bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the effect of a driver’s behaviour on the range of a battery electric vehicle
Authors: Alvarez Roberto , López Alberto , De la Torre Nieves
Published: December 2014

A battery electric vehicle uses the electric energy stored in a battery to supply power to the electric motor. The estimation of an accurate electric range is an important matter because of the consumer’s fear of running out of electricity while driving, often referred to as ‘range anxiety’. This article both analyses and quantifies the influence of driving aggressiveness on the battery life. In order to achieve this, a modification of the New European Driving Cycle is performed, simulating progressively more aggressive behaviours. The calculation of the energy consumption and, accordingly, of the vehicle range is performed through a complete vehicle model implemented in MATLAB/Simulink, where an improvement in the battery model is presented, allowing faster processing. The methodology presented can contribute to more efficient management of the power consumed by the vehicle and a decrease in range anxiety.
Assessment of zigzag theories for free vibration analysis of laminated-composite and sandwich plates
Authors: Sahoo Rosalin , Singh Bhrigu Nath
Published: December 2014

In this work, inverse hyperbolic zigzag theory and inverse trigonometric zigzag theory, recently developed by the authors, are extended for the free vibration analysis of the laminated composite and sandwich plates. The developed plate models satisfy the condition of transverse shear stress continuity at the layer interfaces and the zero traction boundary conditions on the surfaces of the plate obviating the need of shear correction factor. They consider shear strain shape function assuming the nonlinear distribution of transverse shear stresses. The less numbers of independent variables makes the solution computationally effective. An efficient C0 continuous isoparametric serendipity element is employed for the usual discretization of the plate structure. In order to demonstrate the capabilities of the developed models in predicting the structural free vibration response, some representative results are obtained covering different features of laminated composite and sandwich structures such as boundary conditions, aspect ratios and span-to-thickness ratios and the results are compared with those in the literature wherever available. The excellent agreement of the evaluated results with the three-dimensional exact results conclude that the presented models are not only accurate but also efficient.
Effects of tip clearance size on the performance and tip leakage vortex in dual-rows counter-rotating compressor
Authors: Wang Yangang , Chen Weixiong , Wu Canghai , Ren Siyuan
Published: December 2014

Based on the preliminary validation of the numerical results with an experiment, the steady results of different tip clearance size effects on the performance and tip leakage vortex of counter-rotating compressor were discussed. The predicted results showed that the stable margin and isentropic efficiency of the counter-rotating compressor decreased with increasing of the tip clearance size. Furthermore, increasing the tip clearance size had a greater negative effect on the performance of the upstream rotor than the downstream rotor. Detailed flow field analyses further demonstrated that the unstable flow occurred in the two counter-rotating rotors with greater tip clearance size. The rotor downstream was the main unstable factor which caused the counter-rotating compressor to breakdown when a smaller tip clearance size was used.
Corneal topography matching by iterative registration
Authors: Wang Junjie , Elsheikh Ahmed , Davey Pinakin G , Wang Weizhuo , Bao Fangjun , Mottershead John E
Published: December 2014

Videokeratography is used for the measurement of corneal topography in overlapping portions (or maps) which must later be joined together to form the overall topography of the cornea. The separate portions are measured from different viewpoints and therefore must be brought together by registration of measurement points in the regions of overlap. The central map is generally the most accurate, but all maps are measured with uncertainty that increases towards the periphery. It becomes the reference (or static) map, and the peripheral (or dynamic) maps must then be transformed by rotation and translation so that the overlapping portions are matched. The process known as registration, of determining the necessary transformation, is a well-understood procedure in image analysis and has been applied in several areas of science and engineering. In this article, direct search optimisation using the Nelder–Mead algorithm and several variants of the iterative closest/corresponding point routine are explained and applied to simulated and real clinical data. The measurement points on the static and dynamic maps are generally different so that it becomes necessary to interpolate, which is done using a truncated series of Zernike polynomials. The point-to-plane iterative closest/corresponding point variant has the advantage of releasing certain optimisation constraints that lead to persistent registration and alignment errors when other approaches are used. The point-to-plane iterative closest/corresponding point routine is found to be robust to measurement noise, insensitive to starting values of the transformation parameters and produces high-quality results when using real clinical data.
Computational investigation of the time-dependent contact behaviour of the human tibiofemoral joint under body weight
Authors: Meng Qingen , Jin Zhongmin , Wilcox Ruth , Fisher John
Published: December 2014

The knee joint is one of the most common sites for osteoarthritis, the onset and progression of which are believed to relate to the mechanical environment of cartilage. To understand this environment, it is necessary to take into account the complex biphasic contact interactions of the cartilage and menisci. In this study, the time-dependent contact behaviour of an intact and a meniscectomized human tibiofemoral joint was characterized under body weight using a computational model. Good agreement in the contact area and femoral displacement under static loads were found between model predictions of this study and published experimental measurements. The time-dependent results indicated that as loading time progressed, the contact area and femoral vertical displacement of both intact and meniscectomized joints increased. More load was transferred to the cartilage–cartilage interface over time. However, the portions of load borne by the lateral and medial compartments did not greatly vary with time. Additionally, during the whole simulation period, the maximum compressive stress in the meniscectomized joint was higher than that in the intact joint. The fluid pressure in the intact and meniscectomized joints remained remarkably high at the condyle centres, but the fluid pressure at the cartilage–meniscus interface decreased faster than that at the condyle centres as loading time progressed. The above findings provide further insights into the mechanical environment of the cartilage and meniscus within the human knee joint.
Vitamin U, a novel free radical scavenger, prevents lens injury in rats administered with valproic acid
Authors: Tunali S , Kahraman S , Yanardag R
Published: December 2014

Valproic acid (2-propyl-pentanoic acid, VPA) is the most widely prescribed antiepileptic drug due to its ability to treat a broad spectrum of seizure types. VPA exhibits various side effects such as organ toxicity, teratogenicity, and visual disturbances. S-Methylmethioninesulfonium is a derivative of the amino acid methionine and it is widely referred to as vitamin U (Vit U). This study was aimed to investigate the effects of Vit U on lens damage parameters of rats exposed to VPA. Female Sprague Dawley rats were divided into four groups. Group I comprised control animals. Group II included control rats supplemented with Vit U (50 mg/kg/day) for 15 days. Group III was given only VPA (500 mg/kg/day) for 15 days. Group IV was given VPA + Vit U (in same dose and time). Vit U was given to rats by gavage and VPA was given intraperitoneally. On the 16th day of experiment, all the animals which were fasted overnight were killed. Lens was taken from animals, homogenized in 0.9% saline to make up to 10% (w/v) homogenate. The homogenates were used for protein, glutathione, lipid peroxidation levels, and antioxidant enzymes activities. Lens lipid peroxidation levels and aldose reductase and sorbitol dehydrogenase activities were increased in VPA group. On the other hand, glutathione levels, superoxide dismutase, glutathione peroxidase, glutathione reductase, glutathione- S-transferase, and paraoxonase activities were decreased in VPA groups. Treatment with Vit U reversed these effects. This study showed that Vit U exerted antioxidant properties and may prevent lens damage caused by VPA.
Caring for tomorrow’s workforce
Authors: Monteverde Settimio
Published: December 2014

Background:

Preparing tomorrow’s healthcare workforce for managing the growing complexity of care places high demands on students, educators, and faculties. In the light of worrying data about study-related stress and burnout, understanding how students manage stressors and develop resilience has been identified as a priority topic of research. In addition to study-related stressors, also moral stressors are known to characterize the students’ first clinical experiences.

Objectives:

However, current debates show that it remains unclear how healthcare ethics education should address them. In order to clarify this issue, this study first develops the notion of moral resilience as a response to moral stressors involving both situations of moral complexity and moral wrongness. Second, it explores the potential of healthcare ethics education in fostering moral resilience. For this purpose, it defines moral resilience operationally as a reduction of moral distress in a given axis of time measured by a validated tool.

Research design, participants, and context:

The educational transferability was assessed within an explorative, quantitative pre–post interventional study with a purposive sample of 166 nursing students. The educational intervention comprised a lecture introducing the typology of moral stressors. Before and after the lecture, students were presented vignettes depicting morally stressful situations.

Ethical considerations:

The competent research ethics committee confirmed that no ethical approval was needed. Informed consent was obtained from participants.

Findings:

Three of four vignettes showed a modest but statistically significant reduction in measured levels of distress after the lecture (p < 0.05, α = 5%).

Discussion:

The study shows the potential of healthcare ethics education in providing students with transformative knowledge that fosters moral resilience.

Conclusion:

In times of global scarcity of educational resources, healthcare ethics education has an important contribution to offer in the promotion of students’ mental and physical health by strengthening the knowledge base of moral resilience. This legitimates its costs for societies, faculties, and professional bodies.
Whose success? The state–foreign capital nexus and the development of the automotive industry in Slovakia
Authors: Pavlínek Petr
Published: December 2014

Using the case study of Slovakia, this article considers the role of the state in the rapid growth of the automotive industry in integrated peripheral markets of the global automotive industry. Although this growth has been mainly driven by the investment strategies of automotive lead firms, the state has played an important role by accommodating the strategic needs of foreign capital through neoliberal economic policies. In addition to secondary sources, the empirical research is based on a 2010 survey of 299 Slovak-based automotive firms with a response rate of 44% and on 38 on-site firm-level interviews conducted between 2011 and 2013 and one in 2005. The analysis draws upon approaches in economic geography, international political economy and upon global value chains and global production networks perspectives to argue that the successful development of the automotive industry in Slovakia has been achieved at the expense of its overwhelming dependence on foreign capital and corporate capture. The article considers the potential consequences of dependent industrial development for the domestic automotive industry and its position in the international division of labor.
Factors Influencing Patients’ Contract Choice With General Practitioners in Shanghai
Authors: Jing Limei , Shu Zhiqun , Sun Xiaoming , Chiu John F. , Lou Jiquan , Xie Chunyan
Published: December 2014

The general practitioner (GP) system has been widely applied around the world and experimented with in Shanghai, China. To analyze some of the influencing factors on patient-GP contracts, we developed a questionnaire and conducted site investigations in 2011 and 2012 to 1200 patients by random sampling from 6 pilot community health service (CHS) centers in Pudong, Shanghai. The t test, χ2 test, factor analysis, and logistic regression analysis were used to analyze the data. The factors influencing patients’ contract behavior were age (OR = 1.03; 95%CI = 1.02-1.04), education level (OR = 0.83; 95% CI = 0.75-0.93), social interaction of social capital (OR = 1.34; 95% CI = 1.15-1.56), acceptance of first contact in community (OR = 3.25; 95% CI = 2.07-5.12), the year of investigation (OR = 2.58; 95% CI = 1.92-3.47), and the exposure to publicity (OR = 1.60; 95% CI = 1.39-1.85). Elderly patients formed a focus group to sign contracts with GPs. To increase trust in GPs by patients, it is recommended to improve the level of CHSs, strengthen publicity, and cultivate social capital among patients.
Interposition Bone Block Arthrodesis for Revision Hallux Metatarsophalangeal Joint Surgery
Authors: Malhotra Karan , Nunn Tim , Qamar Faisal , Rao Vadlamani , Shanker Jai
Published: December 2014

Background:

The operative management of failed hallux metatarsophalangeal joint surgery can be difficult. There is often substantial shortening of the first ray. Arthrodesis of the first metatarsophalangeal joint is one treatment option, but results in further shortening of the first ray.

Methods:

We present a large retrospective series of patients who had an interposition bone block arthrodesis procedure performed using a nonvascularized tricortical autologous iliac crest bone graft in an attempt to maintain first ray length. Twenty-four patients (25 feet) underwent this salvage procedure over a 10-year period. The mean follow-up period was 62 (range, 11-117) months.

Results:

Indications included failed hallux valgus surgery, Keller’s procedures, various other first metatarsal osteotomies, and failed arthrodesis procedures with shortening of the first ray. All patients had tricortical iliac crest grafts inserted into bony defects of mean length 10.7 (range, 8-15) mm. Fixation was achieved using either multiple wires or a low-profile plate. Mean lengthening was 4.4 (range, 0-8) mm. Three feet went on to nonunion requiring further revision surgery and at latest follow-up 2 had united. All patients underwent removal of a stabilizing Kirschner wire. Median patient-reported outcome score using the Foot and Ankle Disability Index was 84.6 (range, 37.5-97.1).

Conclusion:

These results suggest this procedure was successful in salvaging failed first ray surgery and prevented further shortening. We believe good results can be achieved, but care must be taken to ensure wound closure without excessive tension to permit wound healing.

Level of Evidence:

Level IV, retrospective case series.
A Socioenvironmental Shale Gas Controversy
Authors: Molinatti Gregoire , Simonneau Lionel
Published: December 2014

In this case study, we analyze the discourse, practices and representations of a group of scientists who issued public statements about the French shale gas controversy. The reasons they gave for engaging in this process of communication focused on their social responsibility, their collective ad hoc expertise and the neutrality of their position. We also investigated how these scientists actually produced their communications, despite the tensions between individual and collective positions. We discuss how this experience led them to reflect both individually and collectively on their representations of science in society.
Rivaroxaban in the Treatment of Venous Thromboembolism and the Prevention of Recurrences
Authors: Arcelus Juan I. , Domènech Pere , Fernández-Capitan Ma del Carmen , Guijarro Ricardo , Jiménez David , Jiménez Sonia , Lozano Francisco S. , Monreal Manel , Nieto José A. , Páramo José A.
Published: December 2014

Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism. Until recently, treatment of VTE was based on parenteral or low-molecular-weight heparin for initial therapy (5-10 days) and oral vitamin K antagonists for long-term therapy. Those treatments have some limitations, including parenteral administration (heparins), the need for frequent monitoring and dose adjustments, interactions with several medications, and dietary restrictions (vitamin K antagonists). Rivaroxaban is a new oral direct factor Xa inhibitor with a wide therapeutic window, predictable anticoagulant effect, no food interactions, and few drug interactions. Consequently, no periodic monitoring of anticoagulation is needed, and fixed doses can be prescribed. EINSTEIN program demonstrated that rivaroxaban was as effective as and significantly safer than standard therapy for treatment of VTE. Rivaroxaban was recently authorized so doubts exist about how to use it in daily clinical practice. This document aims to clarify common questions formulated by clinicians regarding the use of this new drug.
‘Like a soccer camp for boys’
Authors: Pawlowski Charlotte Skau , Ergler Christina , Tjørnhøj-Thomsen Tine , Schipperijn Jasper , Troelsen Jens
Published: December 2014

Boys are more physically active than girls and the greatest gender difference in children’s physical activity is found in institutional settings such as school recess. However, research on gender relations, performances and practices that maintain gendered differences in physical activity during recess is still limited. Drawing on a qualitative dataset and a social constructivist gender view, the aim of this study was to investigate how construction of gendered activity patterns and social positions in the schoolyard lead to gendered practices in self-organized play during recess. At 17 Danish schools a total of 460 minutes of recess were observed and 17 go-along group interviews (one at each school), including in total 111 fourth graders (58 girls), were conducted. We found six gender typologies with varying behaviours, needs and power relations. The majority of children were prejudiced in their play, reinforcing gender binarism with boys being more physically active than girls. However, we also found groups such as soccer-playing girls and sedentary computer gaming boys who defied the gender stereotypes. These groups felt limited in their activities because of a hierarchy where not being skilled and sporty implied a lesser status in the hegemonic masculinity and even exclusion from play. More detailed research into what is required for particularly the least active groups is needed to successfully increase both the girls’ and overall physical activity levels.
May–Thurner syndrome and other obstructive iliac vein lesions: Meaning, myth, and mystery
Authors: Birn Jeffrey , Vedantham Suresh
Published: December 2014

Acute and chronic venous disorders of the lower extremities affect millions of people and cause substantial disability. Long ago, surgeons and pathologists identified the presence of ‘spur-like’ abnormalities of the left common iliac vein; these abnormalities were hypothesized to result from compression and/or irritation from the adjacent crossing right common iliac artery. In the 1990s, physicians, starting to perform catheter-directed thrombolysis to treat extensive deep vein thrombosis (DVT), observed that about 50% of patients had an iliac vein stenosis. Vascular physicians have become aware of the occasional patient with otherwise-unexplained extremity swelling and/or pain but without a DVT history who is subsequently found to have an iliac vein abnormality. These ‘lesions’ have been hypothesized to elevate ambulatory venous pressures and thereby produce lower-extremity symptoms, increase the risk of initial and recurrent DVT episodes, and increase the risk of treatment failure with medical and endovascular therapies for thrombotic and non-thrombotic venous conditions. As a result, many practitioners now actively seek iliac venous obstructive ‘lesions’ when evaluating patients with known or suspected venous disease. However, for many patients, it continues to be unclear what degree of obstruction to venous blood flow is being caused by such lesions, how clinically significant they are, how much emphasis should be placed on identifying them, and when they should be treated. This article seeks to improve the knowledge base of vascular practitioners who make clinical decisions about the diagnosis and treatment of obstructive iliac vein lesions.
The PHaVE List: A pedagogical list of phrasal verbs and their most frequent meaning senses
Authors: Garnier Mélodie , Schmitt Norbert
Published: December 2014

As researchers and practitioners are becoming more aware of the importance of multi-word items in English, there is little doubt that phrasal verbs deserve teaching attention in the classroom. However, there are thousands of phrasal verbs in English, and so the question for practitioners is which phrasal verbs to focus attention upon. Phrasal verb dictionaries typically try to be comprehensive, and this results in a very large number of phrasal verbs being listed, which does not help practitioners in selecting the most important ones to teach or test. There are phrasal verb lists available (Gardner and Davies, 2007; Liu, 2011), but these have a serious pedagogical shortcoming in that they do not account for polysemy. Research indicates that phrasal verbs are highly polysemous, having on average 5.6 meaning senses, although many of these are infrequent and peripheral. Thus practitioners also need guidance about which meaning senses are the most useful to address in instruction or tests. In response to this need, the PHrasal VErb Pedagogical List (PHaVE List) was developed. It lists the 150 most frequent phrasal verbs, and provides information on their key meaning senses, which cover 75%+ of the occurrences in the Corpus of Contemporary American English. The PHaVE List gives the percentage of occurrence for each of these key meaning senses, along with definitions and example sentences written to be accessible for second language learners, in the style of the General Service List (West, 1953). A users’ manual is also provided, indicating how to use the list appropriately.
Socioeconomic inequalities in cause-specific mortality after disability retirement due to different diseases
Authors: Polvinen A. , Laaksonen M. , Gould R. , Lahelma E. , Leinonen T. , Martikainen P.
Published: December 2014

Aims: Socioeconomic inequalities in both disability retirement and mortality are large. The aim of this study was to examine socioeconomic differences in cause-specific mortality after disability retirement due to different diseases. Methods: We used administrative register data from various sources linked together by Statistics Finland and included an 11% sample of the Finnish population between the years 1987 and 2007. The data also include an 80% oversample of the deceased during the follow-up. The study included men and women aged 30-64 years at baseline and those who turned 30 during the follow-up. We used Cox regression analysis to examine socioeconomic differences in mortality after disability retirement. Results: Socioeconomic differences in mortality after disability retirement were smaller than in the population in general. However, manual workers had a higher risk of mortality than upper non-manual employees after disability retirement due to mental disorders and cardiovascular diseases, and among men also diseases of the nervous system. After all-cause disability retirement, manual workers ran a higher risk of cardiovascular and alcohol-related death. However, among men who retired due to mental disorders or cardiovascular diseases, differences in social class were found for all causes of death examined. For women, an opposite socioeconomic gradient in mortality after disability retirement from neoplasms was found. Conclusions: The disability retirement process leads to smaller socioeconomic differences in mortality compared with those generally found in the population. This suggests that the disability retirement system is likely to accurately identify chronic health problems with regard to socioeconomic status.
Single-anastomosis gastric bypass: Better, faster, and safer?
Authors: Victorzon M.
Published: December 2014

Background and Aims:

Metabolic surgery is evolving and safer, but more effective alternatives are constantly sought for. The single-anastomosis gastric bypass was first described in 2001, and although controversial, this operation is gaining fast in popularity worldwide. This review is aiming at a critical evaluation of the procedure in the light of the literature.

Methods:

The abstracts of 73 articles were reviewed, and after removal of case studies, duplicates, and irrelevant articles, 10 articles remained for closer review.

Results:

Several thousand of this operation have been performed for more than 15 years. It is claimed to be an easier, safer, faster, and more effective metabolic operation compared to the standard Roux-en-Y gastric bypass. The proponents of this operation also claim that this operation is easier to revise and reverse, leaving more options compared to the situation after standard bypass in case of failure. However, there is much controversy surrounding this method, mainly concerning the possible harmful and in the long-term even carcinogenic effects of biliopancreaticoduodenal reflux in the gastric pouch.

Conclusion:

The single-anastomosis gastric bypass may be an attractive alternative metabolic operation. However, further studies with robust, long-term follow-up are needed.
A frequency-based substructuring approach to efficiently model position-dependent dynamics in machine tools
Authors: Law Mohit , Ihlenfeldt Steffen
Published: December 2014

Structural deformations of machine tool components that translate and/or rotate relative to each other to realize tool motion results in tool point dynamics varying along the tool path. These changing dynamics interact with the cutting process and the control loop of the drives to limit machine performance, making it necessary to virtually characterize these interactions such as to guide design decisions. To facilitate rapid evaluation of these varying dynamics, this paper describes a generalized frequency-based substructuring approach that combines the position-invariant component level receptances at the contacting interfaces between substructures to obtain the position-dependent tool point response. Receptances at the contacting interfaces are approximated by projecting them to a point to facilitate a multiple point receptance coupling formulation. Complete machine behavior is represented by just a few sets of receptances, making the model computationally more efficient than full-order finite element models and other dynamic substructuring methods. Position-dependent dynamic behavior for a representative three axis milling machine is simulated and numerically verified. Rapid investigations of the varying dynamics assist in virtually characterizing machine performance before eventual prototyping.
Dynamic analysis of a slider-crank mechanism with two types of non-ideal revolute joints
Authors: Xu Li Xin , He XiaoPing , Han Lin , Yang Yu Hu
Published: December 2014

Rolling element bearings and journal bearings are typical components comprising a revolute joint in a mechanical system. In the traditional dynamic analysis of multi-body systems, these two types of bearings are generally treated as ideal revolute joints and are modelled by kinematic constraints. The non-linearity of such bearings including internal radial clearance, local contact deformation, friction, lubrication and other phenomena associated with real joints are routinely ignored. In this work, an approach to the dynamic modelling of a multi-body system with these two types of non-ideal revolute joints is outlined. These non-ideal joints were modelled by their force interaction. In rolling element bearings, the frictionless multi-point contacts and bearing kinematics are considered. In the case of a journal bearing, the normal contact force and tangential dry friction force are considered. A planar slider-crank mechanism with multiple non-ideal revolute joints including a rolling ball bearing and two journal bearings is presented as a numerical example to demonstrate application of this approach. The variations of slider kinetic characteristics and the bearing reaction force are used to expound the dynamic characteristics of the mechanism when multiple non-ideal revolute joints are considered.
Moneyball Revisited
Authors: Weimar Daniel , Wicker Pamela
Published: December 2014

In Moneyball, the assumption was made that the baseball labor market undervalues specific player skills. This study investigates whether this is also the case for player effort in professional soccer which had no significant effect on players’ market values in previous research. Specifically, it examines the effect of effort on team performance in soccer using team-game day data from three seasons ( N = 1,514) of the German Bundesliga. Two effort measures are applied: (1) total distance run and (2) number of intensive runs (>20 km/hr) per player and per match. The results of probit models show that both effort measures have a significant positive effect on whether the observed team won the observed match in separate estimations. In the full model, only the effect of running distance remains positive, while intensive runs become negative. Given the insignificant effect of effort on players’ market values in previous research, we suggest that there may be a Moneyball phenomenon in soccer in the sense that the soccer labor market undervalues running distance. The findings imply that decision makers in professional soccer should consult player statistics to a greater extent.
How Do You Think I Feel?
Authors: Reale Michelle
Published: December 2014

These poems are a representation of refugees’ experience of arrival to an emergency refugee camp in southeastern Sicily, right after the tragic shipwreck of refugees at Lampedusa, in which more than 360 Eritreans lost their lives. These poems give witness to the harsh reality of death, dislocation, confusion, and grief of the men, women, and children who flee their homeland(s) and attempt to find life in a country that is largely hostile to them.
Personalized Integrative Oncology: Targeted Approaches for Optimal Outcomes
Authors: Lee Richard T , Yang Peiying , Greenlee Heather , Bauer-Wu Susan , Balneaves Lynda G. , Zick Suzanna
Published: December 2014

The 11th International Conference of the Society for Integrative Oncology (SIO) brought together more than 300 clinicians, researchers, patients, and advocates to hear and interact with world-leading experts about the latest research in the areas of nutrition, exercise, acupuncture, health services research, meditation, and other integrative disciplines. The conference theme, “Personalized Integrative Oncology: Targeted Approaches for Optimal Outcomes,” highlighted innovations in personalized medicine and ways this growing field will advance the evolution of individualized integrative cancer care to the next level. This year’s conference also featured a clinical track focusing on clinical information for the practicing health care professional. The conference’s rigorous schedule included 3 keynotes, 4 plenary sessions, 2 interdisciplinary tumor boards, 5 workshops, 45 concurrent oral sessions, and 106 posters. In addition to the conference theme, keynote and plenary sessions presented topics on stress and cancer, the importance of sleep for cancer patients, epigenetic mechanisms of lifestyle and natural products, recently published Journal of the National Cancer Institute monograph on integrative oncology, SIO’s clinical practice guidelines for breast cancer survivors, and a joint session of the American Academy of Hospice and Palliative Medicine and SIO about supportive care and symptom management. This highly successful conference helped further the mission of the SIO to advance evidence-based, comprehensive, integrative health care to improve the lives of people affected by cancer.
Awareness of Federal Regulatory Mechanisms Relevant to Community-Engaged Research
Authors: Fullerton Stephanie M. , Anderson Emily E. , Cowan Ketch , Malen Rachel C. , Brugge Doug
Published: December 2014

Few studies or investigators involved in community-engaged research or community-based participatory research have examined awareness and adoption of federal regulatory mechanisms. We conducted a survey of investigators affiliated with the 10 National Institutes of Health (NIH) Centers for Population Health and Health Disparities. A questionnaire designed to capture experience with the conduct and oversight of community-engaged research, and awareness of pertinent regulatory mechanisms, including Federalwide Assurances (FWAs), Individual Investigator Agreements (IIAs), and Institutional Review Board Authorization Agreements (IAAs), was completed by 101 respondents (68% response rate). Although most were aware of FWAs, only a minority of those surveyed reported knowledge of IAAs and IIAs and even fewer had used them in their research with community partners. Implications for future training and oversight are discussed.
Diabetic ketoacidosis due to fulminant type 1 diabetes: A rare subtype of type 1 diabetes leading to unusual sequelae
Authors: Lane Andrew S , Champion Bernard , Orde Sam , Dravec Danijela
Published: December 2014

Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D), which without treatment leads to death. Fulminant type 1 diabetes (FT1D) is a subtype characterised by a markedly rapid and almost complete destruction of pancreatic β-cells, with acute onset leading to severe metabolic derangement and commonly ICU admission. We present a case of an 18-year-old male presenting with FT1D with two rare complications of pneumomediastinum and stress-induced cardiomyopathy (SIC) with significant myocardial necrosis. We also discuss the aetiology of the pneumomediastinum; the latest thoughts on SIC: moving beyond the simple description of ‘Takotsubo cardiomyopathy’; the role of troponins in critical illness; and genetic predisposition for DKA due to FT1D.
Employment, social dependency and return to work after intensive care
Authors: Quasim Tara , Brown Judith , Kinsella John
Published: December 2014

Quality of life is an important measure of outcome in intensive care survivors. As return to employment is a key determinant of quality of life, we performed a prospective observational, cohort study of 75 intensive care unit patients who survived to hospital discharge. Approximately 2 years after intensive care unit discharge, 64% (18/28) of those employed before intensive care unit had returned to work. Of the rest, 10 were not working, two were unemployed, one was temporarily sick and seven were permanently sick. When health utility scores were assessed in the various employment categories, quality of life was particularly poor in the unemployed and permanently sick with median (interquartile range) scores of 0.082(−0.045−0.665) and 0.053(−0.160−0.769) respectively. Of the retired population, 95% returned to their own home with 50% requiring a family member to act as their carer. This study has demonstrated that patients who returned to work after a critical illness had a better quality of life at follow up, compared to the unemployed and permanently sick. In addition, there may be a burden on family members who act as carers for their relatives on discharge from hospital after a critical illness. Further work is required in this important area.
A report of a regional service for post-prostatectomy urinary incontinence: a model for best practice?
Authors: Almallah Y. Zaki , Grimsley Samuel J.S.
Published: December 2014

Introduction:

Post-prostatectomy incontinence (PPI) is a potentially highly significant complication of a common urological procedure. Pathophysiology may be multifactorial but most commonly involves urinary sphincter weakness. The gold standard treatment for severe incontinence is artificial urinary sphincter but multiple alternatives exist. The growing incidence of PPI has led to the development of a specialized regional service dedicated to management

Patients and methods:

In 2004 a regional referral protocol for PPI was established with a dedicated clinic at a single centre for assessment and management including videourodynamics, pelvic floor rehabilitation, biofeedback and a consultant with a specialist interest in PPI surgery. Data regarding all in-house and tertiary referrals to this clinic between 2004 and 2011 were analysed with patients categorized by symptom severity.

Results:

A total of 267 patients were referred to the post-prostatectomy service (mean age 66.6, range 49–83 years) with numbers increasing year on year. Two-thirds of these were tertiary referrals: 27.7% of referrals were for mild symptoms, 35.2% moderate and 33.3% severe. One-third of referrals were made within 2 years of the primary procedure. Just over half of referred patients underwent invasive treatment including 24.3 artificial sphincter (24.3%) and male slings (22.8%). 7.5% patients were managed with medication, 14.6% were managed conservatively with containment therapy only. One-fifth remain under assessment or have deferred treatment.

Conclusion:

PPI is of increasing personal and societal impact which should be identified early and supported. Investigation and management can be standardized and intervention at a high volume centre achieved by early specialist referral.
Epidemiology and outcomes of Stenotrophomonas maltophilia and Burkholderia cepacia infections among trauma patients of India: a five year experience
Authors: Rajkumari Nonika , Mathur Purva , Gupta Amit K , Sharma Kumkum , Misra Mahesh C
Published: December 2014

Background:

Infections by uncommon non-fermenting Gram negative bacteria are on the rise, but little is known about the risk factors and drug resistance in trauma patients in India. This study explored the infections caused by Stenotrophomonas maltophilia and/or Burkholderia cepacia in trauma patients over a period of 5 years.

Material and methods:

Patients admitted for trauma care with S. maltophilia and/or B. cepacia isolated from clinical specimens were enrolled. Characteristics regarding the strain isolation, drug sensitivity pattern, multidrug resistance (MDR), patient, outcomes, and differentiation of true infection from colonisation were observed.

Results:

Of the total 233 isolates, 102 were S. maltophilia and 131 were B. cepacia; 4.3% were responsible for polymicrobial infections with other bacteria. There were more B. cepacia MDR isolates than S. maltophilia. Maximum resistance was found to tetracycline (86.7%) and tobramycin (86.7%) in B. cepacia and to co-trimoxazole (68.7%) in S. maltophilia. Of these, 21 (16.03%) had a fatal outcome and the remaining 111 (84.7%) were discharged healthy. The in-hospital mortality rate associated with B. cepacia was much (16%) higher than S. maltophilia (13%) at this centre.

Conclusion:

The analysis of epidemiology and outcome of these infections will help to inform their management and treatment.
Examining the policies and guidelines around the use of masks and respirators by healthcare workers in China, Pakistan and Vietnam
Authors: Chughtai Abrar Ahmad , MacIntyre C Raina , Zheng Yang , Wang Quanyi , Toor Zafar Iqbal , Dung Tham Chi , Hien Nguyen Tran , Seale Holly
Published: December 2014

Background:

There is an ongoing debate regarding the type of respiratory protection that should be recommended for use for healthcare workers.

Materials and methods:

A cross-sectional survey was conducted in three countries: China, Pakistan and Vietnam.

Results:

In China and Pakistan, the infection control guidelines were developed to be in line with the recommendations from the World Health Organization (WHO) and the Centers for Disease Control and Prevention, while in the Vietnamese guidelines the recommendations correspond with the WHO suggestions only. The guidelines from all three countries document the need for training and fit testing; however there is no system to monitor the training and fit testing programs. Across the three countries, there was some inconsistency with regard to the types of products (i.e. masks vs. respirators) recommended for influenza, severe acute respiratory syndrome (SARS) and tuberculosis.

Conclusions:

Available evidence should be examined and a comprehensive policy should be developed on the use of masks and respirators. The policy should address critical areas such as regulation, training, fit testing and reuse.
The effect of different oral hygiene treatments on the occurrence of ventilator associated pneumonia (VAP) in ventilated patients
Authors: Lev Amiram , Aied Abu Sebeih , Arshed Shibli
Published: December 2014

Background:

We compared the incidence of ventilator associated pneumonia (VAP) among patients treated with comprehensive oral care to those treated with conventional methods of oral care.

Methods:

We conducted a prospective, controlled study in an intensive care unit of 90 ventilated patients. Patients in the study group received a comprehensive oral hygiene treatment regimen that involved tooth brushing, suctioning, sodium bicarbonate, rinsing with an antiseptic solution containing 1.5% hydrogen peroxide and a mouth moisturiser. Patients in the control group received a more conventional treatment that included cleaning with a sponge and atraumatic clamp, and rinsing with a 0.2% solution of chlorhexidine gluconate.

Results:

Among the 90 patients admitted to the ICU, 8.9% of the study group developed VAP compared with 33.3% of the control group ( p< 0.004). The development of VAP per 1,000 ventilation days was 10.2 in the study group, and 29.5 in the control group ( p< 0.06). The mean number of ventilation days and the mean number of hospitalisation days were also lower in the study group.

Conclusions:

In patients who are ventilated, a comprehensive oral hygiene treatment regimen that includes tooth brushing, suctioning and rinsing with an antiseptic is more effective in preventing VAP than more conventional protocols.
Communication Richness
Authors: Susskind Alex M.
Published: December 2014

Despite everyone’s best efforts, restaurant service falls short at times. In those situations, guests perceive a service failure, and many complain. This study of 513 guests in three U.S. markets examines the guest characteristics that seem to drive the channel used for those complaints. Using a framework of media richness theory, the study found that guests who are more educated, more likely to complain, more frustrated, and in need of greater information about the service failure will typically take their complaint directly to management, either face-to-face or via written communication. On the other hand, those who are less educated or less frustrated will instead complain to line staff or use corporate guest-comment cards. Some of these findings appear not to support media richness theory, as face-to-face complaints are the richest channel (whether to line staff or management). However, it appears that for this sample of restaurant guests, the idea of taking it to the top (both in person or in writing) is important, particularly for frustrated, educated guests.
Environmental Security and Governance at the Water–Energy Nexus: Greenpeace in China and India
Authors: Hauger J. Scott , Daniels Michael , Saalman Lora
Published: December 2014

Non-governmental organizations (NGOs) provide an important resource to good governance involving complex issues of environmental security. We explore that role by looking at recent campaigns concerned with security at the coal–water nexus in India and China, undertaken by regional arms of Greenpeace, an important international NGO. We find that, at the national level, the impact of NGOs on environmental governance depends deeply on an organization’s relation to government. In China, Greenpeace East Asia serves the government’s interest by providing an external source of information on activities and perceptions at the provincial level. An NGO such as Greenpeace East Asia is perceived as valuable and is tolerated as long as it acts in accordance with the unwritten rules of engagement with the government, as practiced by domestic NGOs. Greenpeace India, by comparison, is one among many NGOs, tolerated as a matter of democratic principle, but suspect because of its international connections. Greenpeace India has yet to have a meaningful impact on governance at the coal–water nexus. Greenpeace East Asia, on the other hand, appears to have found a role that can impact environmental governance, but is dependent upon operating within bounds that are set by the Chinese model of government.
‘Revolutionary Taxation’ and the Logistical and Strategic Dilemmas of the Maoist Insurgency in the Philippines
Authors: Quimpo Nathan Gilbert
Published: December 2014

In recent years, Maoist insurgents in the Philippines have intensified their extortion activities through ‘revolutionary taxation’ and through the collection of ‘permit to campaign’/‘permit to win’ (PTC/PTW) fees during elections. This article examines why the Communist Party of the Philippines (CPP), through its guerrilla force, the New People’s Army (NPA), has resorted to, and put greater emphasis on, ‘revolutionary’ extortion. It analyzes whether greed rather than grievance has now become the main driving factor behind the Maoist insurgency, and what the turn to larger scale extortion indicates about the CPP-NPA’s logistical situation and its revolutionary strategy. The author argues that the intensification of revolutionary extortion has been brought about by the decline, uncertainty or political indefensibility of other revenue sources, and by favourable factors such as high levels of electoral violence and the mining boom. Despite the turn to extortion, the CPP-NPA has not degenerated into banditry and it continues to be an ideologically motivated revolutionary force. Rather than demonstrating the renewed strength of the Maoist insurgency, however, the stepped-up extortion activities are showing up the insurgents’ serious logistical problems, and continuing strategic dilemmas.