bluuebunny/crossref_metadata_2025 huggingface dataset:
GuideLiner Mother‐and‐Child Guide Catheter Extension: A Simple Adjunctive Tool in PCI for Balloon Uncrossable Chronic Total Occlusions
Authors: KOVACIC JASON C. , SHARMA AMIT B. , ROY SWATHI , LI JENNIFER R. , NARAYAN RAJEEV , KIM DONG‐BIN , SHARMA SAMIN K. , KINI ANNAPOORNA S.
Published: August 2013

Objectives

To investigate the use of the GuideLiner “mother‐and‐child” guide catheter extension system as a simple solution to facilitate initial device delivery in balloon uncrossable chronic total occlusions (CTOs) undergoing percutaneous coronary intervention (PCI).

Background

During PCIs for CTO lesions, an important reason for procedural failure is the inability to deliver a balloon or microcatheter across the lesion.

Methods

We retrospectively accessed our interventional registry for 07/01/2010 to 03/21/2012 and extracted data on all CTO lesions involving GuideLiner catheter use. Cine review was performed to identify cases where a guidewire had crossed the CTO and the use of a GuideLiner catheter facilitated initial device delivery.

Results

We identified 28 patients that underwent PCI for CTO with a GuideLiner catheter used to assist initial balloon or microcatheter advancement across the culprit lesion. Mean overall CTO length was 26.3 ± 18.1 mm. The GuideLiner catheter was successful in delivering a small balloon to the CTO lesion in 85.7% of cases (24/28). A single CTO PCI resulted in a distal guidewire perforation, but there was no hemodynamic compromise or pericardial effusion and the patient was discharged the next day. Overall procedural success in these selected cases (where a guidewire had already crossed the CTO) was 89.3% (25/28).

Conclusions

The GuideLiner mother‐and‐child catheter is a simple, safe and efficacious adjunctive device for difficult CTO PCIs where despite standard measures it is not possible to deliver an initial balloon or microcatheter across the occluded segment.
A modified Maquet technique for management of cranial cruciate avulsion in a cat
Authors: Allan R. M.
Published: August 2013

This case report describes the management of cranial cruciate ligament avulsion from the femur of a four‐year‐old Norwegian Forest cat that presented with a history of lameness which had not improved with conservative treatment. During medial arthrotomy, avulsion of the cranial cruciate ligament from the caudomedial aspect of the lateral femoral condyle was suspected and the torn portion resected. A modified Maquet technique was performed on the left tibia resulting in a rapid improvement in lameness postoperatively. Histopathology of the resected cranial cruciate ligament confirmed avulsion. To the authors’ knowledge this is the first reported use of this technique in the cat, and the first of stifle instability due to cranial cruciate ligament avulsion from the femur in the cat.
Conservative management of fractures of the third metatarsal bone in the racing greyhound
Authors: guilliard M. J.
Published: August 2013

Objective

To assess (2006 to 2012) conservative management for treatment of fractures of the third metatarsal bone (MT3) in racing greyhounds.

Methods

All racing greyhounds with MT3 fractures seen prospectively between 2006 and 2012 were included. Fracture morphology, type of conservative management, outcome and the time to a return to racing were recorded. Outcome was assessed either by communication with the trainer or by accessing the website of the Greyhound Board of Great Britain to find the complete racing history of the dog.

Results

Eighteen cases were evaluated. Six had a support dressing and 12 had no external dressings, treatment consisting of kennel rest alone. Two dogs were retired from racing at the time of injury, two dogs sustained other injuries and the remainder (n=14) returned to successful racing with no loss of form.

Clinical Significance

Conservative management for MT3 fractures consisting of a programme of exercise restriction carries an excellent prognosis for a return to previous racing form. External support dressings do not appear to be necessary either for the welfare of the dog or for fracture management.
‘It was caused by the carelessness of the parents’: cultural models of child malnutrition in southern Malawi
Authors: Flax Valerie L.
Published: August 2013

Parents’ conceptions of child growth, health and malnutrition are culturally bound, making information about local understandings of malnutrition and its causes necessary for designing effective nutrition programmes. This study used ethnographic methods to elucidate cultural models of child care and malnutrition among the Yao of southern Malawi. Data were collected in six rural villages from 28 key informant interviews with village chiefs and traditional healers among others and 18 focus group discussions with parents and grandmothers of young children. For the Yao, lack of parental care is a key cause of poor child health and can lead to thinness (kunyililika) or swelling (kuimbangana). Parents are said to be careless if they are not attentive to the child's needs, are unable to provide adequate quality or quantity of food, or fail to follow sexual abstinence rules. Maintaining abstinence protects the family and failure to do so causes the transfer of ‘heat’ from a sexually active parent to a ‘cold’ child and results in child health problems, including signs and symptoms of malnutrition. These findings indicate that the Yao understanding of care is much broader than the concept of care during feeding described in the nutrition literature. In addition, the Yao note the importance of several key feeding practices supported by international agencies and understand the influence of illness on child nutritional status. These congruencies with the public health frame should be used together with information about the cultural context to design more socially and emotionally relevant care and nutrition programmes among the Yao.
Predicted implications of using percentage weight gain as single discharge criterion in management of acute malnutrition in rural southern Ethiopia
Authors: Forsén Emmanuel , Tadesse Elazar , Berhane Yemane , Ekström Eva‐Charlotte
Published: August 2013

Mid‐upper arm circumference (MUAC) is increasingly used in identifying and admitting children with acute malnutrition for treatment. It is easy to use because it does not involve height assessment, but its use calls for alternative discharge criteria. This study examined how use of percentage weight gain as discharge criterion would affect the nutritional status of children admitted into a community‐based management programme for acute malnutrition in rural southern Ethiopia. Non‐oedematous children (n = 631) aged 6–59 months and having a MUAC of <125 mm were studied. By simulation, 10%, 15% and 20% weight was added to admission weight and their nutritional status by weight‐for‐height z‐score (WHZ) was determined at each target. Moderate and severe wasting according to World Health Organization WHZ definitions was used as outcome. Applying the most commonly recommended target of 15% weight gain resulted in 9% of children with admission MUAC <115 mm still being moderately or severely wasted at theoretical discharge. In children with admission MUAC 115–124 mm, 10% of weight gain was sufficient to generate a similar result. Children failing to recover were the ones with the poorest nutritional status at admission. Increasing the percentage weight gain targets in the two groups to 20% and 15%, respectively, would largely resolve wasting but likely lead to increased programme costs by keeping already recovered children in the programme. Further research is needed on appropriate discharge procedures in programmes using MUAC for screening and admission.
Review: Could neurotransmitters influence neurogenesis and neurorepair after stroke?
Authors: Sánchez‐Mendoza E. , Bellver‐Landete V. , Merino J. J. , González M. P. , Martínez‐Murillo R. , Oset‐Gasque M. J.
Published: August 2013

Brain ischaemia and reperfusion produce alterations in the microenvironment of the parenchyma, including ATP depletion, ionic homeostasis alterations, inflammation, release of multiple cytokines and abnormal release of neurotransmitters. As a consequence, the induction of proliferation and migration of neural stem cells is redirected towards the peri‐infarct region. The success of new neurorestorative treatments for damaged brain implies the need to describe with greater accuracy the mechanisms in charge of regulating adult neurogenesis, under both physiological and pathological conditions. Recent evidence demonstrates that many neurotransmitters, glutamate in particular, control the subventricular zone (SVZ), thus being part of the complex signal network that exerts a remarkable influence on the production of new neurones. Neurotransmitters provide a link between brain activity and SVZ neurogenesis. Therefore, a deeper knowledge of the role of neurotransmitters systems, such as glutamate and its transporters, in adult neurogenesis, may prove a valuable tool to be utilized as a neurorestorative therapy in this pathology.
Biomechanical changes in the pharynx and upper esophageal sphincter after modified balloon dilatation in brainstem stroke patients with dysphagia
Authors: Lan Y. , Xu G. , Dou Z. , Wan G. , Yu F. , Lin T.
Published: August 2013

Background

Few studies have investigated the biomechanical changes in the upper esophageal sphincter (UES) and pharyngeal function after successful dilatation therapy for dysphagia. Using high‐resolution manometry (HRM), we examined the biomechanical properties of swallowing in brainstem stroke patients with dysphagia following modified balloon dilation therapy.

Methods

30 brainstem stroke patients with dysphagia were included. Patients in the experimental group received 3 weeks of modified balloon dilatation treatment and regular dysphagia therapy. Patients in the control group received 3 weeks of regular dysphagia therapy only. Efficacy of treatment was evaluated before and following intervention. Functional oral intake was measured using the Functional Oral Intake Scale (FOIS). Pharyngeal maximum pressures and duration, UES residual pressure and duration during swallowing were measured using HRM.

Key Results

In the experimental group, the feeding tube was able to be removed in 12 of 15 patients, vs 2 of 15 patients in the control group. The experimental group had 4‐point median improvement, while control groups only had 1‐point improvement in FOIS scores. In the experimental group, posttreatment UES relaxation and pharyngeal propulsion were both significantly improved for the three materials (p < 0.05) and UES resting pressure approximated normal. In the control group, pharyngeal propulsion was improved for water and thick liquids (p < 0.05) but not for paste material; there was no improvement in posttreatment UES relaxation for all three materials (p > 0.05).

Conclusions & Inferences

Dysphagia therapy with modified dilatation improved UES relaxation, strengthened pharyngeal propulsion, restored UES resting pressure and improved functional oral intake to a greater extent than regular therapy alone.
Identification of gingipain‐specific I‐Ab‐restricted CD4+T cells following mucosal colonization with Porphyromonas gingivalis in C57BL/6 mice
Authors: Bittner‐Eddy P.D. , Fischer L.A. , Costalonga M.
Published: August 2013

Chronic periodontitis is associated with Porphyromonas gingivalis infection. Although virulence factors of P. gingivalis are hypothesized to contribute to the pathogenesis of periodontitis, it is unclear whether the local CD4+ T‐cell‐mediated response they elicit prevents or contributes to periodontal bone destruction. We hypothesize that major histocompatibility complex class II I‐Ab‐binding peptides existing in Kgp and RgpA are presented to CD4+ T cells during P. gingivalis oral colonization. The protein sequences of gingipains RgpA and Kgp, and OMP40 and OMP41 of P. gingivalis were scanned using an I‐Ab‐binding matrix. From this analysis we identified 53 candidate peptides that had the potential to engage the peptide‐binding groove of the I‐Ab molecule of C57BL/6 mice. An ELISpot‐based screen revealed those peptide‐primed effector/memory CD4+ T cells that could be re‐stimulated in vitro with P. gingivalis or the peptide itself to produce interleukin‐17A or interferon‐γ. Two immunodominant peptides, Kgp467–477 (pKgp) and RgpA1054–1064/Kgp1074–1084 (pR/Kgp) were identified and engineered to be displayed on I‐Ab molecular tetramers. Peptide pR/Kgp is conserved across all sequenced P. gingivalis strains. C57BL/6 mice were orally inoculated with P. gingivalis strain 53977 and cervical lymph node cells were stained with phycoerythrin‐conjugated pKgp::I‐Ab and pR/Kgp::I‐Ab tetramers. We found that only pR/Kgp::I‐Ab bound with the desired specificity to gingipain‐specific CD4+ T cells. The pR/Kgp::I‐Ab tetramer complex will allow the identification of effector/memory CD4+ T cells specific for two virulence factors of P. gingivalis strains associated with periodontal disease.
Long‐term outcome in stroke survivors after discharge from a convalescent rehabilitation ward
Authors: Mutai Hitoshi , Furukawa Tomomi , Araki Kasumi , Misawa Kousuke , Hanihara Tokiji
Published: August 2013

Aim

The aim of this study was to investigate the long‐term mortality, daily living activities, social activity, and symptoms of depression, in post‐stroke patients discharged to their homes from a convalescent rehabilitation ward, and to determine the relationship between demographic variables and long‐term outcome.

Methods

This study included 252 consecutive stroke patients (140 men; mean age, 72.4 ± 10.8 years) who had been admitted to a convalescent rehabilitation ward for inpatient rehabilitation. Follow‐up assessment was made by postal questionnaire for up to >1 year after discharge, and included the modified Rankin scale, Frenchay activities index (FAI), and Geriatric Depression Scale.

Results

Of the 192 respondents (76.2%), 160 (83.3%) were living at home. Eighty‐three (51.8%) were independent. Cumulative post‐stroke mortality at 1 and 3 years was 3.7% and 19.4%, respectively.Mean total FAI score was 26.5 ± 10.9, suggesting that social inactivity was common. The estimated prevalence of depression was 21.6%. Coronary artery disease and motor functional independence measures were significantly associated with mortality, whereas age, recurrent stroke, severity of paralysis, and motor functional independence measures were significant predictors of independence. In the cross‐sectional logistic model, depression symptoms were inversely associated with FAI score.

Conclusions

The mortality rate of patients discharged to their home following inpatient rehabilitation is relatively low. Social inactivity and depression symptoms, however, remain common during the chronic phase, and the severity of depression and restriction of participation were interrelated.
Influence of patient characteristics on duration of seclusion/restrain in acute psychiatric settings in Japan
Authors: Noda Toshie , Sugiyama Naoya , Sato Makiko , Ito Hiroto , Sailas Eila , Putkonen Hanna , Kontio Raija , Joffe Grigori
Published: August 2013

Aim

The aim of this study was to investigate the current state of duration of seclusion/restraint in acute psychiatric settings in Japan and the effect of patient characteristics on duration of seclusion/restraint.

Methods

During an 8‐month period starting from November 2008, duration of seclusion/restraint and patient characteristics were investigated in 694 psychiatric inpatients who experienced seclusion/restraint in three emergency and three acute wards at four psychiatric hospitals. Reasons for starting seclusion/restraint were also assessed. Analysis was performed using generalized linear models, with the duration of seclusion/restraint as the dependent variable and patient characteristics and reasons for starting seclusion/restraint as independent variables.

Results

Of the patients secluded/restrained, 58.6% had a primary diagnosis of schizophrenia (F20–F29) and a large proportion (37.9%) were secluded/restrained due to hurting others. Median hours ofseclusion/restraint were 204 and 82 h, respectively. The duration of seclusion was longer for patients with F20–F29 than those with disorders due to psychoactive substance use (F10–F19) or other diagnoses (F40–F99), and when the reason was danger of hurting others. In contrast, the duration of restraint in female patients and in patients with F10–F19 diagnosis was shorter.

Conclusion

The duration of seclusion/restraint at acute psychiatric care wards in Japan are much longer than those reported by previous overseas studies. Although Japanese structure issues such as more patients per ward and a lower ratio of nurses need to be considered, skills for dealing with patients with primary diagnosis of F20–F29 secluded due to danger posed to others should be improved.
Noneism, Ontology, and Fundamentality
Authors: von Solodkoff Tatjana , Woodward Richard
Published: August 2013

In the recent literature on all things metaontological, discussion of a notorious Meinongian doctrine—the thesis that some objects have no kind of being at all—has been conspicuous by its absence. And this is despite the fact that this thesis is the central element of the noneist metaphysics of Richard Routley (1980) and Graham Priest (2005). In this paper, we therefore examine the metaontological foundations of noneism, with a view to seeing exactly how the noneist's approach to ontological inquiry differs from the orthodox Quinean one. We proceed by arguing that the core anti‐Quinean element in noneism has routinely been misidentified: rather than concerning Quine's thesis that to be is to be the value of a variable, the real difference is that the noneist rejects what we identify as Quine's “translate‐and‐deflate” methodology. In rejecting this aspect of Quinean orthodoxy, the noneist is in good company: many of those who think that questions of fundamentality should be the proper focus of ontological inquiry can be read as rejecting it too. Accordingly, we then examine the differences between the noneist's conception of ontology and that offered by the fundamentalist. We argue that these two anti‐Quinean approaches differ in terms of their respective conceptions of the theoretical role associated with the notion of being. And the contrast that emerges between them is, in the end, an explanatory one.
Judgmental Forecasting: Cognitive Reflection and Decision Speed
Authors: Moritz Brent , Siemsen Enno , Kremer Mirko
Published: August 2013

This research analyzes how individual differences affect performance in judgmental time‐series forecasting. Decision makers with the ability to balance intuitive judgment with cognitive deliberation, as measured by the cognitive reflection test, tend to have lower forecast errors. This relationship holds when controlling for intelligence. Furthermore, forecast errors increase for very fast or very slow decisions. We provide evidence that forecast performance can be improved by manipulating decision speed.
Electrophysiological responses to visuospatial regularity
Authors: Makin Alexis D. J. , Rampone Giulia , Pecchinenda Anna , Bertamini Marco
Published: August 2013

Humans are quicker to detect reflectional than rotational or translational symmetry, despite the fact that these patterns are equally regular. We were interested in the neural correlates of these perceptual effects. Participants viewed random, reflection, rotation, and translation patterns while we recorded EEG from the scalp. Half the participants classified the pattern regularity overtly, the other half did not explicitly attend to pattern regularity but reported rare oddball trials, where two squares were embedded among the dots. The amplitude of a symmetry‐related ERP known as the sustained posterior negativity was most pronounced for reflection, then rotation and translation. We suggest that reflectional symmetry, despite its biological significance, may not be processed by unique visual mechanisms, but instead it could be a preferred stimulus for a more general regularity‐sensitive network in the extrastriate visual cortex.
Who governs? Delegations and delegates in global trade lawmaking
Authors: Halliday Terence C. , Pacewicz Josh , Block‐Lieb Susan
Published: August 2013

Who governs in the international organizations (IOs) that promulgate global norms on trade and commercial law? Using a new analytic approach, this paper focuses on previously invisible attributes of a global legislature – the state and non‐state delegations and delegates that create universal norms for international trade and commercial law through the most prominent trade law legislature, the UN Commission on International Trade Law (UNCITRAL). Based on ten years of fieldwork, extensive interviews, and unique data on delegation and delegate attendance and participation in UNCITRAL's Working Group on Insolvency, we find that the inner core of global trade lawmakers at UNCITRAL represent a tiny and unrepresentative subset of state and non‐state actors. This disjunction between UNCITRAL's public face, which accords with a global norm of democratic governance, and its private face, where dominant states and private interests prevail, raises fundamental questions about legitimacy and efficacy of representation in global lawmaking.
Multivariate ratio analysis reveals Trigonoderus pedicellarisThomson (Hymenoptera, Chalcidoidea, Pteromalidae) as a valid species
Authors: LÁSZLÓ ZOLTÁN , BAUR HANNES , TÓTHMÉRÉSZ BÉLA
Published: August 2013

We demonstrate by multivariate ratio analysis (MRA) the validity of two female colour morphs as separate species in what was previously regarded as a single species, Trigonoderus cyanescens (Förster, 1841) (Hymenoptera: Pteromalidae). As a result, T. pedicellaris Thomson, 1878 stat.r., is resurrected from synonymy under T. cyanescens and T. filatus binubilatus Erdős, 1960 syn.n. is synonymized with T. cyanescens. More than 20 characters were measured as part of two MRA dataset analyses. The first analysis excluded all measurements related to the gaster, whereas the second included gaster length, gaster breadth and seventh gaster tergite breadth. The first analysis revealed that the best separating morphometric ratios for the two species are head breadth:metatibia length and OOL:parastigma length, whereas the second analysis revealed OOL:gaster length as the second best separating ratio. The measurement error of all characters was below the admissible level of 30%. Gaster length proved to be a good character for separating the two groups, showed the lowest measurement error, and its percentage coefficient of variation was not greater than for other characters. This indicates that gaster length should not be discarded out‐of‐hand as a morphometric character in Pteromalidae. The variables that gave the best separating ratios included different body parts; therefore we suggest that the body of a specimen should be taken as a whole for use in MRA analyses, where each distance measurement can interact freely with any other. A key, figures and re‐descriptions of T. cyanescens and T. pedicellaris are provided.
COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE CISTERNA CHYLI IN DOGS
Authors: Birch Sally , Barberet Virginie , Bradley Kate , Parsons Kevin , Warren‐Smith Christopher
Published: August 2013

Previous lymphangiographic studies have investigated the use of computed tomography (CT) for characterizing the thoracic duct and its tributaries in dogs. However, there is limited published information on the appearance of the canine cisterna chyli using CT. The objective of this retrospective study was to describe the features of the canine cisterna chyli in pre‐ and post‐contrast abdominal CT studies. The presence, location, shape, maximum width, size compared with the aortic diameter (Ao:cisterna chyli ratio) and mean attenuation of the cisterna chyli were recorded from archived abdominal CT scans of 30 dogs. Breed, age, sex and neutering status were also noted. A cisterna chyli was identified in 26 of the dogs (87%). In 22 cases a cisterna chyli could be reliably identified prior to intravenous contrast administration and in all 26 cases in postcontrast images. The cisterna chyli was most commonly located right dorsolateral to the abdominal aorta between L1 and L4. Shape varied on transverse images from crescent‐like to globular and maximum diameters ranged from 5 to 9 mm. The Ao:cisterna chyli ratio varied between 0.29 and 0.71 (mean value—males: 0.32; females: 0.38). On pre‐contrast images the mean Hounsfield units were 21.3HU (range: –3.8 to 64.25). Mild enhancement of the cisterna chyli post‐contrast was observed in 24 dogs (80%). Findings supported the use of pre‐ and post‐contrast abdominal CT as a non‐invasive method for assessing qualitative and quantitative characteristics of the canine cisterna chyli.
An Experimental Investigation on the Fabrication of Micro/Meso Surface Features by Metallic Roll-to-Plate Imprinting Process
Authors: Gao Zhaoyang , Peng Linfa , Yi Peiyun , Lai Xinmin
Published: August 2013

Metallic components with large-area functional surface micro/mesostructures have been increasingly utilized in various industrial fields, such as friction/wear reduction, viscous drag reduction, and energy efficiency enhancement. Roll-to-plate (R2P) imprinting process is an efficient and economical method in fabricating micro/mesofeatures on the large-area surface of the metal parts. However, process design methods based on scale law cannot be directly used due to size effects. Its formability is greatly influenced by tool feature size and material grain size. In this study, a lab-scale R2P imprinting system was developed to fabricate the microsructures on the surface of metallic materials. The specimens of pure aluminum and pure copper with various size grains were prepared. Rigid die with geometric dimensions was fabricated and series of experiments were conducted. The microfeature height of the imprinted workpiece was measured to evaluate the effects of tool feature dimensions (width, spacing, and fillet) and metal grain sizes. It is found that the groove width and fillet had more significant effect on the microfeature formation among the die cavity geometric parameters. Wider groove could enhance the microforming ability and large fillet could improve the flowing ability. From the viewpoint of polycrystalline material, grain structures significantly affected the microfeature formation. When the grain size was smaller than the groove width, the material flowed more easily into the die cavity with increasing of the grain size because of the decrease of grain boundary strengthening effect.
Comparison of Some Parameter Estimation Techniques Applied to Proton Exchange Membrane Fuel Cell Models
Authors: Havasi Ágnes , Horváth Róbert , Szabó Tamás
Published: August 2013

The functioning and the achievable power of a proton exchange membrane fuel cell (PEMFC) are determined by several parameters simultaneously. Part of these cannot be measured directly. They must be estimated with parameter fitting techniques. In order to give reliable estimations for the unknown parameters, we first set up an adequate finite difference numerical solution of the mathematical model of the fuel cell. Then the values of the unknown parameters are calculated by fitting the model results to measurements. In this paper our primary aim is to compare several parameter fitting tools on the model of a PEMFC and give a prescription for the use of these methods. We test three methods together with their variants: the Levenberg–Marquardt method, the trust region method, and the simulated annealing method, among which the Levenberg–Marquardt method turns to be the most efficient one.
Fabrication of Three-Dimensional Functional Microstructures on Curved Substrates Using Three-Dimensional Microlens Projection
Authors: Zhang Hao , Li Lei , Scheiding Sebastian , Gebhardt Andreas , Risse Stefan , Eberhardt Ramona , Tünnermann Andreas , Yao Donggang , Yi Allen Y.
Published: August 2013

In this research, an innovative 3D micromachining process for functional microstructures on curved surfaces is introduced. An injection molded 3D polymethylmethacrylate (PMMA) microlens array was used as projection optics. A layer of positive photoresist SPR 220 was spin coated on a curved substrate. Preselected patterns were projected onto the photoresist by using a home-built exposure system. Microstructures were created on the curved substrate after development. The 3D projection micromachining method was evaluated through several experiments, and predesigned masks were prepared to fabricate microstructure array of various dimensions and distributions, demonstrating its 3D micromachining capabilities. Finally, this method was utilized to control the surface roughness of the curved substrates by generating microsquare protuberance arrays, forming a 3D functionally graded material (FGM). Further experimental results using a goniometer showed that this method can create functional microstructures for wettability control on steep curved substrates. All these results indicated that the proposed micromachining process is capable of fabricating 3D microstructures on curved surfaces and provides a cost-effective solution to challenging manufacturing problems.
Experimental Study of Failure Modes and Scaling Effects in Micro-Incremental Forming
Authors: Beltran Michael , Malhotra Rajiv , Nelson A. J. , Bhattacharya Anirban , Reddy N. V. , Cao Jian
Published: August 2013

Incremental forming (IF) is a relatively new technique that uses a simple hemispherical ended tool moving along a predefined three-dimensional toolpath to deform a sheet of metal into the desired shape. The greater process flexibility and higher formability in IF have resulted in greater academic and industrial interest in this process as it can successfully produce ultrathin parts beyond the forming limit seen in conventional stamping and the process does not require any geometry-specific tooling. Another emerging paradigm in manufacturing has been the increasing application of forming in micromanufacturing. The above stated process characteristics of IF make it an ideal candidate for being incorporated into the micromanufacturing paradigm. This work investigates micro-IF to examine how forces and occurrence of sheet failure change when the geometric dimensions of incremental forming are scaled down. The development of a highly repeatable micro-IF experimental setup is described and experiments are performed to show that a previously unknown buckling mode of deformation exists in micro-incremental forming, that is linked to the material microstructure. The analysis provides guidelines for the design and understanding of the micro-incremental forming process.
Optimization of Planetary Movement Parameters for Microhole Drilling by Micro-Electrical Discharge Machining
Authors: Guo Xuejie , Yu Zuyuan , Lv Zhongwei , Li Jianzhong , Natsu Wataru
Published: August 2013

Microholes are widely used in industrial products, such as engine nozzles and filters for biomedical industry. Electrical discharge machining (EDM) is one of processes to drill microholes in alloy with high aspect ratio. However, the achievable aspect ratio of a microhole by micro-EDM is limited. To improve the aspect ratio of a microhole drilled by micro-EDM, the planetary movement of electrode is applied during machining. It was found that the machining efficiency of microhole drilling can be further improved by proper setting of planetary movement of electrode, such as the electrode feed rate and movement speed of electrode in XY plane. In this paper, a theoretical model is proposed to optimize parameters of the planetary movement of electrode. Microholes are drilled aided with planetary movement using different machining parameters to verify the model. Experimental results agree with theoretical values, which indicate the validity of the proposed model. This model provides certain theoretical basis for machining parameter selection when microholes are drilled aided with planetary movement.
Kinetostatics of S-(nS)PU-SPU and S-(nS)PU-2SPU Nonholonomic Parallel Wrists
Authors: Di Gregorio Raffaele
Published: August 2013

S-(nS)PU-SPU and S-(nS)PU-2SPU are two types of nonholonomic wrists that are generated from the “ordinary” wrists of type S-3SPU (fully parallel wrists (FPW)), by replacing a spherical pair (S) with a nonholonomic spherical pair (nS) according to the rules stated by Grosch et al. (2010, “Generation of Under-Actuated Manipulators With Nonholonomic Joints From Ordinary Manipulators,” ASME J. Mech. Rob., 2(1), p. 011005). Position analysis, controllability, and path planning of these two wrist types have been addressed and solved in two previous papers (Di Gregorio, R., 2012, “Type Synthesis of Underactuated Wrists Generated From Fully-Parallel Wrists,” ASME J. Mech. Des., 134(12), p. 124501 and Di Gregorio, R., 2012, “Position Analysis and Path Planning of the S-(nS)PU-SPU and S-(nS)PU-2SPU Underactuated Wrists,” ASME J. Mech. Rob., 4(2), p. 021006) of this author, which demonstrated that simple closed-form formulas are sufficient to control their configuration and to implement their path planning. Their kinetostatics and singularity analysis have not been addressed, yet; and they are studied in this paper. Here, the singularity analysis will reveal, for the first time, the existence of a somehow novel type of singularities, here named “jamming singularity,” that jams the platform motion in some directions and that is also present in all the parallel manipulators with SPU limbs (e.g., Gough-Stewart platforms) where it can be considered a particular type of “leg singularity.” Moreover, the static analysis will demonstrate that the reaction forces due to the static friction, in the nonholonomic constraint, can be controlled in the same way as the generalized forces exerted by the actuators, and that the possible slippage, in the same constraint, can be easily monitored and compensated.
Adaptive Control for Uncertain Hysteretic Systems
Authors: Zou Xiaotian , Luo Jie , Cao Chengyu
Published: August 2013

This paper presents an approach to use the L1 adaptive controller for a class of uncertain systems in the presence of unknown Preisach-type hysteresis in input, unknown time-varying parameters, and unknown time-varying disturbances. The hysteresis operator can be transformed into an equivalent linear time-varying (LTV) system with uncertainties, which means that the effect of the hysteresis can be considered as general uncertainties to the system. Without constructing the inverse hysteresis function, the L1 adaptive control is used to handle the uncertainties introduced by the hysteresis, as well as system dynamics. The adaptive controller presented in this paper ensures uniformly bounded transient and tracking performance for uncertain hysteretic systems. The performance bounds can be systematically improved by increasing the adaptation rate. Simulation results with Preisach-type hysteresis are provided to verify the theoretical findings.
Drugs and Bugs
Authors: Voora Deepak
Published: August 2013

Knowing how a specific bacterial strain inactivates the cardiac drug digoxin can pinpoint new biomarkers for tailoring therapy.
A New Drug on the Block
Authors: Sheth Anandi N.
Published: August 2013

A new synthetic compound with a different mechanism of action from traditional tuberculosis (TB) drugs is safe and effective in a mouse model of TB.
Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt
Authors: Jabir Shehab , Frew Quentin , Thompson Richard , Dziewulski Peter
Published: August 2013

A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.
Cardio-respiratory failure secondary to ectopic Cushing's syndrome as the index presentation of small-cell lung cancer
Authors: von Stempel Conrad , Perks Clarissa , Corcoran John , Grayez Jamal
Published: August 2013

A 79-year-old woman, a smoker, presented to the emergency department with a 2-week history of progressive dyspnoea and peripheral oedema, preceded by flu-like symptoms that had failed to improve despite antibiotics. Examination identified severe hypertension and signs consistent with severe fluid overload. Baseline chest X ray showed a right-sided abnormality. In the context of an extensive smoking history CT thorax was indicated which demonstrated a right-sided hilar mass and lymphadenopathy. Blood tests showed an unexplained metabolic alkalosis with partial respiratory compensation and hypokalaemia prompting endocrinological tests investigating Cushing's syndrome. Urinary cortisol was measured at 3174 nmol/L/24 h (normal<560), serum adrenocorticotropic hormone (ACTH) of 215 ng/L (normal<46). Pleural fluid cytology confirmed a diagnosis of small-cell lung cancer (SCLC). The patient's condition deteriorated despite intravenous diuretics and nitrates, metyrapone and non-invasive ventilation. Treatment was withdrawn 1 week after admission. The clinical course in the presence of biochemical derangement and SCLC is highly suggestive of paraneoplastic ectopic ACTH secretion.
Oral lichen planus in a young Indian child
Authors: Khandelwal Vishal , Nayak Prathibha Anand , Nayak Ullal Anand , Gupta Amit
Published: August 2013

Lichen planus (LP) is one of the most distinct mucocutaneous diseases. It is common with the middle aged and elderly population but has rarely been described in children. Incidences of oral LP in children is most commonly reported amongst Asians. We present a 10-year-old Indian girl with the documented clinical aspects and histopathological studies.
Complicated bile duct stones
Authors: Roy Ashwin , Martin Derrick
Published: August 2013

Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or formde novoin the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system.
What attributes of patients affect their involvement in safety? A key opinion leaders’ perspective
Authors: Buetow Stephen , Davis Rachel , Callaghan Kathleen , Dovey Susan
Published: August 2013

Objective

Little is known about which attributes the patients need when they wish to maximise their capability to partner safely in healthcare. We aimed to identify these attributes from the perspective of key opinion leaders.

Design

Delphi study involving indirect group interaction through a structured two-round survey.

Setting

International electronic survey.

Participants

11 (65%) of the 17 invited internationally recognised experts on patient safety completed the study.

Outcome measures

50 patient attributes were rated by the Delphi panel for their ability to contribute maximally to safe health care.

Results

The panellists agreed that 13 attributes are important for patients who want to maximise the role of safe partners. These domains relate to: autonomy, awareness, conscientiousness, knowledge, rationality, responsiveness and vigilance; for example, important attributes of autonomy include the ability to speak up, freedom to act and ability to act independently. Spanning seven domains, the attributes emphasise intellectual attributes and, to a lesser extent, moral attributes.

Conclusions

Whereas current safety discourses emphasise attributes of professionals, this study identified thepatientattributes which key opinion leaders believe can maximise the capability of patients to partner safely in healthcare. Further research is needed that asks patients about the attributes they believe are most important.
Cost-effectiveness of HCV case-finding for people who inject drugs via dried blood spot testing in specialist addiction services and prisons
Authors: Martin Natasha K , Hickman Matthew , Miners Alec , Hutchinson Sharon J , Taylor Avril , Vickerman Peter
Published: August 2013

Objectives

People who inject drugs (PWID) are at high risk for acquiring hepatitis C virus (HCV), but many are unaware of their infection. HCV dried blood spot (DBS) testing increases case-finding in addiction services and prisons. We determine the cost-effectiveness of increasing HCV case-finding among PWID by offering DBS testing in specialist addiction services or prisons as compared to using venepuncture.

Design

Cost-utility analysis using a dynamic HCV transmission model among PWID, including: disease progression, diagnosis, treatment, injecting status, incarceration and addition services contact.

Setting

UK.

Intervention

DBS testing in specialist addiction services or prisons. Intervention impact was determined by a meta-analysis of primary data.

Primary and secondary outcome measures

Costs (in UK £, £1=US$1.60) and utilities (quality-adjusted life years, QALYs) were attached to each state and the incremental cost effectiveness ratio (ICER) determined. Multivariate uncertainty and one-way sensitivity analyses were performed.

Results

For a £20 000 per QALY gained willingness-to-pay threshold, DBS testing in addiction services is cost-effective (ICER of £14 600 per QALY gained). Under the base-case assumption of no continuity of treatment/care when exiting/entering prison, DBS testing in prisons is not cost-effective (ICER of £59 400 per QALY gained). Results are robust to changes in HCV prevalence; increasing PWID treatment rates to those for ex-PWID considerably reduces ICER (£4500 and £30 000 per QALY gained for addiction services and prison, respectively). If continuity of care is >40%, the prison DBS ICER falls below £20 000 per QALY gained.

Conclusions

Despite low PWID treatment rates, increasing case-finding can be cost-effective in specialist addiction services, and in prisons if continuity of treatment/care is ensured.
Onyx is associated with poor venous penetration in the treatment of spinal dural arteriovenous fistulas
Authors: Blackburn Spiros L , Kadkhodayan Yasha , Ray Wilson Z , Zipfel Gregory J , Cross DeWitte T , Moran Christopher J , Derdeyn Colin P
Published: August 2013

Background and purpose

The use of Onyx has become the mainstream for the treatment of cranial dural arteriovenous fistulas (AVFs) and arteriovenous malformations, but the reported success for type I spinal dural arteriovenous fistulas (sDAVFs) remains limited. We review our experience with Onyx and report its limitations in the treatment of spinal AVFs.

Materials and methods

We retrospectively reviewed the Interventional Neuroradiology Procedure database at Washington University for cases of sDAVF embolization. Radiology reports were reviewed for fistula classification, treatment technique, and initial and follow-up results. Angiographic images were reviewed to confirm diagnosis, treatment, and penetration of embolisate into the draining vein.

Results

With the use of Onyx, sDAVFs were obliterated in six of seven patients at the time of treatment. Follow-up angiography confirmed sDAVF obliteration in two patients, and recurrence in two cases. Two patients had no follow-up. One patient not cured at the time of treatment was treated surgically. Of the nine total treatments, Onyx successfully crossed the nidus into the draining vein in only four cases. Successful venous embolization was facilitated with positioning of the microcatheter to less than 5 mm from the nidus in three of the four cases. The use of n-butyl cyanoacrylate (NBCA) resulted in venous penetration in eight of 10 cases, and short term follow-up cure in seven of 10 patients.

Conclusions

Our experience with Onyx for type I sDAVF embolization has been tempered by difficulty in achieving venous penetration and, consequently, a high rate of recurrence. For management of these fistulas, we favor NBCA or surgical treatment.
SPREADING DYNAMICS OF NANODROPS: A LATTICE BOLTZMANN STUDY
Authors: GROSS MARKUS , VARNIK FATHOLLAH
Published: August 2013

Spreading of nano-droplets is an interesting and technologically relevant phenomenon, where thermal fluctuations lead to unexpected deviations from well-known deterministic laws. Here, we apply the newly developed fluctuating nonideal lattice Boltzmann (LB) method [M. Gross, M. E. Cates, F. Varnik and R. Adhikari, J. Stat. Mech.2011, P03030 (2011)] for the study of this issue. Confirming the predictions of Davidovich and coworkers [Phys. Rev. Lett.95, 244905 (2005)], we provide the first independent evidence for the existence of an asymptotic, self-similar noise-driven spreading regime in both two- (2D) and three-dimensional (3D) geometry. The cross over from the deterministic Tanner's law, where the drop's base radius b grows (in 3D) with time as b ~ t1/10 and the noise dominated regime, where b ~ t1/6 is also observed by tuning the strength of thermal noise.
STUDY OF THE NON-NBT PHASE IN Sr DOPED NBT THIN FILMS
Authors: XU HUIZHONG , WANG YAPING , LI DAJI , XU JIANYUAN , WANG ZHUO , ZHEN LIANG
Published: August 2013

The morphology, composition and mechanism of the non-NBT phase in the Sr -doped NBT [SNBT, ( Na 0.5 Bi 0.5)1-x Sr x TiO 3] thin films by chemical method were investigated using XRD, SEM, crystallization analysis and thermodynamics analysis. The results showed that the non-NBT phase is the porphyroblastic grains in the matrix and looks like a plate-shaped polyhedron. The mechanism of the non-NBT phase formation is that the Sr 2+ and Na + combined with [Formula: see text] to form initial simple titanate, such as SrTiO 3, Na 2 TiO 3, or NBT phase decomposed because of the volatilization of Bi under a higher annealing temperature or longer annealing duration, and then transform into the secondary simple titanates ( Sr 2+,2 Na +) TiO 3 or ( Sr , Na )x Ti y O z. Moreover, the NBT phase disappeared for the SNBT films annealing at temperatures higher than 600°C and for 15 min.
PHOTOCHEMICAL FABRICATION OF TRANSITION METAL NANOPARTICLES USING CdS TEMPLATE AND THEIR CO-CATALYSIS EFFECTS FOR TiO2 PHOTOCATALYSIS
Authors: BADHWAR NIDHI , GUPTA NIDHI , PAL BONAMALI
Published: August 2013

Transition metal nanoparticles were prepared by chemical dissolution of CdS template from metal photodeposited CdS nanorod (length = 70–85 nm and width = 5–6 nm) heterocomposites. Size (9–10 nm) of metal nanoparticles obtained after CdS removal was larger than the size (4–6 nm) of metal nanodeposits over CdS template. The obtained Au nanoparticles displayed a broad red shifted absorption band at 660 nm, whereas Pt , Pd and Rh nanoparticles exhibit featureless absorption spectra. Elemental analysis confirms the complete removal of CdS template from Au – CdS ( Au — 2.65 at.%) and Ag – CdS ( Ag — 2.06 at.%) composites showing no Cd peak. These metal nanoparticles imparted dissimilar co-catalytic activity of TiO 2 for photocatalytic degradation of salicylic acid in the order Au > Pt > Pd > Ag > Rh as a function of their nature, electronegativity, redox potential and work function.