bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the MJO Have a Westward Group Velocity?
Authors: Chen Guosen , Wang Bin
Published: January 2018

Current theoretical studies have a debate on whether the Madden–Julian oscillation (MJO) has a zero or westward group velocity. A recent analysis of the observed Hovmöller diagram of MJO signals suggested that the MJO has a significant westward group velocity. Here it is shown that the observed MJO has a negligibly small group velocity, which is manifested in two aspects. First, on the wavenumber–frequency spectra diagram the precipitation spectra indicate quasi independence of the MJO frequency on wavenumber, suggesting a nearly vanishing group velocity. Second, on the Hovmöller diagram of the regressed intraseasonal daily precipitation, the MJO group velocity is defined by the propagation of the wave envelopes of the precipitation and is shown to be negligibly small for the eastward propagating signals. The causes of the discrepancy between this study and the recent study mentioned above are the calculating method and the data filtering process. The group velocity in the recent study is calculated by the propagation of local convection extrema, which does not necessarily indicate the propagation of the wave envelopes. More importantly, the westward propagation of the local convection extrema is an artifact of the data filtering. The Hovmöller diagram in the recent study was constructed by using only the eastward propagating wavenumber-1–5 signals. This truncation of data onto the planetary scales of the eastward wavenumber domain fails to resolve the Maritime Continent “barrier effect,” causing significant artificial westward propagation of local convection extrema.
Uncertainty of Integrated Intensity Following Line Profile Fitting of Multiline Spectra
Authors: Surmick David M. , Boukari Hacene , Woodward Jonathan , Stowe Ashley C. , Melikechi Noureddine
Published: January 2018

A novel method of determining the total uncertainty in the integrated intensity of fitted emission lines in multipeaked emission spectra is presented. The proposed method does not require an assumption of the type of line profile to be specified. The absolute difference between a fit and measured spectrum defines the uncertainty of the integrated signal intensity and is subsequently decomposed to determine the uncertainty of each peak in multiline fits. Decomposition relies on tabulating a weighting factor, which describes how each peak contributes to the total integral uncertainty. Applications of this method to quantitative approaches in laser-induced breakdown spectroscopy analysis are described.
Surface Spectroscopic Signatures of Mechanical Deformation in High-Density Polyethylene (HDPE)
Authors: Averett Shawn C. , Stanley Steven K. , Hanson Joshua J. , Smith Stacey J. , Patterson James E.
Published: January 2018

High-density polyethylene (HDPE) has been extensively studied, both as a model for semi-crystalline polymers and because of its own industrial utility. During cold drawing, crystalline regions of HDPE are known to break up and align with the direction of tensile load. Structural changes due to deformation should also manifest at the surface of the polymer, but until now, a detailed molecular understanding of how the surface responds to mechanical deformation has been lacking. This work establishes a precedent for using vibrational sum-frequency generation (VSFG) spectroscopy to investigate changes in the molecular-level structure of the surface of HDPE after cold drawing. X-ray diffraction (XRD) was used to confirm that the observed surface behavior corresponds to the expected bulk response. Before tensile loading, the VSFG spectra indicate that there is significant variability in the surface structure and tilt of the methylene groups away from the surface normal. After deformation, the VSFG spectroscopic signatures are notably different. These changes suggest that hydrocarbon chains at the surface of visibly necked HDPE are aligned with the direction of loading, while the associated methylene groups are oriented with the local C2 v symmetry axis roughly parallel to the surface normal. Small amounts of unaltered material are also found at the surface of necked HDPE, with the relative amount of unaltered material decreasing as the amount of deformation increases. Aspects of the nonresonant SFG response in the transition zone between necked and undeformed polymer provide additional insight into the deformation process and may provide the first indication of mechanical deformation. Nonlinear surface spectroscopy can thus be used as a noninvasive and nondestructive tool to probe the stress history of a HPDE sample in situations where X-ray techniques are not available or not applicable. Vibrational sum-frequency generation thus has great potential as a platform for material state awareness (MSA) and should be considered as part of a broader suite of tools for such applications.
A Bayesian Approach to Robust Skewed Autoregressive Processes
Authors: Maleki Mohsen , Arellano-Valle Reinaldo B. , Dey Dipak K. , Mahmoudi Mohammad R. , Jalali Seyed Mohammad J.
Published: January 2018

This article studies autoregressive (AR) models assuming innovations with scale mixtures of skew-normal (SMSN) distributions, an attractive and flexible family of probability distributions. A Bayesian analysis considering informative prior distributions is presented. Comprehensive simulation studies are performed to support the performance of the proposed model and methods. The proposed methods are also applied on a real-time series data which has previously been analysed under Gaussian and Student- t AR models.
Cognitive work hardening for return to work following depression: An intervention study
Authors: Wisenthal Adeena , Krupa Terry , Kirsh Bonnie H. , Lysaght Rosemary
Published: January 2018

Background.

Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode.

Purpose.

This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention.

Method.

A single group ( n = 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data.

Findings.

Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements.

Implications.

Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research.
The effect of social support, gratitude, resilience and satisfaction with life on depressive symptoms among police officers following Hurricane Katrina
Authors: McCanlies Erin C , Gu Ja Kook , Andrew Michael E , Violanti John M
Published: January 2018

Background:

Police officers in the New Orleans geographic area faced a number of challenges following Hurricane Katrina.

Aim:

This cross-sectional study examined the effect of social support, gratitude, resilience and satisfaction with life on symptoms of depression.

Method:

A total of 86 male and 30 female police officers from Louisiana participated in this study. Ordinary least-square (OLS) regression mediation analysis was used to estimate direct and indirect effects between social support, gratitude, resilience, satisfaction with life and symptoms of depression. All models were adjusted for age, alcohol intake, military experience and an increase in the number of sick days since Hurricane Katrina.

Results:

Mean depressive symptom scores were 9.6 ± 9.1 for females and 10.9 ± 9.6 for males. Mediation analyses indicates that social support and gratitude are directly associated with fewer symptoms of depression. Social support also mediated the relationships between gratitude and depression, gratitude and satisfaction with life, and satisfaction with life and depression. Similarly, resilience mediated the relationship between social support and fewer symptoms of depression.

Conclusion:

Social support, gratitude and resilience are associated with higher satisfaction with life and fewer symptoms of depression. Targeting and building these factors may improve an officer’s ability to address symptoms of depression.
Studying grounding arrangements of the LVDC system through simulation
Authors: Shabani Arash , Mazlumi Kazem
Published: January 2018

Low-voltage DC (LVDC) systems may soon become an integral part of our electric grid. Faults on DC lines are usually pole-to-ground faults that depend on the grounding arrangement of the DC system. The grounding of the LVDC system is not adequately covered in the literature and there is no comprehensive standard for it. This paper studies the effect of various grounding arrangements of the LVDC system on pole-to-ground fault protection. An overall scheme of the LVDC system is modeled and a pole-to-ground fault is placed on the DC lines. Possible grounding arrangements are analyzed employing MATLAB/Simulink software and detailed discussion is given for each arrangement. Finally, simulation results are compared and a preferred grounding arrangement is selected with the objective of having selective and effective protection without device damage.
Factors affecting removal of bacterial pathogens from healthcare surfaces during dynamic wiping
Authors: Edwards NWM , Best EL , Goswami P , Wilcox MH , Russell SJ
Published: January 2018

Wiping of surfaces contaminated with pathogenic bacteria is a key strategy for combating the transmission of healthcare associated infections. It is essential to understand the extent to which removal of bacteria is modulated by fiber properties, biocidal liquid impregnation and applied hand pressure. The influence of intrinsic and extrinsic factors on the removal efficiencies of pathogenic bacteria was studied. Nonwoven wipes made of either hydrophobic (polypropylene) or hygroscopic (lyocell) fibers were manufactured and dynamic removal efficiency of bacteria studied. The single most important parameter affecting bacterial removal efficiency was impregnation with biocidal liquid ( p < 0.05). For inherently hygroscopic 100% regenerated cellulose (lyocell) wipes impregnated with biocidal liquid, removal of E. coli, S. aureus and E. faecalis improved by increasing the fabric surface density and wiping pressure to their maximal values – 150 g.m–2 and 13.80 kN.m–2, respectively. For inherently hydrophobic 100% polypropylene nonwoven wipes, the same conditions maximized the removal efficiency of S. aureus, but for E. coli and E. faecalis a reduction in the wiping pressure to 4.68 kN.m–2 was required. Best practice involves the use of higher surface density wipes (150 g.m–2) containing regenerated cellulose fibers loaded with liquid biocide, and applied with the greatest possible wiping pressure.
Technology-Based Employability Curriculum and Culturally Diverse Learners With Disabilities
Authors: Williams-Diehm Kendra L. , Miller Christina R. , Sinclair Tracy E. , Wronowski Meredith L.
Published: January 2018

As technology continues to permeate our culture and society, K–12 educators search for strategies to build student capacity and engagement with technology. Although the digital divide around access to technology has been decreasing, there is still a significant gap in the utilization of technology for educational purposes by culturally diverse learners. Even more vulnerable to unequal access to technology for educational use are culturally diverse students with a documented disability. TechNow is a promising transition-focused technology training class for high school students with disabilities. A three-factor analysis of variance revealed significant improvements in perceptions of technology skill acquisition and use of software by Latino and Native American high school students with disabilities enrolled in TechNow compared to the control group. Implications of these results suggest acquisition of critical transition skills for culturally diverse learners are enhanced through the TechNow program.
An Immunopathological Evaluation of the Porcine Cholecyst Matrix as a Muscle Repair Graft in a Male Rat Abdominal Wall Defect Model
Authors: Balakrishnan-nair Dhanush Krishna , Nair Narayanan Divakaran , Venugopal Syam Kunnekkattu , Das Vijayan Narayana , George Sisilamma , Abraham Mammen John , Eassow Saji , Alison Malcolm Ronald , Sainulabdeen Anoop , Anilkumar Thapasimuthu Vijayamma
Published: January 2018

With the increasing use of animal-based biomaterials for regenerative medical applications, the need for their safety assessment is paramount. A porcine cholecyst-derived scaffold (CDS), intended as a muscle repair graft, prepared by a nondetergent/enzymatic method was engrafted in a rat abdominal wall defect model. Host tissue–scaffold interface samples were collected 2, 8, and 16 weeks postimplantation and evaluated by histopathology, immunohistochemistry, and electron microscopy. The nature of the tissue reaction was compared with those induced by a jejunum-derived scaffold (JDS) prepared by the same method and a commercial-grade small intestinal submucosa (CSIS) scaffold. A study of the immunopathological response in major lymphoid tissues and immunophenotyping for M1 and M2 macrophages was performed at the host tissue–scaffold interface. Further, “irritancy scores” for CDS and JDS were determined using CSIS as the reference material. Both CDS and JDS appeared to be potential biomaterials for muscle grafts, but the former stimulated a skeletal muscle tissue remodeling response predominated by M2 macrophages. The data support the notion that biomaterials with similar biocompatibility, based on local tissue response on implantation, may cause differential immunogenicity. Additionally, CDS compared to JDS and CSIS was found to be less immunotoxic.
The Prediction Value of the Systemic Inflammation Score for Oral Cavity Squamous Cell Carcinoma
Authors: Eltohami Yousif I. , Kao Huang‐Kai , Lao William Wei‐Kai , Huang Yenlin , Abdelrahman Mohamed , Liao Chun‐Ta , Yen Tzu‐Chen , Chang Kai‐Ping
Published: January 2018

Objectives

This study aimed to investigate the potential prognostic role of the oral cancer systemic inflammation score (SIS) based on serum albumin levels and the lymphocyte‐to‐monocyte ratio in patients with oral squamous cell carcinoma (OSCC) after treatment.

Study Design

A retrospective cohort study.

Setting

Tertiary care center.

Subjects and Methods

The study involved 613 patients who were treated for OSCC between September 2005 and December 2014. The association of the oral cancer SIS with various clinicopathological features was investigated. A nomogram based on different clinicopathological features and SIS was established to predict prognosis.

Results

Higher SIS was significantly associated with older age (P =. 0013), advanced tumor status (P <. 0001), tumor depth (P <. 0001), advanced overall pathologic stage (P <. 0001), and extranodal extension (P =. 0045), as well as the presence of perineural invasion (P =. 0341). Higher SIS, older age, overall stage, and extranodal extension were demonstrated to be independent prognostic indicators for shorter overall survival (P <. 0001). A nomogram comprising SIS, TNM stage, and the degree of cell differentiation, as well as perineural invasion and extranodal extension, was developed to predict the prognosis of these patients. The c‐index of the nomogram model based on TNM staging only was 0.688 and could be increased to 0.752 if SIS and several other clinicopathological parameters were incorporated.

Conclusions

Higher SIS is associated with many poor prognosticators, and the nomogram that was established and based on the incorporation of SIS might strengthen the prediction of prognosis in patients with OSCC.
Perineural Invasion in Parotid Gland Malignancies
Authors: Huyett Phillip , Duvvuri Umamaheswar , Ferris Robert L. , Johnson Jonas T. , Schaitkin Barry M. , Kim Seungwon
Published: January 2018

Objectives

To investigate the clinical predictors and survival implications of perineural invasion (PNI) in parotid gland malignancies.

Study Design

Case series with chart review.

Setting

Tertiary care medical center.

Subjects and Methods

Patients with parotid gland malignancies treated surgically from 2000 to 2015 were retrospectively identified in the Head and Neck Cancer Registry at a single institution. Data points were extracted from the medical record and original pathology reports.

Results

In total, 186 patients with parotid gland malignancies were identified with a mean follow‐up of 5.2 years. Salivary duct carcinoma (45), mucoepidermoid carcinoma (44), and acinic cell carcinoma (26) were the most common histologic types. A total of 46.2% of tumors were found to have PNI. At the time of presentation, facial nerve paresis (odds ratio [OR], 64.7; P <. 001) and facial pain (OR, 3.7; P =. 002) but not facial paresthesia or anesthesia (OR, 2.8, P =. 085) were predictive of PNI. Malignancies with PNI were significantly more likely to be of advanced T and N classification, be high‐risk pathologic types, and have positive margins and angiolymphatic invasion. PNI positivity was associated with worse overall (hazard ratio, 2.62; P =. 001) and disease‐free survival (4.18; P <. 001) on univariate Cox regression analysis. However, when controlling for other negative prognosticators, age, and adjuvant therapy, PNI did not have a statistically significant effect on disease‐free or overall survival.

Conclusions

PNI is strongly correlated with more aggressive parotid gland malignancies but is not an independent predictor of worse survival. Facial paresis and pain were predictive of PNI positivity, and facial paresis correlated with worse overall and disease‐free survival.
Violence work: policing and power
Authors: Seigel Micol
Published: January 2018

Present ad hoc outcries about police excesses such as shootings of young black men on the streets and mass incarceration miss the point about the nature and role of the police, argues the author. Coining her own counter-category, ‘violence work’, she shows how the police carry out violence work for the state; policing being the quintessential translation of state power. In a considered argument taking in the history of colonial policing, the development of racial capitalism and US foreign intervention, the article discusses a number of fallacies about policing: that it is civilian and distinguishable from the military; that it is a public service rather than a private endeavour; and that it is locally based and municipally controlled. Policing is in fact the human-scale expression of the state. She discusses a number of state theorists from Adam Smith, to Poulantzas, Foucault, Agamben and Hall and contemplates the role of the state to the market. The piece lifts the assumptions about public safety, state/private sector, place and scale to reveal the ideological landscape that legitimates state-market violence.
The Provenance and Cultic Context of an Egyptian Bronze Flute in the British Museum (EA 12742)
Authors: Lanciers Eddy
Published: January 2018

Onomastic data prove that the bronze flute BM EA 12742 originates from the Theban area, probably the West Bank (Theban Necropolis or Hermonthis). The instrument may have been used in the cult of the sacred ibises and falcons in Dra Abu’l-Naga or in a cult of the sacred ibis and Montu in Hermonthis.
Persika in der Repräsentation der ägyptischen Elite
Authors: Wasmuth Melanie
Published: January 2018

Egyptian elite representation in the Twenty-seventh Dynasty features a number of statues with Persian honour awards. The following paragraphs discuss the socio-cultural significance of displaying Persian jewellery in the statues of Udjahorresnet in the Musei Vaticani, of Ptahhotep in the Brooklyn Museum, and of a man of unknown name in the Landesmuseum Karlsruhe. The context of these persika will be contrasted to those in the tomb reliefs of Petosiris in Tuna el-Gebel, which open up very different lines of interpretation.
Systematically Applying UDL to Effective Practices for Students With Learning Disabilities
Authors: Cook Sara Cothren , Rao Kavita
Published: January 2018

Based on the premise that instruction should be designed from the outset to reduce barriers, Universal Design for Learning (UDL) guidelines provide a set of flexible options and scaffolds to ensure access for all learners. Using the UDL framework, teachers and researchers can systematically adapt effective practices that have been established by methodologically sound research studies to have meaningful gains for students with learning disabilities (LD). Specifically, we suggest that teachers can select an effective practice and then use the UDL framework to individualize the practice (while maintaining core components). Furthermore, we propose that researchers may use this approach to (a) clearly define how UDL was applied to a practice and (b) systematically measure the effects of UDL when applied to practices that have been established as effective by methodologically sound research. Although teachers and researchers can apply UDL to effective practices for all students, in this article, we highlight how secondary teachers can design and adapt effective practices for students with LD, who need intensive interventions to improve skills (e.g., reading comprehension, decoding) and access to grade-level curriculum.
Therapeutic Plasma Exchange Use in Pediatric Neurologic Disorders at a Tertiary Care Center: A 10-Year Review
Authors: Agarwal Sonika , Keller Jake R. , Nunneley Chloe E. , Muscal Eyal , Braun Michael C. , Srivaths Poyyapakkam , Lotze Timothy E.
Published: January 2018

Pediatric neurologic conditions requiring therapeutic plasma exchange are rare in children and literature is sparse. The study aims to determine the outcomes, safety, and feasibility of therapeutic plasma exchange treatment in pediatric neurologic disorders. This retrospective analysis looked at the outcomes and safety of therapeutic plasma exchange in children (n = 50) with neurologic conditions. Patient age ranged <1 to 19 years old with a mean of 10.35 years. Of the 50 children treated with plasmapheresis, 26 patients received inpatient rehabilitation. At discharge, functional status can be summarized as follows: 24 (48%) with mental status impairment, 10 (20%) with vision impairment, 19 (38%) with bladder incontinence, and 37 (74%) with motor impairment. Three-month follow-up: 30% with mental status impairment, 10% with vision impairment, 18% with bladder incontinence, and 52% with motor impairment. Therapeutic plasma exchange is an effective and safe therapy for neurological conditions in the pediatric population.
Fault-tolerant pose and inertial parameters estimation of an uncooperative spacecraft based on dual vector quaternions
Authors: Yuan Jianping , Hou Xianghao , Sun Chong , Cheng Yu
Published: January 2018

Estimating the parameters of an unknown free-floating tumbling spacecraft is an essential task for the on-orbit servicing missions. This paper proposes a dual vector quaternion based fault-tolerant pose and inertial parameters estimation algorithm of an uncooperative space target using two formation flying small satellites. Firstly, by utilizing the dual vector quaternions to model the kinematics and dynamics of the system, not only the representation of the model is concise and compacted, but also the translational and rotational coupled effects are considered. By using this modeling technique along with the measurements from the on-board vision-based sensors, a dual vector quaternion based extended Kalman filter for each of the two small satellites is designed. Secondly, both of the estimations from each small satellite will be used as inputs of the fault-tolerant algorithm. This algorithm is based on the fault-tolerant federal extended Kalman filter strategy to overcome the estimation errors caused by the faulty measurements, the unknown space environment and the computing errors by setting the appropriate ratios of the two estimations from the first step dual vector quaternions extended Kalman filter. Together with the first and second steps, a novel fault-tolerant dual vector quaternions federal extended Kalman filter using two formation flying small satellites is proposed by this paper to estimate the pose and inertial parameters of a free-floating tumbling space target. By utilizing the estimation algorithm, a good prior knowledge of the unknown space target can be achieved. Finally, the proposed dual vector quaternion federal extended Kalman filter is validated by mathematical simulations to show its robust performances.
Factors associated with recent unsuppressed viral load in HIV-1-infected patients in care on first-line antiretroviral therapy in South Africa
Authors: Joseph Davey D , Abrahams Z , Feinberg M , Prins M , Serrao C , Medeossi B , Darkoh E
Published: January 2018

Unsuppressed viral load (VL) in patients on antiretroviral therapy (ART) occurs when treatment fails to suppress a person’s VL and is associated with decreased survival and increased HIV transmission. The objective of this study was to evaluate factors associated with unsuppressed VL (VL > 400 copies/ml) in patients currently in care on first-line ART for ≥ 6 months attending South African public healthcare facilities. We analysed electronic medical records of ART patients with a VL result on record who started ART between January 2004 and April 2016 from 271 public health facilities. We present descriptive and multivariable logistic regression for unsuppressed VL at last visit using a priori variables. We included 244,370 patients (69% female) on first-line ART in April 2016 for ≥ 6 months. Median age at ART start was 33 years (7% were < 15 years old). Median duration on ART was 3.7 years. Adjusting for other variables, factors associated with having an unsuppressed VL at the most recent visit among patients in care included: (1) < 15 years old at ART start (adjusted odds ratio [aOR]=2.58; 95% CI = 2.37, 2.81) versus 15–49 years at ART start, (2) male gender (aOR = 1.29; 95% CI = 1.25, 1.35), (3) 6–12 months on ART versus longer (aOR = 1.34; 95% CI = 1.29, 1.40), (4) on tuberculosis (TB) treatment (aOR = 1.78; 95% CI = 1.48, 2.13), and (5) prior ART exposure versus none (aOR = 1.20; 95% CI = 1.08, 1.32). Approximately 85% of the ART cohort who were in care had achieved viral suppression, though men, youth/adolescents, patients with prior ART exposure, those with short duration of ART, and patients on TB treatment had increased odds of not achieving viral suppression. There is a need to develop and evaluate targeted interventions for ART patients in care who are at high risk of unsuppressed VL.
Renal outcomes in patients initiated on tenofovir disoproxil fumarate-based antiretroviral therapy at a community health centre in Malawi
Authors: Chikwapulo Bongani , Ngwira Bagrey , Sagno Jean Baptiste , Evans Rhys
Published: January 2018

Tenofovir-based antiretroviral therapy (TDF ART) is the first-line regimen for human immunodeficiency virus (HIV) in Africa. However, contemporary data on nephrotoxicity are lacking. We determined the renal outcomes of patients commenced on TDF ART in Malawi. ART-naïve patients initiated on TDF ART at a community health centre between 1 July 2013 and 31 December 2015 were included. The estimated glomerular filtration rate (eGFR, Cockcroft-Gault) was recorded at the initiation of therapy and over 18 months thereafter. The prevalence of renal impairment at ART initiation (eGFR < 60 ml/min) and the incidence of nephrotoxicity (eGFR < 50 ml/min) were determined. A total of 439 patients (median age: 32 years; 317 [72.2%] female) were included. Twenty-one (4.8%) patients had renal impairment at ART initiation; eGFR improved in all during follow-up. Nephrotoxicity occurred in 17 (4.0%) patients with eGFR > 50 ml/min at baseline, predominantly within the first six months of therapy. Increasing age and diastolic hypertension (>100 mmHg) were independent risk factors for nephrotoxicity development. The prevalence of kidney disease at ART initiation was 4.8% and nephrotoxicity occurred in 4.0%. Some eGFR decline may have been due to weight gain. Targeted monitoring of kidney function six months after TDF initiation should be considered in Malawi.
Acroangiodermatitis mimicking Kaposi’s sarcoma in an HIV-positive man
Authors: Goorney BP , Newsham J , Fitzgerald D , Motta L
Published: January 2018

Kaposi’s sarcoma (KS) is the commonest human immunodeficiency virus (HIV)-related malignancy with its characteristic cutaneous morphological appearance and histopathological features. However, it can be simulated by other co-morbid opportunistic infections and unrelated dermatological conditions. We describe such a case of acroangiodermatitis in an HIV co-infected man, based on exclusion of KS histologically and the absence of human herpesvirus 8, the causative agent of KS.
Time for Bourdieu: Insights and oversights
Authors: Atkinson Will
Published: January 2018

This paper explores the role of time in Pierre Bourdieu’s social theory with a view to highlighting, and plugging, some of its conceptual gaps. It proceeds by identifying four elements of the social structuring of temporal experience: the temporal structure of consciousness; field rhythms and pace; imposed timings; and time binds. The first two of these Bourdieu brought to the fore, even if there are some aspects of his account in need of further development. The third he posited without tracing through the full conceptual consequences, while the fourth requires some reorientation and additional work to accommodate it. The latter I undertake by elaborating on a few concepts drawn from both Bourdieu’s corpus and phenomenology.
One State’s Use of Program Evaluation to Improve Correctional Practices
Authors: Lovins Lori Brusman , Latessa Edward J.
Published: January 2018

Trends in criminal justice programming can sometimes lead one to question the direction the field is taking related to rehabilitation. This article presents one state’s attempt to evaluate the quality of residential treatment services in the state across a primary and then follow-up outcome evaluation. This article outlines study results specific to treatment effects by risk. The study finds consistent evidence in support of the risk principle across both studies. The article also outlines what the state did with the recommendations from these studies, and how that affected the delivery of correctional programming in that state.
Physicians’ Perceptions of Hope and How Hope Informs Interactions With Patients: A Qualitative, Exploratory Study
Authors: Wolf Airin , Garlid Catherine F. , Hyrkas Kristiina
Published: January 2018

Objectives:

Today some studies of physicians’ perceptions of hope are available, but not studies of how hope informs patient care. The objectives of this qualitative study were to describe the ways physicians conceptualize hope and how these may inform interactions with their patients.

Methods:

Ten physicians working in a large tertiary care teaching hospital were interviewed. They represented palliative care, oncology, and 7 other specialties. Minimal amount of background information was collected. In-depth interviews were conducted during spring of 2016. Open coding and the constant comparison method were used to identify emerging themes from the transcribed data. Validation method included member checking.

Results:

Hope was defined as an abstract, evolving concept characterized by future-oriented wishes; offering possibilities for reframing and shaping new meaning; an attitude of positivity or optimism; an attribute of the human condition with emotional and relational roots; and as a response to the existential inevitability of suffering and death. Three themes describing hope emerged: “assessing hope,” “fostering and sustaining hope,” and “attributes and outcomes of hope.”

Conclusions:

The findings show how physicians conceptualize hope and how these conceptions differ in the empirical light of the study. Physicians’ perceptions of “hope” may evolve when entering into a therapeutic relationship exploring the needs and desires of patients. Physicians’ perspectives about “hope” may at times not be solely their own but are those of their patients and thus resulting in an amalgamation, or a rebuilding/rekindling of hope amidst hopelessness, that suits a particular relationship.
Latissimus Dorsi Flap in Breast Reconstruction
Authors: Sood Rachita , Easow Jeena M. , Konopka Geoffrey , Panthaki Zubin J.
Published: January 2018

Background:

Surgeons employ the latissimus dorsi flap (LDF) for reconstruction of a large variety of breast cancer surgery defects, including quadrantectomy, lumpectomy, modified radical mastectomy, and others. The LDF may be used in delayed or immediate reconstruction, in combination with tissue expanders for a staged reconstruction, with implant-based immediate reconstruction, or alone as an autogenous flap.

Methods:

The authors discuss the historical uses and more recent developments in the LDF. More recent advancements, including the “scarless” approach and augmentation with the thoracodorsal artery perforator flap, are discussed.

Results:

The LDF is a reliable means for soft tissue coverage providing form and function during breast reconstruction with acceptable perioperative and long-term morbidities.

Conclusions:

When there is a paucity of tissue, the LDF can provide tissue volume in autologous reconstruction, as well as a reliable vascular pedicle for implant-based reconstruction as in the setting of irradiated tissue.
Application of Fluorescence-Guided Surgery to Subsurface Cancers Requiring Wide Local Excision
Authors: Samkoe Kimberley S. , Bates Brent D. , Elliott Jonathan T. , LaRochelle Ethan , Gunn Jason R. , Marra Kayla , Feldwisch Joachim , Ramkumar Dipak B. , Bauer David F. , Paulsen Keith D. , Pogue Brian W. , Henderson Eric R.
Published: January 2018

The excision of tumors by wide local excision is challenging because the mass must be removed entirely without ever viewing it directly. Positive margin rates in sarcoma resection remain in the range of 20% to 35% and are associated with increased recurrence and decreased survival. Fluorescence-guided surgery (FGS) may improve surgical accuracy and has been utilized in other surgical specialties. ABY-029, an anti-epidermal growth factor receptor Affibody molecule covalently bound to the near-infrared fluorophore IRDye 800CW, is an excellent candidate for future FGS applications in sarcoma resection; however, conventional methods with direct surface tumor visualization are not immediately applicable. A novel technique involving imaging through a margin of normal tissue is needed. We review the past and present applications of FGS and present a novel concept of indirect FGS for visualizing tumor through a margin of normal tissue and aiding in excising the entire lesion as a single, complete mass with tumor-free margins.
Bacterial Colonization of Chronic Hemodialysis Catheters: Evaluation with Endoluminal Brushes and Heparin Aspirate
Authors: Koch M. , Coyne D. , Hoppe-Bauer J. , Vesely T. M.
Published: January 2018

Tunneled catheters serve as interim access during maturation of a graft or fistula, or as a permanent vascular access in those patients who have exhausted their traditional access sites. However, bacteremia rates are high in patients with chronic catheters and indiscriminate removal of catheters during bacteremia increases morbidity and costs. A method to identify whether a catheter was colonized with the offending bacteria, without requiring catheter removal is desirable.

We compared endoluminal brushing and heparin aspiration, to detect catheter colonization, in 24 asymptomatic patients undergoing elective tunneled hemodialysis catheter removal. The incidence of catheter colonization was highly correlated with catheter duration of ≥ 30 days (p=0.03). Staphylococcus epidermidis represented 68% of the organisms isolated. No other organism accounted for more than 7% of the total. Fifteen (62.5%) of the 24 catheters had positive cultures. Eleven of the catheters were positive by culture of heparin aspirate and eight were positive by endoluminal brushing. Only four of the catheters were positive by both methods. The arterial lumen was more likely to have positive cultures than the venous lumen using either method.

In this prospective investigation of tunneled hemodialysis catheters in asymptomatic patients we have demonstrated that a heparin aspirate sample is more likely to detect catheter colonization than a sample obtained using an endoluminal brush. Furthermore, 75% of catheters present for more than 30 days were colonized. Further study is needed to determine if the heparin aspirate method could be used in patients with bacteremia to accurately identify catheters that need removal.
A Venous “Patch” Technique Improves Patency Rate of Primary Radiocephalic Fistulas
Authors: Titiz M.I. , Yalti T. , Krand O. , Aydin Ç. , Berber I.
Published: January 2018

A retrospective study was designed to evaluate the outcome of native wrist arteriovenous fistula (AVF) constructed with standard versus venous “patch” techniques in terms of immediate, early and late failures. Between January 1991 and July 2001, 1948 patients underwent primary wrist radiocephalic AVF. Thirty eight per cent (740) of the fistulas were created using the venous patch technique. Immediate and/or early failure rate was significantly lower in the venous “patch” technique (Group II) compared to the standard technique (Group I). Although the difference in late failures between Groups I and II did not reach statistical significance, the cumulative patency rates were significantly better in Group II. Radiocephalic fistula constructed with the use of venous patch is recommended whenever the anatomy is feasible.
Antibiotic Lock Technique for Prevention of Cuffed Tunnel Catheter Associated Bacteremia
Authors: Pervez A. , Ahmed M. , Ram S. , Torres C. , Work J. , Zaman F. , Abreo K.
Published: January 2018

Background

Central venous cuffed tunnel catheters are commonly used for short term or long term hemodialysis access. However, catheter-associated bacteremia is a common complication. It has been suggested that the addition of antibiotics to the catheter during the interdialytic interval results in a decrease in bacterial colonization and thereby a decrease in catheter associated infections. To test this hypothesis, a prospective, randomized study was performed comparing a gentamicin citrate mixture to standard heparin as the catheter lock. The effect of covering the catheter hub in a sterile bag on the infection rate was additionally tested.

Methods

From January 1999 to April 2000, all patients who underwent tunnel catheter placement or change (55 catheters) in the Nephrology Interventional Laboratory at Louisiana State University Health Sciences Center in Shreveport, were prospectively randomized as follows: group 1 (n=14): Antibiotic lock with tricitrasol (46.7%), gentamicin (40 mg/ml) and saline in a ratio of 1:5:5 and catheter hub covered with a sterile plastic bag after cleaning with a 10% povidone iodine solution; group 2 (n=22): Heparin lock and sterile plastic bag over catheter hub after cleaning with povidone iodine; and group 3 (n=19): Heparin lock alone. The primary end points of the study were catheter-associated bacteremia and thrombosis. Catheter loss due to access maturation, transplant or transfer were censored.

Results

There were a total of 4,805 at risk patient-days. The total number of catheter associated bacteremias were one in group 1, four in group 2 and four in group 3. The number of catheter associated bacteremias per 1000 patient-days in each group was 0.62, 3.05, and 2.11 respectively. The sixty day percent survival of catheters in each group was 74 ± 12, 55 ± 12 and 59 ± 11 respectively.

Conclusions

1) Tricitrasol and gentamicin as an antibiotic lock reduced the incidence of catheter associated bacteremia; 2) Covering the catheter hub with a sterile bag did not provide an additional advantage; 3) The antibiotic lock improved overall survival of catheters.
Vascular Rupture during Angioplasty of Hemodialysis Graft-Related Stenoses
Authors: Pappas J.N. , Vesely T.M.
Published: January 2018

Purpose

To retrospectively determine the incidence and outcome of angioplasty-induced ruptures that occurred during treatment of hemodialysis graft-related stenoses.

Materials and Methods

During a five year period 1222 patients with dysfunctional or thrombosed polytetrafluoroethylene (PTFE) hemodialysis grafts underwent angioplasty procedures at our institution. Angioplasty-induced vascular ruptures occurred in 24 (2.0%) patients. The locations of these ruptures were: basilic vein (10), venous anastomosis (7), cephalic vein (5), brachial vein (1) and intragraft (1). The mean length of the treated stenoses was 2.4 centimeters.

Results

Manual compression was used to treat the vascular rupture in ten patients. One patient was treated with endovascular balloon tamponade and one patient underwent stenting of the rupture site. Despite the rupture, 15 patients had completion of the angioplasty procedure. In nine patients the procedure was abandoned due to persistent stenosis at the rupture site. There were no major complications as a result of these ruptures. Follow-up was available in ten of these patients. All ten underwent at least one successful hemodialysis treatment. In five of these patients the hemodialysis graft failed within 30 days after the rupture. The mean primary patency following rupture in the ten patients with follow-up was 87.5 days (range 5 – 225 days).

Conclusion

The incidence of angioplasty-induced vascular rupture of hemodialysis-related stenoses is low and despite the injury, the majority (62%) of procedures can be completed. However, in our experience the long-term patency of the vascular access was suboptimal.
Secondary Migration of a Central Venous Catheter: A Rare Complication
Authors: Caruselli M. , Pieroni G. , Franceschi A. , Santelli F. , Bechi P. , Pagni R.
Published: January 2018

The Authors describe a case of spontaneous migration in the right jugular vein of a central venous catheter tip, properly positioned in the right atrium through the right subclavian vein two days before.
The Role of Surveillance in Mature Arteriovenous Fistula Management
Authors: Tessitore N. , Bedogna V. , Poli A.
Published: January 2018

The existing guidelines recommend arteriovenous fistulae (AVF) surveillance by access blood flow (Qa) measurement and the correction of hemodynamically significant stenoses to prolong access survival. Unfortunately, many studies supporting these recommendations are inadequate methodologically; therefore, both the optimal criteria for surveillance and the value of preventive stenosis repair in AVF remain controversial. Recent literature confirms that Qa measurement allows an accurate identification of both stenosis (area under the curve (AUC) ranging from 0.80–0.93) and access at risk of failure (AUC ranging from 0.82–0.98) in AVFs and suggests a Qa <700–1000 ml/min and/or a reduction in Qa >25% as optimal predictors for stenosis and a Qa <400 ml/min for incipient thrombosis. Recent prospective studies evaluated whether Qa surveillance could improve AVF patency rates compared to monitoring based on clinical and dialysis-related criteria alone. The majority of studies have historical, rather than concurrent, control groups and provide conflicting results, some showing a reduction and some showing no change in thrombosis rates by Qa monitoring. On the other hand, the few randomized controlled studies available show that Qa surveillance, when coupled with preemptive intervention, reduces the already low thrombosis rate in AVF and suggest that the functional access life can be prolonged. However, there is still the need for additional methodologically adequate studies to understand fully the role of surveillance in AVF management.
Transparent Film Dressings for Intravascular Catheter Exit-Site
Authors: Gallieni M.
Published: January 2018

Transparent polyurethane film is recommended for catheter site insertion dressing by the American guidelines for the prevention of infections associated with intravascular catheters. It has been proven to offer the advantages of excellent adhesion, firm support of the catheter, good tolerability, ease of application and fewer replacements per catheter lifetime. The last two features save nursing time and result in healthcare cost savings.
Levels of Anxiety and Pain during Chemotherapy with Peripheral versus Central Vascular Access: An Experimental Evaluation
Authors: Silvestri V. , Nerini L. , Missio G. , Masini M. , Faggi S. , Gori A. , Panella M.
Published: January 2018

Purpose

The purpose of this research was to evaluate pain and anxiety levels in patients undergoing chemotherapy via central venous catheter (CVC) and peripheral venous access (PVA).

Method

The sample consisted of 56 cancer patients undergoing at least one chemotherapy treatment cycle. They were divided into two groups based on the administration method of the chemotherapeutic drug: the experimental group (patients with CVC) and the control group (patients with PVA). The instruments used were the following: for multidimensional pain evaluation the Italian Pain Questionnaire (QUID, devised by De Benedettis et al), and the Visual Analogue Scale (VAS) Chart of Pain. To evaluate the state and anxiety traits, the State-Trait Anxiety Inventory (STAI questionnaire, by D. Spielberg) was used, and we used structured interviews for the statistical survey.

Results

Analyzing the data from the STAI questionnaire, it appeared that the state-trait anxiety levels of the experimental group and the control group were not significantly different (analysis of the mean difference made using the Student's t-test). The average scores of the STAI questionnaire for both groups fell within the normal range. This indicated that the anxiety level was unaffected by the introduction of the device (the CVC). The data collected with the QUID questionnaire and subsequent statistical analysis demonstrated that the difference between the means (Student's t-test) of the experimental group and the control group was significantly lower, as regards perception of the sensorial and evaluative quality of pain (p=0.05) in the experimental group. From the evaluation of the VAS method, it appeared that the difference between the means was not significant in either group, although the distribution of frequency tended towards lower values in the experimental group with respect to the control group. This confirms previous QUID research where a lower pain level is recorded.

Conclusions

Analysis of the data collected via the structured interview revealed that most of the CVC sample did not respond to catheter insertion as a sign of a worsening of their illness.