bluuebunny/crossref_metadata_2025 huggingface dataset:
Does multilocus inherited neoplasia alleles syndrome have severe clinical expression?
Authors: Stradella Agostina , del Valle Jesús , Rofes Paula , Feliubadaló Lídia , Grau Garces Èlia , Velasco Àngela , González Sara , Vargas Gardenia , Izquierdo Ángel , Campos Olga , Tornero Eva , Navarro Matilde , Balmaña-Gelpi Judith , Capellá Gabriel , Pineda Marta , Brunet Joan , Lázaro Conxi
Published: December 2018

Importance

Genetic testing of hereditary cancer using comprehensive gene panels can identify patients with more than one pathogenic mutation in high and/or moderate-risk-associated cancer genes. This phenomenon is known as multilocus inherited neoplasia alleles syndrome (MINAS), which has been potentially linked to more severe clinical manifestations.

Objective

To determine the prevalence and clinical features of MINAS in a large cohort of adult patients with hereditary cancer homogeneously tested with the same gene panel.

Patients and methods

A cohort of 1023 unrelated patients with suspicion of hereditary cancer was screened using a validated panel including up to 135 genes associated with hereditary cancer and phakomatoses.

Results

Thirteen (1.37%) patients harbouring two pathogenic mutations in dominant cancer-predisposing genes were identified, representing 5.7% (13/226) of patients with pathogenic mutations. Most (10/13) of these cases presented clinical manifestations associated with only one of the mutations identified. One case showed mutations in MEN1 and MLH1 and developed tumours associated with both cancer syndromes. Interestingly, three of the double mutants had a young age of onset or severe breast cancer phenotype and carried mutations in moderate to low-risk DNA damage repair-associated genes; two of them presented biallelic inactivation of CHEK2. We included these two patients for the sake of their clinical interest although we are aware that they do not exactly fulfil the definition of MINAS since both mutations are in the same gene.

Conclusions and relevance

Genetic analysis of a broad cancer gene panel identified the largest series of patients with MINAS described in a single study. Overall, our data do not support the existence of more severe manifestations in double mutants at the time of diagnosis although they do confirm previous evidence of severe phenotype in biallelic CHEK2 and other DNA repair cancer-predisposing genes.
Environment at the time of injury determines injury patterns in pelvic blast
Authors: Webster Claire Elizabeth , Clasper J , Gibb I , Masouros S D
Published: December 2018

The use of explosives by terrorists, or during armed conflict, remains a major global threat. Increasingly, these events occur in the civilian domain, and can potentially lead to injury and loss of life, on a very large scale. The environment at the time of detonation is known to result in different injury patterns in casualties exposed to blast, which is highly relevant to injury mitigation analyses. We describe differences in pelvic injury patterns in relation to different environments, from casualties that presented to the deployed UK military hospitals in Iraq and Afghanistan. A casualty on foot when injured typically sustains an unstable pelvic fracture pattern, which is commonly the cause of death. These casualties die from blood loss, meaning treatment in these should focus on early pelvic haemorrhage control. In contrast, casualties injured in vehicle present a different pattern, possibly caused by direct loading via the seat, which does not result in pelvic instability. Fatalities in this cohort are from injuries to other body regions, in particular the head and the torso and who may require urgent neurosurgery or thoracotomy as life-saving interventions. A different strategy is therefore required for mounted and dismounted casualties in order to increase survivors.
Military psychological trauma and therapy: a review of EMDR treatment and supervision in the UK Ministry of Defence
Authors: Frappell-Cooke Wendy , McCauley M
Published: December 2018

Psychological injury has been associated with military service, and this can result in a variety of mental health symptoms and disorders. A range of barriers to help-seeking have been identified in the military and mental health services have sought to address such factors through effective and efficient care and consultation. The use of eye movement desensitisation and reprocessing forms part of a repertoire of trauma-focused therapies within the UK’s Armed Forces. This article will outline the application of this approach within the British military, along with the role of specialist clinical supervision in treating those affected by operational trauma.
Drs Bramhall and Bawa-Garba and the rightful domain of the criminal law
Authors: Ost Suzanne
Published: December 2018

In the wake of two recent high-profile, controversial cases involving the prosecution and conviction of Drs Bramhall and Bawa-Garba, this article considers when it is socially desirable to criminalise doctors’ behaviour, exploring how the matters of harm, public wrongs and the public interest can play out to justify—or not, as the case may be—the criminal law’s intervention. Dr Bramhall branded his initials on patients’ livers during transplant surgery, behaviour acknowledged not to have caused his patients any harm by way of injury to their organs. Dr Bawa-Garba misdiagnosed and failed to properly assess a 6-year-old boy with pneumonia and sepsis under her care, who subsequently died. Taking account of contextual and public interest concerns, can and should there be exceptions to imposing criminal liability where a doctor’s behaviour is deemed grossly negligent and a significant contribution to a patient’s death? And is it really appropriate to subject a doctor to penal sanction where he may have committed a private wrong against a patient, but does not set back their interests?
What (or sometimes who) are organoids? And whose are they?
Authors: Lavazza Andrea
Published: December 2018

In terms of ethical implications, Boers, van Delden and Bredenoord (2018) have made an interesting step forward with their model of organoids as hybrids, which seeks to find a balance between subject-like value and object-like value. Their framework aims to introduce effective procedures not to exploit donors and to increase their engagement, but it does not seem to take sufficient account of how organoids are used and how donors and society as a whole may want to act about such uses. I will concentrate my remarks on three points that I consider relevant. The first comment concerns the so-called mini-brains. The second one is related to the issue of consent and long-term ‘control’ over the organic material granted by donors. The last comment focuses on ‘genetic minorities’.
Balloon-assisted tracking technique to overcome intracranial stenosis during thrombectomy for stroke
Authors: Burkhardt Jan-Karl , Shapiro Maksim , Tanweer Omar , Litao Miguel , Chancellor Breehan , Raz Eytan , Riina Howard A , Nelson Peter Kim
Published: December 2018

Anatomical vessel obstacles such as an intracranial stenosis in stroke are challenging and may lead to delayed clot access for thrombectomy. We describe a simple and effective technique to overcome the step-off between the intermediate catheter and an intracranial vessel stenosis during thrombectomy. The patient presented with acute embolic left middle cerebral artery occlusion and a favorable penumbral pattern. Clot access was made challenging by focal stenosis in the ipsilateral cavernous segment. The balloon-assisted tracking technique was effective in traversing the step-off to enable TICI 3 aspiration thrombectomy. This simple and effective technique should be kept in mind during stroke procedures where a proximal stenotic obstacle complicates access to the site of occlusion.
Dual screen and confirm rapid test does not reduce overtreatment of syphilis in pregnant women living in a non-venereal treponematoses endemic region: a field evaluation among antenatal care attendees in Burkina Faso
Authors: Langendorf Céline , Lastrucci Céline , Sanou-Bicaba Isabelle , Blackburn Kara , Koudika Marie-Hortense , Crucitti Tania
Published: December 2018

Objectives

In resource-limited settings, screening pregnant women for syphilis using rapid diagnostic tests (RDTs) is a key tool in the prevention of congenital syphilis. However, most syphilis RDTs detect only treponemal antibodies (T-RDT), meaning antibiotics may be provided unnecessarily to previously treated pregnant women, particularly in non-venereal treponematoses endemic regions. We estimated the potential reduction in overtreatment when comparing T-RDT (SD Bioline) to a newer rapid test (Dual Path Platform (DPP) Screen and Confirm Assay, Chembio) detecting both treponemal and non-treponemal antibodies.

Methods

Pregnant women in Déou, Burkina Faso, screened for syphilis during antenatal care (ANC) visits were prospectively enrolled in the study after providing consent. DPP and T-RDT tests were performed on whole blood specimens. Plasma was tested in an international reference laboratory by Treponema pallidum passive particle agglutination (TPPA) and quantitative rapid plasma reagin (RPR). Presumptive active syphilis was defined as a result that was both TPPA and RPR reactive.

Results

Of the 242 pregnant women included in the study, 91 (37.6%) had presumptive active syphilis and 19.0% had RPR titres ≥8. DPP testing did not reduce the number of pregnant women who would have been overtreated compared with T-RDT (0.0% vs 2.5%; p=0.218) and had a higher proportion of underdiagnosis (48.4% vs 2.2%; p<0.001). Seven women with high RPR titres ≥8 would not have received treatment had only DPP testing been used.

Conclusion

In the first evaluation comparing DPP with traditional screening methods in pregnant women, we saw no reduction in unnecessarily treated syphilis and an underestimation of those needing treatment. High seroprevalence in the population may indicate the presence of other treponemal infections in the area, and further study of DPP in a variety of Sahelian and other contexts is warranted.
Distal plate fracture as a novel complication following TTA surgery in two dogs
Authors: Ortiz Victor , Arthurs Gareth , Kulendra Nicola
Published: December 2018

Two Rottweilers with cranial cruciate ligament (CCL) disease were referred for evaluation and treatment. Both patients underwent radiographs and examination under sedation, which confirmed CCL disease. Arthrotomy of the affected stifles revealed a partial CCL rupture in one patient and a complete CCL rupture in the other patient. The two patients underwent tibial tuberosity advancement (TTA) for treatment. In both cases, the TTA plate broke and the patients underwent a second operation to replace the broken plate. One patient was lost to follow‐up after the second operation, while the other had acceptable function of the leg. Metallurgical analysis of the explanted plate in the second patient revealed corrosion as the predominant mechanism of plate failure. Despite the inherent resistance to corrosion presented by titanium implants, it is still possible for corrosion to lead to implant failure. However, replacement of the failed implant could lead to full recovery.
Voice Disorders in Obstructive Sleep Apnea: Prevalence, Risk Factors, and the Role of CPAP
Authors: Roy Nelson , Merrill Ray M. , Pierce Jenny , Sundar Krishna M.
Published: December 2018

Objective:

Obstructive sleep apnea (OSA) is characterized by frequent interruptions in breathing related to upper airway collapse during sleep and may adversely affect phonatory function. This study aimed to: (1) establish the prevalence, risks, and quality of life burden of voice disorders in OSA and (2) explore the relation between voice disorders and positive airway pressure (PAP) therapy.

Study Design:

Cross-sectional, descriptive epidemiology study.

Methods:

Analyses were based on 94 individuals with OSA (53 men, 41 women; mean age = 54.7 ± 12.8 years) who completed a telephone interview.

Results:

Twenty-eight percent of participants reported having a current voice disorder. Of those with a current voice disorder, 83% had experienced symptoms for at least a year, and 58% had symptoms for at least 4 years. The prevalence of a current voice disorder was greater in women than men (44% vs 15%, P = .0020) but did not vary significantly across different age groups, body mass index (BMI), apnea/hypopnea index (AHI) severity, or medical history. After adjusting for sex, consistent use of PAP therapy (with humidification) was associated with (1) lower occurrence of voice disorders in women (Mantel-Haenszel [MH] χ2 P = .0195), (2) reduced snoring severity accompanied by fewer voice disorders in men (MH χ2 P = .0101), and (3) fewer reports of acid reflux as a possible trigger for voice problems (MH χ2 P = .0226). Patients with OSA who also had a current voice disorder experienced lower overall quality of life compared to those without.

Conclusions:

Chronic, longstanding voice disorders are common in women with OSA and produce significant adverse effects on quality of life. Nightly PAP use (with humidification) was associated with fewer voice symptoms and reduced severity of snoring and acid reflux as possible contributors. Further research is necessary to better understand the origin of these voice disorders in OSA and their potential response to treatment.
Location Type Choice for Face-to-Face Interactions in Business Centers
Authors: Weijs-Perrée Minou , Appel-Meulenbroek Rianne , Arentze Theo
Published: December 2018

Business centers offer flexible shared workspaces and facilities to multiple organizations, which provide more freedom in where to interact with others. However, knowledge on where different types of organizational interactions take place in business centers and how this behavior is influenced is still lacking. Therefore, the aim of this study is to analyze the location choice for different types of face-to-face interactions. Data, collected by means of an experience sampling method (ESM), were analyzed using a mixed multinomial logit (MMNL) model. Results showed that interorganizational interactions take place less frequently at workspaces or formal meeting spaces and more frequently at shared spaces such as the coffee corner or canteen. These interactions are also more likely to be influenced by the physical work environment, as these interactions were found to be mainly coincidental. Results of this study could help office designers with regard to stimulating face-to-face interactions among organizations.
Social Work in Funeral Homes, a Unique Chinese Practice?
Authors: Huang Yunxian , Tan Weijia , Tat Tsang A. Ka
Published: December 2018

Social workers were introduced to funeral homes in China amid the transition and expansion of both the funeral home industry and the social work profession and are proving to play a valuable, though under-researched role in serving not just clients but also communities and funeral home staff. Funeral home social work fills gaps in after-death care and mental health and is distinct from palliative, hospice, end-of-life, and bereavement social work. Based on the experiences of funeral homes that employ social workers, this article argues that this innovation may bring new ideas to bridge some of the service gaps in after-death care in China and globally. This article outlines the support that will be needed from funeral homes, social work service agencies, and educational and research institutes to facilitate further development of funeral home mental health and social services and to promote the professionalization of funeral home social workers in China.
Depressive Symptoms and Coping Strategies Among Indian University Students
Authors: Sawhney Manisha , Kunen Seth , Gupta Ashum
Published: December 2018

Depression is now the leading cause of disability worldwide, and globally more than 300 million people of all ages suffer from depression. Depression, despite its major health consequences, frequently goes unnoticed among university students, since their lives are often filled with symptoms normally associated with depression (e.g., loss of sleep, low energy, anxiety, and sadness). Successful adaptation to depression depends on the use of adequate coping strategies. The extent to which university students in India with high and low levels of depressive symptoms use adequate or inadequate coping strategies has not been evaluated. Based on the Center for Epidemiological Scale for Depression score, students were assigned to either the high depressive symptoms or the low depressive symptoms group. We used the Coping Response Inventory-Adult to determine the dominant coping strategies used by the two depressive symptoms groups. The high depressive symptom group resorted to more avoidant coping strategies than the low depressive symptom group, and women were more likely to use avoidant coping strategies than men.
Durability testing of electronic textile surface resistivity and textile antenna performance
Authors: Xu Bin , Eike Rachel J , Cliett Allyson , Ni Ling , Cloud Rinn , Li Yang
Published: December 2018

As wearable electronics become more prevalent in everyday life, there is a growing desire to integrate circuits and antennae into clothing. One way that this integration may occur is through use of electronic textiles (e-textiles). However, changes in environmental and wear conditions may affect the conductive data communication performance of the e-textile, such as surface resistivity and antenna radiation characteristics. In this study, the effects of pilling, wrinkling, abrasion, and laundering of e-textiles were examined for resistivity performance. E-textile resistivity performance from both direct current (DC) and radiofrequency (RF) perspectives were measured following AATCC and ASTM standards. For DC performance, results indicate that pilling causes severe damage to e-textile resistivity, while laundering and wrinkling did not substantially affect e-textile resistivity performance. For RF performance in this study, an e-textile microstrip patch antenna was designed and data were collected under similar environmental and wear conditions. RF performance change corresponds with DC performance change. The findings of this paper highlight limitations of the evaluated e-textile performance, and provide new perspectives regarding improvements to e-textile fabrication for sustaining performance through environmental and wear operations.
The Stories We Tell: How Merit Narratives Undermine Success for Urban Youth
Authors: Generett Gretchen Givens , Olson Amy M.
Published: December 2018

This article looks at the American Dream as a merit narrative to understand how it supports barriers to educational success for educators working to improve the lives of students in urban schools. Hard work/perseverance and individualism are interrogated as components of merit narratives used to sustain the American Dream. We analyze data from six educators who identify as advocates. We conclude that the stories educators tell reify individuals’ hard work/perseverance, rather than dispel myths of meritocracy, thereby blaming the lack of success on students’ inadequate effort as opposed to schools designed to maintain the status quo.
Empowerment in the Public Sector: Testing the Influence of Goal Orientation
Authors: García-Juan Beatriz , Escrig-Tena Ana B. , Roca-Puig Vicente
Published: December 2018

Empowerment has emerged as an important new issue in the public sector organization setting in the wake of mainstream new public management (NPM). Nevertheless, few studies in this frame have combined structural (managerial) and psychological (individual) approaches in an integrative study of empowerment. There is also a need to examine the moderating variables involved in this relationship, as well as to extend research on work motivation in public management. This study explores the effect of structural empowerment on psychological empowerment, and it also draws on goal orientation (GO) theory to examine the moderating role of employees’ GO in this link. The model is tested on a sample of 521 Spanish local authority employees. The results do not confirm the direct link between structural and psychological empowerment, but show that learning GO has considerable moderating power in this relationship, and its interaction with structural empowerment affects employees’ psychological empowerment levels.
The relationship between airtightness and ventilation in new UK dwellings
Authors: Crawley Jenny , Wingfield Jez , Elwell Cliff
Published: December 2018

The UK’s Air Tightness Testing and Measurement Association competent persons scheme collects pressure test data and metadata from the majority of new build dwellings in the UK. This article uses the dataset to investigate the importance of the ventilation strategy in airtightness design and construction. Design and measured airtightness were tested for association with declared ventilation strategy. It was found that ventilation strategy makes a statistically significant difference to airtightness; however, this difference is too small to be practically relevant. Properties with mechanical ventilation and heat recovery (MVHR) were shown to have a mean designed air permeability only 0.46 m3/m2h lower than naturally ventilated dwellings. Seventy-three per cent of homes with MVHR have design airtightness greater than or equal to 5 m3/m2h and 17% of naturally ventilated dwellings have design airtightness less than 5 m3/m2h. We discuss how current design is not maximising the CO2, cost and air quality benefit of each ventilation strategy. A new approach to regulatory compliance is proposed, which explicitly links the designed airtightness and chosen ventilation system. It is suggested that compliance could then be achieved using a set of airtightness ranges linked to appropriate ventilation strategies. This could be expected to result in reduced energy consumption and carbon emissions for new build homes compared to the current approach and would also potentially lead to better outcomes for occupants in terms of indoor air quality.

Practical application: Analysis of a large database of the airtightness of new UK dwellings found that ventilation strategy makes very little difference to airtightness design. For dwellings with MVHR, the results suggest that infiltration levels are too high to maximise the energy savings; for naturally ventilated homes, there may be air quality issues. Coupling airtightness design and ventilation strategy can reduce a dwelling’s energy demand and can support achieving the required energy performance rating.
Comparison between blood and non-blood cardioplegia in tetralogy of Fallot
Authors: Romolo Harvey , Hernisa Latifa , Fakhri Dicky , Rachmat Jusuf , Dwi Mulia Dina , Rahmat Budi
Published: December 2018

Background

Cardioplegia is an integral part of myocardial protection. The superiority of blood cardioplegia in adult patients has been reported. However, this is yet to be studied in cyanotic pediatric patients.

Methods

A randomized open-label trial was conducted in 70 patients with tetralogy of Fallot. They were divided into two groups: 35 patients had crystalloid cardioplegia (controls), and 35 had blood cardioplegia. Lactate and coronary oxygen extraction in arterial blood and the coronary sinus were measured immediately after cessation of cardiopulmonary bypass, 15 and 30 min later. Postoperative mortality, major adverse cardiac events, mechanical ventilation time, inotrope administration, arrhythmias, right ventricular function, intensive care unit and hospital length of stay were observed.

Results

There were no significant differences in clinical outcomes or lactate levels. There was a significant difference in coronary oxygen extraction immediately and 15 min after cessation of cardiopulmonary bypass ( p = 0.038, p = 0.015).

Conclusion

Blood cardioplegia gave a better postoperative oxygen extraction value but there were no differences in myocardial damage or clinical outcome between the two groups.
Financial Neoliberalism and Exclusion with and beyond Foucault
Authors: Christiaens Tim
Published: December 2018

In the beginning of the 1970s Michel Foucault dismissed the terminology of ‘exclusion’ for his projected analytics of modern power. This rejection has had major repercussions on the theory of neoliberal subject-formation. Many researchers disproportionately stress how neoliberal dispositifs produce entrepreneurial subjects, albeit in different ways, while minimizing how these dispositifs sometimes emphatically refuse to produce neoliberal subjects. Relying on Saskia Sassen’s work on financialization, I argue that neoliberal dispositifs not only apply entrepreneurial norms, but also suspend their application for groups that threaten to harm the population’s profitability. Neoliberal dispositifs not only produce entrepreneurial subjects but also surplus populations that are expelled from the overall population to maintain its productivity. Here, the concept of ‘exclusion’ is appropriate if understood in Agamben’s sense of an inclusive exclusion. The surplus population is part of neoliberal dispositifs, but only as the element to be abandoned.
Fundamental clinical skills of adult cardiopulmonary bypass: results of the 2017 national survey
Authors: Searles Bruce , Darling Edward , Riley Jeffrey , Wiles Jason R.
Published: December 2018

Introduction:

Training students to become entry-level perfusionists requires evaluation and assessment of their clinical skills. While our professional organizations have compiled resources which identify the profession’s knowledge base and categorical skills applied to clinical practice, these resources are lacking the necessary detail to develop validated clinical assessment rubrics. Therefore, the purpose of this project is to identify, through expert opinion, the detailed fundamental skills necessary to perform adult cardiopulmonary bypass (CPB).

Methods:

We define a fundamental skill based upon frequency of use and risk of harm. A skill that experts report is conducted in >50% of their CPB cases – and, if not properly conducted, can cause harm, is deemed a fundamental skill. To identify these skills, a 73-question survey was developed and posted on PerfList and PerfMail from May 2017 to July 2017.

Results:

The results from 261 respondents were analyzed. The demographics of the participants were representative of the workforce. Twenty skills were surveyed and all 20 met the criteria to be identified as a fundamental skill. Data regarding the actions, assessments and behaviors that may be associated with fundamental skills were also identified.

Conclusions:

Based upon this survey data, we have identified that there is consensus within our profession regarding the fundamental skills of adult CPB and a core body of actions, assessments and behaviors that experts perform when conducting these skills. This information may be incorporated into the entry-level educational process to inform curricula and design valid assessment rubrics.
Impact of a Hand Hygiene Curriculum and Group Handwashing Station at Two Primary Schools in East Africa
Authors: Pasewaldt Stephanie E. , Baller Stephanie L. , Blackstone Sarah R. , Bryan Malenke Lucy
Published: December 2018

Proper handwashing reduces the transmission of deadly, preventable diseases. Schools, even those with limited resources, have the power to promote handwashing through simple, effective interventions. This study evaluated the impact of a school-based handwashing program consisting of two interventions: a hand-hygiene curriculum and group handwashing station. Quantitative and open-ended pre/postintervention surveys were administered to students at one primary school in Kenya ( n = 38) and at one primary school in Uganda ( n = 57). Matching procedures were followed at each school. Paired ttests for pre/postsurveys demonstrated an increase in students’ knowledge ( p < .001) and frequency of handwashing ( p < .001). After 6 months, students were still engaging in daily group handwashing. The curriculum increased knowledge, and the handwashing station enabled students to translate their knowledge into action. This study supports educational interventions combined with built environmental interventions should be used to promote handwashing behaviors and emphasizes the role of group handwashing stations.
Impacts of Real Depreciation and Appreciation on Aggregate Output in Taiwan
Authors: Hsing Yu
Published: December 2018

Extending the IS-MP-AS model, this article finds that real depreciation helped to raise real gross domestic product (GDP) during 1999.Q1-2010.Q2 whereas real appreciation helped to increase real GDP during 2010.Q3-2016.Q4. In addition, a lower world real interest rate, a higher stock price, a higher real oil price or a lower expected inflation would increase real GDP. More deficit spending as a percent of GDP does not affect real GDP.

JEL Classification: F41, E62
Evaluating Article Search and Selection Procedures in Special Education Literature Reviews
Authors: King Seth , Davidson Kimberly , Chitiyo Argnue , Apple Derrick
Published: December 2018

Literature reviews allow education professionals to identify effective interventions and assess trends in research and practice. However, issues with transparency and the specific methods used in conducting literature searches have the potential to limit the utility of reviews. This study evaluated the description of article search procedures and selection processes appearing in literature reviews and meta-analyses published in special education journals from 2004 to 2016. Findings reveal a considerable increase in the number of published meta-analyses and systematic reviews over this time period. Nonetheless, the validity of reviews is potentially undermined by incomplete descriptions of methods. Reports of inclusion criteria further suggests the results of many reviews may be biased. A discussion of implications follows a description of findings.
Bibliometric and Textual Analysis of Historical Patterns in Maternal–Infant Health and Nursing Issues in The Canadian NurseJournal, 1905–2015
Authors: Marcellus Lenora
Published: December 2018

Study background

Journals are key learning mechanisms for nursing organizations. Analysis of publications provides opportunities to explore influences, priorities, and perspectives of nurses over time.

Purpose

To identify historical trends in maternal–infant health and nursing practice.

Methods

Historical bibliometric and content analysis of articles in The Canadian Nurse, 1905–2015. Six hundred sixty-eight lead publications in the journal were identified. Data were extracted on authorship, writing style, geographical distribution, and language, and content themes were determined.

Results

Five hundred twenty-five publications were written by nurses, and 272 came from the Ontario and Quebec. Nine key content areas were identified, including changing families, women’s bodies, prenatal care, birth care, postpartum care, when things go wrong, and keeping babies healthy. The number of maternal–infant publications in this national journal has been decreasing since the emergence of specialty journals.

Conclusion

Advances in perinatal nursing practice over the past 115 years in Canada reflect emerging scientific developments and evolving social values. These articles traced the medicalization and reclamation of pregnancy and childbirth, the shifting role of nurses in relation to other health and social care providers, and the impact of determinants of health on the well-being of mothers, infants, and families.
Research on fault early warning and the diagnosis of machine tools based on energy fault tree analysis
Authors: Chen Xuezhen , Song Zhiyong , Li Hai , Gong Qinghong , Li Ying , Wang Feng
Published: December 2018

At present, the status of the monitoring of computerized numerical control machine tools is still in the initial stage, and there is no uniform standard for fault early warning and diagnosis of machine tools. A standardized and comprehensive machine tool condition monitoring method based on energy fault tree analysis is proposed. The power, current and temperature inside the numerical control system and the signal of the external vibration sensor are collectively referred to as energy. A new energy fault tree is used to identify the location of the fault. At the same time, the client of computerized numerical control system internal information collection and analysis is developed. The characteristic frequency of each key component is analysed by theoretical mechanics, and an overall monitoring method is proposed to improve the monitoring efficiency. Finally, the reliability of the monitoring method is verified by experiments. The surface roughness of the parts is reduced by approximately 50%, which lays the foundation for the application of the engineering.
Finite element analysis of the residual stress of automotive wheel made of long glass fiber-reinforced thermoplastic composite
Authors: Chai Weihao , Liu Xiandong , Shan Yinchun , Wan Xiaofei , Jiang Er
Published: December 2018

To increase the simulation accuracy, a finite element analysis method for the prediction of the residual stress distribution in the injection molded wheel made of the long glass fiber-reinforced thermoplastic composite (LGFT) is studied, and a simulation method of the wheel bending fatigue test considering the residual stress distribution is investigated in this paper. First, the in-cavity residual stress is calculated using the molding simulation method. Then the residual stress relaxation process is analyzed and the final residual stress distribution is obtained. With the residual stress as the initial stress, the structural simulation of the LGFT wheel under the bending load is performed. To evaluate the influence of the residual stress on the LGFT wheel, an additional simulation without considering the residual stress is conducted. The result shows that the interior stress considering residual stress is much higher than that without considering residual stress. To verify the simulation accuracy of these two cases, the high-stress area locations in the simulation results are compared with the damage locations in physical bending fatigue test. The result illustrates that the simulation result considering the residual stress accords with the experimental result better. Therefore, the simulation result of the residual stress is reasonable, and it is necessary to consider residual stress in the simulation of the LGFT wheel.
Design and optimization of spin micro-generator's rotating rack used in trajectory correction fuze under high-impact loadings
Authors: Hui Jianghai , Gao Min , Li Xinpeng
Published: December 2018

Buffer structure is a traditional measure to improve the ammunition's performance of withstanding impact loadings during launch process. On that basis, this paper proposes a parametric optimization for the gasket, which is served as buffer structure in spin microgenerator's rotating rack used in trajectory correction fuze to effectively reduce the stress of bearings used in the rack. It is a finite element dynamic simulation based on rack-projectile-barrel coupling to acquire variation of the bearings' stress. A rack-projectile-barrel coupling model is built and the simulation pre-process is described. At first, the parametric analysis for the gasket is conducted. The effect of the gasket's axial thickness and elastic modulus on the bearings' stress is studied, and the results show that singly changing one of the two gasket's parameters cannot effectively reduce the two-ball bearings' stress. Then, based on the two gasket's parameters, the design of experiment method is applied with 25 sample points established. A kind of approximation, response surface model is created and its fitting accuracy is verified. Single-objective and multi-objective optimization are conducted based on the response surface model, respectively. And the multi-objective optimization for the gasket can successfully reduce the two bearings' stress to the value below the bearing material's yield strength. In addition, to check the optimization's effectiveness, an experiment is carried out and the results indicate that the gasket whose axial thickness and elastic modulus have been optimized can effectively improve the rotating rack's performance of withstanding impact loadings.
Drag reduction within radial turbine rotor passages using riblets
Authors: Khader MA , Sayma AI
Published: December 2018

In this paper, reducing the friction losses in a radial inflow turbine rotor surface by adding engineered features (riblets) is explored. Initially, computational fluid dynamics analysis was used to study the operating mechanism of riblets and to test their ability to reduce drag within the rotor passage when running the turbine at the design point. Thereafter, riblets with different heights and spacing have been implemented at the rotor hub to study the effect of riblets geometry and arrangement on the drag reduction, which leads to determine the riblet geometry where the maximum benefit on turbine performance can be achieved. The effect of riblets on boundary layer development and on the secondary flow generation within the rotor passage has been examined. It was found that the introduction of riblets could reduce the wall shear stress at the hub surface, and on the other hand, they contribute to increasing the stream-wise vorticity within the rotor passage. The maximum wall shear reduction was achieved with riblet with relative height hrel = 2.5% equivalent to 19.3 wall units, while the maximum performance happens when using riblets with hrel = 1.5% equivalent to 11.8 wall units as the later contributes less in secondary flow generation within the passage. For riblets with height more than 19.3 wall units, the overall effect is negative, as they cause an increase in drag and give rise to secondary flow leading to lower turbine performance.
Wear behavior of friction pairs of different materials for ultra-high-pressure axial piston pump
Authors: Zhang Jin , Qiu Xiaogang , Gong Xuezhi , Kong Xiangdong
Published: December 2018

This paper evaluates the wear of two different materials (ceramic and 30Cr2MoVA) of friction pairs of ultra-high-pressure axial piston by means of experimental investigations. Face sliding wear test was carried out on wear testing machine to analyze the coefficient of friction during boundary friction. Then wear amount of the sample is obtained by weighing with the electronic balance. The change of the surface morphology was observed by a laser confocal microscope. By comparing the friction coefficient, wear amount, surface morphology, temperature change, and roughness of the two samples, it has been found that ceramic materials have lower friction coefficient, better wear resistance, and less oil temperature rise than 30Cr2MoVA material. By the above research results it was found that ceramic materials perform better than 30Cr2MoVA, which provides the foundation for further study of the friction pair of the ultra-high-pressure axial piston pump.
Career Development of People With Disabilities: Self-Determination as a Skill Set or a Mind-Set?
Authors: Kwon Chang-kyu
Published: December 2018

Self-determination in career development of people with disabilities has been a widely studied topic among researchers. However, previous research shows that this concept has been narrowly defined as a skill set that individuals can acquire. This article maintains that there is a gap in and a need for understanding and developing the self-determination of people with disabilities as a mind-set in their career development. By applying constructive-developmental theory to career construction theory, the author proposes a new conceptual model of the career development of people with disabilities and provides narrative as a method for practicing it.
The Firebird: Integration of Folktale and Folk Song
Authors: May Brittany Nixon
Published: December 2018

Literature provides a wonderful impetus for both meaningful integration and music study, as it can be used to guide students to understanding the relationships between music and other disciplines, varied cultural and historical contexts, and experiences in daily life. This column presents the benefits of integrating literature in the music classroom, and provides an example of an integration lesson using the Russian folktale of The Firebird and the music of Stravinsky.
Topical Tranexamic Acid for the Treatment of Acute Epistaxis: A Systematic Review and Meta-analysis
Authors: Gottlieb Michael , DeMott Joshua M. , Peksa Gary D.
Published: December 2018

Objective: To compare topical tranexamic acid (TXA) with control groups for the treatment of acute epistaxis assessing bleeding cessation, discharge within 2 hours, rebleeding rates, complication rates, and patient satisfaction. Data Sources: PubMed, CINAHL, LILACS, Scopus, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched from inception to November 2018. Study Selection and Data Extraction: All randomized controlled trials comparing topical TXA with control groups for the treatment of acute epistaxis in humans were included. There were no age, language, or date restrictions. Data were double extracted into a predefined worksheet, and quality analysis was performed using the Cochrane Risk of Bias tool. Data Synthesis: Three studies (n = 408 patients) were identified. Topical TXA was not associated with a statistically significant difference in cessation of bleeding within 30 minutes. However, more patients were discharged within 2 hours of arrival, there were fewer episodes of rebleeding within both the first 24 hours and at 1 week, and there was higher patient satisfaction in the TXA group. There was no difference identified in complication rates. Relevance to Patient Care and Clinical Practice: This review compares topical TXA with control groups for epistaxis and discusses the risks and benefits of adding this therapy to usual care. Conclusions: Topical TXA appears to be a reasonable option for the treatment of acute epistaxis, with reduced rebleeding rates, shorter discharge times, and minimal risk of complications. Topical TXA may be considered as part of the treatment of acute epistaxis.
Is Online Training an Effective Workforce Development Strategy for Transition Service Providers? Results of a Comparative Study
Authors: Brennan Eileen M. , Sellmaier Claudia , Jivanjee Pauline , Grover Leigh
Published: December 2018

Service providers working with transition-aged young people with mental health disorders require specialized research-based training to better meet their needs. A 10-module interactive online training program, Promoting Positive Pathways to Adulthood (PPPA), was developed to build service provider competencies to improve outcomes for the youth with whom they work. In total, 19 organizations participated in a longitudinal quasi-experimental study that compared training outcomes for participants receiving PPPA online training only (Group 1) with those receiving PPPA online training with team-based practice activities (Group 2). Most of the 63 service providers participating in the training were females, below 40 years, had at least one college degree, and were non-Hispanic White. Both groups made significant gains in their transition-related knowledge, and their self-efficacy to provide transition services. Group 2 with additional practice activities achieved significantly higher knowledge scores than Group 1 receiving online-only training. Team-based activities evaluated by Group 2 participants as more engaging and culturally relevant were also rated as more likely to help improve practice. Future research is needed to track youth outcomes after service provider training, and to examine the organizational supports necessary to promote knowledge translation for transition service providers.
Prevalence of Deep Vein Thrombosis in Low-Risk Patients After Elective Foot and Ankle Surgery
Authors: Sullivan Martin , Eusebio Ilian Dominiq , Haigh Kristin , Panti Juan Paulo , Omari Abdullah , Hang Jacqueline R.
Published: December 2018

Background:

The evidence regarding the prevalence of deep vein thrombosis (DVT) after foot and ankle surgery in elective patients that need to be 6 weeks non–weight bearing postoperatively is incomplete and has limitations.

Methods:

The prevalence of DVT in 114 procedures involving the hindfoot and midfoot was determined using ultrasonographic surveillance at 2 and 6 weeks after surgery.

Results:

The prevalence of DVT was observed to be 25.4%. The majority (68.9%) of DVTs were diagnosed at the ultrasonographic scan performed 2 weeks postoperatively. The remainder (31.1%) of DVTs were diagnosed at the 6-week postoperative ultrasonographic scan. At least 75% of the patients who had early and late DVT had no clinical symptoms or signs of DVT. The prevalence of DVT in clinically detectable patients was 6%. The average age of patients with early DVT was 62.2 years, significantly higher compared to those who had no DVT. The mean tourniquet time for patients with early DVT was 68.1 minutes, significantly higher compared to those without DVT. All DVTs detected were distal to the popliteal vein.

Conclusions:

The prevalence of clinically silent DVT was significantly higher than was previously thought. We believe this increased rate is directly attributable to the use of ultrasonographic surveillance postsurgery both at 2 and 6 weeks. The risk of DVT continued after the 2-week visit, and 30% of the DVTs were detected at the ultrasonographic scan at 6 weeks.

Level of Evidence:

Level II, prospective cohort.
Supination External Rotational Ankle Fracture Injury Pattern Correlation With Regional Bone Density
Authors: Warner Stephen J. , Gausden Elizabeth B. , Levack Ashley E. , Lorich Dean G.
Published: December 2018

Background:

Rotational ankle fractures can present with an array of possible osseous and ligamentous injury combinations in reliable anatomic locations. What accounts for these different injury patterns and whether specific patient and injury factors underlie the different injury patterns is unclear. The purpose of this study was to determine whether causative factors exist that could account for the various injury patterns seen with rotational ankle fractures.

Methods:

A registry of operatively treated supination external rotation stage IV (SER IV) ankle fractures was used to identify patients. Computed tomography imaging was used to calculate regional bone density by using average Hounsfield unit measurements on axial images from the distal tibia and fibula. Patients were grouped into those with no posterior or medial malleolar fracture (equivalent group), those with either a posterior or medial malleolus fracture (bimalleolar group), and those with both posterior and medial malleolar fractures (trimalleolar group). Sixty-seven patients met inclusion criteria.

Results:

Regional bone density at the ankle, as measured with Hounsfield units, was significantly higher in the equivalent group (371) than in the bimalleolar group (271, P < .0001) and trimalleolar group (228, P < .0001). Logistic regression analyses identified regional bone density as a significant predictor of a medial malleolus fracture ( P = .002) and of a posterior malleolus fracture ( P = .005).

Conclusion:

In our cohort of SER IV ankle fractures, regional bone density at the ankle significantly correlated with the presence and number of malleolar fractures compared with ligamentous ruptures. Treating surgeons can use this information to anticipate bone quality during operative fixation based on ankle fracture injury pattern. In addition, the presence of a trimalleolar ankle fracture was a significant indicator of poor bone quality and may represent the first clinical sign of abnormal bone metabolism in many patients.

Level of Evidence:

Level III, prognostic retrospective cohort study.