bluuebunny/crossref_metadata_2025 huggingface dataset:
Dysautonomy in different death risk groups (Rassi score) in patients with Chagas heart disease
Authors: Merejo Peña Catherine Masiel , Reis Michel Silva , Pereira Basílio de Bragança , Nascimento Emília Matos do , Pedrosa Roberto Coury
Published: January 2018

Background

It has been difficult to prove that “catecholamine‐induced cardiomyopathy” contributes to the mechanism of sudden cardiac death in Chagas heart disease. Also, it is almost impossible to rule out the possibility that it is not involved in the process. More importantly, the vagal‐cholinergic pathway in the ventricle plays a direct role in the prevention of the initiation of complex ventricular arrhythmias, including nonsustained ventricular tachycardia, ventricular fibrillation responsible for sudden death.

Objective

To determine frequency of parasympathetic autonomic indices among the different groups of risk of cardiovascular death when stratified by Rassi score.

Methods

Patients with Chagas heart disease were selected and divided into three risk groups by Rassi score. A fourth group, non‐Chagas group, was of similar age and gender. All were subjected to analysis of heart rate variability during controlled breathing (RSA) and tilt table passive test (tilt test). High frequency and low frequency/high frequency ratio were calculated and presented by box‐plot. Also, t‐test was used to compare the two groups.

Results

It was observed that the parasympathetic and sympathetic component were affected, when the risk group increased the response was worsened to the stimulus (RSA or Tilt). Also, the low‐risk group was jeopardized, when compared to the non‐Chagas group.

Conclusion

The loss of parasympathetic modulation was present in all Rassi risk groups, including the low risk, indicating that a morphological change of the myocardium represents a detectable neurofunctional change.
Effect of remote ischemic preconditioning on left atrial remodeling and prothrombotic response after radiofrequency catheter ablation for atrial fibrillation
Authors: Han Ruijuan , Liu Xiaoqing , Zheng Meili , Zhao RuiPing , Liu XiaoYan , Yin Xiandong , Liu Xingpeng , Tian Ying , Shi Liang , Sun Kai , Yang Xinchun
Published: January 2018

Background

Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) is known to induce left atrial remodeling and prothrombotic response.

Aims

This study aimed to evaluate the effect of remote ischemic preconditioning (RIPC) on left atrial remodeling and prothrombotic response induced by RFCA of AF.

Methods

Forty‐four patients with drug‐refractory paroxysmal AF undergoing RFCA were randomized into RIPC (four short episodes of forearm ischemia) and control groups before the procedure. Blood samples were collected before RIPC/sham RIPC, and 24 and 72 hours later after the procedure. The atrial remodeling marker matrix metalloproteinase‐9 (MMP‐9) and endothelial damage marker von Willebrand factor (vWF) were measured using enzyme‐linked immunosorbent assay. Platelet activation was evaluated by flow cytometric measurements of the expression of platelet P‐selectin (CD62P) and active glycoprotein IIb/IIIa receptor (PAC‐1). The early recurrence of atrial fibrillation (ERAF) in the two groups was observed over the subsequent 3 months.

Results

RFCA resulted in a significant increase in MMP‐9 and vWF in both the groups, which persisted for 72 hours. However, the expression of CD62P and PAC‐1 showed less increase during RFCA in either group. The RIPC group showed a lower increase in MMP‐9 and vWF compared with the control group. In contrast, no significant differences were found in the trend of expression of CD62P and PAC‐1 during RFCA between the two groups. The AF recurrence in the 3 months after the ablation was significantly lower in the RIPC group than in the control group.

Conclusions

RIPC before RFCA for paroxysmal AF significantly reduces the increase in markers of left atrial remodeling and endothelial damage associated with the procedure, and results in a lower ERAF.
Long‐term outcomes following cryoablation of atrioventricular nodal reentrant tachycardia in children
Authors: Karacan Mehmet , Çelik Nida , Akdeniz Celal , Tuzcu Volkan
Published: January 2018

Background

Atrioventricular nodal reentrant tachycardia (AVNRT) is a common tachyarrhythmia substrate in children, which is successfully treated by catheter ablation using radiofrequency or cryothermal energy. In recent years, cryoablation (Cryo) using electroanatomical system guidance is more commonly preferred for use in children in order to decrease the risk of an atrioventricular block. However, there are concerns regarding the long‐term efficacy of Cryo in treating AVNRT. We aimed to evaluate the feasibility, safety, and long‐term efficacy of Cryo for AVNRT in children.

Methods and results

A total of 275 consecutive children above 4 years of age diagnosed with AVNRT were included in our study. The EnSite system (St. Jude Medical, Inc., St. Paul, MN, USA) was used to reduce or eliminate fluoroscopy. The study included 275 patients (148 females, age: 11.9 ± 3.6 years) undergoing catheter ablation for AVNRT from July 2012 to September 2016. Acute success was obtained in all (100%) patients with a mean procedure time of 140 ± 44 minutes. Fluoroscopy was used in only 12 (4.4%) patients. During a follow‐up time of 25.6 ± 13.5 months (median: 23 months), AVNRT recurred in 12 of 279 (4.4%) of the patients. Age, sex, number of Cryo lesions, and catheter tip size (6‐mm vs 8‐mm) were not predictive for recurrence. In nine patients, a repeat ablation was successfully performed with cryoenergy.

Conclusions

Cryo for AVNRT is a safe and effective procedure with excellent long‐term outcomes. The use of electroanatomical systems during ablation significantly decreases exposure to fluoroscopy without compromising success.
The prevalence of depressive symptoms among Arab adolescents: Findings from Jordan
Authors: Dardas Latefa Ali , Silva Susan G. , Smoski Moria J. , Noonan Devon , Simmons Leigh Ann
Published: January 2018

Background

The lack of research regarding the current profile of adolescent depression in the Arab countries in general, and Jordan in particular, makes it difficult to design, implement, and disseminate effective interventions to improve the prevention, diagnosis, and treatment of adolescent depression in the region. The purpose of this study was to estimate a national prevalence of depressive symptoms among adolescents in Jordan, and to identify characteristics associated with severity of depression.

Methods

A descriptive, cross‐sectional, nationally representative school survey was utilized. A total of 2,349 Jordanian adolescents aged 12–17 completed and returned the survey packets, which included the Beck Depression Inventory‐II and measures of sociodemographics and health history. Participants represented all three regions in the country, with 34% from the northern (suburban) region, 43% from the central (urban) region, and 23% from the southern (rural) region.

Results

The majority of the adolescents were females (59%) and 15–17 years old (67%). Almost 14% reported having at least one chronic health problem, 15% reported having a mental health problem, 25% reported having academic difficulties, 8% reported that they had received a psychiatric diagnosis, and 22% reported that they had sought psychological help at some point in the past. The mean total depression score was 16.3 (SD = 11.2, 95% CI = 15.8–16.7), with 34% of the sample reporting moderate to severe depression. Depression was significantly higher among respondents who were female, ages 14–15 years, and living in families with low monthly incomes; and who reported having a chronic health problem, mental health problem, learning difficulty, a psychiatric diagnosis and/or seeking previous psychological help.

Conclusions

Our findings should serve as an alarm, particularly given that rates of depression in the Arab countries are expected to increase rapidly in the context of the Arab Spring. Healthcare providers, researchers, and educators should focus attention on developing effective and culturally appropriate screening, prevention, and intervention approaches using evidence‐based guidelines to promote Jordanian adolescent mental health, particularly for depression.
Infection cycle ofAlternaria brassicicolaonBrassica oleracealeaves under growth room conditions
Authors: Macioszek V. K. , Lawrence C. B. , Kononowicz A. K.
Published: January 2018

Development of the necrotrophic fungusAlternaria brassicicolawas evaluated during infection of three cabbage varieties:Brassica oleraceavar. capitataf.alba‘Stone Head’ (white cabbage),B. oleraceavar. capitataf. rubra‘Langedijker Dauer’ (red cabbage) andB. oleraceavar. capitataf. sabauda‘Langedijker Dauerwirsing’ (Savoy cabbage). Following inoculation of cabbage leaves, conidial germination, germ tube growth, and appressorium formation were analysed during the first 24 h of infection. Differences in the dynamics of fungal development on leaves were observed, e.g. approximately 40% of conidia germinated on Savoy cabbage leaves at 4 h post‐inoculation (hpi) while only 20% germinated on red and white cabbage leaves. Leaf penetration on the three cabbage varieties mainly occurred through appressoria, rarely through stomata. Formation of infection cushions was found exclusively on red cabbage. Appressoria were first observed on red cabbage leaves at 6 hpi, and on white and Savoy cabbage leaves at 8 hpi. Conidiogenesis occurred directly from mature conidia at an early stage of fungal development (10 hpi), but later (48 hpi) it occurred through conidiophores. Disease progress and changes in the morphology of leaf surfaces were also observed. At the final 120 hpi measurement point, necroses on all investigated varieties were approximately the same size. Based on detailed light and electron microscopic analyses, an outline of theA. brassicicolainfection cycle onB. oleracealeaves under growth room conditions has been proposed. According to the authors’ knowledge, this report represents the most detailed up‐to‐date description of infection ofB. oleraceavarieties byA. brassicicola.
End‐stage renal disease treatment options education: What matters most to patients and families
Authors: St. Clair Russell Jennifer , Boulware L. Ebony
Published: January 2018

Treatment modality education can offer many important benefits to patients and their families. Evidence suggests such education can increase use of home dialysis, reduce catheter use, decrease 90‐day mortality, and increase transplantation. While these benefits are encouraging, not all patients are offered options education and when they are, it may not be presented in a way that is immediately applicable to them and their lives. Furthermore, little is known regarding specific characteristics (e.g. format such as group or individual or in‐person or online, duration, teaching methods, location, content) of educational programs that are most successful. No single approach has emerged as a best practice. In the absence of such evidence, adult learning principles, such as involving patients and families in the development programs and materials, can serve as a guide for educational development. Adult learning principles can enhance options education, evolving them from information delivery to a person‐centered, values‐based endeavor that helps match treatment to values and lifestyle.
Understanding successful and unsuccessful landings of aerial maneuver variations in professional surfing
Authors: Forsyth J. R. , Riddiford‐Harland D. L. , Whitting J. W. , Sheppard J. M. , Steele J. R.
Published: January 2018

Although performing aerial maneuvers can increase wave score and winning potential in competitive surfing, the critical features underlying successful aerial performance have not been systematically investigated. This study aimed to analyze highly skilled aerial maneuver performance and to identify the critical features associated with successful or unsuccessful landing. Using video recordings of the World Surf League's Championship Tour, every aerial performed during the quarterfinal, semifinal, and final heats from the 11 events in the 2015 season was viewed. From this, 121 aerials were identified with the Frontside Air (n = 15) and Frontside Air Reverse (n = 67) being selected to be qualitatively assessed. Using chi‐squared analyses, a series of key critical features, including landing over the center of the surfboard (FS Air χ2 = 14.00, FS Air Reverse χ2 = 26.61; P < .001) and landing with the lead ankle in dorsiflexion (FS Air χ2 = 3.90, FS Air Reverse χ2 = 13.64; P < .05), were found to be associated with successful landings. These critical features help surfers land in a stable position, while maintaining contact with the surfboard. The results of this study provide coaches with evidence to adjust the technique of their athletes to improve their winning potential.
Culture change and mandating quality improvement
Authors: Bartlett Thomas , Hewertson Edward , Vassallo Michael
Published: January 2018

Background

A mandatory programme of quality improvement (QI) education was developed for newly qualified Foundation Year 1 (FY1) doctors to complete their curriculum requirements. Their perceptions were evaluated to refine the programme.

Methods

The programme delivered theoretical and experiential learning. Participants were asked to form groups and to come up with their own projects addressing the areas of need that they had identified. The 9‐month group project included formal teaching and a formal presentation to the hospital. There was access to facilitation and teaching throughout. Self‐rating questionnaires were used to measure the effects of the programme on knowledge and motivation. In a quasi‐experimental design, data were compared before and after the programme, and comparison data were collected from the FY1 of the previous year.

Results

Across the domains of knowledge, attitudes and motivations, there were no significant differences between the pre‐intervention group and the comparison group. Pre‐ and post‐intervention [mean (SD) median] there was a significant increase in overall QI knowledge [2.1 (0.76) 2.0 versus 3.2 (0.62) 3.0; p = 0.000]; however, by the end the FY1s were less motivated to complete the projects [3.9 (0.54) 4.0 versus 3.4 (0.91) 4.0; p = 0.02] and were less positive about them [2.3 (0.69) 2.0 versus 3.0 (0.77) 3.0; p = 0.005]. They felt that the projects were less important for their professional development [3.89 (0.66) 4.0 versus 3.1 (0.73) 3.0; p = 0.000] and were less likely to generate positive change in the long term [2.72 (0.61) 3.0 versus 3.4 (0.92) 3.5; p = 0.007].

Doctors perceptions [of QI] were evaluated to refine a mandatory programme

Discussion

Despite delivering a successful theoretical and experiential QI teaching programme with more trainee involvement, the results suggest that mandatory participation for the completion of training risks losing the innovative and creative force of junior doctors and, for some, reducing it to a tick‐box exercise.
Regional cerebral tissue oxygen saturation changes following blood transfusion in neuro‐intensive care unit patients – a pilot observational study
Authors: Muthuchellappan R. , Shaikh N. A. , Surve R. M. , Ganne U. R. S. , Philip M.
Published: January 2018

Background

Although central venous oxygen saturation (ScvO2) is used to decide on red blood cell (RBC) transfusion, whether its improvement is associated with parallel improvement in cerebral oxygenation is not adequately studied. This study looked at changes in regional cerebral tissue oxygen saturation (rSO2) following RBC transfusion in neuro‐intensive care unit (ICU) patients.

Methods

In this prospective observational pilot study, rSO2 was measured in adult neuro‐ICU patients before RBC transfusion, at the end and at 6, 12, 18 and 24 h after RBC transfusion. rSO2 measurements were taken using cerebral oximetry on both sides of the hemicraniums. Haemoglobin, central venous pressure, ScvO2 and temperature were recorded during the study period. Arterial oxygen content, central venous oxygen content and cerebral fractional oxygen extraction were calculated. Mann Whitney U test was used to study the changes in variables at baseline and at 24 h following RBC transfusion. Friedman's test was used to study changes in parameters from baseline to 24 h post‐transfusion. A P value of <0·05 was considered to be significant.

Results

The data from 13 subjects were analysed. rSO2 increased significantly following RBC transfusion on both sides of the brain (P = 0·002, P = 0·007), with a corresponding decrease in cerebral fractional oxygen extraction (P = 0·001, P = 0·007).

Conclusions

RBC transfusion increased rSO2 significantly on both sides of the brain. As patients' outcomes were not studied, whether this increase in regional cerebral oxygen saturation is beneficial or if it is because of excess DO2 is still unclear. Further studies are required to clarify this issue.
Exposure to the new wave of offshoring: An unemployment perspective
Authors: Zhang Rui
Published: January 2018

This paper examines the impact of increasing service offshoring in a two‐sector economy. We find that it leads to lower domestic unemployment if the marginal task‐specific offshoring cost in the service sector is sufficiently large. Under this condition, the jobs created due to enhanced productivity outweigh the jobs that are destroyed. The reduction in unemployment increases the cost of hiring domestic workers, thus encouraging firms in the manufacturing sector to increase their offshoring scale and productivity. This, in turn, increases their cost savings and may lead to a further decrease in unemployment. Hence, complementarity between two sectors’ offshoring activities may emerge. We calibrate the model using economic parameters from Belgium, and the calibration results predict varied unemployment trends and impacts on manufacturing‐sector offshoring activities with different task‐specific offshoring cost schedules.
The Analysis of Fuel Consumption and Exhaust Emissions From Forklifts Fueled by Diesel Fuel and Liquefied Petroleum Gas (LPG) Obtained Under Real Driving Conditions
Authors: Fuc Pawel , Lijewski Piotr , Kurczewski Przemyslaw , Ziolkowski Andrzej , Dobrzynski Michal
Published: January 2018

The paper presents an analysis of gaseous exhaust emissions and fuel consumption obtained from two forklifts based on the measurements performed under actual driving conditions. The first of the investigated objects was fitted with a diesel engine and the second with a spark ignition engine fueled with LPG. In order to carry out the research, the authors developed a proprietary methodology because the VDI 2198 test procedure (developed by VDI - Association of German Engineers) for the determination of forklift energy consumption, did not fully reflect the actual conditions of operation of these vehicles. The VDI procedure only determines the energy consumption according to predetermined sequences (collecting load, load transport, load-dropping) performed only in indoor areas. The authors developed a test route composed of similar sequences i.e. collecting load, load transport, load-dropping and driving without a load. The measurements were carried out in a warehouse and outdoors, which better reflected the actual forklift driving conditions. During the trials, the exhaust emissions were measured (Semtech - Portable Emission Measurement System) along with the driving parameters such as speed, acceleration and distance covered. Based on the obtained parameters, on-road exhaust emissions and fuel consumption were obtained. The obtained data allowed a comparison of the measurement conditions and the type of fuel used for the forklifts. Both tested vehicles were loaded with identical type of load of the same weight.
Hexafly-INT Experimental Flight Test Vehicle (EFTV) Aero-Thermal Design
Authors: Scigliano Roberto , Pezzella Giuseppe , Di Benedetto Sara , Marini Marco , Steelant Johan
Published: January 2018

Over the last years, innovative concepts of civil high-speed transportation vehicles were proposed. In this framework, the Hexafly-INT project intends to test in free-flight conditions an innovative gliding vehicle with several breakthrough technologies on-board. This approach will help to gradually increase the readiness level of a consistent number of technologies suitable for hypervelocity flying systems. The vehicle design, manufacturing, assembly and verification is the main driver and challenge in this project. The prime objectives of this free-flying high-speed cruise vehicle shall aim at a conceptual design demonstrating a high aerodynamic efficiency in combination with high internal volume; controlled level flight at a cruise Mach number of 7 to 8;an optimal use of advanced high-temperature materials and structures. Present research describes the aero-thermal design process of the Experimental Flight Test Vehicle, namely EFTV. The glider aeroshape design makes maximum use of databases, expertise, technologies and materials elaborated in previously European community co-funded projects LAPCAT I & II [1][2], ATLLAS I & II [3][4] and HEXAFLY [5]. The paper presents results for both CFD and Finite Element aero-thermal analysis, performed in the most critical phase of the experimental flight leading to the selection of materials for the different components and to a suitable Thermal Protection System.
Two-Stage Precession Type Gear: Design, Geometric and Kinematic Analysis
Authors: Macyszyn Łukasz , Myszkowski Adam , Staniek Roman , Pabiszczak Stanisław
Published: January 2018

The paper presents the theoretical bases, design and the principle of operation of two-stage precession type transmission with face meshing. Description and the principle of forming the face meshing which is modified by the original method have been shown as well. Dimensional relations between particular components of the gears are established and the analysis of optimal gear ratio, depending on the number of teeth or magnets on the circumferences of meshing gear wheels is also provided in the paper.

For further analysis four prototypes of mechanical precession transmission with face meshing were designed, built and investigated. Those prototypes present different sizes, reduction ratio and precession angle. Investigations, described in the paper, helped to determine the gear efficiency rate as well as the maximal torque that could be transferred for the given rotary speed.

This paper presents also the conception of the design of a novel double stage precession magnetic gear with face neodymium magnets. The results of the initial studies are the background of the further research in the field of magnetic precession type transmission.
The Virtual Cam Method Application and Verification on Locating Key Instant Centers of Ten-Bar 1-DOF Indeterminate Linkages
Authors: Liu Zhengqi , Chang Yin-ping
Published: January 2018

Planar ten-bar single degree of freedom linkages have 230 valid isomers, 53 of them are kinematically indeterminate, i.e. their complete sets of instant centers cannot be obtained simply from Kennedy Theorem. This paper investigates a graphical approach, i.e. virtual cam method, to help locate the key instant centers of these kinematically indeterminate linkages, after that all the instant centers can be located by Kennedy Theorem accordingly. The criteria of application are proposed and examined carefully, the results are verified against traditional Kennedy Theorem approach and CAD modeling.
Influence of Process Parameters on Electrochemical Micromachining of Nimonic 75 Alloy
Authors: Pillai Hariharan Perianna , Chinnakulanthai Sampath Shamli , Elumalai Rajkeerthi , Hariharan Shruthilaya , Natarajan Yuvaraj
Published: January 2018

Electrochemical micromachining process is one among the successful micromachining technique, which uses the electrochemical energy and is recognized for machining difficult-to-cut materials. One such material is Nimonic 75 alloy, which is used to make gas turbine components. In this study, an effort has been made to machine micro-hole profiles in Nimonic 75 with a thickness of 500 μm using two different electrolytes. A combination of sodium bromide, hydrofluoric acid and ethylene glycol has been chosen as the first electrolyte, while the second is a combination of sodium chloride and sodium nitrate. Solid tungsten carbide of diameter 500 μm is used as the tool in each case. For layout of experiments, Taguchi orthogonal array was chosen with following input parameters namely voltage, micro-tool feed rate and duty cycle. Performance characteristics such as material removal rate, overcut and conicity have been assessed for each electrolyte. Experimental results have shown that the first electrolyte yields lower values of overcut (OC) and conicity, whereas the second electrolyte gives higher material removal rate (MRR). Further, the optimal combinations of process parameters have been found by implementing the TOPSIS procedure and the results were found to be in good agreement with the experimental outcomes.
Analysis and Design of a Low Reynolds Propeller for Optimal Unmanned Aerial Vehicle (UAV) Flight
Authors: Mushynski Alan T. , Johnson T. J.
Published: January 2018

This paper presents a method for optimization of an airfoil and propeller for a small scale Unmanned Aerial Vehicle (UAV) operating in a low Reynolds number state. Operation at a low Reynolds number, generally less than 300,000, lowers the efficiency of the propeller due to greater drag forces on the airfoil. Most hovering-type small scale UAVs generate lift solely with the thrust created by the propellers, and their overall flight characteristics and performance are heavily influenced by propeller and motor efficiency. The method described in this paper generates and optimizes airfoils using the Class/Shape Function Transformation Technique (CST) for the airfoil geometry and a hybrid pattern and particle swarm optimizer to drive Xfoil as a panel method solver for lift and drag coefficients. It then uses a modified Blade Element Momentum Theory equation with a function minimum optimization to determine the propeller characteristics that provide the best figure of merit (FOM) for a hovering and rising thrust state from the optimized airfoils. The propellers are then modeled and analyzed using Computational Fluid Dynamics (CFD) to compare against the thrust and torque values obtained from the optimization program. The results from the CFD analysis indicate an increase of 18 percent in efficiency when compared to a similar stock propeller. Similar increases in efficiency results were obtained when the optimized propeller was manufactured and tested on a thrust stand against the stock propeller.
Experimental Analysis for the Anisotropic Flows in Cancellous Bone
Authors: Ito Makoto , Tupin Simon , Anzai Hitomi , Suzuki Anna , Ohta Makoto
Published: January 2018

Cancellous bone contains bone marrow where hematopoietic stem cells (HSCs) are produced. Those cells represent an interest in the treatment of leukemia during which transplantation of bone marrow is performed to replace patient degraded cells. HSCs are usually harvested by a puncture in the cancellous bone of the donor’s ilium using a needle. However, this procedure can cause severe burden to the donor because of its high invasiveness. The flow of bone marrow is strongly related to the harvesting of HSCs and permeability is one of the major parameters to characterize cancellous bone. Previous researches have already shown an anisotropy of permeability in femur, whereas punctures are usually performed in the iliac cancellous bone.

The objective of this paper is to characterize the anisotropic permeability of iliac cancellous bone.

Digital images of a porcine iliac cancellous bone sample were obtained by micro-computed tomography (micro-CT), and three locations were selected to fabricate bone models, reproduced by 3D printing at three times magnification. To compare the structure of manufactured models, porosity and its variations along X, Y and Z direction were evaluated from micro-CT images.

To measure permeability, a specific perfusion system was developed. The pressure drop between the upstream and the downstream of bone models were measured at different flow rates, reaching a Reynolds number of 27–158, appropriate for the aspiration condition. Darcy-Forchheimer’s law was then applied to calculate the permeability and Forchheimer coefficient of bone models.

Results revealed different porosities and resultant permeabilities for each bone nodels. A positive correlation links those two parameters. Different fluctuations of porosity were evaluated along each direction although no significant difference of average porosity was observed. On the other hand, different permeabilities and Forchheimer coefficients were measured in each direction with various degrees of anisotropy. Permeabilities in three orthogonal directions of the model ranged from 1.96 × 10−10 to 4.29 × 10−10 m2. Results indicate that transport properties in cancellous bone depend on the flow directions. The anisotropy of permeability can be used for evaluation of flow in cancellous bone.
Effect of Metal Additive Manufacturing on the Engineering Design of Manufacturing Tooling: A Case Study on Dies for Plastic Extruded Products
Authors: Zhang Bin , Tarantino Bob , Lieber Samuel C.
Published: January 2018

Metal Additive Manufacturing (MAM) has had a tremendous impact in reimagining the design and manufacture of products in a number of industries. The use of MAM to directly produce products continues to be investigated; however, the area of manufacturing tooling has yet to be fully explored. MAM provides a unique opportunity to introduce features that make manufacturing tooling better equipped to efficiently produce complex products. A recent example includes MAM produced molds for the injection molding industry. MAM, in this case, provides the ability to introduce unique features, such as cooling channels, that could not be introduced practically with SM processes. This study explores the use of MAM towards the engineering and design of Extrusion Die Tooling for plastic extruded products. Plastic extrusion is a high-volume manufacturing process for a broad range of products from tubing to window frames. These extruded plastic products come in not only a range of sizes, but also different polymer materials. A series of extrusion dies are currently needed in the process in order to achieve the final shape of the product. These dies are effectively designed in two dimensional Computer Aided Design (CAD) packages, because of the current preferred method of fabrication, wire Electrical Discharge Machining (EDM). This study explores the effect of MAM on the extrusion die engineering design process. The explored cases center on common extruded plastic products including tubing and constant wall U-channels. The study first describes how sets of extrusion dies are currently designed in CAD in order to produce the desired extruded product features with established advanced manufacturing processes (EDM). The study then details the effect of using the MAM alternative on the design process, CAD methods selected, and the extrusion die features. The impact of MAM on the extruded die design process are discussed in order to provide guidelines for when it should be considered in order to effectively achieve features on the described extruded plastic products.
Combating Carbapenem-Resistant Acinetobacter baumannii by an Optimized Imipenem-plus-Tobramycin Dosage Regimen: Prospective Validation via Hollow-Fiber Infection and Mathematical Modeling
Authors: Landersdorfer Cornelia B. , Yadav Rajbharan , Rogers Kate E. , Kim Tae Hwan , Shin Beom Soo , Boyce John D. , Nation Roger L. , Bulitta Jürgen B.
Published: January 2018

We aimed to prospectively validate an optimized combination dosage regimen against a clinical carbapenem-resistant
Acinetobacter baumannii
(CRAB) isolate (imipenem MIC, 32 mg/liter; tobramycin MIC, 2 mg/liter). Imipenem at constant concentrations (7.6, 13.4, and 23.3 mg/liter, reflecting a range of clearances) was simulated in a 7-day hollow-fiber infection model (inoculum, ∼10
7.2
CFU/ml) with and without tobramycin (7 mg/kg q24h, 0.5-h infusions). While monotherapies achieved no killing or failed by 24 h, this rationally optimized combination achieved >5 log
10
bacterial killing and suppressed resistance.
Development and validation of an instrument for measuring the burden of medicine on functioning and well-being: the Medication-Related Burden Quality of Life (MRB-QoL) tool
Authors: Mohammed Mohammed A , Moles Rebekah J , Hilmer Sarah N , Kouladjian O’Donnel Lisa , Chen Timothy F
Published: January 2018

Objective

Medication-related burden (MRB) is a negative experience with medicine, which may impact on psychological, social, physical and financial well-being of an individual. This study describes the development and initial validation of an instrument specifically designed to measure MRB on functioning and well-being—the Medication-Related Burden Quality of Life (MRB-QoL) tool.

Methods

An initial pool of 76-items for MRB-QoL was generated. The link to MRB-QoL survey was sent to a sample of consumers living with at least one chronic medical condition and taking ≥3 prescription medicines on a regular basis. Exploratory factor analysis (EFA) was used to determine the underlining factor structure. Internal consistency (Cronbach’s α) and construct validity were examined. The latter was examined through correlation with Medication Regimen Complexity Index (MRCI), Drug Burden Index (DBI) and Charlson’s Comorbidity Index (CCI).

Results

367 consumers completed the survey (51.2% male). EFA resulted in a 31-item, five-factor solution explaining 72% of the total variance. The five subscales were labelled as ‘Routine and Regimen Complexity’ (11 items), ‘Psychological Burden’ (six items), ‘Functional and Role Limitation’ (seven items), ‘Therapeutic Relationship’ (three items) and ‘Social Burden’ (four items). All subscales showed good internal consistency (Cronbach’s α 0.87 to 0.95). Discriminant validity of MRB-QoL was demonstrated via its correlations with MRCI (Spearman’s r −0.16 to 0.08), DBI (r 0.12 to 0.28) and CCI (r −0.23 to −0.15). Correlation between DBI and ‘Functional and Role Limitation’ subscale (r 0.36) indicated some evidence of convergent validity. Patients with polypharmacy, multiple morbidity and DBI >0 had higher median scores of MRB-QoL providing evidence for known group validity.

Conclusions

The MRB-QoL V.1 has good construct validity and internal consistency. The MRB-QoL may be a useful humanistic measure for evaluating the impact of pharmaceutical care interventions on patients’ quality of life. Future research is warranted to further examine additional psychometric properties of MRB-QoL V.1 and its utility in patient care.
Patient satisfaction with hospital care and nurses in England: an observational study
Authors: Aiken Linda H , Sloane Douglas M , Ball Jane , Bruyneel Luk , Rafferty Anne Marie , Griffiths Peter
Published: January 2018

Objectives

To inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments.

Design

Cross-sectional surveys of 66 348 hospital patients and 2963 inpatient nurses.

Setting

Patients surveyed were discharged in 2010 from 161 National Health Service (NHS) trusts in England. Inpatient nurses were surveyed in 2010 in a sample of 46 hospitals in 31 of the same 161 trusts.

Participants

The 2010 NHS Survey of Inpatients obtained information from 50% of all patients discharged between June and August. The 2010 RN4CAST England Nurse Survey gathered information from inpatient medical and surgical nurses.

Main outcome measures

Patient ratings of their hospital care, their confidence in nurses and doctors and other indicators of their satisfaction. Missed nursing care was treated as both an outcome measure and explanatory factor.

Results

Patients’ perceptions of care are significantly eroded by lack of confidence in either nurses or doctors, and by increases in missed nursing care. The average number of types of missed care was negatively related to six of the eight outcomes—ORs ranged from 0.78 (95% CI 0.68 to 0.90) for excellent care ratings to 0.86 (95% CI 0.77 to 0.95) for medications completely explained—positively associated with higher patient-to-nurse ratios (b=0.15, 95% CI 0.10 to 0.19), and negatively associated with better work environments (b=−0.26, 95% CI −0.48 to −0.04).

Conclusions

Patients’ perceptions of hospital care are strongly associated with missed nursing care, which in turn is related to poor professional nurse (RN) staffing and poor hospital work environments. Improving RN staffing in NHS hospitals holds promise for enhancing patient satisfaction.
Neuropsychological assessment in epilepsy
Authors: Baxendale Sallie
Published: January 2018

The role of the neuropsychological assessment in the management of people with epilepsy has evolved considerably over the past 25 years. This paper describes some of the most common applications of a neuropsychological assessment in the diagnosis, management and treatment of people with epilepsy. It describes the factors that influence the interpretation of neuropsychological test scores in this patient group and outlines the limitations of the investigation. It gives guidelines for the optimal timing of a referral, together with timelines and indications for reassessment, and provides a checklist to help the referring clinician get the most from a neuropsychological assessment for their patients with epilepsy.
The discontinuity of environmental effects monitoring in the Lower Athabasca region of Alberta, Canada: institutional challenges to long-term monitoring and cumulative effects management
Authors: Cronmiller Joshua G. , Noble Bram F.
Published: January 2018

Long-term regional environmental monitoring, coupled with shorter-term and more localized monitoring carried out under regulatory permitting processes, is foundational to identifying, understanding, and effectively managing cumulative environmental effects. However, monitoring programs that emerge to support cumulative effects science are often short-lived initiatives or disconnected from land use planning and regulatory decision making. This paper examines the history and evolution of environmental monitoring in the Lower Athabasca region of Alberta, Canada, and the enabling and constraining influences of institutional arrangements. Methods involved a review of regional-scale monitoring programs based on an analysis of monitoring agency mandates, performance reports, and external program reviews, supplemented by discussions with monitoring program or agency key informants to triangulate results. Results show that monitoring to support cumulative effects understanding in the Lower Athabasca has advanced considerably, especially since the mid-1990s, but its relevance to, and impact on, cumulative effects management and decision making has been stifled by institutional arrangements. Monitoring has been episodic, reflecting shifting priorities and competing mandates; criticized by stakeholders based on concerns about transparency, credibility, influence over decision making; and characterized by short-lived commitments by the agencies involved. This has generated significant uncertainty about the stability of institutional arrangements to support long-term environmental monitoring, and tensions between the need for scientific autonomy for credible science whilst ensuring the pursuit of monitoring questions that are relevant to the day-to-day needs of regulatory decision makers. Regional monitoring programs require, at a minimum, clear vision and agreed-upon monitoring questions that are of scientific and management value, meaningful and balanced stakeholder engagement, and a clear governance process to ensure credibility and influence of monitoring results on decision making.
Scutellaria baicalensis and Cancer Treatment: Recent Progress and Perspectives in Biomedical and Clinical Studies
Authors: Cheng Chien-Shan , Chen Jie , Tan Hor-Yue , Wang Ning , Chen Zhen , Feng Yibin
Published: January 2018

Scutellaria baicalensis (Huangqin in Chinese) is a major traditional Chinese medicine (TCM) herb, which has a long history of use in the treatment of a variety of symptoms correlated with cancer. In the past decade, the potential of S. baicalensis and single compounds derived from it as anticancer agents targeting various pathways has received extensive research attention. Specifically, the proliferation and metastases inhibiting properties of the single compounds in cancer have been studied; however, the underlying mechanisms remain unclear. This review summarizes the various mechanisms, pathways and molecular targets involved in the anticancer activity of S. baicalensis and its single compounds. However, the aim of this review is to provide a more thorough view of the last 10 years to link traditional use with modern research and to highlight recently discovered molecular mechanisms. Extracts and major flavonoids derived from S. baicalensis have been found to possess anticancer effects in multiple cancer cell lines both in vitro and in vivo. Further investigation is warranted to better understand the underlying mechanisms and to discover novel targets and cancer therapeutic drugs that may improve both the survival and quality of life of cancer patients.
Red Pepper Seed Inhibits Differentiation of 3T3-L1 Cells during the Early Phase of Adipogenesis via the Activation of AMPK
Authors: Kim Hwa-Jin , You Mi-Kyoung , Wang Ziyun , Kim Hyeon-A
Published: January 2018

Obesity is the main risk factor for metabolic syndromes and there has been an upsurge in demand for effective therapeutic strategies. This study investigated the effect of red pepper seed water extract (RPS) on the process of differentiation in 3T3-L1 adipocytes. RPS treatment significantly suppressed cellular lipid accumulation and reduced the expression of adipocytes-associated proteins, peroxisome proliferator-activated receptor-[Formula: see text] (PPAR-[Formula: see text]), CCAAT/enhancer-binding proteins [Formula: see text] (C/EBP [Formula: see text]), sterol regulatory element binding protein-1c (SREBP-1c), as well as fatty acid synthase (FAS), and fatty acid binding protein 4 (FABP4). The inhibitory effect of RPS on differentiation was mainly through the modulation of the C/EBP [Formula: see text] and C/EBP [Formula: see text] expression at the early phase of differentiation. Moreover, at the early phase of differentiation, RPS markedly increased the phosphorylation of AMP-activated protein kinase (AMPK). Such enhancing effect of RPS was abolished in the presence of compound C. Our results suggest that activation of AMPK at early stage of adipogenesis is involved in the anti-adipogenesis effect of RPS.
Scalable Parallel Model Checking via Monte-Carlo Tree Search
Authors: Milewicz Reed M. , Poulding Simon
Published: January 2018

The future of model checking lies in parallel and distributed computing, but parallel graph search algorithms tailored to directed model checking remains an underdeveloped area of research. In this work, we examine the application of parallel Monte Carlo Tree Search algorithms. We demonstrate how exploratory, randomly sampled rollouts of the search space, coordinated through a minimally communicating work-sharing protocol, can enable us to push the boundaries on the scope and scale of problems amenable to serial search.
Variability and Complexity in Software Design
Authors: Galster Matthias , Weyns Danny , Goedicke Michael , Zdun Uwe , Cunha Jácome , Chavarriaga Jaime
Published: January 2018

Today's software systems must accommodate a wide range of usage and deployment scenarios. The increasing size and heterogeneity of software-intensive systems, dynamic and critical operating conditions, fast moving and highly competitive markets, and increasingly powerful and versatile hardware makes it more and more difficult to handle the additional complexity in design caused by variability. This paper reports results of the Second International Workshop on Variability and Complexity in Software Design. It also outlines directions the field might move in the future.
Designing and implementing accessible wearable interactions for people with motor impairments
Authors: Malu Meethu
Published: January 2018

Emerging wearable technologies like head-mounted displays (e.g., Google Glass) and wrist-worn devices (e.g., Fitbit, Apple Watch 2.0) are always available, have the potential to provide quick access to information and offer relatively hands-free interaction compared to smartphones. Additionally, they can collect continuous health and fitness-related information of their wearer. For people with disabilities, these technologies may also offer possibilities of independent use. However, people with upper body motor impairments may not be able to gain from the potential benefits that these wearables can offer. For example, challenges related to performing multi-touch gestures and text entry, may magnify as the interaction space of some wearables gets even smaller. In my dissertation, I explore the potential impacts and assess the accessibility of existing mainstream wearable technologies, including head-mounted displays, smartwatches, and fitness trackers. Consequently, I implement and evaluate accessible wearable interactions for people with motor impairments for these wearables, specifically head-mounted displays and smartwatches.
DNA-Encoded Chemical Libraries: A Selection System Based on Endowing Organic Compounds with Amplifiable Information
Authors: Neri Dario , Lerner Richard A.
Published: January 2018

The discovery of organic ligands that bind specifically to proteins is a central problem in chemistry, biology, and the biomedical sciences. The encoding of individual organic molecules with distinctive DNA tags, serving as amplifiable identification bar codes, allows the construction and screening of combinatorial libraries of unprecedented size, thus facilitating the discovery of ligands to many different protein targets. Fundamentally, one links powers of genetics and chemical synthesis. After the initial description of DNA-encoded chemical libraries in 1992, several experimental embodiments of the technology have been reduced to practice. This review provides a historical account of important milestones in the development of DNA-encoded chemical libraries, a survey of relevant ongoing research activities, and a glimpse into the future.