bluuebunny/crossref_metadata_2025 huggingface dataset:
Shape optimization of annular S-ducts by CFD and high-order polynomial response surfaces
Authors: Immonen Eero
Published: March 2018

Purpose

This paper aims to design an optimal shape for an annular S-duct, considering both energy losses and exit flow uniformity, starting from a given baseline design. Moreover, this paper seeks to identify the design factors that affect the optimal annular S-duct designs.

Design/methodology/approach

The author has carried out computational fluid dynamic (CFD)-based shape optimization relative to five distinct numerical objectives, to understand their interrelations in optimal designs. Starting from a given baseline S-duct design, they have applied control node-induced shape deformations and high-order polynomial response surfaces for modeling the functional relationships between the shape variables and the numerical objectives. A statistical correlation analysis is carried out across the optimal designs.

Findings

The author has shown by single-objective optimization that the two typical goals in S-duct design, energy loss minimization and exit flow uniformity, are mutually contradictory. He has presented a multi-objective solution for an optimal shape, reducing the total pressure loss by 15.6 per cent and the normalized absolute radial exit velocity by 34.2 per cent relative to a baseline design. For each of the five numerical objectives, the best optimization results are obtained by using high-order polynomial models.

Research limitations/implications

The methodology is applicable to axisymmetric two-dimensional geometry models.

Originality/value

This paper applies a recently introduced shape optimization methodology to annular S-ducts, and, it is, to the author’s knowledge, the first paper to point out that the two widely studied design objectives for annular S-ducts are contradictory. This paper also addresses the value of using high-order polynomial response surface models in CFD-based shape optimization.
Design of material microstructures for maximum effective elastic modulus and macrostructures
Authors: Da Daicong , Cui Xiangyang , Long Kai , Huang Guanxin , Li Guangyao
Published: March 2018

Purpose

In pure material design, the previous research has indicated that lots of optimization factors such as used algorithm and parameters have influence on the optimal solution. In other words, there are multiple local minima for the topological design of materials for extreme properties. Therefore, the purpose of this study is to attempt different or more concise algorithms to find much wider possible solutions to material design. As for the design of material microstructures for macro-structural performance, the previous studies test algorithms on 2D porous or composite materials only, it should be demonstrated for 3D problems to reveal numerical and computational performance of the used algorithm.

Design/methodology/approach

The presented paper is an attempt to use the strain energy method and the bi-directional evolutionary structural optimization (BESO) algorithm to tailor material microstructures so as to find the optimal topology with the selected objective functions. The adoption of the strain energy-based approach instead of the homogenization method significantly simplifies the numerical implementation. The BESO approach is well suited to the optimal design of porous materials, and the generated topology structures are described clearly which makes manufacturing easy.

Findings

As a result, the presented method shows high stability during the optimization process and requires little iterations for convergence. A number of interesting and valid material microstructures are obtained which verify the effectiveness of the proposed optimization algorithm. The numerical examples adequately consider effects of initial guesses of the representative unit cell (RUC) and of the volume constraints of solid materials on the final design. The presented paper also reveals that the optimized microstructure obtained from pure material design is not the optimal solution any more when considering the specific macro-structural performance. The optimal result depends on various effects such as the initial guess of RUC and the size dimension of the macrostructure itself.

Originality/value

This paper presents a new topology optimization method for the optimal design of 2D and 3D porous materials for extreme elastic properties and macro-structural performance. Unlike previous studies, the presented paper tests the proposed optimization algorithm for not only 2D porous material design but also 3D topology optimization to reveal numerical and computational performance of the used algorithm. In addition, some new and interesting material microstructural topologies have been obtained to provide wider possible solutions to the material design.
A novel nature-inspired optimization based neural network simulator to predict coal grindability index
Authors: Yazdani S. , Hadavandi Esmaeil , Hower James , Chehreh Chelgani Saeed
Published: March 2018

Purpose

Hardgrove grindability index (HGI) is an important physical parameter used to demonstrate the relative hardness of coal particles. Modeling of HGI based on coal conventional properties is a quite complicated procedure. The paper aims to develop a new accurate model for prediction of HGI that is called optimized evolutionary neural network (OPENN).

Design/methodology/approach

The procedure for generation of the proposed OPENN predictive model was performed in two stages. In the first stage, as the high dimensionality involved in the input space, a correlation-based feature selection (CFS) algorithm was used to select the most important influencing variables for HGI prediction. In the second stage, a combination of differential evolution (DE) and biography-based optimization (BBO) algorithms as a global search method were applied to evolve weights of a multi-layer perception neural network.

Findings

The proposed OPENN was examined and compared with other typical models using a wide range of Kentucky coal samples. The testing results showed that the accuracy of the proposed OPENN model is significantly better than the other typical models and can be considered as a promising alternative for HGI prediction.

Originality/value

As HGI test is relatively expensive procedure, there is an economical interest on HGI modeling based on coal conventional properties (proximate, ultimate and petrography); the proposed OPENN model to estimate HGI would be a valuable and practical tool for coal industry.
Model-based multi-objective optimization of cure process control for a large CFRP panel
Authors: Shevtsov Sergey , Zhilyaev Igor V. , Tarasov Ilya , Wu Jiing-Kae , Snezhina Natalia G.
Published: March 2018

Purpose

The purpose of this paper is to develop the multi-objective optimization approach and its numerical implementation to synthesise the model-base control for the part curing at autoclave processing, which supplies the stability and uniformity of the structure and mechanical properties of the material within the cured composite part.

Design/methodology/approach

The approach includes conversion of the cured part and mold geometry from their computer-aided design (CAD) to computer-aided engineering (CAE) representation, a finite element (FE) formulation of the coupled forward heat transfer/thermal kinetic problem with the parameters of prepreg, which should be determined by the thermal analysis, and, finally, a mapping of the area of 4D design space (thermal control parameters) to 2D objective space, whose coordinates are the maximum deviations of degree of cure and temperature within the cured part calculated at each call of the FE model.

Findings

The present modeling and optimization approach to the cure process control of the prepreg with thermosetting resin, as well as the means of visualizing optimization results, allow providing insight into complex curing phenomena, estimating the best achievable quality indicators of manufactured composite parts, finding satisfactory parameters of the control law and deciding considering all manufacturing constraints.

Research limitations/implications

The research can be effectively used to optimize the cure process control for a wide class of polymeric composite parts, even with a complex geometry, but it requires the exact conversion of the geometry of the modeled part from the CAD to CAE environment, which implies the need for excluding all topological imperfections of original CAD model to eliminate the possible formation of void elements and other reasons that do not allow the correct FE meshing. Because thermal, rheological and kinetics parameters, which include the governing equations of cure process, depend on the reinforcing fibers, and especially on the resin properties, the thermal testing for the new modeled prepreg needs to be performed.

Practical implications

Computer implementation of the proposed approach and numerical method for model-based optimal control synthesis for composite part cure process can be used in aircraft, rotorcraft, ship and automotive technologies at the design of manufacturing process of the large composite parts with complex shape.

Social implications

This will allow much better quality for large-scale composite parts, excluding very expensive, time-, energy- and material-consuming multiple cure process testing.

Originality/value

This is first time the problem of optimal control synthesis for curing the large-scale composite parts of complex shape was solved.
Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange
Authors: Lin Sunny C. , Everson Jordan , Adler‐Milstein Julia
Published: March 2018

Objective

To assess whether the level of health information exchange (HIE) in U.S. hospitals is related to technology capabilities, incentives to exchange, or both.

Study Setting

A total of 1,812 hospitals attesting to stage 2 of Medicare's Meaningful Use Incentive Program through April 2016.

Study Design

Hospital‐level, multivariate OLS regression with state fixed effects was used to analyze the relationship between technology capability and incentives measures, and percent of care transitions with summary of care records (SCRs) sent electronically to subsequent providers.

Principal Findings

Stage 2 hospitals reported sending SCRs electronically for an average of 41 percent (median = 33 percent) of transitions. HIE level is related to four capability measures, one incentive measure, and one measure that is related to both capability and incentive. Percent of transitions with SCRs sent electronically was 3 percentage points higher (95 percent CI: 0.1–5.1) for hospitals with a third‐party HIE vendor, 3 percentage points higher (95 percent CI: 0.5–5.4) for hospitals with an EHR vendor as their HIE vendor, and 3 percentage points higher (95 percent CI: 0.4–5.4) for hospitals that automatically alert primary care providers. The direction and statistical significance of the relationships between specific EHR vendor and electronic SCR transmission level varied by vendor. Nonprofits and government hospitals performed 5 percentage points higher (95 percent CI: 1.5–9.1) and 8 percentage points higher (95 percent CI: 3.4–12.3) than for‐profits. Hospitals in systems performed 3 percentage points higher (95 percent CI: 0.8–6.1).

Conclusion

The overall level of HIE is low, with hospitals sending an SCR electronically for less than half of patient transitions. Specific hospital characteristics related to both technology capabilities and incentives were associated with higher levels of HIE.
A Rare Fatal Complication of Llizarov Procedure
Authors: Sikary Asit Kumar , Kumar Mahesh , Dhaka Shivani , Subramanian Arulselvi
Published: March 2018

Ilizarov process is used for the management of multiple fractures, polytrauma conditions, cosmetic limb lengthening, and fracture malunion. Complications associated with the process are nerve palsy, joint contracture, premature or delayed osseous consolidation, a nonunion and permanent stiffness of the joint, pin tract infection, edema, and transient paresthesia, etc. In our case, there was a fatal complication. A 25‐year‐old African lady underwent the Ilizarov procedure for femur lengthening in a hospital in New Delhi, India. During her first distraction process, she suddenly collapsed at the hospital and could not be revived. At postmortem, a small hematoma was seen around the surgically fractured area. On histopathology of internal organs, fat globules were present in the vasculature of brain and lungs. Cause of death was opined as due to fat embolism. This is the first case reported of a fatal fat embolism following Ilizarov procedure for limb lengthening in a healthy adult.
MARKETIZED MENTALITY, COMPETITIVE/EGOISTIC SCHOOL CULTURE, AND DELINQUENT ATTITUDES AND BEHAVIOR: AN APPLICATION OF INSTITUTIONAL ANOMIE THEORY*
Authors: GROß EVA M. , HÖVERMANN ANDREAS , MESSNER STEVEN F.
Published: March 2018

We analyze the individual‐level and school‐level determinants of delinquency through the lens of a macro‐sociological theory of crime—institutional anomie theory (IAT). The concept of a “marketized mentality” is introduced as a predictor of students’ delinquency, along with an egoistic/competitive school culture—a feature of the school community. Five hypotheses pertaining to the readiness to use violence and self‐reported delinquency were assessed using multilevel modeling with data from a survey in Germany for 4,150 students clustered in 69 schools. The results largely meet theoretical expectations. The measure of marketized mentality exhibits robust relationships with both forms of delinquency at the individual level, and an egoistic/competitive school culture helps explain variation in levels of these forms of delinquency across schools. Also consistent with expectations, the anti‐social effects of marketized mentality are accentuated for both the readiness to use violence and committing instrumentally motivated property offenses as a competitive/egoistic school climate increases. The results of our analyses reveal that bringing in concepts of IAT can appreciably enhance understanding of the characteristics of students and features of communal school organization that are conducive to youthful offending.
Southwestern Intermittent and Ephemeral Stream Connectivity
Authors: Goodrich D.C. , Kepner W.G. , Levick L.R. , Wigington P.J.
Published: March 2018

Ephemeral and intermittent streams are abundant in the arid and semiarid landscapes of the Western and Southwestern United States (U.S.). Connectivity of ephemeral and intermittent streams to the relatively few perennial reaches through runoff is a major driver of the ecohydrology of the region. These streams supply water, sediment, nutrients, and biota to downstream reaches and rivers. In addition, they provide runoff to recharge alluvial and regional groundwater aquifers that support baseflow in perennial mainstem stream reaches over extended periods when little or no precipitation occurs. Episodic runoff, as well as groundwater inflow to surface water in streams support limited naturally occurring riparian communities. This paper provides an overview and comprehensive examination of factors affecting the hydrologic, chemical, and ecological connectivity of ephemeral and intermittent streams on perennial or intermittent rivers in the arid and semiarid Southwestern U.S. Connectivity as influenced and moderated through the physical landscape, climate, and human impacts to downstream waters or rivers is presented first at the broader Southwestern scale, and secondly drawing on a specific and more detailed example of the San Pedro Basin due to its history of extensive observations and research in the basin. A wide array of evidence clearly illustrates hydrologic, chemical, and ecological connectivity of ephemeral and intermittent streams throughout stream networks.
Efficacy and safety of a second‐generation biodegradable polymer sirolimus‐eluting stent: One‐year results of the CREDIT 2 trial
Authors: Xu Kai , Han Yaling , Xu Bo , Yang Yuejin , Wang Geng , Li Hui , Sun Yong , Tao Ling , Wang Haichang , Yuan Zuyi , Liu Huiliang , Liu Jinghua , Jia Yongping , Ma Genshan , Fu Guosheng , Li Xiaodong , Li Shuren , Wang Shouli , Pu Kui ,   the CREDIT 2 Investigators
Published: March 2018

Aims

We performed a multicenter, randomized controlled trial to determine the noninferiority of a novel biodegradable polymer drug‐eluting stent (BP‐DES), the EXCEL 2 stent, to the first‐generation BP‐DES, the EXCEL stent.

Methods and Results

Patients (n = 419) scheduled to undergo percutaneous coronary intervention (PCI) were randomized to receive either the EXCEL 2 stent (n = 208) or the EXCEL stent (n = 211) from 15 Chinese centers. At 9 months, primary endpoint in‐stent late loss (LL) difference was −0.03 mm (95% confidence interval: −0.09 mm to 0.04 mm) between the EXCEL 2 group (0.14 ± 0.26 mm) and the EXCEL group (0.16 ± 0.36 mm), demonstrating the noninferiority of EXCEL 2 to EXCEL in terms of in‐stent LL (P for noninferiority < .0001). Besides, target lesion failure (TLF) was statistically lower in EXCEL 2 group compared with EXCEL through 1 year (HR [95%CI] = 0.45 [0.20,0.98], Plog‐rank = .04). Definite/probable ST was observed in 0.0% vs 1.9% (P = .12) of EXCEL 2 vs EXCEL‐treated subjects.

Conclusions

The second‐generation BP‐DES (EXCEL 2) was noninferior to the first‐generation BP‐DES (EXCEL) for the primary endpoint of in‐stent LL at 9 months.

Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02057978.
Impact of Jahnigen/GEMSSTAR Scholarships on Careers of Recipients in Emergency Medicine and on Development of Geriatric Emergency Medicine
Authors: Rosen Tony , Shah Manish , Lundebjerg Nancy E. , Singh Cynthia , McMillian Melissa , Sarli Cathy C. , Suiter Amy M. , Lee Andrew G. , Burton John R. , Carpenter Christopher R.
Published: March 2018

Background

The Jahnigen Career Development Awards program was launched in 2002 with private funding and transformed into the Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR) program in 2011 through support from the National Institute on Aging and medical specialty professional societies. The Jahnigen/GEMSSTAR program has provided grants to early career physician‐scientists from 10 surgical and related medical specialties to initiate and sustain research careers in the geriatric aspect of their discipline. From 2002 to 2016, there were 20 Jahnigen/GEMSSTAR recipients in emergency medicine (EM). The goal of this investigation was to examine the impact of Jahnigen/GEMSSTAR awards on careers of EM recipients and on development of academic geriatric EM.

Methods

We conducted an online survey of the 20 EM recipients from 2002 to 2016 and analyzed their academic productivity, research impact, career trajectory, and contributions to geriatric EM since receiving the award.

Results

All 20 Jahnigen/GEMSSTAR scholars completed the survey. Scholars have published a median of 33 peer‐reviewed articles (interquartile range [IQR] = 10–97) since the award, with median annual publication rates of 4.5 (IQR = 1.6–7.0). All scholars had h‐indices of 6 or more, with a median of 18 (IQR = 9–28). Jahnigen/GEMSSTAR scholars have served as principal investigator (PI) or co‐PI on 126 grants since their award, with 90% having served as PI on at least one additional grant and 30% having received National Institutes of Health Career Development Awards. All scholars reported believing that the Jahnigen/GEMSSTAR was very helpful or helpful for career progress. Most (85%) reported ongoing contributions to geriatric EM in research, education, or administration.

Conclusions

After the Jahnigen/GEMSSTAR award, EM scholars have been highly academically productive and successful, and the award has been instrumental in their career development. Awardees have been critical to the development of geriatric EM.
Lipopolysaccharide and cAMP modify placental calcitriol biosynthesis reducing antimicrobial peptides gene expression
Authors: Olmos‐Ortiz Andrea , García‐Quiroz Janice , Avila Euclides , Caldiño‐Soto Felipe , Halhali Ali , Larrea Fernando , Díaz Lorenza
Published: March 2018

Problem

Calcitriol, the hormonal form of vitamin D3 (VD), stimulates placental antimicrobial peptides expression; nonetheless, the regulation of calcitriol biosynthesis in the presence of bacterial products and its consequence on placental innate immunity have scarcely been addressed.

Method of study

We investigated how some bacterial products modify placental VD metabolism and its ability to induce antimicrobial peptides gene expression.

Results

Cultured human trophoblasts biosynthesized calcitriol only in the presence of its precursor calcidiol, a process that was inhibited by cyclic‐AMP but stimulated by lipopolysaccharide (LPS). Intracrine calcitriol upregulated cathelicidin, S100A9, and β‐defensins (HBDs) gene expression, while LPS further stimulated HBD2 and S100A9. Unexpectedly, LPS significantly repressed cathelicidin basal mRNA levels and drastically diminished calcidiol ability to induce it. Meanwhile, cyclic‐AMP, which is used by many microbes to avoid host defenses, suppressed calcitriol biosynthesis, resulting in significant inhibition of most VD‐dependent microbicidal peptides gene expression.

Conclusion

While LPS stimulated calcitriol biosynthesis, cyclic‐AMP inhibited it. LPS downregulated cathelicidin mRNA expression, whereas cyclic‐AMP antagonized VD‐dependent‐upregulation of most antimicrobial peptides. These findings reveal LPS and cyclic‐AMP involvement in dampening placental innate immunity, highlighting the importance of cyclic‐AMP in the context of placental infection and suggesting its participation to facilitate bacterial survival.
The psychology of social class: How socioeconomic status impacts thought, feelings, and behaviour
Authors: Manstead Antony S. R.
Published: March 2018

Drawing on recent research on the psychology of social class, I argue that the material conditions in which people grow up and live have a lasting impact on their personal and social identities and that this influences both the way they think and feel about their social environment and key aspects of their social behaviour. Relative to middle‐class counterparts, lower/working‐class individuals are less likely to define themselves in terms of their socioeconomic status and are more likely to have interdependent self‐concepts; they are also more inclined to explain social events in situational terms, as a result of having a lower sense of personal control. Working‐class people score higher on measures of empathy and are more likely to help others in distress. The widely held view that working‐class individuals are more prejudiced towards immigrants and ethnic minorities is shown to be a function of economic threat, in that highly educated people also express prejudice towards these groups when the latter are described as highly educated and therefore pose an economic threat. The fact that middle‐class norms of independence prevail in universities and prestigious workplaces makes working‐class people less likely to apply for positions in such institutions, less likely to be selected and less likely to stay if selected. In other words, social class differences in identity, cognition, feelings, and behaviour make it less likely that working‐class individuals can benefit from educational and occupational opportunities to improve their material circumstances. This means that redistributive policies are needed to break the cycle of deprivation that limits opportunities and threatens social cohesion.
Droplet digital polymerase chain reaction assay and peptide nucleic acid‐locked nucleic acid clamp method for RHOA mutation detection in angioimmunoblastic T‐cell lymphoma
Authors: Tanzima Nuhat Sharna , Sakata‐Yanagimoto Mamiko , Komori Daisuke , Hattori Keiichiro , Suehara Yasuhito , Fukumoto Kota , Fujisawa Manabu , Kusakabe Manabu , Matsue Kosei , Wakamatsu Hirotake , Shimadzu Mitsunobu , Chiba Shigeru
Published: March 2018

Angioimmunoblastic T‐cell lymphoma (AITL) is a subtype of nodal peripheral T‐cell lymphoma (PTCL). Somatic RHOA mutations, most frequently found at the hotspot site c.50G > T, p.Gly17Val (G17V RHOA mutation) are a genetic hallmark of AITL. Detection of the G17V RHOA mutations assists prompt and appropriate diagnosis of AITL. However, an optimal detection method for the G17V RHOA mutation remains to be elucidated. We compared the sensitivity and concordance of next‐generation sequencing (NGS), droplet digital PCR (ddPCR) and peptide nucleic acid‐locked nucleic acid (PNA‐LNA) clamp method for detecting the G17V RHOA mutation. G17V RHOA mutations were identified in 27 of 67 (40.3%) PTCL samples using NGS. ddPCR and PNA‐LNA clamp method both detected G17V mutations in 4 samples in addition to those detected with NGS (31 of 67, 46.3%). Additionally, variant allele frequencies with ddPCR and those with NGS showed high concordance (P < .001). Three other RHOA mutations involving the p.Gly17 position (c.[49G > T;50G > T], p.Gly17Leu in PTCL198; c.[50G > T;51A > C], p.Gly17Val in PTCL216; and c.50G > A, p.Gly17Glu in PTCL223) were detected using NGS. These sequence changes could not appropriately be detected using the ddPCR assay and the PNA‐LNA clamp method although both indicated that the samples might have mutations. In total, 34 out of 67 PTCL samples (50.7%) had RHOA mutations at the p.Gly17 position. In conclusion, our results suggested that a combination of ddPCR/PNA‐LNA clamp methods and NGS are best method to assist the diagnosis of AITL by detecting RHOA mutations at the p.Gly17 position.
Antinociceptive potency of enkephalins and enkephalinase inhibitors in the mouse model of colorectal distension—proof‐of‐concept
Authors: Fabisiak Adam , Sobocińska Małgorzata , Kamysz Elżbieta , Fichna Jakub , Zielińska Marta
Published: March 2018

Irritable bowel syndrome (IBS) is a chronic disease characterized by abdominal pain and changes in bowel habits. Patients with IBS comprise a significant portion of attendants at the outpatient clinics. Targeting intestinal opioid receptors was found successful in alleviating pain and diarrhea—two major symptoms of IBS. In this study, we aimed to evaluate a novel potential pharmacological option: the use of enkephalinase inhibitors in therapy of visceral pain occurring in the course of IBS. We thus assessed the antinociceptive efficacy of enkephalins: Leu‐enkephalin and Met‐enkephalin, and enkephalinase inhibitors: opiorphin and sialorphin in the mouse model of visceral pain induced by colorectal distension. Leu‐enkephalin, Met‐enkephalin, and sialorphin, but not opiorphin, at the dose of 1 mg/kg injected subcutaneously potently decreased the visceromotor response to colon distension as compared to control. To conclude, enkephalinase inhibitors are worth being considered as potential therapeutics in patients with chronic abdominal pain and/or changed bowel habits, that is, suffering from IBS.
Foetal, neonatal and child vitamin D status and enamel hypomineralization
Authors: van der Tas Justin T. , Elfrink Marlies E.C. , Heijboer Annemieke C. , Rivadeneira Fernando , Jaddoe Vincent W.V. , Tiemeier Henning , Schoufour Josje D. , Moll Henriëtte A. , Ongkosuwito Edwin M. , Wolvius Eppo B. , Voortman Trudy
Published: March 2018

Objectives

Recent literature suggested that higher vitamin D concentrations in childhood are associated with a lower prevalence of molar incisor hypomineralization (MIH). As tooth development already starts in utero, we aimed to study whether vitamin D status during foetal, postnatal and childhood periods is associated with the presence of hypomineralized second primary molars (HSPMs) and/or MIH at the age of six.

Methods

Our study was embedded in the Generation R Study, a population‐based, prospective cohort from foetal life onwards in Rotterdam, the Netherlands. HSPMs and MIH were scored from intraoral photographs of the children at their age of six. Serum 25(OH)D concentrations were measured at three points in time, which resulted in three different samples; mid‐gestational in mothers’ blood (n = 4750), in umbilical cord blood (n = 3406) and in children's blood at the age of 6 years (n = 3983).

Results

The children had a mean (±SD) age of 6.2 (±0.5) years at the moment of taking the intraoral photographs. After adjustment for confounders, no association was found between foetal 25(OH)D concentrations and the presence of HSPMs (OR 1.02 per 10 nmol/L higher 25(OH)D, 95% CI: 0.98‐1.07) or MIH (OR 1.05 per 10 nmol/L increase, 95% CI: 0.98‐1.12) in 6‐year‐olds. A higher 25(OH)D concentration in umbilical cord blood resulted in neither lower odds of having HSPM (OR 1.05, 95% CI: 0.98‐1.13) nor lower odds of having MIH (OR 0.95, 95% CI: 0.84‐1.07) by the age of six. Finally, we did not find higher 25(OH)D concentrations at the age of six to be associated with a significant change in the odds of having HSPM (OR 0.97, 95% CI: 0.92‐1.02) or MIH (OR 1.07, 95% CI: 0.98‐1.16).

Conclusions

25(OH)D concentrations in prenatal, early postnatal and later postnatal life are not associated with the presence of HPSMs or with MIH at the age of six. Future observational research is required to replicate our findings. Furthermore, it is encouraged to focus on identifying other modifiable risk factors, because prevention of hypomineralization is possible only if the causes are known.
ZNF687 mutations are frequently found in pagetic patients from South Italy: implication in the pathogenesis of Paget's disease of bone
Authors: Divisato G. , Scotto di Carlo F. , Petrillo N. , Esposito T. , Gianfrancesco F.
Published: March 2018

Paget's disease of bone (PDB) is a skeletal disorder whose molecular basis is not fully elucidated. However, 10% of patients show a familial PDB and 35% of them carry mutations in the SQSTM1 gene. We recently reported a founder mutation (p.Pro937Arg) in the ZNF687 gene, underlying PDB complicated by giant cell tumor (GCT/PDB) and rarely occurring in PDB patients without neoplastic degeneration. Since 80% of Italian GCT/PDB patients derive from Avellino, we hypothesized that ZNF687 mutation rate was higher in this region than elsewhere. Interestingly, our molecular analysis on 30 PDB patients showed that 33% hosted ZNF687 mutations, with the p.Pro937Arg identified in 8 familial cases. Two novel ZNF687 mutations (p.Pro665Leu and p.Gln784Glu) were detected in 2 sporadic patients. Only 2 subjects were positive for the p.Pro392Leu mutation in SQSTM1. ZNF687‐mutated patients showed a severe PDB, with a remarkable number of affected sites. in vitro studies revealed that the ZNF687‐mutant osteoclasts appeared as giant sized with up to 150 nuclei, never described in PDB. Finally, we also confirmed the causality of the p.Pro937Arg mutation in 4 additional GCT/PDB cases deriving from the same geographic area, indicating that PDB and GCT/PDB represent 2 sides of the same coin.
Aberrant intrinsic functional connectivity in thalamo‐cortical networks in major depressive disorder
Authors: Kong Qing‐Mei , Qiao Hong , Liu Chao‐Zhong , Zhang Ping , Li Ke , Wang Li , Li Ji‐Tao , Su Yun'Ai , Li Ke‐Qing , Yan Chao‐Gan , Mitchell Philip B. , Si Tian‐Mei
Published: March 2018

Objective

Growing evidence has implicated dysfunction of the thalamus and its projection cortical targets in depression. However, the anatomical specificity of thalamo‐cortical connectivity in major depressive disorder (MDD) remains unknown due to the regional heterogeneity of the thalamus and limited methods to examine this.

Methods

Resting‐state fMRI was collected on 70 MDD patients and 70 healthy controls. The thalamus was parcellated based on connectivity with six predefined cortical regions of interest (ROIs). The segmented thalamic nuclei were used as seeds to map connectivity with the rest of the whole brain. The cortical‐to‐thalamus connectivity values and thalamus‐based connectivity maps were compared between groups.

Results

The cortical ROIs demonstrated correlations with spatially distinct zones within the thalamus. We found a trend toward reduced parietal ROI‐to‐thalamus connectivity in MDD. Importantly, MDD patients demonstrated reduced connectivity between prefrontal and parietal thalamus ROIs and bilateral middle frontal gyrus (MFG) and the right posterior default mode network (DMN) and between the prefrontal and motor thalamus ROIs and lateral temporal regions. Conversely, increased connectivity emerged between the motor thalamus ROI and right MFG and right medial frontal gyrus/anterior cingulate; between motor/somatosensory thalamus ROIs and right posterior DMN; between prefrontal/somatosensory thalamus ROIs and cerebellum; and between the parietal thalamus ROI and left insula.

Conclusions

This study is the first to examine the anatomical specificity of thalamo‐cortical connectivity disturbances in MDD. Subjects with MDD demonstrated altered thalamo‐cortical connectivity characterized by a complex pattern of region‐dependent hypo‐ or hyperconnectivity. We therefore speculate that selectively modulating the connectivity of thalamo‐cortical circuitry may be a potential novel therapeutic mechanism for MDD.
Long‐term effects of traumatic dental injuries of primary dentition on permanent successors: A retrospective study of 596 teeth
Authors: Tewari Nitesh , Mathur Vijay Prakash , Singh Neerja , Singh Subash , Pandey Ramesh Kumar
Published: March 2018

Background/Aims

Traumatic dental injuries of the primary dentition (TDI‐p) have a global prevalence of approximately 11%‐47%. They have immediate and long‐term effects. Original research analysing the long‐term sequelae of TDI‐p on permanent dentition (LSP) are few in number. The aim of this study was to explore the correlation between age of TDI‐p, type of TDI‐p and LSP.

Material and Methods

Retrospective analysis of patient data from 2008‐2017, reporting with LSP due to TDI‐p, was performed. Uniform protocols and complete radiographic‐photographic records were analysed. There were 638 LSP reported with 596 teeth having complete records.

Results

There were 286 children with 153 males (53.5%) and 133 females (46.5%). Mean age of TDI‐p causing LSP was 36.57 ± 11.51 months, with severity increasing in the younger age group. The highest number of LSP was associated with avulsion injuries (218, 36.58%), and the odds ratio of the type of TDI‐p affect the severity of LSP was 2.0163. Mean age of reporting was 8.54 ± 2.19 years and was lowest for enamel discolorations. Most LSP were not associated with any associated feature (AF), although impaction was highest among all AF (63, 10.57%).

Conclusion

Age and type of TDI‐p affect LSP, with the former being the stronger determinant of its severity. Mean age of reporting of LSP is dependent upon both type of LSP and AF. LSP due to TDI‐p can further be graded in terms of severity.
The Impact of Service‐Learning Targeting Apparel Design Majors: A Qualitative Analysis of Learning Growth
Authors: Eike Rachel J. , Myers Beth , Sturges Diana
Published: March 2018

To implement service‐learning in an apparel course, students led a mending and alterations shop that served the campus community. This study investigated the impact of participating in service‐learning on students’ skills in apparel construction, management, and communication. Students completed task log reflections and midterm and end of term learning growth reflections. This qualitative information was analyzed and six discipline‐specific themes emerged. The themes were as follows: (i) apparel design skills, (ii) collaboration, (iii) self‐efficacy and growth, (iv) problem‐solving, (v) communication and terminology, and (vi) comfort zone. Overall, the service‐learning component was deemed a valuable way to prepare students for careers in the fiber, textile, and clothing industry.
Movement behaviour in adults with haemophilia compared to healthy adults
Authors: Timmer M. A. , Pisters M. F. , de Kleijn P. , de Bie R. A. , Schutgens R. E. G. , Veenhof C.
Published: March 2018

Background

Limited research has been published regarding movement behaviour of adult persons with haemophilia (PWH). It is hypothesized that avoidance of activities and more sedentary behaviour cause poorer physical functioning.

Aim

To determine differences in movement behaviour between PWH and healthy adults.

Methods

Movement behaviour was measured with an accelerometer distinguishing between; lying/non‐wear, sitting, standing, walking, running and cycling. Time spent on activities was compared between PWH and healthy adults, using absolute time spent on activities and activities as percentage of wear time.

Results

One hundred and five PWH (32 mild/moderate with a mean age of 42.8 ± 15.1, severe 42.1 ± 13.6) and 98 healthy adults (mean age 41.9 ± 15.5) showed that adults with severe haemophilia sit and stand more than healthy adults (4.5 [CI 0.6‐8.4] and 4.2 [CI 1.8‐6.6] h/wk, respectively) and walk and run less (3.4 [CI 1.4‐5.3] hours and 33.6 [CI 19.0‐41.7] min/wk, respectively). Patients with mild/moderate haemophilia stand more than healthy adults (3.3 [CI 0.1‐6.4] h/wk). Differences in sitting between severe haemophilia and healthy adults and differences in standing between mild/moderate haemophilia and healthy adults disappeared when using activities as percentage of wear time.

Conclusion

Movement behaviour of adults with severe haemophilia differs from healthy adults, mainly due to less walking and less running. No differences were found in other activities and postures or the distribution of movement behaviour over the day. No significant differences were found between adults with mild/moderate haemophilia and healthy adults.
Effectiveness of the Medtep Hemophilia online platform for adherence to prophylactic treatment in haemophilia patients: Results from a 1‐year observational study
Authors: Cuesta‐Barriuso R. , López‐Pina J. A. , Nieto‐Munuera J. , Sagarra‐Valls G. , Panisello‐Royo J. M. , Torres‐Ortuño A.
Published: March 2018

Introduction

Medtep Hemophilia platform is an online tool that allows patients with congenital coagulopathies to keep track of their daily condition‐related events with the objective of ensuring successful adherence to therapy.

Aim

To assess the effectiveness of Medtep Hemophilia in improving adherence to prophylactic treatment in haemophilia A and B patients in a 1‐year prospective observational study, as well as its impact on the patient's disease status.

Methods

Patients (>13 years old) received support material to familiarize themselves with Medtep Hemophilia. Adherence to treatment, quality of life (QoL) and illness perception were assessed. Values at baseline, 1, 6 and 12 months, and changes from baseline value were analysed. The Hemophilia Joint Health Score (HJHS) test was applied at baseline and study completion.

Results

Forty‐six patients were enrolled (43 evaluable). After 1 year, 56.4% patients showed continued use of the platform (100% compliance) whereas 25.6% were inactive. Treatment adherence increased both significantly (P < .001) and progressively during the study. Similarly, improved QoL and illness perception were observed with respect to baseline in most of the questionnaire components (P < .05 after 12 months). A patient's age had no influence on the results, whereas compliant patients (>80% of platform use) tended to score better than noncompliant. The HJHS test values remained similar during the study.

Conclusion

The Medtep Hemophilia online platform helped the studied patients with haemophilia to improve their adherence to prophylactic treatment, while increasing their QoL and illness perception, as well as joint arthropathies stabilization.
Highlights of the 2017 European AIDS Clinical Society (EACS) Guidelines for the treatment of adult HIV‐positive persons version 9.0
Authors: Ryom L , Boesecke C , Bracchi M , Ambrosioni J , Pozniak A , Arribas J , Behrens G , Mallon PGM , Puoti M , Rauch A , Miro JM , Kirk O , Marzolini C , Lundgren JD , Battegay M ,   the EACS Governing Board
Published: March 2018

Background

The European AIDS Clinical Society (EACS) Guidelines have since 2005 provided multidisciplinary recommendations for the care of HIV‐positive persons in geographically diverse areas.

Guideline highlights

Major revisions have been made in all sections of the 2017 Guidelines: antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Newly added are also a summary of the main changes made, and direct video links to the EACS online course on HIV Management. Recommendations on the clinical situations in which tenofovir alafenamide may be considered over tenofovir disoproxil fumarate are provided, and recommendations on which antiretrovirals can be used safely during pregnancy have been revised. Renal and bone toxicity and hepatitis C virus (HCV) treatment have been added as potential reasons for ART switches in fully virologically suppressed individuals, and dolutegravir/rilpivirine has been included as a treatment option. In contrast, dolutegravir monotherapy is not recommended. New recommendations on non‐alcoholic fatty liver disease, chronic lung disease, solid organ transplantation, and prescribing in elderly are included, and human papilloma virus (HPV) vaccination recommendations have been expanded. All drug–drug interaction tables have been updated and new tables are included. Treatment options for direct‐acting antivirals (DAAs) have been updated and include the latest combinations of sofosbuvir/velpatasvir/voxilaprevir and glecaprevir/pibrentasvir. Recommendations on management of DAA failure and acute HCV infection have been expanded. For treatment of tuberculosis (TB), it is underlined that intermittent treatment is contraindicated, and for resistant TB new data suggest that using a three‐drug combination may be as effective as a five‐drug regimen, and may reduce treatment duration from 18‐24 to 6‐10 months.

Conclusions

Version 9.0 of the EACS Guidelines provides a holistic approach to HIV care and is translated into the six most commonly spoken languages.
PLATFORM PRICING IN MIXED TWO‐SIDED MARKETS
Authors: Gao Ming
Published: March 2018

When a consumer can appear on both sides of a two‐sided market, such as a user who both buys and sells on eBay, the platform may want to bundle the services it provides to two sides. I develop a general model for such “mixed” two‐sided markets and show that a monopolist platform's incentive to bundle and its optimal pricing strategy are determined by simple formulas using familiar price elasticities of demand, which embody the bundling effect, and price‐cost margins adjusted for network externalities, which incorporate “two‐sidedness.” The optimal pricing rule in such markets generalizes the familiar Lerner formula.
Closing the gap in Indigenous health inequity – Is it making a difference?
Authors: Deravin L. , Francis K. , Anderson J.
Published: March 2018

Aim

This paper will review progress towards the identified targets within the Australian government policy document commonly known as ‘Closing the Gap’ and examine the role of nurses in supporting its implementation.

Background

Australia is not alone in seeking to address the health inequity between Indigenous and non‐Indigenous people. Globally such health inequities are similar and require interventions supported by governments in conjunction with health and education systems to affect desired change. For this reason, it is timely to undertake a review of progress on the impact of the Closing the Gap initiative.

Sources of evidence

The Australian national partnership agreement and subsequent annual performance reports issued between 2010 and 2017.

Discussion

Targets set within the Australian government national partnership agreement have had a range of success. Those targets not on track require significant long‐term investment to ensure their success. Nurses as a large professional group are powerful advocates to speak up and support policy change that affects disempowered social groups.

Conclusion

Long‐term social change takes time, yet without the commitment of Australian Governments through effective policy and economic support, the inequity in the health of Indigenous people will continue both now and in the future.

Implications for health and social policy

Nurses, as the largest health professional group, are uniquely placed to support and implement social change at all levels of health care (primary, secondary and tertiary) and to lobby government to amend policy alongside those who are disempowered.

Implications for nursing practice

Health promotion and education programmes that are led by nurses can make an impact to health disparities within groups who are most at risk.
One‐pot combustion synthesis and efficient broad spectrum photoactivity of Bi/BiOBr:Yb,Er/C photocatalyst
Authors: Liang Shuhui , Zhang Tongtong , Zhang Dafeng , Pu Xipeng , Shao Xin , Li Wenzhi , Dou Jianmin
Published: March 2018

A highly efficient broad spectrum responsive Bi/BiOBr:Yb,Er/C ternary composite was synthesized by a simple one‐pot combustion method using nitrates and citric acid as raw materials. Experimental results show that Er3+/Yb3+ were successfully doped into BiOBr lattice, and metallic Bi nanoparticles and carbon species were formed simultaneously. Compared with pure BiOBr and Bi/BiOBr/C, as‐synthesized Bi/BiOBr:Yb,Er/C ternary photocatalyst is highly responsive in the UV‐visible‐NIR range, and possesses the best photodegradation performance for Rhodamine B, phenol, and imidacloprid under visible, NIR, or solar light irradiation, which can be attributed to the synergetic effects of surface plasma resonance of metallic Bi, up‐conversion transition of Er3+ and heterojunctions (Bi/BiOBr, Bi/C, and BiOBr/C). Moreover, a plausible mechanism was given, the main active species, and photostability of samples were studied. The solar light photoactivity and influences of pH value and anions (Cl−, SO42−, CO32−, HCO3−, and NO3−) were also investigated. This study highlights the advantages of synergetic effects of SPR, up‐conversion and heterojunctions, which provides a useful guide toward the rational design of broad spectrum (UV‐visible‐near infrared) photocatalysts.
Cultural aspects of death notification following cardiopulmonary resuscitation
Authors: Hassankhani Hadi , Haririan Hamidreza , Porter Joanne E. , Heaston Sondra
Published: March 2018

Aims

To explore the lived experience of resuscitation team members involved in notifying family members when a patient dies following a resuscitation event in an Iranian cultural context.

Background

Death notification to the family is indeed a difficult and an important issue for resuscitation team members. The way health professionals deliver news to family members should incorporate elements of sensitivity, timing and adequate clinical explanations with emphasis on the efforts made by the professionals during the resuscitation.

Design

A phenomenological study.

Method

Over a period of 5 months (June 2016–November 2016) eleven nurses and six physicians were interviewed using an in‐depth interview process applying Van Manen's hermeneutic phenomenological approach for data collection and analysis. The participants were recruited from six tertiary hospitals in Tabriz, Iran.

Findings

There were two main themes that emerged from the data analysis including: “contributing factors on the impact of notification” and “notification strategies”. A further 13 subthemes emerged under the main themes. Several culturally related issues emerged with the participants feeling more comfortable informing male rather than female relatives about the death of the patient following a resuscitation.

Conclusions

Notifying family members of a patient's death is a stressful and culturally sensitive task for the resuscitation team members. The nature of the patient's presenting condition, together with the various resuscitation interventions can result in relatives responding unpredictably. Providing health professionals with the appropriate training and skills to effectively communicate with family members will ensure that the families’ level of preparedness, understanding and cultural beliefs are taken into consideration.