bluuebunny/crossref_metadata_2025 huggingface dataset:
Flash vapor fuel injector development
Authors: Zhang Xiaohua , Palazzolo Alan , Tucker Randall , Kascak Albert , Kweon Chol-Bum
Published: August 2015

Following the single-fuel initiative, the US Army is transitioning its power plants from running on various fuels to a single fuel—JP-8. Due to its low vapor pressure, JP-8 could not be used to cold start or run gasoline engines without extensive retrofit. The feasibility of running a low compression ratio, spark ignition engine with direct injection of heated JP-8 was investigated. A preliminary study found that a small piston-type spark ignition engine would not start or run on JP-8 unless JP-8 was heated to certain temperature. JP-8’s thermal decomposition, or coking, was found to be a serious issue that must be addressed if fuel heating method would be used. A flash heater concept was proposed to solve problems of JP-8’s low vapor pressure on running low compression ratio spark ignition engines, as well as JP-8’s coking issue at high temperature. A flash vapor fuel injector was designed and tested to be capable of heating up JP-8 from 26.7 °C to its vaporization temperature of >154.4 °C under one-tenth of a second at the required flow rate. The longest duration heating test (>1 million injections) did not show any coking sign with flash heating. Ignition test results show equivalent or superior ignition characteristics of pre-heated JP-8 (with heater temperature at 260.0 °C or above) provided by the developed flash vapor fuel injector, compared with non-heated aviation gasoline.
Pub crawls at a Bulgarian nightlife resort: A case study using crowd theory
Authors: Tutenges Sébastien
Published: August 2015

Drawing on the classical crowd theories of Tarde, Le Bon, Durkheim, and Canetti, this article examines pub crawl crowds at the Bulgarian nightlife resort, Sunny Beach. The article argues that there are elements in classical crowd theory which can be used to advance the current research on tourist crowds such as those at pub crawls. The main strength of the theories lies in their ability to bring us close to crowd dynamics in their lived immediacy: the flow of emotions, collective attunement, the role of guides, and patterns of destruction—these are some of the issues that the theories can help us to understand. A major weakness of the theories is that they exaggerate the irrationality of crowds while neglecting the background conditions of crowd activities. The article is based on fieldwork among Danish tourists and guides in Sunny Beach. The key data come from 45 in-depth interviews and observations of 14 pub crawls.
Catering for yourself: Food experiences of self-catering tourists
Authors: Therkelsen Anette
Published: August 2015

The self-catering aspects of tourism-related food consumption have not been given much research attention so far, and hence, the purpose of this article is to expand our understanding of self-catering tourists’ food experiences. Tourists’ food relations are argued to be influenced by several forces: the multi-faceted nature of the individual tourist’s demands, the group dynamics within the travelling unit and the place-specific context of the tourism activity. Qualitative interviews with a diverse group of self-catering tourists enable an explorative discussion of food experiences of self-catering tourists. The analysis demonstrates that food has an experiential potential for a broad cross-section of self-catering tourists, but also that food is considered a non-experiences by some. Tourists’ relations to food is often a combination of two or more experiences, and may equally be concerned with the consumer object (pleasure and health) and the consumer context (social bonding and sense of place).
Association between diabetic retinopathy and subclinical atherosclerosis in China: Results from a community-based study
Authors: Liu Yu , Teng Xiangyu , Zhang Wei , Zhang Ruifeng , Liu Wei
Published: August 2015

Purpose:

To evaluate the association of diabetic retinopathy with subclinical atherosclerosis in middle-aged and elderly Chinese with type 2 diabetes.

Methods:

A cross-sectional community-based study was performed among 1607 patients aged 40 years or older in Shanghai. Non-mydriatic digital fundus photography examination was used in diabetic retinopathy detection. Presence of elevated carotid intima-media thickness or carotid plaque was defined as subclinical atherosclerosis.

Results:

The prevalence of diabetic retinopathy was 15.1% in total patients. Patients with diabetic retinopathy were more likely to have elevated carotid intima-media thickness, carotid plaque and subclinical atherosclerosis than those without diabetic retinopathy (37.9% vs 30.7%, 57.6% vs 49.6% and 64.6% vs 57.1%, respectively). The presence of diabetic retinopathy was significantly associated with increased odds of subclinical atherosclerosis (odds ratio = 1.93, 95% confidence interval = 1.03–3.60) after full adjustments.

Conclusion:

The presence of diabetic retinopathy was significantly associated with subclinical atherosclerosis in middle-aged and elderly patients with type 2 diabetics in China.
Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes
Authors: Mache Stefanie , Jensen Sarah , Jahn Reimo , Steudtner Mirko , Ochsmann Elke , Preuß Geraldine
Published: August 2015

Background. The aim of the present study was to evaluate the effectiveness of a worksite multicomponent health promotion intervention on eating behavior and attitudes, changes in body weight, and readiness to make eating behavior changes among workers over a 12-month intervention period. Method. A total of 3,095 workers of a logistic company participated in a quasi-experimental comparison group study design. The intervention group received a multicomponent health training. Two of the main elements of the multicomponent intervention were physical exercise training and nutrition counseling/training. During the pilot year, participants completed a survey at baseline and again after 12 months to assess physical activity–, health-, and diet-related factors. Results. Results showed that participants’ body weight did not significantly decrease in the intervention group. Mean weight loss in the intervention groups was 0.5 kg (body mass index = 0.1 kg/m2). Eating behaviors in the intervention group improved more than in the comparison group. Some positive intervention effects were observed for the cognitive factors (e.g., changes in eating attitudes). Baseline readiness to change eating behavior was significantly improved over time. Conclusions. We demonstrated initial results of a long-term multicomponent worksite health promotion program with regard to changes in body weight, eating behavior, and attitudes. This evaluation of a 12-month pilot study suggests that a worksite health promotion program may lead to improvements in nutritional health behaviors for a number of workers. An investigation of long-term effects of this multicomponent intervention is strongly recommended.
Needlefelt carpet waste as lightweight aggregate for polymer concrete composite
Authors: Pakravan Hamid R , Memarian F
Published: August 2015

In this research work, the feasibility of using the needlefelt carpet waste as a lightweight aggregate for producing lightweight polymer concrete was studied. Carpet waste was shredded into small pieces and added to the polymer concrete mixture to reduce the density of the resultant product. Incorporation of a small amount of carpet waste (2.5% in weight of concrete) decreased the density of polymer concrete up to 23%. The results show that the flexural and compressive strength of lightweight polymer concretes decreased by increasing the carpet waste content. Compressive strength of lightweight polymer concrete significantly decreased with increase in the waste content. All lightweight polymer concrete samples under flexural test exhibited the post-cracking response with a remarkable improvement in the toughness and the strain capacity. An increase in the energy-absorption capacity from 53% to 129% was observed for lightweight polymer concrete samples, depending on the waste content.
Participation of Students with Moderate to Severe Disabilities in the General Curriculum: The Effects of the Self-Determined Learning Model of Instruction
Authors: Agran Martin , Cavin Michael , Wehmeyer Michael , Palmer Susan
Published: August 2015

This study investigated the effects of the Self-Determined Learning Model of Instruction (SDLMI) on the academic skill performance of three junior high school students with moderate to severe intellectual disabilities. The academic skills taught were aligned to the district general curriculum, and extended benchmarks were individually determined. The students were instructed to engage in a self-regulated problem-solving strategy, as well as to use one or more additional student-directed learning strategies. The results suggested that all students were able to acquire and maintain target academic skills to mastery levels. Also, all stakeholders had positive perceptions about the value of such instruction. The implications of these findings relative to the general curriculum initiative are discussed.
A National Survey of the Educational Planning and Language Instruction Practices for Students with Moderate to Severe Disabilities Who are English Language Learners
Authors: Mueller Tracy Gershwin , Singer George H. S. , Carranza Francisco D.
Published: August 2015

This article examines findings from a national survey of a sample of special educators who serve students with moderate to severe disabilities who are English language learners (ELLs). The survey requested information related to respondent assessment and instructional practices, second language resource availability, satisfaction, and language decision procedures for ELL students. Results indicated many of the respondents assessed and instructed their students in English, lacked ELL training, experienced resource shortages, and did not include parents in the language of instruction decision. Additional findings revealed that teacher satisfaction was predicted by the availability of second language resources, and the administration appeared to have a significant influence on the inclusion/exclusion of parents in the language decision process. The implications of these findings are presented.
Promoting Access to the General Curriculum Using Peer Support Strategies
Authors: Carter Erik W. , Kennedy Craig H.
Published: August 2015

Promoting access to the general curriculum for students with disabilities has emerged as a central theme of recent legislative and policy initiatives. Ensuring that students with severe disabilities benefit fully from the myriad learning and social opportunities available through the general curriculum remains an important challenge, particularly at the secondary level. We discuss peer support interventions, a form of peer-mediated intervention, as an effective approach for engaging youth with severe disabilities more meaningfully in the general curriculum, as well as promoting academic success for classmates serving as peer supports. We describe the core elements of these interventions, review research pertaining to the academic and social benefits available to participating students, and discuss factors that may account for the effectiveness and social acceptability of this intervention approach.
The Application of Positive Psychology and Self-Determination to Research in Intellectual Disability: A Content Analysis of 30 Years of Literature
Authors: Shogren Karrie A. , Wehmeyer Michael L. , Buchanan Cindy L. , Lopez Shane J.
Published: August 2015

In recent decades, there have been shifts in the conceptualization of intellectual disability and increased attention has been directed toward the importance of identifying and capitalizing on the strengths and capabilities of people with intellectual disabilities as a means to promote meaningful participation, community inclusion, and quality of life outcomes. However, there are little data on the extent to which research in the field of intellectual disability has been influenced by these new conceptualizations. This paper reports the results of a content analysis of 30 years of literature that examines the degree to which research in the field has emphasized the strengths and capabilities of people with intellectual disabilities, as well as the degree to which this literature base has included constructs associated with positive psychology and self-determination. Our review found that there has been a shift toward research focusing on the capacities of people with intellectual disabilities. Additionally, there is a growing body of literature that focuses on constructs within the parameters of positive psychology, including self-determination. However, such research still represents a minority of the scholarship in the field.
Metabolism-Guided Bowel Resection
Authors: Diana Michele , Noll Eric , Diemunsch Pierre , Moussallieh François-Marie , Namer Izzie-Jacques , Charles Anne-Laure , Lindner Véronique , Agnus Vincent , Geny Bernard , Marescaux Jacques
Published: August 2015

Background. Strip-based handheld devices can measure lactatemia on capillary blood obtained by needle puncturing. We aimed to assess the kinetic of bowel capillary lactates, metabolomics profiling, and mitochondria respiratory rate in a prolonged model of bowel hypoperfusion. Materials and Methods. In 6 pigs, a 3- to 4-cm ischemic segment was created in 6 small bowel loops (total = 36 loops) by clamping the vascular supply, for a duration of 1 to 6 hours. Hourly, 5 blood samples were obtained by puncturing the serosa, and lactates were measured using a handheld analyzer. Samples were made at the following regions of interest (ROIs): center of the ischemic area (1), proximal and distal clinical margins of resection (2a-2b), and vascularized zones (3a-3b). Every hour, surgical biopsies of ROIs were sampled. Activity of bowel mitochondria complexes was measured after 1, 3, and 5 hours of ischemia. Quantification of metabolites was performed on all samples (total N = 180). Results. Capillary lactates were significantly higher at ROI 1 versus ROI 3ab at all time points. After 1 hour lactates at the margins were significantly higher than those at vascularized areas ( P = .0095), showing a mismatch between visual assessment and actual perfusion status. From 2 to 6 hours, there was no difference in lactates between ROIs 2a-2b and 3a-3b. Maximal tissue respiration decreased significantly after 1 hour (ROI 1 vs ROI 3ab). Seven metabolites (lactate, glucose, aspartate, choline, creatine, taurine, and tyrosine) expressed significantly different evolutions between ROIs. Conclusions. Capillary lactates could help precisely estimate local bowel perfusion status.
Environmental Effects of BPA
Authors: Canesi Laura , Fabbri Elena
Published: August 2015

Research on bisphenol A (BPA) as an environmental contaminant has now major regulatory implications toward the ecosystem health, and hence it is incumbent on scientists to do their research to the highest standards possible, in order that the most appropriate decisions are made to mitigate the impacts to aquatic wildlife. However, the contribution given so far appears rather fragmented. The present overview aims to collect available information on the effects of BPA on aquatic vertebrates and invertebrates to provide a general scenario and to suggest future developments toward more comprehensive approaches useful for aquatic species protection.
Global Assessment of Bisphenol A in the Environment
Authors: Corrales Jone , Kristofco Lauren A. , Steele W. Baylor , Yates Brian S. , Breed Christopher S. , Williams E. Spencer , Brooks Bryan W.
Published: August 2015

Because bisphenol A (BPA) is a high production volume chemical, we examined over 500 peer-reviewed studies to understand its global distribution in effluent discharges, surface waters, sewage sludge, biosolids, sediments, soils, air, wildlife, and humans. Bisphenol A was largely reported from urban ecosystems in Asia, Europe, and North America; unfortunately, information was lacking from large geographic areas, megacities, and developing countries. When sufficient data were available, probabilistic hazard assessments were performed to understand global environmental quality concerns. Exceedances of Canadian Predicted No Effect Concentrations for aquatic life were >50% for effluents in Asia, Europe, and North America but as high as 80% for surface water reports from Asia. Similarly, maximum concentrations of BPA in sediments from Asia were higher than Europe. Concentrations of BPA in wildlife, mostly for fish, ranged from 0.2 to 13 000 ng/g. We observed 60% and 40% exceedences of median levels by the US Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey in Europe and Asia, respectively. These findings highlight the utility of coordinating global sensing of environmental contaminants efforts through integration of environmental monitoring and specimen banking to identify regions for implementation of more robust environmental assessment and management programs.
Banding for type IA endoleak after endovascular abdominal aortic repair: An underexposed treatment option
Authors: van Lammeren GW , Ünlü Ç , De Vries JPPM
Published: August 2015

More challenging abdominal aortic aneurysms with unfavorable proximal aortic neck anatomy are treated with endovascular means. As a consequence, proximal inadequate sealing may result in type IA endoleak, which in turn can lead to abdominal aortic aneurysm progression or rupture. The presence of type IA endoleak is an indication for secondary interventions. External aortic banding can be a good option to solve a type IA endoleak, but is underreported in literature; we present two cases and review literature.
Impact of an educational program on knowledge and perceptions of physicians towards generic medicines in Kuala Lumpur, Malaysia
Authors: Kumar Rohit , Hassali Mohamed A , Alrasheedy Alian A , Saleem Fahad , Kaur Navneet , Wong Zhi Y
Published: August 2015

Objective

To evaluate the impact of an educational program on knowledge and perceptions of physicians towards generic medicines.

Methods

This is a single-cohort pre-/post-intervention study. It was conducted with physicians from different private hospitals in Kuala Lumpur, Malaysia. The intervention was in the form of an interactive lecture that addressed several topics related to generic medicines. A validated questionnaire was used to assess the impact of the intervention on the knowledge and perceptions of physicians.

Results

A total of 28 out of 30 invited physicians agreed to attend and participate in the program (response rate 93.3%). The intervention improved the knowledge of physicians regarding the bioequivalence regulatory requirements (3.6% vs. 32.1% for pre- and post-intervention respectively, p = 0.008). Moreover, it improved their knowledge about several aspects of generic medicines including their bioequivalence, efficacy and safety ( p = 0.004, p = < 0.001, p = 0.034, respectively). The intervention had also a positive impact on the physicians’ perceptions.

Conclusion

The study findings showed that a simple, educational intervention could improve the knowledge and perceptions of physicians towards generic medicines.
Paul Nizan: Conspiracy and the contemplation of crime
Authors: Ruggiero Vincenzo
Published: August 2015

Paul Nizan (1905–1940) is also known in France as the ‘impossible communist’, for his long-term allegiance to the Party and the abrupt cancellation of his membership, in the late 1930s, following the Nazi–Soviet pact. This paper discusses a number of his writings, focusing particularly on his best known novel, The Conspiracy, where a revolutionary cell plans illegal political action. Conflict, nihilism, suicide and betrayal are among the topics stemming from the novel, which will be examined from a criminological perspective. The analysis will primarily address ‘cultural’ aspects of crime and refer to notions such as ‘thrill’ and ‘seductions of crime’ among others. These notions, it will be argued, require some revision in the face of the imagined or actual criminality described in the novel.
Towards an understanding of the role of DNA methylation in rheumatoid arthritis: therapeutic and diagnostic implications
Authors: Cribbs Adam , Feldmann Marc , Oppermann Udo
Published: August 2015

The term ‘epigenetics’ loosely describes DNA-templated processes leading to heritable changes in gene activity and expression, which are independent of the underlying DNA sequence. Epigenetic mechanisms comprise of post-translational modifications of chromatin, methylation of DNA, nucleosome positioning as well as expression of noncoding RNAs. Major advances in understanding the role of DNA methylation in regulating chromatin functions have been made over the past decade, and point to a role of this epigenetic mechanism in human disease. Rheumatoid arthritis (RA) is an autoimmune disorder where altered DNA methylation patterns have been identified in a number of different disease-relevant cell types. However, the contribution of DNA methylation changes to RA disease pathogenesis is at present poorly understood and in need of further investigation. Here we review the current knowledge regarding the role of DNA methylation in rheumatoid arthritis and indicate its potential therapeutic implications.
Use of a Continuous External Tissue Expander in Total Ankle Arthroplasty
Authors: Huh Jeannie , Parekh Selene G.
Published: August 2015

Despite major improvements in surgical technique and implant designs in total ankle arthroplasty (TAA), wound healing complications are still commonly encountered. Not only do these problems delay postoperative recovery and threaten functional outcomes, they also carry an increased risk of progression to deep wound infection, which can jeopardize ultimate retention of the implant. In an effort to reduce the high frequency of wound-related complications after TAA, we have incorporated the use of continuous external tissue expansion (CETE) to augment our closures of the anterior ankle incision. CETE is an innovative technique that is currently being used to aid in the rapid closure of acute and chronic full thickness soft tissue defects, including fasciotomy wounds, high grade open fractures, and chronic foot ulcers. By exploiting the viscoelastic properties of the skin, this technique not only facilitates wound edge approximation of full thickness defects, it also helps take tension off tenuous incisions, thus allowing them to heal and reducing the chance for wound dehiscence. This is the first description of the use of an external tissue expander for the prevention of wound healing complications in the setting of TAA. Since introducing CETE to the closure of our TAA incisions, we have seen a decrease in the number of postoperative wound complications and time to wound healing. Based on our experience, we believe that the use of CETE for the prophylactic management of tenuous surgical incisions, specifically those used in the anterior approach to the ankle during TAA, is both safe and efficacious.

Levels of Evidence: Level V: Technique tip
Sport Specialization, Part I
Authors: Myer Gregory D. , Jayanthi Neeru , Difiori John P. , Faigenbaum Avery D. , Kiefer Adam W. , Logerstedt David , Micheli Lyle J.
Published: August 2015

Context:

There is increased growth in sports participation across the globe. Sports specialization patterns, which include year-round training, participation on multiple teams of the same sport, and focused participation in a single sport at a young age, are at high levels. The need for this type of early specialized training in young athletes is currently under debate.

Evidence Acquisition:

Nonsystematic review.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Conclusion:

Sports specialization is defined as year-round training (greater than 8 months per year), choosing a single main sport, and/or quitting all other sports to focus on 1 sport. Specialized training in young athletes has risks of injury and burnout, while the degree of specialization is positively correlated with increased serious overuse injury risk. Risk factors for injury in young athletes who specialize in a single sport include year-round single-sport training, participation in more competition, decreased age-appropriate play, and involvement in individual sports that require the early development of technical skills. Adults involved in instruction of youth sports may also put young athletes at risk for injury by encouraging increased intensity in organized practices and competition rather than self-directed unstructured free play.

Strength-of-Recommendation Taxonomy (SORT):

C.
The “Empty Vessel” Physician
Authors: Schroeder Juliana , Fishbach Ayelet
Published: August 2015

Although much research examines how physicians perceive their patients, here we study how patients perceive physicians. We propose patients consider their physicians like personally emotionless “empty vessels”: The higher is individuals’ need for care, the less they value physicians’ traits related to their personal lives (e.g., self-focused emotions), but the more they value physicians’ traits related to patients (e.g., patient-focused emotions). In an initial study, participants recalled fewer personal facts (e.g., marital status) about physicians who seemed more important to their health. In subsequent experiments, participants in higher need for care believed physicians have less personal emotions. Although higher need individuals, such as patients in a clinic, perceived their physicians to be personally emotionless, they wanted the clinic to hire physicians who displayed patient-focused emotion. We discuss implications of perceiving physicians as empty vessels for health care.
Physical restraints among the elderly in the acute care setting: Prevalence, complications and its association with patients’ characteristics
Authors: Ang Shin Yuh , Bakar Aloweni Fazila Abu , Perera Karen , Wee Say Li , Manickam Aines , Lee Julian Hui Min , Haridas Dira , Shamsudin Hanis Farhana , Chan Joon Kai
Published: August 2015

Aims:

This study aimed to identify the prevalence and circumstances of the use of physical restraints, complications associated with its use and its association with patients’ characteristics.

Methods:

This is a prospective observational study design. A convenience sample of elderly patients (aged 65 and above) who were admitted to an acute care hospital from February 2012 to August 2012 were tracked daily to monitor the use of physical restraints during hospitalization. Patient-related variables and type of physical restraint used were gathered from the medical records and the Multi-Dimensional Dementia Assessment Scale was completed through interviews with nurses who had cared for the patients. Independent t-test or Chi-square (χ2) tests were used to examine the effect of a single variable on the use of physical restraints. Multiple logistic regression was done to predict the patient-related variables to the likelihood of being placed on physical restraints.

Results:

Altogether, 998 patients accounting for 1048 admission episodes, were included in this study, of which 84 admission episodes involved the use of physical restraints (8%). Major reasons for restraints include ‘Behavioural/confused/violent’ ( n= 55; 65%) and to prevent falls ( n=53; 62%). Regression analysis indicated that male gender, behavioural changes, memory disturbance, impaired physical function, the use of anti-psychotic drugs and higher psychiatric workload predicted the likelihood of being put on physical restraints. The strongest predictor was memory disturbances with an odds ratio of 30.

Conclusion:

The prevalence of physical restraints used was higher than that in published literature for acute care hospitals. Preventive strategies would need to be targeted for the elderly, who suffered from memory disturbances upon admission.
Identifying an important change estimate for the Multiple Sclerosis Walking Scale-12 (MSWS-12v1) for interpreting clinical trial results
Authors: Mehta Lahar , McNeill Manjit , Hobart Jeremy , Wyrwich Kathleen W , Poon Jiat-Ling , Auguste Priscilla , Zhong John , Elkins Jacob
Published: August 2015

Background

The 12-question Multiple Sclerosis Walking Scale (MSWS-12v1) is a widely-used patient-reported outcome (PRO) measure of walking ability in multiple sclerosis (MS).

Objective

To estimate the magnitude of an important change in MSWS-12v1 scores for the interpretation of meaningful subject-level improvements across a 6-month trial of MS patients with walking disability.

Methods

MOBILE was a 6-month exploratory study assessing fampridine’s effect on walking ability in 132 people with MS. Three PRO measures assessed walking ability: MSWS-12v1, EuroQol 5-Dimension-5 Level (EQ-5D-5L) mobility question, and a patient global impression of change (PGIC) in overall walking ability. Pre-specified anchor- and distribution-based analyses estimated the MSWS-12v1 change scores representing an important change for participants. Results were triangulated to propose a single best value indicating meaningful improvement.

Results

Using baseline to week 2 through week 24 change scores, anchor-based analyses demonstrated mean and median improvements of 5.2–6.6 (PGIC) and 9.7–13.4 (EQ-5D-5L mobility) points on the MSWS-12v1, indicating meaningful improvements. The distribution-based estimate was 6.8 points. Triangulation across the results suggested an 8-point reduction in MSWS-12v1 score represents an important subject-level change in these participants.

Conclusion

In similar MS clinical trials, an 8-point improvement on the MSWS-12v1 is a reasonable estimate of meaningful improvement in walking ability.
Fixation Versus Replacement in Geriatric Hip Fractures
Authors: Palanisamy Arul Murugan , Doshi H. K. , Selvaraj Dahshaini , Chan William , Naidu G. , Ramason R.
Published: August 2015

Introduction:

Although there is evidence of improved functional outcomes with our “integrated care pathway” for geriatric hip fractures, we do not know if there is a significant difference in functional recovery of activities of daily living and attainment of independence in self-care between patients who underwent fixation and those treated with arthroplasty.

Objective:

To determine whether such a difference exists in surgically fixed hip fractures.

Materials and Methods:

Patients with hip fracture treated surgically were divided into group A (internal fixation, n = 213) and group B (arthroplasty, n = 199). Demographic data, Charlson comorbidity index (CCI) score, time to surgery, and length of stay were recorded. Inpatient complications and mortality rates were also documented. Modified Barthel Index (MBI) scores were recorded for the following intervals: prefall, discharge, 6-month, and at 1-year follow-up.

Results:

The mean age (A: 80 years and B: 81years), CCI (A: 5.41 and B: 5.43), and length of stay (A: 13.6 days and B: 15.2 days) were not significantly different. However, there was a significant difference ( P < .05) in time to surgery (A: 102.2 hours and B: 86.6 hours). Complication rates were about 6% in both groups (A = 6.57%: urinary infections = 13, wound infections = 1 and B = 6.03%: urinary infections = 10, wound infections = 1, pressure ulcer = 1). The preinjury MBI scores were significantly different ( P < .05; A: 91.65 and B: 88.19), however, there was no significant difference in scores measured at discharge (A: 60.79 and B: 59.39), 6 months (A: 77.65 and B: 77.47) and 1 year (A: 80.71 and B: 83.03). Patients who underwent surgery for hip fracture had overall recovered 90.9% of their preinjury function (overall MBI at 1 year: 81.83).

Conclusion:

The MBI scores reflect the extent of attainment of independence in self-care, and actual functional recovery is gauged from the percentage of recovery of preinjury function at 1 year postsurgery. We conclude that the type of surgery may not be a significant factor in determining independence in self-care although patients who had arthroplasty had recovered more function at 1 year postsurgery than those who underwent fixation (percentage recovery of preinjury function—A: 88.1% and B: 94.1%).
Violent Video Games and Children’s Aggressive Behaviors
Authors: Milani Luca , Camisasca Elena , Caravita Simona C. S. , Ionio Chiara , Miragoli Sarah , Di Blasio Paola
Published: August 2015

The literature provides some evidence that the use of violent video games increases the risk for young people to develop aggressive cognitions and even behaviors. We aimed to verify whether exposure to violent video games is linked to problems of aggression in a sample of Italian children. Four questionnaires were administered to 346 children between 7 and 14 years of age, attending primary and secondary schools in Northern Italy. Variables measured were externalization, quality of interpersonal relationships, aggression, quality of coping strategies, and parental stress. Participants who preferred violent games showed higher scores for externalization and aggression. The use of violent video games and age were linked to higher levels of aggression, coping strategies, and the habitual video game weekly consumption of participants. Our data confirm the role of violent video games as risk factors for problems of aggressive behavior and of externalization in childhood and early adolescence.
Human Bite of a Staff Nurse on a Psychiatric Unit
Authors: Suguna Anbazhagan , Joseph Bobby
Published: August 2015

Occupational violence among health care professionals is a cause for concern, although often neglected especially in developing countries like India. Violence undermines the healing mission of the health care organization and interferes with the ability of the health care team to optimally contribute to positive patient outcomes. The authors discuss a case of a human bite of a staff nurse on a psychiatric unit in a tertiary care Indian hospital. The reported violence against this staff nurse lead to her admission for emergency care followed by emotional stress. Issues related to prevention of occupational violence are also discussed.
A Security Guard With West Nile Virus Encephalitis
Authors: Smith Letha
Published: August 2015

A 57-year-old male working as a security supervisor in an office building was seen for return to work by the on-site occupational health nurse. He was observed to have slow gait as he entered the clinic waiting area, was pale, diaphoretic, and slow in responding to questions. His return to work note stated he was recovering from West Nile Virus (WNV). Implications for return to work are presented.
The Importance of the Intercondylar Notch in Anterior Cruciate Ligament Tears
Authors: Fernández-Jaén Tomás , López-Alcorocho Juan Manuel , Rodriguez-Iñigo Elena , Castellán Fabián , Hernández Juan Carlos , Guillén-García Pedro
Published: August 2015

Background

The factors associated with anterior cruciate ligament (ACL) tears are not completely clear. Some studies have shown that patients with a narrow intercondylar notch have a predisposition for ACL tears.

Purpose

To determine the relationship between the α angle and intercondylar notch width measurements and ACL tears.

Study Design

Case-control study; Level of evidence, 3.

Methods

A total of 530 patients (308 with ACL rupture, 222 with healthy ACLs) were included in this study. The α angle and intercondylar width were measured from magnetic resonance images (MRIs). Binary logistic regression analysis was performed to determine the influence of the variables on ACL status (normal or torn). Odds ratios (ORs) and their respective 95% CIs were also calculated.

Results

No significant differences in patient age and the affected knee were found between patients with normal or torn ACLs. The mean α angle was higher in patients with a torn ACL than in those with an intact one (57.5° ± 5.5° vs 56.2° ± 4.5°; P = .009). Intercondylar width was significantly lower in patients with a torn ACL than in those with an intact one (18.2 ± 3.1 vs 19.5 ± 3.6 mm; P < .001). A highly significant difference between men and women was found for mean intercondylar notch width (19.3 ± 3.3 vs 17.4 ± 3.1 mm; P < .001). In a logistic regression model, sex, intercondylar width, and α angle were statistically significant when adjusted for age.

Conclusion

Study results suggest that the ACL tears are associated with a narrow intercondylar notch and a high α angle, and that tears occur more frequently in men than in women.

Clinical Relevance

The model proposed in this study could be used by the physician in the medical office as a tool to identify the risk factors that may predispose a patient for a potential ACL tear.
Political Islam: An African Perspective
Authors: Solomon Hussein
Published: August 2015

Political Islam continues to gain adherents across the African continent. In an attempt to understand why this is the case, this article explores the historical evolution of political Islam or Islamism. Three case studies are then provided to examine the implementation of this ideology—the Muslim Brotherhood in Egypt, Sudan’s National Islamic Front and Al Shabab in Somalia. In conclusion, we examine the future of political Islam from the perspective of secularism.
Contrast-Enhanced Ultrasound Reveals Masked Post-Baseline Wedge Transplant Biopsy Pseudoaneurysm
Authors: Araújo Nordeval Cavalcante , Suassuna José Hermógenes Rocco
Published: August 2015

Biopsy of the transplanted kidney is known to cause intraparenchymal renal vascular injury. The most common vascular complications include arteriovenous fistula (AVF) and pseudoaneurysm (PA). We report a case of a patient who underwent cadaveric renal transplantation and developed an AVF and a PA after an on-table wedge biopsy. The PA was missed during the standard Doppler sonographic examination because of its small size but was unmasked with the use of contrast-enhanced ultrasound (CEUS). Fourteen days after the first CEUS, the procedure was repeated and showed complete thrombosis of the PA.
Recent progress in Fe3O4 based magnetic nanoparticles: from synthesis to application
Authors: Shan J. , Wang L. , Yu H. , Ji J. , Amer W. A. , Chen Y. , Jing G. , Khalid H. , Akram M. , Abbasi N. M.
Published: August 2015

Fe3O4 based magnetic polymer nanoparticles (MPNPs) are densely studied for several decades. These Fe3O4 based MPNPs can be used in wastewater treatment and biological field such as magnetic resonance imaging contrast agents, hyperthermia therapy and protein separation. The Fe3O4 based MPNPs are attractive because they combine the advantages of magnetism and polymers together. In order to obtain the practical application in the above mentioned areas, the bare Fe3O4 needs to be functionalised with different kinds of molecules like organic small molecules and polymers and some inorganic molecules like silica, metals and carbon. In this review, the chemical preparation methods, different modification methods and various applications of the Fe3O4 based MPNPs are introduced.
Increased alveolar soluble annexin V promotes lung inflammation and fibrosis
Authors: Buckley Susan , Shi Wei , Xu Wei , Frey Mark R. , Moats Rex , Pardo Annie , Selman Moises , Warburton David
Published: August 2015

The causes underlying the self-perpetuating nature of idiopathic pulmonary fibrosis (IPF), a progressive and usually lethal disease, remain unknown. We hypothesised that alveolar soluble annexin V contributes to lung fibrosis, based on the observation that human IPF bronchoalveolar lavage fluid (BALF) containing high annexin V levels promoted fibroblast involvement in alveolar epithelial wound healing that was reduced when annexin V was depleted from the BALF.

Conditioned medium from annexin V-treated alveolar epithelial type 2 cells (AEC2), but not annexin Vper se, induced proliferation of human fibroblasts and contained pro-fibrotic, IPF-associated proteins, as well as pro-inflammatory cytokines that were found to correlate tightly (r>0.95) with annexin V levels in human BALF. ErbB2 receptor tyrosine kinase in AECs was activated by annexin V, and blockade reduced the fibrotic potential of annexin V-treated AEC-conditioned medium.In vivo, aerosol delivery of annexin V to mouse lung induced inflammation, fibrosis and increased hydroxyproline, with activation of Wnt, transforming growth factor-β, mitogen-activated protein kinase and nuclear factor-κB signalling pathways, as seen in IPF.

Chronically increased alveolar annexin V levels, as reflected in increased IPF BALF levels, may contribute to the progression of IPF by inducing the release of pro-fibrotic mediators.
miR-17 overexpression in cystic fibrosis airway epithelial cells decreases interleukin-8 production
Authors: Oglesby Irene K. , Vencken Sebastian F. , Agrawal Raman , Gaughan Kevin , Molloy Kevin , Higgins Gerard , McNally Paul , McElvaney Noel G. , Mall Marcus A. , Greene Catherine M.
Published: August 2015

Interleukin (IL)-8 levels are higher than normal in cystic fibrosis (CF) airways, causing neutrophil infiltration and non-resolving inflammation. Overexpression of microRNAs that target IL-8 expression in airway epithelial cells may represent a therapeutic strategy for cystic fibrosis.

IL-8 protein and mRNA were measured in cystic fibrosis and non-cystic fibrosis bronchoalveolar lavage fluid and bronchial brushings (n=20 per group). miRNAs decreased in the cystic fibrosis lung and predicted to target IL-8 mRNA were quantified in βENaC-transgenic, cystic fibrosis transmembrane conductance regulator (Cftr)-/-and wild-type mice, primary cystic fibrosis and non-cystic fibrosis bronchial epithelial cells and a range of cystic fibrosisversusnon-cystic fibrosis airway epithelial cell lines or cells stimulated with lipopolysaccharide,Pseudomonas-conditioned medium or cystic fibrosis bronchoalveolar lavage fluid. The effect of miRNA overexpression on IL-8 protein production was measured.

miR-17 regulates IL-8 and its expression was decreased in adult cystic fibrosis bronchial brushings, βENaC-transgenic mice and bronchial epithelial cells chronically stimulated withPseudomonas-conditioned medium. Overexpression of miR-17 inhibited basal and agonist-induced IL-8 protein production in F508del-CFTR homozygous CFTE29o−tracheal, CFBE41o−and/or IB3 bronchial epithelial cells.

These results implicate defective CFTR, inflammation, neutrophilia and mucus overproduction in regulation of miR-17. Modulating miR-17 expression in cystic fibrosis bronchial epithelial cells may be a novel anti-inflammatory strategy for cystic fibrosis and other chronic inflammatory airway diseases.
COPD comorbidities network
Authors: Divo Miguel J. , Casanova Ciro , Marin Jose M. , Pinto-Plata Victor M. , de-Torres Juan P. , Zulueta Javier J. , Cabrera Carlos , Zagaceta Jorge , Sanchez-Salcedo Pablo , Berto Juan , Davila Rebeca Baz , Alcaide Ana B. , Cote Claudia , Celli Bartolome R.
Published: August 2015

Multimorbidity frequently affects the ageing population and their co-existence may not occur at random. Understanding their interactions and that with clinical variables could be important for disease screening and management.

In a cohort of 1969 chronic obstructive pulmonary disease (COPD) patients and 316 non-COPD controls, we applied a network-based analysis to explore the associations between multiple comorbidities. Clinical characteristics (age, degree of obstruction, walking, dyspnoea, body mass index) and 79 comorbidities were identified and their interrelationships quantified. Using network visualisation software, we represented each clinical variable and comorbidity as a node with linkages representing statistically significant associations.

The resulting COPD comorbidity network had 428, 357 or 265 linkages depending on the statistical threshold used (p≤0.01, p≤0.001 or p≤0.0001). There were more nodes and links in COPD compared with controls after adjusting for age, sex and number of subjects. In COPD, a subset of nodes had a larger number of linkages representing hubs. Four sub-networks or modules were identified using an inter-linkage affinity algorithm and their display provided meaningful interactions not discernible by univariate analysis.

COPD patients are affected by larger number of multiple interlinked morbidities which clustering pattern may suggest common pathobiological processes or be utilised for screening and/or therapeutic interventions.
Neutrophil proteases alter the interleukin-22-receptor-dependent lung antimicrobial defence
Authors: Guillon Antoine , Jouan Youenn , Brea Deborah , Gueugnon Fabien , Dalloneau Emilie , Baranek Thomas , Henry Clémence , Morello Eric , Renauld Jean-Christophe , Pichavant Muriel , Gosset Philippe , Courty Yves , Diot Patrice , Si-Tahar Mustapha
Published: August 2015

Chronic obstructive pulmonary disease (COPD) is punctuated by episodes of infection-driven acute exacerbations. Despite the life-threatening nature of these exacerbations, the underlying mechanisms remain unclear, although a high number of neutrophils in the lungs of COPD patients is known to correlate with poor prognosis. Interleukin (IL)-22 is a cytokine that plays a pivotal role in lung antimicrobial defence and tissue protection. We hypothesised that neutrophils secrete proteases that may have adverse effects in COPD, by altering the IL-22 receptor (IL-22R)-dependent signalling.

Usingin vitroandin vivoapproaches as well as reverse transcriptase quantitative PCR, flow cytometry and/or Western blotting techniques, we first showed that pathogens such as the influenza virus promoteIL-22Rexpression in human bronchial epithelial cells, whereasPseudomonas aeruginosa, bacterial lipopolysaccharide or cigarette smoke do not. Most importantly, neutrophil proteases cleave IL-22R and impair IL-22-dependent immune signalling and expression of antimicrobial effectors such as β-defensin-2. This proteolysis resulted in the release of a soluble fragment of IL-22R, which was detectable both in cellular and animal models as well as in sputa from COPD patients with acute exacerbations.

Hence, our study reveals an unsuspected regulation by the proteolytic action of neutrophil enzymes of IL-22-dependent lung host response. This process probably enhances pathogen replication, and ultimately COPD exacerbations.
An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features
Authors: Fischer Aryeh , Antoniou Katerina M. , Brown Kevin K. , Cadranel Jacques , Corte Tamera J. , du Bois Roland M. , Lee Joyce S. , Leslie Kevin O. , Lynch David A. , Matteson Eric L. , Mosca Marta , Noth Imre , Richeldi Luca , Strek Mary E. , Swigris Jeffrey J. , Wells Athol U. , West Sterling G. , Collard Harold R. , Cottin Vincent
Published: August 2015

Many patients with an idiopathic interstitial pneumonia (IIP) have clinical features that suggest an underlying autoimmune process but do not meet established criteria for a connective tissue disease (CTD). Researchers have proposed differing criteria and terms to describe these patients, and lack of consensus over nomenclature and classification limits the ability to conduct prospective studies of a uniform cohort.

The “European Respiratory Society/American Thoracic Society Task Force on Undifferentiated Forms of Connective Tissue Disease-associated Interstitial Lung Disease” was formed to create consensus regarding the nomenclature and classification criteria for patients with IIP and features of autoimmunity.

The task force proposes the term “interstitial pneumonia with autoimmune features” (IPAF) and offers classification criteria organised around the presence of a combination of features from three domains: a clinical domain consisting of specific extra-thoracic features, a serologic domain consisting of specific autoantibodies, and a morphologic domain consisting of specific chest imaging, histopathologic or pulmonary physiologic features.

A designation of IPAF should be used to identify individuals with IIP and features suggestive of, but not definitive for, a CTD. With IPAF, a sound platform has been provided from which to launch the requisite future research investigations of a more uniform cohort.