bluuebunny/crossref_metadata_2025 huggingface dataset:
Thermoacoustic analysis of combustion chambers with varying temperature: Numerical solutions and comparison with experiments
Authors: Hernando Carmen M , Cavalieri André VG , Lacava Pedro T , Corá Rogério
Published: December 2018

In the present work, a numerical and experimental study of the thermoacoustic instabilities of a combustor is performed. The numerical model is represented by the one-dimensional linearised Euler Equation and an n-τ formulation for flame transfer function that describes the unsteady combustion response to these acoustic disturbances. This approach is similar to other simplified models present in the literature. However, most theoretical works assume a constant density and speed of sound in the medium, which is not realistic for combustion chambers, as the mean temperature is expected to decrease spatially as one moves away from the combustion area. Hence, to compare with experiments where chamber temperature is spatially varying, we developed a numerical solution procedure, seeking eigenvalues (complex-valued frequencies ω) indicating the stability characteristics of a given mode. Due to the non-linear dependence of the flame transfer function with ω, eigenvalues are found with a non-linear root-finding method. The acquired results met those obtained experimentally, indicating that the proposed model is capable of predicting the thermoacoustic behaviour of the combustion chamber.
A new power-based method to determine the first arrival information of an acoustic emission wave
Authors: Das Avik Kumar , Leung Christopher KY
Published: December 2018

Acoustic emission is a powerful experimental structural health monitoring technique for determining the location of cracks formed in a member. Pinpointing wave arrival time is essential for accurate source location. Conventional arrival detection technique’s accuracy deteriorates rapidly in low signal to noise ratio (5–40 dB) region, thus unsuitable for source location due to this inaccuracy. A new technique to pinpoint the arrival time based on the power of the wave is proposed. We have designed an adaptive filter based on the power characteristics of acoustic emission wave. After filtration of the acoustic emission wave, sliding window is employed to accurately identify the region of wave arrival based on the change in transmitted power. The results from various experimental and numerical arrival time detection experiments consistently show that the proposed methodology is stable and accurate for a wide range of signal to noise ratio values (5–100 dB). Particularly, in signal to noise ratio region (5–40 dB), the method is significantly more accurate as compared to the other methods described in the literature. The method was then employed to study the localized damage progression in a steel fiber–reinforced beam under four-point bending. The results suggest that calculated source location using the new method is consistent with that from visual inspection of the member at failure and more accurate than the localization results from existing method.
Un Estudio Piloto del Clima Laboral de las Enfermeras Mexicanas: A Pilot Study of Mexican Nurses’ Work Environments
Authors: Squires Allison , Fletcher Jason , Hidalgo Hortensia Castañeda , Nigenda Gustavo
Published: December 2018

Introducción:

Llevar a cabo un estudio piloto para examinar el clima laboral de las enfermeras en México utilizando un instrumento comparable internacionalmente.

Métodos:

La versión en español de la Escala de Práctica Ambiental del Índice de Trabajo de las Enfermeras fue el instrumento usado en este investigación. Un estudio piloto transversal de 453 enfermeras mexicanas de seis sitios utilizando técnicas de recolección de datos en papel y en línea. El estudio se realizó entre 2011 y 2013. El análisis de componentes principales analizó la fiabilidad y validez del instrumento traducido.

Resultados:

El instrumento traducido produjo cinco factores, pero las cargas de los ítems difirieron. Sin embargo, el instrumento fue capaz de identificar áreas problemáticas y no problemáticas del ambiente de trabajo de las enfermeras mexicanas.

Conclusiones:

La versión en español mexicano del instrumento puede evaluar de manera confiable el ambiente de trabajo hospitalario en México.
Study of Meltblown Structures Formed by Robotic and Meltblowing Integrated System: Impact of Process Parameters on Fiber Diameter Distributions
Authors: Farer Raoul , Batra Subhash K. , Ghosh Tushar K. , Grant Eddie , Seyam Abdelfattah M.
Published: December 2018

In previous publication, the influence of process parameters on the fiber orientation of the meltblown web was evaluated [4]. The meltblown webs were formed using Robotic Fiber Assembly and Control System (RFACS), which is described in previous publications [3, 4]. In this paper, parametric studies evaluating the effect of polymer throughput rate, attenuating air pressure and temperature, and die temperature, on fiber diameter distributions of meltblown webs from polypropylene produced by RFACS are reported. Fiber diameters were determined by analyzing fabric images obtained through scanning electron microscopy (SEM). Under the specific conditions explored, the fraction of fibers of diameter smaller than 10 microns (μm) can increase by 72% with a 7.9 × 10−2 g/min/hole (82%) reduction in throughput. A 54% increase of the same can be observed with a 2.8 bar (400%) increase in attenuating air pressure. A change of 45°C (16 %) in air temperature is shown not to significantly affect fiber diameters produced, while an increase of 67°C (26%) in die temperatures can result in an increase of 17% in the fraction of fibers of diameter smaller than 10μm. All fiber diameter distributions are shown to be unique to the condition evaluated as no overlap across distributions for changes in a given parameter is observed. Further fiber fraction smaller than 10 μm data is also shown to be unique to each parameter evaluated.
Investigation of the Fiber, Bulk, and Surface Properties of Meltblown and Electrospun Polymeric Fabrics
Authors: Tsai Peter P. , Chen WeiWei , Roth J. Reece
Published: December 2018

We measured and compared the properties of meltblown and electrospun fabrics made of nylon and polyurethane (PU). Properties of interest included surface energy/wettability, strength, fiber diameter, and microscopic structure as revealed by scanning electron microscopy (SEM). We also report new data on the diameters of electrospun fibers measured from digitized SEM images of electrospun nylon, polyurethane (PU), polyacrylonitrile (PAN), polycaprolactone (PCL), and polycarbonate (PC) fabrics. The electrospinning process produced fibers with diameters in the range from 10 nm to several microns. It was found that the strength per unit areal weight of electrospun nanofiber nylon fabric was up to ten times that of the meltblown material, and for polyurethane (PU) fabric, from 2.5–3 times that of the melt-blown material.
Melt Blowing Polyoxymethylene Copolymer
Authors: Zhao Ron (Rongguo)
Published: December 2018

Polyoxymethylene (POM) copolymer is one of the relatively new, high performance engineering polymers. Its high crystallinity provides this polymer with excellent properties, including great tensile strength and stiffness, high toughness, good resilience, and low surface friction. POM also possesses excellent chemical resistance to a wide range of materials, comparing favorably with many thermoplastic polymers.

Fine fibered products of POM may find applications in specialty filtration, such as hydrocarbon fuel filtration, and hydraulic fluid filtration.

This paper discusses the melt blowing process for POM with an emphasis on the effects of spinnerette setting on the fiber property. It also discusses the relationship of process/web properties for this specific polymer and compares it with that of PP in terms of processability.
Analysis of a Converging, Annular, Isothermal Melt Blowing Jet Using Computational Fluid Dynamics
Authors: Moore Eric M. , Papavassiliou Dimitrios V. , Shambaugh Robert L.
Published: December 2018

An unconventional melt blowing die was analyzed using computational fluid dynamics (CFD). This die has an annular configuration wherein the jet inlet is tapered (the cross-sectional area decreases) as the air approaches the die face. It was found that the flow characteristics of this die are different from conventional slot and annular dies. In particular, for the tapered die the near-field normalized turbulent kinetic energy was found to be lower at shallow die angles. Also, it was found that the peak mean velocity behavior was intermediate between that of conventional annular and slot dies. The centerline turbulence profiles were found to be qualitatively similar to those of annular dies; quantitatively, higher values were present for tapered dies.
Comfort Perception of Breathable and Nonbreathable Diapers
Authors: Wright Audra , Akin Frank
Published: December 2018

Breathable diapers were rated significantly drier, cooler and more comfortable than nonbreathable diapers over a range of controlled environmental conditions. Healthy, continent adults evaluated two types of diapers, one of which contained a microporous, breathable outer cover and the other a standard occlusive cover, in a series of blinded, comparison studies under various external conditions and activity levels. The subjects were capable of perceiving comfort or discomfort in the diaper area to a remarkable degree. Subjective perceptions of warmth and wetness underneath the diaper correlated with objective measurements of temperature and relative humidity (RH). Comfort ratings for the breathable diaper increased significantly over that of the nonbreathable garment as ambient temperature, RH and physical activity increased. Data analysis showed that the sensation of wetness in the diaper area was strongly associated with discomfort.
Melt-Spun Polybutylene Fibers and Nonwovens
Authors: Ortiz Diana L. , Shambaugh Robert L.
Published: December 2018

Polybutylene (PB-1) fibers were spun at spinning speeds of 250–2500 m/min. A tensile tester was used to analyze the stress-strain behavior of these fibers. In addition, birefringence and the effect of aging were examined. A DMA (dynamic mechanical analyzer) was used to measure the storage modulus and loss modulus of the fibers. Nonwoven mats of the fibers were prepared and compression tests were run on these mats. The properties of the polybutylene fibers and mats were compared with the properties of common polypropylene fibers and mats.
The 1992 Revision of the Good News Bible: The Context for Revision
Authors: Burke David G.
Published: December 2018

This article surveys the wider context in the 1970s–1980s that compelled Bible publishers to prepare revisions of their translations: the rapid shift in spoken English was making the masculine-heavy English of major Bible translations feel antiquated to readers. The Good News Bible New Testament was first published in 1966 and its Old Testament in 1976, but already by the mid-1980s revision was being contemplated by the American Bible Society. The revision process was thoroughgoing and collaborative, with all English-using Bible Societies participating. More than 6,000 revisions were proposed and reviewed, with about 2,500 meeting consensus. Most were related to gender-exclusion, but a few were exegetical. Although the United Bible Societies’ Hebrew Old Testament Text Project recommendations on almost 6,000 textual cruxes were published in preliminary form by 1979, the Good News Bible revision process could not incorporate those data. An addendum discusses the addition of the deuterocanonical books in 1979.
An unusual case of tuberous sclerosis incidentally discovered in adulthood: case report and review of the literature
Authors: Ferrara Dolores , Vallone Gianfranco , Tedeschi Enrico , Ponsiglione Andrea , Stanzione Arnaldo , Pisani Antonio , Imbriaco Massimo
Published: December 2018

Tuberous sclerosis (TS) is a relatively rare multi-organ disorder generally diagnosed in infancy and described as a clinical triad of sebaceous adenoma, mental retardation, and seizures. Angiomyolipoma (AML) is the most common benign renal tumor usually found incidentally as a solitary small echogenic lesion on grayscale ultrasound. Less commonly, it is part of the TS complex and is seen as multiple lesions in both kidneys. We describe an unusual case of TS incidentally diagnosed in a 37-year-old female patient with several and bilateral renal AMLs and a single cortical–subcortical tuber in the right parieto-occipital cerebral lobe.
Effects of Remnant Tissue Preservation on Tunnel Enlargement After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Hamstring Tendon
Authors: Masuda Tetsuro , Kondo Eiji , Onodera Jun , Kitamura Nobuto , Inoue Masayuki , Nakamura Eiichi , Yagi Tomonori , Iwasaki Norimasa , Yasuda Kazunori
Published: December 2018

Background:

The effects of remnant tissue preservation on tunnel enlargement after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction have not yet been established.

Hypothesis:

The preservation of ACL remnant tissue may significantly reduce the degree and incidence of tunnel enlargement after anatomic double-bundle ACL reconstruction, while the remnant-preserving procedure may not significantly increase the incidence of tunnel coalition after surgery.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 79 patients underwent anatomic double-bundle ACL reconstruction. Based on the Crain classification of ACL remnant tissue, 40 patients underwent the remnant-preserving procedure (group P), and the remaining 39 patients underwent the remnant-resecting procedure (group R). There were no differences between the 2 groups concerning all background factors, including preoperative knee instability and intraoperative tunnel positions. All patients were examined using computed tomography and a standard physical examination at 2 weeks and 1 year after surgery.

Results:

During surgery, the femoral and tibial anteromedial (AM) tunnel sizes in both groups averaged 6.6 and 6.5 mm, respectively. The femoral and tibial posterolateral (PL) tunnel sizes in both groups averaged 6 and 6 mm, respectively. There were no differences in the intraoperative tunnel positions and tunnel sizes between groups. Concerning the femoral AM tunnel, the degree of tunnel enlargement in the oblique coronal and oblique axial views in group P was significantly less than that in group R ( P = .0068 and .0323, respectively). Regarding the femoral AM tunnel cross-sectional area, the degree and incidence of tunnel enlargement in group P were significantly less than those in group R ( P = .0086 and .0278, respectively). There were no significant differences in tunnel coalition between groups. In each group, there were no significant relationships between tunnel enlargement and each clinical outcome.

Conclusion:

Remnant preservation in anatomic double-bundle ACL reconstruction reduced enlargement of the femoral AM tunnel and did not increase the incidence of tunnel coalition. This is one of the advantages of remnant-preserving ACL reconstruction.
Correct Interpretations of Fixed-effects Models, Specification Decisions, and Self-reports of Intended Votes: A Response to Mutz
Authors: Morgan Stephen L.
Published: December 2018

The author thanks Professor Mutz for her informative reaction to his article. In this six-part response, the author first addresses Professor Mutz’s new claim that “Morgan’s interpretation suggests a misunderstanding of the panel models.” The author explains that this concern with his understanding can be set aside because Mutz’s interpretations of her own fixed-effects models are incorrect. The author then discusses very briefly four areas of disagreement that readers will want to judge on their own: the value of prejudice-incorporating explanations in comparison with status threat–only explanations, measurement assumptions about support for free trade, the value of adjustments for party identification, and how best to consider the political preferences of nonwhite voters when evaluating the status-threat explanation. The author concludes with a defense of two of his own prior published articles that Mutz critiques in her comment in an apparent attempt to widen the field of contestation.
Wage subsidies targeted to jobseekers with disabilities: subsequent employment and disability retirement
Authors: Angelov Nikolay , Eliason Marcus
Published: December 2018

In many countries, a non-negligible percentage of the working-age population has impairments that also entail reduced work capacity, and disability retirement is increasing. Despite this, studies on the effects of policies aimed at enhancing the labour market inclusion among people with disabilities, such as targeted wage subsidies, are surprisingly few. In an attempt to fill this gap, we have studied how wage subsidies affect future labour market outcomes for jobseekers with disabilities, in terms of employment and disability retirement. By using inverse probability weighting applied to rich Swedish register data, we contrast participants in the wage subsidy program to observably similar non-participants during a 19-year period. We find that participation was associated with both positive and negative labour market outcomes. On the negative side, participants were less likely to have unsubsidised employment. On the positive side, leaving the labour market through the disability insurance program was somewhat less common among participants. Moreover, using a broader employment measure including subsidised jobs, the participants were found to be employed to a larger extent, which could be interpreted either as locking-in effects or as fostering labour market inclusion.
Randomized Phase II Trial of Cisplatin and Etoposide in Combination With Veliparib or Placebo for Extensive-Stage Small-Cell Lung Cancer: ECOG-ACRIN 2511 Study
Authors: Owonikoko Taofeek K. , Dahlberg Suzanne E. , Sica Gabriel L. , Wagner Lynne I. , Wade James L. , Srkalovic Gordan , Lash Bradley W. , Leach Joseph W. , Leal Ticiana B. , Aggarwal Charu , Ramalingam Suresh S.
Published: December 2018

Purpose

Veliparib, a poly (ADP ribose) polymerase inhibitor, potentiated standard chemotherapy against small-cell lung cancer (SCLC) in preclinical studies. We evaluated the combination of veliparib with cisplatin and etoposide (CE; CE+V) doublet in untreated, extensive-stage SCLC (ES-SCLC).

Materials and Methods

Patients with ES-SCLC, stratified by sex and serum lactate dehydrogenase levels, were randomly assigned to receive four 3-week cycles of CE (75 mg/m2 intravenously on day 1 and 100 mg/m2 on days 1 through 3) along with veliparib (100 mg orally twice per day on days 1 through 7) or placebo (CE+P). The primary end point was progression-free survival (PFS). Using an overall one-sided 0.10-level log-rank test, the study had 88% power to demonstrate a 37.5% reduction in the PFS hazard rate.

Results

A total of 128 eligible patients received treatment on protocol. The median age was 66 years, 52% of patients were men, and Eastern Cooperative Oncology Group performance status was 0 for 29% of patients and 1 for 71%. The respective median PFS for the CE+V arm versus the CE+P arm was 6.1 versus 5.5 months (unstratified hazard ratio [HR], 0.75 [one-sided P = .06]; stratified HR, 0.63 [one-sided P = .01]), favoring CE+V. The median overall survival was 10.3 versus 8.9 months (stratified HR, 0.83; 80% CI, 0.64 to 1.07; one-sided P = .17) for the CE+V and CE+P arms, respectively. The overall response rate was 71.9% versus 65.6% (two-sided P = .57) for CE+V and CE+P, respectively. There was a significant treatment-by-strata interaction in PFS: Male patients with high lactate dehydrogenase levels derived significant benefit (PFS HR, 0.34; 80% CI, 0.22 to 0.51) but there was no evidence of benefit among patients in other strata (PFS HR, 0.81; 80% CI, 0.60 to 1.09). The following grade ≥ 3 hematology toxicities were more frequent in the CE+V arm than the CE+P arm: CD4 lymphopenia (8% v 0%; P = .06) and neutropenia (49% v 32%; P = .08), but treatment delivery was comparable.

Conclusion

The addition of veliparib to frontline chemotherapy showed signal of efficacy in patients with ES-SCLC and the study met its prespecified end point.
Molecular High-Grade B-Cell Lymphoma: Defining a Poor-Risk Group That Requires Different Approaches to Therapy
Authors: Sha Chulin , Barrans Sharon , Cucco Francesco , Bentley Michael A. , Care Matthew A. , Cummin Thomas , Kennedy Hannah , Thompson Joe S. , Uddin Rahman , Worrillow Lisa , Chalkley Rebecca , van Hoppe Moniek , Ahmed Sophia , Maishman Tom , Caddy Josh , Schuh Anna , Mamot Christoph , Burton Catherine , Tooze Reuben , Davies Andrew , Du Ming-Qing , Johnson Peter W.M. , Westhead David R.
Published: December 2018

Purpose

Biologic heterogeneity is a feature of diffuse large B-cell lymphoma (DLBCL), and the existence of a subgroup with poor prognosis and phenotypic proximity to Burkitt lymphoma is well known. Conventional cytogenetics identifies some patients with rearrangements of MYC and BCL2 and/or BCL6 (double-hit lymphomas) who are increasingly treated with more intensive chemotherapy, but a more biologically coherent and clinically useful definition of this group is required.

Patients and Methods

We defined a molecular high-grade (MHG) group by applying a gene expression–based classifier to 928 patients with DLBCL from a clinical trial that investigated the addition of bortezomib to standard rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. The prognostic significance of MHG was compared with existing biomarkers. We performed targeted sequencing of 70 genes in 400 patients and explored molecular pathology using gene expression signature databases. Findings were validated in an independent data set.

Results

The MHG group comprised 83 patients (9%), with 75 in the cell-of-origin germinal center B-cell-like group. MYC rearranged and double-hit groups were strongly over-represented in MHG but comprised only one half of the total. Gene expression analysis revealed a proliferative phenotype with a relationship to centroblasts. Progression-free survival rate at 36 months after R-CHOP in the MHG group was 37% (95% CI, 24% to 55%) compared with 72% (95% CI, 68% to 77%) for others, and an analysis of treatment effects suggested a possible positive effect of bortezomib. Double-hit lymphomas lacking the MHG signature showed no evidence of worse outcome than other germinal center B-cell-like cases.

Conclusion

MHG defines a biologically coherent high-grade B-cell lymphoma group with distinct molecular features and clinical outcomes that effectively doubles the size of the poor-prognosis, double-hit group. Patients with MHG may benefit from intensified chemotherapy or novel targeted therapies.
Mortality of Adult Patients With Cancer Admitted to an Intensive Care Unit in Chile: A Prospective Cohort Study
Authors: Panay Sergio , Ruiz Carolina , Abarca Marcelo , Nervi Bruno , Salazar Ignacio , Caro Paulo , Muñiz Sabrina , Briones Juan , Bruhn Alejandro , Mondaca Sebastian
Published: December 2018

Purpose

Increasing numbers of reports have shown acceptable short-term mortality of patients with cancer admitted into the intensive care unit (ICU). The aim of this study was to determine the mortality of critically ill patients with cancer admitted to the ICU in a general hospital in Chile.

Materials and Methods

This was a prospective cohort trial in which we included all patients with cancer admitted to the ICU between July 2015 and September 2016. Demographic, physiologic, and treatment data were registered, and survival at 30 days and 6 months was evaluated. A prespecified subgroup analysis considering the admission policy was performed. These subgroups were (1) ICU admission for full code management and (2) ICU trial (IT).

Results

During the study period, 109 patients with cancer were included. Seventy-nine patients were considered in the full code management group and 30 in the IT. The mean age of patients was 60 years (standard deviation [SD], 15), and 56% were male. Lymphoma was the most frequent malignancy (17%), and 59% had not received cancer treatment because of a recent diagnosis. The mean Acute Physiology and Chronic Health Evaluation and Sequential-Related Organ Failure Assessment scores were 22.2 (SD, 7.3) and 7 (SD, 3), respectively. There were no differences in vasopressor, fluid, or transfusion requirements between subgroups. Lactate levels, Sequential-Related Organ Failure Assessment scores (day 1, 3, and 5), complications, and ICU length of stay were similar. In the entire cohort, 30-day and 6-month mortality was 47% and 66%, respectively. There was no difference in mortality between subgroups according to the admission policy.

Conclusion

Patients admitted to the ICU in a developing country are at high risk for short-term mortality. However, there is a relevant subgroup that achieves 6-month survival, even among patients who undergo an IT.
Review of Haploidentical Hematopoietic Cell Transplantation
Authors: Khan Mehreen A. , Bashir Qaiser , Chaudhry Qamar-un-Nisa , Ahmed Parvez , Satti Tariq M. , Mahmood Syed K.
Published: December 2018

Use of haploidentical (haplo) donors for hematopoietic cell transplantation (HCT) has significantly increased in the last decade. The major advantage with this strategy is universal availability and faster acquisition of the donor, along with affordability and provision of immunotherapy in post-transplantation period. Historically, haplo-HCT was associated with compromised outcomes because of high rates of graft-versus-host disease and graft failure, but after the development of a post-transplantation high-dose cyclophosphamide strategy, which results in selective T-cell depletion, these issues have been addressed to a large extent. Nevertheless, graft failure, high treatment-related mortality due to graft-versus-host disease, infections, delayed immune reconstitution, and disease relapse remain significant concerns. As the experience with haplo-HCTs grows, the clinical outcomes are becoming more at par with those seen with fully matched unrelated donor allogeneic HCTs.
Improving Health and Cancer Services in Low-Resource Countries to Attain the Sustainable Development Goals Target 3.4 for Noncommunicable Diseases
Authors: Morgan Graeme W. , Foster Kirsty , Healy Brendan , Opie Craig , Huynh Vu
Published: December 2018

The United Nations Sustainable Development Goals 2015 to 2030 includes a specific goal for health (Sustainable Development Goal [SDG] 3) with 13 targets, including SDG3.4 for the control and treatment of noncommunicable diseases (NCDs), namely, cardiovascular diseases, cancer, diabetes, and chronic lung disease. There is considerable concern that SDG3.4 may not be achieved. The WHO Best Buys for NCDs has emphasized prevention, and although crucial, it alone will not achieve the 30% reduction in NCDs by 2030. Likewise, a strengthened health system is required as all NCDs are likely to require hospital facilities and community services for optimal management. This is a major problem for low-resource countries (LRCs) —that is, low-income countries and lower-middle-income countries—as most currently have a poorly developed health system, including cancer services, in need of upgrading. This is a result of the extreme poverty of LRCs, where 40% to 80% of the population live on less than USD $1.25 per day, with the average health spending by governments in low-income countries at $110 per person per year. In this article, we outline a comprehensive national cancer services plan for LRCs. Surgery, radiotherapy, and chemotherapy for cancer treatment also require input from other specialties, such as anesthesia, pathology, laboratory medicine, a blood bank, and diagnostic radiology. This will provide a focus for adding additional specialties, including cardiology, respiratory medicine, and psychiatry, to support the management of all NCDs and to contribute to the overall strengthening of the health system. The national cancer services plan for LRCs will require significant funding and input from both in-country and overseas experts in health, cancer, and finance working collaboratively. Success will depend on thoughtful strategic planning and providing the right balance of overseas support and guidance, but ensuring that there is in-country ownership and control of the program is essential.
Patient-Centered Medical Homes in Community Oncology Practices: Changes in Spending and Care Quality Associated With the COME HOME Experience
Authors: Waters Teresa M. , Kaplan Cameron M. , Graetz Ilana , Price Mary M. , Stevens Laura A. , McAneny Barbara L.
Published: December 2018

PURPOSE:

We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality.

PATIENTS AND METHODS:

We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for clinical and sociodemographic differences. Our primary outcome was 6-month medical spending per beneficiary. Secondary outcomes included 6-month out-of-pocket spending, inpatient and ambulatory care–sensitive hospitalizations, readmissions, length of stay, and emergency department and evaluation and management visits.

RESULTS:

Before COME HOME, 6-month medical spending was $2,975 higher for the study group compared with controls (95% CI, $1,635 to $4,315; P < .001) and increasing at a similar rate. After intervention, this difference was reduced to $318 (95% CI, −$1,105 to $1,741; P = .661), a significant change of −$2,657 (95% CI, −$4,631 to −$683; P = .008) or 8.1% savings relative to 6-month average spending ($32,866). COME HOME was also associated with significantly reduced (10.2 %) emergency department visits per 1,000 patients per 6-month period ( P = .024). There were no statistically significant differences in other outcomes.

CONCLUSION:

COME HOME was associated with reduced Medicare spending and improved emergency department use. The patient-centered medical home model holds promise for oncology practices, but improvements were not uniform.
Fibroblast growth factor-6 enhances CDK2 and MAKT expression in microvesicles derived from human stem cells extracted from exfoliated deciduous teeth
Authors: Othman Ahmed , Mubarak Rabab , Sameer Marwa , Sabry Dina
Published: December 2018

Background: Stem cells from human exfoliated deciduous teeth (SHEDs) are considered one of the most convenient sources of adult stem cells. This study aimed to examine the effect of fibroblast growth factor 6 (FGF-6) on SHEDs and evaluate CDK2 and MATK gene expression in SHED-derived microvesicles (MVs). SHEDs were cultured from deciduous teeth pulp.

Methods: SHEDs were divided into two groups: the control group and test groups, with and without FGF-6 supplementation, respectively. After the third passage, SHED proliferation was assessed by MTT assay. MVs were purified and CDK2 and MATK gene expression was assessed by real time polymerase chain reaction. SHEDs were identified by their positivity for CD90 and CD73, and negativity for CD45 and CD34.

Results: SHEDs proliferation in the test group was significantly higher than in the control group (P<0.001). mRNA from SHED-derived MVs from the test group exhibited a markedly elevated expression of CDK2 and MAKT, (P<0.002 and P<0.005, respectively) in comparison with those of the control group. FGF-6 enhanced the proliferation of SHEDs. Proliferation enhancement is favorable for the production of a large number of stem cells, which will then be beneficial for cell-based therapies.

Conclusions: CDK2 and MAKT genes in SHED-derived MVs can be used as molecular biomarkers for SHED proliferation.
Over the counter: The potential for easing pharmacy provision of family planning in Senegal
Authors: Peterson Jill , Brunie Aurelie , Diop Ibrahima , Diop Seynabou , Stanback John , Chin-Quee Dawn
Published: December 2018

Background:This research assessed the potential for expanding access to family planning through private sector pharmacies in Senegal, by examining the quality of the services provided through private sector pharmacies, and pharmacy staff and client interest in private sector pharmacy-based family planning services.

Methods:This was a cross-sectional, descriptive study conducted in eight urban districts in and around Dakar and two urban districts outside of Dakar employing an audit of 225 pharmacies, a survey with 486 private sector pharmacy staff and a survey with 3,567 women exiting private sector pharmacies.

Results:Most (54%) pharmacies reported offering method-specific counseling to clients. Family planning  commodities were available in all pharmacies, and 72% had a private space available to offer counseling. Three quarters (76%) did not have any counseling materials available.

49% of pharmacists and 47% of assistant pharmacists reported receiving training on family planning during their professional studies. Half had received counseling training. Few pharmacists met pre-determined criteria to be considered highly knowledgeable of the oral contraceptive pill (OCP) and injectable contraceptive provision (0.6% and 1.1%).

Overall, 60% of women surveyed were current family planning users and 11% procured their method through a private sector pharmacy. Among non-users of family planning, and current users who did not obtain their method through a pharmacy, 47% said they would be interested in procuring a method through a private sector pharmacy.

Conclusions:Senegal’s urban, private sector pharmacies are well-positioned to meet the increasing desire for modern contraception. With proper training, pharmacy staff could better provide effective counseling and provision of OCPs and injectables, and lifting the requirement for a prescription could help support gains in contraceptive prevalence.
The psychophysiological research using the polygraph in the framework of professional selection on the service of the interior ministry in the native language of the candidate
Authors: Скляренко Инна , SKLYARENKO INNA , Синчагова Валентина , Shinagawa Valentina
Published: December 2018

The article describes the specifics of the special psychophysiological researches with polygraph use, as part of the professional selection of candidates on service in bodies of internal Affairs, insufficient knowledge of the Russian language. The authors discuss the stages of conducting of a special psychophysiological researches with polygraph use by the professional selection of candidates. Each of the stages - preparatory, precipitately actually test, evaluate results, final interview is described taking into account the engagement with the applicant at the service of an interpreter. The article presents the technology of preparation for carrying out of psychophysiological research with two translators, including five blocks, reflects the functional role of the polygraph, the primary and secondary translators, and the sequence of their execution.

The authors draw attention to the fact that the involvement of two translators to the procedure of special psycho-physiological research enables to reveal risk factors of citizens of the Russian Federation, candidates for service in the police Department with insufficient level of knowledge of the Russian language.
Student corporatism: the test of strength
Authors: Терновая Людмила , Tyernovaya Lyudmila
Published: December 2018

The monograph analyzes the directions of development of student corporatism from the origin of the University system in Europe to the present day. The connection between the process of education in higher education and the activity of students, especially during the daily and festive life of students of higher educational institutions. Attention is paid to the variety of symbols of student corporations, as well as the image of higher education institutions and the contribution of students to its formation.
Wound care in older adults
Authors: Carlin Alexandra
Published: December 2018

Wound care in older adults is complex. A logical, structured approach should be taken, using a nursing process such as assessing, planning, implementing and evaluating. This clinical focus paper outlines the nursing process to support wound care in this patient group. It recommends considering dressing selection as a cost-effective, prescribing decision because of the risks and comorbidities associated with these patients.
Preparing to improve access for young people's mental healthcare
Authors: Crompton Heidi , Hardy Sheila
Published: December 2018

As half of all mental health problems manifest before the age of 14, access to treatment can seriously affect on long-term health outcomes. Heidi Crompton and Sheila Hardy describe how they prepared general practice staff to better manage young people's mental health

Background:

It is estimated that half of all mental health problems manifest before the age of 14, with 25% enduring mental health conditions up to the age of 24. However, less than 50% receive treatment at the time. The aim of this project was to prepare staff so that they could improve access to treatment for young people with mental health problems presenting in a general practice setting.

Method:

Staff at a practice in Dorset, UK, were given training to enable them to recognise when a young person may have a mental health problem and know what actions to take. A computer template was developed to assist them to carry out a safe, detailed assessment of a young person's mental health in a timely manner, and self-help materials were provided. Communication was set up with other organisations, such as Child and Adolescent Mental Health Services, school nursing, and counselling, to address the gap in services that patients experience.

Results:

Training was received positively. Staff demonstrated increased knowledge and confidence following the session and reported that they would use the template. Use of the template was checked and it had been used eight times in the 4 weeks following the training. A survey carried out 4 months after the training showed that staff thought they were more likely to ask a young person about their mental health and provide them with supportive materials.

Conclusion:

Staff at the practice felt prepared to manage young people's mental health. There is a need to measure the effect of the interventions on the young people with mental health problems using the service. The plan is to continue and expand the project.
Species Typing of Nontuberculous Mycobacteria by Use of Deoxyribozyme Sensors
Authors: Wood Hillary N , Sidders Ashelyn E , Brumsey Lauren E , Morozkin Evgeny S , Gerasimova Yulia V , Rohde Kyle H
Published: December 2018

BACKGROUND

Nontuberculous mycobacteria (NTM) species are a rising threat, especially to patients living with pulmonary comorbidities. Current point-of-care diagnostics fail to adequately identify and differentiate NTM species from Mycobacterium tuberculosis (Mtb). Definitive culture- and molecular-based testing can take weeks to months and requires sending samples out to specialized diagnostic laboratories.

METHODS

In this proof-of-concept study, we developed an assay based on PCR amplification of 16S ribosomal RNA (rRNA) rrs genes by using universal mycobacterial primers and interrogation of the amplified fragments with a panel of binary deoxyribozyme (BiDz) sensors to enable species-level identification of NTM (BiDz-NTMST). Each BiDz sensor consists of 2 subunits of an RNA-cleaving deoxyribozyme, which form an active deoxyribozyme catalytic core only in the presence of the complimentary target sequence. The target-activated BiDz catalyzes cleavage of a reporter substrate, thus triggering either fluorescent or colorimetric (visually observed) signal depending on the substrate used. The panel included BiDz sensors for differentiation of 6 clinically relevant NTM species (Mycobacterium abscessus, Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium fortuitum, Mycobacterium kansasii, and Mycobacterium gordonae) and Mtb.

RESULTS

Using the fluorescent BiDz-NTMST assay, we successfully identified the species of 38 clinical isolates. In addition, a subset of strains was tested with visual BiDz sensors, providing proof-of-concept for species typing of NTM by the naked eye.

CONCLUSIONS

The BiDz-NTMST assay is a novel platform for rapid identification of NTM species. This method is highly specific and significantly faster than current tools and is easily adaptable for onsite diagnostic laboratories in hospitals or clinical laboratories.
Concurrent Single-Cell RNA and Targeted DNA Sequencing on an Automated Platform for Comeasurement of Genomic and Transcriptomic Signatures
Authors: Kong Say Li , Li Huipeng , Tai Joyce A , Courtois Elise T , Poh Huay Mei , Lau Dawn Pingxi , Haw Yu Xuan , Iyer Narayanan Gopalakrishna , Tan Daniel Shao Weng , Prabhakar Shyam , Ruff Dave , Hillmer Axel M
Published: December 2018

BACKGROUND

The comeasurement of both genomic and transcriptomic signatures in single cells is of fundamental importance to accurately assess how the genetic information correlates with the transcriptomic phenotype. However, existing technologies have low throughput and laborious work flows.

METHODS

We developed a new method for concurrent sequencing of the transcriptome and targeted genomic regions (CORTAD-seq) within the same single cell on an automated microfluidic platform. The method was compatible with the downstream library preparation, allowing easy integration into existing next-generation sequencing work flows. We incorporated a single-cell bioinformatics pipeline for transcriptome and mutation analysis.

RESULTS

As proof of principle, we applied CORTAD-seq to lung cancer cell lines to dissect the cellular consequences of mutations that result in resistance to targeted therapy. We obtained a mean detection of 6000 expressed genes and an exonic rate of 50%. The targeted DNA-sequencing data achieved a 97.8% detection rate for mutations and allowed for the identification of copy number variations and haplotype construction. We detected expression signatures of tyrosine kinase inhibitor (TKI) resistance, epidermal growth factor receptor (EGFR) amplification, and expansion of the T790M mutation among resistant cells. We also identified characteristics for TKI resistance that were independent of EGFR T790M, indicating that other alterations are required for resistance in this context.

CONCLUSIONS

CORTAD-seq allows assessment of the interconnection between genetic and transcriptomic changes in single cells. It is operated on an automated, commercially available single-cell isolation platform, making its implementation straightforward.
PERAN SERTA MASYARAKAT DAN KEWENANGAN PEMERINTAH DALAM KONSERVASI MANGROVE SEBAGAI UPAYA MENCEGAH ROB DAN BANJIR SERTA SEBAGAI TEMPAT WISATA
Authors: Turisno Bambang Eko , Suharto R. , Priyono Ery Agus
Published: December 2018

Penelitian bertujuan menganalisis peran serta masyarakat dan kewenangan Pemerintah dalam konservasi mangrove sebagai upaya mencegah rob dan banjir  serta sebagai Tempat Wisata. Metode pendekatan yang digunakan adalah normatif, spesifikasi penelitian deskriptif analitis,  analisis menggunakan metode analisis kualitatif. Data-data yang dipergunakan adalah data sekunder, meliputi informasi tentang peran serta masyarakat,  kewenangan Pemerintah, wisata mangrove,  konservasi hutan serta bahan-bahan hukum maupun data  penunjang lainnya. Hutan mangrove dimanfaatkan sebagai budidaya, sebagai upaya mencegah banjir dan rob,  hutan mangrove juga sebagai tempat konservasi dan tempat wisata. Penanaman pohon mangrove sebagai rehabilitasi pantai dilakukan dengan langsung ditanam di tanah atau dengan teknik bronjong serta melibatkan masyarakat. Partisipasi masyarakat dalam pengelolaan ekosistem mangrove disamping agar terjaga konservasi mangrove juga akan meningkatan kesejahteraan masyarakat.  Kolaborasi antara sektor wisata, pemerintah daerah dan masyarakat dalam konservasi mangrove harus diintegrasikan. Kontribusi Penelitian sebagai masukan bagi pemerintah khususnya pemerintah daerah dan masyarakat  dalam memanfaatkan hutan mangrove dengan menjaga konservasinya.
Cell proliferation induced by modified cationic dextran
Authors: Kamiński Kamil , Stalińska Krystyna , Niziołek Anna , Wróbel Maria , Nowakowska Maria , Kaczor-Kamińska Marta
Published: December 2018

The interaction between oppositely charged membranes and polycations causes cell aggregation, loss of membrane fluidity, and membrane degeneration and may cause an increase of its permeability. Unfortunately, the interaction is the reason why the use of polycations in medicine is severely limited. Therefore, in this paper, we share our observations related to the action of 40-kDa dextran modified using glycidyltrimethylammonium chloride, resulting in increased fibroblast cell proliferation. Using viability and proliferation tests [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide, crystal violet, 3H-thymidine incorporation], we have observed that cationic dextran derivatives exert a positive impact on nonepithelial cell proliferation in vitro. This phenomenon has been noted for human and mouse fibroblasts and several other nonepithelial cell lines. However, the effect seems to be most pronounced for fibroblast cell lines. The presented studies allow to examine the impact of the polymer structure and the methods of its cationic modification on this newly observed phenomenon. The observation is unique because positively charged macromolecules usually exhibit high toxicity in all cell types in vitro.
Thirty-minutes’ exposure to smartphone call triggers neutrophil activation in vitro
Authors: Lippi Giuseppe , Danese Elisa , Brocco Giorgio , Benati Marco , Salvagno Gian Luca , Montagnana Martina , Franchini Massimo
Published: December 2018

Background:

Despite accumulating evidence about the negative health effects of exposure to electromagnetic fields emitted by mobile phones, no information is available on the potential impact of radiofrequency (RF) waves on polymorphonuclear leukocytes biology.

Methods:

Two sequential whole blood tubes were collected from 16 ostensibly healthy volunteers. After placing the former tube of each subject in a plastic rack, 1 cm from a commercial smartphone (carrier frequency, 900 MHz), a call was placed on the smartphone and a communication lasting 30 min was manually activated. The latter blood tube of each volunteer was placed in another plastic rack, for an identical period of time, avoiding close contact with sources of RF waves. A complete blood count was then assessed in all whole blood samples, using Advia 2120.

Results:

The 30-min exposure of blood to RF waves did not induce significant variations of total and differential leukocyte counts. A significant decrease was however observed for many neutrophils parameters, with median percentage variation of −3.9% for the lobularity index (LI), −29.8% for the myeloperoxidase index (MPXI), −0.6% for the neutrophil cluster mean x (NEUTx) and −0.7% for the neutrophil cluster mean y (NEUTy), respectively. The percentage of blood samples with reduced values after exposure to RF waves was 81% for LI, 88% for NEUTx and 100% for both MPXI and NEUTy.

Conclusions:

The results of this study show that exposure to smartphone RF waves triggers activation of neutrophils in vitro, as mirrored by the significant variations observed in many activation parameters in Advia 2120.