bluuebunny/crossref_metadata_2025 huggingface dataset:
Presynaptic loss of dynamin‐related protein 1 impairs synaptic vesicle release and recycling at the mouse calyx of Held
Authors: Singh Mahendra , Denny Henry , Smith Christina , Granados Jorge , Renden Robert
Published: October 2018

Key points

This study characterizes the mechanisms underlying defects in synaptic transmission when dynamin‐related protein 1 (DRP1) is genetically eliminated. Viral‐mediated knockout of DRP1 from the presynaptic terminal at the mouse calyx of Held increased initial release probability, reduced the size of the synaptic vesicle recycling pool and impaired synaptic vesicle recycling.

Transmission defects could be partially restored by increasing the intracellular calcium buffering capacity with EGTA‐AM, implying close coupling of Ca2+ channels to synaptic vesicles was compromised.

Acute restoration of ATP to physiological levels in the presynaptic terminal did not reverse the synaptic defects.

Loss of DRP1 impairs mitochondrial morphology in the presynaptic terminal, which in turn seems to arrest synaptic maturation.

Impaired mitochondrial biogenesis and function is implicated in many neurodegenerative diseases, and likely affects synaptic neurotransmission prior to cellular loss. Dynamin‐related protein 1 (DRP1) is essential for mitochondrial fission and is disrupted in neurodegenerative disease. In this study, we used the mouse calyx of Held synapse as a model to investigate the impact of presynaptic DRP1 loss on synaptic vesicle (SV) recycling and sustained neurotransmission. In vivo viral expression of Cre recombinase in ventral cochlear neurons of floxed‐DRP1 mice generated a presynaptic‐specific DRP1 knockout (DRP1‐preKO), where the innervated postsynaptic cell was unperturbed. Confocal reconstruction of the calyx terminal suggested SV clusters and mitochondrial content were disrupted, and presynaptic terminal volume was decreased. Using postsynaptic voltage‐clamp recordings, we found that DRP1‐preKO synapses had larger evoked responses at low frequency stimulation. DRP1‐preKO synapses also had profoundly altered short‐term plasticity, due to defects in SV recycling. Readily releasable pool size, estimated with high‐frequency trains, was dramatically reduced in DRP1‐preKO synapses, suggesting an important role for DRP1 in maintenance of release‐competent SVs at the presynaptic terminal. Presynaptic Ca2+ accumulation in the terminal was also enhanced in DRP1‐preKO synapses. Synaptic transmission defects could be partially rescued with EGTA‐AM, indicating close coupling of Ca2+ channels to SV distance normally found in mature terminals may be compromised by DRP1‐preKO. Using paired recordings of the presynaptic and postsynaptic compartments, recycling defects could not be reversed by acute dialysis of ATP into the calyx terminals. Taken together, our results implicate a requirement for mitochondrial fission to coordinate postnatal synapse maturation.
Aerodynamic Interaction Between an Incoming Vortex and Tip Leakage Flow in a Turbine Cascade
Authors: Zhou Kai , Zhou Chao
Published: October 2018

In turbines, secondary vortices and tip leakage vortices form in the blade passage and interact with each other. In order to understand the flow physics of this vortices interaction, the effects of incoming vortex on the downstream tip leakage flow are investigated by experimental, numerical, and analytical methods. In the experiment, a swirl generator was used upstream of a linear turbine cascade to generate the incoming vortex, which could interact with the downstream tip leakage vortex (TLV). The swirl generator was located at ten different pitchwise locations to simulate the quasi-steady effects. In the numerical study, a Rankine-like vortex was defined at the inlet of the computational domain to simulate the incoming swirling vortex (SV). The effects of the directions of the incoming vortices were investigated. In the case of a positive incoming SV, which has a large vorticity vector in the same direction as that of the TLV, the vortex mixes with the TLV to form one major vortex near the casing as it transports downstream. This vortices interaction reduces the loss by increasing the streamwise momentum within the TLV core. However, the negative incoming SV has little effects on the TLV and the loss. As the negative incoming SV transports downstream, it travels away from the TLV and two vortices can be identified near the casing. A triple-vortices-interaction kinetic model is used to explain the flow physics of vortex interaction, and a one-dimensional mixing analytical model are proposed to explain the loss mechanism.
Mycobacteriophages
Authors: Hatfull Graham F.
Published: October 2018

Mycobacteriophages are viruses that infect mycobacterial hosts. A large number of mycobacteriophages have been isolated and genomically characterized, providing insights into viral diversity and evolution, as well as fueling development of tools for mycobacterial genetics. Mycobacteriophages have intimate relationships with their hosts and provide insights into the genetics and physiology of the mycobacteria and tools for potential clinical applications such as drug development, diagnosis, vaccines, and potentially therapy.
Fulminant Staphylococcal Infections
Authors: Gillet Yves , Henry Thomas , Vandenesch Francois
Published: October 2018

Fulminant staphylococcal infection indicates an explosive, intense, and severe infection occurring in a patient whose previous condition and antecedent would never have caused any anticipation of life-threatening development. This includes necrotizing pneumonia, necrotizing fasciitis, and to some extent toxic shock syndrome and infective endocarditis. In the three former diseases, toxin production plays a major role whereas in the latter (fulminant presentation of infective endocarditis), association with any particular toxinic profile has never been demonstrated. This article reviews the clinical, pathophysiological, and therapeutic aspects of these diseases.
Fatal gastric distension in a gold thioglucose mouse model of obesity
Authors: Nitezki Tina , Kleuser Burkhard , Krämer Stephanie
Published: October 2018

This case report addresses the problem of underreporting negative results and adverse side effects in animal testing. We present our findings regarding a hyperphagic mouse model associated with unforeseen high mortality. The results outline the necessity of reporting detailed information in the literature to avoid duplication.

Obese mouse models are essential in the study of obesity, metabolic syndrome and diabetes mellitus. An experimental model of obesity can be induced by the administration of gold thioglucose (GTG). After transcending the blood-brain barrier, the GTG molecule interacts with regions of the ventromedial hypothalamus, thereby primarily targeting glucose-sensitive neurons. When these neurons are impaired, mice become insensitive to the satiety effects of glucose and develop hyperphagia. In a pilot study for optimising dosage and body weight development, C57BL/6 mice were treated with GTG (0.5 mg/g body weight) or saline, respectively. Animals were provided a physiological amount of standard diet (5 g per animal) for the first 24 hours after treatment to prevent gastric dilatation. Within 24 hours after GTG injection, all GTG-treated animals died of gastric overload and subsequent circulatory shock. Animals developed severe attacks of hyperphagia, and as the amount of provided chow was restricted, mice exhibited unforeseen pica and ingested bedding material. These observations strongly suggest that restricted feeding is contraindicated concerning GTG application. Presumably, the impulse of excessive food intake was a strong driving force. Therefore, the actual degree of suffering in the GTG-induced model of hyperphagia should be revised from moderate to severe.
How Funerals Accomplish Family: Findings From a Mass-Observation Study
Authors: Walter Tony , Bailey Tara
Published: October 2018

The article analyses how potentially conflicting frames of grief and family operate in a number of English funerals. The data come from the 2010 Mass-Observation directive “Going to Funerals” which asked its panel of correspondents to write about the most recent funeral they had attended. In their writings, grief is displayed through conventional understandings of family. Drawing on Randall Collins, we show how the funeral stratifies mourners into family or nonfamily, a stratification accomplished—by family and nonfamily—through both outward display and inner feeling. The funerals described were more about a very traditional notion of family than about grief; family trumped grief, or at least provided the frame through which grief could be written about; and perceptions of “family” prompted emotions which in turn defined family. The funerals were portrayed as a distinct arena privileging family over the fluid and varied personal attachments highlighted in both the new sociology of personal life and in the concept of disenfranchised grief.
Correlation of imaging and intraoperative findings in Pott’s puffy tumour
Authors: Olmaz Burak , Cingoz Mehmet , Akdogan Emin , Kandemirli Sedat G
Published: October 2018

Introduction

Pott’s puffy tumour is characterised by frontal bone osteomyelitis accompanied by subperiosteal abscess. It can be further complicated by intracranial extension of the infectious process.

Case presentation

A 12-year-old boy initially presented with signs and imaging findings of pan-sinusitis. Despite antibiotic therapy, there was progressive swelling of the forehead region. Subsequent imaging studies revealed osteomyelitis of frontal bone, subcutaneous abscess and extension into intracranial space. The abscesses were surgically drained, and craniectomy for osteomyelitis was carried out.

Conclusion

The initial symptoms of Pott’s puffy tumour can be subtle, and antibiotic use may mask the underlying sinister involvement of intracranial structures. Imaging plays an important role both in diagnosis and detection of possible intracranial complications.
Analysis of curve parameters to characterize multidirectional fabric wrinkling by a double extraction method
Authors: Sun Fengxin , Guo Mingrui , Hu Xiaorui , Wang Lei , Gao Weidong
Published: October 2018

Fabrics with good shape-retention properties are strongly expected to improve the aesthetic feeling, comfort and easy-care performance of clothing in daily life, and the efficient characterization of the wrinkle recovery property of fabrics is a necessary approach to facilitate the development of garments with good shape retention. Here, a double extraction method was presented to evaluate fabric wrinkling based on the wrinkling-induced residual force–displacement curves. The correlation analysis was used to determine applicable evaluation indices in order to cluster the wrinkle recovery property of fabrics based on a K-means clustering algorithm. Moreover, subjective judgements were conducted and compared with the objective K-means cluster method. The results show that there is good consistency between objective K-means clustering and subjective judgements, indicating that the indices featured from wrinkling-induced residual force–displacement curves can be used to evaluate the wrinkle recovery of fabrics. Therefore, the double extraction method is a starting point for the rapid identification of wrinkle recovery of fabrics by the mechanical performance of textiles.
Autoimmune haemolytic anaemia associated with P. vivax malaria
Authors: Taneja Sunil , Agarwal Neha
Published: October 2018

Autoimmune haemolytic anaemia due to malaria or following its treatment with artesunate is rare. A child presented with severe anaemia after being treated with artesunate for P. vivax malaria. Blood transfusion was difficult as cross-matching showed major incompatibility; group O negative blood under the cover of steroids was transfused. Oral steroids were given for six weeks. The patient made a complete recovery.
Train-Level and Car-Level Modeling of Hazardous Materials Release in Railroad Incidents
Authors: Iranitalab Amirfarrokh , Khattak Aemal
Published: October 2018

This paper quantifies the impacts of incident, railroad, environment. and train/car characteristics on the probability of hazardous material (hazmat) release in a hazmat-carrying train incident and provides a prediction tool for hazmat release. Two sets of models utilized the Federal Railroad Administration 2012–2016 rail equipment incident dataset. The units of analyses for these two sets were trains and hazmat cars. Binary logit and binary mixed logit models were investigated to account for hazmat release and potential single-level and two-level grouping in the data (owing to possible hazmat release interdependence among hazmat cars belonging to a train and trains belonging to an incident). Development of receiver operating characteristics curves improved the prediction performance of the models by defining an appropriate cutoff point. Results showed that derailment increased hazmat release probability more than other incident types. Incidents resulting from signal and communication causes were most likely to result in hazmat release. Higher proportion of damaged/derailed hazmat cars and proportion of hazmat cars in a train, track classes 2 and 3, higher train speed, and train gross tonnage were the other important factors. Results of mixed models showed hazmat release from cars belonging to a train were interdependent and hazmat release from trains belonging to an incident were independent. Although models at both levels led to useful results, car-level models had better prediction performance.
Street Intersection Characteristics and Their Impacts on Perceived Bicycling Safety
Authors: Wang Kailai , Akar Gulsah
Published: October 2018

Safety concerns are among the main issues that deter people from bicycling in the U.S. Earlier studies have explored the associations between characteristics of intersection design and bicyclists’ safety perceptions. Research shows that there are significant links between bicycling choice, safety perceptions, bicycling experience levels, and socio-demographics. Yet the existing bicycling safety-rating models do not control for individuals’ socio-demographics and their levels of bicycling experience, which are known to affect bicycling choice. This study develops a Perceived Bicycling Intersection Safety (PBIS) model which helps engineers, planners, and decision makers to understand better how a wide range of intersection features contribute to bicyclists’ safety perceptions, controlling for socio-demographics and bicycling experience. The empirical analysis is based on an online visual survey conducted at the main campus of The Ohio State University through March and April 2017. Results showed that visual surveys are effective in capturing information about bicycling preferences. The paper concludes with recommendations for infrastructure decisions and suggestions for future research. The results of this study can help planners design street intersections that bicyclists will prefer. Our model can be applied elsewhere to test the effects of different intersection and street features.
Use of Deep Learning to Predict Daily Usage of Bike Sharing Systems
Authors: Yang Hong , Xie Kun , Ozbay Kaan , Ma Yifang , Wang Zhenyu
Published: October 2018

The use of bikes among stations is often spatiotemporally imbalanced, causing many problems in daily operations. Predictively knowing how the system demand evolves in advance helps improve the preparedness of operational schemes. This paper aims to present a predictive modeling approach to analyze the use of bicycles in bike sharing systems. Specifically, a deep learning (DL) approach using the convolutional neural networks (CNNs) was proposed to predict the daily bicycle pickups at both city and station levels. A numerical study using data from the Citi Bike system in New York City (NYC) was performed to assess the performance of the proposed approach. Other than the historical records, relevant information like weather was also incorporated in the modeling process. The modeling results show that the proposed approach can achieve improved predictive performance in both city- and station-level analyses, confirming the merits of the proposed method against other baseline approaches. In addition, including information from neighboring stations into the models can help improve the performance of station-level prediction. The predictive performance of the CNN was also found to be related to parameters such as temporal window, number of neighboring stations, learning ratio, patch size, and the inclusion of additional data such as drop-offs. Thus, the implementation of the proposed models requires necessary calibration to determine appropriate parameters for a given bike sharing system.
Runaway Jury: An Analysis of State Laws Concerning Juror Impeachment
Authors: Rowe Brenda I. , McCann Wesley S.
Published: October 2018

The no impeachment rule bars the admission into evidence of juror testimony regarding jury deliberations in proceedings questioning the validity of a verdict. In Pena-Rodriguez v. Colorado, the U.S. Supreme Court created a constitutional exception to the no impeachment rule to allow impeachment of a verdict by a juror’s testimony regarding a fellow juror’s clear statement during jury deliberations indicating reliance on racial bias as a substantial motivating factor for that juror’s vote. This study traces the history of the no impeachment rule, analyzes the Court’s decision in Pena-Rodriguez v. Colorado, examines variation in exceptions provided by states’ statutory no impeachment rules, and discusses the likely impact of Pena-Rodriguez as well as policy implications of the current state of no impeachment statutes.
Intersectionality, Work, and Well-Being: The Effects of Gender and Disability
Authors: Brown Robyn Lewis , Moloney Mairead Eastin
Published: October 2018

Intersectionality emphasizes numerous points of difference through which those who occupy multiple disadvantaged statuses are penalized. Applying this consideration to the workplace, we explore ways in which status-based and structural aspects of work undermine women and people with physical disabilities and diminish psychological well-being. We conceptually integrate research on the workplace disadvantages experienced by women and people with disabilities. Drawing on a longitudinal analysis of community survey data that includes a diverse sample of people with and without physical disabilities, we explore the claim that women with disabilities are burdened by greater disadvantage in work settings compared to men with disabilities and women and men without disabilities. We find evidence that in comparison with these groups, women with disabilities on average are more psychologically affected by inequitable workplace conditions, partly because they earn less, are exposed to more workplace stress, and are less likely to experience autonomous working conditions.
Suppression of cavitation in the draft tube of Francis turbine model by J-Groove
Authors: Chen Zhenmu , Choi Young-Do
Published: October 2018

Cavitation is recognized as a phenomenon that can cause serious damage to a hydro turbine and can reduce its performance when operating at off-design point. This is an undesired phenomenon, which needs to be improved. In order to suppress the cavitation in the Francis turbine draft tube, a technology with grooved draft tube named J-Groove is introduced in the Francis turbine. The Francis turbine performance and the internal flow characteristic are investigated both with and without J-Groove installation by the experimental method and numerical simulation. Visualization was used to capture the cavitation rope in the Francis turbine draft tube to compare with the computational fluid dynamics analysis result. The results show that the turbine performance both with and without J-Groove installation is quite similar. Regardless of impact on performance of Francis turbine by J-Groove, it suppresses the cavitation vortex rope and pressure fluctuation in the Francis turbine draft tube efficiently.
Configuration analysis of a reconfigurable Rubik's snake robot
Authors: Liu Jinguo , Zhang Xin , Zhang Ketao , Dai Jian S , Li Shujun , Sun Qi
Published: October 2018

Versatility and adaptability are the most prominent advantages of reconfigurable modular robotic systems. Unlike integrated robotic systems, reconfigurable modular robots can be rearranged to adapt to unpredictable environments. This paper presents a novel reconfigurable modular robot inspired by the Rubik's snake toy. For this reconfigurable Rubik's snake robot, the special feature is that it can work as not only a mechanism but also as a reconfigurable structure. In this paper, the configuration analysis is the core content. The concept of valid configurations is proposed to describe valid, controllable, and non-interference configurations. The configuration analysis theories are introduced in accordance with the configuration representation, the isomorphism analysis, the interference analysis, and the motion sequence analysis. Here, the configuration representation is proposed to define the position and orientation of two modules by using the adjacency matrix and the binary digital code, respectively. The equivalent digital code and the configuration ring are used to distinguish the same or symmetric configurations for the open and closed isomorphism configurations, respectively. Meanwhile, a case study is conducted to verify the effectiveness of the isomorphism analysis. Furthermore, the working space interference method is introduced to detect the interference issue in the process of forming target configurations. To accomplish a target configuration properly, the motion sequence matrix is defined to describe the motion sequence for achieving a target configuration. Finally, an experiment on the configuration transformation is demonstrated to verify the rationality and correctness of the theories of configuration analysis.
Judicious selection of available rail steels to reduce life-cycle costs
Authors: Bevan Adam , Jaiswal Jay , Smith Andrew , Ojeda Cabral Manuel
Published: October 2018

The rate of rail degradation and hence its expected life is not uniform throughout any railway network and is governed by a combination of track, traffic and operating characteristics in addition to the metallurgical attributes of the rail steel. Consequently, it is suggested that any route or network is not a single linear asset but is a compilation of individual segments with different track characteristics, degradation rates and expected life spans. Thus, the choice of rail steel grade to maximise life (and minimise life-cycle costs) needs to combine knowledge of the metallurgical attributes of the available rail steels with the conditions prevailing at the wheel–rail and vehicle–track interfaces, whilst also considering the economic costs and benefits of the different options. This paper focuses on the classification of the susceptibility to rail degradation in various parts of a mixed-traffic network using vehicle dynamics simulation. The metallurgical attributes of the currently available rail steels are summarised along with an assessment of the life-cycle costs and wider economic implications associated with selection of a rail steel which provides improved resistance to the key degradation mechanisms of rolling contact fatigue and wear. Overall, the proposed methodology, which incorporates engineering, metallurgical and economic assessments, provides guidance on the circumstances in which the introduction of alternative rail steels make sense (or not) from an economic perspective.
Empiric antimicrobial treatment for asymptomatic sexual contacts of sexually transmitted infection in the era of antimicrobial resistance: time to rethink?
Authors: Pearce Elizabeth , Chan Derek J , Smith Don E
Published: October 2018

Prudent prescribing of antimicrobials is essential in ameliorating the public health problem of antimicrobial resistance. This retrospective audit assesses whether empiric antimicrobial treatment for asymptomatic sexual contacts of sexually transmitted infection is appropriate based on laboratory confirmation.
Resolution of large aortic valve vegetations in antiphospholipid syndrome treated with therapeutic anticoagulation: a report of two cases and literature review
Authors: Yuriditsky E , Torres J , Izmirly P M , Belmont H M
Published: October 2018

Non-bacterial thrombotic endocarditis in antiphospholipid syndrome presents a management dilemma. Large mobile valvular lesions pose an increased risk of stroke and arterial embolization. However, surgical excision or valve replacement in such patients carries high morbidity and mortality, while anticoagulation alone has limited data. We describe two patients with antiphospholipid syndrome presenting with neurologic events and large non-bacterial aortic valve vegetations. Both patients were successfully managed with anticoagulation and demonstrated rapid dissolution of lesions without evidence of recurrent embolic events. We provide a literature review describing additional cases managed with anticoagulation with dissolution of valvular lesions over time. Our cases further support the efficacy and safety of anticoagulation in patients with antiphospholipid syndrome and non-bacterial thrombotic endocarditis in the context of arterial embolization.
Therapeutic response to glucocorticoids, anticoagulation and plasma exchange in a patient with primary antiphospholipid syndrome presenting with purpura fulminans
Authors: Plüß M , Zeisberg M , Müller G A , Vasko R , Korsten P
Published: October 2018

We report the case of a 25-year-old female patient who presented with purpura fulminans as a manifestation of primary antiphospholipid syndrome. Purpura fulminans is considered a rare cutaneous manifestation of antiphospholipid syndrome. Most frequently, it occurs in the context of catastrophic antiphospholipid syndrome and is associated with significant morbidity and mortality, either due to loss of affected extremities or thromboembolic damage to internal organs. After insufficient efficacy of parenteral anticoagulation and oral glucocorticosteroid treatment, we escalated treatment to high-dose intravenous glucocorticosteroid and five consecutive sessions of plasma exchange with good and sustained clinical response. At follow-up six months after admission, skin manifestations had healed with scarring, and no additional thrombotic events had occurred. Plasma exchange may hold promise as a therapeutic option in refractory or severe cases of antiphospholipid syndrome-related purpura fulminans with extensive cutaneous necrosis, although evidence is limited.
Giving G a Meaning: An Application of the Bifactor-(S-1) Approach to Realize a More Symptom-Oriented Modeling of the Beck Depression Inventory–II
Authors: Heinrich Manuel , Zagorscak Pavle , Eid Michael , Knaevelsrud Christine
Published: October 2018

The Beck Depression Inventory–II is one of the most frequently used scales to assess depressive burden. Despite many psychometric evaluations, its factor structure is still a topic of debate. An increasing number of articles using fully symmetrical bifactor models have been published recently. However, they all produce anomalous results, which lead to psychometric and interpretational difficulties. To avoid anomalous results, the bifactor-(S-1) approach has recently been proposed as alternative for fitting bifactor structures. The current article compares the applicability of fully symmetrical bifactor models and symptom-oriented bifactor-(S-1) and first-order confirmatory factor analysis models in a large clinical sample ( N = 3,279) of adults. The results suggest that bifactor-(S-1) models are preferable when bifactor structures are of interest, since they reduce problematic results observed in fully symmetrical bifactor models and give the G factor an unambiguous meaning. Otherwise, symptom-oriented first-order confirmatory factor analysis models present a reasonable alternative.
Convergent, Discriminant, and Concurrent Validity of Nonmemory-Based Performance Validity Tests
Authors: Webber Troy A. , Critchfield Edan A. , Soble Jason R.
Published: October 2018

To supplement memory-based Performance Validity Tests (PVTs) in identifying noncredible performance, we examined the validity of the two most commonly used nonmemory-based PVTs—Dot Counting Test (DCT) and Wechsler Adult Intelligence Scale–Fourth edition (WAIS-IV) Reliable Digit Span (RDS)—as well as two alternative WAIS-IV Digit Span (DS) subtest PVTs. Examinees completed DCT, WAIS-IV DS, and the following criterion PVTs: Test of Memory Malingering, Word Memory Test, and Word Choice Test. Validity groups were determined by passing 3 (valid; n = 69) or failing ⩾2 (noncredible; n = 30) criterion PVTs. DCT, RDS, RDS–Revised (RDS-R), and WAIS-IV DS Age-Corrected Scaled Score (ACSS) were significantly correlated (but uncorrelated with memory-based PVTs). Combining RDS, RDS-R, and ACSS with DCT improved classification accuracy (particularly for DCT/ACSS) for detecting noncredible performance among valid-unimpaired, but largely not valid-impaired examinees. Combining DCT with ACSS may uniquely assess and best supplement memory-based PVTs to identify noncredible neuropsychological test performance in cognitively unimpaired examinees.
Evaluation of acoustic emission burst detection methods in a gearbox under different operating conditions
Authors: Leaman F. , Niedringhaus C. , Hinderer S. , Nienhaus K.
Published: October 2018

In account of its abilities to follow the damage progression, also at early stages, the acoustic emission (AE) analysis has become an attractive technique for machine condition monitoring. An AE analysis involves the detection of transients within the signals, which are called AE bursts. Traditional methods for AE burst detection are based on the definition of threshold values. When the machine under analysis works under variable operating conditions, threshold-based methods could lead to poor results due to the influence of these conditions on the AE generation. The present work compares the ability of three AE burst detection methods in a planetary gearbox working under different rotational speeds and loads. The results showed that performance could be significantly improved by using factors of the root mean square value as threshold values instead of fixed values. Among the evaluated methods, the method that includes demodulation and differentiation as a signal processing technique had the best performance overall.
A Rigorous Approach to Large-Scale Elicitation and Analysis of Patient Narratives
Authors: Schlesinger Mark , Grob Rachel , Shaller Dale , Martino Steven C. , Parker Andrew M. , Rybowski Lise , Finucane Melissa L. , Cerully Jennifer L.
Published: October 2018

Patient narratives have emerged as promising vehicles for making health care more responsive by helping clinicians to better understand their patients’ expectations, perceptions, or concerns and encouraging consumers to engage with information about quality. A growing number of websites incorporate patients’ comments. But existing comments have fragmentary content, fail to represent less vocal patients, and can be manipulated to “manage” providers’ reputations. In this article, we offer the first empirical test of the proposition that patient narratives can be elicited rigorously and reliably using a five-question protocol that can be incorporated into large-scale patient experience surveys. We tested whether elicited narratives about outpatient care are complete (report all facets of patient experience), balanced (convey an accurate mix of positive and negative events), meaningful (have a coherent storyline), and representative (draw fulsome narratives from all relevant subsets of patients). The tested protocol is strong on balance and representativeness, more mixed on completeness and meaningfulness.
Activist Affect
Authors: Harris Anne , Jones Stacy Holman
Published: October 2018

This brief essay considers what new materialist thought and affect theory in particular might bring to activist politics, particularly the need to sustain the energy and power of public assembly in the form of political marches into a movement that persists in and through time. We consider the site of both terrorist and activist acts not only as a public space—or stage—upon which both acts occur, but instead as public body that keeps the movement moving.
Niraparib – A promising drug with hematological toxicity
Authors: Patibandla Naga SK , Monga Dulabh K
Published: October 2018

Ovarian cancer is the second most common and the most lethal gynecological malignancy in the western world. Unfortunately, there are lack of methods for early screening and diagnosis of the disease. Because of this, most of the cases are diagnosed at an advanced stage and have poor prognosis. The standard treatment of ovarian cancer is maximal cytoreductive surgical debulking followed by platinum-based chemotherapy. There are new molecular agents available for maintenance therapy of ovarian cancer including anti-angiogenic therapies, poly adenosine diphosphate ribose polymerase inhibitors, inhibitors of growth factor signaling, or folate receptor inhibitors, as well as several immunotherapeutic approaches. Niraparib is a poly adenosine diphosphate ribose polymerase inhibitor that has shown to be clinically effective as maintenance therapy in patients with platinum sensitive, recurrent ovarian cancer. Studies have shown the median duration of progression-free survival was significantly longer among those receiving niraparib than among those receiving placebo, regardless of presence or absence of BRCA gene mutations or homologous recombination deficiency status. Studies have shown that treatment-emergent Grade 3 or Grade 4 hematological events were observed in patients receiving niraparib including thrombocytopenia (33.8%), anemia (25.3%) and neutropenia (19.6%). Most of the hematological laboratory abnormalities occurred within the first three treatment cycles. After dose adjustment, the incidence of hematological abnormalities was infrequent beyond cycle 3. We are reporting two cases of Grade III/IV neutropenia and thrombocytopenia in patients treated with niraparib in our institution. Unfortunately, one of the patients succumbed to septic shock secondary to right lower lobe pneumonia while severely neutropenic. The second patient’s blood counts improved after discontinuing the medication and with supportive transfusions during the hospitalization.
Translation and validation of the Chinese version of the Cancer Stigma Scale
Authors: Ye Xuan , Liu Hong-Yue , Lu Sheng-Rong , Zhai Qing , Yu Bo
Published: October 2018

Purpose

To test the reliability and validity of the Chinese version of the Cancer Stigma Scale (CASS).

Methods

After translation, back-translation and cross-cultural adaptation of the CASS into Chinese (C-CASS), a random online survey of the general population in China was conducted. Reliability was analyzed by internal consistency (Cronbach’s α) and construct validity was analyzed by confirmatory factor analysis. The C-CASS was evaluated in a sample of 382 non-cancer patients through online format.

Results

The study found that the C-CASS had satisfactory internal reliability (Cronbach’s α of the overall scale and six components was 0.88 and 0.70–0.89, respectively). Confirmatory factor analysis confirmed the six-factor structure (χ2/df = 2.2, GFI = 0.91, CFI = 0.94, RMSEA = 0.056, SRMR = 0.065). Younger individuals and those who had less knowledge of cancer showed more negative attitudes towards cancer.

Conclusion

The C-CASS had adequate internal consistency, reliability and indices of model fit, allowing its feasible use to assess levels of cancer stigma in Chinese populations.
Laser transmission joining of thermoplastic fasteners: Application for thermoset CFRP
Authors: Brodhun J , Blass D , Dilger K
Published: October 2018

A laser transmission-based joining process is investigated, joining one thermoplastic adherend (PA6) which is transparent for the applied laser radiation with another adherend being a thermoset carbon fiber-reinforced plastic. The application is addressed to use thermoplastic fasteners to join different materials to thermoset carbon fiber-reinforced plastic parts. The influence of different laser intensities and different amounts of introduced energies to the joint are investigated. Therefore, laser parameters such as scan speed and laser power are varied using a fiber laser and a scanner optic. The same laser source is used to pretreat the thermoset surface exposing the C-fibers before joining. The performance and the quality of the joints are evaluated by mechanical shear-tests and microscopic cross sections. The results show the significant influence of laser intensity and energy on damage-mechanisms but also the possibility to provide good quality joints reaching up to 13.8 MPa.
Modified prophylactic 5‐fr pancreatic duct stent enhances the rate of spontaneous dislodgement: A multicenter randomized controlled trial
Authors: He Qibin , Wang Lei , Peng Chunyan , Zou Xiaoping , Zhan Qiang , Xu Yaping , Liu Qiang , Qian Junbo , Gong Lei , Shen Yingzhou , Chen Jianping
Published: October 2018

Background and objectives

Prophylactic pancreatic duct stent placement effectively reduces post‐endoscopic retrograde cholangiopancreatography pancreatitis in high‐risk patients, but the optimal stent remains unclear. We modified a 5‐Fr, 3 cm pancreatic stent by removing the flange on the pancreatic side and compared the rate of spontaneous dislodgement and complications with the ordinary stent.

Methods

This was a randomized controlled trial at six tertiary endoscopic centers. Patients deemed high risk for post‐endoscopic retrograde cholangiopancreatography pancreatitis randomly received modified or ordinary pancreatic stent. The primary outcome was spontaneous stent dislodgement at five days and 14 days. Secondary outcomes were the success rate of stent placement and complications.

Results

A total of 276 patients were randomly assigned to receive modified stents (mS group) and ordinary stents (oS group). The placement of a pancreatic stent was successful in all 276 patients. There were no significant differences between groups with respect to age, sex, major diagnosis, or indications for stenting. At five days the spontaneous dislodgement rate was 47.72% for the mS group and 15.67% for the oS group (p<0.001); at 14 days the rates were 84.21% and 42.65%, respectively (p < 0.001). Post‐endoscopic retrograde cholangiopancreatography pancreatitis occurred in 6.52% of all patients. There were no significant differences regarding the incidences of post‐endoscopic retrograde cholangiopancreatography pancreatitis, hemorrhage or fever.

Conclusions

The modified short 5‐Fr stent has a higher spontaneous dislodgement rate than ordinary pancreatic stent, thus obviating the need for endoscopic removal. The modified pancreatic stent does not increase the incidence of post‐endoscopic retrograde cholangiopancreatography pancreatitis or other complications. The endoscopist can consider removing the flange on the pancreatic duct side for prophylactic pancreatic duct manipulation.
International TV series distribution on Chinese digital platforms: Marketing strategies and audience engagement
Authors: Gilardi Filippo , Lam Celia , Tan K Cohen , White Andrew , Cheng Shuxin , Zhao Yifan
Published: October 2018

The relationship between online media platforms in China and fan groups is a dynamic one when it comes to the distribution of international TV series and other media content, as media platforms incorporate user-generated content to encourage or foster audience engagement. Through a series of case studies, this article investigates how international TV series are acquired, distributed, marketed and curated on Chinese online video platforms. This helps to identify specific strategies and themes used by these platforms to promote international content and engage users. These marketing techniques, however, are not always as successful as expected, suggesting the need for a closer examination of the types of engagement sought by media platforms, and the ways in which Chinese audiences have responded within their cultural context.
Royal Dynasties, Political Representation and Positive Discrimination: A Comparison of Two Constituencies in Northwestern Odisha
Authors: Skoda Uwe , Bag Minaketan
Published: October 2018

The article based on longterm anthropological fieldwork in the area does not only look at Bamra as a rather successful dynasty in Odishan politics but compares it with a neighbouring former princely state of Bonai. While the former is now a general seat, the latter is a reserved constituency for Scheduled Tribes (STs) effectively depriving the royal family of its passive voting rights. It is argued that positive discrimination significantly shaped their electoral fortunes. It led in one case to a dynasty of princely politicians, though they are increasingly competing with rising Other Backward Classes (OBCs) forming their own, though still relatively shallow dynasties. However, a few kilometers away, arguably through the shifting support of former royals in Bonai for several MLAs, no other, potentially competing political dynasty has emerged, while relatively lower STs are also claiming political representation in a competitive field, in which royal influence is still relevant.
Supporting student nurses who have their first clinical placement in the community nursing team
Authors: Carr Jacqui , Taylor Rachel , Pitt Margaret
Published: October 2018

First year student nurses are increasingly undertaking their first placement with community nurses. The importance of how this initial learning experience is introduced by the higher education institution, as well as how the student is welcomed and integrated into the community nursing team, cannot be underestimated. Following positive anonymous feedback from students, which indicated that they had benefitted from the introduction, welcome and integration they experienced, the university and mentors reviewed how this had been done to identify good practice to share with colleagues. Students indicated that their welcome and integration had helped them to feel part of the team and enhanced learning, because they were so well supported, and mentors had facilitated learning experiences by acknowledging that this was their first placement experience. It is notable that mentors were committed to the students' learning and used workplace social capital to optimise the student experience. At a time when retention of students is essential to increase the future workforce, mentors dedicated to student learning are acting as ambassadors for the community workforce, and may well encourage students to have a career in community nursing.
Diabetes care in care home and residential settings
Authors: Gregory Sarah
Published: October 2018

An increasing number of people require insulin to manage their diabetes, many of them in supported environments such as residential care homes. Community nursing teams are likely to have a growing caseload of care home residents who require diabetes care, including insulin injections, and many unregistered practitioners are being asked to take on this role. If community nurse leads, matrons, frailty teams and pharmacy teams work together to provide training to staff in care homes (particularly unregistered practitioners), diabetes care can be improved. This has to be suitable for groups and for people with different levels of understanding, and supported by written resources. Courses are interactive to engage and motivate all learners, and methods of teaching include group work, visual teaching aids and games. Self-assessment around competencies, using a competency framework, not only demonstrates the development of staff but also highlights key areas of diabetes care.
The clinical approach to managing herpes simplex virus encephalitis
Authors: Leahy Christopher B , Mathur Sachin , Majeed Tahir
Published: October 2018

This article explains the approach to managing a patient with herpes simplex virus encephalitis. Acute encephalopathy is a common and often intimidating presentation in an acute general medical setting. Application of key principles will enable the generalist to take life-saving action before obtaining any specialist input. Viral infection is the most common cause (48.2%) of encephalitis; another large group is cases of autoimmune aetiology. Early diagnosis of encephalitis is crucial to ensure that the right treatment is given on time.

Guidelines on the management of viral encephalitis were published by the British Association of Neurologists and British Infection Association ( Solomon et al, 2012 ), but adherence to these standards by clinicians has been found to be suboptimal ( Han and Coebergh, 2017 ). This puts lives in danger, in the context of a treatable, serious, acute presentation. Although viral infection is the most common cause of encephalitis, an awareness of rarer forms of autoimmune encephalitis is necessary. The differential diagnosis of autoimmune encephalitis is important because the disease is potentially treatable with immunosuppressive agents. Paraneoplastic limbic encephalitis may present months or years before the detection of a tumour.
Acute medical problems in pregnancy
Authors: Coad Felicity , Nelson-Piercy Catherine
Published: October 2018

The maternal population in the UK has become an increasingly challenging group of patients to manage. Women with pre-existing and often complex medical conditions are successfully conceiving. Most physicians will have had some involvement in the care of obstetric patients admitted with medical problems, and a lack of experience and fear of causing harm may result in essential investigations and treatment being withheld.

The physiological changes in pregnancy can complicate the interpretation of observations and test results. This article discusses the presentation of commonly encountered medical problems in the obstetric population, including breathlessness, chest pain, palpitations, seizure and headache. It covers specific investigations and suggested treatment in this subset of patients. These women should receive the same level of care and attention as those who are not pregnant. Early diagnosis and effective management can help to reduce maternal morbidity and mortality caused by medical problems arising during pregnancy.
Assault bill: incoming law aims to protect paramedics
Authors: Quaile Alistair
Published: October 2018

While unacceptable, attacks on paramedics seem to have become commonplace. New legislation now promises to toughen sentences for assaults on emergency workers on duty. Alistair Quaile reports on the details of the assault bill, while our social media followers have their say as we highlight their comments throughout the article
Promoting gender equality
Authors: Pywell Charlotte
Published: October 2018

After research named Middlesbrough as the worst place to grow up as a girl, a project at Unity City Academy set out to empower its young female students. Charlotte Pywell explains
Curriculum design and delivery: Part 5
Authors: Bromley Matt
Published: October 2018

When designing our curriculum, we should work backwards from the intended outcomes. Continuing his curriculum series, Matt Bromley models what this process might look like
Creating therapeutic schools
Authors: Knight Shahana
Published: October 2018

In a new series, expert Shahana Knight advises on supporting the emotional and mental health of children and staff, offering easy whole-school and classroom-specific ideas and activities
Do you talk about death?
Authors: Penny Alison
Published: October 2018

It is perhaps the one issue that many children will experience but which schools don't talk about. Alison Penny gives five reasons for making death and dying part of your curriculum