bluuebunny/crossref_metadata_2025 huggingface dataset:
Objective Thoracoscopic Criteria in Differentiation between Benign and Malignant Pleural Effusions
Authors: Ellayeh Mohamed , Bedawi Eihab , Banka Radhika , Sundaralingam Anand , George Vineeth , Kanellakis Nikolaos , Hallifax Robert , Abdelwahab Heba , Rezk Nasef , Hewidy Asem , Ali Raed , Wrightson John , Rahman Najib
Published: August 2021

Background: Thoracoscopy is the “gold standard” diagnostic modality for investigation of suspected pleural malignancy. It is postulated that meticulous assessment of the pleural cavity may be adequate to indicate malignancy through the macroscopic findings of nodules, pleural thickening, and lymphangitis. We attempted to critically assess this practice, by precisely defining objective macroscopic criteria which might differentiate benign from malignant pleural diseases according to intrapleural pattern and anatomical location, and thereby to explore the predilection of abnormalities to specific sites on pleural surfaces. Methods: A structured review of recorded video footage from medical thoracoscopy procedures in 96 patients was conducted by 2 independent assessors. Abnormalities were scored on agreed, objective criteria for the presence of nodules, lymphangitis and inflammation on each of the costoparietal, visceral and diaphragmatic surfaces. The costoparietal pleura was divided into 6 levels (apical, middle, and inferior surfaces of the lateral and posterior parietal pleura). The anterior surface of the costoparietal pleura was excluded from analysis after interim review as this surface was rarely seen. Results: In the benign group, inflammation was the predominant finding in 65% (n = 33; costoparietal), 44% (n = 21; visceral), and 42% (n = 15; diaphragmatic). Nodules were detected in 24% (n = 12; costoparietal), 8% (n = 4; visceral), and 8% (n = 3; diaphragmatic). The most affected surfaces with inflammation were the middle lateral (60%) and the inferior lateral (57.8%) parts of the costoparietal pleura. In the malignant group, nodules were the predominant finding according to surface in 73% (n = 33; costoparietal), 32% (n = 13; visceral) and 48% (n = 17; diaphragmatic). Inflammation was detected in 44% (n = 20; costoparietal), 25% (n = 10; visceral), and 29% (n = 10; diaphragmatic). The most affected surfaces with nodules were the middle lateral (67.4%) and inferior lateral (66.7%) costoparietal pleural surfaces. Conclusion: This is the first detailed, anatomical description of abnormalities in the pleural space during thoracoscopy. While nodules were the predominant pattern in malignant pleural effusion, they were detected in 24% of benign diagnoses. Detection of nodules in >1 area of the costoparietal pleura was in favor of a malignant diagnosis. Inflammation was the predominant pattern in benign pleural effusion. Our results suggest that macroscopic nodules in malignant diagnoses have a predilection for the middle and inferior surfaces of the lateral costoparietal pleura.
Intraoperative Neuromonitoring for Tethered Cord Surgery in Infants: Challenges and Outcome
Authors: Udayakumaran Suhas , Nair Niveditha S. , George Mathew
Published: August 2021

Objective: The aim of this study was to evaluate the efficacy and safety of intraoperative neuromonitoring (IONM) in surgery for tethered cord in infants. Materials and Methods: The study included 87 infants who underwent surgery for closed spinal dysraphism under IONM. Their preoperative neurological and urological statuses were compared with postoperative status clinically. The study design was prospective, and the study’s duration was from January 2011 to February 2020. IONM was performed (TcMEP and direct mapping) with an Xltek Protektor 32 IOM system, Natus Neurology/medical Inc., Middleton, USA. Statistical analysis in the form of χ2 is conducted using SPSS. Results: Overall, among 87 patients, clinical improvement was seen in 28 (28/29) patients with motor deficits, 17 (17/24) with bladder deficits, and 18 (18/24) with bowel deficits. The monitorability for motor and sphincter was 97.3% and 90.7%, respectively. The sensitivity of IONM in predicting new motor deficit was 100%, whereas the specificity was 100%. The negative predictive value of predicting motor deficit was 100%, with a diagnostic accuracy of 100%. There were no complications in this cohort related to the IONM. Conclusions: The study has highlighted that the use of IONM is sensitive in identifying motor injury in infants with reliable outcome correlation. Assessment, monitoring, and outcome correlation of bladder and sphincteric functions are a challenge in this cohort.
Retinal Neurovascular Structural Changes in Optical Coherence Tomography and the Relationship between These Changes and White Matter Hyperintensities in Patients with Migraine
Authors: Altunisik Erman , Oren Burak
Published: August 2021

Introduction: This study aimed to reveal whether retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) inner plexiform layer, and choroidal layer (CL) thicknesses differed in patients with migraine. Optical coherence tomography (OCT) was used to measure these neurovascular structural changes and determine the relationship between these structures and cranial white matter hyperintensities (WMHs). Methods: This retrospective comparative registry study included a total of 155 individuals aged 18–55 (mean, 33.50 ± 8.34), consisting of 110 migraine patients and 45 healthy controls. Results: RNFLs were thinner in the migraine group than the control group but not to a statistically significant degree. However, in both eyes, peripapillary RNLF thickness in some specific quadrants was found to be significantly thinner in the patient group than the control group. GCLs were significantly thinner in the migraine group than the control group. CLs were significantly thicker in the migraine group than in the control group. There was no significant difference between the OCT parameters of patients with and without WMH. An inverse correlation was found between disease duration and CL thickness. CLs were significantly thicker in patients in attack periods than those in attack-free periods. There was no significant difference between the OCT parameters of the migraine with aura and migraine without aura subgroups. Discussion/Conclusions: Retinal neural and vascular structures might be affected in migraine sufferers, including those in subgroups. Rebound vasodilation may cause alterations in CL thickness during a migraine attack. Factors other than hypoperfusion may contribute to the pathophysiology responsible for the formation of WMH.
Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry
Authors: Gallo Francesco , Gallone Guglielmo , Kim Won-Keun , Reifart Jörg , Veulemans Verena , Zeus Tobias , Toggweiler Stefan , De Backer Ole , Søndergaard Lars , Mangieri Antonio , Khokhar Arif , De Marco Federico , Regazzoli Damiano , Reimers Bernhard , Muntané-Carol Guillem , Estévez-Loureiro Rodrigo , Espino Antonio , Moscarelli Marco , Armario Xavier , Mylotte Darren , Gorla Riccardo , Bhadra Oliver Daniel , Conradi Lenard , Marroquin Donday Luis Alfonso , Nombela-Franco Luis , Barbanti Marco , Reddavid Claudia , Criscione Enrico , Brugaletta Salvatore , Regueiro Ander , Pérez-Fuentes Pedro , Nicolini Elisa , Piva Tommaso , Tzanis Giorgos , Rodes-Cabau Josep , Colombo Antonio , Giannini Francesco
Published: August 2021

Background:

An increased degree of aortic angulation (AA) represents a challenging feature for bioprosthesis positioning. Whether AA has an impact on procedural outcomes of contemporary self-expanding valves remains unsettled. The aim of this study was to evaluate the impact of AA on procedural outcomes of transcatheter aortic valve replacement with contemporary self-expanding valves.

Methods:

The HORSE (Horizontal Aorta in Transcatheter Self-Expanding Valves) is an international, retrospective registry including 3862 consecutive patients undergoing transcatheter aortic valve replacement with either Evolut R/PRO (n=1959) or ACURATE neo (n=1903) devices. Patients undergoing Evolut R 34 mm implantation were excluded as no comparable prosthesis size for ACURATE neo is available. AA was evaluated with preprocedural computed tomography, and its impact on device success was evaluated.

Results:

In the overall population, AA did not have any impact upon device success, also when adjusting for in-study outcome predictors (odds ratio for 1° increment, 0.99 [95% CI, 0.98–1.01],
P
=0.306). However, increased AA was associated with lower device success with use of the Evolut R/PRO valves (odds ratio, 0.97 [95% CI, 0.95–0.99];
P
=0.004), but not the ACURATE neo valves (odds ratio, 1.00 [95% CI, 0.98–1.03],
P
=0.304). The best AA cutoff value predicting device success was 49° (47% of the study cohort). Among patients with AA≥49°, Evolut R/PRO valves were associated with lower device success as compared to the ACURATE neo valve (inverse probability weighting odds ratio, 0.62 [95% CI, 0.46–0.83];
P
=0.002).

Conclusions:

Horizontal aorta, as defined by an AA ≥49°, is a common feature among transcatheter aortic valve replacement candidates and predicts device failure of the Evolut R/PRO valves, but not of the ACURATE neo valve. AA may be an effect modifier of the association between self-expanding valve type and device success.
Multicenter Cohort Study, With a Nested Randomized Comparison, to Examine the Cardiovascular Impact of Preterm Preeclampsia
Authors: McCarthy Fergus P. , O’Driscoll Jamie M. , Seed Paul T. , Placzek Anna , Gill Carolyn , Sparkes Jenie , Poston Lucilla , Marber Mike , Shennan Andrew H. , Thilaganathan Basky , Leeson Paul , Chappell Lucy C.
Published: August 2021

This study evaluated whether planned early delivery would ameliorate cardiovascular dysfunction 6 months postpartum, compared with usual care with expectant management, in women with late preterm preeclampsia. We conducted a mechanistic observational study in women with preterm preeclampsia between 34
+0
and 36
+6
weeks’ gestation, nested within a randomized controlled trial of planned early delivery versus expectant management (usual care), in 28 maternity hospitals in England and Wales. Women were followed up 6 months postpartum with cardiovascular assessments. The primary outcome was a composite of systolic and diastolic dysfunction (by 2009 and 2016 definitions of diastolic dysfunction). Between April 27, 2016, and November 30, 2018, 623 women were found to be eligible, of whom 420 (67%) were recruited. One hundred thirty-three women were randomized to planned delivery, 137 women were randomized to expectant management within the trial, while 150 women received expectant management outside of the trial. 321 (76.4%) completed their 6 month echocardiography assessment. 10% (31/321) had a left ventricular ejection fraction <55% while 71% (229/321) remained hypertensive. There were no differences in the primary outcome between the 2 randomized groups (planned delivery versus expectant management) using either the 2009 (risk ratio, 1.06 [95% CI, 0.80–1.40]) or 2016 definitions (risk ratio, 0.78 [0.33–1.86]). In conclusion, we demonstrated that late preterm preeclampsia results in persistence of hypertension in the majority and systolic LV dysfunction in 10%, of women 6 months postpartum. Planned early delivery does not affect these outcomes. Preeclampsia is not a self-limiting disease of pregnancy alone.
The Quaternary Stratigraphy of a Section of the Sibowe River, South-West Swaziland.
Authors: Ampe Carole
Published: August 2021

In south-west Swaziland a river terrace along the Sibowe river is formed by active river incision. A complex profile along this terrace showing alluvial and colluvial deposits reflecting changes in environmental conditions since at least the last 30000 years is exposed. Examination of soil characteristics, relative position of the composite strata as well as river dynamics leads to a stratigraphic interpretation which has been fitted into a time frame. The basal gravel, alluvial in nature, dates from before the deposition of the Mphunga colluvium which has been deposited between 30 300 and 8490 before present. On the colluvium occurs an alluvium most probably deposited during the Early Holocene. The incision of the terrace to its present level has occurred during the Late Holocene.
Sites and objects, indigenous library and the history of Laimbwe, Cameroon
Authors: Kah Henry Kam
Published: August 2021

This study focuses on the construction of the history of the Laimbwe people of Cameroon through indigenous methods of enquiry and/or epistemologies. These include analyses of surviving historical objects, sites and artefacts from the pre-colonial period to the reunification of British Southern Cameroons with the Cameroun Republic in 1961. Some traditional items of the Laimbwe people of Cameroon and existing artefacts as well as sites reveal a very rich history with information that Western and conventional research have not vividly captured. In this paper, we reflect on the salience of these sources in understanding the rich socio-cultural and political history of the Laimbwe. There is a need to document this as an indigenous African library in this age of globalisation so that indigenous knowledge systems are disseminated to a wider academic audience. A construction of Laimbwe history through these indigenous forms of the library present them as new perspectives of local epistemologies beyond the capture of the western library introduced into Africa during the colonial period and even before. It continues to shape the way African national and local histories are written based on Western interpretations and or epistemologies.
Distribution and frequent occurrence of diatom taxa (Bacillariophyta) inhabiting warmer oceans in Seogwipo coast of Jeju Island, southernmost Korea
Authors: JOH GYEONGJE
Published: August 2021

The epiphytic diatoms attached to seaweeds and benthic diatom assemblages, have been collected along the Seogwipo coast in Jeju Island, South Korea. In the last three-year survey, 80 diatom taxa inhabiting warmer oceans have been found, including those in the tropical and subtropical regions such as the Pacific Ocean, the Caribbean Sea, the western Indian Ocean, and other warmer regions. These diatom flora shows a worldwide pattern that concentrated around the Tropic of Cancer. This survey of local areas reveals the existence of many rare or retrieved taxa that were not well known until recently. Furthermore, some of them, including Aulacodiscus affinis, Leudugeria janischii, Hyalosynedra lanceolata, Trachyneis velata var. ornata, Lyrella concilians have been reported for the first time since the first entry or haven been reported only once. Of the diatom flora described here, 48 taxa are new to South Korea and previously unrecorded in the local area.
New records of solitary vespid wasps (Hymenoptera: Vespidae: Masarinae and Eumeninae s. l.) from the Nakhchivan Autonomous Republic of Azerbaijan
Authors: FATERYGA ALEXANDER V. , PROSHCHALYKIN MAXIM YU. , MAHARRAMOV MAHIR M. , ASTAFUROVA YULIA V.
Published: August 2021

An account on 35 species in the family Vespidae (subfamilies Masarinae, Eumeninae s. str., and Raphiglossinae) is presented. Genera Jugurtia de Saussure, 1854, Quartinia André, 1884, Brachypipona Gusenleitner, 1967, and Cyrtolabulus van der Vecht, 1969, as well as 17 species and one subspecies are new to Azerbaijan. Three additional species are new to the Nakhchivan Autonomous Republic; the records of nine species confirm previous doubtful reports from the territory of the autonomy. One species is excluded from the fauna of Azerbaijan. New synonymies are proposed: Antepipona orbitalis (Herrich-Schäffer, 1839) = A. orbitalis ballioni (Morawitz, 1867), syn. nov.; A. varentzowi (Morawitz, 1895) = A. laevigata (Blüthgen, 1951), syn. nov.; Euodynerus disconotatus (Lichtenstein, 1884) = E. disconotatus sulfuripes (Morawitz, 1885), syn. nov. = E. disconotatus laniensis Giordani Soika, 1979, syn. nov.; E. semisaecularis (von Dalla Torre, 1889) = E. semisaecularis macedonicus (Blüthgen, 1951), syn. nov.; Gymnomerus laevipes (Shuckard, 1837) = G. laevipes scandinavus (de Saussure, 1856), syn. nov.; Odynerus albopictus de Saussure, 1856 = O. albopictus calcaratus (Morawitz, 1885), syn. nov. = O. albopictus kazakhstanicus Kurzenko, 1977, syn. nov. Hitherto unknown males of Brachyodynerus kusdasi Gusenleitner, 1967 and Brachypipona orientalis Gusenleitner, 2004 are described. The number of species of solitary Vespidae known from the Nakhchivan Autonomous Republic of Azerbaijan is increased to 91, with one additional subspecies which requires a revision. A preliminary list of these wasps of the whole Azerbaijan is presented; it contains 107 identified species and one additional subspecies.
A taxonomic revision of the South American species of Pseudocanthon Bates, 1887 (Coleoptera: Scarabaeidae: Scarabaeinae: Deltochilini)
Authors: NAZARÉ-SILVA EVERTON E. , SILVA FERNANDO A.B.
Published: August 2021

The South American species of Pseudocanthon Bates, 1887 (Coleoptera: Scarabaeidae: Scarabaeinae: Deltochilini) are reviewed. In this work, 10 valid species and two subspecies are recognized for the genus. Among these species, five are recorded in South America, including three new species: P. perplexus (LeConte, 1847), P. xanthurus (Blanchard, 1847), P. vazdemelloi new species, P. pantanensis new species, and P. chaquensis new species. A lectotype is designated for P. xanthurus (Blanchard, 1847). In this revision, each species is analyzed as follows: a detailed literature review, an identification key for the South American species, a diagnosis, descriptions, illustrations of key morphological characters, list of examined material, and geographic distribution.
Post-Operative Wound Infection by Multiple Zoonotic Organisms
Authors: Albert Matthew , Wright Jesse P. , Ocariz Brandon
Published: August 2021

Rhodococcus hoagii (formerly Rhodococcus equi), originally isolated from equine species, is primarily transmitted through inhalation of contaminated aerosols such as dust and even breath of infected livestock. Pasteurella multocida is a common cause of cellulitis secondary to canine and feline bites. These are 2 zoonotic microbes that can present with potentially life-threatening, systematic illness in immunocompromised patients.

In this brief report, we delineate the clinical course of a 42-year-old post-operative patient (status post-elective exploratory laparotomy, extensive adhesiolysis, and excision of enterocutaneous fistula with creation of an end ileostomy) who developed multiple infections involving these two zoonotic microbes. The patient is an enthusiast of exotic animals with an extensive occupational history as a zookeeper. She was determined to be HIV negative but has a significant history of Crohn’s disease managed with systemic immunosuppressive therapy. This case highlights her unusual constellation of post-operative infections and her subsequent medical management.
Introduction to the Special Issue: Integration of Practice, Advocacy, and Research in Counseling Psychology
Authors: Moore-Lobban Shavonne , Singh Anneliese A. , O’Leary Wiley Mary
Published: August 2021

In this article, we introduce the special issue of The Counseling Psychologist on the integration of practice, advocacy, and research in counseling psychology. This special issue was driven by Dr. Shavonne Moore-Lobban’s project as a member of the Society for Counseling Psychology Leadership Collaborative. The aim of the special issue is to highlight the unique practice, advocacy, and research contributions of practitioners, and specifically focus on the integration of the three roles of everyday counseling psychologists. There are six practitioner-led manuscripts that strengthen a focus within counseling psychology of the integration across the three roles, and through the diverse lens of counseling psychologists as therapists, supervisors, educators, researchers, program developers, and advocates. The development of this special issue is reviewed. We provide a brief summary of the manuscripts and discuss implications for continued integration.
Global scientific collaboration: A social network analysis and data mining of the co-authorship networks
Authors: Isfandyari-Moghaddam Alireza , Saberi Mohammad Karim , Tahmasebi-Limoni Safieh , Mohammadian Sajjad , Naderbeigi Farahnaz
Published: August 2021

Co-authorship networks consist of nodes and numerous links indicating scientific collaboration of researchers. These networks could be studied through social networks analysis and data mining techniques. The focus of the article is twofold: the first objective is the analysis of the co-authorship networks of the top 60 countries that had the highest number of scientific publications in the world, and the second one is the discovery of collaboration patterns of highly cited papers of these countries. To do so, all scientific publications of the top 60 countries in all fields as well as their highly cited papers were included in the study period between 2011 and 2015. The research samples in the first part included 10,460,999 documents and in the second part encompassed 711,025 highly cited papers. Required data were extracted from web of science database. To analyse co-authorship networks, centrality indices and clustering coefficient were used. UCINET, Pajek, VOSviewer and BibExcel software were used to map co-authorship networks of the countries and to calculate indices. Finally, the discovery of collaboration patterns in highly cited papers is studied through association rules. The research data indicated that over 95% of documents has been produced by the top 60 countries. In addition, the USA, Germany, England, France and Spain launched the most co-authorship. Quantitatively, there have been the most powerful collaboration links between China and the USA, the USA and England, the USA and Germany, and the USA and Canada. The clustering data indicated that collaborations of the top countries of the world were in three main clusters. The Friedman test showed that there was a significant difference in the priorities of the countries for collaboration; and the USA, China, England, Germany, France, Japan and Italy are in the top priority for collaboration, respectively. The results of collaboration pattern in highly cited papers indicated that the USA participates in more than half of collaboration patterns for producing highly cited papers.
Comprehensive Evaluation Model and Empirical Research on Railway Freight Rates in a Competitive Environment
Authors: Zeng Jin , Qi Fangrong , Guo Shaoyuan , Zeng Jinhao
Published: August 2021

This study aims to establish criteria to evaluate performance in railway freight pricing policy and to strengthen the marketing ability of the railway freight enterprise. The evaluation method used in our study is known as the improved grey relation analysis evaluation. Fifteen factors that influence freight pricing strategy are selected in this paper to establish a freight rate evaluation index system and comprehensive evaluation index values for monthly freight rates are calculated. The improved grey relation analysis not only considers the relation between each index and freight rate but also examines the relationship between each index. We find that the comprehensive evaluation state using the improved grey relation analysis evaluation method can better fit the 2015–2017 changes in monthly railroad freight revenue than the traditional grey relation analysis evaluation. Furthermore, an optimal pricing model for freight shipping by train is built and calculated using the bi-level programming model. Finally, the S Railway Bureau’s actual coal transportation in 2017 is taken as an experiment to support the validity of the improved grey relation analysis method. We find that when the monthly results of improved grey evaluation grades are compared with the grade evaluation of the gap between the historical shipping coal rates and the optimal freight shipping rates, the comparison of results matches well. The research work is helpful to policymakers who need to judge the performance of the market price.
Novel Model to Predict Critical Strain Energy Release Rate in Semi-Circular Bend Test as Fracture Parameter for Asphalt Mixtures Using an Artificial Neural Network Approach
Authors: Barghabany Peyman , Zhang Jun , Mohammad Louay N. , Cooper Samuel B. , Cooper Samuel B.
Published: August 2021

Growing use of recycled asphalt materials in asphalt pavement means the current volumetric-based Superpave mixture design may not address durability concerns arising from replacement of a proportion of virgin binder with recycled ones. To address this limitation, performance-based testing is introduced to supplement conventional volumetric mixture design in assessing cracking performance of asphalt mixtures. Louisiana Department of Transportation and Development’s Specifications for Roads and Bridges specify a criterion for the critical strain energy release rate, Jc, obtained from semi-circular bend (SCB) test as a complement of current practice to evaluate cracking resistance of asphalt mixtures. Quality control/assurance practices, however, require SCB samples to be long-term aged for five days at 85°C, which is a time-consuming process. Therefore, it is beneficial to be able to estimate SCB Jc for long-term aged asphalt mixtures based on SCB Jc measured from plant-produced asphalt mixtures. Asphalt mixture aging is complex, and various variables are involved in the aging process, including volumetric properties of asphalt mixture and chemical/rheological characteristics of asphalt binder. With the capability of artificial neural network (ANN) to address complex relationships between input and output variables, this study aims to predict the fracture parameter, SCB Jc, of asphalt mixtures using ANN. A total of 34 asphalt mixtures were selected for this study. SCB fracture test and asphalt binder tests for chemical and rheological characterization were conducted. Stepwise regression analysis was used to determine the significant parameters in the correlation with SCB Jc. With determined significant parameters, ANN using the gradient descent backpropagation approach was then applied to develop and validate the predictive model. It was shown that the developed ANN model was able to predict the fracture parameter, SCB Jc, of asphalt mixtures more accurately than linear and non-linear regression models.
Taxi Global Positioning System Data in Urban Road Network: A Methodology to Identify Key Road Clusters Based on Travel Speed–Traffic Volume Correlation
Authors: Li Yi , Li Weifeng , Yu Qing , Yang Han
Published: August 2021

Urban traffic congestion is one of the urban diseases that needs to be solved urgently. Research has already found that a few road segments can significantly influence the overall operation of the road network. Traditional congestion mitigation strategies mainly focus on the topological structure and the transport performance of each single key road segment. However, the propagation characteristics of congestion indicate that the interaction between road segments and the correlation between travel speed and traffic volume should also be considered. The definition is proposed for “key road cluster” as a group of road segments with strong correlation and spatial compactness. A methodology is proposed to identify key road clusters in the network and understand the operating characteristics of key road clusters. Considering the correlation between travel speed and traffic volume, a unidirectional-weighted correlation network is constructed. The community detection algorithm is applied to partition road segments into key road clusters. Three indexes are used to evaluate and describe the characteristic of these road clusters, including sensitivity, importance, and IS. A case study is carried out using taxi GPS data of Shanghai, China, from May 1 to 17, 2019. A total of 44 key road clusters are identified in the road network. According to their spatial distribution patterns, these key road clusters can be classified into three types—along with network skeletons, around transportation hubs, and near bridges. The methodology unveils the mechanism of congestion formation and propagation, which can offer significant support for traffic management.
A Qualitative Study of the Social and Lived Experiences of Homebound Older Adults
Authors: Cheng Joyce M. , Batten George P. , Yao Nengliang (Aaron)
Published: August 2021

Objective:

The number of homebound older adults is increasing in the United States. We aimed to examine their social and lived experiences and to understand their perspectives on their situation, feelings, and coping mechanisms.

Methods:

We conducted a cross-sectional qualitative study using semi-structured interviews with 18 older homebound individuals in Central Virginia.

Results:

Homebound older adults experienced both physical and mental health challenges that restricted their ability to participate in activities of daily living, recreation, and social interactions. Participants often felt dependent, helpless, lonely, and socially isolated. Those who communicated regularly with friends, family, and health care providers reported positive benefits from these interactions.

Discussion:

Participants faced challenges to their physical, emotional, and mental well-being. Our findings might help clinicians, policymakers, and community organizations understand how to better support homebound older adults. We should provide educational opportunities, respect their autonomy, and implement initiatives to address their isolation and loneliness.
A QMM-MOP methodology for the maintenance scheduling of multistage manufacturing systems with a stream of deterioration
Authors: Lu Biao
Published: August 2021

In multistage manufacturing systems, a stream-of-deterioration (SOD) phenomenon poses two challenges for effective preventive-maintenance (PM) scheduling. First, the deterioration of each machine contributes to the deterioration of the final-product quality, and thus timely PM should be conducted to prevent excessive quality deterioration. Second, the deterioration of different machines leads to different degrees of deterioration in the final-product quality; thus, the PM of different machines will result in different degrees of improvement in the final-product quality. To address both challenges, a QMM-MOP methodology that adopts an interactive bi-level scheduling framework is proposed. In machine-level scheduling, a quality-integrated maintenance model (QMM) is developed by incorporating intermediate-product quality deterioration into the total cost to schedule timely PM for each individual machine. In system-level scheduling, maintenance-operation prioritization (MOP), based on a SOD-enabled quality-improvement factor, is proposed to select machines for PM. The case study shows that the proposed methodology can ensure a higher final-product quality with a lower total cost. The contribution of this paper is to develop a QMM-MOP methodology that integrates product-quality improvement into an interactive bi-level PM scheduling framework and enables MOP based on the-quality improvement factor to best improve the final-product quality.
Analytical modeling of tool failure boundary map in milling titanium alloy
Authors: Du Yan-jie , Yue Cai-xu , Li Xiao-chen , Liu Xian-li , Liang Steven Y.
Published: August 2021

As a typical aerospace difficult-to-machine material, tool failure in milling titanium alloy Ti6Al4V will reduce the stability of the milling process and affect the surface quality of the workpiece. Aiming at the fact that cemented carbide tools are prone to wear failure and breakage failure in milling titanium alloy, a safe tool failure boundary map is provided to ensure that the tools will not occur failure with the cutting parameters selected in the safe area during the prediction time. Based on the processing characteristics of Ti6Al4V, the failure boundary map mainly considers three forms of tool failure: flank wear, rake wear, and cutting edge breakage. By revealing the three failure mechanisms, the failure analytical model is established and the failure boundary map is obtained. Compared with the experimental results, it has good consistency, and the research results can provide a reference for the field of titanium alloy cutting process.
Book review: Sasanka Perera, The Fear of the Visual? Photography, Anthropology, and Anxieties of Seeing
Authors: Reddy Busam Monika
Published: August 2021

Sasanka Perera, The Fear of the Visual? Photography, Anthropology, and Anxieties of Seeing. Orient Blackswan, 2020, 260 pp., ₹850 (hardback).
The SIF protocol: A seven-step strategy to minimize complications potentially related to the insertion of femorally inserted central catheters
Authors: Brescia Fabrizio , Pittiruti Mauro , Ostroff Matthew , Spencer Timothy R , Dawson Robert B
Published: August 2021

The insertion of central venous catheters through the femoral veins is not uncommon and is potentially associated with the risk of immediate puncture-related complications and severe late complications as infection and thrombosis. As for other central venous access devices, the use of a standardized protocol of insertion and the correct application of evidence-based strategies are beneficial in reducing the risk of complications. We proposed a standardized protocol (S.I.F.: Safe Insertion of Femorally Inserted Central Catheters) consisting of seven strategies that should be part of vascular cannulation and should be adopted during the insertion of femoral venous catheters, aiming to minimize immediate, early and late insertion-related complications. These strategies include: preprocedural evaluation of the patient history and of the veins, appropriate aseptic technique, ultrasound guided puncture and cannulation of the vein, intra-procedural assessment of the tip position, adequate protection of the exit site, proper securement of the catheter, and appropriate coverage of the exit site.
Tumor lysis Syndrome in a Patient with Metastatic Breast Cancer Treated with Alpelisib
Authors: Handy Caitlin , Wesolowski Robert , Gillespie Michelle , Lause Michael , Sardesai Sagar , Williams Nicole , Grimm Michael , Kassem Mahmoud , Ramaswamy Bhuvaneswari
Published: August 2021

Purpose:

Tumor lysis syndrome (TLS) is a rare but life-threatening phenomenon that occurs mainly in patients with aggressive hematologic or highly chemotherapy sensitive solid tumors such as high-grade neuroendocrine carcinoma or testicular cancer. Tumor lysis syndrome is exceedingly rare in hormone receptor-positive, HER2-negative breast cancer. Furthermore, TLS following treatment with alpelisib, a novel phosphatidylinositol 3-kinase (PI3K) inhibitor used to treat PIK3CA-mutated (gene encoding p110α subunit of PI3K), hormone receptor positive advanced breast cancer, has never been described in patients with nonhematologic malignancies.

Methods:

In the following case, we present a patient with hormone receptor-positive, HER2-negative, PIK3CA-mutated metastatic breast cancer who developed TLS 12 days after starting fulvestrant and alpelisib.

Results:

Patient was promptly treated with improvement in her renal function to baseline without requiring renal replacement therapy. Alpelisib was resumed at a reduced dose with no further complications.

Conclusion:

Through this case, we discuss the potential complications of TLS and the importance of prompt recognition and treatment.
Preventing children’s death by heatstroke: How alternative accident theories affect policy design and evaluation
Authors: Di Giulio Marco
Published: August 2021

When public policies are designed from scratch, with no or limited possibility of learning from past experience, decision makers rely on their creativity and lateral thinking to counterbalance cognitive biases. One of the crucial issues for both evaluators and policy makers in such situations is not only to elaborate a sound theory of the programme but also to be aware of the existence of competing theories to solve the same problem. Being able to detect such theories constitutes an essential step to avoid ‘Type III errors’, that is, enacting the right solution for the ‘wrong’ problem. Reflecting on the analysis of two programmes aimed at preventing the death of children by heatstroke, this article illustrates the implications of alternative ‘accident theories’ for the evaluation of safety policies.
Viscoelastic stressed microbeam analysis based on Moore–Gibson–Thompson heat equation and laser excitation resting on Winkler foundation
Authors: Abouelregal Ahmed E , Ahmad Hijaz , Badr Souha K , Almutairi Bander , Almohsen Bandar
Published: August 2021

In this work, a modified viscoelastic model of initially stressed microbeam on the base of the Winkler foundation under the effect of ultrafast laser heating and axial stress has been proposed. Viscosity effects are taken into account following the Kelvin–Voigt model. The governing equation for the thermoelastic vibration of the microbeam is obtained when the thermal field effect is defined by the non-Fourier Moore–Gibson–Thompson (MGT) heat equation. The microbeam is seen as an Euler–Bernoulli beam that is exposed to varying sinusoidal heat. An analytical solution to the problem has been presented on the basis of the Laplace transform in addition to applying a numerical method to find inverse transformations. A numerical illustration is organized in the discussion section which discusses the impact of different effective parameters both on the vibrational behavior of a microbeam system and on the field variables. The viscous damping coefficient, laser pulse duration, and axial load greatly affect the deflection and temperature responses. The results obtained are verified and compared with the literature.
The antifascist boxing body: Political somatics in boxe popolare
Authors: Pedrini Lorenzo , Brown David , Navarini Gianmarco
Published: August 2021

Palestre popolari (‘people’s gyms’) are flourishing in contemporary Italy. These gyms are run by leftist grassroots organizations (ANTIFA), which promote an alternative boxing style: boxe popolare (‘people’s boxing’). Drawing on a three-year ethnography, this article focuses on body usages in boxe popolare. Connecting Mauss with Bourdieu, the study elucidates that the ways in which bodies are deployed in boxe popolare shape a scheme of dispositions – mutualism, combat, engagement and conviviality – forming an antifascist pugilistic habitus. A leftist physicality is hence incorporated as an interpolation of political dispositions with virtues of prowess, self-control and toughness, instilled in boxe popolare bodies regardless of their gender identity. This emergent leftist physicality becomes bodily hexis as soon as it is displayed publicly by the fighters, both men and women, as the legitimate representation of the political community to which they belong. The study ends highlighting implications for research about political somatics.
An innovative machine learning based framework for water distribution network leakage detection and localization
Authors: Fan Xudong , Yu Xiong (Bill)
Published: August 2021

Leakages in the underground water distribution networks (WDNs) waste over 1 billion gallon of water annually in the US and cause significant socio-economic loss to our communities. However, detecting and localization leakage in a WDN remains a challenging technical problem despite of significant progresses in this domain. The progresses in machine learning (ML) provides new ways to identify the leakage by data-driven methods. However, in-service WDNs are short of labeled data under leaking conditions, which makes it infeasible to use common ML models. This study proposed a novel machine learning (ML)-based framework for WDN leak detection and localization. This new framework, named clustering-then-localization semi-supervised learning (CtL-SSL), uses the topological relationship of WDN and its leakage characteristics for WDN partition and sensors placement, and subsequently utilizes the monitoring data for leakage detection and leakage localization. The CtL-SSL framework is applied to two testbed WDNs and achieves 95% leakage detection accuracy and around 83% final leakage localization accuracy by use of unbalanced data with less than 10% leaking data. The developed CtL-SSL framework advances the leak detection strategy by alleviating the data requirements, guiding optimal sensor placement, and locating leakage via WDN leakage zone partition. It features excellent scalability, extensibility, and upgradeability for applications to various types of WDNs. It will provide valuable a tool in sustainable management of the WDNs.
AbsorbaSeal™ 5.6.7F vascular closure device: A good laboratory practice chronic study evaluating safety and efficacy in a healthy porcine model
Authors: Ayuso Sullivan A , Shipp R Caroline , Aladegbami Bola G , Farquharson Delton , Lawson Denny , Bassett Randy
Published: August 2021

Objectives

Vascular closure devices (VCDs) are widely used for arteriotomy closure after percutaneous catheter–based procedures. In comparison to manual compression, VCDs have been associated with shorter time to hemostasis, shorter time to ambulation, and also decreased length of stay. Complexity of deployment, lack of immediate hemostasis, and residual deformity of the arterial wall remain as limitations of current VCDs. The aim of this study was to investigate the AbsorbaSeal™ 5.6.7F vascular closure device, a novel, completely bioabsorbable, intuitive, and easy to use VCD which uses a compressive, “sandwich”-type design comprising a low profile intravascular distal seal and gasket and an extravascular floating foot and proximal seal, in an open infrarenal aortic swine model.

Methods

Eight fully heparinized swine at a good laboratory practices facility underwent AbsorbaSeal™ 5.6.7F VCD closure of three 6F arteriotomies each in the proximal, mid, and distal infrarenal aorta. Two swine underwent harvest at each of four time cohorts: 30, 60, 90, and 120 days. Acute and chronic procedural safety and efficacy, as well as target site vascular remodeling over time, were the primary outcomes evaluated. Secondary outcome measures included local and systemic inflammatory responses, end-organ tissue analysis, and device-related complications through the follow-up periods. Histopathological evaluation was performed by a blinded pathologist. Standard statistical methods were used.

Results

In deployment of 24 AbsorbaSeal™ 5.6.7F VCDs, there were no device-related complications or mortalities. All deployments resulted in rapid arteriotomy seal (100% deployment success), with a mean time to hemostasis (cessation of arterial flow) of 21.5 s (median: 6.5 s) across a mean activated clotting time (ACT) of 356 s. Twenty of the 24 implant sites (83%) attained complete hemostasis within 20 s. Immediate post-implant and pre-termination angiographies at all time points were performed of all swine which demonstrated normal aortic appearance and tissue structure and normal downstream vascular beds. At 30 days, each implant’s intravascular distal seal and gasket were removed from the circulation and completely covered with a smooth neointimal layer. Minimal inflammation and no intimal or luminal thrombus were observed at any site at every time point.

Conclusions

AbsorbaSeal™ 5.6.7F is a safe, effective, and secure VCD that demonstrates rapid hemostasis in a fully heparinized open aortic porcine model. Removal from circulation and complete coverage of the intravascular distal seal and gasket with neointima occurred within 30 days post-implant. Natural transmural vessel healing from the arteriotomy itself with minimal inflammation was noted for each implant at every time point.
Dynamic and gradual coupled reliability analysis of the transmission system of a shearer cutting arm
Authors: Zhu Lisha , Yuan Cong , Li Huanjun , Huang Jing
Published: August 2021

The strong impact and heavy load imposed on the transmission system of a shearer cutting arm is a potential cause of system variation and deterioration. And the overall equipment performance and output efficiency of a drum shearer cutting arm depends to a large degree on the reliability of the transmission system. Therefore, the current study proposes an innovative method for precise prediction of the reliability of the transmission system considering dynamic characteristic and performance degradation. Firstly, for the sake of quantifying the time-dependent reliability with deterioration parameters, a dynamic model of the geared rotor system is established based on the finite element method and the dynamic response is derived based on the main failure mode and the stochastic process model. Then the reliability and reliability sensitivity are estimated based on the probability perturbation theory and the fourth-order moment method. Finally, the proposed method is validated through a comparison to the canonical Monte Carlo Simulation method, which exhibits an average discrepancy of merely 3%. The present method serves as a theoretical guidance and applicable tool for both design and manufacture of coal shearers.
Representing Chinese Indonesians: Pribumi Discourse and Regional Elections in Post-Reform Indonesia
Authors: Chen Jonathan
Published: August 2021

Utilising Pitkin’s concept of representation, this article surveys the landscape of Chinese Indonesian political representation since the advent of regional elections in 1999. Analyses of the dataset of individual profiles of Chinese Indonesian executives, as they adopt inclusive-pairing tactics by taking on deputised roles or appeal using charisma, had demonstrated that there was a visible transition from “descriptive” towards more “substantive” forms of political representation in various constituencies – seen as the most important dimension of ideal representation despite the presence of soft ethnic politics. Recent appeals to indigenism ( pribumi-ism), especially in the wake of Jakarta governor Ahok’s failed re-election bid in 2017, had the effect of confining representational politics towards the narrow margins of ethnicity above all else. This article looks at the precarity of thedivide between pribumis and Chinese Indonesians ( Tionghoa) from the perspective of political representation at the regions and fills in the lacuna of political representativeness in post-reform Indonesia – overlooked so far by critiques of democracy.
The role of noninvasive imaging in the diagnostic workup for pulsatile tinnitus
Authors: Tao Alice J , Parikh Neal S , Patsalides Athos
Published: August 2021

Objective

We sought to assess the diagnostic yield of advanced noninvasive imaging in the evaluation of patients with pulsatile tinnitus.

Background

Pulsatile tinnitus can be caused by high-risk cerebrovascular pathologies such as arteriovenous fistulae. The role of advanced noninvasive imaging, including magnetic resonance angiography and magnetic resonance venography, in the diagnostic evaluation of pulsatile tinnitus is not well defined.

Design and methods

We performed a retrospective cohort study of patients presenting for outpatient diagnostic evaluation of pulsatile tinnitus from January 2018 to March 2020 at Weill Cornell Medicine. Patients with non-pulsatile tinnitus and established etiologic diagnoses were excluded. Systematic chart abstraction was summarized using standard descriptive statistics. Univariate logistic regression was used to identify factors associated with nondiagnostic noninvasive imaging.

Results

A total of 187 patients (139 (74.3%) women) took part in this study, with a mean age of 48.6 years (standard deviation ( SD) = 15.5 years) and a mean body mass index (BMI) of 26.9 kg/m2 ( SD = 6.1 kg/m2). Of the 187 patients, 121 (64.7%) underwent exclusively noninvasive imaging, and 66 (35.3%) patients also had digital subtraction angiography (DSA). In patients who had exclusively noninvasive imaging, 62 (51.2%) patients received a diagnosis. In patients who underwent noninvasive and DSA imaging, 14 (21.2%) patients received a diagnosis based on DSA. Patients who were older at symptom onset (odds ratio (OR) = 1.05; 95% confidence interval (CI) 1.01–1.09) and those with a lower BMI (OR = 0.88, 95% CI 0.77–0.98) were more likely to have nondiagnostic noninvasive imaging.

Conclusion

Noninvasive cerebrovascular imaging often uncovers the etiology of pulsatile tinnitus. DSA remains useful for additional evaluation for patients with specific associated features.