bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypohydrostatic Simulation of a Quasi-Steady Baroclinic Cyclone
Authors: Hsieh Tsung-Lin , Garner Stephen T. , Held Isaac M.
Published: February 2020

Simulations of baroclinic cyclones often cannot resolve moist convection but resort to convective parameterization. An exception is the hypohydrostatic rescaling, which in principle can be used to better represent convection with no increase in computational cost. The rescaling is studied in the context of a quasi-steady, convectively active, baroclinic cyclone. This is a novel framework with advantages due to the unambiguous time-mean structure. The rescaling is evaluated against high-resolution solutions up to a 5-km grid spacing. A theoretical scaling combining convective-scale dynamics and synoptic-scale energy balance is derived and verified by the simulations. It predicts the insensitivity of the large-scale flow to resolution finer than 40 km and to moderate rescaling, and a weak bias in the cyclone intensity under very large rescaling. The theory yields a threshold for the rescaling factor that avoids large-scale biases. Below the threshold, the rescaling can be used to control resolution errors at the convective scale, such as the distribution of extreme precipitation rates.
Evidence for Elevation-Dependent Warming in the St. Elias Mountains, Yukon, Canada
Authors: Williamson Scott N. , Zdanowicz Christian , Anslow Faron S. , Clarke Garry K. C. , Copland Luke , Danby Ryan K. , Flowers Gwenn E. , Holdsworth Gerald , Jarosch Alexander H. , Hik David S.
Published: February 2020

The climate of high midlatitude mountains appears to be warming faster than the global average, but evidence for such elevation-dependent warming (EDW) at higher latitudes is presently scarce. Here, we use a comprehensive network of remote meteorological stations, proximal radiosonde measurements, downscaled temperature reanalysis, ice cores, and climate indices to investigate the manifestation and possible drivers of EDW in the St. Elias Mountains in subarctic Yukon, Canada. Linear trend analysis of comprehensively validated annual downscaled North American Regional Reanalysis (NARR) gridded surface air temperatures for the years 1979–2016 indicates a warming rate of 0.028°C a−1 between 5500 and 6000 m above mean sea level (MSL), which is ~1.6 times larger than the global-average warming rate between 1970 and 2015. The warming rate between 5500 and 6000 m MSL was ~1.5 times greater than the rate at the 2000–2500 m MSL bin (0.019°C a−1), which is similar to the majority of warming rates estimated worldwide over similar elevation gradients. Accelerated warming since 1979, measured by radiosondes, indicates a maximum rate at 400 hPa (~7010 m MSL). EDW in the St. Elias region therefore appears to be driven by recent warming of the free troposphere. MODIS satellite data show no evidence for an enhanced snow albedo feedback above 2500 m MSL, and declining trends in sulfate aerosols deposited in high-elevation ice cores suggest a modest increase in radiative forcing at these elevations. In contrast, increasing trends in water vapor mixing ratio at the 500-hPa level measured by radiosonde suggest that a longwave radiation vapor feedback is contributing to EDW.
Meteorological Drought Migration in the Poyang Lake Basin, China: Switching among Different Climate Modes
Authors: Zhou Han , Zhou Wen , Liu Yuanbo , Yuan Yanbin , Huang Jiejun , Liu Yongwei
Published: February 2020

The spatiotemporal variability of droughts over a region can often be characterized by combining orthogonal climate modes with corresponding temporal coefficients. The temporal characteristics of climate modes have been extensively addressed, while their spatial development remains largely unexplored. Hence, this study investigated the spatiotemporal evolution of meteorological droughts from the perspective of climate modes. Nearly 50 years of monthly precipitation records (1960–2007) from 73 meteorological stations in the Poyang Lake basin, China, were used. The standardized precipitation index at a 1-month scale was applied to quantify meteorological droughts. The dominant modes of the droughts over the basin were identified using principal component analysis, K-means cluster analysis, and analysis of variance. Based on the trajectory migration identification method, the role of the climate modes in spatiotemporal evolution was analyzed. The results showed that four spatial modes of the droughts in the basin were identified. The spatial extents, centroids, and severity of the drought clusters based on the identified modes were significantly consistent with those based on the meteorological stations (R2 > 0.8, p < 0.05), which indicated that these modes could mostly match the large areas where serious dry/wet conditions occurred. Moreover, their performances in characterizing the spatiotemporal evolutional features (severity, migration distance, and pattern) of drought events were valid, which indicated that they might be considered as the elementary constituents of the historical meteorological drought events across the basin. The findings might offer some implications to understand drought development and causes through possible connections between the dominant modes and climate variability.
Polarimetric Radar Characteristics of Simulated and Observed Intense Convective Cores for a Midlatitude Continental and Tropical Maritime Environment
Authors: Matsui Toshi , Dolan Brenda , Iguchi Takamichi , Rutledge Steven A. , Tao Wei-Kuo , Lang Stephen
Published: February 2020

This study contrasts midlatitude continental and tropical maritime deep convective cores using polarimetric radar observables and retrievals from selected deep convection episodes during the MC3E and TWPICE field campaigns. The continental convective cores produce stronger radar reflectivities throughout the profiles, while maritime convective cores produce more positive differential reflectivityZdrand larger specific differential phaseKdpabove the melting level. Hydrometeor identification retrievals revealed the presence of large fractions of rimed ice particles (snow aggregates) in the continental (maritime) convective cores, consistent with theZdrandKdpobservations. The regional cloud-resolving model simulations with bulk and size-resolved bin microphysics are conducted for the selected cases, and the simulation outputs are converted into polarimetric radar signals and retrievals identical to the observational composites. Both the bulk and the bin microphysics reproduce realistic land and ocean (L-O) contrasts in reflectivity, polarimetric variables of rain drops, and hydrometeor profiles, but there are still large uncertainties in describingZdrandKdpof ice crystals associated with the ice particle shapes/orientation assumptions. Sensitivity experiments are conducted by swapping background aerosols between the continental and maritime environments, revealing that background aerosols play a role in shaping the distinct L-O contrasts in radar reflectivity associated with raindrop sizes, in addition to the dominant role of background thermodynamics.
Intermediate Intraseasonal Variability in the Western Tropical Pacific Ocean: Meridional Distribution of Equatorial Rossby Waves Influenced by a Tilted Boundary
Authors: Zhang Zhixiang , Pratt Larry J. , Wang Fan , Wang Jianing , Tan Shuwen
Published: February 2020

Intermediate-depth intraseasonal variability (ISV) at a 20–90-day period, as detected in velocity measurements from seven subsurface moorings in the tropical western Pacific, is interpreted in terms of equatorial Rossby waves. The moorings were deployed between 0° and 7.5°N along 142°E from September 2014 to October 2015. The strongest ISV energy at 1200 m occurs at 4.5°N. Peak energy at 4.5°N is also seen in an eddy-resolving global circulation model. An analysis of the model output identifies the source of the ISV as short equatorial Rossby waves with westward phase speed but southeastward and downward group velocity. Additionally, it is shown that a superposition of first three baroclinic modes is required to represent the ISV energy propagation. Further analysis using a 1.5-layer shallow water model suggests that the first meridional mode Rossby wave accounts for the specific meridional distribution of ISV in the western Pacific. The same model suggests that the tilted coastlines of Irian Jaya and Papua New Guinea, which lie to the south of the moorings, shift the location of the northern peak of meridional velocity oscillation from 3°N to near 4.5°N. The tilt of this boundary with respect to a purely zonal alignment therefore needs to be taken into account to explain this meridional shift of the peak. Calculation of the barotropic conversion rate indicates that the intraseasonal kinetic energy below 1000 m can be transferred into the mean flows, suggesting a possible forcing mechanism for intermediate-depth zonal jets.
Optimizing the Lightning Warning Radii at Spaceport Florida
Authors: Sanderson Dawn L. , White Edward D. , Geyer Andrew J. , Roeder William P. , Gutman Alex J.
Published: February 2020

Air Force Manual 91–203 (AFMAN 91–203) directs that a lightning warning be issued when lightning is occurring within a 5 nautical mile (n mi; 1 n mi = 1.852 km) radius of a predetermined location. The 45th Weather Squadron (45 WS), located on the central eastern coast of Florida, provides weather support to Cape Canaveral Air Force Station, NASA Kennedy Space Center, and Patrick Air Force Base. The primary objective of this study is to optimize the lightning warning safety buffer; in particular, to determine if the 5 n mi safety radius can be reduced while maintaining a desired level of safety. The research uses processed Lightning Detection and Ranging II (LDAR-II) data from 2013 to 2016 to map the movement of preexisting lightning storms using ellipses. These ellipses are updated with every lightning flash. The distance from the ellipse boundary of each flash occurring outside the ellipse is recorded. Those exterior flash distances are then used to find the best-fit distribution from which the stand-off distance for the desired level of safety can be calculated. The distances from the edge of the ellipse are fit to a Weibull distribution and a reduction in the radius by 1 to 4 or 5 n mi is selected as the optimized balance between safety and operational impact. The 4 or 5 n mi radii are tested with a resulting failure rate of 3.58%, with an average savings of 130.75 false alarms and 15.7 8-h man days a year for the months of May–September.
Effect of Over the Counter Ibuprofen Dosing after Sinus Surgery for Chronic Rhinosinusitis: A Prospective Cohort Pilot Study
Authors: Miller Craig , Humphreys Ian M. , Davis Greg E.
Published: February 2020

Introduction:

Management of pain following endoscopic sinus surgery (ESS) often involves intermittent use of opioid medications. Given the current opioid crisis, many surgeons aim to minimize opioid prescriptions. However, surgeons often avoid the use of NSAIDs following ESS out of concern for increased bleeding risk. We sought to evaluate the effectiveness and safety of over the counter dosing of ibuprofen on pain and bleeding rates following ESS.

Methods:

Prospective cohort pilot study of patients undergoing ESS. Patients self-selected either control arm (acetaminophen and PRN oxycodone) or intervention arm (alternating ibuprofen with acetaminophen, and PRN oxycodone). Outcome measures included pain (10-point visual analog scale [VAS]), bleeding rate (10-point VAS), and number of opiate pills consumed.

Results:

Thirty-nine patients completed the study (15 control and 24 intervention). Overall, patients in the intervention arm reported decreased pain levels at days 1 (−0.9 [95%CI: −2.2, 0.5], 3 (−0.9 [95%CI: −2.3, 0.5]), and 7 (−0.6 [95%CI: −1.8, 0.6]), as well as decreased postoperative bleeding at those same days −0.9 [95%CI: −2.1, 0.4], −0.9 [95%CI: −2.1, 0.4], and −0.7 [95% CI: −1.2, −0.7], compared to controls. Opiate consumption was similar between groups with patients consuming on average four opiate pills (oxycodone 5 mg).

Conclusions:

Over the counter dosing of ibuprofen along with acetaminophen may yield better pain control after sinus surgery compared to acetaminophen alone. Additionally, there was no significant difference in epistaxis in the ibuprofen cohort compared to the cohort who did not take ibuprofen. Furthermore, this study showed very few opioid pills were consumed after routine ESS regardless of pain regimen prescribed. A larger trial is needed to make definitive statements on safety and efficacy.

Level of Evidence:

2b
The Harder They Fall? A Response to Wickens et al. (2019) Regarding the Generalizability of Lumberjack Predictions to Complex Work Settings
Authors: Jamieson Greg A. , Skraaning Gyrd
Published: February 2020

Objective

This article is a response to Wickens et al.’s (2019) critique of Jamieson and Skraaning (2019).

Background

Wickens et al. (2019) offer a five-point critique of Jamieson and Skraaning (2019) that they claim tempers the strength of our conclusions.

Approach

We first correct a misrepresentation in the critique and then respond to each of the criticisms.

Results

We preserve the strength of our skeptical conclusions about the applicability of the lumberjack model to complex work settings.

Applications

We continue to caution system designers about the lack of evidence supporting the lumberjack model in the context of complex work systems.
A continuum damage mechanics model for fatigue and degradation of fiber reinforced materials
Authors: Hohe Jörg , Gall Monika , Fliegener Sascha , Hamid Zalikha Murni Abdul
Published: February 2020

Objective of the present study is the definition of a continuum damage mechanics material model describing the degradation of fiber reinforced materials under fatigue loads up to final failure. Based on the linear elastic framework, a brittle damage model for fatigue conditions is derived, where the damage constitutes the only nonlinearity. The model accounts for damage effects by successive degradation of the elastic moduli. Assuming that material damage is driven by microplastic work, a stress-driven damage evolution equation is defined. For generality, a fully three-dimensional formulation on single ply level is employed. The model is implemented into a finite element program. In a validation against experimental data on filament-wound carbon fiber reinforced material, the model proves to provide a good numerical approximation of the damage during the cyclic loading history up to final material failure.
The effect of powder addition manner and volume fraction of reinforcement on tribological behavior of Al7075/B4C surface composite produced by friction stir processing
Authors: Karpasand Farshid , Ardestani Mohammad , Abbasi Alireza
Published: February 2020

Al7075/B4C surface composites were fabricated by friction stir processing using four passes. The B4C powders were added into the prepared grooves with 1 and 2 mm width at the surface of Al7075 alloy in two different manners. In the first one, the B4C powders were added prior to the four consecutive passes in one stage. In the second manner, the powders were added in two stages, prior to the first pass and following the second one. The microstructural evaluations showed that the increase in the volume fraction of reinforcement significantly reduced the matrix grain size. Meanwhile, the reinforcement had a more homogeneous and uniform distribution in the samples processed through four consecutive passes. The maximum hardness and wear resistance was achieved in the one-stage powder-added samples, containing higher volume fraction of the reinforcement. A direct relationship was observed between the wear resistance and the composite layer hardness. The wear mechanism in the Al7075 substrate and the non-reinforced friction stir processed sample was the delamination of unstable aluminum oxide tribolayer. However, in the composite samples, a mechanically mixed layer, containing aluminum, chromium, and iron mixed oxides was formed along with B4C on the worn surface. In the two-stage powder-added samples, containing lower amounts of reinforcement, the detachment of mechanically mixed layer resulted in three-body abrasive wear condition and high friction coefficient. However, the most stable mechanically mixed layer was formed on the surface of the one-stage powder-added sample containing higher amounts of B4C.
Influence of stacking sequence of basalt-fiber grilles on mechanical properties for textile-reinforced concrete and theoretical prediction
Authors: Jia Minghao , Xiao Xueliang , Lu Xuefeng , Feng Guyu , Qian Kun
Published: February 2020

The purpose of this study is to investigate the effective way of laying up basalt-fiber grilles in concrete to improve mechanical properties, involving how the evolution of cracks is hindered and how the strength of concrete is increased by basalt filaments. In this research, three layers of basalt fiber grilles were placed in different positions of concrete composites. The compressive, splitting tensile, and beam flexural properties of the concrete composites were studied after 28 days of as-made sample curing. The reason for reduced cracks growing from basalt fiber grilles was analyzed to reveal the mechanism of increased strength and toughening of concrete composites. The results showed that a reasonable lay-up method has the highest value of utilization rate and can improve the compressive and split tensile strength of concrete specimens, especially for the flexural specimens. The reason was found to be the energy absorption, stress transfer, and bridging load-bearing effect of the basalt-fiber grilles on the hindering of the expansion of loading-induced cracks effectively. A theoretical model was thereafter developed to predict the flexural strength of concrete beam composites based on grille lay-up architecture. According to the analytical model, the corresponding predicted values compared with experimental results indicate a good coincidence and a reasonable accuracy, which is less than 12% of their discrepancy.
Comparison of 2 Ear Molding Systems for Nonsurgical Management of Newborn Auricular Deformities
Authors: Xiong Hao , Wang Xiaoya , Li Genghui , Xu Jingjing , Zhai Jinming , Chen Siyi , Lu Yuewen , Chen Yueling , Zheng Yiqing , Yang Haidi
Published: February 2020

Background:

Congenital auricular deformities are common diseases in newborn infants. We compared the efficacy of 2 ear molding systems in the nonsurgical management of newborn auricular deformities in Chinese infants.

Methods:

A total of 462 newborns with auricular deformities were treated with either the EarWell or the LiangEar ear molding systems. The posttreatment outcome was graded as excellent, fair, and poor. The differences in effectiveness between the 2 ear molding systems and factors that may affect the posttreatment outcome were analyzed.

Results:

Both ear molding systems showed substantial efficacy in the treatment of newborn auricular deformities. The effective rate was comparable between the EarWell and the LiangEar systems for 4 types of auricular deformities (cryptotia, prominent ear, helical rim abnormality, and cup ear), while the costs for the LiangEar systems were half as much as that for the EarWell systems. Multivariate regression analysis showed that earlier time points at treatment initiation, less severe auricular deformities, treatment duration, and breastfeeding were the most significant predictive factors for a better outcome.

Conclusion:

Our findings demonstrate that using the EarWell and the LiangEar systems are both optimal nonsurgical approaches for treatment of most newborn auricular deformities.
The return of religion or the end of religion? On the need to rethink religion as a category of social and political life
Authors: Svenungsson Jayne
Published: February 2020

During the last decades of the 20th century, Western philosophy saw a renewed interest in religion, often referred to as ‘the return of religion’. At about the same time, a growing number of anthropologists and historians began to draw attention to the cultural and ideological bias of the category of religion, revealing its roots in a particular phase of early modern European history. This article gives an overview of these significant theoretical developments and explores both the tensions and similarities between the different scholarly traditions. Drawing on both discourses, it argues that we need to rethink the way we use religion as a category for organizing social and political life. If religion can no longer be taken as a purely descriptive category but rather should be seen as part of specific discursive practices, then we need to critically ponder the implications of the ways in which we map certain customs, behaviours and motifs as ‘religious’ and others as ‘secular’.
Dynamics of norm contestation in the Chemical Weapons Convention: The case of ‘non-lethal agents’
Authors: Martínková Hana , Smetana Michal
Published: February 2020

In this article, we use an adapted version of Wayne Sandholtz’s cycle of normative change to examine the dynamics of contestation of norms against incapacitating chemical agents and riot control agents, often imprecisely grouped together under the term ‘non-lethal chemical weapons’. We draw on a concept-driven analysis of statements and in-depth interviews with individual stakeholders to track the gradual development of the issue towards norm change within the Chemical Weapons Convention. Our findings highlight several key factors conducive to normative change, particularly the role of the Dubrovka incident as the ‘deviant event’, discursive decoupling of the two classes of chemicals, and new framing and ‘rebranding’ of incapacitating chemical agents as ‘CNS-acting chemicals’. At the same time, we also examine factors that significantly slowed down attempts by norm entrepreneurs to attract attention to the issue, such as the saliency of the use of chemical weapons in Syria, which effectively sidelined the problem of ‘non-lethal’ agents in the overall debate.
Las Periodistas Paramos in Spain: Professional, feminist Internet activism
Authors: Bernal-Triviño Ana , Sanz-Martos Sandra
Published: February 2020

This article analyses how the group Las Periodistas Paramos (We the Women Journalists Stop) arose and developed within the context of the feminist strike that took place in Spain on 8 March 2018 (‘8M’). The purpose of this research is to understand how this community began and its typology, to analyse the selection of digital tools in the process and to outline the strengths and weaknesses of the group on the basis of participants’ experiences. Using three qualitative methods, specifically an interview, non-participant observation and focus groups, the group’s collective work dynamics and its evolution are defined. The results obtained show that this is a community of interest that has collaboratively broadened its initial objectives, surmounted ideological differences, contributed to the feminist movement and grown exponentially by expanding its activities to embrace other Spanish cities and foreign correspondents.
Beyond the city region? Uneven governance and the evolution of regional economic development in Scotland
Authors: Clelland David
Published: February 2020

The sub-national governance of economic development in the UK has, since 2010, been reconfigured towards city-regions and ‘place-based’ approaches at least notionally embedded in specific local needs and resources. In the context of asymmetric decentralisation and fiscal austerity, this raises questions about places outside or peripheral to this framework, and the risk of further divergence in relative capacities to ‘do’ economic development. While changes in England are subject to extensive critique, institutional arrangements in Scotland have received less attention, having avoided comparable dramatic restructuring. The governance of economic development has however undergone significant evolution, with elements of both centralisation and regionalisation apparent. This paper maps emerging sub-national geographies in Scotland through the lens of state rescaling and multi-scalar governance. Analysing processes of change, it argues that the UK Government’s extension of ‘City Deals’ to Scotland made more explicit tensions within an existing city-regional approach and prompted greater attention to implications for peripheral and non-city regions. The introduction of Deals for non-city regions, a system of regional economic partnerships, and a new enterprise agency for the rural South, can all be seen as attempts to reconcile this focus on city-regions as drivers of growth with a desire for ‘regional equity’, and as the latest developments in an ongoing search for the appropriate scales for policy.
Nurses’ knowledge of law at the end of life and implications for practice: A qualitative study
Authors: Willmott Lindy , White Ben , Yates Patsy , Mitchell Geoffrey , Currow David C , Gerber Katrin , Piper Donella
Published: February 2020

Background:

Some patients do not receive adequate pain and symptom relief at the end of life, causing distress to patients, families and healthcare professionals. It is unclear whether undertreatment of symptoms occurs, in part, because of nurses’ concerns about legal and/or disciplinary repercussions if the patient dies after medication is administered.

Aim:

The aim was to explore nurses’ experiences and knowledge of the law relating to the provision of end-of-life pain and symptom relief.

Design:

Semi-structured interviews with nurses were assessed using a six-stage hybrid thematic analysis technique.

Setting/participants:

Four face-to-face and 21 telephone interviews were conducted with nurses who routinely prescribed and/or administered pain and symptom relief to patients approaching the end of their lives in Queensland and New South Wales, Australia.

Results:

While many nurses had no personal experiences with legal or professional repercussions after a patient had died, the fear of hastening death and being held accountable was frequently discussed and regarded as relevant to the provision of inadequate pain and symptom relief. Concerns included potential civil or criminal liability and losing one’s job, registration or reputation. Two-thirds of participants believed that pain relief was sometimes withheld because of these legal concerns. Less than half of the interviewed nurses demonstrated knowledge of the doctrine of double effect, the legal protection for health professionals who provide end-of-life pain and symptom relief.

Conclusion:

Education is urgently required to strengthen nurses’ knowledge of the legal protections supporting the provision of appropriate palliative medication, thereby improving their clinical practice with end-of-life patients.
Effects of Schematic Chunking on Enhancing Geometry Performance in Students With Math Difficulties and Students at Risk of Math Failure
Authors: Zhang Dake , Indyk Amanda , Greenstein Steven
Published: February 2020

Schematic chunks denote patterns, schemes, or sophisticated rules and knowledge stored in the long-term memory in the form of chunks. We investigated whether schematic chunking is effective in improving the performance of students with math difficulties (MD) and students at risk of math failure, and how the complexity level of geometry problems and students’ content knowledge moderate the effects of a visual chunking accommodation. A 3 (problem difficulty level) × 2 (plain version/chunking version) ×2 (cheat sheet provided/not provided) mixed design was used. Thirty-three students, including 18 with MD and 15 at risk, were randomly assigned to two groups: A “cheat sheet” of related theorems was provided to one group but not the other. Students in both groups received two versions of a geometry test: (a) a test with a plain figure representation, and (b) a parallel test with coloring and marks that highlighted the elements of a schematic chunk. Results found a main effect of chunking for all participants, and the chunking effect was greater for difficult one-step and multi-step problems than for simple one-step problems. Providing a cheat sheet increased the chunking effects for solving only the difficult one-step problems pertaining to low-frequency theorems for students with MD.
The Mediating Role of Cognitive Processing in the Relationship Between Negative and Positive Effects of Trauma Among Female Victims of Domestic Violence
Authors: Ogińska-Bulik Nina , Michalska Paulina
Published: February 2020

Exposure to domestic violence may lead not only to negative but also positive consequences of trauma. Negative effects are indicated by posttraumatic stress symptoms (PTSSs), and positive effects by posttraumatic growth (PTG) changes. PTG has been conceptualized to follow experiences of PTSSs. Therefore, the positive and negative effects of trauma appear to be related to one another. The cognitive processing may play a special role in determining whether the positive and negative consequences of trauma exposure are experienced. The aim of the study was to establish the mediating role of multiple patterns of cognitive processing, reflected by the cognitive strategies used to cope with trauma, in the relationship between negative and positive posttraumatic changes in women following domestic violence. Data were obtained from 63 Polish women who had experienced domestic violence. The age of the respondents ranged from 19 to 71 years ( M = 42.25, SD = 14.81). The Polish versions of the following standardized tools were used: the Posttraumatic Stress Disorder Checklist (PCL-5), the Posttraumatic Growth Inventory (PTGI), and the Cognitive Processing of Trauma Scale (CPOTS). PTSS severity appeared to be negatively related to that of PTG. Negative coping strategies were positively related to the PTSS severity but negatively to PTG, while positive strategies were negatively related to the PTSS severity but positively to PTG. Cognitive strategies for coping with trauma, such as resolution/acceptance, downward comparison, and regret, appeared to play a mediating role in the relationship between PTSS severity and PTG. Positive coping strategies strengthen the occurrence of positive posttraumatic changes while strategy of regret weakens the PTG changes occurrence. The process of adaptation and human development among people who have experienced traumatic events is favored by the use of more frequent positive and less frequent negative strategies of dealing with trauma.
Multicentre registry data analysis comparing outcomes of culture-negative peritonitis and different subtypes of culture-positive peritonitis in peritoneal dialysis patients
Authors: Htay Htay , Cho Yeoungjee , Pascoe Elaine M , Hawley Carmel , Clayton Philip A , Borlace Monique , Badve Sunil V , Sud Kamal , Boudville Neil , Chen Jenny HC , Sypek Matthew , Johnson David W
Published: February 2020

Background:

The outcomes of culture-negative peritonitis in peritoneal dialysis (PD) patients have been reported to be superior to those of culture-positive peritonitis. The current study aimed to examine whether this observation also applied to different subtypes of culture-positive peritonitis.

Methods:

This multicentre registry study included all episodes of peritonitis in adult PD patients in Australia between 2004 and 2014. The primary outcome was medical cure. Secondary outcomes were catheter removal, hemodialysis transfer, relapsing/recurrent peritonitis and peritonitis-related death. These outcomes were analyzed using mixed effects logistic regression.

Results:

Overall, 11,122 episodes of peritonitis occurring in 5367 patients were included. A total of 1760 (16%) episodes were culture-negative, of which 77% were medically cured. Compared with culture-negative peritonitis, the odds of medical cure were lower in peritonitis caused by Staphylococcus aureus (adjusted odds ratio (OR) 0.62, 95% confidence interval (CI) 0.52–0.73), Pseudomonas species (OR 0.20, 95% CI 0.16–0.26), other gram-negative organisms (OR 0.48, 95% CI 0.41–0.56), polymicrobial organisms (OR 0.30, 95% CI 0.25–0.35), fungi (OR 0.02, 95% CI 0.01–0.03), and other organisms (OR 0.61, 95% CI 0.49–0.76), while the odds were similar in other (non-staphylococcal) gram-positive organisms (OR 1.11, 95% CI 0.97–1.28). Similar results were observed for catheter removal and hemodialysis transfer. Compared with culture-negative peritonitis, peritonitis-related mortality was significantly higher in culture-positive peritonitis except that due to other gram-positive organisms. There was no difference in the odds of relapsing/recurrent peritonitis between culture-negative and culture-positive peritonitis.

Conclusion:

Culture-negative peritonitis had superior outcomes compared to culture-positive peritonitis except for non-staphylococcal gram-positive peritonitis.
“Can I go to Glasgow?” Learnings from patient involvement at the 17th Congress of the International Society for Peritoneal Dialysis (ISPD)
Authors: Gutman Talia , Manera Karine E , Baumgart Amanda , Johnson David W , Wilkie Martin , Boudville Neil , Craig Jonathan C , Dong Jie , Jesudason Shilpa , Mehrotra Rajnish , Neu Alicia , Shen Jenny I , Van Biesen Wim , Blake Peter G , Brunier Gillian , Cho Yeoungjee , Jefferson Nichole , Lenga Ilan , Mann Neelem , Mendelson Asher A , Perl Jeffrey , Sanabria Rafael Mauricio , Scholes-Roberston Nicole , Schwartz Daniel , Teitelbaum Isaac , Tong Allison
Published: February 2020

Background:

Recognition of the discrepancy between the research priorities of patients and health professionals has prompted efforts to involve patients as active contributors in research activities, including scientific conferences. However, there is limited evidence about the experience, challenges, and impacts of patient involvement to inform best practice. This study aims to describe patient and health professional perspectives on patient involvement at the Congress of the International Society for Peritoneal Dialysis (ISPD).

Methods:

Semi-structured interviews were conducted with 14 patients/caregivers and 15 health professionals from six countries who attended ISPD. Interviews were recorded and transcribed verbatim, and transcripts were analyzed thematically.

Results:

We identified four themes: protecting and enhancing scientific learning (grounding science in stories, sharing and inspiring new perspectives, distilling the key messages of research presentations, striking a balance between accommodating patients and presenting the science); democratizing access to research (redistributing power, challenging the traditional ownership of knowledge, cultivating self-management through demystifying research); inadequate support for patient/caregiver delegates (lacking purposeful inclusion, challenges in interpreting research findings, soliciting medical advice, difficulty negotiating venue and program, limited financial assistance in attending); and amplifying impact beyond the room (sparking innovation in practice, giving patients and families hope for the future).

Conclusions:

Patient involvement at the ISPD Congress clarified the applicability of research to patient care and self-management, democratized science, and strengthened the potential impact of research. More structured support for patients to help them purposefully articulate their experience in relation to session objectives may enhance their contribution and their own learning experience.
Targeted Education ApproaCH to improve Peritoneal Dialysis Outcomes (TEACH-PD): A feasibility study
Authors: Chow Josephine SF , Adams Kelly , Cho Yeoungjee , Choi Peter , Equinox Keri-Lu , Figueiredo Ana E , Hawley Carmel M , Howard Kirsten , Johnson David W , Jose Matthew D , Lee Anna , Longergan Maureen , Manera Karine E , Moodie Jo-Anne , Paul-Brent Peta-Anne , Pascoe Elaine M , Reidlinger Donna , Steiner Genevieve Z , Tomlins Melinda , Tong Allison , Voss David , Boudville Neil C
Published: February 2020

Background:

There is substantial variation in peritonitis rates across peritoneal dialysis (PD) units globally. This may, in part, be related to the wide variability in the content and delivery of training for PD nurse trainers and patients.

Aim:

The aim of this study was to test the feasibility of implementing the Targeted Education ApproaCH to improve Peritoneal Dialysis Outcomes (TEACH-PD) curriculum in real clinical practice settings.

Methods:

This study used mixed methods including questionnaires and semi-structured interviews (pretraining and post-training) with nurse trainers and patients to test the acceptability and usability of the PD training modules implemented in two PD units over 6 months. Quantitative data from the questionnaires were analysed descriptively. Interviews were analysed using thematic analysis.

Results:

Ten PD trainers and 14 incident PD patients were included. Mean training duration to complete the modules were 10.9 h (range 6–17) and 24.9 h (range 15–35), for PD trainers and patients, respectively. None of the PD patients experienced PD-related complications at 30 days follow-up. Three (21%) patients were transferred to haemodialysis due to non-PD–related complications. Ten trainers and 14 PD patients participated in the interviews. Four themes were identified including use of adult learning principles (trainers), comprehension of online modules (trainers), time to complete the modules (trainers) and patient usability of the manuals (patient).

Conclusion:

This TEACH-PD study has demonstrated feasibility of implementation in a real clinical setting. The outcomes of this study have informed refinement of the TEACH-PD modules prior to rigorous evaluation of its efficacy and cost-effectiveness in a large-scale study.
Clinicians’ experiences with remote patient monitoring in peritoneal dialysis: A semi-structured interview study
Authors: Walker Rachael C , Tong Allison , Howard Kirsten , Palmer Suetonia C
Published: February 2020

Background:

Fear of catastrophic events and uncertainty about safety at home are barriers to choosing peritoneal dialysis (PD). Remote monitoring may address these concerns and is increasingly being used in patients on automated peritoneal dialysis (APD). This study aims to describe clinicians’ perspectives and experiences of remote monitoring in caring for patients on PD.

Methods:

We conducted semi-structured interviews with nephrologists and dialysis nurses across nine dialysis units in New Zealand who had experience using remote monitoring with patients on APD. Interviews were transcribed and analysed using thematic analysis.

Results:

Thirteen registered nurses and 12 nephrologists or nephrologists-in-training (total N = 25) participated. Four themes were identified: promoting and maintaining PD (providing reassurance to patients through continual surveillance, supporting confidence at home and sustaining PD as the patient-preferred treatment); enabling data-driven decisions (using comprehensive clinical data in providing timely and accessible care, and identifying and supporting patient adherence); establishing boundaries for use (negotiating privacy and independence, clarifying clinician and patient responsibilities and strengthening nursing innovation and capability); and enhancing patient-focused care (developing empathy for patients, enabling self-management and reducing time and financial burden in accessing care).

Conclusions:

Remote monitoring is valued by clinicians in promoting and maintaining patients on PD and enabling data-driven decisions. Remote monitoring enhances patient-focused care, but clinicians also emphasise the need to protect patient privacy and establish boundaries for use. Remote monitoring that supports the clinicians’ role and adheres to principles of data security maintains patient privacy may enhance care and outcomes for patients on PD.
Prescribing peritoneal dialysis for high-quality care in children
Authors: Warady Bradley A , Schaefer Franz , Bagga Arvind , Cano Francisco , McCulloch Mignon , Yap Hui-Kim , Shroff Rukshana
Published: February 2020

Background:

Peritoneal dialysis (PD) remains the most widely used modality for chronic dialysis in children, particularly in younger children and in lower and middle income countries (LMICs). We present guidelines for dialysis initiation, modality selection, small solute clearance, and fluid removal in children on PD. A review of the literature and key studies that support these statements are presented.

Methods:

An extensive Medline search for all publications on PD in children was performed using predefined search criteria.

Results:

High-quality randomized trials in children are scarce and current clinical practice largely relies on data extrapolated from adult studies or drawn from observational cohort studies in children. The evidence and strength of the recommendation is GRADE-ed, but in the absence of high-quality evidence, the opinion of the authors is provided and must be carefully considered by the treating physician, and adapted to local expertise and individual patient needs as appropriate. We discuss the timing of dialysis initiation, factors to be considered when selecting a dialysis modality, the assessment and management of volume status on PD, achieving optimal small solute clearance, and the importance of preserving residual kidney function. While optimal dialysis must remain the goal for every patient, a careful discussion with fully informed patients and caregivers is important to understand the patient and family’s expectations of dialysis and reasonable adjustments to the dialysis program may be considered in accordance with a philosophy of shared decision-making.

Conclusions:

There continues to be very poor evidence in the field of chronic PD in children and these recommendations can at best serve to guide clinical decision-making. In LMICs, every effort should be made to conform to the framework of these statements, taking into account resource limitations.
Complement system activation and peritoneal membrane alterations: Culprit or innocent bystander?
Authors: Borceux Pauline , Morelle Johann , Goffin Eric
Published: February 2020

Peritoneal dialysis (PD) accounts for approximately 10% of the dialysis population worldwide. Major concern limiting long-term PD success is the loss of the peritoneal membrane function after prolonged exposure to dialysis solutions. The complement system is a major component of the innate immune system, which provides a first-line defense against pathogens. Uncontrolled activation of the complement system directly contributes to the pathophysiology of rare and common kidney diseases and to a growing number of nonrenal diseases. Here, we review currently available evidence of complement activation in patients treated with PD and its association with structural and functional alterations of the peritoneal membrane. Mainly, evidence point toward a local, intraperitoneal, production of complement molecules in response to PD exposure. Dialysis fluids, particularly glucose, play a role in complement activation and dysregulation leading to untoward PD-related pathophysiological processes such as peritoneal fibrosis, angiogenesis, and vasculopathy and, perhaps, encapsulating peritoneal fibrosis development. These findings could lead to further development and use of anticomplement therapeutics in PD patients to prevent membrane damage.
Inverse determination of the flow curve in large range of strains for cylindrical tensile specimen
Authors: Chen Junfu , Guan Zhiping , Yang Changhai
Published: February 2020

In this study, an inverse method with the integration of finite element simulation and optimization algorithms is proposed to determine the flow curve of cylindrical specimen characterized by the modified Voce hardening model. The tensile test is repetitiously simulated with different combinations of model parameters designed through Latin hypercube design method, where the baseline values and variation ranges of model parameters are identified through Leroy–Bridgman method, obtaining different simulated load–displacement curves. The corresponding response is defined as the sum of the absolute area difference between the simulated load–displacement curves and the experimental one. The relationship between the model parameters and the response is established through response surface methodology and the optimal parameters combination in the modified Voce model is then determined through nonlinear programming by quadratic Lagrangian. In the case of uniaxial tensile test of mild steel Q345, the inversely identified flow curve is validated by numerically reproducing the experimental load–displacement curve and necking profile. The results indicate that the proposed inverse method is capable of evaluating the flow curve in large range of strains for cylindrical specimen accurately.
Deep learning-based inertia tensor identification of the combined spacecraft
Authors: Chu Weimeng , Wu Shunan , He Xiao , Liu Yufei , Wu Zhigang
Published: February 2020

The identification accuracy of inertia tensor of combined spacecraft, which is composed by a servicing spacecraft and a captured target, could be easily affected by the measurement noise of angular rate. Due to frequently changing operating environments of combined spacecraft in space, the measurement noise of angular rate can be very complex. In this paper, an inertia tensor identification approach based on deep learning method is proposed to improve the ability of identifying inertia tensor of combined spacecraft in the presence of complex measurement noise. A deep neural network model for identification is constructed and trained by enough training data and a designed learning strategy. To verify the identification performance of the proposed deep neural network model, two testing set with different ranks of measure noises are used for simulation tests. Comparison tests are also delivered among the proposed deep neural network model, recursive least squares identification method, and tradition deep neural network model. The comparison results show that the proposed deep neural network model yields a more accurate and stable identification performance for inertia tensor of combined spacecraft in changeable and complex operating environments.
Pinning synchronization control of complex networks with partial couplings
Authors: Li Yanzhou , Liu Yishan , Wu Yuanqing , He Shenghuang
Published: February 2020

In this article, the pinning synchronization problem of complex networks with a target node via sampled-data communications is considered. Due to partial couplings among the nodes in complex networks, a decoupling method is adopted to investigate each channel of complex networks independently. By constructing a time-dependent Lyapunov function, it is proved that the pinning synchronization of complex networks with a target node can be achieved if the control parameters are appropriately selected. Furthermore, further study is needed to investigate the pinning synchronization of complex networks in the presence of constant delay. A novel criterion is obtained using Jensen’s inequality and Wirtinger’s inequality. It is worth noting that the lower and upper bounds of the sampling intervals can be calculated by linear matrix inequality box of MATLAB. Theoretical results are well verified through a numerical simulation.