bluuebunny/crossref_metadata_2025 huggingface dataset:
The gut microbiome primes a cerebroprotective immune response after stroke
Authors: Singh Vikramjeet , Sadler Rebecca , Heindl Steffanie , Llovera Gemma , Roth Stefan , Benakis Corinne , Liesz Arthur
Published: May 2018

Microbiome alterations have been shown to affect stroke outcome. However, to what extent the presence of a gut microbiome per se is affecting post-stroke neuroinflammation has not been tested. By comparing germfree mice with recolonized (Ex-GF) and conventional SPF mice, we were able to demonstrate that bacterial colonization reduces stroke volumes. Bacterial colonization increased cerebral expression of cytokines as well as microglia/macrophage cell counts in contrast to improved stroke outcome. Interestingly, the microbiome-mediated brain protection was absent in lymphocyte-deficient mice. These findings support the concept of lymphocyte-driven protective neuroinflammation after stroke under control of the microbiome.
Patients’ and Clinicians’ Perceptions of Antibiotic Prescribing for Upper Respiratory Infections in the Acute Care Setting
Authors: Broniatowski David A. , Klein Eili Y. , May Larissa , Martinez Elena M. , Ware Chelsea , Reyna Valerie F.
Published: May 2018

Reducing inappropriate prescribing is key to mitigating antibiotic resistance, particularly in acute care settings. Clinicians’ prescribing decisions are influenced by their judgments and actual or perceived patient expectations. Fuzzy trace theory predicts that patients and clinicians base such decisions on categorical gist representations that reflect the bottom-line understanding of information about antibiotics. However, due to clinicians’ specialized training, the categorical gists driving clinicians’ and patients’ decisions might differ, which could result in mismatched expectations and inefficiencies in targeting interventions. We surveyed clinicians and patients from 2 large urban academic hospital emergency departments (EDs) and a sample of nonpatient subjects regarding their gist representations of antibiotic decisions, as well as relevant knowledge and expectations. Results were analyzed using exploratory factor analysis (EFA) and multifactor regression. In total, 149 clinicians (47% female; 74% white), 519 online subjects (45% female; 78% white), and 225 ED patients (61% female; 56% black) completed the survey. While clinicians demonstrated greater knowledge of antibiotics and concern about side effects than patients, the predominant categorical gist for both patients and clinicians was “why not take a risk,” which compares the status quo of remaining sick to the possibility of benefit from antibiotics. This gist also predicted expectations and prior prescribing in the nonpatient sample. Other representations reflected the gist that “germs are germs” conflating bacteria and viruses, as well as perceptions of side effects and efficacy. Although individually rational, reliance on the “why not take a risk” representation can lead to socially suboptimal results, including antibiotic resistance and individual patient harm due to adverse events. Changing this representation could alter clinicians’ and patients’ expectations, suggesting opportunities to reduce overprescribing.
Developing Models to Evaluate Pregnancy Outcomes
Authors: Sager Joyce T. , Haug Peter J. , Turner Charles W. , Hebertson Richard M.
Published: May 2018

The authors examined the proposition that the patient charge for a labor-and-delivery admission can be used as a crude index of pregnancy outcomes. They are developing models of the relationships of certain complications of pregnancy to this outcome variable. These models could be used to estimate potential cost benefits associated with specific prenatal interventions and assist in identifying the areas that should be included in the authors’ expert system.
Quality Control in a Medical Information System
Authors: Haug Peter J. , Frederick Philip R. , Tocino Irena
Published: May 2018

Quality assurance techniques provide an opportunity to identify sources of error and to provide the feedback necessary to prevent their repetition. The authors outline an effort to define the steps required for effective quality management procedures in a computerized medical information system (MIS). The computerized management of medical information can be used not only to enhance current quality management activities but also to extend the realm of quality assurance to areas that have heretofore resisted management. Quality-management techniques have the potential for measuring and improving medical decision making processes central to patient care.
Alternate Approaches to a UMLS
Authors: Bishop Charles W.
Published: May 2018

A scheme for the continuing development of Meta-1, a taxonomy of medical subjects based on MeSH and other systems, is described. The objective is a single, structured classification for medical knowledge.
Advanced Parking Space Management Strategy Design: An Agent-Based Simulation Optimization Approach
Authors: Zhao Cong , Li Siyu , Wang Wei , Li Xinghua , Du Yuchuan
Published: May 2018

In this paper, we present a bi-level approach to determine optimal parking management in large parking lots with multiple user classes and different types of parking spaces. The upper level of the model aims to maximize the social benefits of the local parking system, such as the system searching time and walking time by drivers. The lower level is a simulation system constructed using the multi-agent modeling environment NetLogo. However, it is essential to understand how drivers choose their parking location, then we can describe drivers’ movements and responses to different parking management strategies in the micro-simulation system. This study presents the results from a stated preference experiment on the choice behavior of drivers in Shanghai, China. The model attributes are walking distance, traveling time and uncertainties towards finding a vacant parking spot, which were selected based on a literature review. A simulated annealing algorithm is adapted to solve this bi-level simulation optimization model. The approach is applied to optimize parking management in the campus of Tongji University, China. The results show that the implementation of different duration limits is useful to adapt the time-varying demand with different user classes. The approach provides a powerful tool for strategically designing parking management, and for assessing parking policies and parking information systems.
Pavement Friction Modeling using Texture Measurements and Pendulum Skid Tester
Authors: Alhasan Ahmad , Smadi Omar , Bou-Saab Georges , Hernandez Nacu , Cochran Eric
Published: May 2018

Pavement frictional behavior affects pavement performance in terms of vehicle safety, fuel consumption, and tire wear. Comprehending and interpreting pavement friction measurements is a challenging task, because of friction sensitivity to several uncontrollable factors. These factors include: pavement surface conditions, such as the type and thickness of contaminants and fluids on the surface and their interaction with friction forces; and the device operating conditions, such as sliding speed, material properties and geometry of the rubber slider used, and operating temperature. Despite the efforts to describe and quantify the impact of varying conditions on pavement friction, which ultimately will allow for a better harmonization of friction measurements, there is a need to better understand the link between the surface texture and physical friction measurements. In this paper, Persson’s friction model is used to analyze and understand the impact of surface texture on frictional behavior of dry pavement surfaces. The model was used to analyze 18 test locations, which were compared with the dry kinetic coefficients of friction (COF) estimated using a British pendulum tester (BPT). The results show that Persson’s friction model could predict the COF estimated from the BPT results with relatively high accuracy. In addition, the model could provide a profound explanation of the frictional forces mechanism. Finally, it was found that the mean profile depth (MPD) cannot provide a full picture of the frictional behavior. However, combining MPD with the Hurst exponent, texture measurements can potentially provide a full physical explanation of the frictional behavior for road surfaces.
Vehicle Reidentification in a Connected Vehicle Environment using Machine Learning Algorithms
Authors: Miao Zuoyu , Head K. Larry , Beak Byungho
Published: May 2018

Deployment of connected vehicles will become possible for most American cities in the next 10 to 20 years. Connected vehicle (CV) applications (e.g., mobility, safety, environment) are constantly receiving vehicle data. The current ID protection mechanism assumes a vehicle’s ID changes every 5 minutes, so the topic of rematching vehicles is of interest in privacy protection and performance measure research. This paper explores the possibility of rematching connected vehicles’ IDs using popular machine learning techniques, including logistic regression (LR), linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), linear and nonlinear support vector machine (SVM) and nearest neighbor algorithms. An experiment is conducted using a microscopic traffic simulation model through a software-in-the-loop technique. The best average mismatching rate is 14%. To assess potential factors’ effects on matching accuracy, a Poisson mixed regression model is analyzed under the Bayesian inference framework. Findings are: different matching algorithms vary in matching performance and the linear SVM, the QDA and the LDA have the best accuracy results; traffic volume and market penetration rate have little impact on matching results; location and number of vehicles to be matched are considered significant. The results make the performance measurement of future CV applications feasible and also suggest that more secure mechanisms are needed to protect the public.
A Vibration-Based Vehicle Classification System using Distributed Optical Sensing Technology
Authors: Zhao Hongduo , Wu Difei , Zeng Mengyuan , Zhong Sheng
Published: May 2018

This paper presents a vibration-based vehicle classification system using distributed optical vibration sensing (DOVS) technology and describes a comprehensive classification method including signal processing and feature extraction. With low maintenance costs, this system can collect vehicle classification data in a larger scale. At first, it utilizes an embedded sensing fiber as a distributed sensor to collect traffic-induced vibration signals, and then extracts several features from the raw signals to estimate axle configurations and identify vehicle categories. At the same time, an empirical mode decomposition (EMD)-based method is applied to reconstruct signals for features extraction, and then several extraction algorithms are proposed to obtain the axle configuration, moving speed, and frequency-domain feature of each vehicle. When all features are extracted, a multi-step classifier is designed to categorize vehicles into different classes. In addition, to evaluate the classification performance of this system, a prototype system was installed on a relief road in Shanghai, China using precast concrete pavement technology. With an overall accuracy of 89%, the test results show a good performance of this classification system.
Multimodal Level of Service Methodologies: Evaluation of the Multimodal Performance of Arterial Corridors
Authors: Zuniga-Garcia Natalia , Ross Heidi W. , Machemehl Randy B.
Published: May 2018

The principal objective of this research is to evaluate the multimodal performance of arterial corridors using currently available multimodal level of service (MMLOS) methodologies. Eight different MMLOS approaches are applied to a case study using an arterial corridor section in Austin, Texas. The methodologies applied are: Highway Capacity Manual; Transit Capacity and Quality of Service Manual; Charlotte, NC, Urban Street Design Guidelines; pedestrian and bicycle environmental quality indices; assessment of level of traffic stress; bicycle compatibility index; deficiency index; and Walk Score®, Bike Score®, and Transit Score®. The analysis is focused on the assessment of pedestrian, bicycle, and transit modes. The methodologies are evaluated and contrasted. The paper provides a comprehensive review of the current state of practice of multimodal evaluation and recommendations about the most appropriate approaches to assess multimodal performance of arterial corridors.
Numerical and Experimental Predictions of Texture-Related Influences on Rolling Resistance
Authors: Mansura Dmytro A. , Thom Nicholas H. , Beckedahl Hartmut J.
Published: May 2018

To overcome rolling resistance (RR) a typical vehicle on average consumes 4152 MJ/119 L of fuel annually as a result of both vehicle and pavement factors. A slight improvement in surface texture arrangement may therefore decrease fuel consumption bringing substantial long-term socio-economic benefits. This aligns with ever-tighter limits on CO2 in the USA (163 g/km until 2025) fostering sustainable construction/exploitation of tires/pavements. This paper describes a multi-scale 3-D numerical methodology to calculate micro-distortional RR and contact indentations of surface aggregates into visco-elastic tread compound accounting for loading, velocity, temperature, and compound properties. It consists of a micro-scale tread block single aggregate model and a macro-scale car tire finite element model, rolling in steady-state mode over a rigid smooth surface. The surface texture is idealized in terms of hemispherical indenters. The micro-distortional RR estimates are based on contact force and energy lost per single stone. The computed contact/normal forces peak significantly due to visco-elastic effects at the beginning of the tire–surface contact phase, followed by a gradually relaxing stress region with a sudden release at the end of the interaction. The contact forces appear to be of a reasonable distribution and magnitude. It is found that micro-distortional RR is higher on a rougher and sparsely packed surface compared with a smoother and more tightly packed case. To determine the total tire-related RR, macro-distortional RR can then be added. The predictions were qualitatively confirmed and adjusted against real bituminous mixes by experimental testing, showing a reasonable agreement.
How Do Feminist-Identified Women Cope With Discrimination? A Feminist Standpoint and Grounded Theory Study
Authors: Watson Laurel B. , Flores Mirella J. , Grotewiel Morgan , Brownfield Jenna M. , Aslan Sara , Farrell Michelle
Published: May 2018

Women experience a higher incidence of mental health concerns compared to men, and scholars have located these challenges within a discriminatory sociocultural context. Although scholars have suggested that feminist attitudes may shield women from discrimination, research on the protective role of feminist attitudes is discrepant and suggests that there are distinct differences between those who do and do not self-identify as feminist; namely, self-identifiers may be more protected in the face of discrimination. Utilizing grounded theory and intersectional feminist standpoint methodologies, in this study we sought to understand the ways that self-identified womanist and feminist women cope with discrimination. We found that women’s feminist and cultural identities intersected, each informing the other and influencing coping mechanisms and well-being. Moreover, results demonstrated that feminist women call upon a variety of different coping mechanisms in response to discrimination, including advocacy, social support, self-care, cognitive processes, disengagement, connecting to one’s femininity, and religion and spirituality. Although possessing a feminist and/or womanist identity appeared to be protective in some cases, at other times it did not. Some participants expressed feeling marginalized from the feminist community and felt that their greater awareness of oppression was an additional source of distress. Based on these findings, we provide suggestions for mental health clinicians and research scholars.
Interference Screw Versus Suture Endobutton Fixation of a Fiber-Reinforced Meniscus Replacement Device in a Human Cadaveric Knee Model
Authors: Patel Jay M. , Brzezinski Andrzej , Raole Deep A. , Dunn Michael G. , Gatt Charles J.
Published: May 2018

Background:

Meniscal lesions represent one of the most common intra-articular knee injuries. Meniscus replacement devices are needed to restore load distribution and knee stability after meniscectomy. Fixation of these devices is crucial to the generation of hoop stresses and the distribution of loads in the joint.

Purpose:

To evaluate 2 different fixation techniques (suture endobutton and interference screw) for implantation of a novel meniscus device.

Study Design:

Controlled laboratory study.

Methods:

In 7 human cadaveric knees (aged 17-61 years), 1 anterior and 2 potential posterior tunnel locations were investigated, and both fixation techniques were tested in each tunnel. The native meniscus roots, devices fixed with a suture endobutton, and devices fixed with an interference screw were gripped with cryoclamps, and tibias were drilled and loaded into a custom jig. Samples were preloaded, preconditioned, loaded for 500 cycles (50-150 N), and tested in tension until failure.

Results:

For all 3 tunnels, suture fixation resulted in greater elongation (54.1%-150.7% greater; P < .05) during cyclic loading than interference screw fixation, which approximated the native roots. Both fixation techniques displayed ultimate tensile loads in the same range as native roots. However, stiffness of the suture fixation groups (36.5-41.6 N/mm) was only 28% to 37% of that of the interference screw fixation groups (98.7-131.6 N/mm), which had values approaching those of the native roots (anterior: 175.4 ± 24.2 N/mm; posterior: 157.6 ± 22.9 N/mm).

Conclusion:

Interference screw fixation was found to be superior to suture fixation with regard to elongation and stiffness, a finding that should be considered in the design and implantation of novel meniscus replacement devices.

Clinical Relevance:

With the emergence of various devices for total meniscus replacement, the establishment of fixation strategies is crucial for the generation of tensile hoop stresses and the efficacy of these approaches.
Primary Circumferential Acetabular Labral Reconstruction: Achieving Outcomes Similar to Primary Labral Repair Despite More Challenging Patient Characteristics
Authors: Scanaliato John P. , Christensen Daniel L. , Salfiti Catherine , Herzog Mackenzie M. , Wolff Andrew B.
Published: May 2018

Background:

Treatment of acetabular labral tears with moderate or severe intrasubstance damage or segmental defects remains a substantial challenge. Circumferential labral reconstruction with iliotibial band allograft is a relatively new technique that has been proposed to restore stability and eliminate high-stress junction points.

Purpose:

To compare outcomes between hips treated with primary allograft circumferential labral reconstruction and primary labral repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All consecutive hips between 2014 and 2015 that underwent primary reconstruction or primary repair by the senior surgeon were included and compared. Hips that had a prior intra-articular procedure were excluded. Patient-reported outcome (PRO) scores and visual analog scales were completed by patients within 1 week before surgery and between 22 and 26 months postoperatively. PROs included the modified Harris Hip Score, the International Hip Outcome Tool, and the 12-Item Short Form Health Survey for physical health. Pain and satisfaction were assessed with visual analog scales. Crude and inverse probability of treatment weighting comparisons of PROs between groups were performed.

Results:

A total of 162 hips met the inclusion criteria for this study, including 99 labral repairs and 63 complete labral reconstructions. Patients who underwent labral reconstruction were, on average, older (43.4 vs 29.5 years; P < .01), had a slightly higher body mass index (24.6 vs 23.0; P < .01), had hips with a higher Tönnis grade (grade 1 or 2: 25% vs 9%; P < .01), had higher preoperative pain scores (49.9 vs 41.5; P = .01), and had hips with more severe pathology (68% vs 5%; P < .01) as compared with patients with labral repair hips. Five (5%) labral repair hips and 5 (8%) labral reconstruction hips failed treatment ( P = .48). Among hips that did not fail (n = 94 repairs, n = 58 reconstructions), all demonstrated statistically significant improvements in PROs, and there was no statistical difference in PROs between groups after weighting ( P > .05).

Conclusion:

Primary circumferential labral reconstruction is a viable treatment option with promising short-term outcomes for hips that demonstrate moderate or severe labral damage. Despite less favorable preoperative characteristics, labral reconstruction offers similar outcomes when compared with labral repair in hips with less severe pathology.
Hemoadsorption in cardiac shock with bi	ventricular failure and giant-cell myocarditis: A case report
Authors: Dogan Günes , Hanke Jasmin , Puntigam Jakob , Haverich Axel , Schmitto Jan D
Published: May 2018

Purpose:

Giant-cell myocarditis represents a rare and often fatal autoimmune disorder. Despite extracorporeal life support being a valid treatment option, alternatives to control the underlying inflammatory response remain sparse. A new hemoadsorption device (CytoSorb) has recently been introduced to treat patients with an excessive inflammatory response.

Methods:

A 57-year-old patient developed fulminant right heart failure, respiratory insufficiency, hemodynamic instability, and oliguric–anuric renal failure. An extracorporeal life support together with an Impella was implanted for circulatory support. Due to non-pulsatility, acontractility of the left ventricle and a heavily reduced right ventricular function, a left ventricular assist device implantation and change from extracorporeal life support to veno-pulmonary arterial extracorporeal membrane oxygenation was performed. Since adequate hemodynamic stabilization could not be achieved and due to increasing inflammatory mediators and bilirubin levels, the decision was made to additionally integrate a CytoSorb hemoadsorber into the system.

Results:

The combined treatment resulted in a clear and steady improvement in hemodynamics and the inflammatory condition with marked reductions in all measured parameters throughout the treatment period. Metabolic acidosis resolved and liver function improved.

Conclusion:

Extracorporeal life support therapy represents a bridging approach to heart transplantation or to cardiac recovery and can be complemented by CytoSorb as an independent therapeutic option. The patient described herein with giant-cell myocarditis and fulminant cardiac failure who received substantial extracorporeal support in combination with CytoSorb hemoadsorption therapy benefited in terms of an improvement of organ function and his inflammatory situation.
The problem of romance in an analytic group
Authors: Doron Yael
Published: May 2018

The phenomenon of two participants falling in love in a group and continuing this love outside the group is not so rare, despite the ‘law’ explicitly forbidding personal contacts in between the group sessions. In this article, I wish to argue that a romance in a group should not be seen only as a phenomenon that occurs between two participants, but also as a transpersonal symptom of the group, a matrix event, and a special sort of ‘relations disorder’. As such, it binds the whole dynamic matrix and should be deciphered, processed and also understood at the group level. When this kind of romance develops in the group, it may lead to a serious crisis in the group, but it can also become an opportunity for individual participants, as well as for the group as a whole, including the conductor, to develop.
Synthesis of a thin-layer gelatin nanofiber mat for cultivating retinal cell
Authors: Shakibaie Mehdi , Tabandeh Fatemeh , Shariati Parvin , Norouzy Amir
Published: May 2018

Thin-layer gelatin nanofiber mats were fabricated as a biodegradable scaffold for proliferating human retinal pigment epithelium. Together with MTT assay, the glucose consumption rate, lactate formation, and lactate dehydrogenase activity of the human retinal pigment epithelium cells—on the gelatin nanofibers—were analyzed as indicators for cell growth and viability. The results showed that gelatin nanofiber did not make any toxic effect on the cells and the growth rate was comparable to the tissue culture plates. Using the fabricated thin-layer nanofibers let the by-product to leave which in turn cause less adverse effect on the cells. The biodegradability and stability of the gelatin nanofibers were optimized as a function of reaction time.
Intelligent transient calibration of a dual-loop EGR diesel engine using chaos-enhanced accelerated particle swarm optimization algorithm
Authors: Zhang Yunfan , Zhou Quan , Li Ziyang , Li Ji , Xu Hongming
Published: May 2018

This article proposes an intelligent transient calibration method for the air-path controller of a light-duty diesel engine. This method is developed based on the chaos-enhanced accelerated particle swarm optimization algorithm. The target is to reduce the engine’s fuel consumption during transient scenarios by optimizing the controller parameters. The advanced dual-loop exhaust gas recirculation system is first introduced. Then, it formulates the transient calibration process as a multiple-objective optimization problem with constraints. Different from steady state calibration, the proposed method designs a new cost-function to evaluate the controller’s transient performance. The intelligent transient calibration module is programmed in MATLAB code. Interface between the calibration module and a physical engine plant is established via ETAS INCA. The optimization result of the proposal method is discussed by comparing it with the result of existing calibration methods. The engine performance with the calibrated controller is evaluated based on engine tests.
Smart mischief: an attempt to demystify the Smart Cities craze in India
Authors: Chakrabarty Antarin
Published: May 2018

This paper attempts to demystify and deconstruct the current Smart Cities craze in India. It does so by refusing to be distracted by the discourses of the Smart Cities idea in general and of the Smart Cities Mission of the Government of India in particular. It focuses instead on the privatized physical spaces of urban inequality in India, specifically gated neighbourhoods and integrated townships. It argues that just as these privatized spaces have increased in size and complexity over time, their corresponding legitimizing ideologies have also evolved and become more sophisticated, to finally give birth to their newest avatar – Smart Cities. Seen in this light, Smart Cities appear less as a novel idea floated to guide the sustainable development of our future cities, and more as an ideological cover for the ongoing processes of neoliberal urbanization. The paper buttresses these arguments with an analysis of the design process of integrated township projects that I have been involved in, comparing the essential characteristics of these projects with the operational aspects and components of the Smart Cities Mission.
The migrant in the market: Care penalties and immigration in eight liberal welfare regimes
Authors: Lightman Naomi
Published: May 2018

This article disaggregates high- and low-status care work across eight liberal welfare regimes: Australia, Canada, Iceland, Ireland, Israel, Switzerland, the United Kingdom and the United States. Using Luxembourg Income Study data, descriptive and multivariate analyses provide support for a ‘migrant in the market’ model of employment, notwithstanding variation across countries. The data demonstrate a wage penalty in both high- and low-status care employment in several liberal welfare regimes, with the latter (service jobs in health, education and social work) more likely to be part-time and situated in the private sector. Migrant care workers are found to work disproportionately in low-status, low-wage types of care and, in some cases, to incur additional wage penalties compared to native-born care workers with equivalent human capital.
Fitting mechanistic epidemic models to data: A comparison of simple Markov chain Monte Carlo approaches
Authors: Li Michael , Dushoff Jonathan , Bolker Benjamin M
Published: May 2018

Simple mechanistic epidemic models are widely used for forecasting and parameter estimation of infectious diseases based on noisy case reporting data. Despite the widespread application of models to emerging infectious diseases, we know little about the comparative performance of standard computational-statistical frameworks in these contexts. Here we build a simple stochastic, discrete-time, discrete-state epidemic model with both process and observation error and use it to characterize the effectiveness of different flavours of Bayesian Markov chain Monte Carlo (MCMC) techniques. We use fits to simulated data, where parameters (and future behaviour) are known, to explore the limitations of different platforms and quantify parameter estimation accuracy, forecasting accuracy, and computational efficiency across combinations of modeling decisions (e.g. discrete vs. continuous latent states, levels of stochasticity) and computational platforms (JAGS, NIMBLE, Stan).
Ten‐year profile of acute poisoning patients presenting to an Accident and Emergency Department requiring intensive care in a regional hospital of Hong Kong
Authors: Ng Fu
Published: May 2018

Background:

Hong Kong Poison Information Centre publishes annual reports on all poisoning cases received by the Centre in that year since 2006. However, there is little data about acute poisoning cases requiring intensive care unit admissions in Hong Kong.

Objective:

To report and analyze the 10‐year poisoning data of acute poisoning patients presenting to an Accident and Emergency Department requiring intensive care in a regional hospital of Hong Kong.

Methods:

This was a retrospective study on patients presented from January 2007 to December 2016. These cases were retrieved from Clinical Data Analysis and Reporting System of the Hospital Authority, Hong Kong. Clinical data of these cases were then retrieved from patients’ electronic records.

Results:

A total of 270 cases were analyzed during the period. There were 152 (56.3%) male patients and 118 (43.7%) female patients. The middle aged group (age 30–39 and age 40–49) constitutes nearly half (48.6%) of all these admissions. Around 50% of them had history of psychiatric illness. Nearly 40% of them were known substance abusers. Majority of the patients (66.7%) were admitted directly from Accident and Emergency Department. The commonest cause was suspected self‐harm (56.3%). When ethanol (13%) was excluded, the five commonest types of poisons were benzodiazepine (26.3%), opioids (20.7%), zopiclone (18.5%), carbon monoxide poisoning (13%), and household products (10.7%). Twenty‐seven patients (10%) had decontamination done in Accident and Emergency Department or Emergency Medicine Ward. 112 patients (41.5%) were given one or more antidotes in Accident and Emergency Department and Emergency Medicine Ward. Altered mental status was the most frequently found complications (72.2%) in these patients. 76 patients (28.1%) required endotracheal intubation in Accident and Emergency Department. The length of stay in Intensive Care Unit ranged from 1 to 7 days with an average of 2.1 days. There were 25 deaths (9.3%) and 31 patients with major effects (11.5%).

Conclusion:

An estimate of 9.4% of acute poisoning patients presenting to Accident and Emergency Department might need Intensive Care Unit care at certain stage of their hospital stay. Benzodiazepine, opioids, zopiclone, carbon monoxide poisoning, and ethanol were the top five poisons in our series from 2007 to 2016. The mortality rate (9.3%) was high in our series given that there were more substance abusers.
Experience and Views of Oncology and Palliative Care Professionals on a Corounding Model of Care for Inpatients With Advanced Cancer
Authors: Yang Grace Meijuan , Yoon Sungwon , Tan Yung Ying , Liaw Karen
Published: May 2018

Background:

Palliative care is associated with better outcomes in advanced cancer, but there is limited research comparing different models of palliative care delivery alongside oncology care. For inpatients with cancer, palliative care is mostly delivered through a consult service, primarily relying on oncologist-initiated referrals to a separate specialist palliative care team. In our hospital setting, we piloted a palliative care and oncology corounding model of care.

Aim:

To explore the views and experience of oncology and palliative care professionals on the corounding model compared to an inpatient consult service.

Design:

A qualitative study nested within a pre–post study of the corounding model of care, with semistructured interviews using thematic analysis.

Setting/Participants:

Eleven doctors and nurses involved in the pilot corounding model were interviewed.

Results:

Two main themes emerged: (1) the efficiency of care delivery and (2) quality of patient care. The theme on the efficiency of care delivery was related to access to palliative care input, team communications, and parallel workflow. The quality of patient care was described in terms of holistic approach to cancer care and rapport building with patients and their families. Most participants acknowledged positive aspects of the corounding model, yet some minor concerns were reported, such as disagreements between oncology and palliative care professionals.

Conclusions:

This study provides insights into the benefits and drawbacks of a corounding model of care for inpatients. The views of health-care professionals can be incorporated into the development of integrated oncology and palliative care models to improve care for patients with advanced cancer.
Stability of a thermoelastic mixture with second sound
Authors: Alves Margareth S. , Ferreira Marcio V. , Muñoz Rivera Jaime E. , Villagrán O. Vera
Published: May 2018

We consider the one-dimensional model of a thermoelastic mixture with second sound. We give a complete characterization of the asymptotic properties of the model in terms of the coefficients of the model. We establish the necessary and sufficient conditions for the model to be exponential or polynomial stable and also the conditions for which there exist initial data for where the energy is conserved.
Nonlinear Transformations in Organizational Research: Possible Problems and Potential Solutions
Authors: Becker Thomas E. , Robertson Melissa M. , Vandenberg Robert J.
Published: May 2018

We examined the use of nonlinear transformation of variables in a random sample of 323 articles published in six top journals during 2012-2017. Coding categories included the number of transformed variables, the type of transformation, the kinds of variables transformed, reasons provided for transforming variables, how transformed results were reported, and pre- and posttransformation analysis of variables. Common problems include insufficient justification for transforming variables, overreliance on log transformations, failure to report important information on the effects of transformation, and incomplete reporting and discussion of transformed results. Perhaps most importantly, there was frequent misalignment between statements of hypotheses, typically stated in terms of nontransformed variables, and the transformed data used to test them. We discuss the implications of these problems for science and practice, offer recommendations for addressing the issues, and provide illustrations of how to implement the recommendations.
An Integrative Methodology for Organizational Oppositions: Aligning Grounded Theory and Discourse Analysis
Authors: Fairhurst Gail T. , Putnam Linda L.
Published: May 2018

The study of organizational tensions, contradictions, dialectics, and paradoxes is on the rise in the organizational sciences. This article sets forth an integrative methodology for studying these oppositional phenomena by aligning grounded theory techniques with the little “d” and big “D” orientations of organizational discourse analysis. This integrative methodology not only aids in identifying and determining various types of organizational oppositions and responses to them, but also fosters assessment of their potential power effects and micro organizing dynamics. We provide detailed steps for undertaking this integrative methodology, illustrate these steps with an extended example, and conclude with a discussion of new directions for using this approach.
No consensus on physicians’ preferences on vascular access management after kidney transplantation: Results of a multi-national survey
Authors: Voorzaat Bram M , Janmaat Cynthia J , Wilschut Esther D , Van Der Bogt Koen EA , Dekker Friedo W , Rotmans Joris I
Published: May 2018

Objective:

Arteriovenous fistulas for hemodialysis vascular access are a burden for the cardiovascular system. After successful kidney transplantation, prophylactic arteriovenous fistula ligation may improve cardiac outcomes; however, evidence is scarce. This survey investigates physicians’ preference for management of arteriovenous fistulas and identifies the factors associated with preference for either arteriovenous fistula ligation or maintenance.

Materials and methods:

A survey was sent to members of eight national and international Nephrology and Vascular Surgery societies. The survey comprised eight case vignettes of asymptomatic patients with a functioning arteriovenous fistula after kidney transplantation. Characteristics possibly associated with treatment preferences were arteriovenous fistula flow, left ventricular ejection fraction, and patient age. Respondents were asked to state preference to maintain or ligate the arteriovenous fistula. Linear mixed-effects models were used to investigate the association of treatment preference with case characteristics.

Results:

A total of 585 surveys were returned. A reduced left ventricular ejection fraction of 30% (beta 0.60, 95% confidence interval 0.55; 0.65) and a high flow of 2500 mL/min (beta 0.46, 95% confidence interval 0.41; 0.51) were associated with a higher preference for arteriovenous fistula ligation. Disagreement among respondents was considerable, as in four out of eight cases less than 70% of respondents agreed on the arteriovenous fistula management strategy.

Conclusion:

Although respondents recognize a reduced left ventricular ejection fraction and a high flow as the risk factors, the high disagreement on management preferences suggests that evidence is inconclusive to recommend arteriovenous fistula ligation or maintenance after kidney transplantation. More research is needed to determine optimal arteriovenous fistula management after successful kidney transplantation.
In Silico Study on Molecular Sequences for Identification of Paphiopedilum Species
Authors: Vu Huyen-Trang , Huynh Phuong , Tran Hoang-Dung , Le Ly
Published: May 2018

Our study searched all available sequences of Paphiopedilum from NCBI (National Center for Biotechnology Information) and tested for their species resolution capability in single as well as in combination forms. A total of 28 loci were applied for analyses in the study. From the nuclear genome, the highest resolution was of LFY, followed by ACO, DEF4, and RAD51. These 4 loci were found to be even better than the popular region ITS for Paphiopedilum identification. Among the chloroplast regions, the intergenic spacer atpB- rbcL gave the highest species resolution (76.7%), followed by matK, trnL, rpoC2, and ycf1. The divergence of CHS, XDH, 18S, Nad1, ccsA, rbcL, and ycf2 was very low and should not be used as identifying markers for Paphiopedilum. In addition, 2-locus combinations could improve significantly the resolving capability for the genus, in which 14/36 data sets could be resolved completely (100%) with interspecies relationships. The indel information was also effective supporting data for molecular discrimination of species.
One voice or different choice? Vote defection of European Union member states in the United Nations General Assembly
Authors: Burmester Nicolas , Jankowski Michael
Published: May 2018

Existing research suggests that European Union member states are increasingly able to act in concert in the United Nations General Assembly. Based on several hundred co-ordination meetings per year, the European Union ‘speaks with one voice’ on most of the resolutions voted upon in the United Nations General Assembly. However, little is known about instances where the European Union member states do not vote coherently. Three questions remain unanswered. First, what factors determine deviating voting behaviour of European Union member states? Second, who are the most frequent defectors from the European Union’s majority position? Third, which voting blocs within the European Union can be identified? The article answers these questions in a quantitative design by controlling for domestic factors, issues of resolutions and the position of the United States. The results suggest that domestic factors determine deviating voting behaviour far less than agenda-related issues and the position of the United States.
Using Twitter to recruit participants for health research: An example from a caregiving study
Authors: Wasilewski Marina Bastawrous , Stinson Jennifer N , Webster Fiona , Cameron Jill Irene
Published: May 2018

Twitter has the potential to optimize research conduct, but more research is needed around the nature of study-related tweets and strategies for optimizing reach. In the context of our caregiving study, we aimed to describe the nature and extent of study-related tweets, the extent to which they were shared by others, and their potential reach. To do so, we conducted a secondary analysis of our Twitter recruitment. We aggregated and categorized study-related tweets and analyzed the reach of the 10 most retweeted tweets. Results indicated that of 71 caregivers, 27 were recruited via Twitter. General recruitment tweets were most-shared by users. Tweet reach ranged from 5273 to 62,144 users. Twitter caregivers were demographically comparable to non-Twitter caregivers but had higher Internet proficiency and fewer children. Overall, using a personal Twitter account can expand the reach of study recruitment. Future research should compare different recruitment strategies and explore characteristics that may challenge the heterogeneity of Twitter samples.
Foreign presents or foreign presence? Resident perceptions of Australian and Chinese tourists in Niseko, Japan
Authors: Nelson Kim , Matthews Amie Louise
Published: May 2018

Over the past decade Niseko, a small ski resort in Japan, has experienced rapid growth in international tourism. Informed by a small-scale qualitative study, this article provides an account of Niseko residents’ perceptions of tourism and, more specifically, compares their responses to two key groups of inbound tourists, those from Australia and China. Where increases in the number of Australian tourists and tourism business owners have had significant influence on this previously homogeneous town, the reaction of residents to Australians is generally more positive than the response reserved for the more recent arrival of Chinese tourists. Although the former group is associated with increased living costs, leakage of profits and inappropriate behaviour, Australians were generally characterised by research participants as ‘friendly’ and ‘relaxed’ and relations were typically described as ‘harmonious’. Conversely, Chinese tourists were viewed by residents as being pushy and demanding, and these host–guest interactions were described as ‘difficult’. Drawing on Japanese notions of hospitality and residents’ discussions of cultural difference, this article explores the different reactions engendered by foreign presence, pointing as it does so to the ambivalence and contingency that underpins many host–guest relationships.
A mobile narrative community: Communication among senior recreational vehicle travellers
Authors: Pearce Philip L , Wu Mao-Ying
Published: May 2018

Narrative communities consist of closely interacting participants who frequently discuss their views of the world. The aims of this study were to establish the credibility of using a narrative community approach to the recreational vehicle (RV) market and, if appropriate, both identify common themes in the public discourse and direct attention to sensitive issues which those seeking to influence this market need to consider. Primary data were collected in Australia through focus groups at a typical regional RV rally site. This material was supplemented by close study of the main membership magazine produced for the target group. The researchers were able to confirm the applicability of the narrative community approach through noting the frequent repetition of symbolic stories, recurring phrases and highly favoured topics. The extended focus group conversations and the supplementary materials revealed six highly consistent themes binding the perspectives of the RV tourists. The celebrated common concerns were enjoying a new family, safety, freedom, health and living economically while contributing to the communities visited. This commonality was seen as constituting enthusiastic advocacy for RV travel and opens lines of communication for those seeking to influence RV users.
A system approach to selective catalyst reduction DeNOx monolithic reactor modelling using bond graphs
Authors: Nielsen Jørgen Bremnes , Pedersen Eilif
Published: May 2018

Stricter NOx emission limits for marine diesel engines have resulted in a market demand for engine external NOx reduction solutions. This demand has led to the development of ammonia-based selective catalytic reduction DeNOx systems for marine applications. For selective catalytic reduction systems in general, mathematical modelling and numerical simulation have been essential for increasing knowledge, improving the design and developing control algorithms. This has resulted in higher NOx reduction performance, reducing NH3 slip and improving transient and start-up performance. Due to the increasing complexity of diesel-engine-based power systems, it is often argued that system development requires a simulation-based design approach to reduce development cost and increase development speed. For this to be cost-effective, reusable and interchangeable models of appropriate complexity need to be available. In this article, a system approach is applied to modelling of selective catalytic reduction DeNOx monolithic reactors. Three models with different levels of fidelity are developed using the bond graph method. The three models are compared by simulating dynamic conditions to uncover differences between the models. In addition, accuracy is investigated by comparing the simulation results with measurement data. The contribution in this article can be summarized to be an exploration of monolith selective catalytic reduction DeNOx modelling in a system simulation framework, and investigation of the effect of selective catalytic reduction model fidelity on a coupled system performance prediction.