bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep neural network-based wind speed forecasting and fatigue analysis of a large composite wind turbine blade
Authors: Kulkarni Pravin A , Dhoble Ashwinkumar S , Padole Pramod M
Published: September 2018

The purpose of this paper is to analyze the modern deep neural networks such as nonlinear autoregressive network with external inputs and a recurrent neural network called long short-term memory for wind speed forecast for long-term and use the prediction for fatigue analysis of a large 5 MW wind turbine blade made of composite materials. The use of machine learning algorithms of advanced neural network applied for engineering problems is increasing recently. The present paper therefore brings as important connection between these latest machine learning methods and engineering analysis of complex wind turbine blades which are also the focus of researchers in renewable system design and analysis. First, a nonlinear autoregressive network with external inputs neural network model using Levenberg–Marquardt back propagation feed forward algorithm is developed with 5 years of environment parameters as input. Similarly, a long short-term memory based model is developed and compared. The chosen long short-term memory model is used for developing two-year wind speed forecast. This wind pattern is used to create time varying loads on blade sections and cross-verified with National Renewable Energy Laboratory tools. A high-fidelity CAD model of the NREL 5 MW blade is developed and the fatigue analysis of the blade is carried out using the stress life approach with load ratio based on cohesive zone modeling. The blade is found to have available life of about 23.6 years. Thus, an integrated methodology is developed involving high-fidelity modeling of the composite material blade, wind speed forecasting using multiple environmental parameters using latest deep learning methods for machine learning, dynamic wind load calculation, and fatigue analysis for National Renewable Energy Laboratory blade.
Fully coupled thermo-magneto-electro-elastic properties of unidirectional smart composites with a piezoelectric interphase
Authors: Haghgoo M , Ansari R , Hassanzadeh-Aghdam MK , Darvizeh A
Published: September 2018

In the present study, the effect of PZT-5A piezoelectric interphase on the effective thermo-magneto-electro-elastic properties of CoFe2O4 piezomagnetic matrix composites reinforced with carbon fibers is investigated. In this type of three-phase smart composite, the unidirectional fiber is coated with the piezoelectric shell. To this end, the fully coupled thermo-magneto-electro-elastic constitutive relations are developed for a unit cell-based micromechanical model in conjunction with a proper representative volume element. The influences of piezoelectric interphase thickness on the effective properties of the unidirectional smart composite are extensively investigated at different carbon fiber volume fractions up to 70%. The results demonstrate that piezoelectric interphase can greatly affect the overall thermo-magneto-electro-elastic properties of the smart composites. For two-phase smart composites, the present predictions are found to be in close proximity with the Mori–Tanaka results, which validates the present model.
An experimental oscillation damping impedance control for the Novint Falcon haptic device based on the phase trajectory length function concept
Authors: Zarei Mojtaba , Kalhor Ahmad , Tale Masouleh Mehdi
Published: September 2018

This paper aims at designing an oscillationless open-loop impedance controller for a well-known low-cost haptic device, namely the Novint Falcon haptic device. In this regard, the oscillation number index standing for the ratio of the traversed path in the corresponding phase portrait systems for a certain state to its radial value is employed to evaluate the oscillatory behavior of the system. Based on the identified parameters of the dynamic equation, a precise model of the intended robot is developed in the SimMechanics simulator. According to the obtained results in the simulation, one can infer that there is a certain impedance value in which the value of the oscillation number index has its minimum value. The obtained experimental results reveal that the oscillation number index based controller possesses lower oscillation in comparison to the Falcon’s official software development kit. In fact, by tuning the system’s impedance will result in a better performance for the haptic purposes.
Prediction of stress distribution in press-fit process of interference fit with a new theoretical model
Authors: Wang Xingyuan , Lou Zhifeng , Wang Xiaodong , Hao Xiupeng , Wang Yue
Published: September 2018

Interference fit is widely used in many industrial fields for its high ability to transmit an axial force or torque between a shaft and hub. But the performance of interference fits during their life in service is limited by stress concentrations and surface wear. Nowadays, theoretical methods based on thick-walled cylinder theory become increasingly abundant. However, the prediction results of stress distribution in press-fit process are not accurate for ignoring the stress concentrations. Since the stress distribution is significant for analysis of surface wear and assembly quality, especially for precision assembly of small parts, the purpose of this study is to build a new theoretical model to predict the stress distribution. The stress distribution equation was deduced based on a simplified model that a nonuniform linear load acts on a portion of semi-infinite plane. Finally, the stress distribution in the press-fit process was analyzed by the theoretical model, as well as the stress distribution of different material pairs (Ni36CrTiAl–50Ni-50Fe, AISI 1045–AISI 1045) under full contact condition. The comparison between theoretical and numerical results shows that the new theoretical model has high accuracy in predicting stress distribution and maximum stress, and the relative error is less than 17%. Therefore, the new theoretical model can give more reasonable results and provide a more reliable approach for design of interference fits. Furthermore, the model provides a method for the optimization of interference analysis under different structures and working conditions, and gives a theoretical basis for real-time estimation of assembly quality.
New approach integrating the health, safety, and environment systems for the maintenance function in industries
Authors: Irhirane Elhassan , Bounit Ahmed , Dakkak Badr , Benmoussa Rachid , Bourquia Nawal
Published: September 2018

Health, safety, and environment risk assessment, based on company quality, health, safety, and environment commitments, constitutes a precondition in the definition of the strategy to be adopted by the maintenance service. The imperfections of the knowledge; the disputes over opinions among decision-makers; and the absence of health, safety, and environment equipment risk assessment integrated models hinder the assessment of risk acceptability. In this article, we propose a health, safety, and environment risk management approach for the equipment maintenance. This approach expands the scope of action relative to the overall equipment risk-level assessment. It is based, on one hand, on fuzzy logic and, on the other hand, on two methods of decision-making support: the method of converting verbal judgments into numerical values and the pair comparison of decision criteria. This approach allows the maintenance service to implement a health, safety, and environment risk control policy for the most critical equipment. Therefore, it allows to improve the staff and product safety and to protect the environment in accordance with the strategic objectives.
Interrogating ‘authoritarian neoliberalism’: The problem of periodization
Authors: Ryan Matthew DJ
Published: September 2018

From the legislated ‘embedding’ of neoliberalism as seen with constitutional debt ceilings, through sweeping free trade agreements, to the direct, violent suppression of political freedoms; democracy today seems to be under siege from all sides. In response to these troubling developments, Ian Bruff (2014) recently introduced the concept of ‘authoritarian neoliberalism’ to understand increasingly undemocratic forms of state and state action in the current conjuncture. This article argues that although ‘authoritarian neoliberalism’ presents a useful development in our understanding of these processes, the concept faces several challenges – in particular, that of obscuring a broader history of authoritarianism and its contradictions, by separating neoliberalism into distinct phases. This article considers two moments of authoritarianism within the history of neoliberalism: the United Kingdom under Margaret Thatcher, and the Greek experience of mandated austerity within the strictures of the European Monetary Union (EMU). Through these examples, the article will engage with claims that the ‘authoritarian neoliberalism’ of the post-2007 context is somehow ‘qualitatively distinct’ from earlier forms. It is argued that an enforced separation between these two cases is unhelpful, and that more fruitful directions for this emerging research agenda lie not in a conceptual separation of the past, but rather a consideration of the durability of authoritarian state forms.
Evaluation of an Online “Internationalization at Home” Course on the Social Contexts of Addiction
Authors: Lee Bonnie K. , Cai Huixiang
Published: September 2018

Internationalization of higher education to include international, intercultural, or global components into the delivery of postsecondary education has drawn increasing attention in the last two decades. A globally relevant course focusing on the “Social Contexts of Addiction” engaged students’ online interaction at a Canadian university with learners from across various institutions in mainland China, Macau, and Hong Kong. Although “internationalization at home” (IaH) is one of the most prevalent themes in the internationalization literature, empirical evaluation of its merits along with the challenges of its implementation is still limited. In this article, the authors used student and faculty feedback to identify the design factors of this online IaH course that facilitated its success and transformative benefits. Discussion highlighted several follow-up strategic initiatives to broaden the adoption and conversations on internationalization in teaching, and the necessity of multilevel support and alignments among government, university, and faculty leadership to sustain internationalization efforts across the curriculum.
Gioia’s Rules of the Game
Authors: Gioia Denny
Published: September 2018

I have been editing the “Provocations and Provocateurs” section of JMI since 2005. In all that time, I have not written an essay for my own section. I am redressing that gross injustice to myself in the following little treatise. A few years ago I wrote an essay for a volume entitled How to Get Published in the Best Management Journals. That brief piece generated quite a lot of interest because it lifted the curtain on some of the informal “rules” or processes that can help scholars publish. I thought a version of that short essay would be useful for JMI’s readers.
A Guide to Evaluation of Quality Improvement and Patient Safety Educational Programs: Lessons From the VA Chief Resident in Quality and Safety Program
Authors: Butcher Rebecca L. , Carluzzo Kathleen L. , Watts Bradley V. , Schifferdecker Karen E.
Published: September 2018

With the recent proliferation of quality improvement (QI) and patient safety (PS) education programs, guidance is needed on how to assess the effectiveness of these programs. Without a systematic approach, evaluation efforts may end up being disjointed, lead to excess participant burden, or yield unhelpful feedback because of poor fit with program priorities. This article presents a framework for developing a multilevel evaluation infrastructure using examples from the evaluation of the national Department of Veterans Affairs Chief Resident in Quality and Safety program, a 1-year, post-accreditation program to develop leadership and teaching skills in QI and PS. It illustrates how to apply the framework to establish evaluation priorities and methods, and shares sample results and how they are used to guide program improvements and track important outcomes at multiple levels. The framework is particularly relevant to other nonaccredited advanced QI/PS programs, yet offers useful considerations for evaluating any advanced medical education program.
Lessons Learned in Providing Claims-Based Data to Participants in Health Care Innovation Models
Authors: Cohen Martin F. , Irie Sarah M. , Russo C. Allison , Pav Veronika , O’Connor Shannon L. , Wensky Suzanne G.
Published: September 2018

The Centers for Medicare & Medicaid Services (CMS) has been providing data to organizations participating in a range of innovation models to help them implement interventions and to provide feedback on performance. The authors studied 18 CMS models to gain a better understanding of factors contributing to model participants’ use or nonuse of CMS-provided data. Factors that contribute to greater use include providing data that participants view as actionable, some type of accountability for performance, robust learning support, participants having resources to work with the data, and soliciting ongoing feedback about the data and related learning needs. Factors that discourage data uptake include time lag, lack of aggregated multi-payer data, exclusion of data for sensitive diagnoses, and small sample sizes. Claims-based data from payers can be an important source of information to innovation model participants. Lessons from this study can increase the usefulness of such data.
Development and Validation of the Positive Parenting Schema Inventory (PPSI) to Complement the Young Parenting Inventory (YPI) for Schema Therapy (ST)
Authors: Louis John P. , Wood Alex M. , Lockwood George
Published: September 2018

The factor structure of an initial item pool of 207 positive parenting items was investigated (Manila; n = 520, 538) to develop the Positive Parenting Schema Inventory. Single group and multigroup confirmatory factor analyses of the Positive Parenting Schema Inventory showed invariance of the factor structure in six out of the seven levels on two other independent samples (Eastern, Indonesia; n = 366, 383; Western, the United States; n = 204, 214). Good values for reliability were obtained for its seven subscales (50 items) using coefficient omegas (.71 to .95). Evidence of validity based on test content, response processes (item responses to desired inferences), internal structure (exploratory and confirmatory factor analyses), relations to other variables (correlations with other instruments), and consequences of testing (correlations with positive schemas) were demonstrated. A core tenet of schema therapy theory was supported in that recall of past positive parenting patterns were associated with current levels of positive schemas.
When Weather Forecasters Are Wrong: Image Repair and Public Rhetoric After Severe Weather
Authors: Compton Josh
Published: September 2018

Weather forecasts are a unique type of prediction rhetoric—science communication with inherent uncertainty and multiple potential interpretations from diverse audiences. When forecasts are wrong, audiences often turn their ire toward the weather forecaster. This rhetorical analysis considers image repair efforts of a meteorologist following a botched winter storm forecast. Implications for communication efforts of weather forecasters are offered, in addition to consideration of insight into the larger realm of the rhetoric of science.
Improving Patient–Provider Communication and Therapeutic Practice Through Better Integration of Electronic Health Records in the Exam Room: A Pilot Study
Authors: Patel Minal R. , Smith Alyssa , Leo Harvey , Hao Wei , Zheng Kai
Published: September 2018

Background. The rapid proliferation of electronic health records (EHRs) in clinics has had mixed impact on patient-centered communication, yet few evaluated interventions exist to train practicing providers in communication practices. Aims. We extended the evidence-based Physician Asthma Care Education (PACE) program with EHR-specific communication strategies, and tested whether training providers with the extended program (EHR-PACE) would improve provider and patient perceptions of provider communication skills and asthma outcomes of patients. Method. A pilot randomized design was used to compare EHR-PACE with usual care. Participants were providers ( n = 18) and their adult patients with persistent asthma ( n = 126). Outcomes were assessed at baseline and 3- and 6-month postintervention, including patient perception of their provider’s communication skills and provider confidence in using EHRs during clinical encounters. Results. Compared with the control group, providers who completed the EHR-PACE program reported significant improvements at 3-month follow-up in their confidence with asthma counseling practices (estimate 0.90, standard error [ SE] 0.4); p < .05) and EHR-specific communication practices (estimate 2.3, SE 0.8; p < .01), and at 6-month follow-up, a significant decrease in perception that the computer interferes with the patient–provider relationship (estimate −1.0, SE 0.3; p < .01). No significant changes were observed in patient asthma outcomes or their perception of their provider’s communication skills. Discussion. Training providers with skills to accommodate EHR use in the exam room increases provider confidence and their perceived skills in maintaining patient-centered communications in the short term. Conclusion. Evidence-supported training initiatives that can increase capacity of busy providers to manage increased computing demands shows promise. More research is needed to fully evaluate EHR-PACE on patients’ health status and their perceptions of their provider’s care through a large-scale trial.
Massive Perivillous Fibrin Deposition of an Enterovirus A-Infected Placenta Associated With Stillbirth: A Case Report
Authors: Feist Henning , Turowski Gitta , Hussein Kais , Blöcker Thordis , Heim Albert
Published: September 2018

Massive perivillous fibrin deposition (MFD) is a morphologically defined severe placental lesion associated with perinatal morbidity and mortality. The etiology is unknown, and recurrence risk in subsequent pregnancies is assumed to be high. In most cases, a pathologic immune reaction is supposed to be responsible for the lesion. We report a case of a pregnant woman’s suffering from hand, foot, and mouth disease in the 20th gestational week. Subsequently, MFD developed in the placenta and was followed by intrauterine growth restriction and stillbirth in the 29th gestational week. Enterovirus A with high homology to Coxsackievirus A16 was detected in the placenta by means of immunohistochemisty and reverse transcription polymerase chain reaction. This infection could be a rare cause of MFD and should be taken into consideration in the differential diagnosis of the individual etiology. Recurrence risk of virus-related MFD is expected to be lower than in MFD without infectious association.
Pathology of Neonatal Non-albicans Candidiasis: Autopsy Study and Literature Review
Authors: Hemedez Claire , Trail-Burns Elizabeth , Mao Quanfu , Chu Sharon , Shaw Sunil K , Bliss Joseph M , De Paepe Monique E
Published: September 2018

Introduction/Objectives

Non- albicans Candida species such as Candida parapsilosis and Candida glabrata have emerged as prevalent pathogens in premature infants. The aim of this study was to systematically delineate the histopathologic findings in neonatal non- albicans candidiasis.

Methods

We performed a retrospective clinicopathologic analysis of extremely premature (23–28 weeks’ gestation) infants diagnosed with invasive candidiasis. Archival autopsy tissues were subjected to periodic acid-Schiff, methenamine-silver and anti- Candida (immuno)histochemical stains, as well as dual anti- Candida and anti-cytokeratin or anti-CD31 immunofluorescence assays. In addition, we studied the prevalence of intestinal Candida colonization in a consecutive autopsy series of extremely premature infants.

Results

Based on positive postmortem blood and/or lung cultures, invasive candidiasis (3 non- albicans and 11 Candida albicans) was diagnosed in 14 of the 187 extremely premature infants examined between 1995 and 2017. In contrast to the well-known inflammatory and tissue-destructive phenotype of congenital C. albicans infection, invasive non- albicans candidiasis/candidemia caused by C. parapsilosis and C. glabrata was inconspicuous by routine hematoxylin-eosin-based histopathologic analysis despite a heavy fungal presence detected in intestines, lungs, and blood by targeted (immuno)histochemical assays. Intestinal colonization by Candida species was identified in 16 of the 26 (61%) extremely premature neonates who had lived for at least 1 week, as assessed by anti- Candida immunostaining.

Conclusion

Invasive neonatal non- albicans candidiasis/candidemia appears to have no distinct histopathologic signature. Based on the notoriously low sensitivity of fungal blood cultures and the observed high frequency of Candida intestinal colonization (>50%), it is likely that non- albicans candidiasis/candidemia may be underdiagnosed in (deceased) preterm infants. Routine inclusion of targeted (immuno)histochemical fungal detection strategies in the perinatal autopsy may lead to deeper insight into the prevalence and clinical relevance of neonatal non- albicans candidiasis.
Destination Satisfaction and Revisit Intention of Tourists: Does the Quality of Airport Services Matter?
Authors: Seetanah Boopen , Teeroovengadum Viraiyan , Nunkoo Robin
Published: September 2018

This study focuses on the link between tourists’ satisfaction with the quality of airport services at a destination and their intention to revisit. The influence of tourists’ overall satisfaction with a destination on their behavioral intentions has been well established both at theoretical and empirical levels; however, the particular role of satisfaction with airport services has been so far largely neglected. Researchers have recognized the vital importance of tourists’ experience with airport services because of the fact that the airport is the first and last encounter that they experience when visiting a country. As such, the focus of the present study pertains to evaluating the satisfaction level of tourists visiting Mauritius and examining its resulting effect on their behavioral intentions. The study uses the survey methodology for data collection and involved the distribution of self-administered questionnaires to a sample of 1,721 tourists at the SSR airport in Mauritius. Exploratory factor analysis is used to extract meaningful dimensions of airport services and a multinomial probit analysis is conducted to test for the impact of satisfaction with airport services on revisit intention while taking into account other control variables. Interestingly, airport services are seen to significantly influence the probability of repeat tourism.
Sustainable implementation of innovative, technology-based health care practices: A qualitative case study from stroke telemedicine
Authors: Bagot Kathleen L , Moloczij Natasha , Barclay-Moss Karen , Vu Michelle , Bladin Christopher F , Cadilhac Dominique A
Published: September 2018

Introduction

Technology-based innovation requires long-term changes to workforce routines, otherwise practices will not be sustained. The aim of this study was to identify influential factors in the ongoing use of an acute stroke telemedicine programme.

Methods

A new acute stroke telemedicine programme in a regional hospital receiving 375 patients with stroke or transient ischaemic attack per year was used as an exploratory case study. Semi-structured interviews with acute care and emergency department clinicians ( n = 25) were conducted at two time-points: after a six-month pilot and then after a further 12-month implementation phase. Interviews (between 12–60 min) were recorded, transcribed and analysed inductively using descriptive thematic analysis. Reported barriers and facilitators were compared with those previously reported pre-implementation (deductive analysis) to identify changes over time. Using an implementation framework and a behaviour change taxonomy, strategies were developed to address influential factors on sustainability.

Results

New facilitators were identified including hospital system changes, benefits to clinicians and telemedicine becoming standard practice. New and ongoing barriers included infrequent use, competing demands and the continued resistance to a specific treatment.

Discussion

Understanding the factors supporting a health service in successfully implementing change can accelerate population benefits. The innovation itself may include barriers to be addressed, and barriers and facilitators can change over time. Individual attitudes remain critical to initial and ongoing success. Strategies proposed included promoting benefits across the organisation and allaying uncertainties with site-specific evidence. The effectiveness of these strategies, however, needs to be evaluated. Strategies sustaining change post-implementation should be considered.
Low-noise structure optimization of a heavy commercial vehicle cab based on approximation model
Authors: Zhang Zhiyong , Zhang Yibo , Huang Caixia , Liu Xin
Published: September 2018

Structure design for reducing noise is essential and widely studied because cab interior noise seriously affects the ride comfort of the driver and passengers, especially for heavy commercial vehicles. This paper proposes an enhancement investigation on the low-noise structure performance of a cab in a heavy commercial vehicle based on an approximation model. A series of vibroacoustic tests with varying running speeds are implemented first to acquire the vibration signals at four cab suspensions and the sound pressure signal at the right ear of the driver. The finite element model and structure–acoustic coupled model of the cab of a heavy commercial vehicle are established sequentially. When the vibration accelerations measured in the tests are converted into excitation signals using the cab structure–acoustic coupled model, the sound pressure of the right ear of the driver is predicted, and the accuracy of the cab structure–acoustic coupled model is then verified. After panel acoustic contribution analysis, an approximation model of critical panel thickness and the peak noise near the right ear of the driver is established in accordance with the radial basis function. Genetic algorithm is utilized to solve an optimization model to obtain optimal panel thicknesses. By comparing the right ear sound pressure before and after optimization, the results confirm that optimized panel thicknesses can reduce sound pressure level of the critical frequency.
Nonlinear analysis of cylindrical roller bearing under the influence of defect on individual and coupled inner–outer race
Authors: Patel Sachin P , Upadhyay S H
Published: September 2018

In this paper, new mathematical model has been developed for the cylindrical roller bearing by considering coupled influence of radial deflection due to normal loading, roller titling, roller skewing, radial clearance, and also individual as well as coupled inner and outer race defects. Novel defect function is also developed for inner and outer race defects based on literature, to make a set of nonlinear equations for mathematical model, which are solved by using MATLAB. Newmark-β method is applied to solve the equation of motion. The results are plotted in time domain, velocity-displacement, and envelope analysis. The obtained results show the sensitiveness of the system with the variations in speed for the inner, outer, and combined inner–outer race defects. The peak displacement, velocity, and acceleration have been observed for various defects which are helpful to obtain the system’s dynamic behavior under speed varying condition for combined radial and axial load. A major finding of this paper is regarding the understanding of the system’s behavior like periodic to chaotic under varying speed conditions with the attention of individual and coupled inner and outer race defects with the inclusion of normal loading, tilting, skewing, and radial clearance effect and validation of simulated results with the calculated one.
A retrofit for asbestos-based brake pad employing palm kernel fiber as the base filler material
Authors: Achebe CH , Chukwuneke JL , Anene FA , Ewulonu CM
Published: September 2018

The development of automobile brake pad using locally sourced palm kernel fiber was carried out. Asbestos, a carcinogenic material, has been used for decades as a friction material. This development has thus prompted a couple of research efforts geared towards its replacement for brake pad manufacture. Palm kernel fiber was used as an alternative filler material in conjunction with various quantities of epoxy resin as the matrix. Three sets of compositions were made, and the resulting specimens subjected to physical and mechanical tests using standard materials, procedures, and equipment. The essence is to determine their suitability and hence possible performance in service. The result showed that sample C with 40% palm kernel fiber content having hardness, compressive strength, abrasion resistance, specific gravity, water absorption, and oil absorption of 178 MPa, 96.2 MPa, 1.67 mg/m, 1.8 g/cm3, 1.86%, and 0.89%, respectively, had an optimum performance rating. It was equally ascertained that increase in the filler content had the effect of increase in hardness, wear resistance, and specific gravity of the composite brake pad, while water and oil absorption got decreased when compared with results obtained by other researchers using conventional brake pads made of other friction materials including asbestos. This is an indicator that palm kernel fiber is a possible and effective retrofit for asbestos as a filler material in automotive brake pad manufacture.
‘There is still so much inside’: The impact of personalised reminiscence, facilitated by a tablet device, on people living with mild to moderate dementia and their family carers
Authors: Ryan Assumpta A , McCauley Claire O , Laird Elizabeth A , Gibson Aideen , Mulvenna Maurice D , Bond Raymond , Bunting Brendan , Curran Kevin , Ferry Finola
Published: September 2018

The aim of this qualitative study was to explore the impact of a home-based, personalised reminiscence programme facilitated through an iPad app on people living with dementia and their family carers. Semi-structured interviews were used to collect data from 15 people living with dementia and 17 family carers from a region of the United Kingdom. The interviews were recorded, transcribed and analysed using thematic analysis. Six key themes emerged related to usability (‘It’s part of my life now’); revisiting the past (‘Memories that are important to me’); home use (‘It was homely’); impact on the person living with dementia (‘It helped me find myself again’); gains and abilities (‘There is still so much inside’) and impact on relationships (‘It’s become very close’). These themes highlighted the impact of the reminiscence experience at an individual and relationship level for people living with dementia and their carers. The reminiscence experience also appeared to facilitate the development of new insights among participants that emphasised abilities and gains rather than disabilities and losses. The significance of personal memories was a core theme although this was not without its challenges, particularly if memories were distressing. The reminiscence experience was differentiated by individual roles. Carers tended to become more relationship-focused, whereas people living with dementia highlighted the significance of learning new skills. The study concluded that individual specific reminiscence supported by an iPad app can have a positive impact on people living with dementia and their carers at an individual and relationship level.
Optimization of mechanical, thermal, and ignition properties of polyester fabric using urea and phosphoric acid
Authors: Younis A A
Published: September 2018

This research aimed to improve anti-dripping and ignitability properties of polyester fabric polyethylene terephthalate (PET) by using urea (CO(NH2)2), phosphoric acid (H3PO4), methyltrimethoxysilane (MTMS) via sol-gel technique. Methyl groups served as blocking groups preventing oxygen from penetrating into PET specimen, so the fire stopped. The interaction between the coating and irradiated surface of PET was detected by Fourier-transform infrared spectroscopy using UV/ozone for different time periods. The mechanical properties (tensile and elongation %) of the specimens were tested according to ISO 13934. The thermogravimetric analysis, derivative thermogravimetric analysis, and differential scanning calorimetry proved that the new coating has a direct efficiency to protect the PET fabric from ignition. Different standard test methods, ISO 4589, ASTM D635, and EN ISO 1716, were used to investigate the ignition properties of untreated and treated specimens. The results showed that the coated specimens with a urea solution only as a first layer, and then the sol solution as the second layer have the highest flame retardant effect compared to the other methods. This results in improving the dripping and ignition properties of a polyester fabric.
Development of nonwoven automotive carpets made of recycled PET fibers with improved abrasion resistance
Authors: Atakan Raziye , Sezer Serdar , Karakas Hale
Published: September 2018

In this study, velour design molded automotive carpets made of recycled polyethylene terephthalate (PET) fibers were developed via needle-punching process to improve their abrasion resistance properties. Initially, virgin PET fibers and recycled PET (rPET) fibers derived from PET bottle wastes were supplied from different producers and they were tested in terms of their fiber properties such as fiber length, crimp, tensile strength, elongation, tenacity, and intrinsic viscosity. It was demonstrated that recycled fibers from bottle wastes used in the study have lower tenacity and higher elongation than virgin PET fibers. In the second part, rPET fibers to be used in manufacturing in terms of their desired properties were selected. Subsequently, molded automotive carpets were produced from the selected rPET fibers and virgin PET fiber blends with adjusted manufacturing and molding parameters. Developed carpets were tested for abrasion resistance performance and they were evaluated according to requested specification. Results showed that carpets made of 85% rPET + 15% bicomponent PET had almost equal performance in terms of both fiber loss and carpet appearances with carpets consisting of 80% PET + 20% bicomponent PET. Carpets made of recycled PET fibers offer the manufacturer low raw material costs in addition to ecological advantages.
Complete Clinical Remission of Stage IV Triple-Negative Breast Cancer Lung Metastasis Administering Low-Dose Immune Checkpoint Blockade in Combination With Hyperthermia and Interleukin-2
Authors: Kleef Ralf , Moss Ralph , Szasz A. Marcell , Bohdjalian Arthur , Bojar Hans , Bakacs Tibor
Published: September 2018

The prognosis of triple-negative breast cancer with metastases after chemotherapy remains dismal. We report the case of a 50-year-old female with first disease recurrence at the axillary lymph node and, later on, bilateral pulmonary metastases with severe shortness of breath. The patient received low-dose immune checkpoint blockade (concurrent nivolumab and ipilimumab) weekly over 3 weeks with regional hyperthermia 3 times a week, followed by systemic fever-range hyperthermia induced by interleukin-2 for 5 days. She went into complete remission of her pulmonary metastases with transient WHO I-II diarrhea and skin rash. The patient remained alive for 27 months after the start of treatment, with recurrence of metastases as a sternal mass, and up to 3 cm pleural metastases. This exceptional response should instigate further research efforts with this protocol, which consists only of approved drugs and treatments.
A New Approach for Lifestyle Medicine Payment
Authors: Beckman Ken
Published: September 2018

With more than 85% of health care costs attributable to chronic health conditions, an emphasis on treating the underlying causes of these conditions is imperative. Lifestyle medicine offers treatments that can reverse a wide range of chronic health conditions at minimal cost and without negative side effects. Although one might expect its use to be widespread among health care professionals, it is far from common in everyday practice. A significant contributing factor is the lack of financial incentives for health care providers who practice lifestyle medicine. Current practitioners generally do not receive remuneration consistent with the cost savings resulting from reversing chronic health conditions using lifestyle medicine. The Actuarial Patient Value model offers a new approach to encourage the practice of lifestyle medicine through the use of cash financial incentives based on actual patient health outcomes. This model aligns the incentives of the 3 primary stakeholders in the health care system by offering providers increased compensation, giving patients the opportunity to learn about and achieve optimal health, and reducing costs for health care payers.
Hybrid atherectomy for lower extremity peripheral arterial disease
Authors: Turkyilmaz Saygin , Kavala Ali Aycan
Published: September 2018

Objective

To evaluate the effectiveness of directional atherectomy with a Phoenix atherectomy system in lower extremity peripheral arterial disease (LE-PAD).

Materials and methods

A retrospective review of subjects who had undergone atherectomy for severe and occluded LE-PAD. Demographic data, procedural properties, and follow-up information were recorded. The technical, procedural and clinical successes were reported.

Results

In total, 120 subjects were evaluated. The superficial femoral artery (SFA) group consisted of 64 subjects (53.3%), and the popliteal group consisted of 56 (46.7%) subjects. Groups did not differ in terms of age, gender, comorbid diseases and tobacco use. In both groups, four subjects (6.3% of SFA and 7.1% of the popliteal group) experienced extravasation was encountered in from the vessel during the procedure. During atherectomy, two (3.3%) of the subjects in the SFA group and one (1.9%) subject in the popliteal group experienced vessel dissection. Acute technical success in this study was 96.7% for SFA and 98.1% for the popliteal group. Overall technical success was 97.7%. In the first 72 h, three (5%) of the subjects in the SFA group and four (7.7%) of the subjects in the popliteal group experienced major adverse events. Acute procedural success in this study was 91.7% for SFA and 90.4% for the popliteal group. Overall procedural success was 91.1%. Success was defined as an improvement of at least one grade in the Rutherford classification; two (3.3%) subjects did not demonstrate improvements in the SFA group, and the clinical success rate was 96.7%. All subjects in the popliteal group demonstrated an improvement of at least one grade in the Rutherford classification, and clinical success was 100%. When the groups combined all subjects, the clinical success in this study was 98.2%.

Conclusion

Directional atherectomy with a Phoenix atherectomy system demonstrated comparable results with the literature.
Contemporary trends and outcomes of thrombolytic therapy for acute lower extremity ischemia
Authors: Bath Jonathan , Kim Ryan J , Dombrovskiy Viktor Y , Vogel Todd R
Published: September 2018

Objective

Acute limb ischemia is a common vascular emergency requiring immediate intervention. Thrombolysis has been widely utilized for acute limb ischemia; the purpose of this study is to analyze contemporary trends, outcomes and complications of thrombolysis for acute limb ischemia.

Methods

Patients were identified from the Nationwide Inpatient Sample (2003–2013) using ICD-9. Patients undergoing emergency thrombolysis for acute limb ischemia were evaluated. Three groups were analyzed: thrombolysis alone, thrombolysis and endovascular procedure (T+ENDO), and failed thrombolysis requiring open surgery (T+OPEN).

Results

A total of 162,240 patients with acute limb ischemia were estimated: 33,615 patients (20.7%) underwent thrombolysis as the initial treatment. Mean age was 66.2 ± 34.9 years with 54% male. The utilization of thrombolysis increased significantly during the study period (16.8–24.2%, p < 0.0001). The most common group was thrombolysis and endovascular procedure (40.7%), followed by thrombolysis alone (34.1%), and T+OPEN (25.2%). Thrombolysis and endovascular procedure increased significantly over time (31.6–47.8%, p < 0.0001) whereas thrombolysis alone and T+OPEN significantly decreased (39.6–28.6% and 28.7–23.6%, respectively, p < 0.0001). Overall mortality was 4.9%; thrombolysis and endovascular procedure compared to thrombolysis alone and T-OPEN had a lower mortality rate (3.2% vs. 6.1% and 5.9%, p < 0001). The overall stroke rate was 1.9%; thrombolysis alone had the highest stroke rate (3.0%, p < 0.0001) with thrombolysis and endovascular procedure the lowest (1.2%) and T+OPEN 1.7%. The highest amputation rate was T+OPEN (11.6%, p < 0.001) compared to thrombolysis and endovascular procedure (5.1%) and thrombolysis alone (5.3%). T+OPEN had the highest incidence of cardiac (5.5%), respiratory (7.3%) and renal complications (12.5%), pneumonia (4.0%), and fasciotomy (16.8%) (all p < 0.0001).

Conclusion

Thrombolysis remains an effective treatment for acute limb ischemia with increased utilization over time. There was a significant increase in thrombolysis and endovascular procedure leading to improved outcomes. Thrombolysis alone carried the highest mortality and stroke rate, with T+OPEN associated with the highest amputation and complications. Although thrombolysis is effective, 25% of patients required an open procedure suggesting that patient selection for thrombolysis first instead of open surgery continues to be a clinical challenge.
Initial outcomes of endovenous laser ablation with 1940 nm diode laser in the treatment of incompetent saphenous veins
Authors: Park Insoo
Published: September 2018

Objectives

To investigate the initial outcomes of 1940 nm diode laser in the treatment of incompetent saphenous veins.

Methods

This was a prospective observational study. We treated 89 patients with 160 incompetent saphenous veins using a 1940 nm diode laser and bare fiber. The laser’s power was set to 4.5 W with a mean linear endovenous energy density of 50.4 J/cm.

Results

The one-month closure rate was 100%. The post-procedural pain score at 6 h, 1 day, 10 days, and 1 month was 0.85 ± 1.04, 0.65 ± 1.01, 0.82 ± 1.25, and 0.47 ± 0.82, respectively. Complications encountered included paresthesia (3.8%) and thrombophlebitis (4.4%), whereas no cases of endovenous heat-induced thrombosis were observed.

Conclusion

The 1940 nm laser and bare fiber at 50.4 J/cm showed satisfactory initial outcomes with less pain and fewer complications, in the treatment of incompetent saphenous veins.
Nurses' practices in the context of primary healthcare in Portugal
Authors: Dalla Nora Carlise Rigon , Schaefer Rafaela , Neves-Amado João
Published: September 2018

Aim

The aim of this study was to identify and categorise the nursing practices of Portuguese nurses in the context of primary healthcare services.

Methods

A scoping review was undertaken using the Latin American and Caribbean Health Sciences literature database; Spanish Bibliographic Index of Health Sciences; Medical Literature Analysis and Retrieval System Online; Cochrane Library; Scientific Electronic Library Online; El Banco de Datos de Enfermería nursing database; and Cumulative Index to Nursing and Allied Health Literature databases. The search strategy included articles of original research, which involved nurses or nursing practices in the context of Portugal’s primary healthcare, published in Portuguese, Spanish and/or English. The review involved the analysis of 11 studies published in Latin American, Brazilian and Portuguese journals, therefore all were available in Portuguese, published between 2007 and 2013.

Results

From the analysis it was possible to establish four categories of primary healthcare nurses’ work: technical procedures, health promotion, independent actions, and management and training practices.

Conclusions

Primary healthcare nursing in Portugal is challenged in the context of making more effective use of its own competences, investing more in actions of health promotion and disease prevention and less in technical curative procedures, thus contributing to better performance in the Portuguese National Health System.
Evaluation of individuals’ health beliefs and their association with testicular self-examination: adult sample from Amasya
Authors: Gümüş Kenan , Terzi Banu
Published: September 2018

Background

Testicular self-examination is important for the early diagnosis and treatment of testicular cancer; the nature of the examination itself influences individuals’ health beliefs about testicular self-examination.

Methods

This descriptive research study was carried out using 152 individuals working at Amasya University between August and November 2016. A personal information form and Champion’s Health Belief Model Scale were used for the data collection stage of this research. Descriptive statistical tests, Mann–Whitney U test, Kruskal–Wallis variance analysis and Cronbach’s alpha were used in the data analysis stage.

Results

Analysis of respondents’ sociodemographic data revealed that the study participants’ mean age was 38.88 ± 9.36, and that 112 participants (73.7%) were married and 76 participants (50.0%) had a graduate degree at the time the study was conducted. Of the research participants, 134 (88.2%) had no training on testicular self-examination; a statistically significant difference ( p < 0.05) was found between participants’ consciousness of their capability to perform testicular self-examination on their own and the mean factor scores of the Champion’s Health Belief Model Scale’s ‘barriers of testicular self-examination’ and ‘self-effectiveness’ items.

Conclusion

The study found that health beliefs play a part in individuals’ positive health behaviours regarding testicular self-examination.
The Power of Shape: How Shape of Node-Link Diagrams Impacts Aesthetic Appreciation and Triggers Interest
Authors: Carbon Claus-Christian , Mchedlidze Tamara , Raab Marius Hans , Wächter Hannes
Published: September 2018

Positive effects of aesthetically appreciated designs have long been studied and confirmed since the 19th century: such designs are more enjoyable, they are more forgivable for glitches and can increase users’ performance. In the field of information visualization, studies of aesthetics are still a niche approach. In the current study, we aim to specifically understand which parameters in a visualization of node-link diagrams make them aesthetically pleasing-an important extension to already existing research on usability and readability aspects. We investigated how the shape of the outline of such diagrams influences the aesthetic judgments on two of the most important dimensions of aesthetic appeal: beauty and interest. We employed different outlines to node-link diagrams and compared them with uniformly filled shapes, varying two important variables typically impacting aesthetics: complexity and curvature. This was done for a short (100 ms) and ad libitum presentation time. Diagrams with curvier outlines were perceived as more beautiful, while diagrams with more complex outlines were considered to be more interesting. These dependencies already exist for presaccadic perception (100 ms) and are slightly stronger for unlimited presentation time. We also found that curvature is a predictor for beauty only for unlimited presentation time. Aesthetic appeal was very similar for diagrams and pure shapes, so many results from fundamental research on aesthetics can potentially be transferred to the community of network visualization, assisting to improve visualizations also in aesthetic regards.