bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric evaluation of an interview-administered version of the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh
Authors: Uddin Mohammed Nazim , Islam Fakir M Amirul , Al Mahmud Abdullah
Published: June 2018

Objective

The aim of this study was to translate, adapt and validate the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh.

Design

Cohort study.

Setting

Narail district, Bangladesh.

Participants

A random sample of 2425 adults of age 18–90 years was recruited.

Outcome measure

Validation of the K10 was the major outcome. Sociodemographic factors were measured to assess if the K10 needed adjustment for factors such as age or gender. The Rasch measurement model was used for the validation, and RUMM 2030 and SPSS V.24 software were used for analyses.

Results

Initial inspection of the total sample showed poor overall fit. A sample size of 300, which is more satiated for Rasch analysis, also showed poor overall fit, as indicated by a significant item–trait interaction (χ2= 262.27, df=40, p<0.001) and item fit residual values (mean=–0.25, SD=2.49). Of 10 items, five items were disordered thresholds, and seven items showed misfit, suggesting problems with the response format and items. After removing three items (‘feel tired’, ‘depressed’ and ‘worthless’) and changing the Likert scale categories from five to four categories, the remaining seven items showed ordered threshold. A revised seven-item scale has shown adequate internal consistency, with no evidence of multidimensionality, no differential item functioning on age and gender, and no signs of local dependency.

Conclusions

Analysis of the psychometric validity of K10 using the Rasch model showed that 10 items are not appropriate for measuring psychological distress in rural Bangladesh. A modified version of seven items (K7) with four response categories would provide a psychometrically more robust scale than the original K10. The study findings suggest repeating the K7 version in other remote areas for further validation can substantiate an efficient screening tool for measuring psychological distress among the general Bangladeshi population.
Hospitalisation and mortality outcomes of patients with comorbid COPD and heart failure: a systematic review protocol
Authors: Axson Eleanor L , Sundaram Varun , Bloom Chloe I , Bottle Alex , Cowie Martin R , Quint Jennifer K
Published: June 2018

Introduction

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist in patients. Many studies have explored the short-term and long-term outcomes of patients with comorbid COPD and HF; however, there have been discrepancies in their findings.

Methods and analysis

In this systematic review, MEDLINE and Embase will be searched using a prespecified search strategy. Randomised controlled trials and studies conducted in the general population that employ analytical or descriptive (longitudinal or case–control) study designs that report odds ratios (ORs), hazard ratios (HRs), or risk ratios (RRs) of mortality or hospitalisation, comparing patients with comorbid COPD and HF with patients with just COPD, will be selected. Screening by title and abstract, then full-text screening will be conducted by two reviewers. The Population, Exposure, Comparator, Outcomes, Study (PECOS) characteristics framework will be used to systemise the data extraction from selected studies. Study quality will be assessed using an adapted version of the Newcastle-Ottawa risk of bias tool. Data extraction and the risk of bias will also be conducted by two reviewers. Given sufficient homogeneity of selected studies, a meta-analysis will be conducted. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria will be used to assess the quality of cumulative evidence.

Dissemination

With this review, we hope to improve the understanding of clinical outcomes of patients with comorbid COPD and HF. We intend to publish the results of our review in a peer-reviewed journal and to present our findings at national and international meetings and conferences.

PROSPERO registration number

CRD42018089534
No association between DNA methylation and COPD in never and current smokers
Authors: de Vries Maaike , van der Plaat Diana A , Vonk Judith M , Boezen H Marike
Published: June 2018

Introduction

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease with cigarette smoke as the main risk factor for its development. Since not every smoker develops COPD, other factors likely underlie differences in susceptibility to develop COPD. Here, we tested if DNA methylation may be such a factor by assessing the association between DNA methylation levels and COPD in never and current smokers from the general population.

Methods

For the current study, 1561 subjects were non-randomly selected from the LifeLines cohort study. We included 903 never smokers and 658 current smokers with and without COPD, defined as pre-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <70%. Subsequently, we performed robust regression analysis on whole blood DNA methylation levels of 420 938 CpG sites with COPD as outcome.

Results

None of the CpG sites in both the never and the current smokers were genome-wide significantly associated with COPD. CpG site cg14972228 annotated toSIPAL3was most significant (p=5.66×10−6) in the never smokers, while CpG site cg08282037 annotated toEPS8L1was most significant (p=1.45×10−5) in the current smokers.

Conclusion

In contrast to a previous, smaller study, we did not observe any significant association between DNA methylation levels and the presence of COPD, independent of smoking status. Apparently, DNA methylation studies are highly variable.
Mortality among diagnostic medical radiation workers in South Korea, 1996–2015
Authors: Lee Won Jin , Ko Seulki , Bang Ye Jin , Cha Eun Shil , Lee Kyoung-Mu
Published: June 2018

Objectives

To evaluate the risk for all-cause and cause-specific mortality in diagnostic medical radiation workers in South Korea.

Methods

The study population included all diagnostic medical radiation workers enrolled in the National Dosimetry Registry (NDR) between 1996 and 2011. NDR data were linked with mortality data obtained from national registries through 2015. Standardised mortality ratios (SMRs) and relative standardised mortality ratios (rSMRs) were calculated for external comparison and for adjustment of the cohort’s overall healthiness.

Results

A total of 1099 deaths (974 in men and 125 in women) were reported from among 80 837 medical radiation workers. The SMRs for all causes of death were significantly lower than expected in both men (SMR 0.45, 95% CI 0.42 to 0.48) and women (SMR 0.49, 95% CI 0.41 to 0.58). No excesses were observed for any specific cause of death. The findings were similar by job title, calendar year of entry and year of birth. However, relative to all causes of death, mortality from all cancers (rSMR 1.60, 95% CI 1.41 to 1.82), leukaemia, colon cancer, stomach cancer and diseases of the circulatory system increased significantly among male workers. The results for female workers were limited due to small number of deaths; however, the rSMR for all cancers was significantly elevated (rSMR 1.70, 95% CI 1.17 to 2.46).

Conclusions

This cohort showed lower mortality among diagnostic medical radiation workers than in the general population. However, occupational factors may have been involved in the increased relative mortality for several causes of death.
Relationship Between Plasma 8‐OH‐Deoxyguanosine and Cardiovascular Disease and Survival in Type 2 Diabetes Mellitus: Results From the ADVANCE Trial
Authors: Thomas Merlin C. , Woodward Mark , Li Qiang , Pickering Raelene , Tikellis Christos , Poulter Neil , Cooper Mark E. , Marre Michel , Zoungas Sophia , Chalmers John ,   the ADVANCE Collaborative Group
Published: June 2018

Background

8‐Oxo‐2′‐deoxyguanosine (8‐oxo‐2′‐
dG
) is a biomarker of oxidative
DNA
damage that is associated with cardiovascular disease and premature mortality in the general population. Although oxidative stress has a proven role in cardiovascular complications in diabetes mellitus, evidence for a relationship between plasma 8‐oxo‐2′‐
dG
and major cardiovascular outcomes in diabetes mellitus is weak.

Methods and Results

A case‐cohort study was performed in 3766 participants with prevalent diabetes mellitus in the
ADVANCE
(Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial (
ClinicalTrials.gov
number
NCT
00145925). The hazard ratios for mortality and major acute cardiovascular events were derived using Cox regression models. During a median of 5 years of follow‐up, 695 (18.4%) participants in this enriched cohort died (including 354 deaths from cardiovascular disease). Individuals with higher levels of 8‐oxo‐2′‐
dG
were more likely to die. After adjusting for cardiovascular disease risk factors, the hazard ratio for a 1‐SD increase in plasma 8‐oxo‐2′‐
dG
was 1.10 (95% confidence interval, 1.01–1.20;
P
=0.03). This was driven by an independent association between plasma 8‐oxo‐2′‐
dG
and cardiovascular death (hazard ratio, 1.23; 95% confidence interval, 1.10–1.37 [
P
<0.001]). By contrast, no association was seen between 8‐oxo‐2′‐
dG
and noncardiovascular disease death (of which cancer was the major single cause). 8‐Oxo‐2′‐
dG
was also not significantly associated with either nonfatal myocardial infarction or nonfatal stroke.

Conclusions

In adults with type 2 diabetes mellitus, increased levels of 8‐oxo‐2′‐
dG
are independently associated with all‐cause mortality and cardiovascular mortality in adults with longstanding type 2 diabetes mellitus who participated in the
ADVANCE
trial, consistent with the role of oxidative damage in the development and progression of cardiovascular decompensation in diabetes mellitus.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00145925.
Delphi Analysis of Science Gaps in the 2015 American Heart Association Cardiac Arrest Guidelines
Authors: Panchal Ashish R. , Cash Rebecca E. , Crowe Remle P. , Coute Ryan , Way David , Aufderheide Tom , Merchant Raina M.
Published: June 2018

Background

Current cardiac arrest guidelines have limited high‐quality scientific evidence to support recommendations for care. The quality of scientific evidence on which guidelines are based may correlate with improved patient outcomes and meaningful survival. We sought to develop a prioritized list of knowledge gaps in resuscitation to assist researchers, policy makers, and funding agencies in their decision‐making process.

Methods and Results

A 4‐stage modified Delphi method was used with a panel of cardiac arrest experts. Experts addressed the prompt: “What are the top 3 gaps in knowledge involving cardiac arrest care that should be research priorities for National Institutes of Health/American Heart Association funding to have the greatest impact on public health?” Knowledge gaps were identified in the initial round, rated in a second round, and rank ordered in the third round, and they underwent final review and consensus (final round). The outcome was 10 knowledge gaps, with prioritization of the top 3 gaps. A total of 61 gaps, with 19 distinct themes, were identified by participants. The 10 knowledge gaps most likely to affect public health identified by the expert panel included, in order, the following: telecommunicator cardiopulmonary resuscitation, hemodynamic monitoring for goal‐directed resuscitation, reasons why bystanders fail to respond, optimization of postarrest care, out‐of‐hospital cardiac arrest identification and response, individualizing resuscitation strategies, predicting patients at risk, tools for neuroprognostication, optimal airway management, and optimizing educational strategies.

Conclusions

Ten priorities for cardiac arrest research were identified, but consensus was not reached on the prioritized top 3. Future research should address these gaps to potentially improve resuscitation guideline evidence quality.
Dietary Docosahexaenoic Acid Reduces Oscillatory Wall Shear Stress, Atherosclerosis, and Hypertension, Most Likely Mediated via an IL‐1–Mediated Mechanism
Authors: Alfaidi Mabruka A. , Chamberlain Janet , Rothman Alexander , Crossman David , Villa‐Uriol Maria‐Cruz , Hadoke Patrick , Wu Junxi , Schenkel Torsten , Evans Paul C. , Francis Sheila E.
Published: June 2018

Background

Hypertension is a complex condition and a common cardiovascular risk factor. Dietary docosahexaenoic acid (DHA) modulates atherosclerosis and hypertension, possibly via an inflammatory mechanism. IL‐1 (interleukin 1) has an established role in atherosclerosis and inflammation, although whetherIL‐1 inhibition modulates blood pressure is unclear.

Methods and Results

Male apoE−/−(apolipoprotein E–null) mice were fed either a high fat diet or ahigh fat dietplusDHA(300 mg/kg per day) for 12 weeks. Blood pressure and cardiac function were assessed, and effects ofDHAon wall shear stress and atherosclerosis were determined.DHAsupplementation improved left ventricular function, reduced wall shear stress and oscillatory shear at ostia in the descending aorta, and significantly lowered blood pressure compared with controls (119.5±7 versus 159.7±3 mm Hg,P<0.001, n=4 per group). Analysis of atheroma followingDHAfeeding in mice demonstrated a 4‐fold reduction in lesion burden in distal aortas and in brachiocephalic arteries (P<0.001, n=12 per group). In addition,DHAtreatment selectively decreased plaque endothelialIL‐1β (P<0.01).

Conclusions

Our findings revealed that raised blood pressure can be reduced by inhibitingIL‐1 indirectly by administration ofDHAin the diet through a mechanism that involves a reduction in wall shear stress and local expression of the proinflammatory cytokineIL‐1β.
Extracellular Fluid Excess Is Significantly Associated With Coronary Artery Calcification in Patients With Chronic Kidney Disease
Authors: Park Seohyun , Lee Chan Joo , Jhee Jong Hyun , Yun Hae‐Ryong , Kim Hyoungnae , Jung Su‐Young , Kee Youn Kyung , Yoon Chang‐Yun , Park Jung Tak , Kim Hyeon Chang , Han Seung Hyeok , Kang Shin‐Wook , Park Sungha , Yoo Tae‐Hyun
Published: June 2018

Background

Extracellular fluid (
ECF
) excess is an independent predictor of cardiovascular morbidity in patients undergoing dialysis. This study aimed to investigate the relationship between
ECF
status, which is affected by renal function, and coronary artery calcification (
CAC
), which is a marker of cardiovascular disease, in patients with chronic kidney disease (
CKD
).

Methods and Results

A total of 1741 patients at all stages of pre‐dialysis
CKD
from the prospective observational cohort of CMERC‐HI (Cardiovascular and Metabolic Disease Etiology Research Center‐High Risk) were analyzed for the association between
ECF
status and
CAC
.
ECF
status was defined as extracellular water‐to‐total body water ratio (
ECW
/
TBW
) measured using bioelectrical impedance analysis.
ECF
excess was defined as
ECW
/
TBW
≥0.390 or ≥0.400 depending on its severity. To define
CAC
, Agatston coronary artery calcium scores were measured. A total coronary artery calcium score of ≥400 was defined as
CAC
. The
CKD
stages were defined according to estimated glomerular filtration rate calculated using the
CKD
Epidemiology Collaboration equation.
ECW
/
TBW
and the proportion of
ECF
excess increased with progressing
CKD
stages. Multivariable logistic regression analyses showed that
ECW
/
TBW
was independently associated with
CAC
(per 0.01 increase of
ECW
/
TBW
, odds ratio 1.168, 95% confidence interval, 1.079–1.264,
P
<0.001). The adjusted
R
2
for predicting higher coronary artery calcium scores and
CAC
significantly improved after
ECW
/
TBW
was added to conventional factors. This association was further confirmed by net reclassification and integrated discriminant improvements, sensitivity analysis, and subgroup analysis.

Conclusions

ECF
status is independently associated with a high risk of
CAC
in patients with
CKD
.

Study Registration

URL
:
https://www.clinicaltrials.gov/
. Unique identifier: NCT02003781.
Cerebral Protection During Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic Heart Disease
Authors: Heeger Christian‐Hendrik , Metzner Andreas , Schlüter Michael , Rillig Andreas , Mathew Shibu , Tilz Roland Richard , Wohlmuth Peter , Romero Maria E. , Virmani Renu , Fink Thomas , Reissmann Bruno , Lemes Christine , Maurer Tilman , Santoro Francesco , Schmidt Tobias , Ghanem Alexander , Frerker Christian , Kuck Karl‐Heinz , Ouyang Feifan
Published: June 2018

Background

Catheter ablation of ventricular tachycardia (
VT
) is associated with the risk of cerebral embolism. The origin of periprocedural brain embolism in the setting of
VT
ablation is often unknown and strategies to avoid it are sparse. The aim of this study was to assess the safety and feasibility of an endovascular 2‐filter‐based cerebral protection system (
CPS
) in left ventricular
VT
ablation procedures in patients with ischemic heart disease. Furthermore, histopathological correlates of periprocedural embolization were investigated.

Methods and Results

In this pilot study, 11 patients with ischemic heart disease and sustained
VT
underwent left ventricular catheter ablation under
CPS
surveillance. The placement of the
CPS
was conducted before the ablation procedure via the right radial artery. The
VT
ablation procedure was performed via a combined transaortic and transseptal approach. All
VT
s were successfully ablated. Placement and retrieval of the
CPS
was successful and safe in all cases. No periprocedural complications related to the
CPS
were observed and no periprocedural transient ischemic attack or stroke occurred. Debris captured by the
CPS
was detected in all patients. Histology revealed that acute thrombus was the most common type of debris (91%), followed by arterial wall tissue (73%) and foreign material (55%). Less frequently found were myocardium (27%), calcification (9%), necrotic core (9%), and valve tissue (9%).

Conclusions

Cerebral protection during
VT
ablation seems to be safe and feasible. Ablation procedures of
VT
are associated with embolization of embolic debris, which was found in every patient.
Lack of a Tricuspid Regurgitation Doppler Signal and Pulmonary Hypertension by Invasive Measurement
Authors: O'Leary Jared M. , Assad Tufik R. , Xu Meng , Farber‐Eger Eric , Wells Quinn S. , Hemnes Anna R. , Brittain Evan L.
Published: June 2018

Background

Transthoracic echocardiography (
TTE
) is used to estimate pulmonary artery systolic pressure, but an adequate tricuspid regurgitation velocity (
TRV
) needed to calculate pulmonary artery systolic pressure is not always present. It is unknown whether the absence of a measurable
TRV
signifies normal pulmonary artery pressure.

Methods and Results

We extracted hemodynamic,
TTE
, and clinical data from Vanderbilt's deidentified electronic medical record in all patients referred for right heart catheterization between 1998 and 2014. Pulmonary hypertension (
PH
) was defined as mean pulmonary artery pressure ≥25 mm Hg. We examined the prevalence and clinical correlates of
PH
in patients without a reported
TRV
. We identified 1262 patients with a
TTE
within 2 days of right heart catheterization. In total, 803/1262 (64%) had a reported
TRV
, whereas 459 (36%) had no reported
TRV
. Invasively confirmed
PH
was present in 47% of patients without a reported
TRV
versus 68% in those with a reported
TRV
(
P
<0.001). Absence of a
TRV
yielded a negative predictive value for excluding
PH
of 53%. Right ventricular dysfunction, left atrial dimension, elevated body mass index, higher brain natriuretic peptide, diabetes mellitus, and heart failure were independently associated with
PH
among patients without a reported
TRV
.

Conclusions

PH
is present in almost half of patients without a measurable
TRV
who are referred for both
TTE
and right heart catheterization. Clinical and echocardiographic features of left heart disease are associated with invasively confirmed
PH
in subjects without a reported
TRV
. Clinicians should use caution when making assumptions about
PH
status in the absence of a measurable
TRV
on
TTE
.
The neo-Weberian state and the neodevelopmentalist strategies in Latin America: the case of Uruguay
Authors: Ramos Conrado , Milanesi Alejandro
Published: June 2018

This article seeks to contribute to the development of the neo-Weberian theory of public administration by making it travel to the Latin American context. We argue that this model of public administration reform, identified in continental European states, tends to be present in some Latin American countries that have followed neodevelopmentalist models of economic development. The neo-Weberian political strategy promotes a public sector modernization that enhances its steering and coordination capacities which is functional to a neodevelopmental view that aims to rebuild the state’s central role in leading economic growth and social cohesiveness. Yet, the public management model that is implanted resembles an ‘imperfect’ neo-Weberianism due to the institutional deficiencies of these countries and the difficulties in providing a clear reform script. We provide this link by decoding the main outlines of the public management model in Uruguay in the context of the reforms implemented by the Frente Amplio.

Points for practitioners

The article demonstrates two central points. First, that the processes of public sector reform are usually linked to other broader development strategies and to calculations of political feasibility. This can explain to some extent the options taken by politicians. Second, public sector reforms are often a combination of multiple administrative doctrines. This poses the risk of being unsystematic, incoherent or even contradictory.
Relationships Amongst Aggression, Self-Theory, Loneliness, and Depression in Emerging Adults
Authors: Yavuzer Yasemin , Albayrak Güldener , Kılıçarslan Suat
Published: June 2018

The purpose of this study was to examine the relationships amongst aggression, self-theory, loneliness, and depression. The study group consisted of 904 student volunteers from various undergraduate programs of a university in Central Anatolia. Simple and hierarchical multiple linear regression analyses, as well as t-tests, were used to analyze the data. In the preliminary analysis performed, females’ depression levels and males’ aggression levels are higher. The study findings revealed that self-theory negatively and significantly predicted aggression, whereas loneliness and depression positively and significantly predicted aggression in emerging adulthood. Another important finding showed that both direct and indirect relationships exist between self-theory and aggression. According to these findings, loneliness and depression play partially mediating roles individually, and fully mediating roles together, with regard to the relationship between self-theory and aggression.
Gritty Leaders: The Impact of Grit on Positive Leadership Capacity
Authors: Schimschal Sarah E. , Lomas Tim
Published: June 2018

The concepts of grit and positive leadership are central to extraordinary performance. However, to date there has been little empirical analysis of the relationship between a leader’s level of grit and their capacity to implement positive leadership strategies and practices. This correlational study explores these linkages, taking grit subfactors into consideration as well as three dimensions of positive leadership. Convenience sampling was used to survey 100 leaders across a range of industries. Respondents completed the Grit Scale and 18 questions from the Positive Leadership Practices Self-Assessment. Results indicated that grit positively correlated with positive leadership, and perseverance exhibited a stronger relationship than passion. Further, grit accounted for variance in positive leadership. These findings provide a solid evidence base for giving leaders access to development opportunities that can accelerate the growth of grit and positive leadership.
Attachment as a Core Feature of Resilience: A Systematic Review and Meta-Analysis
Authors: Darling Rasmussen Pernille , Storebø Ole Jakob , Løkkeholt Trine , Voss Line Gaunø , Shmueli-Goetz Yael , Bojesen Anders Bo , Simonsen Erik , Bilenberg Niels
Published: June 2018

Background

Research has pointed to secure attachment as a possible key factor of resilience in adulthood.

Objective

We aimed to investigate the role of secure attachment as a potential core feature in the properties of resilience.

Methods

We conducted a systematic review in accordance with PRISMA guidelines followed by a meta-analysis.

Results

Thirty-three studies were included in the review, and 10 of these, including 2305 subjects, were used for meta-analysis. The raw correlation coefficients ranged from .20 to .57, which indicated weak to moderate correlations between resilience and attachment. The synthesized correlation coefficients indicated that the correlations were significant and highly unlikely to be due to random variation. All studies are also reported on qualitatively.

Conclusions

In both of our meta-analyses and in the narratively reported studies, we found that secure attachment is associated with the presence of resilience.
Assessment of Equivalent Thickness Design Principles for Geosynthetic Reinforced Pavements by Way of Accelerated Testing
Authors: Robinson W. Jeremy , Tingle Jeb. S. , Norwood Gregory J. , Howard Isaac L.
Published: June 2018

The Engineer Research and Development Center (ERDC) of the U.S. Army Corps of Engineers has performed multiple laboratory and full-scale evaluations of geosynthetic reinforced pavements. One result from early geosynthetic reinforced pavement evaluations was a pavement design methodology implemented in ETL 1110-1-189: Use of Geogrids in Pavement Construction. Since that time, the evaluations have been primarily focused on comparing performance between varying types of geosynthetic products. While the studies have independently compared the discrete performance of single geosynthetic reinforced sections to unreinforced sections, a comprehensive analysis of available data has not been performed to validate or refine the implemented design methodology. The objective of this effort was to assemble available data from laboratory and full-scale testing conducted at ERDC for the primary purpose of assessing the flexible pavement design methodology presented in ETL 1110-1-189. Simplifying assumptions were made to allow comparison of varying loading and pavement structure conditions. This assessment found that the combined dataset supports the original design curve produced with the equivalent thickness methodology described in ETL 1110-1-189. The updated dataset would reduce the equivalent reinforced thickness by approximately 1.0-inches (25.4 mm) at unreinforced thicknesses less than 14 inches (356 mm), providing a slightly more conservative result. The adjusted data converged with the original equivalency chart at an unreinforced thickness of approximately 16 inches (406 mm).
Driver’s Visual Performance in Rear-End Collision Avoidance Process under the Influence of Cell Phone Use
Authors: Li Xiaomeng , Rakotonirainy Andry , Yan Xuedong , Zhang Yuting
Published: June 2018

Rear-end crash is the most common type of on-road traffic crash, and cell phone use contributes to the increase of rear-end crashes. The effects of cell phone use on driving performance have been thoroughly investigated in previous research with various measurements. However, change in driver’s visual performance while using a cell phone in situations with high rear-end risk has not yet been fully understood. This driving simulator study investigated drivers’ eye movement performance in a rear-end collision avoidance maneuver during cell phone conversation. Eye movement data of 36 participants were collected in a car-following scenario featuring imminent rear-end collision. The whole collision avoidance process was divided into four stages for eye movement data analysis, including normal driving stage, brake response stage, deceleration adjusting stage, and speed recovering stage. Results showed that the average pupil size, fixation duration, and dwell time on the leading vehicle increased significantly during the brake response and deceleration adjusting stages. This indicated that the drivers’ cognitive workload increased during these stages. Drivers used blink inhibition and quick saccade as a visual compensation strategy to mitigate the increased workload from cell phone use during the brake response stage. However, in the deceleration adjusting stage, the cell phone use condition led to a lower fixation frequency on the leading vehicle than in the no phone use condition. Professional drivers were found to pay more visual attention to the leading vehicle than non-professional drivers in the normal driving stage.
Analysis of Toll Lanes Access Violation Behavior: Example of Express Toll Lanes on I-405
Authors: Hinohara Hiroyuki , Wang Yinhai
Published: June 2018

Washington State has introduced express toll lanes (ETLs) on I-405 as a managed lane project. One of problems in the operation of ETLs operation is the access violation in which vehicles cross the double white lines, which separate ETLs from general purpose lanes. The objective of this paper is to identify access violation patterns and quantitatively describe the relationship between access violation frequency and traffic condition, user type and road segment characteristics. Finally, this paper develops negative binomial models to predict access violation frequency. The analysis results show that that traffic conditions factors influence violation behavior differently depending on whether the violation occurred when entering or exiting ETLs, which suggests that entry and exit violation behaviors should be analyzed separately. In addition, the finding that casual users commit violations more frequently than frequent users implies the possibility of unintentional violations. It is expected that these results support enforcement against violations and improve ETLs operation in the future.
Risk Management and Data Needs: A State of the Practice Survey of State Highway Agencies
Authors: Nlenanya Inya , Smadi Omar
Published: June 2018

Risk management analysis is one of the new requirements under MAP-21 that separates transportation asset management programs from business as usual for the state departments of transportation (DOTs). Based on this requirement, each agency will discuss the concept of risk and how it should be incorporated into its transportation asset management program as well as how it informs maintenance practices, asset replacement or rehabilitation, and emergency management and response planning. This will require an agency to provide a list of risk exposures and document its system-wide risk management strategy. This paper presents the results of a state of the practice survey of how agencies are developing their risk-based asset management plan and discusses recommendations for future research. The results show that state highway agencies are increasingly adapting the way they do business to include explicit considerations of risks. At the moment, this consideration of risk is not linked to data, and as a result most agencies do not have a data driven way of tracking risk and updating their risk exposures. The significance of the results highlights the need for further research on data driven risk management and to synthesize methodologies for integrating risk assessment into an agency’s decision-making process.
Lowering Bicycle Stress One Link at a Time: Where Should We Invest in Infrastructure?
Authors: Moran Sarah K. , Tsay William , Lawrence Sean , Krykewycz Gregory R.
Published: June 2018

This paper presents a new, regional-scale application of low-stress bicycle connectivity analysis. While prior network-based analyses have focused on the overall improvement in connectivity that could be achieved by implementing a package of projects from a comprehensive bike plan, the purpose of this project was to wholly evaluate potential improvements in connectivity through individual improvements at the street segment level. Using scripts and database tools, levels of traffic stress were assigned to the road network. Incorporating numerous computational optimization measures, shortest paths were calculated between millions of origin and destination pairs to identify the road segments that could most benefit low-stress connectivity. The resulting ranked list of links providing the greatest connectivity benefit allows planners to more efficiently prioritize locations for further investigation and analysis.
Changes in Individual Economic Activities and Regional Market Structures Caused by Rural Road Improvements in Cambodia
Authors: Idei Rika , Kato Hironori
Published: June 2018

In rural areas of developing countries, most individuals engage in farming of staple foods and trading them in their local markets for daily earnings. If a road is improved, what would happen to those markets and the local populations’ economic activities? This study aimed to examine the effects of rural road improvements on local economic activities and market structures in rural areas of Cambodia using quantitative and qualitative data collected from face-to-face interviews. The data included both individual economic status and households’ travel behavior around their markets. This study showed that improving road conditions helps low-income individuals visit a market frequently and releases rice farmers from the time and cost burdens of transporting their rice to markets or enables customers to now approach them directly for trades. The enhancement of economic activities was also confirmed among local populations on the roadsides, particularly groups with economic capacities, and this effect was distributed to markets even beyond the roadsides. Our findings suggest that rural road improvements enhance the economic status of individuals who engage in dominant economic activities along the improved roads and that these benefits extend beyond roadside markets themselves. However, such positive impacts were not realized by households that did not own any land for rice farming and whose economic status remained poor. Instruments should be integrated into future rural road improvement projects to include households of small economic capacities in the local economic development process.
Laboratory Investigation of Pavement Backfilling Materials for Micro-Trenching in Cold Regions
Authors: Hashemian Leila , Rios Vinicius Afonso Velasco , Bayat Alireza
Published: June 2018

This study investigated the performance of different materials in a micro-trench composite backfilling design. Laboratory tests were conducted to evaluate the effect of cold temperatures and freeze/thaw cycles on a cement grout and seven preparatory cold asphalt mixes. To compare the performance of cold mix asphalt and epoxy grout with hot mix asphalt as the host material, rutting tests and dynamic modulus tests at different loading frequencies and temperatures were conducted. Finally, laboratory scale micro-trench samples were prepared using different backfilling materials and were loaded using a wheel tracker after freeze/thaw conditioning. The results showed that cement grout could effectively be used to secure the conduit inside the trench. It was also concluded that using high-quality cold mix asphalt, a compatible material with hot mix asphalt, could improve micro-trench durability compared with epoxy grout.
Complex modal analysis and coupled electromechanical simulation of energy harvesting piezoelectric laminated beams
Authors: Pasharavesh Abdolreza , Ahmadian MT , Zohoor H
Published: June 2018

In this paper, coupled electromechanical behavior of a vibrational energy harvesting system composed of a unimorph piezoelectric laminated beam with a large attached tip mass is investigated. To achieve this goal, first the electromechanically coupled partial differential equations governing the lateral displacement and output voltage of the harvester are extracted through exploiting the Hamilton’s principle. Considering vibration damping due to mechanical to electrical energy conversion, a complex modal analysis is performed to extract the complex eigenfrequencies and eigenfunctions of the system. Furthermore, an exact analytical solution is presented for the system response to the harmonic base excitations, including output voltage and harvested power. To validate the analytical results, at the next step a finite element simulation is conducted through ABAQUS software. To perform a fully-coupled analysis which brings into account the effect of harvesting circuit, user subroutine User-defined Amplitude (UAMP) is utilized to calculate the voltage–current relation and impose the correct electrical charge on the electrodes in each step by monitoring the output voltage of the system at previous time increments. Results of both analytical and numerical simulations are compared for a Micro-Electro-Mechanical Systems (MEMS) harvester as a case study, where a very good agreement is observed between them.
Urinary vitamin D-binding protein, a novel biomarker for lupus nephritis, predicts the development of proteinuric flare
Authors: Go D J , Lee J Y , Kang M J , Lee E Y , Lee E B , Yi E C , Song Y W
Published: June 2018

Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Conventional biomarkers for assessing renal disease activity are imperfect in predicting clinical outcomes associated with LN. The aim of this study is to identify urinary protein biomarkers that reliably reflect the disease activity or predict clinical outcomes. A quantitative proteomic analysis was performed to identify protein biomarker candidates that can differentiate between SLE patients with and without LN. Selected biomarker candidates were further verified by enzyme-linked immunosorbent assay using urine samples from a larger cohort of SLE patients ( n = 121) to investigate their predictive values for LN activity measure. Furthermore, the association between urinary levels of a selected panel of potential biomarkers and prognosis of LN was assessed with a four-year follow-up study of renal outcomes. Urinary vitamin D-binding protein (VDBP), transthyretin (TTR), retinol binding protein 4 (RBP4), and prostaglandin D synthase (PTGDS) were significantly elevated in SLE patients with LN, especially in patients with active LN ( n = 21). Among them, VDBP well correlated with severity of proteinuria (rho = 0.661, p < 0.001) and renal SLE Disease Activity Index (renal SLEDAI) (rho = 0.520, p < 0.001). In the four-year follow-up, VDBP was a significant risk factor (hazard ratio 9.627, 95% confidence interval 1.698 to 54.571, p = 0.011) for the development of proteinuric flare in SLE patients without proteinuria ( n = 100) after adjustments for multiple confounders. Urinary VDBP correlated with proteinuria and renal SLEDAI, and predicted the development of proteinuria.
Impassioned Communication and Virtual Support Roles of Online Postings: The Case of Self-Harmers
Authors: Davis Sarah , Lewis Christopher Alan
Published: June 2018

Although there is an emerging literature on online users support groups, limited research has focused on the online users support groups concerned with self-harm. This study reports the findings of inductive content analysis of self-harm online messages from one self-harm online users group. One hundred messages were examined. Categories were determined and inductive analysis revealed online self-harm postings showed two themes. The first theme was “impassioned communication,” 76% of the postings had this major theme. There were three subthemes included in this theme: being a “failure,” “people not understanding,” and “improvement.” The second theme was “virtual support.” Although presented as two separate themes, “impassioned communication” and “virtual support” are interrelated as some postings suggested the need for support with impassioned communication. These results support the established view that the Internet is the place where individuals can access emotional support or social integration, especially helpful for those who are, or feel, marginalized (e.g., those experiencing disenfranchised grief and self-harming). This study shows the usefulness of utilizing online message boards as a research tool for conducting research among populations that are difficult to access.
Post-occupancy evaluation of urban public housing in Korea: Focus on experience of elderly females in the ageing society
Authors: Rieh Sun-Young
Published: June 2018

Female elderly individuals make up the majority of public housing residents. Inappropriate guidelines have been neglecting their differentiated needs and this has been negatively affecting their quality of life in public housing. Recognizing the specific needs of female seniors is a key to successful provision of public housing by the government because the proportion of female seniors in public housing has been increasing. This research aims to assess urban public rental housing through post-occupancy evaluation of six housing projects that were developed by public housing authorities in Korea. Focusing on flexibility, safety, accessibility and support for care, questionnaires and interviews were conducted to provide gender-sensitive directions for public housing designs in an ageing society. There are four main findings: (i) The nuclear family-oriented floor plan needs to be changed to provide flexibility reflecting the diverse lifestyles of one or two member residents. (ii) The life safety guideline that assumed housing is mainly catered for healthy young residents would need major revision. (iii) Accessibility issues would need to consider the presence of a caregiver and flexible application, depending on the lifecycle of elderly individuals. (iv) The support for care with a complicated smart home system would need improvement.
Combination of thermal cycling and vibration loading effects on the fatigue life of solder joints in a power module
Authors: Ghaderi Davood , Pourmahdavi Maryam , Samavatian Vahid , Mir Omid , Samavatian Majid
Published: June 2018

In this work, the combination of vibration loading and thermal cycle effects on the fatigue properties of a solder joint in a Metal-Oxide-Semiconductor Field-Effect Transistor (MOSFET) discrete was investigated. The fatigue mechanism under each loading mode was individually analyzed, and then according to the incremental damage superposition approach, the simultaneous effects were thoroughly studied. Under thermal cycling, the creep behavior of the solder is linked to the fatigue life. In fact, the creep accumulated strain in each thermal cycle has a straight relation to the failure time of solder joint. The origin of stress/strain in the assembly is owing to the sharp difference between coefficients of thermal expansions of the components in the electronic package. Regarding the vibration loading, the root mean square of peeling stress as a widely acceptable failure indicator was used to evaluate the vibration effects on the fatigue life. It is determined that the maximum stress is concentrated at the corner of solder layer. This result was similar to the outcomes of thermal cycling. The results also indicated that the combination of thermal and mechanical loadings accelerates the failure of the solder joint of the power MOSFET. Furthermore, the experimental and simulation studies showed similar results and approved the crack initiation at the corner of solder layer.
Planning a ‘slum free' Trivandrum: Housing upgrade and the rescaling of urban governance in India
Authors: Williams Glyn , Omanakuttan Umesh , Devika J , Jagajeevan N
Published: June 2018

This paper examines how India’s national urban development agenda is reshaping relationships between national, State and city-level governments. Jawaharlal Nehru National Urban Renewal Mission, the flagship programme that heralded a new era of urban investment in India, contained a range of key governance aspirations: linking the analysis of urban poverty to city-level planning, developing holistic housing solutions for the urban poor, and above all empowering Urban Local Bodies to re-balance relationships between State and city-level governments in favour of the latter. Here, we trace Jawaharlal Nehru National Urban Renewal Mission’s implementation in Kerala’s capital city, Trivandrum (Thiruvananthapuram), where the city’s decentralised urban governance structure and use of ‘pro-poor’ institutions to implement housing upgrade programmes could have made it an exemplar of success. In practice, Trivandrum’s ‘city visioning’ exercises and the housing projects it has undertaken have fallen short of Jawaharlal Nehru National Urban Renewal Mission’s lofty goals. The contradictions between empowering cities and retaining centralised control embedded within this national programme, and the unintended city-level consequences of striving for Jawaharlal Nehru National Urban Renewal Mission funding success, have reshaped urban governance in ways not envisaged within policy. As a result, Jawaharlal Nehru National Urban Renewal Mission has been important in rescaling governance relationships through three interlinked dynamics of problem framing, technologies of governance and the scalar strategy of driving reform ‘from above’ that together have ensured the national state’s continued influence over the practices of urban governance in India.
Platelet Function Testing for Cardiac Surgery Patients on Antiplatelet Therapy: The Extreme Variability of Point-Of-Care Tests
Authors: O. Ondondo Beatrice
Published: June 2018

Platelets play a pivotal role in coagulation, and both quantitative and qualitative platelet defects can lead to major bleeding during and after surgery. Moreover, patients with cardiac disease are often on antiplatelet therapies as part of routine management, which predisposes to increased risk of perioperative bleeding due to inhibited platelet function. In some cases, antiplatelet therapy is interrupted briefly before scheduled cardiac surgery in order to reduce the risk of haemorrhage; however, this can increase the risk of perioperative thrombosis if not monitored carefully. Furthermore, individual patients respond differently to antiplatelet therapy. Therefore, point-of-care tests that determine platelet function could provide improved, personalised evidence-based treatment and management of such high-risk cardiac patients. This article reviewed various methods and devices used for testing platelet function at point-of-care in cardiac patients on antiplatelet therapy who were undergoing cardiac surgery. The consensus is that point-of-care testing of platelet function can offer three main advantages for the timely management of preoperative and perioperative coagulation in cardiac surgery patients who are on antiplatelet therapy: 1.) Assessing the effectiveness of antiplatelet therapy to quickly identify patients with resistance, who have increased risk of pre- and perioperative thrombotic events. 2.) Assessing platelet function recovery following treatment withdrawal to determine optimal timings for cardiac surgery, in order to avoid excessive haemorrhage, and reduce waiting times and hospitalisation costs for patients scheduled for cardiac surgery. 3.) Efficient use of transfusion blood products. However, an important finding of this review is that there exists extreme variability and a lack of correlation among the various point-of-care platelet function testing assays. Furthermore, the assays show inconsistencies in predicting blood loss, or adverse thrombotic and haemorrhagic events in cardiac patients on antiplatelet therapy and those undergoing surgery. It is imperative that point-of-care platelet function tests accurately predict the risks of bleeding and thrombosis in order to be clinically relevant in the preoperative, perioperative and long-term post-operative care and management of cardiac surgery patients on antiplatelet therapy. The extreme variability of these tests, coupled with inconsistencies in predicting adverse events do not support the high costs of large-scale implementation.