bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebral angiography using transauricular access in a rabbit model: a new technique
Authors: Kim Hak Jin , Choi Seon Hee , Kim So-Hyeon , Kim Yong-Woo , Jhun Byung Hak , Lee Deug-Woo , Yoo Jin-Wook
Published: April 2020

Background

Cerebral angiography in a rabbit model is widely used in the field of interventional radiology. Conventionally, the femoral artery is used for cerebral angiography in radiology departments. However, angiographic studies require surgical cutdown of the femoral artery, which is technically difficult.

Purpose

To evaluate a new cerebral angiography technique involving a transauricular approach in a rabbit model.

Material and Methods

In each of 10 rabbits, central auricular arteries were punctured in the right or left ear with a 20-gauge i.v. catheter. A microcatheter (2.0 F) with a 0.016-inch guide wire was introduced through the i.v. catheter and advanced to the aortic arch. The microcatheter and guide wire were advanced selectively into cerebral arteries and angiography was performed.

Results

Central auricular arteries were successfully punctured with 20-gauge i.v. catheters. After approaching the aortic arch, microcatheter tips and guide wires were advanced manually to cerebral arteries on both sides. Difficulties in selecting the carotid arteries were resolved by using a looping technique within the cardiac chamber. Microcatheter loops within the cardiac chamber disappeared or remained during artery superselection.

Conclusion

Transauricular cerebral angiography appears to be a feasible technique for brain or carotid intervention studies in rabbits. In addition, vertebral angiography using a transauricular approach is possible using the looping technique. Selection of carotid or vertebral arteries on each side was not difficult when the microcatheter and guide wire were looped within the cardiac chamber. The ear chosen for the initial puncture does not appear to be important.
Multiple bilateral pulmonary epithelioid hemangioendothelioma mimicking metastatic lung cancer: case report and literature review
Authors: Xiong Wenji , Wang Yanbo , Ma Xiaobo , Ding Xiaobo
Published: April 2020

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor of low to intermediate malignancy, which originates from vascular endothelial cells. Most patients with PEH are asymptomatic and the tumor occurs most frequently in women. Typical radiologic images of patients with PEH are multiple irregular nodules with punctate calcification and pleural indentation. Here, we describe a 54-year-old woman who presented with multiple bilateral nodules of different sizes and well-defined borders, as well as lung markings, without punctate calcification or pleural indentation. These atypical computed tomography images resulted in misdiagnosis as metastatic lung cancer. Right upper lobe wedge resection was performed; intraoperative frozen pathologic examination suggested that the tumor was benign. However, immunohistochemical analysis revealed the presence of PEH. Subsequently, the patient chose watchful waiting, rather than chemotherapy. This rare case of PEH with atypical computed tomography findings, which was misdiagnosed as metastatic lung cancer, demonstrates that intraoperative frozen analysis is unreliable; thus, histopathological analysis is necessary.
Prevalence and socio-demographic characteristics of persons who have never had a headache among healthy voluntary blood donors – a population-based study
Authors: Olofsson Isa Amalie , Kogelman Lisette , Rasmussen Andreas , Erikstrup Christian , Sørensen Erik , Paarup Helene M , Hjalmgrim Henrik , Banasik Karina , Nielsen Kaspar René , Burgdorf Kristoffer Soelvsten , Pedersen Ole Birger Vesterager , Ullum Henrik , Olesen Jes , Hansen Thomas Folkmann
Published: April 2020

Introduction

Headache is an extremely prevalent disorder with a lifetime prevalence of 90–99%. However, a small fraction of people never experiences a headache. Research on people without headache could uncover protective factors in headache, but to our knowledge no study on headache-free individuals has been published. We aim to estimate the prevalence of headache-free individuals among Danish blood donors, and to describe the socio-demographics and health factors of headache-free participants.

Materials and methods

In all, 38,557 healthy volunteers were recruited as part of the Danish Blood Donor Study. Headache-free participants were identified based on the question “Have you ever experienced a headache of any kind?”. Utilising the Danish registries and self-reported questionnaires, we analysed socio-demographic and lifestyle factors using logistic regression adjusted for age and sex.

Results

The prevalence of headache-free individuals was 4.1% (n = 1362) with a female-male ratio of 1:2.2. To be headache free was significantly associated with an employment status as a student, a low level of income and a regular alcohol consumption.

Discussion

The prevalence of headache-free individuals was comparable to population-wide studies of headache. To be headache free was not associated with a high socio-economic status. Further studies on people without headache will hopefully reveal protective factors in headache, and this novel approach might be useful in other very prevalent disorders.
Impeller (straight blade) design variations and their influence on the performance of a centrifugal blood pump
Authors: Fang Peng , Du Jianjun , Yu Shunzhou
Published: April 2020

Introduction:

The miniaturization of blood pumps has become a trend due to the advantage of easier transplantation, especially for pediatric patients. In small-scale pumps, it is much easier and more cost-efficient to manufacture the impeller with straight blades compared to spiral-profile blades.

Methods:

Straight-blade impeller designs with different blade angles, blade numbers, and impeller flow passage positions are evaluated using the computational fluid dynamics method. Blade angles (θ = 0°, 20°, 30°, and 40°), blade numbers ( N = 5, 6, 7, and 8), and three positions of impeller flow passage (referred to as top, middle, and bottom) are selected as the studied parametric values.

Results:

The numerical results reveal that with increasing blade angle, the pressure head and the hydraulic efficiency increase, and the average scalar shear stress and the normalized index of hemolysis decrease. The minimum radial force and axial thrust are obtained when θ equals 20°. In addition, the minimum average scalar shear stress and normalized index of hemolysis values are obtained when N = 6, and the maximum values are obtained when N = 5. Regarding the impeller flow passage position, the axial thrust and the stagnation area forming in the impeller eye are reduced as the flow passage height declines.

Conclusion:

The consideration of a blade angle can greatly improve the performance of blood pumps, although the influence of the blade number is not very easily determined. The bottom position of the impeller flow passage is the best design.
Pediatric-Onset Postural Orthostatic Tachycardia Syndrome in a Single Tertiary Care Center
Authors: Staples Anthony , Thompson Nicolas R. , Moodley Manikum
Published: April 2020

Aim:

We characterize the pediatric postural orthostatic tachycardia syndrome (POTS) population seen at a single tertiary care referral center.

Method:

Retrospective chart review of all pediatric POTS patients seen in our center between 2015 and 2017. Pediatric POTS was defined as chronic, at least 3 months, symptoms of orthostatic intolerance associated with excessive orthostatic tachycardia as determined by tilt table testing with orthostatic heart rate increment of ≥40 bpm within 5 minutes of head-up tilt or absolute orthostatic heart rate ≥130 bpm for patients 13 years old and younger and ≥120 bpm for those 14 years and older. We looked at demographics, presenting symptoms, comorbidities, examination findings, investigation findings, treatment, and patient reported outcomes. Outcome measures were separated by patient report and group comparisons were made using 2-sample t tests or Mann-Whitney U tests for continuous variables and Fisher exact tests for categorical variables.

Results:

One hundred thirty-four patients with pediatric onset POTS were identified. The mean age was 15 years. Seventy-nine percent of patients were female and 90% were white. The most common presenting symptoms included dizziness/lightheadedness (88%), syncope (54%), and palpitations (40%). Many patients had significant comorbidities attributable to numerous bodily systems, most commonly headache syndromes (migraine 43%, nonspecific headache 22%, chronic daily headache 14%, and new daily persistent headache 5%) and chronic fatigue (60%). Low vitamin D and insufficient iron stores were commonly seen. The majority of patients improved or had resolution of symptoms following treatment (70%). When separated by outcome, statistically significant differences were found for glucose (patients whose symptoms resolved had higher median glucose), palpitations (patients whose symptoms resolved were less likely to have palpitations), constipation (patients whose symptoms were stable/worsened were more likely to have constipation), and unexplained pain (patients whose symptoms were stable/worsened were more likely to have unexplained pain).

Conclusions:

Pediatric POTS is a chronic condition with a fairly good prognosis following appropriate treatment. It is associated with numerous comorbidities that necessitate multidisciplinary expert care.
Examining the Influence of Financial Assistance and Employment Services on the Criminal Justice Outcomes of Women on Probation
Authors: Wilfong Jordan , Golder Seana , Logan TK , Higgins George
Published: April 2020

Although low income is common across the U.S. probation population, women offenders experience it more than men. However, despite the connection between income and probation outcomes, limited research has been conducted on programs that could improve the financial circumstances of female probationers. This study examined the influence on probation outcomes of receiving government financial assistance programs and employment services. The findings indicated that participants who received Social Security Disability Insurance more often were less likely to become incarcerated. Implications include expanding cash assistance programs to provide more substantial monthly incomes for women probationers, particularly those with disabilities, in order to increase financial stability and improve criminal justice outcomes.
Running for Success: Marathon Boom and Middle-Class Bodies in Estonia
Authors: Gross Toomas
Published: April 2020

Since the turn of the millennium, the number of Estonians running at least one marathon a year has grown nearly twentyfold. This paper links the marathon boom in Estonia to novel ideas about the “good life” among a subset of the country’s middle class, also situating the phenomenon in the broader context of post-1991 socio-economic changes. Drawing on fifty narrative interviews with recreational runners and a content analysis of various runners’ blogs, the article pays special attention to “runners’ bodies.” Recreational marathoners consciously put their bodies at the service of their “selves” by submitting the body to regular physical strain, which fits with their distinctively middle-class ideals of self-discipline, motivation, diligence, and perseverance. But runners’ bodies are also “bodies for others”—they not only encapsulate but also display these ideals. Approaching runners’ bodies as “bodies for selves” and as “bodies for others,” the article makes two arguments. Firstly, a fit body as physical capital and the “purposeful suffering” that long-distance running almost inevitably leads to have recently shifted to the core of living a “good life” in the case of growing numbers of the Estonian middle class. Secondly, the “others” for middle-class runners’ bodies are first and foremost the sedentary and generally overweight bodies of their own class. For a subset of the Estonian middle class, a slim and fit running body, in combination with changed consumption practices and reference groups, serves to distinguish themselves from the generalised idea of a middle-class person in today’s Estonia.
Introduction: The Middle Class in Post-socialist Europe: Ethnographies of Its “Good Life”
Authors: Crăciun Magdalena , Lipan Ștefan
Published: April 2020

In this special section, drawing from ethnographic research undertaken in Estonia, Russia, Romania, and Bulgaria between 2013 and 2017, we argue that in post-socialist Europe the notions of “middle class” and “good life” have become interchangeable. Related dialectically, each can be substituted for the other as a signifier of a field of aspirations and possibilities. In the current period of persistent economic crisis, deepening social inequality, and growing political turmoil, this interchangeability is a significant ideational conjunction, making it possible to declare middle-class aspirations inherently ethical and thus depoliticise them. Equally important, this interchangeability sustains the continuous idealisation of middle-classness in the face of accumulating frustrations, disappointments, and disillusionments among both the aspiring and the more established middle classes. Nevertheless, our interlocutors differ in their understanding of the kind of “good life” that middle-classness supports. Beyond individual horizons of expectations and socio-economic positions, these differences stem from their experience of recent economic and political crises and from their location at the more, and the less, prosperous local and global “margins.” These differences illustrate the fluidity of these signifiers, which unify an otherwise heterogeneous set of meanings, practices, and relationships.
Research and application of variable DOF compliant five-bar mechanism based on novel compliant torsion joint in vehicle side door latch
Authors: Wang Mingyuan , Hang Lubin
Published: April 2020

In this paper, a novel compliant joint with torsion spring (CJTS) is proposed in order to realize the power release (Note: The “power release” feature means that the closure system with a latch assembly including a pawl-ratchet release mechanism is controlled by at least one electric actuator.) feature of the vehicle side door latch. A new type of variable degree of freedom (DOF) compliant five-bar mechanism (VDCM) based on the novel compliant joint is constructed. The novel compliant mechanism is characterized by multiple motion modes of planar five-bar mechanism and four-joint, crank-shaper, crank-oscillating block mechanism. These motion modes can be switched through the different choices of driving joints and limiting stoppers. This compliant mechanism is effectively implanted into a vehicle side door latch as a sub-branch to perform power release function. The force-adaptive characteristic of the VDCM ensures compatibility with extant manual release branches. Drifting displacement of the CJTS’s torsion spring rotation center in the groove is proposed as a compliant index to describe the compatibility and force-adaptive characteristics under various working modes. The relationship between torsion spring stiffness and mechanism characteristic point motion trajectory or position recovery time duration or motion accuracy is studied. The results show that the introduction of compatibility and force-adaptive characteristics is able to reduce the shaking forces exerted on the mechanism frame. The shaking forces will be further reduced by changing equivalent mass center position of the component. Furthermore, the practicability of the novel compliant mechanism is experimentally validated on the force-displacement test platform. The work in this paper provides a reference for the multi-mode motion mechanical design in a confined space of the latch.
An insight into the stress corrosion cracking resistance of friction stir processed and micro arc oxidation coated ZE41 grade magnesium alloy
Authors: Radhika Koganti , Lakshminarayanan AK
Published: April 2020

The stress corrosion cracking behavior of friction stir processed, micro arc oxidation coated and a composite coated (friction stir processed-micro arc oxidation) ZE41 magnesium alloy were studied in modified simulated body fluid (m-SBF) solution at room temperature. Friction stir processing was carried out with a tool rotation speed of 650 rpm and a traverse speed of 50 mm/min. The results showed that fine equi-axed grain structure with an average grain size of ∼2.8 µm, fragmentation, and partial dissolution of T-phase and Zr-rich particles was achieved through friction stir processing. Specially designed two electrode coating method was adopted to produce samples with micro arc oxidation coating in silicate solution. The stress corrosion cracking susceptibility of base metal, friction stir processed, micro arc oxidation, and composite coated friction stir processed-micro arc oxidation samples were evaluated through constant load testing at five different stress levels. The results indicated higher stress corrosion cracking susceptibility for base metal compared to friction stir processed; micro arc oxidation and friction stir processed-micro arc oxidation samples. Grain refinement and microstructure homogenization enhanced stress corrosion cracking resistance of friction stir processed sample whereas the barrier effect of coating during initial stages of corrosion improved stress corrosion cracking resistance of micro arc oxidation sample compared to base metal. Among all the samples, friction stir processed-micro arc oxidation exhibited superior stress corrosion cracking resistance due to the self-repairing mechanism of friction stir processing, which in turn improved the corrosion resistance of micro arc oxidation layer. The fractographic features revealed different stress corrosion cracking mechanisms for base metal, friction stir processed, micro arc oxidation, and friction stir processed-micro arc oxidation samples. T-phase and Zr-rich particles played major role in the initiation of corrosion pits and resulted in stress corrosion cracks.
A novel approach for experimental identification of vehicle dynamic parameters
Authors: Yao Di , Ulbricht Philipp , Tonutti Stefan , Büttner Kay , Günther Prokop
Published: April 2020

Pervasive applications of the vehicle simulation technology are a powerful motivation for the development of modern automobile industry. As basic parameters of road vehicle, vehicle dynamic parameters can significantly influence the ride comfort and dynamics of vehicle, and therefore have to be calculated accurately to obtain reliable vehicle simulation results. Aiming to develop a general solution, which is applicable to diverse test rigs with different mechanisms, a novel model-based parameter identification approach using optimized excitation trajectory is proposed in this paper to identify the vehicle dynamic parameters precisely and efficiently. The proposed approach is first verified against a virtual test rig using a universal mechanism. The simulation verification consists of four sections: (a) kinematic analysis, including the analysis of forward/inverse kinematic and singularity architecture; (b) dynamic modeling, in which three kinds of dynamic modeling method are used to derive the dynamic models for parameter identification; (c) trajectory optimization, which aims to search for the optimal trajectory to minimize the sensitivity of parameter identification to measurement noise; and (d) multibody simulation, by which vehicle dynamic parameters are identified based on the virtual test rig in the simulation environment. In addition to the simulation verification, the proposed parameter identification approach is applied to the real test rig (vehicle inertia measuring machine) in laboratory subsequently. Despite the mechanism difference between the virtual test rig and vehicle inertia measuring machine, this approach has shown an excellent portability. The experimental results indicate that the proposed parameter identification approach can effectively identify the vehicle dynamic parameters without a high requirement of movement accuracy.
Strong Effort Manipulations Reduce Response Caution: A Preregistered Reinvention of the Ego-Depletion Paradigm
Authors: Lin Hause , Saunders Blair , Friese Malte , Evans Nathan J. , Inzlicht Michael
Published: April 2020

People feel tired or depleted after exerting mental effort. But even preregistered studies often fail to find effects of exerting effort on behavioral performance in the laboratory or elucidate the underlying psychology. We tested a new paradigm in four preregistered within-subjects studies ( N = 686). An initial high-demand task reliably elicited very strong effort phenomenology compared with a low-demand task. Afterward, participants completed a Stroop task. We used drift-diffusion modeling to obtain the boundary (response caution) and drift-rate (information-processing speed) parameters. Bayesian analyses indicated that the high-demand manipulation reduced boundary but not drift rate. Increased effort sensations further predicted reduced boundary. However, our demand manipulation did not affect subsequent inhibition, as assessed with traditional Stroop behavioral measures and additional diffusion-model analyses for conflict tasks. Thus, effort exertion reduced response caution rather than inhibitory control, suggesting that after exerting effort, people disengage and become uninterested in exerting further effort.
Transplanted Human Neural Progenitor Cells Attenuate Motor Dysfunction and Lengthen Longevity in a Rat Model of Ataxia
Authors: Tierney Wesley M. , Uhlendorf Toni L. , Lemus Aaron J.J. , Ortega Bianca A. , Magaña Jesse , Ochoa Jessica , Van Trigt William , Cruz Angelica , Kopyov Alex , Kopyov Oleg V. , Cohen Randy W.
Published: April 2020

The spastic Han Wistar (sHW) rat serves as a model for human ataxia presenting symptoms of motor deterioration, weight loss, shortened lifespan, and Purkinje neuron loss. Past studies revealed that human neural progenitor cells (NPCs) improved ataxic symptoms at 20 d posttransplantation in sHW rats. In this study, we investigated the fate and longer-term effectiveness of these transplanted NPCs. Rats were placed into four treatment groups: an untreated normal control group ( n = 10), an untreated mutant rat control ( n = 10), a mutant group that received an injection of dead NPCs ( n = 9), and a mutant group that received live NPCs ( n = 10). Bilateral cerebellar injections containing 500,000 of either live or dead NPCs were performed on mutant sHW rats at 40 d of age. Motor activity for all mutant rats started to decline in open field testing around day 35. However, at day 45, the live NPC-treated mutants exhibited significant improvements in open field activity. Similar improvements were observed during rotarod testing and weight gain through the completion of the experiments (100 d). Immunohistochemistry revealed few surviving human NPCs in the cerebella of 80- and 100-d-old NPC-treated mutants; while cresyl violet staining revealed that live NPC-treated mutants had significantly more surviving Purkinje neurons compared to mutants that were untreated or received dead NPCs. Direct stereotactic implantation of NPCs alleviated the symptoms of ataxia, acting as a neuroprotectant, supporting future clinical applications of these NPCs in the areas of ataxia as well as other neurodegenerative diseases.
Practice of Postpartum Warming Among Mothers in Brunei
Authors: Muhammad Wafiuddin Wa’ie Illyana Rashidah , Koh Soo Quee David , H. Sharbini Shahrimawati , Mohd Noor Salmah H. , Kisut Ramlah , Tuah Nik AA , Abdul Rahman Hanif , Kifli Nurolaini , H. Abdul Hamid Mas Rina Wati , Abdul-Mumin Khadizah H.
Published: April 2020

Introduction: Postpartum warming is widely practiced among women in Asian countries despite unsubstantiated health claims. This study aimed to identify sources of knowledge and explore the practices of postpartum warming among mothers in Brunei. Methods: A cross-sectional study using a self-administered questionnaire was conducted on 124 mothers who had experience in postpartum warming. Results: Coal was commonly used for heat. Main source of knowledge came from family members. Older women had significantly lower intention to perform the practice in future pregnancies. Women who lived in nuclear families practiced it to a significantly higher frequency compared with those living in extended families. Discussion: Women still practice warming to adhere with family expectations and traditions although noticeable changes have been observed as society modernizes. It still poses a risk of carbon monoxide poisoning and fire hazard from burning coal. Future studies should focus on health and safety aspects to provide evidence on the actual health benefits and ameliorate risk factors.
Should Cleft Surgery Always be Performed During the Matutine Time? Analysis of Early and Late Postoperative Complications in a Cleft Center
Authors: Restrepo Daniel Velez , Sato Marilson Hideki , Cardoso Fernanda Saturnino , da Silva Freitas Renato
Published: April 2020

Objective:

Surgeries performed in the afternoon schedule were discouraged by Smile Train Foundation for patients younger than 2 years. The aim of this study is to present the incidence of complications discriminating time of surgery (morning/afternoon) in a reference center in Curitiba (Brazil) during 2017.

Design:

Retrospective study that evaluated all cleft surgeries that were performed at Assistance Center for Cleft Lip and Palate during 2017. Complications correlated with surgery period (morning/afternoon), type of surgery, and operating surgeon were studied. Statistical analysis was performed to find any association between discrete variables.

Setting:

Tertiary, institutional

Participants:

One hundred eighty-seven patients with cleft lip and/or cleft palate/cleft lip and palate, who were evaluated and submitted to surgery in the center and had less than 24 months of age, were included in the study.

Interventions:

One hundred twenty-four cheiloplasties and 63 palatoplasties were performed.

Main Outcome Measure:

Incidence of complications.

Results:

From the total of cheiloplasties, the number of complications was 2 (1.6%) and from the total of palatoplasties the number of complications was 11 (17%); 8.1% of surgeries that were performed in the morning had any complication compared to 5.1% of surgeries performed in the afternoon. Statistical analysis of discrete variables with χ2 test showed no correlation between surgery schedule and complications (χ2 = 0.62).

Conclusion:

The number of complications was not higher in the afternoon scheduled surgeries. Surgeon expertise had a statistically significant correlation with the absence of complications (χ2 = 20.57).
Occurrence of and Factors Associated With the Presence of Aflatoxin M1 in Breast Milk of Mothers in Fethiye, Turkey
Authors: Karayağiz Muslu Gonca , Özdemir Mehmet
Published: April 2020

Aflatoxins comprise a group of mycotoxins that are found in the environment. Exposure to aflatoxins has been reported to cause serious health problems in humans. Since aflatoxin M1 (AFM1) is secreted in breast milk, the exposure of infants to this toxin is an important concern. The aim of this study was to determine the prevalence, levels of, and factors associated with the presence of AFM1 in breast milk of mothers in Fethiye, Turkey. Breast milk samples were taken from 100 mothers who had given birth over the period of October–November 2017. The AFM1 content of the samples was determined via enzyme-linked immunosorbent assay. The lowest limit for milk samples in the Ridascreen® AFM1 commercial test kit is 5 ng/L. Because of this, AFM1 levels below 5 ng/L in the breast milk samples were assessed as negative. Of the breast milk samples tested, 53 were positive. The average AFM1 amount in the positive samples was 6.36 ng/L (ppt; range 5.10–8.31 ng/L). Mothers who were housewives, lived in damp, humid houses, or ate spices or dried fruits and vegetables had significantly greater prevalence of AFM1 in their breast milk than those who were employed, did not report dampness or mold in the home, or did not eat spices or dried fruits and vegetables. AFM1 in breast milk could be an important risk factor for infant health. Informing the public about food safety could reduce the amount of AFM1 being transferred into breast milk via food channels.
Tourism, economic growth, energy consumption, and CO2 emissions in China
Authors: Zhang Jiekuan , Zhang Yan
Published: April 2020

In this article, we for the first time applied the vector error correction model (VECM) Granger causality approach to investigate the short-run and long-run causal relationships among tourism, economic growth, energy consumption, and carbon dioxide (CO2) emissions for 30 Chinese provinces over the period 2000–2017. The results implied that the analyzed variables became stationary at their first differences. The panel cointegration tests indicated the presence of a long-term equilibrium relationship among these four analyzed variables. Results from the VECM Granger causality tests suggested that the bidirectional short-term causalities were statistically confirmed between gross domestic product (GDP) and tourism. Additionally, we found that some unidirectional short-run causalities existed running from energy consumption to other analyzed variables and bidirectional long-run causalities existed between CO2 emissions and GDP, CO2 emissions and tourism, and GDP and tourism. Moreover, we also found the existence of unidirectional long-term causalities running from energy consumption to other analyzed variables. Based on these findings, we highlighted some key policy implications to develop China’s sustainable tourism.
The cooling effect of a spray fan in an indoor hot environment
Authors: Meng Xiaojing , Lv Yihang , Yang Honggang , Wang Yi
Published: April 2020

The aim of this study is to evaluate the cooling effect of a spray fan in an indoor hot environment. An experimental workplace with a thermal environment of high temperature and radiation intensity was set up. The hot environment of the experimental workplace could not meet occupational health requirements when the heat source temperature exceeded 150°C. The effects of air velocity and relative humidity on the natural wet bulb temperature, black globe temperature and wet bulb globe temperature (WBGT) were investigated. The maximum reduction of the WBGT was about 1.7°C, with an air velocity increase by 1 m/s. There was a notable cooling effect on the hot environment for low air velocities (e.g. 0–2 m/s), while the cooling effect only increased slightly for high air velocity (e.g. 2–5 m/s). We also found that the indoor WBGT declined by 0.2–0.8°C when the relative humidity was increased by about 10%. These results may provide guidance for reducing heat stress in industrial hot environment.
Gutter Characteristics and Stent Compression of Self-Expanding vs Balloon-Expandable Chimney Grafts in Juxtarenal Aneurysm Models
Authors: Meekel Jorn P. , van Schaik Theodorus G. , Lely Rutger J. , Groot Gerie , van der Meijs Bram B. , Wisselink Willem , Blankensteijn Jan D. , Yeung Kak K.
Published: April 2020

Purpose: To assess in silicone juxtarenal aneurysm models the gutter characteristics and compression of different types of chimney graft (CG) configurations. Materials and Methods: Fifty-seven combinations of Excluder C3 or Conformable Excluder stent-grafts (23, 26, and 28.5 mm) were deployed in 2 silicone juxtarenal aneurysm models with 3 types of CGs: Viabahn self-expanding (VSE; 6 and 13 mm) or Viabahn balloon-expandable (VBX; 6, 10, and 12 mm) stent-grafts and Advanta V12 balloon-expandable stent-grafts (ABX; 6 and 12 mm). Setups were divided into 4 groups on the basis of increasing CG and main graft (MG) diameters. Two independent observers assessed gutter size and type as well as CG compression on computed tomography scans using postprocessing software. Results: In the smaller diameter combinations (6-mm CG and 23-, 26-, and 28.5-mm MGs), both VSE (p=0.006 to 0.050) and ABX (p=0.045 to 0.050) showed lower gutter areas and volumes compared with VBX. In turn, the VBX showed a nonsignificant tendency to decreased compression, especially compared to ABX. Use of the Excluder C3 showed a 6-fold increase in type A1 gutters (related to type Ia endoleak) as compared to the Conformable Excluder (p=0.018). Balloon-expandable stent-grafts (both ABX and VBX) showed a 3-fold increase in type A1 gutters in comparison with self-expanding stent-grafts (p=0.008). Conclusion: The current study suggests that use of the Conformable Excluder in combination with VSE chimney grafts is superior to the other tested CG/MG combinations in terms of gutter size, gutter type, and CG compression.
Straddling the divide: Early years preservice teachers’ experiences working within dual policy contexts
Authors: Mahony Linda , Disney Leigh , Griffiths Sara , Hazard Helen , Nutton Georgie
Published: April 2020

This study explored the lived experiences of 20 Australian early childhood preservice teachers while on practical experience placement and examined the factors that informed their pedagogical experiences when working across both prior-to-school and school settings. Transcripts from interviews were analysed using grounded theory-informed methodology. Findings highlighted that preservice teachers’ prior experiences, and their experiences during placement, shaped their perspectives and pedagogical decisions when working across the two education contexts. Findings showed a disparity between preservice teachers’ practical experiences on placement in prior-to-school and school settings. Understanding the discontinuities for early childhood preservice teachers between the two education environments is instructive for theoretical knowledge, content design of tertiary degrees and the support needed for successful transference of skills and induction into early childhood teaching contexts. Close work with industry partners is needed on mentorship and explicit application of early childhood technical knowledge in differing curricula environments.
The effect of adenosine in inducing cardiac arrest for endovascular treatment of paediatric high-flow brain and spinal vascular malformation
Authors: Ghorbani Mohammad , Asaadi Sina , Nouri Mohsen , Asl Mahdi Kadkhodazadeh , Lafta Ghazwan Alwan , Bahrami Reza , Mortazavi Abolghasem
Published: April 2020

Introduction

Endovascular treatment of high-flow vascular lesions with onyx may be very dangerous due to premature occlusion of the vein resulting from high flow-induced migration of this embolic substance without occlusion of the feeding vessels and the nidus. It is also dangerous because of the risk of occlusion of the normal vessels around the lesion. Inducing temporary cardiac arrest using adenosine may be helpful in limiting and minimizing these risks. However anaesthetic management of this procedure in children suffering from high-flow vascular lesions is difficult and challenging.

Methods

We report three paediatric patients with high-flow cerebrospinal vascular lesions that underwent endovascular treatment under general anaesthesia and temporary cardiac arrest with adenosine. Adenosine was administered in escalating doses to induce a few seconds of cardiac standstill and the onyx injection was synchronized with the onset of adenosine-induced cardiac standstill, the fistula being occluded by onyx.

Results

There were no complications in peri-procedural treatment in all three cases. Post-embolization angiography revealed complete obliteration of the lesion, and the patients’ neurological status progressively improved at follow-up.

Conclusion

Adenosine-induced temporary cardiac standstill was successfully used to facilitate safe and controlled endovascular onyx embolization of high-flow central nervous system vascular lesions.
Epithelial–Myoepithelial Carcinoma of the Lacrimal Sac and Literature Review of the Lacrimal System
Authors: Sharma Dhruv , Neiweem Ashley , Davis Kyle , Prendes Mark , Chundury Rao , Illing Elisa
Published: April 2020

Background

Epithelial–myoepithelial carcinomas make up less than 0.1% of head and neck malignancies and are regarded as rare, low-grade malignant neoplasms of the salivary gland. They are thought to arise from intercalated ducts with histopathology showing a classic biphasic morphology of an outer layer of myoepithelial cells and inner layer of epithelial cells. These tumors most commonly occur in the parotid gland; however, rare cases have also been described in the nasal cavity, nasopharynx, subglottis, base of tongue, and the lacrimal gland.

Objective

To describe the clinical presentation, surgical management, and histopathology of the first reported case of lacrimal sac epithelial–myoepithelial carcinoma. To conduct a literature review of this malignancy, which is present in the lacrimal system.

Methods

Case report (n = 1) and literature review.

Results

We report a case of a 72-year-old man presenting with epiphora and a lacrimal sac mass with intranasal extension on imaging and nasal endoscopy. A combined endoscopic endonasal and open approach provided successful definitive treatment for final pathologic diagnosis of epithelial–myoepithelial carcinoma of the lacrimal sac, with orbital reconstruction and lacrimal stenting providing good cosmetic and functional results.

Conclusions

After PubMed database search for any case series or reports of lacrimal system epithelial–myoepithelial carcinomas, we believe this is the first documented case originating from the lacrimal sac. Although the histopathology of this tumor is distinct, unusual location and clinical presentation may pose significant diagnostic difficulties.
Rescue Augmentation: Increased Stability in Augmentation After Initial Loosening of Pedicle Screws
Authors: Weiser Lukas , Huber Gerd , Sellenschloh Kay , Püschel Klaus , Morlock Michael M. , Viezens Lennart , Lehmann Wolfgang
Published: April 2020

Study Design:

Biomechanical study.

Objectives:

Failure of pedicle screws is a major problem in spinal surgery not only postoperatively, but also intraoperatively. The aim of this study was to evaluate whether cement augmentation may restore mounting of initially loosened pedicle screws.

Methods:

A total of 14 osteoporotic or osteopenic human cadaveric vertebral bodies (L2)—according to quantitative computed tomography (QCT)—were instrumented on both sides by conventional pedicle screws and cement augmented on 1 side. In vitro fatigue loading (cranial-caudal sinusoidal, 0.5 Hz) with increasing peak force (100 N + 0.1 N/cycles) was applied until a screw head displacement of 5.4 mm (∼20°) was reached. After loosening, the nonaugmented screw was rescue augmented, and fatigue testing was repeated.

Results:

The fatigue load reached 207.3 N for the nonaugmented screws and was significantly ( P = .009) exceeded because of initial cement augmentation (300.6 N). The rescue augmentation after screw loosening showed a fatigue load of 370.1 N which was significantly higher ( P < .001) compared with the nonaugmented screws. The impact of bone density on fatigue strength decreased from the nonaugmented to the augmented to the rescue-augmented screws and shows the greatest effect of cement augmentation on fatigue strength at low bone density.

Conclusions:

Rescue augmentation leads to similar or higher fatigue strengths compared with those of the initially augmented screws. Therefore, the cement augmentation of initially loosened pedicle screws is a promising option to restore adequate screw stability.
It’s a small, small, small world: The Icesave dispute and global orders of difference
Authors: Bier Jess
Published: April 2020

Drawing on Roy and Ong’s work on worlding, this article introduces the concept of orders of difference to analyze the selective incorporation of the nation-state into supranational political and economic systems. I argue that attending to orders of difference is necessary to better understand the ways that imagined equality is mobilized to reproduce global injustice. I do so through a combined examination of the liberal globalism of the iconic “It’s a Small World” ride at Disney theme parks and Iceland's role in the Icesave dispute—a key struggle of the 2007–8 financial crisis. The design of the Small World 1 ride effects a form of worlding by ordering differences into those that are similar enough to be permitted and those that are too different to be incorporated. In the process, the ride invokes a small world 2 that precisely encapsulates the more complex globalisms that inform the organizational structure of supranational bodies like the European Union and European Economic Area. Global finance is said to be one of the world’s most seamless supranational systems, but one of its many seams was made visible during the Icesave dispute as two orders of difference came into conflict: European Economic Area membership and Icelandic politics. Representatives of the Netherlands and the UK argued that Iceland’s membership in the European Economic Area meant that Iceland was fully the same as other member nations, while those from Iceland successfully argued that its domestic and international economies were irreducibly different. The dispute thus hinged upon a debate over how differences are ordered within and between nations, including the number of permissible orders and the precise extent to which member nations are or should be made commensurable through supranational geopolitics.
Exercise intolerance in chronic thromboembolic pulmonary hypertension after pulmonary angioplasty
Authors: Kikuchi Hanako , Goda Ayumi , Takeuchi Kaori , Inami Takumi , Kohno Takashi , Sakata Konomi , Soejima Kyoko , Satoh Toru
Published: April 2020

Introduction

Exercise pulmonary hypertension is common in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who experience shortness of breath during exercise and reduced exercise capacity despite normalised pulmonary arterial pressure (PAP) at rest; however, the relationship between exercise pulmonary hypertension and exercise capacity remains unclear. Here we aimed to determine whether exercise pulmonary hypertension is related to exercise capacity and ventilatory efficiency in CTEPH patients with normalised resting haemodynamics after pulmonary balloon angioplasty (BPA).

Patients and methods

In total, 249 patients with CTEPH treated with BPA (mean±sd age 63±14 years; male:female 62:187) with normal mean PAP (mPAP) (<25 mmHg) and pulmonary arterial wedge pressure (≤15 mmHg) at rest underwent cardiopulmonary exercise testing with right heart catheterisation. mPAP–cardiac output (CO) during exercise was plotted using multipoint plots. Exercise pulmonary hypertension was defined by a mPAP–CO slope >3.0.

Results

At rest, pulmonary vascular resistance was significantly higher in the exercise pulmonary hypertension group (n=116) than in the non-exercise pulmonary hypertension group (n=133). Lower peak oxygen consumption (13.5±3.8 versus 16.6±4.7 mL·min−1·kg−1; p<0.001) was observed in the former group. The mPAP–CO slope was negatively correlated with peak oxygen consumption (r= −0.45, p<0.001) and positively correlated with the minute ventilation versus carbon dioxide output slope (r=0.39, p<0.001).

Conclusions

Impaired exercise capacity and ventilatory efficiency were observed in patients with CTEPH who had normalised PAP at rest but exercise pulmonary hypertension.
The effect of e-health interventions promoting physical activity in older people: a systematic review and meta-analysis
Authors: Kwan Rick Yiu Cho , Salihu Dauda , Lee Paul Hong , Tse Mimi , Cheung Daphne Sze Ki , Roopsawang Inthira , Choi Kup Sze
Published: April 2020

Introduction

The objectives of this review paper were to synthesize the data from randomized controlled trials in the literature to come to a conclusion on the effects of e-health interventions on promoting physical activity in older people.

Methods

The Medline, CINAHL, Embase, PsycINFO, and SportDiscus databases were searched for articles about studies that 1) recruited subjects with a mean age of > 50 years, 2) tested e-health interventions, 3) employed control groups with no or less advanced e-health strategies, 4) measured physical activity as an outcome, 5) were published between 1st January 2008 and 31st May 2019, and 6) employed randomized controlled trials. The risk of bias in individual studies was assessed using the Physiotherapy Evidence Database scale. To examine the effects of the interventions, variables quantifying the amount of physical activity were extracted. The within-group effects of individual studies were summarized using Hedges g and 95% confidence intervals. Between-group effects were summarized by meta-analyses using RevMan 5.0 with a random effect model.

Results

Of the 2810 identified studies, 38 were eligible, 25 were included in the meta-analyses. The within-group effect sizes (Hedges g) of physical activity in the intervention group at T1 ranged from small to large: physical activity time (0.12 to 0.84), step counts (− 0.01 to 11.19), energy expenditure (− 0.05 to 0.86), walking time (0.13 to 3.33), and sedentary time (− 0.12 to − 0.28). The delayed effects as observed in T2 and T3 also ranged from small to large: physical activity time (0.24 to 1.24) and energy expenditure (0.15 to 1.32). In the meta-analysis, the between-group effect of the e-health intervention on physical activity time measured by questionnaires, physical activity time measured by objective wearable devices, energy expenditure, and step counts were all significant with minimal heterogeneity.

Conclusion

E-health interventions are effective at increasing the time spent on physical activity, energy expenditure in physical activity, and the number of walking steps. It is recommended that e-health interventions be included in guidelines to enhance physical activity in older people. Further studies should be conducted to determine the most effective e-health strategies.