bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of longitudinally intermittent movement of cutting tool in drilling of AISI 1045 steel: A three-dimensional numerical simulation
Authors: Lotfi Mohammad , Amini Saeid
Published: July 2018

Applying ultrasonic vibrations in machining process is an effective method to improve desired machinability factors. In this study, a three-dimensional finite element model is developed to evaluate effect of added vibratory movement of cutting tool on output parameters in conventional drilling of AISI 1045 steel. Heat generation on drill faces, strain, and damage of deformed chip in addition to thrust force are taken into account to be analyzed. Besides, a dynamometer and a vision measuring microscope are used to investigate generated thrust force and built-up edge during conventional and ultrasonic-assisted drilling. As a result, it is shown that vibratory movement of drill bit results in lower temperature to be generated on tool faces resulting in almost elimination of built-up edge. Moreover, higher damage value resulted by additional chip bending is observed when ultrasonic vibration is added to the operation.
En marge du discours « néo-réactionnaire » : Le rap identitaire
Authors: Achille Étienne
Published: July 2018

L’omniprésence du discours « néo-réactionnaire » dans le débat public est un des phénomènes les plus remarquables de ce début de siècle. Alors qu’il continue de s’amplifier et pèse plus que jamais dans l’espace idéologique français, il semble opportun de tester les limites de la théorisation actuelle de ce courant hétéroclite dont la dimension populaire n’a peut-être pas été appréciée à sa juste valeur. Cet essai démontre que le discours « néo-réactionnaire » commence aussi à être pris en charge par d’autres acteurs, en revêtant notamment des formes plus populaires comme la musique qui investissent d’autres lieux du quotidien, touchent d’autres publics et différentes générations, tout en empruntant des canaux de diffusion parallèles à ceux des intellectuels généralement associés au mouvement. Il s’agira d’examiner, à travers une réflexion sur le rappeur contemporain Kroc Blanc, un tel vecteur « alternatif » de propagation du discours « néo-réactionnaire » : le rap identitaire.
In the limelight: French women from the banlieues on stage in Ahmed Madani’s F(l)ammes (2017)
Authors: Levasseur Bruno
Published: July 2018

This article considers how French theatre has contributed to debates on the condition of women living in the banlieues in a post-2015 context of terrorist attacks and a nationwide state of emergency. Focusing on the play F(l)ammes (2017) by Ahmed Madani, which interrogates women’s lived experiences, this article examines how theatre, drawing upon psychotherapeutic practices, engages with the complex interweaving of race, class and gender in marginalised French urban spaces. Using Nacira Guénif-Souilamas’s analysis of women from the banlieues and Stuart Hall’s work on the negotiation of multiple identities, this article suggests that F(l)ammes and the acting workshops from which it emerged eschew mass media representations of the French banlieues as violent, dangerous territories and offer an unusual, women-centred counter-discourse on the French nation.
Sporting memory and its heritagisation: The example of Roland-Garros
Authors: Violette Louis , Attali Michaël
Published: July 2018

This study aims to help establish a history of selecting and forgetting in the field of sport by examining the frameworks and representations which structure collective relationships with the past. Extending the field of memory to the sporting sphere directly implies highlighting a plurality of heritage notions and values together with as many issues of institutional legitimacy. In this respect, examining the memory-based strategy advocated by the French Tennis Federation at Roland-Garros shows the wish to build a common national heritage, in reaction to the many representations of sporting modernity. Through reappropriation of history, memory thus takes on the role of legitimising the various forms of modernity, by inscribing them into the continuity of sport through time. It also, however, raises the question of its own construction and instrumentalisation.
Aerodynamic performance and flow characteristics analysis of Tesla turbines with different nozzle and outlet geometries
Authors: Qi Wenjiao , Deng Qinghua , Jiang Yu , Feng Zhenping , Yuan Qi
Published: July 2018

The aerodynamic performance and flow characteristics of a multichannel nozzled Tesla turbine were investigated numerically with different nozzle and outlet geometries at different rotational speeds. Two kinds of nozzle geometries were proposed: one nozzle channel to one disc channel (named as one-to-one turbine) and one nozzle channel to several disc channels (named as one-to-many turbine). Simplified radial outlet and real axial outlet geometries of the Tesla turbines were adopted to research the influence of outlet geometries. The results show that compared with the one-to-many turbine, the isentropic efficiency of the one-to-one turbine is much higher; while the flow coefficient is much lower. In addition, in the middle disc channels (DC1 and DC2) of which two walls are rotating disc walls, the flow fields are almost the same, but different from that in the side channel (DC3) of which one wall is a rotating wall and the other one is a stationary casing wall. DC1 and DC2 generate more torque with less working fluid, thus the disc spacing distance of DC3 should be narrower than that of DC1 and DC2. Compared to the one-to-many turbine, the working fluid flowing through DC1 and DC2 of the one-to-one turbine is much less, and the flow path lines are much longer. The results of different turbine outlet geometries show that compared with the turbines with radial outlet, the isentropic efficiency of the one-to-many turbine with axial outlet is a little higher, while that of the one-to-one turbine with axial outlet is lower. This is due to the larger torque on the disc hole walls, despite a lot more total pressure loss in the exhaust vent of the one-to-many turbine. Therefore, the contribution of disc hole walls to torque cannot be neglected in numerical simulations.
Sample size for binary logistic prediction models: Beyond events per variable criteria
Authors: van Smeden Maarten , Moons Karel GM , de Groot Joris AH , Collins Gary S , Altman Douglas G , Eijkemans Marinus JC , Reitsma Johannes B
Published: July 2018

Binary logistic regression is one of the most frequently applied statistical approaches for developing clinical prediction models. Developers of such models often rely on an Events Per Variable criterion (EPV), notably EPV ≥10, to determine the minimal sample size required and the maximum number of candidate predictors that can be examined. We present an extensive simulation study in which we studied the influence of EPV, events fraction, number of candidate predictors, the correlations and distributions of candidate predictor variables, area under the ROC curve, and predictor effects on out-of-sample predictive performance of prediction models. The out-of-sample performance (calibration, discrimination and probability prediction error) of developed prediction models was studied before and after regression shrinkage and variable selection. The results indicate that EPV does not have a strong relation with metrics of predictive performance, and is not an appropriate criterion for (binary) prediction model development studies. We show that out-of-sample predictive performance can better be approximated by considering the number of predictors, the total sample size and the events fraction. We propose that the development of new sample size criteria for prediction models should be based on these three parameters, and provide suggestions for improving sample size determination.
Human peripheral blood mononuclear cells enriched in endothelial progenitor cells via quality and quantity controlled culture accelerate vascularization and wound healing in a porcine wound model
Authors: Kado Makiko , Tanaka Rica , Arita Kayo , Okada Kayoko , Ito-Hirano Rie , Fujimura Satoshi , Mizuno Hiroshi
Published: July 2018

The transplantation of endothelial progenitor cells (EPCs) is used to promote wound angiogenesis. In patients with chronic wounds and accompanying morbidities, EPCs are often compromised in number and function. To overcome these limitations, we previously developed a quality and quantity controlled (QQ) culture system to enrich peripheral blood mononuclear cells (PBMNCs) in EPCs. To evaluate the wound healing efficacy of mononuclear cells (MNCs) harvested after QQ culture (QQMNCs), preclinical studies were performed on large animals. MNCs harvested from the blood of healthy human subjects were cultured in the presence of angiogenic cytokines and growth factors in a serum-free medium for 7 days. A total of 5 × 106 QQMNCs per full-thickness skin defect or control saline was injected into wounds induced in cyclosporine-immunosuppressed pigs. EPC colony-forming assays revealed a significantly higher number of definitive (partially differentiated) EPC colony-forming units in QQMNCs. Flow cytometry evaluation of QQMNC surface markers showed enrichment of CD34+ and CD133+ stem cell populations, significant reduction in CCR2+ cell percentages, and a greater than 10-fold increase in the percentage of anti-inflammatory M2-type macrophages (CD206+ cells) compared with PBMNCs. Wounds treated with QQMNCs had a significantly higher closure rate. Wounds were harvested, frozen, and sectioned at day 21 postoperatively. Hematoxylin and eosin staining revealed that the epithelization of QQMNC-treated wounds was more advanced than in controls. Treated wounds developed granulation tissue with more mature collagen and larger capillary networks. CD31 and human mitochondrial co-staining confirmed the presence of differentiated human cells within newly formed vessels. Real-time polymerase chain reaction (PCR) showed upregulation of interleukin 6 (IL-6), IL-10, and IL-4 in the wound bed, suggesting paracrine activity of the transplanted QQMNCs. Our data demonstrate for the first time that QQ culture of MNCs obtained from a small amount of peripheral blood yields vasculogenic and therapeutic cells effective in wound healing.
National Identity and Veteran Culture in a Border Region: The Danish Minority in the German Army during the First World War
Authors: Christensen Claus Bundgård
Published: July 2018

This article examines whether a distinctive type of war experience developed among the 26,000 soldiers from the Danish minority in Schleswig south of the Dano–German border who were conscripted into the German Army during the First World War. The analysis is focused on how the soldiers voiced their national identity during their encounters with the German Army and the civilian populations in Eastern and Western Europe. Subsequently, it is investigated whether the veteran culture, which developed among the troops from the Danish minority, was marked by a distinct war experience.
Examining the experiences of the first openly gay male team sport athlete in Spain
Authors: Vilanova Anna , Soler Susanna , Anderson Eric
Published: July 2018

Spanish sports literature is devoid of studies investigating the voices of gay athletes. Using semi-structured interviews, the purpose of this research was to examine the contextually relevant experiences of the first-ever openly gay elite athlete in a Spanish team sport context. Our investigation covers multiple personal and institutional layers of the sporting complex, which are analysed in three ways: (a) using Troiden’s notions of identity; (b) using Anderson’s Inclusive Masculinity Theory; and (c) using McCormack’s theory of gay discourse. Our findings reveal that coming out was a more positive experience than the athlete had expected. He experienced inclusivity from his teammates, trainers, managers and supporters. There was no physical aggression or verbal harassment. He did, however, frequently hear antigay language spoken, which he reported as not being homophobic. Our findings provide one of the few examinations of this topic outside of the USA.
‘A chain reaction’ or the necessity of collective actions for consumers in cartel cases
Authors: Weber Franziska
Published: July 2018

As a particularity of competition law, damage caused by a legal violation generally travels down the supply chain. An overcharge incurred by the direct purchaser is often at least partially passed on to the next level in the supply chain, and so on, ending with the final consumer. Damage is typically widespread once it reaches the consumer level. Thus, the consumer’s rational response is not to initiate an individual lawsuit. The classical solution is to improve the incentive structure with some form of collective redress. The principle of effectiveness as defined in Article 4 of the Antitrust Damages Directive requires an effective procedural remedy for each victim of a competition law infringement, but the Directive is silent regarding collective actions. Drawing on arguments on the rational apathy problem with consumer lawsuits, we analyse why this ‘silence’ upsets the European principle of effectiveness. We show why this omission is particularly harmful in the competition law case. We conclude that the time to introduce collective actions to ensure the effectiveness of European competition law has arrived. Such mechanisms do not have to be entirely harmonised across the European Union – different shapes in different Member States or even alternative solutions to the same effect are perfectly permissible.
Multiple episodes of 1080 (sodium monofluoroacetate) intoxication in a California calf-raising operation
Authors: Adaska John M. , Rimoldi Guillermo , Blanchard Patricia C. , Champagne John , Poppenga Robert H. , Mostrom Michelle
Published: July 2018

Over a 1-y period, a California calf-raising operation experienced 4 separate episodes of sudden death in 4–6-mo-old steers. Each episode occurred in 1–3 contiguous pens on 1 of 3 properties owned by the operation, but eventually all 3 properties were involved. In each episode, animals appeared normal at the evening feeding but at the subsequent morning feeding were found dead or dying. Remaining live calves had a stiff gait and were often dribbling urine, but did not show respiratory signs until they were down and agonal. At postmortem examination, calves consistently had moderate-to-large numbers of ecchymotic and suffusive hemorrhages on the epicardial surface and moderate-to-large amounts of fluid in the pericardial sac. Pulmonary edema and/or moderate amounts of watery fluid in the thoracic and abdominal cavities were present in a smaller percentage. On histologic examination, the myocardium had variable myofiber degeneration characterized by hypereosinophilia and fragmentation with mild interstitial infiltrates. Testing of heart and liver samples for monensin found levels lower than in previous cases of monensin toxicity. Rumen content was negative for oleandrin and grayanotoxins. Sodium monofluoroacetate (trade name: 1080) was consistently detected at ⩾10 ppb in kidney and liver, and was concluded to be the cause of the intoxication.
Food Sources of Sodium in Korean Americans With Type 2 Diabetes: Implications for Cardiovascular Disease
Authors: Ko Jisook , Timmerman Gayle M. , Kim Kim B. , Kim Miyong T.
Published: July 2018

Introduction: Excess sodium intake can increase the risk of high blood pressure and cardiovascular disease, common comorbidities for those with type 2 diabetes mellitus (T2DM). The purpose of this study is to describe sodium intake and high sodium food sources among Korean Americans (KAs) with T2DM. Method: This study, a descriptive, secondary analysis of baseline data from a clinical trial for diabetes, recruited KAs with T2DM ( n = 232) from the community. Results: Average dietary sodium intake was 3,433 mg. Major sources of dietary sodium were from bicultural diets: noodles and dumplings, Korean-style soups, kimchi, breads and snacks, and boiled or seasoned vegetables. Participants who consumed excessive sodium were more likely to consume more calories and be male, married, and more recently diagnosed with T2DM. Discussion: High consumption of sodium among KAs with T2DM supports the need to develop effective, tailored interventions addressing dietary sodium that incorporates the individual’s culture.
The Policy to Practice Gap: Factors Associated With Practitioner Knowledge of CAPTA 2010 Mandates for Identifying and Intervening in Cases of Prenatal Alcohol and Drug Exposure
Authors: Lloyd Margaret H. , Akin Becci A. , Brook Jody , Chasnoff Ira J.
Published: July 2018

This article describes results from a state-wide survey of social services professionals ( n = 259) regarding knowledge of the Child Abuse Prevention and Treatment Act Reauthorization of 2010 (CAPTA), clinically based markers of prenatal substance exposure (PSE), and appropriate child protection responses following a PSE referral. Few respondents were aware of CAPTA, and knowledge of clinical markers of PSE and appropriate child protective services responses to prenatal exposure varied according to substance type (alcohol or drugs). Regression models revealed that fewer years in practice and fewer annual drug referrals predicted more drug-exposure knowledge. Fewer years in practice and awareness of CAPTA predicted more alcohol-exposure knowledge. Policy implementation strategies are needed to increase the likelihood that CAPTA achieves its desired intent, particularly with professionals who have been in the field longer and may be less open to changing practice behaviors.
Radon Testing Status in Schools by Radon Zone and School Location and Demographic Characteristics: United States, 2014
Authors: Jones Sherry Everett , Foster Stephanie , Berens Andrew S.
Published: July 2018

Radon is a naturally occurring, radioactive, colorless, odorless gas, and the second leading cause of lung cancer. The 1990–1991 National School Radon Survey estimated that more than 70,000 schoolrooms nationwide had “high short-term radon levels.” Using data from a nationally representative survey of schools in the United States ( N = 568; response rate = 69%), we examined the location and demographic characteristics of U.S. schools that had ever been tested for radon and whether having been tested varied by radon zone, which predicts average indoor radon levels in U.S. counties. Overall, 46.0% (95% confidence interval [39.8%, 52.4%]) of schools reported that they had ever been tested for radon. Testing significantly varied by region, percentage of minority students, and radon zone. These findings highlight the need for improved awareness of radon testing in schools, as testing is the only way to identify when remediation is needed.
Attachment Disorganization in Childhood
Authors: Kindsvatter Aaron , Tansey Matthew
Published: July 2018

Attachment disorganization is a particularly severe form of attachment insecurity often associated with dysfunctional parent–child relationships. Attachment disorganization has highly variable presentations, often manifesting differently in infancy, early childhood, and in early and late adolescence. This article examines the developmental trajectory of children with attachment disorganization across the life span. The contribution of dysfunctional parenting to the manifestation of attachment disorganization is explored. Clinical methods designed for parents and parent–child dyads are discussed.
Relationship Educator Experiences of Couple Improvement and Group Dynamics in Relationship Education With Low-Income Couples
Authors: Wheeler Naomi J. , Harris Shaywanna , Young Mark E.
Published: July 2018

Relationship education (RE) interventions improve relationship quality and distress; yet, little is known about the origins of positive gains derived from RE. Couples identified benefits from the group format of RE; however, the perspective of facilitators is neglected. Therefore, the current investigation included two focus groups ( N = 9) with RE facilitators from one federal RE program for low-income couples. Five themes emerged from the phenomenological analysis including (a) therapeutic factors of groups, (b) participant attributes, (c) stress, (d) insight/awareness, and (e) program attributes. Applications of RE facilitator experiences, specifically group factors observed, may inform RE facilitator training, intervention, and implementation.
Marital Text
Authors: Hatch S. Gabe , Dowdle Krista K. , Aaron Sean C. , Braithwaite Scott R.
Published: July 2018

Face-to-face prevention-focused relationship education programs have generally been efficacious in improving couples’ communication and relationship satisfaction. Computer-based interventions have furthered the dissemination of these interventions, so anyone with access to a computer can participate in the intervention. One of the next steps in this line of research is finding affordable and convenient ways to disseminate this information. One possibility is text messaging. The current study examined the feasibility of utilizing text messages as a dissemination tool for relationship enhancement. In this study, 128 married individuals were randomly assigned to a control condition ( n = 64), where relationship-related text messages were not received, or to a treatment condition ( n = 64), where relationship-related text messages were received. Individuals assigned to the treatment condition responded positively toward the intervention. Participants’ dropout and retention rates were promising, and 99% of the participants supplied authentic phone numbers. Participants reported the intervention helped them make changes in their relationship, and that the text messages’ content was beneficial to their relationship. Strengths, limitations, and ideas for future research are discussed, as well as the implications for utilizing text messages as a dissemination tool for preventative relationship education.
Traveling wave analytical solutions of vibration band gaps of composite periodic beams
Authors: Zhang Zhen , Li Tuanjie , Tang Yaqiong
Published: July 2018

This paper is concerned with elastic wave propagation and vibration band gaps in periodic beams formed by alternating combinations of various materials with the same geometric parameters. Such composite periodic systems have the similar feature of filtering characteristics of periodic beams. The study is performed by using an exact analytical approach based on a combination of the traveling wave analysis method and periodic structure theory. Based on the wave theory, a general mathematical model of composite periodic beam with uniform cross-section is established, the band gaps mechanism and vibration characteristics of this model are discussed, and the analytical solutions of the dynamic model and the explicit expression of band gaps are derived. Based on these equations, an explicit expression is provided for the calculation of intermediate frequency boundary frequency, all the band gaps information can be obtained in an exact and simple manner, and several illustrative examples are also provided.
Cultural Change: Implementation of a Recovery Program in a Veterans Health Administration Medical Center Inpatient Unit
Authors: McDonagh James G. , Haren William Blake , Valvano Mary , Grubaugh Anouk L. , Wainwright Frank C. , Rhue Colette H. , Pelic Christine M. , Pelic Christopher G. , Koval Renee , York Janet A.
Published: July 2018

INTRODUCTION:The Freedom Commission’s recommendations, Substance Abuse and Mental Health Services Administration’s framework, and policy directives on recovery-oriented services have fueled the recovery transformation. Mental health recovery services have been implemented in a broad range of outpatient settings. However, psychiatric inpatient units remained embedded in the traditional model of care. AIMS: The purpose of this article is to describe an ongoing quality improvement implementation of recovery services in a Veterans Health Administration acute psychiatric inpatient unit. METHOD: An interprofessional Partnership for Wellness delivered 4 to 6 hours per day of evidence-based recovery and holistic population-specific health programs. Veteran, system, and program indicators were measured. RESULTS: Preliminary indicators over a 2-year period suggest that Veterans rated group content and relevance high, pre–post psychiatric rehospitalization rates decreased by 46%, and fidelity to recommended strategies was high. CONCLUSIONS: The project success reflects strong leadership, a partnership of committed staff, effective training, and an organizational culture exemplifying excellence in Veteran services and innovation.
Subchondral drilling for chondral flaps reduces the risk of total hip arthroplasty in femoroacetabular impingement surgery at minimum five years follow-up
Authors: Haefeli Pascal C , Tannast Moritz , Beck Martin , Siebenrock Klaus A , Büchler Lorenz
Published: July 2018

Introduction:

The best treatment of acetabular chondral flaps during surgery for femoroacetabular impingement (FAI) is unknown. We asked if subchondral drilling improves clinical and radiographic outcome and if there are factors predicting failure.

Methods:

We treated 79 patients with symptomatic FAI and acetabular chondral flaps with surgical hip dislocation between January 2000 and December 2007. Exclusion of all patients with previous hip pathology or trauma resulted in 62 patients (80 hips). The chondral flap was slightly debrided in 43 patients/51 hips (control group). In 28 patients/29 hips (study group), additional osseous drilling was performed. 4 patients (5 hips, 6%) were lost to follow-up. Mean follow-up was 9 years (5–13 years). The groups did not differ in demographic data, radiographic parameters or follow-up. Clinical outcome was assessed with the Merle d’Aubigné score, modified Harris Hip Score and University of California Los Angeles activity score and progression of osteoarthritis with the Tönnis grade.

Results:

No patient underwent conversion to total hip arthroplasty (THA) in the drilling group compared to 7 patients (8 hips, 16%) in the control group ( p = 0.005); in the remaining hips, clinical scores and progression of Tönnis grade did not differ. Increased acetabular coverage, age and body mass index were univariate predictive factors for conversion to THA. No drilling was as an independent predictive factor for conversion to THA (hazard ratio 58.07, p = 0.009).

Conclusion:

Subchondral drilling under acetabular chondral flaps during surgical treatment of FAI is an effective procedure to reduce the rate of conversion to THA.
Survival Outcomes of Retreatment with Trastuzumab and Cytotoxic Chemotherapy for HER2-Positive Recurrent Patients With Breast Cancer Who Had Been Treated with Neo/adjuvant Trastuzumab Plus Multidrug Chemotherapy: A Japanese Multicenter Observational Study
Authors: Yamashiro Hiroyasu , Sawaki Masataka , Masuda Norikazu , Okumura Yasuhiro , Takano Toshimi , Tokunaga Eriko , Saito Tsuyoshi , Sagara Yasuaki , Yamazaki Kosuke , Kawaguchi Yoshihiro , Lee Tecchuu , Ozaki Shinji , Yamagami Kazuhiko , Yamamoto Naohito , Kuroi Katsumasa , Suwa Hirofumi , Ohtani Shoichiro , Ito Toshikazu , Yasuno Shinji , Morita Satoshi , Ohno Shinji , Toi Masakazu
Published: July 2018

Background:

There are little data on the usefulness of trastuzumab (TZM) retreatment as the first-line treatment for patients with HER2 (human epidermal growth factor receptor 2)–positive breast cancer recurrence after perioperative treatment with TZM.

Aim:

To clarify the outcome and safety of TZM retreatment in patients with recurrent HER2-positive breast cancer.

Method:

An observational study was conducted on patients who relapsed after primary systemic therapy with TZM using the central registration system. The primary end point was progression-free survival (PFS). Secondary end points consisted of the response rate, overall survival (OS), and safety.

Result:

In total, 34 patients were registered between July 2009 and June 2012. The median follow-up time was 23.7 months (2-24 months). The 1- and 2-year PFS rates were 46.9% (95% confidence interval (95% CI): 29.2%-62.9%) and 29.8% (95% CI: 15.0%-46.3%), respectively (median 10.6 months). The median PFS time for patients receiving TZM combined with CTx was 13.9 months. The 1-and 2-year OR rates were 93.9 (95% CI: 77.9%-98.4%) and 84.8% (95% CI: 67.4%-93.4%). Trastuzumab-induced grade 3/4 adverse events were not observed.

Conclusions:

This study suggests that the PFS and OS in Japanese patients who relapsed after perioperative TZM therapy improved or were similar to those in previous reports. Differences in patient backgrounds and treatments must be considered when interpreting the results. Trastuzumab should be used combination with CTx and/or HTx for retreatment. Retreatment with TZM is safe. Trial registration: UMIN000002738.
Successful Endoscopic Treatment of Post-esophagectomy Refractory Reflux Using OverStitch: The First Clinical Case
Authors: Nagase Hirotsugu , Yamasaki Makoto , Yanagimoto Yoshitomo , Kanemura Takashi , Higashi Shigeyoshi , Momose Kota , Kato Ryo , Miyazaki Yasuhiro , Makino Tomoki , Takahashi Tsuyoshi , Kurokawa Yukinori , Miyata Hiroshi , Takiguchi Shuji , Mori Masaki , Doki Yuichiro , Nakajima Kiyokazu
Published: July 2018

Aims:

The reflux of duodeno-gastric contents into the remnant esophagus (gastric tube-esophageal reflux: GTER) is a significant issues in long-term esophageal cancer survivors after radical esophagectomy. We attempted endoscopic valve (funnel) creation for prevention for GTER using OverStitch endoscopic suturing system.

Methods:

The OverStitch was mounted onto a standard double-channel endoscope. Under general anesthesia, the funnel creation was attempted by placing semi-full thickness sutures on the gastric wall, at 3 cm distal to the primary esophago-gastric anastomosis. The postoperative outcomes were also evaluated.

Results:

In total, 4 sutures were needed and the operating time was 62 minutes without complication. The endoscopic and swallowing studies, as well as pH profile, were all improved postoperatively. The patient’s quality of life was dramatically improved with complete disappearance of night-time reflux in spine position.

Conclusions:

Endoscopic antireflux funnel creation was feasible and safe. This procedure may become a useful treatment for patients with severe GTER after esophagectomy.
Lobbying against sugar taxation in the European Union: Analysing the lobbying arguments and tactics of stakeholders in the food and drink industries
Authors: Tselengidis Arsenios , Östergren Per-Olof
Published: July 2018

Aims: This study investigates the lobbying actors of the food and drink industry (FDI), their web lobbying arguments used in the sugar taxation debate and the tactics deployed when facing legislative restrictions on their products to curb the burden of non-communicable diseases in Europe. Methods: A stakeholder analysis was performed to identify the FDI’s actors lobbying against sugar taxation within the EU Platform for Action on Diet, Physical Activity and Health during December 2015. Qualitative content analysis was applied to assess the FDI’s web lobbying claims related to three main concepts (sugar as a product, sugar’s association with non-communicable diseases and sugar taxation), guided by a framework for corporate political activity. Results: The web site content of a front organization and six FDI lobbyists was analysed. Some new strategies emerged alongside known corporate strategies (‘questioning the effectiveness of regulation and promoting benefits of a withdrawal’, ‘promoting sugar’s good traits and shift the blame away from it’ and ‘establishing relationships with trade unions’). The lobby tactics were similar to those previously applied by the tobacco industry in Europe, although the argument that sugar is a natural ingredient in many foods was unique to the FDI. Conclusions: The observed tactics and arguments presented by the FDI in opposition to sugar taxation have striking similarities with those previously used by the tobacco industry. An improved understanding of the stakeholders’ mandate and resources and their most important tactics will strengthen the position of public health experts when debating sugar taxation with the FDI, which may contribute to improving population health.
Pus Samples in Complicated Appendicitis: An Important Investigation or a Waste of Resources: A Prospective Cohort Study
Authors: Akingboye A. A. , Davies B. , Tien T.
Published: July 2018

Background and Aims:

Appendicitis is a common presentation to hospital with appendectomy being the treatment of choice. Pre-operative administration of broad-spectrum antibiotics is common, but obtaining intra-abdominal pus samples is not. After an initial 6-month retrospective audit and departmental teaching on the importance of intra-peritoneal pus sampling, we aimed to determine whether intra-operative pus samples changed antibiotic management.

Materials and Methods:

Following the initial audit cycle, a 6-month prospective cohort study was conducted. Clinical data were collected on a predetermined proforma to assess the effectiveness of the intervention and antibiotic prescribing practice. The data collected during the whole 1-year period was analyzed.

Results:

During the 1-year period, 440 patients were identified as undergoing a laparoscopic procedure. After exclusion, 261 patients were identified as undergoing laparoscopic appendectomies, of which 141 (54%) were classified as complicated laparoscopic appendectomies. A total of 35 out of 141 (25%) pus samples were sent of which 24 (17%) resulted in positive cultures, with only nine of these positive cultures reported prior to the patient being discharged. No patient had their antibiotic regimen changed as a result of the culture results. There were three cases of cultures resistant to local antibiotics, but without significant clinical outcome. One of these patients developed a post-operative complication, but the antibiotic regimen was changed to broad spectrum rather than a specific antibiotic based on culture sensitivity. Of the 141 patients with complicated laparoscopic appendectomies, five (3.5%) developed post-operative complications: one readmission requiring a laparoscopic washout for pelvic collection, three (2%) cases of pelvic collections managed conservatively, and one case of prolonged paralytic ileus managed non-operatively.

Conclusion:

Overall, none of the patients with positive cultures had a change in prescribed antibiotics based on culture results. Hence, the routine practice of intra-peritoneal pus sampling following complicated appendicitis remains of little clinical value.
Five-Year Outcome of Laparoscopic Sleeve Gastrectomy, Resolution of Comorbidities, and Risk for Cumulative Nutritional Deficiencies
Authors: Kikkas E. M. , Sillakivi T. , Suumann J. , Kirsimägi Ü. , Tikk T. , Värk P. R.
Published: July 2018

Background and Aims:

The aim of this study was to evaluate the long-term (5-year follow-up) results of laparoscopic sleeve gastrectomy in terms of weight loss and obesity-related comorbidities, as well as the risk factors associated with postoperative nutritional deficiencies.

Material and Methods:

The first 99 consecutive patients who underwent laparoscopic sleeve gastrectomy for the treatment of morbid obesity between October 2008 and August 2011 at Tartu University Hospital were followed prospectively in cohort study. The outpatient hospital follow-up visits were conducted at 3 months, 1 year, and 5 years postoperatively. At 5 years, the follow-up rate was 90.9%; 86 laparoscopic sleeve gastrectomy patients were included in final analysis.

Results:

The mean excess weight loss (%EWL) was 44.3% ± 13.0%, 75.8% ± 23.1%, and 61.0% ± 24.3% at 3 months, 1 year, and 5 years, respectively. A linear association between preoperative weight and weight at 5 years was found. Remission rates at 5-year follow-up for type 2 diabetes, hypertension, dyslipidemia, and obstructive sleep apnea were 68.8%, 32.7%, 27.4%, and 61.5%, respectively (all p < 0.05). There was a statistical difference (p < 0.05) in the dynamics of triglyceride, low-density lipoprotein, and high-density lipoprotein level at 5-year follow-up but the level of total cholesterol did not show significant improvement. The risk for cumulative iron, vitamin B12 deficiency, and anemia was 20%, 48%, and 28%, respectively.

Conclusion:

In conclusion, laparoscopic sleeve gastrectomy ensured long-term excess weight loss 61.0% at 5 years. Laparoscopic sleeve gastrectomy has a long-term effect on significant improvement in the median values of triglycerides, low-density lipoproteins, and high-density lipoproteins, but not on total cholesterol levels. There is a risk of postoperative vitamin B12 and iron deficiency.
Clutch micro-slip control in gearshifts for dual clutch transmission
Authors: Lu Tongli , Zhou Bin , Zhang Jianwu , Wang Xiwen
Published: July 2018

Micro-slip control of multi-disc clutches is effective for attenuation of vibration and smooth gearshifts in dual clutch transmission. This paper proposes a method to apply micro-slips on the clutches for gearshift process, which differs from the conventional lockup control. The vehicle powertrain is modelled as a six degrees of freedom dynamic system, including a hydraulic actuator model. Micro-slips of dual clutches are realised by a closed-loop feedback controller according to the control-oriented model. The controller is used to evaluate demands of the clutch torques and transform them to input currents for the hydraulic solenoid valves. Numerical analysis and experiment are preformed, and the results show that the effect of clutch micro-slips is significant in improving the shift smoothness and the drive comfort of the dual clutch transmission during gearshifts.
Selection of Activity Items for Development of the Activity Card Sort–Japan Version
Authors: Uemura Jun-ichi , Tanikaga Miki , Tanaka Masahiro , Shimose Manae , Hoshino Aiko , Igarashi Go
Published: July 2018

The Activity Card Sort (ACS) can both record the clients’ participation and any changes, which is a useful tool for practitioners to establish tailored occupation-focused goals. However, there is a limitation to apply the ACS to Japanese older adults as it consists of culturally relevant activities in the United States. The aim of this study was to select activity items reflecting Japanese older adults’ lifestyles and opinions to develop the Activity Card Sort–Japan Version (ACS-JPN). In the item selection process, a two-round questionnaire survey was conducted for community-dwelling Japanese older adults (Round 1: n = 177, M age = 69.9 years; Round 2: n = 178, M age = 74.9 years). Seventy-two activity items were finally included in the ACS-JPN and were classified into four domains. The ACS-JPN has some unique features compared with other ACS versions. This study only selected activity items. Further work on psychometric properties is needed.
Patient Factors That Influence How Physicians Discuss Active Surveillance With Low-Risk Prostate Cancer Patients: A Qualitative Study
Authors: Brooks Joanna Veazey , Ellis Shellie D. , Morrow Emily , Kimminau Kim S. , Thrasher J. Brantley
Published: July 2018

For men diagnosed with prostate cancer, making treatment decisions can be overwhelming. Navigating treatment options, along with potential treatment side effects, can be difficult, and patients often rely heavily on the advice of their physicians. This study was aimed at understanding more about the way urologists talk with their patients about one treatment option: active surveillance (AS), a recognized management strategy for men with low-risk prostate cancer that includes close observation and monitoring of the cancer. This study reports, through 22 interviews with urologists, that urologists believe patients are hesitant about AS for a number of reasons, including misperceptions about cancer severity, anxiety, aversion to repeated biopsies that accompany AS, or family member preferences. Because urologists play an influential role in educating patients about treatment options, the discussion around AS can be impacted by barriers that physicians believe matter for their patients. Improving awareness among urologists about what factors impact their patient education about low-risk prostate cancer is important. Identifying tools to improve shared decision making in this area could result in treatment decisions that are increasingly concordant with patients’ values, concerns, and goals.
Feeding head of relative rotary based on EDEM+FLUENT
Authors: Xiaoxia Sun , Wenjun Meng , Yuan Yuan
Published: July 2018

This article takes an efficient feeding head as the research object to study its work mechanism and perform dynamics analysis of the materials in the feeding head. In addition, this article obtains the physical prototype of a three-dimensional model and the feeding surface equation through the surface data of the feeding head and investigates different unfold lines of the feeding surface. In addition, this article recommends a curve equation of the feeding head under different friction coefficients through EDEM + FLUENT simulation analysis and conducts a research on transport and feeding quantity to deduce the equation for the transport quantity of the feeding head. Finally, the verity of the preceding curve equation and transport quantity is confirmed, which has important guiding significance for the feeding head design.
Modeling and simulation of minimum time-handling inverse dynamics of a vehicle
Authors: Zhang Li-Xia , Pan Fu-Quan , Zhang Hui , Feng Ting
Published: July 2018

The performance of a vehicle in minimum time handling is highly important for the safety of the vehicle. In this study, a vehicle motion state equation with 3 degrees of freedom was established on the basis of the lateral, yaw, and longitudinal motions of the vehicle. Equations on the linear tire and motion trajectory were established with consideration of longitudinal load transfer to establish the vehicle-handling dynamics model. Steering-wheel angle, driving force equation set, and yaw angle equation had been introduced to convert the vehicle-handling dynamics model into the vehicle-handling inverse dynamics model. By introducing performance index, control set, and several constraint conditions, an optimal control model of the vehicle minimum time handling was established, which was solved by improved direct multiple-shooting nonlinear programming method. A comparison of the simulation results of ADAMS/Car and MATLAB showed that both of the optimal routes input were in tangent with the road boundary. We can observe through the longitudinal velocity that the MATLAB simulation results are more similar to a straight line than that of the ADAMS/Car simulation results, which meet the psychological expectation of a driver. Thus, the inverse dynamics model on minimum time handling of the vehicle is reasonable and feasible.
Media Ownership and Public Service News: How Strong Are Institutional Logics?
Authors: Benson Rodney , Neff Timothy , Hessérus Mattias
Published: July 2018

This article analyzes the extent to which diverse institutional logics (stock market, privately held, civil society, public) are linked to the exercise of one important mode of media ownership power: public service orientation. The research draws on a content analysis of a total of fifty-one news organizations in Sweden, France, and the United States, representing, respectively, Hallin and Mancini’s democratic corporatist, polarized pluralist, and liberal models. We find that two types of institutional logics—affordance and homogenization—shape the amount and type of public-service-oriented news. On average, public-service-oriented news was highest at civil-society-owned media, but there was significant variation within this category: We call this kind of institutional logic an affordance logic because it affords but does not guarantee a certain kind of news content. Public media, on the other hand, exhibited the least deviation across outlets within each country, thus exemplifying a strong homogenization logic. All forms of ownership, but especially privately held and civil society media, exhibited significant variations across individual organizations. Economic field dominance, as in the United States, did not produce greater homogenization across ownership fields as predicted by field theory.
Streaming, Bouncing, and Rotation: The Polka Dance Stimulus
Authors: Remijn Gerard B. , Yoshizawa Tatsuya , Yano Hiroaki
Published: July 2018

When the objects in a typical stream-bounce stimulus are made to rotate on a circular trajectory, not two but four percepts can be observed: streaming, bouncing, clockwise rotation, and counterclockwise rotation, often with spontaneous reversals between them. When streaming or bouncing is perceived, the objects seem to move on individual, opposite trajectories. When rotation is perceived, however, the objects seem to move in unison on the same circular trajectory, as if constituting the edges of a virtual pane that pivots around its axis. We called this stimulus the Polka Dance stimulus. Experiments showed that with some viewing experience, the viewer can “hold” the rotation percepts. Yet even when doing so, a short sound at the objects’ point of coincidence can induce a bouncing percept. Besides this fast percept switching from rotation to bouncing, an external stimulus might also induce slower rotation direction switches, from clockwise to counterclockwise, or vice versa.
Datafication and data fiction: Narrating data and narrating with data
Authors: Dourish Paul , Gómez Cruz Edgar
Published: July 2018

Data do not speak for themselves. Data must be narrated—put to work in particular contexts, sunk into narratives that give them shape and meaning, and mobilized as part of broader processes of interpretation and meaning-making. We examine these processes through the lens of ethnographic practice and, in particular, ethnography’s attention to narrative processes. We draw on a particular case in which digital data must be animated and narrated by different groups in order to examine broader questions of how we might come to understand data ethnographically.
Developing and Sustaining a Regional School Counselor Leadership Team
Authors: Brown Carleton H. , Ayala Crystal
Published: July 2018

This qualitative research study explored the development and sustainability of a regional school counseling leadership team (RSCLT) organized by district school counselor supervisors. Four supervisors participated in two rounds of individual interviews. The data revealed five themes: (a) experience as chair; (b) leadership representation and structure; (c) resources, policies, and procedures; (d) professional development; and (e) university collaborations. Findings indicate that an RSCLT provides support for ongoing, meaningful, productive regional professional development for school counselors and assists smaller districts with limited resources. We discuss implications for school counselors and district school counselor supervisors.
Black Teachers’ Retention and Transfer Patterns in North Carolina: How Do Patterns Vary by Teacher Effectiveness, Subject, and School Conditions?
Authors: Sun Min
Published: July 2018

Despite public interest and government action toward diversifying the teaching workforce in U.S. public schools, our knowledge about the retention and transfer patterns of Black teachers lacks specificity and clarity. In this study, I find that Black teachers’ annual retention rate was about 4 percentage points lower than that of White teachers in North Carolina elementary and secondary schools from 2004 to 2015. This Black-White teacher retention gap can largely be explained by Black teachers’ experience and education and the challenging school and community contexts in which these teachers worked. Compared with White teachers who had similar professional attributes and worked in similar school settings, Black teachers were more likely to stay in schools serving a larger proportion of Black students and to move to a school that served a higher proportion of Black students. The marginal probability of Black teachers’ retention received an additional boost with an increase in teachers’ observational ratings and math value-added scores. Stronger school leadership and higher-quality professional development predict a higher retention rate of more effective Black teachers.