bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of decortication and pleurectomy in chronic empyema patients
Authors: Bagheri Reza , Haghi Seyed Ziaollah , Dalouee Marziyeh Nouri , Rajabnejad Ata'ollah , Basiri Reza , Hajian Tahereh
Published: January 2016

Background

Fibrosis that occurs in the chronic phase of pleural empyema restricts lung movement and impairs pulmonary function. It also leads to asymmetry of the chest wall. We evaluated the efficacy of decortication and pleurectomy in improving these adverse consequences.

Methods

Data of 50 patients (42 males, mean age 49.1 ± 19.46 years) with chronic empyema who underwent lung decortication via a posterolateral thoracotomy between 2004 and 2014 were reviewed in this study. All patients had pulmonary function tests before and after surgery. Computed tomography was used to determine transverse and anteroposterior diameters of the chest before and after surgery.

Results

The patients were followed up for 11.5 ± 4.5 months. Mean forced expiratory volume in 1 s was 62.5% ± 13.61% before surgery vs. 77.3% ± 13.31% after surgery ( p < 0.001). Mean forced vital capacity was 60.6% ± 14.38% before surgery vs. 78.5% ± 12.64% after surgery ( p < 0.001). The improvement in patients with reduced chest wall diameters was significant ( p < 0.001). Improvements in pulmonary function tests and chest wall diameters were not significantly different between patients with tuberculosis ( n = 10) and those with other diseases ( n = 40; p < 0.05).

Conclusion

Decortication and pleurectomy via a posterolateral thoracotomy significantly improves pulmonary function and chest wall diameters in patients with chronic empyema due to tuberculosis or other diseases.
Posthumanism, the Social and the Dynamics of Material Systems
Authors: Henkel Anna
Published: January 2016

Technology has developed to the point where a clear distinction between nature and culture seems to be dissolving. Against this background, a broad aspect of social research has emerged that considers an interdependence between the social and the material. So far, social-systems cybernetics as described by Luhmann has remained rather marginalized in these discussions. This article is intended to overcome this marginalization by developing the concept of meaning. Meaning can abstractly be defined as a ‘doing negativity’. Returning to systems theory, it becomes obvious that verbalized meaning (expressed through language) is only one possible medium of meaning. Adopting some concepts from Helmuth Plessner, I introduce another medium of meaning – corporealized meaning (expressed in physical terms), which also operates meaningfully along the distinction between actuality and potentiality, and thus does negativity. I discuss consequences of observing the relationship between sociality and materiality from this perspective.
How working with psychologists has influenced probation practice
Authors: Ramsden Jo , Joyes Emma , Gordon Neil , Lowton Mark
Published: January 2016

The Offender Personality Disorder (OPD) Pathway initiative has been in operation now for over a year and a number of different projects are working across the country to support its implementation. These projects involve health and probation working in partnership to enhance the case management of offenders who present in a way that is consistent with a personality disorder diagnosis. In other words, agencies are working together as never before to share expertise, to collaborate and co-produce risk assessments and sentence plans and to support offenders more effectively, particularly at times of transition. So what is the impact? This paper uses real life case examples to report some of the innovative practice developments that have come about during the first year of one such project (in Yorkshire/Humberside). It also uses qualitative data from focus groups with offender managers to explore the impact of working differently. The paper will highlight some of the helpful and challenging aspects for offender managers of working in partnership with a different organisation and organisational culture and will look at how the formulation-led, psychologically informed influence from health has affected both their personal and professional life. The paper will go on to discuss what we consider to be some of the challenges for the project in the coming months and years, and how the project intends to adapt to meet them.
Genetics in chronic venous disease
Authors: Grant Yasmin , Onida Sarah , Davies Alun
Published: January 2016

Chronic venous disease is highly prevalent in the Western world, with varicose veins being the most common form of clinical manifestation. With recent developments in sequencing technology, clinicians and geneticists alike are embarking on a journey to identify and unravel the genetic candidates of chronic venous disease. There is now currently substantial evidence to suggest the presence of genetic influences in the aetiology and pathology of venous disease. Despite this, the precise nature and profile of the genes involved in chronic venous disease remain a poorly understood entity. Moreover, it is strikingly apparent that the majority of venous genetic studies conducted over the past decade do not adhere to fundamental research principles. The emergence of high-throughput genotyping platforms permits a more systematic search for inherited components of venous disease. Pursuing a genome-wide frontier has the potential to reveal novel critical metabolic pathways and explain the genetic susceptibility of chronic venous disease. An expedited knowledge of the genetic factors in the aetiology of venous disease may translate into better prevention or treatment, which would benefit patients suffering from its clinical sequelae. Researchers should be urged to foster collaborative links and design a genome-wide case-control association study as an international consortium to provide a statistically robust paradigm in the field of chronic venous disease genetics. This will carry promise for clinically relevant progress and represent a first step towards better understanding of the genetics of chronic venous disease aetiology.
Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data
Authors: Peres Roxane , De Guio François , Chabriat Hugues , Jouvent Eric
Published: January 2016

Cerebral small vessel diseases of the brain are a major determinant of cognitive impairment in the elderly. In small vessel diseases, the most easily identifiable lesions, both at post-mortem evaluation and magnetic resonance imaging, lie in subcortical areas. However, recent results obtained post-mortem, particularly in severe cases, have highlighted the burden of cortex lesions such as microinfarcts and diffuse neuronal loss. The recent development of image post-processing methods allows now assessing in vivo multiple aspects of the cerebral cortex. This systematic review aimed to analyze in vivo magnetic resonance imaging studies evaluating cortex alterations at different stages of small vessel diseases. Studies assessing the relationships between small vessel disease magnetic resonance imaging markers obtained at the subcortical level and cortex estimates were reviewed both in community-dwelling elderly and in patients with symptomatic small vessel diseases. Thereafter, studies analyzing cortex estimates in small vessel disease patients compared with healthy subjects were evaluated. The results support that important cortex alterations develop along the course of small vessel diseases independently of concomitant neurodegenerative processes. Easy detection and quantification of cortex changes in small vessel diseases as well as understanding their underlying mechanisms are challenging tasks for better understanding cognitive decline in small vessel diseases.
Oxygen challenge magnetic resonance imaging in healthy human volunteers
Authors: Dani Krishna A , Moreton Fiona C , Santosh Celestine , Lopez Rosario , Brennan David , Schwarzbauer Christian , Goutcher Colin , O’Hare Kevin , Macrae I Mhairi , Muir Keith W
Published: January 2016

Oxygen challenge imaging involves transient hyperoxia applied during deoxyhaemoglobin sensitive (T2*-weighted) magnetic resonance imaging and has the potential to detect changes in brain oxygen extraction. In order to develop optimal practical protocols for oxygen challenge imaging, we investigated the influence of oxygen concentration, cerebral blood flow change, pattern of oxygen administration and field strength on T2*-weighted signal. Eight healthy volunteers underwent multi-parametric magnetic resonance imaging including oxygen challenge imaging and arterial spin labelling using two oxygen concentrations (target FiO2 of 100 and 60%) administered consecutively (two-stage challenge) at both 1.5T and 3T. There was a greater signal increase in grey matter compared to white matter during oxygen challenge (p < 0.002 at 3T, P < 0.0001 at 1.5T) and at FiO2 = 100% compared to FiO2 = 60% in grey matter at both field strengths (p < 0.02) and in white matter at 3T only (p = 0.0314). Differences in the magnitude of signal change between 1.5T and 3T did not reach statistical significance. Reduction of T2*-weighted signal to below baseline, after hyperoxia withdrawal, confounded interpretation of two-stage oxygen challenge imaging. Reductions in cerebral blood flow did not obscure the T2*-weighted signal increases. In conclusion, the optimal protocol for further study should utilise target FiO2 = 100% during a single oxygen challenge. Imaging at both 1.5T and 3T is clinically feasible.
A Strength-Based Arts and Play Support Program for Young Survivors in Post-Quake China: Effects on Self-Efficacy, Peer Support, and Anxiety
Authors: Ho Rainbow T. H. , Lai Angel H. Y. , Lo Phyllis H. Y. , Nan Joshua K. M. , Pon Alicia K. L.
Published: January 2016

A year after the earthquake in Sichuan, China, a strength-based arts and play support program was launched to promote the well-being of young survivors, and this study was designed to examine its effectiveness. It was hypothesized that participation in the program would have direct positive effects on general self-efficacy and peer support, and that these would mediate the effect of the program on anxiety. One hundred twelve Grade 4 students joined the study, the measures of which included the General Self-Efficacy Scale, the Classmate Support Scale, and the Generalized Anxiety subscale in the Spence Children’s Anxiety Scale. The results showed that participation in the program was associated with increased general self-efficacy and peer support, which lowered anxiety, although the relationship was not statistically significant. This study has provided insights for the development of a culturally sound arts and play program for young disaster victims in China.
Long-term follow-up of large symptomatic hepatic cysts treated by percutaneous ethanol sclerotherapy
Authors: Jang Se Young , Park Soo Young , Tak Won Young , Kweon Young Oh , Ryeom Hunkyu
Published: January 2016

Background

As a minimally invasive treatment, ethanol sclerotherapy has been used for large symptomatic hepatic cysts, but there are not many long-term reports on treatment outcomes and safety.

Purpose

To evaluate the long-term outcomes of percutaneous ethanol sclerotherapy in patients with large symptomatic hepatic cysts.

Material and Methods

This study included 43 symptomatic, enlarging hepatic cysts in 42 patients who had undergone ethanol sclerotherapy from 2003 to 2013 and were followed up for >1 year. The treatment outcomes were evaluated in terms of the reduction of cyst size and resolution of symptoms. The patients were followed up for a mean period of 33 months with either ultrasound or computed tomography examination.

Results

Thirty-nine hepatic cysts (91%) were successfully treated with ethanol sclerotherapy, showing resolution of symptoms and remarkable reduction in cyst volume. Eight hepatic cysts (19%) disappeared completely, and 31 hepatic cysts (72%) decreased in size during the follow-up period. The mean diameter of the cysts decreased from 12.5 ± 4.4 cm to 3.8 ± 3.4 cm during follow-up. There were no immediate serious complications related to the procedure. There were four cases (9%) of treatment failure requiring subsequent surgical procedures.

Conclusion

Percutaneous ethanol sclerotherapy can be considered as an effective first-line treatment for large symptomatic hepatic cysts.
Signal characteristics of normal adult bone marrow in whole-body diffusion-weighted imaging
Authors: Cui Feng-Zhen , Cui Jian-Ling , Wang Shi-Lei , Yu Hong , Sun Ying-Cai , Zhao Na , Cui Sheng-Jie
Published: January 2016

Background

Knowledge of the signal characteristics of normal adult bone marrow in whole-body diffusion-weighted (DW) images (WB-DWI) is essential for correctly interpreting DW images in clinical practice; however, these factors have not yet been clearly determined.

Purpose

To evaluate the signal characteristics of normal adult bone marrow in WB-DWI, to correlate these characteristics with age and gender, and to determine the causes of these phenomena.

Material and Methods

Ninety-eight healthy volunteers underwent WB-DWI (b = 0 and 800 s/mm2). Two radiologists visually evaluated the signal characteristics of bone marrow in DW images separately. One radiologist measured the apparent diffusion coefficient (ADC) of the thoracic and lumbar vertebrae, bilateral femur (including head, neck, and proximal and distal femoral shaft), bilateral humeral head, ilium, and scapula. The signal characteristics of normal bone marrow were analyzed.

Results

The visual evaluation results of DW images indicated that hyperintensity of bone marrow was more frequently seen in women aged 21–50 years (68.4%) than in men aged 21–50 years (3.3%) ( P < 0.001), men aged 51–81 years (5.9%) ( P < 0.001), and women aged 51–81 years (15.4%) ( P = 0.001). However, no statistically significant difference was found between men and women aged 51–81 years ( P = 0.565). The ADC of bone marrow was significantly higher in women than in men aged 21–50 years. Bone marrow ADC showed significant negative correlation with age in women but not in men.

Conclusion

The signal intensity of bone marrow varies with age and gender in DW images. ADC and the T2 shine-through effect contributed to the bone marrow signal intensity in DW images, and the latter effect may predominate.
MR appearance of normal uterine endometrium considering menstrual cycle: differentiation with benign and malignant endometrial lesions
Authors: Shitano Fuki , Kido Aki , Kataoka Masako , Fujimoto Koji , Kiguchi Kayo , Fushimi Yasutaka , Konishi Ikuo , Togashi Kaori
Published: January 2016

Background

The thickness and signal intensity (SI) of normal uterine endometrium on T2-weighted (T2W) imaging changes depend on the menstrual cycle phase. Cases of normal endometrium that appear similar to endometrial lesions sometimes occur, and may result in misdiagnosis.

Purpose

To investigate normal endometrial appearance in luteal phase (LP) compared to that in follicular phase (FP), and to differentiate these appearances with those of endometrial lesions.

Material and Methods

Thirty-two normal volunteers prospectively underwent magnetic resonance (MR) examinations during LP and FP. Patients with pathologically confirmed endometrial polyps ( n = 9), hyperplasia ( n = 7), and cancer ( n = 15), who underwent MR examinations, were evaluated for comparison. Endometrial appearance was categorized into the following five types on sagittal T2W imaging and compared between LP, FP, and endometrial lesions: type 1, homogeneous higher SI; type 2, homogeneous iso SI; type 3, a bright midline and a peripheral iso SI layer; type 4, a lower/iso SI central line; and type 5, heterogeneous lower/iso SI. Endometrial thickness and SI were measured and also compared.

Results

Endometrial lesions were more frequently categorized as type 5 than normal endometrium ( P < 0.05). Endometrial thickness in LP (mean, 1.0 cm) was significantly greater than that in FP (0.6 cm), but not significantly different from polyps (1.1 cm), hyperplasia (1.0 cm), and cancer (0.9 cm). SI in FP was significantly higher than that in LP and that of all endometrial lesions.

Conclusion

Differentiation between normal endometrium in LP and endometrial lesions may be difficult based on thickness alone. Heterogeneous low SI may help to differentiate normal endometrium from endometrial lesions. Performing MR imaging during FP may also help due to higher SI of normal endometrium.
Understanding the dimensions of home for people returning home post stroke rehabilitation
Authors: Hodson Tenelle , Aplin Tammy , Gustafsson Louise
Published: January 2016

Introduction

Home is a meaningful and important place and the transition to home from hospital is considered a significant point in recovery for people after stroke. Six dimensions of the home environment have previously been described as important for well-being and contributing to one's experience of home: the physical, social, personal, temporal, occupational and societal dimensions. The aim of this study was to understand the experience of home for people with stroke after discharge to home from hospital rehabilitation.

Method

A secondary template analysis applied the dimensions of home to semi-structured interviews that explored the transition to home experience for seven participants with stroke at 4–6 weeks post discharge.

Results

All six dimensions were present in the descriptions of returning to home from stroke rehabilitation. The social, personal and occupational dimensions appeared to be the most prominent and often centred on loss or change.

Conclusion

People returning home after a stroke enter a different home environment than the one they experienced prior to stroke, with changes experienced in all dimensions of home. Closer attention to the dimensions during discharge preparation may enhance the transition experience.
Fictive place
Authors: Overton John , Murray Warwick E.
Published: January 2016

The construction of ‘fictive place’ is ever more common in capitalist production and exchange. It could be argued that the adoption of Geographical Indications (GIs) is a form of resistance to the homogenizing effects of globalization. In some ways fictive place-making can be seen as a means of adding value to land; however, we argue that fictive place has become a factor of production in its own right. We investigate this through a discussion of fictitious capital and the rise of GIs. We draw evidence from the wine sector and suggest that other networks are increasingly constituted of similar processes.
Modified Broström Procedure for Chronic Ankle Instability With Generalized Joint Hypermobility
Authors: Huang Bingzhe , Kim Yong Tae , Kim Jung Uk , Shin Jung Hoon , Park Yong Wook , Kim Hyong Nyun
Published: January 2016

Background:

Chronic ankle instability with generalized joint hypermobility (GJH) is considered a contraindication for the modified Broström procedure. The most widely accepted definition of GJH is a Beighton score of ≥4 on a 9-point scale. However, it is not clear whether this criterion can be applied to determine the GJH that would lead to a poor outcome after a modified Broström procedure. Some of the previous studies that report unfavorable outcomes do not specify the tests or cutoff scores used to determine the GJH, and, in fact, some of the patients with GJH in these studies had good outcomes.

Hypothesis:

The modified Broström procedure results in satisfactory outcomes in patients who have chronic ankle instability with GJH if the contralateral uninjured ankle shows a normal varus talar tilt and anterior talar translation during stress tests.

Study Design:

Case series; Level of evidence, 4.

Methods:

Modified Broström procedure was performed in 32 patients with chronic ankle instability with GJH if the contralateral uninjured ankle showed a normal varus talar tilt and anterior talar translation on stress tests. The mean patient age at surgery was 21.7 years, and the mean follow-up duration was 27.4 months.

Results:

The Karlsson-Peterson ankle score significantly improved from a mean ± SD of 63.6 ± 7.1 preoperatively to 90.4 ± 6.7 at the final postoperative follow-up ( P < .001). Sixteen patients were very satisfied with the results, 10 patients were satisfied, 3 patients rated their satisfaction as fair, and 1 patient was dissatisfied with the results. Nine patients sustained ankle sprains after the surgery, 6 of which were mild sprains. Although 3 of these 9 patients had a mechanically unstable ankle on stress radiographs, they were satisfied with the postoperative results. None of the patients required a reoperation.

Conclusion:

GJH was not a contraindication for the modified Broström procedure if the contralateral uninjured ankle showed a normal varus talar tilt and a normal anterior talar translation on stress tests. Further studies are needed to better define GJH affecting the ankle.
Influence of multiwall carbon nanotube alignment on vibration damping of nanocomposites
Authors: Jangam Sasidhar , Raja S , Maheswar Gowd B Uma
Published: January 2016

In the present work, the damping behavior of multiwall carbon nanotubes/polymer nanocomposites has been studied by aligning the carbon nanotubes (CNTs) in the matrix using DC electric field during the curing of composite. Nanocomposite specimens have been fabricated for three different CNT loadings (0.1, 0.2, and 0.3 wt%) to prepare two types, namely randomly oriented and aligned. The alignment of nanocomposites has developed a strong anisotropy in the composite. Microstructural analysis and electrical conductivity tests are carried out to examine the CNTs alignment. It is evident from the obtained results that a significant improvement is achieved in electrical conductivity of aligned nanocomposites over randomly oriented one. Dynamic mechanical analysis and flexural vibration experiments have been performed to study the frequency dependent damping behavior of nanocomposites. In case of aligned nanocomposites, significant enhancement is noticed in the material damping for the tested frequency band width of 0–30 Hz; also the flexural tests have shown an improvement up to 37% in structural damping compared to randomly oriented. The influence of CNT coating on fiber in improving anisotropic nature of fiber has been studied experimentally and it is found that the coating of CNT reinforced resin has enhanced simultaneously the straining capability and anisotropic nature of the fiber, without compromising its mechanical properties. Further, the vibration damping behavior of the CNT coated fiber is evaluated using digital image correlation technique and it is noticed that CNT dispersion on the fiber improves its damping ability by 2.6%.
Failure analysis of carbon fiber reinforced composite subjected to low velocity impact and compression after impact
Authors: Han Geng , Guan Zhidong , Li Xing , Du Shanyi
Published: January 2016

Composites are very sensitive to the load in the direction of thickness, especially out-plane low velocity impact (LVI). In this article, the detailed failure mechanisms of composite laminates with four material systems (CCF300/Epoxy, CCF300/Bismaleimide, CCF800/Epoxy, and CCF800/Bismaleimide) under the loading of LVI and compression after impact (CAI) were studied by experiment and finite element analysis. In finite element model, a newly proposed multi-scale failure criterion (MMF3) and cohesive elements are used to determine the intralaminar damage and interlaminar delamination, respectively. Through experiment and finite element analysis, it can be concluded that the damage tolerance performance of epoxy resin composites are better than that of bismaleimide resin composites, and the damage tolerance performance of CCF300 carbon fiber composites are better than that of CCF800 carbon fiber composites. The proposed multi-scale failure analysis method can effectively simulate the impact and CAI damage process of composite laminates.
Effect of Long-Term Body-Mass-Based Resistance Exercise on Cognitive Function in Elderly People
Authors: Ikudome Sachi , Mori Shiro , Unenaka Satoshi , Kawanishi Masashi , Kitamura Takahiro , Nakamoto Hiroki
Published: January 2016

The study examined the effect of a body-mass-based home exercise program on cognitive functioning among 170 male and female elderly people (52-81 years). This program comprised five kinds of resistance exercises that elderly people can perform at home without supervision or specialized equipment using only their body mass for resistance. Various cognitive tasks were used to assess cognitive functioning, including a simple reaction task, Go/No-Go reaction task, Stroop task, serial subtraction task, and coincident timing task. These tasks were performed before and after a 3-month body-mass-based home exercise program. Although there were no significant improvements in the simple reaction and coincident timing tasks, significant improvement was shown in the Go/No-Go reaction task and serial subtraction task. This study shows that even simple resistance exercise, using only body mass for resistance, may be an effective method for preventing age-related cognitive decline of inhibitory control and working memory among elderly people.
Baltimore’s Juvenile Curfew
Authors: Wallace Lacey N.
Published: January 2016

Juvenile curfew statutes are used in hundreds of cities across the United States to prevent juvenile offending and victimization. In spite of their popularity, there is disagreement in the existing literature as to whether juvenile curfews are truly effective. The current study assesses the effectiveness of a change in the juvenile curfew statutes in Baltimore, MD. Data consist of police arrest records for the months preceding and following the curfew change. Regression analyses address both change in arrest totals and change in the ratio of youth to adult arrests and the ratio of arrests within curfew hours to outside of curfew hours. Results indicate an increase in the ratio of youth to adult arrests during curfew hours. However, arrest totals were decreasing overall at the time of the curfew change. Implications for further investigation are discussed.
The effect of temperature on the biodegradation properties of municipal solid waste
Authors: Zhao Yan Ru , Liu Tie Jun , Chen Xiang Sheng , Xie Qiang , Huang Li Ping
Published: January 2016

The aim of this study is to analyse the effect of temperature on the biodegradation and settlement properties of municipal solid waste by using bioreactors. Three kinds of controlled temperature were performed during the biodegradation test; the variation of weight, leachate and biogas production were carefully monitored. The degradation test indicated that more leachate leaked out owing to the external compression and polymer hydrolysis reaction in the aerobic phase, which could lead to the decrease of biodegradation rate in the anaerobic phase. A proper temperature range in favour of enhancing biodegradation of refuse was obtained, which ranged from 22 °C to 45 °C. Finally, an empirical equation of biodegradation ratio was proposed, which incorporated the temperature effect. In the end, the validation of this proposed model is verified, and is proved to be reasonable for predicting degradation velocity in landfills.
“Refugee Voices”
Authors: Cabot Heath
Published: January 2016

This article considers the parallels between ethnographic work and refugee advocacy to show how these knowledge forms seek and yet fail to represent “refugee voices.” The predicaments of refugees in Greece have recently captured the attention of the world owing to Greece’s crucial position in the 2015 “European refugee crisis,” but Greece has long been on the frontlines of refugee reception in the EU. Based on ethnographic research conducted between 2005 and 2013, I analyze the ethnographic logics attached to European advocacy projects surrounding refugees in Greece. I explore their use of tragic tropes, and I argue that ethnographers employ similar tactics to carve out space for marginalized voices. I argue that the representational practices of ethnography and advocacy alike are haunted by various “ghosts”: traces of silenced subjects who index both the limits and possibilities of representation. I argue, ultimately, for a humbling of the ethnographer: for a careful consideration of the power of not knowing in our work, and for recognition of the overlaps between ethnographic knowledge and dominant formations of power.
Managing Subdural Bleeding Associated With Rivaroxaban
Authors: Faust Andrew C. , Woodard Sarah , Koehl Jennifer L. , Mees William , Steinke Douglas , Denetclaw Tina Harrach
Published: January 2016

Objective:

To report 3 cases of subdural bleeding associated with rivaroxaban managed by 3-factor prothrombin complex concentrate (PCC3).

Case Summaries:

Case 1 presented with a 1-cm thick subdural hematoma (SDH) 12 hours after her last dose of rivaroxaban. Case 2 presented with a right 1-cm acute right SDH with 2 to 3 mm of midline shift 24 hours after his last dose of rivaroxaban. Case 3 presented with a 1.8-cm thick right cerebral convexity hematoma 12 hours after her last dose of rivaroxaban. All patients received 23 to 35 units/kg PCC3 with 1 to 3 units of fresh frozen plasm (FFP) and demonstrated no progression in lesions measured by repeat computed tomography (CT). Two patients were discharged to rehabilitation facilities and 1 patient ultimately died due to the location of the lesion.

Discussion:

Rivaroxaban has no specific antidote. Current bleeding management strategies are based on expert opinion. The risks and benefits for differing strategies are unclear, and no clinical experience has been reported to date. These cases begin to illuminate differences among choices for managing bleeding associated with Xa inhibitors.

Conclusion:

In this case series, 25 to 35 units/kilogram PCC3 and FFP 1 to 3 units ceased rivaroxaban-associated bleeding without thrombogenic complications.
Number of Comorbidities Negatively Influence Psychological Outcomes of the Elderly Following Hip Fracture in Taiwan
Authors: Huang Yueh-Fang , Liang Jersey , Shyu Yea-Ing Lotus
Published: January 2016

Objective: Hip fracture usually affects psychological functions of the elderly, and comorbidities often interfere with their recovery. However, little is known about the influence of number of comorbidities on their psychological outcomes. Method: Data from a previous study of 461 hip-fractured elders treated at a medical center in northern Taiwan were analyzed by the generalized estimating equation approach. Outcomes were assessed at 1, 3, 6, 12 months following discharge by the Geriatric Depression Scale (GDS), Mini-Mental State Examination, and two subscales of the Medical Outcomes Study Short Form 36: role limitations due to emotional problems, and Mental Health (MH). Results: Hip-fractured elders with more comorbidities were more likely to have cognitive impairment (β = 0.224, p = .004), higher GDS scores (β = 0.328, p = .001), and worse MH (β = −1.784, p = .009) during the first year following discharge. Discussion: Having more comorbidities negatively influenced the psychological outcomes of elderly patients with hip fracture.
Partnership working in sport and physical activity promotion: An assessment of processes and outcomes in community sports networks
Authors: Baker Colin , El Ansari Walid , Crone Diane
Published: January 2016

Community sports networks were established in 2007 to coordinate local sport and physical activity promotion. Partnerships continue to be used to deliver policy. It is important to understand the relationship between the internal structure of partnerships and their outcomes. This study assesses associations between predictor variables relating to partnership structure and process and four intermediary partnership outcomes: satisfaction, synergy, commitment and effectiveness. A retrospective analysis of data was conducted on 171 surveys administered between September 2008 and March 2009 from community sports network members in England. The predictor variables explained 67% of the variance in synergy, 75% of the variance in satisfaction, 63% of the variance in commitment and 46% of the variance in effectiveness. Sustaining a positive benefits-to-costs relationship, establishing effective communication and partnership strategy, and demonstrating impact were predictive of the four intermediary partnership outcomes. Further research is warranted to help establish a detailed understanding of partnership processes and outcomes.
Optimal speed control of a multiple-mass train for minimum energy consumption using ant colony and genetic algorithms
Authors: Sandidzadeh Mohammad Ali , Alai Mohammad Reza
Published: January 2016

Today, rail transport systems are widely used in the world. Because of the high consumption of energy in these systems, finding ways to optimize their energy consumption is important. One of the best ways to save more energy and prevent the losses of rail transportation is using the optimal speed profile. In this article, intelligent algorithms, involving ant colony optimization for continuous domain [Formula: see text] and genetic algorithm, are applied to the energy efficiency problem of electrical trains for various track gradients and curvatures. With proper determination of switching points in the moving strategies such as acceleration, cruising, and coasting, the optimal speed profile for the safe journey of trains will be obtained. For the simulation, real data from rail tracks of Tehran metro have been incorporated.
Experimental investigation on the performance characteristics of a 2D trapped vortex combustor
Authors: Ezhil Kumar PK , Kumar Pravendra , Mishra DP
Published: January 2016

The performance characteristics of a 2D trapped vortex combustor (TVC) are investigated experimentally in terms of the exhaust gas emission level, combustion efficiency, and the exit temperature uniformity. The present study reveals that the EICO and EIUHC emission levels are sensitive to mainstream Reynolds number ( Rems), cavity equivalence ratio ( Øc), and primary air velocity ( Vp). Besides this, mainstream premixing also has significant impact on the emitted pollutant level. Moreover, the NOx emission level can be reduced to very low levels (<2.6 ppm), which will be difficult to achieve in conventional combustors. Combustion efficiency calculated from these emission results indicates that it is influenced by cavity equivalence ratio and primary air velocity. For particular Rems, Vp, and Øc, combustion efficiency closer to 99% could be achieved for the merged flame cases, especially at higher primary air velocity. On the other hand, for a particular value of Vp, an increase in Rems tends to quench the cavity flame leading to reduction in combustion efficiency. This study also indicates that flame merging helps in efficient utilization of fuel and thus leading to better combustion efficiency. Besides this, the conditions for achieving lower pattern factor ( PF) are also brought out from exit temperature measurements. Pattern factor as low as 0.1 could be achieved particularly at higher Vp cases. It can be noted that this value is lower than that of the PF value of swirl combustors (0.2–0.4). Based on the present investigations, it can be concluded that TVC is a viable technology to be considered for future gas turbine application.
Numerical simulation of SGT-600 gas turbine combustor, flow characteristics analysis, and sensitivity measurement with respect to the main fuel holes diameter
Authors: Aligoodarz Mohammadreza , Soleimanitehrani Mohammadreza , Karrabi Hadi , Ehsaniderakhshan Faeze
Published: January 2016

In this article, the combustion chamber of SGT600 gas turbine with 18 Alstom EV burners is numerically simulated to investigate the flow field and combustion properties and analyze the sensitivity of this combustor to diameter of main fuel holes. The three-dimensional simulation is carried out based on the turbulent flame closure model for the two-equation turbulence model, k-ɛ, using OpenFOAM code for SGT600 industrial gas turbine burner. An accurate grid combined of structured and unstructured mesh scheme is employed, which is sufficiently fined in areas of high gradients. Grid independency is investigated and validation of the code established comparing the outlet temperature and flame shape with experimental results. Excellent agreement between numerical analyses and experimental data was observed, so that the difference between calculated and measured outlet temperature was 0.1%. On the basis of reasonable matching of the predicted and experimental results for the combustor, the computational fluid dynamics model enables the prediction of the heat shield and combustor’s wall temperature and critical points of operation. In this article, flow-field and operation condition of this combustor and sensitivity analysis with respect to the main fuel holes diameter are numerically investigated.
Effect of heart rate on the hemodynamics of bileaflet mechanical heart valves’ prostheses (St. Jude Medical) in the aortic position and in the opening phase: A computational study
Authors: Jahandardoost Mehdi , Fradet Guy , Mohammadi Hadi
Published: January 2016

To date, to the best of the authors’ knowledge, in almost all of the studies performed around the hemodynamics of bileaflet mechanical heart valves, a heart rate of 70–72 beats/min has been considered. In fact, the heart rate of ~72 beats/min does not represent the entire normal physiological conditions under which the aortic or prosthetic valves function. The heart rates of 120 or 50 beats/min may lead to hemodynamic complications, such as plaque formation and/or thromboembolism in patients. In this study, the hemodynamic performance of the bileaflet mechanical heart valves in a wide range of normal and physiological heart rates, that is, 60–150 beats/min, was studied in the opening phase. The model considered in this study was a St. Jude Medical bileaflet mechanical heart valve with the inner diameter of 27 mm in the aortic position. The hemodynamics of the native valve and the St. Jude Medical valve were studied in a variety of heart rates in the opening phase and the results were carefully compared. The results indicate that peak values of the velocity profile downstream of the valve increase as heart rate increases, as well as the location of the maximum velocity changes with heart rate in the St. Jude Medical valve model. Also, the maximum values of shear stress and wall shear stresses downstream of the valve are proportional to heart rate in both models. Interestingly, the maximum shear stress and wall shear stress values in both models are in the same range when heart rate is <90 beats/min; however, these values significantly increase in the St. Jude Medical valve model when heart rate is >90 beats/min (up to ~40% growth compared to that of the native valve). The findings of this study may be of importance in the hemodynamic performance of bileaflet mechanical heart valves. They may also play an important role in design improvement of conventional prosthetic heart valves and the design of the next generation of prosthetic valves, such as percutaneous valves.
2nd BASHH Oxford Diagnostics Course, November 2015
Authors: Patel RR , White JA , Menon-Johansson AS , Sadiq ST , Ross JD
Published: January 2016

The second British Association for Sexual Health and HIV Oxford Diagnostics Course of 2015 focussed on recent challenges and emerging concepts within diagnostics and service design. In response to increasing sexually transmitted infection rates and subsequent demand on UK sexual health services, multiple approaches to improving patient flow and reducing waiting times were presented. The value of novel remote sexually transmitted infection testing was explored, with a description of the patient journey, emerging demographics and rates of testing uptake for the UK’s leading National Health Service provider. A cost-benefit evaluation was made for the use of nucleic acid amplification tests versus traditional microscopy and culture for detecting Trichomonas vaginalis, with practical consideration of application to higher risk groups. Two speakers stressed the importance of vigilance against growing antimicrobial resistance. The significance of testing for genotypic markers for antimicrobial resistance, and the emergence of point-of-care tests for resistance were also presented. The meeting closed with a first-hand account of tendering, and practical advice on rebuilding professional relationships and services after a competitive process.
Agreement Attraction and Impasse Aversion
Authors: Tuncel Ece , Mislin Alexandra , Kesebir Selin , Pinkley Robin L.
Published: January 2016

In the present studies, we examined the positive value of agreement and the negative value of impasse. Participants chose to give up real value and sacrifice economic efficiency in order to attain an agreement outcome and avoid an impasse outcome. A personally disadvantageous option was selected significantly more often when it was labeled “Agreement” rather than “Option A,” and a personally advantageous option was avoided significantly more often when it was labeled “Impasse” rather than “Option B.” In a face-to-face negotiation, a substantial proportion of individuals reached an agreement that was inferior to their best alternative to agreement. We showed that the appeal of agreement and the aversion to impasse both contribute to this effect, yet the aversion to impasse is the stronger of the two motivations. These findings have important implications for negotiators.
Numerical investigation of the unsteady flow behaviors in a counter-rotating axial compressor
Authors: Mao Xiaochen , Liu Bo
Published: January 2016

Unsteady numerical simulations of a counter-rotating axial compressor are performed to investigate the unsteady effects of rotor–rotor interaction process and the tip flow unsteady behavior near the stall operating condition. The results show that potential effects from the rear rotor have a more pronounced influence on the front rotor. Because of the interaction between the two rotors and the unsteady flow behaviors, the strongest fluctuant regions are different for the two rotors. Additionally, the oscillation on the pressure side is generally much stronger than that on the suction side. Frequency analyses show that self-unsteadiness occurs with the frequency of 0.76 blade passing frequency due to the impingement of the tip leakage flow on the pressure side near leading edge of the adjacent blade. An interesting phenomenon, i.e., the emergence of a local high pressure spot, is observed in the tip region. As a whole, it is concluded that there are two key effects of the emergence of the local high pressure zone in the tip region: (a) more leading edge spillage of tip leakage flow and increasing the risk to trigger stall; and (b) a decrease in blockage associated with double-leakage of tip clearance flow within the influenced region of the local high pressure zone.
The Long-Term Public Health Benefits of Breastfeeding
Authors: Binns Colin , Lee MiKyung , Low Wah Yun
Published: January 2016

Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer.
Cross-Validating Chinese Language Mental Health Recovery Measures in Hong Kong
Authors: Bola John , Chan Tiffany Hill Ching , Chen Eric HY , Ng Roger
Published: January 2016

Objectives:

Promoting recovery in mental health services is hampered by a shortage of reliable and valid measures, particularly in Hong Kong. We seek to cross validate two Chinese language measures of recovery and one of recovery-promoting environments.

Method:

A cross-sectional survey of people recovering from early episode psychosis ( n = 121) and family members ( n = 49) was taken. Two recovery measures, the Mental Health Recovery Measure and the recovery subscale of the Peer Outcomes Protocol, and one measure of recovery-promoting environments, the Recovery Self-Assessment, were used. The Psychosis Recovery Inventory was incorporated to assess construct validity.

Results:

Internal consistency reliability for each measure was high ( r = .71–.94); one-factor solutions were parsimonious. People in recovery rated their risk for relapse lower than did their family members.

Conclusions:

Moderately strong positive correlations among recovery measures lend support to construct validity. Several “recovery-promoting environment” items should be reassessed for cultural fit in Hong Kong.
Readiness for Hospital Discharge, Health Literacy, and Social Living Status
Authors: Wallace Andrea S. , Perkhounkova Yelena , Bohr Nicole L. , Chung Sophia Jihey
Published: January 2016

Patient characteristics and lack of preparedness are associated with poor outcomes after hospital discharge. Our purpose was to explore the association between patient characteristics and patient- and nurse-completed Readiness for Hospital Discharge Scale (RHDS). We conducted a prospective study of 70 Veterans being discharged from medical and surgical units. Differences in RHDS knowledge subscale scores were found among literacy levels, with lower perceived knowledge reported for those with marginal or inadequate literacy ( p = .03). Differences in RHDS expected support subscale scores were also found, with those who were unmarried and/or living alone ( p < .001) anticipating less support upon discharge. No other differences were found. Similar differences were found for the RHDS completed by nurses. These findings suggest that the RHDS appears responsive to differences in health literacy and social environment, adding to evidence of its utility as a tool to identify, and plan interventions for, those at risk for readmission.
Rediscussing Anticoagulation in Distal Deep Venous Thrombosis
Authors: Krutman Mariana , Kuzniec Sergio , Ramacciotti Eduardo , Varella Andrea Yasbek Monteiro , Zlotnik Mira , Teivelis Marcelo Passos , Tachibana Adriano , de Campos Guerra João Carlos , Wolosker Nelson
Published: January 2016

Background:

Distal deep venous thrombosis (DVT) accounts for approximately half of all the cases of lower limb thrombosis. The impact and management of this condition is still controversial. This study aims to evaluate the incidence of pulmonary embolism (PE) in patients with distal DVT in comparison to proximal DVT and evaluate the correlation between DVT and PE extension.

Methods:

100 patients with acute lower limb DVT diagnosed with whole leg Doppler ultrasound from January 2006 to December 2014 were retrospectively analyzed. Active investigation for PE was carried out in all patients using multislice computed tomography angiography. Classification of DVT and PE was based on the proximal extension of the thrombus.

Results:

The overall incidence of PE in our sample patients was 72%. In the subgroup analysis, incidence of PE was equal in both the proximal and distal DVT groups (77%, p > 0.99). PE was detected in 43% of the patients with isolated calf vein thrombosis (ICVT). No statistical difference was observed between the distribution of lobar, segmental and subsegmental PE in the 3 DVT subgroups (p = 0.665); however, truncular PE was only observed in the proximal DVT group.

Conclusion:

Distal DVT is associated with a high incidence of PE compared to proximal DVT. Distal DVT and ICVT can provoke PE with involvement of proximal vessels in the pulmonary arterial tree, even in asymptomatic patients. Our study arises discussion in the controversial debate regarding the need for routine anticoagulation in distal DVT.