bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Outcomes of Single-Port Laparoscopic Placement of Peritoneal Dialysis Catheter
Authors: Pan Alan , Poi Mun J. , Matos Jesus , Jiang Jenny S. , Kfoury Elias , Echeverria Angela , Bechara Carlos F. , Lin Peter H.
Published: June 2016

Introduction:

Laparoscopic insertion of peritoneal dialysis (PD) catheter has become a preferred method compared to the traditional open technique for PD catheter insertion. We retrospectively report the outcome of 1-port laparoscopic placement PD catheters in our institution.

Methods:

A total of 263 patients with end-stage renal disease who underwent single-trocar laparoscopic PD catheter insertion during a recent 6-year period were reviewed. Laparoscopic technique involves introducing a PD catheter over a stiff guidewire into the abdominal cavity through a 10-mm laparoscopic port. Pertinent clinical variables, procedural complications, and follow-up outcome were analyzed.

Results:

There were 182 men and 81 women. The mean age was 56 years. Technical success was 95.8%. Catheter occlusion was the most common early complications (<6 months) that occurred in 4 (1.5%) patients. Late complications (> 6 months) including catheter occlusion, cuff extrusion, catheter leakage, catheter migration, infection, and hernia occurred in 5 patients (1.9%), 2 patients (0.8%), 3 patients (1.1%), 3 patients (1.1%), 6 patients (2.3%), and 4 patients (1.5), respectively. Mean follow-up time was 39 ± 18 months. Catheter survival rate at 1, 2, 3, 4, and 5 years was 96%, 94%, 90%, 85%, and 82%, respectively.

Conclusion:

Laparoscopic PD catheter implantation via a single-trocar utilizing a stiff guidewire technique is feasible and safe. This method can result in low complication and high catheter survival rate.
Late Leakage of the Aortic Stump After Removal of an Infected Graft
Authors: Stefano Bonardelli , Franco Nodari , Emanuele Botteri , Iacopo Barbetta
Published: June 2016

The residual stump after excision of an infected aortic graft may be subject to acute blowout due to chronic mechanical stress on a weak arterial wall. We present a case of late aortic stump disruption that required revision after 12 months from graft removal. Our strategy consisted of avoiding reexposure of the pararenal aorta by creating a new supraceliac stump with healthy aortic wall after antegrade visceral debranching. This case confirms the need for long-term surveillance of aortic stumps. The use of a supraceliac approach minimizes the risk of intraoperative blowout and postoperative disruption.
Adult Consequences of Bully Victimization
Authors: Hoffman Chrystina Y. , Phillips Matthew D. , Daigle Leah E. , Turner Michael G.
Published: June 2016

Although evidence exists that bully victimizations are related to a range of negative outcomes later in the life course, existing research has largely ignored the timing of the victimization experience. Using data from the National Longitudinal Survey of Youth 1997, the present study uses propensity score matching to investigate the adult consequences of victims experiencing repeated bullying in childhood, adolescence, or both developmental periods. Individuals victimized as children reported higher instances of arrests, convictions, violence, and substance use than child nonvictims. The results point to the importance of implementing effective prevention programs early in the life course.
Lifestyle Medicine Practice
Authors: Dysinger Wayne S.
Published: June 2016

The practice of lifestyle medicine is different than typical medical practices. Reimbursement systems are strong drivers of practice models. Lifestyle Medicine Solutions (LMS) has developed a primary care lifestyle medicine practice that implements: 1) a new clinical care model, and 2) innovative reimbursement strategies. The key assumptions, care model, reimbursement model and financial partners used by LMS are discussed. To achieve the promise that lifestyle medicine brings for decreasing both the chronic disease burden and rising health care costs, new lifestyle medicine delivery models must continue to be explored and implemented. The goal is for the lifestyle medicine choice to be available to each patient and each provider.
Dynamic extreme stress prediction of bridges based on nonlinear mixed Gaussian particle filtering algorithm and structural health monitoring data
Authors: Fan Xueping , Liu Yuefei
Published: June 2016

In the long-term service period, the bridge health monitoring system produced a huge amount of monitoring stress data; proper handling of these data is one of the main difficulties in the field of structural health monitoring, especially to predict the structural stress based on the monitored data. The objectives of this article are to present: (1) a nonlinear dynamic model, (2) a nonlinear mixed Gaussian particle filtering algorithm for predicting the monitored data based on the dynamic model, and (3) an approach combining nonlinear mixed Gaussian particle filtering algorithm with structural health monitoring data to predict the structural stress under uncertainty in real time. And an actual example is provided to illustrate the application and feasibility of the proposed models and methods.
Grey–Taguchi method to optimize the percent zinc coating balances edge joints for galvanized steel sheets using metal inert gas pulse brazing process
Authors: Songsorn Khasempong , Sriprateep Keartisak , Rittidech Sampan
Published: June 2016

The objective of this work was to optimize the percent zinc coating balances edge joints of galvanized steel sheets using the metal inert gas pulse brazing process. The Taguchi method and grey relational analysis were used to determine the relationship between the metal inert gas pulse brazing process parameters and percent zinc coating balances edge joints. The metal inert gas pulse brazing process parameters used in this study included wire feed speeds, arc voltages, travel speed, peak currents, and pulse frequency. The characteristics of metal inert gas pulse brazing process that were considered to find response were percent zinc coating balances edge joints on the upper edge joint (PZBEJ1), the lower edge joint (PZBEJ2), and the back sides of the edge joint (PZBEJ3). Analysis of variance was performed to determine the impact of an individual process parameter on the quality parameters. The results showed that the optimal parameters in which grey relational grade increases at the highest level were wire feed speeds at 3.25 m/min, arc voltages at 16 V, travel speeds at 0.9 m/min, peak currents at 425 A, and pulse frequency at 35 Hz. These parameters gave a 74.90% higher response value than those of the initial parameters of metal inert gas pulse brazing process.
Flexible dynamic analysis of an offshore wind turbine installed on a floating spar platform
Authors: Zhu Xiangqian , Yoo Wan-Suk
Published: June 2016

Flexible dynamic analysis is a critical process in designing offshore wind turbines that are composed of several huge components. This process was implemented with a hybrid method of finite element multibody system using commercial software in this article. Based on this method, the tower and blades were modeled as flexible components using three-dimensional solid elements. The effect of flexible deformation of the tower and blades on the global motions of the floating wind turbine was investigated by comparing the simulation results from the flexible body modeling with those from the rigid body modeling. The tower, blades, and spar platform were divided into sections according to the geometry configuration of the 5-MW OC3-Hywind floating wind turbine. The time- and position-dependent loads, coming from the wind, wave, and mooring system, were expressed approximately with respect to the divided sections. The relationships between the global motions and the external loads were studied, which indicated that the wind loads had dominant influences on the translational motions and the rotational motions were mainly generated by the propagating waves.
Multi-skeleton model for top-down design of complex products
Authors: Chu Dexin , Lyu Guolin , Chu Xuening , Shen Jing
Published: June 2016

Generally, there are two alternative design approaches available to engineers: bottom-up and top-down. Considering the sharp increase in the complexity of most mechanical products, the top-down design approach is more widely adopted in the development of complex products. However, in traditional top-down design process, design parameters are communicated through single-skeleton models, and design units are strongly coupled due to the multi-dimensional complexity of products. Toward this end, a new top-down design approach based on multi-skeleton model is proposed in this article. First, in accordance with different kinds of design parameters, three major skeleton models are defined, including location skeleton model, published skeleton model, and design skeleton model. And the characteristics of multi-skeleton models are also described. Then, the top-down design process based on the multi-skeleton model is explored, especially in the multi-skeleton modeling phase. It is also illustrated in detail that how to realize design parameter transmission and design unit reuse. Subsequently, it elaborates the communicating way and structure optimization of design parameters to support parameters controlled publishing and design units reuse. Finally, a meteorological satellite and a crawler crane design cases are implemented to expound the feasibility and effectiveness of the proposed framework.
Innovation-supporting tools for novice designers: Converting existing artifacts and transforming new concepts
Authors: Liu Ying-Chieh , Kao Chin-Yu , Chakrabarti Amaresh , Chen Chien-Hung
Published: June 2016

Generating a range of concepts is often a significant challenge for novice designers given their limited design experience and domain knowledge. This article develops a tool to support novice designers in formulating a design strategy for converting existing artifacts or mechanical objects into abstract representations. The app-based tool is aimed at supporting novice designers in (1) archiving existing artifacts, (2) converting artifacts into abstract representations for divergent activities, and (3) observing the kinematic movements of three-dimensional mechanical objects through augmented reality. An experiment conducted in 2014 investigated how the tool’s augmented reality function and the proposed strategy supported novice designers. A total of 13 second-year industrial design students generated 88 separate ideas. From 12 possible mechanical movements, four participants generated between 11 and 22 ideas each, while another five participants generated 1 or 2 ideas each. Each participant successfully proposed a concept that adapted the selected mechanism in response to a given problem in a given environment. Comparing pre- and posttest scores of each participant, 11 of 13 participants improved their knowledge of kinematic mechanisms. The results suggested that the use of the proposed tool and strategy has potential to help some novice designers explore new concepts and acquire related design knowledge.
Study on control schemes of flexible steering system of a multi-axle all-wheel-steering robot
Authors: Zhang Pingxia , Gao Li , Zhu Yongqiang
Published: June 2016

It is well known that a multi-axle wheeled robot possesses larger load capability and also higher drive performance. However, its steering flexibility is degraded due to the large number of wheels. In order to solve this problem, in this article, we proposed three control schemes based on the center of rotation or the steering angles of both the first- and last-axle wheels. To release these control schemes, steering mode selection and also the left wheel’s steering angle in a specific axle are added approaching a practical application. Thereafter, the remaining wheels’ steering angles can be calculated with the Ackerman steering theorem. In order to verify the control effects, a five-axle all-wheel-steering wheeled robot has been developed with the Bluetooth wireless monitor system. Based on the newly designed robot, validation experiments are carried out, such as lateral movement, situ rotation, and multi-mode steering within a narrow space. The results indicate that the proposed design in this article can ensure a more flexible and faster movement within a narrow space. It shows large potential in obstacle avoidance compared with the conventional partial-wheel steering mode.
Simulation of rock fragmentation induced by a tunnel boring machine disk cutter
Authors: Li Huiyun , Du Erxia
Published: June 2016

A constitutive model based on the Johnson–Cook material model and the extended Drucker–Prager strength criterion was implemented in LS-DYNA to simulate the rock failure process induced by a single disk cutter of a tunnel boring machine. The normal, rolling, and side forces were determined by numerical tests. The simulation results showed that the normal and rolling forces increased with increasing penetration while the side force changed little. The normal force also increased under the conditions of confining pressures. The damage region of rock and cutting forces were also obtained by simulation of two disk cutters acting in tandem with different cutting spacings. The optimum ratio of cutter spacing to penetration depth determined from numerical modeling agrees well with that obtained by linear cutting machine tests. The average normal and rolling forces acting on the first cutter are slightly greater than those acting on the second when the cutting disk spacing is relatively small. The numerical modeling was verified to accurately capture the fragmentation of rock induced by disk cutter.
Simulation of cavitation performance of an axial flow pump with inlet guide vanes
Authors: Feng Weimin , Cheng Qian , Guo Zhiwei , Qian Zhongdong
Published: June 2016

The cavitation performance of an axial flow pump with inlet guide vanes for different flow rates is studied in this article. The effects of inlet guide vanes on pump hydraulic performance and cavitation are investigated, where the total vapor fraction of impeller zone ( Ftv) is calculated to predict the critical net positive suction head, which is compared with that predicted by efficiency criterion for different flow rates. The influences of the development of cavitation on internal flow in impeller zone are also investigated. The results obtained show that the cavitation performance of axial flow pump can be improved at off-design flow conditions by adjusting angles of inlet guide vanes to positive values at low flow rates and by regulating angles of inlet guide vanes to negative values at high flow rates. As the net positive suction head decreases, the vapor fraction first increases slowly and then increases greatly, clearly presenting cavitation process from inception to full development, which can be used to predict the required net positive suction head. When net positive suction head decreases to the value around required net positive suction head, the cavitation zone from tip of blade suction side close to leading edge and the cavitation zone from hub part of the blade suction side connect together. After the connection, the cavitation zones have great influence on the velocity flow, leading to the decrease in pump performance.
Study on automatic deduction method of overall transfer equation for branch multibody system
Authors: Rui Xue , Wang Guoping , Zhang Jianshu , Rui Xiaoting , Sun Lu
Published: June 2016

The transfer matrix method for multibody system is a new method developed in recent 20 years for studying multibody system dynamics. The new version of transfer matrix method for multibody system and automatic deduction theorem of system overall transfer equation have been formed in 2012. The overall transfer equation plays one of the key roles for transfer matrix method for multibody system. In order to study branch system dynamics with new version of transfer matrix method for multibody system, the automatic deduction theorem of overall transfer equation has been expanded in this article, which made it practicable to deduce automatically the overall transfer equation for branch system with new version of transfer matrix method for multibody system. The transfer equations and transfer matrices of typical elements are developed for the automatic deduction theorem of overall transfer equation. Thereby new version of transfer matrix method for multibody system owns the following features: there is no need to establish the global dynamics equation of system, by which the study on multibody system dynamics will be simplified greatly; the automatic deduction of overall transfer equation for multibody system is realized, consequently the algorithm is simple and highly programmable; moreover, the order of system matrix is always low, which result in high computational speed. The branch multibody system dynamics has been computed with the automatic deduction theorem of overall transfer equation as well as ordinary multibody system dynamics method. The computational results obtained by the two methods have good agreements, which validate the automatic deduction theorem of overall transfer equation for branch multibody system.
An optimum design on rollers containing the groove with changeable inner diameter based on response surface methodology
Authors: Zhao Xi , Zhang Zhimin , Xue Yong
Published: June 2016

In order to realize the precision plastic forming of the revolving body component with changeable wall thickness, a kind of roller containing grooves with changeable inner diameter is put forward, as the forming mould of the technology of rolling-extrusion. Specifically, first, the arc length of the groove in the roller is designed according to the prediction on the forward slip value during the process of forming, to make accurate control of the actual length of the forming segments; then, to obtain better parameters of the roller structure, a second-order response surface model combining finite element numerical simulation and response surface methodology was put forward, taking the factor of forming uniformity as evaluation index. The result of the experiment shows that, for the formed component, not only the size can meet the needs but also each mechanical property index can be greatly improved, which verify the rationality of the forward slip model and the structural parameter of the optimum model based on the response surface methodology.
Numerical investigation of boiling heat transfer on hydrocarbon mixture refrigerant in vertical rectangular minichannel
Authors: Li Huixing , Liu Yu
Published: June 2016

In order to investigate the characteristics of boiling heat transfer for hydrocarbon mixture refrigerant in plate-fin heat exchanger which is used in the petrochemical industry field, a model was established on boiling heat transfer in vertical rectangular channel. The simulated results were compared with the experimental data from literature. The results show that the deviation between the simulated results and experimental data is within ±15%. Meanwhile, the characteristic of boiling heat transfer was investigated in vertical rectangular minichannel of plate-fin heat exchanger. The results show that the boiling heat transfer coefficient increases with the increase in quality and mass flux and is slightly impacted by the heat flux. This is because that the main boiling mechanism is forced convective boiling while the contribution of nucleate boiling is slight. The correlation of Liu and Winterton is in good agreement with the simulation results. The deviation between correlation calculations and simulation results is mostly less than ±15%. These results will provide some constructive instructions for the understanding of saturated boiling mechanism in a vertical rectangular minichannel and the prediction of heat transfer performance in plate-fin heat exchanger.
Visual nesting system for irregular cutting-stock problem based on rubber band packing algorithm
Authors: Liao Xiaoping , Ma Junyan , Ou Chengyi , Long Fengying , Liu Xiangsha
Published: June 2016

This article deals with the packing problem of irregular items allocated into a rectangular sheet to minimize the waste. Conventional solution is not visual during the packing process. It obtains a reasonable and relatively satisfactory solution between the nesting time and nesting solution. This article adopts a physical method that uses rubber band packing algorithm to simulate a rubber band wrapping those packing irregular items. The simulation shows a visual and fast packing process. The resultant rubber band force is applied in the packing items to translate, rotate, and slide them to make the area decrease and obtain a high packing density. An improved analogy QuickHull algorithm is presented to obtain extreme points of rubber band convex hull. An adaptive module could set a variable rubber band force and a variable time step to make a proper convergence and no intersection. A quick convex decomposition method is used to solve the problem of concave polygon. A plural vector expression approach is adopted to calculate the resultant vector of the rubber band force. Several cases are compared with the benchmark problems to prove rubber band packing algorithm performance.
Performance-oriented asymptotic tracking control of hydraulic systems with radial basis function network disturbance observer
Authors: Hu Jian , Qiu Yang
Published: June 2016

Uncertainties, including parametric uncertainties and uncertain nonlinearities, always exist in positioning servo systems driven by a hydraulic actuator, which would degrade their tracking accuracy. In this article, an integrated control scheme, which combines adaptive robust control together with radial basis function neural network–based disturbance observer, is proposed for high-accuracy motion control of hydraulic systems. Not only parametric uncertainties but also uncertain nonlinearities (i.e. nonlinear friction, external disturbances, and/or unmodeled dynamics) are taken into consideration in the proposed controller. The above uncertainties are compensated, respectively, by adaptive control and radial basis function neural network, which are ultimately integrated together by applying feedforward compensation technique, in which the global stabilization of the controller is ensured via a robust feedback path. A new kind of parameter and weight adaptation law is designed on the basis of Lyapunov stability theory. Furthermore, the proposed controller obtains an expected steady performance even if modeling uncertainties exist, and extensive simulation results in various working conditions have proven the high performance of the proposed control scheme.
Ziprasidone as a Potential Abortive Therapy for Status Migrainosus
Authors: Landsness Eric C. , Wang Leo H. , Bucelli Robert C.
Published: June 2016

Migraine headache is among the most prevalent neurologic disorders. Status migrainosus often leads to hospitalization, and multiple medications are sometimes required for symptomatic relief. In 2008, neurologists at our institution started using the atypical antipsychotic ziprasidone as an abortive medication for status migrainosus. The Clinical Investigation Data Exploration Repository was used to search for patients admitted to the Barnes-Jewish Hospital inpatient neurology service with diagnoses of “headache” or “migraine.” Patients were identified as having status migrainosus if they met the International Headache Society criteria for a migraine lasting >72 hours. Clinical records of identified patients were then entered into a secure online database (REDCap). Between 2008 and 2015, a total of 34 patients received 10 to 40 mg of ziprasidone for the treatment of status migrainosus. Among patients who received ziprasidone, headache severity decreased 5.68 ± 3.0 points on a 10-point scale, from admission to discharge. Ziprasidone was the last abortive medication added prior to discharge in 65% of cases. The 30-day readmission rate for migraine headache in patients who received ziprasidone was 12%. Ziprasidone was well tolerated, with side effects limited to a mild dystonic reaction (n = 1), rhinorrhea (n = 1), and a prolonged QTc of 495 milliseconds (n = 1). This observational study suggests that ziprasidone may be a safe, effective abortive medication for the treatment of status migrainosus. Further studies comparing ziprasidone to standard of care are warranted.
Supporting the Student’s Graduated Independence in Diabetes Care
Authors: Jackson Crystal C. , Albanese-O’Neill Anastasia
Published: June 2016

The gradual progression to self-management is a critical milestone for children/adolescents with diabetes. This article provides recommendations to facilitate collaboration between the student’s family, diabetes healthcare provider, and school nurse to support and implement a plan that enables the child/adolescent to acquire the skills and knowledge necessary to successfully transition to independent management of diabetes.
Wise Reasoning in the Face of Everyday Life Challenges
Authors: Grossmann Igor , Gerlach Tanja M. , Denissen Jaap J. A.
Published: June 2016

How stable vs. dynamic is wisdom in daily life? We conducted a daily diary study of wise reasoning (WR) by recording people’s reflections on daily challenges in terms of three facets: intellectual humility, self-transcendence, and consideration of others’ perspectives/compromise. We observed substantial and systematic intraindividual variability in WR, with wiser reasoning in the social versus nonsocial contexts. State-level WR variability was potent in predicting a bigger-picture construal of the event, more positive (vs. negative) emotions, greater emotional complexity, lower emotional reactivity, less thought suppression, and more reappraisal and forgiveness. In contrast, on the trait level, we observed only a few associations to emotional complexity and reappraisal. We discuss implications for conceptualization and measurement of wisdom-related thought.
Domestication of smartphones and mobile applications: A quantitative mixed-method study
Authors: de Reuver Mark , Nikou Shahrokh , Bouwman Harry
Published: June 2016

Smartphones are finding their way into our daily lives. This paper examines the domestication of smartphones by looking at how the way we use mobile applications affects our everyday routines. Data is collected through an innovative quantitative mixed-method approach, combining log data from smartphones and survey (perception) data. We find that there are dimensions of domestication that explain how the use of smartphones affects our daily routines. Contributions are stronger for downloaded applications than for native applications. Especially applications that require interaction with others, such as social media and instant messaging, have a serious impact on our day-to-day routines. As a result, appropriation is core in incorporating smartphones in daily life routines. However, frequency of use and the total number of minutes spent on a given type of application per day affect our everyday routines in different ways. This paper is the first quantitative domestication study that focuses on smartphones rather than feature phones. The theoretical contribution and practical implications are outlined.
Race, Ethnicity, Risky Lifestyles, and Violent Victimization
Authors: Madero-Hernandez Arelys , Fisher Bonnie S.
Published: June 2016

Empirical studies have established that Blacks and Hispanics are two of the most violently victimized racial/ethnic groups in the United States, but the mechanisms that underlie these disparities in victimization risk are not well understood. This study tests a mediation model developed from criminal opportunity theories that may explain the disparities. Using data from the Project on Human Development in Chicago Neighborhoods, the results show that Black and Hispanic adolescents were twice as likely as their White counterparts to be violently victimized, and these disparities remained after controlling for demographic characteristics and prior victimization. As to the hypothesized sources of these disparities, there was mixed evidence regarding the mediation model. Although risky lifestyles were significantly related to violent victimization and eliminated all disparities between Black and White youth, they failed to eliminate victimization disparities between Hispanics and White youth. The implications of these findings are discussed in light of theory and victimization prevention.
A Human Rights Lens on Full Employment and Decent Work in the 2030 Sustainable Development Agenda
Authors: Frey Diane F. , MacNaughton Gillian
Published: June 2016

On September 25, 2015, the United Nations General Assembly adopted the Sustainable Development Goals (SDGs) as the blueprint for a global partnership for peace, development, and human rights for the period 2016 to 2030. The 2030 agenda follows on the heels of the Millennium Development Goals (MDGs), adopted in 2001, which set the international development agenda for the period 2001 to 2015. This article uses a human rights lens to demonstrate that the MDGs and the SDGs have not addressed full employment and decent work in a manner that is consistent with the Decent Work Agenda of the International Labour Organization and international human rights legal obligations of the UN member countries. It concludes that the new 2030 development agenda sadly aligns with market-based economic growth strategies rather than the realization of the human rights to full employment and decent work for all.
Examining Teacher Outcomes of the School-Wide Positive Behavior Support Model in Norway
Authors: Sørlie Mari-Anne , Ogden Terje , Olseth Asgeir Røyrhus
Published: June 2016

Research on teacher outcomes of the School-Wide Positive Behavior Support (SWPBS) model has been scarce. The present study adds to the knowledge base by examining the effects of the Norwegian version of SWPBS (N-PALS) on school staffs’ behavior management practices and on their individual and collective efficacy. Questionnaire data were collected from staff and students (Grades 4-7) at four measurement points across four successive school years in 28 intervention schools and 20 comparison schools. Using longitudinal multilevel analyses, indications of positive 3-year main effects of the N-PALS model were observed for staff-reported collective efficacy, self-efficacy, and positive behavior support practices. The intervention effects as measured by Cohen’s d ranged from .14 to .91. The effects on student perceptions of teachers’ behavior management strategies were, however, not consistent with the positive staff ratings. Results are discussed in relation to prior research, future research, and study limitations.
Development and Validation of an 18-Item Medium Form of the Ravens Advanced Progressive Matrices
Authors: Sefcek Jon A. , Miller Geoffrey F. , Figueredo Aurelio José
Published: June 2016

The Ravens Advanced Progressive Matrices (APM) is a widely used measure of general intelligence ( g), both across settings and cultures. Due to its lengthy 40-min administration time, several researchers have developed short-form scales, yet these forms typically yield a significantly lower reliability. This article describes the creation of an 18-item short form (APM-18) and its validation in three samples of Southwestern U.S. university students (total N = 633). The APM-18 shows similar psychometric properties to both the previously published 36-item long form and 12-item short form, but retains a reliability estimate closer to the original APM. This, plus the shorter administration time (25 min) relative to the complete APM (40-60 min), makes it useful for time-constrained or mass-testing situations.
Young Adulthood Is the Crucible of Personality Development
Authors: Roberts Brent W. , Davis Jordan P.
Published: June 2016

The last two decades have seen a rapid acceleration of research on personality development focusing on the periods of late adolescence and young adulthood. The findings paint a picture of surprising quiescence in adolescence followed by a period of tremendous growth and change in personality traits in young adulthood. The patterns and potential reasons for these changes are discussed in the context of the Neo-Socioanalytic model of personality and the theory of emerging adulthood. The potential for convergence and collaboration between the fields of personality development and emerging adulthood is discussed.
Rural Transformation in India in the Decade of Miraculous Economic Growth
Authors: Ohlan Ramphul
Published: June 2016

The study empirically measures the pattern and extent of rural transformation in India using a comprehensive assessment system based on three multidimensional indices, namely rural development index, rural transformation index and urban–rural coordination index. The constructed rural transformation index shows that rural India has undergone a sweeping transformation during the decade of sharp economic growth. The transformation that occurred in India is accompanied by an improvement in the rural development level. The analysis indicates that India’s urban–rural coordination has slightly declined between 2001 and 2011. In addition, large regional disparities in rural transformation are shown. Based on findings, it is argued that policies aimed at region-specific rural transformation types may be an effective way to shape a more integrated urban–rural development pattern in India.
Public Health in Practice: Development of an Undergraduate Domestic Off-Campus Public Health Program
Authors: Walser-Kuntz Debby , Iroz Cassandra Bryce
Published: June 2016

An innovative program, Public Health in Practice, successfully combines the best practices of academic civic engagement (service learning) with domestic off-campus study. Although our college does not offer a public health major or minor, there is strong student interest in this field of study. As a response, we developed a program where students enroll in two sequential introductory public health courses; between the two courses, students study off-campus with the same instructor. Unlike the majority of U.S. undergraduate public health off-campus experiences that involve travel abroad, this program focused on domestic public health. By working on local community-based projects and traveling to Minneapolis/St. Paul and Washington, DC, the students were able to compare public health efforts at local, state, and national scales. Our mixed-methods approach of evaluation using student pre/post surveys along with integrative reflections indicated that participants demonstrated an increase in (1) knowledge related to nationally identified public health competencies, (2) sense of agency in effecting change in communities, (3) understanding of how to work ethically with and in communities, and (4) personal awareness and clarification of future career paths. The combination of local, community-based ACE projects with a domestic study away resulted in improved student learning outcomes, increased confidence, and a shift in student attitudes.
Physical, morphological, and wound healing properties of a polyurethane foam-film dressing
Authors: Lee Seung Moon , Park Il Kyu , Kim Yong Soo , Kim Hyun Jung , Moon Hanlim , Mueller Stefan , Jeong Young-IL
Published: June 2016

Background

We investigated the physicochemical properties of Medifoam® N and its wound healing performance compared to other commercially available polyurethane (PU) foam dressing in vitro and in vivo to gain insight in their clinical performance.

Methods

Wound contact layer and cross-section of eleven polyurethane foam dressings were assessed with field-emission scanning electron microscope. Thickness, density, tensile strength, elongation, moisture-vapor transmission rate (MVTR), retention and absorptivity were measured to compare physical properties. Phosphate-buffered saline (PBS) solution absorption patterns were compared. An animal model for wound-healing was applied to validate in vitro findings.

Results

Among eleven tested foam dressings, Medifoam® N has the smallest pore and cell sizes with excellent uniformity, i.e. it has 25 ~ 75 μm on the wound contact layer and 100 ~ 350 μm in the cross-section while other dressings have a larger pose size with larger variability. Compared to other PU foams, Medifoam® N also has moderate thickness, density, tensile strength, elongation and MVTR. Furthermore, it has excellent fluid absorption and retention capacity. These intrinsic properties of Medifoam® N contributed to improve fluid absorption patterns, i.e. other dressing material flawed out PBS solution on the dressings while Medifoam® N retained all the tested solutions. In animal wound-healing study, Medifoam® N treated animals showed excellent angiogenesis and collagen deposition even though epithelial recovery rate was not significantly different to other dressings.

Conclusions

Medifoam® N has optimized physical properties and thus improved fluid absorption/retention capacity. Compared to other dressings, Medifoam® N showed excellent fluid absorption patterns and these characteristics contributed to improved wound healing and excellent angiogenic potential. We found that Medifoam® N showed the best results among the employed dressing samples.
Frontline Science: ATF3 is responsible for the inhibition of TNF-α release and the impaired migration of acute ethanol-exposed monocytes and macrophages
Authors: Hu Chaojie , Meng Xiaoming , Huang Cheng , Shen Chenlin , Li Jun
Published: June 2016

Binge drinking represses host innate immunity and leads to a high risk of infection. Acute EtOH-pretreated macrophages exhibit a decreased production of proinflammatory mediators in response to LPS. ATF3 is induced and counter-regulates the LPS/TLR4 inflammatory cascade. Here, we investigated the potential role of ATF3 in LPS tolerance in acute ethanol-pretreated macrophages. We found that there was an inverse correlation between ATF3 and LPS-induced TNF-α production in acute ethanol-pretreated murine monocytes and macrophages. The knockdown of ATF3 attenuated the inhibitory effects of acute ethanol treatment on LPS-induced TNF-α production. Furthermore, ChIP assays and co-IP demonstrated that ATF3, together with HDAC1, negatively modulated the transcription of TNF-α. In binge-drinking mice challenged with LPS, an up-regulation of ATF3 and HDAC1 and a concomitant decrease in TNF-α were observed. Given that HDAC1 was concomitantly induced in acute ethanol-exposed monocytes and macrophages, we used the HDACi TSA or silenced HDAC1 to explore the role of HDAC1 in acute ethanol-treated macrophages. Our results revealed that TSA treatment and HDAC1 knockdown prevented acute ethanol-induced ATF3 expression and the inhibition of TNF-α transcription. These data indicated a dual role for HDAC1 in acute ethanol-induced LPS tolerance. Furthermore, we showed that the induction of ATF3 led to the impaired migration of BM monocytes and macrophages. Overall, we present a novel role for ATF3 in the inhibition of LPS-induced TNF-α and in the impairment of monocyte and macrophage migration.
Milk fat globule epidermal growth factor-8 limits tissue damage through inflammasome modulation during renal injury
Authors: Brissette Marie-Joëlle , Laplante Patrick , Qi Shijie , Latour Mathieu , Cailhier Jean-Francois
Published: June 2016

Mediators released by apoptotic renal resident cells play a crucial role in modification of the inflammatory microenvironment. We have demonstrated that milk fat globule epidermal growth factor 8 (MFG-E8) is released by apoptotic cells, which results in reduced proinflammatory cytokine production by macrophages. The present study was designed to study the role of MFG-E8 on the modulation of tissue damage and macrophage phenotype in a renal inflammatory model, unilateral ureteral obstruction (UUO). C57BL/6 WT or MFG-E8 KO mice underwent ureteral ligation for 3, 7, and 14 d to evaluate renal injury. MFG-E8 (30 µg/kg) or vehicle was also administered i.p. MFG-E8 administration reduced kidney damage and fibrosis compared with control, whereas its absence in MFG-E8 KO mice was associated with more severe disease. Moreover, MFG-E8 administration was associated with decreased inflammasome activation in the kidney. Furthermore, adoptive transfer of MFG-E8–stimulated macrophages reduced activation of inflammasome and tissue damage. In all cases, both the systemic administration of MFG-E8 and MFG-E8–treated macrophages promoted accumulation of anti-inflammatory CD206+ macrophages. We propose that the protective role of MFG-E8 is mediated through anti-inflammatory macrophage reprogramming which results in decreased inflammasome activation, preventing severe tissue damage. These data provide valuable insight for identification of MFG-E8 as a novel target in modulation of inflammatory diseases.
Health Literacy and Outcomes in Multiple Sclerosis
Authors: Henson Lily Jung
Published: June 2016

Health literacy is an important consideration when managing patients with multiple sclerosis. Literacy impacts comprehension about patient condition, participation in medical decision making, and compliance with treatment plans. Awareness of health literacy allows clinicians to tailor their approach to individual patients and improve the overall care of patients.
Pediatric Demyelination
Authors: Narula Sona , Banwell Brenda
Published: June 2016

Purpose of Review:

This review summarizes a general approach to pediatric demyelination as well as specific features of each of the acquired demyelinating syndromes to help clinicians in their evaluation of children with these disorders. Case studies are included to illustrate the expanding phenotype of many of these syndromes.

Recent Findings:

With the creation of consensus definitions for the pediatric acquired demyelinating syndromes, recognition of demyelination in children has increased, as has understanding of the clinical and radiologic features, prognosis, and response to treatment. Collaborative studies and multicenter clinical trials are ongoing and needed to appropriately evaluate emerging therapies for some of the chronic demyelinating disorders, such as multiple sclerosis and neuromyelitis optica (NMO) spectrum disorder.

This review will aid the clinician in identifying key features of the pediatric acquired demyelinating syndromes and highlights a general approach for the diagnosis and treatment of these disorders.
Switching or Discontinuing Disease-Modifying Therapies for Multiple Sclerosis
Authors: Miller Aaron E.
Published: June 2016

Purpose of Review:

This article reviews the reasons for discontinuation or switching of multiple sclerosis disease-modifying therapy as well as procedures that might mitigate risk to the patient under such circumstances.

Recent Findings:

Recent review of the literature, as well as the author’s extensive clinical experience, indicate that the discontinuation of multiple sclerosis disease-modifying therapies occurs for many reasons. Often one medication is stopped at the recommendation of the physician in order to switch to another medication. However, often the decision to discontinue medication is made by the patient. Unfortunately, in still other situations, treatment is stopped because of circumstances beyond the control of either patient or physician (eg, a loss of insurance coverage). Currently available data do not permit a conclusion about whether it is ever safe to discontinue disease-modifying therapy in a stable patient without the expectation of return of disease activity.

Clinicians must help patients avoid unnecessary and undesirable cessation of disease-modifying therapy. While switches of therapy are often necessary, steps to minimize both adverse events and the risk of recurrent disease should be undertaken. Whether disease-modifying therapy can ever be purposely discontinued without incurring a significant risk of disease recurrence remains to be determined.
Early Relapsing Multiple Sclerosis
Authors: Jones David E.
Published: June 2016

Purpose of Review:

This article provides an evidence-based approach to the management of patients with early relapsing multiple sclerosis (MS).

Recent Findings:

Numerous clinical trials have shown the role of disease-modifying therapies in reducing relapses and new MRI lesions in patients with relapsing MS. Many of these trials also show the ability of these agents to delay disability progression, and a few suggest that disease-modifying therapies may slow brain atrophy in relapsing MS; however, very few suggest that disease-modifying therapies can improve symptoms or disability. The therapeutic armamentarium of disease-modifying therapies includes five interferon formulations, two versions of glatiramer acetate, mitoxantrone, natalizumab, fingolimod, teriflunomide, dimethyl fumarate, and alemtuzumab.

Although multiple disease-modifying therapies exist, the risks of these vary markedly, head-to-head comparator trials are limited, and no prospective biomarkers for treatment efficacy exist; therefore, choosing a disease-modifying therapy for an individual patient with MS is a difficult decision. This difficulty is compounded by limitations in predicting a patient’s disease course, and the risk tolerance of the patient and opinions of the care partner need to be factored into the decision analysis as well. After a disease-modifying therapy is chosen, vigilance for clinical or radiographic breakthrough disease is very important, as this may suggest a suboptimal response to the chosen therapy. Furthermore, the role of symptom management and wellness should always remain part of the approach to the patient with MS.
Acute Multiple Sclerosis Relapse
Authors: Berkovich Regina Radner
Published: June 2016

Purpose of Review:

This article discusses acute exacerbations (relapses) of multiple sclerosis (MS). Relapses are a hallmark of MS and are often associated with significant functional impairment and decreased quality of life. This review discusses the proposed pathophysiology of MS relapses, triggering factors, associated markers, variants of clinical presentation, and diagnostic recommendations.

Recent Findings:

Most MS exacerbations are followed by a period of repair leading to clinical remission; however, residual deficits may persist after MS relapse and contribute to the stepwise progression of disability. Treatment of MS relapses is important as it helps to shorten the duration of disability associated with their course. Successful treatment of relapse helps patients with MS obtain a vital sense of being able to gain control over the disease. Patients with relapsing MS who receive treatment report better outcomes than those who are simply observed. This article discusses treatment options for MS relapse, including systemic corticosteroids, adrenocorticotropic hormone, and plasma exchange. Recent findings related to the mechanisms of action of steroids and adrenocorticotropic hormone are also reviewed, and other potential therapies are assessed. A proposed algorithm for MS relapse management is presented, including strategies for steroid-resistant MS exacerbations.

MS relapses need to be recognized in a timely manner and treated using recommended therapeutic methods.