bluuebunny/crossref_metadata_2025 huggingface dataset:
A ten-year review of chronic cor pulmonale secondary to respiratory diseases in Ghana
Authors: Oduro-Boatey Collins , Adzosii Della
Published: June 2017

Chronic cor pulmonale is defined as right ventricular failure secondary to pulmonary hypertension. Our study reviewed all cases of chronic cor pulmonale secondary to respiratory diseases in a ten-year period (2004–20014) in the Department of Child Health, Korle-Bu Teaching Hospital, Ghana. Nine cases of chronic cor pulmonale were recorded during the period. The age range was 1–9 years (average age = 3 years). Obstructive sleep apnoea secondary to adenoid hypertrophy was the commonest cause of pulmonary hypertension.
Microstructural investigation of gas shale in Longmaxi Formation, Lower Silurian, NE Sichuan Basin, China
Authors: Sun Shasha , Liang Feng , Tang Ligen , Wu Jin , Ma Chao
Published: June 2017

The purpose of this paper is to probe into the nature and variability in vertical microstructure within Longmaxi gas shales of well WX2, Lower Silurian, located in the NE Sichuan Basin of China. To understand the pore system of these rocks, the total porosity, pore size distribution (PSD), surface area, organic geochemistry, and mineralogy, some image analyses by electron microscopy are performed. The obtained results indicated the following. (1) Gas shales have a complex pore structure. Total porosity from helium pycnometry ranges between 0.75% and 4.62%. Total organic content ranges between 3.4 wt.% and 11 wt.%, and vitrinite reflectance measured between 2.5% and 3.1%. The gas shales are quartz and clay rich. (2) Focused ion beam milling and field emission scanning electron microscopy provide high-resolution images of pores distribution and types. Three primary types of pores, organic matter (OM)-hosted pores, mineral-hosted pores, and micro-fractures, and 11 subgroups have been recognized. (3) The N2 isotherm curves are grouped into two types, II b as well as IV a, with the hysteresis loop belonging to Type B, reflecting the morphology of slits pores, and Type A, presenting cylinder pores. Combination of N2 and CO2 isotherm curve shows bimodal in two diameter sections, 0.3–1 nm and 2–5 nm, revealing meso-pores play important role in pore volume, whereas the micro-pores have great influence on pore specific surface area. (4) Total organic carbon (TOC) is considered to be the dominant contributor to total porosity and pore types, with the proportion of OM-hosted pores following the upward decreasing tendency of TOC. In plane, pore types are controlled by sedimentary facies. The OM-hosted pores are more prevalent in deep shelf facies within lower part of shale other than upper formation, instead of shallow shelf facies.
Study of factors affecting shale gas adsorption by simplified local density-Peng–Robinson method
Authors: Guo Wei , Zuo Luo , Yu Rongze , Zhang Xiaowei , Wang Li
Published: June 2017

Shale gas has become an important source of natural gas, and a significant portion of gas in the reservoir exists in an adsorbed state. Thus, knowledge of gas adsorption behavior is important to estimate original gas in place and shale gas production. In this paper, shale gas adsorption affecting factors which include temperature, pressure, pore type, and diameters were studied quantitatively and systematically using simplified local density model. It was found that the main affecting factors were temperature, pore type, diameter, and pressure; type I kerogen has the lowest and type III kerogen has the largest excess adsorption gas capacity; due to the interaction energy between gas molecules and pore wall molecules, gas has the highest local density near the pore wall and the lowest density in the middle of the pore under a certain pressure and temperature; the increment of gas density as temperature decreases near the pore wall is significant, but the bulk methane gas density shows a very small change due to temperature change; the ratio of excess adsorption gas to free gas declines and its rate slows down as pressure increases; when the pore diameter increased from 1.5 to 5 nm, the ratio of excess adsorption gas to the total gas amount decreases rapidly; the excess adsorption gas of type III kerogen takes up 89% of the total gas amount with diameter of 1.5 nm and takes 70% of the total gas amount with diameter increases to 5 nm; the excess adsorption gas of type I kerogen takes 71% of the total gas amount with diameter of 1.5 nm and takes up 43% of the total gas amount with diameter increases to 5 nm. Local gas density in different kinds of pores under different conditions also provided a way to calculate gas transport in pores that take adsorption gas into consideration.
Tetralogy of Fallot, left ventricular clot, aortic dissection: rare association
Authors: Jariwala Pankaj , Kale Satya Sridhar , Sepur Lakshmana , Padma Kumar Edla Arjun
Published: June 2017

Cases of uncorrected adult tetralogy of Fallot are rare and mostly manifest secondary to complications. A 30-year-old man presented with progressive breathlessness and severe chest discomfort. Echocardiography revealed tetralogy of Fallot with a left ventricular apical clot and DeBakey type I dissection of the aorta. The patient underwent successful surgical correction. The combination of preoperative complications in the setting of uncorrected tetralogy of Fallot, such as a left ventricular clot and DeBakey type I dissection of the aorta, is very rare.
Microvascular fluid exchange during CPB with deep hypothermia circulatory arrest or low flow
Authors: Elvevoll Bjørg , Husby Paul , Kvalheim Venny L. , Stangeland Lodve , Mongstad Arve , Svendsen Øyvind S.
Published: June 2017

Objective:

Use of deep hypothermic low-flow (DHLF) cardiopulmonary bypass (CPB) has been associated with higher fluid loading than the use of deep hypothermia circulatory arrest (DHCA). We evaluated whether these perfusion strategies influenced fluid extravasation rates and edema generation differently per-operatively.

Materials and Methods:

Twelve anesthetized pigs, randomly allocated to DHLF (n = 6) or DHCA (n = 6), underwent 2.5 hours CPB with cooling to 20°C for 30 minutes (min), followed by 30 min arrested circulation (DHCA) or 30 min low-flow circulation (DHLF) before 90 min rewarming to normothermia. Perfusion of tissues, fluid requirements, plasma volumes, colloid osmotic pressures and total tissue water contents were recorded and fluid extravasation rates calculated. During the experiments, cerebral microdialysis was performed in both groups.

Results:

Microvascular fluid homeostasis was similar in both groups, with no between-group differences, reflected by similar fluid extravasation rates, plasma colloid osmotic pressures and total tissue water contents. Although extravasation rates increased dramatically from 0.10 (0.11) ml/kg/min (mean with standard deviation in parentheses) and 0.16 (0.02) ml/kg/min to 1.28 (0.58) ml/kg/min and 1.06 (0.41) ml/kg/min (DHCA and DHLF, respectively) after the initiation of CPB, fluid filtrations during both cardiac arrest and low flow were modest and close to baseline values. Cerebral microdialysis indicated anaerobic metabolism and ischemic brain injury in the DHCA group.

Conclusion:

No differences in microvascular fluid exchange could be demonstrated as a direct effect of DHCA compared with DHLF. Thirty minutes of DHCA was associated with anaerobic cerebral metabolism and possible brain injury.
Changing leadership in peripheral city region development: The case of Liverpool’s high technology sectors
Authors: Anderton Dane
Published: June 2017

This article examines the effects of changing place leadership when developing knowledge-intensive industries in a peripheral city region. This study examined the video games and life sciences industries in Liverpool City Region. Both have an established presence in the city region and are key to the city region’s knowledge economy strategy. Few studies have examined why different types of regions experience diverse path-dependent development. By tracing the two high technology sectors back to their conception it has become apparent that the most significant developments have been between 2005 and 2015. During this period, the city region saw increased public intervention and underwent institutional change. The analysis highlights that the public and institutional leadership in the city region prior to 2010 managed to reinvigorate the industrial base and increase R&D capacity in the high technology sectors and develop institutional assets to sustain growth in the region. The change in leadership post-2010 highlighted the life science industries dependence on public leadership and support, compared with the video games industry. There are still issues within the city region’s labour market and concerns around the underdevelopment of soft infrastructures post-2010. If these sectors are to be resilient, policymakers need to improve the transition between leaders in regional development so that best practices and soft infrastructures are inherited, maintained or improved. Additionally, policymakers should also plan for the long-term engagement required when developing high technology sectors such as life sciences in peripheral city regions, where pathways to market carry uncertainty and demand for a highly qualified labour market is increased. The evidence is derived from 58 primary qualitative interviews with firms’ owner-managers and supporting institutions at a local and national scale. Secondary data both qualitative and quantitative have also been used to supplement the analysis and inform the broader context.
Climate policy and leadership in a metropolitan region: Cases from the United States
Authors: Bartling Hugh
Published: June 2017

In the absence of a cohesive national approach to address climate change, the burden of climate policy making has been borne by subnational governments in the United States. This article discusses the conditions and initiatives that contributed to the ways in which local municipalities have become important centres for climate policy making in the United States and explores the challenges and opportunities for planning for climate change at the local and regional level in this policy context. In particular, the article focuses on the role of leadership in regions for contributing the necessary political support for policy action and the technical capacities needed for carbon accounting. The article focuses on two case studies in the midwestern region of the United States and discusses the differences in bureaucratic commitment to climate policy, the roles of various entities from the non-governmental sector and the important role of citizen activism in advocating for robust climate policy. While leadership in the governmental and civil society sectors is important for agenda setting and carbon accounting for local policy-makers, minimal intra-regional planning and regulatory power over key utility provision can limit climate action. The article concludes with a critical assessment of the efficacy of local climate planning in the United States.
Place leadership and the social contract: Re-examining local leadership in the East Midlands
Authors: Quinn Martin
Published: June 2017

This paper uses Social Contract Theory to (re) examine attempts to establish leadership roles in the East Midlands, Corby, Leicestershire and Northamptonshire between 1998 and 2015. In doing so, it makes a unique contribution to the study of place leadership by drawing on classical political theory to explore a contemporary issue in regional debate. To do this, the paper explores three stages of leadership development in the East Midlands of England, cutting across scale and place to argue that in order to establish and embed a contract with the locality leaders must take into account both the territorial and relational characteristics of their place. Where the territory had little cohesion, or did not cover a single area of economic functionality it was difficult to establish, or justify, leadership roles in those territories. In areas of economic functionality leadership required the involvement of the Local Government to demonstrate the legitimacy of the contract on offer.
Non-profit leadership at local level: Reflections from Central and Eastern Europe
Authors: Potluka Oto , Kalman Judit , Musiałkowska Ida , Idczak Piotr
Published: June 2017

Successful leadership in local development requires not only a vision, but good communication skills, stakeholder involvement, strategic planning and coordination and popular support via public participation. Our empirical study contributes to filling the gap in the literature about the role of non-profit leadership in urban and regional development. We study the characteristics of politicians in civil society and that of civil society’s leaders in politics as a prerequisite for successful local development. For this, we draw on the survey data of 374 local politicians from four large cities in Central Europe: Prague, Bratislava, Budapest and Poznań. The research affirms that non-profit non-governmental organisations do play an important role in local development and reveals similarities in all analysed cities, though with some variance. Local political elites are identified as engaging significantly in civil society organisations, despite low levels of general trust in these countries. About two-thirds of the local politicians who took part in the survey participate actively in civil society organisations in their respective cities but not coming from a previous non-profit non-governmental organisation employment. Not only are they active, but many of them also have positions as managers or directors, or as members of the board of directors in these organisations. Although neither membership nor leadership in non-profit non-governmental organisations appears to increase a local politician’s chance of being elected, except when those are engaged in local development or environmental issues. As spatial leadership plays an important role in the construction of new agendas and identities we have also investigated the views of local politicians on decentralisation, government service provision efficiency and the importance of several local policy topics, and found some puzzling differences across our V4 cities that possibly reflect cultural differences. Non-profit leadership in urban development is a neglected topic so far in the literature, our study adds empirical results from Central and Eastern Europe, yet there is ample room for future research.
How can urban and local leadership teams navigate the impending international relations revolution? A practitioner viewpoint
Authors: Marlow David
Published: June 2017

The practice of cities and regions nurturing external and international relations has been part of their roles and functions literally for millennia. More than ever, in an era of globalisation, international breakdown and dysfunction, local leaders need to look outward, identify their localities' international opportunities and challenges, and put in place measures to address them. This viewpoint is based on a briefing the author produced for LGIU (Local Government Information Unit -a think tank owned by UK local authority members) in November 2016. It outlines the case for UK LAs, with neighbours and partners as appropriate, to recognise the importance of a coherent approach to international affairs through the BREXIT negotiation period and beyond. It suggests a framework for formulating this approach, and draws on some examples of internationalisation that are already established and operating. It also suggests opportunities for local government as a sector to influence Government’s priorities and approach. This may be better promoted across relevant LA associations, with partners (e.g. LEPs, universities, NGOs, etc.) and at UK as well as individual nation level.
Integration of Action and Size Perception Through Practice
Authors: Coutte Alexandre , Camus Thomas , Heurley Loïc , Brouillet Denis
Published: June 2017

Size perception is known to influence our usual interactions with environment. Numerous studies highlighted that during the visual presentation of an object, the properties of manual actions vary as a function of this object’s size. In order to better understand the dynamic variations of relationships between size perception and action, we used an experimental paradigm consisting in two phases. During a previous implicit learning phase, a manual response (right or left) was specifically associated with the appearance of a large or small stimulus. During further test phase, participants were required to prepare a response while discriminating the color of a stimulus (GO/No GO task). We observed that the response execution was faster when the size of the stimulus was congruent with the size that had been associated to this response (during implicit learning phase). These results suggest that when a response usually co-occurs with visual stimuli characterized by a specific size pattern, the response and the size pattern become integrated. Any subsequent preparation and execution of this action are therefore influenced by the reactivation of this visual pattern. This result brings out new insights on how sensorimotor interactions may modulate the ability to anticipate perceptive size variations in the environment.
Motivation in mechanics of materials classes: An experimental approach
Authors: Lopes Figueiredo da Silva Hugo Miguel Andrade , Costa Manuel João , de Meireles José Filipe Bizarro
Published: June 2017

This work presents a novel didactic methodology for the approximation of the students to the subject of Mechanics of Materials, with the aim of improving the understanding of the inertia moment, and its relevance on the mechanical behaviour of structures. The students have grouped on groups of two to three persons. The work consisted in designing the most efficient beam having in mind several design constraints. Tensile tests were performed to determine the relevant material properties. Those were used for the analytic dimensioning of the beams. The aim of the work is to obtain the highest efficiency possible, since it results in the best mark, as possible. The efficiency was measured by the maximum load on experimental bending testing, divided by the mass of the beam. The results, as well as the interest of the methodology are discussed. It is proved that this methodology can be useful for the students to apply theoretical concepts and, at the same time, to give a deeper understanding of real experimental tests.
A mathematically assisted methodology for the experimental calculation of the internal gear ratios to extend the lifecycle of a hobbing machine
Authors: Sakaridis Emmanouil S , Ntourmas Georgios D , Athanasopoulos Stavros D , Markopoulos Angelos P
Published: June 2017

Manufacturing of gears can be achieved with various methods, including the cutting of gears in a hobbing machine. The function of such a machine tool is based on a combination of timing gears which synchronize all moving components accurately. Variations in the synchronization, which alter the geometric features of the gear being cut, are achieved via external gearboxes with interchangeable gears. Thus, precise knowledge of the change gears that correspond to the desired gear geometry is essential in order to operate the machine tool properly. The hobbing machine examined in this paper had remained unused for years, without a manual to indicate the correct use of the external gearboxes. The task was to render the machine tool functional by devising an experimental procedure for the calculation of the internal gear ratios and the correct combination of change gears, making use only of simple tools. The project was carried out successfully and proved to be an excellent case study to delve into the manufacturing as well as the use of gears. The documentation of the whole procedure and a short explanatory video are integrated within the educational aids of a relative course in the School of Mechanical Engineering of the National Technical University of Athens.
A novel virtual simulation teaching system for numerically controlled machining
Authors: Li Yongxiang , Zhang Dan , Guo Haixia , Shen Jiayi
Published: June 2017

With the progress and development of education, teaching by means of computer becomes more and more popular. In this article, a novel virtual simulation system teaching method is presented for numerically controlled engineering training as it helps students acquire the theoretical knowledge, practical skills, and the problem troubleshooting techniques on the usage of numerically controlled machines and programming. The architecture underlying theoretical basis for numerically controlled teaching system based on virtual machining technology is described. Furthermore, we have designed a study to explore the project’s impact on students. The study is based on an experimental approach to evaluate the impact of virtual simulation system teaching on student results during the first year, and then the questionnaire surveys were performed to analyze students’ perception of the impact that virtual simulation system teaching had on the students’ learning efficacy and level of motivation during the development of numerically controlled machining course. The final results show that the proposed teaching system for numerically controlled machining in the paper has been proved effective and feasible in practical application.
Austerity urbanism in England: The ‘regressive redistribution’ of local government services and the impact on the poor and marginalised
Authors: Hastings Annette , Bailey Nick , Bramley Glen , Gannon Maria
Published: June 2017

That contemporary austerity is being realised to a large extent in and through cities is a growing theme in urban scholarship. Similarly, the concern that the economically marginalised are disproportionately impacted as ‘austerity urbanism’ takes hold drives a significant body of research. While it is clear that substantial austerity cuts are being downloaded onto cities and their governments, the evidence on whether it is the most disadvantaged fractions of the urban population which suffer as a consequence remains thin. Moreover, the mechanisms by which the downloading to the poor occurs are unclear. This paper identifies how austerity cuts are transmitted to the poor and marginalised in the context of severe cuts to the spending power of English local government. It identifies three transmission mechanisms and shows how these operate and with what outcomes, drawing on empirical evidence at the English national and local city levels. The paper provides robust evidence from national data sources and from in-depth, mixed-method case studies to show that the effects of austerity urbanism are borne most heavily by those who are already disadvantaged. It also demonstrates the importance of identifying the specific mechanisms by which downloading on to the poor occurs in particular national contexts, and how this contributes to understanding, and potentially resisting, the regressive logic of austerity urbanism.
Reducing Stigma in Media Professionals: Is there Room for Improvement? Results from a Systematic Review
Authors: Maiorano Alessandra , Lasalvia Antonio , Sampogna Gaia , Pocai Benedetta , Ruggeri Mirella , Henderson Claire
Published: June 2017

Objective:

The mass media may increase stigma against people with mental health problems by reinforcing common stereotypes. Media professionals thus represent a target group for antistigma interventions. This paper aims to review available literature on antistigma interventions for mass media professionals, seeking to clarify what kind of interventions have been found to be effective in reducing mental health stigma among mass media professionals.

Method:

Six electronic databases (MEDLINE, PsycINFO, Embase, Cochrane Reviews Library and Cochrane Central Register of Controlled Trials, Web of Science, and Applied Social Sciences Index & Abstracts) were systematically searched through March 2017 for studies addressing antistigma interventions on mass media professionals. 

Results:

A total of 27 studies on antistigma interventions targeted to media professionals were found. Reviewed articles were classified into 3 categories: media-monitoring projects/reporting guidelines ( n = 23), interventions for educating journalists ( n = 2), and interventions for educating journalism students ( n = 2). Overall, antistigma interventions for media professionals seem to have some effect in improving reporting style, thus providing a more balanced portrayal of people with mental health problems: the most promising interventions are contact-based educational approaches and the provision of guidelines by authoritative institutions.

Conclusion:

It should be useful to promote and disseminate contact-based educational interventions targeted to journalists and to include specific modules on mental health topics in the training curricula of journalism students. However, as research in the field suffers from several limitations, high-quality studies exploring the long-term effect of antistigma interventions for media professionals are needed.
Sol–gel derived lithium-releasing glass for cartilage regeneration
Authors: Li Siwei , Maçon Anthony LB , Jacquemin Manon , Stevens Molly M , Jones Julian R
Published: June 2017

Wnt-signalling cascade is one of the crucial pathways involved in the development and homeostasis of cartilage. Influencing this pathway can potentially contribute to improved cartilage repair or regeneration. One key molecular regulator of the Wnt pathway is the glycogen synthase kinase-3 enzyme, the inhibition of which allows initiation of the signalling pathway. This study aims to utilise a binary SiO2–Li2O sol–gel derived glass for controlled delivery of lithium, a known glycogen synthase kinase-3 antagonist. The effect of the dissolution products of the glass on chondrogenic differentiation in an in vitro 3D pellet culture model is reported. Dissolution products that contained 5 mM lithium and 3.5 mM silicon were capable of inducing chondrogenic differentiation and hyaline cartilaginous matrix formation without the presence of growth factors such as TGF-β3. The results suggest that sol–gel derived glass has the potential to be used as a delivery vehicle for therapeutic lithium ions in cartilage regeneration applications.
Preparation and in vivo evaluation of a silicate-based composite bone cement
Authors: Ma Bing , Huan Zhiguang , Xu Chen , Ma Nan , Zhu Haibo , Zhong Jipin , Chang Jiang
Published: June 2017

Silicate-based cements have been developed as a class of bioactive and biodegradable bone cements owing to their good in vitro bioactivity and ability to dissolve in a simulated body fluid. Until recently, however, the in vivo evidence of their ability to support bone regeneration is still scarce. In the present study, a pilot in vivo evaluation of a silicate-based composite bone cement (CSC) was carried out in a rabbit femur defect model. The cement was composed of tricalcium silicate, 45S5 bioglass and calcium sulfate, and the self-setting properties of the material were established. The in vivo bone integration and biodegradability of CSC were investigated and compared with those of bioactive glass particulates, and a calcium phosphate cement. The results showed that CSC underwent a relatively slower in vivo degradation as compared with bioactive glass and calcium phosphate cement. Histological observation demonstrated that bone contact area at the interface between the surrounding bone and CSC gradually increased with time proceeding. CSC kept its structural integrity during implantation in vivo because of its acceptable mechanical strength. These results provide evidence of effectiveness in vivo and suggest potential clinical applications of the silicate-based composite bone cements.
A versatile method for bladder segmentation in computed tomography two-dimensional images under adverse conditions
Authors: Pinto João Ribeiro , Tavares João Manuel RS
Published: June 2017

This article presents the design and evaluation of an algorithm for urinary bladder segmentation in medical images, from contrastless computed tomography studies of patients suffering from bladder wall tumours. These situations require versatile methods of segmentation, able to adapt to the structural changes the tumours provoke in the bladder wall, reflected as irregularities on the images obtained, creating adversities to the segmentation process. This semi-automatic method uses fuzzy c-means clustering, a Gaussian-curve-based intensity transformation, and active contour models, requiring only the physician’s input of a single seed point for each anatomical view, in order to segment the bladder volume in all frames that include it. The performance of the method was evaluated on eight patients of The Cancer Genome Atlas–Urothelial Bladder Carcinoma collection, achieving approximately 79% of successful segmentations for small tumour patients (below 2.0 cm of diameter) and approximately 72% between 2.0 and 2.9 cm. Successful segmentations for small tumour patients presented an average of 3.7 mm Hausdorff distance and 91.0% degree of overlap. The promising performance attained, especially for small tumour patients, revealed a high potential of this method to serve as basis for an effective early-stage bladder wall tumour computer-aided diagnosis system.
Retrospective analysis of nephritis response and renal outcome in a cohort of 928 Egyptian lupus nephritis patients: a university hospital experience
Authors: Momtaz M , Fayed A , Wadie M , Gamal S M , Ghoniem S A , Sobhy N , Kamal Elden N M , Hamza W M
Published: June 2017

Aim

We aim to describe the pattern of response to treatment in a cohort of Egyptian lupus nephritis (LN) patients and to define variable prognostic factors.

Methods

We retrospectively analyzed records of 928 systemic lupus erythematosus (SLE) patients (898 females, 30 males) with biopsy-confirmed LN seen between 2006 and 2012 at Cairo University hospitals.

Results

Our study involved 928 SLE patients with a mean age of 26.25 ± 6.487 years, mean LN duration at time of renal biopsy 6.48 ± 4.27 months, mean SLEDAI 28.22 ± 11.7, and mean follow-up duration of 44.14 ± 17.34 months. Induction treatment achieved remission in 683 patients. Remission was achieved in all 32 patients with class II LN, compared to 651/896 (72.7%) patients in classes III, IV, and V. Induction by intravenous (IV) cyclophosphamide achieved response in 435/575 (75.7%) patients, while induction by mycophenolate mofetil (MMF) resulted in response in 216/321 (67.3%) patients ( p = 0.0068). Nephritic flares were least observed when MMF was used for maintenance (30/239 (12.6%) patients), compared to 71/365 patients (19.5%) ( p = 0.0266) when azathioprine (AZA) was used, and 22/79 patients (27.8%) ( p = 0.002) with IV cyclophosphamide. Class IV LN, high chronicity index, presence of crescents, and interstitial fibrosis in biopsies were all associated with chronic kidney disease (CKD) development eventually ( p < 0.001, p = 0.005, p = 0.012, and p = 0.031, respectively). By the end of the study duration, 305 (32.7%) patients had CKD. Logistic regression detected that high baseline serum creatinine, failure to achieve remission, hypertension, and nephritic flare were the main risk factors for poor renal outcome ( p < 0.001, p < 0.001, p = 0.004, and p < 0.001, respectively). The 5 years’ mortality was 69 (7.4%) patients with sepsis being the main cause of death.

Conclusion

IV cyclophosphamide superseded as induction treatment, while MMF was the best maintenance treatment. High serum creatinine, hypertension, and nephritic flare were the main risk factors for poor renal outcome.
Sensitivity analysis for frequency based prediction of crack size in composite plates with through-the-width delamination
Authors: Juhász Zoltán , Turcsán Tamás , Tóth Tamás Bence , Szekrényes András
Published: June 2017

This work combines modal analysis measurements with a novel 2D finite element plate model, which is capable to determine the delamination growth based on the change in the measured frequencies. The base of the presented method is a finite element model incorporating the Classical Laminated Plate Theory, and it is capable to estimate the eigenfrequencies of a rectangular plate with through-the-width delamination and straight crack front using arbitrary boundary conditions. The model contains special types of finite elements for modelling the delamination. This results a contact free model, which improves the simulation speed significantly. Using this model, the characteristic of the change of the eigenfrequencies with respect to the delamination growth can be obtained. These results can serve as reference, and according to the theoretical curves, the actual size of the delamination can be estimated based on the change in the measured frequencies. According to our measurement results, it can serve as a good reference for modal analysis. The experiment shows that the model can predict the effect of the delamination growth on the eigenfrequencies very well. Additional conclusions are drawn based on further numerical simulations, which can aid the model based modal analysis of composite plates.
An exponential constitutive model excluding fibres under compression: Application to extension–inflation of a residually stressed carotid artery
Authors: Li Kewei , Ogden Ray W , Holzapfel Gerhard A
Published: June 2017

Detailed information on the three-dimensional dispersion of collagen fibres within layers of healthy and diseased soft biological tissues has been reported recently. Previously we have proposed a constitutive model for soft fibrous solids based on the angular integration approach which allows the exclusion of any compressed collagen fibre within the dispersion. In addition, a computational implementation of that model in a general purpose finite element program has been investigated and verified with the standard fibre-reinforcing model for fibre contributions. In this study, we develop the proposed fibre dispersion model further using an exponential form of the strain-energy function for the fibre contributions. The finite element implementation of this model with a rotationally symmetrical dispersion of fibres is also presented. This includes explicit expressions for the stress and elasticity tensors. The performance and implementation of the new model are demonstrated by means of a uniaxial extension test, a simple shear test, and an extension–inflation simulation of a residually stressed carotid artery segment. In each example we have obtained good agreement between the finite element solution and the analytical or experimental results.
Nature of coupling in non-conservative distributed parameter systems attached to external damping sources
Authors: Bellos John , Inman Daniel J , Bakas Nikolaos
Published: June 2017

Non-conservative distributed parameter systems connected to external damping sources and possessing non-normal modes are analyzed in this work. The mathematical model of such systems is presented and real valued modal analysis is used to obtain the coupled modal equations of motion. A decoupling technique is developed using Fourier expansion, fictitious damping ratios, modal coupling parameters and pseudo forces. The method is applicable to all types of excitation. A normal mode criterion in the form of non-proportionality indices is also provided. The theoretical predictions are verified through application to a non-conservative Euler–Bernoulli beam with non-proportional damping configuration and various types of boundary conditions. Numerical examples emphasize the response errors associated with the proportional damping assumption and reveal the advantages of the proposed approach over the exact method.
Cost-effectiveness of Memory Assessment Services for the diagnosis and early support of patients with dementia in England
Authors: Gomes Manuel , Pennington Mark , Wittenberg Raphael , Knapp Martin , Black Nick , Smith Sarah
Published: June 2017

Background

Policy makers in England advocate referral of patients with suspected dementia to Memory Assessment Services (MAS), but it is unclear how any improvement in patients’ health-related quality of life (HRQL) compares with the associated costs.

Aims

To evaluate the cost-effectiveness of MAS for the diagnosis and follow-up care of patients with suspected dementia.

Method

We analysed observational data from 1318 patients referred to 69 MAS, and their lay carers (n = 944), who completed resource use and HRQL questionnaires at baseline, three and six months. We reported mean differences in HRQL (disease-specific DEMQOL and generic EQ-5D-3L), quality-adjusted life years (QALYs) and costs between baseline and six months after referral to MAS. We also assessed the cost-effectiveness of MAS across different patient subgroups and clinic characteristics.

Results

Referral to MAS was associated with gains in DEMQOL (mean gain: 3.48, 95% confidence interval: 2.84 to 4.12), EQ-5D-3L (0.023, 0.008 to 0.038) and QALYs (0.006, 0.002 to 0.01). Mean total cost over six months, assuming a societal perspective, was £1899 (£1277 to £2539). This yielded a negative incremental net monetary benefit of −£1724 (−£2388 to −£1085), assuming NICE’s recommended willingness-to-pay threshold (£30,000 per QALY). These base case results were relatively robust to alternative assumptions about costs and HRQL. There was some evidence that patients aged 80 or older benefitted more from referral to MAS (p < 0.01 from adjusted mean differences in net benefits) compared to younger patients. MAS with over 75 new patients a month or cost per patient less than £2500 over six months were relatively more cost-effective (p < 0.01) than MAS with fewer new monthly patients or higher cost per patient.

Conclusions

Diagnosis, treatment and follow-up care provided by MAS to patients with suspected dementia appears to be effective, but not cost-effective, in the six months after diagnosis. Longer term evidence is required before drawing conclusions about the cost-effectiveness of MAS.
Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis in elderly patients with pulmonary embolism: A SEATTLE II sub-analysis
Authors: Carroll Brett J , Goldhaber Samuel Z , Liu Ping-Yu , Piazza Gregory
Published: June 2017

Elderly patients with acute pulmonary embolism (PE) have higher mortality than non-elderly patients, but receive systemic fibrinolysis less frequently. In this sub-analysis of the SEATTLE II trial, we evaluated the efficacy and safety of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis in elderly patients with submassive and massive PE. We compared patients ⩾65 years old with those <65 years old. Eligible patients had proximal PE and a right ventricular-to-left ventricular (RV/LV) diameter ratio ⩾0.9 on chest computed tomography (CT). The primary efficacy outcome was the change in chest CT-measured RV/LV diameter ratio at 48 hours after procedure initiation. The primary safety outcome was major bleeding within 72 hours. Sixty-two patients were ⩾65 years of age and 88 were <65 years of age. The RV/LV diameter ratio decreased in both groups 48 hours post-procedure, with a mean change of −0.47 in those ⩾65 and −0.39 in those <65 years old, with no difference between groups ( p = 0.31). Major bleeding occurred in nine (15%) of those ⩾65 and in six (7%) of those <65 years old ( p = 0.17). Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis resulted in a similar reduction in RV/LV diameter ratio in elderly patients with massive and submassive PE compared with non-elderly patients.
Determinants of teachers’ collaborative use of information and communications technology for teaching and learning: A European perspective
Authors: Drossel Kerstin , Eickelmann Birgit , Schulz-Zander Renate
Published: June 2017

Collaboration between teachers constitutes an important predictor for the successful implementation of digital media in schools and teaching. The present contribution examines the supporting conditions of ICT (information and communications technology)-related teacher collaboration as a feature of school quality in six selected European educational systems on the basis of the instruments and data administered by the International Association for the Evaluation of Educational Achievement’s study of ICILS 2013 (International Computer and Information Literacy Study 2013). Along the ICILS 2013 theoretical framework, predictors on the level of the school and classroom, antecedents regarding teachers’ attitudes and competencies, variables concerning processes at school and in class, as well as teachers’ background variables, are analysed. The regression analysis shows no consistent differences regarding the coefficients of different predictors with respect to ICT-related collaboration in the countries where teachers have expressed a high, medium or low rate of agreement with ICT-related collaboration.
Approximation of the added resistance of ships with small draft or in ballast condition by empirical formula
Authors: Liu Shukui , Papanikolaou Apostolos
Published: June 2017

An attempt was made to extend and further tune the existing formula for approximating the added resistance in head seas to cover a wider range of speed and to account the impact of loading conditions; a new parameter based on B/ T was introduced after conducting extensive parametric study to capture the influence of draft on the added resistance; the trim effect has also been investigated; Furthermore, the draft effect on the added resistance due to diffraction is further tuned and simplified. The derived formula uses only a few input, including only some ship dimensions to yield an estimation of the added resistance of ships in regular waves. Numerical results show that the added resistance of various ships in head seas at low speeds, as well as the added resistance of tankers in ballast condition and cruise ships, can be properly captured by the new formula. Hence, it meets the demand of fast examination of the minimum power; it can also be used in the early design stage of a ship for power estimation.
Thermal and compression characteristics of aerogel-encapsulated textiles
Authors: Xiong Xiaoman , Yang Tao , Mishra Rajesh , Kanai Hiroyuki , Militky Jiri
Published: June 2017

In this work, a new approach to apply silica aerogel into textiles by laser treatment and laminating technique was used to fabricate aerogel-encapsulated textiles. Thermal insulation performance of the prepared multilayer aerogel-encapsulated laminated fabrics was characterized in terms of thermal conductivity, thermal resistance and thermal diffusivity by Alambeta instrument. Infrared thermography data were collected by FLIR ThermaCAM TVS300 thermal camera. The ORIENTEC STA-1225 Universal Testing Machine was employed for testing the compression properties like compression resistance, compression resilience and thickness loss. Results showed that the aerogel-encapsulated structure has significant effect on thermal insulation enhancement. A temperature gap of 1℃ to 1.5℃ was observed between aerogel-filled samples and regular ones. It is also found that nonwoven fabrics with aerogel-filled voids generally have lower compression resistance than regular nonwovens, samples with air-filled voids and aerogel-filled voids are observed to recover compression to a lower extent than regular samples. Nonwoven based aerogel-encapsulated composites exhibit lower thickness loss in comparison with untreated composites. The findings in this study can be used for further research in aerogel-encapsulated composites.
Mechanical and comfort properties of hydroentangled nonwovens from comber noil
Authors: Ahmad Faheem , Tausif Muhammad , Hassan Muhammad Zahid , Ahmad Sheraz , Malik Mumtaz H
Published: June 2017

Cotton is one of the most important commodity fibres and is widely employed in apparels. At present, the share of natural fibres in production of nonwoven fabrics is low and are used in opt applications. The cotton fibre is conventionally converted into woven and knitted fabrics by short staple spinning methods. The comber noil is short fibre waste produced when cotton yarns are combed. The aims of the current study were to employ comber noil for the preparation of hydroentangled cotton nonwovens at varying water jet pressures and conveyor speeds. The effect of these parameters was studied with respect to mechanical and comfort properties of the prepared fabrics. The results showed that these variables can help to manufacture fibrous assemblies with engineered properties, according to required application area.
Navigating tissue chips from development to dissemination: A pharmaceutical industry perspective
Authors: Ewart Lorna , Fabre Kristin , Chakilam Ananthsrinivas , Dragan Yvonne , Duignan David B , Eswaraka Jeetu , Gan Jinping , Guzzie-Peck Peggy , Otieno Monicah , Jeong Claire G , Keller Douglas A , de Morais Sonia M , Phillips Jonathan A , Proctor William , Sura Radhakrishna , Van Vleet Terry , Watson David , Will Yvonne , Tagle Danilo , Berridge Brian
Published: June 2017

Tissue chips are poised to deliver a paradigm shift in drug discovery. By emulating human physiology, these chips have the potential to increase the predictive power of preclinical modeling, which in turn will move the pharmaceutical industry closer to its aspiration of clinically relevant and ultimately animal-free drug discovery. Despite the tremendous science and innovation invested in these tissue chips, significant challenges remain to be addressed to enable their routine adoption into the industrial laboratory. This article describes the main steps that need to be taken and highlights key considerations in order to transform tissue chip technology from the hands of the innovators into those of the industrial scientists. Written by scientists from 13 pharmaceutical companies and partners at the National Institutes of Health, this article uniquely captures a consensus view on the progression strategy to facilitate and accelerate the adoption of this valuable technology. It concludes that success will be delivered by a partnership approach as well as a deep understanding of the context within which these chips will actually be used.

Impact statement

The rapid pace of scientific innovation in the tissue chip (TC) field requires a cohesive partnership between innovators and end users. Near term uptake of these human-relevant platforms will fill gaps in current capabilities for assessing important properties of disposition, efficacy and safety liabilities. Similarly, these platforms could support mechanistic studies which aim to resolve challenges later in development (e.g. assessing the human relevance of a liability identified in animal studies). Building confidence that novel capabilities of TCs can address real world challenges while they themselves are being developed will accelerate their application in the discovery and development of innovative medicines. This article outlines a strategic roadmap to unite innovators and end users thus making implementation smooth and rapid. With the collective contributions from multiple international pharmaceutical companies and partners at National Institutes of Health, this article should serve as an invaluable resource to the multi-disciplinary field of TC development.
Re-randomization tests for unplanned changes in clinical trials
Authors: Proschan Michael A
Published: June 2017

Despite the best efforts of investigators, problems forcing design changes can occur in clinical trials. Changes are usually relatively minor, but sometimes not. The primary endpoint or analysis may need to be revised, for example. It is common to regard any conclusion from such a tarnished trial as hypothesis-generating rather than definitive. This article reviews a very useful technique, re-randomization tests, for dealing with such anomalies. Re-randomization tests remain valid for testing a strong null hypothesis that treatment has no effect on the data that led to design changes. Another way of expressing this is that the data used to inform a design change must give no information about the treatment labels. This restriction has implications for limiting the amount of information examined by a committee deciding whether to make design alterations. While nothing can eliminate the pall cast by breaches of protocol, re-randomization tests following blinded and limited data examination go a long way toward amelioration.