bluuebunny/crossref_metadata_2025 huggingface dataset:
Collecting data for global surgical indicators: a collaborative approach in the Pacific Region
Authors: Guest Glenn Douglas , McLeod Elizabeth , Perry William R G , Tangi Vilami , Pedro Joao , Ponifasio Ponifasio , Hedson Johnny , Tudravu Jemesa , Pikacha Douglas , Vreede Eric , Leodoro Basil , Tapaua Noah , Kong James , Oten Bwabwa , Teapa Deacon , Korin Stephanie , Wilson Leona , Mesol Samson , Tuneti Kabiri , Meara John G , Watters David A
Published: November 2017

In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enable countries to measure their surgical and anaesthesia care delivery. These indicators have subsequently been accepted by the World Bank for inclusion in the World Development Indicators. With support from the Royal Australasian College of Surgeons and the Pacific Islands Surgical Association, 14 South Pacific countries collaborated to collect the first four of six LCoGS indicators. Thirteen countries collected all four indicators over a 6-month period from October 2015 to April 2016. Australia and New Zealand exceeded the recommended LCoGS target for all four indicators. Only 5 of 13 countries (38%) achieved 2-hour access for at least 80% of their population, with a range of 20% (Papua New Guinea and Solomon Islands) to over 65% (Fiji and Samoa). Five of 13 (38%) countries met the target surgical volume of 5000 procedures per 100 000 population, with six performing less than 1600. Four of 14 (29%) countries had at least 20 surgical, anaesthesia and obstetric providers in their workforce per 100 000 population, with a range of 0.9 (Timor Leste) to 18.5 (Tuvalu). Perioperative mortality rate was reported by 13 of 14 countries, and ranged from 0.11% to 1.0%. We believe it is feasible to collect global surgery indicators across the South Pacific, a diverse geographical region encompassing high-income and low-income countries. Such metrics will allow direct comparison between similar nations, but more importantly provide baseline data that providers and politicians can use in advocacy national health planning.
Prevention of acute kidney injury through accurate fluid balance monitoring
Authors: Davies Andrew , Srivastava Seema , Seligman William , Motuel Lorraine , Deogan Vardeep , Ahmed Shaza , Howells Nicholas
Published: November 2017

Acute kidney injury (AKI) is associated with increased patient morbidity, mortality and an extended hospital stay. The financial burden to the National Health Service is high and it can affect up to one in five inpatients. Optimal fluid balance management is essential for the prevention of AKI and this can be particularly challenging in the patient with trauma. Our aim was to reduce the rate of AKI in patients with traumatic injuries in the regional trauma centre.

We developed new fluid balance charts and documented how well these were completed. The number of AKI alerts per month was calculated on our pathology system. Scenario training was delivered at handover meetings and an e-learning tool was designed at three levels: healthcare assistants; nurses; and medical staff, dietetics and pharmacists. Educational posters were placed in clinical areas and patient information leaflets produced. Junior doctors were regularly informed of AKI rates on the ward.

The number of AKI alerts on our trauma ward declined from 50 in January 2016 to 19 in November 2016. The mean monthly rate of AKI fell 33% following the invention (P<0.001). Completion of fluid balance charts improved; 6 hourly urine output documentation increased from 36% to 68% and running 1 hourly output increased from 80% to 96%. Calculation of total daily fluid balance rose from 12% to 72%, before decreasing to 32%. This highlighted the need for continued encouragement.

Improved fluid balance monitoring led to a reduction in the prevalence of AKI in patients admitted to this trauma centre.
Improving OSA screening and diagnosis in patients with hypertension in an academic safety net primary care clinic: quality improvement project
Authors: Bakhai Smita Y , Nigam Mansi , Saeed Musa , Krishnan Amita , Reynolds Jessica L
Published: November 2017

Obstructive sleep apnoea (OSA) is more prevalent in patients with hypertension (HTN), and associated morbidities include stroke, heart failure and premature death. In the Internal Medicine Clinic (IMC), over 70% of the patients had a diagnosis of HTN and obesity. We identified a lack of OSA screening in patients with HTN. The aim of this quality improvement (QI) was to increase OSA diagnosis to 5% from the baseline rate of less than 1% in patients with HTN between the ages of 18 and 75 years over 6 months at IMC. We used the Plan-Do-Study-Act (PDSA) method. The QI team performed root cause analysis to identify materials/methods, provider and patient-related barriers. PDSA cycle included: (1) integration of customised workflow of loud Snoring, Tiredness, Observed apnea, high blood Pressure (STOP)-Body mass index (BMI), Age, Neck circumference, and Gender (BANG) OSA screening tool in the electronic health record (EHR); (2) physician education of OSA and EHR workflow; and (3) completion of STOP survey by patients, which was facilitated by nursing staff. The outcome measure was the percentage of OSA diagnosis in patients with HTN. The process measures included the percentage of patients with HTN screened for OSA and the increase in sleep study referrals in hypertensive patients with STOP-BANG score of ≥3. Increase in patient wait time and cost of sleep study were the balance measures. Data analysis was performed using weekly statistical process control chart. The average increase in OSA screening rate using the STOP-BANG tool was 3.88%. The significant variation seen in relation to PDSA cycles was not sustainable. 32% of patients scored ≥3 on the STOP-BANG tool, and 10.4% had a confirmed diagnosis of OSA. STOP-BANG tool integration in the EHR and a team approach did not result in a sustainable increase in OSA screening. OSA diagnosis was increased to 3.3% in IMC patient population within the 6-month period. The team identified multiple barriers to screening and diagnosis of OSA in the IMC.
Improving service user self-management: development and implementation of a strategy for the Richmond Response and Rehabilitation Team
Authors: Sanders Julie , Fitzpatrick Joanne M
Published: November 2017

Community rapid response and rehabilitation teams are used to prevent avoidable hospital admissions for adults living with multiple long-term conditions and to support early hospital discharge by providing short-term intensive multidisciplinary support. Supporting self-management is an important service intervention if desired outcomes are to be achieved. A Care Quality Commission inspection of the Richmond Response and Rehabilitation Team in 2014 identified that self-management plans were not routinely developed with service users and reported this as requiring improvement. This quality improvement project aimed to develop and implement a self-management strategy for service users and for 90% of service users to have a personalised self-management plan within 3 months. The quality improvement intervention used the Plan-Do-Study-Act model comprising: (1) the development of a self-management plan, (2) staff education to support service users to self-manage using motivational interviewing techniques, (3) piloting the self-management plan with service users, (4) implementation of the self-management plan and (5) monthly audit and feedback. Evaluation involved an audit of the number and quality of self-management plans developed with service users and a survey of staff knowledge and confidence to support service users to self-manage. Following implementation of the intervention, the number of self-management plans developed in collaboration with service users increased from 0 to 187 over a 4-week period. Monthly audit data confirmed that this improvement has been sustained. Results indicated that staff knowledge and confidence improved after an education intervention. Quality improvement methods facilitated development and operationalisation of a self-management strategy by a community rapid response and rehabilitation team. The next phase of the project is to evaluate the impact of the self-management strategy on key service outcomes including self-efficacy, unplanned and emergency hospital admissions and early discharges.
Diagnosis of psychosocial risk factors in prevention of low back pain in athletes (MiSpEx)
Authors: Wippert Pia-Maria , Puschmann Anne-Katrin , Arampatzis Adamantios , Schiltenwolf Marcus , Mayer Frank
Published: November 2017

Background

Low back pain (LBP) is a common pain syndrome in athletes, responsible for 28% of missed training days/year. Psychosocial factors contribute to chronic pain development. This study aims to investigate the transferability of psychosocial screening tools developed in the general population to athletes and to define athlete-specific thresholds.

Methods

Data from a prospective multicentre study on LBP were collected at baseline and 1-year follow-up (n=52 athletes, n=289 recreational athletes and n=246 non-athletes). Pain was assessed using the Chronic Pain Grade questionnaire. The psychosocial Risk Stratification Index (RSI) was used to obtain prognostic information regarding the risk of chronic LBP (CLBP). Individual psychosocial risk profile was gained with the Risk Prevention Index – Social (RPI-S). Differences between groups were calculated using general linear models and planned contrasts. Discrimination thresholds for athletes were defined with receiver operating characteristics (ROC) curves.

Results

Athletes and recreational athletes showed significantly lower psychosocial risk profiles and prognostic risk for CLBP than non-athletes. ROC curves suggested discrimination thresholds for athletes were different compared with non-athletes. Both screenings demonstrated very good sensitivity (RSI=100%; RPI-S: 75%–100%) and specificity (RSI: 76%–93%; RPI-S: 71%–93%). RSI revealed two risk classes for pain intensity (area under the curve (AUC) 0.92(95% CI 0.85 to 1.0)) and pain disability (AUC 0.88(95% CI 0.71 to 1.0)).

Conclusions

Both screening tools can be used for athletes. Athlete-specific thresholds will improve physicians’ decision making and allow stratified treatment and prevention.
Comparison of two low-sensitivity urine pregnancy tests for confirming the success of early medical abortion
Authors: Millar Sarah Louise , Cameron Sharon Tracey
Published: November 2017

Background

We introduced a single-window low-sensitivity urine pregnancy test (LSPT) to replace a double-window LSPT (both 1000 IU hCG) for self-assessment of the outcome of early medical abortion (EMA) (≤63 days gestation) 2 weeks later. We wished to compare assessment of outcomes of EMA with each LSPT.

Methods

A retrospective review of the outcomes of EMA during 10 months' use of the double-window LSPT and the subsequent 10 months' use of the single-window LSPT to compare (i) detection of ongoing pregnancies and (ii) false-positive and invalid results with each LSPT.

Results

492 and 555 women self-assessed the outcome of their EMA with the double- and single-window LSPTs, respectively. Ongoing pregnancies were uncommon and occurred in 4/1047 women (0.4%). Two of these four women did not conduct a LSPT as they presented before the LSPT was due with scant bleeding or continuing pregnancy symptoms. False-positive LSPT results occurred in 6 (1.2%) and 19 (3.4%) double- and single-window LSPT tests, respectively (P=0.0244). Invalid results were reported in 18 (3.6%) and 6 (1.1%) of double- and single-window LSPT groups, respectively (P=0.01).

Conclusion

The introduction of the single-window LSPT has not impacted on the detection of ongoing pregnancy or on contact with the service due to a positive or invalid LSPT. Services could consider use of either LSPT but should also place emphasis on informing women about the clinical signs and symptoms that suggest failed abortion.
Rear-facing versus forward-facing child restraints: an updated assessment
Authors: McMurry Timothy L , Arbogast Kristy B , Sherwood Christopher P , Vaca Federico , Bull Marilyn , Crandall Jeff R , Kent Richard W
Published: November 2017

Objectives

The National Highway Traffic Safety Administration and the American Academy of Pediatrics recommend children be placed in rear-facing child restraint systems (RFCRS) until at least age 2. These recommendations are based on laboratory biomechanical tests and field data analyses. Due to concerns raised by an independent researcher, we re-evaluated the field evidence in favour of RFCRS using the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) database.

Methods

Children aged 0 or 1 year old (0–23 months) riding in either rear-facing or forward-facing child restraint systems (FFCRS) were selected from the NASS-CDS database, and injury rates were compared by seat orientation using survey-weighted χ2tests. In order to compare with previous work, we analysed NASS-CDS years 1988–2003, and then updated the analyses to include all available data using NASS-CDS years 1988–2015.

Results

Years 1988–2015 of NASS-CDS contained 1107 children aged 0 or 1 year old meeting inclusion criteria, with 47 of these children sustaining injuries with Injury Severity Score of at least 9. Both 0-year-old and 1-year-old children in RFCRS had lower rates of injury than children in FFCRS, but the available sample size was too small for reasonable statistical power or to allow meaningful regression controlling for covariates.

Conclusions

Non-US field data and laboratory tests support the recommendation that children be kept in RFCRS for as long as possible, but the US NASS-CDS field data are too limited to serve as a strong statistical basis for these recommendations.
Sing Your Heart Out: community singing as part of mental health recovery
Authors: Shakespeare Tom , Whieldon Alice
Published: November 2017

This paper reports on a qualitative evaluation of a Norfolk-based network of community singing workshops aimed at people with mental health conditions and the general public. The aims of the study were (a) to evaluate the effectiveness of the Sing Your Heart Out (SYHO) project and (b) to identify the key features which made the project distinctive. The study draws on 20 interviews with participants, two focus groups with organisers and workshop leaders, and participative observation over a 6-month period. Interviewees all reported improvement in or maintenance of their mental health and well-being as a direct result of engagement in the singing workshops. For most it was a key component, and for some the only and sufficient component in their recovery and ongoing psychological stability. SYHO was regarded as different from choirs and from most other social groups and also different from therapy groups, music or otherwise. The combination of singing with an inclusive social aspect was regarded as essential in effecting recovery. The lack of pressure to discuss their condition and the absence of explicit therapy was also mentioned by most participants as an important and welcome element in why SYHO worked for them. The combination of singing and social engagement produced an ongoing feeling of belonging and well-being. Attendance provided them with structure, support and contact that improved functioning and mood. We conclude that the SYHO model offers a low-commitment, low-cost tool for mental health recovery within the community.
Evidence and speculation: reimagining approaches to architecture and research within the paediatric hospital
Authors: McLaughlan Rebecca , Pert Alan
Published: November 2017

As the dominant research paradigm within the construction of contemporary healthcare facilities, evidence-based design (EBD) will increasingly impact our expectations of what hospital architecture should be. Research methods within EBD focus on prototyping incremental advances and evaluating what has already been built. Yet medical care is a rapidly evolving system; changes to technology, workforce composition, patient demographics and funding models can create rapid and unpredictable changes to medical practice and modes of care. This dynamism has the potential to curtail or negate the usefulness of current best practice approaches. To imagine new directions for the role of the hospital in society, or innovative ways in which the built environment might support well-being, requires a model that can project beyond existing constraints. Speculative design employs a design-based research methodology to imagine alternative futures and uses the artefacts created through this process to enable broader critical reflection on existing practices. This paper examines the contribution of speculative design within the context of the paediatric hospital as a means of facilitating critical reflection regarding the design of new healthcare facilities. While EBD is largely limited by what has already been built, speculative design offers a complementary research method to meet this limitation.
Kapees3: A High-Quality VLSI Placement Tool Using Nesterov’s Method for Density Penalty
Authors: Pawanekar Sameer , Kapoor Kalpesh , Trivedi Gaurav
Published: November 2017

We present an analytical approach that is based on nonlinear programming to perform VLSI standard cell placement. Our method first clusters a netlist to reduce the number of cells and then performs quadratic optimization on the reduced netlist. Finally, it uses Nesterov’s method for solving nonlinear equations for the problem. The framework of our tool, Kapees3, is scalable and generates high quality results. The experimental results for Peko Suite 1 and Peko Suite 2 benchmarks show promising improvements. Our placement tool outperforms NTUPlace3, Dragon, Feng Shui, Capo10.5, by 46%, 57%, 48% and 25%, respectively, on PEKO Suite 1. For PEKO Suite 2, our placement tool outperforms NTUPlace3, Dragon, Feng Shui, Capo10.5 and mPL6 by 30%, 47%, 57%, 69% and 2.7%, respectively. On MMS benchmarks, we obtain wirelength improvement over Capo10.5 by 56.62%, FLOP by 7.84%, FastPlace by 11.55%, ComPLx by 4.58%, POLAR by 23.67%, mPL6 by 9.96% and NTUPlace3-Unified by 2.96%.
A 0.6 V MOS-Only Voltage Reference for Biomedical Applications with 40 ppm/∘C Temperature Drift
Authors: Nagulapalli R. , Hayatleh K. , Barker Steve , Raparthy Sumathi , Yassine Nabil , Lidgey John
Published: November 2017

This paper exploits the CMOS beta multiplier circuit to synthesize a temperature-independent voltage reference suitable for low voltage and ultra-low power biomedical applications. The technique presented here uses only MOS transistors to generate Proportional To Absolute Temperature (PTAT) and Complimentary To Absolute Temperature (CTAT) currents. A self-biasing technique has been used to minimize the temperature and power supply dependency. A prototype in 65[Formula: see text]nm CMOS has been developed and occupies 0.0039[Formula: see text]mm2, and at room temperature, it generates a 204[Formula: see text]mV reference voltage with 1.3[Formula: see text]mV drift over a wide temperature range (from [Formula: see text]40[Formula: see text]C to 125[Formula: see text]C). This has been designed to operate with a power supply voltage down to 0.6[Formula: see text]V and consumes 1.8[Formula: see text]uA current from the supply. The simulated temperature coefficient is 40[Formula: see text]ppm/[Formula: see text]C.
A computational examination of the binding interactions of amyloidβ and human cystatin C
Authors: Sharma Arun K. , Persichetti Joseph , Tale Ermin , Prelvukaj Gent , Cropley Tyler , Choudhury Rajib
Published: November 2017

The physiological role of human cystatin C (HCC) in the brain of individuals suffering from Alzheimer’s disease (AD) is currently an uncertainty in the scientific community. The protein complex interface between HCC and amyloid[Formula: see text] (A[Formula: see text]), an aggregated protein in the AD brain, is of great interest due to the potential roles of HCC as an agonist and/or antagonist in AD progression. Thus, to understand the molecular details of HCC–A[Formula: see text] interactions, all-atom molecular dynamic simulations were performed in explicit water under physiological conditions. Rigid body protein–protein docking was utilized to obtain the best modes of interactions between A[Formula: see text] and HCC by using energy functions that comprise pairwise shape complementarity with desolvation and electrostatics. Subsequently, two top docking structures were simulated and evaluated for molecular interactions. A detailed trajectory analysis indicates favorable binding conformations between A[Formula: see text] and HCC where A[Formula: see text] goes through major conformational rearrangements while HCC retains its major secondary structures throughout the simulations. Root mean square deviation, radius of gyration and solvent accessible surface area analyses also suggest a larger conformational sampling for A[Formula: see text] in comparison to HCC. Moreover, hydrogen bonding and hydrophobic interactions were found to have important roles in the stability of complexes between A[Formula: see text] and HCC. Overall, the results obtained from this study provide molecular insight into the interaction pathways of A[Formula: see text] and HCC and emphasize the importance of noncovalent forces in biomolecular interactions of therapeutic significance.
Distribution Network Design with Distributors Advance Payment and Fuzzy Commitment
Authors: Halat Kourosh , Hafezalkotob Ashkan
Published: December 2017

This paper investigates the distribution network design problem in a two-echelon decentralized supply chain with a manufacturer and number of candidate distributors. A game theoretical approach is proposed for the problem while the objective of the chain members is to minimize the inventory costs and create stable network. Due to the disparity of power among chain members, manufacturers ask distributors to pay a fraction of the purchase cost in advance. On the other hand, distributors have a fuzzy commitment that affects the network stability. The Stackelberg equilibrium is developed for the problem and a methodology structure is proposed for decision-making on the network design alternatives, at the end the numerical example is presented for more explanation.
Object equivalence: revisiting object equality profiling (an experience report)
Authors: Infante Alejandro , Bergel Alexandre
Published: December 2017

Modern object-oriented programming languages greatly alleviate the memory management for programmers. Despite the efficiency of garbage collection and Just-In-Time program analyzes, memory still remains prone to be wasted.

A bloated memory may have severe consequences, including frequent execution lags due to a high pressure on the garbage collector and suboptimal object dependencies.

We found that dynamically monitoring object production sites and the equivalence of the produced objects is key to identify wasted memory consumption caused by redundant objects. We implemented optimizations for reducing the memory consumption of six applications, achieving a reduction over 40% in half of the applications without having any prior knowledge of these applications.

Our results partially replicate the results obtained by Marinov and O'Callahan and explore new ways to identify redundant objects.
Avoiding useless mutants
Authors: Fernandes Leonardo , Ribeiro Márcio , Carvalho Luiz , Gheyi Rohit , Mongiovi Melina , Santos André , Cavalcanti Ana , Ferrari Fabiano , Maldonado José Carlos
Published: December 2017

Mutation testing is a program-transformation technique that injects artificial bugs to check whether the existing test suite can detect them. However, the costs of using mutation testing are usually high, hindering its use in industry. Useless mutants (equivalent and duplicated) contribute to increase costs. Previous research has focused mainly on detecting useless mutants only after they are generated and compiled. In this paper, we introduce a strategy to help developers with deriving rules to avoid the generation of useless mutants. To use our strategy, we pass as input a set of programs. For each program, we also need a passing test suite and a set of mutants. As output, our strategy yields a set of useless mutants candidates. After manually confirming that the mutants classified by our strategy as "useless" are indeed useless, we derive rules that can avoid their generation and thus decrease costs. To the best of our knowledge, we introduce 37 new rules that can avoid useless mutants right before their generation. We then implement a subset of these rules in the MUJAVA mutation testing tool. Since our rules have been derived based on artificial and small Java programs, we take our MUJAVA version embedded with our rules and execute it in industrial-scale projects. Our rules reduced the number of mutants by almost 13% on average. Our results are promising because (i) we avoid useless mutants generation; (ii) our strategy can help with identifying more rules in case we set it to use more complex Java programs; and (iii) our MUJAVA version has only a subset of the rules we derived.
Nutrient Sensing in Cancer
Authors: Torrence Margaret E. , Manning Brendan D.
Published: December 2017

Cell-intrinsic mechanisms of nutrient sensing are intimately linked to adaptive metabolic responses, and these pathways play critical roles in the complex and dynamic nutrient environment of a growing tumor. Nutrient-responsive transcription factors (e.g., HIF, SREBP, ATF4) and signaling pathways (e.g., mTORC1, AMPK) allow tumor cells to tune their metabolic output and strategies to fluctuations in nutrient availability, thus balancing tumor cell proliferation and survival with a combination of anabolic and adaptive responses. Coupling these nutrient-sensing mechanisms to the control of recycling and scavenging processes, such as autophagy and macropinocytosis, further enhances the adaptability to nutrients within tumors. Here, we discuss the key nutrient-sensing pathways active in cancer cells, how oncogenic events influence these pathways, and their likely contributions to tumor growth and survival. A better understanding of nutrient-sensing strategies and metabolic adaptations within the tumor microenvironment is critical to defining and targeting metabolic vulnerabilities in cancer.
Arteriovenous Fistula after Anatomic All-Inside Anterior Cruciate Ligament Reconstruction
Authors: Fuchs Mathijs C. H. W. , Dietvorst Martijn , Vaes Roel , Loos Maarten , Somford Matthijs P. , Janssen Rob P. A.
Published: November 2017

We present the first case of an arteriovenous fistula after an all-inside anterior cruciate ligament (ACL) reconstruction. A seventeen-year-old boy had an uneventful ACL reconstruction. Four weeks after surgery, the patient was seen with a pulsating swelling at the lateral distal upper leg. Vascular consultation led to the diagnosis of pseudoaneurysm and arteriovenous fistula of the lateral superior genicular artery. Most likely, fistula is caused by the stab incision for preparation of the femoral tunnel, and no anatomical cause was found. The clinical presentation, previous cases of arteriovenous fistula after arthroscopic ACL reconstruction, possible causes, and management are discussed.
Efficacy of Combined XingZhi‐YiNao Granules and Hyperbaric Oxygen Therapy for Cognition and Motor Dysfunction in Patients with Delayed Encephalopathy after Acute Carbon Monoxide Poisoning
Authors: Qin Li , Meihua Chu , Dadong Guo , Li Wang , Jinglin Wang , Xiaoyu Ding , Mingjun Bi , Yong Zou
Published: November 2017

Purpose. To investigate the efficacy of XingZhi‐YiNao (XZYN) granules and hyperbaric oxygenation (HBO) for cognition and motor dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods. Eighty‐nine patients with DEACMP were randomly divided into control group (n = 19), HBO group (n = 32), and XZYN group (n = 38). All patients received conventional treatment. HBO group received HBO therapy once daily. XZYN group received extra XZYN granules plus HBO treatment. The related indexes including activity of daily living (ADL) scale, Montreal cognitive assessment (MoCA) scale, and mini mental state examination (MMSE) scale were measured. Cerebral white matter injury, age related white matter changes (ARWMC) scale, and the amplitude and latency of P300 were assessed. Results. Compared with control group, the neurological function scores of ADL, MoCA, and MMSE in HBO and XZYN groups were significantly improved, the impairment degree of brain white matter and cognition function were obviously alleviated, the latencies of P300 were significantly shortened, and the amplitudes of P300 were evidently increased (P < 0.05). Treatment efficacy of XZYN group was superior to that of HBO group (P < 0.05). Conclusion. Combined XZYN granules and HBO can significantly improve cognition and motor functions in patients with DEACMP.
WOS-ELM-Based Double Redundancy Fault Diagnosis and Reconstruction for Aeroengine Sensor
Authors: Zhao Zhen , Liu Zhexu , Sun Yigang , Liu Jingya
Published: November 2017

In order to diagnose sensor fault of aeroengine more quickly and accurately, a double redundancy diagnosis approach based on Weighted Online Sequential Extreme Learning Machine (WOS-ELM) is proposed in this paper. WOS-ELM, which assigns different weights to old and new data, implements weighted dealing with the input data to get more precise training models. The proposed approach contains two series of diagnosis models, that is, spatial model and time model. The application of double redundancy based on spatial and time redundancy can in real time detect the hard fault and soft fault much earlier. The trouble-free or reconstructed time redundancy model can be utilized to update the training model and make it be consistent with the practical operation mode of the aeroengine. Simulation results illustrate the effectiveness and feasibility of the proposed method.
Upper‐Bound Multi‐Rigid‐Block Solutions for Seismic Performance of Slopes with a Weak Thin Layer
Authors: Zheng Gang , Yang Xinyu , Zhou Haizuo , Ha Da , Zhang Tianqi
Published: November 2017

The presence of a weak layer has an adverse influence on the seismic performance of slopes. The upper‐bound solution serves as a rigorous method in the stability analysis of geotechnical problems. In this study, a multi‐rigid‐block solution based on the category of the upper‐bound theorem of limit analysis is presented to examine the seismic performance of nonhomogeneous slopes with a weak thin layer. Comparison of the static factors of safety is conducted with various solutions (i.e., limit analysis with a different failure mechanism, limit equilibrium solution, and numerical method), and the results exhibit reasonable consistency. An analytical solution in estimating the critical yield acceleration coefficient is derived, and the influence of slope angle, slope height, and soil strength on the critical yield acceleration coefficient and failure mechanism is analyzed. Subsequently, Newmark’s analytical procedure is employed to evaluate cumulative displacement with various real earthquake acceleration records as input motion. Results show that the strength and geometric parameters have a remarkable influence on the critical yield acceleration coefficient, and the cumulative displacement increases with the increasing slope angle.
Effect of Buttermilk on the Physicochemical, Rheological, and Sensory Qualities of Pan and Pita Bread
Authors: Al-Jahani Amani H.
Published: November 2017

The aim of this study was to evaluate the influence of buttermilk on the physicochemical and sensory attributes of pan and pita breads. Different amounts of buttermilk (30, 60, and 100% of added water) were mixed with other ingredients of pan and pita bread formulations. The doughs and bread were analyzed for rheological, physicochemical, and sensory qualities. The results demonstrated that incorporation of different concentrations of buttermilk in bread formulations progressively enhanced water absorption capacity, dough development time, gelatinization temperature, and peak viscosity, whereas it reduced the dough stability and temperature at peak viscosity. Supplementation of wheat flour with 30% buttermilk significantly (P≤ 0.05) enhanced the physical properties of pan bread compared to nonsupplemented control. Incorporation of different percentages of buttermilk in bread formulation concomitantly (P≤ 0.05) increased protein, oil, and ash contents and it reduced the carbohydrate contents of both types of bread. Incorporation of 60 and 100% of buttermilk in bread formula showed low scores of all sensory attributes compared to control and 30% buttermilk containing pan and pita bread. In conclusion, supplementation of bread formulas with 30% buttermilk is recommended for improving the nutritional and sensorial qualities of pan and pita bread.
Comparative Analysis of Hybrid Models for Prediction of BP Reactivity to Crossed Legs
Authors: Kaur Gurmanik , Arora Ajat Shatru , Jain Vijender Kumar
Published: November 2017

Crossing the legs at the knees, during BP measurement, is one of the several physiological stimuli that considerably influence the accuracy of BP measurements. Therefore, it is paramount to develop an appropriate prediction model for interpreting influence of crossed legs on BP. This research work described the use of principal component analysis- (PCA-) fused forward stepwise regression (FSWR), artificial neural network (ANN), adaptive neuro fuzzy inference system (ANFIS), and least squares support vector machine (LS-SVM) models for prediction of BP reactivity to crossed legs among the normotensive and hypertensive participants. The evaluation of the performance of the proposed prediction models using appropriate statistical indices showed that the PCA-based LS-SVM (PCA-LS-SVM) model has the highest prediction accuracy with coefficient of determination (R2) = 93.16%, root mean square error (RMSE) = 0.27, and mean absolute percentage error (MAPE) = 5.71 for SBP prediction in normotensive subjects. Furthermore, R2 = 96.46%, RMSE = 0.19, and MAPE = 1.76 for SBP prediction and R2 = 95.44%, RMSE = 0.21, and MAPE = 2.78 for DBP prediction in hypertensive subjects using the PCA-LSSVM model. This assessment presents the importance and advantages posed by hybrid computing models for the prediction of variables in biomedical research studies.
Excessive Autophagy Activation and Increased Apoptosis Are Associated with Palmitic Acid-Induced Cardiomyocyte Insulin Resistance
Authors: Li Shanxin , Li Hui , Yang Di , Yu Xiuyan , Irwin David M. , Niu Gang , Tan Huanran
Published: November 2017

Diabetic cardiomyopathy (DCM) remains the major cause of death associated with diabetes. Researchers have demonstrated the importance of impaired cardiac insulin signaling in this process. Insulin resistance (IR) is an important predictor of DCM. Previous studies examining the dynamic changes in autophagy during IR have yielded inconsistent results. This study aimed to investigate the dynamic changes in autophagy and apoptosis in the rat H9c2 cardiomyocyte IR model. H9c2 cells were treated with 500 μM palmitic acid (PA) for 24 hours, resulting in the induction of IR. To examine autophagy, monodansylcadaverine staining, GFP-LC3 puncta confocal observation, and Western blot analysis of LC3I-to-LC3II conversion were used. Results of these studies showed that autophagic acid vesicles increased in numbers during the first 24 hours and then decreased by 36 hours after PA treatment. Western blot analysis showed that treatment of H9c2 cells with 500 μM PA for 24 hours decreased the expression of Atg12-Atg5, Atg16L1, Atg3, and PI3Kp85. Annexin V/PI flow cytometry revealed that PA exposure for 24 hours increased the rate of apoptosis. Together, this study demonstrates that PA induces IR in H9c2 cells and that this process is accompanied by excessive activation of autophagy and increases in apoptosis.
Sepsis byPasteurella multocidain an Elderly Immunocompetent Patient after a Cat Bite
Authors: Caserza Lara , Piatti Gabriella , Bonaventura Aldo , Liberale Luca , Carbone Federico , Dallegri Franco , Ottonello Luciano , Gustinetti Giulia , Del Bono Valerio , Montecucco Fabrizio
Published: November 2017

Pasteurella multocidacolonizes animal scratches and bites. This bacterium was described to cause sepsis or endocarditis mainly in immunocompromised patients. We report the case of a 92-year-old woman presenting at the Emergency Department with coma and fever a week after the bite of her cat. The cat bite was misdiagnosed at admission partly due to an underestimation of this event by the patient’s relatives. An inflamed area localized at perimalleolar skin of the right leg was detected. Laboratory biomarkers of inflammation were elevated. The cerebral computed tomography (CT) scan with angiographic sequences showed a complete occlusion of right intracranial vertebral artery. Total body CT scan and abdominal echocardiography were negative for foci of infection. Three consecutive blood cultures were positive forPasteurella multocida. A diagnosis of sepsis byPasteurella multocidawas made, and the patient recovered after a specific antimicrobial treatment. In order to confirm the animal transmission, the cat saliva was cultured and found positive forPasteurella multocidawith a similar antibiotic sensitivity to that isolated from the patient. In conclusion, the case of a patient with coma and fever after a cat bite was presented. The transmission of pathogens from pets has to be carefully considered as an important route of infection in immunocompetent patients.
A Security and Efficient Routing Scheme with Misbehavior Detection in Delay-Tolerant Networks
Authors: Li Feng , Si Yali , Lu Ning , Chen Zhen , Shen Limin
Published: November 2017

Due to the unique network characteristics, the security and efficient routing in DTNs are considered as two great challenges. In this paper, we design a security and efficient routing scheme, called SER, which integrates the routing decision and the attacks detection mechanisms. In SER scheme, each DTNs node locally maintains a one-dimensional vector table to record the summary information about the contact with other nodes and the trust degree of other nodes. To obtain the global status and the contact relationship among all nodes, the trusted routing table consisting of vectors of all nodes is built in each DTNs node. The method for detecting malicious nodes and selfish nodes is proposed, which exploits the global summary information to analyze the history forwarding behavior of node and judge whether it is a malicious node or selfish node. The routing decision method is proposed based on trust degree of forwarding messages between nodes, which adopts trust degree as relay node selection strategy. Simulation results show that compared with existing schemes SER scheme could detect the attacks behavior of malicious nodes and selfish nodes, at the same time, with higher delivery rate and lower average delivery delay.
Cost-Effectiveness and Budget Impact Analysis of Apatinib for Advanced Metastatic Gastric Cancer from the Perspective of Health Insurance System
Authors: Bai Yongrui , Xu Yuejuan , Wu Bin
Published: November 2017

Objective. This study evaluated the cost-effectiveness of apatinib in patients with chemotherapy-refractory mGC. Patients and Methods. A Markov model was developed to simulate the clinical course of typical patients with chemotherapy-refractory metastatic gastric cancer (mGC). We estimated the 10-year quality-adjusted life-years (QALY), costs, and incremental cost-effectiveness ratios (ICER). Model inputs were derived from the published literature and government sources. Direct costs were estimated from the perspective of the Chinese health insurance system. A scenario analysis for a Patient Assistance Programme (PAP) was performed. Results. Baseline analysis showed that apatinib increased the cost and QALYs by $7859 and 0.192, respectively, relative to conventional chemotherapy, resulting in an ICER of $40,997/QALY gained. When PAP was available, the ICER was $21,132/QALY. Probabilistic sensitivity analyses confirmed that apatinib with PAP achieved nearly 65% likelihood of cost-effectiveness at the threshold of $22,200. One-way sensitivity analyses demonstrated that the utility of progression-free survival was the most influential factor on the robustness of the model. Budget impact analysis estimated that the annual increase in fiscal expenditures would be approximately 0.45 million dollars. Conclusions. Our analysis suggests that apatinib is likely cost-effective in patients with chemotherapy-refractory mGC when PAP is available.
Pneumocephalus after the Treatment of an Inoperable Superior Sulcus Tumor with Chemoradiation
Authors: Albert Ashley , Allbright Robert , Nichols Todd , Farley Edward , Vijayakumar Srinivasan
Published: November 2017

Background. Pneumocephalus is a rare phenomenon that can occur as a complication after operations involving the thoracic discs, following thoracotomy for tumor resection, and after an intracranial operation or cranial trauma. This complication frequently occurs when a tumor is located in the costovertebral angle and an operative intervention creates a tear in the dura resulting in a pleural-dural fistula. Case Presentation. We describe the case of a 58-year-old man with an inoperable superior sulcus tumor who developed pneumocephalus after the initiation of chemoradiation secondary to a pleural-dural fistula. Conclusions. Although a rare occurrence, pneumocephalus should be considered when patients with tumors in the superior sulcus treated with radiation develop neurologic symptoms characteristic of increased intracranial pressure.
Study on the Inhibitory Effects of Ephedra Aconite Asarum Decoction on LPS‐Induced Dendritic Cells
Authors: Ji Wenting , Hu Jinghong , Yu Xue , Zhang Lanlan , Liu Min , Wang Qingguo
Published: November 2017

Dendritic cells (DCs) can secrete cytokines stimulated by lipopolysaccharide (LPS), which leads to not just acute inflammatory responses but also Th1 polarization. Furtherly, chronic inflammation or autoimmune diseases could be triggered. As a classic Traditional Chinese Medicine formula, Ephedra Aconite Asarum Decoction with the main ingredients of ephedrine and hypaconitine can show effect on anti‐inflammation and immunoregulation. But it remains unclear whether Ephedra Aconite Asarum Decoction controls DCs. In this study, we investigated the effects of Ephedra Aconite Asarum Decoction on LPS‐induced bone marrow‐derived DCs (BMDCs) in vitro. We found that Ephedra Aconite Asarum Decoction lowered surface costimulators on DCs and reduced the expression of Th1 type cytokines. Yet it is slightly beneficial for shifting to Th2. Our work reveals that the Ephedra Aconite Asarum Decoction can regulate Th1 inflammation through intervening DCs.
Tabetri™ (Tabebuia avellanedae Ethanol Extract) Ameliorates Osteoarthritis Symptoms Induced by Monoiodoacetate through Its Anti-Inflammatory and Chondroprotective Activities
Authors: Park Jae Gwang , Yi Young-Su , Hong Yo Han , Yoo Sulgi , Han Sang Yun , Kim Eunji , Jeong Seong-Gu , Aravinthan Adithan , Baik Kwang Soo , Choi Su Young , Son Young-Jin , Kim Jong-Hoon , Cho Jae Youl
Published: November 2017

Although osteoarthritis (OA), a degenerative joint disease characterized by the degradation of joint articular cartilage and subchondral bones, is generally regarded as a degenerative rather than inflammatory disease, recent studies have indicated the involvement of inflammation in OA pathogenesis. Tabebuia avellanedae has long been used to treat various diseases; however, its role in inflammatory response and the underlying molecular mechanisms remain poorly understood. In this study, the pharmacological effects of Tabetri (Tabebuia avellanedae ethanol extract (Ta-EE)) on OA pathogenesis induced by monoiodoacetate (MIA) and the underlying mechanisms were investigated using experiments with a rat model and in vitro cellular models. In the animal model, Ta-EE significantly ameliorated OA symptoms and reduced the serum levels of inflammatory mediators and proinflammatory cytokines without any toxicity. The anti-inflammatory activity of Ta-EE was further confirmed in a macrophage-like cell line (RAW264.7). Ta-EE dramatically suppressed the production and mRNA expressions of inflammatory mediators and proinflammatory cytokines in lipopolysaccharide-stimulated RAW264.7 cells without any cytotoxicity. Finally, the chondroprotective effect of Ta-EE was examined in a chondrosarcoma cell line (SW1353). Ta-EE markedly suppressed the mRNA expression of matrix metalloproteinase genes. The anti-inflammatory and chondroprotective activities of Ta-EE were attributed to the targeting of the nuclear factor-kappa B (NF-κB) and activator protein-1 (AP-1) signaling pathways in macrophages and chondrocytes.
Periodic Travelling Wave Solutions of Discrete Nonlinear Schrödinger Equations
Authors: Hennig Dirk
Published: November 2017

The existence of nonzero periodic travelling wave solutions for a general discrete nonlinear Schrödinger equation (DNLS) on one-dimensional lattices is proved. The DNLS features a general nonlinear term and variable range of interactions going beyond the usual nearest-neighbour interaction. The problem of the existence of travelling wave solutions is converted into a fixed point problem for an operator on some appropriate function space which is solved by means of Schauder’s Fixed Point Theorem.
A New Open Loop Approach for Identifying the Initial Rotor Position of a Permanent Magnet Synchronous Motor
Authors: Zhu Qixin , Xiong Lei , Liu Hongli , Zhu Yonghong , Zhang Guoping
Published: November 2017

The precision of initial rotor position detection is critical for the start and running performance of permanent magnet synchronous motor (PMSM). This work describes a new open loop approach for identifying the initial position of a PMSM with an incremental encoder, even when a constant load torque is being applied. By giving a testing current with high frequency to the stator winding, the initial rotor position of a PMSM can be detected with reasonable accuracy. The rotor almost does not move during the process of identification. The FFT algorithms are used to remove the phase bias effects in identification. Our approach is quicker and simpler than the conventional approaches.
Molecular Signatures of Radiation Response in Breast Cancer: Towards Personalized Decision-Making in Radiation Treatment
Authors: Speers Corey , Pierce Lori J.
Published: November 2017

Recent advances in gene expression profiling have allowed for a more sophisticated understanding of the biology of breast cancers. These advances led to the development of molecular signatures that now allow clinicians to more individually tailor recommendations regarding the utility and necessity of systemic therapies for women with breast cancer. Indeed, these molecularly based tests have been incorporated into national and international best practice guidelines and are now part of routine practice. Similar, though slower, progress is being made in the development of molecular signatures predictive of radiation response and necessity for women with breast cancer. This article will discuss the history of radiation response signature development, the current state of these signatures under ongoing clinical development, the barriers to their clinical adoption, and upcoming changes and opportunities that may allow for the personalized radiation treatment recommendations enabled by the development of these signatures.