bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated With Timely Blood Glucose Testing and Insulin Administration in Patients Receiving Mealtime Insulin Coverage in Medical Surgical Units
Authors: Kaisen Ann R. , Parkosewich Janet A. , Bonito Kelly A.
Published: February 2018

Purpose

The purpose of the study was to identify the rate and factors associated with timely mealtime capillary blood glucose (CBG) testing and insulin coverage in hospitalized patients with diabetes.

Methods

A descriptive-correlational design was used with a random sample of patients (n = 77) and nurses (n = 36) on a medicine and a neuroscience unit of a large Magnet hospital. After written consent was obtained, post-meal patient and nurse interviews were conducted to collect information about patient, nurse, and situational factors known to influence timely mealtime diabetes care.

Results

Timely CBG testing occurred on 85.7% of the patient participants, and 71.4% received timely insulin coverage. Timely CBG testing was associated (unadjusted) with telling the patient care associate to obtain a finger stick (FS) prior to meals and patient off the unit during mealtime. The odds of having insulin administered on time was significantly and independently associated with the nurse caring for fewer patients, patients waiting for insulin prior to eating, and patients knowing pre-meal FS was high.

Conclusions

One situational factor and 2 patient factors were independently associated with timely insulin coverage prior to meals. Interventions aimed at raising staff awareness of these factors and providing tailored education to patients may improve the odds of having insulin administered on time.
Organizational Creativity, Play and Entrepreneurship
Authors: Eghenter Anna Scalfi
Published: February 2018

Artistic practice is applied as a tool of experimental research that acquires, as a necessary and decisive component, the identification of the organizational nature of the context on which it acts. The artistic frame allows the exceptional chance of developing experimentation within the spaces of everyday life, acting on its own operational rules. In response to the analysis of the context, an ‘organizational analogue’ is conceived and presented as a work of art. The ‘Analogous’ is not a representation or a performance, but rather the assumption, via linguistic mimesis, of a pre-extant object, to the shape of which a change is activated. The product is evaluated on the border of the language through which it interacts, allowing the components of the environment to negotiate its pertinence. An experimental approach based on which within the context one can find a game of which to identify the field, the rules and the players. An organizational artistic practice of playing that has juridical, economic and identity implications.
Chest pain CT in the Emergency Department: evaluating the coronary arteries even when not specifically asked for?
Authors: Morsbach Fabian , Hinzpeter Ricarda , Higashigaito Kai , Benz David , Manka Robert , Keller Dagmar I , Alkadhi Hatem
Published: February 2018

Background

Computed tomography (CT) for excluding acute aortic syndrome (AAS) and pulmonary embolism (PE) simultaneously in patients with chest pain could be used to exclude coronary artery disease (CAD).

Purpose

To evaluate the frequency of further testing for CAD in patients receiving a CT in the emergency department (ED) for simultaneous evaluation for AAS and PE.

Material and Methods

This retrospective study was conducted over a three-year period including all patients with acute chest pain visiting our ED. All patients were included that received an electrocardiography (ECG)-gated CT of the entire chest enquiring simultaneously for AAS and PE. Those patients were followed up for 30 days after their initial ED visit whether they received further testing for CAD.

Results

Within the study period, a total of 157 patients with acute chest pain received a chest pain CT for simultaneous evaluation of both AAS and PE. Image quality was deemed sufficient to evaluate the coronary arteries in 80% of the patients. Thirty-seven patients (24%) underwent additional testing for CAD within 30 days of their ED visit, including catheter coronary angiography (n = 25), cardiac-stress single-photon emission-CT (n = 6), and cardiac magnetic resonance imaging (MRI) (n = 6).

Conclusion

Of patients presenting to the ED with acute chest pain who received a chest pain CT for simultaneous evaluation of AAS and PE, 24% had further imaging for CAD within 30 days of the initial ED visit. Immediate evaluation of the coronary arteries as part of a chest pain CT should be considered here for not delaying diagnosis.
Physiological uptake of 18F-FDG in the vertebral bone marrow in healthy adults on PET/CT imaging
Authors: Shen Guohua , Liang Meng , Su Minggang , Kuang Anren
Published: February 2018

Background

18F-fluorodeoxyglucose *Equal contributors. positron emission tomography/computed tomography (18F-FDG PET/CT) has proven to be a valuable imaging modality for the assessment of bone marrow condition.

Purpose

To investigate the physiological uptake of 18F-FDG in the vertebral bone marrow in healthy adults on PET/CT imaging, and correlate the appearance with clinical factors including gender, body mass index, and age.

Material and Methods

A total of 64 healthy individuals underwent PET/CT scan, and for each vertebral body, the mean and maximum standardized uptake value (SUVmean and SUVmax) were determined in the central slice of vertebral body on the transversal fused PET/CT image. For each individual, the FDG uptake of the four regions was obtained by averaging the SUVmean and SUVmax of the vertebrae in individual regions.

Results

The FDG uptake from thoracic to sacral vertebrae showed an upward trend first, then a downward trend, while that of cervical vertebrae was relatively stable. The SUVmax and SUVmean values of bone marrow in the old group (age ≥ 50 years) were significantly lower than those in the young group (age < 50 years) in all regions of the spine ( P < 0.05). FDG uptake of the whole spine showed significant negative correlation with age, and the strongest correlation was observed in lumbar spine (SUVmean: r = −0.364, P < 0.05; SUVmax: r = −0.344, P < 0.05).

Conclusion

FDG uptake showed a tendency to increase first then decrease from thoracic to sacral vertebrae while the tendency was not obvious in cervical vertebrae. In addition, the glycolytic metabolism of all the four regions decreased with advancing age.
Modelling the deformation of continuous fibre-reinforced thermoplastics subjected to hygrothermal loading
Authors: Grätzl Thomas , Hille Manuel , Schramm Norbert , Kroll Lothar
Published: February 2018

For the application of continuous fibre-reinforced thermoplastics in car body structures it has to be ensured that they can pass through the automotive paint shop. There are substantial chemical, hygroscopic and thermal impacts throughout this process that can affect the shape of such components. The aim of this study is to model the deformation behaviour of continuous fibre-reinforced thermoplastics under hygrothermal loading. Relaxation tests were performed to assess temperature-dependent and viscoelastic behaviour. Input parameters for temperature and moisture distribution were determined experimentally and computed using finite difference method. A straightforward approach based on classical laminate theory is presented that comprises anisotropic viscoelasticity as well as hygroscopic, thermal and polymer-chemical effects. The introduced phenomenological model was successfully used to describe the deformation of five different laminate layups both dry and fully saturated with moisture.
A Pharmacy-Based Electronic Handoff Tool to Reduce Discharge Prescribing of Atypical Antipsychotics Initiated in the Intensive Care Unit: A Quality Improvement Initiative
Authors: Kram Bridgette L. , Schultheis Jennifer M. , Kram Shawn J. , Cox Christopher E.
Published: February 2018

Purpose:

To evaluate whether a pharmacist-initiated electronic handoff tool can reduce the overall, and potentially inappropriate, hospital discharge prescribing rate of atypical antipsychotics (AAP) initiated in AAP-naive critically ill adults.

Methods:

This pre–post quality improvement study was initiated in 5 intensive care units (ICUs) at a large academic medical center. An electronic handoff tool (iVent) was utilized in the post-intervention period to enhance pharmacist communication at inpatient transitions of care.

Results:

Of the 358 included patients, the proportion of hospital survivors with an AAP initiated in the ICU receiving a hospital discharge prescription was not different between the pre- and post-intervention period (28.6% vs 22.2%, P = .12). The proportion of ICU survivors with an AAP continued at the time of ICU transfer to the floor was reduced post-intervention (78.7% vs 66.7%, P = .012). Additionally, the overall proportion of a patient’s hospitalization receiving an AAP was also reduced (50.4% vs 42.8%, P = .008). A multivariate logistic regression demonstrated thatutilization of the electronic handoff tool was not associated with a reduction in hospital discharge prescribing of an AAP (odds ratio [OR]: 0.97, 95% confidence interval [CI]: 0.57-1.65).

Conclusions:

A pharmacy-initiated electronic handoff tool may reduce the proportion of AAP-naive ICU survivors with an AAP continued at the time of ICU transfer. The handoff tool was not associated with a significant reduction in the discharge prescribing rates of AAPs for hospital survivors, but a clinically meaningful reduction was possibly achieved due to enhanced communication enabled by this tool.
Dental Radiography of the Horse
Authors: Limone Leah E. , Baratt Robert M.
Published: February 2018

This step-by-step article describes radiographic imaging of the horse’s teeth and paranasal sinuses with standard radiographic equipment. Obtaining radiographs of the horse’s skull that are of diagnostic quality can be challenging. The descriptions offered in this article can help practitioners become more comfortable with obtaining diagnostic images, which will improve recognition of radiographic signs of dental and paradental pathology.
A Modified Technique for Extraction Site Closure of the Maxillary Molars in a Dog
Authors: Ritchie Curt
Published: February 2018

Performing oral surgery in dogs can present unique challenges. Among those challenges are the varying size and anatomical shape of the oral cavity in veterinary patients. Very small dogs and brachycephalic breeds provide limited exposure to the caudal maxilla. With the addition of an endotracheal tube and tie, the operating window can be quite limited and difficult to visualize and instrument. The following is a simple yet effective step-by-step procedure of tension-free closure of maxillary molar extractions in the dog.
Quality improvement strategies and tools: A comparative analysis between Italy and the United States
Authors: Villa Stefano , Restuccia Joseph D , Anessi-Pessina Eugenio , Rizzo Marco Giovanni , Cohen Alan B
Published: February 2018

Italian and American hospitals, in two different periods, have been urged by external circumstances to extensively redesign their quality improvement strategies. This paper, through the use of a survey administered to chief quality officers in both countries, aims to identify commonalities and differences between the two systems and to understand which approaches are effective in improving quality of care. In both countries chief quality officers report quality improvement has become a strategic priority, clinical governance approaches, and tools—such as disease-specific quality improvement projects and clinical pathways—are commonly used, and there is widespread awareness that clinical decision making must be supported by protocols and guidelines. Furthermore, the study clearly outlines the critical importance of adopting a system-wide approach to quality improvement. To this extent Italy seems lagging behind compared to US in fact: (i) responsibilities for different dimensions of quality are spread across different organizational units; (ii) quality improvement strategies do not typically involve administrative staff; and (iii) quality performance measures are not disseminated widely within the organization but are reported primarily to top management. On the other hand, in Italy chief quality officers perceive that the typical hospital organizational structure, which is based on clinical directories, allows better coordination between clinical specialties than in the United States. In both countries, the results of the study show that it is not the single methodology/model that makes the difference but how the different quality improvement strategies and tools interact to each other and how they are coherently embedded with the overall organizational strategy.
The design and manufacturing of fluidic oscillators for composite aircraft structures
Authors: Aly Ahmed , Colton Jonathan
Published: February 2018

Active flow control devices have been proven to reduce drag and delay stall on commercial aircraft. This leads to lower fuel usage and thus reduced flight costs. However, there is a large uncertainty as to how to integrate active flow control devices into aircraft, specifically those with composite structures. In addition, the cost of manufacturing active flow control devices for large-scale production has not been previously studied. In this article, design concepts for the attachment of a fluidic oscillator to a composite aircraft structure are investigated. A systematic approach from the conceptual design to the final design is performed using different design tools. A cost analysis is performed to select the most cost-effective design configuration based on large volume fluidic oscillator production. Through design validation and cost estimation, the final design is shown to be feasible for large volume manufacturing.
Feature learning method of acoustic emission signal during single-grit scratching on BK7 in brittle regime
Authors: Bi Guo , Xu Taolin , Kang Jianyun , Peng Yunfeng
Published: February 2018

Acoustic emission (AE) signal is released from a material as it undergoes deformation and fracture processes. AE signal provides enough information for monitoring of the interaction between tool and material. AE RMS, AE count rates, and frequency characteristics are always employed in AE-based monitoring techniques. Monitoring sensitivity is not satisfied because information implies in AE signal is lost or weaken to some extent for the present monitoring parameters. When a hard-brittle material is removed in brittle regime, burst-type AE (b-AE) associated with crack and chip is predominant compared with low-amplitude continuous-type AE. It will be more objective and physically meaningful if b-AE event is taken as a unit to be monitored. This paper is dedicated to the method of monitoring b-AE event in AE signal. Ignoring background noise, an AE signal can be looked as a convolution of b-AE events and corresponding coefficients. b-AE events correspond to brittle transient behaviors and include information of fracture mechanism. Coefficients represent intensity and location of crack and chip during removal processes. The two elements of the convolution contain different aspects of signal feature. Considering randomness of AE signals, the convolution form will be realized by self-learning from training data set of AE signals. Dictionary-learning algorithm for decaying oscillation modes of b-AE and sparse representation procedure of an AE signal are detailed in this paper based on the convex optimization theory. AE signals in brittle regime are acquired from tests of single diamond grit scratching on BK7. Simulation and experimental results verify the correctness of the feature learning method. According to the method proposed in this paper, b-AE can be objectively monitored without the interference of varying machining parameters.
Evaluation of machine learning algorithms for detection of road induced shocks buried in vehicle vibration signals
Authors: Lepine Julien , Rouillard Vincent , Sek Michael
Published: February 2018

Road surface imperfections and aberrations generate shocks causing vehicles to sustain structural fatigue and functional defects, driver and passenger discomfort, injuries, and damage to freight. The harmful effect of shocks can be mitigated at different levels, for example, by improving road surfaces, vehicle suspension and protective packaging of freight. The efficiency of these methods partly depends on the identification and characterisation of the shocks. An assessment of four machine learning algorithms (Classifiers) that can be used to identify shocks produced on different roads and test tracks is presented in this paper. The algorithms were trained using synthetic signals. These were created from a model made from acceleration measurements on a test vehicle. The trained Classifiers were assessed on different measurement signals made on the same vehicle. The results show that the Support Vector Machine detection algorithm used in conjunction with a Gaussian Kernel Transform can accurately detect shocks generated on the test track with an area under the curve (AUC) of 0.89 and a Pseudo Energy Ratio Fall-Out (PERFO) of 8%.
Higher specialty training in genitourinary medicine: A curriculum competencies-based approach
Authors: Desai Mitesh , Davies Olubanke , Menon-Johansson Anatole , Sethi Gulshan Cindy
Published: February 2018

Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the ‘usefulness’ of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.
Limits of a simplified controller design based on integral plus dead time models
Authors: Huba Mikuláš , Bélai Igor
Published: February 2018

This article presents design and evaluation of filtered proportional–integral controllers and filtered Smith predictor–inspired constrained dead time compensators. Both are based on the integral plus dead time and on the first-order time delayed plant models. They are compared as for tuning simplicity, robustness and noise attenuation. Such a comparison, which presents a robustness test regarding the importance of the internal plant feedback approximation, may be carried out by performance measures built on deviations of the input and output transient responses from their ideal shapes. When combined with integral of absolute error measures of both solution types with the disturbance responses set as nearly equivalent, we can see that the filtered Smith predictor setpoint responses may be significantly faster than the filtered proportional–integral controller responses, more robust and, using higher-order filters, also sufficiently smooth. Furthermore, tuning of the possibly higher-order filters for filtered Smith predictor is simpler. Its overall design is more transparent and straightforward with respect to the control constraints, where the filtered Smith predictor requires some additional anti-windup measures.
Parameter estimation of nonlinear systems using a robust possibilistic c-regression model algorithm
Authors: Jabeur Telmoudi Achraf , Soltani Moez , Chaouech Lotfi , Chaari Abdelkader
Published: February 2018

This article studies the problem of inappropriate parameter estimation for nonlinear system when the dataset is contaminated by noise based on fuzzy c-regression models. In comparison to the existing algorithms in the literature, the proposed method uses a generalized objective function that reduces the errors of partitioning datasets contaminated by noise, and as a consequence an accurate model is obtained. Indeed, it combines a modified version of possibilistic c-means procedure with fuzzy c-regression models. The weighted least squares method is exploited to identify the parameters contained in the consequent (THEN part). The results of this study demonstrate the effectiveness of the proposed method compared with other extended versions of the fuzzy c-regression model algorithm such as modified fuzzy c-regression model algorithm, possibilistic c-regression model and interval type-2 fuzzy c-regression model algorithm as well as other techniques existing in the literature.
Organizational Characteristics and Engagement in Open Innovation: Is There a Link?
Authors: Naqshbandi M. Muzamil
Published: February 2018

This study explores whether or not firms with different characteristics engage in open innovation (OI) differently. The aim specifically is to examine how firms differ in engaging in inbound and outbound OI based on their characteristics: type of industry, age, market orientation, firm ownership, size in terms of number of employees and annual revenue. Data were collected from 133 firms operating in various high-tech industries in Malaysia. Results obtained using several one-way analysis of variance (ANOVA) tests show that a firm’s engagement in OI is a function of the type of industry the firm is operating in, its ownership structure and its size in terms of number of employees and revenue earned. However, engagement in OI was not found to be related to firms’ age or their market orientation. These findings shed light on the characteristics of firms that engage in OI more than others, thus having vital implications for theory and practice. The article presents a discussion of these findings along with limitations and future research directions.
Otologic Outcomes With Two Different Surgical Protocols in Patients With a Cleft Palate
Authors: D’Andréa Grégoire , Maschi Claude , Savoldelli Charles , Caci Hervé , Bailleux Sonanda
Published: February 2018

Objective:

To compare otologic outcomes in patients with cleft palate who underwent 2 different surgical protocols.

Design:

Monocentric retrospective analysis of medical reports.

Patients, Participants:

All consecutively treated patients affected by a cleft palate, born between January 1998 and December 2002 (group 1) and between January 2007 and December 2010 (group 2).

Interventions:

Patients in group 1 underwent Veau-Wardill-Kilner palatoplasty at 10 months and had ventilation tubes inserted in case of otitis media with effusion (OME) during surgery. Patients in group 2 underwent Sommerlad intravelar veloplasty at 5 months. Ventilation tubes were inserted only in case of persistent OME.

Main Outcome Measure(s):

The need for a second set of ventilation tubes to be inserted in case of persistent OME, the presence of OME at the age of 2 years, and tympanic abnormalities at the age of 5 years were analyzed.

Results:

There was no statistically significant difference either for the presence of OME at the age of 2 years (27 [45%] vs 32 [57.14%], respectively, in groups 1 and 2; P = .191) or for tympanic abnormalities at the age of 5 years (20 [33.33%] vs 15 [26.79%]; P = .433). Statistically significant difference was found for the need to insert a second set of ventilation tubes in case of persistent OME (29 [48.33%] vs 12 [21.42%], respectively; P = .02).

Conclusion:

Early Sommerlad intravelar veloplasty may reduce persistent OME and consequently the need for ventilation tubes insertion, compared to later Veau-Wardill-Kilner palatoplasty.
The Joint Roles of Career Decision Self-Efficacy and Personality Traits in the Prediction of Career Decidedness and Decisional Difficulty
Authors: Penn Lee T. , Lent Robert W.
Published: February 2018

We examined the differential roles that career decision-making self-efficacy and the Big Five traits of neuroticism, extroversion, and conscientiousness may play in relation to career decision status and decisional difficulty. Following assumptions of the social cognitive model of career self-management, we hypothesized that the relations of the personality traits to level of decidedness and choice/commitment anxiety (CCA), a key source of indecision, would be mediated by self-efficacy. We also examined the possibility that the traits could function to moderate the relation of self-efficacy to the dependent variables. Employing a sample of 182 undergraduates, we found support for a mediational model in which each of the personality traits relates to self-efficacy which, in turn, predicts CCA and decidedness. In addition, conscientiousness was found to moderate the relation of career decision-making self-efficacy to CCA, and extroversion moderated the relation of self-efficacy to decidedness. We consider the findings in relation to the social cognitive model and discuss their implications for future research and career decision-making interventions.
How Young Adolescents Draw Themselves: A Comparison Across Three Ecosocial Contexts in Southern Madagascar
Authors: Scheidecker Gabriel , Gernhardt Ariane , Rübeling Hartmut , Holtmannspötter Jona , Keller Heidi
Published: February 2018

The present study investigated the impact of young adolescents’ learning environment on their culturally mediated view of themselves as expressed in their self-drawings. The sample consisted of 83 young adolescents, 35 male and 48 female, aged 10 to 14 years with an overall average of 12 years living in three diverse ecosocial contexts within the Southern region of Madagascar: 28 participants were recruited in rural villages, 14 adolescents lived in a small town, and 41 adolescents were raised in a large city. The participants did not differ in age or gender distribution. The analyses revealed significant differences in the adolescents’ emotional expressions, drawing styles, visual appearances, and figure sizes in their self-depictions, which were in line with ecosocial variations in their learning environments. The findings are interpreted in light of the participants’ varying socialization experiences, access to formal education, and exposure to modern media and a Western lifestyle.
Comparison of the effectiveness of venous thromboembolism prophylaxis with enoxaparin between obese and non-obese patients
Authors: Alnatsheh Abdelmajid H , Beckett Robert D , Waterman Stacy
Published: February 2018

Objective

The purpose of this study is to compare the incidence of venous thromboembolism between obese and non-obese hospitalized patients who received United States Food and Drug Administration-approved prophylactic enoxaparin doses and to describe enoxaparin dosing strategies used in obese patients.

Methods

This was a retrospective cohort study including patients who were admitted to Parkview Regional Medical Center, Parkview Hospital, or Parkview Orthopedic Hospital between September 2011 and August 2012 and received at least one dose of enoxaparin 30 mg twice daily or enoxaparin 40 mg once daily for venous thromboembolism prophylaxis. Patients classified based on their body mass index into three groups, Group 1 (non-obese: body mass index < 25 kg/m2), Group 2 (overweight: body mass index ≥ 25 kg/m2 but < 30 kg/m2), and Group 3 (obese: body mass index ≥ 30 kg/m2). The primary endpoint was venous thromboembolism occurrence within 90 days, considering day 1 of hospitalization as day 1.

Results

Of the 428 patients included, 8 cases of venous thromboembolism (1.9%) were identified; 3 in the non-obese group, 2 in the overweight group, and 3 in the obese group, no statistically significant differences were found between the three groups, p = 0.81. When venous thromboembolism incidence was adjusted for age and sex, no statistically significant differences were found between overweight (OR = 0.685; 95% CI 0.115–4.095), obese (OR = 0.797; 95% CI 0.353–1.796), and combined overweight and obese (OR = 0.656; 95% CI 0.154–2.799) groups compared to patients with normal body weight.

Conclusion

This study did not find a statistically significant difference in venous thromboembolism incidence between obese, overweight, and non-obese hospitalized patients receiving approved enoxaparin prophylaxis doses.
Randomized pilot study to compare metal needles versus plastic cannulae in the development of complications in hemodialysis access
Authors: Marticorena Rosa M , Dacouris Niki , Donnelly Sandra M
Published: February 2018

Background:

Hemodialysis requires needle insertions every treatment. Needle injury (mechanical or hemodynamic) may cause complications (aneurysms/stenosis) that compromise dialysis delivery requiring interventions. Metal needles have a sharp slanted “V”-shaped cutting tip; plastic cannulae have a dull round tip and four side holes. Preliminary observations demonstrated a difference in intradialytic blood flow images and mean Doppler velocities at cannulation sites between the two devices. Complications from mechanical and hemodynamic trauma requiring interventions were compared in each group.

Materials and methods:

In all, 33 patients (13 females and 17 new accesses) were randomized to metal group (n = 17) and plastic group (n = 16). Mechanical trauma was minimized by having five nurses performing ultrasound-guided cannulations. Complications were identified by the clinician and addressed by the interventionalists, both blinded to study participation. Patients were followed for up to 12 months.

Results:

Baseline characteristics were not significant. Procedures to treat complications along cannulation segments increased from 0.41 to 1.29 per patient (metal group) and decreased from 1.25 to 0.69 per patient (plastic group; p = 0.004). The relative risks of having an intervention (relative risk = 1.5, 95% confidence interval = 0.88–2.67) and having an infiltration during hemodialysis (relative risk = 2.26, 95% confidence interval = 1.03–4.97) were higher for metal needles. Time to first intervention trended in favor of plastic cannula (p = 0.069). Cost of supplies for these interventions was approximately CAD$20,000 lower for the plastic group.

Conclusion:

Decreased burden of illness related to cannulation (less infiltrations during hemodialysis) and Qb were associated with plastic cannulae. Decreased procedure costs were suggested during the study period in the plastic group.
Postcapitalist precarious work and those in the ‘drivers’ seat: Exploring the motivations and lived experiences of Uber drivers in Canada
Authors: Peticca-Harris Amanda , deGama Nadia , Ravishankar M. N.
Published: February 2018

In this inductive, qualitative study, we observe how Uber, a company often hailed as being the poster-child of the sharing economy facilitated through a digital platform may also at times represent and reinforce postcapitalist hyper-exploitation. Drawing on the motivations and lived experiences of 31 Uber drivers in Toronto, Canada, we provide insights into three groups of Uber drivers: (1) those that are driving part-time to earn extra money in conjunction with studying or doing other jobs, (2) those that are unemployed and for whom driving for Uber is the only source of income, and (3) professional drivers, who are trying to keep pace with the durable digital landscape and competitive marketplace. We emphasize the ways in which each driver group simultaneously acknowledges and rejects their own precarious employment by distancing techniques such as minimizing the risks and accentuating the advantages of the driver role. We relate these findings to a broader discussion about how driving for Uber fuels the traditional capitalist narrative that working hard and having a dream will lead to advancement, security and success. We conclude by discussing other alternative economies within the sharing economy.
Diagnosis of retinal detachments by a tele-ophthalmology screening program
Authors: McCord Sarah A , Lynch Mary G , Maa April Y
Published: February 2018

In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic.

Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.
Hijacking the dispatch protocol: When callers pre-empt their reason-for-the-call in emergency calls about cardiac arrest
Authors: Riou Marine , Ball Stephen , O’Halloran Kay L , Whiteside Austin , Williams Teresa A , Finn Judith
Published: February 2018

This article examines emergency ambulance calls made by lay callers for patients found to be in cardiac arrest when the paramedics arrived. Using conversation analysis, we explored the trajectories of calls in which the caller, before being asked by the call-taker, said why they were calling, that is, calls in which callers pre-empted a reason-for-the-call. Caller pre-emption can be disruptive when call-takers first need to obtain an address and telephone number. Pre-emptions have further implications when call-takers reach the stage when they are required to deliver the scripted turn ‘ tell me exactly what happened’. When there has been a pre-emption earlier on, callers tend to treat the scripted turn as a request for more information and may not repeat their reason-for-the-call. This can occasion delays and important information can be lost. We identified an effective alternative strategy used by some call-takers, pre-emption repeat, which callers treat as a request for confirmation.
A review of the integrity of metallic vehicle armour to projectile attack
Authors: Lenihan Donncha , Ronan William , O'Donoghue Padraic E , Leen Sean B
Published: February 2018

This article presents a review of engineering and design aspects relevant to the mechanical and structural integrity of military vehicular armour, including materials-related technologies. Theoretical, experimental and numerical techniques for assessment are discussed and evaluated. A number of prominent material constitutive models are comparatively assessed. The Johnson–Cook model is shown to be particularly consistent in terms of agreement with experimental data, identification of material constants and ease of application. The article also discusses different numerical codes used and their relevance over time. Finally, it is argued that there is a need for a materials design tool for military vehicular armour.
Between a ‘media circus’ and ‘seeing justice being done’: Metajournalistic discourse and the transparency of justice in the debate on filming trials in British newspapers
Authors: Garcia-Blanco Iñaki , Bennett Lucy
Published: February 2018

Public trust in the criminal justice system in England and Wales has been low since the 1990s, and accusations that the system is arcane, lacking transparency, soft on criminals and removed from the society it serves are common. The government, together with many lawyers, journalists and experts, believes that lifting the ban on televising trials may enhance the transparency of the judicial system, and eventually lead to higher levels of public trust. Drawing on the most systematic content analysis of the coverage of this debate between 1984 and 2016, we analyse how this issue was debated in British national newspapers. In addition to examining how newspapers presented this policy debate, we also explore how the coverage discussed the impact that filming trials could have upon journalistic practice. Our analysis shows how metajournalistic discourse resorts to high-profile and celebrity cases when examining journalistic practice. Newspapers constructed this issue as a quandary between increasing the transparency of the judicial system, and the risk that justice would become sensationalised, ignoring key elements in the debate, and the role that journalists themselves may play in that process.
It makes you make the time: ‘Obligatory’ leisure, work intensification and allotment gardening
Authors: Schoneboom Abigail
Published: February 2018

This ethnographic study of busy allotment-holders explores the juxtaposition of time spent on the allotment with paid employment and caregiving. Highlighting the recent surge in allotment demand among professionals such as nurses and educators, the article examines the seeming contradiction of adding a very time-consuming responsibility onto an already packed schedule. It shows how the allotment’s normative structure creates a sense of obligation, helping busy professionals make the time to explore what most pleases. The research is informed by the idea that paid work continually extends its reach and that leisure is caught up in the dynamics of intensification. It suggests instrumental use of the allotment in ways that are functional for wage labour, yet it also argues that contemporary leisure has been over-characterized as an extension of internalized control and urges closer attention to the allotment as fertile soil for the post-work imaginary.
Predictors of COPD in symptomatic smokers and ex-smokers seen in primary care
Authors: Tupper Oliver Djurhuus , Kjeldgaard Peter , Løkke Anders , Ulrik Charlotte Suppli
Published: February 2018

Even in subjects at high risk of chronic obstructive pulmonary disease (COPD), the diagnosis is often missed due to lack of awareness of symptoms and risk factors. The objective of this study was to identify predictors of a diagnosis of COPD in symptomatic current and ex-smokers seen in a primary care setting. General practitioners ( n = 241) consecutively recruited subjects ≥ 35 years, with tobacco exposure, at least one respiratory symptom (i.e. cough, sputum, wheeze, dyspnoea and/or recurrent lower respiratory tract infections), and no previous diagnosis of obstructive airways disease. Information on age, smoking status, body mass index (BMI) and dyspnoea (Medical Research Council (MRC) dyspnoea scale) was obtained. Individuals with airway obstruction (i.e. forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio (FVC) < 0.70) at initial spirometry had a diagnostic spirometry after administration of a bronchodilator. COPD was defined as the presence of symptoms, tobacco exposure and persistent airflow limitation. The most prevalent symptoms were cough (72%) and dyspnoea (48%). Of 3875 (50% females, mean age 57 years) subjects screened, 700 (18.1%) were diagnosed with COPD. Multivariate logistic regression analysis revealed that increasing age 50–59 years (OR 2.4, 95% CI 1.8–3.3), 60–69 years (OR 4.1, 95% CI 3.1–5.5), ≥70 years (OR 5.7, 95% CI 4.2–7.8), BMI < 25 (OR 2.3, 95% CI 1.9–2.7), being current smoker (OR 1.2, 95% CI 1.01–1.5), self-reported dyspnoea (OR 1.7, 95% CI 1.4–2.0), wheeze (OR 1.9, 95% CI 1.5–2.3) and sputum (OR 1.4, 95% CI 1.1–1.7) were associated with a significantly higher risk of being diagnosed with COPD. No association was found between gender, cough and recurrent respiratory tract infections and a diagnosis of COPD. Among symptomatic smokers and ex-smokers seen in primary care, self-reported sputum production, wheeze, dyspnoea and low BMI identify a subgroup with a higher likelihood of COPD.
Proteomic analysis identifies NPTX1 and HIP1R as potential targets of histone deacetylase-3-mediated neurodegeneration
Authors: Qu Zhe , D’Mello Santosh R
Published: February 2018

A defining feature of neurodegenerative diseases is the abnormal and excessive loss of neurons. One molecule that is particularly important in promoting neuronal death in a variety of cell culture and in vivo models of neurodegeneration is histone deacetylase-3 (HDAC3), a member of the histone deacetylase family of proteins. As a step towards understanding how HDAC3 promotes neuronal death, we conducted a proteomic screen aimed at identifying proteins that were regulated by HDAC3. HDAC3 was overexpressed in cultured rat cerebellar granule neurons (CGNs) and protein lysates were analyzed by mass spectrometry. Of over 3000 proteins identified in the screen, only 21 proteins displayed a significant alteration in expression. Of these, 12 proteins were downregulated whereas 9 proteins were upregulated. The altered expression of five of these proteins, TEX10, NPTX1, TFG, TSC1, and NFL, along with another protein that was downregulated in the proteomic screen, HIP1R, was confirmed using Western blots and commercially available antibodies. Because antibodies were not available for some of the proteins and since HDAC3 is a transcriptional regulator of gene expression, we conducted RT-PCR analysis to confirm expression changes. In separate analyses, we also included other proteins that are known to regulate neurodegeneration, including HDAC9, HSF1, huntingtin, GAPDH, FUS, and p65/RELA. Based on our proteomic screen and candidate protein approach, we identify three genes, Nptx1, Hip1r, and Hdac9, all known to regulate neurodegeneration that are robustly regulated by HDAC3. Given their suggested roles in regulating neuronal death, these genes are likely to be involved in regulating HDAC3-mediated neurotoxicity.

Impact statement

Neurodegenerative diseases are a major medical, social, and economic problem. Recent studies by several laboratories have indicated that histone deacetylase-3 (HDAC3) plays a key role in promoting neuronal death. But the downstream mediators of HDAC3 neurotoxicity have yet to be identified. We conducted a proteomic screen to identify HDAC3 targets the results of which have been described in this report. Briefly, we identify Nptx1, Hip1r, and Hdac9 as genes whose expression is altered by HDAC3. Investigating how these genes are involved in HDAC3 neurotoxicity could shed valuable insight into neurodegenerative disease and identify molecules that can be targeted to treat these devastating disorders.
Scorpion inhibits epithelial–mesenchymal transition and metastasis of hepatocellular carcinoma
Authors: Yan Yi-Quan , Xie Juan , Wang Jing-Fu , Shi Zhao-Feng , Zhang Xiang , Du Yong-Ping , Zhao Xing-Cheng
Published: February 2018

Hepatocellular carcinoma (HCC) is one of the most malignant diseases worldwide. The unfavorable clinical outcome and poor prognosis are due to high rates of recurrence and metastasis after treatments. Some scholars of traditional Chinese medicine suggested that endogenous wind-evil had played an important role in metastasis of malignant tumor. Therefore, the drug of dispelling wind-evil could be used to prevent cancer metastasis and improve the poor prognosis. So we wondered whether Scorpion, one of the most important wind calming drugs, has antitumor effect especially in epithelial–mesenchymal transition (EMT) and metastasis of HCC in this research. We found that Scorpion-medicated serum could inhibit proliferation, induce apoptosis, and decrease migration and invasion capacity of Hepa1-6 cells in vitro. Meanwhile, we observed that water decoction of Scorpion restrained tumor growth and metastasis in nude mouse of HCC metastasis models. Further experiments showed that Scorpion could suppress EMT, which is characterized by increased epithelial marker E-cadherin expression and decreased mesenchymal markers N-cadherin and Snail expression following Scorpion treatment both in vitro and in vivo. These results suggested that the Scorpion could inhibit Hepa1-6 cells’ invasion and metastasis in part by reversing EMT and providing a possible potential approach for preventing HCC metastasis.

Impact statement

The unfavorable clinical outcome and poor prognosis of hepatocellular carcinoma (HCC) are due to high rates of recurrence and metastasis after treatments. Here we found Scorpion, one of the most important wind calming drugs, has antitumor effect. Scorpion-medicated serum inhibited the proliferation, induced apoptosis, and decreased migration and invasion capacity of Hepa1-6 cells in vitro. Water decoction of Scorpion restrained tumor growth and metastasis in nude mouse of HCC metastasis models. Further experiments showed that Scorpion could suppress EMT of HCC both in vitro and in vivo. Our results suggested that the Scorpion could inhibit Hepa1-6 cells’ invasion and metastasis in part by reversing EMT and providing a possible potential approach for preventing HCC metastasis.
A College at the Crossroads: The Case of the College of Business Administration at Abu Dhabi University
Authors: Krotova Pitzel Camba , Krotov Vlad
Published: February 2018

The College of Business Administration at Abu Dhabi University, a private university in the United Arab Emirates, has been experiencing a decline in enrollment for several years. This decline in enrollment is believed to be associated with a number of internal and external factors, such as intense competition from local and international universities, aftereffects of an economic downturn in the country, fading popularity of business degrees, and many others. Despite the college obtaining Association to Advance Collegiate Schools of Business (AACSB) accreditation and implementing a number of enrollment management indicatives, the problem of low enrollment remains. Since student tuition is the main source of funds for the university, the problem of low student enrollment should be addressed swiftly.
Research on optimal layout of cutter-head system of rock tunnel-boring machine based on Archimedes spiral theory
Authors: Chen Yadong , Wei Tianhua , Gong Tianxing
Published: February 2018

In order to obtain the satisfied rock-breaking requirements, the layout of cutter-head system of tunnel-boring machine are optimized and analysed to work efficiently by the scientific and reasonable design. An integrated method which can optimize exactly the cutter-head system considering equivalent life principle and force balance based on Archimedes spiral theory is proposed in this article. The effect of installation radius of cutter on wear coefficient and tunnelling coefficient is analysed using equivalent life principle. The force balance models are established using optimization of cutter arrangement. The comparison between the simulation and experimental results shows that the kinematic and dynamic of cutter-head system are reasonable based on Archimedes spiral method. It can be concluded that, therefore, the proposed integration method can offer a theoretical foundation and reference for dynamic optimal design for cutter-head system.