bluuebunny/crossref_metadata_2025 huggingface dataset:
Plantarflexion Torque Following Reconstruction of Achilles Tendinosis or Rupture with Flexor Hallucis Longus Augmentation
Authors: Monroe Michael T. , Dixon David J. , Beals Timothy C. , Pomeroy Gregory , Crowley David L. , Manoli Arthur
Published: January 2017

Nine patients treated surgically for Achilles tendon rupture (7 patients) or tendinosis (2 patients) with primary repair or debridement and augmentation with the flexor hallucis longus muscle-tendon unit were evaluated at a mean of 19 months postoperative. Subjective evaluation revealed a high level of satisfaction. All patients returned to work and only two patients reported limitation in their recreational activities. The mean post-operative AOFAS Ankle-Hindfoot Score was 90 points. Four patients reported mild occasional pain and one patient complained of moderate daily pain. Motion assessment showed a 20% increase in the hallux MTP dorsiflexion compared to the non-operative side (p = 0.045). No difference in ankle motion was noted.

Cybex II+ dynamic evaluation of plantarflexion peak torque was complete on both extremities. The torque deficit on the reconstructed extremity was 20% (p = 0.01) at 120 degrees per second and 26% (p = 0.003) at 30 degrees per second. There is no significant difference between the torque deficit recorded for patients with Achilles rupture and those with Achilles tendinosis. A trend toward improved torque production with longer follow up was observed.
A Determination of Ankle Kinematics Using Fluoroscopy
Authors: Komistek Richard D. , Stiehl James B. , Buechel Frederick F. , Northcut Eric J. , Hajner Mary E.
Published: January 2017

In vivo weight-bearing studies utilizing dynamic video fluoroscopy have been shown to offer an accurate and reproducible method for determining the kinematics of a joint. The purpose of this study was to evaluate translational and rotational motions of the distal tibia relative to the talus in the sagittal and frontal planes. Ten subjects, each having a normal ankle and a total ankle arthroplasty on the opposite side (Buechel-Pappas Total Ankle, Endotec, South Orange, NJ), were studied under in vivo, weight-bearing conditions using video fluoroscopy. All ten subjects were judged to have a successful arthroplasty without demonstrable pain or ligament instability. Under weight-bearing conditions, each subject performed successive motions moving from maximum dorsiflexion to plantarflexion. At maximum dorsiflexion, both the normal and implanted ankles had similar sagittal midline talar contact positions but with plantar flexion, implanted ankles had increased posterior talar contact. Contact points on the distal tibia revealed that the lateral surface contacted at the midline or posterior throughout range-of-motion with minimal translation. The medial distal tibia contacted the talus posterior on plantarflexion and often moved anteriorly with dorsiflexion. This translation described relative external rotation of the distal tibia on plantar flexion and internal rotation on dorsiflexion. The measured distances were larger for the implanted ankles with higher variability. The average range-of-motion was 37.4° for normal ankles and 32.3° for implanted ankles. This study defines the normal kinematic rotational and translational motions of the ankle joint by accurately describing the three dimensional joint orientations. The implanted ankles experienced rotational and translational motions but had contacts more posterior, possibly related to surgical technique or alterations of ligamentous tension.
ACE Phenotyping as a Guide Toward Personalized Therapy With ACE Inhibitors
Authors: Danilov Sergei M. , Tovsky Stan I. , Schwartz David E. , Dull Randal O.
Published: January 2017

Background:

Angiotensin-converting enzyme (ACE) inhibitors (ACEI) are widely used in the management of cardiovascular diseases but with significant interindividual variability in the patient’s response.

Objectives:

To investigate whether interindividual variability in the response to ACE inhibitors is explained by the “ACE phenotype”—for example, variability in plasma ACE concentration, activity, and conformation and/or the degree of ACE inhibition in each individual.

Methods:

The ACE phenotype was determined in plasma of 14 patients with hypertension treated chronically for 4 weeks with 40 mg enalapril (E) or 20 mg E + 16 mg candesartan (EC) and in 20 patients with hypertension treated acutely with a single dose (20 mg) of E with or without pretreatment with hydrochlorothiazide. The ACE phenotyping included (1) plasma ACE concentration; (2) ACE activity (with 2 substrates: Hip-His-Leu and Z-Phe-His-Leu and calculation of their ratio); (3) detection of ACE inhibitors in patient’s blood (indicator of patient compliance) and the degree of ACE inhibition (ie, adherence); and (4) ACE conformation.

Results:

Enalapril reduced systolic and diastolic blood pressure in most patients; however, 20% of patients were considered nonresponders. Chronic treatment results in 40% increase in serum ACE concentrations, with the exception of 1 patient. There was a trend toward better response to ACEI among patients who had a higher plasma ACE concentration.

Conclusion:

Due to the fact that “20% of patients do not respond to ACEI by blood pressure drop,” the initial blood ACE level could not be a predictor of blood pressure reduction in an individual patient. However, ACE phenotyping provides important information about conformational and kinetic changes in ACE of individual patients, and this could be a reason for resistance to ACE inhibitors in some nonresponders.
The Mediating Role of Emotions in the Relationship between Frames and Attribution of Responsibility for Health Problems
Authors: Major Lesa Hatley
Published: January 2017

This experiment explored the effects of thematic and episodic and gain and loss frames on emotional responses and attribution of responsibility. Also, it analyzed whether or not emotions mediate the effect of frames on attribution of responsibility. Participants were randomly assigned to read stories about obesity and lung cancer that employed thematic/loss, thematic/gain, episodic/loss, or episodic/gain frames. The relationship between gain frames and social attribution of responsibility was mediated by guilt. Thematic, episodic, loss, and gain frames elicited significant emotional responses when used in stories about lung cancer and obesity.
Do Emotions Spark Interest in Alternative Tobacco Products?
Authors: Popova Lucy , So Jiyeon , Sangalang Angeline , Neilands Torsten B. , Ling Pamela M.
Published: January 2017

Background. Exposure to advertisements for tobacco products and tobacco warning labels evokes emotions. This study evaluated the association of discrete positive and negative emotions with interest in alternative tobacco products. Method. In 2013, 1,226 U.S. adult nonsmokers and current smokers viewed advertisements for moist snuff, snus, and electronic cigarettes (e-cigarettes) with various warning labels and then indicated their emotional responses in terms of anger, anxiety, sadness, guilt, disgust, discouragement, hope, and contentment. Outcomes were openness to using moist snuff, snus, and e-cigarettes in the future and interest in a free sample of each product. Data were analyzed in 2016. Results. Hope was positively associated with openness and interest across all alternative tobacco products as was contentment for moist snuff and snus. Anger was negatively associated with openness to moist snuff and e-cigarettes, disgust negatively to moist snuff and snus, and anxiety negatively to e-cigarettes. Being a current smoker, ever trying a corresponding product, being male, and younger age were associated with greater openness to and interest in moist snuff and snus. For e-cigarettes, being a current smoker, ever trying e-cigarettes, and being female were associated with greater openness, and being a current smoker was associated with greater odds of selecting a free sample. Conclusions. Positive emotions, particularly hope, were consistently positively associated with interest in alternative tobacco products. Hope is widely used by tobacco and e-cigarette companies to advertise their products. Antitobacco messages should aim to lower hope associated with tobacco products but increase hope for cessation or life without tobacco.
Malignant Pilomatrixoma Arising on the Previously Irradiated Face: Case Report and Literature Review
Authors: Karaaslan Onder , Can Murat Melih , Silistreli Ayse Ozlem Karatas , Bedir Yagmur Kaan , Caliskan Gorkem
Published: January 2017

Background:

Malignant pilomatrixoma (also known as pilomatrix carcinoma) is a very rare malignant neoplasm derived from the hair matrix. These slow-growing malignancies of the skin are found in the lower dermis and subcutaneous fat layer. They can exhibit local aggressive behavior or distant metastasis. This malignancy can arise as a solitary lesion de novo or through transformation of a pilomatrixoma over a long period. There is no known distinct etiologic factor or predisposing condition for this kind of malignancy.

Objective and Conclusion:

We present an interesting case of a 65-year-old man with a pilomatrix carcinoma arising on the previously irradiated face due to the malignant neoplasm of the parotid gland. This is the first report of a pilomatrix carcinoma that has developed on a region that has undergone radiotherapy for another malignancy.

Renseignements de base:

Le pilomatrixome malin (aussi appelé « carcinome à pilomatrix ») est une tumeur maligne très rare issue de la matrice du poil. Ces tumeurs cutanées malignes à croissance lente se trouvent dans le derme profond et la couche adipeuse sous-cutanée. Elles peuvent présenter un comportement agressif local ou des métastases distales. Cette tumeur maligne peut se développer sous forme de lésion solitaire de novo ou à la suite d'une transformation d'un pilomatrixome de longue durée. Aucun facteur étiologique distinct et aucune condition prédisposante pour ce type de tumeur maligne ne sont connus.

Objectif and conclusion:

Nous exposons le cas intéressant d'un homme de 65 ans présentant un carcinome à pilomatrix au visage et dont le visage a été préalablement irradié pour traiter une tumeur maligne de la glande parotide. Il s'agit du premier cas de carcinome à pilomatrix rapporté qui s'est développé à un endroit qui a subi une radiothérapie pour traiter une autre tumeur maligne.
Effective Treatment of Nodular Amyloidosis with Carbon Dioxide Laser
Authors: Lesiak Aleksandra , Rakowski Adam , Brzezinska Agnieszka , Rogowski-Tylman Michal , Kolano Pawel , Sysa-Jedrzejowska Anna , Narbutt Joanna
Published: January 2017

Background:

Nodular amyloidosis is a rare form of localized cutaneous amyloidosis that is characterized by nodules located on the extremities, trunk, genitalia, or face. In treatment regimens, many approaches have been described, including carbon dioxide (CO2) laser therapy.

Objective:

We present a case of a 60-year-old white male with a 20-year history of disseminated waxy, purpuric, yellowish, and bullous skin lesions on the trunk and extremities. The skin changes were accompanied by pain during palpation and were temporarily pruritic.

Method:

Based on histologic and direct immunofluorescence test findings, the diagnosis of cutaneous nodular amyloidosis was established. Skin lesions were treated with a CO2 laser. During surgery, treated tissue was found to be slightly friable, and there was a little problem with hemostasis that correlated with amyloid infiltration of the dermis and blood vessels. However, after 8 weeks, we observed clinical improvement of all treated areas with the presence of atrophic scars. In the regions of laser therapy, no recurrence of the disease was observed during a 12-month follow-up.

Conclusion:

Based on these results, we conclude that CO2 laser has a beneficial effect in the treatment of nodular amyloidosis; however, surgery procedures may be associated sometimes with tissue friability and poor hemostasis.

Contexte:

L'amylose nodulaire est une forme rare d'amylose cutanée localisée, qui se caractérise par des nodules situés sur les membres, le tronc, les organes génitaux, et la face. Diverses formes de traitement ont été décrites, notamment le traitement au laser à gaz carbonique (CO2).

Objectif:

Nous exposons ici le cas d'un homme de 60 ans, de race blanche, présentant, depuis une vingtaine d'années, des lésions cutanées bulleuses, jaunâtres, purpuriques, et d'apparence cireuse, disséminées sur le tronc et les membres. Les lésions s'accompagnaient de douleur à la palpation et étaient prurigineuses pendant un certain temps.

Méthode:

Le diagnostic d'amylose nodulaire cutanée a été posé d'après les résultats de l'examen histologique et de l'immunofluorescence directe. Les lésions ont été traitées au laser à CO2. Les tissus se montraient légèrement friables durant la chirurgie, et l'hémostase était quelque peu difficile en raison de l'infiltration amyloïde du derme et des vaisseaux sanguins. Toutefois, une amélioration clinique de toutes les régions traitées a été marquée, au bout de 8 semaines, par l'apparition de cicatrices atrophiques. Il n'y a pas eu de récidive de la maladie dans les régions traitées au laser, au cours d'un suivi de 12 mois.

Conclusion:

Nous avons déduit des résultats que le laser à CO2 avait un effet favorable sur l'amylose nodulaire; cependant, l'intervention chirurgicale peut parfois être gênée par la friabilité des tissus et une mauvaise hémostase.
A critical reading of the European Union’s social innovation policy discourse: (Re)legitimizing neoliberalism
Authors: Fougère Martin , Segercrantz Beata , Seeck Hannele
Published: January 2017

In this article, we conduct a critical reading of the European Union social innovation policy discourse. We argue that rather than being a transformative discourse within European Union policy, European Union social innovation policy discourse reinforces neoliberal hegemony by (re)legitimizing it. Inspired by post-foundational discourse theory and Glynos and Howarth’s logics of critical explanation, we analyse three central European Union social innovation policy documents. We characterize what kind of political project is articulated in and through European Union social innovation policy discourse, and uncover how it relates to neoliberal political rationality. Our contribution lies in showing (1) how the social logics of European Union social innovation policy can be understood as both ‘roll-out’ and ‘roll-with-it’ neoliberalization, thereby relegitimizing and naturalizing neoliberalism; (2) how the political logics of European Union social innovation policy pre-empt the critique of ‘roll-back’ neoliberalization and thus legitimize decreased public expenditure; and (3) how the fantasmatic logics make European Union social innovation policy ideologically useful in relegitimizing neoliberalism through the win-win-win fantasy and the ethical responsibilization of subjects. We argue that resisting the neoliberalizing power of European Union social innovation policy discourse implies resisting the fantasmatic grip of social innovation as carrying a sublime win-win-win. Instead of accepting social innovation as driven by a replication of best practices, we need to understand social innovations as conceived and suited for particular social issues in particular contexts: we call for a different win-win mindset that does not blind innovators to possible negative impacts of social innovations.
Friction characteristics of magneto-rheological fluid on DLC- and PTFE-coated surfaces
Authors: Zhang Peng , Lee Kwang-Hee , Lee Chul-Hee
Published: January 2017

In this study, the friction characteristics of a magneto-rheological fluid are examined with different surface process technologies such as polytetrafluoroethylene coatings and diamond-like carbon coatings by using a reciprocating friction tester. The friction characteristics of the magneto-rheological fluid are also examined with diamond-like carbon coatings at various temperatures. The substrate material (plate) used for coating with diamond-like carbon and polytetrafluoroethylene is aluminum (Al6061), which is widely used in engineering applications. The descending sequence of the coefficients of friction is Al6061 > diamond-like carbon > polytetrafluoroethylene. The surfaces are observed by scanning electron microscopy before and after the experiment. In addition, the chemical compositions of the worn surfaces were analyzed using energy-dispersive X-ray spectroscopy. By comparing the results, the friction characteristics of the magneto-rheological fluid are analyzed based on the different coating methods.
Taking data seriously: the value of actor-network theory in rethinking patient experience data
Authors: Desai Amit , Zoccatelli Giulia , Adams Mary , Allen Davina , Brearley Sally , Rafferty Anne Marie , Robert Glenn , Donetto Sara
Published: January 2017

Hospitals are awash with patient experience data, much of it collected with the ostensible purpose of improving the quality of patient care. However, there has been comparatively little consideration of the nature and capacities of data itself. Using insights from actor-network theory, we propose that paying attention to patient experience data as having agency in particular hospital interactions allows us to better trace how and in what circumstances data lead (or fail to lead) to quality improvement.
Accuracy of Teleradiology in Skeletal Disorders: Solitary Bone Lesions and Fractures
Authors: Martel J , Jiménez M D , Martín-Santos F J , López-Alonso A
Published: January 2017

To evaluate the diagnostic accuracy of digitized film radiography and digital teleradiology for detecting bone fractures and for studying solitary bone lesions, we examined 633 single radiographs from 373 patients (159 with solitary bone lesions, 123 with fractures and 91 without pathology). Radiographs were digitized using a commercial teleradiology workstation and transmitted to a local hospital over a standard telephone line. Images were reviewed by two groups of three experienced radiologists. Receiver operating characteristic (ROC) curves were analysed for conventional films, digitized images and transmitted teleradiology images. No significant differences were found among readers for the evaluation of bone fractures and solitary bone lesions. Teleradiology systems permit remote expert consultation, and telediagnosis therefore is a powerful tool in telemedicine.
Should the ‘C’ in ‘ABCDE’ Be Altered to Reflect the Trend towards Hypotensive Resuscitation?
Authors: Sapsford W.
Published: January 2017

Background:

Fluid resuscitation of trauma victims currently differs, depending on whether the Advanced Trauma Life Support (ATLS), Prehospital Trauma Life Support (PHTLS) or Battlefield Advanced Trauma Life Support (BATLS) algorithm is utilised. Resuscitation protocol depends on the situation of the patient before definitive surgical control of the haemorrhage can be achieved, that is, in the prehospital phase (the urban, rural or battlefield setting) or in the emergency room. The principle difference is between hypotensive (PHTLS and BATLS, in the prehospital phase) and normotensive (ATLS, in the emergency room) resuscitation. The aim of this review was to determine if there is sufficient evidence to consider altering the ATLS resuscitation algorithm to a hypotensive model prior to definitive surgical control of haemorrhage.

Method:

A literature review was conducted of the experimental and clinical evidence for hypotensive resuscitation.

Results:

Uncontrolled haemorrhage models are too severe. They do not realistically mimic — And their results cannot easily be extrapolated into — Clinical scenarios. One important clinical trial, inspired by these experimental models, has rightly influenced resuscitation of shocked prehospital patients towards a ‘scoop and run’ approach and permissive hypotension but it is specific to patients with penetrating trauma alone.

Conclusion:

There is insufficient evidence to alter the current ATLS algorithm in the emergency room in favour of hypotensive resuscitation. The future of resuscitation is considered.
Congenital Diaphragmatic Hernia: Improved Surgical Results Should Influence Abortion Decision Making
Authors: Gudbjartsson T. , Gunnarsdottir A. , Topan C. Z. , Larsson L. T. , Rosmundsson Th , Dagbjartsson A.
Published: January 2017

Aims:

To compare surgical results for congenital diaphragmatic hernia (CDH) in two Scandinavian university hospitals and to evaluate the effects of abortions on the clinical profile of CDH in Iceland.

Methods:

A retrospective study including all CDH-cases in Iceland 1983–2002 and children referred to Lund University Hospital 1993–2002. Aborted fetuses with CDH from a nation-wide Icelandic abort-registry were also included.

Results:

In Iceland, 19 out of 23 children with CDH were diagnosed < 24 hours from delivery, one with associated anomalies. Eight fetuses were diagnosed prenatally and seven of them aborted, three having isolated CDH at autopsy. In Iceland, 15 of 18 children operated on survived surgery (83% operative survival). In Lund 28 children were treated with surgery, 23 of them diagnosed early after birth or prenatally. Four children did not survive surgery (86% operative survival) and 9 (31%) had associated anomalies. All the discharged children treated in Iceland and Lund are alive, 3–22 years postoperatively.

Conclusion:

CDH is a serious anomaly where morbidity and mortality is directly related to other associated anomalies and pulmonary hypoplasia. However, majority of CDH patients do not have other associated anomalies. In spite of improved surgical results (operative mortality < 20%), a large proportion of pregnancies complicated with CDH are terminated. We conclude that the improved survival rate after corrective surgery must be emphasized when giving information to parents regarding abortion of fetuses with a prenatally diagnosed CDH.
Smoking Increases the Incidence of Complicated Diverticular Disease of the Sigmoid Colon
Authors: Turunen P. , Wikström H. , Carpelan-Holmström M. , Kairaluoma P. , Kruuna O. , Scheinin T.
Published: January 2017

Backround and Aims:

The aim of this study was to establish whether smoking is associated with complicated diverticular disease and adverse outcomes of operative treatment of diverticular disease. Smoking has been associated with increased rate of perforations in acute appendicitis as well as failure of colonic anastomosis in patients resected for colonic tumours. It has also been suggested that smoking is a risk factor for complicated diverticular disease of the colon.

Material and Methods:

Retrospective investigation of records of 261 patients electively operated for diverticular disease in Helsinki university Central Hospital during a period of five years.

Results:

The smokers underwent sigmoidectomy at a younger age than the non-smokers (p = 0.001) and they had an increased rate of perforations (p = 0.040) and postoperative recurrent diverticulitis episodes (p = 0.019).

Conclusions:

We conclude that smoking increases the likelihood of complications in diverticulosis coli. The development of complicated disease also seems to proceed more rapidly in smokers.
Comparison of Linear versus Circular Stapling Techniques in Laparoscopic Gastric Bypass Surgery — A Pilot Study
Authors: Giordano S. , Tolonen P. , Victorzon M.
Published: January 2017

Background:

There is major variability in how the gastrojejunostomy (GJ) is created when laparoscopic gastric bypass (LRYGB) is performed. This is a prospective, non-randomised pilot comparison of two different techniques during our learning curve period performed by two different surgeons with similar surgical experience.

Methods:

From March 2006 until May 2008, 71 consecutive patients, 28 men and 43 woman, mean age 44 (range 24 to 62 years) who were operated for morbid obesity by laparoscopic bypass surgery have been included. Mean preoperative Body Mass Index (BMI) (range) was 47 (34–63). The patients were divided into two groups on the basis of the stapler used. Group 1 comprised 30 patients who underwent surgery using a 25 mm circular stapler to create the GJ. Group 2 comprised 41 patients who underwent surgery using a 45 mm, blue cartridge linear stapler. Operative time, intra-operative complications, hospital stay, major and minor complications were detected.

Results:

Intra-operative complications occurred in 4 patients (13.3%) in Group 1, in 5 patients (12.2%) in Group 2. Re-operations occurred 3 times (10.0%) in Group 1, and 4 times (9.8%) in Group 2 due to anastomotic complications, bleeding and/or bowel obstruction. Major complications occurred in four patients in Group 1 (13.3%) and in seven patients in Group 2 (17.1%). There was a significant difference in the overall morbidity rate (major and minor complications), which was 56.7% in Group 1 and 34.1% in Group 2 (p = 0.05). Mean operative time in Group 1 was 135 minutes, and in Group 2 122 minutes. Mean hospital stay was significantly shorter in Group 2 (3.9 days) than in Group 1 (5.7 days, p = 0.04).

Conclusions:

Learning to handle the technique when performing the gastrojejunostomy during laparoscopic gastric bypass surgery may be faster and easier by using the linear stapler. This may be important knowledge for centres considering starting LRYGB practice, although the surgeon factor needs to be taken in account. The results should be interpreted with caution because the confounding effect of one surgeon performing one type of operation while the other surgeon (is performing) the second type of operation could not be taken into account in this prospective non-randomized analysis.
Surgical Wound Infections after Vascular Surgery: Prospective Multicenter Observational Study
Authors: Turtiainen J. , Saimanen E. , Partio T. , Kärkkäinen J. , Kiviniemi V. , Mäkinen K. , Hakala T.
Published: January 2017

Background and Aims:

This multicenter prospective observational study defined the incidence and risk factors of surgical wound infections (SWI) after infrarenal aortic and lower limb vascular surgery procedures and evaluated the severity and costs of these infections.

Methods:

The study cohort comprised of 184 consecutive patients. Postoperative complications were recorded. The additional costs attributable to SWI were calculated.

Results:

Eighty-four (46%) patients had critical ischaemia, 81 (45%) patients underwent infrainguinal bypass surgery and 64 (35%) received vascular prosthesis or prosthetic patch. Forty-nine (27%) patients developed SWI. Staphylococcus aureus was the leading pathogen cultured from the wound. Forty-seven of the 49 infected wounds responded to and healed with the treatment. SWI was the cause of one major amputation. Independent predictors for SWI were infrainguinal surgery (OR 7.2, 95% Cl 2.92–17.65, p < 0.001), obesity (OR 6.1, 95% Cl 2.44–15.16, p < 0.001) and arteriography injection site within the operative area (OR 2.5, 95% Cl 1.13–5.48, p = 0.02). The average cost attributable to SWI was 3320 €.

Conclusion:

The incidence of SWI after vascular surgery is high. The risk factors for SWI are infrainguinal surgery, obesity and arteriography injection site within the operative area. SWI increases morbidity and costs of operative treatment.
Multiple crack identification in frame structures using a hybrid Bayesian model class selection and swarm-based optimization methods
Authors: Fatahi Laleh , Moradi Shapour
Published: January 2017

Crack identification in engineering structures has been widely investigated by researchers. Most of the literature on multiple crack identification, however, has focused on rather simple structures like beams and it is often assumed that the number of cracks is known while this is not a practical assumption. In this article, multiple crack identification in frame structures is investigated based on experimental vibration data using the Bayesian model class selection and swarm-based optimization methods to identify both the number of cracks and their characteristics. To this end, first, the numerical model of the intact frame is updated based on the natural frequencies of the intact state using the particle swarm inspired multi-elitist artificial bee colony algorithm. After updating the intact model of the structure, a set of numerical models of the cracked frame with different numbers of cracks is constructed. Since the number of cracks is not known a priori, the Bayesian model class selection is employed to find the most plausible model class in order to predict the number of cracks. Then, the parameters of the cracks are identified using the particle swarm inspired multi-elitist artificial bee colony algorithm. Instead of pinpointing to one optimal solution obtained after a large number of function evaluations, a set of best solutions whose objective values are less than 10−5 are recorded and the regions where the best solutions are concentrated are identified to see how the solution would differ if less number of function evaluations is employed. To fully assess the effectiveness of this approach, both numerical and experimental examples are utilized. The results confirm the effectiveness of the proposed method for identifying multiple cracks in the frames using a few experimental natural frequencies of the structure. The effect of using more natural frequencies on the accuracy of the location and depth of the cracks is also studied.
The detection and policing of gun crime: Challenges to the effective policing of gun crime in Europe
Authors: Hellenbach Mike , Elliott Sue , Gerard F. Jeane , Crookes Becky , Stamos Thanos , Poole Helen , Bowen Erica
Published: January 2017

Despite a shared understanding across the European Union (EU) that access to firearms by the general public should be restricted, detailed legislation regarding the ownership, use and trade of firearms varies between EU member states. It is unclear, however, how such variations impact on the policing of gun-enabled crime. By using qualitative data generated from interviews with police, policy and decision makers from 13 European countries, we aim to determine how stakeholders perceive that national variations in firearms legislation affect the policing of gun-enabled crime within and across EU countries. Four main themes were identified from the qualitative data: disparities in legislation, disparities in the priority given and the resources allocated to investigations into gun-enabled crime, as well as interventions. Owing to the aforementioned disparities, cross-national investigations into incidents of gun crime are at risk of remaining impaired in their effectiveness. Therefore, more legislative coherency as well as sustainable long-term interventions will be needed to successfully reduce ownership and use of firearms in the criminal world. In this context, a departure from an exclusive use of an economic model of gun crime is recommended to allow for a better understanding of the dynamics of the black gun market.
Don’t be fooled by ignorant schoolmasters: On the role of the teacher in emancipatory education
Authors: Biesta Gert
Published: January 2017

The question I address in this article is how we might understand the role of the teacher in education that seeks to promote emancipation. I take up this question in conversation with German and North-American versions of critical pedagogy with, the works of Paulo Freire and with that of Jacques Rancière. I show that in each case we find not only a strong argument for emancipatory education but also a distinct view about the role of the teacher. My aim is partly to show the different ways in which the role of the teacher in emancipatory education can be conceived and to make clear how this role is related to the different understandings of emancipation and the dynamics of emancipatory education. The motivation for writing this article also stems from what I see as a rather problematic interpretation of the work of Rancière in recent educational scholarship, one where the key message of his 1991 book The Ignorant Schoolmaster is taken to be that anyone can learn without a teacher and that this alleged ‘freedom to learn’ would constitute emancipation. I challenge such a constructivist interpretation of Rancière’s work and argue that the key message of The Ignorant Schoolmaster is that emancipatory education is not a matter of transfer of knowledge from a teacher who knows to a student who does not (yet) know, but nonetheless is a process in which teachers and their teaching are indispensable. This will allow me to argue why and how teaching remains essential for emancipatory education and why we should therefore not be fooled into thinking that ignorant schoolmasters, because they have no knowledge to give, have nothing to teach and can be done away with.
Mapping the methylation status of the miR-145 promoter in saphenous vein smooth muscle cells from individuals with type 2 diabetes
Authors: Riches Kirsten , Huntriss John , Keeble Claire , Wood Ian C , O’Regan David J , Turner Neil A , Porter Karen E
Published: January 2017

Type 2 diabetes mellitus prevalence is growing globally, and the leading cause of mortality in these patients is cardiovascular disease. Epigenetic mechanisms such as microRNAs (miRs) and DNA methylation may contribute to complications of type 2 diabetes mellitus. We discovered an aberrant type 2 diabetes mellitus–smooth muscle cell phenotype driven by persistent up-regulation of miR-145. This study aimed to determine whether elevated expression was due to changes in methylation at the miR-145 promoter. Smooth muscle cells were cultured from saphenous veins of 22 non-diabetic and 22 type 2 diabetes mellitus donors. DNA was extracted, bisulphite treated and pyrosequencing used to interrogate methylation at 11 CpG sites within the miR-145 promoter. Inter-patient variation was high irrespective of type 2 diabetes mellitus. Differential methylation trends were apparent between non-diabetic and type 2 diabetes mellitus–smooth muscle cells at most sites but were not statistically significant. Methylation at CpGs −112 and −106 was consistently lower than all other sites explored in non-diabetic and type 2 diabetes mellitus–smooth muscle cells. Finally, miR-145 expression per se was not correlated with methylation levels observed at any site. The persistent up-regulation of miR-145 observed in type 2 diabetes mellitus–smooth muscle cells is not related to methylation at the miR-145 promoter. Crucially, miR-145 methylation is highly variable between patients, serving as a cautionary note for future studies of this region in primary human cell types.
Providing Support to Families considering the Option of Organ Donation: An Innovative Training Method
Authors: Jacoby Liva , Crosier Vicki , Pohl Henry
Published: January 2017

Families must make decisions about organ donation for a loved one during intensely emotional circumstances in the hospital, where support from others is crucial to their coping. Research about families' experiences during the decision-making process regarding donating their loved ones' organs has shown that quality of hospital care and receiving psychosocial support are important factors influencing their decision. Typically, a donation coordinator from the local organ procurement organization approaches the family about the option of donation, whereas the role of medical and nursing staff is to convey diagnostic and prognostic information to the family. Currently, no requirement is in place for training of professional staff in communication skills for approaching and interacting with families about organ donation. This article discusses a simulated training method in empathic communication used for supporting families who are approached about organ donation. This innovative method can be adapted to and should be tested with professional audiences.
Revascularization of Kidney Allograft after Renal Artery Occlusion Secondary to Angioplasty
Authors: Subramaniam Murali , Edwards Richard , Osman Hisham Y.
Published: January 2017

Arterial thrombosis causing complete occlusion is a rare event in the natural history of a transplanted allograft; an incidence of 1.4% has been reported. This condition usually results from technical problems, hyperacute rejection, severe atherosclerosis, or injury to donor or recipient arteries. The treatment of choice is transplant nephrectomy. We report a case of renal artery occlusion after a therapeutic radiological procedure and subsequent salvaging of the graft. The case report shows that an aggressive surgical approach toward restoring circulation is worth the effort.
African American Consent and Nonconsent Cases: Are There Significant Differences?
Authors: Dodd-McCue Diane , Tartaglia Alexander
Published: January 2017

Background

Previous research has examined the differences in organ donation consent rates between African Americans and other racial/ethnic groups. However, there is limited examination of whether differences exist between African American families that consent and those that do not.

Objective

To examine if there are significant differences between African American families that consent to donation compared to those that do not.

Methods

A random sample of 120 African American potential donor cases from an academic medical center between 1997 and 2004 were included in this study. Variables of interest included next-of-kin relationships, family interactions, knowledge of donor wishes, family initiation of the donation discussion, and satisfaction with the donation process.

Results

The data include 32 consent and 88 nonconsent cases. Compared to nonconsent cases, consent cases differed significantly in next-of-kin knowledge of donor wishes, frequent involvement of parents, and infrequent involvement of spouses. Donor wishes were known in 19% of consent cases but in none of the nonconsent cases. A parent was the dominant next-of-kin decision maker in 68% of consent cases, compared to 36% of nonconsent cases. A spouse assumed the dominant role in 29% of nonconsent cases but in only 6% of consent cases. Of these differences, wishes known, parental involvement, and spousal involvement were statistically significant ( P= .000, P= .002, and P= .013, respectively).

Conclusions

The results highlight the statistically significant differences between African American consent and nonconsent cases: knowledge of donor wishes and those involved in the donation decision. These results reinforce the importance of programs that encourage African American families to discuss donation with loved ones.
RNAi Based Approaches to the Treatment of Malignant Glioma
Authors: Mathupala Saroj P. , Guthikonda Murali , Sloan Andrew E.
Published: January 2017

RNA interference (RNAi) is a recently discovered, powerful molecular mechanism that can be harnessed to engineer gene-specific silencing in mammalian tissues. A mechanism, where short double-stranded RNA (dsRNA) molecules, when introduced into cells elicit specific “knock-down” of gene expression via degradation of targeted messenger RNA, has lately become the technique of choice for analysis of gene function in oncology research. Thus, RNAi is currently being extensively evaluated as a potential therapeutic strategy against malignant gliomas, since surgical, radiological, and chemotherapeutic interventions during the past few decades have done little to improve the poor prognosis rate for patients with these dreaded tumors. This review summarizes the pre-clinical studies that are currently underway to test the validity of RNAi as a potential therapeutic strategy against malignant gliomas, and discusses the potential technical Hurdles that remain to be overcome before the technique can become a promising clinical therapy to combat this frequently lethal disease.
Exploring First-Year College Students’ Cultural Competence
Authors: Tharp D. Scott
Published: January 2017

The development of college students’ cultural competence is important in an increasingly diverse world. This exploratory, qualitative, action research study examined how 158 first-year students understood and applied core concepts after participating in a standardized diversity and social justice lesson plan designed using transformative education principles. Three student affairs staff conducted content analysis on credit-bearing reflection papers submitted after participation in the lesson plan. Data were manually coded and collectively analyzed revealing themes regarding students’ abilities to accurately discuss multiple core concepts, demonstrate internalized responsibility, and indicate self-growth, all of which were related to students’ conceptual understanding and intrapersonal application of concepts. Implications are discussed for designing curricular and cocurricular diversity initiatives that utilize a multiplicity of concepts and social identities, promote intrapersonal development, and explore systems of privilege and oppression as part of the transformational learning process.
5-Year Angiographic and Clinical Follow-up of Coil-Embolised Intradural Saccular Aneurysms
Authors: Batista LL , Mahadevan J. , Sachet M. , Alvarez H. , Rodesch G. , Lasjaunias P.
Published: January 2017

The purpose of the paper is the follow-up of embolised intradural saccular Arterial Aneurysms (AA), excluding giant, dissecting, inflammatory, fusiform or AA associated to BVAM.

Since its introduction in 1991, the Guglielmi Detachable Coil has offered protection against aneurysmal rebleeding in the critical few days and months after SAH regardless of the grade. A number of questions remain: is complete angiographic obliteration necessary at first embolisation? What duration of clinical / angiographic follow-up (FU) is required to ensure the risk of haemorrhage has been eliminated? What is the long-term protection against rebleeding?

One hundred and two patients with 160 intradural saccular AA embolised before april 1997 were selected for this study. They had at least 5-yrs clinical FU, of which 22 patients had a mid-term (3 years) and 45 patients had a 5-year or more angiographic FU (mean 67,7 months per patient).

Twenty-eight embolised AAs with 100% occlusion at 1 year, remained unchanged on the 5-year angiograms. A further 14 patients with complete occlusion at 1 year showed persisting complete occlusion on angiogram at 3-years FU, which in our series means that complete occlusion after the first year post-embolisation implies that the aneurysm will remain completely occluded. All secondary spontaneous thromboses (27.6% of cases), occurred during the first year pos-embolisation. In six patients with subtotal or partial occlusion no change was seen for three consecutive years of FU; none showed later change at 5-year angiography. Below 80% occlusion our series does not provide enough information but we consider the situation instable.

No mortality related to the procedure was observed in the unruptured AA group. No bleeding or re-bleeding has occurred since the beginning of our experience (1993) in saccular AA treated by GDC-Coil. Coil-embolisation of properly selected patients is effective in protecting against bleeding or re-bleeding at short and long-term with stable morphological results provided a strict follow-up control is established at short term.
Treatment Strategy for Cerebral Aneurysms Based on the Evidence of the Efficacy of GDC Embolization
Authors: Miyachi S. , Negoro M. , Sahara Y. , Suzuki O. , Hattori K. , Kobayashi N. , Kojima T. , Handa T. , Nakabayashi K. , Takahashi I. , Fukui K. , Iwakoshi T. , Hattori T. , Okamoto T. , Yoshida J.
Published: January 2017

The authors reviewed 531 patients with cerebral aneurysms treated with Guglielmi detachable coils (GDCs) over 5 years to clarify both the advantages and disadvantages of embolization based on the evidence of complications by aneurysm profile. There were 52 technical complications, 25 of which resulted in unfavorable patient outcomes. Intraoperative rupture, the most serious complication exacerbating the patient's condition, occurred in 19 patients, 4 of whom expired. All of these aneurysms were very small and were mostly located in the AcomA and PICA portions. Thirteen patients encountered thromboembolic complications, 6 of whom were elderly with acute ruptured aneurysms at MCA and the tip of BA. For large or giant aneurysms manifesting the mass effect, particularly those in the ICA-C2 portion compressing the optic nerve, the saccular packing did little to ameliorate the symptoms, and subsequent surgical or endovascular trapping was needed.

Therefore, saccular embolization of endovascularly difficult, very small AcomA aneurysms and large C2 aneurysm with visual symptoms should be used sparingly based on a risk-benefit assessment.
Staged Carotid Stenting and Carotid Endarterectomy for Bilateral Internal Carotid Artery Stenosis
Authors: Fukuda H. , Iihara K. , Sakai N. , Murao K. , Sakai H. , Higashi T. , Kogure S. , Takahashi J. , Hayashi K. , Nagata I.
Published: January 2017

The purpose of this study was to evaluate the efficacy and safety of staged carotid stenting (CS) and carotid endarterectomy (CEA) for bilateral internal carotid artery stenosis.

With this strategy, initial carotid stenting was performed for the high grade carotid stenosis to reduce the risk of subsequent CEA. Eight patients were treated with staged CS and CEA; CS for asymptomatic side followed by CEA for symptomatic side. Sufficient revascularization was obtained in all procedures but one CS procedure.

Two minor stroke caused by distal embolism occurred during the perioperative period of CS. Postprocedural persistent hypotension was observed in one CS procedure. The mean interval between CS and CEA was 19.8 days. In conclusion, although our strategy has some advantages such as avoidance of bilateral cranial nerve palsy and shorter admission period over staged CEA, relatively high complication rate was noted at the first CS without any stroke morbidity post CEA.

Our preliminary result showed that further reduction of periprocedural complication rate at the initial stenting is mandatory for this approach justified.
Technique and Clinical Results of Carotid Stenting under Distal Protection
Authors: Terada T. , Tsuura M. , Matsumoto H. , Masuo O. , Yamaga H. , Tsumoto T. , Itakura T.
Published: January 2017

We perfomed carotid artery stenting (CAS) in 215 patients from August 1997 to October 2003 mainly using the distal protection technique. Our technique and clinical results are described in this paper.