bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-invasive treatment with near-infrared light: A novel mechanisms-based strategy that evokes sustained reduction in brain injury after stroke
Authors: Strubakos Christos D , Malik Michelle , Wider Joseph M , Lee Icksoo , Reynolds Christian A , Mitsias Panayiotis , Przyklenk Karin , Hüttemann Maik , Sanderson Thomas H
Published: May 2019

Ischemic stroke is a debilitating disease that causes significant brain injury. While restoration of blood flow is critical to salvage the ischemic brain, reperfusion can exacerbate damage by inducing generation of reactive oxygen species (ROS). Recent studies by our group found that non-invasive mitochondrial modulation with near-infrared (NIR) light limits ROS generation following global brain ischemia. NIR interacts with cytochrome c oxidase (COX) to transiently reduce COX activity, attenuate mitochondrial membrane potential hyperpolarization, and thus reduce ROS production. We evaluated a specific combination of COX-inhibitory NIR (750 nm and 950 nm) in a rat stroke model with longitudinal analysis of brain injury using magnetic resonance imaging. Treatment with NIR for 2 h resulted in a 21% reduction in brain injury at 24 h of reperfusion measured by diffusion-weighted imaging (DWI) and a 25% reduction in infarct volume measured by T2-weighted imaging (T2WI) at 7 and 14 days of reperfusion, respectively. Additionally, extended treatment reduced brain injury in the acute phase of brain injury, and 7 and 14 days of reperfusion, demonstrating a >50% reduction in infarction. Our data suggest that mitochondrial modulation with NIR attenuates ischemia–reperfusion injury and evokes a sustained reduction in infarct volume following ischemic stroke.
A deadly trap for para-aortic lymph node dissection in patients with horseshoe kidney as a complication: a case report
Authors: Zhou Qian , Chen Xinliang
Published: May 2019

Horseshoe kidney is a rare congenital renal dysplasia. It is often associated with various anatomical abnormalities, including renal vessel and ureter variability, which increase unpredictable surgical risks. This current report describes the case of a 42-year-old woman diagnosed as having cervical squamous cell carcinoma complicated by horseshoe kidney. She underwent laparoscopic radical hysterectomy, bilateral oophorectomy and lymph node dissection, including dissection of the pelvic, presacral and para-aortic lymph nodes. The surgery was challenging, but no serious complications occurred. Postoperative multi-slice computed tomography angiography confirmed the anatomical variation of the renal location, ureter and renal vessels. To our knowledge, this is the first reported case of cervical carcinoma complicated with horseshoe kidney.
Application of fast-track surgery in the perioperative period of laparoscopic partial nephrectomy for renal tumors
Authors: Kang Chunmei , Qiao Xueliang , Sun Meiling
Published: May 2019

Objectives

This study aimed to examine application of fast-track surgery (FTS) in the perioperative period of laparoscopic partial nephrectomy for renal tumors, and to discuss its effects and safety.

Methods

Eighty patients who received laparoscopic partial nephrectomy in urinary surgery from January 2016 to December 2017 were selected and randomly classified as the observation group (n = 40) and control group (n = 40). Traditional treatments were performed in the control group, while FTS was applied in the observation group. The complication rate after the operation was recorded.

Results

The duration of the operation and intraoperative blood loss were not different between the groups. The duration of anesthesia and fluid transfusion volume on the day of the operation were significantly less in the observation group than in the control group. The rates of infection of the incisional wound, nausea and vomiting, and anastomotic stomal bleeding were not significantly different between the groups. However, the rates of postoperative urinary tract infection, abdominal distension, thirst, hypothermia, and pulmonary infection were significantly lower in the observation group than in the control group.

Conclusion

Application of FTS in laparoscopic partial nephrectomy contributes to postoperative recovery and reduction of postoperative complications.
Schwannosis in Three Foals and a Calf
Authors: Miranda Ileana C. , Taylor Kyle R. , Castleman William , de Lahunta Alexander , Summers Brian A. , Miller Andrew D.
Published: May 2019

Proliferation of ectopic Schwann cells within the central nervous system (CNS) parenchyma (schwannosis) in early life is most commonly associated with human neurofibromatosis type-2 and has been unrecognized in domestic animals. Three foals and a calf, 5 to 11 weeks old, with progressive neurological signs from birth were studied. Histologically, at multiple levels of the spinal cord, all animals had bilateral plaques of proliferative spindle cells, predominantly affecting the white matter adjacent to dorsal and ventral nerve roots and variably extending into the gray matter. Proliferating cells had strong intracytoplasmic immunoreactivity for the Schwann cell markers myelin protein zero and periaxin, highlighting the formation of peripheral nervous system (PNS) myelin within the spinal cord. In all cases, foci of disorganized neural tissue (glioneuronal hamartomas) were present, which in 2 cases formed a mass effect that resulted in syringohydromyelia. Neonatal presentation suggests a congenital maldevelopment of the nervous system, with spontaneous invasion of PNS-derived Schwann cells into the CNS.
After Isolation: Mirrors between Parallel Worlds and New Conceptual Spaces of Activism in Post-Revolutionary Iran
Authors: Saeidi Shirin , Vafa Amirhossein
Published: May 2019

In this article, we theoretically conceptualise the renegotiation of participatory action and activism through the formation of intellectual space that is self-reflective and upheld by what we metaphorically describe as mirrors between parallel worlds. Rethinking what activism is and how an individual relates to their social group is dependent on different levels of self-reflection, self-criticism and competing scales of insertion of other people’s struggles into one’s own political vision in an effort to intellectually rectify the local tensions that emerge in a post-revolutionary context where people are disconnected from global-level activism. A significant aspect of this analysis is our interlocutors’ imaginative capacity to draw from other people’s experiences through cultural and visual artefacts and integrate them into their own life history with the intention to address national or group-specific dilemmas. While some have drawn attention to the importance of noting how spaces for activism are remade in the post-revolutionary context due to such sentiments as disappointment, we instead examine the formation of conceptual spaces of activism within the context of isolation in contemporary Iran. Empirically, we bring together a political analysis of the novel Bevatan by Reza AmirKhani, and interviews conducted with English literature students in Shiraz.
Torque and pitch angle control of a wind turbine using multiple adaptive neuro-fuzzy control
Authors: Sahoo Satyabrata , Subudhi Bidyadhar , Panda Gayadhar
Published: May 2019

This article presents a multiple adaptive neuro-fuzzy inference system-based control scheme for operation of the wind energy conversion system above the rated wind speed. By controlling the pitch angle and generator torque concurrently, the generator power and speed fluctuation can be reduced and also turbine blade stress can be minimized. The proposed neuro-fuzzy-based adaptive controller is composed of both the Takagi–Sugeno fuzzy inference system and neural network. First, a step change in wind speed and then a simulated wind speed are considered in the proposed adaptive control design. A MATLAB/Simulink model of the wind turbine system is prepared, and simulations are carried out by applying the proportional integral, fuzzy-proportional integral and the proposed adaptive controller. From the obtained results, the effectiveness of the proposed adaptive controller approach is confirmed.
Queue-Based Guidance for Signalization Consideration at Two and Three-Legged Intersections
Authors: Warchol Shannon , Rouphail Nagui , Vaughan Chris , Kearns Brendan
Published: May 2019

This research collected and analyzed gap acceptance in North Carolina to develop a data-driven method for determining the need for considering additional signalization analysis at intersections with fewer than four legs. This method can be used for movements that merge with or cross two lanes of oncoming traffic. It is intended to provide guidance and support to traffic engineers in their decision-making process. Charts are provided to determine the expected 95th percentile queue lengths for left-turn, right-turn, and U-turn movements crossing or merging with two lanes of conflicting traffic. This situation is typically present along four-lane roadways where a one-way primary movement opposes either a minor road right-turn movement or a left-turn movement, or in the case of a median U-turn opening. Adjustment factors to the conflicting flowrate were developed to account for the presence of upstream signalized intersections. This method less frequently recommends further signal consideration when compared with the Manual on Uniform Traffic Control Devices peak hour warrant, but is similar to the delay-based level of service D/E threshold for two-way stop-controlled intersections in HCM6 Chapter 19.
Behavioral Analysis of Drivers Following Winter Maintenance Trucks Enabled with Collision Avoidance System
Authors: Verma Rajat , Saedi Ramin , Zockaie Ali , Gates Timothy J.
Published: May 2019

Winter maintenance trucks (WMTs) often operate at lower speeds during inclement weather and roadway conditions, creating potential safety issues for motorists following close behind. In this study, a new prototype radar-based rear-end collision avoidance and mitigation system (CAMS) was tested to assess its impact on the behavior of drivers following WMTs. The system is designed to flash an auxiliary rear-facing warning light upon detection of a vehicle encroaching within an unsafe relative headway with the rear of the WMT. A series of field evaluations was performed during actual winter maintenance operations to assess the effectiveness of the system compared with normal operating conditions (i.e., without the CAMS warning light) toward improving driver behavior related to rear-end crash risk. Specifically, two measures were assessed: (a) rate of vehicles encroaching beyond a safe time headway threshold to the rear of the WMT, and (b) the reaction–response time of drivers. Classification and regression tree models were created for identifying the relevant factors influential in determining the change in driver response. The results indicate that this warning light was effective in reducing the likelihood of the subject drivers crossing beyond a relative headway of 4.5 s. It was also effective in reducing the reaction and response times of the drivers by 0.83 and 0.55 s (36% and 20% reduction), respectively. Although the results were encouraging, additional field testing is recommended before conclusions are drawn regarding the traffic safety impacts of the system.
Effects of arrangement and shape of MWCNT and GNP reinforcements on nanocomposite mechanical properties
Authors: Zarasvand Kamran Alasvand , Golestanian Hossein , Alasvand Zarasvand Kianoush
Published: May 2019

In this investigation, multi-walled carbon nanotubes (MWCNTs) and graphene nanoplatelets were used to prepare two-phase and hybrid epoxy-based nanocomposites. Tensile and compressive mechanical properties of nanocomposites containing different amounts of MWCNTs and graphene nanoplatelets were determined using experimental, micromechanical, and numerical methods. Moreover, micrographs from samples’ fracture surfaces were obtained using field emission scanning electron microscope. Numerical simulations were carried out to investigate the effects of aligned and randomly distributed straight and sinusoidal MWCNTs and graphene nanoplatelets weight fraction on nanocomposite mechanical properties. To achieve our goals, three different sets of models consisting of MWCNTs, graphene nanoplatelets, and hybrid nano-fillers were analyzed. First, six different models consisting of aligned hybrid nanocomposite were analyzed to investigate the effect of arrangements of MWCNTs and graphene nanoplatelets on nanocomposites Young’s moduli. Then, models containing sinusoidal nano-fillers were generated based on the arrangement of the aligned model which had the best correlation with experimental measurements. Also, more realistic nanocomposite models consisting of randomly distributed straight nano-reinforcements were created to investigate the effects of reinforcement distribution on nanocomposite properties. To examine the accuracy of numerical simulations, Halpin–Tsai micromechanical method modified for hybrid nanocomposites was used. Numerical results were compared with micromechanical predictions and experimental measurements and good agreement was observed.
Self-Regulation and Rhetorical Problem Solving: How Graduate Students Adapt to an Unfamiliar Writing Project
Authors: Roderick Ryan
Published: May 2019

Research on writing and transfer has shown that writers who have sophisticated rhetorical knowledge are well equipped to adapt to new situations, yet less attention has been paid to how a writer’s adaptability is influenced by their writing processes. Drawing on Zimmerman’s sociocognitive theory of self-regulation, this study compared the writing processes taken up by graduate student writers composing a research proposal for their final project in a tutor-training practicum. Findings from process logs, interviews, and drafts differentiated self-regulation strategies associated with varying degrees of success. The more successful writers framed problems in terms of potential solutions, used problems to set goals, and reacted to problems by creating a narrative of progress; in contrast, less successful writers avoided problems or framed them as dead-ends. Compared to the less successful writers, the more successful writers concluded the project with robust knowledge about research proposal writing. These findings suggest that self-regulation strategies may be linked to an ability to develop rhetorical knowledge and practices in the face of challenging writing situations.
Potassium Bromide in the Treatment of Pediatric Refractory Epilepsy
Authors: Kodama Kazuo , Omata Taku , Watanabe Yoshimi , Aoyama Hiromi , Tanabe Yuzo
Published: May 2019

Objective:

We evaluated potassium bromide’s (KBr’s) efficacy and tolerability for pediatric refractory epilepsy.

Methods:

We retrospectively reviewed the records of 42 patients treated with KBr in our hospital between 2008 and 2016 (age: 4 months to 19 years; mean: 6.2 years). Thirteen of them had 2 seizure types. The treatment durations ranged from 1 month to 6 years (mean: 15.0 months).

Results:

KBr had an excellent effect (seizure-free status) in 3 patients (7.1%), a moderate effect (>50% reduction in seizure frequency from the pretreatment baseline) in 21 patients (50.0%), and no effect (<50% reduction in seizure frequency from the pretreatment baseline) in 18 patients (42.9%). The effective daily doses ranged from 20 to 80 mg/kg (mean: 50.0 mg/kg). KBr was effective in 59.1% patients with generalized epilepsy (n = 22), 55.6% patients with focal epilepsy (n = 18), and both patients with Dravet syndrome. An excellent or moderate effect was found in 72.2% patients with tonic seizures (n = 18), 66.6% patients with generalized tonic-clonic seizures (n = 6), 75.0% patients with secondary generalized seizures (n = 4), 46.2% patients with focal seizures (n = 13), and 20% patients with infantile spasms (n = 10) but no patients with myoclonic seizures (n = 2). Adverse effects including drowsiness, excitement, and rashes were reported in 13 patients (31.0%).

Conclusions:

These findings suggest that KBr is particularly effective for tonic seizures, generalized tonic-clonic seizures, and secondary generalized seizures. Although the adverse effects need further attention, KBr should be considered for pediatric refractory epilepsy.
Neurologic Examination Findings Associated With Small Cerebellar Volumes After Prematurity
Authors: Tam Emily W.Y. , Chau Vann , Lavoie Raphaël , Chakravarty M. Mallar , Guo Ting , Synnes Anne , Zwicker Jill , Grunau Ruth , Miller Steven P.
Published: May 2019

To help clinicians understand what to expect from small cerebellar volumes after prematurity, this study aims to characterize the specific impacts of small cerebellar volumes on the infant neurologic examination. A prospective cohort of preterm newborns (<32 weeks’ gestational age) had brain magnetic resonance imaging (MRI) studies at term-equivalent age. Cerebellar volumes were compared with neurologic examination findings in follow-up, adjusting for severity of intraventricular hemorrhage, white matter injury, and cerebellar hemorrhage. Deformation-based analyses delineated regional morphometric differences in the cerebellum associated with these findings. Of 119 infants with MRI scans, 109 (92%) had follow-up at 19.0±1.7 months corrected age. Smaller cerebellar volume at term was associated with increased odds of truncal hypotonia, postural instability on standing, and patellar hyperreflexia ( P < .03). Small cerebellar volume defined as <19 cm3 by 40 weeks was associated with 7.5-fold increased odds of truncal hypotonia ( P < .001), 8.9-fold odds postural instability ( P < .001), and 9.7-fold odds of patellar hyperreflexia ( P < .001). Voxel-based deformation-based morphometry showed postural instability associated with paravermian regions. Small cerebellar volume is associated with specific abnormalities on neurologic examination by 18 months of age, including truncal tone, reflexes, and postural stability.
Thioketal-crosslinked: ROS-degradable polycations for enhanced in vitro and in vivo gene delivery with self-diminished cytotoxicity
Authors: Zheng Nan , Xie Dan , Zhang Zhiyi , Kuang Jia , Zheng Yubin , Wang Qing , Li Yang
Published: May 2019

The irreversible correlation between the transfection efficiency and cytotoxicity of polycations has always been the huge obstacle that severely limited the gene delivery efficiency. The undesired inconsistency could be mainly attributed to the molecular weight (MW) of the polycations, that is, polymers with high MW and positive charge densities exhibited enhanced transfection efficiency but with associated cytotoxicity. To address such critical challenge, we developed the degradable high MW polymers strategy which could condense DNA for the internalization and release DNA upon the trigger-responsive degradation. In this work, two kinds of degradable PEI-based polymers were prepared via the polyaddition of PEI600 and dienes with ester groups or thiol ketal groups. The PEI-based degradable polymers could efficiently condense plasmid DNA to form the nano-complexes with the size around 180 nm. They also exhibited improved gene delivery efficiency compared with commercial available transfection reagent, PEI25k, and were 380–520 folds higher than PEI600 in HeLa cells. The toxicity of the polymers could be reduced by the rapid degradation upon acid or ROS triggering as well as intracellular release of DNA and the cell viability could reach higher than 80% even at high doses. ROS-responsive PEI-based polymers also demonstrated its potential applications especially in cancer cells, which were proved by the enhanced in vivo gene expression in cancer cells. Our strategy therefore allows an effective tool to manipulate the relationship between transfection efficiency and cytotoxicity of polycations, and thus provides an effective insight into the rational design of non-viral gene delivery vectors.
Collagen-hydroxyapatite composite substitute and bone marrow nuclear cells on posterolateral spine fusion in sheep
Authors: Ding Ming , Koroma Kariatta Esther , Sorensen Jesper Roed , Sandri Monica , Tampieri Anna , Jespersen Stig M , Overgaard Søren
Published: May 2019

The effects of a large collagen-hydroxyapatite (COL-HA) substitute with or without isolated bone marrow nuclear cells (BMNC) on spine fusion were evaluated using a two-level posterolateral spinal fusion model in sheep. Six sheep each were included in both the COL-HA and autograft groups. In each animal, spine fusions were performed at two levels by randomization with or without BMNC. After an observation period of 4.5 months, the fusion blocks (length = 50 mm) were harvested and evaluated by micro-CT with respect to fusion rate and microarchitecture, and histology was performed to qualitatively assess new bone morphology. BMNC supplementation did not lead to significant differences in fusion rates or microarchitectural properties in the both groups ( p = 0.56). Porosity decreased significantly in the COL-HA group ( p = 0.002), suggesting a relatively fast degradation of COL-HA. Qualitative histology assessment revealed quick reabsorption of COL-HA replaced by newly formed bone, and this new bone morphology was similar to autograft. Interestingly, COL-HA generated significant amounts of new bone in vivo which were similar to autograft, and the presence of BMNC seemed to enhance this process. Apart from porosity, the comparable fusion rate and similar microarchitectural parameters suggested equal performance of COL-HA and autograft with respect to spine fusion and bone quality. In conclusion, the COL-HA with BMNC demonstrated comparable fusion rates as the autograft. COL-HA was capable of forming new bone and was revealed to be similar to the autograft with respect to microarchitectural properties apart from porosity of the fusion blocks.
Ensuring Compensation Committees Understand the Impact of the Excise Tax on Provider and Executive Compensation
Authors: Otto James M. , Flannery Thomas P.
Published: May 2019

The tax law changes that Congress enacted and the President signed into law in late December 2017 included a new employer-paid excise tax that applies to annual compensation above $1 million provided to certain of the highest paid employees of most tax-exempt organizations. The excise tax may also apply to severance paid to a broader group of employees. The law requires these organizations—and as a result, their boards or compensation committees—to understand the basics of the law as well as the process by which executives and employees are identified and their compensation and severance is reviewed. This article discusses the key concepts of the excise tax and helps guide committees on the steps in the process that committees should take, so that they are in a position to understand if—and when—the excise tax could apply.
Characteristic analysis of a micro-/nanopositioning stage with coupling errors by the gravity
Authors: Lin Chao , Li Pingyang , Shen Zhonglei , Yu Jiang
Published: May 2019

The piezo-actuated micro-/nanopositioning stages are often used in the current precision engineering applications, and the coupling deformation under the gravity of the stage is critical to error analysis. Considering the torsional deformation and bending deformation of the flexure hinges, the coupling error’s analytical model of the positioning stage along the Z-axis is derived by using the virtual work principle and the elastic beam theory. The performance of the proposed theoretical model is analyzed and verified by the comparison between two common materials, and the quantities of the piezoelectric actuators are also analyzed with the impact on the coupling deformation of the stage along the Z-axis. Through the comparison and analysis of theoretical results, simulation results and experimental results, the maximum error between finite element analysis and experimental results is 11.43%, with the rest fluctuates within 10%, which proves the correctness of the theoretical model. It is concluded that gravity generated by the workload and the stage does have an influence on the coupling deformation along the Z-axis of the micro-/nanopositioning stage. It cannot be ignored in the analysis and consideration of the positioning stage.
A triangular vortex generator modeling on a DU97-W-300 airfoil by a source term model
Authors: Galera L , Martinez-Filgueira P , Fernández-Gámiz U , Zulueta E , Lopez JM , Blanco JM
Published: May 2019

Vortex generators are passive devices employed to improve the aerodynamic performance of aircraft and wind turbine blades. More concretely, these devices have high potential in improving the power output of wind turbines that are producing less power than expected. Besides, it can improve the aerodynamic performance of the nearest parts to the rotor of turbine blades that usually enter in stall. The main goal of this article is to model the triangular vortex generator effect on a DU97-W-300 airfoil by a source term model. This is aimed by comparing the lift and drag coefficients from experimental studies with the data obtained in the computational fluid dynamics study. Furthermore, the vertical path and the size and strength of the vortex are studied for different angles of attack in order to see how the vortex genertaor behaves in different conditions.
Effect of conic baffles in the shell and helical tube heat exchangers
Authors: Koyun Tansel , Jumaah Omar M
Published: May 2019

In the present study, computational fluid dynamics techniques are used to investigate numerically the performance of a heat exchanger (shell and helical tube) in order to improve its ability of transferring the heat through its body. The heat exchanger model includes a helical tube, a shell and baffles where the latter are of a cone shaped and distributed in the center and in the shell side. The angle and length of baffles are taken to be varied in the range of 0° to 90° and 10 cm to 35 cm, respectively. The major findings of the thermal analyses show that due to the baffles shape of the shell, the fluid moves inside the domain, with continuous baffles, and varies significantly, which is resulted in a significant increase in the heat transfer coefficient in the heat exchanger. The maximum amount of the transferred heat was obtained at the angle of 80° and length of 30 cm of the baffle.
Estimation of data adaptive minimal clinically important difference with a nonconvex optimization procedure
Authors: Zhou Zehua , Zhao Jiwei , Bisson Leslie J.
Published: May 2019

Understanding the limitation of solely relying on statistical significance, researchers have proposed methods to draw biomedical conclusions based on clinical significance. The minimal clinically important significance is one of the most fundamental concepts to study clinical significance. Based on an anchor question usually available in the patients' reported outcome, Hedayat et al. presented a method to estimate minimal clinically important significance using the classification technique. However, their method implicitly requires that the binary outcome of the anchor question is equally likely, i.e. the balanced outcome assumption. This assumption cannot be guaranteed a priori when one designs the study; hence, it cannot be satisfied in general. In this paper, we propose a data adaptive method, which can overcome this limitation. Compared to Hedayat et al., our method uses a faster gradient based algorithm and adopts a more flexible structure of the minimal clinically important significance at the individual level. We conduct comprehensive simulation studies and apply our method to the chondral lesions and meniscus procedure study to demonstrate its usefulness and also its outperformance.
Prediction of microfibril angle in Dahurian larch wood using visible–near infrared spectroscopy and chemometric techniques
Authors: Li Ying , Via Brian K , Cheng Qingzheng , Li Yaoxiang
Published: May 2019

The microfibril angle of the S2 layer in the secondary cell wall of the tracheid is important for molecular and microscopic properties that influence collapse resistance, longitudinal modulus of elasticity and other lateral properties of conifers at the macroscopic level. This research aimed to investigate the feasibility of using a fruit fly optimization algorithm for visible and near infrared modeling optimization of Dahurian larch wood microfibril angle prediction. Originally, the linear relationship between microfibril angle and their raw spectra and visible and near infrared spectra pretreated by wavelet transform was established. Then, a nonlinear coupled model was built by combining the stepwise regression analysis and generalized regression neural network methods. As a final point, fruit fly optimization algorithm was used for optimizing stepwise regression analysis–generalized regression neural network coupled model. It was found that stepwise regression analysis–generalized regression neural network coupled model coupled model based on the optimization of fruit fly optimization algorithm simplify visible and near infrared spectral data and its prediction results ([Formula: see text] = 0.90, RMSEP = 0.75, mean average percentage error ([Formula: see text]) = 0.05) outperforms original partial least squares model ([Formula: see text] = 0.86, RMSEP = 0.88, [Formula: see text] = 0.06). This work demonstrated the feasibility of using improved chemometric techniques for improving the precision of visible and near infrared spectra in the prediction of microfibril angle.
Patient advocacy in nursing: A concept analysis
Authors: Abbasinia Mohammad , Ahmadi Fazlollah , Kazemnejad Anoshirvan
Published: May 2019

Background:

The concept of patient advocacy is still poorly understood and not clearly conceptualized. Therefore, there is a gap between the ideal of patient advocacy and the reality of practice. In order to increase nursing actions as a patient advocate, a comprehensive and clear definition of this concept is necessary.

Research objective:

This study aimed to offer a comprehensive and clear definition of patient advocacy.

Research design:

A total of 46 articles and 2 books published between 1850 and 2016 and related to the concept of patient advocacy were selected from six databases and considered for concept analysis based on Rodgers’ evolutionary approach.

Ethical considerations:

This study was approved by the Research Ethics Committee of Tarbiat Modares University.

Findings:

The attributes of patient advocacy are safeguarding (track medical errors, and protecting patients from incompetency or misconduct of co-workers and other members of healthcare team), apprising (providing information about the patient’s diagnosis, treatment, and prognosis, suggesting alternatives of healthcare, and providing information about discharge program), valuing (maintaining self-control, enabling patients to make decisions freely, maintaining individualization and humanity, maintaining patient privacy, and acting in the patients’ values, culture, beliefs, and preferences), mediating (liaison between patients, families, and healthcare professionals, being patients’ voice, and communicate patient preferences and cultural values to members of the healthcare team), and championing social justice in the provision of healthcare (confronting inappropriate policies or rules in the healthcare system, identifying and correcting inequalities in delivery of health services, and facilitating access to community health services and health resources).

Discussion and conclusion:

The analysis of this concept can help to develop educational or managerial theories, design instruments for evaluating the performance of nurses in patient advocacy, develop strategies for enhancing patient advocacy, and improve the safety and quality of nursing care in the community and healthcare system.
Role of RUNX2 transcription factor in epithelial mesenchymal transition in non-small cell lung cancer: Epigenetic control of the RUNX2 P1 promoter
Authors: Herreño Angélica María , Ramírez Andrea Carolina , Chaparro Viviana Paola , Fernandez María José , Cañas Alejandra , Morantes Carlos Fabian , Moreno Olga María , Brugés Ricardo Elias , Mejía Juan Andrés , Bustos Fernando José , Montecino Martín , Rojas Adriana P
Published: May 2019

Lung cancer has a high mortality rate in men and women worldwide. Approximately 15% of diagnosed patients with this type of cancer do not exceed the 5-year survival rate. Unfortunately, diagnosis is established in advanced stages, where other tissues or organs can be affected. In recent years, lineage-specific transcription factors have been associated with a variety of cancers. One such transcription factor possibly regulating cancer is RUNX2, the master gene of early and late osteogenesis. In thyroid and prostate cancer, it has been reported that RUNX2 regulates expression of genes important in tumor cell migration and invasion. In this study, we report on RUNX2/ p57 overexpression in 16 patients with primary non-small cell lung cancer and/or metastatic lung cancer associated with H3K27Ac at P1 gene promoter region. In some patients, H3K4Me3 enrichment was also detected, in addition to WDR5, MLL2, MLL4, and UTX enzyme recruitment, members of the COMPASS-LIKE complex. Moreover, transforming growth factor-β induced RUNX2/ p57 overexpression and specific RUNX2 knockdown supported a role for RUNX2 in epithelial mesenchymal transition, which was demonstrated through loss of function assays in adenocarcinoma A549 lung cancer cell line. Furthermore, RUNX2 increased expression of epithelial mesenchymal transition genes VIMENTIN, TWIST1, and SNAIL1, which reflected increased migratory capacity in lung adenocarcinoma cells.
“Bringing Tap Back”: Expanding the “Sodabriety” Teen Advisory Council Approach in Tennessee High Schools
Authors: Smith Laureen H. , Sexton Courtney , Pettigrew Kimberly , Eastburn Sarah
Published: May 2019

Sugar-sweetened beverages (SSBs) are a large source of added sugar in teenagers’ diets, comprising 20–25% of daily calories. Despite efforts, teens in rural and southern states continue to have the high SSB consumption rates. Using Teen Advisory Councils (TAC), students designed and delivered school-specific interventions at five Tennessee schools. Using repeated measures models with Bonferroni correction, data were collected on SSBs and water consumption at baseline and 30 days postintervention. The 573 participants ranged from 13 to 19 years; mean age 15.97 years ( SD = 1.4). Daily SSB servings decreased from a mean of 2.37 ( SD = 2.06) to 1.87 ( SD = 1.89; p = .024). Weekly SSB behaviors decreased 10%. Daily water consumption increased 19.5% to 4.46 ( SD = 2.97) servings ( p = .03). Student-led efforts supported behavioral changes. TACs were effective at changing lifestyle behaviors. Community-driven solutions may result in manageable changes to sustain behaviors.
Nonlinear free vibration analysis of functionally graded rotating composite Timoshenko beams reinforced by carbon nanotubes
Authors: Heidari Mahsa , Arvin Hadi
Published: May 2019

In this paper, the linear and nonlinear free vibrations of functionally graded rotating composite Timoshenko beams reinforced by carbon nanotubes are presented. The formulation is based on the assumptions of Timoshenko beam theory in addition to consideration of the nonlinear von Karman strain–displacement relationship. The effective material properties of carbon nanotube reinforced composites are determined employing the Mori–Tanaka micromechanics model and the extended mixture rule. For the carbon nanotube reinforced composite beams, uniform distribution and four types of functionally graded distribution patterns of single-walled carbon nanotube reinforcements are considered. A differential transform method is applied on the nondimensionalized equations of motion to release the flapping modeshapes and the associated natural frequencies. The direct method of multiple scales is implemented to derive the effective nonlinearity and the corresponding nonlinear natural frequency. The accuracy of the present outcomes is validated by the comparison with the results given in the literature. The numerical results are presented in both tabular and graphical forms to investigate the effects of nanotube volume fractions, distribution types of the carbon nanotubes, and rotation speed on linear and nonlinear free vibration characteristics of carbon nanotube reinforced composite beam. The results demonstrate the important role of carbon nanotube distribution profile on linear and nonlinear free vibration features.
Using a moving load to simultaneously detect location and severity of damage in a simply supported beam
Authors: Mousavi Mohsen , Holloway Damien , Olivier J C
Published: May 2019

This paper demonstrates the feasibility of simultaneously identifying both the location and severity of structural damage in a beam by using two independent moving load experiments. First, a simple but sufficiently accurate single degree of freedom model is presented to simulate the structure efficiently over a wide range of relevant inputs. We then introduce a damage sensitive feature (DSF) based on the integral of the velocity time history of the beam at its midspan when the load moves over the beam. A critical velocity, a function only of the beam’s first natural frequency and length, is obtained for the proposed DSF, upon which the damage can be located more accurately. The only required data for the damage detection is the midspan velocity-time history of the cracked beam subjected to a moving load, and the midspan static deflection of the intact beam subjected to a load of the same magnitude. In the last section of this paper, the capability of the proposed DSF is examined in the presence of noise. The results demonstrate the capability of the proposed method to find both the damage location and severity successfully, and methods for further reducing the effects of noise are suggested.
The Lived Experience of Stop and Search in Scotland: There Are Two Sides to Every Story
Authors: Deuchar Ross , Miller Johanne , Densley James
Published: May 2019

This article presents data emerging from ethnographic research that sought to explore the extent to which stop and search procedures in Scotland are underpinned by a focus on procedural justice and the impact they have on young people. Data were collected via participant observation of police deployments and semi-structured interviews with 23 law enforcement officers and 46 young people. The emerging insights suggested that differential views on and approaches to policing in different parts of the country were leading to varying experiences of stop and search and procedural justice. The young people interviewed in the east of the country had more positive relationships with the police and a stronger belief in procedural justice. Conversely, the tendency to use stop and search as a deterrent from crime in the west of Scotland resulted in deteriorated relationships, institutionalization of the use of the tactic, and a perceived lack of procedural justice.
Localized and overall interaction effects of irregular interfacial bonds and elastic edge restraints for sandwich and functionally graded multilayer circular plates with normal/shear tractions
Authors: Alipour MM , Shariyat M
Published: May 2019

In the present article, interactions of the effects of the interfacial bond’s irregularity, shear and normal tractions, and flexible edge supports on the distributions of the lateral deflections and stress of the laminated/sandwich circular plates are investigated, for the first time. To widen the applicability of the research, the layers are assumed to be functionally graded ones. A layerwise model that unlike the traditional layerwise theories, not only guarantees continuity of the transverse stress components but also takes into account the discontinuity of all of the displacement components at the imperfect or damaged bonds between layers is proposed. The governing equations are derived based on the principle of minimum potential energy and solved based on the Maclaurin transformation analytical method. Results are enhanced through a three-dimensional elasticity correction. Results reveal that while compliance of the edge restraint has a significant role on the magnitude of the global displacements, amount of the discontinuities in the displacement components at the mutual interfaces is mainly affected by both the local and global (mean) bond stiffness. Furthermore, while both the compliance of the elastic edge restraint and irregularity of the bonds increase the stress and displacement components, each combination of these parameters may specifically lead to magnifications of the stresses in a particular layer of the plate.
Correlation between corneal involvement and anterior chamber flare in epidemic keratoconjunctivitis
Authors: Kiyat Pelin , Palamar Melis , Yilmaz Suzan Guven , Emre Sinan
Published: May 2019

Purpose:

To investigate the correlation between corneal involvement and anterior chamber flare using a laser flare meter in eyes with epidemic keratoconjunctivitis.

Methods:

A total of 82 eyes of 50 (32 female and 18 male) consecutive patients with epidemic keratoconjuctivitis were evaluated. Besides complete opthalmic examination, anterior chamber flare measurements with laser flare meter (FM 600, Kowa, Kowa Company Ltd., Nagoya, Japan) were performed. The relationship between corneal involvement, subepithelial deposits, and anterior chamber flare was assessed.

Results:

The mean age of the patients was 36.32 ± 18.77 (range 4–75) years and the mean duration of complaints was 5.28 ± 2.65 (range 1–12) days. The biomicroscopic findings were conjunctival hyperemia in 82 (100%), follicular reaction in 66 (80.5%), eyelid edema in 56 (68.3%), punctate epitheliopathy in 38 (46.3%), and subepithelial deposits in 36 (43.9%) eyes. The mean flare value was 17.35 ± 12.62 (range 2.0–45.0) photons/ms. Flare measurements were significantly higher in eyes with subepithelial deposits (p < 0.001).

Conclusions:

Subepithelial deposits seem to occur in eyes with higher anterior chamber inflammation in epidemic keratoconjunctivitis. The laser flare meter might be a useful tool to predict subepithelial deposit development in these patients.
Anatomic study on the blood supply to the femoral head following hip resurfacing using the posterior approach
Authors: Alsheri Mohammed , Bali Kamal , Railton Pamela , Ponjevic Dragana , Matyas John , Powell James
Published: May 2019

Objectives:

The aim of this study was to investigate femoral head perfusion following cadaveric hip resurfacing using the posterior approach.

Methods:

This cadaveric study involved injecting Higgins India ink into the common iliac arteries and evaluating the distribution of ink in the resurfaced heads using the modified Spalteholz technique. The study consisted of 2 parts. The 1st part involved utilisation of 22 cadaveric hips for establishing the injection and histological technique. The 2nd part of the study included 4 control cadaveric hips and 12 cadaveric hips with posterior approach hip resurfacing. Each specimen was divided into 15 zones (12 head zones and 3 neck zones) to evaluate detailed geographic distribution of dye-containing blood vessels.

Results:

All 4 controls had good flow of ink to all head zones and the neck region. In all the resurfaced heads, there was good flow to all the neck zones. 6 resurfaced specimens had no dye flow to any of the head zones. In the remaining 6, dye-stained vessels were seen variably in the anterior and middle zones but were consistently absent in the posterior zones of the head. Zones representing the antero-inferior parts of femoral head had the maximum flow of ink, followed by zones representing middle-inferior parts.

Conclusions:

Posterior approach for hip resurfacing arthroplasty results in vascular insult to the femoral head, with posterior zones more affected than the anterior zones. The persistence of the dye in the intraosseous blood vessels of the neck and in anteroinferior head may be a source of revascularisation of the femoral head after posterior approach hip resurfacing.
A Mechanism for the Development of Chronic Traumatic Encephalopathy From Persistent Traumatic Brain Injury
Authors: Demock Melissa , Kornguth Steven
Published: May 2019

A mechanism that describes the progression of traumatic brain injury (TBI) to end-stage chronic traumatic encephalopathy (CTE) is offered in this article. This mechanism is based upon the observed increase in the concentration of both tau protein and of human leukocyte antigen (HLA) class I proteins; the HLA increase is expressed on the cell membrane of neural cells. These events follow the inflammatory responses caused by the repetitive TBI. Associated inflammatory changes include macrophage entry into the brain parenchyma from increased permeability of the blood-brain barrier (BBB) and microglial activation at the base of the sulci. The release of interferon gamma from the microglia and macrophages induces the marked increased expression of HLA class I proteins by the neural cells and subsequent redistribution of the tau proteins to the glial and neuronal surface. In those individuals with highly expressed HLA class I C, the high level of HLA binds tau protein electrostatically. The ionic region of HLA class I C (amino acid positions 50-90) binds to the oppositely charged ionic region of tau (amino acid positions 93-133). These interactions thereby shift the cellular localization of the tau and orient the tau spatially so that the cross-linking sites of tau (275-280 and 306-311) are aligned. This alignment facilitates the cross-linking of tau to form the intracellular and extracellular microfibrils of tau, the primary physiological characteristic of tauopathy. Following endocytosis of the membrane HLA/tau complex, these microfibrils accumulate and produce a tau-storage-like disease. Therefore, tauopathy is the secondary collateral process of brain injury, resulting from the substantial increase in tau and HLA expression on neural cells. This proposed mechanism suggests several potential targets for mitigating the clinical progression of TBI to CTE.
Influence of design embodiment on the performance of squeeze-film levitation contacts
Authors: Almurshedi A , Atherton M , Mares C , Stolarski T , Miyatake M
Published: May 2019

Conveying of lightweight and delicate parts is an important issue in some manufacturing processes. Two levitation devices, one based on horn transducer (Langevin type) and the other one in the form of a plain rectangular plate made of aluminium firmly fastened at both ends with a surface-mounted piezoelectric actuator, are compared. Both devices operate on a squeeze-film levitation mechanism. To this end, physical experiments were carried out and it was found that the device utilizing horn-type transducer yields better levitation performance.