bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a new hybrid yarn construction from recycled carbon fibres for high-performance composites. Part III: Influence of sizing on textile processing and composite properties
Authors: Hengstermann Martin , Hasan Mir Mohammad Badrul , Scheffler Christina , Abdkader Anwar , Cherif Chokri
Published: May 2019

The processing of recycled carbon fibres (rCFs) into hybrid yarn constructions is a promising recycling option, converting rCF into products with added value. Along with fibre length and strength, the sizing of rCF crucially affects their processing behaviour and subsequent composite properties. This article reports on the influence of sizing on the processing properties of rCF by mixing with polyamide (PA) 6 fibres to form a hybrid yarn construction. Moreover, resulting composite properties were studied as well. Thus, commercially available CF with thermoplastic and thermoset matrix compatible sizing in addition to pyrolyzed rCF without sizing was used for the investigations presented in this article. Results revealed that different sizing strongly influence the processing of rCF and PA 6 into hybrid yarn constructions. The opening and bending behaviour of rCF bundles with different sizing varied during the carding process so that various degrees of fibre shortening occurred. As expected, the sizing developed for thermoplastic matrix enabled the highest tensile and flexural strengths in thermoplastic composites. These findings greatly contribute to the understanding of rCF processing from different or unknown sources on industrial scale.
Cellulose triacetate fiber-reinforced polystyrene composite
Authors: Saeed Usman , Dawood Uthman , Ali Arshad Mahmood
Published: May 2019

The increase in demand for natural fibers in development of the composites has grown rapidly due to the cost-effectiveness, low density, biodegradability, and renewability. The lack of appropriate interfacial bonding between the cellulose fibers and the thermoplastic matrix is one of the disadvantages faced during their application. Also, the properties of composite made of thermoplastic polystyrene (PS) and cellulose acetate fibers are not compatible due to the poor wettability and interfacial adhesion. In the study presented, PS reinforced with cellulose triacetate is being prepared by melt blending in a twin-screw extruder with the induction of fusabond (FB). The influence of the cellulose acetate and FB content on PS composite is being investigated using thermogravimetric analysis, tensile test, dynamic mechanical analysis, scanning electron microscopy, and X-ray photoelectron spectroscopy. The addition of FB enhances interfacial adhesion demonstrated by the improvement in storage modulus, reduction in damping peak value, and the increase in thermal stability of the composite. The inclusion of FB not only increases the % elongation but also improves the impact strength of the cellulose triacetate-reinforced PS composite under dynamic loading. Moreover, the interaction between PS with cellulose triacetate fiber is indicated by the results of X-ray photospectroscopy and fracture surface morphology. The results show that the addition of FB is suitable for use in cellulose fiber-reinforced PS composite for packaging, automotive, and biomedical applications.
Accounting for HIV Health Disparities: Risk and Protective Factors Among Older Gay and Bisexual Men
Authors: Emlet Charles A. , Fredriksen-Goldsen Karen I. , Kim Hyun-Jun , Jung Hyunzee
Published: May 2019

Objective: This study examines whether disparities exist in poor health and depressive symptomatology among older gay/bisexual men (50+) with ( n = 371) and without ( n = 973) HIV. If so, what risk/promoting factors account for those disparities? Method: These cross-sectional analyses used 2014 data from the Aging With Pride: National Health, Aging, and Sexuality/Gender Study. Results: Those with HIV reported poorer health and more depressive symptomatology accounted for by lower income, resilience and social support, and more lifetime victimization. Poorer health among those with HIV was associated with more chronic conditions. Higher depressive symptomatology was associated with diagnosed anxiety and drug addiction. Community engagement reduced disparities in poor health and depression. Implications: Older gay/bisexual men living with HIV infection are at greater risk for physical and mental health issues. Assessments should be conducted with attention to these risk factors. Interventions for improving social support, resilience, and community engagement are warranted.
Numerical and experimental investigation of the pressure fluctuation in a mixed-flow pump under low flow conditions
Authors: Shen Xi , Zhang Desheng , Xu Bin , Zhao Ruijie , Jin Yongxin , Chen Jian , Shi Weidong
Published: May 2019

In this paper, the large eddy simulation is utilized to simulate the flow field in a mixed-flow pump based on the standard Smagorinsky subgrid scale model, which is combined with the experiments to investigate pressure fluctuations under low flow conditions. The experimental results indicated that the amplitude of fluctuation at the impeller inlet is the highest, and increases with the reduction of the flow rate. The main frequencies of pressure fluctuation at the impeller inlet, impeller outlet, and vane inlet are blades passing frequency, while the main frequency at the vane outlet changes with the flow rate. The results of the simulation showed that the axial plane velocity at impeller inlet undergoes little change under 0.8 Qopt. In case of 0.4 Qopt, however, the flow field at impeller inlet becomes complicated with the axial plane velocity changing significantly. The flow separation is generated at the leading edge of the suction surface at t* = 0.0416 under 0.4 Qopt, which is caused by the increase of the incidence angle and the influence of the tip leakage flow. When the impeller rotates from t* = 0.0416 to t* = 0.1249, the flow separation intensified and the swirling strength of the separation vortex is gradually increased, leading to the reduction of the static pressure, the rise of adverse pressure gradient, and the generation of backflow. The static pressure at the leading edge of the impeller recovers gradually until the backflow is reached. In addition, the flow separation is the main reason for the intensification of the pressure fluctuation.
Unified NMPC framework for attitude and position control for a VTOL UAV
Authors: Murilo André , Lopes Renato Vilela
Published: May 2019

In this article, a parameterized nonlinear model predictive control strategy is developed for trajectory tracking and stabilization of a quadrotor unmanned aerial vehicle. The control strategy handles structurally with constraints on commands and input derivatives and deals with model uncertainties and white noise on whole state vector. Moreover, the resulting parametrization decreases the number of decision variables related to the nonlinear optimization problem substantially, which highly facilitates the attainment of the optimal control sequence. The proposed nonlinear model predictive control framework also enables the use of different nonlinear formulations of the unmanned aerial vehicle whatever the complexity of the model being used. Simulation results for different flight conditions are presented in order to show the efficiency of the tracking performance and highlight the advantages of the proposed control scheme.
Predicting Financially Distressed Small- and Medium-sized Enterprises in Malaysia
Authors: Abdullah Nur Adiana Hiau , Ahmad Abd Halim , Zainudin Nasruddin , Rus Rohani Md
Published: May 2019

This study investigates factors that might predict financially distressed small- and medium-sized enterprises (SMEs) 4 years, 3 years, 2 years and 1 year prior to distress. We employ logistic regression to identify the predictors of distressed SMEs in the manufacturing sector. Debt ratio is found to be consistently significant throughout the period of study. It is the main cause of failure among SMEs in Malaysia, as they rely heavily on debt to support their operations. The finding also shows that young companies have a higher probability of failure than established companies and that the bigger the size of a company, the higher the probability of that company entering distress. Other factors that are also found to be significant are current ratio, short-term liabilities to total liabilities, return on assets, sales to total assets and net income to share capital. In addition, the 1-year and 2-year prior to distress models provide the highest accuracy rate in detecting financially distressed SMEs.
Heterodox and Orthodox Discourses in the Case of Lyme Disease: A Synthesis of Arguments
Authors: Hinds Kate , Sutcliffe Katy
Published: May 2019

In this article, we examine the arguments made by authors of published academic articles concerning the debates surrounding chronic Lyme disease (CLD). CLD is an example of a contested condition and shares problems of legitimacy with other medically unexplained conditions such as chronic fatigue syndrome. We use a critical discourse analysis (CDA) approach to understand the arguments of the authors to establish the legitimacy, or not, of a CLD diagnosis. This enabled us to make sense of the nature of the stalemate between patient groups and advocates of the medical establishment, as performed by authors of academic articles. In this article, we bring together the arguments to explain the polemical debate and to support accounts that avoid the impasse to give us greater insight into the experience of chronic illness.
Dynamic recrystallization-dependent damage modeling during hot forming
Authors: Imran Muhammad , Szyndler Joanna , Afzal Muhammad Junaid , Bambach Markus
Published: May 2019

Hot forming processes are extensively used to produce semi-finished and finished components. At elevated temperatures, dynamic recovery and recrystallization processes occur that enable large shape changes at low forming forces. In steel, non-metallic inclusions cannot be avoided during metallurgical processes. They may induce damage in the same way as at room temperature, but the softening of the matrix due to dynamic recrystallization may be used to control the initiation and progression of damage. Damage models do not take into account that dynamic recrystallization reduces the local stresses at the interface of matrix–inclusion. The purpose of the presented study is to analyze the interaction between dynamic recrystallization and damage initiation. Using representative volume elements, the influence of dynamic recrystallization on damage initiation is studied at different temperatures, strain rates, and stress states. Based on this study, a damage model is devised that couples dynamic recrystallization and damage on the macro level and hence can be used in macroscopic process simulations.
Expanding the Scope of Resilience Research With Socioeconomically Disadvantaged Men: Considering the Sociocultural Context
Authors: Blair Katelyn , Voith Laura A. , Zhang Lixia , Yoon Susan
Published: May 2019

Research has uncovered resilience as a dynamic and alterable process. However, few studies have examined resilience across the life span, particularly with men who are at high risk of a myriad of poor health outcomes. Study aims were to explore protective factors and resilience across the life span among a sample of socioeconomically disadvantaged men ( N = 32), considering the context of their lived experiences, using focus groups. Thematic analysis resulted in four themes: (a) mainstream protective factors (i.e., prosocial activities, generative opportunities, supportive adults, community investment), (b) context-specific protective factors (i.e., growing up early, criminal justice involvement, gang involvement), (c) demonstration of mainstream resilience, and (d) demonstration of context-specific resilience. This study adds to the limited body of resilience research with marginalized men. Findings point to targeted changes at the structural and environmental levels, in addition to individual-level interventions, to affect meaningful change in the lives of socioeconomically disadvantaged men.
Natural Law and Protestant Reform: Lessons from the Forgotten Reformer
Authors: Charles J. Daryl
Published: May 2019

Despite Protestants’ suspicion of natural law ethics in their recent history, there are signs that in some Protestant circles a re-awakening to the importance of natural law is occurring. This is as it should be, given the fact that the magisterial reformers of the 16th century all affirmed without equivocation the natural law. Foremost among these champions was the forgotten reformer, Phillip Melanchthon, whose remarkable output and influence during the 16th century were unparalleled and whose emphasis on natural law reasoning was notable.
The Unseeing Eye: Disability and the Hauntology of Derrida’s Ghost—An Analysis in Three Parts
Authors: Hodkinson Alan
Published: May 2019

Through the employment of the three stanzas of Thomas Hardy’s poem “The Self-Unseeing,” this article seeks to tremble the picture of disability located in the pedagogical materials in English schools. By mobilizing, and then reversing, Derrida’s concept of the visor and the ghost, as well as Bentham’s Panopticon, this story reveals the power of the them, the their, and the they. In materializing the ghost of the real of disability within a utopia of hope, this story deconstructs the power of their transparent house by revealing people with disabilities as magnificent beings.
Bending and thermal buckling of unsymmetric functionally graded sandwich beams in high-temperature environment based on a new third-order shear deformation theory
Authors: Tran Thanh Trung , Nguyen Nam Hoang , Do Thom Van , Minh Phung Van , Duc Nguyen Dinh
Published: May 2019

This paper presents new results of static bending in high temperature and thermal buckling of sandwich functionally graded beam based on new third-order shear deformation theory (TSDT) and finite element formulations. We assume that the sandwich beam placed in a high-temperature environment for a long time, and so that the temperature distributions uniformly across the beam thickness and material properties are temperature-dependent. Using this TSDT, the analysis does not need any shear correction factors and has no shear-locking. The results show that not all functionally graded structures could process similar to mechanical behaviors and have the ability to perform in high temperature.
Dynamic stability of the rotating carbon nanotube-reinforced adaptive sandwich beams with magnetorheological elastomer core
Authors: Fadaee M , Talebitooti M
Published: May 2019

This paper reports on the numerical results that are performed with a freely vibrating magnetorheological elastomer sandwich beams reinforced by carbon nanotubes, exposed to an angular velocity and a magnetic field. The shear deformable beam model of the Timoshenko is employed to model the top and bottom functionally graded carbon nanotube reinforced (FGCNTR) layers, whereas a linear viscoelastic behavior is considered for the magnetorheological elastomer core layer. Using the Hamilton principle as well as a differential quadrature method, the natural frequencies and corresponding loss factors are derived. Convergence study and comparison results with the literature show a high stability and accuracy of the present approach. Enhancement of angular velocity causes a significant increasing and decreasing trends for the natural frequencies and loss factors, respectively. Observations reveal that there is an optimum value for the magnetic field intensity in which the loss factor is the maximum. Also, the effects of carbon nanotube distributions and geometric parameters of the magnetorheological elastomer and FGCNTR layers on the modal parameters are examined.
Intraoperative pneumatic tourniquet use may improve the clinical outcomes of arteriovenous fistula creations
Authors: Wang Shouwen , Wang Michele S
Published: May 2019

Objectives:

A major pathology affecting the usability of arteriovenous fistulas for hemodialysis is juxta-anastomosis stenosis. Intraoperative pneumatic tourniquet eliminates the use of vascular clamps, reduces vascular trauma, and may then reduce the juxta-anastomosis stenosis. The aim of this study was to compare the outcomes of arteriovenous fistula creations using the tourniquet-assisted approach versus the clamp-assisted approach.

Methods:

This retrospective study analyzed the outcomes of primary arteriovenous fistulas created by the lead author from 2008 to 2017 and met the specified inclusion criteria applied to both groups.

Results:

A total of 575 patients were included. Upon comparing the tourniquet group ( n = 411) with the clamp group ( n = 164): the primary arteriovenous fistula failure rate was significantly lower (2.4% vs 7.3%, p = 0.01); the percentage of arteriovenous fistula used for hemodialysis without initial interventions was significantly higher (71.5% vs 45.1%, p < 0.001) and with initial interventions was conversely lower (26.0% vs 47.6%, p < 0.001); the primary patency rate of the whole fistula conduits was significantly higher (44.2% vs 23.0% at 1 year, p < 0.001) and so was the cumulative patency rate (97.2% vs 92.6% at 1 year, p < 0.001); and the juxta-anastomosis primary patency rate (free of interventions for the juxta-anastomosis region) was higher (71.0% vs 47.8% at 1 year, p < 0.001). Based on multivariate Cox proportional hazards regression analyses, the effect of tourniquet use on the juxta-anastomosis primary patency remained significant (hazard ratio = 2.24, 95% confidence interval = 1.72–2.93, p < 0.001) when other significant factors (fistula location, gender, and diabetes) were considered.

Conclusion:

Intraoperative pneumatic tourniquet may significantly improve the clinical outcomes of arteriovenous fistula creations by reducing juxta-anastomosis trauma and subsequent stenosis.
A Collaborative Approach: Care Staff and Families Working Together to Safeguard the Quality of Life of Residents Living With Advanced Dementia
Authors: Hughes Sian Ellen , Woods Bob , Algar-Skaife Katherine , Jelley Hannah , Jones Catrin Hedd
Published: May 2019

Objectives:

This study aimed to explore the quality of life and well-being of care home residents living with advanced dementia, how personalised care can be achieved where the person is completely dependent on others for care and how individuals’ choices and human rights were upheld.

Methods:

The study design used a qualitative approach, with data collected through in-depth, semi-structured interviews with 8 family members, all of whom visited daily, and 8 care staff.

Results:

Emerging themes highlighted the importance of family involvement, signs of well-being, communication and the valued role of direct care staff.

Discussion:

Participants were able to identify factors of residents’ well-being in residents living with advanced dementia. Family members who visited daily saw themselves working collaboratively with care staff to maintain the quality of life of their relatives and engage in proxy decision making. Regarding human rights, the emphasis was on avoiding abuse, rather than promoting well-being.
Dynamic behaviors of a high-speed turbocharger rotor on elliptical floating-ring bearings
Authors: Zhang Congcong , Wang Yongliang , Men Rixiu , He Hong , Chen Wei
Published: May 2019

Floating-ring bearings are commonly used in automotive turbocharger applications due to their low cost and their suitability under extreme rotation speeds. This type of bearings, however, can become a source of noise due to oil whirl-induced sub-synchronous vibrations. The scope of this paper is to examine whether the concept of a floating-ring bearing with an elliptical clearance might be a solution to suppress sub-synchronous vibrations. A very time-efficient approximate solution for the Reynolds equation to the geometry of elliptical bearings is presented. The nonlinear dynamic behaviors of a turbocharger rotor supported by two concepts of elliptical floating-ring bearings are systematically investigated using run-up simulations. For the first concept of elliptical floating-ring bearings i.e. the outer bearing of the floating-ring bearing changed in the form of elliptical pattern (see Figure 1(b) in the article), some studies have pointed out that its steady-state and dynamic performances are superior to plain cylindrical floating-ring bearings but, the nonlinear run-up simulation results shown that this type of elliptical floating-ring bearings is not conducive to reduce the self-excited vibration levels. However, for the second type of elliptical floating-ring bearings i.e. both the inner and outer films of the floating-ring bearing changed in the form of elliptical pattern (see Figure 1(c) in the article), it is shown that the sub-synchronous vibrations have been considerably suppressed. Hence, the second noncircular floating-ring bearing design is an attractive measure to suppress self-excited vibrations.[Figure: see text]
A probabilistic semantic analysis of eHealth scientific literature
Authors: Drosatos George , Kaldoudi Eleni
Published: May 2019

Introduction

eHealth emerged as an interdisciplinary research area about 70 years ago. This study employs probabilistic techniques to semantically analyse scientific literature related to the field of eHealth in order to identify topics and trends and discuss their comparative evolution.

Methods

Authors collected titles and abstracts of published literature on eHealth as indexed in PubMed. Basic statistical and bibliometric techniques were applied to overall describe the collected corpus; Latent Dirichlet Allocation was employed for unsupervised topics identification; topics trends analysis was performed, and correlation graphs were plotted were relevant.

Results

A total of 30,425 records on eHealth were retrieved from PubMed (all records till 31 December 2017, search on 8 May 2018) and 23,988 of these were included to the study corpus. eHealth domain shows a growth higher than the growth of the entire PubMed corpus, with a mean increase of eHealth corpus proportion of about 7% per year for the last 20 years. Probabilistic topics modelling identified 100 meaningful topics, which were organised by the authors in nine different categories: general; service model; disease; medical specialty; behaviour and lifestyle; education; technology; evaluation; and regulatory issues.

Discussion

Trends analysis shows a continuous shift in focus. Early emphasis on medical image transmission and system integration has been replaced by increased focus on standards, wearables and sensor devices, now giving way to mobile applications, social media and data analytics. Attention on disease is also shifting, from initial popularity of surgery, trauma and acute heart disease, to the emergence of chronic disease support, and the recent attention to cancer, infectious disease, mental disorders, paediatrics and perinatal care; most interestingly the current swift increase is in research related to lifestyle and behaviour change. The steady growth of all topics related to assessment and various systematic evaluation techniques indicates a maturing research field that moves towards real world application.
Informatics and interaction: Applying human factors principles to optimize the design of clinical decision support for sepsis
Authors: Schubel Laura , Mosby Danielle L , Blumenthal Joseph , Capan Muge , Arnold Ryan , Kowalski Rebecca , Seagull F Jacob , Catchpole Ken , Schwartz J Sanford , Franklin Ella , Littlejohn Robin , Miller Kristen E
Published: May 2019

In caring for patients with sepsis, the current structure of electronic health record systems allows clinical providers access to raw patient data without imputation of its significance. There are a wide range of sepsis alerts in clinical care that act as clinical decision support tools to assist in early recognition of sepsis; however, there are serious shortcomings in existing health information technology for alerting providers in a meaningful way. Little work has been done to evaluate and assess existing alerts using implementation and process outcomes associated with health information technology displays, specifically evaluating clinician preference and performance. We developed graphical model displays of two popular sepsis scoring systems, quick Sepsis Related Organ Failure Assessment and Predisposition, Infection, Response, Organ Failure, using human factors principles grounded in user-centered and interaction design. Models will be evaluated in a larger research effort to optimize alert design to improve the collective awareness of high-risk populations and develop a relevant point-of-care clinical decision support system for sepsis.
It’s the text, stupid! Mobile phones, religious communities, and the silent threat of text messages
Authors: Rosenberg Hananel , Blondheim Menahem , Katz Elihu
Published: May 2019

This study explores the Jewish ultra-Orthodox “kosher cellphone,” a device that can be used only for voice calls. It asks why the leadership of this highly textual community didn’t stop at blocking Internet use over the kosher cellphone and went on to block texting messages as well. Using both interviews with ultra-Orthodox anti-cellphone-activists and content analysis of online discussions among community members, the study analyzes the perception of threat that underlies the prohibition of texting, and explores how this prohibition is received in the community. The findings show that in contrast to the threat posed by improper content, which affects the external boundaries of this enclave community, blocking texting stems from a perception that the technology’s configuration threatens intra-communal monitoring and the control of the dissemination of information within the communal space. Our findings add a number of dimensions to the current understanding of the nexus of new media, social control, and isolated religious communities.
Multimodal enactment of characters in conference presentations
Authors: Valeiras-Jurado Julia , Ruiz-Madrid Noelia
Published: May 2019

In academic oral genres such as conference presentations, speakers resort to more than words to convey meaning. Research also suggests that persuasion, an important element of the communicative purpose of conference presentations, is frequently achieved through a combination of semiotic modes. Therefore, a skilful orchestration of these modes can be considered key to achieving effective communication in this genre. However, our understanding of persuasion has often focused on specific elements of the message considered in isolation and mainly from the linguistic perspective. Relatively little attention has been paid to the overall persuasive effect achieved by the complex multimodal ensemble. This study approaches the analysis of persuasive strategies in conference presentations combining multimodal discourse analysis and ethnographic methods. It focuses on a particular attention-getting technique: enactment of characters, or acting the part of a person that is being referred to. Our analysis shows how it is achieved through the orchestration of different modes such as words, intonation, gestures, head movements, gaze and facial expression.
Perceived individual and societal values of news and paying for subscriptions
Authors: Chen Weiyue , Thorson Esther
Published: May 2019

This study examines antecedents of paying for news subscriptions. Taking the customer-perceived value approach, we investigate the impact of perceived quality and perceived journalistic and societal value of news. News habit strength, different motivations for news use, and entertainment spending were also examined for their value in predicting how much people report paying for news. Results of a national survey (N = 403) show that perceived quality of news, habit strength, motivation of social–cultural interactions, and entertainment spending are positively predictive of how much people pay, after demographic controls. These findings not only suggest practical implications for news organizations seeking to increase subscriber support but also raise critical questions about how Americans’ relationships with newspaper news is degrading.
To affiliate, or not to affiliate. Transaction costs and governance choices in luxury hotels in Germany
Authors: Pedrini Matteo , De Bernardi Chiara
Published: May 2019

This paper examines the choice of affiliation or no affiliation to a large hotel chain from the viewpoint of luxury hotel property owners in Germany. Grounded in transaction cost theory, this study identifies how uncertainty and frequency influence the owners’ choice of unaffiliated operation and affiliation. The study augments the traditional governance literature in the field of the hotel by shedding light on the market/hierarchy decision of property owners rather than on the market entry strategies of international hotels firm. Through a multiple regression analysis on a sample of 122 existing five-star hotels in Germany, this study provides new empirical evidence that a frequent contract conclusion with the same hotel chain and a “hotel unrelated” background of the owner increases the likelihood of affiliation. In contrast to what transaction cost theory traditionally predicts, our results reveal that uncertainty is not influencing the owners’ market/hierarchy decision.
The heterogeneous repercussions of killing Osama bin Laden on global terrorism patterns
Authors: Fisher Daren , Becker Michael H.
Published: May 2019

The United States has adopted the targeted killing of high-ranking members of terrorist organizations to disrupt terrorist networks and exert general deterrence. The most salient of these killings occurred on 2 May 2011, when US Navy Seals killed Osama bin Laden in Pakistan. Although general deterrence suggests this should result in decreased subsequent terrorism, high-profile targeted killings can also result in increased terrorist violence through backlash. This study uses dual trajectory analysis to examine the divergent influence that the killing of bin Laden had on global terrorism trends between November 2007 and May 2014. These analyses reveal that killing bin Laden did not have the desired deterrent impact on global terrorism or on terrorism committed by Al Qaeda.
Predictive Value of 99MTC-hynic-toc Scintigraphy in Lung Neuroendocrine Tumor Diagnosis
Authors: Boutsikou Efimia , Porpodis Konstantinos , Chatzipavlidou Vasiliki , Hardavella Georgia , Gerasimou George , Domvri Kalliopi , Papadopoulos Nikitas , Avramidou Vasiliki , Spyratos Dionisis , Kontakiotis Theodoros , Zarogoulidis Konstantinos
Published: May 2019

Background:

Νeuroendocrine tumors of the lungs are rare arising in the thymus and gastro-entero-pancreatic tract and belonging to foregut of neuroendocrine tumors. The aim of the present prospective study was to estimate the potential impact of single-photon emission computed tomography somatostatin receptor scintigraphy using 99mTc-Tektrotyd on diagnosis, treatment response, and prognosis in patients with neuroendocrine tumors of the lungs.

Methods:

Thirty-six patients with neuroendocrine tumors of the lungs were evaluated by using 99mTc-HYNIC-TOC scintigraphy. The scintigraphic results were compared to liver tissue uptake (Krenning score). Likewise, the functional imaging results were compared with biochemical indices including chromogranin A, neuroendocrine-specific enolase, and insulin-like growth factor 1 at the time of diagnosis (baseline) and disease progression.

Results:

The number of somatostatin receptors, expressed with Krenning score, did not show any correlation with the survival of patients both at baseline ( P = .08) and at disease progression ( P = .24), and scintigraphy results did not relate significantly to progression-free survival. Comparing the results of 99mTc-HYNIC-TOC scintigraphy according to the response of patients in the initial treatment, a statistically significant negative correlation was observed both in the first and in the second scintigraphy with patients’ response ( P = .001 and P < .001, respectively). The concentrations of biochemical markers were in accordance with scintigraphy results in the diagnosis.

Conclusion:

This study indicates that 99mTc-HYNIC-TOC scintigraphy appears to be a reliable, noninvasive technique for detection of primary neuroendocrine tumors and their locoregional or distant metastases, although it cannot be used as a neuroendocrine tumors of the lungs predictive technique.
Robotic Versus Laparoscopic Rectal Surgery for Rectal Cancer: A Meta-Analysis of 7 Randomized Controlled Trials
Authors: Li Laiyuan , Zhang Weisheng , Guo Yinyin , Wang Xiaolin , Yu Huichuan , Du Binbin , Yang Xiongfei , Luo Yanxin
Published: May 2019

Background. Robotic surgery has been recently used as a novel tool for rectal surgery. This study assessed the current evidence regarding the efficiency, safety, and potential advantages of robotic rectal surgery (RRS) compared with laparoscopic rectal surgery (LRS). Methods. We comprehensively searched PubMed, Embase, and the Cochrane Library databases and performed a systematic review and cumulative meta-analysis of all randomized controlled trials (RCTs) assessing the 2 approaches. Results. Seven RCTs including a total of 1022 cases were identified. The conversion rate is significantly lower for RRS (odds ratio: 0.29; 95% confidence interval: 0.09 to 0.96; P = .04). The length of the distal margin was significantly shorter in the LRS group than in the RRS group (weighted mean difference: 0.60; 95% confidence interval: 0.09 to 1.10; P = .02). Perioperative complication rates, harvested lymph nodes, positive circumferential resection margins, complete total mesorectal excision, first flatus, and length of stay did not differ significantly between approaches ( P > .05). Conclusions. This meta-analysis indicates that RRS is a safe and effective approach. It is not inferior to LRS in terms of oncologic outcomes and postoperative complications. Future large-volume, well-designed RCTs with extensive follow-up are awaited to confirm and update the findings of this analysis.
Evolution of Minimally Invasive Surgical Aortic Valve Replacement at a Veterans Affairs Medical Center
Authors: Liang Norah E. , Wisneski Andrew D. , Wozniak Curtis J. , Ge Liang , Tseng Elaine E.
Published: May 2019

Objective

The majority of minimally invasive surgical aortic valve replacements (MIAVRs) are performed at high-volume cardiac surgery centers. However, outcomes at lower volume federal facilities are not yet reported in the literature and not captured in the national Society of Thoracic Surgeons (STS) database. Our study objective was to describe the evolution of MIAVR at a Veterans Affairs Medical Center (VAMC).

Methods

A single-center retrospective cohort study was performed of 114 patients who underwent MIAVR for isolated aortic valvular disease between January 2011 and August 2018. Preoperative STS risk factors were determined and perioperative outcomes were analyzed.

Results

By 2016, 100% of isolated surgical aortic valve replacements were performed as MIAVRs at our VAMC. Introduction of automatic knot-fastening devices, single-shot del Nido cardioplegia, and rapid deployment valves decreased aortic cross-clamp (AXC) times from a median of 96 (interquartile range [IQR]: 84 to 103) to 53 minutes (38 to 61, P < 0.001, Kruskal–Wallis). Thirty-day mortality was 0.9%. Median length of hospital stay was 9 days (7 to 13). Postoperative atrial fibrillation occurred in 54% of patients, stroke occurred in 1.8% of patients, and 7.1% of patients required permanent pacemakers. Transition to rapid deployment valves decreased postoperative mean pressure gradient from median 14 mmHg (10 to 17) to 7 mmHg (4.7 to 10, P < 0.001, Mann–Whitney). At median 1.5-year follow-up echocardiogram, mean gradient was 10.8 mmHg with mild paravalvular leak rate of 1.8%.

Conclusions

Facilitating technologies decreased operative times during MIAVR adoption at our VAMC. For patients with isolated aortic valve pathology, MIAVR can be performed with low morbidity and mortality at lower volume federal institutions, with outcomes comparable to those reported from higher volume centers.
Working-Class Men’s Constructions of Help-Seeking When Feeling Depressed or Sad
Authors: Mahalik James R. , Dagirmanjian Faedra R.
Published: May 2019

In this study, we conducted interviews with 12 working-class men employed in industrial and manual labor to identify their constructions of help-seeking in response to feeling depressed or sad. The semistructured interview format explored participant men’s understanding and reactions to depression or sadness, their experiences of depression and reluctance to seek help, and their own and others’ reactions to seeking help for feeling depressed or sad. Utilizing the consensual qualitative research methodology, four domains emerged: Concern About Threat and Stigma, Being a Man Means Not Seeking Help, Experiences of Safety and Relief, and Conditions That Reduce Threat and Stigma. The results suggest the need to account for men’s experiences of both negative influences (e.g., masculinity injunctions, stigma, and threat to manhood status), as well as adaptive influences (e.g., contexts that reduce stigma) when addressing men’s help-seeking for depression and sadness. The domains are illustrative of several theoretical frameworks including social-psychological models of social norms and stigma, precarious manhood theory, inclusive masculinity theory, as well as convergence with other research examining working-class men. Implications are discussed for outreach and practice addressing men’s depression and help-seeking.
Improved outcomes from endovascular aortic repair in younger patients: Towards improved risk stratification
Authors: Hsieh Wan Chin , Kan Chung Dann , Hsieh Chong Chao , Omara Mohamed , Henry Brandon Michael , Davidovic Lazar B
Published: May 2019

Objectives

Abdominal aortic aneurysms are conventionally treated by open repair surgery. While endovascular aortic repair improves survival in high-risk patients, younger patients (40–65 years) potentially at lower risk with asymptomatic abdominal aortic aneurysms undergoing endovascular aortic repair usually have poorer post-operative outcomes and require longer term follow-up. In this study, clinical data on younger patients were analyzed to investigate whether endovascular aortic repair leads to poorer short- and long-term outcomes.

Methods

This was a systematic review and meta-analysis of articles comparing clinical outcomes in patients aged 40–65 years undergoing open repair or endovascular aortic repair and published between 2000 and 2017. In-hospital mortality, long-term mortality, and post-operative complication data were retrieved from eligible studies and clinical outcomes were compared. Twenty-one retrospective cohort analyses were included, accounting for 250,837 patients (149,051 endovascular aortic repair; 101,786 open repair). Risk ratios were pooled using the DerSimonian and Laird random effects model. All statistical analyses were performed in Review Manager 5.3.

Results

Younger patients with asymptomatic abdominal aortic aneurysms undergoing endovascular aortic repair had a significantly reduced 30-day mortality (odds ratio (OR) = 0.40, 95% confidence intervals (CI) 0.28–0.57; p < 0.00001), long-term mortality (OR = 0.37, 95% CI 0.17–0.82; p = 0.01), incidence of reintervention (OR = 0.47, 95% CI 0.34–0.66; p < 0.0001), and incidence of renal failure (OR = 1.58, 95% CI 1.37–1.82; p < 0.00001).

Conclusions

Endovascular aortic repair may improve short- and long-term survival and reduce post-operative complications in younger patients with asymptomatic abdominal aortic aneurysms.
Prescribed performance adaptive fault-tolerant trajectory tracking control for an ocean bottom flying node
Authors: Qin Hongde , Wu Zheyuan , Sun Yanchao , Sun Yushan
Published: May 2019

The ocean bottom flying node is a novel autonomous underwater vehicle that explores the oil and gas resources in deep water. Thousands of the ocean bottom flying nodes track different predefined trajectories arriving at target points in a small ocean area, respectively. A class of prescribed performance adaptive trajectory tracking control method is investigated for the ocean bottom flying node trajectory tracking problem with ocean current disturbances, model uncertainties as well as thruster faults. Based on a predefined performance function and an error transformation, the ocean bottom flying node trajectory tracking error is restricted to prespecified bounds to ensure a desired transient and steady response. Radial basis function neural network is used to approximate the general uncertainty caused by ocean current disturbances, model uncertainties, and thruster faults. Further, the upper bound of approximation error is estimated by an adaptive law. Using the adaptive laws, we propose a prescribed performance adaptive trajectory tracking controller. The simulation examples on an ocean bottom flying node system show that the proposed control scheme can compensate for the effect of the general uncertainty while obtaining the fast transient process and expected trajectory tracking accuracy.
Assessing the effect of night ventilation on PCM performance in high-rise residential buildings
Authors: Soudian Shahrzad , Berardi Umberto
Published: May 2019

This article investigates the possibility to enhance the use of latent heat thermal energy storage (LHTES) as an energy retrofit measure by night ventilation strategies. For this scope, phase change materials (PCMs) are integrated into wall and ceiling surfaces of high-rise residential buildings with highly glazed facades that experience high indoor diurnal temperatures. In particular, this article investigates the effect of night ventilation on the performance of the PCMs, namely, the daily discharge of the thermal energy stored by PCMs. Following previous experimental tests that have shown the efficacy of LHTES in temperate climates, a system comprising two PCM layers with melting temperatures selected for a year-around LHTES was considered. To quantify the effectiveness of different night ventilation strategies to enhance the potential of this composite PCM system, simulations in EnergyPlusTM were performed. The ventilation flow rate, set point temperature, and operation period were the main tested parameters. The performance of the PCMs in relation to the variables was evaluated based on indoor operative temperature and cooling energy use variations in Toronto and New York in the summer. The solidification of the PCMs was analyzed based on the amount of night ventilation needed in each climate condition. The results quantify the positive impact of combining PCMs with night ventilation on cooling energy reductions and operative temperature regulation of the following days. In particular, the results indicate higher benefits obtainable with PCMs coupled with night ventilation in the context of Toronto, since this city experiences higher daily temperature fluctuations. The impact of night ventilation design variables on the solidification rate of the PCMs varied based on each parameter leading to different compromises based on the PCM and climate characteristics.
Democratic localism and the implementation of the Community Remedy in England and Wales
Authors: Heap Vicky , Paterson Craig
Published: May 2019

This article assesses the development and implementation of the Community Remedy anti-social behaviour policy by Police and Crime Commissioners (PCCs) in England and Wales. The Community Remedy, introduced by the Anti-Social Behaviour, Crime and Policing Act (2014), allows victims of ‘low-level’ anti-social behaviour to select an informal action for their offender from a list designed by their local PCC via consultation with the public. This article reports the results of a benchmarking exercise that investigates how PCCs have translated this policy into practice by examining: public consultation procedures; the contents of the Community Remedy documents; and police usage. The findings indicate an uneven implementation across regions with variable levels of engagement from PCCs, police forces and members of the public. We assess the enactment and adoption of this new power alongside its potential to stimulate democratic localism.
The Racial Politics of Cultural Capital: Perspectives from Black Middle-Class Pupils and Parents in a London Comprehensive
Authors: Wallace Derron
Published: May 2019

Drawing on 13 in-depth interviews and three focus-group interviews with Black middle-class pupils, along with 14 in-depth interviews with their parents, this article highlights Black parents’ and pupils’ strategic use of Black cultural capital to contest White hegemony in the curricula at a large state comprehensive school in South London. The findings of this study underscore the racial politics of cultural capital as experienced by the Black middle classes. The results also spotlight the quiet alliances between Black middle-class pupils and parents to challenge the racial blindspots of state school curricula and negotiate changes throughout the school community. This article adds to scholarship in cultural sociology by highlighting the calculated intergenerational work among the Black middle classes – perspectives that are often missing in traditional class analyses.
Do People Value Recorded Music?
Authors: Marshall Lee
Published: May 2019

How much do the majority of people value music, and can or should that level of value be reflected in music’s economic value? The dramatic decline in the economic value of recorded popular music in the 21st century has prompted much debate about music being ‘devalued’ and the perceived ‘value gap’ between music’s socio-cultural and economic values. Using the economic decline of recorded music as a springboard, this article takes a different approach, however. It offers a theoretical analysis of popular music consumption practices organised thematically in terms of ‘music as object’ (focusing on the social values generated and perceived by recorded music artefacts) and ‘music as sound’ (focusing on the way that most contemporary musical experiences are characterised by music being background sound or accompaniment). Overall, the argument is that ‘music’ may not be as culturally valued by people as is commonly assumed. The way that music operates as a low-value entity to many people is perhaps reflected in the cultural and economic contours of the digital music industry, though they are not caused by digitisation per se.
Who’s who? Championing the ‘#TheatreCapChallenge’
Authors: Gorman Suzanne , Cox Tessa , Hart Rebecca Sandford , Marais Lewis , Wallis Scott , Ryan Julie , Handbury Michele
Published: May 2019

Our Developing Perioperative Practice service improvement project, sponsored by the Royal Bournemouth Hospital, addressed whether the remarkably simple idea of putting names and roles on hats in theatre would improve communication and patient care. We were inspired by our own experiences as a group of student Operating Department Practitioners: unfamiliarity with members of the team, wanting to feel included in the work but not out of our depth, and by social media campaigns such as the ‘#TheatreCapChallenge’ and ‘#hellomynameis’, aiming to humanise care and increase patient safety. Researching, clinically trialling and presenting this project gave us a systematic approach to improving the quality of care within the theatre environment.