bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening for postoperative delirium in patients with acute hip fracture: Assessment of predictive factors
Authors: Koskderelioglu Asli , Onder Ozlem , Gucuyener Melike , Altay Taskin , Kayali Cemil , Gedizlioglu Muhtesem
Published: June 2016

Aim

The aim of the present study was to estimate the incidence and risk factors of delirium during the early postoperative period after hip fracture surgery. Furthermore, we investigated the accuracy of the Confusion Assessment Method for the Intensive Care Unit (CAM‐ICU) for detection and assessment of delirium in orthopedic patients.

Methods

We consecutively recruited patients aged 65 years or older undergoing hip fracture surgery. The presence of delirium was determined daily by two of the authors according to the CAM‐ICU criteria. A further evaluation was made with the reference standard Diagnostic and Statistical Manual of Mental Disorders Fourth Edition criteria for delirium. Their cognitive function was evaluated with the Mini‐Mental State Examination, and possible depressive mood with the Beck Depression Inventory. Baseline characteristics, as well as the American Society of Anesthesiologists classification and clinical outcomes, were analyzed for a correlation with accompanying delirium.

Results

Among 109 patients, 20 (18.3%) were diagnosed with delirium. The concurrent validity of CAM‐ICU was good (kappa = 0.84). Specificity was 98.9%, and sensitivity was 80%. Multivariate regression analysis showed that Mini‐Mental State Examination (P = 0.001; odds ratio 0.75, 95% confidence interval 0.65–0.86) and Beck Depression Inventory scores (P = 0.001; odds ratio 1.13, 95% confidence interval 1.05–1.22) correlated with the occurrence of delirium.

Conclusıons

The present results show that CAM‐ICU is highly sensitive and specific to identify delirium in hip fracture patients in the postoperative period. Among all of the risk factors, cognitive impairment and depressive mood were strongly associated with postoperative delirium. We suggest that a preoperative assessment of cognition and depression might be useful for identifying patients with a higher risk of postoperative delirium. Geriatr Gerontol Int 2017; 17: 919–924.
Geriatric risk in the surgical management of infectious spondylitis
Authors: Ha Jae Hong , Kim Se Ho , Park Sang‐Min , Lee Choon‐Ki , Chang Bong‐Soon , Kim Hyoungmin
Published: June 2016

Aim

The purpose of the present study was to evaluate and compare clinical outcomes in patients aged >65 years and <65 years who have undergone surgery for infectious spondylitis, and to identify any prognostic factors.

Methods

We reviewed 60 consecutive patients treated surgically for infectious spondylitis. We reviewed patients’ medical records especially focusing on comorbidities, preoperative serum albumin levels, postoperative complications and control of infection on follow up. Statistical analysis was carried out to determine whether these various factors affected clinical outcomes.

Results

Postoperative complication rates (P = 0.764) and infection control rates (P = 0.275) were not significantly different between the two groups. Univariate analysis did not show a correlation between age and clinical outcome, whereas body mass index (BMI; P = 0.04), Charlson Comorbidity Index (CCI; P = 0.017), American Society of Anesthesiologists (ASA) grade (P = 0.006) and serum albumin (P = 0.003) were associated with overall postoperative complications. BMI (P = 0.002) and CCI (P = 0.000) were also associated with postoperative fatalities. The χ2‐test for trend also showed that CCI (P = 0.018), ASA grade (P = 0.007) and low serum albumin (<3.5 mg/dL; P = 0.004) were associated with postoperative complications. Logistic regression analysis showed that ASA grade (P = 0.034) and BMI (P = 0.044) were related to overall postoperative complications. Receiver operating characteristic curve analysis using ASA grade and BMI to predict major postoperative complications and fatality showed an area under the curve value of 0.793 (P = 0.001) and 0.942 (p=0.002), respectively.

Conclusions

BMI, ASA grade, CCI scores and serum albumin levels, rather than age, might be useful in predicting clinical outcome in surgery for infectious spondylitis in elderly patients. Geriatr Gerontol Int 2017; 17: 984–990.
‘TÄTER LITE’ – UNSERE MÜTTER, UNSERE VÄTER AND THE MANUFACTURING OF EMPATHY WITH GERMAN WARTIME TRAUMA
Authors: Schmitz Helmut
Published: June 2016

Unsere Mütter, unsere Väter, produced by Nico Hofmann's company TeamWorx for ZDF in 2014, was the most expensive German TV production to date and was successfully sold to a global audience, including the US where it was awarded an Emmy, and China. The article examines the mini‐series in the context of its German reception and the previous debates around representations of German suffering. It argues that the film combines two previously separate modes of visual representation, the historicist mode, known from Der Untergang and Dresden, and the traumatised aesthetics of contemporary immersive film and TV productions, such as Saving Private Ryan or Band of Brothers. Particular attention is paid to the issue of the manufacturing of audience empathy and film's claim to historical veracity, ostensibly supported by the two documentaries from Guido Knopp's ‘Redaktion Zeitgeschichte’ that accompanied the screenings.

Unsere Mütter, unsere Väter, produziert von Nico Hofmanns Firma TeamWorx, war die bislang teuerste deutsche Fernsehproduktion und wurde erfolgreich global verkauft, unter anderem nach USA, wo die Miniserie einen Emmy gewann, und nach China. Der Artikel untersucht die Miniserie im Kontext ihrer deutschen Rezeption und der vorhergehenden Debatten um ‘Deutsches Leiden’. Er zeigt auf, dass der Film zwei bislang getrennte visuelle Modi kombiniert, den u. a. aus Der Untergang und Dresden bekannten Historizismus und die traumatische Ästhetik zeitgenössischen ‘immersiven’ Filmemachens, bekannt aus z. B. Saving Private Ryan oder Band of Brothers. Besonderes Augenmerk liegt dabei auf der Herstellung von Zuschauerempathie und auf der vom Film beanspruchten historischen Wahrheit, die von den beiden die Ausstrahlungen begleitenden Dokumentationen aus Guido Knopps ‘Redaktion Zeitgeschichte’ beglaubigt wird.
The internalization of Helicobacter pylori plays a role in the failure of H. pylori eradication
Authors: Wang You‐hua , Lv Zhi‐fa , Zhong Yao , Liu Dong‐sheng , Chen Shu‐ping , Xie Yong
Published: June 2016

Background

Helicobacter pylori (H. pylori) internalization involves invasion of cells by the bacterium. Several studies have shown that H. pylori can invade human gastric epithelial cells, immune cells, and Candida yeast in vivo and in vitro. Whether bacterial invasion plays a role in eradication failure is unclear.

Aim

To investigate the relationship between H. pylori invasion of GES‐1 cells and H. pylori eradication failure.

Materials and Methods

Forty‐two clinical strains isolated from H. pylori‐positive patients with different outcomes after treatment with furazolidone‐based therapy were examined (17 failures and 25 successes). The H. pylori strains were shown to be susceptible to amoxicillin and furazolidone, and the patients also exhibited good compliance. Genotyping was performed for cagA and vacA (s and m). The antibiotic susceptibility of the strains to amoxicillin, furazolidone, clarithromycin, metronidazole, and levofloxacin was determined by E‐tests. The levels of H. pylori invasion of GES‐1 cells were detected by gentamicin colony‐forming unit assays.

Results

The internalization level in the eradication success group was 5.40±5.78 × 10−3 cfu/cell, and the median was 6.194 × 10−3 cfu/cell; the internalization level in the eradication failure group was 8.98±5.40 × 10−3 cfu/cell, and the median was 10.28 × 10−3 cfu/cell. The eradication failure group showed a greater invasion level than the eradication success group (P<.05). No significant difference was observed between the susceptible strains and the resistant strains when the internalization levels were compared (P>.05).

Conclusions

The results showed that H. pylori invasion of the gastric epithelia might play a role in eradication failure.
Effect of Nb Doping on Hydration and Conductivity of La27W5O55.5−δ
Authors: Cao Yong , Duan Nanqi , Jian Li , Evans Anna , Haugsrud Reidar
Published: June 2016

Hydration properties and electrical characteristics of the high‐temperature proton conductor La27(W0.85Nb0.15)5O55.5−δ are investigated by means of thermogravimetry, impedance spectroscopy, and the electromotive force (EMF) method as a function of temperature, water vapor, and oxygen partial pressures, as well as isotope exchange measurements in order to elucidate the mechanism and thermodynamics of protons formation and transport. The highest proton conductivity, 1.3 × 10‐3 S/cm, is achieved at 700°C in wet O2. Proton self‐diffusion coefficients are estimated from thermogravimetric measurements of hydration and conductivity data. Comparison of the conductivity characteristics between nominally pure and Nb‐substituted materials reveals that the ionic conductivity increases and the activation energy decreases with Nb doping. These differences are discussed to reflect changes in the structure promoting ionic transport rather than changing the concentration of defects to any large extent.
Harming Civilians and the Associative Duties of Soldiers
Authors: Van Goozen Sara
Published: June 2016

According to International Humanitarian Law and many writing on just war theory, combatants who foresee that their actions will harm or kill innocent non‐combatants are required to take some steps to reduce these merely foreseen harms. However, because often reducing merely foreseen harms place burdens on combatants – including risk to their lives – this requirement has been criticised for requiring too much of combatants. One reason why this might be the case is that combatants have duties to each other and to their compatriots, such as duties to keep them safe, which are weighty enough to override their duties to foreign non‐combatants. In this article, I argue that arguments against the requirement to limit merely foreseen harms which rely on combatants' associative duties fail to establish that it is permissible for combatants to prioritise their own safety over the reduction of merely foreseen harms. Although the argument based on associative duties might work in individual cases, factors peculiar to the situation of combatants mean that such justifications are not normally available to them.
Concordance in phylogeography and ecological niche modelling identify dispersal corridors for reptiles in arid Australia
Authors: Melville Jane , Haines Margaret L. , Hale Joshua , Chapple Stephanie , Ritchie Euan G.
Published: June 2016

Aim

Using the rock‐specialist agamid Ctenophorus caudicinctus as a model, we test hypothesized biogeographical dispersal corridors for lizards in the Australian arid zone (across the western sand deserts), and assess how these dispersal routes have shaped phylogeographical structuring.

Location

Arid and semi‐arid Australia.

Methods

We sequenced a c. 1400 bp fragment of mtDNA (ND2) for 134 individuals of C. caudicinctus as well as a subset of each of the mtDNA clades for five nuclear loci (BDNF, BACH1, GAPD, NTF3, and PRLR). We used phylogenetic methods to assess biogeographical patterns within C. caudicinctus, including relaxed molecular clock analyses to estimate divergence times. Ecological niche modelling (Maxent) was employed to estimate the current distribution of suitable climatic envelopes for each lineage.

Results

Phylogenetic analyses identified two deeply divergent mtDNA clades within C. caudicinctus – an eastern and western clade – separated by the Western Australian sand deserts. However, divergences pre‐date the Pleistocene sand deserts. Phylogenetic analyses of the nuclear DNA data sets generally support major mtDNA clades, suggesting past connections between the western C. c. caudicinctus populations in far eastern Pilbara (EP) and the lineages to the east of the sand deserts. Ecological niche modelling supports the continued suitability of climatic conditions between the Central Ranges and the far EP for C. c. graafi.

Main conclusions

Estimates of lineage ages provide evidence of divergence between eastern and western clades during the Miocene with subsequent secondary contact during the Pliocene. Our results suggest that this secondary contact occurred via dispersal between the Central Ranges and the far EP, rather than the more southerly Giles Corridor. These events precede the origins of the western sand deserts and divergence patterns instead appear associated with Miocene and Pliocene climate change.
Monistic dualism and the body electric: An ontology of disease, patient and clinician for person‐centred healthcare
Authors: Pârvan Alexandra
Published: June 2016

Ontology is involved in medical care, because what both doctors and patients think the disease, the patient and the doctor are affects the giving and receiving of care, and hence the definition of medical care as profession. Going back to ancient philosophical views of disease as ‘bounded entity’ or as ‘relation’ (still echoed in contemporary theories and mindsets), I propose a way to think ontologically about disease that places it in necessary connection with the patient as person. Drawing on Augustine's views on disease, bodily integrity, and the human person as mind‐body unit, I speak of ‘monistic dualism’ as the view where the unit and health of the person is continuously and personally generated by the mind's attention to and action on the body, whether the body is impaired or not. Monistic dualism is identified as the ontological position of both patients who are (or can become) healthy within illness and clinicians who are ‘healthy’ in their profession. It is what guides both to create what their body is in a personal state of integrity or health. This ‘metaphysical body’ is termed ‘the body electric’ in patients, and I argue that clinicians can attend properly to the diseased body by attending to patients' metaphysical body. As clinicians offer metaphysical care to themselves, employing monistic dualism to create their metaphysical body, they should not deny it to patients. Ontology cannot be part of medical care without making metaphysical care a requirement.
The effect of an automated point of care tool on diagnosis and management of childhood obesity in primary care
Authors: Gentile Natalie , Cristiani Valeria , Lynch Brian A , Wilson Patrick M , Weaver Amy L , Rutten Lila J , Jacobson Debra J , Chaudhry Rajeev , Sriram Swetha , Kumar Seema
Published: June 2016

Background

Childhood obesity is underdiagnosed in primary care practices. Our study aimed to compare rates of documentation of diagnosis of obesity and counselling for nutrition and physical activity at an academic primary care practice prior to and following implementation of a body mass index (BMI)‐based electronic point of care clinical reminder tool.

Methods

We performed a retrospective record review of children aged 2–18 years undergoing well child visits during any of three calendar years (2009, 2011 and 2013). The electronic clinical reminder tool was implemented in September 2010. Records of children with BMI > 95th percentile were electronically searched for terms of documentation of diagnosis of obesity and nutrition and physical activity counselling. Multivariable logistic regression models were used to adjust for potential patient and provider confounders.

Results

Among those with BMI ≥ 95th percentile, there was a statistically significant increase in documentation of diagnosis of obesity (45.5% in 2009 vs. 52.4% in 2011; P < 0.001; adjusted odds ratio 1.36; 95% CI 1.13–1.65) and in counselling for physical activity and nutrition (66.8% in 2009 vs. 75.2% in 2011; P < 0.001; adjusted odds ratio 1.33; 95% CI 1.06–1.66) following implementation of the tool. Compared with 2011, there was no statistically significant increase in documentation of obesity (50.4%) or nutrition and physical activity counselling (77.9%) in 2013.

Conclusions

The implementation of a point of care clinical reminder tool was associated with improvement in documentation of diagnosis of obesity and counselling for nutrition and physical activity. Further studies are needed to determine the impact of these automated tools on weight outcomes in children.
A philosophical argument against evidence‐based policy
Authors: Anjum Rani Lill , Mumford Stephen D
Published: June 2016

Rationale, aims and objectives

Evidence‐based medicine has two components. The methodological or ontological component consists of randomized controlled trials and their systematic review. This makes use of a difference‐making conception of cause. But there is also a policy component that makes a recommendation for uniform intervention, based on the evidence from randomized controlled trials.

Methods

The policy side of evidence‐based medicine is basically a form of rule utilitarianism. But it is then subject to an objection from Smart that rule utilitarianism inevitably collapses. If one assumes (1) you should recommend the intervention that has brought most benefit (the core of evidence‐based policy making), (2) individual variation (acknowledged by use of randomization) and (3) no intervention benefits all (contingent but true), then the objection can be brought to bear.

Conclusions

A utility maximizer should always ignore the rule in an individual case where greater benefit can be secured through doing so. In the medical case, this would mean that a clinician who knows that a patient would not benefit from the recommended intervention has good reason to ignore the recommendation. This is indeed the feeling of many clinicians who would like to offer other interventions but for an aversion to breaking clinical guidelines.
Estimating tissue‐specific discrimination factors and turnover rates of stable isotopes of nitrogen and carbon in the smallnose fanskateSympterygia bonapartii(Rajidae)
Authors: Galván D. E. , Jañez J. , Irigoyen A. J.
Published: June 2016

This study aimed to estimate trophic discrimination factors (TDFs) and metabolic turnover rates of nitrogen and carbon stable isotopes in blood and muscle of the smallnose fanskateSympterygia bonapartiiby feeding six adult individuals, maintained in captivity, with a constant diet for 365 days.TDFswere estimated as the difference between δ13Cor δ15Nvalues of the food and the tissues ofS. bonapartiiafter they had reached equilibrium with their diet. The duration of the experiment was enough to reach the equilibrium condition in blood for both elements (estimated time to reach 95% of turnover: Ct95%blood = 150 days, Nt95%blood = 290 days), whilst turnover rates could not be estimated for muscle because of variation among samples. Estimates of Δ13Cand Δ15Nvalues in blood and muscle using all individuals were Δ13Cblood= 1·7‰, Δ13Cmuscle= 1·3‰, Δ15Nblood= 2·5‰ and Δ15Nmuscle= 1·5‰, but there was evidence of differences ofc.0·4‰ in the Δ13Cvalues between sexes. The present values forTDFsand turnover rates constitute the first evidence for dietary switching in batoids based on long‐term controlled feeding experiments. Overall, the results showed thatS. bonapartiihas relatively low turnover rates and isotopic measurements would not track seasonal movements adequately. The estimated Δ13Cvalues inS. bonapartiiblood and muscle were similar to previous estimations for elasmobranchs and to generally accepted values in bony fishes (Δ13C = 1·5‰). For Δ15N, the results were similar to published reports for blood but smaller than reports for muscle and notably smaller than the typical values used to estimate trophic position (Δ15Nc.3·4‰). Thus, trophic position estimations for elasmobranchs based on typical Δ15Nvalues could lead to underestimates of actual trophic positions. Finally, the evidence of differences inTDFsbetween sexes reveals a need for more targeted research.
Effect of non‐surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C‐peptide and the Homeostasis Assessment Index
Authors: Mammen Jerry , Vadakkekuttical Rosamma Joseph , George Joseraj Manaloor , Kaziyarakath Jaishid Ahadal , Radhakrishnan Chandni
Published: June 2016

Aim

A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non‐surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis.

Methods

Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re‐evaluated after 3 months.

Results

All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C‐peptide, Homeostasis Assessment (HOMA) Index–insulin resistance, and HOMA–insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and –25.44 ± 36.81, respectively; for the control group, they were significant at –1.66 ± 1.89, –1.48 ± 1.86, and 31.42 ± 38.82 respectively (P < 0.05). There was a significant decrease in fasting blood glucose and glycosylated hemoglobin A1c from baseline to 3 months in the case group (P < 0.05).

Conclusion

The present study showed that periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis.
From the southern right whale hunting decline to the humpback whaling expansion: a review of whale catch records in the tropical western South Atlantic Ocean
Authors: de Morais Igor Oliveira Braga , Danilewicz Daniel , Zerbini Alexandre Novaes , Edmundson William , Hart Ian B. , Bortolotto Guilherme Augusto
Published: June 2016

Historical catch records from whaling activity are crucial for assessments of whale populations. However, several gaps in the exploitation history for many populations from before the twentieth century create limitations that may lead to overestimates of the recovery of these populations. The history of modern whaling along the Brazilian coast is relatively well known. However, several questions relating to the pre‐modern period, during and before the nineteenth century, remain unanswered. For example, the level of exploitation of humpback whalesMegaptera novaeangliaeand southern right whalesEubalaena australisin this period is unknown.

Pre‐modern whaling in Brazil began in 1602 and lasted until the 1920s. Whales were captured using manual harpoons from either rowing boats or sailing boats, and processed at land stations called ‘armações’. A review of the history and oil production of these stations indicates that substantial catches occurred.

Pre‐modern whaling records also indicate the collapse of the southern right whale population in the western South Atlantic Ocean. Increasingly rare reports of sightings for the nineteenth century and the closing of the last armação in the breeding grounds off southern Brazil indicate that this population collapsed by 1830.

Armações operating in north‐eastern Brazil remained active through the 1800s, and targeted humpback whales until modern whaling techniques were introduced in the early 1900s. It is estimated that between approximately 11000 and 32000 individuals of this species were captured at these coastal whaling stations from 1830 to 1924.
The Portfolio Balance Mechanism and QE in the Euro Area
Authors: Priftis Romanos , Vogel Lukas
Published: June 2016

The paper analyses quantitative easing (QE) in a dynamic general‐equilibrium model which includes assets of different types and maturity. We explicitly model asset purchases by the central bank and their impact on the central bank's balance sheet. In particular, QE is captured by central bank purchases of long‐term government bonds financed by enhanced liquidity provision to the private sector. With imperfect substitutability between asset classes, QE affects the term premium, stock prices, the exchange rate and the private sector's saving decision. We use the model to simulate the European Central Bank's (ECB's) QE path as announced in early 2015. With six basis points term‐premium reduction the model generates 0.9 per cent effective euro depreciation and raises real GDP in the euro area by 0.3 per cent and prices by 0.5 per cent by 2016. Enduring periods of low interest rates strengthen the expansionary effect of QE in the short and medium term. Frontloading of asset purchases has little impact on output and inflation effects as long as the duration of the balance sheet expansion remains unchanged. Expansionary effects of QE are reduced if the central bank purchases eligible assets from foreign rather than domestic counterparties.
Quality of life of nursing home residents in China: A mediation analysis
Authors: Xiao Huimin , Yoon Ju Young , Bowers Barbara
Published: June 2016

We examined whether the relationship between activities of daily living and quality of life was mediated by depression, and identified differences of the mediating effects by age group. In this cross‐sectional survey, 231 older adults were recruited from eight nursing homes. The path analysis indicated that depression played an important mediating role in the relationship between activities of daily living and quality of life. Depression appeared to be more significant for the mental health component as an outcome compared to the physical health component of quality of life. The impact of depression as a mediator for the older old group was greater than the young–middle group. This finding increases our understanding of the impact of age on the mediating effect of depression on the relationship between activities of daily living and quality of life. Healthcare providers should consider older adults' age differences when integrating physical or depression programs into clinical practice to enhance quality of life.
Efficiency of electricity distribution utilities in India: a data envelopment analysis
Authors: Meher Shibalal , Sahu Ajoy
Published: June 2016

The study makes an effort to measure the relative efficiency of electricity distribution utilities (DUs) of 17 unbundled states in India using a Frontier tool, viz. data envelopment analysis. The model with constant returns to scale is applied to evaluate the relative efficiency of different sample DUs. The input‐orientation measure has been used to calculate the efficiency score of 40 DUs for the year 2012–2013. It is observed that there is existence of inefficiency in 29 out of the 40 sample utilities. These inefficient utilities have the potential to become efficient utilities by benchmarking against the most efficient utilities. In order to supply the same output, these utilities need to reduce their use of inputs to the level of most productive scale size. The regulators need to pay special attention to enhance the efficiency of these inefficient DUs by exploring alternative approaches like incentive‐based regulation.
A Cross‐Sectional Study of Community‐Based Maternal and Child Health Interventions Involving Women's Health Volunteer Groups in Rural Myanmar
Authors: Oguro Michiko , Horiuchi Shigeko
Published: June 2016

Objective

This study identified the relationship between interventions with women's health volunteer groups in two Myanmar villages and maternal and child health outcomes.

Design and Sample

This cross‐sectional study included 188 women aged 15–49 years old with at least one ≤5‐year‐old child. The women were randomly selected from two control and two experimental villages.

Measures

Data were collected via structured interview with a questionnaire based on the UNICEF Multiple Indicator Cluster Survey.

Results

Logistic regression analyses confirmed that women's health volunteer group intervention was related to the participants’ receiving any antenatal care (OR: 6.99, p < .01) and having knowledge regarding danger signs during the perinatal period (OR: 15.08, p < .001), modern contraceptive methods (OR: 44.52, p < .001), acceptable first aid (OR: 14.04, p < .001), and malaria prevention (OR: 40.30, p < .001). A skilled midwife had the most significant relationship with patients’ receiving any antenatal care (OR: 65.18, p < .001). Distance from urban area negatively related to appropriate disposal of the child's stool (i.e., flushed in a latrine; OR: 7.51, p < .05).

Conclusions

This study shows that women's health volunteer groups may positively affect the diffusion of the need to seek antenatal care and health knowledge in rural Myanmar. The importance of skilled midwives is also highlighted, especially in resource‐limited settings.
Reduction of bacteria and human immunodeficiency virus Type 1 infectivity of platelet suspension in plasma using xenon flash‐pulse light in a bench‐scale trial
Authors: Abe Hideki , Shiba Masayuki , Niibe Yoshiyuki , Tadokoro Kenji , Satake Masahiro
Published: June 2016

BACKGROUND

Current pathogen reduction systems for platelet concentrates (PCs) require addition of chemical compounds and/or reduction of plasma content in PCs. We have investigated a new method using xenon (Xe) flash‐pulse light without additional compounds or plasma replacement.

STUDY DESIGN AND METHODS

An aliquot of apheresis platelets (PLTs) in plasma inoculated with bacteria or human immunodeficiency virus Type 1 (HIV‐1) was irradiated with Xe flash‐pulse light (Xe flash phototreatment). Bacterial growth was monitored up to 6 days of storage, whereas HIV‐1 infectivity was assayed just after treatment. Pairs of Xe flash‐phototreated and untreated PCs were examined for PLT lesion during the storage period.

RESULTS

Under the current conditions, a low titer (1.8 colony‐forming units [CFUs]/mL) of Staphylococcus aureus did not proliferate during the 6‐day storage period, but grew in some cases at high‐titer (24.0 CFUs/mL) inoculation. HIV‐1 infectivity was reduced by 1.8 log. PLT recovery of the treated PCs was lower than untreated ones. An increase of mean PLT volume and glucose consumption, together with a decrease of hypotonic shock response and pH, were enhanced by the treatment. CD62P‐ and PAC‐1–positive PLTs increased after the treatment, indicating the induction of PLT activation. Among biologic response modifiers, soluble CD40 ligand was significantly increased in the treated PCs on Day 6.

CONCLUSIONS

Xe flash phototreatment could prevent bacterial proliferation and reduce HIV‐1 infectivity in 100% plasma PCs without any additional compounds, but enhanced PLT storage lesions. Further improvement is required to increase the potency of pathogen inactivation with reducing PLT damage.
Influence of Water Content on the Behavior of Partially Saturated Fouled Ballast
Authors: Yang Zhenning , Ho Carlton L. , Joy Richard , Dabhade Nandan C.
Published: June 2016

The water content of fouled ballast is important when considering the shear strength and deformability of the ballast, and therefore critical in evaluating whether the track is at risk of excessive deformations warranting a speed restriction order. Fouled ballast from northeastern United States was tested in the laboratory to assess changes in shear strength and deformability as a function of water content. X-ray fluorescence analysis determined that the fouling material was 95% by weight basalt in origin. No more than 5% of the fouling material could be attributed to the abraded concrete ties. The field capacity of the fouled ballast was measured to be at a water content of 10%. Freezing and thawing tests indicated that approximately 4% of mass loss could be expected as a result of 25 freeze/thaw cycles. 6-inch triaxial tests, TX-CIDC, were conducted on the ballast at water contents between dry and field capacity (10%). As the ballast was partially saturated, volume change was measured using circumferential string potentiometers. The water content had an influence on the shear strength and the modulus of elasticity of the fouled ballast. The Mohr-Coulomb friction angle decreased from 47.3° for the dry ballast to 42.5° for the field capacity ballast. The Mohr-Coulomb cohesion decreased from 3.38 psi to nearly zero with initial addition of water, but increased to 6.18 psi as the water content reached field capacity. This is likely attributable to changes in capillary tension of the partially saturated fouling material. The average shear strength, Mohr-Coulomb friction angle, Mohr-Coulomb cohesion, modulus of elasticity and Poisson’s Ratio all showed weakening and strengthening effect by addition of water.
Modeling Track Geometry Degradation Using Support Vector Machine Technique
Authors: Hu Can , Liu Xiang
Published: June 2016

Analyzing track geometry defects is of crucial importance for railway safety. Understanding when a defect will need to be repaired can help in both planning a preventive maintenance schedule and reducing the probability of track failures. This paper discusses the data cleaning and analysis processes for modeling track geometry degradation. An analytical data model named the Support Vector Machine (SVM) was developed to model the deterioration of track geometry defects. This paper mainly focuses on the following three defect types — surface, cross level and dip. The model accounts for traffic volume, defect amplitude, track class, speed and other potential factors. Results demonstrate that the proposed analytical data model can have a prediction accuracy above 70%.
Effect of Prestressing Wire Indentation Type on the Bond Performance and Flexural Capacity of Pretensioned Concrete Crossties Subjected to Cyclic Loading
Authors: Momeni Amir Farid , Peterman Robert J. , Beck B. Terry , Wu Chih-Hang John , Bodapati Naga Narendra B.
Published: June 2016

Load tests were conducted on pretensioned concrete prisms cast with 13 different 5.32-mm-diameter prestressing wire types that are used in the manufacture of pretensioned concrete railroad ties worldwide. The tests were specifically designed to evaluate the bond performance of wires with different indentation type under the cyclic loading. The prestressing wires were denoted “WA” through “WM” and indentation types included smooth, spiral, chevron, diamond, 2-dot and 4-dot. Four wires were embedded into each concrete prism, which had a 3.5″ (88.9 mm) × 3.5″ (88.9 mm) square cross section. The wires were initially pulled to 7000 pounds (31.14 KN) and gradually de-tensioned when the concrete compressive strength reached 4500 psi (31.03 MPa). A consistent concrete mixture with type III cement, water-cement ratio of 0.32 and a 6-in. slump was used for all prisms.

For each type of wire one 69 in-long (175.26 cm) prism was tested in 4-point-bending under the cyclic load and one under static load at 20-in (50.8 cm) embedment length. For cyclic load tests, the prisms were supported by two rollers spanning 45″ (114.3 cm) and load was applied on a spreading beam set on the top of the test prism. The prism setup and loading configuration were symmetric and load was applied to the prism from spreading beam to two bearings spaced 15″ (38.1 cm) apart. During each test, a concentrated load with the rate of 250 lb/min (1112 N/min) was applied until two cracks were observed at the maximum moment region on the test prisms (region between two bearings).

Once cracks were observed, the load was held constant for 3 minutes at the cracking load. After holding load constant for three minutes, load started to cycle between 400 lb (1779 N) to 4000 lb (17790 N) with the frequency of 3 Hz. The test was designed to go through 200,000 cycles and interlock limits were assigned to the program to stop the test in case of prism failure under the cyclic loading. For prisms able to finish 200,000 cycles of load, the procedure was to unload to zero and start loading the prism with the rate of 250 lb/min (1112 N/min) until prism failed. Values of load, mid-span deflection, and wires end-slip were continuously monitored and recorded during each test. Load-vs-deflection graphs were then plotted and compared for prisms with each wire type, and the maximum sustained moment was also calculated for each test. Also, a set of statically load tests were conducted on the identical pretensioned prisms to compare the results of statically and cyclically load tests. The cyclic load tests revealed that there is a significant difference in the bond performance of different wire types under the cyclic loading and they behave differently under cycles of loadings and unloadings.
Field Measured Dynamic Effects and Load Distribution in a Prestressed Concrete Light Rail Bridge
Authors: Khan Easa , Linzell Daniel G. , Frankl Bernard A. , Lobo John A. , Lozano Samuel
Published: June 2016

Live load performance of a recently constructed, prestressed concrete bridge was investigated to determine the Impact Factors (IMs), the Girder Distribution Factors (GDFs). The bridge was subjected to controlled static and dynamic loading using two Denver Transit Partners (DTP) electric-multiple-unit rail cars prior to a commuter rail line being placed into service. The rail cars travelled along northbound and southbound tracks of the four span, horizontally curved, bridge at various speeds. A total 24 tests were conducted and response was measured using a combination of strain sensors and accelerometers installed at critical sections on the supporting girders. Results for IMs and GDFs obtained from the field tests are presented. These results are also compared against relevant code provisions and these preliminary results indicated that IMs are insensitive to train speed and are smaller than investigated code provisions and that measured GDFs were different than those provided by these code provisions.
GNSS-Based Train Trajectory Simulation System
Authors: Wang Jian , Tao Weijie , Grasso Toro Federico , Baocai Rangtai , Lu Debiao , Liu Jiang
Published: June 2016

Integrating Global Navigation Satellite System (GNSS) into railway application has a great potential because of its various advantages, such as lower cost, less trackside equipment, higher positioning accuracy, easier maintenance and so on. Railway system is a safety-critical system that requires high reliability, safety and real-time performance, so GNSS technology must be tested, verified and validated in railway system before putting into practical applications. However, due to the unavoidable restrictions and inconvenience of the railway field conditions, these tests cannot be accomplished on site. On this basis, this paper has developed a GNSS-based train trajectory simulation system which can provide GNSS data simulation of multi-train trajectory in multiple scenarios in order to support the tests and research of GNSS-based railway application, especially GNSS-based train localisation system and GNSS-based train control system.

The GNSS-based train trajectory simulation system is based on the railway timetable (also called schedule), rolling stock information and digital track map. The paper firstly researches on the timetable that stores information of each train at each specified station, including arrival time, departure rime, track to be occupied, and connections to other trains. With the timetable simulation, the train’s trajectory can be generated using the information provided by the digital track map. The output trajectory data is mainly GGA sentence which is compliant with the National Marine Electronics Association (NMEA) 0183 standard. The paper also calculates the satellite visibility based on satellite ephemeris to simulate the number of visible satellites during the trajectory with changing time and space. All the information and data, such as timetable, speed/distance curve, distance/time curve, station track occupation state, can be visualized and updated in graphics and diagrams for better view. In addition, the train motion behavior of acceleration, cruising, coasting and braking can also be modelled in the system, as well as the driver’s behavior.

The GNSS-based train trajectory simulation system has been realized using C# programming language in Microsoft Visual Studio 2010. And the field data of Shanxi coal railway transportation company railroad is used in the system. The simulation system is tested and the experimental results show that the developed simulation system can perform the expected functions, and provided data source for GNSS-based train localisation system. In addition, this simulation system has a good performance in compatibility and scalability.
Fatigue Analysis of Rail-Head-to-Web Fillet at Bolted Rail Joint Under Various Impact Wheel Load Factors and Support Configurations
Authors: Zhu Kaijun , Edwards J. Riley , Qian Yu , Andrawes Bassem O.
Published: June 2016

As one of the weakest locations in the track superstructure, the rail joint encounters different types of defects and failures, including rail bolt-hole cracking, rail head-web cracking or separation, broken or missing bolts, and joint bar cracking. The defects and failures are mainly initiated by the discontinuities of both geometric and mechanical properties due to the rail joint, and the high impact loads induced by the discontinuities. Continuous welded rail (CWR) overcomes most disadvantages of the rail joints. However, a large number of rail joints still exist in North American Railroads for a variety of reasons, and bolted joints are especially prevalent in early-built rail transit systems. Cracks are often found to initiate in the area of the first bolt-hole and rail-head-to-web fillet (upper fillet) at the rail end among bolted rail joints, which might cause further defects, such as rail breaks or loss of rail running surface. Previous research conducted at the University of Illinois at Urbana-Champaign (UIUC) has established an elastic static Finite Element (FE) model to study the stress distribution of the bolted rail joint with particular emphasis on rail end bolt-hole and upper fillet areas. Based on the stress calculated from the FE models, this paper focuses on the fatigue performance of upper fillet under different impact wheel load factors and crosstie support configurations. Preliminary results show that the estimated fatigue life of rail end upper fillet decreases as impact factor increases, and that a supported joint performs better than a suspended joint on upper fillet fatigue life.
Vibration Analysis of a Coupled Multibody Dynamic Model of a Contact Mechanics Roller Rig
Authors: Meymand Sajjad Z. , Taheri Mehdi , Hosseinipour Milad , Ahmadian Mehdi
Published: June 2016

This study develops a detailed multi-body dynamic model of the Virginia Tech Roller Rig (VTRR) using multi body simulation software package SIMPACK. The Virginia Tech Roller Rig, a single-wheel roller rig with vertical plane roller configuration, is a state of the art testing fixture for experimental investigation of wheel-rail contact mechanics and dynamics. In order to have a better understanding of the dynamics at the contact, dynamic behavior and interaction of various components and subsystems of the rig need to be understood. In addition, it is essential to make sure that the measurements are only due to particular subject of study and not any intermittent source of disturbance. Any unwanted vibration at the contact needs to be compensated in the data measurements. To this end, a fully detailed model of the rig including all the components is developed in SIMPACK. The coupled multibody dynamic model represents all the major components of the rig and their interactions. The multibody dynamic model is employed for conducting noise, vibration, harshness (NVH) analysis of the rig. An Eigenvalue analysis provides the modal frequencies and mode shapes of the system. The modal analysis predicts the first natural frequency of the rig to be approximately 70 Hz, providing a relatively high bandwidth for evaluating the dynamics at the wheel-rail interface. Only dynamic that could have higher frequencies than the rig’s bandwidth is wheel-rail squeal. The model is also used to evaluate the performance of the contact force measurement system designed for the rig. The results show that the contact forces can be estimated precisely using the force measurement system.
Case Studies of PTC-Preventable Accidents
Authors: Schlesinger Dave
Published: June 2016

A 1969 collision of two Penn Central train resulted in four fatalities and forty-five injuries. This accident could have been prevented, had some type of train control system been in place. After this accident, the National Transportation Safety Board (NTSB) asked the Federal Railroad Administration (FRA) to study the feasibility of requiring railroads to install some type of automatic train control system that would prevent human-factor caused accidents. Over the next almost four decades, a number of additional accidents occurred, culminating in the January, 2005 Graniteville Norfolk-Southern accident and the September, 2008 Metrolink Chatsworth accident.

A little more than one month after the Metrolink accident, Congress passed the Rail Safety Improvement Act, which requires Positive Train Control (PTC). To better explain the positive train control requirements, this paper traces each to a detailed case study. Four different accidents are studied, each being an example of one of the four, core positive train control requirements. Included in the case study is a discussion about how positive train control would have prevented the accident, had it been present.

This provides positive train control implementers and other railroad professionals with a better understanding of the factors that have caused or contributed to the cause of the positive train control preventable accidents studied.
Moisture Effects on Degraded Ballast Shear Strength Behavior
Authors: Qian Yu , Mishra Debakanta , Tutumluer Erol , Hashash Youssef M. A. , Ghaboussi Jamshid
Published: June 2016

Ballast consisting of large sized aggregate particles with uniform size distribution is an essential component of the track substructure, to facilitate load distribution and drainage. As freight tonnage accumulates with traffic, ballast will accumulate an increasing percentage of fines due to either aggregate breakdown or outside contamination such as subgrade soil intrusion and coal dust collection. According to the classical text by Selig and Waters [1], ballast degradation from traffic involves up to 76% of all fouling cases; voids will be occupied by fines from the bottom of ballast layer gradually causing ballast clogging and losing its drainage ability. When moisture is trapped within ballast, especially fouled ballast, ballast layer stability is compromised. In the recent studies at the University of Illinois, the focus has been to evaluate behavior of fouled ballast due to aggregate degradation using large scale triaxial testing. To investigate the effects of moisture on degraded ballast, fouled ballast was generated in the laboratory through controlled Los Angeles (LA) abrasion tests intended to mimic aggregate abrasion and breakdown and generate fouled ballast at compositions similar to those observed in the field due to repeated train loadings. Triaxial shear strength tests were performed on the fouled ballast at different moisture contents. Important findings of this preliminary study on characterizing wet fouled ballast are presented in this paper. Moisture was found to have a significant effect on the fouled ballast strength behavior. Adding a small amount of 3% moisture (by weight of particles smaller than 3/8 in. size or smaller than 9.5 mm) caused test specimens to indicate approximately 50% decrease in shear strength of the dry fouled ballast. Wet fouled ballast samples peaked at significantly lower maximum deviator stress values at relatively smaller axial strains and remained at these low levels as the axial strain was increased.