bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis of Thin-Capped Fibroatheromas in Intravascular Optical Coherence Tomography Images
Authors: Phipps Jennifer E. , Hoyt Taylor , Vela Deborah , Wang Tianyi , Michalek Joel E. , Buja L. Maximilian , Jang Ik-Kyung , Milner Thomas E. , Feldman Marc D.
Published: July 2016

Background—

Intravascular optical coherence tomography (IVOCT) images are recorded by detecting light backscattered within coronary arteries. We hypothesize that non–thin-capped fibroatheroma (TCFA) causes may scatter light to create the false appearance of IVOCT TCFA.

Methods and Results—

Ten human cadaver hearts were imaged with IVOCT (n=14 coronary arteries). IVOCT and histological TCFA images were coregistered and compared. Of 21 IVOCT TCFAs (fibrous cap <65 μm, lipid arc >1 quadrant), only 8 were true histological TCFA. Foam cell infiltration was responsible for 70% of false IVOCT TCFA and caused both thick-capped fibroatheromas to appear as TCFA, and the appearance of TCFAs when no lipid core was present. Other false IVOCT TCFA causes included smooth muscle cell–rich fibrous tissue (12%) and loose connective tissue (9%). If the lipid arc >1 quadrant (obtuse) criterion was disregarded, 45 IVOCT TCFAs were identified, and sensitivity of IVOCT TCFA detection increased from 63% to 87%, and specificity remained high at 92%.

Conclusions—

We demonstrate that IVOCT can exhibit 87% (95% CI, 75%–93%) sensitivity and 92% specificity (95% CI, 86%–96%) to detect all lipid arcs (both obtuse and acute, <1 quadrant) TCFA, and we also propose new mechanisms involving light scattering that explain why other plaque components can masquerade as TCFA and cause low positive predictive value of IVOCT for TCFA detection (47% for obtuse lipid arcs). Disregarding the lipid arc >1 quadrant requirement enhances the ability of IVOCT to detect TCFA.
Derivation and Validation of Prognosis-Based Age Cutoffs to Define Elderly in Cardiac Surgery
Authors: Afilalo Jonathan , Steele Russell , Manning Warren J. , Khabbaz Kamal R. , Rudski Lawrence G. , Langlois Yves , Morin Jean-Francois , Picard Michael H.
Published: July 2016

Background—

The age cutoff to define elderly is controversial in cardiac surgery, empirically ranging from ≥65 to ≥80 years. Beyond semantics, this has important implications as a starting point for clinical care pathways and inclusion in trials. We sought to characterize the relationship between age and adverse outcomes in patients undergoing cardiac surgery and to derive and validate prognosis-based age cutoffs.

Methods and Results—

Six thousand five hundred seventy one consecutive adult patients undergoing cardiac surgery at 3 hospitals in the United States and Canada were included in the cohort. Logistic regression models and generalized additive models with thin-plate splines were fit to the data. The age distribution was 50 to 59 years in 1244 (18.9%), 60 to 69 years in 2144 (32.6%), 70 to 79 years in 2000 (30.4%), ≥80 years in 1183 (18.0%) patients. After controlling for sex and type of operation, the relationship between age and 30-day operative mortality was found to be nonlinear. Receiver operating characteristic analysis showed that the optimal cutoffs to identify older patients at higher risk of operative mortality were greater than 74, 78, and 75 years for isolated coronary bypass, isolated valve surgery, and coronary bypass plus valve surgery, respectively. These age cutoffs were validated in an independent cohort.

Conclusions—

The relationship between age and operative mortality is not linear, manifesting a steeper rise after age 75 for coronary bypass and approaching octogenarian age for isolated valve surgery. Rather than using arbitrary age cutoffs to define elderly, the outcomes-based cutoff of ≥75 years should be used to identify the population of older adults that has higher risk and may benefit from preoperative geriatric evaluation and optimization.
Association Between Hospital Performance on Patient Safety and 30‐Day Mortality and Unplanned Readmission for Medicare Fee‐for‐Service Patients With Acute Myocardial Infarction
Authors: Wang Yun , Eldridge Noel , Metersky Mark L. , Sonnenfeld Nancy , Fine Jonathan M. , Pandolfi Michelle M. , Eckenrode Sheila , Bakullari Anila , Galusha Deron H. , Jaser Lisa , Verzier Nancy R. , Nuti Sudhakar V. , Hunt David , Normand Sharon‐Lise T. , Krumholz Harlan M.
Published: July 2016

Background

Little is known regarding the relationship between hospital performance on adverse event rates and hospital performance on 30‐day mortality and unplanned readmission rates for Medicare fee‐for‐service patients hospitalized for acute myocardial infarction (
AMI
).

Methods and Results

Using 2009–2013 medical record‐abstracted patient safety data from the Agency for Healthcare Research and Quality's Medicare Patient Safety Monitoring System and hospital mortality and readmission data from the Centers for Medicare & Medicaid Services, we fitted a mixed‐effects model, adjusting for hospital characteristics, to evaluate whether hospital performance on patient safety, as measured by the hospital‐specific risk‐standardized occurrence rate of 21 common adverse event measures for which patients were at risk, is associated with hospital‐specific 30‐day all‐cause risk‐standardized mortality and unplanned readmission rates for Medicare patients with
AMI
. The unit of analysis was at the hospital level. The final sample included 793 acute care hospitals that treated 30 or more Medicare patients hospitalized for AMI and had 40 or more adverse events for which patients were at risk. The occurrence rate of adverse events for which patients were at risk was 3.8%. A 1% point change in the risk‐standardized occurrence rate of adverse events was associated with average changes in the same direction of 4.86% points (95%
CI
, 0.79–8.94) and 3.44% points (95%
CI
, 0.19–6.68) for the risk‐standardized mortality and unplanned readmission rates, respectively.

Conclusions

For Medicare fee‐for‐service patients discharged with
AMI
, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30‐day all‐cause mortality and on unplanned readmissions.
Long-Term Outcome After Carotid Artery Stenting
Authors: Jonsson Magnus , Lindström David , Gillgren Peter , Wanhainen Anders , Malmstedt Jonas
Published: July 2016

Background and Purpose—

Long-term outcome after carotid artery stenting (CAS), a less invasive technique than carotid endarterectomy (CEA), for prevention of stroke, is unclear. The aim was to assess long-term outcomes after CAS, compared with CEA, in a nationwide cohort study.

Methods—

All patients registered in the national Swedish Vascular Registry (Swedvasc) treated with primary CAS between 2005 and 2012 were identified. For every CAS, 2 CEA controls, matched for sex, age, procedure year, and indication (symtomatic/asymtomatic), were chosen. Postoperative stroke was identified by cross-matching the cohort with the InPatient Registry and charts review. Primary end point was ipsilateral stroke or death >30 days postoperatively.

Results—

A total of 1157 patients were included, 409 CAS and 748 CEA; 73% men with mean age 70 years and 69% were symptomatic. Risk factor profile was similar between the 2 groups. Median follow-up time was 4.1 years. Ipsilateral stroke or death of >30 days postoperatively occurred in 95 of 394 in the CAS group versus 120 of 724 in the CEA group (adjusted hazard ratio, 1.59; 95% confidence interval, 1.15–2.18). The corresponding adjusted rates for death, ipsilateral stroke of >30 days, and any stroke or death of >30 days were 25.7% versus 18.6% (hazard ratio, 1.20; 95% confidence interval, 0.84–1.72), 9.4% versus 2.9% (hazard ratio, 3.40; 95% confidence interval, 1.53–7.53), 34.2% versus 23.6% (hazard ratio, 1.49; 95% confidence interval, 1.10–2.00) for the CAS group versus CEA group, respectively.

Conclusions—

In this nationwide cohort study, CAS was associated with an increased long-term risk of ipsilateral stroke and death during after the perioperative phase when compared with CEA.
Family History and Risk of Recurrent Stroke
Authors: Chung Jong-Won , Kim Beom Joon , Han Moon-Ku , Kang Kyusik , Park Jong-Moo , Park Sang-Soon , Park Tai Hwan , Cho Yong-Jin , Hong Keun-Sik , Lee Kyung Bok , Kim Jae Guk , Ko Youngchai , Lee SooJoo , Nah Hyun-Wook , Kim Dae-Hyun , Cha Jae-Kwan , Oh Mi-Sun , Yu Kyung-Ho , Lee Byung-Chul , Jang Myung Suk , Lee Ji Sung , Lee Juneyoung , Bae Hee-Joon
Published: July 2016

Background and Purpose—

The association between family history of stroke and stroke recurrence remains unclear.

Methods—

Using a web-based multicenter stroke registry database, information on history of stroke in first-degree relatives was collected prospectively for acute ischemic stroke patients who were hospitalized within 7 days of onset. The collected information was categorized as follows: type of the affected relative(s) with stroke (paternal, maternal, sibling, or 2 or more) and age of the relative’s stroke onset (<50, 50–59, 60–69, and ≥70 years). Stroke recurrence was captured prospectively using a predetermined protocol. Subgroup analyses were performed according to the patient’s age at the index stroke.

Results—

Among 7642 patients, 937 (12.3%) had a history of stroke in their first-degree relatives and 475 (6.2%: 201 within and 274 after 3 weeks from index stroke) experienced stroke recurrence (median follow-up, 365 days). In multivariable Cox proportional hazard models, overall family history was not associated with stroke recurrence (hazard ratio, 1.08; 95% confidence interval, 0.81–1.43). However, the details of their family histories, including relative’s age at stroke onset (<50 years: hazard ratio, 2.14; 95% confidence interval, 1.004–4.54) and stroke history in a sibling (hazard ratio, 1.67; 95% confidence interval, 1.09–2.58), were independently associated with stroke recurrence after adjusting for potential confounders. The associations appeared to be stronger in young adults with stroke (age, <55 years) than in older stroke patients.

Conclusions—

This study suggests that elevated risks of recurrent stroke are associated with having relatives with early-onset stroke and siblings with stroke histories, implying that additional precautions may be needed in such populations.
The Future as a Design Problem
Authors: Reeves Stuart , Goulden Murray , Dingwall Robert
Published: July 2016

An often unacknowledged yet foundational problem for design is how ‘futures‘ are recruited for design practice. This problem saturates considerations of what could or should be designed. We distinguish two intertwined approaches to this: ‘pragmatic projection’, which tries to tie the future to the past, and ‘grand vision’, which ties the present to the future. We examine ubiquitous computing as a case study of how pragmatic projection and grand vision are practically expressed to direct and structure design decisions. We assess their implications and conclude by arguing that the social legitimacy of design futures should be increasingly integral to their construction.
Graphic Design as a University Discipline in Argentina, 1958–1985
Authors: Devalle Verónica
Published: July 2016

The article aims to reconstruct the emergence and consolidation of graphic design as a university discipline in Argentina. It is a process that started in the late 1950s and has intersected with various important historical moments—for instance, the early dialogue between Max Bill and Argentinean avant-garde artists, such as Alfredo Hlito and Tomás Maldonado in the immediate postwar period. Also instrumental in the process were the networks between Brazilian modernism—especially from Rio de Janeiro and São Paulo—and avant-garde artists from Montevideo and Buenos Aires, as well as the gradual arrival of what is known as the Modern Movement in the practice of architecture and in its teaching in universities. It reviews the institutions that were pioneers of design education in Argentina. The cases addressed are the National University of Cuyo (UNCu), National University of La Plata (UNLP), the Centre for Research in Industrial Design (CIDI), the Centre of Arts and Communication (CAYC), the Pan American School of Art (EPA), and the National University of Buenos Aires (UBA). While the national universities and CIDI are public institutions, the CAYC and EPA were private initiatives.
Beyond Resolving Dilemmas: Three Design Directions for Addressing Intrapersonal Concern Conflicts
Authors: Ozkaramanli Deger , Desmet Pieter M. A. , Özcan Elif
Published: July 2016

A potent way of designing for emotion is to design for concerns. However, people have multiple, and often, conflicting concerns. Such conflicts create emotional dilemmas: One may need to spend a Sunday afternoon working to meet a deadline, and at the same time, wish to attend a birthday party. In this paper, we consider conflicting concerns as a design opportunity: Any of the concerns can be a starting point for designing products or services that appeal to the users. However, we propose that the tension created by the conflict can be more inspiring than the involved concerns in isolation. In this paper, we present an analysis of 109 existing products through which we identify three directions these products seem to use to address users' dilemmas. These directions are resolving dilemmas, moderating dilemmas, and triggering dilemmas. We discuss the similarities and differences between these directions and their potential contribution to design fields such as designing for emotions and designing for subjective wellbeing.
The genus Lolia from freshwater habitats in Egypt with one new species
Authors: ABDEL-AZIZ FATEN A.
Published: July 2016

A new species of Lolia and the sexual morph of L. aquatica are described, with illustrations, from decayed submerged wood in the River Nile, Egypt. Molecular phylogenetic analyses of partial SSU and LSU rDNA sequence data place the sexual morph of L. aquatica and the new species, L. dictyospora in a monophyletic clade, distant from the closely related fungi in the freshwater family Lindgomycetaceae. Pairwise LSU rDNA sequence alignment of the sexual/asexual morphs of L. aquatica are 99% similar. Lolia species are characterized by pseudothecial or stromatic, immersed to erumpent, dark-brown to black, coriaceous to sub-carbonaceous ascomata, cylindric-clavate, bitunicate, fissitunicate, short pedicellate asci, yellow to reddish-brown, phragmo- or dictyospores, surrounded by prominent gelatinous sheath. Lolia species are phylogenetically distant from the closely related genera: Leptosphaeria (Leptosphaeriaceae) and Massariosphaeria (Pleosporales incert. sed.). Lolia differs from Leptosphaeria in having a prominent large gelatinous ascospore sheath, while this is absent in Leptosphaeria species. Lolia differs from Massariosphaeria in having smaller ascospores and fewer transverse septa. Based on molecular data and morphology, a new species, Lolia dictyospora, is established.
Two new species of the genus Apolygus China (Hemiptera: Heteroptera: Miridae: Mirinae) from the Korean Peninsula, with a key to Korean Apolygus species
Authors: KIM JUNGGON , JUNG SUNGHOON
Published: July 2016

Two new species of the genus Apolygus are described from the Korean Peninsula: A. rubrifasciatus sp. nov. and A. atriclavus sp. nov. Descriptions and diagnoses, and some biological information are presented with photographs and illustrations. A key to the Korean Apolygus species is also provided.
Morphology and DNA barcoding reveal a new species of Eudicella from East Africa (Coleoptera: Scarabaeidae: Cetoniinae)
Authors: Seidel Matthias
Published: July 2016

A new species of Eudicella White, 1839 (Coleoptera: Scarabaeidae: Cetoniinae), is described from Uganda and Kenya: E. nana new species. Morphological and genetic analyses of the new taxon and phenotypically allied species are given. Eudicella nana is compared with its hypothesized sister species, E. darwiniana Kraatz, 1880, and diagnostic characters that distinguish it from other species occurring in the same region are provided.
Forensic Hair Differentiation Using Attenuated Total Reflection Fourier Transform Infrared (ATR FT-IR) Spectroscopy
Authors: Manheim Jeremy , Doty Kyle C. , McLaughlin Gregory , Lednev Igor K.
Published: July 2016

Hair and fibers are common forms of trace evidence found at crime scenes. The current methodology of microscopic examination of potential hair evidence is absent of statistical measures of performance, and examiner results for identification can be subjective. Here, attenuated total reflection (ATR) Fourier transform-infrared (FT-IR) spectroscopy was used to analyze synthetic fibers and natural hairs of human, cat, and dog origin. Chemometric analysis was used to differentiate hair spectra from the three different species, and to predict unknown hairs to their proper species class, with a high degree of certainty. A species-specific partial least squares discriminant analysis (PLSDA) model was constructed to discriminate human hair from cat and dog hairs. This model was successful in distinguishing between the three classes and, more importantly, all human samples were correctly predicted as human. An external validation resulted in zero false positive and false negative assignments for the human class. From a forensic perspective, this technique would be complementary to microscopic hair examination, and in no way replace it. As such, this methodology is able to provide a statistical measure of confidence to the identification of a sample of human, cat, and dog hair, which was called for in the 2009 National Academy of Sciences report. More importantly, this approach is non-destructive, rapid, can provide reliable results, and requires no sample preparation, making it of ample importance to the field of forensic science.
Metabolites Associated With Malnutrition in the Intensive Care Unit Are Also Associated With 28‐Day Mortality
Authors: Mogensen Kris M. , Lasky‐Su Jessica , Rogers Angela J. , Baron Rebecca M. , Fredenburgh Laura E. , Rawn James , Robinson Malcolm K. , Massarro Anthony , Choi Augustine M. K. , Christopher Kenneth B.
Published: July 2016

Background: We hypothesized that metabolic profiles would differ in critically ill patients with malnutrition relative to those without. Materials and Methods: We performed a prospective cohort study on 85 adult patients with systemic inflammatory response syndrome or sepsis admitted to a 20‐bed medical intensive care unit (ICU) in Boston. We generated metabolomic profiles using gas and liquid chromatography and mass spectroscopy. We followed this by logistic regression and partial least squares discriminant analysis to identify individual metabolites that were significant. We then interrogated the entire metabolomics profile using metabolite set enrichment analysis and network model construction of chemical‐protein target interactions to identify groups of metabolites and pathways that were differentiates in patients with and without malnutrition. Results: Of the cohort, 38% were malnourished at admission to the ICU. Metabolomic profiles differed in critically ill patients with malnutrition relative to those without. Ten metabolites were significantly associated with malnutrition (P < .05). A parsimonious model of 5 metabolites effectively differentiated patients with malnutrition (AUC = 0.76), including pyroglutamine and hypoxanthine. Using pathway enrichment analysis, we identified a critical role of glutathione and purine metabolism in predicting nutrition. Nutrition status was associated with 28‐day mortality, even after adjustment for known phenotypic variables associated with ICU mortality. Importantly, 7 metabolites associated with nutrition status were also associated with 28‐day mortality. Conclusion: Malnutrition is associated with differential metabolic profiles early in critical illness. Common to all of our metabolome analyses, glutathione and purine metabolism, which play principal roles in cellular redox regulation and accelerated tissue adenosine triphosphate degradation, respectively, were significantly altered with malnutrition.
Resting Energy Expenditure of Children and Adolescents With Nonalcoholic Fatty Liver Disease
Authors: Martincevic Inez , Mouzaki Marialena
Published: July 2016

Background:The mainstay of treatment for pediatric nonalcoholic fatty liver disease (NAFLD) is lifestyle modification, which includes dietary changes that lead to slow but sustained weight loss or weight stabilization in growing children. Accurate estimation of energy requirements is necessary to achieve this goal. The objective of this study was to assess the accuracy of the most commonly used equations in predicting the resting energy expenditure (REE) of children with NAFLD. Methods: This was a retrospective study performed in a single institution. The predictive accuracy of various equations was assessed by comparing their estimates against the measured REE obtained with indirect calorimetry. Accuracy was defined as an estimate within 10% of measured REE. Results: Fifty‐six children (70% male; 52% white and 36% Asian) with a median age of 13 years were included. The median measured REE was 1829 kcal/d. Of the equations studied, the Schofield had the smallest average bias (–32 kcal/d; confidence interval, –121 to 56). The Schofield and Molnar equations were the most accurate, providing REE estimates within 10% of measured in 59% of cases. The remaining equations had lower and variable predictive accuracy. The use of adjusted body weight in predictive equations did not improve the predictive accuracy. Conclusion: In a cohort of children and adolescents with NAFLD, the Schofield and Molnar equations performed best in predicting energy expenditure. However, predictive equations were often inaccurate, suggesting that clinicians should interpret their results with caution and consider using indirect calorimetry when available.
Challenges of Quantifying FODMAPs in Enteral Nutrition Formulas: Evaluation of Artifacts and Solutions
Authors: Halmos Emma P. , Bogatyrev Alex , Ly Elizabeth , Liels Kelly L. , Muir Jane G. , Gibson Peter R.
Published: July 2016

Background: Diarrhea associated with enteral nutrition has been attributed to excessive FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content of formulas. This study aimed to readdress their FODMAP content by measuring fermentation‐specific effects after a formula load in healthy participants and by defining issues with analytical methods. Methods: Breath hydrogen production expressed as mean area under the curve (AUC) for 12 hours after ingestion of 15 g lactulose or 500 mL of 1 of 2 formulas of seemingly different FODMAP content was evaluated in a double crossover design. Quantification of specified FODMAPs via enzymatic and liquid chromatographic assays was assessed with additional controls to investigate the influence of maltodextrin and sucrose present in the formulas, and alternative assays were applied. Results: In 15 hydrogen‐producing participants, AUC following both formulas was minimal (≤21 ppm/12 h) compared with 15 g lactulose (P < .001). Elevated breath hydrogen was detectable when >2.5 g fructo‐oligosaccharide was consumed. Maltodextrin showed dose‐dependent interference with enzymatic measurement of fructans and coeluted with raffinose with liquid chromatography. Application of an alternative fructan assay that includes additional enzymes to hydrolyze maltodextrins indicated that fructan content was <15% of that previous reported. Galacto‐oligosaccharide (GOS) content could not be estimated by chromatography due to maltodextrins. An enzymatic assay, while overestimating GOS content, showed it to be very low. Conclusion: FODMAPs were not detected in enteral formulas in human bioassays, and their content may be grossly overestimated mainly due to high formula concentrations of maltodextrin. Better estimates of FODMAP content in enteral formulas can be made by alternative assay approaches.
Surgery in MEN 2A Patients Older Than 5 Years with Micro‐MTC
Authors: Tonelli Francesco , Giudici Francesco , Marcucci Tommaso , Cavalli Tiziana , Spini Simona , Gheri Riccardo Gionata , Brandi Maria Luisa
Published: July 2016

In multiple endocrine neoplasia syndrome type 2A (MEN 2A), early total thyroidectomy (TT; performed before the age of 5 years) is the best option to prevent medullary thyroid carcinoma (MTC) development, but the management of MEN 2A patients diagnosed after childhood is still under debate. Seventeen consecutive patients diagnosed with MEN 2A after the age of 5 years (mean age, 23.3 years) with a pathologic diagnosis of micro‐MTC without nodal involvement were enrolled. All patients underwent TT with thymectomy and central compartment lymph node dissection. During surgery, parathyroid tissue removal occurred in 14 patients. No major postoperative complications nor persistent hypoparathyroidism was observed. After a mean follow‐up of 16.6 years, no patient developed primary hyperparathyroidism or disease recurrence. Even if TT is recommended before the age of 5, when MEN 2A diagnosis is performed after this age in micro‐MTC without nodal involvement, TT with thymectomy and central compartment lymphadenectomy can provide good oncologic and functional results.
Endoscopic Endonasal Repair of Septal Perforation with Interpositional Auricular Cartilage Grafting via a Mucosal Regeneration Technique
Authors: Ozturan Orhan , Yenigun Alper , Senturk Erol , Eren Sabri Baki , Aksoy Fadlullah
Published: July 2016

We evaluated the efficacy of interpositional auricular cartilage grafting for perforation with an endoscopic endonasal approach via a mucosal regeneration technique. In total, 12 patients with symptomatic septal perforations were operated on by way of an endoscopic endonasal approach after an adequately sized cartilage graft was harvested. The graft was inserted between the circumferentially incised and elevated flaps of the perforation and secured by vertical and horizontal nonabsorbable aligning approximation stitches and prolonged placement of silicone splints. The average perforation size was 12.3 mm (range, 4‐19 mm). Bleeding, incrustation, pain, whistling respiration, and nasal congestion symptoms were relieved entirely in 10 of 12 patients (83.3%) who had successful treatment. This study showed that an endoscopic endonasal approach via a mucosal regeneration technique without direct mucosa‐to‐mucosa repair can be applied successfully without disrupting the neighboring nasal structures for septal perforations up to 20 mm and as effectively as other, more complex surgical interventions.
Appropriateness and avoidability of terminal hospital admissions: Results of a survey among family physicians
Authors: Reyniers Thijs , Deliens Luc , Pasman H Roeline W , Vander Stichele Robert , Sijnave Bart , Houttekier Dirk , Cohen Joachim
Published: July 2016

Background:

Although the acute hospital setting is not considered to be an ideal place of death, many people are admitted to hospital at the end of life.

Aim:

To examine what proportion of terminal hospital admissions among their patients family physicians consider to have been avoidable and/or inappropriate; which patient, family physician and admission factors are associated with the perceived inappropriateness or avoidability of terminal hospital admissions; and which interventions could have prevented them, from the perspective of family physicians.

Design:

Survey among family physicians, linked to medical record data.

Setting:

Patients who had died non-suddenly in the acute hospital setting of a university hospital in Belgium between January and August 2014.

Results:

We received 245 completed questionnaires (response rate 70%) and 77% of those hospital deaths ( n = 189) were considered to be non-sudden. Almost 14% of all terminal hospital admissions were considered to be potentially inappropriate, almost 14% potentially avoidable and 8% both, according to family physicians. The terminal hospital admission was more likely to be considered potentially inappropriate or potentially avoidable for patients who had died of cancer, when the patient’s life expectancy at the time of admission was limited, by family physicians who had had palliative care training at basic, postgraduate or post-academic level, and when the admission was initiated by the patient, partner or other family.

Conclusion:

Timely communication with the patient about their limited life expectancy and the provision of better support to family caregivers may be important strategies in reducing the number of hospital deaths.
The geographies of food banks in the meantime
Authors: Cloke Paul , May Jon , Williams Andrew
Published: July 2016

Geographies of food banks have focused predominantly on issues of neoliberal political-economy and food insecurity. In this paper, we trace alternative understandings of food banking – as spaces of care, and as liminal spaces of encounter capable of incubating political and ethical values, practices and subjectivities that challenge neoliberal austerity. Our aim is to develop a conceptual approach to voluntary welfare capable both of holding in tension the ambivalent and contradictory dynamics of care and welfare in the meantime(s), and of underlining some of the more hopeful and progressive possibilities that can arise in and through such spaces of care.
Curriculum development for technology-based entrepreneurship education
Authors: Kazakeviciute Agne , Urbone Renata , Petraite Monika
Published: July 2016

University-based entrepreneurship education is facing a paradigm shift between the classical ‘business school’ and the contemporary cross-disciplinary ‘technology venturing’ approach, mainly advocated by engineering schools and other communities outside business schools. The conflict is between structured ‘business planning and executing’ following a tradition of management education, and ‘opportunity search and exploitation’, following Schumpeterian entrepreneurial thought and reflecting the method common to cross-disciplinary discoveries in science, thus reflecting the nature of entrepreneurship. In the latter approach, the entrepreneurship curriculum is built as a platform for the interaction of a variety of disciplines to enhance cross-disciplinary thinking. Based on a comparative analysis of internationally acknowledged entrepreneurship education programmes, this article presents the cross-disciplinary and cross-cultural approach to the technology entrepreneurship curriculum development for undergraduates at Kaunas University of Technology in Lithuania. The method relies on the sequential development of individual, team-based and business skills. These three levels of competence development build the framework for the curriculum design and course didactics, which focus on mixed group work, international curriculum design and teaching, and participation in international innovation challenges. The efficiency of the method was assessed using student entrepreneurial attitude testing (at the start and end of the course) and international student achievement testing (achievements in the international business idea contest). The article offers an insight into the development of a technology-based entrepreneurship curriculum which is relevant to universities in Europe and worldwide.
Community-based, nurse-led post-exposure prophylaxis: results and implications
Authors: O’Byrne Patrick , MacPherson Paul , Roy Marie , Orser Lauren
Published: July 2016

HIV medications can be used as post-exposure prophylaxis to efficaciously prevent an HIV-negative person who has come into contact with HIV from becoming HIV-positive. Traditionally, these medications have been available in emergency departments, which have constituted a barrier for the members of many minority groups who are greatly affected by HIV transmission (i.e. gay, bisexual and other men who have sex with men, and persons who use injection drugs). From 5 September 2013 through 4 September 2015, we sought to increase the use of HIV post-exposure prophylaxis by having registered nurses provide these medications, when indicated, in community clinics in Ottawa, Canada. We undertook a chart review of patients who accessed services for HIV post-exposure prophylaxis in this period. Over the two years of data collection, 112 persons requested HIV post-exposure prophylaxis and 64% (n = 72) initiated these medications. Most (93%, or n = 67, of the 72 initiations) were among men, with 88% (n = 59) of these men reporting same sex sexual partners. Among these 58 men, 31% (n = 18) had sexual contact with other men known to be HIV-positive. Among women (n = 8), five initiated post-exposure prophylaxis: three after needle-sharing contact or sexual contact with a male partner who reportedly shared needles, and two after unprotected vaginal sex with a male partner known to be HIV-positive. Overall, no one was diagnosed with HIV at the four-month HIV testing follow-up, although six persons were diagnosed with HIV from the baseline HIV testing, and an additional four were diagnosed with HIV during routine HIV testing one year after completing post-exposure prophylaxis. In total, nine persons in our sample were thus diagnosed with HIV during the study period, which accounted for 9.4% (n = 10 of 106) of all reported HIV diagnoses in Ottawa during this time. We conclude that nurse-initiated HIV post-exposure prophylaxis can be an effective way to provide HIV prevention services to persons who are at high-risk for HIV.
Experimental parametric analysis of an energy harvester based on highly nonlinear solitary waves
Authors: Li Kaiyuan , Rizzo Piervincenzo
Published: July 2016

We investigate experimentally five different designs of an energy harvester based on mechanical vibration and highly nonlinear solitary waves. The harvester consists of a metamaterial formed by granular chains, an oscillator that taps the metamaterial, a solid in contact with the metamaterial, and a piezoelectric element glued to the solid. The overall principle is that the oscillator taps the metamaterial and creates a train of solitary waves along each chain. At the interface between the chains and the solid, part of the acoustic energy refracts into the solid where it coalesces at a point and triggers the vibration of the solid. Here, a transducer converts the focalized stress wave and the waves generated by the reverberation with the edges into electric potential. In the study presented in this article, we evaluate the effect of certain harvester parameters on the amount of energy that can be extracted. We considered five different designs by changing the oscillator, the dimension of the array, the solid material, and the transducer boundary condition. For each design we computed the power density, and we found that the density obtained with the best design is four orders of magnitude higher than the worst design.
Inverse estimation of impact force on a composite panel using a single piezoelectric sensor
Authors: Kalhori Hamed , Ye Lin , Mustapha Samir
Published: July 2016

Identification of location and magnitude of impact forces on a rectangular carbon fibre–epoxy honeycomb composite panel has been experimentally investigated through an inverse approach. The dynamic signals captured by a single piezoelectric (PZT) sensor installed on the panel remotely from the impact locations are utilized to identify the impact forces generated by an instrumented hammer. A number of potential impact locations on the panel are assumed to be known a priori. An actual impact is then occurred at one or two of these locations. The objective is to simultaneously identify the location and magnitude of the impact forces using the PZT sensor. The problem is solved through minimization of an extended matrix form of the convolution integral incorporating linear superposition of the responses due to impact at different locations. The under-determined problem is ill-posed and is regularized by Tikhonov and generalized cross validation methods. It is revealed that impact forces occurred at any location among four possible locations can be well identified.
An overview of diversified reinforcement on aluminum metal matrix composites: Tribological aspects
Authors: Mistry Jitendra M , Gohil Piyush P
Published: July 2016

Aluminum metal matrix composites have found applications in manufacturing of various components such as piston, cylinder block, and brake drum, in which wear and friction are important phenomenon. This paper presents an overview of diversified reinforcement on aluminum metal matrix composites in terms of tribological aspects. A comprehensive literature review is carried out on aluminum metal matrix composites based on individual reinforcement and multiple reinforcements including various product applications. The research review is summarized in form of tribology wheel for aluminum metal matrix composites, which encompass fields involved in tribology, fabrication processes/parameters, reinforcement(s) and matrix contribution, tribological testing parameter, statistical analytical technique, and product application areas of AMCs. The tribology wheel becomes helpful in selecting parameters with possible permutation and combination for further improvement of tribological properties. Finally, comments are addressed regarding the future work on tribological aspects of aluminum metal matrix composites.
The speculative social role of art and finance
Authors: Booth Peter
Published: July 2016

With a notable shift in the nature of contemporary finance, art and finance are increasingly characterized by their semi-autonomous and abstracted natures. By demonstrating how speculation can intersect with the notion of belief and extending Maurizio Lazzarato’s work on the conditions necessary for belief, the article argues that art and finance’s properties of semi-autonomy and abstraction make them ideal sites for speculation. Drawing from work in economics, critical finance studies and art theory, it is argued that people speculate for reasons that go beyond rational capital accumulation, and the article concludes with the suggestion that the non-monetary benefits of speculation, in particular, are causing art and finance to increasingly become substitute and competing platforms.
Experimental investigation on hygrothermal behaviour and the surface condensation risk of a data centre
Authors: Cho Jinkyun , Park Sanghyun , Lim Taesub , Kim Byungseon S.
Published: July 2016

Condensation under the floor slabs of office rooms adjoining data centres is a serious concern because thermal comfort and information and communications technology equipment are both sensitive to high humidity levels. Surface condensation risk depends mainly on the surface energy balance and moisture content of ambient air. This paper describes an evaluation method for assessing condensation risk of indoor environment conditions and the effect of remedial measures and presents a strategy to solve the condensation risk problems using experimental measurements and numerical simulations. The condensation risks due to air temperature and humidity were calculated for two zones between information and communications technology server rooms and office areas. We analysed the structural insulation performance and space cooling conditions, supply air temperature of the information and communications technology server rooms. The change in indoor temperature of non-information and communications technology spaces was predicted to find the cause of the condensation state. The results show that application of floor slab insulation and high supply air temperature by the computer room air-conditioning unit can substantially increase the lowest temperature of the interior surfaces and the temperature factor and reduce indoor relative humidity, thus preventing surface condensation in the non-information and communications technology spaces adjacent to the information and communications technology server rooms.
Recruitment challenges and strategies: Lessons learned from an early-stage dyadic intervention (innovative practice)
Authors: Szabo Sarah M , Whitlatch Carol J , Orsulic-Jeras Silvia , Johnson Justin D
Published: July 2016

An increasing number of family caregivers are seeking services and support due in large part to the dramatic increase in the number of older adults obtaining dementia diagnoses. This paper describes barriers and challenges experienced by our research team in recruiting early-stage dementia caregiving dyads into research studies. Effective recruitment and screening strategies to address these barriers are also discussed. Recruitment and enrollment success depends on these strategies as well as having well-trained recruitment staff who are knowledgeable about the study and have experience working with older adults, and more specifically, persons with dementia.
Creativity, diversity, and integration: Radical change in the bachelor of music curriculum
Authors: Myers David E
Published: July 2016

During 2013–2014, the Task Force on the Undergraduate Music Major of the USA’s College Music Society prepared a report entitled Transforming Music Study from its Foundations: A Manifesto for Progressive Change in the Undergraduate Preparation of Music Majors. The report is a call for increased relevance in undergraduate music studies that prepare students for leadership, adaptability, and initiative in advancing the values of music and musicians in a techno-global society. Specifically, the task force recommends that curricula derive from the three pillars of creativity, diversity, and integration, arguing that composition, improvisation, performance, and theoretical-cultural-historic music studies be taught holistically and in ways authentic to the art and practice of music itself. In addition, the report calls for greater participation by students in planning degree programs that provide trajectories in keeping with their goals and interests, and for greater nimbleness that enhances curricular adaptations on an ongoing basis.
Who is audience?
Authors: Beeching Angela M
Published: July 2016

Music conservatoires have generally neglected focusing on a key issue: that of audiences—their needs and wants, why they value particular music, and how music actually functions in any particular community. Yet audience is typically a musician’s first contact with the “real world”; understanding audience (one’s market or customers) is essential to building a sustainable career in music today. This paper focuses on how music students and faculty can explore the issue of audience. Using examples from US conservatoires and concepts from the business world, the paper highlights a number of entrepreneurial learning activities to use within and beyond the classroom and rehearsal space. It also connects this learning with curriculum reform, empathy development, and Design Thinking. The paper argues that our challenge as educators is to design classroom activities that build the life skills needed not just for a student’s immediate future but for a lifetime of learning and community participation.
Understanding the Impact of Lottery Incentives on Web Survey Participation and Response Quality
Authors: Zhang Chan , Lonn Steven , Teasley Stephanie D.
Published: July 2016

Cumulative evidence is mixed regarding the effect of lottery incentives on survey participation; little is known about why this strategy sometimes works and other times fails. We examined two factors that can influence the effectiveness of lottery incentives as suggested by leverage-salience theory: emphasis of survey attributes in invitations and characteristics of target populations. We conducted a web survey experiment where one condition highlighted lottery incentives in the e-mail invitations (incentive-centered condition) and the other highlighted the value of the survey with a brief mention of the lottery (survey-centered condition). We found that the incentive-centered condition had a significantly higher response rate than the survey-centered condition, especially among individuals with a relatively low income. Although invitation emphasis affected respondent compositions regarding motives for participation, the differences in response quality between the two experimental conditions were small and mostly not significant.
Cardiac rehabilitation improves the blood plasma properties of cardiac patients
Authors: Gwoździński Krzysztof , Pieniążek Anna , Czepas Jan , Brzeszczyńska Joanna , Jegier Anna , Pawlicki Lucjan
Published: July 2016

Cardiac rehabilitation (CR) improves exercise tolerance and general function. However, its effects on blood plasma in cardiac patients remain uncertain. Our aim was to examine the effect of comprehensive CR on the oxidative stress parameters and antioxidant plasma status in patients with coronary artery disease (CAD) after cardiac interventions. Exercise-based rehabilitation was established as ergometer training, adjusted for individual patients’ physical efficiency. Training was repeated three times a week for two months. The standard biochemical (total cholesterol, HDL, LDL, triglycerides and erythrocyte sedimentation rate) and metabolic parameters (peak oxygen uptake [VO2] and peak workload) were determined. We assessed plasma viscosity, lipid peroxidation, carbonyl compounds levels, glutathione (GSH) and ascorbate (ASC) levels and the non-enzymatic antioxidant capacity of plasma in 12 patients with CAD before and after CR. Parameters were examined before exercise, immediately after exercise, and 1 h later. We also compared morphological and biochemical parameters of blood, as well as other parameters such as heart rate and blood pressure (resting and exercise), VO2max and peak workload (W) before and after CR. Before CR, a significant decrease in GSH concentration was observed 1 h after exercise. Conversely, after CR, GSH, and ASC levels remained unchanged immediately after exercise. However, ASC increased after CR after exercise and 1 h later in comparison to before CR. There was a significant increase in ferric reduction ability of plasma immediately after exercise after CR, when compared with before CR. CR improved several blood biochemical parameters, peak VO2, induced an increase in systolic blood pressure peak, and patients’ peak workload. After CR, improvements were detected in oxidative stress parameters, except in the level of carbonyls. These changes may contribute to the increased functional heart capacity and better tolerance to exercise and functional capacity of the patients. These improvements could indicate better prognosis of future cardiac events and hospitalization and better quality of life.
Dynamical analysis of fractional order model of immunogenic tumors
Authors: Arshad Sadia , Baleanu Dumitru , Huang Jianfei , Tang Yifa , Al Qurashi Maysaa Mohamed
Published: July 2016

In this article, we examine the fractional order model of the cytotoxic T lymphocyte response to a growing tumor cell population. We investigate the long-term behavior of tumor growth and explore the conditions of tumor elimination analytically. We establish the conditions for the tumor-free equilibrium and tumor-infection equilibrium to be asymptotically stable and provide the expression of the basic reproduction number. Existence of physical significant tumor-infection equilibrium points is investigated analytically. We show that tumor growth rate, source rate of immune cells, and death rate of immune cells play vital role in tumor dynamics and system undergoes saddle-node and transcritical bifurcation based on these parameters. Furthermore, the effect of cancer treatment is discussed by varying the values of relevant parameters. Numerical simulations are presented to illustrate the analytical results.