bluuebunny/crossref_metadata_2025 huggingface dataset:
Kappa Coefficients for Missing Data
Authors: De Raadt Alexandra , Warrens Matthijs J. , Bosker Roel J. , Kiers Henk A. L.
Published: January 2019

Cohen’s kappa coefficient is commonly used for assessing agreement between classifications of two raters on a nominal scale. Three variants of Cohen’s kappa that can handle missing data are presented. Data are considered missing if one or both ratings of a unit are missing. We study how well the variants estimate the kappa value for complete data under two missing data mechanisms—namely, missingness completely at random and a form of missingness not at random. The kappa coefficient considered in Gwet ( Handbook of Inter-rater Reliability, 4th ed.) and the kappa coefficient based on listwise deletion of units with missing ratings were found to have virtually no bias and mean squared error if missingness is completely at random, and small bias and mean squared error if missingness is not at random. Furthermore, the kappa coefficient that treats missing ratings as a regular category appears to be rather heavily biased and has a substantial mean squared error in many of the simulations. Because it performs well and is easy to compute, we recommend to use the kappa coefficient that is based on listwise deletion of missing ratings if it can be assumed that missingness is completely at random or not at random.
Sedation for Vitreoretinal Surgery: A Comparison of Anaesthetist-Administered Midazolam and Patient-Controlled Sedation with Propofol
Authors: Morley H. R. , Karagiannis A. , Schultz D. J. , Walker J. C. , Newland H. S.
Published: January 2019

Local anaesthesia is increasingly being used for vitreoretinal surgery, but the optimal technique for sedation remains unclear. Anaesthetist-administered midazolam, which is often used, was compared in this study to patient-controlled sedation with propofol in 43 patients undergoing 50 vitreoretinal procedures. A variety of patient, anaesthetist and surgical endpoints were measured. There were no significant outcome differences between the two agents except that midazolam produced more amnesia for the local anaesthetic eye block. However, several outcomes and the observations in patients who experienced both agents showed a trend in favour of propofol for intraoperative sedation. We conclude that both approaches are safe and that patient-controlled sedation with propofol is at least as satisfactory as anaesthetist-administered midazolam.
Correlation between Extravascular Lung Water and Oxygenation in ALI/ARDS Patients in Septic Shock: Possible Role in the Development of Atelectasis?
Authors: Szakmany T. , Heigl P. , Molnar Z.
Published: January 2019

This study aimed to evaluate the relationship between PaO2/FiO2 ratio and extravascular lung water in septic shock-induced acute respiratory distress syndrome in a prospective observational clinical trial.

Twenty-three patients suffering from sepsis induced acute respiratory distress syndrome were recruited. All patients were ventilated in pressure control/support mode. Haemodynamic parameters were determined by arterial thermodilution (PiCCO) eight hourly for 72 hours. At the same time blood gas analyses were done and respiratory parameters were also recorded. Data are presented as mean±SD. For statistical analysis Pearson's correlation test, and analysis of variance (ANOVA) was used respectively.

Significant negative correlation was found between extravascular lung water and PaO2/FiO2 (r= −0.355, P<0.001), and significant positive correlation was shown between extravascular lung water and PEEP (r=0.557, P<0.001). A post-hoc analysis was performed when “low” PEEP: <10 cmH2O and “high” PEEP: (10 cmH2O PEEP was applied, and neither the oxygenation, nor the driving pressure or the PaCO2 differed significantly, but the extravascular lung water showed significant difference when “high” or “low” PEEP was applied (13±5 vs 9±2 ml/kg respectively, P=0.001).

This study found significant negative correlation between extravascular lung water and PaO2/FiO2. The mechanism by which extravascular lung water affects oxygenation is unknown but the significant positive correlation between PEEP and extravascular lung water shown in this trial suggests that the latter may have a role in the development of alveolar atelectasis.
Sevoflurane versus Propofol for Induction of Anaesthesia for Electroconvulsive Therapy: A Randomized Crossover Trial
Authors: Loughnan T. , McKenzie G. , Leong S.
Published: January 2019

Propofol is often used to induce anaesthesia for electroconvulsive therapy. Some patients who receive propofol have fits of poor quality or inadequate duration despite increasing electroconvulsive therapy doses. Sevoflurane has been reported to exhibit pro-convulsant properties in some “at-risk” patients during anaesthesia for other procedures. The purpose of this study was to perform a randomized crossover trial in patients undergoing electroconvulsive therapy, comparing the effects on seizure parameters of propofol versus sevoflurane induction. Patients were randomly allocated to receive either sevoflurane or propofol for their first treatment. In the subsequent treatment the alternative agent was used.

Patients in both treatment groups exhibited equally good fits, with those in the sevoflurane group having slightly better morphology, which is the most subjective of the parameters measured. The sevoflurane administrations were associated with slightly higher pulse rates and blood pressures.

Sevoflurane provides a suitable alternative to propofol for anaesthesia in patients undergoing electroconvulsive therapy, although the slightly greater pulse rate rise and blood pressure rise should be considered in patients with ischaemic heart disease.
Anaesthetic Implications of Vascular Type Ehlers-Danlos Syndrome
Authors: Lane D.
Published: January 2019

Vascular type Ehlers-Danlos syndrome is an inherited connective tissue disease, which is typified by tissue fragility, joint hypermobility, a tendency to bleed excessively and rupture of the uterus, the bowel and arteries. Two case reports are presented which describe the anaesthetic management of patients with spontaneous bowel perforations due to vascular type Ehlers-Danlos syndrome. Both cases were associated with relatively minor problems. The implications of this condition for anaesthesia include difficulty (and risk of complications) with vascular access, a risk of spontaneous arterial rupture in the perioperative period, possible cervical spine instability and airway trauma on intubation. There is also a risk of excessive bleeding, potentially difficult neuraxial anaesthesia and an increased risk of epidural haematoma. There also may be associated cardiac or pulmonary disease. However, these two cases and the limited previously published literature suggest that such potential complications are actually rare and that anaesthesia may be conducted in a relatively standard manner in most circumstances.
Trends in intra-aortic balloon counterpulsation: Comparison of a 669 record Australian dataset with the multinational Benchmark Counterpulsation Outcomes Registry
Authors: Lewis P. A. , Mullany D. V. , Townsend S. , Johnson J. , Wood L. , Courtney M. , Joseph D. , Walters D. L.
Published: January 2019

The aim of this study was to review and describe indications for intraaortic balloon counterpulsation (IABP) use and identify the impact these have on outcomes at an Australian cardiothoracic tertiary referral hospital. A secondary aim was comparison of the Australian practice with a large multinational IABP data registry. Patient demographics, IABP indication, IABP complication rate and mortality in 662 patients treated with IABP at The Prince Charles Hospital (TPCH), Brisbane, between January 1994 and December 2004 inclusive were compared with The Benchmark Counterpulsation Outcomes Registry. Data were collected between 1994 and 2000 by retrospective patient record review and prospectively using the Benchmark database from 2001 to 2004. Statistical analysis was undertaken usingSAS (v8.2) software. The mean age of patients managed with IABP at TPCH (71.6% male) was 63.4 years (SD 12.4). In-hospital mortality rate was 22% and the complication rate was 10.3%. TPCH indications for IABP were: weaning from cardiopulmonary bypass (34.2%); cardiogenic shock (24.4%); preoperative support (13%); catheter laboratory support (10.6%); refractory ventricular failure (7.3%); ischaemia related to intractable ventricular arrhythmias (4.5%); unstable refractory angina (4%); mechanical complications due to acute myocardial infarction (1.2%) and other (0.4%) (0.4% not reported). In comparison to Benchmark, IABP at TPCH demonstrated a prejudice toward intraoperative use (34.2% versus 16.6%; P= <0.0001) and an aversion to catheter laboratory support (10.6% versus 19%; P= <0.0001). TPCH and Benchmark IABP outcomes demonstrated comparable mortality (22% versus 20.8%; P=ns) but increased TPCH complications (10.3% vs. 6.2%; P= <0.0001) owing to a 2% difference in observed insertion site bleeding.
Survival after Massive Hydroxychloroquine Overdose
Authors: Gunja N. , Roberts D. , McCoubrie D. , Lamberth P. , Jan A. , Simes D. C. , Hackett P. , Buckley N. A.
Published: January 2019

Hydroxychloroquine overdose is infrequently reported and the majority of recommendations come from the greater experience with chloroquine poisoning. We report two cases of massive hydroxychloroquine poisoning (20 g in each case), both of which received advanced cardiac life support and a treatment regimen consisting of sodium bicarbonate, adrenaline and potassium. Both these patients survived beyond their initial rapid deterioration and cardiovascular collapse to be discharged from hospital without sequelae. These patients had the highest reported non-lethal serum concentrations (13.8 and 26.0 mg/l). They both demonstrated rapid recovery from a pre-arrest condition, following aggressive correction of electrolyte and pH disturbance and rapid distribution of the drug to peripheral tissues.
Cardiac Complications and Mortality Rates in Diabetic Patients following Non-cardiac Surgery in an Australian Teaching Hospital
Authors: Bolsin S. N. C. , Raineri F. , Lo S. K. , Cattigan C. , Arblaster R. , Colson M.
Published: January 2019

This retrospective study of diabetic patients undergoing non-cardiac surgery has identified that a greater number of patients are at risk of cardiac complications and death in the perioperative period than had previously been suggested. As well as insulin-dependent diabetic patients and patients with elevated creatinine (>178 μmol/l) as previously found, our study suggests that non-insulin-dependent diabetic patients and patients with creatinine >120 μmol/l are also at increased risk of cardiac complications and death following non-cardiac surgery. This increases by a factor of six those diabetic patients at risk of perioperative complications from non-cardiac surgery and also increases the number of patients with renal failure similarly at risk. The study confirms similar risks of cardiac complications and death to other recently published data and suggests ongoing comparisons will contribute to quality assurance activities in anaesthesia and surgery.
A Retrospective Observational Study Examining the Admission Arterial to End-Tidal Carbon Dioxide Gradient in Intubated Major Trauma Patients
Authors: Hiller J. , Silvers A. , McIlroy D. R. , Niggemeyer L. , White S.
Published: January 2019

Major trauma patients who are intubated and ventilated are exposed to the potential risk of iatrogenic hypercapnic and hypocapnic physiological stress. In the pre-hospital setting, end-tidal capnography is used as a practical means of estimating arterial carbon dioxide concentrations and to guide the adequacy of ventilation. In our study, potentially deleterious hypercapnia (mean 47 mmHg, range 26 to 83 mmHg) due to hypoventilation was demonstrated in 49% of 100 intubated major trauma patients arriving at a major Australian trauma centre. A mean gradient of 15 mmHg arterial to end-tidal carbon dioxide concentration difference was found, highlighting the limitations of capnography in this setting. Moreover, 80% of the patients in the study had a head injury. Physiological deadspace due to hypovolaemia in these patients is commonly thought to contribute to the increased arterial to end-tidal carbon dioxide gradient in trauma patients. However in this study, scene and arrival patient hypoxia was more predictive of hypoventilation and an increased arterial to end-tidal carbon dioxide gradient than physiological markers of shock. Greater vigilance for hypercapnia in intubated trauma patients is required. Additionally, a larger study may confirm that lower end-tidal carbon dioxide levels could be safely targeted in the pre-hospital and emergency department ventilation strategies of the subgroup of major trauma patients with scene hypoxia.
Anaesthesia-Related Morbidity in Victoria: A Report from 1990 to 2005
Authors: McNicol L. , Mackay P.
Published: January 2019

This report involves a review of 736 cases of anaesthesia-related morbidity reported from 1990 to 2005 by the Victorian Consultative Council on Anaesthetic Mortality and Morbidity. Using a combination of an established classification system, emerging categorisation definitions and appropriate keywords, an analysis of the clinical issues and contributory factors was undertaken. Airway-related morbidity, respiratory complications and drug-related adverse events are the most commonly reported. Organisational issues are increasingly implicated in adverse anaesthesia outcomes.
Intraoperative Hypothermia is Associated with an Increased Intensive Care Unit Length-of-Stay in Patients Undergoing Elective Open Abdominal Aortic Aneurysm Surgery: A Retrospective Cohort Study
Authors: Jeyadoss J. , Thiruvenkatarajan V. , Watts R. W. , Sullivan T. , Van Wijk R. M. A. W.
Published: January 2019

Intraoperative hypothermia in open elective abdominal aortic aneurysm repair may be associated with increased hospital morbidity. This retrospective, single centre study investigated whether there was an association between intraoperative hypothermia in open elective abdominal aortic aneurysm repair and postoperative in-hospital morbidity. The data of 119 patients who underwent open infrarenal abdominal aortic aneurysm repair between January 2006 and January 2011 were collected. The electronic databases from the hospital, intensive care unit, transfusion medicine and operating theatres were linked by the patient's unique identifiers including date of birth and unit record number. Intraoperative nasopharyngeal temperature measurements were collected manually from paper-based anaesthetic records. The study group included 102 out of the 119 patients. Sixty-six patients (64.6%) had intraoperative hypothermia as defined by temperature <36°C. Intraoperative temperature was not predictive of hospital length-of-stay or any of the other perioperative complications such as acute renal failure, acute respiratory complications, acute myocardial infarction, transfusion requirements or postoperative infection. In the normothermic group, the number of hours in the intensive care unit was 35% lower (ratio of means=0.65; 95% confidence interval 0.51 to 0.84; P=0.0008), even after adjusting for possible confounders such as age, duration of anaesthesia, size of aneurysm, comorbidities and transfusion. Intraoperative hypothermia is a persisting problem and more aggressive warming strategies may need to be identified and employed to achieve normothermia.
Minimum Effective Anaesthetic Volume of 0.5% Ropivacaine for Ultrasound-Guided Popliteal Sciatic Nerve Block in Patients Undergoing Foot and Ankle Surgery: Determination of ED50 and ED95
Authors: Jeong J. S. , Shim J. C. , Jeong M. A. , Lee B. C. , Sung I. H.
Published: January 2019

Compared to nerve stimulation or classic paraesthesia techniques, ultrasound (US)-guided popliteal sciatic nerve block requires a smaller volume of local anaesthetic. The up-and-down method was used to determine the minimum effective anaesthetic volume of 0.5% ropivacaine necessary for US-guided popliteal sciatic nerve block to achieve successful surgical anaesthesia for foot and ankle surgery. The study included 32 patients receiving an US-guided popliteal sciatic nerve bock. The starting dose of 0.5% ropivacaine was set at 30 ml, which was decreased by 3 ml if the block succeeded and increased by 3 ml if the block failed. After the injection of local anaesthetic, the degree of sensory and motor blockade of the tibial and common peroneal nerves was assessed every 5 minutes for 30 minutes. The ED50 and ED95 volumes of local anaesthetic were 6 ml and 16 ml, respectively. The success rates of sensory blockade of the tibial nerve and common peroneal nerve were 69% and 88%, respectively. The success rates of motor blockade of these nerves were 75% and 90%, respectively. The ED50 and ED95 of 0.5% ropivacaine for US-guided popliteal sciatic nerve block were 6 ml and 16 ml, respectively.
Venous Admixture Effect during One-lung Anaesthesia
Authors: Torda T. A. , O'Brien H. D. , McCulloch C. , Tsui K.
Published: January 2019

The venous admixture was measured before, during, and after deflation of one lung during anaesthesia for thoracotomy in 10 subjects ventilated with 50% oxygen. The mean oxygen saturation fell from 99% before deflation of the lung to 89% after 30 minutes’ atelectasis. The pH and carbon dioxide tension did not change significantly. The shunt was 38% of cardiac output five minutes after and 41% 30 minutes after deflation. The reciprocal of the arterial venous oxygen content difference correlated positively with the shunt, suggesting that increased venous admixture is accompanied by increased cardiac output.
Balanced Total Intravenous Anaesthesia and Intraocular Pressure
Authors: Norbury A. , Rocke A. D. , Brock-Utne J. G. , Mackenzie R. , Welsh N. , Downing J. W.
Published: January 2019

Twenty patients, aged 21 to 48 years and rated ASA physical status I, were studied during ophthalmic surgery. Ten subjects (Group I) received thiopentone, halothane and nitrous oxide in oxygen, and ten (Group II) received total intravenous anaesthesia, using flunitrazepam and ketamine. Ventilation was controlled mechanically with the aid of a muscle relaxant.

Both anaesthetic techniques caused a significant decrease in intraocular pressure. After an initial decline in systolic arterial pressure and an increase in heart rate, cardiovascular status was well maintained in the two series. Side effects were uncommon with both techniques.

Balanced total intravenous anaesthesia with flunitrazepam, ketamine and relaxant appears to offer a safe alternative to conventional inhalation narcosis for intraocular surgery.
A Comparative Study of the Measurement of Mean Arterial Blood Pressure Using Automatic Oscillometers, Arterial Cannulation and Auscultation
Authors: Rutten A. J. , Ilsley A. H. , Skowronski G. A. , Runciman W. B.
Published: January 2019

Mean brachial artery pressures determined by five different non-invasive automatic oscillometric and one auscultatory preferred (oscillometric back-up) blood pressure (BP) monitors were compared with mean arterial pressures (MAP) obtained by cannulation of the radial artery of the same arm. The devices tested all performed similarly, showing a wide range of variation (+40% to −29%) compared with the directly measured MAP, and all tended to over-read at low values and under-read at high values. Trend information was generally acceptable, but occasionally was misleading. In addition, using one of the devices, systolic and diastolic blood pressure measurements were compared with those obtained by auscultation. This gives a range of differences from +22 to −25 mmHg for systolic and +20 to −12 mmHg for diastolic BP measurements. (The average fell within 1.0 mmHg of the auscultatory measurement, with a standard deviation of 10 mmHg.) Thus, the automatic oscillometric BP monitors tested were comparable in accuracy to auscultatory BP measurement, and are satisfactory for routine use in the appropriate clinical context. However, in settings where significance is to be attached to individual BP readings rather than to trends, or where a high degree of accuracy is required, automatic oscillometric machines cannot be regarded as satisfactory alternatives to arterial cannulation.
Vasoconstrictor Effects of Adrenaline in Human Septic Shock
Authors: Lipman J. , Roux A. , Kraus P.
Published: January 2019

In an open prospective study, adrenaline administration in ten patients with eleven episodes of septic shock was studied. Appropriate supportive therapy (antibiotics, laparotomies, parenteral alimentation, ventilation) was given as needed. Haemoglobin was kept at or above 12 g%, pulmonary capillary wedge pressure kept at approximately 15 mmHg, and cardiac index at greater than 4.5 l/min/m2. Only when systemic vascular resistance (SVR) dropped below 600 dyn. s. cm−5 was adrenaline given to raise the latter to no higher than 800 dyn. s. cm−5 and the adrenaline was titrated to this end point.

Adrenaline was used at doses up to 0.47 μg/kg/min for up to nineteen days. There was no reliable dose response curve for adrenaline: each septic insult needed different dosages. However, if high enough doses were given, SVR eventually increased. There was no deterioration in cardiac index nor further increase in pulse rate and no renal damage was demonstrated. Only one patient died in septic shock. Two others died from causes not directly related to sepsis and another two while still in hospital, but again not septic. Five patients were eventually discharged from hospital.

Adrenaline can thus be used as a vasoconstrictor in septic shock without adverse effects, but initial doses have to be high and the effects measured and titrated carefully. Used this way, adrenaline provides time for the eradication of sepsis.
Level of Consciousness on Arrival in the Recovery Room and the Development of Early Respiratory Morbidity
Authors: Parr S. M. , Robinson B. J. , Glover P. W. , Galletly D. C.
Published: January 2019

An audit review of 16,065 patients undergoing operative procedures under general anaesthesia was carried out to examine the relationship between early postoperative respiratory complications and the level of consciousness of patients on arrival in the recovery room. In patients aged over ten years, the incidence of respiratory complications was significantly (P < 0.005) related to the level of consciousness independant of ASA grade or age. Since the level of consciousness of patients arriving in the recovery room could be modified by changes to anaesthetic practice it is concluded that a significant reduction in respiratory complications might be possible if anaesthetists used general anaesthetic techniques which returned patients awake to the recovery room.
Carbon Monoxide Poisoning
Authors: Gorman D. F. , Runciman W. B.
Published: January 2019

Carbon monoxide is a common domestic and industrial poison which may be lethal. Survivors can develop permanent neuropsychiatric disability. The mechanisms of toxicity are poorly understood and the traditional criteria used to determine the severity of the poisoning have low predictability. Oxygen is the recommended antidote to carbon monoxide, but it appears that oxygen under hyperbaric conditions repeated either daily or as indicated by the patient's condition may be required to provide an effective dose. A reliable marker of the severity of carbon monoxide poisoning is urgently needed so that trials of alternative regimens can proceed.
The Efficacy of Antivenom in Prevention of Cardiovascular Depression and Coagulopathy Induced by Brown Snake (Pseudonaja) Species Venom
Authors: Tibballs J. , Sutherland S.
Published: January 2019

The efficacy of antivenom in prevention of cardiovascular depression and coagulopathy induced by Brown Snake species (Pseudonaja textilis, Pseudonaja affinis) was investigated in anaesthetised mechanically ventilated dogs. Venom and antivenom in variable amounts were incubated together at 37°C for 30 minutes prior to intravenous injection. The dose of antivenom required to prevent severe cardiovascular depression and coagulopathy induced by Pseudonaja textilis venom was 25 times the current recommended dose for clinical use. A tenfold dose of antivenom was required to neutralise similar effects induced by Pseudonaja affinis venom. Large amounts of antivenom may be required in clinical use if coagulopathy or cardiovascular depression are present after envenomation by species of the Brown Snake genus.
Time-dependent Error in the APACHE II Scoring System
Authors: Sleigh J. W. , Brook R. J. , Miller M.
Published: January 2019

Using the APACHE II scoring system, the risk of death was calculated for 189 patients in the Wanganui Intensive Care Unit and 194 patients in the Harare Intensive Care Unit. Using tables of actual and predicted outcome, the predictive power of the system was compared in patients grouped according to the length of time that they spent in the ICU. The predictive error increased from 15% in those patients staying less than six days, to 38% in those staying six days or more (P < 0.01). The predictive accuracy of the APACHE II system appeared to decrease with the length of time the patient stayed in the Intensive Care Unit.
Failed Intubation in the Intensive Care Unit Managed with Laryngeal Mask Airway and Percutaneous Tracheostomy
Authors: Divatia J. V. , Kulkarni A. P. , Sindhkar S. , Upadhye S. M.
Published: January 2019

We report the management of failed intubation in a critically ill, hypoxic and catabolic patient with sepsis and acute lung injury. Insertion of a laryngeal mask airway restored ventilation and corrected hypoxia. As the laryngeal mask provides only a temporary airway, it was essential to secure the airway by percutaneous tracheostomy to initiate mechanical ventilation.
Estimation of Alveolar Deadspace Fraction Using Arterial and End-Tidal CO2: A Factor Analysis Using a Physiological Simulation
Authors: Hardman J. G. , Aitkenhead A. R.
Published: January 2019

The alveolar deadspace as a fraction of alveolar ventilation (VDalv/VTalv), while technically difficult to measure, is an objective monitor of pulmonary disease progression and a predictor of successful weaning from mechanical ventilation. The aim of the study was to examine the relationship between the arterial to end-tidal Pco2 gradient (Pa-E’co2) and VDalv/VTalv and between (Pa-E’CO2)/PaCO2 and VDalv/VTalv using the Nottingham Physiology Simulator, an original, validated physiology simulation. The relationships were observed while pulmonary shunt, anatomical deadspace, ventilatory minute volume and metabolic rate were varied. The relationship between Pa-E’co2 and VDalv/VTalv was non-linear and was affected significantly by all the factors except anatomical deadspace. The relationship between (Pa-E’CO2)/PaCO2 and VDalv/VTalv (best fit: VDalv VTalv=1.135(Pa-E’co2)/Paco2-0.005) during normal physiological conditions was approximately linear and less influenced by physiological variation. Shunt and anatomical deadspace caused some inaccuracy, although they are unlikely to prevent the clinical usefulness of this formula.
Dynamic response of single-walled carbon nanotubes based on various shell theories
Authors: Palacios Jorge A , Ganesan Rajamohan
Published: January 2019

Carbon nanotubes are used in several engineering applications because of their superior mechanical properties. Scientific works still need to be carried out, especially on their dynamic response. These studies mainly focus on modal analysis, considering zigzag and armchair nanotubes, and sometimes, varying chirality. However, these works do not present any results on the steady-state responses. Therefore, the objective of this paper is to perform different studies, in terms of the stiffness response, modal analysis and steady-state response of single-walled carbon nanotubes by using a 3D finite-element model of the single-walled carbon nanotube, under different types of boundary conditions, to provide more results in this field. The single-walled carbon nanotube is modeled as a space frame structure by using the Morse potential and as a thin shell model based on various shell theories. A static analysis is performed to compare the stress–strain behavior between the Morse potential and the thin shell model. A parametric study on chirality effects and aspect ratio is also conducted to determine which shell theory is more suitable to model the mechanical behavior of single-walled carbon nanotubes. Finally, the analysis of harmonic response is conducted to describe the steady-state response between both the models.
Systematic review of research relating to heavy-duty machine tool foundation systems
Authors: Tian Yang , Liu Zhifeng , Xu Xinpeng , Wang Guang , Li Qiwei , Zhou Yang , Cheng Jiangli
Published: January 2019

The quality of heavy-duty machine tool foundations can drastically affect the operating life and working precision of the tool, and the high cost of manufacture has drawn a lot of attention. This article summarized the research status of the relevant literature on the characteristics, vibration isolation, foundation optimization, and quality inspection of heavy-duty machine tool-foundation system, induced the influencing laws of the influencing factors of the system, reviewed the highlights and achievements in the research of heavy machine tool-foundation system at present, and put forward some problems and development directions existing in the research of heavy machine tool-foundation system. It lays a foundation for realizing the judgment of the concrete foundation quality and improving the processing precision and the maintenance of the heavy machine tool.
Damping performance analysis of magnetorheological damper with serial-type flow channels
Authors: Hu Guoliang , Liu Hao , Duan Jinfu , Yu Lifan
Published: January 2019

In order to obtain a larger damping force with the limited axial size of the vehicle suspension system, a new magnetorheological damper with serial-type flow channels was developed. The piston head was equipped with two piston end covers, three piston non-magnetic sleeves, and four piston magnetic sleeves, which were sequentially combined into three serial-type flow channels to form three groups of effective damping gaps. The structure and principle of the proposed magnetorheological damper were described in detail, and the model for calculating damping force was deduced too. Simulation and analysis for the proposed magnetorheological damper was implemented using electromagnetic field simulation software. The damping performance was tested and analyzed on the test rig under different applied current, amplitude, and frequency excitation. The experimental results show that the damping force is 6838 N under the load excitation with frequency of 1 Hz, amplitude of 7.5 mm, and current of 1.5 A, which is 1.6 times than the expected damping force. The equivalent damping coefficient is attained to 290 kN/s m−1, which shows that the developed magnetorheological damper has high vibration control ability and good mechanical properties.
Nonlinear dynamic behavior and stability of a rotor/seal system with the dynamic vibration absorber
Authors: Xu Qi , Niu Junkai , Yao Hongliang , Zhao Lichao , Wen Bangchun
Published: January 2019

The dynamic vibration absorbers have been applied to attenuate the critical or unbalanced vibration but may create the fluid-induced vibration instability in the rotor/seal system. The major purpose of this study is devoted to the effects of the dynamic vibration absorber on the nonlinear dynamic behavior and stability of the fluid-induced vibration in the rotor/seal system. The dynamic vibration absorber is attached on the shaft in the perpendicular directions. The model of the rotor/seal-dynamic vibration absorber system is established as the modified Jeffcott rotor system, and Muszynska nonlinear seal force is applied. The numerical method is used for the dynamic behavior analysis. The effects of the natural frequency and damping ratio of the dynamic vibration absorber on the dynamic behavior are discussed. The stability of the rotor/seal-dynamic vibration absorber system is judged by the eigenvalue theory. The variations of the instability threshold with the parameters of the dynamic vibration absorber are obtained. The results show that the instability threshold and instability vibration frequency are changed by the dynamic vibration absorber. The parameters of the dynamic vibration absorber must be selected carefully to avoid reducing the instability threshold and causing the instability vibration to occur in advance when the dynamic vibration absorber is applied to attenuate the critical or unbalanced vibration of the rotor/seal system.
A rare case of Fitz-Hugh–Curtis syndrome caused by Chlamydia trachomatis in an HIV-positive male patient
Authors: Lisičar Iva , Begovac Josip , Zekan Šime
Published: January 2019

Fitz-Hugh–Curtis syndrome, a rare complication of pelvic inflammatory disease, is an inflammation of the liver capsule (thus called perihepatitis) and the surrounding peritoneum. It occurs extremely rarely in men and is typically characterized by a sudden onset of severe pain in the right upper abdominal quadrant. Ultrasound examination of the liver does not reveal any morphologic changes, and liver function tests are usually normal. Computerized tomography shows the thickening of the perihepatic fat, but definitive diagnosis is only possible by direct visualization by laparoscopy or laparotomy. We present a 33-year-old HIV-positive man with Chlamydia trachomatis proctitis who developed severe right upper abdominal quadrant pain. Abdominal ultrasound did not show any liver pathology, while computerized tomography revealed hepatic capsular thickening. After 21 days of doxycycline therapy, the patient’s symptoms subsided. Based on the clinical presentation and liver computerized tomography examination, the diagnosis of proctitis and the resulting Fitz-Hugh–Curtis syndrome was made. Although it is rarely seen in male patients, it should be a part of differential diagnosis in patients who present with right upper abdominal quadrant pain, especially in men who have sex with other men.
The effect of omega‐3 fatty acids on clinical and paraclinical features of intractable epileptic patients: a triple blind randomized clinical trial
Authors: Omrani Shaghayegh , Taheri Mohammad , Omrani Mir Davood , Arsang‐Jang Shahram , Ghafouri‐Fard Soudeh
Published: January 2019

Long chain omega‐3 fatty acids (omega‐3 FAs) supplements have been shown to exert beneficial effects in patients with epilepsy through elevation of seizure thresholds and dampening of inflammatory responses. In this triple blind randomized, placebo‐controlled parallel group trial of omega‐3 FA supplementation, 180 mg eicosapentaenoic acid (EPA) and 120 mg docosahexaenoic acid (DHA) as well as placebo capsules were administered twice a day in 50 patients with refractory seizure during a 16‐week period respectively. Seizure frequency and duration were reduced after completion of the treatment in the supplement group. The supplementation resulted in a significant decrease in TNF‐α and IL‐6 concentrations. Further studies are needed to compare different omega‐3 FA compositions and determine the most effective dose and treatment duration as well as the long term benefits of this supplementation.
Vascular Adhesion Protein-1 Is Associated With Acute Kidney Injury in High-Risk Patients After Cardiac Surgery
Authors: Meersch Melanie , Küllmar Mira , Renfurm Ronny , Margraf Andreas , Bormann Eike , Zarbock Alexander
Published: January 2019

BACKGROUND:

Acute kidney injury is a common complication after cardiac surgery, with a high impact on morbidity and mortality. Vascular adhesion protein-1 is involved in inflammation, which, in turn, is part of the development of acute kidney injury after cardiac surgery.

METHODS:

In this ancillary study to the RENal effects of Remote Ischemic Preconditioning in cardiac surgery trial, we investigated whether vascular adhesion protein-1 might be associated with the development of acute kidney injury in high-risk patients after cardiac surgery. In total, 114 patients were included in this data set. Acute kidney injury was defined by the Kidney Disease: Improving Global Outcomes criteria serum creatinine and/or urine output. Vascular adhesion protein-1 concentrations were measured at baseline (before surgery), 4 hours, and 12 hours after cardiopulmonary bypass.

RESULTS:

Vascular adhesion protein-1 levels at 12 hours were significantly higher in patients with acute kidney injury (no acute kidney injury, 271 ng/mL [Q1, Q3, 179, 364 ng/mL] versus acute kidney injury, 384 ng/mL [Q1, Q3, 311, 478 ng/mL]; P < .001). Moreover, patients developing acute kidney injury had higher differences in vascular adhesion protein-1 levels between 12 hours and baseline (P < .001) and between 12 and 4 hours (P < .001) after cardiopulmonary bypass. At a cut point difference value of 99 ng/mL (95% CI, 63–133) between 12 hours and baseline, patients with differences >99 ng/mL showed a higher occurrence rate of acute kidney injury (acute kidney injury, 78.6% versus no acute kidney injury, 31.5%; P < .001). Receiver-operating characteristic curve analyses demonstrated best performance for vascular adhesion protein-1 levels at 12 hours for acute kidney injury within 72 hours after surgery, especially in the subgroup of patients with chronic kidney disease (area under the receiver-operating characteristic curve, 0.78; P < .001).

CONCLUSIONS:

Vascular adhesion protein-1 is elevated in patients developing acute kidney injury assuming that vascular adhesion protein-1 plays a crucial role in the development of acute kidney injury in high-risk patients after cardiac surgery.
A Missing Tooth Found in the Nasal Cavity After an Attempt at Insertion of a Nasogastric Tube: A Case Report
Authors: Osaka Yoshimune , Morita Yoshihisa
Published: January 2019

Dental injury is one of the most common complications of tracheal intubation. Although teeth dislodged during tracheal intubation are usually found in the oral cavity, we encountered a case of a missing tooth found in the nasal cavity in an intubated patient. A 62-year-old man with 4 loose teeth in the upper jaw was scheduled for laparoscopic hernia repair. After our second attempt at insertion of a nasogastric tube via the left naris, we discovered that a tooth had been dislodged. A lateral-view radiograph revealed the dislodged tooth in the nasal cavity. The ectopic tooth was removed by an otorhinolaryngologist.
A Novel Tool to Guide Reintegration of Anesthesiologists Into Clinical and Academic Work After Concussion
Authors: Hatton Kevin W. , Bacon J. David , McKinney Katherine , Schell Randall M.
Published: January 2019

Concussion is a common form of mild traumatic brain injury that can cause somatic, cognitive, and behavioral impairments lasting days to weeks. There are no published guidelines or recommendations to facilitate the safe and successful reintegration of anesthesiologist clinicians and trainees into clinical and academic work after concussion. We developed a simple 4-phase postconcussion recovery protocol for anesthesiologists who have suffered concussion and describe the successful use of this postconcussion recovery protocol to support reintegration of an Anesthesiology Critical Care Medicine fellow who developed mild concussion during vacation leave.
Spinal Cord Trauma During Subarachnoid Anesthesia for Cesarean Delivery: A Case Report
Authors: Palmer Craig M. , Baysinger Curtis L.
Published: January 2019

Spinal cord trauma can occur during subarachnoid blockade and can result in significant morbidity for the patient. Careful attention to lumbar insertion level is essential to prevent injury.
Exercise Training Prevents Doxorubicin-induced Mitochondrial Dysfunction of the Liver
Authors: HINKLEY J. MATTHEW , MORTON AARON B. , ICHINOSEKI-SEKINE NORIKO , HUERTAS ANDRES MOR , SMUDER ASHLEY J.
Published: January 2019

Purpose

Doxorubicin (DOX) is a highly effective chemotherapeutic agent used in the treatment of a broad spectrum of cancers. However, clinical use of DOX is limited by irreversible and dose-dependent hepatotoxicity. The liver is the primary organ responsible for the clearance of antineoplastic agents, and evidence indicates that hepatotoxicity occurs as a result of impaired mitochondrial efficiency during DOX metabolism. In this regard, exercise training is sufficient to improve mitochondrial function and protect against DOX-induced cytotoxicity. Therefore, the purpose of this study was to determine whether short-term exercise preconditioning is sufficient to protect against DOX-induced liver mitochondrionopathy.

Methods

Female Sprague–Dawley rats (4–6 months old) were randomly assigned to one of four groups: 1) sedentary, treated with saline; 2) sedentary, treated with DOX; 3) exercise trained, treated with saline; and 4) exercise trained, treated with DOX. Exercise-trained animals underwent 5 d of treadmill running habituation followed by 10 d of running for 60 min·d−1 (30 m·min−1; 0% grade). After the last training bout, exercise-trained and sedentary animals were injected with either DOX (20 mg·kg−1 i.p.) or saline. Two days after drug treatment, the liver was removed and mitochondria were isolated.

Results

DOX treatment induced mitochondrial dysfunction of the liver in sedentary animals because of alterations in mitochondrial oxidative capacity, biogenesis, degradation, and protein acetylation. Furthermore, exercise preconditioning protected against DOX-mediated liver mitochondrionopathy, which was associated with the maintenance of mitochondrial oxidative capacity and protein acetylation.

Conclusion

These findings demonstrate that endurance exercise training protects against DOX-induced liver mitochondrial dysfunction, which was attributed to modifications in organelle oxidative capacity and mitochondrial protein acetylation.
Quadriceps Impairment Is Associated with Gait Mechanics in Young Adults with Obesity
Authors: VAKULA MICHAEL N. , FISHER KOREN L. , GARCIA STEVEN A. , HOLMES SKYLAR C. , POST BRETT K. , COSTA PABLO B. , PAMUKOFF DEREK N.
Published: January 2019

Purpose

Obesity influences gait and muscle function, which may contribute to knee osteoarthritis. This study aimed 1) to compare gait biomechanics and quadriceps function between individuals with and without obesity and 2) to examine the association between quadriceps function and gait biomechanics.

Methods

Forty-eight individuals with and 48 without obesity participated and were matched on age and sex. Gait biomechanics at standardized and self-selected speeds were used to assess peak vertical ground reaction force (vGRF), vertical loading rate (vLR), internal knee extension moment (KEM), peak knee flexion angle (KFA), knee flexion excursion (KFE), and knee joint stiffness. Quadriceps function was assessed using peak isometric strength (peak torque), early (RTD100) and late (RTD200) rate of torque development (RTD), and vastus lateralis cross-sectional area (CSA) and echo intensity (EI).

Results

When normalized to fat-free mass, individuals with obesity had lower RTD100 (P = 0.04) and RTD200 (P = 0.02) but higher vastus lateralis CSA (P < 0.01) and EI (P < 0.01) compared with normal weight controls. The group–speed interaction was significant for normalized vGRF (P < 0.01), normalized vLR (P = 0.02), normalized KEM (P = 0.03), and normalized knee joint stiffness (P = 0.02). Post hoc analyses indicate a smaller normalized vGRF and normalized KEM, and lower knee joint stiffness in individuals with obesity compared with normal weight controls at self-selected speed. There were main effects of speed for all kinematic and kinetic variables, and body mass index group for all absolute kinetic variables as well as normalized vGRF (all P < 0.001). A lower vastus lateralis EI (P = 0.04) and greater RTD100 (P < 0.01) were associated with a larger KEM in individuals with obesity.

Conclusion

Individuals with obesity have quadriceps dysfunction that is weakly associated with KEM during walking. Exercise interventions that improve quadriceps function may improve walking mechanics.
Fungsi Intermediary Bank Aceh Setelah Melakukan Konversi Menjadi Bank Umum Syariah
Authors: Purwanto Purwanto
Published: January 2019

Sebagai  salah satu Negara dengan  penduduk muslim terbesar didunia, Indonesia merupakan pasar potensial bagi bisnis berbasis syariah termasuk industri keuangan syariah. Pemerintah Indonesia telah melakukan berbagai upaya agar industri keuangan syariah dapat berkembangan di Indonesia salah satunya adalah dengan membuat ketentuan diperbolehkannya bank konvensional melakukan konversi menjadi bank syariah. Kebijakan tersebut ternyata berdampak positif dalam meningkatkan market share industri perbankan syariah terhadap pangsa pasar industri keuangan di Indonesia. Pada tahun 2016-2017 market share industri keuangan syariah meningkat menjadi 5,3% dan 5,78% padahal pada tahun 2015  market share industri perbankan syariah hanya 4,83%. Meningkatkanya market share industri perbankan syariah, salah satunya disebabkan konversi bank Aceh menjadi bank Aceh Syariah pada tahun 2016. Konversi yang dilakukan oleh Bank Aceh secara umum berdampak positif terhadap market share industri perbankan syariah, namun bagaimana kondisi pada internal pada bank Aceh Syariah sendiri apakah ada perubahan signifikan bank Aceh Syariah dalam menjalankan fungsi intermediary? Guna mencari atas pertanyaan ini maka studi ini perlu dilakukan. Studi ini menggunakan analisis kuantitatif dengan pendekatan before after. Data penelitian yang digunakan adalah data skunder yaitu data laporan keuangan bank Aceh Syariah selama 18 bulan sebelum konversi dan 18 bulan setelah konversi. Analisis data menggunakan paired sample t-test dengan menggunakan software SPSS.21. Hasil dari studi ini membuktikan bahwa setelah melakukan konversi menjadi bank Aceh Syariah ada perbedaan yang signifikan dalam menjalankan fungsi intermediary baik dari sisi jumlah pembiayaan dan jumlah DPK. Hal ini menunjukkan bahwa perubahan brand bank Aceh menjadi Syariah berdampak positif dengan keputusan masyatakat untuk menggunakan produk bank Aceh Syariah.
Analisis Pengaruh CAR, NPF, FDR dan Inflasi terhadap Profitabilitas Perbankan Syariah di Indonesia
Authors: Munir Misbahul
Published: January 2019

The increasing number of sharia financial institutions in Indonesia is accompanied by an increase in literature review regarding sharia financial institutions. Renewal of studies related to the development of Islamic finance in Indonesia is important to continue. This study aims to examine the factors that affect the level of profitability of Islamic banking in Indonesia in the latest conditions and the latest data. The approach used is quantitative descriptive. Based on the F test, the f-statistic value obtained was 0.000085 below 0.05 (five percent). In other words, the independent variables including CAR, NPF, FDR, and inflation simultaneously have a significant effect on the dependent variable ROA. Whereas in a formal manner, based on the t-test, the NPF variable has a positive and significant effect on ROA. While the CAR, FDR and inflation variables have no effect on ROA.
Deteksi Kebangkrutan pada Industri Asuransi Syariah di Indonesia
Authors: Bakhtiar Fayakhun , Munir Misbahul , Qasas Ahsan Al
Published: January 2019

This study aims to predict the potential bankruptcy of a sharia insurance company. The analysis model used is the modified Altman Z-score analysis model. The Altman Z-score measurement model will be represented by the ratio of the network model to total assets, retained earnings to total assets, earnings before interest to total assets and capital book value to the book value of debt. The results showed that in 2011-2017 5 sharia insurance companies were in a safe zone (not bankrupt), there was only one sharia insurance company in the gray zone.