bluuebunny/crossref_metadata_2025 huggingface dataset:
Introducing high-flow nasal cannula oxygen therapy at the intermediate care unit: expanding the range of supportive pulmonary care
Authors: Plate Joost D J , Leenen Luke P H , Platenkamp Marc , Meijer Joost , Hietbrink Falco
Published: August 2018

Background

Non-invasive respiratory support is a frequent indication for intermediate care unit (IMCU) admission. Extending the possibilities of respiratory support at the IMCU with high-flow nasal cannula oxygen therapy (HFNC) may prevent intensive care unit (ICU) transfer and invasive ventilation. However, the safety and limitations of HFNC administration in the stand-alone IMCU setting are not yet studied. This study therefore aims to investigate to what extent and in which patients HFNC can safely be administered at a stand-alone mixed surgical IMCU.

Methods

A case series, using retrospectively collected data, was performed after the first year of introducing HFNC at a stand-alone IMCU. The following variables were collected: indication to start HFNC, vital parameters and arterial blood gas measurements. Primary outcome was 30-day mortality. Secondary outcome was transfer to the ICU.

Results

A total of 96 admissions were included. The indications to start HFNC at the IMCU were predominantly pathologies of pulmonary origin (n=67, 69.8%). Less frequent indications were prolonged support postweaning (n=15), non-pulmonary sepsis (n=7) and post-trauma resuscitation (n=6). The average PaO2/FiO2ratio at start of HFNC was 152 (95% CI 139 to 165). 30-day mortality was 7, of which 5 were admitted with treatment restrictions (no ICU policy) and 2 deaths were unrelated to HFNC. Transfer to the ICU occurred in 18 (18.8%) admissions, of which 12 received invasive mechanical ventilation. Reason for ICU transfer was mainly PaO2/FiO2 ratio<100 under maximum non-invasive treatment (n=12, 66.7%). Application of HFNC at the IMCU prevented 162 days of ICU admission.

Discussion

Administration of HFNC at a stand-alone surgical IMCU may be safe as it expands the range of supportive possibilities and thereby reduces the need for ICU admissions.Pulmonary indications to start HFNC increase the risk of ICU transfer and mechanical ventilation.

Level of evidence

Level VI.
Emergency diagnosis and treatment of congenital lobar emphysema in a puppy
Authors: Earley Naomi F , Herrtage Michael E , Hall Jon L
Published: August 2018

Congenital lobar emphysema is a rare condition in dogs. A three-month-old pug presented with acute dyspnoea and radiographic findings diagnosed congenital lobar emphysema. Due to the patient’s rapidly deteriorating ventilation, an emergency right middle lung lobectomy was performed and recovery was uneventful. This case report describes the importance of making a prompt and accurate diagnosis of this condition, based on radiographic findings, to facilitate immediate treatment.
The unique giant Irish moss (Chondrus crispus) from Basin Head: health assessment in relation to reference sites on Prince Edward Island
Authors: Tummon Flynn Paula , Garbary David , Novaczek Irene , Miller Anthony , Quijón Pedro A.
Published: August 2018

Irish moss (Chondrus crispus Stackhouse) is a red alga that is common in Atlantic Canada. A unique strain of this species, the giant Irish moss, grows in a single location and is under strict protection. Unlike the common coastal form, the giant Irish moss reproduces solely by fragmentation and is found in gametophyte form. A 99.9% decline in giant Irish moss abundance (1999–2012) prompted this study to address two questions: whether the giant Irish moss remains 100% vegetative and gametophytic, and whether such decline is related to factors leading to a reduction in photosynthetic health. Six populations of the common Irish moss strain were compared with two populations of giant Irish moss, and their life history phases determined using a resorcinol method. The common Irish moss populations exhibited a 65%–86% ratio of gametophytic:tetrasporophytic fronds, while both giant strain populations were 100% gametophytic. Photosynthetic efficiency was measured with Pulse-Amplitude-Modulation (PAM) fluorometry and neither giant moss population had significantly different quantum yield values from the littoral populations. Hence, these analyses provided no evidence of giant Irish moss being exposed to particular sources of stress linked to water or habitat quality and alternative factors explaining the decline of this unique strain are proposed.
Public Support for Democratic Reform in post-Mubarak Egypt
Authors: Muedini Fait , Dettrey Bryan
Published: August 2018

This article investigates support for democracy after the overthrow of Egypt’s long-time President Hosni Mubarak. It specifically examines concerns prompting the protests and support for several democratic reforms in Egyptian governance. The results suggest corruption slightly outweighed the lack of democracy as a primary concern of Egyptians over the last few years. Specific democratic reforms such as a fair judicial system and the ability to criticize government receive significant support. Less support is found for equal rights for women and considerably less support for civilian control of the military. The article concludes with a discussion of how little support for providing civilian control over the military may represent an obstacle to a democratic transition. Democratic consolidations are more likely to be successful if democracy is “the only game in town”.
1
The role of the military in the ouster of Mubarak and now Mursi suggests the military has significant influence on Egyptian governance, with little support for altering this institutional arrangement.
Tackling Concentrated Animal Agriculture in the Middle East through Standards of Investment, Export Credits, and Trade
Authors: Blattner Charlotte E.
Published: August 2018

Saudi Arabia, the United Arab Emirates, and Qatar are the main investors in farm animal production outside their territory, prompting a mass-adoption of concentrated animal feeding operations in investment-importing states like Iran and Pakistan. Global actors like the International Finance Corporation and the Food and Agriculture Organization espouse the Middle Eastern states’ investment strategy by generously supporting it with direct payments and feed. Because intensified animal agricultural production systems are known to cause environmental pollution, threaten public health and food security, and pose a moral hazard for animals, this article makes use of existing cross-border relationships to the Middle East to counter the growing agricultural trend towards intensification. Specifically, the article examines whether and how international investment standards, export credit standards, bilateral investment treaties, and bilateral free trade agreements can be used to encourage responsible investment and trade flows that factor in the interests of animals.
More of the Same: Discursive Reactions of Members of Knesset to the 2011 ‘Social Protest’ in Israel
Authors: Avigur-Eshel Amit
Published: August 2018

The 2011 ‘Social Protest’ in Israel was motivated by discontent with the outcomes of neo-liberal economic policies. Moreover, during rallies protest leaders used explicit counter-neo-liberal ideas and discourse. Nonetheless, this article shows that Members of Knesset (the Israeli parliament) used neo-liberal ideas and discourse more following the protest than they had done before its outbreak. Relying on recent theoretical developments emphasizing the importance of ideas and discourse in social and political analysis, I account for Members of Knesset’s ideas and discourse through analyzing explanation clauses accompanying private member bills. The article concludes by suggesting that the protest may have turned neo-liberal ideas from a means used by economic experts to promote economic liberalization to a means used by politicians to demonstrate their democratic responsiveness to citizens’ economic demands.
Learning outcomes and assessment methodology: Case study of an undergraduate engineering project
Authors: Naqvi Syed Rameez , Akram Tallha , Haider Sajjad Ali , Khan Wilayat , Kamran Muhammad , Muhammad Nazeer , Nawaz Qadri Nadia
Published: August 2018

Considering the effectiveness of outcome-based education and its increasing implementation in higher education, we propose a set of course learning outcomes that may be related to any engineering problem, in particular the final year project in undergraduate engineering programs. We also show how these outcomes may be mapped to program learning outcomes identified by the Washington Accord. Our case study is an embedded vision system developed by our own group, which we assess against these outcomes using the proposed self-assessment report rubrics. We conclude by presenting assessment reports for our project from two expert academics showing how well it managed to attain the course learning outcomes. This work is intended to give students a direction to professionally as well as ethically approach a particular design problem, and at the same time help the instructors evaluate their students’ projects by simply adopting the proposed assessment methodology.
Effect of Relative Versus Absolute Quantitative Messages Regarding Suicide on the Perceived Severity of the Phenomenon
Authors: Levi-Belz Yossi , Gamliel Eyal
Published: August 2018

Presentation of epidemiological information about the absolute number of suicides has been used occasionally to increase awareness of the suicide phenomenon. This study investigated the effectiveness of absolute quantitative messages versus relative messages. An example of relative messages would be comparing the number of suicide deaths with the number of deaths by car accidents. Participants were randomly presented with absolute or relative messages regarding suicide. They were then requested to indicate the degree of severity they attributed to the suicide phenomenon, being the level to which they view the phenomenon as sufficiently important to mandate national intervention and resource allocation. Relative messages proved more effective than absolute ones in yielding greater perceived severity of suicide. Increasing public and policymakers’ awareness of the suicide phenomenon could be aided by presenting information in relative terms.
Relation between mechanism of soil removal from fabrics and a parameter derived from probability density functional method for washing force analysis
Authors: Oya Masaru
Published: August 2018

The probability density functional method is one of the washing force analysis methods that combines the classical kinetic analysis of detergency method and risk calculation method using probability density function. This paper discusses the relation between soil removal mechanisms and the value of σ rl, which is one of the two parameters used in the probability density functional method. Four repetitive washing tests were conducted using test fabrics soiled with iron(III) oxide, carbon black, four kinds of water-soluble dyes and three kinds of oily dyes, and the removal (%) was analyzed with the probability density functional method. The results show that the range of σ rl varied with removal mechanisms; mechanical removal of particle soil (0.01–0.6), dissolution into water of water-soluble soil (0.3–1.4), solubilization of oily soil into surfactant micelle (1.0–2.0) and emulsification or dispersion of oily soil (≥3.0). This tendency can be used for estimating the removal mechanism of any washing system where the soil type is unknown.
Functional health status of adults with serious mental illness and diabetes mellitus: A latent profile analysis
Authors: McKibbin Christine L , Lee Aaron , Glaser Dale , Kanuch Stephanie , Cassidy Kristin , Thomas Charles , Gunzler Douglas , McCormick Richard , Dawson Neal V , Sajatovic Martha
Published: August 2018

Objective

Adults with serious mental illness are at increased risk for diabetes mellitus and diabetes-related complications. This article classifies subgroups among people with serious mental illness and comorbid diabetes with respect to functional status and examines differences among those groups.

Methods

This analysis used a baseline sample of 157 adults with serious mental illness and diabetes mellitus enrolled in a National Institute of Health-funded research study. Latent profile analysis was used to distinguish health status profiles and investigate how these subgroups differed across assessment domains.

Results

Participants with depression, schizophrenia, and bipolar disorder (n = 157) were included in the study. Mean age was 52.9 years (standard deviation = 9.8), and 62 (40%) were African American. From the latent profile analysis, a three-class model appeared to provide the best fit. Class 1 (34.9%) had a very low functional health status approximately two standard deviations below the general population mean. Class 2 (43.7%) had a low functional status approximately one standard deviation below the general mean. Class 3 (21.4%) had moderate functional status with scores near population mean. Groups differed on measures of personal characteristics, clinical status and symptom severity, self-care behaviors, and environmental characteristics.

Conclusions

Although individuals with schizophrenia generally have poor prognosis once they develop diabetes, latent profile analysis identified distinct health status subgroups. Although all three groups demonstrated illness burden, the pattern of differences between these groups across measures may suggest the need for different interventions for highly diverse adults who received care within safety-net primary care.
Social support deficit and depression treatment outcomes in patients with acute coronary syndrome: Findings from the EsDEPACS study
Authors: Kim Ju-Wan , Kang Hee-Ju , Bae Kyung-Yeol , Kim Sung-Wan , Shin Il-Seon , Yoon Jin-Sang , Hong Young Joon , Ahn Youngkeun , Jeong Myung Ho , Kim Jae-Min
Published: August 2018

Objectives

This study aimed to investigate whether social support deficit has moderating effects on depressive and cardiac outcomes in an antidepressant trial for depressed patients with acute coronary syndrome as a secondary analysis using Escitalopram for DEPression in acute coronary syndrome study (ClinicalTrial.gov registry number: NCT00419471).

Methods

In total, 217 acute coronary syndrome patients with Diagnostic and Statistical Manual of Mental Disorders, 4th edition depressive disorders were randomized into two groups that received escitalopram (N = 108) or placebo (N = 109) for 24 weeks. Social support deficit was evaluated by validated scales at study entry. Depressive outcomes were measured using the Hamilton Depression Rating Scale, the Montgomery Asberg Depression Rating Scale, and the Beck Depression Inventory. Cardiac outcomes included echocardiography (left ventricular ejection fraction and wall motion scores), electrocardiography (heart rate, PR interval, QRS duration, and QTc duration), and laboratory test results (troponin I and creatine kinase-MB).

Results

A higher social support deficit at baseline was significantly associated with less improvement in Hamilton Depression Rating Scale, Montgomery Asberg Depression Rating Scale, Beck Depression Inventory scores, and serum troponin I levels after adjustment for corresponding baseline scores, covariates associated with social support deficit at baseline, and treatment status. The strength of these associations was more prominent in the placebo group compared to the escitalopram group.

Conclusions

Evaluation of social support deficit in depressed acute coronary syndrome is important, and particularly during the acute phase, depressed acute coronary syndrome patients with social support deficit should be treated more carefully to improve treatment outcomes, given that social support deficit was predictive of poorer depressive and cardiac outcomes during the 24-week treatment period. Acute coronary syndrome patients with social support deficit should be treated more carefully to improve treatment outcomes.
Lessons in early identification and treatment from a case of disabling vitamin C deficiency in a child with autism spectrum disorder
Authors: Rafee Yaseen , Burrell Katherine , Cederna-Meko Crystal
Published: August 2018

Background

Autism spectrum disorder is a heterogenous neurodevelopmental condition accompanied by a variety of associated features. Case reports suggest one such associated feature, food selectivity, increases risk for nutritional deficiencies; however, little attention has been given to prevent and treat nutritional deficiencies in youth with autism spectrum disorder.

Method

Single case report.

Results

This single case report presents a child with autism spectrum disorder and food selectivity difficulties that resulted in severe vitamin C deficiency. Although eventually corrected, the nutritional deficiency was debilitating, required invasive interventions, and resulted in significant social/emotional and economic costs.

Conclusions

We review the course of treatment and highlight strategies to prevent and more effectively treat nutritional deficiencies in youth with autism spectrum disorder.
Assessing phonological awareness in Italian children with and without developmental dyslexia: The contribution of a new pseudo-word blending task
Authors: Fastame Maria Chiara , Cardis Anna , Callai Daniela
Published: August 2018

The current study investigated the capacity of a new test assessing phonological awareness to detect differences between Italian children with and without developmental dyslexia. Specifically, the task involves blending of a list of pseudo-words, and excludes lexical knowledge as a source of task performance. Fifty-four third to fifith Italian graders were presented a battery of tests assessing phonological awareness, reading, writing, and verbal short-term memory abilities. A multivariate analysis of covariance, with age as a covariate, revealed that proficient readers outperformed students with developmental dyslexia in all cognitive measures considered, except verbal short-term memory. Moreover, high concordance was found between the new pseudo-word blending task, and well-known word blending, writing, and reading tests, respectively. In conclusion, the new phonological awareness task seems to be a useful tool for the detection of poor blending abilities of Italian children and thus it could be used to screen phonological awareness in primary schools. Implications for school psychology research and practice, including across linguistic contexts, are emphasized; for example, the new blending task could aid discrimination of proficient and dyslexic readers speaking other languages characterized by a transparent orthography, such as Greek, Spanish, Turkish.
Structural and fractal characterization of adsorption pores of middle–high rank coal reservoirs in western Yunnan and eastern Guizhou: An experimental study of coals from the Panguan syncline and Laochang anticline
Authors: Zhang Junjian , Wei Chongtao , Yan Gaoyuan , Lu Guanwen
Published: August 2018

To better understand the structural characteristic of adsorption pores (pore diameter < 100 nm) of coal reservoirs around the coalbed methane production areas of western Yunnan and eastern Guizhou, we analyzed the structural and fractal characteristics of pore size range of 0.40–2.0 nm and 2–100 nm in middle–high rank coals ( Ro,max = 0.93–3.20%) by combining low-temperature N2/CO2 adsorption tests and surface/volume fractal theory. The results show that the coal reservoirs can be divided into three categories: type A ( Ro,max < 2.15%), type B (2.15% <  Ro,max <2.50%), and type C ( Ro,max > 2.15%). The structural parameters of pores in the range from 2 to 100 nm are influenced by the degree of coal metamorphism and the compositional parameters (e.g., ash and volatile matter). The dominant diameters of the specific surface areas are 10–50 nm, 2–50 nm, and 2–10 nm, respectively. The pores in the range from <2 nm provide the largest proportion of total specific surface area (97.22%–99.96%) of the coal reservoir, and the CO2-specific surface area and CO2-total pore volume relationships show a positive linear correlation. The metamorphic degree has a much greater control on the pores (pore diameter less than 2 nm) structural parameters than those of the pore diameter ranges from 2 to 100 nm. Dv1 and Dv2 can characterize the structure of 2–100 nm adsorption pores, and Dv1 (volume heterogeneity) has a positive correlation with the pore structural parameters such as N2-specific surface area and N2-total pore volume. This parameter can be used to characterize volume heterogeneity of 2–10 nm pores. Dv2 (surface heterogeneity) showed type A > type B > type C and was mainly affected by the metamorphism degree. Ds2 can be used to characterize the pore surface heterogeneity of micropores in the range of 0.62–1.50 nm. This parameter has a good correlation with the pore parameters (CO2-total pore volume, CO2-specific surface area, and average pore size) and is expressed as type C < type B < type A. In conclusion, the heterogeneity of the micropores is less than that of the meso- and macropores (2–100 nm). Dv1, Dv2, and Ds2 can be used as effective parameters to characterize the pore structure of adsorption pores. This result can provide a theoretical basis for studying the pore structure compatibility of coal reservoirs in the region.
Nanoscale pore characteristics and fractal characteristics of organic-rich shale: An example from the lower Cambrian Niutitang Formation in the Fenggang block in northern Guizhou Province, South China
Authors: Gu Yang , Ding Wenlong , Yin Min , Jiao Baocheng , Shi Siyu , Li Ang , Xiao Zikang , Wang Zhitao
Published: August 2018

Organic-rich marine shale in South China has great potential for gas generation, and the pore structure has a considerable influence on the enrichment of shale gas. The nanoscale pore characteristics and fractal characteristics of the Niutitang shales in the Fenggang block were studied by means of methane adsorption and low-pressure nitrogen adsorption experiments, porosity and permeability tests, X-ray diffraction analyses, organic geochemical analyses, and field emission scanning electron microscopy. The fractal geometry of the pore structure was assessed, and the factors influencing the pore structure were determined. We used a fractal Frenkel–Halsey–Hill-based method to obtain the fractal dimensions D1 and D2 by nitrogen adsorption at relative pressures of 0–0.5 and 0.5–1, respectively. The relationships between the shale pore structure parameters and the fractal dimensions, the mineral composition, the total organic carbon content, and the pore structure parameters of shale are discussed. In addition, the significance of D1 and D2 and the implications of the fractal dimension for the adsorption capacity of shale are investigated. The results show that the two fractal dimensions are positively correlated with total organic carbon content and specific surface area, negatively correlated with quartz content and average pore diameter, but have a weak relationship with clay mineral content and total pore volume. The Niutitang shale samples are dominated by mesopores, and the pore structure is complicated. The results presented here indicate that fractal analyses represent an effective method of characterizing the complexity of pore structure.
Do pre-school episodic syndromes predict migraine in primary school children? A retrospective cohort study on health care data
Authors: Albers Lucia , von Kries Rüdiger , Straube Andreas , Heinen Florian , Obermeier Viola , Landgraf Mirjam N
Published: August 2018

Objective

To assess the relative risk, predictive value and population attributable risk fraction of pre-school episodic syndromes for later migraine in primary school age children.

Methods

This retrospective cohort study used health insurance data on 55,035 children born in 2006 with no diagnosis of migraine up to the age of 5 years. The relative risk, probability and population attributable risk fraction of migraine prompting a physician visit at the age of 6–10 years in children with episodic syndromes included in the International Classification of Headache Disorders (benign paroxysmal torticollis, benign paroxysmal vertigo, cyclic vomiting syndrome, recurrent abdominal symptoms and abdominal migraine) and those not included in the International Classification of Headache Disorders (pavor nocturnus, somnabulism and bruxism) diagnosed up to the age of 5 years were determined.

Results

The period prevalence of individual episodic syndromes ranged between 0.01% and 1.40%. For episodic syndromes included in the International Classification of Headache Disorders (recurrent abdominal symptoms and abdominal migraine) and for the episodic syndromes not included in the International Classification of Headache Disorders (somnambulism), the risk for later migraine was increased by factors of 2.08, 21.87 and 3.93, respectively. The proportion of risk for migraine in primary school children explained by any episodic syndromes included in the International Classification of Headache Disorders was 2.18% and for any episodic syndromes not included in the International Classification of Headache Disorders it was 0.59%.

Conclusion

Several pre-school episodic syndromes are risk factors for migraine in primary school age children. The fraction of migraine in primary school age children explained by prior episodic syndromes, however, is below 3%. A probability to develop primary school age migraine above 50% was only observed for abdominal migraine.
Evaluation, characterization, and engine performance of complementary fuel blends of butanol–biodiesel–diesel from Aleurites moluccanus as potential alternative fuels for CI engines
Authors: Atabani AE , Mekaoussi M , Uguz Gediz , Arpa Orhan , Ayanoglu Abdulkadir , Shobana Sutha
Published: August 2018

Biodiesel has gained worldwide attention due to its renewable aspects. However, it needs more quality improvement. Recently, butanol has been considered as a favorable alternative fuel or additive over methanol and ethanol in compression ignition (CI) engines. In this regard, the present work deals with the evaluation of butanol–diesel–biodiesel blends as potential alternative fuels. In this work, biodiesel has been produced from Aleurites moluccanus oil followed by blending with Euro-diesel and butanol. Important characteristics such as kinematic viscosity, density and cloud point besides FT-IR, UV-vis spectra, TGA, DSC and NMR (13C and 1H) were analyzed. Some important engine and emission performance parameters, such as BP, BSFC, CO, HC, NOx and EGT were also studied in this work. Results revealed that blending butanol and Euro-diesel with biodiesel improves the properties of pure biodiesel such as kinematic viscosity (2.41–3.55 mm2/s) and density (841.8–884.6 kg/m3), while maintaining an acceptable range for cold flow properties that are analogous to Euro-diesel. In addition, reduction in BP (24.65–26.35%), HC (52.57–38.71%), and CO (39.18–30.4%) was observed for all the blends at full load compared to Euro-diesel. However, increases in both BSFC (38.17–41.14%) and NOx (24.18–8.35%) were observed. Overall, the blends appear to be good alternatives to biodiesel–diesel blends. Thus, butanol–biodiesel–diesel blends can be considered as potential sustainable fuels for fossil diesel.
Hepatitis B virus reactivation following imatinib therapy: A comparative review of 9 cases
Authors: Inayat Faisal , Song Fei , Ali Nouman Safdar , Aslam Muhammad Haseeb , Aloma Aishatu , Hachem Hilal , Saif Muhammad Wasif
Published: August 2018

Patients undergoing cytotoxic or immunosuppressive therapy for cancer have an established predilection for hepatitis B virus reactivation; however, the risk associated with newer molecularly targeted agents has not been well investigated. Imatinib, a small molecule tyrosine kinase inhibitor, induces rapid and sustained clinical benefit by inhibiting a number of signaling pathways, including BCR-ABL and c-KIT. We report the case of a patient who developed hepatitis B virus reactivation while receiving imatinib therapy for gastrointestinal stromal tumor. Furthermore, a structured literature search of the medical databases consisting of MEDLINE and PubMed was performed using the terms “hepatitis B”, “reactivation”, and “imatinib”. The search identified nine case reports only. The data on patients’ characteristics, epidemiology, clinical features, comorbid conditions, diagnosis, and management are summarized. Imatinib-associated hepatitis B virus reactivation was reported in seven patients with chronic myeloid leukemia, one with desmoid tumor, and one with gastrointestinal stromal tumor. This review serves to outline our current understanding of the epidemiology, risk factors, and pathophysiology of chronic hepatitis B virus reactivation secondary to imatinib therapy as well as the current approaches to diagnosis and management of this condition. We aim to increase awareness about this possible association and advocate for hepatitis B virus screening prior to imatinib therapy, especially in patients who are at increased risk for chronic hepatitis B virus infection.
Asymptotic theory of 3D thermoelastic stress analysis of honeycomb sandwich panels with composite facesheets
Authors: Rao MV Peereswara , Renji K , Harursampath Dineshkumar
Published: August 2018

This work presents an asymptotical thermoelastic model for analyzing symmetric composite sandwich plate structures. Use of three-dimensional finite elements to analyze real-life composite sandwich structures is computationally prohibitive, while use of two-dimensional finite element cannot accurately predict the transverse stresses and three-dimensional displacements. Endeavoring to fill this gap, the present theory is developed based on the variational asymptotic method. The unique features of this work are the identification and utilization of small parameters characterizing the geometry and material stiffness coefficients of sandwich structural panels in addition to the small parameters pertaining to any plate-like structure. In this formulation, using variational asymptotic method, the three-dimensional thermoelastic problem is mathematically split into a one-dimensional through-the-thickness analysis, and a two-dimensional reference surface analysis. The through-the-thickness analysis provides the constitutive relation between the generalized two-dimensional strains, and the generalized force resultants for the plate analysis, it also provides a set of closed-form solutions to express the three-dimensional responses in terms of two-dimensional variables, which are determined by solving the equilibrium equations of the plate reference surface. Numerical results are illustrated for a typical composite sandwich panel subjected to a linear-bisinusoidal thermal loading. The three-dimensional responses of the composite sandwich structure from the present theory are compared with the three-dimensional finite element solutions of MSC NASTRAN®. The results from the present theory agree closely with three-dimensional finite element results and yet enable order of magnitude saving in computational resources and time.
The flexural and impact behavior of the laminated aluminum-epoxy/basalt fibers composites containing nanoclay: An experimental investigation
Authors: Bahari-Sambran Farid , Eslami-Farsani Reza , Arbab Chirani Shabnam
Published: August 2018

In this study, the effect of different weight percents of modified/unmodified nanoclay particles on the flexural and impact properties of fiber–metal laminates made of 2024-T3 aluminum sheets and basalt fibers as the reinforcements and epoxy as the matrix was investigated. As a first step, the surface of nanoclay particles was modified by the silane-coupling agent. The creation of the functional groups on the surface of nanoclay particles was confirmed by Fourier transform infrared spectroscopy analyses. The modified nanoclay with different weight percents of 0, 1, 3, and 5 was added into the epoxy matrix; then, for the better distribution and dispersion of nanoparticles in the matrix, the mechanical and ultra-sonication machines were used. Also, to ensure better interaction and adherence between the matrix and the aluminum sheets, the mechanical and chemical treatments were conducted. Then, the mixture of epoxy and nanoclay with woven basalt fibers and aluminum sheets was used to fabricate fiber–metal laminates. To survey the effect of these nanoparticles on the mechanical properties, the three-point bending test and the high-velocity impact test were used. The results showed that the maximum effect of adding nanoclay particles on the flexural and impact behavior was obtained by using 3 wt.% of the modified nanoclay. These properties of fiber–metal laminates, which contained the 3 wt.% unmodified nanoclay, were weakened in comparison to a similar specimen containing the modified nanoclay. Furthermore, the flexural modulus was enhanced by increasing the weight percent of the nanoparticles. Also, to investigate the fracture mechanism, the field emission scanning electron microscope was used. The microscopic images revealed that adding nanoclay particles led to the improvement of the interaction between the matrix and basalt fibers, thereby improving the flexural and impact properties.
What would most help improve the quality of life of older family carers of people with dementia? A qualitative study of carers’ views
Authors: Oliveira Deborah , Sousa Lidia , Aubeeluck Aimee
Published: August 2018

Older family carers of people with dementia provide a substantial amount of care for people with dementia in the UK. Caregiving can be stressful and burdensome for these individuals, who are also experiencing psychological and physical changes resulting from their own ageing process. However, little is known about what impacts their quality of life, how this can be improved and what we should prioritise. This brief report asks one simple question to older family carers of people living with dementia – “What would most help improve your quality of life as a carer?” Qualitative data were collected from 150 carers who completed an anonymous paper survey during the development and validation of a quality of life tool for use with this population (DQoL-OC). Participants were individuals aged 60 and over and were providing care for a family member with dementia at home in the UK. Carers were recruited from a variety of voluntary organizations, community-based carers’ groups, health services and via online forums. A thematic approach was used to analyse the carers’ comments and three main overarching themes were identified. The quality of life of older family carers can be enhanced by having more time away from caregiving, accessing health and social services that are dementia friendly and by having economic support. Future care, policies and research should aim to address these key areas in order to promote better quality of life for older carers of people with dementia. Further implications for practice, policy and research are discussed.
Barriers to intra-familial prevention of type 2 diabetes: A qualitative study on horizons of significance and social imaginaries
Authors: Grabowski Dan , Andersen Tue Helms
Published: August 2018

Objectives

In families living with type 2 diabetes, relatives have a significantly heightened risk of developing the disease. In many families, both the person with type 2 diabetes and his/her relatives lack detailed knowledge about this risk. One obstacle to constructive intra-familial prevention and risk reduction is the lack of perceived familial disease relevance. The objective of the present study is to explore barriers to prevention in families with at least one adult with type 2 diabetes.

Methods

Data were gathered during eight problem assessment and ideation workshops with families. The data were analyzed using radical hermeneutics and interpreted using Taylor’s concepts of social imaginaries and horizons of significance.

Results

The analysis revealed three main barriers: (1) Sole responsibilities and the absence of collective practices, (2) intra-familial differences in perceptions of risks and future health, and (3) lack of perceived disease significance and the ensuing lack of mutual care. The participating families all experienced one or more of the three identified primary barriers.

Discussion

The study has produced important knowledge about barriers to familial prevention of type 2 diabetes. The findings confirm that familial prevention is indeed a complex matter that calls for the use of complexity-oriented approaches in health care practice.
Unmet needs of family caregivers of hospitalized older adults preparing for discharge home
Authors: McCusker Jane , Yaffe Mark , Lambert Sylvie D , Cole Martin , de Raad Manon , Belzile Eric , Ciampi Antonio , Amir Ella , Hidalgo Marcela
Published: August 2018

Objectives

To describe unmet needs of caregivers of hospitalized older adults during the transition from hospital back home, and identify subgroups with different needs.

Methods

Patients and family caregivers were recruited from an acute care hospital in Montreal, Canada. Measures included Instrumental Activities of Daily Living (IADL), Hospital Anxiety and Depression Scale (HADS), Zarit burden scale, and Family Inventory of Needs. Dimensions of unmet needs were explored with principal component analysis; regression tree models were used to identify subgroups with different unmet needs.

Results

A total of 146 patient-caregiver dyads were recruited. Three categories of caregiver unmet needs were identified: patient medical information; role clarity and support; and reassurance. Caregiver subgroups with highest unmet needs were those with high burden of care plus depressive symptoms ( n = 46) and those caring for patients with low IADL scores ( n = 10).

Discussion

Caregivers with high burden and depression are those with the greatest unmet needs during the care transition.
Revised partial coupling in fluid–particulate systems
Authors: Elghannay Husam A , Tafti Danesh K
Published: August 2018

Fluid equations in Computational Fluid Dynamics coupled with Discrete Element Method (CFD-DEM) simulations solve the volume-averaged Navier–Stokes equations. Full coupling between the dispersed phase and continuous phase is made by the exchange of source terms as well as the void fraction. The void fraction is calculated from the presence of the particles in the computational fluid cells while the source terms are calculated from the point mass force models of the fluid–particle interaction forces. Dense particulate system with large spatiotemporal variations in the void fraction shows hard convergence behavior. This can impact the robustness of the solver during the time integration process. One option is to use partial coupling by neglecting the explicit effect of void fraction in the fluid momentum equations while retaining its effect on force models. Although the partial coupling is more stable and shows better convergence behavior, the mobility of the particles is found to be reduced as compared to the full-coupling approach. In the current work, we propose a revised partial coupling in which a modified fluid velocity is used in point mass force models to compensate for the omission of the void fraction in the fluid governing equations. The effectiveness of this method is demonstrated in a fluidized bed and in sediment transport simulations. In both cases it is shown that the use of the proposed method gives very good comparisons with the fully coupled simulations while reducing the fluid calculation time by factors ranging from 1.35 to 4.35 depending on the flow conditions. The revised partial coupling is not recommended as a substitute for full coupling in dense systems but as an alternate approach when full coupling leads to numerical difficulties.
Deposition of bolus and continuously inhaled aerosols in rhythmically moving terminal alveoli
Authors: Xi Jinxiang , Talaat Khaled , Si Xiuhua April
Published: August 2018

The particle dynamics in an oscillating alveolus under tidal breathing can be dramatically different from those in a static alveolus. Despite its close relevance to pulmonary drug delivery and health risk from airborne exposure, quantifications of alveolar deposition are scarce due to its inaccessibility to in vivo measurement instruments, tiny size to replicate in vitro, and dynamic wall motions to model. The objective of this study is to introduce a numerical method to quantify alveolar deposition with continuous particle release in a rhythmically oscillating alveolus by integrating the deposition curves for bolus aerosols and use this method to develop correlations applicable in assessing alveolar drug delivery efficiency or dosimetry of inhaled toxicants. An idealized blind-end terminal alveolus model was developed with rhythmically moving alveolar boundary conditions in phase with tidal breathing. The dynamic wall expansion mode and magnitude were based on experimentally measured chest wall motions and tidal volumes. A well-validated Lagrangian tracking model was used to simulate the transport and deposition of inhaled micrometer particles. Large differences were observed between dynamic and static alveoli in particle motion, deposition onset, and final alveolar deposition fraction. Alveolar deposition of bolus aerosols is highly sensitive to breath-holding duration, particle release time, and alveolar dimension. For 1 µm particles, there exists a cut-off release time (zero bolus deposition), which decreases with alveolar size (i.e., 1.0 s in a 0.2-mm-diameter alveolus and 0.56 s in a 0.8-mm-diameter alveolus). The cumulative alveolar deposition was predicted to be 39% for a 0.2-mm-diameter alveolus, 22% for a 0.4-mm-diameter alveolus, and 10% for a 0.8-mm-diameter alveolus. A cumulative alveolar deposition correlation was developed for inhalation delivery with a prescribed period of drug release and the second correlation for the time variation of alveolar deposition of ambient aerosols, both of which captured the relative dependence of the particle release time and alveolar dimension.
Biomechanical testing of trans-humeral all-suture anchors for rotator cuff repair
Authors: Aramberri-Gutiérrez Mikel , Martínez-Menduiña Amaia , Boyle Simon , Valencia Maria
Published: August 2018

Background

Rotator cuff tears are one of the most common causes of shoulder pain. All-suture anchors are increasingly being used in the arthroscopic repair of rotator cuff tears. The purpose of this experimental study is to evaluate the biomechanical properties of all-suture anchors at different insertion sites in the proximal humerus relevant to rotator cuff repairs and the remplissage procedure.

Methods

Sixteen cadaveric shoulders were used for the study. Four all-suture anchors were inserted in each proximal humerus at common anchor insertion sites on the rotator cuff footprint and a simulated Hill–Sachs defect. Cyclic loading and load-to-failure tests were undertaken. The number of cycles, load to failure and nature of failure were recorded.

Results

The all-suture anchors placed in the cuff footprint using a transosseous technique displayed superior biomechanical properties. Sutures sited in this way demonstrated a maximum tensile load to failure of 542 N as well as a highest mean load to failure and the maximum number of cycles before anchor failure. In descending order, all-suture anchors placed in the lateral footprint were significantly superior to those located in the medial row and in a simulated Hill–Sachs defect.

Discussion

Anchors placed in the rotator cuff footprint exceeded the physiological isometric abduction forces for the supraspinatus and infraspinatus. Data obtained from our study suggest that all-suture anchors are strong enough to be used for the repair of rotator cuff tears.
Early treatment versus expectative management of patent ductus arteriosus in preterm infants: a multicentre, randomised, non-inferiority trial in Europe (BeNeDuctus trial)
Authors: Hundscheid Tim , Onland Wes , van Overmeire Bart , Dijk Peter , van Kaam Anton H. L. C. , Dijkman Koen P. , Kooi Elisabeth M. W. , Villamor Eduardo , Kroon André A. , Visser Remco , Vijlbrief Daniel C. , de Tollenaer Susanne M. , Cools Filip , van Laere David , Johansson Anne-Britt , Hocq Catheline , Zecic Alexandra , Adang Eddy , Donders Rogier , de Vries Willem , van Heijst Arno F. J. , de Boode Willem P.
Published: August 2018

Background

Much controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants, especially in those born at a gestational age (GA) less than 28 weeks. No causal relationship has been proven between a (haemodynamically significant) PDA and neonatal complications related to pulmonary hyperperfusion and/or systemic hypoperfusion. Although studies show conflicting results, a common understanding is that medical or surgical treatment of a PDA does not seem to reduce the risk of major neonatal morbidities and mortality. As the PDA might have closed spontaneously, treated children are potentially exposed to iatrogenic adverse effects. A conservative approach is gaining interest worldwide, although convincing evidence to support its use is lacking.

Methods

This multicentre, randomised, non-inferiority trial is conducted in neonatal intensive care units. The study population consists of preterm infants (GA < 28 weeks) with an echocardiographic-confirmed PDA with a transductal diameter > 1.5 mm. Early treatment (between 24 and 72 h postnatal age) with the cyclooxygenase inhibitor (COXi) ibuprofen (IBU) is compared with an expectative management (no intervention intended to close a PDA). The primary outcome is the composite of mortality, and/or necrotising enterocolitis (NEC) Bell stage ≥ IIa, and/or bronchopulmonary dysplasia (BPD) defined as the need for supplemental oxygen, all at a postmenstrual age (PMA) of 36 weeks. Secondary outcome parameters are short term sequelae of cardiovascular failure, comorbidity and adverse events assessed during hospitalization and long-term neurodevelopmental outcome assessed at a corrected age of 2 years. Consequences regarding health economics are evaluated by cost effectiveness analysis and budget impact analysis.

Discussion

As a conservative approach is gaining interest, we investigate whether in preterm infants, born at a GA less than 28 weeks, with a PDA an expectative management is non-inferior to early treatment with IBU regarding to the composite outcome of mortality and/or NEC and/or BPD at a PMA of 36 weeks.

Trial registration

This trial is registered with the Dutch Trial RegisterNTR5479(registered on 19 October 2015), the registry sponsored by the United States National Library of Medicine Clinicaltrials.govNCT02884219(registered May 2016) and the European Clinical Trials DatabaseEudraCT 2017–001376-28.