bluuebunny/crossref_metadata_2025 huggingface dataset:
A complete methodology for identifying dynamics of heavy machine tool through operational modal analysis
Authors: Mao Xinyong , Yan Ruizhi , Cai Hui , Li Bin , Luo Bo , He Songping
Published: February 2016

Heavy machine tool work under such high-load conditions that chatter vibrations are prone to occur, which significantly diminishes the machining efficiency and quality. Stability lobe diagrams are commonly used to select appropriate spindle speed and axial depth of cut to get rid of chatter and maximize the material removal rate. However, this needs precise identification of the dynamics of the entire machine tool structure, especially in the low-frequency range. Operational modal analysis has been the proven technique for estimating dynamic characteristics of machine tool structures in operation conditions. In this article, a complete methodology was presented for employing operational modal analysis for heavy machine tool in machining conditions. A random cutting exciting method originally presented by Minis is modified which generates pseudorandom impulse force to excite a heavy vertical lathe structure. And the excitation signal of random cutting force was modeled to analyze the effect of cutting parameters on energy and frequency band of the excitation. One operational modal analysis method, the pLSCF (referred to as PolyMAX) method, was employed to estimate modal parameters during machining. It was also observed in chatter tests that the operational modal analysis results are more accurate than the traditional impact test results in characterizing the dynamics of machine tool structure in machining.
Optimal fiber orientation and topology design for compliant mechanisms with fiber-reinforced composites
Authors: Tong Xinxing , Ge Wenjie , Zhang Yonghong
Published: February 2016

An approach for designing compliant mechanisms with glass fiber-reinforced epoxy materials is presented to obtain the optimum fiber orientation and topology structure simultaneously in this paper. Four-node hybrid stress elements and nodal design variables are adopted to suppress the islands and checkerboard phenomenon without additive filter technology and constraint. Taking fiber orientation and relative density as design variables, minimizing the weighted linear combination of the mutual strain energy and the strain energy is considered as objective function to achieve the desired deformation and enough load-carrying capacity of compliant mechanisms with the volume constraint. The displacement field of structure is obtained by the finite element analysis, and the non-linear optimization problem is solved via the well-known method of moving asymptotes. The numerical examples of designing compliant inverters and grippers with different weighted factors are investigated to demonstrate the effectiveness of the proposed method.
An adaptive framework to enhance microscopic traffic modelling: an online neuro-fuzzy approach
Authors: Kazemi Reza , Abdollahzade Majid
Published: February 2016

Because of various environmental factors (e.g. road type and traffic congestion) and the involvement of human action (e.g. drowsiness and consciousness level), the time-variant nature of the car-following process necessitates the use of adaptive modelling approaches. In contrast with the existing car-following models with a fixed structure, this paper proposes an adaptive framework based on an online local linear neuro-fuzzy model, supported by a recursive singular spectrum analysis signal-processing technique, to model the time-variant car-following behaviour in a microscopic traffic flow. The online local linear neuro-fuzzy model is initially trained by a set of offline data and then is adapted to the car-following data by means of an adaptive weighted least-squares technique. Furthermore, the recursive singular spectrum analysis technique is employed to decompose the traffic data in an online manner and then to remove useless components (e.g. the measurement noise) to produce well-behaved data. The proposed synergistic approach is applied to real-world car-following data, collected at the Hollywood freeway section of the US 101 Highway. The empirical results demonstrate that the developed approach successfully describes the car-following behaviour while conventional offline models fail in the case of large variations in the traffic data or congestion in the traffic flow.
Elastokinematics of a rectilinear rear independent suspension
Authors: Liu Xiang , Zhao Jingshan , Zhang Jie , Chen Wei
Published: February 2016

The rectilinear rear independent suspension investigated in this paper benefits from its excellent kinematic characteristics. Because of the over-constraints of the rectilinear rear independent suspension as a rigid-flexible coupled multi-body system, its elastokinematics are heavily dependent on the compliance characteristics. This paper proposes an efficient approach to establish its elastokinematic model based on the transfer matrix method. First, the overall system transfer equation of the rectilinear rear independent suspension is established. Then, the statics equation is obtained by introducing external loads and expanding the overall system transfer equation. Different configurations of rubber bushings are discussed with respectg to the natural frequency and the static deflections. Comparisons between numerical simulations and kinematic and compliance tests not only verified the approach but also demonstrated the excellent wheel alignment capacity of the rectilinear rear independent suspension.
Investigation on the combustion noise of a pilot-ignited direct-injection natural-gas engine
Authors: Li Menghan , Zhang Qiang , Li Guoxiang
Published: February 2016

In this paper, the effects of the injection timing, the injection pressure and the engine load on the combustion noise of a pilot-ignited direct-injection natural-gas engine were explored by analysing the separate components of the in-cylinder pressure. The results suggested that retarding the injection timing and reducing the injection pressure are effective ways of controlling the combustion noise. This can be attributed to the promoted burning rate at advanced injection timings and to the increased injection pressure. However, the effect of the engine load seems to be less obvious, although the resonance pressure level appears to increase with increasing engine load; the estimated combustion noise shows a decreasing tendency.
Composite energy-absorbing structures combining thin-walled metal and honeycomb structures
Authors: Zhou Hui , Xu Ping , Xie Suchao
Published: February 2016

The energy-absorbing structure of a crashworthy railway vehicle was designed by combining the characteristics of thin-walled metal structures and aluminum honeycomb structures: finite element models of collisions involving energy-absorbing structures were built in ANSYS/LS-DYNA. In these models, the thin-walled metal structure was modeled as a plastic kinematic hardening material, and the honeycomb structure was modeled as an equivalent solid model with orthotropic–anisotropic mechanical properties. The analysis showed that the safe velocity standard for rail vehicle collisions was improved from 25 km/h to 45 km/h by using a combined energy-absorbing structure; its energy absorption exceeded the sum of the energy absorbed by the thin-walled metal structure and honeycomb structure when loaded separately, because of the interaction effects of thin-walled metal structure and aluminum honeycomb structure. For an aluminum honeycomb to the same specification, the composite structure showed the highest SEA when using a thin-walled metal structure composed of bi-grooved tubes, followed by that using single-groove tubes: that with a straight-walled structure had the lowest SEA.
Modeling and experimental verification of the flow characteristics of an active controlled microfluidic valve with annular boundary
Authors: Pan Chun-Peng , Wang Dai-Hua
Published: February 2016

The principle and structural configuration of an active controlled microfluidic valve with annular boundary driven by a circular piezoelectric unimorph actuator is presented in this article. Its active controlled flowrate is modeled using the classical laminated plate theory and the extended Bernoulli equation in fluid mechanics. According to the established mathematical model, we simulate and analyze the influence of the voltage applied to the circular piezoelectric unimorph actuator and the structural parameters on the flow characteristics. The prototypes of the active controlled microfluidic valves with annular boundaries of three different combinations of the inner and outer radii are fabricated and tested. The experimental results show that the active controlled microfluidic valves with annular boundaries possess the on/off switching capability and the continuous control capability of the fluid with simple structure and easy fabrication processing; the maximum flowrate of the active controlled microfluidic valve with the annular boundary with the inner and outer radii of 1.5 and 3.5 mm, respectively, is 0.14 mL/s when the differential pressure of the inlet and outlet of the active controlled microfluidic valve is 1000 Pa and the voltage applied to circular piezoelectric unimorph actuator is 100 V; and the established flowrate model can accurately predict the controlled flowrate of the active controlled microfluidic valves with the maximum relative error of 6.7%.
Healthcare resource use and costs associated with renal impairment in US patients with bone metastases from solid tumors
Authors: Qian Yi , Arellano Jorge , Bhowmik Debajyoti , Thomson Erin , Smith David M , Hechmati Guy , Song Xue
Published: February 2016

Introduction

During cancer progression, more than half of patients develop renal insufficiency, including chronic kidney disease. The primary and secondary objectives of this study were to estimate healthcare resource use and costs, respectively, associated with renal impairment in patients with bone metastases from solid tumors in the United States.

Methods and materials

This was a retrospective, observational cohort study conducted using administrative claims data for individuals with solid tumors and bone metastases. Control patients were matched to renal impairment patients using propensity scores (ratio up to 3:1) based on demographics, clinical characteristics, and baseline costs. Average per-patient per-year healthcare resource utilization and costs (total costs and cost components; 2013 dollars) were reported.

Results

In total, 2616 renal impairment patients were matched to 7211 control patients. Renal impairment patients had greater healthcare resource use compared with controls, including a greater mean number of hospital admissions (4.4 versus 2.1), longer average stay per hospital admission (7.4 versus 6.5 days), as well as greater mean number of physician office visits (22.9 versus 18.8), emergency department visits (3.1 versus 2.0), and hospital-based outpatient visits (18.8 versus 16.0) compared with control patients. Total costs were > $50,000 higher among renal impairment patients ($142,267 versus $88,839; P < 0.001), with hospital costs accounting for $72,557 for renal impairment patients, and $27,858 for control patients ( P < 0.001).

Conclusion

The healthcare resource use and costs associated with renal impairment in patients with bone metastases from solid tumors is high; efforts to reduce renal impairment in this population, including the potential avoidance of nephrotoxic agents, are warranted.
Modeling the isothermal inactivation curves of Listeria innocua CECT 910 in a vegetable beverage under low-temperature treatments and different pH levels
Authors: Vega Sandra , Saucedo Daniela , Rodrigo Dolores , Pina Consuelo , Armero Carmen , Martínez Antonio
Published: February 2016

Thermal inactivation kinetics of Listeria innocua CECT 910 inoculated in a vegetable beverage at three pH conditions (4.25, 4.75, and 5.20), four levels of temperature (50, 55, 60, 65℃), and different treatment times (0–75 min) were obtained. Survival curves did not follow a log-linear relationship and consequently were fitted to various mathematical models: Weibull, Geeraerd, Cerf with shoulder, and the modified Gompertz equation. Results indicated that the best model for the treatment conditions was the modified Gompertz equation, which provides the best goodness-of-fit and the lowest Akaike information criterion value. Sensitivity analysis indicated that the most influential factors affecting the final microbial load were temperature and time in the case of the higher temperature level (65℃) and time in the case of the lower temperature level (50℃).
Physicochemical, sensory, and nutritional quality of fresh-cut “Rojo Brillante” persimmon affected by maturity stage and antibrowning agents
Authors: Sanchís Elena , Mateos Milagros , Pérez-Gago María B
Published: February 2016

To prevent enzymatic browning of fresh-cut ‘Rojo Brillante’ persimmon, different combinations of ascorbic acid (AA) and citric acid (CA) with calcium chloride (CaCl2) were tested in fruit harvested at two maturity stages (MS1 and MS2). Color, firmness, sensory quality, total vitamin C, radical scavenging activity, total phenolic content, and carotenoids were evaluated over nine days of storage at 5 ℃. Antibrowning dips reduced enzymatic browning if compared with the control samples. Selecting fruits with good firmness and the addition of 10 g/l CaCl2 help prevent loss of firmness of fresh-cut “Rojo Brillante” persimmons treated with acidic solutions as antibrowning agents to control enzymatic browning. The limit of marketability of the persimmon fruit processed at MS1 was significantly reduced by the burst of the disorder known as “flesh browning,” and only the samples treated with 10 g/l CA + 10 g/l CaCl2 maintained a limit of marketability close to seven days. At MS2, all the antibrowning solutions allowed a limit of marketability of seven storage days at 5 ℃. Nutritional quality was not affected by either antibrowning dips or cutting processes, but MS at harvest was.
Out of the Cheris
Authors: Gorringe Hugo
Published: February 2016

Dalits (ex-untouchables) in Tamil Nadu, as in many other places of India, have historically resided in cheris or settlements set apart from the village or oor. Cheris often lack amenities like schools, ration shops, health centers or panchayat buildings and are set off the main road down poorly lit and surfaced roads, revealing the significance of space and the spatiality of social relations to the caste system. As Dalits in Tamil Nadu have mobilized politically, they have challenged the hierarchical nature of social space in the face of much backlash, seeking to create meaningful public spaces that are open to, and representative of, all castes. This article concerns the Dalit contestations over space and the wider ramifications of such struggles in the sociopolitical sphere, and argues that the process of democratization requires alterations to social and well as political spaces and institutions.
Friction analysis at elastic-plastic contact of rough surfaces using n-point asperity model
Authors: Waghmare Ajay K , Sahoo Prasanta
Published: February 2016

The paper describes a theoretical study of friction at elastic-plastic contact of rough surfaces in n-point asperity model framework and based on accurate finite element analysis of elastic-plastic deformation of single asperity contact. Plasticity index, a well-defined nondimensional parameter is used to study the prospective situations arising out of variation in material properties and surface roughness. Using practical values of material properties and surface roughness parameters, results are obtained for the behavior of applied load, friction force, and coefficient of friction as a function plasticity index and mean separation of surfaces. It is observed that with increase in amount of plastic deformation, the load required to be applied for maintaining a particular level of separation between contacting surfaces increases while the frictional force decreases. Coefficient of friction is independent of applied load in predominantly plastic domain of deformation but varies nonlinearly in other domains of deformation. Also, for the same applied load the coefficient of friction increases with increase in elastic deformation.
When seconds count: A study of communication variables in the opening segment of emergency calls
Authors: Penn Claire , Koole Tom , Nattrass Rhona
Published: February 2016

The opening sequence of an emergency call influences the efficiency of the ambulance dispatch time. The greeting sequences in 105 calls to a South African emergency service were analysed. Initial results suggested the advantage of a specific two-part opening sequence. An on-site experiment aimed at improving call efficiency was conducted during one shift (1100 calls). Results indicated reduced conversational repairs and a significant reduction of 4 seconds in mean call length. Implications for systems and training are derived.
Science and scepticism: Drug information, young men and counterpublic health
Authors: Farrugia Adrian , Fraser Suzanne
Published: February 2016

It is perhaps no surprise that young people can be sceptical of the drug-related information they receive in school-based health education, health promotion and the media. Significant societal anxiety surrounds young people’s drug consumption, so it is tempting to approach this scepticism as a problem to be solved. In this article, we look closely at a group of young Australian men (n = 25), all of whom hold deeply sceptical views about the drug information they received in schools, social marketing campaigns and public speech generally. We do not approach their scepticism as a problem to be solved in itself, however. Instead, we analyse its origins and how it relates to the way knowledge is constructed in drug education, health promotion and media accounts of drug use. To conceptualise this scepticism, we draw on Irwin and Michael’s analysis of the changing relationship between science and society, Warner’s theorisation of publics and counterpublics, and Race’s related notion of ‘counterpublic health’. The article organises the data into three key themes: scepticism about the accuracy of the claims made about drug risks and dangers, scepticism about representations of drug users, and scepticism about the motivations behind the health messages and drug policy in general. We then draw these different aspects of scepticism together to argue that the young men can be seen to constitute a health ‘counterpublic’, and we consider the implications of this approach, arguing for what has been described as a more diplomatic engagement between science and publics.
Energy performance of buildings in Poland on the basis of different climatic data
Authors: Grudzińska Magdalena , Jakusik Ewa
Published: February 2016

Typical Meteorological Years (TMY) were prepared in Poland due to the introduction of obligatory energy certification for buildings. They are based on source data collected by the Institute of Meteorology and Water Management from 1971 to 2000. Predictions indicate that until the end of the 21st century, the air temperature will increase. Therefore, the characteristics obtained with the use of TMY may differ from the energy demand of buildings used nowadays. This article compares energy demand calculated with the use of TMY and subsequent climatic data from 2001 to 2012, for three different locations in Poland. The analyses were performed with the use of the dynamic simulation computer program, for typical living quarters in a multifamily residential building with different construction and window orientation. Results obtained with the use of TMY and subsequent climatic data show that the typical years can be used for the evaluation of heating demand. However, cooling demand calculated with the use of TMY was significantly lower in comparison with the mean cooling demand for the years 2001–2012. This may distort the energy needs and indoor environment conditions in summer, and cause discomfort or unnecessary energy use in presently occupied dwellings.
Accept no substitutes
Authors: Belk Russell
Published: February 2016

Arnould and Rose raise some interesting issues regarding my sharing paper (Belk 2010). We agree on some points, but I find that most of their contentions are misguided and are based on misunderstandings of the original paper, social science, the extended self, and the theory of the gift. Their alternative offering of mutuality is also perplexingly self-contradictory, romanticized, and illogical. In this reply I point out issues on which we agree as well as reasons for disagreement.
Cracking the enigma of asset bubbles with narratives
Authors: Teeter Preston , Sandberg Jörgen
Published: February 2016

The hysteria and destruction created by asset bubbles have garnered widespread attention in recent years, resulting in a wealth of studies on these events from a range of disciplines. However, despite these efforts, we, as a diverse research community, have failed to predict, prevent, and even explain asset bubbles, while bouts of speculative mania continue to wreak havoc on the world’s economies. We argue that periods of intense market speculation are driven by narratives and narrative thought, and thus narrative research represents a promising alternative by which we may ultimately be able to crack the enigma of asset bubbles. In this article, we explain the core reasons behind this argument, outline a three-stage narrative perspective of asset bubble formation, and provide a research agenda for future narrative studies on these events.
A Psychometric Analysis of the Child Behavior Checklist for Elementary School Children in Qatar
Authors: Al-Hendawi Maha , Keller Clayton , Cloninger Lea
Published: February 2016

The Child Behavior Checklist for children 6 to 18 (CBCL/6-18) is a widely used, standardized parent rating scale. However, few studies have tested the psychometric properties of this instrument in the Arab world despite the great need for such instruments to support the identification and education of children with emotional, behavioral, and social problems in these countries. In this study, we examined the configural invariance and reliability of the core items of the CBCL present in both of its editions using the Arabic translation of the CBCL/6-18 and a sample of 1,360 elementary school children in Qatar. Results from the confirmatory factor analysis (CFA) supported the factor structure of Achenbach’s eight-syndrome scales of the CBCL/6-18 for our sample in (a) its overall fit, (b) pattern of factor loadings, (c) syndrome correlations, and (d) comparability of results in other societies. Internal consistency was high. Categorization of the sample as normal, borderline, and clinical using standard scoring produces proportions roughly in line with expectations, but points to the need for local norms and validation of the instrument prior to its clinical use in Qatar.
Reviewing the Assumptions About Men’s Mental Health: An Exploration of the Gender Binary
Authors: Smith Dena T. , Mouzon Dawne M. , Elliott Marta
Published: February 2016

Many researchers take for granted that men’s mental health can be explained in the same terms as women’s or can be gauged using the same measures. Women tend to have higher rates of internalizing disorders (i.e., depression, anxiety), while men experience more externalizing symptoms (i.e., violence, substance abuse). These patterns are often attributed to gender differences in socialization (including the acquisition of expectations associated with traditional gender roles), help seeking, coping, and socioeconomic status. However, measurement bias (inadequate survey assessment of men’s experiences) and clinician bias (practitioner’s subconscious tendency to overlook male distress) may lead to underestimates of the prevalence of depression and anxiety among men. Continuing to focus on gender differences in mental health may obscure significant within-gender group differences in men’s symptomatology. In order to better understand men’s lived experiences and their psychological well-being, it is crucial for scholars to focus exclusively on men’s mental health.
Male Breast Cancer Has Limited Effect on Survivor’s Perceptions of Their Own Masculinity
Authors: Rayne Sarah , Schnippel Kathryn , Thomson John , Reid Joanna , Benn Carol
Published: February 2016

The purpose of the current study was to describe male breast cancer in Johannesburg, South Africa, and assess whether male breast cancer patients’ perception of their own masculinity was affected by having a cancer commonly seen in women. A retrospective file review was carried out at two hospitals, one private and one government, of male breast cancer patients from 2007 to 2012 followed by a telephone survey of patients identified during review. Of approximately 3,000 breast cancer patients seen in the 5 years reviewed, 23 cases of male breast cancer were identified. Most were diagnosed with invasive ductal carcinoma ( n = 19, 83%). Stage at presentation was from stages 0 to 3 (Stage 0 [ n = 2, 9%], Stage 1 [ n = 3, 13%], Stage 2 [ n = 12, 52%], Stage 3 [ n = 6, 26%]) and no patients were metastatic at presentation. The telephonic survey was completed by 18 patients (78%). Nearly all ( n = 17/18) shared their diagnosis with family and close friends. Two thirds of patients delayed presentation and government hospital patients were more likely to present later than private sector hospital patients. Although most male breast cancer patients sampled did not perceive the breast cancer diagnosis as affecting their masculinity, Black men and those treated in government hospitals were less likely to be aware of male breast cancer, and were more likely to have their perception of their own masculinity affected.
Novel device, a temporary guidewire fixator
Authors: Bosaeus Linus , Mani Kevin , Wanhainen Anders , Liungman Krister
Published: February 2016

A novel device for distal fixation of a guidewire was tested in regards to deployment and retrieval, deposition in the blood stream and force of fixation in a pig model. Eleven pigs were subjected to full anaesthesia and heparinized to active clotting time 250–350 s. Uninterrupted blood flow during 4 h deposition was assessed by angiography and inspected for thrombus deposition upon retrieval. The force of fixation was investigated up to the level of loss of fixation (displacement force). The device was successfully deployed and retrieved in over 40 cases. In one case, an alternative method for bailout retrieval was used. Deposition for 4 h was performed, and uninterrupted blood flow was verified by angiography. No instances of arterial occlusion or thrombosis were detected. The median dislocation force was 7.6 N. No arterial rupture or dissection was detected following the loss of fixation. As a conclusion, the device was considered safe and functional in this animal test model.
A survey of 0 + 5 vascular surgery residency candidates: Perceptions of an applicant pool
Authors: Lajos Paul , Negrete Alejandro , Ravin Reid , Marin Michael , Faries Peter
Published: February 2016

Background

Applications to integrated (0 + 5) vascular surgery residencies have increased, while total applications have stayed relatively constant. This survey sought to document the perceptions of 0 + 5 vascular surgery applicants.

Methods

Academic faculty conducted interviews for 0 + 5 residency match at an academic medical center in preparation for the National Resident Matching Program (NRMP) Main Residency Match. Applicant pool (n = 20) perceptions were determined with surveys. Participation was anonymous and voluntary.

Results

Nineteen interviewees (26.3% female: 73.7% male), age (26.8 ± 2.6 years) responded (95% response rate). Of 19 respondents, 68% became interested in vascular surgery in their third year with 53% becoming aware of 0 + 5 programs in their third year. All respondents identified a vascular surgery attending at their institution as significant mentors. Forty-seven percent identified their mentor during their third year of medical school. All respondents felt that 0 + 5 training would prepare them adequately for the workforce and board certification exams. Almost all (89%) had plans to seek jobs immediately upon completion of residency.

Conclusion

Applicants remained positive about their planned training and career paths. Attending vascular surgeons were identified as the strongest mentors, yet most students decided only in their third and fourth years to pursue 0 + 5 residencies. Educational debt remains a concern, and there may be consideration for a concerted effort to recruit potential candidates sooner.
Educational reforms and marketization in Norway – A challenge to the tradition of the social democratic, inclusive school?
Authors: Helgøy Ingrid , Homme Anne
Published: February 2016

A social democratic, egalitarian public sector and a corporatist political economy have been strong, distinctive and enduring characteristics of Norwegian education. However, this article demonstrates that the education sector has experienced a period of rapid and extensive implementation of New Public Management (NPM) reforms and post-NPM reforms the past 15 years. In contrast to other scholars, who claim that NPM is not contested but rather consistently promoted and maintained by centre-left governments, we argue that from 2005 such governments have added new ideas of government and implemented new methods of steering education in line with post-NPM reforms. To regain central capacity and control and to compensate for the negative effects of NPM on social inclusion and equality, new measures for input control were adopted, and the negative effects of marketization were to some degree moderated by later educational reforms.
Schools, choice and reputation: Local school markets and the distribution of symbolic capital in segregated cities
Authors: Bunar Nihad , Ambrose Anna
Published: February 2016

An exploration is presented of how urban spaces, polarized by class and ethnicity, structure the basic conditions of emerging local school markets. The authors investigate how the distribution of symbolic capital, or ‘hot knowledge’ of the market, affects schools, the market, and the urban spaces themselves. The study is guided by theoretical notions involving lived local school markets, competitive spaces and symbolic capital. Methodologically, the study is based on ethnographic fieldwork at three compulsory schools in Stockholm. Analytically, the ways in which relations among urban spaces and school choice, and actors’ perceptions of these relations, affect the actors’ subsequent positioning in the local market, are illustrated. The authors’ main conclusion is that despite nationally defining principles mandating fairness, transparency and integration, school choice policy is being implemented on an uneven playing field, aggravating current patterns of segregation in education and even housing. Consequently, a call is made for an urgent reframing of some of the policy’s nationally defining principles.
A comparison between the MoCA and the MMSE visuoexecutive sub-tests in detecting abnormalities in TIA/stroke patients
Authors: Mai Lauren M , Sposato Luciano A , Rothwell Peter M , Hachinski Vladimir , Pendlebury Sarah T
Published: February 2016

Background

Executive dysfunction predicts stroke risk, dementia, and mortality. The Montreal cognitive assessment detects more visuoexecutive dysfunction than the mini-mental state examination but it is unclear which of the individual Montreal cognitive assessment visuoexecutive items contribute to the better performance of the Montreal cognitive assessment. We therefore determined the relative performance of the Montreal cognitive assessment visuoexecutive sub-tests versus the mini-mental state examination pentagon copying in patients with stroke and transient ischemic attack.

Methods

Mini-mental state examination and Montreal cognitive assessment were administered to a prospective, population-based cohort of stroke, and transient ischemic attack patients from the Oxford Vascular Study at six month or five-year follow-up between November 2007 and June 2009. We compared the proportion of participants with incorrect Montreal cognitive assessment visuoexecutive tasks and sub-tasks but correct mini-mental state examination pentagon copying versus the proportion with incorrect MMSE pentagon copying but correct visuoexecutive Montreal cognitive assessment sub-test and individual sub-test items.

Results

Among 412 patients assessed with the mini-mental state examination and Montreal cognitive assessment, the Montreal cognitive assessment detected more visuoexecutive dysfunction than the mini-mental state examination (OR 11.4, 95% CI 8.2–15.8, p < 0.001). The likelihood of incorrect mini-mental state examination pentagon copying increased as the numbers of correct MoCA visuoexecutive responses decreased: 2/106 (1.9%) and 9/10 (90.0%) incorrect mini-mental state examination pentagon copying for 5/5 and 0/5 correct Montreal cognitive assessment visuoexecutive tasks, respectively (p for trend 0.005). Each Montreal cognitive assessment visuoexecutive sub-task, including trails (39.6%), cube copying (49.5%), and clock drawing (59.0%), detected more patients with visuoexecutive dysfunction than the mini-mental state examination pentagon copying (20.6%, p < 0.001).

Conclusion

All three of the Montreal cognitive assessment visuoexecutive sub-tests detected more abnormalities than the mini-mental state examination pentagon copying and thus contributed to the over 10-fold superiority of Montreal cognitive assessment over the mini-mental state examination for detection of visuoexecutive dysfunction.
The anti-inflammatory effects of baicalin through suppression of NLRP3 inflammasome pathway in LPS-challenged piglet mononuclear phagocytes
Authors: Ye Chun , Li Sali , Yao Wenxu , Xu Lei , Qiu Yinsheng , Liu Yu , Wu Zhongyuan , Hou Yongqing
Published: February 2016

In this study, the anti-inflammatory effects and mechanisms of baicalin on LPS-induced NLRP3 inflammatory pathway were investigated in piglet mononuclear phagocytes (control, LPS stimulation, LPS stimulation + 12.5 µg/ml baicalin, LPS stimulation + 25 µg/ml baicalin, LPS stimulation + 50 µg/ml baicalin and LPS stimulation + 100 µg/ml baicalin). The levels of reactive oxygen species (ROS), the secretion levels of IL-1β, IL-18 and TNF-α, mRNA expression levels of IL-1β, IL-18, TNF-α and NLRP3, as well as the protein levels of cleaved caspase-1 p20 were significantly increased after LPS-challenge in vitro. However, LPS stimulation did not influence apoptosis-associated speck-like protein and caspase-1 mRNA levels, which are also components of the NLRP3 inflammasome. Baicalin at 50 µg/ml and 100 µg/ml could inhibit the production of ROS, TNF-α, IL-1β and IL-18, and down-regulate mRNA expression of IL-1β, IL-18, TNF-α and NLRP3, as well as expression of cleaved caspase-1 p20. These results showed that the anti-inflammatory effects of baicalin occurred via the regulation of the release of ROS and mRNA expression of NLRP3. The anti-inflammatory activity of baicalin could be related to the suppression of NLRP3 inflammasome pathway under LPS stimulation.
Potential role of systemic thrombolysis in acute submassive intermediate risk pulmonary embolism: review and future perspectives
Authors: Teleb Mohamed , Porres-Aguilar Mateo , Anaya-Ayala Javier E. , Rodriguez-Castro Carlos , Porres-Muñoz Mateo , Mukherjee Debabrata
Published: February 2016

Submassive (intermediate risk) pulmonary embolism (PE) continues to be a significantly morbid disease process that remains unrecognized, inadequately risk stratified and suboptimally treated. Appropriate early clinical and imaging-based risk stratification represents the cornerstone for adequate therapeutic decision making, particularly for the selection of candidates who may benefit the most from systemic thrombolysis. The relevance of estimating clinical prognostic scores, in combination with imaging data, for accurate assessment of right ventricular function and laboratory biomarkers, indicative of myocardial injury for identification of normotensive patients at intermediate risk for an adverse short-term outcome are emphasized in this review. Recent clinical trials have demonstrated improvement in hemodynamics and mortality with the use of systemic thrombolysis among intermediate risk patients; however, it came at the cost of a significantly increased risk of major bleeding. Catheter-based therapies have garnered considerable clinical interest in recent years; of particular note is the ultrasound accelerated catheter-directed thrombolysis which has emerged as a novel and attractive alternative therapeutic modality with an increasing number of single center studies and ongoing randomized trials. Our review focuses on the major trials and studies involved in submassive PE in the recent literature including the role of thrombolytic therapy. We include major trials with reasonable sample size and extensive review of the potential side effects, such as major bleeding.
Efficacy and toxicity of salvage weekly paclitaxel chemotherapy in non-Asian patients with advanced oesophagogastric adenocarcinoma
Authors: Tarazona Noelia , Smyth Elizabeth C. , Peckit Clare , Chau Ian , Watkins David , Rao Sheela , Starling Naureen , Cunningham David
Published: February 2016

Objectives:

Survival for oesophagogastric adenocarcinoma (OGA) patients varies globally and clinical trial results are seldom replicated in clinical practice. We sought to examine the efficacy and toxicity of salvage paclitaxel chemotherapy for patients with advanced OGA at our institution.

Methods:

Advanced OGA patients treated with paclitaxel between June 2011 and February 2014 were identified from the electronic record at the Royal Marsden Hospital (RMH), London. Chart review was performed to obtain demographics, performance status (PS), laboratory parameters, radiological response and dates of progression, death and last follow up. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Multivariate Cox regression analysis examined the interaction between clinical and laboratory parameters and survival.

Results:

Fifty-seven patients were identified; OS and PFS were 5.8 and 2.6 months respectively. From first-line chemotherapy, median OS was 14.3 months. Two-year and three-year survival rates from diagnosis were 26% and 13%. More than or equivalent to Grade 3 neutropenia occurred in 13% of patients. In multivariate analysis, PS more than or equal to 2, alkaline phosphatase (ALP) more than or equal to100 U/L, and previous rechallenge with platinum were independent prognostic factors for OS.

Conclusions:

OGA cancer patients treated at RMH with salvage paclitaxel had an OS equivalent to patients in clinical trials with more (33%) PS = 2 patients treated and less haematological toxicity than Asian patients. Eastern Cooperative Oncology Group (ECOG) PS more than or equal to 2, ALP more than or equal to 100 U/L, and prior platinum rechallenge were associated with poor survival. However, the proportion of patients surviving more than or equal to two years from diagnosis demonstrates a clinically relevant improvement from historical controls.
Changes in Type 2 Diabetes Mellitus Patients in German Primary Care Prior to (2006) and After (2010, 2014) Launch of New Drugs
Authors: Jacob Louis , Waehlert Lilia , Kostev Karel
Published: February 2016

Aims:

The aim was to analyze the changes in a German type 2 diabetes population prior to (2006) and after (2010, 2014) launch of new drugs.

Methods:

Patients with T2DM in 2006, 2010, and 2014 were recruited for the study. Demographic data included age, gender, and health insurance type (private/statutory). Drug prescription, mean costs per patient, HbA1c levels, macrovascular complications, and time before first insulin prescription were analyzed.

Results:

In all, 64 098, 77 219, and 85 004 T2DM patients were included for 2006, 2010, and 2014, respectively. The mean age (65.9-66.9 years), proportion of men (50.8%-53.8%), and proportion of patients with private health insurance (6.6%-7.2%) differed significantly for each of the 3 years. There was a 1.25-fold increase in the total costs per patient, linked with an increase in the costs associated with the use of new drugs and a decrease in those associated with the use of old drugs, respectively. HbA1c levels were slightly better regulated in 2014 than in 2006 and 2010. The share of macrovascular complications decreased significantly over time, dropping from 27.4% in 2006 to 24.6% in 2014. The mean duration before first insulin treatment increased from 1225 days in 2006 to 1406 days in 2014.

Conclusions:

The new drugs analyzed in this study had positive effects on HbA1c levels, macrovascular complications, and mean time before first insulin treatment.
Using Evidence-Based Design to Improve Pharmacy Department Efficiency
Authors: Greenroyd Fraser L. , Hayward Rebecca , Price Andrew , Demian Peter , Sharma Shrikant
Published: February 2016

Using a case study of a pharmacy department rebuild in the South West of England, this article examines the use of evidence-based design to improve the efficiency and staff well-being with a new design. This article compares three designs, the current design, an anecdotal design, and an evidence-based design, to identify how evidence-based design can improve efficiency and staff well-being by reducing walking time and distance. Data were collected from the existing building and used to measure the efficiency of the department in its current state. These data were then mapped onto an anecdotal design, produced by architects from interviews and workshops with the end users, and an evidence-based design, produced by highlighting functions with high adjacencies. This changed the view on the working processes within the department, shifting away from a focus on the existing robotic dispensing system. Using evidence-based design was found to decrease the walking time and distance for staff by 24%, as opposed to the anecdotal design, which increased these parameters by 9%, and is predicted to save the department 248 min across 2 days in staff time spent walking.
A High-Grade Chondrosarcoma of Calcaneum Mimicking as a Benign Pathology
Authors: Baba Muzamil Ahmad , Nazir Naila , Shabeer Maajid , Mir Bashir Ahmed , Kawoosa Altaf Ahmad
Published: February 2016

This case is presented to highlight a rare case of chondrosarcoma of calcaneum in a young adult mimicking as a benign pathology and to highlight the diagnosis and early management of such cases to prevent complications and even death. Chondrosarcoma constitutes less than 10% of all primary malignancies of bone and occurs mostly in proximal locations such as pelvis, proximal femur, and proximal humerus. We present a case of high-grade chondrosarcoma at a very rare site, calcaneum of a 40-year-old male that was mimicking as a benign pathology. This case report highlights the importance of proper clinical examination, evaluation, and suspicion for benign occurring lesions to prevent complications related to a delay in diagnosis.

Levels of Evidence: Therapeutic, Level IV: Case study
Athletes at High Altitude
Authors: Khodaee Morteza , Grothe Heather L. , Seyfert Jonathan H. , VanBaak Karin
Published: February 2016

Context:

Athletes at different skill levels perform strenuous physical activity at high altitude for a variety of reasons. Multiple team and endurance events are held at high altitude and may place athletes at increased risk for developing acute high altitude illness (AHAI). Training at high altitude has been a routine part of preparation for some of the high level athletes for a long time. There is a general belief that altitude training improves athletic performance for competitive and recreational athletes.

Evidence Acquisition:

A review of relevant publications between 1980 and 2015 was completed using PubMed and Google Scholar.

Study Design:

Clinical review.

Level of Evidence:

Level 3.

Results:

AHAI is a relatively uncommon and potentially serious condition among travelers to altitudes above 2500 m. The broad term AHAI includes several syndromes such as acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Athletes may be at higher risk for developing AHAI due to faster ascent and more vigorous exertion compared with nonathletes. Evidence regarding the effects of altitude training on athletic performance is weak. The natural live high, train low altitude training strategy may provide the best protocol for enhancing endurance performance in elite and subelite athletes. High altitude sports are generally safe for recreational athletes, but they should be aware of their individual risks.

Conclusion:

Individualized and appropriate acclimatization is an essential component of injury and illness prevention.
Oral dissolution therapy for radiolucent kidney stones. An old treatment revisited
Authors: Alsinnawi M , Maan Z , Rix GH
Published: February 2016

Objective:

We present our experience using oral bicarbonate as a dissolution therapy for radiolucent kidney stones in the pre-dual energy CT era.

Methods:

A retrospective analysis of dissolution therapy was undertaken over a four-year period. Stones were diagnosed as radiolucent on conventional KUB X-ray in combination with either ultrasound or CT KUB. Oral bicarbonate was given at a dose of 2 g tds orally, increased to 2 g five times daily according to urinary pH. Patients monitored their own urine dipstick daily to achieve a pH of at least seven.

Results:

Altogether 27 patients were identified with radiolucent stones. Stone size varied from 4–40 mm. Average length of therapy was nine weeks. Of the patients, 17 had renal U/S and six had CT KUB as end point imaging. We found that 39% had complete dissolution, 18% had a partial response and 43% showed no response. A high serum uric acid level correlated with a higher incidence of dissolution. Cost-benefit analysis shows bicarbonate therapy to be more cost-effective than lithotripsy, ureteroscopy or nephrolithotomy.

Conclusions:

Bicarbonate therapy remains an attractive option for the treatment of radiolucent kidney stones. The presence of hyperuricaemia or hyperuricosuria appears to influence the success rate. Further prospective randomised studies are needed to identify the most tolerable and effective treatment regime as well as the optimal duration of treatment. Dual-energy CT may hold the key to identifying patients most likely to benefit from treatment.
Accounting for the social: Investigating commensuration and Big Data practices at Facebook
Authors: van der Vlist Fernando N
Published: February 2016

This study explores Big Data practices at Facebook through an investigation of the role of commensuration or ‘the transformation of different qualities into a common metric’ in the structuration of analysis and interaction with a major online social media platform. It proposes a conceptual framework and demonstrates the empirical potential of a pragmatic approach based on reading published materials and available documentation. Facebook’s Data Warehousing and Analytics Infrastructure serves as an illustrative example to begin tracing out and describe data assemblages in more detail. In being attentive to the motivations, drivers and challenges engineers face when dealing with Big Data, it is argued that their solutions can enable and support but also constrain specific analytical and transactional capabilities or data flows between various devices and actors. The analysis thus moves beyond methodological critiques of the utility of Big Data that lack empirical support and specificity. It is further argued that analytics not just describe but also actively participate in the enactment of social worlds, thereby opening possibilities for new markets or market segments to arise. Online sociality accounts for a model of the social that makes it visible and measurable qua markets inviting data recontextualisation and the creation of value along multiple axes. Contra Facebook’s claim to make the web more ‘social’, an investigation of commensuration brings to the fore the question how the social is accounted for in the first place.