bluuebunny/crossref_metadata_2025 huggingface dataset:
In pursuit of the African PhD: A critical survey of emergent policy issues in select sub-Saharan African nations, Ethiopia, Ghana and South Africa
Authors: Molla Tebeje , Cuthbert Denise
Published: April 2016

After decades of decline, African higher education is now arguably in a new era of revival. With the prevalence of knowledge economy discourse, national governments in Africa and their development partners have increasingly aligned higher education with poverty reduction plans and strategies. Research capacity has become a critical development issue; and widening participation to doctoral education is seen as an instrument for enhancing this capacity. Against this backdrop, this paper presents a review of emerging initiatives and policies that have some bearing on the PhD in select sub-Saharan African nations, namely Ethiopia, Ghana and South Africa. The findings show a shared optimism about the economic value of higher education, and explicate divergences and convergences in the framing of problems and policy responses related to doctoral education across the three nations. In the conclusion we reflect on challenges and policy omissions in the pursuit of the African PhD.
Learning how to do up buttons: Professionalism, teacher identity and bureaucratic subjectivities in early years settings
Authors: Pupala Branislav , Kascak Ondrej , Tesar Marek
Published: April 2016

Early years education in Europe and elsewhere around the world is currently in the spotlight due to political and economical changes and subsequent promises of effective investment into its provision. In this article we analyse everyday preschool practices in Slovakia in terms of tensions between policies, the teachers workforce and the concept of professionalism. Through bureaucratic scientisation, teachers become subjects with bureaucratic subjectivities, and they are expected to devote increasing amounts of time to planning, reporting and administrative tasks. Teachers are decreasingly focused on the actual work on the ground with the children, and are concerned instead with notions of accountability and reporting, which supposedly raises their professional status. Slovakia’s experience of the bureaucratic subjectivities of early years teachers has complex ramifications for European and overseas countries as it problematises and unmasks the global issues of complex tensions between the teachers and policy documents.
EEG in Sarcoidosis Patients Without Neurological Findings
Authors: Bilgin Topçuoğlu Özgür , Kavas Murat , Öztaş Selahattin , Arınç Sibel , Afşar Gülgün , Saraç Sema , Midi İpek
Published: April 2016

Sarcoidosis is a multisystem granulomatous disease affecting nervous system in 5% to 10% of patients. Magnetic resonance imaging (MRI) is accepted as the most sensitive method for detecting neurosarcoidosis. However, the most common findings in MRI are the nonspecific white matter lesions, which may be unrelated to sarcoidosis and can occur because of hypertension, diabetes mellitus, smoking, and other inflammatory or infectious disorders, as well. Autopsy studies report more frequent neurological involvement than the ante mortem studies. The aim of this study is to assess electroencephalography (EEG) in sarcoidosis patients without neurological findings in order to display asymptomatic neurological dysfunction. We performed EEG on 30 sarcoidosis patients without diagnosis of neurosarcoidosis or prior neurological comorbidities. Fourteen patients (46.7%) showed intermittant focal and/or generalized slowings while awake and not mentally activated. Seven (50%) of these 14 patients with EEG slowings had nonspecific white matter changes while the other half showed EEG slowings in the absence of MRI changes. We conclude that EEG slowings, when normal variants (psychomotor variant, temporal theta of elderly, frontal theta waves) are eliminated, may be an indicator of dysfunction in brain activity even in the absence of MRI findings. Hence, EEG may contribute toward detecting asymptomatic neurological dysfunction or probable future neurological involvement in sarcoidosis patients.
Factors Associated With HPV Vaccine Initiation, Vaccine Completion, and Accuracy of Self-Reported Vaccination Status Among 13- to 26-Year-Old Men
Authors: Thomas Rachel , Higgins Lisa , Ding Lili , Widdice Lea E. , Chandler Emmanuel , Kahn Jessica A.
Published: April 2016

Human papillomavirus (HPV) vaccination coverage in young men is suboptimal. The aims of this study were (a) to examine HPV vaccination and factors associated with HPV vaccination in men 13 to 26 years of age and (b) to examine and determine factors associated with accurate self-report of vaccination. Young men ( n = 400) recruited from a teen health center and a sexually transmitted disease (STD) clinic completed a survey. Accuracy was defined as correct report of at least one dose and number of doses. Mean age was 21.5 years, 104 (26.0%) received at least one vaccine dose and 49 (12.3%) received all three doses. Factors significantly associated with receipt of at least one dose in multivariable models included recruitment site (teen health center vs. STD clinic, adjusted odds ratio [AOR] = 2.75), public versus other insurance (AOR = 2.12), and age (AOR = 0.68). Most young men accurately reported their vaccination status but accuracy of report differed by age: 50.6% of 14- to 18-year-olds, 75.9% of 19- to 21-year-olds, and 93.2% of 22- to 26-year-olds. Most (293, 73.3%) accurately reported number of doses received. Age was associated with accuracy of self-report of at least one vaccine dose (AOR = 1.42), while recruitment site (STD vs. teen health center, AOR = 2.56) and age (AOR = 1.44) were associated with accuracy of self-report of number of vaccine doses. In conclusion, HPV initiation and completion in this study sample were low. Teen health center attendance, public insurance, and younger age were associated with vaccine initiation; older age and STD clinic setting were associated with accurate vaccination self-report.
Guidelines for reducing image retakes of general digital radiography
Authors: Lin Chih-Sheng , Chan Po-Chou , Huang Kuang-Hua , Lu Chun-Feng , Chen Yung-Fu , Lin Chen Yun-O
Published: April 2016

Image retake of radiological examinations not only increases the risk of radiation exposure of the patients, but also wastes the medical resource and degrades the quality of services of the hospitals. This study aimed at discovering factors affecting image retake of general digital radiography for setting guidelines to reduce the image retaking rate. A total of 98,503 general X-ray images retrieved from the picture archiving and communication system database of a medical center in central Taiwan were analyzed. The results showed that the total retaking rate was 4.89% with the position error (56.05%) was the main factor causing image retakes and chest examination showed the highest frequency (1544 cases). On the other hand, skull/face exhibited the highest retaking rate (9.81%) among various types of examinations. After discovering the factors affecting the image retaking rate, suitable guidelines were proposed and introduced. The image retake rate had been significantly reduced to 4.38% and 3.57% 1 month and 6 months, respectively, after the introduction of guidelines. In conclusion, image retake analysis is a quality indicator and is effective for quality assurance of digital radiology. Regular analysis of image retake can find factors inducing image retake and is useful for designing guidelines to reduce the image retake rate.
Investigation of hydraulic force of a 1000-MW pressurized water reactor under hypothetical drop accident of core barrel assembly
Authors: Jiang Jin , Zhang Lisheng , Li Yanhui , Fu You
Published: April 2016

In this study, we conducted a simulation investigation of a hypothetical core barrel assembly drop accident based on the dynamic mesh model. The investigation included three separate circumstances: high-temperature dynamic water, high-temperature still water, and low-temperature still water. Results showed that dynamic parameters (e.g. velocity and resultant force) of the drop assembly in high-temperature dynamic water are smaller than those in still water due to the buffer effect of the flowing water. The velocity and hydraulic force in the dynamic water situation increased quickly at first and then remained stable throughout the remainder of the experiment; due to turbulence effect, the hydraulic force fluctuated slightly, first increased, then decreased, and then reached as stable a level in still water as that in dynamic water. The velocity of the drop assembly showed parabolic growth.
Heat transfer capability simulation of high-temperature heat pipe in supersonic vehicle leading edge applications
Authors: Liu Donghuan , Liu Yinghua
Published: April 2016

A numerical method is proposed to determine the heat transfer capability of the high-temperature heat pipe and the stagnation temperature with supersonic vehicle leading edge applications. The finite element method is employed here to perform the temperature field simulation. Without considering the heat transfer limitations of the heat pipe, such as capillary limit and sonic limit, both numerical and experimental results indicate that equivalent high thermal conductivity method is a reasonable way to simulate the heat transfer capability of the high-temperature heat pipe in preliminary design of a heat-pipe-cooled leading edge. Several important parameters’ effects on the thermal protection performance are also numerically investigated.
Effect of gas quantity on two-phase flow characteristics of a mixed-flow pump
Authors: Fu Qiang , Zhang Fan , Zhu Rongsheng , Wang Xiuli
Published: April 2016

The inlet gas quantity has a great influence on the performance and inner flow characteristics of a mixed-flow pump. In this article, both numerical and experimental methods are used to carry out this research work. The effects under the steady gas volume fraction state and the transient gas quantity variation process on the mixed-flow pump are investigated and compared in detail. It could be concluded that the head of the mixed-flow pump shows slight decline at the low gas volume fraction state, while it decreases sharply at the high gas volume fraction state and then decreases with the increasing gas quantity. There is an obvious asymmetric blade vapor density on the blade suction side under each cavitation state. The cavities can be weakened obviously by increasing the inlet gas volume fraction within a certain range. It has little influence on the internal unsteady flow of the mixed-flow pump when the gas volume fraction is less than 10%, but the pump starts to operate with a great unsteady characteristic when the inlet gas volume fraction increases to 15%.
EU Falsified Medicines Directive mandatory requirements for secondary care: A concise review
Authors: Naughton BD , Vadher B , Smith J , Smith G , Chapman SR , Dopson S , Brindley DA
Published: April 2016

Since the publication of the Falsified Medicines Directive in 2011 and the subsequent delegated regulation in February 2016, there has been much discussion surrounding the level of Falsified Medicines Directive compliance required by secondary care institutions. Due to the heterogeneous nature of the secondary care drug distribution cycle, the Falsified Medicines Directive allows certain dispensations for ‘healthcare institutions’, this manuscript reviews the Falsified Medicines Directive and delegated regulation in an effort to understand and explain these dispensations and the true impact of the Falsified Medicines Directive on secondary care in an effort to address common misconceptions amongst stakeholders.
Match demands of professional rugby football codes: A review from 2008 to 2015
Authors: Hogarth Luke W , Burkett Brendan J , McKean Mark R
Published: April 2016

Rugby football codes have continually increased in popularity and are played professionally around the world at domestic, national and international level. Coaching professionals can use the findings of this review to guide training practices for the professional rugby football player, particularly those players who may be competing concurrently or transferring between codes. The development of repeated high-intensity exercise ability should be a key emphasis of training programmes especially for players who are aiming to compete at higher competition standards. Importantly, there are considerable differences in repeated high-intensity exercise demands of match-play for different positional groups. For greatest transference to match performance, training programs should replicate the frequency and duration of repeated high-intensity exercise bouts in addition to the relative contribution of high-intensity running, tackling and physical collisions. Training programmes should not neglect developing players’ prolonged high-intensity running ability as high-speed running efforts may occur separately from repeated high-intensity exercise bouts and likely place considerable demands on rugby football players, particularly in rugby sevens competition. Rugby football players have been shown to experience transient fatigue patterns during match-play where teams may be susceptible to conceding points or sustaining injury. Improved physical conditioning strategies may reduce development of match-fatigue; however, research is yet to investigate the influence of fitness levels and team strategies. A better understanding of these factors and how they interact with match-fatigue will assist with the improvement of training practices for professional rugby football players.
Midwives, medicine and natural births
Authors: Bull Sofia
Published: April 2016

This article examines how the often juxtaposed concepts ‘natural birth’ and ‘medically assisted birth’ figure in Jordemødrene, Barnmorskorna and En unge i minuten: three Scandinavian documentary programmes depicting midwifery and childbirth. Through comparisons between US and UK birthing shows, the study considers the socio-historically specific construction of birthing practices and the figure of the midwife. Non-invasive approaches to labour are celebrated as symbols of an essential ‘women’s culture’ that asserts female agency, but medical technology and pain medication also figure as potential tools for female empowerment, thus rendering the midwife a malleable figurehead for multiple strands of feminism.
‘If this was a human…’
Authors: Mills Brett
Published: April 2016

The television documentary series The Supervet (Channel 4, 2014–) follows the eponymous Noel Fitzpatrick as he carries out experimental surgery on animals seemingly beyond help. This article examines the series in order to explore how this programme depicts animal medicine. Drawing on animal studies approaches, it argues that the programme foregrounds the humans rather than the animals, and, in its focus on surgery, legitimizes humans’ dominance of other species. In doing so, it argues that television’s representational strategies struggle with offering depictions that are not human centred.
Supporting GPs to remain mentally healthy: What works?
Authors: Balme Ellie , Gerada Clare
Published: April 2016

Doctors are some of the most resilient members of society; they have to be, so as to be able to survive not just a long and gruelling training, but also constant exposure to disease, distress and disability. They must be able to bounce back after adversity, and get on with their job. All the evidence is that healthcare professionals, particularly doctors, do tend to ‘tough it out’. Doctors tend to be stoical, denying their vulnerability, slow to ask for help, and working on long after they should have taken sick leave. However, they are not invincible and they can, and do, suffer from the same stresses as the patients they treat. This article will explore the causes of mental ill-health among GPs, the concept of resilience and initiatives that can improve a GP’s ability to survive in turbulent times.
Perceived Closeness to Multiple Social Connections and Attachment Style
Authors: Lee Juwon , Gillath Omri
Published: April 2016

Throughout life people form multiple close connections. These connections play an important role, such as providing social and instrumental support. Despite this, relatively little is known about how and why closeness to multiple others changes over time. To fill this gap, we examined changes in perceived closeness to multiple social connections and used a well-studied relational individual difference—attachment style—to shed light on those changes. Multilevel analysis and different indexes revealed that attachment avoidance was associated with lower mean perceived closeness and greater fluctuations in perceived closeness over time. These associations were moderated by attachment anxiety, such that low levels of avoidance and anxiety (i.e., security) were associated with greater stability of perceived closeness. Our results demonstrate that perceived closeness in one’s social connections tend to change, even over relatively short periods of time, and individual differences such as attachment style are important correlates of these changes.
Three-dimensional printed polymeric system to encapsulate human mesenchymal stem cells differentiated into islet-like insulin-producing aggregates for diabetes treatment
Authors: Sabek Omaima M , Farina Marco , Fraga Daniel W , Afshar Solmaz , Ballerini Andrea , Filgueira Carly S , Thekkedath Usha R , Grattoni Alessandro , Gaber A Osama
Published: April 2016

Diabetes is one of the most prevalent, costly, and debilitating diseases in the world. Pancreas and islet transplants have shown success in re-establishing glucose control and reversing diabetic complications. However, both are limited by donor availability, need for continuous immunosuppression, loss of transplanted tissue due to dispersion, and lack of vascularization. To overcome the limitations of poor islet availability, here, we investigate the potential of bone marrow–derived mesenchymal stem cells differentiated into islet-like insulin-producing aggregates. Islet-like insulin-producing aggregates, characterized by gene expression, are shown to be similar to pancreatic islets and display positive immunostaining for insulin and glucagon. To address the limits of current encapsulation systems, we developed a novel three-dimensional printed, scalable, and potentially refillable polymeric construct (nanogland) to support islet-like insulin-producing aggregates’ survival and function in the host body. In vitro studies showed that encapsulated islet-like insulin-producing aggregates maintained viability and function, producing steady levels of insulin for at least 4 weeks. Nanogland—islet-like insulin-producing aggregate technology here investigated as a proof of concept holds potential as an effective and innovative approach for diabetes cell therapy.
Patient outcome after surgical management of the spinal accessory nerve injury: A long-term follow-up study
Authors: Göransson Harry , Leppänen Olli V , Vastamäki Martti
Published: April 2016

Objectives:

A lesion in the spinal accessory nerve is typically iatrogenic: related to lymph node biopsy or excision. This injury may cause paralysis of the trapezius muscle and thus result in a characteristic group of symptoms and signs, including depression and winging of the scapula, drooped shoulder, reduced shoulder abduction, and pain. The elements evaluated in this long-term follow-up study include range of shoulder motion, pain, patients’ satisfaction, delay of surgery, surgical procedure, occupational status, functional outcome, and other clinical findings.

Methods:

We reviewed the medical records of a consecutive 37 patients (11 men and 26 women) having surgery to correct spinal accessory nerve injury. Neurolysis was the procedure in 24 cases, direct nerve repair for 9 patients, and nerve grafting for 4. Time elapsed between the injury and the surgical operation ranged from 2 to 120 months. The patients were interviewed and clinically examined after an average of 10.2 years postoperatively.

Results:

The mean active range of movement of the shoulder improved at abduction 44° (43%) in neurolysis, 59° (71%) in direct nerve repair, and 30° (22%) in nerve-grafting patients. No or only slight atrophy of the trapezius muscle was observable in 75%, 44%, and 50%, and no or controllable pain was observable in 63%, 56%, and 50%. Restriction of shoulder abduction preceded deterioration of shoulder flexion. Patients’ overall dissatisfaction with the state of their upper extremity was associated with pain, lower strength in shoulder movements, and occupational problems.

Conclusion:

We recommend avoiding unnecessary delay in the exploration of the spinal accessory nerve, if a neural lesion is suspected.
A lateral tarsorrhaphy with forehead hitch to pre-empt and treat burns ectropion with a contextual review of burns ectropion management
Authors: Lymperopoulos Nikolaos S , Jordan Daniel J , Jeevan Ranjeet , Shokrollahi Kayvan
Published: April 2016

[Formula: see text]

Introduction:

Facial burns around the eyes and eyelid ectropion can lead to corneal exposure, irritation, dryness, epiphora, infection or visual loss. We undertook a review of the published articles describing management of eyelid burns as well as methods to treat or prevent ectropion. We describe early experience of a surgical technique that we have found to mitigate ectropion in facial burns with peri-ocular involvement.

Materials and methods:

Two illustrative cases with our surgical technique is described from our experience of three cases. We reviewed the literature using the PubMed and EMBASE databases using the search terms ‘burn’ and ‘ectropion’.

Results:

The literature review produced a total of 17 relevant papers. Treatment options for eyelid burns were varied and were invariably level 4 or 5 evidence. Various techniques were used to treat eyelid burns including the use of a full thickness skin graft with or without concurrent scar contracture release but also use of a local flap reconstruction with or without a tissue expander or release of the underlying muscle. Other techniques included canthoplasty, Z-plasty, forehead flaps, fat transfer, and tarsorrhaphy with full thickness skin grafting. In general, the focus of articles was therapeutic and reconstructive rather than pre-emptive/preventative management.

Procedure:

We describe our early experience of a novel technique for temporary lateral tarsorrhaphy with forehead hitch which protexts the globe and counters the scar- and gravity-related ectropic effects on the lower eyelids.

Discussion:

Facial burns pose a difficult problem to the burn surgeon, especially when the eyelids are affected, both directly or indirectly. The optimal surgical management of eyelid burns remains unclear and the literature base lies mainly in the domain of case series. We review the literature on this subject and tabulate our findings and also describe our contribution to this area with a method of lateral and lower lid elevator that we have found valuable.
An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit
Authors: Isitt Catherine E , McCloskey Kayleigh A , Caballo Alvaro , Sharma Pranev , Williams Andrew , Leon-Villapalos Jorge , Vizcaychipi Marcela P
Published: April 2016

[Formula: see text]

Objectives:

Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors contributing to graft failure.

Methods:

Inclusion criteria were admission to our Burns Intensive Care Unit (BICU) between January 2009 and October 2013 with a major burn. After exclusion for death before hospital discharge or prior skin graft at a different hospital, 35 patients remained and were divided into those with successful autografts (n=16) and those with a failed autograft (n=19). For the purposes of this study, we defined poor autograft viability as requiring at least one additional skin graft to the same site. Logistic regression of variables was performed using SPSS (Version 22.0 IBMTM).

Results:

Age, Sex, %Total Burn Surface Area or Belgian Outcome Burns Injury score did not significantly differ between groups. No differences were found in any surgical factor at logistic regression (graft site, harvest site, infection etc.). When all operations were analysed, the use of colloids was found to be significantly associated with graft failure (p=0.035, CI 95%) and this remained significant when only split thickness skin grafts (STSGs) and debridement operations were included (p=0.034, CI 95%). No differences were found in crystalloid use, intraoperative temperature, pre-operative haemoglobin and blood products or vasopressor use.

Conclusions:

This analysis highlights an independent association between colloids and graft failure which has not been previously documented.
Lasers and ancillary treatments for scar management: personal experience over two decades and contextual review of the literature. Part I: Burn scars
Authors: McGoldrick Rory B , Sawyer Adam , Davis Christopher R , Theodorakopoulou Evgenia , Murison Maxwell
Published: April 2016

[Formula: see text]

[Formula: see text]

[Formula: see text]

The formation of a wide range of excessive scars following various skin injuries is a natural consequence of healing. Scars resulting from surgery or trauma affect approximately 100 million people per annum in the developed world and can have profound physical, aesthetic, psychological and social consequences. Thus, scar treatment is a priority for the plastic surgeon.

We aim to explore new approaches to the management of such scarring. The senior authors current use of laser technology, chemotherapeutic agents, pharmacotherapy and cryosurgery will be reviewed. This is placed in the context of the current literature and evidence base and is illustrated with case studies, starting with burns scars in part I, and focusing on keloid and hypertrophic scars in part II, acne scars in part III and finally pigmented scars in part IV. In Part I we focus on burns scar treatment with fractional ablative 10,600 nm wavelength carbon dioxide (CO2) laser therapy.
Team-Based Hypertension Management to Improve Blood Pressure Control
Authors: Kravetz Jeffrey D. , Walsh Robert F.
Published: April 2016

Objective: Hypertension is the most common condition seen in primary care, occurring in 1 in 3 adults in the United States. The patient-centered medical home provides an opportunity for proactive, team-based care of hypertension. The purpose of this pilot study was to measure the effectiveness of a team-based approach to blood pressure management in a busy, primary care setting. Methods: Using panel management within 2 primary care clinics, a cohort of patients with blood pressures >160/100 mm Hg, was identified. The patients at 1 clinic were contacted by the primary care team and offered multiple interventions aimed at improving blood pressure control; including discussion of medication compliance, medication titration, home blood pressure monitoring, nutritional counseling, and motivational interviewing. The change in blood pressure for these patients at 4 months was compared to a parallel primary care clinic within the same medical center whose patients were treated with usual primary care. Results: A total of 350 and 315 patients were included in the intervention and usual care cohorts, respectively. At 4 months, the decrease of systolic blood pressure in the intervention group was significantly greater than in the usual care group (15.6 vs 9.9 mm Hg; P < .001). Sixty-two percent of patients in the intervention group had lower systolic blood pressures post intervention, compared with 41% of usual care patients ( P < .001). Reduction in diastolic blood pressure occurred in 54% of intervention patients, compared with 37% of usual care patients ( P < .001). Conclusions: Our findings demonstrate the effectiveness of a team-based approach to blood pressure management. This can provide a framework for implementation of team-based care for hypertension in the patient-centered medical home.
Twelve Years in the Life of Airline Websites
Authors: Powell C. Michael
Published: April 2016

Perhaps no innovation in history has affected marketing management as pervasively as has the advent of e-commerce. This revolutionary new channel has required businesses to acquire an entirely new set of skills and approaches to promotion, pricing, and distribution. The necessity for e-commerce website operators to more deeply understand consumer behavior when engaged in e-commerce has become a central and crucial factor in website success or failure. As predicted nearly 20 years ago, travel bookings have moved almost entirely to the World Wide Web (WWW). For the past 12 years, data have been collected concerning traveler’s preferences, concerns, and perceptions of airline websites in particular. This research reviews and comments on the evolution of those sites and consumer perceptions of efficiency, ease of use, and usefulness. The results of this study are intended to guide airlines in their pursuit of customer satisfaction and increased profits.
Pheochromocytoma Masquerading as “Diabetic Ketoacidosis”
Authors: Hedley Jeffrey Stephen , Law Sidney , Phookan Sujoy , Lee Maria Nien-Feng , Ioachimescu Adriana , Levit Rebecca D.
Published: April 2016

Diabetic ketoacidosis is a routinely encountered diagnosis in medicine. Physicians are trained early on to look for precipitants. Most clinicians assess for medication compliance, infection, ischemia, and the like. We present a case of pheochromocytoma presenting as “diabetic ketoacidosis.” The case serves as an example for broadening the differential diagnosis for patients with similar presentations. Additionally, the case helps inform our understanding of the so-called “stress reactions” that are commonly invoked in clinical rationale.
How I treat patients with inherited bleeding disorders who need anticoagulant therapy
Authors: Martin Karlyn , Key Nigel S.
Published: April 2016

Situations that ordinarily necessitate consideration of anticoagulation, such as arterial and venous thrombotic events and prevention of stroke in atrial fibrillation, become challenging in patients with inherited bleeding disorders such as hemophilia A, hemophilia B, and von Willebrand disease. There are no evidence-based guidelines to direct therapy in these patients, and management strategies that incorporate anticoagulation must weigh a treatment that carries a risk of hemorrhage in a patient who is already at heightened risk against the potential consequences of not treating the thrombotic event. In this paper, we review atherothrombotic disease, venous thrombotic disease, and atrial fibrillation in patients with inherited bleeding disorders, and discuss strategies for using anticoagulants in this population using cases to illustrate these considerations.
Fixed point results in $C^{*}$-algebra-valued metric spaces are direct consequences of their standard metric counterparts
Authors: Kadelburg Zoran , Radenović Stojan
Published: April 2016

Very recently, Ma et al. (Fixed Point Theory Appl. 2014:206, 2014) introduced $C^{*}$

C
∗

-algebra-valued metric spaces as a new concept. Also, Ma and Jiang (Fixed Point Theory Appl. 2015:222, 2015), generalizing this concept, introduced $C^{*}$

C
∗

-algebra-valued b-metric spaces. In both frameworks, these and other authors proved some fixed point results. We show in this paper that all these results (as well as many others) can be directly obtained as consequences of their standard metric or b-metric counterparts.
Systemic delivery of IL-27 by an adeno-associated viral vector inhibits T cell-mediated colitis and induces multiple inhibitory pathways in T cells
Authors: Zhu Xiaotong , Liu Zhihao , Liu Jin-Qing , Zhu Jianmin , Zhang Jianchao , Davis Jonathan P , Chu Jianhong , Yu Jianhua , Zhou Jie , Li Ming-Song , Bai Xue-Feng
Published: April 2016

IL-27 is a heterodimeric cytokine that is composed of two subunits, i.e., EBV-induced gene 3 and IL-27p28 (also known as IL-30). Although the role of endogenous IL-27 in the pathogenesis of autoimmune colitis, an experimental model of human inflammatory bowel disease, remains controversial, IL-27 local delivery has been shown to inhibit autoimmune colitis. IL-30 has been shown to inhibit Th1 and Th17 responses and is considered a potential therapeutic for certain autoimmune diseases. In this study, we have compared the therapeutic efficacy of adeno-associated viral vector-delivered IL-27 and IL-30 in a murine model of autoimmune colitis. We found that 1 single administration of adeno-associated viral vector-delivered IL-27, but not adeno-associated viral vector-delivered IL-30, nearly completely inhibited autoimmune colitis. Adeno-associated viral vector-delivered IL-27 administration inhibited Th17 responses and induced T cell expression of IL-10, programmed death ligand 1, and stem cell antigen 1. Intriguingly, adeno-associated viral vector-delivered IL-27 treatment enhanced Th1 responses and inhibited regulatory T cell responses. Experiments involving the adoptive transfer of IL-10-deficient T cells revealed that adeno-associated viral vector-delivered IL-27-induced IL-10 production was insufficient to mediate inhibition of autoimmune colitis, whereas anti-programmed death 1 antibody treatment resulted in the breaking of adeno-associated viral vector-delivered IL-27-induced T cell tolerance. Thus, systemic delivery of IL-27 inhibits Th17 responses and induces multiple inhibitory pathways, including programmed death ligand 1 in T cells, and adeno-associated viral vector-delivered IL-27, but not IL-30, may have a therapeutic potential for the treatment of human inflammatory bowel disease.
Leprosy as a model to understand cancer immunosurveillance and T cell anergy
Authors: Park Andrew J , Rendini Tina , Martiniuk Frank , Levis William R
Published: April 2016

Leprosy is a disease caused by Mycobacterium leprae that presents on a spectrum of both clinical manifestations and T cell response. On one end of this spectrum, tuberculoid leprosy is a well-controlled disease, characterized by a cell-mediated immunity and immunosurveillance. On the opposite end of the spectrum, lepromatous leprosy is characterized by M. leprae proliferation and T cell anergy. Similar to progressive tumor cells, M. leprae escapes immunosurveillance in more severe forms of leprosy. The mechanisms by which M. leprae is able to evade the host immune response involve many, including the alterations of lipid droplets, microRNA, and Schwann cells, and involve the regulation of immune regulators, such as the negative checkpoint regulators CTLA-4, programmed death 1, and V-domain Ig suppressor of T cell activation—important targets in today’s cancer immunotherapies. The means by which tumor cells become able to escape immunosurveillance through negative checkpoint regulators are evidenced by the successes of treatments, such as nivolumab and ipilimumab. Many parallels can be drawn between the immune responses seen in leprosy and cancer. Therefore, the understanding of how M. leprae encourages immune escape during proliferative disease states has potential to add to our understanding of cancer immunotherapy.
Applying Latent Class Analysis to Risk Stratification for Perioperative Mortality in Patients Undergoing Intraabdominal General Surgery
Authors: Kim Minjae , Wall Melanie M. , Li Guohua
Published: April 2016

BACKGROUND:

Perioperative risk stratification is often performed using individual risk factors without consideration of the syndemic of these risk factors. We used latent class analysis (LCA) to identify the classes of comorbidities and risk factors associated with perioperative mortality in patients presenting for intraabdominal general surgery.

METHODS:

The 2005 to 2010 American College of Surgeons National Surgical Quality Improvement Program was used to obtain a cohort of patients undergoing intraabdominal general surgery. Risk factors and comorbidities were entered into LCA models to identify the latent classes, and individuals were assigned to a class based on the highest posterior probability of class membership. Relative risk regression was used to determine the associations between the latent classes and 30-day mortality, with adjustments for procedure.

RESULTS:

A 9-class model was fit using LCA on 466,177 observations. After combining classes with similar adjusted mortality risks, 5 risk classes were obtained. Compared with the class with average mortality risk (class 4), the risk ratios (95% confidence interval) ranged from 0.020 (0.014–0.027) in the lowest risk class (class 1) to 6.75 (6.46–7.02) in the highest risk class. After adjusting for procedure and ASA physical status, the latent classes remained significantly associated with 30-day mortality. The addition of the risk class variable to a model containing ASA physical status and surgical procedure demonstrated a significant increase in the area under the receiver operator characteristic curve (0.892 vs 0.915; P < 0.0001).

CONCLUSIONS:

Latent classes of risk factors and comorbidities in patients undergoing intraabdominal surgery are predictive of 30-day mortality independent of the ASA physical status and improve risk prediction with the ASA physical status.
Aging Changes the Contribution of Spinal and Corticospinal Pathways to Control Balance
Authors: Baudry Stéphane
Published: April 2016

The maintenance of balance in an upright posture involves the modulation of the spinal and descending pathways converging onto the motor neurons that innervate the ankle plantar flexor muscles. The present article examines the hypothesis of an age-associated change in the respective contributions of spinal and corticospinal pathways to adjust the soleus muscle activity when standing.
Cardiovascular Strain of Firefighting and the Risk of Sudden Cardiac Events
Authors: Smith Denise L. , DeBlois Jacob P. , Kales Stefanos N. , Horn Gavin P.
Published: April 2016

Approximately 45% to 50% of line-of-duty deaths in the fire service are caused by sudden cardiac deaths, which most often occur during or shortly after firefighting duties. We present a theoretical model linking the cardiac, vascular, and hematological responses of firefighting to the triggering of sudden cardiac death in susceptible individuals.
Local government partnership working: a space odyssey. Or, journeys through the dilemmas of public and private sector boundary-spanning actors
Authors: Nicholson John , Orr Kevin
Published: April 2016

In this article we explore the dilemmas experienced by boundary-spanning actors working at the intersection of local government and the private sector. We suggest that these dilemmas are entwined with the disruption, transformation and reproduction of local government traditions. We utilise structuration theory to understand how agency is both constrained and enabled by traditions and how such agency in turn affects traditions. In drawing on the accounts of both public and private sector actors in one English region over a 10-year period, we decentre the public sector and reveal the flux inherent in working across different traditions of practice.
Participatory policy making under authoritarianism: the pathways of local budgetary reform in the People’s Republic of China
Authors: Xiaojun Yan , Ge Xin
Published: April 2016

Citizen participation in policy making is essential in democracies, but there is much less understanding of the process and substance of it in non-democratic states. Taking local budgetary process as an example, this article compares three pathways of participatory reform undertaken by the communist regime in China, namely the representative pathway, the consultative pathway and the transparency pathway. All three are initiated and administered by the local governments, but differ in a number of crucial aspects from the level of institutionalisation to the form of state–citizenry interaction. These three pathways provide directions the Party-state might consider for nationwide policy reform.
Crime mapping and Geographical Information Systems in crime analysis
Authors: Argun Uğur , Dağlar Murat
Published: April 2016

As essential apparatus in crime analysis, crime mapping and Geographical Information Systems (GIS) are being progressively more accepted by police agencies. Development in technology and the accessibility of geographic data sources make it feasible for police departments to use GIS and crime mapping. GIS and crime mapping can be utilized as devices to discover reasons contributing to crime, and hence let law enforcement agencies proactively take action against the crime problems before they become challenging. The purpose of this study is to conduct a literature review of Geographical Information System and Crime Mapping in Crime Analysis and to propose policy recommendations regarding to implementation of crime mapping and GIS. To achieve this purpose, first a historical evaluation of GIS and crime mapping will be rendered and then the importance of place will be explained in terms of assessing crime problems accurately.
Child marriages in Turkey with different aspects
Authors: Gök Maide
Published: April 2016

Child marriages are one of the most improtant reasons of gender inequality in the family in Turkey, as well as a widespread social problem we face is seen all over the world. This situation increases the need for child marriages to be viewed from a different dimension to the phenomenon and to reveal all aspects of this problem. The issue of child marriages are being addressed in the literature in recent years has been the subject of research in different disciplines, but most of the work is focused on a single dimension of child marriage or depending on the specific area it seems they are trying to identify child marriage. In current study, although carried to contribute to the debate on the concept of child marriage, legal issues, medical, economic, social and political dimensions are presented with an integrated approach. In present study, it has been found that child marriages are an important result of observed gender inequalities in social, political, and economic life and child marriages have been found to cause to continue the gender inequality on women’s lives. However, the cultural codes, values and inequalities, the deterioration of the family structure, social movements, and migration are seen to have an impact on child marriages. In this study, many suggestions are offered to solve the problem of child marriages such as ensuring gender equality in childhood, abandoning conditioning on gender roles, and increasing education level and the law enforcement.
Diversity and distribution of Pteridophytes from Satara District, Maharashtra (India)
Authors: Patil Sachin , Lavate Rajendra , Rawat Vineet , Dongare Meena
Published: April 2016

The diversity and distribution along different ecological gradients of eighty six species of pteridophytes from the Satara district were studied. Amongst these species most common species were viz., Adiantum philippense, Aleuritopteris bicolor, Azolla pinnata subdp. asiatica, Marsilea minuta, Pityrogramma calomelanos, Pteridum revolutum, Pteris vittata, Selaginella ciliris and Tectaria coadunata.
A Novel Apparatus for Obtaining In Situ Estimates of Anisotropism Hydraulic Conductivity in Fractured Rocks
Authors: Zhou Zhifang , Zhao Yanrong , Wang Jinguo , Zheng Hu
Published: April 2016

The transmissivity of fractured rocks is the essential data of groundwater resource assessment, groundwater pollution prediction, and the seepage controlling underground project in the consolidated rock regions. However, most of the current experimental methods only provide the macroscopic hydraulic conductivity and the cost is very high. In this paper, a new apparatus is developed to detect the anisotropy of hydraulic conductivity in fractured rocks, which is called the Fractured Rocks Slug Testing (FRST) system. The FRST system consists of image orientation recognition equipment, the slug testing equipment, and a computer and data-acquisition console. The inside view of the testing well/borehole can be obtained by the imaging equipment. The occurrence of the fractures can be detected by the electronic compass. The other parameters like the water level displacement and pressure can also be collected during testing. Moreover, an example test was conducted in the fractured consolidated rock region to verify the effectiveness of the FRST apparatus.
Exploring Compaction Methods for Laboratory Performance of Full Depth Reclamation
Authors: Smith S. , Henrichs C. , Braham A.
Published: April 2016

Full depth reclamation (FDR) is a pavement recycling technique that incorporates the entire pavement section to create a rehabilitated, stabilized pavement layer. This method is cost effective, environmentally friendly, and structurally viable. Unfortunately, there is some uncertainty regarding how this composite material is classified. In this study, the material characterization of FDR was explored by comparing the effect of different compaction methods on the optimum moisture content, optimum amount of foamed asphalt or asphalt emulsion, the tensile strength, and the stability of the mixture. The superpave gyratory compactor (SGC) is typically used for the compaction of HMA samples, and the Proctor hammer is the most common method of compaction for soil samples. In addition to comparing these two methods, different sized compaction molds and varying amounts of compactive effort were considered. Samples compacted with the modified Proctor hammer produced the highest dry unit weights. Although samples compacted in the SGC had higher tensile strengths. At optimum mixture proportions, moisture conditioned samples compacted with the modified proctor hammer did not reach the minimum tensile strength requirements.
Applications of Ground-Penetrating Radar (GPR) to Detect Hidden Beam Positions
Authors: Kilic Gokhan
Published: April 2016

Ground-penetrating radar (GPR) uses electromagnetic waves to investigate the structures. In this investigation method, an electromagnetic wave is transmitted using an antenna and the received signal is recorded. Detection of beam positions in this GPR data requires the skills of a trained human operator. This study utilized a multi-layer neural network to detect beam positions in the GPR data. The visual description and definition of GPR data has major disadvantages and a neural network has been studied to overcome these shortcomings. A set of 32,740 training vectors with a length of 64 data was implemented to train the neural network. A new set of 16,370 testing vectors with a length of 64 data was then prepared to test the performance. Testing results suggest that the neural network is promising methods for the detection of beam positions in the GPR data.
Development of Standard Fatigue Vehicle Force Models Based on Actual Traffic Data by Weigh-In-Motion System
Authors: Tian H. , Chang W. , Li F.
Published: April 2016

Fatigue damage caused by vehicle-induced forces is a critical factor that affects the safety and the longevity of steel box girder bridges. Accurate vehicle force models are essential for quantifying fatigue in the design and the evaluation of bridge structures. Vehicle forces are random and exhibit significant variations, so to accurately determine a statistical distribution, a large amount of information and measurements is required. In this study, vehicle traffic information gathered by a weigh-in-motion (WIM) system at the Xihoumen Bridge, an over-water suspension bridge in Zhoushan, China, was analyzed for data such as the vehicle type, the gross weight, the axle weight (force), and the wheelbase. New insights into the analysis of measured vehicle information to obtain vehicle fatigue forces required for numerical simulations were gained. In addition, methods to determine various important vehicle parameters such as gross and axle weights and wheelbase were described. These techniques can be used to determine vehicle-induced fatigue forces for bridge structures.