bluuebunny/crossref_metadata_2025 huggingface dataset:
Mania and psychosis associated with right parietal meningioma
Authors: Moore Emily , Srivastava Anshuman A , Rajaram Manoharan Senthil Vel Rajan , Hussain Najeeb
Published: November 2019

Objective

Meningioma is the most common type of primary central nervous system and intracranial tumor, and psychiatric changes attributed to meningioma include depression, apathy, psychosis, and personality changes. We present a case of a 59-year-old man with right parietal meningioma who developed mania with psychotic features throughout multiple hospitalizations.

Method

Single-case report.

Results

The patient originally presented with headache and bilateral lower extremity weakness. He was found to have a large medial sphenoidal wing meningioma and a small right parietal meningioma. The sphenoidal wing meningioma was removed via craniotomy, but the right parietal meningioma was not resected. In the following years, the patient developed symptoms of mania and psychosis which coincided with an increase in size of the right parietal meningioma.

Conclusions

Previous studies have linked right parietal meningioma to psychosis, but this case is one of the first to suggest that right parietal meningioma may be associated with the development of mania along with psychotic features.
Hormone replacement therapy with L-thyroxine promotes working memory and concentration in thyroidectomized female patients after differentiated thyroid carcinoma
Authors: Cordes Joachim , Woite Maya , Engelke Christina , Regenbrecht Gunnar , Kahl Kai G , Schmidt-Kraepelin Christian , Henning Uwe , Kamp Daniel , Klimke Ansgar
Published: November 2019

Objective

It is well established that long-term hypothyroidism is associated with cognitive deficits. Based on recent literature, we hypothesized that pharmacologically induced euthyroidism would lead to improved cognitive performance compared to a hypothyroid state.

Methods

We analyzed data from 14 nondepressed thyroidectomized female patients after differentiated thyroid carcinoma during hypothyroidism (due to a four-week withdrawal of thyroid hormone, T1) and euthyroidism brought about by substitution with L-thyroxine (T2). At both measurement points, patients completed a cognitive test battery as our dependent measure and Beck’s Depression Inventory to control depressive states.

Results

A Wilcoxon signed-rank tests revealed a significant improvement in the Rey–Osterrieth complex figure test (cognitive reproduction), Z = −3.183, p = 0.001, and the D2 concentration score, Z = −1.992, p = 0.046 in euthyroidism compared to hypothyroidism.

Conclusions

Our results confirm that hormone replacement therapy with L-thyroxine promotes cognitive reproduction and concentration in thyroidectomized female patients after differentiated thyroid carcinoma.
Trajectories of belonging and enduring technology: 2G phones and Syrian refugees in the Kurdistan Region of Iraq
Authors: Hayes Jordan
Published: November 2019

Digital migration studies has confronted its own Eurocentric tendencies and cautioned against the ‘technological fetishization’ of migrants. Like Gillespie et al.’s Mapping Refugee Media Journeys: Smart Phones and Social Media Networks, much of its literature to date investigates the use of smartphones by asylum seekers in Europe. In contrast, this article summarizes a study engaging Syrian nationals in the Kurdistan Region of Iraq, tracing relationships between their movement, uses of communication devices and expressions of belonging. Leveraging an infrastructural understanding of digital literacies, it brings to light the role played by 2G rather than smart devices and infrastructures in the respondents’ maintenance of the strong ties that inform mobility. This endurance of 2G technology suggests the exclusions that can result from the use of specific devices and applications in the definition of scholarly inquiries.
Was the Little Ice Age the coolest Holocene climatic period in the Italian central Alps?
Authors: Zerboni Andrea , Mariani Guido S , Castelletti Lanfredo , Ferrari Elena S , Tremari Marco , Livio Franz , Amit Rivka
Published: November 2019

The Estimation of the relative intensity of different cold periods occurring during the Late Quaternary is a difficult task, particularly in non-glaciated mountain landscapes and where high- to medium-resolution archives for proxy data are lacking. In this paper, we study a Holocene polycyclic soil sequence in the central Alps (Val Cavargna, Northern Italy) to estimate climatic parameters (specifically Temperature) changes in non-glaciated, high altitude environments. We investigate this key site through palaeopedological and micromorphological analyses in order to understand phases of soil development and detect hidden evidence of cold conditions during its formation. Three phases of pedogenesis can be recognized and attributed in time to different periods during the Holocene. Pedogenetic phases were separated by two truncation and deposition episodes related to the reactivation of slope processes under cold conditions at the onset of the Neoglacial and the Iron Age Cold Epoch, respectively. Micromorphological evidence of frost action in the soil can instead relate to pedogenetic processes acting in the Little Ice Age. The different expression of these three cold periods corresponds to changes in climatic conditions, pointing to the Little Ice Age as a cooler/drier period in comparison to the preceding ones.
An experimental model of veno-venous arterial extracorporeal membrane oxygenation
Authors: Belliato Mirko , Caneva Luca , Aina Alessandro , Degani Antonella , Mongodi Silvia , Prahl Wittberg Lisa , Pellegrini Carlo , Broman Lars M , Iotti Giorgio Antonio
Published: November 2019

Introduction:

Veno-venous arterial extracorporeal membrane oxygenation is a hybrid-modality of extracorporeal membrane oxygenation combining veno-venous and veno-arterial extracorporeal membrane oxygenation. It may be applied to patients with both respiratory and cardio-circulatory failure.

Aim:

To describe a computational spreadsheet regarding an ex vivo experimental model of veno-venous arterial extracorporeal membrane oxygenation to determine the return of cannula pairs in a single pump–driven circuit.

Methods:

We developed an ex vivo model of veno-venous arterial extracorporeal membrane oxygenation with a single pump and two outflow cannulas, and a glucose solution was used to mimic the features of blood. We maintained a fixed aortic impedance and physiological pulmonary resistance. Both flow and pressure data were collected while testing different pairs of outflow cannulas. Six simulations of different cannula pairs were performed, and data were analysed by a custom-made spreadsheet, which was able to predict the flow partition at different flow levels.

Results:

In all simulations, the flow in the arterial cannula gradually increased differently depending on the cannula pair. The best cannula pair was a 19-Fr/18-cm arterial with a 17-Fr/50-cm venous cannula, where we observed an equal flow split and acceptable flow into the arterial cannula at a lower flow rate of 4 L/min.

Conclusion:

Our computational spreadsheet identifies the suitable cannula pairing set for correctly splitting the outlet blood flow into the arterial and venous return cannulas in a veno-venous arterial extracorporeal membrane oxygenation configuration without the use of external throttles. Several limitations were reported regarding fixed aortic impedance, central venous pressure and the types of cannulas tested; therefore, further studies are mandatory to confirm our findings
Intrathoracic retention of insoluble hyaluronic acid and its absorption process in rats
Authors: Uemura Akiko , Ogawa Shingo , Tanaka Ryou
Published: November 2019

Background:

Post-thoracotomy adhesions are frequent postoperative complications. It has been reported that insoluble hyaluronic acid may prevent adhesions.

Materials and methods:

This study had two objectives: first, to determine the in vivo degradation and absorption process, as well as the intrathoracic retention, of solid insoluble hyaluronic acid membrane; and second, to elucidate the association between postoperative intrathoracic retention and the morphological changes of insoluble hyaluronic acid in 12 Wistar rats. Insoluble hyaluronic acid membranes were cut into 2.0 cm × 1.0 cm rectangles in a dry state. After weighing, the test membranes were soaked and washed with saline to be implanted after pericardiotomy via thoracotomy. At Days 4, 7, 10, 14, and 28 after implantation, the rats were euthanized, the chest was opened, and the condition and implantation site of the inserted test membrane were examined.

Results:

Although approximately 10 days were required for the test membrane to decrease to half in the thoracic cavity, the intrathoracic remnant decreased to a mean of ~2% just 4 days later.

Conclusion:

This study clarified the time-dependent degradation process and remnants of insoluble hyaluronic acid in the thoracic cavity. A close relationship between the intrathoracic remnant of insoluble hyaluronic acid and its morphological change associated with degradation was demonstrated.
Different component ratio of polyamide 1212/thermoplastic polyurethane blends: Effect on phase morphology, mechanical properties, wear resistance, and crystallization behavior
Authors: Xu Dinghong , Zhou Ying , Guo Jianbing , He Weidi , Wu Hongming , Qin Shuhao , Yu Jie
Published: November 2019

In this work, blends of polyamide 1212 (PA1212) and thermoplastic polyurethane (TPU) elastomer of different group distribution ratios were prepared by melt blending. The effects of different TPU additional ratios on static and dynamic mechanical properties, crystallization, and wear resistance were investigated. Scanning electron microscopy images show that the phase morphology of the blended alloy changes from an island structure to a co-continuous phase structure and then to a sea-island structure. Mechanical tests show that as the proportion of TPU in the blend increases, the flexural modulus increases, and the tensile strength and notched impact strength decrease first and then increase. Dynamic mechanical analysis shows an increase in the storage modulus ( G′) and a broadening of the loss factor peak. In addition, with the increase of TPU content, the crystallinity of PA1212 in the system decreased slightly first, and the crystallinity of PA1212 increased remarkably after the TPU content was further increased to 80 wt%.
The Associations Between Career Decision-Making Difficulties and Negative Emotional States
Authors: Anghel Ella , Gati Itamar
Published: November 2019

Career decision-making difficulties are the challenges encountered by individuals before, during, or after choosing one’s career. This study tested the associations between career decision-making difficulties and depression, anxiety, and stress, considering the career decision status of participants. Students in a precollege preparatory program filled out questionnaires at the beginning and near the end of the academic year ( N = 137). The correlations between career decision-making difficulties, as measured by the Career Decision-Making Difficulties, and negative emotional states measured by the Depression, Anxiety, and Stress Scales, were positive at both administrations ( r T1 = .24, r T2 = .38). Using a multivariate analysis of variance, we have found that those who became more decided had fewer career decision-making difficulties ( d = 1.26). The changes in career decision status were not associated with either depression, anxiety, or stress. However, overall negative emotions intensified among students who were still undecided at the end of the year ( d = 0.72). Implications for research and practice are discussed.
Climate hazards in small and medium cities in the Amazon Delta and Estuary: challenges for resilience
Authors: De Lima Ana C B , Almeida Oriana , Pinedo-Vasquez Miguel , Lee Tien Ming , Rivero Sergio , Schramski Sam , Mansur Andressa Vianna
Published: November 2019

Recent research on climate vulnerability in cities in the Amazon Delta and Estuary (ADE) shows that about 1.2 million people are at risk of flooding due to the rapid unplanned occupation of lowlands and the absence of investment in infrastructure and services. In this study, we use secondary climate and census data, interviews and focus groups in four small cities in the Amazon Delta and Estuary (SCADEs), to discuss how residents and local governments perceive and respond to climate hazards and their implications. These SCADEs may be better equipped than other urban areas to deal with challenges brought by climate change, due partially to residents’ high mobility between urban and rural areas and a tradition of adaptive actions in a dynamic social and environmental context. However, persistent flooding and sinkholes demonstrate the limited capacity of local governments to cope with the dynamics of accelerated occupation of floodplain areas in SCADEs.
Experimental analysis on thermal and friction factor characteristics of fluid flow in tube with novel double strip helical screw tape
Authors: Chaurasia Shashank R , Sarviya RM
Published: November 2019

An experimental analysis has been carried out to investigate the thermal and friction factor characteristics of fluid flow in a tube with double strip helical screw tape (DS-HST) inserts with different values of twist ratio and compared with single strip helical screw tape inserts and plain tube. Water is used as a working fluid at different flow rates with constant heat flux conditions. CFD analysis is also carried out to visualize thermal and fluid flow characteristics of fluid flow in tube with inserts. Experimental results have showed that Nusselt number and friction factor have attained excellent enhancement with double strip helical screw tape inserts in the range of flow rates than single strip helical screw tape inserts at the value of twist ratio 1.5. Correlation is also developed for Nusselt number with a range of Reynolds number, twist ratio and number of strips. Moreover, the performance ratio has attained maximum value at twist ratio of 2.5 with high values of flow rate. It is concluded that DS-HST is able to attain enhancement in the efficiency of heat exchanger, causing a reduction in size for thermal applications.
Contagion of Entrepreneurial Passion: Effects on Employee Outcomes
Authors: Hubner Sylvia , Baum Matthias , Frese Michael
Published: November 2019

This article analyzes the contagion process of entrepreneurial passion and its effects on employee outcomes. We develop a mediation model showing entrepreneurs’ entrepreneurial passion affects an employee passion response, which in turn affects employee outcomes. We draw on a dual-process perspective to analyze how entrepreneurs’ emotional and identity displays interact to create employees’ perceptions of entrepreneurs’ passion, and question whether the contagion effect uniformly works for all employees. Our empirical studies, one field study and one experiment, provide empirical support for a contagion effect of entrepreneurial passion, and show the particularities of the effects of entrepreneurs’ passion on employee outcomes.
Simulation in Social Work Education: A Scoping Review
Authors: Kourgiantakis Toula , Sewell Karen M. , Hu Ran , Logan Judith , Bogo Marion
Published: November 2019

Purpose:

This article presents a scoping review that synthesized empirical studies on simulation in social work (SW) education. The review maps the research examining characteristics of simulation studies in SW education and emerging best practices.

Method:

Using Arksey and O’Malley’s scoping review framework to develop the methodology and following the PRISMA-ScR checklist, we selected 52 studies for this review.

Results:

Most studies were published in North America and included quantitative (37%), qualitative (31%), and mixed methods (33%). Simulation was used to teach generalist and specialized practice with interprofessional practice as the highest area of specialization. Simulation was also used for assessment purposes, and the Objective Structured Clinical Examination was a commonly reported method. We identified several facilitators and barriers to using simulation effectively for teaching and assessment.

Conclusions:

Our analysis permitted us to identify emerging best practices that can be used to guide teaching. Implications for SW research, teaching, and practice are discussed.
Emphasizing Technology Over Instruction: Adapting a 20-Year-Old Survey to Examine the Climate of K–12 Instructional Technology Leadership in Public School Districts
Authors: Edelberg Thomas
Published: November 2019

Current research on computer technology integration in K–12 school classrooms indicates that student learning outcomes remain flat despite heavy investment. Examining school leadership conceptions about technology integration might reveal a way to reverse this trend. This study adapts a survey instrument from Brush and Bannon and applies it to Indiana school district superintendents. Key findings indicate respondents perceive developing technology goals and plans for a school district, providing instructional support, and integrating technology into a core curriculum are very important for instructional technology leadership, but educational experiences and credentials are less important. However, respondents from school districts with smaller student enrollments and who report having little or no knowledge of instructional technology tend to view educational experiences and credentials more highly than respondents from larger schools and who report being very knowledgeable. Implications are that superintendents tend to emphasize the technology-use aspect of instructional technology leadership over instructional proficiencies.
A Virtual Noninvasive Way of Constructing a Nasoalveolar Molding Plate for Cleft Babies, Using Intraoral Scanners, CAD, and Prosthetic Milling
Authors: Shanbhag Gajanan , Pandey Swapnil , Mehta Nirali , Kini Yogesh , Kini Ashwini
Published: November 2019

Presurgical nasoalveolar molding (PNAM) is a key step in the early management of cleft babies. It involves making an impression of the alveolar segments and the lip elements, after which an appliance is fabricated and activated to achieve optimal alveolar and nasal positions for a superior surgical result. These appliances are fabricated and activated in babies as young as 10 days, and the molding is ideally carried on till the baby is ready for the primary lip repair. This article outlines in detail a digital method of fabricating the PNAM appliance using a combination of intraoral scans, computer-assisted digital software, and computer-assisted machining, facilitated by milling machines. This process obviates impression making and the subsequent laboratory procedures.
Implementation of a Pharmacist-Driven Detailed Penicillin Allergy Interview
Authors: Mann Katrina L. , Wu Janet Y. , Shah Sneha S.
Published: November 2019

Background: Self-reported penicillin allergies may be outdated or inaccurate, leading to the use of alternative antimicrobials that may be less effective, more toxic, and/or more expensive. Although penicillin skin tests can provide accurate assessments of penicillin allergies, these procedures are not feasible at all institutions. Another solution is to conduct a detailed penicillin allergy interview (DPAI), which can potentially lead to optimization of antimicrobial therapy. Objective: The purpose of this study was to assess the impact of a pharmacist-driven DPAI protocol. The primary objective was to measure the number of patients requiring a change to their allergy profile following DPAI. Secondary objectives included characterizing allergy profile updates and measuring the number of recommendations to switch to a β-lactam agent, provider acceptance rate, and patient tolerance. Methods: Standardized pharmacist-driven DPAIs were conducted prospectively on adult patients admitted with a documented penicillin allergy. The allergy profile within the electronic health record (EHR) was updated and a recommendation to switch to noncarbapenem β-lactam therapy was made when indicated by a decision algorithm. Results: A total of 175 (37.5%) patients received a DPAI. Of these, 133 (76.0%) required a change to their allergy profile. Additionally, 135 (77.1%) patients interviewed were on antimicrobial therapy, with 42 (31.1%) meeting criteria to switch to noncarbapenem β-lactam therapy; of which 31 (73.8%) patients were successfully transitioned, with no signs or symptoms of intolerance. Conclusions and Relevance: Implementation of pharmacist-driven DPAIs can provide updated and corrected allergy information within the EHR, allowing for de-escalation and/or optimization of antimicrobial therapy.
Modelling and control of flexible guided lifting system with output constraints and unknown input hysteresis
Authors: Wang Naige , Cao Guohua , Wang Lei , Lu Yan , Zhu Zhencai
Published: November 2019

Modelling and control vibration is studied for the flexible guided lifting system in the presence of output constraints, input hysteresis, guided rope fault, etc. Flexible guided lifting system, subjected to external disturbances from the boundary disturbance or fluid interaction, is an inherent distributed parameter system with time-varying length and infinite dimensions. According to extended Hamilton’s principle, the governing equation in the form of hybrid partial differential equations and ordinary differential equations is derived to reflect the dynamic response of such multiple ropes under the boundary disturbances and multiple constraints. Adaptive neural network control combining with backstepping technique is subsequently designed to suppress undesirable vibration and stabilise the system, where the neural network is provided as a feedforward compensator for the unknown hysteresis nonlinearities in the control input. Asymptotic stability and uniform boundedness of the system are guaranteed through the Lyapunov theorem, which indicates that all states are uniformly convergent by LaSalle’s invariance principle. The original governing equation is solved numerically by using the finite difference method, where simulation results are illustrated to validate the efficiency of the hybrid partial differential equation and ordinary differential equation model and the adaptive stabilisation design.
Video-Based Interventions for Cancer Control: A Systematic Review
Authors: Blake Kelly D. , Thai Chan , Falisi Angela , Chou Wen-Ying Sylvia , Oh April , Jackson Devlon , Gaysynsky Anna , Hesse Bradford W.
Published: November 2019

Background. The use of videos for patient and public health education has been widely adopted and well documented in the literature. Aims. To conduct a systematic review of empirical studies that used video-based interventions for cancer prevention and control to document study designs, settings, approaches, targeted cancer sites and behaviors, and outcomes and to identify gaps in research and practice. Method. PubMed, PsychINFO, CINAHL, SCOPUS, and Web of Science were searched for studies published in the 30-year period from 1984 to 2014. Of 1,521 articles identified, duplicates were removed, and titles and abstracts of 779 were examined for eligibility. In all, 315 articles met the inclusion criteria and were coded by three independent coders. Interrater reliability was assessed. Descriptive frequencies and proportions were calculated. Results. Studies evaluating video interventions for cancer prevention and control have increased over time. The majority used randomized controlled trial designs (54%), followed by single-group pre–posttest designs (18%). Most were delivered in health care settings (39%). Detection (30%) and treatment (16%) were the cancer control continuum stages most frequently addressed, with breast cancer (29%) being the most frequently targeted cancer site. The behavior most commonly targeted was screening/early detection (39%). Topics such as caregiving, coping, palliative care, and end of life were rarely addressed. The majority (69%) reported being successful at achieving their stated objectives, though outcomes varied across studies. Conclusions. Video interventions have been widely utilized for cancer prevention and control, with demonstrated successes. Future research should test innovative designs and new delivery platforms and should include underrepresented topics and cancer sites.
Approach to the Assessment and Management of Pediatric Patients with Atopic Dermatitis: A Consensus Document. Section II: Comorbid Disease in Pediatric Atopic Dermatitis
Authors: Hong Chih-ho , Joseph Marissa , Kim Vy HD , Lansang Perla , Lara-Corrales Irene
Published: November 2019

Pediatric atopic dermatitis (AD) is one of the most common skin conditions encountered by health-care providers caring for infants, children, and adolescents. Pediatric patients with AD may present with other allergic and nonallergic comorbidities that require appropriate treatment and referral. They may also experience a trajectory of allergic diseases known as the atopic march, which depends on a complex interaction between genetic and environmental factors and likely involves early epidermal barrier dysfunction. Here we provide a review and clinical recommendations on the assessment and referral of comorbidities in pediatric AD.
Management of Pearly Penile Papules: A Review of the Literature
Authors: Honigman Anthony D. , Dubin Danielle P. , Chu Justin , Lin Matthew J.
Published: November 2019

Pearly penile papules (PPPs) are benign, dome-shaped lesions found around the corona of the penis. Despite being asymptomatic and benign in nature, the appearance of PPPs may cause a great deal of psychological distress to both the patient and their sexual partner. While patient reassurance may be the first-line treatment, several other treatment modalities including cryotherapy, electrodessication and curettage, and laser therapy have all been used to treat PPPs in order to achieve a cosmetic outcome that satisfies the patient. Based on the evaluation of the existing literature, ablative laser therapies offer satisfactory cosmetic outcomes with good long-term results.
Frontier justice: international law and ‘lawless’ spaces in the “War on Terror”
Authors: Nylen Alexandria J
Published: November 2019

How does the discourse of international law facilitate extraterritorial state violence? This paper synthesizes insights from International Relations, comparative politics, and legal studies in order to explore how the sovereign foundations of international law may render “frontier territories” exceptionally vulnerable to external military intervention. I argue that international law’s focus on sovereignty constitutes frontier territories as “ambiguous,” which leads to discursive conflicts over how to define these spaces, what is considered “legal” and “illegal” action within them, and who gets to define their status. All of this creates a conducive environment for powerful international governments to denigrate frontier territories as “lawless,” by rhetorically constructing them as exceptional legal spaces that do not deserve the same protections as areas ordered by sovereign ideals. To illuminate this empirically, I conduct a discourse analysis of 16 distinct legal documents from the Obama White House, including internal memorandums and public speeches on the legal standing of drone strikes in Pakistan, Yemen, and Somalia.
Crimmigration, imprisonment and racist violence: Narratives of people seeking asylum in Great Britain
Authors: Bhatia Monish
Published: November 2019

The past five decades have witnessed a dramatic growth in immigration controls. The external controls have expanded, but at the same time, there has been a proliferation of internal control measures. The British state has increasingly resorted to using penal machinery to punish people who violate immigration laws. Individuals can now be prosecuted under the criminal law and receive custodial sentences for immigration crimes. This article draws upon narratives, interviews and experiences of asylum seekers who were imprisoned for such crimes, in order to understand how their trauma is exacerbated and ways in which injuries are strategically and deliberately inflicted by the state and built within legal and policy frameworks. It draws attention to the racist nature of the crimmigration system and production of violence.
Human-aided artificial intelligence: Or, how to run large computations in human brains? Toward a media sociology of machine learning
Authors: Mühlhoff Rainer
Published: November 2019

Today, artificial intelligence (AI), especially machine learning, is structurally dependent on human participation. Technologies such as deep learning (DL) leverage networked media infrastructures and human-machine interaction designs to harness users to provide training and verification data. The emergence of DL is therefore based on a fundamental socio-technological transformation of the relationship between humans and machines. Rather than simulating human intelligence, DL-based AIs capture human cognitive abilities, so they are hybrid human-machine apparatuses. From a perspective of media philosophy and social-theoretical critique, I differentiate five types of “media technologies of capture” in AI apparatuses and analyze them as forms of power relations between humans and machines. Finally, I argue that the current hype about AI implies a relational and distributed understanding of (human/artificial) intelligence, which I categorize under the term “cybernetic AI.” This form of AI manifests in socio-technological apparatuses that involve new modes of subjectivation, social control, and digital labor.
Gas chromatography/mass spectrometry analysis of reaction products of sulfur mustards with phenol
Authors: Veeresham A , Sandeep M , Reddy T Jagadeshwar , Suresh Pal A , Srinivas K , Prabhakar S
Published: November 2019

Screening of chemicals related to chemical weapons convention including their all possible degradation and reaction products in environmental samples is important in the organization for prohibition of chemical weapons verification process. Sulfur mustards, commonly known as blistering agents, are included in schedule 1 chemicals of chemical weapons convention. Because of the presence of chlorine atoms in sulfur mustards, they are highly reactive and prone to react with other organic molecules such as phenols to produce corresponding reaction products. Thus, it is important to screen for not only the sulfur mustards but also their reaction products for verification process. The sulfur mustards and their degradation products have been routinely analyzed by gas chromatography/mass spectrometry method, however, the methods are yet to establish for the reaction products. In this study, the reaction products of the sulfur mustards with phenol (compounds 1–7) were studied by gas chromatography/mass spectrometry under electron ionization and chemical ionization conditions. The EI spectra of 1–7 displayed molecular ion and characteristic fragments that provided structure information. Mostly the fragment ions were due to homolytic cleavages involving C–O, C–S, and C–C cleavages. The methane or isobutane CI spectra showed M+., [M + H]+, and [M − H]+ ions including reagent specific adduct ions. The CI spectra also showed other adduct ions formed by association of analyte molecule with its most abundant fragment ion. The gas chromatography/retention index values were also calculated, which support unambiguous identification of targeted molecules in suspected environmental samples. The method was demonstrated for detection of the targeted molecules spiked in soil samples.
A distributed expectation maximization-principal component analysis monitoring scheme for the large-scale industrial process with incomplete information
Authors: Wang Xuanyue , Yang Xu , Huang Jian , Chen Xianzhong
Published: November 2019

Large-scale process monitoring has become a challenging issue due to the integration of sub-systems or subprocesses, leading to numerous variables with complex relationship and potential missing information in modern industrial processes. To avoid this, a distributed expectation maximization-principal component analysis scheme is proposed in this paper, where the process variables are first divided into several sub-blocks using two-layer process decomposition method, based on knowledge and generalized Dice’s coefficient. Then, the missing information of variables is estimated by expectation maximization algorithm in the principal component analysis framework, then the expectation maximization-principal component analysis method is applied for fault detection to each sub-block. Finally, the process monitoring and fault detection results are fused by Bayesian inference technique. Case studies on the Tennessee Eastman process is applied to show the effectiveness and performance of our proposed approach.
Clinical Care Redesign to Improve Value for Trigger Finger Release: A Before-and-After Quality Improvement Study
Authors: Burn Matthew B. , Shapiro Lauren M. , Eppler Sara L. , Behal Rajneesh , Kamal Robin N.
Published: November 2019

Background: Trigger finger release (TFR) is a commonly performed procedure. However, there is great variation in the setting, care pathway, anesthetic, and cost. We compared the institutional cost for isolated TFR before and after redesigning our clinical care pathway. Methods: Total direct cost to the health system (excluding the surgeon and anesthesiology costs) and time spent by the patient at the surgery center were collected for 1 hand surgeon’s procedures at an ambulatory surgery center over a 3-year period. We implemented a redesigned pathway that altered phases of care and anesthetic use by transitioning from intravenous (IV) sedation to wide awake local anesthesia with no tourniquet. Cost data were reported as percentage change in the median and compared both pre- to post-implementation and with 2 control surgeons using the traditional pathway within the same center. Power analysis was based on prior work on a carpal tunnel pathway. Significance was defined by a P-value < .05. Results: Ten TFRs (90% local with IV sedation) and 44 TFRs (89% local alone) were performed pre- and post-implementation, respectively. From pre- to post-implementation, the study surgeon’s total direct cost decreased by 18%, while the control surgeons decreased by 2%. Median time spent at the surgery center decreased by 41 minutes post-implementation with significantly shorter setup time in the operating room (OR), total time in the OR, and time spent in recovery prior to discharge. Conclusions: Redesigning the care pathway for TFR led to a decrease in institutional cost and patient time spent at the surgery center.
Efficient wireless charging system for supercapacitor-based electric vehicle using inductive coupling power transfer technique
Authors: Elahi Ahsan , Amin Arslan Ahmed , Shami Umar Tabraiz , Usman Muhammad Tayyab , Iqbal Muhammad Sajid
Published: November 2019

Wireless charging has become an emerging challenge to reduce the cost of a conventional plug-in charging system in electric vehicles especially for supercapacitors that are utilized for quick charging and low-energy demands. In this article, the design of an efficient wireless power transfer system has been presented using resonant inductive coupling technique for supercapacitor-based electric vehicle. Mathematical analysis, simulation, and experimental implementation of the proposed charging system have been carried out. Simulations of various parts of the systems are carried out in two different software, ANSYS MAXWELL and MATLAB. ANSYS MAXWELL has been used to calculate the various parameters for the transmitter and receiver coils such as self-inductance ( L), mutual inductance ( M), coupling coefficient ( K), and magnetic flux magnitude ( B). MATLAB has been utilized to calculate output power and efficiency of the proposed system using the mathematical relationships of these parameters. The experimental setup is made with supercapacitor banks, electric vehicle, wattmeters, controller, and frequency generator to verify the simulation results. The results show that the proposed technique has better power transfer efficiency of more than 75% and higher power transfer density using a smaller coil size with a bigger gap of 4–24 cm.
The joys and frustrations of an environmental law-maker
Authors: Korhola Eija-Ritta
Published: November 2019

For many years, environmental politics was seen as a relatively light policy area. In many European countries environmental issues were usually delegated to the Greens. As a result, until recently, climate and environmental policy has been dominated by the political approach and emphasis of the green movement. Today, however, political leaders across Europe are finally seeing how political environmental politics actually is. There is also a growing understanding that the green approach may not be the only possible way forward. Due to its top-down, bureaucratic and inflexible approach to the policy area, the green agenda may in fact sometimes even be dangerous. Thus, this article argues that the time has come to shift the paradigms of environmental politics and climate politics from the politics of limitation to the politics of possibilities. The European People’s Party family could offer a real alternative to the green agenda and show the merits of environmental subsidiarity.
Sex-related differences in exercise performance and outcome of patients with hypertrophic cardiomyopathy
Authors: Ghiselli Luca , Marchi Alberto , Fumagalli Carlo , Maurizi Niccolò , Oddo Andrea , Pieri Francesco , Girolami Francesca , Rowin Ethan , Mazzarotto Francesco , Cicoira Mariantonietta , Ribichini Flavio , Arretini Anna , Targetti Mattia , Passantino Silvia , Cecchi Franco , Marchionni Niccolò , Maron Martin , Mori Fabio , Olivotto Iacopo
Published: November 2019

Aims

Exercise performance is known to predict outcome in hypertrophic cardiomyopathy (HCM), but whether sex-related differences exist is unresolved. We explored whether functional impairment, assessed by exercise echocardiography, has comparable predictive accuracy in females and males with HCM.

Methods

We retrospectively evaluated 292 HCM patients (46 ± 16 years, 72% males), consecutively referred for exercise echocardiography; 242 were followed for 5.9 ± 4.2 years.

Results

Peak exercise capacity was 6.5 ± 1.6 metabolic equivalents (METs). Sixty patients (21%) showed impaired exercise capacity (≤5 METs). Exercise performance was reduced in females, compared with males (5.6 ± 1.6 vs 6.9 ± 1.5 METs, p < 0.001; peak METs ≤ 5 in 40% vs 13%, p < 0.001), largely driven by a worse performance in women >50 years of age. At multivariable analysis, female sex was independently associated with impaired exercise capacity (odds ratio: 4.67; 95% confidence interval (CI): 1.83–11.90; p = 0.001). During follow-up, 24 patients (10%) met the primary endpoint (a combination of cardiac death, heart failure requiring hospitalization, sustained ventricular tachycardia, appropriate implantable cardioverter defibrillator discharge, resuscitated sudden cardiac death and cardioembolic stroke). Event-free survival was reduced in females (p = 0.035 vs males). Peak METs were inversely related to outcome in males (hazard ratio (HR) per unit increase: 0.57; 95% CI: 0.39–0.84; p = 0.004) but not in females (HR: 1.22; 95% CI: 0.66–2.24; p = 0.53).

Conclusions

Female patients with HCM showed significant age-related impairment in functional capacity compared with males, particularly evident in post-menopausal age groups. While women were at greater risk of HCM-related complications and death, impaired exercise capacity predicted adverse outcome only in men. These findings suggest the need for sex-specific management strategies in HCM.
Implementing Social Determinants of Health Screening at Community Health Centers: Clinician and Staff Perspectives
Authors: Herrera Carolina-Nicole , Brochier Annelise , Pellicer Michelle , Garg Arvin , Drainoni Mari-Lynn
Published: November 2019

Purpose: Screening for social determinants of health (SDOH) during primary care office visits is recommended by pediatric and internal medicine professional guidelines. Less is known about how SDOH screening and service referral can be successfully integrated into clinical practice. Methods: Key informant interviews with 11 community health center (CHC) clinicians and staff members (medical assistants and case managers) were analyzed to identify themes related to integrating a SDOH screening and referral process (augmented WE CARE model) into their workflow. Results: CHC clinicians and staff believed the augmented WE CARE model benefited their patients and the CHC’s mission. Most clinicians found the model was easy to implement. Some staff members had difficulty prioritizing the nonclinical intervention and were confused about their roles and the role of the patient navigator. The eligibility requirements and time needed to access local SDOH resources frustrated clinicians. Discussion: SDOH screening and referral care models can help support the mission of CHCs by identifying unmet material needs. However, CHCs have organizational and administrative challenges that successful interventions must address. CHCs need clinical champions for SDOH models because the screening and follow-up processes involve clinical staff. Additional support for SDOH models might include piloting the SDOH screening model workflow and formalizing the workflow before implementation, including the specific roles for clinicians, staff, and patient navigators.
The Cavoatrial Anastomosis Procedure in Anomalous Connection of Superior Vena Cava to Left Atrium
Authors: Gerrah Rabin , Fonseca Escalante Elizabeth , Gorenflo Matthias , Loukanov Tsvetomir
Published: November 2019

Anomalous connection of the superior vena cava to the morphologic left atrium is a rare congenital systemic venous abnormality. As opposed to pulmonary venous anomalies, the significant right-to-left shunt in these patients warrants a correction early in life. Optimal repair technique for combined pulmonary and systemic venous anomalies is not defined yet. Herein, we describe a neonate with such a diagnosis treated with cavoatrial anastomosis, known as Warden procedure with excellent results.
Analysis of FDA Warning Letters Issued to Indian Pharmaceutical and Medical Device Companies: A Retrospective Study
Authors: Bablani Shray , Janodia Manthan D.
Published: November 2019

Background:

FDA issues warning letters to pharmaceutical manufacturers, distributors, or clinical investigators if it observes serious violations of federal regulations. These warning letters contain the details about the nature of the violations observed and the corrective actions recommended by the FDA. A follow-up inspection may be requested by the recipient after taking the corrective actions.

Methods:

Analysis of warning letters issued to Indian pharmaceutical companies from January 1, 2005, to December 31, 2018, was carried out. The warning letters were extracted from FDA’s public database.

Results:

Across the 14-year study period, the number of warning letters issued to Indian pharmaceutical and medical device manufacturers has gradually increased. Of all the violations listed in these warning letters, 85.87% were related to the failure of compliance with the cGMP guidelines. Moreover, 80.72% of these warning letters were not followed by a close-out warning, which indicated that the violations listed in these warning letters could not be resolved.

Conclusion:

As the inability of the recipients to comply with the cGMP guidelines formed the majority of the violations observed in the warning letters, more resources and manpower have to be assigned to the manufacturing process of the pharmaceutical products.
Mathematics Teacher and Curriculum Quality, 2005 and 2016
Authors: Hill Heather C. , Lovison Virginia , Kelley-Kemple Thomas
Published: November 2019

Efforts to improve teachers’ knowledge and to change the nature of curriculum materials have dominated mathematics reforms since the late 1990s. In this article, we compared middle school teachers’ mathematical knowledge for teaching (MKT) and curriculum use between 2005 and 2016 to assess progress toward these key goals. We found teachers’ MKT increased an amount equal to the average teacher in the 2005 sample improving five percentile points. However, No Child Left Behind’s attempts to encourage mathematics degrees in this population do not explain this increase, as teachers were less likely in 2016 than in 2005 to possess such a degree. Instead, our data are consistent with schools hiring more knowledgeable individuals during the Great Recession. Between surveys, the strength of the association between teacher MKT and student demographic characteristics decreased, although equity gaps still persist. Finally, our data suggest a modest movement toward standards-based curriculum materials over this period.
The Utility of Echocardiography for Non-ST-Segment Elevation Myocardial Infarction: A Retrospective Study
Authors: Ha Edward T. , Cohen Marc , Fields Paul J. , Van Daele Jessie , Gaeta Theodore J.
Published: November 2019

Objective:

The objectives were to assess factors associated with a higher likelihood of predicting acute coronary atherothrombosis (ACA) in non-ST-segment elevation myocardial infarction (NSTEMI), evaluate the impact of adding echocardiographic data, and develop an algorithm that would reduce overutilization of emergent angiography.

Methods:

Data were retrospectively analyzed on a patient cohort presenting to an emergency department of an urban community hospital with NSTEMI from October 1, 2015, to July 31, 2018. The inclusion criterion was any adult patient with a first-time, primary diagnosis of NSTEMI without high-risk features. The main outcome variables were the presence of ACA on angiography.

Results:

Seventy-three patients with NSTEMI were included in this study. Logistic regression analysis identified the following independent variables useful for predicting ACA: age, wall motion abnormality on echo, and levels of low-density lipoprotein. The model’s overall fit was highly significant ( P = .0012).

Conclusion:

An integrative approach was demonstrated for the management of patients with NSTEMI presenting to the hospital. Although the positive predictive value of echo in predicting ACA was limited, when combined with demographic attributes and risk factors, it proved to be successful in determining the need for angiography in patients with NSTEMI.
The effect of cooling rate on immiscible silicate liquid microstructure: an example from the Palaeogene dykes of Northeast England
Authors: Honour Victoria C. , Holness Marian B. , Stock Michael J.
Published: November 2019

The migration and accumulation of immiscible silicate liquids may play a significant role in the differentiation of crustal magma bodies and the formation of some economic mineral deposits. However, our understanding of the processes that control the segregation of these liquids is currently limited by the short timescales of petrological experiments. Detailed microstructural investigations of Palaeogene basaltic dykes from Northeast England, coupled with simple 1D thermal models, constrain the effects of cooling rate on the microstructure of unmixed immiscible silicate liquids under natural conditions. The size of unmixed Fe-rich droplets within a continuous silicic phase is related to the cooling rate by a power law, with droplet diameter increasing with decreasing cooling rate, accompanied by an increase in the number of droplets. Fe-rich droplet coarsening is a result of diffusion-controlled growth. The average apparent aspect ratio and grain size of matrix plagioclase crystals indicate that nucleation and growth of these grains probably occurred in a static (or only weakly convecting) fluid dynamical regime.