bluuebunny/crossref_metadata_2025 huggingface dataset:
NIRS is having a renaissance; but not all the pieces are moving at the same speed
Authors: Ciurczak Emil W
Published: March 2019

Near-infrared has been a staple in many industries for over four decades but has lagged behind in the other, consumer-based industries. One reason is that the Pharma industry is highly regulated and producers have been hesitant to attempt any changes. Since 2004, numerous guidances from the FDA and EMA, along with guidelines from the International Council for Harmonisation, have encouraged and, in reality, given permission to the Pharma industry to enter the 21st century. Together with financial pressures, available technologies are moving the industry to new levels of quality and safety (and profit).
Communicating the Quest for Sustainability: Ecofeminist Perspectives in Sarah Orne Jewett’s ‘A White Heron’
Authors: Parashar Archana , Kumar Mukesh
Published: March 2019

The objective of this article is to study the relationship between men, women and nature in Sarah Orne Jewett’s ‘A White Heron’ by using ecofeminist perspectives. The cultural and moral vision of Jewett is imperative to the scope of American regionalist writing and her work characterizes the extreme concern to representing the region from which the author comes. The setting of the story holds its relevance even in the twenty-first century when the world is facing a deep ecological crisis. In ‘A White Heron’, Sarah Orne Jewett narrates the story of a 9-year-old girl Sylvia, exploring the grounds around her home in search of a prized white heron. Therefore, I suggest, it is through this relationship that the author demonstrates regional sustainability through clearly defined repressive gender roles, feminizing the concept of submissiveness while masculinizing attitudes of dominance over nature and competence in dealing with the challenges that nature presents.
Circulating miRNA-1290 as a potential biomarker for response to chemoradiotherapy and prognosis of patients with advanced oral squamous cell carcinoma: A single-center retrospective study
Authors: Nakashima Hikaru , Yoshida Ryoji , Hirosue Akiyuki , Kawahara Kenta , Sakata Junki , Arita Hidetaka , Yamamoto Tatsuro , Toya Ryo , Murakami Ryuji , Hiraki Akimitsu , Shinohara Masanori , Ito Takaaki , Kuwahara Yoshikazu , Nakayama Hideki
Published: March 2019

MicroRNAs are a class of small, endogenous, noncoding 18- to 24-nucleotide-long RNAs that can regulate multiple processes related to cancer progression. However, their clinical value in patients with oral squamous cell carcinoma has not yet been fully explored. Therefore, the aim of this study was to investigate the clinical significance of circulating microRNAs in oral squamous cell carcinoma patients. The expression levels of circulating miR-1246 and miR-1290 in healthy volunteers and oral squamous cell carcinoma patients were examined by quantitative real-time polymerase chain reaction. The expression levels of both microRNAs in the radioresistant oral squamous cell carcinoma cell line (SAS-R) and the parent cell line (SAS) and in the conditioned medium obtained from these cell lines were also examined by quantitative real-time polymerase chain reaction. In addition, the correlations between circulating microRNA status and various clinicopathological features in 55 oral squamous cell carcinoma patients with locally advanced oral squamous cell carcinoma who underwent surgery following 5-fluorouracil-based chemoradiotherapy were examined. The expression level of miR-1290 was significantly lower in the plasma of oral squamous cell carcinoma patients than in that of healthy volunteers (p < 0.01). The expression levels of microRNAs in the conditioned medium and in the cells varied from cell to cell. In the clinicopathological analyses, the frequency of patients with low miR-1290 levels was significantly higher among cases with lower pathological differentiation and among those with a poor pathological response for preoperative chemoradiotherapy (p = 0.030 each). Furthermore, Cox regression analysis based on the 5-year overall survival and disease-free survival revealed that miR-1290 status was a significant prognostic factor for patients with oral squamous cell carcinoma (hazard ratio = 0.169, p = 0.008, and hazard ratio = 0.186, p = 0.008, respectively). Circulating miR-1290 status could be a valuable biomarker for predicting the clinical response to chemoradiotherapy as well as overall survival in patients with oral squamous cell carcinoma.
Understanding the Parent Experience in Child Custody Decision-Making: How Social Workers Can Help
Authors: Archer-Kuhn Beth
Published: March 2019

Parent perspective and experience is largely absent from the research literature in child custody decision-making, making it challenging for social workers to understand the parent experience. Research often focuses on outcome studies regarding children’s adjustment and well-being, with little attention to the parent voice. This article addresses this gap using a phenomenological approach. Eighteen participants were recruited from a mid-sized community in Ontario through the mandatory information program (MIP). In-depth interviews and thematic analysis reveal five themes: (a) redefining role, (b) the importance of agency, (c) shared decision-making, (d) the battleground—barriers to shared decision-making, and (e) complexities involved in shared decision-making. These findings illuminate shared parenting challenges, highlighting the need for family supports and services in navigating challenging post-separation realities.
Electrical self-sensing of strain and damage of thermoplastic hierarchical composites subjected to monotonic and cyclic tensile loading
Authors: Rodríguez-Uicab O , Martin-Barrera C , May-Pat A , Can-Ortiz A , Gonzalez-Chi PI , Avilés F
Published: March 2019

Electrical monitoring of strain and damage in multiscale hierarchical composites comprising unidirectional aramid fibers modified by multiwall carbon nanotubes and polypropylene as matrix is investigated. The key factor for electrical self-sensing in these thermoplastic composites is the formation of a multiwall carbon nanotube network, which is achieved by using two material architectures. In the first architecture, the multiwall carbon nanotubes are dispersed within the polypropylene matrix, while aramid fibers remain unmodified. The second architecture uses also multiwall carbon nanotube-modified polypropylene matrix, but the aramid fibers are also modified by depositing multiwall carbon nanotubes. Under tensile loading, the electrical response is nonlinear with strain ( ε), and the piezoresistive sensitivity was quantified by gage factors corresponding to low ( ε < 0.25%) and high ( ε > 0.3%) strain regimes. Such gage factors were 4.83 (for ε < 0.25%) and 13.2 (for ε > 0.3%) for composites containing multiwall carbon nanotubes only in the polypropylene matrix. The composites containing multiwall carbon nanotubes in the matrix and fibers presented higher piezoresistive sensitivity, with average gage factors of 9.24 ( ε < 0.25%) and 14.0 ( ε > 0.3%). The higher sensitivity to strain and damage for a specific material architecture was also evident during cyclic and constant strain loading programs and is attributed to the preferential localization of multiwall carbon nanotubes in the hierarchical composite.
Online force control of a shape-memory-alloy-based 2 degree-of-freedom human finger via inverse model and proportional–integral–derivative compensator
Authors: Mirzakhani F , Ayati SM , Fahimi P , Baghani M
Published: March 2019

In this work, a model-based controller is developed to track the force at fingertip of an artificial hand. To do so, shape-memory-alloy wires are implemented as an actuator in the finger. Besides, different aspects of modeling, including force relations, kinematics, and heat transfer analysis, are investigated. A modified version of Brinson’s model is used to capture thermomechanical behavior of shape-memory-alloy wires. A controller is designed to control the applied potential difference between shape-memory-alloy wires and consequently control the electrical current in these wires based on the shape-memory-alloy wires model. The main goal of the proposed controller is force controlling of a 2-degree-of-freedom hand finger. This controller contains shape-memory-alloy constitutive model used for compensating system uncertainties. Furthermore, a proportional–integral–derivative controller/compensator is included in the closed-loop system. The compensator acts only on the derivative-type states, and this is one of the differences of this work compared to that of similar literature. The results of three arbitrary reference input signals are reported confirming the model prediction and simulation results are in good agreement with experimental tests. The analysis of the relative tracking error for an arbitrary reference signal is 11% in experimental test and 4% in the simulation.
The Role of Ultrasound-Guided Therapeutic Thoracentesis in an Outpatient Transitional Care Program: A Case Series
Authors: Segaline Nicole , Wang Jeffrey , Bethancourt Bruce , Ota Ken S.
Published: March 2019

Background:

Symptomatic pleural effusions create discomfort and are a frequent cause of hospitalization. Ultrasound-guided thoracentesis is a key palliative intervention to assist in the management of this vulnerable population. Our institution has created a multidisciplinary transitional care program to address the needs of those discharged from the hospital with chronic complex conditions, including symptomatic pleural effusions.

Methods:

This case series was performed in a transitional care clinic between May 8, 2017, and December 11, 2018. Eight unique patients with symptomatic pleural effusions were referred to our clinic posthospital discharge and treated with ultrasound-guided thoracentesis. A retrospective review was performed to assess procedure details, complications, and follow-up emergency department visits or hospital readmissions. Additionally, cost comparison data were obtained from the hospital financial system.

Results:

Of the 8 unique patients, 15 thoracenteses were performed over the 19-month period in the transitional care clinic. The median age of the cohort was 56 years old (range: 39-92 years). All patients reported an immediate relief of symptoms (dyspnea and/ or pain) and no procedural complications. The total cost of performing an ultrasound-guided thoracentesis in the transitional care clinic was 61.8% that of performing the procedure in the hospital (US$537.61 vs US$869.65).

Conclusion:

All 8 patients experienced an immediate relief in pleural effusion-related symptoms following thoracentesis. Our experience helps reveal the safety, efficacy, and cost-efficiency of ultrasound-guided thoracentesis in providing symptom management for patients with pleural effusions in a transitional care clinic.
Social Media Activism in the Digital Age: Testing an Integrative Model of Activism on Contentious Issues
Authors: Chon Myoung-Gi , Park Hyojung
Published: March 2019

The purpose of this study was to propose an integrative model of activism that explains why and how individuals in the networked society are engaged in contentious issues. Incorporating the situational theory of problem solving (STOPS), hostile media perception, affective injustice, and social media efficacy, this study examined how the integrative model of activism predicts social media activism and offline activism on three issues of gun ownership, immigration, and police use of power. The integrative model of activism provides a valuable standpoint to understand activist publics and serves as a springboard for further scholarly discussion on activism and conflict resolution.
Strain fields in cracked bodies under antiplane shear for a generalised non-hardening material law
Authors: Zappalorto M
Published: March 2019

An exact, closed form, solution is derived for the non-linear stress distribution in a cracked body under antiplane shear deformation. A generalised, non work-hardening, law is introduced to describe the material behaviour, and the stress and strain fields are derived in closed form. Such a new generalised material law includes the effect of a new parameter, a, which allows the transition from the ideally elastic behaviour (low strain regime) to the pure non-linear behaviour (large strain regime) to be modulated. A discussion is carried out on the features of the new solution and on the behaviour of stresses and strains close to and far away from the crack tip.
Multivariate analysis of risk factors for re-dislocation after revision for dislocation after total hip arthroplasty
Authors: Herman Amir , Masri Bassam A , Duncan Clive P , Greidanus Nelson V , Garbuz Donald S
Published: March 2019

Background:

The treatment for recurrent dislocation of a total hip arthroplasty is surgical using varied techniques and technologies to reduce the chances of re-dislocation and re-revision. The goal of this study is to compare operative techniques to reduce re-dislocation and re-revision in revision hip arthroplasty due to recurrent dislocations.

Methods:

A retrospective study of revision hip arthroplasties done due to recurrent dislocation prior to 01 January 2014. Electronic physician and provincial health records were used to collect patients’ initial and follow-up data. Treatment failure was defined as either aseptic re-revision or re-dislocation without revision. Time to event was considered as the re-revision date or the date of second dislocation when the latter endpoint was used.

Results:

Of 379 operations, 88 (23.2%) had aseptic repeat revision or recurrent dislocation. Of these: 66 (75.0%) due to dislocation with re-revision; 10 (11.4%) due to dislocation with no re-revision surgery; 5 (5.7%) due to aseptic loosening of components; 3 (3.4%) due to osteolysis; 3 (3.4%) due to pseudotumour; and 1 (1.1%) due to periprosthetic fracture. The following factors increase risk of failure: the use of augmented-liners (lipped, oblique and high-offset liners; HR = 1.68, 95% CI, 1.05–2.69), periprosthetic femur fracture (HR = 2.80, 95% CI, 1.39–8.21) and pelvic discontinuity (HR = 3.69, 95% CI, 1.66–8.21). Femur head sizes 36–40 mm are protective (HR = 0.54, 95% CI, 0.31–0.86). In abductor dysfunction the use of focal constrained liners decreases the risk of failure (HR = 0.13, 95% CI, 0.018–0.973).

Conclusions:

Larger head sizes and focal constrained liners (abductors dysfunction) should be used and fully constrained liners and augmented-liners should be avoided in a revision hip arthroplasty due to recurrent dislocations.
The Synergistic Role of Diet and Exercise in the Prevention, Pathogenesis, and Management of Ulcerative Colitis: An Underlying Metabolic Mechanism
Authors: Stavsky Jonah , Maitra Radhashree
Published: March 2019

Ulcerative colitis (UC) is a biologically complex condition characterized by chronic, relapsing inflammation of the gastrointestinal tract. The relative incidence of this debilitating condition is increasing and sociologically damaging outcomes are a continued reality. Several etiological theories for UC are currently under investigation, spanning between genetic and environmental determinants. From an environmental perspective, previous literature reviews have demonstrated the independent effectiveness of specific diet and exercise patterns in modifying UC immuno-pathophysiology. This article explores the synergistic role of diet and aerobic exercise in the prevention, pathogenesis, and management of UC in the context of recent immunological research. Through a unifying mechanism—that is, microbial influence of colonic inflammation and immuno-pathophysiology—the simultaneous reduction of pro-inflammatory dietary sulfurous amino acid intake (ie methionine, cysteine, homocysteine, and taurine) and the upregulation of aerobic exercise frequency (which spurs the colonization of anti-inflammatory butyrate, acetate, and propionate producing microbial taxa) demonstrate the clinical efficacy of incorporating both diet and exercise modifications for UC prevention and management through pathogenic alterations.
Clinical Characteristics and Satisfaction of Liraglutide Treatment among Patients with Type 2 Diabetes: A Prospective Study
Authors: Al Hayek Ayman A , Robert Asirvatham A , Al Dawish Mohamed A
Published: March 2019

Background:

Evaluation of patient-reported results, treatment satisfaction, in particular, is popularly gaining recognition as crucial to the assessment of the efficiency of new therapies. The aim of this study is to examine the clinical features and treatment satisfaction with liraglutide in insulin-dependent obese patients having uncontrolled diabetes.

Methods:

A prospective study was performed for 12 weeks using 64 type 2 diabetes (T2D) patients, 30 to 70 years of age, who came in for treatment to the Diabetes Treatment Center in Prince Sultan Military Medical City, Riyadh, Saudi Arabia, from November 2017 to July 2018. All the patients enrolled in this study were given liraglutide in addition to their existing treatment. For the first week, they were subcutaneously administered 0.6 mg once per day, which was gradually raised to 1.2 mg after 1 week, and the final given dose went up to 1.8 mg per day until the study period was completed. Purposive and suitable selection of the respondents was performed at their convenience. They were interviewed adopting the Diabetes Treatment Satisfaction Questionnaire (Arabic version) at baseline and after 12 weeks. Besides, the clinical variables like hemoglobin A1c (HbA1c), fasting blood sugar (FBS), total daily insulin dose (TDD), number of injections, and hypoglycemia/weeks were also recorded at baseline and at the end of the study.

Results:

In comparison with the baseline values, notable positive differences were identified in the domains of treatment satisfaction, namely, satisfied with current treatment ( P = .0001), frequency of perceived hyperglycemia ( P = .0001), frequency of perceived hypoglycemia ( P = .0001), convenience of current treatment ( P = .0001), understanding diabetes ( P = .0001), recommend the current treatment ( P = .018), and continue the present treatment ( P = .0001) when the study is completed. After 12 weeks, the addition of liraglutide to the existing treatment showed significant positive changes on FBS ( P = .0001), HbA1c ( P = .001), TDD ( P = .0001), number of injections ( P = .0001), documented hypoglycemia/weeks ( P = .0005), and body weight ( P = .0001) in comparison with the baseline values.

Conclusions:

The addition of liraglutide to the existing treatment raised the level of treatment satisfaction and minimized the frequency of hypoglycemic/hyperglycemic events apart from the other clinical variables.
Reduced dynamics of functional connectivity and cognitive impairment in multiple sclerosis
Authors: d’Ambrosio Alessandro , Valsasina Paola , Gallo Antonio , De Stefano Nicola , Pareto Deborah , Barkhof Frederik , Ciccarelli Olga , Enzinger Christian , Tedeschi Gioacchino , Stromillo M Laura , Arévalo Maria J , Hulst Hanneke E , Muhlert Nils , Koini Marisa , Filippi Massimo , Rocca Maria A
Published: March 2019

Background:

In multiple sclerosis (MS), abnormalities of brain network dynamics and their relevance for cognitive impairment have never been investigated.

Objectives:

The aim of this study was to assess the dynamic resting state (RS) functional connectivity (FC) on 62 relapsing-remitting MS patients and 65 sex-matched healthy controls enrolled at 7 European sites.

Methods:

MS patients underwent clinical and cognitive evaluation. Between-group network FC differences were evaluated using a dynamic approach (based on sliding-window correlation analysis) and grouping correlation matrices into recurrent FC states.

Results:

Dynamic FC analysis revealed, in healthy controls and MS patients, three recurrent FC states: two characterized by strong intra- and inter-network connectivity and one characterized by weak inter-network connectivity (State 3). A total of 23 MS patients were cognitively impaired (CI). Compared to cognitively preserved (CP), CI-MS patients had reduced RS-FC between subcortical and default-mode networks in the low-connectivity State 3 and lower dwell time (i.e. time spent in a given state) in the high-connectivity State 2. CI-MS patients also exhibited a lower number and a less frequent switching between meta-states, as well as a smaller distance traveled through connectivity states.

Conclusion:

Time-varying RS-FC was markedly less dynamic in CI- versus CP-MS patients, suggesting that slow inter-network connectivity contributes to cognitive dysfunction in MS.
Conceptualizing bullying in children with autism spectrum disorder: Using a mixed model to differentiate behavior types and identify predictors
Authors: Morton Hannah E , Gillis Jennifer M , Mattson Richard E , Romanczyk Raymond G
Published: March 2019

Children with autism spectrum disorder experience bullying more frequently than their typical peers. Inconsistent definitions for and imprecise measurement of bullying in the literature impede a better understanding of this difference, and multiple types of bullying topographies create additional dimensions for analysis. In this study, participants rated the severity of bullying depicted in written vignettes of child-dyadic interactions. The vignettes varied across child age (4–15 years old) and described either one of four different types of bullying or non-bullying behavior. Participants included teachers and parents of children with autism spectrum disorder and community members without an autism spectrum disorder child. Participants’ severity ratings of vignettes that described bullying differed by bullying type (i.e. verbal, physical, cyber, and interpersonal). Multilevel modeling revealed that bullying severity ratings are impacted by the age of children in the vignette, being a community member without children, and other demographic variables. These findings have implications for research methodology, assessment, and conceptualization of bullying in typical children as well as those with autism spectrum disorder.
Measuring a Breathing Wall's effectiveness and dynamic behaviour
Authors: Alongi Andrea , Angelotti Adriana , Mazzarella Livio
Published: March 2019

Breathing Walls are building structures based on porous materials crossed by an airflow, which act both as building envelopes and ventilation system components. In climates where both heating and cooling are needed, a pro-flux configuration (heat and air mass both flowing in the same direction) might be alternated with a contra-flux configuration (heat and air mass flowing in opposite directions) during the year or even on a day. Understanding and modelling the Breathing Walls' stationary and dynamic behaviour is thus fundamental, in order to optimize their design and to fully exploit their energy-saving potential. In this experimental study, a small-scale no-fines concrete Breathing Wall was investigated. The steady-state contra-flux tests performed in a Dual Air-Vented Thermal Box laboratory apparatus were used to derive the heat recovery efficiency of the sample as a function of the cross airflow velocity. The effectiveness of this technology was then evaluated in a virtual case study. An optimal airflow velocity across the Breathing Wall was found, leading to energy savings between 9% and 14%. Dynamic tests were performed assuming a sinusoidal variation of the operative temperature on one side of the sample. They showed how airflow velocity affected the Breathing Wall inertia and dynamic behaviour.
Correlation research of rotor–stator interaction and shafting vibration in a mixed-flow pump
Authors: Li Wei , Ji Leilei , Shi Weidong , Yang Yongfei , Awais Muhammad , Wang Yulu , Xu Xiwei
Published: March 2019

In order to study the shaft system vibration of mixed-flow pump under rotor–stator interaction, the unsteady pressure fluctuation characteristics are measured and the rotor axis orbit obtained based on the Bentley 408 data acquisition system. The relationship between pressure fluctuation and vibration characteristics of shaft system at the blade passing frequency is analyzed. The results show that the pressure fluctuation amplitude is the largest and the rotor–stator interaction effect is the most obvious in the middle of the impeller. Along the direction of the main stream, the velocity energy is converted into pressure energy, the rotor–stator interaction effect is gradually weakened, and the main frequency of the pressure pulsation gradually turns from the 4 X frequency to the 1 X frequency of the impeller rotation frequency. The hydraulic stirring vibration and other factors lead to jagged sharp corners on the original axis orbit. The axis orbit of 1 X frequency is an ellipse with little difference between long and short axis while the 2 X frequency is the opposite, from which the existence of arcuate rotary whirl and misalignment phenomenon of the rotor can be judged. Combined with time–frequency characteristics of pressure pulsation, it can be found that the hydraulic imbalance has a great influence on the vibration of the shafting, while the rotor–stator interaction at the blade passing frequency takes the second place, which is the main factor of inducing the 4 X frequency vibration of the axis orbit. This study targets is that providing practical guidance for improving operation stability and preventing the vibration failure of the mixed-flow pump.
Brand yourself, design your future: Portfolio-building in the social media age
Authors: Scolere Leah
Published: March 2019

While the portfolio-building narrative has long been established as central to work in the creative industries, the evolving form of the creative portfolio as a key component of the self-brand and the implications on creative work in the age of social media have been comparatively underexplored. This empirical project draws on a year-long qualitative study composed of in-depth interviews of 56 graphic design professionals about their use of social media platforms that cater to creative professionals. This study identifies the social media logics of the design portfolio as multi-platformed, connected, and temporally dynamic, suggesting a new pace, constancy, and subjectivity of what it means for cultural producers to build, maintain, and distribute their portfolio of projects to sustain their creative careers. As the portfolio becomes digitally distributed across a social media ecology, the labor of portfolio production for creative aspirants becomes never-ending and requires an intensified performative of “always designing.”
Conceptualizing Senior Tourism Behaviour: A Life Events Approach
Authors: Huber Dominik , Milne Simon , Hyde Kenneth F
Published: March 2019

This article utilizes the context of senior tourism to conceptualize life events and their impacts on tourism behaviour. Life events are markers in the individual life course that can be used to explain the formation of travel patterns. This study adopts a qualitative biographical research methodology to explore the life trajectories and related tourism behaviours of 23 senior citizens in Freising, Germany, to gain an in-depth understanding of how and why tourism behaviour changes across the individual life course. Life events can have a strong impact on tourism behaviour; they can interrupt existing travel patterns or prompt new ones. Life events and their theoretical underpinnings form a largely untouched field in the domain of tourism and represent an area worthy of more extensive research. A better understanding of life events as they relate to tourism behaviours presents opportunities for the tourism industry to develop and design custom-tailored products and services.
Data Collection in Cross-cultural Ethnographic Research
Authors: Wutich Amber , Brewis Alexandra
Published: March 2019

Collecting data for cross-cultural research is time consuming and expensive. We report on techniques for efficient and effective cross-cultural data collection, drawn from 18 cross-cultural studies we conducted in 22 countries. We discuss research design, site selection and collaboration building, ethical review, cross-site protocol design, data collection pitfalls, and data quality checks.
Graft Patency after Robotically Assisted Coronary Artery Bypass Surgery
Authors: Kitahara Hiroto , Nisivaco Sarah , Balkhy Husam H.
Published: March 2019

Objective

With advances in robotic instrumentation and technology, both robotically assisted minimally invasive direct coronary artery bypass (RMIDCAB) and totally endoscopic coronary artery bypass (TECAB) have been widely used over the past 20 years. Graft patency is the most important outcome in coronary bypass surgery and is associated with long-term prognosis. In this article we reviewed all experts’ studies in the field of robotic assisted coronary artery bypass and investigated graft patency in patients who underwent RMIDCAB or TECAB.

Methods

We performed a literature search in PubMed from 1999 to 2018 using the terms “Robotic” and “Coronary bypass” and/or “Minimally invasive” and/or “Totally endoscopic.” Of the articles found, studies investigating graft patency were specifically selected.

Results

In 33 articles, a total of 4,000 patients underwent robotic assisted coronary artery bypass surgery either by a RMIDCAB (2,396) or by a TECAB (1,604) approach. The graft patency was assessed by invasive angiography or computed tomographic angiography in all studies. The mean graft patency at early (<1 month), midterm (<5 years), and long-term (>5 years) follow-up was 97.7%, 96.1%, and 93.2% in RMIDCAB and 98.8%, 95.8%, and 93.6% in TECAB, respectively.

Conclusions

The graft patency of robotic assisted coronary artery bypass was equivalent to reported outcomes of the conventional approach. These results should encourage the adoption of robotic approaches in coronary bypass surgery.
Design of a frictionless magnetorheological damper with a high dynamic force range
Authors: Macháček Ondřej , Kubík Michal , Strecker Zbyněk , Roupec Jakub , Mazůrek Ivan
Published: March 2019

This article discusses an increase in dynamic force range in a spring–damper unit achieved by elimination of sealings’ friction. This friction is a part of damping force that cannot be controlled; therefore, it is undesirable in magnetorheological dampers. A new design of a magnetorheological damper with no friction force is described and compared with a traditional magnetorheological damper consisting of a piston and piston rod seals. In the traditional design, fluid is forced to flow by a hydraulic cylinder with high friction caused by sealings. In order to eliminate this friction, a frictionless unit made of metal bellows was designed. Elastic metal bellows can be sealed only by static seals. The measurement of force–velocity dependency was carried out for the original and the new damper with the same magnetorheological valve. The results indicate that the frictionless unit exhibits a significant improvement in the dynamic force range. In the case of adaptive-passive damping control, the increase in the dynamic force range enables the improvement of vibration elimination in the entire frequency range.
Two-dimensional model of wave-induced response of seabed around permeable submerged breakwater
Authors: Asumadu Richard , Zhang Ji-Sheng , Hubert Osei-Wusuansa , Akoto Alex Baffour
Published: March 2019

This article focuses on a two-dimensional numerical model established to determine the seabed dynamic response in the region of a permeable submerged breakwater. The wave motion in this article is governed by the volume-averaged Reynolds-averaged Navier–Stokes equation, whereas Biot’s poro-elastic equation determines the seabed foundation. The water surface is recorded using the volume of fluid technique. In this study, the results for the two-dimensional seabed dynamic response for both the consolidation status and the dynamic wave-induced response status for the seabed foundation coupled with submerged breakwater are illustrated. The numerical results examined from the dynamic pore pressure, the effective stresses, the shear stress, and the seabed soil displacements revealed that the impact of dynamic response at the offshore zone/seaward on the seabed foundation is more developed than at the onshore zone/harbor side. Parametric results analysis as regards the effect of the wave, the seabed, and the submerged breakwater structure variation significantly affected the seabed foundation response coupled with the breakwater structure. The numerical outcome on the liquefaction potential shows that the seabed foundation is more seemingly to liquefy and happen approximately at the toe of the submerged breakwater under the wave loading.
Foggy image–sharpening method with multi-channel polarization information system
Authors: Li Ronghua , Chu Qingqing , Zhao Kaichun , Piao Junfeng
Published: March 2019

This article aims to reduce the influence of heavy fog on the outdoor imaging equipment and to maximally improve the foggy image resolution. It is known that reflected light of the object includes the abundant target polarization information. The foggy image can be restored by these information of the target and the airlight. Therefore, this article introduces a multi-channel polarization information system and defogging algorithm accordingly. The polarization information system provides a necessary solution for the accurate application of a specific algorithm, since it can ensure the accuracy of acquired image information. The key point of the proposed algorithm lies in accurately estimating the parameters in the polarization defogging model. Based on the normal threshold distribution comparison, it can avoid the highlight portion of the non-sky area in the image and accurately estimate the airlight intensity at infinite distance so as to effectively reduce the color distortion of the bright area. The median filtering algorithm is used to obtain the airlight degree of polarization by using three obtained polarization scenes. At last, this article analyzes the experimental results through defogging evaluation indexes and compared the result obtained by this algorithm with others.
Frequency of post-stroke pneumonia: Systematic review and meta-analysis of observational studies
Authors: Badve Monica S , Zhou Zien , van de Beek Diederik , Anderson Craig S , Hackett Maree L
Published: March 2019

Background

Post-stroke pneumonia and other infectious complications are serious conditions whose frequency varies widely across studies.

Aims

We conducted a systematic review to estimate the frequency of post-stroke pneumonia and other types of major infection.

Summary of review

MEDLINE, EMBASE, CINAHL, and PsycINFO databases were searched for prospective studies with consecutive recruitment of stroke patients. The primary outcome was post-stroke pneumonia. Secondary outcomes were any infection and urinary tract infection. Quality assessment was done using Newcastle Ottawa scale. Heterogeneity of estimates across study populations was calculated using Cochran's Q (heterogeneity χ2) and I2 statistics. A total of 47 studies (139,432 patients) with 48 sample populations were eligible for inclusion. Mean age of patients was 68.3 years and their mean National Institute of Health Stroke Scale score was 8.2. The pooled frequency of post-stroke pneumonia was 12.3% (95% confidence interval [CI] 11%–13.6%; I2 = 98%). The pooled frequency from 2011 to 2017 was 13.5% (95% CI 11.8%–15.3%; I2 = 98%) and comparable with earlier periods (P interaction = 0.31). The pooled frequency in studies in stroke units was 8% (95% CI 7.1%–9%; I2 = 78%) and significantly lower than other locations (P interaction = 0.001). The pooled frequency of post-stroke infection was 21% (95% CI 13%–29.3%; I2 = 99%) and of post-stroke urinary tract infection was 7.9% (95% CI 6.7%–9.3%; I2 = 96%).

Conclusion

Approximately 1 in 10 stroke patients experience pneumonia during the acute period of hospital care. The frequency of post-stroke pneumonia has remained stable in recent decades but is lower in patients receiving stroke unit care compared to management in other ward settings.
Evaluation of antibiotic prophylaxis for gastrointestinal surgeries in a teaching hospital: An interventional pre–post study
Authors: Elyasi Sepideh , Fattahi Masum Asiyeh , Bahreyni Amirhossein , Samani Seyed Sattar , Atamanesh Ahmad , Abdollahi Abbas , Mousavi Maryam
Published: March 2019

Surgical site infections are related to a high morbidity, mortality and healthcare costs. Despite ample evidence demonstrating the effectiveness of antimicrobials to prevent surgical site infections, inappropriate timing, antibiotic selection and excessive continuation of antibiotics are common in practice. In this study, we compare the appropriateness of antibiotic prophylaxis in gastrointestinal surgery, before and after an evidence-based guideline implementation. One hundred patients were evaluated in each group. The implementation of the guideline resulted in significant reduction of incorrect use of antibiotics from 55% to 18% (P = 0.002). It also reduced duration of prophylactic antibiotics (43% vs. 23%, P = 0.025). Inappropriate doses diminished but not significantly (8% vs. 5%, P = 0.321). Based on our results, in more than half of of these cases patients received incorrect antibiotic prophylaxis regimens for gastrointestinal surgery in this hospital. Local guideline implementation can result in reduction of antibiotic use, dose and duration errors.
The ageing population
Authors: Toukan Zein
Published: March 2019

The UK is undergoing a significant demographic change, due to a steadily ageing population. By 2040 nearly one-in-four people will be aged 65 years or over. This will have several implications for the individual, society, the healthcare system and the economy. This article aims to highlight some of the risk factors that contribute to increased morbidity and mortality in older people and to outline strategies aimed at reducing ill health and disability.
Evaluation of information technology impact on bank’s performance: The Ghanaian experience
Authors: Appiahene Peter , Missah Yaw Marfo , Najim Ussiph
Published: March 2019

With the introduction of information technology (IT), a lot of organizations are making significant investment on them. These organizations see IT as a tool for having a competitive advantage. This increasing dependence on IT by organizations has generated the debate to assess its impact on organization’s performance. The results of previous studies on IT and firms’ performance are consistently attributed to the lack of valid quantitative measures. Non-parametric models like data envelopment analysis (DEA) have been suggested to be a good qualitative measure of IT impact on organizations performance compared to parametric methods. This current study applied a two-stage DEA model on 444 Ghanaian bank branches. The efficiencies were determined using the Robust DEA package in R programming. The results suggested that IT had significant impact on the banks’ overall performance as a good number of them (78.82%) were efficient in their entire operations, even though their respective efficiencies in deposit and investment were not good. In conclusion, further studies can combine DEA with machine learning algorithms to study the impact of IT on firms’ performances using the study’s data.
Retrieving the constitutive properties of a concrete target from a single instrumented penetration test
Authors: Feldgun Vladimir R , Yankelevsky David Z
Published: March 2019

Penetration into concrete is an important problem that attracted many researches who developed analytical models and numerical solutions. Most of the advanced methods account for the material properties through their constitutive equations, combined from the failure envelope and the equation of state. These properties are rarely available in many cases, and in different experimental reports it is missing. For lack of any other option, analysts borrow available equations that were developed for other concrete types, with the doubt of their suitability. In a limited number of tests, instrumented projectiles are used and the deceleration time history is recorded. Rarely, the constitutive properties are also provided and analysis can be conducted. Otherwise, analysis cannot be carried out and prediction and validation of the recorded deceleration curve cannot be conducted. The present article refers to such instrumented tests where the constitutive properties are not available. It aims at unveiling the relationship between the deceleration curve and the constitutive properties and at solving, for the first time, the inverse problem of a penetration problem in order to retrieve major constitutive equation parameters from the acceleration time-history record. The major new feature of the present article is identification of the failure envelope parameters in the Mohr–Coulomb form as well as the parameters of the Shock Hugoniot equation of state for which procedures have been developed. The present approach allows to retrieve required information regarding the equation of state and failure envelope from a single instrumented experiment that provides the projectile deceleration time-history record. It is shown that the retrieved parameters of the failure envelope and the equation of state are in good agreement with reported constitutive parameters that are based on experimental data. The retrieved data allow to carry out penetration time-history predictions of different projectiles at different impact velocities on the same concrete.
Clinical audit as a tool to optimize contracted private healthcare provision: Testing the waters in resource-deprived Greece
Authors: Souliotis Kyriakos , Golna Christina , Mantzana Vasiliki , Papaspyropoulos Sotirios , Koutsovasilis Anastasios , Sotiropoulos Alexios
Published: March 2019

Background and Aims:

Clinical audit is applied to optimize clinical practice and quality of healthcare services while controlling for money spent, critically in resource-deprived settings. This case study reports on the outcomes of a retrospective clinical audit on private hospitalizations, for which reimbursement had been pending by the Health Care Organization for Public Servants (OPAD) in Greece. This case study is the first effort by a social insurance organization in Greece to employ external clinical audit before settling contracted private healthcare charges.

Methods:

One thousand two hundred hospitalization records were reviewed retrospectively and a fully anonymized clinical audit summary report created for each one of them by a team of clinical audit experts, proposing evidence-based cuts in pending charges where medical services were deemed clinically unnecessary. These audit reports were then collated and analysed to test trends in overcharges among hospitalized insureds per reason for hospitalization.

Results:

The clinical audit report concluded that 17.4% of a total reimbursement claim of €12,387,702.18 should not be reimbursed, as it corresponded to unnecessary or not fully justifiable according to evidence-based, best practice, medical service provision. The majority of proposed cuts were related to charges for medical devices, which are borne directly by social insurance with no patient or private insurance co-payment.

Conclusion:

Clinical audit of hospital practice may be a key tool to optimize care provision, address supplier-induced demand and effectively manage costs for national health insurance, especially in circumstances of budgetary constraints, such as in austerity-stricken settings or developing national healthcare systems.
Combination of oral vancomycin and intra-colonic vancomycin: Successful treatment of complicated pseudomembranous colitis in a child patient
Authors: Bozkurt Hüseyin Sancar , Kara Banu
Published: March 2019

The Clostridium difficile infection–related disease varies from mild diarrhoea to pseudomembranouscolitis. Although C. difficile infection is commonly considered to be a hospital-acquired infection, a significant number of cases are community acquired. Community-acquired C. difficile infection can exhibit itself as ileus or toxic megacolon. Severe C. difficile infection that is unresponsive to intravenous metronidazole therapy requires more aggressive medical management and even surgical intervention. We present our case results for which vancomycin was administered both orally and intra-colonically. With this method, we treated the community acquired C. difficile infection patient who was presented as ileus.
An Implementation of a Computerized Cognitive Behavioral Treatment Program to Address Student Mental Health Needs: A Pilot Study in an After-School Program
Authors: Sanders Sara , Lane Jessica J. , Losinski Mickey , Nelson Jessica , Asiri Abdullah , Holloway Samantha M. K. , Rogers Elizabeth
Published: March 2019

This study evaluated the feasibility and effectiveness of an abbreviated computerized cognitive behavioral therapy (CCBT) software program, Camp Cope-A-Lot, in an after-school setting for elementary students identified as at risk for anxiety and other behavioral problems. Analysis of data from a small sample of students randomly assigned to a treatment or control group suggests that CCBT programs may ease the internalizing symptoms of students. We discuss limitations and implications for practitioners and future research.
A modified tarsal sinus approach for intra-articular calcaneal fractures
Authors: Zhan Junfeng , Hu Chuanzhen , Zhu Nan , Fang Wang , Jing Juehua , Wang Gang
Published: March 2019

Background:

Plate fixation using traditional lateral L-shape approach for intra-articular calcaneal fractures is complicated by 30% of wound complications, and the lateral small incision techniques with a tarsal sinus approach cannot sufficiently address all the fragments. A modified tarsal sinus approach with combined advantages of traditional lateral L-shape and tarsal sinus approaches for the treatment of intra-articular calcaneal fractures was developed.

Method:

This prospective study included 29 patients (13 Sanders type II and 16 type III) with calcaneal fractures were managed with this technique. Calcaneal height, width, length, Bohler’s angle, and Gissane angle were measured preoperatively, postoperatively, and at 1-year follow-up. Functional outcomes were assessed based on American Orthopedic Foot and Ankle Society (AOFAS) ankle/hindfoot score.

Results:

Twenty-nine patients with average follow-up time of 18 (range 13–29) months were included. The radiographs demonstrated significant corrections of the Bohler’s angle and Gissane angle, calcaneal width, length, and height from preoperation to postoperation and 1-year follow-up. Among all follow-up patients, one case had skin necrosis but healed after dressing. Another case had symptoms of numbness in the sural innervation area, which disappeared after 5 months of physical therapy and drug therapy. One case showed degenerative changes of subtalar joint at 1-year follow-up. No other wound complications like incision infection (superficial or deep) and wound dehiscence occurred. At 1-year follow-up, the mean AOFAS score was 90.2 ± 17.7 (range 70–98) and the good and excellent rate was 89.7%.

Conclusion:

The modified tarsal sinus approach in the treatment of Sander’s type II and III calcaneal fractures allowed adequate reduction and rigid fixation with low incidence of wound complications. Compared to sinus tarsi approach, this technique required shorter learning curve and was more easily mastered by young orthopedic surgeons. Thus, it was worthy of application clinically.