bluuebunny/crossref_metadata_2025 huggingface dataset:
Levothyroxine Sodium Tablets: Chemical Equivalence and Bioequivalence
Authors: Curry Stephen H. , Gums John G. , Williams Lisa L. , Curry R. Whitney , Wolfson Bernard B.
Published: May 2016

Two brands of levothyroxine sodium tablets were compared in vivo for bioequivalence in a double-blind, randomized study. The tablets were identical in levothyroxine content. Evaluation was by means of triiodothyronine (uptake), tetraiodothyronine, free thyroxine index, total triiodothyronine by radioimmunoassay, and thyroid-stimulating hormone measurements. No differences in clinical response were found in a study with a high statistical power. It was concluded that the two brands were bioequivalent because of chemical equivalence, use of micronized levothyroxine powder in tablet production with at least one of the brands, and scrupulous attention to quality control during the manufacturing process, all of which contributed to assurance of homogeneity of the products and close adherence (± five percent) to the claimed potency.
Survey of Vancomycin Monitoring Guidelines in Illinois Hospitals
Authors: Fitzsimmons William E. , Postelnick Michael J. , Tortorice Peter V.
Published: May 2016

Disparity exists in published recommendations for monitoring of vancomycin serum concentrations. To evaluate the degree of disparity of practice in Illinois, directors of pathology of 202 Illinois hospitals were surveyed to assess their vancomycin monitoring practices. Of the 202 surveys mailed, 82 were returned for a response rate of 41 percent. Most hospitals have 200–500 beds (60 percent) and are nonteaching institutions (72 percent). Two thirds of the hospitals sent vancomycin to an outside laboratory for analysis. Timing of postinfusion (peak) concentrations ranged from 0 minutes following end of infusion to 360 minutes. Approximately one half of the institutions reported a peak therapeutic range of 30–40 mg/L at 30 minutes following end of infusion. A great majority of institutions were consistent in recommended trough range, with 48 of 55 reporting 5–10 mg/L. Although there is some consistency among at least half of the hospitals, there is a great deal of variability among the other half in peak monitoring guidelines.
Blind versus Nonblind Review: Survey of Selected Medical Journals
Authors: Cleary John D. , Alexander Bruce
Published: May 2016

The publication of scientific research in medical journals is a lengthy process. Submitted manuscripts are often reviewed by two or more outside reviewers who evaluate each manuscript for publication acceptability. The process of manuscript evaluation by an editor-selected reviewer (“peers” or “referees”) is termed “peer review.” One issue involving the peer-review process is the use of blind versus nonblind referees. The purpose of this survey was to determine the percentage of a select group of medicine-related journals that blind their reviewers. We surveyed 114 English language journals. Journal editors were sent a survey that asked two questions: (1) are the referees who review your manuscripts blinded to the identity of the authors? and (2) is the editor blinded to the identity of the authors until after the review of the manuscripts is complete? Ninety-six of 114 (84.2 percent) surveys were returned. Ten journals published invited manuscripts only and were excluded from the survey. Only 18.6 percent (16 of 86) of the journals currently blind referees. None of the journals' editors were blind to the identity of the manuscripts' authors.
Chlorpromazine Accumulation and Sudden Death in a Patient with Renal Insufficiency
Authors: Dorson Peter G. , Crismon M. Lynn
Published: May 2016

Sudden death has been reported in psychiatric patients before and after the advent of antipsychotic medications. A case of sudden death following chlorpromazine administration in a schizophrenic patient is presented. After receiving a mean daily dose of 780 mg for five days, the patient died suddenly. Laboratory work on day 2 of hospitalization indicated a calculated creatinine clearance of 14 ml/min. The autopsy was noncontributory except for a blood chlorpromazine concentration of 1534 ng/ml. The potential cause of death in this patient and the proposed mechanisms of sudden death in psychiatric patients are discussed. The effect of renal and hepatic disease on chlorpromazine plasma concentrations is presented. This case is the first report of sudden death in a psychiatric patient with a documented elevated antipsychotic plasma concentration. It is also the first report of an elevated chlorpromazine blood concentration in a patient with renal insufficiency.
Rhabdomyolysis Associated with Cocaine Intoxication
Authors: Skluth Hilary A. , Clark John E. , Ehringer George L.
Published: May 2016

A case of a patient who had an acutely toxic reaction to cocaine ingestion and later developed acute renal failure secondary to rhabdomyolysis is described. Evidence of rhabdomyolysis was noted by the combination of myalgia, urine discoloration, and elevated serum concentrations of muscle enzymes. Although the mechanism of the rhabdomyolysis is unknown, the clinical presentation resembled that of a norepinephrine-induced vasoconstrictive effect that alters the metabolic demands of the muscle in such a way that the muscle is damaged.
Paresthesia and Back Pain in a Patient Receiving Vancomycin during Hemodialysis
Authors: Cohen Louise Glassner , Souney Paul F. , Taylor Susan Joy
Published: May 2016

A 36-year-old woman was admitted for initiation of hemodialysis for chronic renal failure. Two days after catheter placement the patient developed a fever that persisted and resulted in subsequent removal of the catheter. Although blood cultures were negative, cultures of the catheter tip were positive for Staphylococcus epidermidis. An initial vancomycin dose was well tolerated, but the patient later experienced numbness and tingling of her lower back accompanied by pain ten minutes after initiation of the second dose. Symptoms abated when the vancomycin infusion was discontinued, and the drug was subsequently well tolerated when reinstituted at a slower infusion rate. Similar symptoms were observed five minutes into a vancomycin infusion a week later that also resolved after decreasing the infusion rate. Patients on hemodialysis receiving vancomycin should be carefully monitored during drug administration for the development of paresthesia and spasmodic lower back pain.
Review of Diclofenac and Evaluation of its Place in Therapy as a Nonsteroidal Antiinflammatory Agent
Authors: Skoutakis Vasilios A. , Carter Charles A. , Mickle Timothy R. , Smith Valorie H. , Arkin Charles R. , Alissandratos Jane , Petty Daniel E.
Published: May 2016

Diclofenac sodium is a nonsteroidal antiinflammatory drug (NSAID) that has been used in 120 countries since its introduction in Japan in 1974. It is currently the eighth largest-selling drug and the most frequently used NSAID in the world. Diclofenac, a phenylacetic acid derivative, is a potent inhibitor of cyclooxygenase enzyme activity, and may also interact with the lipoxygenase enzyme pathway, and with the release and reuptake of arachidonic acid. Diclofenac is almost completely absorbed, highly protein-bound, penetrates well into synovial fluid, and is extensively metabolized. Comparative studies have shown that diclofenac is at least equivalent in efficacy to aspirin and other NSAID when used for the treatment of rheumatic diseases such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Diclofenac also possesses potent analgesic properties. Clinical trials suggest that diclofenac has a favorable side-effect profile, excellent patient tolerability, and a lower patient dropout rate when compared with aspirin and other NSAID.
Oral Etoposide
Authors: Phillips Nancy C.
Published: May 2016

Etoposide, a semisynthetic derivative of podophyllotoxin, has been commercially available for intravenous use for a number of years, and has been used as part of first-line combination chemotherapy programs for small cell lung cancer (SCLC). It has also been used to treat testicular cancer, non-small cell lung cancer, and a variety of other malignancies. Etoposide for oral use has become commercially available and is approved for use in the treatment of SCLC. Although no clinical trials comparing intravenous and oral etoposide in SCLC have been reported, several pharmacokinetic studies have been described. These studies have demonstrated a mean bioavailability of 50 percent, with a wide range among patients. Other pharmacokinetic parameters are similar for both the intravenous and oral methods of administration. Based on these results, the recommended dose of oral etoposide is twice the intravenous dose. Oral etoposide has been demonstrated to be effective in the treatment of SCLC. It offers a reasonable and cost-effective outpatient alternative for this group of patients.
Disposition of Cefonicid in Orthopedic Surgery Patients
Authors: Ackerman Bruce H. , Trang John M. , Nelson Carl L. , Pearce Charles E. , Manning Janice T. , Harrison Barry H.
Published: May 2016

Ten patients undergoing hip reconstructive procedures were given a single prophylactic dose of cefonicid 15 mg/kg to evaluate intraoperative and perioperative drug disposition in the surgical setting. Timed postinfusion serum samples were collected over 24 hours and resulting concentration versus time data were subjected to noncompartmental pharmacokinetic analysis. Bone samples were obtained in eight of ten patients with mean bone concentrations of 13.3 μg/g (range 8.2–25.1). Postinfusion serum concentrations at five minutes postinfusion ranged from 200.8 to 316.7 μg/ml; the 12-hour mean was 19.1 μg/ml (range 4.0–48) and the 24-hour mean was 4.3 μg/ml (range 0.0–13.8). Protein binding at three sampling times ranged from 88 to 96.5 percent, increasing over time as total cefonicid concentrations fell. The mean half-life in our patients was 3.5 hours, compared with 4.8 hours in our four controls. These data indicate that altered protein binding and intraoperative events alter the disposition of cefonicid. Although differences in disposition parameters between patients and controls were not statistically significant, suboptimal serum cefonicid concentrations were observed in four orthopedic patients.
Rapid Methylprednisolone Clearance in a Patient with Cystic Fibrosis
Authors: Green Christopher G. , Kraus Connie K. , Lemanske Robert F. , Farrell Philip M. , Jusko William J.
Published: May 2016

A pharmacokinetic investigation of administered corticosteroids was conducted in a 16-year-old girl with cystic fibrosis (CF). Equivalent doses of methylprednisolone were given orally and intravenously on consecutive days. Oral bioavailability was essentially 100 percent, ruling out impaired absorption. Drug half-life was shorter and both clearance and volume of distribution were greater in this patient than in normal young adults. From one patient it is impossible to conclude that this unusual disposition of corticosteroids is characteristic of CF. Given the interest in use of corticosteroids in this population, and the examples of other drugs with altered pharmacokinetics in patients with CF, further investigation is warranted.
Flucytosine Interference with Serum Creatinine Determinations
Authors: Santeiro Maria L. , Thompson Dennis F. , Sagraves Rosalie
Published: May 2016

A patient receiving intravenous amphotericin B and oral flucytosine was found to have falsely elevated serum creatinine values. Flucytosine has been reported to interfere with serum creatinine determinations when measured by the Kodak Ektachem-700 analyzer but not when the Jaffe reaction is employed. Serum creatinine values were determined by the two methods on six serum samples obtained from this patient at various times throughout her hospitalization. Flucytosine can cause clinically significant false elevations in serum creatinine when measured by the Kodak Ektachem-700 analyzer.
Vancomycin-Associated Exfoliative Dermatitis during Continuous Ambulatory Peritoneal Dialysis
Authors: Gutfeld Marcia B. , Reddy Padma V. , Morse Gene D.
Published: May 2016

Vancomycin is commonly prescribed to patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for catheter-related infections and acute episodes of peritonitis. Although adverse dermatological reactions have been reported secondary to the rapid intravenous infusion of vancomycin, the intraperitoneal route of administration has been used routinely during CAPD without these effects. This case report describes a CAPD patient with systemic lupus erythematosus who developed erythema multiforme that progressed to exfoliative dermatitis during intermittent intraperitoneal vancomycin therapy for a catheter-related exit-site/tunnel infection.
Professional Liability for Pharmacists: A Focus on Pharmacy Practice Acts
Authors: Munger Mark A. , Green Jeffrey A. , Greve Paul A. , Lovejoy Lynn S.
Published: May 2016

The increased complexity of pharmacotherapeutics and the expanded role of pharmacists in the drug-use process may bring about an increased liability exposure for failure to conform to a professional standard of care. Therefore, a survey of 51 state pharmacy practice acts was conducted: (1) to establish a nationwide statutory definition of pharmacy practice, and (2) to outline possible use of the statutes in civil and administrative law. Twenty percent of state statutes contain no definition of pharmacy practice. Of the remaining 41 states, dispensing (97.5 percent), compounding (92.5 percent), interpretation and evaluation of prescriptions (68.2 percent), and consultation (73 percent) are legally defined. Pharmacokinetic consultation, drug administration, pharmacist prescribing, and pharmaceutical research are defined in one, seven, four, and one state(s), respectively. Pharmacists may face legal responsibilities from both the courts and state boards of medical and pharmacy practice. Aggressively updating the statutes and regulations to reflect contemporary pharmacy practice may provide a mechanism for a defense in court litigation and regulatory action.
Algorithms for Dosage and Therapeutic Monitoring of Theophylline
Authors: Mangues M. Antonia , Bonal Joaquin , Farré Rosa , Massó J. Francesc
Published: May 2016

Theophylline is widely prescribed in Spain. Because this drug has a narrow therapeutic range and high interindividual pharmacokinetic variability, it is essential to adapt the dosage to each patient. In order to simplify the drug individualization we are proposing three algorithms to apply to intravenous loading and maintenance doses and to oral doses. The initial recommended dosages have been established using the pharmacokinetic parameters obtained from patients treated with theophylline in our hospital. Because the pharmacokinetic behavior of theophylline may be different in other populations, dosage requirements may not be the same. A minimum number of blood sample collections is proposed in an attempt to improve the cost-benefit relationship in theophylline therapy.
Predicting Caffeine Plasma Concentrations Resulting from Consumption of Food or Beverages: A Simple Method and its Origin
Authors: Pfeifer Robert W. , Notari Robert E.
Published: May 2016

Multiple dosage regimens for therapeutic agents are commonly comprised of a constant dosing interval and a constant dose size. This is not true for the ingestion of a pharmacologically active agent that is a component in a dietary source. Caffeine is contained in foods and beverages that are regular components of the diet for many people. Because daily intake is unsystematic, a computer program was written to simulate caffeine plasma concentration-time courses following ingestion of variable amounts on irregular schedules. Literature values for caffeine pharmacokinetics, for the caffeine content in various foods and beverages, and for consumer habits were employed to simulate various caffeine plasma concentration-time courses. By searching for predictable traits in a wide variety of plasma concentration-time courses representing normal adults, a simple noncomputer method was developed to allow individuals to estimate caffeine plasma concentrations based on personal intake habits. Changes in the time courses due to smoking, oral contraceptive use, and liver disease, all of which alter caffeine pharmacokinetics, were also examined.
Comparative Human Bioavailability Study of Macrocrystalline Nitrofurantoin and Two Prolonged-Action Hydroxymethylnitrofurantoin Preparations
Authors: Guelen Pieter J.M. , Boerema Johannes B.J. , Vree Tom B.
Published: May 2016

This single-blind crossover study compared the human bioavailability of macrocrystalline nitrofurantoin (Furadantine MC) and two prolonged-action hydroxymethylnitrofurantoin formulations (Urfadyn PL, bid, and Uridurine, tid), based on plasma nitrofurantoin concentrations and urinary nitrofurantoin excretion. The drugs were administered to 16 healthy females for a single day according to the recommended daily dosages. For comparison, Furadantine MC was administered both at the qid dosage recommended by the manufacturer and at tid dosage. Pharmacokinetic parameters determined were maximum plasma concentration after first dose, minimum plasma concentration after first dose, area under the plasma concentration-time curve (AUC), cumulative renal excretion over 30 hours (ARE), overall renal clearance, total body clearance, and bioavailability relative to Furadantine MC qid, based on plasma AUC (F) and ARE (Fren). F for Furadantine MC 100 mg tid was 108 ± 25 percent (mean ± SD); for Uridurine 100 mg tid and Urfadyn PL 100 mg bid, F equalled 86 ± 33 percent and 53 ± 20 percent (p<0.05), respectively. A similar relationship was observed between Fren for Furadantine MC 100 mg qid and the respective Fren of Furadantine MC 100 mg tid, Uridurine 100 mg tid, and Urfadyn PL 100 mg bid. No significant difference was found between the respective F and Fren of each of the drugs studied. Although bioavailability was comparable for Furadantine MC tid and qid, the single-day design of these studies precludes inferring that these dosage schedules are therapeutically equivalent. However, the significantly lower relative bioavailabilities for the prolonged-action hydroxymethylnitrofurantoin formulations suggest that Urfadyn PL 100 mg bid and Uridurine 100 mg tid are not pharmacokinetically equivalent to Furadantine MC.
Evaluation of a Patient-Completed versus Health Professional-Conducted Medication History
Authors: Montpetit Lynne M. , Roy Myrella T.
Published: May 2016

Medication histories are considered an essential component of clinical pharmacy practice, but they are time-consuming. A study was undertaken to determine how reliable and time-saving a patient-completed medication history form alone could prove to be compared with the amount of information recorded in the medical chart and with a pharmacist-patient form review. Within 24 hours of admission, the patient was given the form to fill out. The pharmacist returned 24 hours later and reviewed the form with the patient. Of 13 questions asked, the form was significantly superior in obtaining information to the chart in 11 and to the review in 6 (p < 0.05 per question). The review rated better than the chart on all questions (p < 0.05 per question). The amount of time required to hand out and review the form (mean 7.35 min) was not significantly different from the time required of a pharmacist to conduct a conventional medication history, according to the Canada Workload Measurement Study statistics. It can therefore be concluded that the patient-completed form is not an effective or time-saving method of conducting a medication history.
A human–machine interaction approach of block erection schedule with three-dimensional spatial constraints
Authors: Bao Jinsong , Wang Qian , Zhen Xiaohu , Zhang Jianguo , Ji Xia
Published: May 2016

When the spatial constraints are taken into account, the problem about dispatch and optimization of block erection in shipbuilding becomes more complicated. A human–machine interaction approach is proposed and extended to quickly find an approximate optimal solution. First, a steer genetic algorithm enables users to guide the computing to an effective iterative direction and leverages the computing. The model of block erection dispatch to the crane is a parallel machine scheduling problem with spatial constraints. The genetic crossover operators can be guided according to the activities of block erection in shipbuilding. Two criteria are presented to justify the effectiveness of the proposed algorithm and a fitness function is given to represent the makespan. Moreover, three-dimensional spatial constraints, which affect the parallel machine scheduling problem heavily, are visualized. A better erection path can be obtained dynamically, when the users are in an immersive environment. Finally, a three-dimensional layout prototype system of block erection is developed with real size, embedded with an interactive genetic algorithm optimization to solve this problem with the objective of minimizing makespan.
Ciliated Foregut Cyst of the Common Hepatic Duct
Authors: Cottreau Jonathan , Costa Andreu , Walsh Mark , Arnason Thomas
Published: May 2016

Ciliated foregut cysts typically arise in the liver and pancreas, with rare cases reported to arise in the gallbladder wall. Herein, we describe an unusual case of a patient with a ciliated foregut cyst arising from the wall of the common hepatic duct, which has not been reported previously. As a result of its unique anatomical location, the cyst was mistaken for a type II choledochal cyst on preoperative imaging. The cyst caused intermittent biliary obstruction that resolved following surgical resection.
Achieving Clinical Competencies Through Community-Based Clinical Experiences
Authors: Stricklin Suzanne Martin
Published: May 2016

BACKGROUND: Twenty-five percent of American adults experience a diagnosable psychiatric mental health (PMH) problem each year, and acute care medical-surgical nurses carry on average a five- to six-patient load per shift. Traditionally, U.S. PMH clinical experiences have occurred on inpatient units located within acute care hospitals or psychiatric hospital settings. However, many nursing programs are moving much of the PMH clinical experience to community-based settings. OBJECTIVES: This study aims to investigate how prelicensure undergraduate baccalaureate (BSN) student nurses and their faculty perceive students’ ability to achieve learning outcomes in community-based PMH clinical settings. This study’s research questions include the following: (a) What are student nurses’ perceptions of their abilities to achieve learning outcomes in community-based PMH clinical settings? (b) What are faculty’s perceptions of the students’ abilities to achieve learning outcomes in community-based PMH clinical settings? (c) What are student nurses’ perceptions of their abilities to transfer knowledge gained in their community-based PMH clinical experiences to other health care settings? DESIGN: Qualitative descriptive study with data collected through semistructured interviews, questionnaires, focus groups, and campus and clinical site visits. RESULTS: Three student themes emerged from the data: meeting the challenges of developing PMH nursing skills, sharing multiple experiences of feeling competent, and empowering all nurses through PMH nursing skills. Three themes also emerged from the faculty data: seizing the day(s), sharing competency, and broadly empowering nursing students. CONCLUSIONS: Baccalaureate students are able to achieve PMH clinical competencies through the use of community-based experiences and to transfer PMH competencies to other clinical settings.
Quality of deli-style turkey enriched with plant sterols
Authors: Grasso S , Brunton NP , Lyng JG , Harrison SM , Monahan FJ
Published: May 2016

Low-fat meat products could be excellent carriers for plant sterols, known for their cholesterol-lowering properties. In this study, we developed a protocol for the manufacture of a deli-style turkey enriched with plant sterols (S) at a level sufficient to deliver the maximum plant sterols amount recommended for cholesterol reduction by the European Food Safety Authority (3 g of plant sterols per day) in a 70 g portion. We investigated the stability of the plant sterols and the effects of their addition on the product quality. Plant sterols remained stable during the seven-day storage period. The addition of plant sterols significantly affected some texture parameters, shear force, lipid oxidation, L values and water-holding capacity compared with control (C). Sensory analysis was carried out by an untrained panel (32) using the difference-from-control test between C and S samples to evaluate first the extent of the overall sensory difference and then the extent of sensory difference on colour, texture and flavour. Results indicated that panellists considered the intensity of the difference between C and S samples to be ‘small’. Plant sterols could be used as a potential health-promoting meat ingredient with no effect on plant sterol stability but with some effects on texture and sensory characteristics.
Improving the effectiveness and efficiency of outpatient services: a scoping review of interventions at the primary–secondary care interface
Authors: Winpenny Eleanor M , Miani Céline , Pitchforth Emma , King Sarah , Roland Martin
Published: May 2016

Objectives

Variation in patterns of referral from primary care can lead to inappropriate overuse or underuse of specialist resources. Our aim was to review the literature on strategies involving primary care that are designed to improve the effectiveness and efficiency of outpatient services.

Methods

A scoping review to update a review published in 2006. We conducted a systematic literature search and qualitative evidence synthesis of studies across five intervention domains: transfer of services from hospital to primary care; relocation of hospital services to primary care; joint working between primary care practitioners and specialists; interventions to change the referral behaviour of primary care practitioners and interventions to change patient behaviour.

Results

The 183 studies published since 2005, taken with the findings of the previous review, suggest that transfer of services from secondary to primary care and strategies aimed at changing referral behaviour of primary care clinicians can be effective in reducing outpatient referrals and in increasing the appropriateness of referrals. Availability of specialist advice to primary care practitioners by email or phone and use of store-and-forward telemedicine also show potential for reducing outpatient referrals and hence reducing costs. There was little evidence of a beneficial effect of relocation of specialists to primary care, or joint primary/secondary care management of patients on outpatient referrals. Across all intervention categories there was little evidence available on cost-effectiveness.

Conclusions

There are a number of promising interventions which may improve the effectiveness and efficiency of outpatient services, including making it easier for primary care clinicians and specialists to discuss patients by email or phone. There remain substantial gaps in the evidence, particularly on cost-effectiveness, and new interventions should continue to be evaluated as they are implemented more widely. A move for specialists to work in the community is unlikely to be cost-effective without enhancing primary care clinicians’ skills through education or joint consultations with complex patients.
Identification of model-free structural nonlinear restoring forces using partial measurements of structural responses
Authors: Lei Y , Luo SJ , He MY
Published: May 2016

Identification of nonlinear structural system is an important but challenging task for structural health monitoring. Due to the complexities of structural nonlinearities, it is hard to establish proper mathematical models for some structural nonlinear behaviors. Moreover, only partial structural responses can be measured in practice; it is essential to conduct identification of nonlinear structural systems using only partial measurements of structural responses. To cope with these issues, an algorithm is proposed in this article for the identification of some model-free structural nonlinear restoring forces using only partial measurements of structural responses. First, an equivalent linear structural system is introduced for the identification of the locations of structural nonlinearities. Then, a model-free structural nonlinear restoring force is approximated by a power series polynomial. The unknown coefficients of the power series polynomials together with other structural parameters are identified by the extended Kalman filter so that the characteristics of the behaviors of the model-free of nonlinear restoring forces can be identified. Some numerical examples including the identification of two nonlinear multi-story shear frames and a planar nonlinear truss with different structural nonlinear restoring forces are used to validate the proposed algorithm.
Fatigue reliability assessment considering traffic flow variation based on weigh-in-motion data
Authors: Zhang Jing , Au FTK
Published: May 2016

The remaining service life of a bridge is an important criterion for the bridge master to make decisions of maintenance and rehabilitation. In the assessment of fatigue problems of steel and composite bridges, a crucial step is to determine the fatigue stress spectra, which are usually obtained through field measurements. In this study, the standard fatigue vehicle spectrum of Ting Kau Bridge in Hong Kong is obtained from the dynamic weigh-in-motion system that monitors the traffic flow and volume and axle and gross vehicle weights. An advanced probabilistic loading model is proposed to simulate the vehicles running along the bridge based on measurements from the weigh-in-motion system considering not only the diurnal variations of traffic flow within different time intervals but also the rate of change of the annual traffic. The statistical fatigue reliability assessment at critical locations can then be carried out to estimate the remaining service life of the bridge.
Nonlinear finite element analysis of fibre-reinforced polymer/concrete joints
Authors: Baky Hussien Abdel , Ebead Usama A , Neale Kenneth W
Published: May 2016

The objective of this research work is to simulate the interfacial shear response of fibre-reinforced polymer/concrete joints using a micromechanics-based concrete approach. The M4 version of the microplane concrete theory is coded in FORTRAN and implemented as a parallel user-defined subroutine into the commercial finite element software package ADINA. This article first focuses on three-dimensional nonlinear micromechanics-based finite element analyses. Then, validations are carried out using experimental results of 40 fibre-reinforced polymer/concrete joints. The objective is to assess the accuracy of the microplane approach to represent the interfacial shear behaviour of the fibre-reinforced polymer/concrete joints as an alternative to implementing interface elements. At the end of this article, numerical comparisons are presented between the predictions using a phenomenological concrete constitutive law adopted in the software package (with a smeared crack model) and the micromechanics-based analysis (microplane theory) to simulate the concrete behaviour.
Designing optimal tuned mass dampers using improved harmony search algorithm
Authors: Yazdi HA , Saberi H , Saberi H , Hatami F
Published: May 2016

In this article, the optimum parameters of tuned mass dampers for suppressing the dynamic responses of multi degree-of-freedom structures induced by base excitations are proposed. The improved harmony search algorithm, which has been successfully applied in many fields, is used for tuning the tuned mass dampers under seismic loading. The parameters of tuned mass dampers including mass, damping coefficient, spring stiffness, and location are assumed as design variables and two objective functions have been considered. The results of the numerical simulations modeling of two 10-story shear structures show that tuned mass dampers are very effective in the reduction in energy responses of structures under recorded earthquakes. Also, the objective function offered in this article with better uniform distribution in transfer functions is more reliable than those which will be discussed in the following sections. Furthermore, in all earthquakes, the maximum displacement of tuned mass dampers and force exerted by tuned mass dampers on the structure for the offered objective function are considerably less. A discussion on the validity of the model used by Bekdaş and Nigdeli is also presented in detail. The results indicate that for developing reliable preliminary-design criteria, the proposed analysis-based approach presented herein has the potential to provide better calculation of the responses of such structures.
Ultrasound for confirmation of thoracostomy tube placement by emergency medicine residents
Authors: Nakitende Damali , Gottlieb Michael , Ruskis Jennifer , Kimball Deborah , Christian Errick , Bailitz John
Published: May 2016

Introduction

Thoracostomy tubes are placed in the Emergency Department for numerous indications, including hemothoraces, pneumothoraces, and empyemas. After insertion, a portable single view chest radiograph is typically performed minutes later to confirm thoracostomy tubes position. However, up to 2.6% of thoracostomy tubes are ultimately determined to be misplaced. Failure to adequately drain the chest in a timely manner may have disastrous consequences. Ultrasonography by expert sonographers has been previously described to evaluate thoracostomy tubes position. The purpose of this study was to assess the accuracy of ultrasound for confirmation of thoracostomy tubes placement by Emergency Medicine residents.

Methods

We conducted a prospective, randomized, blinded study using a cadaveric model for ultrasound confirmation of thoracostomy tube placement by resident physicians. Thirty-five Emergency Medicine residents performed a total of 140 confirmations. The primary outcome of the study was the sensitivity and specificity of EM resident-performed ultrasonography to correctly confirm thoracostomy tube placement. Secondary outcomes included time to identification, operator confidence, and subgroup analysis by resident training level.

Results

The study demonstrated an overall sensitivity of 100% (95% CI 94–100%) and specificity of 96% (95% CI 87–99%) for intrathoracic placement. Post-graduate year (PGY) 1 EM residents demonstrated 100% (95% CI 76–100%) sensitivity and 100% (95% CI 76–100%) specificity. PGY 2 EM residents demonstrated 100% (95% CI 87–100%) sensitivity and 94% (95% CI 79–99%) specificity. PGY 4 EM residents demonstrated 100% (95% CI 80–100%) sensitivity and 95% (95% CI 75–100%) specificity. The total time to identification was 16 seconds (95% CI 13–19). Overall operator confidence was 4.0/5.0 (95% CI 3.8–4.1).

Conclusion

Emergency medicine residents were able to quickly identify thoracostomy tube location using ultrasound with a high degree of accuracy in a cadaveric model after a brief educational session.
Assessment of what/for what? Teachers’ and head teachers’ views on using well-being and involvement as a screening measure for conducting baseline assessment on school entry in English primary schools
Authors: Guimaraes Sofia , Howe Sally , Clausen Sigrid Brogaard , Cottle Michelle
Published: May 2016

Baseline assessment has recently been trialled as part of an accountability measure in English primary schools. The research presented in this colloquium examines the views of teachers related to using well-being and involvement indicators as a starting point for baseline assessment. The findings suggest that the focus on well-being was welcomed by the teachers, but provoked discussion regarding the situational nature of well-being, particularly in the context of scoring well-being as a part of the performative assessment process.
In and out of neoliberalism: Reconsidering the sociology of Raymond Aron
Authors: Gane Nicholas
Published: May 2016

This article reconsiders the work of Raymond Aron in order to explore the fracture lines that existed (and in many ways continue to exist) between conservative forms of political liberalism, as advocated by Aron, and neoliberal ideas of economic or market freedom associated with Hayek and his followers. These tensions between Aron and Hayek are analysed by assessing Aron’s involvement in the Mont Pèlerin Society and the Congress for Cultural Freedom through the 1950s, and then considering the arguments of his 1962 review of Hayek’s Constitution of Liberty and his 1963 Jefferson Lectures. While Aron has been largely neglected in the existing literature on neoliberalism, it will be argued that he was the key sociological figure to engage critically with neoliberalism in its formative years and, beyond this, that the value of his work today lies in its defence of the social basis of democracy and freedom against the raw economism of neoliberal thought.
Walking in the neighbourhood: Performing social citizenship in dementia
Authors: Phinney Alison , Kelson Elizabeth , Baumbusch Jennifer , O’Connor Deborah , Purves Barbara
Published: May 2016

The proliferation of community-based activity programs for people with dementia suggests an appetite for new approaches to support quality of life and well-being for this population. Such groups also have potential to promote social citizenship, although this remains poorly understood. This article presents findings from a subset of data from an ethnographic study of a community-based program for people with young onset dementia; it focuses on Paul’s Club and the experiences of 12–15 members who are physically healthy, with moderate to moderately severe dementia. Analysis suggests how aspects of social citizenship are constructed and revealed through the Club’s everyday practice of walking in the neighbourhood. Three major themes emerged: Keeping the focus off dementia; Creating a place of belonging; and Claiming a place in the community. How the group balances consideration of members’ vulnerability and agency is discussed, and the article concludes with implications for future practice and research initiatives.
Micro-citizenship, dementia and long-term care
Authors: Baldwin Clive , Greason Michelle
Published: May 2016

In recent years there has been an increasing interest in the concept of citizenship as a lens through which to understand dementia practice. This move from an individualist, personhood-based approach towards an understanding of people with dementia as a group facing social and structural discrimination parallels, in some ways, that previously seen in the realms of disability and mental health which have sought to politicize those experiences. In so doing, the debate has sought to reconfigure power relations, insisting that members of such discriminated groups are people with power entitled to the same from life as everyone else. Much of the discussion to date has, understandably, focused on the larger issues of social inclusion, rights and responsibilities – reflecting the traditional concern of citizenship of individuals’ relationship to the state or the society in which they live. More recently, there has been a move to conceptualising citizenship as a practice – something that is realised through action and in relationship – rather than a status bestowed. In this paper, we seek to contribute to the discussion by introducing the concepts of midi- and micro-citizenship, taken from organisation studies, as a further means by which to link the personal and the political, and as grounds to build citizenship-alliances between people with dementia living in long-term care (LTC) facilities and front-line dementia care staff. We will then seek to illustrate the usefulness of these concepts in understanding citizenship in practice in LTC facilities through analysis of data drawn from focus groups involving LTC staff, and interviews with family carers whose relatives live in LTC facilities. In conclusion, we will explore some of the possibilities that such an approach holds for dementia care practice.
Citizenship and people living with dementia: A case for the ethics of care
Authors: Brannelly Tula
Published: May 2016

The ethics of care is an emerging field of interest in many disciplines, including care for people with dementia. The ethics of care as proposed by Joan Tronto is a political argument for care together with a set of principles, the integrity of care, to guide and critique practice. This two-pronged approach enables on one hand, a political, complex and situated examination of inequality, and on the other hand the integrity of care provides a set of principles to guide inclusive citizenship practices. This approach has the significant advantage of recognition of the fight that people with dementia face to achieve rights and citizenship as an issue of social justice. In this paper, three challenges to citizenship are discussed in relation to people with dementia using an ethics of care lens: (a) citizenship as a relationship between the individual and the state; (b) citizenship as a practice and (c) citizenship as identity and belonging. I propose that citizenship can be achieved by promoting inclusion in defining and creating policy, research and practice.
Scanning the conceptual horizons of citizenship
Authors: Bartlett Ruth
Published: May 2016

This article scans recent developments within citizenship studies and relates them to the field of dementia, specifically the ‘dementia friendly communities’ agenda. The dementia friendly communities agenda is selected for several reasons, most notably because, it is an area of practice in the field of dementia where citizenship is perhaps most clearly enacted. The aim of the article is to help with the advancement of social citizenship as a key concept for dementia studies, by using two of the latest ideas within citizenship studies; namely, understandings of citizenship as (a) occurring in ordinary places and (b) potentially enacted within the domestic sphere to explore dementia friendly communities. It is argued that the interplay between these two developments pave the way for deeper consideration and realisation of social citizenship in the context of people with dementia.
End-of-life decision making for persons with dementia: Proxies' perception of support
Authors: Noh Hyunjin , Kwak Jung
Published: May 2016

Healthcare proxies need support in making end-of-life decisions for persons with dementia (PWD). This study explored perceptions of support in decision making among proxies of PWD through semi-structured interviews with 20 proxies. Thematic analysis identified three sources of support: family, doctors, and religiosity/spirituality. Family's engagement in care discussions and support for proxies' decisions were viewed helpful while disagreement or criticism, combined with lack of knowledge about PWD's condition and needs, were not. Doctors were viewed supportive when proxies felt doctors respected their opinions and PWD's wishes. Doctor-PWD rapport influenced proxies' views of medical advice from doctors. Although religiosity/spirituality provided guidance and hope, it also presented conflicts when PWD's wishes differed from proxies' beliefs. Therefore, families of PWD should be provided with assistance in reconciling or mediating family conflicts and further education about the illness trajectory as well as risks/benefits of life-sustaining treatments. Assistance should also be provided to address religious/spiritual conflicts.
Vibro-acoustic modulation–based damage identification in a composite skin–stiffener structure
Authors: Ooijevaar Ted , Rogge Matthew D , Loendersloot Richard , Warnet Laurent , Akkerman Remko , Tinga Tiedo
Published: May 2016

Vibro-acoustic modulation–based damage identification relies on the modulation of a high-frequency carrier signal by an intenser low-frequency vibration signal due to damage-induced structural nonlinearities. A time domain analysis of the vibro-acoustic modulation phenomena was presented at multiple spatial locations in an impact damaged composite skin–stiffener structure. The instantaneous amplitude and frequency of the carrier velocity response were extracted to analyze the intermodulation effects between the two excitation signals. Increased amplitude modulations at the damaged region revealed the presence, location, and length of the skin–stiffener damage. The damage hardly modulated the frequency of the carrier response. This difference in behavior was attributed to the nonlinear skin–stiffener interaction introduced by the periodic opening and closing of the damage, according to earlier research by authors on the same structure. A parametric study showed that the amplitude and phase of the amplitude modulation are dependent on the selected carrier excitation frequency, and hence the high-frequency wave field that is introduced. This work demonstrates not only the potential but also the complexity of the vibro-acoustic modulation based damage identification approach.
Measurement properties of the Timed Up & Go test in patients with COPD
Authors: Mesquita Rafael , Wilke Sarah , Smid Dionne E , Janssen Daisy JA , Franssen Frits ME , Probst Vanessa S , Wouters Emiel FM , Muris Jean WM , Pitta Fabio , Spruit Martijn A
Published: May 2016

We aimed to investigate the construct validity of the Timed Up & Go (TUG) test in chronic obstructive pulmonary disease (COPD), to identify characteristics related to an abnormal TUG time and to examine the responsiveness of the TUG to pulmonary rehabilitation (PR). TUG time was assessed before and after comprehensive PR in 500 COPD patients, and compared cross-sectionally in 100 non-COPD subjects. Physical health outcomes, mental health outcomes, symptom-related outcomes and multidimensional indices were assessed in COPD patients only. Good convergent and discriminant validity was demonstrated by fair-to-moderate correlation with physical health outcomes, symptom-related outcomes and multidimensional indices ( rs = 0.18–0.70) and by little correlation with mental health outcomes ( rs = 0.21–0.26). COPD patients had a worse TUG time than non-COPD subjects, demonstrating known-groups validity. A TUG time of 11.2 seconds had good sensitivity (0.75) and specificity (0.83) for identifying patients with a baseline 6-minute walk distance <350 m. TUG time improved after PR ( p < 0.0001) and a change of 0.9–1.4 seconds was identified as clinically important. The TUG is valid and responsive in COPD. An abnormal result is indicative of poor health outcomes. This simple test provides valuable information and can be adopted in clinical and research settings.
Approaches for process and structural finite element simulations of braided ligament replacements
Authors: Gereke Thomas , Döbrich Oliver , Aibibu Dilbar , Nowotny Jorg , Cherif Chokri
Published: May 2016

To prevent the renewed rupture of ligaments and tendons prior to the completed healing process, which frequently occurs in treated ruptured tendons, a temporary support structure is envisaged. The limitations of current grafts have motivated the investigation of tissue-engineered ligament replacements based on the braiding technology. This technology offers a wide range of flexibility and adjustable geometrical and structural parameters. The presented work demonstrates the possible range for tailoring the mechanical properties of polyester braids and a variation of the braiding process parameters. A finite element simulation model of the braiding process was developed, which allows the optimization of production parameters without the performance of further experimental trials. In a second modelling and simulation step, mechanical properties of the braided structures were virtually determined and compared with actual tests. The digital element approach was used for the yarns in the numerical model. The results show very good agreement for the process model in terms of braiding angles and good agreement for the structural model in terms of force-strain behaviour. With a few adaptions, the models can, thus, be applied to actual ligament replacements made of resorbable polymers.