bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanical Properties and Microstructures of Gfrp Rebar after Long-Term Exposure to Chemical Environments
Authors: Park Hae-Kyun , Lee Su-Jin , Kim Yoon-Jeong , Jang Chang-Il , Won Jong-Pil 
Published: September 2018

This study describes accelerated degradation tests on glass fibre-reinforced polymer (GFRP) rebar to evaluate its long-term durability. The tests used simulated building acid, sulphate and de-icing environments. We measured the resulting reduction in the mechanical properties of the rebar and performed a microstructural degradation analysis of the rebar. The acidic environment consisted of a 0.6% acetic acid solution at a pH of 2.92, whereas the sulphate environment contained 3% sodium sulphate solution, and the de-icing environment was composed of 4% calcium chloride solution. Tensile strength tests were performed to measure the mechanical properties of the rebar after it was immersion in one of the environments for 50 to 100 days. We also measured the change in the internal pore distribution and in the shape of the rebar surface morphology using mercury intrusion porosimetry (MIP) and scanning electron microscopy (SEM) technology to observe the microstructure degradation. The tests demonstrated that GFRP rebar exposed to degradation environments exhibited only slight reductions in mechanical properties with time. Areas of surface degradation were difficult to observe in the SEM analysis, and the MIP pore values were very small, indicating a dense structure. Since the durability of GFRP rebar was not adversely affected to an appreciable degree by exposure to the degradation environments, it was deemed suitable for use in concrete reinforcements.
Plasticising and Stabilising Effect of Novel Epoxidised Mee Oil on PVC
Authors: Gamage Padmasiri K , Farid Ahmed S 
Published: September 2018

The plasticising and stabilising effects of novel epoxidised Mee oil (EMO) and its derivatives on poly (vinyl chloride) were investigated. Peroxymethanoic acid was used to epoxidise Mee oil and the product was characterised by FTIR, iodine value, and oxirane content. Solubility parameter values were also determined. Plasticising effects of PVC incorporating EMO were evaluated using tensile and mechanical properties as well as FTIR. It was found that substantial levels of 100% epoxidised oil derivatives of Mee oil (E100M) could be added to PVC; typically about 50 phr E100M with 30 phr of DOP. It was observed that increasing levels of E100M with DOP enhanced the plasticising efficiency; flexibility, percentage elongation, softness, and MFI. The stability provided by EMO in terms of changes in elastic modulus during high-temperature ageing was modelled kinetically, and it was found that the kinetic model obeyed a law of the form: ln (log Ea – log E) = kt + C Activation energy values for the change in elastic modulus of PVC suggest some degree of synergism between EMO and Ca/Zn stearate system. Clearly E100M may be regarded as an effective secondary plasticiser as well as a stabiliser; perhaps more so than the other oil derivatives of Mee oil.
An Introduction to the Mathematical Modeling in the Study of Cancer Systems Biology
Authors: Alameddine Abdallah K , Conlin Frederick , Binnall Brian 
Published: September 2018

Background: Frequently occurring in cancer are the aberrant alterations of regulatory onco-metabolites, various oncogenes/epigenetic stochasticity, and suppressor genes, as well as the deficient mismatch repair mechanism, chronic inflammation, or those deviations belonging to the other cancer characteristics. How these aberrations that evolve overtime determine the global phenotype of malignant tumors remains to be completely understood. Dynamic analysis may have potential to reveal the mechanism of carcinogenesis and can offer new therapeutic intervention. Aims: We introduce simplified mathematical tools to model serial quantitative data of cancer biomarkers. We also highlight an introductory overview of mathematical tools and models as they apply from the viewpoint of known cancer features. Methods: Mathematical modeling of potentially actionable genomic products and how they proceed overtime during tumorigenesis are explored. This report is intended to be instinctive without being overly technical. Results: To date, many mathematical models of the common features of cancer have been developed. However, the dynamic of integrated heterogeneous processes and their cross talks related to carcinogenesis remains to be resolved. Conclusions: In cancer research, outlining mathematical modeling of experimentally obtained data snapshots of molecular species may provide insights into a better understanding of the multiple biochemical circuits. Recent discoveries have provided support for the existence of complex cancer progression in dynamics that span from a simple 1-dimensional deterministic system to a stochastic (ie, probabilistic) or to an oscillatory and multistable networks. Further research in mathematical modeling of cancer progression, based on the evolving molecular kinetics (time series), could inform a specific and a predictive behavior about the global systems biology of vulnerable tumor cells in their earlier stages of oncogenesis. On this footing, new preventive measures and anticancer therapy could then be constructed.
The Implementation Gap in Laparoscopic Simulation Training
Authors: Fjørtoft K. , Konge L. , Gögenur I. , Thinggaard E. 
Published: September 2018

Background and Aims: Simulation-based training in laparoscopy can improve patient safety and efficiency of care, but it depends on how it is used. Research in medical education has moved from demonstrating transferability of simulation training to the operating room to how to best implement it. This study aims to investigate how simulation-based training in laparoscopy has been implemented Scandinavia. Material and Methods: An online survey was sent out to medical doctors at surgical, gynecological, and urological departments at 138 hospitals in Denmark, Norway, and Sweden. The questionnaire included questions on respondents’ baseline characteristics, opinions, access, and actual use of simulation-based training in laparoscopy. Results: In total, 738 respondents completed the survey. Of these, 636 (86.2%) of respondents agreed or strongly agreed that simulation-based training in laparoscopy should be mandatory. A total of 602 (81.6%) had access to simulation-based training in laparoscopy. Of the total 738 respondents, 141 (19.1%) were offered structured training courses, 129 (17.5%) were required to reach a predefined level of competency, and 66 (8.9%) had mandatory courses in laparoscopy. In all, 72 (9.8%) had never used simulation-based training in laparoscopy. Conclusion: An implementation gap in laparoscopic simulation-based training still exists in Scandinavia. Simulation equipment is generally available, but there is a lack of structured simulation-based training.
A New In-Mould Decoration Process using Real Wood Veneer
Authors: Makenji K. , Goodship V. , Buckley S. , Evered C. 
Published: September 2018

The use of real wood by manufacturers in automotive interiors is seen as a mark of a premium car quality. The current manufacture of aesthetic veneered components is both costly, resource demanding and time consuming. An alternative in-mould decoration manufacturing method is considered here, using back injection moulding of wood veneer onto plastic components. Two common polymer materials, polypropylene, (PP) and acrylonitrile, butadiene, styrene, (ABS) are used with four different types of wood veneer in a simple geometry plate mould. It was found that all these samples moulded satisfactorily and good adhesion was achieved. Shrinkage values of the mouldings are presented. Boil tests resulted in adhesion failure for all the ABS samples whilst the PP samples remained adhered to the wood laminate. This was found to be due to the rheology of the polymers and the resultant level of melt penetration, which was measured using optical microscopy. Scanning Electron Microscopy, (SEM) revealed that a high level of interaction is present at the interface with parts made from PP. The PP was found to penetrated voids and opening in the veneer and even travel into resin ducts. This was true throughout the range of veneer types. This high level of interaction has increased the surface area of the interface thereby securing a mechanical interlock condition. PP's of this MFI or higher would be suitable for this injection moulded application based on the findings to date. On the other hand parts made from ABS had a very poor level interaction present with voids evident at the interface in the order of 25 μm. The poor level of interaction has resulted in a low contact surface are resulting in the failure to the test regime.
Gender-related outcomes of chimney EVAR within the PERICLES registry
Authors: Torsello G , Usai MV , Scali S , Kubilis P , Veith FJ , Markatis F , Donas KP 
Published: September 2018

Objective Gender-related differences in outcomes in complex endovascular aortic repair have not been profoundly investigated. Use of low profile abdominal devices as in chimney endovascular repair may be beneficial for female patients with pararenal pathologies. With the chimney technique, there is no need for large introduction sheaths. This could be an advantage in case of smaller in diameter iliac access especially in combination with stenosis or elongation. Aim of the present study was to compare the perioperative and mid-term outcomes between males and females patients treated with the chimney/snorkel technique for pararenal aortic pathologies. Methods The PERICLES registry collected the world wide experience with the chimney technique. According to the gender, patients were classified in two cohorts. Primary endpoints were freedom from occlusion of the chimney grafts and reintervention. Secondary endpoints included access site complications and need for surgical or interventional revision, Endoleak Type I rate, 30-day overall complications and mortality. Univariate comparison P-values were generated using either the likelihood ratio χ2 test, the Fisher exact test, the Wilcoxon rank sum test, or the log rank test. Kaplan–Meier curves estimated the outcomes in the long run. Results A total of 412 patients underwent Ch-EVAR, 71 (17%) females and 341 (83%) males with a mean age for both groups being 74 years were included in the present study. After 36 months of mean follow-up, no statistically significant difference was observed between the two cohorts regarding re-interventions ( P= .44). Freedom from occlusion rates at 36 months did not differed between the two groups (females 84% vs. 80% for males ( P= .033). For patients receiving more than one chimney stent, the odds of having a complication did not differ between males and females (M:F OR = 2.0, 95% CI: 0.6–6.4, P = 0.228); 30-day mortality was 0% in the female group, instead five male patients died within one month. ( P = 0.59). The incidence of acute renal failure was low in both groups without statistical difference: 2 (3.1%) vs. 13 (4.6%) 58 ( P = 1.00). Neither patient received an endoconduit to insert the abdominal device. Conclusions No statistically significant difference regarding the freedom from reintervention and chimney graft patency was observed between the two genders. The results highlight the beneficial use of the chimney technique in female patients who can have potentially higher risk of access complications.
Association between serum uric acid and carotid disease in patients with atherosclerotic acute ischemic stroke
Authors: Arévalo-Lorido José Carlos , Carretero-Gómez Juana , Robles Pérez-Monteoliva Nicolás Roberto 
Published: September 2018

Aim The role of serum uric acid in ischemic stroke is controversial. On the one hand, it has a role as neuroprotectant in acute phase, but on the other hand, it may promote atherosclerosis in carotid arteries. Our aim is to investigate the association of serum uric acid levels at admission of acute ischemic stroke patients with carotid disease. Methods Cross-sectional study of patients admitted due to acute ischemic stroke. Clinical and laboratory variables were recorded. The carotid disease was defined based on the findings of carotid echography intima to media thickness and stenosis. Patients were grouped according to these findings. Robust statistical methods were applied into analysis. Results A total of 245 patients were recruited through a stroke registry. Their values of serum uric acid were related to both carotid intima to media thickness and stenosis showing a positive relationship between serum uric acid levels and intima to media thickness by Pearson correlation ( p < 0.05). Similarly, after adjusting for all potential confounders, eGFR, glucose, age and serum uric acid levels, (OR 1.26 (95% CI 1.04 −1.52, p¼0.01), were identified as independent predictors for having a intima to media thickness ≥1 mm. Similarly, by grouping patients in tertiles of the serum uric acid distribution, we found a predominantly greater carotid disease in the tertile with the highest levels of serum uric acid ( p < 0.005). Conclusion Our study supports the hypotheses that serum uric acid levels have different roles in the case of ischemic stroke. Its effects on the vascular wall contribute to the development of atherosclerosis and carotid disease.
What is the acceptability of real time 1:1 videoconferencing between clinicians and patients for a follow-up consultation for multi-directional shoulder instability?
Authors: Gilbert Anthony W , Jaggi Anju , May Carl R 
Published: September 2018

Background The use of real time 1:1 videoconferencing is growing in popularity in clinical practice. Authors have explored the effectiveness and acceptability of videoconferencing for patients; however, little research exists on the viewpoints of clinicians. Methods Patients with atraumatic shoulder instability attending a tertiary treatment centre were offered the choice of videoconferencing or a face-to-face consultation for their follow-up session. Immediately after the consultation a semi-structured interview was conducted to explore the underlying reasons behind its use and acceptability. Results All clinicians found the use of videoconferencing acceptable provided the patients were aware of its benefits and limitations. Of the 13 patients included in this study, seven chose to undergo a videoconferencing consultation. It was acceptable provided the clinical practice could be modified to achieve the objectives of the consultation. The use of videoconferencing required access to a quiet room with the appropriate technology. Conclusion Videoconferencing is not acceptable to all. Benefits included not having to travel and the opportunity to assess and treat patients in their home environment. The use of videoconferencing did not allow for ‘hands-on’ assessment which was important for less experienced clinicians.
Incidence Rate of Post-Kidney Transplant Infection: A Retrospective Cohort Study Examining Infection Rates at a Large Canadian Multicenter Tertiary-Care Facility
Authors: Cowan Juthaporn , Bennett Alexandria , Fergusson Nicholas , McLean Cheynne , Mallick Ranjeeta , Cameron D. William , Knoll Greg 
Published: September 2018

Background: Reducing post-operative infections among kidney transplant patients is critical to improve long-term outcomes. With shifting disease demographics and implementation of new transplantation protocols, frequent evaluation of infection rate and type is necessary. Objective: Our objectives were to assess the incidence and types of post-operative infections in kidney transplant recipients at a large tertiary-care facility and determine sample sizes needed for future intervention trials. Design: Retrospective cohort study. Setting: The Ottawa Hospital, Ottawa, Ontario. Patients: Adult kidney transplant patients, N = 142. Measurements: Demographic data, transplant protocol, infections up to 2 years following transplantation. Methods: Infections within 2 years following transplantation in all kidney transplant recipients between January 2011 and December 2012 were reviewed. Sample sizes were determined using all-cause infection rates and infection-free survival data. Results: Of 142 patients, 44 (31.0%) had at least one infection. The incidence of infection was 36.2 per 100 patient-years by 2 years post-transplant. A total of 32 (22.5%) patients had 56 infection-related hospitalizations with 73.2% occurring in the first year. In the first 2 years, urinary tract infections had the highest incidence (18.1 per 100 patient-years) followed by skin (3.9 per 100 patient-years), cytomegalovirus (3.9 per 100 patient-years), and bacteremia (3.9 per 100 patient-years). Results indicate that 206 patients per study arm would be needed to show a 30% reduction in the 2-year incidence of infection post-transplantation. Limitations: Infection rates may be slightly underestimated due to the relatively short 2-year follow-up; however, the highest infection-risk period was captured within this time frame. Conclusions: Infections post-kidney transplant are still common, particularly urinary tract infections. They are associated with significant morbidity and hospitalization. Given the feasible sample sizes calculated in this study, intervention trials are indicated to further reduce infection rates within the first 2 years post-kidney transplantation.
A Magnetic Resonance Imaging–Based Staging System for Osteochondritis Dissecans of the Elbow: A Validation Study Against the International Cartilage Repair Society Classification
Authors: Kohyama Sho , Ogawa Takeshi , Mamizuka Naotaka , Hara Yuki , Yamazaki Masashi 
Published: September 2018

Background: Evaluations of the stability of osteochondritis dissecans (OCD) lesions of the elbow using magnetic resonance imaging (MRI) have resulted in reports with variable accuracy. Therefore, the International Cartilage Repair Society (ICRS) classification remains the gold standard to determine OCD lesion stability. Because OCD commonly occurs in pediatric patients, a noninvasive method comparable with the ICRS classification is desired. Hypothesis/Purpose: Based on the previous literature, the capitellum of unstable OCD lesions has an irregular outline on MRI because of displacement or dislocation of the lesion via synovial fluid inflow. Therefore, we defined a 4-stage classification, similar to the ICRS classification, which focused on the outline of the capitellum and articular cartilage status on MRI without subchondral bone information. The purpose of this study was to validate this MRI-based staging system against the ICRS classification and to verify its accuracy in diagnosing unstable OCD lesions of the elbow. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 81 patients with OCD of the elbow who were surgically treated were evaluated. The MRI-based stages were as follows: stage 1, normal-shaped capitellum and articular cartilage without signal intensity change; stage 2, normal-shaped capitellum and articular cartilage with signal intensity change; stage 3, irregular-shaped capitellum and discontinuity of the articular cartilage; and stage 4, dislocated lesion with an articular cartilage defect. Agreement between the MRI and ICRS classifications was evaluated, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for lesion instability were determined. The intraclass correlation coefficient (ICC) for intrarater and interrater reliability of the MRI-based staging system was calculated. Results: Agreement between the MRI-based staging system and the ICRS classification was 88.9%, with a sensitivity of 98.4%, specificity of 84.2%, PPV of 95.3%, and NPV of 94.1% for diagnosing an unstable lesion. The ICC was high for both intrarater (0.925) and interrater (0.915-0.939) reliability. Conclusion: The MRI-based staging system corresponded well with the ICRS classification, providing an accurate preoperative assessment of OCD lesions of the elbow, even with minimal subchondral bone information.
Reforming care without bureaucracy
Authors: Tyrer Peter 
Published: September 2018

The Care Programme Approach was a valiant attempt to improve the aftercare of people with severe mental illness after discharge from hospital. It was introduced as a response to a scandal, not an advance in knowledge, and has always suffered by being a reaction to events rather than a trailblazer for the future. It may have dragged the worst of care upwards, but at the expense of creating a bureaucratic monstrosity that has hindered good practice by excessive attention to risk, and vastly increased paperwork with intangible benefit. It needs to be simplified to allow practitioners greater scope for collaborative solutions, less minatory oversight and better use of strained resources.Declaration of interestNone.
Clozapine is associated with secondary antibody deficiency
Authors: Ponsford Mark , Castle Daniel , Tahir Tayyeb , Robinson Rebecca , Wade Wendy , Steven Rachael , Bramhall Kathryn , Moody Mo , Carne Emily , Ford Catherine , Farewell Daniel , Williams Paul , El-Shanawany Tariq , Jolles Stephen 
Published: September 2018

BackgroundSchizophrenia affects 1% of the population. Clozapine is the only medication licensed for treatment-resistant schizophrenia and is intensively monitored to prevent harm from neutropenia. Clozapine is also associated with increased risk of pneumonia although the mechanism is poorly understood.AimsTo investigate the potential association between clozapine and antibody deficiency.MethodsPatients taking clozapine and patients who were clozapine-naive and receiving alternative antipsychotics were recruited and completed a lifestyle, medication and infection-burden questionnaire. Serum total immunoglobulins (immunoglobulin (Ig)G, IgA, IgM) and specific IgG antibodies to haemophilus influenzae type B, tetanus and IgG, IgA and IgM to pneumococcus were measured.ResultsImmunoglobulins were all significantly reduced in the clozapine-treated group (n= 123) compared with the clozapine-naive group (n= 111). Odds ratios (ORs) for a reduction in clozapine:control immunoglobulin values below the fifth percentile were IgG, OR = 6.00 (95% CI 1.31–27.44); IgA, OR = 16.75 (95% CI 2.18–128.60); and IgM, OR = 3.26 (95% CI 1.75–6.08). These findings remained significant despite exclusion of other potential causes of hypogammaglobulinaemia. In addition, duration on clozapine was associated with decline in IgG. A higher proportion of the clozapine-treated group reported taking more than five courses of antibiotics in the preceding year (5.3% (n= 5) versus 1% (n= 1).ConclusionsClozapine use was associated with significantly reduced immunoglobulin levels and an increased proportion of patients using more than five antibiotic courses in a year. Antibody testing is not included in existing clozapine monitoring programmes but may represent a mechanistic explanation and modifiable risk factor for the increased rates of pneumonia and sepsis-related mortality previously reported in this vulnerable cohort.Declaration of interestS.J. has received support from CSL Behring, Shire, LFB, Biotest, Binding Site, Sanofi, GSK, UCB Pharma, Grifols, BPL SOBI, Weatherden, Zarodex and Octapharma for projects, advisory boards, meetings, studies, speaker and clinical trials.