bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy-based damage descriptions to assess fatigue life of steel samples undergoing various multiaxial loading spectra
Authors: Ahmadzadeh GR , Varvani-Farahani A
Published: November 2017

The present study evaluates fatigue damage of four steel alloys, mild steel, SS347, SNCM439, and SNCM630, by means of Socie, Ellyin, and Varvani-Farahani damage models. The Socie model assesses fatigue damage through product of maximum principal strain amplitude and maximum normal stress on the maximum principal strain plane. Damage description by Ellyin was developed as both elastic and plastic strain energies over loading spectrum were integrated. The elastic–plastic response of materials is evaluated through use of Garud’s constitutive plasticity model to achieve components of stress/ strain and corresponding stress–strain hysteresis loops. Based on the Varvani-Farahani model, components of stress and strain calculated from largest Mohr’s circles over peak-valley events are employed to assess fatigue damage. Overall damage was calculated on the basis of energy-based models from counted reversals over entire loading blocks and related to fatigue life. The Socie approach overpredicted lives for steel samples. Predicted life data for mild steel and SS347 samples fell below the midline based on the Ellyin’s model. Both Ellyin and Varvani-Farahani models showed a good agreement of predicted lives for steel samples within factors ±3 as compared with experimental data. The choice of damage assessment was highly related to consistency of damage descriptions to crack formation and early growth, stress/strain components, material properties, and loading spectrum.
School Nurse Perceptions of Nurse–Family Relationships in the Care of Elementary Students With Chronic Conditions
Authors: Brown Camille , Looman Wendy S. , Garwick Ann E.
Published: November 2017

The purpose of this study was to explore school nurse perceptions of the nurse–family relationship in the care of elementary students with asthma and attention-deficit hyperactivity disorder (ADHD). A cross-sectional survey design was used to collect data from 97 school nurses in Minnesota. The Family Nursing Practice Scale measured nurses’ perceptions of their family nursing practice. Bivariate analyses were conducted to compare scores by factors at the community, school, nurse, and child levels. Results suggest that school nurses have positive appraisals of their family nursing practice, though scores were generally lower in the context of ADHD compared to asthma. Participants with a graduate degree reported greater skill in working with families, whereas novice nurses reported less confidence working with families and less comfort initiating family involvement in care. Results suggest that interventions at the nurse and school levels may support enhanced family nursing practice by nurses caring for students with chronic conditions.
Blurring Lines? How Locally Based Collaborations Handle the Redistribution/Development Tradeoff
Authors: Lyon Melissa Arnold , Henig Jeffrey R.
Published: November 2017

The tension between the pursuit of equity versus economic growth has been a central focus on the field of urban politics. Although local governance regimes have tended to focus on growth policies and the accommodation of business interests, regime theorists have argued that it is possible, albeit challenging, to construct sustainable coalitions to support equity agendas. In this article, we empirically examine the equity/development trade-off with a focus on the renewed interest in locally based, cross-sector collaborations for educational improvement, providing a nuanced picture of how these initiatives present themselves to the public. We find that a substantial proportion of initiatives describe themselves as equity oriented or both equity and economic growth oriented. Labeling these education initiatives as growth oriented is more typical of collaborations that started in prior decades, whereas an orientation toward equity is more common in collaborations with greater union and community organization representation and those affiliated with national networks.
A look back on 30 years of the Gordon Bell Prize
Authors: Bell Gordon , Bailey David H , Dongarra Jack , Karp Alan H , Walsh Kevin
Published: November 2017

The Gordon Bell Prize is awarded each year by the Association for Computing Machinery to recognize outstanding achievement in high-performance computing (HPC). The purpose of the award is to track the progress of parallel computing with particular emphasis on rewarding innovation in applying HPC to applications in science, engineering, and large-scale data analytics. Prizes may be awarded for peak performance or special achievements in scalability and time-to-solution on important science and engineering problems. Financial support for the US$10,000 award is provided through an endowment by Gordon Bell, a pioneer in high-performance and parallel computing. This article examines the evolution of the Gordon Bell Prize and the impact it has had on the field.
Technological innovations and the rise of social inequalities in health
Authors: Weiss Daniel , Eikemo Terje Andreas
Published: November 2017

Social inequalities in health have been categorised as a human-rights issue that requires action. Unfortunately, these inequalities are on the rise in many countries, including welfare states. Various theories have been offered to explain the persistence (and rise) of these inequalities over time, including the social determinants of health and fundamental cause theory. Interestingly, the rise of modern social inequalities in health has come at a time of great technological innovation. This article addresses whether these technological innovations are significantly influencing the persistence of modern social inequalities in health. A theoretical argument is offered for this potential connection and is discussed alongside the typical social determinants of health perspective and the increasingly popular fundamental cause perspective. This is followed by a proposed research agenda for further investigation of the potential role that technological innovations may play in influencing social inequalities in health.
The health gap: Doctors and the social determinants of health
Authors: Marmot Michael
Published: November 2017

The social gradient in health has the clear implication that action to improve health and reduce inequalities has to take place at social level, not simply depending on individual changes. Individuals’ ability to change is constrained by social circumstances. The evidence that the magnitude of the gradient varies between countries, and can change within a country over time, suggests that conscious strategies to change it can be successful. In my review of evidence in Britain, the Marmot Review, we made recommendations in six domains: give every child the best start in life; education and life-long learning; employment and working conditions; ensure that everyone has at least the minimum income necessary to lead a health life; healthy and sustainable places; taking a social determinants approach to prevention.

A big question is the role of health professionals in action on social determinants of health. We have identified five actions in implementing recommendations: education and training; seeing the patient in broader perspective; the health service as employer; working in partnership; advocacy. The evidence is encouraging that health professionals can make a big difference in advancing the cause of health equity.
Public support for European Union economic policies
Authors: Kanthak Leon , Spies Dennis C
Published: November 2017

General attitudes of citizens toward the European Union (EU) have frequently been analyzed. However, European integration represents a multifaceted process and citizen attitudes may well depend on the precise nature of policy proposals. In this contribution, we analyze the determinants of specific support for three prominent EU economic policy proposals: the Transatlantic Trade and Investment Partnership, Eurobonds, and a EU financial transaction tax. Drawing on Eurobarometer data, we find that four standard explanatory factors—ideology, utility, identity, and cues—also affect support for these policies. However, they do so in systematically different ways, depending on whether the policies primarily represent positive or negative integration and market-making or market-correcting, on how they affect national sovereignty, and on how they are affected by complexity and salience.
The European Union democratic deficit: Substantive representation in the European Parliament at the input stage
Authors: Sorace Miriam
Published: November 2017

The analysis compares voters' preferences in economic policy to political parties' economic written parliamentary questions during the 2009–2014 term of the European Parliament. The corpus of over 55,000 written questions was ideologically scaled via crowdsourcing. The analysis shows that parties are unresponsive to second-order and to disengaged voters. The results also suggest that there is no upper class bias in European Parliament political representation. The data highlight a strong tendency of EP7 political parties to cluster around the position of the average European voter, at the expense of their average supporter. The democratic deficit is therefore at most a pluralism deficit in the European Parliament, since substantive representation in the European Parliament is successful as far as the majoritarian norm is concerned.
Air entrainment and mixture distribution in Diesel sprays investigated by optical measurement techniques
Authors: Riess Sebastian , Weiss Lukas , Peter Andreas , Rezaei Javad , Wensing Michael
Published: November 2017

Mie scattering, Schlieren technique and Raman spectroscopy are used to analyse air entrainment and mixture distribution in sprays at Diesel engine-relevant ambient conditions. Mixture formation for Diesel, gas-to-liquid Diesel, biodiesel (rapeseed methyl ester) and ethanol is investigated. The utilization of different fuels leads to locally equal mass flow ratios of fuel and ambient gas in the spray. The air entrainment process is dominated by conservation of the total spray momentum flux. Shortly after nozzle exit, the amount of ambient gas in the spray is high enough to make it the dominating component of the flow. Already 7 mm after the nozzle exit, the mass flow of ambient gas equals the mass flow of fuel. Also, the local mixture distribution in the spray – investigated by means of Raman spectroscopy – is fuel independent. Different physical properties of the fuels do (nearly) not influence the air entrainment and macroscopic mixture formation process, as the differences and the amount of fuel are too small to have a significant effect. Injection pressure and the resulting momentum flux are the dominating parameters of mixture formation. Because of the magnitude of the ambient gas content, the spray can be regarded as a gas jet.
Identifying predictors of students’ perception of and engagement with assessment feedback
Authors: Ali Nadia , Ahmed Lubna , Rose Sarah
Published: November 2017

Higher education students’ perception of and level of engagement with the feedback they receive has gained increasing attention in the literature to identify areas which require educators’ attention. However, predictors of students’ perception and engagement have yet to be identified. To address this, a survey measuring students’ views and practices regarding feedback was completed. Characteristics of the individual student (gender, age and whether English is their first language), the learning environment (student living on or off campus) and course-related variables (year of study of the course and whether the second subject was the same or a different discipline) were analysed to assess whether these variables predict students’ perception and engagement with feedback. Multivariate analysis established that the only significant predictor variable was year of study of the course, thus identifying a key predictor while ruling out numerous potential predictors. As the only significant predictor of students’ relationship with feedback was their year of study, further analyses were conducted to establish which specific areas of perception of and engagement with feedback change as a function of this.
Safety of Zilver PTX Drug-Eluting Stent Implantation Following Drug-Coated Balloon Dilation in a Healthy Swine Model
Authors: Torii Sho , Yahagi Kazuyuki , Mori Hiroyoshi , Harari Emanuel , Romero Maria E. , Kolodgie Frank D. , Young Brandt , Ragheb Anthony , Virmani Renu , Finn Aloke V.
Published: November 2017

Purpose: To compare the safety of Zilver PTX drug-eluting stents (DES) following drug-coated balloon (DCB) angioplasty or conventional balloon angioplasty (BA) in a healthy porcine iliofemoral artery model. Methods: DES implantation following DCB (DCB+DES) or BA (BA+DES) was assessed by angiography and histology in the nondiseased iliofemoral arteries of 20 animals, with sacrifice at 1, 3, and 6 months. Safety assessment compared quantitative measures of vessel integrity (eg, preservation of artery geometry, structure, and lumen dimensions; absence of aneurysm; malapposition) and histological parameters (eg, excessive inflammation). The percentage of uncovered struts could not be >30% per section and the endothelial cell loss had to be <50%. The vascular and skeletal muscle changes in the downstream regions were also assessed histologically for evidence of emboli. Results: No significant differences in safety parameters, including inflammation and endothelial cell loss, were observed between the 2 groups at all time points. Percentage of fibrin was significantly higher in DCB+DES at 3 months [20.0% (IQR 11.6, 28.4) vs BA+DES 4.2% (IQR 1.4, 9.6), respectively; p=0.04], with consistent trends between groups at all time points. Medial smooth muscle cell loss peaked at 1 month and was not statistically different between groups at any time point, although the loss was greater in the DCB+DES group. Sections with arterioles exhibiting paclitaxel-associated fibrinoid necrosis in downstream tissues were observed exclusively in the DCB group at 1 month (14.3% of sections) and 3 months (11.5%). Conclusion: This preclinical study suggests that Zilver PTX stent implantation is a safe strategy after DCB angioplasty and might be considered for patients who require stenting after DCB treatment.
Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement – A Qualitative Study
Authors: Canella Claudia , Mikolasek Michael , Rostock Matthias , Beyer Jörg , Guckenberger Matthias , Jenewein Josef , Linka Esther , Six Claudia , Stoll Sarah , Stupp Roger , Witt Claudia M.
Published: November 2017

Background: Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. Objectives: The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. Method: In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. Results: With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Conclusion: Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.
The Significance of Impulsive Error in Children With ADHD
Authors: Liao Yu-Chi , Guo Nai-Wen , Chen Shin-Jaw , Tsai Hsing-Fang , Fang Jhih-Hong , Chen Jia-Jin , Su Bei-Yi
Published: November 2017

A deficit of inhibition ability is a neuropsychological problem in children with attention deficit hyperactivity disorder (ADHD). We investigated whether in children who made impulsive error (IE), less error-related negativity (ERN) would correlate with poorer executive attention functions (EAFs). Ninety children (49 with ADHD and 41 without ADHD) were investigated by a 4-minute simple reaction time task and simultaneous electroencephalogram. When they made IE, the ERN in response-locked event-related potential (ERP) was defined as error awareness. The average area under curve of ERN in the control group with IEs was used as the proper criterion for regrouping the children with ADHD into 2 groups: ADHD children with enough ERN (ADHD-enough ERN) and those with less ERN (ADHD-less ERN). EAFs from Comprehensive Nonverbal Attention Test were used as objective indices, and behavioral questionnaires were used as subjective indices and statistically analyzed within ADHD groups. Forty-eight percent of the children made IEs. ADHD(n = 31, 63%) was significantly more than in the control group (n = 12, 29%; P < .001). The ADHD group had significantly less ERN than did the control group while making IE, especially at frontal and central electrodes ( P < .01). Both ADHD-less ERN and ADHD-enough ERN groups had poorer subjective EAFs on questionnaires. Only the ADHD-less ERN group had significant poorer objective EAFs on the Comprehensive Nonverbal Attention Test than did the ADHD without IE. We conclude that investigating the IE and ERN of IE in children with ADHD might help to differentiate subtypes of ADHD with different neuropsychological abilities, and the possibility that ADHD-less ERN children might be confirmed a meaningful subgroup that needs close follow-up, treatments different from standard, or both.
An analytical model based on the G-equation for the response of technically premixed flames to perturbations of equivalence ratio
Authors: Albayrak Alp , Polifke Wolfgang
Published: November 2017

A model for the response of technically premixed flames to equivalence ratio perturbations is proposed. The formulation, which is an extension of an analytical flame tracking model based on the linearized G-equation, considers the flame impulse response to a local, impulsive, infinitesimal perturbation that is transported by convection from the flame base towards the flame surface. It is shown that the contributions of laminar flame speed and heat of reaction to the impulse response exhibit a local behavior, i.e. the flame responds at the moment when and at the location where the equivalence ratio perturbation reaches the flame surface. The time lag of this process is related to a convective time scale, which corresponds to the convective transport of fuel from the base of the flame to the flame surface. On the contrary, the flame surface area contribution exhibits a non-local behavior: albeit fluctuations of the flame shape are generated locally due to a distortion of the kinematic balance between flame speed and the flow velocity, the resulting wrinkles in flame shape are then transported by convection towards the flame tip with the restorative time scale. The impact of radial non-uniformity in equivalence ratio perturbations on the flame impulse response is demonstrated by comparing the impulse responses for uniform and parabolic radial profiles. Considerable deviation in the phase of the flame transfer function, which is important for thermo-acoustic stability, is observed.
Serum uric acid level predicts adverse outcomes after myocardial revascularization or cardiac valve surgery
Authors: Lazzeroni Davide , Bini Matteo , Camaiora Umberto , Castiglioni Paolo , Moderato Luca , Bosi Davide , Geroldi Simone , Ugolotti Pietro T , Brambilla Lorenzo , Brambilla Valerio , Coruzzi Paolo
Published: November 2017

Background

High levels of serum uric acid have been associated with adverse outcomes in cardiovascular diseases such as myocardial infarction and heart failure. The aim of the current study was to evaluate the prognostic role of serum uric acid levels in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery.

Design

We performed an observational prospective cohort study.

Methods

The study included 1440 patients with available serum uric acid levels, prospectively followed for 50 ± 17 months. Mean age was 67 ± 11 years; 781 patients (54%) underwent myocardial revascularization, 474 (33%) cardiac valve surgery and 185 (13%) valve-plus-coronary artery by-pass graft surgery. The primary endpoints were overall and cardiovascular mortality while secondary end-points were combined major adverse cardiac and cerebrovascular events.

Results

Serum uric acid level mean values were 286 ± 95 µmol/l and elevated serum uric acid levels (≥360 µmol/l or 6 mg/dl) were found in 275 patients (19%). Overall mortality (hazard ratio = 2.1; 95% confidence interval: 1.5–3.0; p < 0.001), cardiovascular mortality (hazard ratio = 2.0; 95% confidence interval: 1.2–3.2; p = 0.004) and major adverse cardiac and cerebrovascular events rate (hazard ratio = 1.5; 95% confidence interval: 1.0–2.0; p = 0.019) were significantly higher in patients with elevated serum uric acid levels, even after adjustment for age, gender, arterial hypertension, diabetes, glomerular filtration rate, atrial fibrillation and medical therapy. Moreover, strong positive correlations between serum uric acid level and probability of overall mortality ( p < 0.001), cardiovascular mortality ( p < 0.001) and major adverse cardiac and cerebrovascular events ( p = 0.003) were found.

Conclusions

Serum uric acid levels predict mortality and adverse cardiovascular outcome in patients undergoing myocardial revascularization and/or cardiac valve surgery even after the adjustment for age, gender, arterial hypertension, diabetes, glomerular filtration rate and medical therapy.
The Uptake of Human Papillomavirus Vaccination and Its Associated Factors Among Adolescents: A Systematic Review
Authors: Loke Alice Yuen , Kwan Miu Ling , Wong Yuen-Ting , Wong Alice Kar Yan
Published: November 2017

Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.
Exploring the Missing Link Between the Concussion “Crisis” and Labor Politics in Professional Sports
Authors: Brayton Sean , Helstein Michelle T. , Ramsey Mike , Rickards Nicholas
Published: November 2017

This study focuses on connections between labor struggles in professional sports and the epidemic of concussions among athletes, specifically in the National Football League (NFL) and National Hockey League (NHL). Using a critical discourse analysis (CDA), we explain how popular media presents concussions in ways that are informative but often avoid a more politicized discussion of the athlete as a manual worker whose body succumbs to use and abuse of sport. We found two recurring themes in the North American popular press, including a tendency to (1) rely on a trope of “millionaires-versus-billionaires” to explain (and minimize) recent labor lockouts in the NFL and NHL and (2) shift focus on league deniability to athletes’ self-responsibility in the concussion “crisis.” Despite the urgency in which sports concussions and brain injuries have been reported in recent years, the two narratives work to discourage readers from recognizing how such health issues arise under specific relations of production, and that an athlete is a particular type of worker whose body is subjected to decline and disposability like so many other bodies under late capitalism. As we argue, working conditions are inseparable from concussions in professional sports, a phenomenon that requires further development within the popular press.
Physical and Functional Differences in Youth Baseball Players With and Without Throwing-Related Pain
Authors: Greenberg Elliot M. , Lawrence J. Todd R. , Fernandez-Fernandez Alicia , Shah Kshamata , McKenna Casey , Rowan Marcus L. , Kim JongMyung , McClure Phillip
Published: November 2017

Background:

Identifying risk factors that contribute to shoulder and elbow pain within youth baseball players is important for improving injury prevention and rehabilitation strategies.

Hypothesis:

Differences will exist between youth baseball players with and without a history of upper extremity pain on measures related to growth, shoulder performance, and baseball exposure.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 84 youth baseball players were divided into 2 groups based on self-reported history of throwing-related arm pain. Group differences for growth-related, shoulder performance, and baseball exposure variables were analyzed by use of parametric and nonparametric tests, as appropriate. Multivariate logistic regression was used to assess variables most predictive of pain.

Results:

The group of athletes with pain (n = 16) were taller and heavier, played more baseball per year, and had greater pitching velocity. Athletes with pain also had greater loss of internal rotation range of motion and greater side-to-side asymmetry in humeral retrotorsion (HRT), attributable to lower degrees of HRT within the nondominant humerus. Multivariate analysis revealed that player height was most predictive of pain, with a 1-inch increase in height resulting in a 77% increased risk of pain.

Conclusion:

Vertical growth that accompanies adolescence increases the risk of experiencing throwing-related pain in youth baseball players. Players who are taller, particularly those with faster pitching velocities, are at the greatest risk for developing pain and should be more carefully monitored for resultant injury. The degree of nondominant HRT may have a relationship to the development of pain, but further research is required to better understand the implications of this observation.
Patterns of Gendered Performance Differences in Large Introductory Courses at Five Research Universities
Authors: Matz Rebecca L. , Koester Benjamin P. , Fiorini Stefano , Grom Galina , Shepard Linda , Stangor Charles G. , Weiner Brad , McKay Timothy A.
Published: November 2017

Significant gendered performance differences are signals of systemic inequity in higher education. Understanding of these inequities has been hampered by the local nature of prior studies; consistent measures of performance disparity across many disciplines and institutions have not been available. Here, we report the first wide-ranging, multi-institution measures of gendered performance difference, examining more than a million student enrollments in hundreds of courses at five universities. After controlling for factors that relate to academic performance using optimal matching, we identify patterns of gendered performance difference that are consistent across these universities. Biology, chemistry, physics, accounting, and economics lecture courses regularly exhibit gendered performance differences that are statistically and materially significant, whereas lab courses in the same subjects do not. These results reinforce the importance of broad investigation of performance disparities across higher education. They also help focus equity research on the structure and evaluative schemes of these lecture courses.
Prenatal Sonographic Detection of Multiple Congenital Anomalies: A Case of Severe Arthrogryposis Multiplex Congenita (AMC)
Authors: Bildner Amy , Jackson Daniel
Published: November 2017

This case study describes an obstetrical patient who presented for a routine second-trimester morphology sonogram in which the fetus was found to have arthrogryposis multiplex congenita. Other abnormalities visualized included a single umbilical artery, hypoplastic nasal bone, polyhydramnios, and poorly visualized lateral ventricles. Amniocentesis demonstrated a normal microarray with a negative result for cytomegalovirus and toxoplasmosis. This case study highlights the utility of prenatal sonography to identify functional abnormalities of the fetal musculoskeletal system.
Intuitive Real-Time Multidimensional Diagnostic Sonographic Image Optimization Technology
Authors: Borreani Giampaolo , Biagini Carlo , Pesce Roberto , Bombino Luca , Forzoni Leonardo
Published: November 2017

Diagnostic medical sonography (DMS) is an operator and patient dependent examination where anatomical and hemodynamic analysis settings have to be adjusted in real-time while scanning. Several techniques were developed so far to perform the DMS acquisition and post processing adjustments quickly and to maximize their easiness. A new easyMode Technology was recently implemented in order to drastically simplify the operator system setup to only three macro-parameters related to the desired effect in terms of: resolution/penetration, contrast/soft, smooth/sharp. A multidimensional algorithm varies simultaneously several internal system parameters to modify the image in the direction of the macro-parameter varied by the user. No prior knowledge of ultrasound physics or technology is required to adjust the macro-parameter, the effects of which are directly visible on the sonographic image in real-time (for instance, to optimize the level of smoothness with respect to sonographic image contrast). The aim of the easyMode is to increase productivity, reduce sonographer’s work-related musculoskeletal disorders due to extensive use of the ultrasound system control panel, and increase diagnostic confidence based on the intuitive optimization of the sonographer’s desired effect, instead of an engineering approach to real-time scanning optimization.
Mesenchymal stem cells expressing osteoprotegerin variants inhibit osteolysis in a murine model of multiple myeloma
Authors: Higgs Jerome T. , Lee Joo Hyoung , Wang Hong , Ramani Vishnu C. , Chanda Diptiman , Hardy Cherlene Y. , Sanderson Ralph D. , Ponnazhagan Selvarangan
Published: November 2017

Key Points

The study developed a mouse model of bone disseminated myeloma disease as in humans. The study established therapeutic potential of OPG variants to revert myeloma bone damage in vivo.
Improving reverse time migration angle gathers by efficient wavefield separation
Authors: Zhang Dongliang , Fei Tong W. , Luo Yi
Published: November 2017

Angle-domain common-image gathers (ADCIGs) play an important role for migration quality control and velocity analysis. ADCIGs can be constructed by using optical flow to compute propagation directions of seismic waves, which originate and propagate from source and receiver locations. When upgoing and downgoing waves interfere with each other, the optical flow method can generate incorrect propagation angles and produce problematic ADCIGs. To overcome this problem, separating upgoing and downgoing waves is required. The challenge is that separating the wavefields often requires huge memory to store all the snapshots of the propagating 3D wavefields. We have developed a computationally efficient algorithm to separate the wavefields into upgoing and downgoing waves by storing only one additional snapshot of the wavefields at a single time step. Applying the optical flow method on the separated downgoing wavefield produces improved ADCIGs; the improvements are well-verified by tests on synthetic and field data sets.
Cost-Benefit Analysis of Seismic Mitigation Measures for Wine Barrel Stacks
Authors: Jaimes Miguel A. , Candia Gabriel , Favier Philomène
Published: November 2017

This study conducts a cost-benefit analysis of alternative seismic risk mitigation methods for wine barrel stacks. The Chilean wine industry is presented as an illustrative case study in which performance metrics, such as the expected annual loss (EAL) and benefit-cost ratios, are computed for wineries at different locations. By computing seismic risk within a consistent framework, this study shows the value of cost-benefit simulations for defining the best mitigation strategies and allocating economic resources. Likewise, this approach helps communicate information to decision makers because it is presented in a simple and transparent way, even if they are not familiar with formal risk studies. For three-level wine barrel stacks, it was observed that the Cradle Extender® (MS1) prevents a large number of barrel collapses and provides the highest benefit-cost ratio. On the other hand, for six-level wine barrel stacks, the prestressed cable (MS2) is more effective than MS1 as it prevents the barrel stack from overturning. No significant loss reduction is apparent in four- and five-level wine barrel stacks with the use of mitigation strategies; indeed, the mitigation strategies could generate greater losses and, therefore, other alternatives must be proposed.
Primary constrained TIPS for treating refractory ascites or variceal bleeding secondary to hepatic cirrhosis
Authors: Rabei R , Mathesovian S , Tasse J , Madassery S , Arslan B , Turba U , Ahmed O
Published: November 2017

Objective:

To report an initial experience using a primary constrained transjugular intrahepatic portosystemic shunt (TIPS) technique for treating cirrhotic patients with refractory ascites or variceal bleeding.

Methods:

All patients undergoing primary constrained (n = 9) and conventional (n = 18) TIPS between July 2014 and June 2016 were retrospectively reviewed. Preprocedure demographics, Child–Pugh, model for end-stage liver disease and technical variables were recorded. Outcomes measured included technical and clinical success, complications, 30-day mortality, as well as necessity for TIPS revision. Average (SD) and median follow-up was 237 (190) and 226 days.

Results:

All constrained and conventional TIPS were technically successful (100%). Clinical success as defined as a reduction or improvement in presenting symptoms was 88.9% (8/9) and 100% (18/18) in the constrained and conventional groups, respectively (p = 1). The average reduction in portosystemic gradient was lower in the constrained group, 6.1 mmHg compared with 10.6 mmHg in the conventional group (p = 0.73). The rate of hepatic encephalopathy following TIPS placement was higher in the conventional group [16.7% (3/18)] compared with 0% in the constrained group (p = 0.52). The percentage of patients requiring TIPS revision was lower in the constrained group, although the results were not significant (11.1 vs 22.2%, p = 0.63).

Conclusion:

Primary constrained TIPS is a feasible modification to conventional TIPS with similar technical and clinical success rates. A trend towards a smaller reduction in the portosystemic gradient and need for revision was observed in the constrained group.

Advances in knowledge:

Primary constrained TIPS allows for greater stepwise control over shunt diameter and may represent an improved technique for patients at risk for hepatic encephalopathy.
Effects of dose-escalated radiotherapy in combination with long-term androgen deprivation on prostate cancer
Authors: Tomita Natsuo , Soga Norihito , Ogura Yuji , Furusawa Jun , Shimizu Hidetoshi , Adachi Sou , Tanaka Hiroshi , Kato Daiki , Koide Yutaro , Makita Chiyoko , Tachibana Hiroyuki , Kodaira Takeshi
Published: November 2017

Objective:

We aimed to examine the effects of a dose escalation for prostate cancer patients receiving long-term androgen deprivation therapy (ADT).

Methods:

A retrospective analysis of 605 patients treated with radiotherapy (RT) and long-term ADT (National Comprehensive Cancer Network criteria-defined intermediate-risk, minimum 10 months; high-risk and very-high-risk, minimum 20 months) was performed. The median ADT time was 31 months. Cox’s proportional hazards models were used to compare biochemical disease-free survival (bDFS), clinical relapse-free survival (cRFS) and overall survival (OS) between the ≥70, <78 Gy group and 78 Gy group in a univariate analysis and to assess the effects of the dose escalation on bDFS in a multivariate analysis.

Results:

After a median follow-up of 70 months, 5-year bDFS was significantly better in the 78 Gy group than in the ≥70, <78 Gy group [96 vs 83%; hazard ratio 3.6 (95% confidence interval 2.2–6.1); p < 0.001]. 5-year cRFS and OS were similar between the two groups. The multivariate analysis showed that RT dose was still an independent prognostic factor of bDFS (p = 0.005).

Conclusion:

The results of the present study suggest that dose escalations result in significant improvements in bDFS, even when used in combination with long-term ADT. A longer follow-up is needed to clarify the effects of dose escalations on cRFS and OS.

Advances in knowledge:

It remains unclear whether high-dose RT is necessary for improving the outcomes of patients receiving long-term ADT. The results suggest that dose escalations result in significant improvements in biochemical control.
Towards enhanced PET quantification in clinical oncology
Authors: Zaidi Habib , Karakatsanis Nicolas
Published: November 2017

Positron emission tomography (PET) has, since its inception, established itself as the imaging modality of choice for the in vivo quantitative assessment of molecular targets in a wide range of biochemical processes underlying tumour physiology. PET image quantification enables to ascertain a direct link between the time-varying activity concentration in organs/tissues and the fundamental parameters portraying the biological processes at the cellular level being assessed. However, the quantitative potential of PET may be affected by a number of factors related to physical effects, hardware and software system specifications, tracer kinetics, motion, scan protocol design and limitations in current image-derived PET metrics. Given the relatively large number of PET metrics reported in the literature, the selection of the best metric for fulfilling a specific task in a particular application is still a matter of debate. Quantitative PET has advanced elegantly during the last two decades and is now reaching the maturity required for clinical exploitation, particularly in oncology where it has the capability to open many avenues for clinical diagnosis, assessment of response to treatment and therapy planning. Therefore, the preservation and further enhancement of the quantitative features of PET imaging is crucial to ensure that the full clinical value of PET imaging modality is utilized in clinical oncology. Recent advancements in PET technology and methodology have paved the way for faster PET acquisitions of enhanced sensitivity to support the clinical translation of highly quantitative four-dimensional (4D) parametric imaging methods in clinical oncology. In this report, we provide an overview of recent advances and future trends in quantitative PET imaging in the context of clinical oncology. The pros/cons of the various image-derived PET metrics will be discussed and the promise of novel methodologies will be highlighted.
Do we know enough to find an adjunctive therapy for cerebral malaria in African children?
Authors: Riggle Brittany A. , Miller Louis H. , Pierce Susan K.
Published: November 2017

Cerebral malaria is the deadliest complication of malaria, a febrile infectious disease caused byPlasmodiumparasite. Any of the five humanPlasmodiumspecies can cause disease, but, for unknown reasons, in approximately 2 million cases each yearP. falciparumprogresses to severe disease, ultimately resulting in half a million deaths. The majority of these deaths are in children under the age of five. Currently, there is no way to predict which child will progress to severe disease and there are no adjunctive therapies to halt the symptoms after onset. Herein, we discuss what is known about the disease mechanism of one form of severe malaria, cerebral malaria, and how we might exploit this understanding to rescue children in the throes of cerebral disease.
Why sensitive bacteria are resistant to hospital infection control
Authors: van Kleef Esther , Luangasanatip Nantasit , Bonten Marc J , Cooper Ben S.
Published: November 2017

Background: Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning.

Methods: We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio (IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains.

Results: For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤  0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while communityacquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions.

Conclusions: Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally, following differences in their adaptation to hospital and community-based transmission. Observed lack of effectiveness of control measures for sensitive strains does not provide evidence that infection control interventions have been ineffective in reducing resistant strains.
Proteomic analysis of extracellular vesicles from a Plasmodium falciparum Kenyan clinical isolate defines a core parasite secretome
Authors: Abdi Abdirahman , Yu Lu , Goulding David , Rono Martin K. , Bejon Philip , Choudhary Jyoti , Rayner Julian
Published: November 2017

Background: Many pathogens secrete effector molecules to subvert host immune responses, to acquire nutrients, and/or to prepare host cells for invasion. One of the ways that effector molecules are secreted is through extracellular vesicles (EVs) such as exosomes. Recently, the malaria parasite P. falciparum has been shown to produce EVs that can mediate transfer of genetic material between parasites and induce sexual commitment. Characterizing the content of these vesicles may improve our understanding of P. falciparum pathogenesis and virulence.

Methods: Previous studies of P. falciparum EVs have been limited to long-term adapted laboratory isolates. In this study, we isolated EVs from a Kenyan P. falciparum clinical isolate that had been adapted to in vitro culture for a relatively shorter period, and characterized their protein content by mass spectrometry (data are available via ProteomeXchange, with identifier PXD006925).

Results: We show that P. falciparum extracellular vesicles (PfEVs) are enriched in proteins found within the exomembrane compartments of infected erythrocytes such as Maurer’s clefts (MCs), as well as the secretory endomembrane compartments in the apical end of the merozoites, suggesting that PfEVs may play a role in parasite-host interactions. Comparison of this dataset with previously published datasets helps to define a core secretome present in PfEVs.

Conclusions: P. falciparum extracellular vesicles contain virulence-associated parasite proteins. Analysis of PfEVs contents from a range of clinical isolates, and their functional validation may improve our understanding of the virulence mechanisms of the parasite, and potentially identify new targets for interventions or diagnostics.