bluuebunny/crossref_metadata_2025 huggingface dataset:
Flow-induced vibration and stability analysis of carbon nanotubes based on the nonlocal strain gradient Timoshenko beam theory
Authors: Bahaadini Reza , Saidi Ali Reza , Hosseini Mohammad
Published: August 2018

A nonlocal strain gradient Timoshenko beam model is developed to study the vibration and instability analysis of the carbon nanotubes conveying nanoflow. The governing equations of motion and boundary conditions are derived by employing Hamilton’s principle, including the effects of moving fluid, material length scale and nonlocal parameters, Knudsen number and gravity force. The material length scale and nonlocal parameters are considered, in order to take into account the size effects. Also, to consider the small-size effects on the flow field, the Knudsen number is used as a discriminant parameter. The Galerkin approach is chosen to analyze the governing equations under clamped–clamped, clamped–hinged and hinged–hinged boundary conditions. It is found that the natural frequency and critical fluid velocity can be decreased by increasing the nonlocal parameter or decreasing the material length scale parameter. Furthermore, it is revealed that the critical flow velocity does not affected by two size-dependent parameters and various boundary conditions in the free molecular flow regime.
The Financial Impact of an Avoided Readmission for Teaching and Safety-Net Hospitals Under Medicare’s Hospital Readmission Reduction Program
Authors: Hoffman Geoffrey J. , Tilson Sibyl , Yakusheva Olga
Published: August 2018

We examined the financial incentives to avoid readmissions under Medicare’s Hospital Readmission Reduction Program for safety-net hospitals (SNHs) and teaching hospitals (THs) compared with other hospitals. Using Medicare’s FY2016 Hospital Compare and readmissions data for 2,465 hospitals, we tested for differential revenue gains for SNHs ( n = 658) relative to non-SNHs ( n = 1,807), and for major ( n = 231) and minor ( n = 591) THs relative to non-THs ( n = 1,643). We examined hospital-level factors predicting differences in revenue gains by hospital type. The revenue gains of an avoided readmission were 10% to 15% greater for major THs compared with non-THs ($18,047 vs. $15,478 for acute myocardial infarction) but no different for SNHs compared with non-SNHs. The greater revenue gains for THs were strongly positively predicted by hospitals’ poor initial readmission performance. We found little evidence that the Hospital Readmission Reduction Program creates disincentives for SNHs and THs to invest in readmission reduction efforts, and THs have greater returns from readmissions avoidance than non-THs.
Upholding “Colonial Unknowing” Through the IRB: Reframing Institutional Research Ethics
Authors: Sabati Sheeva
Published: August 2018

This article considers the institutionalization of research ethics as a site of “colonial unknowing” in which the racial colonial entanglements of academic research and institutions are obscured. I examine the origin stories situating Institutional Review Boards (IRBs) as a response to cases of exceptional violence, most notably the Tuskegee syphilis experiment, within an otherwise neutral history of research. I then consider how the 2018 revisions to the Common Rule extend “colonial unknowing” by decontextualizing the forms of risk involved in social and behavioral research. I situate these complicities as necessary starting points toward anticolonial research ethics of “answerability.”
Associations Between Forced and “Persuaded” First Intercourse and Later Health Outcomes in Women
Authors: McCarthy-Jones Simon , Bulfin Ailise , Nixon Elizabeth , O’Keane Veronica , Bacik Ivana , McElvaney Rosaleen
Published: August 2018

The effects of nonconsensual first experiences of sexual intercourse in women are understudied. This was investigated in 3,875 adult women of whom 6.7% reported “persuaded” first-sex and 0.8% reported forced first-sex. Compared with willing first-sex, both forced and “persuaded” first-sex occurred earlier, involved a greater age difference between partners, and were associated with more lifetime sexual partners and some measures of worse psychological well-being. In addition, “persuaded” first-sex was associated with worse general physical health. “Persuaded” first-sex and its relation to health need to be better understood, along with how culture influences women’s experiences of first-sex.
Reply to Lessons in Program Evaluation: The ACTV Batterer Program Study and Its Claims
Authors: Zarling Amie
Published: August 2018

Gondolf, Bennett, and Mankowski raise many concerns about the ACTV batterers’ intervention program (BIP) and the Zarling, Bannon, and Berta evaluation of ACTV, including (a) the researchers’ and the Iowa Department of Corrections’ promotion of ACTV; (b) research design, outcome measure, and results; (c) contextual issues; and (d) the effectiveness debate surrounding BIPs. The current commentary responds to each of these concerns, as well as identifies errors and corrects misinformation in their article. It is hoped that this response will also clarify the broader context of ACTV development and research and contribute to the ongoing discussion about BIPs.
Financing a Just Transition
Authors: Zadek Simon
Published: August 2018

Climate goals can only be realized with a major shift in financing toward low-carbon, climate-resilient assets, notably infrastructure. Progress has been made, but the world is not currently on a viable let alone a just transition pathway. The rules and norms governing the financial system itself are an important factor shaping financial flows. Positively, recent developments highlight a growing receptivity on the part of financial market actors and those governing the financial system to take account of climate and broader sustainable development considerations. Building on such receptivity to reinforce the underlying broader purpose the financial system is a precondition for a just transition.
A Statistical Significance Test for Necessary Condition Analysis
Authors: Dul Jan , van der Laan Erwin , Kuik Roelof
Published: August 2018

In this article, we present a statistical significance test for necessary conditions. This is an elaboration of necessary condition analysis (NCA), which is a data analysis approach that estimates the necessity effect size of a condition X for an outcome Y. NCA puts a ceiling on the data, representing the level of X that is necessary (but not sufficient) for a given level of Y. The empty space above the ceiling relative to the total empirical space characterizes the necessity effect size. We propose a statistical significance test that evaluates the evidence against the null hypothesis of an effect being due to chance. Such a randomness test helps protect researchers from making Type 1 errors and drawing false positive conclusions. The test is an “approximate permutation test.” The test is available in NCA software for R. We provide suggestions for further statistical development of NCA.
Nonlinear static response analysis of sandwich beams using the Refined Zigzag Theory
Authors: Ascione Alessia , Gherlone Marco
Published: August 2018

The Refined Zigzag Theory (RZT) is assessed for the buckling and nonlinear static response analysis of multilayered composite and sandwich beams. A nonlinear formulation of the RZT is developed taking into account geometric imperfections and nonlinearities using the Von Kármán nonlinear strain-displacement relations. FE analyses are conducted employing C0-beam elements based on the RZT and the Timoshenko Beam Theory (TBT) to model three sandwich beams with different core materials and slenderness ratios, in both simply supported and cantilever configurations. The reference solutions are obtained by high-fidelity FE commercial codes, Abaqus® and Nastran®. The first two buckling loads are evaluated for the beams without initial imperfections. Several shapes are then assumed as geometric imperfections to calculate the beams’ nonlinear response to axial-compressive loads. The comparisons show the very high accuracy of the RZT (comparable to high fidelity FE commercial codes) for both the buckling and nonlinear static analyses and its superior capability with respect to the TBT to deal with sandwich beams with low slenderness ratio and higher face-to-core stiffness ratio.
Studying alternative approaches for placement of cuffed hemodialysis catheters in hemodialysis patients with bilateral internal jugular vein occlusion
Authors: Gouda Zaghloul Elsafy , Emara Mahmoud Mohamed , Elbarbary Hany Said , Koura Mahmoud Abdel Aziz , Elarbagy Ahmed Rabie
Published: August 2018

Introduction:

Internal jugular vein occlusion often makes necessary the use of less desirable routes as external jugular, subclavian, and femoral vein approaches in addition to inferior vena cava approaches. This a prospective cross-sectional follow-up study of the alternative approaches for placement of cuffed hemodialysis catheters in end-stage renal disease patients with bilateral internal jugular vein occlusion from the interventional nephrology point of view.

Method:

The study was conducted on 134 end-stage renal disease patients who were referred for insertion of a challenging hemodialysis catheter due to bilateral internal jugular vein occlusion. Ultrasound Doppler guided catheter insertion was used as a routine practice in addition to fluoroscopy or post insertion X-ray to localize catheter tip position and exclude complications. Follow-up of patients was conducted until the end of the study or catheter removal.

Findings:

The most highly prevalent alternative approach is the trans-external iliac vein inferior vena cava approach (43.28%) followed by external jugular vein approach (14.93%), innominate vein approach (10.18%), internal jugular vein collaterals by interventional radiology (7.46%), femoral vein approach (7.46%), transhepatic approach (5.97%), subclavian vein approach (5.22%), and finally the retrograde femoral vein approach (1.49%).

Discussion:

End-stage renal disease patients maintained on regular hemodialysis who have bilateral internal jugular vein obstruction and non-functioning arteriovenous fistula/graft is a daily scenario in nephrology practice. Our study showed that there is a variety of approaches for the insertion of cuffed hemodialysis catheters other than occluded internal jugular veins. Interventional nephrologists have a major role in solving the problem of poor hemodialysis vascular access. These alternative approaches can conserve the anatomically limited number of percutaneous access sites in each patient.
Formin Proteins FHOD1 and INF2 in Triple-Negative Breast Cancer: Association With Basal Markers and Functional Activities
Authors: Heuser Vanina D , Mansuri Naziha , Mogg Jasper , Kurki Samu , Repo Heli , Kronqvist Pauliina , Carpén Olli , Gardberg Maria
Published: August 2018

Basal-like breast cancer is an aggressive form of breast cancer with limited treatment options. The subgroup can be identified immunohistochemically, by lack of hormone receptor expression combined with expression of basal markers such as CK5/6 and/or epidermal growth factor receptor (EGFR). In vitro, several regulators of the actin cytoskeleton are essential for efficient invasion of basal-like breast cancer cell lines. Whether these proteins are expressed in vivo determines the applicability of these findings in clinical settings. The actin-regulating formin protein FHOD1 participates in invasion of the triple-negative breast cancer cell line MDA-MB-231. Here, we measure the expression of FHOD1 protein in clinical triple-negative breast cancers by using immunohistochemistry and further characterize the expression of another formin protein, INF2. We report that basal-like breast cancers frequently overexpress formin proteins FHOD1 and INF2. In cell studies using basal-like breast cancer cell lines, we show that knockdown of FHOD1 or INF2 interferes with very similar processes: maintenance of cell shape, migration, invasion, and proliferation. Inhibition of EGFR, PI3K, or mitogen-activated protein kinase activity does not alter the expression of FHOD1 and INF2 in these cell lines. We conclude that the experimental studies on these formins have implications in the clinical behavior of basal-like breast cancer.
Application of Hydropedological Information to Conceptualize Pollution Migration From Dry Sanitation Systems in the Ntabelanga Catchment Area, South Africa
Authors: Mamera Matthew , van Tol Johan J
Published: August 2018

The hydrological response of catchments is determined by the combined hydropedological response of hillslopes. In the Ntabelanga area, 56% of the households use pit latrines and untreated drinking groundwater supplies. Soil morphological properties and their spatial distribution were used to conceptualize hillslope hydropedological behaviour to determine the fate of Escherichia coli and faecal coliform from 4 pit latrines. Four hillslopes below the pit latrines (MT1, MT2, MT3, and MT4) occur above first-order tributaries to the Tsitsa River, South Africa, were studied. The studied sites are adjacent to the proposed footprint of a planned multi-purpose storage dam, Ntabelanga. Apedal soils, without morphological evidence of saturation, dominated the upper slopes of MT1 and the lower slopes of MT2, thus promoting vertical drainage. Hydromorphic properties were observed at the soil/bedrock interface in the lower parts of MT1 and the entire slope of MT4. This signifies slowly permeable bedrock and the occurrence of lateral flow. High clay contents and strong structured soils were dominant in MT3, indicating slow internal drainage with a large adsorption capacity. The conceptual models derived from morphological properties were verified using soil physical and organic pollutant measurements. In general, hydraulic conductivity values support the interpretations made from soil morphological measurements. Faecal coliforms and E coli bacteria counts were mostly <1 CFU/g soil in MT1, MT2, and MT4; hillslope migrations were detected in MT3 posing pollution risks.
Refractory Palmoplantar Pustular Psoriasis Treated With High-Dose Ustekinumab After Initial Failure
Authors: Bohdanowicz Michal , Sajic Dusan
Published: August 2018

Palmoplantar pustular psoriasis (PPPP) is a form of psoriasis that can be difficult to treat. We describe a case of PPPP in a patient who failed multiple therapies, including ustekinumab. The patient subsequently developed inflammatory bowel disease (IBD), and restarting ustekinumab, with inflammatory bowel disease loading doses and optimization, resulted in complete resolution of her PPPP. This success occurred after she developed tachyphylaxis against the usual dosing of ustekinumab, demonstrating a recapture of the treatment response.
Factorial study of diesel engine oil contamination effects on steel and ceramic sliding contacts
Authors: Ramkumar P , Harvey TJ , Wood RJK , Rose AD , Woods DC , Lewis SM
Published: August 2018

The present work investigates the effects of diesel contaminants and their interaction on tribological properties for bearing steel (En31) and ceramic (Si3N4) sliding contacts using a factorial study. The contaminants are soot, sulphuric acid, moisture and oxidation, and each contaminant has three different level of concentration (low, medium and high) in the test matrix. The factorial test matrix consisted of 20 tests, constructed from a quarter fractional factorial test matrix with four points at the medium values for the contaminants. Results from this matrix required six further tests to elucidate aliased pairs of interactions using Bayesian model selection. A pin-on-disc tribometer was used to carry out all the experiments. All tests were carried out under ambient conditions at 5 m/s sliding speed and contact stress of 1.5–2.05 GPa to simulate a valve-train in a diesel engine with fully formulated heavy-duty diesel engine oil used as lubricant. Four different tribological properties were studied. The factorial study showed that charge was influenced by tribocouple material; the silicon nitride discs produced higher charge than steel discs. However, it was opposite for friction; the silicon nitride disc gave lower friction and the pins showed higher friction than their steel counterparts. For wear scar and temperature, soot contaminant was found to be important. The two important interactions were found for the charge response, with the interaction between sulphuric acid and pin material being more important than sulphuric acid–oxidation interaction. Similarly to charge, an interaction between sulphuric acid and pin material interaction was found for friction.
Over three decades study populations in progressive multiple sclerosis have become older and more disabled, but have lower on-trial progression rates: A systematic review and meta-analysis of 43 randomised placebo-controlled trials
Authors: Nicholas Richard S , Han Erika , Raffel Joel , Chataway Jeremy , Friede Tim
Published: August 2018

Background:

Progression is the major driver of disability and cost in multiple sclerosis (MS). However, the search for treatments in progressive multiple sclerosis (PMS) has not mirrored the success in relapsing MS.

Objectives:

To assess changes in PMS trials over time.

Methods:

PubMed, MEDLINE and Embase were searched to identify randomised, double-blind, placebo-controlled trials in PMS. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used, study quality was assessed and trends were examined by regression.

Results:

Placebo groups of 43 studies published between 1988 and 2018 were included. The mean age at trial entry increased by 9.8 years per decade (95% confidence interval (CI): [2.7; 4.9]; p < 0.001). Mean baseline Expanded Disability Status Scale (EDSS) scores increased by 0.36 points (95% CI: [0.09; 0.62]; p = 0.009) and disease durations at baseline were prolonged by 1.8 years (95% CI: [0.7; 2.9]; p = 0.003) per decade. The trials became larger, specifically placebo groups increased by about 222 patients (95% CI: [36; 409]; p = 0.021) and 88 patients (95% CI: [12; 165]; p = 0.025) per decade for primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS), respectively. The proportion of patients on placebo experiencing disability progression within 24 months decreased by 7.6 percentage points (95% CI: [1.2; 14.1]; p = 0.022) per year.

Conclusion:

Over three decades, PMS trial populations changed and are now older, with a longer disease duration and more disability, with lower on-trial progression rates.
Going undercover: Online domestic tourism marketing communication in closed and open Facebook groups
Authors: Roth-Cohen Osnat , Lahav Tamar
Published: August 2018

Due to the importance of social media for domestic tourism consumers, small-medium enterprises (SMEs) include online marketing using Facebook in their strategic communication efforts. Using unique tactics to embed unidentified messages, they exploit open and closed Facebook groups under the disguise of organic users. This study evaluates the entrance of small domestic tourism business owners into Israeli Facebook groups, analyzing their consumer engagement tactics using virtual ethnography (netnography) as a research method. Netnography is a qualitative approach to data collection in virtual communities. In this research, the procedure was multistep: observation, qualitative data collection of closed and open tourism Facebook groups, and analysis and presentation of results as well as their implications. Key findings indicate that SME marketing efforts mimic organic user activities, exploiting virtual characteristics on Facebook groups (e.g. a sense of community, belonging, and trust). Another notable phenomenon is the undisclosed marketing communication tool kit employed to transmit message. It includes tactics such as separation of private and business profiles, exploitation of family relations, and repeat recommendations. This research adds to the understanding of online tourism marketing in virtual communities by analyzing the messaging optimization tool kit for targeting Facebook-using audiences.
Additive manufacturing of polyethylene terephthalate glycol /carbon fiber composites: An experimental study from filament to printed parts
Authors: Ferreira Isaac , Vale Diogo , Machado Margarida , Lino Jorge
Published: August 2018

This research focuses on the definition and application of a characterization methodology to determine the characteristics of fused deposition modeling 3D printing materials. Commercial short fiber reinforced and unreinforced polyethylene terephthalate glycol parts were tested achieving comparison terms. The presented methodology is composed of three classes: thermal analysis, mechanical testing, and material morphology. Filament was tensile tested with specially developed setup for determining the mechanical properties of raw materials. Standardized flexural and tensile samples were printed 100% dense in both materials and tested. Differential scanning calorimetry results showed that the thermal properties of both materials do not change with successive heating cycles. Thermogravimetric analysis allowed to understand the thermal stability of materials and quantify the amount of fiber in the matrix. Tensile tests indicated that the addition of fibers increases the Young’s modulus by 70.10% but there is lesser withstanding of stress by 28.21%. Flexural tests exhibited an increase in flexural modulus of 191.38% and 5.14% in flexural strength for the reinforced polyethylene terephthalate glycol, due to the presence of fiber. Microscopic analysis revealed a 12% of void spots and fiber alignment accordingly to the deposition path.
Aiding together? Europeans’ attitudes on common aid policy
Authors: Kiratli Osman S
Published: August 2018

This article explores the determinants of individual support for common aid policy in the European Union, the largest multilateral contributor of foreign aid. Using the 2016 Eurobarometer survey data, I first investigate the influence of individuals’ assessments of aid objectives on support for multilateral disbursements, and second, I explore the effect of country-level factors, population and economic power. Multilevel regression models reveal that those who prioritize economic infrastructural projects in developing countries are highly negative of the utilization of EU channels. Conversely, individual preferences for the promotion of democratic reforms and the provision of basic necessities are strongly and positively associated with the dependent variable. The results also demonstrate that individuals living in lower income and less populated polities are more positively disposed towards common aid policy.
Back to the rough ground: Textual, oral and enactive meaning in comparative political theory
Authors: Rollo Toby
Published: August 2018

The emerging field of comparative political theory (CPT) seeks to expand our understanding of politics through intercultural dialogues between diverse systems of political thought. CPT acknowledges diverse modes of political understanding, yet the field is still methodologically focused on textual forms of political practice and learning. I argue that the privileging of political literature in CPT has been inherited from orthodox political theory and the history of political thought and that the prioritizing of text over oral and enactive practices places constraints on intercultural dialogue. First, methodological focus on texts inhibits dialogue with Indigenous traditions that do not prioritize text in the same way or to the same extent in the reproduction of political culture. Second, the incorporation of oral traditions tends to conflate orality with text in ways that obfuscate the contribution of enactive performance. One result of these methodological oversights is that CPT risks recapitulating some of the historical exclusionary logics that it seeks to overcome.
Electromechanical impedance-based damage identification enhancement using bistable and adaptive piezoelectric circuitry
Authors: Kim Jinki , Wang Kon-Well
Published: August 2018

The electromechanical impedance-based damage identification approaches have shown excellent potential in identifying small-sized structural defects, while maintaining simplicity in implementation. The available independent impedance measurement data sets, however, are generally far fewer than the number of required system parameters. As a result, the inverse problem for damage identification is seriously underdetermined, which undermines the reliability of damage prediction since the inverse solution becomes extremely sensitive to even small amount of error in the measurement, especially in practical applications with unavoidable noise and damping influences. This research aims to advance the state of the art by developing a novel approach that (a) enables highly accurate measurement of damage-induced impedance variations against noise and (b) fundamentally improves the underdetermined inverse problem to reliably identify the location and severity of small damages. This new approach utilizes the strongly non-linear bifurcation phenomena in bistable electrical circuits that may exhibit dramatic changes in the response due to small input variations. In this study, an array of bistable circuits is strategically integrated with the structure and piezoelectric transducer so that small damage-induced changes in the piezoelectric impedance can be accurately determined by monitoring whether each circuit exhibits intra- or inter-well responses. This measurement data set is greatly enriched by utilizing an adaptive piezoelectric circuitry with tunable inductor integrated with the monitored structure, which introduces more degrees of freedom into the system. By selectively tuning the inductance values, the dynamic characteristic of the electromechanically coupled system can be altered, thereby one can significantly increase the number of impedance variation measurements for the same damage profile. The enriched data set is utilized to fundamentally improve the underdetermined inverse problem for damage identification. A series of numerical and experimental damage identification studies verify that the proposed methodology can significantly enhance the accuracy and reliability of impedance-based damage identification.
Understanding Intimate Partner Violence in the Asian Communities in America: A Systematic Review
Authors: Kim Chunrye , Schmuhl Margaret
Published: August 2018

The goal of this study is to provide a systematic review of empirically based journal articles published between 2006 and 2016 that address intimate partner violence (IPV) among Asian communities in the United States. We analyzed 57 peer-reviewed journal articles published in English. Most studies employed quantitative research designs that were cross-sectional in nature and focused on examining the statistical relationships between variables. Sociodemographic variables were the most frequently used variables to predict IPV, while health outcome variables were the most frequently used variables caused by IPV. Theoretical frameworks, methodology, and policy implications used in other studied were discussed in depth. Based on the findings of our study, we recommended future research avenues that can fill the gap in scholarly journal articles investigating the Asian communities.
Appraisal of electrospun textile scaffold comprising polyurethane decorated with ginger nanofibers for wound healing applications
Authors: Mani Mohan Prasath , Jaganathan Saravana Kumar , Ismail Ahmad Fauzi
Published: August 2018

Nowadays, the synthetic biodegradable polymeric scaffolds were widely utilized for skin tissue engineering applications. The usage of nanofibrous scaffold manufactured through textile technologies has gained a widespread cynosure in wound healing applications. In this study, an electrospun textile scaffold based on polyurethane polymer incorporated with ginger extracts is hypothesized to possess unique properties facilitating wound healing. The fabricated electrospun membranes were characterized through scanning electron microscopy, Fourier transform infrared, thermogravimetric analysis, atomic force microscopy, and contact angle measurements. Coagulation assays such as activated prothrombin time, partial thromboplastin time, and hemolysis assay were performed for the electrospun membranes to determine their antithrombogenicity nature. Further, the cytocompatibility studies were evaluated using human dermal fibroblast cells to determine the toxicity of the electrospun polyurethane and their blends. Scanning electron microscopy revealed the reduced fiber (615 ± 154.31 nm) and pore (706 ± 90.07 nm) than the control (fiber diameter 1159 ± 147.48 nm and pore diameter 1087 ± 62.51 nm). Upon ginger incorporation, the wettability (80.33° ± 4.51) and surface roughness (389 nm) of the polyurethane was improved revealed in the contact angle and atomic force microscopy analysis. Infrared spectroscopy and thermogravimetric analysis study revealed the interaction of ginger with polyurethane by showing hydrogen bond formation and leaving an excess residue. The fabricated nanocomposites exhibited faster blood clotting time indicated in the activated prothrombin time and partial thromboplastin time. Further, hemolytic index and cytocompatibility studies revealed that the fabricated nanocomposites (Hemolytic index—0.96% and proliferation rate—159 ± 5.57%) showed nontoxic nature to the red blood cells and enhanced proliferation rate of human dermal fibroblast cells compared to the pristine polyurethane (hemolytic index—2.56% and proliferation rate—132 ± 3.61%). Our findings showed that polyurethane-based fibrous scaffolds comprising ginger exhibited desirable characteristics suitable for skin tissue engineering applications.
Negative-Pressure Wound Therapy Promotes Wound Healing by Enhancing Angiogenesis Through Suppression of NLRX1 via miR-195 Upregulation
Authors: Liu Yu , Tang Ningning , Cao Ke , Wang Shaohua , Tang Sijie , Su Honghui , Zhou Jianda
Published: August 2018

Negative-pressure wound therapy (NPWT) is one of the most advanced therapeutic methods in the treatment of various hard-to-heal acute and refractory chronic wounds. Recent emerging evidence points to a role of the microRNA-mediated regulation of angiogenesis in ischemic tissues, and a series of microRNAs associated with angiogenesis have been successively identified. In this study, we found that miR-195 expression was significantly upregulated and the microvessel density (MVD) was increased in granulation tissue collected 7 days after NPWT compared with those in the pre-NPWT tissue. Moreover, the expression of NLRX1, the potential target gene of miR-195, was down-regulated in post-NPWT compared with that in pre-NPWT tissue. Significant negative correlations were detected between miR-195 and NLRX1 expression levels ( r = −.856, P < .001) and between NLRX1 expression and MVD ( r = −.618, P < .05), whereas miR-195 expression was positively correlated with MVD in the granulation tissue ( r = .630, P < .05). In summary, NPWT may suppress NLRX1 expression through the upregulation of miR-195 expression, thus efficaciously promoting angiogenesis in the granulation tissue to enhance wound healing.
Is It Time to Re-Evaluate the Ethics Governance of Social Media Research?
Authors: Samuel G. , Ahmed W. , Kara H. , Jessop C. , Quinton S. , Sanger S.
Published: August 2018

This article reports on a U.K. workshop on social media research ethics held in May 2018. There were 10 expert speakers and an audience of researchers, research ethics committee members, and research institution representatives. Participants reviewed the current state of social media ethics, discussing well-rehearsed questions such as what needs consent in social media research, and how the public/private divide differs between virtual and real-life environments. The lack of answers to such questions was noted, along with the difficulties posed for ethical governance structures in general and the work of research ethics committees in particular. Discussions of these issues enabled the creation of two recommendations. The first is for research ethics committees and journal editors to add the category of ‘data subject research’ to the existing categories of ‘text research’ and ‘human subject research’. This would reflect the fact that social media research does not fall into either of the existing categories and so needs a category of its own. The second is that ethical issues should be considered at all stages of social media research, up to and including aftercare. This acknowledges that social media research throws up a large number of ethical issues throughout the process which, under current arrangements for ethical research governance, risks remaining unaddressed.
Intrarater and Interrater Reliability of the Soong Classification for Distal Radius Volar Locking Plate Placement
Authors: Creighton James J. , Jensen Courtney D. , Kaplan F. Thomas D.
Published: August 2018

Background: The purpose of this study was to analyze the intrarater and interrater reliability of the Soong classification for volar locking plate placement on a randomly selected, consecutive series of radiographs. Our hypothesis was that the classification would be reliable. Methods: Six physicians of differing levels of training (orthopedic surgery intern to fellowship-trained upper extremity staff) were asked to review 40 radiographs in a random order on 2 separate occasions, 4 weeks apart. All observers graded each image (0, 1, or 2) based on the corresponding Soong grade. A weighted κ was used to determine the intrarater agreement. The interrater agreement was determined using an intraclass coefficient: Results: The intrarater reliability using a weighted κ ranged from 0.229 (95% confidence interval [CI]: 0.048-0.411) to 0.946 (95% CI: 0.840-1.051). The interrater intraclass coefficient for Randomization 1 was 0.944 (95% 0.912-0.967) and Randomization 2 was 0.877 (95% CI: 0.797-0.930). Conclusion: The Soong classification is a reliable tool, both interrater and intrarater, for assessing distal radius volar locking plate placement. The classification system remained reliable despite a randomly selected, consecutive series of images and physician observers of varying levels of training.
Role of Computed Tomography Scan in Dental Trauma: A Cross-Sectional Study
Authors: Li Feng , Li Jun , Zhang Deming , Wu Feng
Published: August 2018

Background:

Dental trauma is caused by fracture(s) in the vertical plane and the horizontal plane of roots. The objective of this study is to perform multiple diagnostic modalities for the diagnosis of horizontal root fracture(s) of the tooth.

Methods:

A total of 250 patients with dental complaints were subjected to intraoral radiography, multidetector helical computed tomography (MDHCT), and limited cone beam computed tomography (LCBCT). The suspected tooth was extracted, visually inspected, and subjected to microcomputed tomography (micro-CT). Images were observed in the lightbox, and a fracture was considered if it had been directly visualized as radiolucent line traversing tooth root. Wilcoxon test/Tukey post hoc test was performed at 99% of confidence level.

Results:

With respect to visual inspection, for LCBCT, intraoral radiography, MDHCT, and micro-CT, sensitivities were 0.988, 0.972, 0.967, and 0.979; accuracies were 0.956, 0.785, 0.905, and 0.888; false-positive values were 5, 21, 12, and 11; and false-negative values were 3, 24, 3, and 11, respectively. The area of the image visible at one time was in the order of treatment without radiography < intraoral radiography < MDHCT < micro-CT < LCBCT.

Conclusion:

The LCBCT had the highest sensitivity and accuracy for diagnosis of horizontal tooth root fracture(s).

Level of Evidence:

I.

Trial Registry:

researchregistry3647, dated December 31, 2016 ( www.researchregistry.com ).
Effect of mounting brackets on thermal performance of buildings with ventilated facades
Authors: Nowak Katarzyna , Byrdy Aleksander
Published: August 2018

Ventilated facades systems have become a widely used solution for elevations of commercial buildings. Yet, those systems use metal frames and brackets that interrupt continuity of thermal insulation by creating point thermal bridges. The influence of anchorage systems on the total performance of walls is either neglected or simplified upon assumption that their influence is not important because the thermal insulation is thick enough. This article, based on three-dimensional analyses, demonstrates a significant impact of point bridges created by the anchorage systems of ventilated building facades on the heat loss. The results emphasize the need for individual calculations.
Cholestatic liver diseases: new targets, new therapies
Authors: Santiago Priscila , Scheinberg Andrew R. , Levy Cynthia
Published: August 2018

Cholestatic liver diseases result from gradual destruction of bile ducts, accumulation of bile acids and self-perpetuation of the inflammatory process leading to damage to cholangiocytes and hepatocytes. If left untreated, cholestasis will lead to fibrosis, biliary cirrhosis, and ultimately end-stage liver disease. Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are the two most common chronic cholestatic liver diseases affecting adults, and their etiologies remain puzzling. While treatment with ursodeoxycholic acid (UDCA) has significantly improved outcomes and prolonged transplant-free survival for patients with PBC, treatment options for UDCA nonresponders remain limited. Furthermore, there is no available medical therapy for PSC. With recent advances in molecular biochemistry specifically related to bile acid regulation and understanding of immunologic pathways, novel pharmacologic treatments have emerged. In this review, we discuss the standard of care and emphasize the various emerging treatments for PBC and PSC.
Increasing trend in admission rates and costs for acute diverticulitis during 2005–2015: real-life data from the Abruzzo Region
Authors: Cammarota Simona , Cargiolli Martina , Andreozzi Paolo , Toraldo Bernardo , Citarella Anna , Flacco Maria Elena , Binda Gian Andrea , Annibale Bruno , Manzoli Lamberto , Cuomo Rosario
Published: August 2018

Background:

Scarce data are available on the epidemiological trend of diverticulitis and its financial burden in Italy. The aim of this work was to explore a potential variation in the rate and costs of hospital admissions for uncomplicated and complicated diverticulitis over the last decade.

Methods:

We selected all hospitalizations for diverticulitis of residents in the Abruzzo Region, Italy between 2005 and 2015. Age-standardized hospitalization rates (HRs) per 100,000 inhabitants for overall, uncomplicated and complicated diverticulitis were calculated. A linear model on the log of the age-standardized rates was used to calculate annual percentage changes (APC). Costs were derived from the official DRG tariff.

Results:

From 2005 to 2015, the HR for acute diverticulitis increased from 38.9 to 45.2 per 100,000 inhabitants (APC + 1.9%). The HR for complicated diverticulitis increased from 5.9 to 13.3 (APC + 7.6%), whereas it remained stable for uncomplicated diverticulitis. The mean hospital cost was 1.8-times higher for complicated diverticulitis compared with that for uncomplicated disease and 3.5-times higher for patients with a surgery stay compared with that for patients with a medical stay.

Conclusion:

During the last decade, in the Abruzzo Region, the HRs for diverticulitis and their costs increased significantly, mainly due to disease complications. Further studies are needed to explore strategies to prevent complications and to realise cost-saving policies.
Indoleamine 2,3-dioxygenase-dependent expansion of T-regulatory cells maintains mucosal healing in ulcerative colitis
Authors: Acovic Aleksandar , Simovic Markovic Bojana , Gazdic Marina , Arsenijevic Aleksandar , Jovicic Nemanja , Gajovic Nevena , Jovanovic Marina , Zdravkovic Natasa , Kanjevac Tatjana , Harrell C. Randall , Fellabaum Crissy , Dolicanin Zana , Djonov Valentin , Arsenijevic Nebojsa , Lukic Miodrag L. , Volarevic Vladislav
Published: August 2018

Background:

Dendritic cell (DC)-derived indolamine 2,3-dioxygenase (IDO) degrades tryptophan to kynurenine, which promotes conversion of inflammatory T cells in immunosuppressive regulatory T cells (Tregs). We analyzed the significance of the IDO:Treg axis for inducing and maintaining mucosal healing in ulcerative colitis (UC).

Methods:

Dextran sodium sulphate (DSS)-induced colitis in BALB/c mice (model for mucosal healing) and C57BL/6 mice (model for persistent disease) was used. Serum, fecal samples and colon-infiltrating immune cells of 65 patients with UC with mucosal healing or persistent colitis were analyzed.

Results:

Significantly higher serum levels of kynurenine and downregulated inflammatory cytokines were noticed in DSS-treated BALB/c mice compared with C57BL/6 mice. Increased IDO activity and attenuated capacity for antigen presentation and production of inflammatory cytokines, observed in BALB/c DCs, was followed by a significantly lower number of inflammatory T helper 1 (Th1) and Th17 cells and a notably increased number of Tregs in the colons of DSS-treated BALB/c mice. DCs and Tregs were crucially important for the maintenance of mucosal healing since their depletion aggravated colitis. Mucosal healing, followed by an increase in kynurenine and intestinal Tregs, was re-established when BALB/c DCs were transferred into DC-depleted or Treg-depleted DSS-treated BALB/c mice. This phenomenon was completely abrogated by the IDO inhibitor. Significantly higher serum and fecal levels of kynurenine, accompanied by an increased presence of intestinal Tregs, were noticed in patients with UC with mucosal healing and negatively correlated with disease severity, fecal calprotectin, colon-infiltrating interferon γ and interleukin-17-producing cells, serum and fecal levels of inflammatory cytokines.

Conclusion:

IDO-dependent expansion of endogenous Tregs should be further explored as a new approach for the induction and maintenance of mucosal healing in patients with UC.
Changes in student physical health behaviour: an opportunity to turn the concept of a Healthy University into a reality
Authors: Haas J , Baber M , Byrom N , Meade L , Nouri-Aria K
Published: August 2018

Aims:

Previous studies have reported a high prevalence of unhealthy behaviours in the student population, which the Healthy University concept is now seeking to address, by taking a settings approach to health promotion. This study investigated how far students are already seeking to make changes to improve their health behaviour while in a university setting, to help inform the development of Healthy Universities.

Methods:

Data on student health behaviour change, health indicators and demographics were gathered from 550 students attending two London universities, via an online questionnaire released through the student union email system at one university and through iPads at a student centre at the other.

Results:

In total, 84% of respondents reported making changes to try to become healthier while at university, primarily for proactive health reasons rather than reacting to a perceived health or weight issue. Universities and student unions were reported as influencing behaviour change by only five students. Compared with previous studies, a higher proportion of respondents were pursuing healthier lifestyles, including only 11% reporting they smoked. There were some statistically significant demographic differences as regards alcohol consumption, physical activity, the types of food students were seeking to avoid and the reasons for this.

Conclusion:

The findings provide a novel perspective on student health behaviour and suggest that the traditional stereotype of a hedonistic student lifestyle freed from family constraints may need to be reassessed. Universities and student unions appear to have a significant opportunity to build on a more health conscious cohort of students, employing targeted approaches where appropriate, to encourage positive health behaviour change and make the Healthy Universities concept a reality, with important public health implications.
Osteochondritis Dissecans of the Knee: Short-Term Outcomes of a Hybrid Technique to Restore a Partially Salvageable Progeny Fragment
Authors: Melugin Heath P. , Desai Vishal S. , Levy Bruce A. , Tanaka Yoshinari , Horibe Shuji , Nakamura Norimasa , Krych Aaron J.
Published: August 2018

Objective

This retrospective case series describes a hybrid fixation technique and determines the clinical outcomes, knee function, and activity level of patients at short-term follow-up.

Design

Seventeen patients (18 knees) with unstable osteochondritis dissecans (OCD) lesions involving the knee were treated with a hybrid fixation technique in which the salvageable fragment was fixed and osteochondral autograft transplantation system (OATS) was used for the unsalvageable fragment. Thirteen lesions involved the medial femoral condyle, 4 involved the lateral femoral condyle, and 1 involved the patella. Mean patient age was 17 years (range 12-28 years). All lesions were International Cartilage Repair Society (ICRS) grade III or IV. The patients were prospectively followed postoperatively. Outcome measures included the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and the Tegner activity scale.

Results

At mean follow-up of 36 months (range 24-67.2 months), the mean postoperative KOOS scores, given as mean (SD), were as follows: Quality of Life (QoL) 91.1 (17.0), Activities of Daily Living (ADL) 99.5 (1.5), Sport 94.5 (11.2), Pain 97.4 (5.8), and Symptoms 95.9 (6.5). Mean IKDC score was 96.2 (7.0). There was no significant difference between mean preinjury (7.95, SD = 1.1) and mean postoperative (7.45, SD = 1.5) Tegner scores ( P = 0.363). The mean Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was 87.5 at a mean 7.8 months (range 3-18 months) postoperation. There were no reported complications.

Conclusion

The results of this case series suggest that patients with partially salvageable OCD lesions involving the knee can have positive short-term outcomes and can expect a low complication rate when treated with a hybrid technique of fixation with osteochondral autograft transfer.
Labour Rights and the Case Law of the European Court of Justice
Authors: Teklè Tzehainesh
Published: August 2018

This article examines the role of International Labour Standards (ILS) adopted by the International Labour Organisation (ILO) in the case law of the Court of Justice of the European Union (CJEU) within a global context characterised, on the one hand, by a multiplicity of domestic, supranational and international legal sources and adjudicator and supervisory bodies operating in the labour law field; and, on the other, by an increasing use of ILS by domestic and regional courts. These are, thus, building bridges between the plurality of legal systems and fostering coherence in the interpretation of labour rights. Based on a thorough examination of the case law of the CJEU and against the broader background of the EU legal and policy approach to labour rights and ILS, this article shows that despite the above-mentioned general trend the CJEU has been making a limited use of ILS and these have been having a limited bearing on its judgments. The article highlights why this is problematic and identifies the underlying causes. Finally, it presents arguments in favour of, and legal and methodological avenues to achieve, a greater reliance by the CJEU on ILS and the work of the ILO bodies supervising their application.