bluuebunny/crossref_metadata_2025 huggingface dataset:
Corrosion failure analysis of a railway tanker containing concentrated sulfuric acid
Authors: Wu Haomin , Zou Changjun
Published: August 2018

In this paper, the authors carried out a corrosion failure analysis of a railway tanker containing 92.5% sulfuric acid, in order to investigate the cause of the leakage accident that occurred in 2016 and to provide a theoretical basis for preventing similar accidents. The morphology and chemical composition of the corrosion scale were characterized by SEM and EDS. The theoretical corrosion rate of the railway tanker was calculated using weight loss experiments. The corrosion behavior model was established by electrochemical experiments. In order to investigate the cause of this leakage, a mechanical model was established, and the force of the railway tanker during transportation was analyzed through ANSYS software. The results show that the tanker material (low-alloy high-tensile structural steel, Q295A) meets the quality standard, and the main cause of this leakage accident was the local corrosion failure of the tanker leading to a crack due to stress during the transportation process. The corrosion source is diluted H2SO4 solution. The main component of the corrosion scale was Fe2O3. The theoretical corrosion rate was in the range of 1.413–1.978 mm/a, and the corrosion rate increased with the decrease in the concentration of H2SO4. The corrosion type was pitting corrosion. When the brake is applied when the tanker is in full load, the stress inside the tanker is about 8.94 times higher compared to a tanker with empty load in the static state. Because of this uneven force, a crack may develop leading to leakage from the corroded area of the tanker.
Outcomes in juvenile onset lupus: single center cohort from a developing country
Authors: Aggarwal A , Phatak S , Srivastava P , Lawrence A , Agarwal V , Misra R
Published: August 2018

Introduction

About 10–20% of systemic lupus erythematosus (SLE) patients have onset in childhood and have more severe organ involvement. Survival of juvenile SLE patients is improving worldwide. Long-term data of childhood onset SLE from developing countries is scarce.

Methods

Clinical and laboratory data at initial presentation and follow-up visits were retrieved from clinic files, hospital information system and personal interviews. Treatment received, complications, flares, outcomes and death were recorded. Survival was calculated using Kaplan–Meier survival curves and regression analysis was done for predictors of mortality.

Results

Children with SLE ( n = 273, 250 girls) had a median age at onset of 14 years and duration of illness prior to diagnosis at our hospital of 1 year. Fever and arthritis were the most common presenting manifestations. Renal disease was seen in 60.5% and central nervous system (CNS) disease in 29%. The median follow-up period in 248 patients was 3.5 years. Fourteen children died, and 10 of these had active disease at the time of death. The mean actuarial survival was 24.5 years and survival rates at 1, 5 and 10 years were 97.9%, 95% and 89% respectively. Fever, CNS disease, anti-dsDNA levels and serious infections predicted death on univariate and multivariate analysis. Infections were seen in 72 children (26.3%), and 38 of these infections were serious. One-third of the patients had damage on the last follow-up. Flares were seen in 120 children, the majority being major flares.

Conclusion

Outcomes of pediatric SLE in North Indian children are similar to those seen in developed countries. Infections pose a major challenge in these patients.
Priming text function in personification allegory: A corpus-assisted approach
Authors: Cordell Jacqueline
Published: August 2018

Current linguistic examination of allegory focuses on its cognitive structure as conceptual metaphor, with its linguistic form realised in the absence of a target domain (Crisp, 2001; 2008). The present study addresses the intersection of conceptualisation and form in examining how personification allegory functions within a literary context as either fictional world or thematic elements. Central to this is the idea of lexical priming, which suggests that readers are both textually and experientially primed to interpret personified referents allegorically or non-allegorically depending on their contextual use. In this article I draw on Mahlberg and McIntyre’s (2011) framework for literary text function to take an integrated cognitive-corpus approach to exploring allegorical function through the lens of lexical priming, with corpus analysis revealing the patterns on which these cognitive primings are textually based. To this end, real-world examples of personification allegory are drawn from the Middle English allegorical poem Piers Plowman relative to a corpus of other late medieval poetic literature. My main findings suggest that the textual functionality attributed to allegorical referents is neither mutually exclusive nor directly correlative to a particular textual pattern, but rather contingent on the degree of animacy-based priming evidenced in their core semantic meaning or textual foregrounding. These results additionally indicate that function-based primings depend on the type of allegory appearing in the text (i.e. property versus class allegory).
Institutional change and transformations in labour and employment standards
Authors: Bureau Marie-Christine , Dieuaide Patrick
Published: August 2018

Initially employed by lawyers and geopolitical experts, the concept of ‘grey zones’ can be usefully applied to analyse the recent changes on the labour market. It provides a means of bypassing the dualist approaches that contrast waged work and self-employment, insiders and outsiders, or, then again, formal and informal work in a binary way. It provides visibility of the decoherence between the institutions associated with waged status and actual employment practices, and the layering of several different kinds of regulation. The ‘grey zones’ approach thus provides an analytical framework for understanding a wide variety of situations and studying various processes of institutional change, giving the actors of this change their rightful place. Although grey zones are often areas where laws are absent or weak, through these actors they can also give rise to new institutions.
Outcome of surgical stabilisation of acetabular fractures in 16 cats
Authors: Haine David L , Parsons Kevin , Barthelemy Nicolas , Burton Neil , Langley-Hobbs Sorrel L
Published: August 2018

Objectives

The aim of this study is to describe the presentation, surgical management and perioperative outcome of cats with acetabular fractures.

Methods

Case records and radiographs of cats with acetabular fractures were reviewed from presentation to the end of follow-up. Surgical technique, complications, radiographic reduction and the presence of neurological deficits were recorded.

Results

Sixteen cats with 17 acetabular fractures met the inclusion criteria. All fractures were associated with concurrent orthopaedic injuries. All cats were either moderately or severely lame on presentation. Five fractures were stabilised using screws, wire, pins and polymethylmethacrylate, nine were repaired using a straight dynamic compression plate and three were repaired using a locking plate. Two of seven cats that were neurologically normal prior to surgery developed transient neuropraxia following surgery. There were three major complications and no minor complications. At the end of follow-up 3/16 cats had full function, whereas 13/16 had acceptable function.

Conclusions and relevance

All cats undergoing surgical stabilisation of acetabular fractures returned to full or acceptable function by the end of the follow-up period and there was a low number of intraoperative and short-term complications. Neurological deficits were common preoperatively, but the majority of these deficits had resolved by follow-up.
Assessment of menace response in neurologically and ophthalmologically healthy cats
Authors: Quitt Pia R , Reese Sven , Fischer Andrea , Bertram Simon , Tauber Clara , Matiasek Lara
Published: August 2018

Objectives

Assessment and interpretation of menace response (MeR) in cats can be challenging. The prevalence of abnormal MeR in healthy cats is unknown. The aim of this study was to prospectively evaluate MeR in visually healthy cats.

Methods

Fifty cats without history or clinical evidence of neurological or ophthalmological disease were assessed by two examiners: standing behind the cat (mode A), in front of the cat (mode B), and in front of the cat, covering the contralateral eye (mode C). MeR was scored from 1–5 (absent, weak, moderate, strong, complete). Examination modes were compared concerning presence and score (descriptive statistic, 95% confidence interval, χ2 test). This was compared to a three-level scoring system (negative, reduced, positive). Score reproducibility between the two examiners was assessed (Cohen’s kappa [κ] test). Video footage allowed self-re-evaluation and evaluation of the second examiner (κ analysis). Learning/tiring effect (McNemar test), influence of age, body weight (Spearman’s rho test), skull type (χ2 test) and being an indoor or outdoor cat (Mann–Whitney U-test) were evaluated.

Results

MeR was always elicited with at least one technique. Comparable results were obtained with the five- and three-level scoring systems. Mode A achieved strong/complete (positive) MeR in 84.5%, mode B in 82% and mode C in 60%. Exact score reproducibility between the two examiners was slight to fair (κ = 0.208–0.281). Intrarater agreement for video self-assessment (κ = 0.544–0.639), as well as inter-rater agreement (extrinsic video assessment), was moderate to substantial (κ = 0.584–0.645). No learning/tiring effect ( P = 0.530) or association with body weight ( P = 0.897), age ( P = 0.724), skull type ( P >0.05) and being an indoor/outdoor cat ( P = 0.511) were evident.

Conclusions and relevance

The majority of visually healthy cats revealed a strong/complete MeR when the contralateral eye remained uncovered, but 40% failed when the contralateral eye was covered. The most reliable examination mode was achieved standing behind the cat.
Sleep, Lifestyle Behaviors, and Cardiometabolic Health Markers in Overweight/Obese Young Adults: A Pilot Study Using the SenseWear® Armband
Authors: Cha EunSeok , Talman Molly Sarah , Massey Ann H. , Yan Fengxia , Rogers Ann E.
Published: August 2018

Aim:

This pilot study examined associations between sleep quality and metabolic risk profiles, underlying hormones, inflammatory markers, and behaviors in overweight and obese young adults, aged 18–29 years.

Design:

Cross-sectional, descriptive, correlational study design.

Method:

A partial sample ( n = 29) was re-recruited from a parent study on screening for risk of early-onset diabetes. BodyMedia’s SenseWear® armband was used to assess sleep quality. Based on the percentage of consolidated sleep days during the past week, participants were classified as poor, fair, or good sleepers. Multiple multivariate general linear models were used to examine group differences in study variables after adjusting for obesity impact.

Results:

There were no significant differences among groups in age (mean 23.5 ± 2.9 years) or body mass index (mean 38.0 ± 8.9 kg/m2). Good sleepers ( n = 12, 41.4%) showed the longest nocturnal sleep duration (7:53 ± 1:00 hr), followed by fair ( n = 12, 41.4%, 7:23 ± 1:34 hr) and poor sleepers ( n = 5, 17.2%, 5:34 ± 0:56 hr). Poor sleepers showed the highest plasma resistin (η2 = .103) and ghrelin (η2 = .205) levels and caloric (η2 = .255) and sodium (η2 = .156) intakes. No differences in clinical metabolic markers or serum leptin or adiponectin were observed.

Conclusions:

Overweight/obese young adults had irregular sleep schedules and patterns, indicators of poor sleep quality, that were possibly associated with changes in dietary behaviors and underlying plasma hormones. In addition to traditional clinical cardiometabolic markers, plasma resistin and ghrelin may be good predictors of heightened vulnerability to cardiometabolic diseases in overweight/obese young adults with poor-quality sleep.
Placement of tunneled cuffed catheter for hemodialysis: Micropuncture kit versus Angiocath IV catheter
Authors: Lee Jin Ho , Hwang Seun Deuk , Song Joon Ho , Kim HeeYeoun , Lee Dong Yeol , Oh Joon Seok , Sin Yong Hun , Kim Joong Kyung
Published: August 2018

Introduction:

Tunneled cuffed catheters provide stable, instantaneous, long-term intravenous access for hemodialysis. Because catheterization is often performed in emergency situations, speed and accuracy are emphasized.

Methods:

We retrospectively compared the Micropuncture kit with the standard 18-gauge Angiocath IV catheter for tunneled cuffed catheter insertion in the right jugular vein. From June 2016 to May 2017, 31 tunneled cuffed catheters were successfully inserted via the Micropuncture kit and another 31 via the Angiocath IV catheter. All patients underwent the same ultrasound-guided procedure performed by a single experienced interventionalist. Procedure time was the time from draping of the patient to the completion of povidone dressing after the catheterization. In our center, the Angio Lab nurse maintains records, including procedure time and method for every procedure. All patient records were retrospectively tracked through electronic medical record review. The primary outcome was procedure time and the secondary outcomes were complications and cost-effectiveness.

Results:

There were no significant differences in the patients’ demographic data between the two groups. However, procedure time was significantly shorter in the Angiocath group than in the Micropuncture group (12.4 ± 3.5 vs 17.6 ± 6.9 min, p = 0.001); there were no serious complications, such as hemorrhage, pneumothorax, or hematoma, in both groups. Moreover, cost-effectiveness was better in the Angiocath group than in the Micropuncture group (0.34 vs 52 US$, p < 0.01).

Conclusions:

Using the Angiocath IV catheter can reduce procedure time and cost with no severe complications. Moreover, experienced practitioners can reduce the risk of complications when using Angiocath. There are several limitations to this study. First, it was retrospective; second, it was not randomized; and finally, it was conducted by only one experienced interventionalist.
An accurate method for determination of the performance characteristics of membrane-type restrictors
Authors: Pan Wei , Zhang Yongtao , Lu Changhou
Published: August 2018

The determination of flow rate and fluid resistance for membrane-type restrictors is modified in this paper, and it can be more accurate and confident from the measurements in experiments. Three coupled equations including Reynolds equation, membrane deformation equation of large axisymmetric deflection and flow rate equation have been used to establish the mathematical model of membrane-type restrictor and solved simultaneously. Several cases are simulated by the traditional method and the modified numerical method, and the simulation results are compared with experimental data for flow rates and fluid resistances. It has been found that the determination of the performance characteristics of membrane-type restrictors is significantly affected by the hypotheses of membrane deflection scales, the pressures distribution and the gap height between the sill and membrane. The numerical results of the modified method are much more approximated to the actual flow rate measured in Kang et al.’s work than those of the traditional formula, and the proposed method can increase the determination accuracy of the flow rate and restriction coefficient in the design of membrane-type restrictors distinctly.
The effectiveness of voice-on and voice-off instruction on ASL vocabulary acquisition
Authors: Traxler Rachel Elizabeth , Nakatsukasa Kimi
Published: August 2018

Whether to use spoken English for the instruction of American Sign Language (ASL) is a pedagogical debate for those teaching hearing second language learners. Previous investigations have found the use of learners’ first language to be beneficial for vocabulary acquisition. Studies on sign languages, however, have found that a class taught completely using signs is more beneficial than a class that incorporates spoken English, although the cognitive theory of multimedia learning argues that receiving input in various modalities fosters learning. In the present study, the efficacy of voice-on or voice-off instruction for acquisition of ASL vocabulary is examined. Twenty-six hearing adult students in an ASL class received either voice-on (spoken English) or voice-off (ASL only) instruction for 13 vocabulary items. They completed a comprehension test in the pretest, immediate posttest, and delayed posttest, as well as a production test in the immediate and delayed posttest. The results showed significant improvements over time for both conditions for comprehension and production; however, no differences between the two conditions were observed.
Self-efficacy, infant feeding practices, and infant weight gain: An integrative review
Authors: Bahorski Jessica S , Childs Gwendolyn D , Loan Lori A , Azuero Andres , Morrison Shannon A , Chandler-Laney Paula C , Hodges Eric A , Rice Marti H
Published: August 2018

It has been suggested that self-efficacy specific to parenting or feeding may influence the decisions parents make regarding infant feeding; however, a review of this topic has not been conducted. The purpose of this integrative review is to synthesize the literature regarding the potential role of self-efficacy in infant feeding practices or infant weight gain. A total of 40 articles were used to guide this review, which were classified into three categories examining an association with self-efficacy (1) breastfeeding; (2) infant feeding practices such as parental feeding style and dietary quality; and (3) infant weight gain. Evidence regarding breastfeeding self-efficacy (BFSE) and breastfeeding is extensive; mothers with a higher sense of BFSE more often initiate breastfeeding and breastfeed for longer durations. The evidence regarding self-efficacy and the association with infant feeding practices other than breastfeeding is sparse. However, several studies report that mothers who have a higher sense of self-efficacy are more likely to follow infant feeding practices which align with recommendations. The authors have speculated an association between self-efficacy and infant weight gain; yet, to date, no study has found a significant association. More research is needed on the topic, particularly in diverse populations and with fathers and mothers.
Model updating–based damage detection of a concrete beam utilizing experimental damped frequency response functions
Authors: Pu Qianhui , Hong Yu , Chen Liangjun , Yang Shili , Xu Xikun
Published: August 2018

This article evaluates the use of experimental frequency response functions for damage detection and quantification of a concrete beam with the help of model updating theory. The approach is formulated as an optimization problem that intends to adjust the analytical frequency response functions from a benchmark finite element model to match with the experimental frequency response functions from the damaged structure. Neither model expansion nor reduction is needed because the individual analytical frequency response function formulation is derived. Unlike the commonly used approaches that assume zero damping or viscous damping for simplicity, a more realistic hysteretic damping model is considered in the analytical frequency response function formulation. The accuracy and anti-noise ability of the proposed approach are first verified by the numerical simulations. Next, a laboratory reinforced concrete beam with different levels of damage is utilized to investigate the applicability in an actual test. The results show successful damage quantification and damping updating of the beam by matching the analytical frequency response functions with the experimental frequency response functions in each damage scenario.
The Chinese Cohort 60s and Japan: A journey of emotions
Authors: Zhang Yunzi , Cai Liping , Qiu Shangzhi
Published: August 2018

The Chinese outbound market exerts a substantial economic impact on the Japanese tourist industry. Yet history-inspired disputes between the two nations often cause fluctuations in the market. Through a qualitative inquiry with 27 interviewees, this study explores how the Chinese Cohort 60’s memories of, and emotions toward, Japan have evolved in the past 60 years and how the interplay of memories and emotions explain the cohort’s intention to visit Japan. Three subgroups emerged from the interview data, which exhibited different degrees of travel intention that were attributable to the variation of their memories of Japan. While all three subgroups held the declarative memory of the anti-Japanese war, regions of interviewees’ origin and their family histories were found to be significantly related to their distinctive emotions toward Japan. A Memory-Emotion-Time framework is developed that illustrates how memory and emotion influence one’s travel decisions in the context of history.
Hydroelastic analysis of surface-piercing propeller through one-way and two-way coupling approaches
Authors: Javanmardi Nasrin , Ghadimi Parviz
Published: August 2018

Semi-submerged operation of surface-piercing propellers can cause severe structural stress and deflection due to the high-rate variation of the hydrodynamic loads on each blade in one cycle of revolution. Therefore, a proper hydroelastic analysis regarding these propellers seems imperative. Accordingly, in this article, hydrodynamic performance of a surface-piercing propeller is studied by considering the structural flexibility. The one-way and two-way coupled unsteady Reynolds-averaged Navier–Stokes equations (finite volume method used for the fluid analysis) and direct finite element method (used for the structural analysis) are utilized to analyze an 821-b surface-piercing propeller model. The obtained ventilation patterns and hydrodynamic loads on a single blade of this propeller are compared with the published experimental data. ANSYS multiphysics solvers are used to conduct the targeted simulations. The results are presented for different velocity ratios in the range of [0.8, 1.2] and Froude number Fr = 6.0. The blade maximum deformation and von Mises stress are presented in one cycle of revolution. Based on the obtained results, one may conclude that both the adopted approaches predict the propeller transient hydrodynamic characteristics with good accuracy, compared with the experimental data. However, the two-way approach displays lower maximum structural displacement and stress than one-way simulation. This is attributed to the fact that the two-way approach takes into consideration the added mass and damping effects of the surrounding fluid around the blade.
Application of 4T-PET fibers/nonwovens for leucocyte filters
Authors: Huang Wan-Chen , Lo Shyh-Chyi , Lin Dong-Tsamn , Wang Jyh-Horng , Young Tai-Horng
Published: August 2018

Polyethylene terephthalate (PET) fiber with four T-lobe cross section (4T-fiber) has been applied to textile products due to the structural characteristic of micro-grooved channels to provide the high wicking, warming, and elastic properties. In this study, nonwoven (NW) filters composed of one layer of 4T-PET NW (containing 65% 4T-fibers) with one, three, or five layers of polypropylene (PP) NW (4T-PET NW + PP NW × 1, 3, or 5) were proposed for blood filtration to remove leucocytes to reduce blood transfusion-related adverse reactions. The removal rate of leucocytes could be enhanced when the PP NW layers were increased. The presence of the 4T-PET NW on the surface of five layers of PP NW (4T-PET NW + PP NW × 5) filters resulted in a higher erythrocyte recovery rate without losing the capability to remove leucocytes and platelets. Based on the theoretical analysis, leucodepletion filters were further prepared by stacking four 4T-PET NW + PP NW × 5 units together. The optimum filtration results of the filters for filtrating 110 mL of red blood cell concentrates could be prepared when four units of 4T-PET NW + PP × 5 NW placed in a series combination.
High-Frequency Irreversible Electroporation for Intracranial Meningioma: A Feasibility Study in a Spontaneous Canine Tumor Model
Authors: Latouche Eduardo L. , Arena Christopher B. , Ivey Jill W. , Garcia Paulo A. , Pancotto Theresa E. , Pavlisko Noah , Verbridge Scott S. , Davalos Rafael V. , Rossmeisl John H.
Published: August 2018

High-frequency irreversible electroporation is a nonthermal method of tissue ablation that uses bursts of 0.5- to 2.0-microsecond bipolar electric pulses to permeabilize cell membranes and induce cell death. High-frequency irreversible electroporation has potential advantages for use in neurosurgery, including the ability to deliver pulses without inducing muscle contraction, inherent selectivity against malignant cells, and the capability of simultaneously opening the blood–brain barrier surrounding regions of ablation. Our objective was to determine whether high-frequency irreversible electroporation pulses capable of tumor ablation could be delivered to dogs with intracranial meningiomas. Three dogs with intracranial meningiomas were treated. Patient-specific treatment plans were generated using magnetic resonance imaging-based tissue segmentation, volumetric meshing, and finite element modeling. Following tumor biopsy, high-frequency irreversible electroporation pulses were stereotactically delivered in situ followed by tumor resection and morphologic and volumetric assessments of ablations. Clinical evaluations of treatment included pre- and posttreatment clinical, laboratory, and magnetic resonance imaging examinations and adverse event monitoring for 2 weeks posttreatment. High-frequency irreversible electroporation pulses were administered successfully in all patients. No adverse events directly attributable to high-frequency irreversible electroporation were observed. Individual ablations resulted in volumes of tumor necrosis ranging from 0.25 to 1.29 cm3. In one dog, nonuniform ablations were observed, with viable tumor cells remaining around foci of intratumoral mineralization. In conclusion, high-frequency irreversible electroporation pulses can be delivered to brain tumors, including areas adjacent to critical vasculature, and are capable of producing clinically relevant volumes of tumor ablation. Mineralization may complicate achievement of complete tumor ablation.
Navigation Systems for Treatment Planning and Execution of Percutaneous Irreversible Electroporation
Authors: Fuhrmann Irene , Probst Ute , Wiggermann Philipp , Beyer Lukas
Published: August 2018

The application of navigational systems has the potential to improve percutaneous interventions. The accuracy of ablation probe placement can be increased and radiation doses reduced. Two different types of systems can be distinguished, tracking systems and robotic systems. This review gives an overview of navigation devices for clinical application and summarizes first findings in the implementation of navigation in percutaneous interventions using irreversible electroporation. Because of the high number of navigation systems, this review focuses on commercially available ones.
Preoperative PROMIS Scores Predict Postoperative PROMIS Score Improvement for Patients Undergoing Hand Surgery
Authors: Bernstein David N. , Houck Jeff R. , Gonzalez Ronald M. , Wilbur Danielle M. , Miller Richard J. , Mitten David J. , Hammert Warren C.
Published: August 2018

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) can be used alongside preoperative patient characteristics to set postsurgery expectations. This study aimed to analyze whether preoperative scores can predict significant postoperative PROMIS score improvement. Methods: Patients undergoing hand and wrist surgery with initial and greater than 6-month follow-up PROMIS scores were assigned to derivation or validation cohorts, separating trauma and nontrauma conditions. Receiver operating characteristic curves were calculated for the derivation cohort to determine whether preoperative PROMIS scores could predict postoperative PROMIS score improvement utilizing minimal clinically important difference principles. Results: In the nontrauma sample, patients with baseline Physical Function (PF) scores below 31.0 and Pain Interference (PI) and Depression scores above 68.2 and 62.2, respectively, improved their postoperative PROMIS scores with 95%, 96%, and 94% specificity. Patients with baseline PF scores above 52.1 and PI and Depression scores below 49.5 and 39.5, respectively, did not substantially improve their postoperative PROMIS scores with 94%, 93%, and 96% sensitivity. In the trauma sample, patients with baseline PF scores below 34.8 and PI and Depression scores above 69.2 and 62.2, respectively, each improved their postoperative PROMIS scores with 95% specificity. Patients with baseline PF scores above 52.1 and PI and Depression scores below 46.6 and 44.0, respectively, did not substantially improve their postoperative scores with 95%, 94%, and 95% sensitivity. Conclusions: Preoperative PROMIS PF, PI, and Depression scores can predict postoperative PROMIS score improvement for a select group of patients, which may help in setting expectations. Future work can help determine the level of true clinical improvement these findings represent.
Microsurgical clipping and endovascular treatment of middle cerebral artery aneurysms in an interdisciplinary treatment concept: Comparison of long-term results
Authors: Schwartz Christoph , Aster Hans-Christoph , Al-Schameri Rahman , Müller-Thies-Broussalis Erasmia , Griessenauer Christoph J , Killer-Oberpfalzer Monika
Published: August 2018

Objective

Treatment of middle cerebral artery (MCA) aneurysms has been historically considered as the almost exclusive domain of microsurgical clipping. This retrospective single-center study assesses whether microsurgical clipping or endovascular treatment (i.e. coiling and/or stenting) for MCA aneurysms yielded better occlusion rates and clinical outcome.

Methods

We identified patients with a minimum clinical follow-up of 12 months who had undergone MCA aneurysm repair either by clipping or by endovascular treatment between 2005 and 2015. Aneurysm occlusion rates were assessed by the Raymond-Roy Occlusion Classification (RROC) and patients’ clinical outcome was measured by the modified Rankin Scale (mRS). All patients had been treated in an interdisciplinary treatment concept at a large neurovascular center; both treatment modalities were available at all times.

Results

Ninety-two eligible patients with MCA aneurysms, of whom 21.7% patients were treated for subarachnoid hemorrhages, were included; 38 patients underwent endovascular therapy and 54 clipping. The median age at treatment was 53.5 years (range, 25–79 years) and the median clinical follow-up was 98.5 months (range, 18–213 months). Occlusion rates were significantly higher in the clipping cohort (RROC = 1: 96.3% vs 78.9%; p = 0.04), long-term clinical outcome was better in the endovascular treatment cohort (mRS ≤ 1: 100.0% vs 90.8%; p < 0.01). Permanent treatment-associated morbidity was seen more commonly in the clipping cohort (9.3% vs 0.0%).

Conclusions

Both treatment modalities are associated with excellent clinical and radiological outcome if applied within an interdisciplinary treatment concept. Endovascular aneurysm repair appears to be an attractive treatment alternative compared to clipping with low complication rates for well-selected patients.
Model for improvement of overall equipment effectiveness of beerfilling lines
Authors: He Fei , Shen Kang , Lu Lijing , Tong Yifei
Published: August 2018

In this article, the efficiency loss of a beer filling line is investigated and modeled to improve its system performance in terms of overall equipment effectiveness and productivity. First, research is aimed at problems related to beer filling line resulting from poor production management where utilization and productivity of filling machines are low. This article derives the overall equipment effectiveness of filling machines and overall throughput effectiveness of the filling line, with the overall throughput effectiveness of general system (OTE(S)) obtained based on these measurements. Based on these metrics, the efficiency evaluation system is established. Next, according to the efficiency evaluation indexes, overall equipment effectiveness, and OTE(S), the overall efficiency of filling machines and filling line are calculated, respectively. From the results, the stenciling machine has the lowest efficiency. However, considering overall throughput effectiveness indexes and production capacity, unit 3 is the bottleneck and limits the entire productivity. Finally, efficiency loss is analyzed based on the overall equipment effectiveness and OTE(S) calculation results. Using a fishbone diagram for analysis, the cause of equipment loss is summarized and countermeasures are offered. Theory of constraint is used to analyze the efficiency loss of the filling line and give suggestions for improvement. This research can help beer enterprises achieve continuous improvement of equipment efficiency and production capacity.
Comparing two methods for delivering clinical trial informed consent information to older adults: singular versus stepped approach
Authors: O’Hare Fleur , Flanagan Zachary , Nelson Mark , Curtis Andrea , Heritier Stephane , Spark Simone , Zoungas Sophia
Published: August 2018

Background

Adapting the informed consent process to the needs of older adults may enhance engagement and willingness to participate in a clinical trial. A key aspect of the process is being provided with written clinical trial information and consent documents and having an opportunity to discuss the information with the researcher. However, there are no guidelines on the most appropriate method for delivering this information to older adults and it is not known whether the delivery method is a facilitator or barrier towards clinical trial participation.

Aims

To compare two delivery methods of informed consent on recruitment, refusal to continue and randomisation rates in a general practice-based clinical trial involving older adults.

Methods

In a matched cohort sub-study as part of the STAtins in Reducing Events in the Elderly clinical trial, 520 participants were allocated into two groups by age, gender and attending general practice location, to receive the trial information and consent form in the mail (Method 1) prior to the first baseline visit or in person (Method 2) at the visit where a comprehensive informed consent process took place.

Results

Compared with Method 1, potential participants assigned to Method 2 were more likely to agree to attend the first baseline screening visit (refusal rate 20% vs 13.5%, respectively, p = 0.05). However, there was no significant difference in the proportion of participants recruited into the trial by providing written informed consent at the first baseline screening visit. For each informed consent delivery method, similar proportions of participants refused to take part in the trial by the end of the screening phase. Randomisation rates in the two groups were also similar. Time to conduct the informed consent procedure took significantly longer with Method 2 compared with Method 1 (median time 20 vs 15 min, respectively, p < 0.01). Interest in the research trial topic was the main reason cited (33.4%) for considering trial participation.

Conclusion

Later delivery of informed consent documents to potential participants in this trial was associated with a small increase in attendance at the first, in person, screening visit. However, the randomisation rate of participants into the trial was not affected by the method and timing of delivery of informed consent information. Similar randomisation rates occurred whether potential participants were mailed informed consent documents prior to the first in person screening visit or were given the information at the screening visit.
In Vitro Sugar Interference Testing With Amperometric Glucose Oxidase Sensors
Authors: Boehm Ryan , Donovan John , Sheth Disha , Durfor Andrew , Roberts Jason , Isayeva Irada
Published: August 2018

Background:

Electrochemical enzymatic glucose sensors are intended to measure blood or interstitial fluid glucose concentrations. One class of these glucose sensors are continuous glucose monitors (CGMs), indicated for tracking and trending of glucose concentrations in interstitial fluid and as an adjunct to blood glucose testing. Currently approved CGMs employ a glucose oxidase (GOx) electrochemical detection scheme. Potential interfering agents can impact the accuracy of results obtained by glucose sensors, including CGMs.

Methods:

Seven sugars, seven sugar alcohols, and three artificial sweeteners were in vitro screened for interference with amperometric glucose oxidase (GOx) sensors at concentrations greater than physiologic concentrations. Galactose was investigated further at physiologically relevant concentrations using a custom amperometric system. Furthermore, glucose and galactose calibration experiments were conducted to facilitate multiple enzyme kinetic analysis approaches (Michaelis-Menten and Hill equation) to understand the potential source and mechanism of interference from galactose.

Results:

Under in vitro testing, except for galactose, xylose and mannose, all screened compounds exhibited interference bias, expressed in mean absolute relative difference (MARD), of ⩽ 20% even at concentrations significantly higher than normal physiologic concentrations. Galactose exhibited, CGM-dependent, MARD of 47-72% and was subjected to further testing. The highest recorded mean relative difference (MRD) was 6.9 ± 1.3% when testing physiologically relevant galactose concentrations (0.1-10 mg/dL). Enzyme kinetic analysis provided calculations of maximum reaction rates ([Formula: see text]), apparent Michaelis constants ([Formula: see text]), and Hill equation h parameters for glucose and galactose substrates for the enzymes in the CGMs.

Conclusion:

Under the conditions of in vitro screening, 14 of the 17 compounds did not exhibit measuarable interference. Galactose exhibited the highest interference during screening, but did not substantially interfere with CGMs under the conditions of in vitro testing at physiologically relevant concentrations. Enzyme kinetic analysis conducted with galactose supported the notion that (1) the reactivity of GOx enzyme toward nonglucose sugars and (2) the presence of enzymatic impurities (such as galactose oxidase) are two potential sources for sugar interference with GOx glucose sensors, and thus, should be considered during device development.
Confiding Secrets and Well-Being
Authors: Slepian Michael L. , Moulton-Tetlock Edythe
Published: August 2018

How does confiding secrets relate to well-being? The current work presents the first empirical examination of mechanisms by which confiding diverse real-world secrets to known others predicts well-being. We examined over 800 participants with more than 10,000 secrets in total, finding that confiding a secret does not predict reduced instances of concealment. Rather, confiding a secret predicts higher well-being through perceived coping efficacy. Correlational and experimental studies find that through confiding a secret, people feel they obtain social support and are more capable in coping with the secret. Additionally, through perceived coping efficacy, confiding a secret predicts less frequent mind wandering to the secret. Confiding predicts higher well-being through changing the way and how often people think about their secret.
Electronic monitoring and monitoring probation: The case of Ireland
Authors: Moss Brian
Published: August 2018

Set against an environment of diverse reforms across the domestic criminal justice system, including new oversight arrangements, the current article considers how probation in Ireland has almost entirely escaped notice. A case for probation oversight is made on the basis of its caseload size but also a decade of unaccounted use of electronic monitoring (EM). Global EM use highlights questions about domestic probation standards, research and planning. Shortcomings within the legislative consultation process around the tool’s role, the lack of any evaluation of EM suppliers and increasing focus on data management to date also bolster a case for oversight of Irish probation. A principal issue within this set of challenges for probation is how EM might adjust traditional agency values. Overall, the contention is made that the assumed exceptionalism of Republic of Ireland’s criminal justice system, that which acts as a buffer to change, may no longer be valid.
Mediating Instructional Reform: An Examination of the Relationship Between District Policy and Instructional Coaching
Authors: Woulfin Sarah L.
Published: August 2018

Districts make and implement policies aiming to improve structures, practices, and outcomes. Instructional coaching has become a popular lever to catalyze instructional improvement efforts. However, many questions remain about the alignment between coaching and reforms. This article draws on coupling theory to analyze the relationship between district policy and instructional coaches’ work. Using qualitative case study data from a midsized urban district, I illuminate how coaching reflected three reforms: data use, teacher evaluation, and the Elementary English Language Arts program. I argue that cultural-cognitive, normative, and regulative mechanisms shaped the linkages between each reform and coaches’ work in schools. I reveal that structures and routines of coaching matter for coupling policy with practice. These findings have implications for policymakers, scholars, and educators concerned with leaders’ roles and responsibilities in enacting instructional reform.
Surgically treated lung cancer patients: do they all smoke and would they all have been detected with lung cancer screening?
Authors: Laisaar Tanel , Sarana Bruno , Benno Indrek , Laisaar Kaja-Triin
Published: August 2018

Since publication of the National Lung Cancer Screening Trial (NLST) results early lung cancer detection has been widely studied, targeting individuals based on smoking history and age. However, over recent decades several changes in lung cancer epidemiology, including risk factors, have taken place. The aim of the current study was to explore smoking prevalence among lung cancer patients who had been treated surgically or undergone a diagnostic operation and whether these patients would have met the NLST inclusion criteria.

All patients operated on for lung cancer in a university hospital in Estonia between 2009 and 2015 were included. Data were collected from hospital records.

426 patients were operated on for lung cancer, with smoking history properly documented in 327 patients (87 females; median age 67 years). 170 (52%) patients were smokers, 97 (30%) patients were ex-smokers and 60 (18%) patients were nonsmokers. The proportion of females among smokers was 15%, among ex-smokers was 9% and among nonsmokers was 87%. 107 of our patients would not have met the NLST age criteria and 128 of our patients would not have met the NLST smoking criteria. In total, 183 patients (56% (79% of females and 48% of males)) would not have met the NLST inclusion criteria.

Only half of surgically treated lung cancer patients were current smokers and more than half did not meet the NLST inclusion criteria.
Gel electrophoresis of human sperm: a simple method for evaluating sperm protein quality
Authors: Fanny Jumeau , Julien Sigala , Francisco-Jose Fernandez-Gomez , Sabiha Eddarkaoui , Sophie Duban-Deweer , Luc Buée , Hélène Béhal , Nicolas Sergeant , Valérie Mitchell
Published: August 2018

Background

The limitations of conventional sperm analyses have highlighted the need for additional means of evaluating sperm quality.

Methods

In a study of a cohort of 245 men with known conventional sperm parameters, one-dimensional PAGE was used to monitor protein content and quality in samples from individual ejaculates.

Results

The sperm protein content varied markedly from sample to another, especially in the high-molecular-weight range. The intensity of the 80–110 kDa bands was correlated with progressive motility (r = 0.15,p = 0.015)and was significantly higher (p = 0.0367) in the group of men with conventional parameters above the World Health Organization’s 2010 reference values than in the group with at least one subnormal parameter (i.e. semen volume, sperm concentration, sperm count per ejaculate, progressive motility, proportion of normal forms or multiple anomaly index below the lower reference value). Using mass spectrometry, the 80–110 kDa bands were found to correspond primarily to three proteins from the flagellum’s fibrous sheath: A-kinase anchor protein 4, A-kinase anchor protein 3, and spermatogenic cell-specific type 1 hexokinase.

Conclusion

One-dimensional PAGE constitutes a simple, rapid, reliable, inexpensive method for analyzing proteins associated with sperm motility in individual human ejaculates.
Precision Trial Drawer, a Computational Tool to Assist Planning of Genomics-Driven Trials in Oncology
Authors: Melloni Giorgio E.M. , Guida Alessandro , Curigliano Giuseppe , Botteri Edoardo , Esposito Angela , Kamal Maude , Le Tourneau Christoph , Riva Laura , Magi Alberto , de Maria Ruggero , Pelicci Piergiuseppe , Mazzarella Luca
Published: August 2018

Purpose

Trials that accrue participants on the basis of genetic biomarkers are a powerful means of testing targeted drugs, but they are often complicated by the rarity of the biomarker-positive population. Umbrella trials circumvent this by testing multiple hypotheses to maximize accrual. However, bigger trials have higher chances of conflicting treatment allocations because of the coexistence of multiple actionable alterations; allocation strategies greatly affect the efficiency of enrollment and should be carefully planned on the basis of relative mutation frequencies, leveraging information from large sequencing projects.

Methods

We developed software named Precision Trial Drawer (PTD) to estimate parameters that are useful for designing precision trials, most importantly, the number of patients needed to molecularly screen (NNMS) and the allocation rule that maximizes patient accrual on the basis of mutation frequency, systematically assigning patients with conflicting allocations to the drug associated with the rarer mutation. We used data from The Cancer Genome Atlas to show their potential in a 10-arm imaginary trial of multiple cancers on the basis of genetic alterations suggested by the past Molecular Analysis for Personalised Therapy (MAP) conference. We validated PTD predictions versus real data from the SHIVA (A Randomized Phase II Trial Comparing Therapy Based on Tumor Molecular Profiling Versus Conventional Therapy in Patients With Refractory Cancer) trial.

Results

In the MAP imaginary trial, PTD-optimized allocation reduces number of patients needed to molecularly screen by up to 71.8% (3.5 times) compared with nonoptimal trial designs. In the SHIVA trial, PTD correctly predicted the fraction of patients with actionable alterations (33.51% [95% CI, 29.4% to 37.6%] in imaginary v 32.92% [95% CI, 28.2% to 37.6%] expected) and allocation to specific treatment groups (RAS/MEK, PI3K/mTOR, or both).

Conclusion

PTD correctly predicts crucial parameters for the design of multiarm genetic biomarker-driven trials. PTD is available as a package in the R programming language and as an open-access Web-based app. It represents a useful resource for the community of precision oncology trialists. The Web-based app is available at https://gmelloni.github.io/ptd/shinyapp.html .