bluuebunny/crossref_metadata_2025 huggingface dataset:
Slip Effects on a Ree-Eyring Liquid Peristaltic Flow Towards an Inclined Channel and Variable Liquid Properties
Authors: Balachandra H. , Rajashekhar C. , Mebarek-Oudina F. , Manjunatha G. , Vaidya H. , Prasad K. V.
Published: September 2021

The current paper aims to model the flow of blood in narrow arteries by taking non-Newtonian Ree-Eyring fluid. The impact of wall properties, slip, mass, and heat transport are considered. In earlier studies, the viscosity of blood was considered a constant parameter. However, many
researchers have claimed that the blood’s viscosity in the peripheral region is less than that of the core region. Thus, the present model incorporates the variation in thermal conductivity and viscosity, which takes a vital character in scrutinizing blood flow in narrow arteries. The
mathematical model is developed on low Reynold’s number approximation and long wavelength, leading to the governing non-linear equations representing the flow phenomena. The governing non-linear partial differential equations are resolved by utilizing the series solution method (perturbation
technique). MATLAB programming has been used to plot the pictorial representation of all the parameters through the flow quantities. The investigation shows that the variable velocity slip parameter and viscosity develops the velocity profiles. Further, the liquid parameter can be used to
control the dimension of the trapped bolus. Moreover, the obtained outcomes aid in recognizing the flow of blood in micro arteries.
Buoyant Convective Flow and Heat Dissipation of Cu–H2O Nanoliquids in an Annulus Through a Thin Baffle
Authors: Pushpa B. V. , Sankar M. , Mebarek-Oudina F.
Published: September 2021

This article numerically investigates the buoyant convective flow and thermal transport enhancement of Cu–H2O nanoliquid in a differentially heated upright annulus having a thin baffle. For the analysis, the outer and inner cylinders are cooled and heated respectively
through insulated top and lower boundaries. Also, the baffle temperature is assumed to be that of the hot cylinder. The finite difference based numerical technique is used to solve the system of equations governing the physical processes. The findings are accessible in terms isotherms, streamlines
and Nu number for wider ranges of baffle positions and lengths, Rayleigh numbers, and by considering different nanofluid (NF) volume fractions. The average Nu number is enhanced in addition of the Cu nanoparticle to the base liquid and it is also found the liquid flow
and heat transport can be successfully controlled via the appropriate selection of baffle location and length. Principally, the baffle length having 20% of annular width placed at 80% of the annular height has been found to produce higher thermal transport rates as compared to other choices
of baffle lengths and positions.
Soret and Dufour Effects on MHD Nonlinear Convective Flow of Tangent Hyperbolic Nanofluid Over a Bidirectional Stretching Sheet with Multiple Slips
Authors: Das Manik , Nandi Susmay , Kumbhakar Bidyasagar , Shanker Seth Gauri
Published: September 2021

The purpose of the present analysis is to investigate the Soret and Dufour effects on steady and incompressible MHD nonlinear convective flow of tangent hyperbolic nanofluid over a permeable stretching surface with multiple slip conditions at the wall. Also, nonlinearly varying thermal
radiation, heat generation and chemical reaction along with a vanishing nanoparticle mass flux condition at the surface are taken into account. Further, Rosseland’s approximation for an optically thick and grey medium is used to approximate heat flux due to radiation. Suitable similarity
transformations are employed to transform governing PDEs into a system of ODEs. The resulting nonlinear equations are then solved numerically using the shooting technique based on the Runge-Kutta Cash-Karp method. The upshots of various physical parameters on velocity, temperature and concentration
distributions are illustrated and displayed through figures. The variations in coefficients of local skin friction, Nusselt and Sherwood numbers are explained and presented in tabular form. The obtained results are validated with the previously reported results for a particular case of the
present fluid flow problem, and an outstanding correlation is noticed from the comparison. Graphical results reveal that the nonlinear convection parameters for both temperature and concentration accelerate the primary flow. However, the Dufour number diminishes the fluid temperature near
the wall, and the Soret number uplifts the concentration profile within the boundary layer.
Insurance Status Effect on Laryngeal Cancer Survival: A Population Based Study
Authors: Abt Nicholas B. , Miller Lauren E. , Parikh Anuraag , Bhattacharyya Neil
Published: September 2021

Objective:

To analyze insurance status effect on overall survival (OS) and disease-specific survival (DSS) in laryngeal cancer.

Study Design:

Cross-sectional population analysis.

Setting:

Surveillance, Epidemiology, and End Results (SEER) database.

Participants:

Laryngeal cancer patients from 2007 to 2016.

Main Outcome Measures:

Kaplan-Meier method with log-rank statistic analyzed OS and DSS by insurance status. Multivariable cox proportional hazard modeling generated survival prognostic factors.

Results:

Of 19 667 laryngeal cancer cases, initial disease presentation was stage I: 7770 patients (39.5%), stage II: 3337 patients (17.0%), stage III: 3289 patients (16.7%), and stage IV: 5226 patients (26.6%). Patients had non-Medicaid insurance (15 523, 78.9%), had Medicaid (3306, 16.8%), or were uninsured (891, 4.5%). Mean and median OS for insured, Medicaid, and uninsured patients were 60.5, 49.6, and 56.6 and 74.0, 40.0, and 65.0 months, respectively. Following multivariable analysis, OS for insured, Medicaid, and uninsured patients was stage I: 87.9, 82.8, and 88.4 ( P < .001), stage II: 79.1, 75.1, and 78.3 ( P = .12), stage III: 68.7, 66.1, and 72.1 ( P = .11), and stage IV: 57.1, 51.7, and 50.3 ( P < .001) months. DSS mean survival times were 77.0, 65.8, and 67.7 months ( P < .001) for insured, Medicaid, and uninsured patients. Age (HR: 1.02/year, P < .001) and black (HR: 1.15, P = .001) compared to white race predicted worse survival. Compared to insured status, Medicaid insurance carried a death hazard ratio of 1.40 ( P < .001) and uninsured status had a death hazard ratio of 1.40 ( P < .001).

Conclusion:

Insured laryngeal cancer patients had prolonged OS and DSS compared to Medicaid and uninsured patients. Medicaid patients had equivalent survival outcomes to uninsured patients.

Level of Evidence:

2c.
Comparison of ultra-performance liquid chromatography and ARK immunoassay for therapeutic drug monitoring of voriconazole
Authors: Peña-Lorenzo Diego , Rebollo Noemi , Sánchez-Hernández José German , Zarzuelo-Castañeda Aranzazu
Published: September 2021

Background

Therapeutic drug monitoring (TDM) of voriconazole is recommended for personalizing doses. The objective of this study was to compare the enzyme immunoassay developed by ARKTM Diagnostics Inc. for the quantification of voriconazole adapted to the Architect C4000 autoanalyzer (Abbott®) with ultra-performance liquid chromatography using ultraviolet detector (UPLC-UV) method.

Materials and Methods

Linearity, precision and accuracy of both methods were validated according to the Food and Drug Administration (FDA) and European Medicines Agency guidelines. The limit of quantification (LOQ) of the UPLC-UV method was determined experimentally. Both methods were applied to the analysis of 62 samples from patients. Correlation was evaluated by Passing-Bablok analysis and the concordance by the Bland–Altman method. Dosage recommendations were generated; the discordances according to the technique were evaluated.

Results

All validation parameters determined for UPLC-UV met the criteria set out and LOQ of 0.1 μg/mL was established. However, when the enzyme immunoassay was used to determine concentrations ≤1 μg/ml, CVs were >20%. A linear correlation between both methods was found. However, an overestimation of immunoassay (systematic error of 0.39 μg/mL) was detected. In 11.3% of the samples, the differences in concentrations when they were determined by different techniques would imply a different therapeutic regime. These samples had concentrations close to 1 μg/mL.

Conclusion

Although both techniques can be used for TDM of voriconazole, when a value close to the lower limit of the therapeutic range is determined by the ARKTM immunoassay, it would be better to verify the result by a non-automated technique to avoid possible underdosing.
Using the Patient Health Questionnaire to estimate prevalence and gender differences of somatic symptoms and psychological co-morbidity in a secondary inpatient population with abdominal pain
Authors: Stieler Melissa , Pockney Peter , Campbell Cassidy , Thirugnanasundralingam Vaisnavi , Gan Lachlan , Spittal Matthew , Carter Gregory
Published: September 2021

Background:

Somatic disorders and somatic symptoms are common in primary care populations; however, little is known about the prevalence in surgical populations. Identification of inpatients with high somatic symptom burden and psychological co-morbidity could improve access to effective psychological therapies.

Methods:

Cross-sectional analysis ( n = 465) from a prospective longitudinal cohort study of consecutive adult admissions with non-traumatic abdominal pain, at a tertiary hospital in New South Wales, Australia. We estimated somatic symptom prevalence with the Patient Health Questionnaire-15 at three cut-points: moderate (⩾10), severe (⩾15) and ‘bothered a lot’ on ⩾3 symptoms; and psychological co-morbidity with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 at standard (⩾10) cut-points. We also examined gender differences for somatic symptoms and psychological co-morbidity.

Results:

Prevalence was moderate (52%), female predominance (odds ratio = 1.71; 95% confidence interval = [1.18, 2.48]), severe (20%), no gender difference (1.32; [0.83, 2.10]) and ‘bothered a lot’ on ⩾3 symptoms (53%), female predominance (2.07; [1.42, 3.03]). Co-morbidity of depressive, anxiety and somatic symptoms ranged from 8.2% to 15.9% with no gender differences.

Conclusion:

Somatic symptoms were common and psychological triple co-morbidity occurred in one-sixth of a clinical population admitted for abdominal pain. Co-ordinated surgical and psychological clinical intervention and changes in clinical service organisation may be warranted to provide optimal care.
Investigating the influence of expressive writing exercises on the working memory of middle adolescents and young adults in South Africa
Authors: Swart Jonita , Janeke Chris
Published: September 2021

This study investigated the influence of expressive writing on the working memory capacity of middle adolescents (learners 15–17 years old) and young adults (students 18–24 years old) in the South African context. The assumption underlying the research was that expressive writing about a stressful event would reduce unwanted thoughts and the resultant demand on cognitive resources, thereby increasing working memory capacity. Two experiments were conducted involving a sample of 28 school learners and a sample of 38 university students. In each experiment, the participants were assigned to three writing conditions: a factual event for the control group and either just a stressful event, or a solution to a stressful event, for the two experimental groups. It was postulated that the solution-focused group would gain the most from the expressive writing tasks. Working memory capacity assessments were conducted before and after the expressive writing intervention and again about 14 weeks later to test for a long-term effect on working memory capacity. A positive effect was found regarding the working memory capacity of the students, but there was no statistically significant improvement in the working memory capacity of the learners. Furthermore, although the results of the student groups did indicate that an expressive writing intervention may enhance working memory capacity, this effect was not mostly restricted to the solution-focused experimental groups as was hypothesised. Instead, the results suggested that expressive writing exercises may have had a positive effect on the memory performance of all three groups.
Competitive Rationales: Beneath the Surface of Competitive Behavior
Authors: Andrevski Goce , Miller Danny , Le Breton-Miller Isabelle , Ferrier Walter
Published: September 2021

Competitive dynamics research has focused on studying whether rivals are able and likely to carry out competitive actions, typically by examining indirect reasons such as characteristics of the actions themselves, the firms involved, or the competitive context. We explore why rivals initiate a specific competitive action at a particular time and situation. Drawing from the philosophy of action literature, we introduce the concept of competitive rationales to examine the primary reasons that cause tactical actions. Given the rapid exchanges characterizing tactical competitive dynamics, we conducted an inductive, multicase study to explore the reasons behind over 800 discrete tactical decisions carried out by 9 professional basketball coaches during 15 basketball games. To garner insight, we develop a conceptual framework revealing their types and scope. Even during intense head-to-head rivalry, most rationales were not rivalrous but were instead organizational—to optimize resource use, strategic consistency, and reputation—or social—to manage relationships. Moreover, the three main types of rationales varied in scope, extending beyond immediate competitive situations and rivals to address longer term, strategic outcomes, and assorted stakeholders. Thus, our analysis reveals these rationales to be complex and potentially difficult for rivals to decipher. It also recasts each component of the dominant awareness-motivation-capability (AMC) model of rivalry, suggesting that awareness is challenged by subtle rationales, motivation drives not only action but also forbearance, and capability is both a requirement and product of action.
Intra-aortic balloon pump versus percutaneous Impella© in emergency revascularisation for myocardial infarction and cardiogenic shock: systematic review
Authors: Frain Kristina , Rees Paul
Published: September 2021

Objectives:

Mortality rates in patients with acute myocardial infarction and cardiogenic shock (AMI-CS) remain persistently high despite advances over the past decade in percutaneous mechanical circulatory support. This systematic review aims to analyse the existing literature to compare mortality outcomes in patients mechanically supported by intra-aortic balloon pump or percutaneous Impella 2.5/CP© for AMI-CS undergoing emergency revascularisation.

Methods:

The following MeSH terms were applied to the databases Ovid Medline, Ovid Embase, Cochrane and Web of Science: ‘Intra-aortic balloon pump’, ‘Impella’, ‘Cardiogenic shock’, ‘Myocardial Infarction’ and ‘Mortality’. This yielded 2643 studies. Using predefined inclusion and exclusion criteria, the studies were initially screened by title and abstract before full text analysis.

Results:

Fourteen studies met eligibility criteria: two randomised controlled trials (RCTs) and 12 observational studies. Data from a total of 21,006 patients were included across the studies. Notably, one study claimed reduced mortality with IABP versus control, and one study concluded that Impella© improved survival rates over the IABP. The average 30-day all-cause mortality in patients supported by IABP was 38.1%, 54.3% in Impella© groups and 39.4% in control groups.

Conclusion:

AMI-CS presents an important cohort of patients in whom conducting RCTs is difficult. As a result, the literature is limited. Analysis of the available literature suggests that there is insufficient evidence to support superior survival in those supported by IABP or Impella© when compared to control despite suggestions that the Impella© offers superior haemodynamic support. Limitations of the studies have been discussed to outline suggestions for future research.
Venoarterial extracorporeal membrane oxygenation with intra-aortic balloon pump for postcardiotomy cardiogenic shock: A systematic review and meta-analysis
Authors: Huang Daochao , Xu Anyi , Guan QiongChan , Qin Jie , Zhang Chuang
Published: September 2021

Objective:

Intra-aortic balloon pump (IABP) is currently recommended as a strategy to address the increased afterload in patients who received venoarterial extracorporeal membrane oxygenation (VA-ECMO). The benefit of VA-ECMO with IABP in postcardiotomy cardiogenic shock is inconclusive. A systematic review and meta-analysis was conducted to assess the influence of VA-ECMO with IABP for postcardiotomy cardiogenic shock (PCS).

Methods:

The Cochrane Library, PubMed, and Embase were searched for all articles published from 1 January, 1964 to July 11, 2020. Retrospective cohort studies targeting the comparison of VA-ECMO with IABP and isolated VA-ECMO were included in this study.

Results:

We included 2251 patients in the present study (917 patients in the VA-ECMO with IABP group and 1334 patients in the isolated VA-ECMO group). Deaths occurred in 589 of 917 patients (64.2%) in the VA-ECMO with IABP group and occurred in 885 of 1334 patients (66.3%) in isolated VA-ECMO group. Pooling the results of all studies showed that VA-ECMO with IABP was not related to a reduced in-hospital mortality in patients who received VA-ECMO for PCS (RR, 0.95; 95% CI, 0.86–1.04; p = 0.231). In addition, VA-ECMO with IABP was not related to an increased rate of VA-ECMO weaning in patients who received VA-ECMO for PCS (RR, 1.28; 95% CI, 0.99–1.66; p = 0.058).

Conclusions:

This study indicates that VA-ECMO with IABP did not improve either in-hospital survival or weaning for VA-ECMO in postcardiotomy cardiogenic shock patients.
End of life care for people with severe mental illness: Mixed methods systematic review and thematic synthesis (the MENLOC study)
Authors: Edwards Deborah , Anstey Sally , Coffey Michael , Gill Paul , Mann Mala , Meudell Alan , Hannigan Ben
Published: September 2021

Background:

Parity of esteem means that end-of-life care for people with severe mental illness should be of equal quality to that experienced by all.

Aim:

To synthesise international, English language, research and UK policy and guidance relating to the organisation, provision, and receipt of end-of-life care for people with severe mental illness.

Design:

A mixed methods systematic review was conducted following the Evidence for Policy and Practice Information and Co-ordinating Centre approach and informed by a stakeholder group. We employed thematic synthesis to bring together data from both qualitative and quantitative studies, and from non-research material. We assessed the strength of synthesised findings using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approaches.

Data sources:

Ten electronic databases were searched from inception to December 2019, along with 62 organisational websites. Quality appraisal was conducted using Critical Appraisal Skills Programme checklists or other study design-specific alternatives as necessary.

Results:

Of the 11,904 citations retrieved, 34 research publications were included plus 28 non-research items. The majority of research was of high or acceptable quality. An overarching synthesis including 52 summary statements, with assessments of confidence in the underpinning evidence, was produced using four themes: Structure of the system; Professional issues; Contexts of care; and Living with severe mental illness.

Conclusions:

Implications for services and practice reflect evidence in which there is a high degree of confidence. Partnership should be developed across the mental health and end-of-life systems, and ways found to support people to die where they choose. Staff caring for people with severe mental illness at the end-of-life need education, support and supervision. End-of-life care for people with severe mental illness requires a team approach, including advocacy. Proactive physical health care for people with severe mental illness is needed to tackle problems of delayed diagnosis.
Nurse perspectives on the psychosocial care of patients with urinary incontinence in home hospice: A qualitative study
Authors: Russell David , Stoddard Michelina D , Morgan Natalie , McDonald Margaret V , Dignam Ritchell , Bowles Kathryn H , Prigerson Holly G , Chughtai Bilal
Published: September 2021

Background:

Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers.

Aim:

This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and the strategies that nurses employ to maximize patient and family comfort.

Design:

Qualitative descriptive study using semi-structured interviews.

Setting/participants:

Nurses employed at a large not-for-profit hospice agency in New York City.

Results:

Analyses of 32 interviews revealed three primary themes. First, nurses considered urinary incontinence to be associated with multiple psychosocial issues including embarrassment for patients and caregiver burden. Second, nurses described urinary incontinence as a threat to patient dignity and took steps to preserve their continence function. Third, nurses assisted patients and their families to cope with urinary incontinence through normalization, reframing incontinence as part of the disease process, mobilizing caregiving assistance, and encouraging use of continence supplies such as diapers and liners.

Conclusion:

Urinary incontinence influences the psychosocial care of patients receiving home hospice and nurses employ strategies to maximize patient and family comfort. Additional research is needed to examine the psychosocial benefits of facilitated discussions with patients and family members about incontinence, provision of caregiving support, and distribution of comprehensive incontinence supplies to patients with fewer resources.
In Vivo Evaluation of Micronucleus Frequencies in Buccal Mucosal Cells of Orthodontic Patients with and Without Fluoride Use
Authors: Chitra Prasad , Prashantha GS , Rao Arun , Jois Harshvardhan S
Published: September 2021

Introduction:

Fluoride agents to prevent white spot lesions are used often during orthodontic treatment. The beneficial effects of fluoride, when consumed within permissible limits on dental structures, are well known. Their implications on underlying biological tissues, however, are unknown. Mouthwashes and dentifrices with fluorides are associated with metal ion release into the mouth with possible cell genotoxicity. Since these cariostatic agents are frequently used during orthodontic therapy, a deeper understanding of the effects of fluoride on oral tissues was considered necessary.

Methodology:

Three groups of patients (30 each)—group 1 (untreated controls), group 2 (non-fluoridated), and group 3 (Fluoridated) were analyzed. Patients in groups 2 and 3 were bonded with the same bracket prescription and treated with similar archwire sequences. Buccal mucosal cells at 4 specific time periods (before treatment, 1 week, 30 days, and 6 months) were collected, using a wooden tongue depressor, and assessed for any nuclear abnormalities. Comparisons of changes were made with an untreated control group and also between the non-fluoridated and fluoridated groups. Relevant conclusions were drawn after analysis of the results.

Results:

Greater number of nuclei were observed at the 30-day time interval in the fluoridated group, which was statistically significant at P < .001.

Conclusion:

Use of fluoridated oral hygiene products in patients undergoing fixed orthodontic treatment with NiTi archwires could increase the risk of micronuclei formation in buccal mucosal cells.
Revisiting the ring hoop test in additively manufactured metal tubes
Authors: Pragana João PM , Bragança Ivo MF , Silva Carlos MA , Martins Paulo AF
Published: September 2021

This paper is focussed on the mechanical and formability characterisation of wire-arc additive manufactured (WAAM) AISI 316-L stainless-steel tubes. The methodology to be presented involved carrying out tension and ring hoop tension tests on specimens extracted from the tube longitudinal, transverse and inclined directions. The force evolutions, acquired from the load cells, and the strain measurements, retrieved from digital image correlation and from thickness measurements along the cracks, allowed obtaining the stress-strain curves, the strain paths and the onset of failure by fracture for the three different tube directions. Special attention was paid to the ring hoop test, which was revisited to determine the appropriateness of using ring specimens with one or two dumbbell geometries. The originality of using the ring hoop tension test in WAAM tubes with strong anisotropic behaviour allowed obtaining strain loading paths that range from plane strain to pure shear deformation conditions. Resort to commercial AISI 316-L stainless-steel tubes during the presentation is included for reference purposes.
Comparison of Modified Yield-Line and Punching Shear Capacities for Concrete Traffic Barriers and Bridge Rails
Authors: Loken Andrew E. , Steelman Joshua S. , Rosenbaugh Scott K. , Faller Ronald K. , Holt John M.
Published: September 2021

The traditional, triangular yield-line method used by most departments of transportation for analyzing concrete traffic barriers and bridge rails has been largely unchanged since 1978. Testing of concrete barriers since this time has indicated that the triangular yield-line method is not qualitatively representative of observed damage patterns and is overconservative. Further, the conversion from NCHRP Report 350 to the crash test criteria from the Manual for Assessing Safety Hardware (MASH) will result in increases to lateral impact loads; therefore, overconservative analysis practices may result in many concrete barriers being unnecessarily deemed inadequate. In this research, alternative analysis methods for concrete barriers were extracted from an extensive literature review of concrete barrier investigations. These methods were applied to a sample of eight concrete barriers to demonstrate and compare their effects on capacity estimates. Alternative methods included trapezoidal yield-line mechanisms, effects of impact heights lower than the top of the barrier, punching shear evaluation, and consideration of expected material strengths. Capacity estimates of the selected barriers were increased by an average of 47 percent when alternative methods were cumulatively applied. Although the traditional method does not consider punching shear, the capacity of one of the eight barriers was controlled by punching shear rather than by yield-line flexure. With the alternative methods applied, seven of the eight barriers were deemed adequate relative to the increased lateral loads corresponding to MASH criteria for Test Levels 2 through 5. By contrast, if analyzed according to the traditional method, three of the eight barriers would have been deemed insufficient considering MASH loads.
Modeling Demographic Relocation in Response to Climate Risk Factors and Gentrification Displacement Pressures
Authors: Roy Sneha , Vinayak Pragun , Von Stroh David
Published: September 2021

Climate risk factors, including wildfire, sea level rise, inland flooding, and extreme heat, as well as gentrification displacement pressures will be primary drivers of migration in the coming years. Travel demand modeling relies on reasonable and appropriate forecasts of demographic totals at the detail of travel analysis zones. Methodologies for developing scenarios in response to individual and combined climate risk factors are described, drawing on work undertaken for the Southern California Association of Governments SoCal Regional Climate Adaptation Framework. Methodologies for developing scenarios in response to gentrification displacement pressures of low-income workers are described, drawing on work carried out for the California Statewide Freight Forecasting and Travel Demand Model. These methodologies leverage modeling tools that are readily available to agencies, allowing for rapid testing of scenarios and integration with other planning processes. Climate adaptation and housing policy, respectively, are currently in need of greater integration and coordination. Future directions are explored to integrate these methodologies and create a combined demographic relocation model, sensitive to both climate risk factors and the affordability and gentrification displacement pressures arising out of shifting demand–supply dynamics and population–job balance in high growth areas.
Shear Strength and Drainage Characteristics of Elastomeric Polyurethane Treated Coal-Fouled Ballast
Authors: Hussaini Syed Khaja Karimullah , Gundavaram Dinesh
Published: September 2021

The shear behavior and drainage characteristics of coal-fouled ballast when treated with elastomeric polyurethane are assessed by means of large-scale direct shear and permeability tests. The results from direct shear tests confirmed that the shear strength of both stabilized and unstabilized coal-fouled ballast was highly influenced by the extent of fouling (VCI: void contamination index). The performance index (PI) of elastomer-stabilized coal-fouled ballast (ESFB), determined as the fraction of shear strength of fouled ballast to the shear strength of fresh and unstabilized ballast, lies in the range of 1.23 to 0.84. Moreover, the performance of ESFB having VCI ≥30% was found to be either similar to or poorer than that of clean ballast without any treatment, thus indicating that the elastomer treatment may be provided only to ballast with VCI ≤30%. The results from constant head permeability tests indicate that the hydraulic conductivity of ballast ( k) is highly influenced by the presence of fouling materials but is only slightly reduced as a result of the elastomer stabilization. The k of ballast decreased from 43 to 0.18 mm/s as the VCI increased from 0 to 75%. For VCI ≥ 45% the k of ballast was found to be lower than that recommended for sub-ballast. On the other hand, the k of ballast reduced slightly from 43 to 37 mm/s because of the elastomer stabilization. Furthermore, an empirical relationship is established between k and e to determine the k of both stabilized and unstabilized fouled ballast.
Comparison of International Brittle Fracture Design Code Provisions for Steel Bridges
Authors: Chien Michelle Y. X. , Walbridge Scott , Kühn Bertram
Published: September 2021

Brittle fracture is a major concern to structural engineers as it has significant consequences for safety and cost. Although modern day occurrences of brittle fracture are rare, it is well known that they can occur without warning and may lead to the sudden closure of a bridge, loss of service, expensive repairs, and/or loss of property or life. In Canada, steel bridge fracture is a particularly significant concern because of the harsh climate. If the toughness properties are improperly specified, many steels could be on the lower shelf of the toughness-temperature curve. A comparison of brittle fracture design provisions around the world reveals that more sophisticated approaches have been developed for modeling and understanding brittle fracture in existing and new bridges than those currently in use in North America, including Canada and the U.S.A. This paper describes the European brittle fracture provisions and presents a comparison of the North American and European design provisions using the example of a typical steel-concrete composite highway bridge. On the basis of this comparison, situations where one set of design rules may be more or less conservative are identified, and opportunities for improvement and areas warranting further study are highlighted.
Survival analysis in the incident dialysis patients by different modalities
Authors: Lv Wenlv , Chen Xiaohong , Wang Yaqiong , Yu Jiawei , Cao Xuesen , Ding Xiaoqiang , Zou Jianzhou , Shen Bo , Nie Yuxin
Published: September 2021

Background:

To analysis survival in onset uremic patients who initiating HD or PD dialysis in our dialysis center.

Methods:

Between Jan. 2015 and June. 2018, patients with onset uremia and initiating planned-start dialysis were retrospectively enrolled in this study and followed up to January, 2019. The relationships between the types of dialysis modality and patient prognosis were assessed.

Results:

A total of 460 patients were included in the final analysis. Of which, 213 patient (46.30%) undergoing PD and 247 patients (53.70%) undergoing HD with arteriovenous fistula. The average follow-up time was 27.9 months. Eighty-seven (18.91%) patients died during the study period. The all-cause mortality was 127 per 1000 person-year. It was 102 per 1000 person-year in the HD group and 171 per 1000 person-year in the PD group ( p < 0.01). However, dialysis modality was not an independent predictor for survival. During the first year after dialysis initiation, patient survival was comparable between the PD and HD groups (log-rank p = 0.14). As the dialysis age increased over 1 year, HD patients seemed to have a better survival as compared to that of PD patient (log-rank p < 0.05), especially those older than 65 years and without DN.

Conclusions:

Though dialysis modality was not an independent factor for overall survival, HD therapy seemed to be more suitable for patients without DN.
Complaints Matter: Seriousness of Elder Mistreatment Citations in Nursing Homes Nationwide
Authors: Liu Pi-Ju , Caspi Eilon , Cheng Ching-Wei
Published: September 2021

Mistreatment of nursing home residents is prevalent and leads to harmful consequences. The Centers for Medicare & Medicaid Services’s (CMS) mission to protect residents’ right to be free from mistreatment is implemented partially through state survey agencies’ (SSAs) issuance of deficiency citations. The goal of this study was to compare SSA standard surveys and SSA complaint investigations with regard to the seriousness (scope and severity) of the mistreatment citations issued. A cumulative link mixed model was built to estimate the differences between standard surveys and complaint investigations in the seriousness of four core and two secondary mistreatment citations nationwide from 2014 to 2017. In all of the six mistreatment deficiency citations, complaint investigations were more likely to be determined as more serious compared with standard surveys. The findings reinforce the importance of strengthening nursing homes’ and CMS/SSA response to consumers’ concerns and grievances before they escalate into more harmful mistreatment.
Fabrication and biological evaluation of porous β-TCP bioceramics produced using digital light processing
Authors: Xu SongFeng , Zhang Hang , Li Xiang , Zhang XinXin , Liu HuanMei , Xiong Yinze , Gao RuiNing , Yu ShengJi
Published: September 2021

Beta-tricalcium phosphate ( β-TCP) refers to one ideal bone repair substance with good biocompatibility and osteogenicity. A digital light processing (DLP)-system used in this study creates bioceramic green part by stacking up layers of photocurable tricalcium phosphate-filled slurry with various β-TCP weight fractions. Results show that the sintering shrinkage is anisotropic and the shrinkage vertically reaches over that horizontally. The obtained porous β-TCP parts have both macroporous outer structure and microporous inner structure, the macropore size is 400–600 μm and the micropore size is 500–1500 nm. The mechanical tests show that the porous β-TCP bioceramic’s compressive strength reaches 16.53 MPa. The cell culture confirmed that the porous β-TCP bioceramic is capable of achieving the effective attaching, growing, and proliferating pertained to mouse osteoblast cells. This study identified considerable blood vessels and significant ectopic bone forming obviously based on the histologically-related assessment when implanting to rabbit femoral condyle deficiency for 3 months. Thus, under high bioactive property and osteoinductivity, and large precision and mechanical strength that can be adjusted, the DLP printed porous β-TCP ceramics is capable of being promising for special uses of bones repairing.
Force and vibration analysis in biomechanical preparation of root canals using reciprocating endodontic file system: In vitro study
Authors: Thakur Vinod Singh , Kankar Pavan Kumar , Parey Anand , Jain Arpit , Jain Prashant Kumar
Published: September 2021

The shaping and cleaning of the root canal are very important in root canal treatment. The excessive force and vibration during biomechanical preparation of the root canal may result in failure of the endodontic file. In this study, force and vibration analysis was carried out during root canal preparation. The samples of human extracted (premolar) teeth were provided by the College of Dental Science and Hospital. Endodontic instruments for reciprocating motion, such as the WaveOne Gold file system, had been used for root canal preparation. Force and vibration signals were recorded by dynamometer and accelerometer, respectively. The acquired signals were denoised using the db4 (SWT denoising 1-D) wavelet. Four levels of decomposition were carried out for each signal. The signal denoising technique was used to remove unwanted noise from the acquired signal. FESEM analysis was used to visualize the levels of severity of endodontic files during the cleaning and shaping of the root canal. In most of the cases, the failure occurred due to the improper use of the root canal instrumentation. The optimum amount of force was used to avoid the file failure and provided the proper instrumentation. The curve fitting regression model was used to find the interdependency between force and vibration.
3D pull-out finite element simulation of the pedicle screw-trabecular bone interface at strain rates
Authors: Çetin Ahmet , Bircan Durmuş Ali
Published: September 2021

Biomedical experimental studies such as pull-out (PO), screw loosening experience variability mechanical properties of fresh bone, legal procedures of cadaver bone samples and time-consuming problems. Finite Element Method (FEM) could overcome experimental problems in biomechanics. However, material modelling of bone is quite difficult, which has viscoelastic and viscoplastic properties. The study presents a bone material model which is constructed at the strain rates with the Johnson-Cook (JC) material model, one of the robust constitutive material models. The JC material constants of trabecular bone are determined by the curve fitting method at strain rates for the 3D PO finite element simulation, which defines the screw-bone interface relationship. The PO simulation is performed using the Abaqus/CAE software program. Bone fracture mechanisms are simulated with dynamic/explicit solutions during the PO phenomenon. The paper exposes whether the strain rate has effects on the PO performance. Moreover, simulation reveals the relationship between pedicle screw diameter and PO performance. The results obtained that the maximum pull-out force (POF) improves as both the screw diameter and the strain rate increase. For 5.5 mm diameter pedicle screw POFs were 487, 517 and 1708 N at strain rate 0.00015, 0.015 and 0.015 s−1, respectively. The FOFs obtained from the simulation of the other screw were 730, 802 and 2008 N at strain rates 0.00015, 0.0015 and 0.015, respectively. PO phenomenon was also simulated realistically in the finite element analysis (FEA).
Association of MALAT-1 gene single nucleotide polymorphisms with genetic susceptibility to systemic lupus erythematosus
Authors: Mao Yan-Mei , He Yi-Sheng , Wu Guo-Cui , Hu Yu-Qian , Xiang Kun , Liao Tao , Yan Yu-Lu , Yang Xiao-Ke , Shuai Zong-Wen , Wang Gui-Hong , Pan Hai-Feng , Ye Dong-Qing
Published: September 2021

Background: Abnormal expression and function of long non-coding RNAs (lncRNAs) are closely related to the pathogenesis of systemic lupus erythematosus (SLE). In this study, we aimed to investigate the association of lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) gene single-nucleotide polymorphisms (SNPs) with susceptibility and clinical characteristics of SLE patients. Methods: A case-control study including 489 SLE patients and 492 healthy controls was conducted. Four MALAT-1 SNPs (rs4102217, rs591291, rs11227209, and rs619586) were genotyped in all subjects, their correlation with SLE susceptibility and clinical characteristics were also analyzed. Results: Results showed that the rs4102217 locus was associated with the risk of SLE. In recessive models, the GG+CG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC ( p = 0.036, OR = 0.348, 95% CI: 0.124–0.975). In additive models, the GG genotype of rs4102217 was associated with the decreased risk of SLE compared to CC ( p = 0.040, OR = 0.355, 95% CI: 0.127–0.996). However, no association was found between MALAT-1 gene polymorphism and clinical manifestations of SLE (all p > 0.05). Conclusion: In summary, MALAT-1 rs4102217 is associated with susceptibility to SLE, suggesting that MALAT-1 may play a role in SLE.
Green Bonds and Asset Classes: New Evidence from Time-varying Copula and Transfer Entropy Models
Authors: Hung Ngo Thai
Published: September 2021

The green bond market has gradually developed worldwide since its debut in 2007 and is viewed as a new form of investment. This study explores the time-varying interdependence between green bond and conventional asset classes, namely Bitcoin price, Standard and Poor’s (S&P) 500, Clean Energy Index, Goldman Sachs Commodity Index (GSCI) Commodity Index and 10-year US bond spanning from May 2013 to December 2019, using both time-varying copula and transfer entropy models. We first focus on static and dynamic correlations between the green bond and other assets, and then identify the causal association among them. The findings suggest that green bonds and other assets have conditional time-varying dependence, and dependence is relatively low. Using transfer entropy, further evidence is gained for causal associations between two variables, which is depicted by two categories like mono-direction and bi-direction. Such nexus reveals the transmitter and receiver of return innovations on these markets. These findings make a considerable contribution to policymakers and environmentally friendly investors with green bond positions.
Takore i te Kai Ava’ava (Quit smoking), a mCessation Program Adapted for the Cook Islands: Indicators of Potential for Tobacco Control
Authors: Ringi Teinatangi , Aumea Herman Josephine , Tairi Maina , Dobson Rosie , Nosa Vili , Whittaker Robyn , McCool Judith
Published: September 2021

Mobile phone–based smoking cessation interventions (mCessation) are an established evidence-based intervention designed to support smokers to quit. Evidence of impact to date is modestly positive but skewed in favor of high-resourced countries, with less evidence of value added to low-resourced settings. Takore i te Kai Ava’ava, a text message–based smoking cessation program, was delivered to smokers living on the island of Rarotonga in 2019. Eighty-eight smokers consented to take part. Participants completed a baseline questionnaire about current smoking behavior and previous quit attempts; follow-up measures at 2 months assess quit attempts feedback on the program. Thirty-two people completed the follow-up interviews; 10 (31%) had not smoked in the past 7 days, 23 (72%) reported a serious quit attempt, and 29 (91%) felt the program was effective for the Cook Islands. Takore i te Kai Ava’ava was deemed to be highly acceptable and potentially cost-effective.
Health Services Utilization Among Older Adults in Vietnam: Evidence From the National Household Living Standard Survey 2016
Authors: Nguyen Mai P.
Published: September 2021

This study—using multinomial logistic regressions—analyzed a national sample of 2977 older adults to examine factors associated with their health services utilization in four types of health providers—namely, commune health stations (CHSs), private clinics, private hospitals, and public hospitals in Vietnam. Older Vietnamese favored using public hospitals for their health consultancies, even for regular health checkups. For nonsevere illness, the relative risk ratio of choosing private clinics was three times (95% CI: 2.2-4.1) that of CHSs. Possession of public health insurance was a key enabling factor that influenced the older adults’ choice of CHSs over private clinics. Older adults of ethnic minority and living in rural areas were more likely to use CHSs than other health facilities. This study suggests a substantial quality improvement of services at CHSs, an innovative reform toward a diversified structure of private and public clinics to address diverse needs and to strengthen primary care for older adults.
Systemic mucoid degeneration of the arterial tunica intima in a young dog
Authors: Ichikawa Yoshiki , Heishima Mizuki , Vyhnal Kristin , Aoshima Keisuke , Sasaoka Kazuyoshi , Kinoshita Ryohei , Kobayashi Atsushi , Takiguchi Mitsuyoshi , Kimura Takashi
Published: September 2021

A 27-mo-old, spayed female mixed-breed dog was presented with left forelimb pain, which progressed to full thickness necrosis of the soft tissues of multiple limbs. Clinical imaging and postmortem examination suggested multiple large arterial thromboemboli. Histologic examination of vascular lesions revealed markedly thickened tunica intima with polypoid intraluminal projections, which partially to entirely occluded the arterial lumen. The expanded tunica intima was comprised of intimal accumulation of Alcian blue–positive matrix with scattered spindle-to-satellite cells. These cells were positive for von Willebrand factor and vimentin but negative for α–smooth muscle actin, suggesting endothelial origin. Deposition of the intimal mucoid matrix was observed in the elastic and muscular arteries associated with regional ischemic changes. Mucoid emboli, likely from fragmentation of proliferative intimal tissue, were identified in smaller vessels supplied by affected arteries. Based on these findings, we diagnosed systemic mucoid degeneration of the arterial tunica intima. Such systemic arterial degeneration characterized by deposition of mucoid matrix in the tunica intima has not been reported previously in dogs, to our knowledge, and should be distinguished from thromboembolism and other degenerative vascular diseases.
Marginal Walking
Authors: Ng-Chan Taien
Published: September 2021

I propose the concept of marginal walking as a critically creative framework that nourishes and supports the spaces of the margins as a corrective and a prescription to the stresses of everyday racism, which is difficult to see or describe, but underlies every interaction in everyday public spaces. Drawing from my reflections on the increase of anti-Asian hate during the global pandemic of 2020 to 2021, I investigate how news of racist incidents circulates through digital networks that are entangled with quotidian places such as parks, grocery stores, and public transit. Through such concepts as autocartography and strata-mapping, as explored through my own research-creation practices as well as through participatory walks given by my artist collective Hamilton Perambulatory Unit (HPU), I look at how conscious acts of sensing and intervening in marginal everyday space can contribute to the creation of alternative narratives and knowledge that is necessary for change.