bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing Transportation Engineering and Planning Metrics for Rural Volunteer Driver Programs
Authors: Hanson Trevor R. , Goudreau Matthieu
Published: January 2019

Car-based volunteer driver programs have emerged as important providers of transportation in many rural and low-density locations in which automobile dependence is high and transit access is negligible. The degree of this importance is not known, yet it can be expected that demand for these services will increase commensurate with the transportation needs of the aging population. The challenge remains that there is limited technical guidance for existing and new programs to anticipate and respond to the anticipated increases in travel demand from an aging population. It is also unclear how these programs can fit into transportation engineering and planning. This paper presents aggregate results of travel data collected for one year using a uniform data reporting approach by seven car-based volunteer driver programs in New Brunswick, Canada. Users 65 years and older accounted for 49–65% of members, and programs on average made 2.0 stops (trip end) per drive (trip chain), drove 39 km per stop, 61 km per drive, and had an occupancy of 1.5 riders per drive. A total of 88% of drives had 3 or fewer stops, and one drive was cancelled for every 10–11 offered. A total of 49.3% of all stops (excluding home) were for health purposes, with 20.7% for education/work. Seasonal, daily, and hourly trends were observed. Volunteers in groups with <100 riders provided more hours/drive but fewer hours/year than those in larger groups. These data can provide a basis for a more sophisticated approach to program planning and could be useful in forecasting for future demand.
Intimate Partner Violence and Health: The Roles of Social Support and Communal Mastery in Five American Indian Communities
Authors: Schultz Katie , Walls Melissa , Grana Sheryl J.
Published: January 2019

Elevated rates of intimate partner violence (IPV) have been documented among American Indian (AI) populations and multiple negative health outcomes are associated with IPV among the general population. The aims of this study were to examine associations between IPV and health outcomes among AI women and men ( N = 192) in five reservations in the upper Midwest and test for possible moderating roles of social support and communal mastery. Data were from quantitative survey results from the Gathering for Health study, a community-based participatory research project investigating the impact of stress on health among AI adults living with type 2 diabetes. Computer-assisted surveys measured IPV with current or most recent partner, depressive symptoms, adverse physical health conditions frequently co-occurring with type 2 diabetes, drug abuse, and self-reported levels of social support and communal mastery. Forty-eight percent of women and 43% of men reported IPV in their current or most recent relationship. Higher IPV scores were positively associated with depressive symptoms, physical health, and drug abuse and negatively associated with social support and communal mastery. Social support was negatively associated with depressive symptoms and drug abuse, and communal mastery and depressive symptoms were inversely correlated. Ordinary least squares regression analyses demonstrated positive relationships between IPV and all three adverse health outcomes, but communal mastery was not significantly related to any of the outcomes in multivariate models. Social support moderated the effects of IPV on depressive symptoms only and communal mastery demonstrated no moderating effect. Findings suggest that social support may be protective against negative health outcomes among this population and corroborate previous scientific literature on the negative health outcomes specifically related to IPV. Interventions seeking to increase social support may be an area in which to focus IPV preventive and treatment efforts.
How Internet Content Mobilizes Protests: The Case of Two Anti-Government Protests in Korea
Authors: Kim Jarim
Published: January 2019

This study enhances our understanding of the interplay between Internet content and protests. Utilizing 47 in-depth interviews conducted during two mass protests in South Korea, the study investigated how Internet content affects the mobilization of people and if or how the emergence of social networking sites (SNSs) has changed Internet use. Applying qualitative methods, it revealed that the Internet helps mobilize protests by providing a space for reproduced and affective content and exposing people to multiple perspectives against which they can test the legitimacy of their personal beliefs. The study showed that, unlike the Internet, SNSs are less-than-ideal tools for political participation. By focusing on Internet content and examining the use and perception of the Internet in two protests separated by an 8-year interval, this study makes unique contributions in the realm of the Internet and mobilization.
Design and reliability analysis of the electrical control system of the subsea control module
Authors: Wang Liquan , Wang Xiangyu , Lizhang Hanyi , Jia Peng , Yun Feihong , Wang Honghai
Published: January 2019

The subsea control module is the core equipment of the subsea production system, and its electrical control system plays a large role in the failure modes of the subsea control module. Based on a traditional nonredundant programmable logic controller system, a parallel cross-redundancy system is proposed, designed and tested for the electrical control system of the subsea control module to enhance the reliability of the subsea control module within the given space. A success-oriented system decomposition method is proposed on the basis of the reliability block diagram and system logical relationship that effectively reduces the system dimension and solves the problem of the system state-space explosion caused by the number of system components in the Markov model, and the system reliability and mean time to failure models are created. The reliability model is solved by a Markov model successfully. Finally, the redundancy of the system is tested to validate the logical relationship in the reliability model. The reliability and mean time to failure of the system are analyzed in MATLAB. The tests and analysis show that the proposed parallel cross-redundancy system is better than the double hot-standby system, as demonstrated by a higher reliability and longer mean time to failure, and the module failure rate effects have been minimized.
How organic is organic milk? Can we have a quick check?
Authors: van Ruth Saskia , Liu Ningjing
Published: January 2019

The organic market is growing, and confidence is key. However, it is hard to distinguish an organic product from another regular product. In this article we examined a consumer NIRS-Vis device for its capabilities to distinguish organic retail milks from conventional milks. The study revealed differences between the two groups, allowing classification of samples, but these differences were not as distinct as those provided by other devices examined previously. Nevertheless, with some improvement of performance of this kind of devices and integration in smart phones, authentication of foods is within reach of citizens in the near future.
Nonparametric competing risks analysis using Bayesian Additive Regression Trees
Authors: Sparapani Rodney , Logan Brent R , McCulloch Robert E , Laud Purushottam W
Published: January 2019

Many time-to-event studies are complicated by the presence of competing risks. Such data are often analyzed using Cox models for the cause-specific hazard function or Fine and Gray models for the subdistribution hazard. In practice, regression relationships in competing risks data are often complex and may include nonlinear functions of covariates, interactions, high-dimensional parameter spaces and nonproportional cause-specific, or subdistribution, hazards. Model misspecification can lead to poor predictive performance. To address these issues, we propose a novel approach: flexible prediction modeling of competing risks data using Bayesian Additive Regression Trees (BART). We study the simulation performance in two-sample scenarios as well as a complex regression setting, and benchmark its performance against standard regression techniques as well as random survival forests. We illustrate the use of the proposed method on a recently published study of patients undergoing hematopoietic stem cell transplantation.
Using near infrared measurements to evaluate NaCl and KCl in water
Authors: Peters Reisha D , Noble Scott D
Published: January 2019

Spectral differences between aqueous solutions of NaCl and KCl have received minimal attention in previous research due to strong similarities between the two salts and the lack of motivation to differentiate between them. Correlations between salinity and absorbance have been developed previously with varying degrees of linearity but have not been tested to saturation. This work will demonstrate that correlating spectral measurements and the concentration of NaCl and KCl in water can be extended up to the saturation point of both salts and that solutions of these salts with unknown concentrations can be distinguished. Spectral data for samples of NaCl and KCl in single-salt solutions were collected up to saturation and correlations were developed for differentiating between solutions of the two species. These correlations were able to correctly identify the solution type for all solutions in the test set and estimate their concentrations with an average error of 0.9%.
Incidence and Associated Factors of Type 2 Diabetes: A Community-Based Cohort Study in the Central Region of Rural Community in Thailand
Authors: Kittithaworn Annop , Dy Royal , Hatthachote Panadda , Rangsin Ram , Mungthin Mathirut , Narindrarangkura Ploypun , Piyaraj Phunlerd
Published: January 2019

The present study aimed to evaluate the incidence of type 2 diabetes mellitus (T2DM) and associated risk factors among adults in a rural community of Thailand. A prospective cohort study was conducted in a rural community of Thailand. Among 1358 nondiabetics ≥18 years, fasting plasma glucose (FPG) was measured at baseline in 2008 to 2010 and at follow-up evaluation in 2015. After follow-up of 5213 person-years, 122 new cases of T2DM were ascertained corresponding to cumulative incidence of 23.40 per 1000 person-years. The independent factors associated with T2DM were age, male, prehypertension, hypertension, waist circumference, and impaired FPG. The incidence of T2DM in Thailand is high, and many risk factors are converging. The focus of public health efforts should be on abdominal obesity, hypertension, and impaired FPG. Special attention in terms of preventive strategies must be paid to individuals with impaired FPG, as this state is the most prominent predictor of developing T2DM.
Considering Antiracism in Student Teacher Placement
Authors: Fiorentino Matthew C.
Published: January 2019

Student teaching represents the culmination of a preservice music educator’s preparation. In student teaching, notions of the transformative potential of music education may be reinforced or subverted. The placement of student teachers, an underresearched process in music teacher education, may be a space where teacher educators can work toward racial justice. In this article, I explore critical antiracist theory in music teacher education in two fictionalized vignettes. I apply an antiracist lens to the process of student teacher placement to suggest ways to interrogate problematic policies and practices. Avenues for antiracist praxis include (a) naming the racialized nature of an institution’s professional network, (b) mapping the racial landscapes of prospective placements, (c) addressing issues of representation in student teacher placement, and (d) becoming race-power conscious. Through this article, I illustrate how antiracist theory might guide music teacher education toward social action by addressing issues related to racism, racial representation, and school segregation.
Cannabidiol: A New Hope for Patients With Dravet or Lennox-Gastaut Syndromes
Authors: Chen Jeffrey W. , Borgelt Laura M. , Blackmer Allison B.
Published: January 2019

Objective: To review the efficacy, safety, pharmacology and pharmacokinetics of pure, plant-derived cannabidiol (CBD; Epidiolex) in the treatment of Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS). Data Sources: Relevant information was identified through EMBASE and Ovid MEDLINE (1946 to October 2018). Product labeling and https://www.clinicaltrials.gov were also reviewed. Study Selection/Data Extraction: English language articles evaluating efficacy and safety in humans with treatment-resistant epilepsies were reviewed; additional pharmacology and pharmacokinetic studies in humans, animals, and in vitro were also included. Data Synthesis: Pure, plant-based CBD is a pharmaceutical grade extract that exhibits clinically significant antiseizure properties, with a hypothesized multimodal mechanism of action. In the GWPCARE trial series, CBD displayed superior efficacy in reducing key seizure frequencies (convulsive seizures in DS; drop seizures in LGS) by 17% to 23% compared with placebo as adjunctive therapy to standard antiepileptic drugs in patients 2 years of age and older. Common adverse effects were somnolence, diarrhea, and elevated hepatic transaminases. Noteworthy drug-drug interactions included clobazam, valproates, and significant inducers/inhibitors of CYP2C19 and 3A4 enzymes. Relevance to Patient Care and Clinical Practice: A discussion regarding CBD dosing, administration, adverse effects, monitoring parameters, and interactions is provided to guide clinicians. CBD offers patients with DS and LGS a new treatment option for refractory seizures. Conclusion: This is the first cannabis-derived medication with approval from the US Food and Drug Administration. This CBD formulation significantly reduces seizures as an adjunct to standard antiepileptic therapies in patients ≥2 years old with DS and LGS and is well tolerated.
The Expanding Clinical Universe of Polyglutamine Disease
Authors: Huang Shanshan , Zhu Suiqiang , Li Xiao-Jiang , Li Shihua
Published: January 2019

Polyglutamine (polyQ) diseases are a group of hereditary neurodegenerative disorders caused by expansion of unstable polyQ repeats in their associated disease proteins. To date, the pathogenesis of each disease remains poorly understood, and there are no effective treatments. Growing evidence has indicated that, in addition to neurodegeneration, polyQ-expanded proteins can cause a wide array of abnormalities in peripheral tissues. Indeed, polyQ-expanded proteins are ubiquitously expressed throughout the body and can affect the function of both the central nervous system (CNS) and peripheral tissues. The peripheral effects of polyQ disease proteins include muscle wasting and reduced muscle strength in patients or animal models of spinal and bulbar muscular atrophy (SBMA), Huntington’s disease (HD), dentatorubral-pallidoluysian atrophy (DRPLA), and spinocerebellar ataxia type 17 (SCA17). Since skeletal muscle pathology can reflect disease progression and is more accessible for treatment than neurodegeneration in the CNS, understanding how polyQ disease proteins affect skeletal muscle will help elucidate disease mechanisms and the development of new therapeutics. In this review, we focus on important findings in terms of skeletal muscle pathology in polyQ diseases and also discuss the potential mechanisms underlying the major peripheral effects of polyQ disease proteins, as well as their therapeutic implications.
A review of R-DHAP administration in the outpatient setting and a case of the alternative regimen R-DHAX given outpatient for refractory diffuse large B-cell lymphoma
Authors: Hill Hailey , Arnall Justin , Janes Amanda , Hatley Crystal , Swift Kristen , Hargett Christy , Howell Theresa , Griffin Sarah , Larck Christopher , Park Stephen
Published: January 2019

Introduction

Several regimens for treating hematologic malignancies are given inpatient due to multiple factors. Many clinicians are evaluating methods to deliver traditionally inpatient regimens in the outpatient setting to increase patient satisfaction, improve access to therapy, and reduce costs. A regimen traditionally administered inpatient, dexamethasone, cytarabine, and cisplatin (DHAP) is a common and effective salvage regimen for relapsed/refractory non-Hodgkin’s lymphoma. DHAX, which substitutes oxaliplatin for cisplatin, has been identified as a reasonable alternative to DHAP and offers the potential for tolerable administration in the outpatient setting as well.

Case description

A 74-year-old patient with double hit relapsed/refractory diffuse large B cell lymphoma was given rituximab, dexamethasone, high-dose cytarabine, and oxaliplatin (R-DHAX) in our outpatient clinic; however, this regimen is traditionally administered in the inpatient setting. Our main obstacle being cytarabine doses traditionally given 12 h apart. The outpatient regimen given to our patient was rituximab and oxaliplatin on day 1, cytarabine dose one late afternoon on day 2, cytarabine dose two early morning on day 3, and dexamethasone on days 1–4. Doses of oxaliplatin and cytarabine were reduced due to thrombocytopenia experienced with Cycle 1. He did not experience any increased toxicities or complications associated with the regimen moving forward.

Discussion

This illustrates a unique administration of R-DHAX in an infusion center that operates during typical outpatient clinic hours. Both DHAP and DHAX, with or without rituximab, administered in the outpatient setting may be options to consider in relapsed/refractory non-Hodgkin’s lymphoma.
Effect of denosumab versus zoledronic acid on calcium levels in cancer patients with bone metastasis: A retrospective cohort study
Authors: Nasser Sahar M , Sahal Arwa , Hamad Anas , Elazzazy Shereen
Published: January 2019

Objective

To identify the incidence of hypercalcemia and hypocalcemia in zoledronic acid and denosumab groups. Secondary objective was to determine the correlation between calcium supplement and calcium level control.

Methods

An observational retrospective cohort study was conducted by reviewing patient electronic records, laboratory results, and medication charts from 1 August 2015 to 31 July 2016. Adult cancer patients who were diagnosed with bone metastasis secondary to a solid tumor or multiple myeloma and who received either zoledronic acid or denosumab were included. Other indications for bone targeting agents were excluded. Data of bone targeting agents administration encounters were collected, evaluated, and analyzed.

Results

A total of 1141 encounters (for 271 patients) were included. The incidence of hypocalcemia was higher in denosumab compared to zoledronic acid group (5.5% vs. 3.1%, OR = 0.55, 95% CI [0.3–1.0]; P = 0.05). Hypercalcemia incidence was also higher in denosumab group (8.5% vs. 3.1%, OR = 2.9, 95% CI [1.68–5.03]; P < 0.0001). Breast cancer was the most common malignancy associated with hypocalcemia (27.3%) followed by ovarian cancer (25%) and multiple myeloma (22.7%). The risk of developing hypocalcemia was reduced by 16% in patients receiving calcium supplementation (RR = 0.84, 95% CI [0.55–1.20]; P = 0.39).

Conclusion

Denosumab use was associated with higher rates of both hypercalcemia and hypocalcemia compared to zoledronic acid. Adequate supplementation with calcium substantially reduced the risk of hypocalcemia. Our results highlight the importance of taking preventative measures upon bone targeting agents initiation and during treatment including regular monitoring of calcium levels and providing supplements accordingly.
Translingual Practice, Strategic Participation, and Meaning-Making
Authors: Pacheco Mark B. , Daniel Shannon M. , Pray Lisa C. , Jiménez Robert T.
Published: January 2019

This case study examines one third-grade teacher’s strategic participation in translingual practice and the ways that this participation shaped emerging bilingual students’ meaningful engagements with texts. Using a transliteracies perspective, we describe instances of emergence and resonance as students and their teacher leveraged resources coded in English, Arabic, and Spanish to co-construct meaning. Analysis of small-group guided reading, buddy reading, and an interactive read-aloud detail how the teacher used entextualizing, envoicing, and recontextualizing strategies to support students’ participation. Analysis of postinstruction interviews describes how resources, expertise, and emotion resonated within each literacy event and across time for this teacher. We conclude with recommendations for including translingual pedagogies in similar classroom contexts, arguing for the importance of recognizing and developing teachers’ translingual competence, as well as their emerging multilingualism.
Perioperative and Anesthetic Management of Coarctation of the Aorta
Authors: Fox Eric B. , Latham Gregory J. , Ross Faith J. , Joffe Denise
Published: January 2019

Isolated coarctation of the aorta is a relatively common form of congenital heart disease that is characterized by variable degrees of obstruction to aortic outflow. The clinical presentation varies from asymptomatic arterial hypertension to cardiogenic shock. The treatment options include surgical repair or interventional therapy with aortic balloon dilation and stent placement. This article will summarize the pathophysiology as well as describe the surgical and interventional procedures. The anesthetic management for those interventions will be reviewed.
Potential Anti-Cancer Flavonoids Isolated From Caesalpinia bonduc Young Twigs and Leaves: Molecular Docking and In Silico Studies
Authors: Iheagwam Franklyn Nonso , Ogunlana Olubanke Olujoke , Ogunlana Oluseyi Ebenezer , Isewon Itunuoluwa , Oyelade Jelili
Published: January 2019

Tyrosine kinase (TK), vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMP) are important cancer therapeutic target proteins. Based on reported anti-cancer and cytotoxic activities of Caesalpinia bonduc, this study isolated phytochemicals from young twigs and leaves of C bonduc and identified the interaction between them and cancer target proteins (TK, VEGF, and MMP) in silico. AutoDock Vina, iGEMDOCK, and analysis of pharmacokinetic and pharmacodynamic properties of the isolated bioactives as therapeutic molecules were performed. Seven phytochemicals (7-hydroxy-4′-methoxy-3,11-dehydrohomoisoflavanone, 4,4′-dihydroxy-2’-methoxy-chalcone, 7,4′-dihydroxy-3,11-dehydrohomoisoflavanone, luteolin, quercetin-3-methyl, kaempferol-3-O-β-d-xylopyranoside and kaempferol-3-O-α-l-rhamnopyranosyl-(1 → 2)-β-D-xylopyranoside) were isolated. Molecular docking analysis showed that the phytochemicals displayed strong interactions with the proteins compared with their respective drug inhibitors. Pharmacokinetic and pharmacodynamic properties of the compounds were promising suggesting that they can be developed as putative lead compounds for developing new anti-cancer drugs.
Enabling autocracy? Peacebuilding and post-conflict authoritarianism in the Democratic Republic of Congo
Authors: von Billerbeck Sarah , Tansey Oisín
Published: January 2019

Does peacebuilding shape the regime type of countries where international missions are deployed? Most peacebuilding missions take place in authoritarian contexts, and seek to overcome the legacies of conflict by overseeing transitions to democratic rule; however, most regimes that experience peacebuilding still retain some form of authoritarian rule. In this article, we examine the extent to which international peacebuilding missions contribute to the consolidation of post-conflict authoritarian regimes even when their stated aims involve the promotion of democracy. We argue that international peacebuilders can act as enablers of authoritarianism in host countries. We distinguish this category of behaviour from explicit ‘autocracy promotion’, which implies intentional support to autocracy. Instead, enabling is often an unintended consequence, and we identify two mechanisms through which enabling occurs: by building the capacity of incumbent authoritarian leaders and by signalling a permissive environment for authoritarian behaviour for national actors. We illustrate our argument with the case of the United Nations peacekeeping operation in the Democratic Republic of Congo.
Effect of phase difference on dynamic characteristics for a synchronous vibrating system with double eccentric rotors
Authors: Zhang Nan
Published: January 2019

Phase difference is an important factor affecting the performances of the synchronous vibrating system driven by the two excited motors. The nonlinear dynamic models of the synchronous vibrating system under the action of the nonlinear elastic force are established. The periodic solutions for the synchronous vibrating system are theoretically derived using the nonlinear dynamic models. The stabilities of periodic solution for the synchronous vibrating system are theoretically analyzed using Jacobi matrix of the amplitude-frequency-characteristic equation. Using Matlab, the amplitude-frequency characteristics are analyzed through the selected parameters. The relations between the phase difference and the amplitude in the synchronous vibrating system are also investigated. Various nonlinear phenomena, such as the jump phenomenon and the multiple-valued periodic solutions, are reproduced using relation between the phase difference and the amplitude. The stable periodic solutions can be obtained by the different initial conditions, using Runge–Kutta method. The effects of the phase difference on the amplitude are presented for the changes of system parameters (including the stiffness of the soil and the damping of the soil, the mass of the eccentric block). The effects of the dynamic characteristics on the phase difference are analyzed through the difference rates of the two excited motors and the initial conditions of the system. It has been shown that the research results can provide a theoretical basis for the research of the synchronous vibrating system.
New concept and design of electronically controlled cylinder lubrication system for large two-stroke marine diesel engines
Authors: He Yuhai , Zhou Peilin , Xie Liangtao , Zhang Jiyun
Published: January 2019

Lubrication of cylinders between liners and rings is one of the crucial factors that affects the efficient operation of diesel engines. Marine diesel engines usually use inferior heavy fuel oil with high sulphur content, and the acidic substances formed by fuel combustion need alkaline cylinder oil to neutralize. For the operational cost to a marine engine, besides fuel oil, cylinder oil also takes a big share. This article first analyses the advantages and disadvantages of existing cylinder lubrication systems with regard to oil injection control. Second, the control parameters and variables such as the oil injection pressure, timing, oil feed rate and reliability are analysed, and the corresponding control schemes formulated. Third, the control strategies are developed in detail. Finally, verification tests are carried out on an actual engine, with the results showing that the control strategies developed in this article provide a stable, cost-effective, creative and excellent solution for cylinder lubrication with reduced cylinder wear. A thin and uniform oil film distribution is retained on the liner surface, with savings in cylinder oil consumption, lower particulate matter emission levels and improved cylinder liner and piston rings running conditions. The experimental results show that the oil consumption could be reduced by up to 50%.
A Self-Management Training Intervention: Perceptions and Practices of Community Health Workers in South Africa
Authors: Majee Wilson , Anakwe Adaobi , Johnson Levona , Rhoda Anthea , Frantz Jose , Schopp Laura
Published: January 2019

Background. While community health workers (CHWs) are increasingly being used as a strategy for increasing health care access, particularly in rural communities, interventions are needed to improve their skill sets in inspiring health behavior change, both for themselves and among their community clients. Self-management (SM) education interventions have shown to improve health behaviors and well-being. Purpose. This article reports on systematic, in-depth interviews conducted with rural CHWs in South Africa to understand (1) their motivation for participating in SM training, (2) skills gained from training and (3) perceived impact of training on CHW health behavior, both personally and as health professionals. Method. Nineteen rural CHWs who completed an SM training participated in face-to-face semistructured interviews. Transcripts were independently coded by two researchers using the thematic framework approach. Findings. CHWs felt empowered to change their health behavior by skills such as goal setting and action planning, and by growth in self-awareness and confidence. They expressed that their desire to help others motivated them to participate in SM training. Conclusion. SM training programs that address practice skill gaps hold promise in producing health behavior changes for rural CHWs and their clients.
Training Community Residents to Address Social Determinants of Health in Underresourced Communities
Authors: Wennerstrom Ashley , Silver Julia , Pollock Miranda , Gustat Jeanette
Published: January 2019

Disparities in chronic disease and life expectancy remain a significant public health problem and are largely attributable to social determinants of health. Community health workers (CHWs) promote health equity through individual- and community-level activities, and leadership and advocacy skills training make CHWs more likely to catalyze structural change. CHWs are increasingly being integrated into clinical practices to support care management, creating a need for new grassroots community-level advocates. We adapted for community residents an existing CHW training curriculum focused on social determinants of health and effecting community change. We offered 36 hours of training at community-based locations in New Orleans, Louisiana. We assessed baseline civic and community participation and pre- and postknowledge for each lesson. Among 43 enrollees, 42 completed the program. The majority were Black (92.7%), female (92.7%), and retired or unemployed (77.5%), with a median age of 61.5 years. In the past year, 85% of participants had volunteered, 57.1% had been involved with a community organization, and 32.4% had contacted the city council. Participants demonstrated statistically significant increases in knowledge in 5 of 6 lessons. Our success in increasing knowledge of advocacy among a civically engaged group suggests that trainees may become community leaders in addressing social determinants of health.
Development of an adaptive morphing wing based on fiber-reinforced plastics and shape memory alloys
Authors: Ashir Moniruddoza , Hindahl Jan , Nocke Andreas , Cherif Chokri
Published: January 2019

The process of integrating smart materials into fiber-reinforced plastics has been used increasingly to create different high-performance products for lightweight applications. This paper presents the development of an adaptive morphing wing based on fiber-reinforced plastics with shape memory alloys integrated into the reinforcing fabrics. Two types of preforms with varying numbers of integrated weft yarns in shape memory alloys were manufactured for a wing structure on a weaving machine using the pleated woven fabric technology. Subsequently, the realized preforms were infiltrated by a thermoset matrix and characterized mechanically to derive a preferred variant. After developing the adaptive morphing wing, its deformation behavior was characterized by varying current flow and time through shape memory alloys. Results revealed that maximum deformation of the investigated adaptive morphing wing was achieved at a current flow and time of 1 A and 60 s, respectively.
Dynamic Optical Coherence Tomography Is a New Technique for Imaging Skin Around Lower Extremity Wounds
Authors: Holmes Jon , Schuh Sandra , Bowling Frank Lee , Mani Raj , Welzel Julia
Published: January 2019

Chronic wounds such as venous leg ulcers invariably heal slowly and recur. In the case of venous leg ulcers, poor healing of chronic wounds is variously attributed to ambulatory hypertension, impaired perfusion and diffusion, presence of chronic inflammation at wound sites, lipodermatosclerosis, and senescence. The aim of this study was to investigate whether a new technique, optical coherence tomography (OCT), which permits imaging of blood capillaries in the peri-wound skin, can provide new insights into the pathology. OCT and its recent variant, dynamic OCT, permit rapid noninvasive depth-resolved imaging of the capillaries in the superficial dermis via a handheld probe, showing the morphology and density of vessels down to 20 µm in diameter. We used dynamic OCT to investigate 15 chronic wounds and assess characteristics of the vessels at the 4 poles around the wounds, the wound bed, adjacent dermatosclerosis, and unaffected skin. The results of the study show that both vessel morphology and density in the wound edges are dramatically different from that in healthy skin, showing clusters of glomuleri-like vessels (knot-like forms or clumps) and an absence of linear branching vessels, and also greater blood perfusion. Such vessel shapes are reported to be associated with tissue growth. The OCT imaging procedure was rapid and well tolerated by patients and provided new information not available from other devices. Thus, OCT appears to have great promise as a tool for the evaluation and study of chronic ulcers.
Japanese Students Do See the Value of Asking About Child Abuse and Trauma in the Research Setting
Authors: Allard Carolyn B. , Straus Elizabeth , Ra Mai I. , Thomas Katie B. , Kawamura Reiko , Tosaka Yukari
Published: January 2019

Despite evidence regarding the impact of childhood abuse perpetrated by close others, or high betrayal trauma, a number of barriers continue to impede research efforts, including concerns that research may do more harm than good. Research conducted with Western samples has indicated that contrary to such concerns, participants rate the benefit of participating in trauma research as outweighing costs, even when they have a history of high betrayal trauma. Certain non-Western values, such as interpersonal harmony, could play a role in perceptions regarding trauma research participation. The current study evaluated perceptions of 79 Japanese undergraduate students who participated in an online study of child abuse. Japanese students rated the importance of participating in trauma research as greater than any immediate distress it caused. Interpersonal harmony was not related to perceptions of participating in trauma research, nor was a history of high betrayal child trauma. Taken together, these findings support continued research on childhood abuse in non-Western samples.
Changes of 8-OHdG and TrxR in the Residents Who Bathe in Radon Hot Springs
Authors: Yanxiao Gao , Mei Tian , Gang Gao , Xiaochun Wang , Jianxiang Liu
Published: January 2019

This study explored the effects of long-term bathing in radon hot springs on oxidative damage and antioxidation function in humans. In this study, blood was collected from residents in the Pingshan radon hot spring area (RHSA), Jiangzha RHSA, and control area (CA). 8-Hydroxydeoxyguanosine (8-OHdG) and thioredoxin reductase (TrxR), representing oxidation and antioxidant levels, respectively, were analyzed as indices. Compared to the CA group, the RHSA group in the Pingshan and Jiangzha areas showed significantly decreased 8-OHdG levels ( Z = −3.350, −3.316, respectively, P < .05) and increased TrxR levels ( Z = 2.394, 3.773, respectively, P < .05). The RHSA and CA groups in Jiangzha had lower levels of TrxR and 8-OHdG compared to those in Pingshan. This finding may be related to the different radon concentration levels, bathing time and other factors. Results suggested that long-term bathing in radon hot spring may activate antioxidant function and reduce oxidative damage in the body.
Lifestyle Medicine in a Concierge Practice: My Journey
Authors: Serna Dorothy Cohen
Published: January 2019

While lifestyle medicine (LM) has been increasingly recognized for its value in preventing and managing chronic disease, the conventional primary care practice has struggled to be a financially viable model for this time-intensive, highly personalized approach. However, the concierge medicine model provides many advantages to those seeking to incorporate the tenets of LM. Concierge medicine is characterized by smaller patient panels, extended visits, continuous follow-up, and a distinctive emphasis on prevention and wellness. These characteristics promote high-quality, individualized care. North Cypress Internal Medicine and Wellness was able to successfully transform from a more traditional medical model to one with essential LM-focused offerings with expert assistance, as well as ongoing support from a dedicated team of lifestyle-oriented health professionals who provide wellness coaching, proactive chronic care management, and prevention programs. This article describes the transition and includes specific details of services and care offered at a concierge practice. It illustrates how this alternative model can provide an effective solution for delivering the full potential of LM.
Dynamic feedforward control in decoupling space for a four-degree-of-freedom parallel robot
Authors: Song Xiaogang , Zhao Yongjie , Jin Lei , Zhang Peng , Chen Chengwei
Published: January 2019

This article proposes a dynamic feedforward control method for a four-degree-of-freedom parallel robot in decoupling space to improve the control accuracy and robust stability. The mass matrix and the gravity component are obtained from the rigid-body dynamic model that is formulated by means of the link Jacobian matrices and the principle of virtual work. Then using the positive definiteness of the mass matrix and singular value decomposition algorithms, a decoupling transformation matrix is obtained to convert the physical joint space to the decoupling modal space. In the modal space, a decoupling closed-loop controller design has been implemented for each driven leg. Afterward, by applying the gravity component of the dynamic model, a feedforward control subsystem has been designed to compensate the influence of gravity load on the parallel robot, which can further reduce the negative impacts caused by modeling inaccuracies. This numerical simulation analysis shows that the ideal control accuracy and robust stability have been achieved using the dynamic feedforward decoupling control method for the nonlinear and strongly coupled systems of the parallel robot. The described controller has a simple structure and can be easily realized in practice.
Combining system-theoretic process analysis and availability assessment: A subsea case study
Authors: Zhang Juntao , Kim Hyungju , Liu Yiliu , Lundteigen Mary Ann
Published: January 2019

Hazard identification methods are important tools to verify that the system is able to operate according to specifications under different operating conditions. Unfortunately, many of the traditional methods are not adequate to capture possible dysfunctional behavior of complex systems that involve highly coupled parts, non-linear interactions and software-intensive functionalities. The rather recent method named system-theoretic process analysis (STPA) is one promising candidate to improve the coverage of hazard identification in complex and software-intensive system. Still, there is no guideline for utilizing system-theoretic process analysis output to evaluate the potential of loss, which is important for basis of decision-making about system configuration and equipment selection. The focus of this article is to place an interface between system-theoretic process analysis and reliability, availability and maintainability (RAM) analysis. The approach named STPA-RAM model is proposed to translate feedback control loops into stochastic Petri nets for discrete event simulation. The proposed approach is demonstrated with a simple case related to subsea design concept. The major conclusion is that STPA-RAM model extends the application of system-theoretic process analysis, while also improving and as such reducing completeness uncertainty and model uncertainty, associated with input data and information for reliability, availability and maintainability analysis.
Gear pitting fault diagnosis using disentangled features from unsupervised deep learning
Authors: Qu Yongzhi , Zhang Yue , He Miao , He David , Jiao Chen , Zhou Zude
Published: January 2019

Effective feature extraction is critical for machinery fault diagnosis and prognosis. The use of time–frequency features for machinery fault diagnosis has prevailed in the last decade. However, more attentions have been drawn to machine learning–based features. While time–frequency domain features can be directly correlated to fault types and fault levels, data-driven features are typically abstract representations. Therefore, classical machine learning approaches require large amount of training data to classify these abstract features for fault diagnosis. This article proposed a fully unsupervised feature extraction method for “meaningful” feature mining, named disentangled tone mining. It is shown that disentangled tone mining can effectively extract the hidden “trend” associated with machinery health state, which can be used directly for online anomaly detection and prediction. Compared with wavelet transform and time domain statistics, disentangled tone mining can better extract fault-related features and reflect the fault degradation process. Shallow methods, such as principal component analysis, multidimensional scaling and single-layer sparse autoencoder, are shown to be inferior in terms of disentangled feature learning for machinery signals. Simulation analysis is also provided to demonstrate and explain the potential mechanism underlying the proposed method.
Comparison of different lots of endotoxin and evaluation of in vivo potency over time in the experimental human endotoxemia model
Authors: Kiers Dorien , Leijte Guus P. , Gerretsen Jelle , Zwaag Jelle , Kox Matthijs , Pickkers Peter
Published: January 2019

The experimental human endotoxemia model is used to study the systemic inflammatory response in vivo. The previously used lot of endotoxin, which was used for over a decade, is no longer approved for human use and a new Good Manufacturing Practices-grade batch has become available. We compared the inflammatory response induced by either bolus or continuous administration of either the previously used lot #1188844 or new lots of endotoxin (#94332B1 and #94332B4). Compared with lot #1188844, bolus administration of lot #94332B1 induced a more pronounced systemic inflammatory response including higher plasma levels of pro-inflammatory cytokines and more pronounced clinical signs of inflammation. In contrast, continuous infusion of lot #94332B4 resulted in a slightly less pronounced inflammatory response compared with lot #1188844. Furthermore, we evaluated whether lot #1188844 displayed in vivo potency loss by reviewing inflammatory parameters obtained from 17 endotoxemia studies performed in our centre between 2007 and 2016. Despite inter-study variability in endotoxemia-induced effects on temperature, heart rate, symptoms, and leukocyte counts, the magnitude of these effects did not decrease over time. In conclusion, although all lots of endotoxin induce a pronounced inflammatory response, the magnitude differs between lots. We observed no potency loss of endotoxin over time.
Open Versus Endoscopic Approach for Sinonasal Melanoma: A Systematic Review and Meta-analysis
Authors: Hur Kevin , Zhang Paul , Yu Alison , Kim-Orden Natalie , Kysh Lynn , Wrobel Bozena
Published: January 2019

Background

Open resection (OR) of sinonasal mucosal melanoma (SNM) traditionally has been the gold standard for treatment. However, endoscopic resection (ER) has recently become a surgical alternative. The aim of this study was to compare survival outcomes between OR and ER of SNM.

Methods

A literature search encompassing PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and Google Scholar was performed. Two reviewers independently screened for original studies comparing survival outcomes between OR and ER for SNM. Data were systematically collected on study design, patient demographics, outcomes, and level of evidence. Quality assessment was performed using the Newcastle-Ottawa scale (NOS). Meta-analysis of overall survival and disease-free survival was performed using random-effects models.

Results

The initial search yielded 2078 abstracts, of which 9 cohort studies were included for a total of 510 patients from 6 different countries. The average quality of all included studies using the NOS was 7.7 stars. Six out of 7 studies reported no differences in the stages of SNM between patients receiving ER versus OR. Overall survival was longer in the ER group versus OR group (hazard ratio [HR]: 0.68, 95% confidence interval [CI]: 0.49–0.95). There was no significant difference in disease-free survival between groups (HR: 0.59, 95% CI: 0.28–1.25).

Conclusion

Based on the available literature, an endoscopic approach for SNM resection has survival outcomes that are similar or greater compared to an open approach.
How handling missing data may impact conclusions: A comparison of six different imputation methods for categorical questionnaire data
Authors: Stavseth Marianne Riksheim , Clausen Thomas , Røislien Jo
Published: January 2019

Objectives:

Missing data is a recurrent issue in many fields of medical research, particularly in questionnaires. The aim of this article is to describe and compare six conceptually different multiple imputation methods, alongside the commonly used complete case analysis, and to explore whether the choice of methodology for handling missing data might impact clinical conclusions drawn from a regression model when data are categorical.

Methods:

In addition to the commonly used complete case analysis, we tested the following six imputation methods: multiple imputation using expectation–maximization with bootstrapping, multiple imputation using multiple correspondence analysis, multiple imputation using latent class analysis, multiple hot deck imputation and multivariate imputation by chained equations with two different model specifications: logistic regression and random forests. The methods are tested on real data from a questionnaire-based study in the Norwegian opioid maintenance treatment programme.

Results:

All methods performed relatively well when the sample size was large (n = 1000). For a smaller sample size (n = 200), the regression estimates depend heavily on the level of missing. When the amount of missing was ⩾20%, in particular, complete case analysis, hot deck and random forests had biased estimates with too low coverage. Multiple imputation using multiple correspondence analysis had the best performance all over.

Conclusion:

The choice of missing handling methodology has a significant impact on the clinical interpretation of the accompanying statistical analyses. With missing data, the choice of whether to impute or not, and choice of imputation method, can influence clinical conclusion drawn from a regression model and should therefore be given sufficient consideration.