bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstruction of the Gulf Stream from 1940 to the Present and Correlation with the North Atlantic Oscillation
Authors: Watelet Sylvain , Beckers Jean-Marie , Barth Alexander
Published: September 2017

In this study, the Gulf Stream (GS)’s response to the North Atlantic Oscillation (NAO) is investigated by generating an observation-based reconstruction of the GS path between 70° and 50°W since 1940. Using in situ data from the World Ocean Database (WOD), SeaDataNet, International Council for the Exploration of the Sea (ICES), Hydrobase3, and Argo floats, a harmonized database of more than 40 million entries is created. A variational inverse method implemented in the software Data Interpolating Variational Analysis (DIVA) allows the production of time series of monthly analyses of temperature and salinity over the North Atlantic (NA). These time series are used to derive two GS indices: the GS north wall (GSNW) index for position and the GS delta (GSD) index as a proxy of its transport. This study finds a significant correlation (0.37) between the GSNW and the NAO at a lag of 1 year (NAO preceding GS) since 1940 and significant correlations (0.50 and 0.43) between the GSD and the NAO at lags of 0 and 2 years between 1960 and 2014. The authors suggest this 2-yr lag is due to Rossby waves, generated by NAO variability, that propagate westward from the center of the NA. This is the first reconstruction of GS indices over a 75-yr period based on an objective method using the largest in situ dataset so far.
Climatology and Analysis of High-Impact, Low Predictive Skill Severe Weather Events in the Northeast United States
Authors: Vaughan Matthew T. , Tang Brian H. , Bosart Lance F.
Published: September 2017

This study identifies high-impact severe weather events with poor predictive skill over the northeast United States using Storm Prediction Center (SPC) convective outlooks. The objectives are to build a climatology of high-impact, low predictive skill events between 1980 and 2013 and investigate the differences in the synoptic-scale environment and severe weather parameters between severe weather events with low predictive skill and high predictive skill. Event-centered composite analyses, performed using the National Centers for Environmental Prediction Climate Forecast System Reanalysis and the North American Regional Reanalysis, suggest low predictive skill events occur significantly more often in low-shear environments. Additionally, a plurality of low probability of detection (POD), high-impact events occurred in low-shear, high-CAPE environments. Statistical analysis of low-shear, high-CAPE environments suggests high downdraft CAPE (DCAPE) and relatively dry lower levels of the atmosphere are associated with widespread severe weather events. DCAPE and dry boundary layer air may contribute to severe wind gusts through strong negative buoyancy and enhanced evaporative cooling of descending saturated parcels.
A Piecewise Local Partial Least Squares (PLS) Method for the Quantitative Analysis of Plutonium Nitrate Solutions
Authors: Lascola Robert , O’Rourke Patrick E. , Kyser Edward A.
Published: September 2017

We have developed a piecewise local (PL) partial least squares (PLS) analysis method for total plutonium measurements by absorption spectroscopy in nitric acid-based nuclear material processing streams. Instead of using a single PLS model that covers all expected solution conditions, the method selects one of several local models based on an assessment of solution absorbance, acidity, and Pu oxidation state distribution. The local models match the global model for accuracy against the calibration set, but were observed in several instances to be more robust to variations associated with measurements in the process. The improvements are attributed to the relative parsimony of the local models. Not all of the sources of spectral variation are uniformly present at each part of the calibration range. Thus, the global model is locally overfitting and susceptible to increased variance when presented with new samples. A second set of models quantifies the relative concentrations of Pu(III), (IV), and (VI). Standards containing a mixture of these species were not at equilibrium due to a disproportionation reaction. Therefore, a separate principal component analysis is used to estimate of the concentrations of the individual oxidation states in these standards in the absence of independent confirmatory analysis. The PL analysis approach is generalizable to other systems where the analysis of chemically complicated systems can be aided by rational division of the overall range of solution conditions into simpler sub-regions.
Nutritional Assessment of Snacks and Beverages in Southeastern Virginia Daycare Centers
Authors: Nayak Krisha , Hunter Kristin , Owens Jeremy , Harrington John
Published: September 2017

This study sought to determine the nutritional quality of snacks and beverages provided at licensed daycare centers of variable sizes in Southeastern Virginia. This cross-sectional study employed self-report surveys about snack offerings administered at each daycare site that agreed to participate. In addition, researchers completed an observation survey on the day of visit to observe and document the food and beverages actually served at snack time. Although many daycare directors reported serving fresh fruit and vegetables for snacks, there was a poor correlation on the offering of these healthy snacks between researchers and directors ( P < .05). Researchers observed salty, caloric dense foods for snack time more frequently than fresh fruits and vegetables. These findings demonstrate the importance of improving and perhaps regulating the quality and diversity of snacks and beverages offered in childcare, as dietary amendments may prevent the development of childhood obesity.
Skills for life: First aid and cardiopulmonary resuscitation in schools
Authors: Wilks Jeff , Pendergast Donna
Published: September 2017

Objective:

This review considers initiatives in various countries to include mandatory first aid and cardiopulmonary resuscitation (CPR) training in schools, key educational considerations and the supporting empirical evidence, in particular the relevance of first aid and CPR training to broader educational goals of student capability, resilience and self-efficacy.

Method:

Policy documents and reports from international first aid service providers (e.g. British Red Cross) were identified from websites while a parallel search of key bibliographical databases provided relevant papers on teaching first aid and CPR to school children in a range of countries.

Results:

Systematic reviews all show evidence to support the provision of first aid and CPR training courses and programmes in schools, with interventions effective in improving first aid knowledge and skills both post-training and in some studies up to 12 months afterwards. Important factors include ensuring the content is relevant and practical for the target group and offering an opportunity for young people to explore and discuss helping behaviour in emergency situations.

Conclusion:

Age-appropriate first aid and CPR instruction should be integrated into the school curriculum beginning in the primary years and developed/refreshed annually. Topics covered should include calling for help, bleeding, choking, burns, unconsciousness and resuscitation – all within the broader context of being confident and willing to help others. With the right training and support, schoolteachers can effectively deliver first aid instruction to their students. Future research should concentrate on gaps in evidence-based practice, especially measurements to demonstrate the effectiveness of first aid training, in order to advance the case for mandatory first aid education in schools.
Identity, mental health and work: How employees with mental health conditions recount stigma and the pejorative discourse of mental illness
Authors: Elraz Hadar
Published: September 2017

This article asks how identity is constructed for individuals with mental health conditions (MHCs) in the workplace. It takes especial regard to how MHCs are discursively situated, constructed and reconstructed in the workplace. Employees with MHCs face a difficult situation: not only do they need to deal with the stigma and discrimination commonly associated with MHCs, but they must also manage their health condition whilst adhering to organizational demands to demonstrate performance and commitment to work. Discourse analysis derived from 32 interviews with individuals with MHCs delineates how these individuals feel both stigmatized and empowered by their MHCs. The findings address three discursive strands: (i) a pejorative construction of mental illness in employment and society; (ii) contesting mental illness at work by embracing mental health management skills; and (iii) recounting mental illness through public disclosure and change. This article enhances understanding of how the construction of positive identity in the face of negative attributions associated with MHCs contributes to literature on identity, organizations and stigma as well as raising implications for policy and practice.
From horizontal to vertical labour governance: The International Labour Organization (ILO) and decent work in global supply chains
Authors: Thomas Huw , Turnbull Peter
Published: September 2017

The role of the International Labour Organization (ILO) in the governance of global supply chains is typically neglected or simply dismissed as ineffective. This is understandable as global supply chains have undermined the traditional nation state (horizontal) paradigm of global labour governance, most notably the international Conventions agreed by the tripartite constituents (governments, employers and workers’ representatives) of the ILO. But this simply poses the question of whether, and if so how, the ILO can reframe the system of global labour governance to include the (vertical) global supply chains that all too often fail to deliver ‘decent work for all’. Based on an extended ethnographic study, we demonstrate how policy entrepreneurs (international civil servants) within the ILO can play a pivotal role in not only reframing the discourse in a way that resonates with the ‘lived experiences’ of constituents but also ‘orchestrate’ the social partners in order to secure majority support for a process that might ultimately lead to a new standard (Convention) for decent work in global supply chains. A new approach to employment relationships in global supply chains is ‘in the making’, with the potential to improve working conditions and rights at work for millions across the globe.
Access and Utilization of Prenatal Health Care Services in Rural Communities: A Study of Isiekenesi in Imo State
Authors: Ajaegbu Okechukwu Odinaka
Published: September 2017

Pregnancy and childbirth complications are leading causes of death and disability among women of reproductive age, especially in developing countries, with Nigeria experiencing 576 deaths in every 100,000 births. This is particularly worrisome when most of these deaths could be prevented if pregnant women seek prenatal health care services. It is in the light of the foregoing that this research investigates the level of access and factors that influence use of prenatal health care services in Isiekenesi. Secondary and primary data were used for this study. The study adopted questionnaire, IDI, and FGD as data collection instruments. The data was analyzed at univariate and bivariate levels. The high cost of prenatal health care services was identified as a major factor that influences a woman’s decision not to use prenatal health care services. Finally, while all stakeholders should intensify awareness of the importance of using prenatal health care services, concerted effort should be channeled toward reduction of cost or outright free services at least in government-owned health centers in rural areas.
Role of acoustic radiation force impulse and shear wave velocity in prediction of preterm birth: a prospective study
Authors: Agarwal Arjit , Agarwal Shubhra , Chandak Shruti
Published: September 2017

Background

Preterm birth is one of the important causes of neonatal morbidity where we rely on subjective criteria such as modified Bishop’s scoring and contemporary sonographic measurement of cervical length. Acoustic radiation force impulse (ARFI) is a technological advancement in elastography that can be employed in prediction of cervical softening and preterm labor.

Purpose

To evaluate the role of ARFI technique and shear wave velocity (SWV) estimates as a predictor of preterm birth and its comparison with other clinical and sono-elastographic measures.

Material and Methods

Thirty-four pregnant women (gestation age = 28–37 weeks age) showing features suggestive of preterm labor were included and evaluated with modified Bishop’s score, cervical length by ultrasound (US), ARFI to derive Elastography index (EI), and SWV of the cervix. The patients were later divided into two groups, using the clinical outcome of preterm or term delivery.

Results

Twenty patients delivered at term (gestational age > 37 weeks) and 14 were preterm. Receiver operating characteristics (ROC) curves showed SWV with highest sensitivity and specificity (93% and 90%, respectively) for the prediction of preterm birth at a cutoff value of 2.83 m/s. EI and modified Bishop’s score were comparable to each other, but were less sensitive techniques.

Conclusion

Elastographic assessment of antenatal cervix is a novel technique of virtual palpation of internal os and can be utilized as an objective criterion for preterm birth prediction.
Programmatic Moderators of CBT Correctional Treatment for Whites and African Americans
Authors: Spiropoulos Georgia V. , Van Voorhis Patricia , Salisbury Emily J.
Published: September 2017

A recent experimental evaluation of a cognitive behavioral intervention ( Reasoning and Rehabilitation) reported significantly greater reductions in recidivism for White male parolees than African American male parolees. These results prompted the present examination of whether specific program conditions may have differentially impacted program outcomes (returns to prison) for White ( n = 141) and African American ( n = 318) participants. Study participants were tracked for up to 33 months on parole. Discrete-time event history analysis tested for race interactions with the following program attributes: facilitator gender, facilitator race, number of facilitators, class size, and the facilitators’ evaluations of parolee participation on measures pertaining to level of participation, enjoyment, understanding, atmosphere and use of skills in the program. The gender of the facilitator, the number of facilitators, and sizes of the classes differentially affected success rates for African Americans compared with Whites. African American participants achieved more favorable outcomes with female facilitators than male facilitators, and when class sizes and the number of facilitators conformed to program guidelines. No statistically significant interaction effects were found for race of the facilitator, or facilitator evaluations of parolee participation.
Improved clearance designs to minimize aerodynamic losses in a variable geometry turbine vane cascade
Authors: Gao Jie , Wei Ming , Liu Pengfei , Yue Guoqiang , Zheng Qun
Published: September 2017

Variable geometry turbine exists in small mobile gas turbines or some marine gas turbines to enhance the part-load performance. However, there are efficiency penalties associated with the vane partial gap, which is needed for the movement of variable vanes. This paper investigates the vane-end clearance leakage flow for a flat tip, a cavity tip, a winglet tip, a tip with passive injection, and a cavity-winglet tip to assess the possibility of minimizing vane-end clearance losses in a variable geometry turbine cascade. First, calculations were done at the test rig conditions for comparison with measured data, and they were used for validation of computational fluid dynamics model. Then, numerical calculations were done for turbine typical conditions. Specific flow structures of the various clearance designs of variable vanes are described, and then the effects of vane turning, including exit Mach numbers of 0.34, 0.44, and 0.54 as well as turning angles of –6°, 0°, and 6° on total pressure losses and outflow yaw angle for different vane tips are shown. In addition, the sensitivity of aerodynamic losses to vane tip gap height is evaluated. Results show that the strong interactions near the tip endwall region change the near-tip loading distribution significantly. With winglet and cavity-winglet tip designs, the loading distribution becomes very similar to the typical fixed vane, and the total loading is reduced, thus reducing the vane-end losses. Among the different vane tips presented, the cavity-winglet tip achieves the best aerodynamic performance, and the cavity tip has the lowest sensitivity to vane tip gap height. Overall, the cavity-winglet tip is found to be the best choice for variable vanes. The research results can provide useful reference for the vane design in a real high endwall-angle variable geometry turbine.
Reliability optimization of a novel negative Poisson’s ratio forepart for pedestrian protection
Authors: Wang Chun-Yan , Wang Wei-Wei , Zhao Wan-Zhong , Li Yu-Fang , Zhou Guan
Published: September 2017

The bumper system always directly causes the injury of the pedestrian leg in the car–pedestrian accidents. Therefore, it is of practical significance to optimize the bumper structure to enhance the protective effect of the pedestrian leg. Based on the original bumper system, this work proposes a novel negative Poisson’s ratio energy-absorbing forepart with inner hexagonal cellular structure, which is designed at the lower leg impact zone between the bumper beam and the cover. The parametric model of the negative Poisson’s ratio forepart, the lower legform impactor model, and the car–pedestrian collision model are firstly established. Then, through integrating the response surface method, second-order reliability method, and archive-based micro genetic algorithm, a reliability optimization design is further conducted for the negative Poisson’s ratio forepart based on the deterministic optimization results. Simulation results show that the optimized negative Poisson’s ratio forepart not only can significantly enhance the reliability and robustness, but also improve the protective effect of the pedestrian leg.
Competing risks modeling of cumulative effects of time-varying drug exposures
Authors: Danieli Coraline , Abrahamowicz Michal
Published: September 2017

An accurate assessment of drug safety or effectiveness in pharmaco-epidemiology requires defining an etiologically correct time-varying exposure model, which specifies how previous drug use affects the hazard of the event of interest. An additional challenge is to account for the multitude of mutually exclusive events that may be associated with the use of a given drug. To simultaneously address both challenges, we develop, and validate in simulations, a new approach that combines flexible modeling of the cumulative effects of time-varying exposures with competing risks methodology to separate the effects of the same drug exposure on different outcomes. To account for the dosage, duration and timing of past exposures, we rely on a spline-based weighted cumulative exposure modeling. We also propose likelihood ratio tests to test if the cumulative effects of past exposure on the hazards of the competing events are the same or different. Simulation results indicate that the estimated event-specific weight functions are reasonably accurate, and that the proposed tests have acceptable type I error rate and power. In real-life application, the proposed method indicated that recent use of antihypertensive drugs may reduce the risk of stroke but has no effect on the hazard of coronary heart disease events.
Contribution of International Trade in Human Development of Pakistan
Authors: Jawaid Syed Tehseen , Waheed Abdul
Published: September 2017

Very few studies have attempted to examine the relationship between international trade and human development. Some panel and cross-section studies have been done, but mostly Pakistan has not been included. This study examines for the first time ever the effect of aggregate and disaggregate trade on human development in Pakistan by using annual time series data from 1980 to 2013. This study contains five models in which human development with (a) total trade, (b) aggregate exports, (c) aggregate imports, (d) exports of primary commodities, semi-manufactured goods and manufactured goods and (e) imports of consumer goods, imports of capital goods, industrial raw material of consumer goods and industrial raw material for capital goods is considered. Cointegration test has been applied to check the long-run relationship between human development and trade. Sensitivity analysis confirms that initial results are robust. Causality analysis has also been done for the causal relationship between international trade and human development.
Effectiveness of Youth Mental Health First Aid USA for Social Work Students
Authors: Rose Theda , Leitch Judith , Collins Kathryn S. , Frey Jodi J. , Osteen Philip J.
Published: September 2017

Purpose:

Adolescent mental health is a public health priority. Considered an early intervention approach, Youth Mental Health First Aid (YMHFA) trains adults to provide initial assistance to adolescents experiencing a mental health problem or crisis. This study evaluated the effectiveness of the U.S. version of YMHFA (YMHFA-USA) among graduate social work students.

Method:

A quasi-experimental design ( N = 73; intervention, n = 39; comparison, n = 34), using the Mental Health Beliefs and Literacy Scale, assessed the effectiveness of YMHFA-USA. Outcomes were measured at pretest, posttest, and 5 months in the intervention group. Differences between groups were compared at 5 months.

Results:

Statistically significant improvements in attitudes, beliefs, self-confidence, and knowledge were observed among intervention group students. At 5 months, these students had significantly better attitudes and greater knowledge and self-confidence than the comparison group.

Conclusion:

Results indicate YMHFA-USA may improve factors related to master’s level social work students’ abilities to engage with youth experiencing mental health problems.
Determination of the Problems Experienced by Patients Post-Thyroidectomy
Authors: Atasayar Semra , Guler Demir Sevil
Published: September 2017

This descriptive, cross-sectional study investigated problems experienced by patients after undergoing a thyroidectomy. The study included 60 first-time, post-thyroidectomy patients diagnosed with benign thyroid disease from a university hospital’s general surgery clinic in Ankara, Turkey. The data were collected in two stages: interviews with patients on the first day following surgery and postoperative follow-up telephone interviews in each of the first 4 weeks following surgery. The follow-ups revealed that patients principally experienced varying degrees of pain and difficulties in connection with work and recreation, communication, body image, and movement, for up to 4 weeks after surgery. These results showed that patients were particularly prone to problems on the first day and during the first week of the postoperative period; therefore, patients should be provided with follow-up telephone interviews to facilitate easier recovery and to help them overcome any problems experienced during the postoperative period.
Variables Associated With Indiscriminate Friendliness Displayed by Chinese Adoptees in U.S. Families
Authors: Liu Yanhong , Hazler Richard J.
Published: September 2017

The study investigated potential variables associated with indiscriminate friendliness (IF) in children adopted from China by U.S. parents. Children in this study were adopted at a mean age of 19 months and have spent an average of 61 months with their adoptive parents. The sample comprised of 92 U.S. parents with children adopted from China. Children’s age at the time of adoption, length of postadoption time, prior institutional care, and postadoption parenting by adoptive parents were investigated in association with IF. Findings showed that prior institutional care was significantly associated children’s IF, whereas an increase in postadoption time shared with adoptive parents was not accompanied by a decrease in children’s IF. The significant regression model explained 9% of variance in children’s IF. Results provided practical implications for family counselors and other mental health professionals working with adoptive families.
An Evaluation of the Activated Partial Thromboplastin Time Waveform
Authors: Matsumoto Takeshi , Wada Hideo , Fujimoto Naoki , Toyoda Junki , Abe Yasunori , Ohishi Kohshi , Yamashita Yoshiki , Ikejiri Makoto , Hasegawa Kei , Suzuki Kei , Imai Hiroshi , Nakatani Kaname , Katayama Naoyuki
Published: September 2017

The activated partial thromboplastin time (APTT) waveform includes several parameters that are related to various underlying diseases. The APTT waveform was examined in various diseases. Regarding the pattern of APTT waveform, a biphasic pattern of the first or second derivative curve (DC) was observed in patients with hemophilia and patients positive for antiphospholipid (aPL) antibodies or coagulation factor VIII (FVIII) inhibitors. The time of the first and second DC and fibrin formation at 1/2 height were prolonged in patients with hemophilia, patients with inhibitors, patients positive for aPL, patients treated with anti-Xa agents, and patients with disseminated intravascular coagulation (DIC). These values all tended to decrease in pregnant women (at 28-36 weeks’ gestation). The height of the second derivative peak 1 was significantly lower in patients with hemophilia, patients with FVIII inhibitors, patients positive for aPL, patients treated with anti-Xa agents, and patients with DIC; these values tended to be significantly higher in pregnant women. The height of the first DC was significantly lower in patients who were positive for FVIII inhibitors and was significantly higher in patients treated with anti-Xa agents and pregnant women. The height of the first and second DC was useful for the analysis of hemophilia, FVIII inhibitor, and aPL.
What Is Peace? Being an Autoethnographic Account of Methodological Musings From the Beach
Authors: Kavoori Anandam
Published: September 2017

This autoethnographic essay is focused on methodological space of “problematization”—the wrenching intellectual and emotional process (and lived experience) that a scholar goes through before settling into a long-term writing project—in this case travel to different parts of the world, in an attempt to explore the idea and experience of “Peace” in each of those places. Weaving through elements of family memoir, Georgia history, eco-criticism, and Peace Studies (across different sub fields), the essay illuminates the personal and liminal space of methodological engagement before field work.
Using Qualitative Methods to Understand Perceptions of Risk and Condom Use in African American College Women: Implications for Sexual Health Promotion
Authors: McLaurin-Jones TyWanda L. , Lashley Maudry-Beverley , Marshall Vanessa J.
Published: September 2017

Background. Young African American women are disproportionately affected with sexually transmitted infections (STIs) and unintentional pregnancies. Despite adequate knowledge, assertiveness, and negotiation skills, consistent condom use remains low. Aims. We sought to assess the role of pregnancy and STI risk perception in condom decision making among African American women. Method. We conducted a phenomenological qualitative study. Utilizing a purposive sampling strategy, 100 African American women (18-24 years) were recruited from a historically Black college and university for an open discussion of condom use. Thirteen focus groups were conducted via a semistructured interview guide and analyzed with an inductive thematic approach. Results. Uniformly women perceived pregnancy as a greater threat than STIs which appears to be maintained by (a) their sense of fertility, (b) self-care concept, and (c) experiences with condom failure. Thus, women were skeptical about using condoms as a form of contraception. Women perceived casual sex as having the greatest HIV/STI risk and emphasized the importance of assertiveness and self-respect to negotiate condom use. However, condom use in monogamous relationships is less likely due to (a) testing/knowing partner’s status, (b) relationship trust, and (c) the use of hormonal contraception for pregnancy prevention. Perceived threat of infidelity increases condom use. Conclusion. The implications of these findings suggest sexual health promotion programs may focus on improving women’s estimate of the effectiveness of condoms to prevent pregnancy and addressing women’s reliance on testing for STI prevention.
Increasing In-Service Teacher Implementation of Classroom Management Practices Through Consultation, Implementation Planning, and Participant Modeling
Authors: Hagermoser Sanetti Lisa M. , Williamson Kathleen M. , Long Anna C. J. , Kratochwill Thomas R.
Published: September 2017

Numerous evidence-based classroom management strategies to prevent and respond to problem behavior have been identified, but research consistently indicates teachers rarely implement them with sufficient implementation fidelity. The purpose of this study was to evaluate the effectiveness of implementation planning, a strategy involving logistical intervention implementation planning and identification of implementation barriers, and participant modeling, a strategy involving didactic and in vivo intervention training, on teachers’ implementation of an evidence-based classroom management plan. A randomized multiple treatment embedded within a multiple baseline design across participants was used to assess (a) teachers’ adherence to the classroom management plans and quality of implementation and (b) student disruptive behavior in the classroom immediately and at follow-up. Results indicated that teachers’ adherence and quality increased with both implementation planning and participant modeling, but these improvements were not fully maintained at 1- and 2-month follow-up. A similar pattern in student disruptive behavior was also observed. These findings highlight the need for ongoing implementation support for behavioral interventions in schools. Implications for future research and practice are discussed.
In-plane elastic wave propagation in aluminum honeycomb cores fabricated by bonding corrugated sheets
Authors: Ahmed Ammar , Alkhader Maen , Abu-Nabah Bassam
Published: September 2017

Aluminum honeycomb cores are widely used in sandwich structures due to their high stiffness-to-weight ratios and very low densities. However, owing to their porous architecture, honeycomb cores are inherently week and are susceptible to damage due to inadvertent or improper loadings on their encompassing sandwich structure. This damage can potentially lead to the failure of the sandwich structure, and therefore it should be detected and evaluated, preferably using nondestructive methods. Common nondestructive techniques have limited effectiveness in inspecting aluminum honeycombs due to their porous structure and dispersive properties. Since honeycombs are less dispersive at sub-ultrasound frequencies, inspecting them using low and sub-ultrasound frequencies has been introduced lately as a promising alternative to ultrasound inspection. However, this approach requires a priori knowledge of the wave propagation characteristics in the inspected material, which is not readily available for most commercially available aluminum honeycombs, especially the ones manufactured by joining thin corrugated sheets. Thus, this work utilizes finite element computations to assess the low frequency wave propagation characteristics (i.e. phase velocity and dispersive properties) in commercially available aluminum honeycombs made by bonding thin corrugated sheets. Results illustrate that the dispersive behavior and acoustic anisotropy of the studied honeycombs are more significant at higher porosities and high frequencies as well as identify the frequencies below which honeycombs exhibit their least dispersive acoustic behavior.
Oral Immunotherapy With Partially Hydrolyzed Wheat-Based Cereals: A Pilot Study
Authors: Lauener Roger , Eigenmann Philippe A , Wassenberg Jacqueline , Jung Andreas , Denery-Papini Sandra , Sjölander Sigrid , Pecquet Sophie , Fritsché Rodolphe , Zuercher Adrian , Wermeille Antoine , Fontanesi Massimo , Mercenier Annick , Vissers Yvonne M , Nutten Sophie
Published: September 2017

To date, only few studies have assessed oral immunotherapy (OIT) for wheat allergy and often describe severe adverse reactions during therapy. We developed partially hydrolyzed wheat-based cereals (pHC), which were used in a multicenter, open-label, OIT pilot study, in immunoglobulin E–mediated wheat allergy children (NCT01332084). The primary objective of the study was to test whether wheat allergic patients tolerate pHC and primary end point was the presence or not of immediate adverse reactions to pHC during the 1-day initial escalation phase (stepwise increased doses of pHC), with evaluation of the maximum dose tolerated. Of the 9 patients enrolled in the trial, 4 discontinued OIT because of mild to severe reactions at the initial escalation phase. The 5 patients who passed the escalation phase consumed pHC daily for 1 to 6 months. One of these patients withdrew due to noncompliance, whereas the 4 others completed the study and successfully passed the wheat challenge test at the end of the study. About 60% of the adverse events were unrelated to the study product. Our study provides preliminary evidence that pHC is tolerated by a subset of wheat allergic patients. Further studies are warranted to test its efficacy as a potential therapeutic option for wheat allergic patients.
Global climate adaptation governance: Why is it not legally binding?
Authors: Hall Nina , Persson Åsa
Published: September 2017

In the last decade, the United Nations Framework Convention on Climate Change has moved from a strong focus on mitigation to increasingly address adaptation. Climate change is no longer simply about reducing emissions, but also about enabling countries to deal with its impacts. Yet, most studies of the climate regime have focused on the evolution of mitigation governance and overlooked the increasing number of adaptation-related decisions and initiatives. In this article, we identify the body of rules and commitments on adaptation and suggest that there are more attempts to govern adaptation than many mitigation-focused accounts of the international climate regime would suggest. We then ask: to what degree are adaptation rules and commitments legalized in the United Nations Framework Convention on Climate Change? We examine the degree of precision and obligation of relevant decisions through an extensive analysis of primary United Nations Framework Convention on Climate Change documents, secondary literature on adaptation initiatives and institutions, interviews with climate change experts and negotiators, and participant observation at climate negotiations. Our analysis finds that adaptation governance is low in precision and obligation. We suggest that this is partly because adaptation is a contested global public good and because ‘package deals’ are made with mitigation commitments. This article makes a vital contribution to the global environmental politics literature given that adaptation governance is under-studied and poorly understood. It also contributes to the legalization literature by highlighting how contested global public goods may be governed globally, but with low obligation and precision.
Women’s experiences of exercise as a treatment for their postnatal depression: A nested qualitative study
Authors: Pritchett Ruth , Jolly Kate , Daley Amanda J , Turner Katrina , Bradbury-Jones Caroline
Published: September 2017

Women with postnatal depression are often reluctant to take medication postnatally and access to psychological therapies is limited. Exercise offers a freely available treatment option but depressed mothers’ experience of exercise has not been investigated. We conducted a qualitative study nested within a randomised trial of an exercise intervention for women with postnatal depression. Women described deterioration in their sense of identity postnatally and through experiencing depression and described the positive impact exercise had on their sense of self. Views of exercise as treatment for postnatal depression ranged from doubts about its practicality to positive comparisons with other traditional treatments and to improved recovery.
Assessing the capability of conventional in-cylinder insulation materials in achieving temperature swing engine performance benefits
Authors: Andruskiewicz Peter , Najt Paul , Durrett Russell , Payri Raul
Published: September 2017

Materials that enable wall temperature swing to follow the gas temperature throughout a reciprocating internal combustion engine cycle promise the greatest benefits from in-cylinder insulation without detriments to volumetric efficiency or fuel autoignition behavior. An anisotropic barium–neodymium–titanate insulation was selected as a promising off-the-shelf material to begin investigating temperature swing characteristics while maintaining adequate strength and adherence to the aluminum components it was applied to. Experimental analysis showed that permeable porosity within the barium–neodymium–titanate coating resulted in increased heat losses despite thermal insulation, fuel absorption losses, and a reduction in compression ratio. Additionally, the thickest coating suffered severe degradation throughout testing. Any potential benefits of temperature swing insulation were dominated by these losses, emphasizing the need to maintain a sealed coating surface.
Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies
Authors: Dressel Anne , Schneider Robert , DeNomie Melissa , Kusch Jennifer , Welch Whitney , Sosa Mirtha , Yeldell Sally , Maida Tatiana , Wineberg Jessica , Holt Keith , Bernstein Rebecca
Published: September 2017

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A “Biking for Health” study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.
Use of the Nellix Endovascular Aneurysm Sealing System in Combination With Parallel Grafts for the Treatment of a Symptomatic Type V Thoracoabdominal Aortic Aneurysm
Authors: Klonaris Chris , Katsargyris Athanasios , Athanasiadis Dimitris , Liakakos Theodor
Published: September 2017

Purpose: To report endovascular treatment of a symptomatic type V thoracoabdominal aortic aneurysm (TAAA) using the combined techniques of endovascular aneurysm sealing and parallel stent-grafts. Case Report: A 70-year-old man was referred with a symptomatic type V TAAA. The Nellix EndoVascular Aneurysm Sealing (EVAS) System was used in combination with 2 chimney grafts for the celiac artery (CA) and the superior mesenteric artery (SMA); one periscope graft perfused the right renal artery. Completion angiography showed exclusion of the aneurysm and patency of all 3 parallel grafts but occlusion of the left renal artery (LRA) due to unintentional coverage of its ostium by the Nellix endobags. Antegrade catheterization of the LRA failed, requiring implantation of an aortorenal vein bypass. The postoperative course was complicated by acute kidney injury. Imaging at 6 months showed sustained exclusion of the aneurysm, patency of the CA and SMA parallel grafts and left aortorenal bypass but occlusion of the right renal artery periscope graft. Serum creatinine at 6 months was 1.5 mg/dL. Conclusion: The combination of EVAS with parallel grafts for preservation of the visceral vessels may be a feasible technique to treat selected TAAAs in the acute setting when other options are not applicable.
Lessons Learned From the VCU School of Medicine Latino Medical Student Association: A Roadmap for Increasing Diversity in Medical School
Authors: Diaz Adrian , Corredor Margarita , Jackson Donna , Whitehurst-Cook Michelle , Strauss Jerome F.
Published: September 2017

The emphasis on increasing diversity within medical schools is not a new trend. At Virginia Commonwealth University School of Medicine, we made a concerted effort to increase the percentage of Hispanic students in each incoming class. In this article, we highlight the experiences, actions, and lessons learned from key stakeholders. We conclude with a set of recommendations for medical school administrators and students who also seek to increase diversity in their enrollment.
The incidence of pregnancy-related stroke: A systematic review and meta-analysis
Authors: Swartz Richard H , Cayley Megan L , Foley Norine , Ladhani Noor Niyar N , Leffert Lisa , Bushnell Cheryl , McClure JA , Lindsay M Patrice
Published: September 2017

Background

Stroke risk is increased during pregnancy, but estimates of pregnancy-related stroke incidence vary widely.

Aims

A systematic review and meta-analysis was conducted to assess the incidence of stroke during pregnancy and the puerperium. Ovid Medline, EMBASE, and ISI Web of Science were searched for studies published between 1990 and January 2017 reporting stroke incidence during pregnancy and postpartum, from defined pregnancy populations. Pooled analyses were conducted using a random effects approach and expressed as an incidence rate per 100,000 pregnancies, with 95% confidence intervals. Subgroup analyses of stroke type and timing were conducted.

Summary of review

Eleven studies met inclusion criteria. Variation in estimated rates was noted based on geography and study methodology. The pooled crude rate of pregnancy-related stroke was 30.0 per 100,000 pregnancies (95% confidence interval 18.8–47.9). The pooled crude rates from nonhemorrhagic stroke (arterial and cerebral venous sinus thrombosis) were 19.9 (95% confidence interval 10.7–36.9) and from hemorrhage 12.2 (95% confidence interval 6.4–23.2) per 100,000 pregnancies. For studies separately reporting cerebral venous sinus thrombosis, the rates were roughly equal between ischemic stroke (12.2, 95% confidence interval 6.7–22.2), cerebral venous sinus thrombosis (9.1, 95% confidence interval 4.3–18.9), and hemorrhage (12.2, 95% confidence interval 6.4–23.2). The crude stroke rate for antenatal/perinatal stroke was 18.3 (95% confidence interval 11.9–28.2), and for postpartum stroke was 14.7 (95% confidence interval 8.3–26.1).

Conclusions

Stroke affects 30.0 per 100,000 pregnancies, with ischemia, cerebral venous sinus thrombosis, and hemorrhage causing roughly equal numbers and with highest risk peripartum and postpartum. Organized approaches to the management of this high-risk population, informed by existing evidence from stroke and obstetrical care are needed.
Overall survival and progression-free survival with endocrine therapy for hormone receptor-positive, HER2-negative advanced breast cancer: review
Authors: Reinert Tomás , Barrios Carlos H.
Published: September 2017

We reviewed randomized phase II/III trials comparing first- or second-line endocrine therapy as monotherapy or in combination with targeted therapies for treatment of postmenopausal patients with hormone receptor-positive advanced breast cancer. First-line was defined as treatment for endocrine therapy-naïve advanced breast cancer or advanced disease treated with endocrine therapy in the adjuvant/neoadjuvant setting. Second-line was defined as endocrine therapy for advanced breast cancer following disease progression on endocrine therapy for advanced disease. Publications reporting progression-free survival (PFS)/time to progression (TTP) or overall survival (OS) for FDA-approved agents anastrozole, exemestane, fulvestrant 250 mg, fulvestrant 500 mg, letrozole (0.5 and 2.5 mg), megestrol acetate, and tamoxifen as monotherapy, or in combination with everolimus, palbociclib or ribociclib, were assessed. First-line monotherapy with anastrozole, fulvestrant 500 mg or letrozole 2.5 mg significantly improved PFS/TTP versus comparator endocrine therapy; however, only fulvestrant 500 mg improved OS. For endocrine therapy in combination with targeted therapies, palbociclib plus letrozole 2.5 mg, and ribociclib plus letrozole 2.5 mg significantly improved PFS versus letrozole 2.5 mg alone first-line. For second-line monotherapies, exemestane, fulvestrant 500 mg and letrozole 2.5 mg significantly improved PFS/TTP versus comparator endocrine therapy; only fulvestrant 500 mg and letrozole 2.5 mg improved OS. For second-line combination therapies, everolimus plus exemestane, and palbociclib plus fulvestrant 500 mg, improved PFS versus endocrine therapy alone. In both first- and second-line settings, aromatase inhibitors demonstrated PFS benefits versus comparator endocrine therapy; however, fulvestrant 500 mg was the only endocrine therapy included in our review to show both PFS and OS advantages compared with other endocrine therapies. Targeted agents in combination with endocrine therapy have demonstrated PFS improvements both first- and second-line; OS data are awaited.
Predicting Failure of Nonoperative Treatment for Insertional Achilles Tendinosis
Authors: Stenson James F. , Reb Christopher W. , Daniel Joseph N. , Saini Sundeep S. , Albana Mohammed F.
Published: September 2017

Nonoperative treatment for midportion Achilles tendinosis is well defined by the literature. Multiple modalities are described for the management of insertional Achilles pathology, but no consensus exists regarding efficacy. Surgical intervention for insertional Achilles tendinosis (IAT) is successful greater than 80% of the time. Our objective was to risk stratify patients who would fail nonsurgical management of IAT and thus benefit progressing to surgery. We reviewed the records of 664 patients with IAT. The cohort was 53% male and 80% obese. Mean age was 53.7 years (standard deviation 14.7 years). Average duration of symptoms was 10.4 months (standard deviation 28 months). Of the parameters collected, 4 were found to correlate with failing nonoperative treatment: visual analog scale, limited ankle range of motion, previous corticosteroid injection, and presence of Achilles tendon enthesophyte. We found that as the number of risk factors increased so did the chance of failing nonoperative treatment. With all 4 parameters, chance of failing conservative treatment was only 55%. Thus, nonoperative management should be exhausted until surgery is the only remaining option. However, the presence of one of the aforementioned risk factors can aid a surgeon in the decision to pursue surgery in the appropriate clinical scenario.

Levels of Evidence: Level IV: Retrospective Case series