bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovative adaptive viscous damper to improve seismic control of structures
Authors: Javadinasab Hormozabad S , Zahrai SM
Published: April 2019

In this paper, a new adaptive viscous damper (AVD) is proposed and required equations are developed to describe its mechanical behavior. As opposed to conventional adaptive devices, the proposed damper is capable of adapting its own mechanical properties without any need for other devices such as sensors, processing unit, actuators, energy supplies, and wired or wireless connections. Eliminating such equipment not only reduces costs, but also removes related time lag and improves the efficiency of the control system. The proposed AVD includes a cylinder filled with viscous fluid and a piston with a nozzle at its head. The passing area of the nozzle is variable and as a result, the device can cover a range of damping coefficients. For non-extreme excitations, the damping coefficient is relatively small and consequently the damping force is reduced. Conversely, when extreme movements occur, the nozzle contracts a bit and generates relatively large control forces in order to protect the main structure efficiently. The mechanical model of the AVD is created in OpenSees and the damper is implemented in a two-story building example subjected to different earthquake records. The results show that compared to a typical viscous device, the proposed AVD can reduce the mean values of displacement, acceleration, and base shear by up to 52.5, 62.9, and 44.4% and increase the energy dissipation by up to 94.3% for extreme cases. Moreover, for non-extreme cases, the AVD shows a more flexible behavior and reduces the unfavorable damping forces.
Difficult TEE Probe Placement: The Evidence, Troubleshooting Techniques, and a Guide to Alternative Monitoring Options for Intraoperative Physicians
Authors: Hillenbrand Karl D. , Racine Christopher L. , McNeil John S. , Kleiman Amanda M.
Published: April 2019

Transesophageal echocardiography (TEE) imaging has become an essential component of many open and interventional cardiac procedures and has increasing use in monitoring for noncardiac procedures, partly because of an aging population. Whether expected or not, encountering difficulty when inserting the TEE probe presents the anesthesiologist with a conundrum. Repeated insertion attempts increase the risk of a serious complication; however, proceeding without TEE may be unacceptable to the proceduralist or surgeon. The aim of this review is to present the spectrum of complications possible with TEE, propose several evidence-based insertion tips, examine potential alternative cardiac imaging options, and finally, propose a roadmap for providers who encounter difficulty when placing a TEE probe.
Experimental and numerical study of the response to various impact energy levels for composite sandwich plates with different face thicknesses
Authors: Rajput Moeen S , Burman Magnus , Forsberg Fredrik , Hallström Stefan
Published: April 2019

Composite sandwich structures find wide application in the aerospace sector thanks to their lightweight characteristics. However, composite structures are highly susceptible to low-velocity impact damage and therefore thorough characterization of the impact response and damage process for the used material configurations is necessary. The present study investigates the effect of face-sheet thickness on the impact response and damage mechanisms, experimentally and numerically. A uni-directional, non-crimp fabric is used as reinforcement in the face-sheets, and a closed cell Rohacell 200 Hero polymer foam is used as core material. Low-velocity impact tests are performed in a novel instrumented drop-weight rig that is able to capture the true impact response. A range of impact energies are initially utilized in order to identify when low level damage (LLD), barely visible impact damage (BVID) and visible impact damage (VID) occur. A thorough fractography investigation is performed to characterize the impact damage using both destructive and non-destructive testing. The damage from the impacts in terms of dent depth, peak contact force, deflection and absorbed energy is measured. The results show bilinear responses in dent depth vs. impact energy and absorbed energy vs. impact energy. It is found than the BVID energy works well as an indication for the onset of excessive damage. Fractography reveals that there is a failure mode shift between the LLD and the VID energy levels, and that delaminations predominantly grow along the fiber direction and rotate in a spiral pattern through the thickness, following the laminate ply orientations. Finally, a progressive damage finite element model is developed to simulate both the impact response and the delamination extent, incorporating both intra-laminar and inter-laminar damage modes. The simulation shows good agreement with the experiments.
Free vibration analysis of micro plate reinforced with functionally graded graphene nanoplatelets based on modified strain-gradient formulation
Authors: Mohammad-Rezaei Bidgoli Elyas , Arefi Mohammad
Published: April 2019

In this paper, modified strain-gradient theory is developed for size-dependent formulation of micro plate reinforced with functionally graded graphene nanoplatelets. The reinforced micro plate is subjected to thermal and mechanical loads. The functionally graded graphene nanoplatelets are distributed along the thickness direction based on various patterns. The effective material properties of reinforced structure including modulus of elasticity and density or Poisson’s ratio are calculated based on Halpin–Tsai model and rule of mixture, respectively. The kinematic relations are developed based on third-order shear deformation theory. The solution procedure is proposed based on analytical work for custom boundary condition. Before presentation of numerical results, a comprehensive comparative study is performed for validation of present formulation. The numerical results are presented to investigate the influence of important parameters such as weight fraction of GNPs, various distribution of GNPs, three micro length scale parameters and some non-dimensional geometric parameters on the vibration responses.
Phacolytic glaucoma: A nearly forgotten entity
Authors: Dhingra Deepika , Grover Suman , Kapatia Gargi , Pandav Surinder S , Kaushik Sushmita
Published: April 2019

Purpose:

To report a case of phacolytic glaucoma with rupture of anterior lens capsule in a case of hypermature cataract.

Methods:

Case report and literature review.

Results:

An 80-year-old woman presented with cloudiness and pain in the left eye for 1 day. The patient had visual acuity limited to perception of light with raised intraocular pressure of 70 mm Hg. Careful slit-lamp evaluation revealed corneal epithelial edema in superior quadrant and a deep and turbid anterior chamber. Ultrasound biomicroscopy confirmed the presence of a deep anterior chamber, a hypermature cataractous nucleus with lax capsular bag, and ruptured anterior lens capsule. The patient underwent extracapsular cataract extraction. Cytological examination of the lenticular fluid revealed the presence of lens protein-laden macrophages. Post-operatively, the patient had best-corrected visual acuity of 6/60 with advanced glaucomatous optic neuropathy.

Conclusion:

Phacolytic glaucoma can present with a cloudy cornea and a turbid anterior chamber mimicking endophthalmitis. Careful examination and ancillary investigations including ultrasound biomicroscopy was helpful in making an accurate diagnosis.
Development and Validation of a Nomogram Prognostic Model for Patients With Advanced Non-Small-Cell Lung Cancer
Authors: Wang Tao , Lu Rong , Lai Sunny , Schiller Joan H , Zhou Fang Liz , Ci Bo , Wang Stacy , Gao Xiaohan , Yao Bo , Gerber David E , Johnson David H , Xiao Guanghua , Xie Yang
Published: April 2019

Importance:

Nomogram prognostic models can facilitate cancer patient treatment plans and patient enrollment in clinical trials.

Objective:

The primary objective is to provide an updated and accurate prognostic model for predicting the survival of advanced non-small-cell lung cancer (NSCLC) patients, and the secondary objective is to validate a published nomogram prognostic model for NSCLC using an independent patient cohort.

Design:

1817 patients with advanced NSCLC from the control arms of 4 Phase III randomized clinical trials were included in this study. Data from 524 NSCLC patients from one of these trials were used to validate a previously published nomogram and then used to develop an updated nomogram. Patients from the other 3 trials were used as independent validation cohorts of the new nomogram. The prognostic performances were comprehensively evaluated using hazard ratios, integrated area under the curve (AUC), concordance index, and calibration plots.

Setting:

General community.

Main outcome:

A nomogram model was developed to predict overall survival in NSCLC patients.

Results:

We demonstrated the prognostic power of the previously published model in an independent cohort. The updated prognostic model contains the following variables: sex, histology, performance status, liver metastasis, hemoglobin level, white blood cell counts, peritoneal metastasis, skin metastasis, and lymphocyte percentage. This model was validated using various evaluation criteria on the 3 independent cohorts with heterogeneous NSCLC populations. In the SUN1087 patient cohort, the continuous risk score output by the nomogram achieved an integrated area under the receiver operating characteristics (ROC) curve of 0.83, a log-rank P-value of 3.87e−11, and a concordance index of 0.717. In the SAVEONCO patient cohort, the integrated area under the ROC curve was 0.755, the log-rank P-value was 4.94e−6 and the concordance index was 0.678. In the VITAL patient cohort, the integrated area under the ROC curve was 0.723, the log-rank P-value was 1.36e−11, and the concordance index was 0.654. We implemented the proposed nomogram and several previously published prognostic models on an online Web server for easy user access.

Conclusions:

This nomogram model based on basic clinical features and routine lab testing predicts individual survival probabilities for advanced NSCLC and exhibits cross-study robustness.
Collecting and media change, or: Listening to Phish via app
Authors: Kushner Scott
Published: April 2019

Practices of collecting are constrained by media circumstances. To show how changing media circumstances can occasion changes in collecting practices, this article explores one case study, an iOS app developed by a Phish fan to allow streaming audio of fan-made recordings of Phish concert performances. Such practices are part of a history of unofficial music collecting that parallels the history of recorded sound. This case study shows how one collecting community’s practices evolved in the context of changing media conditions: from cassette tape to CD-R to MP3 to streams (and a parallel motion from print to online message boards to app). This progression illustrates the ways that different ways of listening to and accessing recorded music afford different possibilities of collecting music, different links between listener and music, and different relationships among listeners. More precisely, Phish concert recordings, which lent themselves to collection when circulated on cassette, are no longer available to collect when they circulate as streaming media, because streaming is characterized by a relationship of access rather than possession. Among devoted fans, streaming recordings provoke a cultural emphasis on knowledge about music, rather than accumulation of recordings. My argument is rooted in prevailing theories of collecting, which situate collecting as a component of consumer culture emerging from the capitalist expansion stimulated by 19th-century mass production. Ultimately, I argue that when an object of collecting is displaced by changing media conditions, new collecting practices emerge to fill the void.
Venous thromboembolism: A clinician update
Authors: Serhal Maya , Barnes Geoffrey D
Published: April 2019

Venous thromboembolism (VTE) is a common vascular condition. New medications are available to prevent hospital-associated VTE. Strategies are being studied to increase appropriate diagnostic testing utilization. Management of deep vein thrombosis (DVT) and pulmonary embolism (PE) has evolved with the advent of new anticoagulant options and catheter-directed intervention. In light of this, providers are commonly challenged with the decision regarding inpatient versus outpatient management. Which patients require long-term (> 3 months) anticoagulation is challenging and multiple clinical prediction models may be used to help determine the risk–benefit ratio in each patient. The management of VTE is an ongoing area of research and is rapidly evolving.
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization
Authors: Adrian Molly , Zeman Janice , Erdley Cynthia , Whitlock Kathryn , Sim Leslie
Published: April 2019

This study explored the growth of non-suicidal self-injury (NSSI) frequency over 2.5 years in a clinical sample of adolescent girls. Following a functional model of NSSI, the contribution of emotion dysregulation, peer victimization, and psychological maladjustment were evaluated as the predictors of NSSI trajectories. Participants of 99 girls ( Mage = 16.03 years) were admitted for psychiatric hospitalization, who responded to questionnaires assessing NSSI, emotion dysregulation, relational and overt peer victimization, and internalizing and externalizing symptoms. NSSI was also assessed at 6 months and 2.5 years following the baseline assessment. Linear mixed modeling estimated NSSI frequency over time. The findings highlight the stable nature of NSSI and the contribution of emotion dysregulation and internalizing symptoms to NSSI patterns. Peer victimization and externalizing behavior problems were not the significant predictors. Developing interventions targeting these NSSI predictors early in girls’ development may prevent the emergence and maintenance of NSSI.
‘The fact they knew before I did upset me most’: Essentialism and normativity in lesbian and gay youths’ coming out stories
Authors: Jones Lucy
Published: April 2019

This article demonstrates, via discourse analysis of a group of young gay and lesbian people’s coming out stories, the salience of essentialist ideologies on their identity construction. The study reveals underlying normative assumptions in the young people’s narratives, including those associated with binary gender and innate sexual desire, which they employ in order to construct a culturally authentic sexual identity. Through close sociolinguistic analysis of interactions, it is shown how identity construction is directly influenced by broader ideologies. The analysis provides evidence of the continued prevalence of heteronormativity and homonormativity as key influences in young queer people’s identity work.
Needs of lifelong learning for professionalisation of industrial workers: Opportunities and challenges
Authors: Kassim Zarina , Aishah Buang Nor , Halim Lilia
Published: April 2019

Only 23% of Malaysian workforce has tertiary education compared to Organisation for Economic Co-operation and Development countries such as Singapore and Finland that have tertiary education with an average of 28% and around 35%, respectively. This study investigates perceived needs lifelong learning programmes for professionalisation among the workers. A survey was conducted on workers from the industries. Most of the workers felt that lifelong learning programmes provide personal satisfaction. In terms of perceived needs, workers from higher positions in industries need lifelong learning programmes to get better positions and better salaries as compared to those with lower positions in industries to get better job and education. Both groups have different preferences for means of learning whether face-to-face or online learning. The implications are that the government has to change their policy in terms of requirement for these companies to register with the Human Resource Department Fund so that their workers be subsidised for attending lifelong learning programmes and to encourage the participation of public higher learning institutions for providing online and weekend lifelong learning programmes to the workers.
Culture and Sampling Issues With “Green” Attitude Research
Authors: Larson Ronald B. , Kinsey Jean
Published: April 2019

Research on environmental attitudes may be affected by three methodological issues. First, country culture can influence green attitudes. This research found that environmental attitudes in countries with distinctive power distance, individualistic, or indulgent cultures tended to differ from the attitudes in other countries. Second, many green studies use convenience samples of students. Student responses often differ from the general public’s responses. The problem of relying on student samples is illustrated by the second study of cultural effects. Third, social desirability bias can inflate self-reported green attitudes and needs to be controlled. Although the consequences of social desirability bias may not be appreciated by some researchers, many businesses understand the effects and are waiting for consumer behaviors to catch up with their self-reported attitudes. By improving survey methodologies, green researchers can provide better insights to businesses and policy makers about the state of the gap between consumer attitudes and behaviors.
ENKUR Is Involved in the Regulation of Cellular Biology in Colorectal Cancer Cells via PI3K/Akt Signaling Pathway
Authors: Ma Qing , Lu Yin , Gu Ye
Published: April 2019

Colorectal cancer is one of the most prevalent malignancies worldwide. ENKUR is a transient receptor potential canonical–binding protein that acts as a potential regulator or effector of transient receptor potential canonical channels. It also directly interacts with the p85 regulatory subunit of phosphoinositide 3-kinase. However, the role of ENKUR in colorectal cancer remains unclear. In the present study, the expression profiles of ENKUR in the The Cancer Genome Atlas and ONCOMINE databases were analyzed. Significant downregulation of ENKUR was observed in clinical tumor samples of various cancer types, including colorectal cancer. Decreased ENKUR messenger RNA expression and ENKUR protein level were detected in 6 human colorectal cancer cell lines. Silencing of ENKUR in colorectal cancer cells led to enhanced cell proliferation, migration, and invasion, while the opposite effects were achieved in ENKUR-overexpressing cells. Furthermore, ENKUR-underexpressing cells exhibited increased activity of phosphoinositide 3-kinase /Akt signaling pathway. Downregulation of the epithelial marker, E-cadherin, and upregulation of the mesenchymal markers, vimentin and N-cadherin, were detected in ENKUR-underexpressing cells, suggesting the induction of epithelial–mesenchymal transition. In conclusion, the present study demonstrates that ENKUR may be responsible for alterations in the proliferative, migratory, and invasive potential of colorectal cancer cells through possible involvement in the phosphoinositide 3-kinase /Akt signaling pathway.
Developing a Comprehensive, Adaptive, and International Biosafety and Biosecurity Program for Advanced Biotechnology: The iGEM Experience
Authors: Millett Piers , Binz Thomas , Evans Sam Weiss , Kuiken Todd , Oye Ken , Palmer Megan J. , der Vlugt Cécile van , Yambao Kathrina , Yu Samuel
Published: April 2019

Introduction:

The international synthetic biology competition iGEM (formally known as the international Genetically Engineered Machines competition) has a dedicated biosafety and biosecurity program.

Method:

A review of specific elements of the program and a series of concrete examples illustrate how experiences in implementing the program have helped improved policy, including an increasing diversity of sources for genetic parts and organisms, keeping pace with technical developments, considering pathways toward future environmental release, addressing antimicrobial resistance, and testing the efficacy of current biosecurity arrangements.

Results:

iGEM’s program is forward-leaning, in that it addresses both traditional (pathogen-based) and emerging risks both in terms of new technologies and new risks. It is integrated into the technical work of the competition—with clearly described roles and responsibilities for all members of the community. It operates throughout the life cycle of projects—from project design to future application. It makes use of specific tools to gather and review biosafety and biosecurity information, making it easier for those planning and conducting science and engineering to recognize potential risks and match them with appropriate risk management approaches, as well as for specialists to review this information to identify gaps and strengthen plans.

Discussion:

Integrating an increasingly adaptive risk management approach has allowed iGEM’s biosafety and biosecurity program to become comprehensive, be cross-cutting, and cover the competition’s life cycle.
Fabrication of high-performance green hemp/polylactic acid fibre composites
Authors: Xu Zhenzhen , Yang Li , Ni Qignqing , Ruan Fangtao , Wang Hao
Published: April 2019

In this study, a novel compound lamination technique was applied to improve the mechanical properties of hemp fibre-reinforced polylactic acid composites. Polylactic acid fibres were blended with hemp fibres in a specific weight ratio in order to produce needled mats. Then, sections of the needled mat were stacked with several polylactic acid resin layers on either side, then formed hemp/polylactic acid composites through hot-pressing. The tensile and flexural properties of hemp/polylactic acid composites were tested according to ASTM standards. A multi-factor orthogonal analytical approach was adopted to discuss the effect of factors such as the hybrid ratio, forming temperature and pressure on mechanical properties of the developed green composites. The adhesion between the fibres and the matrix in the fracture surfaces and the thermal stability of the produced composites were observed via scanning electron microscopy and thermogravimetric analysis. The component analysis of composites was conducted by infrared spectra for confirming the contribution of polylactic acid. The results showed that adhesion between fibres and matrix was enhanced, as well as mechanical properties also improved, especially the tensile strength and flexural properties were obviously improved by utilizing this novel compounding technique.
Interobserver Reliability of 2 Classification Systems for Open Hand Fractures
Authors: Warrender William J. , Lucasti Christopher J. , Ilyas Asif
Published: April 2019

Purpose: The aim of the study is to determine the reliability of the Tulipan-Ilyas (TI) classification among hand surgeons by utilizing several case studies and to test the null hypothesis that the TI system would have superior interobserver reliability than the Gustilo-Anderson (GA) system for classifying and guiding treatment for open fractures of the hand. Methods: Institutional review board exemption for this study was confirmed. All surgeons were unaware and blinded to the development and origin of the newly proposed TI classification system. Interobserver reliability was computed using the multi-rater κ described by Fleiss. The κ values were interpreted according to the guidelines of Landis and Koch. Interrater reliability was computed utilizing methods described by Shrout and Fleiss. Results: The overall κ value for interobserver reliability was 0.339 (95% confidence interval [CI], 0.304-0.376) for the GA classification and 0.443 (95% CI, 0.423-0.463) for the TI classification, indicating fair and moderate agreement, respectively. According to the intraclass correlation coefficients, the interrater agreement for average measures for both classification systems was excellent, with intraclass correlation coefficient (ICC) values, including the lower CIs, all greater than 0.91. However, for the ICCs for single measures, generalizing only to one rater, the interrater agreement for the GA classification (0.595, 95% CI, 0.387-0.836) was only good, but for the TI classification system was excellent (0.958, 95% CI, 0.912-0.987). Conclusion: The authors recommend the TI classification instead of the GA classification system for use in open fractures of the hand because of its superior interobserver reliability and its hand-specific nature.
Delayed Extension Block Pinning in 27 Patients With Mallet Fracture
Authors: Kootstra Thomas J. M. , Keizer Jort , van Heijl Mark , Ferree Steven , Houwert Marijn , van der Velde Detlef
Published: April 2019

Background: Untreated bony mallet fingers can cause an array of problems; therefore, adequate treatment is essential. The primary aim of this study was to determine the patient-reported functional outcome of delayed surgical intervention of bony mallet fingers. The secondary aim was to determine the complication rate of delayed surgical intervention. Methods: In this single-center retrospective cohort study, all consecutive patients treated between 2010 and 2016 at our level 2 regional teaching hospital were included. Inclusion criterion was a bony mallet finger injury (excluding the thumb), presenting >21 days after injury, treated with extension block pinning. Indications for surgery were >2 mm fragment displacement or volar subluxation of the distal interphalangeal joint. Six to 82 months postoperatively, patients completed the Patient-Rated Wrist and Hand Evaluation (PRWHE) by phone. Complications were extracted by chart review. Results: Twenty-seven patients were included, and all completed the PRWHE. Median time to surgery was 35 days (interquartile range [IQR] = 29-42; range = 22-61). Reasons for delay in surgical treatment were patient/physician delay in 24 cases and failed conservative treatment in 3 cases. The median PRWHE score was 0 (IQR = 0-5; range = 0-22.5). After retrospective assessment of the outpatient charts, no early symptoms of malunion or nonunion were found. One patient had a loss of Kirschner-wire fixation, which was corrected. Three patients had an infection that required antibiotic treatment. Conclusions: Delayed surgical management of bony mallet fingers demonstrated adequate functional outcome with minimal complications when compared with prior literature.
Nerve Conduction Studies in Surgical Cubital Tunnel Syndrome Patients
Authors: Shubert Daniel J. , Prud’homme Joseph , Sraj Shafic
Published: April 2019

Background: Electrodiagnostic studies (EDX) serve a prominent role in the diagnostic workup of cubital tunnel syndrome (CBTS), but their reported sensitivity varies widely. The goals of our study were to determine the sensitivity of EDX in a cohort of patients who responded well to surgical cubital tunnel release (CBTR), and whether the implementation of the Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) criteria improves the sensitivity. Methods: We identified 118 elbows with clinical CBTS who had preoperative EDX and underwent CBTR. The EDX diagnoses were CBTS, ulnar neuropathy (UN), and normal ulnar nerves. We divided the 118 elbows into those that received above-elbow stimulation (XE group) and those that did not (non-XE group). We calculated the sensitivities for all groups and reinterpreted the results according to the AANEM guidelines. Results: Cubital tunnel release provided significant relief in 93.6% of the elbows. Based on the EDX reports, 11% patients had clear CBTS, 23% had UN, and 66% showed no UN. The sensitivities were 11.7% for CBTS and 34.2% for any UN. In the XE group, the sensitivity of the EDX reports for CBTS and UN climbed to 33.3% and 58.3%, respectively. When we calculated the across-elbow motor nerve conduction velocity, the sensitivity for CBTS and UN was 87.5% and 100%, respectively. The XE and non-XE groups showed no difference except for sex, bilaterality, concomitant carpal tunnel release, and obesity ( P < .05). Conclusion: Implementing AANEM guidelines results in significant improvement in correlation of clinical and electrodiagnostic findings of CBTS.
Nonlocal strain gradient theory for bending, buckling, and vibration of viscoelastic functionally graded curved nanobeam embedded in an elastic medium
Authors: Allam Mohamed NM , Radwan Ahmed F
Published: April 2019

This article investigates bending, buckling, and vibration analysis in viscoelastic functionally graded curved nanobeam embedded in an elastic medium under different boundary conditions. The stresses can be calculated based on not only the nonlocal stress field but also the strain gradient stress field according to the nonlocal strain gradient elasticity theory. The present higher order refined curved nanobeam theory which captures shear deformation influence does not need any shear correction factors. Two power-law models are used to describe the continuous variation of material properties of viscoelastic functionally graded curved nanobeam. Governing equations of nonlocal strain gradient viscoelastic functionally graded curved nanobeam are obtained using Hamilton’s principle. To establish the present model, the results are compared with those of functionally graded curved nanobeams. The effects of nonlocal parameter, length scale parameter, viscoelastic damping coefficient, spring stiffness, boundary conditions, and power-law exponent on the bending, buckling, and vibration responses of viscoelastic functionally graded curved nanobeam are discussed.
A novel aerodynamic modeling method for an axisymmetric missile with tiny units
Authors: Chen Gong , Tang Zhigong , Wang Wenzheng , Xu Mingxin
Published: April 2019

This article investigates the aerodynamic modeling problem of an axisymmetric missile with tiny units. Three aerodynamic force models for an axisymmetric air-to-air standard model missile are established. The mathematical model of trigonometric series model, response surface model, and kriging model for roll moment coefficients are developed. An error reduction approach is presented to determine the configuration of the proposed aerodynamic force models. In this approach, the minimum residual sum of the square criterion is acquired to determine the desired sample data point. Moreover, the modeling accuracy of the three models is further discussed. Finally, a model missile with four control surfaces and a cable cover was applied to test the proposed modeling approach in a transonic wind tunnel named as CARDC FL-24.
An acoustic method for condition classification of a water-filled underground siphon
Authors: Feng Zao , Horoshenkov Kirill V , Huang GuoYong
Published: April 2019

This article reports on an application of the k-nearest neighbours pattern recognition and classification technique to condition monitoring in a full-scale, water-filled siphon that is located beneath the underground. An experimental facility has been designed and constructed at the University of Bradford to study using acoustic waves as excitation to observe the characteristics of pipe sediments and wall damages on an underground sewer siphon. The effects of different amounts of sediment inside the siphon and different size of artificial damage on the pipe wall have been studied. The sound pressure level and acoustic energy were calculated from the acoustic signals which were recorded from three hydrophones under several representative siphon conditions to extract useful features in order that the proposed k-nearest neighbours classification algorithm could be applied. It has been proven that acoustic-based approach is capable of providing sufficient information on the condition of pipes for reliable classification and fault detection.
The influence of relatedness proportion on the joint relationship among word frequency, stimulus quality, and semantic priming in the lexical decision task
Authors: Aschenbrenner Andrew J , Yap Melvin J
Published: April 2019

In the lexical decision task, the additive effects of stimulus quality and word frequency have been used to infer the presence of independent processing stages in visual word recognition. Importantly, this pattern can be moderated by semantic priming, suggesting the presence of a retrospective prime retrieval mechanism that is selectively engaged based on task context (i.e., utility of the primes). We examine the sensitivity of this mechanism in two lexical decision experiments that manipulate stimulus quality, word frequency, and semantic priming. Critically, we studied these joint effects when the proportion of related primes was set at .50 or .25. Results indicated that with a .50 relatedness proportion, a three-way interaction was obtained such that additivity between frequency and stimulus quality was found following related semantic primes, but an overadditive pattern was exhibited following unrelated primes. When the relatedness proportion was reduced to .25, this interaction was eliminated. Furthermore, relatedness proportion affected the magnitude of the stimulus quality by priming interaction but not the frequency by priming interaction. These results are interpreted within the context of a flexible lexical processer that adaptively engages processes in response to task context.
Extending the time window for intravenous thrombolysis in acute ischemic stroke using magnetic resonance imaging-based patient selection
Authors: Ringleb Peter , Bendszus Martin , Bluhmki Erich , Donnan Geoffrey , Eschenfelder Christoph , Fatar Marc , Kessler Christof , Molina Carlos , Leys Didier , Muddegowda Girish , Poli Sven , Schellinger Peter , Schwab Stefan , Serena Joaquin , Toni Danilo , Wahlgren Nils , Hacke Werner ,   for the ECASS-4 study group
Published: April 2019

Background

Intravenous thrombolysis with alteplase within a time window up to 4.5 h is the only approved pharmacological treatment for acute ischemic stroke. We studied whether acute ischemic stroke patients with penumbral tissue identified on magnetic resonance imaging 4.5–9 h after symptom onset benefit from intravenous thrombolysis compared to placebo.

Methods

Acute ischemic stroke patients with salvageable brain tissue identified on a magnetic resonance imaging were randomly assigned to receive standard dose alteplase or placebo. The primary end point was disability at 90 days assessed by the modified Rankin scale, which has a range of 0–6 (with 0 indicating no symptoms at all and 6 indicating death). Safety end points included death, symptomatic intracranial hemorrhage, and other serious adverse events.

Results

The trial was stopped early for slow recruitment after the enrollment of 119 (61 alteplase, 58 placebo) of 264 patients planned. Median time to intravenous thrombolysis was 7 h 42 min. The primary endpoint showed no significant difference in the modified Rankin scale distribution at day 90 (odds ratio alteplase versus placebo, 1.20; 95% CI, 0.63–2.27, P = 0.58). One symptomatic intracranial hemorrhage occurred in the alteplase group. Mortality at 90 days did not differ significantly between the two groups (11.5 and 6.8%, respectively; P = 0.53).

Conclusions

Intravenous alteplase administered between 4.5 and 9 h after the onset of symptoms in patients with salvageable tissue did not result in a significant benefit over placebo. (Supported by Boehringer Ingelheim, Germany; ISRCTN 71616222).
Impact of previous stroke on outcome after thrombectomy in patients with large vessel occlusion
Authors: Leker Ronen R , Cohen Jose E , Horev Anat , Tanne David , Orion David , Raphaeli Guy , Amsalem Jacob , Streifler Jonathan Y , Hallevi Hen , Bornstein Natan M , Yaghmour Nour E , Telman Gregory ,   On Behalf of the NASIS-REVASC Study Group
Published: April 2019

Background

Many patients with large vessel occlusion (LVO) who are otherwise candidates for endovascular treatment (EVT) have had previous strokes. We aimed to examine the effect of previous stroke on outcome after EVT.

Methods

Consecutive patients with LVO were prospectively entered into a National Acute Stroke registry of patients undergoing EVT. Patients treated with EVT were divided into those with and without previous strokes. The rates of favorable reperfusion status, mortality, and excellent outcome at 90 days post-stroke as well as symptomatic intracranial hemorrhage (sICH) were evaluated.

Results

A total of 390 underwent EVT and 35 had previous strokes. Patients with previous strokes were significantly older; more frequently had a history of prior myocardial infarction and more often had pre-existing functional disability. Favorable target vessel recanalization was less frequently achieved in patients with previous strokes (60% vs. 82%; p = 0.005) and ordinal regression analysis for functional outcome revealed higher frequency of deterioration at three months in patients with previous strokes. Nevertheless, 9% of these patients maintained their previous disability state and sICH rates did not differ between the groups. Mortality rates at one year post stroke were significantly higher in patients with previous strokes (37% vs. 16%; p = 0.005).

Conclusions

Previous strokes are associated with higher likelihoods of mortality and unfavorable outcome in patients with LVO undergoing EVT. However, because some of these patients maintain their previous disability state, the presence of previous stroke should not be used as an exclusion criterion from EVT.
Project eARTh: participatory arts and mental health recovery, a qualitative study
Authors: Hui Ada , Stickley Theodore , Stubley Michelle , Baker Francesca
Published: April 2019

Aims:

To identify the potential mental health benefits of a rural-based participatory arts programme in the United Kingdom.

Methods:

Fourteen narrative interviews were conducted among participants of the Project eARTh programme. The data were subjected to a thematic analysis process.

Results:

Three overarching themes were identified: identity and self-expression; connectedness through occupation; wellbeing and personal growth. The importance of meaningful relationships was highlighted as preventing social isolation, particularly in rural locations. Engagement in artistic group activities enable participants to connect with their communities.

Conclusions:

Artistic activities help people to develop friendships and to engage with local communities in rural locations. Connectedness to people and places were valued by participants as part of their personal growth. The groups empower people to experience increased confidence and identities beyond illness narratives. Artistic group activities can benefit the mental health of participants in rural locations.
Participants’ perceptions of Kinesio tape for carpal tunnel syndrome: A qualitative study
Authors: Krause Donnamarie , Ryan Sheryl , Krpalek Dragana , Roll Shawn C , Javaherian-Dysinger Heather , Daher Noha
Published: April 2019

Introduction

Kinesio tape is an alternative non-surgical treatment approach for addressing symptoms of carpal tunnel syndrome. The purpose of the study was to investigate individuals’ experiences with the dorsal application of Kinesio tape for carpal tunnel syndrome management and its impact on pain and function.

Method

The study design was a limited phenomenological design study embedded in a randomized controlled trial. Daily symptom journals and semi-structured interviews were completed with 15 participants who were purposefully recruited and randomly allocated to the intervention group of a single blind randomized controlled trial. Kinesio tape was applied dorsally on the affected forearm, wrist, and digits for a duration of two weeks. Transcribed data were analyzed using descriptive coding, coding schemes, and frequency charts to identify emerging themes.

Results

Three themes emerged: Kinesio tape was positively perceived to be effective on decreasing pain, increasing self-efficacy, and improving daily functional performance on tasks previously avoided or abandoned. The most common problem identified was maintaining Kinesio tape on the hands and fingers, to which the majority of participants expressed a desire to learn application.

Discussion

Results of this study suggest that Kinesio tape is a positively perceived intervention for decreasing pain and increasing function for individuals with carpal tunnel syndrome and warrants further consideration as an alternative conservative intervention for carpal tunnel syndrome.
Structure Elucidation and Antioxidant Activity of the Phenolic Compounds from Rhynchosia suaveolens
Authors: Rammohan Aluru , Gunasekar Duvvuru , Reddy Netala Vasudeva , Vijaya Tartte , Deville Alexandre , Bodo Bernard
Published: April 2019

A new benzophenone, 2-hydroxy-3,4-dimethoxybenzophenone (1), together with a known C-glycosylxanthone, mangiferin (2) and two known C-glycosylflavones, isovitexin (3) and isoorientin (4), were isolated from the flowers of Rhynchosia suaveolens DC. (Fabaceae). The structure of the new compound (1) and the known compounds (2-4) were elucidated by extensive 1D and 2D NMR spectral studies. The plant extracts, as well as the isolated compounds, were evaluated for their total phenolic content (TPC), total flavonoid content (TFC) and DPPH radical scavenging activity. Among the isolated compounds, mangiferin (2) and isoorientin (4) showed significant radical scavenging activity comparable with that of ascorbic acid.
The Hospital (Not So) Quiet Zone: Creating an Environment for Patient Satisfaction Through Noise Reduction Strategies
Authors: Walker Linda , Karl Cherry A.
Published: April 2019

Purpose:

To determine whether using existing noise reduction strategies improves patients’ overall satisfaction level during hospitalization on an adult outpatient cardiology unit and to assess whether noise reduction strategies were effective to decrease the ambient noise for both staff and patient environments.

Background:

Excessive noise is a worldwide problem facing hospitals today. Noise has been proven to be detrimental to staff and patient well-being and hospital environment satisfaction levels.

Intervention:

Staff noise perception online surveys, a poster presentation, and education of noise reduction strategies were completed. Two 6-week phases of pre- and postimplementation noise reduction strategies were initiated including closing of the doors, verbal and visual alarm reminders for staff, posting quiet signs, and limiting equipment through the unit. Patient telephone interviews regarding the noise environment during hospitalization in both phases and a follow-up staff noise perception online survey were completed.

Results:

Staff surveys identified noise as an issue on the unit with staff communication (90%) being the main source. This correlated with patient surveys of five rooms closest to the desk considering the unit “noisy.” Post-implementation patient surveys noted that strategies created in helping the unit become “quiet/mostly quiet.” Closing patient doors was most effective in noise reduction, increasing patient unit satisfaction.

Conclusion:

The use of visual cues and staff education are effective in reducing noise levels. Decreased noise levels improved overall patient satisfaction with their hospital experience and created a less stressful work environment.
Surgical Approach to Frontal Sinus Osteoma: A Systematic Review
Authors: Watley Duncan C. , Mong Eric R. , Rana Nikunj A. , Illing Elisa A. , Chaaban Mohamad R.
Published: April 2019

Background

Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma.

Objective

To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence.

Results

A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2%), recurrent sinusitis (30.5%), mucocele (4.3%), cosmetic deformity other than proptosis (12.8%), and proptosis (5.5%). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9%), followed by open osteoplastic flaps (36.9%) and endoscopic assisted (18.2%). Osteoma with anterior (79%) and posterior (73%) attachments were treated statistically more often with endoscopic approach compared with floor (42%) and extrasinus (50%) attachment ( P < .0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63% endoscopic, 29% endoscopic assisted, 8% open, P = .21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients.

Conclusion

Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.
Somatization, Depression, and Anxiety Disorders in a Rhinology Practice
Authors: Alam Elie S. , Musselman Dominique L. , Chyou Darius , Shukri Ghaith , Levine Corinna G. , Sanghvi Saurin , Zhang Hang , Casiano Roy R.
Published: April 2019

Background

Patients present to rhinology clinics with various complaints. Symptoms may be attributable to objective findings, some remain unexplained. The objective is to investigate the incidence of psychological disorders in a rhinologic practice and evaluate a correlation of these psychiatric diseases with rhinologic symptoms.

Methods

Patients presenting to a rhinology clinic were administered the Generalized Anxiety Disorder 7 (GAD 7), Patient Health Questionnaire 9 (PHQ 9), and PHQ 15, psychometric instruments that can screen for generalized anxiety, major depression, and somatization disorder, respectively. Patients’ symptoms, endoscopic findings, medication, and psychiatric history were recorded. Multivariable analysis was performed for patients showed moderate-to-severe anxiety, depression, and somatic symptoms via 3 logistic regressions where the outcome was a GAD 7, PHQ 9, or PHQ 15 above 10.

Results

One hundred ninety-six patients were included for this study. There were 109 females and 87 males with a mean age of 49 years. Overall, 9%, 14%, and 21% exhibited moderate-to-severe anxiety, depressive, and somatization symptoms, respectively. Nasal obstruction was the only statistically significant variable that increased the odds of having moderate-to-severe anxiety symptoms. Similarly, headache, nasal obstruction, and anosmia/hyposmia were associated with increased odds of having depressive symptoms, and female gender, headache, and nasal discharge increased the odds of somatic symptom disorder. Edema was the only objective endoscopic finding, which was associated with depression only.

Conclusions

Patients should be counseled about the pathophysiology and psychiatric comorbidities affecting their primary rhinologic complaints. The provider needs to set realistic treatment expectations in order to achieve the desired clinical outcomes.