bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on shrinkage behaviour of laser sintered PA 3200GF specimens using RSM and ANN
Authors: Negi Sushant , Sharma Rajesh Kumar
Published: June 2016

Purpose

The purpose of this paper is to provide a better understanding of process parameters that have a significant effect on the shrinkage behaviour of laser-sintered PA 3200GF specimens.

Design/methodology/approach

A five-factor, three-level and face-centred central composite design was used to collect data, and two methods, namely, response surface methodology (RSM) and artificial neural network (ANN) were used for predicting shrinkage. Sensitivity analysis based on the developed empirical equations has been carried out to determine the most significant parameter, which contributes the most to control shrinkage. In addition, a comparative analysis has also been performed for the results obtained by RSM and ANN.

Findings

The results revealed that part bed temperature, scan speed and scan spacing are the three dominant parameters, which have a great influence on shrinkage. Strong interactions between laser power-scan spacing, laser power-scan length and scan speed-scan spacing have been observed. Through sensitive analysis, it is observed that shrinkage is more sensitive to the scan speed variations than other four process parameters.

Practical implications

This study can be used as a guide, and the demonstrated results will provide a good technical database to the different additive manufacturing users of various industries such as automobile, aerospace and medical.

Originality/value

To the best of the authors’ knowledge, this is the first study to report the shrinkage behaviour of laser-sintered PA 3200GF parts fabricated under different sintering conditions.
Mechanical properties of urethane diacrylate/bamboo powder composite fabricated by rapid prototyping system
Authors: Chiu Shih-Hsuan , Ivan Ivan , Wu Cheng-Lung , Chen Kun-Ting , Wicaksono Sigit Tri , Takagi Hitoshi
Published: June 2016

Purpose

Stereolithography is a well-established technique for producing complex part for rapid prototyping purpose by using UV or laser as a source for curing process. This technique has been implemented in a lot of industrial sectors. However, the parts fabricated by this technique exhibit low mechanical and thermal properties hindering a fast-growing application. The purpose of this paper is to propose a new method of digital light rapid prototyping (DLRP) system and investigate the effect of the addition of bamboo fiber with surface modification on improvement of mechanical properties of urethane diacrylate/bamboo composite.

Design/methodology/approach

Test specimens were fabricated using aliphatic urethane diacrylate photopolymer as matrix material and bamboo fiber as reinforce material. Adhesion between matrix and reinforce materials is a big issue in compositing, especially when handling bamboo as hydrophilic material and urethane diacrylate as hydrophobic material. To overcome this problem, two surface modifications of bamboo fiber, alkali treatment and silane treatment, were implemented.

Findings

As a result, bamboo fiber can increase mechanical properties of urethane diacrylate photopolymer fabricated by rapid prototyping system.

Originality/value

In this paper, the authors investigate the effect of the addition of bamboo powder with surface modification on mechanical properties. Test specimens were fabricated using aliphatic urethane diacrylate photopolymer as matrix material and bamboo powder as reinforce material.
Process optimization of single screw extruder for development of Nylon 6-Al-Al2O3 alternative FDM filament
Authors: Boparai Kamaljit Singh , Singh Rupinder , Singh Harwinder
Published: June 2016

Purpose

The purpose of this study is to investigate the process parameters of a single-screw extruder for development of Nylon6-Al-Al2O3-based alternative fused deposition modeling process (FDM) feedstock filament (in lieu of commercial acrylonitrile butadiene styrene filament). The effect of major screw extruder parameters on the tensile strength of fabricated filaments has also been analyzed.

Design/methodology/approach

The Taguchi experimental log has been designed for investigating the significance of input parameters of screw extruders (such as mean barrel temperature, die temperature, screw speed, material composition and speed of take up unit) on the tensile strength of fabricated filaments. The suitability of alternative material as an FDM filament has been verified by rheological investigations. The tensile strength of an alternative feedstock filament has been investigated experimentally according to the ASTM-638 standard. The analysis was performed by the analysis of variance (ANOVA) method with the help of MINITAB 17 software. The stiffness of the FDM printed parts with nine different feedstock filaments (prepared by selecting nine different combinations of analytical parameters) was determined by dynamic mechanical analysis (DMA).

Findings

The tensile strength of the feedstock filament was significantly affected by the variation of major input parameters during the processing of alternative material on a single-screw extruder. The ANOVA shows that two process parameters (namely, material composition and die temperature) were significant at the 5 per cent level (“F” value 41 and 21.96, respectively) and remaining two (mean barrel temperature and screw speed) were insignificant at the 5 per cent level. Further, a linear regression model has been developed to predict the tensile strength of the alternative feedstock FDM filament. The results highlight that a deviation of <1 per cent was observed (in the tensile strength of nine sets of experimental runs) as compared to the predicted values of the regression model. In addition to above, the DMA result also indicates that the filament fabricated with optimum combination of parameters has highest stiffness and is more suitable for the FDM system.

Research limitations/implications

During the processing of alternative material in a single-screw extruder and FDM system, the increase of filler contents adversely affects the contact surfaces.

Practical implications

The FDM parts with customized properties (viz., thermal and tribological) can be fabricated with alternative feedstock filament material.

Originality/value

The potential to consider alternative filament material for FDM system includes rapid manufacturing of functional parts, tailor-made grinding tools for dentists and rapid tooling of metal matrix composites having complex geometry.
Latitude delineates patterns of biogeography in terrestrial Streptomyces
Authors: Choudoir Mallory J. , Doroghazi James R. , Buckley Daniel H.
Published: June 2016

The biogeography of Streptomyces was examined at regional spatial scales to identify factors that govern patterns of microbial diversity. Streptomyces are spore forming filamentous bacteria which are widespread in soil. Streptomyces strains were isolated from perennial grass habitats sampled across a spatial scale of more than 6000 km. Previous analysis of this geographically explicit culture collection provided evidence for a latitudinal diversity gradient in Streptomyces species. Here the hypothesis that this latitudinal diversity gradient is a result of evolutionary dynamics associated with historical demographic processes was evaluated. Historical demographic phenomena have genetic consequences that can be evaluated through analysis of population genetics. Population genetic approaches were applied to analyze population structure in six of the most numerically abundant and geographically widespread Streptomyces phylogroups from our culture collection. Streptomyces population structure varied at regional spatial scales, and allelic diversity correlated with geographic distance. In addition, allelic diversity and gene flow are partitioned by latitude. Finally, it was found that nucleotide diversity within phylogroups was negatively correlated with latitude. These results indicate that phylogroup diversification is constrained by dispersal limitation at regional spatial scales, and they are consistent with the hypothesis that historical demographic processes have influenced the contemporary biogeography of Streptomyces.
RNA‐seq analyses reveal insights into the function of respiratory nitrate reductase of the diazotroph Herbaspirillum seropedicae
Authors: Bonato Paloma , Batista Marcelo B. , Camilios‐Neto Doumit , Pankievicz Vânia C. S. , Tadra‐Sfeir Michelle Z. , Monteiro Rose Adele , Pedrosa Fabio O. , Souza Emanuel M. , Chubatsu Leda S. , Wassem Roseli , Rigo Liu Un
Published: June 2016

Herbaspirillum seropedicae is a nitrogen‐fixing β‐proteobacterium that associates with roots of gramineous plants. In silico analyses revealed that H. seropedicae genome has genes encoding a putative respiratory (NAR) and an assimilatory nitrate reductase (NAS). To date, little is known about nitrate metabolism in H. seropedicae, and, as this bacterium cannot respire nitrate, the function of NAR remains unknown. This study aimed to investigate the function of NAR in H. seropedicae and how it metabolizes nitrate in a low aerated‐condition. RNA‐seq transcriptional profiling in the presence of nitrate allowed us to pinpoint genes important for nitrate metabolism in H. seropedicae, including nitrate transporters and regulatory proteins. Additionally, both RNA‐seq data and physiological characterization of a mutant in the catalytic subunit of NAR (narG mutant) showed that NAR is not required for nitrate assimilation but is required for: (i) production of high levels of nitrite, (ii) production of NO and (iii) dissipation of redox power, which in turn lead to an increase in carbon consumption. In addition, wheat plants showed an increase in shoot dry weight only when inoculated with H. seropedicae wild type, but not with the narG mutant, suggesting that NAR is important to H. seropedicae‐wheat interaction.
Migration and perinatal mental health in women from low‐ and middle‐income countries: a systematic review and meta‐analysis
Authors: Fellmeth G , Fazel M , Plugge E
Published: June 2016

Background

Migrant women are at risk of perinatal mental disorders due to stressors experienced before, during and after migration.

Objectives

This systematic review and meta‐analysis summarises the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low‐ and middle‐income countries (LMIC).

Search Strategy

We systematically searched nine electronic databases and the grey literature using a predefined search strategy.

Selection Criteria

Studies were included if they assessed pregnant or postpartum migrants from LMIC, used a structured tool and a case‐control, cross‐sectional, cohort or intervention study design.

Data collection and analysis

Data was double‐extracted. We calculated pooled prevalence of depression and weighted mean anxiety and depression scores. We calculated crude odds ratios from risk factor studies and summarised intervention studies descriptively.

Main results

Forty studies were identified from 10 123 references. Pooled prevalence was 31% [95% condidence interval (CI) 23%–40%] for any depressive disorder and 17% (95% CI 12–23%) for major depressive disorder. Previous depression and lower social support were associated with perinatal depression. There were insufficient data to assess the burden of anxiety, post‐traumatic stress disorder or psychosis in this population.

Conclusions

One in three migrant women from LMIC experiences symptoms of perinatal depression. Social support is an important protective factor. Evidence on LMIC women relocating to other LMIC is lacking. Given the adverse consequences of perinatal mental illness on women and their children, further research in low‐resource settings is a priority.

Tweetable Abstract

One in three migrant women from low‐ and middle‐income countries has symptoms of perinatal depression.
Decoupling practical and legal compliance: Analysis of member states’ implementation of EU policy
Authors: ZHELYAZKOVA ASYA , KAYA CANSARP , SCHRAMA REINI
Published: June 2016

Despite the vast literature on policy implementation, systematic cross‐national research focusing on implementers’ performance regarding different policy issues is still in its infancy. The European Union policies are conducive to examining this relationship in a comparative setting, as the EU member states need to implement various EU directives both legally and in practice. In this study, a first attempt is made to analyse the relationship between legal conformity and practical implementation and the conditions for practical deviations in 27 member states across issues from four policy areas (Internal Market, Environment, Justice and Home Affairs and Social Policy). In line with existing approaches to EU compliance, it is expected that the policy preferences of domestic political elites (‘enforcement’) affect their incentives to ‘decouple’ practical from legal compliance. Instead, administrative and institutional capacities (‘management’) and societal constraints (‘legitimacy’) are likely to limit the ability of policy makers to exert control over the implementation process. The findings suggest that practical deviations arise from policy makers’ inability to steer the implementation process, regardless of their predispositions towards internationally agreed policies. The results have strong implications for the effective application of international rules in domestic settings, as they illustrate that political support for the implementation of ‘external’ policy does not ensure effective implementation in practice.
The Dynamics of Hospital Use among Older People Evidence for Europe Using SHARE Data
Authors: Sirven Nicolas , Rapp Thomas
Published: June 2016

Objective

Hospital services use, which is a major driver of total health expenditures, is expected to rise over the next decades in Europe, especially because of population aging. The purpose of this article is to better understand the dynamics of older people's demand for hospital care over time in a cross‐country setting.

Data source

We used data from the Survey on Health, Ageing, and Retirement in Europe (SHARE), in 10 countries between 2004 and 2011.

Study Design

We estimated a dynamic panel model of hospital admission for respondents aged 50 years or more.

Principal Findings

Following prior research, we found evidence of state dependence in hospital use over time. We also found that rise in frailty—among other health covariates—is a strong predictor of increased hospital use. Progression by one point on the frailty scale [0;5] is associated with an additional risk of about 2.1 percent on average.

Conclusions

Our results support promotion of early detection of frailty in primary care, and improvement of coordination between actors within the health system, as potential strategies to reduce avoidable or unnecessary hospital use among frail elderly.
Regional Price Effects of Extreme Weather Events and Wheat Export Controls in Russia and Ukraine
Authors: Götz Linde , Djuric Ivan , Nivievskyi Oleg
Published: June 2016

We build on the price transmission framework to identify domestic wheat price effects of wheat export controls. We explicitly take into account that a harvest failure causes domestic price effects. Moreover, the analysis at the regional level provides further evidence of the functioning of export controls in a large country. Results suggest a pronounced regional heterogeneity in the strength of domestic price effects of the 2010/11 export ban in Russia. The wheat price dampening effects amount to up to 67% and are strongest in the major wheat exporting region with direct access to the world market. This effect is transmitted to other regions by increased and reversed interregional trade flows. In contrast, we find that regional variation of export controls’ domestic price effects in Ukraine is rather small.
Coincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the Literature
Authors: Arslan Murat Nihat , Melez Deniz Oguzhan , Akcay Arzu , Gur Adem , Sam Bulent , Guven Apaydın Suheyla
Published: June 2016

Nicolau syndrome (NS) is a dermatological adverse reaction of intramuscular injections and is caused by several mechanisms. The etiopathogenesis remains unclear, and several hypotheses have suggested a vascular origin. Rhabdomyolysis (RM) is the destruction of striated muscle, with the subsequent release of muscle cell contents into circulation. NS and RM diagnoses may overlap. Herein, we present the autopsy findings of a 40‐year‐old female with NS complicated with RM. On clinical follow‐up, creatine kinase (CK) was 7146 IU/L, and urea and creatinine levels were elevated on the third day after intramuscular diclofenac injection. Possible ischemic process triggered the RM and subsequent acute renal failure. The opportunity for an early diagnosis was missed because the patient delayed seeking medical aid. The prognosis worsened, and the patient died due to secondary sepsis. Early diagnosis of NS before the occurrence of complications is the most important issue in patient education and can be life‐saving.
An Evaluation of the Calce Method for Age Estimation
Authors: Lam Jessica F. , Johansen Alexandra C. , Rogers Tracy L.
Published: June 2016

The Calce method of skeletal age estimation (Am J Phys Anthropol, 148, 2012 and 11) uses the acetabular surface of the os coxa and was developed using 90 individuals from the J.C.B. Grant Skeletal collection. From this collection, pilot tests using a combined sample size of 55 randomized individuals yielded an accuracy of 54.5%. To eliminate the possible issue of variation within the collection, 30 individuals from those that Calce specifically used were assessed by two analysts. Accuracies of 53.3% and 56.7% were obtained, compared with Calce's reported accuracy of 81% (Am J Phys Anthropol, 148, 2012 and 11). This study also used 30 Japanese individuals from the Nagasaki University modern cadaver collection. Due to the high interobserver error (43.3%) and the low accuracies achieved (40% and 46.7%), the Calce method does not perform well on Japanese samples. The low accuracy of this method in general suggests that the trait descriptions should be refined to assist analysts in properly utilizing the method.
Biogenic selenium nanoparticles: characterization, antimicrobial activity and effects on human dendritic cells and fibroblasts
Authors: Cremonini Eleonora , Zonaro Emanuele , Donini Marta , Lampis Silvia , Boaretti Marzia , Dusi Stefano , Melotti Paola , Lleo Maria M. , Vallini Giovanni
Published: June 2016

Tailored nanoparticles offer a novel approach to fight antibiotic‐resistant microorganisms. We analysed biogenic selenium nanoparticles (SeNPs) of bacterial origin to determine their antimicrobial activity against selected pathogens in their planktonic and biofilm states. SeNPs synthesized by Gram‐negative Stenotrophomonas maltophilia [Sm‐SeNPs(−)] and Gram‐positive Bacillus mycoides [Bm‐SeNPs(+)] were active at low minimum inhibitory concentrations against a number of clinical isolates of Pseudomonas aeruginosa but did not inhibit clinical isolates of the yeast species Candida albicans and C. parapsilosis. However, the SeNPs were able to inhibit biofilm formation and also to disaggregate the mature glycocalyx in both P. aeruginosa and Candida spp. The Sm‐SeNPs(−) and Bm‐SeNPs(+) both achieved much stronger antimicrobial effects than synthetic selenium nanoparticles (Ch‐SeNPs). Dendritic cells and fibroblasts exposed to Sm‐SeNPs(−), Bm‐SeNPs(+) and Ch‐SeNPs did not show any loss of cell viability, any increase in the release of reactive oxygen species or any significant increase in the secretion of pro‐inflammatory and immunostimulatory cytokines. Biogenic SeNPs therefore appear to be reliable candidates for safe medical applications, alone or in association with traditional antibiotics, to inhibit the growth of clinical isolates of P. aeruginosa or to facilitate the penetration of P. aeruginosa and Candida spp. biofilms by antimicrobial agents.
RUNX3 reverses cisplatin resistance in esophageal squamous cell carcinoma via suppression of the protein kinase B pathway
Authors: Li De‐jun , Shi Mo , Wang Zhou
Published: June 2016

Background

Preoperative chemoradiation combined with surgery has been of focus recently in order to improve prognosis in esophageal squamous cell carcinoma (ESCC) patients. Finding biological markers that may assist in predicting the therapeutic effect of chemoradiation may benefit the treatment effect. In this study, the role of RUNX3 in the formation of cisplatin resistance in ESCC was examined.

Methods

The study enrolled 103 stage IIa–IIIb ESCC patients who had undergone esophagectomy. RUNX3 expression in ESCC tissue was detected.

Results

A higher expression of RUNX3 in ESCC patients correlated with a more sensitive response to cisplatin‐based chemotherapy. A consistently lower expression of RUNX3 was found in the ESCC tissues of patients who agreed to perioperative chemotherapy compared with patients who had undergone no preoperative treatment. A lower RUNX3 expression in cisplatin‐resistant ESCC cell lines, Eca109 and TE‐1, was observed compared with parental cell lines. Heterologous RUNX3 expression significantly suppressed cisplatin resistance in Eca109 and TE‐1, both in vitro and vivo. Meanwhile, heterologous RUNX3 expression could inhibit growth and induce apoptosis in cisplatin resistant Eca109 and TE‐1 cell lines in vitro. Remarkable inhibition of the Akt pathway was observed in heterologous RUNX3 expression in Eca109 and TE‐1. Silencing Akt1 could reverse cisplatin resistance in Eca109 and TE‐1.

Conclusion

Our results confirmed that a loss of RUNX3 in ESCC may contribute to cisplatin‐resistance. RUNX3 could reverse cisplatin resistance via suppression of the Akt pathway in ESCC patients.
Menopausal status influences the expression of programmed death (PD)‐1 and its ligand PD‐L1 on immune cells from the human female reproductive tract
Authors: Shen Zheng , Rodriguez‐Garcia Marta , Patel Mickey V. , Barr Fiona D. , Wira Charles R.
Published: June 2016

Problem

The programmed death 1 (PD‐1)/PD‐L1 pathway regulates peripheral tolerance, immune responses, and is up‐regulated in chronic viral infections, including HIV infection. However, expression of PD‐1/PD‐L1 on immune cells from the human female reproductive tract (FRT) and possible regulation by menopause and sex hormones are poorly understood.

Method of study

PD‐1/PD‐L1 expression was analyzed on CD4+ and CD8+ T cells, CD163+ macrophages, and CD11c+ dendritic cells (DC) from endometrium (EM), endocervix (CX) and ectocervix (ECX). Expression after hormone treatment in culture was also evaluated.

Results

PD‐1 and PD‐L1 were constitutively expressed on CD4+ and CD8+ T cells from the FRT. PD‐L1+CD4+ T cells were increased in CX compared to EM and ECX, while no differences were found for PD‐1 or between CD8+ T cells from different sites. Macrophages and DCs constitutively expressed PD‐L1, but not PD‐1, with no differences observed between FRT sites. Pre‐menopausal FRT tissues showed increased PD‐L1 expression on CD8+ T cells, but decreased expression on DCs when compared to post‐menopausal women. In vitro estradiol treatment up‐regulated PD‐L1 expression specifically on CD8+T cells from CX, but had no effect on PD‐1/PD‐L1 expression on the other cell types.

Conclusion

Our results suggest that PD‐L1 may be involved in the differential regulation of FRT immune responses between pre‐menopausal and post‐menopausal women.
Predictive algorithms for early detection of retinopathy of prematurity
Authors: Piermarocchi Stefano , Bini Silvia , Martini Ferdinando , Berton Marianna , Lavini Anna , Gusson Elena , Marchini Giorgio , Padovani Ezio Maria , Macor Sara , Pignatto Silvia , Lanzetta Paolo , Cattarossi Luigi , Baraldi Eugenio , Lago Paola
Published: June 2016

Purpose

To evaluate sensitivity, specificity and the safest cut‐offs of three predictive algorithms (WINROP, ROPScore and CHOP ROP) for retinopathy of prematurity (ROP).

Methods

A retrospective study was conducted in three centres from 2012 to 2014; 445 preterms with gestational age (GA) ≤ 30 weeks and/or birthweight (BW) ≤ 1500 g, and additional unstable cases, were included. No‐ROP, mild and type 1 ROP were categorized. The algorithms were analysed for infants with all parameters (GA, BW, weight gain, oxygen therapy, blood transfusion) needed for calculation (399 babies).

Results

Retinopathy of prematurity (ROP) was identified in both eyes in 116 patients (26.1%), and 44 (9.9%) had type 1 ROP. Gestational age and BW were significantly lower in ROP group compared with no‐ROP subjects (GA: 26.7 ± 2.2 and 30.2 ± 1.9, respectively, p < 0.0001; BW: 839.8 ± 287.0 and 1288.1 ± 321.5 g, respectively, p = 0.0016). Customized alarms of ROPScore and CHOP ROP correctly identified all infants having any ROP or type 1 ROP. WINROP missed 19 cases of ROP, including three type 1 ROP. ROPScore and CHOP ROP provided the best performances with an area under the receiver operating characteristic curve for the detection of severe ROP of 0.93 (95% CI, 0.90–0.96, and 95% CI, 0.89–0.96, respectively), and WINROP obtained 0.83 (95% CI, 0.77–0.87). Median time from alarm to treatment was 11.1, 5.1 and 9.1 weeks, for WINROP, ROPScore and CHOP ROP, respectively.

Conclusion

ROPScore and CHOP ROP showed 100% sensitivity to identify sight‐threatening ROP. Predictive algorithms are a reliable tool for early identification of infants requiring referral to an ophthalmologist, for reorganizing resources and reducing stressful procedures to preterm babies.
Austerity in the United Kingdom: the intersections of spatial and gendered inequalities
Authors: Greer Murphy Amy
Published: June 2016

This commentary examines gendered and spatial inequalities that are increasing under a regime of austerity in the United Kingdom. It is concerned with how inequalities intersect and interact across space and populations. A sense of urgency is vital when discussing the effects of austerity on regions and local communities; five years of cuts have had devastating effects on many deprived areas. An examination of the specific risks to women under austerity is essential. The commentary will be of interest to geographers concerned with the intersections of gender, economy and place. This paper proposes a feminist political economy perspective for the analysis of austerity and place, to acknowledge the centrality of gendered political economy, absent from many geographical studies of austerity.
Interprovincial Migration and Human Capital Formation in China*
Authors: Suzuki Yui , Suzuki Yukari
Published: June 2016

We examine how the rising interprovincial migration of individuals with diverse educational backgrounds affected human capital formation in China in the 1990s. We find that gross outflow migration of those with higher and lower levels of education, respectively, has human capital incentive and disincentive effects. Our estimates suggest that the incentive effect eclipses the disincentive effect in general; however, a surge of migration, particularly among less educated groups, implies more of a disincentive effect in China in the 1990s. We also find that changes in the relative labor supply resulting from net outflow migration mitigate a direct brain drain by both encouraging and discouraging school enrolments.
Asset Accumulation in Rural Households during the Post‐Showa Depression Reconstruction: A Panel Data Analysis*
Authors: Kusadokoro Motoi , Maru Takeshi , Takashima Masanori
Published: June 2016

This paper investigates asset accumulation in Japanese farm households during reconstruction following the Showa Depression. After the Showa Depression, farm households emphasized accumulation of cash and quasi‐money rather than productive assets. The accumulation of cash and quasi‐money is consistent with the buffer stock hypothesis. Evidence regarding accumulation of livestock, which is sometimes used as the buffer stock in modern developing countries, is not conclusive. The presence of well‐developed financial institutions in prewar Japan may have allowed farm households to smooth consumption via cash and quasi‐money.
Impact of a Nursing Skill‐Improvement Intervention on Newborn‐Specific Delivery Practices: An Experience from Bihar, India
Authors: Das Aritra , Nawal Dipty , Singh Manoj K. , Karthick Morchan , Pahwa Parika , Shah Malay B. , Mahapatra Tanmay , Chaudhuri Indrajit
Published: June 2016

Background

High neonatal mortality in India had previously been attributed to the low proportion of institutional deliveries. However, a significant rise in the proportion of facility‐based births over the last decade has not achieved the desired reduction in neonatal mortality possibly as a result of low‐skilled care at facilities. This study evaluated the effectiveness of “Mobile Nurse Training,” a knowledge‐based intervention for nurses to improve essential newborn‐specific delivery practices.

Methods

Eighty health centers with obstetric care facilities were selected from eight districts of Bihar. The intervention teams were composed of two trained nurses who conducted a week‐long workshop per month at every health facility for 6 months. An independent evaluation team conducted baseline and postintervention assessments at every facility. The assessments included passive observation of newborn‐specific delivery practices and recording of results on a preformatted checklist‐based tool.

Results

The intervention was associated with significant increases in the odds of four recommended practices: placing the newborn on mother's abdomen (adjusted odds ratio (AOR) 4.2 [95% CI 3.0–5.9]), wiping the eyes with sterile gauze (AOR 2.2 [95% CI 1.4–3.4]), skin‐to‐skin care (AOR 2.7 [95% CI 2.0–3.5]), and guidance for initiation of breastfeeding (AOR 1.6 [95% CI 1.2–2.1]). The intervention was also found to be positively associated with the summary score for improvements in all newborn‐specific delivery practices. One year after the intervention, the summary practice score remained higher than at baseline, but with some decline over time.

Conclusions

The “Mobile Nurse Training” intervention provides a pathway for improving adherence to recommended newborn‐specific delivery practices among institutional birth attendants in rural Bihar.
Preoperative nomogram to predict the likelihood of complications after radical nephroureterectomy
Authors: Raman Jay D. , Lin Yu‐Kuan , Shariat Shahrokh F. , Krabbe Laura‐Maria , Margulis Vitaly , Arnouk Alex , Lallas Costas D. , Trabulsi Edouard J. , Drouin Sarah J. , Rouprêt Morgan , Bozzini Gregory , Colin Pierre , Peyronnet Benoit , Bensalah Karim , Bailey Kari , Canes David , Klatte Tobias
Published: June 2016

Objectives

To construct a nomogram based on preoperative variables to better predict the likelihood of complications occurring within 30 days of radical nephroureterectomy (RNU).

Patients and Methods

The charts of 731 patients undergoing RNU at eight academic medical centres between 2002 and 2014 were reviewed. Preoperative clinical, demographic and comorbidity indices were collected. Complications occurring within 30 days of surgery were graded using the modified Clavien–Dindo scale. Multivariate logistic regression determined the association between preoperative variables and post‐RNU complications. A nomogram was created from the reduced multivariate model with internal validation using the bootstrapping technique with 200 repetitions.

Results

A total of 408 men and 323 women with a median age of 70 years and a body mass index of 27 kg/m2 were included. A total of 75% of the cohort was white, 18% had an Eastern Cooperative Oncology Group (ECOG) performance status ≥2, 20% had a Charlson comorbidity index (CCI) score >5 and 50% had baseline chronic kidney disease (CKD) ≥ stage III. Overall, 279 patients (38%) experienced a complication, including 61 events (22%) with Clavien grade ≥ III. A multivariate model identified five variables associated with complications, including patient age, race, ECOG performance status, CKD stage and CCI score. A preoperative nomogram incorporating these risk factors was constructed with an area under curve of 72.2%.

Conclusions

Using standard preoperative variables from this multi‐institutional RNU experience, we constructed and validated a nomogram for predicting peri‐operative complications after RNU. Such information may permit more accurate risk stratification on an individual cases basis before major surgery.
TheUSRole in the 1964 Coup inBrazil: A Reassessment
Authors: PEREIRA ANTHONY W.
Published: June 2016

The role of theUSin the 1964 coup inBrazil is controversial. When didUSpolicymakers decide to support the coup conspirators, and why? This article reviews some recent works on the 1964 coup and makes two arguments. First, recently declassified documents show that theUSjoined the coup conspiracy only in 1963 not, as some claim, in 1961 or 1962. Second, many scholars do not explain the actions ofUSpolicymakers, or see their decisions as the inevitable consequence ofUSimperialism. This article argues that shifts inUSdomestic politics during theCold War, as well as the pattern of post‐war foreign policy inLatin America, help explainUSsupport for the coup.
A new model for making Aboriginal policy? Evaluating the Kelowna Accord and the promise of multilevel governance in Canada
Authors: Alcantara Christopher , Spicer Zachary
Published: June 2016

Government policy‐making affecting Indigenous communities in Canada has often been met with stiff resistance from Indigenous leadership. We examine multilevel governance as an alternate model for Aboriginal policy‐making by examining a particular case study: the process leading up to the 2005 Kelowna Accord. We find that although multilevel governance may have the potential to produce highly desirable outcomes, its emergence seems to depend heavily on political agency. Meaningful and enduring change to Aboriginal policy‐making will therefore likely require significant institutional adjustments to the Canadian federation.
Policy work at the sub‐national level: Analytical styles of Canadian and Czech directors and managers
Authors: Nekola Martin , Kohoutek Jan
Published: June 2016

This paper uses data from two countries to develop profiles of policy directors and managers in the sub‐national public bureaucracies of Canada and the Czech Republic. Canadian directors and managers undertake more analytically complex tasks for which research and evaluation is necessary. In comparison, Czech managers are more firmly engaged in project management agendas, and Czech directors tend to rely on personal experience and routine approaches. Overall, the sample shows that different policy styles are emphasized in each country and at different levels ranging from rational‐technical and advisory‐interactive (Canadian directors and managers), process expertise (Czech managers), and a combination of analytical rationality and issue activism (Czech directors).
Effects of prednisolone on energy and fat metabolism in patients with rheumatoid arthritis: tissue‐specific insulin resistance with commonly used prednisolone doses
Authors: Radhakutty Anjana , Mangelsdorf Brenda L. , Drake Sophie M. , Samocha‐Bonet Dorit , Heilbronn Leonie K. , Smith Malcolm D. , Thompson Campbell H. , Burt Morton G.
Published: June 2016

Objective

Glucocorticoids can cause postprandial hyperglycaemia, but the effects on postprandial energy and fat metabolism are uncertain. We investigated the effects of acute and chronic low‐dose prednisolone on fasting and postprandial energy expenditure and substrate metabolism.

Design

An open interventional and cross‐sectional study was undertaken.

Patients and measurements

Eighteen patients who had not taken oral glucocorticoids for ≥6 months were studied before and after 7 days prednisolone (6 mg/day) to assess the acute effects of prednisolone. Baseline data from patients, not on glucocorticoids, were compared with 18 patients on long‐term prednisolone (6·5 ± 1·8 mg/day for >6 months) to assess the chronic effects. Energy expenditure and substrate oxidation were measured using indirect calorimetry before and after a mixed meal. Adipocyte insulin resistance index and insulin‐mediated suppression of NEFA were calculated from fasting and postprandial insulin and NEFA concentrations.

Results

There were no significant differences in resting energy expenditure or diet‐induced thermogenesis with prednisolone. Acute (−2·1 ± 6·2 vs −16·3 ± 4·8 mg/min, P = 0·01) and chronic (−1·4 ± 2·8 vs −16·3 ± 4·8 mg/min, P = 0·01) prednisolone attenuated postprandial suppression of fat oxidation. Chronic (31·6 ± 3·8 vs 17·0 ± 3·3, P = 0·007), but not acute, prednisolone increased adipocyte insulin resistance index. However, insulin‐mediated suppression of NEFA was not significantly different after acute or chronic prednisolone.

Conclusions

Prednisolone does not alter energy expenditure. However, even at low doses, prednisolone exerts adverse effects on fat metabolism, which could exacerbate insulin resistance and increase cardiovascular risk. Attenuated postprandial suppression of fat oxidation, but not lipolysis, suggests that prednisolone causes greater insulin resistance in skeletal muscle than in adipocytes.
EMRdocumentation of physician–patient communication following genomic counseling for actionable complex disease and pharmacogenomic results
Authors: Sweet K. , Sturm A.C. , Schmidlen T. , Hovick S. , Peng J. , Manickam K. , Salikhova A. , McElroy J. , Scheinfeldt L. , Toland A.E. , Roberts J.S. , Christman M.
Published: June 2016

Genomic risk information for potentially actionable complex diseases and pharmacogenomics communicated through genomic counseling (GC) may motivate physicians and patients to take preventive actions. The Ohio State University‐Coriell Personalized Medicine Collaborative is a randomized trial to measure the effects of in‐person GC on chronic disease patients provided with multiplex results. Nine personalized genomic risk reports were provided to patients through a web portal, and to physicians via electronic medical record (EMR). Active arm participants (98, 39% female) received GC within 1 month of report viewing; control arm subjects (101, 54% female) could access counseling 3‐months post‐report viewing. We examined whether GC affected documentation of physician–patient communication by reviewing the first clinical note following the patient's GC visit or report upload to theEMR. Multivariable logistic regression modeling estimated the independent effect of GC on physician–patient communication, as intention to treat (ITT) and per protocol (PP), adjusted for physician educational intervention. Counselees in the active arm had more physician–patient communications than control subjects [ITT, odds ratio (OR): 3.76 (95% confidence interval (CI): 1.38–10.22, p < 0.0094);PP,OR: 5.53 (95%CI: 2.20–13.90, p = 0.0017). In conclusion, GC appreciably affected physician–patient communication following receipt of potentially actionable genomic risk information.
Visual Text Analysis in Digital Humanities
Authors: Jänicke S. , Franzini G. , Cheema M. F. , Scheuermann G.
Published: June 2016

In 2005, Franco Moretti introduced Distant Reading to analyse entire literary text collections. This was a rather revolutionary idea compared to the traditional Close Reading, which focuses on the thorough interpretation of an individual work. Both reading techniques are the prior means of Visual Text Analysis. We present an overview of the research conducted since 2005 on supporting text analysis tasks with close and distant reading visualizations in the digital humanities. Therefore, we classify the observed papers according to a taxonomy of text analysis tasks, categorize applied close and distant reading techniques to support the investigation of these tasks and illustrate approaches that combine both reading techniques in order to provide a multi‐faceted view of the textual data. In addition, we take a look at the used text sources and at the typical data transformation steps required for the proposed visualizations. Finally, we summarize collaboration experiences when developing visualizations for close and distant reading, and we give an outlook on future challenges in that research area.
The LOREC APE registry: operative technique, oncological outcome and perineal wound healing after abdominoperineal excision
Authors: Jones H. , Moran B. , Crane S. , Hompes R. , Cunningham C. ,   on behalf of LOREC group
Published: June 2016

Aim

The Low Rectal Cancer Development programme (LOREC) perineal wound healing registry was developed to record data on abdominoperineal excision (APE) for rectal cancer in colorectal units in England between 2012 and 2014, to understand current practice in operative technique and results.

Method

Surgeons wishing to participate received secure Web‐based access to the registry. Data were collected on preoperative staging, neoadjuvant treatment, operative details, histopathology, early outcome and follow up at 12 months.

Results

Forty‐two units entered 266 patients. Of these, 172 (65%) patients underwent extralevator APE (ELAPE) and 94 had non‐ELAPE procedures. On preoperative staging, 64% were mrT3/4, and 67% received neoadjuvant treatment. For the ELAPE group the perineal wound was closed primarily with mesh in 55% of patients, without mesh in 15% and with a flap in 21%. For non‐ELAPE procedures, 54% of wounds were closed primarily without mesh, 29% primarily with mesh and 5% by a flap. Wound breakdown occurred in 30% and 31% of patients in the ELAPE and non‐ELAPE groups, respectively, and was more common after neoadjuvant radiotherapy. Donor‐site complications occurred in 17% of patients treated with a flap. Perineal morbidity was recorded in 11% of patients at 12 months. On histopathology, the resection margin was positive in 13% of patients in the ELAPE group and in 4% of patients in the non‐ELAPE group.

Conclusion

The LOREC registry provides a picture of current APE practice in England. ELAPE was used in two‐thirds of patients but does not appear to confer any additional morbidity. Primary closure with mesh appeared as effective as flap reconstruction. The prevalence of an involved resection margin was lower than reported in many historical series but still remains high in the ELAPE group.
Modeling Lag‐2 Revisits to Understand Trade‐Offs in Mixed Control of Fixation Termination During Visual Search
Authors: Godwin Hayward J. , Reichle Erik D. , Menneer Tamaryn
Published: June 2016

An important question about eye‐movement behavior is when the decision is made to terminate a fixation and program the following saccade. Different approaches have found converging evidence in favor of a mixed‐control account, in which there is some overlap between processing information at fixation and planning the following saccade. We examined one interesting instance of mixed control in visual search: lag‐2 revisits, during which observers fixate a stimulus, move to a different stimulus, and then revisit the first stimulus on the next fixation. Results show that the probability of lag‐2 revisits occurring increased with the number of target‐similar stimuli, and revisits were preceded by a brief fixation on the intervening distractor stimulus. We developed the Efficient Visual Sampling (EVS) computational model to simulate our findings (fixation durations and fixation locations) and to provide insight into mixed control of fixations and the perceptual, cognitive, and motor processes that produce lag‐2 revisits.
An Extension of a Parallel‐Distributed Processing Framework of Reading Aloud in Japanese: Human Nonword Reading Accuracy Does Not Require a Sequential Mechanism
Authors: Ikeda Kenji , Ueno Taiji , Ito Yuichi , Kitagami Shinji , Kawaguchi Jun
Published: June 2016

Humans can pronounce a nonword (e.g., rint). Some researchers have interpreted this behavior as requiring a sequential mechanism by which a grapheme‐phoneme correspondence rule is applied to each grapheme in turn. However, several parallel‐distributed processing (PDP) models in English have simulated human nonword reading accuracy without a sequential mechanism. Interestingly, the Japanese psycholinguistic literature went partly in the same direction, but it has since concluded that a sequential parsing mechanism is required to reproduce human nonword reading accuracy. In this study, by manipulating the list composition (i.e., pure word/nonword list vs. mixed list), we demonstrated that past psycholinguistic studies in Japanese have overestimated human nonword reading accuracy. When the more fairly reevaluated human performance was targeted, a newly implemented Japanese PDP model simulated the target accuracy as well as the error patterns. These findings suggest that PDP models are a more parsimonious way of explaining reading across various languages.
Color in Reference Production: The Role of Color Similarity and Color Codability
Authors: Viethen Jette , van Vessem Thomas , Goudbeek Martijn , Krahmer Emiel
Published: June 2016

It has often been observed that color is a highly preferred attribute for use in distinguishing descriptions, that is, referring expressions produced with the purpose of identifying an object within a visual scene. However, most of these observations were based on visual displays containing only colors that were maximally different in hue and for which the language of experimentation possessed basic color terms. The experiments described in this paper investigate whether speakers’ preference for color is reduced if the color of the target referent is similar to that of the distractors. Because colors that look similar are often also harder to distinguish linguistically, we also examine the impact of the codability of color values. As a third factor, we investigate the salience of available alternative attributes and its impact on the use of color. The results of our experiments show that, while speakers are indeed less likely to use color when the colors in a display are similar, this effect is mostly due to the difficulty in naming similar colors. Color use for color with a basic color term is affected only when the colors of target and distractors are very similar (yet still distinguishable). The salience of our alternative attribute size, manipulated by varying the difference in size between target and distractors, had no impact on the use of color.
Containment and Support: Core and Complexity in Spatial Language Learning
Authors: Landau Barbara , Johannes Kristen , Skordos Dimitrios , Papafragou Anna
Published: June 2016

Containment and support have traditionally been assumed to represent universal conceptual foundations for spatial terms. This assumption can be challenged, however: Englishinandonare applied across a surprisingly broad range of exemplars, and comparable terms in other languages show significant variation in their application. We propose that the broad domains of both containment and support have internal structure that reflects different subtypes, that this structure is reflected in basic spatial term usage across languages, and that it constrains children's spatial term learning. Using a newly developed battery, we asked how adults and 4‐year‐old children speaking English or Greek distribute basic spatial terms across subtypes of containment and support. We found that containment showed similar distributions of basic terms across subtypes among all groups while support showed such similarity only among adults, with striking differences between children learning English versus Greek. We conclude that the two domains differ considerably in the learning problems they present, and that learninginandonis remarkably complex. Together, our results point to the need for a more nuanced view of spatial term learning.