bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of variability and defects on the mechanical performance of tailorable composites
Authors: Finley James M , Henry Joël , Shaffer Milo SP , Pimenta Soraia
Published: September 2019

Aligned hybrid-fibre discontinuous composites offer the ability to tailor their mechanical response through careful microstructural design. However, with tailorability comes microstructural complexity, which in turn leads to many sources of variability and defects. A virtual testing framework was further extended to investigate the influence of variability and defects on the mechanical performance of various aligned discontinuous composite material systems. This approach identified the most critical sources of variability as (i) fibre strength, (ii) the distance between fibre ends, or (iii) the level of fibre-type intermingling, depending on the material system. Fibre vacancy defects were shown to have the most significant influence on the strength and ductility of aligned discontinuous composites, although this sensitivity can be reduced through hybridisation of the fibre types.
Dielectric characterization of white birch–activated biochar composites: A sustainable alternative to radar-absorbing materials
Authors: Boss Alan FN , Braghiroli Flavia L , Amaral-Labat Gisele , Souza Ariane AT , Baldan Mauricio R , Bouafif Hassine , Koubaa Ahmed , Lenz e Silva Guilherme FB
Published: September 2019

Sustainability can be defined as the ability of meet presents needs without compromise the ability of future generations to find their own needs. In this matter, scientists have been warning about natural resource scarcity, and now several researchers are aiming their efforts to develop sustainable technologies. Here, we focus on finding novel uses to biochar, a carbon rich material made from biomass that is usually applied on soil amendment. To expand its applications, biochars were activated using two different methods: a physical activation using CO2; and a chemical one using KOH. We investigate here the dielectric properties of composites made with both activated biochars from white birch, where composites were made using silicone rubber matrix. It was also investigated the influence of composites made with biochar in powder and in flakes. All samples were characterized over the X-band frequency range. Composites made with powder presented a linear permittivity over the frequency range, while composites made with flakes presented oscillations on different frequencies. These oscillations are related to the composite surface, which induces reflection effects because of flakes arrangement in the top surface. Such effects widen opportunities to engineer new materials to be explored as radar-absorbing materials.
Preventing the Criminalisation of Children Who Have Been Victims of Group-Based Sexual Exploitation Involving Grooming Tactics—Understanding Child Sexual Exploitation as Enslavement
Authors: Arthur Raymond , Down Lisa
Published: September 2019

Recently the United Kingdom has been beset by a moral panic concerning gangs grooming girls for sexual exploitation. This moral panic derived from a number of well-publicised cases, the most infamous of which took place in Rochdale, Greater Manchester. Grooming children has been criminalised by section 15 of the Sexual Offences Act 2003. Adult groomers face up to two years in prison and being automatically placed on the sex offenders register. The Act is intended to protect children from abuse and exploitation. However child victims who have been abused by gangs and coerced into offending may still be liable for prosecution for any offending they have engaged in. Fear of being prosecuted may stop victims coming forward and prevent survivors from moving on with their lives. Such children are often perceived as having made a choice and criminalised. The Modern Slavery Act 2015 was designed to combat modern slavery. Recognising child sexual exploitation as a form of slavery, could lead to victims being protected rather than criminalised themselves for these offences. This article will examine how the law can be reformulated to ensure protection of children from sexual exploitation and also ensuring children are not charged for committing crimes whilst being groomed or coerced. The article will consider the limitation of the statutory defence available under section 45 of the Modern Slavery Act 2015.
The “last railway mania”: The Light Railways Act of 1896 and local railway construction in Britain
Authors: Moore James
Published: September 2019

The Light Railways Act of 1896 stimulated a new “railway mania” with many local lines being promoted across mainland Britain. Although designed to support transport links to remote agricultural districts and fishing ports, this article explores how the new Act was used to promote a wide range of rural, suburban and industrial railway schemes. It evaluates the nature of the new lines built and the constraints that they faced. Despite the initial “mania”, it is argued here that the legislation was not especially successful in encouraging the construction of a large network of new rural railways. The new Light Railway Commissioners were reluctant to sanction schemes that might provide competition with existing mainline railway companies and conservative interests in the railway industry were reluctant to make the radical changes necessary to substantially reduce the costs of railway construction and operation.
Illuminating Smiles and Frowns: Visual-Affective Cueing Influences Viewer Perceptions of Page Layout Images
Authors: Grygarová Dominika , Adámek Petr , Lukavský Jiří , Kesner Ladislav
Published: September 2019

The present research was motivated by the routine digital media practice of producing page layouts as composite images that include several unrelated pictures. We investigated whether or how visually highlighting affective and positional components of pictures in a viewer’s field of vision might influence viewer perception and evaluation of the composite image. We examined combinations of visual, spatial, and affective features of cues in composite images to learn whether they affected the viewer’s attentional capture of other affective information in the composite image and viewer’s affective evaluations. The manipulation check of the feature combinations (positive/negative affect, presence/absence of highlighted color, central/peripheral position) showed significant effects of these features and their interactions on viewers’ eye movements. On the other hand, we observed only a small effect on viewers’ affective evaluations. Our results suggested that media page layout designers might manipulate the viewer’s attention by visual and positional adjustments of affective components in composite images. Future researchers might use this study’s design to better understand the human perception of real media images.
Correlation Between Adenoid Hypertrophy, Tympanometry Findings, and Viscosity of Middle Ear Fluid in Chronic Otitis Media With Effusion, Southern Oman
Authors: Abdel Tawab Hazem M. , Tabook Salim M. Sloma
Published: September 2019

Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid ( P value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.
Does Septorhinoplasty-Related Periorbital Edema Affect Intraocular Pressure and Retina?
Authors: Dikici Oğuzhan , Özmen Süay , Dikici Gülçin Kazaz , Muluk Nuray Bayar , Akkuzu Çağla Çapkur
Published: September 2019

Background:

Open rhinoplasty has been performed for over 50 years. Rhinoplasty procedures have a risk of complications and it is important to follow each step diligently in order to avoid complications. Periorbital edema is the most common complication of septorhinoplasty. As far as we are aware, there are no studies in the available literature examining the impact of the septorhinoplasty on intraocular pressure and the retina.

Objectives:

The aim of this study was to evaluate the effects of septorhinoplasty-related periorbital edema on intraocular pressure and the retina by means of objective tests.

Methods:

Ten patients with phase 4 periorbital edema (5 males and 5 females) who underwent open rhinoplasty with bilateral lateral osteotomies were enrolled in the study. All the patients were examined by an eye specialist for visual acuity, intraocular pressure, retinal nerve fiber layer, and ganglion cell complex pathologies with optical coherence tomography preoperatively and postoperatively on the seventh day.

Results:

Preoperative and postoperative best-corrected visual acuity; intraocular pressure; average, superior, and inferior retinal nerve fiber layer thickness; and total, superior, and inferior ganglion cell complex thickness in both eyes for all patients were within normal limits. There was no statistical difference between preoperative and postoperative values ( P > .05).

Conclusion:

We concluded that periorbital edema after septorhinoplasty causes no significant complications affecting intraocular pressure and visual acuity. We believe that when osteotomies and local anesthetic injections are undertaken correctly, periorbital complications do not affect vision.
Sex- and Site-Related Significance in Cutaneous Head and Neck Melanoma
Authors: Košec Andro , Rašić Ivan , Pegan Alan , Solter Darko , Ćurković Marko , Bedeković Vladimir
Published: September 2019

Cutaneous head and neck melanoma is a separate subgroup of cutaneous melanoma that has a worse prognosis than other primary sites. The aim of this article is to examine the significance of sex and site of primary lesion as additional risk factors. Primary localization distribution and metastatic disease in the neck in a retrospective cohort of 159 patients with cutaneous head and neck malignant melanoma were analyzed. Men develop primary melanoma more frequently than women in the left peripheral head and neck regions ( P = .0364), as well as clinically visible and occult metastatic disease in the left side of the neck ( P = .0138). Patients with clinically occult regional metastatic disease showed a significantly poorer survival rate than the rest of the group that underwent elective neck dissections ( P = .0270). Left-sided disease in male patients may be an additional risk factor in cutaneous head and neck melanoma. Performing elective neck dissections in high-risk patients might identify patients with occult metastatic disease and worse prognosis but does not offer any significant therapeutic benefit.
Synectics model applied in basic theory of computational fluid dynamics
Authors: Sande PC , Sharma S
Published: September 2019

Computational fluid dynamics is taught in many universities and is a trending elective option among engineering students. Although analyzing computational fluid dynamics simulations is exciting enough, the theory is equation intensive, sometimes very abstract and also difficult to visualize for the novice. A creative thinking based approach termed synectics, which involves analogies, was therefore applied in classroom teaching to increase student comfort with the equations. For this purpose six analogies encompassing basic computational fluid dynamics concepts were developed along with pictorial representations, and are presented in this work. These analogies were integrated into classroom teaching via synectics procedures. Student feedback was positive and reflected higher engagement with the course compared to when the metaphoric activity was not implemented. This work attempts to demonstrate the feasibility and value of applying creative techniques, even when teaching a highly structured and equation oriented course such as computational fluid dynamics.
Work Value Transmission From Parents to Children: Early Socialization and Delayed Activation
Authors: Johnson Monica Kirkpatrick , Mortimer Jeylan T. , Heckhausen Jutta
Published: September 2019

This study examines the transmission of work values from parents to children between mid-adolescence and early midlife. The authors propose that work-related values are transmitted from parents to children in two sequential and complementary processes stretched across adolescence and early adulthood. The first process of work value exposure and reception in the family context is captured by the socialization model. The second process is one of delayed value activation, long after initial socialization, when the young adult offspring engages with the demands and vicissitudes of their own emerging careers. The authors find evidence for family socialization in adolescence and also support for the delayed activation model during adulthood. Although parental values were measured more than two decades earlier, the authors find the strongest associations of parent and child values when the offspring were in their late 30s. In addition, parent–child value similarity is heightened when adult children navigate career uncertainty and change, consistent with a delayed activation process.
Agitation, Oxidative Stress, and Cytokines in Alzheimer Disease: Biomarker Analyses From a Clinical Trial With Nabilone for Agitation
Authors: Ruthirakuhan Myuri , Herrmann Nathan , Andreazza Ana C. , Verhoeff Nicolaas Paul L.G. , Gallagher Damien , Black Sandra E. , Kiss Alex , Lanctôt Krista L.
Published: September 2019

The endocannabinoid system has been a target of interest for agitation in Alzheimer disease (AD) because of potential behavioral effects and its potential impact on mechanisms implicated in AD such as oxidative stress (OS) and neuroinflammation. We explored whether serum markers of OS and neuroinflammation were associated with response to the cannabinoid nabilone in agitated patients with AD (N = 38). All participants were enrolled in a 14-week, double-blind, cross-over trial comparing nabilone to placebo (6 weeks each) with a 1-week washout between phases. Samples were collected at the start and end of each phase. The cross-sectional relationship agitation (Cohen Mansfield Agitation Inventory) and OS and inflammatory markers were investigated to select markers of interest. Significant markers were then explored for their relationship with response. The OS marker, 4-hydroxynonenal (4-HNE; F1, 35 = 6.41, P = .016), and the proinflammatory cytokine, tumor necrosis factor-α (TNF-α; F1, 29 = 3.97, P = .06), were associated with agitation severity, and TNF-α remained significantly associated ( F2, 25 = 3.69, P = .04) after adjustment for cognition. In the placebo phase, lower baseline 4-HNE was associated with decreases in agitation severity only (b = 0.01, P = .01), while lower baseline TNF-α was associated with decreases in agitation severity in the nabilone phase only (b = 1.14, P = .045). Changes in 4-HNE were not associated with changes in agitation severity in either phase. In the nabilone phase, lower baseline TNF-α was associated with decreases in agitation severity (b = 1.14, P = .045), and decreases in TNF-α were associated with decreases in agitation severity (b = 1.12, P = .006). These findings suggest that OS and neuroinflammation may be associated with agitation severity, while nabilone may have anti-inflammatory effects.
Constraints and Strategies to Scaling Up in Sport for Development and Peace Organizations: Evidence From the Field
Authors: Welty Peachey Jon , Cohen Adam , Shin Nari
Published: September 2019

The purpose of this study was to explore and examine the constraints faced by managers as they attempt to scale up their sport for development and peace (SDP) organizations, and to identify the strategies they are employing to mitigate these constraints. Previous research has not examined constraints to scaling up in the SDP nonprofit space. Findings revealed three major themes related to challenges within four types of scaling up (quantitative, functional, political, organizational); skepticism about sport as a development tool, funding challenges leading to an entrepreneurial mind-set, and challenges associated with a general lack of business acumen among key leaders. Within each of these three themes, strategies for addressing these constraints are illuminated. These constraints and strategies are positioned within the broader nonprofit context, and theoretical and practical implications for scaling up SDP organizations are also explicated.
From Roots to Results: A Qualitative Case Study of the Evolution of a Public Health Leadership Institute Building Capacity in Collaborating for Equity and Justice
Authors: Wolf Lesley , Vigna Abra J. , Inzeo Paula Tran , Ceraso Marion , Wolff Tom
Published: September 2019

Policy, systems, and environmental change are now widely accepted as critical to sustaining improvements in community health. Evidence suggests that such systems-level change is most effective when driven by community-based partnerships. Yet, after more than three decades of building community-based partnership work, health inequities have continued to deepen. To address health inequities, current and historical distributions of power are increasingly recognized as important considerations in efforts to ensure all individuals have the opportunity to attain their full health potential (i.e., achieving health equity). Building on social determinants of health literature, social injustice and powerlessness are put forth as fundamental causes of health inequities. Focusing on power as a root cause of health and health equity through application of Wolff and colleagues’ six principles requires substantial changes in contemporary public health practice. This case study uses document analysis of a single case, the Community Teams Program, to assess the evolution of a statewide public health leadership program’s efforts to build the capacity of coalition-based teams to catalyze community change in line with Wolff and colleagues’ principles. Deductive, selective coding of the materials surface four themes in the program adaptations: (1) the need to focus on power as a root cause, (2) shifting power through relationship building, (3) storytelling as a way to shift narrative, and (4) building mechanisms into the curriculum that hold coalitions accountable for applying and sustaining learned skills. The themes demonstrate philosophical, pedagogical, and organizational changes to center power building approaches in health promotion. Findings are triangulated by reflections from the program director and recorded reflections of participants captured in existing evaluation data.
The Washtenaw ID Project: A Government-Issued ID Coalition Working Toward Social, Economic, and Racial Justice and Health Equity
Authors: LeBrón Alana M. W. , Cowan Keta , Lopez William D. , Novak Nicole L. , Ibarra-Frayre Maria , Delva Jorge
Published: September 2019

Introduction. The policing of identities through policies that restrict access to IDs issued by U.S. governmental entities disparately affects communities of color; communities who identify as low-income, immigrant, older, and/or transgender; and community members who experience chronic mental illness, housing instability, or incarceration. Yet government-issued IDs are increasingly needed to access health-promoting resources such as housing, banking, social services, and health care, and in interactions with law enforcement. Methods. Since 2012, the Washtenaw ID Project’s coalition-building process has involved communities affected by restrictive ID policies, advocates, and institutional stakeholders to enact community and systems change regarding inequities in government-issued IDs. We discuss the coalition-building process that culminated in the implementation of a photo ID issued by Washtenaw County government as a policy change strategy. We also highlight the community-academic research partnership evaluating the effectiveness of the Washtenaw ID in order to ensure equity in Washtenaw ID access and acceptance. Results. In 2015, 77% of Washtenaw ID holders reported having no other locally accepted ID. At follow-up, Washtenaw ID holders reported favorable Washtenaw ID acceptance rates in several domains (e.g., health care, school), but not when accessing banking services and housing. Additionally, community discussions suggested racial inequities in carding and ID acceptance. We discuss next steps for policy improvement to ensure equitable impact of the ID. Conclusions. Without national policy reform instating access to government-issued IDs for all, the social movement to establish local IDs may improve access to health-related resources contingent on having an ID. Careful attention must be paid to community organizing processes, policy implementation, and evaluation to ensure equity.
Masi methodology: centring Pacific women’s voices in research
Authors: Naepi Sereana
Published: September 2019

Masi methodology is a Pacific women centred research methodology. Using masi as an anchoring metaphor for research ensures that research centres Pacific women’s voices, understands that Pacific women’s voices are valuable and provides a way to acknowledge that the knowledge Pacific women hold is useful for generations to come. Building on previously articulated Pan-Pacific research methodologies and methods, masi as methodology specifies that the Pacific women be centred within the research process. Masi methodology like other Pacific research methodologies and methods is capable of being both Pan-Pacific and regionally specific dependent on which community the research is being conducted with. In its current form, masi methodology is not a method; however, like other Pacific research methodologies and methods, it is expected that masi methodology will grow as more Pacific researchers use and engage with the masi methodology.
Experimental determination of flame speed and flame stretch using an optically accessible, spark-ignition engine
Authors: Afkhami Behdad , Wang Yanyu , Miers Scott A , Naber Jeffrey D
Published: September 2019

The current research experimentally studied flame speed and stretch under engine in-cylinder conditions. A direct-injection, spark-ignition, and optically accessible engine was utilized to image the flame propagation, and E10 was selected as the fuel. Also, three fuel–air mixtures (stoichiometric, lean, and rich) were examined. The flame front was located by processing high-speed images. This study introduces a novel approach for calculation of equivalent spherical flame radius for analysis of flame speed and stretch. Flame front propagation analysis showed that during the flame propagation period, the stretch decreased until the flame front touched the piston surface. This was a common trend for stoichiometric, lean, and rich mixtures, which occurred because the flame radius was the dominant factor in the stretch calculation. In addition, the rich fuel–air mixture showed a lower flame stretch compared to stoichiometric or lean mixture. This was the result of a lower Markstein number for the rich fuel–air mixture. To study the sensitivity of different fuel–air mixtures to the flame stretch, the trajectory of the flame centroid was tracked until the flame front touched the piston surface. The results showed that the end centroid for the lean mixture deviated from the start point more than those of the rich and stoichiometric mixtures because the lean mixture had a higher flame stretch and lower flame speed. Furthermore, comparing the flame stretch at three different engine speeds revealed that increasing the engine speed increased the flame stretch, especially during the early flame development period. According to previous studies which discussed flame stretch as a flame extinguishment mechanism, the probability of flame extinction is higher when the engine speed is higher. Also, uncertainty analysis was conducted to determine the effect of camera setting on the flame stretch. Results showed that a maximum relative uncertainty of 4.5% occurred during the early flame development.
Developing data fusion and recursive estimation methods for online identification of dive plane dynamics of an autonomous underwater vehicle
Authors: Abtahi Seid Farhad , Alishahi Mohammad Mehdi , Azadi Yazdi Ehsan
Published: September 2019

The purpose of this article is to develop an online method to identify the hydrodynamic coefficients of pitch plane of an autonomous underwater vehicle. To obtain necessary data for the identification, the dive plane dynamics should be excited through diving maneuvers. Hence, a controller is needed whose performance and stability are appropriate. To design such a controller, first, hydrodynamic coefficients are approximated using semi-empirical methods. Based on these approximated coefficients, a classic controller is designed at the next step. Since the estimation of these coefficients is uncertain, µ-analysis is employed to verify the robustness of stability and performance of the controller. Using the verified robust controller, some oscillating maneuvers are carried out that excite the dive plane dynamics. Using sensor fusion and unscented Kalman filter, smooth and high-rate data of depth is provided for the depth controller. A recursive identification algorithm is developed to identify the hydrodynamic coefficients of heave and pitch motions. It turns out that some inputs required by the identification are not measured directly by the sensors. But the devised fusion algorithm is able to provide the necessary data for identification. Finally, using the identified coefficients and employing pole placement method, a new controller with better performance is synthesized online. To evaluate the performance of the identification and fusion algorithms, a 6-degree-of-freedom simulation of an autonomous underwater vehicle is carried out.
A design methodology for acoustic resonance-free, high-frequency, dimmable electronic ballast for high-pressure sodium-vapour lamps
Authors: Gupta Bakshi B , Roy B
Published: September 2019

This paper presents a methodology to design acoustic resonance-free, high-frequency, dimmable electronic ballasts for high-pressure sodium vapour (HPSV) lamps having a range of rated wattage (70–400 W). After estimation of the ‘quiet window’ of an HPSV lamp, the proposed iterative algorithm is able to determine the acoustic resonance-free driving frequencies of a design ballast corresponding to 50%–100% power level. On the other hand, a developed wattage and voltage independent HPSV lamp model facilitates finding the required electrical characteristics of HPSV lamps without performing laboratory experimentation. Using the estimated driving frequencies of a design ballast and the synthesized electrical characteristics of the lamp, the design circuit parameters of an electronic ballast are determined. Performance evaluation of the designed ballasts, carried out on the Matlab–Simulink platform, indicates several important attributes, viz. higher power control accuracy (deviation ≤3.69%), near-unity lamp power factor (≥0.98), lower lamp current crest factor (<1.7) and lower lamp current total harmonic distortion (≤12.63%). Results establish the effectiveness of the proposed design methodology to design lightweight and compact electronic ballasts for HPSV lamps with less effort than conventional design practice.
Extraction and characterization of palm fibers and their use to produce wool- and polyester-blended nonwovens
Authors: Sajid Laila , Azmami Oussama , El ahmadi Zakia , Benayada Abbès , Gmouh Said
Published: September 2019

The aim of this work is the production of new nonwovens materials based on wool, polyester and palm fibers ( Washingtonia). The extraction of palm fibers was achieved by the combination of alkaline and bleaching treatments. Chemical composition, mechanical and physical properties of the extracted fibers were first determined. Then, two types of blended nonwovens based on Palm/Wool (P/W) and Palm/Polyester (P/PES) mixtures were produced using the needling technique. The physical and structural properties of produced nonwovens were studied such as surface density, tensile strength, porosity and thermal properties. The results showed that the porosity lies between 83.81% and 86.93% for (P/W) mixtures and between 78.01% and 86.93% for (P/PES) mixtures. The air permeability was found to be between 61.56 m3.m−2.min−1 and 129.01 m3.m−2.min−1 for P/W blend nonwovens and between 22.75 m3.m−2.min−1 and 129.01 m3.m−2.min−1 for P/PES blend ones. The thermal conductivity varies between 36.45 mW/m.K and 43.88 mW/m.K for P/W nonwovens and between 36.45 mW/m.K and 47.70 mW/m.K for P/PES nonwovens. Moreover, the tensile strength of blended nonwovens is found to be higher than that of non-blended ones.
Efficient and secure attribute-based heterogeneous online/offline signcryption for body sensor networks based on blockchain
Authors: Iqbal Jawaid , Umar Arif Iqbal , Amin Noorul , Waheed Abdul
Published: September 2019

In body sensor networks, both wearable and implantable biosensors are deployed in a patient body to monitor and collect patient health record information. The health record information is then transmitted toward the medical server via a base station for analysis, diagnosis, and treatment by medical experts. Advancement in wireless technology although improves the patient health–monitoring mechanism, but still there are some limitations regarding security, privacy, and efficiency due to open wireless channel and limited resources of body sensor networks. To overcome these limitations, we have proposed an efficient and secure heterogeneous scheme for body sensor networks, in which biosensor nodes use a certificate-less cryptography environment to resolve the key escrow and certificate-management problems, while MS uses a public key infrastructure environment to enhance the scalability of the networks. Furthermore, we design an online/offline signcryption method to overcome the burden on biosensor nodes. We split the signcryption process into two phases: offline phase and online phase. In the offline phase, the major operations are computed without prior knowledge of patient data. While in online phase, the minor operations are computed when patient data are known. Besides, we have used a new hybrid blockchain technology approach for the secure transmission of patient information along with attributes stored in the medical server toward the cloud that provides ease of patient data access remotely from anywhere by the authorized users and data backup in case of medical server failure. Moreover, hybrid blockchain provides advantages of interoperability, transparency traceability, and universal access. The formal security analysis of the proposed scheme is proved in the standard model, and informal security assures that our scheme provides resistance against possible attacks. As compared to other existing schemes, our proposed scheme consumes fewer resources and efficient in terms of processing cost, transmission overhead, and energy consumption.
The prognostic value of hypoxia-inducible factor-1α in advanced cancer survivors: a meta-analysis with trial sequential analysis
Authors: Han Susu , Huang Tao , Hou Fenggang , Yao Liting , Wang Xiyu , Wu Xing
Published: September 2019

Background:

Expression of hypoxia-inducible factors (HIFs) has been observed, but their prognostic role in advanced cancers remains uncertain. We conducted a meta-analysis to establish the prognostic effect of HIFs and to better guide treatment planning for advanced cancers.

Methods:

Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Trial sequential analysis (TSA) was also performed. The clinical outcomes included overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), cancer-specific survival (CSS), relapse/recurrence-free survival (RFS), and metastasis-free survival (MFS) in patients with advanced tumors according to multivariate analysis.

Results:

A total of 31 studies including 3453 cases who received chemotherapy, radiotherapy, or chemoradiotherapy were identified. Pooled analyses revealed that HIF-1α expression was correlated with worse OS (HR = 1.61, p < 0.001), DFS (HR = 1.61, p < 0.001), PFS (HR = 1.49, p = 0.01), CSS (HR = 1.65, p = 0.056), RFS (HR = 2.10, p = 0.015), or MFS (HR = 2.36, p = 0.002) in advanced cancers. HIF-1α expression was linked to shorter OS in the digestive tract, epithelial ovarian, breast, non-small cell lung, and clear cell renal cell carcinomas. Subgroup analysis by study region showed that HIF-1α expression was correlated with poor OS in Europeans and Asians, while an analysis by histologic subtypes found that HIF-1α expression was not associated with OS in squamous cell carcinoma. No relationship was found between HIF-2α expression and OS, DFS, PFS, or CSS.

Conclusions:

Targeting HIF-1α may be a useful therapeutic approach to improve survival for advanced cancer patients. Based on TSA, more randomized controlled trials are strongly suggested.
Studies toward the Total Synthesis of Epothilone D: Synthesis of the Thiazole-Containing Northern Segment
Authors: Suzuki Momoko , Hashimoto Shougo , Sakamoto Shun , Kogen Hiroshi , Kobayashi Kenichi
Published: September 2019

Epothilone D, a microtubule-stabilizing macrolide, is an attractive synthetic target molecule as a potential anti-cancer drug candidate. As part of our ongoing synthetic studies of this natural product, this paper describes the synthesis of the thiazole-containing northern segment of epothilone D via an E-selective bromomethylenation and a Ni/Cr-mediated cross-coupling reaction.
Orotracheal treprostinil administration attenuates bleomycin‐induced lung injury, vascular remodeling, and fibrosis in mice
Authors: Nikitopoulou Ioanna , Manitsopoulos Nikolaos , Kotanidou Anastasia , Tian Xia , Petrovic Aleksandar , Magkou Christina , Ninou Ioanna , Aidinis Vassilis , Schermuly Ralph T. , Kosanovic Djuro , Orfanos Stylianos E.
Published: September 2019

Pulmonary fibrosis is a progressive disease characterized by disruption of lung architecture and deregulation of the pulmonary function. Prostacyclin, a metabolite of arachidonic acid, is a potential disease mediator since it exerts anti‐inflammatory and anti‐fibrotic actions. We investigated the effect of treprostinil, a prostacyclin analogue, in bleomycin‐induced experimental pulmonary fibrosis. Bleomycin sulfate or saline was administrated intratracheally to mice (n = 9–10/group) at day 0. Orotracheal aspiration of treprostinil or vehicle was administered daily and started 24 h prior to bleomycin challenge. Evaluation of lung pathology was performed in tissue samples and bronchoalveolar lavage fluid collected 7, 14 and 21 days after bleomycin exposure. Lung injury was achieved due to bleomycin exposure at all time points as indicated by impaired lung mechanics, pathologic lung architecture (from day 14), and cellular and protein accumulation in the alveolar space accompanied by a minor decrease in lung tissue VE‐cadherin at day 14. Treprostinil preserved lung mechanics, and reduced lung inflammation, fibrosis, and vascular remodeling (day 21); reduced cellularity and protein content of bronchoalveolar lavage fluid were additionally observed with no significant effect on VE‐cadherin expression. Bleomycin‐induced collagen deposition was attenuated by treprostinil from day 14, while treprostinil involvement in regulating inflammatory processes appears mediated by NF‐κB signaling. Overall, prophylactic administration of treprostinil, a stable prostacyclin analogue, maintained lung function, and prevented bleomycin‐induced lung injury, and fibrosis, as well as vascular remodeling, a hallmark of pulmonary hypertension. This suggests potential therapeutic efficacy of treprostinil in pulmonary fibrosis and possibly in pulmonary hypertension related to chronic lung diseases.
Enemies and friends in high-tech places: the development and validation of the Online Social Experiences Measure
Authors: Kent de Grey Robert G , Uchino Bert N , Baucom Brian RW , Smith Timothy W , Holton Avery E , Diener Edward F
Published: September 2019

Background

Interpersonal positivity and negativity are separable dimensions both recognized as having important effects on health. Though online social interactions and research examining them are increasingly common, no validated instrument has heretofore been developed to examine social support and social negativity specifically in online contexts. The present studies describe the development and validation of the Online Social Experiences Measure (OSEM) to allow for assessment of online social positivity and negativity simultaneously.

Methods and results

In Study I, responses to a potential item pool were collected from participants ( N = 557), who were then subdivided into two groups for the purposes of cross-validation via exploratory and confirmatory factor analyses. Results suggested the emergence of two factors: online social support (OSEM+ subscale) and online social negativity (OSEM− subscale). Across Studies I and II ( N = 139), the OSEM showed good convergent and discriminant validity, and both subscales had high internal consistency. Study II included an ambulatory cardiovascular assessment and found the OSEM− subscale to be predictive of elevated diastolic blood pressure and heart rate. The OSEM+ subscale was predictive of more favorable cardiovascular readings for some types of participants (e.g. those with a greater number of online-only social ties).

Conclusions

Overall, results suggest online social positivity and negativity may have implications for physical health, and that the OSEM may be a useful tool in understanding online social processes.
Experiences of Patient Incivility: A Qualitative Study
Authors: Vargas Emily A , Mahalingam Ramaswami
Published: September 2019

Background:

Incivility is one of the most prevalent forms of interpersonal mistreatment. Although studies have examined the full range of experiences of incivility against nurses and other hospital personnel, very few studies examined the forms of incivility that patients face in a hospital.

Objective:

To empirically investigate the range of uncivil experiences targeted against patients. Our study furthers our understanding of the phenomenology of incivility from the patients’ perspective.

Method:

We used interpretative phenomenological analysis to analyze participant’s (n = 173) experiences of incivility in a hospital.

Results:

We identified 6 major themes of incivility, namely Insensitivity, Identity Stigma, Gaslighting, Infantilization, Poor Communication, and Ignored.

Conclusion:

The findings highlight that instances of incivility are present in almost all aspects of the patient experience and take on unique forms, given the patient’s role in the hospital. Implications for health consequences are discussed.
Prognostic impact of platelet-to-lymphocyte ratio on diffuse large B-cell lymphoma: a meta-analysis
Authors: Chen Ying , Zhang Zongxin , Fang Qiu , Jian Huiqin
Published: September 2019

Background

Recently, some studies reported the prognostic value of platelet-to-lymphocyte ratio (PLR) in patients with diffuse large B-cell lymphoma (DLBCL), however, the results varied from different studies. Therefore, we performed a meta-analysis to explore the prognostic value of PLR in DLBCL.

Methods

A comprehensive literature retrieval was conducted by using PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Pooled hazard ratio (HR) and 95% confidence interval (CI) were used to evaluate the association of PLR and overall survival (OS) and progression-free survival (PFS). Odd ratios (ORs) and 95% CIs for clinicopathological characteristics were statistically analyzed.

Results

Eight studies with 1931 patients were included for meta-analysis. The pooled analysis indicated that elevated PLR was significantly associated with poor OS (HR = 1.73, 95% CI 1.29–2.31, p < 0.001), but not PFS (HR = 0.85, 95% CI 0.57–1.27, p = 0.438). Furthermore, elevated PLR was significantly associated with presentation of B symptoms (OR = 2.27, 95% CI 1.29–3.98, p = 0.004), elevated lactate dehydrogenase (LDH) (OR = 2.76, 95% CI 2.05–3.72, p < 0.001), higher tumor stage (OR = 2.22, 95% CI 1.66–2.98, p < 0.001), and Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥ 2 (OR = 1.71, 95% CI 1.09–2.69, p = 0.019). However, elevated PLR was not significantly correlated with gender, age or cell of origin.

Conclusion

This meta-analysis revealed that PLR may be an effective and noninvasive biomarker for poor prognosis and aggressive disease characteristics for patients with DLBCL.
Health care providers’ perceptions regarding antimicrobial stewardship programs (AMS) implementation—facilitators and challenges: a cross-sectional study in the Eastern province of Saudi Arabia
Authors: Baraka Mohamed A. , Alsultan Hassan , Alsalman Taha , Alaithan Hussain , Islam Md. Ashraful , Alasseri Abdulsalam A.
Published: September 2019

Background

Infections result from invasions of an organism into body tissues leading to diseases and complications that might eventually lead to death. Inappropriate use of antimicrobials has led to development of antimicrobial resistance (AMR) which has been associated with increased mortality, morbidity and health costs. Antimicrobial stewardship (AMS) programs are designed to ensure appropriate selections of an effective antimicrobial drugs and optimizing antibiotic use to minimize antibiotic resistance by implementing certain policies, strategies and guidelines. The aim of this study was to investigate practitioners’ perceptions regarding AMS implementation and to identify challenges and facilitators of these programs execution.

Methods

Cross-sectional study among health care providers in Eastern province of Saudi Arabia Hospitals. The data was collected using a survey including questions about demographic data and information about clinicians’ (physicians, pharmacists and nurses) previous experience with AMS and prescribing of antibiotics, the level of knowledge and attitudes regarding AMS programs’ implementation.

Results

More than 50% of clinicians (N = 184) reported lack of awareness of AMS programs and their components, whereas 71.2% do not have previous AMS experience. The majority of clinicians (72.3%) noticed increasing number of AMR infections over the past 5 years and (69.6%) were involved in care of patients with an antibiotic-resistant infection. Around 77.2% of respondents reported that formulary management can be helpful for AMS practice and majority of respondents (79.9%) reported that the availability of pathogens and antimicrobial susceptibility testing can be helpful for AMS. Major barriers to AMS implementation identified were lack of internal policy/guidelines and specialized AMS information resources. Lack of administrative awareness about AMS programs; lack of personnel, time limitation, limited training opportunities, lack of confidence, financial issue or limited funding and lack of specialized AMS information resources were also reported 65.8%, 62.5%, 60.9%, 73.9%, 50%, 54.3 and 74.5%, respectively.

Conclusion

Our study identified comprehensive education and training needs for health care providers about AMS programs. Furthermore, it appears that internal policy and guidelines need revision to ensure that the health care providers work consistently with AMS. Future research must focus on the benefit of implementing AMS as many hospitals are not implementing AMS as revealed by the clinicians. We recommend policy makers and concerned health authorities to consider the study findings into account to optimize AMS implementation.
The development of an herbal material quality control strategy considering the effects of manufacturing processes
Authors: Pan Jingjing , He Siyuan , Zheng Jiayao , Shao Jingyuan , Li Ning , Gong Yunqi , Gong Xingchu
Published: September 2019

Background

Quality by design (QbD) is an advanced drug quality control concept that has been gradually implemented in the optimization of manufacturing processes of Chinese medicines. However, the variation of Chinese medicinal material quality has rarely been considered in published works. Because manufacturing processes may lower the variation introduced through different batches of materials, a material quality control strategy should be developed considering the influences of manufacturing processes.

Methods

In this work, the processes of extraction, concentration, water precipitation, and chromatography for notoginseng total saponin (NTS) production were investigated while considering Panax notoginseng quality variation as a sample. Ten process parameters were studied simultaneously using a definitive screening design. After the process critical quality attributes (CQAs) were determined, critical process parameters (CPPs) and critical material attributes (CMAs) were identified simultaneously. Then, models utilizing the CMAs, CPPs, and process CQAs were developed. The design space was then calculated using a Monte Carlo simulation method with an acceptable probability of 0.90. A material quality control strategy considering the influences of manufacturing processes was proposed.

Results

The ginsenoside Rd purity and total saponin purity in the eluate were identified as process CQAs. The ethanol solution concentration used for extraction, the ethanol solution concentration used for elution, and elution time were identified as CPPs. The extractable dry matter content of Panax notoginseng was one of the CMAs. The extractable contents of notoginsenoside R1, ginsenoside Rg1, ginsenoside Rb1, and ginsenoside Rd were the other CMAs. The inequalities implemented to discriminate the high quality and low quality of Panax notoginseng were developed according to the NTS standard of the Xuesaitong injection. Low quality Panax notoginseng should not be released for NTS production. High quality Panax notoginseng can be treated with feasible manufacturing processing parameters. Verification experiments were carried out successfully for 2 batches of high quality Panax notoginseng.

Conclusions

In this work, a quality control strategy for herbal materials was developed considering the matching of process characteristics and material quality attributes. This strategy is promising for application to other Chinese medicines.