bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterior Cruciate Ligament Reconstruction Affects Tibiofemoral Joint Congruency During Dynamic Functional Movement
Authors: Nagai Kanto , Gale Tom , Irrgang James J. , Tashman Scott , Fu Freddie H. , Anderst William
Published: April 2018

Background:

Anterior cruciate ligament reconstruction (ACLR) has been shown to alter kinematics, which may influence dynamic tibiofemoral joint congruency (a measure of how well the bone surfaces fit together). This may lead to abnormal loading of cartilage and joint degeneration. However, joint congruency after ACLR has never been investigated.

Hypotheses:

The ACLR knee will be more congruent than the contralateral uninjured knee, and dynamic congruency will increase over time after ACLR. Side-to-side differences (SSD) in dynamic congruency will be related to cartilage contact location/area and subchondral bone curvatures.

Study Design:

Descriptive laboratory study.

Methods:

The authors examined 43 patients who underwent unilateral ACLR. At 6 months and 24 months after ACLR, patients performed downhill running on a treadmill while synchronized biplane radiographs were acquired at 150 images per second. Dynamic tibiofemoral kinematic values were determined by use of a validated volumetric model-based tracking process that matched patient-specific bone models, obtained from computed tomography, to biplane radiographs. Patient-specific cartilage models, obtained from magnetic resonance imaging, were registered to tracked bone models and used to calculate dynamic cartilage contact regions. Principle curvatures of the subchondral bone surfaces under each cartilage contact area were calculated to determine joint congruency. Repeated-measures analysis of variance was used to test the differences. Multiple linear regression was used to identify associations between SSD in congruency index, cartilage contact area, contact location, and global curvatures of femoral or tibial subchondral bone.

Results:

Lateral compartment congruency in the ACLR knee was greater than in the contralateral knee ( P < .001 at 6 months and P = .010 at 24 months). From 6 to 24 months after surgery, dynamic congruency decreased in the medial compartment ( P = .002) and increased in the lateral compartment ( P = .007) in the ACLR knee. In the lateral compartment, SSD in joint congruency was related to contact location and femur global curvature, and in the medial compartment, SSD in joint congruency was related to contact area.

Conclusion:

ACLR appears to affect dynamic joint congruency. SSD in joint congruency was associated with changes in contact location, contact area, and femoral bony curvature.

Clinical Relevance:

Alterations in tibiofemoral contact location, contact area, and bone shape affect dynamic joint congruency, potentially contributing to long-term degeneration after ACLR.
HPLC Study of Uremic Fluids Related to Optical Dialysis Adequacy Monitoring
Authors: Lauri Kai , Tanner Risto , Jerotskaja Jana , Luman Merike , Fridolin Ivo
Published: April 2018

Purpose

The aim of this study was to investigate uremia-related high-performance liquid chromatography (HPLC) ultraviolet (UV) absorbance profiles of serum and spent dialysate and to study the removal of uremic retention solutes in connection with optical dialysis adequacy monitoring.

Methods

10 uremic patients were investigated using online spectrophotometry at a wavelength of 280 nm over the course of 30 hemodialysis treatments. The dialysate and blood samples were taken and analyzed simultaneously using standard biochemical methods and reversed-phase HPLC. Filters with cutoff at 3 kDa and 70 kDa were used for the pre-treatment of the serum. The chromatographic peaks were detected by a UV detector at wavelengths of 254 and 280 nm.

Results

This study indicated that the main solute responsible for UV absorbance in the spent dialysate is a low-molecular-weight, water-soluble, non-protein-bound compound uric acid (UA). Three additional uremic retention solutes – creatinine (CR), indoxyl sulphate (IS) and hippuric acid (HA) – were identified from the HPLC profiles. The number of detected HPLC peaks was not significantly different for a serum filtered through the 3 kDa or 70 kDa cutoff filters, and was lower for the spent dialysate, indicating that the molecular weight (MW) of the main UV chromophores in the uremic fluids did not exceed 3 kDa. The reduction ratio (RR) estimated by the total area of HPLC peaks at 254 nm and 280 nm in the serum and by the online UV absorbance at 280 nm was best related to the removal of small water-soluble non-protein bound solutes like urea (UR), CR and UA.

Conclusions

The present study contributes new information on the removal of uremic retention solutes during hemodialysis and on the origin of the optical dialysis adequacy monitoring signal.
Early Gut Barrier Dysfunction in Patients with Severe Acute Pancreatitis: Attenuated by Continuous Blood Purification Treatment
Authors: Zhang JianBin , Yuan Chen , Hua Gan , Tong RuYan , Luo XiangFeng , Ying Zhou
Published: April 2018

Objectives

The aim of this study was to investigate the effect of continuous blood purification (CBP) on early gut mucosal dysfunction in patients with severe acute pancreatitis (SAP).

Methods

Patients with SAP were randomized to receive 24 hours of continuous veno-venous hemofiltration (CVVH; n=33) or no CVVH (n=30). Blood samples were taken from the patients at 0, 6, 12, and 24 hours during CVVH therapy. Serum diamine oxidase (DAO) and endotoxin, epithelial permeability, transepithelial electrical resistance (TER) and F-actin rearrangement of the epithelial monolayer were used as the markers for the assessment of gut barrier function and the effect of CBP therapy in patients with SAP.

Results

Patients with SAP had increased levels of serum DAO, endotoxin, and epithelial permeability when compared with normal controls, and the increase was more pronounced in patients with organ dysfunction (p<0.01). F-actin rearrangement, loose cell-cell junction, and iNOS mRNA upregulation were found in all patients. After CBP treatment, Acute Physiology and Chronic Health Evaluation II score and SOFA score improved significantly; levels of serum DAO, endotoxin, and epithelial permeability decreased (p<0.05). CBP also significantly attenuated reorganization of actin and downregulated iNOS mRNA expression and NO production (p<0.05).

Conclusions

CBP can not only improve the general conditions but also effectively improve gut barrier dysfunction. The beneficial effect of CBP on gut barrier dysfunction is associated with the improvement of cytoskeletal instability, by downregulating iNOS through the removal of excess proinflammatory factors.
Long-duration (>4 Weeks) Continuous Renal Replacement Therapy in Critical Illness
Authors: Baird J. Scott , Wald Eric L.
Published: April 2018

Introduction

Decreased pediatric survival has been reported with long-duration (>4 weeks) continuous renal replacement therapy (CRRT), though the practice has not been well-described.

Methods

Retrospective chart review in a children's hospital of all patients treated with CRRT over 2 years (2003–4), including those who underwent long (group 1) and shorter duration (group 2) therapy.

Results

We identified 39 patients: median age was 6 years (range: 0.3–23; 7 were infants), median PRISM III score was 16 (range: 4–35), and the most frequent primary diagnosis was a stem cell transplant (in 12 out of 39). At continuous renal replacement therapy initiation, almost all patients (38 out of 39) had multiorgan dysfunction syndrome, most (35 out of 39) were being treated with at least one inotrope or vasopressor, and median fluid overload was 18% (range: 1–43%). Survival was poor (38%). Groups 1 (n=7) and 2 (n=32) had similar age (p=0.44), PRISM III score (p=0.61), and stem cell transplant diagnosis (p=0.65). At CRRT initiation, the incidence of multiorgan dysfunction syndrome (p=0.18), inotrope or vasopressor treatment (p=0.56), and fluid overload severity (p=0.71) were similar. Those in group 1 had a longer mean CRRT as well as persistent cardiovascular dysfunction limiting the utility of intermittent dialysis. Survival was similar between groups (p=1).

Conclusions

Critically-ill patients treated with long and shorter duration CRRT had a similar survival rate.
Effect of Poly-L-lysine Coating on Retinoic Acid-Loaded PLGA Microspheres in the Differentiation of Carcinoma Stem Cells into Neural Cells
Authors: Nojehdehian Hanieh , Moztarzadeh Fathollah , Baharvand Hossein , Mehrjerdi Narges Zare , Nazarian Hamid , Tahriri Mohammadreza
Published: April 2018

In this study, PLGA microspheres were prepared using a water-in-oil-in-water emulsion/solvent evaporation technique. Some microspheres were coated with poly-L-lysine (an extracellular matrix (ECM) component), and then pluripotent P19 embryonic carcinoma cells were seeded on them. P19 cells attached onto the PLGA microspheres; subsequently, by adding retinoic acid (RA) to cell culture medium as a neurogenic inducer (RA was released from the microspheres), the cells differentiated into neural cells. Size and morphology of PLGA microspheres was characterized by scanning electron microscopy (SEM). Neurogenic differentiation was studied by immunofluorescent staining, real-time polymerase chain reaction (RT-PCR), and light microscopy. Histological assay showed that more cells attached onto microspheres coated with poly-L-lysine than the uncoated group. Immunofluoresent staining and RT-PCR analysis for β-Tubulin, Nestin and Pax6 genes indicated differentiation of P19 cells into neural cells on both coated and uncoated microspheres. It was found that a high surface area of microspheres improves cell attachment and expansion, which was significantly increased in those coated with poly-L-lysine. Finally, these results highlight the versatility of these sample scaffolds as a model system for nerve tissue engineering.
Time-Dependent Metabolic Activity and Adhesion of Human Osteoblast-Like Cells on Sensor Chips with a Plasma Polymer Nanolayer
Authors: Rebl Henrike , Finke Birgit , Schroeder Karsten , Nebe J. Barbara
Published: April 2018

Purpose

To improve orthopedic implant ingrowth, knowledge of the effect of chemical surface modifications on vital cell function in vitro is of importance. Early in our investigations we recognized that amino groups, positively charged via plasma polymerized allylamine, increased cell growth and the actin-filament formation in the initial cell-material contact phase. To gain insight into continuous vital cell behavior on this plasma polymer layer, here we present the metabolic activity of osteoblasts and their time-dependent adhesion using the sensor chip technology.

Methods

We demonstrate a new method for continuous 24 hour-measurements with vital human osteoblast-like cells (MG-63, ATCC) on sensor chips (Bionas® SC 1000) modified with plasma polymerized allylamine (PPAAm). The PPAAm film deposited on the chip is a cross-linked, strongly fixed plasma polymer with relatively high amino functionality and well defined chemical surface composition. We assessed continuous cell adhesion and the metabolic activity, i.e., oxygen consumption and acidification.

Results

We determined that adhesion of vital cells on PPAAm is not only enhanced shortly (1 h) after cell seeding but remained continuously higher for 24 h, which is significant. This nanometer-thin PPAAm layer did not change the overall metabolic activity of MG-63 cells during 24 h.

Conclusion

This tool – using adhesion and metabolic sensor chips – appears to be a suitable method for the recognition of vital cell physiology in biocompatibility measurements of plasma chemical treated surfaces.
Coupled Plasma Filtration Adsorption Reduces Serum Bilirubine in a Case of Acute Hypoxic Hepatitis Secondary to Cardiogenic Shock
Authors: Caroleo Santo , Rubino Antonino S. , Tropea Francesco , Bruno Orlando , Vuoto Domenico , Amantea Bruno , Renzulli Attilio
Published: April 2018

Hypoxic hepatitis (HH) is a severe complication of postoperative low output syndrome, associated with high mortality rates despite appropriate drug therapy. Recently several extracorporeal supportive techniques have become available. We describe the case of a 70-year-old woman who developed HH secondary to cardiogenic shock after cardiac surgery. CPFA proved to be a valid tool for concomitant hemodynamic support and organ replacement therapy.
Expansion of Human Mesenchymal Stem Cells in a Fixed-Bed Bioreactor System Based on Non-Porous Glass Carrier – Part B: Modeling and Scale-up of the System
Authors: Weber Christian , Freimark Denise , Pörtner Ralf , Pino-Grace Pablo , Pohl Sebastian , Wallrapp Christine , Geigle Peter , Czermak Peter
Published: April 2018

Human mesenchymal stem cells (hMSC) are a promising cell source for the manufacturing of cell therapy or tissue-engineered implants. In part A of this publication a fixed-bed bioreactor system based on non-porous borosilicate glass spheres and procedures for the automated expansion of hMSC with high yield and vitality was introduced. Part B of this study deals with the modeling of the process in order to transfer the bioreactor system from the laboratory to the production scale. Relevant model parameters were obtained by fitting them to the experimental data of hMSC-TERT cultivations in scales up to 300 cm3. Scale-up calculations were carried out exemplarily for a target cell number of twenty billion cells.
First Successful use of the New ab5000 Portable Circulatory Support Console as Bridge to Recovery in a Case of Dilated Cardiomyopathy
Authors: Conradi Lenard , Schirmer Johannes , Reiter Beate , Treede Hendrik , Kubik Mathias , Reichenspurner H Hermann C. , Wagner Florian M.
Published: April 2018

Introduction

Growing clinical experience and improved technology have led to more widespread use of ventricular assist devices in patients with end-stage heart failure.

Methods

We report the case of a patient with preexisting cardiomyopathy who arrived at our center in cardiogenic shock and received a biventricular assist device.

Results

The new compact Abiomed Portable Circulatory Support Console facilitated mobilization of the patient which was particularly advantageous in the face of transient hemiparesis. After recovery from cardiogenic shock, device removal was performed following a bridge-to-recovery concept. He was discharged in a state of full cardiac recompensation and is back to everyday life with stable cardiac function up to 24 months after the incident.

Conclusions

This is the first report describing successful clinical use of the AB5000 assist device in combination with the portable console. Furthermore, it underlines the potential of temporary circulatory support to induce permanent myocardial recovery even in cases of preexisting cardiomyopathy.
Accelerated Angiogenic Induction and Vascular Integration in a Novel Synthetic Scaffolding Matrix for Tissue Replacement
Authors: Ring Andrej , Goertz Ole , Al-Benna Sammy , Ottomann Christian , Langer Stefan , Steinstraesser Lars , Schmitz Inge , Tilkorn Daniel
Published: April 2018

Purpose

Reduced or delayed neovascularization is a major obstacle with regard to tissue-engineered constructs. The aim of this study was to evaluate the early microvascular response to a novel degradable ε-caprolactone terpolymer matrix.

Methods

ε-caprolactone terpolymer matrices (Suprathel Plus®; Institute of Textile and Process Engineering, Denkendorf, Germany) were implanted into dorsal skinfold chambers of balb/c mice (n=10). Microcirculatory changes were observed by intravital fluorescence microscopy. Scaffolding matrices from PEGT/PBT copolymer were used as controls (n=10).

Results

The formation of de novo vascular networks within both scaffolding matrices was noted throughout the experiment. A vascular ingrowth of perfused microvessels into the matrices up to 600 μm apart from the edge was noted within 10 days of implantation. The earliest signs of neoangiogenesis were visible in ε-caprolactone terpolymer matrices on day 1. In both scaffolds the new developed vessels extended centripetally from the border of the matrices towards the center and anastomosed to form a perfused microvascular network. There was significantly earlier onset of vascularization, increased vascularized area and higher vessel density in ε-caprolactone terpolymer matrices compared to PEGT/PBT copolymer matrices were observed.

Conclusions

The scaffolding matrix from ε-caprolactone terpolymer allowed for an earlier and more intense induction of angiogenesis and displayed the tendency to vascularize more rapidly within a shorter period of time after transplantation compared to PEGT/PBT copolymer scaffolds, thus indicating its potential application for tissue engineering purposes.
Three-dimensional Microfabricated Scaffolds with Cardiac Extracellular Matrix-Like Architecture
Authors: Rosellini Elisabetta , Vozzi Giovanni , Barbani Niccoletta , Giusti Paolo , Cristallini Caterina
Published: April 2018

In recent years, research in the field of myocardial tissue engineering has advanced thanks to the development of new biomaterials and a more clear understanding of processes that are at the basis of cardiac tissue growth. However, classical porous scaffolds developed during these years to try to reconstruct and mimic heart function have proven to be inadequate because they are not able to reproduce the typical myocardial environment. One approach to increase functionality of tissue-engineered constructs relies on attempts to mimic the microarchitecture of natural tissues, since it is well known that topology is one of the principal stimuli that cells need to activate their functions. The aim of this work was the realization of three-dimensional microfabricated scaffolds, with cardiac extracellular matrix (ECM)-like architecture. For this purpose, samples of pig myocardium were decellularized, embedded in paraffin wax and analyzed under an optical microscope, in order to evaluate the geometrical features of the cardiac ECM. On the basis of these data, a simplified model of the cardiac ECM microarchitecture was designed. Microfabricated scaffolds were realized with Soft Lithography technique, using a bioartificial blend, based on alginate, gelatin and a novel poly(N-isopropylacrylamide)-based copolymer, which we synthesized. The scaffolds were characterized in terms of topological and mechanical properties. Moreover, cell adhesion, proliferation, and differentiation tests were performed. The microfabricated scaffolds showed they matched the anisotropic mechanical properties of adult human left ventricular myocardium, while at the same time being able to promote myoblast alignment in the absence of external stimuli.
Changes in Red Blood Cell Size and Red Cell Fragmentation during Hemodialysis
Authors: Booth John , Pinney Jennifer , Davenport Andrew
Published: April 2018

Introduction

Intradialytic hypotension remains the commonest complication for outpatient hemodialysis. The majority of relative blood volume (RBV) monitoring techniques monitor changes in hematocrit. As hematocrit can potentially be affected by changes in red cell size and hemolysis we studied the change in red blood cell size (MCV) during dialysis and hemolysis.

Methods

MCV was prospectively measured in 176 stable regular adult hemodialysis outpatients (56% male, 27.8% diabetic, mean age 59.5 ±16.2 years) dialyzing against a range of dialysate sodiums (136–145 mmol/L), with cooled dialysate (35–36°C), containing 1 g/L glucose, with constant ultrafiltration profiles. Red cell fragmentation was studied in 41 of the cohort.

Results

Logistical regression analysis showed that the absolute change in MCV was related to the change in hematocrit (F=4.92, β=0.111, p=0.031), and inversely with red cell shrinkage associated with predialysis osmolality (F=5.06, β=0.83, p=0.029), and dialysate sodium (F=4.7, β=0.34, p=0.035). There was no significant increase in red cell fragments during the dialysis sessions.

Conclusions

Indirect assessment of RBV based upon the relative change in hematocrit, depends not only upon the change in plasma water and red blood cell numbers, but also upon MCV. Changes in MCV may theoretically lead to potential effects on RBV measurements.
Rethinking Reproductive Labor through Surrogates’ Invisible Bodily Care Work
Authors: Stoeckle Anabel
Published: April 2018

New reproductive technologies such as egg donation and in-vitro fertilization have opened a global surrogacy market; surrogacy is now one of many options to start a family. However, surrogacy and other intimate acts are not typically categorized as work. The designation of surrogacy arrangements as either “commercial” or “altruistic” has hinged on the surrogate’s motivations, financial hardship, and social locale. These differences, in turn, influence the classification of surrogacy as either work or labor of love. Even when surrogacy is recognized as work – a rare event – altruistic aspects are highlighted while the laboring nature of the activities are obscured. This article argues that surrogates perform reproductive labor; more precisely, their invisible bodily care work, regardless of their locale, motivations, relationship with the intended parent(s), and irrespective of whether they receive payment. Conceptualizing surrogacy as bodily care work has both theoretical and practical implications. Theoretically, extending our understanding of what counts as labor matters. Practically, the recognition of surrogacy as work would extend already existing labor regulations to surrogates as well as allow for the formulation of regulations specific to surrogacy.
Surface characteristics and machining performance of TiAlN-, TiN- and AlCrN-coated tungsten carbide drills
Authors: Dumkum Chaiya , Jaritngam Pakin , Tangwarodomnukun Viboon
Published: April 2018

This article presents a comprehensive analysis of surface characteristics and drilling performance of uncoated and coated tungsten carbide drills. The single- and double-layer coatings of TiN, TiAlN and AlCrN were examined in terms of surface roughness, microhardness and crack resistance. In addition, drilling torque and thrust force were experimentally measured and compared to the developed models based on the drilling mechanics and drill geometries. Tool wear and hole surface roughness were also considered to assess the machining performance of different coated tools. The results revealed that all coated drills can offer better cut surface quality, 28% lower cutting loads and longer tool life than the uncoated drills. Although AlCrN was found to be the hardest coating material among the others, it caused large wear on the cutting edges and poor surface roughness of produced holes. The lowest torque and thrust force were achievable using TiN-coated drill, while the use of TiAlN coating resulted in the lowest surface roughness and smallest tool wear. Furthermore, the drilling torque and thrust force model developed in this study were found to correspond to the experimental measures with the average error of 8.4%. The findings of this work could facilitate the selection of coating materials to advance the machining performance.
A new insight into modelling passive suspension real test rig system with consideration of nonlinear friction forces
Authors: Alzughaibi Ali , Xue Yiqin , Grosvenor Roger
Published: April 2018

The vital purpose of a vehicle suspension system is to isolate the car body and hence passengers, from roadway unevenness disturbances. Implementation of passive suspension systems has continuously improved disconnection from disturbances through available deflection constraints to provide maximum isolation. In the majority of relevant reported research studies, a quarter car is modelled as moving vertically straight for both a viscous damper and a stiffness spring. The motivation for this study, reported here, is to extend the modelling to take account of the actual configuration of a test rig system. Accordingly, a new passive suspension system model is presented, which includes nonlinear lubricant friction forces that affect the linear support body bearings. The friction model established relies on dynamic system analysis and the fact of slipping body on lubricant bearings; this model captures most of the friction behaviours that have been observed experimentally. The suspension model is composed of a car body and wheel unit, and only vertical motion (bounce mode) is addressed. In addition, an active actuator is used to generate the system inputs as a road simulator. Therefore, a nonlinear hydraulic actuator, including the dynamic of servovalve and proportional–integral controller model, is established. This study is validated by experimental work, with simulations achieving C++compiler. As a result, a good agreement is obtained between the experimental and simulation results, that is, the passive suspension system with considered nonlinear friction and the nonlinear hydraulic actuator with servovalve equation models are entirely accurate and useful. The suggested proportional–integral controller successfully derives the hydraulic actuator to validate the control scheme. The ride comfort and handling response are close to that expected for the passive suspension system with road disturbances.
Yaw error correction of ultra-precision stage for scanning beam interference lithography systems
Authors: Lu Sen , Yang Kaiming , Zhu Yu , Wang Leijie , Zhang Ming , Yang Jin
Published: April 2018

The stage yaw error is a key factor affecting the phase distortion of gratings produced by scanning beam interference lithography system. In order to solve this problem, a coarse-fine dual-stage mechanism is proposed, in which an ultra-precision fine positioning stage with yaw error correction function is developed. To achieve nanoscale positioning and sub-microradian yaw motion accuracy, four Lorentz motors are used to drive the fine stage. The internal coupling factors and the mechanism of Lorentz motors motion control are analyzed. Besides, the Abbe error caused by the yaw error is investigated. Positioning and scanning experiments are conducted and the outcomes show that maximum yaw error is 0.33 μrad during constant velocity scanning, which completely meets the grating fabrication requirements.
The EU General Data Protection Regulation: How will it impact the regulation of research biobanks? Setting the legal frame in the Mediterranean and Eastern European area
Authors: Penasa Simone , de Miguel Beriain Iñigo , Barbosa Carla , Białek Anna , Chortara Theodora , Pereira André Dias , Jiménez Pilar Nicolás , Sroka Tomasz , Tomasi Marta
Published: April 2018

On 25 May 2018, the EU General Data Protection Regulation (GDPR) will come into force. As with the Data Protection Directive (95/46/EC), the regulation of biobanks for scientific research will be profoundly affected by this reform. Accordingly, a comparative survey of some of the existing national regulatory frameworks is of value to aid understanding of whether and how EU Member States will need to realign their systems to ensure compliance with the new Regulation. This article provides a comparison of the positions of Member States in the Mediterranean and Eastern European area, focusing especially on the existing regulatory framework on biobanks, the definition of personal and genetic data, the pseudonymization process, the processing of personal data for medical research purposes (and its impact on the right to consent of the individuals involved) and the secondary use of such data. The article concludes that effective implementation of the EU GDPR will represent a decisive catalyst for adaptive harmonization of biobanks regulation in the European framework.
Virtual study groups and online Observed Structured Clinical Examinations practices – enabling trainees to enable themselves
Authors: Davidson Dennisa , Evans Lois
Published: April 2018

Objectives:

To explore online study groups as augmentation tools in preparing for the Royal Australian and New Zealand College of Psychiatrists Observed Structured Clinical Examinations (OSCE) for fellowship.

Methods:

An online survey of New Zealand trainees was carried out to assess exam preparedness and openness to virtual study groups and results analysed. Relevant material around virtual study groups for fellowship examinations was reviewed and used to inform a pilot virtual study group. Four New Zealand trainees took part in the pilot project, looking at using a virtual platform to augment OSCE preparation.

Results:

Of the 50 respondents 36% felt adequately prepared for the OSCE. Sixty-four per cent were interested in using a virtual platform to augment their study. Virtual study groups were noted to be especially important for rural trainees, none of whom felt able to form study groups for themselves. The pilot virtual study group was trialled successfully. All four trainees reported the experience as subjectively beneficial to their examination preparation.

Conclusions:

Virtual platforms hold promise as an augmentation strategy for exam preparation, especially for rural trainees who are more geographically isolated and less likely to have peers preparing for the same examinations.
A comparison between Right Unilateral Ultrabrief electroconvulsive therapy and bilateral electroconvulsive therapy in the elderly: a pilot naturalistic observational study
Authors: Narchal Shalini , Harris Anthony WF , Allen Bruce
Published: April 2018

Objectives:

To compare clinical outcomes and adverse effects between Bitemporal (BT) and Right Unilateral Ultrabrief (RUL(UB)) electroconvulsive therapy (ECT) in an elderly population.

Methods:

Patients over the age of 65 years admitted to a tertiary referral hospital over a seven month period requiring ECT received RUL(UB) ECT. They were compared with those who received BT ECT over these and the preceding seven months.

Results:

Twenty-three patients entered the study. No significant differences was observed between the groups in demographic and clinical characteristics or clinical improvement. However, patients who received BT ECT were significantly more likely to be confused post treatment compared with the RUL(UB) group.

Conclusions:

This pilot study found RUL(UB) ECT to be an effective treatment in elderly patients. These patients also suffered significantly less confusion than patients who received BT ECT.
Perceived confidence, competence and training in evidence-based treatments for eating disorders: a survey of clinicians in an Australian regional health service
Authors: Lakeman Richard , McIntosh Christine
Published: April 2018

Objectives:

Eating disorders (EDs) are challenging to treat and contribute to considerable morbidity and mortality. This study sought to identify the educational preparedness, competence and confidence of clinicians to work with people with EDs; and to identify how services might be improved.

Methods:

Clinicians who worked in the emergency department, medical, paediatric wards and mental health services were invited to complete an online survey.

Results:

From the 136 surveys returned, 73% of respondents reported little or no confidence working with EDs. There was a strong linear correlation between perceived confidence and competence and hours of education. Those with 70 or more hours of self-reported training were 2.7 times more likely to rate themselves as both confident and competent. Improving services for people with eating disorders included the provision of appropriate training, improving access to services including psychotherapy, and facilitating consistency in and continuity of care.

Conclusions:

To increase the confidence and competence of the workforce, regular training around EDs should be undertaken. The establishment of a specialist team to provide services across the continuum of care for people with severe or complex EDs appears warranted in a regional health service.
System identification of a low-order heat transfer model for shape memory alloy wires
Authors: Wright Cody , Bilgen Onur
Published: April 2018

Shape memory alloys exhibit a strong thermomechanical coupling. This coupling has been modeled extensively using energy-based constitutive models. Equally as important in the dynamics of shape memory alloy–based systems is the heat transfer behavior. The literature is comprehensive on parameter identification for constitutive models but is lacking in a complete resource for identification of the parameters for the heat transfer behavior. In this article, the parameters for a low-order differential equation heat transfer model are determined through experimental system identification. This is completed with two objectives in mind: keeping the order of the model low and accurately modeling the response within an acceptable tolerance. A comparison of identified model parameters to nominal values shows similar magnitudes in all parameters with exception to a significant difference in the heat transfer coefficient. For all parameters, it is shown that a methodical system identification is necessary to develop an accurate predictive model. This article details a clear method to identify the parameters of the low-order heat transfer model.
Layout design of piezoelectric patches in structural linear quadratic regulator optimal control using topology optimization
Authors: Hu Jun , Zhang Xiaopeng , Kang Zhan
Published: April 2018

This article investigates topology optimization for piezoelectric thin-shell structures under the linear quadratic regulator optimal control. In the optimization model, the structural dynamic compliance is taken as the measure of control performance, and the relative densities describing the distribution of the piezoelectric material are considered as design variables. An artificial material model with penalization on both mechanical and piezoelectric properties is employed. For the purpose of improving computational efficiency of the sensitivity and response analysis, modal superposition method is adopted. The derivative of the Riccati equation governing the linear quadratic regulator control with respect to the design variables is shown to be a Lyapunov equation. In conjunction with the adjoint variable method, the design sensitivities of the dynamic compliance are obtained using the solution of the Lyapunov equation. Numerical examples demonstrate the validity of the proposed method and show the significance of layout design of piezoelectric sensors/actuators. The influences of some key factors on the optimization solutions are discussed. It is shown that the optimized layout of the piezoelectric patches may be significantly influenced by the excitation frequency, but only slightly affected by the choice of the weighting matrix in the linear quadratic regulator control. This work aims to provide an efficient gradient-based mathematical programming method for guiding the layout design of actuators and sensors in smart structures under optimal vibration control. However, the considered model is a purely mathematical one without consideration of engineering realization, thus the optimization result may only serve as an upper bound for practically realizable control performance.
Effects of Palate Repair on Cranial Base and Maxillary Morphology in Patients With Unilateral Complete Cleft Lip and Palate
Authors: Liu Xiyang , Chen Zhenqi
Published: April 2018

Objective:

To identify the effects of palate repair on cranial base and maxillary morphology in patients with unilateral cleft lip and palate (UCLP) and to discover the relevance between cranial base and maxilla through cephalometric analysis.

Design:

Retrospective.

Patients:

Thirty-seven UCLP patients with operated lip (OL) and unoperated palate constituted OL group and were classified into 5 cervical vertebral maturation (CVM) stages. Thirty-seven UCLP patients with operated lip and palate (OLP) and 37 noncleft people with skeletal class I malocclusion were CVM- and sex-matched with the OL group as OLP group and control group, respectively. CVM stage I and II were combined into group 1, CVM stage III to V were combined into group 2.

Interventions:

Lateral cephalograms of all participants were obtained.

Main Outcome Measures:

Cephalometric analysis was employed, and data were compared among groups.

Results:

Length of posterior cranial base (Ba-S) of the OL group was shorter than controls in group 1; Ba-S and the ratio between length of posterior and anterior cranial base (Ba-S/S-N) of the OL and OLP groups were smaller than controls in group 2. No significant differences in cranial base were found between the OL and OLP groups. In group 1, patients of the OLP group showed smaller SNA, ANS-Ptm, and ANS-Ptm/S-N, and patients of the OL group showed smaller ANS-Ptm. In group 2, both OL and OLP groups had smaller sella-nasion-A point angle (SNA), projection distance between ANS and Ptm points on FH plane (ANS-Ptm), and the ratio between ANS-Ptm and anterior cranial base length (ANS-Ptm/S-N).

Conclusions:

Palate repair seems to have no obvious effects on cranial base morphology in patients with UCLP. Those patients with lip operated, whether cleft palate operated or not, tend to have a smaller length of maxilla sagittally and this deformity progresses with age.
Vibration-based damage assessment of structures using signal decomposition and two-dimensional visualization techniques
Authors: Loh Chin-Hsiung , Hsueh Wen , Tu Ya-Ching , Lin Jia-Hua , Kuo Tsai-Jung
Published: April 2018

The objective of this study was to develop a technique for vibration-based damage detection through data reduction and a visualization technique known as Sammon mapping, which directly uses sensing signals. Based on the instrumented accelerometer, damage assessment of the structure is done using either ambient vibration or seismic response for centralized and sensor-level data analyses in the time or frequency domain. For the centralized data analysis, the embedded data matrix [X]m × n was constructed, with m as the number of sensing nodes and n as the number for discrete Fourier amplitude/time series data. Incorporated with the principal component analysis, data compression and pattern recognition were used for damage detection and localization. First, the matrix of mutual distances of data sets from each sensing node on the high-dimensional space was calculated. The two-dimensional space was then generated to create a Sammon mapping configuration. Damage detection and localization could be evaluated through the change in two-dimensional visualization on a Sammon map between different damage states. The proposed two-dimensional visualization technique, which uses multivariate signal-processing algorithms to identify structural damage, was verified using experimental test data of two different damage types of structures (damages occurring either in lower modes or in non-linearity). Using the proposed technique and based on the building’s seismic response data, we can systematically detect the damage occurrence (Level 1 damage detection) and localization (Level 2 damage detection).
All Credentials aren’t Created Equal
Authors: Seamster Louise
Published: April 2018

Louise Seamster on Tressie McMillan Cottom’s Lower Ed.
The Algorithmic Rise of the “Alt-Right”
Authors: Daniels Jessie
Published: April 2018

As with so many technologies, the Internet’s racism was programmed right in—and it’s quickly fueled the spread of White supremacist, xenophobic rhetoric throughout the western world.
Trump’s Immigration Attacks, in Brief
Authors: Romero Mary
Published: April 2018

A look at the Trump administration’s attacks on Mexicans, Muslims, and unauthorized immigrants and how they’ve undermined longstanding policy and public perception.
Making Protest Great Again
Authors: Heaney Michael T.
Published: April 2018

From the Women’s March to Unite the Right, the Trump presidency has gotten underway during an extraordinary period of mobilized American protest. If nothing else, he may very well be making protest great again.
Tobacco 21
Authors: Lantz Paula M.
Published: April 2018

Paula M. Lantz on the evidence around a popular “PUP” law.
Higher Ed can Learn from First-Gen Students
Authors: Cobb Jessica
Published: April 2018

Jessica Cobb on teaching–and learning from–first-gen college students.
Who protects participants in non-inferiority trials when the outcome is death?
Authors: Palmas Walter
Published: April 2018

A non-inferiority design accepts the possibility of some efficacy loss, as part of a “successful”, statistically significant result. That loss may be excessive when the non-inferiority threshold is lenient. However, even stringent significance thresholds and safety monitoring may fail to adequately protect study participants when the primary outcome is death. The OPTIMAAL trial, a large randomized clinical trial performed in high-risk patients, is discussed as an example, using the Belmont Report principles as an ethical frame of reference. OPTIMAAL compared losartan, a new drug, to captopril, a drug known to reduce the risk of death in patients with heart failure after a myocardial infarction. Serious ethical challenges occurred in that study. Firstly, subjects had to tolerate captopril to participate, meaning that participation implied the possibility of higher risk of death if randomized to the losartan arm, as compared to the standard of care. Additionally, the stopping rules had to ensure enough power to detect non-inferiority, and potentially tolerated additional participant deaths as the study went on. There may have been fifty additional deaths in the losartan arm by the end of the trial—deaths that perhaps could have been prevented if participants took captopril. Those features represent a challenge to the beneficence principle. Finally, it is unclear whether the consenting process adhered to the respect of persons principle, because consent forms were not published, and we cannot determine whether a clear description of the risk of death during participation was provided.
Extended operating times are more efficient, save money and maintain a high staff and patient satisfaction
Authors: Herron Jonathan Blair Thomas , French Rachel , Gilliam Andrew Douglas
Published: April 2018

Current public sector austerity measures necessitate efficiency savings throughout the NHS. Performance targets have resulted in activity being performed in the private sector, waiting list initiative lists and requests for staff to work overtime. This has resulted in staff fatigue and additional agency costs. Adoption of extended operating theatre times (0800-1800 hours) may improve productivity and efficiency, with potentially significant financial savings; however, implementation may adversely affect staff morale and patient compliance. A pilot period of four months of extended operating times (4.5 hour sessions) was completed and included all theatre surgical specialties. Outcome measures included: the number of cases completed, late starts, early finishes, cancelled operations, theatre overruns, preoperative assessment and 18-week targets. The outcomes were then compared to pre-existing normal working day operating lists (0900-1700). Theatre staff, patient and surgical trainee satisfaction with the system were also considered by use of an anonymous questionnaire. The study showed that in-session utilisation time was unchanged by extended operating hours 88.7% (vs 89.2%). The service was rated as ‘good’ or ‘excellent’ by 87.5% of patients. Over £345,000 was saved by reducing premium payments. Savings of £225,000 were made by reducing privately outsourced operation and a further £63,000 by reviewing staff hours. Day case procedures increased from 2.8 to 3.2 cases/day with extended operating. There was no significant increase in late starts (5.1% vs 6.8%) or cancellation rates (0.75% vs 1.02%). Theatre over-runs reduced from 5% to 3.4%. The 18 weeks target for surgery was achieved in 93.7% of cases (vs 88.3%). The number of elective procedures increased from 4.1 to 4.89 cases/day. Only 13.33% of trainees (n = 33) surveyed felt that extended operating had a negative impact on training. The study concludes that extended operating increased productivity from 2.8 patients per session to 3.2 patients per session with potential savings of just over £2.4 million per financial year. Extrapolating this to the other 155 trusts in England could be a potential saving of £372 million per year. Staff, trainee and patient satisfaction was unaffected. An improved 18 weeks target position was achieved with a significant reduction in private sector work. However, some staff had difficulty with arranging childcare and taking public transport and this may prevent full implementation.
Researching with Twitter timeline data: A demonstration via “everyday” socio-political talk around welfare provision
Authors: Brooker Phillip , Barnett Julie , Vines John , Lawson Shaun , Feltwell Tom , Long Kiel , Wood Gavin
Published: April 2018

Increasingly, social media platforms are understood by researchers to be valuable sites of politically-relevant discussions. However, analyses of social media data are typically undertaken by focusing on ‘snapshots’ of issues using query-keyword search strategies. This paper develops an alternative, less issue-based, mode of analysing Twitter data. It provides a framework for working qualitatively with longitudinally-oriented Twitter data (user-timelines), and uses an empirical case to consider the value and the challenges of doing so. Exploring how Twitter users place “everyday” talk around the socio-political issue of UK welfare provision, we draw on digital ethnography and narrative analysis techniques to analyse 25 user-timelines and identify three distinctions in users’ practices: users’ engagements with welfare as TV entertainment or as a socio-political concern; the degree of sustained engagement with said issues, and; the degree to which users’ tweeting practices around welfare were congruent with or in contrast to their other tweets. With this analytic orientation, we demonstrate how a longitudinal analysis of user-timelines provides rich resources that facilitate a more nuanced understanding of user engagement in everyday socio-political discussions online.
Conservative in Practice: The Transformation of the Samajwadi Party in Uttar Pradesh
Authors: Verniers Gilles
Published: April 2018

Political conservatism in India is usually associated with right-wing traditionalist positions infused with religion, or with forms of economic liberal conservatism, the kind of which the Swatantra Party briefly incarnated. This article asks if the notion of conservatism can be useful to study non-Hindu right parties, by considering the trajectory of the Samajwadi Party, in the state of Uttar Pradesh (UP). Born out of the socialist tradition, the Samajwadi Party spearheaded the struggle for reservations, secularism and the quest of power of the middle peasantry, in the early 1990s. It gradually transformed into a family holding associated with caste preferentialism, cronyism and the criminalization of politics. This article seeks to account for these transformations by examining the party’s trajectory since its origins, its ideological underpinnings and the evolution of its sociological composition, placed in the context of changing electoral politics in UP.