthroplasties when compared to stable reverse shoulder arthroplasties.

Conclusions

Younger patients are at higher risk for instability after Grammont type reverse shoulder arthroplasty implantation. Conversely, lateralized reverse shoulder arthroplasties resulted protective. When conservative treatment had failed, shoulder stability can be obtained with reoperation or prosthetic revision (needed in 70% of the cases), but to the price of lower functional results.
Syndesmotic Fixation Utilizing a Novel Screw: A Retrospective Case Series Reporting Early Clinical and Radiographic Outcomes
Authors: Stenquist Derek , Velasco Brian T. , Cronin Patrick K. , Briceño Jorge , Miller Christopher P. , Riedel Matthew D. , Kwon John Y.
Published: July 2019

Background. Syndesmotic disruption occurs in 20% of ankle fractures and requires anatomical reduction and stabilization to maximize outcomes. Although screw breakage is often asymptomatic, the breakage location can be unpredictable and result in painful bony erosion. The purpose of this investigation is to report early clinical and radiographic outcomes of patients who underwent syndesmotic fixation using a novel metal screw designed with a controlled break point. Methods. We performed a retrospective review of all patients who underwent syndesmotic fixation utilizing the R3lease Tissue Stabilization System (Paragon 28, Denver, CO) over a 12-month period. Demographic and screw-specific data were obtained. Postoperative radiographs were reviewed, and radiographic parameters were measured. Screw loosening or breakage was documented. Results. 18 patients (24 screws) met inclusion criteria. The mean follow-up was 11.7 months (range = 6.0-14.7 months). 5/24 screws (21%) fractured at the break point. No screw fractured at another location, nor did any fracture prior to resumption of weight bearing; 19 screws did not fracture, with 8/19 intact screws (42.1%) demonstrating loosening. There was no evidence of syndesmotic diastasis or mortise malalignment on final follow-up. No screws required removal during the study period. Conclusion. This study provides the first clinical data on a novel screw introduced specifically for syndesmotic fixation. At short-term follow up, there were no complications and the R3lease screw provided adequate fixation to allow healing and prevent diastasis. Although initial results are favorable, longer-term follow-up with data on cost comparisons and rates of hardware removal are needed to determine cost-effectiveness relative to similar implants.

Level of Evidence: Level IV: Retrospective case series
Sharing Your Story With Data
Authors: Maughan Erin D. , Mehr Deb
Published: July 2019

This interview provides an example of how a school nurse presented her data to the school board. It is a practical example of how to apply the principles found in the article on data presentation, which is the final article in the “data and school nursing” articles series being published in NASN School Nurse.
Precision medicine in adult and pediatric obesity: a clinical perspective
Authors: Bomberg Eric M. , Ryder Justin R. , Brundage Richard C. , Straka Robert J. , Fox Claudia K. , Gross Amy C. , Oberle Megan M. , Bramante Carolyn T. , Sibley Shalamar D. , Kelly Aaron S.
Published: July 2019

It remains largely unknown as to why some individuals experience substantial weight loss with obesity interventions, while others receiving these same interventions do not. Person-specific characteristics likely play a significant role in this heterogeneity in treatment response. The practice of precision medicine accounts for an individual’s genes, environment, and lifestyle when deciding upon treatment type and intensity in order to optimize benefit and minimize risk. In this review, we first discuss biopsychosocial determinants of obesity, as understanding the complexity of this disease is necessary for appreciating how difficult it is to develop individualized treatment plans. Next, we present literature on person-specific characteristics associated with, and predictive of, weight loss response to various obesity treatments including lifestyle modification, pharmacotherapy, metabolic and bariatric surgery, and medical devices. Finally, we discuss important gaps in our understanding of the causes of obesity in relation to the suboptimal treatment outcomes in certain patients, and offer solutions that may lead to the development of more effective and targeted obesity therapies.
Evidence of altered brain network centrality in patients with diabetic nephropathy and retinopathy: an fMRI study using a voxel-wise degree centrality approach
Authors: Wang Yu , Jiang Lei , Wang Xiao-yu , Chen Weizhe , Shao Yi , Chen Qin-kai , Lv Jin-lei
Published: July 2019

Background:

Over recent years, some researchers believe that diabetic nephropathy (DN) and diabetic retinopathy (DR) both independently increase the incidence of brain diseases, such as stroke, cerebral infarction, and cerebral hemorrhage. In the present study, we used the voxel-wise degree centrality (DC) method to investigate potential changes of functional network brain activity in patients with DN and retinopathy (DNR).

Methods:

Twenty DNR patients (9 men, 11 women) and 20 healthy controls (HCs; 9 men, 11 women) were recruited; the controls were matched for age, sex, and educational background. All subjects underwent resting-state functional magnetic resonance imaging. Ophthalmoscopy, renal biopsy and single-photon emission computed tomography were used to evaluate microvascular lesions in the eye and kidney. Data were categorized using receiver operating characteristic curves, and correlation analysis was performed using Pearson’s correlation analysis.

Results:

Compared with HCs, DNR patients showed reduced mean DC values in the right inferior temporal gyrus (RITG) and left subcallosal gyrus regions (LSG) and increased mean DC values in the bilateral precuneus (BP). Moreover, mean DC in the BP was correlated with renal estimated glomerular filtration rate (eGFR; r = 0.762). The area under the curve (AUC) value was 0.829 for BP and 0.839 for RITG and LSG.

Conclusion:

DNR patients showed dysfunction in three different brain regions. The linear correlation between eGFR and mean brain DC values indicates the presence of common diabetic microangiopathy in the brain and kidney, which may provide new ideas for multiorgan microvascular lesions of diabetics.
Prevalence of hyperlipidaemia in adults and its relation to the Mediterranean diet: the Hellenic National Nutrition and Health Survey (HNNHS)
Authors: Magriplis Emmanuella , Panagiotakos Demosthenes , Mitsopoulou Anastasia-Vasiliki , Karageorgou Dimitra , Bakogianni Ioanna , Dimakopoulos Ioannis , Micha Renata , Michas George , Chourdakis Michail , Chrousos George P , Roma Eleftheria , Zampelas Antonis
Published: July 2019

Objectives

A long-term abnormal blood lipid profile increases the risk of cardiovascular disease (CVD). A probable protective role may be played by the Mediterranean diet. The aim of this study was to assess prevalence of dyslipidaemia, assess blood lipid status and treatment and examine the association between blood lipids, dyslipidaemia and Mediterranean diet.

Methods

Data were from the Hellenic National Nutrition and Health Survey (HNNHS). Data from 3775 adults (40.8% males) were obtained by trained personnel and disease status was categorized according to the International Classification of Diseases codes (10th version). Blood lipid measurements were obtained from a subsample ( N = 1080, mean age 40.1 years; 37.8% male). The Mediterranean diet score (MedDiet score) was calculated from 24-h recalls. The relationships between higher MedDiet score (>23), lipid levels and status were examined using linearized multiple linear and logistic regressions, respectively.

Results

In total, 20.7% of the population was dyslipidaemic, with 59.0% (no sex differences) receiving treatment, and 46.6% of the treated having a normal lipid profile. Lipid status awareness was 35.5% (64.5% unaware). Males aged 19–39 had higher total cholesterol, low-density lipoprotein cholesterol and triglycerides, and lower high-density lipoprotein cholesterol levels than females (in mg/dl; p for all <0.05); these were significantly higher in overweight and obese individuals in all age groups, except high-density lipoprotein cholesterol ( p for all <0.001). Higher MedDiet score was associated with significantly lower low-density lipoprotein cholesterol in the pooled sample (−6.39 mg/dl; 95% confidence interval (CI): −12.60, 0.17), in all males (−10.61 mg/dl; 95% CI: −19.89, −1.34) and in overweight and obese males (−15.6 mg/dl; 95% CI: −29.25, –1.94).

Conclusion

This study underlines the abnormal lipid profile in the young, mostly male, population who are highly unaware and under-treated.
Occupational risks evaluation in a centralized antineoplastic agent preparation unit
Authors: Dubray Quentin , Diallo Taibou , Loeuillet Richard , Andre Emilie , Fauqueur Anne-Sophie , Poil Sandrine , Thromas Nathalie , Secretan Philippe-Henri , Cisternino Salvatore , Schlatter Joël
Published: July 2019

Objective:

The global professional risk assessment applied to the central unit of antineoplastic agent preparations is part of a mandatory approach required by the European legislation for workers. This study identified the hazardous situations related to the staff activity and then enabled the preparation of a formal plan of occupational prevention.

Methods:

The nature of study approved by a working group constituted by experts was the global risk analysis. After identifying the hazardous situations, the global risk analysis estimated the risk level of each hazardous situation based on a criticality score, including severity and frequency. The global risk analysis highlighted the initial and residual risks after establishing a plan to reduce the high criticality risks.

Results:

Hence, 33 unacceptable hazardous situations were identified. The critical categories of professional risks were “Product, emissions, and waste risks” with 17 (55%) hazardous situations; “Psychosocial risk factors” with 8 (24%) hazardous situations; and “Risks related to work equipment” with 6 (18%) hazardous situations. Once the risk reduction plan was in place, all hazardous situations were considered under control. The corrective actions led to a reorganization of human resources, the update of protection protocols, and optimization of ergonomic work tools. Staff-specific medical monitoring and regular surface contamination tests have been scheduled annually. In addition, initial and continuous training, specific to product and waste risks, has been updated.

Conclusion:

The global professional risk assessment related to centralized antineoplastic agent preparation unit generated failure in our system and enabled corrective actions for staff safety.
Gender Politics and Discourses of #mansplaining, #manspreading, and #manterruption on Twitter
Authors: Lutzky Ursula , Lawson Robert
Published: July 2019

This article presents the findings of a corpus linguistic analysis of the hashtags #mansplaining, #manspreading, and #manterruption, three lexical blends which have recently found widespread use across a variety of online media platforms. Focusing on the social media and microblogging site Twitter, we analyze a corpus of over 20,000 tweets containing these hashtags to examine how discourses of gender politics and gender relations are represented on the site. More specifically, our analysis suggests that users include these hashtags in tweets to index their individual evaluations of, and assumptions about, “proper” gendered behavior. Consequently, their metadiscursive references to the respective phenomena reflect their beliefs of what constitutes appropriate (verbal) behavior and the extent to which gender is appropriated as a variable dictating this behavior. As such, this article adds to our knowledge of the ways in which gendered social practices become sites of contestation and how contemporary gender politics play out in social media sites.
Cryptococcal Meningitis Presenting as New-Onset Seizures in an Immunocompetent Patient
Authors: Akyeampong Andrea , Solomon Nadia , Boire Nicholas A. , Baqui Aam A.
Published: July 2019

This report describes a 30-year-old immunocompetent male with new-onset seizures, later found on imaging to have 2 enhancing lesions in the brain. The patient underwent a left parietal craniectomy with resection of one of the masses, which demonstrated focal areas of necrosis and many small cystic structures positive for periodic acid-Schiff and Gomori’s methenamine silver special stain. Numerous laboratory examinations, including HIV test, rapid plasma reagin, toxoplasma immunoglobulin G and immunoglobulin M, Lyme, cytomegalovirus, tuberculosis, cysticercosis, and Echinococcus serology, were all negative. Despite negative cerebrospinal fluid (CSF) culture and several negative CSF antigen tests, continued investigation, and follow-up, CSF antigen testing ultimately revealed Cryptococcus as the causative agent. In light of the mysterious and unusual presentation, the authors discuss potential infectious differential diagnoses in patients with atypical clinical presentation, laboratory tests, and surgical pathology.