bluuebunny/crossref_metadata_2025 huggingface dataset:
Plexiform Fibromyxoma (Plexiform Angiomyxoid Myofibroblastic Tumor) of Stomach
Authors: Lee Peter W. T. , Yau Derek T. W. , Lau Patrick P. L. , Chan John K. C.
Published: June 2013

Plexiform fibromyxoma (plexiform angiomyxoid myofibroblastic tumor) is a rare benign mesenchymal tumor of stomach. The plexiform growth of bland-looking spindly cells in a richly vascularized fibromyxoid stroma is distinctive. The described cases are solid tumors associated with ulceration, with the patients presenting with symptoms related to the ulcer or mass effect of the tumor. We report an unusual case presenting as a fistulating abscess. A 42-year-old woman presented with abdominal pain, fever, and elevated white cell count. Computed tomography scan revealed a 12-cm cavitating mass in the gastric antrum, with fistulation to the gastric lumen through an ulcer. Histologic examination showed transmural involvement of the stomach by plexiform islands of fibromyxoid tumor with interspersed delicate capillaries. There was a pseudocyst-like component. The unusual presentation therefore broadens the clinical and pathologic spectrum of this rare tumor type.
Metastatic Malignant Melanoma to Urinary Bladder
Authors: Rishi Arvind , Anderson Todd A. , Kirschenbaum Alexander M. , Unger Pamela D.
Published: June 2013

We present a case of a 61-year-old female presenting with a bladder tumor that occurred 7 years after her previous diagnosis of Clark’s level III mid-back melanoma. The bladder tumor was submitted to histopathology without accompanying clinical history, and an initial diagnosis of high-grade urothelial carcinoma was rendered based on epithelioid and sarcomatoid appearing pleomorphic histopathology. We present this case to highlight the diagnostic challenge presented by the rare occurrence of metastatic melanoma to the urinary bladder and the potential pitfall of this lesion being diagnosed as high-grade urothelial carcinoma in the presence of limited clinical history.
The Schedule for Nonadaptive and Adaptive Personality for Youth (SNAP-Y)
Authors: Linde Jennifer A. , Stringer Deborah , Simms Leonard J. , Clark Lee Anna
Published: June 2013

The Schedule for Nonadaptive and Adaptive Personality–Youth Version (SNAP-Y) is a new, reliable self-report questionnaire that assesses 15 personality traits relevant to both normal-range personality and the alternative DSM-5 model for personality disorder. Community adolescents, 12 to 18 years old ( N = 364), completed the SNAP-Y; 347 also completed the Big Five Inventory–Adolescent, 144 provided 2-week retest data, and 128 others completed the Minnesota Multiphasic Personality Inventory–Adolescent. Outpatient adolescents ( N = 103) completed the SNAP-Y, and 97 also completed the Minnesota Multiphasic Personality Inventory–Adolescent. The SNAP-Y demonstrated strong psychometric properties, and structural, convergent, discriminant, and external validities. Consistent with the continuity of personality, results paralleled those in adult and college samples using the adult Schedule for Nonadaptive and Adaptive Personality–Second Edition (SNAP-2), from which the SNAP-Y derives and which has established validity in personality–trait assessment across the normal–abnormal continuum. The SNAP-Y thus provides a new, clinically useful instrument to assess personality traits and personality pathology in adolescents.
Development and Validation of the Mindfulness-Based Interventions – Teaching Assessment Criteria (MBI:TAC)
Authors: Crane Rebecca S. , Eames Catrin , Kuyken Willem , Hastings Richard P. , Williams J. Mark G. , Bartley Trish , Evans Alison , Silverton Sara , Soulsby Judith G. , Surawy Christina
Published: June 2013

Background. The assessment of intervention integrity is essential in psychotherapeutic intervention outcome research and psychotherapist training. There has been little attention given to it in mindfulness-based interventions research, training programs, and practice. Aims. To address this, the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) was developed. This article describes the MBI:TAC and its development and presents initial data on reliability and validity. Method. Sixteen assessors from three centers evaluated teaching integrity of 43 teachers using the MBI:TAC. Results. Internal consistency (α = .94) and interrater reliability (overall intraclass correlation coefficient = .81; range = .60-.81) were high. Face and content validity were established through the MBI:TAC development process. Data on construct validity were acceptable. Conclusions. Initial data indicate that the MBI:TAC is a reliable and valid tool. It can be used in Mindfulness-Based Stress Reduction/Mindfulness-Based Cognitive Therapy outcome evaluation research, training and pragmatic practice settings, and in research to assess the impact of teaching integrity on participant outcome.
Public Engagement Through the Development of Science-Based Computer Games
Authors: Curtis Vickie
Published: June 2013

New developments in digital technologies are enabling scientists to explore novel avenues of engagement beyond face-to-face approaches. “Gamifying” science through the creation of computer games based on scientific research is part of this trend. Recently, the Wellcome Trust held a competitive “hackfest” called “Gamify Your PhD.” Six finalists were selected to develop their research into a computer game with the help of professional games developers. I was able to observe this event with the aim of exploring the collaboration between scientists and games developers and observing how science-based computer games can be used to engage the wider public.
Adaptive neural network control of robot manipulator using reinforcement learning
Authors: Tang Li , Liu Yan-Jun
Published: June 2013

In this paper, a stable reinforcement learning control approach using neural networks (NNs) is developed for the trajectory tracking of an n-link rigid robot manipulator. The considered systems are in discrete time form. The proposed controller design consists of two NNs. One is the critic network that is used to approximate the long-term cost function, whereas other is that the action NN is employed to generate the system input. Then, an optimal control input can be obtained compared with other robot manipulator systems. Using the Lyapunov approach, the tracking error and weight estimates are proven to be semi-global uniformly ultimately bounded. A simulation example is employed to illustrate the effectiveness of the proposed controller.
Tunable fluidic composite mounts for vibration absorption
Authors: Lotfi-Gaskarimahalle Amir , Scarborough Lloyd H , Rahn Christopher D , Smith Edward C
Published: June 2013

Tuned vibration absorbers have been shown to reduce the forced vibration response at a specific frequency for many applications. This paper presents a novel absorber using fluidic flexible matrix composites (F2MC). Fiber reinforcement of the F2MC tube kinematically links the internal volume with axial strain so that fluid flows in and out of an axially vibrating tube. Coupling of an F2MC tube through a fluid port to a pressurized air accumulator produces a novel absorber that can suppress vibration at the tuned absorber frequency. A 3-D elasticity model for the tube and a lumped model for the fluid mass produce a fourth-order F2MC-mass model. The analytical closed-form isolation frequency is derived and shown to depend primarily on the port inertance, orifice flow coefficient, and the tube parameters. Viscous damping in the orifice can be adjusted to reduce the resonant peak and broaden the isolation bandwidth. With a fully closed orifice, the zero disappears and the system has a single resonant peak. For a constant port inertance, variations in the primary mass do not change the isolation frequency, making the F2MC absorber robust to mass variations. Experimental results validate the theoretical predictions by demonstrating a tunable isolation frequency that is insensitive to primary mass variation as well as a 94% reduction in forced vibration response relative to the closed-valve case at the isolation frequency.
Optimization and simulation on a cartridge valve with silencing grooves
Authors: Xiaofeng He , Xianglin Liu , Longjun Luo , Xiaohui Luo
Published: June 2013

The use of cartridge valves with high pressure and large flow rates in a hydraulic system usually causes serious vibration and noise issues. In this paper, a type of cartridge valve with silencing grooves was presented and its mathematic model was built up. Four types of silencing grooves were selected for the cartridge valve, and they were optimized separately based on the actual application system for testing the safety valve in hydraulic support. Through simulation, their silencing effects were analyzed. The U-shaped groove has been found to be dominant among all the investigated groove types and it can significantly reduce the peak pressure gradient of the tested valve compared with no grooves. This research not only provides a new solution for reducing the vibration and noise of a hydraulic system, but also presents an effective method for the design of silencing grooves on a cartridge valve.
Image encryption algorithm based on total shuffling scheme and chaotic S-box transformation
Authors: Hussain Iqtadar , Shah Tariq , Gondal Muhammad Asif
Published: June 2013

This paper presents an image encryption scheme based on complete shuffling algorithm: limited in the skew tent-map-predicated image cryptosystem and chaotic substitution box transformation. The proposed image encryption algorithm provides extra confusion due to the inclusion of a chaotic S-box. It is well known from the literature that simple image encryption based on a total shuffling scheme is not secure against a chosen cipher text attack. We then projected an extended algorithm which does well against a chosen cipher text attack. Furthermore we analyze the proposed technique for unified average changing intensity (UACI) and NPCR analysis to determine its strength.
Performance evaluation of vibration controller for piezoelectric smart structures in finite element environment
Authors: Dong Xingjian , Peng Zhike , Ye Lin , Hua Hongxing , Meng Guang
Published: June 2013

This study focuses on performance evaluation of an active vibration controller in a closed loop finite element (FE) environment for piezoelectric smart structures by integrating a reduced-order-model-based controller into the FE model. Based on the first-order shear deformation theory, a coupled piezoelectric-mechanical FE model with electric potential variables is developed for the piezoelectric smart structure to provide a platform for vibration analysis and controller design. A system identification technique known as subspace identification method is employed to obtain a multi-input multi-output state space reduced-order model which can with sufficient accuracy predict the behavior of the piezoelectric smart structure under consideration from the inputs and outputs of FE simulations. A linear-quadratic regulator controller together with a Luenberger observer is designed based on the reduced-order model for the purpose of vibration control. The reduced-order-model-based controller is then integrated into an FE environment by updating the actuator voltages according to the controller at each time instant during the transient analysis of FE simulations. Eventually, the performance robustness characteristics of the proposed vibration controller are evaluated in case of structural parameter variations and taking the sensor or actuator offline in a closed loop FE environment. Numerical examples are presented to demonstrate the efficiency of the proposed scheme for evaluating the vibration controller performance of piezoelectric smart structures in a closed loop FE environment.
Dynamic analysis and collision prevention for μ-disc-type inductive micro-motor driven by solenoids
Authors: Tsai Nan-Chyuan , Lin Chih-Che
Published: June 2013

An innovative μ-disc-type inductive micro-motor is proposed and studied in this paper. The novel 3D solenoid-type electromagnetic poles are designed and fabricated by dry isotropic etching technique so that the output torque of the inductive motor can be greatly increased even though a simpler fabrication procedure is employed. On the other hand, the order-reduced dynamic model for the proposed micro-motor is established by using the singular perturbation theory. Based on the order-reduced model, a composite controller is synthesized to prevent potential collision between the disc and the center bearing by sliding mode control strategy and successfully suppress the unfavorable periodic oscillation, due to eccentricity of the disc, by an anti-swaying policy. Eventually, a few comparisons on several typical operational conditions, such as various vacuum levels, van der waals force and periodic disturbance, are also addressed and presented. The efficacy of the composite controller and the performance of the proposed micro-motor are verified by intensive simulations undertaken via the commercial software, Matlab/Simulink, and the interface module dSpace DS 1104 Board. Finally, the superior performance for the proposed micro-motor is assured, e.g., the collision between the disc and the center bearing can be successfully prevented and a constant spinning speed can be retained even if a certain degree of disturbance and uncertainty abruptly occurs.
Quality parameters, bioactive compounds and their correlation with antioxidant capacity of commercial fruit-based baby foods
Authors: Carbonell-Capella Juana M , Barba Francisco J , Esteve María J , Frígola Ana
Published: June 2013

Comprehensive research is required to achieve the optimization of the antioxidant protection through baby foods, in particular, the commercially available fruit-based baby foods. This study investigated the physicochemical properties, ascorbic acid (AA), total carotenoids (TC), total phenolic content (TPC), trolox equivalent antioxidant capacity (TEAC) and oxygen radical absorbance capacity (ORAC) of 23 different commercially available fruit-based baby foods. The main contribution to the total antioxidant capacity (trolox equivalent antioxidant capacity and oxygen radical absorbance capacity) was provided by ascorbic acid, followed by phenolic compounds, in accordance with a mathematical equation obtained from the data: TEAC = 245.906 + 7.727 × (AA) + 1.988 × (TPC) − 0.008 × (TC) and ORAC = 318.662 + 2.775 × (AA) − 0.531 × (TPC) − 0.073 × (TC). Moreover, a positive correlation ( r = 0.346, p < 0.05) was found for oxygen radical absorbance capacity and trolox equivalent antioxidant capacity methods. Baby foods with different kind of fruits used as ingredients showed higher antioxidant capacity. Among the commercial baby foods analysed in this work, that treated by gentle steam cooking process had high levels of bioactive compounds and antioxidant capacity.
Time Course of Renal Proximal Tubule Injury, Reversal, and Related Biomarker Changes in Rats Following Cisplatin Administration
Authors: McDuffie James Eric , Ma Jing Ying , Sablad Marciano , Sonee Manisha , Varacallo Lynn , Louden Calvert , Guy Antonio , Vegas Jennifer , Liu Xuejun , La David , Snook Sandra
Published: June 2013

Cisplatin (CDDP) is known to produce renal proximal tubule injury. Various renal biomarkers have been related to CDDP nephrotoxicity in previous research, but the temporal and spatial relationship of these biomarkers to injury reversal has not been well defined. In this study, the progression and reversal of renal histopathology findings relative to serum and urinary biomarker changes were examined during a 4-week postdose period following single intraperitoneal administration of CDDP (1 mg/kg) or 0.9% saline. Degeneration, vacuolation, inflammation, and regeneration of the S3 segment of proximal tubules were evident 72 hours following CDDP administration. Tubular degeneration and regeneration were also observed at 1 and 1.5 weeks but at lower incidences and/or severity indicating partial reversal. Complete histologic reversal was observed by 2 weeks following CDDP administration. Urinary kidney injury molecule 1 (KIM-1), α-glutathione-S-transferase (α-GST), and albumin levels increased at 72 hours postdosing, concurrently with the earliest histologic evidence of tubule injury. Changes in urinary KIM-1 correlated with KIM-1 immunostaining in the proximal tubular epithelial cells. No significant changes in serum biomarkers occurred except for a minimal increase in urea nitrogen at 1.5 weeks postdosing. Of the novel renal biomarkers examined, urinary KIM-1, α-GST, and albumin showed excellent concordance with CDDP-induced renal injury progression and reversal; and these biomarkers were more sensitive than traditional serum biomarkers in detecting early, acute renal tubular damage confirmed by histopathology. Furthermore, urinary KIM-1, α-GST, and albumin outperformed other biomarkers in correlating with the time of maximum histologic injury.
Epidural dirofilariosis in a paraparetic cat: case report of Dirofilaria immitis infection
Authors: Favole Paolo , Cauduro Alberto , Opreni Mauro , Zanzani Sergio , Albonico Francesca , Manfredi Maria , Cantile Carlo , Lorenzo Valentina
Published: June 2013

A 6-year-old neutered female cat was examined for chronic and progressive pelvic limb ataxia that progressed to non-ambulatory paraparesis over 1 month. Haematological and serum analyses were mainly within normal ranges. Thoracic and abdominal radiographs did not reveal any morphological abnormalities. Magnetic resonance imaging investigation of the thoraco-lumbar spine demonstrated a well-defined, extradural mass that extended into the epidural space from the L2 to L3 vertebral bodies and expanded in the L2 to L3 left intervertebral foramen. During surgery, a long, narrow, white parasite which was weakly adherent to the phlogistic epidural fat tissue was gently removed from the spinal canal. Histological examination of the pathological tissue supported a diagnosis of epidural steatitis surrounding a female adult Dirofilaria immitis. This is a novel case of natural D immitis infection with spinal localisation in a cat, well documented with magnetic resonance investigation, and cytological and histological examinations, introducing a novel differential diagnosis for extradural spinal masses in cats.
Performance of hydrostatic circular thrust pad bearing operating with Rabinowitsch fluid model
Authors: Sharma Satish C , Yadav Saurabh K
Published: June 2013

Polymer-based additives such as poly isobutylene are blended with lubricating oil to enhance the lubricating performance of the base oil. The Rabinowitsch fluid model effectively describes the influence of polymer additives on the lubricating performance of a non-Newtonian (pseudoplastic) lubricant. This article deals with the analysis of a capillary compensated hydrostatic circular thrust pad bearing using Rabinowitsch fluid model. For a circular recess hydrostatic thrust bearing operating with pseudoplastic lubricant, the closed form expressions for load-carrying capacity, lubricant flow rate, fluid film stiffness coefficient and damping coefficient have been obtained using a small perturbation method. The close form solutions for different performance characteristic parameters have been compared with the results obtained from finite element method formulation. The numerically simulated results indicate that pseudoplastic parameter significantly affects the parameters of the bearing performance characteristics such as pocket pressure, lubricant flow rate, fluid film stiffness coefficient and damping coefficient. The value of the fluid film stiffness coefficient gets substantially increased with the pseudoplastic parameter whereas the value of damping coefficient gets reduced. The analytical results presented in this study can be used to obtain an optimum performance of a hydrostatic circular thrust pad bearing.
Making God real and making God good: Some mechanisms through which prayer may contribute to healing
Authors: Luhrmann Tanya Marie
Published: June 2013

Many social scientists attribute the health-giving properties of religious practice to social support. This paper argues that another mechanism may be a positive relationship with the supernatural, a proposal that builds upon anthropological accounts of symbolic healing. Such a mechanism depends upon the learned cultivation of the imagination and the capacity to make what is imagined more real and more good. This paper offers a theory of the way that prayer enables this process and provides some evidence, drawn from experimental and ethnographic work, for the claim that a relationship with a loving God, cultivated through the imagination in prayer, may contribute to good health and may contribute to healing in trauma and psychosis.
Effect of the amount of cork particles on the strength and glass transition temperature of a structural adhesive
Authors: Barbosa AQ , da Silva LFM , Öchsner A
Published: June 2013

The inclusion of particles (micro or nano) is a method to improve the mechanical properties, such as toughness, of structural adhesives. Structural adhesives are known for their high strength and stiffness but also for their low ductility and toughness. There are many processes described in the literature to increase the toughness, the use of rubber particles being one of the most common processes. In the present study, natural micro particles of cork were used with the objective to increase the ductility of a brittle epoxy adhesive. The idea is for the cork particles to act like a crack stopper. The influence of the amount of cork particles was studied. Particles of cork ranging in size from 125 to 250 µm were mixed in the epoxy adhesive Araldite 2020 from Huntsman. The amount of cork in the adhesive was varied between 0.5% and 5% in weight. This evaluation was made using tensile tests and it was evident that the failure strain was related to the amount of cork particles in the resin. The results concerning the single lap joints and the glass transition temperature confirm the increased ductility obtained in the tensile tests.
Visual sentiment analysis of customer feedback streams using geo-temporal term associations
Authors: Hao Ming C , Rohrdantz Christian , Janetzko Halldor , Keim Daniel A , Dayal Umeshwar , Haug Lars erik , Hsu Meichun , Stoffel Florian
Published: June 2013

Large manufacturing companies frequently receive thousands of web surveys every day. People share their thoughts regarding a wide range of products, their features, and the service they received. In addition, more than 190 million tweets (small text Web posts) are generated daily. Both survey feedback and tweets are underutilized as a source for understanding customer sentiments. To explore high-volume customer feedback streams, in this article, we introduce four time series visual analysis techniques: (1) feature-based sentiment analysis that extracts, measures, and maps customer feedback; (2) a novel way of determining term associations that identify attributes, verbs, and adjectives frequently occurring together; (3) a self-organizing term association map and a pixel cell–based sentiment calendar to identify co-occurring and influential opinion; and (4) a new geo-based term association technique providing a key term geo map to enable the user to inspect the statistical significance and the sentiment distribution of individual key terms. We have used and evaluated these techniques and combined them into a well-fitted solution for an effective analysis of large customer feedback streams such as web surveys (from product buyers) and Twitter (e.g. from Kung-Fu Panda movie reviewers).
A poem in a medium not of words: Music, dance and arts education in Rabindranath Tagore’s Santiniketan
Authors: Pritchard Matthew
Published: June 2013

In light of recent attempts to defend the role of the arts in education against the effects of policies based on utilitarian principles, this paper examines the arts educational writings and practical projects of Rabindranath Tagore (1861–1941) at Santiniketan in West Bengal, showing how they were motivated by a Romantic and Upanishadic philosophy centred on the anti-utilitarian concept of ‘surplus’. While the development of Santiniketan’s present arts and music departments away from Tagore’s original ideals is acknowledged and traced, the paper argues that Tagore’s aesthetic and educational philosophy still contains much to challenge us. In many ways, his thought can be seen as more compatible with progressive and liberal arts education than the ideology of high modernism that developed at the same period in Europe.
State of care: the ontologies of child welfare in British Columbia
Authors: de Leeuw Sarah
Published: June 2013

This is a paper about child-welfare regulations, policies, and practices as they impact Indigenous families and communities. I take as my starting point that child welfare, and geographies of Indigenous homes and families, are under-scrutinized ontologies worthy of more investigation especially by geographers interested in understanding neo settler-colonial power – and how to unsettle it. I track historical logics of state intervention into Indigenous families through to the present day, reviewing the empirics of child removals and state interventions into contemporary Indigenous families in British Columbia, Canada. Curtailing the state’s ongoing disruption of Aboriginal families and communities, I conclude, requires understanding child welfare ontologically, as historically contiguous with other colonial projects, and as premised in great part on ungrounded logics of ‘common sense’ that (re)produce Indigenous families and communities as rarified and othered geographies in constant need of intervention.
Do-it-yourself or do-it-with? The regenerative life skills of off-grid home builders
Authors: Vannini Phillip , Taggart Jonathan
Published: June 2013

Drawing from ethnographic research on Canadian people living off-grid we describe and interpret how people without formal training in architecture or construction manage to build their own homes. Our findings show that they do so thanks to what we call regenerative life skills. Juxtaposing our argument in the context of DIY (do-it-yourself) research and discourse we argue that rather than in a solo endeavor off-grid builders engage in relational practices, becoming entangled with others, with historical traditions, with place-specific resources, and with the affordances of the materials they utilize. DIW (do-it-with) relies on the engagement of what we call regenerative life skills − drawing from relational theory and regenerative design.
CRI2012: A proposal for updating the CIE colour rendering index
Authors: Smet KAG , Schanda J , Whitehead L , Luo RM
Published: June 2013

The CIE colour rendering index (CRI) has been criticized for its poor correlation with the visual colour rendering of many spiked or narrowband sources, its outdated colour space and chromatic adaptation transform and the use of a small number of non-optimal reflectance samples that have enabled lamp manufacturers to tune the spectrum of a light source to yield, in some cases, inappropriately high general CRI values. The CRI2012 metric proposed in this paper addresses these criticisms by combining the most state of the art colorimetric colour difference model, i.e. CAM02-UCS, with a mathematical reflectance set that exhibits a highly uniform spectral sensitivity. A set of 210 real reflectance samples has also been selected to provide additional information on the expected colour shifts when changing illumination.
Light adaptation in letter contrast sensitivity: The influence of optical and neural mechanisms
Authors: Arranz I , Matesanz BM , Issolio L , Menéndez JA , Mar S , Aparicio JA
Published: June 2013

This work discusses the relative significance of optical and neural mechanisms in letter contrast sensitivity under different conditions of environmental lighting. A study was carried out on 26 eyes with normal ocular health. Sixteen lighting conditions were obtained by combining different test luminances (from 10 cd/m2 to 600 cd/m2) and surround luminances (from 1 cd/m2 to 600 cd/m2). The results reveal a significant influence of optical factors (pupil size variations and glare effects) on contrast sensitivity when surround luminance changes, and a dominance of neural effects when test luminance changes. Furthermore, test size and illumination conditions are identified for which letter threshold contrasts are not sensitive to surround luminance changes.
Novel matching networks for electrodeless lamp systems
Authors: Shao M , Huang S , Zhao W
Published: June 2013

In order to extend the length of the coaxial cable connection between an electrodeless fluorescent lamp and the associated electronic ballast, a new structure for electrodeless lamp systems is proposed in this paper. Impedance matching networks in the structure are analyzed and designed based on the transmission characteristics of coaxial cable. Efficient topologies and formulae for the matching networks are put forward. Experimental results for a 2.65 MHz electrodeless lamp system with up to 25 m of coaxial cable which validate the structure are presented.
Subjective evaluation of luminance distribution for intelligent outdoor lighting
Authors: Viliūnas V , Vaitkevičius H , Stanikūnas R , Vitta P , Bliumas R , Auškalnytė A , Tuzikas A , Petrulis A , Dabašinskas L , Žukauskas A
Published: June 2013

A large number of physical dimensions and different criteria make choosing the optimal luminance distribution for outdoor lighting difficult. The optimisation becomes even more complex for light-emitting diode-based lighting installations that can be intelligently operated, providing different luminance distributions around a moving traffic participant. This study aims at establishing the main subjective factors for the assessment of the luminance distribution of an intelligent light-emitting diode-based outdoor lighting installation for pedestrians. Semantic-differential scales and Likert scales have been used to identify subjective impressions and to find the main factors for the optimisation of the control of the luminance distribution. Our results reveal two factors that need to be considered when assessing intelligent outdoor lighting installations: a major factor that is related to the subjective feeling of well-being and a minor factor that is related to the physical properties of the environment.
Nursing Leadership in Addressing the Social Determinants of Health
Authors: Lathrop Breanna
Published: June 2013

Social determinants of health have a profound impact on health status and the prevalence of health disparities in the United States. Significant improvements in national health indices are not possible without addressing social determinants of health. Drawing on their historical legacy as patient advocates, patient care expertise, and community focused education, nurses are ideally positioned to lead the nation in strategies to promote health equity. Nurses can embrace this new leadership role through the use of interdisciplinary collaboration, advocacy, political involvement, and community partnerships.
Low Hemoglobin Concentration Is Associated With Poor Outcome After Peripheral Arterial Surgery
Authors: Oshin O. A. , Torella F.
Published: June 2013

Objective:

To assess the influence of low hemoglobin (Hb) concentration on major adverse cardiac events (MACE) and mortality in patients undergoing peripheral arterial surgery.

Methods:

This was a retrospective cohort study of patients undergoing peripheral arterial reconstructive surgery at a tertiary vascular center. Preoperative factors linked with the occurrence of MACE and death on univariate analysis ( P ≤ .1) were included in a multivariate model to confirm the independent association with the outcome variables.

Results:

A total of 360 consecutive patients (238 men) with a mean (standard deviation) age of 69 (10.7) years and Hb of 13.0 (2.12) g/dL treated under the care of a single specialist between January 2004 and December 2011 were included in the analysis. Of these, 193 (53.6%) were anemic. In all, 26 (7%) had a postoperative MACE and 18 (5%) died. On multivariate analysis, age > 80 years (odds ratio [OR] = 3; 95% confidence interval [CI] [1.2-7.5]; P = .025), renal impairment (OR = 3.2; 95% CI [.99-10.2]; P = .053), coronary disease (OR = 3.6; 95% CI [1.5-8.7]; P = .005), and low Hb (OR for each 1 g/dL drop below the mean = 1.4 [1.13-1.7]; P = .002) were independent risk factors for MACE. Unplanned surgery (OR = 4.5; 95% CI [1.2-16.9]; P = .025) and low Hb (OR for each 1 g/dL drop below the mean = 1.5; 95% CI [1.14-1.86]; P = .002) were independent risk factors for death.

Conclusion:

In peripheral arterial surgery, preoperative low Hb is associated with MACE and death. Further investigation is necessary to elucidate whether this relationship is causal. Meanwhile, consideration should be given to treating preoperative anemia as a significant risk factor for adverse outcome in this setting.
How the EEA Came to America
Authors: Morgenstern Leon
Published: June 2013

Surgical stapling instruments, a revolutionary concept in surgical technique, were introduced in the United States in 1967. Notably absent in the new family of American instruments was the circular stapler (EEA) for end-to-end intestinal anastomosis. This strange omission was corrected a decade later. The EEA is now one of the most widely used stapling instruments in the surgical armamentarium.
Modified Trocar With Laser Diode for Instrument Guidance
Authors: Rajab Taufiek Konrad
Published: June 2013

Laparoscopic instruments that are newly inserted into trocars are initially outside the surgeon’s endoscopic field of view. This can make it difficult to accurately position the instrument at the operative site and presents a potential risk to patients since the tip of the instrument could potentially perforate organs and blood vessels while it is advanced blindly. To solve this problem, I have designed a trocar that incorporates a laser pointer to guide laparoscopic instruments while they are outside the endoscopic field of view. The laser dot is projected along the long axis of the trocar. This allows the surgeon to instantly determine the direction and target of the introduced instrument. Furthermore, the projected laser dot serves as evidence of an unobstructed path from the trocar to the target. This modification improves safety in laparoscopic surgery.
Temporary Endoscopic Metallic Stent for Idiopathic Esophageal Achalasia
Authors: Coppola Franco , Gaia Silvia , Rolle Emanuela , Recchia Serafino
Published: June 2013

Idiopathic achalasia is a motor disorder of the esophagus of unknown etiology caused by loss of motor neurons determining an altered motility. It may determine severe symptoms such as progressive dysphagia, regurgitations, and pulmonary aspirations. Many therapeutic options may be offered to patients with achalasia, from surgery to endoscopic treatments such as pneumatic dilation, botulinum injection, peroral endoscopic myotomy, or endoscopic stenting. Recently, temporary placement of a stent was proposed by Cheng as therapy for achalasia disorders, whereas no Western authors have dealt with it up to date. The present study reports our preliminary experience in 7 patients with achalasia treated with a temporary stent. Partially covered self-expanding metallic stents (Micro-Tech, Nanjin, China) 80 mm long and 30 mm wide were placed under fluoroscopic control and removed after 6 days. Clinical follow-up was scheduled to check endoscopic success, symptoms release, and complications. The placement and the removal of the stents were obtained in all patients without complications. Mean clinical follow-up was 19 months. Five out of 7 patients referred total symptoms release and 2 experienced significant improvement of dysphagia. The procedure was not time consuming and was safe; no mild or severe complications were registered. In conclusion, our results may suggest a possible safe and effective endoscopic alternative treatment in patients with achalasia; however, further larger studies are necessary to confirm these promising, but very preliminary, data.
Hybrid Video-Assisted Thoracic Surgery With Segmental–Main Bronchial Sleeve Resection for Non–Small Cell Lung Cancer
Authors: Li Shuben , Chai Huiping , Huang Jun , Zeng Guangqiao , Shao Wenlong , He Jianxing
Published: June 2013

Background. The purpose of the current study is to present the clinical and surgical results in patients who underwent hybrid video-assisted thoracic surgery with segmental–main bronchial sleeve resection. Methods. Thirty-one patients, 27 men and 4 women, underwent segmental–main bronchial sleeve anastomoses for non–small cell lung cancer between May 2004 and May 2011. Results. Twenty-six (83.9%) patients had squamous cell carcinoma, and 5 patients had adenocarcinoma. Six patients were at stage IIB, 24 patients at stage IIIA, and 1 patient at stage IIIB. Secondary sleeve anastomosis was performed in 18 patients, and Y-shaped multiple sleeve anastomosis was performed in 8 patients. Single segmental bronchiole anastomosis was performed in 5 cases. The average time for chest tube removal was 5.6 days. The average length of hospital stay was 11.8 days. No anastomosis fistula developed in any of the patients. The 1-, 2-, and 3-year survival rates were 83.9%, 71.0%, and 41.9%, respectively. Conclusion. Hybrid video-assisted thoracic surgery with segmental–main bronchial sleeve resection is a complex technique that requires training and experience, but it is an effective and safe operation for selected patients.
Getting Our Children to Eat More Fruits and Vegetables
Authors: Luppold Deborah
Published: June 2013

Parents, families and schools play key roles in influencing the eating habits of children. This article reviews several factors that can influence the intake of fruits and vegetables in children. Families that eat together have better overall diets, including intakes of fruits and vegetables. When parents serve as positive role models and make fruits and vegetables more available and accessible to children intakes increase. Schools, through their food and nutrition programs, have increased the amounts of fruits and vegetables offered to children. Assisting parents with simple messages about increasing fruits and vegetables in the home and at meal time for their children can improve health and reduce disease risk.
Caution regarding the choice of standard deviations to guide sample size calculations in clinical trials
Authors: Chen Henian , Zhang Nanhua , Lu Xiaosun , Chen Sophie
Published: June 2013

Background

The method used to determine choice of standard deviation (SD) is inadequately reported in clinical trials. Underestimations of the population SD may result in underpowered clinical trials.

Purpose

This study demonstrates how using the wrong method to determine population SD can lead to inaccurate sample sizes and underpowered studies, and offers recommendations to maximize the likelihood of achieving adequate statistical power.

Methods

We review the practice of reporting sample size and its effect on the power of trials published in major journals. Simulated clinical trials were used to compare the effects of different methods of determining SD on power and sample size calculations.

Results

Prior to 1996, sample size calculations were reported in just 1%–42% of clinical trials. This proportion increased from 38% to 54% after the initial Consolidated Standards of Reporting Trials (CONSORT) was published in 1996, and from 64% to 95% after the revised CONSORT was published in 2001. Nevertheless, underpowered clinical trials are still common. Our simulated data showed that all minimal and 25th-percentile SDs fell below 44 (the population SD), regardless of sample size (from 5 to 50). For sample sizes 5 and 50, the minimum sample SDs underestimated the population SD by 90.7% and 29.3%, respectively. If only one sample was available, there was less than 50% chance that the actual power equaled or exceeded the planned power of 80% for detecting a median effect size (Cohen’s d = 0.5) when using the sample SD to calculate the sample size. The proportions of studies with actual power of at least 80% were about 95%, 90%, 85%, and 80% when we used the larger SD, 80% upper confidence limit (UCL) of SD, 70% UCL of SD, and 60% UCL of SD to calculate the sample size, respectively. When more than one sample was available, the weighted average SD resulted in about 50% of trials being underpowered; the proportion of trials with power of 80% increased from 90% to 100% when the 75th percentile and the maximum SD from 10 samples were used. Greater sample size is needed to achieve a higher proportion of studies having actual power of 80%.

Limitations

This study only addressed sample size calculation for continuous outcome variables.

Conclusions

We recommend using the 60% UCL of SD, maximum SD, 80th-percentile SD, and 75th-percentile SD to calculate sample size when 1 or 2 samples, 3 samples, 4–5 samples, and more than 5 samples of data are available, respectively. Using the sample SD or average SD to calculate sample size should be avoided.
Consultation workshops with patients and professionals: developing a template of patient-centred professionalism in community nursing
Authors: Rapport Frances , Doel Marcus , Hutchings Hayley , Jones Aled , Culley Lorraine , Wright Sarah
Published: June 2013

The study aimed to clarify the notion of patient-centred professionalism through consultation with the public, stakeholders and professionals in order to develop a thematic template within nursing. The paper also examines innovative methodology informing eight template themes developed qualitatively. Patient-centred professionalism has had little coverage in nursing literature, whilst ‘patient-centredness’ is supporting patients through holistic care according to needs and expectations. The study took place in Wales, UK, between October 2009 and September 2010. Data collection entailed consultation workshops with newly qualifying nurses (13 participants), community nurses (nine participants), nursing stakeholders (six participants) and the public (six participants). Analysis involved summative and thematic approaches. Result were revealed through template themes, identified in rank order of significance: the patient, nursing ethos, community nurse as a person, knowledge and skills, working relationships, service delivery, training and information and environment. The patient comes first for nurses and was the major theme of the analysis. This almost goes without saying for nurses, whilst for patients this is a surprise, as they see themselves as marginalised. The patient in patient-centred professionalism has multiple identities, many of which contradict one another – recipient and object of care, a force of resistance and a focus of negotiation. In conclusion, a clearer understanding of the concept should play a central role in policy development for optimal care, informing education and training, and methodological strengths could be explored further by other researchers, across a wide range of contexts.
Recent developments in flexor tendon repair techniques and factors influencing strength of the tendon repair
Authors: Wu Y. F. , Tang J. B.
Published: June 2013

Over the last decade, both basic researchers and surgeons have sought to identify the most appropriate techniques to be applied in flexor tendon repairs. Recent developments in experimental tendon repairs and clinical outcomes of newer repair techniques have been reviewed in an attempt to comprehensively summarize the most critical mechanical factors affecting the performance of tendon repairs and the surgical factors influencing clinical outcomes. Among them, attention to annular pulleys, the purchase and tension of the core suture, and the direction and curvature of the path of tendon motion have been found to be determining factors in the results of tendon repair.
Early rehabilitation after stable osteosynthesis of intra-articular fractures of the metacarpal base of the thumb
Authors: Uludag S. , Ataker Y. , Seyahi A. , Tetik O. , Gudemez E.
Published: June 2013

The aim of this study was to investigate the radiological and functional results of anatomical reduction and stable fixation followed by an early rehabilitation programme in the treatment of fractures of the base of the thumb metacarpal. Sixteen consecutive patients (11 men and five women; mean age: 36.4 years) with intra-articular fractures of the thumb metacarpal base were treated with plate and/or screw fixation between April 2002 and March 2011 at our department. Patients were followed-up for an average period of 15.62 months. Bony healing was achieved in all cases and all patients were able to return to pre-trauma activity levels 12 weeks following surgery. Open reduction with stable internal fixation and an early active rehabilitation programme appears to be an efficient method in the treatment of trapeziometacarpal joint fractures with satisfactory functional and radiological results.
Alarmin HNP-1 promotes pyroptosis and IL-1β release through different roles of NLRP3 inflammasome via P2X7 in LPS-primed macrophages
Authors: Chen Qixing , Jin Yue , Zhang Kai , Li Hui , Chen Wei , Meng Guangxun , Fang Xiangming
Published: June 2013

Defensins are the first endogenous mediators to be characterized as alarmins and play multifunctional roles in immune response. Previous studies reported that human neutrophil peptide (HNP)-1, a member of the α-defensin subfamily, could regulate the IL-1β post-translational process; however, the underlying mechanism remained unknown. Using an LPS-primed THP-1 macrophage model, we found that inhibition of P2X purinoceptor 7 (P2X7) suppressed HNP-1-initiated mature IL-1β release. Confocal microscopy and glutathione S-transferase (GST) pull-down assay demonstrated that HNP-1 bound to P2X7 directly. HNP-1 treatment increased the activated level of caspase-1, and inhibition of caspase-1 abolished IL-1β release. Incubation of LPS-primed macrophages with potassium chloride also prevented HNP-1-induced export of mature IL-1β. Likewise, an ethidium bromide uptake test showed that the P2X7-K+ efflux-caspase-1 signaling pathway triggered by HNP-1 contributed to pyroptotic pore formation. Furthermore, knock down of inflammasome adaptor Nod-like receptor family pyrin domain containing 3 (NLRP3) decreased activated caspase-1 level and reduced pore formation in macrophages, whereas IL-1β release was not significantly impaired. These findings not only illustrated the mechanism for alarmin HNP-1 in enhancing inflammatory response, but also provided therapeutic targets for certain inflammatory diseases in which defensins play important roles.
Infections in Anterior Cruciate Ligament Reconstruction
Authors: Stucken Charlton , Garras David N. , Shaner Julie L. , Cohen Steven B.
Published: June 2013

Context:

Anterior cruciate ligament (ACL) reconstruction is a safe, common, and effective method of restoring stability to the knee after injury, but evolving techniques of reconstruction carry inherent risk. Infection after ACL reconstruction, while rare, carries a high morbidity, potentially resulting in a poor clinical outcome.

Evidence Acquisition:

Data were obtained from previously published peer-reviewed literature through a search of the entire PubMed database (up to December 2012) as well as from textbook chapters.

Results:

Treatment with culture-specific antibiotics and debridement with graft retention is recommended as initial treatment, but with persistent infection, consideration should be given to graft removal. Graft type likely has no effect on infection rates.

Conclusion:

The early diagnosis of infection and appropriate treatment are necessary to avoid the complications of articular cartilage damage and arthrofibrosis.