bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-progressive collapse behavior of beam-to-column assemblies with bolted-angle connections under different span ratios
Authors: Meng Bao , Zhong Weihui , Hao Jiping
Published: October 2017

This article discusses the anti-progressive collapse performance of three specimens, with top-seat angles with double web-angle connections, under different span ratios. Double full-span assemblies extracted from steel frames with a typical column-removal scenario were designed and applied in a monotonic static loading experiment. The failure modes/sequences, strain, internal force conditions, and the transformed law of the resistance mechanism are examined. The results obtained show that specimens with equal spans can provide greater resistance due to full development of flexural and catenary actions. For specimens with unequal spans, the catenary resistance from the short beam portion is larger than that from the long beam portion, and the asymmetry of the span is not beneficial to the structure’s bearing capacity in preventing progressive collapse. The three specimens’ dynamic increase factors are also discussed in terms of the energy balance principle and their development trend for nonlinear static analysis related to catenary action.
Seismic retrofit analysis of concrete coupled shear wall structures with laterally restrained steel plate coupling beams
Authors: Cheng Bei , Yang Cantian , Su Ray KL
Published: October 2017

Many existing deep reinforced concrete coupling beams that have low span-to-depth ratios are not desirable for seismic design due to their potential brittle failure with limited ductility and deformability. Previous experimental and numerical studies have demonstrated that the laterally restrained steel plate retrofitting method could effectively enhance the seismic performance of deep coupling beams. This article aims to develop a nonlinear finite element model based on the OpenSees software to accurately predict the behavior of coupled shear walls with or without laterally restrained steel plate coupling beams. The numerical results reveal that the seismic performance of the laterally restrained steel plate retrofitted coupled shear walls can be significantly enhanced. Furthermore, a genetic algorithm is adopted to determine the optimal positions of laterally restrained steel plate coupling beams. It is found that desirable seismic performance can be achieved by retrofitting coupling beams in the middle and higher floors of a building with coupled shear walls. However, only retrofitting coupling beams on the lower floors should be avoided because this could result in the serious degradation of the lateral load-carrying capacity and stiffness of the coupled shear walls.
Optimal transverse position for overweight trucks to cross simply supported multi-girder bridges
Authors: Yan Junyuan , Deng Lu , He Xuhui
Published: October 2017

Recent years has witnessed a steady increase in the issued overweight vehicle permits. Damage and deterioration of bridges caused by overweight vehicles have received increasing attention. Most previous studies on overweight vehicles have focused on the routing and weight regulation of overweight trucks while little attention has been paid to the determination of the optimal transverse position for overweight trucks to cross highway bridges. This article aims to investigate the optimal transverse position for overweight trucks to cross the simply supported multi-girder bridges and provide suggestions for the management of overweight vehicles. Finite element analysis is performed for a group of prefabricated concrete bridges commonly used in China under the action of overweight trucks with varying transverse positions, and the optimal transverse position is determined based on the maximum bending stress of the girders. The effects of a few important factors, including the superstructure configuration, length of bridge spans, number of girders, type of girder connections, and support conditions, on the optimal transverse truck position are also investigated. The findings in this article highlight the importance of the transverse position of overweight trucks when crossing multi-girder bridges.
Nonlinear analysis of reinforced concrete plane frames exposed to fire using direct stiffness method
Authors: Prakash P Ravi , Srivastava Gaurav
Published: October 2017

This article presents a framework based on the direct stiffness method for nonlinear thermo-mechanical analysis of reinforced concrete plane frames subjected to fire. It accounts for geometric nonlinearity, material nonlinearity, and nonlinear thermal gradients and incorporates two-way coupling between thermal and structural analyses. Force deformation relations are derived from classical Euler–Bernoulli beam theory and are expressed in terms of temperature-dependent stability and bowing functions. This is one of the unique features of proposed framework and allows a coarser spatial discretization to be used as opposed to full finite element–based approaches (such as SAFIR [registered trademark of the software SAFIR developed at the University of Liege]). The cross sections of the structural members are discretized with two-dimensional meshes for thermal analysis while structural analysis utilizes a line element based on direct stiffness method. Equivalent bending and axial rigidities of this line element are computed using several fibers along the length of the member, passing through the nodes of the two-dimensional mesh used for thermal analysis. The total strain at each fiber is decomposed into mechanical, thermal, creep, and transient thermal components. A discrete damage parameter is introduced at fiber level to ensure irreversibility of crushing and cracking in accordance with relevant constitutive laws. Five numerical examples are presented to demonstrate the accuracy and efficacy of the developed framework with respect to theoretical solutions, experimental observations, and some of the existing macro- and micro-finite element–based approaches. It is found that the developed framework can predict the response of reinforced concrete structures very well.
Elucidation of the role of rotation speed and stirring direction on AA 7075-B4C surface composites formulated by friction stir processing
Authors: Rana Harikrishna , Badheka Vishvesh
Published: October 2017

In the present research investigation, aluminum–boron carbide surface composites were fabricated using friction stir processing technique. Boron carbide powder particles were incorporated into AA 7075 substrate by the thermomechanical mixing generated through multiple passes of friction stir processing. A parametric investigation was conducted to encounter homogeneous boron carbide powder particles distribution in the substrate matrix by employing various parameter combination sets like tool rotational speed and alteration in tool travel direction. Microstructural characterizations were performed by means of optical microscopy, scanning electron microscopy and X-ray diffraction analysis to investigate on boron carbide powder particles distribution, phases present, and grain morphologies in the substrate matrix. Homogeneous distribution of boron carbide powder particles was observed for surface composites processed at lowest tool rotational speed. Uniform boron carbide powder particles distribution in the processed zone along with various strengthening mechanisms brought about two-fold increase in microhardness and wear resistance of the prepared composites.
Decreased class size, increased active learning? Intended and enacted teaching strategies in smaller classes
Authors: Wright Mary C , Bergom Inger , Bartholomew Tracy
Published: October 2017

Small class size is often used as an indicator of quality in higher education, and some research suggests that instructors in smaller classes more often use activities that are learner-centered and that involve physical and mental activity on the part of learners, such as group work, simulations, and case studies. However, we have little information on how instructors change their pedagogical practice when they teach in large- versus small-class settings. In this study, we examine alignment between intended and enacted teaching strategies, or initial plans and specific ways in which instructors reported altering their teaching in the context of a university policy shift to smaller classes. Furthermore, we examine instructional challenges in this shift to call attention to professional development needs of small-class teaching and to best leverage the benefits of such activities for student performance and retention.
Dividing the indivisible
Authors: Wintein Stefan , Heilmann Conrad
Published: October 2017

Philosophical theories of fairness propose to divide a good that several individuals have a claim to in proportion to the strength of their respective claims. We suggest that currently, these theories face a dilemma when dealing with a good that is indivisible. On the one hand, theories of fairness that use weighted lotteries are either of limited applicability or fall prey to an objection by Brad Hooker. On the other hand, accounts that do without weighted lotteries fall prey to three fairness paradoxes. We demonstrate that division methods from apportionment theory, which has hitherto been ignored by philosophical theories of fairness, can be used to provide fair division for indivisible goods without weighted lotteries and without fairness paradoxes.
National Bodies: Political Ontology, Cultural Citizenship, and Migrant Rugby
Authors: McLeod Christopher Michael
Published: October 2017

Athletes, their bodies, and their sport performances validate and vivify the nation by lending physical form to an imagined community. For bodies to express and enact so consistently as to constitute a coherent nation, they must be assembled, defined, and motivated within a complex arrangement of culture, civil society, and institutions. Aihwa Ong called this arranging of people with national objectives cultural citizenship. In this article, I write autoethnographic vignettes of my experiences as a migrant and rugby player from Aotearoa/New Zealand playing in the U.S. South, which I use to demonstrate and add to Ong’s theories on embodiment, cultural citizenship, and the nation. I argue that a nation is an unlikely achievement dependent on its members; members, such as athletes, enact their nation in by augmenting its affects, most notably by making the nation capable of having a physical encounter. I recommend qualitative scholars and sport sociologists study instances where athletes and other members fail to embody the nation, because this is where scholars can best observe and study the contingency of nations.
The Efficacy and Safety of Transcutaneous Acupoint Interferential Current Stimulation for Cancer Pain Patients With Opioid-Induced Constipation: A Prospective Randomized Controlled Study
Authors: Zhu Hua-dong , Gong Zhen , Hu Bing-wei , Wei Qiao-ling , Kong Jun , Peng Cong-bin
Published: October 2017

Introduction. Opioid-induced constipation (OIC) is a principal complication secondary to analgesic therapy for cancer pain patients who suffer moderate to severe pain. In this study, we observe the efficacy and safety of transcutaneous acupoint interferential current (IFC) stimulation in those patients with OIC. Methods. A total of 198 patients were randomly allocated to the IFC group and control group in a 1:1 ratio. Finally, 98 patients in the IFC group received 14 sessions administered over 2 weeks, whereas 100 patients in the control group took lactulose orally during the same period. Observation items were documented at management stage and at follow-up stage according to Cleveland Constipation Scales (CCS), pain Numeric Rating Scales (NRS) and Patient Assessment of Constipation Quality of Life (PAC-QoL). Results. The total curative effects of the IFC group and the control group were indistinguishable (76.5% vs 70.0%, P = .299). Regarding CCS and PAC-QoL scores, no significant difference was observed between the 2 groups during the management time and at the follow-up stage of week 3 ( P > .05, respectively), but groups were distinguished at the follow-up stage of week 4 ( P < .001 and P = .031, respectively). The pain NRS decreased significantly at management stage week 2 and follow-up stage week 3 and week 4 ( P = .013, P = .041, P = .011, respectively). Conclusions. Transcutaneous acupoint IFC therapy over acupoints of Tianshu (ST25) and Zhongwan (RN12) may improve constipation and quality of life in cancer patients receiving opiates; further studies are worthwhile.
Erectile Dysfunction in Young Myocardial Infarction Survivors: Evaluation, Follow Up
Authors: Dostálová Gabriela , Hlubocká Zuzana , Bayerová Kristýna , Bělohlávek Jan , Linhart Aleš , Karetová Debora
Published: October 2017

Erectile dysfunction significantly affects quality of life in young men. Authors have evaluated erectile function in men with coronary artery disease (CAD) and the relationship between the degree of erectile dysfunction (ED) and the age of their first acute myocardial infarction (AMI). The incidence of erectile dysfunction in three groups of patients of AMI survivors was investigated: AMI survivors younger than 45 years, AMI survivors older than 65 years, and normal male population aged between 30 and 60 years. Erectile function was assessed by the International Index of Erectile Function (IIEF-5) questionnaire. In post-AMI male patients younger than 45 years ( n = 76), mild ED occurred in 26% and severe in 7%. In the older AMI group, mild ED occurred in 52% and severe in 38%. In the control group age matched to younger survivors, 96% denied ED and only one control patient had a score of 20 on the IIEF-5. A paradoxical result was observed in patients using beta blockers (BB), who had better scores than the group without BB. Statin treatment had a positive influence on the score in questionnaires. Those on statins had an average score of 21.0 ± 4.9 vs. without statin 17.7 ± 5.7, p = .03. The current findings identified that the prevalence of ED is relatively high in young patients with CAD and is related to treatment of the CAD. The overall increase in ED presence suggests that the background of their coronary event is not due to destabilization of single focused atheroma but may reflect a generalized atherosclerotic process.
Internal Fixation of Displaced Intra-articular Fractures of the Hallux Through a Dorsomedial Approach: A Technical Tip
Authors: Nishikawa Danilo Ryuko Cândido , Duarte Fernando Aires , de Cesar Netto Cesar , Monteiro Augusto César , Albino Rômulo Ballarin , Fonseca Fabio Corrêa Paiva
Published: October 2017

Phalangeal fractures of the toes represent common injuries of the forefoot. In the hallux, most fractures occur at the distal phalanx and frequently result from a direct crushing type of injury. Intra-articular fractures of the hallux are usually treated nonoperatively, except when the fragments are displaced and the joint is incongruent. Displaced fractures treated nonoperatively can result in degenerative arthritis of the interphalangeal joint, causing pain and range of motion limitation, hindering gait and weightbearing. The aim of this study was to present an option of operative approach in the treatment of displaced interphalangeal joint fractures of the hallux, along the medial border of the extensor hallucis longus tendon. It is our understanding that this approach minimizes injury to the soft tissue envelope, allowing a rigid fixation and early weightbearing and range of motion.

Levels of Evidence: Level V: Expert opinion
Perceptions of foreign aid project quality in Bangladesh
Authors: Winters Matthew S. , Dietrich Simone , Mahmud Minhaj
Published: October 2017

How does information about the presence of foreign financing in a development project change people’s perceptions of that project? Using an informational experiment in Bangladesh, we find that information about US financing of a specific development intervention sends a positive signal about project quality; this effect is concentrated among individuals who are the least likely to have been exposed to the information ex ante. The information does not change the already high demand for foreign aid but does help citizens target their demands toward the existing donor. That foreign funding can be a signal of project quality helps explain an existing finding in the literature that individuals prefer foreign aid projects to government projects.
A prospective study comparing whole-body skeletal X-ray survey with 18F-FDG-PET/CT, 18F-NaF-PET/CT and whole-body MRI in the detection of bone lesions in multiple myeloma patients
Authors: Dyrberg Eva , Hendel Helle W. , Al-Farra Gina , Balding Lone , Løgager Vibeke B. , Madsen Claus , Thomsen Henrik S.
Published: October 2017

Background

For decades, the most widely used imaging technique for myeloma bone lesions has been a whole-body skeletal X-ray survey (WBXR), but newer promising imaging techniques are evolving.

Purpose

To compare WBXR with the advanced imaging techniques 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 18F-sodium fluoride (NaF) PET/CT and whole-body magnetic resonance imaging (WB-MRI) in the detection of myeloma bone lesions.

Material and Methods

Fourteen patients with newly diagnosed multiple myeloma were prospectively enrolled. In addition to WBXR, all patients underwent FDG-PET/CT, NaF-PET/CT, and WB-MRI. Experienced specialists performed blinded readings based on predefined anatomical regions and diagnostic criteria.

Results

In a region-based analysis, a two-sided ANOVA test showed that the extent of detected skeletal disease depends on the scanning technique ( P < 0.0001). Tukey’s multiple comparison test revealed that WB-MRI on average detects significantly more affected regions than WBXR ( P < 0.005), FDG-PET/CT ( P < 0.0001), and NaF-PET/CT ( P < 0.05). In a patient-based analysis, a Cochran’s Q test showed that there are no significant differences in the proportion of patients with bone disease detected by the different scanning techniques ( P = 0.23). Determination of intrareader variability resulted in Kappa coefficients corresponding to moderate (FDG-PET/CT) and substantial agreement (WB-MRI, WBXR, NaF-PET/CT).

Conclusion

WB-MRI detects on average significantly more body regions indicative of myeloma bone disease compared to WBXR, FDG-PET/CT, and NaF-PET/CT. The lack of significance in the patient-based analysis is most likely due to the small number of study participants.
Enhancing Reappraisal by Linking Cognitive Control and Emotion
Authors: Cohen Noga , Mor Nilly
Published: October 2017

In the current study we explored whether training individuals to recruit cognitive control prior to exposure to negative pictures can facilitate the propensity to use reappraisal and reappraisal success. Participants were randomly assigned to one of two groups. In the training group, negative pictures were typically preceded by a stimulus that recruits cognitive control, whereas in the control group, negative pictures were typically preceded by a stimulus that does not recruit cognitive control. Participants were subsequently asked to reflect on a negative personal event and to later reappraise the event. As predicted, compared to participants in the control group, those in the training group were more likely to use reappraisal spontaneously, and when instructed to reappraise, were more successful in doing so. We argue that the ability to employ cognitive control has a causal role in reappraisal use and success.
Desistance and Severity of Alcohol Use Disorder: A Lifespan-Developmental Investigation
Authors: Lee Matthew R. , Boness Cassandra L. , McDowell Yoanna E. , Vergés Alvaro , Steinley Douglas L. , Sher Kenneth J.
Published: October 2017

Key to an understanding of alcohol use disorder (AUD) are the drinking-related reductions that begin in young adulthood and continue throughout the adult lifespan. Research is needed to precisely characterize the form of these reductions, including possible developmental differences across the lifespan. Using U.S.-representative data, we estimated multiple-group Markov models characterizing longitudinal transitions among five drinking statuses and differences in transition patterns across six adult age periods. While past research indicates relative developmental stability in overall AUD-desistance rates, we found far higher rates of Severe AUD desistance in young adulthood relative to later ages. Especially considering the dramatic change reflected by Severe AUD desistance (from 6+ symptoms to 0–1 symptoms), this result indicates a substantial developmental shift, with Severe AUD desistance rates peaking at 43% to 50% across ages 25 to 34 and then dropping to 22% to 24% across ages 35 to 55. We discuss implications regarding practical significance of young-adult “maturing out” and predictions regarding lifespan variability in desistance mechanisms.
Early HIV Diagnosis Leads to Significantly Decreased Costs in the First 2 Years of HIV Care in an Urban Charity Hospital in New Orleans
Authors: Halperin Jason , Katz Morgan , Pathmanathan Ishani , Myers Leann , Van Sickels Nicholas , Seal Paula Sereebutra , Richey Lauren E.
Published: October 2017

We undertook a retrospective cohort study of patients with a positive HIV test in the emergency department who were then linked to care. Inpatient, outpatient, and emergency costs were collected for the first 2 years after HIV diagnosis. Fifty-six patients met the inclusion criteria; they were predominantly uninsured (73%) and African American (89%). The median total cost for a newly diagnosed patient over the first 2 years was US$36 808, driven predominantly by outpatient costs of US$17 512. Median inpatient and total costs were significantly different between the lowest (<200 cells/mm3) and highest (>499 cells/mm3) CD4 count categories (US$21 878 vs US$6607, P <.05; US$61 378 vs US$18 837, P <.05, respectively). Total costs were significantly different between viral load categories <100 000 HIV-RNA copies/mL and ≥100 000 HIV-RNA copies/mL (US$28 219 vs US$49 482, P <.05). Costs were significantly lower among patients diagnosed earlier in their disease. Decreased cost is another factor supporting early diagnosis and linkage to care for patients with HIV.
Clinical Outcomes of Hip Arthroscopic Surgery in Patients With Femoral Retroversion: A Matched Study to Patients With Normal Femoral Anteversion
Authors: Hartigan David E. , Perets Itay , Walsh John P. , Chaharbakhshi Edwin O. , Yuen Leslie C. , Domb Benjamin G.
Published: October 2017

Background:

Femoral retroversion has been noted as a possible risk factor for poor clinical results after hip arthroscopic surgery.

Purpose:

To compare the outcomes of the arthroscopic treatment of hip abnormalities in patients with femoral retroversion to patients with femoral anteversion between 10° and 20°.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Between November 2011 and September 2013, 790 hip arthroscopic procedures were performed at a single institution. Of these, 59 hips (7.5%) were located in patients with femoral version ≤0°, calculated using preoperative magnetic resonance imaging. These patients were pair matched, based on body mass index ±5 kg/m2, age ±5 years, and Tönnis grade, with 59 patients with femoral anteversion between 10° and 20°. Exclusion criteria included Perthes disease, inflammatory arthritis, slipped capital femoral epiphysis, previous hip surgery, abductor repair, lateral center-edge angle <20°, Tönnis grade >1, and acetabular profunda or protrusio. Patient-reported outcomes (PROs) were recorded preoperatively, at 3 months postoperatively, and annually thereafter. The PROs utilized were the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS). The visual analog scale (VAS) was collected to assess the patients’ pain; patient satisfaction scores (0-10) were also collected. Radiographs were collected at the above time intervals as well.

Results:

Two patients from the control group and 1 patient from the retroverted group required total hip arthroplasty at a mean 19.5 and 26.3 months, respectively. Both groups demonstrated significant improvement from their preoperative state in all PRO and VAS scores ( P < .001). No differences in preoperative, postoperative, or change in PRO and VAS scores between the groups were noted.

Conclusion:

Patients with femoral retroversion reported similar outcomes compared to patients with normal femoral version when undergoing hip arthroscopic surgery. Both groups had similar improvements from the preoperative state.
Bedtime Use of Technology and Associated Sleep Problems in Children
Authors: Fuller Caitlyn , Lehman Eric , Hicks Steven , Novick Marsha B.
Published: October 2017

Children comprise one of the largest consumer groups of technology. Sleep is fundamental to optimal functioning during childhood, including health and behavior. The purpose of this study was to explore bedtime electronic use and its impact on 3 health consequences—sleep quantity and quality, inattention, and body mass index. Parents of 234 children, ages 8 to 17 years, were surveyed to quantify hours of technology use (computer, video games, cell phone, and television), hours of sleep, and inattentive behaviors. Using any device at bedtime was associated with a statically significant increased use of multiple forms of technology at bedtime and use in the middle of the night, reducing sleep quantity and quality. Little association was found between technology use and inattention. A statistically significant association was found between bedtime technology use and elevated body mass index. Clinicians should discuss the impact of technology at bedtime to prevent harmful effects of overexposure.
RV568, a narrow-spectrum kinase inhibitor with p38 MAPK-α and -γ selectivity, suppresses COPD inflammation
Authors: Charron Catherine E. , Russell Paul , Ito Kazuhiro , Lea Simon , Kizawa Yasuo , Brindley Charlie , Singh Dave
Published: October 2017

Novel anti-inflammatory approaches targeting chronically activated kinase pathways in chronic obstructive pulmonary disease (COPD) are needed. We evaluated RV568, a p38 mitogen-activated protein kinase-α and -γ and SRC family kinase inhibitor, in cellular andin vivomodels relevant to COPD and examined its safety and efficacy in COPD patients.

The anti-inflammatory activities of RV568 were tested in primary cultured monocytes, macrophages and bronchial epithelial cells andin vivoin lipopolysaccharide and cigarette smoke-exposed murine models. RV568 was evaluated in a 14-day trial in COPD patients.

RV568 showed potent anti-inflammatory effects in monocytes and macrophages, which were often greater than those of corticosteroids or the p38 inhibitor Birb796. RV568 combined with corticosteroid had anti-inflammatory effects suggestive of a synergistic interaction in poly I:C-stimulated BEAS-2B cells and in the cigarette smoke model. In COPD patients, inhaled RV568 (50 µg and 100 µg) improved pre-bronchodilator forced expiratory volume in 1 s (69 mL and 48 mL respectively) and significantly reduced sputum malondialdehyde (p<0.05) compared to placebo, although there were no changes in sputum cell counts. Adverse events during RV568 and placebo treatment were similar.

RV568 shows potent anti-inflammatory effects on cell and animal models relevant to COPD. RV568 was well-tolerated and demonstrated a modest clinical benefit in a 14-day COPD clinical trial.
Association between lung cancer somatic mutations and occupational exposure in never-smokers
Authors: Paris Christophe , Do Pascal , Mastroianni Bénédicte , Dixmier Adrien , Dumont Patrick , Pichon Eric , Chouaid Christos , Coudert Bruno , Foucher Pascal , Fraboulet Séverine , Locatelli-Sanchez Myriam , Baize Nathalie , Dansin Eric , Moreau Lionel , Vincent Michel , Missy Pascale , Morin Franck , Moro-Sibilot Denis , Couraud Sébastien
Published: October 2017

Occupational exposure constitutes a common risk factor for lung cancer. We observed molecular alterations in 73% of never-smokers, 35% of men and 8% of women were exposed to at least one occupational carcinogen. We report herein associations between molecular patterns and occupational exposure.

BioCAST was a cohort study of lung cancer in never-smokers that reported risk factor exposure and molecular patterns. Occupational exposure was assessedviaa validated 71-item questionnaire. Patients were categorised into groups that were unexposed and exposed to polycyclic aromatic hydrocarbons (PAH), asbestos, silica, diesel exhaust fumes (DEF), chrome and paints. Test results were recorded forEGFR, KRAS, HER2, BRAFandPIK3mutations, andALKalterations.

Overall, 313 out of 384 patients included in BioCAST were analysed. Asbestos-exposed patients displayed a significantly lower rate ofEGFRmutations (20%versus44%, p=0.033), and a higher rate ofHER2mutations (18%versus4%, p=0.084).ALKalterations were not associated with any occupational carcinogens. The DEF-exposed patients were diagnosed with aBRAFmutation in 25% of all cases. Chrome-exposed patients exhibited enhancedHER2andPIK3mutation frequency.

Given its minimal effects in the subgroups, we conclude that occupational exposure slightly affects the molecular pattern of lung cancers in never-smokers. In particular, asbestos-exposed patients have a lower chance ofEGFRmutations.
A review of Jonathan J. Webster and Xuanwei Peng (eds.), Applying Systemic Functional Linguistics: the state of the art in China today. London & New York: Bloomsbury Academic, 2017
Authors: Lu Jian
Published: October 2017

The present paper is to review Applying Systemic Functional Linguistics: the state of the art in China today, a volume to highlight the contribution of Chinese scholars to the development of systemic functional linguistics.
The Effect of Adding Subarachnoid Epinephrine to Hyperbaric Bupivacaine and Morphine for Repeat Cesarean Delivery: A Double-Blind Prospective Randomized Control Trial
Authors: Katz Daniel , Hamburger Joshua , Gutman David , Wang Ryan , Lin Hung-Mo , Marotta Michael , Zahn Jeffrey , Beilin Yaakov
Published: October 2017

BACKGROUND:

Spinal anesthesia has become the most common type of anesthetic for cesarean delivery. The major limitation to spinal anesthesia is that the duration of the anesthetic may not be adequate in the event of a prolonged surgery. Some practitioners add epinephrine to hyperbaric bupivacaine to increase the duration, although its effect has not been fully studied. We therefore aimed to evaluate whether adding epinephrine to the spinal medication prolongs the duration of action of the resultant block in women presenting for repeat cesarean delivery.

METHODS:

Sixty-eight patients were randomized to receive no epinephrine (NE group), epinephrine 100 µg (low-dose [LD] group), or epinephrine 200 µg (high-dose [HD] group) with a standardized spinal mixture (1.5 mL 0.75% hyperbaric bupivacaine with 0.25 mg morphine). Sixty-five patients were included for primary analysis. Our primary outcome was time to intraoperative activation of the epidural catheter or postoperative regression of sensory blockade to T-10 dermatome level as measured by pinprick sensation; motor recovery was a secondary outcome, and graded via a Modified Bromage scale.

RESULTS:

Block onset time, vital sign changes, and the incidence of hypotension; nausea, and vomiting were similar among groups. Median difference in time to T-10 regression was greatest in the HD group compared to the NE group (median difference [min] [95% confidence interval]: 40 [15–60]; P = .007), followed by the HD group to the LD group (30 [15–45]; P = .007). Comparisons of LD to NE were not significant, but trended to an increase in T-10 regression time (10 [−15 to 30]; P = .76). Median difference in time to knee extension (Bromage 3) was also greatest in the HD group when compared to both the LD and NE group (median difference [min] [95% confidence interval]: 30 [0–60]; P = .034, 60 [0–93]; P = .007). Median difference time to knee extension (min) between the LD and NE group was also significant (37.5 [15–60]; P = .001]. Pain scores during the procedure were higher in the NE group (median [interquartile range] HD: 0 [0–0], LD: 0 [0–0], NE: 0 [0–3]; P = .02) during uterine closure and were otherwise not significantly different from the other groups.

CONCLUSIONS:

In this single center, prospective, double-blind, randomized control trial, the addition of epinephrine 200 µg to hyperbaric bupivacaine and preservative-free morphine for repeat cesarean delivery prolonged the duration of the sensory blockade. Motor blockade was similarly prolonged and block quality may have been enhanced.
Anesthetic Management of a Patient With De Novo Hereditary Sensory and Autonomic Neuropathy, Type VII: A Case Report
Authors: Rafer Lorenzo , Mooney James
Published: October 2017

An 18-month-old patient with hereditary sensory and autonomic neuropathy, type VII undergoing general anesthesia for Nissen fundoplication and gastrostomy tube is presented. This is the first reported case of a patient with this particular genetic mutation receiving general anesthesia. We presented the major intraoperative events during the procedure. The anesthetic considerations and implications of caring for a patient with this particular mutation and patients with other variations of hereditary sensory and autonomic neuropathy are also discussed. We show that a patient with de novo hereditary sensory and autonomic neuropathy, type VII without anhidrosis did not require intraoperative narcotics and did not experience bradycardia, asystole, or hemodynamic compromise.
Direct Ultrasound of the Pulmonary Artery Helps Diagnose a Rare Cause of Right Ventricular Failure After Heart Transplantation: A Case Report
Authors: McNeil John S. , Pham Si M. , Huffmyer Julie L.
Published: October 2017

Pulmonary artery anastomosis stenosis is a rare cause of right ventricular failure after orthotopic heart transplantation. In this case report, direct ultrasound of the pulmonary artery helped diagnose stenosis at a location not visible on transesophageal echocardiography or even with standard epicardial ultrasound views. It is important to evaluate all vascular anastomoses after heart or lung transplantation because surgical revision of these lesions is facile, but if left undiagnosed, significant morbidity or mortality is likely.
Predicting poor outcome from simple ankle injuries: a prospective cohort study
Authors: Bullock Stuart A , Allen Georgina M , Watson Marion S , Wilson David J
Published: October 2017

Background:

Sprained ankles are common and when there are no signs or evidence of a fracture, conventional management is conservative. At present, there are no clinical markers to identify those that may develop persisting instability and disability that would require rehabilitation or surgery.

Objectives:

To investigate the nature and extent of soft tissue ankle injuries, and to consider whether the anatomical severity of injury can predict functional outcome.

Methods:

Patients attending a local Accident and Emergency Department in Oxford with an acute ankle injury with no clinical requirement for radiographs, or where radiographs were normal, were invited into the study. Within 5 days, patients underwent a diagnostic ultrasound examination, a cone beam CT study and a disability assessment. Ultrasound and physiotherapy assessments were repeated at 3 and 6 months.

Results:

100 patients were recruited and grouped based upon injuries. 58 had simple ankle injuries, 21 complex, 19 had significant fractures and 2 were excluded from further follow up analysis. There were no clinically significant differences in pain, disability or functional outcomes between the groups at all points of the study.

Conclusion:

Medium to long term clinical outcomes were not solely determined by the severity of injury. Some patients with simple injuries were seen to have ongoing problems, whereas some with complex injuries recovered completely in a shorter period.

Advances in knowledge:

The severity of an ankle injury determined by radiological imaging does not necessarily dictate the severity of a patient’s symptoms and the trajectory of their recovery.
Contrast enhancement in abdominal computed tomography: influence of photon energy of different scanners
Authors: Taguchi Narumi , Oda Seitaro , Nakaura Takeshi , Utsunomiya Daisuke , Funama Yoshinori , Imuta Masanori , Yuki Hideaki , Nagayama Yasunori , Kidoh Masafumi , Hirata Kenichiro , Iyama Yuji , Namimoto Tomohiro , Kai Noriyuki , Hatemura Masahiro , Yamashita Yasuyuki
Published: October 2017

Objective:

Different CT scanners have different X-ray spectra and photon energies indicating that contrast enhancement vary among scanners. However, this issue has not been fully validated; therefore, we performed phantom and clinical studies to assess this difference.

Methods:

Two scanners were used: scanner-A and scanner-B. In the phantom study, we compared the contrast enhancement between the scanners at tube voltage peaks of 80, 100 and 120 kVp. Then, we calculated the effective energies of the two CT scanners. In the clinical study, 40 patients underwent abdominal scanning with scanner-A and another 40 patients with scanner-B, with each group using the same scanning protocol. The contrast enhancement of abdominal organs was assessed quantitatively (based on the absolute difference between the attenuation of unenhanced scans and contrast-enhanced scans) and qualitatively. A two-tailed independent Student's t-test and or the Mann–Whitney U test were used to compare the discrepancies.

Results:

In the phantom study, contrast enhancement for scanner-B was 36.9, 32.6 and 30.8% higher than that for scanner-A at 80, 100 and 120 kVp, respectively. The effective energies were higher for scanner-A than for scanner-B. In the quantitative analysis for the clinical study, scanner-B yielded significantly better contrast enhancement of the hepatic parenchyma, pancreas, kidney, portal vein and inferior vena cava compared with that of scanner-A. The mean visual scores for contrast enhancement were also significantly higher on images obtained by scanner-B than those by scanner-A.

Conclusion:

There were significant differences in contrast enhancement of the abdominal organs between the compared CT scanners from two different vendors even at the same scanning and contrast parameters.

Advances in knowledge:

Awareness of the impact of different X-ray energies on the resultant attenuation of contrast material is important when interpreting clinical CT images.
Recent insights into PERK-dependent signaling from the stressed endoplasmic reticulum
Authors: McQuiston Alexander , Diehl J Alan
Published: October 2017

The unfolded protein response (UPR) is an evolutionarily conserved stress response to intra- and extracellular conditions that disrupt endoplasmic reticulum (ER) protein-folding capacity. The UPR is engaged by a variety of disease conditions, including most cancers as well as both metabolic and neurodegenerative disorders. Three transmembrane transducers—PERK, IRE1, and ATF6—are responsible for activating downstream signaling pathways that mediate the UPR and subsequent stress response pathways. PERK, an ER resident transmembrane protein kinase, initiates both pro-apoptotic and pro-survival signaling pathways. In the context of neoplasia, PERK and its downstream targets alter gene expression that can be both pro- and anti-tumorigenic. In this review, we discuss recent advances in understanding how canonical and non-canonical PERK-mediated signaling pathways influence cell fate, tumor progression, and tumor suppression and avenues for therapeutic intervention.
Assessment of dynamic efficiency of enterprise development
Authors: Терентьева Татьяна , Terent'eva Tat'yana , Смицких Ксения , Smickih Kseniya
Published: October 2017

Presents social and economic outcomes proyavlyayutsya in the long time period and satisfying stakeholder interests. Substantiated types of performance according to the criteria of the interests of main stakeholders (business, social, budget). We consider the development of organizational mechanism for monitoring the dynamic efficiency of enterprise development at the regional and interregional levels, and assess the positive and negative trends in the development of entrepreneurship. The obtained results are fundamental in the development of the roadmap of business, the adjustment of its development strategy, amendments to the program documents in the sphere of entrepreneurship development. For public authorities and local governments, nonprofit organizations, representing the interests of the business community (public associations of small and medium enterprises, non-profit associations, through their trade unions), business entities and associations.
The Advantage of a Combined SPECT/CT in the Diagnosis of Bone Metastases
Authors: РЫжков А. , RYzhkov A. , Крылов А. , Krylov A. , Ширяев С. , Shiryaev S. , Щипахина Я. , Schipahina Ya. , Кочергина Н. , Kochergina N.
Published: October 2017

Purpose: To define the diagnostic capabilities of SPECT/CT in comparison with WBS in patients with bone metastases.

Material and methods: It was included 67 patients with bone metastases of breast cancer, prostate cancer and other tumors. The evaluation was included WBS and SPECT/CT.

Results: All patients were divided into 2 groups: with single and multiple metastases. SPECT/CT showed higher efficiency in detecting bone metastases than WBS. The full detection of bone metastases with WBS ranged from 31 to 56 % compared to SPECT/CT for groups respectively. In some cases (for groups respectively 4 % to 9.5 % depending on the number of metastases and their localization) of WBS was not informative, recorded the absence of lesions.

Conclusion: SPECT/CT can improve the diagnosis of bone metastasis.
Locoregional Hyperthermia Of Malignant Tumors: Methods, Thermometry, Machines
Authors: Курпешев О. , Kurpeshev O. , J. van der Zee J. van der Zee , J. van der Zee J. van der Zee
Published: October 2017

The review presents an analytical review of the basic techniques of radiofrequency HT, thermometry, characteristics of some hyperthermic apparatus for locoregional HT (LRHT). All methods of LRHT aim to create a relatively uniform temperature distribution in the tumor in the range of 41–46 °C without overheating the normal tissues. However, this is not always achievable, and especially difficult for deep-seated tumors. This is due to certain limitations or disadvantages of the available hyperthermic systems. Application of LRHT is a complex procedure and therefore hyperthermia treatment remains a privilege for the major cancer clinics. There are only general guidelines for the application of LRHT, standards of treatment are difficult to define due to the inhomogeneous distribution of the electromagnetic (EM) power in organs and tissues (tumors) at different frequencies. Standards of treatment should be developed for each specific device on the basis of experimental and clinical studies. A common problem for all hyperthermia systems is the limited possibility to monitor temperature. A possible solution to this problem is to use magnetic resonance imaging (MRI) or ultrasound (US) for non-invasive thermometry. The application of LRHT to deep-seated tumors is mainly done with capacitive systems, or radiative systems with phased array antennas. The limiting factor in capacitive HT is overheating of the subcutaneous fat (SF). The application of LRHT to superficial tumors is best done with radiative applicators, because this method has the most optimal temperature distribution. The heating pattern of radiative systems in depth depends of the frequency of the used electromagnetic radiation. The superficial temperature can be influenced by a perfused water bolus.
Outpatient therapy: textbook for independent work of students of the 5th course of medical faculty
Authors: Карманова Тамара , Karmanova Tamara , Бабушкин Игорь , Babushkin Igor' , Лычев Валерий , Lychev Valeriy
Published: October 2017

The textbook presents the main al-gorithms of forming General Practi-tioner’s competence in diagnostics, treatment, dispensary observation, working ability examination, reha-bilitation of the patients with respira-tory, cardiovascular, digestive dis-eases and psychosomatic disorders.
The contents of the textbook con-form to the Federal State Education-al Standard for the Major 31.05.01 «General Medicine». Target au-dience: university medical students
Hyperglycemia Alters the Protein Levels of Prominin-1 and VEGFA in the Retina of Albino Rats
Authors: Almasry Shaima M. , Habib Eman K. , Elmansy Rasha A. , Hassan Zeinab A.
Published: October 2017

In this study, we addressed the potential relationship between prominin-1 (prom1) and vascular endothelial growth factor (VEGFA) in diabetes-induced retinopathy. In total, we examined 28 retinas from 14 rats with streptozotocin-induced diabetes and 30 retinas from 15 untreated control rats. ELISA was used to measure the level of prom1 and VEGFA in retinal tissue homogenates. Immunohistochemical techniques were used with antibodies directed against prom1, VEGFA, and CASP-3. After 180 days of diabetes induction, we performed light and electron microscopy studies on rat eyes to evaluate histopathological changes and to estimate the de novo metric “Diabetic Retinopathy Histopathological Index” (DRHI). These changes were then correlated to the tissue and immunoexpression levels of prom1 and VEGFA. The data showed a significant upregulation of the tissue levels and optical densities (ODs) of VEGFA and prom1 immunoreactivity in diabetic retinas compared with controls. Both the tissue levels and OD values of prom1 and VEGFA correlated significantly with each other and to the diabetic structural changes as calculated by DRHI. Taken together, these data provide new insight into the potential role of prom1 and VEGFA in the development of diabetic retinopathy.
A LUTA SINDICAL COMO PROCESSO DE DEFESA DAS POLÍTICAS PÚBLICAS DE EDUCAÇÃO INFANTIL NO MUNICÍPIO DE BETIM
Authors: Da Silva Otávio Henrique Ferreira , Soares Ademilson de Sousa
Published: October 2017

O artigo é parte da dissertação de mestrado que estudou as políticas públicas de Educação Infantil no município de Betim e tem como objetivo analisar as ações do Sindicato Único dos Trabalhadores em Educação de Minas Gerais (Sind-UTE) nas políticas públicas de Educação Infantil em Betim no período correspondente a 2011-2016. A base metodológica para esta parte da pesquisa foi a análise de documentos sobre a Educação Infantil na cidade. Como resultado, aponta-se o lugar de destaque ocupado pelo Sind-UTE nas lutas em defesa da Educação Infantil. No entanto, fica evidenciada a necessidade de que a população betinense participe mais dessas lutas. Uma proposta promissora, nesse sentido, seria a criação de um Fórum Municipal da Educação Infantil para a construção de um projeto na cidade para a educação da primeira infância.
MINISTRA DO TST DIZ QUE A REFORMA TRABALHISTA É NEGATIVA PARA O TRABALHADOR BRASILEIRO
Authors: Golembiewski Carlos , Guerini Eduardo , Oliveira Micheline Ramos de
Published: October 2017

A Ministra do Tribunal Superior do Trabalho (TST), Delaíde Alves Miranda Arantes, esteve na UNIVALI no mês de junho para participar do Seminário “As reformas, a terceirização e as mudanças no mundo do Trabalho” – promovido pelo Sindicato dos Professores de Itajaí e região. No evento, que teve o apoio do Curso de Direito, a ministra trouxe uma mensagem de enfrentamento às reformas que estão em curso no Brasil, nas áreas Trabalhista e Previdenciária. Na entrevista, concedida aos professores do Mestrado em Gestão de Políticas Públicas, a ministra disse que nem o Governo e nem o Parlamento tem legitimidade para promover reformas que tiram Direitos Sociais dos trabalhadores. Ela falou da origem humilde, do empoderamento feminino, da reforma trabalhista e do preconceito que enfrenta até no TST por ser mulher.