bluuebunny/crossref_metadata_2025 huggingface dataset:
A case of panitumumab containing chemotherapy causing interstitial lung disease: early recognition and treatment resulting in a good outcome
Authors: Rezkallah Kamal Naguib Makar , Ahmed Adnan , Patel Sabah , Kozma Kelly
Published: February 2019

Panitumumab is a recombinant human IgG2monoclonal antibody which is used for the treatment of patients with metastatic colorectal cancer (mCRC) with disease progression on or following FOLFIRI (fluoropyrimidine, oxaliplatin and irinotecan) containing chemotherapy regimen. We report a case of an 83-year-old Hispanic man, non-smoker, with KRAS/NRAS wild-type mCRC of the liver who was treated with 9 cycles of FOLFOX4 (fluorouracil, leucovorin and oxaliplatin) and cetuximab. Follow-up abdominal imaging showed progression of CRC, requiring initiation of panitumumab in addition to FOLFIRI. After 2 cycles of this combination chemotherapy, he presented with acute hypoxaemic respiratory failure. Pulmonary imaging showed new onset of interstitial lung disease (ILD). He was treated with systemic corticosteroids with marked improvement of ILD. We aim to highlight the risk of severe life-threatening ILD associated with panitumumab. Early recognition of this serious adverse event helps avoid unnecessary administration of systemic antibiotics and prevent mortality.
Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: evidence from a Tanzania National Survey
Authors: Bintabara Deogratius , Ernest Alex , Mpondo Bonaventura
Published: February 2019

Objective

This study used a nationally representative sample from Tanzania as an example of low-resource setting with a high burden of maternal and newborn deaths, to assess the availability and readiness of health facilities to provide basic emergency obstetric and newborn care (BEmONC) and its associated factors.

Design

Health facility-based cross-sectional survey.

Setting

We analysed data for obstetric and newborn care services obtained from the 2014–2015 Tanzania Service Provision Assessment survey, using WHO-Service Availability and Readiness Assessment tool.

Primary and secondary outcome measures

Availability of seven signal functions was measured based on the provision of ‘parental administration of antibiotic’, ‘parental administration of oxytocic’, ‘parental administration of anticonvulsants’, ‘assisted vaginal delivery’, ‘manual removal of placenta’, ‘manual removal of retained products of conception’ and ‘neonatal resuscitation’. Readiness was a composite variable measured based on the availability of supportive items categorised into three domains: staff training, diagnostic equipment and basic medicines.

Results

Out of 1188 facilities, 905 (76.2%) were reported to provide obstetric and newborn care services and therefore were included in the analysis of the current study. Overall availability of seven signal functions and average readiness score were consistently higher among hospitals than health centres and dispensaries (p<0.001). Furthermore, the type of facility, performing quality assurance, regular reviewing of maternal and newborn deaths, reviewing clients’ opinion and number of delivery beds per facility were significantly associated with readiness to provide BEmONC.

Conclusion

The study findings show disparities in the availability and readiness to provide BEmONC among health facilities in Tanzania. The Tanzanian Ministry of Health should emphasise quality assurance efforts and systematic maternal and newborn death audits. Health leadership should fairly distribute clinical guidelines, essential medicines, equipment and refresher trainings to improve availability and quality BEmONC.
Cost-effectiveness of cell salvage and donor blood transfusion during caesarean section: results from a randomised controlled trial
Authors: McLoughlin Carol , Roberts Tracy E , Jackson Louise J , Moore Philip , Wilson Matthew , Hooper Richard , Allard Shubha , Wrench Ian , Beresford Lee , Geoghegan James , Daniels Jane , Catling Sue , Clark Vicki A , Ayuk Paul , Robson Stephen , Gao-Smith Fang , Hogg Matthew , Lanz Doris , Dodds Julie , Khan Khalid S
Published: February 2019

Objectives

To evaluate the cost-effectiveness of routine use of cell salvage during caesarean section in mothers at risk of haemorrhage compared with current standard of care.

Design

Model-based cost-effectiveness evaluation alongside a multicentre randomised controlled trial. Three main analyses were carried out on the trial data: (1) based on the intention-to-treat principle; (2) based on the per-protocol principle; (3) only participants who underwent an emergency caesarean section.

Setting

26 obstetric units in the UK.

Participants

3028 women at risk of haemorrhage recruited between June 2013 and April 2016.

Interventions

Cell salvage (intervention) versus routine care without salvage (control).

Primary outcome measures

Cost-effectiveness based on incremental cost per donor blood transfusion avoided.

Results

In the intention-to-treat analysis, the mean difference in total costs between cell salvage and standard care was £83. The estimated incremental cost-effectiveness ratio (ICER) was £8110 per donor blood transfusion avoided. For the per-protocol analysis, the mean difference in total costs was £92 and the ICER was £8252. In the emergency caesarean section analysis, the mean difference in total costs was £55 and the ICER was £13 713 per donor blood transfusion avoided. This ICER is driven by the increased probability that these patients would require a higher level of postoperative care and additional surgeries. The results of these analyses were shown to be robust for the majority of deterministic sensitivity analyses.

Conclusions

The results of the economic evaluation suggest that while routine cell salvage is a marginally more effective strategy than standard care in avoiding a donor blood transfusion, there is uncertainty in relation to whether it is a less or more costly strategy. The lack of long-term data on the health and quality of life of patients in both arms of the trial means that further research is needed to fully understand the cost implications of both strategies.

Trial registration number

ISRCTN66118656.
Effects of traditional Chinese exercise on cardiac rehabilitation after percutaneous coronary intervention: study protocol for network meta-analysis of randomised controlled trials
Authors: Luo Chuanjin , Wen Junmao , Sun Weipeng , Li Ting , Yu Xiaojiang , Zhang Tian , Zhou Xiaoqi , Wu Wei , Li Rong
Published: February 2019

Introduction

Coronary heart disease (CHD) is the most common cause of death worldwide. Percutaneous coronary intervention (PCI) has been shown to reduce mortality in patients with CHD. However, there are still recurrences of cardiovascular events after PCI. Cardiac rehabilitation (CR) in patients with established CHD is associated with reductions in cardiovascular mortality and hospital admissions, as well as improved quality of life. More and more clinical trials suggest that traditional Chinese exercise (TCE) plays a positive role in patients post-PCI. The primary purposes of the current study are to conduct a network meta-analysis of randomised trials to determine the effects of TCE in patients after PCI, and to separately compare the effects of tai chi, baduanjin and yijinjing on CR after PCI.

Methods and analysis

Studies will be retrieved from the following databases: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data, Chinese BioMedical Database and Chinese Science and Technology Periodicals Database, from inception to December 2018. We will include randomised controlled trials that are related to the effects of TCE therapies in patients after PCI. The primary outcomes will be all-cause mortality, revascularisations, health-related quality of life and hospitalisations. Two reviewers will independently select eligible articles. For each included article, two reviewers will independently extract the data and assess the risk of bias by using the Cochrane risk of bias tool. Bayesian network meta-analyses will be conducted to pool all treatment effects. The ranking probabilities for the optimal intervention of various treatments (tai chi, baduanjin or yijinjing) will be estimated by the mean ranks and surface under the cumulative ranking curve. The Grading of Recommendations Assessment, Development and Evaluation System will be used to assess the quality of evidence.

Ethics and dissemination

The results will be disseminated through peer-reviewed publications. They will provide consolidated evidence to inform clinicians on the potential functions of TCE in CR, and to provide reliable evidence for the application of TCE.

Trial registration number

CRD42018088415.
Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study
Authors: Nishikawa Yoshitaka , Tsubokura Masaharu , Takahashi Yoshimitsu , Nomura Shuhei , Ozaki Akihiko , Kimura Yuko , Morita Tomohiro , Sawano Toyoaki , Oikawa Tomoyoshi , Nakayama Takeo
Published: February 2019

Objectives

Sustaining emergency care access is of great concern. The aim of this study is to evaluate access to emergency care in a repopulated village following the 2011 Fukushima disaster.

Design

This research was a retrospective observational study. The primary outcome measure was total emergency medical services (EMS) time. A Bayesian time series analysis was performed to consider local time series trend and seasonality.

Setting

The residents in Kawauchi Village, Fukushima, Japan were forced to evacuate after the 2011 Fukushima disaster. As the radiation dose was an acceptable level, the residents began the process of repopulation in April 2012.

Participants

This study included patients transported by EMS from January 2009 to October 2015. Patients transported during the evacuation period (from March 2011 to March 2012) were excluded.

Results

A total of 781 patients were transferred by EMS (281 patients before the disaster, 416 after repopulation and 84 during the evacuation period). A Bayesian time series analysis revealed an increase in total EMS time, from the first request call to arrival at a hospital of 21.85 min (95% credible interval 14.2–29.0, Bayesian one-sided tail-area probability p=0.001). After the disaster, 42.3% of patients were transported to a partner hospital.

Conclusions

Total EMS time increased after repopulation of the area affected because of a massive number of hospital closures. Proactive partnerships would be a possible countermeasure in the affected areas after a major disaster.
Effects of new dock-less bicycle-sharing programs on cycling: a retrospective study in Shanghai
Authors: Jia Yingnan , Ding Ding , Gebel Klaus , Chen Lili , Zhang Sen , Ma Zhicong , Fu Hua
Published: February 2019

Objectives

To examine (1) the effect of new dock-less bicycle-sharing programmes on change in travel mode and (2) the correlates of change in travel mode.

Design

A retrospective natural experimental study.

Setting

12 neighbourhoods in Shanghai.

Participants

1265 respondents were recruited for a retrospective study in May 2017.

Main outcome measures

Prevalence of cycling before and after launch of dock-less bicycle-sharing programme.

Results

The proportion of participants cycling for transport increased from 33.3% prior to the launch of the bicycle-sharing programmes to 48.3% 1 year after the launch (p<0.001). Being in the age group of 30–49 years (OR 2.28; 95% CI 1.30 to 4.00), living within the inner ring of the city (OR 2.27; 95% CI 1.22 to 4.26), having dedicated bicycle lanes (OR 1.37, 95% CI 1.12 to 1.68) and perceiving riding shared bicycles as fashionable (OR 1.46, 95% CI 1.21 to 1.76) were positively associated with adopting cycling for transport. Access to a public transportation stop/station (OR 0.82, 95% CI 0.67 to 0.99) was inversely correlated with adopting cycling for transport.

Conclusions

Dock-less bicycle sharing may promote bicycle use in a metropolitan setting. Findings from this study also highlight the importance of cycling-friendly built environments and cultural norms as facilitators of adopting cycling.
Improving the management of musculoskeletal conditions: can an alternative approach to referral management underpinned by quality improvement and behavioural change theories offer a solution and a better patient experience? A mixed-methods study
Authors: Tzortziou Brown Victoria , Underwood Martin , Westwood Olwyn M , Morrissey Dylan
Published: February 2019

Objectives

To assess whether a quality improvement-based approach to referral management can result in better musculoskeletal care within general practice.

Design

Prospective cohort study using mixed methodology including random-effects meta-analysis and interrupted time series.

Setting and participants

36 general practices in East London.

Intervention

Informed by the results of a Cochrane review on educational interventions to improve general practitioners’ (GPs) musculoskeletal care, we developed a multifaceted intervention, underpinned by quality improvement and behavioural change theories. It combined locally agreed clinical pathways, feedback on referral rates, clinical audit and peer review.

Main outcome measures

Referral letter content, pathway adherence, referral rates, inter-practice variability and patient experience were evaluated before and after the intervention.

Results

Referral letter content on suspected diagnosis and prior management improved from a pooled preintervention proportion of 59% (95% CI 53% to 65%) and 67% (95% CI 61% to 73%), respectively, to 77% (95% CI 70% to 84%) and 81% (95% CI 74% to 88%). Pathway adherence improved from a pooled preintervention percentage of 42% (95% CI 35% to 48%) to 66% (95% CI 57% to 76%). The effect was greater across all quality outcomes for practices with baseline performance below or equal to the pooled baseline performance. There were reductions in the variability and rates of orthopaedic referrals at 6, 12 and 18 months (referral rate relative effect 32% (95% CI 14% to 48%), 30% (95% CI 7% to 53%) and 30% (95% CI 0% to 59%), respectively). Patient rating of how well GPs explained the musculoskeletal condition improved by 29% (95% CI 14% to 43%) and patient perception on the usefulness of the GP appointment improved by 24% (95% CI 9% to 38%).

Conclusions

A quality improvement-based approach to referral management which values GPs’ professionalism can result in improvements across a range of outcomes including referral quality, patient experience, referral rates and variability.
Effectiveness and optimal dosage of resistance training for chronic non-specific neck pain: a protocol for a systematic review with a qualitative synthesis and meta-analysis
Authors: Price Jonathan , Rushton Alison , Tyros Isaak , Heneghan Nicola R
Published: February 2019

Introduction

The prevalence of neck pain is increasing rapidly with a high percentage of patients going on to experience recurrent or chronic symptoms. The resulting pain and disability are commonly managed using a variety of treatments including exercise. Resistance training exercise aimed at the neck and shoulders is advocated to treat chronic non-specific neck pain (CNSNP), however the dosage of prescribed exercise varies considerably between studies. The aim of this study is to evaluate the effectiveness of resistance training in CNSNP and to determine an optimal dosage that should be prescribed in clinical practice.

Methods and analysis

A systematic review with qualitative synthesis and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, PEDro, Zetoc, Index to Chiropractic Literature ChiroAcces, PubMed, grey literature sources and key journals will be searched. Randomised clinical trials investigating resistance training exercise in adults with CNSNP using outcome measures of pain and/or disability will be eligible for inclusion. Two reviewers will independently screen for eligibility, extract data and assess risk of bias (Cochrane risk of bias tool) with a third reviewer mediating in cases of disagreement. Data will be synthesised qualitatively to investigate intervention effectiveness and to determine the effect of exercise dosage on pain and disability. Meta-analysis using a random-effects model will be conducted where sufficient clinical homogeneity exists. The strength of the overall body of evidence will be assessed and reported using Grading of Recommendations Assessment, Development and Evaluation.

Ethics and dissemination

This study raises no ethical issues. Results will inform exercise prescription to improve management of CNSNP. Results will be published in a peer-reviewed journal and presented at conferences.

PROSPERO registration number

CRD42018096187.
Prevalence of amblyopia and strabismus in Hani school children in rural southwest China: a cross-sectional study
Authors: Zhu Hui , Pan Chenwei , Sun Qigang , Huang Dan , Fu Zhujun , Wang Jing , Chen Xuejuan , Wang Zijing , Liu Hu
Published: February 2019

Purpose

To determine the prevalence rate of amblyopia and strabismus in Chinese Hani ethnic school-aged children.

Methods

All grade 1 and grade 7 students in Mojiang Hani Autonomous County, located in southwest China, were invited for comprehensive eye examinations performed by experienced ophthalmologists and optometrists, including visual acuity, ocular alignment and movements, cycloplegic autorefraction, anterior segment and fundus examinations. Standard definitions of amblyopia and strabismus were applied to calculate their prevalence rate.

Results

A total of 1656 (91.0% response rate) grade 1 Hani students and 1394 (92.8% response rate) grade 7 Hani students participated in the study. Amblyopia was present in 25 Hani students (0.82%, 95% CI 0.55% to 1.20%), with no significant differences in grade (p=0.42) and gender (p=0.69). Among these 25 amblyopic children, 17 had unilateral amblyopia and eight had bilateral amblyopia, including 16 anisometropic, eight binocular refractive and one strabismic. Strabismus was found in 59 Hani students (1.93%, 95% CI 1.50% to 2.48%), including 47 with intermittent exotropia, six with constant exotropia, five with constant esotropia and one with unilateral superior oblique palsy. The prevalence rate of strabismus was higher in grade 7 students than grade 1 students with borderline significance (2.44%vs1.50%, p=0.07), but was similar by gender (2.16% in boys vs 1.68% in girls, p=0.36).

Conclusion

The prevalence of amblyopia and strabismus in Chinese Hani school children are both lower than that previously reported for Chinese Han children in China and for many other racial/ethnic populations from non-China studies. Refractive error is the major cause for amblyopia and intermittent exotropia is the primary strabismus type.
Benign spindle cell lesions of the breast: a diagnostic approach to solitary fibrous tumour, nodular pseudoangiomatous stromal hyperplasia and nodular fasciitis
Authors: Naso Julia R , Chiu Connie G , Goecke Michelle E , Chang Debra , Shiau Carolyn J
Published: February 2019

Benign spindle cell lesions of the breast include neoplastic and reactive entities that are diagnostically challenging given their rarity and similar histomorphology. Accurate diagnosis on percutaneous core biopsy within this category is essential as some lesions require excision and surveillance, whereas others may be observed. We present three cases of rare benign spindle cell lesions of the breast that reflect the diversity of this group: solitary fibrous tumour, nodular pseudoangiomatous stromal hyperplasia and nodular fasciitis. Through these cases, we discuss the associated differential diagnosis and demonstrate how emerging ancillary studies can be integrated into a diagnostic approach. We highlight distinctive clinical and histopathological features and summarise recent updates to the clinical management of these lesions. An organised approach to the broad differential of spindle cell lesions is essential for appropriate diagnosis and treatment.
Rethinking Confidentiality in Qualitative Research in the Era of Big Data
Authors: Kamanzi Adalbertus , Romania Megan
Published: February 2019

This article takes the big data era as a starting point to examine common assumptions about confidentiality and privacy, arguing that confidentiality is a westernized notion that is currently facing various challenges because of the present shift toward the openness of data access across multiple platforms. We contend that the notion of privacy is more dynamic in many non-Western societies and, therefore, we want to challenge confidentiality as a necessary condition for research. Revisiting the first author’s experience working with participatory qualitative data collection methods, we argue that there are communities where confidentiality matters less; in such communities, instead of engaging in strict confidentiality procedures, particularly since confidentiality will never be achieved, qualitative researchers should build on the attitudes of such communities and go beyond the notion of individual privacy to better facilitate the formulation of community action plans for possible interventions in areas of perceived societal needs.
High Medicaid Nursing Homes: Organizational and Market Factors Associated With Financial Performance
Authors: Weech-Maldonado Robert , Lord Justin , Pradhan Rohit , Davlyatov Ganisher , Dayama Neeraj , Gupta Shivani , Hearld Larry
Published: February 2019

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. The purpose of this study is to examine the organizational and market factors that may be associated with better financial performance among high Medicaid nursing homes. Data sources included Long-Term Care Focus (LTCFocus), Centers for Medicare and Medicaid Services’ (CMS) Medicare Cost Reports, CMS Nursing Home Compare, and the Area Health Resource File (AHRF) for 2009-2015. There were approximately 1108 facilities with high Medicaid per year. The dependent variables are nursing homes operating and total margin. The independent variables included size, chain affiliation, occupancy rate, percent Medicare, market competition, and county socioeconomic status. Control variables included staffing variables, resident quality, for-profit status, acuity index, percent minorities in the facility, percent Medicaid residents, metropolitan area, and Medicare Advantage penetration. Data were analyzed using generalized estimating equations with state and year fixed effects. Results suggest that organizational and market slack resources are associated with performance differentials among high Medicaid nursing homes. Higher financial performing facilities are characterized as having nurse practitioners/physician assistants, more beds, higher occupancy rate, higher Medicare and Medicaid census, and being for-profit and located in less competitive markets. Higher levels of Registered Nurse (RN) skill mix result in lower financial performance in high Medicaid nursing homes. Policy and managerial implications of the study are discussed.
Nursing Home Quality and Financial Performance: Is There a Business Case for Quality?
Authors: Weech-Maldonado Robert , Pradhan Rohit , Dayama Neeraj , Lord Justin , Gupta Shivani
Published: February 2019

This study examines the relationship between nursing home quality and financial performance to assess whether there is a business case for quality. Secondary data sources included the Online Survey Certification and Reporting (OSCAR), Certification and Survey Provider Enhanced Reporting (CASPER), Medicare Cost Reports, Minimum Data Set (MDS 2.0), Area Resource File (ARF), and LTCFocus for all free-standing, nongovernment nursing homes for 2000 to 2014. Data were analyzed using panel data linear regression with facility and year fixed effects. The dependent variable, financial performance, consisted of the operating margin. The independent variables comprised nursing home quality measures that capture the three dimensions of Donabedian’s structure-process-outcomes framework: structure Registered Nurse (RN) hours per resident day, Licensed Practical Nurse (LPN) hours per resident day, Certified Nursing Assistant (CNA) hours per resident day, RN skill mix), process (facility-acquired restraints, facility-acquired catheters, pressure ulcer prevention, and restorative ambulation), and outcomes (facility-acquired contractures, facility-acquired pressure ulcers, hospitalizations per resident, rehospitalizations, and health deficiencies). Control variables included size, average acuity index, market competition, per capita income, and Medicare Advantage penetration rate. This study found that the operating margin was lower in nursing homes that reported higher LPN hours per resident day and higher RN skill mix (structure); higher use of catheters, lower pressure ulcer prevention, and lower restorative ambulation (process); and more residents with contractures, pressure ulcers, hospitalizations and health deficiencies (outcomes). The results suggest that there is a business case for quality, whereas nursing homes that have better processes and outcomes of care perform better financially.
Funny Cats and Politics: Do Humorous Context Posts Impede or Foster the Elaboration of News Posts on Social Media?
Authors: Heiss Raffael , Matthes Jörg
Published: February 2019

On Social Network Sites (SNS), citizens are frequently exposed to political news posts embedded in humorous context posts, such as funny videos or pictures. Using data from two experimental studies and a two-wave panel study, we test the effect of exposure to humorous context posts on message elaboration, and the consequences for political participation and knowledge. Results from the experimental studies indicated that incidental exposure to political posts in the context of humorous posts can increase message elaboration and in turn knowledge and participation. In line with these findings, results from the panel analysis revealed that exposure to humorous posts boosted message elaboration only among individuals who rarely used SNS for news. However, for citizens who use SNS for news more frequently, the effect of humor exposure on elaboration turned negative. While the panel data suggest that message elaboration positively affected political participation, there was no positive effect on knowledge.
Improving Diabetes Care: Should We Reconceptualize Diabetes Burnout?
Authors: Abdoli Samereh , Jones Danielle Hessler , Vora Amit , Stuckey Heather
Published: February 2019

Purpose

The purpose of this study was to explore and understand the experience of diabetes burnout among people with diabetes (PWD).

Methods

A qualitative descriptive analysis of 35 blog narratives published in 21 diabetes blogs from the United States, United Kingdom, and Ireland, written by PWD, provided the basis for this study’s definition of diabetes burnout. Data management (Nvivo 11 Pro) and analysis included 3 phases: immersion, reduction, and interpretation (kappa = 0.91).

Results

Findings included 5 main themes that described diabetes burnout: (1) burnout is a “detachment” from diabetes care, (2) the “demanding life” of diabetes leads to burnout, (3) struggling with “perfect” numbers adds to burnout, (4) “life events” are catalysts to burnout, and (5) overcoming burnout is like “climbing out of a difficult hole.”

Conclusions

Analysis of blog narratives provided unique insights into the concept of diabetes burnout. Five themes were identified that ranged from diabetes care detachment to difficulties in overcoming diabetes. These data provide an increased understanding of diabetes burnout and the factors that may contribute to diabetes burnout. To advance the science of diabetes burnout and to improve person-centered diabetes care and quality of life for PWD, further research is needed.
Pulmonary artery flotation catheter combined with pump-controlled retrograde trial off as a trial for weaning from veno-arterial extracorporeal membrane oxygenation: a case report
Authors: Xu Ying , Gu Qin
Published: February 2019

Background:

The Swan–Ganz catheter is a reliable method used to monitor hemodynamics in intensive care units. Pump-controlled retrograde trial off is a new weaning test for veno-arterial extracorporeal membrane oxygenation in recent years. The objective of this report is to describe a case in which pulmonary artery flotation catheter hemodynamic monitoring in combination with pump-controlled retrograde trial off was sufficient for veno-arterial extracorporeal membrane oxygenation weaning.

Methods:

We report the case of an adolescent patient with acute heart failure due to acute severe myocarditis in veno-arterial extracorporeal membrane oxygenation, intra-aortic balloon pump, and pulmonary artery flotation catheter hemodynamic monitoring.

Results:

Pulmonary artery flotation catheter hemodynamic monitoring pre- and post pump-controlled retrograde trial off was successfully proven to predict decannulation success. The patient was weaned off of the extracorporeal membrane oxygenation, intra-aortic balloon pump, and pulmonary artery flotation catheter. His cardiac function gradually recovered, and he was discharged.

Conclusion:

The combination of pulmonary artery flotation catheter hemodynamic monitoring and pump-controlled retrograde trial off can increase the possibility of veno-arterial extracorporeal membrane oxygenation successful decannulation.
Field Calibration of Fatigue Models of Cementitiously Stabilized Pavement Materials for Use in the Mechanistic-Empirical Pavement Design Guide
Authors: Li Xiaojun , Wang Jingan , Wen Haifang , Muhunthan Balasingam
Published: February 2019

The use of cementitiously stabilized materials (CSM), such as lean concrete, cement-stabilized aggregate, and soil stabilized with cement, lime, fly ash, or combinations thereof in the subgrade, sub-base, and base layers of flexible and rigid pavement structures, is a widely accepted practice by many state highway agencies. However, the bottom-up fatigue cracking models of cementitiously stabilized layers (CSL) described in the AASHTO Interim Mechanistic-Empirical Pavement Design Guide Manual of Practice (referred to as the MEPDG) have not been calibrated for CSM based on their field performance. In addition, top-compression fatigue as well as the effects of increases in the modulus and strength values of CSM over time, erosion, and freeze–thaw and wet–dry cycles on the fatigue properties of CSM are not considered in the MPEDG. To address these deficiencies, this research calibrated the bottom-up fatigue model, and developed and calibrated the top-compression fatigue model, with consideration of modulus and strength growth, erosion, and freeze–thaw and wet–dry cycles. Reasonable correlations between the predicted modulus values and measured modulus values are found for CSL. Further study is needed to refine the calibration and validate the models based on a larger population of field data that covers different material types, climatic zones, and traffic conditions.
Minimizing Work Zone Mobility Impacts using Project Coordination
Authors: Theiss LuAnn , Ullman Gerald L.
Published: February 2019

Under the Every Day Counts program, the Federal Highway Administration has been promoting technologies and practices that can shorten the project delivery process, enhance durability and safety, reduce congestion, and improve environmental sustainability. The focus is on providing efficiency through technology and collaboration. This includes strategies for Project Coordination (PC) which can be applied to a single project, or more commonly, among multiple projects within a corridor, network, or region, and possibly across agency jurisdictions, to minimize work zone impacts and produce time and cost savings. The purpose of this document is to provide guidance on implementing PC in the planning, design, and delivery phases of projects. It summarizes key steps for successfully implementing PC, using a systematic approach to meet a specific set of clearly defined objectives. The steps include: establishing the PC vision; developing details of how PC will occur; educating and informing personnel and stakeholders; implementing the PC process; and refining the process. A case study of PC in Texas is included to demonstrate successful application of the approach.
Tracking the Impact of a Toll Increase on Managed Lane Travel Behavior
Authors: Burris Mark W. , Ashraf Sruthi
Published: February 2019

Tolled managed lanes (ML) are an innovative way to increase capacity and regulate demand on roadways. They are still relatively new and a lot remains unknown about how travelers choose to use MLs or not. This paper uses disaggregate real-world travel data of travelers who choose between paying a toll to use ML or travel toll free on the adjacent general purpose lanes (GPL). The travel behavior before and after a toll increase is evaluated. The change in toll rates did not affect the overall ML use as anticipated. Overall, ML use increased after the toll increase. In addition, frequent ML users (more than 10 ML trips in a month) and infrequent ML users (1–3 ML trips in a month) behaved differently following the increase in the toll.
Long-Term Behavior of a Geosynthetic Reinforced Soil Integrated Bridge System in Hawaii
Authors: Ooi Phillip S. K. , Adams Michael T. , Lawrence Joseph B.
Published: February 2019

A 109.5-Ft-long Geosynthetic Reinforced Soil Integrated Bridge System (GRS-IBS) in Hawaii was instrumented to measure superstructure strains, vertical pressures below the footing, lateral pressures behind the end wall and modular block facing, and lateral displacements of the facing. Field surveys were also performed to measure the bridge footing settlement. The field data showed that: (1) with time the superstructure compressive concrete strains gradually increased and the end wall lateral pressures gradually decreased, evidence of superstructure concrete creep and shrinkage; (2) three years after construction, the total footing settlement was ≈ 1.2 in.; and (3) the bridge superstructure undergoes daily and seasonal thermal expansion and contraction cycles. Also seasonally, the vertical pressures beneath the footing, lateral pressures behind the end walls, and superstructure strains fluctuate cyclically. The vertical footing pressure closest to the stream experienced the greatest daily pressure fluctuation (≈ 2500−3000 psf), while the one nearest the end wall experienced the least. Based on the results of cyclic triaxial tests on a basalt aggregate similar to the GRS backfill to estimate permanent deformation of the abutment due to daily pressure fluctuations, it was estimated that the permanent strain ≈ 1%, comparable to what was observed in the bridge footing. After three years, the total settlement is about 1.6% of the GRS abutment height; ≈ 0.7% of this is due to the structure dead weight and the remaining 0.9% is due to cyclic loading, consistent with the 1% cyclic strain from laboratory permanent deformation tests.
Estimation of willingness-to-pay for the MSW disposal system by choice experiment approach: A case study of Taiwan
Authors: Chen Ying-Chu
Published: February 2019

In Taiwan, municipal solid waste (MSW) is separated into general, recyclable, and food waste categories. General waste must be packaged into pre-paid trash bags before final disposal. Recyclable items and food waste are collected separately to reduce the costs of using pre-paid trash bags. This study applied a choice experiment approach to evaluate marginal willingness-to-pay (WTP) in different MSW disposal system scenarios. Variables include cleanliness, location for purchasing pre-paid trash bags, frequency of waste collection, and distance to waste disposal. The results indicate that cleanliness, location, and distance influence public behavior, acceptance, and participation. Higher collection frequency decreases public acceptance. Some of the socio-economic variables of the respondents, including age, education, and marriage status, affect MSW management alternatives. The marginal WTP of the scenarios in this study ranged from US$0.04-0.07 per trash bag. Online purchasing of pre-paid trash bags is more cost-effective and should be encouraged. The results of this study provide useful information for the development of policies related to waste management systems.
Influence of the pH control strategy and reactor volume on batch fermentative hydrogen production from the organic fraction of municipal solid waste
Authors: Baldi Francesco , Iannelli Renato , Pecorini Isabella , Polettini Alessandra , Pomi Raffaella , Rossi Andreina
Published: February 2019

Three different experimental sets of runs involving batch fermentation assays were performed to evaluate the influence of the experimental conditions on biological hydrogen production from the source-separated organic fraction of municipal solid waste collected through a door-to-door system. The fermentation process was operated with and without automatic pH control, at a pH of 5.5 and 6.5, food-to-microorganism ratios of 1/3 and 1/1 (wet weight basis) and with different working volumes (0.5 and 3 L). The experimental results showed that the pH control strategy and the reactor volume did not affect the final hydrogen production yield but played an important role in determining the time evolution of the process. Indeed, although the different experimental conditions tested yielded comparable hydrogen productions (with maximum average values ranging from 68.5 to 88.5 NLH2 (kgTVSOF)−1), the automatic pH control strategy improved the process from the kinetic viewpoint resulting in a t95 reduction from an average of 34.9 h without automatic pH control to an average of 19.5 h.
Woody Biomass Processing and Rural Regional Development
Authors: Jackson Randall W. , Borges Ferreira Neto Amir , Erfanian Elham , Járosi Péter
Published: February 2019

The authors report on the economic impacts of introducing woody biomass processing in an economically distressed, but heavily forested Central Appalachian U.S. region. Woody biomass is a readily available unconventional energy source that has the potential to boost the rural region’s economy. They use a static regional computable general equilibrium model to assess long-run economic impacts of two woody biomass processing production pathways of biomass to ethanol through fermentation and biomass to biofuel through fast pyrolysis. While the 232 to 370 jobs and $13 million to $21 million income might seem small relative to the multicounty region, the localized impact on the county in which the facility would be sited, even for the direct jobs and income impacts, would be much more substantial. The authors conclude that woody biomass processing is a viable economic development option for the study area and similar rural regions.
Creatures Bound for Glory: Biotechnological Enhancement and Visions of Human Flourishing
Authors: Burdett Michael , Lorrimar Victoria
Published: February 2019

The human enhancement debate is fundamentally based on divergent ideals of human flourishing. Using the complementary, though often contrasting, foci of creaturehood and deification as fundamental to the good life, we examine these visions of human flourishing inherent in transhumanist, secular humanist and critical posthumanist positions on human enhancement. We argue that the theological anthropologies that respond to human enhancement and these other ideologies tend to emphasise either creaturehood or deification to the neglect or detriment of the other. We propose in response that understanding humans as creatures bound for glory integrates both dimensions of the human being into the one grand vision of flourishing God has for humanity.
Thinking security through the event: Materiality, politics and publicity in the Litvinenko affair
Authors: Ingram Alan
Published: February 2019

While the turn towards materiality over the course of the last decade has enriched studies of security in a variety of ways, the security field continues to pose challenges for materially oriented thinking. This article argues that while recent materially oriented work on security has been concerned with events, working through the question of the event as a central analytical strategy is a promising way of addressing such challenges and developing broader insights. The article develops this argument by working through a particular event, the killing of the former Russian security agent Alexander Litvinenko in London in 2006 by means of the radioactive element polonium 210. Approaching the event via the archive and report of the public inquiry that subsequently took place into it, and reflecting further on the utility of Bruno Latour’s idea of dingpolitik for materially oriented work on security, the article explores transformations of materiality, politics and publicity, and draws out how polonium 210 came to figure in the killing and the inquiry as actant, trace and evidence. In conclusion, the article reflects on the conceptual value of working through events and the methodological issues raised in the analysis.
Do emigrants’ remittances cause Dutch disease? A developing countries case study
Authors: Polat Burçak , Rodríguez Andrés Antonio
Published: February 2019

Although the positive socio-economic effects of remittances for recipient countries in the short term are unmistakable, inflows of remittances may at the same time exert adverse effects on the trade competitiveness of an economy, by appreciating the real exchange rate. This phenomenon is characterised as an instance of the ‘Dutch disease’ – the negative impact of windfall revenue inflows on the competitiveness of other tradable sectors and hence on overall economic growth. While the real effect of workers’ remittances on real exchange rates in a recipient economy is still a controversial issue, several studies have analysed evidence for the existence of the ‘Dutch disease’ phenomenon in various sets of countries. The main objective of this study is to examine whether remittance flows have had any adverse effect on the international trade competitiveness of a selected group of developing countries during the period from 1995 to 2014. Using a one-step system Generalised Method of Moments specification within a simultaneous equation approach, it shows that remittance flows depreciate the real exchange rate at their levels and that the lagged value of remittances create the Dutch disease for this country group. In addition, we confirm that while trade openness and world real interest rates contribute to a depreciation in real exchange rates, gross domestic product per capita and net Official Development Aid inflows tend to appreciate real exchange rates. A policy implication is that trade liberalisation policies that lower tariff rates on capital imports and new export-oriented incentive programmes should be accompanied by measures designed to prevent appreciation in the real exchange rate: steps in this direction such as recent macroeconomic and prudential capital flow management initiatives are briefly referenced.

JEL Codes: F20, F21, F22, F23
Ally Versus Adversary Behaviors: The Utility of a Special Education Advocate During Conflict Between Parents and Professionals
Authors: Gershwin Tracy , Vick Anna Moriarity
Published: February 2019

Navigating the special education system can leave many parents confused, overwhelmed, and struggling to find information, particularly when in conflict with professionals. One source of solace for such families is the support of an advocate. This article presents a qualitative interview study with 43 special education stakeholders (parents, professionals, and advocates) about the utility of an advocate during conflict. Findings indicated two distinct advocate behaviors, the ally and the adversary, were either helpful or unhelpful during issues of conflict between parents and professionals. Furthermore, participants discussed variability in the amount of advocate expertise and training. We conclude with recommendations for policy, practice, and future research.
Theoretical and experimental studies of a piezoelectric ring energy harvester
Authors: Zhang XF , Tzou HS
Published: February 2019

Based on the electromechanical coupling of piezoelectricity, a piezoelectric ring energy harvester is designed and tested in this study, such that the harvester can be used to power electric devices in the closed-circuit condition. Output energies across the external resistive load are evaluated when the ring energy harvester is subjected to harmonic excitations, and various design parameters are discussed to maximize the power output. In order to validate the theoretical energy harvesting results, laboratory experiments are conducted. Comparing experiment results with theoretical ones, the errors between them are under 10% for the output voltage. Laboratory experiments demonstrate that the ring energy harvester is workable in practical applications.
Boosting the efficiency of a footstep piezoelectric-stack energy harvester using the synchronized switch technology
Authors: Liu Haili , Hua Rui , Lu Yang , Wang Ya , Salman Emre , Liang Junrui
Published: February 2019

In this article, the self-supported power conditioning circuits are studied for a footstep energy harvester, which consists of a monolithic multilayer piezoelectric stack with a force amplification frame to extract electricity from human walking locomotion. Based on the synchronized switch harvesting on inductance (SSHI) technology, the power conditioning circuits are designed to optimize the power flow from the piezoelectric stack to the energy storage device under real-time human walking excitation instead of a simple sine waveform input, as reported in most literatures. The unique properties of human walking locomotion and multilayer piezoelectric stack both impose complications for circuit design. Three common interface circuits, for example, standard energy harvesting circuit, series-SSHI, and parallel-SSHI, are compared in terms of their output power to find the best candidate for the real-time-footstep energy harvester. Experimental results show that the use of parallel-SSHI circuit interface produces 74% more power than the standard energy harvesting counterpart, while the use of series-SSHI circuit demonstrates a similar performance in comparison to the standard energy harvesting interface. The reasons for such a huge efficiency improvement using the parallel-SSHI interface are detailed in this article.
Public Expressions of Trust and Distrust in Governmental Dietary Advice in Sweden
Authors: Bergman Karolin , Eli Karin , Osowski Christine Persson , Lövestam Elin , Nowicka Paulina
Published: February 2019

We examine public trust and distrust in governmental food and nutrition authorities, through analyzing 727 letters sent electronically to the Swedish National Food Agency by lay people. Using thematic analysis, four themes were developed, defining public expressions of trust and distrust in official dietary advice. Trust was expressed as (a) seeking to confirm and clarify dietary advice or (b) seeking official arbitration between competing dietary advice. Distrust was expressed as (c) questioning and scrutinizing dietary advice or (d) protesting and resisting dietary advice. Notably, expressions of distrust employed discursive practices that both mirrored authoritative discourses and subverted official advice, by appealing to scientific language and “alternative” evidence. All letters positioned the agency as the ultimate authority on healthy eating; notwithstanding whether the agency’s advice was to be followed or resisted. Thus, the letters revealed how the same authoritative discourses can simultaneously be a site of public trust and distrust.