bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Plasma Metabolomics to Identify Potential Biomarkers of Blood Pressure Progression
Authors: Lin Yi-Ting , Salihovic Samira , Fall Tove , Hammar Ulf , Ingelsson Erik , Ärnlöv Johan , Lind Lars , Sundström Johan
Published: May 2020

Objective:

The pathophysiology of hypertension remains incompletely understood. We investigated associations of circulating metabolites with longitudinal blood pressure (BP) changes in the Prospective Investigation of the Vasculature in Uppsala Seniors cohort and validated the findings in the Uppsala Longitudinal Study of Adult Men cohort.

Approach and Results:

Circulating metabolite levels were assessed with liquid- and gas-chromatography coupled to mass spectrometry among persons without BP-lowering medication at baseline. We studied associations of baseline levels of metabolites with changes in BP levels and the clinical BP stage between baseline and a follow-up examination 5 years later. In the discovery cohort, we investigated 504 individuals that contributed with 757 observations of paired BP measurements. The mean baseline systolic and diastolic BPs were 144 (19.7)/76 (9.7) mm Hg, and change in systolic and diastolic BPs were 3.7 (15.8)/−0.5 (8.6) mm Hg over 5 years. The metabolites associated with diastolic BP change were ceramide, triacylglycerol, total glycerolipids, oleic acid, and cholesterylester. No associations with longitudinal changes in systolic BP or BP stage were observed. Metabolites with similar structures to the 5 top findings in the discovery cohort were investigated in the validation cohort. Diacylglycerol (36:2) and monoacylglycerol (18:0), 2 glycerolipids, were associated with diastolic BP change in the validation cohort.

Conclusions:

Circulating baseline levels of ceramide, triacylglycerol, total glycerolipids, and oleic acid were positively associated with longitudinal diastolic BP change, whereas cholesterylester levels were inversely associated with longitudinal diastolic BP change. Two glycerolipids were validated in an independent cohort. These metabolites may point towards pathophysiological pathways of hypertension.
Factors influencing decisions on contralateral symmetrisation procedure among patients with breast cancer
Authors: Lim GH , Choo CH , Allen JC Jr , Ng RP
Published: May 2020

INTRODUCTION Oncoplastic breast-conserving surgery (OBCS) can cause breast asymmetry. Although contralateral breast surgery to achieve symmetry was offered to these patients, the uptake of symmetrisation was variable. We aimed to determine the factors that deter patients with breast cancer undergoing OBCS from opting for symmetrisation. METHODS All patients with breast cancer who underwent OBCS of displacement type with no symmetrisation were prospectively surveyed to explore the social, economic, psychological and physical reasons against symmetrisation. RESULTS A total of 28 patients participated in a survey administered at a mean 21.6 (range 2–47) months after OBCS. A combination of factors, such as worry and desire to treat breast cancer first (67.9%), not being overly concerned about breast cosmesis (57.1%) and fear of pain from additional operation (28.6%), deterred patients from immediate symmetrisation. Worry and desire to treat breast cancer first was the most important single factor for 50% of the patients. Reasons for no delayed symmetrisation included not being overly concerned about breast cosmesis (70.4%), fear of breast cancer recurrence (48.1%) and being happy with current breast cosmesis (33.3%), with the former two reasons equally cited as the single most important deterrent by 30% of patients each. CONCLUSION A combination of factors may deter patients from symmetrisation. The most significant factors deterring OBCS among patients were worry and desire to treat breast cancer first for immediate symmetrisation, and not being overly concerned about breast cosmesis and fear of breast cancer recurrence for delayed symmetrisation. Reassuring these patients may increase their uptake of symmetrisation, thereby improving patient cosmesis and satisfaction.
Safety of a rapid outpatient hydration protocol for patients with renal impairment requiring intravenous iodinated contrast media for computed tomography
Authors: Wee NK , Tiong SC , Lee CH , H'ng MWC
Published: May 2020

INTRODUCTION Patients receiving intravenous iodinated contrast media for computed tomography (CT) are predisposed to contrast-induced nephropathy. Chronic kidney disease is an important risk factor, and hydration is the mainstay of prevention. While inpatients can undergo intravenous hydration, limited knowledge exists regarding regimens for outpatients. We employed a rapid outpatient hydration protocol to reduce postponement of imaging appointments for patients with suboptimal estimated glomerular filtration rate (eGFR). METHODS From June 2015, we amended our CT preparation protocol to mandate rapid hydration (oral, intravenous or both) for patients with an eGFR of 30–60 mL/min/1.73 m2. Patients receiving this hydration protocol from June to November 2015 were followed up for one month to monitor any admissions for fluid overload, and up to one year to determine the long-term effect on eGFR. RESULTS 226 outpatients received the hydration protocol, which correlated with a 95% reduction in postponement of imaging appointments. No complications of fluid overload from hydration were encountered. A significant association was observed between age and decrease in eGFR, but this was not significant when stratified by drop in eGFR category. No statistical significance was found between decrease in eGFR and gender or race. Higher baseline eGFR was less likely to be associated with decrease in eGFR after imaging. Type of hydration was not related to a drop in eGFR category for patients with an eGFR of 45–59 mL/min/1.73 m2. CONCLUSION We defined a shorter hydration regimen that is safe to use in the outpatient setting.
Simplified instructional phrasing in dispatcher-assisted cardiopulmonary resuscitation – when ‘less is more’
Authors: Leong WK , Leong SH , Arulanandam S , Ng M , Ng YY , Ong MEH , Mao RH
Published: May 2020

INTRODUCTION In our national emergency dispatch centre, the standard protocol for dispatcher-assisted cardiopulmonary resuscitation (DACPR) in out-of-hospital cardiac arrests (OHCAs) involves the instruction ‘push 100 times a minute 5 cm deep’. As part of quality improvement, the instruction was simplified to ‘push hard and fast’. METHODS We analysed all dispatcher-diagnosed OHCAs over four months in 2018: January to February (‘push 100 times a minute 5 cm deep’) and August to September (‘push hard and fast’). We also performed secondary per-protocol analysis based on the protocol used: (a) standard (n = 48); (b) simplified (n = 227); and (c) own words (n = 231). RESULTS A total of 506 cases were included: 282 in the ‘before’ group and 224 in the ‘after’ group. Adherence to the protocol was 15.2% in the ‘before’ phase and 72.8% in the ‘after’ phase (p < 0.001). The mean time between instruction and first compression for the ‘before’ and ‘after’ groups was 34.36 seconds and 26.83 seconds, respectively (p < 0.001). Time to first compression was 238.62 seconds and 218.83 seconds in the ‘before’ and ‘after’ groups, respectively (p = 0.016). In the per-protocol analysis, the interval between instruction and compression was 37.19 seconds, 28.31 seconds and 32.40 seconds in the standard protocol, simplified protocol and ‘own words’ groups, respectively (p = 0.005). The need for paraphrasing was 60.4% in the standard protocol group and 81.5% in the simplified group (p < 0.001). CONCLUSION Simplified instructions were associated with a shorter interval between instruction and first compression. Efforts should be directed at simplifying DACPR instructions.
Individualized artificial titanium alloy spinal lamina with 3D printing technology
Authors: Li Jianwen , Li Songbo , Liu Xianyin , Wei Fuxin , Wang Xiaoshuai , Fang Guanjun , Chen Yaoxin , Liu Zhiwei , Lu Jianfeng , Ye Guobiao , Zhong Shu , Yin Yuchao
Published: May 2020

Background: Laminectomy and decompression is a common procedure for treating spine diseases. However, due to the lack of a posterior, bony braced structure, the dural sac and nerve roots can adhere to the surrounding tissues, and scar formation can occur in muscle and soft tissues.
This can cause new compression post surgery, and failure of the operation. Objective: This study aimed to produce an individualized titanium alloy spine lamina using 3D printing technology, and to evaluate its effectiveness by implantation in human cadaveric spines. Methods:
Six adult lumbar cadaver specimens were used, and computed tomography (CT) was used to obtain DICOM medical digital image standard data. The lumbar vertebrae structure was reconstructed by three-dimensional (3D) modeling software, and then simulated lumbar laminectomy was performed. Based
on the characteristics of the original lamina, an artificial spine lamina was designed, including suture holes at the posterior ligament attachment point and a locking screw hole for fixation. A titanium alloy spine lamina was fabricated by 3D printing, and a guide plate to assist artificial
lamina implantation was designed. Using the guide plated, L4 lumbar vertebrae segment laminectomy was performed on the 6 lumbar spine specimens, titanium alloy spine lamina were implanted and fixed with cortical bone trajectory screws. After implantation, CT was performed to record the length
of the screw, the trajectory of the screw in the pedicle, and changes of bony spinal canal volume and anteroposterior diameter of the spinal canal. Results: The morphology of artificial spine lamina matched that of the original lamina. The artificial lamina was easy to implant, and
matched the original lamina. The laminas were fixed by 12 cortical screws (diameter, 4.5 mm; median length, 34.67 ± 1.97 mm). CT scan indicated that all screws passed through the pedicle cortex by < 2 mm (2 screws penetrated the inner wall). The bony canal volume of the L4 vertebral
pedicle was 311.23 ± 38.17 mm2 before operation and 356.17 ± 43.11 mm2 after operation, and there was statistical difference (P < 0.001). The anteroposterior diameter of spinal canal was 17.82 ± 2.03 mm before surgery and 20.67 ±
2.38 mm after surgery, and they were statistically different (P < 0.001). Conclusion: An individualized artificial titanium alloy spine lamina designed and produced with 3D printing technology can be used to reconstruct the structure of the posterior spine complex after lumbar
laminectomy. The artificial lamina can increase the volume of the spinal canal and provide a posterior ligament reconstruction attachment point.
Exploring distillation-pervaporation hybrid process in a single column using hollow fiber pervaporation composite membranes as structured packing
Authors: Zhuang Liwei , Cao Qingyuan , Liang Fei , Hu Yichao , Su Weite , Wen Xin , Ma Xiao-Hua , Xu Zhen-Liang
Published: May 2020

This study developed a novel strategy for azeotrope separation such as ethanol-water binary system. Distillation-pervaporation hybrid process was employed by using hollow fiber pervaporation composite membranes as structured packing in a single hybrid column rather than using pervaporation
as an externally connected unit of the distillation column. The separating limitation of azeotrope challenged in conventional distillation could be readily overcome by continually removing water from the hybrid system via pervaporation. The competition between distillation and pervaporation
has been found to be cause of unexpected concentration distribution in the hybrid column. The mass flux of mixture decreased with time whereas the selectivity of water to ethanol first increased then decreased with time. Analysis of this system illustrated that the increase in heating power
and membrane area shortened time for obtaining certain content of ethanol in the mixture. However, faster decline in mass flux occurred due to an increase in the removal rate of water. With respect to its simplicity, efficiency and broad applicability, this hybrid process is expected to provide
a benchmark for the enhancement of distillation-pervaporation process by hollow fiber membrane packing.
High reliability thermistor probes for early detection of breast cancer using skin contact thermometry with thermal imaging
Authors: Arathy K. , Ansari Seema , Malini K. A.
Published: May 2020

Early detection and wide spread screening of breast cancer can reduce the mortality rate considerably. Affordable and easy to use screening device is essential for mass screening. In this paper, we demonstrate a simple, precise and easy tool for screening and early detection of breast
cancer based on the higher temperature of abnormal tissues. We have made excellent reliability chip thermal sensor probes and developed 3D and 2D thermal imaging system that can predict the hot spot precisely by simple surface temperature measurements. The chip thermal sensor probes show less
than 0.5% drift in resistance upon thermal and electrical aging. Various phantom experiments were conducted to demonstrate the use of chip thermistor probes for predicting the position of the heater location accurately. We have also found that the subtle changes in surface temperatures were
accurately picked up by the thermistors. It is observed that simulated and experimental results were having best fit within root mean square error of 0.055.
Effects of surface microstructure and molding parameters on injection bonding strength of polyphenylenesulphide-aluminum alloy
Authors: Xu Zhenyu , Li Ning
Published: May 2020

The direct injection molding process of PPS-aluminum alloy composite parts under vacuum condition was conducted and the processing parameters were optimized through the numerical simulation and orthogonal test design. The effect of surface microstructure of the aluminum alloy splines
and injection molding processing parameters on the bonding strength of the composite parts were discussed. The results show that the bonding strength of the composite parts increases with not only the increase in the diameter and quantity of the microscopic pores and also the surface roughness
of the aluminum alloy splines. The bonding strength can also been improved under a higher vacuum. The bonding strength is highly correlated to the micromechanical interlocking structure formed by the PPS embedding into the rough surface of the aluminum alloy splines.
Study of the Influence of Temperature on the Optical and Structural Properties of Dolomite
Authors: Loureço Lucas Train , Duarte Celso de Araujo , Foryta Dietmar William , Titon Bruno Guimarães , Vasconcellos Eleonora Maria Gouvêa
Published: May 2020

The present work reports the results of structural and optical investigations in samples of natural dolomite, subjected to thermal treatment at different temperatures (500 ℃ to 700 ℃) and times (one up to three hours). The motivation is the evaluation of the changes that may occur in carbonaceous asteroids and meteorites, respectively, subjected to the action of the solar radiation and heated during the fall in the atmosphere. We carried out scanning electron microscopy, electron dispersive spectroscopy, X-ray diffraction, optical reflectance and photoluminescence measurements
Revolutions and the liberal peace: Peacebuilding as counterrevolutionary practice?
Authors: Pogodda Sandra
Published: May 2020

This article explores the relationship between contemporary revolutionary agency, domestic reforms and liberal peacebuilding in the aftermath of the Arab Uprisings. In particular, it focuses on the tensions between the liberal peace’s orthodox and emancipatory strands by asking: Does liberal peacebuilding support or hinder revolutionary emancipation in the Arab region? The article aims to close a gap in PCS scholarship by delivering insights into contemporary revolutionary processes (here called ‘everyday state formation’). After elaborating the disjunctures between revolutionary agency and liberal peacebuilding interventions in the spheres of statebuilding, development and democratisation, many peacebuilding interventions appear as counterrevolutionary practices.
Estimating the Relationship Between Special Education De-Identification for Emotional Disturbance and Academic and School Discipline Outcomes: Evidence From Wisconsin’s Longitudinal Data
Authors: Curran F. Chris , Bal Aydin , Goff Peter , Mitchell Nicholas
Published: May 2020

Students placed in special education programs for emotional and behavioral disorders with emotional disturbance (ED) identification have academic outcomes that lag both students in regular and special education. This issue is especially important for youth attending urban schools. Although prior research has examined students identified as ED, little research has examined how students who experience de-identification fare with regard to academic or behavioral outcomes. To our knowledge, this is the first study to examine the relationship between ED de-identification and student outcomes in the United States. The study uses longitudinal, administrative data to estimate the relationship between special education de-identification from ED and both academic and school discipline outcomes. Results of regression models with a variety of fixed effects, including student fixed effects, suggest that students who are de-identified have higher academic achievement after de-identification and a lower probability of experiencing an in-school suspension (ISS). Results for out-of-school suspension (OSS) are mixed. The results suggest that appropriately timed exit from special education services for students with ED who have been determined by individualized education program (IEP) teams to be suitable for de-identification is unlikely to harm students academically but that extra attention to OSS may be needed. The results point to the need for more attention to de-identification.
Fundamentals of Automation Engineering: A hybrid project-based learning approach
Authors: Kataria Devika , Sanchez Gustavo , Govindasamy Siddhartan
Published: May 2020

This paper describes authors’ experience with designing and teaching a new course on “Fundamentals of Automation Engineering”, based on a hybrid Project-Based Learning approach. The proposed challenge for students was to develop a low-cost Material Handling Machine, equipped with basic control functions. The project was executed in three stages, with different activities/tasks performed during each stage, which finally led to successful completion of the challenge. Detailed course file containing syllabus, learning objectives, assessment rubric, project goals, and deliverables was provided to students at first stage. Handouts and assignments were also provided weekly to students, which required extensive use of library resources (self-learning). Feedback survey was conducted fortnightly and suggestions were considered for course improvement. In this paper, authors discuss course organization, learning and assessment activities, and perception of students.
Prevalence of mental disorders among people who are homeless: An umbrella review
Authors: Hossain Md Mahbub , Sultana Abida , Tasnim Samia , Fan Qiping , Ma Ping , McKyer E Lisako J , Purohit Neetu
Published: May 2020

Background:

Homelessness is a major problem that critically impacts the mental health and well-being of the affected individuals. This umbrella review aimed to evaluate the current evidence on the prevalence of mental disorders among homeless people from evidence-based systematic reviews and meta-analyses.

Methods:

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Joanna Briggs Institute (JBI) methodology for umbrella reviews. We searched 12 major databases and additional sources to identify systematically conducted reviews and meta-analyses reporting the prevalence of mental disorders among homeless populations.

Results:

We evaluated 1,277 citations and found 15 reviews meeting our criteria. Most studies were conducted among high-income countries with samples from different age groups. Studies reported high prevalence rates of depressive and anxiety disorders, schizophrenia spectrum and psychotic disorders, substance use disorders, suicidal behavior, bipolar and mood disorders, neurocognitive disorders and other mental disorders among homeless people. Moreover, studies also reported a high burden of co-occurring mental and physical health problems among the homeless experiencing mental disorders.

Conclusion:

This umbrella review synthesized the current evidence on the epidemiological burden of mental disorders in homelessness. This evidence necessitates advanced research to explore psychosocial and epidemiological correlates and adopt multipronged interventions to prevent, identify and treat mental disorders among homeless populations.
Systematic CHAAOS: Teaching Vocabulary in English/Language Arts Special Education Classes in Middle School
Authors: O’Connor Rollanda E. , Sanchez Victoria M. , Jones Brian T. , Suchlit Luisana , Youkhanna Valencia , Beach Kristen D. , Widaman Keith
Published: May 2020

In this multi-year study, we taught English/Language Arts teachers of students with learning disabilities in middle school to incorporate 15 min of daily vocabulary activities with students in their intact special education English/Language Arts classes. During Year 1, teachers taught 48 words to their sixth grade students, who learned and retained the words significantly better than the students in business-as-usual (BAU) control classes. In the current study, we report the second year results, as the sixth grade students entered seventh grade. Students ( n = 42) in treatment classes again learned 48 new vocabulary words significantly better than similar students in BAU ( n = 21) special education classes. In seventh grade, students also outperformed BAU students on maintenance of these age-appropriate words ( p < .001) and on a standardized measure of vocabulary ( p = .04).
When New Life Meets Death: Three Hermeneutic Case Studies From Switzerland
Authors: Fleming Valerie , Robb Yvonne , Matteo Caroline , Meier-Magistretti Claudia
Published: May 2020

Pregnant women in Switzerland expect safe and healthy birth outcomes for themselves and their babies. However, in 2018, 691 died in infancy with gaps identified in the provision of services to parents in such circumstances. Our study aims to illustrate these gaps and how, from participants’ perspectives, they were addressed. A hermeneutic method was employed to analyze three cases: one from each major language region was via primary health-care providers. A thematic analysis was carried out with individual participants followed by a cross-case comparison which showed a hermeneutic of rupture, the juxtaposition of time and reshaping the family. This article shows the unique journeys experienced by parents whose baby dies before or shortly after birth in one country where neither the language nor experience is shared. The derivation of three hermeneutic themes may resonate with other parents or health professionals.
Not Taking a Joke: The Influence of Target Status, Sex, and Age on Reactions to Workplace Humor
Authors: Sacco Donald F. , Brown Mitch , May Haley D.
Published: May 2020

The current study tasked undergraduates with serving as hypothetical human resource workers to evaluate complaints of offensive and inoffensive humor used by male and female employees in a fictitious company who varied in employment status and age. Offensive humor was deemed more problematic in its usage, particularly among female perceivers. Contrary to hypotheses, its usage was more problematic for male and older employees than for female and younger employees. In addition, participants were more averse to both offensive and inoffensive humor from high-status and older men relative to women with similar characteristics. We frame results with consideration of recent social trends.
The Right Fit? Classroom Mismatch in Middle School and Its Inconsistent Effect on Student Learning
Authors: Fitzpatrick Brian R. , Mustillo Sarah
Published: May 2020

Research on college admissions shows that all students tend to benefit from overmatching, but high-status students are most likely to be overmatched, and low-status students are most likely to be undermatched. This study examines whether mismatching takes place when students are sorted into classrooms in middle school. Given prior research on effectively maintained inequality, we theorize that classroom sorting acts as an opportunity for privileged parents to obtain a qualitative advantage for their children. Our research uses administrative data from Indiana and hierarchical linear models to analyze classroom mismatch in sixth through eighth grades. We find that privileged students are more likely to be overmatched in both math and English language arts (ELA) classrooms but that overmatching is beneficial in math but detrimental in ELA. This suggests that inequality can be effectively maintained only if parents have an accurate understanding of what constitutes an advantage.
Beyond tabulated utopias: Action and contradiction in urban environments
Authors: Castán Broto Vanesa
Published: May 2020

In this commentary I reflect upon the possibilities for action to deliver sustainable and just urban environments. I depart from the questions that inspire this special issue: what is it about cities that enables them to make a substantial contribution to environmental dilemmas? And how did cities become the darling trope of the international environmental policy regime? I use the metaphor of ‘the Crystal Palace’ to situate proposals for sustainable urbanism in a spectrum of options between naïve idealism and full-fledged cynicism. I argue that between those two extremes there are multiple alternatives to advance sustainable futures. Urban political ecology (UPE) is in a privileged position to reveal the contradictions inherent in the current incarnation of sustainable urbanism. That is why UPE scholars cannot miss the opportunity to produce context-relevant research to change urban sustainability policies and beliefs. In the second part of this commentary, I explore a case study already presented elsewhere in the special issue. The case of the successive unsuccessful projects for Olympic candidacy in Jaca (Spain) shows the impact of a series of speculative design exercises to build a technocratic eco-city. However, Jaca’s Olympic dreams have historical and cultural roots in the town. Its inhabitants have both propelled and contested the Olympic project at different moments over the evolution of the project. Progressive forms of environmentalism also emerge from the encounter between urban history and utopian thinking.
Letting a Picture Speak a Thousand Words: Arts-based Research in a Study of the Careers of Female Academics
Authors: Sharafizad Fleur , Brown Kerry , Jogulu Uma , Omari Maryam
Published: May 2020

This article presents an adaptation of an arts-based research method usually reserved for child-focused research to examine organizational processes. We developed Draw, Write, Reflect (DWR), advancing a known method, Draw and Write, for investigating phenomena relating to child participants, to explore a new context: adults engaging in academic careers. This article reports on the rationale behind the novel use of this research method, outlines a DWR procedure for future research, and contains reflections of both the researchers and the respondents regarding their experiences participating in DWR. Offering participants a combination of visual and oral methods allowed the researchers to obtain data in a more individualized approach steered by participants’ preferences. The multidimensional insights obtained through DWR would not have been attainable through each method on its own. Furthermore, we argue arts-based research can serve as a vehicle for disseminating academic work beyond conventional academe to a growing, nonacademic audience.
Cardiovascular and stroke disease risk among doctors: a cross-sectional study
Authors: Pillay Roshni , Rathish Balram , Philips Geetha M , Kumar R Anil , Francis Abin
Published: May 2020

The leading causes of death in the world are cardiovascular disease (CVD) and stroke according to the World Health Organization, as is also the case in India. There is also a high prevalence of major conventional risk factors in India, where 18.3%, 9.0% and 14.1% of adults are diagnosed with hypertension, diabetes and smoking, respectively. The aim of the present study was to look at the risk of CVD among doctors in our country using a validated tool developed by the National Health Service (NHS) in the UK, the QRISK3 calculator.
Rethinking the Formalism-Substantivism Debate in Social Science: A Perspective from Recent Developments in Economic Methodology
Authors: Gao Yuan
Published: May 2020

Taking as its point of departure the 1960s formalism-substantivism debate in social science methodology, this article argues that what is distinctive about the new development of formalism in economics since then is mainly the prevalence of using “complete models”—tractable, manipulable, and fully specified mathematical objects—to construct and express theories. The objective of complete models is not to establish general laws, but to formulate auxiliary devices of cognition to facilitate the explanation of targeted aspects of the empirical world; not to create idealistic or ideological discourses, but to derive implications with empirically delimited utility—this in order to make inferences that cannot be achieved via purely qualitative methods. This methodological trend is to some extent a substantivization of formalist economics. Exploring its nature can help clarify the unique cognitive value of contemporary formalism and answer the question of why substantivism is still an irreplaceable approach to social scientific studies, even in an age dominated by formalism.
Challenges and possibilities of developing cardiac surgery in a peripheral hospital of low- and middle-income countries
Authors: Tiwari Kaushal K , Grapsa Julia , Laudari Shankar , Pazdernik Michal , Vervoort Dominique
Published: May 2020

Objective:

Over a million cardiac surgeries are performed every year around the globe. However, approximately 93% of world population living in low- and middle-income countries have no access to cardiac surgery. The incidence of rheumatic and congenital heart disease is high in Nepal, while only 2,500-3,000 cardiac surgeries are performed annually. The aim of our study is to analyze challenges and opportunities of establishing a cardiac surgery program in a peripheral hospital of Nepal.

Methods:

We analyzed our effort to establish a cardiac surgery program in a peripheral hospital in Nepal.

Results:

Out of 2,659 consulted and diagnosed patients, we performed 85 open-heart surgeries in 4 years. Mean age of patients was 38.35 ± 14.13 years. The majority of patients were male (62.4% of patients) with 65.9% suffering from rheumatic heart disease. Average intensive care unit stay and hospital stay were 2.32 ± 1.1 and 8.29 ± 2.75 days, respectively. No in-hospital mortality was observed.

Conclusion:

We conclude that developing cardiac surgical care in a peripheral hospital of a developing country is feasible with support from government, foreign colleagues, local teams, and non-governmental organizations. The availability of a regular cardiac surgery service in the periphery of the country makes such services more accessible for the patients and helps in reducing the long waiting lists and unmanageable workload in the established cardiac centers in the capital city.
From Orange to Red: Why the Security Services of Ukraine Changed the Approach to Handling Protests from 2004 to 2014
Authors: Kaul Eli Charles
Published: May 2020

This article looks at the structural and institutional changes that occur within the Security Services of Ukraine (SBU) between the Orange Revolution and Euromaidan. Why did a security service that was hailed as a protector of democracy when it stood against the national police, under the command of the Interior Ministry (MVS) who were attempting to quash the Orange Revolution protests in 2004 become a leading suspect in the anti-democratic shootings that occurred in the Euromaidan protests in 2014? One potential explanation is the pervasive patronage political shifts that result in personnel changes atop the hierarchy of the SBU. Another is that the bifurcated political structure (presidential powers vs. those of the legislature) of Ukraine shifted creating a realignment of political loyalties. A third potential explanation is institutional change that altered the entire Ukrainian political system between 2004 and 2014. This article uses archival data, content analysis of media publications, and semistructured interviews with experts in the field of Ukrainian security to examine the changes occurring within the SBU that lead to a violent reaction towards protesters in 2014.
Experimental investigations into extrusion-based 3D printing of PCL/CIP composites for microwave shielding applications
Authors: Rath Usharani , Pandey Pulak Mohan
Published: May 2020

In the present work, a solvent-based extrusion 3D printing technique has been utilized to fabricate polymer composites comprising of polycaprolactone (PCL) polymer and carbonyl iron particles. A homogenous composite ink containing PCL and carbonyl iron filler particles with suitable solvent was synthesized with required viscosity for the 3D printing operation. Rectangular samples were successfully fabricated using the extrusion 3D printing technology. A response surface methodology was utilized for planning the set of fabrication experiments so as to estimate the effect of process parameters, namely infill density, printing speed and filler concentration on the printed composite density, percentage of shrinkage and compressive strength. Shrinkage was found to reduce with an increase in infill density and filler concentration. However, density was found to shoot up with an increase in infill density and filler concentration. Similarly, compressive yield strength was improved with an increase in infill density and filler concentration. Increase in shrinkage and density values and decrease in compressive yield strength value were noticed with an increase in the printing speed. Furthermore, a genetic algorithm multiobjective optimization tool was utilized to obtain optimum process parameters to minimize shrinkage, minimize density and maximize compressive yield strength for the electronics and microwave applications of the fabricated composite. A microwave shielding performance test of the developed composite was also carried out as a case study. The shielding performance test indicated the efficacy of the polymer composite fabricated using solvent-based extrusion 3D printing technique.
Holistic Nursing in Practice: Mindfulness-Based Yoga as an Intervention to Manage Stress and Burnout
Authors: Hilcove Kelly , Marceau Catherine , Thekdi Prachi , Larkey Linda , Brewer Melanie A. , Jones Kerry
Published: May 2020

Purpose

Effects of a mindfulness-based (MB) yoga practice on stress, burnout, and indicators of well-being among nurses and health care professionals (HCPs).

Design

A randomized controlled trial, 80 HCPs assigned to either MB yoga intervention or control group.

Method

The MB yoga intervention group ( n = 41) attended weekly yoga classes and practiced yoga independently. The control group ( n = 39) did not receive the yoga intervention. Study participants completed pre- and postintervention questionnaires, instruments included (a) Perceived Stress Scale; (b) Maslach Burnout Inventory; (c) Vitality subscale of the Medical Outcomes Study Short Form–36; (d) Global Sleep Quality item, (e) Mindfulness Awareness Survey, and (f) subscale of the Brief Serenity Scale. Diurnal salivary cortisol and blood pressure were assessed pre and postintervention.

Results

Significant improvements ( p < .01) noted in MB yoga compared with control for self-reported factors, including stress (Perceived Stress Scale), burnout (Maslach Burnout Inventory), vitality (Medical Outcomes Study Short Form–36), sleep (GSQ), serenity/inner haven (IH), and mindfulness (Mindfulness Awareness Survey). Diurnal cortisol slopes and blood pressure were not significantly improved.

Conclusion

The MB yoga intervention had a statistically significant effect on the health and well-being of nurses and HCPs, most specifically for measures of stress; perceived stress, burnout, vitality, sleep quality, serenity, and mindfulness.
Current frequency effect on electromagnetic tube expansion
Authors: Dond SK , Choudhary Hitesh , Dikshit Biswaranjan , Kolge Tanmay , Sharma Archana
Published: May 2020

The frequency of capacitor discharge current is an important parameter in the electromagnetic forming process. In the present work, simulation and experimental study of electromagnetic expansion is carried out on aluminium tubes (Al 5052). The aim is to obtain the optimum frequency of discharge current that gives maximum tube expansion at constant discharge energy. A two-dimensional axisymmetric numerical simulation model is developed that couples electromagnetic and structural phenomenon sequentially. After validating experimental tube expansion results with numerical results, the simulation model is used to analyse the effect of variation in current frequency on the tube expansion. It is observed that maximum tube expansion and higher process efficiency occurred at 5 kHz, which is considered as the optimum frequency for the used experimental set-up. In contrast to sheet forming case observed in the literature, results of tube expansion show that maximum forming is obtained at a frequency where the ratio of skin depth to tube thickness is less than 1. It is also noticed that the optimum frequency depends on the inductance and resistance of the system.
Study on the residual stress distribution of railway rails
Authors: Li Yang , Chen JinJie , Wang JianXi , Zhao Hu , Chen Long
Published: May 2020

Rolling contact fatigue damage of rails is significantly influenced by residual stresses. A three-dimensional elastic-plastic finite element model of wheel–rail contact was established in the present study, and the influence of initial stresses resulting from rail manufacturing process on the residual stress distribution of rails was analyzed. The repeated rolling passes were simulated and the stable residual stress distribution of rails was obtained. The influence of factors, such as wheel load, friction coefficient, and longitudinal creep rate, on the residual stress distribution of rails was investigated. It is found that within the limited special scale affected by the wheel–rail contact, the difference between the longitudinal residual stress with initial stresses applied and that without initial stresses applied becomes quite small once enough rolling passes have occurred (i.e., 10 rolling passes). When the initial stresses are applied, the longitudinal residual compressive stress on wheel–rail contact center of the rail is approximately 500 MPa. The residual compressive stress decreases with the increasing depth and changes from compression to tension at the depth of 6 mm beneath wheel–rail contact center of the rail. The wheel load mainly affects the residual stress distribution along the depth direction beneath rail surface. The friction coefficient mainly affects the residual stress distribution on the rail surface. The longitudinal creep rate has a great influence on the longitudinal residual stresses at the surface and along the depth of the rail.
Hysteresis modeling of piezoelectric actuator using particle swarm optimization-based neural network
Authors: Zhang Quan , Shen Xin , Zhao Jianguo , Xiao Qing , Huang Jun , Wang Yuan
Published: May 2020

Piezoelectric actuators have been received much attention for the advantages of high precision, no wear and rapid response, etc. However, the intrinsic hysteresis behavior of the piezoelectric materials seriously degraded the output performance of piezoelectric actuators. In this paper, to decrease such nonlinear effects and further improve the output performances of piezoelectric actuators, a modified nonlinear autoregressive moving average with exogenous inputs model, which could describe the rate-dependent hysteresis features of piezoelectric actuators was investigated. In the experiment, the different topologies of the proposed back propagation neural network algorithm were compared and the optimal topology was selected considering both the tracking precision and the structure complexity. The experimental results validated that the modified nonlinear autoregressive moving average with exogenous inputs model featured the hysteresis characteristics description ability with high precision, and the predicted motion matched well with the real trajectory. Then, the initial parameters of the back propagation neural network algorithm were further optimized by particle swarm optimization algorithm. The experimental results also verified that the proposed model based on particle swarm optimization–back propagation neural network algorithm was more accurate than that identified through the conventional back propagation neural network algorithm, and has a better predicting performance.
Exploring wall shear stress spatiotemporal heterogeneity in coronary arteries combining correlation-based analysis and complex networks with computational hemodynamics
Authors: Calò Karol , De Nisco Giuseppe , Gallo Diego , Chiastra Claudio , Hoogendoorn Ayla , Steinman David A , Scarsoglio Stefania , Wentzel Jolanda J , Morbiducci Umberto
Published: May 2020

Atherosclerosis at the early stage in coronary arteries has been associated with low cycle-average wall shear stress magnitude. However, parallel to the identification of an established active role for low wall shear stress in the onset/progression of the atherosclerotic disease, a weak association between lesions localization and low/oscillatory wall shear stress has been observed. In the attempt to fully identify the wall shear stress phenotype triggering early atherosclerosis in coronary arteries, this exploratory study aims at enriching the characterization of wall shear stress emerging features combining correlation-based analysis and complex networks theory with computational hemodynamics. The final goal is the characterization of the spatiotemporal and topological heterogeneity of wall shear stress waveforms along the cardiac cycle. In detail, here time-histories of wall shear stress magnitude and wall shear stress projection along the main flow direction and orthogonal to it (a measure of wall shear stress multidirectionality) are analyzed in a representative dataset of 10 left anterior descending pig coronary artery computational hemodynamics models. Among the main findings, we report that the proposed analysis quantitatively demonstrates that the model-specific inlet flow-rate shapes wall shear stress time-histories. Moreover, it emerges that a combined effect of low wall shear stress magnitude and of the shape of the wall shear stress–based descriptors time-histories could trigger atherosclerosis at its earliest stage. The findings of this work suggest for new experiments to provide a clearer determination of the wall shear stress phenotype which is at the basis of the so-called arterial hemodynamic risk hypothesis in coronary arteries.
Foreign Direct Investment and Total Factor Productivity: Any Nexus?
Authors: Abdullah Mohammed , Chowdhury Murshed
Published: May 2020

This study examines the impact of foreign direct investment (FDI) on the total factor productivity (TFP) of host countries. Extensions of the new growth theory provide a framework in which FDI increases the growth rate of a host country through technology transfer, diffusion and spillover effects. We construct four new series of TFP using the framework of neoclassical growth models. We also address the issue of endogeneity using the generalized method of moments. Our estimations using a balanced panel of 77 low- and middle-income countries suggest that FDI could not promote TFP in the countries studied. Our sensitivity analysis, in terms of alternative estimation methods, data, models and time period, reinforces the findings. We observe that the lack of absorptive capacity is likely to be an important reason for not having a direct relationship between FDI and TFP.

JEL Classification: F21, F23, O33, F43, C33
Does Greater Creditor Protection Affect Firm Borrowings? Evidence from IBC
Authors: Jose Jibin , Herwadkar Snehal S. , Bilantu Prabal , Razak Shihas Abdul
Published: May 2020

The Insolvency and Bankruptcy Code (IBC) in India ushered in a new era of creditor-in-control regime with an in-built mechanism for time-bound resolution. This article examines the impact of the Code on firm borrowings and cost of funds. Using firm-level data on 4,531 firms for the period 2012–2018, we find that implementation of IBC has had many desirable consequences from a policy perspective. It helped in deleveraging of firms as their reliance on borrowings—whether long-term or short-term—declined. Further analysis suggests that this is especially true for weak and large firms. The stronger creditor protection is, thus, a step in the direction of reducing the burden on banks and further market deepening.

JEL Classification: G32, G33, G38, D22, O16
A freelancers’ cooperative as a case of democratic institutional experimentation for better work: a case study of SMart-Belgium
Authors: Charles Julien , Ferreras Isabelle , Lamine Auriane
Published: May 2020

This article discusses the experimentation led by SMart in Belgium, a worker cooperative founded to support freelance artists – and subsequently extended to other freelancers – with the aim of helping them reduce four forms of uncertainties that affect such workers. Over the past 20 years, SMart has sought to secure broader access to social protections for these workers, shifting its strategies to accommodate the changes in rules set by the Belgian federal state. Today, experimentation abounds for various types of intermediation with new forms of employment, but SMart is notable for its ambition to build a cooperative firm providing the protections of wage work to beneficiaries otherwise ignored by social policies. Based on qualitative research conducted from a Deweyan perspective, and 48 in-depth interviews with SMart worker-members, the authors examine the ways in which SMart can be considered an example of democratic institutional experimentation providing collective capabilities to its worker-members in pursuit of better work.
Anti–Factor Xa Activity of Fixed-Dose Fondaparinux in Low-Body-Weight Patients With Acute Coronary Syndrome
Authors: Wongcharoen Wanwarang , Tantisirivit Nualnit , Norasetthada Lalita , Gunaparn Siriluck , Phrommintikul Arintaya
Published: May 2020

Background:

Fixed-dose 2.5 mg of fondaparinux subcutaneous injection once daily has been recommended in treatment of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) irrespective of body weight (BW). However, data on anti–factor Xa (anti-FXa) activity of fondaparinux are scarce in low-BW patients.

Objective:

We aimed to assess anti-FXa activity of fondaparinux in low-BW patients (BW < 50 kg) compared with normal-BW patients (BW ≥ 50 kg) who presented with NSTE-ACS.

Methods:

This is a prospective cohort study of patients with NSTE-ACS receiving fondaparinux. Anti-FXa activity was measured 4 hours after 2.5 mg subcutaneous injection of fondaparinux after the first 2 doses.

Results:

Among 87 enrolled patients, 18 (21%) had BW <50 kg. Patients in the low-BW group were older and had lower creatinine clearance. Median duration of fondaparinux therapy was 3 (IQR 2-4) days. Anti-FXa activity after the first dose of fondaparinux was similar between the low-BW and normal-BW groups (0.40 ± 0.15 vs 0.40 ± 0.17 mg/L, P = 0.914). However, anti-FXa activity after the second dose of fondaparinux was significantly higher in the low-BW group as compared with the normal-BW group (0.53 ± 0.10 vs 0.44 ± 0.16 mg/L, P = 0.011). Multivariate analysis showed that BW was the only independent factor that inversely correlated with anti-FXa activity. There was only 1 bleeding event during hospitalization in the normal-BW group and none in the low-BW group.

Conclusion and Relevance:

Anti-FXa activity of the second dose of fondaparinux was higher in low-BW patients but still within the expected range.