bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgeon Ability to Appropriately Address the Calcified Cartilage Layer: An In Vitro Study of Arthroscopic and Open Techniques
Authors: Yanke Adam B. , Lee Andrew S. , Karas Vasili , Abrams Geoffrey , Riccio Mark L. , Verma Nikhil N. , Bach Bernard R. , Cole Brian J.
Published: July 2019

Background:

Microfracture is a commonly utilized cartilage restoration technique for articular cartilage defects. While the removal of the calcified cartilage layer (CCL) has been shown to be critical with in vivo models, little is known with regard to surgeon reliability to adequately perform the technique.

Purpose:

To evaluate surgeon reliability in removing the CCL utilizing open and arthroscopic techniques.

Study Design:

Controlled laboratory study.

Methods:

Eleven cadaveric knees were utilized to create four 12-mm diameter defects in the anterior and posterior medial femoral condyles. Eleven fellowship-trained surgeons were asked to perform the following procedures: remove the CCL open, retain the CCL open, remove the CCL arthroscopically, and retain the CCL arthroscopically. Samples underwent histologic staining and analysis with 3-dimensional micro–computed tomography. The latter was used to calculate the percentage of the CCL that was removed or retained across the entire defect.

Results:

When surgeons were asked to retain the CCL arthroscopically, 48% ± 41% (mean ± SD) remained. When surgeons were asked to remove the CCL arthroscopically, 24% ± 35% remained. There was no statistical difference between these groups ( P > .05). When the CCL was retained during open preparation, 60% ± 39% remained. During attempts to remove the CCL in an open manner, 19% ± 28% remained. There was a significant difference in the amount of CCL remaining between the open removal and open retaining groups ( P = .03). There were no significant differences in the percentage of CCL remaining between the open and arthroscopic preservation groups and between the open and arthroscopic removal groups.

Conclusion/Clinical Relevance:

This study highlights the significant variability in surgeon ability to reliably retain or remove the CCL. However, there appears to be improved ability of surgeons to more reliably remove or retain the CCL in an open fashion as compared with the arthroscopic approach.
Association Between a Rule Change to Reduce Home Plate Collisions and Mild Traumatic Brain Injury and Other Injuries in Professional Baseball Players
Authors: Green Gary , D’Angelo John , Coyles Jon , Penny Ian , Golfinos John G. , Valadka Alex
Published: July 2019

Background:

Improved player safety is an important goal of professional baseball. Prevention of mild traumatic brain injury (concussion) is an area of emphasis because of the potential for long-term as well as short-term sequelae.

Hypothesis:

A rule change can lower the incidence of concussions and other injuries in professional baseball.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This study included a retrospective review of data entered concurrently into professional baseball’s electronic medical record system. All minor and major league teams are required to use this system. All injuries are captured by creation of a new record in the system at the time of the injury. All active minor and major league players from 2011 to 2017 were included. The 30 major league clubs have 1200 roster players and play 162 games per season. The approximately 200 minor league clubs have about 7500 active players and play 56 to 144 games annually that combine for approximately 330,000 athlete-exposures per season. Before the 2014 season, Major League Baseball, in conjunction with its players association, instituted a rule limiting home plate collisions between base runners and catchers that applied to both Major League Baseball and Minor League Baseball. All concussions and other injuries at home plate from 2011 to 2017 were analyzed by mechanism and player position.

Results:

From 2011 to 2013, an annual mean of 100 injuries occurred from home plate collisions in the minor and major leagues, resulting in a mean loss of 2148 days annually. After the rule change, there was a mean 55 home plate collision injuries with 936 days lost per season ( P < .0001 for injuries and days lost). A mean 11 concussions attributed to these collisions occurred annually in the minor and major leagues before the rule change, as compared with 2.3 per year after ( P = .0029). There were no major league concussions from these collisions after the rule change. The mean annual number of days missed because of concussions at home plate dropped from 276 before 2014 to 36 per year after 2014 ( P = .0001).

Conclusion:

This rule change was associated with significant reductions in the numbers of concussions and other injuries caused by collisions at home plate as well as significant decreases in time lost from play.
Doing Right and Feeling Good: Ethical Food and the Shopping Experience
Authors: Schoolman Ethan D.
Published: July 2019

Does engaging in ethical consumption make shopping more enjoyable? Or does contending with social and environmental impacts in the supermarket add stress and worry to the practice of buying food? In this paper, I contribute to debates over ethical consumption and the shopping experience by directly addressing the question: Is ethical consumption associated with more enjoyable everyday shopping, specifically where food is concerned? Based on a survey of faculty, staff, and students at a large university, I show that even when controlling for socioeconomic characteristics and for where people shop, consumers who buy a range of ethical foods are more likely to take pleasure in food shopping as a whole. In other words, doing right may lead to feeling good—and this connection may represent not just an important motivation for acting on ethical values while shopping but also an integral part of what it means to be an ethical consumer.
The Complexities of Culturally Responsive Organized Activities: Latino Parents’ and Adolescents’ Perspectives
Authors: Ettekal Andrea Vest , Simpkins Sandra D. , Menjívar Cecilia , Delgado Melissa Y.
Published: July 2019

Grounded in bioecological theories, this mixed-method article examines aspects of culturally responsive organized activities. Study 1 used path analysis to quantitatively test relations between ethnic cultural features of activities (ways of integrating ethnic culture) and concurrent experiences ( N = 150 Latino adolescents). Findings were mixed, such that some features (e.g., teaching ethnic culture) predicted positive (e.g., increased autonomy) and negative (e.g., emotional) experiences. Study 2 disentangled the nuances of ethnic culture by qualitatively exploring perspectives on three features ( N = 34 Mexican-origin adolescent-parent dyads): ethnic cultural content, same-ethnic leaders/peers, and Spanish language use. Thematic analysis revealed the complexities of ethnic culture. Some parents and adolescents wanted activities that represented mainstream American culture; others wanted Latino ethnic culture, but were unhappy with the ways it was integrated into activities. Parents and adolescents thought their ethnic culture was misrepresented (e.g., Cinco de Mayo was celebrated as Mexican Independence Day) or represented narrowly (e.g., La Bamba was the school band’s only Mexican song). Findings suggest that integrating ethnic cultural features is not an “all or nothing” decision, and how it is done matters considerably. Families’ perspectives and voice would help ensure ethnic culture is integrated in authentic, preferred ways.
La transformation du réseau québécois de la santé : une opportunité de repositionnement stratégique des soins infirmiers
Authors: Dubois Sylvie
Published: July 2019

Dans le cadre de la mise en place d’une nouvelle gouvernance du réseau de la santé et des services sociaux du Québec, la Direction nationale de soins et services infirmiers (DNSSI) du ministère de la Santé et des Services sociaux (MSSS) a réalisé une démarche de repositionnement stratégique. L’objectif visait à favoriser l’exercice d’un leadership infirmier efficace et dont les actions sont porteuses de changements, pour ultimement influencer la définition des politiques et des orientations nationales en santé. Après une brève mise en contexte, cet article résume les grandes étapes de la démarche de repositionnement réalisée en partenariat avec les directrices de soins infirmiers (DSI) du réseau de la santé et des services sociaux (RSSS) et les résultats qui en découlent. L’article présente également le processus menant à la détermination des priorités de la DNSSI, la nature des actions posées par cette dernière et les considérations tenues en compte dans le choix de ses actions. Il conclut sur les retombées de la démarche de repositionnement.
On secondary recycling of ZrO2-reinforced HDPE filament prepared from domestic waste for possible 3-D printing of bearings
Authors: Singh Rupinder , Kumar Ranvijay , Tiwari Shubham , Vishwakarma Shubham , Kakkar Shivam , Rajora Vishal , Bhatoa Sahil
Published: July 2019

In this study, an innovative route for secondary recycling (with zirconium oxide (ZrO2) reinforcement) has been proposed based on melt processing of high-density polyethylene (HDPE) in low-temperature bearing applications. Initially, secondary recycled HDPE, acrylonitrile butadiene styrene, and nylon 6 thermoplastic composites were investigated for melt flow index (MFI) according to ASTM D1238 standard. Based on the acceptable MFI, secondary recycled HDPE matrix was selected for second-stage processing on twin screw extrusion (TSE). The final process involves reinforcement of ZrO2 into HDPE matrix by TSE in 60:40 ratio (by weight %) for preparation of feedstock filament (for possible 3-D printing of bearings). The results of the study suggest that for processing of HDPE, 40% ZrO2 composite matrix, 50 r min−1 screw speed, 190°C barrel temperature, and 15 kg applied load are the best setting of TSE (for maximizing the tensile strength of feedstock filament). The results are also supported by wear properties, thermal stability, and morphological analysis (based on scanning electron microscopy and electron-dispersive X-ray analysis).
Study on barium titanate and graphene reinforced PVDF matrix for 4D applications
Authors: Sharma Ravinder , Singh Rupinder , Batish Ajay
Published: July 2019

This article reports the experimental investigations of polyvinylidene fluoride (PVDF) matrix-based composite feedstock filament (reinforced with barium titanate (BTO) and graphene (Gr) for possible 4-D printing applications) using fused deposition modeling (FDM). The mechanical, rheological, thermal, and morphological properties of in-house prepared FDM filament are also reported. The FDM feedstock filament was prepared with a twin-screw extruder (TSE). The process parameters of TSE for preparation of smart material-based filament with uniform dispersion of reinforcement (BTO and Gr) in the PVDF matrix have also been explored. Finally, the prepared filament has been used on FDM setup (without any change in hardware/software) for printing piezoelectric sensor with 4-D capabilities. The results of the study suggest that BTO and Gr have significant effect on the melt flow index of PVDF. The composite prepared with reinforcement of BTO and Gr shows a continuous flow, along with better thermal stability (based upon differential scanning calorimetry analysis), when 10–20 wt% BTO was added to the PVDF matrix. The observed maximum peak and break strength of the PVDF composite was 29.57 MPa and 26.50 MPa, respectively. The scanning electron microscopy and energy-dispersive X-ray analysis results reveal that the filament prepared with 20% BTO and extruded at 200°C with a screw speed of 40 r/min has better dispersion of reinforcement among the selected parametric settings. Finally, a piezoelectric response of 20 pC/N has been measured on the FDM-printed thermally stable sample suitable for 4-D applications.
Documenting Geographic Isolation of Schools and Examining the Implications for Education Policy
Authors: Curran F. Chris , Kitchin James
Published: July 2019

Geographic isolation of K-12 schools represents a unique challenge to schools with implications for school funding, staffing, resource acquisition, consolidation, transportation, and school choice among others. To date, little research has documented the extent of geographic isolation at a national scale or how it varies across school contexts. Using the Common Core of Data and the Private School Universe Survey, this study estimates the extent of geographic isolation nationally and explores how such isolation varies across contexts. Estimates are calculated and compared using as the crow flies distance, road travel distance, and travel time. Results indicate that geographic isolation of schools is relatively high within district, particularly in rural areas. Although inclusion of schools in nearby districts greatly reduces isolation, many local markets of schools remain small. Results further show that geographic isolation varies greatly across states and across student demographics. Implications for policy are discussed.
Iberian missionaries in God’s vineyard: Enlarging humankind and encompassing the globe in the Renaissance
Authors: Romano Antonella
Published: July 2019

During the century of colonial expansion by the Iberian monarchies, the presence of the Church alongside the colonizers was not just a logical continuation of the medieval idea of the good prince who was advised and accompanied by men of faith. It also underlined the political dimension of the ‘spiritual conquest’ and the equally political dimension of the cultural practices accompanying it. There are numerous works that have emphasized this with regard to the American continents in particular, where the connection between the forces present, which quickly led to the destruction and subjugation of the local populations, brought about Spanish colonial domination over large swathes of the ‘West Indies’. Those scholars who have concentrated on the ‘East Indies’, and China in particular, have emphasized acculturation or accommodation, highlighting the cultural rather than the political dimension of contact. This article explores the significant asymmetries in the understanding of humankind developed by the missionaries in their analyses of the Americas and the East Indies. These asymmetries stemmed largely from their distinct roles and functions in the process of colonial or imperial contact. I argue that these asymmetries obscure our understanding of what missionaries contributed to the global circulation of knowledge of lands and peoples new to Europeans in the 16th and 17th centuries, in part by defining ‘savagery’ and locating it mostly in the ‘West Indies’.
A ‘monster with human visage’: The orangutan, savagery, and the borders of humanity in the global Enlightenment
Authors: Sebastiani Silvia
Published: July 2019

To what extent did the debate on the orangutan contribute to the global Enlightenment? This article focuses on the first 150 years of the introduction, dissection, and public exposition of the so-called ‘orangutan’ in Europe, between the 1630s, when the first specimens arrived in the Netherlands, and the 1770s, when the British debate about slavery and abolitionism reframed the boundaries between the human and animal kingdoms. Physicians, natural historians, antiquarians, philosophers, geographers, lawyers, and merchants all contributed to the knowledge of the orangutan, while also reshaping the boundaries of humanity: when the human/animal divide narrowed, the divide between ‘savage’ and ‘civilized’ peoples crystallized, becoming wider than in any previous period.
Multi-response optimization of friction stir welding process parameters for dissimilar joining of Al6101 to pure copper using standard deviation based TOPSIS method
Authors: Sharma Nidhi , Khan Zahid A , Siddiquee Arshad Noor , Wahid Mohd Atif
Published: July 2019

Friction stir welding is a new and effective solid-state welding process for joining dissimilar materials such as aluminum (Al) and copper (Cu). Joint quality of the friction stir welded materials gets influenced by the welding strategy and different friction stir welding process parameters, i.e. rotational speed, welding speed, tool design, tool pin offset, and tilt angle. In this paper, the effect of combination of different friction stir welding process parameters during joining of Al-6101 and pure copper is studied using Taguchi L18 orthogonal array. Four friction stir welding process parameters, i.e. shoulder diameter (A), pin offset (B), welding speed (C), and rotational speed (D) each at three levels except shoulder diameter, which is at two levels are selected. The effect of different combinations of these parameters on ultimate tensile strength and micro-hardness of the joints is investigated. Subsequently, single response optimization for ultimate tensile strength and micro-hardness and multi-response optimization of ultimate tensile strength and micro-hardness taken together is carried out to obtain the optimal combination of the friction stir welding process parameters. Taguchi method is used for single response optimization, whereas Taguchi-based TOPSIS method is employed for multi-response optimization. For single optimization, the optimum combination of the friction stir welding parameters yielding maximum strength and micro-hardness are A1B1C2D2 and A2B1C2D3, respectively. The optimum combination of the process parameters for multi-response optimization is A2B1C2D2. From the results of the study for single- and multi-response optimization, it is revealed that the rotational speed is the most significant process parameter affecting the tensile strength and micro-hardness of the joints followed by the welding speed. Further, the macro/microstructure and micro-hardness profile of the joint obtained at the optimal combination of the multi-response optimization are given and discussed for better understanding of material mixing and joining.
Vehicle tests showing how the weather in autumn influences the wheel–rail traction characteristics
Authors: Meierhofer Alexander , Trummer Gerald , Bernsteiner Christof , Six Klaus
Published: July 2019

Train operators report low adhesion in autumn, which they suspect is caused by fallen leaves on a track surrounded by forest and farmland. To investigate and quantify this effect, vehicle tests have been performed in autumn on a track partially surrounded by forest. To also investigate the influence of different weather conditions, the tests were performed on a day with sunny weather and one with high humidity in the morning and drizzle at noon. The results were then compared to other tests and different creep force models from the literature. The results showed a significant influence of the surrounding forest on the traction especially in sunny weather.
Study on the vibration suppression of a flexible carbody for urban railway vehicles with a magnetorheological elastomer-based dynamic vibration absorber
Authors: Wen Yongpeng , Sun Qian , Zou Yu , You Haoming
Published: July 2019

Magnetorheological elastomer is a new kind of intelligent material that mainly incorporates micron-sized ferromagnetic particles into a polymer. A dynamic vibration absorber that is based on the controllable shear modulus of magnetorheological elastomer is widely used in vibration systems. In the study, a flexible carbody model with a magnetorheological elastomer dynamic vibration absorber is established. A design method of a semiactive dynamic vibration absorber that is based on magnetorheological elastomer is introduced, and the operational principle of the semiactive dynamic vibration absorber is also discussed. To improve the vibration absorption performance of the magnetorheological elastomer dynamic vibration absorber, via multiple regression analysis, the optimal design frequency expressions for both the rigid vibration and the elastic vibration of the carbody are fitted. Parameter determination for the magnetorheological elastomer dynamic vibration absorber is investigated in detail. Then, the effects on the rigid vibration and the elastic vibration with the magnetorheological elastomer vibration absorber both with the passive vibration absorber and without a vibration absorber are analyzed. Finally, Sperling’s riding index is used to evaluate the feasibility and the performance of the magnetorheological elastomer dynamic vibration absorber in a practical application. The results demonstrate that the vibration of the carbody can be effectively reduced by using the magnetorheological elastomer dynamic vibration absorber instead of the dynamic vibration absorber without the magnetorheological elastomer. The magnetorheological elastomer dynamic vibration absorber that is modified by the optimum frequency provides superior vibration reduction performance and improves the riding quality of the railway vehicle.
Mephedrone and chemsex: when it stops being a party and becomes a fatal problem
Authors: Troya Jesús , Martínez de Gándara Amalia , Ryan Pablo , Cuevas Guillermo , Pardo Virginia
Published: July 2019

Chemsex is the use of psychoactive substances, mainly gamma-hydroxybutyrate, 4-methylmethcathinone (mephedrone), and methamphetamines to facilitate and enhance the experience of sexual intercourse. The toxicity of these drugs may be problematic and lead to a fatal outcome in some patients. We present the case of a 26-year-old man living with human immunodeficiency virus whose frequent use of mephedrone caused his death.
Assessing the quality of routine HIV testing data in the community setting ‘COBATEST Network’
Authors: Reyes-Urueña J , Fernàndez-Lopez L , Montoliu A , Conway A , Tavoschi L , Klavs I , Cosmaro L , Eibl I , Dominković Z , Pichon F , Casabona J ,   The COBATEST Network
Published: July 2019

The COBATEST Network of Community-Based Voluntary Counselling and STI/HIV Testing (CBVCT) services was created to standardise monitoring and evaluation of CBVCT services across Europe. This study aims to assess the quality of data collected in the network from 2015 to 2016. A survey was completed by 34 COBATEST Network members and an evaluation was performed of data quality based on three dimensions: transcription validity, completeness and consistency. The weakest area that we identified was data management processes. Only 8.8% of services had a written procedure to address data quality errors, 29.4% had procedures in place to resolve discrepancies and 35.3% performed quality control. We found that 41.2% of services utilised the COBATEST data, 11.8% made decisions based on the COBATEST data and 61.8% analysed their data in an independent manner for internal purposes. We conclude that while services have reliable data to support planning and management of services, improvements to quality procedures would ensure data are translated into evidence. This evidence would support further expansion of CBVCT services in the EU/EEA, including the integration of CBVCT-generated data into national surveillance systems.
Energy performance assessment in terms of primary energy and exergy analyses of the nursing home and rehabilitation center
Authors: Kuzgunkaya Ebru Hancioglu
Published: July 2019

This paper concerns with the energy analysis (based on primary energy) and exergy analysis of Narlıdere Nursing Home and Rehabilitation Center (NNHRC) in İzmir, Turkey that was chosen as a sample public building. The Center services as a nursing and rehabilitation center for the aged and it also includes a geriatric division operating as a hospital. The Center was analyzed using the actual energy consumption data derived from several energy audits. Energy efficiency (according to the primary energy ratio) and exergy efficiency of the facility were calculated to be 59% and 14%, respectively. The results have indicated that the exergy efficiencies of space heating and cooling have the lowest values compared with the other units of facility. Specific primary energy consumption and specific exergy consumption of the facility were found to be 271.91 kWh/m2 year and 290.23 kWh/m2 year, respectively. Sustainability index value of the overall NNHRC was found to be 1.621.
Performance investigation of a solar still having polythene film cover and black painted stainless steel basin integrated with a photovoltaic module–direct current heater
Authors: Riahi Ali , Zakaria Nor Azazi , Isa Mohamed Hasnain , Wan Yusof Khamaruzaman , Mahinder Singh Balbir Singh , Mustaffa Zahiraniza , Takaijudin Husna
Published: July 2019

This work investigated the performance of two solar stills with similar polythene film cover and black painted stainless steel basin. One was a passive solar still and the other named active solar still was augmented with an external heat source of a photovoltaic module with output power of 45.9 W and a direct current heater. The maximum daily water production of active solar still and passive solar still was 4.36 and 3.21 L/m2, respectively. The estimated cost per L/m2 for active solar still and passive solar still was USD 0.045 and 0.015, respectively. The quality of water produced from both solar stills met World Health Organization drinking water standards.
Improved dendroclimatic calibration using blue intensity in the southern Yukon
Authors: Wilson R , Anchukaitis K , Andreu-Hayles L , Cook E , D’Arrigo R , Davi N , Haberbauer L , Krusic P , Luckman B , Morimoto D , Oelkers R , Wiles G , Wood C
Published: July 2019

In north-western North America, the so-called divergence problem (DP) is expressed in tree ring width (RW) as an unstable temperature signal in recent decades. Maximum latewood density (MXD), from the same region, shows minimal evidence of DP. While MXD is a superior proxy for summer temperatures, there are very few long MXD records from North America. Latewood blue intensity (LWB) measures similar wood properties as MXD, expresses a similar climate response, is much cheaper to generate and thereby could provide the means to profoundly expand the extant network of temperature sensitive tree-ring (TR) chronologies in North America. In this study, LWB is measured from 17 white spruce sites ( Picea glauca) in south-western Yukon to test whether LWB is immune to the temporal calibration instabilities observed in RW. A number of detrending methodologies are examined. The strongest calibration results for both RW and LWB are consistently returned using age-dependent spline (ADS) detrending within the signal-free (SF) framework. RW data calibrate best with June–July maximum temperatures (Tmax), explaining up to 28% variance, but all models fail validation and residual analysis. In comparison, LWB calibrates strongly (explaining 43–51% of May–August Tmax) and validates well. The reconstruction extends to 1337 CE, but uncertainties increase substantially before the early 17th century because of low replication. RW-, MXD- and LWB-based summer temperature reconstructions from the Gulf of Alaska, the Wrangell Mountains and Northern Alaska display good agreement at multi-decadal and higher frequencies, but the Yukon LWB reconstruction appears potentially limited in its expression of centennial-scale variation. While LWB improves dendroclimatic calibration, future work must focus on suitably preserved sub-fossil material to increase replication prior to 1650 CE.
The Spike-and-Slab Lasso regression modeling with compositional covariates: An application on Brazilian children malnutrition data
Authors: Louzada Francisco , Shimizu Taciana KO , Suzuki Adriano K
Published: July 2019

There are considerable challenges in analyzing large-scale compositional data. In this paper, we introduce the Spike-and-Slab Lasso linear regression in the presence of compositional covariates for parameter estimation and variable selection. We consider the well-known isometric log-ratio (ilr) coordinates to avoid misleading statistical inference. The separable and non-separable (adaptative) Spike-and-Slab Lasso penalties are compared to verify the advantages of each approach. The proposed method is illustrated on simulated and on real Brazilian child malnutrition data.
Perversion and Perpetration in Female Genital Mutilation Law: The Unmaking of Women as Bearers of Law
Authors: Pardy Maree , Rogers Juliet , Seuffert Nan
Published: July 2019

Female genital cutting (FGC) or, more controversially, female genital mutilation, has motivated the implementation of legislation in many English-speaking countries, the product of emotive images and arguments that obscure the realities of the practices of FGC and the complexity of the role of the practitioner. In Australia, state and territory legislation was followed, in 2015, with a conviction in New South Wales highlighting the problem with laws that speak to fantasies of ‘mutilation’. This article analyses the positioning of Islamic women as victims of their culture, represented as performing their roles as vehicles for demonic possession, unable to authorize agency or law. Through a perverse framing of ‘mutilation’, and in the case through the interpretation of the term ‘mutilation’, practices of FGC as law performed by women are obscured, avoiding the challenge of a real multiculturalism that recognises lawful practices of migrant cultures in democratic countries.
Analysis of wood thermal degradation using 2D correlation of near infrared and visible-light spectroscopy
Authors: Mahdiyanti Siti Hanifah , Inagaki Tetsuya , Tsuchikawa Satoru
Published: July 2019

Wood changes its properties, especially color, as a result of thermal degradation. In this study, change in wood properties due to thermal degradation have been studied using the nondestructive test methods of near infrared spectroscopy, CIELAB color measurement, visible-light spectroscopy, and Arrhenius time–temperature superposition. Arrhenius time–temperature superposition allowed analysis of near infrared and visible-light spectra, and color parameters to predict thermal degradation and color change of wood at 120–180℃ for 6 min to nine months duration. Two-dimensional correlation spectroscopy for the complementary analysis of near infrared and visible-light spectroscopy was applied to investigate chemical changes during wood thermal degradation that cause the observed color change. Visible-light spectroscopy with CIELAB color measurement was used to obtain information on color changes, and near infrared spectroscopy was applied in the measurement of chemical changes during thermal degradation. Changes in spectral intensities in 2D correlation spectroscopy indicated that different chemical components are responsible for color change during heat treatment and accelerated aging of wood. With dry-thermal treatment, the hemicellulose content decreased following a color change, whereas cellulose and lignin/extractives decreased with hygro-thermal treatment.
Ethical leadership, nursing error and error reporting from the nurses’ perspective
Authors: Barkhordari-Sharifabad Maasoumeh , Mirjalili Narges-Sadat
Published: July 2019

Background:

Nursing errors endanger patient safety, and error reporting helps identify errors and system vulnerabilities. Nursing managers play a key role in preventing nursing errors by using leadership skills. One of the leadership approaches is ethical leadership.

Aim:

This study determined the level of ethical leadership from the nurses’ perspective and its effect on nursing error and error reporting in teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Research design:

This was a cross-sectional descriptive study.

Participants and research context:

A total of 171 nurses working in medical-surgical wards were selected through random sampling. Data collection was carried out using “ethical leadership in nursing, nursing errors and error reporting” questionnaires. Data were analyzed with SPSS20 using descriptive and analytical statistics.

Ethical considerations:

This study was approved by the Ethics Committee for Medical Research. Ethical considerations such as completing informed consent form, ensuring confidentiality of information, explaining research objectives, and voluntary participation were observed in the present study.

Findings:

The results showed that the level of nursing managers’ ethical leadership was moderate from the nurses’ point of view. The highest and the lowest levels were related to the power-sharing and task-oriented dimensions, respectively. There was a significant relationship between nursing managers’ level of ethical leadership with error rates and error reporting.

Conclusion:

The development of ethical leadership approach in nursing managers reduces error rate and increases error reporting. Programs designed to promote such approach in nursing managers at all levels can help reduce the level of error rate and maintain patient safety.
Experimentally validated model and analytical investigations on power optimization for piezoelectric-based wireless power transfer systems
Authors: Truong Binh Duc , Williams Shane , Roundy Shad
Published: July 2019

This article presents a near-field low-frequency wireless power transfer system utilizing a piezoelectric transducer with magnet tip mass as a receiver. The interaction moment between the uniform B field generated by a Helmholtz coil and the magnet is the means to deliver the electrical energy from the transmitter to an electrical load, which is therefore referred to as magneto-mechano-electric effect. This is the first time a complete equivalent circuit model of such a structure is developed and experimentally verified. Based on the lumped model, various aspects of the power optimization problem are thoroughly discussed, providing a comprehensive view of the system and an important premise for further study.
On the efficiency of energy harvesters: A classification of dynamics in miniaturized generators under low-frequency excitation
Authors: Blad Thijs WA , Tolou Nima
Published: July 2019

Although motion energy harvesting at the small scales has been a research topic for over 20 years, the implementation of such generators remains limited in practice. One of the most important contributing factors here is the poor performance of these devices under low-frequency excitation. In this research, a new metric is proposed to evaluate the performance and bandwidth of generators at low frequencies. For that, a classification based on the dynamics was made. It was found that the highest efficiencies were found in single-degree-of-freedom resonators where a large motion amplification was achieved. Smaller generators can be designed by limiting the motion through end-stops at the cost of a reduced efficiency. Moreover, it was argued that upon miniaturization, resonators could be outperformed by generators using a frequency up-conversion principle.
Is There a Correlation Between Nasolabial Appearance and Dentoalveolar Relationships in Patients With Repaired Unilateral Cleft Lip and Palate?
Authors: Lee Tara V. N. , Ireland Anthony J. , Atack Nikki E. , Deacon Scott A. , Jones Timothy E. M. , Matharu Jason , Wills Andrew , Al-Ghatam Rana , Richard Bruce M. , Ness Andy R. , Sandy Jonathan R.
Published: July 2019

Objective:

To determine whether a relationship exists between the aesthetic scores given to photographic records of the nasolabial region of patients with repaired unilateral cleft lip and palate (UCLP) and the 5-Year Olds’ Index scores of study models for the same participants.

Design:

Retrospective study.

Setting:

University of Bristol Dental Hospital, United Kingdom.

Participants:

Patients with nonsyndromic UCLP previously enrolled in the Cleft Care UK (CCUK) Study.

Methods:

The CCUK participants, who had both study models and photographs (frontal and worm’s eye view), were identified and their records retrieved. These were rated by 2 consultants and 2 senior registrars in orthodontics. The 5-Year Olds’ Index was used to score the study models, and at a separate sitting, a 5-point Likert scale was used to score the cropped frontal and worm’s eye view photographs of the same children. The results were analyzed using intraclass correlation coefficients and Cohen κ.

Main Outcome Measures:

Correlation between the aesthetic scores of the photographic views and the concordant 5-Year Olds’ Index scores of the study models.

Results:

The intraclass correlation coefficient scores showed very poor agreement between the photographic views and their concordant study models. The level of inter- and intra-rater reliability was strongest when scoring the study models.

Conclusions:

There was no agreement between the scores given to various photographic views and their corresponding study models. Scoring the study models using the 5-Year Olds’ Index was the most reliable outcome measure for this age-group.
An Anatomic and Clinical Study of the Innervation of the Dorsal Midfoot Capsule
Authors: Shi Glenn G. , Williams Meredith A. , Whalen Joseph L. , Wilke Benjamin K. , C. Kraus Jonathan
Published: July 2019

Background:

Dorsal pain from osteoarthritic midfoot joints is thought to be relayed by branches of the medial and lateral plantar, sural, saphenous, and deep peroneal nerves (DPN). However, there is no consensus on the actual number or pathways of the nervous branches for midfoot joint capsular innervation. This study examined the DPN’s terminal branches at the midfoot joint capsules through anatomic dissection and confirmation of their significance in a clinical case series of patients with midfoot pain relief after DPN block.

Methods:

Eleven cadaveric lower leg specimens, 6 left and 5 right, were dissected using operative loupe magnification. We preserved the terminal branches and recorded their paths and branching patterns. Joint capsular innervations were individually noted. To confirm our hypothesis of significant dorsal midfoot joint capsular innervation by the DPN, we also performed an institutional review board–approved retrospective chart review of 37 patients with painful dorsal midfoot osteoarthritis who underwent diagnostic local anesthetic injection block of the DPN. The percentage of temporary pain relief after the injection was recorded.

Results:

Terminal innervation of the DPN branches showed distribution of the second and third tarsometatarsal joints in all specimens. Inconsistent innervation of the naviculocuneiform (9/11), fourth (7/11), first (6/11), and fifth (4/11) tarsometatarsal and calcaneocuboid joints (1/11) were observed. The retrospective review of pain relief in patients with dorsal midfoot pain due to arthritis after diagnostic injection demonstrated a mean of 92.1% improvement.

Conclusion:

Innervation of the dorsal midfoot joint capsule appears to follow a consistent distribution across 3 joints: second and third tarsometatarsal joints and the naviculocuneiform joint. Acute relief of dorsal midfoot arthritic pain after diagnostic injection suggests that dorsal midfoot nociceptive pain is at least partly transmitted by the DPN.

Level of Evidence:

Level IV, case series.
Knowledge, Attitude, and Practice Regarding Breast Cancer Early Detection Among Women in a Mountainous Area in Northern Vietnam
Authors: Toan Do Thi Thanh , Son Dinh Thai , Hung Le Xuan , Minh Luu Ngoc , Mai Dinh Le , Hoat Luu Ngoc
Published: July 2019

Breast cancer is the most common cancer in women all over the world, also in Vietnam. In recent years, the incidence of breast cancer has been increasing in Vietnam, and most cases are diagnosed at late stages, making treatment more difficult. More and better early detection could help more women to survive. The aim of this study was to identify the current knowledge, attitude and practice about early detection of breast cancer as well as potential predictors of breast cancer screening among women aged 20 to 49 year in a mountainous commune in Thanh Hoa Province, Vietnam, in a largely ethnic Muong population. Women aged 20 to 49 years were selected by systematic random sampling to participate in a cross sectional study in October 2017. They were interviewed with a closed questionnaire about their knowledge of breast cancer, its risk factors, and warning signs. A checklist for performance of breast self-examination was also applied. Three hundred six women agreed to participate in the study. More than half had a low level of knowledge, and were weak in attitude and practice about breast self-examination, clinical breast examination, breast ultrasound, and mamography. Among women who had practiced at least 1 screening method, 17.0% mentioned clinical breast examination, and only 13.8% reported practicing breast self-examination. Factors associated with practice included knowledge about breast cancer early detection (BCED), ethnicity, income, the BCED information approach, and the BCED screening programs approach. The finding of a very low proportion of women in the mountainous setting with good awareness and practice on early detection of breast cancer is important evidence to inform the BCED intervention program developers about where and how to target which information, especially to reach more ethnic minority women.
The Value of CT and MRI for Determining Thymoma in Patients With Myasthenia Gravis
Authors: Tuan Phung Anh , Vien Mai Van , Dong Hoang Van , Sibell David , Giang Bui Van
Published: July 2019

The aim of the study was to evaluate the usefulness of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating thymoma from nonthymoma abnormalities in patients with myasthenia gravis (MG). A cross-sectional study of 53 patients with MG, who had undergone surgical thymectomy, was conducted at 103 Hospital (Hanoi, Vietnam) and Cho Ray Hospital (Ho Chi Minh City, Vietnam) during August 2014 and January 2017. The CT and MRI images of patients with MG were qualitatively and quantitatively (radiodensity and chemical shift ratio [CSR]) analyzed to determine and compare their ability to distinguish thymoma from nonthymoma abnormalities. Logistic regression was used to identify the association between imaging parameters (eg, CSR) and the thymoma status. The receiver operating curve (ROC) analysis was used to determine the differentiating ability of CSR and radiodensity. As results, of the 53 patients with MG, 33 were with thymoma and 20 were with nonthymoma abnormalities. At qualitative assessment, MRI had significantly higher accuracy than did CT in differentiating thymoma from nonthymoma abnormalities (94.3% vs 83%). At quantitative assessment, both the radiodensity and CSR were significantly higher for thymoma compared with nonthymoma groups ( P < .001). The ROC analysis showed that CSR had significantly higher sensitivity (Se) and specificity (Sp) than radiodensity in discriminating between the 2 groups (CSR: Se 100%, Sp 95% vs radiodensity: Se 90.9%, Sp 70%). When combining both qualitative and quantitative parameters, MRI had even higher accuracy than did CT in thymoma diagnosis ( P = .031). In conclusion, chemical shift MRI was more accurate than CT for differentiating thymoma from nonthymoma in patients with MG.
Nonclinical Safety and Toxicokinetics of MnTE-2-PyP (BMX-010), a Topical Agent in Phase 2 Trials for Psoriasis and Atopic Dermatitis
Authors: Gad Shayne C. , Sullivan Dexter W. , Mujer Cesar V. , Spainhour Charles B. , Crapo James D.
Published: July 2019

Since our earlier publication (Gad et al, 2013), BioMimetix has advanced BMX-010 (Manganese (III) meso-tetrakis(N-ethylpyridinium-2-yl)porphyrin or MnTE020PyP; CASRN 219818-60-7) into clinical development as a topical agent for the treatment of psoriasis, atopic dermatitis, and pruritus (idiopathic nonspecific itch). A multiple dose phase I study has been completed in 64 patients without any serious adverse effects. During the course of development, the formulation was initially a gel but has been modified to a cream formulation. The nonclinical safety program has been carried onward to assess preclinical risk to patients. Additional studies completed and reported here include dermal sensitization in a Guinea Pig maximization test study, 2 rabbit phototoxicity studies, a 28-day oral toxicity study in juvenile mice, a 28-day topical systemic toxicity study in Gottingen minipigs, range-finding studies, and complete embryo–fetal developmental toxicity (Segment II) studies in mice and rabbits, an ICH M7 compliant qualification of impurities using 2 (Q)SAR in silico methods, and a 14-day subcutaneous toxicity study of mice to qualify an impurity. All studies (except the (Q)SAR evaluations) were performed in accordance with Good Laboratory Practices (GLP) using Good Manufacturing Practices (GMP) drug substance. The systemic toxicity studies, with the exception of the juvenile toxicity study, included toxicokinetic evaluations, which are reported here. The phase I clinical study had 67 patient participants who received topically applied BMX-010, and there were no notable safety findings and included pharmacokinetic determinations on these patients which are also reported here. Chronic GLP toxicity studies have been initiated in the mouse (6-month oral) and minipig (9-month dermal). To date, the only observed nonclinical toxicity remains a reversible hypertension seen in mice in response to Cmax levels with a no effect threshold, and there have been no drug-related adverse effects.
Diagnostic Utility of Pathological Investigations in Late Gestation Stillbirth: A Cohort Study
Authors: Lou Si Kei , Keating Sarah , Kolomietz Elena , Shannon Patrick
Published: July 2019

Objective

Near term unexpected stillbirth is a common, complex diagnostic challenge. We review a large cohort of near term to term gestation unexpected fetal deaths to document the common patterns of pathology and evaluate the utility of various standard autopsy procedures.

Methods

A total of 123 perinatal autopsies consisting of 94 intrauterine fetal deaths (IUFDs) and 29 intrapartum deaths (IPDs) were reviewed. Deaths were classified according to the laboratory investigations establishing cause of death.

Results

Cause of death was attributable to placental pathology without autopsy in 55.3% of IUFD and 17% of IPD. Correlative findings at autopsy increased the ability to establish cause of death in 86.2% of IUFD and 62% of IPD. Histology was largely corroborative, with the brain, lungs, and heart demonstrating significant changes in 46%, 34.5%, and 13.8%, respectively. Microbiology was corroborative but demonstrated single organism growth in 6 of 29 cases of fatal acute chorioamnionitis. Newborn metabolic screening revealed only elevated thyroid-stimulating hormone levels in 3 cases, of questionable relevance. Aneuploidy was established by screening molecular studies in 5 IUFDs, all of which had external or visceral dysmorphism. Karyotype was established in 69 cases and was not contributory in any of the IPD: 3 IUFDs had changes of unknown significance. Cause of death was not established at autopsy in 9% of IUFD and 10% of IPD.

Discussion

This is the largest uniformly investigated cohort of late gestation unexpected fetal deaths studied. We confirm the importance of both placental and fetal autopsy in establishing cause of death. Autopsy histology, microbiology, and cytogenetics provide important but largely corroborative data.