bluuebunny/crossref_metadata_2025 huggingface dataset:
An Algorithm for the Rational Choice of Sodium Profile during Hemodialysis
Authors: Ursino M. , Colì L. , Dalmastri V. , Volpe F. , La Manna G. , Avanzouni G. , Stefoni S. , Bonomini V.
Published: March 2018

The incidence of intradialytic disequilibrium syndrome and symptomatic hypotension has increased significantly among dialysis patients over the last ten years. Profiled hemodialysis (PHD) is a new technique, based on the intradialytic modulation of dialysate sodium concentration, which aspires to reduce to previous imbalances.

This paper presents a new algorithm for the determination of a rational dialysate sodium profile during PHD. A mathematical model of solute kinetics, monocompartmental for sodium and bicompartmental for urea is used. The algorithm allows the sodium profile to be elaborated a priori before each dialysis session, respecting the individual sodium mass removal and weight gain. A procedure allowing the adjustment of the method to the individual characteristics, on the basis of routine measurements performed before each session is also presented.

The method was validated during seven dialysis sessions. Comparison between data measured in vivo and those predicted by the model showed standard deviations corresponding to the range of laboratory measurement errors: 1.50 mEq/L for sodium and 0.87 mmol/L for urea. In vivo implementation of PHD by our algorithm allows one to remove an amount of sodium close to that established a priori on the basis of patient's need.
In Vivo Model to Study the Biocompatibility of Peritoneal Dialysis Solutions
Authors: Wieczorowska-Tobis K. , Korybalska K. , Polubinska A. , Radkowski M. , Breborowicz A. , Oreopoulos D.G.
Published: March 2018

This study was designed to analyze the complex morphologic and functional effects of dialysis solutions on peritoneum in a rat model on chronic peritoneal dialysis. Peritoneal catheters were inserted into 10 male, Wistar rats and the animals were dialyzed twice daily for 4 weeks with 4.25% Dianeal. During the study we observed two opposite effects: healing of the peritoneum after catheter implantation - decreased cell count in dialysate, decreased permeability of the peritoneum to glucose and total protein, increased volume of drained dialysate; and damage to the membrane due to its exposure to peritoneal dialysis solution - increased hyaluronic acid levels in dialysate, a tendency of the peritoneum to thicken when compared to non-dialyzed animals. Our rat model of CAPD may be used for quantitative and qualitative assessment of the effects of peritoneal dialysis solution on the peritoneum during chronic dialysis
Evaluation of the Expert System for Respiratory Therapy of Newborns on Archival Data
Authors: Michnikowski M. , Rudowski R. , Siugocki P. , Grabowski J. , Rondio Z. , Lindström D.P.
Published: March 2018

The aim of this study was to evaluate the artificial ventilation expert system for neonates (AVES-N) using archival data. The recommendations of the system were compared to the decisions made by the expert-physician in the same clinical situation (patient condition, respirator settings). In our retrospective study we used data of 320 newborns which were ventilated in the Neonatal Intensive Care Unit of the Vanderbilt University Hospital in Nashville (USA). Best agreement between the recommendations of the system and the decisions of the experts was found for positive end expiratory pressure (PEEP), inspired oxygen fraction (FiO2) and peak inspiratory pressure (PIP) – about 70%. Worse agreement was found for time related parameters: respiratory frequency (f) – 54%, time of inspiration (ti) – 46%, time of next blood gas analysis – 15%. The expert system advised lower Fio2 PEEP and f. The differences were smaller in a group of patients who survived than in a group of patients who died. The overall agreement of the AVES-N advice and real therapeutic actions leads to the clinical evaluation of the expert system. The differences can be attributed to a) different therapeutic strategies at 2 NICU's, b) missing data regarding complications in the data base which were not taken into account by the expert system.
Pathophysiological Considerations concerning Uni- and Biventricular Mechanical Cardiac Assist
Authors: Waldenberger F.R.
Published: March 2018

Mechanical assisted circulation by the means of cardiac assist devices is a routine procedure in modern cardiac surgery and cardiology. We investigated the impact of mechanical unloading on regional myocardial “stunning” and the influence of assisted circulation on left heart and right heart failure persevered by an ultimate addition of pulmonary hypertension in experimental set ups.

We found that mechanical unloading either during ischemia or in the early reperfusion phase attenuates stunning and enhances the return of synchronous heart performance.

In our global dysfunction model we showed that the right heart is dispensable. Sufficient inflow to the left heart is provided unless pulmonary hypertension is present. Also additional left heart support can not overcome the deleterious situation and in select cases only additional right heart support can prevent the “low LVAD output” syndrome.

We conclude that mechanical assisted circulation and mechanical unloading are beneficial in case of regional and global dysfunction persevered by pulmonary hypertension, however, the knowledge about interactions of assist systems and the circulation has to be improved in order to optimize clinical assist device performance.
Experience with Uni- (LVAD) and Biventricular (ECMO) Circulatory Support in Postcardiotomy Pediatric Patients
Authors: Borowski A. , Korb H.
Published: March 2018

In six pediatric patients with postoperative low-output-syndrome (LOS), uni-(LVAD) and biventricular (ECMO) assist systems with Biomedicus centrifugal pump were used. ECMO was applied in 5 children aged between 3 days and 16 years, one infant with an age of 16 months was implanted with LVAD. One patient from the ECMO-group and the patient with LVAD-support survived. Analysis of vital organ functions during ECMO and LVAD support are presented and characteristics of both support systems for use in pediatric patients with postcardiotomy LOS based on worldwide experience discussed. In conclusion, both, uni- (LVAD) and biventricular circulatory support (ECMO) using Biomedicus centrifugal pump can be safely applied for management of postcardiotomy LOS even in neonates, however, ECMO support in comparison to LVAD is a more aggressive approach associated with a higher complication rate.
Microsystems in Medicine
Authors: Wallrabe U. , Ruther P. , Schaller T. , Schomburg W. K.
Published: March 2018

The complexity of modern surgical and analytical methods requires the miniaturisation of many medical devices. The LIGA technique and also mechanical microengineering are well known for the batch fabrication of microsystems. Actuators and sensors are developed based on these techniques. The hydraulic actuation principle is advantageous for medical applications since the energy may be supplied by pressurised balanced salt solution. Some examples are turbines, pumps and valves. In addition, optical sensors and components are useful for analysis and inspection as represented by microspectrometers and spherical lenses. Finally, plastic containers with microporous bottoms allow a 3-dimensional growth of cell culture systems.
A New Biosensor for Continuous Monitoring of the Spent Dialysate Urea Level in Standard Hemodialysis
Authors: Calzavara P. , Calconi G. , Da Rin G. , Canini E. , Paolini F
Published: March 2018

This study gives the results in terms of precision and repeatability of a new on-line urea monitoring system (Ureascan P2 Hospal) capable of measuring the urea concentrations in the spent dialysate. The Ureascan P2 Hospal (UP2H), fitted on single-pass dialysis machines (Integra-Hospal), functions by the presence of a disposable mini-reactor containing urease. The passage through the reactor of a minimum quantity of spent dialysate from the filter diluted with a pH 7 buffer solution (1 ml/min) increases its ionic strength, which is detected by a differential measurement of conductivity in proportion to the urea concentration in the dialysis liquid. We studied 13 dialysis sessions, with bicarbonate buffer, in 8 anuric patients. From 4 to 7 dialysate samples were taken during each treatment to determine the urea and 65 samples were analysed overall. Urea values from the UP2H were compared with those measured on the Dimension Du Pont analyser. Simple linear regression analysis showed an excellent correlation between the 2 measuring methods (r=0.987; p<0.001). The Bland-Altman test gave an average difference between the urea values measured with the UP2H and in the laboratory of 1.3±1.2 mg/dl. The agreement limits between 2 SD were - 1.2 mg/dl and +3.8 mg/dl respectively. In conclusion, the UP2H we have developed has proved to be a reliable and very useful instrument for adapting, through the urea kinetic mathematical models, the dialysis dose for individual patients.
Measurement of the Upper Limit of Vulnerability during Defibrillator Implantation can Substitute Defibrillation Threshold Measurement
Authors: Bessho R. , Tanaka S.
Published: March 2018

We investigated whether defibrillation thresholds (DFTs) could be measured more safely during defibrillator implantation by measuring the upper limit of vulnerability (ULV) without using any special equipment.

Nonthoracotomy ICD implantation with endocardial leads was performed in 13 patients, and through the use of the ICD function itself, ULV and DFT were measured using the delayed four-episode up-down algorithm. Myocardial injures caused by high-energy current were assessed by electrocardiograms and serial CPK-MB.

ULV was confirmed in all cases, and it strongly correlated with DFT. The average ULV was 5.9 ± 3.3J, while the average DFT was 7.9 ± 4.3J (r = 0.89, p < 0.0001, DFT = 1.20+1.14x ULV). The average ULV was thus significantly lower (p < 0.01). Although six patients were on amiodarone therapy, the strong correlation between ULV and DFT was also maintained (r = 0,97), p < 0.01) in these patients.

In all cases, the CPK-MB failed to increase, and no myocardial injuries were detectable on electrocardiograms.

We confirmed that ULV could be easily and safety measured during ICD implantation, and that ULV could be used instead of DFT.
pO2 Measurement in an Experimental Model of Patellar Tendon Autograft Pro-Anterior Cruciate Ligament
Authors: Rocca M. , Giavaresi G. , Aldini N. Nicoli , Fini M. , Marcacci M. , Zaffagnini S. , Giardino R.
Published: March 2018

Thirty-four sheep were submitted to surgery substituting the native ACL with the central third of the patellar tendon, ten enter this study. The purpose was to find a possible relationship between tissue pO2 and healing processes considering also the biomechanical and histomorphological aspects of the grafts. Four of them were sacrificed under general anaesthesia after 6 months, and six after 1 year in order to perform tissue pO2 measurement and an analysis of microvessel density on specimens of the normal ACL and the graft. Our data showed higher pO2 values of the autografts after 6 months. After 1 year the data was comparable to those of native ACL. This was confirmed by a microvessel count of the histological specimens and the data was in relationship to biomechanical and histomorphological analysis. Tissue pO2 can be observed and recorded in “in vivo” ACL, and patellar tendon used as graft, with no injury to their integrity. The monitoring system might be considered as an experimental tool for indirect controls of the anterior cruciate substitutes.
Use of Single Dose Low-Molecular-Weight Heparin in Long Hemodialysis
Authors: Lai K.N. , Ho K. , Li M. , Szeto C.C.
Published: March 2018

Low-molecular-weight (LMW) heparin has recently been used for anti-coagulation in maintenance hemodialysis. The LMW heparin was administered as a single bolus in hemodialysis that usually lasted for four hours or less. The regimen for administering LMW heparin in hemodialysis of longer duration (5 hours or more) is not well documented and manufacturers recommend a supplementary dose equivalent to one-quarter of the initial dose to be given at 4 hours after the commencement of hemodialysis. In this study, we explored whether administering a single dose of LMW heparin is feasible in hemodialysis of longer duration. Maintenance five-hour hemodialysis sessions were performed in nine uremic patients with two different heparin regimens: single dose of LMW heparin (nadroparin) 12,500 ICU AXa at the beginning of dialysis or a priming dose of nadroparin 10,000 ICU AXa at the beginning of dialysis followed by a supplementary dose of nadroparin 2,500 ICU AXa at the beginning of the fifth hour of dialysis. Clots in the airtraps or clotting of the dialyser were not observed in hemodialysis with the single dose heparin regimen. The anti-Xa activities at different time intervals during dialysis were above the therapeutic range of 0.5 U/ml except towards the end of the hemodialysis treatment. There was no difference between anti-Xa activities determined in dialysis sessions using two different regimens of LMW heparin at any individual time interval. The anti-throm-botic effect determined by the area under the time response curve for anti-Xa activity was comparable in the two LMW heparin regimens. Hence, our findings suggest a single bolus dose of LMW heparin (nadroparin) at 12,500 ICU AXa provides adequate, safe, and effective anti-coagulation for five-hour hemodialysis. This practice is convenient and avoids the necessity of administering a double dose of LMW heparin.
Exhaustion of Vascular Endowment in Hemodialysis: Proposal for a Permanent Inlet Access
Authors: Bellinghieri G. , Ricciardi B. , Costantino G. , Torre F. , Santoro D. , Cimadoro D. , Savica V.
Published: March 2018

The subcutaneous reservoir is a new vascular access for patients on regular hemodialysis (HD).

A double chamber in Titanium- Pirolytic Carbon with siliconic boreable superior caps is inserted in to a subcutaneous subclavian side, and always in subcutis connected to two siliconic catheters located in the right jugular resulting in the right atrium.

The puncture of each chamber is performed with a special hemodialysis-cannula telescopically assembled on a “dilatation tube”, in which a stylet is inserted.

In correct sequence, the cutaneous planes and the caps are bored, dilated, and finally the HD cannula after sliding over the previous structures is positioned in the inner chamber, closing the HD circuit.

In our study two patients were implanted, with a survival of 24 months, good compliance, no cardiovascular impairments and lack of catheteral pathology.
High Density Culture of Immortalized Liver Endothelial Cells in the Radial-flow Bioreactor in the Development of an Artificial Liver
Authors: Matsuura T. , Kawada M. , Hasumura S. , Nagamori S. , Osata T. , Yamaguchp M. , Hataba Y. , Tanaka H. , Shimizu H. , Unemura Y. , Nonaka K. , Iwaki T. , Kojima S. , Aizaki H. , Mizutani S. , Ikenaga H.
Published: March 2018

Liver endothelial cells are important components of the tissue along the hepatic sinusoid. They are responsible for microcirculation in the liver and scavenger functions. It would therefore be important to include these cells in any hybrid type of artificial liver in addition to hepatocytes. However, it is difficult to culture these cells in vitro. The development of a liver endothelial cell line, which maintains the characteristics of the primary culture, would thus be of great benefit in the development of an artificial liver. In the present study we established immortalized liver endothelial cells from the liver of an H-2Kb-tsA58 transgenic mouse, which harbors the SV40 TAg gene. Hepatic sinusoidal cells isolated from H-2Kd-tsA58 mouse proliferated In the presence of γ-interferon at 33°C. Four clones were established, out of which clone M1 had the highest amounts of PGI2 production, as well as plasminogen activator activity and internalized acetylated low density lipoprotein. On culture dishes the M1 cells grew individually and spread. Sieve plates on the cell surface were not readily visible, but small pores were detected under electron microscopic observation. These results suggest that M1 clone cells originated from liver endothelial cells. Moreover it was possible to culture the immortalized liver endothelial cells in a radial-flow bioreactor for 5 days, with a maximum 6-keto prostaglandin F1α production of 25 μg per day. This suggests that immortalized liver endothelial cells and a radial-flow bioreactor can prove useful tools in the development an artificial liver.
Salvage and Reinfusion of Chyle in Closed Chest Injury
Authors: Montebugnoli M. , Borghi B. , Bugamelli B. , Righi U. , Boaron D.M. , Valbonesi M. , Baroncini S.
Published: March 2018

The aim of this study was to describe a system of salvaging and reinfusing chyle which accumulated in the right pleural cavity of a patient after a thoracic duct lesion caused by a closed chest injury associated with amyelic fracture of the dorsal spine D10-D11. The chyle was collected in a reservoir (BT 844 Dideco), transfered by an electronic pump (BT 797 recovery Dideco) to a storage bag, microfiltered and then reinfused to the patient.

A solution was needed to prevent the patient with severe chylothorax, from having immunological and metabolic imbalance. The long period of conservative treatment with our system was imposed by the onset of acute post-traumatic myocardic infarction which delayed surgery.

From experience gained, we can say that using total parenteral nutrition, chyle can not only be salvaged but also reinfused, respecting the strict rules of hygiene.
Family-related Disparities in College Enrollment across the Great Recession
Authors: Cozzolino Elizabeth , Smith Chelsea , Crosnoe Robert L.
Published: March 2018

The economic crisis of the Great Recession in the late 2000s had implications for the intergenerational transmission of inequality within families. Studying patterns of college enrollment across the Great Recession among U.S. youth from diverse family contexts provides insight into how economic volatility can either compound or undercut the advantages that some parents can give their children. Although college enrollment among 18- to 21-year-olds did not decline during or after the Great Recession, analyses of the National Longitudinal Survey of Youth 1979–Young Adult cohort revealed that this general trend subsumed variability by family history, local economic conditions, and age. Histories of family stability and sufficiency were associated with higher odds of college enrollment over time and across age, but this advantage was largest during the Recession in high-unemployment communities. These results illuminate how life course consequences of early family life can fluctuate with volatility and opportunity in the broader economy.
An Updated Evidence-Based Practice Review on Teaching Mathematics to Students With Moderate and Severe Developmental Disabilities
Authors: Spooner Fred , Root Jenny R. , Saunders Alicia F. , Browder Diane M.
Published: March 2018

The purpose of this review was to examine the body of research on teaching mathematics to students with moderate and severe developmental disability that has been published since 2005, reflecting changes in both the academic expectations for this population and research and design standards in the evidence-based practice (EBP) era. We examined research on teaching mathematical skills for students with moderate and severe developmental disability from 2005–2016 and found 36 studies (33 single-case and three group-experimental studies), updating the Browder, Spooner, Ahlgrim-Delzell, Harris, and Wakeman analysis. Of the 36 studies included in the review, 22 single-case and three group-design studies received a rating of high or adequate quality using the National Technical Assistance Center on Transition (NTACT) indicator criteria. In addition to systematic instruction, instructional procedures of technology-aided instruction, graphic organizers, manipulatives, and explicit instruction were found to be EBPs in teaching mathematics to this population.
Achieving maximum dimensional accuracy and surface quality at the shortest possible time in single-point incremental forming via multi-objective optimization
Authors: Taherkhani Abolfazl , Basti Ali , Nariman-Zadeh Nader , Jamali Ali
Published: March 2018

Single-point incremental forming is a novel and flexible method for producing three-dimensional parts from metal sheets. Although single-point incremental forming is a suitable method for rapid prototyping of sheet metal components, there are limitations and challenges facing the commercialization of this process. Dimensional accuracy, surface quality, and production time are of vital importance in any manufacturing process. The present study is aimed at selecting proper forming parameters to produce sheet metal parts which possess dimensional accuracy and good surface quality at the shortest time. Four parameters (i.e. tool diameter, tool step depth, sheet thickness, and feed rate) are chosen as design variables. These parameters are used for the modeling of the process using Group Method of Data Handing(GMDH) artificial neural networks. The data necessary for establishing empirical models are obtained from single-point incremental forming experiments carried out on a computer numerical control milling machine using central composite design. After the evaluation of the model accuracy, single- and multi-objective optimization are performed via genetic algorithm. The performance of the design variables of a tradeoff point corresponding to one of the experiments shows the efficiency and accuracy of the models and the optimization process. Considering the priorities of objective functions, a designer will be able to set proper process parameters.
Effects of revolute clearance joint on the dynamic behavior of a planar space arm system
Authors: Miao Huihui , Li Bing , Liu Jie , He Anqi , Zhu Shangkun
Published: March 2018

Space arm system is a typical multibody mechanical system requiring high operation stability and precision connected by kinematic joints. As joint clearance is inevitable during the manufacturing and mounting process, it turns into a critical problem affecting the dynamic characteristics and kinematic accuracy of the mechanism. A space arm system deploying stably and accurately is the prerequisite to guarantee the final satellite pointing accuracy once it is into its working state. Thus, the space arm system needs to have good dynamic characteristics and stability during its deploying process and to have accurate and reliable positioning characteristics during its locking process. For the deploying process, the mathematical model of a multibody system with clearance joint has been established as a foundation to study the influence of clearance properties, including clearance size, clearance joint locations, numbers of clearance joints and lubrication on the dynamic performance and motion stability of a two-degrees-of-freedom space arm system. The mathematical model of a locking mechanism has been established to study the clearance effects on the pointing accuracy of the space arm system during its locking process. The simulation results show that, the clearance has different effects on the dynamic characteristics of the space arm system during its different working processes.
The Akiba Mashinani Trust, Kenya: a local fund’s role in urban development
Authors: Weru Jane , Okoyo Omondi , Wambui Mary , Njoroge Patrick , Mwelu Jacinta , Otibine Evans , Chepchumba Ann , Wanjiku Regina , Wakesho Tabitha , Njenga Maina John Pius
Published: March 2018

This paper describes the funding and financial services provided by the Akiba Mashinani Trust (AMT) to support the Kenyan Homeless People’s Federation (Muungano wa Wanavijiji). Muungano is a federation of autonomous savings groups with over 60,000 members from informal settlements across Kenya. Savings are critical because they enable wealth accumulation, demonstrate the capacity of the community to repay loans and hence leverage additional resources, and build social capital among members. AMT is able to use these savings as seed capital for revolving funds at the community, city and national scales. The funds offer informal settlers a range of financial products, including community project loans, which allow savings groups to finance social housing, sanitation and basic infrastructure in an affordable way. Therefore, unlike formal banking and microfinance institutions, AMT positions its financial services within a broader effort to improve the physical and social fabric of urban informal settlements. The experiences of Muungano and AMT demonstrate the catalytic impact of establishing appropriate financial services geared towards low-income groups – and crucially, how the savings of low-income people can leverage government resources to achieve more inclusive cities.
Making people the subject: community-managed finance systems in five Asian countries
Authors: Boonyabancha Somsook , Kerr Thomas
Published: March 2018

This paper presents the findings of a two-year study of community finance systems (including community-based savings and loan groups, and larger city-based funds) that are operated by established urban poor community organizations in five Asian countries (Cambodia, Nepal, Philippines, Sri Lanka and Thailand), with support from their partner organizations. These five groups are the principal national urban poor organizations in their respective countries, and their community savings and city funds – as well as their other development initiatives – have all grown to national scale. The study, in which the chief researchers, data-gatherers and analysts were community members themselves, was managed by the Asian Coalition for Housing Rights (ACHR). It was conceived as an opportunity to look in greater detail at the different models of community finance these important groups have developed, in their very different national contexts, and to compare their various aspects, draw out some key elements and lessons, and see how these people-driven finance systems can be strengthened, scaled up and brought into the formal finance and development structures in their countries.
Financing the inclusive city: the catalytic role of community savings
Authors: Shand Wayne , Colenbrander Sarah
Published: March 2018

Global conversations around financing urban development typically neglect the importance of coordinating the activities of different stakeholders behind a shared vision for their city. In particular, low-income and other marginalized groups must be seen as entrepreneurs and partners in service delivery to enhance the efficacy of resource use and to reduce poverty. This paper explores the creation of non-traditional business models and alliances to invest in informal settlements. It presents examples from India, Kenya, Pakistan, Thailand and Zimbabwe, where local authorities, commercial banks and other formal actors have co-financed and co-delivered urban plans, housing and infrastructure through collaborations with organized groups of the urban poor. These groups make three critical contributions: financial resources, detailed information on the composition of informal settlements, and capabilities for collective decision-making and action. These contributions are underpinned by the financial and social capital developed through collective saving, and enable the delivery of complex urban improvements at scale.
Vulval lichen planus–lichen sclerosus overlap
Authors: Howard Matthew , Hall Anthony
Published: March 2018

Vulval lichen planus–lichen sclerosus overlap is an emerging observation. Few clinical reports exist with no reviews of literature. We present a focused update of this phenomenon and discuss a clinical case. We report a 63-year-old woman with a 20-year history of ulcerative vulvo-vaginitis, initially diagnosed as benign mucous membrane (cicatricial) pemphigoid. This led to prolonged treatment with oral corticosteroids with minimal improvement in symptoms. Subsequent complications of long-term use of systemic corticosteroid ensued. A clinico-pathological diagnosis of severe erosive lichen planus was made on clinical findings and on non-specific biopsy changes of ulceration and inflammation. Treatment with topical clobetasol propionate 0.05% ointment twice daily led to dramatic improvement of ulceration, easing of discomfort and marked improvement in quality of life. Clinical examination revealed Wickham’s striae on the labia majora supporting the diagnosis. Six years after commencement of topical clobetasol, white plaques were noticed on the labia majora, perineum and peri-anal region consistent with lichen sclerosus, confirmed by repeat vulval skin biopsy and on vulvectomy. This case highlights the challenge of diagnosis of extensive vulvo-vaginal ulceration and the necessity to re-examine a previous diagnosis if there is poor response to treatment.
Regulation, New Venture Creation, and Resource-Advantage Theory: An Analysis of the U.S. Brewing Industry
Authors: Friske Wesley M. , Zachary Miles A.
Published: March 2018

Regulation is an important means by which policymakers address social costs. However, recent research suggests that managing social costs often comes at the expense of entrepreneurial activity. We explore this duality by extending resource-advantage theory to examine the effects of excise taxes, small business tax credits and exemptions, and sales restrictions on rates of new venture creation in the U.S. brewing industry. Our longitudinal analysis of state-level brewery regulations reveals that taxes and sales restrictions have adverse but limited effects on new venture creation over time. Furthermore, tax credits and exemptions are positively associated with growth rates of new ventures.
Infrared–ultrasonic sensor fusion for support vector machine–based fall detection
Authors: Chen Zhangjie , Wang Ya
Published: March 2018

This article presents an infrared–ultrasonic sensor fusion approach for support vector machine–based fall detection, often required by elderly healthcare. Its detection algorithms and performance evaluation are detailed. The location, size, and temperature profile of the user can be estimated based on a novel sensory fusion algorithm. Different feature sets of the support vector machine–based machine learning algorithm are analyzed and their impact on fall detection accuracy is evaluated and compared empirically. Experiments study three non-fall activities, standing, sitting, and stooping, and two fall actions, forward falling and sideway falling, to simulate daily activities of the elderly. Fall detection accuracy studies are performed based on discretely and continuously (closer to reality) recorded experimental data, respectively. For the discrete data recording, an average accuracy of 92.2% is achieved when the stand-alone Grid-EYE is used and the accuracy is increased to 96.7% when sensor fusion is used. For the continuous data recording (180 training sets, 60 test sets at each distance), an average accuracy less than 70.0% is achieved when the stand-alone Grid-EYE is used and the accuracy is increased to around 90.3% after sensor fusion. New features will be explored in the next step to further increase detection accuracy.
Analysis on vibration energy concentration of the one-dimensional wedge-shaped acoustic black hole structure
Authors: Li Xi , Ding Qian
Published: March 2018

The transverse vibration energy of a plate with a wedge-shaped profile can be trapped by acoustic black hole effect to its edge portion, in case the wedge thickness is diminished according to the power-law h( x) =  εxm with m ≥ 2.0. The acoustic black hole effect exhibits potential ability for passive vibration control and energy harvesting. In this article, the transfer matrix method is adopted to establish and solve the dynamical model of acoustic black hole structure. Energy ratio is defined as a ratio of the energy trapped within the edge portion to that of the whole wedge, to illustrate the energy concentration effect. Analyses show that both the strain energy ratio and kinetic energy ratio of the acoustic black hole structure achieve the minimum when the wedge is in resonances, although these two kinds of energy come to peaks at this case. However, in the case of small length of the edge portion, the strain energy ratio reaches the highest peaks at the second and higher resonances, rather than at the first one. Generally, the best effect of energy concentration occurs when m ranges from 2.5 to 3.0. Reducing the truncation thickness and increasing the maximum height can improve the energy trapping.
Grim FATE: Learning About Systems Thinking in an In-Depth Climate Change Simulation
Authors: Waddington David I. , Fennewald Thomas
Published: March 2018

Background. Simulations of complex systems have a long history of use for the study and promotion of systems thinking, yet more can be done in identifying games that promote development of systems thinking.

Aim. This study is an exploration of the hypothesis that FATE OF THE WORLD, a challenging and complex climate change simulation, can promote systems thinking about climate change.

Questions. This article analyzes players’ engagement with FATE OF THE WORLD using three key questions: 1. In what ways does the game support thinking about climate change as a complex system? 2. Does the game correspond to players’ a priori model of climate change? 3. How do players relate to FATE as an artifact they embrace, critique, and tinker with?

Method. 33 participants were matched into control and test groups, and experimental participants were assigned to play a full game scenario of FATE OF THE WORLD. Experimental and control groups were compared using pre-and-post intervention concept maps. Post interviews were conducted with the test group.

Results.Concept maps revealed statistically significant differences between the control and test groups. Interviews revealed diversity in learning outcomes and the ways in which acceptance of the game’s model of climate change influenced learning.

Conclusions. FATE serves as proof-of-concept for the power of complex simulations to promote systems thinking as well as in-depth reflection on key social challenges. However, simulations like FATE are unlikely to serve well as stand-alone educational tools, which highlights the importance of effective teaching to accompany the game.
Sharing Genetic Risk Information: Implications for Family Nurses Across the Life Span
Authors: Metcalfe Alison
Published: March 2018

Sharing genetic risk information in families can be very challenging. However, the consequences of poor communication can be detrimental to the psychological health and well-being of parents and children in the present and the long term. Family nursing can play an important role in supporting family communication about genetic conditions. This role has several components: Firstly, improved assessment of families affected by or at risk from inherited genetic conditions. Secondly, facilitation of families’ discussions of genetic risk, especially between parents and children. Family nurses can use an integrated model of family care to support parents and their children in discussion of genetic risk information throughout the child’s development, including provision of assistance specifically for young people, who want to discuss the issues they face with informed nurses. Thirdly there is a role for family nurses in educating other specialist nurses in taking a more family-focused approach when they are caring for patients affected by genetic conditions. If the full benefits of genomic technologies are to be recognized and implemented, it is essential that the relational impact of the science be strengthened to enhance family relationships and support genetic risk information sharing.
On high-order approximations for describing the lagging behavior of heat conduction
Authors: Chiriţă Stan
Published: March 2018

This paper is dedicated to high-order effects of thermal lagging in correlation with heat transfer models in micro- or nanoscale, relating the number of energy carriers and the associated resonance phenomenon under high-frequency excitations. Thus, a class of constitutive equations is considered for the heat flux describing high-order effects in the lagging behavior of heat transport. Tzou’s model, which is based on time-differential dual-phase-lag approximations of heat conduction, is generalized, incorporating the microstructural interaction effect in the fast-transient process of heat transport. More precisely, polynomial approximations of order n for the heat flux vector and of order m for the gradient of the temperature variation are considered. Further, well-posedness is established for solutions of the specific initial boundary value problems for the mathematical model when: (i) [Formula: see text]; (ii) [Formula: see text]; and (iii) [Formula: see text]. This means that uniqueness and continuous dependences of solutions are established with respect to the given prescribed data. With this aim, some modified initial boundary value problems related to the operators of the constitutive equation are introduced and suitable time-weighted measures of the solution are presented, and are used to establish the uniqueness theorems and to generate some estimates describing the continuous dependence of solutions with respect to the given data for each of the three cases specified. Moreover, the spatial behavior of the transient solutions is studied and an influence domain result is established for [Formula: see text], while for [Formula: see text] some exponential decay estimates of Saint-Venant type are established. All results are established without restrictions on the characteristic parameters of the constitutive equation other than that the product of the coefficients of the time derivatives of greatest order of the two operators involved in the constitutive equation is positive.
TLE1 Expression in Malignant Rhabdoid Tumor and Atypical Teratoid/Rhabdoid Tumor
Authors: Duncan Virginia E , Wicker Jason A , Kelly David R , Li Rong
Published: March 2018

Malignant rhabdoid tumors (MRT; atypical teratoid/rhabdoid tumor [ATRT] in the central nervous system) are aggressive tumors in infants and children which can overlap with other sarcomas, such as synovial sarcoma (SS). The gold standard for SS diagnosis is characterization of the t(X;18) chromosomal translocation. However, stratification of cases for molecular analysis is not always straightforward or feasible. Recent literature suggests transducer-like enhancer of split 1 (TLE1) protein expression may distinguish SS from certain histologic mimics; however, this has not been investigated in MRT and ATRT. We stained whole-tissue sections of 18 archived cases of MRT and ATRT with TLE1. Nuclear expression was scored using a 4-tiered (0, 1+, 2+, and 3+) scale describing staining intensity, extent, or combination of both. The majority of MRT and ATRT cases showed some TLE1 immunoreactivity (n = 16; 89% for ≥1 + staining); 14 (78%) of total cases showed ≥2 + positivity using any of the 3 scoring systems. Over half (n = 10; 56%) of cases showed ≥2 + staining; 4 (22%) cases showed 3 + strong and diffuse TLE1 staining measured by all scoring systems in agreement. Although still of potential use, we urge caution in the interpretation of TLE1 when the differential diagnosis includes both SS and MRT or ATRT.
A Systematic Review of Placental Biomarkers Predicting Small-for-Gestational-Age Neonates
Authors: Ruchob Rungnapa , Rutherford Julienne N. , Bell Aleeca F.
Published: March 2018

Background:

Neonates born small for gestational age (SGA) face increased risk of neonatal mortality, childhood developmental problems, and adult disease. The placenta is a key factor in SGA development because of its multiple biological processes that underlie fetal growth. However, valid and reliable placental biomarkers of SGA have not been determined.

Objectives:

The objective of this article was to systematically identify and review studies examining associations between placental biomarkers and SGA and assess those biomarkers’ predictive value.

Methods:

Use of the matrix method and the PRISMA guidelines ensured systematic identification of relevant articles based on selection criteria. PubMed, CINAHL, and EMBASE were searched for English articles published in 2005–2016 that addressed relationships between placental biomarkers and SGA.

Results:

The search captured 466 articles; 13 met selection criteria. The review identified 14 potential placental biomarkers for SGA, with placental growth factor and soluble fms-like tyrosine kinase 1 being the most commonly studied. However, findings for these and other biomarkers have often been contradictory. Thus, no placental biomarkers have been confirmed as reliable for predicting SGA.

Conclusion:

The inconsistent findings suggest low placental biomarker reliability, perhaps due to the multifactorial nature of SGA. This review is novel in its focus on identifying potential placental biomarkers for SGA, producing a better understanding of how placental function underlies fetal growth. Nevertheless, use of placental biomarkers alone may not be adequate for predicting SGA. Therefore, combinations of biomarkers and other predictive tests should be evaluated for their ability to predict risk of SGA.
Effect of arteriovenous graft flow rate on vascular access hemodynamics in a novel modular anastomotic valve device
Authors: McNally Andrew , Akingba A George , Sucosky Philippe
Published: March 2018

Purpose:

Perturbed vascular access hemodynamics is considered a potential driver of intimal hyperplasia, the leading cause of vascular access failure. To improve vascular access patency, a modular anastomotic valve device has been designed to normalize venous flow between hemodialysis periods while providing normal vascular access during hemodialysis. The objective of this study was to quantify the effects of arteriovenous graft flow rate on modular anastomotic valve device vascular access hemodynamics under realistic hemodialysis conditions.

Methods:

Modular anastomotic valve device inlet and outlet flow conditions and velocity profiles were measured by ultrasound Doppler in a vascular access flow loop replicating arteriovenous graft flow rates of 800, 1000, and 1500 mL/min. Fluid–structure interaction simulations were performed to identify low wall shear stress regions on the vein wall and to characterize them in terms of temporal shear magnitude, oscillatory shear index, and relative residence time. The model was validated with respect to the Doppler measurements.

Results:

The low wall shear stress region generated downstream of the anastomosis under low and moderate arteriovenous graft flow rates was eliminated under the highest arteriovenous graft flow rate. Increase in arteriovenous graft flow rate from 800 to 1500 mL/min resulted in a substantial increase in wall shear stress magnitude (27-fold increase in temporal shear magnitude), the elimination of wall shear stress bidirectionality (0.20-point reduction in oscillatory shear index), and a reduction in flow stagnation (98% decrease in relative residence time). While the results suggest the ability of high arteriovenous graft flow rates to protect the venous wall from intimal hyperplasia–prone hemodynamics, they indicate their adverse impact on the degree of venous hemodynamic abnormality.
Using an Assessment Tool to Further Tobacco Control Accomplishment in Thailand
Authors: Charoenca Naowarut , Kungskulniti Nipapun , Sritabutra Duangkamon , Pitayarangsarit Siriwan , Hamann Stephen L
Published: March 2018

Background:

Because implementation of the Framework Convention on Tobacco Control (FCTC), a World Health Organization (WHO) treaty to reduce tobacco use, is an important goal of the 2015 United Nations Sustainable Development Goals (SDGs) and Thailand has sought to fully comply with all its articles, a multiperspective assessment was developed to ensure that any gaps in compliance with FCTC provisions were identified and addressed.

Method:

One assessment mechanism of this multicomponent assessment was the development by experts and use by stakeholders of a 3-tiered rating of all major provisions of the main articles of the FCTC. The results of the performance ratings on FCTC articles by a diverse group of stakeholders were used to spotlight areas of local and regional implementation and compliance with FCTC provisions.

Results:

Implementation ratings by stakeholders generally followed the chronology of WHO priorities as reflected in the development by WHO of guidelines for the various FCTC articles with highest ratings for articles 6, 8, 11, 12, 14, 15, and 16. However, only 5 articles (Articles 6, 11, 12, 15, and 16) reached level 2 (effectiveness) of the 3-level rating; articles 6, 8, 11, 13, and 14 are discussed because they are the WHO priority articles of the MPOWER tobacco control policy. Importantly, stakeholders cited problems with lack of completeness of present Thai law and processes for enforcement, as well as lack of public understanding regarding tobacco control strategies and provisions.

Conclusions:

Overall, the breadth and inclusiveness of the stakeholder approach devised for improving implementation by the Tobacco Control Research and Knowledge Management Center provided greater understanding about shortcomings of present policy and resource management which informed the Tobacco Products Control Act passed in 2017 and plans for advancing stronger Thai regulation by local and national government.
Oviposition Strategies of Tachinid Parasitoids: Two Exorista Species as Case Studies
Authors: Dindo Maria Luisa , Nakamura Satoshi
Published: March 2018

Oviposition strategies and mechanisms of host selection in parasitoids may be crucial for the success of parasitization and parasitoid production. These aspects are far less known in tachinid parasitoids than in hymenopteran parasitoids. Depending on the species, parasitoid flies may adopt direct or indirect oviposition strategies. The ‘direct type’ females lay eggs on or, in relatively a few species, inside the host body. This review describes cues involved in host selection by tachinid parasitoids and their oviposition strategies and presents 2 case studies in more detail, focusing on Exorista larvarum and Exorista japonica. These 2 polyphagous parasitoids of Lepidoptera lay macrotype eggs directly on the host cuticle. Both species have been used as biological control agents in inoculative release against the gypsy moth Lymantria dispar in the Northern United States. Improved knowledge of the mechanisms involved in host selection and oviposition strategies may increase the possibility of eliciting oviposition by these tachinids on target lepidopterous hosts (and even artificial substrates), thus facilitating their rearing and ultimately making their exploitation as regulators of target insect pests more feasible and efficient.