bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuropathology of Spontaneous Hypertensive Encephalopathy in Cats
Authors: Church Molly E. , Turek Bradley J. , Durham Amy C.
Published: May 2019

Pathologic features of 12 cats with naturally acquired systemic hypertension and concomitant hypertensive encephalopathy were analyzed. All cats demonstrated acute onset of signs localized to the forebrain and/or brainstem, including stupor, coma, and seizures. All cats had systemic hypertension, ranging from 160 to 300 mm Hg. Gross lesions were identified in 4 of 12 cases, including caudal herniation of the cerebrum and cerebellum, sometimes with compression of the rostral colliculus and medulla. Histologically, all cases featured bilaterally symmetrical edema of the cerebral white matter. Associated vascular lesions, especially arteriolar hyalinosis, were also observed. Concurrent lesions were chronic tubulointerstitial nephritis (11/12 cases), adenomatous hyperplasia of the thyroid gland (4 cases), hypertensive choroidal arteriopathy (6 cases), and left ventricular hypertrophy (5 cases). This study demonstrates that the typical histologic manifestation of spontaneous hypertensive encephalopathy in cats is bilaterally symmetrical edema of the subcortical cerebral white matter.
Short-term wind speed forecasting based on autoregressive moving average with echo state network compensation
Authors: Tian Zhongda , Wang Gang , Ren Yi
Published: May 2019

In order to improve the forecasting accuracy of short-term wind speed, a forecasting method based on autoregressive moving average with echo state network compensation is proposed in this article. First, the linear and nonlinear characteristics of short-term wind speed can be determined by Brock–Dechert–Scheinkman statistics method. Then, autoregressive moving average model is used for modeling and to forecast the linear component of short-term wind speed. The linear component of short-term wind speed sequence is obtained. Artificial bee colony algorithm–optimized echo state network model is used as the forecasting model of forecasting error sequences with the nonlinear characteristic. Finally, the final forecasting value is obtained by adding forecasting values of autoregressive moving average model and forecasting error values of echo state network model. k-fold cross-validation is used to improve the generalization ability of the forecasting model. The simulation comparison results show that the proposed forecasting method has higher prediction accuracy with the smaller prediction error. The forecasting indicators are also better than other forecasting methods.
News stories framed episodically offer more diversified portrayals of immigrants
Authors: Somaini Francesco
Published: May 2019

This study investigated the representations of immigrants emerging from frames used in news stories in the two largest-circulation daily newspapers in Arizona: The Arizona Republic and the Arizona Daily Star. A quantitative content analysis of 380 stories published in the two dailies’ websites in 2013 found the news coverage of immigration generally unfavorable to immigrants. Stories framed episodically provided less negative representations of immigrants than stories framed thematically did. Journalists interested in producing more diversified coverage of immigration should consider writing more stories using a predominantly episodic frame.
Clinical Significance of Incidental Rolandic Spikes in Children With Absence Epilepsy
Authors: Datta Anita N. , Wallbank Laura , Mak Jeremy C. H. , Wong Peter K. H.
Published: May 2019

Purpose:

Absence epilepsy and benign epilepsy of childhood with central temporal spikes are common childhood epilepsy syndromes. Although 3-Hz generalized spike-wave discharges are almost always associated with absence seizures, rolandic spikes can be present in individuals without rolandic seizures. The co-occurrence of 3-Hz generalized spike-wave and rolandic spikes is very rare. Our objective was to compare clinical features of patients with absence epilepsy with and without rolandic spikes, to determine if the additional feature of rolandic spikes has any clinical significance.

Methods:

Clinical information of 17 children with absence epilepsy and rolandic spikes was compared to an age-matched control group of 90 children with absence epilepsy.

Results:

Although most patients had excellent seizure control at follow-up, epilepsy comorbidities (cognitive and emotional problems) were observed. Comparing study vs control groups, there was no difference with anxiety (2 [11.8%] vs 8 [9%]), behavioral issues (4 [23.5%] vs 10 [11%]), mood disorders (0 vs 2 [2%]), and attention-deficit hyperactivity disorder (4 [24%] vs 10 [11%]). Significant differences were also observed: more global-developmental (5 [29%] vs 5 [6%], P < .009) and expressive-language (4 [24%] vs 5 [6%], P < .034) delay and more difficulties with school performance (11 [65%] vs 32 [36%], P < .025), especially with language-related tasks (6 [35%] vs 5 [6%], P < .001).

Conclusion:

Our results confirm the presence of additional epilepsy comorbidities in patients with absence epilepsy when rolandic spikes are present. Rolandic spikes in patients with absence epilepsy may be a marker of additional cognitive challenges that physicians should be aware of.
Numerical investigation of cold flow over regular and wavy V-gutters
Authors: Mollaei Mohammadreza , Ghassemi Hojat
Published: May 2019

In this paper, the numerical study of cold flow over two types of regular and wavy V-gutter flame holders has been presented. The edges of the V-gutter, which are smooth in the regular case, are shaped in a sinusoidal form with different phase angles on upper and lower edges. The three-dimensional numerical analysis has been performed using the finite volume method and the renormalization group k–ɛ model has been used for turbulence modeling. The results were compared and validated by an existing experimental work based on the particle image velocimetry method. This study provided the fluid flow structure behind the V-gutter, the dimensions of the recirculation region, the behavior of vortex shedding phenomenon, and the static pressure distribution in the wake area. According to the results, the recirculation length for the sinusoidal case with 90 ° of the phase difference is the largest compared with the other cases, which increases the mass flow rate of the fresh unburnt mixture into the recirculation region and improves flame stability. The results also show that the 90 ° wavy V-gutter case has the lowest pressure drop in the wake region, which reduces the drag coefficient against the main flow. The values of the Strouhal number are approximately the same and equal to 0.27 for both cases (the regular and the 90 ° cases). Therefore, it is concluded that the 90 ° wavy V-gutter shows better performance than the regular V-gutter in flame stabilization.
Nursing and euthanasia: A narrative review of the nursing ethics literature
Authors: Pesut Barbara , Greig Madeleine , Thorne Sally , Storch Janet , Burgess Michael , Tishelman Carol , Chambaere Kenneth , Janke Robert
Published: May 2019

Background:

Medical Assistance in Dying, also known as euthanasia or assisted suicide, is expanding internationally. Canada is the first country to permit Nurse Practitioners to provide euthanasia. These developments highlight the need for nurses to reflect upon the moral and ethical issues that euthanasia presents for nursing practice.

Purpose:

The purpose of this article is to provide a narrative review of the ethical arguments surrounding euthanasia in relationship to nursing practice.

Methods:

Systematic search and narrative review. Nine electronic databases were searched using vocabulary developed from a stage 1 search of Medline and CINAHL. Articles that analysed a focused ethical question related to euthanasia in the context of nursing practice were included. Articles were synthesized to provide an overview of the literature of nursing ethics and euthanasia.

Ethical Considerations:

This review was conducted as per established scientific guidelines. We have tried to be fair and respectful to the authors discussed.

Findings:

Forty-three articles were identified and arranged inductively into four themes: arguments from the nature of nursing; arguments from ethical principles, concepts and theories; arguments for moral consistency; and arguments from the nature of the social good. Key considerations included nursing’s moral ontology, the nurse–patient relationship, potential impact on the profession, ethical principles and theories, moral culpability for acts versus omissions, the role of intention and the nature of the society in which euthanasia would be enacted. In many cases, the same assumptions, values, principles and theories were used to argue both for and against euthanasia.

Discussion:

The review identified a relative paucity of literature in light of the expansion of euthanasia internationally. However, the literature provided a fulsome range of positions for nurses to consider as they reflect on their own participation in euthanasia. Many of the arguments reviewed were not nursing-specific, but rather are relevant across healthcare disciplines. Arguments explicitly grounded within the nature of nursing and nurse–patient relationships warrant further exploration.
Ethical issues related to the use of gerontechnology in older people care: A scoping review
Authors: Sundgren Suvi , Stolt Minna , Suhonen Riitta
Published: May 2019

Background:

Demographic trends indicate growth of population aged 65 and older in Western countries. One of the greatest challenges is to provide high-quality care for all. Technological solutions designed for older people, gerontechnology, can somewhat balance the gap between resources and the increasing demand of healthcare services. However, there are also ethical issues in the use of gerontechnology that need to be pointed out.

Purpose:

To describe what ethical issues are related to the use of gerontechnology in the care of community-dwelling older people.

Methods:

A scoping review was performed to identify and analyse studies concerning ethical issues when using gerontechnology in the home care of older people. The literature search was limited to studies published after 1990 and addressed to the electronic databases CINAHL, PubMed, Cochrane, Medic, IEEE Explore and Web of Science. The search was performed in July−August 2018. Data from empirical studies were analysed using thematic analysis.

Ethical considerations:

This scoping review was conducted in accordance with good scientific practice. The work of other researchers was respected and cited appropriately.

Results:

A total of 17 studies were identified. Two main themes were found. ‘Balancing between the benefits of using gerontechnology and the basic rights of older people’, consisted of the subthemes safety, privacy and autonomy. The other main theme, ‘Gerontechnology as a risk of insecurity for older people’, included the subthemes fear of losing human contact and concern and fear. Surveillance and monitoring technologies were mainly studied.

Conclusion:

These results suggest that there may be ethical issues related to the use of gerontechnology and they must therefore be taken into consideration when implementing technology in the care of community-dwelling older people.
Conscientious object in nursing: Regulations and practice in two European countries
Authors: Dobrowolska Beata , McGonagle Ian , Pilewska-Kozak Anna , Kane Ros
Published: May 2019

Background:

The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery.

Aim:

To present (a) the arguments for and against conscientious objection in nursing practice, (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice.

Design:

Discussion paper.

Ethical considerations:

Ethical guidelines has been followed at each stage of this study.

Findings:

Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights.

Discussion and conclusion:

Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice.
Characterization of nurses’ duty to care and willingness to report
Authors: McNeill Charleen , Alfred Danita , Nash Tracy , Chilton Jenifer , Swanson Melvin S
Published: May 2019

Background:

Nurses must balance their perceived duty to care against their perceived risk of harm to determine their willingness to report during disaster events, potentially creating an ethical dilemma and impacting patient care.

Research aim:

The purpose of this study was to investigate nurses’ perceived duty to care and whether there were differences in willingness to respond during disaster events based on perceived levels of duty to care.

Research design:

A cross-sectional survey research design was used in this study.

Participants and research context:

Using a convenience sample with a snowball technique, data were collected from 289 nurses throughout the United States in 2017. Participants were recruited through host university websites, Facebook, and an American Nurses Association discussion board.

Ethical considerations:

Institutional review board approval was obtained from the University of Texas at Tyler and the University of Arkansas.

Findings:

Analysis of willingness to report to work based on levels of perceived duty to care resulted in the emergence of two groups: “lower level of perceived duty to care group” and “higher level of perceived duty to care group.” The most discriminating characteristics differentiating the groups included fear of abandonment by co-workers, reporting because it is morally the right thing to, and because of imperatives within the Nursing Code of Ethics.

Discussion:

The number of nurses in the lower level of perceived duty to care group causes concern. It is important for nursing management to develop strategies to advance nurses’ safety, minimize nurses’ risk, and promote nurses’ knowledge to confidently work during disaster situations.

Conclusion:

Level of perceived duty to care affects nurses’ willingness to report to work during disasters. Primary indicators of low perceived duty to care are amenable to actionable strategies, potentially increasing nurses’ perceived duty to provide care and willingness to report to work during disasters.
Women’s Experiences of Defecating in the Open: A Qualitative Study
Authors: Abdul Azeez E.P.  , Negi Dandub Palzor , Mishra Aditi
Published: May 2019

The issue of open defecation is ubiquitous in a country like India where certain demographic groups are underprivileged and often the victims of substandard life and human right violations. Women are the direct victims of open defecation and the non-availability of toilets and the practice of open defecation makes women vulnerable to health risks and gender-based violence. The present article analyses the practice of open defecation by conducting in-depth interviews with 30 women in the reproductive age group in the five villages of Bandarsindri, Kheda, Sirohi, Mundoti and Nahoriyain in central Rajasthan. The study found that women’s experience of open defecation is accompanied by fear, shame, lack of privacy and dignity, and conflict—all of which impact the overall quality of life.
Promoting Spiritual Health and Holistic Wellness
Authors: Ghiya Ghanshyam Dass
Published: May 2019

Promoting spiritual health is essential for achieving holistic wellness. The modern era has recorded a sharp increase in lifestyle diseases such as high blood pressure, high blood sugar, allergic disorders, psychosomatic disorders, mental illnesses and diseases associated with low immunity. The goal of positive health for all remains unachieved as the World Health Organization (WHO) has not included ‘spiritual health’ in its definition of health. The basic pathophysiology of most of the diseases could be explained scientifically through the primary respiratory mechanism (PRM). The PRM is ‘breathe spark plug’. If strengthened, it could influence and decline occurrence of lifestyle diseases and lead to a positive health status. Recent emphasis on yoga, meditation and wellness by the Government of India are some of the available methods to achieve positive health. This article discusses the role of PRMs to understand and improve health and well-being. We propose that the inclusion of yoga and meditation in the primary health care as promoted by the Government of India is one of the best available methods to achieve positive health and holistic wellness.
Determinants of Health-seeking Behaviour in Northeast India
Authors: Ngangbam Sapana , Roy Archana K.
Published: May 2019

India’s northeast region comprises eight states, which, together, is home to 3.8 per cent of the country’s population. The quality of healthcare and manpower availability remains a cause for concern in the region, affecting the overall health-seeking behaviour of the people. This study attempts to understand the determinants of utilization of healthcare services in Northeast India. Healthcare and morbidity data for this study are based on a Northeast India sample from the National Sample Survey Organization’s (NSSO’s) health consumption data (2014). Probit, multinomial and mixed conditional logit models were employed in the study. In Northeast India, uneducated, higher-aged, Schedule Castes/Schedule Tribes (SCs/STs), Muslims, rural people and district people are served less by medical institutions and because of poor road connectivity they either remain untreated or seek care at underequipped primary healthcare services, while their counterparts utilize private facilities mostly for outpatient care and either public hospital or private facilities for inpatient care. There is also a tendency to substitute alternative healthcare when the cost of an inpatient healthcare service rises. To protect the interest of marginalized people and achieve the target of accessible, affordable and quality healthcare, the government needs to strengthen the primary healthcare in rural areas and improve the quality of healthcare in urban areas without increasing the cost of treatment.
Dual infection with an emergent strain of canine distemper virus and canine parvovirus in an Arctic wolf under managed care
Authors: Stilwell Justin M. , Anis Eman , Wilkes Rebecca P. , Rissi Daniel R.
Published: May 2019

A 6-wk-old managed male Arctic wolf with lethargy, drooling, dehydration, elevated temperature, and acute onset of seizures was submitted for autopsy. The wolf had been vaccinated with a multivalent vaccine exactly 2 wk prior to presentation. Grossly, long bones were brittle and easily fractured under pressure; the intestinal contents were mucoid and yellow. Histologically, there was widespread lymphoid and hematopoietic necrosis, failure of endochondral ossification within long bones, as well as intranuclear and intracytoplasmic inclusions in various tissues and cell types. Canine distemper virus was detected in numerous tissues by IHC and confirmed by RT-rtPCR and sequencing as an American-4 strain, an emerging strain in domestic dogs and wildlife species in the southeastern United States. The clinical and pathologic findings associated with this emergent CDV strain have not been reported previously in wolves, to our knowledge. Canine parvovirus 2 (CPV-2b) was also detected in the spleen by IHC and confirmed by conventional PCR as a wild-type strain. The exact impact of CPV-2b on the clinical course is unknown. Early vaccination in this case may have predisposed this Artic wolf to developing clinical disease.
The Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model
Authors: Andrews Margaret M. , Boyle Joyceen S.
Published: May 2019

The goals of the Andrews/Boyle Transcultural Interprofessional Practice (TIP) model are to provide a patient- or client-centered systematic, logical, orderly, scientific process for delivering safe, culturally congruent and competent, affordable, accessible, evidence-based, and quality care for people from diverse backgrounds across the life span. Key components of the TIP model include the context from which people’s health-related values, attitudes, beliefs, and practices emerge; the interprofessional health care team; effective verbal and nonverbal communication among all team members; and a five-step systematic, scientific problem-solving process—assessment, mutual goal setting, and planning, implementing, and evaluating the effectiveness of therapeutic interventions and care. The model is applicable wherever nurses practice, teach, learn, lead, consult, and conduct research domestically and globally.
Obama’s Urban Legacy: The Limits of Braiding and Local Policy Coordination
Authors: Stoker Robert P. , Rich Michael J.
Published: May 2019

We examine the distribution of selected place-based urban assistance grants provided by the Obama administration to the 50 largest U.S. cities. Our analysis contributes to understanding Obama’s urban legacy by separating planning from implementation grants, distinguishing between policy domains, and acknowledging the limitations of local policy coordination. Facing staunch Congressional opposition to its urban agenda, administration officials encouraged local participants to finance their revitalization projects by braiding (seeking resources from many sources and coordinating and integrating existing federal funding streams locally to create comprehensive, synergistic initiatives). However, braiding was not always successful. Cities struggled to win federal grants in multiple policy domains and to coordinate the use of grants they did win, as braiding made an already difficult process even more demanding and complex.
Intertwined microlattices greatly enhance the performance of mechanical metamaterials
Authors: Vangelatos Zacharias , Melissinaki Vasileia , Farsari Maria , Komvopoulos Kyriakos , Grigoropoulos Costas
Published: May 2019

Mechanical metamaterials demonstrate augmented properties derived from their engineered structure. Advances in three-dimensional (3D) printing technologies have enabled the fabrication of complex metamaterial structures even at the microscale, contributing to the development of light-weight materials with superior mechanical properties. However, understanding of metamaterial strain hardening that is intrinsic to both the structure and arrangement of novel unit cells is sparse and fairly empirical. The main objective of this study was to introduce a new design approach for 3D mechanical metamaterials with enhanced strain hardening and energy absorption, fabricated at the microscale by multiphoton lithography, which is the only fabrication technique that can produce micrometer length scales and high structural complexity. This was accomplished by intertwining simple polyhedra to create more complex geometries in 3D space, using penetration twins as a point of reference, a mechanism of crystal in-growth wherein distinct crystals appear to penetrate each other. This structural principle was used to intertwine the lattice members of the structure and tailor their buckling behavior. The present design is inspired by the first stellation of the rhombic dodecahedron. With this concept, plastic deformation can be controlled through localized buckling of select lattice members. Finite element simulations and nanoindentation experiments demonstrate remarkably improved performance with respect to both strain hardening and energy dissipation of the structure compared to both the bulk material and one of the most thoroughly studied ultralight, ultrastiff mechanical metamaterials, the octet truss.
A Ferguson Effect, the Drug Epidemic, Both, or Neither? Explaining the 2015 and 2016 U.S. Homicide Rises by Race and Ethnicity
Authors: Gaston Shytierra , Cunningham Jamein P. , Gillezeau Rob
Published: May 2019

In 2015 and 2016, U.S. homicide rates rose dramatically amid two historic social phenomena: a police legitimacy crisis related to an alleged “Ferguson effect” and the opioid epidemic. To empirically explain this increase, we compile county-level data on race/ethnic-specific homicides from 2014 to 2016 along with contemporaneous county-level data on police killings of civilians, citizen protests, fatal drug overdoses, structural disadvantage, and other factors. Regression analysis suggests that both police illegitimacy and the drug epidemic contributed to Black and White homicide rises, particularly in structurally disadvantaged counties. However, we find no such association for Hispanic homicide increases.
Myocardial Infarction in the Neonate Without Coronary Artery Occlusion and Structurally Normal Heart: A Report of 2 Cases in Twin Pregnancies and Review of the Literature
Authors: Sathirareuangchai Sakda , Placek Alexander L , Killeen Jeffrey L , Thompson Karen S
Published: May 2019

Myocardial infarction (MI) is a common diagnosis in the adult population and is associated with coronary artery atherosclerosis. However, it is an unusual diagnosis in the pediatric population, especially in the neonatal period. The authors present 2 autopsy cases of MI in newborn babies of twin pregnancies with normal heart and coronary arteries. The first case is that of a 10-day-old female, monochorionic-diamniotic, twin B born at 29 weeks’ gestation. The autopsy revealed diffuse subacute MI in both ventricles, which was compatible with a global hypoxic event during perinatal period. The hypoxic insult was likely caused by maternal HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome as evident in the placental examination, which showed placental infarct and decidual arteriopathy. The second case is that of a 2-day-old term male, dichorionic-diamniotic, twin A with an antenatal history of prolonged rupture of membranes. The hospital course was complicated by neonatal sepsis. The autopsy showed diffuse hemorrhage in the internal organs including the heart, along with myocyte necrosis. The overall findings were consistent with multiorgan dysfunction syndrome resulting from sepsis. Previous reported cases of MI in neonates without coronary artery occlusion were also reviewed and portrayed.
A Mechanistic Model of Gut–Brain Axis Perturbation and High-Fat Diet Pathways to Gut Microbiome Homeostatic Disruption, Systemic Inflammation, and Type 2 Diabetes
Authors: Lew Kelley Newlin , Starkweather Angela , Cong Xiaomei , Judge Michelle
Published: May 2019

Type 2 diabetes (T2D) is a highly prevalent metabolic disease, affecting nearly 10% of the American population. Although the etiopathogenesis of T2D remains poorly understood, advances in DNA sequencing technologies have allowed for sophisticated interrogation of the human microbiome, providing insight into the role of the gut microbiome in the development and progression of T2D. An emerging body of research reveals that gut–brain axis (GBA) perturbations and a high-fat diet (HFD), along with other modifiable and nonmodifiable risk factors, contribute to gut microbiome homeostatic imbalance. Homeostatic imbalance or disruption increases gut wall permeability and facilitates translocation of endotoxins (lipopolysaccharides) into the circulation with resultant systemic inflammation. Chronic, low-grade systemic inflammation ensues with pro-inflammatory pathways activated, contributing to obesity, insulin resistance (IR), pancreatic β-cell decline, and, thereby, T2D. While GBA perturbations and HFD are implicated in provoking these conditions, prior mechanistic models have tended to examine HFD and GBA pathways exclusively without considering their shared pathways to T2D. Addressing this gap, this article proposes a mechanistic model informed by animal and human studies to advance scientific understanding of (1) modifiable and nonmodifiable risk factors for gut microbiome homeostatic disruption, (2) HFD and GBA pathways contributing to homeostatic disruption, and (3) shared GBA and HFD pro-inflammatory pathways to obesity, IR, β-cell decline, and T2D. The proposed mechanistic model, based on the extant literature, proposes a framework for studying the complex relationships of the gut microbiome to T2D to advance study in this promising area of research.
Angiographic features of polypoidal choroidal vasculopathy using indocyanine green angiography and optical coherence tomography angiography: A comparative study
Authors: Singh Sumit Randhir , Goyal Prakhar , Parameswarappa Deepika C , Goud Abhilash , Chhablani Jay
Published: May 2019

Background:

To compare the vascular lesion size using optical coherence tomography angiography and indocyanine green angiography in eyes with polypoidal choroidal vasculopathy.

Methods:

Treatment-naïve cases (46 eyes of 44 patients) with polypoidal choroidal vasculopathy were retrospectively analyzed. The comparison of mean area of branching vascular network and polyp detection rate was done between indocyanine green angiography and optical coherence tomography angiography and correlated with various optical coherence tomography features.

Results:

The mean age of the study patients was 62.33 ± 10.74 years. The mean branching vascular network size was 7.47 ± 5.74 and 7.51 ± 5.69 mm² in indocyanine green angiography and optical coherence tomography angiography, respectively, with an excellent correlation (r = 0.997). Optical coherence tomography angiography overestimated (mean ± SD: 0.28 ± 0.19 mm²) and underestimated branching vascular network area (0.36 ± 0.33 mm²) in 23 eyes each as compared to indocyanine green angiography. However, the difference in branching vascular network size was not statistically significant (p = 0.53). Indocyanine green angiography and optical coherence tomography angiography could identify polyps in 43 of 46 (93.48%) and 32 of 46 (69.57%) patients, respectively.

Conclusion:

Branching vascular network size measurements with indocyanine green angiography and optical coherence tomography angiography were comparable and showed significant correlation, albeit the polyp identification rate was lower with optical coherence tomography angiography. Optical coherence tomography angiography may serve as a useful substitute to indocyanine green angiography in measurements of branching vascular network for photodynamic therapy and follow-up of polypoidal choroidal vasculopathy eyes.
The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 (VA LV VFQ-48): Performance of the Italian version
Authors: Di Maggio Ilaria , Virgili Gianni , Giacomelli Giovanni , Murro Vittoria , Sato Giovanni , Amore Filippo , Villani Gianfrancesco Maria , Fortini Stefania , Turco Simona , Pece Alfredo , Rizzo Roberta , Galan Alessandro , Giordani Lucia , Mucciolo Dario Pasquale , Nota Laura
Published: May 2019

Purpose:

The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 is among the most validated tools to collect patient-reported outcomes in a low-vision population. We have aimed to conduct a pilot validation of the Italian version of the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48.

Methods:

The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 was translated using a standardized procedure and then administered to consecutive low-vision patients attending rehabilitation services in three centers. Patients were interviewed by a trained psychologist regarding the individual items of the tool.

Results:

We included 131 patients with a mean visual acuity of 0.91 logMAR (standard deviation: 0.42 logMAR), mostly affected by age-related macular degeneration. The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 showed high internal consistency (Cronbach’s alpha: 0.98) and good item-test and item-rest correlation (median: 0.73 and 0.71, respectively). Both the overall score and the subscale (reading, visual motor, mobility and visual information) scores significantly correlated with visual acuity, reading acuity and speed. Reading speed achieved the best absolute correlation with the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 scores (Spearman r: 0.39–0.49).

Conclusion:

The Italian version of the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 is a valid tool to assess patients attending low-vision services. Revising a few items may further improve the tool.
Factors affecting arteriovenous fistula dysfunction: A narrative review
Authors: Gameiro Joana , Ibeas Jose
Published: May 2019

Vascular access dysfunction is one of the most important causes of morbidity and mortality in haemodialysis patients, contributing to up to one third of hospitalisations and accounting for a significant amount of the health care costs of these patients. In the past decades, significant scientific advances in understanding mechanisms of arteriovenous fistula maturation and failure have contributed to an increase in the amount of research into techniques for creation and strategies for arteriovenous fistula dysfunction prevention and treatment, in order to improve patient care and outcomes. The aim of this review is to describe the pathogenesis of vascular access failure and provide a comprehensive analysis of the associated risk factors and causes of vascular access failure, in order to interpret possible future therapeutic approaches. Arteriovenous fistula failure is a multifactorial process resulting from the combination of upstream and downstream events with consequent venous neo-intimal hyperplasia and/or inadequate outward remodelling. Inflammation appears to be central in the biology of arteriovenous fistula dysfunction but important triggers still need to be revealed. Given the significant association of arteriovenous fistula failure and patient’s prognosis, it is therefore imperative to further research in this area in order to improve prevention, surveillance and treatment, and ultimately patient care and outcomes.
Numerical simulation of ice-induced vibrations of steady-state type
Authors: Qiu Wenliang , Wu Tianyu
Published: May 2019

Ice force is one kind of nonnegligible external loads that nature exerts on structures. The action of drifting ice floes may induce strong vibrations of offshore structures, and further reduce the structural safety and serviceability. The aim of this article is to develop a method to simulate the most dangerous situation during the interaction between ice and structure, that is, the ice-induced vibrations of steady-state type. A simulation methodology to realize structural steady-state vibration is proposed; it can simulate a special phenomenon of negative damping. The calculation of effective ice pressure is accomplished by an empirical formula which considers the dependence of the crushing strength on the ice velocity. The most important contribution of the simulation method is to capture the steady-state vibration phenomenon. The presented simulation methodology is conducted on the same model test introduced in a referenced study to verify the efficacy. Calculational examples show good agreements with the results of the model test, and the frequency contents of the generations coincide well with the targets. They directly prove the validity of the proposed simulation method. In addition, the numerical simulation method can be used in connection with finite element programs to perform a steady-state vibration analysis of offshore structures.
The road from “vocation”: Weber and Veblen on the purposelessness of scholarship
Authors: Turner Stephen
Published: May 2019

“ Science as a Vocation” describes an ideal of scholarship for a vanished world. Images of the past university still color our idea of the university. Weber dispelled illusions about the university of his own time, and pointed to its cruelty and irrationality. Veblen did something similar for the American university of his time, defended a similar ideal, and foresaw the effects of disciplinarization and the quantification of academic life. They both provide insights into the ways in which the autonomy of academic inquiry has been transformed, and the price that has been paid for the present forms of autonomy. But a consideration of these changes also reveals the reasons for the change in academic values over the last century and what has been lost.
Emergent Use of a Branched Arch Device to Treat an Ascending Aortic Rupture: A Branch-to-Branch Through-and-Through Wire Technique to Compensate for Rotation Error
Authors: Eleshra Ahmed S. , Kölbel Tilo , Rohlffs Fiona , Scheerbaum Martin , Konstantinou Nikolaos , Tsilimparis Nikolaos
Published: May 2019

Purpose: To present a novel means of overcoming a rotation error when treating a ruptured ascending aorta with a branched arch endograft. Technique: The technique is demonstrated in an 83-year-old patient with cardiac and respiratory comorbidities and a contained rupture of the ascending aorta who was referred for endovascular therapy. Computed tomography angiography (CTA) showed progressive pseudoaneurysm and mediastinal hematoma, but the limited landing zone required the use of an inner branched arch endograft that was designed for another patient. The device became malrotated clockwise during deployment, so cannulation of the first inner branch was done using a branch-to-branch through-and-through wire from the second inner branch. The final angiogram showed a good result, with patency of the supra-aortic vessels and exclusion of the rupture. The patient was discharged 2 weeks later without complications. The 1-month CTA was free from endoleak. The patient returned to his normal activity 3 months later. Conclusion: The use of a branched arch stent-graft for emergent repair of a ruptured ascending aorta is feasible.
The Use of Samples Originating From Doping Control Procedures for Research Purposes: A Qualitative Study
Authors: Devriendt Thijs , Phillips Amicia , Shabani Mahsa , Borry Pascal
Published: May 2019

Doping control samples may be used for research purposes by the World Anti-Doping Agency (WADA)-accredited laboratories after their compulsory storage period has expired. This study investigates opinions of stakeholders toward the governance of antidoping research on these samples and to evaluate the current framework. Semistructured interviews were conducted with stakeholders in antidoping research. The distinction between research and quality assurance in the International Standard for Laboratories (ISL) is neither well-understood nor interpreted uniformly by WADA-accredited labs. Most laboratories would not seek ethics approval for research on doping control samples. Interviewees considered that athletes should be better informed on what antidoping research can entail. A consistent and uniform approach toward the consent should be employed worldwide. Standards and safeguards should be implemented to reduce the risk of reidentification. Centralization of the Informed Consent Form in the ADAMS (Anti-Doping Administration & Management System) database would facilitate providing more information and allow the implementation of the right to withdraw.
Fabrications of small diameter compliance bypass conduit using electrospinning of clinical grade polyurethane
Authors: Faturechi Rahim , Hashemi Ata , Abolfathi Nabiollah , Solouk Atefeh , Seifalian Alexander
Published: May 2019

Objective

Compliance and viscoelastic mismatches of small diameter vascular conduits and host arteries have been the cause of conduit’s failure.

Methods

To reduce these mismatches, the aim of this study was to develop and characterize a polyurethane conduit, which mimics the viscoelastic behaviors of human arteries. Electrospinning technique was used to fabricate tubular polyurethane conduits with similar properties of the human common carotid artery. This was achieved by manipulating the fiber diameter by altering the syringe flow rate of the solution. The mechanical and viscoelastic properties of the fabricated electrospun polyurethane conduits were, then, compared with commercially available vascular conduits, expanded polytetrafluoroethylene, polyethylene terephthalate (Dacron®) and the healthy human common carotid arteries. In addition, a comprehensive constitutive model was proposed to capture the visco-hyperelastic behavior of the synthetic electrospun polyurethanes, commercial conduits and human common carotid arteries.

Results

Results showed that increasing the fiber diameter of electrospun polyurethanes from 114 to 190 nm reduced Young’s modulus from 8 to 2 MPa. Also, thicker fiber diameter yielded in higher conduits’ viscosity. Furthermore, the results revealed that proposed visco-hyperelastic model is strongly able to fit the experimental data with great precision which proofs the reliability of the proposed model to address both nonlinear elasticity and viscoelasticity of the electrospun polyurethanes, commercial conduits and human common carotid arteries.

Conclusions

In conclusion, statistical analysis revealed that the elastic and viscous properties of 190 nm fiber diameter conduit are very similar to that of human common carotid artery in comparison to the commercial expanded polytetrafluoroethylene and Dacron® that are up to nine and seven times stiffer than natural vessels. Therefore, based on our findings, from the mechanical point of view, by considering the amount of Young’s modulus, compliance, distensibility and viscoelastic behavior, the fabricated electrospun polyurethane with fiber diameter of 189.6 ± 52.89 nm is an optimum conduit with promising potential for substituting natural human vessels.
Haptics control of an arm exoskeleton for virtual reality using PSO-based fixed structure H∞ control
Authors: Silawatchananai Chaiyaporn , Parnichkun Manukid
Published: May 2019

This article proposes a robust haptics control algorithm for an arm exoskeleton in virtual reality application that guarantees the robustness of the force displaying performance. The developed arm exoskeleton allows the user to sense the profile of virtual objects through joints at wrist, elbow, and shoulder. Forces exerted by the user are directly measured by load cells attached to the links, which are used to determine the corresponding velocity command based on virtual impedance. Due to the imperfection of modeling and the measurement noises from load cells and encoder quantization, the force displaying performance of the device tends to degrade with increasing oscillation, causing permanent damages to the device and user. To solve this problem, a Particle swarm optimization (PSO)-based fixed structure H∞ controller is proposed to control the developed arm exoskeleton. The control performance of the proposed controller is evaluated by both simulation and experiment. The results show that the proposed controller can achieve better tracking performance in comparison with proportional–integral–derivative controller in terms of less oscillation and fast response.
Development of a Novel Tool to Support Engagement With Continuous Glucose Monitoring Systems and Optimize Outcomes
Authors: Barnard-Kelly Katharine D. , Polonsky William H.
Published: May 2019

Background:

Increasing numbers of people with diabetes, especially those with type 1 diabetes (T1D), are using continuous glucose monitoring (CGM) systems to support their diabetes self-management, yet even so only approximately 30% of individuals with T1D meet the American Diabetes Association HbA1c target of 58 mmol/mol (7.5%) for children and 53 mmol/mol (7.0%) for adults. We aimed to produce a useful tool for people with diabetes to improve personalized understanding of CGM.

Method:

A brief leaflet titled “Guidelines to Improve Glucose Control Using CGM” was developed for people with diabetes. Semistructured interviews were held with 12 adults with T1D, focusing on their views regarding the relevance, readability, and usability of the newly revised leaflet. Participants were specifically asked to share what they would find most useful in terms of information and advice provided as well as how to make use of that in the context of their own diabetes self-management. Data were analyzed thematically and used to inform revisions of the leaflet content.

Results:

Data highlighted information and advice needs as well as personalization in terms of own diabetes management.

Conclusions:

CGM systems are associated with improved medical and psychosocial outcomes, especially when used effectively to meet the individual needs of the user. Ensuring greater understanding of the individual’s expectations when first starting CGM, matching experience and skills to meet those expectations, and tailoring use to the individual needs of each person with diabetes (PWD) are all required to achieve widespread and consistent benefit.
Choosing a Vibratory Test to Pair With Semmes Weinstein Monofilament Testing for Evaluating Lower Extremity Sensation in Patients With Diabetes: A Comparison of Three Vibratory Methodologies
Authors: Raymond Bryan , Steriovski James , Gillyard KaNesha , Yang Chalen , Wu Stephanie C. , Crews Ryan T.
Published: May 2019

Background:

Numerous guidelines recommend pairing Semmes-Weinstein monofilament (SWM) testing with a secondary clinical test when screening for diabetic peripheral neuropathy, yet time is very limited in clinical practice. This study compared the time to complete and the diagnostic agreement of three vibratory sensation tests.

Methods:

Sixty-five individuals (42% male; aged: 61 ± 12 years) were recruited. A single investigator administered the following tests bilaterally: 10-site SWM, traditional tuning fork (TTF), electronic tuning fork (ETF), and vibration perception threshold (VPT) via biothesiometer. Times to physically administer the tests were compared with a one-way repeated measures ANOVA. Cochran’s Q test was used to compare the varied tests’ diagnostic agreement.

Results:

The ANOVA indicated there were significant ( P < .001, partial eta squared = .442) differences in time to complete the varied tests. Sidak post hoc comparisons indicated the VPT (21.2 ± 14.3) testing took an intermediate time to complete, while the ETF (9.7 ± 6.5) and TTF (10.1 ± 7.5) tests took the least amount of time, and the SWM (28.6 ± 8.4) test took the longest time. There were also numerous significant differences ( P ≤ .001) between the different tests in regards to neuropathy diagnoses.

Conclusions:

Tuning fork methods required 11 seconds less to administer than VPT testing. Although that may seem trivial, it is worth noting peripheral neuropathy screening often fails to occur in the precious few minutes clinicians are allotted per patient. Considering ETF’s intrinsic control of stimulus amplitude and its ease of use with an embedded timer, the ETF is recommended over the TTF. Clinicians should also be mindful that different tests yield different diagnostic conclusions.