bluuebunny/crossref_metadata_2025 huggingface dataset:
The Risk Conflicts Perspective
Authors: Maeseele Pieter
Published: July 2015

Starting from a perspective of democratic politics, this essay argues that the problem lies not in any “unjustified” politicization of risk controversies; quite to the contrary, it lies in their depoliticization or their capture in a postpolitical consensus. To this end, the prevailing storylines in public discourse on risk controversies are shown to be based on invalid assumptions regarding nature and science and on exclusionary mechanisms. In response, the risk conflicts perspective is put forward as an analytical framework, which allows us to evaluate mediated public discourse on the extent to which democratic debate and citizenship are facilitated. For the fields of science and environment communication, this entails a shift in emphasis from a focus on the epistemic level to the level of the political. We conclude by discussing the potential transformative impacts of this perspective for academic research, public discourse, as well as the directly involved social actors, in relation to the controversies in question.
A world first in collaborative cross-discipline agriculture and engineering education project
Authors: Zins Julien , Bonzani Nicolas
Published: July 2015

Digital farm project is an international collaborative engineering project for engineers as well as for students. This paper aims to provide the steps to be followed to draw up a successful action plan. To conduct this type of project, it is imperative to proceed in stages, have expert human resources in the field, and possess appropriate and efficient software with perfect control over it. It is also advisable to start with a multi-site project in a critical size before embarking on a project involving a hundred users. Finally, it is essential to have a network of trusted international partners with required skills in the field.
Mechanical and thermal properties of sisal fiber reinforced acrylated epoxidized castor oil toughened diglycidyl ether of bisphenol A epoxy nanocomposites
Authors: Reddy Paluvai Nagarjuna , Mohanty Smita , Nayak SK
Published: July 2015

In this study, the bio-based epoxy nanocomposites were prepared from acrylated epoxidized castor oil toughened diglycidyl ether of bisphenol A epoxy network filled with sisal fibers and cloisite 30B clay. The chemical structure of acrylated epoxidized castor oil resin was confirmed by Fourier transform infrared and Proton nuclear magnetic resonance (1HNMR) spectroscope techniques. Mechanical and thermal properties of the sisal fiber reinforced acrylated epoxidized castor oil toughened diglycidyl ether of bisphenol A epoxy composites and nanocomposites were investigated. Mechanical tests revealed that bio-based epoxy nanocomposites (containing 80% diglycidyl ether of bisphenol A/20% acrylated epoxidized castor oil / 30% treated sisal fiber/ 1% cloisite 30B weight ratio) were found to be higher in tensile strentgh to 78%, flexural strentgh to 44% and impact strength to 20% than the 80% diglycidyl ether of bisphenol A/20% acrylated epoxidized castor oil matrix. Thermogravimetric analysis results showed that the thermal stability of diglycidyl ether of bisphenol A /acrylated epoxidized castor oil matrix increased with the incorporation of alkali-silane-treated sisal fiber and cloisite 30B nanoclay. The apparent activation energy was increased from 236 to 273 KJ/mol with the addition of 1% cloisite 30B clay and 30% alkali-silane-treated sisal fiber to the 80% diglycidyl ether of bisphenol A /20% acrylated epoxidized castor oil matrix. Scanning electron microscopy was performed to investigate the fracture behaviour at the fiber-matrix interface.
Failure analysis of carbon nanotube/epoxy composites having a broken carbon nanotube
Authors: Kirtania Sushen , Chakraborty Debabrata
Published: July 2015

In the present work, multi-scale finite element analysis of carbon nanotube/epoxy composites having a broken carbon nanotube has been performed to assess the severity of such a fiber (i.e. carbon nanotube) break. A square representative volume element having nine-carbon nanotubes has been considered for the analysis. Considering a small debonding around the broken fiber as a crack front, stress redistribution around the break is studied. Using the concept of linear elastic fracture mechanics, strain energy release rates around the debonding have been calculated using virtual crack closure integral method. Quadratic stress criterion has been used to assess the delamination initiation at the interface of broken carbon nanotube and the matrix. Virtual crack closure integral along with quadratic stress criterion has been used to determine the critical strain energy release rate. Results from the present analysis show that the fiber volume fraction does not have significant influence on the ineffective length of the broken carbon nanotube. A high magnitude of interfacial shear stress is observed to have developed in the vicinity of the fiber break indicating the chances of debonding. All the three components of strain energy release rate have been determined and the influences of important parameters on the value of strain energy release rate have also been studied.
Solvothermal recovery of carbon fibers from thermoset polymer-based carbon fiber reinforced polymers
Authors: Huang Youfu , Ge Zhengxiang , Zhao Chongjun , Dong Jianbo , Shitian Muzi , Ma Weifeng , Wang Gefei , Qian Xiuzhen
Published: July 2015

Clean, undamaged carbon fibers were easily separated from thermoset epoxy-based carbon fiber reinforced polymers through a two-step solvothermal method by using propanol or benzyl alcohol as solvents. The recovered carbon fibers were characterized by thermal gravity analysis, Fourier transform infrared spectroscopy, scanning electron microscopy, and mechanical tensile strength tests together with the digital photos. Results show that solvothermal temperature and duration, as well as pretreatment in dichloromethane play important roles in recovering carbon fiber. In addition, the tensile strength of the recovered carbon fibers remains approximately 94.5–98% of virgin carbon fibers.
Role of Autoantibodies to N-Methyl-d-Aspartate (NMDA) Receptor in Relapsing Herpes Simplex Encephalitis: A Retrospective, One-Center Experience
Authors: Sutcu Murat , Akturk Hacer , Somer Ayper , Tatli Burak , Torun Selda Hancerli , Yıldız Edibe Pembegul , Şık Guntulu , Citak Agop , Agacfidan Ali , Salman Nuran
Published: July 2015

Post–herpes simplex virus encephalitis relapses have been recently associated with autoimmunity driven by autoantibodies against N-methyl-d-aspartate (NMDA) receptors. Because it offers different treatment options, determination of this condition is important. Between 2011 and 2014, 7 children with proven diagnosis of herpes simplex virus encephalitis were identified in a university hospital of Istanbul. Two patients had neurologic relapse characterized mainly by movement disorders 2 to 3 weeks after initial encephalitis. The first patient received a second 14 days of acyclovir treatment together with antiepileptic drugs and left with severe neurologic sequelae. The second patient was found to be NMDA receptors antibody positive in the cerebrospinal fluid. She was treated with intravenous immunoglobulin and prednisolone. She showed substantial improvement, gradually regaining lost neurologic abilities. Post–herpes simplex virus encephalitis relapses may frequently be immune-mediated rather than a viral reactivation, particularly in children displaying movement disorders like choreoathetosis. Immunotherapy may provide benefit for this potentially devastating condition, like the case described in this report.
Effects of the orientation of anti-BMP2 monoclonal antibody immobilized on scaffold in antibody-mediated osseous regeneration
Authors: Ansari Sahar , Freire Marcelo , Choi Moon G , Tavari Azadeh , Almohaimeed Mohammad , Moshaverinia Alireza , Zadeh Homayoun H
Published: July 2015

Recently, we have shown that anti-BMP2 monoclonal antibodies (mAbs) can trap endogenous osteogenic BMP ligands, which can in turn mediate osteodifferentiation of progenitor cells. The effectiveness of this strategy requires the availability of the anti-BMP-2 monoclonal antibodies antigen-binding sites for anti-BMP-2 monoclonal antibodies to bind to the scaffold through a domain that will leave its antigen-binding region exposed and available for binding to an osteogenic ligand. We examined whether antibodies bound to a scaffold by passive adsorption versus through Protein G as a linker will exhibit differences in mediating bone formation. In vitro anti-BMP-2 monoclonal antibodies was immobilized on absorbable collagen sponge (ACS) with Protein G as a linker to bind the antibody through its Fc region and implanted into rat calvarial defects. The biomechanical strength of bone regenerated by absorbable collagen sponge/Protein G/anti-BMP-2 monoclonal antibodies immune complex was compared to ACS/anti-BMP-2 monoclonal antibodies or ACS/Protein G/isotype mAb control group. Results demonstrated higher binding of anti-BMP-2 monoclonal antibodies/BMPs to C2C12 cells, when the mAb was initially attached to recombinant Protein G or Protein G-coupled microbeads. After eight weeks, micro-CT and histomorphometric analyses revealed increased bone formation within defects implanted with absorbable collagen sponge/Protein G/anti-BMP-2 monoclonal antibodies compared with defects implanted with absorbable collagen sponge/anti-BMP-2 monoclonal antibodies ( p < 0.05). Confocal laser scanning microscopy (CLSM) confirmed increased BMP-2, -4, and -7 detection in sites implanted with absorbable collagen sponge/Protein G/anti-BMP-2 monoclonal antibodies in vivo. Biomechanical analysis revealed the regenerated bone in sites with Protein G/anti-BMP-2 monoclonal antibodies had higher mechanical strength in comparison to anti-BMP-2 monoclonal antibodies. The negative control group, Protein G/isotype mAb, did not promote bone regeneration and exhibited significantly lower mechanical properties ( p < 0.05). Altogether, our results demonstrated that application of Protein G as a linker to adsorb anti-BMP-2 monoclonal antibodies onto the scaffold was accompanied by increased in vitro binding of the anti-BMP-2 mAb/BMP immune complex to BMP-receptor positive cell, as well as increased volume and strength of de novo bone formation in vivo.
Are Future Doctors Taught to Respond to Intimate Partner Violence? A Study of Australian Medical Schools
Authors: Valpied Jodie , Aprico Karina , Clewett Janita , Hegarty Kelsey
Published: July 2015

Intimate partner violence (IPV) is a leading cause of morbidity and mortality among women of childbearing age. This study aimed to describe delivery of IPV education in Australian pre-vocational medical degrees, and barriers and facilitators influencing this delivery. Eighteen Australian medical schools offering pre-vocational medical degrees were identified. Two were excluded as they had not finalized new curricula. One declined to participate. At least one staff member from each of the remaining 15 schools completed a telephone survey. Main outcome measures included whether IPV education was delivered within the degree, at what stage, and whether it was compulsory; mode and number of hours of delivery; and barriers and facilitators to delivery. Twelve of the medical schools delivered IPV education (median time spent per course = 2 hr). IPV content was typically included as part of Obstetrics and Gynecology or General Practice curriculum. Barriers included time constraints and lack of faculty commitment, resources, and funding. The two schools that successfully implemented a comprehensive IPV curriculum used an integrated, advocacy-based approach, with careful forward planning. Most Australian pre-vocational medical students receive little or no IPV education. The need remains for a more consistent, comprehensive approach to IPV education in medical degrees.
A method of eliminating the vibration signal noise of hydropower unit based on NA-MEMD and approximate entropy
Authors: An Xueli , Yang Junjie
Published: July 2015

A new vibration signal denoising method of hydropower unit based on noise-assisted multivariate empirical mode decomposition (NA-MEMD) and approximate entropy is proposed. Firstly, the NA-MEMD is used to decompose the signal into a number of intrinsic mode functions. Then, the approximate entropy of each component is computed. According to a preset threshold of approximate entropy, these components are reconstructed to denoise vibration signal of hydropower unit. The analysis results of simulation signal and real-world signal show that the proposed method is adaptive and has a good denoising performance. It is very suitable for online denoising of hydropower unit's vibration signal.
Guidance scheme for operating multiple ship defense missiles with dual seekers
Authors: Jeon Byoung-Ju , Bang Jun , Park Bong-Gyun , Ahn Jaemyung , Tahk Min-Jea
Published: July 2015

This paper proposes a guidance scheme to operate ship defense missiles using dual seekers—radio frequency and strapdown imaging infrared seekers—against the threat of antiship missiles. Key challenges associated with considered operational concept such as the multipath error of an radio frequency seeker, the narrow field of view of an strapdown imaging infrared seeker, and the interference between the target and defense missiles are identified. A guidance scheme that can address these challenges is proposed by combining an optimal guidance law for the midcourse phase and the proportional navigation guidance for the terminal phase. A relationship among interceptor/target velocity, minimum line-of-sight angle for the radio frequency seeker, and the field of view of the strapdown imaging infrared seeker for a successful intercept is analytically derived and graphically presented. Numerical simulations for the engagements between ship defense missiles and an antiship missile demonstrate the validity of the proposed guidance scheme.
Durable survival after chemotherapy in a HIV patient with Burkitt’s lymphoma presenting with massive upper gastrointestinal bleeding
Authors: Law Man F , Chan Hay N , Pang Chun Y , Lai Ho K , Ha Chung Y , Ng Celia , Ho Rita , Wong Cheuk K , Yeung Yiu M , Yip Sze F
Published: July 2015

Massive upper gastrointestinal bleeding is an uncommon presentation of Burkitt’s lymphoma in a patient with HIV/AIDS, and is seldom reported in the literature. A 39-year-old man who has sex with men presented with abdominal pain and massive haematemesis and a rapid drop in haemoglobin level to 4.8 g/dL. Upper gastrointestinal endoscopy showed a large blood clot in the stomach, and an emergency laparotomy was performed because of unstable haemodynamics. This showed active bleeding from multiple tumours in the fundus and body of the stomach. The patient underwent gastrectomy and gastric biopsy confirmed Burkitt’s lymphoma. Further tests showed lymphoma involvement in bone marrow and central nervous system. The patient tested positive for HIV, and had a CD4 count of 212 cells/mm3 and viral load of 18,000 copies/mL at diagnosis. He was commenced on a chemotherapy regimen of CODOX-M/IVAC, and highly active antiretroviral therapy consisting of indinavir, stavudine and lamivudine. The major side effect was peripheral neuropathy. Infective complications during chemotherapy were controlled by broad-spectrum antibiotics and anti-fungal agents. Complete remission of the lymphoma was achieved after the chemotherapy and remission was maintained for more than 14 years.
Differences in risk behaviours, HIV/STI testing and HIV/STI prevalence between men who have sex with men and men who have sex with both men and women in China
Authors: Davis Alissa , Best John , Luo Juhua , Van Der Pol Barbara , Dodge Brian , Meyerson Beth , Aalsma Matthew , Wei Chongyi , Tucker Joseph D ,   Social Entrepreneurship for Sexual Health Research Group
Published: July 2015

Differences in risk behaviours between men who have sex with men (MSM) and men who have sex with both men and women (MSMW) have important implications for HIV and sexually transmitted infection (STI) transmission. We examined differences in risk behaviours, HIV/STI testing, self-reported HIV/STI diagnoses, and linkage to HIV care between MSM and MSMW across China. Participants were recruited through three MSM-focused websites in China. An online survey containing items on socio-demographics, risk behaviours, testing history, self-reported HIV/STI diagnosis, and linkage to and retention in HIV care was completed from September to October 2014. Chi square tests and logistic regression analyses were conducted. MSMW were less likely to use a condom during last anal sex ( p ≤ 0.01) and more likely to engage in group sex ( p ≤ 0.01) and transactional sex ( p ≤ 0.01) compared to MSM. Self-reported HIV/STI testing and positivity rates between MSM and MSMW were similar. Among HIV-infected MSM, there was no difference in rates of linkage to or retention in antiretroviral therapy when comparing MSM and MSMW. Chinese MSM and MSMW may benefit from different HIV and STI intervention and prevention strategies. Achieving a successful decrease in HIV/STI epidemics among Chinese MSM and MSMW will depend on the ability of targeted and culturally congruent HIV/STI control programmes to facilitate a reduction in risk behaviours.
Hepatitis B revaccination in HIV-infected vaccine non-responders: is double dosing always necessary?
Authors: Chatkittikunwong Garnpawee , Khawcharoenporn Thana
Published: July 2015

Limited data exist on hepatitis B revaccination strategies for HIV-infected individuals who do not develop immunity after the first vaccination series. A retrospective cohort study was conducted to assess the immunogenicity of the second series of hepatitis B vaccine given in standard dosing (SD) and double dosing (DD) strategies among Thai HIV-infected adults during the period from January 2006 to December 2014. Of the 120 eligible patients, 68 (57%) were men, median age was 38 years old, 87 (73%) received SD and 33 (27%) received DD revaccination. The demographic and clinical characteristics of SD and DD groups were comparable. The overall vaccine response rate was significantly higher in DD group than SD group (97% vs. 70%; p = 0.001). Independent factors associated with no response to hepatitis B revaccination were receipt of SD vaccine (adjusted odds ratio [aOR] 16.04; p = 0.009), age ≥ 40 years (aOR 3.66; p = 0.009) and CD4 cell count at the time of revaccination less than 450 cells/µL (aOR 2.96; p = 0.04). These findings suggest that DD hepatitis B revaccination series should be given in HIV-infected patients who were at least 40 years old or had CD4 counts less than 450 cells/µL after no response to the first vaccination series.
John Goodsir FRS (1814–1867): Pioneer of cytology and microbiology
Authors: Gardner Dugald
Published: July 2015

John Goodsir, pioneer of the concept that all tissues are formed of cells, was born in 1814 into a family of medical practitioners in Anstruther, Fife, Scotland where he was captivated by the marine life he saw daily in his childhood. His ambition was to follow his father and grandfather in medicine. Aged 13, he studied at St Andrews University before being apprenticed to an Edinburgh dentist and completing an original analysis of the embryology of human dentition. He became the student of Robert Knox at the Royal College of Surgeons of Edinburgh and then Conservator of the University Anatomy museum. He exchanged this position for one at the College of Surgeons before accepting the full University post. Beginning in 1830 with the compound microscope, he studied natural history and anatomy, describing his discoveries to many societies. Appointed to the Edinburgh Chair of Anatomy in 1846, his investigations of the cell as the unit of all tissues were recognised internationally. A critic of Darwin, he believed that Man could not evolve. However, malnutrition, the death of a brother and of a friend and collaborator, Edward Forbes, contributed to progressive illness and Goodsir died at Wardie, Edinburgh in 1867.
Bayesian Melding Approach to Estimate the Reproduction Number for Tuberculosis Transmission in Indian States and Union Territories
Authors: Narula Pankaj , Azad Sarita , Lio Pietro
Published: July 2015

Tuberculosis (TB) is one of the most common infectious diseases and a leading cause of death in the world. Despite the full implementation of Revised National Tuberculosis Control Programme, the disease continues to be a leading cause of morality and economic burden in India. The basic reproduction is a fundamental key parameter that quantifies the spread of a disease. In this article, we present a Bayesian melding approach to estimate the basic reproduction number using a deterministic model of TB. We present a point estimate of the basic reproduction number of 35 states and union territories of India during 2006 to 2011. The basic reproduction number of TB for India is computed to be 0.92, which indicates the slow elimination of TB in India during 2006 to 2011.
Critical Analysis of Strategies for Determining Rigor in Qualitative Inquiry
Authors: Morse Janice M.
Published: July 2015

Criteria for determining the trustworthiness of qualitative research were introduced by Guba and Lincoln in the 1980s when they replaced terminology for achieving rigor, reliability, validity, and generalizability with dependability, credibility, and transferability. Strategies for achieving trustworthiness were also introduced. This landmark contribution to qualitative research remains in use today, with only minor modifications in format. Despite the significance of this contribution over the past four decades, the strategies recommended to achieve trustworthiness have not been critically examined. Recommendations for where, why, and how to use these strategies have not been developed, and how well they achieve their intended goal has not been examined. We do not know, for example, what impact these strategies have on the completed research. In this article, I critique these strategies. I recommend that qualitative researchers return to the terminology of social sciences, using rigor, reliability, validity, and generalizability. I then make recommendations for the appropriate use of the strategies recommended to achieve rigor: prolonged engagement, persistent observation, and thick, rich description; inter-rater reliability, negative case analysis; peer review or debriefing; clarifying researcher bias; member checking; external audits; and triangulation.
Early Stages of Hyaline Membrane Formation Detected in Alveolar Mouths in Diffuse Alveolar-Damage-Associated Diseases
Authors: Ohtsuki Yuji , Fujita Jiro , Yoshinouchi Takeo , Enzan Hideaki , Iguchi Mitsuko , Lee Gang-Hong , Furihata Mutsuo
Published: July 2015

To study the early stages of hyaline membrane (HM) formation, diffuse alveolar damage (DAD) was thoroughly investigated using immunohistochemical methods in 15 autopsy cases, which consisted of various types of interstitial pneumonias and pulmonary diseases derived from nonmalignant or malignant diseases. Alveolar mouths (AMs) that were presumed to be normal were ultrastructurally examined in detail, by using pulmonary tissues in the pneumothorax. It is interesting to note that during the initial stages of HM formation in AMs, fragmented eosinophilic masses were closely attached to AMs as irregular fragments or by a cap-like structure. The ultrastructure revealed some distance between the capillary spaces and surface epithelium of the AMs, indicating that the epithelial cells at the AMs might be often easily damaged even by minor stimuli; they can be considered as “locus minoris resistentiae.” HMs were found to be formed initially at the site of AMs derived from fragmented eosinophilic masses in not only pulmonary but also extrapulmonary diseases, including both nonmalignant and malignant diseases. These irregular eosinophilic masses, representing the early shape of HMs, were immunohistochemically positive for the epithelial membrane antigens, namely, surfactant protein A and factor VIII antigen, and occasionally for KL-6 and cytokeratins. These results suggested that fragmented irregular masses represent the initial phase of HM formation. Five of 15 cases were focally negative for KL-6 at the initial irregular mass of HMs. Because KL-6 is one of the fundamental components of pulmonary surface elements, it needs to be studied further by detailed clinicopathological examination.
High-Resolution Metabolomics
Authors: Li Shuzhao , Dunlop Anne L. , Jones Dean P. , Corwin Elizabeth J.
Published: July 2015

Most complex health conditions do not have a single etiology but rather develop from exposure to multiple risk factors that interact to influence individual susceptibility. In this review, we discuss the emerging field of metabolomics as a means by which metabolic pathways underlying a disease etiology can be exposed and specific metabolites can be identified and linked, ultimately providing biomarkers for early detection of disease onset and new strategies for intervention. We present the theoretical foundation of metabolomics research, the current methods employed in its conduct, and the overlap of metabolomics research with other “omic” approaches. As an exemplar, we discuss the potential of metabolomics research in the context of deciphering the complex interactions of the maternal–fetal exposures that underlie the risk of preterm birth, a condition that accounts for substantial portions of infant morbidity and mortality and whose etiology and pathophysiology remain incompletely defined. We conclude by providing strategies for including metabolomics research in future nursing studies for the advancement of nursing science.
Non-Newtonian and running-in wear effects in journal bearings operating under mixed lubrication
Authors: Allmaier H , Sander DE , Priebsch HH , Witt M , Füllenbach T , Skiadas A
Published: July 2015

For the study of mixed lubrication in dynamically loaded journal bearings, this paper employs a combined experimental and simulative approach. Extensive measurements on a journal bearing test rig with a low-viscosity 0W20 multi-grade lubricant with a strong Non-Newtonian behaviour provide the basis for the investigation of the lubrication conditions in journal bearings. In this paper, temperature effects and the influence of running-in (breaking-in) wear are investigated. To this task, a high dynamic load is applied to the journal bearing under test. To vary the lubrication conditions, only the journal speed is changed. To investigate the lubrication conditions a detailed and validated simulation approach is utilized that takes into account both the piezoviscous effect and the non-Newtonian behaviour of the investigated lubricant as well is able to describe metal–metal contact. With this combined approach the run-in process of the journal bearing under test can be investigated as well as the role of temperature settling effects.
Why Chinese print journalists embrace the Internet
Authors: Hassid Jonathan , Repnikova Maria
Published: July 2015

Western media studies have largely presented the relationship between new and traditional media as adversarial, often claiming that the Internet challenges the survival of traditional journalism. Focusing on China, this article re-evaluates this relationship in a non-Western context. Relying on extensive interviews with Chinese journalists, we argue that the relationship between China’s print and Internet media is symbiotic. Although it does challenge traditional business models, the Internet also helps journalists improve their commercial competitiveness and presents new channels for resisting censorship and expanding the boundaries of permissible reporting.
Effectiveness of Viabahn in the Treatment of Superficial Femoral Artery Occlusive Disease
Authors: Zhang Lei , Bao Junmin , Zhao Zhiqing , Lu Qingsheng , Zhou Jian , Jing Zaiping
Published: July 2015

Purpose: To evaluate the effectiveness of the Viabahn stent-graft in the treatment of superficial femoral artery (SFA) occlusive disease. Methods: A systematic review and meta-analysis of published studies was performed to evaluate the efficacy of the Viabahn for SFA lesions. Studies were stratified according to controlled vs uncontrolled design and analyzed using random-effects models. Outcomes are reported as the risk ratio (RR) and 95% confidence interval (CI). Four prospective randomized controlled trials, one retrospective controlled study, and 9 uncontrolled studies were identified. Results: In controlled studies, primary patency with the Viabahn was superior to other interventions at 1 year (RR 0.63, 95% CI 0.49 to 0.82, p<0.001) and ankle-brachial index (ABI) improvement was greater at 6 months (mean difference 0.05, 95% CI 0.01 to 0.09, p=0.01) compared with other interventions. Subgroup analysis demonstrated a lower incidence of stent fracture in lesions with >15-cm stented lengths. In uncontrolled studies, ABI improvement was consistently superior at all measurement points during follow-up. Conclusions: Current evidence suggests that the Viabahn stent-graft is a safe and effective option for symptomatic SFA lesions. Prospective multicenter randomized controlled trials with long-term follow-up are needed to confirm the sustained efficacy of the Viabahn device.
Foot Embolization During Limb Salvage Procedures in Critical Limb Ischemia Patients Successfully Managed With Mechanical Thromboaspiration
Authors: Gandini Roberto , Merolla Stefano , Chegai Fabrizio , Del Giudice Costantino , Stefanini Matteo , Pampana Enrico
Published: July 2015

Purpose: To illustrate the use of a mechanical thromboaspiration device originally designed for clot retrieval in acute stroke in the treatment of acute distal embolism occurring during percutaneous revascularization of the femoropopliteal and below-the-knee arterial segments. Technique: The Penumbra system was adapted for aspiration of thrombus in the distal foot arteries as a standalone device. The 2 over-the-wire, tapered lumen catheters have long working lengths (139 cm for the 4MAX to 153 cm for the 3MAX) that allow advancement below the ankle even with a retrograde contralateral approach. Once the occluded arterial segment is reached, the catheters are connected to the dedicated pump for continuous vacuum aspiration. The use of the device is illustrated in 3 diabetic patients (1 woman and 2 men; ages 88, 70, and 73 years, respectively) undergoing limb salvage procedures who experienced distal embolization that would have seriously jeopardized the foot circulation. The lumens of the occluded arteries were restored without complication. Conclusion: While further evaluation in a larger cohort of patients is needed, this initial experience using the Penumbra system in the peripheral vasculature suggests that this is a rapid, effective approach to address intraprocedural foot embolization and avoid possible grave clinical sequelae.
A Novel Bubble-Mixture Method to Improve Dynamic Images in Carbon Dioxide Angiography
Authors: Chang Te-I , Chan Chih-Yang , Su Shing-Kuan , Wang Shoei-Shen , Wu I-Hui
Published: July 2015

Purpose: To present a novel method of preparing carbon dioxide (CO2) for contrast enhancement.Technique: CO2 angiography can often produce poor image enhancement, especially in dependent vessels due to buoyancy of the gas. A new technique for premixing the CO2 gas with the patient’s blood and dispersing it into the bubble mixture before injection was developed. Comparative dynamic images showed bubble-mixed CO2 angiography had less fragmentation, more even distribution, and more sustainability than the same volume of pure CO2. Conclusion: The alteration of CO2 gas toward a semiliquid form demonstrates an easy and reproducible concept to improve the dynamic image quality of traditional CO2 angiography.
Perioperative and Long-term Outcomes of Endovascular Treatment for Subclavian Artery Disease From a Large Multicenter Registry
Authors: Soga Yoshimitsu , Tomoi Yusuke , Fujihara Masahiko , Okazaki Shinya , Yamauchi Yasutaka , Shintani Yoshiaki , Suzuki Kenji ,   on behalf of the SCALLOP Investigators
Published: July 2015

Purpose: To investigate the perioperative and long-term outcomes of endovascular therapy (EVT) for subclavian artery disease in a large-scale multicenter study. Methods: The study analyzed the outcomes from a multicenter retrospective registry (SubClavian Artery disease treated with endovascuLar therapy; muLticenter retrOsPective registry: SCALLOP) of 718 consecutive patients with upper extremity artery disease who underwent EVT between January 2003 and December 2012 at 37 Japanese cardiovascular centers. Of the 718 patients enrolled in the registry, 162 patients were excluded, leaving 553 patients (mean 70±7 years, range 41–91; 405 men) who underwent primary EVT for de novo subclavian artery disease (560 arms). Results: Procedure success was achieved in 96.8% (100% for stenoses, 91% for total occlusions). The perioperative complication rate was 9.2%. Stroke was found in 1.8%, with ipsilateral posterior infarction accounting for 0.9%. The 30-day mortality was 0.7%. The mean follow-up was 39±24 months. Primary patency estimates were 90.6%±1.3%, 83.4%±1.8%, and 80.5%±2.2% at 1, 3, and 5 years, respectively. There was no significant difference in primary patency between stenotic and occlusive lesions. Secondary patency estimates were 99.2%±0.4%, 98.2%±0.6%, and 97.7%±0.8% at 1, 3, and 5 years, respectively. The respective overall survival rates were 94.6%±1.0%, 86.8%±1.7%, and 79.0%±2.4%. There were 86 deaths during follow-up, of which half were due to cardiovascular causes. On multivariate analysis, critical hand ischemia (hazard ratio [HR] 4.6, 95% CI 2.06 to 10.2, p<0.001), cerebrovascular disease (HR 1.9, 95% CI 1.14 to 3.06, p=0.01), current smoking (HR 1.8, 95% 1.14 to 2.79, p=0.01), and lesion length (in 1-cm increments; HR 1.02, 95% CI 1.00 to 1.04, p=0.03) were negative independent predictors of primary patency, while IVUS use (HR 0.6, 95% CI 0.30 to 0.96, p=0.04) was a positive predictor of primary patency. Conclusion: Primary angioplasty/stenting for subclavian artery disease afforded acceptable outcomes in terms of perioperative complications and long-term patency.
Two Blades-Up Runs Using the JetStream Navitus Atherectomy Device Achieve Optimal Tissue Debulking of Nonocclusive In-Stent Restenosis
Authors: Shammas Nicolas W. , Aasen Nicole , Bailey Lynn , Budrewicz Jay , Farago Trent , Jarvis Gary
Published: July 2015

Purpose: To determine the number of runs with blades up (BU) using the JetStream Navitus to achieving optimal debulking in a porcine model of femoropopliteal artery in-stent restenosis (ISR). Methods: In this porcine model, 8 limbs were implanted with overlapping nitinol self-expanding stents. ISR was treated initially with 2 blades-down (BD) runs followed by 4 BU runs (BU1 to BU4). Quantitative vascular angiography (QVA) was performed at baseline, after 2 BD runs, and after each BU run. Plaque surface area and percent stenosis within the treated stented segment were measured. Intravascular ultrasound (IVUS) was used to measure minimum lumen area (MLA) and determine IVUS-derived plaque surface area. Results: QVA showed that plaque surface area was significantly reduced between baseline (83.9%±14.8%) and 2 BD (67.7%±17.0%, p=0.005) and BU1 (55.4%±9.0%, p=0.005) runs, and between BU1 and BU2 runs (50.7%±9.7%, p<0.05). Percent stenosis behaved similarly with no further reduction after BU2. There were no further reductions in plaque surface area or percent stenosis with BU 3 and 4 runs (p=0.10). Similarly, IVUS (24 lesions) confirmed optimal results with BU2 runs and no additional gain in MLA or reduction in plaque surface area with BU3 and 4. IVUS confirmed no orbital cutting with JetStream Navitus. There were no stent strut discontinuities on high-resolution radiographs following atherectomy. Conclusion: JetStream Navitus achieved optimal tissue debulking after 2 BD and 2 BU runs with no further statistical gain in debulking after the BU2 run. Operators treating ISR with JetStream Navitus may be advised to limit their debulking to 2 BD and 2 BU runs to achieve optimal debulking.
Retrograde Target Vessel Catheterization as a Salvage Procedure in Fenestrated/Branched Endografting
Authors: Oikonomou Kyriakos , Katsargyris Athanasios , Brinster Clayton J. , Renner Hermann , Ritter Wolfgang , Verhoeven Eric L. G.
Published: July 2015

Purpose: To present retrograde target vessel catheterization as a bailout technique in fenestrated and branched endografting (F/B-EVAR). Methods: Between November 2003 and November 2014, 11 (1.6%) of 671 consecutive patients with juxtarenal, suprarenal, and thoracoabdominal aortic aneurysms required retrograde target vessel access as a bailout measure during F/B-EVAR due to failure of an antegrade approach. The target vessels involved the left renal artery (LRA) in 6 patients, the celiac artery (CA) in 3 patients, the right renal artery (RRA) in 1 patient, and both renal arteries in 1 patient. Results: The target vessels were successfully catheterized and secured with stent-grafts in 10 patients; a single case was unsuccessful because the fenestration was in the wrong position and blocked against the arterial wall. One (9.1%) patient died within 30 days. Major perioperative complications occurred in 6 patients, including 3 with renal function deterioration, 2 with access-site wound dehiscence, and a case of pneumonia. Median hospital stay was 20 days (range 7–60) and median intensive care unit stay was 2.5 days (range 0–9). Over a mean 26-month follow-up (range 1–60), one unrelated death occurred. Reintervention was required in 1 patient due to progression of an aneurysm of the right iliac artery. Conclusion: Retrograde target vessel access in F/B-EVAR is a feasible bailout procedure when antegrade cannulation fails. Secondary technical success is high, but the procedure is associated with higher perioperative morbidity and longer hospital stay.
Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease
Authors: Iezzi Roberto , Posa Alessandro , Santoro Marco , Nestola Massimiliano , Contegiacomo Andrea , Tinelli Giovanni , Paolini Alessandra , Flex Andrea , Pitocco Dario , Snider Francesco , Bonomo Lorenzo
Published: July 2015

Purpose: To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. Methods: Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56–89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. Results: All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. Conclusion: Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy.
Synthesis and characterization of dual-curable epoxyacrylates for polyester cord/rubber applications
Authors: Yildiz Zehra , Gungor Atilla , Onen Aysen , Usta Ismail
Published: July 2015

In this study, bisphenol-A-based acrylated epoxy oligomers were prepared and utilized to improve the adhesion strength of polyester cords onto rubber. The structure of the oligomers was characterized by Fourier transform infrared spectroscopy and 1H-NMR spectroscopy. Ultraviolet-curable adhesive formulations were prepared by using acrylated epoxy oligomers and applied onto the polyester cord fabric by a dip-coating method and irradiated. Ultraviolet-cured coatings were characterized by thermal and scanning electron microscope analysis, contact angle measurements. In the second stage of the experiment, ultraviolet-cured polyester cords were adhered onto rubber under heat and pressure. The prepared adhesive formulation was expected to improve the adhesion strength. The adhesion strength of the coated material was evaluated by using peel test as a function of the carboxyl/epoxide ratio. The adhesion strength of 18.0 N/cm was obtained when the carboxyl/epoxide ratio was set as 1. It was observed that peel strength, contact angle, and surface energy values of acrylated epoxies strongly depend on the acrylic acid content of the oligomer.
Intraoperative idiopathic subarachnoid hemorrhage during carotid artery stenting: A case report and literature review
Authors: Okamura Akitake , Nakaoka Mitsuo , Ohbayashi Naohiko , Yahara Kaita , Nabika Shinya
Published: July 2015

Carotid artery stenting (CAS) has a fatal complication of intracranial hemorrhage (ICH) associated with cerebral hyperperfusion syndrome (CHS), i.e. brain hemorrhage and subarachnoid hemorrhage (SAH). Although SAH accounts for a small percentage of these patients, it is difficult to make a differential diagnosis of this syndrome from CHS without ICH because the clinical presentations resemble each other. Furthermore, not only does the cause of SAH following CAS remain unclear but also the role of controlling postoperative blood pressure is not detected in preventing ICH after CAS. Herein, we report a case of SAH following CAS and review previous literature to discuss the mechanism and the management of this fatal complication. A 78-year-old woman with a history of arteriosclerotic obliteration and myocardial infarction was referred to our department for intervention to asymptomatic severe stenosis of the right internal carotid artery. We performed CAS under local anesthesia. Although her blood pressure was controlled to normotension during the procedure, the patient complained of headache following predilation. Postoperative emergent non-contrast computed tomography revealed SAH with leakage of contrast medium occupying the right sylvian fissure. We continued strict blood pressure control, and the patient was discharged without any neurological deficit. A well-opened lumen of the stent was recognized three months later at the outpatient visit. Strict control of intraoperative and postoperative blood pressure may improve the outcome of SAH following CAS though the role in preventing ICH after CAS is unclear.
Crohn’s disease: a clinical update
Authors: Ha Francis , Khalil Hanan
Published: July 2015

Crohn’s disease is increasing in prevalence worldwide. It arises from a complex interplay between both genetic predisposition and environmental influence. A search of databases and clinical practice guidelines was performed to provide the most up-to-date evidence-based approach for diagnosing and managing patients with Crohn’s disease. No single gold standard investigation exists. Whilst full ileocolonoscopy with biopsies remains the mainstay for diagnosis, other less invasive imaging modalities are being actively considered in the workup, as well as the use of serological markers. Management should incorporate dietary and lifestyle modifications where necessary, the use of medications in induction and remission of disease, and consideration of surgical intervention where medical therapy has failed.
Usability of the Novel Liraglutide 3.0 mg Pen Injector Among Overweight or Obese Adult Patients With or Without Prior Injection Experience
Authors: Fujioka Ken , Sparre Thomas , Sun Lily Yong-Hui , Krogsgaard Susanne , Kushner Robert F.
Published: July 2015

Background:

Obesity is associated with multiple comorbidities and increased mortality, making it an important target for treatment. However, achieving and maintaining weight loss by diet and physical activity remains challenging, and may often require pharmacotherapy. Liraglutide 3.0 mg has recently been approved for weight management in the United States, Canada, and EU. The current analysis used a summative usability test to assess safety and effectiveness, ease of use, and training requirements for the novel liraglutide 3.0 mg pen injector.

Methods:

Of the 234 participants, half received instructions for use and video-based training and/or opportunity to handle the device. All participants (excluding pharmacists) performed 6 tasks followed by post- task interviews on task difficulty, device ease of use, and any use errors, close calls, and operational difficulties. Tasks included differentiation of correct box and pen injector, medication clarity assessment, normal, dose reversal, and end-of-content injection. Number/type of use errors, close calls, and operational difficulties were evaluated.

Results:

All assessed participants interpreted the instructions for use correctly. No potentially serious use errors, and low numbers of nonserious errors, were reported. Overall, participants committed 105 use errors related to handling, with no potential for harm. A total of 25 close calls and 44 operational difficulties were reported without any pattern indicative of a design flaw. Marked differences in the incidence of events were observed for trained versus untrained participants regardless of prior injection experience. Participants rated ease of use as 6.4/7.

Conclusions:

The liraglutide 3.0 mg pen injector is safe and easy to use for liraglutide administration. New device features allow for safe use after brief training.
Total Worker Health
Authors: Campbell Karen , Burns Candace
Published: July 2015

Total Worker Health™ is defined as a “strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance worker health and well-being.” This strategy aligns workplace safety with individual behaviors that support healthy lifestyles. The Patient Protection and Affordable Care Act of 2010 presumes that incentive-oriented worksite health promotion provides a critical pathway to reduce group health costs. Because of their scientific and clinical backgrounds, professional nurses are well qualified to educate and assist individuals with healthy lifestyle choices. Occupational health nurses and patient advocates can shape wellness initiatives that best serve both employees and their employers.
Exploring Experiences and Perceptions of Aging and Cognitive Decline Across Diverse Racial and Ethnic Groups
Authors: Roberts Lisa R. , Schuh Holly , Sherzai Dean , Belliard Juan Carlos , Montgomery Susanne B.
Published: July 2015

Objective: To explore how older adults from three prominent ethnoracial groups experience cognitive decline and aging. Method: Semistructured key informant interviews (KIIs) and focus groups (FGs) were conducted with caregivers, experts, and older adults. Results: ( N = 75). Fifteen KIIs regarding cognitive aging issues were conducted among health care professionals and community-based agencies serving older adults. Eight FGs included family caregivers and physicians, and six FGs with Latino, African American, and White older adult community members. Major themes included (a) personal expectations about aging, (b) societal value of older adults, (c) model of care preferred, and (d) community concerns. An overarching theme was a sense of loss associated with aging; however, how this loss was experienced and dealt with varied. Discussion: Distinct patterns of concerns and views are important to understand for the development of programs aimed at meeting the needs of diverse older adult community members to improve health outcomes.