bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Intensive Distribution Logistics Network Design and Profit Allocation Problem considering Sharing Economy
Authors: Gan Mi , Yang Shuai , Li Dandan , Wang Mingfei , Chen Si , Xie Ronghui , Liu Jiyang
Published: April 2018

The rapid growth of logistics distribution highlights the problems including the imperfect infrastructure of logistics distribution network, the serious shortage of distribution capacity of each individual enterprise, and the high cost of distribution in China. While the development of sharing economy makes it possible to achieve the integration of whole social logistic resources, big data technology can grasp customer’s logistics demand accurately on the basis of analyzing the customer’s logistics distribution preference, which contributes to the integration and optimization of the whole logistics resources. This paper proposes a kind of intensive distribution logistics network considering sharing economy, which assumes that all the social logistics suppliers build a strategic alliance, and individual idle logistics resources are also used to deal with distribution needs. Analyzing customer shopping behavior by the big data technology to determine customer’s logistics preference on the basis of dividing the customer’s logistics preference into high speed, low cost, and low pollution and then constructing the corresponding objective function model according to different logistics preferences, we obtain the intensive distribution logistics network model and solve it with heuristic algorithm. Furthermore, this paper analyzes the mechanism of interest distribution of the participants in the distribution network and puts forward an improved interval Shapley value method considering both satisfaction and contribution, with case verifying the feasibility and effectiveness of the model. The results showed that, compared with the traditional Shapley method, distribution coefficient calculated by the improved model could be fairer, improve stakeholder satisfaction, and promote the sustainable development of the alliance as well.
Ordinary Cannulated Compression Screws or Headless Cannulated Compression Screws? A Synthetic Bone Biomechanical Research in the Internal Fixation of Vertical Femoral Neck Fracture
Authors: Zhang Baokun , Liu Jingwen , Zhang Wei
Published: April 2018

Purpose. The purpose of this study is to verify whether the headless cannulated compression screw (HCCS) has higher biomechanical stability than the ordinary cannulated compression screw (OCCS) in the treatment of vertical femoral neck fractures. Materials and Methods. 30 synthetic femur models were equally divided into 2 groups, with 50°, 60°, and 70° Pauwels angle of femoral neck fracture, under 3D printed guiding plates and C-arm fluoroscopic guidance. The femur molds were fixed with three parallel OCCSs as OCCS group and three parallel HCCSs as HCCS group. All specimens were tested for compressive strength and maximum load to failure with a loading rate of 2 mm/min. Results. The result showed that there was no significant difference with the compressive strength in the Pauwels angle of 50° and 60°. However, we observed that the maximum load to failure with the Pauwels angle of 50°, 60°, and 70° and the compressive strength with 70° of HCCS group showed better performance than the OCCS group. Conclusion. HCCS performs with better biomechanical stability than OCCS in the treatment of vertical femoral neck fracture, especially with the Pauwels angle of 70°.
Nonsyndromic Bilateral Posterior Maxillary Supernumerary Teeth: A Report of Two Cases and Review
Authors: Mahto Ravi Kumar , Dixit Shantanu , Kafle Dashrath , Agarwal Aradhana , Bornstein Michael , Dulal Sanad
Published: April 2018

Supernumerary tooth/hyperdontia is defined as those teeth which are present in excess of the usual distribution of twenty deciduous and thirty-two permanent teeth. It can be seen in both syndromic and nonsyndromic patients. In Nepalese population, prevalence of supernumerary tooth is documented to be 1.6%. To the best of our knowledge, no studies from Nepal have reported the incidence of bilateral maxillary paramolars or the combination of unilateral maxillary paramolar and distomolar till date. Hence, we are reporting these two cases with a brief review of literature to put emphasis on incidence, prevalence, proposed hypothesis for etiology, and management of supernumerary teeth.
A Case of Biliary Tract Infection Caused by KPC-2-ProducingKluyvera ascorbata
Authors: Wang Lu , Jing Ying , Lai Kaisheng , An Jingna , Yang Jiyong
Published: April 2018

Kluyveraspp. can cause various infections. However, carbapenemase-producingKluyveraspp. has not been previously reported. We report a case of biliary tract infection caused by KPC-2-producingK. ascorbatain a 13-year-old female. To the best of our knowledge, this is the first report on infection caused by carbapenemase-producingKluyveraspp.
p66Shc Mediates Mitochondrial Dysfunction Dependent on PKC Activation in Airway Epithelial Cells Induced by Cigarette Smoke
Authors: Zhang Ming , Tang Jingjing , Shan Hu , Zhang Qiuhong , Yang Xia , Zhang Jie , Li Yali
Published: April 2018

Airway epithelial mitochondrial injury plays a critical role in the pathogenesis of chronic obstructive pulmonary disease (COPD). The p66Shc adaptor protein is a newly recognized mediator of mitochondrial dysfunction. However, little is known about the effect of p66Shc on airway epithelial damage in the development of COPD. The aim of the present study is to investigate the roles of p66Shc and its upstream regulators in the mitochondrial injury of airway epithelial cells (Beas‐2b) induced by cigarette smoke extract (CSE). Our present study revealed that CSE increased p66Shc expression and its mitochondrial translocation in concentration and time‐dependent manners in airway epithelial cells. And p66Shc siRNA significantly attenuated mitochondrial dysfunction and cell injury when airway epithelial cells were stimulated with 7.5% CSE. The total and phosphorylated expression of PKCβ and PKCδ was significantly increased associated with mitochondrial dysfunction and cell injury when airway epithelial cells were exposed to 7.5% CSE. The pretreatments with pharmacological inhibitors of PKCβ and PKCδ could notably suppress p66Shc phosphorylation and its mitochondrial translocation and protect the mitochondria and cells against oxidative damage when airway epithelial cells were incubated with 7.5% CSE. These data suggest that a novel PKCβ/δ‐p66Shc signaling pathway may be involved in the pathogenesis of COPD and other oxidative stress‐associated pulmonary diseases and provide a potential therapeutic target for these diseases.
A Platform for e-Health Control and Location Services for Wandering Patients
Authors: Carrizales-Villagómez Samantha Yasivee , Nuño-Maganda Marco Aurelio , Rubio-Loyola Javier
Published: April 2018

Wandering patients frequently have diseases that demand continuous health control, such as taking pills at specific times, constant blood pressure and heart rate monitoring, temperature and stress level checkups, and so on. These could be jeopardized by their wandering behavior. Mobile applications that focus on health care have received special interest from medical specialists. These applications have been widely accepted, due to the availability of smart devices that include sensors. However, sensor-based applications are highly energy demanding and as such, they can be unaffordable in mobile e-health control due to battery constraints. This paper presents the design and implementation of a platform aimed at providing support in e-health control and provision of location services for wandering patients through real-time medical and mobility information analysis. The platform includes a configurable mobile application for heart rate and stress level monitoring based on Bluetooth Low Energy technology (BLE), and a web service for monitoring and control of the wandering patients. Due to battery limitations of smart devices with sensors, the mobile application includes energy-efficient handling and transmission policies to make more efficient the transmission of medical information from the sensor-based smart device to the web service. In turn, the web service provides e-health control services for patients and caregivers. Through the platform functionality, caregivers (and patients) can receive notifications and suggestions in response to emergency, contingency situations, or deviations from health and mobility patterns of the wandering patients. This paper describes a platform that conceals continuous monitoring with energy-efficient applications in favor of e-health control of wandering patients.
Gefitinib Inhibits Bleomycin‐Induced Pulmonary Fibrosis via Alleviating the Oxidative Damage in Mice
Authors: Li Li , Cai Lin , Zheng Linxin , Hu Yujie , Yuan Weifeng , Guo Zhenhui , Li Weifeng
Published: April 2018

Pulmonary fibrosis (PF) is a life‐threatening interstitial lung disease. In this study, we tried to reveal the model of action between high‐mobility group box 1 (HMGB1) and α‐smooth muscle actin (α‐SMA) and the protective role of gefitinib in pulmonary fibrosis induced by the administration of bleomycin aerosol in mice. For the mechanism study, lung tissues were harvested two weeks after modeling to detect the coexpression of HMGB1 and α‐SMA by immunohistochemistry and immunofluorescence staining. Protein‐DNA interactions were analyzed using a pulldown assay to study the relationship between HMGB1 and α‐SMA. For the gefitinib treatment study, the mice were divided into three groups: phosphate‐buffered saline (PBS) control group, PBS‐treated PF group, and gefitinib‐treated PF group. Gavage of gefitinib or PBS (20 mg/kg/day) was performed after bleomycin treatment for two weeks until the mice were sacrificed. Lung and blood samples were collected to assess the histological changes, oxidative stress, and expression of NOXs, HMGB1, EGFR, MAPKs, AP‐1, and NF‐κB to determine the curative effect and related molecular mechanisms. The results revealed the high coexpression of α‐SMA and HMGB1 in some interstitial cells in the fibrotic lung. The DNA‐protein pulldown analysis proved that HMGB34367 acted as a novel transcriptional factor for the α‐SMA promoter and participated in the eventual development of pulmonary fibrosis. Second, gefitinib could significantly decrease lung fibrotic changes and the level of MDA and recover the T‐AOC level. Meanwhile, gefitinib could also reduce the NOX1/2/4, HMGB1, p‐EGFR, p‐ERK, p‐JNK, p‐P38, p‐NF‐κB, p‐c‐Jun, and p‐c‐Fos expression levels in fibrotic lungs. The present study suggested that gefitinib could alleviate lung fibrosis through the HMGB1/NOXs‐ROS/EGFR‐MAPKs‐AP‐1/NF‐κB signal in bleomycin‐induced pulmonary fibrosis.
Computational Approach to Investigating Key GO Terms and KEGG Pathways Associated with CNV
Authors: Luo YuanYuan , Yan Yan , Zhang Shiqi , Li Zhen
Published: April 2018

Choroidal neovascularization (CNV) is a severe eye disease that leads to blindness, especially in the elderly population. Various endogenous and exogenous regulatory factors promote its pathogenesis. However, the detailed molecular biological mechanisms of CNV have not been fully revealed. In this study, by using advanced computational tools, a number of key gene ontology (GO) terms and KEGG pathways were selected for CNV. A total of 29 validated genes associated with CNV and 17,639 nonvalidated genes were encoded based on the features derived from the GO terms and KEGG pathways by using the enrichment theory. The widely accepted feature selection method—maximum relevance and minimum redundancy (mRMR)—was applied to analyze and rank the features. An extensive literature review for the top 45 ranking features was conducted to confirm their close associations with CNV. Identifying the molecular biological mechanisms of CNV as described by the GO terms and KEGG pathways may contribute to improving the understanding of the pathogenesis of CNV.
Successful Clarithromycin Monotherapy in a Patient with Primary Follicular Lymphoma of the Duodenum
Authors: Kiesewetter Barbara , Dolak Werner , Mayerhoefer Marius E. , Simonitsch-Klupp Ingrid , Raderer Markus
Published: April 2018

Primary follicular lymphoma of the duodenum (FL-D) constitutes a rare subtype of extranodal follicular lymphoma with a usually indolent course. To date, no distinct treatment recommendations have been defined for those patients. We report the case of a 58-year-old male patient presenting with endoscopically assessed, symptomatic FL-D who was treated with clarithromycin monotherapy in analogy to recent data for mucosa-associated lymphoid tissue lymphoma. Each treatment cycle consisted of clarithromycin 500 mg twice daily for 3 weeks followed by a 2-week break. After four cycles of treatment, the patient showed a very good response with normal macroscopic findings confirmed by endosonographic examination and only focal minimal residual disease of lymphoma persisting in the histological assessment. The patient is currently asymptomatic and without treatment for 24+ months. As clarithromycin combines antimicrobial and direct antiproliferative effects mediated through a variety of pleiotropic mechanisms, this appears to be an interesting treatment approach for indolent lymphoma, particularly in those where a chronic infectious background cannot be completely ruled out, i.e., gastrointestinal manifestations. We suggest further investigation of this treatment approach.
Metabolic Syndrome Severity and Risk of CKD and Worsened GFR: The Jackson Heart Study
Authors: DeBoer Mark D. , Filipp Stephanie L. , Musani Solomon K. , Sims Mario , Okusa Mark D. , Gurka Matthew
Published: April 2018

Background/Aims: The metabolic syndrome (MetS), as assessed using dichotomous criteria, is associated with increased risk of future chronic kidney disease (CKD), though this relationship is unclear among African Americans, who have lower risk for MetS but higher risk for CKD. Methods: We performed logistic regression using a sex- and race-specific MetS-severity z-score to assess risk of incident CKD among 2,627 African-American participants of the Jackson Heart Study, assessed at baseline and 8 years later. Based on quartile of baseline MetS severity, we further assessed prevalence of being in the lowest quartile of baseline GFR, the lowest quartile of relative GFR at follow-up, microalbuminuria and incident CKD. Results: Higher MetS-severity was associated with higher prevalence of GFR in the lowest quartile at baseline among males and females. Among African-American females but not males, higher baseline MetS-severity was associated with a higher prevalence of baseline elevations in microabuminuria (p<0.01), steep decline in GFR (p<0.001) and a higher incidence of CKD (p<0.0001). Women in increasing quartiles of baseline MetS-severity exhibited a linear trend toward higher odds of future CKD (p<0.05), with those in the 4th quartile of MetS-severity (compared to the 1st) having an odds ratio of 2.47 (95% confidence interval 1.13, 5.37); no such relationship was seen among men (p value for trend 0.49). Conclusion: MetS-severity exhibited sex-based interactions regarding risk for future GFR deterioration and CKD, with increasing risk in women but not men. These data may have implications for triggering CKD screening among African-American women with higher degrees of MetS-severity.
Cardiovascular and Cerebrovascular Emergency Department Visits Associated With Wildfire Smoke Exposure in California in 2015
Authors: Wettstein Zachary S. , Hoshiko Sumi , Fahimi Jahan , Harrison Robert J. , Cascio Wayne E. , Rappold Ana G.
Published: April 2018

Background

Wildfire smoke is known to exacerbate respiratory conditions; however, evidence for cardiovascular and cerebrovascular events has been inconsistent, despite biological plausibility.

Methods and Results

A population‐based epidemiologic analysis was conducted for daily cardiovascular and cerebrovascular emergency department (
ED
) visits and wildfire smoke exposure in 2015 among adults in 8 California air basins. A quasi‐Poisson regression model was used for
zip
code‐level counts of
ED
visits, adjusting for heat index, day of week, seasonality, and population. Satellite‐imaged smoke plumes were classified as light, medium, or dense based on model‐estimated concentrations of fine particulate matter. Relative risk was determined for smoky days for lag days 0 to 4. Rates of
ED
visits by age‐ and sex‐stratified groups were also examined. Rates of all‐cause cardiovascular
ED
visits were elevated across all lags, with the greatest increase on dense smoke days and among those aged ≥65 years at lag 0 (relative risk 1.15, 95% confidence interval [1.09, 1.22]). All‐cause cerebrovascular visits were associated with smoke, especially among those 65 years and older, (1.22 [1.00, 1.49], dense smoke, lag 1). Respiratory conditions were also increased, as anticipated (1.18 [1.08, 1.28], adults >65 years, dense smoke, lag 1). No association was found for the control condition, acute appendicitis. Elevated risks for individual diagnoses included myocardial infarction, ischemic heart disease, heart failure, dysrhythmia, pulmonary embolism, ischemic stroke, and transient ischemic attack.

Conclusions

Analysis of an extensive wildfire season found smoke exposure to be associated with cardiovascular and cerebrovascular
ED
visits for all adults, particularly for those over aged 65 years.
Dominic of Flanders’ Critique of John Duns Scotus’ Primary Argument for the Univocity of Being
Authors: D’Ettore Domenic
Published: April 2018

This article considers the attempt by a prominent fifteenth-century follower of Thomas Aquinas, Dominic of Flanders (a.k.a. Flandrensis, 1425-1479), to address John Duns Scotus’ most famous argument for the univocity of being. According to Scotus, the intellect must have a concept of being that is univocal to substantial and accidental being, and to finite and infinite being, on the grounds that an intellect cannot be both certain and doubtful through the same concept, but an intellect can be certain that something is a being while doubting whether it is a substance or accident, finite or infinite. The article shows how Flandrensis’ reply in defence of analogy of being hinges on a more fundamental disagreement with Scotus over the division of the logically one. It also shows how Flandrensis’ answer to this question commits him to a position on the unity of the concept of being that lies between the positions of Scotus and of Flandrensis’ earlier Thomistic sources.
Driving with Parkinson’s disease: Cut points for clinical predictors of on-road outcomes
Authors: Alvarez Liliana , Classen Sherrilene
Published: April 2018

Background.

Parkinson’s disease (PD) is a common neurodegenerative disorder that impacts a person’s fitness to drive. Practitioners require a sensitive and predictive battery of clinical tests to identify at-risk drivers.

Purpose.

This study aimed to identify clinical predictors and their optimal cut points, sensitivity, specificity, and predictive values of on-road outcomes in drivers with PD.

Method.

Participants ( N = 101) underwent a comprehensive driving evaluation. We identified predictors of pass/fail outcomes through logistic regression and computed optimal cut points through receiver operating characteristic curves and corresponding Youden indexes.

Findings.

The Trail Making Test Part B (Trails B; sensitivity = .89, specificity = .74; positive predictive value [PPV] = .71; negative predictive value [NPV] = .91) and contrast sensitivity (sensitivity = .82, specificity = .63; PPV = .61; NPV = .84) emerged as significant predictors. The optimal cut point for the Trails B was 108 s (area under the curve = .86).

Implications.

Occupational therapists can benefit from implementing Trails B and contrast sensitivity screening as part of in-office screening of potentially at-risk drivers with PD.
Identifying opportunities for value chain development in the Kenyan coffee sector
Authors: Aragie Emerta
Published: April 2018

By developing a model that describes the Kenyan coffee value chain, this study evaluates opportunities emanating from four scenarios representing productivity gains in the various value chain stages of the coffee sector and additional three scenarios reflecting shifts in market situations. Results show that productivity-enhancing policies have stronger effects on coffee output and export performance if they target the milling stage of the value chain. Export subsidy and favourable external marketing conditions also have stronger effects, distributed comparably across the various value chain stages. We, however, found that these gains in the coffee sector come at the expense of other cash crops such as cotton, tea, sugar and tobacco. The approach followed in this study is relevant as this trade-off between coffee and the other cash crop sectors may not be visibly shown using standard value chain approaches.
Open thinking
Authors: Cook Deborah
Published: April 2018

Adorno thought that substantive change was not just desirable but also possible. He also offered ideas about what positive change might look like on the basis of his determinate negation of damaged life. This paper begins by exploring Adorno’s ideas about possibility and determinate negation. It also discusses his views about the sort of changes that might be made. Given Adorno’s ideas about the possibility of change, the paper ends by challenging Fabian Freyenhagen’s reading of Adorno (in Adorno’s Practical Philosophy) as a methodological, epistemic, and substantive negativist.
Dissecting intramyocardial hematoma with flexuous channel in myocardium masquerading as a ventricular pseudoaneurysm
Authors: Hao Xinghai , Lu Yang , Zhang Zhu , Jia Ming
Published: April 2018

We report a 58-year-old acute myocardial infarction patient with dissecting intramyocardial hematoma (DIH) disguised as a ventricular pseudoaneurysm. DIH with a flexuous and narrow channel in the myocardium was confirmed during the operation, which extended deeply into the periphery of the ventricular wall. This DIH connected with the left ventricle via a narrow-necked flexuous channel of the myocardial defect and looked like a bulged sac surrounded by a thin wall of myocadium. No pericardium effusion was seen. Based on this report, we believe that a DIH has plentiful variety and this specific kind of DIH should be differentially diagnosed with pseudoaneurysm.
Diagnosis and endovascular treatment of iliac venous compression syndrome
Authors: Sang Hong-fei , Li Jia-hong , Du Xiao-long , Li Weng-dong , Lei Feng-rui , Yu Xiao-bin , Zhu Li-wei , Li Cheng-long , Li Xiao-qiang
Published: April 2018

Objectives

To report *The first two authors contributed equally to this work. our clinical experience on diagnostic criteria and endovascular management in patients with iliac venous compression syndrome.

Method

Between July 2013 and May 2015, 85 consecutive patients with suspected iliac venous compression syndrome were evaluated by transfemoral venography and intravascular ultrasonography. Venographic evidence of iliac venous occlusion, stenosis, or pelvic collateral vessels, and the degree of stenosis as examined with intravascular ultrasonography were recorded. The endovascular procedure, complications, clinical outcome, and the Venous Clinical Severity Score were evaluated before and after the intervention.

Results

Of the 85 limbs, 66 cases of iliac venous compression syndrome were confirmed and 19 cases were excluded. In all of the 66 patients, we successfully performed endovascular intervention (22 balloon dilations, 44 balloon dilations + stenting). Two patients with stent implantation developed acute lower extremity deep vein thrombosis, resulted in successful lysis of the thrombus with catheter-directed thrombolysis.

Conclusions

The presence of intraluminal spurs and pelvic collateral vessels represents not only pathological and anatomical changes by long-term mechanical compression, but also indicators of the severity of iliac venous compression syndrome. The degree of stenosis cannot accurately represent the severity and treatment of iliac venous compression syndrome, especially in the right iliac vein. Endovascular intervention is a safe and effective treatment that reduces lower extremity symptoms. Full and intentional dilation of the intraluminal spurs is an important technical aspect, which is often ignored.
Natural language instructions for human–robot collaborative manipulation
Authors: Scalise Rosario , Li Shen , Admoni Henny , Rosenthal Stephanie , Srinivasa Siddhartha S
Published: April 2018

This paper presents a dataset of natural language instructions for object reference in manipulation scenarios. It comprises 1582 individual written instructions, which were collected via online crowdsourcing. This dataset is particularly useful for researchers who work in natural language processing, human–robot interaction, and robotic manipulation. In addition to serving as a rich corpus of domain-specific language, it provides a benchmark of image–instruction pairs to be used in system evaluations and uncovers inherent challenges in tabletop object specification. Example code is provided for easy access via Python.
Safety of concurrent adjuvant radiotherapy and chemotherapy for locally advanced soft tissue sarcoma
Authors: Greto Daniela , Loi Mauro , Saieva Calogero , Muntoni Cristina , Delli Paoli Camilla , Becherini Carlotta , Ciabatti Cinzia , Perna Marco , Campanacci Domenico , Terziani Francesca , Beltrami Giovanni , Scoccianti Guido , Bonomo Pierluigi , Meattini Icro , Desideri Isacco , Simontacchi Gabriele , Mangoni Monica , Livi Lorenzo
Published: April 2018

Introduction:

This retrospective study analyzes the safety and feasibility of concurrent chemoradiotherapy (CRT) in adjuvant treatment of soft tissue sarcoma (STS).

Methods:

A total of 158 patients with STS were retrospectively analyzed. Anthracycline-based computed tomography was performed in high-risk patients. Acute radiotherapy toxicity and chemotherapy-related toxicity were assessed according to the Common Terminology Criteria for Adverse Events 4.0; late radiotherapy toxicity was recorded according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.

Results:

Fifty-four (34.2%) patients received CRT. Mean follow up was 5.4 years (range .2–21.1 years). Local DFS–recurrence-free survival, distant DFS–relapse-free survival, and overall survival were 79.1%, 76.4%, and 64.6%, respectively, at last follow-up. Leukopenia occurred in 11.4% of patients. Skin acute toxicity developed in 60.1% of patients and determined interruption of radiotherapy treatment in 19 (12%) patients. Nineteen patients (12%) experienced moderate fibrosis (grade 2). Mild and moderate joint stiffness was recorded in 16 (10.1%) patients. Size ≥5 cm was the only predictor of local recurrence at multivariate analysis (hazard ratio [HR] 9.65, 95% confidence interval [CI] 1.28–72.83, p = .028). Age and stage resulted as independent distant relapse predictors (HR 4.77, 95% CI 1.81–12.58, p = .002 and HR 4.83, CI 1.41–16.57, p = .012, respectively). At Cox regression univariate analysis, Karnofsky Performance Status, size, and stage were significant survival predictors (HR 2.23, 95% CI 1.02–4.87, p = .045; HR 2.88, 95% CI 1.10–7.52, p = .031; HR 2.59, 95% CI 1.11–6.04, p = .028).

Conclusions:

Concurrent CRT is a well-tolerated treatment option with no additional toxicity compared to exclusive radiotherapy or sequential CRT.
The influence of work on the transition to retirement: A qualitative study
Authors: Eagers Jackie , Franklin Richard C , Broome Kieran , Yau Matthew K
Published: April 2018

Introduction

Retirement from work is a complex process, with work influencing this transition. Occupational therapists can facilitate a meaningful occupational transition to retirement for better health and wellbeing in later life. This article explores (1) how work attributes influence and relate to the work-to-retirement transition stages, (2) the relationship of findings to the Model of Human Occupation volitional processes and (3) the potential occupational therapy role.

Method

Semi-structured interviews were completed with retirees. In this qualitative study, themes were identified in relation to the work-to-retirement transition stages using thematic analysis with findings related to the Model of Human Occupation volitional processes.

Findings

Eleven Australian participants (five females, six males) were recruited. Themes and sub-themes were identified within each stage of the work-to-retirement transition and collectively encapsulated all volitional processes. Themes were time to move on, taking action, ceasing work, feeling retired, letting go and work-related involvement.

Conclusion

Work attributes related to personal factors, social factors, meaningful occupational engagement and the nexus of work and retirement influence all work-to-retirement transition stages. Volition assists in explaining the complexity of this transition. Occupational therapists can assist older workers to continue working or identify and implement meaningful occupations to replace work activities in retirement.
Unit Price or Lump Sum? A Stochastic Cost-Based Decision-Making Tool for Design-Bid-Build Projects
Authors: Khalafalla Mohamed , Rueda-Benavides Jorge
Published: April 2018

The appropriate selection of procurement tools and strategies is a key factor in the successful completion of construction projects. Despite the increasing use of alternative project delivery methods by the public agencies, the traditional design–bid–build (DBB) approach is still the most used and accepted project delivery method in the US. The purpose of this study is to present an innovative tool that introduces an objective criterion into the selection of resurfacing projects for design–bid–build —lump sum (DBB-LS) projects. This criterion consists of a comparison of the stochastic construction cost estimate for a candidate project if procured under DBB-LS versus its stochastic cost estimate if a unit price (UP) approach is used. The proposed decision-making tool was developed using non-linear regression techniques, Monte Carlo Simulation, and data from 86 resurfacing projects completed by the Florida Department of Transportation (FDOT) between January 2015 and March 2017: 63 UP and 23 LS projects. To facilitate the use of the tool by decision makers, the mathematical functions involved in the cost comparison between these two approaches have been comprised into a nomogram, allowing a quick approximation of the probability of having a lower cost under each compensation approach and the potential savings or extra costs of using an LS provision. The nomogram also allows the estimation of potential LS cost implications under different confidence levels, providing FDOT with the ability to make decisions at different levels of risk.
Evaluation of the Transportation Research Board Minority Student Fellows Program
Authors: Willson Richard , Febey Karen
Published: April 2018

This paper evaluates the Transportation Research Board (TRB) Minority Student Fellows Program (Program). Initiated in 2010, the Program supports students from select Historically Black Colleges and Universities, Hispanic-Serving Institutions, and Native American Pacific Islander-Serving Institutions to attend TRB’s Annual Meeting and present a student-authored research paper. The Program is intended to increase involvement of those groups in TRB and the transportation profession. This evaluation considers the Program’s performance against stated and implicit goals using a survey of mentees; qualitative reflections by the Program manager, a mentor, and a mentee; and indirect outcome metrics. Conclusions are that the Program was successful in increasing exposure to TRB, contributing to the growth of fellows as transportation professionals, and encouraging ongoing TRB participation. With regard to operations, the Program achieved visibility and attracted external funding, which bodes well for its sustainability. Lessons learned include crafting appropriate rules for participation and finding the right balance between critique and support in the paper review process. There are opportunities to extend the mentoring experience with continued involvement of past fellows.
Determination of Pulmonary Tissue volume, Pulmonary Capillary Blood Flow and Diffusing Capacity of the Lung before and after Hemodialysis
Authors: Morrison J.T. , Wilson A.F. , Vaziri N.D. , Brunsting L. , Davis J.
Published: April 2018

In order to better understand changes in lung function before and after dialysis, we studied eight patients with end-stage renal disease undergoing chronic hemodialysis. Pulmonary tissue volume (Vt), pulmonary capillary blood flow (Q̇c), the diffusing capacity for carbon monoxide (DLCO), arterial blood gases and body weight were measured before and after dialysis. A single breath, constant expiratory flow technique for determination of DLCO, Q̇c and Vt was used. DLCO, Q̇c, arterial carbon dioxide, and body weight were reduced post dialysis (P ≤ .01) while Vt failed to change. The alveolar-arterial oxygen difference rose 12 mmHg (P = .01). These results are consistent with pulmonary microembolization during dialysis with deterioration of gas exchange and Q̇c. These changes appear to occur independent of significant changes in Vt. Possible physiologic mechanisms are discussed.
In-Vitro Blood Compatibility Studies on a New Polymer-Coated Charcoal for Haemoperfusion
Authors: Hughes R.D. , Langley P.G. , Williams R.
Published: April 2018

The blood compatibility of a new polyhema-coated charcoal (Biotec) has been studied in an in-vitro haemoperfusion circuit. The mean inlet platelet levels after 4 hours of perfusion were 99.5 ± SE 4.2% of the initial value and mean white cell levels were 81.9 ± SE 5.8% of initial. No rises in Swank screen filtration pressure were detected. Initial evaluation of this charcoal in patients with fulminant hepatic failure should be possible without platelet-protective agents.
Studies on Cyanide and Thiocyanate in Uraemia
Authors: Yatzidis H. , Koutsicos D. , Vlassopoulos D. , Cristodoulou D. , Yulis G.
Published: April 2018

Cyanide and thiocyanate was measured in blood and in peritoneal lavage solution in patients with advanced or terminal renal failure. The behavior of these substances was comparable to that of normal people. Our finding does not support the hypothesis of an indirect toxicity of urea via its previous conversion to cyanate. Cyanate ion has not been implicated in the toxic status of chronic uraemia.
Combined Hemodialysis-hemoperfusion Treatment Reduces the time of Substitutive Therapy in Chronic Uremia
Authors: Stefoni S. , Feliciangeli G. , Colì L. , Scolari M.P. , Bonomini V.
Published: April 2018

Charcoal hemoperfusion has long been used in chronic uremia as an adjunct or substitute for conventional hemodialysis.

In this study a regular combination of hemoperfusion and hemodialysis was used to cut down the weekly substitutive sessions from 3 to 2. Ten RDT patients were treated with the reduced-time schedule for 5–56 weeks. Clinical and metabolic conditions remained stable in all patients and no sign of inadequate treatment appeared. Long-term charcoal hemoperfusion was confirmed to be a safe and risk-free procedure. No change in platelets, white cells, red cells, fibrinogen and other hematochemical parameters were detected.
Studies of Adsorbents for Hemoperfusion in Artificial Liver Support. I. Preparation and in Vitro Studies of Cross-Linked Agarose Beads Entrapped Activated Charcoal (CAAC)
Authors: Xu C.X. , Tang X.J. , Niu Z. , Li Z.M.
Published: April 2018

A new method for the preparation of the cross-linked agarose beads entrapped activated charcoal (CAAC) is reported. Since the agarose-encapsulated adsorbents reported elsewhere cannot stand high temperature for sterilization, the CAAC has the advantage of thermal stability to withstand autoclave at 121°C. for ½ hour without breaking up or melting. A further advantage of CAAC is that the adsorbent has a much better consistency with good mechanical strength and elasticity, so that it can be formed into beads of a diameter less than 1 mm. This will not only give a better adsorption capacity than larger beads, but can also assure a better blood flow than soft beads which usually interfere in hemoperfusion due to compacting and sludging. Preliminary investigations indicate that the CAAC is relatively hemocompatible.
Polyacrilonytrile versus Cuprophan Membranes for Hemodialysis: Evaluation of Efficacy and Biocompatibility by Platelet Aggregation Studies
Authors: Berrettini M. , Buoncristiani U. , Parise P. , Ballatori E. , Nenci G.G.
Published: April 2018

The short- and long-term effect of hemodialysis with two different membranes — cuprophan and polyacrilonytrile — on platelet aggregation has been investigated in 12 uremic patients undergoing extracorporeal dialysis, passing from one treatment to the other. Cuprophan membranes failed to correct the defective platelet aggregation of uremia, and their thrombogenicity was documented by a fall in platelet count and further impairment of platelet aggregation during dialysis. On the contrary, polyacrilonitryle membranes showed the capacity to correct completely but transiently the platelet aggregation, without changes in platelet count. The results indicate that polyacrilonytrile membranes show a better biocompatibility toward platelets than cuprophan membranes.
Plasma Exchange in Five Patients with Acute Guillain Barré syndrome
Authors: de Jager A.E.J. , The T.H. , Sibinga C. Th. Smit , Das P.C.
Published: April 2018

During the last 3 years plasma exchanges were undertaken in 5 patients with acute Guillain Barré syndrome (G.B.S.). All the patients were admitted in the intensive respiratory care unit and had received six plasma exchange procedures over two weeks (each procedure consists of 2–3 L exchange). The first patient improved dramatically after the second exchange. Moderate success was obtained in two patients. One patient did not show any effect. The fifth patient received plasma exchange one day after her recovery phase had begun but the course of recovery remained uneffected.

The effect of plasma exchange was analysed as the patients’ response to motor activity, and compaired with a historical control group consisting of 50 acute G.B.S. patients admitted in the intensive respiratory care area over the last 25 years. Plasma exchange does not seem to have excerted any significant effect although at any given time the plasma exchange group had higher motor activity than that of the control group. A controlled clinical trial especially in the early phase of the disease is emphasized.
Patients with High Titers of Circulating Immune Complexes are Most Likely to Benefit from Plasmapheresis Treatment
Authors: Valbonesi M. , Garelli S. , Mosconi L. , Manca F. , Cantarella S. , Celada F.
Published: April 2018

Intermittent flow centrifugation system was utilized in the management of 17 patients with IC diseases. 14 out of 14 patients that had high levels of ICs prior to plasmapheresis showed both clinical and immunochemical evidence of improvement with plasmapheresis.

3 patients had no evidence of circulating ICs prior to plasmapheresis: in these cases no apparent result was acheived after the apheretic therapy. Although the striking correlation between IC removal and clinical result is not a formal proof of responsibility of CIC in the pathogenesis of the disease, it is suggested that quantitative determinatin of CICs (utilizing several different recognition units) may be a useful parameter in the decision to apply plasmapheresis in the therapy of selected autoimmune diseases.
Heterogeneous Density and Ultrastructure of rabbit's Peritoneal Microvasculature
Authors: Gotloib L. , Shustak A. , Bar-Sella P. , Eiali V.
Published: April 2018

In this study, samples of mesenteric diaphragmatic peritoneum and peritoneum covering the inner side of the ventral abdominal wall of apparently normal rabbits were examined under electron microscopy. Mesentery appeared as the most vascularized peritoneal segment (71,1% of the total number of observed capillaries). Diaphragmatic and parietal peritoneum contributions to the total examined microvascular bed were of 17,9% and 10,9% respectively. Only 3,2% of peritoneal diaphragmatic capillaries were of the fenestrated type.

This qualitative and quantitative heterogeneity of the peritoneal microcirculation combined with the different contribution of each peritoneal segment to the total peritoneal surface area, the different mesothelial cell density of visceral and parietal peritoneum, and the different permeability of parietal visceral peritoneum suggest that, in vivo, whole organ permeability studies would eventually show just an average of an unknown distribution of segmental peritoneal permeabilities.
Spontaneous Plasma Exchange by Gravity
Authors: Landini S. , Coli U. , Lucatello S. , Fracasso A. , Morachiello P. , Righetto F. , Scanferla F. , Bazzato G.
Published: April 2018

Lysagth et al have reported a semplified model of spontaneous plasmapheresis by placing between an A-V shunt a conventional plasmafilter. On the basis of this experience we tried to make a further semplification of this apparatus using a single venous puncture, obtaining by gravity sufficient transmembrane pressure for plasma separation. By alternatively lowering and elevating the system, plasma is separated from the blood and packed red cells are reinfused after a new pass through the filter with FFP or plasma substitutes.
Unintentional Weight Loss in Chronic Hemodialysis Patients - A Diagnostic Dilemma
Authors: Umlauf E. , Asmus G. , Von Herrath D. , Schaefer K.
Published: April 2018

Reasons for an unintentional weight loss were investigated in a retrospective study of 26 (13.5%) patients who, out of 192 patients, had revealed a continuous linear weight loss of more than 4 kg since commencing hemodialysis treatment. The investigated serum parameters were not indicative, nor were the regularly performed tuberculin tests and the computer tomography helpful for the diagnosis. However, from the analysis of the causes for hospital admission it appears that hemodialysis patients with wasting suffer especially frequently from a sepsis. Physicians should be aware of this complication which induces further body weight loss.
Acute Renal Failure Amongst Children in a Tropical Environment
Authors: Chugh K.S. , Narang A. , Kumar L. , Sakhuja V. , Unni V. Narayanan , Pirzada R. , Singh N. , Pereira B.J.G. , Singhal P.C.
Published: April 2018

The pathogenetic factors leading to acute renal failure (ARF) in 223 children between the ages of 20 days and 14 years were studied. Diarrhoeal diseases were responsible for ARF in 49.8%, acute glomerulonephritis in 34.1%, drug induced intravascular hemolysis in glucose -6-phosphate dehydrogenase deficiency in 4.5%, snake bite in 4%, hemolytic uremic syndrome in 2.2%, and miscellaneous causes in 5.4%. Dialysis was instituted in 178 children and the others were treated conservatively. Renal histology in 39 out of 76 children who presented with an acute nephritic illness revealed acute endocapillary proliferative glomerulonephritis in 27 and crescentic glomerulonephritis in 12. The histology in 79 out of 147 remaining patients showed acute tubular necrosis in 64, acute cortical necrosis in 13, and acute interstitial nephritis in 2. Overall mortality was 27.4%. This high incidence of ARF due to infective diarrhoeas and dysentery reflects poor socio-economic and hygienic conditions, inadequate facilities in rural areas, delays in seeking medical advice, and lack of knowledge about fluid and electrolyte therapy amongst the staff.
Performance Evaluation of Cascade Filtration with High Flow Rate Recirculating Plasma on the Secondary Filter
Authors: Busnach G. , Dal Col A. , Perrino M.L. , Brando B. , Brunati C. , Minetti L.
Published: April 2018

Cascade filtration (CF) has been performed in 67 on-line procedures in 9 normolipidemic patients with paraproteinemic disorders. A modified dead-end technique has been employed, with high flow rate recirculating plasma on the plasma fractionation filter (QD recycled CF), and an albumin-rich, globulin-poor filtrate was reinfused into the patient. Postprocedure recoveries were 81 ± 15% for albumin, 55 ± 23% for IgM and 48% for cryocrit, with an increase in A/G ratio from 1.8 to 2.1. An improvement was observed also in antiatherogenic/atherogenic lipoproteins ratio, suggesting a possible use of this technique in the treatment of familial hypercholesterolemia. Plasma primary separation was obtained by centrifugation or by filtration, and no significant differences were observed on subsequent protein fractionation process. An albumin priming of the plasmafractionation circuit accounted for an additional 13% saving in postprocedure level. Different surface area secondary filters have been employed: with larger surfaces, larger volumes were processed without any increase in the waste volume and with reduced need for washouts, but with an additional loss of small molecules possibly due to entrapping onto the membrane.
Re-evaluation of Ascorbic Acid Deficiency in Hemodialysed Patients
Authors: Papastephanidis C. , Agroyannis B. , Tzanatos-Exarchou H. , Orthopoulos B. , Koutsicos D. , Frangos-Plemenos M. , Kallitsis M. , Yatzidis H.
Published: April 2018

In 92 uremic patients under chronic hemodialysis without ascorbic acid supplementation, serum ascorbic acid was measured before hemodialysis and between two sessions. The results indicated a more serious ascorbic acid deficiency of patients than in previous studies. This difference might be explained by the highly specific enzymatic method applied in the present study, excluding any potential interference of various serum reducing substances.
Serum Amylase and Isoamylase in Chronic Renal Failure
Authors: Bardella M.T. , Bianchi M.L. , Molteni N. , Garbin C. , Valenti G. , Buccianti G. , Bianchi P.A.
Published: April 2018

In 37 patients with chronic renal failure (CRF) serum amylase was higher than in 33 normal subjects (483 U/L ± SD 185 versus 267 ± SD 66 U/L, p < 0.05); while the percentage of pancreatic isoenzymes was within normal limits in 34 patients and only slightly increased in 3. Seventeen of the patients were on conservative treatment, 10 on hemodialysis and 10 on continuous ambulatory peritoneal dialysis; no significant differences in serum amylase levels were detected between these subgroups. No correlation was found between serum BUN or creatinine and serum amylase but a positive correlation was found between these enzyme levels and duration of CRF (p < 0.05) in the patients on conservative treatment.
Orally Ingested Microencapsulated Urease and an Adsorbent, Zirconium Phosphate, to Remove Urea in Kidney Failure
Authors: Wolfe E.A. , Chang T.M.S.
Published: April 2018

Dialysis is the conventional treatment for chronic renal failure. It is cumbersome, expensive and time-consuming and thus alternate treatments have long been sought. A compact system consisting of haemoperfusion in series with ultrafiltration can nearly replace dialysis. A urea removal system is the only step required to complete this approach. The potential of combining a microencapsulated enzyme, urease, with an ammonium ion adsorbent, zirconium phosphate, to remove urea was examined in vitro. Urease converts urea to ammonium ions which are then adsorbed on-to zirconium phosphate. This combination would be most effective in the intestinal tract. The capacity of zirconium phosphate is probably not enough to effect the removal of enough urea to completely replace dialysis in patients with no renal function. However, this system could potentially 1) delay the onset of dialysis therapy in patients who still have some renal function, either alone or in combination with haemoperfusion-ultrafiltration, or 2) reduce dialysis treatment times.