bluuebunny/crossref_metadata_2025 huggingface dataset:
The Decomposition of Bisphenol a Diglycidyl Ether/Alicyclic Amine Hardened Networks in Near-critical Water
Authors: Yuyan Liu , Li Li , Songquan Wu , Yuting Liu
Published: September 2018

The decomposition of bisphenol A diglycidyl ether/alicyclic amine hardened networks in near-critical water was studied in this paper. It is possible to decompose thermosetting epoxy resin completely at 260 °C for 1 h with 1 g/5 ml feedstock ratio. The decomposition rate of epoxy resin increased with an increase in reaction temperature. The decrease in sample size led to higher decomposition rate, and the catalysts NH4Cl and H2SO4 had the higher positive effect on the decomposition rate. Thermogravimetry analysis (TGA) showed that thermal decomposition was not the primary factor for the collapse of networks in the temperature range studied. Gas Chromatography-Mass Spectrometry (GC-MS) showed the main components of the soluble decomposed compounds were bisphenol A, hydroxybenzene, olefin and ketone compounds and their content varied during the reaction. The hydrolysis of ether bond was regarded as the key factor in the process of decomposition reaction of bisphenol A diglycidyl ether/alicyclic amine hardened networks.
Analysis of the Draping Behaviour of Multi-Layer Textiles using Digital Image Processing
Authors: Taha I. , Abdin Y. , Ebeida S.
Published: September 2018

The draping behaviour of woven fabrics in moulds is essential for the production of textile composites that should fulfil specific aesthetic and performance requirements. This study focuses on the draping behaviour of multiple layers of natural jute and glass fibre woven fabrics and their hybrid combinations. Results show that it is not only the number of layers that plays a vital role in determining the overall draping behaviour of multi layer reinforcements, but also the order in which the setup is prepared. Image processing techniques using Matlab were performed to describe the draping behaviour of single, double and triple layer setups.
A review on electroactive polymers development for aerospace applications
Authors: Bashir Musavir , Rajendran Parvathy
Published: September 2018

Newfangled smart materials have inspired the researchers to look for more efficient materials that can respond to specific stimuli and retain the original shape. Electroactive polymers are such materials which are capable of sensing and real-time actuation. Various electroactive polymers are excellent candidates due to high strain rate, fast response, reliability and high mechanical compliance despite tough manufacturing. In this study, electroactive polymers are reviewed and the general enabling mechanisms employing their distinct characteristics are presented, and the factors influencing the properties of various electroactive polymers are also discussed. Our study also enumerates the current trends in the development of electroactive polymers along with its progress in aerospace discipline. The electromechanical properties of electroactive polymer materials endow them the capability to work as both sensors and actuators in the field of aerospace. Hence, we provide an overview of various applications of electroactive polymers in aerospace field, notably aircraft morphing. These actuators are vastly used in aerospace applications like Mars Nano-rover, space robotic, flapping wings and active flap. Therefore, the electroactive polymer applications such as effective actuators can be investigated more in their materials, molecular interactions, electromechanics and actuation mechanisms. Considering electroactive polymers unique properties, they will endeavour the great potential applications within aerospace industry.
An Introduction to the Mathematical Modeling in the Study of Cancer Systems Biology
Authors: Alameddine Abdallah K , Conlin Frederick , Binnall Brian
Published: September 2018

Background:

Frequently occurring in cancer are the aberrant alterations of regulatory onco-metabolites, various oncogenes/epigenetic stochasticity, and suppressor genes, as well as the deficient mismatch repair mechanism, chronic inflammation, or those deviations belonging to the other cancer characteristics. How these aberrations that evolve overtime determine the global phenotype of malignant tumors remains to be completely understood. Dynamic analysis may have potential to reveal the mechanism of carcinogenesis and can offer new therapeutic intervention.

Aims:

We introduce simplified mathematical tools to model serial quantitative data of cancer biomarkers. We also highlight an introductory overview of mathematical tools and models as they apply from the viewpoint of known cancer features.

Methods:

Mathematical modeling of potentially actionable genomic products and how they proceed overtime during tumorigenesis are explored. This report is intended to be instinctive without being overly technical.

Results:

To date, many mathematical models of the common features of cancer have been developed. However, the dynamic of integrated heterogeneous processes and their cross talks related to carcinogenesis remains to be resolved.

Conclusions:

In cancer research, outlining mathematical modeling of experimentally obtained data snapshots of molecular species may provide insights into a better understanding of the multiple biochemical circuits. Recent discoveries have provided support for the existence of complex cancer progression in dynamics that span from a simple 1-dimensional deterministic system to a stochastic (ie, probabilistic) or to an oscillatory and multistable networks. Further research in mathematical modeling of cancer progression, based on the evolving molecular kinetics (time series), could inform a specific and a predictive behavior about the global systems biology of vulnerable tumor cells in their earlier stages of oncogenesis. On this footing, new preventive measures and anticancer therapy could then be constructed.
Minding less: Exploring mindfulness and mindlessness in organizations through Skillful Means
Authors: Vu Mai Chi , Wolfgramm Rachel , Spiller Chellie
Published: September 2018

Mindfulness has received increased attention in organizational studies. Yet we ask, is mindfulness necessary, indeed achievable, in every “moment” and every context? Mindfulness as co-opted by organizations is often considered a positive and helpful state, while little attention is paid to the important notion of mindlessness. Our comprehensive exploratory review of mindfulness and mindlessness highlights theoretical debates and responds to calls for a more balanced approach to mindlessness and mindfulness. In addition, it highlights practical implications to management learning by introducing Eastern Buddhist principles of non-attachment, practiced through the key concept of Skillful Means. A distinctive contribution of this article is a Five-Fold Framework detailing five aspects of a skillful mindful and mindless approach: context-flexibility, managerial emotional display, managerial learning under complex situations and dilemmas, transferring mindfulness practices from individual to organizational level, and context-sensitive research.
The Implementation Gap in Laparoscopic Simulation Training
Authors: Fjørtoft K. , Konge L. , Gögenur I. , Thinggaard E.
Published: September 2018

Background and Aims:

Simulation-based training in laparoscopy can improve patient safety and efficiency of care, but it depends on how it is used. Research in medical education has moved from demonstrating transferability of simulation training to the operating room to how to best implement it. This study aims to investigate how simulation-based training in laparoscopy has been implemented Scandinavia.

Material and Methods:

An online survey was sent out to medical doctors at surgical, gynecological, and urological departments at 138 hospitals in Denmark, Norway, and Sweden. The questionnaire included questions on respondents’ baseline characteristics, opinions, access, and actual use of simulation-based training in laparoscopy.

Results:

In total, 738 respondents completed the survey. Of these, 636 (86.2%) of respondents agreed or strongly agreed that simulation-based training in laparoscopy should be mandatory. A total of 602 (81.6%) had access to simulation-based training in laparoscopy. Of the total 738 respondents, 141 (19.1%) were offered structured training courses, 129 (17.5%) were required to reach a predefined level of competency, and 66 (8.9%) had mandatory courses in laparoscopy. In all, 72 (9.8%) had never used simulation-based training in laparoscopy.

Conclusion:

An implementation gap in laparoscopic simulation-based training still exists in Scandinavia. Simulation equipment is generally available, but there is a lack of structured simulation-based training.
Fuel wall film effects on premixed flame propagation, quenching and emission
Authors: Tao Mingyuan , Ge Haiwen , VanDerWege Brad , Zhao Peng
Published: September 2018

The formation of fuel wall film is a primary cause for efficiency loss and emissions of unburnt hydrocarbons and particulate matters in direct injection engines, especially during cold start. When a premixed flame propagates toward a wall film of liquid fuel, flame structure and propagation could be fundamentally affected by the vaporization flux and the induced thermal and concentration stratifications. It is, therefore, of both fundamental and practical significance to investigate the consequent effect of a wall film on flame quenching. In this work, the interaction of a laminar premixed flame and a fuel wall film has been studied based on one-dimensional direct numerical simulation with detailed chemistry and transport. The mass and energy balance at the wall film interface have been implemented as boundary condition to resolve vaporization. Parametric studies are further conducted with various initial temperatures of 600–800 K, pressures of 7–15 atm, fuel film and wall temperatures of 300–400 K. By comparing the cases with an isothermal dry wall, it is found that the existence of a wall film always promotes flame quenching and causes more emissions. Although quenching distance can vary significantly among conditions, the local equivalence ratio at quenching is largely constant, suggesting the dominant effects of rich mixture and rich flammability limit. By further comparing constant volume and constant pressure conditions, it is observed that pressure and boiling point variation dominate the vaporization boundary layer development and flame quenching, which further suggests that increased pressure during compression stroke in engines can significantly suppress film vaporization. Emissions of unburnt hydrocarbon, soot precursor and low-temperature products before and after flame quenching are also investigated in detail. The results lead to useful insights on the interaction of flame propagation and wall film in well-controlled simplified configurations and shed light on the development of wall film models in three-dimensional in-cylinder combustion simulation.
Synthesis and Characterization of Bismaleimide (1,3-bismaleimido benzene) – Vinyl Ester Oligomer Modified Unsaturated Polyester Interpenetrating Matrices
Authors: Sharmila R. Josephine , Alagar M. , Kumar R. Suresh
Published: September 2018

Bismaleimide - vinyl ester oligomer modified unsaturated polyester interpenetrating network systems were developed. Unsaturated polyester was modified with 10%, 20%, 30% (by wt) of vinyl ester oligomer with benzoyl peroxide as curing agents. The vinyl ester oligomer toughened unsaturated polyester matrix systems were further modified with 5%, 10% and 15% (by wt.) of 1,3-bismaleimido benzene. Thermal behaviour of the matrices were characterised by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and heat deflection temperature analysis. Mechanical properties were studied by ASTM methods. Data obtained from mechanical and thermal studies indicated that the introduction of vinyl ester oligomer into unsaturated polyester improves the fracture toughness with marginal reduction in the values of heat deflection temperature, and glass transition temperature. However, the introduction of BMI into VEO incorporated unsaturated polyester resin enhanced both thermal and mechanical behaviour of unsaturated polyester resin.
A New In-Mould Decoration Process using Real Wood Veneer
Authors: Makenji K. , Goodship V. , Buckley S. , Evered C.
Published: September 2018

The use of real wood by manufacturers in automotive interiors is seen as a mark of a premium car quality. The current manufacture of aesthetic veneered components is both costly, resource demanding and time consuming. An alternative in-mould decoration manufacturing method is considered here, using back injection moulding of wood veneer onto plastic components.

Two common polymer materials, polypropylene, (PP) and acrylonitrile, butadiene, styrene, (ABS) are used with four different types of wood veneer in a simple geometry plate mould. It was found that all these samples moulded satisfactorily and good adhesion was achieved. Shrinkage values of the mouldings are presented.

Boil tests resulted in adhesion failure for all the ABS samples whilst the PP samples remained adhered to the wood laminate. This was found to be due to the rheology of the polymers and the resultant level of melt penetration, which was measured using optical microscopy.

Scanning Electron Microscopy, (SEM) revealed that a high level of interaction is present at the interface with parts made from PP. The PP was found to penetrated voids and opening in the veneer and even travel into resin ducts. This was true throughout the range of veneer types. This high level of interaction has increased the surface area of the interface thereby securing a mechanical interlock condition. PP's of this MFI or higher would be suitable for this injection moulded application based on the findings to date.

On the other hand parts made from ABS had a very poor level interaction present with voids evident at the interface in the order of 25 μm. The poor level of interaction has resulted in a low contact surface are resulting in the failure to the test regime.
Adhesive Properties of Neoprene-Phenolic-EPN Blends
Authors: Varghese Lity Alen , Abraham Beena T , Thachil Eby Thomas
Published: September 2018

This study investigates the adhesive properties of neoprene-phenolic-EPN blends for SBR-SBR and Al-Al bonding. The effect of varying the phenolic: EPN ratio on adhesive properties was studied. The first part (Case A) brings out the significance of blending a phenolic copolymer with epoxidized phenolic novolac (EPN) resin and neoprene rubber. The phenolic resin was the product of condensation of a mixture of phenol and cardanol with formaldehyde. Cardanol, a meta-substituted phenol, is the main ingredient of cashew nut shell liquid (CNSL), a renewable resource. In the second part (Case B), the phenolic resin used was a commercial resin based on p-tertiary butyl phenol. For SBR-SBR bonds, 30 phr EPN in the phenolic/EPN blend leads to optimal shear and peel properties for both Cases A & B. For Al-Al bonds, on the other hand, 60-80 phr EPN in the phenolic/EPN blend gives optimal properties for shear and peel properties for both cases. The formulation containing cardanol performs better on Al-Al bonds while the t-butyl phenol based formulation is better suited for SBR-SBR bonds. Morphological studies using SEM indicate greater energy absorption and improved bond strength on addition of EPN into neoprene-phenolic formulations for both for SBR-SBR and Al-Al bonding. The successful application of cardanol, a renewable resource, for adhesive formulation is of significance.
Testosterone replacement therapy and hospitalization rates in men with COPD
Authors: Baillargeon Jacques , Urban Randall James , Zhang Wei , Zaiden Mohammed Fathi , Javed Zulqarnain , Sheffield-Moore Melinda , Kuo Yong-Fang , Sharma Gulshan
Published: September 2018

Testosterone deficiency is common in men with chronic obstructive pulmonary disease (COPD) and may exacerbate their condition. Research suggests that testosterone replacement therapy (TRT) may have a beneficial effect on respiratory outcomes in men with COPD. To date, however, no large-scale nationally representative studies have examined this association. The objective of the study was to assess whether TRT reduced the risk of respiratory hospitalizations in middle-aged and older men with COPD. We conducted two retrospective cohort studies. First, using the Clinformatics Data Mart—a database of one of the largest commercially insured populations in the United States—we examined 450 men, aged 40–63 years, with COPD who initiated TRT between 2005 and 2014. Second, using the national 5% Medicare database, we examined 253 men, aged ≥66 years, with COPD who initiated TRT between 2008 and 2013. We used difference-in-differences (DID) statistical modeling to compare pre- versus post-respiratory hospitalization rates in TRT users versus matched TRT nonusers over a parallel time period. DID analyses showed that TRT users had a greater relative decrease in respiratory hospitalizations compared with nonusers. Specifically, middle-aged TRT users had a 4.2% greater decrease in respiratory hospitalizations compared with nonusers (−2.4 decrease vs. 1.8 increase; p = 0.03); and older TRT users had a 9.1% greater decrease in respiratory hospitalizations compared with nonusers (−0.8 decrease vs. 8.3 increase; p = 0.04). These findings suggest that TRT may slow disease progression in patients with COPD. Future studies should examine this association in larger cohorts of patients, with particular attention to specific biological pathways.
Integrating Sexual Assault Resistance, Bystander, and Men’s Social Norms Strategies to Prevent Sexual Violence on College Campuses: A Call to Action
Authors: Orchowski Lindsay M. , Edwards Katie M. , Hollander Jocelyn A. , Banyard Victoria L. , Senn Charlene Y. , Gidycz Christine A.
Published: September 2018

Sexual assault prevention on college campuses often includes programming directed at men, women, and all students as potential bystanders. Problematically, specific types of sexual assault prevention are often implemented on campuses in isolation, and sexual assault risk reduction and resistance education programs for women are rarely integrated with other approaches. With increasing focus on the problem of sexual assault on college campuses, it is timely to envision a comprehensive and interconnected prevention approach. Implementing comprehensive prevention packages that draw upon the strengths of existing approaches is necessary to move toward the common goal of making college campuses safer for all students. Toward this goal, this commentary unpacks the models and mechanisms on which current college sexual assault prevention strategies are based with the goal of examining the ways that they can better intersect. The authors conclude with suggestions for envisioning a more synthesized approach to campus sexual assault prevention, which includes integrated administration of programs for women, men, and all students as potential bystanders on college campuses.
Gender-related outcomes of chimney EVAR within the PERICLES registry
Authors: Torsello G , Usai MV , Scali S , Kubilis P , Veith FJ , Markatis F , Donas KP
Published: September 2018

Objective

Gender-related differences in outcomes in complex endovascular aortic repair have not been profoundly investigated. Use of low profile abdominal devices as in chimney endovascular repair may be beneficial for female patients with pararenal pathologies. With the chimney technique, there is no need for large introduction sheaths. This could be an advantage in case of smaller in diameter iliac access especially in combination with stenosis or elongation. Aim of the present study was to compare the perioperative and mid-term outcomes between males and females patients treated with the chimney/snorkel technique for pararenal aortic pathologies.

Methods

The PERICLES registry collected the world wide experience with the chimney technique. According to the gender, patients were classified in two cohorts. Primary endpoints were freedom from occlusion of the chimney grafts and reintervention. Secondary endpoints included access site complications and need for surgical or interventional revision, Endoleak Type I rate, 30-day overall complications and mortality. Univariate comparison P-values were generated using either the likelihood ratio χ2 test, the Fisher exact test, the Wilcoxon rank sum test, or the log rank test. Kaplan–Meier curves estimated the outcomes in the long run.

Results

A total of 412 patients underwent Ch-EVAR, 71 (17%) females and 341 (83%) males with a mean age for both groups being 74 years were included in the present study. After 36 months of mean follow-up, no statistically significant difference was observed between the two cohorts regarding re-interventions ( P= .44). Freedom from occlusion rates at 36 months did not differed between the two groups (females 84% vs. 80% for males ( P= .033). For patients receiving more than one chimney stent, the odds of having a complication did not differ between males and females (M:F OR = 2.0, 95% CI: 0.6–6.4, P = 0.228); 30-day mortality was 0% in the female group, instead five male patients died within one month. ( P = 0.59). The incidence of acute renal failure was low in both groups without statistical difference: 2 (3.1%) vs. 13 (4.6%) 58 ( P = 1.00). Neither patient received an endoconduit to insert the abdominal device.

Conclusions

No statistically significant difference regarding the freedom from reintervention and chimney graft patency was observed between the two genders. The results highlight the beneficial use of the chimney technique in female patients who can have potentially higher risk of access complications.
Association between serum uric acid and carotid disease in patients with atherosclerotic acute ischemic stroke
Authors: Arévalo-Lorido José Carlos , Carretero-Gómez Juana , Robles Pérez-Monteoliva Nicolás Roberto
Published: September 2018

Aim

The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease.

Methods

Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis.

Results

A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 −1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005).

Conclusion

Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.
Forever trapped in the imaginary of late capitalism? The serialized true crime podcast as a wake-up call in times of criminological slumber
Authors: Yardley Elizabeth , Kelly Emma , Robinson-Edwards Shona
Published: September 2018

Within this article, we explore the emergence of the serialized true crime podcast through an ultra-realist lens. These representations have become increasingly popular in recent years and appear to embody changing sensibilities towards crime and criminal justice – we critically consider whether serialized true crime podcasts do or could represent a change from the true crime of the past. More importantly, we question the extent to which academic criminology is equipped to engage in critical analysis of this media and address the questions that they raise about crime and society’s response to it in late capitalist society.
Trafficking in Human Beings: Made and Cut to Measure? Anti-trafficking Docufictions and the Production of Anti-trafficking Truths
Authors: Sharapov Kiril , Mendel Jonathan
Published: September 2018

This article responds to Gozdziak’s (2015: 30) call to explore how the knowledge that informs public debates about human trafficking is generated. Media imagery and narratives play a significant role in constructing both knowledge and ignorance. This article reflects on the construction of such knowledge by analysing how anti-trafficking docufiction videos from the Unchosen competition dramatize trafficking. We draw on Goffman’s (1974) work on frames to analyse how these videos present a simplified interpretation of reality, where certain constructed aspects of trafficking and exploitation are represented by video-makers as illustrating the general. In doing so, we highlight how anti-trafficking docufictions help efface everyday exploitation. The article contributes both to the empirical research on the construction of knowledge about trafficking, and to critical conceptual work on (anti)trafficking, exploitation and ignorance. It is part of a broader project to challenge exceptionalizing and individualizing representations of human trafficking – aiming to engage better with everyday exploitation.
Posterior interosseous artery pedicle flap: an anatomical study of the relationship between the posterior interosseous nerve and artery
Authors: Keogh Angus , Graham David James , Tan Bryan
Published: September 2018

The anatomical relationships of the posterior interosseous artery and nerve are not well described. To characterize these relationships, ten cadaveric forearms were dissected and the relationships between the posterior interosseous nerve, its branches, and the posterior interosseous artery documented. The dissection of the posterior interosseous artery flap can be conceptualized in three zones with decreasing risk to the nerve as the dissection proceeds from proximal to distal. Provided fine motor branches of the posterior interosseous nerve are protected during the dissection of the nerve and artery, this flap can be harvested with safety.
What is the acceptability of real time 1:1 videoconferencing between clinicians and patients for a follow-up consultation for multi-directional shoulder instability?
Authors: Gilbert Anthony W , Jaggi Anju , May Carl R
Published: September 2018

Background

The use of real time 1:1 videoconferencing is growing in popularity in clinical practice. Authors have explored the effectiveness and acceptability of videoconferencing for patients; however, little research exists on the viewpoints of clinicians.

Methods

Patients with atraumatic shoulder instability attending a tertiary treatment centre were offered the choice of videoconferencing or a face-to-face consultation for their follow-up session. Immediately after the consultation a semi-structured interview was conducted to explore the underlying reasons behind its use and acceptability.

Results

All clinicians found the use of videoconferencing acceptable provided the patients were aware of its benefits and limitations. Of the 13 patients included in this study, seven chose to undergo a videoconferencing consultation. It was acceptable provided the clinical practice could be modified to achieve the objectives of the consultation. The use of videoconferencing required access to a quiet room with the appropriate technology.

Conclusion

Videoconferencing is not acceptable to all. Benefits included not having to travel and the opportunity to assess and treat patients in their home environment. The use of videoconferencing did not allow for ‘hands-on’ assessment which was important for less experienced clinicians.
DHE-Induced Peripheral Arterial Vasospasm in Primary Raynaud Phenomenon: Case Report
Authors: Khalife Jane , Lauritsen Clinton G. , Liang John , Shah Syed O.
Published: September 2018

Dihydroergotamine (DHE) is primarily a serotonin 5HT1B and 5HT1D receptor agonist used for acute migraine treatment. It is associated with acute vasoconstriction mediated through the 5HT1B receptor and is contraindicated in patients with history of cardiac disease and peripheral vascular disease. We present a case of acute peripheral arterial vasospasm in a patient with primary Raynaud phenomenon while receiving inpatient treatment for status migrainosus with intravenous (IV) DHE. The patient is a 35-year-old female with a history of chronic migraine and primary Raynaud phenomenon. After 15 doses of IV DHE, the patient reported paresthesias of the right hand and was noted to have absent right radial and ulnar pulses to palpation. Portable arterial Doppler study demonstrated abnormal flat line pulse volume recordings (PVRs) in the right second, third, and fourth digits, with markedly dampened PVR in the right thumb and fifth finger along with no ulnar PVR detectable at the wrist. Duplex revealed bilateral severely diminished flow in the right ulnar and radial arteries without acute occlusions. Computed tomography angiogram of right upper extremity visualized arteries through the mid-forearm but not distally. Dihydroergotamine was discontinued, and the patient was started on oral amlodipine and aspirin. Repeat Doppler ultrasound 3 days later revealed normal arm and digital waveforms bilaterally consistent with resolution of vasospasm. This case highlights a potential complication of IV DHE therapy. Risk may be increased in patients with primary Raynaud phenomenon. We suggest cautious use of IV DHE in this population.
Do third-party supporters recognize their party is out of the running? Evidence from Canada
Authors: Raymond Christopher D.
Published: September 2018

While the literature on tactical voting suggests third parties are not likely to form under first-past-the-post rules, the literature also provides several potential explanations for why third parties have flourished in several first-past-the-post systems, and why voters will support these parties. This research note examines the most popular of these explanations, which holds that voters supporting parties placing third or worse in their district fail to recognize their party is out of the running. Using Canadian Election Study data from three recent elections, the results show that most voters supporting parties placing third or worse in their districts recognize that their parties are not likely to finish first or second. These results suggest more attention should be paid to other potential explanations for third-party voting in first-past-the-post systems.
Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
Authors: Cowan Juthaporn , Bennett Alexandria , Fergusson Nicholas , McLean Cheynne , Mallick Ranjeeta , Cameron D. William , Knoll Greg
Published: September 2018

Background:

Reducing post-operative infections among kidney transplant patients is critical to improve long-term outcomes. With shifting disease demographics and implementation of new transplantation protocols, frequent evaluation of infection rate and type is necessary.

Objective:

Our objectives were to assess the incidence and types of post-operative infections in kidney transplant recipients at a large tertiary-care facility and determine sample sizes needed for future intervention trials.

Design:

Retrospective cohort study.

Setting:

The Ottawa Hospital, Ottawa, Ontario.

Patients:

Adult kidney transplant patients, N = 142.

Measurements:

Demographic data, transplant protocol, infections up to 2 years following transplantation.

Methods:

Infections within 2 years following transplantation in all kidney transplant recipients between January 2011 and December 2012 were reviewed. Sample sizes were determined using all-cause infection rates and infection-free survival data.

Results:

Of 142 patients, 44 (31.0%) had at least one infection. The incidence of infection was 36.2 per 100 patient-years by 2 years post-transplant. A total of 32 (22.5%) patients had 56 infection-related hospitalizations with 73.2% occurring in the first year. In the first 2 years, urinary tract infections had the highest incidence (18.1 per 100 patient-years) followed by skin (3.9 per 100 patient-years), cytomegalovirus (3.9 per 100 patient-years), and bacteremia (3.9 per 100 patient-years). Results indicate that 206 patients per study arm would be needed to show a 30% reduction in the 2-year incidence of infection post-transplantation.

Limitations:

Infection rates may be slightly underestimated due to the relatively short 2-year follow-up; however, the highest infection-risk period was captured within this time frame.

Conclusions:

Infections post-kidney transplant are still common, particularly urinary tract infections. They are associated with significant morbidity and hospitalization. Given the feasible sample sizes calculated in this study, intervention trials are indicated to further reduce infection rates within the first 2 years post-kidney transplantation.
Innovation and value in pre-commercial procurement
Authors: Brogaard Lena
Published: September 2018

Governments increasingly use novel forms of public procurement to stimulate innovation in public service delivery. A notable example is pre-commercial procurement. Launched by the European Commission a decade ago, pre-commercial procurement encourages research and development of new solutions for the public sector. However, limited theoretical and empirical studies have made it difficult to assess and improve use of the model to foster public innovation. Based on two pre-commercial procurement projects in Denmark, the article aims to complete the first systematic and theory-based evaluation of national experiences. The evaluation shows that sufficient resources, participant and management commitment, and focused management of the collaborative process contributed to successful development and testing of a new solution in one of the projects. Meanwhile, technical obstacles in developing a prototype resulted in termination of the other project. In this case, the pre-commercial procurement model cannot accommodate significant changes to the agreed solution during the innovation process.
Regulation performance of public–private partnerships in the Portuguese water sector
Authors: Marques Rui Cunha , Silvestre Hugo Consciência
Published: September 2018

Starting from transaction costs (and new institutional economic approaches, this study sought to understand the influence of the regulatory structure and incentives on the performance of public–private partnerships in Portugal. The findings of this case study show that agency participation in the mediation process between parties is time consuming and improper from a technical perspective; in addition, the agency is captured by political interests, which does not favor users’ interests or the sustainability of water services. Thus, the regulatory structure and incentives cannot be dependent on political nominations, and existing contractual rules need to be reassigned.
A Magnetic Resonance Imaging–Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification
Authors: Kohyama Sho , Ogawa Takeshi , Mamizuka Naotaka , Hara Yuki , Yamazaki Masashi
Published: September 2018

Background:

Evaluations of the stability of osteochondritis dissecans (OCD) lesions of the elbow using magnetic resonance imaging (MRI) have resulted in reports with variable accuracy. Therefore, the International Cartilage Repair Society (ICRS) classification remains the gold standard to determine OCD lesion stability. Because OCD commonly occurs in pediatric patients, a noninvasive method comparable with the ICRS classification is desired.

Hypothesis/Purpose:

Based on the previous literature, the capitellum of unstable OCD lesions has an irregular outline on MRI because of displacement or dislocation of the lesion via synovial fluid inflow. Therefore, we defined a 4-stage classification, similar to the ICRS classification, which focused on the outline of the capitellum and articular cartilage status on MRI without subchondral bone information. The purpose of this study was to validate this MRI-based staging system against the ICRS classification and to verify its accuracy in diagnosing unstable OCD lesions of the elbow.

Study Design:

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

Methods:

A total of 81 patients with OCD of the elbow who were surgically treated were evaluated. The MRI-based stages were as follows: stage 1, normal-shaped capitellum and articular cartilage without signal intensity change; stage 2, normal-shaped capitellum and articular cartilage with signal intensity change; stage 3, irregular-shaped capitellum and discontinuity of the articular cartilage; and stage 4, dislocated lesion with an articular cartilage defect. Agreement between the MRI and ICRS classifications was evaluated, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for lesion instability were determined. The intraclass correlation coefficient (ICC) for intrarater and interrater reliability of the MRI-based staging system was calculated.

Results:

Agreement between the MRI-based staging system and the ICRS classification was 88.9%, with a sensitivity of 98.4%, specificity of 84.2%, PPV of 95.3%, and NPV of 94.1% for diagnosing an unstable lesion. The ICC was high for both intrarater (0.925) and interrater (0.915-0.939) reliability.

Conclusion:

The MRI-based staging system corresponded well with the ICRS classification, providing an accurate preoperative assessment of OCD lesions of the elbow, even with minimal subchondral bone information.
Reforming care without bureaucracy
Authors: Tyrer Peter
Published: September 2018

The Care Programme Approach was a valiant attempt to improve the aftercare of people with severe mental illness after discharge from hospital. It was introduced as a response to a scandal, not an advance in knowledge, and has always suffered by being a reaction to events rather than a trailblazer for the future. It may have dragged the worst of care upwards, but at the expense of creating a bureaucratic monstrosity that has hindered good practice by excessive attention to risk, and vastly increased paperwork with intangible benefit. It needs to be simplified to allow practitioners greater scope for collaborative solutions, less minatory oversight and better use of strained resources.

Declaration of interest

None.
Clozapine is associated with secondary antibody deficiency
Authors: Ponsford Mark , Castle Daniel , Tahir Tayyeb , Robinson Rebecca , Wade Wendy , Steven Rachael , Bramhall Kathryn , Moody Mo , Carne Emily , Ford Catherine , Farewell Daniel , Williams Paul , El-Shanawany Tariq , Jolles Stephen
Published: September 2018

Background

Schizophrenia affects 1% of the population. Clozapine is the only medication licensed for treatment-resistant schizophrenia and is intensively monitored to prevent harm from neutropenia. Clozapine is also associated with increased risk of pneumonia although the mechanism is poorly understood.

Aims

To investigate the potential association between clozapine and antibody deficiency.

Methods

Patients taking clozapine and patients who were clozapine-naive and receiving alternative antipsychotics were recruited and completed a lifestyle, medication and infection-burden questionnaire. Serum total immunoglobulins (immunoglobulin (Ig)G, IgA, IgM) and specific IgG antibodies to haemophilus influenzae type B, tetanus and IgG, IgA and IgM to pneumococcus were measured.

Results

Immunoglobulins were all significantly reduced in the clozapine-treated group (n= 123) compared with the clozapine-naive group (n= 111). Odds ratios (ORs) for a reduction in clozapine:control immunoglobulin values below the fifth percentile were IgG, OR = 6.00 (95% CI 1.31–27.44); IgA, OR = 16.75 (95% CI 2.18–128.60); and IgM, OR = 3.26 (95% CI 1.75–6.08). These findings remained significant despite exclusion of other potential causes of hypogammaglobulinaemia. In addition, duration on clozapine was associated with decline in IgG. A higher proportion of the clozapine-treated group reported taking more than five courses of antibiotics in the preceding year (5.3% (n= 5) versus 1% (n= 1).

Conclusions

Clozapine use was associated with significantly reduced immunoglobulin levels and an increased proportion of patients using more than five antibiotic courses in a year. Antibody testing is not included in existing clozapine monitoring programmes but may represent a mechanistic explanation and modifiable risk factor for the increased rates of pneumonia and sepsis-related mortality previously reported in this vulnerable cohort.

Declaration of interest

S.J. has received support from CSL Behring, Shire, LFB, Biotest, Binding Site, Sanofi, GSK, UCB Pharma, Grifols, BPL SOBI, Weatherden, Zarodex and Octapharma for projects, advisory boards, meetings, studies, speaker and clinical trials.
Use of Patient-Reported Outcome Measures in Quality Oncology Practice Initiative–Registered Practices: Results of a National Survey
Authors: Zhang Biqi , Lloyd Whit , Jahanzeb Mohammad , Hassett Michael J.
Published: September 2018

Purpose:

Measuring patient-reported outcomes (PROs) in clinical practice has been associated with improved survival and quality of life for patients with cancer. However, this application of PROs is relatively new, and little is known about how practices collect PROs, which PROs are measured, and what challenges are met in implementation.

Methods:

We surveyed Quality Oncology Practice Initiative–registered practices in December 2015 to understand the current state of PROs use and identify areas where implementation support may be needed. PRO collectors were asked to describe their views, practices, and challenges with implementation; noncollectors were asked about their interest in and perceived barriers to collection.

Results:

Eighty-nine practices (38% of those that viewed the participation request) completed ≥ 50% of the survey and comprised the analytic sample. Most (79%) responders noted that collecting PROs was a high priority; slightly fewer actually collected PROs (69%). Most collectors (79%) were affiliated with hospitals or medical centers, and nearly all (94%) had electronic health records (EHRs). Collectors saw more patients per week than noncollectors ( P < .01). The PROs used by collectors addressed several topics, including patient distress (78%), symptoms (76%), and experience or satisfaction (70%). Perceived implementation challenges were similar for collectors and noncollectors: patient unwillingness to complete questionnaires and insufficient staff support; noncollectors additionally cited lack of PRO integration in the electronic health records.

Conclusion:

Widespread agreement that PRO collection is important has led to early adoption among a sizable minority of Quality Oncology Practice Initiative practices. Reaching consensus regarding which PROs are meaningful and developing and sharing best-practices that overcome implementation barriers could facilitate implementation and maximize PRO utility.
VAMP7 Regulates Autophagosome Formation by Supporting Atg9a Functions in Pancreatic β-Cells From Male Mice
Authors: Aoyagi Kyota , Itakura Makoto , Fukutomi Toshiyuki , Nishiwaki Chiyono , Nakamichi Yoko , Torii Seiji , Makiyama Tomohiko , Harada Akihiro , Ohara-Imaizumi Mica
Published: September 2018

Dysfunctional mitochondria are observed in β-cells of diabetic patients, which are eventually removed by autophagy. Vesicle-associated membrane protein (VAMP)7, a vesicular SNARE protein, regulates autophagosome formation to maintain mitochondrial homeostasis and control insulin secretion in pancreatic β-cells. However, its molecular mechanism is largely unknown. In this study, we investigated the molecular mechanism of VAMP7-dependent autophagosome formation using VAMP7-deficient β-cells and β-cell–derived Min6 cells. VAMP7 localized in autophagy-related (Atg)9a–resident vesicles of recycling endosomes (REs), which contributed to autophagosome formation, and it interacted with Hrb, Syntaxin16, and SNAP-47. Hrb recruited VAMP7 and Atg9a from the plasma membrane to REs. Syntaxin16 and SNAP-47 mediated autophagosome formation at a step later than the proper localization of VAMP7 to Atg9a-resident vesicles. Knockdown of Hrb, Syntaxin16, and SNAP-47 resulted in defective autophagosome formation, accumulation of dysfunctional mitochondria, and impairment of glucose-stimulated insulin secretion. Our data indicate that VAMP7 and Atg9a are initially recruited to REs to organize VAMP7 and Atg9a-resident vesicles in an Hrb-dependent manner. Additionally, VAMP7 forms a SNARE complex with Syntaxin16 and SNAP-47, which may cause fusions of Atg9a-resident vesicles during autophagosome formation. Thus, VAMP7 participates in autophagosome formation by supporting Atg9a functions that contribute to maintenance of mitochondrial quality.
Calcium influx mediates the chemoattractant-induced translocation of the arrestin-related protein AdcC in Dictyostelium
Authors: Mas Lauriane , Cieren Adeline , Delphin Christian , Journet Agnès , Aubry Laurence
Published: September 2018

Arrestins are key adaptor proteins that control the fate of cell-surface membrane proteins and modulate downstream signaling cascades. Dictyostelium discoideum genome encodes six arrestin-related proteins, harboring additional modules besides the arrestin domain. Here, we studied AdcB and AdcC, two homologs that contain C2 and SAM-domains. We showed that AdcC, in contrast to AdcB, responds to various stimuli (such as the chemoattractants cAMP and folate) known to induce a cytosolic calcium rise by a transient translocation to the plasma membrane and that calcium is a direct regulator of AdcC localization. This response requires the calcium-dependent membrane targeting C2 domain and the double SAM domain involved in AdcC oligomerization, revealing a mode of membrane targeting and regulation unique among members of the arrestin clan. AdcB shares several biochemical properties with AdcC including in vitro binding to anionic lipids in a calcium-dependent manner and auto-assembly as large homo-oligomers. AdcB can interact with AdcC; still its intracellular localization is insensitive to calcium. Despite their high degree of homology and common characteristics, AdcB and AdcC are therefore likely to fulfill distinct functions in amoeba.
Co-expression of sperm membrane proteins CMTM2A and CMTM2B is essential for ADAM3 localization and male fertility in mice
Authors: Fujihara Yoshitaka , Oji Asami , Kojima-Kita Kanako , Larasati Tamara , Ikawa Masahito
Published: September 2018

Chemokines are signaling proteins that are secreted to induce chemotaxis during immunological events. However, the functions of transmembrane-type chemokine-like factor (CKLF) and the protein family CMTM (CKLF-like MARVEL transmembrane domain containing) remain to be determined. In this study, we focused on the testis-specific mouse Cmtm gene cluster (Cmtm1, Cmtm2a, and Cmtm2b) and generated CRISPR/Cas9-mediated mutant mice to examine its physiological functions. Although Cmtm1 mutant mice were fertile, Cmtm2a and Cmtm2b double mutant mice had defects in male fertility due to impaired sperm function. We found that co-expression of sperm membrane proteins CMTM2A and CMTM2B is required for male fertility and affects the localization of the sperm membrane protein ADAM3 in regulating sperm fertilizing ability.