bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical and experimental study on the joint forming mechanism in the pneumatic splicing process
Authors: Zhou Yingjie , Wu Zhenyu , Liu Yisheng , Xiang Zhong , Hu Xudong
Published: March 2019

This study presents an investigation on the joint forming mechanism of pneumatic splicing by numerical and experimental methods. A one-way coupling numerical model concerning interaction between fluid and filaments was established to simulate the complex motion of a flexible body in a spiral flow field. The airflow field in the splicing chamber, which contributes to longitudinal and normal aerodynamic force along a filament regarded as a digital chain composed of a series of interconnected rods, was obtained by a two-equation turbulent computational fluid dynamics model. Contact-friction behavior within filaments was also taken into consideration. An iterative algorithm was adopted to update the displacement of filaments and the corresponding aerodynamic force. A high-speed visualization test bench was built to record the sequence motion of filaments in the splicing process. The splicing mechanism within flexible filaments was identified by comparison between the experimental data and numerical results. The filament portion located in the homolateral rotating channel with respect to orifice is blown to bent by the jet airflow. It contributes to a frontal area in the axial airflow direction, causing the filament to be retracted toward its fixed end. Meanwhile, the portion in the contralateral rotating channel tries to wrap around the opposite filaments due to the spiral airflow. The interaction between filaments generates the contact force and related friction force, which commonly resists the retracting force exerted on the homolateral filament portion. The competition between the two forces determines whether the joint can be formed. Furthermore, the influence of the overlapping length on splicing behavior was discussed.
Sister Outsider and Audre Lorde in the Netherlands: On Transnational Queer Feminisms and Archival Methodological Practices
Authors: Frank Chandra
Published: March 2019

This article takes direction from the transnational feminist lesbian encounter that took place between the Dutch collective Sister Outsider and Audre Lorde in the 1980s to reflect on the role of archives within transnational feminist research. Drawing on archival materials from the International Archive for the Women’s Movement (IAV) at Atria (Institute on Gender Equality and Women’s History) in Amsterdam in the Netherlands, and the Audre Lorde Papers at Spelman College in Atlanta, Georgia in the United States, I consider how fragmented archives offer stories on kinship, intimacy and loss. Taking into account the ‘absences’ and ‘presences’ (Lewis, 2017) produced in this archival research project, I propose an archival research methodology that is rooted in a practice of ‘orientation’ (Ahmed, 2006a, 2006b), ‘listening’ (Campt, 2017) and ‘intervention’ (Appadurai, 2003).
Let There Be Clamor: Exploring the Emergence of a New Public Sphere in India and Use of Social Media as an Instrument of Activism
Authors: Dey Sreyoshi
Published: March 2019

This article traces the emergence of a new public sphere in India by applying a critical-cultural theoretical lens to the digital discourse on the Twitter platform surrounding the 2014 Jadavpur University student movement against on-campus sexual violence. Social media platforms allowed the student movement to challenge not only the sociopolitical complications in academia but also the structural silence surrounding issues of sexual assault in the country. In this study, the method of qualitative textual analysis is used to critically analyze the tweets made using the hashtag #hokkolorob (meaning “let there be clamor”), during the movement. The findings in this examination indicate that the Internet today has the capacity to guide public opinion formation, influence collective action, and is emerging as a discursive public sphere among the youth of India. This study contributes toward an understanding of the use of social media communication for political mobilization in the Indian context.
How do mothers manage their privacy with adolescents? Exploring mother–adolescent communication in Mexican immigrant families
Authors: Shin YoungJu
Published: March 2019

The present study seeks to understand how Mexican immigrant mothers manage private information with adolescent children activating the state of emotional parentification. “Emotional parentificiation” occurs when there is a role reversal between parent and adolescent where the child is prematurely given adult responsibilities in the family and provides emotional support to parents. Sixteen Mexican immigrant mothers participated in individual interviews and as a result of the thematic analysis, three themes were identified: (1) adolescent children serving as a reluctant confidant, (2) adolescent children becoming a deliberate confidant, and (3) adolescent children employing confidant privacy rule strategies. Findings discussed mothers’ perspective of adolescent children coping with unsolicited private information from their mothers during parent–adolescent conversations where the adolescent children were put into a situation of being a reluctant confidant. Findings also demonstrated that some adolescent children became a deliberate confidant seeking information from their mothers. In reaction to mothers’ disclosure, the study identified three types of confidant privacy rule strategies used by adolescent children, that is, comforting, mediating, and protecting.
Morphine self-administration alters the expression of translational machinery genes in the amygdala of male Lewis rats
Authors: Ucha Marcos , Coria Santiago M , Núñez Adrián E , Santos-Toscano Raquel , Roura-Martínez David , Fernández-Ruiz Javier , Higuera-Matas Alejandro , Ambrosio Emilio
Published: March 2019

Background:

Addiction is a chronic disorder with a high risk of relapse. The neural mechanisms mediating addictions require protein synthesis, which could be relevant for the development of more effective treatments. The mTOR signaling pathway regulates protein synthesis processes that have recently been linked to the development of drug addiction.

Aims:

To assess the effects of morphine self-administration and its subsequent extinction on the expression of several genes that act in this pathway, and on the levels of specific phosphoproteins (Akt, Gsk3α/β, mTOR, PDK1 and p70 S6 kinase) in the amygdala, nucleus accumbens, and the prefrontal cortex.

Methods:

Male Lewis rats underwent morphine self-administration (1 mg/kg) for 19 days. They subsequently were submitted to extinction training for 15 days. Rats were killed either after self-administration or extinction, their brains extracted, and gene expression or phosphoprotein levels were assessed.

Results:

We found an increase in Raptor and Eif4ebp2 expression in the amygdala of rats that self-administered morphine, even after extinction. The expression of Insr in the amygdala of control animals decreased over time while the opposite effect was seen in the rats that self-administered morphine.

Conclusions:

Our results suggest that morphine self-administration affects the gene expression of some elements of the translational machinery in the amygdala.
Effects of Pavement Condition on LCCA User Costs
Authors: Okte Egemen , Al-Qadi Imad L. , Ozer Hasan
Published: March 2019

Life cycle cost analysis (LCCA) is one of the well-established methods to determine the cost-effective alternative between different transportation infrastructure projects. Life cycle cost of a roadway alternative consists of agency and user costs over an analysis period appropriately selected. Agency costs include initial construction costs, and maintenance and rehabilitation costs incurred within the analysis period. User costs incur when there is a work zone present and also during normal operating conditions. In traditional LCCA, adopted by many agencies around the United States, it is assumed that the difference in user cost between alternatives mainly arise from work zone costs. The costs that arise during normal operating conditions (mainly vehicle operating costs) are not dependent on project alternatives and thus are traditionally considered to be negligible. This paper introduces a methodology to test the sensitivity of vehicle operating costs to roughness and texture profile quantitatively and evaluate its contribution to LCCA calculations. It was hypothesized that even the slight changes in surface profile between various alternatives may result in different user costs between the alternatives. A case study is presented to illustrate the effect of user costs of normal operating conditions on LCCA analysis results. Case study showed that vehicle operating costs that arise during normal operation may greatly affect the results of LCCA and should be considered, especially for low-volume traffic projects.
A novel gentamicin-releasing wound dressing prepared from freshwater fish Cyprinus carpio collagen cross-linked with carbodiimide
Authors: Lukáč Peter , Hartinger Jan Miroslav , Mlček Mikuláš , Popková Michaela , Suchý Tomáš , Šupová Monika , Závora Jan , Adámková Václava , Benáková Hana , Slanař Ondřej , Bartoš Martin , Chlup Hynek , Lambert Lukáš , Grus Tomáš
Published: March 2019

Our study presents a novel collagen wound dressing prepared from freshwater fish skin ( Cyprinus Carpio) collagen type I. Half of the sponges were cross-linked with carbodiimide. The cross-linked and non-cross-linked collagen sponges were subsequently impregnated with gentamicin and lyophilized thus allowing for the attainment of the appropriate gentamicin content without the removal thereof during the cross-linking stage. The structure was evaluated via micro-CT and infrared spectrometry and the structural stability and gentamicin release properties were evaluated in phosphate buffer solution. The sponges were further tested via a rat model of an infected wound with Pseudomonas aeruginosa inoculation and compared with a reference commercial product. The sponges thus prepared provided a degree of open porosity that was comparable to or higher than that of the reference commercial product. Spectrometry analysis revealed that the cross-linked collagen sponge and reference commercial product sponge preserved their secondary collagen structure after 168 h while early accelerated degradation was observed with respect to the non-cross-linked collagen sponge. Gentamicin was released rapidly from all the sponges. Compared to those animals with gentamicin-containing sponges or gentamicin administered intramuscularly, the animals with the cross-linked collagen sponge without gentamicin exhibited marked clinical and laboratory infection signs. Both the administration routes (intramuscular and via gentamicin-containing sponges) provided similar gentamicin plasma levels. The resulting highly homogeneous product which was characterized by excellent structural and clinical properties proved effective in terms of the treatment of a surgical wound infection in a rat model. We demonstrated that all the gentamicin was released from the sponge and was absorbed in the systemic circulation. This is the first time that Cyprinus Carpio collagen has been used in the preparation of wound dressings. Thus, gentamicin-containing sponges provide a promising tool for the treatment and prevention of surgical site infections.
Attenuation of hydrogenperoxide-induced oxidative damages in L929 fibroblast cells by sulfated polysaccharides isolated from the edible marine algae Padina tetrastromatica
Authors: Jose Geena Mariya , Raghavankutty Mahadevan , Kurup G Muraleedhara
Published: March 2019

Sulfated polysaccharides are polymers with potent biological roles such as antioxidant, anticancer, anti-inflammatory, and immunomodulatory activities. They are gaining significance in advanced healthcare research, since they can control oxidative cellular damages by arresting the reactive oxygen species. Hence, this study aims to evaluate the cellular antioxidant potential of sulfated polysaccharides isolated from the marine algae Padina tetrastromatica in L929 cells. The monosaccharide composition of sulfated polysaccharides was determined using high-performance liquid chromatography. The protective effect of sulfated polysaccharides on L929 fibroblast cells under H2O2-induced oxidative stress has been evaluated using MTT assay, acridine orange/ethidium bromide staining, flow cytometry, comet assay, DCFH-DA staining, fluorometry, and biochemical assays. Sulfated polysaccharides were found to contain glucose, fucose, xylose, and uronic acid. It was non-toxic to L929 cells and effectively increased the viability of mouse fibroblast cells under induced oxidative stress. Various cellular damages such as apoptosis, plasma membrane alterations, DNA damage, and lipid peroxidation induced by H2O2 have been attenuated by sulfated polysaccharides. This might be due to the reduction of intracellular reactive oxygen species level by sulfated polysaccharides as observed in DCFH-DA staining. Sulfated polysaccharides improved the activity of intracellular antioxidant status and glutathione system. The augmentation of endogenous antioxidant enzymes and glutathione system by sulfated polysaccharides can be the possible reason for the reduction of intracellular reactive oxygen species, prevention of apoptosis, and betterment of viability in L929 cells. The study confirms the potent antioxidant activity of the sulfated polysaccharides in addition to their structural and nutritional roles.
Tanshinone IIA Ameliorates Spatial Learning and Memory Deficits by Inhibiting the Activity of ERK and GSK-3β
Authors: Lin Li , Jadoon Sarmad Sheraz , Liu Shang-Zhi , Zhang Ru-Yi , Li Fan , Zhang Mei-Ya , Ai-Hua Tan , You Qiu-Yun , Wang Ping
Published: March 2019

Background:

Alzheimer disease (AD) is the most common type of dementia which is becoming a primary problem in the present society, but it lacks effective treatment methods and means of AD. Tanshinone IIA (Tan IIA) has been reported to have neuroprotective effects to restrain the Aβ25 -35-mediated apoptosis. However, few studies try to understand how Aβ1-42 affects hyperphosphorylation of tau and how Tan IIA regulates this process at the molecular level.

Methods:

Fifty male Sprague-Dawley rats were randomly divided into 5 groups and infused through the lateral ventricle with Aβ1-42 except the control group. Then the rats were treated with Tan IIA through intragastric administration for 4 weeks. After the ability of learning and memory being measured, histomorphological examination and Western blot were used to detect the possible mechanism in the AD-associated model rats.

Results:

We observed that Aβ1-42 infusion could induce spatial learning and memory deficits in rats. Simultaneously, Aβ1-42 also could reduce the neuron in cornu ammonis 1 and dentate gyrus of hippocampus, as well as increase the levels of cleaved caspase 3, hyperphosphorylated tau at the sites Ser396, Ser404, and Thr205 with enhancing staining of black granules in brain. We also found that Aβ1-42 could increase the activity of extracellular signal-regulated protein kinase (ERK) and glycogen synthase kinase-3β (GSK-3β). Meanwhile, these phenomena could be ameliorated when Tan IIA was used.

Conclusion:

We concluded that Tan IIA might have neuroprotective effect and improving learning and memory ability to be a viable candidate in AD therapy with mechanisms involving the ERK and GSK-3β signal pathway.
Examining Medication Stewardship: A Nursing Perspective
Authors: Carroll Karen
Published: March 2019

Stewardship equates to the care and management of resources. The outcome of focusing on goal-centered care planning from a nursing theoretical basis includes medication management and goes beyond tasks and guidelines.
Unsteady aerodynamic modeling based on fuzzy scalar radial basis function neural networks
Authors: Wang Xu , Kou Jiaqing , Zhang Weiwei
Published: March 2019

In this paper, a fuzzy scalar radial basis function neural network is proposed, in order to overcome the limitation of traditional aerodynamic reduced-order models having difficulty in adapting to input variables with different orders of magnitude. This network is a combination of fuzzy rules and standard radial basis function neural network, and all the basis functions are defined as scalar basis functions. The use of scalar basis function will increase the flexibility of the model, thus enhancing the generalization capability on complex dynamic behaviors. Particle swarm optimization algorithm is used to find the optimal width of the scalar basis function. The constructed reduced-order models are used to model the unsteady aerodynamics of an airfoil in transonic flow. Results indicate that the proposed reduced-order models can capture the dynamic characteristics of lift coefficients at different reduced frequencies and amplitudes very accurately. Compared with the conventional reduced-order model based on recursive radial basis function neural network, the fuzzy scalar radial basis function neural network shows better generalization capability for different test cases with multiple normalization methods.
Trump, Twitter, and the First Amendment
Authors: Roberts Jemimah
Published: March 2019

This article considers the constitutional implications of US President Donald Trump’s use of Twitter. This issue arose in the recent case of Knight First Amendment Institute at Columbia University v Trump, where a US federal court considered for the first time whether Trump’s actions in blocking users from his personal Twitter account violated the First Amendment to the US Constitution. In exploring the US court’s treatment of this question, the article will consider the challenges that arise in applying established free speech doctrine to newly emerging technologies, concluding with some reflections from an Australian perspective.
Adaptive pitch control of full-scale ship composite propeller using shape memory alloy to enhance propulsive efficiency in off-design conditions
Authors: Das HN , Kapuria S
Published: March 2019

In this study, we investigate the use of shape memory alloy for adaptive control of twist of the propeller blade for a full-scale marine composite propeller of actual blade geometry, to offset the reduction in its hydrodynamic efficiency in off-design conditions. A full-scale ship propeller of 4.2 m diameter, made of graphite–epoxy laminate integrated with Nitinol fibre–reinforced hybrid composite (shape memory alloy hybrid composite) patches, is considered. The shape memory alloy hybrid composite patches are placed such that the recovery stress induced on heating the pre-strained shape memory alloy fibres embedded in martensite phase to the austenite phase causes twisting deformation in the propeller blade. The open water performance is estimated from the flow solution obtained using the finite volume method considering viscous flow and fluid structure interaction, while the deformation analysis is performed using the finite element method based on the first-order shear deformation theory, considering the nonlinearity due to large deformation. It is shown for the first time for a ship propeller of actual size and shape that the heating of the shape memory alloy fibres generates sufficient twist in the propeller to cause appreciable improvement (up to 6.3%) in its hydrodynamic efficiency in off-design conditions with lower advance ratios, thereby enhancing its fuel efficiency.
Transient analysis of nonlinear locally resonant metamaterials via computational homogenization
Authors: van Nuland Tim FW , Silva Priscilla B , Sridhar Ashwin , Geers Marc GD , Kouznetsova Varvara G
Published: March 2019

In this paper, the transient computational homogenization scheme is extended to allow for nonlinear elastodynamic phenomena. The framework is used to analyze wave propagation in a locally resonant metamaterial containing hyperelastic rubber-coated inclusions. The ability to properly simulate realistic nonlinearities in elasto-acoustic metamaterials constitutes a step forward in metamaterial design as, so far, the literature has focused only on academic nonlinear material models and simple lattice structures. The accuracy and efficiency of the framework are assessed by comparing the results with direct numerical simulations for transient dynamic analysis. It is found that the band gap features are adequately captured. The ability of the framework to perform accurate nonlinear transient dynamic analyses of finite-size structures is also demonstrated, along with the significant computational time savings achieved.
Estimating transition coefficients for reconstructing coherent series of mortality by cause of Death
Authors: Camarda Carlo G
Published: March 2019

Regular revisions of the classification of diseases and the consequent disruptions of mortality series are well-known issues in long-term cause-of-death analysis. Given basic assumptions and medical knowledge about possible exchanges across causes of death in the revision years, redistribution of counts of causes of death into a new classification can be viewed as a constrained optimization problem. Penalized likelihood within a quadratic programming framework allows estimation of exchanges that vary smoothly over age groups. The approach is illustrated using both German data on malignant neoplasms and French data on heart diseases.
Autonomous bolt loosening detection using deep learning
Authors: Zhang Yang , Sun Xiaowei , Loh Kenneth J , Su Wensheng , Xue Zhigang , Zhao Xuefeng
Published: March 2019

Machine vision-based structural health monitoring is gaining popularity due to the rich information one can extract from video and images. However, the extraction of characteristic parameters from images often requires manual intervention, thereby limiting its scalability and effectiveness. In contrast, deep learning overcomes the aforementioned shortcoming in that it can autonomously extract feature parameters (e.g. structural damage) from image datasets. Therefore, this study aims to validate the use of machine vision and deep learning for structural health monitoring by focusing on a particular application of detecting bolt loosening. First, a dataset that contains 300 images was collected. The dataset includes two bolt states, namely, tight and loosened. Second, a faster region-based convolutional neural network was trained and evaluated. The test results showed that the average precision of bolt damage detection is 0.9503. Thereafter, bolts were loosened to various screw heights, and images obtained from different angles, lighting conditions, and vibration conditions were identified separately. The trained model was then employed to validate that bolt loosening could be detected with sufficient accuracy using various types of images. Finally, the trained model was connected with a webcam to realize real-time bolt loosening damage monitoring.
Is Axillary Better Than Femoral Artery Cannulation in Repair of Acute Type A Aortic Dissection?
Authors: Ram Eilon , Krupik Yoav , Lipey Alexander , Shinfeld Ami , Peled Yael , Kogan Alexander , Raanani Ehud , Sternik Leonid
Published: March 2019

Objective

We compared early and late outcomes of patients who underwent femoral versus axillary artery cannulation for repair of acute type A aortic dissection.

Methods

Between 2004 and 2017, we retrospectively evaluated the clinical outcomes of 135 consecutive patients who underwent emergency surgery for acute type A aortic dissection repair. Patients were divided into 2 groups: those who underwent femoral ( n = 84) and those who underwent right axillary ( n = 51) artery cannulation. Mean patient age was 63 ± 13 years and 88 (65%) were male.

Results

Overall operative mortality was 12.6% (axillary 15.7%, femoral 10.7%; P = 0.564). Patients who underwent axillary compared to femoral artery cannulation had a statistically nonsignificant higher operative mortality rate among both stable and unstable patients (13% vs. 6.5%, P = 0.405 and 40% vs. 22.7%, P = 0.818, respectively). While there was no difference in major complication rates, such as stroke, low cardiac output, and surgical revision for bleeding/tamponade, there was a higher incidence of renal failure that required dialysis in patients who underwent axillary cannulation (12% vs. 1%, P = 0.022). Multivariate analysis demonstrated that predictors for the composite endpoint of operative mortality or severe organ malperfusion, such as renal failure or cerebrovascular accident, were hemodynamic instability on admission (OR 3.87; 95% CI, 1.23 to 12.63; P = 0.021), lower preoperative creatinine clearance (OR 0.94; 95% CI, 0.90 to 0.97; P < 0.001); and the use of axillary artery cannulation (OR 4.1; 95% CI, 1.43 to 12.78; P = 0.011). Among those discharged from hospital, the 3-year survival rate was 91% in the axillary group and 87% in the femoral group ( P = 0.772).

Conclusions

Based on our experience, emergent surgery for both stable and unstable patients with acute type A aortic dissection demonstrated similar survival rates and significantly less renal impairment when using the femoral cannulation approach.
A real-time signal control strategy at an isolated pedestrian crossing based on radar data
Authors: Qu Xu , Guo Tangyi , Guo Jin , Lin Yi , Ran Bin
Published: March 2019

Fixed-time traffic signal control strategy in an isolated pedestrian crossing tends to reduce traffic capacity and expose vulnerable road users to more danger. To mitigate the negative impact of previous control strategy, this study proposed an optimal real-time signal timing strategy to protect pedestrian crossing and at the same time minimize the system-wide traffic delay. With the application of a wide-area radar data, the features of vehicles, pedestrians, and the passing time of non-motor vehicles and pedestrian were captured considering conflicts and traffic delay. The support vector machine for regression was utilized to hypothesize traffic delay by training. The discrete values of hypothetical passing time will be tested. The minimum value of delay can be recognized and the corresponding hypothetical passing time will be recommended as the green time for crossing. The performance of the proposed ORSTS outperformed the fixed-time traffic signal control strategy in reducing traffic delay by 22.3%.
Reliability sensitivity analysis using axis orthogonal importance Latin hypercube sampling method
Authors: Zhao Wei , Chen YangYang , Liu Jike
Published: March 2019

In this article, a combined use of Latin hypercube sampling and axis orthogonal importance sampling, as an efficient and applicable tool for reliability analysis with limited number of samples, is explored for sensitivity estimation of the failure probability with respect to the distribution parameters of basic random variables, which is equivalently solved by reliability sensitivity analysis of a series of hyperplanes through each sampling point parallel to the tangent hyperplane of limit state surface around the design point. The analytical expressions of these hyperplanes are given, and the formulas for reliability sensitivity estimators and variances with the samples are derived according to the first-order reliability theory and difference method when non-normal random variables are involved and not involved, respectively. A procedure is established for the reliability sensitivity analysis with two versions: (1) axis orthogonal Latin hypercube importance sampling and (2) axis orthogonal quasi-random importance sampling with the Halton sequence. Four numerical examples are presented. The results are discussed and demonstrate that the proposed procedure is more efficient than the one based on the Latin hypercube sampling and the direct Monte Carlo technique with an acceptable accuracy in sensitivity estimation of the failure probability.
A systematic review of the association between fatigue and cognition in chronic noncommunicable diseases
Authors: Menzies Victoria , Kelly Debra L , Yang Gee S , Starkweather Angela , Lyon Debra E
Published: March 2019

Objectives

Fatigue is one of the most common symptoms associated with chronic noncommunicable diseases, and it may also increase cognitive impairment. However, associations between fatigue and cognitive impairment in chronic illnesses remain unclear. Therefore, the purpose of this systematic review was to examine research that investigated associations between level of fatigue and cognitive status.

Methods

PubMed/Medline, PsycINFO, CINAHL, and Cochrane Database were searched for articles published between 2012 and 2018 using search terms fatigue, cognition, and various iterations of these terms. Study quality was assessed by the Joanna Briggs Institute Critical Appraisal Checklist tool.

Results

Of 1799 citations, 10 studies in samples of individuals with cancer, multiple sclerosis, neurosarcoidosis, and chronic fatigue syndrome met the inclusion criteria. Fatigue was found to be significantly correlated with cognitive impairment in one cancer-related study ( r = –.480, p < .001), one multiple sclerosis study ( β= –0.52, p < .0001), and two chronic fatigue syndrome studies ( r = 0.397, p < .001; r = 0.388, p < .001).

Discussion

There is insufficient evidence examining the relationship between fatigue and cognitive impairment in patients with chronic illnesses. As a result, more studies are needed that examine potential relationships between these two symptoms in order to develop effective treatments for individuals living with a chronic noncommunicable disease.
Leadership and populism: A parallel reading of Hannah Arendt and Franz Neumann
Authors: Sanders Paul
Published: March 2019

Populism was the Cambridge Dictionary’s new word of the year 2017. The surge in interest reflects recent events such as the UK Brexit referendum, the arrival of Donald Trump at the helm of the US presidency, or the electoral victories of self-styled anti-establishment leaders throughout Europe and the World. The first part of this article explores the scientific status of populism. It concludes that the widespread use of populism as a term obscures a number of epistemic and conceptual limitations, arguing that ‘trouble-in-democracy’ is the more pertinent and more penetrating lens. The configuration of this populism focus has consequences on the definition of populist leadership, which is dominated by the notion of charisma. Through engagement with Hannah Arendt and her fellow exile Franz Neumann the article proposes an alternative phenomenological framework for apprehending populist leadership. To do this, it relies on the analogies between populist and totalitarian leadership. Finally, it maps out the priority areas for the deployment of populist discourse and practice, arguing that this is where non-populist (responsible) leaders should be focusing their efforts.
Nurses anaesthetists’ versus patients’ assessment of anxieties in an ambulatory surgery setting
Authors: Arakelian Erebouni , Färdig Martin , Nyholm Lena
Published: March 2019

Background

Failure to assess patients’ anxiety perioperatively by means of a validated instrument makes the assessment arbitrary. Studies are lacking about how well nurse anaesthetists estimate patients’ preoperative worries.

Purpose

To compare the nurse anaesthetists’ estimations of patients’ preoperative anxieties with the patients’ own assessment of their anxieties.

Design

Quantitative prospective design.

Methods

Eighty-five pairs of patients and nurse anaesthetists in two ambulatory surgery units in a university hospital in Sweden were included. Patients’ perioperative anxieties were graded using the Numeric Visual Analogue Anxiety Scale.

Results

The nurse anaesthetist overestimated the patients’ level of preoperative anxiety in 53% of patients and underestimated patients’ anxieties in 31% of the patients. Consensus was seen in 16% of the pairs. In fifty-six pairs (65%), the difference between the estimation of level of patients’ anxiety according to Numeric Visual Analogue Anxiety Scale was between −3 (overestimation) and +3 levels (underestimation). Median levels of anxiety were estimated as 3 within the patient group and 4 among the nurse anaesthetists.

Conclusions

Systematic assessment of patients’ level of anxiety could lead to identifying patients with severe anxiety levels and to offer more individualised treatment. The patients’ own estimation must form the basis for the discussion and treatment.
The cost effectiveness of REACH-HF and home-based cardiac rehabilitation compared with the usual medical care for heart failure with reduced ejection fraction: A decision model-based analysis
Authors: Taylor Rod S , Sadler Susannah , Dalal Hasnain M , Warren Fiona C , Jolly Kate , Davis Russell C , Doherty Patrick , Miles Jackie , Greaves Colin , Wingham Jennifer , Hillsdon Melvyn , Abraham Charles , Frost Julia , Singh Sally , Hayward Christopher , Eyre Victoria , Paul Kevin , Lang Chim C , Smith Karen
Published: March 2019

Background

The REACH-HF (Rehabilitation EnAblement in CHronic Heart Failure) trial found that the REACH-HF home-based cardiac rehabilitation intervention resulted in a clinically meaningful improvement in disease-specific health-related quality of life in patients with reduced ejection fraction heart failure (HFrEF). The aims of this study were to assess the long-term cost-effectiveness of the addition of REACH-HF intervention or home-based cardiac rehabilitation to usual care compared with usual care alone in patients with HFrEF.

Design and methods

A Markov model was developed using a patient lifetime horizon and integrating evidence from the REACH-HF trial, a systematic review/meta-analysis of randomised trials, estimates of mortality and hospital admission and UK costs at 2015/2016 prices. Taking a UK National Health and Personal Social Services perspective we report the incremental cost per quality-adjusted life-year (QALY) gained, assessing uncertainty using probabilistic and deterministic sensitivity analyses.

Results

In base case analysis, the REACH-HF intervention was associated with per patient mean QALY gain of 0.23 and an increased mean cost of £400 compared with usual care, resulting in a cost per QALY gained of £1720. Probabilistic sensitivity analysis indicated a 78% probability that REACH-HF is cost effective versus usual care at a threshold of £20,000 per QALY gained. Results were similar for home-based cardiac rehabilitation versus usual care. Sensitivity analyses indicate the findings to be robust to changes in model assumptions and parameters.

Conclusions

Our cost-utility analyses indicate that the addition of the REACH-HF intervention and home-based cardiac rehabilitation programmes are likely to be cost-effective treatment options versus usual care alone in patients with HFrEF.
Oral plexiform schwannoma: A case report and relevant immunohistochemical investigation
Authors: Sergheraert Johan , Zachar Dominique , Furon Vincent , Khonsari Roman-Hossein , Ortonne Nicolas , Mauprivez Cedric
Published: March 2019

Schwannomas are benign peripheral nerve sheath tumors originating from the Schwann cells. Most schwannomas in the head and neck region are solitary; however, multiple schwannomas affecting one or more nerves suggest a possible association with neurofibromatosis type 2 and schwannomatosis. Plexiform schwannoma is a rare variant of conventional schwannoma that is characterized by intraneural multinodular growth. This grow pattern has also been observed with other neural tumors which may make diagnosis more difficult. Herein, we report the case of a 28-year-old woman who presented a solitary plexiform schwannoma of great palatine nerve. In the present case, we focused on immunohistochemical analysis in daily practice for the differential diagnosis of schwannomas and their mainly morphological mimics, especially with plexiform neurofibroma, granular cell tumor and malignant peripheral nerve sheath tumors. We also discussed on SMARBC1/IN1 marker usefulness in combination with brain magnetic resonance imaging for the distinction of solitary schwannoma from neurofibromatosis type 2 or schwannomatosis.
Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis
Authors: Frank Rachel M. , Kunze Kyle N. , Beck Edward C. , Neal William H. , Bush-Joseph Charles A. , Nho Shane J.
Published: March 2019

Background:

Female patients undergoing surgery for femoroacetabular impingement syndrome (FAIS) often experience inferior clinical outcomes and higher failure rates when compared with male patients. The influence of athletic status on hip arthroscopic outcomes in female patients, however, is unclear.

Purpose:

To compare patient-reported outcomes (PROs) of athletic and nonathletic female patients undergoing hip arthroscopic surgery for FAIS, and to determine the return-to-sports rate in the athlete group.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Two-year PROs were assessed in female patients who had undergone hip arthroscopic surgery for FAIS by a single surgeon. Patients who self-identified as athletes were compared with nonathletes. Preoperative and postoperative PRO scores including the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport-Specific (HOS-SS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction were analyzed and compared between athletes and nonathletes. Subanalysis was performed based on patient age and body mass index (BMI).

Results:

A total of 330 female patients undergoing hip arthroscopic surgery for FAIS were identified. Of these, 221 patients identified as athletes (mean age, 29.1 ± 11.1 years; mean BMI, 23.0 ± 3.5 kg/m2) and 109 as nonathletes (mean age, 39.3 ± 11.4 years; mean BMI, 27.8 ± 5.8 kg/m2). Both groups demonstrated improvements in HOS-ADL, HOS-SS, mHHS, VAS for pain, and VAS for satisfaction scores ( P < .001 for all). Athletes had significantly higher postoperative PRO scores compared with nonathletes ( P < .001 for all). A 1:1 matched-pair subanalysis of 97 athletes and 97 nonathletes controlling for age and BMI indicated that these relationships held independently of potential demographic confounders ( P < .001 for all). The number of patients meeting the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for the HOS-ADL, HOS-SS, and mHHS was significantly higher in athletes aged ≤25 years versus those aged >25 years and for athletes versus nonathletes ( P < .05 for all). Further, 189 of 194 athletes returned to sports at a mean of 6.0 ± 3.9 months postoperatively, with 93.7% reporting returning to the same or higher level of competition.

Conclusion:

Among female patients undergoing hip arthroscopic surgery for FAIS, patients considered athletes achieved superior clinical outcomes compared with patients considered nonathletes. In addition, younger female athletes had higher rates of achieving the MCID and PASS for all PRO measures.
Effects of aged stored autologous red blood cells on human plasma metabolome
Authors: D’Alessandro Angelo , Reisz Julie A. , Zhang Yingze , Gehrke Sarah , Alexander Keisha , Kanias Tamir , Triulzi Darrell J. , Donadee Chenell , Barge Suchitra , Badlam Jessica , Jain Shilpa , Risbano Michael G. , Gladwin Mark T.
Published: March 2019

Cold storage of blood for 5 to 6 weeks has been shown to impair endothelial function after transfusion and has been associated with measures of end-organ dysfunction. Although the products of hemolysis, such as cell-free plasma hemoglobin, arginase, heme, and iron, in part mediate these effects, a complete analysis of transfused metabolites that may affect organ function has not been evaluated to date. Blood stored for either 5 or 42 days was collected from 18 healthy autologous volunteers, prior to and after autologous transfusion into the forearm circulation, followed by metabolomics analyses. Significant metabolic changes were observed in the plasma levels of hemolytic markers, oxidized purines, plasticizers, and oxidized lipids in recipients of blood stored for 42 days, compared with 5 days. Notably, transfusion of day 42 red blood cells (RBCs) increased circulating levels of plasticizers (diethylhexyl phthalate and derivatives) by up to 18-fold. Similarly, transfusion of day 42 blood significantly increased circulating levels of proinflammatory oxylipins, including prostaglandins, hydroxyeicosatrienoic acids (HETEs), and dihydroxyoctadecenoic acids. Oxylipins were the most significantly increasing metabolites (for 9-HETE: up to ∼41-fold, P = 3.7e-06) in day 42 supernatants. Measurements of arginine metabolism confirmed an increase in arginase activity at the expense of nitric oxide synthesis capacity in the bloodstream of recipients of day 42 blood, which correlated with measurements of hemodynamics. Metabolic changes in stored RBC supernatants impact the plasma metabolome of healthy transfusion recipients, with observed increases in plasticizers, as well as vasoactive, pro-oxidative, proinflammatory, and immunomodulatory metabolites after 42 days of storage.
Seismic impedance inversion using dictionary learning-based sparse representation and nonlocal similarity
Authors: She Bin , Wang Yaojun , Liu Zhining , Cai Hanpeng , Liu Wei , Hu Guangmin
Published: March 2019

We have addressed the seismic impedance inversion problem, which is often ill posed because of inaccurate and insufficient data. The approach taken is based on dictionary learning and sparse representation. By shifting a patch window of fixed size on all well-log data, a large number of small overlapping patches are generated. Then regarding these patches as a training set and using K-singular value decomposition algorithm, we obtain a dictionary that describes the common features of subsurface models within the current survey area. On the basis of the assumption that the subsurface geology has similarity and lateral continuity to some extent, the dictionary is used to approximate each model via sparse representations over the learned dictionary. In particular, we impose the sparse representations as additional constraints into the inversion procedure, leading to a well-defined objective function that can not only fit the observed seismic data but also honor the features of the well-log data. We adopt a coordinate descent strategy to solve this objective function. Meanwhile, to enforce lateral continuity in the inverted models, we use an additional stage in which we use the nonlocal similarity information that is extracted from seismic data as spatial coherent prior knowledge to refine the estimated models. Compared with several traditional impedance inversion methods, our algorithm can produce solutions of much higher quality qualitatively and quantitatively.
Maternal Noninfectious Fever Enhances Cell Proliferation and Microglial Activation in the Neonatal Rat Dentate Gyrus
Authors: Pancaro Carlo , Boulanger-Bertolus Julie , Segal Scott , Watson Chris J. , St Charles Irene , Mashour George A. , Marchand James E.
Published: March 2019

BACKGROUND:

Fever and increased maternal interleukin-6 (IL-6) plasma levels in labor are associated with an increased risk of adverse events in offspring, including neonatal seizures, cerebral palsy, and low intelligence scores at school age. However, the neural changes in the neonate that might mediate the adverse effects of maternal noninfectious fever are not fully characterized. This study was designed to test the hypothesis that induced maternal noninfectious fever alters neonatal neural progenitor cell proliferation and enhances microglial activation in the rat dentate gyrus of the hippocampus.

METHODS:

Systemic vehicle or IL-6 was given 3 times to near-term pregnant rats (n = 7/group) every 90 minutes, and maternal core temperature was recorded. Neonatal brains were processed and analyzed for dentate gyrus cell proliferation (using Ki-67, n = 10/group, and glial fibrillary acidic protein, n = 6/group) and resident microglia activation (using ionized calcium-binding adaptor protein-1 [Iba-1], n = 6/group). In separate studies, the authors assessed microglia proliferation using Ki-67/Iba-1 costaining (n = 5/group).

RESULTS:

Compared to controls, exposure to IL-6 resulted in significant maternal temperature increase [mean temperature difference 0.558°C (95% CI, 0.417–0.698; P < .0001)]. Following maternal IL-6, Ki-67 cell proliferation in the dentate gyrus was 55 % higher in neonates whose mother received IL-6 (38.8 ± 9.2) compared with those that received vehicle (25.1 ± 7.8); mean difference 13.7 (95% CI, 5.68–21.71); (P = .0021). Glial fibrillary acidic protein cell proliferation was 40% higher in the neonatal dentate gyrus whose mother received IL-6 when compared to controls (713 ± 85.52 vs 500 ± 115); mean difference 212 (95% CI, 82.2–343.4); (P = .004). Resident microglial activation was 90% higher in the dentate gyrus of neonates whose mother received IL-6 when compared to controls (71.8 ± 9.3 vs 37.8 ± 5.95); mean Iba-1 in stained cells was significantly different between IL-6 and vehicle groups 34 (95% CI, 23.94–44.05); (P < .0001). Proliferating microglia, determined by the colocalization of Ki-67 and Iba-1, were not different in the vehicle (8.8 % ± 3.19 %) and the IL-6 (5.6% ± 2.3%) groups (mean difference 3.2% (95% CI, -0.8–7.25) (P = .1063).

CONCLUSIONS:

IL-6 is sufficient to induce maternal systemic temperature increases in near-term pregnant rats as well as neuronal, glial, and neuroinflammatory changes in the dentate gyrus of the neonatal hippocampus. These alterations might disrupt fetal neurodevelopment during a vulnerable period.
Effect of Dynamic Versus Stylet-Guided Intubation on First-Attempt Success in Difficult Airways Undergoing Glidescope Laryngoscopy: A Randomized Controlled Trial
Authors: Mazzinari Guido , Rovira Lucas , Henao Liliana , Ortega Juan , Casasempere Alma , Fernandez Yolanda , Acosta Mariana , Belaouchi Moncef , Esparza-Miñana José Miguel
Published: March 2019

BACKGROUND:

Tracheal intubation failure in patients with difficult airway is still not uncommon. While videolaryngoscopes such as the Glidescope offer better glottic vision due to an acute-angled blade, this advantage does not always lead to an increased success rate because successful insertion of the tube through the vocal cords may be the limiting factor. We hypothesize that combined use of Glidescope and fiberscope used only as a dynamic guide facilitates tracheal intubation compared to a conventional Glidescope technique with a preshaped nondynamic stylet.

METHODS:

One hundred sixty adult patients with predicted difficult airway were randomly assigned to a conventional Glidescope (standard Glidescope group) or a combined Glidescope + fiberscope group intubation. In the Glidescope + fiberscope group under direct vision from the Glidescope, tracheal intubation was performed using the fiberscope as a guide without using fiberoptic vision, while in the standard Glidescope group, a conventional stylet-guided intubation technique was performed. We evaluated the rate of tracheal intubation success at first attempt as the primary end point (Fisher exact test). The difference between groups in airway injury, time to successful intubation, and the need for an alternative technique was also evaluated.

RESULTS:

First-attempt intubation success was higher in the Glidescope + fiberscope group than in the standard Glidescope group (91% vs 67%; P = .0012; fragility index, 8; absolute risk reduction, 24% [95% CI, 12%–36%]). Median time to successful tracheal intubation was shorter in the Glidescope + fiberscope group (50 vs 64 seconds; P = .035). Airway injury rate was lower in the Glidescope + fiberscope group than in the standard Glidescope group (1% vs 11%; P = .035; fragility index, 1; absolute risk reduction, 10% [95% CI, 3%–18%]). Alternative rescue technique requirements to achieve tracheal intubation were higher in the standard Glidescope group (24% vs 4%; P < .001; fragility index, 7).

CONCLUSIONS:

The use of a dynamic, flexible guide during a Glidescope laryngoscopy in patients with a predicted difficult airway compared to a standard intubation technique improves first-attempt intubation success, decreases the incidence of airway injury and time to successful intubation, as well as the need of an alternative technique to succeed.