bluuebunny/crossref_metadata_2025 huggingface dataset:
Transversely Retropalatal Collapsibility Measured by Regular Endoscopy Is Associated with Position Independency and Apnea‐Hypopnea Index
Authors: Lee Li‐Ang , Chen Hung Chin , Hsin Li Jen , Li Hsueh‐Yu , Fang Tuan‐Jen
Published: September 2014

Objectives:

Investigate whether the retropalatal airway collapsibility defined by regular endoscopy with Müller's maneuver could be used for predicting position independency and apnea‐hypopnea index (AHI) in patients with obstructive sleep apnea (OSA).

Methods:

This was a retrospective study and a total of 77 polysomnographies (mean AHI = 25.75 ± 22.69) and 77 awake endoscopies with Müller's maneuver between January 2010 and October 2013 were reviewed from 45 OSA patients (40 men and 5 women; mean age, 40.7 ± 1.6 years). Transverse/longitudinal diameters and collapsibilities of the airway at the level of the uvular base were measured using a picture archiving and communication system. Intra‐ and interrater reliabilities were assessed. Associations among the retropalatal airway dimensions, AHI (total, supine, and lateral), and position independency (defined as a supine AHI of <2 times of the lateral AHI) were statistically analyzed.

Results:

Measurement of transverse diameters and transverse/longitudinal collapsibilities was highly reliable within and between raters (all intraclass correlation coefficients >0.8) but longitudinal diameters measurement was less reliable. Transverse collapsibility significantly correlated with position independency (r = 0.545, P =. 019). It was also independently significantly associated with total (beta = 0.522, P <. 001), supine (beta = 0.480, P =. 001), and lateral (beta = 0.412, P =. 006) AHI after multiple linear regression.

Conclusions:

Regular endoscopy with Müller's maneuver continues to be an important clinical tool to evaluate the upper airway among OSA patients and a high transversely retropalatal collapsibility is a hallmark of non‐positional and/or severe OSA.
Occurrence of Aerodigestive Foreign Bodies in Children Less Than 12 Years Old in Uganda
Authors: Nakku Doreen , Tamwesigire Imelda
Published: September 2014

Objectives:

(1) Determine the prevalence and common types of aerodigestive foreign bodies. (2) Determine the nonclinical factors that influence their occurrence among children under 12 years of age.

Methods:

A case control study between February and October 2012. The study population was all children between 6 months and 12 years old presenting to the ENT clinic at Mbarara Regional Referral Hospital. Consecutive and random sampling was used for cases and controls respectively. The cases were recruited after removal of the foreign body in theater. Information collected included biodata, circumstances surrounding the occurrence of the foreign body, the type of foreign body, and the family's socioeconomic status.

Results:

Prevalence was 6.6% with M:F = 2:1. The most common foreign bodies were seeds in the airway and coins in the esophagus. There was a strong association between the type of foreign body and activity of the child at the time of the incident (P =. 001). A middle level socioeconomic status had a significantly lower risk (odds ratio = 0.27, P =. 01). Older mothers’ children were protected. In multivariate analysis using the child's age and sex, mother's age, and socioeconomic status of the family, females had a risk of 39% compared with the males (P =. 03).

Conclusions:

The prevalence of aerodigestive foreign bodies is relatively high. Risk factors include age under 5 years, male sex, the child's activity at the time, and younger age of the mother. A higher socioeconomic status and female sex are protective. Therefore nonclinical factors influence the occurrence of aerodigestive foreign bodies among children.
Combined Endovascular and Surgical Treatment of Cervicofacial Arteriovenous Malformations
Authors: Colletti Giacomo , Mandala Marco , Moneghini Laura , Frigerio Alice , Melchiorre Fabio , Grimmer Fredrik J.
Published: September 2014

Objectives:

Arteriovenous malformations (AVMs) often cause disfigurement and severe functional disturbances. An improper approach can unlock an explosive growth in the AVM and present a very high risk of relapse. Recurrent AVMs are much harder to cure. Intraoperative massive bleeding is a tangible risk if AVMs are treated surgically without preparatory endovascular embolization. The study's aims were: (1) Recognize and clearly diagnose a cervicofacial AVM. (2) Describe the indications and techniques to treat cervicofacial AVMs. (3) Analyze the critical importance of a combined endovascular and surgical approach.

Methods:

The most accepted indications and techniques concerning head and neck AVMs are gathered from a review of the literature and compared with the personal experience of the authors with 10 AVMs of the soft tissues of the head and neck and 4 AVMs of the facial bones. All patients underwent preoperative endovascular embolization with n‐butyl cyanoacrylate followed by surgical removal of the malformation within 48 hours of the procedure.

Results:

One early case of AVM of the maxilla was complicated by massive intraoperative hemorrhage despite preoperative embolization. One maxillo‐mandibular AVM recurred 2 years after the treatment. In all patients an improvement in cosmetic appearance was documented. Smaller AVMs were easier to manage and had the best results.

Conclusions:

An aggressive combined endovascular‐surgical treatment seems to be the only “curing” strategy for head and neck AVMs. A thoughtful preoperative balance must be made within a multidisciplinary team and clearly discussed with the patient.
Tonsil Surgery in Sweden 2013: Indications, Surgical Methods, and Complication Rates
Authors: Stalfors Joacim , Odhagen Erik , Ericsson Elisabeth , Söderman Anne‐Charlotte Hessén , Hultcrantz Elisabeth , Sunnergren Ola , Hemlin Claes
Published: September 2014

Objectives:

Describe how tonsil surgery was performed in Sweden 2013.

Methods:

The National Tonsil Surgery Register in Sweden collects detailed information regarding indication, surgery, and complications for tonsil operations. The purpose of the register is primarily to provide a basis for the description of a clinic and stimulate quality improvement programs. Also, the data can be used for research. All clinics are encouraged to include all tonsil surgeries in Sweden in the register, and during 2013, over 80% of all tonsil surgeries are estimated to be included. Information registered through questionnaires is data regarding indication, surgery performed, and complications such as readmission or return to theater due to bleeding.

Results:

A total of 11,029 tonsil surgeries were registered in 2013. Surgical methods used were tonsillectomy (4726), tonsillectomy with adenoidectomy (1632), tonsillotomy (738), and tonsillotomy with adenoidectomy (3933). Tonsillectomy was mainly used for infectious indications while tonsillotomy was used for obstructive/sleep apnea indications. Tonsillectomy was performed with cold knife (3056) or diathermy scissor (1217). Tonsillotomy was performed with coblation (653). Primary bleeding was registered in 1.8% of the total cohort. Readmission due to secondary bleeding was registered in 5.9% of the total cohort, but 11.4% after tonsillectomy and 2.2% after tonsillotomy. Return to theater because of bleeding was registered in 2.1%.

Conclusions:

Detailed information regarding tonsil surgery can be assessed with the National Tonsil Surgery Register in Sweden. Data can be used for studies on a large population and provide new knowledge.
Trends in American and Canadian Contribution to the Otolaryngology Literature
Authors: Lin June Rui Jun , Gurberg Joshua , Akabari Elaheh , White Paul , Nunez Desmond A.
Published: September 2014

Objectives:

Assess the 2008‐2012 American and Canadian contribution to the world otolaryngology literature.

Methods:

All articles published from January 2008 to December 2012 in 8 otolaryngology journals were reviewed. Book reviews, letters, correspondence, and meeting abstracts were excluded. Nationality, author numbers, and study types were extracted. Nationality of the article was defined by the publishing department's country of origin. Articles were categorized into primary clinical research, primary basic science research, secondary research such as systematic reviews and meta‐analyses, and other articles that did not fit the aforementioned classifications. Articles originating from the United States, Canada, and the rest of the world were statistically compared using Mantel‐Haenszel Common Odds Ratio Estimate, Pearsons chi‐squared, and Fisher exact tests.

Results:

A total of 3635 articles published in the journals surveyed were analyzed. Canadian‐authored papers decreased from 12.8% in 2008‐2009 to 10.2% in 2011‐2012, whereas American‐authored papers increased from 27.9% in 2008‐2009 to 30.1% in 2011‐2012. These changes were statistically significant (P =. 031). Multiauthorship (≥5 authors) increased in Canadian papers (P =. 015), whereas this trend had not been observed in American papers (P =. 566). Study types from the United States and Canada had not significantly changed from 2008‐2009 to 2011‐2012 (P =. 137).

Conclusions:

There were significant changes in otolaryngology publishing trends in the United States and Canada. Increase in multiauthorship in Canadian‐authored papers possibly suggests increased collaboration with multi‐disciplines and decreased investigator productivity.
A Comparison of the Dynasplint Trismus System to Tongue Depressor Therapy in Improving Treatment‐Related Trismus
Authors: Zhang Mike W. , Khichi Sunny S. , Cochran Phillip G. , Clemons Lisa , Carroll William R. , Withrow Kirk P. , Rosenthal Eben L.
Published: September 2014

Objectives:

(1) Evaluate and compare the effectiveness of tongue depressors and the Dynasplint Trismus System to manage trismus in head and neck cancer patients. (2) Analyze factors that may indicate improved outcomes for patients in trismus management.

Methods:

Single‐institution randomized controlled cross‐over study (2007‐2013). Fifty‐three patients with trismus as a complication of cancer treatment were enrolled in the study at an academic tertiary care center. Twenty‐seven patients were randomized to a treatment arm using Dynasplint, while 26 were enrolled in a treatment arm using tongue depressors to perform stretching exercises. The primary outcome was interval measurement of incisor‐to‐incisor opening during and at the completion of tongue depressor therapy compared to Dynasplint usage. Pretreatment and treatment characteristics, including type of cancer treatments used, were analyzed for association with rate of improvement.

Results:

Dynasplint and tongue depressors both significantly increased the maximal incisal opening of patients at 3 months compared with baseline (P <. 01 in both treatment arms). A statistically significant difference in outcomes between the treatment arms was not found at any time point. Patients who received only surgery and no radiation showed significantly more improvement in maximal incisal opening from baseline to 3 months (P =. 0036) and 6 months (P =. 012).

Conclusions:

Surgical therapy alone responds better to trismus therapy compared to dual modality therapy. Both Dynasplint Trismus System and tongue depressors were able to improve the trismus status for patients with equal effectiveness. Ease of use and cost favor the management with tongue depressors.
Depression as a Contributing Factor in Postoperative Functional Performance Status (PFPS): A Prospective Study
Authors: Barber Brittany , Zhang Han , O'Connell Daniel A. , Harris Jeffrey R. , Seikaly Hadi
Published: September 2014

Objectives:

The incidence of depressive symptoms in head and neck cancer (HNC) patients has been shown to be up to 40% during treatment and can affect patients’ desires to rehabilitate after surgery. The objectives in this study were to (1) evaluate the relationship between preoperative depressive symptoms and postoperative functional performance status (PFPS) and (2) assess the effect of preoperative depressive symptoms on length of hospital stay (LOHS), completion of adjuvant therapy (CAT), rate of postoperative readmission, and loss of follow‐up.

Methods:

A prospective cohort study was conducted in new adult HNC patients undergoing surgery as primary therapy from January 2013 to January 2014 measuring baseline preoperative depressive symptomatology on the Quick Inventory of Depressive Symptomatology (QIDS) and PFPS was assessed on the Functional Assessment of Cancer Therapy‐Head & Neck (FACT‐HN) 6 months from the initial presentation. Secondary outcomes assessed included LOHS, CAT, rate of readmission due to failure to thrive, and loss of follow‐up. A Mann‐Whitney U test and chi‐squared analyses were used to assess the difference between the Normal‐Mild and Moderate‐Severe QIDS groups.

Results:

Preliminary results of the prospective study demonstrate an incidence of preoperative moderate‐severe depression of 29.2% and significant difference in FACT‐HN scores between moderate‐severely depressed patients and those with normal‐mild symptoms (P =. 03). CAT scores trended to lower in the MS group (P =. 09), but there was no significant difference in loss of follow‐up (P =. 24).

Conclusions:

Depression should be recognized as a contributive factor in postoperative functional performance status.
Early Prediction of Oral Calcium and Vitamin D Requirements in Post‐thyroidectomy Hypocalcemia
Authors: Aldhahri Saleh F. , Terkawi Abdullah S. , Mubasher Mohamed , Al Essa Mohamed , Al Muhawas Fida
Published: September 2014

Objectives:

Optimize and individualize post‐thyroidectomy hypocalcemia management.

Methods:

A multicenter, standardized prospective study was conducted. Demographic, clinical, and biochemical data were collected. Parathyroid hormone (PTH) was measured preoperatively, then at 1 and 6 hours postoperatively. The optimal required doses of calcium and vitamin D were defined as those maintaining the patients as asymptomatic and their cCa ≥ 2 mmol/L. They were used as an endpoint in a generalized linear mixed effect modeling (GLIMMIX) aiming to identify the best predictors of optimal required doses. Models were evaluated by goodness of fit (Akaike information criteria), receiver operating characteristic curves, and sensitivity analysis.

Results:

A total of 168 patients met inclusion criteria; mean age was 41.8 years, 85.1% were female, 49.3% had a body mass index (BMI) >30, and 64% had vitamin D deficiency. Of the patients, 25.6% had post‐thyroidectomy hypocalcemia, of whom 18 (41.9%) were symptomatic and received intravenous calcium. First‐hour percentage drop in PTH correlated positively with the severity of hypocalcemia (P <. 0001). The GLIMMIX prediction model for oral calcium requirement was based on first‐hour percentage change from preoperative PTH level, preoperative actual PTH, BMI, and thyroid function. The same predictors were identified for vitamin D, except that thyroid function was replaced with vitamin D status. These factors were used to build predictive equations for calcium and vitamin D doses.

Conclusions:

Our findings could help in optimizing the management of post‐thyroidectomy hypocalcemia. They can assist in early identification of those who are not at risk of hypocalaemia and can guide early effective management of those at risk.
Functional Swallowing Outcomes after Transoral Robotic Supraglottic Laryngectomy
Authors: Bayrak Sinehan , Davis Amanda , Vural Emre A.
Published: September 2014

Objectives:

(1) Defining functional swallowing outcomes as well as determining an expected length of time for patients to safely return to a normal oral diet in transoral robotic surgery (TORS) for resection of supraglottic laryngeal cancer.

Methods:

Retrospective chart review of patients who underwent TORS for resection of laryngeal cancer from 2011‐2013. ASHA's National Outcomes Measurement System, oral diet levels, and dependency on tube feedings were used as outcome measures.

Results:

Eleven patients were included in this study. Five out of 11 patients completed the treatment program and follow‐up care, 100% returned to full oral diets in an average of 18.6 weeks, and all subsequently had their g‐tube removed. Sixty percent of these patients continued to require compensatory swallowing techniques (ie, supraglottic swallowing maneuver) and/or modified diets (ie, thickened liquids) in order to safely consume oral diet without aspiration. Two patients died; 1 patient was lost to follow‐up; 3 patients were still NPO at last contact.

Conclusions:

Patients who have undergone supraglottic laryngectomy will likely experience significant dysphagia, but good functional swallowing outcomes should be expected in the intermediate term.
Human Papillomavirus‐16 E7 Viral Load Predicts Distant Metastasis in Oral Cavity Squamous Cell Carcinoma
Authors: Huang Chung‐Guei , Lee Li‐Ang , Tsao Kuo‐Chien , Liao Chun‐Ta , Shih Shin‐Ru , Yen Tzu‐Chen
Published: September 2014

Objectives:

Human papillomaviruses (HPV) seem to be related to distant metastasis (DM) in advanced oral cavity squamous cell carcinoma (OSCC) patients. The objective of this study was to investigate whether high‐risk HPV viral load may predict DM among patients with OSCC and stratify patients for risk‐adapted treatment.

Methods:

We measured viral load of E7 oncogenes for HPV‐16 and HPV‐18 by quantitative PCR tests in paraffin‐embedded surgical specimens from 312 OSCC of which the HPV genotypes had been determined previously. Multivariable regression analysis was used to identify the independent prognostic factors for 5‐year DM.

Results:

Only the HPV‐16 E7 viral load was a significant adverse predictor of 5‐year DM. By multivariable analysis, high HPV‐16 E7 viral load (≥15.0 copies/genome); pathological N2 status (pN2); tumor depth ≥11 mm; extracapsular spread (ECS); and level IV/V metastases were independent risk factors for DM and identified 3 prognostic groups. In the high‐risk group (level IV/V metastases or high HPV‐16 E7 viral load plus pN2, tumor depth ≥11 mm, or ECS), the 5‐year DM rate was 77.5%. In the intermediate‐risk group (high HPV‐16 E7 viral load, pN2, tumor depth ≥11 mm, or ECS), the 5‐year DM rate was 17.8%. Finally, the 5‐year DM rate was 1.3% in the low‐risk group (no risk factors).

Conclusions:

Among OSCC patients, a high HPV‐16 E7 viral load and the presence of specific pathological risk factor(s) identify a subgroup of patients at high‐risk of 5‐year DM. These subjects may benefit from a more intensive follow‐up program and aggressive therapeutic strategies.
Crazy paving radiography finding in asymptomatic pulmonary alveolar proteinosis
Authors: Choi Young Rak , Chang You-Jin , Kim Si Wook , Choe Kang Hyeon , Lee Ki Man , An Jin-Young
Published: September 2014

Pulmonary alveolar proteinosis is a rare disorder characterized by alveolar accumulation of surfactant phospholipids and protein components. The symptoms and prognosis are extremely variable. Bronchoalveolar lavage fluid and/or transbronchial lung biopsy are useful for diagnosis; surgical lung biopsy is often unnecessary but useful in the focal involvement. We report a case of pulmonary alveolar proteinosis in a 50-year-old woman, confirmed by a video-assisted thoracoscopic surgery biopsy from the initial focal involvement, with normal bronchoalveolar lavage and transbronchial lung biopsy findings.
24 hours of an #outcry: The networked publics of a socio-political debate
Authors: Maireder Axel , Schlögl Stephan
Published: September 2014

This article explores the development of a social–political discussion on everyday sexism in Germany, labelled ‘#aufschrei’ (German for ‘outcry’), that started as a small Twitter conversation and evolved into a nationwide debate within 24 hours. After discussing the relationship of social actions, social networks and interlinked digital objects in the construction of networked publics, the authors propose to understand #aufschrei as an ‘ad hoc’ public – a communication sphere evolving around a shared topic within the spaces of the networked public sphere. Applying both computational research approaches and traditional content analysis to a large set of Twitter data, the authors reconstruct the dynamics of the debate in relation to concepts of horizontal and vertical segments of the public sphere. The conclusion calls for a theoretical re-evaluation of how those concepts can be applied to networked publics, and for an increased research effort to develop comprehensive methods for visualising or objectifying networked publics.
Diffusion-weighted imaging during MR-guided radiofrequency ablation of hepatic malignancies: analysis of immediate pre- and post-ablative diffusion characteristics
Authors: Hoffmann Rüdiger , Rempp Hansjörg , Schraml Christina , Schwenzer Nina , Grözinger Gerd , Blumenstock Gunnar , Rothgang Eva , Pereira Philippe L , Claussen Claus D , Clasen Stephan
Published: September 2014

Background

Previous studies have shown a benefit of magnetic resonance (MR)-diffusion-weighted imaging (DWI) for follow-up after liver radiofrequency (RF) ablation. However, no data are available concerning acute changes of DWI characteristics immediately after RF ablation.

Purpose

To analyze and compare the MR-diffusion characteristics of pre-interventional hepatic malignancies and the ablation zone during successful MR-guided RF ablation.

Material and Methods

This retrospective study was conducted in accordance with the guidelines of the local institutional review board. Forty-seven patients with 29 HCC (24 patients) and 30 hepatic metastases (23 patients) underwent MR-guided radiofrequency ablation including DWI before and immediately after ablation (b = 50, 400, 800 s/mm2). Two reviewers (A and B) analyzed DWI with focus on detectability of the tumor before ablation and characteristics of the coagulative area after treatment. Mean apparent diffusion coefficient (ADC) was compared between liver, untreated tumor, and hyperintense areas in post-ablative DWI (b = 800 s/mm2) with the paired Student’s t-test.

Results

Pre-ablative: the reviewers classified 19/29 (A) and 23/29 (B) HCC and 25/30 (A and B) metastases as detectable in DWI. Post-ablative: a hyperintense rim surrounding the ablation zone was observed in 28/29 treated HCC and 30/30 treated metastases (A and B). A homogenous hypointense central ablation zone was found in 18/29 (A) and 20/29 (B) treated HCC and 17/30 (A & B) treated metastases in DWI. ADC of the rim was significantly lower than ADC of the liver ( P < 0.001).

Conclusion

DWI enables visualization of the target tumor in MR-guided liver radiofrequency ablation in most cases. A common post-ablative DWI finding is a hyperintense rim with decreased ADC surrounding the ablation zone.
Making Sense of Imprisonment
Authors: van Ginneken Esther F. J. C.
Published: September 2014

The literature on prison effects is characterised by a focus on negative outcomes. There is a need to acknowledge individual differences. The theme of posttraumatic growth emerged in a subsample of interviews from a study on psychological adjustment in prison. The narratives of this subsample (six female, first-time prisoners) were used to explore the phenomenon of posttraumatic growth during imprisonment. It is argued that the initial shock of incarceration challenged these prisoners’ assumptive worlds, but they managed to overcome this crisis by finding meaning in the prison experience and using it as an opportunity for personal development. This facilitated a positive reconstruction of their identity. The potential implications of posttraumatic growth for desistance are discussed.
Current status and applications of hybrid micro-machining processes: A review
Authors: Unune Deepak Rajendra , Mali Harlal Singh
Published: September 2014

The hybrid micro-machining process employs simultaneous or ensuing action of two or more machining processes or takes aid of some energy assistance in material removal to enhance advantages and minimize potential disadvantages found in individual material removal techniques. There are various examples, such as abrasive electro-discharge grinding, electrochemical discharge machining, laser-assisted turning, and jet-assisted machining. This article presents a novel classification of and reviews the past and present research and applications of the hybrid micro-machining process, highlighting its effects on response variables such as material removal rate, tool wear, and surface roughness. Although hybrid micro-machining has been an active research area in non-conventional and critical machining since few years, insufficient knowledge about capabilities in sizes, materials, machinery, and manipulating devices is still a major constraint in the development of these processes. In the near future, there is ample scope for the hybrid micro-machining process in exploring issues in material removal at micro-scale, effect of residual stresses, and environment.
The estimation of cutting force coefficients in milling of thin-walled parts using cutter with different tooth radii
Authors: Dong Xinfeng , Zhang Weimin , Sun Jiabin
Published: September 2014

The precise estimation of the cutting force coefficients in milling is very important, which has great impact on the precise calculation of the milling forces and the stability lobes of the system. On the basis of the imprecise estimation of cutting force coefficients in milling of thin-walled part using cutter with different tooth radii, the calculation process of actual cutting force coefficients is proposed in this article. First, based on the different amplitudes of milling forces caused by the long and short teeth of cutter, the nominal milling forces and nominal cutting force coefficients are constructed, and the radii error of the long and short teeth of cutter is calculated. Then, actual cutting force coefficients are derived based on radii error of cutter teeth. Finally, an experiment is performed to verify the validity of the calculation process of actual cutting force coefficients proposed in this article, and the results show that the actual cutting force coefficients obtained by consideration of radii error are more effective than theoretical cutting force coefficients obtained without consideration of radii error in the calculation of milling forces.
A novel approach to integrate artificial potential field and fuzzy logic into a common framework for robots autonomous navigation
Authors: Melingui Achille , Merzouki Rochdi , Mbede Jean Bosco , Chettibi Taha
Published: September 2014

Artificial potential field and fuzzy logic are efficient approaches for mobile robots autonomous navigation. However, both have advantages and drawbacks. Their integration into a common control scheme can significantly improve the performances of the resulting hybrid controller. In this article, we propose a novel hybrid approach in order to better exploit their advantages. The present work contributes in three aspects: first, the proposed control scheme integrates interval type-2 fuzzy logic concepts with artificial potential field concepts into a common framework in order to better exploit their advantages. Second, the proposed control scheme is a simple and realizable design for real-time implementation because only 15 fuzzy rules are sufficient to control the mobile robot. Third, the proposed control scheme is a synthesized design which utilizes both heuristic knowledge and the sampled input–output data pairs. An implementation in real-time on an omnidirectional mobile robot validates the effectiveness of the proposed control scheme.
Health Risk Behavior Among Thai Youth
Authors: Sirirassamee Tawima , Sirirassamee Buppha
Published: September 2014

This study aims to establish the prevalence of risky health behaviors among Thai youth and to characterize the prevalence of these behaviors by gender, age group, educational status, and region. We analyzed data from a population-based, nationally representative, cross-sectional survey of 938 youth aged between 13 and 24 years, sampled from Bangkok and 4 regions of Thailand. The 2011 Youth Risk Behavior Surveillance System questionnaire was used to measure youth risk behaviors. This study finds that 15.9% of respondents had engaged in physical fights, and 8.1% had been cyber bullied. The prevalence of current cigarette smoking, alcohol, and marijuana use were 22.3%, 27.9%, and 2.3%, respectively. The prevalence of risky behaviors among Thai youth were found to be high, including behaviors that contribute to unintentional injuries and violence, unsafe sexual behaviors, and cigarette and alcohol consumption.
Conceptions of Diabetes and Diabetes Care in Young People With Minority Backgrounds
Authors: Boman Åse , Bohlin Margareta , Eklöf Mats , Forsander Gun , Törner Marianne
Published: September 2014

Adolescents with type 1 diabetes (T1DM) need stable self-care routines for good metabolic control to minimize future cardiovascular health complications. These routines are demanding, and might be particularly challenging in underprivileged groups. The aim of this study was to gain in-depth knowledge on the experience of adolescents with T1DM and a non-Swedish background regarding factors that might influence their ability to take care of themselves; in particular, factors that might influence diabetes management routines, their social situation, and the support they receive from caregivers. We interviewed 12 adolescents with T1DM and minority backgrounds. The results indicated resources and constraints in the adolescents’ social context and in the health care organization. The adolescents developed conceptions that helped to explain and excuse their self-care failures, and their successes. These findings highlight the importance of integrating T1DM as part of the individual’s personal prerequisites. We discuss implications for the organization of diabetes care for adolescents.
Exploring the Mental Health Effects of Political Trauma With Newly Arrived Refugees
Authors: Shannon Patricia J. , Wieling Elizabeth , McCleary Jennifer Simmelink , Becher Emily
Published: September 2014

We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress.
Recent Developments in Drug Therapy for Aplastic Anemia
Authors: Willis Lauren , Rexwinkle Amber , Bryan Jeffrey , Kadia Tapan M.
Published: September 2014

Objective: This article reviews recent developments in immunosuppressive therapy (IST) for aplastic anemia (AA) patients who are not candidates for stem cell transplant (SCT); including, front-line, salvage, and novel treatment options with a focus on response rates (RRs) and overall survival (OS). Data Sources: A PubMed literature search was performed from 1977 to June 2014 using the search terms aplastic anemia, horse antithymocyte globulin (hATG), rabbit ATG (rATG), thymoglobulin, and cyclosporine (CSA). Additional references were identified from a review of literature citations. Study Selection and Data Extraction: All English-language studies investigating IST for treatment of AA in non–SCT candidates were evaluated. Data Synthesis: Studies indicate addition of CSA and corticosteroids to hATG for treatment of AA improves RRs, decreases relapse rates, and improves 5-year OS. hATG improved RRs, relapse rates, and OS compared to rATG in the front-line setting. Studies support the use of rATG when front-line IST with hATG fails or when hATG is unavailable. Front-line daclizumab can be considered for nonsevere AA (NAA); however, data is limited. Alemtuzumab or eltrombopag are options for relapsed AA in select patients. Conclusions: hATG with methylprednisolone and CSA is recommended for front-line treatment of AA, whereas rATG is reserved for salvage therapy. Front-line use of daclizumab has been studied in NAA patients, but additional prospective trials are needed before this is adopted into clinical practice. Alemtuzumab and eltrombopag have been studied for treatment of AA; recruiting is ongoing in clinical trials to assess the appropriate dosing strategy and place in therapy.
Fabrication and property of discarded denim fabric/polypropylene composites
Authors: Wei Baochun , Xu Fujun , Azhar Sayed Waqar , Li Wei , Lou Luyang , Liu Wei , Qiu Yiping
Published: September 2014

In this study, discarded denim fabric was adopted to enhance the mechanical and thermal properties of polypropylene (PP). The composites with different fiber weight fractions were designed and fabricated by using a hand layup and hot pressing method. The tensile, impact, and flame-retardant properties of the composites were investigated and their morphology was observed by scanning electron microscopy. Owing to the integrity structure and good mechanical property of denim fabric, the tensile strength and impact strength of the 84 wt% denim-reinforced composite were up to 57 MPa and 5.1 J/mm, which super exceed those of the ramie/PP composites (26 MPa) and flax/PP composites (0.36 J/mm). In addition, the flame-retardant properties of the composites were modified by three methods. The results showed that the composites composed of flame-retardant-modified denim fabric exhibited the limiting oxygen index value of 27.3%, much higher than that of the modified PP composites (<19.2%) and untreated composites (<19.2%). Composites made by using flame-retardant PP and modified denim fabric simultaneously attained highest limiting oxygen index at 28.7%. The discarded denim fabric/PP composites showed good mechanical and flame-retardant properties and thus could substitute the traditional composites in automotive interior, packing materials and engineering materials.
Judges and Friends
Authors: Collins Paul M. , Martinek Wendy L.
Published: September 2014

We contribute to the literature on political psychology, interest groups, and judicial decision making by examining whether ideology mediates the effect of amicus curiae briefs on decision making in the U.S. courts of appeals. Using an original data set, we find evidence that moderate and conservative judges are influenced by amicus briefs, but that liberal judges do not respond to these persuasion attempts. We conclude that this form of interest group lobbying influences judicial decision making by at least some judges and that understanding the efficacy of this interest group strategy requires an appreciation of how political actors process persuasive information.
Sex Differences in the Measurement Invariance and Factors That Influence Structured Judgments of Risk Using the Structured Assessment of Violence Risk in Youth (SAVRY)
Authors: Childs Kristina K. , Frick Paul J. , Gottlieb Katie
Published: September 2014

The goals of this study were to test the measurement invariance of the Structured Assessment of Violence Risk in Youth (SAVRY) across sex and to assess whether the same items on the SAVRY influenced practitioners’ judgments about the risk for boys and girls separately. Using administrative data from 292 adjudicated juvenile offenders placed in state custody, we found that the internal structure of risk was invariant across sex. We also found both similarities and differences in the factors used to make judgments about risk across boys and girls. Our results provide support for the use of the SAVRY for boys and girls and supplement previous research examining the predictive validity of the SAVRY, the structured professional judgment framework for juvenile justice risk assessment, and the utility of the SAVRY across gender groups.
How Words Transcend and Pictures Immerse
Authors: Rim SoYon , Amit Elinor , Fujita Kentaro , Trope Yaacov , Halbeisen Georg , Algom Daniel
Published: September 2014

Drawing from construal level theory, we test the hypothesis that words promote thinking of events in terms of their abstract and central features (i.e., high-level construal), whereas pictures promote thinking in terms of more concrete and idiosyncratic features (i.e., low-level construal). In Experiments 1a and 1b, we found that verbal (vs. pictorial) presentation of objects led to broader, more inclusive categorization of those objects. In Experiment 2, we found that word (vs. picture) priming led to greater global (vs. local) processing of subsequent perceptual information. Finally, in Experiments 3 and 4, we tested the opposite direction of causality. Thinking about high-level “why” versus relatively low-level “how” (Experiment 3) and thinking about high-level categories versus relatively low-level exemplars (Experiment 4) led to more verbal versus pictorial thought. These findings provide converging evidence that medium (word, picture) is associated with level of construal.
Successful treatment of acquired uterine arterial venous malformation using N-butyl-2-cyanoacrylate under balloon occlusion
Authors: Woodhams Reiko , Ogasawara Go , Ishida Kenichiro , Fujii Kaoru , Yamane Takuro , Nishimaki Hiroshi , Matsunaga Keiji , Inoue Yusuke
Published: September 2014

We present two cases of acquired uterine arterial venous malformation (AVM) which was diagnosed because of massive genital bleeding successfully treated with transcatheter arterial embolization (TAE), using N-butyl-2-cyanoacrylate (NBCA) under balloon occlusion. Balloon occlusion at the uterine artery was performed in both patients for diffuse distribution of NBCA in multiple feeding branches, as well as to the pseudoaneurysm, and for the prevention of NBCA reflux. In one of our patients, balloon occlusion of the draining vein was simultaneously performed to prevent NBCA migration through accompanying high-flow arteriovenous fistula (AVF). Doppler ultrasound at 6 months of both patients documented persistent complete occlusion of AVM. Complete and safe obliteration of acquired uterine AVM was accomplished using NBCA as embolic agent, under balloon occlusion at the communicating vessels of acquired uterine AVM.
The re-evaluation of the measurement of pain in population-based epidemiological studies: The SHAMA study
Authors: Flüß Elisa , Bond Christine M , Jones Gareth T , Macfarlane Gary J
Published: September 2014

Background:

While many pain patients rely on pain-relieving treatments to manage their pain, pain-related research commonly quantifies pain status using validated questionnaires without taking into account that information. This will lead to an underestimate of the burden of pain in the community. To ensure a more accurate assessment of the prevalence and severity of pain, this study aimed to develop a pain management questionnaire and to assess how much population-based pain estimates change when pain management is considered.

Methods:

This study was a cross-sectional population-based study in Grampian, north-east Scotland. A total of 4600 people, aged 25 years and over, were randomly selected from a population sample frame and sent a questionnaire on pain and pain management. Population estimates of pain were determined twice: with the use of standard pain status questionnaires (‘current pain’) and with the use of a newly developed enhanced pain status questionnaire to determine patients’ estimated pain without pain management (‘all pain’).

Results:

The prevalence of current pain was 50.5% (95% CI = 48.0, 52.9). Of those who reported no current pain, 11.6% (95% CI = 9.4, 13.8) reported that they would have had pain had they not managed their pain. Thus, the all pain prevalence was 56.2% (95% CI = 53.7, 58.7). This difference in prevalence rates was statistically significant (difference = 5.7%; 95% CI = 2.2, 9.2). Likewise, participants’ pain severity significantly increased when they estimated their pain without pain management (p < 0.001, Wilcoxon-signed rank test).

Conclusions:

Failure to assess pain management information results in an underestimation of pain prevalence and severity. This should be considered in future epidemiological studies.

Summary points

Pain management information is currently not considered for the assessment of pain in epidemiological population-based studies. Since pain management can affect people’s pain status drastically, it is likely that we currently underestimate the true burden of pain in studies assessing pain. Incorporating self-reported pain management information in an epidemiological study of pain led to significantly increased estimates of both pain prevalence and pain severity. It is therefore crucial to collect and take into account people’s pain management information in future studies for a more accurate measurement of pain.
A survey of birth order status of students studying for medical degree at the University of Sheffield
Authors: Clayton Sarah , Apperley Elizabeth , Hannon Fergus , Karia Anika , Baxter Victoria , Julious Steven A
Published: September 2014

Summary

Objective

It is hypothesised that firstborn children and only children are more intelligent with higher intelligence scores having been observed in firstborn or only children. Evidence of the increased intelligence has been suggested by the fact that 21/23 (91%) of US astronauts, 23/43 (53%) of US presidents and between 75 and 80% of students at Harvard are firstborn or only children. It is of interest to investigate, therefore, whether a high achieving career such as medicine has a disproportionate number of firstborn or only children.

Design

A survey of medical students.

Setting

The University of Sheffield Medical School.

Participants

All students studying medicine in the academic year 2011–2012.

Main outcome measures

The proportion of firstborn or only children.

Results

There was a disproportionate number of students who were firstborn or only children: 53% (95% CI 49 to 58%). The expected percentage is 39.8% and therefore we can reject the null hypothesis. The results were consistent across all phases of study.

Conclusions

There is a higher than expected proportion of medical students at the University of Sheffield who are firstborn or only children. The data though highlight the issue of comparing populations. Here we are comparing a population of medical students with a general population. A comparison which may not be appropriate as medical students may be drawn from a subsample of the general population.
Evaluating evidence for atrophic scarring treatment modalities
Authors: Patel Lopa , McGrouther Duncan , Chakrabarty Kaushik
Published: September 2014

Summary

Introduction

Atrophic scars cause significant patient morbidity. Whilst there is evidence to guide treatment, there does not appear to be a systematic review to analyse the efficacy of treatment options.

Objectives

To retrieve all evidence relating to atrophic scar treatment and evaluate using the Clinical Evidence GRADE score in order to allow clinicians to make evidence-based treatment choices.

Method

Searches were performed in Medline, EMBASE, CINHL and Cochrane to identify all English studies published evaluating treatment of atrophic scars on adults excluding journal letters. Each study was allocated a GRADE score based on type of study, quality, dose response, consistency of results and significance of results. The end score allowed categorisation of evidence into high, moderate, low or very low quality.

Results

A total of 41 studies were retrieved from searches including randomised controlled trials, observational studies, retrospective analyses and case reports of which 7% were allocated a high-quality score, 10% a moderate score, 7% a low score and 75% a very low score. Treatment modalities included ablative laser therapy, non-ablative laser therapy, autologous fat transfer, dermabrasion, chemical peels, injectables, subcision, tretinoin iontophoresis and combination therapy.

Conclusion

There is a paucity of good-quality clinical evidence evaluating treatment modalities for atrophic scarring. Evidence supports efficacy of laser, surgery and peel therapy. Further biomolecular research is required to identify targeted treatment options and more randomised controlled trials would make the evidence base for atrophic scar treatment more robust.
In Vitro Attenuation of Thermal-Induced Protein Denaturation by Aerial Parts of Artemisia scoparia
Authors: Khan Murad Ali , Khan Haroon , Tariq Shafiq Ahmad , Pervez Samreen
Published: September 2014

The goal of this study was to explore the aerial parts of Artemisia scoparia (crude extract, total flavonoid contents, and aqueous fraction) for protein denaturation potential. The crude extract provoked marked attenuation of thermal-induced denatured protein in a concentration-dependent manner with maximum inhibition of 54.05 μg/mL at 500 μg/mL and IC50 of 449.66 μg/mL. When total flavonoid contents were studied, it illustrated most dominant activity concentration dependently with maximum amelioration of 62.16 μg/mL at 500 μg/mL and IC50 of 378.35 μg/mL. The aqueous fraction also exhibited significant activity with maximum of 56.75% inhibition at 500 μg/mL and IC50 of 445.10 μg/mL. It can be concluded on the basis of the results that the crude extract, flavonoid contents, and aqueous fraction of the plant possessed significant inhibition on thermal-induced denatured protein.
Effects of Using an iPod App to Manage Recreation Tasks
Authors: Uphold Nicole M. , Douglas Karen H. , Loseke Dannell L.
Published: September 2014

A withdrawal design study evaluated the effectiveness of using constant time delay to teach six adults with a developmental disability to program and use an iPod touch® as an electronic photographic activity schedule (ePAS). The ePAS, created with the First Then Visual Schedule app, consisted of photographs of different exercises to complete during their workout time at the recreation facility on their community college campus. Dependent variables included the percent of correct steps programming the device and the percent of exercises completed correctly. All participants learned to program their iPod touch® within six sessions and maintained the skill during the second intervention condition. For generalization, participants programmed self-selected exercises into the device and performed each exercise.
Enthusiasts, Delayers, and the Ambiguous Middle
Authors: Willoughby Brian J. , Hall Scott S.
Published: September 2014

Utilizing a sample of 571 college students, we examined the varying marital paradigms held by emerging adults. Drawing on Marital Paradigm Theory, we explored how beliefs about Marital Salience, timing, process, context, permanence, and centrality created unique paradigms about marriage. We found evidence that emerging adults can be separated into at least three marital paradigms, labeled Enthusiast, Delayer, and Hesitant. We found that most emerging adults hold a Hesitant marital paradigm highlighted by a strong belief in the importance of marriage and a desire to marry but a general belief in the lack of Marital Permanence and a hesitation to marry quickly. Other results suggested that marital paradigms are linked to demographic characteristics such as age and religiosity and also linked to risk-taking behaviors, particularly alcohol use and binge drinking rates. Specifically, those emerging adults who held an Enthusiast paradigm reported less alcohol or binge drinking compared to those in the Hesitant class.