bluuebunny/crossref_metadata_2025 huggingface dataset:
Life course socioeconomic position and incidence of mid–late life depression in China and England: a comparative analysis of CHARLS and ELSA
Authors: Ruiz Milagros , Hu Yaoyue , Martikainen Pekka , Bobak Martin
Published: June 2019

Background

Despite the growing prevalence of depression in the Chinese elderly, there is conflicting evidence of life course socioeconomic position (SEP) and depression onset in China, and whether this association is akin to that observed in Western societies. We compared incident risk of mid–late life depression by childhood and adulthood SEP in China and England, a country where mental health inequality is firmly established.

Methods

Depression-free participants from the China Health and Retirement Longitudinal Study (N=8508) and the English Longitudinal Study of Ageing (N=6184) were studied over 4 years. Depressive symptoms were classified as incident cases using the Center for Epidemiologic Studies Depression Scale criteria. Associations between SEP (education, wealth, residence ownership and childhood/adolescent deprivation) and depression symptom onset were assessed using Cox proportional hazards models. In China, we also investigated children’s government employment status as a SEP marker.

Results

Higher education and wealth predicted lower incidence of depression in both countries. The association with non-ownership of residence appeared stronger in England (HR 1.61, 95% CI 1.41 to 1.86) than in China (HR 1.11, 95% CI 0.95 to 1.29), while that with childhood/adolescent deprivation was stronger in China (HR 1.43, 95% CI 1.29 – 1.60) than in England (HR 1.33, 95% CI 0.92 to 1.92). Chinese adults whose children were employed in high-status government jobs, had lower rates of depression onset.

Conclusions

Consistent findings from China and England demonstrate that SEP is a pervasive determinant of mid–late life depression in very diverse social contexts. Together with conventional measures of SEP, the SEP of children also affects the mental health of older Chinese.
Neurophysiological, nerve imaging and other techniques to assess chemotherapy-induced peripheral neurotoxicity in the clinical and research settings
Authors: Argyriou Andreas A , Park Susanna B , Islam Badrul , Tamburin Stefano , Velasco Roser , Alberti Paola , Bruna Jordi , Psimaras Dimitri , Cavaletti Guido , Cornblath David R
Published: June 2019

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common dose-limiting side effect of several anticancer medications. CIPN may involve multiple areas of the peripheral nervous system from the autonomic and dorsal root ganglia (DRG) to the axon and any peripheral nerve fibre type. Large diameter sensory myelinated (Aβ) fibres are more frequently involved, but motor, small myelinated (Aδ), unmyelinated (C) or autonomic fibres may also be affected. Here, we review the current evidence on techniques for the CIPN assessment in the clinical and experimental settings. Nerve conduction studies (NCS) may be used at the subclinical and early CIPN stage, to assess the extent of large nerve fibre damage and to monitor long-term outcomes, with the sural or dorsal sural nerve as the most informative. The quantitative sensory neurological examination provides valuable data alongside NCS. Quantitative sensory testing and nerve excitability studies add information regarding pathophysiology. Nerve MRI and ultrasound may provide information on enlarged nerve, increased nerve signal intensity and DRG or spinal cord changes. Skin biopsy, corneal confocal microscopy, laser-evoked potentials, contact heat-related potentials and microneurography may reveal the extent of damage to small unmyelinated nerve fibres that go undetected by NCS. The information on the role of these latter techniques is preliminary. Hence, the use of multimodal testing is recommended as the optimal CIPN assessment strategy, employing objective NCS and other specialised techniques together with subjective patient-reported outcome measures.
Moral uncertainty and the farming of human-pig chimeras
Authors: Koplin Julian , Wilkinson Dominic
Published: June 2019

It may soon be possible to generate human organs inside of human-pig chimeras via a process called interspecies blastocyst complementation. This paper discusses what arguably the central ethical concern is raised by this potential source of transplantable organs: that farming human-pig chimeras for their organs risks perpetrating a serious moral wrong because the moral status of human-pig chimeras is uncertain, and potentially significant. Those who raise this concern usually take it to be unique to the creation of chimeric animals with ‘humanised’ brains. In this paper, we show how that the same style of argument can be used to critique current uses of non-chimeric pigs in agriculture. This reveals an important tension between two common moral views: that farming human-pig chimeras for their organs is ethically concerning, and that farming non-chimeric pigs for food or research is ethically benign. At least one of these views stands in need of revision.
Real-world comparison of clopidogrel, prasugrel and ticagrelor in patients undergoing primary percutaneous coronary intervention
Authors: Krishnamurthy Arvindra , Keeble Claire , Anderson Michelle , Somers Kathryn , Burton-Wood Natalie , Harland Charlotte , Baxter Paul , McLenachan Jim , Blaxill Jonathan , Blackman Daniel J , Malkin Christopher , Wheatcroft Stephen , Greenwood John
Published: June 2019

Background

There is a paucity of real-world outcome data comparing clopidogrel, prasugrel and ticagrelor in primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI). We sought to assess the association of choice of oral P2Y12-receptor inhibitor with clinical outcomes following PPCI for STEMI in a large consecutive patient series.

Methods

Demographic, procedural and 12-month outcome data were prospectively collected for all patients undergoing PPCI in Leeds, UK, between 01 January 2009 and 31 December 2011, and 01 January 2013 and 31 December 2013. Clinical endpoints were 30-day and 12-month all-cause mortality, recurrent MI and 30-day HORIZONS-major bleeding. Logistic regression analyses were undertaken to adjust for confounding factors.

Results

Prasugrel (n=1244) was associated with lower adjusted 30-day (OR 0.53 (0.34–0.85)) and 12-month (OR 0.55 (0.38–0.78)) mortality, and 12-month MI (OR 0.63 (0.42–0.94)) compared with clopidogrel (n=1648). Importantly, prasugrel was associated with lower adjusted 30-day mortality (OR 0.51 (0.29–0.91)) compared with ticagrelor (n=811). Lower 30-day (OR 0.40 (0.17–0.94)) and 12-month (OR 0.54 (0.32–0.93)) MI were observed in ticagrelor compared with clopidogrel, an association absent in comparison with prasugrel. Adjusted bleeding were not statistically significantly different among the P2Y12-receptor inhibitors.

Conclusion

In this large consecutive real-world series, prasugrel was associated with lower adjusted 30-day mortality compared with ticagrelor and clopidogrel, and lower adjusted 12-month mortality compared with clopidogrel. Both prasugrel and ticagrelor were associated with lower recurrent MI following PPCI compared with clopidogrel, with no overall increase in adjusted bleeding.
Transformer Fault Diagnosis Based on BP‐Adaboost and PNN Series Connection
Authors: Yan Chun , Li Meixuan , Liu Wei
Published: July 2019

Dissolved gas‐in‐oil analysis (DGA) is a powerful method to diagnose and detect transformer faults. It is of profound significance for the accurate and rapid determination of the fault of the transformer and the stability of the power. In different transformer faults, the concentration of dissolved gases in oil is also inconsistent. Commonly used gases include hydrogen (H2), methane (CH4), acetylene (C2H2), ethane (C2H6), and ethylene (C2H4). This paper first combines BP neural network with improved Adaboost algorithm, then combines PNN neural network to form a series diagnosis model for transformer fault, and finally combines dissolved gas‐in‐oil analysis to diagnose transformer fault. The experimental results show that the accuracy of the series diagnosis model proposed in this paper is greatly improved compared with BP neural network, GA‐BP neural network, PNN neural network, and BP‐Adaboost.
Temporal Trends on Percutaneous Mitral Commissurotomy: 30 Years of Experience
Authors: Desnos Cyrielle , Iung Bernard , Himbert Dominique , Ducrocq Grégory , Urena Marina , Cormier Bertrand , Brochet Eric , Ou Phalla , Vahanian Alec , Bouleti Claire
Published: June 2019

Background

Percutaneous mitral commissurotomy (
PMC
) was the first available transcatheter technique for treatment of mitral valve diseases. Experience has led to extending the indications to patients with less favorable characteristics. We aimed to analyze (1) the temporal trends in characteristic and outcomes of patients undergoing
PMC
in a single center over 30 years and (2) the predictive factors of poor immediate results of
PMC
.

Methods and Results

From 1987 to 2016, 1 full year for each decade was analyzed: 1987, 1996, 2006, and 2016. Poor immediate results of
PMC
were defined as a mitral valve area <1.5 cm
2
or
MR
(mitral regurgitation) grade >2. Mitral anatomy was assessed using the Cormier classification and the fluoroscopic extent of calcification. Six hundred three patients were included: 111, 202, 205, and 85, respectively. Mean age increased >10 years over time (
P
<0.0001). Mitral anatomy was less favorable over the years: the presence of calcification increased from 25% of patients at the beginning of
PMC
to >40% during the past decade (
P
<0.0001) with a 3‐fold increase in severe mitral calcification. Consistently, the proportion of good immediate results decreased over time (
P
<0.05) but remained at 76% in 2016. Multivariate analysis showed 3 predictive factors of poor immediate results: smaller baseline mitral valve area (
P
<0.0001), pre‐
PMC MR
grade 2 (
P
<0.01), and the presence or amount of calcification (
P
<0.001).

Conclusions

This clinic's patients became significantly older with more frequent and severe calcification in the past decade. Predictive factors of poor immediate results were related to valve anatomy, including calcification. Despite challenges raised by severe calcification,
PMC
was still successful in >3 out of 4 patients in recent years.
Percutaneous Mitral Balloon Valvuloplasty: Worldwide Trends
Authors: Palacios Igor F.
Published: June 2019

See Article
Desnos et al
Balancing Weight Loss and Sarcopenia in Elderly Patients With Peripheral Artery Disease
Authors: Kokkinidis Damianos G. , Armstrong Ehrin J. , Giri Jay
Published: June 2019

See Article
Polonsky et al
A species radiation among South African flightless spring katydids (Orthoptera: Tettigoniidae: Phaneropterinae: Brinckiella Chopard)
Authors: NASKRECKI PIOTR , BAZELET CORINNA S.
Published: July 2019

A previously unknown radiation among flightless spring katydids (Tettigoniidae: Phaneropterinae: Brinckiella) in Western and Northern Cape provinces of South Africa is described. Seven species are described as new (B. aptera n. sp., B. arboricola n. sp., B. elegans n. sp., B. karooensis n. sp., B. mauerbergerorum n. sp., B. serricauda n. sp., and B. wilsoni n. sp.) and one species (B. viridis Chopard) is redescribed.
Cranial anatomy of Jeholosaurus shangyuanensis (Dinosauria: Ornithischia) from the Early Cretaceous of China
Authors: BARRETT PAUL M. , HAN FENG-LU
Published: July 2019

A detailed description of the skull and mandible of the Chinese cerapodan ornithischian dinosaur Jeholosaurus shangyuanensis (Lower Cretaceous, Yixian Formation) is presented for the first time and this information is used to reassess its phylogenetic position. Jeholosaurus can be distinguished from all other cerapodans on the basis of one autapomorphy (a row of small foramina on the nasal) and a character combination that is unique among ornithischians. Previously undescribed specimens add considerably to our knowledge of Jeholosaurus, providing new insights into its anatomy and ontogeny. Revised character scores increase the resolution of phylogenetic hypotheses and provide additional support for placement of Jeholosaurus within Ornithopoda.
Eco-friendly castor oil-based UV-curable urethane acrylate zinc oxide nanocomposites: Synthesis and viscoelastic behavior
Authors: Madhi Abbas , S Hadavand Behzad
Published: June 2019

Attention to environmental problems and the importance of maintaining it have caused the researchers to pay more attention in this regard. The production of polymers and resins has increased in recent years and has affected by environmental pollution due to their long-term degradation. An appropriate solution to this problem is the synthesis of degradable and environmentally friendly polymers and resins. Using natural materials in the synthesis of polymers and resins can help them to be environmentally friendly. The purpose of this research is to synthesize urethane acrylate resins using natural resources. For this purpose, the urethane acrylate pre-polymer was synthesized with castor oil. Then, using modified zinc oxide nanoparticles with 1, 3 and 5 wt% urethane acrylate zinc oxide nanocomposites were produced. The use of castor oil as a degradable part and lack of organic solvent in radiation systems led to the creation of an environmentally friendly resin. Subsequently, the viscoelastic behavior of the prepared nanocomposite was evaluated. Spectrometry results confirm the synthesized resin structure. The morphology of nanocomposites confirmed the proper particle size distribution in a 3 wt.% sample. The results of the dynamic mechanical thermal analysis test showed that increasing the amount of modified nano ZnO could increase the glass transition temperature, and the maximum value was observed in 5 wt.% modified nano ZnO (69.7℃).
A three-dimensional progressive damage model for drop-weight impact and compression after impact
Authors: Pham Dinh Chi , Lua Jim , Sun Haotian , Zhang Dianyun
Published: June 2019

In this paper, an enhanced three-dimensional continuum damage mechanics model is applied to predict the drop-weight impact response and compression after impact failure of a fiber-reinforced polymer composite specimen. The three-dimensional progressive damage model incorporates a three-dimensional maximum stress criterion to predict the intra-ply damage initiation, followed by a fracture-energy-based smeared crack model to capture the post-peak softening behavior. Driven by the dominant through-the-thickness failure under impact loading, a three-dimensional continuum damage model is implemented for the three-dimensional solid element via its explicit material model for Abaqus (VUMAT) to capture the effect of three-dimensional stress state and the interaction of matrix cracking and delamination. Abaqus’ restart analysis capability is used to activate the compression after impact analysis using the final damage state from the dynamic impact analysis. Both the dynamic failure and the compression after impact are demonstrated via a suite of verification examples followed by the sensitivity analysis using distinct impact configurations. The predictive capability of the proposed three-dimensional damage model is first verified using a static open-hole tension test. Applications of the damage model are then demonstrated for simulations of the dynamic drop-weight tests and compression after impact tests. A comparative study on the developed method is performed using the results predicted from the open-source CompDam. A sensitivity study is also performed to demonstrate the impact energy-dependent failure mode. The proposed model has shown its advantages in performing a quick assessment of impact damage and its effects on the residual compressive strength.
Evaluation of single-component chitosan fiber: from advanced materials to contemporary fashion manufacturing
Authors: Luo Xue , Li Li
Published: June 2019

Advancements in material science have driven the development of the textile industry. Chitosan has inherent advantages, such as biodegradability, nontoxicity, and antibacterial and wound acceleration properties. It has been applied in the textile industry as a coating on fabrics. Nevertheless, research on single-component chitosan fibers is scant. The advantages of single-component chitosan fibers include improved comfort, laundry durability, abrasion resistance, and structural flexibility. To fill the mentioned research gap, this study developed an industrial-manufacturing-based method for testing and analyzing chitosan fibers. This method was demonstrated by studying the physical and biological performance of commercial chitosan fibers. Studying the characteristics of the chitosan fibers revealed the influence of the fiber structure on their performance. Although chitosan fibers with a higher degree of deacetylation had a shorter molecular chain, they exhibited higher strength. Moreover, the molecular weight and deacetylation degree influenced biological performance. Chitosan fibers with higher deacetylation degree chitosan had better antimicroorganism performance on Staphylococcus aureus, Escherichia coli, and Candida albicans; however, no such relationship was observed for the solution form of chitosan. These results imply a difference in antimicroorganism mechanisms between the fiber (solid) form and solution form of chitosan.
Factors Associated With Mental Health Status Among Older Primary Caregivers in Japan
Authors: Ninomiya Sumi , Tabuchi Keiji , Rahman Md Moshiur , Kobayashi Toshio
Published: June 2019

This study aimed to elucidate factors affecting the mental health status of older primary caregivers. Participants comprised 81 pairs of home care recipients aged ≥65 years and primary caregivers aged ≥65 years who were caring for the recipients. We used an individual interview method, which covered basic attributes, activities of daily living by Barthel Index, mental health status by Center for Epidemiologic Studies Depression Scale (CES-D), sense of coherence (SOC), and sense of care burden by Japanese version of the Zarit Burden Interview (J-ZBI). The score for the comprehensibility subscale of the SOC was significantly higher for the old-old caregivers compared with the young-old caregivers ( P < .01). A significant positive correlation between the number of years of caregiving and the score for the SOC meaningfulness subscale was seen for the young-old caregivers ( P < .05). For the old-old caregivers alone, negative correlations were seen between the CES-D score and the scores for all the SOC items. Multiple linear regression analysis using CES-D as the dependent variable showed a significant positive relationship to J-ZBI in all caregivers ( P < .01). In contrast, a significant negative relationship was seen with meaningfulness, an SOC subscale only for the old-old caregivers. Meaningfulness as well as J-ZBI was extracted as a factor affecting the mental health status of the old-old caregivers, suggesting that higher SOC relates to lower stress levels with a remarkable decline in physical condition. Meaningfulness, an SOC subscale, is an important factor for improving the mental health of old-old caregivers.
Not in My Backyard: Personal Politics and Resident Attitudes toward Tourism
Authors: Litvin Stephen W. , Smith Wayne W. , McEwen William R.
Published: June 2019

This research looks at the relationship between political libertarianism and personal self-interest, as informed by the concept of NIMBYism (not-in-my-backyard) that underlies much of the resident attitude toward tourism literature. Based on a comprehensive survey of more than 500 residents from Charleston, South Carolina, a city heavily dependent on tourism, the research determined, as the literature would predict, that general views toward tourism were highly dependent on where one lives. However, for specific tourism issues, one’s personal political views tended to trump geography. Application of theory and suggestions for tourism policy makers are provided.
Disaggregating Homicide: Changing Trends in Subtypes over Time
Authors: Skott Sara
Published: June 2019

Due to the heterogeneity of homicide, certain subtypes of homicide might have remained stable or even increased over time in the overall context of decline. Adding to the research attempting to identify a standardized classification system of homicide, this study used a novel, sophisticated statistical approach (multilevel latent class analysis [MLCA]) and an inductive theoretical stance to identify subtypes of homicide in Scotland and to examine how these types have changed over time. Using variables relating to the victim, offender, and the incident of homicide, four between-level types with three within-level classes of offenders in each type were identified. The findings showed that while all homicide types demonstrated an absolute decrease, domestic homicides had demonstrated a relative increase over time. Implications for policy, theory, and practice are discussed.
Medical Waste Management in Community Health Centers: Different Experience From East Azerbaijan Province, Iran
Authors: Saadati Mohammad , Azami-Aghdash Saber , Rezapour Ramin
Published: June 2019

We provide commentary on the article “Medical Waste Management in Community Health Centers” to extend our results and highlight private community performance. We also present a new approach to medical waste management in PHCs through using various forms of Public–Private Partnership models.
Alternative Conversion Methods for Transition Probabilities in State-Transition Models: Validity and Impact on Comparative Effectiveness and Cost-Effectiveness
Authors: Jahn Beate , Kurzthaler Christina , Chhatwal Jagpreet , Elbasha Elamin H. , Conrads-Frank Annette , Rochau Ursula , Sroczynski Gaby , Urach Christoph , Bundo Marvin , Popper Niki , Siebert Uwe
Published: June 2019

Background. In state-transition models (STMs), decision problems are conceptualized using health states and transitions among those health states after predefined time cycles. The naive, commonly applied method (C) for cycle length conversion transforms all transition probabilities separately. In STMs with more than 2 health states, this method is not accurate. Therefore, we aim to describe and compare the performance of method C with that of alternative matrix transformation methods. Design. We compare 2 alternative matrix transformation methods (Eigenvalue method [E], Schure-Padé method [SP]) to method C applied in an STM of 3 different treatment strategies for women with breast cancer. We convert the given annual transition matrix into a monthly-cycle matrix and evaluate induced transformation errors for the transition matrices and the long-term outcomes: life years, quality-adjusted life-years, costs and incremental cost-effectiveness ratios, and the performance related to the decisions. In addition, we applied these transformation methods to randomly generated annual transition matrices with 4, 7, 10, and 20 health states. Results. In theory, there is no generally applicable correct transformation method. Based on our simulations, SP resulted in the smallest transformation-induced discrepancies for generated annual transition matrices for 2 treatment strategies. E showed slightly smaller discrepancies than SP in the strategy, where one of the direct transitions between health states was excluded. For long-term outcomes, the largest discrepancy occurred for estimated costs applying method C. For higher dimensional models, E performs best. Conclusions. In our modeling examples, matrix transformations (E, SP) perform better than transforming all transition probabilities separately (C). Transition probabilities based on alternative conversion methods should therefore be applied in sensitivity analyses.
Narrative archetypes in the imagery of clients in Guided Imagery and music therapy sessions
Authors: Dukic Helena , Parncutt Richard , Bunt Leslie
Published: June 2019

This study explores imagery evoked by Guided Imagery and Music’s (GIM) ‘Nurturing’ programme (seven classical orchestral compositions) and relates it to Jung’s Eros principle (passive and nurturing). Participants’ statements during 23 GIM sessions were recorded, transcribed and categorised by five coders into seven sub-categories, three of which belonged to Jung’s Eros (Flora, Fauna, Feelings), three to his Logos (Events, Structures, Actions), and one (Characters) that mixed Eros and Logos. The same categorisation was applied to 23 randomly selected fairy-tales from different cultures as a comparison. We predicted that participants’ imagery would be mainly Eros, corresponding to the choice of music. In fact, categories Structures(Logos), Flora(Eros), Fauna(Eros) and Feelings(Eros) occurred significantly more often in participants’ imagery than in the fairy-tale comparisons. These categories are plot-static: they do not generate active relationships between characters. Events(Logos), Actions(Logos) and Characters(Eros/Logos) occurred significantly less often. We conclude that music of the ‘Nurturing’ programme elicits mostly the Eros type imagery. It has the psychological function of creating an emotional-scenic background, but does not drive the narrative plot. In this sense, it may be misleading to describe the music of ‘Nurturing’ as a kind of virtual narrative or as having narrative structure or function.
An interpretative phenomenological analysis of exercisers’ use of music during workouts
Authors: Hallett Rachel , Lamont Alexandra
Published: June 2019

This study explores exercisers’ use of self-selected music. Ten participants (seven female, three male) aged 26–58 years who exercised regularly took part in semi-structured interviews about their exercise and music use. Interviews explored how they sourced, selected and experienced music during exercise. The recorded data were transcribed and analysed using interpretative phenomenological analysis (IPA) to identify common patterns while also recognising individual experience. Four themes were identified: Taking control, referring to overcoming internal and external challenges through music; It’s all about me, involving self-identity and social positioning; Exercise-music literacy, concerning musical judgement and technological skills; and Embodiment, concerning body-music-hardware interactions and synchronisation. The results show examples of circumstances under which music provides exercisers with both positive and negative experiences. The findings contribute to understanding of the effects of music in exercise and demonstrate the individuality of preferences and usage.
Music in dreams: A diary study
Authors: König Nina , Schredl Michael
Published: June 2019

In every culture and nation music has been mentioned as a sort of natural language. While the existence of dreams including music in musicians has been anecdotally reported, music in dreams have been rarely studied empirically. In the present study, 425 participants, mostly psychology students, reported their dreams in a dream diary for 14 days as well as the intensity of their dream emotions and answered a questionnaire about whether they play existing music or compose new music during the day. As expected, for persons playing an instrument in their leisure time, there was a direct link between playing an instrument during the day and having more dreams including music, thus confirming the continuity hypothesis of dreaming. In addition, dreams including music were more positively-toned regarding emotions than dreams in general. Further research might investigate, for example, whether dreams including music play a role in improving music performance skills.
The effect of concurrent visual feedback on adult singing accuracy
Authors: Paney Andrew S , Tharp Kevin L
Published: June 2019

The purpose of this study was to test the effect of concurrent visual feedback on adult non-musicians’ growth in pitch accuracy over 10 weeks. University students not majoring in music were randomly assigned to one of two groups and played a computer game, SingingCoach, that provided concurrent visual feedback based on their singing accuracy. The pre-/post-test design with a treatment showed that both groups improved their scores significantly over 10 weeks, but the treatment group, the group that received concurrent feedback, did not score significantly higher than the control group that received no concurrent feedback. Participants’ ratings of their own singing increased significantly over the 10 weeks. Singing more often, particularly with objective, concurrent feedback, may help inexperienced singers improve their singing and their perception of their own singing potential.
Young Driver Crashes with Cyclists: Identifying Training Opportunities
Authors: Haworth Narelle , Legge Matthew , Twisk Divera , Bonham Jennifer , O’Hare Tyler , Johnson Marilyn
Published: June 2019

To understand where driver training should focus to contribute to improving the safety of cyclists, this study compared bicycle-motor-vehicle (BMV) crashes involving novice drivers (under 25 years) with those involving experienced drivers in the Australian states of Victoria, Queensland, and South Australia. Novice drivers were involved in only a small proportion of BMV crashes and were not over-represented on a per-license basis. For both driver groups, most crashes happened on lower speed roads, at intersections, and during the day. In contrast to expectations, the distribution of types of BMV crashes differed little between experienced and novice drivers. The absence of major differences between experienced and novice drivers may result from learning opportunities being too infrequent in low-volume cycling countries, but this hypothesis needs further testing. A comparison between Queensland and Victoria showed three situations with a higher proportion of young driver crashes: in the evening in both states, Right through-opposing directions (Victoria only), and From footway-maneuvering (Queensland only). These patterns are likely to be indicative of young driver experiences. When their time on the road increases, so does their exposure to risk and to challenging driving conditions (e.g., driving in darkness). On the other hand, these patterns may also point to effects of legislation on young driver crashes, for instance cycling on the sidewalk in Queensland. The results suggest that training for novice drivers needs to supplement a wider strategy to improve cyclist safety (including infrastructure and traffic management improvements) and that training needs to be tailored to state-specific conditions.
Feasibility of a Lifestyle Physical Activity Intervention to Prevent Memory Loss in Older Women With Cardiovascular Disease: A Mixed-Methods Approach
Authors: Halloway Shannon , Wilbur JoEllen , Schoeny Michael E. , Braun Lynne T. , Aggarwal Neelum T. , Miller Arlene M. , Crane Melissa M. , Volgman Annabelle S.
Published: June 2019

Background

Memory loss in older age affects women more than men and cardiovascular disease is a leading risk factor. Physical activity can improve memory in healthy older adults; however, few physical activity interventions have targeted women with cardiovascular disease, and none utilized lifestyle approaches.

Purpose

The purpose of this study was to examine feasibility, acceptability, and preliminary effects of a 24-week lifestyle physical activity intervention (physical activity prescription, five group meetings, and nine motivational interviewing calls).

Methods

A sequential mixed-methods approach was used. Participants were 18 sedentary women ≥65 years with cardiovascular disease and without cognitive impairment recruited in August 2017. Feasibility, acceptability, self-reported health, accelerometer-assessed physical activity, and neurocognitive memory tests were measured using a pre-post test design. Two post-intervention focus groups ( n = 8) were conducted in June 2018. Concept analysis was used to identify barriers/motivators of intervention participation.

Results

Meeting attendance was >72% and retention was 94%. Participants rated the program with high satisfaction. There were significant improvements at 24 weeks in self-rated physical health, objective daily steps, and estimated cardiorespiratory fitness ( d = .30–.64). Focus group themes generated recommendations for modifying the intervention.

Conclusion

Findings support adapting the intervention further for women with cardiovascular disease and testing it in an efficacy trial.
Welding sequence optimisation in the automotive industry: A review
Authors: Beik Varshan , Marzbani Hormoz , Jazar Reza
Published: June 2019

Spot welding is the most common technique used to join sheet metals in the automotive industry due to the fast rate of production. Optimising the welding process including the sequence, number and location of the welds would significantly improve the quality of the final product and production cost. This paper presents an overview on the available methods to plan and optimise various aspects of the welding process including welding sequence, weld quantity and location. Firstly, the welding concept in the automotive industry is briefly reviewed. Secondly, the welding process optimisation with emphasis on the welding sequence is discussed. The common gaps and challenges are identified and, lastly, future research to plan and optimise the welding sequence in the automotive body is outlined.
Yaw and lateral stability control for four-wheel-independent steering and four-wheel-independent driving electric vehicle
Authors: Wang Chunyan , Heng Bo , Zhao Wanzhong
Published: June 2019

Based on the traditional four-wheel steering system, this paper combines the steer-by-wire system and four-wheel-independent driving technology to develop a new steer-by-wire four-wheel-independent steering and four-wheel-independent driving electric vehicle, which can realize four-wheel-independent steering and four-wheel-independent driving. Aiming at the steering actuator redundancy characteristics of the four-wheel-independent steering and four-wheel-independent driving vehicle, a hierarchical control method is proposed in this paper. In view of parameters perturbation of vehicle speed and tire cornering stiffness and the model uncertainty problem, the structure singular value μ is used to study the stability control of four-wheel-independent steering and four-wheel-independent driving vehicle under multiple perturbations in the upper layer, and verifies the advantages of μ controller by comparing it with H∞ control and proportional-integral-derivative control. The lower layer is aimed at the redundancy of vehicle steering actuator, an on-line reconfigurable steering angle and driving force allocation control method based on tire force optimal allocation is proposed. This method can not only optimize the tire longitudinal force and lateral force distribution under normal conditions but also reconstruct the distribution control strategy on-line under fault conditions, realizing active fault tolerance. Finally, simulations by MATLAB/Simulink and hardware-in-the-loop experiments are conducted to verify the proposed control method. The simulation results show that the designed controller can maintain good stability under the conditions of model perturbation, separation pavement, and actuator failure.
Fuzzy sliding mode based active disturbance rejection control for active suspension system
Authors: Wang Haoping , Lu Yeqing , Tian Yang , Christov Nicolai
Published: June 2019

This article deals with the control problem of 7-degrees of freedom full-car suspension system which takes into account the spring-damper nonlinearities, unmodeled dynamics and external disturbances. The existing active disturbance rejection control uses an extended state observer to estimate the “total disturbance” and eliminate it with state error feedback. In this article, a new type of active disturbance rejection control is developed to improve the ride comfort of full car suspension systems taking into account the suspension nonlinearities and actuator saturation. The proposed controller combines active disturbance rejection control and fuzzy sliding mode control and is called Fuzzy Sliding Mode active disturbance rejection control. To validate the system mathematical model and analyze the controller performance, a virtual prototype is built in Adams. The simulation results demonstrate better performance of Fuzzy Sliding Mode active disturbance rejection control compared to the existing active disturbance rejection control.
Assessment of Opioid Cross-reactivity and Provider Perceptions in Hospitalized Patients With Reported Opioid Allergies
Authors: Powell Marissa Z. , Mueller Scott W. , Reynolds Paul M.
Published: June 2019

Background: The incidence of opioid allergy cross-reactivity in hospitalized patients with historical opioid allergies remains unknown. Objectives: The purpose of this study was to characterize the incidence of newly suspected IgE-mediated reactions (IMRs) based on clinical criteria among patients with a chart-documented opioid allergy and to assess clinician perceptions of opioid allergies. Methods: This retrospective cohort study was conducted in hospitalized adults with a historically documented opioid allergy who received a subsequent opioid. The primary outcome was the incidence of allergic cross-reactivity between clinical and chemical opioid classes in patients with historical IMRs (H-IMRs) identified by clinical criteria, ICD-9 diagnosis codes, or allergic reaction treatment. Secondary outcomes included the incidence of opioid intolerances incorrectly documented as allergies and a survey to clinicians to assess the impact of opiate warnings on prescribing practices. Results: A total of 499 patients with historical opioid allergies were included. H-IMR to an opioid of any class was not significantly associated with IMR cross-reactivity to the same or any other class, with cross-reactivity rates ranging from 0% to 6.7%. Of the historical chart-documented allergies, 249 reactions (50%) were determined to be intolerances. A total of 461 (92.5%) patients successfully tolerated readministration of opioids despite a chart-documented allergy, and 8 (1.6%) patients developed possible IMR (7 pruritus, 1 possible anaphylaxis). Survey results (n = 54) indicated that opiate allergy warnings were neutral or unlikely to change opiate prescribing. Conclusions: The risk of IMRs caused by opioids is low in patients with H-IMRs to opioids. Opioid allergy documentations may propagate alert fatigue and unwarranted prescribing changes.
Relationship Between Chronic Lateral Ankle Instability and Hindfoot Varus Using Weight-Bearing Cone Beam Computed Tomography
Authors: Lintz François , Bernasconi Alessio , Baschet Louise , Fernando Céline , Mehdi Nazim ,   the Weight Bearing CT International Study Group, de Cesar Netto Cesar
Published: June 2019

Background:

Varus hindfoot deformity may increase the risk of chronic lateral ankle instability (CLAI). Our aim was to analyze hindfoot alignment (HFA) in patients with CLAI using weight-bearing cone beam computed tomography (WBCT) to assess this risk.

Methods:

This retrospective, comparative analysis was carried out using an existing WBCT database (Talas, CurveBeam LLC), including data sets for 370 consecutive feet (189 patients) obtained between July 2016 and October 2018 at a single institution. The software provided semiautomated measurement of HFA, given as foot ankle offset (FAO). Univariate analysis was conducted to compare feet with and without CLAI against sex, age, body mass index, and FAO. Significant variables were included in a multivariable logistic model with random effects to take into account correlation between feet of the same patient.

Results:

Forty-three feet had CLAI (34 patients). FAO ( P = .0009) was significant for CLAI by univariate analysis. Mean FAO was −2.2% ± 5.5% (varus) and + 2.6% ± 4.7% (valgus) with and without CLAI history, respectively. Multivariable logistic regression adjusted for sex and age demonstrated a 35% increased odds ratio (OR) of CLAI per 1% reduction in FAO value (varus) (adjusted OR=0.64, 95% confidence interval [CI]: 0.49-0.84; P = .001) and no significant effect of sex (adjusted OR=0.52; P = .617) or age (adjusted OR=0.94; P = .165) after adjustment for FAO.

Conclusion:

A positive relationship was found between varus HFA and the risk to have CLAI. Systematic recording of FAO measurements from WBCT images along with clinical data regarding CLAI history proved successful at quantifying the risk of CLAI.

Level of Evidence:

Level III, retrospective cohort study.
Fast–slow dynamic behaviors of a hydraulic generating system with multi-timescales
Authors: Zhang Jingjing , Chen Diyi , Zhang Hao , Xu Beibei , Li Huanhuan , Aggidis George A. , Chatterton Steven
Published: June 2019

Hydraulic generating systems are widely modeled in the literature for investigating their stability properties by means of transfer functions representing the dynamic behavior of the reservoir, penstock, surge tank, hydro-turbine, and the generator. Traditionally, in these models the electrical load is assumed constant to simplify the modeling process. This assumption can hide interesting dynamic behaviors caused by fluctuation of the load as actually occurred. Hence, in this study, the electrical load characterized with periodic excitation is introduced into a hydraulic generating system and the responses of the system show a novel dynamic behavior called the fast–slow dynamic phenomenon. To reveal the nature of this phenomenon, the effects of the three parameters (i.e., differential adjustment coefficient, amplitude, and frequency) on the dynamic behaviors of the hydraulic generating system are investigated, and the corresponding change rules are presented. The results show that the intensity of the fast–slow dynamic behaviors varies with the change of each parameter, which provides reference for the quantification of the hydraulic generating system parameters. More importantly, these results not only present rich nonlinear phenomena induced by multi-timescales, but also provide some theoretical bases for maintaining the safe and stable operation of a hydropower station.
Pathological complete response rates with pertuzumab-based neoadjuvant chemotherapy in breast cancer: A single-center experience
Authors: Matthews Christina M , Nymberg Kristen , Berger Michael , Vargo Craig A , Dempsey Jessica , Li Junan , Ramaswamy Bhuvaneswari , Reinbolt Raquel , Sardesai Sagar , Wesolowski Robert , Williams Nicole , Lustberg Maryam
Published: June 2019

Background

Pertuzumab-based neoadjuvant chemotherapy (NAC) has demonstrated successful pathologic complete response (pCR) rates when administered to patients with human epidermal growth factor receptor 2 (HER2)-positive, locally advanced breast cancer and has become standard of care. This study aimed to identify pCR rates in patients receiving a variety of pertuzumab-based NAC regimens. The effect of the addition of an anthracycline and impact of anthracycline and taxane sequencing on pCR was also assessed.

Methods

A retrospective, single-center review was conducted on patients with operable, human epidermal growth factor receptor 2 (HER2)-positive breast cancer that received one of five pertuzumab-containing NAC regimens followed by definitive surgery.

Results

Ninety-six patients were included in the analysis; overall, pCR was attained in 49 patients (51%). Of the 61 patients who received an anthracycline-containing NAC regimen, 30 (49%) attained a pCR. Of the 35 patients who received the non-anthracycline NAC regimen, 19 (54%) attained a pCR; difference in pCR was not statistically significant ( p = 0.63). Anthracycline/taxane sequence analysis showed that of the patients attaining pCR with an anthracycline-containing NAC, 77% of patients received the taxane portion upfront ( p = 0.17). Relative dose intensity of the anthracycline portion was similar irrespective of treatment sequence. However, relative dose intensity of the taxane portion was decreased with upfront anthracycline administration.

Conclusion

These findings support current recommendations of adding pertuzumab to established regimens for treatment of locally advanced, HER2-positive, early stage breast cancer. The benefit of adding an anthracycline in the neoadjuvant setting remains unclear. Patients treated with the taxane portion of NAC upfront appeared to have a higher rate of pCR and better relative dose intensity than patients who received the anthracycline portion upfront, but differences were not statistically significant. These findings should be verified in a prospective clinical trial.
Complete responses to two different anti-PD1 agents in a metastatic melanoma patient
Authors: Kilickap Saadettin , Guven Deniz C , Aktepe Oktay H , Aktas Burak Y , Dizdar Omer
Published: June 2019

In the last decade, immune checkpoint inhibitors changed the landscape of metastatic melanoma. However, the optimal duration of treatment and treatment cessation in responders is largely unknown. Herein, we represent a heavily pretreated metastatic melanoma case who had a complete response to pembrolizumab and also a complete response with nivolumab after progression during drug-free follow-up. We think that reinduction with a different anti-PD1 antibody may be used in patients with metastatic melanoma responders. Clinical trials with prespecified sequential treatment protocols and large real-life data can further delineate this subject.
Perceptions of Media’s Contribution Toward Stigmatization of Mental Health by Saudi Arabian Nurses
Authors: Alyousef Seham Mansour , Alhamidi Sami Abdulrahman , Albloushi Monirah , Eid Thurayya Abduwahid
Published: June 2019

BACKGROUND: Public often obtains mental health information from mass media and Saudi Arabia is characterized by high media penetration. Fictional and nonfictional media dramatize, trivialize, and misrepresent characteristics and needs of clients who need mental health care and may create and reinforce existing stigma. This pattern of stigma may adversely affect mental health care clients, practitioners, education, and programs. Portrayal of mental illness and opportunities for care in Saudi Arabia need development. OBJECTIVE: This study examined Saudi graduate nurses’ perceptions of stigma created by mass media and influence on public perceptions of mental health issues and use of these views to formulate ways to effect changes in mental health care availability and delivery. METHOD: Participants included 18 graduate practicing female mental health nurses at King Saud University School of Nursing. Qualitative data were collected using individual interviews and analyzed using NVivo 10.1 software for thematic content analysis. RESULTS: The core theme that emerged was “stigma in media,” which in turn had five subthemes: (a) media portrayal, (b) mass media, (c) social stigma, and (d) mental health care services. CONCLUSION: This inquiry may be helpful in enabling development of stigma-reduction programs by shedding light on the role of mass media in forming normative behavior and attitudes toward mental illness in Saudi culture.
Social Determinants of Depression Among Older Black Women Living With HIV
Authors: De Oliveira Giovanna C. , Cianelli Rosina , Villegas Natalia , Solorzano Martinez Angel , Hires Kimberly , Muheriwa Sadandaula R.
Published: June 2019

BACKGROUND: The prevalence of depression spans age-groups, but it can be particularly destructive for older people with chronic illness. Among older Black women living with HIV (OBWLH), multiple social determinants have been associated with the prevalence and severity of depression. A greater understanding of the impact of the social determinants at the individual, interpersonal, and community levels is needed. AIMS: To explore social determinants of depression among OBWLH at the intrapersonal, interpersonal, and community levels. METHOD: Cross-sectional descriptive design. RESULTS: A total of 118 OBWLH were analyzed in the study. Depression was prevalent among the participants. Approximately 89.8% of the participants had moderate to severe depressive symptoms. Health status, exercise, and social support were significant predictors of depression in the sample. CONCLUSION: Social determinants at multiple levels play a significant role in the occurrence and management of depression among OBWLH. Implications for practice, education, and research can be drawn from these findings.