bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the correlation between scales determining disease severity in patients with moderate‐severe chronic plaque‐type psoriasis
Authors: Gundogdu Mustafa , Kundakci Nihal
Published: November 2020

Background

Psoriasis is a chronic erythematous‐squamous disease. The results of studies related with the correlation between methods used in determining disease severity are contradictory.

Aims

The aim of this cross‐sectional study is to evaluate the correlation between Psoriasis Area and Severity Index (PASI) and body surface area (BSA) involvement which are used to determine psoriasis severity and which are evaluated by the physician and Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI) which are evaluated by the patients.

Methods

Demographic data, PASI, BSA, DLQI, and PDI values of the patients were recorded. The correlation between the scales was evaluated.

Results

51 patients, 11 female (21.6%) and 40 male (78.4%), were included in the study. Average age was found as 44.76 ± 11.14, while average disease duration was found as 20.74 ± 7.94. Average PASI, BSA, DLQI and PDI values were found as 17.27 ± 7.49, 33.90 ± 13.87, 15.09 ± 7.48, 23.58 ± 10.20, respectively. In the evaluation of the correlation between the scales, while PASI was found to be correlated with BSA involvement (r = 0.780 P = .000), DLQI and PDI were not found to be correlated. On the other hand, correlation was also found between DLQI and PDI (r = 0.641 P = .000).

Conclusion

There is no correlation between physical assessment methods (PASI, BSA) and quality of life scales (DLQI, PDI).
Emergency stress management among nurses: A lesson from the COVID‐19 outbreak in China–a cross‐sectional study
Authors: Liao Changju , Guo Linghong , Zhang Cuicui , Zhang Meiqi , Jiang Wenjing , Zhong Ying , Lin Qingfang , Liu Yin
Published: November 2020

Aims and objectives

To assess the level of stress response, self‐efficacy and perceived social support status of working nurses during the outbreak of the COVID‐19 and investigate potential factors affecting their stress.

Background

The stress level of clinical nurses directly affects their physical and mental health and work efficiency.

Design

This study was a cross‐sectional investigation, which was performed following the STROBE checklist. The current study was conducted in February 2020 by selecting clinical nurses from the Zigong First People's Hospital for investigation.

Methods

At the peak of the COVID‐19 outbreak in China, we assessed clinical nurses with the Stanford Acute Stress Reaction Questionnaire, the General Self‐Efficacy Scale and the Perceived Social Support Scale. Specifically, the nurses were divided into three groups: (a) nurses supporting Wuhan; (b) nurses in the department of treating the COVID‐19 patients in our hospital (epidemic department); and (c) nurses in the general department without the COVID‐19 patients in our hospital (non‐epidemic department).

Results

A total of 1092 clinical nurses were surveyed with 94 nurses in Wuhan, 130 nurses treating COVID‐19 patients in our hospital and 868 nurses working without direct contact with diagnosed COVID‐19 patients. The mean stress score of all surveyed nurses was 33.15 (SD: 25.551). There was a statistically significant difference in stress response scores between different departments. Noticeably, the nurses who went to support in Wuhan showed a weaker stress response than the nurses who stayed in our hospital (mean: 19.98 (Wuhan) vs. 32.70 (epidemic department in our hospital) vs. 34.64 (non‐epidemic department in our hospital)). In addition, stress was negatively correlated with general self‐efficacy and perceived social support.

Conclusion

The present study suggested that the stress status of second‐line nurse without direct contact with diagnosed COVID‐19 patients was more severe than that of first‐line nurses who had direct contact with COVID‐19 patients.

Relevance to clinical practice

Our study indicated the importance of psychological status of second‐line medical staff during the global pandemic.
Psychological differences between toilet trained and non‐toilet trained 4‐year‐old children
Authors: Axelrod Michael I. , Larsen Ray J. , Jorgensen Keith , Stratman Bobbie
Published: November 2020

Objective

Late to complete toilet training has been associated with many psychological factors including behavior and mood problems. Unfortunately, the majority of the research is specific to children with elimination disorders or children identified as incontinent after the age of 7 years. The current study addressed gaps in the literature by comparing the psychological functioning of children not toilet trained by their 4‐year‐old well child care visit with their toilet trained peers.

Design and Methods

Parent reports of internalizing and externalizing behavior using the Child Behavior Checklist (CBCL) were compared across groups, non‐toilet trained and toilet trained, for 150 children recruited during their 4‐year‐old well child health care visit. Independent samples t tests of group means and χ2 analyses were performed on all CBCL scales.

Results

Results found no clinically or statistically significant differences between groups on parents' reports of internalizing and externalizing behavior. The current study provides no evidence that delays in successfully completing toilet training by 4 years of age were related to psychological problems for this sample of children.

Practice Implications

Nursing professionals in primary care settings are positioned to provide anticipatory guidance to parents of children not yet toilet trained. Findings from the current study offer evidence that delays in toilet training might not be related to psychopathology, and these children are not likely to require intervention outside the pediatric setting and could be effectively managed by primary care health providers employing evidence‐based toilet training protocols.
Hepatitis C virus infection mortality trends according to three definitions with special concern for the baby boomer birth cohort
Authors: Sheu Ming‐Jen , Liang Fu‐Wen , Lu Tsung‐Hsueh
Published: November 2020

We examined mortality trends of hepatitis C virus (HCV) infection in the United States in 1999‐2018 according to the following definitions: HCV as the underlying cause of death (UCOD), HCV mentioned anywhere on the death certificate (mentioned), and HCV recorded in Part 1 of the death certificate. By using entity axis information in mortality multiple‐cause files, we ascertained the position of HCV on the death certificate. Joinpoint regression analysis was used to evaluate changes in HCV mortality rates according to the definitions. The age‐standardized HCV mortality rates (deaths per 100,000 people) in terms of UCOD, mentioned, and Part 1 were, respectively, 1.36, 2.87 and 1.94, in 1999; increased to 1.90, 5.09 and 2.96 in 2013; and declined to 0.98, 3.77 and 2.29 in 2018. The mentioned/UCOD mortality ratio was 2.11 in 1999 and increased to 3.86 in 2018. The mentioned/Part 1 ratio was almost identical (ie 1.48 in 1999 and 1.65 in 2018). The extent of decline from 2014 to 2018 differed according to the definitions; the annual per cent changes for UCOD, mentioned, and Part 1 were −14.6%, −7.1% and −9.8%, respectively. For the same age group, the baby boomer subcohort 1950‐1954 had the highest mortality rates among the subcohorts (1945‐1949, 1955‐1959 and 1960‐1964). HCV mortality according to HCV in Part 1 of the death certificate—the explicit opinion of a certifying physician that HCV played a substantial role and directly caused death—differed from that according to HCV as UCOD and HCV mentioned.
Is there a unique symptom in lower urinary tract dysfunction in children?
Authors: Özen Mehmet A. , Taşdemir Mehmet , Aygün Murat S. , Necef Işıl , Aydın Emrah , Bilge Ilmay , Eroğlu Egemen
Published: November 2020

Objectives

Lower urinary tract symptoms (LUTS), particularly urgency, incontinence and intermittency are common in children and it is suggested that the specific symptoms may be used for definite diagnosis for LUT dysfunction (LUTD). This study was performed to investigate the relationship between each LUTD and its associated symptoms, using uroflowmetry/electromyography (UF/EMG) as a diagnostic tool.

Methods

Each patient was categorized into one of four LUT conditions which were overactive bladder (OAB), dysfunctional voiding (DV), underactive bladder and primary bladder neck dysfunction (PBND), according to UF/EMG results. Patients' complaints and findings were documented by using voiding dysfunction symptom score, bladder diary, urine analysis and ultrasonography. In addition, a detailed history of bowel habits (including use of Rome III criteria) was obtained.

Results

There were 189 children of which 106 were female. The OAB was the largest group including 91 patients, followed by the DV group which had 61 patients. The symptoms specific to any LUTD group were constipation and hesitancy (P < .05). Hesitancy was present in 89.4% with PBND and constipation was present in 78.6% of patients with DV. None of other symptoms were able to differentiate any LUTD group from the other.

Conclusions

While certain symptoms are often presumed by clinicians to imply specific diagnoses, the main outcome of this study is that there is a generally weak correlation between the specificity of symptoms and LUTD. Symptoms‐based approach may lead to misdiagnosis in LUTD. Thus, it may be essential to focus on the underlying pathologies and UF/EMG test may help this.
Medical students' experiences and needs from written reflective journal feedback
Authors: Rozental Lior , Meitar Dafna , Karnieli‐Miller Orit
Published: November 2020

Introduction

Reflective ability is an important skill for enhancing professionalism and developing communication skills. To improve reflective ability, medical educators encourage use of written reflective journals, for which feedback is important. It is difficult for educators to anticipate how their feedback will be perceived. Therefore, this study examined students' experiences with educators' written feedback on reflective journals.

Methods

A qualitative, immersion/crystallization analysis of 60 written feedback texts to 15 medical students (30 identified by students as meaningful and 30 as less meaningful) and in‐depth semi‐structured interviews with these students. We did not define ‘meaningful’, to leave room for students' own interpretations. We analysed the feedback to identify what it includes (its components) and analysed the interviews to learn about students' experiences of receiving the feedback and the specific components.

Results

Students experienced five components as meaningful: supportive and encouraging statements; legitimisation of their emotions; educators sharing personal‐professional experiences; asking questions to enhance reflection; and focusing on the students' main concern. These components enhanced students' willingness to read and learn from the feedback. Three components were experienced as less meaningful: detached, impersonal feedback; negative tone (criticism); and technical issues, for example brevity. These disappointing and hurtful components led students to pay less attention to the feedback or to invest less effort in future written assignments.

Conclusions

The present study identified components in written reflective journal feedback texts and the experience and needs of students who received them. It showed the complexity of writing reflective feedback because of the need to support students through it, help them deal with emotions, identify and focus on personal content that matters to them, and provide opportunities to develop and enhance their reflective ability, while being mindful of their emotional state. To help educators in this challenging task, a self‐assessment mnemonic (‘FEEDBACK’) for use before sending the initial feedback was developed.
Exosomes derived from idiopathic gingival fibroma fibroblasts regulate gingival fibroblast proliferation and apoptosis
Authors: Yin Shunhui , Jia Fengmei , Ran Liquan , Xie Liangkun , Wu Zhiyao , Zhan Yeming , Zhang Yan , Zhang Mingzhu
Published: November 2020

Objective

Exosomes have been proved to play an essential role in intercellular information transmission. However, few researches focused on exosomes derived from gingival fibroblasts (GFs) of IGF. The aim of this study is to investigate the effect of exosomes derived from GFs of IGF (IGF‐GFs) on the proliferation and apoptosis of normal gingival fibroblasts (N‐GFs).

Methods

Gingival fibroblasts were cultured and identified using immunocytochemistry. Exosomes were isolated with exosomes extraction kit and characterized by transmission electron microscopy (TEM) and flow cytometry. PKH67 labeling was further used to trace the intracellular distribution of the exosomes. And MTS assay was used to test the effective concentration and time course of IGF‐GFs‐derived exosomes. Furthermore, the expression of PCNA, Ki67, Bcl‐2, and Bax in N‐GFs was analyzed by qRT‐PCR and Western blot.

Results

Exosomes were isolated from IGF‐GFs; the identification of exosomes and gingival fibroblasts was successfully finished. Moreover, we found that N‐GFs co‐cultured with exosomes showed a great increase in PCNA and Bcl‐2 levels, and a moderate increase in Ki67 levels. By contrast, the levels of Bax were significantly reduced.

Conclusion

These results suggest that exosomes derived from idiopathic gingival fibroma fibroblasts are involved in the regulation of gingival fibroblast proliferation and apoptosis.
Epidemiological profile and clinical implications of oral squamous cell carcinoma adjacent to dental implants
Authors: Ramos Joab Cabral , Alves Fábio Abreu , Kowalski Luiz Paulo , dos Santos‐Silva Alan Roger , Vargas Pablo Agustin , Lopes Márcio Ajudarte
Published: November 2020

Objectives

Describe the epidemiological profile of patients with oral squamous cell carcinoma (OSCC) around dental implants (DI), investigate the spectrum of clinical and pathological characteristics, and discuss the implications of diagnosis delay of these lesions.

Methods

Retrospective analysis of patients treated of OSCC adjacent to DI at A.C. Camargo Cancer Center between 2009 and 2020.

Results

Thirty one patients were identified, being women the majority (58.1%). The mean age of the patients was 68.8 years. Never smoker corresponds to 46.9% and never alcohol consumer to 54.9% of the sample. OPMD was reported in 45.2% of patients, affecting mainly women (78.5%). Leukoplakia (63.7%) followed by oral lichen planus (36.3%) was the most common OPMD found in women. OSCC adjacent to DI occurred in the inferior gingiva/alveolar mucosa in 48.3% of cases, and ulceration was the most common clinical appearance (87%). Peri‐implantitis (PI) was initial clinical diagnosis in 16.1% of cases.

Conclusions

Oral squamous cell carcinoma adjacent to DI was more common in women over 70 years old, non‐smokers and non‐drinker, and the majority had oral leukoplakia before the diagnosis of OSCC. OSCC may present clinical and radiographic features that resemble PI which can delay the diagnosis and impair the prognosis.
Evaluation of cross‐reactivity between casein components using inhibition assay and in silico analysis
Authors: Naito Michihiro , Matsui Teruaki , Yamada Chikako , Tagami Kazunori , Ito Komei , Izumi Hidehiko
Published: November 2020

Background

We previously reported that the specific IgE levels to αs1‐casein (CN) and β‐CN in patients with cow's milk allergy decreased with similar dynamics during oral immunotherapy. Therefore, we hypothesized that αs1‐ and β‐CN have strong cross‐reactivity among CN components, despite the low similarity in the full‐length amino acid sequences.

Methods

The αs1‐, β‐, and κ‐CN were purified from commercial cow's milk. We recruited 39 patients with cow's milk allergy, and the serum IgE levels for each CN component were measured by enzyme‐linked immunosorbent assay (ELISA). Cross‐reactivity between CN components was investigated by competitive ELISA against αs1‐CN. Sequence homology between CN components at the peptide level was calculated using in silico analysis and quantified by the property distance (PD) value.

Results

The αs1‐CN–specific IgE levels exhibited a strong positive correlation with the β‐CN–specific IgE (r = 0.945, P < .001). Complete competition was observed by β‐CN against αs1‐CN, suggesting the presence of common epitopes between them. In silico analysis detected 24 peptide sets with PD values lower than 10 between αs1‐ and β‐CN, and 14 sets between αs1‐ and κ‐CN. The amino acid sequences of αs1‐CN (E61‐E70) and β‐CN (I12‐E21) that showed the lowest PD value (5.30) were present in the characteristic sequence known as casein phosphopeptide (CPP).

Conclusion

We detected strong cross‐reactivity between CN components. Furthermore, we found highly homologous sequences in the CPP region, which contains a core sequence of "SSSEE" with phosphorylated serine residues.
Salt stress reduces root water uptake in barley (Hordeum vulgare L.) through modification of the transcellular transport path
Authors: Knipfer Thorsten , Danjou Mathieu , Vionne Charles , Fricke Wieland
Published: November 2020

The aim of the study was to understand the hydraulic response to salt stress of the root system of the comparatively salt‐tolerant crop barley (Hordeum vulgare L.). We focused on the transcellular path of water movement across the root cylinder that involves the crossing of membranes. This path allows for selective water uptake, while excluding salt ions. Hydroponically grown plants were exposed to 100 mM NaCl for 5–7 days and analysed when 15–17 days old. A range of complementary and novel approaches was used to determine hydraulic conductivity (Lp). This included analyses at cell, root and plant level and modelling of water flow. Apoplastic barrier formation and gene expression level of aquaporins (AQPs) was analysed. Salt stress reduced the Lp of root system through reducing water flow along the transcellular path. This involved changes in the activity and gene expression level of AQPs. Modelling of root‐Lp showed that the reduction in root‐Lp did not require added hydraulic resistances through apoplastic barriers at the endodermis. The bulk of data points to a near‐perfect semi‐permeability of roots of control plants (solute reflection coefficient σ ~1.0). Roots of salt‐stressed plants are almost as semi‐permeable (σ > 0.8).
Connexins in melanoma: Potential role of Cx46 in its aggressiveness
Authors: Orellana Viviana P. , Tittarelli Andrés , Retamal Mauricio A.
Published: November 2020

Melanoma is the most aggressive skin cancer, and in metastatic advanced states, it is completely refractory to chemotherapy. Therefore, it is relevant to understand the molecular bases that rule their aggressiveness. Connexins (Cxs) are proteins that under normal physiological conditions participate in intercellular communication, via the exchange of signaling molecules between the cytoplasm and extracellular milieu and the exchange of ions/second messengers between the cytoplasm of contacting cells. These proteins have shown important roles in cancer progression, chemo‐ and radiotherapy resistance, and metastasis. Accordingly, Cx26 and Cx43 seem to play important roles in melanoma progression and metastasis. On the other hand, Cx46 is typically expressed in the eye lens, where it seems to be associated with oxidative stress protection in fiber lens cells. However, in the last decade, Cx46 expression has been associated with breast and brain cancers, due to its role in potentiation of both extracellular vesicle release and cancer stem cell‐like properties. In this review, we analyzed a potential role of Cx46 as a new biomarker and therapeutic target in melanoma.
Dermatologic manifestations in pediatric patients after liver and HSCT: A 20‐year retrospective cohort study
Authors: Tangthanapalakul Amatanun , Chaijitraruch Nataruks , Techavichit Piti , Sosothikul Darintr , Chatproedprai Susheera , Chongsrisawat Voranuch , Tempark Therdpong , Wananukul Siriwan
Published: November 2020

LT and HSCT are now potentially curative treatments for many medical conditions. Dermatologic manifestations are one of the sequelae after transplantation. To study the prevalence and associated risk factors of dermatologic manifestations after pediatric LT and HSCT. A 20‐year retrospective cohort study was conducted in children, aged ≤15 years, who received LT or HSCT from January 1, 1997, to December 31, 2017. Medical records were reviewed for data collection until December 31, 2018. A total of 70 LT and 51 HSCT recipients were included. The percentages of overall dermatologic manifestations after LT and HSCT were 64.3% and 64.7%, respectively. Viral infection was the most common manifestation in both groups, with mucocutaneous HSV infection as the most prevalent. One HSCT recipient developed leukemia cutis. GVHD was revealed in 27.5% of HSCT recipients. Impetigo and xerosis were significantly observed in patients using azathioprine and prednisolone. Approximately two‐thirds of pediatric LT and HSCT recipients experienced dermatologic manifestations, potentially associated with immunosuppressive agents. Thus, regular skin examination and optimized immunosuppression would be beneficial in these recipients.
The Case for a Unified Science of Operations
Authors: Spearman Mark L. , Hopp Wallace J.
Published: November 2020

Throughout its history, the industrial engineering/operations management (IE/OM) field has relied heavily on axiomatic models and empirical studies of individual systems. But, unlike other engineering and management disciplines, it lacks a clear foundation in a descriptive science. Exceptional results like the famous “bullwhip effect” paper by Lee et al. (1997) hint at the powerful potential for a descriptive science of operations. But the very fact that such works are exceptional suggests that they are held to a high bar in the publishing process. This may be symptomatic of the cultural norms that have prevented our field from producing a rigorous scientific foundation. In this study, we make a case for why developing a unified science of operations is essential for IE/OM education, practice and research. We provide examples and a tentative framework to illustrate what such a science might look like and use this framework to generate a testable hypothesis about a powerful relationship between variability buffers in and operations system. We conclude with suggestions of measures we can take collectively to promote development of the science of operations.
Esca‐affected grapevine leaf metabolome is clone‐ and vintage‐dependent
Authors: Moret Florian , Delorme Gaël , Clément Gilles , Grosjean Claire , Lemaître‐Guillier Christelle , Trouvelot Sophie , Adrian Marielle , Fontaine Florence
Published: November 2020

Esca is a complex grapevine trunk disease caused by wood‐rotting ascomycetes and basidiomycetes and leading to several foliar and wood symptoms. Given that the esca expression can be influenced by several environmental, physiological, and genetic factors, foliar symptoms are inconsistent in incidence and prevalence and may appear 1 year but not the following. We have previously reported a clone‐dependent expression of the disease in cv Chardonnay. Owing to metabolome analysis, we could discriminate the metabolite fingerprint of green leaves collected on diseased vines of clones 76 and 95. These clone‐dependent fingerprints were year‐dependent in intensity and nature. The present work was conducted to determine if the clone‐dependent disease expression observed is specific to Chardonnay or if it also occurs in another cultivar. A plot located in the Jura vineyard (France) and planted with both 1004 and 1026 clones of Trousseau, a cultivar highly susceptible to esca, was thus selected and studied during 2017 and 2018. A year‐dependent variation of the symptoms expression was first observed and a possible relationship with rainfall is hypothesized and discussed. Moreover, a higher percentage of the clone 1026 vines expressed disease, compared to the 1004 ones, suggesting the higher susceptibility of this clone. Finally, metabolomic analyses of the remaining green leaves (i.e, without symptom expression) of partial esca‐apoplectic vines allowed us to confirm a clone‐dependent metabolic response to the disease. The metabolite fingerprints obtained differed in nature and intensity to those previously reported for Chardonnay and also between years.
Predictors of CPAP outcome in hospitalized COVID‐19 patients
Authors: Noeman‐Ahmed Yasser , Gokaraju Sriya , Powrie Duncan J. , Amran Dora A. , El Sayed Iman , Roshdy Ashraf
Published: November 2020

Watch the video abstract
A Proposal for Integrating Theories of Complexity for Better Understanding Global Systemic Risks
Authors: Haas Armin , Laubichler Manfred , Applegate Joffa , Steudle Gesine , Jaeger Carlo C.
Published: November 2020

The global financial crisis of 2008 has shown that the present financial system involves global systemic risks. The dimension of these risks is hard to grasp with the conceptual tools that have been developed to tackle conventional risks like fire or car accidents. While modern societies know quite well how to deal with conventional risks, we have not yet been equally successful at dealing with global systemic risks. For managing this kind of risks, one needs to understand critical features of specific global systems where many human agents interact in ever changing complex networks. Here we apply two specific dimensions of complexity theory for dealing with global systemic risk in an integrated fashion: normal accidents and extended evolution. Both of them have successfully been applied to the analysis of systemic risks. As a paradigmatic example of global systemic risks, we focus on the global financial crisis that began in 2008, and suggest that the future evolution of the financial system could either see a further increase in complexity, or a reversal to a less complex system. We explore and contrast the implications of normal accident theory and extended evolution perspectives and suggest a four‐point research strategy informed by complexity theory for better understanding global systemic risks in financial systems.
Clearing the clouds: Case‐report and review of the literature
Authors: Relvas Miguel , Beco Ana , Pereira Luciano , Oliveira Ana , Silvano José , Silva Rui , Marques Nídia , Santos Lurdes , Coentrão Luís , Pestana Manuel
Published: November 2020

In peritoneal dialysis (PD), a cloudy dialysate is an alarming finding. Bacterial peritonitis is the most common cause, however, atypical infections and non‐infectious causes must be considered. A 46‐year‐old man presented with asthenia, paraesthesia, foamy urine and hypertension. Laboratory testing revealed severe azotaemia, anaemia, hyperkalaemia and nephrotic‐range proteinuria. Haemodialysis was started through a central venous catheter. Later, due to patient preference, a Tenckhoff catheter was inserted. Conversion to PD occurred 3 weeks later, during hospitalization for a presumed central line infection. A month later, the patient was hospitalized for neutropenic fever. He was diagnosed an acute parvovirus infection and was discharged under isoniazid for latent tuberculosis. Four months later, the patient presented with fever and a cloudy effluent. Peritoneal fluid (PF) cytology was suggestive of infectious peritonitis, but the symptoms persisted despite antibiotic therapy. Bacterial and mycological cultures were negative. No neoplastic cells were detected. Mycobacterium tuberculosis eventually grew in PF cultures, despite previous negative molecular tests. Directed therapy was then initiated with excellent response. Thus, facing a cloudy effluent, one must consider multiple aetiologies. Diagnosis of peritoneal tuberculosis is hampered by the lack of highly sensitive and specific exams. Here, diagnosis was only possible due to positive mycobacterial cultures.
Inter‐observer evaluation of erythema‐directed photography for the assessment of erythema and telangiectasias in rosacea
Authors: Dall'Oglio Federica , Verzi Anna Elisa , Lacarrubba Francesco , Giuffrida Giorgia , Milani Massimo , Micali Giuseppe
Published: November 2020

Background

Persistent centrofacial erythema associated with telangiectasias is one of the most common phenotypes of rosacea in clinical practice, and the assessment of each component is crucial as each of them may require a different approach. The aim of this study was to evaluate the inter‐observer reliability of standard photography vs erythema‐directed photography for the assessment of erythema and telangiectasias in rosacea.

Materials and methods

One hundred full‐face images of 50 rosacea patients (50 standard photographs and 50 erythema‐directed digital photographs) were evaluated by 8 independent experienced dermatologists using a 5‐item score for erythema and telangiectasias, respectively. Inter‐rater reliability, by comparing erythema and telangiectasias scores and calculating the percentage of agreement between evaluators, was assessed and the strength of agreement using the Cohen's Kappa values (95% CI) was calculated.

Results

Poor and fair strength of agreement for erythema and telangiectasias using standard photography vs moderate and good strength of agreement using erythema‐directed digital photography was found.

Conclusion

Erythema‐directed digital photography may provide a better strength of agreement and higher reliability among independent observers compared to standard photography in the assessment of erythema and telangiectasias in rosacea, thus suggesting new horizons for digital appraisal of skin diseases.
Control ofAilanthus altissimausing cut stump and basal bark herbicide applications in an eighteenth‐century fortress
Authors: Fogliatto Silvia , Milan Marco , Vidotto Francesco
Published: November 2020

The Cittadella di Alessandria (Italy) is a military fortification that was built in the 18th century. The site has recently been abandoned and is now colonised by weeds, including the invasiveAilanthus altissima. The aim of the study was to compare the efficacy of different herbicides (glyphosate, a mixture of aminopyralid + fluroxypyr and triclopyr + fluroxypyr) applied to cut stumps or to the basal bark ofA. altissima. For the cut stump application, plants were first cut at the base and then immediately sprayed and for the basal bark application, the lower 50 cm of the plants was sprayed with the herbicides; untreated cut plants were used as a control, for comparison. Two runs per study were carried out (in summer 2015 and in spring 2016). Efficacy was assessed up to 2018 by counting the resprouts and their height in the cut stump application and, for the basal bark treatment, by measuring the variation in the plant circumference after treatment. The cut stump treatment carried out in summer greatly reduced the number of resprouts, compared to the spring treatment, to less than one sprout per plant when aminopyralid + fluroxypyr was used, and its efficacy lasted for about two years. The basal bark treatment did not control the species, but lower levels of variation in circumference and greater mortality were detected in plants treated with aminopyralid + fluroxypyr. Considering the high level of infestation of the site and the high risk of plant resprouting, repeated cut stump treatments with aminopyralid + fluroxypyr would be preferable to eradicate this invasive species.
The smooth locus in infinite-level Rapoport–Zink spaces
Authors: Ivanov Alexander B. , Weinstein Jared
Published: November 2020

Rapoport–Zink spaces are deformation spaces for$p$-divisible groups with additional structure. At infinite level, they become preperfectoid spaces. Let${{\mathscr M}}_{\infty }$be an infinite-level Rapoport–Zink space of EL type, and let${{\mathscr M}}_{\infty }^{\circ }$be one connected component of its geometric fiber. We show that${{\mathscr M}}_{\infty }^{\circ }$contains a dense open subset which is cohomologically smooth in the sense of Scholze. This is the locus of$p$-divisible groups which do not have any extra endomorphisms. As a corollary, we find that the cohomologically smooth locus in the infinite-level modular curve$X(p^{\infty })^{\circ }$is exactly the locus of elliptic curves$E$with supersingular reduction, such that the formal group of$E$has no extra endomorphisms.
Circulating leptin levels in patients with myalgic encephalomyelitis, chronic fatigue syndrome or fibromyalgia: a systematic review protocol
Authors: Musker Michael , McArthur Alexa , Munn Zachary , Wong Ma-Li
Published: November 2020

Objective:

The objective of the review is to evaluate circulating levels of leptin in people diagnosed with myalgic encephalomyelitis chronic fatigue syndrome or fibromyalgia syndrome and to investigate the differences compared with healthy controls.

Introduction:

Myalgic encephalomyelitis chronic fatigue syndrome is a condition that has major symptoms, including self-reported fatigue, post-exertional malaise, and unexplained pain across the body. The widespread pain is measured in a systematic way and is often referred to as fibromyalgia. The two disorders have many similarities, but their association with leptin has indicated that leptin may affect the role of pro-inflammatory cytokines and symptom severity.

Inclusion criteria:

This review will consider observational studies of varying study designs including prospective and retrospective cohort studies, case-control studies, time-series, and analytical cross-sectional studies that include both cases and healthy comparators. Cases will include a diagnosis of myalgic encephalomyelitis, chronic fatigue syndrome, and/or fibromyalgia. Controls are people without this diagnosis, usually healthy participants. Only studies published in English will be included due to limited resources for translation.

Methods:

This protocol will be reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist and will follow the JBI methodology for systematic reviews of etiology and risk. A comprehensive search strategy will include PubMed, Embase, Scopus, Science Direct, and PsycINFO. Two reviewers will screen, critically appraise eligible articles, and extract data using a standardized data extraction tool informed by JBI SUMARI. The authors will complete a quantitative analysis that synthesizes findings across studies using pooled effect sizes and confidence intervals of the measures provided.

Systematic review registration number:

PROSPERO CRD42020169903
Housing Profile Design for Improved Apex Seal Lubrication Using a Finite Length Roller Elastohydrodynamic Lubrication Model
Authors: Liu Zhong , Gu Thomas , Pickens David , Nishino Takayuki , Jane Wang Q.
Published: November 2020

Finite-length roller contacts are found in apex seal-housing interfaces in rotary engines, as well as in many other mechanical systems, such as those at the interfaces of meshing gear teeth, cam followers, and roller bearings. Rollers are usually designed with crowns and modified ends to mitigate the negative effects of misalignment, thermal deformation, and edge-induced non-uniform displacement. A crowned-roller elastohydrodynamic lubrication model is enriched and employed to investigate seven housing surface profiles, including a sinusoidal recess, sinusoidal ends, the combination design of a sinusoidal recess and sinusoidal ends, multiple sinusoidal recesses, a concave shape, and a concave shape with sinusoidal ends or round corners, aiming to improve the tribological performance of the interface via increasing the minimum film thickness but reducing the average and maximum film thicknesses, and lowering friction coefficient. The modified discrete convolution and fast Fourier transform method with duplicated padding is utilized to deal with the potential free-end-surface effect. The simulation results suggest that the combinations of a concave shape and sinusoidal ends, or round corners, are the best designs because they can help distribute the lubricant most uniformly without causing a negative edge effect.
Approximation of the Step-to-Step Dynamics Enables Computationally Efficient and Fast Optimal Control of Legged Robots
Authors: Bhounsule Pranav A. , Kim Myunghee , Alaeddini Adel
Published: November 2020

Legged robots with point or small feet are nearly impossible to control instantaneously but are controllable over the time scale of one or more steps, also known as step-to-step control. Previous approaches achieve step-to-step control using optimization by (1) using the exact model obtained by integrating the equations of motion, or (2) using a linear approximation of the step-to-step dynamics. The former provides a large region of stability at the expense of a high computational cost while the latter is computationally cheap but offers limited region of stability. Our method combines the advantages of both. First, we generate input/output data by simulating a single step. Second, the input/output data is curve fitted using a regression model to get a closed-form approximation of the step-to-step dynamics. We do this model identification offline. Next, we use the regression model for online optimal control. Here, using the spring-load inverted pendulum model of hopping, we show that both parametric (polynomial and neural network) and non-parametric (gaussian process regression) approximations can adequately model the step-to-step dynamics. We then show this approach can stabilize a wide range of initial conditions fast enough to enable real-time control. Our results suggest that closed-form approximation of the step-to-step dynamics provides a simple accurate model for fast optimal control of legged robots.
A Practical Safety Factor Method for Reliability-Based Component Design
Authors: Yin Jianhua , Du Xiaoping
Published: November 2020

Reliability-based design (RBD) identifies design variables that maintain reliability at a required level. For many routine component design jobs, RBD may not be practical as it requires nonlinear optimization and specific reliability methods, especially for those design jobs which are performed manually or with a spreadsheet. This work develops a practical approach to reliability-based component design so that the reliability target can be achieved by conducting traditional component design repeatedly using a deterministic safety factor. The new component design is based on the First Order Reliability Method, which iteratively assigns the safety factor during the design process until the reliability requirement is satisfied. In addition to a number of iterations of deterministic component design, the other additional work is the calculation of the derivatives of the design margin with respect to the random input variables. The proposed method can be used for a wide range of component design applications. For example, if a deterministic component design is performed manually or with a spreadsheet, so it the reliability-based component design. Three examples are used to demonstrate the practicality of the new design method.
The Design of Disk Cam Mechanisms With a Translating Follower Having an Added Dual-Roller Intermediate Link
Authors: Hsu Kuan-Lun , Chou Sun-Liang
Published: November 2020

This paper provides a methodology to design a disk cam mechanism that has a translating follower with dual rollers. Dual rollers are joined by an oscillating link and can contact cam profile simultaneously throughout working cycle of cam rotation. The application of this novel follower can offer two engagements in cam-follower pair to spread the induced normal force and reduce the contact stress between cam and follower. Two examples are worked to demonstrate application of design procedures and to illustrate the capability of reducing contact stress of this novel follower. The results show that the contact stress of such a cam mechanism can be reduced by 28.85% in comparison with that of the cam mechanism with a common translating roller follower.
A Convolutional Neural Network-Based Patent Image Retrieval Method for Design Ideation
Authors: Jiang Shuo , Luo Jianxi , Pava Guillermo Ruiz , Hu Jie , Magee Christopher L.
Published: November 2020

The patent database is often used in searches of inspirational stimuli for innovative design opportunities because of its large size, extensive variety and rich design information in patent documents. However, most patent mining research only focuses on textual information and ignores visual information. Herein, we propose a convolutional neural network (CNN)-based patent image retrieval method. The core of this approach is a novel neural network architecture named Dual-VGG that is aimed to accomplish two tasks: visual material type prediction and international patent classification (IPC) class label prediction. In turn, the trained neural network provides the deep features in the image embedding vectors that can be utilized for patent image retrieval and visual mapping. The accuracy of both training tasks and patent image embedding space are evaluated to show the performance of our model. This approach is also illustrated in a case study of robot arm design retrieval. Compared to traditional keyword-based searching and Google image searching, the proposed method discovers more useful visual information for engineering design.
Kinematics, Workspace Optimization, and Performance Evaluation of a 3-Leg 6-DOF Robot in RRRS Configuration
Authors: Jensen Nathan A. , Nelson Carl A.
Published: November 2020

Underactuated parallel manipulators that achieve 6 DOF via multiple controllable degrees of freedom per leg are often pursued and reported due to their large workspaces. This benefit comes at a cost to the manipulator’s performance, however. Such manipulators must then be evaluated in order to characterize their kinematics in terms of position and motion. This paper establishes a pair of inverse kinematic solutions for a previously proposed and prototyped 3-leg, 6-DOF parallel robot. These solutions are then used to define the robot’s workspace with experimental validation and to optimize the robot’s geometry for maximum workspace volume. The linear components of the Jacobian are then defined, allowing for analysis of the manipulability of the robot. The full Jacobian is also defined, and singularities are examined throughout the workspace of the robot.
Efficient Parametric Optimization for Expensive Single Objective Problems
Authors: Weaver-Rosen Jonathan M. , Malak Richard J.
Published: November 2020

Parametric optimization solves optimization problems as a function of uncontrollable or unknown parameters. Such an approach allows an engineer to gather more information than traditional optimization procedures during design. Existing methods for parametric optimization of computationally or monetarily expensive functions can be too time-consuming or impractical to solve. Therefore, new methods for the parametric optimization of expensive functions need to be explored. This work proposes a novel algorithm that leverages the advantages of two existing optimization algorithms. This new algorithm is called the efficient parametric optimization (EPO) algorithm. EPO enables adaptive sampling of a high-fidelity design space using an inexpensive low-fidelity response surface model. Such an approach largely reduces the required number of expensive high-fidelity computations. The proposed method is benchmarked using analytic test problems and used to evaluate a case study requiring finite element analysis. Results show that EPO performs as well as or better than the existing alternative, P3GA, for these problems given an allowable number of function evaluations.
Data Mining From Endmill Tool Catalog Information Based on the Use of a Machine Learning Method
Authors: Asakura Akihito , Hirogaki Toshiki , Aoyama Eiichi , Kodama Hiroyuki
Published: November 2020

In recent years, the needs associated with the development of new technologies in the manufacturing industry that utilize big data typified by the Internet-of-Things (IoT) and artificial intelligence (AI) have been increasing. Recent computer-aided manufacturing (CAM) systems have evolved so that unskilled technicians can create tool paths relatively easily with numerically controlled (NC) programs, but tool-cutting conditions used for machining cannot be automatically determined. Therefore, many unskilled technicians often set the cutting conditions based on the recommended conditions described in the tool catalog. However, given that the catalog contains large-scale data on machining technology, setting the proper conditions becomes a time-consuming and inefficient process. In this study, we aimed to construct a system to support unskilled technicians to determine the optimum machining conditions. To this end, we constructed a prediction model using a random forest machine learning method to predict the cutting conditions. It was confirmed that the prediction with the random forest method can be performed with high accuracy based on the cutting conditions recommended by the tool maker. Thus, the effectiveness of this method was verified.
Large Scale Topology Optimization of 3D Static Mixers
Authors: Sun Sicheng , Ghandhi Jaal , Qian Xiaoping
Published: November 2020

Topology optimization (TO) was conducted for three dimensional static fluid mixers. The problem is optimized using the weakly coupled Navier-Stokes equation at low Reynolds number (Re ≤ 1) and a convection-diffusion equation. The domain was discretized with up to 10 million cells. The optimizations were run with 1024 to 2048 CPUs on a national supercomputer. For a mixer in a square cross-section channel, the mixing was improved by 83% for a modest 2.5 times higher pressure drop compared with the open straight channel. For a cylindrical cross-section tee arrangement, the mixing improved by 91% with a 2.5 times higher pressure drop compared to the straight channel.
A Sequential Calibration and Validation Framework for Model Parameter Updating and Bias Correction
Authors: Jiang Chen , Liu Yixuan , Hu Zhen , Mourelatos Zissimos P. , Gorsich David , Jayakumar Paramsothy
Published: November 2020

Model parameter updating and bias correction plays an essential role in improving the validity of Modeling and Simulation (M&S) in engineering design and analysis. However, it is observed that the existing methods may either be misled by potentially wrong information if the computer model cannot adequately capture the underlying true physics, or be affected by the prior distributions of the unknown model parameters. In this paper, a sequential model calibration and validation (SeCAV) framework is proposed to improve the efficacy of both model parameter updating and model bias correction, where the model validation and Bayesian calibration are implemented in a sequential manner. In each iteration, the model validation assessment is employed as a filter to select the best experimental data for Bayesian calibration, and to update the prior distributions of uncertain model parameters for the next iteration. The calibrated parameters are then integrated with model bias correction to improve the prediction accuracy of the M&S. A mathematical example is employed to demonstrate the advantages of the SeCAV method.