bluuebunny/crossref_metadata_2025 huggingface dataset:
Current Concepts in the Operative Management of Acromioclavicular Dislocations: A Systematic Review and Meta-analysis of Operative Techniques
Authors: Gowd Anirudh K. , Liu Joseph N. , Cabarcas Brandon C. , Cvetanovich Gregory L. , Garcia Grant H. , Manderle Brandon J. , Verma Nikhil N.
Published: October 2018

Background:

Acromioclavicular (AC) instability is a frequent injury affecting young and athletic populations. Symptomatic, high-grade dislocations may be managed by a myriad of operative techniques that utilize different grafts to achieve reduction. Comparative data are lacking on the ability of these techniques to achieve excellent patient outcomes and stable AC reduction and to minimize complications.

Purpose:

To systematically review the outcomes and complications of different techniques of AC joint reconstruction.

Study Design:

Systematic review and meta-analysis.

Methods:

The MEDLINE, Scopus, Embase, and Cochrane Library databases were accessed to perform a systematic review of the scientific literature from 2000 to 2018 using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following keywords: “acromioclavicular” and “reconstruction.” Included articles were evaluated for loss of reduction, complication rate, revision rate, and change in coracoclavicular distance. Articles were stratified by graft and surgical material used: suture only, Endobutton with suture, TightRope, GraftRope, synthetic artificial ligament, tendon graft, and Weaver-Dunn coracoacromial ligament transfer. These outcomes were pooled using a random-effects model and stratified by surgical technique and arthroscopic versus open reconstruction.

Results:

Fifty-eight articles were included in the analysis, with 63 homogeneous populations composed of 1704 patients. The mean age was 37.1 years (range, 15-80 years) with a mean follow-up of 34.3 months (range, 1.5-186 months). The overall failure rate was 20.8% (95% CI, 16.9%-25.2%). The overall pooled complication rate was 14.2% (95% CI, 10.5%-18.8%). The most common complications were infection (6.3% [95% CI, 4.7%-8.2%]), fracture to the coracoid or distal clavicle (5.7% [95% CI, 4.3%-7.6%]), and hardware/button failure (4.2% [95% CI, 3.1%-5.8%]). There were no differences between arthroscopic and open techniques in regard to loss of reduction ( P = .858), overall complication rate ( P = .774), and revision rate ( P = .390). Open surgery had a greater rate of clavicular/coracoid fractures than arthroscopic surgery ( P = .048). Heterogeneity, best assessed from the pooled loss of reduction, was measured as I2 = 64.0%.

Conclusion:

Open and arthroscopic AC joint reconstruction techniques have no differences in loss of reduction, the complication rate, and the revision rate based on the available literature. Complications are significant, and profiles vary between surgical techniques, which should be evaluated in the decision making of selecting the technique.
Factor Structure, Measurement Invariance, Criterion Validity, and Reliability of the School Kindness Scale: Turkish Middle School Sample
Authors: Yurdabakan İrfan , Uz Baş Aslı
Published: October 2018

The aim of the study is to adapt the School Kindness Scale (SKS) to Turkish, and to examine its psychometric properties. For this purpose, two separate samples were used. Totally, 611 middle school students (302 boys, corresponding to 49.43% and 309 girls, corresponding to 50.57%) participated in the Study 1, and 759 middle school students (369 boys, corresponding to 48.62% and 390 girls, corresponding to 51.38%) participated to Study 2. In Study 1, exploratory factor analysis suggested that the SKS has a unidimensional structure, with factor loadings varying from .64 to .72. The SKS total score appears to be reliable (Cronbach’s α = .71 in Study 1, and McDonald’s ω = .82 in Study 2). Using confirmatory factor analysis, the 1-factor model was found to fit the data well. The results of measurement invariance suggest that the SKS measures similar constructs for boys and girls. Significant positive correlations were found between SKS, student-rated school climate, resilience, and life satisfaction, providing further evidence of the construct validity of the Turkish version of the SKS. The evidence suggests that scores from the Turkish version of the SKS are reliable and suitable to be used to assess school kindness in Turkish middle school students.
The Promise and Challenge of Integrating Multidisciplinary and Civically Engaged Learning
Authors: Norton Richard K. , Gerber Elisabeth R. , Fontaine Paul , Hohner Gail , Koman Patricia D.
Published: October 2018

Today’s students need to become specialists in their profession while also recognizing the blinders that specialization brings—they need both disciplinary and meta-disciplinary learning. Today’s universities need to innovate by providing an education responsive to contemporary demands. They also need to show their relevance to the broader publics they serve. This article critically assesses a teaching initiative that brings together existing courses from multiple disciplines working for public-oriented clients to collaborate on closely related problems. The Michigan Engaging Community through the Classroom initiative was designed to enhance students’ learning by making them smarter, more pragmatic, and wiser while simultaneously enhancing the university’s public service. This article assesses the promise and the challenges of such a complex initiative and summarizes preliminary findings from student and community partner evaluations. The initiative has been challenging to implement because of the faculty dedication it requires. Developing robust evaluations of student learning has proven difficult as well. We have found that when student, faculty, and partner expectations are raised but not fulfilled, frustrations run high. When coordination and collaboration align, however, student learning can be enriched and public service enhanced. The article concludes by discussing lessons learned and presenting models of collaboration developed in turn.
Chronic Comorbid Illnesses Predict the Clinical Course of 866 Patients Requiring Prolonged Mechanical Ventilation in a Long-Term, Acute-Care Hospital
Authors: Frengley J. Dermot , Sansone Giorgio R. , Kaner Robert J.
Published: October 2018

Objective:

To determine whether burdens of chronic comorbid illnesses can predict the clinical course of prolonged mechanical ventilation (PMV)patients in a long-term, acute-care hospital (LTACH).

Methods:

Retrospective study of 866 consecutive PMV patients whose burdens of chronic comorbid illnesses were quantified using the Cumulative Illness Rating Scale (CIRS). Based on increasing CIRS scores, 6 groups were formed and compared: group A (≤25; n = 97), group B (26-28; n = 105), group C (29-31; n = 181), group D (32-34; n = 208), group E (35-37; n = 173), and group F (>37; n = 102).

Results:

As CIRS scores increased from group A to group F, rates of weaning success, home discharges, and LTACH survival declined progressively from 74% to 17%, 48% to 0%, and 79% to 21%, respectively (all P < .001). Negative correlations between the mean score of each CIRS group and correspondent outcomes also supported patients’ group allocation and an accurate prediction of their clinical course (all P < .01). Long-term survival progressively declined from a median survival time of 38.9 months in group A to 3.2 months in group F ( P < .001). Compared to group A, risk of death was 75% greater in group F ( P = .03). Noteworthy, PMV patients with CIRS score <25 showed greater ability to recover and a low likelihood of becoming chronically critically ill. Diagnostic accuracy of CIRS to predict likelihood of weaning success, home discharges, both LTACH and long-term survival was good (area under the curves ≥0.71; all P <.001).

Conclusions:

The burden of chronic comorbid illnesses was a strong prognostic indicator of the clinical course of PMV patients. Patients with lower CIRS values showed greater ability to recover and were less likely to become chronically critically ill. Thus, CIRS can be used to help guide clinicians caring for PMV patients in transfer decisions to and from postacute care setting.
Impact of Intensive Care Unit Discharge Delays on Patient Outcomes: A Retrospective Cohort Study
Authors: Bose Somnath , Johnson Alistair E. W. , Moskowitz Ari , Celi Leo Anthony , Raffa Jesse D.
Published: October 2018

Objective:

Patients often overstay in intensive care units (ICU) after they are deemed discharge ready. The objective of this study was to examine the impact of such discharge delays (DD) on subsequent in-hospital morbidity and mortality.

Design:

Retrospective cohort study.

Setting:

Single tertiary academic medical center.

Patients:

Adult patients admitted to the medical ICU between 2005 and 2011.

Interventions:

For all patients, DD (ie, time between request for a ward bed and time of ICU discharge) was calculated. Discharge delays was dichotomized as long (≥24 hours) or short (<24 hours). Multivariable linear and logistic regressions were used to assess the association between dichotomized DD and post-ICU clinical outcomes.

Results:

Overall, 9673 discharges were included of which 10.4% patients had long DDs. In the fully adjusted model, a long delay was not associated with increased odds of death (adjusted odds ratio [aOR]: 0.99, 95% confidence interval [CI]: 0.74-1.31, P = .95) but was associated with a shorter log plus one of post-ICU discharge length of stay (LOS; regression coefficient: −0.13, 95% CI: −0.17 to −0.08, P < .001). Longer DD was not associated with more hospital-free days (HFD: a composite of post-ICU LOS and in-hospital mortality). Shorter DDs were associated with shorter LOS when LOS was measured from the time of ward bed request as opposed to the time of ICU discharge.

Conclusions:

In this study, long DD was associated with a slight decrease in post-ICU LOS but longer LOS when measured from the point of ward bed request, suggesting a potential role for more aggressive discharge planning in the ICU for patients with long DDs. There was no association between long DD and subsequent mortality or HFD.
Surfing with Bourdieu! A Qualitative Analysis of the Fluid Power Relations among Surfers in the Line-Ups
Authors: Uekusa Shinya
Published: October 2018

This study demonstrates an example of the fluid power dynamics among surfers in the water. The data was collected via my ethnography of surfers at a surf spot in California, accompanied by a small number of in-depth interviews. Drawing upon Bourdieu’s theories, surfers use multiple capital to exercise their power to increase the likelihood of catching high-quality waves, which appear to be scarce commodities. Focusing on the experiences of vulnerable surfers, quality waves are not evenly distributed. However, this pilot study revealed that surfers’ social status in the cultural spaces do not necessarily reflect their ability to catch quality waves, and vulnerable surfers negotiate and resist the power structure. Furthermore, some forms of capital are contextual, and advantages became disadvantages as the context changes, demonstrating the fluid nature of the power dynamics in the water. In using Bourdieu’s theories, this article will suggest a fruitful theory for future surfing research.
Performativity and the Disability Category: Solving The Zero Theorem
Authors: Mladenov Teodor
Published: October 2018

This article explores critically the relationship between capitalist performativity and the disability category. It draws on Jean-François Lyotard’s analysis of postmodernity to define ‘performativity’ as the principle of performance enhancement governing the world of contemporary techno-capitalism. The analysis then traces the historical development of the disability category in the 20th and 21st centuries and explains its complex interlinking with performativity. Special attention is paid to the impact of neoliberalism since the 1980s that includes both the disability category’s administrative shrinking and its market-based expansion. These theoretical and historical reflections are supplemented by a reading of Terry Gilliam’s movie The Zero Theorem. The conclusion discusses some possibilities for resisting performativity, suggested by the disability studies perspective espoused in the article.
Combined Insulin and GLP-1 Receptor Agonists: Simplifying Treatment or Adding Obstacles?
Authors: Yang Tianrui , Cutshall B. Tate , Tatara Alexandra , Ruegger Melanie
Published: October 2018

The US Food and Drug Administration recently approved 2 combination products containing a basal insulin and a glucagon-like peptide 1 receptor agonist: insulin glargine/lixisenatide and insulin degludec/liraglutide. These agents were shown to be noninferior in lowering hemoglobin A1c compared to basal insulin and are indicated for patients inadequately controlled on basal insulin or glucagon-like peptide 1 receptor agonists alone. The clinical implications of these agents are unclear due to limitations in the clinical trials and limited recommendations in current guidelines. While these agents may provide financial and adherence benefits, their role is likely limited to the outpatient setting. With the availability of these agents, concerns with transitions of care arise due to multiple vulnerabilities in reconciling these agents throughout the inpatient admission and discharge process. Provider awareness of the availability and dosing of insulin glargine/lixisenatide and insulin degludec/liraglutide is essential to reduce errors in the medication reconciliation process.
Hyperthermal atomic oxygen durable transparent silicon-reinforced polyimide
Authors: Qian Min , Xuan Xiao Yang
Published: October 2018

A clear poly(amic acid) was reinforced by a trisilanolphenyl polyhedral oligomeric silsesquioxane (POSS) by direct dissolution, and transparent silicon-reinforced polyimide (Si-RPI) films with different POSS loadings were obtained after curing, showing high transmittance of >90% within 380–800 nm. The Si-RPI films were exposed to a ground hyperthermal atomic oxygen (AO) beam. The erosion depths and derived erosion yields of the materials decreased with POSS loadings. At a 20 wt% POSS loading, the Si-RPI showed an erosion yield of 0.13 × 10−24 cm3 atom−1 at a fluence of 2.79 × 1020 O atoms cm−2. Surface morphology and element composition characterization on Si-RPI indicated that SiOx-based passivating layers were formed on surfaces upon the hyperthermal AO attack. This study suggests a facile way of reinforcing Si into transparent polyimide for a promising candidate of spacecraft coating material operating in low Earth orbit.
Dynamic simulation of tank stabilizer based on adaptive control
Authors: Chen Yu , Yang Guolai
Published: October 2018

Tank stabilizer is a control system keeping the bore axis in the desired sighting angle. For the control problem of the stabilizer in the case of uncertain parameters, the adaptive control method is introduced to design the vertical tank stabilizer with the nonlinear dynamic model of vertical stabilizer given in the paper. In the design, the multiple parameter uncertainties of the hydraulic servo system are fully considered and the linear feedback control is used to improve the asymptotic stability of the system. The vertical stabilizer of tank is simulated in MATLAB/Simulink environment. In addition, a dynamic model of tank on the move is established based on multi-body system theory, vehicle terramechanics and gun launch dynamics. Then the established dynamic model is combined with the designed controller based on the RecurDyn/Control module. The numerical calculation results show that the adaptive control method can effectively control the muzzle vibration of tank on the move and it can satisfy the requirement of actual vertical stabilization accuracy. But some nonlinear factors of the gun such as the flexibility of the barrel will seriously influence the desired stabilization accuracy of the vertical tank stabilizer. A comparison experiment between adaptive control and proportional–integral–derivative control is also presented to show the effectiveness of the adaptive control method. The research provides a feasible way to improve the firing accuracy of tank firing on the move.
Fast simulation of railway pneumatic brake systems
Authors: Teodoro Ícaro P , Ribeiro Daniel F , Botari Tiago , Martins Thiago S , Santos Auteliano A
Published: October 2018

The pneumatic brake system is the most important safety component in freight trains. Understanding its behavior during operation is crucial to identify the causes of technical problems and to improve driving techniques. Commercial codes can be used to analyze the system, aiming to develop better braking procedures and to predict eventual problems. However, these codes are not aimed to improve driver's skills or to predict the effects of unexpected driver's actions on the system, which can be done using train simulators and requires real-time simulations. This work focuses on modeling the pneumatic brake system to estimate the pressure along the brake line in real time by employing two different methods: the lumped characteristics approach and an isothermal approach using the Navier–Stokes equation. The results from both models match with the ones from a commercial software, which is known to represent adequately the system's behavior on the field. Using processing time as the selection criteria, this work shows that the lumped characteristics method is the best choice to be employed in real-time simulations.
Proper orthogonal decomposition analysis of boundary layer oscillating aspiration controlling separation flows in two-dimensional compressor cascades
Authors: Xu Hao , Cai Le , Ding Jun , Chen Shaowen , Wang Songtao , Wang Zhongqi
Published: October 2018

Vortex structures of the separation flow fields in two-dimensional compressor cascades controlled by the boundary layer oscillating suction are numerically investigated. The proper orthogonal decomposition method is adopted to present the variation of characteristics owned by large-scale vortices. It is found that introducing unsteady excitations with proper frequencies into the steady aspiration results in a more effective control effect and the optimal oscillation frequency should be in line with the characteristic frequencies of the steady aspirated flow field. The separation flows can be decomposed in to several basic structures with the dominant one being in the manner of Karman vortex street regardless of the control method adopted. The boundary layer oscillating suction not only alleviates the separation by removing low-energy fluid, but also intensifies the harmonic flow element represented by proper orthogonal decomposition modes with others suppressed. The well-organized vortex shedding process could contribute to the loss reduction to some extent.
Therapeutic Effects of Umbilical Cord Blood-Derived Mesenchymal Stem Cells Combined with Polydeoxyribonucleotides on Full-Thickness Rotator Cuff Tendon Tear in a Rabbit Model
Authors: Kwon Dong Rak , Park Gi-Young , Moon Yong Suk , Lee Sang Chul
Published: October 2018

While therapies using mesenchymal stem cells (MSCs) to treat rotator cuff tendon tear (RCTT) have yielded some promising preliminary results, MSCs therapy has not yet completely regenerated full-thickness RCTT (FTRCTT). It has recently been reported that polydeoxyribonucleotide (PDRN) is effective in the treatment of chronic rotator cuff disease. We hypothesized that local injection of human umbilical cord blood-derived (UCB)–MSCs with PDRN would be more effective in regenerating tendon tear than UCB-MSCs alone. The purpose of this study was to evaluate the effects of UCB–MSCs combined with different doses of PDRN on the regeneration of RCTT in a chronic RCTT model by using a rabbit model. New Zealand white rabbits ( n = 24) with FTRCTT were allocated randomly into three groups (8 rabbits per group). Three different injectants (G1-S, 0.2 mL UCB-MSCs; G2-P1, 0.2 mL UCB-MSCs with one injection of 0.2 mL PDRN; G3-P4, 0.2 mL UCB-MSCs, and four injections of 0.2 mL PDRN per week) were injected into FTRCTT under US-guidance. After the rabbits were euthanized, we evaluated ross morphological and histological change. Motion analysis was also performed. There were significant differences in gross morphological changes between before, and at 4 weeks after injection, in all three groups, but no differences were found among the three groups. Masson’s trichrome (MT) or anti-type 1 collagen antibody (COL-1)-positive cell densities in G2-P1 and G3-P4 were improved significantly compared with those in G1-S, but showed no significant difference between G2-P1 and G3-P4. On motion analysis, walking distance and fast walking time in G2-P1 and G3-P4 were significantly longer/higher than those in G1-S, but showed no significant differences between G2-P1 and G3-P4. These results demonstrated that there was no significant difference in the gross morphologic change of tendon tear between UCB-MSCs only and combination with PDRN injection in rabbit model of chronic traumatic FTRCTT. Furthermore, there were no significant differences in the regenerative effects between high and low doses of (0.8 and 0.2) mL of PDRN.
A Model for Human Islet Transplantation to Immunodeficient Streptozotocin-Induced Diabetic Mice
Authors: Estil·les Elisabet , Téllez Noèlia , Nacher Montserrat , Montanya Eduard
Published: October 2018

Streptozotocin (STZ) is a cytotoxic glucose analogue that causes beta cell death and is widely used to induce experimental diabetes in rodents. The sensitivity of beta cells to STZ is species-specific and human beta cells are resistant to STZ. In experimental islet transplantation to rodents, STZ-diabetes must be induced before transplantation to avoid destruction of grafted islets by STZ. In human islet transplantation, injection of STZ before transplantation is inconvenient and costly, since human islet availability depends on organ donation and frail STZ-diabetic mice must be kept for unpredictable lapses of time until a human islet preparation is available. Based on the high resistance of human beta cells to STZ, we have tested a new model for STZ-diabetes induction in which STZ is injected after human islet transplantation. Human and mouse islets were transplanted under the kidney capsule of athymic nude mice, and 10–14 days after transplantation mice were intraperitoneally injected with five consecutive daily doses of STZ or vehicle. Beta-cell death increased and beta-cell mass was reduced in mouse islet grafts after STZ injection. In contrast, in human islet grafts beta cell death and mass did not change after STZ injection. Mice transplanted with rodent islets developed hyperglycemia after STZ-injection. Mice transplanted with human islets remained normoglycemic and developed hyperglycemia when the graft was harvested. STZ had no detectable toxic effects on beta cell death, mass and function of human transplanted islets. We provide a new, more convenient and cost-saving model for human islet transplantation to STZ-diabetic recipients in which STZ is injected after islet transplantation.
Output Gap, Money Growth and Interest Rate in Japan: Evidence from Wavelet Analysis
Authors: Tiwari Aviral Kumar , Olayeni Olaolu Richard , Sherafatian-Jahromi Reza , Adejonwo Olofin Sodik
Published: October 2018

This article investigated the relationship between output, money and interest rate, using wavelet tools for the period 1972–2017. Application of such tools is helpful in answering particularly two questions: first, what the strength and direction of the causal relationships between money, output and interest rate is, and second, whether the relationship is cyclical or anti-cyclical in nature. Findings from this article show that output and money are highly coherent in low, middle and high frequencies, and coherence increases while controlling for interest rate, with money growth as the leading variable most of the time across frequencies. Output and interest rate are equally highly coherent, mostly at high frequency and some bits of middle frequency; coherence increases with the control for money, and interest rate often times leads the relationship. Also, money and interest rate are coherent at low, middle and high frequencies with interest rate leading the relationship, and controlling the effect of output increases the coherence at some times and decreases at other times. There are observable evidences of both cyclical and anti-cyclical relationships among the variables. Policy decisions should be cautious of shortrun moves in order not to trigger undesired long-run outcomes since no difference is observed in the direction of causation over time–frequency.

JEL: C49, E43, E52
Institutional entrepreneurship in a religious order: The 1741 Constituciones of the Hospitaller Order of Saint John of God
Authors: Baños Sánchez-Matamoros Juan , Carrasco Fenech Francisco
Published: October 2018

An extensive branch of accounting literature studies accounting and religion. The variety of religious organizations studied, theoretical approaches, and roles assigned to accounting are as extensive as the range of the values that are rooted in religious organizations. However, the literature has not yet described the role of the individual in the spread of accounting and accountability into a religious organization and what leads the individual to advocate such change. The concept of institutional entrepreneurship can shed light on this topic. To this end, this work studies the change in the Constituciones (rules) of the Hospitaller Order of Saint John of God in eighteenth-century Spain. Father Ortega, as General of the Order, played a key role supporting the implementation of accounting and accountability techniques.
Combined Sclerosing and Spindle Cell Rhabdomyosarcoma in Previous Craniotomy Site: A Case Report and a Review of the Literature
Authors: Gui Hongxing , Lhospital Elliott , Staddon Arthur P. , Nagda Suneel N. , Zager Eric L. , Zhang Paul J. L. , Brooks John S.
Published: October 2018

Sclerosing rhabdomyosarcoma (RMS) is a rare subtype of RMS with unique prominent stromal hyalinization and a pseudovascular architecture. It overlaps morphologically with spindle cell RMS and poses both diagnostic and therapeutic challenges because of its rarity and aggressive clinical course. In this article, we report a case of sclerosing RMS arising from a prior craniotomy site, which demonstrated both sclerosing and spindle cell components. A literature review of RMS with sclerosing morphology identified 122 cases. Our review documents the following: sclerosing RMS occurs in both childhood and adult populations, has a predilection for the head and neck areas, and has a worse prognosis in adults. Sclerosing RMS harbors a high frequency of MYOD1 mutations, conferring a poor clinical outcome. Sclerosing RMS and spindle RMS likely represent a morphologic spectrum of one entity.
Efficacy of environmental friendly disinfectants against the major postharvest pathogens of stone fruits on plastic and wood surfaces
Authors: Bernat M , Casals C , Teixidò N , Torres R , Carballo BC , Usall J
Published: October 2018

Disinfection of surface facilities during postharvest handling operation is an important practice to avoid secondary fruit infections at stone fruit packinghouses. The aim of this work was to evaluate the effect of six environmental friendly disinfectants against Monilinia fructicola, Penicillium expansum, Rhizopus spp., and Alternaria spp. on plastic and wood surfaces. Hydrogen peroxide, peracetic acid, sodium hypochlorite, Mico-E-pro®, Proallium FRD-N®, and DMC Clean-CNS® were used as the disinfectants. Untreated and surfaces treated with water were used as controls. Plastic and wood surfaces were sampled with Rodac plates at 2 and 24 h after treatments and the number of colonies were counted. In general, all disinfectants reduce the number of viable conidia from all studied surfaces. Hydrogen peroxide used in a concentration of 150 mg L−1 was the less effective disinfectant in all studied pathogens. The commercial product Mico-E-pro® composed of oregano, onion, and orange extract at a dose of 10 mg L−1 was the most effective disinfectant. Rhizopus spp. was the pathogen more resistant to the disinfectants followed by P. expansum, M. fructicola, and Alternaria spp. Water decreased the number of conidia adhered to the surface. In addition, the untreated control showed substantial conidia reduction after 24 h of artificial inoculation.
Toward a Model of Global Meaning Making
Authors: Tierney Robert J.
Published: October 2018

Drawing upon tenets of critical theory, cultural capital, global epistemologies, decolonization, Indigenous ways of knowing, mobility and translanguaging, ethics, and global citizenship, this article proposes a model of cross-cultural meaning making and worldly reading as a foundation for global epistemological eclecticism in our research and pedagogical pursuits. The imaginary represents an aspirational model in the interest of decolonizing and supporting “other”—notably confronting western exclusivity and racism and mobilizing epistemologies of southern scholars and Indigenous communities.
Thermally induced microcracks and mechanical property of composite honeycomb sandwich structure: Experiment and finite element analysis
Authors: Hegde Sandesh Rathnavarma , Hojjati Mehdi
Published: October 2018

Microcracking in composite honeycomb sandwich structure and its effect on mechanical properties are studied in this paper. A methodology is presented to study the extent of mechanical strength degradation of composite sandwich structure, subjected to thermal fatigue. The material under study is used for spacecraft structural applications. The test coupons were exposed to thermal cycling at elevated temperature as high as +150°C inside the oven and cryogenic temperature of −190°C by dipping in liquid nitrogen, which is comparable to the thermal environment experienced by spacecraft structures. After each thermal cycle, coupons were inspected for microcracks under an optical microscope at the cross section. The microcracks were then quantified using parameters like crack length and crack density with increase in the number of cycles. Flatwise tensile test was conducted on the coupons after every 10 thermal cycles, up to 60 cycles, to make a correlation between crack density and mechanical strength. It was observed that by increasing the number of thermal cycles, the crack density increases and the flatwise tensile strength decreases up to a specific number of cycles. Finite element analysis was performed to predict the possible location of microcracks formation and compared with experimental observation. Good correlation was observed.
Mathematical method for analysis of the asymmetric retinal vascular networks
Authors: Zhu Zhipeng , He Chao , Zhang Yingli , Yue Xiangji , Ba Dechun
Published: October 2018

Purpose:

The purpose of this study was to quantitatively investigate the haemodynamics and oxygen transmission of the retina.

Methods:

Considering the effect of Fåhraeus-Lindqvist effect on the apparent viscosity of blood and the actual haematocrit in blood vessels, this study used the currently known retinal parameters (e.g. blood flow obtained by Doppler Fourier domain optical coherence tomography, FD-OCT for short) to construct a retinal blood circulation model consisting of an asymmetric vascular network system.

Results:

The blood flow velocity and the vascular diameter in the retinal blood vessels satisfied the exponential relationship. The wall shear stress was related to the release of nitric oxide synthase and endothelin-1 by endothelial cells and played an important role in retinal blood flow regulation. In the retinal arteries, the oxygen tension ranged from 98 to 65 mmHg, and the oxygen saturation ranged from 97.3% to 92.2%. In the retinal veins, the oxygen tension was approximately 41.8 mmHg, and the oxygen saturation ranged from 79.2% to 77.3%. The difference in oxygen content of the arteriovenous network was 5.4 (ml O2/dl blood), and the oxygen extraction of the superior temporal arteriovenous network was 86 (μl/min*ml O2/dl blood).

Conclusion:

Compared with previous relevant experimental data, the numerical model established in this article demonstrates reliability. It also helps advance our understanding of the retinal pathological processes related to hemodynamics and metabolism.
Lacrimal sac lymphoma: A series of Japanese patients
Authors: Sabundayo Maria Suzanne , Takahashi Yasuhiro , Kakizaki Hirohiko
Published: October 2018

Purpose:

To present cases of primary lacrimal sac lymphoma in a Japanese population.

Methods:

In this retrospective case series, five cases (two males and three females; mean age: 49.8 years; age range: 38–62 years) were included. Clinical features, diagnostic findings, and treatment outcomes were collected and reviewed.

Results:

Most patients presented with a swelling or mass in the medial canthal area. Only one patient presented with epiphora, while another patient also complained of pain which was due to inflammation. Imaging studies revealed a lacrimal sac mass with involvement of the nasolacrimal duct and variable involvement of the nasal cavity. Histopathological findings revealed three cases of diffuse large B-cell lymphoma, one case of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, and one case of follicular lymphoma. Four cases were treated with a combination of chemotherapy and immunotherapy, with one case necessitating additional radiotherapy. One case was treated with immunotherapy alone. The mean follow-up was 23 (range: 3–50) months. Four cases showed complete remission, while the remaining patient is still ongoing treatment.

Conclusion:

Diffuse large B-cell lymphoma is the most common type of lacrimal sac lymphoma in this series. Lacrimal sac tumors should be ruled out in the presence of epiphora, dacryocystitis, or a mass in the medial canthus, even in the absence of pain or bleeding. Combined chemotherapy and immunotherapy is an effective treatment for these cases.
Eye injuries in children – incidence and outcomes: An observational study at a dedicated children’s eye casualty
Authors: Jolly Rohit , Arjunan Mousindha , Theodorou Maria , Dahlmann-Noor Annegret H
Published: October 2018

Purpose:

Trauma is an important cause of visual loss in children and may affect their quality of life. Prevention and legislation can reduce the incidence of trauma, and appropriate and timely treatment can improve prognosis. We aimed to describe incidence of eye injuries in children and the adherence to national and local management guidelines.

Methods:

Retrospective service evaluation at a tertiary hospital (Moorfields Eye Hospital, London, UK) which operates a dedicated children’s eye casualty. The electronic patient administration system and electronic patient record system (Openeyes) were used to identify children who presented with eye injuries between January 2015 and December 2015.

Results:

Of 2397 first-time attendances to our children’s casualty, 508 were for injuries (estimated incidence 21.1%, 95% confidence interval: 19.5%–22.7%). Mean age at presentation was 7.51 (standard deviation: 7.97) years; boys were more commonly affected than girls (69%). The most common injury was corneal abrasion, followed by blunt and chemical injury; severe injuries such as penetrating trauma were rare. Injuries were sustained mostly during play or sports. Two children sustained permanent loss of vision in the affected eye.

Conclusion:

Our findings are comparable to other published reports. Adherence to management guidelines is high, but documentation of advice given to families can be improved. Regular training of staff and collaboration with organisations outside the hospital can increase awareness of eye injuries in children.
The national burden of periprosthetic hip fractures in the US: costs and risk factors for hospital readmission
Authors: Reeves Russell A , Schairer William W , Jevsevar David S
Published: October 2018

Introduction:

Periprosthetic hip fractures (PPFX) are serious complications that result in increased morbidity, mortality and healthcare costs. Decreasing hospital readmissions has been a recent healthcare focus, but little is known about the overall costs associated with PPFX or the risk factors associated with readmissions. We investigated patient demographics, treatment types, 30- and 90-day readmission rates, direct costs, and patient risk factors associated with PPFX readmission.

Methods:

We used the 2013 Nationwide Readmissions Database to select patients who underwent total hip arthroplasty (THA), revision THA, and PPFX treated with open reduction internal fixation (ORIF) or revision THA. Survival analysis was used to evaluate the 90-day all-cause hospital readmission rate, and risk factors were identified using a Cox proportional hazards model, adjusting for patient and hospital characteristics.

Results:

We identified 1269 patients with PPFX treated with ORIF and 3254 treated with revision THA. 90-day readmissions were 20.9% and 27.3%, respectively. Patients with PPFX were older, female, and had multiple medical comorbidities. Patient factors associated with increased risk of readmission include: age; comorbidities; and discharge to skilled nursing facility; Medicare or Medicaid insurance. Hospital factors associated with increased risk of readmission include: large hospitals; nonprofits; metropolitan and teaching hospitals. The cost of readmission for PPFX treated with ORIF was $17,206 and revision THA was $16,504.

Discussion:

Periprosthetic hip fractures have high rates of hospital readmission, implying a significant burden to the healthcare system. Identifying risk factors is an important step towards identifying treatment pathways that can improve outcomes.
Superior wear performances of one-step forming TiCp/Ni3Al-Ni3Al multi-coating on powder metallurgy master alloy substrate
Authors: Yang Zirun , Zhang Benguo , Jiang Haiqing , Xia Haidi , Zhang Xinjiang , Jiang Cuifeng
Published: October 2018

One-step forming TiCp/Ni3Al-Ni3Al multi-coating on powder metallurgy 316L stainless steel substrate was fabricated by vacuum hot-pressing sintering technology and its wear performances at different loads and ambient temperatures were investigated. The wear weight loss of TiCp/Ni3Al-Ni3Al multi-coating increased with the increase in the applied load and a mild-to-severe wear transition occurred. Inversely, the coating’s wear weight loss decreased as the ambient temperature increased. The high wear resistance at elevated temperatures was mainly attributed to high work-hardening capacity and high temperature strength of Ni3Al matrix. Besides, the mechanically mixed layer with dispersed TiC particulates prevented the substrate from plastic deformation and thermal softening, which were conducive to improve the wear resistance of the coating.
Locking in fair weather friends: Assessing the fate of Chinese communist elite when their patrons fall from power
Authors: Shih Victor , Lee Jonghyuk
Published: October 2018

A growing literature shows robust evidence that patronage by high-level politicians greatly enhanced officials’ chance of promotion in the largest one-party dictatorship in the world, China. There have been few works on whether patrons’ exits, even when they were retirements, had an impact on followers’ career prospects. This question concerns the core theoretical issue of whether factional ties are self-reinforcing mechanisms. That is, patron–client relationships were only useful for patrons if they knew that clients would suffer if they fell from power. This mechanism creates strong incentives for clients to engage in political struggle on behalf of their patrons, regardless of the patrons’ monitoring capacity. We control for a range of unobserved heterogeneity and show that patrons’ exits from the political elite had a significantly negative impact on clients’ chance of promotion and also diminished their chance of retaining their incumbent positions.
The big bad wolf’s view: The evaluation clients’ perspectives on independence of evaluations
Authors: Pleger Lyn E. , Hadorn Susanne
Published: October 2018

The independence of evaluations has gained increasing attention in research. So far, research has mainly focused on evaluators’ experiences when confronted with pressure, leading to a restricted view of the complex context in which evaluations take place. Therefore, this article broadens the debate and follows the call by previous studies to pay attention to evaluation clients, which have been identified as the main influencing stakeholders within evaluation processes. The findings of an online survey among Swiss evaluation clients show that most clients have never been told by evaluators that they put the latter under pressure, even though previous studies found that half of the evaluators feel pressured. Nonetheless, clients frequently experience conflicts during evaluations that are often caused by a lack of a common understanding between evaluators and clients. Thus, we conclude that preventive measures are needed to increase the parties’ mutual comprehension, and ultimately, the quality of evaluation results.
Effectiveness of a novel, automated telephone intervention on time to hospitalisation in patients with COPD: A randomised controlled trial
Authors: Sink Eric , Patel Kunjan , Groenendyk Jacob , Peters Robert , Som Avik , Kim Ellen , Xing Maggie , Blanchard Melvin , Ross Will
Published: October 2018

Introduction

Owing to its capacity to perform remote assessments, telemedicine is rising as a new force in chronic obstructive pulmonary disease (COPD) management. We conducted an eight month randomised-controlled-trial to study the effect of an automated telemedicine intervention on patients’ time-to-hospitalisation.

Methods

A total of 168 patients with a diagnosis of COPD in the past 24 months were enrolled to receive the intervention at a primary care clinic. The treatment group received daily phone messages from an automated system asking them to report if they were breathing better than, worse than, or the same as the day prior. Patients reported their breathing status by responding to the text message or call. If a patient reported breathing worse, an alert was sent directly to that patient’s provider within the clinic. The control group received the same daily phone messages as the treatment group. However, no proactive breathing alerts were ever generated to the provider for these subjects. The primary outcome was the subjects’ time-to-first-COPD-related hospitalisation following the start of messages.

Results

The treatment group’s time-to-hospitalisation was significantly different than the control group’s with a hazard ratio of 2.36 (95% confidence interval 1.02–5.45, p = 0.0443). The number needed-to-treat ratio was 8.62. Subject engagement consistently ranged between 60% and 75%. The treatment group received both proactive monitoring and follow-up care from the providers.

Discussion

Active monitoring with provider feedback enables the detection of exacerbation events early enough for subjects to avoid admissions. The use of non-smartphone interventions reduces barriers to care presented by more complicated and expensive technologies. This intervention represents a simple, innovative, and inexpensive tool for improved COPD management.
Tablet-based tele-audiometry: Automated hearing screening for schoolchildren
Authors: Samelli Alessandra G , Rabelo Camila M , Sanches Seisse G Gandolfi , Martinho Ana C , Matas Carla G
Published: October 2018

Introduction

To assess the performance of a tablet-based tele-audiometry method for automated hearing screening of schoolchildren through a comparison of the results of various hearing screening approaches.

Methods

A total of 244 children were evaluated. Tablet-based screening results were compared with gold-standard pure-tone audiometry. Acoustic immittance measurements were also conducted. To pass the tablet-based screening, the children were required to respond to at least two out of three sounds for all the frequencies in each ear. Several hearing screening methods were analysed: exclusively tablet-based (with and without 500 Hz checked) and combined tests (series and parallel). The sensitivity, specificity, positive and negative predictive values and accuracy were calculated.

Results

A total of 9.43% of children presented with mild to moderate conductive hearing loss (unilateral or bilateral). Diagnostic values varied among the different hearing screening approaches that were evaluated: sensitivities ranged from 60 to 95%, specificities ranged from 44 to 91%, positive predictive values ranged from 15 to 44%, negative predictive values ranged from 95 to 99%, accuracy values ranged from 49 to 88%, and area under curve values ranged from 0.690 to 0.883. Regarding diagnostic values, the highest results were found for the tablet-based screening method and for the series approach.

Discussion

Compared with the results obtained by conventional audiometry and considering the diagnostic values of the different hearing screening approaches, the highest diagnostic values were generally obtained using the automated hearing screening method (including 500 Hz). Thus, this application, which was developed for the tablet computer, was shown to be a valuable hearing screening tool for use with schoolchildren. Therefore, we suggest that this hearing screening protocol has the potential to improve asynchronous tele-audiology service delivery.
Heaven, hell, and attitudes toward physician-assisted suicide
Authors: Sharp Shane
Published: October 2018

Using data from the 2007 Baylor Religion Survey, I evaluate whether beliefs in heaven and hell are associated with attitudes toward physician-assisted suicide. I find that those who believe in heaven and those who believe in hell tend to have negative attitudes toward physician-assisted suicide, even when controlling for other religiosity and sociodemographic variables. I also find that the belief in hell mediates the effect of the belief in heaven on attitudes toward physician-assisted suicide, suggesting that the fear of hell, more so than the reward of heaven, may lead people to have negative attitudes toward physician-assisted suicide.
Advanced combustion free-piston engines: A comprehensive review
Authors: Zhou Yingcong , Sofianopoulos Aimilios , Lawler Benjamin , Mamalis Sotirios
Published: October 2018

A reciprocating engine without a crank-slider mechanism is called a free-piston engine. If the piston is directly connected to a linear alternator, it is called a free-piston linear alternator. Free-piston engines and free-piston linear alternators have the potential to offer solutions for future hybrid electric vehicles and stationary power generation, by enabling direct conversion of mechanical energy to electricity. They benefit from reduced friction losses compared to conventional engines and can have variable compression ratio, which enables combustion control and optimization. Their widespread application has been limited by the necessity for high-speed control strategies. However, their operating characteristics can provide high efficiency, especially when used with low temperature combustion strategies. Low temperature combustion combines the high thermal efficiency of diesel engines, with the low soot emissions of spark-ignition engines, and low NO x emissions because of low burned gas temperatures. This article provides a comprehensive review of free-piston engine technology, with a focus on advanced combustion processes and their potential for use in future powertrain systems.