bluuebunny/crossref_metadata_2025 huggingface dataset:
Method for determining gasoline surrogate component proportions and development of reduced chemical kinetics model of the determined surrogate fuel
Authors: Kong Jun , Qin Yanxin , Zheng Zhaolei
Published: February 2019

Response surface method is used to build models for predicting an octane number and determining the component proportions of a gasoline surrogate fuel. The fuel is synthesized using toluene, iso-octane, and n-heptane and is referred to as toluene reference fuel. The built models include second-order model and third-order model. Both models can excellently predict the octane number of the toluene reference fuel with known component proportions. Moreover, the third-order model is more accurate than second-order model in determining the component proportions of the toluene reference fuel, and the relative error is less than 8%. Therefore, the third-order model can accurately predict the octane number and determine the component proportions of the toluene reference fuel. Moreover, a new reduced mechanism of the toluene reference fuel is proposed and validated by using shock tube ignition delay and in-cylinder pressure in a homogeneous charge compression ignition engine. The toluene reference fuel mechanism coupled with third-order model is used to simulate the ignition delay of American gasoline (RD387) and the homogeneous charge compression ignition combustion behaviors of European gasoline (ULG95). Both cases are simulated thoroughly.
Investigation of the power losses of the hybrid transmission DE-REX based on modeling and measurement
Authors: Shen Ye , Viehmann Andreas , Rinderknecht Stephan
Published: February 2019

Electric and hybrid powertrains are developed to reduce the energy and fuel consumption of vehicles. Recently, multi-speed transmission systems were discussed for further reduction of the energy consumption of electric vehicles. Therefore, analyzing the power losses of such transmissions is of interest. In this paper, the novel powertrain concept DE-REX (Two-Drive-Transmission with Range-Extender) and the experimental investigation of its overall power losses is first introduced. A method is then developed to model and analyze the power losses of this hybrid transmission based on experimental data. After the validation of the method, the overall power loss model is eventually applied to estimate the power losses of the transmission at other driving modes, which were not measured on the test rig. The method is used to understand the characteristics of power losses inside the transmission in a hybrid powertrain and to optimize powertrain power losses in future.
Effect of Deformation Temperature, Strain Rate and Strain on the Strain Hardening Exponent of Copper/Aluminum Laminated Composites
Authors: Liu Shuaiyang , Wang Aiqin , Xie Jingpei
Published: February 2019

In order to investigate the strain hardening behaviour of Cu/Al laminated composites, isothermal compression tests were conducted in the temperature range of 300–450 °C and stain rate range of 0.01–1 s−1. Based on the experimental data, stain hardening exponent n was calculated to evaluate the strain hardening ability of Cu/Al laminated composites during the deformation process. The results show that deformation temperature, strain rate, strain and laminated structure are all responsible for the evolution of flow stress during the isothermal compression. The highly non-linear character of Ln σ - Ln ε curves shows the dynamic competition between work hardening and dynamic softening, and dynamic softening gradually plays a dominant role with the increase of strain. Furthermore, strain hardening exponent n is more sensitive to deformation temperature than strain rate. Lower deformation temperature and higher strain rate contribute to the enhancement of strain hardening exponent n.
Nonlinear Performance of Concrete Beam Reinforced with Prestressed Hybrid Cfrp/Gfrp Composite Sheet
Authors: Jian Zhang , Chao Jia , Jiawei Tian
Published: February 2019

The consolidation technology of prestressed hybrid fibre CFRP/GFRP sheet takes full advantages of the initiative of the prestressed reinforcement and force transferring of the composite materials features, which belongs to relatively advanced reinforcement strategies in reinforcement area. This paper derives nonlinear composite element and shell element to simulate concrete beam and the prestressed hybrid fibre CFRP/GFRP sheet. Besides, the characters of nonlinear concrete beams are described by the Owen yielding criterion and the Hinton crushing criterion. Meanwhile, the three-dimensional prestressing effects of the composite CFRP/GFRP materials have been realized and the nonlinear finite element computer program of reinforced system has been compiled. In order to determine the best stress condition of prestressed hybrid fibre CFRP/GFRP composite materials, the optimal hybrid CFRP/GFRP ratio is achieved through the systematic calculation based on two main properties which take the strength and ductility properties into consideration. The results show that the optimal CFRP/GFRP hybrid ratio is one of the major factors to impact its mechanical properties of the reinforced structure which has been strengthened by the prestressed hybrid fibre CFRP/GFRP sheet. And the theoretical method and calculation model that determine the optimal hybrid CFRP/GFRP ratio in this paper is reasonable and reliable. The research conclusions can be used as a reference in practice construction design.
Building a solution-focused career counselling strategy for career indecision
Authors: Akyol Elvan Y , Bacanlı Feride
Published: February 2019

The literature contains quite a few theoretical and case study articles with respect to the development and use of solution-focused brief therapy. However, very few of these studies focus on the effects of using solution-focused therapy principles and techniques in career counselling. This study is aimed to examine the effect of a five-session solution-focused brief career counselling on reducing a university student’s career indecision. A university student who had a career indecision problem participated in the research. The career counselling process was assessed by using pre- to post-test result changes of the counselee. In order to measure the career indecision level of the counselee, Career Decision-Making Difficulties Questionnaire was used. The Career Decision-Making Difficulties Questionnaire was administrated before the beginning of the first session and after the termination session as a pre- and post-test. At the end of the five-session solution-focused brief career counselling process, the results demonstrated that the client’s career decision-making difficulty level was reduced. The findings of the study were discussed based on the results of the research in the relevant literature.
Stress regarding academic expectations, career exploration, and school attachment: The mediating role of adolescent–parent career congruence
Authors: Çelik Eyüp
Published: February 2019

The aim of this study was to investigate the mediating effect of adolescent–parent career congruence in the relationships between academic expectations stress and school attachment, and academic expectations stress and career exploration. Data were collected from a sample of 476 adolescents. This study found that adolescent–parent career congruence predicted career exploration and school attachment, academic expectations stress predicted school attachment, but academic expectations stress did not predict career exploration. The results suggested that the relationship between academic expectations stress and school attachment, and academic expectations stress and career exploration, were partially mediated by adolescent–parent career congruence.
Eight types of “baby boomer” entrepreneurs
Authors: Zhang Ting
Published: February 2019

This study developed a typology of eight heterogeneous types of baby boomer entrepreneurs and extended the occupational choice model regarding driving factors for entrepreneurialism in this population. The study relied on monthly USA Current Population Survey data across 11 years (2006–2016), and using 2-sample t-tests and multilevel mixed-effects logistic regression models that incorporated both individual- and metropolitan-level effects, found that new and unincorporated baby boomer entrepreneurs were more likely than their continuing and incorporated counterparts, respectively, to come from central cities, and that continuing, new opportunity, full-time, and incorporated baby boomer entrepreneurs were more likely than new, new necessity, part-time, and unincorporated baby boomer entrepreneurs, respectively, to be physically healthier and better educated. The typology and findings on USA baby boomers have global implications for career progression in older workers.
A case study of feedback and cognitive assessment of a young adult inpatient with major depressive disorder
Authors: Tickell Ashleigh M , Scott Elizabeth M , Hickie Ian B , Hermens Daniel F
Published: February 2019

Objectives:

Neurocognitive assessment and feedback to a young adult inpatient.

Methods:

Computerised neurocognitive assessment and feedback.

Results:

A collaborative process of personalised intervention.

Conclusions:

Personalised feedback in this setting can be employed as a management tool to identify and prioritise care.
An adaptive fuzzy sliding mode controller for uncertain underactuated mechanical systems
Authors: Bessa Wallace M. , Otto Svenja , Kreuzer Edwin , Seifried Robert
Published: February 2019

Underactuated mechanical systems are frequently encountered in several industrial and real-world applications such as robotic manipulators with elastic components, aerospace vehicles, marine vessels, and overhead container cranes. The design of accurate controllers for this kind of mechanical system can become very challenging, especially if a high level of uncertainty is involved. In this paper, an adaptive fuzzy inference system is combined with a sliding mode controller in order to enhance the control performance of uncertain underactuated mechanical systems. The proposed scheme can deal with a large class of multiple-input–multiple-output underactuated systems subject to parameter uncertainties, unmodeled dynamics, and external disturbances. The convergence properties of the resulting intelligent controller are proved by means of a Lyapunov-like stability analysis. Experimental results obtained with an overhead container crane demonstrate not only the feasibility of the proposed scheme, but also its improved efficacy for both stabilization and trajectory tracking problems.
Descriptive epidemiology and test characteristics of cats diagnosed with Microsporum canis dermatophytosis in a Northwestern US animal shelter
Authors: DeTar Lena G , Dubrovsky Vladimir , Scarlett Jan M
Published: February 2019

Objectives

The aims of this descriptive study were to identify risk factors for feline Microsporum canis infection at shelter intake, to describe screening test accuracy, and to refine confirmatory testing time frames.

Methods

Database records for the general feline population and intake data, medical records and fungal culture logs for cats diagnosed with M canis at a limited admissions shelter were accessed retrospectively for a period of 2 years.

Results

The feline population at the study shelter had a prevalence of M canis of 1.8% (95% confidence interval [CI] 1.6–2.0%). Kittens were eight (95% CI 4.8–13.5) times more likely to present with dermatophytosis than adults. Although more cats presented with M canis during summer and autumn, season was not significant when the model was controlled for age. Owner-surrendered cats were half as likely (95% CI 0.41–0.77) as transported cats to be diagnosed with M canis. Wood’s lamp examinations had a sensitivity of 66.8% (95% CI 60.2–73.4) and a specificity of 74.8% (95% CI 64.2–85.1) compared with dermatophyte test medium (DTM) culture. In 78.8% (95% CI 61–91) of littermate or household groups with mixed Wood’s lamp results, all cats were DTM culture positive. Under consistent incubation conditions, 202/202 diagnostic DTM plates for M canis-infected cats showed recognizable colony growth before 7 days (median 4 days), and 19/19 fomite carrier cat cultures showed growth before 12 days (median 5 days).

Conclusions and relevance

Applying the results of this study to shelter protocols could optimize diagnostic approaches and shorten the length of stay for shelter cats and kittens, resulting in streamlined shelter operations and improved feline welfare.
Mechanical and electrical properties of hybrid honeycomb sandwich structure for spacecraft structural applications
Authors: Shifa Madni , Tariq Fawad , Chandio Ali D
Published: February 2019

Multiphase composite sheets containing carbon fiber and functionalized multiwall carbon nanotubes in epoxy matrix were manufactured through compression molding technique. The loading of f-MWCNTs was varied (0.0, 0.1, 0.25 and 0.5 wt.% of epoxy matrix), while the quantity of carbon fiber was kept constant, i.e. ∼60 wt.% of the final composite in all samples. Prepared multiphase composite sheets were subjected to flexural test and the sheet offering maximum flexural strength was selected for subsequent hybrid sandwich structure manufacturing. Hybrid sandwich structure was manufactured via vacuum bagging process by bonding composite face sheet to the aluminum honeycomb core through an adhesive. Mechanical performance of hybrid sandwich structure was evaluated by performing flexural and quasi-static indentation tests, while electrical performance of hybrid sandwich structure was investigated by performing electromagnetic interference shielding effective and electrostatic dissipation tests. Optical and scanning electron microscopy was carried out for microstructural investigations. Fractography was also performed on composite face sheet after flexural test to study the underlying high flexural strength mechanism. Neat sandwich structure without functionalized multiwall carbon nanotubes addition was also manufactured and tested for comparison. Results show that hybrid sandwich structure outperformed the neat sandwich structure in all tests.
Investigation of Theta Rhythm Effect in Detection of Finger Movement
Authors: Ketenci Seniha , Kayikcioglu Temel
Published: February 2019

Movements cause changes in cortical rhythms emanating from the sensorimotor area. It is known that alpha and beta brainwaves take an important role of motor activity and motor imagery. Besides, theta rhythm is considered to carry substantial information about movement initiation and execution. In this study, effect of theta brainwave on movement detection was investigated in four-right handed participants who performed extensions with fingers of right hand using electroencephalography (EEG). Movement and rest epochs from continuous EEG record were extracted using muscle signals. Channels located over sensorimotor area were selected and referenced according to common average and Laplacian reference methods. Power spectral density function was used to display existence of theta band in frequency domain. To analyze theta, alpha and beta rhythms of the epochs individually and together, we filtered them to their interval range with Butterworth bandpass infinite filter before feature extraction and classification stages. Then, principal component analysis and Hjorth parameters were chosen to extract efficient features in the study aiming to investigate the effect of theta brainwaves on finger movement detection. According to classification accuracies using support vector machine classifier, alpha, beta, theta rhythms and also their different combinations were compared with each other. The performance of the epochs including alpha, beta and theta rhythms were the best and they were classified ~2% to 4% higher value in accuracy than the signals including only alpha and beta rhythms. According to this, it has proved that theta brainwave takes a role and makes contribution to motor activity.
Vacuum tribological properties of a composite Mo–MoS2film after atomic oxygen exposure irradiation
Authors: Ma Guo-zheng , He Peng-fei , Wang Yi-wen , Chen Shu-ying , Liu Ming , Xing Zhi-guo , Wang Hai-dou
Published: February 2019

A composite Mo–MoS2solid-lubrication film measuring approximately 2-µm thick was prepared using a two-step composite process involving magnetron sputtering of Mo film followed by low-temperature ion sulfurization. Microstructure of the said film was characterized using scanning electron microscopy, energy dispersive spectroscopy, X-ray diffraction, Auger electron spectroscopy, and X-ray photoelectron spectroscopy, and nanomechanical properties of the Mo and Mo–MoS2film were tested using a nanoindenter. The Mo–MoS2film and GCr15 substrate were irradiated by atomic oxygen with the self-developed MSTS-1 space tribometer system equipped with an atomic oxygen beam at a flux of 9 × 1019atoms/cm2. Subsequently, vacuum tribological properties of the said substrate and film were examined and compared. Results demonstrated that the Mo film possessed a smooth and dense structure with stable nanomechanical properties. Part of the elemental Mo translated into MoS2post sulfurizing, thereby forming the Mo–MoS2composite film with an alternating soft and hard structure. The Mo–MoS2film demonstrated a low and stable friction coefficient of approximately 0.15 along with only a slight wear in vacuum. The film surface could be oxidized and eroded when exposed to the highly active and energetic atomic oxygen. Post atomic oxygen erosion, the film thickness demonstrated a decrease, and small amounts of MoO3were observed on the surface. However, all structural and property changes were limited to the superficial layer. The excellent tribological performance of the film could be restored when the surface layer was removed after a certain period of sliding friction.
Metaphorical incarnations of the “other” and Iranian International Relations discourses
Authors: Masoudi Heidarali
Published: February 2019

Iranian International Relations academics have impacted both the official and public discourses on foreign policy issues, and vice versa. More specifically, how the “other” is constructed in Iranian International Relations discourses has an important role in determining how Iran acts in world politics. Assuming that International Relations discourses in Iran are inextricably intertwined with the construction of the “other,” this article aims to investigate how Iranian International Relations scholars use metaphors as linguistic tools for the representation of the “other.” Specifically, this article analyzes the metaphorical construction of the “other” in Iranian International Relations academic texts. Applying metaphor analysis, instances of the “other” have been selected and analyzed. The hypothesis was that there are two different categories of metaphors representing the “other”: first, there are context-oriented metaphorical incarnations that attempt to construct Iran’s “relationship” with others in foreign arenas, considering internal and external opportunities and limitations; and, second, there are essentialist metaphorical incarnations of particular actors, such as the US, Israel and Arab states as the “other.” The analysis shows that body and religion can be regarded as nodal points around which context-oriented and essentialist International Relations metaphorical discourses, respectively, have been articulated. The context-oriented discourse is inspired by realist insights into home-grown Iranian International Relations while the essentialist discourse is influenced by official foreign policy rhetoric and Iranian historical culturalism.
The canalization of morality in institutional settings: Processes of values development within military socialization
Authors: Schmitz Wortmeyer Daniela , Branco Angela Uchoa
Published: February 2019

In this article, we aim at analyzing, from a cultural psychological approach of semiotic dynamics, institutional practices guided to promote the development of moral values in the military. Along these socialization processes, each subject actively reconstructs the external messages in particular ways, interacting with social suggestions according to preexistent affective-semiotic orientations. Based on a longitudinal qualitative study conducted over three years at the Academia Militar das Agulhas Negras, which graduates the Brazilian Army’s combatant career commissioned officers, we analyze cultural canalization practices used by the military taking into account the affective-semiotic dynamics involved. We also focus the impacts of military socialization on the internalization of the value of Discipline by three subjects in order to illustrate the variability of meaning making and affective bonding in that context. Our goal is to contribute to the understanding of how institutions canalize moral values, while individuals also play an active role in their own development.
Impact of sodium bicarbonate treatment of waste hemp fibers on the properties of dicyanate ester of bisphenol-A/bisphenol-A-based benzoxazine resin composites
Authors: Zegaoui Abdeldjalil , Zhang Hui-yan , Derradji Mehdi , Qadeer Dayo Abdul , Cai Wan-an , Zhang Li-li , Wang Jun , Medjahed Aboubakr , Abdelhafid Ghouti Hamid , Liu Wen-bin
Published: February 2019

This present study details an experimental investigation on understanding the effects of surface-modified waste hemp fibers on the overall properties of thermosetting resin blends composed of dicyanate ester of bisphenol-A and bisphenol-A-based benzoxazine resins. At first, the hemp fibers were subjected to sodium bicarbonate treatment, and then various experimental tests in terms of the Fourier-transform infrared spectroscopy, scanning electron microscopy, and thermogravimetric analysis tests were, respectively, carried out to understand the influence of the as-used treatment on the structural, morphological, and thermal properties of the hemp fibers. The obtained results from the surface characterization evidently demonstrated the positive sodium bicarbonate impacts on the properties of the hemp fibers. After that, various amounts of the treated fibers were incorporated within the dicyanate ester of bisphenol-A/bisphenol-A-based benzoxazine resin blends and the obtained composite materials were characterized for their structural, mechanical behavior and thermal properties. The obtained results clearly revealed that the prepared blend composites were identified to possess good bending and impact strength properties; however, a slight decline was observed in the thermal properties. The scanning electron microscopy and Fourier-transform infrared spectroscopy investigations demonstrated a good dispersion of the fibers within the blend matrix, and also an enhanced fiber–blend matrix interfacial adhesion, which were plausibly behind the improved mechanical properties of the prepared blend composites.
Engineering the microbiome for animal health and conservation
Authors: Jin Song Se , Woodhams Douglas C , Martino Cameron , Allaband Celeste , Mu Andre , Javorschi-Miller-Montgomery Sandrine , Suchodolski Jan S , Knight Rob
Published: February 2019

Interest in animal microbiomes as therapeutics is rapidly expanding, as techniques to study the microbial world decrease in cost and increase in accessibility and case studies from human medicine receive widespread attention. In this review, we summarize the current state of techniques to modify the microbiome to improve animal health, focusing on applications in domestic pets, farm animals, and in wild settings for conservation. We discuss options for modifying the microbiome, including community-wide changes such as fecal microbiota transplants, prebiotics, probiotics, and antibiotics, and more targeted approaches such as phage therapy and CRISPR-Cas. We conclude that although much remains to be done in untangling the basic biology of microbiome-directed therapies in animals, the rapid progress currently being made in human medicine and the examples to date of application of probiotics and other microbiome-directed therapies in taxa ranging from horses to salamanders to bees suggest excellent prospects for these technologies as they are further developed and as data on both the benefits and risks are carefully and systematically collected.

Impact statement

Considering the clear effects of microbiota on important aspects of animal biology and development (including in humans), this topic is timely and broadly appealing, as it compels us to consider the possibilities of altering the microbiome (without antibiotics) to positively affect animal health. In this review, we highlight three general approaches to manipulating the microbiome that have demonstrated success and promise for use in animal health. We also point out knowledge gaps where further inquiry would most benefit the field. Our paper not only provides a short and digestible overview of the current state of application, but also calls for further exploration of the microbial diversity at hand to expand our toolkit, while also leveraging the diversity and flexibility of animal systems to better understand mechanisms of efficacy.
Re-Membering, Re-Framing, and Re-Imagining Latino Leadership in Education: Reflections on Community, Higher Learning, and Higher Education
Authors: Guajardo Miguel A. , Guajardo Francisco , Salinas Cristina , Cardoza Lisa
Published: February 2019

This document traverses through a series of genealogical stories that span close to a century to provide context to higher learning, education, and development. The stories of elders help us re-member their dreams, re-frame the process for growth, and re-imagine the possibilities for development at the self, organizational, and community levels. Grounded in a community context, the authors present the history of people, place, and work as they learn to become more effective educators.
Collateral Damage in the Middle of Transformation: School Board Politics in Lieu of a Student’s Academic Needs
Authors: Perry-Higgs Jacqueline
Published: February 2019

This case focuses on a novice principal who advocates for a student who was assigned to the first grade for 3 consecutive years. As the instructional leader of the school, the novice principal is troubled by ethics and social justice issues involved to make the decision to assign the student to his age-appropriate grade. The student was placed in the exceptional students’ program to receive services for a specific learning disability in reading and writing during his first year returning to public school. The student will enter the second grade at the age of 9 years. The superintendent does not support the novice principal. The novice principal now has to decide next steps as a transformative leader in the district.
Barriers to Receiving HPV Vaccination Among Men in a Chinese Community: A Qualitative Study in Hong Kong
Authors: Siu Judy Yuen-man , Fung Timothy K.F. , Leung Leo Ho-man
Published: February 2019

Human papillomavirus (HPV) can cause various diseases; low-risk strains can cause genital warts, whereas high-risk strains can cause cervical cancer and cancer of the vulva in women and cancers of the penis, anus, and oropharynx in men. Although HPV affects men, literature has reported that the prevalence of HPV vaccination is far lower among men than among women. Few studies have examined perceptions and acceptability of the HPV vaccine among men, particularly in Chinese communities. In this study, the acceptability of the HPV vaccine to men was investigated using Hong Kong men as a case group. A qualitative research approach was adopted. Thirty-nine men were purposively sampled for the in-depth individual semistructured interviews from June to October 2017 to investigate their perceptions of the HPV vaccine and the barriers for them to receive the vaccination. Limited knowledge and awareness of HPV-related issues, low perceived risk of HPV infection, perceived association between HPV vaccine and promiscuity, and lack of accessible official information on HPV-related topics were identified as the key barriers. These barriers intermingled with the sociocultural environment, cultural values of sexuality, and patriarchal gender values. HPV vaccine is shown to be socially constructed as a vaccine for women exclusively and for promiscuity. The participants were discouraged from receiving HPV vaccination because of its signaling of socially deviant promiscuity. Cultural taboo on sex served as a social oppression of open discussion about HPV vaccine and affected the participants’ perceived need of vaccination. Perceived insignificance of reproductive organs also influenced the participants’ perceived need of vaccination.
Preseason Dynamic Balance Performance in Healthy Elite Male Soccer Players
Authors: Onofrei Roxana-Ramona , Amaricai Elena , Petroman Radu , Surducan Dan , Suciu Oana
Published: February 2019

Lower limb musculoskeletal injuries in sports are linked with balance abnormalities and altered postural control. Dynamic balance screening should be performed in order to identify athletes at risk. The purpose of the study was to evaluate the preseason dynamic balance performance and side-to-side asymmetry of healthy elite male soccer players, using modified Star Excursion Balance Test (mSEBT). Seventy-three elite soccer players (23.8 ± 5.4 years) were evaluated using the mSEBT. Normalized reach distances, side-to-side asymmetries, and composite scores were determined. The composite scores were 93.33% ± 8.99% for dominant leg and 93.36% ± 9.23% for nondominant leg. No significant differences were found between dominant and nondominant limb in any direction. The mSEBT is an easy-to-use tool to measure the dynamic balance performance in elite athletes. It can be applied successfully during preseason physical examinations. Future studies are needed to establish predictive cutoff points in order to increase mSEBT use in screening soccer players for dynamic balance abnormalities and identify those at risk for noncontact lower limb injuries.
Optimization design of aeronautical hydraulic pipeline system based on non-probabilistic sensitivity analysis
Authors: Zhang Zheng , Zhou Changcong , Wang Wenxuan , Yue Zhufeng
Published: February 2019

This article investigates the design of constraint hoops in the aeronautical hydraulic pipeline system. Non-probabilistic sensitivity analysis is used to screen out the hoops which are insensitive to the maximum stress response, the maximum displacement response as well as the first-order natural frequency. The analysis result can give guidance to reduce the size and weight of the pipeline system. Based on the pretreatment analysis, the position coordinates of the remaining constraint hoops are further optimized. Comparison before and after optimization reveals that the dynamic performances of the pipeline system are significantly improved. This study indicates that the proposed method can provide an effective solution for the design of aeronautical hydraulic pipeline systems.
Remembering the medical practices: How health workers narrate their most negative experiences
Authors: Arias-Sánchez Samuel , Saavedra Javier , Santamaría Andrés , Smorti Andrea
Published: February 2019

People from different labor contexts and practices often narrate diverse memories about their past professional experiences. By analyzing professional memories, we can increase our understanding of how health professionals are able to integrate the diverse problems, which they may encounter within their profession. We have focused on the analyses of the most negative memories of a particular group of doctors related to their work experience. After interviewing 24 professionals of different specialties, their narratives were analyzed using the criteria of specificity, agency, and theme of the memory. Most memories were considered specific as they were vividly remembered with attention to detail. Men have more narratives linked to agency, while the majority of women develop narratives linked to communion. Furthermore, five clearly differentiated topics were observed regarding the professional’s degree of experience. A qualitative analysis of the memories of these professionals, as well as a description of the appropriation process of the discursive features is presented.
Mean platelet volume mediated the relationships between heavy metals exposure and atherosclerotic cardiovascular disease risk: A community-based study
Authors: Zhu Chunmei , Wang Bin , Xiao Lili , Guo Yanjun , Zhou Yun , Cao Limin , Yang Shijie , Chen Weihong
Published: February 2019

Background

Heavy metals were related to increased risk of atherosclerotic cardiovascular disease (ASCVD). However, potential mechanisms under such associations remain unclear. We aimed to investigate the mediating role of mean platelet volume in the associations between heavy metals exposure and 10-year ASCVD risk.

Method

Urinary heavy metals and mean platelet volume were measured in 3081 adults from the Wuhan-Zhuhai cohort in China. The associations between urinary heavy metals, mean platelet volume and 10-year ASCVD risk were separately analyzed through generalized linear models and logistic regression models. Mediation analyses were conducted to assess the role of mean platelet volume in the associations between urinary heavy metals and 10-year ASCVD risk.

Results

After adjusting for potential confounders, 10-year ASCVD risk was positively associated with urinary iron (odds ratio (OR) = 1.142, 95% confidence interval (1.038–1.256)), copper (OR = 1.384 (1.197–1.601)), zinc (OR = 1.520 (1.296–1.783)), cadmium (OR = 1.153 (0.990, 1.342)) and antimony (OR = 1.452 (1.237–1.704)), and negatively related with urinary barium (OR = 0.905 (0.831–0.985)). Also, we found significant dose–response relationships between urinary iron, zinc, antimony and mean platelet volume, as well as between mean platelet volume and 10-year ASCVD risk (all pfor trends < 0.05). Furthermore, mediation analyses indicated that mean platelet volume mediated 17.55%, 6.15% and 7.38% of the associations between urinary iron, zinc, antimony and 10-year ASCVD risk, respectively (all pvalue < 0.05).

Conclusions

Elevated concentrations of urinary iron, copper, zinc, cadmium and antimony were associated with increased risk of 10-year ASCVD. Mean platelet volume partially mediated the associations of urinary iron, zinc and antimony with 10-year ASCVD risk.
Changes in circulating pro-protein convertase subtilisin/kexin type 9 levels – experimental and clinical approaches with lipid-lowering agents
Authors: Macchi C , Banach M , Corsini A , Sirtori CR , Ferri N , Ruscica M
Published: February 2019

Regulation of pro-protein convertase subtilisin/kexin type 9 (PCSK9) by drugs has led to the development of a still small number of agents with powerful activity on low-density lipoprotein cholesterol levels, associated with a significant reduction of cardiovascular events in patients in secondary prevention. The Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) and Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab (ODYSSEY OUTCOMES) studies, with the two available PCSK9 antagonists, i.e. evolocumab and alirocumab, both reported a 15% reduction in major adverse cardiovascular events. Regulation of PCSK9 expression is dependent upon a number of factors, partly genetic and partly associated to a complex transcriptional system, mainly controlled by sterol regulatory element binding proteins. PCSK9 is further regulated by concomitant drug treatments, particularly by statins, enhancing PCSK9 secretion but decreasing its stimulatory phosphorylated form (S688). These complex transcriptional mechanisms lead to variable circulating levels making clinical measurements of plasma PCSK9 for cardiovascular risk assessment a debated matter. Determination of total PCSK9 levels may provide a diagnostic tool for explaining an apparent resistance to PCSK9 inhibitors, thus indicating the need for other approaches. Newer agents targeting PCSK9 are in clinical development with a major interest in those with a longer duration of action, e.g. RNA silencing, allowing optimal patient compliance. Interest has been expanded to areas not only limited to low-density lipoprotein cholesterol reduction but also investigating other non-lipid pathways raising cardiovascular risk, in particular inflammation associated to raised high-sensitivity C-reactive protein levels, not significantly affected by the present PCSK9 antagonists.
Invasive melanoma in a 5-year-old Canadian patient: A case report
Authors: Yuen Joanna , AlZahrani Fatmah , Horne Garnet , Naert Karen , McCalmont Timothy , Unger Kathy , Fiorillo Loretta
Published: February 2019

Atypical Spitzoid lesions pose a distinct challenge in classification as they may comprise a mixture of both classic benign nevus and cutaneous melanoma characteristics. Immunostaining and molecular analysis, such as comparative genomic hybridization, can assist in narrowing the differential diagnosis. We present a case of a 5-year-old male with an atypical Spitzoid lesion on his back. Initial histopathology revealed a relatively symmetric lesion with mitotic figures and poor maturation of melanocytes with descent into the dermis. Immunohistochemistry demonstrated a loss of p16, and array comparative genomic hybridization revealed a loss of chromosome 9, supporting a diagnosis of invasive melanoma arising in conjunction with a remnant of a conventional melanocytic nevus. This case is the first in Canada to demonstrate the use of array comparative genomic hybridization for diagnosing melanoma in a young paediatric patient.
Symptomatic colonic lipomas: Report of two cases and a review of the literature
Authors: Sapalidis Konstantinos , Laskou Stella , Kosmidis Christoforos , Passos Ioannis , Mantalobas Stelios , Michalopoulos Nikolaos , Alexandrou Vyron , Koimtzis George , Koulouris Charilaos , Katsaounis Athanasios , Amaniti Aikaterini , Pavlidis Efstathios , Zarogoulidis Paul , Kesisoglou Isaak
Published: February 2019

Colonic lipomas are the second most common benign tumor of the colon. During a systematic literature search, a lack of review is observed. This study reports two cases of colonic lipomas and also tries to review the clinical and pathologic features of the reported symptomatic lipomas.
British Menopause Society consensus statement on the management of estrogen deficiency symptoms, arthralgia and menopause diagnosis in women treated for early breast cancer
Authors: Marsden Jo , Marsh Mike , Rigg Anne ,   on behalf of The British Menopause Society
Published: February 2019

This guidance document by the British Menopause Society provides an overview of the management of women experiencing estrogen deficiency symptoms and arthralgia following a breast cancer diagnosis. It is now recommended that breast cancer patients are referred to health care professionals with an expertise in menopause for the management of such symptoms, which in turn often involves liaison with patients’ breast cancer teams. However, as many women initially present to primary health care professionals for advice, this statement is aimed to support the latter in such consultations by providing information about symptom aetiology, current management strategies and controversies and identifying useful practice points.
A comparison of fasciocutaneous and adipofascial methods in the reverse sural artery flap for treatment of diabetic infected lateral malleolar bursitis
Authors: Kim Kyu Jin , Ahn Jung Tae , Yoon Kyung Tack , Lee Jae Hoon
Published: February 2019

Purpose:

Infected lateral malleolar bursitis occurring as a diabetic complication requires debridement and flap surgery because it cannot be treated by conservative methods. The most accessible flap is the reverse sural artery flap, which can be harvested as a fasciocutaneous flap or an adipofascial flap. The purpose of this study was to compare the two types of flap methods performed in patients with diabetic infected lateral malleolar bursitis.

Methods:

Twenty-nine cases of diabetic infected lateral malleolar bursitis treated with reverse sural artery flap between 2006 and 2017 were analyzed retrospectively. Fasciocutaneous flap methods were performed in 15 cases (group A), and adipofascial flap methods were performed in 14 cases (group B). Patients in the two groups did not differ in sex or age. The mean follow-up period was 16 months.

Results:

All flaps survived. Infection was controlled at a mean of 2.4 months in both groups. At final follow-up, infection recurred in one case of each group, which was treated with antibiotics. No case developed an ulcer in the flaps. The patients were able to ambulate in regular shoes. All but one of the patients (28 patients) expressed satisfaction with the aesthetic appearance following treatment. No case required a debulking operation.

Conclusion:

Both the fasciocutaneous and adipofascial methods for reverse sural artery flaps were shown to be viable options for the control of diabetic lateral infection. In addition, the two groups did not differ in terms of appearance or complication rate following treatment.
HIV Status and Contraceptive Utilization among Women in Cameroon
Authors: Budhwani Henna , Hearld Kristine Ria , Dionne-Odom Jodie , Manga Simon , Nulah Kathleen , Khan Michelle , Welty Thomas , Welty Edith , Tita Alan Thevenet
Published: February 2019

Objective:

We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers.

Methods:

Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.1%) and uninfected women. Multivariate analyses examined associates of contraceptive utilization and desire to become pregnant.

Results:

Contraceptive utilization was associated with higher education, living with HIV, monogamy, and higher parity ( P < .001). Women living with HIV had 66% higher odds of using contraceptives than their negative peers (odds ratio [OR]: 1.66, confidence interval [CI]: 1.45-1.91, P < .001). Polygamous women had 37% lower odds of using contraceptives compared to monogamous women (OR: 0.63, 95% CI: 0.52-0.75, P < .001).

Conclusion:

Increasing contraceptive utilization in resource-constrained settings should be a priority for clinicians and researchers. Doing so could improve population health by reducing HIV transmission between partners and from mother to child.
Effect of Operative Time on Short-Term Adverse Events After Isolated Anterior Cruciate Ligament Reconstruction
Authors: Agarwalla Avinesh , Gowd Anirudh K. , Liu Joseph N. , Garcia Grant H. , Bohl Daniel D. , Verma Nikhil N. , Forsythe Brian
Published: February 2019

Background:

A longer operative time has been previously recognized as a risk factor for short-term complications after various orthopaedic procedures; however, it has yet to be investigated as an independent risk factor for postoperative complications after anterior cruciate ligament (ACL) reconstruction.

Purpose:

To identify whether a longer operative time in ACL reconstruction is an independent risk factor for the development of postoperative complications, hospital readmissions, or an extended length of stay within 30 days of the index procedure.

Study Design:

Descriptive epidemiology study.

Methods:

Patients undergoing ACL reconstruction between 2005 and 2016 were identified using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Cases with concomitant procedures were excluded from the analysis. We evaluated the association between operative time and preoperative variables such as patient age, sex, body mass index, comorbidities, and procedure. Correlations between adverse events and operative time, while controlling for the above preoperative variables, were calculated using multivariate Poisson regression with robust error variance.

Results:

A total of 14,159 procedures were included in this investigation. The mean patient age was 32.6 ± 10.8 years, the mean body mass index was 27.7 ± 6.5 kg/m2, and the mean operative time was 89.7 ± 28.6 minutes. Patients who were between the ages of 18 and 30 years (mean operative time, 95.1 ± 27.8 minutes; relative risk [RR], 17.7; P < .001), male (mean operative time, 91.9 ± 28.3 minutes; RR, 4.7; P < .001), and nondiabetic (mean operative time, 89.8 ± 28.6 minutes; RR, 7.1; P = .011) were associated with a longer operative duration. The overall complication rate was 1.1%. After adjusting for demographic characteristics and procedures, 15-minute incremental increases in operative duration were associated with an increased risk of deep vein thrombosis (RR, 1.12; P = .042), surgical site infections (RR, 1.21; P = .001), and sepsis (RR, 1.66; P < .001) as well as increased readmission rates (RR, 1.23; P = .001) and an extended length of stay (RR, 1.18; P = .008).

Conclusion:

While the overall adverse risk rate after ACL reconstruction remains low, marginal increases in operative time are associated with an increased risk of adverse events such as deep vein thrombosis, surgical site infections, sepsis, an extended length of stay, and readmissions. Thus, the operating physician and surgical staff should make all efforts to coordinate and prepare for each case to maximize surgical efficiency.
Urban vibrancy and safety in Philadelphia
Authors: Humphrey Colman , Jensen Shane T , Small Dylan S , Thurston Rachel
Published: February 2019

Statistical analyses of urban environments have been recently improved through publicly available high resolution data and mapping technologies that have been adopted across industries. These technologies allow us to create metrics to empirically investigate urban design principles of the past half-century. Philadelphia is an interesting case study for this work, with its rapid urban development and population increase in the last decade. We outline a data analysis pipeline for exploring the association between safety and local neighborhood features such as population, economic health, and the built environment. As a particular example of our analysis pipeline, we focus on quantitative measures of the built environment that serve as proxies for vibrancy: the amount of human activity in a local area. Historically, vibrancy has been very challenging to measure empirically. Measures based on land use zoning are not an adequate description of local vibrancy and so we construct a database and set of measures of business activity in each neighborhood. We employ several matching analyses to explore the relationship between neighborhood vibrancy and safety, such as comparing high crime versus low crime locations within the same neighborhood. We find that neighborhoods with more vacancy are associated with higher crime but within neighborhoods, crimes tend not to be located near vacant properties. We also find that longer term residential ownership in a local area is associated with lower levels of crime. In addition, we find that more crimes tend to occur near business locations but businesses that are active (open) for longer periods are associated with fewer crimes. As additional sources of urban data become available, our analysis pipeline can serve as the template for further investigations into the relationships between safety, economic factors, and the built environment at the local neighborhood level.