bluuebunny/crossref_metadata_2025_split huggingface dataset:
PERFORMANCE OF STONE MASTIC ASPHALT MIX USING SELECTED FIBRES
Authors: Arshad Ahmad Kamil , Mansor Syahirah , Shafie Ekarizan , Hashim Wardati 
Published: July 2016

Stone Mastic Asphalt (SMA) is a gap-graded asphalt mixture that depends on the stone-to-stone contact to provide its load carrying capacity against rutting. However, binder draindown is a problem for SMA mixtures, due to its intentional high binder content. This paper details the performance evaluation of two different cellulose fibres used in SMA14 mix; synthetic fibre (Viatop66) and natural fibre (Kenaf) to prevent binder drainage. The cellulose fibres, 0.3 percent by weight of the mixture, were uniformly combined with the dried aggregate before the asphalt cement was added during mixing process. Laboratory specimens were prepared using 50 blows of the Marshall hammer per side. The Optimum Binder Content (OBC) for the SMA14 mix with Viatop66 was found to be 6.1 percent, while the OBC for the SMA14 mix with Kenaf was found to be 5.9 percent. Rut depth obtained for SMA14 mix Kenaf was lower (1.6 mm) compared with SMA14 mix with Viatop66 (1.8 mm). The tensile strength ratio recorded for both mixes are greater than 80 percent, indicating adequate stripping resistance. The fibres were found to interact well with other substances in the SMA14 mix using the Environment Scanning Electron Microscopy (ESEM). This indicates that the natural fibre could efficiently retain the binder in the mix. Therefore, natural fibre (Kenaf) could be an alternative material to replace the synthetic fibre for the SMA14 mixture.
Failure Mechanisms of Weld Bonded Lap Joints Between Composite/Metal Adherends
Authors: Li Lijun , Sun Lingyu 
Published: July 2016

Weld-bonding, a combination of spot welding and adhesive bonding, is a primary method of joining the composite underbody to the steel body-in-white (BIW). This concept is provided by the Automotive Composites Consortium (ACC) to ensure the compatibility with the OEM assembly processes.
This paper established the finite element model of the weld bonded lap joint based on the published specimen dimensions, and compared the ultimate load and failure mode with their experimental results. Their good agreements demonstrated the accuracy of the numerical model and simulation method. Using this model, the progressive failures within the joints were predicted under static tensile loading and impact loading, respectively. The impact resistant capability of this joint was evaluated and the load transfer path among the adhesives, welded spot, composite and HSS adherend was discussed. The influences of relative thickness and relative stiffness between the adhesives and the two adherends on the failure modes were studied numerically, and the map chart for failure mode prediction was provided for weld bonded lap joints of bi-materials adherends, which is helpful for engineering application.
Survival of the Fittest: How Bacterial Pathogens Utilize Bile To Enhance Infection
Authors: Sistrunk Jeticia R. , Nickerson Kourtney P. , Chanin Rachael B. , Rasko David A. , Faherty Christina S. 
Published: July 2016

SUMMARY

Bacterial pathogens have coevolved with humans in order to efficiently infect, replicate within, and be transmitted to new hosts to ensure survival and a continual infection cycle. For enteric pathogens, the ability to adapt to numerous host factors under the harsh conditions of the gastrointestinal tract is critical for establishing infection. One such host factor readily encountered by enteric bacteria is bile, an innately antimicrobial detergent-like compound essential for digestion and nutrient absorption. Not only have enteric pathogens evolved to resist the bactericidal conditions of bile, but these bacteria also utilize bile as a signal to enhance virulence regulation for efficient infection. This review provides a comprehensive and up-to-date analysis of bile-related research with enteric pathogens. From common responses to the unique expression of specific virulence factors, each pathogen has overcome significant challenges to establish infection in the gastrointestinal tract. Utilization of bile as a signal to modulate virulence factor expression has led to important insights for our understanding of virulence mechanisms for many pathogens. Further research on enteric pathogens exposed to this
in vivo
signal will benefit therapeutic and vaccine development and ultimately enhance our success at combating such elite pathogens.
Stress Physiology of Lactic Acid Bacteria
Authors: Papadimitriou Konstantinos , Alegría Ángel , Bron Peter A. , de Angelis Maria , Gobbetti Marco , Kleerebezem Michiel , Lemos José A. , Linares Daniel M. , Ross Paul , Stanton Catherine , Turroni Francesca , van Sinderen Douwe , Varmanen Pekka , Ventura Marco , Zúñiga Manuel , Tsakalidou Effie , Kok Jan 
Published: July 2016

SUMMARY

Lactic acid bacteria (LAB) are important starter, commensal, or pathogenic microorganisms. The stress physiology of LAB has been studied in depth for over 2 decades, fueled mostly by the technological implications of LAB robustness in the food industry. Survival of probiotic LAB in the host and the potential relatedness of LAB virulence to their stress resilience have intensified interest in the field. Thus, a wealth of information concerning stress responses exists today for strains as diverse as starter (e.g.,
Lactococcus lactis
), probiotic (e.g., several
Lactobacillus
spp.), and pathogenic (e.g.,
Enterococcus
and
Streptococcus
spp.) LAB. Here we present the state of the art for LAB stress behavior. We describe the multitude of stresses that LAB are confronted with, and we present the experimental context used to study the stress responses of LAB, focusing on adaptation, habituation, and cross-protection as well as on self-induced multistress resistance in stationary phase, biofilms, and dormancy. We also consider stress responses at the population and single-cell levels. Subsequently, we concentrate on the stress defense mechanisms that have been reported to date, grouping them according to their direct participation in preserving cell energy, defending macromolecules, and protecting the cell envelope. Stress-induced responses of probiotic LAB and commensal/pathogenic LAB are highlighted separately due to the complexity of the peculiar multistress conditions to which these bacteria are subjected in their hosts. Induction of prophages under environmental stresses is then discussed. Finally, we present systems-based strategies to characterize the “stressome” of LAB and to engineer new food-related and probiotic LAB with improved stress tolerance.
Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre
Authors: Day Alexander C , Dhallu Sandeep K , Maurino Vincenzo , Wilkins Mark R 
Published: July 2016

ObjectivesTo describe the initial outcomes following installation of a cataract surgery laser system.SettingNational Health Service cataract surgery day care unit in North London, UK.Participants158 eyes of 150 patients undergoing laser-assisted cataract surgery.InterventionsLaser cataract surgery using the AMO Catalys femtosecond laser platform.Primary and secondary outcome measuresPrimary outcome measure: intraoperative complications including anterior and posterior capsule tears. Secondary outcome measures: docking to the laser platform, successful treatment delivery, postoperative visual acuities.ResultsMean case age was 67.7±10.8 years (range 29–88 years). Docking was successful in 94% (148/158 cases), and in 4% (6/148 cases) of these, the laser delivery was aborted part way during delivery due to patient movement. A total of 32 surgeons, of grades from junior trainee to consultant, performed the surgeries. Median case number per surgeon was 3 (range from 1–20). The anterior capsulotomy was complete in 99.3% of cases, there were no anterior capsule tears (0%). There were 3 cases with posterior capsule rupture requiring anterior vitrectomy, and 1 with zonular dialysis requiring anterior vitrectomy (4/148 eyes, 2.7%). These 4 cases were performed by trainee surgeons, and were either their first laser cataract surgery (2 surgeons) or their first and second laser cataract surgeries (1 surgeon).ConclusionsDespite the learning curve, docking and laser delivery were successfully performed in almost all cases, and surgical complication rates and visual outcomes were similar to those expected based on national data. Complications were predominately confined to trainee surgeons, and with the exception of intraoperative pupil constriction appeared unrelated to the laser-performed steps.
‘My independent streak may get in the way’: how older adults respond to falls prevention education in hospital
Authors: Hill Anne-Marie , Francis-Coad Jacqueline , Haines Terry P , Waldron Nicholas , Etherton-Beer Christopher , Flicker Leon , Ingram Katharine , McPhail Steven M 
Published: July 2016

ObjectivesThe aim of the study was to determine how providing individualised falls prevention education facilitated behaviour change from the perspective of older hospital patients on rehabilitation wards and what barriers they identified to engaging in preventive strategies.DesignA prospective qualitative survey.MethodsOlder patients (n=757) who were eligible (mini-mental state examination score>23/30) received falls prevention education while admitted to eight rehabilitation hospital wards in Western Australia. Subsequently, 610 participants were surveyed using a semistructured questionnaire to gain their response to the in-hospital education and their identified barriers to engaging in falls prevention strategies. Deductive content analysis was used to map responses against conceptual frameworks of health behaviour change and risk taking.ResultsParticipants who responded (n=473) stated that the education raised their awareness, knowledge and confidence to actively engage in falls prevention strategies, such as asking for assistance prior to mobilising. Participants’ thoughts and feelings about their recovery were the main barriers they identified to engaging in safe strategies, including feeling overconfident or desiring to be independent and thinking that staff would be delayed in providing assistance. The most common task identified as potentially leading to risk-taking behaviour was needing to use the toilet.ConclusionsIndividualised education assists older hospital rehabilitation patients with good levels of cognition to engage in suitable falls prevention strategies while on the ward. Staff should engage with patients to understand their perceptions about their recovery and support patients to take an active role in planning their rehabilitation.
Six ways not to improve patient flow: a qualitative study
Authors: Kreindler Sara Adi 
Published: July 2016

BackgroundAlthough well-established principles exist for improving the timeliness and efficiency of care, many organisations struggle to achieve more than small-scale, localised gains. Where care processes are complex and include segments under different groups' control, the elegant solutions promised by improvement methodologies remain elusive. This study sought to identify common design flaws that limit the impact of flow initiatives.MethodsThis qualitative study was conducted within an explanatory case study of a Canadian regional health system in which multitudinous flow initiatives had yielded no overall improvement in system performance. Interviews with 62 senior, middle and departmental managers, supplemented by ∼700 documents on flow initiatives, were analysed using the constant comparative method.ResultsFindings suggested that smooth flow depends on linking a definedpopulationto appropriatecapacityby means of an efficientprocess; flawed initiatives reflected failure to consider one or more of these essential elements. Many initiatives focused narrowly on process, failing to consider that the intended population was poorly defined or the needed capacity inaccessible; some introduced capacity for an intended population, but offered no process to link the two. Moreover, interveners were unable to respond effectively when a bottleneck moved to another part of the system. Errors of population, capacity and process, in different combinations, generated six ‘formulae for failure’.ConclusionsTypically, flawed initiatives focused on too small a segment of the patient journey to properly address the impediments to flow. The proliferation of narrowly focused initiatives, in turn, reflected a decentralised system in which responsibility for flow improvement was fragmented. Thus, initiatives' specific design flaws may have their roots in a deeper problem: the lack of a coherent system-level strategy.
One-two-triage: validation and reliability of a novel triage system for low-resource settings
Authors: Khan Ayesha , Mahadevan S V , Dreyfuss Andrea , Quinn James , Woods Joan , Somontha Koy , Strehlow Matthew 
Published: July 2016

ObjectivesTo validate and assess reliability of a novel triage system, one-two-triage (OTT), that can be applied by inexperienced providers in low-resource settings.MethodsThis study was a two-phase prospective, comparative study conducted at three hospitals. Phase I assessed criterion validity of OTT on all patients arriving at an American university hospital by comparing agreement among three methods of triage: OTT, Emergency Severity Index (ESI) and physician-defined acuity (the gold standard). Agreement was reported in normalised and raw-weighted Cohen κ using two different scales for weighting, Expert-weighted and triage-weighted κ. Phase II tested reliability, reported in Fleiss κ, of OTT using standardised cases among three groups of providers at an urban and rural Cambodian hospital and the American university hospital.ResultsNormalised for prevalence of patients in each category, OTT and ESI performed similarly well for expert-weighted κ (OTT κ=0.58, 95% CI 0.52 to 0.65; ESI κ=0.47, 95% CI 0.40 to 0.53) and triage-weighted κ (κ=0.54, 95% CI 0.48 to 0.61; ESI κ=0.57, 95% CI 0.51 to 0.64). Without normalising, agreement with gold standard was less for both systems but performance of OTT and ESI remained similar, expert-weighted (OTT κ=0.57, 95% CI 0.52 to 0.62; ESI κ=0.6, 95% CI 0.58 to 0.66) and triage-weighted (OTT κ=0.31, 95% CI 0.25 to 0.38; ESI κ=0.41, 95% CI 0.35 to 0.4). In the reliability phase, all triagers showed fair inter-rater agreement, Fleiss κ (κ=0.308).ConclusionsOTT can be reliably applied and performs as well as ESI compared with gold standard, but requires fewer resources and less experience.
Does elevated urinary 5-hydroxyindole acetic acid level predict acute appendicitis in children?
Authors: Bosak Versic Ana , Glavan Nedeljka , Bukvic Nado , Tomasic Zlatko , Nikolic Harry 
Published: July 2016

BackgroundAcute appendicitis is the most common abdominal surgical emergency in children, and appendectomy is the most frequent acute abdominal operation. Prompt diagnosis and surgical treatment are required to reduce the risk of perforation and prevent complications, especially in small children. Enterochromaffin cells that contain large amounts of serotonin are mostly located in the distal appendix. Serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) could therefore be a marker for acute appendicitis.ObjectiveWe tested urinary 5-HIAA concentrations in spot urine samples from children with acute appendicitis.MethodsWe enrolled 93 patients who underwent surgery for suspicion of acute appendicitis. The diagnosis was made intraoperatively and confirmed histopathologically. Additionally, urine samples from 102 healthy children were collected as controls. Their 5-HIAA was measured using high-performance liquid chromatography.ResultsAcute appendicitis was diagnosed in 81 patients, whereas there were other explanations for abdominal pain in the remaining 12 patients in the non-appendicitis group. The control group comprised 102 healthy children. Considering the median of all measured 5-HIAA values as the cut-off, we analysed the proportions of patients with elevated values in all the groups. Our analysis showed that statistically there was no significant difference in the distribution of percentages among the groups. The area under the curve for 5-HIAA was 0.55 (95% CI 0.47 to 0.62) with sensitivity and specificity 60.4% and 48.9%, respectively.ConclusionsUrine 5-HIAA concentration measured in spot samples is not a reliable method for diagnosing acute appendicitis in children.
A systematic review of patients', parents' and healthcare professionals' adrenaline auto-injector administration techniques
Authors: El Turki Aisha , Smith Helen , Llewellyn Carrie , Jones Christina J 
Published: July 2016

IntroductionIn order to enable fast treatment response to anaphylactic reactions, adrenaline auto-injectors (AAI) have been developed and manufactured. It has been reported in several studies that administration technique is suboptimal. The primary purpose of this study was to review the nature and extent of the deficiencies in administration technique among patients, parents/caregivers and healthcare professionals.MethodsRelevant publications were identified between 1998 and 2015 using two search methods: a keyword search in Embase, PubMed, British Nursing Index and Cumulative Index to Nursing and Allied Health Literature and a search of reference lists of relevant articles.ResultsTwenty-three studies met the inclusion criteria. Overall, 37% of patients, 32% of parents/caregivers and 21% of healthcare professionals demonstrated correct administration technique. For studies which employed a before-and-after training study design, correct technique was achieved in 77% of patients, 79% of caregivers and 65% of healthcare professionals. The most consistently observed error was the failure to hold the device in place for the recommended time. For patients, factors associated with good technique were being aged over 18 years, trained in AAI administration by an allergist, prescribed an AAI for more than 30 months, having a history of severe anaphylaxis and membership of a support group. For parents/caregivers in addition to those mentioned, being given a training device with which to practice, improved technique.DiscussionThere was wide variation in administration techniques reported. However, studies designed using before-and-after training show that even a brief demonstration and educational intervention can improve technique. Further studies are required to design and pilot acceptable and cost-effective educational materials.
Response of Manitoba soils to banding phosphorus with sulfate or carbonate salts
Authors: Manimel Wadu Mihiri C.W. , Goh Tee Boon , Akinremi Olalekan O. 
Published: July 2016

Applications of sulfate and carbonate salts have been shown to improve the solubility of phosphorus (P) in model calcareous soils. It is unclear how these treatments will influence P solubility in real soils. The objective of this study was to determine the effect of sulfate or carbonate salts on P solubility in selected Manitoba soils. We hypothesized that the application of carbonate or sulfate salts in a fertilizer band could enhance the solubility of P in Manitoba soils. Different salt mixtures were prepared by mixing either monopotassium phosphate (MPP) or monoammonium phosphate (MAP) with K2SO4, (NH4)2SO4, MgSO4, or (NH4)2CO3. After the 2 wk of incubation of salt-treated soils, both P sources decreased soil pH significantly. The addition of salts did not significantly affect pH in most of the soils. There was a significant treatment effect (P < 0.0001), a significant soil effect (P < 0.0001), and a significant soil by treatment interaction (P < 0.0001) on water-extractable P. Coapplication of either sulfates or (NH4)2CO3salt increased soluble P in some soils by 6%–44% or 11%–14%, respectively. Application of carbonate or sulfate salts increased P solubility only in soils with a smaller ratio of HCl-extractable Ca to ammonium acetate-extractable Ca.
Nuclear factor-κB regulates expression of platelet phospholipase C-β2 (PLCB2)
Authors: Mao Guangfen , Jin Jianguo , Kunapuli Satya P. , Rao A. Koneti 
Published: July 2016

SummaryPhospholipase C (PLC)-β2 (gene PLCB2) is a critical regulator of platelet responses upon activation. Mechanisms regulating of PLC-β2 expression in platelets/MKs are unknown. Our studies in a patient with platelet PLC-β2 deficiency revealed the PLCB2 coding sequence to be normal and decreased platelet PLC-β2 mRNA, suggesting a defect in transcriptional regulation. PLCB2 5’- upstream region of the patient revealed a heterozygous 13 bp deletion (-1645/-1633 bp) encompassing a consensus sequence for nuclear factor-κB (NF-κB). This was subsequently detected in three of 50 healthy subjects. To understand the mechanisms regulating PLC-β2, we studied the effect of this variation in the PLCB2. Gel-shift studies using nuclear extracts from human erythroleukaemia (HEL) cells or recombinant p65 showed NF-κB binding to oligonucleotide with NF-κB site; in luciferase reporter studies its deletion reduced PLCB2 promoter activity. PLCB2 expression was decreased by siRNA knockdown of NF-κB p65 subunit and increased by p65 overexpression. By immunoblotting platelet PLC-β2 in 17 healthy subjects correlated with p65 (r=0.76, p=0.0005). These studies provide the first evidence that NF-kB regulates MK/platelet PLC-β2 expression. This interaction is important because of the major role of PLC-β2 in platelet activation and of NF-κB in processes, including inflammation and atherosclerosis, where both are intimately involved.Supplementary Material to this article is available online at www.thrombosis-online.com.
Nocturnal Hypoxemia Due to Obstructive Sleep Apnea Is an Independent Predictor of Poor Prognosis After Myocardial Infarction
Authors: Xie Jiang , Sert Kuniyoshi Fatima H. , Covassin Naima , Singh Prachi , Gami Apoor S. , Wang Shihan , Chahal C. Anwar A. , Wei Yongxiang , Somers Virend K. 
Published: July 2016

Background

Obstructive sleep apnea (
OSA
) is an important risk factor for the development of cardiovascular diseases including myocardial infarction (
MI
). The aim of this study was to investigate the effects of
OSA
on prognosis after
MI
, and to determine which specific measures of
OSA
severity best predicted outcomes.

Methods and Results

We performed a prospective study, in which 112 patients without a prior diagnosis of sleep apnea underwent comprehensive polysomnography within a median of 7 days after
MI
. Patients were followed up at 6‐monthly intervals (±2 weeks) for a total of 48 months. Patients classified with central apnea (n=6) or those using continuous positive airway pressure (n=8) after polysomnography were excluded from analyses. The primary end point was major adverse cardiac events, including death from any cause, recurrent
MI
, unstable angina, heart failure, stroke, and significant arrhythmic events. Forty of 98 patients (41%) had
OSA
(apnea‐hypopnea index ≥15 events/h).
OSA
patients had higher major adverse cardiac event rates when compared to those without
OSA
(47.5% versus 24.1%; χ
2
=5.41,
P
=0.020). In a multivariate model that adjusted for clinically relevant variables including age, left ventricular ejection fraction, diabetes mellitus, oxygen desaturation index, and arousal index, significant hypoxemia, as defined by nocturnal nadir oxygen saturation ≤85%, was an independent risk factor for major adverse cardiac events (hazard ratio=6.05,
P
=0.004) in follow‐up 15 months after baseline.

Conclusions

Nocturnal hypoxemia in
OSA
is an important predictor of poor prognosis for patients after
MI
. These findings suggest that routine use of low‐cost nocturnal oximetry may be an economical and practical approach to stratify risk in post‐
MI
patients.