bluuebunny/crossref_metadata_2025 huggingface dataset:
Mathematical methods for SCADA data mining of onshore wind farms: Performance evaluation and wake analysis
Authors: Astolfi Davide , Castellani Francesco , Terzi Ludovico
Published: January 2016

Supervisory control and data acquisition (SCADA) systems have become widely diffuse in modern wind energy technology. The slowdown of new installations and the increasing percentage of energy entering the grid from renewable stochastic sources has diverted attention to the careful optimization of operating farms. Elaborating the complex data stream from SCADA systems into knowledge poses technological and scientific challenges. SCADA data analysis therefore lies at the crossroads of mechanical engineering, applied mathematics, statistics and physics. In the present work, mathematical methods are proposed for tackling the complexity of SCADA data. This idea is to elaborate simplified and more powerful data sets through one action: discretization of continuous quantities. The approach is employed for two very different issues: performance evaluation and wake effects analysis, which is investigated from the point of view of power losses, due to the difficulties associated with optimal turbine alignment with the wind. Two indexes for performance evaluation are formulated. Recurrent non-trivial orientation patterns of clusters of turbines are individuated, and the efficiency associated to them is analyzed. The methods are tested on two wind farms situated in southern Italy.
Quantification Analysis of the Intraoperative Bacterial Contamination Rate and Level in Osteochondral Autografts
Authors: Alomar Abdulaziz Z. , Somily Ali Mohammed , Alraiyes Thamer M. , Bin Nasser Ahmad S. , Aljassir Fawzi F.
Published: January 2016

Background:

Inadvertent contamination of osteochondral (OC) autografts during harvesting and preparation can lead to significant complications and can cause the operating team to weigh the infection risk after reimplantation against discarding the OC fragment. The most commonly reported contamination mechanism is the accidental dropping of an OC fragment; however, associated contamination levels remain unclear. The rate and level of contamination during standard harvesting and preparation are also unknown.

Purpose:

To quantitatively evaluate the rate and level of bacterial contamination of OC autografts during harvesting and preparation compared with those of accidently dropped autografts.

Study Design:

Controlled laboratory study.

Methods:

Under sterile conditions, 138 fresh OC specimens were harvested and retrieved from 23 primary total knee arthroplasties (TKAs). Six OC fragments were retrieved from each TKA: 3 were used as controls, and 3 were dropped onto the operating room floor. Each specimen was incubated to allow for aerobic and anaerobic growth, and the number of colony-forming units (CFUs) per gram was calculated.

Results:

Contamination rates (positive cultures) for the control and dropped groups were 29% (n = 20/69) and 42% (n = 29/69), respectively. The difference in the contamination rate between groups was not statistically significant ( P = .109). The most common organisms identified were Staphylococcus aureus (40%) in the control group and Staphylococcus epidermidis (24.1%) and Bacillus species (20.7%) in the dropped group. The contamination level (CFUs/g) for both groups was low. The median (range) CFUs/g among the contaminated specimens in the dropped and control groups were 27 (1-120) and 3 (1-15), respectively ( P < .0001).

Conclusion:

A relatively high rate of OC autograft contamination can be expected during harvesting and preparation (29%) or after accidentally dropping a specimen (42%). Although the types of organisms isolated differed between specimens contaminated during harvesting and preparation and dropped specimens, the quantification of the autograft contamination level revealed a very low CFUs/g in both cases.

Clinical Relevance:

The intraoperative autograft contamination level is very low. Hence, in cases of grafts with a known contamination incident, saving and reimplanting them after proper decontamination is recommended over discarding them or using an allograft.
Risk Factors for Short-term Complications of Anterior Cruciate Ligament Reconstruction in the United States
Authors: Cvetanovich Gregory L. , Chalmers Peter N. , Verma Nikhil N. , Cole Brian J. , Bach Bernard R.
Published: January 2016

Background:

Anterior cruciate ligament reconstruction (ACLR) is a commonly performed procedure that is highly successful in restoring knee stability and function. The incidence of early ACLR complications and the risk factors for these complications are not well defined.

Purpose:

To determine the incidence of 30-day complications and patient and surgical risk factors for complications after ACLR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent ACLR between 2005 and 2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database using Current Procedural Terminology billing codes. Postoperative complications in the 30-day period after surgery were identified. Potential patient and surgical risk factors for 30-day complications after ACLR were analyzed using univariate and multivariate analyses.

Results:

A total of 4933 patients were identified. Major complications occurred in 27 patients (0.55%), and minor complications occurred in 43 patients (0.87%), with overall complications occurring in 66 patients (1.34%). The most common complications were symptomatic deep venous thrombosis requiring treatment (n = 27; 0.55%), return to the operating room (n = 18; 0.36%), superficial infections (n = 10; 0.20%), deep infections (n = 7; 0.14%), and pulmonary embolism (n = 6; 0.12%). A single mortality (0.02%) occurred. Multivariate analyses demonstrated that smoking, dyspnea, a history of chronic obstructive pulmonary disease, and recent weight loss were all risk factors for the development of overall complications, although in combination, these factors accounted for only 3% of the variance in the complication rate.

Conclusion:

ACLR has a low incidence of complications (1.34%) in the early postoperative period, with the most common being symptomatic venous thromboembolic disease requiring treatment, return to the operating room, and infections. Because ACLR is an elective procedure, surgeons should use this information to counsel patients on risks and to guide their decision making about patient selection.
Is Knee Pain During Adolescence a Self-limiting Condition?
Authors: Rathleff Michael S. , Rathleff Camilla R. , Olesen Jens L. , Rasmussen Sten , Roos Ewa M.
Published: January 2016

Background:

The prevalence of adolescent knee pain is 33%, and patellofemoral pain (PFP) is the most common diagnosis with a nontraumatic onset. The 2-year prognosis of adolescent PFP compared with other types of knee pain is unknown.

Purpose:

To investigate the 2-year prognosis of knee pain among adolescents with and without a diagnosis of PFP.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

In 2011, a cohort of 2200 adolescents aged 15 to 19 years answered an online questionnaire on musculoskeletal pain. Of these, 504 reported knee pain, and 153 of these were clinically diagnosed with PFP. After 2 years, the 504 adolescents, as well as 252 randomly selected adolescents who did not report knee pain in 2011, were contacted again. Primary outcome at follow-up was the proportion of adolescents with knee pain during the last week prior to follow-up.

Results:

Overall, 55.9% (95% CI, 50.8%-60.9%) of those reporting knee pain at baseline also reported pain 2 years later. Adolescents diagnosed with PFP had a 1.26 (95% CI, 1.05-1.50) higher relative risk (RR) of knee pain at follow-up compared with other types of knee pain. Adolescents with PFP were significantly more likely to reduce or stop sports participation compared with adolescents with other types of knee pain. Of those without knee pain at baseline, 12.8% (95% CI, 8.4%-17.2%) reported knee pain at follow-up in 2013. Adolescents with knee pain at baseline had a 4.51 (95% CI, 3.15-6.45) higher RR of knee pain at follow-up compared with adolescents without knee pain at baseline.

Conclusion:

Knee pain during adolescence, and PFP in particular, is in most cases present after 2 years and thus may not be self-limiting. A greater focus on early detection and prevention of knee pain during adolescence is needed.
Translating Strong for Life Into the Community Care Program: Lessons Learned
Authors: Danilovich Margaret K. , Hughes Susan L. , Corcos Daniel M. , Marquez David X. , Eisenstein Amy R.
Published: January 2016

We used a randomized controlled trial to test the implementation of Strong for Life (SFL), a resistance exercise intervention, using 32 home care aides (HCAs) as exercise leaders with their 42 homebound older adult clients enrolled in the Community Care Program, a Medicaid 1915(c) waiver program. Mixed-methods were used to analyze outcomes of program satisfaction rates, training session evaluations, program fidelity, and job descriptive index scores. Results indicate that it is feasible for HCAs to implement SFL safely with clients. Participants viewed SFL as highly satisfactory and HCAs were able to adapt SFL for their clients. HCAs have high job satisfaction, and leading SFL enhances work achievement and pride. Our results show it is possible to train HCAs to implement SFL with their clients in addition to providing usual care services, participation positively affects both care partners, and this is a feasible and practical delivery model to provide exercise for adults receiving home- and community-based services.
Relationships Among Intimate Partner Violence, Work, and Health
Authors: Wathen C. Nadine , MacGregor Jennifer C. D. , MacQuarrie Barbara J.
Published: January 2016

Intimate partner violence (IPV) is a major public health problem, and recent attention has focused on its impact on workers and workplaces. We provide findings from a pan-Canadian online survey on the relationships among IPV, work, and health. In total, 8,429 people completed the survey, 95.5% of them in English and 78.4% female. Reflecting the recruitment strategy, most (95.4%) were currently working, and unionized (81.4%). People with any lifetime IPV experience reported significantly poorer general health, mental health, and quality of life; those with both recent IPV and IPV experience over 12 months ago had the poorest health. Among those who had experienced IPV, about half reported that violence occurred at or near the workplace, and these people generally had poorer health outcomes. Employment status moderated the relationship between IPV exposure and health status, with those who were currently working and had experienced IPV having similar health status to those without IPV experience who were not employed. While there were gender differences in IPV experience, in the impacts of IPV at work, and in health status, gender did not moderate any associations. In this very large data set, we found robust relationships among different kinds of IPV exposure (current, recent, and lifetime), health and quality of life, and employment status, including the potentially protective effect of current employment on health for both women and men. Our findings may have implications for strategies to address IPV in workplaces, and should reinforce emerging evidence that IPV is also an occupational health issue.
Mobbing in Schools and Hospitals in Uruguay
Authors: Buunk Abraham P. , Franco Silvia , Dijkstra Pieternel , Zurriaga Rosario
Published: January 2016

In the present study in secondary schools and hospitals in Uruguay ( N = 187), we examined the relationship between feeling the victim of mobbing and a perceived loss of status. Nearly all forms of mobbing were more prevalent among hospital employees than among school employees. Among hospital employees, 40.4%, and among school employees, 23.9% reported being the victim of mobbing at least once a week. Being the victim of mobbing was, in both hospitals and schools, more prevalent among older employees, and in hospitals, among employees who were more highly educated and who had been employed for a longer time. Men and women did not differ in reporting that one was a victim of mobbing, but men reported more perceived loss of status than women. However, among women, being the victim of mobbing was much more strongly related to experiencing a loss of status than among men. Several explanations for this gender difference and the practical and theoretical implications of the results are discussed.
Model-predictive-control-based novel anti-skid method for electric vehicles using the wheel acceleration and the motor torque
Authors: Liu Xiang , Li Mian , Xu Min
Published: January 2016

To solve the oil shortage and emission problems resulting from millions of conventional vehicles driven by engines, vehicle electrification has become one of the possible solutions recognized worldwide. A model-predictive-control-based anti-skid method for electric vehicles is presented in this paper. In this control strategy, a novel single parameter, denoted Rat, is regulated to constrain the skid of the vehicle. Rat is the ratio of the wheel acceleration to the drive motor torque, both of which are easy to obtain for electric motors. It is proved in this paper that, for electric vehicles, the wheel slip can be detected using the new parameter Rat. Model predictive control is employed in this research to restrict Rat within its safety region. Both the simulation results and the experimental results show that the model predictive control Rat method introduced in this paper can detect and prevent the potential skid of the electric vehicles.
Development of a low-cost motorcycle riding simulator for emergency scenarios involving swerving
Authors: Savino Giovanni , Pierini Marco , Lenné Michael G
Published: January 2016

The development of advanced riding assistance systems requires the analysis of user reactions in emergency situations. Motorcycle riding simulators are an alternative to ‘on-road’ testing so that virtual environment dangerous scenarios can be investigated without risks for the participants. In this paper, we propose a process for validation of a low-cost motorcycle simulator characterized by, first, an elastic resistance on the steering input and, second, a counter-steering strategy. For this, 16 riders tested the simulator in different manoeuvres, including a cornering manouvre in a non-urban environment, a slalom manoeuvre and a lane-change manoeuvre. Objective evaluations and subjective evaluations showed that the simulator was realistic, in particular for investigating lateral avoidance scenarios. The development of suitable motorcycle simulators will significantly advance the field of motorcycle safety research.
Tuberculosis screening in patients with HIV: An audit against UK national guidelines to assess current practice and the effectiveness of an electronic tuberculosis-screening prompt
Authors: Fox-Lewis A , Brima N , Muniina P , Grant AD , Edwards SG , Miller RF , Pett SL
Published: January 2016

A retrospective clinical audit was performed to assess if the British HIV Association 2011 guidelines on routine screening for tuberculosis in HIV are being implemented in a large UK urban clinic, and if a tuberculosis-screening prompt on the electronic patient record for new attendees was effective. Of 4658 patients attending during the inclusion period, 385 were newly diagnosed first-time attendees and routine tuberculosis screening was recommended in 165. Of these, only 6.1% of patients had a completed tuberculosis screening prompt, and 12.1% underwent routine tuberculosis screening. This audit represents the first published UK data on routine screening rates for tuberculosis in HIV and demonstrates low rates of tuberculosis screening despite an electronic screening prompt designed to simplify adherence to the national guideline. Reasons why tuberculosis screening rates were low, and the prompt ineffective, are unclear. A national audit is ongoing, and we await the results to see if our data reflect a lack of routine tuberculosis screening in HIV-infected patients at a national level.
Reducing pressure oscillations in discrete fluid power systems
Authors: Hansen Anders Hedegaard , Pedersen Henrik C
Published: January 2016

Discrete fluid power systems featuring transmission lines inherently include pressure oscillations. Experimental verification of a discrete fluid power power take off system for wave energy converters has shown the cylinder pressure to oscillate as force shifts are performed. This article investigates how cylinder pressure oscillations may be reduced by shaping the valve opening trajectory without the need for closed loop pressure feedback. Furthermore the energy costs of reducing pressure oscillations are investigated.
A novel twin-shaft rotor layout with active magnetic couplings for vibration control
Authors: Lusty Chris , Sahinkaya Necip , Keogh Patrick
Published: January 2016

A novel rotor topology is proposed with the goal of reducing vibration in high speed rotor systems. Reduction in vibration at critical speeds is targeted. In essence, the novel topology consists of a hollow tube rotor coupled to a secondary non-rotating shaft located concentrically within the primary rotor. The two shafts are linked via a number of actively managed magnetic couplings. The topology is provided, along with an analysis comparing the out-of-balance vibration response of the proposed rotor to a comparable simple passive rotor. Designs for a test rig based on this topology are presented, together with an outline of anticipated testing and development of the idea. Special consideration is given to the design of the magnetic bearings, which form the system couplings. An internal-stator homopolar bearing design fabricated from soft magnetic composite is presented. The qualities of soft magnetic composite as a bearing core material are shown to be comparable with a standard laminated core with the added advantage of minimal eddy current losses within the primary rotor.
Antenatal reflex DNA screening for trisomy 18 and trisomy 13 in addition to Down’s syndrome
Authors: Bestwick Jonathan P , Wald Nicholas J
Published: January 2016

Objective

Antenatal reflex DNA screening for Down’s syndrome has a high screening performance. We aimed to determine the performance of trisomy 18 and trisomy 13 reflex DNA screening when added to Down’s syndrome screening.

Methods

In our modelled screening protocol, women provide two samples: a serum sample for a Combined test and a plasma sample for a possible DNA test. Women with Down’s syndrome, trisomy 18, or trisomy 13 Combined test risks above a single cut-off have a reflex DNA test using the plasma sample, without the need to recall them to collect another sample and provide counselling. Women with a failed DNA test (after a second attempt using a fresh plasma sample) have an Integrated test, and are classified as positive if any of the Down’s syndrome, trisomy 18, or trisomy 13 Integrated test risks are greater than 1 in 25.

Results

At 1 in 800 term risk cut-offs for Down’s syndrome, trisomy 18, and trisomy 13, an estimated 10% of women are reflexed to DNA screening, yielding a 91% Down’s syndrome detection rate, an 89% trisomy 18 detection rate, and a 79% trisomy 13 detection rate for a 0.05% false-positive rate. At a 1 in 1900 term risk cut-off for Down’s syndrome, trisomy 18, or trisomy 13, an estimated 20% of women are reflexed to DNA screening, and this yields a 94% Down’s syndrome detection rate, a 92% trisomy 18 detection rate, and an 84% trisomy 13 detection rate for a 0.10% false-positive rate.

Conclusion

Reflex DNA screening for trisomies 18 and 13 can be usefully added to reflex DNA screening for Down’s syndrome.
Vibration analysis of a rectangular-hollow-sectional beam with an external crack
Authors: Liping Peng , Chusheng Liu
Published: January 2016

The vibration property of a rectangular-hollow-sectional beam with an external crack were theoretically and experimentally studied in this paper. The external part-through crack and through-thickness crack were considered. Linear elastic fracture mechanics were employed to establish the theoretical formula for computing the equivalent torsion spring stiffness of the two external cracks. Then, the experimental method of obtaining the equivalent torsion spring stiffness was developed. It is seen that the test data match fairly well with the analytical data. On this basis, the transfer matrix method was introduced to obtain the frequency equations of these cracked beams under three classic boundary conditions, and followed by the numerical method for calculating natural frequencies. Experimental tests on clamped–free beams were used to verify the accuracy. It should be noted that a part-through crack may lead to a more distinct natural frequency reduction than the through-thickness crack.
Becoming More Complete
Authors: (Wie) Yusuf Juita-Elena , O’Connell Lenahan , Rawat Pragati , Anuar Khairul
Published: January 2016

The complete streets movement calls for streetscapes designed for safe and convenient walking, biking, and transit usage by all residents including children, the elderly, and the disabled. This study reviews state-level complete streets policies. Our research questions are: (1) In what ways do the states with a complete streets policy differ from the states without one? (2) Have complete streets policies become more comprehensive over time? (3) Does the type of policy—a law passed by a state legislature versus an executive-level policy—change the comprehensiveness of the policy? We find that urbanized states are more likely to have complete streets policies. Diffusion of the policy appears weakly associated with adjacency of adopting states. The type of policy was related to the comprehensiveness of early complete streets policies, but the differences diminish as these policies have gained traction in recent years. Over time, state-level complete streets policies have become more comprehensive in content.
Excessive Daytime Sleepiness in Stroke Survivors
Authors: Ding Qinglan , Whittemore Robin , Redeker Nancy
Published: January 2016

Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors’ quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946—April; Week 2, 2015), Embase (OvidSP 1974—March; Week 1, 2015), and PsycINFO (OvidSP 1967—April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors.
Assumptions about life hardship and pain perception
Authors: Hoffman Kelly M. , Trawalter Sophie
Published: January 2016

The present work examines whether people assume that those who have faced hardship feel less pain than those who have not, and whether this belief contributes to the perception that Blacks feel less pain than Whites. In Experiments 1 and 2, participants received information about a Black and/or White target person’s life hardship and then rated the target person’s pain. Participants reported that the target individual would feel less pain if s/he had experienced greater hardship. Importantly, racial bias emerged but only when hardship information was consistent with expectations about race and life hardship; that is, participants reported that the Black (vs. White) target individual would feel less pain only if s/he had experienced greater hardship. In Experiment 3, participants read that hardship either toughens or weakens the body, and then rated a Black or White target person’s pain. Racial bias emerged but only when supported by lay beliefs. Specifically, participants reported that the Black (vs. White) target individual would feel less pain but only if they endorsed the belief that hardship leads to toughness. Taken together, these findings suggest that perceptions of hardship shape perceptions of pain and contribute to racial bias in pain perception. These findings also suggest that eliminating this racial bias will require challenging lay beliefs; it will require the recognition that people who have faced great hardship feel just as much, if not more, pain.
The role of contrast-enhanced ultrasound imaging in the follow-up of patients post-endovascular aneurysm repair
Authors: Jawad Nadia , Parker Pamela , Lakshminarayan Raghuram
Published: January 2016

Endovascular aneurysm repair is a minimally invasive technique for the treatment of abdominal aortic aneurysms. Patients who undergo endovascular aneurysm repair are potentially at risk of developing problems related to the graft such as the development of endoleaks. Endoleaks can cause expansion of the aneurysmal sac, which can potentially lead to rupture. It is for this reason that lifelong surveillance of patients is required to assess the graft and the aneurysmal sac. This article discusses the role of contrast-enhanced ultrasound in the follow-up of patients post-endovascular aneurysm repair. Contrast-enhanced ultrasound is rapidly becoming a powerful, accurate and cost-effective tool to complement computed tomography in the follow-up of endovascular aneurysm repair patients. Real-time imaging of contrast filling into the arterial system means that contrast-enhanced ultrasound is an excellent problem-solving tool, particularly when assessing for the type and anatomy of endoleaks. In some instances, contrast-enhanced ultrasound can detect endoleaks when other modalities are equivocal.
Holistic approach to achieving low-energy, high-rise residential buildings
Authors: Cianfrone Christian , Roppel Patrick , Hardock Dieter
Published: January 2016

As codes and standards evolve toward low- or net zero–energy buildings, the practicality of achieving these targets in high-rise concrete construction gets increasingly challenging. High-rise residential buildings are becoming more common as cities redevelop and add density. Current design and construction practice for high-rise multi-unit residential buildings present a number of constraints with regard to achieving high levels of energy performance. These practice issues typically include (a) the desire to maximize glass to enhance marketability, daylight, and views; (b) the desire to provide access to the outdoors via extended balconies; (c) the need for Code-mandated non-combustibility and life safety requirements; (d) a preference for building systems that minimize exterior construction access and streamlines construction sequencing; (e) the adoption of increased structural load requirements; and/or (f) the drive to minimize initial capital costs. The outcome of these combined constraints is often poor energy efficiency, with the burden of higher operating costs deferred to future owners. There has been significant industry discussion on the poor energy performance of this class of building, but there is very little guidance or long-term factual strategic information beyond broad principles of minimizing glazing areas, maximizing glazing performance, increasing airtightness, and adding more insulation to opaque areas. This article explores the prospect of energy use becoming a primary consideration in high-rise residential buildings and what that will likely mean for the typical competing constraints mentioned earlier. This article utilizes the current common construction practices for concrete-framed, high-rise residential buildings in heating dominated climates (ASHRAE Zones 4 to 7) as a baseline to evaluate the impact of the interconnected variables related to reducing overall heating energy use. The objective is to weigh the impact of individual improvements against integrated bundles of measures to develop a roadmap and a better understanding of a practical path toward low-energy, high-rise residential buildings. The article focuses on solutions related to building envelope performance but from a holistic perspective that recognizes the interaction and contribution of mechanical systems typical of this construction type. The building envelope parameters covered includes glazing performance (for both conventional and innovative technologies) and opaque wall performance (with a focus on specific details to reduce thermal bridging rather than increasing insulation levels). The analysis presented draws upon three-dimensional thermal modeling, whole building energy analysis, field testing and monitoring, and typical construction costs. The goal is to develop realistic targets for high-rise buildings and identify improvements that can be arrived at by market forces rather than those that can only be realized through more stringent and enforceable codes and standards.
Effects of built-in balcony on thermal performance in residential buildings: A case study
Authors: Namli Lutfu
Published: January 2016

In this study, effects of built-in balcony on thermal performance in residential buildings were investigated numerically by means of open-ended structure approach. For this purpose, the parametric study has been carried out for various ratios of balcony depth/balcony height ( L/ H), closed barrier height/balcony height ( h/ H) and Rayleigh numbers ( Ra) using a computer program in case of no wind for laminar flow. Analyses were conducted for Rayleigh numbers ranging from 103 to 106. The calculations were carried out for the ratios of L/ H, namely, 0.0, 0.24 and 0.6, and the ratios of h/ H, namely, 0.0, 0.18 and 0.35. The working fluid was assumed to be air ( Pr = 0.71). According to the findings, for Ra ⩽ 104, Nusselt number ( Nu) decreases with the increasing ratio of L/ H for the constant h/ H = 0.35. However, for Ra ≥ 105, Nu sharply decreases with the increasing ratio of L/ H, while Nu again sharply increases after L/ H ≅ 0.25 and almost remains constant after L/ H ≅ 0.5. For the constant L/ H = 0.54, Nu decreases with the increasing ratio of h/ H for the whole Ra. It is suggested that the ratio of L/ H should not be over 0.35 and the ratio of h/ H should be at least 0.35.
Culturally contested corporeality: Regulation of the body in New Zealand and Japanese early childhood education
Authors: Burke Rachael S , Duncan Judith
Published: January 2016

Children’s bodies occupy a culturally contested space in the early childhood arena. In New Zealand, children’s bodies have increasingly become the focus of regulation. The early childhood centre has become a site of constant surveillance, turning teachers into ‘disciplinary individuals’ who are internally controlled by their own behaviour. This increased regulation mirrors that of other Western contexts. In contrast, Japanese early childhood education still places children’s bodies at the centre of preschool life. Shared embodied experiences serve to consolidate certain traits and qualities identified as Japanese and intimate physical contact is valued. This article is based on ethnographic research conducted at an early childhood centre in New Zealand and a kindergarten in Japan. We argue that in New Zealand early childhood circles, the child’s body has become the focus of civilising routines which limit physical touch between adults and children, and minimise attention to the body. Asian early childhood education contexts are often depicted as overly controlling. However, we suggest that while Japanese children’s bodies may be subject to routine and management, they are viewed through a lens of nostalgia and innocence which allows for greater freedom of the corporeal.
Implementation of a visceral surgery clinical pathway: Evaluating patient satisfaction with information, safety and involvement in care
Authors: Cudré Léon , Mabire Cédric , Pellet Joanie , Demartines Nicolas
Published: January 2016

Background

Care pathways are essential to ensure continuity, quality, efficient use of resources and positive patient outcomes. Although patient satisfaction is widely considered a major indicator of care quality, it remains largely unexamined in the context of care pathway implementation. The aim of this study was to assess patient satisfaction during implementation of a care pathway for recurrent surgeries.

Method

A newly designed questionnaire was utilized to examine patient satisfaction among adult patients hospitalized for visceral surgery at the University Hospital of Lausanne (CHUV). Analysis was conducted through nine care pathways frequently performed in visceral surgeries.

Results

Of the 280 patients surveyed, 258/280 (92%) of patients were satisfied with information received, 255/280 (91%) with the safety and 210/280 (75%) with their involvement in decision-making and care.

Conclusion

Patient satisfaction ratings of the care received during the care pathway were high. Complete and personalized information seems to be the key element for patients’ sense of safety and involvement in decision making and care.
Endobronchial ultrasound: morphological predictors of benign disease
Authors: Gogia Pratibha , Insaf Tabassum Z. , McNulty William , Boutou Afroditi , Nicholson Andrew G. , Zoumot Zaid , Shah Pallav L.
Published: January 2016

The objective of this study was to assess the utility of endobronchial ultrasound (EBUS) morphology of lymph nodes in predicting benign cytology of transbronchial needle aspirates in a prospective observational study.

Five ultrasonic morphological characteristics of mediastinal and hilar lymph nodes were recorded: size, shape, margins, echogenic appearance and the presence of a central blood vessel. These characteristics were correlated with the final diagnosis. A total of 402 consecutive patients (237 males and 165 females) undergoing EBUS were studied.

The final diagnosis was malignant disease in 244 (60.6%) and benign disease in 153 (38.05%) subjects. Out of 740 sampled nodes, in 463 (62.6%) malignant cells were identified, whereas in 270 (36.5%) nodes, no malignant cells were identified. On univariate analysis small size, triangular shape and the presence of a central vessel were predictive of a benign aetiology. In the final multivariate model, a predictive probability of 0.811 (95% CI 0.72–0.91) for benign disease was found if lymph node size was <10 mm and a central vessel was present.

Sonographic appearances of lymph nodes improve the predictive probability of EBUS for benign aetiologies, and may reduce the number of nodes requiring sampling and the need for further invasive investigations.
Electrical impedance tomography (EIT) for quantification of pulmonary edema in acute lung injury
Authors: Trepte Constantin J. C. , Phillips Charles R. , Solà Josep , Adler Andy , Haas Sebastian A. , Rapin Michael , Böhm Stephan H. , Reuter Daniel A.
Published: January 2016

Background

Assessment of pulmonary edema is a key factor in monitoring and guidance of therapy in critically ill patients. To date, methods available at the bedside for estimating the physiologic correlate of pulmonary edema, extravascular lung water, often are unreliable or require invasive measurements. The aim of the present study was to develop a novel approach to reliably assess extravascular lung water by making use of the functional imaging capabilities of electrical impedance tomography.

Methods

Thirty domestic pigs were anesthetized and randomized to three different groups. Group 1 was a sham group with no lung injury. Group 2 had acute lung injury induced by saline lavage. Group 3 had vascular lung injury induced by intravenous injection of oleic acid. A novel, noninvasive technique using changes in thoracic electrical impedance with lateral body rotation was used to measure a new metric, the lung water ratioEIT, which reflects total extravascular lung water. The lung water ratioEIT was compared with postmortem gravimetric lung water analysis and transcardiopulmonary thermodilution measurements.

Results

A significant correlation was found between extravascular lung water as measured by postmortem gravimetric analysis and electrical impedance tomography (r = 0.80; p < 0.05). Significant changes after lung injury were found in groups 2 and 3 in extravascular lung water derived from transcardiopulmonary thermodilution as well as in measurements derived by lung water ratioEIT.

Conclusions

Extravascular lung water could be determined noninvasively by assessing characteristic changes observed on electrical impedance tomograms during lateral body rotation. The novel lung water ratioEIT holds promise to become a noninvasive bedside measure of pulmonary edema.
Patient-centred innovation to ensure access to diabetes care in Cambodia: the case of MoPoTsyo
Authors: van Olmen Josefien , Eggermont Natalie , van Pelt Maurits , Hen Heang , de Man Jeroen , Schellevis François , Peters David H. , Bigdeli Maryam
Published: January 2016

Background

The increasing prevalence of chronic diseases puts a high burden on the health care systems of Low and Middle Income Countries which are often not adapted to provide the care needed. Peer support programmes are promoted to address health system constraints. This case study analyses a peer educator diabetes programme in Cambodia, MoPoTsyo, from a health system’s perspective. Which strategies were used and how did these strategies change? How is the programme perceived?

Methods

Data were collected through semi-structured interviews with patients, MoPoTsyo staff and peer educators, contracted pharmacy staff and health workers, health care workers and non-contracted pharmacists and managers and policy makers at district, provincial and national level. Four areas were purposively selected to do the interviews. An inductive content analysis was done independently by two researchers.

Results

MoPoTsyo developed into three stages: a focus on diabetes self-management; a widening scope to ensure affordable medicines and access to other health care services; and aiming for sustainability through more integration with the Cambodian public system and further upscaling. All respondents acknowledged the peer educators’ role and competence in patient education, but their ideas about additional tasks and their place in the system differed. Indirectly involved stakeholders and district managers emphasized the particular roles and responsibilities of all actors in the system and the particular role of the peer educator in the community. MoPoTsyo’s diagnostics and laboratory services were perceived as useful, especially by patients and project staff. Respondents were positive about the revolving drug fund, but expressed concerns about its integration into the government system. The degree of collaboration between health care staff and peer educators varied.

Conclusion

MoPoTsyo responds to the needs of people with diabetes in Cambodia. Key success factors were: consistent focus on and involvement of the target group, backed up by a strong organisation; simultaneous reduction of other barriers to care; and the ongoing maintenance of relations at all levels within the health system. Despite resistance, MoPoTsyo has established a more balanced relationship between patients and health service providers, empowering patients to self-manage and access services that meet their needs.
Myosin-IIA regulates leukemia engraftment and brain infiltration in a mouse model of acute lymphoblastic leukemia
Authors: Wigton Eric J , Thompson Scott B , Long Robert A , Jacobelli Jordan
Published: January 2016

Leukemia dissemination (the spread of leukemia cells from the bone marrow) and relapse are associated with poor prognosis. Often, relapse occurs in peripheral organs, such as the CNS, which acts as a sanctuary site for leukemia cells to escape anti-cancer treatments. Similar to normal leukocyte migration, leukemia dissemination entails migration of cells from the blood circulation into tissues by extravasation. To extravasate, leukemia cells cross through vascular endothelial walls via a process called transendothelial migration, which requires cytoskeletal remodeling. However, the specific molecular players in leukemia extravasation are not fully known. We examined the role of myosin-IIA a cytoskeletal class II myosin motor protein, in leukemia progression and dissemination into the CNS by use of a mouse model of Bcr-Abl-driven B cell acute lymphoblastic leukemia. Small hairpin RNA-mediated depletion of myosin-IIA did not affect apoptosis or the growth rate of B cell acute lymphoblastic leukemia cells. However, in an in vivo leukemia transfer model, myosin-IIA depletion slowed leukemia progression and prolonged survival, in part, by reducing the ability of B cell acute lymphoblastic leukemia cells to engraft efficiently. Finally, myosin-IIA inhibition, either by small hairpin RNA depletion or chemical inhibition by blebbistatin, drastically reduced CNS infiltration of leukemia cells. The effects on leukemia cell entry into tissues were mostly a result of the requirement for myosin-IIA to enable leukemia cells to complete the transendothelial migration process during extravasation. Overall, our data implicate myosin-IIA as a key mediator of leukemia cell migration, making it a promising target to inhibit leukemia dissemination in vivo and potentially reduce leukemia relapses.
Cigarette smoke inhibits efferocytosis via deregulation of sphingosine kinase signaling: reversal with exogenous S1P and the S1P analogue FTY720
Authors: Tran Hai B , Barnawi Jameel , Ween Miranda , Hamon Rhys , Roscioli Eugene , Hodge Greg , Reynolds Paul N , Pitson Stuart M , Davies Lorena T , Haberberger Rainer , Hodge Sandra
Published: January 2016

Alveolar macrophages from chronic obstructive pulmonary disease patients and cigarette smokers are deficient in their ability to phagocytose apoptotic bronchial epithelial cells (efferocytosis). We hypothesized that the defect is mediated via inhibition of sphingosine kinases and/or their subcellular mislocalization in response to cigarette smoke and can be normalized with exogenous sphingosine-1-phosphate or FTY720 (fingolimod), a modulator of sphingosine-1-phosphate signaling, which has been shown to be clinically useful in multiple sclerosis. Measurement of sphingosine kinase 1/2 activities by [32P]-labeled sphingosine-1-phosphate revealed a 30% reduction of sphingosine kinase 1 (P < 0.05) and a nonsignificant decrease of sphingosine kinase 2 in THP-1 macrophages after 1 h cigarette smoke extract exposure. By confocal analysis macrophage sphingosine kinase 1 protein was normally localized to the plasma membrane and cytoplasm and sphingosine kinase 2 to the nucleus and cytoplasm but absent at the cell surface. Cigarette smoke extract exposure (24 h) led to a retraction of sphingosine kinase 1 from the plasma membrane and sphingosine kinase 1/2 clumping in the Golgi domain. Selective inhibition of sphingosine kinase 2 with 25 µM ABC294640 led to 36% inhibition of efferocytosis (P < 0.05); 10 µM sphingosine kinase inhibitor/5C (sphingosine kinase 1-selective inhibitor) induced a nonsignificant inhibition of efferocytosis, but its combination with ABC294640 led to 56% inhibition (P < 0.01 vs. control and < 0.05 vs. single inhibitors). Cigarette smoke-inhibited efferocytosis was significantly (P < 0.05) reversed to near-control levels in the presence of 10–100 nM exogenous sphingosine-1-phosphate or FTY720, and FTY720 reduced cigarette smoke-induced clumping of sphingosine kinase 1/2 in the Golgi domain. These data strongly support a role of sphingosine kinase 1/2 in efferocytosis and as novel therapeutic targets in chronic obstructive pulmonary disease.
Implementation and Validation of Telepathology Triage at Cancer Referral Center in Rural Rwanda
Authors: Mpunga Tharcisse , Hedt-Gauthier Bethany L. , Tapela Neo , Nshimiyimana Irenee , Muvugabigwi Gaspard , Pritchett Natalie , Greenberg Lauren , Benewe Origene , Shulman David S. , Pepoon James R. , Shulman Lawrence N. , Milner Danny A.
Published: January 2016

Purpose

Connecting a cancer patient to the appropriate treatment requires the correct diagnosis provided in a timely manner. In resource-limited settings, the anatomic pathology bridge to efficient, accurate, and timely cancer care is often challenging. In this study, we present the first phase of an anatomic telepathology triage system, which was implemented and validated at the Butaro District Hospital in northern rural Rwanda.

Methods

Select cases over a 9-month period in three segments were evaluated by static image telepathology and were independently evaluated by standard glass slide histology. Each case via telepathology was classified as malignant, benign, infectious/inflammatory, or nondiagnostic and was given an exact histologic diagnosis.

Results

For cases triaged as appropriate for telepathology, correlation with classification and exact diagnosis demonstrated greater than 95% agreement over the study. Cases in which there was disagreement were analyzed for cause, and the triage process was adjusted to avoid future problems.

Conclusion

Challenges to obtaining a correct and complete diagnosis with telepathology alone included the need for immunohistochemistry, assessment of the quality of images, and the lack of images representing an entire sample. The next phase of the system will assess the effect of telepathology triage on turnaround time and the value of on-site immunohistochemistry in reducing that metric and the need for evaluation outside of telepathology.
How Do Gymnastics Coaches Provide Movement Feedback in Training?
Authors: Jeraj Damian , Veit Juliane , Heinen Thomas , Raab Markus
Published: January 2016

The augmented feedback athletes receive from their coach is essential to improve performance. The aim of this exploratory study was to identify how coaches consider six feedback factors which might have an influence on the error-correction process. The six feedback factors were developed from a heuristic model of error correction, namely: a) visual perspective, b) visual experience, c) motor experience, d) personal relationship between coach and athlete, e) methodological knowledge, and f) biomechanical knowledge. Seventy-three active gymnastics coaches were asked to rank the importance and frequency of use of these six factors. In addition, we examined, in an exploratory way, if moderators can partly explain the weightings. Results show that the feedback factors can be ranked in importance and frequency of use, with methodological knowledge being the most essential in an error-correction situation. More studies are needed that explore if coaches should guide feedback according to their own motor experience. Gaze training for coaches is needed to improve the feedback and, ultimately, the movements.