bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Tax Risk Affect Investor Valuation of Tax Avoidance?
Authors: Drake Katharine D. , Lusch Stephen J. , Stekelberg James
Published: February 2017

We examine how investors value tax avoidance (measured as the level of cash effective tax rates [ETRs]) and tax risk (measured as the volatility of cash ETRs), and how these constructs interact to influence firm value. Our results suggest that investors positively value tax avoidance but negatively value tax risk and, most importantly, that greater tax risk moderates the positive valuation of tax avoidance. In additional analyses, we find that contemporaneous measures of tax avoidance and tax risk provide insight into future tax cash flows and that our results hold using GAAP ETR-based measures of tax avoidance and tax risk. Finally, our results are robust to a battery of sensitivity checks including controlling for idiosyncratic and systematic risk, the cost of equity capital, and unrecognized tax benefits in the post-FIN 48 period, among others. Broadly, our findings provide new evidence on how taxes affect firm value and suggest that tax avoidance and tax risk should be considered jointly rather than in isolation.
Semantic tag recommendation based on associated words exploiting the interwiki links of Wikipedia
Authors: Hong Hyun-Ki , Kim Gun-Woo , Lee Dong-Ho
Published: February 2017

The volumes of multimedia content and users have increased on social multimedia sites due to the prevalence of smart mobile devices and digital cameras. It is common for users to take pictures and upload them to image-sharing websites using their smartphones. However, the tag characteristics deteriorate the quality of tag-based image retrieval and decrease the reliability of social multimedia sites. In this article, we propose a semantic tag recommendation technique exploiting associated words that are semantically similar or related to each other using the interwiki links of Wikipedia. First, we generate a word relationship graph after extracting meaningful words from each article in Wikipedia. The candidate words are then rearranged according to importance by applying a link-based ranking algorithm and then the top-k words are defined as the associated words for the article. When a user uploads an image, we collect visually similar images from a social image database. After propagating the proper tags from the collected images, we recommend associated words related to the candidate tags. Our experimental results show that the proposed method can improve the accuracy by up to 14% compared with other works and that exploiting associated words makes it possible to perform semantic tag recommendation.
Acquired transdiaphragmatic hernia: an unusual cause of cardiac tamponade
Authors: D’Orio Virginie , Demondion Pierre , Lebreton Guillaume , Coutance Guillaume , Varnous Sheida , Leprince Pascal
Published: February 2017

Transdiaphragmatic peritoneopericardial hernia is a rare complication after peritoneopericardial window formation, coronary artery bypass grafting using the gastroepiploic artery, or subxiphoid epicardial pacemaker insertion. We describe two different clinical presentations of transdiaphragmatic peritoneopericardial hernia in patients who had undergone recent heart transplantation. One was an exceptional case of cardiac tamponade caused by small bowel strangulation through a diaphragmatic defect.
Giving when it costs
Authors: Day Lisa C. , Impett Emily A.
Published: February 2017

Do some people exhibit a greater willingness to sacrifice in romantic relationships and derive more satisfaction from doing so, even in the face of high costs? In a cross-sectional study and a daily experience study, we show that people low in interdependent self-construal were less willing to sacrifice when the costs were relatively high, whereas people high in interdependent self-construal were equally willing to make high- and low-cost sacrifices. Further, when people low in interdependent self-construal chose to sacrifice, they felt less authentic when the costs were high, which in turn, detracted from their satisfaction with sacrifice. In contrast, people high in interdependent self-construal did not feel less authentic and were buffered against feeling less satisfied when making more costly sacrifices. The findings identify a set of individuals who are more willing to sacrifice, even in the face of high costs, and who feel more satisfied and authentic when doing so.
The value of adding sub-valvular procedures for chronic ischemic mitral regurgitation surgery: a meta-analysis
Authors: Moscarelli Marco , Athanasiou Thanos , Speziale Giuseppe , Punjabi Prakash P. , Malietzis George , Lancellotti Patrizio , Fattouch Khalil
Published: February 2017

Background:

The most performed repair technique for the treatment of chronic ischemic mitral regurgitation in patients referred for bypass grafting remains restricted annuloplasty. However, it is associated with a high rate of failure, especially if severe tenting exists.

Objectives:

To understand if adjunctive sub-valvular mitral procedures may provide better repair performance.

Methods:

A systematic literature review identified six studies of which five fulfilled the criteria for meta-analysis. Outcomes for a total of 404 patients (214 had adjunctive sub-valvular procedures and 190 restricted annuloplasty) were meta-analyzed using random effects modeling. Heterogeneity and subgroup sensitivity analysis were assessed. Primary endpoints were: late recurrence of moderate mitral regurgitation, left ventricle remodeling and coaptation depth at follow-up. Secondary endpoints were: early mortality, mid-term survival and operative outcomes.

Results:

Sub-valvular procedure technique was associated with a significantly lower late recurrence of mitral regurgitation (Odds ratio (OR) 0.34, 95% Confidence Interval (CI) [0.18, 0.65], p=0.0009), smaller left ventricle end-systolic diameter (Weighted Mean Difference (WMD) -4.06, 95% CI [-6.10, -2.03], p=0.0001) and reduced coaptation depth (WMD -2.36, 95% CI [-5.01, -0.71], p=0.009). These findings were consistent, even in studies that included patients at high risk for repair failure (coaptation depth >10 mm and tenting area >2.5 cm2). A low degree of heterogeneity was observed. There was no difference in terms of early mortality and mid-term survival; sub-valvular technique was associated with prolonged cardiopulmonary and cross-clamp time.

Conclusions:

Adding sub-valvular procedures when repairing ischemic chronic mitral valve regurgitation may be associated with better durability, even in the case of the presence of predictors for late failure.

Perspective:

Surgical sub-valvular adjunctive procedures have to be considered in the case of the presence of echocardiographic predictors for late failure.
Early rehabilitation after hospital admission for road trauma using an in-reach multidisciplinary team: a randomised controlled trial
Authors: Wu Jane , Faux Steven G , Estell John , Wilson Stephen , Harris Ian , Poulos Christopher J , Klein Linda
Published: February 2017

Objective:

To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma.

Design:

Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries.

Setting:

Four participating trauma services in New South Wales, Australia.

Subjects:

A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days.

Intervention:

Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care).

Main measures:

The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2).

Results:

Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up.

Conclusion:

No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.
Parental experiences with a paediatric palliative care team: A qualitative study
Authors: Verberne Lisa M , Schouten-van Meeteren Antoinette YN , Bosman Diederik K , Colenbrander Derk A , Jagt Charissa T , Grootenhuis Martha A , van Delden Johannes JM , Kars Marijke C
Published: February 2017

Background:

Parents of children with a life-limiting disease have to rely on themselves at home while adequate paediatric palliative care is lacking. In several countries, paediatric palliative care teams are introduced to ensure continuity and quality of care and to support the child and the family. Yet, little is known about how parents experience such multidisciplinary teams.

Aim:

To obtain insight into the support provided by a new paediatric palliative care team from the parents’ perspective.

Design:

An interpretative qualitative interview study using thematic analysis was performed.

Setting/participants:

A total of 47 single or repeated interviews were undertaken with 42 parents of 24 children supported by a multidisciplinary paediatric palliative care team located at a university children’s hospital. The children suffered from malignant or non-malignant diseases.

Results:

In advance, parents had limited expectations of the paediatric palliative care team. Some had difficulty accepting the need for palliative care for their child. Once parents experienced what the team achieved for their child and family, they valued the team’s involvement. Valuable elements were as follows: (1) process-related aspects such as continuity, coordination of care, and providing one reliable point of contact; (2) practical support; and (3) the team members’ sensitive and reliable attitude. As a point of improvement, parents suggested more concrete clarification upfront of the content of the team’s support.

Conclusion:

Parents feel supported by the paediatric palliative care team. The three elements valued by parents probably form the structure that underlies quality of paediatric palliative care. New teams should cover these three valuable elements.
Histogram analysis of volume-based apparent diffusion coefficient in breast cancer
Authors: Park Ga Eun , Kim Sung Hun , Kim Eun Jeong , Kang Bong Joo , Park Mi Sun
Published: February 2017

Background

Breast cancer is a heterogeneous disease. Recent studies showed that apparent diffusion coefficient (ADC) values have various association with tumor aggressiveness and prognosis.

Purpose

To evaluate the value of histogram analysis of ADC values obtained from the whole tumor volume in invasive ductal cancer (IDC) and ductal carcinoma in situ (DCIS).

Material and Methods

This retrospective study included 201 patients with confirmed DCIS (n = 37) and IDC (n = 164). The IDC group was divided into two groups based on the presence of a DCIS component: IDC–DCIS (n = 76) and pure IDC (n = 88). All patients underwent preoperative breast magnetic resonance imaging (MRI) with diffusion-weighted images at 3.0 T. Histogram parameters of cumulative ADC values, skewness, and kurtosis were calculated and statistically analyzed.

Results

The differences between DCIS, IDC–DCIS, and pure IDC were significant in all percentiles of ADC values, in descending order of DCIS, IDC–DCIS, and pure IDC. IDC showed significantly lower ADC values than DCIS, and ADC50 was the best indicator for discriminating IDC from DCIS, with a threshold of 1.185 × 10–3 mm2/s (sensitivity of 82.9%, specificity of 75.7%). However, multivariate analysis of obtained ADC values showed no significant differences between DCIS, IDC–DCIS, and pure IDC ( P > 0.05).

Conclusion

Volume-based ADC values showed association with heterogeneity of breast cancer. However, there was no additional diagnostic performance in histogram analysis for differentiating between DCIS, IDC–DCIS, and pure IDC.
Background echotexture classification in breast ultrasound: inter-observer agreement study
Authors: Kim Won Hwa , Lee Su Hyun , Chang Jung Min , Cho Nariya , Moon Woo Kyung
Published: February 2017

Background

According to the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS), background echotexture in breast ultrasound (US) can be categorized as homogeneous or heterogeneous.

Purpose

To prospectively evaluate the inter-observer agreement of a four-category classification in background echotexture assessments of breast US and to determine whether background echotexture is related to breast cancer risk factors, including mammography density.

Material and Methods

Thirty-eight healthy women (age range, 25–72) were recruited. Eleven radiologists performed breast US on all participants and classified each background echotexture into four categories (homogeneous, mild, moderate, and marked heterogeneous). The inter-observer agreement in the assessments was measured using kappa statistics (к). The association between background echotexture and breast cancer risk factors, including mammographic density, menopausal status, and parity, were evaluated using Spearman’s correlation coefficient (ρ) and multiple linear regression analysis.

Results

There was moderate inter-observer agreement between the radiologists for the four categories of background echotexture (average к = 0.45). Heterogeneity of the background echotexture was positively correlated with mammographic density in both pre- and postmenopausal women (premenopausal, ρ = 0.42, P < 0.0001; postmenopausal, ρ = 0.56, P < 0.0001). Multiple linear regression analysis revealed that mammographic density and parity were significantly associated with background echotexture.

Conclusion

Background echotexture assessment of breast US using a four-category classification showed moderate inter-observer agreement, and more heterogeneous background echotexture was associated with denser breasts and lower parity.
Effects of preferred relaxing music after acute stress exposure: A randomized controlled trial
Authors: de la Torre-Luque Alejandro , Díaz-Piedra Carolina , Buela-Casal Gualberto
Published: February 2017

In daily contexts, coping with stressful events involves a great level of personal resources to recover baseline conditions efficiently, a process called stress recovery. The aim of this study was to assess the effects of an intervention based on preferred relaxing music on the recovery after stress exposure. We also analyzed the effect of gender on stress recovery. Fifty-eight undergraduates underwent a paradigm of laboratory-based stress induction and were randomly assigned to either the control or the experimental group. The recovery period included either silent resting (control group) or listening to their preferred music to become relaxed (experimental group) for 15 minutes. Cardiovascular measures and self-reported emotional states were monitored across the stress induction and recovery stages. Participants in the experimental group exhibited higher levels of heart-derived high frequency power, and greater sample entropy in the recovery period. They also showed lower levels of self-reported states of anxiety, depression, and negative affect, as well as greater levels of positive affect. Gender-related differences were also found during recovery for both cardiovascular and self-reported measures. To conclude, interventions based on preferred relaxing music allow promotion of a healthier recovery and improve affective state after acute stress exposure considering differential outcomes according to gender.
Outcomes After Biologically Augmented Isolated Meniscal Repair With Marrow Venting Are Comparable With Those After Meniscal Repair With Concomitant Anterior Cruciate Ligament Reconstruction
Authors: Dean Chase S. , Chahla Jorge , Matheny Lauren M. , Mitchell Justin J. , LaPrade Robert F.
Published: February 2017

Background:

Meniscal repair in the setting of anterior cruciate ligament (ACL) reconstruction has demonstrated superior outcomes compared with isolated meniscal repair. Limited evidence exists for the effects of biological augmentation in isolated meniscal repair, particularly as compared with meniscal repair with concomitant ACL reconstruction.

Purpose/Hypothesis:

The purpose of this study was to compare the outcomes and survivorship of meniscal repair in 2 cohorts of patients: meniscal repair with biological augmentation using a marrow venting procedure (MVP) of the intercondylar notch, and meniscal repair with concomitant ACL reconstruction. We hypothesized that the clinical outcomes and survivorship of meniscal repair with concomitant ACL reconstruction would be improved compared with meniscal repair with biological augmentation.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Inclusion criteria were skeletally mature patients aged ≥16 years who underwent inside-out meniscal repair and either a concomitant MVP of the intercondylar notch or ACL reconstruction. Patients were excluded from this study if they were skeletally immature, underwent meniscus root or radial tear repair, or underwent meniscal repair with concurrent ligamentous reconstruction not limited to the ACL. At the preoperative evaluation and a minimum 2 years after the index meniscal repair procedure, patients were administered a subjective questionnaire. Differences in outcome scores, survivorship, and failure rates between the cohorts were assessed. Failure was defined as reoperation with meniscectomy or revision meniscal repair.

Results:

There were 109 patients (52 female, 57 male) who met the inclusion criteria for this study. There were 37 knees in cohort 1 (isolated meniscal repair plus MVP) and 72 knees in cohort 2 (meniscal repair plus ACL reconstruction). The failure status was known in 95 patients, and patient-reported outcome scores were obtained in 89 (82%) patients. Both cohorts demonstrated a significant improvement in all outcome scores, and there was no significant difference in any of the preoperative or postoperative outcome measures. The overall failure rate was 9.5% (9/95). There were 4 (12.9%) failures in cohort 1 and 5 failures (7.8%) in cohort 2, with no significant difference in failures between the cohorts ( P = .429). There was a significant association between failure and female sex ( P = .001).

Conclusion:

The most important finding in this study was that there was no difference in outcomes in meniscal repair performed with biological augmentation using an MVP versus that performed concomitantly with ACL reconstruction. The similar outcomes reported for meniscal repair with an MVP and meniscal repair with ACL reconstruction may be partly attributed to biological augmentation.
Defining the “Substantial Clinical Benefit” After Arthroscopic Treatment of Femoroacetabular Impingement
Authors: Nwachukwu Benedict U. , Chang Brenda , Fields Kara , Rebolledo Brian J. , Nawabi Danyal H. , Kelly Bryan T. , Ranawat Anil S.
Published: February 2017

Background:

The minimal clinically important difference (MCID) has been defined in orthopaedics and is the smallest change that a patient considers meaningful. Less is known about improvements that the patient perceives as clinically considerable, or the substantial clinical benefit (SCB). For the young, highly functioning patient cohort with femoroacetabular impingement (FAI), the SCB is an important measure of clinical success.

Purpose:

To derive the SCB for FAI treatment and identify outcome score thresholds and patient variables predictive of the SCB.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

The modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living (HOS-ADL) and sport (HOS-Sport) subscales, and the international Hip Outcome Tool (iHOT-33) were prospectively administered to 364 patients with a minimum 1-year follow-up. At 1 year postoperatively, patients graded their hip function based on several anchor responses such as “no change” and “much improved.” The SCB was defined as the change on each outcome tool that equated to the difference between “no change” and “much improved” on the health transition question. Receiver operating characteristic analysis with area under the curve (AUC) was used to identify optimal values that were most representative of the SCB. Multivariable analysis identified patient variables predictive of the SCB.

Results:

The net change in outcome scores corresponding to the SCB for the mHHS, HOS-ADL, HOS-Sport, and iHOT-33 was 19.8, 10.0, 29.9, and 24.5, respectively. The following postoperative outcome scores demonstrated excellent distinction (AUC >0.8) between “no change” and “much improved” and thus were considered absolute values for the postoperative SCB: 82.5 (mHHS), 93.3 (HOS-ADL), 84.4 (HOS-Sport), and 63.5 (iHOT-33). Preoperative scores on the HOS-ADL (83.3) and HOS-Sport (50.0) were significant threshold cutoffs, above which attaining the SCB became less likely. Younger age and lower Outerbridge grade were predictive of achieving the SCB.

Conclusion:

The SCB has not been previously defined in the hip preservation literature and is complementary to the MCID as the upper bound for clinically significant improvement. We identified predictive preoperative and diagnostic postoperative outcome scores for the SCB that can be used to manage patient expectations and grade outcomes. These findings are objective criteria for defining clinical success after arthroscopic FAI treatment.
Extrathymic production of thymulin induced by oxidative stress, heat shock, apoptosis, or necrosis
Authors: Lunin Sergey M , Khrenov Maxim O , Glushkova Olga V , Vinogradova Elena V , Yashin Valery A , Fesenko Evgeny E , Novoselova Elena G
Published: February 2017

Thymic peptides are immune regulators produced mainly in the thymus. However, thymic peptides such as thymosin-α and thymopoietin have precursors widely expressed outside the thymus, localized in cell nuclei, and involved in vital nuclear functions. In stress-related conditions, they can relocalize. We hypothesized that another thymic peptide, thymulin, could be similarly produced by non-thymic cells during stress and have a precursor therein. Non-thymic cells, including macrophages and fibroblasts, were exposed to oxidative stress, heat, apoptosis, or necrosis. Extracellular thymulin was identified in media of both cell types 2 h after exposure to stress or lethal signals. Therefore, thymulin is released by non-thymic cells. To examine possible thymulin precursors in non-thymic cells, macrophage lysates were analyzed by western blotting. Bands stained with anti-thymulin antibody were detected in two locations, approximately 60 kDa and 10 kDa, which may be a possible precursor and intermediate. All of the exposures except for heat were effective for induction of the 10 kDa protein. BLAST search using thymulin sequence identified SPATS2L, an intranucleolar stress-response protein with molecular weight of 62 kDa, containing thymulin-like sequence. Comparisons of blots stained with anti-thymulin and anti-SPATS2L antibodies indicate that SPATS2L may be a possible candidate for the precursor of thymulin.
Comparison of chitosan microsphere versus O-carboxymethyl chitosan microsphere for drug delivery systems
Authors: Zhou Gang , Zhang Jing , Tai Jun , Han Qianyi , Wang Lei , Wang Kunpeng , Wang Shengcai , Fan Yubo
Published: February 2017

The development of controlled drug delivery systems for bone regeneration, especially microspheres, has become a research hotspot in recent years. Chitosan and its derivative O-carboxymethyl chitosan have been considered to be an effective way for controlled drug delivery due to their nontoxicity and biodegradability. Currently, most of the studies have researched on synthesizing and characterizing chitosan and O-carboxymethyl chitosan. However, few studies have focused on the differences between chitosan microspheres and O-carboxymethyl chitosan microspheres directly. In this study, chitosan and O-carboxymethyl chitosan microspheres were developed by water-in-oil emulsification cross-linking method using vanillin as the cross-linking agent, and then their physicochemical properties were evaluated by Fourier transform infrared spectroscopy, scanning electron microscopy, and in vitro release testing. The results showed that O-carboxymethyl chitosan was successfully modified by adding carboxymethyl group at the chitosan C6 position.The particle size of chitosan microspheres (50–90 µm) was significantly larger than that of O-carboxymethyl chitosan microspheres (10–50 µm), and the drug release profile of O-carboxymethyl chitosan microspheres showed larger initial burst release within the first day and sustained release at the fourth day, while chitosan microspheres showed sustained release at the seventh day. In addition, Cell Counting Kit-8 assay showed that MC3T3-E1 proliferated well and highly expressed the alkaline phosphatase marker protein on both chitosan and O-carboxymethyl chitosan microspheres. Overall, both chitosan and O-carboxymethyl chitosan microspheres showed good biocompatibility, and chitosan microspheres were superior to O-carboxymethyl chitosan microspheres. Moreover, the different drug release rates suggest that chitosan and O-carboxymethyl chitosan microspheres have the potential to be used for the repair of different bone defects.
In vivo safety and efficacy of sericin/poly(vinyl alcohol)/glycerin scaffolds fabricated by freeze-drying and salt-leaching techniques for wound dressing applications
Authors: Ampawong Sumate , Aramwit Pornanong
Published: February 2017

In our previous works, two techniques (freeze-drying and salt-leaching) were introduced to fabricate the sericin/poly(vinyl alcohol)/glycerin scaffolds. The freeze-dried and salt-leached sericin/poly(vinyl alcohol)/glycerin scaffolds with the same composition showed distinguished physical and in vitro biological characteristics. In this study, the in vivo safety and efficacy tests of both scaffolds as dressing materials for the healing of full-thickness wounds in rat model were performed in comparison with the clinically used dressing, Allevyn®. In the safety test, the scaffolds were implanted subcutaneously, and the signs of tissue irritation including the extent of inflammatory cells, calcification, vascularization, and fatty infiltration were scored. In the efficacy test, the scaffolds were applied to the full-thickness wound (1.5 cm × 1.5 cm), and the epithelialization and collagen formation in the wound were evaluated. Both freeze-dried and salt-leached scaffolds were characterized as non- to slightly irritant implantable materials. The freeze-dried scaffold minimally causes irritation to the tissue possibly because it was derived from the non-chemical relevant process. Furthermore, the freeze-dried scaffold showed the highest wound healing efficiency as characterized by the fastest epithelialization and highest extent of collagen formation. This might be due to the more sustained release of sericin from the freeze-dried scaffold, compared to that of the salt-leached scaffold. Therefore, fabrication process seemed to directly regulate the properties and applicability of the scaffolds. The safety and efficacy of the dressing materials in wound healing application depended not only on the materials themselves but also on the fabrication process that produces them.
Urban Public Transport
Authors: McLeod Sam , Scheurer Jan , Curtis Carey
Published: February 2017

This article reviews the literature on current “best practice” principles for planning public transport (PT) networks within the context of planners seeking to transition their cities toward sustainable mobility. An overview is provided of the history of ideas about network development. The emerging frontiers for multimodal, demand-responsive PT and the potential implications of new transport technology on traditional PT are discussed. The future role of transit-oriented development within PT network structures is considered. The “moderators” to network design that may impede future best practice brings the article to conclusion.
Local Geographies of Digital Inequality
Authors: Blank Grant , Graham Mark , Calvino Claudio
Published: February 2017

Combining data from a sample survey, the 2013 Oxford Internet Survey, with the 2011 UK Census, we employ small area estimation to estimate Internet use in small geographies in Britain. This is the first attempt to estimate Internet use at any small-scale level. Doing so allows us to understand the local geographies of British Internet use, showing that the area with least use is in the North East, followed by central Wales. The highest Internet use is in London and southeastern England. The most interesting finding is that after controlling for demographic variables, geographic differences become nonsignificant. The apparent geographic differences appear to be due to differences in demographic characteristics. We conclude by considering the policy implications of this fact.
Conflict on the Red River: Applying the institutional collective action framework to regional flood policy
Authors: Bauroth Nicholas G
Published: February 2017

In reaction to major flooding, local governments in Minnesota and North Dakota formed a cooperative network to construct a $1.2 billion flood diversion along the Red River of the North. Threatened by this diversion, a second set of governments formed their own network in opposition to flood policy. This study uses propositions derived from the Institutional Collective Action framework to examine formal contracts at the core of these cooperative networks, as well as the circumstances under which the contracts were negotiated. It considers the ability of the framework to understand interlocal cooperation where regional consensus is nonexistent. The study finds that the two sets of governments faced very different transaction costs, resulting in contrasting approaches to governance.
Electrochemical micromachining: Review of factors affecting the process applicability in micro-manufacturing
Authors: Leese Rebecca , Ivanov Atanas
Published: February 2017

Electrochemical machining is a non-conventional machining technique used across a large range of industries from aero to medical. A large number of papers exist on the topic of electrochemical machining and electrochemical micromachining which is a daunting task to evaluate for anyone new to the subject. This article aims to summarise some of the major parameters used in electrochemical machining which affect machining accuracy, machining rate and the suitability of the process for micromachining. This article does not propose to be in any way complete but a starting point for anyone new to the subject of electrochemical machining. This article aims to find new areas to study within the electrochemical micromachining field.
An improved high-order statistical moment method for structural reliability analysis with insufficient data
Authors: Zhang Tianxiao , He David
Published: February 2017

The fourth-order moment method for reliability analysis of structural systems can be practically applied to effectively address the problem of reliability calculation and analysis with insufficient probability data. For complicated reliability analysis problems, however, this method can lead to inaccurate and unstable reliability calculation results. In this paper, an improved high-order statistical moment method for structural reliability analysis with insufficient data is presented. The presented method is inferred using the properties of statistical moment of standard normal distribution parameter and therefore is possible to obtain more stable and accurate calculation of the reliability indexes of a structural system with insufficient probability data. Two numerical examples are provided to show the performance of the presented method. The example results have shown that the method proposed in this paper not only improves the calculation accuracy and stability, but also brings the calculation results closer to the project conditions. The developed high-moment method for reliability calculation of structural systems provides a practical and effective theoretical base and technical support for the reliability design of structural systems.
Contact and bending fatigue behaviour of austempered ductile iron gears
Authors: Gorla Carlo , Conrado Edoardo , Rosa Francesco , Concli Franco
Published: February 2017

In the present paper a research programme aimed at investigating both the bending and contact fatigue properties of an austempered ductile iron applied to gears is presented, in order to determine reliable values of the limits, which take into account the influence of the production process, to be applied in the design of gearboxes. The bending fatigue tests are performed according to the single tooth fatigue approach and the pitting tests are performed with a back-to-back rig. Metallurgical analysis is performed on the failed specimens, in order to understand the origin and the propagation of the failures and to appreciate the influence of the micro-structure on the performances obtained.
Impact of nonlinear thermal radiation on stagnation-point flow of a Carreau nanofluid past a nonlinear stretching sheet with binary chemical reaction and activation energy
Authors: Zaib A , Rashidi MM , Chamkha AJ , Mohammad NF
Published: February 2017

This research peruses the characteristics of nanoparticles on stagnation point flow of a generalized Newtonian Carreau fluid past a nonlinear stretching sheet with nonlinear thermal radiation. The process of mass transfer is modeled using activation energy and binary chemical reaction along with the Brownian motion and thermophoresis. For energy activation a modified Arrhenius function is invoked. With regard to the solution of the governing differential equations, suitable transformation variables are used to obtain the system of nonlinear ordinary differential equations before being numerically solved using the shooting method. Graphical results are shown in order to scrutinize the behavior of pertinent parameters on velocity, temperature profiles, and concentration of nanoparticle. Also, the behavior of fluid flow is investigated through the coefficient of the skin friction, Nusselt number, Sherwood number, and streamlines. Results showed that the velocity ratio parameter serves to increase the velocity of fluid and reduces the temperature distribution and nanoparticle concentration. The results were compared with the available studies and were found to be in excellent agreement.
Characterisation and optimisation of a real-time diesel engine model
Authors: Dowell Peter G , Akehurst Sam , Burke Richard D
Published: February 2017

Accurate real-time engine models are an essential step to allow the development of control algorithms in parallel to the development of engine hardware using hardware-in-the-loop applications. A physics-based model of the engine high-pressure air path and combustion chamber is presented. The model was parameterised using data from a small set of carefully selected operating conditions for a 2.0 l diesel engine. The model was subsequently validated over the complete engine operating map with exhaust gas recirculation and without exhaust gas recirculation. A high level of fit was achieved with R2 values above 0.94 for the mean effective pressure and above 0.99 for the air flow rate. The model run time was then reduced for real-time application by using forward differencing and single-precision floating-point numbers and by calculating the in-cylinder prediction for only a single cylinder. A further improvement of 25% in the run time was achieved by improving the submodels, including the strategic use of one-dimensional and two-dimensional look-up tables with optimised resolution. The model exceeds the performance of similar models in the literature, achieving a crank angle resolution of 0.5° at 4000 r/min. This simulation step size still yields good accuracy in comparison with a crank angle resolution of 0.1° and was validated against the experimental results from a New European Driving Cycle. The real-time model allows the development of control strategies before the engine hardware is available, meaning that more time can be spent to ensure that the engine can meet the performance and the emissions requirements over its full operating range.
‘Shrouded in a dark fog’: comparison of the diagnosis of pellagra in Venice and general paralysis of the insane in the United Kingdom, 1840–1900
Authors: Priani Egidio
Published: February 2017

The debate on the causes and the nature of pellagra in Italy during the nineteenth century resembles and evokes the similar debate on General Paralysis of the Insane (GPI) that was growing at the same time in the United Kingdom. Pellagra and GPI had a massive and virulent impact on the populations of Italy and the UK, respectively, and contributed to a great extent to the increase and overcrowding of the asylum populations in these countries. This article compares the two illnesses by examining the features of their nosographic positioning, aetiology and pathogenesis. It also documents how doctors arrived at the diagnoses of the two diseases and how this affected their treatment.
Central nervous system vasculitis in systemic lupus erythematosus: a case series report in a tertiary referral centre
Authors: Rodrigues M , Galego O , Costa C , Jesus D , Carvalho P , Santiago M , Malcata A , Inês L
Published: February 2017

Central nervous system (CNS) vasculitis (CNS) in systemic erythematosus lupus (SLE) is a rare and challenging diagnosis. We report four cases of CNS vasculitis that occurred 5 to 16 years after the diagnosis of SLE. Magnetic resonance imaging (MRI) detected different features suggestive of CNS vasculitis: enhancement and thickening of the vascular wall, vascular stenosis, ischemic brain lesions and intracerebral haemorrhage unlikely to correspond to other mimic aetiologies. Three patients received combination therapy with glucocorticoids (GC) and cyclophosphamide (CYC). Intravenous human immunoglobulin (IVIG) was administered when the patient had a past history of serious adverse event to CYC or high infectious risk. All patients showed imagiological improvement, at least partially, 5 to 23 days after starting treatment. We discuss the management of CNS in SLE including the role of magnetic resonance imaging (MRI).
Clinico-pathological features of repeat renal biopsies in patients with lupus nephritis at Groote Schuur Hospital, Cape Town
Authors: Kajawo S , Botha F C J , Okpechi I G
Published: February 2017

Background

Repeat renal biopsies in patients with lupus nephritis are usually done to guide treatment or to establish disease chronicity. Their value is not clear from available literature. There are also no available data in Africa to guide clinicians.

Methods

This was a retrospective study of patients undergoing a repeat renal biopsy between January 2003 and December 2014 from a single centre in Cape Town, South Africa. Relevant demographic, clinical and histological records of patients with repeat renal biopsies were documented. Comparison of data from first and second renal biopsy was performed.

Results

Forty-four patients had at least two biopsies done during the study period. Most patients were females (81.8%). The mean biopsy interval was 2.8 ± 1.8 (range 0.38–9.4) years. Proteinuria was the main indication for the repeat biopsy (36.1%). The glomerular filtration rate and proteinuria worsened between the two biopsies ( p = 0.001 and 0.019, respectively) suggesting disease progression. Most patients (65.4%) with a non-proliferative class of lupus nephritis at first biopsy progressed into a proliferative class, whereas patients with initial proliferative lupus nephritis at first biopsy (77.8%) remained as proliferative at repeat biopsy. Treatment was changed in 85% of patients at second biopsy.

Conclusion

Repeat renal biopsies in patients with lupus nephritis presents a useful means of assessing disease progression and provides guidance regarding modification of treatment. More studies are, however, required to evaluate the value of repeat biopsies and perhaps the need for protocol renal biopsies in patients with lupus nephritis.
Quantitative imaging biomarkers: Effect of sample size and bias on confidence interval coverage
Authors: Obuchowski Nancy A , Bullen Jennifer
Published: February 2017

Introduction

Quantitative imaging biomarkers (QIBs) are being increasingly used in medical practice and clinical trials. An essential first step in the adoption of a quantitative imaging biomarker is the characterization of its technical performance, i.e. precision and bias, through one or more performance studies. Then, given the technical performance, a confidence interval for a new patient’s true biomarker value can be constructed. Estimating bias and precision can be problematic because rarely are both estimated in the same study, precision studies are usually quite small, and bias cannot be measured when there is no reference standard.

Methods

A Monte Carlo simulation study was conducted to assess factors affecting nominal coverage of confidence intervals for a new patient’s quantitative imaging biomarker measurement and for change in the quantitative imaging biomarker over time. Factors considered include sample size for estimating bias and precision, effect of fixed and non-proportional bias, clustered data, and absence of a reference standard.

Results

Technical performance studies of a quantitative imaging biomarker should include at least 35 test–retest subjects to estimate precision and 65 cases to estimate bias. Confidence intervals for a new patient’s quantitative imaging biomarker measurement constructed under the no-bias assumption provide nominal coverage as long as the fixed bias is <12%. For confidence intervals of the true change over time, linearity must hold and the slope of the regression of the measurements vs. true values should be between 0.95 and 1.05. The regression slope can be assessed adequately as long as fixed multiples of the measurand can be generated. Even small non-proportional bias greatly reduces confidence interval coverage. Multiple lesions in the same subject can be treated as independent when estimating precision.

Conclusion

Technical performance studies of quantitative imaging biomarkers require moderate sample sizes in order to provide robust estimates of bias and precision for constructing confidence intervals for new patients. Assumptions of linearity and non-proportional bias should be assessed thoroughly.
Performance Evaluation of Healthcare Systems
Authors: K.R. Sinimole
Published: February 2017

Recognizing the importance of health in the process of economic and social development and for improving the quality of life of the citizens, the Government of India launched the National Rural Health Mission (NRHM). Under the decentralization scheme of NRHM, the district was supposed to be the hub around which all health and family welfare services were to be planned and managed. Therefore, it is important to understand the performance of each district with respect to the implementation of NRHM. Moreover, one of the objectives of NRHM is to reduce infant mortality and to increase access to immunization and nutrition programmes. Given the wide scope of the Mission and multiplicity of activities, it is important to carry out its appraisal with an objective of evaluating the performance of districts in terms of their immunization coverage among rural population. Hence, this study aims at understanding the efficiency of health system in Kerala by evaluating the performance of each district in Kerala.
Determinants of Health among Senior Citizens
Authors: Tyagi Renu , Paltasingh Tattwamasi
Published: February 2017

As age advances, the elderly develop vulnerability to illness resulting in more health problems. Such issues are further influenced by several socio-economic factors like gender, education, geographical location, living arrangements etc. Health of the senior citizens is considered to be an important public health issue which requires serious attention. Main objective of this paper is to study the health profile of the senior citizens and related risk factors influencing their health. This study was conducted in different areas of Ahmedabad district in Gujarat with selected samples. Both elderly men and women were interviewed. Findings of the study have reflected the impacts of various socio-economic characteristics that affect the lifestyle and health of the elderly. The influence on the morbidity trend is found to be often diverse for gender, age groups and other socio-economic variables.
Implementing Quality Healthcare Strategies for Improving Service Delivery at Private Hospitals in India
Authors: Agarwal Varsha , L. Ganesh
Published: February 2017

Healthcare is becoming the largest growing sector of India because of its huge coverage, providing services and investment by public and private players. In India growth of private hospitals have totally changed the scenario of health care delivery. This study explores the effectiveness of the strategies to provide quality health care and thereby improving the service delivery in Private Hospitals. In total 122 responses were collected after administering the questionnaires. The findings of this study reveals that quality health care strategies has positive impact on service delivery. Quality health care strategies showed a different kind of associations with three measures of quality namely structure, process and outcome measures. The implications from the study provides the need of multifaceted approach for implementing quality improvement strategies and adoption of the model for the same. This study recommends a blend of quality improvement programs with increased ICT (Information and Communication Technology) applications for enhancing the turnaround time. Further study can be conducted on other healthcare quality dimensions and strategic interventions that can enhance the quality of health care and clinical outcomes in Private Hospitals in India.
Perception towards Regular Health Check-ups
Authors: Rath Badri Narayan , Deb Amrita
Published: February 2017

The aim of this case study is to explore the perception of the rural people for regular health check-ups. A survey was conducted in 500 households in a village in Telangana in March 2012 to get an overview about the inhabitants’ health and their willingness to go for regular check-ups. Since majority of the respondents reported not visiting doctors or hospitals regularly, the key determinants for avoidance of such health check-ups was examined. The objective was to discover factors that may be addressed in future when healthcare facilities would be made available to these villages. The major determinants for avoidance of regular health check-ups were estimated through a logit model. The health locus of control index was constructed using five questions related to attitude and perception on regular health check-up. The results indicate that demographic factors like gender and age, economic factors such as family income and family health expenditure, distance, cost of availing a doctor and health locus of control are the key determinants for avoiding regular health check-up in rural India. However, due to increasing awareness among the rural population over the years, majority of the respondents are willing to pay a minimal amount of money and ready to use the electronic device which can monitor their health.