bluuebunny/crossref_metadata_2025 huggingface dataset:
An integrated finite element method, response surface methodology, and evolutionary techniques for modeling and optimization of machining fixture layout for 3D hollow workpiece geometry
Authors: Sundararaman KA , Padmanaban KP , Sabareeswaran M , Guharaja S
Published: September 2016

Machining fixtures play inevitable role in manufacturing to ensure the machining accuracy and workpiece quality. The layout of fixture elements, clamping forces, and machining forces significantly affect the workpiece elastic deformation during machining. The clamping and machining forces are necessary to immobilize and machine the workpiece, respectively. Finding the appropriate layout of fixture elements is the other possible way to reduce the workpiece deformation, which in turn improves the machining accuracy. The finite element method interfaced with evolutionary techniques is normally used for fixture layout optimization. In the finite element method, the workpiece is discretized into a number of small elements and fixture elements are placed only on the nodes. Hence, evolutionary techniques are capable of searching the optimal fixture layout from those discrete nodal points than from the entire area on the locating and clamping face. To overcome these limitations, in this research paper, response surface methodology is employed to establish a quadratic model between the position of fixture elements and maximum workpiece deformation. This enables the optimization techniques to search for the optimal solution in the continuous domain of the solution space. Then, the real-coded genetic algorithm based discrete optimization, continuous optimization based on binary-coded genetic algorithm and particle swarm optimization are employed to optimize the developed quadratic model and their performances are compared. The result clearly shows that the integration of finite element method, response surface methodology with particle swarm optimization is better than the integration with genetic algorithm to optimize the machining fixture layout and also reduces the computational complexity and time to a greater extent.
Turbulent heat transfer enhancement in an air-to-water heat exchanger
Authors: Sheikholeslami Mohsen , Domiri Ganji Davood
Published: September 2016

Hydrothermal behavior in a water-to-air double-pipe heat exchanger is studied experimentally and numerically. To achieve fully developed conditions, the heat exchanger was built with additional lengths before and after the test section. Commercial code (ANSYS 14) is used for numerical section. In order to enhance rate of heat transfer, discontinuous helical fins is utilized. Results show that Nusselt number augments with the enhancement of Reynolds number and Prandtl number, which are calculated at bulk temperature. The use of square section helical fins also shows a higher heat transfer enhancement rate than that of the circular one. Thermal performance factor is an increasing function of the open area ratio.
Effects of lay-up sequence in thick composite tubes for helicopter landing gears
Authors: Yazdani Sarvestani Hamidreza , Hojjati Mehdi
Published: September 2016

Analysis and design of composite helicopter landing gears are challenges. Cross tubes of helicopter landing gears consist of straight tubes at the middle and curved tubes at the sides. In this work, to simulate ground handling, thick laminated composite straight tubes subjected to pure bending moments are studied using a new high-order simple-input analytical method. The accuracy of the proposed method is subsequently verified by comparing the numerical results obtained using the proposed method with finite element method and experimental data. The results show good agreement. High efficiency in terms of computational time is achieved when the proposed method is used as compared with finite element method. In addition, a simple non-dimensional coefficient is proposed to predict interlaminar radial stresses of thick composite straight tubes.
Sexually transmitted infections other than HIV/AIDS among women of low socio-economic class attending antenatal clinics in Khartoum, Sudan
Authors: Abdelrahim Nada A , Ahmed Hiba I , Fadl-Elmula Imad M , Bayoumi Magdi A , Homeida Mamoun M
Published: September 2016

Sexually transmitted infections (STIs) are major health threats affecting people globally; however, the burden of STIs is greatest in low-income countries. Since they are physiologically more vulnerable, women are mostly affected. The risk is increased dramatically during pregnancy leading to serious health complications that may affect the newborn. Underprivileged pregnant women attending antenatal clinics for routine checkups in displaced camps, a women's prison and several peripheral health centres were clinically and laboratory screened for trichomoniasis, chlamydial infections, gonorrhea and syphilis. A total of 426 women with an age range of 14-45 years were included. Clinical data, blood, cervical and vaginal swabs were collected. Conventional bacteriological and serological methods were applied. All attendees were HIV1/2-negative. The prevalence of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum infections was found to be 7.8%, 4.9%, 0% and 5%, respectively. Although vaginal discharge, among other symptoms, is known to be the most significant indicator for STIs, our identified positive predictive value was only 14.1%. We conclude that use of syndromic approach for diagnosing and treating attendees of antenatal settings is of low clinical value and many easily curable STIs will be overlooked. Consequently, trichomoniasis, chlamydial infection and syphilis prevailed widely among this population.
Changing trends in Spanish library services: Conceptualization and measurement in official statistics
Authors: Villarroya Anna , Ateca-Amestoy Victoria
Published: September 2016

The purpose of this paper is to analyse how public libraries have been conceptualized and measured in official Spanish statistics over the past 15 years. This allows us to reflect on the transformation of the very nature and aims of libraries during the first 15 years of the 21st century. We examine the main official statistical source of information on cultural participation, the Survey on Cultural Habits and Practices in Spain, and track the impact of social change and digitization on library services. By analysing the 2002–2003, 2006–2007, 2010–2011 and 2014–2015 surveys, we monitor changes in the questionnaires and in the derived indicators, and relate the findings to general trends and challenges for public libraries in contemporary societies.
Community Health Impacts from Oil and Gas Development in Texas
Authors: Vera Lourdes
Published: September 2016

Sharon Wilson is a community organizer for the nonprofit organization Earthworks. After leaving her office job managing data for the oil and gas industry, she started organizing in response to negative impacts from unconventional oil and gas extraction methods near her Texas home and throughout the state. She describes the environmental health impacts of oil and gas development aided by new technologies and regulatory exemptions set forth by the 2005 Energy Policy Act. Production has spread to previously unexplored regions over the last decade, including her property on the Barnett Shale in North Texas, where she has interacted with energy corporations and observed the intensification of residents’ health issues. I structured the questions in this interview to highlight her unique perspective on organizing in relation to current regulatory loopholes, health impacts of oil and gas development, and the experiences individuals have had with representatives from the industry.
The Romantic Retreat Is Not Club Med
Authors: Epstein William M.
Published: September 2016

“Feminist standpoint epistemology” is not a serious philosophy but a romantic evasion of the application of science to social services. There are numerous limitations to the application of the scientific method to the practice of social work and the social services. Nonetheless, a pragmatic approach to understanding social reality and the evaluation of social interventions is more desirable than feminist standpoint epistemology. Yet the romantic dominates social work and social decision-making in the United States and may explain the precipitous decline of social work over the past century. Indeed, much should be said for closing down social work education and the field itself in order to try an alternative that might better serve people in need.
All CLEAR? Preparing for IT Downtime
Authors: Kashiwagi Deanne T. , Sexton Meredie D. , Souchet Graves C. Estelle , Johnson Jay M. , Callies Byron I. , Yu Roger C. , Thompson Jeffrey M.
Published: September 2016

Health care information technology (IT) outages pose a threat to patient safety and patient care continuity. Organizations’ downtime plans must be updated regularly and staff at the work area level should have experience with implementing IT outage operations through downtime drills. This article describes the study institution’s IT Outage Toolkit, based on the acronym CLEAR, which guides the development of a downtime plan as well as design, execution, and assessment of work area downtime drills. Self-report and external audits of downtime drills help identify performance gaps and gaps in downtime plans.
Assessing the Negative and Positive Emotion-Dependent Nature of Risky Behaviors Among Substance Dependent Patients
Authors: Weiss Nicole H. , Tull Matthew T. , Dixon-Gordon Katherine , Gratz Kim L.
Published: September 2016

Despite literature highlighting the relevance of negative and positive emotions to risky behaviors, little research has examined the emotion-dependent context of risky behaviors. This study sought to develop and validate a comprehensive measure of the frequency and emotion-dependent context of distinct clinically relevant risky behaviors (the Risky Behavior Questionnaire [RBQ]), as well as to examine the unique relations of the RBQ Negative and Positive Scales (which assess the general tendency to engage in risky behaviors in the context of negative vs. positive emotions, respectively) to specific risky behaviors. Participants were 176 patients in a residential substance use disorder treatment facility ( M age = 34.18; 65.3% White, 53.4% female). Results provided support for the construct and incremental validity (relative to extant measures of related constructs) of the RBQ Scales, as well as the differential relevance of RBQ Negative and Positive Scales to specific risky behaviors.
Clinical Predictive Value of Cystatin C in Pediatric Sickle Cell Disease: A Marker of Disease Severity and Subclinical Cardiovascular Dysfunction
Authors: Tantawy Azza Abdel Gawad , Adly Amira Abdel Moneam , Ismail Eman Abdel Rahman , Abdelazeem Mai
Published: September 2016

Background:

Patients with sickle cell disease (SCD) are at high risk of renal dysfunction and cardiovascular morbidity. The association between cystatin C and renal function is well known, however, cystatin C has recently emerged as a strong predictor of cardiovascular events and adverse outcomes in patients with and without kidney disease, mostly related to both inflammation and atherosclerosis.

Aim:

To determine cystatin C levels in 53 children and adolescents with SCD compared to 40 age- and sex-matched healthy controls and assess its relation to markers of hemolysis, iron overload, sickle vasculopathy, and carotid intima–media thickness (CIMT).

Methods:

Patients with SCD in steady state were studied, focusing on hydroxyurea therapy, hematological profile, serum ferritin, high-sensitivity C-reactive protein (hs-CRP), urinary albumin–creatinine ratio (UACR), and serum cystatin C. Echocardiography and CIMT were assessed using high-resolution ultrasound. Heart disease was defined by systolic left ventricle dysfunction (shortening fraction <30% or ejection fraction <55%).

Results:

Carotid IMT was significantly higher in patients with SCD compared to controls ( P < .001). Patients with SCD having nephropathy, heart disease, or history of frequent sickling crisis (≥3 attacks/y) had significantly higher cystatin C levels than those without ( P < .05). Patients with SCD treated with hydroxyurea had lower cystatin C levels than untreated patients ( P = .039). High-sensitivity C-reactive protein, UACR, ejection fraction, and CIMT were independently related to cystatin C in multiple regression analysis. The cutoff values of cystatin C for detection of renal or cardiovascular complications were determined.

Conclusion:

Cystatin C may be considered a biological marker for vascular dysfunction and subclinical atherosclerosis in SCD.
Fifty Years of Life: The Story of a Satirical Weekly
Authors: Mott Frank Luther
Published: September 2016

This article on the old Life will appear as a chapter in the fourth volume of A History of American Magazines, the first three volumes of which brought Dean Mott, of the School of Journalism at the University of Missouri, the 1939 Pulitzer Prize for history. From 1930 to 1934 Dr. Mott was editor of the Quarterly.
Ways to Collaborate with the Magazine Industry
Authors: Arpan Floyd G.
Published: September 2016

More cooperation between schools of journalism and the magazine field not only is desirable but also possible, Mr. Arpan explains, citing practical examples. He is associate professor at the Medill School of Journalism, in charge of the magazine sequence on the Evanston campus.
An Annotated Bibliography of Journalism Subjects in American Magazines: May, June, and July 1948
Authors: Swindler William F. ,   Assisted, Reddick Dewitt C. , Price Granville
Published: September 2016

The professional aspect of journalism came in for an especial degree of discussion during the spring of 1948 as the ACEJ made its long-awaited announcement of its first list of accredited institutions. Several individual schools reported on their educational programs in the trade and professional journals, and in the newspaper field an increasing interest was shown in problems of improved news writing and readability of news copy. These seemed to be related signs of a general awareness that journalism was in a state of change. Mechanically this was reflected in continued research into “cold type” printing and related processes, the Chicago Tribune's experiment with newsprint made from straw, and the Chicago Herald-American's work in magnetic ad layout sheets. The printers’ fight with publishers over the Taft-Hartley law continued indecisively, meantime. With television coverage of the national political conventions in Philadelphia, radio in the field of public events entered a major new phase of development itself, and in radio circles also there was increased interest in the professional responsibility of communications. —W. F. S.
Professional Help-Seeking for Adolescent Dating Violence in the Rural South: The Role of Social Support and Informal Help-Seeking
Authors: Hedge Jasmine M. , Sianko Natallia , McDonell James R.
Published: September 2016

Structural equation modeling with three waves of data was used to assess a mediation model investigating the relationship between perceived social support, informal help-seeking intentions, and professional help-seeking intentions in the context of adolescent dating violence. The sample included 589 adolescents from a rural, southern county who participated in a longitudinal study of teen dating violence victimization and perpetration. Results suggest that informal help-seeking intentions are an important link between perceived social support and professional help-seeking intentions. Findings highlight the importance of informal help-seeking and informal help-giving in fostering professional help-seeking for adolescent victims and perpetrators of dating violence.
Intimate Partner Violence Among Help-Seeking Deaf Women: An Empirical Study
Authors: Ballan Michelle S. , Freyer Molly Burke , Powledge Lauren , Marti C. Nathan
Published: September 2016

Deaf women face heightened rates of intimate partner violence (IPV) compared with hearing women, yet limited research has focused on IPV among this population. Empirical studies are warranted to examine the unique experiences and resource needs of Deaf women, along with barriers excluding Deaf participants from IPV research and service provision. Our study addresses these gaps by providing a profile of 80 Deaf women attending an IPV program serving individuals with disabilities. Demographic and psychosocial characteristics, referral channels that led women to the program, and services sought post-referral are discussed to help guide best practices with Deaf survivors of IPV.
Assessment of Sex Offenders With the Minnesota Multiphasic Personality /Inventory–2–Restructured Form
Authors: Tarescavage Anthony M. , Cappo Bruce M. , Ben-Porath Yossef S.
Published: September 2016

This study examined the association between scores on the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) with static and dynamic risk assessment instruments, including the STATIC-99 and Level of Service Inventory–Revised (LSI-R). The sample included 304 male adults who were convicted of sexual offenses against children and were referred to a sex offender treatment program. On average, the sample had a Low-Moderate risk of re-offending according to the STATIC-99 and LSI-R. The results indicated that MMPI-2-RF scale scores in this setting are characterized by relatively high levels of under-reporting and externalizing psychopathology compared with the normative sample. We also found that scale scores in this sample produced reliability estimates that were similar to the normative sample. Finally, external correlations between the MMPI-2-RF scales and the risk assessment instruments indicated that the test was associated in expected ways with constructs measured by these instruments. Correlations were most robust among scales in the externalizing/behavioral dysfunction domain of the MMPI-2-RF. Overall, the results of the study support and guide use of the test in this population.
Self-Modeling to Promote Social Initiations With Young Children With Developmental Disabilities
Authors: Buggey Tom , Crawford S. Caroline , Rogers Chelsea L.
Published: September 2016

Video self-modeling (VSM) uses a method called feedforward to provide children the opportunity to view themselves as they perform in a more advanced or appropriate manner than they do presently. Typically, this is accomplished through the careful editing of videos. Studies on VSM and social skills with children on the autism spectrum ages 3 to 4 years have produced mixed results. In this study, a single-subject multiple-baseline design across four children (three on the autism spectrum and one with Down syndrome) with a mean age of 4 years 2 months was used to determine whether VSM would facilitate social initiations. This study was meant to be a replication of a study published in 2012. Positive changes were seen for all four children. The relationship between age and VSM efficacy is discussed along with other factors that may influence VSM outcomes with young children.
It’s more than a job: discourse and the treatment of elite footballers accused of sexual violence
Authors: Waterhouse-Watson Deb
Published: September 2016

In the 21st century, ‘playing’ football at the elite level is a profession in a multi-billion dollar business. However, the way it is imagined in media discourse and the popular imagination positions football and its athletes as transcending mere ‘work’, portraying them as ‘larrikin’ national heroes, pseudo-religious figures and role models. Taking the case of Andrew Lovett as a case study, a footballer ultimately fired after being charged with sexual assault, this article demonstrates the persistence of ‘non-work’ discourses in media reporting using mixed-methods discourse analysis. It shows how ‘transcendent’ discourses provide a logical framework that makes treating footballers differently from those in other public professions seem reasonable, enabling clubs and leagues to act in their own best interests.
Taking the local food movement one step further: An exploratory case study of hyper-local restaurants
Authors: De Chabert-Rios Jacqueline , Deale Cynthia S
Published: September 2016

The number of restaurateurs owning farms or gardens that supply part of their operations’ fresh produce and other food products has increased considerably over the past few years. This phenomenon, termed “hyper-local,” involves a significant commitment that goes well beyond purchasing local food. Hyper-local restaurateurs take on the tasks of a farmer/gardener, a job that requires a variety of skills and presents numerous challenges. While some research studies have addressed local purchasing, local farm-to-restaurant relationships and decision making, and various consumer issues, very little work has focused on the hyper-local phenomenon. Therefore, this exploratory qualitative study was undertaken to understand the reasons why some restaurateurs are entering the farming business and to learn about the financial, operational, and customer-related benefits and challenges encountered by restaurateurs operating their own farms. A case study approach was used to gather information from three restaurateurs that currently own and operate farms that provide products for their restaurants. The study explores the benefits, rewards, and challenges of these types of operations, their possible financial issues, motivations of the restaurateurs, and issues that could impact the growth potential of this trend.
Efficiency scaling method of gasoline engines for different geometries and the application in hybrid vehicle simulation
Authors: Hamann Harry , Münning Daniel , Gorzalka Philip , Zillmer Michael , Eilts Peter
Published: September 2016

This work presents a scalable model of a naturally aspirated gasoline engine forecasting the effective efficiency map for varying cylinder displacements. Engine test bench measurements and a global nonlinear hybrid optimization method were used to calibrate the engine model. The validation showed a good prediction of engine efficiency by the scaling model with a mean error of 2% compared with the measurements. A pure scaling of the cylinder displacement led to overall small changes in the effective engine efficiency map. In addition to the development of a scalable engine model, a forward-looking hybrid vehicle simulation model was used in order to evaluate the impact of different engine cylinder displacements on fuel consumption. For this purpose, simulations for varying cylinder displacements were performed in a series–parallel hybrid drivetrain of an A-class vehicle in two driving cycles. The simulation results showed a small influence of different engine cylinder displacements on fuel consumption for the given configuration.
Working with the carnivalesque at the seaside: Transgression and misbehaviour in a tourism workplace
Authors: Chapman Anya , Light Duncan
Published: September 2016

To date, consideration of the carnivalesque at the seaside has focussed on the practices and behaviour of tourists. Less attention has been paid to tourism employees who are not participants in the carnival but may nevertheless be affected by the ‘playful crowd’ that they work with. This study focuses on employees in a seaside amusement park. Employees regularly experienced ‘misbehaviour’ (such as abusive language, attempted theft and violence) by visitors reflecting the spirit of carnival. Employees responded by treating tourists with contempt and retaliated with tactics such as cheating, and reciprocal abuse and violence. The spirit of carnival rubbed off on employees in other ways such as using alcohol or drugs in the workplace, and participation in casual sexual encounters with both other staff and customers. In a variety of ways, employees inverted and transgressed the norms of the hospitality encounter in ways which reflected the influence of the carnival.
Searching for my palm tree: Epistemological journeying of a child welfare doctoral student
Authors: Sky Iona
Published: September 2016

This article explores a social work doctoral student’s self-reflexive journey in search of a suitable epistemology for her qualitative social work doctoral research with lesbian, gay, bisexual, trans and queer (LGBTQ) youth in child welfare. It will highlight the deep influence that colonialism and imperialism can have on embodied knowledge and the importance of pushing against these paradigms to help bring forward the voices from the margins.
Annual daylight glare evaluation: Impact of weather file selection
Authors: Deng Q-G , Cao G-Y , Liu Z-C , Wang Z-S , Yang Y , He X-Y , Yu J-J
Published: September 2016

This paper illustrates the results of daylight glare simulations of a simple office carried out using five different five weather data files (Chinese typical year weather, CSWD(C), CSWD(A), international weather for energy calculations and Meteonorm), for three Chinese locations (Beijing, Shanghai and Guangzhou). The aim is to analyse the impact of choosing one weather file or the other on the prediction of daylight glare in the interior environment. The results show that using the Chinese typical year weather and CSWD(C) files can make a better prediction of the time distribution of daylight glare than the others. Analysis of the total amount of daylight glare leads to the conclusion that the Chinese typical year weather file should be recommended when considering extreme weather conditions and the CSWD(C) or Meteonorm files should be recommended in normal weather conditions.
Sports Fans, Alcohol Use, and Violent Behavior: A Sociological Review
Authors: Ostrowsky Michael K.
Published: September 2016

This review makes four contributions to the sociological study of sports fans, alcohol use, and violent behavior. First, this article focuses explicitly on the relationship between alcohol use and violent behavior among sports fans. This is a worldwide social problem, yet it is quite understudied. Second, this article synthesizes the fragmented literature on alcohol use and violent behavior among sports fans. Third, this article identifies four broad sets of risk factors—sociocultural, event/venue, police, and crowd—that appear to be closely related to violent behavior among sports fans. Finally, to help explain the possible correlation between alcohol and violence among sports fans, this article draws upon the key understandings from the literature on alcohol and violence in wider society. The article concludes with suggestions for future research.
Does the Home Advantage Depend on Crowd Support? Evidence From Same-Stadium Derbies
Authors: Ponzo Michela , Scoppa Vincenzo
Published: September 2016

We investigate to what extent crowd support contributes to the home advantage in soccer, disentangling this effect from other mechanisms such as players’ familiarity with the stadium and travel fatigue. To evaluate the relevance of crowd support in determining home advantage, we analyze same-stadium derbies (matches among teams that share the same stadium), in which teams enjoy different levels of support from the crowd—the home team has many more supporters mainly because of season ticket holders—while teams do not differ in terms of travel fatigue or familiarity with the stadium. Our estimation results suggest the existence of a sizable crowd support’s effect on the home advantage generated through the encouragement of players’ performance. Furthermore, we find consistent evidence that the support of the crowd tends to bias referee’s decisions (in terms of penalties, red cards, and yellow cards) in favor of the home team.
Polypyrrole/barium titanate/poly(acrylonitrile-co-methylacrylate)–deposited cotton fabrics: Electromagnetic shielding
Authors: Engin Sagirli FZ , Kayali ES , Sarac AS
Published: September 2016

In this study, polypyrrole was deposited separately on barium titanate, barium titanate-poly (acrylonitrile-co-methylacrylate) nanocomposite-coated textile fabrics by an in-situ chemical polymerization process. Electromagnetic shielding effectiveness, electrical conductivity, chemical structure, and morphology of fabrics were fully characterized and systematically studied for investigation of individual effects of barium titanate, pyrrole polymer, and barium titanate-poly (acrylonitrile-co-methylacrylate) on obtained fabrics’ conductivity and shielding behaviour. Electromagnetic shielding effectiveness of the fabrics was determined according to the ASTM D4935-10 protocol, by using a coaxial transmission line measurement technique in the frequency range of 15–3000 MHz. Electrical characteristics were measured by the two-end method. Electromagnetic shielding effectiveness data suggested that polypyrrole-coated fabrics had better electromagnetic shielding effectiveness than polypyrrole-barium titanate and barium titanate-poly (acrylonitrile-co-methylacrylate)-coated fabrics. On the other hand, conductivity increased due to the interaction between polypyrrole and barium titanate-poly (acrylonitrile-co-methylacrylate), with fabric conductivity values also increased with the use of barium titanate. Spectroscopic characterizations of coated fabrics were determined using Fourier transform infrared spectroscopy. Analyses demonstrated that there is a strong interaction between cotton and polypyrrole and barium titanate, and also with poly (acrylonitrile-co-methylacrylate)-barium titanate. Morphological characterizations of the coated fabrics were examined by scanning electron microscopy. Colour measurements of fabric samples were performed for determination of colour intensity as a function of polymerization efficiency.
The Healing Effect of Low-Temperature Atmospheric-Pressure Plasma in Pressure Ulcer
Authors: Chuangsuwanich Apirag , Assadamongkol Tananchai , Boonyawan Dheerawan
Published: September 2016

Pressure ulcers are difficult to treat. Recent reports of low-temperature atmospheric-pressure plasma (LTAPP) indicated its safe and effectiveness in chronic wound care management. It has been shown both in vitro and vivo studies that LTAPP not only helps facilitate wound healing but also has antimicrobial efficacy due to its composition of ion and electron, free radicals, and ultraviolet ray. We studied the beneficial effect of LTAPP specifically on pressure ulcers. In a prospective randomized study, 50 patients with pressure ulcers were divided into 2 groups: Control group received standard wound care and the study group was treated with LTAPP once every week for 8 consecutive weeks in addition to standard wound care. We found that the group treated with LTAPP had significantly better PUSH (Pressure Ulcer Scale for Healing) scores and exudate amount after 1 week of treatment. There was also a reduction in bacterial load after 1 treatment regardless of the species of bacteria identified.
Aortic Endograft Infection by Pasteurella multocida
Authors: Jayakrishnan Thejus T. , Keyashian Brian , Amene Juliet , Malinowski Michael
Published: September 2016

Infection of an aortic endograft is a rare complication following endovascular aneurysm repair. These patients have been treated with explantation of the graft to obtain source control followed by an extra-anatomic bypass to restore circulation. The present case study describes an interesting case of Pasteurella infection involving an aortic endograft managed nonoperatively by percutaneous drainage and graft preservation.
Patent Femoropopliteal Vein Bypass Graft 45 Years After Implantation
Authors: Klonaris Chris , Katsargyris Athanasios , Doulaptsis Mikes , Athanasiadis Dimitris , Liakakos Theodor
Published: September 2016

Patency of femoropopliteal vein bypass above the knee has been estimated between 69% and 77% at 5 years. This article reports a case of a patent femoropopliteal vein bypass 45 years after implantation without any reintervention. The morphologic alterations observed after 45 years at this vein bypass graft are additionally discussed.
An Evaluation of the Middle East Research Training Initiative Tool in Assessing Effective Functioning of Research Ethics Committees
Authors: Jaoko Walter , Bukusi Elizabeth , Davis Arlene M.
Published: September 2016

The effective functioning of a research ethics committee (REC) can be evaluated using self-assessment tools. The Middle East Research Ethics Training Initiative (MERETI) tool can be used by one member, typically the Chair, to score an REC. The consistency of these scores across several members of an REC has never been evaluated. This study examined whether results would be consistent irrespective of who conducts the assessment. One REC’s effective functioning was assessed by several members ( n = 13). The Chair’s scores were compared with scores of other members in relation to their duration of REC membership, research ethics training, gender, and employer’s institutional affiliation to the REC. The Chair’s overall score was higher than the other members’ scores by 11%. No significant differences in scores were obtained in relation to duration of REC membership ( p = .72), interval since last research ethics training ( p = .94), and gender ( p = .27). The MERETI tool is thus consistent irrespective of who performs the assessment.
Carpal Coalitions and Metacarpal Synostoses
Authors: Gottschalk Michael B. , Danilevich Maxim , Gottschalk Hilton P.
Published: September 2016

Background: Carpal coalition and metacarpal synostosis are uncommon congenital anomalies of the carpus and hand. Methods: A comprehensive review of the literature was performed to help guide surgical and non-surgical treatment of carpal coalition and metacarpal synostosis. Results: The embryology, epidemiology, medical and surgical management, and associated outcomes are detailed. Conclusions: Most patients with these disorders will likely benefit from conservative measures. Surgery should be considered in patients with pain and limitations in wrist and hand function.
Assessment of the vulnerable carotid atherosclerotic plaque using contrast-enhanced ultrasonography
Authors: Filis Konstantinos , Toufektzian Levon , Galyfos George , Sigala Fragiska , Kourkoveli Panagiota , Georgopoulos Sotirios , Vavuranakis Manolis , Vrachatis Dimitrios , Zografos George
Published: September 2016

Carotid atherosclerosis represents a primary cause for cerebrovascular ischemic events and its contemporary management includes surgical revascularization for moderate to severe symptomatic stenoses. However, the role of invasive therapy seems to be questioned lately for asymptomatic cases. Numerous reports have suggested that the presence of neovessels within the atherosclerotic plaque remains a significant vulnerability factor and over the last decade imaging modalities have been used to identify intraplaque neovascularization in an attempt to risk-stratify patients and offer management guidance. Contrast-enhanced ultrasonography of the carotid artery is a relatively novel diagnostic tool that exploits resonated ultrasound waves from circulating microbubbles. This property permits vascular visualization by producing superior angiography-like images, and allows the identification of vasa vasorum and intraplaque microvessels. Moreover, plaque neovascularization has been associated with plaque vulnerability and ischemic symptoms lately as well. At the same time, attempts have been made to quantify contrast-enhanced ultrasonography signal using sophisticated software packages and algorithms, and to correlate it with intraplaque microvascular density. The aim of this review was to collect all recent data on the characteristics, performance, and prognostic role of contrast-enhanced ultrasonography regarding carotid stenosis management, and to produce useful conclusions for clinical practice.
Effects of a health promotion program on medication adherence to antiplatelet therapy among ischemic stroke patients in Hainan Province, China
Authors: Su Qingjie , Li Chaoyun , Long Faqing , Chen Bin , Wan Zhongqin , Wu Yingman , Dai Mingming , Wang Desheng , Zhang Yuhui , Wang Bufei
Published: September 2016

Survivors of ischemic stroke are still at a significant risk for recurrence. Antiplatelet agents are the treatment of first choice for long-term secondary prevention of vascular events. This study aims to assess a health promotion program on medication adherence to antiplatelet therapy among ischemic stroke patients in Hainan province, China. In five hospitals from the intervention group, four highly experienced physicians trained 62 neurologists, who in turn trained 613 stroke patients to improve their awareness and adherence to antiplatelet therapy. Physicians and patients of the control group received usual stroke management programs. After one-year follow-up, the proportion of patients who took the antiplatelet therapy increased significantly in the intervention group, reaching 73.2%, with a pre–post difference between two arms of 22.9% ( P < 0.01). There was also a significant net increase in the proportion of patients with awareness of antiplatelet therapy (24.4%, P < 0.01). Multivariate analysis illustrated health promotion program, higher education, annual household income, insurance, and medical status affected antiplatelet drug use in stroke patients. In conclusion, the health promotion program, based on a train-the-trainer approach, showed positive eﬀects on awareness of and adherence to antiplatelet therapy, which has the potential to be scaled up to other resource-limited areas.
Pediatric Acquired von Willebrand Disease With Berlin Heart Excor Ventricular Assist Device Support
Authors: Gossai Nathan , Brown Nicholas M. , Ameduri Rebecca , Zantek Nicole D. , Louis James St. , Steiner Marie E.
Published: September 2016

Background:

The balance of hemostasis and anticoagulation is a concern for patients dependent upon ventricular assist devices (VADs). Bleeding is a common complication with both short- and long-term use of these devices. A better understanding of the risk factors and etiologies of bleeding associated with these devices is needed and could improve the overall results. We sought to determine the relationship of mechanical circulatory assist device use with acquired von Willebrand disease (avWD) in children.

Methods:

Data were analyzed retrospectively via review of the medical record of 19 consecutive patients who were supported with the Berlin EXCOR VAD for greater than 24 hours. Laboratory testing for avWD was performed at the discretion of the clinical team, often in association with clinical bleeding.

Results:

Of 19 pediatric patients, 10 (52.6%) had laboratory testing consistent with avWD. Median time to detection of avWD was 35 days postimplantation of device (range 0-310 days). Both minor mucosal bleeding and bleeding requiring intervention were highly prevalent in patients in whom avWD was identified (10/10 [100%] and 7/10 [70%]). The mean age of all patients was 3.3 years, but patients found to have avWD tended to be older (mean 5.3 years) and supported with larger volume VADs.

Conclusions:

This experience demonstrates a high prevalence of avWD following EXCOR implantation. Bleeding, older age, and larger VAD size may be associated with avWD. These results should stimulate critical evaluation of individualized anticoagulation regimens in pediatric VAD patients.
Twenty Years of Adult Congenital Heart Surgery
Authors: Long Michael A. , Smit Francis E. , Brown Stephen C.
Published: September 2016

Background:

Lack of data exists on the surgical management of adult congenital heart disease on the African continent. This study was undertaken to describe the clinical profile and surgical outcome of adult patients with congenital heart disease undergoing surgery in a single-center African study population.

Methods:

A retrospective medical chart review of consecutive adult patients (≥18 years) undergoing congenital heart surgery between October 1995 and December 2015 at our institution was undertaken. We described cardiac diagnosis, diagnostic complexity, risk profile, and surgical morbidity and mortality.

Results:

Data were collected of 233 surgical procedures performed in 219 patients (45.6% males). The most common diagnostic category was septal defects (41.2%), followed by right heart lesions (17.2%), left heart lesions (12.4%), thoracic arteries (9.0%), and conduit failure (6.9%). Twenty-four percent of patients presented in functional class III or IV, and 46% of patients met the criteria for the simple Bethesda diagnostic class. Preoperative risk factors were identified in 19.8% of patients. Corrective surgery was performed in 71.7% of cases, reoperative surgery in 27.6%, and palliative surgery in 0.8%. Right ventricle to pulmonary artery conduit placement comprised 53.1% of reoperations. The overall hospital mortality was 1.7%. Postoperative complications occurred in 26.3% of cases.

Conclusions:

This study presents a detailed description of this emerging population in a developing world context. Our outcomes data suggest that adult congenital heart disease surgery is feasible in a Southern African tertiary referral center with low operative mortality and acceptable morbidity.
Konno Operation
Authors: Kurosawa Hiromi
Published: September 2016

The Konno operation consists of a prosthetic aortic valve replacement by using an anterior enlargement of the small aortic annulus. The original procedure includes a longitudinal incision in the aortic septum placed near the midpoint between the two coronary ostia, a vertical incision in the outflow tract of the right ventricle to join the septal incision, prosthetic aortic valve replacement, and patch reconstruction of the outflow tracts of both ventricles by means of a fusiform Dacron patch. The concept of this operation has been applied in other complex operations, such as modified Konno operation, Ross-Konno operation, and aortic valve replacement after arterial switch operation.
Variation in Perfusion Strategies for Neonatal and Infant Aortic Arch Repair
Authors: Meyer David B. , Jacobs Jeffrey P. , Hill Kevin , Wallace Amelia S. , Bateson Brian , Jacobs Marshall L.
Published: September 2016

Background:

Regional cerebral perfusion (RCP) is used as an adjunct or alternative to deep hypothermic circulatory arrest (DHCA) for neonates and infants undergoing aortic arch repair. Clinical studies have not demonstrated clear superiority of either strategy, and multicenter data regarding current use of these strategies are lacking. We sought to describe the variability in contemporary practice patterns for use of these techniques.

Methods:

The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010-2013) was queried to identify neonates and infants whose index operation involved aortic arch repair with cardiopulmonary bypass. Perfusion strategy was classified as isolated DHCA, RCP (with less than or equal to ten minutes of DHCA), or mixed (RCP with more than ten minutes of DHCA). Data were analyzed for the entire cohort and stratified by operation subgroups.

Results:

Overall, 4,523 patients (105 centers) were identified; median age seven days (interquartile range: 5.0-13.0). The most prevalent perfusion strategy was RCP (43%). Deep hypothermic circulatory arrest and mixed perfusion accounted for 32% and 16% of cases, respectively. In all, 59% of operations involved some period of RCP. Regional cerebral perfusion was the most prevalent perfusion strategy for each operation subgroup. Neither age nor weight was associated with perfusion strategy, but reoperations were less likely to use RCP (31% vs 45%, P < .001). The combined duration of RCP and DHCA in the RCP group was longer than the DHCA time in the DHCA group (45 vs 36 minutes, P < .001).

Conclusion:

There is considerable variability in practice regarding perfusion strategies for arch repair in neonates and infants. In contemporary practice, RCP is the most prevalent perfusion strategy for these procedures. Use of DHCA is also common. Further investigation is warranted to ascertain possible relative merits of the various perfusion techniques.
Exploring Targeted Contrast-Enhanced Ultrasound to Detect Neural Inflammation
Authors: Volz Kevin R. , Evans Kevin D. , Kanner Christopher D. , Basso D. Michele
Published: September 2016

Targeted contrast-enhanced ultrasound (TCEUS) is an innovative method of molecular imaging used for detection of inflammatory biomarkers in vivo. By targeting ultrasound contrast to cell adhesion molecules (CAMs), which are known inflammatory markers within neural tissue, a more direct evaluation of neural inflammation can be made. Due to the novel nature of TCEUS, standardized methods of image analysis do not yet exist. Time intensity curve (TIC) shape analysis is currently used in magnetic resonance contrast imaging to determine temporal behavior of perfusion. Therefore, the presented research attempts to determine TIC shape analysis utility in TCEUS imaging by applying it to TCEUS scans targeted to CAMs present in neural inflammation. This was done in an animal model that underwent a traumatic spinal cord injury to induce inflammation ( n = 31). Subjects were divided into four groups, each receiving a TCEUS targeted to a different CAM seven days after surgery (P-selectin, intracellular adhesion molecule 1 [ICAM-1], vascular cell adhesion molecule 1 [VCAM-1], and control). TICs were generated using average pixel intensity within the injured region of the spinal cord. TIC shape analysis found similar curves were produced while targeting P-selectin and VCAM-1, both demonstrating rapid and sustained enhancement. Control injections demonstrated no enhancement. ICAM-1 injections demonstrated limited enhancement and a shape similar to the control.
Reversed Diastolic Flow in Page Kidney Following Native Kidney Biopsy
Authors: Araújo Nordeval Cavalcante , Suassuna José Hermógenes Rocco
Published: September 2016

Page kidney phenomenon occurs due to external compression of a kidney by either subcapsular or perinephric hematoma, tumor, lymphocele, or urinoma. This article describes a case of reversed diastolic arterial flow on Doppler insonation in a Page kidney due to external compression as a consequence of native kidney biopsy-induced perinephric hematoma. Reversed diastolic arterial flow has already been reported in Page kidney in renal allografts; however, we are not aware of any report of such a finding in a native kidney. This report highlights the importance of being aware of the possible occurrence of the reversion of the diastolic flow in Doppler sonography in Page kidney, even though it is rare. Moreover, this case illustrates the short but severe impact of Page kidney on renal function and suggests that a conservative approach is an effective treatment option even in a moderate to severe perinephric hematoma.
Perturbed hematopoiesis in mice lacking ATMIN
Authors: Anjos-Afonso Fernando , Loizou Joanna I. , Bradburn Amy , Kanu Nnennaya , Purewal Sukhveer , Da Costa Clive , Bonnet Dominique , Behrens Axel
Published: September 2016

Key Points

ATMIN deletion using Vav-Cre causes chronic leukopenia, with fewer B cells and common myeloid progenitors. Long-term HSCs in ATMIN-deficient mice show increased cell cycling and are more prone to exhaustion under stress.
Respiratory clinical guidelines inform ward-based nurses’ clinical skills and knowledge required for evidence-based care
Authors: Johnson Alisha M. , Smith Sheree M.S.
Published: September 2016

Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory patients.

17 guidelines were identified in our systematic review. The quality assessment demonstrated variability in these guidelines. Common core knowledge and technical and non-technical skills were identified. These include pathophysiology, understanding of physiological measurements and monitoring, education, counselling, and ward and patient management.

The knowledge and skills extracted from respiratory clinical guidelines may inform a curriculum for ward-based respiratory nursing to ensure optimal care of adult patients.